The Complexities of HIV Transmission and Progression
HIV is one of the world's sexually transmitted diseases but then it ranks as one of the worst since it has no cure and if not treated can lead to death but a lot of people do nt know much about the disease except from the fact that it is a sexually transmitted one.
HIV stands for Human Immunodeficiency Virus, I am sure you that before so maybe it might sound like a cliche to you but then what is a cliche when it has to do with health. It belongs to the retrovirus class of viruses which uses RNA to encode their genetic information rather than DNA, and they attack our white blood cell known as CD4 of our immune system also known as helper T-cells.
You must have heard that to contract HIV, you need to have come in contact with an infected bodily fluid such as blood, vaginal fluids, semen, and breast milk. So this means that having unprotected coitus, sharing needles, during childbirth, breastfeeding of child, and through infected blood transfusions can be ways of contracting the virus but they cannot spread through casual contacts like handshake, kissing, and sharing utensils.
What do you think will happen if a person had intercourse with an infected person? For discordant couples, research shows that having anal intercourse puts the other person at a risk of one transmission per 72 sex acts, and this is because the mucosal lining of the rectum and anus is thinner and could tears causing the virus to enter into the body. With this, we can see reason why man to man intercourse leaves a person at high risk of contracting HIV since they have higher chances of participating in anal sex.
People who participate in insertive anal intercourse are at a 1 in 900 sex act risk of getting HIV because the penis is thicker than the mucosal lining of the anus or rectum and it is more risky than receptive penile-vaginal intercourse which has a risk of 1 in 1250 sex act. Although receptive penile-vaginal intercourse might look less risky, insertive penile-vaginal intercourse is less risky with a 1 in 2500 sex acts. Put simple, that a non-infected male is less likely to get it from an infected female while a non-infected female is more likely to get HIV from an infected male since females have a larger vaginal lining that could be exposed to the virus from the semen, and receptive or insertive penile-oral intercourse had 0-4 transmission per 10000 sex acts.
In the case of blood-borne exposure, the risk of getting HIV from blood transfusion is 9 out of 10 transfusions. HIV risk for Needle sharing injection drug use is 1 out of 150 cases, with percutaneous needle stick, the risk of HIV is 1 out of 435, and mucous membrane exposure to blood is 1 out of 1000.
While this is for discordant couples, it is important to say that people who have multiple partners have a high risk of contracting HIV more since they have a higher possibility of coming in contact with people with HIV who do not know they have it and these people can be at the acute phase of the virus where they have a high viral load.
When people have HIV, so many of them do not get symptoms as they are asymptomatic and by the time they begin to get symptoms, the symptoms can be mild and the patient can think they are suffering from minor illnesses like flu, where they suffer fever, muscle aches, fatigue, and rash. They can also have ulcerations of the skin and mucous membranes, and weight loss. With the symptoms appearing 2 to 4 weeks after exposure and they can resolve on their own but for some people, the symptoms doesn't go away helping the patient to get treatment early.
Since HIV target the CD4 cells which is the major regulator of most immune function, people start to have reduced immune response over time once the CD4 is killed and the body cannot replace them. At this point, the person reaches the viral set point where the plasma virus concentration reaches a steady level and then it leads to chronic HIV. Most people during this stage do not have symptoms but the CD4 cells decline. When the CD4 cells drop to 200 cells per micro liter, then the person acquires AIDS. At the point, the body cannot protect itself against other opportunistic infections
HIV presents a multifaceted challenge, necessitating a comprehensive understanding of its transmission, progression, and impact on the immune system. Through education, prevention measures, and timely intervention, we can strive to mitigate the devastating effects of this virus and improve outcomes for those affected by it.
Reference
https://helloclue.com/articles/sex/hiv-sexual-transmission-risk-factors-and-prevention
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368909/
https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/hiv-aids/causes/risk-of-exposure.html
https://www.jstor.org/stable/48511901
https://hivrisk.cdc.gov/about-the-data/
https://www.uptodate.com/contents/acute-and-early-hiv-infection-clinical-manifestations-and-diagnosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564102/
https://www.cdc.gov/hiv/basics/hiv-transmission/injection-drug-use.html
https://www.cdc.gov/hiv/basics/hiv-testing/test-types.html
https://www.uptodate.com/contents/acute-and-early-hiv-infection-treatment
https://www.ncbi.nlm.nih.gov/books/NBK562734/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564102/
https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00579-0
https://www.ncbi.nlm.nih.gov/books/NBK513289/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440548/
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