AIDS: We Are All At Risk!
by Andrea Walsh
Over 50,000 people in the U.S. have died from Acquired Immunodeficiency Syndrome (AIDS) and an estimated 1.5 to 3 million people in the U.S . are infected with the Human Immunodeficiency Virus (HIV), the agent that causes AIDS. Gay men and intravenous drug users have been wrongly thought to be the only AIDS-infected populations. While it is true that most of the AIDS deaths in this country have been from these populations, HIV has spread into all segments of society. "Everybody is at risk and it's important that people use safe sex now," says Vicky Nicewander at the Washtenaw County Department of Public Health. "Weighing risk factors against each other is like playing a kind of Russian roulette. It's important to get informed, practice and teach safe sex in order to reduce risk and save lives."
AIDS is the final stage of HIV infection. HIV can be spread unknowingly to others via the exchange of body fluids, primarily through unsafe sex (sex without protection against exchange of body fluids) or drug needle sharing. HIV infection is not the same as having AIDS, rather it is preliminary to the onset of ARC (AIDS Related Complex) or AIDS. The HIV virus infects the cells of the immune system and the brain. HIV can remain latent for as long as 20 years. (The median amount of time before someone shows symptoms is about 10 years.) During this latency period, HIV weakens the immune system's ability to fight infection. Eventually, diseases that the immune system could ordinarily fight become deadly.
People with ARC suffer many of the same illnesses as do people with AIDS . They have night sweats, persistent diarrhea, fungus infections, and chronic fatigue. However, they do not suffer the opportunistic infections that eventually kill people with AIDS. (The most common of these infections are Pneumocystis Carinii Pneumonia and a cancer called Kaposi's Sarcoma.) ARC is thought to precede AIDS, though sometimes it leads directly to death. According to a 1989 Ms. Magazine special report, women seem especially prone to ARC. The National Center for Disease Control (CDC) which has been tracking AIDS since 1981, does not include people infected with ARC or HIV in its reports.
While HIV is very destructive inside the body, it dies after being exposed to the air. It cannot be spread through casual contact like hugging, shaking hands, working together, massage, and face-to-face conversation according to the Michigan Department of Public Health. It is not spread by sharing eating utensils or by contact with toilet seats. Mosquitoes do not transmit the virus either.
HIV is virtually impossible to transmit unless blood or other infected fluids come into contact with open cuts or mucous membranes, say Cindy Patton and Janis Kelly in "Making It: A Woman's Guide to Sex in the Age of AIDS." The body fluids most heavily contaminated with HIV are blood and semen. Semen contains white blood cells which are the carriers of HIV. Cervical and vaginal fluid may contain enough virus to allow transmission in some instances, such as when there is a high white blood cell count in the fluid as at the time of a common yeast infection or via menstrual blood.
The HIV-infected fluid must be transferred through a direct route. Sharing needles puts fluid directly into veins. Anal intercourse without a
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condom allows semen to be absorbed through anal membranes. Transmission during vaginal intercourse with a man not wearing a condom could allow entry through the cervix and probably the vaginal walls.
While it poses a lower risk, there may be risk of transmission through oral sex. According to Patton and Kelly, some studies indicate that routine activities like flossing and brushing teeth or eating crisp foods like chips or toast may make micToscopic cuts in gums and tongue where the virus can enter. Nicewander said that other studies indÃcate that only obvious cuts or open sores in the mouth may allow transmission.
Blood transfusions received between 1978 and March 1985 may also be a risk factor. Transfusions after March 1985 are at low risk because all donated blood has been tested for HIV antibodies since that time. People who engage in high-risk behavior are asked not to donate blood, organs or tissue, or semen for artificial insemination.
HIV-infected women may not know they are infected and decide to give birth. A baby born to an infected woman has a 5/050 chance of being born with HIV. An infant's HIV status cannot be determined until 10 or 11 months after birth when its immune system kicks in. A woman can transmit HIV to her baby in utero, during birth, or by breastfeeding.
According to Nicewander, Washtenaw County has had 46 people diagnosed with AIDS since 1985 when the first case was reported. It is estimated by the CDC that for every one case of AIDS there are five to ten people with ARC and 50 to 100 HIV-infected people. "Given local populations," Nicewander says, "we would more realistically guestimate that about 2500 people in this county may have been HIV-infected."
The Facts and You
Given the facts, there are some important things to consider and to do to manage the risks associated with spreading AIDS. HIV can be spread by people who do not know they are infected. You can become infected by having had contact with an HIV carrier only once, maybe many years ago.
Even though you may not be engaging in high risk behavior now, it is possible to carry and transmit the virus or to receive the virus unless you follow safe sex practices. If you are sexually active you are at risk. Consider being tested if you think you may have been exposed to HIV.
The usual HIV antibody test screens a small amount of blood using an enzyme-linked immunosorbent assay (ELISA) to detect the presence of antibodies (proteins in the blood that work to eliminate foreign proteins). A positive result is tested again because the ELISA test tends to produce false positives. If the second result is positive, it is analyzed a third time using the more precise and more expensive Western Blot procedure. A confirmed positive test means you have been infected with the virus and that antibodies to the virus are in your blood. This means you can transmit the virus to others. A positive test does not mean that you have AIDS.
A negative antibody test means either you have not made antibodies yet or you are not infected with HIV. If you think you have been exposed, a negative test does not mean you are immune, or that you will not become infected if exposed again. There is usually a delay of two weeks to six months between infection and when you produce antibodies. During this time you can transmit the virus to sex partners, needle buddies, and unbom children. If you have been engaged in risky behavior, or are partners with someone who has, and you test negative, wait six months and get tested a second time to confirm that the first test wasn't during the period before antibodies appear.
Carolyn Forbes of Wellness Network, Inc. suggests that there are benefits to being tested for HIV infection. According to Forbes, if you test positive, you may improve your quality of life by using knowledge about the onset of AIDS. Co-factors in the development of AIDS include drug use, diet, and stress. Moving into a more healthful lifestyle can prevent the onset of AIDS. If you test HIV positive there are groups and support systems you can participate in. It may be possible to participate in research programs that could help you as well as society. If you have access to health care, you may be able to utilize immune system monitoring that will prevent the onset of opportunistic diseases that kill people once AIDS is developed.
Forbes suggests there are also drawbacks to early testing to consider. "It's important for people to do an inventory before getting tested. What if they do test positive? Will their emotional state suffer? Are they insured or can they afford doctor visits? Will they change their behavior?"
Free testing is available in Washtenaw County through the County Health Department at 555 Towner, Ypsilanti, MI 48197, 485-2181. Testing is also free of charge for U-M students through the University Health Service at 207 Fletcher, Ann Arbor 48109, 763-4384. There is a $35 charge for non-students.
For further information: Wellness Networks Inc., Michigan (WNI) provides access to general AIDS information and referral to medical, social, and community AIDS resources. Brochures and educational materiais are available on request. AIDS Hotline 1-800-872-AIDS. TDD line for hearing impaired: (313) 547-3655 on weekdays only. Prisoners can call WNI collect (313) 5479040. Washtenaw County Department of Public Health: Counseling, HIV antibody tests, information, 485-2181. Huron Valley Friends provides a food bank, personal assistance and financial support. HVF 24-hour hotline 747-9068.