Saturday, February 28, 2009

HIV/AIDS

HIV/AIDS

Acquired Immune Deficiency Syndrome, or AIDS, is caused by an infection with the Human Immunodeficiency Virus (HIV), which attacks selected cells in the immune system and produces defects in function. It is a disease that has only been recognized for the past 22 years (“AIDS”). The first AIDS cases were reported in 1981. Since then, more than 665,000 AIDS cases have been reported in the United States. AIDS has also been the cause of more than 400,000 deaths (“AIDS”). The AIDS disease has become a problem of epidemic proportions. In order to become a more informed society, the citizens of America need to know the definition, methods of contraction, and modes of prevention of the HIV/AIDS infection.The United States Center for Disease Control and Prevention has established criteria for defining cases of AIDS. These criteria are based on laboratory evidence such as





It is assumed that these people will eventually develop AIDS. However, they lead to a severe suppression of the immune system's ability to resist harmful organisms. The virus also tends to reach certain brain cells. Many of the defects may not be apparent for years. They have expanded screening procedures to exclude anyone with a history of risk behavior for AIDS or symptoms suggestive of AIDS ("Acquired"�"�). "� The Year 200 Grolier Multimedia Encyclopedia. Combating it is a major challenge to biomedical scientists and health-care providers. Practicing sexual abstinence is the only guaranteed method of not contracting the disease through sexual intercourse. A sterile needle should always be used, and it should be discarded after one use. This leaves the body open to invasion by various infections. T4 cell count, the presence of certain opportunistic diseases, and a range of other conditions ("AIDS"�). No cure or vaccine now exists for AIDS.

Thursday, February 12, 2009

Ways of attacking HIV

Ways of attacking HIV

HIV has a complex life-cycle that involves several steps. Disease progression occurs when the virus replicates (reproduces) and infects new cells. The key goal of antiretroviral therapy is to slow – or ideally stop – HIV replication and enable recovery of the immune system.

Antiretroviral drugs, targeting different steps in the viral life-cycle, are the mainstay of HIV treatment. These include, but are not limited to:

  • Nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs and NtRTIs).
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs).
  • Protease inhibitors.
  • Integrase inhibitors.
  • Fusion inhibitors.
  • CCR5 inhibitors.

There are a number of other candidate drugs in clinical trials, including one in a class called 'maturation inhibitors', as well as innovations in immune-based strategies.

The standard of care for anyone on antiretroviral treatment is highly active antiretroviral therapy (HAART) using drugs with at least two different mechanisms of action (for example, two NRTIs plus either an NNRTI or a protease inhibitor). Over time, HIV can develop mutations that make it resistant to drugs. For this reason, people who have more treatment experience may need more drugs to construct an effective regimen. By targeting multiple steps in the viral life-cycle simultaneously, the emergence of resistance can be slowed or prevented.

Researchers have also explored other approaches for treating HIV, such as inhibiting cellular factors the virus needs for its replication, gene therapy that protects cells from infection, and removal of cells that are already infected. Many of these approaches are experimental and some remain purely theoretical. But there is evidence that complementary therapies such as nutrient supplements – used in conjunction with antiretroviral therapy – can improve the overall health of people with HIV.

Since the advent of effective combination antiretroviral therapy in the mid-1990s, researchers have discovered much about how best to treat HIV, and treatment has shifted from managing opportunistic illness to suppressing the virus to the greatest extent possible. New studies are showing that even at CD4 cell counts between 350 and 500 cells/mm3, there is a greater risk of morbidity and mortality from non-AIDS illnesses.

While viral load suppression is considered an indicator of effective therapy, the ultimate goal of treatment is to preserve immune function, increase disease-free survival, and reduce mortality. Once HIV replication is controlled, a person’s CD4 cell count usually rises over time, but this occurs more slowly in some patients. Researchers are studying various ways to promote immune system reconstitution and HIV-specific immune response.

Effective antiretroviral therapy has dramatically improved survival and lowered the incidence of opportunistic illnesses and other conditions related to immune suppression in people with HIV. But much remains to be learned about long-term treatment, including whether it is possible to completely eradicate HIV from the body.

Thursday, February 5, 2009

What are some of the other tests available?

What are some of the other tests available?

These are other reliable, government-approved tests which are widely available:

Rapid Testing: Samples are obtained and analyzed using the ELISA test. The results are usually available within ten to sixty minutes. If the result is positive, a follow-up test is required, usually by drawing blood and sending the sample to a laboratory for Western blot testing. If the result is negative, there is no need for additional testing and the result can be considered conclusive.

Convenient and faster, this method is often used in healthcare settings, particularly where urgency is an issue such as with someone who is pregnant or about to give birth. Because it provides a result so quickly, this is an increasingly popular method for testing.

Several rapid HIV tests have been approved for the FDA, all of which can only be performed by healthcare providers (they cannot be purchased directly by consumers). The approved tests are the Oraquick Rapid HIV Antibody Test (using oral fluid or blood samples), the Oraquick Rapid HIV-1/2 Antibody Test (tests for both HIV-1 and HIV-2 using blood samples), the Clearview Complete HIV 1/2 and HIV 1/2 STAT-PAK (a blood sample is used to check for antibodies to HIV-1 and HIV-2), the Reveal Rapid HIV-1 Antibody Test (requires a blood sample), and the Uni-Gold Recombigen HIV Test (requires a blood sample). While the time to conduct each of these tests do vary, they all yield results in less than an hour. The FDA approved a rapid HIV test in November 2010, called the INSTI kit. It uses blood from a finger stick and provides results within 60 seconds. If you are interested in any of these tests, you should call your healthcare provider to see if he or she conducts these tests and, if not, where you may go to have one done.

The collection of oral fluids to look for HIV antibodies using the Oraquick Rapid HIV Antibody Test may not be as accurate as the other rapid assays that use blood samples. There were reports starting in 2005 that some testing sites in Los Angeles, San Francisco, and New York City had higher rates of false-positive test results than usual, meaning that the Oraquick Rapid HIV Antibody Test using oral fluids (but not blood samples) falsely detected antibodies in people who were not infected with HIV. Most—though not all—of these sites later found that there were problems with how the tests were being handled by providers. However, the test is still highly accurate in terms of detecting antibodies in people who are infected with HIV (it has an extremely low false-negative rate).

It's very important to understand these new tests do not change the length of time you have to wait after a possible exposure to HIV to get a reliable result. You still need to wait three months (13 weeks), to allow time for antibodies to become detectable in the blood for an accurate result.

The Oraquick, Clearview, Reveal Rapid, and Uni-Gold Recombigen tests are not the only rapid tests available. Some hospitals, clinics and a few private doctors' offices have their own in-house rapid tests, which are also completely reliable.

Home Sample Collection Tests: Using a provided safety lancet, you will need to prick your fingertip and place drops of blood on the blood specimen card included in the test kit. You only need enough blood to fill a circle the size of a dime. The kit will contain a unique identifying number that you'll need to have handy to learn the results. The blood specimen card is then sent to a designated laboratory where it is tested using the ELISA/Western blot tests. The results are usually available within three to seven days and are accessed by calling a telephone number provided by the laboratory. The results, along with counseling, are provided by trained counselors over the telephone.

The Home Access Kits are the only home-collection kits approved by the Food and Drug Administration (FDA) and is the only home sample collection test that should be used to check for HIV infection. The Home Access HIV-1 Test System provides results in seven business days (not including Sundays and Holidays) and The Home Access Express HIV-1 Test System provides results in three business days. These home-collection kits are available at most pharmacies or can be ordered from the manufacturer (Home Access Health Corporation): 1-800-448-8378, or www.homeaccess.com.

Oral Fluid Test: A device is used to collect oral (mouth) fluid (i.e. saliva). Oral fluids can contain antibodies to HIV, which can be detected using the ELISA and Western blot tests. The Oraquick Rapid HIV Antibody Test, which has a high degree of accuracy and produces results in less than an hour, can be conducted using oral specimens. Oral specimens are usually collected using the OraSure HIV-1 Oral Specimen Collection Device, which can then be tested using the rapid assay or traditional testing procedures. Because oral specimen collection is so easy and comfortable to accomplish, this test is often used in clinics, doctors' offices, hospitals, and school-based and university health centers.
Urine-Based Test: A urine sample, collected in a cup, is used for the ELISA/Western blot tests. The results of this noninvasive and non-technical method can be obtained at a return visit, typically in one to two weeks. It's commonly used in community-based and outreach settings, adolescent, school and university-based settings. Anyone with a positive urine result must have a confirmatory blood test.

Wednesday, February 4, 2009

Male and female condoms

Male and female condoms

There are two main types of condom. What is generally called a condom is the 'male' condom, a sheath or covering which fits over a man's penis, and which is closed at one end.

There is also now a female condom, or vaginal sheath, which is used by a woman and fits inside the vagina. There are two types available: The FC / FC2 female condom and the the VA w.o.w. Condom Feminine.

This page discusses the male condom, but you can find out more about female condoms and how to use them in our female condoms page.

What are condoms made of?

Condoms are usually made of latex or polyurethane. If possible you should use a latex condom, as they are slightly more reliable and in most countries they are most readily available. Latex condoms can only be used with water based lubricants, not oil based lubricants such as Vaseline or cold cream as they break down the latex.

Polyurethane condoms are made from a type of plastic. They are suitable for the small number of people who are allergic to latex. Polyurethane condoms are thinner than latex condoms, and so can increase sensitivity. However, they are more expensive than latex condoms and slightly less flexible so more lubrication may be needed. Both oil and water based lubricants can be used with them.

It's not clear whether latex or polyurethane condoms are stronger. However, with both types the likelihood of breakages is very small if used correctly.

Condoms, lubrication and spermicides

The lubrication on condoms varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use. It can also help prevent condom breakage.

Some condoms and lubricants contain spermicide. Spermicides are chemical products that inactivate or kill sperm to prevent pregnancy. Condoms containing the spermicide nonoxynol-9 were previously thought to help prevent the transmission of HIV and other STDs. However, nonoxynol-9 sometimes causes adverse effects, which can facilitate the transmission of HIV. Therefore you should only use condoms and lubricants containing nonoxynol-9 if you are HIV negative and know your partner is too. However, using a condom (even if it contains nonoxynol-9) is much safer than having unprotected sex.

What shapes are there and which should I choose? What about flavoured condoms?

Condoms come in a variety of shapes. Most have a reservoir tip although some have a plain tip. Condoms may be regular shaped (with straight sides), form fit (indented below the head of the penis), or they may be flared (wider over the head of the penis). Ribbed condoms are textured with ribs or bumps, which can increase sensation for both partners.

It's up to you which shape you choose. All of the differences in shape are designed to suit different personal preferences and enhance pleasure. It is important to communicate with your partner to be sure that you are using condoms that satisfy both of you.

Condoms also come in a variety of colours. Some are flavoured to make oral sex more enjoyable. They are also safe to use for penetrative sex as long as they have been tested and approved.

What about the condom size?

Condoms are made in different lengths and widths. Different manufacturers produce varying sizes.

There is no standard length for condoms, though those made from natural rubber will always stretch if necessary to fit the length of the man's erect penis.

The width of a condom can vary. Some condoms have a slightly smaller width to give a 'closer' fit, whereas others will be slightly larger.

The brand names will be different in each country, so you will need to do your own investigation of different names.

Where can I get condoms?

Family planning and sexual health clinics provide condoms free of charge. Condoms are available to buy from supermarkets, convenience stores and petrol/gas stations. Vending machines selling condoms are found in toilets at many locations. You can also order then online from different manufacturers and distributors.

There are no age limits for buying condoms. Buying a condom no matter how old you are shows that you are taking responsibility for your actions.

How can I check a condom is safe to use?

In the UK, condoms that have been properly tested and approved carry the British Standard Kite Mark or the EEC Standard Mark (CE). In the USA, condoms should be FDA approved, and elsewhere in the world, they should be ISO approved. Some countries have their own approval marks. To find out more see our page about condom effectiveness.

Condoms have an expiration (Exp) or manufacture (MFG) date on the box or individual packet - you should not use the condom if this date has passed. It's important to check this when you use a condom. You should also make sure the packet and the condom appear to be in good condition.

Condoms can deteriorate if not stored properly as they are affected by both heat and light. So it's best not to use a condom that has been stored in your back pocket, your wallet, or the glove compartment of your car. If a condom feels sticky or very dry you shouldn't use it as the packaging has probably been damaged.