HIV/AIDS

AIDS is an acronym for acquired immune deficiency syndrome, a health condition that leads to the deterioration of the immune system and is caused by infection with the human immunodeficiency virus (HIV). AIDS is not a disease per se but rather a health syndrome that results in a weakened immune system, mostly due to the destruction of CD4+ T-cells, and that in turn results in susceptibility to numerous pathogens (viral, bacterial, fungal, and protozoal) that may lead to opportunistic infections and death. Individuals with AIDS are highly susceptible to these life-threatening pathogens and to certain types of cancer.

The number of individuals living with HIV and deaths due to AIDS increases daily, and because not all cases of HIV infection or AIDS are reported, official statistics are usually estimates rather than counts of reported cases and may vary by agency. According to the World Health Organization, in 2005 about 1.2 million Americans were infected with HIV, up from 1.1 million in 2003, and in 2005 about 16,000 died from AIDS (UNAIDS/WHO, 2006, Annex 2). The Centers for Disease Control and Prevention (CDC) estimates are slightly different: just under 1 million cases in the United States in 2005 and just over 17,000 deaths from AIDS (CDC, 2005). Recent data suggest that AIDS disproportionately affects communities of color, including African American and Latinos/Latinas. According to the CDC, in the United States, as of 2005, there were approximately 400,000 AIDS cases among African Americans, 387,000 among whites, and 156,000 among Latinos. The case rate per 100,000 population in 2005 was 75.0 for black non-Hispanics, 26.4 for Hispanics, 10.0 for American Indian/Alaska Natives, 7.5 for white non-Hispanics, and 4.9 for Asian/Pacific Islanders (CDC, 2005).

Table 1 Regional Statistics on HIV/AIDS

According to the UN estimates, across the world in 2005, there were 38.6 million individuals living with HIV/AIDS and approximately 2.8 million deaths. The UN report says 38.6 million were living with HIV in 2005, of whom 4.1 million were newly infected. There were 2.8 million deaths. The majority of the cases worldwide (36.3 million) are adults. Additionally, approximately 4.1 million people were newly infected in 2005. The vast majority of these cases (24.5 million, or approximately 63%) are in sub-Saharan Africa, where in recent years there has been an annual death rate from AIDS of 2 million people. In Asia (not including Oceania), there are approximately 8.3 million cases, 1.6 million in Latin America, and 1.5 million in eastern Europe and central Asia. North America and western Europe together have about 2 million cases. In addition to countries in [Page 498]sub-Saharan Africa, countries of the former Soviet Union, including Russia, and Asian Pacific nations such as Thailand are experiencing vast increases in new HIV infections.

Figure 1 A Global View of HIV: 38.6 Million People Living With HIV/AIDS

The first published report of AIDS occurred in the now landmark report of June 5, 1981, by the CDC in its weekly Morbidity and Mortality Weekly Report (MMWR). This report described five sexually active young gay men in Los Angeles who were diagnosed with Pneumocystis carinii pneumonia (PCP). The MMWR editor remarked that “the occurrence of pneumocystosis in these five previously healthy individuals with underlying immunodeficiency is unusual.” Shortly thereafter, on July 3, 1981, another report appeared in MMWR identifying 26 young men in the New York area who had been diagnosed with PCP as well as the skin cancer Kaposi's sarcoma. While both these health conditions had been noted in the United States among elderly, the occurrence of these ailments among these men was of concern because at their age, they would have been expected to have normally functioning immune systems. Initial hypotheses to explain the development of this condition among these men included the use of amyl nitrate as well as the high levels of sexually transmitted infections in this segment of the population. Because the disease appeared to be confined to gay men, it was initially named GRID (gay-related immune deficiency). However, by 1982, it became apparent that the syndrome was not confined to gay men, and AIDS cases were documented among injection drug users. By the middle of 1982, 355 cases had been documented in five different states—California, Florida, New Jersey, New York, and Texas—and the disease was renamed AIDS. By early 1983, AIDS was being reported in 16 different countries around the world, [Page 499]and in the first 3 years of the epidemic, the rates of diagnosis doubled every 6 months. Shortly thereafter, two research teams working independently in the United States and France each identified a virus and antibodies to the virus that appeared in the systems of individuals with AIDS and that were respectively named HTLV-III (human T-cell lymphotropic virus) and LAV (lymphadenopathy-associated virus). Recognizing that these two names were being used for the identical virus, researchers renamed the pathogen HIV in 1986.

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