World AIDS Day

Today is World AIDS Day; a day to raise awareness that Acquired ImmunoDeficiency Syndrome is still around and remains a global problem. That it remains an epidemic is distressing. Education is critical. Knowing that the disease is caused by viral infection is a necessary first step: the Human Immunodeficiency Virus (HIV;in all its nasty variations) is the transmissible agent. The next step is to make everyone aware of the virus’ three routes of transmission:

  1. Sexual transmission
  2. Through blood
  3. From mother to child

The first two mechanisms of transmission can be prevented by safe sex, not sharing needles, screening of blood donations and good (i.e. sterile) surgical technique. As mentioned in the well-written AVERT article, cultural taboos hinder progress on these fronts. The third, mother-to-child, transmission route is more difficult to address. It’s a multi-factorial problem, with cultural problems (stigma again rears its ugly head) and funding problems. It requires primarily access to medical care, followed by drug availability and also needs infrastructure in terms of clean water supplies. But it’s not insurmountable, just expensive and with difficult logistics.

Sadly, in the void left by unaffordable treatments, there are many who defy years of properly controlled experiments by peddling their “quackery”, as rounded up by the always-alert Ben Goldacre. Words fail me at some of these “alternative” so-called treatments. Music to treat a retroviral infection: where do these people come from? And while it is quite possible that, one day, a potent anti-viral will be found in some as-yet-unstudied flower, bloody “flower essences” will only make you smell better while the virus rampages through your body and destroys your immune system. It’s amazing that these people are not told to cease and desist. While doing a rough search on whether any of these quacks have led to HIV-infected people ditching their AZT cocktails, I came across another piece of lunacy, which was essentially a two page rant on how the HIV does not cause AIDS, an attack on the “self-serving interests of the few” (read: the medical community) and quotes something about “The Ostrich’s View of Medicine”. Too right it’s the ostrich’s view: Head. In. Sand.

Writing as one who is part of the “self-serving few”, although not directly involved in HIV research, I’d like to point you to some more rational links. For very recent advances in HIV research, Coturnix has the low-down on the special issue of PLoS Medicine special issue with the latest on transmission, detection and treatment of HIV infection. The PLoS family of journals are all Open Access, which really means open access, given an internet connection. A good place to start with an overview of where things stand with prevention and treatment is the PLoS editorial, which highlights recent failures and successes with a variety of prophylactics and behavioral modification programs to protect the most vulnerable as well as the difficulties in fighting against a constantly-changing virus.

Another way of finding published work that costs zilch is to perform a search using PubMedCentral, a database of either open access articles or articles for which the full-text has been provided by the journal: e.g. a search for HIV on PMC. PMC uses Boolean terms, so if you’re interested in studies on the transmission of HIV, merely add “AND transmission” to the search query.

For a graphical, but mainly accurate, portrayal of the infection and disease process, have a look at the BBC’s Biology of AIDS.

More linkage can, as always, be found on the wikipedia pages.

Should you wish to take some action, you could do worse than make a pledge to talk to someone who needs to know about AIDS, campaign for access to treatment or take the easy way out and donate some dosh:

Take the Lead. Register your Pledge NOW!
Stop AIDS in Children

In the case of HIV infections, prevention really is better than cure. Even if you’re a lucky soul living in a developed nation and have health insurance of some sort, do you really want to be taking a host of antiretrovirals for the rest of your life? Prevention is easy for those of us living in clean and safe environments. It’s simple. Don’t share needles. Make sure your tattoo artist sterilises his equipment. And have safe sex. Get a condom. Use it. As Death herself puts it: “Which would you rather be? A little embarrassed or a lot dead?”

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