Vinod Anand | 14 Jan 2012

In 1981, the Centers for Disease Control and Prevention (CDC) reported the first cases of AIDS in the United States where a rare pneumonia in young gay men was found to have resulted from infection with the human immunodeficiency virus (HIV).

SOON HIV/AIDS emerged as a global pandemic that still continues to demand urgent attention. According to World Health Organization (WHO), HIV is one of the world?s leading infectious killers, claiming more than 25 million lives over past three decades. There were approximately 34 million people living with HIV in 2010. CDC estimates 1.2 million people in the United States are living with HIV infection. One in five (20%) of those people are unaware of their infection.

The situation is far worse in India where an estimated 2.4 million people ore infected with HIV and about 40% of these people don?t know that they are infected. Hence, it is important for all people who may have been exposed to HIV to be tested, to know their status and get requisite medical care, if warranted. According WHO, most people living with HIV or at risk for HIV do not have access to prevention, core, and treatment.

AIDS is an HIV-induced deficiency of cellular immunity characterized by opportunistic diseases like Pneumonia, Kaposi Sarcoma, tuberculosis and others. Although HIV is a lot like other viruses, including those that cause flu or common cold, there is a vital difference. While the human immune system can clear most viruses overtime, it isn't the case with HIV. The virus primarily attacks CD4 or T-cells in the human body. It uses them to make copies of itself and then destroys them. The progressive decline of CD4 reaches a stage where the body cannot fight infections anymore leading to what is diagnosed as AIDS.To date, there is no cure for AIDS.

It is critical to understand and restrict HIV/AIDS from further transmission. HIV is primarily transmitted through a variety of body fluids of infected individuals, such as blood, breast milk, semen and vaginal secretions. The possible means of HIV transmission are unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding.

However, HIV does not spread through ordinary day-to-day contact such as kissing, hugging, shaking hands, or shoring personal objects, food or water.Despite multiple challenges, there have been successes and promising signs for better management of HIV/AIDS. Once considered to be terminal illness, HIV/AIDS is now viewed as a chronic incurable disease. The advent of highly active antiretroviral therapy (HA.AT) has increased the life-expectancy of HIV-infected people to a significant extent. Antiretroviral treatment reduces the viral load of the HIV-infected person. While treatment with antiretroviral (ARV) medicines improves the health of those infected with HIV, it also significantly reduces the risk of transmitting HIV to an uninfected sexual partner.

Early this year, HPTN-052, a large-scale clinical trial sponsored by the U.S. Government confirmed that treating an HIV-infected individual with antiretroviral drugs can significantly reduce the risk of sexual transmission to an uninfected partner, by about 96%.The increased longevity of the HIV-infected people comes with another set of social problems since they now need to go back to work, look for career options, and support themselves. The common concerns are workplace discrimination, managing medical needs at the workplace, psychological impact, social stigma, and suicidal tendency in many cases. We all need to understand that people with HlV are part of society. They can continue to live and do their jobs as well as they could before they were infected. We all need to learn to live with HIM. This involves understanding people with HIV, respecting their privacy by not divulging their status to others, and giving them support.

The United States supports a wide range of activities?from research and development to technical assistance and financial support to other nations?to combat the global NV/AIDS pandemic. Through the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR) initiative, the U.S. has made enormous progress in responding to the global HIV/AIDS pandemic, working with countries heavily impacted by HIV/AIDS to help expand access to treatment, care, and prevention. PEPFAR is the cornerstone and largest component of the U-S. President?s Global Health Initiative.On July 13, 2010, the Obama administration released the National HIV/AIDS Strategy (NHAS). This ambitious plan is America?s first-ever comprehensive coordinated HIV/AIDS roadmap with clear and measurable targets to be achieved by 2015. NHAS has three primary goals?reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. The ultimate vision for President Obama's NHAS is to make the United States a place where new HIV infections are rare and when they occur, every person regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, has unfettered access to high quality, life-extending care, free from stigma and discrimination.