The impact of HIV and AIDS on the American population

¶ … HIV / AIDS on American Society

What is HIV and where did it come from? The Centers for Disease Control and Prevention (CDC) (a primary source) explains that HIV stands for human immunodeficiency virus, and once a person acquires this virus, "…you have it for life" (CDC). There is no effective cure, that is the bad news; but the better news according to the CDC is that HIV "…can be controlled" because there is a treatment called antiretroviral therapy (ART) (CDC). In fact while just a few years ago a person with HIV could expect to have full-blown AIDS within a few years, but with the ART treatment, many HIV sufferers can expect to have "…a nearly normal life…" (CDC).

The source of HIV is believed to be chimpanzees in West Africa, and how this came about related to the fact that Africans hunted the chimpanzees for food and at some time Africans apparently came into direct contact with the blood of a chimpanzee that was infected with a strain of HIV (CDC). The HIV may well have been in the blood of apes "…as far back as the late 1800s," the CDC explains. This paper covers a number of issues and impacts regarding the U.S. population and HIV / AIDS

How does a person contract HIV or STDs?

A person can acquire HIV or other sexually transmitted diseases (STD) in several ways, according to a book by professor Gregory Moffatt. The person at "highest risk for contracting most sexually transmitted diseases is sexually promiscuous individuals and those who share needles with others" (Moffatt, 2004, 247-48). Some STDs (including HIV) can be transmitted through blood transfusions, but in the main, STDs are transmitted "…when body fluids (semen and blood) come into contact with soft, mucus-lined tissues of the body," Moffatt explains. Those tissues include the vagina, urethra, anus and the mouth, and open cuts, sores, or blisters are entry points for STDs, Moffatt goes on (248).

On the subject of open cuts and sores, on 248 Moffatt points out that when a gay man has anal intercourse with another man, there is a great risk of getting HIV and spreading HIV or other STDs. Why? The anus is "not large enough to accommodate an erect penis," and hence, some anal tissue is likely to be torn and this opening (however slight) provides a "point of entry for the transmission of the HIV virus" (Moffatt, 248).

Some younger people mistakenly believe that just avoiding sexual intercourse is adequate to protect against HIV and STDs; however, even "casual sexual contact" or "oral sex" can be enough to cause the person to become infected (Moffatt, 248). Likewise, Moffatt continues, there are "…well-intentioned organizations" that have "…falsely communicated that use of a condom will prevent the spread of STDs"; and while condoms do offer some protection, there is no assurance that using a condom prevents the spreading of HIV or other STDs (Moffatt, 248).

STDs include the following in addition to HIV: pubic lice (crabs); gonorrhea and syphilis; hepatitis (A & B); genital herpes; genital warts; and Chlamydia (the "fastest-spreading sexually transmitted disease in the United States") (Moffatt, 249).

What are the stages of HIV?

The Centers for Disease Control and Prevention point out that within two to four weeks after a person has been infected with HIV he or she may begin to feel ill with "…flu-like symptoms"; this period is referred to as "acute retroviral syndrome (ARS) or primary HIV infection" (CDC, p. 2). The virus uses existing immune system cells to "…make copies of itself" while destroying those cells in the process (CDC, p. 2). Next, there is a period called "Clinical latency (inactivity or dormancy)"; the HIV is still alive and active but there are lower levels of reproduction of the cells. If the HIV-infected individual is treated with the antiretroviral therapy (ART) he or she may live for "several decades," CDC continues (p. 2).

But, on the other hand, if the person is not treated with ART, within a few years he or she may become infected with AIDS (acquired immunodeficiency syndrome) (CDC, p. 2). How does a person really know if he or she is infected with HIV? The symptoms alluded to in the paragraph above this one included flu-like symptoms, which include "fever, enlarged lymph nodes, sore throat and rash" (CDC, p. 2).

How does HIV affect the body?

In the book HIV / AIDS: Health Solutions by professor Savitri Ramaiah the author explains that lymphocytes are the white blood cells in the body, and in normal times these lymphocytes (about 25% of the total white blood cell count) respond immediately to different infections a person might get. The B cells and T cells (the two types of lymphocytes) produce antibodies to fight viruses; the B cells' job is to identify germs and viruses and the T cells are the ones that make copies of itself (note the section on ART above this section) (Ramaiah, 2008).

The HIV proteins, enzymes and RNA collect "…just inside the wall of the infected T cell," Ramaiah explains; and proteins that cover the virus are collected inside the wall of the T cell, which by now has become infected. Meantime the "long chains of proteins and enzymes" that have formed inside infected cells are "…cut into smaller pieces" by an enzyme called "protease" (Ramaiah). Next, these smaller pieces spread infection to other T cells, the author explains.

How did society react to HIV / AIDS?

The Kaiser Family Foundation (KFF) reports that because the U.S. was likely the first nation in which AIDS cases were officially reported (in 1981), a great deal of attention was focused on the U.S. And in fact the U.S. has been in "…the spotlight both for its leadership and controversy" (KFF, 2012). There were "early fears" that AIDS would become a "generalized epidemic," albeit those fears did not turn out to be valid; however, the response of many in America was to blame homosexuality, since society understood that AIDS could be transmitted through homosexual activities. There was, the KFF executive summary discloses, "considerable and disproportionate impact on certain groups, particularly men who have sex with men (MSM), racial/ethnic minorities, and immigrants." In fact it is fair to say that a degree of hatefulness accompanied the early responses from the "straight" community towards gays; those who were homophobic used the HIV / AIDS epidemic to spew aspersions toward the gay community.

However, as knowledge as to other ways AIDS can be spread became available (mother-to-child transmission and needle sharing and infected blood products), there was a lessening of blame on the gay community (KFF). The United States has invested "…the largest sums toward HIV research" of any other country, and over time the stigma attached to people that are HIV-positive has "lessened…in high-income countries" but in fact a stigma does remain, KFF concludes.

HIV and AIDS among American Indians and Alaska Natives

In a peer-reviewed article (Ethnicity and Health) the authors report that American Indians and Alaska Natives (AI/AN) only represent 1% of AIDS cases in the U.S. (McNaghten, et al., 2005). However AI/AN are reported to have shown "high rates of Chlamydia, gonorrhea, and syphilis from 1996 through 2000" (McNaghten, 57). Among all females in the U.S., AI/AN females had "…the second highest rates of Chlamydia, gonorrhea, and syphilis" that was reported in the above-mentioned time frame (McNaghten, 57). What is the impact of HIV / AIDS on the AI/AN population? McNaghten explains that Caucasians represented 73.7% of all people in the U.S. And Caucasians represented 37.8% of all people living with AIDS; these number dwarf the percentage of AI/AN in the U.S. (0.7%) and the percentages of AI/AN living with AIDS, which is just 0.3% (61).

Persons 50 years and older -- HIV / AIDS

The Administration on Aging reports that about 31% of people living with HIV are "over the age of 50." In fact the AOA claims that 17% of "…all new HIV / AIDS cases occur among people" who are fifty years of age and older (AOA). The National Institute on Aging (NIA) (primary source) claims that "Almost one-fourth of all people with HIV / AIDS" in the U.S. are fifty years of age or older, and the NIA explains that older Americans "know less about HIV / AIDS than younger people do" (NIA). Reasons why older people know less about HIV / AIDS include: a) they do not come into contact with information about condoms, needle-sharing, or getting tested as often as younger people do; b) their healthcare workers and educators "…often do not talk with middle-aged and older people" about HIV / AIDS; c) older people are far less likely to discuss their personal sexual behaviors with doctors; and d) in turn, doctors tend not to ask older people about their drug use, their sexual activities or any "risky behaviors" they may engage in (NIA).

The Center for Disease Control and Prevention urges older people to "abstain from sex (oral, anal, or vaginal sex) until you are in a relationship with only one person…and each of you knows the other's HIV status" (CDC). If an older person believes that he or she has been exposed to an STD (like gonorrhea, syphilis, or Chlamydia trachomatis), "get treatment" because these STDs can "increase your risk of getting HIV (CDC). Also, the CDC explains to older people that having sex while high on drugs or alcohol is risky because "…being high can make you more likely to take risks"; moreover, there are "ABCs" for older people, and they stand for: A (abstinence); B (Be faithful); and C (condoms) (CDC).

Drug use statistics

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2010, about 22.6 million Americans (twelve years old and older) were "…current illicit drug users," which means they had used an illicit drug within a month of the time of the survey (SAMHSA, 2012). The 22.6 million is just under 9% of the U.S. population, and the "illicit drugs" referenced include: "marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically" (SAMHSA).

The most common of the illicit drugs mentioned by SAMHSA is marijuana (there were an estimated 17.4 million users in the month the study was done); in the three years between 2007 and 2010, marijuana usage increased from 5.8% of the population to 6.9%, which reflects actual numbers from 14.4 million to 17.4 million Americans 12 or older (SAMHSA). As for cocaine users in the U.S., only 0.6% of the U.S. population used cocaine on a regular basis (1.5 million); that is a decrease in usage from 2006 (when 1.0% of the population used regularly) (SAMHSA).

As for hallucinogens, 1.2 million Americans were regular users which included 695,000 who had used Ecstasy on a regular basis; and concerning prescription-type psychotherapeutic drugs, 7 million Americans were regular users (for nonmedical purposes), which is 2.7% of the American population (SAMHSA). When it comes to older people (50 to 59), SAMHSA reports that illicit drug use "…increased from 2.7% in 2002 to 5.8% in 2010"; this takes into account "baby boomers" who perhaps started using drugs (notably marijuana) at a young age and have continued through their middle age and senior years.

In his book U.S. Drug Policy, journalist Renard Teipelke claims that for the American population aged 12 and older the use of "illicit drugs has stayed the same for the years 2002 to 2008," which means that about 8% of Americans are involved with illicit drugs, which is similar to the data from SAMHSA (Teipelke, 2010, p. 4). The main group of illicit drug users, Teipelke explains, are those between the ages of 16 to 29; as to university and college students who graduated, 51.8% had tried illicit drugs at some time, but for those individuals who only completed high school, just 37.7% had experimented with illicit drugs (p. 4). Teipelke writes that he obtained his data from the National Survey on Drug Use and Health.

Pornography and HIV

An article in the Los Angeles Times (August 25, 2013) that a 28-year-old actress in the pornography industry (her screen name is Cameron Bay) has tested positive for HIV (Sewell, 2013, p. A29). Hence, the adult film industry is calling for "…a nationwide moratorium" on producing any additional films until further research and results can be obtained, Sewell writes. Did Bay get HIV on a movie set? There is no evidence of that, but it puts more pressure on the industry to observe the measure passed by Los Angeles County voters in 2012 calling for pornography actors to use condoms, Sewell continued.

The actress said, "As difficult as this news is for me, I am hopeful that no other performers have been affected. I plan on doing everything possible to assist the medical professionals and my fellow performers," she continued. But her "long-term plan" is to take care of her own health, she added (Sewell, A29).

Is the CIA guilty of a massive conspiracy and cover-up?

An article in Time (2008) points out that ever since the CDC first announced that the HIV / AIDS, there have been rumors that the CIA instigated this epidemic in order to "…wipe out homosexuals and African-Americans (Time). High-profile political leaders and others have helped to perpetuate this rumor; among those is South African President Thabo Mbeki, who insisted that the U.S. government manufactured the disease in "military labs" (Time). And Nobel Peace Prize recipient Wangari Maathai (an ecologist in Kenya) "…used the international spotlight to support that theory as well" (Time).

Some conspiracy theorists suggest that the CIA "…deliberately injected gay men with the virus during the 1978 hepatitis-B experiments" that were conducted in Los Angeles, New York, and San Francisco (Time). Others supporting these rumors believe when President Richard Nixon combined the U.S. Army's bio-warfare department with the National Cancer Institute (in 1971), somehow the late president instituted a hideously immoral policy to infect gay and minority men (Time). Actually, the Time article concludes that the co-discoverers of HIV (Dr. Robert Gallo of the National Cancer Institute and Dr. Luc Montagnier from the Pasteur Institute in Paris) maintain that the likely origins of the virus came from monkeys during the 1930s.

Conclusion

The impact that HIV / AIDS has had on American society has been significant notwithstanding the fact that in recent years there has been less information about HIV / AIDS in the media than at the outset of the discovery of the virus. This paper covered the facts as to how HIV is acquired, how HIV impacts the human body, the timeline of HIV / AIDS, the illicit drug usage by the American population, how society responded to HIV / AIDS and what medicines are used to control the HIV virus, among other aspects of the epidemic. The fact that African-Americans currently are acquiring HIV at a faster rate than other minorities or Caucasians is a fact that should be addressed by the healthcare community with greater emphasis than is currently being done; and moreover, the media and political leaders should be making the case that caution and preventative measures can protect individuals from acquiring HIV.