HIV / AIDS on American Society What

¶ … 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.

Timeline of events in U.S. Global HIV / AIDS policy

The Public Broadcast Service (PBS) put together a timeline on the events related to the emergence of and response to HIV / AIDS. A few of those dates will be presented here as background into how the U.S. responded to this new and frightening disease: a) in 1981 the CDC reported "rare cases of pneumonia in young gay men" (in 1982 AIDS was recognized); b) in the early 1980s gay activists began pushing for research money and access to drugs; c) in the 1980s science identified the HIV virus and began testing the drug AZT; d) in 1985 the Pentagon began testing all recruits for HIV (rejecting those that were positive); e) the U.S. Surgeon General (Koop) issued a report in 1986 calling for prevention; f) in 1987 the FDA "strengthens regulation of condom manufacturing and Congress approved $30 million to states; also in 1987 Congress approves the "Helms Amendment" banning funds for AIDS educational materials that "…promote or encourage, directly or indirectly, homosexual activities"; g) in 1989 Congress created the "National Commission on AIDS"; h) in 1990 Ryan White died at the age of 18 and Congress approves funds for "community-based care and treatment services"; i) in 1992 AIDS becomes the "…number one cause of death for U.S. men ages 25 to 44"; j) in 1995 President Clinton established the "Presidential Advisory Council on HIV / AIDS"; k) the first anti-retroviral drugs became available in 1996; l) in 1997 AIDS-related deaths declined by more than 40%; and m) the George W. Bush Administration promotes "abstinence" as HIV prevention in 2002 and in 2003 Bush announces a five-year, $15 billion initiative to "…address HIV, tuberculosis and malaria in hard-hit countries" (Public Broadcast Service, 2008).

How did the media report the HIV / AIDS between the years 1992 and 2007 -- and what percentage of new AIDS cases have been reported to be African-Americans?

In the peer-reviewed publication, Critical Arts: A South-North Journal of Culture & Media Studies, the authors conducted an analysis of AIDS coverage in 24 daily newspapers in the United States for the years 1992 through 2007 (fifteen years). What they found in that research was that there has been a dramatic decline in coverage of the HIV / AIDS epidemic as well as a "…shift in portrayal of risk in the U.S." (Stevens, et al., 2013). There was a shift in focus over those fifteen years of newspaper coverage, Stevens explains, and the newer focus was on the HIV / AIDS problems internationally, not in the U.S. (Stevens, 352).

Hence, because there was more attention paid to the HIV / AIDS epidemic overseas, the impact on Americans was given reduced visibility; and the "racial disparity" that was indeed found in that newspaper coverage failed to provide "context" -- and the authors find that fact an uncomfortable one given the seriousness of the illness for African-Americans. To wit, more than thirty years after AIDS became a feared disease, African-Americans account for half of the new cases reported in the United States; this is pertinent because African-Americans only represent 12.3% of the population in the United States (Stevens, 353).

The HIV infection rates are "particularly high for African-American women, youth, and men who have sex with men," Stevens continues; and given this statistical reality, Stevens (and "scholars") blame the media for being "silent" on the impact HIV / AIDS has had on African-Americans. A recent survey by the Kaiser Family Foundation (referenced by Stevens on page 353) shows that "…73% of African-Americans reported wanting to know more about HIV transmission." As to how many newspapers covered the HIV / AIDS infections in minorities, only 3% of all stories on HIV / AIDS covered issues related to minorities and only 5% of the HIV / AIDS coverage in The New York Times between 1981 through 1993 specifically mentioned African-Americans (Stevens, 353).

Basic coverage of HIV / AIDS in the U.S. "peaked in June 1993," when there was an average of 840 stories in those 24 newspapers per month, Stevens explains (358). During the period subsequent to 1993 the HIV / AIDS issues "…often highlighted infection through non-risky behaviour" (like mother-to-child transmissions or from blood transfusions); also, those newspapers tended to frame the stories as "human interest pieces" that zeroed in on people that had HIV / AIDS and how they were coping (Stevens, 358). It seemed that in the 1990s HIV / AIDS was an "African problem" -- particular in Uganda, because Uganda went through a "dramatic decline in its AIDS case rates" -- not an American problem (Stevens, 360).

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.