HIV infection, or AIDS, was the eighth leading cause of death in the United States in 1995. During that year, an estimated 42,506 people in this country died from complications caused by this disorder, a rate of 16.2 per 100,000 population (Rosenberg et al., 1996). The human immunodeficiency virus (HIV) attacks the body's immune system and makes the infected person more vulnerable to a host of viral, bacterial, and malignant disease. The virus can be transmitted by hypodermic needles or drug paraphernalia, by transfusions of infected blood, and from an infected mother to her child during delivery. The principal method of transmission of the virus is from men having sex with men, followed by drug injections, heterosexual contact, blood transfusion, and use of HIV-infected blood coagulants by hemophiliacs.
Death due to HIV infection is more common during young and middle adulthood (ages 25-44), in men than in women, and higher in blacks—male and female—than in whites. However, the disorder is no respecter of age. For example, the HIV death rate for men between the ages of 45 and 64 was 26.4 for whites and 127.1 for blacks in 1994 (Singh et al., 1996).
HIV is a progressive disorder, in that infected individuals do not seem to be sick at first but often develop serious infections or cancers after several years. The symptoms of HIV infection—feelings of tiredness, confusion, loss of appetite, and swollen glands-are not unlike those accompanying many other illnesses and are therefore easy to confuse with them. Additional symptoms are problems of balance and coordination, in addition to declines in memory, concentration, decision-making ability, and self-control. The presence of such symptoms, combined with a positive blood test for HIV, leads to a diagnosis of AIDS (acquired immunodeficiency syndrome). Death may not come for several years in an infected individual, but when it does, the typical immediate cause is Pneumocystis carinii pneumonia (PCP) or a rare type of skin cancer known as Kaposi's sarcoma.
Neither a vaccine to prevent HIV infection nor a cure for AIDS is presently available, but certain drugs can inhibit the spread of the virus. Efforts to control the AIDS epidemic have involved health education programs designed to increase public knowledge of the disorder and how it spreads. Such programs emphasize condom usage, decreasing the number of sex partners, other safe-sex practices (including abstinence), and an avoidance of needle sharing among intravenous drug users.
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