Being one of the most fatal viruses in the nation, AIDS (Acquired Immunodeficiency Syndrome) is now a serious public health concern in most major U.S. cities and in countries worldwide. Since 1986, there have been impressive advances in understanding the AIDS virus, its mechanisms, and its routes of transmission. However, despite countless hours and millions of dollars spent on research, there is still no drug that can cure infection with the virus or a vaccine that can prevent it. AIDS is the leading cause of death among adults, so individuals are taking more precautions with sexual intercourse, and medical facilities are screening blood more thoroughly.
Even though HIV (Human Immunodeficiency Virus) can be transmitted through sharing non-sterilized needles and syringes, sexual intercourse, blood transfusion, and bodily fluids, it is not transmitted through casual contact or by biting or blood-sucking insects. The development of the AIDS epidemic began with the first reported cases in 1982. Epidemiologists at the Center for Disease Control immediately began tracking the disease backward in time as well as forward. They determined that the first cases of AIDS in the United States probably occurred in 1977. By early 1982, 15 states, the District of Columbia, and 2 foreign countries had reports of AIDS cases, however, the total remained low: 158 men and 1 woman.
Surprisingly, more than 90 percent of the men were homosexual or bisexual. It is known that more than 70 percent of AIDS victims are homosexual or bisexual men, and less than 5 percent are heterosexual adults. By December of 1983, there were 3,000 reported cases of AIDS in adults from 42 states, the District of Columbia, and Puerto Rico, and the disease had been recognized in 20 other countries. Researchers were closely examining the health of the general homosexual population in the area with the largest number of cases of the new disease to recognize the extent of infection.
For many years, physicians knew that homosexual men who reported large numbers of sexual partners had more episodes of venereal diseases and were at a higher risk of hepatitis B virus infection than the rest of the population. However, coincidentally with the appearance of AIDS, other debilitating problems began to appear more frequently. The most common was swollen glands, often accompanied by extreme fatigue, weight loss, fever, chronic diarrhea, decreased levels of blood platelets, and fungal infections in the mouth. This condition was labeled ARC (AIDS Related Complex). The isolation of HIV in 1983 and 1984 and the development of techniques to produce large quantities of the virus paved the way for a battery of tests to determine the relationship between AIDS and ARC and the magnitude of the carrier problem.
Using several different laboratory tests, scientists looked for antibodies against HIV in the blood of AIDS and ARC patients. They found that almost 100 percent of those with AIDS or ARC had the antibodies – they were seropositive. In contrast, less than one percent of persons with no known risk factors were seropositive.
Definition of AIDS: AIDS is defined as a disease that is at least moderately predictive of defects in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease. Such diseases include Kaposi’s Sarcoma, Pneumocystis carnii pneumonia, and other serious opportunistic infections. After the discovery of HIV and the development of HIV-antibody tests, the case definition of AIDS was updated to reflect the role of the virus in causing AIDS, but the scope of the definition remained almost the same.
HIV is primarily transmitted through sexual activity, including both homosexual and heterosexual activity. The first recognized case was among homosexual and bisexual men. Numerous studies have shown that men who have multiple sexual partners and those who engage in receptive anal intercourse are at a higher risk of HIV infection than other homosexual men. Researchers have found a strong connection between HIV infection and rectal trauma, enemas before sex, and physical signs of disruption of the tissue lining the rectum.
Homosexual women tend to have a very low incidence of venereal disease in general, and AIDS is no exception. Female-to-female transmission is highly uncommon, although it has been reported in one case and suggested in another. In the reported case, traumatic sex practices apparently resulted in transmission of HIV from a woman who had acquired the virus through IV drug abuse to her non-drug-using sexual partner. The first heterosexual transmission (male to female) was reported in 1983.
