Acquired Immune Deficiency Syndrome (AIDS) was first reported in the United States in 1981 and has since become a major worldwide pandemic. AIDS is caused by the Human Immunodeficiency Virus (HIV). By killing or impairing cells of the immune system, HIV progressively destroys the body’s ability to fight infections and certain cancers. Individuals diagnosed with AIDS are susceptible to life-threatening diseases called opportunistic infections, which are caused by microbes that usually do not cause illness in healthy people.

More than 600,000 cases of AIDS have been reported in the United States since 1981, and as many as 900,000 Americans may be infected with HIV. The epidemic is growing most rapidly among minority populations and is a leading killer of African-American males. According to the U.S. Centers for Disease Control and Prevention (CDC), the prevalence of AIDS is six times higher in African-Americans and three times higher among Latinas than among whites.

Statistics • Blacks accounted for 20,187 (50%) of the estimated 40,608 AIDS cases diagnosed in the 50 states and the District of Columbia.
• The rate of AIDS diagnoses for black adults and adolescents was 10 times the rate for whites and nearly 3 times the rate for Hispanics. The rate of AIDS diagnoses for black women was nearly 23 times the rate for white women. The rate of AIDS diagnoses for black men was 8 times the rate for white men.
• The 185,988 blacks living with AIDS in the 50 states and the District of Columbia accounted for 44% of the 421,873 people in those areas living with AIDS.
• Of the 68 US children (younger than 13 years of age) who had a new AIDS diagnosis, 46 were black.
• Since the beginning of the epidemic, blacks have accounted for 397,548 (42%) of the estimated 952,629 AIDS cases diagnosed in the 50 states and the District of Columbia.
• From the beginning of the epidemic through December 2005, an estimated 211,559 blacks with AIDS died.

HIV is also spread most commonly by sexual contact with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum or mouth during sex.  HIV also is spread through contact with infected blood. Prior to the screening of blood for evidence of HIV infection and before the introduction in 1985 of heat-treating techniques to destroy HIV in blood products, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment, the risk of acquiring HIV from such transfusions is extremely small. HIV frequently is spread among injection drug users by the sharing of needles or syringes contaminated with minute quantities of blood of someone infected with the virus. However, transmission from patient to health-care worker or vice-versa via accidental sticks with contaminated needles or other medical instruments is rare.
Women can transmit HIV to their fetuses during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV also can be spread to babies through the breast milk of mothers infected with the virus. If the drug AZT is taken during pregnancy, the chance of transmitting HIV to the baby is reduced significantly. If AZT treatment of mothers is combined with cesarean sectioning to deliver infants, infection rates can be reduced to 1 percent.

Although researchers have detected HIV in the saliva of infected individuals, no evidence exists that the virus is spread by contact with saliva. Laboratory studies reveal that saliva has natural compounds that inhibit the infectiousness of HIV. Studies of people infected with HIV have found no evidence that the virus is spread to others through saliva such as by kissing. No one knows, however, the risk of infection from so-called “deep” kissing, involving the exchange of large amounts of saliva, or by oral intercourse. Scientists also have found no evidence that HIV is spread through sweat, tears, urine or feces.
Studies of families of HIV-infected people have shown clearly that HIV is not spread through casual contact such as the sharing of food utensils, towels and bedding, swimming pools, telephones or toilet seats. HIV is not spread by biting insects such as mosquitoes or bedbugs.

Because early HIV infection often causes no symptoms, it is primarily detected by testing a person’s blood for the presence of antibodies (disease-fighting proteins) to HIV. HIV antibodies generally do not reach detectable levels until one to three months following infection and may take as long as six months to be generated in quantities large enough to show up in standard blood tests. HIV testing may also be performed on saliva and urine samples, in addition to blood samples. People exposed to HIV should be tested for HIV infection as soon as they are likely to develop antibodies to the virus. Such early testing will enable them to receive appropriate treatment at a time when they are most able to combat HIV and prevent the emergence of certain opportunistic infections (see Treatment below). Early testing also alerts HIV-infected people to avoid high-risk behaviors that could spread HIV to others.

HIV testing is done in most doctors’ offices or health clinics and should be accompanied by counseling. Individuals can be tested anonymously at many sites if they have particular concerns about confidentiality. In addition, blood samples for anonymous HIV testing may now be collected at home. Home-based test kits are available by telephone order or over the counter at pharmacies.

Two different types of antibody tests, ELISA and Western Blot, are used to diagnose HIV infection. If a person is highly likely to be infected with HIV and yet both tests are negative, a doctor may test for the presence of HIV itself in the blood. The person also may be told to repeat antibody testing at a later date, when antibodies to HIV are more likely to have developed.

Babies born to mothers infected with HIV may or may not be infected with the virus, but all carry their mothers’ antibodies to HIV for several months. If these babies lack symptoms, a definitive diagnosis of HIV infection using standard antibody tests cannot be made until after 15 months of age. By then, babies are unlikely to still carry their mothers’ antibodies and will have produced their own, if they are infected. New technologies to detect HIV itself are being used to more accurately determine HIV infection in infants between ages 3 months and 15 months. A number of blood tests are being evaluated to determine if they can diagnose HIV infection in babies younger than 3 months.

Since no vaccine for HIV is available, the only way to prevent infection by the virus is to avoid behaviors that put a person at risk of infection, such as sharing needles and having unprotected sex.  Because many people infected with HIV have no symptoms, there is no way of knowing with certainty whether a sexual partner is infected unless he or she has been repeatedly tested for the virus or has not engaged in any risky behavior. CDC recommends that people either abstain from sex or protect themselves by using male latex condoms whenever having oral, anal or vaginal sex. Only male condoms made of latex should be used, and water-based lubricants should be used with latex condoms.

Although some laboratory evidence shows that spermicides can kill HIV organisms, in clinical trials, researchers have not found that these products can prevent HIV. The risk of HIV transmission from a pregnant woman to her fetus is significantly reduced if she takes AZT during pregnancy, labor and delivery, and her baby takes it for the first six weeks of life.

STDs

STDs/STIs affect people of all ages, backgrounds, and from all walks of life - in the U.S. alone there are approximately 19 million new cases each year, about half of which occur among youth ages 15-24 years. Getting the facts about STDs/STIs and sexual health is increasingly important. We invite you to explore our Web site and learn more about specific STDs/STIs, tips for reducing risk, and ways to talk with health care providers and partners.

Currently, condoms are the only widely available, proven method for reducing transmission of HIV and other sexually transmitted infections (STIs) during intercourse. Organizations around the world recommend condom use for the prevention of pregnancy and HIV/STIs.

The American Social Health Association (ASHA) supports the promotion and use of male latex condoms to limit the spread of sexually transmitted infections and their harmful consequences.  Condoms are effective when people use them correctly and consistently.

The surest way to avoid transmission of STIs is to abstain from sexual intercourse or to be in a long-term mutually monogamous relationship with a partner who has been tested and is not infected with any sexually transmitted infections. 

People who choose to be sexually active must have access to information and options to reduce their risk. 

And for the millions of people who have previously acquired a viral sexually transmitted infection, effective measures must be taken to protect any future partners from infection: In the United States, there are more than 50 million people estimated to have genital herpes, 20 million people with HPV, and over 1 million people estimated to have HIV, the virus that causes AIDS.