Epidemiology of Human Immunodeficiency Virus (HIV)

By Sophia Francisco

Epidemiology

Millions of people worldwide are currently living with human immunodeficiency virus. Within the United States, the majority of new yearly cases are diagnosed in the southernmost states such as Florida, Georgia, and Louisiana. Diagnosis rates are also highest amongst the 25-34 year old range. Within the past ten years, infection rates have started to stabilize. This means that there has not been an increase in the amount of total yearly infections with the number hovering around 40,000 new infections every year.

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Cause of Death Ranking

Between the years of 1991 and 1996, HIV was the leading cause of death for men, with the second being unintentional injury. This ranking of HIV dropped dramatically in the year 1997 due to increased education as well as the development of treatments. Since 2001, HIV has been in spot number 6 in the rankings of leading cause of death for men preceded by unintentional injury as the first, then suicide, heart disease, cancer, and homicide. The highest that HIV infection has ever ranked for women’s leading cause of death was third. Cancer and unintentional injury have long-term held the first and second rankings. For women, HIV-related deaths increased steadily from 1987 with them peaking in 1994. HIV from then on resumed its place as the sixth leading cause of death for women.

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Progression of Disease

If no treatment is pursued, HIV infection will progress through an acute phase, chronic phase, and then become classified as AIDS. The infection can stay latent, meaning no symptoms are noticed, from week nine after infection up to eight years. After the latency period, of which the length of time can vary for individuals, symptoms will appear. Because of these symptoms an individual can become more likely to develop other conditions called opportunistic diseases. This is because the body is weakened, allowing other infections or illnesses to take hold, further weakening the body. These diseases can include pneumonia, tumors, meningitis, retinitis, etc.

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Transmission

HIV can be transmitted in three ways: sexually, through blood, or through mother-to-child during birth. HIV is not transmitted through air, water, saliva, sweat, tears, insects, pets, food, or drink.

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Treatment

Pre-exposure prophylaxis (PrEP) is a pill that can be used to prevent HIV. This treatment is taken daily by those who are at high risk for contracting the virus.

Post-exposure prophylaxis (PEP) is another form of treatment that is used if someone suspects that they were exposed to HIV. This treatment must be taken within 72 hours of the exposure. For those who already have HIV, there are treatments available that can reduce the viral load and thereby minimize side effects. This treatment is called HAART (highly active antiretroviral therapy) and involves taking three pills. If an individual on HAART misses treatments, the HIV can become resistant which means the levels of the virus can become detectable again. If taken correctly, this pill regimen allows someone with HIV to have such low virus levels that they cannot transmit the virus to others and minimize HIV’s effect on their health. While there are many treatments available, there is no cure and there is no vaccine available yet, with the anticipated availability being in 2030