HIV/AIDS

About the Disease

On June 5, 1981, Michael Gottlieb and his colleagues at the University of California, Los Angeles, published an article titled “Pneumocystis Pneumonia—Los Angeles” in the Morbidity and Mortality Weekly Report, a publication of the Centers for Disease Control and Prevention (CDC), chronicling the experiences of five homosexually active men treated for Pneumocystis carinii at three different hospitals in the greater Los Angeles area. This article, now believed to be the first article documenting acquired immune deficiency syndrome (AIDS) in the United States, noted that Pneumocystis pneumonia is almost exclusively limited to severely immunosuppressed patients and hinted at the possibility of a virus acquired through homosexual contact that might negatively affect the immune system.

By August of the same year, the CDC reported 108 cases of the new disease in the United States. Because all of the early reported cases were found among homosexually active men, it was originally given the name gay-related immune deficiency (GRID). However, as early as 1982, the CDC began receiving reports of GRID in people who were not homosexually active, particularly injection drug users and people who had undergone blood transfusions for various reasons, most noticeably hemophilia. In addition, reported cases of AIDS began surfacing in other nations, many among largely heterosexually active populations. Shortly thereafter, the condition started to be referred to as AIDS to reflect the reality that it was not limited to homosexual transmission.

[Page 630]Today, it is understood that AIDS is caused by the human immunodeficiency virus (HIV), a retrovirus that attacks the cells of the immune system and is transmitted through direct contact at the mucus membrane or the bloodstream with HIV-infected body fluids such as blood, semen, vaginal fluid, and breast milk. The three major modes of transmission for HIV are sexual contact with an HIV-positive individual, exposure to infected bodily fluids such as through injection drug use or blood transfusions, and mother-to-child transmissions. Although saliva does contain trace amounts of HIV, it is now understood that infection from saliva is virtually impossible. eliminate the risk of transmission. Although HIV transmission from blood transfusions is extremely low in the developed world, the World Health Organization (WHO) estimates that much of the world does not have access to a safe, uncontaminated blood supply. As such, HIV transmission from blood transfusions accounts for up to 10% of new HIV infections worldwide each year. For injection drug users, not sharing needles and other drug paraphernalia can lead to decreased risk of HIV transmission. The risk of transmission during pregnancy, labor, and delivery can be reduced from 25% to less than 1% by antiretro-viral therapy and caesarean childbirth.

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