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AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging or destroying the cells of your immune system, HIV interferes with your body's ability to effectively fight off viruses, bacteria and fungi that cause disease. This makes you more susceptible to certain types of cancers and to opportunistic infections your body would normally resist, such as pneumonia and meningitis. The virus and the infection itself are known as HIV. The term acquired immunodeficiency syndrome (AIDS) is used to mean the later stages of an HIV infection.

HIV crosses all cultures, national borders and religions. Anyone of any age, race, sex or sexual orientation can be infected, but you're at greatest risk of HIV/AIDS if you: Have unprotected sex with multiple partners. You're at risk whether you're heterosexual, homosexual or bisexual. Unprotected sex means having sex without using a new latex or polyurethane condom every time. Have unprotected sex with someone who is HIV-positive. Have another sexually transmitted disease, such as syphilis, herpes, chlamydia, gonorrhea or bacterial vaginosis. Share needles during intravenous drug use. Have hemophilia and received blood products between 1977 and April 1985 — the date standard testing for HIV began. Received a blood transfusion or blood products before 1985. Have fewer copies of a gene called CCL3L1 that helps fight HIV infection. Newborns or nursing infants whose mothers tested positive for HIV but did not receive treatment also are at high risk.

Every pregnant woman should be tested for HIV to have a better chance of preventing transmission to her unborn child. If a woman knows she is HIV-infected and already has children, then it is recommended that all of her children be tested for HIV. Even if she has older children and they seem healthy, they could still have an HIV infection if she was already HIV-positive at the time they were born. A blood test is needed to know for sure. However, when a new baby is born to an HIV-infected mother, there is no immediate way to know whether the baby is infected with the virus. This is because if the mother is infected, an ELISA test (which checks for HIV antibodies in the blood), will almost always be positive, too. Babies will have their HIV-infected mother's antibodies (which are passed to the baby through the placenta) even if they are not truly infected with HIV. These babies may remain HIV-antibody positive for up to 18 months after birth, even if they are not actually infected. Infants who are not actually infected with the virus (but are born to HIV-positive mothers) will not make their own antibodies; the HIV antibodies that came from their mothers will gradually disappear from their blood before they reach 2 years of age. Any blood tests performed after this point will likely be HIV-negative. Infants who are infected with HIV from their mothers will begin to make their own HIV antibodies and will generally remain HIV-positive after 18 months of age.

Anti-HIV (also called antiretroviral) medications are used to control the reproduction of the virus and to slow the progression of HIV-related disease. Highly Active Antiretroviral Therapy (HAART) is the recommended treatment for HIV infection. HAART combines three or more anti-HIV medications in a daily regimen, sometimes referred to as a “cocktail”. Anti-HIV medications do not cure HIV infection and individuals taking these medications can still transmit HIV to others. Anti-HIV medications approved by the U.S. Food and Drug Administration (FDA) fall into four classes: 1. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs), such as Efavirenz (Sustiva), bind to and block the action of reverse transcriptase, a protein that HIV needs to reproduce. 2. Nucleoside Reverse Transcriptase Inhibitors (NRTIs), such as zidovudine (Retrovir), tenofovir DF (Viread), and stavudine (Zerit), are faulty versions of building blocks that HIV needs to make more copies of itself. When HIV uses an NRTI instead of a normal building block, reproduction of the virus is stalled. 3. Protease Inhibitors (PIs), such as lopinavir/ritonavir (Kaletra), disable protease, a protein that HIV needs reproduce itself. 4. Fusion Inhibitors, such as enfuvirtide (Fuzeon ), are newer treatments that work by blocking HIV entry into cells. (View more complete list of HIV drugs). How many pills you will need to take and how often you will take them depends on what medications you and your doctor choose. There is no one “best” regimen. You and your doctor will decide which medications are right for you. For people taking HAART for the first time, the recommended regimens are: • Sustiva + Epivir + (Retrovir or Viread or Zerit) • Kaletra + Epivir + (Retrovir or Zerit) In general, taking only one or two drugs is not recommended because any decrease in viral load is almost always temporary without three or more drugs. The exception is the recommendation for pregnant women, who may take Retrovir alone or with other drugs to reduce the risk of passing HIV to their infants. If you are pregnant or considering becoming pregnant, there are additional treatment considerations. The treatment of HIV infection and AIDS is in a highly dynamic state. Individuals with this condition are advised to seek out experts in their local community who are current with the latest modes of therapy and ongoing clinical trials for evaluating newer therapies. The following is a partial list of drugs approved for the treatment of HIVinfection. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs) Delavirdine (Rescriptor, DLV) Pfizer Efavirenz (Sustiva, EFV) Bristol-Myers Squibb Nevirapine (Viramune, NVP) Boehringer Ingelheim Nucleoside Reverse Transcriptase Inhibitors (NRTIs) Abacavir (Ziagen, ABC) GlaxoSmithKline Abacavir,Lamivudine, Zidovudine (Trizivir) GlaxoSmithKline Didanosine (Videx, ddI, Videx EC) Bristol-Myers Squibb Emtricitabine (Emtriva, FTC, Coviracil) Gilead Sciences Lamivudine (Epivir, 3TC) GlaxoSmithKline Lamivudine, Zidovudine (Combivir) GlaxoSmithKline Stavudine ( Zerit, d4T) Bristol-Myers Squibb Tenofovir DF (Viread, TDF) Gilead Sciences Zalcitabine (Hivid, ddC) Hoffmann-La Roche Zidovudine (Retrovir, AZT, ZDV) GlaxoSmithKline Protease Inhibitors (PIs) Amprenavir (Agenerase, APV) GlaxoSmithKline, Vertex Pharmaceuticals Atazanavir (Reyataz, ATV) Bristol-Myers Squibb Fosamprenavir (Lexiva, FPV) GlaxoSmithKline, Vertex Pharmaceuticals Indinavir (Crixivan, IDV) Merck Lopinavir, Ritonavir (Kaletra, LPV/r) Abbott Laboratories Nelfinavir (Viracept, NFV) Agouron Pharmaceuticals Ritonavir (Norvir, RTV) Abbott Laboratories Saquinavir (Fortovase, SQV) Invirase Hoffmann-La Roche Fusion Inhibitors Enfuvirtide (Fuzeon, T-20) Hoffmann-La Roche, Trimeris.

The only way to protect from contracting AIDS sexually is to abstain from sex outside of a mutually faithful relationship with a partner whom the person knows is not infected with the AIDS virus. Otherwise, risks can be minimized if they: Don't have sexual contact with anyone who has symptoms of AIDS or who is a member of a high risk group for AIDS. Avoid sexual contact with anyone who has had sex with people at risk of getting AIDS. Don't have sex with prostitutes. Avoid having sex with anyone who has multiple and/or anonymous sexual partners. Avoid oral, genital and anal contact with partner's blood, semen, vaginal secretions, feces or urine. Unless they know with absolute certainty that their partner is not infected, a latex condom should be used during each sexual act, from start to finish. The use of a spermicidal agent may provide additional protection. Avoid anal intercourse altogether. Don't share toothbrushes, razors or other implements that could become contaminated with the blood of anyone who is or might be infected with the AIDS virus. Exercise caution regarding procedures, such as acupuncture, tattooing, ear piercing, etc., in which needles or other nonsterile instruments may be used repeatedly to pierce the skin and/or mucous membranes. Such procedures are safe if proper sterilization methods are employed or disposable needles are used. Ask what precautions are taken before undergoing such procedures. If an individual is scheduling surgery in the near future, and is able, they could consider donating blood for their own use. This will eliminate completely the already small risk of contracting AIDS through a blood transfusion. It will also eliminate the more substantial risk of contracting other bloodborne diseases (such as hepatitis) from a transfusion. If a person is an IV drug user, adhere to the prevention tips mentioned earlier, as well as: Get professional help for terminating the drug habit. Do not share needles or syringes. Be aware that some street sellers are resealing previously used needles and selling them as new. Clean the needle before using. Some people apparently remain well after infection of the AIDS virus. They may have no physically apparent symptoms of illness. However, if proper precautions are not used with sexual contacts and/or intravenous drug use, these infected individuals can spread the virus to others. Anyone who thinks he or she is infected, or who is involved in high-risk behaviors, should not donate his/her blood, organs, tissues, or sperm as they may now contain the AIDS virus.

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