Queer Peer Services (QPS)
HIV / AIDS / STD's
What is HIV?
HIV is the human immunodeficiency virus that causes AIDS. A member of a group of viruses called retroviruses, HIV infects human cells and uses the energy and nutrients provided by those cells to grow and reproduce.
What is AIDS?
AIDS (acquired immunodeficiency syndrome) is a disease in which the body’s immune system breaks down and is unable to fight off certain infections, known as “opportunistic infections,” and other illnesses that take advantage of a weakened immune system.
When a person is infected with HIV, the virus enters the body and lives and multiplies primarily in the white blood cells. These are the immune cells that normally protect us from disease. The hallmark of HIV infection is the progressive loss of a specific type of immune cell called T-helper or CD4 cells. As the virus grows, it damages or kills these and other cells, weakening the immune system and leaving the individual vulnerable to various opportunistic infections and other illnesses, ranging from pneumonia to cancer. The US Centers for Disease Control and Prevention (CDC) defines someone as having a clinical diagnosis of AIDS if they have tested positive for HIV and meet one or both of these conditions:
- They have experienced one or more AIDS-related infections or illnesses;
- The number of CD4 cells has reached or fallen below 200 per cubic millimeter of blood (a measurement known as T-cell count). In healthy individuals, the CD4 count normally ranges from 450 to 1,200.
How quickly do people infected with HIV develop AIDS?
In some people, the T-cell decline and opportunistic infections that signal AIDS develop soon after initial infection with HIV. Most people remain asymptomatic for 10 to 12 years, and a few for much longer. As with most diseases, early medical care can help prolong a person’s life.
How many people are affected by HIV/AIDS?
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that there are now over 34 million people living with HIV or AIDS worldwide. Most of them do not know they carry HIV and may be spreading the virus to others. In the US, nearly one million people have HIV infection or AIDS — roughly one out of every 250 people. At least 40,000 Americans become newly infected with HIV each year, and it is estimated that half of all people with HIV in the US have not been tested and do not know they are carrying the virus.
Since the beginning of the epidemic, AIDS has killed nearly 19 million people worldwide, including more than 430,000 Americans. AIDS has replaced malaria and tuberculosis as the world’s deadliest infectious disease among adults and is the fourth leading cause of death worldwide. Over 13 million children have been orphaned by the epidemic.
How is HIV transmitted?
A person who is HIV-infected carries the virus in certain body fluids, including blood, semen, vaginal secretions, and breast milk. The virus can be transmitted only if such HIV-infected fluids enter the bloodstream of another person. This kind of direct entry can occur (1) through the linings of the vagina, rectum, mouth, and the opening at the tip of the penis; (2) through intravenous injection with a syringe; or (3) through a break in the skin, such as a cut or sore. Usually, HIV is transmitted through:
- Unprotected sexual intercourse (either vaginal or anal) with someone who is HIV-infected. Women are at greater risk of HIV infection through vaginal sex than men, although the virus can also be transmitted from women to men. Anal sex (whether male-male or male-female) poses a high risk mainly to the receptive partner, because the lining of the anus and rectum are extremely thin and filled with small blood vessels that can be easily injured during intercourse.
- Unprotected oral sex with someone who is HIV-infected. There are far fewer cases of HIV transmission attributed to oral sex than to either vaginal or anal intercourse, but oral-genital contact poses a clear risk of HIV-infection, particularly when ejaculation occurs in the mouth. This risk is increased when either partner has cuts or sores, such as those caused by sexually transmitted diseases (STDs), recent tooth-brushing, or canker sores, which can allow the virus to enter the bloodstream.
- Sharing needles or syringes with someone who is HIV-infected. Laboratory studies show that infectious HIV can survive in used syringes for a month or more, and people who inject drugs should never reuse or share syringes, water, or drug preparation equipment. This includes needles or syringes used to inject illegal drugs such as heroin, as well as steroids. Other types of syringes, such as those used for body piercing and tattoos, can also carry HIV.
- Infection during pregnancy, childbirth, or breast-feeding (mother-to-infant transmission). Any woman who is pregnant or considering becoming pregnant and thinks she may have been exposed to HIV — even if the exposure occurred years ago — should seek testing and counseling. Mother-to-infant transmission has been reduced to just a few cases each year in the US, where pregnant women are tested for HIV, and those who test positive are provided with drugs to prevent transmission and counseled not to breast-feed.
How is HIV not transmitted?
HIV is not an easy virus to pass from one person to another. It is not transmitted through food or air (for instance, by coughing or sneezing). There has never been a case where a person was infected by a household member, relative, coworker, or friend through casual or everyday contact such as sharing eating utensils and bathroom facilities or hugging and kissing. (Most scientists agree that while HIV transmission through deep or prolonged “French” kissing may be possible, it would be extremely unlikely). Here in the US, screening the blood supply for HIV has virtually eliminated the risk of infection through blood transfusions. (And you cannot get HIV from giving blood at a blood bank or other established blood collection center.) Sweat, tears, vomit, feces, and urine do contain HIV, but have not been reported to transmit the disease (apart from two cases involving transmission from fecal matter via cut skin). Mosquitos, fleas, and other insects do not transmit HIV.
How can I reduce my risk of becoming infected with HIV through sexual contact?
If you are sexually active, protect yourself from HIV infection by practicing safer sex. Whenever you have sex, use a condom or “dental dam” (a square of latex recommended for use during oral-genital and oral-anal sex). When used properly and consistently, condoms are extremely effective. But remember:
- Use only latex condoms (or dental dams). Lambskin products provide little protection against HIV.
- Use only water-based lubricants. Latex condoms are virtually useless when combined with oil- or petroleum-based lubricants such as Vaseline or hand lotion. (People with latex allergies can use polyethylene condoms with oil-based lubricants.)
- Use protection each and every time you have sex.
- If needed, consult a nurse, doctor, or health educator for guidance on the proper use of latex barriers.
How can I avoid acquiring HIV from a contaminated syringe?
If you are injecting drugs of any type, including steroids, do not share syringes or other injection equipment with anyone else. (Disinfecting previously used needles and syringes with bleach can reduce the risk of HIV transmission). If you are planning to have any part of your body pierced or to get a tattoo, be sure to see a qualified professional who uses sterile equipment. Detailed HIV prevention information for drug users who continue to inject is available from the CDC’s National Prevention Information Network at 1-800-458-5231 or online at http://www.cdc.gov*.
(* disclaimer below)
Is there a link between HIV and other STDs?
Having a sexually transmitted disease can increase your risk of acquiring and transmitting HIV. This is true whether you have open sores or breaks in the skin (as with syphilis, herpes, and chancroid) or not (as with chlamydia and gonorrhea). Where there are breaks in the skin, HIV can enter and exit the body more easily. Even when there are no breaks in the skin, STDs can cause biological changes that may make HIV transmission more likely. Studies show that HIV-infected individuals who are infected with another STD are three to five times more likely to contract or transmit the virus through sexual contact.
Are there other ways to avoid getting HIV through sex?
The male condom is the only widely available barrier against sexual transmission of HIV. Female condoms are fairly unpopular in the US and still relatively expensive, but they are gaining acceptance in some developing countries. Efforts are also underway to develop topical creams or gels called “microbicides,” which can be applied prior to sexual intercourse to kill HIV and prevent other STDs that facilitate HIV infection.
Are some people at greater risk of HIV infection than others?
HIV does not discriminate. It is not who you are, but what you do that determines whether you can become infected with HIV. Worldwide, sexual intercourse is by far the most common mode of HIV transmission, but in the US, as many as half of all new HIV infections are now associated either directly or indirectly with injection drug use (i.e., using HIV-contaminated needles to inject drugs or having sexual contact with an HIV-infected drug user). Overall, HIV infection is spreading fastest in this country among young people, women, African Americans, and Hispanics.
Are women especially vulnerable to HIV?
In western countries, women are four times more likely to contract HIV through vaginal sex with infected males than vice versa. This biological vulnerability is worsened by social and cultural factors that often undermine women’s ability to avoid sex with partners who are HIV-infected or to insist on condom use. In the US, the proportion of AIDS cases among women more than tripled from 7% in 1985 to 23% in 1999. African American and Hispanic women, who represent less than one-quarter of US women, represent nearly 80% of AIDS cases reported among American women to date.
Are young people at significant risk of HIV infection?
Nearly half of the roughly 40, 000 Americans newly infected with HIV each year are under the age of 25. Approximately two young Americans become infected with HIV every hour of every day, and about 25% of the people now living with HIV in this country became infected when they were teenagers. Statistics show that by the age of 19, at least half of females and 60% of males in this country have engaged in sexual intercourse, and one in six sexually experienced teens has contracted one or more STDs. Many young people also use drugs and alcohol, which can increase the likelihood that they will engage in high-risk sexual behavior.
Are there treatments for HIV/AIDS?
For many years, there were no effective treatments for AIDS. Today, people in the United States and other developed countries can use a number of drugs to treat HIV infection and AIDS. Some of these are designed to treat the opportunistic infections and illnesses that affect people with HIV/AIDS. In addition, several types of drugs seek to prevent HIV itself from reproducing and destroying the body’s immune system:
- Reverse transcriptase inhibitors attack an HIV enzyme called reverse transcriptase. They include abacavir, delavirdine, didanosine (ddI), efavirenz, lamivudine (3TC), nevirapine, stavudine (d4T), zalcitabine (ddC), and zidovudine (AZT);
- Protease inhibitors attack the HIV enzyme protease and include amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir.
Many HIV patients are taking several of these drugs in combination — a regimen known as highly active antiretroviral therapy (HAART). When successful, such combination or “cocktail” therapy can reduce the level of HIV in the bloodstream to very low, even undetectable, levels and sometimes enables the body’s CD4 immune cells to rebound to normal levels.
Researchers are working to develop new drugs known as fusion inhibitors and entry inhibitors that can prevent HIV from attaching to and infecting human immune cells. Efforts are also underway to identify new targets for anti-HIV medications and to discover ways of restoring the ability of damaged immune systems to defend against HIV and the many illnesses that affect HIV-infected individuals. Ultimately, advances in rebuilding the immune systems of HIV patients will benefit people with a number of serious illnesses, including cancer, Alzheimer’s disease, multiple sclerosis, and immune deficiencies associated with aging and premature birth.
Is there a cure for AIDS?
There is still no cure for AIDS. And while new drugs are helping some people with HIV/AIDS live longer, healthier lives, there are many problems associated with them:
- Existing treatments do not work for many people with HIV/AIDS.
- Anti-HIV drugs are highly toxic and can cause serious side effects, including heart damage, kidney failure, and osteoporosis. Many (perhaps even most) patients cannot tolerate long-term treatment with HAART.
- HIV mutates constantly. In as many as 40% of people on HAART, HIV mutates into new viral strains that have become highly resistant to current drugs, and as many as 10% of newly infected Americans are acquiring drug-resistant strains of the virus.
- Because treatment regimens are unpleasant and complex, many patients occasionally miss doses of their medication. Failure to take anti-HIV drugs on schedule and in the prescribed dosage can encourage the development of new viral strains that are resistant to current HIV drugs.
- Even among those who do respond well to treatment, HAART does not eradicate HIV. The virus continues to replicate at low levels and often remains hidden in “reservoirs” in the body, such as the lymph nodes and brain.
Importantly, roughly 95% of all people with HIV/AIDS live in the developing world, where there is virtually no access to antiretroviral treatments. In the US, HAART contributed to a significant decline in the annual number of AIDS-related deaths between 1996 and 1998. But the rate of this decline has now slowed markedly, and some communities have begun reporting an increase in AIDS deaths.
Is there a vaccine to prevent HIV infection?
Despite continued intensive research, experts believe it will be at least a decade before we have a safe, effective, and affordable AIDS vaccine. And even after a vaccine is developed, it will take many years before the millions of people at risk of HIV infection worldwide can be immunized. Until then, other HIV prevention methods, such as practicing safer sex and using sterile syringes, will remain essential.
Can you tell whether someone has HIV or AIDS?
You cannot tell by looking at someone whether he or she is infected with HIV or has AIDS. An infected person can appear completely healthy. But anyone infected with HIV can infect other people, even if no symptoms are present.
How can I know whether I’m HIV-infected?
Immediately after infection, some people may develop mild, temporary flu-like symptoms or persistent swollen glands. Even if you look and feel healthy, you may be infected. The only way to know your HIV status for sure is to be tested for HIV antibodies — proteins the body produces in an effort to fight off infection. This usually requires a blood sample. If a person’s blood has HIV antibodies, that means the person is infected.
Should I get tested?
If you think you might have been exposed to HIV, you should get tested as soon as possible. Here’s why:
- Even in the early stages of infection, you can take concrete steps to protect your long-term health. Many physicians still recommend a “hit early and hit hard” approach to anti-HIV therapy. But even if you don’t begin taking medications right away, regular check-ups with a doctor who has experience with HIV/AIDS will enable you (and your family members or loved ones) to make the best decisions about how and when to begin treatment, without waiting until you get sick. Taking an active approach to managing HIV may give you many more years of healthy life than you would otherwise have.
- If you are HIV-positive, you will be able to take the precautions necessary to protect others from becoming infected.
- If you are HIV-positive and pregnant, you can take medications and other precautions to significantly reduce the risk of infecting your infant, including refraining from breast-feeding.
How can I get tested?
Most people are tested by private physicians, at local health department facilities, or in hospitals. In addition, many states offer anonymous HIV testing. It is important to seek testing at a place that also provides counseling about HIV and AIDS. Counselors can answer questions about high-risk behavior and suggest ways you can protect yourself and others in the future. They can also help you understand the meaning of the test results and refer you to local AIDS-related resources.
Though less readily available, there is also a viral load test that can reveal the presence of HIV in the blood within three to five days of initial exposure, as well as highly accurate saliva tests that are nearly equivalent to blood tests in determining HIV antibody status. You can also purchase a kit that allows you to collect your own blood sample, send it to a lab for testing, and receive the results anonymously. Only the “Home Access” brand kit is approved by the Food and Drug Administration. It can be found at most drugstores.
Keep in mind that while most blood tests are able to detect HIV infection within four weeks of initial exposure, it can sometimes take as long as three to six months for antibodies to reach detectable levels. The CDC currently recommends testing six months after the last possible exposure to HIV.
The CDC’s National AIDS Hotline can answer questions about HIV testing and refer you to testing sites in your area. Operators are available toll-free, 24 hours a day, seven days a week, at:
- 1-800-342-2437 (English)
- 1-800-344-7432 (Spanish)
- 1-800-243-7889 (TTY/deaf access)
Where can I get more information about HIV and AIDS?
There are many valuable sources of HIV/AIDS information, including the following (NOT ON THE RAMAPO WEBSITE):
- The Centers for Disease Control and Prevention at http://www.cdc.gov/hiv/dhap.htm* or the phone numbers above
- Your state or local health department (see your local phonebook)
- Your local AIDS service organization (see your local phonebook)
- amfAR’s HIV/AIDS Treatment Directory at http://www.amfar.org/cgi-bin/iowa/td/index.html*
- HIV InSite at http://hivinsite.ucsf.edu*
- AEGIS (AIDS Education Global Information System) at http://www.aegis.com*
- The Body: An AIDS and HIV Information Resource at http://www.thebody.com*
(* disclaimer below)
How can I help fight HIV/AIDS?
Everyone can play a role in dealing with this epidemic. Here are just a few suggestions for how you can make a difference in the fight against HIV/AIDS:
- Volunteer with your local AIDS service organization.
- Talk with the young people you know about HIV/AIDS.
- Urge government officials to provide adequate funding for AIDS research, prevention education, medical care, and support services.
- Speak out against AIDS-related discrimination.
- Support continued research to develop better treatments and a safe and effective AIDS vaccine by making a donation to [organizations such as] amfAR.
This information was provided by The American Foundation for AIDS Research (amfAR).
From the National Institute of Allergy and Infectious Diseases
- As of the end of 2001, an estimated 40 million people worldwide – 37.2 million adults and 2.7 million children younger than 15 years – were living with HIV/AIDS. More than 70 percent of these people (28.1 million) live in Sub-Saharan Africa; another 15 percent (6.1 million) live in South and Southeast Asia.
- Worldwide, approximately one in every 100 adults aged 15 to 49 is HIV-infected. In Sub-Saharan Africa, about 8.4 percent of all adults in this age group are HIV-infected. In 16 African countries, the prevalence of HIV infection among adults aged 15 to 49 exceeds 10 percent.
- Approximately 48 percent of adults living with HIV/AIDS worldwide are women.
- An estimated 5 million new HIV infections occurred worldwide during 2001; that is, about 14,000 infections each day. More than 95 percent of these new infections occurred in developing countries.
- In 2001, approximately 6,000 young people aged 15 to 24 became infected with HIV every day – that is, about five every minute.
- In 2001 alone, HIV/AIDS-associated illnesses caused the deaths of approximately 3 million people worldwide, including an estimated 580,000 children younger than 15 years.
- Worldwide, more than 80 percent of all adult HIV infections have resulted from heterosexual intercourse.
HIV/AIDS in the United States
From the National Institute of Allergy and Infectious Diseases
- The Centers for Disease Control and Prevention (CDC) estimate that 800,000 to 900,000 U.S. residents are living with HIV infection, one-third of whom are unaware of their infection.
- Approximately 40,000 new HIV infections occur each year in the United States, about 70 percent among men and 30 percent among women. Of these newly infected people, half are younger than 25 years of age.
- Of new infections among men in the United States, CDC estimates that approximately 60 percent of men were infected through homosexual sex, 25 percent through injection drug use, and 15 percent through heterosexual sex. Of newly infected men, approximately 50 percent are black, 30 percent are white, 20 percent are Hispanic, and a small percentage are members of other racial/ethnic groups.
- Of new infections among women in the United States, CDC estimates that approximately 75 percent of women were infected through heterosexual sex and 25 percent through injection drug use. Of newly infected women, approximately 64 percent are black, 18 percent are white, 18 percent are Hispanic, and a small percentage are members of other racial/ethnic groups.
- In the United States, 774,467 cases of AIDS had been reported to the CDC through December 31, 2000.
- The estimated number of new adult/adolescent AIDS cases diagnosed in the United States was 49,691 in 1997, 42,955 in 1998, and 41,680 in 1999.
- In 2000, 41,960 new cases of AIDS in adults/adolescents were reported in the United States. In the same year, 196 new pediatric (<13 years old) AIDS cases were reported.
- The rate of adult/adolescent AIDS cases reported in the United States in 2000 (per 100,000 population) was 74.2 among blacks, 30.4 among Hispanics, 12.7 among American Indians/Alaska Natives, 7.9 among whites, and 4.3 among Asians/Pacific Islanders.
- From 1985 to 2000, the proportion of adult/adolescent AIDS cases in the United States reported in women increased from 7 percent to 25 percent.
- As of the end of 2000, an estimated 322,685 people in the United States were living with AIDS.
- As of December 31, 2000, 448,060 deaths among people with AIDS had been reported to the CDC. AIDS is now the fifth leading cause of death in the United States among people aged 25 to 44, and is the leading cause of death for black men in this age group. Among black women in this age group, HIV ranks third.
- The estimated annual number of AIDS-related deaths in the United States fell approximately 67 percent from 1995 to 1999, from 50,877 deaths in 1995 to 16,767 deaths in 1999.
- Of the estimated 16,767 AIDS-related deaths in the United States in 1999, approximately 50 percent were among blacks, 30 percent among whites, 18 percent among Hispanics, and less than 1 percent among Asians/Pacific Islanders and American Indians/Alaska Natives.
What Do Women Need to Know
From the Body.com
- More women are being infected through heterosexual sex. Many women think AIDS is a disease of gay men. But women get HIV from sharing needles and from heterosexual sex. Heterosexual sex is a growing source of HIV infection in women in the US.
- During sex, HIV is transmitted from men to women much more easily than from women to men. A woman’s risk of infection is higher with anal intercourse, or if she has a vaginal disease.
- Women should know the HIV risk factors for their sex partners. The risk of infection is higher if your sex partner is or was an injection drug user, has other sex partners, has had sex with infected people, or has sex with men. Talk about these risk factors and take steps to protect yourself.
- If you are not absolutely certain about your sex partner’s HIV status, take precautions. Using a condom correctly can prevent most cases of HIV infection. See Fact Sheet 152 for more information on using condoms correctly.
- Many women feel they can not ask their boyfriends or husbands to use condoms. But condoms are the safest way to avoid HIV infection. There is a female condom that provides some protection, but not as much as a male condom. Other forms of birth control, such as birth control pills, diaphragms, or implants do NOT provide protection against HIV.
- Get tested for HIV if you think a sex partner might be at risk. Many women don’t find out they have HIV until they become ill or get tested during pregnancy. If women don’t get tested for HIV, they seem to get sick and die faster than men. But if they get tested and treated, they live as long as men.
- Viral loads may be lower in women. Several studies have shown that women may have lower viral loads during the first few years of HIV infection. At this point, treatment guidelines are the same for women and men.
- Vaginal problems can be early signs of HIV infection. Ulcers in the vagina, or yeast infections that come back within 2 months and don’t clear up easily, can be signs of HIV. Hormone changes, birth control pills, or antibiotics can also cause them. See your doctor to make sure you know the cause.
- Mothers can pass HIV infection to their babies. When a woman with HIV gets pregnant, she can pass HIV to her unborn child. Also, a mother’s breast milk can infect her new baby. See Fact Sheet 611 for more information on HIV and pregnancy.
HIV/AIDS and Young People
From the Body.com
- As is true in much of the world, young women are increasingly at risk of HIV infection in the United States. A 1998 study by the CDC found that HIV prevalence was 50% higher for young women than for young men. Many young women do not have the power either to avoid sex with partners who may be HIV-infected or to ensure the use of condoms, and it is believed that many HIV-positive young women are infected by men older than themselves.
- Men who have sex with men remain at very high risk. At least half of the HIV infections reported in 1999 among young men aged 13 to 24 occurred among men who have sex with men. A seven-city study conducted between 1994 and 1998 found that just over 7% of young men who have sex with men are HIV-positive; the rates increased with age and were higher among African Americans, Hispanics, and men of mixed race than among Caucasian or Asian/Pacific Islanders.
- Minority youth are disproportionately affected by HIV/AIDS. African Americans and Hispanics constitute about 15% of U.S. teenagers; yet, African Americans represent 49% of the 3,725 AIDS cases reported to date among those aged 13 to 19, and 67% of the 4,796 HIV infections reported to date in this age group. Hispanics account for 20% of AIDS cases among teens. Among people ages 20 to 24, young adults from racial or ethnic minority groups account for about 65% of AIDS cases reported so far. And young women of color account for 78% of AIDS cases among young women.
From the National Institute of Allergy and Infectious Diseases
- Through December 2000, 4,061 cases of AIDS in people ages 13 through 19 had been reported to the U.S. Centers for Diseases Control and Prevention (CDC). Many other adolescents are currently infected with HIV but have not yet developed AIDS. Data from the 36 states that conduct HIV case surveillance indicate that among adolescents ages 13 through 19:
- 58 percent were male
- 42 percent were female
- 28 percent were White, not Hispanic
- 50 percent were Black, not Hispanic
- 20 percent were Hispanic
- Asian/Pacific Islander or American Indian/Alaskan Native, less than 1 percent
- Because the average period of time from HIV infection to the development of AIDS is 10 years, most young adults with AIDS were likely infected with HIV as adolescents. Almost 18 percent of all reported cases of AIDS in the United States have occurred in people between the ages of 20 and 29. HIV infection is the ninth leading cause of death in adults ages 25-44.
HIV Infection in Minority Populations
From the National Institute of Allergy and Infectious Diseases
- Minority populations in the United States, primarily African Americans and Hispanics, constitute 56 percent of the more than 700,000 cases of AIDS reported to the U.S. Centers for Disease Control and Prevention (CDC) since the epidemic began in 1981. African Americans make up almost 37 percent of all AIDS cases reported in the United States, yet according to the U.S. Census Bureau, they comprise only 12 percent of the U.S. population. In 1999, Hispanics represented 18 percent of new AIDS cases. Including residents of Puerto Rico, they represent 13 percent of the population in this country.
- According to CDC:
- As of June 2000, African Americans and Hispanics represented 62 percent of AIDS cases reported among men and 81 percent of those in women. Forty-seven percent of reported cases were among African Americans, 19 percent among Hispanics.
- In 1999, the rate of new AIDS cases reported per 100,000 population was 66.0 among African Americans, 25.6 among Hispanics, 8.8 among American Indians/Alaska Natives, and 3.4 among Asians/Pacific Islanders. The rate for African Americans is more than nine times higher than for whites (7.6).
- Almost 58 percent of all women reported with AIDS are African American.
- As of June 2000, Hispanic women represented 20 percent of reported AIDS cases in women.
- African American children represent 58 percent of all pediatric AIDS cases.
- As of June 2000, 224 of 263 (85 percent) pediatric AIDS cases were in African Americans and Hispanics.
- In 1999, AIDS accounted for an estimated 50 percent of deaths among African Americans and 18 percent among Hispanics.
- Injection drug use is a major factor in the spread of HIV in minority communities. Through June 2000, injection drug users accounted for 37 percent of all AIDS cases among both African Americans and Hispanics.
Men and HIV/AIDS
From the UNAIDS website.
- Globally, over half of all people living with HIV/AIDS are men (53%).
- In most regions of the world, two-thirds or more of the people living with HIV/AIDS are men:*
- Australia, New Zealand and Eastern Pacific = 92% (MSM);
- South and Southeast Asia = 65% (Hetero, IDU);
- East Asia and Western Pacific = 87% (MSM , Hetero, IDU);
- Latin America = 75% (MSM, IDU, Hetero);
- North America = 80% (MSM, IDU, Hetero);
- Western Europe = 75% (MSM, IDU);
- Caribbean = 60% (MSM , Hetero);
- North Africa and the Middle East = 80% (Hetero, IDU);
- Eastern Europe and Central Asia = 77% (IDU);
- Sub-Saharan Africa = 45% (Hetero).
- Since the beginning of the epidemic, AIDS has been responsible for more than 9 million deaths among men.
- All over the world, men tend to have more extramarital partners, thereby increasing their own and their primary partners’ risk of contracting HIV.
- Over 70% of HIV infections worldwide occur through sex between men and women.
- 5-10% of HIV infections worldwide occur through sex between men.
- 5% or so of HIV infections worldwide occur among people who inject drugs, four-fifths of whom are men.
* Modes of transmission: Hetero (heterosexual transmission), IDU (transmission through injecting drug use), MSM (sexual transmission among men who have sex with men).
- Atlantic City Health Department*
This agency also conducts counseling and testing at designated sites in the following counties: Cape May, Cumberland, Gloucester & Salem
- Bergen County Counseling Center Hackensack
- Camden County Health Department* Blackwood
This agency also conducts counseling and testing at designated sites in Burlington County
- Camden AHEC (Mobile Unit)
- St. Michaels Medical Center – Newark
- East Orange Health Department – East Orange
- Newark Community Health Center – Newark
- UMDNJ – STOP (Mobile Unit) – Newark
- Newark Beth Israel Medical Center – Newark
- Jersey City Medical Center – Jersey City
- Hunterdon County Department of Health – Flemington
This agency conducts counseling and testing at designated sites in Warren County.
- Henry J. Austin Health Center – Trenton
- Robert Wood Johnson Medical School – New Brunswick
This agency conducts counseling and testing at designated sites in Somerset County.
- Raritan Bay Medical Center – Perth Amboy
- Monmouth Regional Screening Center – Neptune (Jersey Shore Medical Center)
- CheckMate Inc. (Mobile Unit) Asbury Park
- Morristown Memorial Hospital Morristown
- Ocean County Health Department – Toms River
(732) 341-9700 ext. 7502
- St. Joseph’s Hospital and Medical Center – Paterson
- Hyacinth Foundation – Plainfield
- Plainfield Community Health Center – Plainfield
(908) 753-6401 ext. 138
- Elizabeth General Medical Center – Elizabeth
(908) 965-7300 or 965-7605
On February 14, 2001, the question was first asked at Ramapo College. In a meeting with a committee group that set out to plan our annual AIDS Awareness Week, we developed the question that launched this website. Can You Afford to Ignore It? With these few words, we changed the way we approached education, awareness raising, and advocacy for HIV/AIDS issues. With this one question, we challenged the apathy that so many times we hear regarding health issues.
The question was clear, simple, and complete complex. In its simplicity lies the complexities for the question challenges how each of us look at HI and our place in its pandemic map. Pushing through this idea, we developed programs that would equally ask simple questions that required complex, deeper answers. However, on April 2nd of that same year, a new muse presented a new idea. AIDS awareness is not simply one week of events and the recognition of one day in December, but an ongoing awareness of being safe when we are at our most vulnerable. It is about knowing what the real deal is with this disease and knowing enough to be safe and not have to sit in a waiting room waiting to see what a simple blood test will reveal. With the delay of a fundraising dance, we changed the theme of our awareness week into a full fledge campaign that would be in all our faces whenever we roam the halls of our campus.
“HIV: Can You Afford to Ignore It?” is a multimedia campaign that is going beyond anything that has ever been done at Ramapo. From posted ads on bulletin boards to commercials on our campus’s media networks, the message will be heard, seen and read.
Our goal is to assure that members of our community will be better educated about HIV/AIDS and will become advocates in their own right by spreading the knowledge they gain. Our goal is to give a new perspective to HIV awareness and show how all of us can NOT afford to ignore it.
Below are some basic questions and answers about sexually transmitted diseases (STDs). STDs impact all individuals regardless of sex, gender, race/ethnicity, sexual orientation, creed, or social class. For more information on specific and general STDs, testing sites, prevention, etc., visit The Center for Health and Counseling Services (D216/E115), The Women’s Center (C220), Queer Peer Services (C220), or your own health practitioner.
What are sexually transmitted diseases (STDs)?
STDs are diseases that you get by having sex (intercourse, oral or anal) with someone who already has a STD. STDs are some of the most common infectious diseases (diseases that you get from another person) in the United States today. There are more than 20 kinds of STDs that affect more than 13 million women and men in this country each year.
What causes STDs?
STDs are caused by bacteria and viruses. STDs caused by bacteria include chlamydia (“kla-mi-dee-a”), gonorrhea (“gon-or-ree-a”), trichomoniasis (“trik-o-mo-ni-a-sis”), and syphilis (“si-fi-lis”). These STDs can be treated and cured with antibiotics.
STDs caused by viruses include HIV/AIDS, genital herpes, genital warts, and cytomegalovirus (“si-to-meg-a-low-vi-rus”). These STDs can be controlled, but not cured. There is no way to get any of these viruses out of a person’s body once he or she has become infected. Finding and treating STDs early is the best way to take care of you.
What are the most important things for me to know about STDs?
Here is what you need to know about STDs:
- People of all ages, colors, religious backgrounds, and income and education levels get STDs.
- Teenagers and young adults get STDs more often than any other age group. This is because they tend to start having sex at a younger age and have more sex partners. Almost two-thirds of STDs occur in people less than 25 years old.
- The total number of STD cases is going up.
- Many women do not have any obvious signs that they have a STD. Also, the signs of STDs can be confused with other problems and women may not get the right treatment.
- Even if a person has no signs of a STD, he or she can still be infected and pass on the disease.
- Women have a higher chance of getting a STDs than men. Young women have more chance of getting a STDs than older women.
- Women are more likely to have serious health problems from STDs such as:
- Pelvic Inflammatory Disease (PID) – an infection in the uterus, ovaries, and/or fallopian tubes that can cause infertility (not being able to get pregnant) or an ectopic pregnancy (a pregnancy in the fallopian tubes instead of in the uterus).
- Human papillomavirus (HPV) – an infection that can lead to cervical cancer.
- Infant death or disability – mothers with STDs can infect their babies. Some babies die from the infection and other babies are born with serious health problems.
How can I keep from getting STDs?
Here are ways to keep from getting STDs:
- Do not have sex (intercourse, oral, or anal).
- If you have sex:
- use a condom (also use a condom for oral and anal sex);
- ask your sex partner(s) if he or she has HIV/AIDS or other STDs, has had sex with someone who has an STD, or has sores, rashes, or discharge in the genital area; and
- get regular check-ups for STDs if you have sex with more than one person. Get a check-up even if you don’t have any signs of a STD. A check-up cannot prevent STDs, but it can help to detect them in their early stages so they can be treated.
How can I take care of others and myself if I have a STD?
Here’s how you can take care of yourself and others:
- Take all your medicine.
- Tell your sex partner(s) about your infection so that they can be tested and treated right away.
- Do not have sex when you are getting treatment for a STD.
- Use a condom when you have sex after being treated for a STD.
- Do not touch any open sores or rashes from a STD.
- If you do touch an open sore, wash your hands right away
All plants and animals that reproduce sexually may develop sexually transmitted infections. They are also very common among humans. Unfortunately, many people consider sexually transmitted infection a moral issue. But the stigma and shame that result may lead people to neglect taking good care of their sexual health. Many people find it very difficult to talk about their sexual health. But discomfort and shame can get in the way of common sense. They can keep people from taking good care of themselves and their partners by practicing safer sex and getting annual sexual-health checkups with their health care providers.
Safer-sex practice allows couples to reduce their sexual health risks. Safer sex is anything we do to lower our risk of sexually transmitted infection. The basic rule for safer sex is to prevent contact with genital sores and prevent the exchange of body fluids, such as semen, blood, and vaginal secretions.
For good sexual health care, choose a clinician with whom you can be comfortable while discussing these issues. Keep yourself healthy by speaking frankly and openly with your clinician about your sex life and your sexual health concerns. Some clinicians don’t ask – so take charge and speak up. Remember, testing, examination, and treatment for sexually transmitted infections are always confidential.
If you or your partner has any of the following symptoms in the genital area, see a clinician right away:
- abnormal or smelly discharges from the vagina, penis, rectum
- burning sensations
- painful intercourse
- urine changes
- vaginal yeast infections
Some symptoms of sexually transmitted infections are like those of other kinds of infections. They may not even show up in the genital area. But they are serious and mean something is wrong with your health, whether or not they are sexually transmitted. Seek medical advice if any of the following symptoms persist:
- weight loss that is constant, rapid, or unexplained
- coatings of the mouth, throat, or vagina
- abdominal pain
- aching joints
- appetite loss
- bowel problems
- discolored skin
- feeling run down
- general weakness
- hair loss
- hearing loss
- mental disorders
- muscular pain
- night sweats
- sore throat
- swollen glands
- vision loss
Chlamydia is a type of bacteria. It can cause sterility in women and men. In women, it infects the cervix and can spread to the urethra, fallopian tubes, and ovaries. It can cause bladder infections and serious pelvic inflammatory disease (PID), ectopic pregnancy, and sterility. In men, chlamydia infects the urethra and may spread to the testicles, causing epididymitis, which can cause sterility.
Chlamydia can also lead to Reiter’s syndrome – especially in young men. Reiter’s syndrome involves eye infections, urethritis, and arthritis. One in three men who develop Reiter’s syndrome become permanently disabled. In infants, chlamydia can cause pneumonia, eye infections, and blindness. Chlamydia is the most common and most invisible sexually transmitted bacterial infection in America. Three million American men and women become infected every year.
- discharge from the penis or vagina
- pain or burning while urinating, more than usual urination
- excessive vaginal bleeding
- painful intercourse for women
- spotting between periods or after intercourse
- abdominal pain, nausea, fever
- inflammation of the rectum or cervix
- swelling or pain in the testicles
Up to 85 percent of women and 40 percent of men with chlamydia have no symptoms. Many women discover they have chlamydia only because their partners are found to be infected. Other women discover that they must have had it for some time when they are treated for the infertility that it can cause. Symptoms appear in seven to 21 days – if they appear. If your partner is a man, and he has a urinary tract infection, you may have chlamydia.
How chlamydia is spread
- vaginal and anal intercourse
- from the birth canal to the fetus
- rarely, from the hand to the eye
Can be confused with gonorrhea and other conditions. Examination of tissue samples or urine is necessary for correct diagnosis.
Both partners can be treated successfully with antibiotics.
Condoms offer very good protection against chlamydia.
There are more than 60 different human papilloma viruses (HPVs). They cause a variety of warts and other conditions and can remain in the system for life. A few HPVs cause genital warts, but most genital HPV infections are not visible and have no symptoms. Some of these are associated with cancer of the cervix, vulva, or penis. Every year, about 5.5 million Americans are newly infected with genital HPVs – 20 million women and men are now infected. Studies suggest that as many as three-quarters of adults in the United States have been infected with at least one type of HPV virus.
- warts on the genitals, in the urethra, in the anus, and, rarely, in the throat
- genital warts are soft to the touch, may look like miniature cauliflower florets,
and often itch
- untreated genital warts can grow to block the openings of the vagina, anus, or throat and become quite uncomfortable.
It usually takes two to three weeks after infection for warts to develop. In women, genital warts grow more rapidly during pregnancy or when other infections are present.
How genital HPVs are spread
- vaginal and anal intercourse
- very rarely, genital warts spread to the fetus during childbirth.
- oral sex
- microscopic examination of tissue sample
- clinical evaluation of warts during a physical or gynecological exam
- special magnifiers – colposcopes – can detect genital HPVs that cannot be seen with the naked eye during pelvic exams
- Pap tests may reveal precancerous conditions caused by genital HPVs – early treatment prevents cancer of the cervix.
No cure for HPV. Though they may recur, genital warts can be treated in a number of ways. They may be removed by carefully applying, and often reapplying, a prescription medication – podofilox or imiquimod – to the wart. Clinicians offer other treatments, including:
- application of podophyllin or acid
- standard surgery
- laser surgery (vaporizing the wart with a beam of high-powered light)
- cryosurgery (freezing the wart with liquid nitrogen)
- injection of interferon.
Condoms may offer some protection against genital HPVs, but the viruses may “shed” beyond the area protected by a condom
Gonorrhea is a bacterium that can cause sterility, arthritis, and heart problems. In women, gonorrhea can cause pelvic inflammatory disease (PID), which can result in ectopic pregnancy or sterility. During pregnancy, gonorrhea infections can cause premature labor and stillbirth. To prevent serious eye infections that can be caused by gonorrhea, drops of antibiotics are routinely put into the eyes of newborn babies immediately after delivery. More than 600,000 new cases of gonorrhea are reported every year in the U.S.
- For women: frequent, often burning urination; menstrual irregularities, pelvic or lower abdominal pain; pain during sex or pelvic examination; a yellowish or yellow-green discharge from the vagina; swelling or tenderness of the vulva; and even arthritic pain.
- For men: a pus-like discharge from the urethra or pain during urination. Eighty percent of the women and 10 percent of the men with gonorrhea show no symptoms. If they appear, they appear in women within 10 days. It takes from 1-14 days for symptoms to appear in men.
How gonorrhea is spread
- vaginal, anal, and oral intercourse.
Microscopic examination of urethral or vaginal discharges. Cultures taken from the cervix, throat, urethra, or rectum.
Both partners can be successfully treated with oral antibiotics. Often people with gonorrhea also have chlamydia. They must be treated for both infections at the same time.
Condoms offer very good protection against gonorrhea.
Although 90-95 percent of adults with HBV recover completely, the virus can cause severe liver disease and death. Unless they are treated within an hour of birth, 90 percent of the infants born to women with HBV will carry the virus. Pregnant women who may have been exposed to HBV should consider being tested before giving birth so that their babies can be vaccinated at birth or treated if they become ill. Like many other viruses, HBV remains in the body for life.
HBV is the only sexually transmitted infection that is preventable with vaccination. But about 77,000 Americans get HBV every year because they have not been vaccinated. There are now about 75o,000 people with sexually acquired HBV in the U.S.
- extreme fatigue, headache, fever, hives
- lack of appetite, nausea, vomiting, tenderness in the lower abdomen.
Later symptoms: more abdominal pain, dark urine, clay-colored stool, yellowing of the skin and white of the eye – jaundice. HBV may show no symptoms during its most contagious phases. If symptoms appear, they appear within four weeks.
How HBV is spread
In semen, saliva, blood, and urine by:
- intimate and sexual contact, from kissing to vaginal, anal, and oral intercourse
- use of unclean needles to inject drugs
- accidental pricks with contaminated needles in the course of health care. Hepatitis B is very contagious.
None. In most cases the infection clears within 4-8 weeks. Some people, however, remain contagious for the rest of their lives.
Condoms offer some protection against HBV during vaginal, anal, and oral intercourse, but the virus can be passed through kissing and other intimate touching. Children and adults who do not have HBV can get permanent protection with a series of HBV vaccinations.
There are two forms of genital herpes – herpes simplex virus-1 and herpes simplex virus-2. Although herpes-1 is most often associated with cold sores and fever blisters, both forms of herpes may be sexually transmitted. During pregnancy, herpes may cause miscarriage or stillbirth. If active herpes infections are present during childbirth, newborn infants may suffer serious health damage, including developmental disabilities and, rarely, death. Transmission to a newborn is more common during the first episode of the herpes infection and less common during recurrent herpes outbreaks. More than 45 million Americans have been diagnosed with genital herpes. One million new cases are diagnosed every year. Like many other viruses, the herpes simplex virus (HSV) remains in the body for life.
- a recurring rash with clusters of itchy or painful blistery sores appearing on the vagina, cervix, penis, mouth, anus, buttocks, or elsewhere on the body
- painful ulcerations that occur when blisters break open
- the primary outbreak may cause pain and discomfort around the infected area, itching, burning sensations during urination, swollen glands in the groin, fever, headache, and a general run-down feeling.
Symptoms usually appear from 2-20 days after infection – but it may be years before an outbreak occurs.
Recurrences are sometimes related to emotional, physical, or health stresses. During recurrences it is important to observe strict rules of day-to-day hygiene. Wash hands frequently and do not touch the sores. If the sores are touched inadvertently, wash hands immediately. Be particularly careful when handling contact lenses and touching the eyes.
How HSV is spread
- touching, sexual intimacy – including kissing
- vaginal, anal, and oral intercourse.
HSV may be passed from one partner to another, or from one part of the body to another, whenever contact is made with an active herpes virus. Oral sex play can pass herpes from the mouth to the genitals or from the genitals to the mouth.
HSV is most contagious from the time the sores are present until they are completely healed and the scabs have fallen off. Unfortunately, recent studies show that some people may be contagious when they have no symptoms. Mucous membranes of the mouth, anus, vagina, penis, and the eyes are especially susceptible to infection.
Can be confused with syphilis, chancroid, and other sexually transmitted infections. Examination of the sores and laboratory culturing of fluid samples taken from the sores are important. Definitive diagnosis may not be possible if the sores are dried or scabbed by the time you see a clinician. If you think you have herpes, it is important to have a diagnosis early in the outbreak.
No cure. Symptoms can be relieved and the number of recurrences reduced with the drugs valacyclovir, acyclovir, and famciclovir.
Partners should refrain from sexual intimacy from the time they know the blisters are going to recur until after the scabs have completely fallen off the healed sores. Condoms offer some protection against the virus between outbreaks.
Untreated, the syphilis organism – “spirochete” – can remain in the body for life and lead to disfigurement, neurologic disorder, or death. The annual number of reported cases of syphilis in the U.S. has dropped to 70,000 because of effective antibiotics and increased condom use.
- Syphilis has several phases that may overlap one another. They do not always follow in the same sequence. Symptoms vary with each phase, but there are no symptoms most of the time.
- Primary Phase: Painless sores or open, wet ulcers – chancres – often appear from three weeks to 90 days after infection. They last three to six weeks. They appear on the genitals, in the vagina, on the cervix, lips, mouth, or anus. Swollen glands may also occur during the primary phase.
- Secondary Phase: Other symptoms often appear from three to six weeks after the sores appear. They may come and go for up to two years. They include body rashes that last from two to six weeks – often on the palms of the hands and the soles of the feet. There are many other symptoms, including: mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache, and muscle pains.
- Latent Phase: No symptoms. Latent phases occur between other phases or can overlap them.
- Late Phase: One-third of untreated people with syphilis experience serious damage to the nervous system, heart, brain, or other organs, and death may result.
How syphilis is spread
- vaginal, anal, and oral intercourse
- during pregnancy.
Syphilis is especially contagious when sores are present early in the disease – the liquid that oozes from them is very infectious. People are usually not contagious during the latent phases of the first four years of syphilis infections. Untreated syphilis remains latent for many years or a lifetime, but can be spread from a pregnant woman to her fetus.
The effect of syphilis on a fetus is very serious. If untreated, the risks of stillbirth or serious birth defects are high. Birth defects include damage to the heart, brain, and skeleton as well as blindness. It is very important for pregnant women to consider testing for syphilis early, and, sometimes, throughout their pregnancies. Pregnant women with syphilis can be treated to prevent damage to the fetus.
- microscopic examination of fluid from sores
- blood tests
- examination of spinal fluid.
Antibiotics are successful for both partners – but damage caused by the disease in the later phases cannot be undone.
Condoms offer very good protection during vaginal, anal, and oral intercourse.