Monday, March 30, 2009
We know that gay men are at higher risk for HIV. What about lesbian women?
HIV can be transmitted when infected blood and/or vaginal secretions come into contact with a woman's genitals, mouth or with open cuts anywhere on the body. Hence, it is important that when making physical contact to cover the hand with a latex glove. Nothing should be inserted directly in the vagina or around the genital area or anus after it has been in a woman's vagina. This can spread vaginal infections and STDs.
Oral sex between lesbians may still pose a threat for HIV transmission. A dental dam, a split latex glove, or condom is recommended as safety precautions to be used during lesbian sex in order to protect both parties.
What does testing positive for HIV mean? What is meant by the window period? How does a false positive relate to it?
It is important when receiving an HIV test to ask what kind of test is being used. Whenever someone is screened for HIV, two types of tests are used. They are, 1) a reactive test, and 2) a confirmatory test. A reactive HIV test indicates if HIV antibodies are in the blood (such as the Elisa Test). A reactive test may give a false positive reading to anyone with kidney or renal failure, to a woman that has had multiple pregnancies, anyone receiving the influenza vaccine, or to anyone that has received gamma globulin. When a reactive test has a negative result, that means no HIV antibodies were detected. But in order to receive an accurate reading, the CDC recommends you wait a specific window period: six weeks to six months and either abstain from all sexual activity, or practice safe sex in every sexual situation, and then get a confirmatory test, such as the Western Blot Test.
A confirmatory test (such as the Western Blot) provides the HIV status of a person. A positive test result on a confirmatory test means that the person has been infected with HIV, has HIV antibodies in his or her blood, and can infect others.
Can HIV be transmitted through semen during oral sex?
If I'm pregnant and have HIV, will my baby have HIV too?
What research and advances have investigators made concerning HIV/AIDS and women?
Is there any treatment or a cure for HIV/AIDS?
How can I reduce my chances of contracting the human immunodeficiency virus (HIV), the virus that causes AIDS?
What are the symptoms of HIV/AIDS in women?
It is possible for a person infected with HIV to show no signs of infection. For women, the most common symptoms of exposure to the HIV virus are frequent or severe vaginal infections, abnormal PAP smears, or pelvic infections (PID) that are difficult to treat.
Within a few weeks of having been infected, many people have flu-like symptoms. However, in some cases, symptoms do not show for many years. As the infection progresses, some symptoms can include 1) swollen lymph glands in the neck, underarm, or groin area, 2) recurrent fever including "night sweats," 3) rapid weight loss for no apparent reason, 4) constant tiredness, 5) diarrhea and decreased appetite, 6) white spots or unusual blemishes in the mouth.
Saturday, March 28, 2009
Who provides HIV and AIDS care in the home? – Family and friends
What HIV care is needed at home?

Although people living with HIV can be healthy and strong and live perfectly ‘normal’ lives they can experience a range of symptoms that will affect their day-to-day life, and for which they will need care and assistance. In a survey of home-based care patients in Malawi just 15% were able to live as if they did not have the disease. More than one-third needed help with washing and walking, and 28% needed help going to the toilet.11 In a study in South Africa, around 16-17% of people could not control their bladders or bowels and needed help getting on and off the toilet. A similar proportion required help with washing themselves. Poor sanitation makes many of these tasks all the more difficult. In the South African survey less than half of the households had a tap and only 20% of rural homes had access to a flush toilet, with a quarter having no access to any form of toilet or latrine.1
Given the often debilitating effects of HIV, people living with the disease may need assistance performing simple tasks that most of us would take for granted. These could include washing, cooking, feeding, cleaning, purchasing household essentials, going to the toilet and other needs not necessarily specific to AIDS but essential in helping a person live a relatively stable life.
More HIV-related tasks could include purchasing, administering and supporting adherence to ARV drugs and pain relief medication if the infected person is receiving such treatment, as well as helping with nutrition, as the person’s diet may differ from other members of the household. Monitoring and recording progress, making notes of events such as toilet visits, fluid intake and symptom occurrence are also other tasks that can be undertaken by family and home-based care workers and volunteers.13 These very practical measures are in addition to seeing to the person’s social, psychological and emotional needs – often termed ‘psychosocial’ needs – which all of us have but which are often broader and more severe if living with HIVWhy HIV and AIDS care in the home?
The diminished capacity of many countries’ health sectors makes the prospect of having people with HIV treated at home all the more attractive to governments. One South African hospital reported patients’ average stay decreased from 14 days to 3.5 days when referred to a home-based care organisation.6
A potential benefit of being cared for at home is that sick people are continually surrounded by people they love and are familiar with, so they can also receive more flexible and nurturing care. They will also not be exposed to hospital-based infectious diseases. As people with terminal illness generally spend their final moments at home, strengthening the capacity to be cared for also removes the cost and distress of travelling to and from the hospital when they are weakest.
In the UK, the majority of people die in hospital despite between 56% and 74% of people preferring to die at home.7 One cancer patient stated his preferred location of care as:
“Here at home. It’s because I have got my family support here, because the kids are good. My stepson lives with us and my step daughter turns up every now and again.“8
Furthermore, in being cared for at home, a person with HIV may be in a more ready position to work or look after family members for short periods of time while the primary earners work. The family’s time that would otherwise be used travelling to and from hospital can instead be spent doing house work and looking after other family members. Expenditure on transport and hospital costs is also reduced.9
Despite the potential benefits of being cared for at home, often there is little choice as to where someone with HIV is cared for. As mentioned, health facilities may not be able to cope and furthermore, fear of stigma and discrimination from doctors and nurses directed towards people living with HIV could deter people from seeking care in a medical setting. So too could a lack of knowledge that effective treatment is available.10
Why HIV and AIDS care in the home?
In many African countries the adult prevalence rate is over 15%, with the number of infected people as high as 5.7 million in South Africa1.5 million in Mozambique and 2.6 million in Nigeria. Typically, countries with high prevalence have overstretched health systems, a lack of resources and among the lowest levels of hospital beds and health workers per person. The massive epidemic itself contributes to the overburdened health sector. In Kenya, for example, 50-60% of public hospital beds are occupied by HIV patients.2
Country | Doctors per 1000 population3 | Nurses per 1000 population4 | Adult (15-49) HIV Prevalence5 |
---|---|---|---|
Tanzania | 0.02 | 0.37 | 6.2% |
Namibia | 0.30 | 3.06 | 15.3% |
Botswana | 0.40 | 2.65 | 23.9% |
United States | 2.56 | 9.37 | 0.6% |
France | 3.37 | 7.24 | 0.4% |
Cuba | 5.91 | 7.44 | 0.1% |
There are relatively few health workers per person in many African countries making the home the likely location of HIV and AIDS care.
Friday, March 27, 2009
Women and children

Although there are drugs that can reduce the chances of a child acquiring HIV from its mother from about 40% to less than 2%, they are unavailable in many parts of the world. In recent years drugs companies have significantly reduced the price of drugs such as nevirapine and AZT, which help to prevent MTCT in developing countries. However, because of limited human resources and poor infrastructures, many women are still not receiving these drugs. See Preventing Mother-to-child Transmission Worldwide for more information
How is the HIV/AIDS epidemic affecting women?

Caring for ill parents, children or husbands is unpaid and can increase a person’s workload by up to a third17. Women often struggle to bring in an income whilst providing care and therefore many families affected by AIDS suffer from increasing poverty. In some areas of sub-Saharan Africa where a family’s livelihood relies on growing and maintaining crops, the death of farmers can lead to famine18.
The HIV/AIDS epidemic also affects young girls and elderly women. Often households where both the husband and the wife are ill from AIDS, girls are usually the main carers, even if it means that they have to miss school. If both parents die then it tends to be the grandmothers, aunts or cousins who then look after the AIDS orphans
Women and HIV/AIDS - the global picture

Sub-Saharan Africa is one region of the world where the majority of HIV transmission occurs during heterosexual contact. As women are twice as likely to acquire HIV from an infected partner during unprotected heterosexual intercourse than men5, women are disproportionately infected in this region.
Women, HIV and AIDS
Generally women are at a greater risk of heterosexual transmission of HIV. Biologically women are twice more likely to become infected with HIV through unprotected heterosexual intercourse than men3. In many countries women are less likely to be able to negotiate condom use and are more likely to be subjected to non-consensual sex.
Additionally, millions of women have been indirectly affected by the HIV/AIDS epidemic. Women’s childbearing role means that they have to contend with issues such as mother-to-child transmission of HIV. The responsibility of caring for AIDS patients and orphans is also an issue that has a greater effect on women.
There are a number of things that can be done in order to reduce the burden of the epidemic among women. These include promoting and protecting women's human rights, increasing education and awareness among women and encouraging the development of new preventative technologies such as post-exposure prophylaxis and microbicides.
Tuesday, March 24, 2009
Other evidence
Even Koch recognized that in some cases not all of his conditions could be met, so other evidence should also be considered. This is particularly true when the germ is a virus rather than a bacterium.16 Modern scientists are willing to consider a wide range of evidence. In particular, we can ask five key questions:
- Do surveillance statistics show a relationship between HIV and AIDS?
- How well does HIV infection predict illness and death?
- Do drugs designed to combat HIV benefit people with AIDS?
- Are there any credible causes besides HIV?
- What can we learn from Africa?
We'll address these questions after looking at Koch's Postulates.
How can we prove that HIV causes AIDS?
Koch's Postulates
In the nineteenth century, the German scientist Robert Koch developed a set of four "postulates" to guide people trying to prove that a germ causes a disease. Scientists agree that if HIV satisfies all of these conditions with regard to AIDS then it must be the cause of AIDS:15
- Koch 1: The germ must be found in every person with the disease
- Koch 2: The germ must be isolated from someone who has the disease and grown in pure culture
- Koch 3: The germ must cause the disease when introduced into a healthy person
- Koch 4: The germ must be re-isolated from the infected person
Problems with the definition?
The definition of AIDS usually requires a positive HIV test. This means that any connection between HIV and AIDS is artificially strengthened because any cases of "HIV-free AIDS" are discounted. In other words, the definition already assumes that HIV causes AIDS, so it can't be used to prove that theory. However, it is possible to redefine AIDS without reference to HIV or even to any other diseases.
The alternative definition of AIDS requires a CD4+ cell count consistently below 200 cells per cubic millimetre of blood, which cannot be explained by any factor other than HIV (such as cancer, malnutrition, radiation or chemotherapy). No HIV test is required.
It turns out that the vast majority of people diagnosed with AIDS fit these criteria. They form a population that barely existed before 1980, but which now numbers hundreds of thousands in the USA and Europe alone. People with such severe immune deficiency are at very high risk of developing serious illnesses and usually die within months (unless they take antiretroviral drugs).We can use this simple, unambiguous definition to test the association between HIV and AIDS.
What is AIDS?
Before we can begin to look for a cause, we must first work out exactly what type of illness we are talking about.
In early 1981, doctors in New York and California began to report some bizarre new disease outbreaks. In both places, previously healthy young men were showing up with rare illnesses including Kaposi's sarcoma (a kind of tumour) and PCP (a type of pneumonia), which until then had been virtually unheard of among such people. Within months, dozens of similar cases had been reported in 23 American states and in the UK, representing the start of a massive and unprecedented epidemic.5
Doctors soon discovered a distinctive feature of these cases. More than anything else, the men were lacking a specific type of white blood cell, which is essential to a healthy immune system. Normally, people have between 600 and 1,500 "CD4+ cells" (also called T helper cells) in each cubic millimetre of their blood. But the men with the strange new disease typically had very much lower levels. This immune deficiency explained why they were so vulnerable to disease.
The cases were clearly related in time and by population group (initially gay men and injecting drug users). No cause of immune deficiency could be found, but it was clearly not inherited. Scientists therefore grouped together all of these strange new cases under the heading "Acquired Immune Deficiency Syndrome" – or AIDS for short.
In 1982, no-one claimed to know the cause of AIDS, so the first definition was based on the diagnosis of one of 13 rare diseases known to be linked to immune deficiency (including Kaposi's sarcoma and PCP) "occurring in a person with no known cause for diminished resistance to that disease".6 Over the years, the US definition has been refined as hundreds of thousands of similar cases have been documented, sometimes involving other diseases, but always associated with the same distinctive immune deficiency.7 Other definitions have also been developed to suit different situations elsewhere in the world.8
The latest US AIDS definition was created in 1993. Under this definition, someone has AIDS if they have one of 26 specific diseases (28 in children) but no known cause of immune deficiency other than HIV (with some diseases, a positive HIV test is required); or if they have a CD4+ cell count below 200 cells per cubic millimetre of blood, or less than 14% of all lymphocytes, plus a positive HIV test.9
Europe and Canada have similar AIDS definitions to the US, but do not include low CD4+ cell counts.
Who doubts that HIV causes AIDS?
By far the most significant scientist to question the HIV/AIDS theory is Professor Peter Duesberg, a virologist at the University of California at Berkeley, who first wrote about this topic in 1987. Throughout the 1990s and into the new millennium, as HIV/AIDS researchers announced many new discoveries and amassed huge volumes of data, Dr Duesberg remained unconvinced. He admits that HIV exists, but he maintains that it is harmless, and that AIDS is caused by non-contagious factors including drug abuse, malnutrition, and even the very drugs used to combat HIV.2
Other dissidents (often called "denialists" by their opponents) include the Perth Group of medical scientists and physicians from Australia. The Perth Group (led by Eleni Papadopulos) claims that nobody has conclusively proven the existence of HIV, so any proof that HIV causes AIDS has no foundation.3
Dissident arguments have received attention from the popular media, as well as from scientific journals. And with the rise of the Internet, alternative views have found a much wider audience, so that scarcely anyone interested in AIDS can have failed to hear of them.
Some of their followers are intrigued by conspiracy theories involving sinister drug companies or government persecution of minority groups. But alternative explanations can also appeal to those diagnosed with HIV or AIDS, who read that their condition might not be fatal, that they shouldn't take toxic drugs, and that unprotected sex poses no risks. Even a few AIDS service organisations have adopted non-HIV viewpoints.4
However, the proportion of scientists who doubt that HIV causes AIDS is tiny, and shows no sign of increasing. Interest in dissident views appears to have dwindled after the excitement surrounding Thabo Mbeki's AIDS panel and the Durban Declaration in 2000. It seems likely that new and better evidence, including the obvious benefits of modern drug treatments, has caused many former-dissidents to change their minds.
Introduction
"AIDS is caused by infection with a virus called human immunodeficiency virus (HIV). This virus is passed from one person to another through blood-to-blood and sexual contact."1
That's the standard explanation of what causes AIDS. But what evidence do scientists have to support this theory? And why do some websites say that the world has got it terribly wrong – that HIV does not cause AIDS at all?
As an independent AIDS organisation founded in 1986, AVERT has taken a keen interest in the ongoing debate about what causes AIDS. As well as investigating the consensus position, we have followed and carefully considered the arguments of the dissident minority who claim that HIV is harmless or even that it might not exist. This topic is vitally relevant to how our organisation works to prevent people developing AIDS and to help those who are suffering.
It is AVERT's considered opinion that the evidence that HIV causes AIDS is abundant and conclusive. This page outlines some of that evidence, while also mentioning how some dissidents have interpreted things differently. In particular, we'll look for proofs of the following:
- AIDS is a new epidemic disease
- AIDS does not occur without HIV
- HIV infection is the only factor that predicts who will develop AIDS
- Surveillance statistics support the HIV theory
- Modern antiretroviral treatment is highly beneficial.
Sunday, March 22, 2009
What are the implications for an AIDS vaccine?
The development of an AIDS vaccine is affected by the range of virus subtypes as well as by the wide variety of human populations who need protection and who differ, for example, in their genetic make-up and their routes of exposure to HIV. In particular, the occurrence of superinfection indicates that an immune response triggered by a vaccine to prevent infection by one strain of HIV may not protect against all other strains. The effectiveness of a vaccine is likely to vary in different populations unless some innovative method is developed which guards against many virus strains.
Inevitably, different types of candidate vaccines will have to be tested against various viral strains in multiple vaccine trials, conducted in both high-income and developing countries.
What are the treatment implications?
Although most current HIV-1 antiretroviral drugs were designed for use against subtype B, there is no compelling evidence that they are any less effective against other subtypes. Nevertheless, some subtypes may be more likely to develop resistance to certain drugs, and the types of mutations associated with resistance may vary. This is an important subject for future research.
The effectiveness of HIV-1 treatment is monitored using viral load tests. It has been demonstrated that some such tests are sensitive only to subtype B and can produce a significant underestimate of viral load if used to process other strains. The latest tests do claim to produce accurate results for most Group M subtypes, though not necessarily for Group O. It is important that health workers and patients are aware of the subtype/CRF they are testing for and of the limitations of the test they are applying.
Not all of the drugs used to treat HIV-1 infection are as effective against HIV-2. In particular, HIV-2 has a natural resistance to NNRTI antiretroviral drugs and they are therefore not recommended. As yet there is no FDA-licensed viral load test for HIV-2 and those designed for HIV-1 are not reliable for monitoring the other type. Instead, response to treatment may be monitored by following CD4+ T-cell counts and indicators of immune system deterioration. More research and clinical experience is needed to determine the most effective treatment for HIV-2.25
Do HIV antibody tests detect all types, groups and subtypes?
Initial tests for HIV are usually conducted using the EIA (or ELISA) antibody test or a rapid antibody test.
EIA tests which can detect either one or both types of HIV have been available for a number of years. According to the US Centers for Disease Control and Prevention, current HIV-1 EIAs "can accurately identify infections with nearly all non-B subtypes and many infections with group O HIV subtypes."22 However, because HIV-2 and group O infections are extremely rare in most countries, routine screening programs might not be designed to test for them. Anyone who believes they may have contracted HIV-2, HIV-1 group O or one of the rarer subtypes of group M should seek expert advice.
Rapid tests - which can produce a result in less than an hour - are becoming increasingly popular. Most modern rapid HIV-1 tests are capable of detecting all the major subtypes of group M.23 Rapid tests which can detect HIV-2 are also now available.24
Is it possible to be infected more than once?
Until about 1994, it was generally thought that individuals do not become infected with multiple distinct HIV-1 strains. Since then, many cases of people coinfected with two or more strains have been documented.
All cases of coinfection were once assumed to be the result of people being exposed to the different strains more or less simultaneously, before their immune systems had had a chance to react. However, it is now thought that "superinfection" is also occurring. In these cases, the second infection occurred several months after the first. It would appear that the body's immune response to the first virus is sometimes not enough to prevent infection with a second strain, especially with a virus belonging to a different subtype. It is not yet known how commonly superinfection occurs, or whether it can take place only in special circumstances.20 21
Are there differences in transmission?
It has been observed that certain subtypes/CRFs are predominantly associated with specific modes of transmission. In particular, subtype B is spread mostly by homosexual contact and intravenous drug use (essentially via blood), while subtype C and CRF A/E tend to fuel heterosexual epidemics (via a mucosal route).
Whether there are biological causes for the observed differences in transmission routes remains the subject of debate. Some scientists, such as Dr Max Essex of Harvard, believe such causes do exist. Among their claims are that subtype C and CRF A/E are transmitted much more efficiently during heterosexual sex than subtype B.9 10 However, this theory has not been conclusively proven.11 12
More recent studies have looked for variation between subtypes in rates of mother-to-child transmission. One of these found that such transmission is more common with subtype D than subtype A.13 Another reached the opposite conclusion (A worse than D), and also found that subtype C was more often transmitted that subtype D.14 A third study concluded that subtype C is more transmissible than either D or A.15 Other researchers have found no association between subtype and rates of mother-to-child transmission.16 17 18 19
The implications of variability
Does subtype affect disease progression?
A study presented in 2006 found that Ugandans infected with subtype D or recombinant strains incorporating subtype D developed AIDS sooner than those infected with subtype A, and also died sooner, if they did not receive antiretroviral treatment. The study's authors suggested that subtype D is more virulent because it is more effective at binding to immune cells.5 This result was supported by another study presented in 2007, which found that Kenyan women infected with subtype D had more than twice the risk of death over six years compared with those infected with subtype A.6 An earlier study of sex workers in Senegal, published in 1999, found that women infected with subtype C, D or G were more likely to develop AIDS within five years of infection than those infected with subtype A.7
Several studies conducted in Thailand suggest that people infected with CRF A/E progress faster to AIDS and death than those infected with subtype B, if they do not receive antiretroviral treatment.8
Are more subtypes likely to "appear"?
Where are the different subtypes and CRFs found?
The HIV-1 subtypes and CRFs are very unevenly distributed throughout the world, with the most widespread being subtypes A and C.
Subtype A and CRF A/G predominate in West and Central Africa, with subtype A possibly also causing much of the Russian epidemic.4
Historically, subtype B has been the most common subtype/CRF in Europe, the Americas, Japan and Australia. Although this remains the case, other subtypes are becoming more frequent and now account for at least 25% of new infections in Europe.
Subtype C is predominant in Southern and East Africa, India and Nepal. It has caused the world's worst HIV epidemics and is responsible for around half of all infections.
Subtype D is generally limited to East and Central Africa. CRF A/E is prevalent in South-East Asia, but originated in Central Africa. Subtype F has been found in Central Africa, South America and Eastern Europe. Subtype G and CRF A/G have been observed in West and East Africa and Central Europe.
Subtype H has only been found in Central Africa; J only in Central America; and K only in the Democratic Republic of Congo and Cameroon.
What about subtypes E and I?
One of the CRFs is called A/E because it is thought to have resulted from hybridization between subtype A and some other "parent" subtype E. However, no one has ever found a pure form of subtype E. Confusingly, many people still refer to the CRF A/E as "subtype E" (in fact it is most correctly called CRF01_AE).2
A virus isolated in Cyprus was originally placed in a new subtype I, before being reclassified as a recombinant form A/G/I. It is now thought that this virus represents an even more complex CRF comprised of subtypes A, G, H, K and unclassified regions. The designation "I" is no longer used.3
How many subtypes of HIV-1 are there?

The strains of HIV-1 can be classified into three groups: the "major" group M, the "outlier" group O and the "new" group N. These three groups may represent three separate introductions of simian immunodeficiency virus into humans.
Group O appears to be restricted to west-central Africa and group N - discovered in 1998 in Cameroon - is extremely rare. More than 90% of HIV-1 infections belong to HIV-1 group M and, unless specified, the rest of this page will relate to HIV-1 group M only.
Within group M there are known to be at least nine genetically distinct subtypes (or clades) of HIV-1. These are subtypes A, B, C, D, F, G, H, J and K.
Occasionally, two viruses of different subtypes can meet in the cell of an infected person and mix together their genetic material to create a new hybrid virus (a process similar to sexual reproduction, and sometimes called "viral sex").1 Many of these new strains do not survive for long, but those that infect more than one person are known as "circulating recombinant forms" or CRFs. For example, the CRF A/B is a mixture of subtypes A and B.
The classification of HIV strains into subtypes and CRFs is a complex issue and the definitions are subject to change as new discoveries are made. Some scientists talk about subtypes A1, A2, A3, F1 and F2 instead of A and F, though others regard the former as sub-subtypes.
What is the difference between HIV-1 and HIV-2?
There are two types of HIV: HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood, and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2.
Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.
Introduction to HIV types, groups and subtypes
HIV is a highly variable virus which mutates very readily. This means there are many different strains of HIV, even within the body of a single infected person.
Based on genetic similarities, the numerous virus strains may be classified into types, groups and subtypesFriday, March 20, 2009
Assembly, Budding and Maturation
Among the strands of messenger RNA produced by the cell are complete copies of HIV genetic material. These gather together with newly made HIV proteins and enzymes to form new viral particles, which are then released from the cell. The enzyme protease plays a vital role at this stage of the HIV life cycle by chopping up long strands of protein into smaller pieces, which are used to construct mature viral cores.
The newly matured HIV particles are ready to infect another cell and begin the replication process all over again. In this way the virus quickly spreads through the human body. And once a person is infected, they can pass HIV on to others in their bodily fluids.
Transcription and Translation

Reverse Transcription and Integration
HIV life cycle
How many genes does HIV have?
HIV has just nine genes (compared to more than 500 genes in a bacterium, and around 20,000-25,000 in a human). Three of the HIV genes, called gag, pol and env, contain information needed to make structural proteins for new virus particles. The other six genes, known as tat, rev, nef, vif, vpr and vpu, code for proteins that control the ability of HIV to infect a cell, produce new copies of virus, or cause disease.
At either end of each strand of RNA is a sequence called the long terminal repeat, which helps to control HIV replication.

What is RNA?


HIV belongs to a special class of viruses called retroviruses. Within this class, HIV is placed in the subgroup of lentiviruses. Other lentiviruses include SIV, FIV, Visna and CAEV, which cause diseases in monkeys, cats, sheep and goats. Almost all organisms, including most viruses, store their genetic material on long strands of DNA. Retroviruses are the exception because their genes are composed of RNA (Ribonucleic Acid).
RNA has a very similar structure to DNA. However, small differences between the two molecules mean that HIV's replication process is a bit more complicated than that of most other viruses.
What does HIV look like?

Unlike most bacteria, HIV particles are much too small to be seen through an ordinary microscope. However they can be seen clearly with an electron microscope.
HIV particles surround themselves with a coat of fatty material known as the viral envelope (or membrane). Projecting from this are around 72 little spikes, which are formed from the proteins gp120 and gp41. Just below the viral envelope is a layer called the matrix, which is made from the protein p17.
The viral core (or capsid) is usually bullet-shaped and is made from the protein p24. Inside the core are three enzymes required for HIV replication called reverse transcriptase, integrase and protease. Also held within the core is HIV's genetic material, which consists of two identical strands of RNA.HIV stands for Human Immunodeficiency Virus. Like all viruses, HIV cannot grow or reproduce on its own. In order to make new copies of itself it must

What does HIV look like?
Outside of a human cell, HIV exists as roughly spherical particles (sometimes called virions). The surface of each particle is studded with lots of little spikes.
An HIV particle is around 100-150 billionths of a metre in diameter. That's about the same as:
- 0.1 microns
- 4 millionths of an inch
- one twentieth of the length of an E. coli bacterium
- one seventieth of the diameter of a human CD4+ white blood cell.
Thursday, March 19, 2009
Origin of HIV

Scientists identified a type of chimpanzee in West Africa as the source of HIV infection in humans. The virus most likely jumped to humans when humans hunted these chimpanzees for meat and came into contact with their infected blood. Over several years, the virus slowly spread across Africa and later into other parts of the world. For more information
AIDS

AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach this stage. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infection. When someone has one or more specific infections, certain cancers, or a very low number of T cells, he or she is considered to have AIDS.
HIV

HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease.
HIV/AIDS and Women
The good news is that many women with HIV are living longer and stronger lives. With proper care and treatment, many women can continue to take care of themselves and others.
In some respects HIV and AIDS affect women in almost the same way they affect men. For example,
- Women of color (especially African American women) are the hardest hit.
- Younger women are more likely than older women to get HIV.
- AIDS is a common killer, second only to cancer and heart disease for women.
How are women getting HIV?
The most common ways are (in order)
- having sex with a man who has HIV
- sharing injection drug works (needles, syringes, etc.) used by someone with HIV

STATISTICS
HIV/AIDS in 2005
(The following bullets, except for the last one, are based on data from 33 states with long-term, confidential name-based HIV reporting.*)
- HIV/AIDS was diagnosed for an estimated 9,708 women [3].
- High-risk heterosexual contact was the source of 80% of these newly diagnosed infections [3].
- Women accounted for 26% of the estimated 37,163 diagnoses for adults and adolescents [3].
- Of the 126,964 women living with HIV/AIDS, 64% were black, 19% were white, 15% were Hispanic, 1% were Asian or Pacific Islander, and less than 1% were American Indian or Alaska Native [3].
- The estimated number of HIV/AIDS in female adults or adolescents decreased from 11,941 in 2001 to 9,708 in 2005 [3].
- According to a recent CDC study of more than 19,500 patients with HIV in 10 US cities, women were slightly less likely than men to receive prescriptions for the most effective treatments for HIV infection [4].
HIV/AIDS among Women
Early in the epidemic, HIV infection and AIDS were diagnosed for relatively few women and female adolescents (although we know now that many women were infected with HIV through injection drug use but that their infections were not diagnosed) [1]. Today, women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. In 2004 (the most recent year for which data are available), HIV infection was
- the leading cause of death for black women (including African American women) aged 25–34 years.
- the 3rd leading cause of death for black women aged 35–44 years.
- the 4th leading cause of death for black women aged 45–54 years.
- the 4th leading cause of death for Hispanic women aged 35–44 years.
Tuesday, March 17, 2009
Definition of brain tumor
New cases: 21,810
Deaths: 13,070
Definition of bone cancer
New cases: 2,380
Deaths: 1,470
Definition of bladder cancer
New cases: 68,810
Deaths: 14,100
Definition of extrahepatic bile duct cancer
Definition of skin cancer
New cases: more than 1,000,000
Deaths: less than 1,000
Saturday, March 14, 2009
Radiation Therapy
Cancer treatment may vary depending upon the type of cancer, the stage of cancer, and the goal of treatment. Often, one or more treatment modalities may be used in order to provide the most complete treatment for the patient. Increasingly, it is common to use several treatment modalities concurrently (together) or in sequence. This is referred to as multi-modality treatment of the cancer and the modalities may include surgery, chemotherapy, biological therapy, and/or radiation therapy. For the majority of newly diagnosed cancer patients, the optimal treatment may be a multi-modality approach composed of standard therapies that have been established through extensive medical research. For other patients, the most appropriate therapy may still be under investigation and may be available only through a clinical trial.
Radiation therapy works by damaging the DNA in the cancer cell, thereby disabling the cancer cells from reproducing and growing. The cancer cells then die and the cancer shrinks. The objective of radiation therapy is to kill enough cancer cells to maximize the probability of cure and minimize the side effects. Under some circumstances, radiation therapy may also be used as palliation, or palliative care, which is aimed at reducing symptoms but not curing the underlying disease.
Radiation is usually administered in the form of high-energy beams that deposit the radiation dose in the body where cancer cells are located. Radiation therapy, unlike chemotherapy, is considered a local treatment. This means that cancer cells are only killed at the location in the body where the radiation is delivered, called the radiation field. If cancer exists outside the radiation field, those cancer cells are not destroyed by the radiation.
Chemotherapy
Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.
More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.
Being informed about chemotherapy and its potential side effects can help you to proactively manage your own care and optimize your treatment and outcomeIntroduction to Cancer Treatment
Choice of cancer treatment is influenced by several factors, including the specific characteristics of your cancer; your overall condition; and whether the goal of treatment is to cure your cancer, keep your cancer from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, you may receive one or more of the following:
- Surgery
- Chemotherapy
- Radiation therapy
- Hormonal therapy
- Targeted therapy
- Biological therapy
One or more treatment modalities may be used to provide you with the most effective treatment. Increasingly, it is common to use several treatment modalities together (concurrently) or in sequence with the goal of preventing recurrence. This is referred to as multi-modality treatment of the cancer.
Surgery is used to diagnose cancer, determine its stage, and to treat cancer. One common type of surgery that may be used to help with diagnosing cancer is a biopsy. A biopsy involves taking a tissue sample from the suspected cancer for examination by a specialist in a laboratory. A biopsy is often performed in the physician’s office or in an outpatient surgery center. A positive biopsy indicates the presence of cancer; a negative biopsy may indicate that no cancer is present in the sample.
When surgery is used for treatment, the cancer and some tissue adjacent to the cancer are typically removed. In addition to providing local treatment of the cancer, information gained during surgery is useful in predicting the likelihood of cancer recurrence and whether other treatment modalities will be necessary.
Learn more about surgery.
Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.
More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.
Learn more about chemotherapy treatment and the management of side effects.
Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumors. Radiation therapy is not typically useful in eradicating cancer cells that have already spread to other parts of the body. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumor site from a machine outside the body. Internal radiation, or brachytherapy, involves the implantation of a small amount of radioactive material in or near the cancer. Radiation may be used to cure or control cancer, or to ease some of the symptoms caused by cancer. Sometimes radiation is used with other types of cancer treatment, such as chemotherapy and surgery, and sometimes it is used alone.
For more information, go to Radiation Therapy.
Hormones are naturally occurring substances in the body that stimulate the growth of hormone sensitive tissues, such as the breast or prostate gland. When cancer arises in breast or prostate tissue, its growth and spread may be caused by the body’s own hormones. Therefore, drugs that block hormone production or change the way hormones work, and/or removal of organs that secrete hormones, such as the ovaries or testicles, are ways of fighting cancer. Hormone therapy, similar to chemotherapy, is a systemic treatment in that it may affect cancer cells throughout the body.
A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that “target” cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes.
Conventional cancer treatments, such as chemotherapy and radiation therapy, cannot distinguish between cancer cells and healthy cells. Consequently, healthy cells are commonly damaged in the process of treating the cancer, which results in side effects. Chemotherapy damages rapidly dividing cells, a hallmark trait of cancer cells. In the process, healthy cells that are also rapidly dividing, such as blood cells and the cells lining the mouth and GI tract are also damaged. Radiation therapy kills some healthy cells that are in the path of the radiation or near the cancer being treated. Newer radiation therapy techniques can reduce, but not eliminate this damage. Treatment-related damage to healthy cells leads to complications of treatment, or side effects. These side effects may be severe, reducing a patient's quality of life, compromising their ability to receive their full, prescribed treatment, and sometimes, limiting their chance for an optimal outcome from treatment.
Biological therapy is referred to by many terms, including immunologic therapy, immunotherapy, or biotherapy. Biological therapy is a type of treatment that uses the body’s immune system to facilitate the killing of cancer cells. Types of biological therapy include interferon, interleukin, monoclonal antibodies, colony stimulating factors (cytokines), and vaccines.
There is no longer a “one-size-fits-all” approach to cancer treatment. Even among patients with the same type of cancer, the behavior of the cancer and its response to treatment can vary widely. By exploring the reasons for this variation, researchers have begun to pave the way for more personalized cancer treatment. It is becoming increasingly clear that specific characteristics of cancer cells and cancer patients can have a profound impact on prognosis and treatment outcome. Although factoring these characteristics into treatment decisions makes cancer care more complex, it also offers the promise of improved outcomes.
The idea of matching a particular treatment to a particular patient is not a new one. It has long been recognized, for example, that hormonal therapy for breast cancer is most likely to be effective when the breast cancer contains receptors for estrogen and/or progesterone. Testing for these receptors is part of the standard clinical work-up of breast cancer. What is new, however, is the pace at which researchers are identifying new tumor markers, new tests, and new and more targeted drugs that individualize cancer treatment. Tests now exist that can assess the likelihood of cancer recurrence, the likelihood of response to particular drugs, and the presence of specific cancer targets that can be attacked by new anti-cancer drugs that directly target individual cancer cells.
To learn more about personalized cancer care for two common types of cancer, visit the following:
Friday, March 13, 2009
What’s next?
No one would call cancer a normal experience, but by proactively managing aspects of your treatment, you can maintain a sense of normalcy in your life. Fighting cancer is not a challenge you face alone. It's a team effort that involves family, friends, and your healthcare team. Don't overlook the strength that can come from having your support network by your side.
How did I get cancer?
What is Cancer?
A tumor may be benign (non-cancerous) or malignant (cancerous). Cells from cancerous tumors can spread throughout the body. This process, called metastasis, occurs when cancer cells break away from the original tumor and travel in the circulatory or lymphatic systems until they are lodged in a small capillary network in another area of the body. Common locations of metastasis are the bones, lungs, liver, and central nervous system.
The type of cancer refers to the organ or area of the body where the cancer first occurred. Cancer that has metastasized to other areas of the body is named for the part of the body where it originated. For example, if breast cancer has spread to the bones, it is called "metastatic breast cancer" not bone cancer.
Newly Diagnosed
Wednesday, March 11, 2009
How Stress Affects Your Health
Suicide and Suicidal Behavior
Depression and Women
Depression and Women (9) Women and Anxiety Disorders (3) Planning Stress Free Holidays
Women's Mental Health
Tuesday, March 10, 2009
Definition of vulvar cancer

Estimated new cases and deaths from vulvar cancer in the United States in 2008:

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Definition of vaginal cancer:

Estimated new cases and deaths from vaginal (and other female genital) cancer in the United States in 2008:

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Definition of ovarian cancer:

Estimated new cases and deaths from ovarian cancer in the United States in 2008:

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