The human immunodeficiency virus (HIV) targets a host’s immune system and if left untreated, can result in a condition known as AIDS (acquired immunodeficiency syndrome). It is widely believed that HIV originated in central Africa sometime between the late 1800s and the 1920s. Originally a virus that affected chimpanzees, the virus managed to cross species into humans.
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Around the 1980s, the HIV started to receive global attention as it spread to North and South America, Europe, Africa, and Australia. By 2020, 37.7 million people were living with HIV/AIDS around the world, and approximately 680,000 deaths were registered. Despite its prevalence for decades now, there is no cure, and many people still share misconceptions about the disease in terms of transmission and manifestation.
Transmission of HIV
HIV is transmitted via blood and certain body fluids. As such, transfer of blood from one individual to another, for example, is considered high risk. Originally, HIV was thought to spread among homosexual men and recreational drug users who shared needles. As our understanding of the disease has grown, so too has our understanding of its transmission.
HIV is commonly referred to as a sexually transmitted infection (STI) due to the high risk of getting it through intercourse. The use of condoms greatly reduces the risk of exposure but does not entirely eliminate it.
Another activity with high risk of contracting HIV is sharing needles. Although common amongst recreational drug users, there are cases of HIV transmission in gyms from those who share needles for steroids, as well as accidental exposure in hospitals and public areas due to unsecured used needles. Never share needles and once a needle is used, make sure that it is covered securely and placed in an appropriate container.
Unfortunately, it is also possible for the virus to be transmitted from the mother to her child. It is known as perinatal transmission, or mother-to-child transmission, and is the common form of transmission to children.
Transmission can occur during pregnancy, at birth, or during breastfeeding. Fortunately, due to the advances in medicine, the risk has been greatly reduced. If an HIV positive mother takes her medication daily and the newborn is given its medication 4-6 weeks after birth, the risk can be reduced to less than 1 percent.
There are other low risk activities that may cause the transmission of HIV. A common misconception is that HIV can be spread through saliva, which is untrue. It is possible to contract HIV from kissing, but it would be due to open sores in the mouth and it requires prolonged and deep kissing. Transmission of HIV via social kissing on the cheeks or even closed mouth kissing is nearly impossible.
HIV cannot be transmitted via sweat, tears, or even blood-sucking insects such as mosquitoes. The virus requires a human host and cannot survive outside a host for long, therefore touching, hugging, and sharing common facilities are all deemed safe.
Manifestation of HIV/AIDS
Like all viruses, HIV depends on the cells of its host to replicate, as it has no means of its own. Whereas some viruses target less important cells of the body, like the nose mucus, HIV targets the cells of the immune system, specifically helper T-cells. HIV main stages are: Acute HIV, chronic HIV, and AIDS.
Acute HIV, also known as primary infection, occurs in the first several weeks after infection. Within the first 2-4 weeks, an individual may experience flu-like symptoms such as fever, muscle aches, diarrhea, sore throat, and swollen lymph glands, particularly in the neck. These symptoms may only be mild and last for a few weeks, but during this time the viral load in the bloodstream in extremely high, making the person highly infectious. It is important for an individual who thinks he/she may have been exposed to the virus and develops any of the symptoms to be tested immediately.
Chronic HIV, also known as clinical latent infection, is the period in which the virus is seemingly dormant. During this period, a person may not experience any symptoms and can go years without ever noticing. It is a common misconception that the virus cannot be transmitted during this time. Although the risk is lower when compared to the first stage, the virus is still active, just replicating at a slower rate.
Without treatment, this stage can continue for a decade or longer until reaching end stage. At the point of end stage, the viral load in the bloodstream drastically increases and the helper T-cell count quickly dwindles. At this point, the person may experience flu-like symptoms again, as well as be more prone to opportunistic infections.
The stage after the second marks the progression into AIDS. AIDS is the result of a severely damaged immune system. Once the body enters stage 3, the risk of opportunistic infections and cancers dramatically increases.
A healthy individual with a working immune system is constantly exposed to substances that can cause disease, such as fungal spores. In the healthy individual, these fungal spores, for example, do not pose any risk. For those who are immunocompromised, these simple exposures can turn into fatalities as the body cannot fight off the infection.
What makes HIV unique is that the virus itself is typically not directly responsible for deaths, it is the complications and infections associated with it that do.
HIV/AIDS in Jordan
Jordan is fortunate enough to be considered a low HIV epidemic country. The prevalence rate among the general population is estimated to be roughly 0.02 percent and up to 0.05 percent in high-risk groups (sex workers, homosexuals, and drug users).
Unfortunately, the low prevalence of the disease, combined with other social factors, has resulted in less awareness about the disease in comparison to other countries. One survey even found that 75 percent of Jordanians were unaware that condoms reduce the risk of HIV.
For those who are HIV positive, taking the appropriate medication is crucial as it greatly reduce the risk of transmitting the disease. In the Middle East and North Africa, the adherence rate to medication is high (above 85 percent in most countries).
Jordan, on the other hand, has one of the lowest adherence rates in the region, of only 44 percent. Additionally, Jordan has aggressive policies on HIV disease control which include mandatory registration of HIV status, mandatory HIV testing for those seeking employment in the public sector, as well as migration restrictions and possible deportation in HIV positive individuals.
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