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timmy
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Has no life at all |
Location: UK, in Devon
Registered: February 2003
Messages: 13751
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While we know that many, most, cases of HIV allow the development of AIDS my limited knowledge says that one is a viral disease, the Human Immunodeficiency Virus, and the other is a Syndrome, a collection of diverse symptoms too hard to classify.
That one is HIV+ is by no means the guarantee that one will develop the syndrome, especially with modern medicines.
Am I alone in feeling that AIDS is viewed by society as a terrible stigma and an inevitable death sentence whereas being HIV+ is viewed subtly differently? Or am I just a pedantic old fart who thinks that the two ailments are separate?
I believe that the distinction between the two is important. I know that,were I to receive the news that I was HIV+ I would automatically assume that AIDS was likely, but I would not feel the same despair as knowing that or thinking that I had AIDS for sure. I remember the simple shock of discovering I was diabetic. That was bad enough, though it hardly affects me.
So why do we allow the media to refer to HIV/AIDS? Are we so lazy that we can't make the distinction between the two, usually but not necessarily linked, complaints? Or are we just plain stupid? Or is it me?
Author of Queer Me! Halfway Between Flying and Crying - the true story of life for a gay boy in the Swinging Sixties in a British all male Public School
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The HIV virus infects people, but does not usually directly cause observable symptoms, though a proportion of people do experience a month or so of 'flu-like symptoms when they "sero-convert" (ie when antbodies to HIV become detectable in their blood: they "get HIV"). This is why you can't tell anything about a person's HIV status by just meeting them, and why an HIV+ person can be perfectly healthy. This asymptomatic period is classed by the World Health Organisation as "stage 1" and is seen as being HIV+ but not having AIDS.
If unchecked, the HIV virus gradually weakens the body's defences in a number of ways, especially by reducing the number of CD4+ T-cells, a vital part of normal defences. The syndrome known as AIDS - not a very useful name, but one that dates from the time when we knew the effects but not the cause of the syndrome - can be defined in two basic ways. One is when the CD4 cell count drops to below 200 (per µL of blood). The other is by the symptoms: WHO stages 2,3,4. This is characterised by a variety of increasingly-nasty "oportunistic infection" - these are things that are incredibly rare in non-HIV people, but prevalent among those with very compromised immune systems. The classic one, the one that really led to the establishment of AIDS as a distinct syndrome, is of course Kaposi's sarcoma. This, and one or two other conditions, are considered "AIDS-defining conditions": any HIV+ person with one or more of these will be considered to have AIDS. Otherwise, it's a matter of clinical judgement as to when the frequency and nature of opportunistic infections becomes such that the patient is appropriately described as "having AIDS".
The definition based on CD4 count is used a lot in the West, the one involving opportunistic infections is used more in countries where access to Western medical technologies is often limited.
It should be noted that my partner/foster-son's HIV consultant doesn't really believe in using the idea of AIDS - he's far more interested in CD4 count, viral load, and the success with which opportunistic infections can be fought. Last visit, he described the lad as "basically healthy", despite the youngster having been born HIV+ and three months in to a year-long course of treatment for TB. I find this approach rather helpful.
I guess this is a roundabout way of saying that I don't really accept that "Are we so lazy that we can't make the distinction between the two, usually but not necessarily linked, complaints?" They are inextricably linked - by definition, one cannot have AIDS without the presence of HIV in the body, and the presence of HIV will lead** to AIDS over a variable period of time if untreated.
**a very small proportion of the population have a mutation (CCR5-Δ32) in the gene that codes for the CCR5 receptor which results in a very high degree of resistance against HIV-1 infection
"The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. ... Returning violence for violence multiplies violence, adding deeper darkness to a night devoid of stars." Martin Luther King
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timmy
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Has no life at all |
Location: UK, in Devon
Registered: February 2003
Messages: 13751
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I think I should have made myself clearer over the linkage.
Since one cannot progress to AIDS without being HIV+ that linkage is secure. But one may be HIV+ and never develop what we used to call "full blown AIDS" despite living a life that allows death form other natural causes. Usually the latter is not true, or has not been true, but being HIV+ does not mean that one has AIDS.
This is why I contend that there is a distinction.
Author of Queer Me! Halfway Between Flying and Crying - the true story of life for a gay boy in the Swinging Sixties in a British all male Public School
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Well, there is of course a distinction between being HIV+ and having AIDS, though it's often a bit of an arbitrary one depending on a clinical judgement as to just which and how many opportunistic infections count as "having full-blown AIDS".
But treatment for AIDS (as well as treating the particular infection or sarcoma, etc) is pretty much the same as the treatment for living with HIV. The public health measures, and personal actions one can take, to prevent the spread of the HIV virus are pretty much the same as the measures one can effectively take in order to control the increase in those affected by AIDS.
I'm not altogether happy about the expression HIV/AIDS, but it does have the merit of both bracketing the two together and distinguishing them at the same time. It's infinitely better than referring to "the AIDS virus" (which used to be common in the media) and which had a really bad psychological effect on those newly-diagnosed with HIV.
Among those I know who are open about living with HIV, "AIDS" is rarely mentioned: specific infections, CD4 counts, viral load are all more specific and far more meaningful guides to "health".
As a specific example, my youngster was three months ago diagnosed with TB and candidiasis of the oesophagus - this could often be taken as "AIDS-defining illness combination" (WHO stage 3 / 4). But his CD4 count (even when he was street homeless and off medication) has never been below 280, his viral load is currently "undetectable" and his consultant doesn't consider him to "have AIDS", but to be HIV+ and (currently) have TB.
My views on this are, of course, changing rapidly ... although I've had HIV+ guys among my friends for the past two or three decades, it's only the last four months that I've been living with an HIV+ lad. They may change more - I've put myself down for a six-week series of support workshops for HIV negative men living in a sero-discordant relationship, due to start in ten days time, and I'm sure that will cause me to reflect on some of my current understandings.
"The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. ... Returning violence for violence multiplies violence, adding deeper darkness to a night devoid of stars." Martin Luther King
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RichardG
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Getting started |
Location: UK
Registered: December 2007
Messages: 12
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I have much less technical knowledge that NW but have a lot of acquaintances who are HIV+. I think the big change happened when medication began to be effective in preventing the almost automatic progression from HIV+ to Aids. The people I know with HIV live almost completely normal lives with no visible signs of illness and therefore no need to tell everyone about the condition.That is not to say they don't suffer from time to time and no one knows what a life sentence on these drugs will bring.But the good news for them is that HIV does not bring the death sentence of AIDS it once did.
Since the incidence of people contracting AIDS itself is now less common and people have begun to understand more about the risks of HIV, I am not sure that the social stigma is as prevalent as it once was.
Incidentally the virtually universal reason for becoming HIV+ amongst my acquaintaince was having unsafe sex with unknown partners while under the influence of drink or drugs or both. Never ever switch off your natural defences of protection, abstinence or monogamy.
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saben
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On fire! |
Registered: May 2003
Messages: 1537
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I honestly don't know why there is really a different name for what is, to my mind, two stages of the one illness.
Often we refer to non-terminal stages of a terminal illness as "stage one". Isn't HIV+ just "stage one" of AIDS, a stage that one may never transition out of (thankfully).
Look at this tree. I cannot make it blossom when it suits me nor make it bear fruit before its time [...] No matter what you do, that seed will grow to be a peach tree. You may wish for an apple or an orange, but you will get a peach.
Master Oogway
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