Acquired Immunodeficiency Syndrome (AIDS) is called a disease, but is actually a collection of infections and cancers that are generally quite severe and the affected individual shows serious symptoms of at least one of these illnesses. It usually takes several years after initial infection with the Human Immunodeficiency Virus (HIV) for AIDS to show up. Soon after infection, HIV begins to attack the immune system, but this is a very slow process and most people who live with HIV feel perfectly healthy and may not show any symptoms for many years. This is also the reason why many people do not even know whether they are HIV-positive. Once infected, a person can pass the virus on to others. Over the years HIV lives and multiplies in the body and causes serious damage to the immune system. The body becomes vulnerable to illnesses that a normal immune system would otherwise be able to ward off. These conditions - like pneumonia or tuberculosis (TB) - in an HIV positive person are technically called Opportunistic Infections (OIs), simply because they attack the body taking the opportunity of a weakened immune system. In developing nations, there are chances that an individual may suffer from AIDS and succumb to the disease faster than he or she would in developed countries.

Today, world-wide estimates indicate that at least 600 people are infected with HIV every hour, which is why the AIDS pandemic is recognised as one of the most devastating in human history. Since the first clinical report of AIDS in June 1981 in the United States of America, HIV has infected more than 60 million people all over the world in a little over 20 years and more than 20 million have died of AIDS. At the end of 2003, more than 42 million people were living with HIV.

More than 95 percent of all new infections are occurring in developing countries across the world, where the challenge of protecting people from HIV is much greater than what it is in the developed world. In India, HIV infection was first reported in Chennai in 1986. At the end of 2002, it was officially estimated that approximately 4.58 million people have been infected with HIV. It has spread to all the states in India; high-prevalence rates of the infection (more than one percent infection in pregnant women) have been reported from Maharashtra, Karnataka, Tamil Nadu, Andhra Pradesh, Manipur and Nagaland.

HIV or Human Immunodeficiency Virus is a virus infecting humans. It attacks the immune system and the body's defence against disease is slowly damaged and destroyed, a condition known as immune deficiency. HIV is much more dangerous than other viruses, because it directly attacks and hijacks blood cells needed by the immune system to fight infectious diseases. The virus also changes very rapidly and is easily able to evade many of the body's defence systems. There are two types of HIV - 1 and 2 -- and many subtypes. The most common form of the virus found in India is HIV - 1, subtype C.

All of us have many systems that work in our bodies to fight off infection and disease. All these systems are collectively known as the "immune system". When the immune system is able to fight an infection and keep the disease at bay, we say that person is "immune" to the disease. This immunity usually results from a group of specialised blood cells and proteins. It has the ability to recognise the difference between what belongs to the body and what does not. It can learn to recognise dangerous invaders such as germs or viruses responsible for diseases. Fever, swollen glands and rashes, for example, may be signs that the immune system is learning to recognise and fight a new invader.


The problem is that the immune system has only two ways to learn about invaders which may cause disease: Some immunity is inherited when a person is born; otherwise the body only learns to recognise an invader the first time it meets it. If the invading germ is strong enough, it may overcome the immune system in that first attack and the person may become infected. Vaccinations are a way of teaching the immune system to recognise invaders before they attack the body for the first time. This means that people who are vaccinated against a certain disease are sufficiently protected because the immune system is ready for the first attack.

• By having unprotected sexual intercourse (vaginal, anal or oral sex) without a condom with someone who is HIV-infected
• By using or being injured by unsterilised cutting or piercing equipment, such as injection needles or razor blades and by being brought into contact with the blood of someone who is HIV-infected (there is no risk from sharing things like eating utensils or clothes which never come into contact with blood. Similarly, dried blood stains and spit do not carry any risk of transmitting HIV);
• By sharing needles, syringes or other drug injecting equipment with someone who is HIV-infected
• By an HIV-infected mother to her baby during pregnancy, delivery or while breastfeeding;
• By receiving blood transfusions, blood products or organ transplants from an HIV-infected individual and where the mandatory screening for HIV has not been done appropriately;
• By tattooing and/or piercing with improperly sterilised equipment.

• AIDS is the world's fourth largest cause of death in humans. Although it is a fatal condition, treatment with anti-HIV medication can slow down disease progression and help HIV-infected people live a relatively healthy life.
• AIDS hits young people the worst.
• AIDS primarily affects people in the most productive age group (18-49), severely affecting the socio-economic structure of whole families, communities and countries.
• HIV infection has spread rapidly. Before this, it was perhaps during the plague and smallpox epidemics in India during the early twentieth century that there was such an alarming spread of any serious infection
• AIDS is a complex condition to handle. Unlike other diseases like malaria or TB, a person with AIDS has to battle a range of co-infections that are very difficult to manage.
• AIDS still means a great deal of stigma and discrimination. A person living with HIV/AIDS is often treated unfairly and unjustly, much more than those with other infectious diseases.

No. There is no cure for HIV/ AIDS. Since AIDS is a collection of infections, there are medicines that can prevent and control OIs in people affected by HIV/AIDS. These OIs are infections that would either be harmless or at least easily managed in healthy people but they can cripple or kill people with damaged and impaired immune systems, as is the case with people who live with HIV/AIDS.

Today, people living with HIV are receiving treatment using several types of anti-AIDS drugs, commonly known as antiretroviral drugs (ARVs). These drugs can check the pace at which HIV multiplies in the body. But ARVs are meant to be taken life-long, on a daily basis, following a rigid schedule. If patients miss even one dose in 50, the virus can become resistant to the medicines and they lose their effect. Even in patients who remember every dose, the medicines may stop working after some time. In addition, these drugs are very expensive and some of them are known to cause severe adverse reactions. However, a strict treatment regimen and proper care and treatment have been shown to prolong survival and improve the quality of life of people living with HIV/AIDS. Babies born to HIV-infected mothers can be protected against HIV infection if the mother and baby receive ARVs during pregnancy and at delivery.

Currently there is no effective vaccine to prevent HIV/AIDS. Many scientists from across the world agree that an AIDS vaccine is possible. Several vaccine candidates are currently being tested in clinical trials. These trials are conducted over long periods of time among different populations to ensure that a vaccine is safe, stimulates the body to produce the required immune response and is effective. In the last few years, AIDS vaccine research has gathered momentum and is today a global effort. Since the world urgently needs an AIDS vaccine, multiple AIDS vaccine types are being tried at the same time to help scientists, institutions and governments cut short the time that the search will take. India has put the search for an AIDS vaccine on mission status. The government and the President of India have identified it as one of the most important scientific challenges facing the nation.

A preventive vaccine, if found, will not be a treatment for those who are already infected with HIV. Scientists and doctors are working as fast as they can to develop a vaccine but, even if they succeed, a vaccine will probably not be 100 percent effective. We know that people remain protected from HIV infection by relying on classical methods of prevention such as the practice of safe sex, use of condoms and clean needles.