HIV/AIDS Transmission and Symptoms

Human immunodeficiency virus (HIV) is typically a sexually transmitted infection. The risk factors for HIV/AIDS include having vaginal or anal sexual intercourse, sharing contaminated syringes and needles, and receiving tissue and organ transplantations, blood transfusions, and medical procedures involving unsafe or unsterile piercing, cutting, or contaminated materials. HIV is caused by a retrovirus that subsequently serves as a causative agent for acquired immunodeficiency syndrome (AIDS). HIV is serologically divided into two types: HIV-1 (i.e., the most prevalent type globally) and HIV-2 (i.e., the type typically common to West Africa). The environment required for HIV is blood, though it can also be found in other bodily fluids and secretions, including semen, breast milk, and vaginal secretion (Duarte et al., 2023, p. 6). Thus, the physical micro-environment with extensive HIV risks includes sites for drug injections, detention centers, prisons, sites for sex workers, and refugee centers (Rhodes & Simic, 2005). The potentially risky physical macro-environment includes the geographical distribution of the population, the economic and urban migration, trafficking routes for drugs, humans, and sex, labor mobility, and trade routes (Rhodes & Simic, 2005). White blood cells (i.e., CD4+ T cells) are the primary hosts for HIV. Every human is susceptible to HIV, but the risks of infection are enhanced if the potential host already has an STI with mucosal or skin ulceration (Cohen et al., 2019, p. 25). The causal pie model for HIV consists of the absence of antiretrovirals, engagement in risky sexual behaviors, and exposure to an HIV-positive person’s bodily fluids.
An HIV-negative partner commonly contracts HIV after exposure during a sexual encounter with an HIV-positive partner without barrier contraception. HIV transmission may require dozens of exposures to penile-rectal intercourse and hundreds of penile-vaginal intercourses (Cohen et al., 2019, p. 23). However, infection via contaminated needles may occur after a single exposure. The symptoms of HIV come in three stages and appear differently in people (HIV.gov, 2022). Stage 1 (acute HIV infection occurs in 2-4 weeks upon the infection and is similar to flu, including fever, muscle pain, swollen lymph nodes, chills, and fatigue. Some people remain asymptomatic during stage 1 HIV. Stage 2 (clinical latency) starts about nine weeks after the infection (Duarte et al., 2023, p. 2) and indicates a chronic HIV infection, during which the retrovirus continues to multiply slowly. It is often asymptomatic and can last for 10-15 years. During stage 3 (AIDS), the individual’s immune system is exhausted and progresses into AIDS. The symptoms include profuse night sweating, rapid weight loss, pneumonia, depression, inexplicable tiredness, memory loss, at least week-long diarrhea, blotches on and under the skin and inside the individual’s eyelids, mouth, and nose, mouth sores, prolonged lymph node swelling, genital sores, recurring fever, comorbid neurologic disorders, and anus sores.
HIV is diagnosed based on HIV tests that are categorized as the antibody tests (the only FDA-approved test; blood from a vein; detection after 23 to 90 days upon exposure), the antigen/antibody tests (blood or saliva; 18 to 45 days after exposure), and nucleic acid tests (NATs) (blood from a vein; 10 to 33 days after exposure) (Centers for Disease Control and Prevention [CDC], 2022). HIV treatment suggests taking antiretroviral therapy (ART) for general health improvement and reducing HIV transmission risks (Phanuphak & Gulick, 2020, p. 1). Typically, ART includes three drugs taken orally (two NRTIs and either a protease inhibitor, an integrase inhibitor, or a non-nucleoside reverse transcriptase inhibitor) daily (Phanuphak & Gulick, 2020, p. 1). If HIV guidelines and ART therapy are followed, normal life expectancy is ensured. If therapy is not followed or HIV is untreated, it progresses into AIDS, resulting in a patient’s death. Effective ART enhances the patient’s immune function, controls viral replication, and reduces morbidity and mortality (Phanuphak & Gulick, 2020, p. 2).
The data on national morbidity and mortality of HIV can be obtained from the CDC (2023) (https://www.cdc.gov/nchs/fastats/aids-hiv.htm). It is the official website of a governmental agency that publishes data for the general population and health professionals. All statistical data was retrieved from the National Vital Statistics System and the National Center for Health Statistics. No additional sources are needed.

References
Centers for Disease Control and Prevention. (2022, June 2). HIV testing. https://www.cdc.gov/hiv/testing/index.html
Centers for Disease Control and Prevention. (2023, August 18). AIDS and HIV. https://www.cdc.gov/nchs/fastats/aids-hiv.htm
Cohen, M. S., Council, O. D., & Chen, J. S. (2019). Sexually transmitted infections and HIV in the era of antiretroviral treatment and prevention: the biologic basis for epidemiologic synergy. Journal of the International AIDS Society, 22(S6), 23-31. https://doi.org/10.1002/jia2.25355
Duarte, F. H. S., de Oliveira Silva, S., Enders, B. C., de Carvalho Lira, A. L. B., Dantas, R. A. N., & Dantas, D. V. (2023). Early diagnosis of HIV/aids infection: concept analysis. Revista Brasileira de Enfermagem, 76(3), 1-8. https://doi.org/10.1590/0034-7167-2022-0565
HIV.gov. (2022, June 15). Symptoms of HIV. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv/
Phanuohak, N., & Gulick, R. M. (2020). HIV treatment and prevention 2019: Current standards of care. Current Opinion in HIV and AIDS, 15(1), 4-12. https://doi.org/10.1097/COH.0000000000000588
Rhodes, T., & Simic, M. (2005). Transition and the HIV risk environment. BMJ, 331(7510), 220-223. https://doi.org/10.1136%2Fbmj.331.7510.220