The Faith in Prevention Training Manual:Tools for Your HIV/AIDS Ministry
A Faith-Based Model of Partnership to Stop HIV
Developed by Starr Smith, Adler School of Professional Psychology
Chapter 1: HIV/AIDS 101
AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging or destroying the cells of your immune system, HIV interferes with your body's ability to effectively fight off viruses, bacteria, and fungi that cause disease. This makes you more susceptible to certain types of cancers and to opportunistic infections your body would normally resist, such as pneumonia and meningitis. The virus and the infection itself are known as HIV. The term "acquired immunodeficiency syndrome" (AIDS) refers to the later stages of an HIV infection.
Brief History of AIDS
HIV/AIDS was first reported in the United States in 1981. Since then, the disease has spread to thousands of people across the United States and become a major worldwide epidemic. People in countries from Africa to Europe to Australia have become infected with the disease. As some countries continue to ignore the necessity of providing people with a basic understanding of the disease and how it is transmitted, more people become infected every day.
The term AIDS was not coined until 1982, the same year researchers at the Centers for Disease Control and Prevention (CDC) linked the HIV virus to blood and bodily fluids. The number of known deaths from AIDS in the United States in 1982 alone was 853, a high figure considering that people only began showing symptoms of the disease a couple years earlier. One year later, there were 2,304 known deaths from AIDS. That's a staggering increase. The year 1985 marked the first time President Ronald Reagan mentioned the word AIDS in public, during a press conference. In that year, over 5,636 deaths were reported due to AIDS. During the next few years, the United States government finally began to acknowledge the AIDS crisis. During this time, researchers were also developing the first antibody tests to determine the presence of the virus. These tests were put to valuable use testing blood supplies and at-risk patients. Researchers also worked to develop the first anti-HIV medication, called AZT, which had a recommended dosage of one capsule every four hours around the clock.
In 1991, the World Health Organization estimated that over 10 million people were infected with HIV worldwide. Nearly one million of those people, the organization said, lived in the United States. In 1997, over 22 million people were estimated to have the virus. Medical improvements have prolonged survival and renewed hope for HIV-positive people with access to costly drug therapies. Sadly, the vast majority of people with HIV worldwide cannot afford lifesaving treatments. AIDS is still prevalent throughout the world, and it is vital to study the disease and advocate for more concerted efforts to address it.
Let's Talk About the Facts
Despite being a known illness for over 25 years, many people still do not know the truth about HIV/AIDS and have many fears. In this section you will learn what HIV is, how it is contracted and how it is transmitted to others. By the end of this section your HIV/AIDS ministry should know the basic facts regarding HIV and AIDS. As well, you may consider participating in the Red Cross Facts Course for additional training, which will help you comfortably educate your congregation about the facts on HIV/AIDS.
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. AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. It can take years for a person living 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 difficulty fighting infections. When someone has one or more of these infections and a low number of T cells, he or she has AIDS.1
HIV was first identified in the United States in 1981 after a number of gay men started getting sick with a rare type of cancer. It took several years for scientists to develop a test for the virus, to understand how HIV is transmitted between humans, and to determine what people could do to protect themselves. During the early 1980s, as many as 150,000 people became infected with HIV each year. By the early 1990s, this rate had dropped to about 40,000 each year, where it remains at the end of 2007.1
AIDS cases began to fall dramatically in 1996, when new drugs became available. Today, more people than ever are living with HIV/AIDS. The U.S. Centers for Disease Control and Prevention (CDC) estimates that about 1 million people in the United States are living with HIV or AIDS. About one quarter of these individuals do not know that they are infected: not knowing puts them and others at risk.1
HIV is a virus that cannot live for very long outside the body. Therefore, the virus is not transmitted through day-to-day activities such as shaking hands, hugging, or even kissing. You cannot become infected from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, pets, or swimming pools. You also cannot get HIV from mosquitoes. HIV is primarily found in the blood, semen, vaginal fluid, or the breast milk of an infected person.1
HIV is transmitted in 3 main ways:
- Having sex (anal, vaginal, or oral) with someone infected with HIV
- Sharing needles and syringes with someone infected with HIV
- During pregnancy, birth, or postpartum through breastfeeding.1
HIV also can be transmitted through blood infected with HIV. However, since 1985, all donated blood in the United States has been tested for HIV. Therefore, the risk for HIV infection through the transfusion of blood or blood products is extremely low. The U.S. blood supply is considered among the safest in the world.1
Things that put you at an increased risk for HIV include:
- Sharing needles
- Unprotected vaginal, anal or oral sex with multiple partners or anonymous partners
- Working as a sex worker or exchanging sex for money or drugs
- Having an STD such as syphilis, which can increase risk for HIV transmission
- If you have received a blood transfusion before 1985
- Have had unprotected sex with anyone who has any of the above risks1
What are the symptoms of HIV or AIDS?
The only way to know whether you are infected is to be tested for HIV. You cannot rely on symptoms alone because many people who are infected with HIV do not have symptoms for many years. Someone can look and feel healthy but may still be infected. In fact, out of the more than one million people in the United States living with HIV/AIDS approximately ? do not know that they are infected.1 Many people do not develop any symptoms when they first become infected with HIV. Some, however, will get a flu-like illness within three to six weeks after exposure to the virus. This illness, called Acute HIV Syndrome, may include fever, headache, tiredness, nausea, diarrhea and enlarged lymph nodes (organs of the immune system that can be felt in the neck, armpits and groin). These symptoms usually disappear within a week to a month and are often mistaken for another viral infection.
More persistent or severe symptoms may not surface for several years, even a decade or more, after HIV first enters the body in adults, or within two years in children born with the virus. This period of "asymptomatic" infection varies from individual to individual. Some people may begin to have symptoms as soon as a few months, while others may be symptom-free for more 10 than years. However, during the "asymptomatic" period, the virus will be actively multiplying, infecting, and killing cells of the immune system.2 Again, the only way an individual can be 100% sure of his or her HIV status is to be tested. You cannot tell whether someone is infected just by looking at him/her. People can feel perfectly fine and be unaware they are infected with HIV.
Some advanced symptoms of HIV infection include:
- Rapid weight loss
- Dry, persistent cough
- Night sweats or fever
- Swollen lymph glands
- Diarrhea that lasts longer than a week
- White spots on the tongue or in the mouth (Thrush)
- Red, brown, purplish blotches on the skin
- Memory loss or depression3
How is HIV diagnosed?
Once HIV enters the body, the body starts to produce antibodies?substances the immune system creates after an infection.9 A blood test is used to confirm whether a person has been infected with HIV.8 HIV tests look for the presence of antibodies rather than the virus itself. There are many different types of HIV tests which include rapid testing and home testing kits. Rapid and home tests look for the HIV antibodies and not HIV itself.9 Since the only way an individual can know if he/she are infected is through testing, regular (annual is recommended by the CDC) and routine testing is essential.
Who should be tested for HIV?
The CDC recommends that all persons aged 13 to 64 get an HIV test with their annual physical each year. Individuals who engage in risky behaviors have an increased chance of acquiring HIV, and may need to be tested more often. Risky behaviors would include but are not limited to:
- Sharing needles
- Unprotected vaginal, anal or oral sex with multiple partners,
- Exchanging sex for drugs or money
- Having been diagnosed and treated for other STDs such as syphilis, gonorrhea or Chlamydia as well as tuberculosis or hepatitis (other diseases can weaken your immune system)
- Having unprotected sex with a partner/spouse who is engaging in risk behaviors with others
It is also important for women who are or plan to become pregnant to get tested. If a woman is HIV-positive, pregnant, or becomes pregnant, she can receive the necessary medical treatment that can lower the chances of passing HIV to her baby to less than
So what is AIDS?
AIDS, or Acquired Immune Deficiency Syndrome, is a condition that describes an advanced stage of HIV infection. In AIDS, the virus has progressed and causes a significant loss of CD4 cells, which weakens the immune system to the extent that the body is at risk for illnesses and opportunistic infections.5 A positive HIV test does not mean that a person has AIDS. An HIV-infected person receives a diagnosis of AIDS after the development of one AIDS-related illness (opportunistic infection). HIV infection weakens the immune system and makes it difficult to fight off certain infections. These infections are called opportunistic infections because they take advantage of "opportunities" to invade the weakened immune system.6 A person is diagnosed with AIDS when their CD4 count has dropped below 200 cells per cubic millimeter of blood, the level at which the immune system can no longer protect the person from AIDS-defining illnesses or other infections.5
Opportunistic infections which would be considered AIDS-defining illnesses would include, but are not limited to:
- Candidiasis of the mouth, vagina, trachea, lungs or esophagus
- Invasive cervical cancer
- Kaposi's Sarcoma
- PCP pneumonia
Remember, these diseases can also occur in people without HIV infection and those individuals would not be classified as having AIDS. The only sure way to know your status is to get tested.
Currently there is no cure for HIV or AIDS. There is no conclusive treatment to eliminate HIV from the body; however, timely treatment of opportunistic infections can keep one healthy for many years.
The FDA has approved a number of drugs to treat HIV. There is a combination of drugs called "highly active antiretroviral therapy" or HAART (cocktail or combination therapy).
When taken properly, HAART treatment helps people with HIV live longer and have fewer infections or other problems related to their HIV. The drugs work by preventing HIV from replicating and improving your body's ability to fight infections. It is important to remember these medications do not cure HIV, but they can slow down the progress and improve the quality of life.11
There are medications and other drugs that can interact with HIV medications -- making you sicker and the HIV medicines weaker. It is important the doctor knows about all medications, prescription, over-the-counter, herbal remedies, birth control pills and even recreational drugs.11 Vitamins and minerals, along with alternative medicine, have also been used to treat symptoms, but again it is important to ask a doctor about any and every medicine, vitamin or herb being taken.
There are some side effects from HIV/AIDS medications. Some side effects include, but are not limited to: nausea, vomiting, diarrhea, weakness, dizziness, weight loss, liver problems, and decrease in bone density. Staying on HIV medications can be difficult because of the side effects. It is important to talk to a health care provider about what can be done to minimize the side effects.11
Now that you have completed this section do you have all the facts? Do you know the ways in which HIV is spread? Are you able to comfortably and effectively educate your congregation about the facts? You can also receive additional information about the facts on HIV/AIDS through the American Red Cross, the CDC and your local health department.12,13,14,15
Test Your Knowledge
In this section you will answer True/False questions, Fill in the Blank and short answer. Answers will be located at the end of this section
True or False. HIV can be spread if someone sneezes in the room.
True or False. People who are known to have HIV or AIDS should have separate eating utensils, and probably their own bathroom to avoid further transmission.
Name several ways in which HIV can be transmitted.
True or False. Oftentimes, people with HIV are very skinny and, therefore, you CAN tell if someone is HIV positive by looking at them.
HIV stands for _____________ __________________ ___________.
List several ways in which people can protect themselves from the spread of HIV.
True or False. You cannot determine whether you have HIV by symptoms alone, but rather the only way to be 100% sure of what your status is to have a test that test for the presence of antibodies.
Invasive cervical cancer in a woman who is HIV positive, and has a CD4 level under 200 would be known as a _________-____________ _______________.
True or False. AIDS does not have an economic impact on various countries around the globe.
Answers to quiz questions
- False, HIV cannot be spread by someone sneezing
- False, HIV cannot be spread by sharing utensils or a restroom and isolation is not necessary
- Possible ways of HIV transmission include unprotected sex with someone who is HIV positive, intravenous drug use, mother to child
- False. In fact, people with HIV feel well and look just as healthy as anyone else.
- HIV stands for Human Immunodeficiency Virus
- People can protect themselves through abstinence, correctly using a condom each and every time, not sharing needles.
- False. A person would not be able to know their HIV status based on symptoms alone. Symptoms may not show up for months and even years in some individuals. Symptoms of HIV also overlap the symptoms of other illness. If a person feels they are at risk for contracting HIV or have been exposed to the virus the only way to be 100% sure is to be tested.
- AIDS-defining diagnosis.
- False. AIDS has an economic strain on society, especially in countries that are largely impacted.
- Basic Information regarding HIV/AIDS. Available at www.cdc.gov/hiv/topics/basic/index.htm
- What are the early symptoms of HIV infection? Available at www.youandaids.org/About%20HIVAIDS/Symptoms/index.asp
- How can I tell if I am infected with HIV? What are the symptoms? Available at www.cdc.gov/hiv/resources/qa/qa5.htm
- AIDS. Available at http://en.wikipedia.org/wiki/Aids
- Diagnosis of AIDS/HIV-How is HIV Diagnosed. Available at http://aids.about.com/od/hivtesting/a/hiviag.htm
- Glossary of Terms. Available at www.cdc.gov/hiv/topics/surveillance/resources/ guidelines/epi-guideline/la_supp/glossary.htm
- Case Definition of AIDS. The Body. Available at www.thebody.com/content/art14002.html
- How is HIV Infection Diagnosed? Available at www.ehealthmd.com/library/aidswomen/AID_whatis.html
- National HIV Testing Resources. Available at www.hivtest.org/subindex.cfm?FuseAction=FAQ
- Deciding if and When I want to be Tested. Available at www.cdc.gov/hiv/topics/testing/resources/qa/be_tested.htm
- Treatment. Available at www.4woman.gov/hiv/treatment/