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HIV/AIDS 101… continued Anthropology 393 – Cultural Construction of HIV/AIDS Josephine MacIntosh 1 Questions from Yesterday What is Selenium? A trace mineral that is essential to good health Incorporated into proteins to make selenoproteins -- important antioxidant enzymes Help prevent cellular damage from free radicals Only required in small amounts Free radicals linked to chronic diseases such as cancer and heart disease Other selenoproteins help regulate thyroid function and play a role in the immune system 2 What Foods Provide Selenium? Plant foods, some meats and seafood Some nuts (especially Brazil nuts) BUT… the selenium content in food depends on the selenium content of the soil it was raised in/on Selenium deficiency most often reported in regions with low selenium content in the soil 3 Recall… Blood transfusion is the most efficient route for HIV infection Sexual transmission is the most common route of infection 75% to 85% of all HIV infections are sexually transmitted 4 Evolution of a Pandemic “We typically think of a new epidemic in a ‘virgin’ population as something that arises suddenly, sweeps through the population in a few months, and then wanes and disappears” (Anderson, 1996:71). 5 Epidemic Curves Classical epidemic curve is bell-shaped Steepness of slope is a measure of infectivity or contagion Length of the curve describes duration of epidemic Highly infectious diseases (like measles): Short period of infectiousness (generally 2 weeks) Relatively short duration (typically 6 months to a year) 6 Epidemic Curves Not so with HIV/AIDS Marked by elongated curve Lengthy period of infectivity, enduring over generations Several distinct peaks As it moves through different populations (MSMs, IDUs, etc) 7 Infectious Diseases Can Be… Endemic Relatively low but constant presence of the disease in a specific geographic area or population group Epidemic More cases of a disease occur than are expected in a given area or group 8 Infectious Diseases Can Be… Pandemic When an epidemic affects large proportions of a population and spans a wide area (several countries or continents HIV/AIDS May have been endemic to a specific region Is currently a full-fledged epidemic Global distribution gives it pandemic status 9 Incidence Vs. Prevalence Incidence Refers to the total number of persons who became newly infected in a given year Prevalence Refers to the total number of persons who were living with the infection at the end of a given time period 10 Doing the Math In a 1988 study, a mathematical model was used to predict future HIV infection rates based on known AIDS cases The prediction: A “slow but continuous development of the AIDS epidemic over many decades...where the numbers of cases of HIV infection (and hence AIDS) increase faster as time goes on, in compound interest fashion” (Anderson & May, 1992:58) 11 Doing the Math Using this mathematical model and assuming: Exponential growth A doubling time of 3 years It would take: 30 years for the prevalence of HIV to change from 0.001% to a detectable level of 1% 3 years to change from 10 to 20 percent (Anderson & May, 1992:59) 12 Doing the Math Currently, the epidemic is spreading at twice the initial predicted rate Between 1999 & 2002, infection rates have: DOUBLED in East Asia & the Pacific Increased 2 ½ times in North Africa & Middle East Almost TRIPLED in Eastern Europe & Central Asia Eastern Europe & Central Asia currently have the fastest-growing epidemic in the world 13 14 15 Global summary of the HIV and AIDS epidemic, December 2004 Number of people living with HIV in 2004 **Prevalence People newly infected with HIV in 2004 **Incidence AIDS deaths in 2004 Total 39.4 million (35.9 – 44.3 million) Adults 37.2 million (33.8 – 41.7 million) Women 17.6 million (16.3 – 19.5 million) Children under 15 years 2.2 million (2.0 – 2.6 million) Total 4.9 million (4.3 – 6.4 million) Adults 4.3 million (3.7 – 5.7 million) Children under 15 years 640 000 (570 000 – 750 000) Total 3.1 million (2.8 – 3.5 million) Adults 2.6 million (2.3 – 2.9 million) Children under 15 years 510 000 (460 000 – 600 000) The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information. 00003-E-1 – December 2004 16 Adults and children estimated to be living with HIV as of end 2004 Western & Central Europe North America 1.0 million [540 000 – 1.6 million] Caribbean 440 000 [270 000 – 780 000] Latin America 1.7 million [1.3 – 2.2 million] 610 000 [480 000 – 760 000] Eastern Europe & Central Asia 1.4 million [920 000 – 2.1 million] East Asia North Africa & Middle East 540 000 [230 000 – 1.5 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] 1.1 million [560 000 – 1.8 million] South & South-East Asia 7.1 million [4.4 – 10.6 million] Oceania 35 000 [25 000 – 48 000] Total: 39.4 (35.9 – 44.3) million 00003-E-4 – December 2004 17