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HIV/AIDS are unfortunate conditions that are currently affecting the whole world. Some places, especially those in sub-Saharan Africa, are affected more seriously. Nevertheless, these are distinct circumstances. HIV is the virus human immunodeficiency virus, and it causes acquired immunodeficiency syndrome, or AIDS. Infection with HIV is often sexually transmitted, but it can also be transmitted by other bodily fluids as well. The four major routes of transmission are unsafe sex, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (Weiss, 1993). When the infection progresses in some patients, it may cause significant problems for the immune system; hence the name, immunodeficiency. HIV infects primarily white blood cells in the human immune system such as helper T cells, macrophages, and dendritic cells (Cunningham, 2010). HIV infection specifically leads to low levels of CD4+ T cells through three main ways: First, direct viral killing of infected cells; second, increased rates of apoptosis in infected cells; and third, killing of infected CD4 + T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4 + T cell numbers get critically low, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. Most untreated people infected with HIV-1 eventually develop AIDS (Migueles, 2010). These individuals generally get overwhelming infections from opportunistic pathogens or even fulminant cancer that is usually kept at bay by the immune system. The time of progression to AIDS is quite variable among patients, with some moving along to AIDS at a very rapid pace and others taking considerably longer to show any signs of the disease. While there are some treatments for persons with AIDS, most people who go untreated will die within one year after progressing to this stage. The central problem for a patient with HIV is the maintenance of their immune system. Over time, their immune system eventually fails and the patient is susceptible to significant opportunistic infections. These infections begin to appear below the critical threshold of 200 CD4+ cells per µL. At this level, cell mediated immunity is lost, and infections with various types of microbes will begin to appear. In addition, the patient may first notice unexplained weight loss, recurring respiratory tract infections, prostatitis, skin rashes, and oral ulcerations. Common opportunistic infections and tumors, most of which are normally controlled by robust CD4+ T cell-mediated immunity then start to affect the patient. Typically, resistance is lost early on to oral Candida species and to Mycobacterium tuberculosis, which leads to an increased susceptibility to thrush and tuberculosis. Later, reactivation of latent herpes viruses may cause worsening recurrences of herpes simplex eruptions, shingles, Epstein-Barr virus-induced B-cell lymphomas, or Kaposi's sarcoma (Weiss, 1993). There are currently no available cures or vaccines for the HIV virus; however, there are several types of treatments to combat the HIV infection in AIDS patients. For patients who are aware that they have been exposed to the virus, they may be helped by immediate post exposure treatment with anti-retrovirals. It is thought that treatment with these medications may be able to halt the spread of the infection. In July 2010, a vaginal gel containing tenofovir, a reverse transcriptase inhibitor, was shown to reduce HIV infection rates by 39 percent in a trial conducted in South Africa (Karim, 2010). In any event, there is an ongoing problem with resistance to anti-retrovirals has lead to physicians to prescribe a cocktail of drugs to help fight the development of resistance to the treatment. In the United States this is known as highly active antiretroviral therapy, or HAART (Department of Health and Human Services, 2010). These usually include combinations of at least two drugs, with most preparations being three different medications. Typically, these classes are two nucleoside analogue reverse transcriptase inhibitors plus either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor. Most health care workers do not feel there is adequate evidence that suggests even withholding the treatments for HIV infection regardless of the CD4+ count. Nevertheless, most experts in the US agree that treatment should be started for patients when the CD4+ count has fallen below 350. The difficulty is that treatment should be adhered to for the remainder of the patient’s life, and they should be prepared for all of the potential complications that go along with taking anti-retroviral medications. Even though HAART does not cure the disease, many patients have experienced outstanding successes with these drugs when used regularly. Some newer drugs are being developed to help those patients who have had difficult times with the medications because of side effects. No one should become complacent about HIV and AIDS. While current medications can dramatically improve the health of people living with HIV and slow progression from HIV infection to AIDS, existing treatments need to be taken daily for the rest of a person’s life, need to be carefully monitored, and come with costs and potential side effects. At this time, there is no cure for HIV infection. Despite major advances in diagnosing and treating HIV infection, in 2007, 35,962 cases of AIDS were diagnosed and 14,110 deaths among people living with HIV were reported in the United States (Kilmarx, 2008). Almost everyone is familiar with at least some of the ways to prevent the spread of this disease. One of the most important ways to help limit the spread of AIDS is to determine if you have the disease yourself. The majority of people who are infected with HIV do not even know they have the infection, so experts recommend that everyone should be tested for HIV at least once in their lives. Not only is this important for your own health, but it is crucial to avoid spreading the infection to others. Next, the best way to avoid HIV is to not have sexual intercourse. While that is not likely an option for most people, there are ways to make sex safer for all involved. Abstain from sexual activity or be in a long-term mutually monogamous relationship with an uninfected partner. In addition, you should limit your number of sex partners. The fewer partners you have, the less likely you are to encounter someone who is infected with HIV or another STD. If you decide to have sex, or partake in any activities where there is intimate genital contact, be sure to use a condom every single time. Finally, do not inject illicit drugs or share needles. If you are having difficulty getting or staying clean, make sure to use clean needles and paraphernalia every time (Kilmarx, 2008). Not having (abstaining from) sex is the most effective way to avoid transmitting HIV to others. If one chooses to have sex, using a latex condom can help protect your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not 100%, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used. Since the first cases of AIDS were identified more than 25 years ago, millions of people around the world have become infected with HIV, and the epidemic has claimed millions of lives. Globally, there are an estimated 33.4 million people living with HIV/AIDS, including more than one million in the United States. While there have been successes in addressing the epidemic on many fronts, multiple challenges remain in the areas of prevention, care and treatment, research, infrastructure and capacity development, and funding. As AIDS is such a global problem, there are many public health initiatives to help stem the tide of new HIV infections. These include Greater Than AIDS. This group is about the power of individuals acting together to achieve a greater goal- in this case, reducing the spread of HIV. By stressing unity, hope and empowerment, Greater Than AIDS inspires each and every one of us- in our relationships, families and communities- to do our part to stem HIV/AIDS. MTV: It’s Your (Sex) Life is another well known public health initiative. This extensive, Emmy-award winning public education campaign, in partnership with MTV, informs young people about sexual health issues, including HIV/AIDS and other sexually transmitted diseases (STDs). Even outside the US there are well known programs, especially in Africa, where the need may be the greatest. One example is the African Broadcast Media Partnership Against HIV/AIDS. This unprecedented panAfrican coalition of more than 35 television and radio companies from 24 countries across the continent aims to reinvigorate the media response to the HIV/AIDS pandemic in the region. References Cunningham, A.; Donaghy, H.; Harman, A.; Kim, M.; Turville, S. (2010). "Manipulation of dendritic cell function by viruses". Current opinion in microbiology 13 (4): 524–529. Department of Health and Human Services (January 2005). "A Pocket Guide to Adult HIV/AIDS Treatment January 2005 edition". http://www.hab.hrsa.gov/tools/HIVpocketguide05/PktGARTtables.htm. Retrieved 2006-01-17. Karim, Q. A., Karim, S. S. A., Frolich, J. A., Grobler, A. C., Baxter, C., Mansoor, L. E., Kharsany, A. B. M., Sibeko, S., Mlisana, K. P., Omar, Z., Gengiah, T. N., Maarschalk, S., Arulappan, N., Mlotshwa, M., Morris, L., and Taylor, D. (19 July 2010). "Effectiveness and Safety of Tenofovir Gel, an Antiretroviral Microbicide, for the Prevention of HIV Infection in Women". Science 329 (5996): 1168–74. Kilmarx P. Acquired immunodeficiency syndrome. (2008) In: Heymann DL, editor. Control of communicable diseases manual, 19th Edition. Washington, D.C.: APHA Press; 2008. Migueles, S.; Connors, M. (2010). "Long-term Nonprogressive Disease Among Untreated HIVInfected Individuals: Clinical Implications of Understanding Immune Control of HIV". JAMA : the journal of the American Medical Association 304 (2): 194–201. Weiss RA (May 1993). "How does HIV cause AIDS?". Science 260 (5112): 1273–9.