ISBN-10:
0130821969
ISBN-13:
9780130821966
Pub. Date:
11/17/1999
Publisher:
Prentice Hall Professional Technical Reference
AIDS Update 2000 / Edition 1

AIDS Update 2000 / Edition 1

by Gerald J. Stine

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Overview

AIDS is a world-wide pandemic. During the past two decades, more manpower and money has been poured into HIV and AIDS research than into any other disease in history. As we near the twenty-first century, it is hoped that our effort will pay off and we will be successful in eradicating this disease.

We are continually being bombarded with new theories and courses of treatment, while the public awareness of the disease continually evolves and changes. It is important, nay essential, to understand where we have been in order to understand where we are going with this disease in the new millennium. However, keeping up the interpreting this information is extremely difficult. AIDS UPDATE 2000 presents a balanced review of the latest information and most important aspects of HIV infection, HIV disease, and the acquired immune deficiency syndrome. More importantly, AIDS UPDATE 2000 places this information within a biological, medical, social, and legal framework so we can more fully understand this devastating modern-day epidemic.

Author Gerald J. Stine answers the most common questions people have about AIDS and how it affects their immune system, including:

  • how the immune system responds to the HIV disease
  • possible origins of the virus
  • how HIV is transmitted
  • who is most likely to become infected, and why
  • possible means of prevention
  • FDA approved and non-approved therapies in use and their effectiveness
  • the potential for a vaccine
  • tests available to detect HIV infection, their accuracy, cost, availability, and problems of counseling and confidentiality

Product Details

ISBN-13: 9780130821966
Publisher: Prentice Hall Professional Technical Reference
Publication date: 11/17/1999
Edition description: Older Edition
Pages: 520
Product dimensions: 7.03(w) x 9.21(h) x 0.84(d)

Read an Excerpt

PREFACE:

WHY DO I WRITE ABOUT HIV/AIDS?

I began writing about a new disease, later called AIDS, in 1981 shortly after the Centers for Disease Control and Prevention issued the first of its reports. But these writings were limited in scope because not much was known at the time. My writing then was for classroom use. Little did I know at the time of the passion that I would develop about this disease. As the number of infected people and their deaths continued to rise, fear and discrimination reared its ugly head because in some cases people are what they are, and in other cases, because of the lack of available nonbiased educational material. At the time, in the mid-1980s, I felt a need to write, to help educate people about this disease, hopefully to answer questions and reduce the blatant discrimination occurring against those who already had the overwhelming burden of HIV disease. So, I began - I created a college level HIV/AIDS course, taught it for several years, constantly shaping and reshaping the information necessary to help others learn the facts about this pandemic, and to destroy destructive myths. After I felt I had set the record straight in my classroom, I began writing HIV/AIDS college level textbooks so that information on this pandemic could be shared more broadly.

There are many reasons I have not stopped writing about HIV/AIDS. AIDS summons up the greatest themes in literature, among them sex, faith and death - themes that are universal and unexpectedly permanent. Anyone who had lost a loved one to death, untimely or by nature, can read about AIDS and understand the emotional forces that take place. Anyone who has taken care ofsomeone who has been ill understands the need for compassion. Anyone who has faced death from a prolonged or life-threatening illness should be able to identify with those who suffer with AIDS. Anyone interested in uncovering acts of human kindness or conversely acts of despicable behavior can find them in writings about this disease.

But more than any of these reasons, my writing about AIDS is fueled by a need to do something, anything, to help. For the millions of people who are in pain and dying, I have little to offer except my writing. Although my only known risk factor was a blood transfusion in the mid-1970s, I can not help but feel lucky that so far neither AIDS nor any other serious disease threatens my life. Is there a reason that I have been spared to my present age when so many others have died? I write about AIDS, not just because I live but because it is part of our history. The AIDS pandemic has changed my feelings and attitudes towards people. I find myself tender and more sensitive to others. AIDS has changed the world in some way for most everyone and, at least some of the information about this disease - its the impact and repercussions - needs telling. So, I write about AIDS because someone needs to tell the story.

WHAT IS AIDS?

AIDS is defined primarily by a severe immune deficiency, and is distinguished from virtually every other disease in history by the fact that it has no constant, specific symptoms. Once the immune system has begun to malfunction, a broad spectrum of health complications can set in. AIDS (or Acquired Immune Deficiency Syndrome) is an umbrella term for any or all of 26 known diseases and their symptoms. When a person has any of these 26 microbial- or viral-caused opportunistic infections, and also tests positive for antibodies to HIV, he or she is diagnosed with AIDS. An AIDS diagnosis is also given to HIV positive people with a T4 cell count of less than 200/uL of blood.

AIDS: A HUMAN AFFAIR

The history of AIDS is a human affair and is part of a cultural process of attempting to come to terms with a new and often terrifying series of events - of young people dying before their time, of the intermingling of sex and death - in a period in which the world itself is changing before our eyes.

The social meaning of the history of AIDS intimately touches upon ideas about sexuality, social responsibility, individual privacy, health, and the prospect of living a normal life span. Understanding how to respond to AIDS and how to think about this pandemic is important not only for what it reveals about the ways in which health policy is created in the United States and elsewhere, but also for what it implies about the human ability to meet the challenge of future emerging diseases and longstanding public health problems. The HIV/AIDS pandemic is a current and long-term public health problem worldwide.

LESSONS LEARNED

From the lessons of history it is difficult to conceptualize how the AIDS epidemic will be halted, let alone reversed, in the absence of a cheap curative drug or a cheap and effective preventative vaccine. The syphilis epidemic at the early part of the century displayed a similar kind of epidemiology to the present-day AIDS epidemic. The campaigns which were initiated then closely paralleled those in place at present for AIDS. There were vigorous educational programs to reduce sexual high-risk behavior, which were targeted at brothels and prostitutes as well as at military recruits to the United States Army. Scare tactics were spread through the use of posters, pamphlets and radio - today it is television. Serological testing became mandatory before marriages could be licensed in certain states of the USA. But these measures had little appreciable effect on the expansion of the syphilis epidemic. It was only the advent of a cheap, safe, and effective drug, penicillin, which eventually brought the epidemic under control. BUT the bacterium (a spirochete) that causes syphilis does not change or mutate as rapidly as the AIDS virus. There are mutant HIV in the human population for drugs that have yet to be tested and a highly effective preventive vaccine may not be a reality for HIV!

One lesson learned from HIV/AIDS is that any disease that is occurring in a distant part of the globe may be in the United States, in your state or in your town, tomorrow. Twenty or even 15 years ago one would not have expected to read that statement.

The advent of miracle drugs and vaccines that conquered the plagues of polio, smallpox, and measles led many people - including scientists - to believe that the age of killer diseases was coming to an end.

The AIDS epidemic changed that perception, and the best-selling nonfiction book The Hot Zone graphically illustrates how an exotic killer called the Ebola virus - carried into Virginia in 1989 by 450 imported research monkeys - came close to breaking loose in this country. In the hit film Outbreak, Dustin Hoffman plays a doctor battling a deadly virus that neither medicine nor the U.S. government can handle. Today, the Centers for Disease Control and Prevention are rethinking their position on the possibility of new plagues occurring in our lifetimes!

THE AIDS PANDEMIC IN PERSPECTIVE

To place the HIV/AIDS pandemic in perspective, consider Michael Creighton's The Andromeda Strain. The essence of this story revolves around the release of an unidentified and untreatable lethal strain of bacteria into the human population. With a few changes - substituting HIV for bacterium, adjusting the time of death after infection, and describing how one dies from the disease - Creighton could have been writing about HIV/AIDS. But with HIV/AIDS, the onset of a real human tragedy, we are learning about our social contradictions, our strengths and our weaknesses, and we are questioning whether this is a morally acceptable disease. How long will it take for this to become a socially acceptable disease?

AIDS: THE WORST-CASE SCENARIO

As presented in this book, the reader will note the ability of HIV to cause a slow, progressive, and permanent disease. Thus, with no recovery, no loss of infectivity, no development of either individual or group immunity, there is at present no known biological mechanism which can stop the continuing expansion of the disease unless an effective vaccine were to come about, and at present there is no feasible design for such an effective vaccine. The progressive increase in the pool of HIV can, in theory, only lead to an exponential increase in the number of individuals who will become infected until eventually the majority of the sexually active population will be infected unless interventions are at least moderately successful.

It is because this scenario may become reality and because people worldwide are becoming HIV-infected every few seconds and dying of AIDS each minute, and because together we must try to prevent the further spread of HIV, that this text continues to be updated.

This text reviews important aspects of HIV infection, HIV disease, and the acquired immune deficiency syndrome. It presents a balanced review of factual information about the biological, medical, social, economic, and legal aspects of this modern-day pandemic.

The intricacy of the HIV/AIDS pandemic has unfolded over the last 19 years. Many of the details of basic research, applied biology, medicine, and social unrest are presented in an attempt to convey the few victories and many setbacks within this ongoing saga. Medical and social anecdotes help to convey a sense of the HIV/AIDS tragedy worldwide. The history of the disease describes how the virus is and is not transmitted. Throughout the text there is a special focus on risk behaviors and risk situations involved in HIV transmission and the means to prevent its transmission. The number of social issues raised by this disease are mind-boggling. Many of these issues are presented - some as open-ended questions for class discussions. Such questions help the student reflect on what he or she has read.

PURPOSE

The purpose of this text is to present an understandable scientific explanation of what has been learned about HIV/AIDS over the last 19 years. In addition, it is particularly important to provide students with a conceptual framework of the issues raised by the HIV/AIDS pandemic so that they will be better able to deal with the challenges posed by this disease. Clearly, this pandemic poses new and unforeseen problems with no quick biological solutions. Only through reason can we respond in a socially acceptable fashion.

Because there is a constant stream of new information to be interpreted and shared, a new edition will be published every year. What has been learned and what must still be learned to bring HIV infection, HIV disease, and AIDS under control is valuable information to most, if not all, of us.

TEXT USE

This text is intended for use in college-level courses on AIDS and as a supplemental HIV/AIDS resource in medical and nursing schools, in colleges of allied health sciences, in psychology department courses on human sexuality and human behavior, in courses on sexually transmitted diseases, in summer teachers programs, in the training of AIDS counselors, in state-mandated AIDS education courses for health care workers, and for physicians who need a ready source of information on how to prevent HIV infection, HIV disease and its progression to AIDS, and types of therapy available. This text is suitable in those cases where information and education about the various aspects of HIV infection, disease, and AIDS are either wanted or required.

During the 19 years since HIV/AIDS was defined as a new disease, more manpower and money has been poured into HIV/AIDS research than into any other disease in history. Information on the AIDS virus has accumulated at an unprecedented pace. Since the discovery of the AIDS virus in 1982-1983, scientists have learned much about how it functions and how it affects the immune system. More was learned about the AIDS virus in the first 6 years after its discovery than had been learned about the polio virus in the first 40 years of the polio epidemic. During the first 6 years of AIDS research, the virus's genetic material was cloned, its structure ascertained, and individual viral genes identified. In fact, so many billions of dollars have been spent on HIV/AIDS that many now believe that HIV/AIDS research has taken away much-needed resources from other diseases that kill many times more people per year than does AIDS.

TEXT OVERVIEW

Because so much of the HIV/AIDS pandemic has been based on the manipulation of distorted scientific fact, it is necessary to counter these distortions and myths by presenting the most consistent, reproducible, and scientifically acceptable facts as possible. Therefore, this text offers answers to questions many people have about the AIDS virus and how their immune systems are affected by it. Covered herein are the activity of the immune system with respect to HIV disease, where the virus might have come from, how it is transmitted, who is most likely to become infected, viral prevalence (geographical distribution of the number of people infected and those expressing HIV disease and AIDS), possible means of preventing infection, signs and symptoms of HIV disease and AIDS, chronological definitions of AIDS, the opportunistic infections most often associated with AIDS, FDA-approved and non approved drugs and their effectiveness, the potential for a vaccine to the AIDS virus, the tests available to detect HIV infection, the accuracy of these tests, their cost, availability, and confidentiality. The last chapter deals with the fear of HIV infection and the social reaction of the uninfected toward the HIV infected.

The majority of references herein are dated between 1987 and 1999. Every state in the United States has HIV infected people and reported people diagnosed with AIDS. The World Health Organization (WHO) reports that of 209 countries reporting to it, 194 have reported diagnosed cases of AIDS through 1999. The virus is truly pandemic and now threatens most of the human population. Yet it is a preventable disorder, and the steps to prevention are presented in Chapter 9.

ORGANIZATION OF THE TEXT

Chapter 1 presents information on the discovery of the disease and naming of the illness. Chapter 2 discusses the cause of AIDS and the possible origin of the AIDS virus. Chapter 3 presents the biological characteristics of the virus. Chapter 4 presents current retroviral therapy and its problems using those drugs to prevent HIV reproduction. Chapter 5 discusses the human immune system as it relates to HIV disease and the loss of the immune system's function. Chapter 6 presents the various opportunistic diseases, how they are affected by the use of retroviral therapy and forms of cancer associated with HIV disease and AIDS. Chapter 7 discusses the clinical profile of biological indicators of HIV disease and AIDS. Chapter 8 presents the means by which HIV is most efficiently transmitted among humans. Chapter 9 details the most effective means to date of preventing HIV infection and the possibilities for a vaccine. Chapter 10 gives the incidence of HIV infections, HIV disease, and AIDS cases among selected behavioral at-risk persons for HIV infection world wide and in the United States. Chapter 11 presents the prevalence and problems of HIV disease in women, children, and teenagers. Chapter 12 presents those tests most often used to detect the presence of HIV, biological shortcomings of the tests, the confidentiality or lack of confidentiality before and after test results, and costs. Chapter 13 offers insight to the many social ramifications of having HIV disease or AIDS, human attitudes, and behaviors. There is also a glossary of terms and index and a list of telephone numbers to federal, state, and other groups that offer information and help with all aspects of the HIV/ AIDS pandemic.

SPECIAL FEATURES

Each chapter contains chapter concepts, a summary, review questions, and references. Answers to questions appear at the back of the book. Chapters also contain definitions for new terms as they are introduced, illustrations, photographs, and tables. All 13 chapters contain boxed information. All of the chapters contain either highlighted points of view, points of information, cases in point, sidebars, Looking Back Features, Sound Off, Points to Ponder or pro and con discussions. They illustrate and emphasize important events and information about HIV infection, HIV disease, and AIDS. At certain places in the text, there are sets of class discussion statements and class questions. Instructors may wish to challenge the class in these areas.

ACCESS TO INFORMATION

Internet addresses, state HIV/AIDS hotlines, toll-free national HIV/AIDS information on prevention, therapy, health care providers, local and state programs relating to specific areas of research and funding, access to information on women, children and teenage HIV/AIDS programs, and information on where to access materials on what HIV infected parents may want to tell their children about their condition and the disease in general, can be found within and at the ends of most chapters.

TO THE EDUCATORS

As educators, it is our job to expose our students to the new concepts in biology that are shaping humanity's future. To do that, we must expose them to new vocabulary, new methodologies, new information and new ideas. It is my hope that this text will help in this endeavor.

Gerald J. Stine, Ph.D.
904-641-8979
email: gstine@UNF.edu

Table of Contents

1. Discovering AIDS, Naming the Disease.
2. What Causes AIDS: Origin of the AIDS virus.
3. Biological Characteristics of the AIDS virus.
4. Anti-HIV Therapy.
5. The Immunology of HIV Disease/AIDS.
6. Opportunistic Infections and Cancers Associated with HIV Disease/AIDS.
7. A Profile of Biological Indicators for HIV Disease and Progression to AIDS.
8. Epidemiology and Transmission of the Human Immunodeficiency Virus.
9. Preventing the Transmission of HIV.
10. Prevalence of HIV Infections, AIDS Cases, and Deaths Among Select Groups in the United States.
11. Prevalence of HIV Infection and AIDS Cases Among Women, Children, and Teenagers in the United States.
12. Testing for Human Immunodeficiency Virus.
13. AIDS and Society: Knowledge, Attitudes, and Behavior.

Preface

PREFACE:

WHY DO I WRITE ABOUT HIV/AIDS?

I began writing about a new disease, later called AIDS, in 1981 shortly after the Centers for Disease Control and Prevention issued the first of its reports. But these writings were limited in scope because not much was known at the time. My writing then was for classroom use. Little did I know at the time of the passion that I would develop about this disease. As the number of infected people and their deaths continued to rise, fear and discrimination reared its ugly head because in some cases people are what they are, and in other cases, because of the lack of available nonbiased educational material. At the time, in the mid-1980s, I felt a need to write, to help educate people about this disease, hopefully to answer questions and reduce the blatant discrimination occurring against those who already had the overwhelming burden of HIV disease. So, I began - I created a college level HIV/AIDS course, taught it for several years, constantly shaping and reshaping the information necessary to help others learn the facts about this pandemic, and to destroy destructive myths. After I felt I had set the record straight in my classroom, I began writing HIV/AIDS college level textbooks so that information on this pandemic could be shared more broadly.

There are many reasons I have not stopped writing about HIV/AIDS. AIDS summons up the greatest themes in literature, among them sex, faith and death - themes that are universal and unexpectedly permanent. Anyone who had lost a loved one to death, untimely or by nature, can read about AIDS and understand the emotional forces that take place. Anyone who has taken careofsomeone who has been ill understands the need for compassion. Anyone who has faced death from a prolonged or life-threatening illness should be able to identify with those who suffer with AIDS. Anyone interested in uncovering acts of human kindness or conversely acts of despicable behavior can find them in writings about this disease.

But more than any of these reasons, my writing about AIDS is fueled by a need to do something, anything, to help. For the millions of people who are in pain and dying, I have little to offer except my writing. Although my only known risk factor was a blood transfusion in the mid-1970s, I can not help but feel lucky that so far neither AIDS nor any other serious disease threatens my life. Is there a reason that I have been spared to my present age when so many others have died? I write about AIDS, not just because I live but because it is part of our history. The AIDS pandemic has changed my feelings and attitudes towards people. I find myself tender and more sensitive to others. AIDS has changed the world in some way for most everyone and, at least some of the information about this disease - its the impact and repercussions - needs telling. So, I write about AIDS because someone needs to tell the story.

WHAT IS AIDS?

AIDS is defined primarily by a severe immune deficiency, and is distinguished from virtually every other disease in history by the fact that it has no constant, specific symptoms. Once the immune system has begun to malfunction, a broad spectrum of health complications can set in. AIDS (or Acquired Immune Deficiency Syndrome) is an umbrella term for any or all of 26 known diseases and their symptoms. When a person has any of these 26 microbial- or viral-caused opportunistic infections, and also tests positive for antibodies to HIV, he or she is diagnosed with AIDS. An AIDS diagnosis is also given to HIV positive people with a T4 cell count of less than 200/uL of blood.

AIDS: A HUMAN AFFAIR

The history of AIDS is a human affair and is part of a cultural process of attempting to come to terms with a new and often terrifying series of events - of young people dying before their time, of the intermingling of sex and death - in a period in which the world itself is changing before our eyes.

The social meaning of the history of AIDS intimately touches upon ideas about sexuality, social responsibility, individual privacy, health, and the prospect of living a normal life span. Understanding how to respond to AIDS and how to think about this pandemic is important not only for what it reveals about the ways in which health policy is created in the United States and elsewhere, but also for what it implies about the human ability to meet the challenge of future emerging diseases and longstanding public health problems. The HIV/AIDS pandemic is a current and long-term public health problem worldwide.

LESSONS LEARNED

From the lessons of history it is difficult to conceptualize how the AIDS epidemic will be halted, let alone reversed, in the absence of a cheap curative drug or a cheap and effective preventative vaccine. The syphilis epidemic at the early part of the century displayed a similar kind of epidemiology to the present-day AIDS epidemic. The campaigns which were initiated then closely paralleled those in place at present for AIDS. There were vigorous educational programs to reduce sexual high-risk behavior, which were targeted at brothels and prostitutes as well as at military recruits to the United States Army. Scare tactics were spread through the use of posters, pamphlets and radio - today it is television. Serological testing became mandatory before marriages could be licensed in certain states of the USA. But these measures had little appreciable effect on the expansion of the syphilis epidemic. It was only the advent of a cheap, safe, and effective drug, penicillin, which eventually brought the epidemic under control. BUT the bacterium (a spirochete) that causes syphilis does not change or mutate as rapidly as the AIDS virus. There are mutant HIV in the human population for drugs that have yet to be tested and a highly effective preventive vaccine may not be a reality for HIV!

One lesson learned from HIV/AIDS is that any disease that is occurring in a distant part of the globe may be in the United States, in your state or in your town, tomorrow. Twenty or even 15 years ago one would not have expected to read that statement.

The advent of miracle drugs and vaccines that conquered the plagues of polio, smallpox, and measles led many people - including scientists - to believe that the age of killer diseases was coming to an end.

The AIDS epidemic changed that perception, and the best-selling nonfiction book The Hot Zone graphically illustrates how an exotic killer called the Ebola virus - carried into Virginia in 1989 by 450 imported research monkeys - came close to breaking loose in this country. In the hit film Outbreak, Dustin Hoffman plays a doctor battling a deadly virus that neither medicine nor the U.S. government can handle. Today, the Centers for Disease Control and Prevention are rethinking their position on the possibility of new plagues occurring in our lifetimes!

THE AIDS PANDEMIC IN PERSPECTIVE

To place the HIV/AIDS pandemic in perspective, consider Michael Creighton's The Andromeda Strain. The essence of this story revolves around the release of an unidentified and untreatable lethal strain of bacteria into the human population. With a few changes - substituting HIV for bacterium, adjusting the time of death after infection, and describing how one dies from the disease - Creighton could have been writing about HIV/AIDS. But with HIV/AIDS, the onset of a real human tragedy, we are learning about our social contradictions, our strengths and our weaknesses, and we are questioning whether this is a morally acceptable disease. How long will it take for this to become a socially acceptable disease?

AIDS: THE WORST-CASE SCENARIO

As presented in this book, the reader will note the ability of HIV to cause a slow, progressive, and permanent disease. Thus, with no recovery, no loss of infectivity, no development of either individual or group immunity, there is at present no known biological mechanism which can stop the continuing expansion of the disease unless an effective vaccine were to come about, and at present there is no feasible design for such an effective vaccine. The progressive increase in the pool of HIV can, in theory, only lead to an exponential increase in the number of individuals who will become infected until eventually the majority of the sexually active population will be infected unless interventions are at least moderately successful.

It is because this scenario may become reality and because people worldwide are becoming HIV-infected every few seconds and dying of AIDS each minute, and because together we must try to prevent the further spread of HIV, that this text continues to be updated.

This text reviews important aspects of HIV infection, HIV disease, and the acquired immune deficiency syndrome. It presents a balanced review of factual information about the biological, medical, social, economic, and legal aspects of this modern-day pandemic.

The intricacy of the HIV/AIDS pandemic has unfolded over the last 19 years. Many of the details of basic research, applied biology, medicine, and social unrest are presented in an attempt to convey the few victories and many setbacks within this ongoing saga. Medical and social anecdotes help to convey a sense of the HIV/AIDS tragedy worldwide. The history of the disease describes how the virus is and is not transmitted. Throughout the text there is a special focus on risk behaviors and risk situations involved in HIV transmission and the means to prevent its transmission. The number of social issues raised by this disease are mind-boggling. Many of these issues are presented - some as open-ended questions for class discussions. Such questions help the student reflect on what he or she has read.

PURPOSE

The purpose of this text is to present an understandable scientific explanation of what has been learned about HIV/AIDS over the last 19 years. In addition, it is particularly important to provide students with a conceptual framework of the issues raised by the HIV/AIDS pandemic so that they will be better able to deal with the challenges posed by this disease. Clearly, this pandemic poses new and unforeseen problems with no quick biological solutions. Only through reason can we respond in a socially acceptable fashion.

Because there is a constant stream of new information to be interpreted and shared, a new edition will be published every year. What has been learned and what must still be learned to bring HIV infection, HIV disease, and AIDS under control is valuable information to most, if not all, of us.

TEXT USE

This text is intended for use in college-level courses on AIDS and as a supplemental HIV/AIDS resource in medical and nursing schools, in colleges of allied health sciences, in psychology department courses on human sexuality and human behavior, in courses on sexually transmitted diseases, in summer teachers programs, in the training of AIDS counselors, in state-mandated AIDS education courses for health care workers, and for physicians who need a ready source of information on how to prevent HIV infection, HIV disease and its progression to AIDS, and types of therapy available. This text is suitable in those cases where information and education about the various aspects of HIV infection, disease, and AIDS are either wanted or required.

During the 19 years since HIV/AIDS was defined as a new disease, more manpower and money has been poured into HIV/AIDS research than into any other disease in history. Information on the AIDS virus has accumulated at an unprecedented pace. Since the discovery of the AIDS virus in 1982-1983, scientists have learned much about how it functions and how it affects the immune system. More was learned about the AIDS virus in the first 6 years after its discovery than had been learned about the polio virus in the first 40 years of the polio epidemic. During the first 6 years of AIDS research, the virus's genetic material was cloned, its structure ascertained, and individual viral genes identified. In fact, so many billions of dollars have been spent on HIV/AIDS that many now believe that HIV/AIDS research has taken away much-needed resources from other diseases that kill many times more people per year than does AIDS.

TEXT OVERVIEW

Because so much of the HIV/AIDS pandemic has been based on the manipulation of distorted scientific fact, it is necessary to counter these distortions and myths by presenting the most consistent, reproducible, and scientifically acceptable facts as possible. Therefore, this text offers answers to questions many people have about the AIDS virus and how their immune systems are affected by it. Covered herein are the activity of the immune system with respect to HIV disease, where the virus might have come from, how it is transmitted, who is most likely to become infected, viral prevalence (geographical distribution of the number of people infected and those expressing HIV disease and AIDS), possible means of preventing infection, signs and symptoms of HIV disease and AIDS, chronological definitions of AIDS, the opportunistic infections most often associated with AIDS, FDA-approved and non approved drugs and their effectiveness, the potential for a vaccine to the AIDS virus, the tests available to detect HIV infection, the accuracy of these tests, their cost, availability, and confidentiality. The last chapter deals with the fear of HIV infection and the social reaction of the uninfected toward the HIV infected.

The majority of references herein are dated between 1987 and 1999. Every state in the United States has HIV infected people and reported people diagnosed with AIDS. The World Health Organization (WHO) reports that of 209 countries reporting to it, 194 have reported diagnosed cases of AIDS through 1999. The virus is truly pandemic and now threatens most of the human population. Yet it is a preventable disorder, and the steps to prevention are presented in Chapter 9.

ORGANIZATION OF THE TEXT

Chapter 1 presents information on the discovery of the disease and naming of the illness. Chapter 2 discusses the cause of AIDS and the possible origin of the AIDS virus. Chapter 3 presents the biological characteristics of the virus. Chapter 4 presents current retroviral therapy and its problems using those drugs to prevent HIV reproduction. Chapter 5 discusses the human immune system as it relates to HIV disease and the loss of the immune system's function. Chapter 6 presents the various opportunistic diseases, how they are affected by the use of retroviral therapy and forms of cancer associated with HIV disease and AIDS. Chapter 7 discusses the clinical profile of biological indicators of HIV disease and AIDS. Chapter 8 presents the means by which HIV is most efficiently transmitted among humans. Chapter 9 details the most effective means to date of preventing HIV infection and the possibilities for a vaccine. Chapter 10 gives the incidence of HIV infections, HIV disease, and AIDS cases among selected behavioral at-risk persons for HIV infection world wide and in the United States. Chapter 11 presents the prevalence and problems of HIV disease in women, children, and teenagers. Chapter 12 presents those tests most often used to detect the presence of HIV, biological shortcomings of the tests, the confidentiality or lack of confidentiality before and after test results, and costs. Chapter 13 offers insight to the many social ramifications of having HIV disease or AIDS, human attitudes, and behaviors. There is also a glossary of terms and index and a list of telephone numbers to federal, state, and other groups that offer information and help with all aspects of the HIV/ AIDS pandemic.

SPECIAL FEATURES

Each chapter contains chapter concepts, a summary, review questions, and references. Answers to questions appear at the back of the book. Chapters also contain definitions for new terms as they are introduced, illustrations, photographs, and tables. All 13 chapters contain boxed information. All of the chapters contain either highlighted points of view, points of information, cases in point, sidebars, Looking Back Features, Sound Off, Points to Ponder or pro and con discussions. They illustrate and emphasize important events and information about HIV infection, HIV disease, and AIDS. At certain places in the text, there are sets of class discussion statements and class questions. Instructors may wish to challenge the class in these areas.

ACCESS TO INFORMATION

Internet addresses, state HIV/AIDS hotlines, toll-free national HIV/AIDS information on prevention, therapy, health care providers, local and state programs relating to specific areas of research and funding, access to information on women, children and teenage HIV/AIDS programs, and information on where to access materials on what HIV infected parents may want to tell their children about their condition and the disease in general, can be found within and at the ends of most chapters.

TO THE EDUCATORS

As educators, it is our job to expose our students to the new concepts in biology that are shaping humanity's future. To do that, we must expose them to new vocabulary, new methodologies, new information and new ideas. It is my hope that this text will help in this endeavor.

Gerald J. Stine, Ph.D.
904-641-8979
email: gstine@UNF.edu

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