Challenging AIDS

what is aids?


AIDS stands for: Acquired Immune Deficiency Syndrome

AIDS is a medical condition. A person is diagnosed with AIDS when their immune system is too weak to fight off infections.

Since AIDS was first identified in the early 1980s, an unprecedented number of people have been affected by the global AIDS epidemic. Today, there are an estimated 33.3 million people living with HIV and AIDS worldwide.

What causes AIDS?

AIDS is caused by HIV.

HIV is a virus that gradually attacks immune system cells. As HIV progressively damages these cells, the body becomes more vulnerable to infections, which it will have difficulty in fighting off.  It is at the point of very advanced HIV infection that a person is said to have AIDS. It can be years before HIV has damaged the immune system enough for AIDS to develop.



Antiretroviral treatment can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and someone with HIV who is taking treatment could live for the rest of their life without developing AIDS.

An AIDS diagnosis does not necessarily equate to a death sentence. Many people can still benefit from starting antiretroviral therapy even once they have developed an AIDS defining illness. Better treatment and prevention for opportunistic infections have also helped to improve the quality and length of life for those diagnosed with AIDS.

Treating some opportunistic infections is easier than others. Infections such as herpes zoster and candidiasis of the mouth, throat or vagina, can be managed effectively in most environments. On the other hand, more complex infections such as toxoplasmosis, need advanced medical equipment and infrastructure, which are lacking in many resource-poor areas.

It is also important that treatment is provided for AIDS related pain, which is experienced by almost all people in the very advanced stages of HIV infect



Why do people still develop AIDS today?


Even though antiretroviral treatment can prevent the onset of AIDS in a person living with HIV, many people are still diagnosed with AIDS today. There are four main reasons for this:

Caring for a person with AIDS

n the later stages of AIDS, a person will need palliative care and emotional support. In many parts of the world, friends, family and AIDS organisations provide home based care. This is particularly the case in countries with high HIV prevalence and overstretched healthcare systems.

End of life care becomes necessary when a person has reached the very final stages of AIDS. At this stage, preparing for death and open discussion about whether a person is going to die often helps in addressing concerns and ensuring final wishes are followed.

The global AIDS epidemic


Around 2.6 million people became infected with HIV in 2009. Sub-Saharan Africa has been hardest hit by the epidemic; in 2009 over two-thirds of AIDS deaths were in this region.

Parc de l'espoir - AIDS Memorial Park in Montreal, CanadaParc de l'espoir - AIDS Memorial Park in Montreal, Canada

The epidemic has had a devastating impact on societies, economies and infrastructures. In countries most severely affected, life expectancy has been reduced by as much as 20 years. Young adults in their productive years are the most at-risk population, so many countries have faced a slow-down in economic growth and an increase in household poverty. In Asia, HIV and AIDS causes a greater loss of productivity than any other disease. An adult’s most productive years are also their most reproductive and so many of the age group who have died from AIDS have left children behind. In sub-Saharan Africa the AIDS epidemic has orphaned nearly 15 million children.

In recent years, the response to the epidemic has been intensified; in the past ten years in low- and middle-income countries there has been a 6-fold increase in spending for HIV and AIDS. The number of people on antiretroviral treatment has increased, the annual number of AIDS deaths has declined, and the global percentage of people infected with HIV has stabilised.

However, recent achievements should not lead to complacent attitudes. In all parts of the world, people living with HIV still face AIDS related stigma and discrimination, and many people still cannot access sufficient HIV treatment and care. In America and some countries of Western and Central and Eastern Europe, infection rates are rising, indicating that HIV prevention is just as important now as it ever has been. Prevention efforts that have proved to be effective need to be scaled-up and treatment targets reached. Commitments from national governments right down to the community level need to be intensified and subsequently met, so that one day the world might see an end to the global AIDS epidemic.








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Top 10: Most Important Developments in HIV Medicine


    Top 10: 2001 -- 10 Most Important Developments in HIV Medicine
  1. After years of denial, Chinese AIDS experts stated that China was in the midst of what could become a serious epidemic of HIV infection. Researchers estimated that approximately 600,000 people were infected, and the number of people found to be infected was growing by 30% per year.
  2. The US Food and Drug Administration (FDA) issued approval of tenofovir (TDF), the first nucleotide analog approved for HIV-1 treatment.
  3. Thirty-nine pharmaceutical companies withdrew their case attempting to block legislation passed by the South African government that would allow generic substitution and parallel importing.
  4. AIDS activists filed suit against the South African health ministry, attempting to force the government to supply antiretroviral drugs for prevention of mother-to-child transmission (PMTCT) of HIV. In December, the South African High Court ruled that the government must supply nevirapine (NVP) to pregnant women for PMTCT.
  5. According to a US Centers for Disease Control and Prevention (CDC) study, 30% of young gay black men in six US cities were infected with HIV. The CDC also reported that AIDS was the leading cause of death for African Americans between the ages of 25 and 44.
  6. The Indian drug company Cipla offered to sell antiretroviral drugs to Médecins sans Frontières (MSF) for less than US$1 per day, adding to the pressure on multinational pharmaceutical companies to reduce their prices for developing nations.
  7. At the African Summit on HIV/AIDS, Tuberculosis, and Other Infectious Diseases, United Nations (UN) Secretary-General Kofi Annan called for annual spending of US$7 billion to US$10 billion on AIDS in developing countries, up from spending of US$1 billion. The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria was announced; initial commitments amounted to only US$1.6 billion.
  8. The year 2001 marked the 20th anniversary of the first published report describing the disease that would eventually be named AIDS.
  9. Kofi Annan convened the UN General Assembly Special Session on HIV/AIDS, the first such meeting entirely devoted to a public health issue.
  10. A study was presented at the Transplant 2001 conference showing that liver transplants can be successfully performed in some people with HIV. The transplants had previously been avoided due to the fear that the immunosuppressive drugs taken following an organ transplant would harm the immune systems of people with HIV.


  1. China stops denying AIDS epidemic. August 9, 2001. (Accessed August 11, 2005).
  2. US Food and Drug Administration. FDA approves VIREAD for HIV-1 infection. FDA Talk Paper. October 29, 2001. (Accessed August 11, 2005).
  3. Baleta A. Drug firms lose patent rights lawsuit against South Africa's government. Lancet. 2001;357(9265):1347.
  4. Sidley P. AIDS campaigners to take South Africa's health ministry to court. BMJ 2001;323:301; Ashraf H. S Africa must treat HIV-infected pregnant women, says high court judge. Lancet. 2001;358(9299):2139.
  5. Clark C. Paying the price of AIDS. (Accessed August 11, 2005).
  6. Kumar S. Indian company offers low cost AIDS drugs. Lancet. 2001;357(9256):616.
  7. United Nations. Secretary General proposes global fund for fight against HIV/AIDS and other infectious diseases at African leaders summit. Press Release. April 26, 2001. (Accessed August 11, 2005); United Nations. Title, purpose, principles and scope of the fund. October 12, 2001. (Accessed August 11, 2005); Global Fund to Fight AIDS, Tuberculosis and Malaria. Planning phase for Global Fund to Fight AIDS, TB and Malaria concludes with agreement on basic foundations. December 17, 2001. (Accessed August 11, 2005).
  8. Kapp C. Gloomy anniversary and outlook for HIV/AIDS. Lancet. 2001;357(9271):1860.
  9. McLellan F. Annan calls for action on AIDS at UN meeting. Lancet. 2001;357(9274):2107.
  10. Highleyman L. Liver transplants successful in HIV positive people. BETA. 2001;14(2):10.




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