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What Are HIV and AIDS?

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). AIDS is a disease of the immune system for which there is treatment, but no cure, at the present time. The virus (HIV) and the disease it causes (AIDS) are often linked and referred to as "HIV/AIDS."

HIV can be transferred among people if an infected person's blood or other bodily fluid comes in contact with the blood, broken skin, or mucous membranes of an uninfected person. In addition, infected pregnant women can pass HIV to their babies during pregnancy, delivery, and breastfeeding.

HIV destroys a certain kind of white blood cell that is crucial to the normal function of the human immune system. Loss of these CD4+ cells in people with HIV is a key predictor of the development of AIDS. Because of their compromised immune system, people with AIDS often develop infections of the lungs, brain, eyes, and other organs, and they frequently suffer dangerous weight loss, diarrhea, and a type of cancer called Kaposi's sarcoma. [1]

Some hopeful news is that in recent years, HIV is no longer a death sentence, as it was when the epidemic began. This is largely because of treatment with HAART (highly active antiretroviral therapy), a combination of three or more antiretroviral medications that can suppress the virus and prevent or decrease symptoms of illness.

How Many People Have HIV/AIDS?

HIV/AIDS has been a global epidemic for more than 25 years-most of today's youth have never known a world without it. In the United States, the latest estimates indicate that about 1 million people are living with HIV or AIDS.

In 2003, 43,171 new AIDS diseases cases were reported. The number of HIV infections is harder to confirm as only about two-thirds of the States report HIV infections. Estimates from these data indicate that about 40,000 new HIV infections have occurred annually since the early 1990s, down from the peak of 160,000 new infections per year in the mid-1980s.

The Centers for Disease Control and Prevention (CDC) estimates that about one-quarter of the people in the United States who are infected with HIV do not know they are infected. [2]

How are Drug Abuse and HIV Related?

Drug abuse and addiction have been inextricably linked with HIV/AIDS since the beginning of the epidemic. Although injection drug use is well known in this regard, the role that non-injection drug abuse plays more generally in the spread of HIV is less recognized. This is partly due to the addictive and intoxicating effects of many drugs, which can alter judgment and inhibition and lead people to engage in impulsive and unsafe behaviors.

Injection drug use. People typically associate drug abuse and HIV/AIDS with injection drug use and needle sharing. HIV can be transmitted between users when injection drug users share "equipment"-such as needles, syringes, and other drug injection paraphernalia. Other infections-such as hepatitis C-can also be spread this way. Hepatitis C can cause liver disease and permanent liver damage.

Poor judgment and risky behavior. Drug abuse by any route (not just injection) can put a person at risk for getting HIV. Drug and alcohol intoxication affect judgment and can lead to unsafe sexual practices, which put people at risk for getting HIV or transmitting it to someone else.

Biological effects of drugs. Drug abuse and addiction can affect a person's overall health, thereby altering susceptibility to HIV and progression of AIDS. Drugs of abuse and HIV both affect the brain. Research has shown that HIV causes greater neuronal injury and cognitive impairment among Methamphetamine abusers than among HIV patients who do not abuse drugs. In animal studies, Methamphetamine has been shown to increase the amount of HIV in brain cells.

Drug abuse treatment. Since the late 1980s, research has shown that treating drug abuse is an effective way to prevent the spread of HIV. Drug abusers in treatment stop or reduce their drug use and related risk behaviors, including drug injection and unsafe sexual practices. Drug treatment programs also serve an important role in disseminating current information on HIV/AIDS and related diseases, providing counseling and testing services, and offering referrals for medical and social services.

How Are Teens Affected?

Young people are at risk for contracting HIV and developing AIDS. According to CDC, about 38,490 young people age 13 to 24 in the United States had been diagnosed with AIDS by the end of 2003. And the trend was increasing-from 3.9 percent diagnosed with AIDS in 1999 to 4.7 percent in 2003.

In youth, as in adults, some populations are disproportionately affected. African Americans age 13 to 19 represent only 15 percent of the U.S. teenage population, but accounted for 66 percent of new AIDS cases in 2003. [4] The reasons for this disparity are not completely understood; in fact, African American youth have lower rates of drug abuse than Whites and Hispanics. This remains a strong research priority area for NIDA.

In general, middle and late adolescence is a time when young people engage in risk-taking and sensation-seeking-behaviors that may put them in jeopardy of contracting HIV. Regardless of whether a young person takes drugs, unsafe sexual practices increase a person's risk of contracting HIV. But drugs and alcohol can increase the chances of unsafe behavior by altering judgment and decision making.

References

1.	Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention. What Is HIV? (http://www.cdc.gov/hiv/pubs/faq/faq1.htm): Atlanta, GA: CDC, DHHS. Retrieved November 2005.
2.	Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention. Basic Statistics AIDS Cases by Exposure Category (http://www.cdc.gov/hiv/stats.htm#exposure): Atlanta, GA: CDC, DHHS. Retrieved November 2005.
3.	National Institute on Drug Abuse. Research Report Series on HIV/AIDS (http://www.nida.nih.gov/ResearchReports/hiv/hiv.html ): Bethesda, MD: NIDA, NIH, DHHS. Retrieved November 2005.
4.	Centers for Disease Control and Prevention. HIV/AIDS Surveillance in Adolescents, L265 Slide Series (http://www.cdc.gov/hiv/graphics/adolesnt.htm): Atlanta, GA: CDC, DHHS. Retrieved November 2005.
5.	World AIDS Day. World AIDS Day (http://www.worldaidsday.org ): Retrieved November 2005.

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