HIV Infection Transmission | Stages, Predisposing Factors.
HIV infection transmission knowledge nowadays, is paramount since it acts as a basic strategy in fighting this pandemic. Imagine going to the health facility every time just because you need counseling?
Did you know this basic HIV/AIDS information we give clients during their visits empowers many such that they hence teach their communities back home?
Initially, there a no symptoms to an infected person but as HIV progresses to the next stage, illness occurs. Without taking of antiretroviral (ARV) medication, that particular person may get to AIDS stage and finally death. Actually, this is just a tit-bit of what this article talks about.
Otherwise, there are more interesting facts on HIV infection transmission below….
EPIDEMIOLOGY OF HIV
Firstly, what is epidemiology? Basically, the study of disease pattern and its distribution.
Therefore, HIV is a global pandemic.
According to HIV infection transmission research, about 36.7 million people are infected as of 2017 of which 22.9 million are of Sub-Saharan Africa.
In 2017, 940,000 people died of AIDS defining illnesses (A.D.I) globally. Africa remains the most severely affected.
Nevertheless, AIDS-related deaths have been reported to be 36,000 in the year 2016.
However, those on antiretroviral treatment are reported to be 64% adults and 65% children.
In addition, it is estimated globally by 2030, 60 million deaths will occur as a result of A.D.I. In Kenya between 500-700 deaths occur as a result of A.D.I or HIV infection transmission.
Stages of HIV Infection according to WHO.
Stage 1: ASYMPTOMATIC
- There are no visible signs except one experiences fever. This stage of HIV infection transmission involves entry, replication, maturation and release of the virus. The time between exposure and when the test can detect the HIV virus is known as window period.
- The time between exposure and when the signs become visible is called the incubation period. Once the virus enters the cell, it starts to multiply through a process called replication.
- It replicates in the lymph nodes.
Stage 2: SYMPTOMATIC
The symptoms of HIV infection begin to appear (after transmission) but vague. Therefore, the virus continues to spread very fast in the blood hence, the immunity begins to weaken.
The following signs, symptoms and illnesses appear:- fatigue, coughing, diarrhoea, vomiting, headaches, shortness of breath, soar throat, swollen lymph nodes, loss of appetite.
Stage 3: AIDS-RELATED COMPLEX
Immunity begins to breakdown. The following symptoms of HIV infection can be observed:
- Persistent cough
- Persistent diarrhoea
- Shortness of breath
- Night sweats
- Herpes zoster/Shingles
- Change in skin texture, Hand boils
- Extreme loss of weight
Stage 4: END STAGE
The immunity, due to initial HIV infection transmission, completely breaks down. The following symptoms are surface:-
- Mental disorders e.g. Confusion and forgetfulness
- Oral, anal and genital pain, seizures, cancers e.g. cervical
- Loss of vision
- Cancer of immune system i.e. Lymphomas
- Penile cancer
Stage 5: DEATH
Finally, the immunity collapses. Death usually occurs as a result of an opportunistic infection or diseases. The time between transmission of HIV infection or rather, exposure and death with poor management is 46 years. However, with good HIV management, people live for long e.g. Asunta Wagura who has lived with the virus for more than 23 years.
3 Main HIV Predisposing Factors
i.) Cases of Sexually Transmitted Diseases
ii.) Lack of circumcision
- The space between the foreskin and the penis is warm and moist therefore, provides a good media for the growth of microorganisms.
- The glans of uncircumcised penis is more prone to bruises during sexual intercourse as opposed to a glans of a circumcised penis which is hardened.
- The langerhans cells found between the foreskin and the penis tend to attract the HIV virus.
iii.) Number of Sexual Partners
The small n = Your partner’s number of sexual partners.
HIV Infection Transmission Through Blood & Blood Products
Of course, there are other fluids that also have high concentrations of the virus which include semen, vaginal fluids as well as breast milk.
Therefore, apart from blood itself, the products simply include pus and serum. This mode of HIV infection transmission actually explains why one might be HIV positive even without engaging in sexual intercourse!
Now, to cut all these explanations short, let us learn how blood and blood products cause HIV transmission.
1.) Blood Transfusion
HIV Infection can occur if one is transfused with infected blood. Currently in Kenya, like most parts of the world, all the blood we donate is goes through the following tests to avoid transmission:
- HIV, Malaria, Syphilis, Hepatitis B & C and the blood group & Rhesus factor are identified. Contaminated blood has to be discharged immediately in accordance with medical waste disposal guidelines. The safe blood is kept in a blood bank for 3 months and tested again for HIV before being released for use.
2.) Professional Exposure
Many co-practitioners, paramedics, hospital cleaners and waste managers are at risk of HIV infection due to the nature of their work. If at all this happens, do not hesitate to inform your clinician or doctor/in charge.
Usually, an exposed person is put under PEP (Post-Exposure Prophylaxis) before 72 hours after the exposure elapse, for 4 weeks.
3.) People With Injecting Drugs(PWID)
Actually, these people are common in urban areas. In Coast or Mombasa, Kenya we call them “mateja“. In spite of them being PWID, they tend to share some syringes as they are injecting.
However, studies have shown that the prevalence of HIV infection transmission among PWIDs is high if they practice flushback or booting. Therefore, if one has the HIV definitely, transmission will occur.
4.) Traditional Communal Circumcision and FGM (Female Genital Mutilation)
Most communities that circumcise tend to encourage the sharing of circumcising tools as part of the ritual.
For example, the Bukusu community in Western Kenya that practices male circumcision in a ceremonial way every August.
In addition, we also have the Pokot community that has been doing FGM according to their customs. All these practices may lead to transmission of the HIV infection to larger number of adolescents, if safe measures are not in place.
Otherwise, we understand that FGM is against human rights and therefore illegal in most countries but that is a topic for another day!
5.) Sharing of sharp objects during ear-piercing/ notching, body tattooing e.t.c
Firstly, HIV is found in high concentration in the following body fluids:- Blood, vaginal fluids, semen and breast milk.
Secondly, HIV is found in low concentration that is medically not significant in saliva, urine, sweat and tears.
For example, for an infection to take place, one needs contact with 0.001ml of blood or 5 litres of saliva.
Mmaka Abbas. (2020). Jamii-Health Blogger & Community Health Officer/Health Counselor. Mombasa County. Kenya. https://jamii-health.co.ke/