Transmission and Incidence
HIV is not transmitted by casual contact; transmission requires a direct
exchange(intercambio)
of body fluids, such as blood or blood products, breast milk(leche
materna), semen, or vaginal secretions, most commonly as a
result of sexual activity or the sharing of needles(agujas)
among drug users. Such a transmission(tal
transmisión) may also occur from mother to baby
during pregnancy(embarazo)
or at birth. Saliva, tears, urine, feces(heces),
and sweat do not appear to transmit the virus.
By the end of 2002 it was estimated that 42 million people were infected
with HIV worldwide, the great majority in Third World countries(países
del tercer mundo); some 25
million had died from AIDS. The disease in sub-Saharan Africa, which has
been especially hard hit(duro
golpe), in the main(en
general)
has been transmitted heterosexually and has been exacerbated(exacerbado,
incrementado)
by civil wars and refugee problems and less restrictive local mores(costumbres)
with regard to(con
relación a)
sex. Some(unos)
29 million people were infected with HIV in this region, where, in many
countries, the prevalence(predominancia)
of AIDS has lowered(disminuido)
the life expectancy(esperanza
de vida). The epidemic(epidemia)
also has manifested itself in Asia (especially in India, China, Myanmar,
Thailand, and Cambodia) and Latin America.
In the United States, the demographics of AIDS have changed over time(con
el tiempo). In the 1980s it was seen mainly(principalmente) in homosexual and
bisexual men and was one of the spurs(acicates)
to the gay-rights(derechos
de los homosexuales)
movement , as activists lobbied for(presionaron)
research and treatment monies and began education and prevention programs.
Also in the early years(años
recientes), before careful screening of blood products was
deemed necessary(considerado
necesario), the virus was contracted by an estimated 9,000
hemophiliacs, and a small number of people were infected by surgical(quirúrgico)
or emergency blood transfusions. Before long(poco
después), however, the majority of new HIV infections were seen
in drug users who contracted the disease from shared needles or unprotected
sex. A large proportion of infected women are drug users or partners(compañeros) of drug
users. Nearly a third(casi
una tercera parte)
of the infants born to HIV-infected women are infected with the virus. (Some
of these infants test positive for AIDS only because of the mother's
antibodies and later test negative.)
Tests and Treatment
Various blood tests now are used to detect HIV. The most frequently used
test for detecting antibodies to HIV-1 is enzyme immunoassay. If it
indicates the presence of antibodies, the blood is more definitively tested
with the Western blot(mancha)
method. A test that measures directly the viral genes(genes
virales)
in the blood is helpful in assessing(evaluar)
the efficacy of treatments.
There is no cure for AIDS. Drugs such as
AZT , ddI, and
3TC have proved effective(han
demostrado ser efectivas)
in delaying(retrasar)
the onset(aparición)
of symptoms in certain subsets(subconjuntos)
of infected individuals. The addition of a protease inhibitor, such as saquinovir or amprenavir, to AZT and 3TC has proved very effective, but the
drug combination does not eliminate the virus from the body. A recently
approved drug not in the protease inhibitor group, efavirenz (Sustiva), must
be taken with protease inhibitors or older AIDS medicines. Opportunistic
infections are treated with various antibiotics and antivirals(antivíricos),
and patients with malignancies may undergo(sufrir) chemotherapy(quimioterapia).
These measures may prolong life or improve(mejorar) the quality of life, but drugs
for AIDS treatment may also produce painful or debilitating side effects.
Some 30 experimental AIDS vaccines have been developed and tested, but none
has yet proved clearly effective, including one that underwent(experimentó,
siguió)
full-scale testing(test
a gran escala). The development of a successful vaccine against
AIDS has been slowed(enlentecido)
because HIV mutates(muta,
cambia)
rapidly, causing it to become unrecognizable(irreconocible)
to the immune system, and because, unlike(al
contrario que)
most viruses, HIV attacks and destroys essential components of the very
immune system a vaccine is designed to stimulate.
Governments and the pharmaceutical industry continue to be under pressure(bajo
presión)
from AIDS activists and the public in general to find a cure for AIDS.
Attempts at prevention through teaching “safe sex” (i.e., the relatively
safer sex accomplished by the use of condoms), sexual abstinence in
high-risk situations, and the dangers to drug users of sharing needles have
been impeded(impedido)
by those who feel that such education gives license(tal
educación otorga licencia, derecho a) to promiscuity and
immoral behaviors. |
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