HIV Myths

People with HIV look just like everybody else

Around the world, there are a number of different myths about HIV and AIDS. Here are some of the more common ones :

'You would have to drink a bucket of infected saliva to become infected yourself' a typical myth. The fact is, that although HIV is found in saliva, but in quantities too small to infect someone. If you drink a bucket full of saliva from a HIV positive person, you won't be infected. There has been only one recorded case of HIV transmission via kissing, out of all the many millions of recorded cases. In this case, both the partners had extremely bad bleeding gums.

'Sex with a virgin can cure HIV' . . . This myth is very common in some of the parts of Africa, and it is totally untrue and has resulted in rapes of many young girls & children by HIV+ men, who often infect their victims, rather than finding a cure for themselves. Rape is a very a serious crime all around the world and won't cure anything.

'It only happens to gay men / black people / young people, etc' . . . This myth is false too. Most people who have become HIV positive, did not even think that it would happen to them, were proved wrong, when they got infected.

'HIV can pass through latex' . . . Some people have been spreading rumors that the virus is so minute that it can pass through the extremely small holes in latex used to make condoms. This is untrue - latex blocks HIV, as well as sperm - preventing pregnancy, too.

Answers to nonbelievers arguing that HIV doesn't cause AIDS

• The Myth is that HIV antibody testing is unreliable but the Fact is that the diagnosis of infection using antibody testing is one of the best and well-established view in medicine and these tests exceed the performance of most other tests for various other infectious disease, in both sensitivity (the ability of the screening test to give a positive finding when the person tested truly has the disease) and specificity (the facility of the test to provide a negative observation while the people tested are free of the disease under each study). Present HIV antibody tests have both the sensitivity & the specificity over and above 98% and therefore are extremely reliable. With the passage of time and the subsequent developments in the testing methodology has enabled the discovery of genetic material of the virus, the related antigens and finally the virus itself in body fluids and cells. Whereas, though not widely used for the routine testing because it involves very high cost structure and requirements in the form of laboratory equipments, that these direct testing techniques have authenticated the validity of the antibody tests.

• The Myth is that there is no AIDS in Africa. AIDS is nothing more than a new name for old diseases whereas the Fact is that, the ailments that have been associated with AIDS in Africa -- such as wasting syndrome, diarrhoeal diseases and TB -- have existed as very severe problems there for a very long time. Though, high rates of mortality from these dreaded diseases, previously restricted only to the elderly, malnourished & undernourished, are now very common amongst HIV-infected young as well as middle-aged people. It has been observed in a study in Cote d'Ivoire, HIV-seropositive individuals with pulmonary tuberculosis (TB) were 17 times more likely to pass away within a period of six months than HIV-seronegative individuals with pulmonary TB. In Malawi, it has further been observed that the mortality rate is over three years among children who had received recommended childhood immunizations and those who survived the first year of life was 9.5 times higher among HIV-seropositive children than among HIV-seronegative children. The main causes of death were wasting syndrome and respiratory conditions. Findings are similar in other parts of Africa too.

• The Myth is that HIV cannot be the cause of AIDS because researchers are unable to explain precisely how HIV destroys the immune system but on the contrary the fact is that a great deal is known about the pathogenesis of HIV disease, although very important details still remain unexplained so far. However, a thorough understanding of the pathogenesis of any disease isn’t a prerequisite to be familiar with the cause of the same. Most of the infectious carriers of the sickness have been for very long associated with, even before their pathogenic mechanisms were discovered with the disease they cause. Since the research in pathogenesis is quite difficult In case of non availability of precise animal models, the disease-causing mechanisms in many of the diseases, including tuberculosis and hepatitis B are inadequately understood. The reasoning of the critics would probably lead to the conclusion that M. tuberculosis isn’t the cause of tuberculosis or that hepatitis B virus is not the cause of liver disease.

• The Myth is that AZT and other antiretroviral drugs, not HIV, cause AIDS but the Fact is that a great mass of people infected with AIDS have never ever received antiretroviral drugs, including such people in developed countries prior to the licensure of AZT in 1987, and the people in the developing countries even today very few individuals have access to these medications. As with medications for any serious diseases, antiretroviral drugs can have toxic side effects. However, there is no evidence that antiretroviral drugs cause the severe immunosuppression that typifies AIDS, and an ample evidence is available that antiretroviral therapy, when used as per the established and specified procedure, can improve the span and quality of life of the HIV-infected individuals. In the 1980s, clinical trials enrolling patients with AIDS found that AZT given as single-drug therapy conferred a modest (and short-lived) survival advantage compared to placebo. Among HIV-infected patients who had not yet developed AIDS, placebo-controlled trials found that AZT given as single-drug therapy delayed, for a year or two, the onset of AIDS-related illness. Significantly, long-term follow-up of these trails did not show a prolonged benefit of AZT, but also never indicated that the drug increased disease progression or mortality. The lack of excess AIDS cases and death in the AZT arms of these placebo-controlled trials effectively counters the argument that AZT causes AIDS. Subsequent clinical trails found that patients receiving two-drug combinations had up to 50 percent increases in time to progression to AIDS and in survival when compared to people receiving single-drug therapy. In more recent years, three-drug combination therapies have produced another 50 percent to 80 percent improvements in progression to AIDS and in survival when compared to two-drug regimens in clinical trials. Use of potent anti-HIV combination therapies has contributed to dramatic reductions in the incidence of AIDS and AIDS-related deaths in populations where these drugs are widely available, an effect which clearly would not be seen if antiretroviral drugs caused AIDS.

• The Myth is that behavioral factors such as recreational drug use and multiple sexual partners account for AIDS whereas the Fact is that the anticipated behavioral patterns are cause of AIDS, such as multiple sexual partners and long-term substantial drug use, have existed for many years. The AIDS epidemic which is characterized by the occurrence and re-appearance of formerly rare opportunistic infections such as Pneumocystis carinii pneumonia (PCP) did not come about in the United States of America until a formerly unknown human retrovirus -- HIV -- spread all the way through certain communities. Convincing evidence against the hypothesis that behavioral factors cause AIDS comes about from latest studies that have followed partners of homosexual men for long periods of time and observed that only HIV-seropositive men later on develop AIDS. For example, in a prospectively studied group in Vancouver, 715 homosexual men were followed for a median f 8.6 years. Among 365 HIV-positive individuals, 136 developed AIDS. No AIDS-defining illnesses occurred among 350 seronegative men despite the fact that these men reported appreciable use of inhale-able nitrites ("poppers") and other recreational drugs, and were also involved in very frequent receptive anal intercourse. Other studies show that amongst homosexual men and injection drug users, the specific immune deficit that leads to AIDS -- a progressive and continued loss of CD4+ T cells -- is extremely rare in the absence of other immunosuppressive conditions. In the Multicenter AIDS Cohort Study, more than 22,000 T-cell determinations in 2,713 HIV-seronegative homosexual men revealed that only one individual with a CD4+ T cell count persistently lower than 300 cells/mm3, and this individual was receiving immunosuppressive therapy. In a survey of 229 HIV-seronegative injection drug users in New York City, mean CD4+ T cell counts of the group were consistently more than 1000 cells/mm3. Only two individuals had two CD4+ T cell measurements of less than 300/mm3, one of whom died with cardiac disease and non-Hodgkin's lymphoma listed as the cause of death. In another study, HIV-seronegative, long-term heroin addicts had mean CD4+ T cell counts of 1500/mm3, while eleven healthy controls had CD4+ counts of 820 cells/mm3.68

• The Myth is that AIDS among transfusion recipients is due to underlying diseases that necessitated the transfusion, rather than to HIV on the contrary known Fact is otherwise which states that this concept is contradictory to a report filed by the Transfusion Safety Study Group (TSSG), which compared HIV-negative and HIV-positive blood recipients were given transfusions for similar diseases. Approximately 3 years after the transfusion, the mean CD4+ T cell count in 64 HIV-negative recipients was 850/mm3, while 111 HIV-seropositive individuals had average CD4+ T cell count of 375/mm3. By 1993, there were 37 cases of AIDS in the HIV-infected group, but not a single AIDS-defining illness in the HIV-seronegative transfusion recipients.

• The Myth is that high usage of clotting factor, not HIV, leads to CD4+ T-cell reduction and AIDS in hemophiliacs but the Fact remains as this view is also contradictory to several massive studies. For example, among HIV-seronegative patients with hemophilia A enrolled in the Transfusion Safety Study, no significant differences in CD4+ T cell counts were noted between 79 patients with no or minimal factor treatment and 52 with the largest amount of lifetime treatments. Patients in both groups had CD4+ T cell counts within the normal range. In another report from the Transfusion Safety Study, no illustration of AIDS-defining illnesses were observed among 402 HIV-seronegative hemophiliacs who had received factor therapy.

• The Myth is that the distribution of AIDS cases casts doubt on HIV as the cause. Viruses are not gender-specific, yet only a small proportion of AIDS cases are among women while the Fact is that the distribution of AIDS cases, whether in the United States of America or elsewhere in the other parts of the world, consistently mirrors the incidence of HIV in a population. In the United States of America, HIV first came into sight in the populations of homosexual men and injection drug users, a majority of whom are male. Because HIV spreads principally through sexual intercourse or by the exchange of HIV-contaminated needles during injection drug use, it is not at all astonishing that a majority of U.S. AIDS cases have cropped up in men. However, women in this country are ever increasingly becoming HIV-infected, usually through the exchange of HIV-contaminated needles or indulging in sexual intercourse with an HIV-infected men. The CDC estimates that 30 percent of new HIV infections in the United States of America in 1998 were found in women. As the number of HIV-infected women has risen, so has risen the number of female AIDS patients in the U.SA. too. In 1998, approximately 23 % of adult/adolescent AIDS cases in the United States of America were among women and in the same year, AIDS was the fifth foremost cause of death among women aged 25 to 44 in the U.S. In Africa too, HIV was first recognized in sexually active heterosexuals, but a difference noticed in comparison with U.S.A., AIDS cases in Africa have occurred at least as frequently in women as in men i.e. in the same proportion. Overall, the global distribution patterns of HIV infection and AIDS observed so far between men & women is approximately 1:1.

• The Myth is that HIV cannot be the cause of AIDS because the body develops a vigorous antibody response to the virus while the Fact remains that this reasoning somehow do not take into account that innumerous examples of viruses other than HIV can be pathogenic after evidence of immunity appears. Measles virus may stick with for years in brain cells, eventually causing an extremely chronic neurological disease despite the presence of antibodies to fight against the disease. Viruses such as cytomegalovirus, herpes simplex and varicella zoster may be activated even after years of latency and even in the presence of abundant number of antibodies. It was observed that in the animals, viral relatives of HIV with very long and variable latency periods, such as visna virus in sheep, causes central nervous system damage even after the production of antibodies. Also, HIV is very well acknowledged to mutate and reproduce itself to avoid the ongoing immune response of the host.

• The Myth is that only a small number of CD4+ T cells are infected by HIV, not enough to damage the immune system but the Fact is otherwise that emergence of new & latest techniques such as the polymerase chain reaction have facilitated the scientists to establish that a much larger proportion of CD4+ T cells than which was defined in earlier studies are infected, particularly in lymphoid tissues. Further, this also revealed that Macrophages and other cell types are also infected with HIV and serve as reservoirs for the virus. Although the fraction of CD4+ T cells which is infected with HIV at any given point of time is never extremely high (only a very small subset of activated cells work as ideally appropriate goal of infection), several groups have also shown that rapid cyclic deaths of infected cells and further infection of new target cells occur throughout the course of disease.

• The Myth is that HIV is not the cause of AIDS because many individuals with HIV have not developed AIDS and vice versa the Fact states that HIV disease has an invariably prolonged and unpredictable course. The median time between HIV infection and the onset of clinically evident disease is more or less 10 years, according to one of the prospective studies conducted amongst homosexual men in which dates of seroconversion are known. Similar estimates of asymptomatic periods have been made for HIV-infected blood-transfusion recipients, injection drug users and adult hemophiliacs. As in the case of many other diseases, a number of factors could be responsible for influencing the course of HIV disease. Factors such as age or genetic differences between individuals, the level of virulence of the individual strain of virus, as well as exogenous influences such as co-infection with other microbes may determine the rate and severity of HIV disease expression. Similarly, some people infected with hepatitis B, for example, show no symptoms or only jaundice and clear their infection, while others suffer disease ranging from chronic liver inflammation to cirrhosis and hepatocellular carcinoma. Co-factors probably also determine why some smokers develop lung cancer, while others do not.

• The Myth is that some people have many symptoms associated with AIDS but do not have HIV infection whereas the Fact still is that most of the AIDS symptoms result from the development of opportunistic infections and cancers associated with severe immunosuppression which are secondary to HIV. However, immunosuppression has many other different potential source. Individuals who take glucocorticoids and/or immunosuppressive drugs to avoid transplant rejection or for autoimmune diseases can have greater than before vulnerability to unusual infections, as do individuals with certain genetic conditions, severe malnutrition and certain kinds of cancers. There isn’t any evidence available that suggets that the count of such cases have risen with the passage of time, while plentiful epidemiologic proof displays an astounding rise in cases of immunosuppression among those individuals who share one characteristic and that is HIV infection.

• The Myth is that the spectrum of AIDS-related infections seen in different populations proves that AIDS is actually many diseases not caused by HIV whilst the important Fact underlying is that the diseases associated with AIDS, such as PCP and Mycobacterium avium complex (MAC) are not in any way caused by HIV but rather are a result of the immunosuppression caused by the HIV disease. As the immune system of an HIV-infected individual weakens, the patient becomes susceptible to a particular viral, fungal and bacterial infection common in the community. For example, HIV-infected people in certain mid-western and mid-Atlantic regions are more likely to develop histoplasmosis, which is caused by a fungus, than people in New York City. People living in Africa are exposed to different pathogens than those people whose natural habitat is in one of the cities of American sub-continent. Children may be exposed to different infectious agents than adults.