HIV/AIDS is one of the world’s most fatal infectious diseases and almost one million people die from HIV/AIDS each year. In some countries, it’s the leading cause of death.
The human immunodeficiency virus (HIV) damages your body’s immune cells and weakens your ability to fight infection and disease, including some types of cancer. As a result, it makes your immune system weaker, which makes you more prone to infections and some diseases. These become more dangerous for you because your body cannot defend itself very well.
Infected people gradually become immunodeficient leading to acquired immune deficiency syndrome (AIDS), the advanced stage of the disease when the body starts developing complicated health issues. If untreated, this can take from two to 15 years to develop. AIDS cannot be transmitted from one person to another, but HIV can.
Symptoms
In the first few months after infection, there may be no symptoms and an infected person could be unaware of their status, potentially spreading the virus. However, some people experience flu-like symptoms, such as fever, headache, rash and sore throat.
As the infection continues, it gradually weakens the immune system and you may experience swollen lymph nodes, unintentional weight loss, fever, diarrhoea or a persistent cough. Without treatment, the body becomes susceptible to other infections and diseases, including severe bacterial infections and some types of cancer.
How does the virus spread?
HIV is not passed on easily from person to person through the air, like cold and flu viruses, it is transmitted via the exchange of a variety of body fluids from infected people, such as blood, semen, vaginal secretions or breast milk.
The majority of HIV infections are transmitted through sexual activity but transmission can be prevented through condom use (both in heterosexual and homosexual relationships). Unprotected (without a condom) sex with an infected person puts you at risk of infection and this risk varies by the specific sexual act or type of exposure. It is not transmitted by kissing, hugging, shaking hands or sharing food and water.
You can also get infected by contaminated needles, syringes and other injecting equipment or tattooing and piercing using contaminated needles.
There can also be a mother-to-baby transmission but with the right treatment, HIV-positive mothers can have uninfected babies.
Treatment
A few decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. People with HIV who are taking ART and have an undetectable viral load do not spread HIV to their sexual partners.
If you have HIV, a healthy lifestyle is essential as it can support your immune system. On the other hand, an unhealthy lifestyle will burden your immune system and may even weaken it further. A balanced vegan diet, based on fruit and vegetables, pulses, wholegrain products and nuts and seeds, not smoking, limiting or avoiding alcohol and stress-management techniques will give you the best chance for a long and healthy life.
HIV/AIDS in Uganda
Globally, around 1.5 per cent of deaths are caused by HIV/AIDS, in Uganda, HIV/AIDS was responsible for nine per cent of deaths in 2019, in some countries, it’s as high as 20 per cent.
Women are disproportionately affected by HIV in Uganda where out of 1.4 million people living with the disease, 860,000 are women and 80,000 are children. HIV levels are higher in women across all of Sub-Saharan Africa but higher in males across most other regions and more men tend to die from AIDS every year than women. The reasons for these differences are complex as gender inequality and patriarchal norms make it difficult for girls and young women to negotiate safe sex. Women are at greater risk when they have a limited role in sexual decision-making and protection, lower rates of sexual education and higher rates of transactional sex.
In 2022, the World Health Organisation (WHO) published new guidelines on the prevention and management of HIV and other sexually transmitted diseases. Dr Kaggwa Mugagga, the HIV National Professional Officer at WHO Uganda says “Our new HIV management guidelines recommend, among others, that all HIV-positive pregnant women have their viral load checked every three months, rather than every six months, to ensure low transmission risk.”
“When the amount of HIV in the body is continuously suppressed through proper taking of medication, the mother has a high chance of giving birth to an HIV-negative baby” says Dr Jacqueline Balungi Kanywa, Senior Medical Officer and Clinic Manager at Baylor Uganda.
What are the origins of the virus?
There are two main types of virus, HIV-1 and HIV-2, both derived from simian immunodeficiency viruses (SIVs) that circulate in at least 40 species of African non-human primates. Most SIVs infect monkeys and have been circulating in different species, causing them no problems, for many years.
HIV-1 was discovered first and is the most prolific while HIV-2 is most common in western Africa and is becoming more common in India. HIV-1 is a mutated version of a chimpanzee virus, which probably made the species jump to humans as a result of chimpanzees being hunted and eaten.
Chimpanzees, like humans, are apes and it is assumed they acquired SIVs from monkeys, most probably by predation. Scientists believe that the jump from chimpanzees to humans happened in the 1920s, in Kinshasa (called Leopoldville until 1966) in what is now the Democratic Republic of Congo.
HIV-2 comes from sooty mangabey monkeys and the crossover to humans in the 1960s is believed to have happened similarly, through the butchering and consumption of monkey meat. There have since been at least a dozen independent transmissions of SIVs to humans leading to HIV-1 and HIV-2.
Reducing the risk
As we have seen, when the habitats of wild animals are disturbed by people, viruses can jump host, as exemplified by the story of HIV from chimpanzees in the rainforests of West Africa. It’s the same story being replayed around the world with different host species and different viruses, the only constant is humans, disturbing the equilibrium at our peril.
The opportunities for zoonotic transfer of SIVs from primates to humans have existed for hundreds if not thousands of years. However, only in the twentieth century did such viruses spread to detectable levels in humans.
In West Central Africa during the early part of that century, the destabilisation of social structures by invading colonial powers, the rapid growth of major cities and the widespread use of injections may have all contributed to an unprecedented opportunity for the spread of blood-borne viruses.
Furthermore, in the 1960s, a ‘perfect storm’ of population growth, sex and railways allowed HIV to spread across Africa and the world, according to an international team of scientists. They say the booming sex trade, rapid population growth and unsterilised needles used in health clinics probably spread the virus.
Given the ongoing contact between infected primates and people through hunting and butchering, together with the increase of the bushmeat trade and logging, scientists say that it is likely that cross-transmissions are still occurring and human exposure to SIV has increased, as have the social and environmental conditions that support the emergence and spread of new zoonotic infections. One major public health implication is that these SIV strains may not be recognised by HIV-1/HIV-2 screening tests and as a consequence, human infection may go unrecognised for several years and lead to another epidemic.
It’s time to stop eating animals!