Communicable Diseases: Global HIV Epidemiology, Role of Agent, Host and Environmental Factors

Running head: Communicable Diseases 1
Communicable Diseases
By:
Student ID:
Course No:
Tutor:
Date:

Communicable Diseases 2
Human Immunodeficiency Virus (HIV)
Introduction
The Human Immunodeficiency Virus (HIV) is a type of virus that is only found in human
beings and attacks and destroys the immune system thus making the body unable to fight
against illnesses and infections. More specifically, HIV breaks down the immune system of
the body by attacking the white blood cells thus undermining the entire immune system. HIV
virus causes acquired immunodeficiency syndrome (AIDS) which is also its advanced stage.
The individuals infected with HIV may manifest signs of AIDS after a long time ranging
from months to more than fifteen years.
Scientists first discovered strange symptoms of sickness amongst gay men in the US in 1981.
The symptoms included rare chest infection and skin diseases, and the lab test indicated a
damaged immune system. Subsequently, a new virus was identified by French researchers in
1983 and termed as HIV and as the causative virus for AIDS. This virus was later identified
as HIV-1. Another type of HIV was recognized in 1985 as HIV-2 among the sex workers in
Senegal. Appay and Sauce (2008) observes that the HIV-2 has high prevalence in West
Africa and is slightly less harmful and not rapidly transmitted as HIV-1. Advanced researches
have also led to the identification of other several strains of HIV such as strain C which is
prevalent in South Africa. The initial cases of HIV were identified in gay men, but since then
the disease has been reported to be on the highest in marginalized groups and injecting drug
users. However, HIV and AIDS are not restricted to gay men or drug users by injection, but
instead, it is spread through several kinds of sexual conduct or unintentional exposure to HIV
infected blood or any other body fluids. Fettig, Swaminathan, Murrill, and Kaplan (2014)
elucidates that there have been alternating trends in the prevalence and incidence of HIV
worldwide. This paper purposes to explore HIV in all its major aspects. The major sections

Communicable Diseases 3
considered in this paper include the global HIV epidemiology, the role of HIV agents, host
and environmental factors that affect HIV infection and transmission, and potential policy
responses.
Global HIV Epidemiology
The World Health Organization (WHO, 2013) observed that different populations have
varying levels of HIV vulnerability, and they can be determined by centring on certain social
and demographic features of a given area. As a result, the global epidemiology in this paper is
discussed regionally
Sub-Saharan Africa
The UNAIDS (2013) note that HIV dominance in sub-Saharan Africa indicates that the
frequency of new infections is much lower and death rates associated with AIDS is equally
low. The report further suggests that there are over 50% reduction in the incidences of HIV in
sub-Saharan Africa between 2000 and 2012 among the adults, consistent with the reduction
in HIV infections by one million in 2012 compared with 2000 (UNAIDS, 2013).
Additionally, the PLHIV has simultaneously increased by almost six million between 2000
and 2012, and this high survival rate can be ascribed to the use of antiretroviral drugs (ART).
Consequently, the mortality rates due to AIDS has also decreased by 1.2 million between
2000 and 2012. Unprotected heterosexual behaviour is still the leading way of HIV epidemic
in sub-Saharan Africa (UNAIDS, 2013).
Asia
The UNAIDS (2013) report indicates that Asia is the second leading continent in HIV
prevalence after Africa. Just like in sub-Saharan Africa, there is a decrease in HIV incidences
in Asia, but there exist significant epidemiological variations with the noticeable one being

Communicable Diseases 4
that HIV infection is prevalent in key populations. Notwithstanding the reduction in the
spread of HIV, there was an increase in the PLHIV by 1 million between 2000 and 2012 due
to increased survival (UNAIDS, 2013). Furthermore, the AIDS-related mortality rate in Asia
among children and adults have gradually reduced by 70,000 from 2005 to 2012. There is
improvement in the accessibility to ART services while the PMTCT services are still
inadequate, with less than 20% of expectant mothers gaining access to ART. According to the
NHFPC (2014) report, the leading countries in the burden of HIV are India and China with
the primary transmission mode in China being heterosexual (46.5%) followed by injection
drug use (28.4%) (NHFPC, 2014). The report further indicates that sex workers account for
0.3% and MSM for 6.3% of the overall HIV prevalence in China. India reports the highest
number of PLHIV in Asia accounting for 2.1 million individuals living with HIV (PLHIV).
Nevertheless, the prevalence in India significantly varies by region with the Southern states
having higher prevalence rates than the Northern states (UNAIDS, 2013).
North Africa and the Middle East
The Middle East and North Africa have reported a continuous rise in the cases of new HIV
transmissions and death rates, unlike the trend observed in Asia and sub-Saharan Africa.
There was an approximate increase in the cases of PLHIV by 50%, AIDS mortality rate by
32%, and the annual rate of new infections by 60% (World Health Organization, 2011).
However, the overall prevalence of HIV is still epidemic in sub-Saharan Africa than in the
Middle East and North Africa (UNAIDS, 2013). Gökengin, Doroudi, Tohme, Collins, and
Madani (2016) have attributed the lower rate of HIV prevalence in the Middle East and North
Africa to the decreased incidences of sexual risk conduct and the universal male
circumcision. Moreover, available data shows that the common transmission modes for HIV
are injection drug use (IDU), MSM and unprotected sex with the prevalence in countries like