HIV/AIDS Health Article

PREVENTION

Prevention of HIV infections is deceptively simple: Refrain from having sexual contact and from sharing drug-injecting paraphernalia with anyone who is infected. However, the rapid and continuing global spread of HIV, despite its well-known and severe clinical consequences, points out how difficult it is to change risky sexual and drug-taking behaviors. Many successful educational and social interventions have been demonstrated, but sustaining them in large populations for long periods requires extensive resources and a strong public health commitment. For example, latex condoms effectively prevent sexual transmission of HIV, but making them available and educating infected persons or their sex partners to use them correctly and consistently has been accomplished only with extraordinary efforts in a few nations or settings. Some prevention efforts are considered controversial or are opposed by religious or other groups who interpret prevention efforts to reflect an acceptance of behaviors they do not condone on moral grounds.

The research effort to develop a vaccine to prevent HIV infection has been intense, but the biologic obstacles to success are immense and unprecedented. Because HIV permanently infects cells of the immune system, infection of a single cell results in lifelong infection for the host. Thus, a completely effective vaccine would need to prevent even a single cell from becoming infected. No such vaccine exists for any infection, so HIV will require a new vaccine paradigm. Possible lines of research include stimulating the immune system to detect and eliminate HIV-infected cells, or genetically transforming the HIV in an infected person so as to render it nonvirulent.

Further information on HIV and AIDS is widely available in many user-friendly and scholarly formats. The Internet is a rich source of information, with sites sponsored by public health agencies, such as the Joint United Nations Programme on HIV/AIDS (http://www.unaids.org) and the Centers for Disease Control and Prevention (http://www.cdc.gov) particularly recommended. Several texts, popular books, and scholarly journals have been devoted exclusively to AIDS public health issues and scientific research. The first of December has been designated World AIDS Day, and many governments, schools, and organizations sponsor community and educational events to coincide with that date each year.

D. PETER DROTMAN

(SEE ALSO: Behavioral Change; Condoms; Contagion; Epidemics; Prevention; Sexually Transmitted Diseases)

BIBLIOGRAPHY

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