Talk:HIV

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[edit] The role of spermicide in HIV transmission

Under the transmission heading, I appended the sentence which said unprotected sex allowed HIV transmission to include the new research that condom protected sex used with spermicide negates the benefit of condoms, probably due to inflammation of the females mucous membranes. It could probably do with a better source though.

It was removed from where I put it without explanation. I readded it to the bottom of the section, along with the other info about condoms and circumcision.

I reverted your changes, and it was not removed without explanation. My edit summary was this: "condoms + spermicide doesn't = riskier, it is when spermicide alone is used (thus unprotected sex)". Your source was this [1] which I read carefully. It states correctly that use of spermicides alone do not prevent HIV; in fact, it tends to make it a little easier to transmit due to the vaginal inflammation it causes to a female (no studies for males, but the membranes of an anus could be a similar situation). The source also goes on to say how it isn't useful with vaginal contraceptives like cervical caps and diaphragms.
When using spermicide with a condom, it is a bit of a different story. Condoms prevent semen from reaching a vaginal or anal wall whatsoever, while diaphragms/cervical caps are strictly cervical barriers. The semen still reaches a mucous membrane with these vaginal contraceptives. The irritation with the spermicide is present if used with a condom, but contracting HIV while using a condom is soooooo small that adding spermicide isn't going to increase the chance of contraction significantly. And DEFINITELY not enough to support your edit that "...the majority of HIV infections are acquired through unprotected sexual relations, or when condoms are used with spermacides."
As for circumcision, see below for my comments on it and HIV. JoeSmack Talk(p-review!) 16:25, 23 October 2006 (UTC)

Sorry, I didn't realise that there was somewhere else that people could put comments about edits. I see that I worded my original edit incorrectly. I didn't mean that the majority of of infections were caused by spermacide condoms, I just wanted to add that unprotected AND poorly protected intercourse could lead to transmission. To be honest, the infomation that spermacide + condom leads to an increased risk of HIV transmission compared to condoms alone was from a lecture I attended. I will have to speak to the lecturer to try and obtain the reference.

[edit] How many know they are HIV positive?

In a UNAIDS publication, AIDS epidemic update: December 2005, it says "of people living with HIV only one in ten has been tested and knows that he or she is infected." Click here for reference. That would mean 90% of people do not know they are infected right? --D1chow 06:58, 18 August 2006 (UTC)

See, when i read through that i heard that only 10% of the total population infected has been tested (and thus knows they are positive)....wait....is that the same thing? you might be right here - it is a UNAIDS/WHO report which is usually pretty tip top. JoeSmack Talk 07:16, 18 August 2006 (UTC)
A CNN article and a BBC article would also seem to support that 90% do not know they are infected.--D1chow 07:24, 18 August 2006 (UTC)
Allow me to turn back the hands of time - reverted. Although the sources are credible (and i mean the UNAIDS/WHO one more than BBC or, ick, CNN), i think some original research or at least one with a sample size should be found for better support, especially if this is new data. JoeSmack Talk 07:41, 18 August 2006 (UTC)
It seems that using a high number is contentious. However, Peter Piot, executive director of UNAIDS, has used the number 90% before. Data on HIV testing is hard to come by. The main focus of data is on how many and what groups have HIV and have died as a result of HIV. There is some data on country and group specific awareness of HIV infection, which I assume are used to come to the global awareness of HIV infection. There are no graphs or tables that summarize the data like prevalnce rates. After a lot of searching, this seems to be the best source of data. I used Indicator 5.1. It can show you how many came back to get their HIV postive results in multiple countries. Of course, you have to do the math if you want the regional numbers. Most experts do seem to agree that well over 50% do not know they are HIV positive. I think at least "vast majority" should be used to describe the number of people unaware of their HIV infection. D1chow 00:09, 19 August 2006 (UTC)


What percent of the entire population is infected with HIV. Lots of number are bandied about but I have never seen this one. 50%-90% etc mean nothing if we don't know the % in the universe. It could well be that 50%-90% of everyone has HIV. Does anyone have a link to this study - if this study hasn't been done then why not. If HIV is spread by sex then the number should be approaching 100%. —The preceding unsigned comment was added by 159.105.80.219 (talk • contribs).

[edit] Comprehensive Risk Table request

I'd like to request that someone compile a larger PER-ACT risk table (similar to the one in this article), covering as many major STIs as possible, AND the with-condom (/dam /finger cot /etc) vs. no-condom risk. Also, I would suggest adding cunnilingus ("oral intercourse" should be "fellatio" as listed; the two are not identical, and I am editing to that effect) and manual intercourse (both genders). Lastly, if possible, please use a range of statistics if there is significant disagreement about what the risk is - e.g. for fellatio as mentioned below, perhaps tit would be better stated as "0-0.5 / 10k". Thanks! --Sai Emrys 18:32, 14 May 2006 (UTC)

[edit] Language in HIV Test section

The language in the HIV test section (HIV#HIV_test) is somewhat confusing. It makes an assertion that HIV and AIDS are synonymous. The article in general is pretty well written that it doesn't make this same mistake. I am going to make a change, to correct wording.

Currently, it says:

Approximately half of those infected with HIV do not know their HIV status until an AIDS diagnosis is made with an HIV test.

I'm going to change it to say:

Approximately half of those infected with HIV do not know their status until a positive test result is made through one of many HIV tests.

If there are any questions, let me know. --Bsheppard 02:54, 9 July 2006 (UTC)

I'm pretty sure the important destinction here is that half of HIV-positive folk don't know their infected until they've become dianosiable with AIDS. AIDS is usually when you'd start to show opportunistic infection, thus see a doctor, thus get an HIV test, thus become aware you are positive. In order to keep the message of the sentence, I'm changing it to:
Approximately half of those infected with HIV do not know it until an AIDS diagnosis is made with an HIV test.
...that should things a little less confusing, but mentioning that there are more than one set of HIV tests isn't important for this sentence as to mention that an HIV test is the thing identifying HIV-positive status. JoeSmack Talk 07:13, 9 July 2006 (UTC)
i've seen this fact thrown around before so i'm pretty sure it has ground, thus i'm keeping it there; it does however need a citation, of which i've tagged in the article itself.JoeSmack Talk 07:18, 9 July 2006 (UTC)

I changed it back to Bsheppard's version for now, since the other text implied that HIV test positivity resulted in a diagnosis of AIDS. This of course discounts all the people who are discovered through screening for STDs, on blood donations, et cetera. Of course, further refinement may be needed. — Knowledge Seeker দ 07:30, 9 July 2006 (UTC)

Approximately half of those infected do not know their HIV status until it has progressed to an AIDS diagnosis. At this point many people tend to show opportunistic infection, who then see a doctor, get an HIV test and discover they are HIV positive. Alright, it's a little more bulky, but thats ok. It is important that two things are highlighted with this passage, 1) That half of people with HIV don't discover it until an AIDS diagnosis and 2) This diagnosis is often made with the results of an HIV test that proves with high accuracy that an person is HIV positive. If someone can turn what i've written to prose that are easier on the eyes, please change.

[edit] {{fact}} can't be used, but still...

The article says under transmission that "many experts believe that it is premature to recommend male circumcision as part of HIV prevention programs". "Many experts" is an unstated amount, and I think that if it's only the WHO and various other UN segments who advocate that opinion, "many experts" is a bit exaggerated; instead, it should be mentioned which experts (or their affiliations) advocate it, and it will be up to the reader to decide if it indeed is many experts. Ghent 23:43, 11 July 2006 (UTC)

This interests me.. Transmission describes means by which you can be infected with HIV, they all require direct contact with blood or bodily fluids from infected persons.
Am I missing something, or are they trying to say that simply being circumcised reduces your chances of being exposed to HIV positive blood or fluids?
I certainly hope I'm missing something, because the notion that being circumcised reduces your chances of meeting infect people seems completely ludicrous to me. --NoEvidenZ 17:51, 18 October 2006 (UTC)
Man, the jury is still really out on this one (although I can think of a few people on wikipedia who are diehard for AND a few against it). UNAIDS still thinks it's too early to decide, and evidence has been very conflicting. On one hand maybe yes, on one hand maybe no, on one hand the process of circumcision itself with unsterilized/reused tools may lead to more infections - and on and on and on. JoeSmack Talk(p-review!) 18:04, 18 October 2006 (UTC)
NoEvidenZ: you're missing something, but that's just because it's not in the article. The theory is basically that if your penis is exposed to HIV-infected body fluids, having a foreskin might make it somewhat easier for the virus to enter your system. There are two plausible reasons why that might be: the surface under the foreskin could be more physically permeable to infected fluids, because of (a) tiny skin breaks from the foreskin sliding around during intercourse or (b) irritation from other infections that can take hold there; and, the presence of Langerhans cells in the foreskin could make that tissue more susceptible to HIV. I don't think this all needs to be in the article, but some general notion would be helpful. This issue might even deserve its own linked sub-article, because there's been some fairly well publicized discussion with multiple opinions on what the evidence says and what if anything to do about it. ←Hob 02:30, 27 October 2006 (UTC)

[edit] Overlapping with AIDS article

There is a lot of overlapping between the AIDS article and this one. Whole paragraphs, tables and figures are identical in both articles. This needs to be revised: information specific to the disease, should stay in the AIDS article (should as infection risk?) and information specific to the biology of the virus should be kept in this article (should as the origin of the virus). Dycotiles 16:29, 25 July 2006 (UTC)

Obviously there is overlap, but this is kept to a minimum and as such is ok as is. Infection risk is an important part of both articles, and specifics of the disease are talked about, and specifics of AIDS is expanded in the AIDS article. Symptoms of HIV infection and AIDS are two different things and the distinction and expansion in both articles is thus warranted and seen. --Bob 17:03, 25 July 2006 (UTC)

[edit] Reference suggestion

I just read through this article, after hearing a radio program (available online - [2]) on the topic of HIV, which included Anthony Fauci, Joel Gallant (Johns Hopkins School of Medicine), and Helene Gayle (International AIDS Society) as guests. This article seems to have the major points covered that they brought up. But, thought the program might be of interest to people working on this article, maybe useful as a reference? Anyway, great job on this article. --Aude (talk contribs) 01:44, 18 August 2006 (UTC)

[edit] Links

I'm not an expert at this topic but the links section was way too long and unorganized. Per WP:EL, I've trimmed ones that only provided brief information (not much or anything beyond what's already mentioned in this article), broken links, and others that I though didn't meet the external links guidelines. In all honesty, I think the links need to be trimmed further to just the first group, along with the PBS and New Scientist links, and probably keep the online textbooks (they seem informative). Though, perhaps people working on this article would consider some of the other remaining links informative and worth keeping? I also trimmed the three "News" links, thinking that these should either be used as references, or perhaps incorporated with the external links:

The lengthy, unorganized links section would have been my one FAC objection, so hope this helps take care of that. --Aude (talk contribs) 16:20, 18 August 2006 (UTC)

[edit] contact with mucous membrane enough to transmit HIV?

"HIV is transmitted through direct contact of a mucous membrane with a bodily fluid containing HIV" Is this a new discovery? For years people were saying you needed at least small injuries in your mucous membrane to catch the virus. It would be great if there was a reference for this statement. --345Kai 12:54, 22 August 2006 (UTC)

It's not the mucous membranes per se that get in contact with the virus, it's the APC's, dendtritic cells, and T helper cells that have to get into contact with the virus. These are present in lesions (hence the danger of blood - blood contact and anal intercourse) and vaginal and urerthral membranes (hence the danger of vaginal intercourse).

[edit] HIV-2

I think an ideal article would say more about the differences between HIV-1 and HIV-2. HIV-1 may be more viral, but it doesn't say anything about which is harder to cure or which is more lethal. If it's about the same that should be in there too. Mackan 07:02, 4 September 2006 (UTC)

[edit] A small minority remain healthy for many years, with no noticeable symptoms

Eventually, most HIV-infected individuals develop AIDS and die; however a small minority remain healthy for many years, with no noticeable symptoms.

This statement is very vague. What order of magnitude is this "small minority" ? Is it like 10% (then it wouldn't really be "small") or 1% or 0.1% or about how much ? Taw 17:34, 15 September 2006 (UTC)

Indeed, one in ten. Data added with reference. TimVickers 18:15, 15 September 2006 (UTC)


What goofy science. "Eventually, most ...." Eventually 100% die of something. Gay men with AIDS(whatever that is) die in their early 40s and without AIDS they die in their early 40s plus 1 year. They lead a rough life. Has any study taken a random sample of the population and tested to see what % have HIV? I doubt it, but maybe it is out there. The reports I read seem to test for HIV when the immune system is dying. —The preceding unsigned comment was added by 159.105.80.219 (talk • contribs).

[edit] Experimental Treatment

I think there are a lot of research in HIV treatment. And some drugs are being developed or event tested now. Would nice to have some brief description of potential HIV treatment methods.

I think the general feeling here is that covering developing treatments is closer to news coverage than it is to encyclopedic material. So many potential treatments are tried, and so few of them come to fruition, we'd be covering lots of things that wind up having no impact. The noise/signal ratio is high, and maintenance would be a headache.- Nunh-huh 22:59, 21 October 2006 (UTC)

[edit] SIV and pathogenesis

This new bit in the Genetic variability section has me scratching my head:

SIV infection of its natural hosts (African green monkeys (AGMs) or sooty mangabees (SMs)) results in very high levels of the retrovirus in the blood for the natural life of these monkeys without the development of simian AIDS. The immune systems of AGMs and SMs mount at most a very mild immune response to SIV, even though the destruction of naive CD4+ T cells is comparable to that observed in HIV infected patients [emphasis added]

The footnoted article (Kurth & Norley) is not readily available to me, but other articles I found on the same subject (PMID 11842258, PMID 10423122, etc.) seem to state clearly that the strains of SIV-1 native to these monkeys do not cause significant destruction of CD4+ cells, and are therefore not pathogenic in their native hosts; in other hosts, they do destroy CD4+ cells and therefore cause disease. Of course viral load isn't the same as pathogenicity, but I don't understand how you can have loss of T cells "comparable to that observed in HIV-infected patients" and not have progression of disease; if that is indeed true then it needs to be much better explained than this. The same editor added a similar claim to the SIV article, and I've deleted it pending a clarification. ←Hob 06:21, 27 October 2006 (UTC)

OK, I went ahead and edited Genetic variability a bit, removing the confusing part about CD4+ destruction and focusing on the interesting facts that SIV in its natural hosts is relatively benign and also doesn't seem to mutate so much, while in other hosts it behaves more like HIV. The previous version of the text was, I think, too ambitious in stressing the possible link between those facts, a conclusion which isn't sourced to any of the cited studies and therefore looks like editorial opinion - so I softened that part; we can let readers draw their own conclusions, until the science is better. ←Hob 17:24, 28 October 2006 (UTC)

(Just to be even nitpickier: is it really correct to say that SIV in its natural hosts doesn't undergo extensive mutation? Presumably it has the same not-very-accurate reverse transcriptase as always - the mutation happens in the transcription process. I haven't seen any proposed mechanism for not generating mutants; if you don't find lots of mutants in the blood, wouldn't it be more a matter of their relative fitness in a particular host - that is, they're generated, but most of them don't thrive? But I don't have references for this.) ←Hob 17:41, 28 October 2006 (UTC)

(added after a few weeks) ...Did anyone have an opinion about any of the above? I've been at an impasse with User:Clarkgf who still feels my edits were inappropriate. ←Hob 01:22, 14 November 2006 (UTC)

[edit] Life cycle of HIV needs major rewrite

A new study came out saying that most HIV patents will live 24 years, not 10. as people newly infected with HIv view this page, it should be updated promptly by someone qualified to update it. The article I learned this on is here: http://www.cnn.com/2006/HEALTH/11/10/hiv.costs.ap/index.html —The preceding unsigned comment was added by 75.35.144.195 (talk • contribs).

Well, no offense, but CNN doesn't always have their facts straight. They don't reveal the explicit studies used in their article, but I'd love to see em. JoeSmack Talk(p-review!) 05:51, 12 November 2006 (UTC)
I dug it up; i don't have access to it, but what do others think? [3] 05:56, 12 November 2006 (UTC)
As it is projections, and they have no actual human cohort, it is just a projection. how much faity do we put in projections? Do projections from one group constitute worthiness for an encyclopaedia? Should we not instead rely on actual reported clinical data? --Bob 21:46, 13 November 2006 (UTC)
I prefer hard evidence in this case personally. This is also very new info, so its reliability isn't 100% JoeSmack Talk(p-review!) 22:27, 13 November 2006 (UTC)

Text has been (quickly) modified accordingly. (May need a copyedit) --Bob 22:52, 13 November 2006 (UTC)

[edit] Is it possible to contract HIV infection from one intercourse only?

Is it possible to contract HIV infection by 2-3 mins of penis vagina contact? Is there any minimum duration for the contact to get a healthy body contaminated with HIV virus? —The preceding unsigned comment was added by 210.214.27.215 (talk) 20:20, 6 December 2006 (UTC).

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