Introduction
The human immunodeficiency virus (HIV) is mainly a virus. In most case this virus tends to attack a patient’s immune system. HIV cannot be treated, and in most cases, it results in acquired immunodeficiency syndrome (AIDS). Currently, no cure has been developed for HIV. This case means that once an individual is infected, they live with until death. However, good healthcare services and medical care plays a major role in the ability of a person to manage the diseases. This paper will focus mainly on the medical anthropology of HIV/AIDS.
History of Origin
The human immunodeficiency virus was discovered particularly in 1983. Since it was discovered, there have been a lot of studies focused on pinpointing the origin of HIV. In 1999, a team of international researchers claimed the discovery in consideration to the origin of human immunodeficiency virus-1. HIV-1 is considered the predominant strain related to the human immunodeficiency virus, specifically in the developed world. According to the report presented by these researchers, the origin of HIV was mainly from a subspecies of chimpanzees that are mainly native in the west equatorial of Africa. It is believed that the introduction of HIV to humans was through hunting as the population involved got exposed to the virus through infected blood. With time, the transmission of the human immunodeficiency virus was then driven from Africa through sexual practices, migration. Economic, drug use, housing, travel, and war contributed to the spread of the virus in Africa and globally. Currently, millions of people are living with HIV/AIDS in the world (Gallo, 2006).
Etiology and Epidemiology
The first cases the HIV virus, particularly in America, were recorded specifically in 1981. After some time, HIV, which is mainly an ARN of the Retroviridae family, was considered and believed to be considered as an underlying pathogen (Gong et al., 2017). It is believed that the virus probably entire the human population, particularly through cross-specific transmission in consideration to the ancestral virus that was mainly found in wild chimpanzees, which are considered to be the primary origin of the virus. However, the spread of HIV tends to correspond mainly with urbanization and is believed to have happened even before AIDS was recognized.
HIV is mainly a blood-borne pathogen. It is acquired in settings that are mainly non-occupational. In most cases, it will be acquired across the mucous membrane and, most importantly, parenteral methods. These methods involve five major modes of transmission. These modes of transmissions include;
- Injection drug use
- Penetrative sex between men, particularly when unprotected
- Mother to a child either during breastfeeding, pregnancy, or even delivery
- Heterosexual intercourse that is unprotected
- Unsafe blood or its by-products which is commonly related to developing nations.
- The estimated per exposures risk in consideration to the transmission of HIV is as follows.
- Receptive anal intercourse is mainly between one and thirty percent.
Insertive vaginal intercourse is between 0.1 to 1 percent, receptive vaginal and insertive anal intercourse are both between 0.1 to 1 percent, and injection drug use, particularly through sharing of needles and other products, is about 0.67 per contact related to the sharing of a needle. Generally, in this case, the risks tend to increase with advanced HIV disease, presence of genital ulcer diseases, anal and cervical dysplasia, and most importantly, the status of an individual’s circumcision. However, there are still less data in consideration to the transmission of HIV, specifically through oral sex.
Like other viruses, HIV has a specific general life cycle. In most cases, the infections tend to start particularly as the virion attaches itself to a host cell. The two major co-receptors related to type one of this virus include CXCR4 and CCR5. Viral strains can be grouped based on the co-receptor they mainly depend on as either CXCR4-tropic or CCR5-tropic or, in some cases, having a mixed-tropic. CCR5-tropic strains play a major role in predominating, particularly during the early stages of infections. As a result, they tend to remain dominant in between fifty to sixty percent of the late stage of the infection. Capsid-related and, most importantly, envelope-related viral proteins tend to, in most cases, mediate attachment.
Viral proteins play a major role in mediating viral entry to a host cell. As a result, it helps in promoting the fusion of either viral envelop or capsid in consideration to the cell membrane of the involved host. Once the virus enters the host’s cell, it is most likely that it will lose its capsid protein, particularly in a process commonly known as un-coating. As a result, the viral nucleic is therefore made available for replication. Replication depends mainly on the production of protein kinase particularly those that are dependent specifically on nucleoside triphosphate, which must be incorporated into the new viral genome, particularly by the polymerases in consideration to the host or viral cell.
In most cases, viral RNA and DNA can be replicated. As a result, they are transcribed particularly into mRNA. Reverse transcription tends to follow the un-coating process because HIV tends to be a retrovirus of RNA. The next process involves the translocation of the mRNA synthesized to the host’s cell ribosomes. As the viral proteins goes through the synthesizing process mainly by the cell ribosomes of the host, they will get arranged particularly with the viral genome that have been duplicated. The process relayed to assembly will therefore lead to the maturation process.
In maturation, the process is characterized mainly by the viral proteins being cleavage. This process is included mainly by proteases. Therefore, the process is important for virions that have been formed to ensure they become infectious. Viruses will therefore aggress from the host cell. Replication of HIV can involve specific additional processes in consideration to integrations. The integration process plays a major role in influencing the capacity of specific viruses, thus helping in the induction of tumor growth.
Early Attempts
In 1984 after researchers identified the specific cause of AID, the food and drug administration allowed for the first commercial blood test for the human immunodeficiency virus, particularly in 1985. Rock Hudson is considered to be the first high-profile fatality as a result of AIDS. As people and governments feared for the virus to make it into most of the blood banks, the food and drug administration enacted specific rules and regulations. These regulations were focused mainly on banning gay men from ever giving blood, particularly if they had been celibate for a year. However, blood banks ensured they had routine blood tests, particularly for HIV. By the end of 1985, the number of reported AIDS cases rose to more than twenty-thousand. Each region of the world had at least one case. In 1987, azidothymidine (AZT) was made available to the public. It was the first antiretroviral medication for the virus. As time passed, more medications were developed and are now available for public use. In 1988, the world health organization (WHO) first of every December considered it to be the world’s AIDS day. By the end of this decade, there were more than one-hundred-thousand reported cases of AIDS, particularly in the United States. Globally there were about four-hundred-thousand infections of the virus according to data presented by world health organization which was a major issue in general.
Ecological Model
The modified social-ecological model plays a critical role as one of the most important frameworks in characterizing and, most importantly, visualizing risks’ layers related to HIV. The model generally includes five different levels of risks. These levels include stages of the epidemic, individual, public policy, community, and most importantly, network level. Each of these levels plays a critical role in influencing the general understanding of subsequent levels. Logically, there are integrations between these levels and, most importantly, factors involved (Chin & Wilson, 2018). Apart from the epidemic stage, the other four stages act as important targets for effective preventative strategies. However, the porous nature of different levels has been considered a major and unique challenge in the ability to conceptualize a model for infectious diseases.
Biomedical and behavioral strategies have been considered as important ways to focus mainly on reducing the risk of HIV at both network and individual levels. However, the success and effectiveness of these interventions tend to be reduced, particularly by epidemic stages, the community, and public policy levels, in which they tend to be operationalized (Huber & Terézhalmy, 2013). Currently, most evaluations of biomedical and behavioral interventions tend to be focused on efficacy and not necessarily on real-world effectiveness.
Besides, there has also been a renewed focus on the implementation of science with a primary objective of assessing the effectiveness of most of these interventions. There is still a consensus that focuses on the fact that translating the efficacious interventions to effective and reliable programs necessitates thus playing a major role in addressing risk factors, particularly those of higher order. However, there is not enough evidence that has been focused on supporting structural interventions. Besides, programs developed with the aim of changing dynamics within most societies, for example, public policy and stigma, have been challenging, particularly in implementing and evaluating them, then most interventions related to individual-level (Baral et al., 2013). As a result, this has resulted in a rapid scale-up and blinded most trials that have been randomized. Still, more new approaches are important in evaluating most of the evidence used in supporting such interventions transcending randomized trials, particularly those that are controlled.
Logically, defining the risk of HIV characterized at the individual level is important in ensuring effectiveness, particularly in understanding specific dynamics of the virus. However, higher-order structure and social level risks are more likely to contribute and facilitate the transmission of HIV in consideration to a population level. As a result, it is evident that it no longer contributes to more understanding of HIV in characterizing higher numbers of sexual partners, low use of the protective measure, and the sharing of devices used in injecting drugs are associated, casually or not with infections of the virus. As a result, ensuring all epidemiologic studies of the virus play a major role in characterizing structural and social factors underlying high-risk practices is more likely to help develop more actionable data in improving understanding of prevention science in consideration of HIV.
Medical Anthropologists’ Roles
If medical anthropologists could go back in time with the aim of contributing to the understanding of HIV/AIDS. In that case, they should focus mainly on examining how the health of an individual, large social formations, and most importantly, the environment is affected particularly by the interrelationship between people and other species that influenced and contributed to the origin and spread of the virus. The origin of HIV/AIDS leads to a lot of stigmas, particularly towards gay people. Generally, most people, including medical anthropologists, believed that gay people were one of the major ways to spread this disease. As a result, the focus was mainly on gay people, which led to an increase in infections globally. With this chance, medical anthropologists should focus mainly on examining the local context of HIV/AIDS diagnosis, prevention, and the structural and, most importantly, conceptual barriers to ensure effective and positive outcomes in improving the health status of people and communities in general (Panter-Brick & Eggerman, 2018). The focus should be on understanding specific cultural beliefs and, most importantly, local practices that tend to put more people at risk for HIV/AIDS infections. Besides, advocating for equitable access to quality healthcare services and treatment will also be important. The goal should be on promoting culturally appropriate measures and, most importantly, strategies that would have been effective in preventing the spread of HIV. Focusing on such factors would have been easy to ensure effectiveness in understanding the virus better, the risks involved, and, most importantly, specific elements and factors of consideration that contribute to its spread globally. This case would have played a major and important role in regulating the rate of infections related to HIV/AIDS.
References
Baral, S., Logie, C. H., Grosso, A., Wirtz, A. L., & Beyrer, C. (2013). Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC public health, 13(1), 1-8.
Chin, Y. M., & Wilson, N. (2018). Disease risk and fertility: evidence from the HIV/AIDS pandemic. Journal of Population Economics, 31(2), 429-451.
Gallo, R. C. (2006). A reflection on HIV/AIDS research after 25 years. Retrovirology, 3(1), 1-7.
Gong, Z., Xu, X., & Han, G. Z. (2017). ‘Patient 0’and the Origin of HIV/AIDS in America. Trends in microbiology, 25(1), 3-4.
Huber, M. A., & Terézhalmy, G. T. (2013). HIV: Infection Control/Exposure Control Issues for Oral Healthcare Workers.
Panter-Brick, C., & Eggerman, M. (2018). The field of medical anthropology in Social Science & Medicine. Social Science & Medicine, 196, 233-239.
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