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Can people with AIDS get tattoos?

Can people with AIDS get tattoos?


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When I do a Google search, most of the results are about whether or not people can get HIV / AIDS from getting a tattoo through dirt needles. I am, however, curious whether or not it is possible to get a tattoo if you have AIDS.

Quoting wikipedia's entry on tattoos:

Tattooing involves the placement of pigment into the skin's dermis, the layer of dermal tissue underlying the epidermis. After initial injection, pigment is dispersed throughout a homogenized damaged layer down through the epidermis and upper dermis, in both of which the presence of foreign material activates the immune system's phagocytes to engulf the pigment particles.

If your immune system is not working properly, I can imagine that the phagocytes might never respond to the tattoo ink and that the pigment might not ever enter the fibroblasts?


Short answer
People with HIV can get tattoos.

Background
In Africa there are countries that tattoo people identified with HIV (Source: Kenya Today) and some people with HIV find comfort in tattooing biohazard symbols and related images on themselves to express their illness (Source: CNN).

However, as rightly mentioned by @AMR, macrophages which are mainly responsible for ink fixation express CD4 and therefore can be infected by the HIV virus targets.

Hence, while I don't think HIV affects tattooing given the fact that HIV-infected people get tattoos, in theory HIV could reduce the ink fixation.


Posted due to certain inaccuracies in comments and answers provided to this question regarding the Human Immunodeficiency Virus.

It should be noted that while it may not affect the ability for macrophages in the dermis to phagocytose the heavy metals found in the inks used in tattooing, and thus not interfere with the fixing of a tattoo in an HIV+ person, the Human Immunodeficiency Virus, the virus responsible for Acquired Immune Deficiency Syndrome (AIDS) does in fact have the ability to infect any cell type that expresses the cell surface glycoproteins CD4 and CCR5.

Cells that express CD4 and CCR5, barring mutations seen in the bone marrow received by the Berlin Patient (Timothy Ray Brown), among them CD4 "Helper" T-Cells, Macrophages, and certain Dendritic Cells, are all capable of being infected by the HIV virus.

Glycoprotein 120, found on the surface of the HIV envelop, binds with high affinity to CD4. The coreceptor CCR5 then binds to the gp120 CD4 complex and allows the HIV envelop to fuse with the plasma membrane of the host cell. The fusion then delivers the viral nucleocapsid and associated proteins into the cytoplasm of the cell and the infection takes place.

If I had to venture guess, I would say that as Macrophages tend to be present within the dermis of the person for extend periods of time, there is likely enough of a population present in the skin to have the macrophages necessary to fix the inks used in tattooing.


13.56: HIV and AIDS

  • Contributed by CK-12: Biology Concepts
  • Sourced from CK-12 Foundation

How long can a person live with HIV?

Years ago, a diagnosis of an HIV infection was a death sentence. Not today. With the proper medical treatment, an individual can live well over 10 or 20 or more productive years with an AIDS diagnosis. One of the most famous individuals with HIV is Earvin &ldquoMagic&rdquo Johnson, a retired professional basketball player. He was diagnosed in 1991. Over 20 years later, he is still doing well.


The Evolving Biology of AIDS: Scavenger Cell Looms Large

IN a marked shift in focus, researchers are concentrating on what they now see as the crucial, perhaps overriding role of scavenger cells of the immune system in the development of AIDS.

Scientists studying macrophages, white blood cells that are present everywhere in the body, are beginning to find answers to puzzling questions about how the AIDS virus invades the body and causes disease.

In the past, most scientists paid greatest attention to another type of white blood cell, the T-4 cell, in their effort to understand acquired immune deficiency syndrome. The T-4 cells are often invaded and killed by the AIDS virus, and their depletion in patients has been associated with the onset of disease. But the study of those cells has left unanswered many questions about acquired immune deficiency syndrome.

''We definitely have to zero in on the macrophage,'' said Dr. Peggy Johnston of the National Institute of Allergies and Infectious Diseases in Bethesda, Md.

Dr. Jay A. Levy of the University of California School of Medicine at San Francisco, said, ''I go to meetings now and all I hear is the macrophage, the macrophage, the macrophage.'' Dr. Levy said he still believed that T-4 cells and other body cells also play important roles in the disease, but that the macrophage is 'ɺ pivotal cell.''

At a workshop last week on AIDS and the macrophage sponsored by the Cancer Research Institute in New York, many experts described a new vision of AIDS virus infection and some emerging implications.

For several years, some researchers, including Dr. Robert C. Gallo of the National Cancer Institute, a discoverer of the AIDS virus, have suggested that macrophages were important targets of the AIDS virus, and could pass it on to other immune system cells. But only in the last year have researchers had the technical ability to grow macrophages with relative ease and study them in the laboratory.

Now it appears that macrophages may be the first, and sometimes the only, cells invaded by the AIDS virus. This is leading to development of new ways of testing for the virus that may be more accurate than those in current use.

But the new findings also mean that some people who had been declared free of the virus by customary tests may actually be infected, the virus hiding in their macrophages. Studies are beginning that will determine how often this happens and to see whether many people need to be retested.

Scientists believe the findings on the crucial role of macrophages may help explain the mystery of why AIDS patients are especially susceptible to some diseases but not others. It also appears that infected macrophages may be responsible for the dementia that sometimes accompanies AIDS.

With macrophages so clearly important, drugs against AIDS will have to be tested to see if they can curb the virus's action in these cells. It is not yet certain, for example, whether azidothymidine, or AZT, the only drug yet approved against AIDS, deters the virus in macrophages as effectively as it does in T-4 cells.

Macrophages are present in the blood, the brain, mucous membranes, semen and cervical fluid. When they are in the blood, they are traditionally called monocytes.

These macrophage cells, whose name is derived from the words 'ɻig eater'' in Greek, help fight infection by ingesting invaders, such as bacteria and protozoa. They normally do this after being signaled by T-4 cells that these organisms have infected the body. Macrophages also directly activate other immune system cells to attack disease-causing organisms in other ways, such as by producing antibodies.

But even when macrophages are not fighting infections, they are crucial to health. The cells secrete hundreds of substances that keep body tissues alive and growing and that stimulate other immune system cells to fight disease.

Until recently, researchers focused on T-4 cells in their studies of AIDS because these are the cells most obviously destroyed by the virus.

Although the depletion of T-4 cells is still considered central to the development of AIDS, investigators cite evidence that this alone is not sufficient to explain the disease.

Dr. Jacques Leibowitch of the Rene Descartes University in Paris cited two indications that T-4 cell destruction is neither necessary nor sufficient for severe immune system damage to occur. First, he said, people can have secondary infections associated with AIDS while their T-4 cells remain normal in number, usually in the early years after invasion by the virus.

Then, 'ɺt the other end of the story,'' when people are in the later stages of the disease and have virtually no T-4 cells left, ''you can go without an infection for months, or even as long as a year,'' Dr. Leibowitch said. ''If the song of the T-4 orchestra were true, you would have an infection every other second,'' he added. Few T-4 Cells With Virus

Another mystery had been the difficulty in finding T-4 cells containing the AIDS virus, even in patients who had antibodies to the virus and who had symptoms of AIDS. Doctors have estimated that as few as one in a million T-4 cells are infected, which led some to ask where the virus hides.

The emerging picture is that the virus goes to the macrophage first and spreads from there to T-4 cells. The virus kills T-4 cells and thereby prevents these cells from signaling macrophages to fight certain infections. At the same time, the infected macrophages do not function properly to fight diseases even if they are signaled by T-4 cells. As a consequence, patients become vulnerable to organisms that normally would never make them ill.

In addition, scientists believe, infected macrophages do not properly release the substances that keep other tissues growing and healthy. One result, in some patients, may be neurological symptoms of AIDS and widespread destruction of brain cells.

Macrophages serve as a reservoir for the AIDS virus because the virus multiplies in them but does not kill them, as it kills T-4 cells. In T-4 cells, the virus is released from the cells as it reproduces in a process known as budding. In macrophages, the virus buds inward, remaining in the cell rather than being released. Macrophages become ''like beanbags, filled with hundreds of viral particles,'' said Dr. Monte S. Meltzer of Walter Reed Army Institute of Research in Washington. Transmitting the Virus

Infected macrophages can transmit the virus to other cells, possibly by touching the cells. But the infected macrophages may bypass the body's normal immune defenses so that they never trigger the production of antibodies against the AIDS virus. This may explain, scientists said, mysterious cases in which patients developed AIDS without ever having antibodies against the virus in their blood.

A growing number of researchers are looking to macrophages for an explanation of why AIDS patients are plagued with certain infectious diseases but not others. They reason that the infections typical of AIDS mostly involve organisms that invade and kill body cells. These are exactly the types of organisms normally killed by macrophages.

''In the beginning, all the diseases that AIDS patients get are intracellular parasites,'' noted Dr. Jeffrey C. Laurence of Cornell University School of Medicine in New York. 'ɺnd the major way the body attacks intracellular parasites is with macrophages.''

Dr. Levy said macrophages normally engulf and destroy the parasite that causes Pneumocystis carinii pneumonia, the major killer of AIDS patients. But macrophages that are filled with the AIDS virus ''just sit there.''

Dr. Howard E. Gendelman of the Walter Reed Army Institute of Research in Washington also has evidence that infected macrophages may cause AIDS dementia. In laboratory experiments, Dr. Gendelman showed that infected macrophages release a substance that kills brain cells, while healthy macrophages release substances that nourish brain cells. AIDS Virus in Macrophages

Researchers looking at macrophages are now finding that the AIDS virus is there in abundance, even when it canot be isolated from T-4 cells. Dr. Meltzer of Walter Reed isolated AIDS virus from the macrophages of three homosexual men who had been exposed to the virus on many occasions but who had no antibodies to it and who had no detectable virus in their T-4 cells.

The Army is now initiating a study of about a hundred high-risk people with no AIDS antibodies and no evidence of the virus in their T-4 cells to see how often the virus occurs in macrophages but nowhere else.

Once people have antibodies to the AIDS virus, they almost always have the virus in their macrophages, too. And the virus is far more prevalent in macrophages than it is in T-4 cells.

Dr. Suzanne Crowe, Dr. Michael S. McGrath, and Dr. John Mills of the University of California in San Francisco found that they can isolate the AIDS virus from 3 to 9 percent of the macrophages of people who are carriers of the AIDS virus but have no symptoms of disease, and that they can isolate the virus from 10 to 20 percent of the macrophages of people who are ill with AIDS.

Moreover, Dr. Crowe said, these are just the macrophages that are actively releasing the virus. Many more will release it if they are grown for a week or so in the laboratory. Thirty percent of all macrophages from people who are AIDS virus carriers or AIDS patients release the virus under these conditions.

With their new focus on the macrophage, some investigators are beginning to ask whether drugs that they have tested in T-4 cells in the laboratory will also be effective against the virus in macrophages. Limited Drug Testing

''Macrophages sometimes metabolize drugs differently than T-cells,'' said Dr. Samuel Broder of the National Cancer Institute. ''You cannot necessarily assume that a drug that works against the virus in T cells will work against it in macrophages.''

Dr. Broder also said that only a few groups, including his, are actively testing drugs in macrophages.

''Not all labs have the ability or the facilities,'' he said. ''This is not a field you can just get into. You have to make a major commitment.''

So far, several groups have tested AZT with macrophages. The drug prevents replication of the AIDS virus in T cells in the laboratory. Some groups, including Dr. Broder's find it also prevents the replication of the virus in macrophages. But other groups have found it does not.

Other experts are looking at CD-4, a protein that in the laboratory attracts the AIDS virus and prevents it from entering T-4 cells. Several companies are developing synthetic CD-4 cells as a possible new AIDS treatment. But researchers now find that although CD-4 prevents infection of T-4 cells, it was less successful in protecting macrophages. Dr. Crowe said at the meeting that her group tested CD-4 and found it only prevented 95 percent of the AIDS viruses from infecting macrophages in laboratory experiments.

Because the macrophage studies are relatively recent, very little has been published in the scientific literature, Dr. Broder said. But, in the coming months, that should change. ''You're going to hear a lot about this area,'' Dr. Broder said.


A serious question should people with HIV be tattooed??

The main reason HIV is spread is though SEX, this is a fact.

The idea of abstinence is just not going to work, fact.

Condom use is good protection but people do not like using them, in most cases fact.

You can not tell if a person is HIV positive for at least 5 years after infection by looking at them, fact.

Many people living with HIV have unprotected SEX anyway and don’t tell the potential sexual partner, fact.

I am not suggestion that they be tattooed across there forehead. A small tattoo in any area that will be hidden even on the beach that will be seen prior too the sexual act will do nicely.

I have many answers but let’s see what people post on this subject first I am calling for a first class discussion that I believe the law makes should be debating.

I thought this was about HIV people being allowed to get tatoos. This notion is crazy.

HIV isn't the "huge" problem we have nowadays and these people are treated like crap enough from simply having an immune difiency.

EDIT TO ADD: I just read the last line of your thread. YOU are crazy if you think we should tatoo people who have HIV. Gee, I guess we can sure pick out the jews after WWII huh?

[edit on 11/28/2009 by tothetenthpower]

[edit on 11/28/2009 by tothetenthpower]

The question was not meant to be about the actual tattoo but more about the Human rights issue that would surround such a practice but thanks for your input.

Well it's obviously a HUGE human rights issue. You can't force people to have tattoos because of an affliction. There are much better ways of doing this.

You know a med alert bracelet or pendant, that sort of thing.

I dunno I apologize for being brash I just got a WW2 Germany-esque feeling from your post is all.

First of all HIV is near impossible to transfer via tattoo. Just had to get that fact out of the way. The virus us tattoo studios worry about it hepatitus. It is the most easily transfered virus. We follow what are called "universal precautions in order to prevent the spread of blood borne pathogens.

As far as weather or not it is ok for you to get a tattoo. Yes. But you need to be in good health with no current immunity problems. It is best to consult your doctor and see what their take is on your specific case.

I am a tattoo artist of almost 14 years and own my own shop.

Because HIV isn't even the cause of Aids anyway

You'd be Tattooing allot of people who will never get sick anyway


It's your responsibility who you have sex with. I didn't have unprotected sex with my wife (then girlfriend) until we had both been tested for any and all STD's.

Personal responsibility obviates the need to even consider this kind of 'gold star' nightmare.

Further, I'm an acupuncturist - in regular contact with needles and blood. I've spent time practicing in a special facility for HIV patients. And most of the time, in my regular setting, I have no idea who might have what. But this is a path I have chosen, and it's on me to be careful, use popper technique, and to deal with the hazards that come with the territory.

[edit on 28-11-2009 by TrueTruth]

When I wrote the thread above it looked perfectly clear to me but I was wrong as I now see.

Yes the idea that people having been diagnosed with HIV should have a discreet tattoo that will only be visible before the SEX act to show there infection is what I would like too debate.

HIV doesn't exist and not transmitted by sex, so if you think you should be tatooed, then you probably will be tatooed,

next year is the HIV year and everybody who gets swine vaccine will be submited to 'AIDS' patients, due to:

'acute immune deficiency syndrome'

When I wrote the thread above it looked perfectly clear to me but I was wrong as I now see.

No I am not worried about the tattooing process a further description is in an answer below.

When I wrote the thread above it looked perfectly clear to me but I was wrong as I now see.

Yes this is true but such a tattoo should only be visible to a potential sex partner.

I am glad I started this tread because of your comment.

It is become very obvious to me that the people who you would expect top have a good idea of the subject obviously do not.

HIV dose bring on AIDS I watch the dye every week. I work as a volunteer in an HIV/AIDS hospice.

Sorry you are totally wrong please do see my other answers it may save your life.

Ha! I just posted something about this a few hours ago in the Uganda thread.

Well, obviously, I'm all for a big fat yes on this one.

You see, people with a spreadable, permanent passable disease should be tattooed somewhere discrete so that it gives the rest of the populace a reference check. Yeah, doublecheck time, you got tyhe mark, you better wrap it before you tap it.

As I stated before, basically, they're a walking loaded gun and death sentence for anyone they contact within the method of transmission, and if they knowingly and willingly infect another person with it.. instant no questions asked bullet to the back of the head death sentence. period full stop.

Social situations aside, for medical workers as well. Check reference spot, ok, they have this and this, so watch for complications and symptoms.

HIV doesn't exist and not transmitted by sex, so if you think you should be tatooed, then you probably will be tatooed,

next year is the HIV year and everybody who gets swine vaccine will be submited to 'AIDS' patients, due to:

'acute immune deficiency syndrome'

This is horribly, horribly wrong.

It very much does lead to AIDS. I have no idea where this myth sprouted, but I too have been working part time in an HIV/AIDS clinic, as I mentioned, and perhaps you should too. Go talk to the people who've suffered the progression from one to the other. Go talk to a hundred of them.

This a pernicious rumor, and I hope people have the good sense to choose science over myth.

Ha! I just posted something about this a few hours ago in the Uganda thread.

Well, obviously, I'm all for a big fat yes on this one.

You see, people with a spreadable, permanent passable disease should be tattooed somewhere discrete so that it gives the rest of the populace a reference check. Yeah, doublecheck time, you got tyhe mark, you better wrap it before you tap it.

As I stated before, basically, they're a walking loaded gun and death sentence for anyone they contact within the method of transmission, and if they knowingly and willingly infect another person with it.. instant no questions asked bullet to the back of the head death sentence. period full stop.

Social situations aside, for medical workers as well. Check reference spot, ok, they have this and this, so watch for complications and symptoms.

So, you want THEM to be marked, so you don't have to be responsible for who who take home and boink?


HIV cannot be transmitted by spitting, and risk from biting is negligible, says detailed case review

There is no risk of transmitting HIV through spitting, and the risk from biting is negligible, according to research published in HIV Medicine.

An international team of investigators conducted a meta-analysis and systematic review of reports of HIV transmission attributable to spitting or biting. No cases of transmission due to spitting were identified and there were only four highly probable cases of HIV being transmitted by a bite.

The study was motived by the use of spit hoods by police forces in the UK because of the perceived risk of the transmission of HIV and other blood-borne viruses from spitting. The researchers’ findings endorse the position of the National AIDS Trust and Hepatitis C Trust that neither HIV nor hepatitis C virus can be transmitted by spitting, and that the use of spit hoods by police forces to protect offices against these viruses cannot be justified.

Glossary

A month-long course of antiretroviral medicines taken after exposure or possible exposure to HIV, to reduce the risk of acquiring HIV.

Infection control measures used in health care settings aimed at preventing the transmission of HIV and other blood-borne pathogens. These include the use of gloves and other protective gear, and the safe disposal of needles to prevent exposure to blood and other body fluids.

In medical terms, going inside the body.

The conditions which a person must meet to join a research study.

A review of the findings of all studies which relate to a particular research question and which conform to pre-determined selection criteria.

“We undertook a systematic literature review of HIV transmission related to biting or spitting to ensure that decisions about future policy and practice pertaining to biting and spitting incidents are informed by current medical evidence,” explain the study’s authors.

They identified published studies and conference presentations reporting on transmission of HIV via spitting or biting. Inclusion criteria were: discussion of transmission by biting or spitting outcome described by documented HIV antibody test. Two reviewers independently identified studies that were included in the full analysis.

There were no cohort or case-control studies. The investigators therefore assessed the plausibility of HIV being transmitted to a spitting or biting incident according to baseline HIV status, nature of the injury, temporal relationship between the incident and HIV test, and where, available, phylogenetic analysis.

The plausibility of transmission being related to an incident was categorised as high, medium or low.

A total of 742 studies and case reports were reviewed by the authors.

There were no reported cases of HIV transmission attributable to spitting.

A total of 13 studies reported on HIV transmission and biting. The studies consisted of eleven case reports and two case series relating to HIV transmission, or its absence, after a biting incident.

None of the possible cases of HIV transmission due to biting were in the UK or involved emergency workers. The reports included information on 23 individuals, of whom nine (39%) seroconverted for HIV. Six of these cases involved family members, three involved fights resulting in serious wounds, and two were the result of untrained first-aiders placing fingers in the mouth of an individual experiencing a seizure.

“Of the 742 records reviewed, there was no published cases of HIV transmission attributable to spitting, which supports the conclusion that being spat on by an HIV-positive individual carries no possibility of transmitting HIV,” write the authors. “Despite biting incidents being commonly reported occurrences, there were only a handful of case reports of HIV transmission secondary to a bite, suggesting that the overall risk of HIV transmission from being bitten by an HIV-positive person is negligible.”

There were only four highly plausible cases of HIV transmission resulting from a bite. In each case, the person with HIV had advanced disease and was not on combination antiretroviral therapy and was therefore likely to have had a high viral load. The bite caused a deep wound and the HIV-positive person had blood in their mouth.

“Two cases occurred in the context of a seizure whereby an untrained first-aid responder was bitten while trying to protect the seizing person’s airway,” note the researchers. “It is therefore important that both emergency workers and first-aid responders are trained in safe seizure management including non-invasive airway protection and use universal precautions.”

The investigators emphasise that they found no cases of an emergency worker or police officer being infected with HIV because of a bite. They point out that bite injuries are a common reason for attending accident and emergency departments: a review of A&E admissions over a four-year period at a hospital in the United Kingdom found that one person was admitted with a bite wound every three days, on average.

“Current UK guidance on indications for PEP [post-exposure prophylaxis, emergency HIV therapy after a high-risk exposure to HIV] state that ‘PEP is not recommended following a human bite from an HIV-positive individual unless in extreme circumstances and after discussion with a specialist,’” conclude the authors. “Necessary conditions for transmission of HIV from a human bite appear to be the presence of untreated HIV infection, severe trauma (involving puncture of the skins), and usually the presence of blood in the mouth of the biter. In the absence of these conditions, PEP is not indicated, as there is no risk of transmission.”

Cresswell FV et al. A systematic review of risk of HIV transmission through biting or spitting: implications for policy. HIV Med, online edition. DOI: 10.1111/hiv.12625 (2018).


Acquired immunodeficiency syndrome (AIDS): Symptoms, Treatment and Prevention

AIDS (Acquired immunodeficiency syndrome) is a chronic life-threatening disease. Actually, it is a special type of serious infectious disease of the human immune system. It is defined as the HIV post infection condition. Total immunity of the body is damaged by the infection of the HIV. So a patient died easily by any kind of infectious disease.

In 1983, French Scientist Luc Antoine Montagnier and American Scientist Robert Charles Gallo separately described the virus of the AIDS. Montaguier gave the name of this virus as Lymphadenopathy-associated virus (LAV). But Gallo proposed the name for this virus as Human T. cell Lymphotropic virus, stain III (HTLV-III).

Later in 1896, International Committee of Nomenclature of Virus finalized the name as Human Immunodeficiency Virus or HIV. This is a retrovirus which destroys the T-helper cells (lymphucytes) which are essential component of body immune system.

During the late nineteenth or early twentieth century, HIV originated in west-central Africa.

At the end of 2019, thirty-eight million of people were living with HIV. Among them, the majority are the people of sub-Shararan Africa. About 700000 people died from AIDS and 17,0000 people became recently infected by HIV in 2019. At present, AIDs is a pandemic and it is vigorously spreading.


DNA 'Tattoos' Link Adult, Daughter Stem Cells In Planarians

Unlike some parents, adult stem cells don't seem to mind when their daughters get a tattoo. In fact, they're willing to pass them along.

Using the molecular equivalent of a tattoo on DNA that adult stem cells (ASC) pass to their "daughter" cells in combination with gene expression profiles, University of Utah researchers have identified two early steps in adult stem cell differentiation&mdashthe process that determines whether cells will form muscle, neurons, skin, etc., in people and animals.

The U of U researchers, led by Alejandro Sánchez Alvarado, Ph.D., professor of neurobiology and anatomy, identified 259 genes that help defined the earliest steps in the differentiation of adult stem cells in planarians&mdashtiny flatworms that have the uncanny ability to regenerate cells and may have much to teach about human stem cell biology.

The findings, reported in the Sept. 11 issue of Cell Stem Cell establish planarians as an excellent model for studying adult stem cells in a live animal, rather than a laboratory culture dish.

"This allows us to study an entire stem cell population in its own environment," said Sánchez Alvarado, also an investigator with the Howard Hughes Medical Institute and the study's senior author. "It's likely that what we learned here can be applied to our own stem cell biology."

Planarians share similar biology with humans in many ways. They also, for reasons unknown, regenerate cells unlike any other animal&mdashan entirely new worm can form from just a fragment of another worm. Planarians constantly regenerate new cells to replace those that die naturally or from injury.

The process begins when adult stem cells divide into two new cells (daughter cells): one becomes like its mother (a stem cell), while the other will move on to give rise to the cells that will serve specific functions in planarian life. For example, some cells may form part of the worm's musculature, while others will form part of the brain.

Because daughters and mother cells are indistinguishable from each other in appearance, the researchers devised methods to detect specific differences in gene expression in the BrdU-labeled cells. The researchers identified 259 genes associated with the stem cells and their daughters. When the U team disabled some of these genes, they found that in some cases no defects were observed, while in others deficiencies were detected in the way the cells were patterned in regenerating planarians.

Sánchez Alvarado and two colleagues then marked adult stem cells in the worms by injecting BrdU, a synthetic nucleotide that binds with DNA and leaves an unmistakable mark on it, much like a tattoo. (Nucleotides are the structural units of DNA and RNA.) When the adult stem cells divided into daughter cells as part of the worms' normal cell regeneration, the BrdU was passed to the daughter cells in their DNA, allowing the researchers to track these cells. By detecting which genes were expressed in which BrdU-labeled cells, the collection of identified genes allowed the researchers to work out for the first time the lineage of stem cells in planarians.

They found that the daughter cells that move on to differentiate into different cell types do so by going through at least two steps. Although the daughter cells, which the researchers labeled categories 2 and 3, are indistinguishable by appearance, they play different roles in cell differentiation

"It seems as if category 2 cells make category 3 cells," Sánchez Alvarado said. "We don't know which differentiated cells they make, but category 3 cells likely differentiate into many different cell types."

These findings open a window to understanding how multipotent stem cells take differentiation decisions. "This allows us to begin to understand how adult stem cells decide what their daughter cells will become when they grow up," Sánchez Alvarado said. "These molecular markers will help us identify specific differentiated cells and help us determine how a stem cell population decides how many of each of the differentiated cell types it needs to make."

The next big step for Sánchez Alvarado and his colleagues is to identify the molecules that act to restrict cell types into serving specific functions.

George T. Eisenhoffer is first author on the study and Hara Kang is co-author. Both authors are graduate students in the Department of Neurobiology and Anatomy at the University of Utah School of Medicine.

Story Source:

Materials provided by University of Utah Health Sciences. Note: Content may be edited for style and length.


My own personal AIDS tattoo

In 1991, an acquaintance who didn’t know I was HIV-positive shared with me his solution to the epidemic: “People with AIDS should be required to wear tattoos above their private parts.”

That way, he theorized, the innocent would be forewarned before unwittingly having sex with a carrier of the virus.

The conversation inspired a similar discussion in my first novel Uprising, but now, in 2008, I offer a better solution, at least from where I’m standing: tell the whole world via a blog: I have AIDS.

That way, the scared can run, the judgmental can judge, the compassionate can show compassion, the educated can learn, the world can witness, and I don’t have to get a tattoo branding myself.

I have AIDS. I own it. I own who I am. Consider this blog my permanent tattoo. Pretty colorful, huh?


HIV/AIDS: Why Don't Some People Get Sick?

(istockphoto) istockphoto

(CBS) It's a medical mystery that has baffled scientists for nearly two decades. How do some HIV-infected people, about one in 300, keep the virus at such a low level that they don't get sick with full blown AIDS, even if they don't take medicine?

Now, researchers at Massachusetts General Hospital and Harvard University think they have a clue.

It's in the genes, they say, specifically five amino acids in a protein called HLA-B.

"We found that, of the three billion nucleotides in the human genome, just a handful make the difference between those who can stay healthy in spite of HIV infection and those who, without treatment, will develop AIDS," said study co-author Dr. Bruce Walker, MD, director of the Ragon Institute, in a statement.

Well, the protein plays a vital role in the immune system by grabbing onto pieces of a virus and bringing them into the cell membrane where they get tagged for destruction by "killer" T cells. Researchers believe the shape and structure of five critical amino acids on HLA-B help determine whether the immune system can outfox HIV viruses or not.

Trending News

At this point it's high science, but understanding how some people naturally fight HIV, researchers say, is critical to curing it for everyone else.

"We have a long way to go before translating this into a treatment for infected patients and a vaccine to prevent infection," Walker said, "but we are an important step closer."

The study was published in Science.

Anyone infected with HIV, who has a low viral load without medicine is encouraged to join the study. Find out here.


New cause of inflammation in people with HIV identified

While current antiretroviral treatments for HIV are highly effective, data has shown that people living with HIV appear to experience accelerated aging and have shorter lifespans -- by up to five to 10 years -- compared to people without HIV. These outcomes have been associated with chronic inflammation, which could lead to the earlier onset of age-associated diseases, such as atherosclerosis, cancers, or neurocognitive decline. A new study led by researchers at Boston Medical Center examined what factors could be contributing to this inflammation, and they identified the inability to control HIV RNA production from existing HIV DNA as a potential key driver of inflammation. Published in The Journal of Infectious Diseases, the results underscore the need to develop new treatments targeting the persistent inflammation in people living with HIV in order to improve outcomes.

After infection, HIV becomes a part of an infected person's DNA forever, and in most cases, infected cells are silent and do not replicate the virus. Occasionally, however, RNA is produced from this HIV DNA, which is a first step towards virus replication. Antiretroviral treatments help prevent HIV and AIDS-related complications, but they do not prevent the chronic inflammation that is common among people with HIV and is associated with mortality.

"Our study set out to identify a possible association between HIV latently infected cells with chronic inflammation in people with HIV who have suppressed viral loads," said Nina Lin, MD, a physician scientist at Boston Medical Center (BMC) and Boston University School of Medicine (BUSM).

For this study, researchers had a cohort of 57 individuals with HIV who were treated with antiretroviral therapy. They compared inflammation in the blood and various virus measurements among younger (age less than 35 years) and older (age greater than 50 years) people living with HIV. They also compared the ability of the inflammation present in the blood to activate HIV production from the silent cells with the HIV genome. Their results suggest that an inability to control HIV RNA production even with antiretroviral drugs correlates with inflammation.

"Our findings suggest that novel treatments are needed to target the inflammation persistent in people living with HIV," said Manish Sagar, MD, an infectious diseases physician and researcher at BMC and the study's corresponding author. 'Current antiretroviral drugs prevent new infection, but they do not prevent HIV RNA production, which our results point as a potential key factor driving inflammation in people living with HIV."

According to the Centers for Disease Control and Prevention, it is estimated that 1.2 million Americans are living with HIV however, approximately 14 percent of these individuals are not aware that they are infected. Another CDC reporter found that of those diagnosed and undiagnosed with HIV in 2018, 76 percent had received some form of HIV care 58 percent were retained in care and 65 percent had undetectable or suppressed HIV viral loads. Antiretroviral therapy prevents HIV progression and puts the risk of transmission almost to zero.

The authors note that these results need to be replicated in larger cohorts. "We hope that our study results will serve as a springboard for examining drugs that stop HIV RNA production as a way to reduce inflammation," added Sagar, also an associate professor of medicine and microbiology at BUSM.

This study was supported in part by the National Institutes of Health (grant award numbers AG060890 and AI145661, the Boston University Genomic Science Institute and was facilitated by the Providence/Boston Center for AIDS Research.


So you're wondering if a "menage a trois" of HIV-negative sex partners could "create" an HIV infection. YIKES! Let me guess that either you are being home schooled or that you are yet another victim of abstinence-only sex education. Sex does not "create" HIV! HIV is a sexually transmitted disease (similar to gonorrhea, syphilis, etc.). A person infected with HIV (human immunodeficiency virus) can transmit it to an uninfected person via unsafe sex. If, however, one, two, three or more sex partners are not HIV infected, they (obviously?) cannot transmit what they don't have, right? Of course right! Somewhat shockingly, you're not the first person to ask about this. (See below.)

gay anal sex with two hiv negatives Jun 2, 2008 dr bob,

i am really worried because my gay friend and i had gay sex and anal! is there any way we can get HIV or any other form of STI if neither of us have them to begin with?

Advertisement Response from Dr. Frascino

Once again a QTND (question that never dies) arises! Your stressing would have been short-lived if you checked the archives! See below.

How can someone contract HIV? (HIV TRANSMISSION BETWEEN TWO HIV NEGATIVES, 2008) May 13, 2008

How can someone contract HIV? I mean if you have sex with multiple HIV negative people, can you contract it? I dont understand. Can someone get it by having unprotected sex with multiple HIV negative people? I dont understand.

Response from Dr. Frascino

I absolutely agree: You certainly don't understand! Can you contract HIV from having sex with multiple negative people? No, of course not. HIV is a sexually transmitted disease in which an HIV-infected person can transmit the virus to an uninfected person (HIV negative) via unprotected sex. (See below.)

I suggest you spend some time on this site reviewing HIV basics (see below) and also the wealth of information in the archives and on related links pertaining to exactly how HIV is and is not transmitted.

Bareback possibility (HIV TRANSMISSION BETWEEN TWO HIV NEGATIVES) Aug 11, 2007

I want to have bareback sex. we are both negative, & i want to know. if we have bareback sex will we get infected because we bareback.

Response from Dr. Frascino

Here we go again . . . . Can two HIV-negative people give each other HIV. I wish someone could explain to me why such a nonsensical question comes up so frequently! Dude, can two people who don't have a million dollars give each other a million dollars. Just in case you're still wondering, I'll reprint some posts from the archives that address your concern. See below.

Finally, I should mention barebacking is a risk! Remember, your partner is only as negative as his last HIV test and that was taken before the cute pizza delivery guy "delivered" earlier this evening!

HIV between two hiv-negative people?(HIV TRANSMISSION BETWEEN TWO HIV NEGATIVES) Jul 2, 2007

is there a way hiv can develop through a hiv-negative person's vaginal fluid on a hiv-negative's small cut(ripped hang nail) through clothed mutual masturbation?

Response from Dr. Frascino

Here we go again! I find it shocking how often the question of "can two HIV negative people transmit HIV to each other?" comes up! And I find it disheartening to see this question now coming up in the context of mutual masturbation! Can there be any doubt that the lack of sex education in this country has reached critical proportions? Dubya's "abstinence only" sex education policy strikes again!

Rather than reiterate what I've said so many times before, I'll just repost a few questions from the archives.

Question (HIV FROM TWO HIV NEGATIVES) Jan 20, 2007

I was just wondering. Can AIDS come out of no where? Like, if two people are disease free, can an infection occur between them like AIDS assuming they haven't had any other sexual partners. (Asking this about both Hetero and SameSex couples for a paper)

Response from Dr. Frascino

Do you really think there is even a remote possibility that AIDS can come out of nowhere. " I'm glad you are doing a paper, because you obviously have much to learn. See below.

can you get AIDS or HIV by having anal sex or vaginal sex with someone who does not have AIDS or HIV? Such as if semen was to make contact with blood in the body near the anus area.

Response from Dr. Frascino

That this question comes up so very often is a stark reminder of just what a shameful job our country is doing "educating" folks about HIV and STDs in general. No doubt you were home schooled or a product of an "abstinence-only" sex education program. Right? Yeah, I suspected as much.

Now please think this through rationally, OK? HIV is an STD, a sexually transmitted disease, caused by a germ, a virus called human immunodeficiency virus. If neither you nor your partner has the AIDS virus (HIV), how can you possibly transmit or catch it from each other. "Semen coming into contact with blood in the body or near the anus" doesn't create an HIV virus out of thin air any more than it can create a million dollars. So, for instance, if your sex partner isn't already a millionaire, would you expect him to suddenly have a million dollars just because you had sex with him? Of course not! The same thing applies to germs that neither of you have as well!

See below. I'll reprint a similar question from the archives. Please spend some time reviewing the information on this site and at its related links that pertains to how HIV is and is not transmitted, OK?

Good luck. Get informed! Stay safe. Stay well.

Anal sex and aids (CAN TWO HIV NEGATIVES CONTRACT HIV FROM EACH OTHER?) Sep 20, 2006

my husband and i had unprotected anl sex neither of us have aids or HIV and i we are in a monogomus relationship. what are my chances of contacted the HIV virus

Response from Dr. Frascino

Can two HIV-negative people contract HIV/AIDS from having unprotected anal sex with each other? Astoundingly this has become another QTND (Question That Never Dies)! It dramatically points out (1) the failure of sex education, (2) the failure of HIV/AIDS-prevention efforts and (3) the lack of common sense to conquer irrational HIV fears.

I'll reprint a post from the archives that addresses your concerns. I also suggest you spend some time reading the information on this site related to how HIV is and is not transmitted.

Quick question - please help!

My gay partner and I are both HIV- but just now we've gone wild and we performed unprotected sex. Is there a chance to get HIV from unprotected sex if both parties are HIV-? I am really worried now. Please help. Thank you!

Response from Dr. Frascino

"Can you get HIV from unprotected sex if both parties are HIV negative?" Here we go again. Another QTND: Question That Never Dies. Dudes, think about this rationally. HIV is a germ, a virus. Right? OK, check. Germs are spread from an infected person to an uninfected person. For instance, a common cold can be transmitted through the air if the infected person coughs or sneezes on an uninfected person. Right? OK, check. Sexually transmitted diseases, like the clap or syphilis, can be transmitted when the infected person has unprotected sex with an uninfected person. Right? OK, check. Now with this very basic information (even Dubya should understand this much), do you think you can answer your own question? Hint #1: HIV is a sexually transmitted disease.

Hint #2: HIV cannot spontaneously appear just because two uninfected guys get horned up and do a horizontal mattress mambo, forgetting to dress for the occasion. (That would be about as logical as the bizarre notions of "intelligent design" and "virgin birth.") Hint #3: You can't give something away that you don't have to give. Otherwise I'd ask you for a million dollars. But if you don't have a million dollars, you can't give it to me, right? And even if we had nookie, a million dollars wouldn't appear, no matter how hot the encounter may have been. Right? OK, check.

So, what's your final answer.

Hint #4: Dubya probably thinks you can indeed get HIV this way. So considering Dubya has been and continues to be wrong about absolutely everything from the war in Iraq to WMD to Mission Accomplished to Katrina to the economy to the environment to evolution/intelligent design to stem cell research, etc., etc., etc., does this help sway your answer?

OK, if you're still confused, write back and I'll provide more hints.

19 yr old & You said: If your partner were confirmed to be HIV-positive, the risk would be 0.1 to 0.2 percent per episode Sep 28, 2003

Hello Doctor. All I'd like to tell you is that you are doing a great job with your service. Not to take much of your time, based on your statement "if your partner were confirmed to be HIV-positive, the risk would be 0.1 to 0.2 percent per episode." Based on this statement, you are saying that only so much get infected based on one episode. I am just have difficulties in understanding this statement. That really means, if you are lucky based on one episode, you will not be positive, if you are not lucky, then you are positive. So do you think you and many others who are positive, are just having bad luck!! I think this statement is not really accurate. Do you still abide with this statement? My other question is that, how does a guy who is negative turns out positive if he sleeps with someone who is negative. In other words, two negative how, can someone turn positive? How does someone become positive if the couple is both negative. But then, how does someone come positive from the first place, if someone was negative?? Am I making sense?

Response from Dr. Frascino

"Are you making sense?" No, not a bit. Two negatives never make a positive. For HIV to be transmitted, one of the partners needs to be HIV-positive. That's not all that difficult to understand, is it?

"How does someone become positive in the first place?" He (or she) must be exposed to someone who is positive (has the virus). Different types of exposures carry different levels of risk. Yes, the 0.1 to 0.2 percent statistical risk per episode is correct. This risk applies to unprotected receptive vaginal intercourse with a partner who is confirmed to be HIV positive. So this virus isn't all that easy to catch -- however, is it possible for someone to contract the virus with a single exposure (say unprotected sex)? Absolutely.

Does every exposure lead to viral transmission? Absolutely NOT!

So, are those of us who did contract the virus "just having bad luck?" Yes, that's one way of looking at it. I don't think any of us would consider the day we became infected a particularly "good luck" kind of a day. Somehow, this all seems rather intuitive to me, but I do hope it clarifies things a bit for you.

Hi, I will start out by I don't really know much about HIV or AIDS but I have been married for almost 5 years my husband and I are very sexually active. Before him I was also sexually active and I have had several test done and been neg. I have had 2 children by my husband and was tested then and was neg. My question is we have anal sex and vaginal intercourse. I was told if you have anal sex you can get HIV even when both partners do not have HIV. Is this true? Thank You.

Response from Dr. Frascino

I find it shocking that sexually active adults could know so little about HIV/AIDS. Where have you been living for the past 25 years. Kansas. Oh! OK! That explains it. I guess all the time you spent learning about myths like "intelligent design" didn't leave much time for basic science topics, like sexually transmitted diseases.

So you were "told" that if you have anal sex, you can get HIV even when both partners do not have HIV. Hmmm . . . who told you this? The Vatican? Fox News? Karl Rove? No, sweetie, this is not true. Exactly how did you think two completely HIV-negative people could create an HIV virus? I strongly suggest you spend some time reading about HIV/AIDS and other STDs. This Web site is an excellent source for accurate information. Once you've learned the basics, do go back to whoever told you that nonsense about "two negatives plus backdoor action equals HIV positive" and enlighten them with some basic scientific facts and common sense.

HIV positive friend Jul 29, 2006 (HIV BASICS)

Hi Doctor I was going to meet a friend for a coffee at his place and he wanted more than a coffee, he told me that he's HIV positive. How does HIV spread, and what can i do.

Response from Dr. Frascino

So apparently your buddy wanted both coffee and dessert, eh? (Perhaps coffee and hot-crossed buns?)

How is HIV spread. Either you are very young (too young to be drinking coffee) or you just recently arrived from a distant galaxy or you've been home schooled and subjected to an abstinence-only sex education course. Well whatever the reason, it's time you learned about HIV, how it is and is not transmitted and how you can protect yourself from becoming infected while enjoying hot, satisfying sex (with or without the Starbucks). I would suggest you begin with a basic pamphlet on HIV/AIDS. I'll reprint one below ("Facts for Life: What You and the People You Care about Need to Know about HIV/AIDS"). I would then suggest you review more detailed information that can be easily accessed on this site and related links and in the archives of this forum.

Get informed. Stay safe. Stay well.

Facts for Life: What you and the people you care about need to know about HIV/AIDS

amfAR, The Foundation for AIDS Research, is one of the world's leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested nearly $250 million in its programs and has awarded grants to more than 2,000 research teams worldwide. FREQUENTLY ASKED QUESTIONS:

How quickly do people infected with HIV develop AIDS?

How many people are affected by HIV/AIDS?

How is HIV not transmitted?

How can I reduce my risk of becoming infected with HIV through sexual contact?

Are there other ways to avoid getting HIV through sex?

Is there a link between HIV and other sexually transmitted infections?

How can I avoid acquiring HIV from a contaminated syringe?

Are some people at greater risk of HIV infection than others?

Are women especially vulnerable to HIV?

Are young people at significant risk of HIV infection?

Are there treatments for HIV/AIDS?

Is there a vaccine to prevent HIV infection?

Can you tell whether someone has HIV or AIDS?

How can I know if I'm infected?

Where can I get more information about HIV and AIDS?

How can I help fight HIV/AIDS?

HIV stands for human immunodeficiency virus. It is the virus that causes AIDS. A member of a group of viruses called retroviruses, HIV infects human cells and uses the energy and nutrients provided by those cells to grow and reproduce. AIDS stands for acquired immunodeficiency syndrome. It is a disease in which the body's immune system breaks down and is unable to fight off infections, known as "opportunistic infections," and other illnesses that take advantage of a weakened immune system. When a person is infected with HIV, the virus enters the body and lives and multiplies primarily in the white blood cells. These are immune cells that normally protect us from disease. The hallmark of HIV infection is the progressive loss of a specific type of immune cell called T-helper, or CD4, cells. As the virus grows, it damages or kills these and other cells, weakening the immune system and leaving the person vulnerable to various opportunistic infections and other illnesses ranging from pneumonia to cancer. A person can receive a clinical diagnosis of AIDS, as defined by the U.S. Centers for Disease Control and Prevention (CDC), if he or she has tested positive for HIV and meets one or both of theses conditions: The presence of one or more AIDS-related infections or illnesses A CD4 count that has reached or fallen below 200 cells per cubic millimeter of blood. Also called the T-cell count, the CD4 count ranges from 450 to 1200 in healthy individuals. In some people, the T-cell decline and opportunistic infections that signal AIDS develop soon after infection with HIV. But most people do not develop symptoms for 10 to 12 years, and a few remain symptom-free for much longer. As with most diseases, early medical care can help prolong a person's life.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that there are now 40 million people living with HIV or AIDS worldwide. Most of them do not know they carry HIV and may be spreading the virus to others. In the U.S., approximately one million people have HIV or AIDS, and 40,000 Americans become newly infected with HIV each year. According to the CDC, it is estimated that a quarter of all people with HIV in the U.S. do not know they are carrying the virus. Since the beginning of the epidemic, AIDS has killed more than 25 million people worldwide, including more than 500,000 Americans. AIDS has replaced malaria and tuberculosis as the world's deadliest infectious disease among adults and is the fourth leading cause of death worldwide. Fifteen million children have been orphaned by the epidemic. A person who has HIV carries the virus in certain body fluids, including blood, semen, vaginal secretions, and breast milk. The virus can be transmitted only if such HIV-infected fluids enter the bloodstream of another person. This kind of direct entry can occur (1) through the linings of the vagina, rectum, mouth, and the opening at the tip of the penis (2) through intravenous injection with a syringe or (3) through a break in the skin, such as a cut or sore. Usually, HIV is transmitted through: Unprotected sexual intercourse (either vaginal or anal) with someone who has HIV. Women are at greater risk of HIV infection through vaginal sex than men, although the virus can also be transmitted from women to men. Anal sex (whether malemale or malefemale) poses a high risk mainly to the receptive partner, because the lining of the anus and rectum is extremely thin and is filled with small blood vessels that can be easily injured during intercourse. Unprotected oral sex with someone who has HIV. There are far fewer cases of HIV transmission attributed to oral sex than to either vaginal or anal intercourse, but oralgenital contact poses a clear risk of HIV infection, particularly when ejaculation occurs in the mouth. This risk goes up when either partner has cuts or sores, such as those caused by sexually transmitted infections (STIs), recent tooth-brushing, or canker sores, which can allow the virus to enter the bloodstream. Sharing needles or syringes with someone who is HIV infected. Laboratory studies show that infectious HIV can survive in used syringes for a month or more. That's why people who inject drugs should never reuse or share syringes, water, or drug preparation equipment. This includes needles or syringes used to inject illegal drugs such as heroin, as well as steroids. Other types of needles, such as those used for body piercing and tattoos, can also carry HIV. Infection during pregnancy, childbirth, or breast-feeding (mother-to-infant transmission). Any woman who is pregnant or considering becoming pregnant and thinks she may have been exposed to HIVeven if the exposure occurred years agoshould seek testing and counseling. In the U.S., mother-to-infant transmission has dropped to just a few cases each year because pregnant women are routinely tested for HIV. Those who test positive can get drugs to prevent HIV from being passed on to a fetus or infant, and they are counseled not to breast-feed. HIV is not an easy virus to pass from one person to another. It is not transmitted through food or air (for instance, by coughing or sneezing). There has never been a case where a person was infected by a household member, relative, coworker, or friend through casual or everyday contact such as sharing eating utensils or bathroom facilities, or through hugging or kissing. (Most scientists agree that while HIV transmission through deep or prolonged "French" kissing may be possible, it would be extremely unlikely.) Here in the U.S., screening the blood supply for HIV has virtually eliminated the risk of infection through blood transfusions (and you cannot get HIV from giving blood at a blood bank or other established blood collection center). Sweat, tears, vomit, feces, and urine do contain HIV, but have not been reported to transmit the disease (apart from two cases involving transmission from fecal matter via cut skin). Mosquitoes, fleas, and other insects do not transmit HIV.

If you are sexually active, protect yourself against HIV by practicing safer sex. Whenever you have sex, use a condom or "dental dam" (a square of latex recommended for use during oralgenital and oralanal sex). When used properly and consistently, condoms are extremely effective. But remember: Use only latex condoms (or dental dams). Lambskin products provide little protection against HIV. Use only water-based lubricants. Latex condoms are virtually useless when combined with oil- or petroleum-based lubricants such as Vaseline® or hand lotion. (People with latex allergies can use polyethylene condoms with oil-based lubricants). Use protection each and every time you have sex. If necessary, consult a nurse, doctor, or health educator for guidance on the proper use of latex barriers. The male condom is the only widely available barrier against sexual transmission of HIV. Female condoms are fairly unpopular in the U.S. and still relatively expensive, but they are gaining acceptance in some developing countries. Efforts are also under way to develop topical creams or gels called "microbicides," which could be applied prior to sexual intercourse to kill HIV and prevent other STIs that facilitate HIV infection. Having a sexually transmitted infection (STI) can increase your risk of acquiring and transmitting HIV. This is true whether you have open sores or breaks in the skin (as with syphilis, herpes, and chancroid) or not (as with chlamydia and gonorrhea).

Where there are breaks in the skin, HIV can enter and exit the blood-stream more easily. But even when there are no breaks in the skin, STIs can cause biological changes, such as swelling of tissue, that may make HIV transmission more likely. Studies show that HIV-positive individuals who are infected with another STI are three to five times more likely to contract or transmit the virus through sexual contact. If you are injecting drugs of any type, including steroids, do not share syringes or other injection equipment with anyone else. (Disinfecting previously used needles and syringes with bleach can reduce the risk of HIV transmission). If you are planning to have any part of your body pierced or to get a tattoo, be sure to see a qualified professional who uses sterile equipment. Detailed HIV prevention information for drug users who continue to inject is available from the CDC's National Prevention Information Network at 1-800-458-5321 or online at www.cdc.gov/idu. HIV does not discriminate. It is not who you are, but what you do that determines whether you can become infected with HIV. In the U.S., roughly half of all new HIV infections are related directly or indirectly to injection drug use, i.e., using HIV-contaminated needles or having sexual contact with an HIV-infected drug user. With 40,000 Americans contracting HIV each year, there are clearly many people who are still engaging in high-risk behaviors, and infection rates remain alarmingly high among young people, women, African Americans, and Hispanics. Women are at least twice as likely to contract HIV through vaginal sex with infected males than vice versa. This biological vulnerability is worsened by social and cultural factors that often undermine women's ability to avoid sex with partners who are HIV-infected or to insist on condom use. In the U.S., the proportion of HIV/AIDS cases among women more than tripled from 8 percent in 1985 to 27% in 2004. African American and Hispanic women, who represent less than onequarter of U.S. women, account for 80% of new HIV infections among American women each year. At least half of the 40,000 Americans newly infected with HIV each year are under the age of 25. Roughly two young Americans become infected with HIV every hour of every day, and many of the people now living with HIV in the U.S. became infected when they were teenagers. Statistics show that by the 12th grade, about 60 percent of American youth are sexually active, and two-thirds of STIs affect people under age 25. Many young people also use drugs and alcohol, which can increase the likelihood that they will engage in high-risk sexual behavior. For many years, there were no effective treatments for AIDS. Today, a number of drugs are available to treat HIV infection and AIDS. Some of these are designed to treat the opportunistic infections and illnesses that affect people with HIV/AIDS. In addition, several types of drugs seek to prevent HIV itself from reproducing and destroying the body's immune system: Reverse transcriptase inhibitors attack an HIV enzyme called reverse transcriptase. They include abacavir, delavirdine, didanosine (ddl), efavirenz, emtricitabine (FTC), lamivudine (3TC), nevirapine, stavudine (d4T), tenofovir, zalcitabine (ddC), and zidovudine (AZT) Protease inhibitors attack the HIV enzyme protease and include amprenavir, atazanavir, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir, and darunavir. Fusion inhibitors stop virus from entering cells. To date, only one fusion inhibitor, enfuvirtide, has been approved by the Food and Drug Administration. Are young people at significant risk of HIV infection? Are there treatments for HIV/AIDS?

Many HIV patients take these drugs in combinationa regimen known as highly active antiretroviral therapy (HAART). When taken as directed, anti-HIV treatment can reduce the amount of HIV in the bloodstream to very low levels and sometimes enables the body's immune cells to rebound to normal levels. Several drugs can be taken to help prevent a number of opportunistic infections including Pneumocystis carinii pneumonia, toxoplasmosis, cryptococcus and cytomegalovirus infection. Once opportunistic infections occur, the same drugs can be used at higher doses to treat these infections, and chemotherapy drugs are available to treat the cancers that commonly occur in AIDS. Researchers are continuing to develop new drugs that act at critical steps in the virus's life cycle. Efforts are under way to identify new targets for anti-HIV medications and to discover ways of restoring the ability of damaged immune systems to defend against HIV and the many illnesses that affect people with HIV. Ultimately, advances in rebuilding the immune systems of HIV patients will benefit people with a number of serious illnesses, including cancer, Alzheimer's disease, multiple sclerosis, and immune deficiencies associated with aging and premature birth. There is still no cure for AIDS. And while new drugs are helping some people who have HIV live longer, healthier lives, there are many problems associated with them: Anti-HIV drugs are highly toxic and can cause serious side effects, including heart damage, kidney failure, and osteoporosis. Many (perhaps even most) patients cannot tolerate long-term treatment with HAART. HIV mutates quickly. Even among those who do well on HAART, roughly half of patients experience treatment failure within a year or two, often because the virus develops resistance to existing drugs. In fact, as many as 10 to 20 percent of newly infected Americans are acquiring viral strains that may already be resistant to current drugs. Because treatment regimens are unpleasant and complex, many patients miss doses of their medication. Failure to take anti-HIV drugs on schedule and in the prescribed dosage encourages the development of new drugresistant viral strains.

Even when patients respond well to treatment, HAART does not eradicate HIV. The virus continues to replicate at low levels and often remains hidden in "reservoirs" in the body, such as in the lymph nodes and brain. In the U.S., the number of AIDS-related deaths has decreased dramatically because of widely available, potent treatments. But more than 95 percent of all people with HIV/AIDS live in the developing world, and many have little or no access to treatment. Despite continued intensive research, experts believe it will be at least a decade before we have a safe, effective, and affordable AIDS vaccine. And even after a vaccine is developed, it will take many years before the millions of people at risk of HIV infection worldwide can be immunized. Until then, other HIV prevention methods, such as practicing safer sex and using sterile syringes, will remain critical. You cannot tell by looking at someone whether he or she is infected with HIV or has AIDS. An infected person can appear completely healthy. But anyone infected with HIV can infect other people, even if they have no symptoms. Immediately after infection, some people may develop mild, temporary flu-like symptoms or persistently swollen glands. Even if you look and feel healthy, you may be infected. The only way to know your HIV status for sure is to be tested for HIV antibodiesproteins the body produces in an effort to fight off infection. This usually requires a blood sample. If a person's blood has HIV antibodies, that means the person is infected.

If you think you might have been exposed to HIV, you should get tested as soon as possible. Here's why: Even in the early stages of infection, you can take concrete steps to protect your long-term health. Regular check-ups with a doctor who has experience with HIV/AIDS will enable you (and your family members or loved ones) to make the best decisions about whether and when to begin anti- HIV treatment, without waiting until you get sick. Taking an active approach to managing HIV may give you many more years of healthy life than you would otherwise have. If you are HIV positive, you will be able to take the precautions necessary to protect others from becoming infected. If you are HIV positive and pregnant, you can take medications and other precautions to significantly reduce the risk of infecting your infant, including not breast-feeding. Most people are tested by private physicians, at local health department facilities, or in hospitals. In addition, many states offer anonymous HIV testing. It is important to seek testing at a place that also provides counseling about HIV and AIDS. Counselors can answer questions about high-risk behavior and suggest ways you can protect yourself and others in the future. They can also help you understand the meaning of the test results and refer you to local AIDS-related resources. Though less readily available, there is also a viral load test that can reveal the presence of HIV in the blood within three to five days of initial exposure, as well as highly accurate saliva tests that are nearly equivalent to blood tests in determining HIV antibody status. In some clinics you can get a test called OraQuick® that gives a preliminary result in 20 minutes. You can also purchase a kit that allows you to collect your own blood sample, send it to a lab for testing, and receive the results anonymously. Only the Home Access® brand kit is approved by the Food and Drug Administration. It can be found at most drugstores.

Keep in mind that while most blood tests are able to detect HIV infection within four weeks of initial exposure, it can sometimes take as long as three to six months for HIV antibodies to reach detectable levels. The CDC currently recommends testing six months after the last possible exposure to HIV. The CDC's National AIDS Hotline can answer questions about HIV testing and refer you to testing sites in your area. Operators are available toll-free, 24 hours a day, seven days a week, at: 1.800.232.4636 (English, Spanish and TTY/deaf access). There are many valuable sources of HIV/AIDS information, including the following: amfAR's website at www.amfar.org The CDC at www.cdc.gov/hiv or the phone numbers above Your state or local health department (see your local phone book) Your local AIDS service organization (see your local phone book) HIV InSite at hivinsite.ucsf.edu AEGiS (AIDS Education Global Information System) at www.aegis.com The Body: An AIDS and HIV Information Resource at www.thebody.com The Kaiser Family Foundation's HIV/AIDS information section at www.kff.org/hivaids

Everyone can play a role in confronting the HIV/AIDS epidemic. Here are just a few suggestions for how you can make a difference: Volunteer with your local AIDS service organization. Talk with the young people you know about HIV/AIDS. Sponsor an AIDS education event or fund raiser with your local school, community group, or religious organization. Urge government officials to provide adequate funding for AIDS research, prevention education, medical care, and support services. Speak out against AIDS-related discrimination. Support continued research to develop better treatments and a safe and effective AIDS vaccine by making a donation to amfAR



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