Susceptibility to HIV and Strategies to Prevent AIDS

Zirui Li

High School Attached to Northwest Normal University,China

Keywords: HIV, AIDS, Immunodeficiency, Virus, Treatment, COVID-19.

Abstract: HIV (Human Immunodeficiency Virus) is an infectious disease that can progress to AIDS (Acquired

lmmunodeficiency Syndrome), causing deaths. Despite all the advances in understanding the molecular

mechanism of virus entry, replication, propagation and transmission, there is not a complete cure for this

disease. Although the disease can be controlled by antiretroviral therapy, the treatment is not available for

many people, causing a disparity in the care of the population who are infected. Furthermore, as HIV is mainly

transmitted by contact with infected body fluid, such as during sexual intercourse and sharing contaminated

needles, some vulnerable groups in the population are more susceptible to becoming infected. This article

provides an overview of HIV and AIDS by reviewing the current references from an epidemiological

perspective, in addition to discussing treatments available. Moreover, susceptible groups who are vulnerable

to HIV, such as people living in Sub-Saharan Africa, sexual workers, and drug abusers are discussed, and

some solutions are suggested. Finally, a connection between the COVID-19 pandemic and lessons which can

be learned for the HIV diagnosis and treatments is established. In conclusion, HIV and AIDS still remain a

threat to global health, and measures should be taken to not only to study the disease better, but also to find

permanent treatments such as vaccines, despite challenges.

INTRODUCTION

HIV (Human Immunodeficiency Virus) is an

infectious disease caused by retroviruses, which can

develop into AIDS (Acquired Immunodeficiency

Syndrome) if it remains untreated. HIV can be

transmitted through sexual contact, using

contaminated and shared needles, passed from

mother to child during pregnancy and childbirth, and

via contaminated blood transfusion (Cdc.gov. 2021).

Many infected patients do not show any symptoms

during the first few months of infection, and

therefore, can transmit the virus. Some people may

have flu-like symptoms, including fever, headache,

and sore throat during the early phases of the

infection, when the viral load is at its highest

(aidsmap.com. 2021). As the disease develops, the

immune system succumbs, and symptoms become

more pronounced, including swollen lymph nodes,

diarrhea, fever and rapid weight loss (HIV.gov. 2021).

HIV weakens the body's ability to fight other

infections, and people who do not receive treatment

are more susceptible to other diseases, such as

https://orcid.org/0000-0002-1231-2736

cholera, bacterial infections, cryptococcal meningitis

and some cancers (Who.int. 2021). In the battle

against AIDS, the best tactic for the treatment of HIV

is antiretroviral therapy (ART). Approximately 25

unique antiretroviral drugs are already used for the

treatment of adults. But there has not been a definitive

cure for HIV yet. The treatment objectives are to

minimize and sustain the viral load, to obtain immune

function reconstruction and maintain immune

function, to improve the quality of life, and to reduce

morbidity and mortality associated with HIV.

EPIDEMIOLOGY OF HIV

After initial uncertainties in the early 1980s

surrounding the emergence of a new disease, it soon

became apparent that an epidemic and then a

pandemic was underway. Since then, 38 million

people have acquired HIV, including 36.2 million

adults and 1.8 million children under 15 years old. It

is estimated that the number of people living with

HIV has increased by 1.9 million recently, but the

Li, Z.

Susceptibility to HIV and Strategies to Prevent AIDS.

DOI: 10.5220/0011233100003438

In Proceedings of the 1st International Conference on Health Big Data and Intelligent Healthcare (ICHIH 2022), pages 115-123

ISBN: 978-989-758-596-8

115

incidence rate is still 23% lower than in 2010.

Approximately 81% of people are tested for HIV

each year, so the figures are an underestimation, and

the actual number of infections is much higher than

the number recorded. Among people who are now

known to have been infected with HIV, by the end of

the 2019, 36.2 million people living with HIV (67%)

had access to antiretroviral drugs, and nearly 12.6

million people are still waiting for treatment

(HIV.gov. 2021), demonstrating a huge gap between

diagnosis and treatment.

3 DISCUSSION MECHANISMS

3.1 Virus Structure

Studying the susceptibility to HIV and strategies to

prevent AIDS, such as developing antiretroviral

drugs and vaccines, requires an understanding of the

HIV structure, which is discussed below. HIV

particles are spherical and 90-130 nanometers in

diameter (Wikipedia. 2021). The core of the virus is

hollow conical and consists of two identical single-

stranded RNA chains, reverse transcriptases and

proteins (Figure1). Outside the core is the viral shell,

which is three-dimensional symmetry of 20

polyhedromes and contains nuclear shell proteins.

The outermost layer is the envelope, where

glycoproteins have puncture-like structures, and

these are the main binding site of HIV and host cell

receptors. HIV is a retrovirus, with RNA containing

the gag, env and pol genes, as well as six regulatory

genes (tat, vif, vpr, vpx (vpu), nef, rev) (Online

Biology Notes. 2021). The core protein of the gag

gene encodes the virus; the enzymes (retroviruses,

integrated enzymes and proteases), which are

required for replication of the pol gene to encode

virus envelope protein, which is the main antigen for

HIV immunological diagnosis (Wikipedia. 2021).

Regulatory genes encode aid proteins and regulate

viral protein synthesis and replication.

Figure 1. An overview of HIV-1 virus genome (top) and its structure (bottom). The figure was generated using Biorender.

There are two main types of HIV present: HIV-1

and HIV-2. Both are transmitted through the same

routes, but HIV-2 has a lower chance of transmission

than HIV-1 because the immune system responds

better to HIV-2 and responds (Nyamweya, Hegedus,

Jaye, Rowland-Jones, Flanagan, Macallan 2013).

While there are still many essential differences

between HIV-1 and HIV-2, an extended comparison

is beyond the scope of this paper, and an overall

comparison of HIV-1 and HIV-2 is shown in table 1.

Table 1. A comparison of HIV-1 and HIV-2, including their

prevalence, origin, transmission and disease course.

HIV-1 HIV-2

Prevalence Global

West Africa,

Mozambique and

ola

Origin Chimpanzees Sooty mangabeys

MTCT

Relatively

common

Relatively rare

Heterosexual

sprea

Higher Lower

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116

Genetic

Diversit

More Less

Time to AIDS

Less than 10

years

More than 20

years

3.2 HIV Transmission

Studying the transmission of HIV is essential for

tackling susceptibility and preventing disease

progression. HIV can be transmitted through body

fluids during sexual relations with people living with

HIV (anal or vaginal sex), through the sharing of

infected needles, syringes or other drug injection

equipment, and from mother to fetus during

pregnancy and birth.

3.2.1 Sexual Contact

People can contact HIV from their sexual partners

during sexual intercourse without using protection

measures, such as condoms or other medicines that

can prevent or control HIV. Anal sex is the greatest

risk factor for transmitting HIV, especially in men

who have sex with other men, due to the thin lining

of the rectum, which facilitates the HIV virus entry

into the body (Cdc.gov. 2021). Most women contract

HIV from vaginal sex because HIV can enter the

body through the mucous membranes that line on the

vaginal and cervix (Cdc.gov. 2021). Men also can get

HIV from this process because of contact with

contaminated vaginal secretion and blood that carry

the HIV, which enters the body through the opening

penis, which is not circumcised (Cdc.gov. 2021). Oral

sex can also cause transmission if both sexual

partners have small cuts in the mouth and one of them

has HIV. However, HIV transmitted from female to

female is rare (Cdc.gov. 2021).

3.2.2 Transmission Via Blood

The risk of HIV infection from blood transfusions is

very rare worldwide (Avert. 2021). Nowadays, all

blood products (organs and tissues) are tested for the

presence of infections such as HIV. Blood transfusing

is the direct route of transmission (Avert. 2021).

Other factors that may cause direct contact in the

blood are tattoos or body piercings. However, sharing

needles, syringes, or other injection equipment also

puts people at risk for getting HIV. HIV particles can

survive on the syringes for nearly 42 days, depending

on storage temperature and other surrounding factors

(Abdala, Reyes, Carney, Heimer 2000), causing

infection through blood exchange. The use of

contaminated needles in hospitals is extremely rare,

and used needles are treated safely in hospitals

(Avert. 2021). HIV infection via contaminated

needles is a direct route among drug users (Cdc.gov.

2021). Therefore, the Government should increase

drug control, especially intravenous drugs, while

vigorously screening drug users within its jurisdiction

and testing them for HIV. Many of these addicts are

pregnant women, and the vast majority of their

infants become drug addicted to drug and are born

with HIV from birth.

3.2.3 MTCT (Mother to Child

Transmission)

MTCT, as a vertical propagation way of transmission,

is the most common way that children get HIV, which

occurs during pregnancy or breastfeeding. Without

any intervention, transmission rates range from 15%

to 45%

(https://www.who.int/hiv/topics/mtct/about/en.

2021). MTCT is relatively rare with HIV-2. During

pregnancy, the HIV hidden in blood can enter into the

baby’s body through the placenta and umbilical cord.

In addition, it is worth noting that infection can lead

to damage to other organs (cardiovascular, nervous,

bone and other tissues) in adults (Hazra, Siberry, &

Mofenson 2010).

3.3 Immune Response to HIV

At the beginning of HIV infection, the virus first

attacks the mucous membrane tissue of the cell and

then spreads to the lymphatic system (eclipse phase)

(Avert. 2021). About three weeks later, the genetic

material for HIV can be detected, and the virus begins

to proliferate and reach its peak (Avert. 2021). At this

acute phase, the spread of the virus can also be

partially controlled by the action of the adaptive

immune response. Patients show some flu-like

symptoms during the acute phase, which can last

about nine weeks, after which viral load reach the set

point, a stable level (Avert. 2021). Damage to CD4 T

cells caused by HIV viruses can lead to

immunodeficiency and chronic inflammation. After

up to nine years from the onset of infection, HIV

develops into AIDS, a period known as the latent

infection (Figure3). CD4 T cells in a normal adult

body are typically between 500 cells and 1500 cells

per μl (aidsmap.com. 2021); however, the number

frequency of CD4 T cells decreases after HIV

infection as the CD4+ T cell number declines to <350

cells per μl, opportunistic infections and cancers can

develop (Figure2).

Susceptibility to HIV and Strategies to Prevent AIDS

117

Figure 2. A graph demonstrating changes in the CD4+ T cell count and HIV viral load during the disease progression from

HIV to AIDS. The figure is adopted from (

An, Ping, and Cheryl A Winkler. 2010).

3.4 Diagnosis and Clinical Behaviors

Early HIV testing is significant, and if a patient is

HIV-positive, treatment options should be discussed

with the doctor as soon as possible, as well as

decreasing high-risk behaviors to decrease the virus

spread. The most important approach is to prevent

transmission to others during this period and

prioritizing the treatment. Many medical facilities

also offer anonymous and free counseling, including

asking patients about symptoms, psychological state,

medical history, and allergens. There are four main

HIV tests including, ELISA test, home test, saliva test

and viral load test (Parker, Botchan, and Berger

2021).

ELISA (enzyme-linked immunosorbent assay).

This test can be used to detect HIV infection. If an

ELISA test is positive, the Western blot test (blood

test) is usually administered to confirm the diagnosis.

ELISA is very sensitive to chronic HIV infection, but

because antibodies do not produce immediately after

infection, and the infected person may test negative

within weeks to months of infection. Even if the

person's test results turn negative in this window, the

infected person may have a high level of the virus and

is at risk of spreading the infection.

Home test: AIDS test paper is a new generation of

test reagents developed using colloidal gold

immunotomography technology to detect HIV-1/2

endemic antibodies in whole blood, serum or plasma

specimens. Test time is six weeks (42 days), and with

short operating time (generally 15-20 minutes to

observe the results), and without the need for

additional equipment, as well as a high accuracy rate

of 97% to 99%, this method is very fast, and efficient.

However, additional testing confirmation tests may

be required (Bhiva.org. 2021).

Saliva test, a piece of cotton in the test box is used

to collect saliva, which is sent to the laboratory to test,

and test results are usually available within three

days. Further blood tests are required if tested

positive. This test is only checking for antibodies, not

the actual disease (HowStuffWorks, Health,

Medicine and Treatment 2021).

Viral Load test measures the number of HIV

viruses detected in the body. Three techniques for

detecting HIV viral load: reverse transcription and

polymerase chain reaction (RT PCR), branched DNA

(bdna), and nucleic acid sequence based

amplification analysis (Nasba) (Tests 2021).

As mentioned previously, there are three stages

between the development of HIV and AIDS. Within

the acute infection phase, most infected people have

flu-like symptoms such as cough, fever, red rash,

muscle soreness and sore throat. Some people have

no symptoms during the early stage of HIV. If an

individual feels infected with HIV or recently

exposed to HIV, they need to do the HIV test

immediately. In the latent phase, viruses continue to

increase or mutate. Infected people may not feel

uncomfortable or have any symptoms at this stage.

Insisting on treatment at this stage can be effective in

suppressing the disease, but if not treated, it will

develop into the next stage of AIDS in about a decade

(Hivinfo.nih.gov. 2021). When the disease develops

into AIDS, the immune system is already very weak.

Symptoms can also be more severe than before. For

example, rapid weight loss , pneumonia, memory

loss, depression and other neurologic disorders

(Bhiva.org. 2021). At this stage, it is likely that a

small cold will threaten the patient's life. So, HIV

should be detected early and early treatment should

initiate to avoid AIDS.

4 TREATMENT & PREVENTION

As mentioned previously, a latent period occurs

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before the development of HIV into AIDS, and such

progression be hindered by drug treatments. To this

day, there is no complete cure for HIV; however, six

families of antiretroviral drugs are used for

treatments: Non-nucleoside reverse transcriptase

inhibitors, nucleoside reverse transcriptase inhibitors,

protease inhibitors, fusion inhibitors, CCR5 receptor

antagonists and integrase inhibitors (Table 2 shows

below and Figure 3) (HIV.gov. 2021). Antiretroviral

drugs are often used in combination to prevent drug

resistance and multiple viruses from mutating in the

body in a timely manner (Hivinfo.nih.gov. 2021).

These drugs have many side effects, so many patients

cannot adhere long-term to their treatment, which is

also an important factor for the high prevalence of

HIV disease progression to AIDS. Only patients who

respond positively to the condition will cooperate

with their doctors. Maintaining a positive attitude is

also one of the important treatments for diseases.

Drugs are also very expensive, which is an important

reason for patients’ non-compliance.

Table 2. A summary of some of current antiretroviral drugs used for the treatment of HIV. The information in this table was

derived mainly from (Hivinfo.nih.gov. 2021), (Drugs 2021).

Inhibitors Mechanism of action Drug name Side effect

Non-

nucleoside

reverse

transcriptase

inhibitors

Directly inhibit the HIV-1 reverse

transcriptase by binding in a

reversible and non-competitive

manner to the enzyme

Efavirenz

Associated with

rashes including

Stevens-Johnson

syndrome

pPasma cholesterol

concentrations

Nevirapine

Occasionally with

fatal hepatitis

Protease

inhibitors

These inhibit HIV enzyme required

to produce mature infectious viral

particles by cleaving structural

proteins and enzymes from their

precursors.

Atazanavir

Cough, insomnia, depression, numbness of

hands and feet, etc.

Darunavir

Fatigue, anorexia, nausea, jaundice, darker

urine color

Indinavir

Multi-dream, urine pain, blood urine,

crystalline urine

Fusion

inhibitors

Inhibits HIV from fusing to the host

cell

Enfuvirtide

Insomnia, anxiety, peripheral neuropathy,

fatigue

CCR5

receptor

antagonists

Block the CCR5 receptor on the

outside of CD4 cells.

Maraviroc

Cough, stomach pain, or tiredness may

occur. Lightheadedness or dizziness

Integrase

inhibitors

Integrase inhibitor and is indicated in

combination with other antiretroviral

drugs for HIV infection resistant to

first-line ART.

Raltegravir

Trouble sleeping insomnia, headache,

dizziness, nausea, tiredness

Nucleoside

reverse

transcriptase

inhibitors

These inhibit the RNA-dependent

DNA polymerase (reverse

transcriptase) which HIV uses to

convert viral RNA into DNA before

its incorporation into the cell

genome.

Zidovudine

As the disease progresses, adverse

reactions increase

Abacavi

increased cardiovascular ris

Didanosine

Hair loss, allergic reactions, weakness,

pain, chills and fever

Stavudine Anemia, white blood cell deficiency

Susceptibility to HIV and Strategies to Prevent AIDS

119

Figure 3. An overview of antiretroviral therapy approaches used to tackle entry and propagation of HIV. The figure was

generated using Biorender.

Avoiding early HIV infection is the most effective

way to reduce the incidence of AIDS. The early

stages of avoiding infection require a holistic

approach from society and the government. The

following are some suggestions for preventive

measures for both individuals and government.

Personal：

1. Drug use should be strictly prohibited and

syringes are not shared with others.

2. Blood transfusion should be prohibited without

authorization, should be used under the guidance of a

doctor.

3. Personal items such as toothbrushes, razors,

shavers, etc. should not be shared.

4. Condom use as one of the most effective

preventive

measures in sexual life for the prevention

of diseases and AIDS should be encouraged.

5. Direct contact with the blood, semen and milk

of AIDS patients be avoided.

National and international recommendations are

as follows:

Awareness of HIV among the public should be

raised by organizing regular community events,

national awareness campaigns, TV and social media

advertisements, etc.

HIV education should be incorporated into school

and national education curriculum.

Discrimination and stigma against HIV should be

removed by raising awareness.

HIV drug prices should be subsidized and if

possible, free and anonymous HIV testing should be

available.

New needles should be supplied to drug abusers.

Condoms and other preventative measures should

become available in public places such as colleges,

universities, leisure areas, etc.

More funding should be invested on HIV

research.

4.1 Vaccines in the Future

Vaccines have traditionally been the most effective

means of preventing or even eradicating infectious

diseases. Vaccines are safe and cost-effective in

preventing various diseases, disabilities and death.

Similar to smallpox and polio vaccines, preventive

HIV vaccines can help save millions of lives.

Vaccines are synthesized using inactivated and

detoxified microorganisms, injecting treated bacteria,

viruses and toxins into the body to induce an immune

response to help the body fight infection more

effectively (HIV.gov. 2021). But so far, there has been

no vaccine that can completely cure HIV. The biggest

obstacle to the development of HIV vaccines is the

variety of genetic material of the virus. HIV not only

replicates quickly, but also tends to have a high error

rate, during which mutations can form a new type of

HIV virus; new HIV strains will also be re-integrated

in human-to-human transmission (Verywell Health.

2021). As conventional vaccines can only prevent a

limited number of strains, developing a single

vaccine that eradicates more than 60 dominant strains

and multiple recombinant strains worldwide becomes

even more challenging (Verywell Health. 2021).

Developing a safe, efficient, and affordable vaccine

to prevent HIV infection in uninfected people and end

the global spread of HIV is the highest priority of HIV

researchers. Recent research has shown that use

cytomegalovirus (CMV) as a vaccine vector can

protect against multiple infectious diseases including

simian immunodeficiency virus in rhesus macaques

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

120

(Barry, Peter A et al. 2020). This technology is

expected to be used in HIV in humans.

4.2 Susceptible People to HIV Infection

Groups

4.2.1 People Living in Sub-Saharan

Africa

Large generalized epidemics of HIV-1 is a potential

cause of mass mortality and morbidity in sub-Saharan

Africa (UNAIDS 2017). The World Health

Organization reported that almost 70% of the

population in sub-Saharan Africa live with HIV

(Gleason 2012). In addition, approximately 92% of

women and 90% of children living with HIV in the

sub-Saharan area (Ilo.org. 2021). As the availability

of antiretroviral therapy and male medical

circumcision has increased, the rate of new infections

has been reduced (Grabowski, et al. 2017). Despite

such progress, HIV still remains a major problem in

the sub-Saharan Africa region. Some natives still

keep eating uncooked meat, like chimpanzees (most

prevalent strains HIV-1 Group M originated from

these), causing exposure to primate blood (Avert.

2021). Chaotic sexual behavior is also one of the

main ways of transmission. A person with HIV may

have many sexual partners, and in the chronic phase,

the carrier of HIV may not notice, causing the virus

to spread. But in practice, far more people actually

have HIV than are recorded because many people

may fear discrimination or isolation, so they would

deliberately hide their illness or refuse to take HIV

tests. Some people even do not know about HIV and

how it spreads. Racial discrimination still exists in

many Sub-Saharan areas, and many black people fear

that white hospitals misdiagnose them, and many

white doctors do not want to visit and treat a black

man. This can lead to a crisis of confidence in the

local health care system, which reduces medical

efficiency. The class disparity is also one of the

reasons why the health care system of some African

countries is struggling under pressure. Many poor

people with HIV do not receive formal treatment, and

more and better medical resources are in the hands of

those with money and power. Poor people deserve

good housing and equal access to education, factors

that directly or indirectly increase the risk of HIV

infection. The best way to reduce the incidence of

HIV is to spread HIV knowledge across the board so

that everyone knows and understands the disease.

The second is to implement compulsory education

and formulate policies to make education compulsory

are free for all school-age children, similar to the

strategy adopted in China. Furthermore, the

availability of scholarships and bursaries as financial

incentives for school children can prompt their

parents to allow children to attend school. Finally,

there is the fight against the industry, which will be

mentioned in the next section.

4.2.2 Sex Workers

Sex workers are more likely than other groups to be

infected with HIV because of various reasons, such

as agreeing to high-risk sexual behaviors because of

financial incentives (Cdc.gov. 2021). While HIV

prevention programs are feasible for most people,

there are many barriers and discrimination for sex

workers, making them more than thirteen times more

likely to be infected with HIV than the general

population (Avert. 2021). Many sex workers are

discriminated and marginalized, often receive unfair

treatment, such as lack of access to HIV testing or

treatment, which can delay their treatments if they are

infected with HIV (Cdc.gov. 2021). They also have to

have sexual intercourse with various people, but in

some cases, they cannot convince their clients to use

preventative measures, which can make them prone

to infection. Furthermore, sex workers can be young

and lack sufficient knowledge about HIV; for

example, a study in Ukraine found that 20% of female

sex workers were aged between 10 and 19 (Silverman

2011).

5 CORRELATION WITH OTHER

DISEASE

The COVID-19 pandemic has affected almost

everyone’s lives since its spread in 2019. The

negative consequences of COVID-19 have been more

on some people compared to others. COVID-19 has

caused a huge challenge for people living with HIV

as well. Restrictions on travel and cargo transfer have

caused it more difficult to obtain drugs and treatments

available (BMC Public Health. 2021). Therefore,

while there have been some positive effects of the

COVID-19 pandemic on HIV due to a decrease in the

number of HIV cases due to restrictions on people

meeting each other and observing social distancing,

the availability of drugs has become a challenge too.

However, while there has been a global decrease in

HIV cases, some groups in populations still remain

prone to the disease, poverty, sexual exploitation,

food insecurity and drug abuse.

Beyond the disparity in catching the disease,

people with HIV are more susceptible to being

Susceptibility to HIV and Strategies to Prevent AIDS

121

infected with COVID-19 and facing severe

consequences due to a compromised immune system

(Cdc.gov. 2021). But at the same time, governments,

organizations and healthcare systems can learn many

lessons from the COVID-19 pandemic to fight HIV.

In this global fight against the epidemic, various

governments quickly responded to the public health

crisis and imposed strict measures to prevent the

spread of the disease. Additionally, public health

campaigns increased the public’s awareness about

COVID-19, helping to reduce disease transmission.

Furthermore, a global effort resulted in the

production of effective vaccines against SARS-CoV-

2 in an unprecedented time. The rapid development

of vaccines in this fight is also one of the most

important reasons for controlling the disease, and

government funding and researchers' efforts have

allowed the COVID-19 vaccine to be quickly

designed, synthesized, manufactured and be

approved by regulatory agencies. Additionally, the

development and availability of user-friendly

COVID-19 diagnosis kits have enabled rapid and

effective diagnosis to identify infected patients and

prevent further transmission of the disease. While

HIV is a complex disease, many lessons can be

learned from an infectious disease such as COVID-

19 to improve our public health strategies. For

example, a global effort supported by increased

funding and attention is required to find possible

vaccines. Moreover, the development of user-

friendly and accessible diagnosis kits can identify

infected patients to prevent HIV transmission.

Finally, effective public health campaigns can

remove the stigma of HIV and raise awareness of the

disease.

6 CONCLUSIONS

HIV is a major public health concern, which can

cause the development of AIDS and finally death if it

remains untreated. In comparison, the incident rate

has decreased in developed countries over the past

three decades, many developing countries, especially

those in the Sub-Sahara region struggle with the

disease. Even in developed countries, certain groups

within the population, such as those with lower

socioeconomic status, sexual workers, and drug

abusers are more prone to HIV than others. This

demonstrates a social disparity resulting in public

health inequality. Despite all advances in the

understanding of HIV over the past few decades,

more research is required to find better treatment with

fewer side effects in addition to global efforts to

develop vaccines against HIV. The COVID-19

pandemic can provide a fresh perspective in public

health strategies for combatting HIV and AIDS, and

many lessons can be learned at personal, national and

international levels.

REFERENCES

2021. [online] Available at:

<https://www.who.int/hiv/topics/mtct/about/en>

Abdala N, Reyes R, Carney JM, Heimer R. Survival of

HIV-1 in syringes: effects of temperature during

storageexternal icon. Subst Use

Misuse 2000;35(10):1369–83

aidsmap.com. 2021. Viral load. [online] Available at:

<https://www.aidsmap.com/about-hiv/viral-load>

aidsmap.com. 2021. CD4 cell counts. [online] Available at:

<https://www.aidsmap.com/about-hiv/cd4-cell-

counts>

Avert. 2021. Sex workers, HIV and AIDS. [online]

Available at:

<https://www.avert.org/professionals/hiv-social-

issues/key-affected-populations/sex-workers>

Avert. 2021. Blood transfusions & transplants and HIV.

[online] Available at: <https://www.avert.org/hiv-

transmission-prevention/blood-transfusions-

transplants>

Avert. 2021. Blood transfusions & transplants and HIV.

[online] Available at: <https://www.avert.org/hiv-

transmission-prevention/blood-transfusions-

transplants>

Avert. 2021. Origin of HIV & AIDS. [online] Available at:

<https://www.avert.org/professionals/history-hiv-

aids/origin>

Avert. 2021. Symptoms and stages of HIV infection.

[online] Available at: <https://www.avert.org/about-

hiv-aids/symptoms-stages>

Barry, Peter A et al. “Cytomegalovirus-vectored vaccines

for HIV and other pathogens.” AIDS (London,

England) vol. 34,3 (2020): 335-349.

doi:10.1097/QAD.0000000000002396

Bhiva.org. 2021. [online] Available at:

<http://www.bhiva.org/documents/Guidelines/Treatm

ent/2015/2015-treatment-guidelines>

Bhiva.org. 2021. [online] Available at:

<http://www.bhiva.org/documents/Guidelines/Treatm

ent/2015/2015-treatment-guidelines>

BMC Public Health. 2021. Consequences of COVID-19

crisis for persons with HIV: the impact of social

determinants of health - BMC Public Health. [online]

Available at:

<https://bmcpublichealth.biomedcentral.com/articles/1

0.1186/s12889-021-10296-9]>

Cdc.gov. 2021. COVID-19 and HIV | HIV Basics |

HIV/AIDS | CDC. [online] Available at:

<https://www.cdc.gov/hiv/basics/covid-19.html>

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

122

Cdc.gov. 2021. HIV Transmission | HIV Basics |

HIV/AIDS | CDC. [online] Available at:

<https://www.cdc.gov/hiv/basics/transmission.html>

Cdc.gov. 2021. HIV Transmission | HIV Basics |

HIV/AIDS | CDC. [online] Available at:

<https://www.cdc.gov/hiv/basics/transmission.html>

Cdc.gov. 2021. Facts about HIV Stigma | HIV Basics |

HIV/AIDS | CDC. [online] Available at:

<https://www.cdc.gov/hiv/basics/hiv-

stigma/index.html>

Cdc.gov. 2021. HIV and Substance Use | HIV

Transmission | HIV Basics | HIV/AIDS | CDC. [online]

Available at: <https://www.cdc.gov/hiv/basics/hiv-

transmission/substance-use.html>

Cdc.gov. 2021. Sex Workers | HIV by Group | HIV/AIDS |

CDC. [online] Available at:

<https://www.cdc.gov/hiv/group/sexworkers.html>

Drugs, H., 2021. Efavirenz: MedlinePlus Drug

Information. [online] Medlineplus.gov. Available at:

<https://medlineplus.gov/druginfo/meds/a699004.html

Gleason K. HIV research in Sub-Saharan Africa: research

roundup. The Journalist’s Resource 2012. Available

at: https://journalistsresource.org/economics/hiv-aids-

sub-saharan-africa-research-roundup/

Grabowski, M. K. et al. HIV prevention efforts and

incidence of HIV in Uganda. N. Engl. J. Med. 377,

2154–2166 (2017).

Hazra, R., Siberry, G. K. & Mofenson, L. M. Growing up

with HIV: children, adolescents, and young adults with

perinatally acquired HIV infection. Annu. Rev. Med.

61, 169–185 (2010).

HIV.gov. 2021. Global Statistics. [online] Available at:

<https://www.hiv.gov/hiv-basics/overview/data-and-

trends/global-statistics>

HIV.gov. 2021. Symptoms of HIV. [online] Available at:

<https://www.hiv.gov/hiv-basics/overview/about-hiv-

and-aids/symptoms-of-hiv>

HIV.gov. 2021. HIV Vaccines. [online] Available at:

<https://www.hiv.gov/hiv-basics/hiv-

prevention/potential-future-options/hiv-vaccines>

HIV.gov. 2021. Symptoms of HIV. [online] Available at:

<https://www.hiv.gov/hiv-basics/overview/about-hiv-

and-aids/symptoms-of-hiv>

Hivinfo.nih.gov. 2021. FDA-Approved HIV Medicines |

NIH. [online] Available at:

<https://hivinfo.nih.gov/understanding-hiv/fact-

sheets/fda-approved-hiv-medicines>

Hivinfo.nih.gov. 2021. The Stages of HIV Infection | NIH.

[online] Available at:

<https://hivinfo.nih.gov/understanding-hiv/fact-

sheets/stages-hiv-infection>

HowStuffWorks, Health, Medicine and Treatment,

2021. How Does an Oral HIV Test Work?. [online]

HowStuffWorks. Available at:

<https://health.howstuffworks.com/medicine/tests-

treatment/oral-hiv-test>

Ilo.org. 2021. HIV/AIDS in Africa (Africa). [online]

Available at: <https://www.ilo.org/africa/areas-of-

work/hiv-aids/lang--en/index.htm>

Nyamweya S, Hegedus A, Jaye A, Rowland-Jones S,

Flanagan KL, Macallan DC. Comparing HIV-1 and

HIV-2 infection: Lessons for viral

immunopathogenesis. Rev Med Virol. 2013

Jul;23(4):221-40. doi: 10.1002/rmv.1739. Epub 2013

Feb 26. PMID: 23444290.

Online Biology Notes. 2021. Structure, genome and

proteins of HIV - Online Biology Notes. [online]

Available at:

<https://www.onlinebiologynotes.com/structure-

genome-proteins-hiv/>

Parker, M., Botchan, M. and Berger, J., 2021. Mechanisms

and regulation of DNA replication initiation in

eukaryotes.

Silverman JG. Adolescent female sex workers: invisibility,

violence and HIV. Arch Dis Child. 2011

May;96(5):478-81. doi: 10.1136/adc.2009.178715.

Epub 2011 Feb 28. PMID: 21357241.

Tests, M., 2021. HIV Viral Load: MedlinePlus Medical

Test. [online] Medlineplus.gov. Available at:

<https://medlineplus.gov/lab-tests/hiv-viral-load>

This picture adopt from An, Ping, and Cheryl A Winkler.

“Host genes associated with HIV/AIDS: advances in

gene discovery.” Trends in genetics : TIGvol. 26,3

(2010): 119-31. doi:10.1016/j.tig.2010.01.002

ucsfhealth.org. 2021. HIV Diagnosis. [online] Available at:

<https://www.ucsfhealth.org/conditions/hiv/diagnosis

UNAIDS. UNAIDS Data 2017, Document JC2910E.

http://www.unaids.org/

en/resources/documents/2017/2017_data_book (2017).

Verywell Health. 2021. Why Is It So Hard to Make an HIV

Vaccine?. [online] Available at:

<https://www.verywellhealth.com/hiv-vaccine-

development-4057071>

Verywell Health. 2021. Why Is It So Hard to Make an HIV

Vaccine?. [online] Available at:

<https://www.verywellhealth.com/hiv-vaccine-

development-4057071>

Who.int. 2021. HIV/AIDS. [online] Available at:

<https://www.who.int/health-topics/hiv-

aids#tab=tab_2>

Wikipedia. 2021. HIV - Simple English Wikipedia, the free

encyclopedia. [online] Available at:

<https://simple.wikipedia.org/wiki/HIV>

Wikipedia. 2021. HIV - Simple English Wikipedia, the free

encyclopedia. [online] Available at:

https://simple.wikipedia.org/wiki/HIV

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