The myths and facts of how Human Immunodeficiency Virus/Acquired ImmunoDeficiency Syndrome (H.I.V/A.I.D.S) is transmitted in Nigeria is very vague.This is probably because health sponsored promoted jingles and enlightenment campaign only pass information that scares people away from sexual activities. This they believe is an effective method to curb the spread of the disease.
To me, I see that the misleading information on the way the virus spreads has really contributed to its spread in Nigeria. For example, a young man was scared to death about his status. In an attempt to help him on why he think so, he narrated how he had unprotected sex with a female prostitute once. He is the notion that all prostitute are HIV positive hence the fear. This resulted in him living a promiscuous lifestyle because he thinks he is infected. The fear of getting the test is another.
Most persons know the mode of infection. It involves the introduction of the fluid of an infected person into the blood stream of a negative individual. The major means of infection is through unprotected sex acts. These can be between opposite or same gender.
However, I have come to realise that most people in Nigeria do not understand much on the risk of infection. HIV/AIDS is not a very effective or strong disease compared to other viruses like the flu that can be transmitted with just a sneeze. It requires much more than that. To understand it better, let us start from the beginning.
The Cycle Of HIV/AIDS Infection
A person can be infected after the introduction of the virus about four days earlier. The infection normally takes about 2 weeks to 3 months for the virus to be detected. The virus multiplies fast during this period. After this short phase, the virus is in every fluid in the body. The last phase is when it has developed into a full-blown AIDS. At this stage, the viral load is very much.
When Infection Of HIV/AIDS Begins
To be able to infect another negative person, the virus must be in the fluid of the carrier. This is not possible in the first 2-3 days of getting infected, as the virus has not had the time to move to the various parts of the body. After this time, the virus multiplies as fast as possible. After the initial 2-3 days, it moves to most organs and tissues in the body.
The virus is present in every fluid in the body. However, there is some fluid where the virus is not much concentrated in like saliva and tears. The little amount of virus in this fluid made them almost impossible to transmit the virus. That means that a very minute amount of the virus does not cause an infection to a negative person. I will explain this later.
For fluids that contain a good amount of the virus-like semen and vaginal fluid, they have the high risk of causing infection to a negative partner if it finds its way into the body. This also depends on several factors. I will concentrate more on transmission during unprotected sex acts.
The skin of humans is dry and well protected from germs and bacteria. The only way the virus can find its way into the body through the skin is when the person has a cut or sore. Even if it happens, an infection may not take place. This is because for infection to take place, the viral load must be more than the ability of the immune cells at that spot to fight back. That is the rate of multiplication of the virus must exceed the rate of killing them by the immune system.
On the other hand, other parts that are highly vulnerable to the virus are the wet skin such as the vagina, cervix, foreskin, urethra, anus, rectum, mouth, nose, and the penis. However, they are not completely left out without some form of protection though different. The soft skins are covered with mucous membrane. The mucous membrane is made up of epithelial cells. These cells are tightly joined to each other. Some are made of more than one layers giving an extra protection against diseases. However, the better part of it all is that it contains some chemicals and antibodies that can kill germs.
It is now a common knowledge that a lot of people who had unprotected sex with HIV-positive people are still negative after some years. A lot of them had unprotected intercourse with HIV-positive individuals more than once and yet came out clean. This shows one thing; not every sexual activity during unprotected acts with a carrier leads to infection just the way popular jingles make all of us feel. Do you know why?
How Women May Get Infection
The vagina of a woman if protected with the mucous membrane. The epithelial cells prevent the virus in the semen from crossing the membrane into the blood stream after sex. However, the possibility of crossing it is high. This is because the semen containing the virus will reside in there for up to 4 days giving them time to work their way through. In addition, the living condition there is somewhat favourable since it is moist. What if they do go through? Not to worry, there is still hope.
The inside of the mucous membrane contains many immune cells. They are capable of killing germs that manage to find their way through. Unfortunately, the Langerhans cell that is supposed to bring these viruses to the immune cells to kill are now the carriers in the body. This is because the Langerhans cells are easily bound to the virus. However, in most situations, the immune cells are capable of destroying the virus before they multiple. The rate of multiplication must not exceed the rate of killing.
This battle lasts for about three days. If the body lost the battle, the person gets infected and cannot be reversed. However, for rape patients whom an HIV-positive person may rape or one who mistakenly shared a sharp object with a carrier, it is advisable to visit a hospital for the prescription of a suitable antiretroviral. This is because the drugs will boost the immune system to fight the virus in the first 2-3 days.
How Men May Get Infection
There are two ways men can contract HIV/AIDS during unprotected sex. It is through either the penile skin or the lining of the urethra. However, the urethra also has protection just like the vagina of a woman and have an added advantage that the vagina fluid does not go in that much and majority of the few that gets in kicks off after male urination. As for the skin, consider the following
Circumcised And Uncircumcised Men
Removal of the foreskin in the form of circumcision decrease the risk of HIV during unprotected intercourse. A scientist has postulated a couple of reasons for this. They are:
1. Removal or the foreskin reduces the Langerhans cell, the cells the virus normally first attaches itself to before infecting the CD4 cells
2. It reduces the surface area of the penis exposed to the fluid containing the virus
3. The skin covering the head of the penis becomes tougher than normal which further prevents against micro tear
4. The mucosa lining of the foreskin is soft and tender allowing germs penetrate to underlying skin, which is prevented in circumcised male
5. Small pore holes in the foreskin creates an enabling environment for the virus to harbour prolonging the time it stays in it
6. Lastly, it is believed that the penis of uncircumcised men is larger. This size factor is attributed to increased risk of transmission of the virus to sex partners. For the explanation, it is believed that the size causes tear during sex which technically increases the chances of infection for both partners
Further research showed that a greater percentage of HIV-positive people who had normal vaginal sex with negative persons for a long time without protection did not transmit the disease. This is probably because the protection offered by the body did a lot of good work. However, some factors increased the risk of contracting HIV positive through unprotected sex.
Damage To The Cell Layer: The membrane layer is intact. However, rigorous sex activities such as dry sex, rough sex etc.exposes the sex organs to tear. This tear can be an entry point for the virus. A small tear is more than enough entry point for a lot of virus. The more the virus that get to the other layer, the higher the risk of infection. This is the major way HIV is transmitted.
Disease: Some disease especially Sexually Transmitted Infections (S.T.I) can or even cause both the weakening of the immune system and inflammation of the sex organs. This increases the likelihood of infection.
Surface Area: The larger the area that is expose to the virus, the greater the possibility of infection. That is the vagina is larger than the penis.
Viral Load: The semen contains much more virus that vagina fluid.
Duration Of Exposure: The vagina fluid containing the virus does not survive a long time in the penis. Which may be for days.
Stage Of Infection: Also, the stage the carrier is matters a lot. The first 3 days are usually safe for a carrier. However, from the 4th day, the virus starts to multiply rapidly to other parts of the body. At this stage, the virus load is much. It continues and slows down after a while. The last phase is when it is full blown aids which contains much of the virus too. However, there have been successful stories of carriers who are taking their medications and have an undetectable viral load not infecting their partners after numerous encounters.
Time Of Sex: This is for the women. It is believed that unprotected sex before, during or after menstruation is a risk.
Younger women, women that are in stages of giving birth and the old are more prone
Factors That Reduce The Risk
Inflammation: Inflammation of the mucous membrane increase the population of immune cells to the area. This reduces the time travel of the immune cells during HIV infection.
Antiretroviral: A person on antiviral drugs will have an improved immune system that will boost the fight against the virus when it comes into the body.
Vaccines: Since some disease increase, the risk of HIV infection, vaccination against such disease can greatly reduce the risk of infection.
Rate Of Infection
It has been shown that the rate of infecting others reduces with antiretroviral therapy. However, for carriers who are not into drugs, the rate of transmission is shown in the table below
Out of 10000 exposure to the infection without protection
Sexual- Receptive anal intercourse 138
Sexual- Receptive vaginal intercourse 8
Sexual- Insertive anal intercourse 11
Sexual- Insertive vaginal intercourse 4
Transmission from male to female is high=0.08 %
Transmission from female to male is low=0.04 %
1. Unprotected sex with an HIV-positive person does not necessarily lead to infection with the virus
2. The more the number of sex acts with the carrier, the higher the risk
3. Females are at a higher risk of infection than men
4. Risk reduce for men and women when the man is circumcised when any gender is the carrier
5. Virus can be eliminated within the first 3 days of introduction to the body with the right drugs
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