Understanding AIDS and HIV

Human immunodeficiency virus, or 'HIV', is a retrovirus in which cells of the human immune system become impaired or destroyed. This leads to the progressive depletion of the immune system eventually resulting in immunodeficiency. This makes people with HIV more vulnerable to cancers and other “opportunistic infections” which would not otherwise affect them. 

Acquired immunodeficiency syndrome, or 'AIDS', refers to the collection of symptoms and infections associated with severe immunodeficiency, for which HIV is the underlying cause. The presence of certain infections and/or level of immunodeficiency indicate when HIV has progressed to AIDS. 

As of 2018, 37.9 million people globally were living with AIDS, 1.7 million of whom were newly infected. Just 23.3 million of these people had access to antiretroviral therapy. Since the start of the pandemic, 74.9 million people have become infected with HIV while 32 million have died from AIDS-related illness, according to data provided by UNAIDS

And while AIDS-related deaths have declined by 56 percent since the epidemic peak in 2004, hundreds of thousands of people continue to die from the disease, while millions more are at risk of becoming infected. For example, every week, just under 6,000 women between the ages of 15 and 24 become infected with HIV, while in sub-Saharan Africa, four out of five diagnoses of HIV-related infections occur in girls.

UNAIDS says, “Ending the AIDS epidemic is more than a historic obligation to the 39 million people who have died of the disease. It also represents a momentous opportunity to lay the foundation for a healthier, more just and equitable world for future generations. Ending the AIDS epidemic will inspire broader global health and development efforts, demonstrating what can be achieved through global solidarity, evidence-based action and multisectoral partnerships.” 

According to many sources, meanwhile, we do have the tools to end the epidemic, but it will take a collective and multidisciplinary approach. Dr. Gottfried Hirnschall, director of the HIV Department at the World Health Organization, insists, “30 years after the first World AIDS Day campaign, we still cannot be complacent in our response to HIV.”

Here are nine fields of study which can help you tackle HIV and AIDS around the world.

1. Epidemiology

Epidemiology is the branch of medicine that deals with the incidence, distribution, and control of diseases and other factors relating to health. As such, epidemiologists are central to understanding and controlling the AIDS pandemic. 

According to research published in the Journal of Epidemiology, “Epidemiologists have used existing epidemiologic strategies, expanded existing strategies, and developed new strategies to answer key questions about the transmission of HIV, the natural history of HIV at the molecular, host, and community levels, for evaluation of treatment effectiveness and intervention strategies, and to inform public health policy. In responding to the challenge of the pandemic, epidemiologists have also increasingly collaborated with scientists from other disciplines, particularly immunology, virology, and the behavioral sciences.”

2. Urban public health

Over the past few decades we’ve learned that early diagnosis and treatment can play a pivotal role in preventing HIV transmission and its effects. Given the global HIV epidemic tends to be concentrated in major cities, urban public health is paramount.

A BMJ Opinion article written by three HIV experts proposes, “Cities, often by necessity, are incubators for innovation and help drive positive changes in the national response to HIV.  While some cities have successfully implemented many interventions and programs, such as same-day diagnosis and ART initiation, the truth is that some cities are in the beginning stages of modernizing their response. However, we believe that by applying earlier testing and treatment in concert with other new HIV prevention innovations and embracing open data principles and transparent reporting to engage the community major cities will continue to forge ahead in tackling HIV.”

3. Community health education

While awareness about HIV and AIDS has grown over the years, it’s still woefully lacking in some regards -- especially in vulnerable areas. In addition to teaching people about HIV prevention, community health initiatives can also work toward eliminating the stereotypes which act as barriers to treatment. Potential jobs in this area include HIV/Aid educator; policy and government affairs manager; research coordinator; and patient navigator. 

4. Behavioral and community health science

Many factors go into HIV treatment and prevention programs, and not all communities are equally impacted. Brian Mustanski, co-director of Third Coast Center for AIDS Research (CFAR), says, “We have treatments and prevention programs that are highly effective ways of diagnosing people that are very sensitive and methods to identify and respond to new HIV cases. But we haven’t scaled them up to reach the right people at the right time. [...] We have the tools to end the epidemic. Let’s use science to put them into practice.”

Mustanski’s colleague, Nanette Benbow, adds, “Many factors get in the way of people taking medication. If you lack access to care or are not getting your meds because you lost your job and healthcare, or you are struggling with mental health problems or substance use disorders, or have difficulties with childcare, all of that gets in the way. If your life is in upheaval and you’re in survival mode, taking your medication may not be your number-one priority.”

5. Infectious/communicable diseases

HIV is an infectious disease, which simply means it’s caused by organisms, such as viruses, bacteria, fungi or parasites. While these are often harmless, they can also cause disease. Physicians who specialize in infectious disease work with patients with treatment and prevention. Infectious disease researchers, meanwhile, seek out new understanding of how pathogens enter the body and make people sick. 

According to the US National Institute of Allergy and Infectious Diseases (NIAID), while strides have been made in preventing and treating HIV, ensuring a durable end to the pandemic relies on finding a safe and effective vaccine. As such, “NIAID researchers and grantee institutions advance understanding of disease mechanisms and cooperate to move novel HIV prevention and treatment strategies from basic research into clinical practice.”

6. Global health

“The siloed nature of current health services impedes the ability to meet the aims of the Sustainable Development Goals (SDGs) and motivates the need to leverage the progress in the fight against HIV to address other emerging health threats,” proposes research published in The Lancet. Given the increasingly globalized world, and travel between borders, thinking about health -- including topics like HIV -- within a global context is necessary. 

The US’s Office of Disease Prevention and Health Promotion adds, “Improving global health can improve health in the United States and support national and global security interests by fostering political stability, diplomacy, and economic growth worldwide.” 

7. Population and family health/maternal and child

Studies in this area focus on sexual and reproductive health, usually with a focus on women, children, and adolescents. Many also cover topics like family planning, sexual behavior, and decision-making. These are especially relevant given the prevalence of mother-to-child transmission of HIV, which is a preventable phenomenon

8. Policy studies

Public policy refers to what the government and other public officials do or don’t do to address an issue that requires attention. These policies are made on behalf of the public, and can take the form of laws or regulations governing a particular problem. Policy studies, which seeks to understand public policy, is an interdisciplinary field combining political science, economics, sociology, and other academic fields. 

According to The AIDS Institute, “Public policy research is the foundation upon which the agency’s advocacy and education efforts are based. The research program includes analysis and interpretation of information about the AIDS pandemic, related health care issues, and the social impact of disease on society.”

9. Journalism

We’ve already addressed that raising awareness is critical to mitigating AIDS. Journalists are positioned to play a paramount role in this endeavor. 

Stephen Abbot Pugh writes for the International Center for Journalists (IFCJ), “Journalists -- especially those working in this target region — should undertake any efforts they can to better understand the lives of those living with HIV/AIDS and how money is being spent on preventing or treating the virus. Once they are armed with this information, they will be more prepared to counter rumors and equip their countrymen and women with factual information that can help them in this battle.”

Certainly, the world has come a long way since HIV and AIDS first emerged in the 1980s. But there’s still work to be done. Studies in one of these fields can position you to be part of the solution to one of the greatest challenges to human health of our times.