• AIDS (Acquired Immunodeficiency Syndrome) is caused by HIV (the Human Immunodeficiency Virus).
• HIV is mainly transmitted through sexual intercourse.
• Once a person is infected, the virus remains in the body for life.

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  One can be HIV positive and feel completely well for many years.
• When a pregnant woman is infected, there is a one in three chance of her baby becoming infected if no steps are taken to prevent this.
• All people infected with HIV will eventually get AIDS.
• AIDS is a fatal illness.
• There is no drug that can cure HIV infection, but there are drugs that can control the virus and delay the onset of AIDS.
• There is no preventative HIV vaccine available at the moment, however research is ongoing to find one.

AIDS develops during the last stages of HIV infection. AIDS is not a single illness, but the whole clinical picture (a syndrome) that occurs when the immune system fails entirely. A person with a failing immune system is susceptible to a variety of infections that are very unlikely to occur in people with healthy immune systems. These are called opportunistic infections because they take advantage of the body's weakened immune system. Certain types of cancers also occur when the immune system fails.

It may take years for a person's immune system to deteriorate to such an extent that the person becomes ill and a diagnosis of AIDS is made. During this time (which can last from less than one year to as long as 10 years or possibly even longer), a person may look and feel perfectly well. This explains why so many people are unaware that they are infected with HIV. However, even though they feel healthy, they can still transmit the virus to others.

More than 90% of people living with HIV are in developing countries, with sub-Saharan Africa accounting for two thirds of all the HIV-infected people in the world. Unlike Western countries, where HIV has initially affected predominantly homosexual men, in Africa and developing countries HIV is usually spread by sex between men and women (heterosexual sex).

Research into HIV/AIDS is ongoing and new information is emerging rapidly. There are drugs that can dramatically slow down the disease in an infected person. These drugs need to be taken in various combinations in order to be effective and so treatment is generally quite expensive. Also, individuals on the drugs must be monitored by medical personnel trained in the use of antiretroviral therapy because these drugs can potentially cause serious side effects if not taken correctly and if the individual is not monitored properly. However, there is no cure for AIDS. There is also currently no preventative vaccine against HIV infection. At this time the only effective strategy for controlling the spread of HIV is prevention through individual behaviour change, spreading the correct information about preventing HIV infection and the use of condoms and other safe sex measures. Other measures, which should be taken by a country's health system, are screening of blood products and the prevention of infection of patients through contaminated medical equipment. Mother to child infection can be reduced by a short course of an anti-HIV drug given to the mother and new-born baby at the time of delivery. (See “treatment”)

Reviewed by Dr Craig Corcoran, Clinical Virologist, National Health Laboratory Service and University of Cape Town, October 2006.

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