20 years of struggle and action days every December 1
He hit the headlines in the 1980s and 1990s to virtually disappear with the arrival of newspapers of HAART. But AIDS is still there , which continues to infect and kill: more than fifty-five million people affected since the beginning of the epidemic.
WARNING
HIV-digit decline in France in 2007 except in homosexual
Approximately 6500 people have discovered their HIV status in France in 2007, a decrease in new cases except for homosexuals, and 28 to 30,000 people suffering from AIDS at the end of the year, according to the Weekly Epidemiological Bulletin (BEH) on Monday.
A study by researchers at the Institute of Health Watch, published in the special issue HIV / AIDS, reveals that around 6,500 people have discovered the contamination in 2007, a figure down from 2004 (7,500).
The proportion of foreigners has decreased to 40% (53% in 2003), that of males increased to 65% (58% in 2003), reflecting the steady rise in cases among gay men: 26 % of infected people in 2003 to 38% in 2007, the overwhelming majority of French nationality. According
BEH, gays "continue to have risk behaviors vis-à-vis HIV.
Sixty percent of those infected have was through heterosexual contact (98% women and 39% for men). The figure is steadily declining in population since 2003 and foreign heterosexual stable in the French population.
injection drug users represent only 2% of those who discovered their HIV status in 2007. Of the 162 children found infected between 2003 and 2007, almost all has been contaminated by maternal-fetal transmission, with a mean age of 4.8 years at diagnosis.
Five million HIV tests were performed in 2007, but "the epidemic continues," notes the BEH: an estimated 30,000 people unaware they are infected with HIV and "prevention campaigns run out of steam." It should be "earlier diagnosis."
AFP - Monday, December 1, 2008, 8:39
short history of AIDS
1969. That's when the AIDS virus was introduced in the U.S. by a Haitian immigrant. The island of Haiti itself has witnessed the arrival of the disease in 1966 through a person from central Africa. Farther on time is in years 1930 that AIDS would have crossed the species barrier, while human ate meat from infected chimpanzee. Researchers have recently climbed back up the original.
In recent years, the virus spreads, for the moment mainly in the homosexual community. 1981: the disease begins to wreak havoc and teams of researchers describe for the first time this unusual set of symptoms relief grouped under the acronym AIDS, acquired immunodeficiency syndrome. The epidemic has spread to the entire planet. Intercourse, blood transfusion, needle exchange, childbirth ... We realize that modes of contamination are numerous, the world panics .1987 is the emergence of the first antiretroviral compound, AZT, and its attendant side effects. 1996 seems at first to sign the death warrant of HIV: HAART can reduce the virus to almost nil. It says undetectable in the blood. The first years, the side effects of treatment are very heavy, the patient has to swallow dozens of pills a jour.2007: triple therapy, today it is sometimes only two tablets per day, easily forgotten. But the virus is still there. Simply stop the medication for it proliferates again in the body. Yet behaviors are relaxed and the doctors find a daily increase in the number of contamination or other risky behaviors.
More than 25 years after the discovery of the first case, the AIDS epidemic has ravaged entire populations: 25 million dead in the monde33, 2 million HIV infected people today 6 800 700 deaths caused each day5, every day , AIDS, 2.1 million deaths already in 2007
In recent years, the virus spreads, for the moment mainly in the homosexual community. 1981: the disease begins to wreak havoc and teams of researchers describe for the first time this unusual set of symptoms relief grouped under the acronym AIDS, acquired immunodeficiency syndrome. The epidemic has spread to the entire planet. Intercourse, blood transfusion, needle exchange, childbirth ... We realize that modes of contamination are numerous, the world panics .1987 is the emergence of the first antiretroviral compound, AZT, and its attendant side effects. 1996 seems at first to sign the death warrant of HIV: HAART can reduce the virus to almost nil. It says undetectable in the blood. The first years, the side effects of treatment are very heavy, the patient has to swallow dozens of pills a jour.2007: triple therapy, today it is sometimes only two tablets per day, easily forgotten. But the virus is still there. Simply stop the medication for it proliferates again in the body. Yet behaviors are relaxed and the doctors find a daily increase in the number of contamination or other risky behaviors.
More than 25 years after the discovery of the first case, the AIDS epidemic has ravaged entire populations: 25 million dead in the monde33, 2 million HIV infected people today 6 800 700 deaths caused each day5, every day , AIDS, 2.1 million deaths already in 2007
screening late
France is no exception to the rule: it is estimated that 140 000 people now living with HIV, the virus that causes AIDS. "Only 100,000 people are HIV positive and know that followed, Dr. Marina Karmochkine concerned, a doctor specializing in care for HIV positive people. This means that 40,000 people now live quietly, unaware they have HIV . This is doubly unfortunate: they are more likely to have unsafe behavior if they knew they were sick and could not be treated in time. "Each year in France, 7,000 people discover they are infected HIV. "What is worrying is that this figure has not declined since that is watching", sorry Dr. Karmochkine. The difference is that today 50% of people are diagnosed at the stage of AIDS reported, that is to say 5 to 20 years after they were infected. It was nice not to talk as much as in the 1990s, it always dies in 2007 in France, AIDS. The fate of 1,700 people each year.
HIV, how it works?
HIV positive, AIDS sometimes difficult to navigate and understand what really happens in the body. The real name of the virus is HIV, for Human Immunodeficiency Virus (HIV in English). He is responsible of the disease. It is not contagious, that is to say he can not simply s'attraper outdoors, talking with an infected person. However, it is transmitted, in specific cases, if you find yourself in contact with blood or sexual fluids of an infected person.
HIV is particularly dangerous because it attacks our immune system. In fact, its structure enables it to infect and destroy certain white blood cells called T4 lymphocytes. It has on the membrane that surrounds a protein that serves as a key to enter the cell. Thanks to all the elements present within white blood cell, HIV can replicate in multiple copies. Thus, the virus multiplies rapidly.
opportunistic diseases
We talk about HIV when it was tested for HIV and that have been found HIV antibodies in the blood: this means that our organization has been in contact with the virus and he tried to fight it. In vain, in the case of HIV, because once it is installed, no one, for now, has been able to dislodge.
If not detected, and it continues to proliferate, HIV will eventually bring down the rate of T4 lymphocytes in the blood. In normal times, in a healthy individual, this rate should be above 500 T4/mm3 lymphocytes in the blood. When the rate drops, the body is exposed to all sorts of viruses against which it can no longer fight. Below 200 LT4/mm3, multiple infections begin to develop: it is the opportunistic diseases that take advantage of the weakness of the organism to penetrate and grow. That's when we talk about AIDS when the disease was reported. AIDS is the acronym for immunodeficiency syndrome acquise.Parmi these opportunistic diseases, the most common are: PCP, which attacks the lungs. It is caused by a microorganism which circulates widely in the population. But against which AIDS patients can not fight. Symptoms include dry cough, high fever and deteriorating general condition. Cerebral toxoplasmosis: This is a brain abscess. Symptoms vary depending on where it is located: blindness, hemiplegia, etc.. Cytomegalovirus: its symptoms may resemble those of mononucleosis. The patient experiences severe fatigue, is feverish, muscle pain is important, headache up to meningitis ... Kaposi's sarcoma, these famous brown spots on the skin, now so closely associated with AIDS. Sometimes Kaposi's sarcoma also attacks the lungs, with consequences far more serious.
HIV, how do you get it?
During the early years, HIV has spread mainly in gay communities. Some did not hesitate then to call it a "gay disease". However, it was soon found that it was likely to attack anyone. Especially since the modes of contamination are numerous.
"Today in France, the majority of contamination occurs through sexual contact, whether in a heterosexual or homosexual. The virus is present in large quantities in genital secretions, male and female persons untreated or treatment failure, "said Marina Karmochkine. Any unprotected sex with an infected person is at risk. Yes for vaginal penetration, anal penetration, but also, we know less, for the report oro-genital. Oral sex, with or without ejaculation, is a significant risk, as well as the exchange of objects such as sex toys . The risk of contamination in each report is relatively low, but do not protect themselves, it's a bit like playing Russian roulette: just once to be infected. Contamination can also occur through blood. We remember also the tainted blood scandal, it was not that long. Today, transfusion in France is extremely secure. However, contamination can be done if we are stuck with a syringe that is infected or sharing a syringe with a sick person. Generally, any contact with blood infected with HIV at risk.
Contamination can also occur from mother to child during pregnancy, childbirth or through breastfeeding. In the absence of treatment, risks of contamination are of the order of 25%. Quick reminder for those who still hesitate, despite the wide campaigns: AIDS is NOT spread by kissing or touching, or even drinking from the glass of someone else. Similarly, there is no risk in eating the same dish or swimming in the same water that a person with HIV. You can also swap clothes, sit on the same toilet bowl or shower in the same tank: no danger. Even mosquito bites do not pose risks.
How are the monitoring and triple therapy?
You have just been diagnosed HIV positive and you wonder what will be the stages of your care. "The first consultation, long, aims to make a complete inventory of the patient's health, both physically and psychologically and social," explains Dr. Karmochkine, HIV specialist who officiates at the European Hospital Georges Pompidou in Paris. This consultation takes place in a specialized department to care for people with HIV, usually within a hospital.
If the patient was diagnosed in the absence of symptoms, there are good chances that the treatment does not begin immediately. "Without exception, start a therapy against HIV is not in a hurry," says Marina Karmochkine. It takes time to explain what a patient antiretroviral therapy, which can be side effects, etc.. It shall initiate the process when the immune system begin to fall. " In all cases, the patient will be followed regularly, every few months, more if needed. Counselling is often desirable.
Tritherapy
When the immune system begins to decline, it is the time of the first drugs. A little background: In 1987 appears the first drug designed to fight against AIDS, AZT. It aims to stem the fall in the number of T4 lymphocytes. But it is not very effective alone and doubled unpleasant side effects such as nausea or diarrhea. Less than ten years later, in 1996, and landed the first triple is the revolution! By combining three drugs, doctors are able to lower viral load (the amount of virus in the blood) to make HIV undetectable. "These drugs act on enzymes essential to the virus, said Dr. Karmochkine. Thus, HIV is blocked in its evolution, it can not grow or reduce the number of T4 lymphocytes." The advent of HAART is a breath of oxygen for all patients: their life expectancy is increasing dramatically, the sword of Damocles hanging over their heads seems to recede a bit.
the early years, triple therapy is still extremely compelling: patients must swallow up to several dozens of tablets per day at fixed times. Ten years later, considerable progress has reduced the number of these stamps: one to six per day, moyenne.Progrès also made in terms of side effects. At first, they are significant and disabling. The most spectacular is lipodystrophy, in many cases this means fat body are abnormally distributed. The legs and buttocks become very thin, his face is growing while the belly and breasts grow in size, giving patients treated by HAART an easily recognizable face, that cosmetic surgery can not to correct. Emmanuel de Castro said the ordeal he has lived for ten years: "With the triple, I lost all my teeth. I have made repeated phlebitis. I had chickenpox, I developed shingles. No, this is not an easy process! Ten years later, I have only two pills so I'm not complaining. But the side effects are still there. "
There is no cure
Other more serious problems may occur with combination therapy: diabetes, cholesterol, heart attack, hepatitis, pancreatitis and drug ... Less serious but troublesome, nausea, anemia, tingling, loss of libido usually associated with triple therapy. These side effects are likely to emerge, even with newer drugs, although less frequent and less dramatic.
"A lot fewer side effects today"
remains a fundamental factor for the triple therapy is effective: treatment adherence. Too many patients still tend to take it from time to time, then stop it, to resume later. No: the triple therapy should be taken carefully, and everyday life. "In 2008, the medication should lighten but still Emphasize the fact that triple therapy is and will remain a heavy treatment and vital, with its attendant disorders. It is unquestionably a huge step forward for patients but it does not allow a carefree life. The virus is still there, there is no cure for HIV. "Add to that triple therapy is ineffective in approximately 10% of patients." For many, it is because they have first received monotherapy or dual or inappropriate treatment, "says Marina Karmochkine. The virus has become resistant to all molecules existing at the moment. "Without minimizing the importance of an approach to today almost live "normally", it is unclear how the triple therapy is effective in the very long term, since it has only been ten years.
No vaccine, vigilance always appreciated!
No, there is still no vaccine against HIV. Several groups of scientists are working around the world "but the research is not ready to lead. It takes many years," insists Karmochkine Marina.
Moreover, in September 2007, Merck's research was interrupted abruptly. Suspected of having the candidate vaccine could increase the risk of infection in patients who had received injections. In 3000 volunteers, 83 were infected with HIV: 49 had received the vaccine candidate and 34 a placebo injection. These figures are sufficient to raise the stop research but not enough to be statistically significant.
Quiz:
which one is infected?
Which one is it?
one on the right or the left?
Nights No Kpota
Yet since the advent of HAART, a false sense of security has developed, which led to an explosion of risky behavior and thus, inevitably, to further contamination. In the 1990s, however, prevention behaviors were completely entered in the customs. Young people who began their sexual life did not imagine to do without the famous "hood". "Today we are witnessing a real release of the prevention, sorry Marina Karmochkine. I think people feel that AIDS can be treated, we do not die almost over and that, therefore, it does not matter. They are wrong. "Others go even further, adopting voluntary risky behavior, a kind of distrust of the disease." I like taking risks and unprotected sex in part, reflects a patient in the Marina Karmochkine book "Will I know about AIDS." AIDS has forced my sexuality too long. Ras-le-bol speeches feel guilty about my sexuality ... "" We see also occur in straight nights Kpota No, "says Marina Karmochkine, which alarmed the lightness in relation to disease.
Emmanuel Castro, who contracted AIDS in 1984 when the hardly knew what it was, does not understand this behavior in the light. "In my time there was no prevention campaign, it was not even sure how I get it. But now I'm tempted to say that we almost do it on purpose to contracting HIV! We know how it spreads and we can afford to fight. I really do not understand people who seem to deliberately put in danger. AIDS is not insignificant, we still dies TODAY 'Today! And even when you survive, the consequences in everyday life are considerable. "
Discrimination
It is sometimes difficult and delicate to address certain issues. Sexually transmitted diseases are among them.
Ludovic, 32, is HIV positive for over 3 years. Rejected by his family and friends, he explains how the disease is in the eyes of people whose illness is shameful not to talk.
Interview:
How did you discover the disease?
I was often sick. Infections that never ended. My doctor advised me to do a HIV test and it then that I knew. My whole life has changed. A real nightmare. I stayed locked up for weeks.
Do you know how you were infected?
I do not know who infected me. I have had multiple partners and they all said they had not. All the people I had not attended a physical illness. It is true that I let go by the temptation every time. When I had no protection, I went anyway without asking any questions. I knew the last time one of my ex also had the disease. It does not want to see me. In cases like this, defer the blame on each other. Your daily
has it changed?
I hate myself so much so that I dare not even look me in the mirror. It's hard to know I'm dying. It is very scary, just as the disease worsens and anxiety returns. I have nobody to talk to about it except those who are in the same situation as me.
What are the behaviors of your loved ones?
My family moved away and I prefer to talk by phone. The worst part of all this is that my stepfather rose my mother against me. She who had so often I see me completely helpless. She calls me from time to time but it is not enough. Her husband did not want me to come and infect their children. He must believe that AIDS is spread like a cold, as many people think. There are a lot of patients who are left alone because they are pointing.
Some AIDS patients have stopped their salaries in protest against the establishment of the medical deductible. What is your opinion?
The disease is difficult enough to live on a daily basis and this law makes us guilty. I find it unfair that they be patients who finance other patients. The patients can not work and I wonder where will we find the money to fund all these treatments. The drugs are very expensive.
Do you have any advice for young people? Make
especially careful. It falls on the partners who seem normal in shape and we do not ask questions. We must protect themselves because there are more and more young people who are sick and who live very badly.
Interview by Essi Gnaglom
http://20minutes.bondyblog.fr/news/je-suis-malade-et-je-suis-seul
Today in France, on 130,000 HIV-positive, more than a third are directly involved in research or keeping a job. Nearly 50% of people are without a profession and live on less than 680 € / month, while two in three people want to find an activity. Nearly 30% of people infected since 1996 have the feeling of having lost their job because of HIV.
Beyond the medical aspect, being HIV positive is a source of turmoil, both professionally and personally. In professional life, the figures speak for themselves: 40% of men and 55% of infected women aged under 60 were inactive in 2003, according to a study by ANRS (National Agency for AIDS Research). Another study of Sida Info Service drives the point: nearly 6 in 10 patients considered themselves victims of discrimination or exclusion, due to their HIV status. "Hire an HIV inevitably leads to problems of absences. And then we saw some fear on the part of our employees also, "says a French boss. "AIDS place a whole series of obstacles on the course," says Catherine. It is true that there is no requirement to disclose his HIV status. It remains a matter of choice. But facing the future employer, very often, a patient must prove a hole sometimes fifteen years in his CV. "Or simply," said Sophie, attend a day without hair at work. Immediately, you face the rumors. "Consequence: two thirds of their victims silent séropositivité.La privacy atteinteDans also the private sphere, things are much simpler. "You know, reflects Bruno, 26 years, whether an insurance policy, a loan or a simple visit to a dentist with AIDS, nothing is simple. We must hang a little more than others.
Despite his feat at the Beijing Olympics, Australian diver Matthew Mitcham still has no sponsor. He nevertheless won the respect of his fellow citizens (and ours), including that of newspaper readers in Australia "Sydney Morning Herald and The Age, which also awarded him the prize for best performance sport year. Diving is certainly not known for its fabulous commercial contracts, but one would think that if you win the first Australian gold medal for 84 years in this discipline, Mitcham would have interested few large marques.Dans an article devoted to the diver, the "Sydney Morning Herald " asks if homosexuality did not dampen the diver some sponsors ... David Lyall, who handles the management of Mitcham, said that Matthew's sexuality was never mentioned in conversations with potential sponsors ... If that was not mentioned, so ...
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