HIV in Barbados Human immunodeficiency virus also known as HIV is a virus that attacks the immune system of a patient. It is a virus that can be contracted via contact with certain bodily fluids. These fluids include blood, semen, vaginal fluids, rectal fluids and breast milk. Transmission of HIV can occur through sexual intercourse, sharing of needles in drug abuse, vaginal birth and breast-feeding. HIV is a single stranded encapsulated RNA virus; which inserts a DNA copy of its genome into the host cell in order to replicate, this makes it a retrovirus. The immune cells most affected by HIV are the CD4 T-cells; these cells help to fight off infections (HIV/AIDS, 2019). HIV will reduce the number of these cells in the body making the patient more susceptible to opportunistic infections or cancers (HIV/AIDS, 2019).
If the patient remains untreated HIV will progress to acquired immunodeficiency syndrome known as AIDs (HIV/AIDS, 2019). This is when the CD4 T-cell count is so low that patients are unable to combat infections that would normally be nonfatal. AIDs is the last stage of HIV (HIV/AIDS, 2019). There is no cure for HIV and once you contract the virus it stays with you for life. Although HIV has no cure, it is treatable. HIV is treated via antiretroviral therapy or ART. ART was introduced in the mid-1990s (HIV/AIDS, 2019). Treatment with ART as prescribed can reduce the viral load, reducing the virus in the patient’s blood to undetectable levels (HIV/AIDS, 2019). If levels remain undetectable patients can live long healthy lives and have reduced or no risk of transmitting HIV to an HIV-negative partner through sex (HIV/AIDS, 2019). Before ART, patients with HIV could progress to AIDS in just a few years (HIV/AIDS, 2019). Scientists believe that HIV originated in Africa. They believe that HIV is the mutated form of virus that originally affected chimpanzees.
The chimpanzee version of the virus is called simian immunodeficiency virus, or SIV (HIV/AIDS, 2019). Scientist believed that the virus jumped from apes to humans in the late 1800s and mutated into HIV (HIV/AIDS, 2019). The acute stage of HIV infection begins within 2 weeks to a month of being infected (HIV/AIDS, 2019). It can be difficult for a patient to know that there is something wrong because they don’t feel sick right away. When symptoms present it is described as flu-like, this flu-like presentation may last for a couple of weeks (HIV/AIDS, 2019). During this stage patient with HIV are very contagious due to the high amount of virus present in their blood (HIV/AIDS, 2019). The only way to determine whether a patient has HIV is to perform an antigen/antibody test, a nucleic acid test NAT, and an ELISA. To confirm a positive ELISA a Western Blot is performed. The clinical latency stage of HIV infection is when the virus is inactive or dormant (HIV/AIDS, 2019).
Patients who reach this stage have chronic HIV infection but present with no symptoms due to the decreased viral load. This stage may last for decades but some patients progress through this phase faster then others causing them to enter the last stage of HIV infection, AIDS (HIV/AIDS, 2019). Patients who take ARTs are able to prolong this asymptomatic stage of a HIV infection keeping the viral load undetectable (HIV/AIDS, 2019). HIV can still be transmitted during this stage of infection. AIDS is the last stage of HIV infection and is the most severe phase (HIV/AIDS, 2019). In this stage the patients immune system is so badly damaged due to the destruction of CD4 T-cells that the patient becomes prone to opportunistic infections. AIDs is diagnosed when CD4 cells drop below 200 cell/mm (HIV/AIDS, 2019). Symptoms include fever, chills, weight loss, swollen lymph nodes, skin changes and weakness.
Without treatment patient may survive up to 3 years (HIV/AIDS, 2019). Anyone can contract HIV through unprotected sex, intravenous drug use, and failure to screen during pregnancy (National Institute on Drug Abuse, July 2012). Although anyone can be affected by HIV some groups are affected more than others particularly those of African descent. HIV also affects the people of the island of Barbados like anywhere else. After a decade of reduced prevalence of HIV cases, Barbados is now witnessing an increase along with other Caribbean countries like Jamaica and Cuba (Barbados Today, 2017). In 2016 UNAIDS report, the United Nations Special Envoy of HIV to the Caribbean Dr. Edward Greene states that there is a 9% increase in new infections in the Caribbean (Barbados Today, 2017). Dr. Greene estimated that 2:5 people in the region do not know that they have HIV and less than 50% who have it are receiving treatment (Barbados Today, 2017).
There are also some positives to be noted in the region as well, including the reduction of people living with HIV from 450,000 in 2005 to 285,000 in 2015 (Barbados Today, 2017). Dr. Greene also states that there is a 40-60% reduction in HIV/AIDS related deaths and an increase of HIV patient receiving treatment from below 10% to about 50% (Barbados Today, 2017). Dr. Greene lists a few factors that could reduce the progress made in the Caribbean up to now. He states that, “Complacency, for whatever reason, reduced donor funding for treatment, or fall off in government support, including stock outs of drugs, or lack of adherence to treatment by individuals can lead to serious reversals of the gains already made, with implications for our economies” (Barbados Today, 2017). He further states that, “Funding alternatives must be found to deal with the increasing cost of treatment especially due to the fact that persons living with HIV are living longer and must move to more expensive second and third line treatment,” (Barbados Today, 2017). Dr. Greene recommended a few solutions as well to combat the issue, this includes innovations in regional health systems; investment in prevention programs; and placing emphasis on the vulnerable key groups of women, and youth (Barbados Today, 2017).
HIV is no longer a death sentence. It is a viral infection that can be controlled through proper medication and treatment. Efforts to diagnose HIV earlier; particularly for men, improving access to care, collect information on risk behaviors of patients and monitoring high risk populations will help to reduce the prevalence of HIV (Jacqueline Wiltshire-Gay, May 9-13, 2011).