Basic facts about the epidemic and its implications

• Pages: 19-22

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Basic facts about the epidemic and its implications

Appendix I

Basic facts about the epidemic and its implications

Facts about HIV and AIDS

The Human Immunodeficiency Virus (HIV) which causes AIDS is transmitted through body fluids – in

particular blood, semen, vaginal secretions and breast milk. It has bee n established that transmission takes

place in four ways: unprotected sexual intercourse with an infected partner (the most common); blood

and blood products through, for example, infected transfusions and organ or tissue transplants, or the use

of contaminated injection or other skin-piercing equipment; transmission from infected mother to child in

the womb or at birth; and breastfeeding. HIV is not transmitted by casual physical contact, coughing,

sneezing and kissing, by sharing toilet and washing facilities, by using eating utensils or consuming food

and beverages handled by someone who has HIV; it is not spread by mosquitoes or other insect bites.

HIV weakens the human body’s immune system, making it difficult to fight infection. A person may

live for ten years or more after infection, much of this time without symptoms or sickness, although they

can still transmit the infection to others. Early symptoms of AIDS include: chronic fatigue, diarrhoea, fever,

mental changes such as memory loss, weight loss, persistent cough, severe recurrent skin rashes, herpes

and mouth infections, and swelling of the lymph nodes. Opportunistic diseases such as cancers, meningi-

tis, pneumonia and tuberculosis may also take advantage of the b ody’s weakened immune system. Al-

though periods of illness may be interspersed with periods of remission, AIDS is almost always fatal.

Research is currently under way into vaccines, but none is viable as yet. Antiretroviral drugs are available

that slow the progression of the disease and prolong life; at present these are very expensive and conse-

quently unavailable to most sufferers, but the situation is changing rapidly. HIV is a fragile virus, which

can only survive in a limited range of conditions. It can only enter the body through naturally moist places

and cannot penetrate unbroken skin. Prevention therefore involves ensuring that there is a barrier to the

virus, for example condoms or protective equipment such as gloves and masks (where appropriate), and

that skin-piercing equipment is not c ontaminated; the virus is killed by bleach, strong detergents and very

hot water (see Appendix II).

Demographic and labour force impact

At the end of 2000, over 36 million people were living with HIV/AIDS, two-thirds of them in sub-Sa-

haran Africa. Nearly 22 million people have died from AIDS; there were 3 million deaths worldwide for

the 12 months of 2000.

All regions are affected: adults and children with HIV/AIDS number over 25 million in sub-Saharan

Africa; over 6 million in Asia; nearly 2 million in Latin America and the Caribbean; just under 1 million in

North America; half a million in Western Europe; nearly three-quarters of a million in Eastern Europe and

Central Asia; nearly half a million in North Africa and the Middle East. Although the dominant mode of

transmission may vary, regions are experiencing increased rates of infection.

The consequences of AIDS deaths for total population numbers in Africa are clear: by 2010, for 29

countries with prevalence rates of over 2 per c ent, the total population will be 50 million fewer than in the

absence of AIDS. There are sex and age consequences as well, as in many countries women often become

infected at a younger age than men; in Africa over half of new infections are among women. The age

group worst affected everywhere is the 15-49 year-olds, the active population, whose contributions to the

family, society and the economy are thus being lost. The ILO estimates that over 20 million workers glo-

bally are living with HIV/AIDS. The size of the labour force in high-prevalence countries will be b etween

10 and 30 per cent smaller by 2020 than it would have bee n without AIDS; 14 million children have lost

one or bo th parents to AIDS, and many of them will be forced out of school and on to the job market,

exacerbating the problem of child labour.

HIV/AIDS has an enormous impact on infected individuals and their families, as well as on the c om-

munity at large. The implications are serious for the old and young dependants of infected family members.

The impact at the individual and household level is mirrored at the enterprise level and, increasingly, in

the national eco nomy. The epidemic manifests itself in the world of work in many ways: disruption of