Ten More Myths About HIV/AIDS

 

Hi, my name is [PRESENTER NAME]. I’m [PRESENTER ROLE]. Welcome to “Ten More Myths About HIV/AIDS.” This video will correct some common myths and misunderstandings about HIV and AIDS. For each myth, I will first state the myth and then explain the reality.

 

Myth: HIV has never been isolated

 

Reality: HIV could be isolated from nearly all AIDS patients as far back as 1989.[1] It can be isolated from many tissues and fluids including the blood, semen,[2] vaginal secretions,[3] and brain tissue.[4] PCR tests can count how many particles of HIV are present per milliliter of a person’s blood.[5] HIV can be grown in laboratories. It has been photographed with electron microscopes.

 

Myth: HIV tests are often wrong

 

Reality: Modern HIV tests are very accurate. When an individual is tested for HIV, a subsequent test, called a Western Blot, is used to confirm if they are positive. According to Roger Chou, M.D. et al in a 2005 review in the Annals of Internal Medicine, “With confirmatory Western blot, the chance of a false-positive identification in a low-prevalence setting is about 1 in 250,000.”[6]

 

Myth: The U.S. Food and Drug Administration Has Not Approved HIV Tests

 

Reality: This myth is easy to debunk. Go to Google and type in “Donor Screening Assays for Infectious Agents and HIV Diagnostic Assays”. This will take you to the page on the FDA web site listing tests that have been approved for diagnosing HIV infection.

 

Myth: You are better off without ARVs than with them

Myth: Antiretroviral medications are not effective for treating AIDS

 

Reality: Like other medications, ARVs may have unpleasant side effects. Sometimes, these side effects can even be fatal. However, studies have shown that when patients’ HIV disease is advanced enough to require treatment with ARVs, they will on average live longer, and have slower progression of HIV to clinical AIDS, if they are treated with ARVs than if they are not treated with ARVs. A meta-analysis of 54 clinical trials published in the British Medical Journal by Rachel Jordan et al showed that treating patients with one ARV reduced progression to AIDS or death by 30% compared to a placebo. Treating patients with two ARVs reduced progression to AIDS or death by an additional 40% compared to one ARV, and using three ARVs reduced progression by an additional 40% compared to two ARVs.[7] This point is really important and worth emphasizing. Research studies published in peer-reviewed scientific journals have proven that HIV patients treated with ARVs live longer, and progress to clinical AIDS and death more slowly, than patients who are not treated with ARVs.

 

Myth: AIDS is Caused By Antiretroviral Medications (ARVs)

 

Reality: AIDS is caused by HIV infection. Countless cases have been documented where people who were never treated with ARVs developed clinical AIDS. ARVs only became available in the late 1980s. Before then, no one had been treated with ARVs, but tens of thousands of people in the U.S. alone became infected with HIV and progressed to clinical AIDS. Hemophiliacs infected with HIV early in the epidemic had never been treated with ARVs, yet they became infected with HIV and then developed clinical AIDS. Millions of people in the developing world became infected with HIV and developed clinical AIDS long before any ARVs were available there. Infants who are infected by HIV during childbirth or through nursing on breast milk have been seen to progress to clinical AIDS even if they have never been treated with ARVs. If people are infected with HIV, studies have shown that they will generally develop clinical AIDS if they do not get treated and enough time passes. Conversely, studies have shown that treating HIV positive people with ARVs reduces their risk of clinical AIDS and death.

 

Myth: AZT does more harm than good

 

Reality: These criticisms of AZT are out of date since AZT is no longer used alone for the treatment of adults or in the doses previously prescribed. Modern Highly Active Antiretroviral Therapy (HAART) uses multiple antiretroviral drugs simultaneously and is much more effective than AZT alone. But even before HAART was developed, studies showed that AZT alone saved lives. According to the National Institute of Allergy and Infectious Diseases, a study known as BW002 showed that only one of 145 patients treated with AZT died compared to 19 of 137 on a placebo.[8] The same study showed that only 24 patients on AZT had opportunistic infections compared to 45 on the placebo.

 

Myth: AIDS is caused by use of inhaled recreational drugs such as nitrites (also known as “poppers”)

 

Reality: In the early 1980s at the very beginning of the AIDS epidemic, before HIV was isolated and shown to be the cause of AIDS, some researchers thought that AIDS might caused by the use of inhaled recreational drugs such as nitrites. Studies have since shown that AIDS is caused by HIV, not by use of nitrites. A Vancouver study of 715 gay men compared the HIV-positive individuals and the HIV-negative individuals.[9] Discussing that study, the National Institute of Allergy and Infectious Diseases notes that “Among 365 HIV-positive individuals, 136 developed AIDS. No AIDS-defining illnesses occurred among 350 seronegative men despite the fact that these men reported appreciable use of inhalable nitrites ('poppers') and other recreational drugs ....”[10] Among the HIV-positive men, there were 101 AIDS-related deaths; among the HIV-negative men, there were none. CD4 counts dropped among the HIV-positive men but remained stable among the HIV-negative men, regardless of whether they were using nitrite inhalants.

 

Myth: AIDS is caused by injection drug use, not by HIV

 

Reality: Some have claimed that AIDS is caused by the use of injection drugs including factors such as contaminants in the drugs, exposure to bacterial infections due to unsanitary needles, poor sleep and nutrition, and so on. It is certainly true that users of injection drugs are at increased risk of AIDS, but this is because the practice of sharing needles leads to the transmission of HIV, not because of injection drug use itself. Studies have shown that deaths due to AIDS are correlated with being HIV positive, not with the use of injection drugs. Reviewing one such study, the National Institute of Allergy and Infectious Diseases notes that “[I]nvestigators compared 86 HIV-seronegative individuals who had been injecting drugs for a mean of 7.6 years with 70 HIV-seropositive people who had injected drugs for a mean of 9.1 years .... By 1994, there were 25 deaths attributable to AIDS-defining conditions in the seropositive group; among HIV-seronegative individuals, eight deaths occurred, none due to AIDS-defining diseases."[11] The fact that among injection drug users, only those who were HIV-positive died of AIDS-defining illnesses is clear evidence that HIV, not injection drug use itself, is the cause of AIDS.

 

Myth: Humans created HIV

 

Reality: Scientists have studied the genetic sequences of the various strains of HIV and created “family trees” showing the evolution of HIV over time. According to a study by JD Reeves and RW Doms published in the Journal of Genetic Virology, HIV-1 jumped to humans from SIV in chimpanzees, and HIV-2 jumped to humans from SIV in the sooty mangabey monkey.[12] Moreover, according to a study by David Hillis published in Science magazine, “[A]nalysis of the molecular divergence of SIV and HIV genes .... establishes 1931 as the date of origin of the HIV-1 M-group viruses (the principal cause of the AIDS pandemic).”[13]

 

Myths like these are harmful because they confuse people about the origin of HIV and its role as the cause of AIDS. Make sure you get accurate information about HIV and AIDS. Don’t rely on rumors, myths, claims without evidence, or obscure web pages and videos posted on the Internet. Base decisions about your personal health and safety on the findings of research studies published in peer-reviewed scientific journals. HIV causes AIDS. HIV tests can accurately determine whether or not you are infected with HIV. ARVs are effective for treating HIV/AIDS and save lives. Knowing the facts about how HIV is transmitted can mean the difference between life and death. Protect yourself and those around you. Take steps to avoid contracting HIV and to avoid transmitting it if you are HIV positive. This is [PRESENTER NAME].

 

This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on June 22, 2007.

 

References:

 

 



[1] National Institute of Allergy and Infectious Diseases, “The Relationship Between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome,” September 1995, http://www.niaid.nih.gov/publications/hivaids/all.htm.

[2] Zagury et al. "HTLV-III in cells cultured from semen of two patients with AIDS." Science 1984;226(4673):449-51. Ho et al. "HTLV-III in the semen and blood of a healthy homosexual man." Science 1984;226(4673):451-3.

[3] Wofsy et al. "Isolation of AIDS-associated retrovirus from genital secretions of women with antibodies to the virus." Lancet 1986;8,1(8480):527-9.

[4] NIAID, “Relationship,” 1995.

[5] Mellors, J.W., Kingsley, L.A., Rinaldo, C.R., et al. “Quantitation of HIV-1 RNA in plasma predicts outcome after seroconversion.” Annals of Internal Medicine 122: 573-595. (1995)

[6] Roger Chou et al, “Screening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force,” Annals of Internal Medicine, 5 July 05, vol 143, #1, p 55-73. http://www.annals.org/cgi/content/full/143/1/55.

[7] Rachel Jordan et al, "Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy." BMJ 2002;324:757.

[8] NIAID citing Fischl et al, "The efficacy of azidothymidine (AZT)...." N Engl J Med. 1987 Jul 23;317(4):185-91.

[9] Schechter et al, Lancet, 1993 Mar 13;341(8846):658-9.

[10] NIAID, “Relationship,” 1995.

[11] NIAID, “Relationship,” 1995. Discussion of: Schechter MT, Craib KJ, Gelman KA, Montaner JS, et al. “HIV-1 and the aetiology of AIDS.” Lancet 1993;341:658-9.

[12] Reeves JD, Doms RW. "Human immunodeficiency virus type 2." J Gen Virol. 2002 Jun;83(Pt 6):1253-65.

[13] David Hillis, "AIDS: Origins of HIV," Science 9 June 2000, v288, #5472, p1757-1759.