HIV aids Caribbean

Combatting the Prevalence of HIV/AIDS in The Caribbean

HIV Origin and Structure

HIV aids CaribbeanHuman immunodeficiency virus (HIV) is responsible for the acquired immunodeficiency syndrome (AIDS). It is widely believed that HIV-1 and HIV-2 are the results of multiple cross-species transmissions of the simian immunodeficiency virus, which usually infects African primates (Sharp &Hahn, 2011). The transmission event that resulted in HIV took place amongst chimpanzees in Cameroon and gave rise to HIV-1 group M (Sharp & Hahn, 2011).

Both HIV-1 and HIV-2 are a part of the family of Retroviruses and in the genus of Lentiviruses. There are presently many different strains of HIV that are separated as: M for major, N for new and O for outlier groups. The virus itself is approximately 100 nm in diameter with a lipid envelope where different glycoproteins are embedded. The center of the virus contains other viral proteins and its nucleic acid.

The HIV genome consists of two identical single stranded RNA molecules. Both HIV-1 and HIV-2 can result in AIDS, however, the mechanistic differences between the two still are not completely understood. Nonetheless, HIV-2 is characterized by lower transmissibility and a reduced likelihood of progressing into AIDS (Nyamweya, et. al. 2013). HIV-2 occurs at a higher CD4 count and is mainly confined to West Africa while HIV-1 is found worldwide. The body’s immune response to HIV-2 is more protective against progression into AIDS, which provides hope that if these immune responses can be replicated in HIV-1 patients it can increase their survival rates (Nyamweya, et. al. 2013).

HIV Replication Cycle

The replication cycle of lentiviruses like HIV-1 resembles the cycle of retroviruses, however, HIVs target receptors and co-receptors are different from other retroviruses (Freed, 2001). The virus enters the body through the mucous membranes, injured skin, and by parenteral inoculation. The HIV-1 genome encodes for the major proteins. From here, the HIV RNA, reverse transcriptase, integrase and other viral proteins enter the cell. The reverse transcriptase converts the viral RNA into DNA (reverse transcription) and the integrase allows for the new viral DNA to be intertwined with the DNA of the host cell (integration). This creates new viral RNA which is then translocated into the cytoplasm of the cell via a trans-activating protein known as Rev (Freed, 2001). The new viral RNA makes more viral proteins using the cell’s resources and produces immature HIV forms. The virus develops through the help of protease, forming mature virions (Freed, 2001).

HIV Transmission

HIV can be transmitted in five ways: sexual contact with an infected partner, contact with infected blood or blood products, sharing blood contaminated needles and syringes, transmission from mother to unborn child through the placenta, and premastication – pre-chewing food for infants (Krasner, 2010). Despite the fact that HIV/AIDS is not a new disease, there is still no cure or a preventative vaccine. Infected persons are given an AIDS Cocktail or HAART (highly active antiretroviral therapy) which is a combination of drugs that usually includes two reverse transcriptase inhibitors and one protease inhibitor but can also incorporate entry and fusion inhibitors (Krasner, 2010). Although there are several biological ways to eradicate this disease, HIV/AIDS can be described as a social disease. Due to the stigma that has followed the disease since its discovery and the way we view sex in most societies, eradicating this disease will take tremendous work both biologically and socially.

The History of HIV in The Caribbean

The Caribbean, consisting of the Caribbean Sea, the North Atlantic Ocean and the island nations that reside within them are known for attracting large numbers of tourist every year. However, a closer look at these countries may reveal other statistics that describe their grapple with sexual transmitted diseases. Using geographic sequencing, scientist have developed a timeline of the origin of the HIV-1 group M subtype B, the first strand of HIV discovered and the predominant variant of the virus outside of sub-Saharan Africa (Gilbert, Rambaut, et.al, 2007). The results suggest that the subtype B likely moved from Africa to Haiti around 1966 (Gilbert, Rambaut, et.al, 2007). This virus is seen as one of the most genetically diverse subtypes and contributes to the fact that Haiti has the oldest HIV/AIDS epidemicoutside of sub-Saharan Africa. Epidemiologists believe that the virus then dispersed across the Americas through a single migration event out of Haiti around 1969 (Gilbert, Rambaut, et.al, 2007).

Today’s Concerns

Currently, HIV/AIDS exists throughout The Caribbean. Managing the disease has become difficult as the region consists of many different nations that are similar in just as many ways as they are different. This paper seeks to highlight the HIV/AIDS epidemic within The Caribbean. To begin, it is important to note that economic factors, specifically poverty levels, are often associated with the prevalence of HIV/AIDS in certain countries. Evidence shows, however, that there are factors aside from a country’s GDP that relate to their HIV/AIDS situation. For instance, The Bahamas has the highest GDP of all Caribbean countries yet has the highest rates of HIV infections. This shows that although GDP has some effect on the prevention of HIV it is not the only determining factor. If this were so, Haiti, as theCaribbean country with the lowest GDP, would have the highest rates of HIV. That being said, the intervention and funding Haiti receives from other countries has lowered its HIV rates (AIDS Healthcare Foundation, 2017). Despite this, it can be argued that sociocultural and ecological issues are more pertinent for examining the current situation of HIV/AIDS in the Caribbean. English-speaking Caribbean nations have shared sociocultural practices since they were colonized. More specifically, they share legal and religious taboos that result in stigma, shame and denial. These thoughts often inhibit safe sex practices. Additionally, they all rely heavily on the tourism industry and are known around the world as key tourist destinations which provides another useful perspective for explaining why The Caribbean struggles with HIV to such an extent.

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