SODeL

JKUAT

JOMO KENYATTA UNIVERSITY

OF
AGRICULTURE & TECHNOLOGY

SCHOOL OF OPEN, DISTANCE AND eLEARNING

P.O. Box 62000, 00200
Nairobi, Kenya
E-mail: elearning@jkuat.ac.ke
SZL 2111: HIV/AIDs

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LAST REVISION ON March 27, 2013

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SZL2111 HIV/AIDs
This presentation is intended to covered within one week.
The notes, examples and exercises should be supplemented with a good textbook. Most of the exercises have
solutions/answers appearing elsewhere and accessible by
clicking the green Exercise tag. To move back to the same
page click the same tag appearing at the end of the solution/answer.

Errors and omissions in these notes are entirely the responsibility of the author who should only be contacted
through the Department of Curricula & Delivery
(SODeL) and suggested corrections may be e-mailed to
elearning@jkuat.ac.ke.
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SZL2111 HIV/AIDs

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SZL2111 HIV/AIDs
SZL 2111: HIV/AIDs

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Course Description

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General introduction: Public health and hygiene, human reproductive system, sex and sexuality. History of sexually transmitted diseases (STDs); History of Human Immunodeciency virus/
Acquired Immune deciency Syndrome (HIV/AIDS), Comparative information on trends, global and local distribution, Justication of importance of course. Biology of HIV/AIDS; Overview
of immune system, natural immunity to HIV/AIDS. The AIDS
virus and its life cycle, disease progression, transmission and
diagnosis. Discordant couples. Treatment and Management;
nutrition, prevention and control; Abstain, Be faithful, Condom
use, Destigmatize HIV/AIDS (ABCD) methods and antiretro4

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viral drugs and vaccines. Pregnancy and AIDS. Management of
HIV/ AIDS patients. Social and cultural practices: Religion and
AIDS. Social stigma on HIV/AIDS. Behavioral change. Voluntary Counseling and Testing Services. Gender and HIV/AIDS.
Drug and alcohol abuse and HIV/AIDS. Poverty and AIDS.
Families and AIDS orphans. Government policies: Global policies of AIDS. Legal rights of AIDS patients. AIDS Impact: Family /society setup, population, agriculture, education, health,
industry, development, economy and other sectors.
Prerequisite: none

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Course aims

1. To bring about behavioral change

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2. To prevent HIV/AIDS and reduce the threat it poses to
youth/students

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3. To promote HIV/AIDS education as a means of producing

better and more integrated sense of health education in the
student
Learning outcomes

Upon completion of this course you should be able to know;

1. Biology of HIV
2. Transmission of HIV
3. Disease progression and symptoms

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4. Treatment of HIV/AIDs Various strategies of managing of

HIV/AIDs
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5. How to prevent and control of HIV/AIDs
6. Social and cultural practices that contribute to spread of
HIV/AIDs
7. Policies and rights of people living with HIV/AIDs

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8. Implications of HIV/AIDs on various sectors

Instruction methodology
Lectures: oral presentation generally incorporating addi-

tional activities e.g writing on chalk board, exercises, class

questions and discussions or student presentation.
Tutorials to give the students more attention.

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Assignments and Demonstrations.

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Assessment information
The module will be assessed as follows;
10% of marks from two (2) assignments to be submitted
online

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20% of marks from two written CAT to be administered

at JKUAT main campus or one of the approved centres

70% of marks from written Examination to be adminis-

tered at JKUAT main campus or one of the approved centres

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Contents

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1 GENERAL INTRODUCTION
1.1 Introduction . . . . . . . . . . . . . . . . . . . .
1.2 Justication of the course . . . . . . . . . . . .
1.2.1 Reasons for HIV/AIDS education/ why
train in HIV/AIDS . . . . . . . . . . . .
1.3 Denition of Terminologies . . . . . . . . . . . .

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1.4 Public Health and Hygiene . . . . . . . . . . . .
1.4.1 Public health programs may include: . . .

Vaccination . . . . . . . . . . . .

Rural and Urban Health Clinics

Disease Tracking and Epidemiology . . . . . . . . . . . . . . .

Sanitation and Pollution Control

. . . . . . . . . . . . . . . . . .

Medical Research . . . . . . . .

Public Education Campaigns . .

1.5 Types of HIV . . . . . . . . . . . . . . . . . . . .
1.6 Origin, Theories and History of HIV/AIDS . . .
1.6.1 Mysterious origins . . . . . . . . . . . . .
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1.6.2 Religious Theories (God's wrath and witch
craft) . . . . . . . . . . . . . . . . . . . .
1.6.3 Monkey origin theories . . . . . . . . . . .

Hunter theory . . . . . . . . . .

Oral Polio Vaccine (OPV) theory . . . . . . . . . . . . . . . .

The contaminated needle vaccine

. . . . . . . . . . . . . . . . . .

The colonialism theory . . . . .

1.6.4 The conspiracy theory . . . . . . . . . . .
1.6.5 The calculated theory . . . . . . . . . . .
Solutions to Exercises . . . . . . . . . . . . . . . .

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LESSON 1
GENERAL INTRODUCTION

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Learning outcomes

Upon completing this topic, a student should be able to:

Dene of terms related to HIV/AIDS
Understand the meaning of public health and its role in

disease infection
Understand origins, theories and history of HIV/AIDS
Know various types of HIV
Global distribution and trends of HIV/AIDS

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1.1. Introduction

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HIV/AIDS is the worst pandemic the world has experienced in

the last half of the 20th century. It has decimated whole population of people in certain region. If one becomes infected with
HIV, the virus begins to attach the immune system. A person infected with HIV can look and feel perfectly well for many
years and may not even know they are infected. Over a period
of time, it is highly likely that HIV will damage the immune
system and when this happens, one become vulnerable to illness
often referred to as opportunistic infections that a healthy immune system would usually be able to ght o, and this leads to
a condition known as AIDS - Acquired Immunodeciency Syndrome. AIDS is a collection of infections (usually severe) and
cancers that may develop in people who are HIV positive. A per13

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son is said to have AIDS when they have developed one of these
specic illness, this is usually after a signicant period of time
often many years. Some people will receive an AIDS diagnosis
when their T-cell count drops below 200 copies per cubic ml of
blood. The eects that HIV infection may have on an individual vary dramatically. At one end of the spectrum a person may
remain very well with virtually no ill eects. At the other end of
the spectrum a person may have an AIDS diagnosis and develop
a life threatening opportunistic infection. Currently there is no
cure or vaccine for HIV/AIDS. Once a person contracts HIV,
they will remain infected with the virus for life and are able to
transmit the virus to others.

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1.2. Justication of the course

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Education is an important component of preventing the spread

of HIV. Aims of HIV/AIDS training,
To prevent new infections from taking place. i.e.

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 By giving people information about HIV - what HIV

and AIDS are, how they are transmitted, and how
people can protect themselves from infection.
 Teaching people how to put this information to use
and act on it practically for e.g. how to get and use
condoms, how to suggest and practice safer sex, how
to prevent infection in a medical environment or when
injecting drugs.
To improve quality of life for HIV positive people i.e. by -

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 Enabling and empowering them to improve their quality of life.
 To be able to access medical services and drug provision
 To be able to nd appropriate emotional and practical support and help
 Teaching them about the importance of not passing
on the virus
To reduce stigma and discrimination.- Discrimination against

positive people can help the AIDS epidemic to spread

To help people focus upon the person than the disease and

be more caring to the person.

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To provide knowledge on modes of transmission especially

to those aected and how to cope with the infected.

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To initiate and sustain behavior changes necessary to reduce the rate of developing infections through safer sex
practices.

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1.2.1. Reasons for HIV/AIDS education/ why train in

HIV/AIDS

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HIV infection is lifelong and there is no cure

HIV is infectious, and those infected will remain infectious

throughout their lives.

Fear arises from uncertainty of unpredictable medical conditions and reactions of people especially of those close to
them.
Information and knowledge is incomplete about HIV care
and prevention and at times even conicting.
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The infected and aected are likely to have abroad of physical, psychological and social needs which may need adjustments e.g. nances.
Good management can contain some of these problems,

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early identication and intervention.

It provides knowledge needed to initiate and sustain change

in risky behavior.
It helps the infected nd a new or perhaps dierent ap-

proach to using safer sex and responsible social relationships.

It helps those who are infected to leave with the infection.

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1.3. Denition of Terminologies

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Any specialized eld of study has some terms (jargon) that only
professional in that eld comprehend clearly their meaning with
reference to the subject. HIV/AIDS education is a subject that
has borrowed heavily from medical sciences and therefore learners need to familiarize themselves with some terms that are commonly used in the subject
1. Rate - This is the amount of something in relation to something else shown as a proportion or percentage. Often it
reects the idea of specic time. For example, imagine that
10,000 cases of AIDS have been reported to the ministry of
health over the past ten years. You could tell someone this
information alone, or you could say that the country only
has a population of 100,000 people, and the rate of AIDS
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is 0.1, or 10% (10,000 cases divided by 100,000 people).

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2. Incidence-This is how often new cases of a disease appear

in a population during a set period of time, usually one
year. For example, if you wanted to know the incidence of
HIV in a village, you could test all the people in the village
and record that information as your baseline. Then test
all of the same people one year later. Count the number
of people who did not have HIV during the rst test but
did have the virus during the second test. Divide this
number by the total number of uninfected people in the
village. The result is the incidence of HIV in this village
(the number of new infections per person per year).
3. Prevalence - This is the proportion of people who have
a disease in a community at any one point in time. In
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the example above, the prevalence of HIV would be 10%
the rst year (100 cases among 1,000 people living in the
village) and 15% the second year (150 cases among 1,000
people living in the village).

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4. Bias-This occurs when an unexpected factor aects the

results of a study. For example, imagine you want to nd
out how many pregnant women in your town have HIV.
You test all the pregnant women who come to your medical
clinic over a three-month period. Since people with HIV
are more likely to be sick and come to the clinic, and you
tested all pregnant women who came to the clinic, you
will nd more women with HIV than if you tested every
pregnant woman in the town. Testing only sick pregnant
women inuenced your results. Your study was aected by
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bias. Bias can happen even when you are trying to avoid
it. If you ask questions with a tone that tells people that
you want them to answer in a certain way, you can bias
your results. For example, if you want to know how many
people inject drugs but ask, You do not use those illegal,
deadly drugs do you? then fewer people will answer yes
than really do use drugs. Your results will be biased.
5. Endemic - This term describes characteristic of a particular place or among a particular group or area of interest
or activity. From disease point of view, the term is used
to describe a disease occurring within a specic area, region, or locale e.g. Malaria is endemic in a lot of Africa
countries. The term can also be used to describe a species
of organism that is conned to a particular geographical
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region, for example, an island or river basin.

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6. Epidemic - This is an outbreak of a disease that spreads

more quickly and more extensively among a group of people than would normally be expected. Among the diseases
that have occurred in epidemic proportions throughout
history are bubonic plague, inuenza, smallpox, typhoid
fever, tuberculosis, cholera, bacterial meningitis, and diphtheria. Occasionally, childhood diseases such as mumps
and German measles become epidemics.
7. Epidemiology-This is the study of the incidence and distribution of diseases in large populations, and the conditions
inuencing the spread and severity of disease. For example
in the study of the acquired immunodeciency syndrome
(AIDS) epidemic in the early 1980s, both the National
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Cancer Institute (U.S.) and the Pasteur Institute (France)
reported discovering that a retrovirus which came to be
known as the human immunodeciency virus (HIV) was
the main cause of the disease.

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8. Pandemic - a widespread epidemic that aects people in

many dierent countries, across several continents e.g. HIV/AID
1.4. Public Health and Hygiene

Public Health is the protection and improvement of the health

of entire populations through community wide action, primarily
by governmental agencies. Most people think of public health
workers as physicians and nurses, but a wide variety of other
professionals work in public health, including veterinarians, sanitary engineers, microbiologists, laboratory technicians, statisti24

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cians, economists, administrators, attorneys, industrial safety
and hygiene specialists, psychologists, sociologists, and educators. Public health workers engage in activities outside the scope
of ordinary medical practice and these include inspecting and
licensing restaurants; conducting rodent and insect control programs; and checking the safety of housing, water, and food supplies etc. Hygiene is the science dealing with the preservation of
health or the practice or principles of cleanliness. In the public
domain, Public health ocers mainly manage this practice.
1.4.1. Public health programs may include:

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Vaccination
This is the process of making the body resistant to a specic disease by using a vaccine (a chemical that stimulates the body to
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create antibodies to ght a specic infectious organism). Vaccination programs protect people against disease such as measles,
mumps, diphtheria, and other childhood infectious diseases. When
small outbreaks of infectious disease threaten to grow into epidemics, public health ocials may initiate new vaccination programs.

Rural and Urban Health Clinics

Public health agencies operate local clinics that provide free or
reduced-cost medical services to individuals, especially infants
and children, pregnant and nursing women, people with drug
abuse problems, physical disabilities, and other conditions. Public health clinics routinely screen patients for a number of infectious diseases and may provide free treatment if patients test
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positive. Each clinic tracks the incidence of certain communicable diseases in its area, and reports this information to national
and international public health oces.

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Disease Tracking and Epidemiology

Threats to public health concerns change over time and epidemiologists and other ocials continuously evaluate epidemiological trends to determine how best to meet future public health
needs. Epidemiologists and other public health ocials attempt
to break the chain of disease transmission by notifying people
who may be at risk for contracting an infectious disease. Public
health ocials may also ensure that infected people complete
treatment programs, so that the diseases are completely eliminated and the patients are no longer carriers of the infection.
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Sanitation and Pollution Control
Disease-causing organisms are often transmitted through contaminated drinking water. The single most eective way to
limit water-borne diseases is to ensure that drinking water is
clean and not contaminated by sewage. Public health ocials
establish sewage disposal and solid waste disposal systems, and
regularly test water supplies to ensure they are safe. Public
health programs establish and enforce laws for safe food storage and preparation;food-safety guidelines established by public
health ocials.

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Medical Research
Another component of public health is scientic and medical research. Cadres of doctors and scientists work in laboratories to

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establish new ways to prevent, diagnose, treat, and cure disease
and disability. Scientists and doctors employed by the government conduct some biomedical research in public health facilities
to nd better ways to protect human health.

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Public Education Campaigns

Many diseases are preventable through healthy living, and a
primary public health goal is to educate the general public about
how to prevent non-infectious diseases. Health promotion also
encourages people to take advantage of early diagnostic tests
that can make the outcome of disease more favourable e.g. early
detection of breast cancer, for instance, increasing the chances of
a cure. Detection and proper treatment of high blood pressure
reduces the risk of a stroke, the leading cause of permanent
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disability in older people.

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1.5. Types of HIV

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There are 2 main types of HIV: - HIV-1 &HIV-2. Both types are
transmitted by sexual contact, through blood & from motherto-child. They both appear to cause clinically indistinguishable
AIDS. HIV-2 is less easily transmitted & the period between
initial infection & illness is longer. Its uncommon & conic. in
W.Africa. E.g. Senegal, Ghana, Mali, Burkina Faso, Ivory
Coast. Most HIV-2 reported in Brazil, Angola, Mozambique
and Portugal can be traced back to W. African contact. HIV-1
is the predominant virus world wide & generally when people
refer to HIV without specifying the type they refer to HIV-1.
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HIV-1 subtypes
1. Group M (major)
2. Group N (new)

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3. Group O (outlier)
The 3 groups may rep separate introduction of SIV into humans
Group O appears to be restricted to West-central Africa
Group N was discovered in 1998 in Cameroon & is ex-

tremely rare.
More than 90% of HIV-1 infections belong to group M
There are at least 9 subtypes within group M. They include

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A, B, C, D, F, G, H, J, and K.
 HIV1A - found across west east axis from Ivory Coast
to Djibouti via Kenya
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 HIV1B - found in Thailand, Europe and S.America
 HIV1C - found in East Africa, Botswana and South
Africa and is the commonest subtype globally accounting for 50%
 HIV1D - found in Congo, Kenya, Rwanda, Burundi,
Tanzania and Uganda
 HIV1E - found in Thailand, Cameroon, Central African
Republic and Congo
 HIV1F - found in Cameroon and Congo
 HIV1G - found in Congo and Gabon
 HIV1H, J, K - are rear but found in African continent.
In Kenya we have subtypes A, C, and D and this makes

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our country to be ranked amongst the leading countries

with the highest HIV infections.
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Remark. CRFs - Circulating Recombinant forms - Occasionally 2 viruses of di subtypes can meet in the cell of an
infected person & mix together its genetic material to create a
new hybrid virus in a process similar to sexual reproduction &
sometime called viral sex. Many of these strains don't survive
for long but those that infect more than one person are known
as CRFs. E.g. CRF A/B is a mixture of subtype A&B.
1.6. Origin, Theories and History of HIV/AIDS

The origin of AIDS and HIV has puzzled scientists ever since
the illness rst came to light in the early 1980s. For over twenty
years it has been the subject of debate and the cause of countless
arguments, with everything from a promiscuous ight attendant
to a suspect vaccine program being blamed. The rst recognized
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cases of AIDS occurred in the USA in the early 1980s In 1981.
The virus was discovered among homosexuals in the USA. A
number of gay men in New York and San Francisco suddenly
began to develop rare opportunistic infections and cancers that
seemed stubbornly resistant to any treatment. They presented
with a syndrome which included mouth rash, skin problems e.t.c.
At this time, AIDS did not yet have a name, but it quickly
became obvious that all the men were suering from a common
syndrome. Their bodies immunity was weakened and completely
suppressed. Medics wrote their investigations in a journal. In
1983, it was discovered that the symptoms that were earlier
observed were caused by a certain virus called immunodeciency
virus and it was suppressing the immune system. In 1986, it
became clear that the virus discovered in 1981 was spreading

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fast and many people suered from the same condition. In 1986,
in West Africa, another virus was discovered & they called it
immunodeciency virus type2. The discovery of HIV, the Virus
that causes AIDS was made soon after. In Kenya, the 1st case
was noted in 1983 in KNH & it was noted that the body of
the patient had low immunity. From 1981 to date the disease
has claimed 22m lives & is still spreading. There is now clear
evidence to prove that HIV does cause AIDS. So, in order to
nd the source of AIDS, it is necessary to look for the origin
of HIV, and nd out how, when and where HIV rst began to
cause disease in humans. When and where the HIV virus rst
emerged is probably going to remain a mystery for many years
to come. While several theories have been put forward, there
is no conclusive single agreement on the origin of HIV/AIDS.

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Some of the mostly acknowledged theories about the origin of
HIV include:
Mysterious origins .
The tail of the comet theory

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Religious theories (God's wrath and witch craft)

Monkey origin theories
Conspiracy theories
The calculation theory

1.6.1. Mysterious origins

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This theory tries to account for the seemingly mysterious origin

of HIV by locating it out of this world. It suggests that viral
material was carried in the tail gases of a comet passing close
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to the earth and that this material was deposited, subsequently
infecting nearby people. Although famous astronomer's names
have been linked to this theory in the popular press, these scientists deny the possibility of this extraterrestrial phenomena and
any personal connection to the theory.
1.6.2. Religious Theories (God's wrath and witch craft)

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Certain segments of the population have openly stated that their

belief that AIDS is God's wrath since the Scriptures condemn
the homosexual practice in which AIDS was rst observed in the
Western world. If one adds to this belief the mysterious origin
of the virus, and the apparently hopeless prospects for a cure,
it will readily be understood how many have come to believe
in Divine intervention, with AIDS being God's way of destroy-

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ing sinners. If this were so, it would be dicult to see why
God, after watching over thousands of years of vastly diering
sins, should suddenly decide to settle His score with homosexuals and drug addicts rather than any other sinners. The Bible
clearly speaks of a future (and imminent) judgment time when
all sinners no matter what their specic practice will have to
pay the penalty for their sins. It does not tell, however, of a
God who prejudges particular situations and who picks out special groups for early condemnation. Clearly, there are God-given
laws which govern the harmonious interaction of body, mind and
spirit. The origin of HIV/A1DS may be traced to an abuse of
some of those laws pertaining to the physical and emotional or
moral development of man and the presence of sin in the world.
It should be recognized that once the process has started, guilty

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and innocent suer alike nowhere is this more obvious or more
poignant than in the AIDS pandemic. Rather than its being
considered a visitation from God, many Africans believe that
AIDS is caused by another supernatural power-witchcraft and
they use anti-witchcraft rituals and objects to counteract the
infection.
1.6.3. Monkey origin theories

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HIV is a lentivirus that attacks the immune system. Lentiviruses

are in turn part of a larger group of viruses known as retroviruses. lentivirus means slow virus because they take such a
long time to produce any adverse eects in the body and have
been found in a number of dierent animals, including cats,
sheep, horses and cattle. The lentivirus of interest in terms of

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the investigation into the origins of HIV is the Simian Immunodeciency Virus (SIV) that aects monkeys. It is generally
thought that HIV is a descendant of a Simian Immunodeciency
Virus because certain strains of SIVs bear a very close resemblance to HIV-1 and HIV-2, the two types of HIV For example,
HIV-2 corresponds to SIVsm, a strain of the Simian Immunodeciency Virus found in the sooty mangabey (also known as
the green monkey), which is indigenous to western Africa. HIV1, was until recently more dicult to place. Until 1999, the
closest counterpart that had been identied was SIVcpz, found
in chimpanzees, but this virus still had certain signicant dierences from HIV-1. Below are some of the most common theories
about how this zoonosis took place, and how SIV became HIV
in humans. Zoonosis- viral transfer between animals & humans

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Hunter theory
The most commonly accepted theory is that of the hunter. In
this scenario, SIV cpz was transferred to humans as a result of
chimps being killed and eaten or their blood getting into cuts or
wounds on the hunter. Normally the hunter's body would have
fought o SIV, but on a few occasions it adapted itself within
its new human host and become HIV-1. Discoveries such as this
have lead to calls for an outright ban on bush meat hunting to
prevent simian viruses being passed to humans.

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Oral Polio Vaccine (OPV) theory

That HIV was transferred via medical experiments. That HIV
could be traced to the testing of an oral polio vaccine called
Chat, given to about a million people in the Belgian Congo,

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Ruanda and Urundi in the late 1950s. To be reproduced, live polio vaccine needs to be cultivated in living tissue, and Hooper's
belief is that Chat was grown in kidney cells taken from local chimps infected with SIV cpz. This, he claims, would have
resulted in the contamination of the vaccine with chimp SIV,
and a large number of people subsequently becoming infected
with HIV-1. However, in February 2000 the Wistar Institute
in Philadelphia (one of the original places that developed the
Chat vaccine) announced that it had discovered in its stores a
phial of polio vaccine that had been used as part of the program. The vaccine was subsequently analysed and in April 2001
it was announced that no trace had been found of either HIV or
chimpanzee SIV. A second analysis conrmed that only macaque
monkey kidney cells, which cannot be infected with SIV or HIV,

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were used to make Chat. While this is just one phial of many,
most have taken its existence to mean that the OPV vaccine
theory is not possible. The fact that the OPV theory accounts
for just one (group M) of several dierent groups of HIV also
suggests that transferral must have happened in other ways too.
The nal element that suggests that the OPV theory is not credible as the sole method of transmission is the argument that HIV
existed in humans before the vaccine trials were ever carried out.

The contaminated needle vaccine

This is an extension of the original hunter theory. In the 1950s,
the use of disposable plastic syringes became commonplace around
the world as a cheap, sterile way to administer medicines. However, to African healthcare professionals working on inoculation
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and other medical programmes, the huge quantities of syringes
needed would have been very costly. It is therefore likely that
one single syringe would have been used to inject multiple patients without any sterilisation in between. This would rapidly
have transferred any viral particles (within a hunter's blood for
example) from one person to another, creating huge potential
for the virus to multiply in each new individual it entered, even
if the SIV within the original person infected had not yet converted to HIV.

The colonialism theory

The colonialism or Heart of Darkness theory is one of the more
recent theories to have entered into the debate. It is again based
on the basic hunter premise, but more thoroughly explains how
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this original infection could have lead to an epidemic. During
the late 19th and early 20th century, much of Africa was ruled
by colonial forces. In areas such as French Equatorial Africa
and the Belgian Congo, colonial rule was particularly harsh and
many Africans were forced into labor camps where sanitation
was poor, food was scare and physical demands were extreme.
These factors alone would have been sucient to create poor
health in anyone, so SIV could easily have inltrated the labor
force and taken advantage of their weakened immune systems
to become HIV. A stray and perhaps sick chimpanzee with SIV
would have made a welcome extra source of food for the workers. Moore also believes that many of the laborers would have
been inoculated with unsterilized needles against diseases such
as smallpox (to keep them alive and working), and that many

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of the camps actively employed prostitutes to keep the workers
happy, creating numerous possibilities for onward transmission.
1.6.4. The conspiracy theory

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Some say that HIV is a conspiracy theory or that it is manmade. A recent survey carried out in the US for example, identied a signicant number of African Americans who believe
HIV was manufactured as part of a biological warfare program,
designed to wipe out large numbers of black and homosexual
people. Many say this was done under the auspices of the US
federal Special Cancer Virus Program (SCVP), possibly with the
help of the CIA. Some even believe that the virus was spread
(either deliberately or inadvertently) to thousands of people all
over the world through the smallpox inoculation program, or to

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gay men through Hepatitis B vaccine trials.
1.6.5. The calculated theory

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Opponents of the monkey theories argue that viral sequencing

of HIV strains indicate that HIV has been around probably for
hundreds of years. This is latest theory on the origin of HIV
when a team of scientists using computer technology to study
the structure of HIV calculated the rate at which the virus mutates for the HIV viral sub-bytes to have a common ancestor.
This process revealed that HIV originated around 1930 in rural
areas of Central Africa, where the virus may have been present
for many years in isolated communities. The virus probably
did not spread because members of these rural communities had
limited contact with people from other areas. But in the 1960s

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and 1970s, political upheaval, wars, drought, and famine forced
many people from these rural areas to migrate to cities to nd
jobs. During this time, the incidence of sexually transmitted infections, including HIV infection, accelerated and quickly spread
throughout Africa. As world travel became more prevalent, HIV
infection developed into a worldwide epidemic. Studies of stored
blood from the United States suggest that HIV infection was well
established there by 1978. Rather than acquiring HIV from SIV
it is thought that HIV mutated to become ever more infectious.
We will probably never know exactly when and where the virus
rst emerged, but what is clear is that sometime in the middle
of the 20th century, HIV infection in humans develop and into
the epidemic of disease around the world that we now refer to
as AIDS.

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Learning Activities
1. Read more papers and journal articles on current
advances in HIV/Aids research. Visit the reproductive health
clinic/ section in a hospital around you and get to learn various
methods used to control HIV/Aids and other STIs.

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Remark

Example . Give an account of the limitations of Oral Polio

Vaccine Theory as a possible explanation to the origin of HIV?

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: The vaccine used in the program then was discovered

in the stores of the original place that developed it. This was
subsequently analyzed. It was announced that no trace had
been found of either HIV or chimpanzee SIV. A second analysis
conrmed that only macaque monkey kidney cells, which cannot
be infected with SIV or HIV, were used to make Chat and not

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chimpanzee's as earlier suggested. While this is just one phial
of many, most have taken its existence to mean that the OPV
vaccine theory is not possible. The fact that the OPV theory
accounts for just one (group M) of several dierent groups of
HIV also suggests that transferal must have happened in other
ways too. The nal element that suggests that the OPV theory
is not credible as the sole method of transmission is the argument
that HIV existed in humans before the vaccine trials were ever
carried out.

Revision Questions
Exercise 1.

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 Describe the dierence between HIV and AIDS?

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Assignments

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1. Comprehensively discuss the global distribution and trends

of HIV/Aids. Narrow down specically to Kenya and use
current data and information.

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2. Discuss myth associated with HIV/Aids in your community.

References and Additional Reading Materials

1. Maranga R. O, Muya S. M and Ogila K. O (2008) Fundamentals of HIV/AIDS Education. Signon Publishers.
2. Barry D. S. (1999) AIDS and HIV in Perspectives. CPU.
ISBN-13: 9780521627665
3. Ellison G. Parker M., Camphpbell C (2003) Learning from
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HIV and AIDS. Cambridge CPU.ISBN-13: 9780521709286.

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4. Shavitri Ramaiah (2008) HIV/AIDS; Health solutions. Sterling Publishers Ltd. ISBN-9788120733305.

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Solutions to Exercises
Exercise 1. HIV is the human immunodeciency virus that
causes AIDS (acquired immunodeciency syndrome). When
HIV infects someone, the virus enters the body and begins to
multiply and attack immune cells that normally protect us from
disease. It's only when someone with HIV begins to infections
and illnesses that they're diagnosed with AIDS.
Exercise 1

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