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42 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 7 education PATHOLOGY PERSPECTIVES HIV and AIDS: What You Need to Know By Ruth Werner When I started massage school, I bought a used medical dictionary to have on hand for those pre-Google moments when I might need to look up something. After all, how often does medical terminology change, right? The terms HIV and AIDS do not appear in that 1981 text. In fact, the term AIDS wasn't even proposed by the Centers for Disease Control and Prevention until September 1982. Since then, the virus has killed hundreds of thousands of Americans, and millions of people around the world. In this Pathology Perspectives column, we will review the basic technical information about how infection with the human immunodeficiency virus (HIV ) leads to a disease called acquired immune deficiency syndrome (AIDS). We'll look at how these conditions are treated and where massage therapy fits in these contexts. A more philosophical discussion about these conditions, persistent myths about them, and their interface with the massage therapy profession can be found in "HIV AIDS: Up-To-Date Truths for MTs" (page 52). DEFINING IT HIV is a pathogen—a retrovirus called human immunodeficiency virus. A retrovirus is a virus built around RNA (ribonucleic acid), rather than DNA (deoxyribonucleic acid). Retroviruses have to transcribe into DNA before they can replicate inside a host cell, a fact that turns out to be very important in HIV and AIDS treatment. AIDS is a collection of signs and symptoms related to a failure of some specific immune system responses. This condition is the eventual consequence of infection with HIV, if viral replication is not interrupted adequately. BY THE NUMBERS Worldwide, almost 38 million people are HIV positive and almost 2 million of those infections are in children, who were probably infected prenatally or shortly postpartum. There are about 2.1 million new infections a year around the globe, and about 150,000 of those are in young children. Each year, we see some 1.5 million deaths around the world. In all that suffering and sadness, most of what we now understand about how the immune system works comes by way of studying this pathogen. In the United States, about 1.2 million people are HIV positive, but about 13 percent of those don't know their status. An estimated 40,000 new infections occur each year in this country (a decrease of 19 percent since 2005), and this infection leads to some 12,000 deaths each year. Gay and bisexual men are the most- affected group, comprising about 67

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