Women: The New Face of AIDS

While total HIV diagnoses in the U.S. dropped from an all-time high of 150,000 cases annually in the mid-80s to 40,000 cases today, women's numbers have gone in reverse. In 1992, American women accounted for 14% of people living with AIDS; today that number has jumped to nearly 25%.

Globally, the numbers are pandemic. More adult women are living with HIV/AIDS than ever before, nearly 50% of infected people worldwide. In countries throughout the world, women are the fastest-growing population of new HIV infections, and in some places women have surpassed men. In sub-Saharan Africa, for every 10 men living with HIV, there are 14 women living with the virus.

In 2004, 78% of new HIV infections among women were the result of heterosexual contact.
And promiscuity? A recent large-scale study out of London of 59 countries found that there is no link between promiscuity and sexually transmitted diseases. Women are getting AIDS because of economic and social inequalities. Most women who contract HIV worldwide are in monogamous relationships, victimized by partners who have unprotected sex with prostitutes and then bring the disease back home, where a woman is unaware or unable to negotiate condom use. It's not promiscuity, but rather a lack of education and resources that increases the rate of HIV infection.

At home, African-American women are suffering the consequences of poverty, inadequate health care, discrimination, and unsafe sex. African-American women are 20-times more likely to contract HIV than white women, accounting for 67% of new diagnoses; white women account for 15%. Yet black women constitute 13% of the population as a whole, while white women make up 66%.

So why are women at such high risk? The answer is part biological, in that women are twice as likely as men to contract HIV during vaginal intercourse, but mostly sociological.

Hearing Aids

A hearing aid makes sounds louder (amplifies). While hearing aids may amplify some types of sounds more than others, at this time they cannot be made or programmed to amplify only one type of sound, such as a voice. Hearing aids do not restore normal hearing, but they may help people with hearing loss function and communicate more easily.

If you think you have a hearing problem and are thinking about getting a hearing aid, see your doctor. If your doctor thinks you may need a hearing aid, another type of specialist (audiologist) can help determine what type of hearing aid will work best for you. The audiologist will pick a hearing aid based on the type and how much hearing loss you have and other factors. He or she can help you learn how to get the most out of your hearing aid. In general, it usually is better to wear hearing aids in both ears, even if the hearing loss in the ears is not equal.

You also need to consider cost. Hearing aids can be expensive, and they are not always covered by insurance. Be sure to ask about a return policy, in case you are not satisfied with the hearing aid, and any warranties.

Hearing aids differ in how they look, their size, where they are placed in the ear, and how much they can amplify sounds.

All hearing aids consist of:

* A microphone, to pick up sound.
* An amplifier, to make the sound louder.
* A speaker, to deliver the sound into the ear.
* Batteries, to power the hearing aid.

The size of a hearing aid is not a good indicator of its sound quality.

There are three major types of hearing aids:

* Analog adjustable hearing aids are made based on your hearing tests. They amplify both speech and other sounds in the same amount. Your doctor has some flexibility in adjusting them to fit your hearing, and you generally control loudness. These are the least expensive type of hearing aids.
* Analog programmable hearing aids contain a computer chip that your doctor can program to take into account your hearing loss and how you respond to louder sounds. They can be programmed for different hearing environments, such as a one-on-one conversation or a dinner party in a restaurant. You change hearing programs by using a remote control.
* Digital programmable hearing aids can analyze the hearing environment and adjust to the sound. They allow more flexibility in programming than analog hearing aids. They are the most advanced and the most expensive type of hearing aid.

You can wear hearing aids behind the ear, in the outer ear, or in the ear canal. Most newer models fit in the ear or ear canal.

* All parts of a behind-the-ear (BTE) hearing aid are found in a case that fits behind the ear. The case is connected to a plastic ear mold that fits inside the outer ear. BTE hearing aids are used for all degrees of hearing loss, especially very severe hearing loss. They may be better for children because of safety and growth reasons. Poorly fitting BTE ear molds or a buildup of earwax may cause a whistling sound (feedback).
* All parts of an in-the-ear (ITE) hearing aid are found in a case that fits in the outer part of the ear. It can be used by people with mild to severe hearing loss. ITE hearing aids can be used with other hearing devices, such as a telecoil that improves hearing during phone calls. ITE hearing aids can be damaged by earwax and fluid draining from the ear, and their small size may be difficult for some people to handle. Children do not usually use them because the case must be replaced as the child grows.
* All parts of an in-the-canal (ITC) hearing aid are found in a case that fits partly or completely into the ear canal. ITC hearing aids are used by people with mild to moderate hearing loss. They are made to fit the shape and the size of your ear canal. They can be damaged by earwax and fluid draining from the ear, and their small size may be difficult for some people to handle. They are not recommended for children.

Disposable hearing aids that you use for a short period of time are now available. They last for 30 to 60 days. They may be an option for those with mild to moderate hearing loss.


It may take from several weeks to months for you to get used to your hearing aid. You may find that:

* Your hearing aid makes all sounds louder, and you may hear sounds you have not heard for a long time. Your own voice probably will sound very loud, and background noises—such as rustling newspapers, clinking silverware, and other voices—may bother you. You will have to learn to filter out unwanted sounds.
* Your hearing changes as your situation changes. How your hearing aid works will be different when talking quietly to a friend or spouse, enjoying a family dinner, or attending a presentation with a large group of people. In each situation you will have to learn how to adjust your listening.
* Your hearing aid is uncomfortable. It will feel odd in your ear at first and may cause some pain and tenderness in the ear canal. Do not feel you have to wear it 24 hours a day.
Here are some general tips to help you adjust to your new hearing aid.

* Talk to your audiologist about how long to wear your hearing aid. When you first get it, your audiologist often will recommend that you wear it 2 to 3 times a day, for 30 to 60 minutes at a time. Gradually increase the time you wear it. Overloading yourself with new sounds may result in fatigue and discomfort.
* When you first get your hearing aid, try to talk to only one person at a time, in a quiet room. This helps you adjust to the louder sounds without distractions.
* Wear your hearing aid even if you are alone. This is a good time to get used to hearing and filtering out background noise.
* To get used to your own voice, read aloud to yourself. Your voice is louder because it is closer to the hearing aids microphone.
* Adjust your hearing aid when your environment changes. For example, in meetings, sit close to the speaker so that you will be able to see him or her. Try sitting in different parts of a room until you find the spot that is best for your hearing. Change the volume of your hearing aid when necessary.

Schizophrenia: Twice As Common As HIV/AIDS

Twice as many Americans live with schizophrenia than with HIV/AIDS, but a major report by the National Alliance on Mental Illness (NAMI) reveals most Americans are unfamiliar with the disease.

"Americans are not sure what to think about schizophrenia," said NAMI executive director Mike Fitzpatrick. "They know schizophrenia is a medical illness affecting the brain, but it is largely misunderstood. There are gaps in knowledge- and access to treatment. Misinformation, mis perceptions, and misunderstanding represent a public health crisis."
Approximately two million Americans live with schizophrenia. Two-thirds do not receive treatment, even though the disease can be managed successfully.

The survey found the average age at onset was 21, but a nine-year gap exists between symptoms and treatment.

- 85% of Americans recognize schizophrenia as an illness, 79% believe that with treatment, people with the diagnosis can lead independent lives, but only 24% are familiar with it. Many cannot recognize symptoms or mistakenly believe they include "split" or multiple personalities (64%).

- 79% want friends to tell them if they have schizophrenia, but only 46% say they would themselves. Even with treatment, 49% are uncomfortable with the prospect of dating a person with schizophrenia.

- Among people living with schizophrenia, 49% said doctors take their medical problems less seriously, even though the report notes that the death rate from causes like heart disease or diabetes is 2-3 times that of the general population.

- A vast majority believe that better medications (96%) and health insurance (82%) would be most helpful to improving their condition,

- Caregivers agree better medications are needed. Approximately 80% have difficulty getting services for loved ones, 63% have difficulty finding time for themselves, and 41% have provided care for more than 10 years.

"We know what to do to increase recovery, but it requires public support, which depends on public attitudes," Fitzpatrick said.

What is hearing aid?

A hearing aid makes sounds louder (amplifies). While hearing aids may amplify some types of sounds more than others, at this time they cannot be made or programmed to amplify only one type of sound, such as a voice. Hearing aids do not restore normal hearing, but they may help people with hearing lose function and communicate more easily.

What should I do if I think I need a hearing aid?

If you think you have a hearing problem and are thinking about getting a hearing aid, see your doctor. If your doctor thinks you may need a hearing aid, another type of specialist (audiologist) can help determine what type of hearing aid will work best for you. The audiologist will pick a hearing aid based on the type and how much hearing loss you have and other factors. He or she can help you learn how to get the most out of your hearing aid. In general, it usually is better to wear hearing aids in both ears, even if the hearing loss in the ears is not equal.

You also need to consider cost. Hearing aids can be expensive, and they are not always covered by insurance. Be sure to ask about a return policy, in case you are not satisfied with the hearing aid, and any warranties.

What are the different types of hearing aids?

Hearing aids differ in how they look, their size, where they are placed in the ear, and how much they can amplify sounds. All hearing aids consist of:

• A microphone, to pick up sound.
• An amplifier, to make the sound louder.
• A speaker, to deliver the sound into the ear.
• Batteries, to power the hearing aid.

What Happens Inside the Body?

Once HIV enters the human body, it attaches itself to a White Blood Cell (WBC) called CD4. Also, called T4 cells, they are the main disease fighters of the body. Whenever there is an infection, CD4 cells lead the infection-fighting army of the body to protect it from falling sick. Damage of these cells, hence can affect a person's disease-fighting capability and general health.


After making a foothold on the CD4 cell, the virus injects its RNA into the cell. The RNA then gets attached to the DNA of the host cell and thus becomes part of the cell's genetic material. It is a virtual takeover of the cell. Using the cell's division mechanism, the virus now replicates and churns out hundreds of thousands of its own copies. These cells then enter the blood stream, get attached to other CD4 cells and continue replicating. As a result, the number of the virus in the blood rises and that of the CD4 cells declines.


Because of this process, immediately after infection, the viral load of an infected individual will be very high and the number of CD4, low. But, after a while, the body's immune system responds vigorously by producing more and more CD4 cells to fight the virus. Much of the virus gets removed from the blood. To fight the fast-replicating virus, as many as a billion CD4 cells are produced every day, but the virus too increases on a similar scale. The battle between the virus and the CD4 cells continues even as the infected person remains symptom-free.


But after a few years, which can last up to a decade or even more, when the number of the virus in the body rises to very high levels, the body's immune mechanism finds it difficult to carry on with the battle. The balance shifts in favour of the virus and the person becomes more susceptible to various infections. These infections are called Opportunistic Infections because they swarm the body using the opportunity of its low immunity. At this stage, the number of CD4 cells per millilitre of blood (called CD4 Count), which ranges between 500 to 1,500 in a healthy individual, falls below 200. The Viral Load, the quantity of the virus in the blood, will be very high at this stage.


Opportunistic infections are caused by bacteria, virus, fungi and parasites. Some of the common opportunistic infections that affect HIV positive persons are: Mycobacterium avium complex (MAC), Tuberculosis (TB), Salmonellosis, Bacillary Angiomatosis (all caused by bacteria); Cytomegalovirus (CMV), Viral hepatitis, Herpes, Human papillomavirus (HPV), Progressive multifocal leukoencephalopathy (PML) (caused by virus); Candidiasis, Cryptococcal meningitis (caused by fungus) and Pneumocystis Carinii pneumonia (PCP). Toxoplasmosis. Cryptosporidiosis (caused by parasites). HIV positive persons are also prone to cancers like Kaposi's sarcoma and lymphoma.

The Center for Disease Control (CDC), Atlanta has listed a series of diseases as AIDS-defining. When these diseases appear, it is a sign that the infected individual has entered the later stage of HIV infection and has started developing AIDS. The progression of HIV positive persons into the AIDS stage is highly individual. Some people can reach the AIDS stage in about five years, while some remain disease free for more than a decade. Measurement of the viral load and the CD4 count helps a doctor in assessing an infected person's health condition

How do some of the relevant rights apply?

To empower rights-holders to claim their rights, to protect human dignity and to prevent the transmission of HIV, the following rights should be protected so that people will come forward for HIV information, education and means of protection, and will be supported to avoid risky behaviour:

• Non-discrimination : protected against discrimination if seek help or are HIV+
• Right to privacy : protected against mandatory testing; HIV status kept confidential
• Right to liberty and freedom of movement : protected against imprisonment, segregation, or isolation in a special hospital ward
• Right to education/information : access to all HIV prevention education and information and sexual and reproductive health information and education
• Right to health : access to all health care prevention services, including for sexually transmitted infections, tuberculosis, voluntary counseling and testing, and to male and female condoms

Vulnerable populations

Depending on the legal and social situation and the nature of the epidemic in country, some groups may be more vulnerable to infection and impact because of their legal status or lack of human rights protection, e.g. women, children, minorities, indigenous people, poor people, migrant-workers, refugees, sex workers, people who use drugs, men having sex with men, and prisoners.

These groups should have equal access to HIV prevention information, education, and commodities, and to HIV care, support and anti-retroviral treatment; should not be subject to sexual violence or coercion, where applicable; and should be able to participate in the formulation and implementation of HIV and AIDS policies that affect them.

• Non-discrimination/equality before the law : same access as others to services
• Rights to education and health : same access to HIV prevention education and information, and health care services, including STI services and condoms
• Liberty , security of person and freedom from cruel, inhuman and degrading treatment : freedom from violence, including sexual violence, freedom from mandatory testing
• Right to participate in public life : participation in the formulation and implementation of HIV policy

For those living with HIV or otherwise affected by it, the following rights should be protected:

• Non-discrimination and equality before the law : right not to be mistreated on the basis of health status, i.e. HIV status
• Right to health : right not to be denied health care/treatment on the basis of HIV status
• Right to liberty and security of person : right not to be arrested and imprisoned on the basis of HIV status
• Right to marry and found a family , regardless of HIV status
• Right to education : right not to be thrown out of school on the basis of HIV status
• Right to work : right not to be fired on the basis of HIV status
• Right to social security, assistance and welfare : right not to be denied these benefits on the basis of HIV status
• Right to freedom of movement , regardless of HIV status
• Right to seek and enjoy asylum , regardless of HIV status

Human rights and HIV

The risk of HIV infection and its impact feeds on violations of human rights, including discrimination against women and marginalized groups such as sex workers, people who inject drugs and men who have sex with men. HIV also frequently begets human rights violations such as further discrimination and violence. Over the past decade the critical need for strengthening human rights to effectively respond to the epidemic and deal with its effects has become evermore clear. Protecting human rights and promoting public health are mutually reinforcing.

Several countries still have policies that interfere with the accessibility and effectiveness of HIV-related measures for prevention and care. Examples include laws criminalizing consensual sex between men, prohibiting condom and needle access for prisoners, and using residency status to restrict access to prevention and treatment services. At the same time, laws and regulations protecting people with HIV from discrimination are not enacted, or fully implemented or enforced.

Reforming laws and policies that are based in deeply-rooted social attitudes and norms such as gender inequality requires multisectoral collaboration. Although not sufficient to change social attitudes, legislation is important for addressing acts of discrimination. Civil society, including organizations of people living with HIV, as well as other parts of society, including police and justice systems, have a critical role to play. International organizations and donors can also play a positive role in support of local and national actors.

The protection of human rights, both of those vulnerable to infection and those already infected, is not only right, but also produces positive public health results against HIV. In particular, it has also become increasingly clear that:

• National and local responses will not work without the full engagement and participation of those affected by HIV, particularly people living with HIV.
• The human rights of women, young people and children must be protected if they are to avoid infection and withstand the impact of HIV.
• The human rights of marginalized groups (sex workers, people who use drugs, men who have sex with men, prisoners) must also be respected and fulfilled for the response to HIV to be effective.
• Supportive frameworks of policy and law are essential to effective HIV responses.

UNAIDS works to help enable States to meet their human rights obligations, and to empower individuals and communities to claim their rights in the context of the HIV epidemic.

Human Rights and Universal Access: What have Governments committed themselves to?

To ensure the full enjoyment of all human rights and fundamental freedoms by people living with HIV and members of vulnerable groups; promoting access to HIV education and information; full protection of confidentiality and informed consent; intensifying efforts to ensure a wide range of prevention programmes, including information, education and communication, aimed at reducing risk-taking behaviours and encouraging responsible sexual behaviour, including abstinence and fidelity; expanded access to essential commodities, including male and female condoms and sterile injecting equipment; harm-reduction efforts related to drug use; expanded access to voluntary and confidential counselling and testing; safe blood supplies; and early and effective treatment of sexually transmitted infections; developing strategies to combat stigma and social exclusion connected with the epidemic.