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Summary of the Current Local Epidemic

With 9,290 cumulative AIDS cases diagnosed as of December 31, 2004, the Oakland EMA has the 21st largest number of cumulative diagnosed AIDS cases of any U.S. metropolitan area, and a cumulative AIDS caseload larger than that of 18 U.S.states. Alameda County alone has the 4th highest number of reported AIDS cases by major counties in the State of California for 2005, while Contra Costa County ranks 10th in relation to other counties. Oakland also has the 18th highest reported cumulative AIDS caseload out of 107 metropolitan areas listed by the US Centers for Disease Control and Prevention (CDC).

Between January 1, 2003 and December 31, 2004 alone - the most recent two-year period for which figures are available - a total of 570 new cases of AIDS were diagnosed in the Oakland EMA, according to CDC reports. The ethnic composition of these new AIDS cases was 47.28% Black; 19.33% Hispanic; 3.16% Asian/Pacific Islander; 0.35% Native American; 0.35% multi-racial; and 29.53% White. The percentages of new AIDS cases among people of color are much higher than these populations' representation within the general population (see Figure 1 below). African Americans in particular are highly disproportionately represented, with new AIDS case rates nearly four times higher than their representation in the overall community.

Comparison of Oakland EMA Ethnicity Percentages - Total Population and AIDS Case Rates

As of December 31, 2004, the CDC reports that there were 3,666 people living with AIDS (PLWA) in the Oakland EMA. The ethnic / racial composition of this population was 43.44% Black; 13.58% Hispanic; 3.36% Asian/Pacific Islander; 0.36% Native American; 0.16% multi-racial; 39.02% White; and 0.08% Unknown. Of all persons ever diagnosed with AIDS in the target region, 40% are still living with the disease.

Additionally, an estimated 4, 5644 persons are believed to be living with HIV but not yet diagnosed with AIDS as of December 31, 2004. The Ethnic composition of this population is estimated to be 44.5% Black; 12.2% Hispanic; 3.7% Asian/Pacific Islander; 0.3% Native American; 0.1% Multi-racial; and 38.1% White. This means that an estimated combined total of 8,230 individuals were living with HIV and/or AIDS in the two counties of the Oakland EMA as of December 31, 2004.

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What is the difference between HIV and AIDS?

HIV is the virus that causes AIDS.

H - Human: because this virus can only infect human beings.
I - Immune-deficiency: because the effect of the virus is to create a deficiency, or a failure to work properly, within the body's immune system.
V - Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.

A - Acquired: because it is a condition one must acquire or get infected with; not something transmitted through the genes
I - Immune: because it affects the body's immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
D - Deficiency: because it makes the immune system deficient (makes it not work properly)
S - Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections

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How is HIV transmitted?

HIV can be transmitted from an infected person to another through:
  • Blood (including menstrual blood)
  • Semen
  • Vaginal secretions
  • Breast milk
  • pre-ejaculate

Blood contains the highest concentration of the virus, followed by semen, followed by vaginal fluids, followed by breast milk.

Activities That Allow HIV Transmission
  • Unprotected sexual contact
  • Direct blood contact, particularly through sharing injection drug needles.
  • Infections due to blood transfusions, accidents in health care settings or certain blood products are possible, although they are extremely rare nowadays in the United States.
  • Mother to baby (before or during birth, or through breast milk)

Sexual intercourse (vaginal and anal): In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during intercourse (many of which would be unnoticed). Both Anal and vaginal intercourse are high-risk practices.

Oral sex (mouth-penis, mouth-vagina): The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums, and oral membranes is lower than through vaginal or anal membranes. There are documented cases where HIV was transmitted orally, so we can't say that getting HIV-infected semen, vaginal fluid or blood in the mouth is without risk. However, oral sex is considered a low risk practice.

Sharing injection needles: An injection needle can pass blood directly from one person's bloodstream to another. It is a very efficient way to transmit a blood-borne virus. Sharing needles is considered a high-risk practice.

Mother to Child: Mother to child transmission is now rare in the US and other developed countries because pregnant women who are HIV-positive are normally given medications to prevent the fetus from getting infected. However, it is possible for an HIV-infected mother to pass the virus directly before or during birth, or through breast milk. Breast milk contains HIV, and while small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants.

The following "bodily fluids" are NOT infectious:
  • Saliva
  • Tears
  • Sweat
  • Feces
  • Urine

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What are the symptoms of HIV?

Primary HIV infection is the first stage of HIV disease, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by the body (usually 6- 12 weeks).

Some people newly infected with HIV will experience some "flu-like" symptoms. These symptoms, which usually last no more than a few days, might include fevers, chills, night sweats and rashes (not cold-like symptoms). Many other people either do not experience acute symptoms, or have symptoms so mild that they may not notice them.

Given the general character of the symptoms of acute infection, they can easily have causes other than HIV, such as a flu infection. For example, if you had some risk for HIV a few days ago and are now experiencing flu-like symptoms, it might be possible that HIV is responsible for the symptoms, but it is also possible that you have some other viral infection.

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What are the symptoms for AIDS?

There are no common symptoms for individuals diagnosed with AIDS. When immune system damage is more severe, people may experience opportunistic infections (called "opportunistic" because they are caused by organisms which cannot induce disease in people with normal immune systems, but take the "opportunity" to flourish in people with HIV). Most of these more severe infections, diseases, and symptoms fall under the Centers for Disease Control's definition of AIDS. The median time to receive an AIDS diagnosis among those infected with HIV is 7-10 years.

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How long after a possible exposure should I be tested for HIV?

The time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies is commonly called the "Window Period".

Recent studies show that a test taken at least 12 weeks (3 months) after the last possible exposure to the virus provides highly accurate results. Based on those studies, many testing clinics in California and other places use a 3 month window period. Rarely, a person could take up to six months to produce antibodies and that is almost always a person with a severely compromised immune system due to another disease, such as leukemia.

What does this mean for you?

If you test negative on an antibody test taken 3 months or longer after your last possible risk of possible exposure to HIV, you can feel safe in assuming that you do not have the virus. If for some reason you feel anxiety about relying on the 3-month result, you could opt to have another test taken again at 6 months.

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I have heard there are many different types of HIV tests. How do I know which one I should take?

The combination of an Elisa/Western Blot HIV Antibody Test is the traditional testing method for HIV infection. This combination test is looking for the antibodies that develop to fight the HIV virus. There are two ways to conduct this test. Either through a blood draw or through the "Orasure" method (a sample of oral mucus obtained with a specially treated cotton pad that is placed between the cheek and lower gum for two minutes). Both forms, by blood draw or orally, have the same accuracy with their results.

Another type of test that you may hear about is called "Oraquick," sometimes known as the "rapid test." This HIV-1 antibody test offers results that are highly accurate and the results can be determined within 20 minutes. It provides same day results and counseling. You should however be aware that if the results of the test come out to be "preliminary positive," there is a high probability that you have HIV, but it will be necessary to have a confirmatory test to be sure.

Some testing locations in California charge for this type of test, but there are some locations that will provide the test for free. For testing locations you can call the California HIV Hotline at 1-800-367-AIDS or do a referral search on our companion website, AIDSHotline.org.

Other tests that you will hear about are Viral Load tests. These tests are used by physicians to monitor their patients who have already tested positive for HIV antibodies. Viral Load tests are very costly and have never been approved by the FDA for HIV status diagnosis because of the possibility of false-positive and false-negative results. Therefore, they should not be used to determine if one is HIV-positive.

Note: A person who tests positive on a Viral Load cannot obtain a letter of HIV diagnosis based on those results. They must still test positive on an HIV antibody test in order to get the diagnosis. A letter of diagnosis is required to register with most AIDS Service Organizations and to qualify for many governmental assistance programs.

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What do the test results mean?

A positive result means that:
  • You are HIV-positive (carrying the virus that causes AIDS), and
  • You can infect others and should try to implement precautions to prevent doing so.
A negative result means that:
  • No antibodies were found in your blood at this time.
A negative result does NOT mean:
  • You are not infected with HIV (if you are still in the window period),
  • You are immune to AIDS,
  • You have a resistance to infection,
  • You will never get AIDS.

If I test Positive, does that mean that I will die?

Testing positive for HIV means that you now carry the virus that causes AIDS. It does not mean that you have AIDS, nor does it mean that you will die as a result of the infection. Although there is no cure for AIDS, many opportunistic infections that make people sick can be controlled, prevented or eliminated. This has substantially increased the longevity and quality of life for people living with HIV.

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