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Read through case studies where we openly examine and analyse all our actions and decision-making processes during humanitarian emergencies that have led us to speak out.

The Global HIV/AIDS Epidemic

This logistical and supply centre in Brussels provides storage of and delivers medical equipment, logistics and drugs for international purchases for MSF missions. This supply and logistics centre in Bordeaux, France, provides warehousing and delivery of medical equipment, logistics and drugs for international purchases for MSF missions. This logistical centre in Amsterdam purchases, tests, and stores equipment including vehicles, communications material, power supplies, water-processing facilities and nutritional supplements. This medical unit is based in Cape Town, South Africa.

BRAMU specialises in neglected tropical diseases, such as dengue and Chagas, and other infectious diseases. This medical unit is based in Rio de Janeiro, Brazil. Find important research based on our field experience on our dedicated Field Research website. Providing epidemiological expertise to underpin our operations, conducting research and training to support our goal of providing medical aid in areas where people are affected by conflict, epidemics, disasters, or excluded from health care.

Evaluation Units have been established in Vienna, Stockholm, and Paris, assessing the potential and limitations of medical humanitarian action, thereby enhancing the effectiveness of our medical humanitarian work. The Luxembourg Operational Research LuxOR unit coordinates field research projects and operational research training, and provides support for documentation activities and routine data collection. The Intersectional Benchmarking Unit collects and analyses data about local labour markets in all locations where MSF employs people. This Guide explains the terms, concepts, and rules of humanitarian law in accessible and reader-friendly alphabetical entries.

The MSF Paediatric Days is an event for paediatric field staff, policy makers and academia to exchange ideas, align efforts, inspire and share frontline research to advance urgent paediatric issues of direct concern for the humanitarian field. The MSF Foundation aims to create a fertile arena for logistics and medical knowledge-sharing to meet the needs of MSF and the humanitarian sector as a whole.

Nearly 38 million people were living with the human immunodeficiency virus HIV at the end of , the majority of them in sub-Saharan Africa. The cost of first-line drugs are now cheaper than ever, but efforts are still needed to ensure everyone who is living with HIV receives treatment. Over Worldwide, around 20 per cent of people currently infected with the virus don't know their HIV status.

Once someone is diagnosed with the disease, viral load monitoring - measuring the levels of HIV virus in the blood - is essential to ensure that treatment is working. While routine viral load tests are standard in wealthy countries, access in developing countries still lags far behind. There is no cure for HIV, although life-long treatments using combinations of drugs known as antiretrovirals ARVs help combat the virus and enable people to live longer, healthier lives.

While double the amount of people are on treatment today than what there were around five years ago, deadly treatment gaps exist, especially in West and Central Africa, and the Middle East and North Africa, where barely a quarter of people living with HIV receive ARVs. But the price of doing so is high - literally. Second-line regimens are nearly four times the price of first-line regimens. On top of overcoming pricing barriers, adequate medical follow up must ensure a timely identification of resistance and a switch of regimens when needed.

Low HIV prevalence rates - ranging from two to 10 per cent across West and Central African countries, and less than one per cent across the Middle East and North Africa - have left these regions in a blind spot in the global HIV response. These regions lag far behind in attention and investment in tackling the epidemic, resulting in low access to testing and treatment only around a third in West and Central Africa.

It is unacceptable to witness people dying of AIDS within hours of being admitted to our hospitals. In conflict settings and when people are displaced, ensuring the continuity of care for people with HIV - including a constant supply of drugs - can be difficult.

Commercial sex workers including those in pornography have an increased likelihood of contracting HIV. The second most frequent mode of HIV transmission is via blood and blood products. The risk from sharing a needle during drug injection is between 0. People giving or receiving tattoos , piercings , and scarification are theoretically at risk of infection but no confirmed cases have been documented. HIV can be transmitted from mother to child during pregnancy, during delivery, or through breast milk, resulting in the baby also contracting HIV. Due to the increased risk of death without breastfeeding in many areas in the developing world, the World Health Organization recommends either: 1 the mother and baby being treated with antiretroviral medication while breastfeeding being continued 2 the provision of safe formula.

What Is HIV?

HIV is a member of the genus Lentivirus , [84] part of the family Retroviridae. Many species of mammals are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period. Upon entry into the target cell, the viral RNA genome is converted reverse transcribed into double-stranded DNA by a virally encoded reverse transcriptase that is transported along with the viral genome in the virus particle.

The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded integrase and host co-factors. It is more virulent , more infective , [94] and is the cause of the majority of HIV infections globally.

After the virus enters the body there is a period of rapid viral replication , leading to an abundance of virus in the peripheral blood. During primary infection, the level of HIV may reach several million virus particles per milliliter of blood. This weakens the immune system and allows opportunistic infections.

What Are HIV and AIDS? |

T cells are essential to the immune response and without them, the body cannot fight infections or kill cancerous cells. Most people infected with HIV develop specific antibodies i. Since the WHO's staging system does not require laboratory tests, it is suited to the resource-restricted conditions encountered in developing countries, where it can also be used to help guide clinical management. Despite their differences, the two systems allow comparison for statistical purposes. Programs encouraging sexual abstinence do not appear to affect subsequent HIV risk. Universal precautions within the health care environment are believed to be effective in decreasing the risk of HIV.

PEP treatment is recommended after a sexual assault when the perpetrator is known to be HIV positive, but is controversial when their HIV status is unknown. There is currently no cure or effective HIV vaccine.

Treatment consists of highly active antiretroviral therapy HAART which slows progression of the disease. Current HAART options are combinations or "cocktails" consisting of at least three medications belonging to at least two types, or "classes," of antiretroviral agents. The World Health Organization and United States recommends antiretrovirals in people of all ages including pregnant women as soon as the diagnosis is made regardless of CD4 count.

Benefits of treatment include a decreased risk of progression to AIDS and a decreased risk of death.


Specific adverse events are related to the antiretroviral agent taken. Treatment recommendations for children are somewhat different from those for adults. The World Health Organization recommends treating all children less than 5 years of age; children above 5 are treated like adults. In addition to improving current disease, treatment with antiretrovirals reduces the risk of developing additional opportunistic infections.

Dietary intake of micronutrients at RDA levels by HIV-infected adults is recommended by the WHO; higher intake of vitamin A, zinc , and iron can produce adverse effects in HIV positive adults, and is not recommended unless there is documented deficiency. Evidence for supplementation with selenium is mixed with some tentative evidence of benefit. Even with anti-retroviral treatment, over the long term HIV-infected people may experience neurocognitive disorders , [] osteoporosis , [] neuropathy , [] cancers, [] [] nephropathy , [] and cardiovascular disease. Sub-Saharan Africa is the region most affected.

In in the United States approximately 1. In the early days, the CDC did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy , the disease after which the discoverers of HIV originally named the virus. In , two separate research groups led by Robert Gallo and Luc Montagnier declared that a novel retrovirus may have been infecting people with AIDS, and published their findings in the same issue of the journal Science. At the same time, Montagnier's group isolated a virus from a person presenting with swelling of the lymph nodes of the neck and physical weakness , two characteristic symptoms of AIDS.

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Contradicting the report from Gallo's group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier's group named their isolated virus lymphadenopathy-associated virus LAV. Both HIV-1 and HIV-2 are believed to have originated in non-human primates in West-central Africa and were transferred to humans in the early 20th century.

There is evidence that humans who participate in bushmeat activities, either as hunters or as bushmeat vendors, commonly acquire SIV.