As we reflect on 2022, we give thanks for yet another holiday season spent with our dear friends and family. As our small island community slowly inches back toward life before the COVID-19 global pandemic we surely take with us the tremendous number of life-lessons we’ve learned throughout these trying times. However, let us also not forget the other global pandemics that are still raging across the globe and has even made its way to the Mariana Islands.
This AIDS Awareness month we dive into the history of the AIDS epidemic and the tremendous impact it has had on communities including our own. The true origins of the disease and how long humanity has co-existed with it continues to elude scientists to this day. However, we can again be thankful for the life-saving breakthroughs that have since changed the lives of countless people who are living with HIV/AIDS today. By understanding the past, we equip ourselves with the knowledge to prevent, and one day end, one of the deadliest global epidemics in history.
Acquired Immune Deficiency Syndrome (AIDS) was first recognized in 1981 when an increasing number of young homosexual men succumbed to infections that the body would otherwise have been able to endure. Since its discovery, scientists have intensely studied its emergence and epidemic spread with the first inkling as to its roots surfacing in 1986. At this time a similar virus named Human Immunodeficiency Virus Type 2 (HIV-2) was infecting people in West Africa. This virus is now known to be that which causes AIDS a very serious disease in which the virus instead of infecting and killing the body itself, it destroys the human immune system to the point that the body is no longer able to fend off against even the most minor of cold viruses. Both HIV-1 and HIV-2 were found to be related to a collection of Simian Viruses (viruses exclusive to primates) known as SIVs. The closest of these being those found amongst Chimpanzees and Sooty Mangabeys. This close genetic relationship was the first clue to scientists that AIDS had emerged as a result of cross-species infections between humans and primates.
Lentiviruses are a general category of infections that affect mammals, including bovines, horses, sheep, felines and primates. These viruses however, are not anything new for the world with some amongst primate species co-evolving for at least 30,000 years and likely before then. This long history of evolution makes the root cause of its modern occurrences particularly elusive. How could a virus that has co-existed in mammals for tens of thousands of years suddenly make the leap between species only in our modern era? So far science has only come to understand just a fraction of the circumstances that have led us to where we are today.
Evidence from the study of different lentiviruses across several species suggests that these viruses traditionally spread between individuals. This is the first in several mysteries that scientists had to dissect in order to understand its unusual leap between primates and humans. In some species of primates and other mammals it was discovered that transmission is possible through fluids and mucous membranes. This discovery supported the theory that humans would have been able to become infected with the closely related SIV found in chimpanzees simply through close contact with infected blood or body fluids.
Chimpanzee populations however, were for many thousands of years isolated from Human populations and thus the border between humans and primates created by the natural environment kept HIV/AIDS at bay for millennia. Therefore, it is believed that the encroachment on once isolated primates through habitat loss and deforestation are partly to blame for the infection of humans by primate lentiviruses. This encroachment began in the early 20th century with the colonization of Africa which started the expansion of urban populations in once untouched forests. In addition, the capture and handling of primates for various human uses added to the increased chance of cross-species infection.
The AIDS Epidemic
HIV-1 evolves around one million times faster than your typical mammalian DNA. This rapid genetic change is the key to the origins of the AIDS pandemic. For primate viruses it was found that a tremendous number of mutations would have had to occur in order to adapt to the bodies of other species such as humans. For HIV this served as no obstacle as the speed at which the virus mutates made it highly efficient at spreading to human populations. Although initially discovered in 1980, scientists have only now been able to trifle through the many millions of mutations that the virus has undergone in order to trace the last common ancestor of HIV-1 to around 1910 to 1930 during the colonization of west central Africa.
For some 50 to 70 years HIV-1 spread unnoticed before its recognition. Scientists currently place the origin of the early epidemic to Kinshasa, then called Leopoldville in the modern-day Democratic Republic of the Congo a former colony of Belgium. Samples taken from infected individuals between 1959 to 1960 revealed that by then HIV had diversified into several different subtypes well before the declaration of the AIDS epidemic. Although scientists cannot agree on any one event being the precursor of the epidemic, evidence demonstrates that the colonization of Africa and the subsequent expansion of urban populations created the perfect conditions for widespread infections radiating throughout the world.
The global trade routes that were established during the colonial period of the African continent opened a doorway for these once isolated diseases to spread. In addition, scientific research asserts that the staggering rate of contraction of HIV in Africa means that transmission is not exclusive to homosexual populations. This especially since homosexuality is largely illegal in many parts of Africa. Rather the collateral damages caused by war, colonial efforts in Africa, habitat loss for primate populations, and the taking of resources and human lives by force served as a driving force behind the spread of HIV/AIDS.
According to the Guam Department of Public Health and Social Services’ Prutehi Hao program, there are currently 130 Guam residents living with HIV, the Human immunodeficiency virus that causes AIDS. Although a small portion of our island population, we should all be vigilant in our understanding and our efforts to keep our community safe. Today, there are a number of pharmaceuticals that help to keep those living with HIV healthy. However, these same life-saving drugs can cost up to $2,000 per month leaving many thousands of people around the world living with HIV little chance for survival.
It's important to note that these pharmaceuticals are not a cure for the disease, rather maintenance drugs that can allow a person living with HIV to suppress the immunocompromising effects of the virus. This is why despite the advances of modern medicine the battle to end AIDS is far from over. In the U.S. alone there are over 30,000 HIV diagnoses each year. Nearly a quarter of these are amongst straight or heterosexual people, the group with the fastest growing number of new diagnoses. Even with the passing of some forty years since the onset of the epidemic, scientists and health officials globally are spreading awareness on AIDS and the importance of safe sex remains as knowledge is still our most valuable tool to prevent the disease and save lives.
As we gather around our loved ones this season let us be thankful for our good health while also thinking of those whose health has been taken from them by this deadly disease. As well, honor the memory of the countless thousands who lost their lives to HIV/AIDS by spreading awareness this AIDS Awareness month so that we can save the lives of those around us and future generations to come. Although right now no cure may be in sight, what is for sure is that through education and prevention the battle against HIV/AIDS will surely come to an end to make a healthier and safer world for those who are to inherit it.