Acquired Immune Deficiency Syndrome

Since the first case was identified in 1981, acquired immune deficiency syndrome (AIDS) has grown into an epidemic that has taken approximately 500,000 lives in the United States alone. The Joint UNITED NATIONS Programme on HIV/AIDS estimates that at the end of 2002 there were 42 million people living with HIV/AIDS worldwide. During 2002, AIDS caused the deaths of an estimated 3.1 million people. At this time, women were increasingly affected by AIDS; it was estimated that women comprised approximately 50 percent or 19.2 million of the 38.6 million adults living with HIV or AIDS worldwide. No cure has been found, although existing treatment employing multiple drugs has made some gains in prolonging life and reducing pain. Despite the limits of medical science, however, much is known about the disease. It is caused by the human immunodeficiency virus (HIV). Transmitted by bodily fluids from person to person, HIV invades certain key blood cells that are needed to fight off infections. HIV replicates, spreads, and destroys these host cells. When the body's immune system becomes deficient, the person becomes AIDS-symptomatic, which means the person develops infections that the body can no longer ward off. Ultimately, a person with AIDS dies from diseases caused by other infections. The leading killer is a form of pneumonia.

Most of the fear surrounding AIDS has to do with its most common form of transmission: sexual behavior. The virus can be passed through any behavior that involves the exchange of blood, semen, or vaginal secretions. Anal intercourse is the highest-risk activity, but oral or vaginal intercourse is dangerous too. Thus, federal health authorities recommend using a condom—yet they caution that condoms are not 100 percent effective; condoms can leak, and they can break. Highly accurate HIV testing is widely available, and often advisable, since infected people can feel perfectly healthy. Although the virus can be contracted immediately upon exposure to it, symptoms of full-blown AIDS may take up to ten years to appear.

In addition to sexual behavior, only a few other means of HIV transmission exist. Sharing unsterilized needles used in drug injections is one way, owing to the exchange of blood on the needle, and thus intravenous drug users are an extremely high-risk group. Several cities have experimented with programs that offer free, clean needles. These programs have seen up to a 75 percent reduction in new HIV cases. Receipt of donations of blood, semen, organs, and other human tissue can also transmit HIV, although here, at least, screening methods have proved largely successful. Childbirth and breast feeding are also avenues of transmission, and thus children of HIV-positive mothers may be at risk.

The medical facts about HIV and AIDS are especially relevant to the law. Unless exposed in one of a few very specific ways, most people have nothing to fear. Casual contact with people who are infected is safe. Current medical knowledge is quite strong on this point: no one is known to have caught the virus by sitting next to, shaking the hand of, or breathing the same air as an infected person. For this reason, U.S. law has moved to protect the CIVIL RIGHTS of HIV-positive and AIDS-symptomatic persons. Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 (1994) prohibits discrimination against otherwise qualified disabled individuals, including individuals with a contagious disease or an infection such as HIV or AIDS. The AIDS quilt, on display in Washington, D.C., has become a well-known symbol of support for victims of AIDS and their families. Families and supporters of victims of AIDS create a panel to commemorate that person's life and that panel is joined with others from around the country to create the quilt.