The three routes of transmission of AIDS should be clear about what are the initial symptoms of AIDS?

AIDS patients and HIV carriers. HIV exists in the body fluids and organs of infected people, and the blood, semen, vaginal secretion, milk and wound exudate of infected people contain a large amount of HIV, which is highly infectious. Tears, saliva dog dildo , sweat, urine, feces, etc. do not contain this virus without blood and inflammatory exudate, and it is not contagious.

The route of transmission of AIDS:

1. Sexual contact transmission

Sexually transmitted HIV exists in the semen and vaginal secretions of infected people, and spreads between men and women through sexual intercourse (including normal sexual intercourse, anal intercourse and oral sex). Worldwide, 9 out of every 10 adults infected with HIV are transmitted through sexual intercourse, and the more sexual partners there are, the greater the risk of HIV infection. People with venereal diseases are easily infected with HIV when they have sex with people infected with HIV.

Sexual contact transmission is the main way of HIV infection. The spread of HIV can occur in both homosexual and heterosexual intercourse. Worldwide, HIV is mostly transmitted through heterosexual contact. The rate of HIV transmission among adults is shown in the table:

Route of transmission ratio

71% of heterosexual transmission

Homosexuality spread 15%

7% of intravenous drug users

Bloody transmission 5%

Other reasons unknown 2%

In North America and Europe, male homosexual sexual contact-transanal sexual intercourse is the main mode of transmission of the disease. Homosexual and bisexual men are the main groups of HIV infection. 's initial discovery of AIDS patients in the United States is mainly concentrated in gay men. Anal intercourse between gay men can easily cause anal and rectal mucosal trauma, which opens the channel for HIV to enter the bloodstream, so that semen containing a large amount of HIV and male secretions before ejaculation enter the blood circulation through the damaged mucous membrane. In addition, gay men often exchange sexual partners, and some homosexuals have dozens or hundreds of sexual partners, which increases the chance of HIV infection. In Africa and Latin American countries and Southeast Asia, the vast majority of AIDS is infected through heterosexual contact and vaginal intercourse. The prevalence rate of AIDS is 1:1 in the ratio of male to female. The transmission of HIV among members of the opposite sex can be divided into two ways: male → female or female → male. Compared with the two ways, the risk of male → transmission in female was higher than that in female → male transmission. Both semen and cervical secretions can carry HIV. Anatomically, secretions can be retained in women rather than men, so the transmission caused by the exchange of semen and cervical secretions is more effective in men and women with →. In some African countries, there is a custom in which a wife is inherited by her husband's brother after her husband's death, the purpose of which is to prevent the loss of family property. But this inheritance in today's AIDS epidemic in Africa, its inheritance of brothers and wives, but also inherited a deadly dowry, that is, HIV. HIV-positive wives can transmit the virus to their husbands' brothers, so both male → and female → males are important routes of transmission in Africa. Prostitution and whoring play an important role in the spread of AIDS. Clients with HIV transmit the virus to prostitutes, who then transmit it to other clients. If combined with sexually transmitted diseases, the chance of spreading HIV can be greatly increased. Genital erosion and ulcers open the channel for the virus to enter the blood circulation, and the party with genital ulcers is more likely to be infected with HIV. In Southeast Asia, the prevalence of prostitution and whoring has led to the rapid spread of HIV infection. In Thailand, for example, HIV infection rates have increased at an alarming rate since 1990.

Bisexual men are highly dangerous not only to male sexual partners, but also to female sexual partners. Many people in bisexuality are married and may often have sex with prostitutes. These bisexuals who marry or often have sexual contact with the opposite sex may introduce the spread of homosexuality into heterosexual people. Therefore, homosexual and heterosexual sexual behaviors of bisexual men play an important role in the spread of HIV.

The main sexual behaviors related to HIV transmission are transanal sexual intercourse and transvaginal sexual intercourse. Cases of HIV transmission through oral sexual intercourse are rarely reported and are considered to be low-risk sexual behavior. However, if there is oral mucosal erosion or ulcer, it significantly increases the risk of oral sexual intercourse to spread HIV.

2. Transmission by blood

Mainly through the import of HIV-contaminated blood and blood products or the use of HIV-contaminated syringes, needles and spread. It can also be spread through the use of contaminated and unsterilized needle tattoos, ear piercing, acupuncture, and sharing razors and toothbrushes with patients and infected people.

Sharing injection equipment contaminated by HIV, inputting blood or blood components contaminated by HIV, transplanting tissues and organs contaminated by HIV belong to blood transmission. Intravenous drug use has become the second major part of HIV infection in the United States and Western Europe. In some provinces and cities in southern China, intravenous drug use is a major way to spread AIDS. The spread of HIV is due to sharing blood-contaminated needles, syringes and injectable paraphernalia. At the same time, most drug addicts are sexually active, and many of them are infected by HIV due to sexual behavior. They engage in sex or prostitution in exchange for drugs or money. Some studies have found that under general hospital conditions, the probability of using needles and tips contaminated by HIV to pierce the skin at once and infect HIV is 0.3%. Intravenous drug users often draw blood repeatedly to flush out the drugs in the tube, and the blood contaminated by HIV remains in the needle. Generally, HIV in the blood can survive for 15 days at room temperature, and other drug users become infected when they use contaminated syringes. As the number of people sharing syringes increases, so does the risk of HIV infection. On the other hand, drug abuse often increases the desire for sexual contact, if the sex trade in exchange for drugs, will further increase the risk of HIV infection.

Blood transfusion or blood components is one of the important ways of transmission in the early stage of the AIDS epidemic. With the development of modern medicine, blood transfusion or blood products are more and more widely used. Through blood transfusions and blood products, countless patients' lives have been saved. However, if blood or blood products contaminated by HIV are transferred, HIV is directly injected into the blood circulation. Blood components such as V-Ⅲ factor concentrators are extracted from the plasma of many blood donors, so they are more likely to contaminate HIV. About 6 per cent of US blood donors carry HIV, so's early US-made V-Ⅲ factor concentrate caused infection in hemophiliacs around the world. Thousands of healthy blood recipients have been infected with AIDS as a result of HIV contamination at a blood center in France. There must be a long warning about these painful lessons. Now developed countries have strengthened the screening of blood donors, and our country is also constantly strengthening the management of blood donors and blood products. If the blood donor is infected with HIV and the blood supply is in the window period chastity cages , the HIV antibody can not be detected. At present, it is not possible to detect HIV antigen in all blood donors, because the equipment for detecting HIV antigen is complex and expensive. In view of this, it is very important to strengthen and improve the screening system for blood donors, and blood transfusions and blood transfusion products must be cautious.

Organ transplantation technology is an important development of modern medicine. Many patients with end-stage heart, lung, liver, kidney and other organ diseases can be reborn through organ transplantation, but the damaged organs are potentially dangerous. Routine HIV antibody detection of organ donors can significantly reduce the transmission of HIV by organ transplantation. The Centers for Disease Control in the United States has reported that many patients who received kidney, liver, bone marrow transplants were infected with HIV. The iatrogenic transmission is gradually decreasing in the developed countries where HIV is still prevalent. Although the number of people who get sick through this mode of transmission is very small, the impact is significant because it is related to public health problems.

3, mother-to-child transmission mother is AIDS patients or infected, in the process of pregnancy, delivery through the blood or postpartum through breast milk to transmit HIV to the fetus or newborn. Women who have been infected with HIV give birth to children who are likely to be infected with HIV from their mothers. Most children with HIV will die before the age of 3.

AIDS in children, which is vertically transmitted by mothers, was first reported in 1982. This transmission may occur in the uterine cavity, or it may occur during delivery and during postpartum breastfeeding through breast milk containing HIV to the baby.

HIV can be transmitted to the fetus through the placenta. It has been proved that HIV can be isolated from fetuses aborted at 8 weeks of pregnancy. The transmission rate of mother to fetus determines the development stage and immune function of mother infected with HIV, such as the number of T4 lymphocytes and so on. After the fetus is infected with HIV in the womb, it will affect the embryonic development, prone to abortion, or the fetus has developed into AIDS at birth. The earlier the fetus is infected by HIV in the womb, the more likely it is to have a miscarriage or affect the fetal development. The earlier the fetus develops AIDS-related symptoms after birth, the shorter its survival time. At Ndola Pediatric Hospital in Zambia, a total of 265 neonatal HIV/AIDS patients were treated in 1993, of which 86 per cent developed illness in the first 3 weeks of life, including septicemia, bronchitis, deep jaundice and skin lesions, and 74.5 per cent died within 3 months of birth. Newborns who develop the disease within 1 month after birth generally survive no more than 6 months. Mother-to-child transmission may also occur in the process of vaginal delivery. If the fetus has skin and mucous membrane damage during delivery, the HIV in the maternal blood enters the infant blood circulation through the injured wound. Some studies have reported that caesarean section can reduce the transmission of HIV infection from mother to baby.

The virus can be isolated from the milk of HIV-infected mothers, and breastfeeding can transmit HIV to the baby. It has been reported that a mother was infected with HIV after a postpartum blood transfusion and her baby was infected with HIV after sucking her breast milk for 6 months. However adult toys for men , it is not clear how likely it is to be infected with HIV through breastfeeding. Health authorities in the United States have advised mothers with HIV infection not to breastfeed. In many countries in Africa, due to poor economic conditions and insufficient breast milk substitutes, stopping breastfeeding will lead to serious malnutrition, which will endanger the survival of babies faster than HIV infection, so mothers infected with HIV in many African countries still advocate breastfeeding.

Measures to prevent HIV transmission from mother to child include persuading women infected with HIV not to have children and finding pregnant women.

Pregnancy should be terminated. Because of fetal HIV infection, most of them die within 3 years of age after birth, and babies who survive will also become chronically ill children and motherless orphans. There are many ethical, moral and emotional problems here.

What are the initial symptoms of AIDS?

1. Acute infection period

The window period is also at this time. The response of HIV to the stimulation of the body after invading the body. The patient has fever, rash, enlarged lymph nodes, fatigue, sweating, nausea, vomiting, diarrhea, pharyngitis and so on. Some also appear acute aseptic meningitis, characterized by headache, neurological symptoms and meningeal irritation. Peripheral blood examination showed that the total number of white blood cells was normal, or lymphocytes decreased and monocytes increased. During the acute infection period, the symptoms are often mild and easy to be ignored. Six weeks after infection, the serum HIV antibody showed a positive reaction. Since then, there has been a clinical incubation period of varying length, relatively healthy and asymptomatic.

(1) skin damage during acute infection of AIDS.

Skin and mucous membrane is one of the main sites of AIDS attack. The main manifestations of skin injuries are rashes, mostly non-itching red macular papules, occasional diffuse urticaria or water herpes, skin rashes occur mostly on the face and trunk, and severe cases can be seen all over the body. Many AIDS patients take skin damage as the first symptom.

(2) systemic symptoms during acute infection of AIDS.

Systemic symptoms include fever, sore throat, night sweats, joint pain, enlarged lymph nodes and hepatosplenomegaly. Chronic diarrhea is also a very obvious early clinical manifestation of some AIDS patients. The most common clinical symptoms of AIDS patients are recurrent low fever, accompanied by chills, weight loss, fatigue and weakness, weight loss (5-22 kg), lethargy and weakness, unable to support normal physical activity, and no causes of fever, diarrhea and weight loss.

(3) Central nervous system symptoms during acute infection.

About 9% of patients with nervous system injury may develop acute HIV meningitis, with clinical manifestations of fever, headache, vomiting and meningeal irritation, increased monocytes and protein content in cerebrospinal fluid examination. Most of the above symptoms can recover after lasting for 2 to 3 weeks. 20% to 40% of AIDS patients have neurological diseases. Neurological disorders have been recognized as a common cause of morbidity and death in AIDS patients. Central nervous system symptoms often coexist with symptoms caused by various opportunistic infections, the more common being subacute encephalitis.

(4) lymph node enlargement during acute infection.

When patients in high-risk groups develop systemic lymph node enlargement that cannot be explained by other reasons, it is likely to be associated with HIV infection, with an incidence of 55% to 100%. The degree of lymph node enlargement is related to the titer of AIDS antibody in serum, which is often found in cervical, submandibular or axillary lymph nodes. The enlarged lymph nodes are not fused, hard, occasionally tenderness, and there is no change in the surface skin.
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