The last line of defence

 
 

As many students choose contraception over abstinence, Aly Aziz look at just how valuable condoms are.

POPE BENEDICT XVI on his recent trip to Africa, a continent devastated by the prevalence of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), created a stir in the scientific and political community.

condomsHis statement that HIV/AIDS is a “tragedy that cannot be overcome by money alone, that [it] cannot be overcome through the distribution of condoms, which can even increase the problem”, has the scientific community in an uproar. According to Pope Benedict XVI, the solution to the HIV/AIDS issue is abstinence and fidelity as oppose to condom use.

The rationale for the Pope’s comments could be a focus of subjective analysis and a matter of another topic altogether. Instead, lets look upon Sexually Transmitted Infections (STIs), in particular HIV, how it gives rise to AIDS, and the effectiveness of condoms in its prevention.

STIs are diseases transmitted through sexual contact. Most students are aware of the majority of STIs such as herpes, syphilis, gonorrhea and chlamydia. Some are fairly innocuous, with most being treatable by your local medical service. However, HIV is a very different story.

HIV is an STI predominantly spread by person-to-person sexual intercourse, but sharing of needles and mother-to-child transmission during pregnancy are also ways in which the disease spreads. The virus is in saliva as well, but the risk of transmission through such routes, as with kissing, is negligible.

But if HIV is a virus like the one that causes the common cold, and our bodies are able to fight off a common cold, then why shouldn’t we be able to rid ourselves of HIV? To answer this, we need a crash course in immunology.

Our immune system can be thought of as millions of cells – a military of microscopic soldiers – that seek out invaders (infective organisms) within our body and eradicate them. Like a military with a numerous soldiers boasting different skills, there are a variety of immune cells, each with a specified purpose that work together to fight off infective organisms.

“Studies show the effectiveness of condoms in preventing HIV infection to be 87 per cent, with some reports suggesting its effectiveness reaches 98 per cent”

First, a group of specialised immune cells in our blood travel around on the lookout for foreign organisms. Once one is detected, chemical signals released by our ‘lookout’ cells alert other types of immune cells of a possible infection and more importantly, those ‘lookout’ cells also take a piece of the infecting organism (a sample) to show the other cells what the infection looks like.

And this is where it gets interesting. A particular group of immune cells, namely CD4 T-lymphocytes use the ‘sample’ shown to them and decipher the best armament our other immune cells can use to attack the infection. Once informed by CD4 T-lymphocytes, our microscopic soldiers go forward with the knowledge of what the infection looks like and the proper weaponry to defeat and eradicate the offending infection.

Unfortunately, HIV gets around this intricate defense by directly attacking our CD4 T-lymphocytes, those immune cells vital in the coordination of our immune response. What’s more is that HIV periodically changes its appearance to our immune cells and thus when the ‘sample’ is brought back to CD4 T-lymphocytes, by the time arming has taken place, our immune cells are ‘blind’ to what HIV looks like while attacking.

With time, our entire store of CD4 T-lymphocytes is depleted and we become susceptible to other infections that would normally be fought off by an intact immune system. When our immune system reaches a critical point where we are unable to fight off infections, we become immuno-deficient and succumb to AIDS. Death then becomes inevitable due to a myriad of opportunistic infections.

Although HIV is a global phenomenon, its most profound effects are in sub-Saharan Africa, where approximately 22 million people are infected with thousands dying each year due to AIDS.

Efforts are being made to tackle the AIDS epidemic by educating the public of the disease and the modes of transmission while utilising viral monitoring services and prescribing anti-retroviral drugs are having an effect in reducing its prevalence. Condoms are also one of the tools utilised to prevent the spreading of the disease and the use of condoms is critical for not just the African population.

In a nutshell, condoms are contraceptive devices that prevent the transmission of semen from entering the body of a sexual partner. Not only does it prevent pregnancy, but it is also a physical barrier to the transmission of some STIs, including HIV. When applied properly, studies show the effectiveness of condoms in preventing HIV infection to be 87 per cent, with some reports suggesting its effectiveness reaching 98 per cent.

It is not a perfect means of preventing HIV transmission, but it does decrease the risk substantially. Yes, abstinence and fidelity is the ultimate prevention in the risk of HIV transmission, but its practicality is a matter of another debate. For now, this author recommends to wrap it before you tap it.

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Some common myths about condoms:

Myth: Condoms are notorious for breaking during intercourse.
Truth: Less than 2 per cent of condoms break with the majority due to improper application.

Myth: Condoms help prevent against all STIs.
Truth: No. Some STIs are on the skin near the genital area.

Myth: If you are allergic to latex, condoms are out of the question.
Truth: There are alternate materials that condoms are made of such as polyurethane.

Myth: Condoms do not have a shelf life.
Truth: Wrong! There is an expiration date.

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