HIV Infection: Implications on Surgical Practice

Abstract

The human immune deficiency virus (HIV) may have had its origins in Africa; a large percentage of those infected live in sub-Saharan African. HIV is thought to have started and spread unnoticed through the 1960s and 1970s, developing into epidemic proportions in the 1980s. The HIV/AIDS pandemic is currently a global phenomenon that has especially impacted on sub-Saharan Africans because of the large numbers of those affected, as well as poverty and illiteracy so rampant in the continent. The initial hopelessness of the 1980s and early 1990s because of the social stigma and lack of affordable anti-retroviral therapy was replaced with fresh hope, as a result of on-going initiatives that have over the last decade availed anti-retroviral drugs to a population that had would have had no other possibility of accessing this treatment; health education, civic activism, advocacy, government and international recognition and support. The recognition of the threat that HIV/AIDS poses to the survival of mankind, and the measures taken to counter this threat have significantly eroded the social stigma and other complications associated with HIV/AIDS. Fear of whole populations being wiped out, as suggested by the large number of HIV orphans in the 1980s and 1990s was transformed into hope by the availability of ARVs, translating into a large population of patients surviving way beyond what was previously possible. Opportunistic infections, which in the pre-ARV era caused so many deaths, have seen a significant reduction since the introduction of HAART. This improved survival has introduced a number of aspects that have, and are impacting on the practice of surgery globally. The challenge of availing ARVs to the eligible patient population still exists; of an estimated 2.24 million people living with HIV/AIDS in Latin America and the Caribbean in 2008, only 54% were on ARVs (Fink et al. 2011).