Hello, I'm Richard Meisler at the University of Michigan, and I'm happy to welcome you to this course, AIDS: Fear and Hope. I've been teaching on campus courses about AIDS for some time now. I always learn a lot and I hope that you will find the experience productive. In this first session, I'll make some introductory comments about terminology. I'll also have occasion to mention the major problem of stigma toward people who are infected with HIV. And briefly discuss a major government program in the United States that provides medicine and services to HIV positive people. Let's start with HIV, the human immunodeficiency virus. The name is descriptive. It is a virus, it only affects humans, and it attacks the immune system and causes that system to be deficient. Here are two images that depict HIV. The one on the left is a schematic diagram. We will see many of these diagrams. They are designed to help us understand the way the virus works. On the right is an electron microscope photo. The circular shape is a new HIV. The mass at the bottom is part of a white blood cell. The virus is much smaller than the cell which is why we need the electron microscope to see it. The new HIV particle has just emerged, budded, along with thousands of other new HIVs, after reproducing inside the white blood cell. It and the others will move on to find new blood cells to infect, reproduce, and then go on to infect still other cells. We will learn a great deal about HIV, the human immunodeficiency virus, its life cycle, and how it causes AIDS. We will also learn about its connection with SIV, simian immunodeficiency virus, a related virus that infects primates. A person who is infected with HIV will eventually get AIDS, but it may take as many as eight or ten years for that to happen. That is one of the reasons why it is important not to confuse the terms HIV and AIDS. Take a look at these pictures. The person on the left looks pretty sick and it wouldn't be hard to guess that he has AIDS. The boy on the right doesn't look sick, but he also has AIDS. I juxtaposed these two pictures to make a point. You can't tell whether a person has AIDS by looking at him or her. And you certainly can't tell whether a person has been infected by HIV by looking at the person. AIDS is acquired immune deficiency syndrome. It is acquired because a person originally had acquired the HIV infection. It is an immune deficiency syndrome because the person has symptoms or diseases that are the result of a badly weakened immune system. His or her immune system can no longer successfully fight off diseases. We will learn the technical definition that leads to a medical diagnosis of AIDS, but that will come later. The boy on the right is Ryan White. He died of AIDS in 1990 in Indiana. He had become famous because of the discrimination and cruelty he experienced in his school and community because he had AIDS. We will encounter this phenomenon of stigma over and over again in this course. In many places in the world, in many cultures, we will find social rejection of people who have AIDS, or are infected with HIV. Social rejection and serious discrimination of all types. It is impossible to exaggerate the importance of this fact. The epidemic will never be ended unless stigma is radically reduced. I could not let this first session of our course conclude without mentioning this key element of the epidemic. Another reason for mentioning Ryan White today is that a major piece of federal legislation in the US was named in his honor. The Ryan White Care Act. It will become clear as we go along that government must act, and this is an example. The Ryan White Care Act was signed by the President George W. Bush, pictured here on the top. It was reauthorized by the next three US presidents. We see President Clinton signing a reauthorization of the Ryan White Care Act with Ryan's mother looking on. And we also pictures of Presidents George W. Bush and Barack Obama signing subsequent reauthorizations. As we go along we will find that political leadership and government action are central to winning or losing the fight against AIDS. We will learn that the Ryan White Care Act was an important governmental intervention in dealing with the epidemic. I conclude on a personal note. This course is dedicated to Charles and Florence Tate who fought tirelessly for freedom and justice for their people, and for all people.
