Tazama chanzo cha Ukimwi

[[Picha:Hiv budding.jpg | haki | thumb |Namba virusi vya UKIMWI vinavyotoka katika [[seli]].]]
'''Upungufu wa Kinga Mwilini''' (kwa kifupi '''UKIMWI'''; [[kifupisho]] cha [[Kiingereza]] '''AIDS''') ni [[ugonjwa]] unaotokana na [[virusi]] ambavyo kwa [[Kiswahili]] vinaitwa kifupi [[VVU]] ("Virusi vya UKIMWI"; kwa Kiingereza: HIV, yaani "Human Immunodeficiency Virus") na vinashambulia [[mwili]] kwa kuondoa nguvu zake za kupambana na [[maambukizi nyemelezi]] yanayosababisha [[maradhi]]. 
 
Ukimwi ni ugonjwa hatari sana katika [[maisha]] ya [[binadamu]] kwa kuwa husababisha [[kifo|vifo]] (yaani kupotea kwa [[uhai]] wa watu hao). Kwa mujibu wa [[Shirika la Afya Duniani]], kufikia mwaka [[2014]] ugonjwa huu umeua watu [[milioni]] 39, hasa kati ya wanaoishi [[Bara|barani]] [[Afrika]] upande wa [[kusini]] kwa [[Sahara]]. Kwa [[mwaka]] [[2015]] pekee wamefariki watu milioni 1.2 na kati yao [[watoto]] wengi. 

UKIMWI umekuwa na madhara makubwa katika [[jamii]], kama ugonjwa wa mwili na kama chanzo cha [[Ubaguzi wa watu wanaoishi na UKIMWI|ubaguzi]]. Kuna sintofahamu kuhusu UKIMWI kama vile kwamba eti, unaweza kusambazwa kwa kugusana tu bila [[ngono]]. 

Ugonjwa huu pia unasababisha [[madhara ya kiuchumi]] ambayo ni makubwa, hasa kwa nchi maskini. 

Hadi hivi sasa, UKIMWI hauna [[chanjo]] wala [[tiba]], lakini ugonjwa huu unaweza kuepukika kwa kuachana na ngono, ambayo ndiyo husababisha sana ugonjwa huu. Pia, watu wanaweza kujikinga kutokana na ugonjwa huu kwa kuepuka kuchangia vifaa au vitu vyenye [[ncha]] kali.

Kimsingi zaidi ni kwamba ugonjwa huo umetokana na kuenezwa hasa na [[maadili]] mabovu. Dhidi yake watu wanahitaji kuelewa tangu [[Utoto|utotoni]] na [[Ujana|ujanani]] maana ya [[jinsia]] na [[maisha]] kwa jumla, kwamba vinadai [[upendo]], [[nidhamu]] na [[uwajibikaji]], si kufuata [[tamaa]] tofautitofauti daima<ref>{{cite web|url=http://www.catholicnewsagency.com/news/thirty-years-after-aids-discovery-appreciation-growing-for-catholic-approach/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+catholicnewsagency%2Fdailynews+%28CNA+Daily+News%29|title=Thirty years after AIDS discovery, appreciation growing for Catholic approach |publisher=Catholicnewsagency.com|date=June 5, 2011 |accessdate=November 1, 2011}}</ref>. 

Tarehe [[1 Desemba]] kila [[mwaka]] ni [[Siku ya Ukimwi duniani|siku ya UKIMWI duniani]].

==Maana ya jina==
'''UKIMWI''' ni kifupisho cha "'''Upungufu wa Kinga Mwilini'''"
*'' Upungufu'' maana yake UKIMWI unaharibu uwezo wa [[mwili]] kupambana na magonjwa. Si UKIMWI moja kwa moja unaoweza kuua lakini mashambulio ya magonjwa ambayo kwa kawaida yasingekuwa tatizo kubwa.
*'' Kinga'' inahusu [[mfumo wa kingamwili]] ambao ni uwezo wa mwili kujitetea dhidi ya [[ugonjwa]].
*'' Mwili'' usio na kinga unapatwa na matatizo mbalimbali kwa sababu mfumo wa kinga umeharibika, na hauwezi kupigana na ugonjwa wowote.

[[Jina]] la Kiingereza ni '''AIDS = Acquired Immuno Deficiency Syndrome'''.
* acquired - maana mtu hawezi kuwa na hali hii kiasili, ameipata
* immuno - hii inataja ya kwamba tatizo linahusu "immune system" yaani mfumo wa kingamwili
* deficiency - inamaanisha ya kwamba kuna kasoro
* syndrome - ni mkusanyiko wa matatizo ya kiafya; ilhali kingamwili haufanyi kazi tena, mgonjwa anaathiriwa na magonjwa mbalimbali na kuonyesha [[dalili]] za magonjwa hayo yote.

==Mfumo wa kingamwili na VVU==
Kila mtu huwa na [[Mfumo wa kingamaradhi|mfumo wa kingamwili]] ndani yake. [[Seli]] za ulinzi zinazunguka mwilini na kutafuta [[vidubini]] vya nje vinavyoweza kuleta mvurugo na zinaviharibu. Kati ya seli hizi za [[ulinzi]] ni [[seli nyeupe za damu]] (lukosaiti) ambazo ni muhimu sana. 

Ukimwi unasababishwa na VVU. Kama virusi vyote, VVU vinaingia katika mwili kwa kusudi la kuzaa. Virusi haviwezi kuzaa peke yake: vinahitaji seli vinapoweza kuingia ndani yake na kutumia mfumo wa seli kwa kunakili [[DNA]] yake. 

Kwa kawaida virusi vinashambuliwa na mfumo wa kingamwili na kuharibika. Lakini VVU vina tabia mbili za pekee ambazo zinavifanya vvya hatari hasa:
* vinafaulu mara nyingi kuepukana na seli za ulinzi mwilini
* vinaingia hasahasa katika seli nyeupe za damu za aina "seli za T". VVU vikianza kuongezeka katika seli nyeupe ya damu vinadhoofisha na hatimaye kuharibu seli hii.

Maana yake VVU vinashambulia moja kwa moja seli ambazo ni sehemu ya kingamwili na zinazohusika kukinga mwili. Kuenea kwa VVU mwilini kunapunguza idadi ya seli za ulinzi na hivyo kupunguza kiwango cha kingamwili.

Baada ya kupungua kwa kingamwili vidubini vingine vinaendelea kufika mwilini lakini sasa vinaenea zaidi kwa sababu seli za ulinzi zimekuwa chache. Kila [[ambukizo]] linaendelea kwa muda mrefu zaidi na hivyo mwili kwa jumla unateswa kwa muda mrefu zaidi. 

Kadiri Ukimwi unavyoendelea vipindi vya magonjwa vinakuwa virefu zaidi na nguvu za mwili zinapunguapungua. Katika ngazi za mwisho [[idadi]] ya maambukizo inazidi uwezo wa mwili wa kupambana nayo na hapo mtu unakaribia kifo.

== Dalili au simptomi ==
UKIMWI ni [[ugonjwa]] wa [[mfumo wa kingamwili]] wa [[binadamu]] unaosababishwa na virusi vya ukosefu wa kinga mwilini.<ref name="pmid11396444">{{Cite journal|author=Sepkowitz KA|title=AIDS—the first 20 years|journal=N. Engl. J. Med.|volume=344|issue=23| pages=1764–72|year=2001|month=June|pmid=11396444|doi=10.1056/NEJM200106073442306}}</ref>Mwanzoni, baada ya kuambukizwa, mtu anaweza kukumbwa na kipindi kifupi cha [[maradhi]] ya aina ya [[mafua]]. Kwa kawaida, hali hii hufuatwa na kipindi kirefu kisicho na [[dalili]]. Ugonjwa huu huendelea kutatiza [[kingamwili]] jinsi unavyozidi, hivyo kumfanya mtu kuwa katika hatari zaidi ya kupata [[maambukizi]], ikiwa ni pamoja na [[maambukizi nyemelezi]], na [[kansa]] ambayo kwa kawaida hayawaathiri watu walio na kingamwili njema.

Kuna awamu tatu kuu za maambukizi ya VVU: maambukizi makali, awamu fiche na UKIMWI.<ref name=M121>Mandell, Bennett, and Dolan (2010). Chapter 121.</ref><ref name=AIDS2010GOV>{{cite web|title=Stages of HIV|url=http://aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|work=U.S. Department of Health & Human Services|accessdate=13 June 2012|date=Dec 2010|archiveurl=https://web.archive.org/web/20120513062533/http://www.aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|archivedate=2012-05-13}}</ref>

=== Maambukizi makali ===
[[File:Symptoms of acute HIV infection.svg|thumb|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya VVU|275px|Dalili kuu za maambukizi makali ya VVU]]
Kipindi cha kwanza kufuatia maambukizi ya VVU huitwa VVU vikali, VVU vya kimsingi au dalili kali za kudhibiti virusi. <ref name=M121/><ref name=WHOCase2007/> Watu wengi hupata [[maradhi ya mfano wa mafua]] au [[mononyukleosi ambukizi|maambukizi ya mfano wa mononukleosi]] wiki 2 - 4 baada ya kuambukizwa ilhali wengine hawana dalili zozote kuu.<ref>{{cite book|title=Diseases and disorders.|year=2008|publisher=Marshall Cavendish|location=Tarrytown, NY|isbn=978-0-7614-7771-6|page=25|url=http://books.google.ca/books?id=-HRJOElZch8C&pg=PA25}}</ref><ref name=M118/>Dalili hutokea katika asilimia 40-90 ya visa vyote na mara nyingi hujumuisha [[homa]], [[limfadenopathia|tezi kubwa na chungu za limfu]], [[faringitisi|inflamesheni ya koo]], [[upele]], maumivu ya kichwa, na/au vidonda vya kinywa na sehemu za uzazi.<ref name=WHOCase2007/><ref name=M118/>Upele huu, unaotokea katika asilimia 20 - 50 ya visa, hutokea katika kiwiliwili, na kwa kawaida huwa wa [[makiulopapula]].<ref name=Deut2010/> 

Baadhi ya watu pia hupata [[maambukizi nyemelezi]] katika awamu hii.<ref name=WHOCase2007/>Dalili za tumboni na utumboni kama vile kichefuchefu, kutapika au [[kuharisha]] zinaweza kutokea, sawa na dalili za kinuroni za [[niuropathia ya pembeni]] au [[sindromu ya Guillain-Barre]].<ref name=M118/> Muda ya dalili hutofautiana, ingawa kwa kawaida huwa wiki 1 - 2.<ref name=M118/>

Kufuatia sifa zake za kutokuwa dalili maalum, hizi mara nyingi haziwezi kutambulika kama dalili za maambukizi ya VVU. Hata visa vinavyotambuliwa na [[daktari]] wa [[familia]] au katika [[hospitali]] mara nyingi hutambulika vibaya kama baadhi ya visababishi vingi vya [[magonjwa ambukizi]] yaliyo na dalili zinazoingiliana. Kwa hivyo, inapendekezwa kuchunguza VVU katika watu wanaoonyesha homa isiyoelezeka ambao wanaweza kuwa na vipengele hatari vya kuambukizwa.<ref name=M118>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref>

=== Awamu fiche ===
Dalili za kwanza hufuatwa na awamu fiche (VVU visivyo na dalili au VVU vya muda mrefu).<ref name=AIDS2010GOV/>Bila ya matibabu, awamu hii ya pili ya historia asilia ya maambukizi ya VVU inaweza kudumu kutoka miaka 3 <ref>{{cite book|last=Evian|first=Clive|title=Primary HIV/AIDS care: a practical guide for primary health care personnel in a clinical and supportive setting|year=2006|publisher=Jacana|location=Houghton [South Africa]|isbn=978-1-77009-198-6|page=29|url=http://books.google.ca/books?id=WauaC7M0yGcC&pg=PA29|edition=Updated 4th}}</ref> hadi zaidi ya miaka 20;<ref>{{cite book|first=J. W. A. J. Reeders; P. C. Goodman (ed.). With contributions by J. Bedford|title=Radiology of AIDS|year=2001|publisher=Springer|location=Berlin [u.a.]|isbn=978-3-540-66510-6|page=19|url=http://books.google.ca/books?id=xmFBtyPGOQIC&pg=PA19}}</ref> (wastani wa miaka 8).<ref>{{cite book|last=Elliott|first=Tom|title=Lecture Notes: Medical Microbiology and Infection|year=2012|publisher=John Wiley & Sons|isbn=978-1-118-37226-5|page=273|url=http://books.google.ca/books?id=M4q3AyDQIUYC&pg=PA273}}</ref>Ingawa kwa kawaida mwanzoni kuna dalili chache, au hata zisiwemo, karibu mwishoni mwa awamu hii, watu wengi hupatwa na homa, kukonda, matatizo ya tumbo na utumbo, na maumivu ya misuli. <ref name=AIDS2010GOV/>Kati ya asilimia 50 na 70 ya wagonjwa pia hupata [[limfadenopathia]] ya mwili wote inayorejea, ambayo hudhihirika kwa uvimbe usio na kisababishi na usio chungu wa zaidi ya kikundi kimoja cha tezi za [[limfu]] (ila katika sehemu za uzazi) kwa zaidi ya miezi 3 hadi 6.<ref name=M121/>

Ingawa watu wengi walioambukizwa [[VVU-1]] wana kiwango cha virusi kinachoweza kutambulika, na ambacho bila matibabu kitaendelea na kuwa UKIMWI, idadi ndogo (5%) huwa na kiwango kikubwa cha seli za CD4<SUP>+</SUP>([[seli saidizi za T]]) bila [[Udhibiti wa VVU/UKIMWI|matibabu ya kudhibiti virusi]] kwa zaidi ya miaka 5. <ref name=M118/><ref name=LT2010/>Watu hao huainishwa kama wadhibiti wa VVU au watu wasioendeleza kwa muda mrefu, ilhali wale ambao pia hudumisha kiwango cha chini au kisichotambulika cha virusi bila matibabu hujulikana kama "wadhibiti hodari" au "wagandamizaji hodari" <ref name=LT2010>{{cite journal|last=Blankson|first=JN|title=Control of HIV-1 replication in elite suppressors|journal=Discovery medicine|date=2010 Mar|volume=9|issue=46|pages=261–6|pmid=20350494}}</ref>.

=== Ukosefu wa Kinga Mwilini===
[[File:Symptoms of AIDS.svg|thumb|275px|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya UKIMWI|Dalili kuu za maambukizi makali ya UKIMWI.]]
Ukosefu wa Kinga Mwilini (UKIMWI) hufasiliwa kwa msingi wa kiwango cha seli za CD4 <SUP>+</SUP> cha chini ya seli 200 kwa kila µL au kutokea kwa magonjwa maalumu yanayohusiana na maambukizi ya VVU. <ref name=M118/> Bila matibabu maalum, takriban nusu ya watu walioambukizwa VVU hupata UKIMWI katika muda wa miaka 10.<ref name=M118/>Hali zinazotokea mara nyingi zaidi kudhihirisha uwepo wa UKIMWI ni [[numonia ya numosistisi]] (40%), [[kakeksi]] kwa muundo wa dalili dhoofishi za VVU (20%) na [[kandidiasi ya umio]].<ref name=M118/>Dalili nyingine ni pamoja na maambukizi ya [[njia ya pumzi]]<ref name=M118/>.

[[Maambukizi nyemelezi]] yanaweza kusababishwa na [[bakteria]], [[virusi]], [[kuvu]] na [[vimelea]] ambavyo kwa kawaida hudhibitiwa na mfumo wa kingamwili.<ref name=Holmes>{{Cite journal|author=Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA|title= Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa|journal=Clin. Infect. Dis.|year=2003|pages=656–662|volume=36|issue=5|pmid=12594648|doi=10.1086/367655}}</ref>Maambukizi yanayotokea hutegemea, kwa upande mmoja, aina ya [[viumbehai]] vinavyopatikana kwa wingi katika [[mazingira]] ya mtu.<ref name=M118/>Maambukizi hayo yanaweza kudhuru karibu kila [[mfumo wa kibayolojia|mfumo wa viungo]].<ref name=Complications2011>{{cite journal|last=Chu|first=C|coauthors=Selwyn, PA|title=Complications of HIV infection: a systems-based approach|journal=American family physician|date=2011-02-15|volume=83|issue=4|pages=395–406|pmid=21322514}}</ref>

Watu walio na UKIMWI wako katika hatari kuu zaidi ya kupata saratani nyingi zinazosababishwa na virusi, kama vile: [[Sakoma ya Kaposi]], [[limfoma ya Burkitt]], [[limfoma ya mfumo mkuu wa neva]] na [[saratani ya seviksi]].<ref name=Deut2010/>Sakoma ya Kaposi ndiyo saratani inayotokea mara nyingi, yaani katika asilimia 10 hadi 20 ya watu wenye VVU.<ref name=M169>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref>Saratani inayoifuata ni limfoma, ambayo imesababisha vifo vya karibu 16% ya watu wanaoishi na UKIMWI, na ndiyo dalili ya kwanza ya UKIMWI katika asilimia 3 - 4 ya watu.<ref name=M169/>Saratani hizi mbili huhusishwa na [[virusi vya hepesi]] ya binadamu aina ya 8.<ref name=M169/>Saratani ya seviksi hutokea mara nyingi zaidi katika watu walio na UKIMWI kwa sababu ya jinsi inavyohusiana na [[virusi vya papiloma ya binadamu]].<ref name=M169/>

Isitoshe, watu hao mara nyingi huwa na dalili za kimfumo, kama vile homa ya muda mrefu, [[jasho la usiku|jasho]] (hasa usiku), tezi za limfu zilizofura, ubaridi, udhaifu na [[kupoteza uzito]].<ref>{{cite web|title=AIDS|url=http://www.nlm.nih.gov/medlineplus/ency/article/000594.htm|work=MedlinePlus|publisher=A.D.A.M.|accessdate=14 June 2012}}</ref>Kuharisha ni dalili nyingine inayotokea katika takriban 90% ya watu wenye UKIMWI.<ref>{{cite journal|author=Sestak K |title=Chronic diarrhea and AIDS: insights into studies with non-human primates |journal=Curr. HIV Res. |volume=3 |issue=3 |pages=199–205 |year=2005 |month=July |pmid=16022653 |doi= 10.2174/1570162054368084|url=}}</ref>

== Lini na wapi VVU vilianza ==
UKIMWI huchukuliwa kama [[janga]] — yaani [[mlipuko wa ugonjwa]] katika eneo kubwa, na ambao ungali unaenea.<ref name=Kallings/>

UKIMWI ulitambuliwa mara ya kwanza na Vituo vya Kuzuia na Kudhibiti Magonjwa huko Marekani mwaka [[1981]]<ref name=M169/>, ilhali kisababishi chake - VVU - kilitambuliwa mwanzoni mwa [[muongo]] huo nchini huko. <ref>{{Cite journal|author=Gallo RC|title=A reflection on HIV/AIDS research after 25 years|journal= Retrovirology|volume=3|page=72|year=2006|pmid=17054781|doi=10.1186/1742-4690-3-72|url=http://www.retrovirology.com/content/3//72|pmc=1629027}}</ref> 

Matukio ya kwanza yalikuwa katika kikundi kidogo cha [[Uraibu|waraibu]] wa dawa za kudungia na [[wanaume]] [[shoga]] wasiokuwa na visababishi bayana vya udhaifu wa kingamwili na walioonyesha dalili za [[numonia]] ya ''[[Pneumocystis carinii]]'', maambukizi nyemelezi yanayotokea kwa nadra na maarufu katika watu wenye kingamwili dhaifu sana.<ref name=MMWR2>{{Cite journal| author=Gottlieb MS| title=Pneumocystis pneumonia—Los Angeles. 1981| journal=Am J Public Health| volume=96| issue=6| pages=980–1; discussion 982–3| year=2006| pmid=16714472| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| accessdate=March 31, 2009| pmc=1470612| archiveurl=https://web.archive.org/web/20090422042240/http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| archivedate=2009-04-22| deadurl=no}}</ref> 

Punde baadaye, idadi isiyotarajiwa ya mashoga wakapata [[Sakoma ya Kaposi]] (SK), [[saratani ya ngozi]] iliyokuwa nadra sana hapo awali.<ref name="pmid7287964">{{cite journal|author=Friedman-Kien AE|title=Disseminated Kaposi's sarcoma syndrome in young homosexual men|journal=J. Am. Acad. Dermatol.|volume=5|issue=4|pages=468–71|year=1981|month=October|pmid=7287964|doi=10.1016/S0190-9622(81)80010-2|url=}}</ref><ref name="pmid6116083">{{cite journal|author=Hymes KB|title=Kaposi's sarcoma in homosexual men-a report of eight cases|journal=Lancet|volume=2|issue=8247|pages=598–600|year=1981|month=September|pmid=6116083|doi=|url=|author-separator=,|author2=Cheung T|author3=Greene JB|display-authors=3|last4=Prose|first4=NS|last5=Marcus|first5=A|last6=Ballard|first6=H|last7=William|first7=DC|last8=Laubenstein|first8=LJ}}</ref>Visa vingine vingi vya NPC na SK vilitokea huku vikitahadharisha Vituo vya Kudhibiti na Kuzuia Magonjwa nchini Marekani, hivyo kikosi cha kiutendaji kikaundwa ili kuudhibiti mzuko huu.<ref name="Basavapathruni_2007">{{cite journal | title=Reverse transcription of the HIV-1 pandemic | url=https://archive.org/details/sim_faseb-journal_2007-12_21_14/page/3795 | last1=Basavapathruni |first1=A | last2=Anderson | first2=KS | journal=The FASEB Journal |year=2007 | month=December | volume=21 | issue=14 |pages=3795–3808 | doi=10.1096/fj.07-8697rev | pmid=17639073}}</ref>

Katika siku za kwanza, kituo hicho hakikuwa na jina rasmi la ugonjwa huu, mara nyingi wakitumia majina ya magonjwa mengine yaliyohusishwa nao, kwa mfano, [[limfadenopathi]], jina ambalo baadaye wavumbuzi wa VVU waliviita virusi hivi.<ref name=MMWR1982a>{{Cite journal | author=Centers for Disease Control (CDC) |title=Persistent, generalized lymphadenopathy among homosexual males|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001096.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=249–251 | volume=31| issue=19 | pmid=6808340 | accessdate =August 31, 2011}}</ref><ref name=Barre>{{Cite journal|author=Barré-Sinoussi F | title=Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) | journal=Science | year=1983 | pages=868–871 | volume=220 | issue=4599 | pmid=6189183 |doi=10.1126/science.6189183 | bibcode=1983Sci...220..868B| author-separator=,| author2=Chermann JC| author3=Rey F|display-authors=3| last4=Nugeyre| first4=M.| last5=Chamaret| first5=S| last6=Gruest| first6=J| last7=Dauguet| first7=C|last8=Axler-Blin| first8=C| last9=Vezinet-Brun| first9=F
}}</ref> Wavumbuzi pia walitumia “Sakoma ya Kaposi na Maambukizi nyemelezi”, jina lililokuwa la kikosi cha kiutendaji kilichoanzishwa mwaka wa 1981.<ref name=MMWR1982b>{{Cite journal | author=Centers for Disease Control (CDC) | title=Opportunistic infections and Kaposi's sarcoma among Haitians in the United States |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001123.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=353–354; 360–361 | volume=31 | issue=26 | pmid=6811853 | accessdate =August 31, 2011}}</ref> Wakati mmoja, Kituo cha Kudhibiti na Kuzuia Magonjwa kiliunda msemo "ugonjwa wa 4H", kwani [[sindromu]] hii ilionekana kuwaathiri watu wa [[Haiti]], mashoga (homosexuals), wenye [[hemofilia]] na watumiaji wa [[heroini]].<ref name=SciRep470b>{{cite web| publisher=[[American Association for the Advancement of Science]]| date=July 28, 2006| url=http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| title=Making Headway Under Hellacious Circumstances| accessdate=June 23, 2008| format=PDF| archivedate=2008-06-24| archiveurl=https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| =https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf}}</ref> Katika vyombo vikuu vya habari liliundwa neno "[[GRID]]" (lililosimamia "gay-related immune deficiency", yaani "ukosefu wa kinga uliohusishwa na mashoga".<ref name=Altman>{{Cite news
|author=Altman LK |url=http://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html?scp=1&sq=New%20homosexual%20disorder%20worries%20officials&st=cse | title=New homosexual disorder worries health officials | work=The New York Times | date=May 11, 1982 | accessdate =August 31, 2011}}</ref> Hata hivyo, baada ya kutambua kuwa VVU havikuwaathiri jamii ya mashoga pekee,<ref name=MMWR1982b/> ilibainika kuwa neno GRID lilikuwa likipotosha, hivyo neno UKIMWI likaanzishwa kwenye mkutano mnamo Julai 1982.<ref name=Kher>{{Cite news| author=Kher U| title=A Name for the Plague| work=Time| date=July 27, 1982| url=http://www.time.com/time/80days/820727.html| accessdate=March 10, 2008| archiveurl=https://web.archive.org/web/20080307015307/http://www.time.com/time/80days/820727.html| archivedate=2008-03-07| deadurl=no}}</ref> Kufikia Septemba 1982, Kituo cha Kudhibiti na Kuzuia Magonjwa kilianza kuuita UKIMWI.<ref name=MMWR1982c>{{Cite journal
 | author=Centers for Disease Control (CDC) | title=Update on acquired immune deficiency syndrome (AIDS)—United States| journal=MMWR Morb Mortal Wkly Rep. | year=1982 | pages=507–508; 513–514 | volume=31 | issue=37 | pmid=6815471}}</ref>
[[File:Robert Gallo.jpg|thumb|Alt=Mwanaume aliyevalia shati nyeupe na tai, huku akizingizirwa na wanawake watatu na vifaa vya maabara|Robert Gallo, mzinduzi mwenza wa VVU katika miaka ya kwanza ya 1980, akiwa pamoja na (kushoto kwenda kulia) Sandra Eva, Sandra Colombini, na Ersell Richardson.]]
Mnamo 1983, vikundi viwili tofauti vya watafiti vilivyoongozwa na [[Robert Gallo]] na [[Luc Montagnier]] bila kutegemeana vilitangaza kuwa [[retrovirusi]] mpya ilikuwa ikiwaambukiza wagonjwa wa UKIMWI, hivyo wakachapisha matokeo yao katika [[jarida]] la ''[[Science (jarida)|Science]]''.<ref name=Gallo>{{cite journal | author=RC Gallo, PS Sarin, EP Gelmann, M Robert-Guroff, E Richardson, VS Kalyanaraman, D Mann, GD Sidhu, RE Stahl, S Zolla-Pazner, J Leibowitch, and M Popovic |journal=Science |title=Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) |year=1983 | pages=865–867 | volume=220 | doi=10.1126/science.6601823 | pmid=6601823 | issue=4599|bibcode = 1983Sci...220..865G }}</ref><ref name=Montagnier >{{cite doi|10.1126/science.6189183}}</ref> Gallo alidai kuwa virusi vilivyokuwa vimetambuliwa kwa mara ya kwanza na kikundi chake kilikuwa sawa katika [[muundo wa virusi|umbo]] na [[virusi vya binadamu vya limfotrophia-T]]. Kikundi cha Gallo kiliviita virusi hivi HTLV-III. 

Wakati huohuo, kikundi cha Montagnier kilitambua virusi kutoka kwa mgonjwa aliyekuwa na [[uvimbe]] wa [[tezi za limfu]] kwenye [[shingo]] na [[asthenia|udhaifu wa mwili]] ambazo ni dalili mbili bainifu za UKIMWI. Huku wakikanusha ripoti ya kikundi cha Gallo, Montagnier na wenzake walionyesha kuwa viini vya [[protini]] vya virusi hivyo vilikuwa tofauti na HTLV-I kiukingamwili. Kikundi cha Montagnier kiliviita virusi walivyovitambua virusi vinavyohusishwa na limfadenopathi.<ref name="Basavapathruni_2007"/> Virusi hivi vilibainika kuwa sawa mwaka wa 1986 na kubadilishwa na kuitwa VVU.<ref>{{cite book|last=Aldrich|first=ed. by Robert|title=Who's who in gay and lesbian history.|year=2001|publisher=Routledge|location=London|isbn=9780415229746|pages=154|url=http://books.google.ca/books?id=9KA7_1s6w-QC&pg=PA154|coauthors=Wotherspoon, Garry}}</ref>

Leo [[wanasayansi]] wengi wanaamini VVU-1 na VVU-2 vimetokana na [[jamii ya sokwe]] huko [[Afrika Magharibi]] na [[Afrika ya Kati|ya Kati]] mwishoni mwa [[karne ya 19]] au mwanzoni mwa [[karne ya 20]], wakati virusi vya [[SIV]] kutoka kwa [[nyani]] au [[sokwe]] vilikwenda kwa binadamu.<ref name=Orgin2011>{{cite journal|last=Sharp|first=PM|coauthors=Hahn, BH|title=Origins of HIV and the AIDS Pandemic|journal=Cold Spring Harbor perspectives in medicine|date=2011 Sep|volume=1|issue=1|pages=a006841|pmid=22229120|doi=10.1101/cshperspect.a006841|pmc=3234451}}</ref> VVU-1 vinaaminika kutoka kusini mwa [[Cameroon]] kupitia kugeuka kwa VSVU(cpz), (virusi vya sokwe vinavyosababisha ukosefu wa kinga mwilini) vinavyoambukiza sokwe wa mwituni (VVU-1 hutokana na mzuko wa magonjwa ya VSVUcpz katika [[nususpishi]] ya sokwe iitwayo ''[[Pan]] troglodytes troglodytes'').<ref name="pmid9989410">{{cite journal |author=Gao F |title=Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes |journal=Nature |volume=397 |issue=6718|pages=436–41 |year=1999 |month=February |pmid=9989410|doi=10.1038/17130 |url=|bibcode = 1999Natur.397..436G |author-separator=, |author2=Bailes E |author3=Robertson DL|display-authors=3 |last4=Chen|first4=Yalu |last5=Rodenburg |first5=Cynthia M. |last6=Michael |first6=Scott F.|last7=Cummins |first7=Larry B. |last8=Arthur |first8=Larry O. |last9=Peeters |first9=Martine }}</ref><ref name=Keele>{{cite journal | author=Keele, B. F., van Heuverswyn, F., Li, Y. Y., Bailes, E., Takehisa, J., Santiago, M. L., Bibollet-Ruche, F., Chen, Y., Wain, L. V., Liegois, F., Loul, S., Mpoudi Ngole, E., Bienvenue, Y., Delaporte, E., Brookfield, J. F. Y., Sharp, P. M., Shaw, G. M., Peeters, M., and Hahn, B. H. | title=Chimpanzee Reservoirs of Pandemic andNonpandemic HIV-1 | url=https://archive.org/details/sim_science_2006-07-28_313_5786/page/523 | journal=Science | date=28 July 2006| volume=313 | issue=5786 | pages=523–6 | doi = 10.1126/science.1126531 | pmc=2442710 | pmid=16728595|bibcode = 2006Sci...313..523K }}</ref> 

Virusi vinavyohusiana kwa karibu na VVU-2 ni VSVU(smm) ambavyo ni virusi vya [[mangabi mwenye masizi]] (''Cercocebus atys atys''), [[tumbili]] wa kale anayeishi Afrika Magharibi (kutoka [[kusini]] mwa [[Senegali]] hadi [[magharibi]] mwa [[Côte d'Ivoire]]).<ref name="Reeves" /> [[Tumbili wa kisasa]] kama vile [[tumbili wa Usiku|tumbili bundi]] wana ukinzani wa maambukizi ya [[VVU-1]] kwa sababu ya [[uunganishaji jeni|uunganishaji]] wa [[jeni]] [[mbili]] zinazokinzana na virusi.<ref name=Goodier>{{cite journal | author=Goodier, J., and Kazazian, H. | title=Retrotransposons Revisited: The Restraint and Rehabilitation of Parasites | journal=Cell |year=2008 | pages=23–35 | volume=135 | issue=1 | doi = 10.1016/j.cell.2008.09.022 | pmid=18854152}}(subscription required)</ref>
VVU-2 inadhaniwa kuruka kizuizi cha spishi katika angalau matukio matatu tofauti, hivyo kupelekea vikundi vitatu vya virusi hivi ambavyo ni M, N na O. <ref name=Kalish2005>{{cite journal |author=Kalish ML |title=Central African hunters exposed to simian immunodeficiency virus |journal=Emerg Infect Dis |volume=11 |issue=12 |pages=1928–30 |year=2005 |pmid=16485481|doi=10.3201/eid1112.050394 |author-separator=, |author2=Wolfe ND |author3=Ndongmo CD |author4=McNicholl J|author5=Robbins KE |display-authors=5 |last6=Aidoo |first6=Michael |last7=Fonjungo |first7=Peter N. |last8=Alemnji|first8=George |last9=Zeh |first9=Clement |pmc=3367631}}</ref>

Kuna ushahidi kuwa wanadamu wanaoshughulikia [[nyama za mwituni]] kwa kuwinda au kuziuza, kwa kawaida hupata VSVU.<ref name=Kalish2005/>Hata hivyo, virusi hivyo ni dhaifu na hukandamizwa na mfumo wa kingamwili baada ya wiki kadhaa za kuambukizwa. Inadhaniwa kuwa maambukizi kadhaa ya virusi hivyo kutoka kwa mtu hadi mwingine katika mfululizo wa haraka huhitajika ili vipate wakati unaotosha kubadilika na kuwa VVU.<ref name=Marx2001>{{cite journal |author=Marx PA, Alcabes PG, Drucker E |title=Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa|volume=356 |issue=1410 |pages=911–20 |year=2001 |pmid=11405938 |journal=Philos Trans R Soc Lond B Biol Sci|pmc=1088484 |doi=10.1098/rstb.2001.0867|url=http://rstb.royalsocietypublishing.org/content/356/1410/911.full.pdf}}</ref> Zaidi ya hayo, kwa sababu ya kiwango chake kidogo cha kuambukiza kutoka kwa mtu hadi mwingine, virusi hivyo vinaweza tu kuenea katika wingi wa watu iwapo kuna njia moja au mbili za hatari ya kuambukizana ya kiwango cha juu. Njia hizi zinadhaniwa kutokuwepo barani Afrika kabla ya karne ya 20.

Njia maalumu za hatari kubwa ya maambukizi zinazoruhusu virusi hivi kubadilika ili kuweza kuishi katika wanadamu na kuenea katika jamii yote hutegemea wakati uliopendekezwa wa kuvuka kutoka kwa mnyama hadi mwanadamu. Tafiti za kijeni za virusi hivi zinadokeza kuwa chanzo cha hivi karibuni zaidi cha VVU-1 ya kikundi M kilitokea mnamo 1910. <ref name=Worobey2008>{{cite journal|last1=Worobey |first1=Michael |last2=Gemmel |first2=Marlea |last3=Teuwen |first3=Dirk E. |last4=Haselkorn|first4=Tamara |last5=Kunstman |first5=Kevin |last6=Bunce |first6=Michael |last7=Muyembe |first7=Jean-Jacques|last8=Kabongo |first8=Jean-Marie M. |last9=Kalengayi |first9=Raphaël M. |title=Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960 |journal=Nature |volume=455 |issue=7213 |pages=661–4 |year=2008 |pmid=18833279| doi=10.1038/nature07390|url=http://www.nature.com/nature/journal/v455/n7213/pdf/nature07390.pdf |bibcode = 2008Natur.455..661W }} (subscription required)</ref> Wanaotaja kipindi hicho maalumu huhusisha mzuko wa janga la VVU na kuibuka kwa [[ukoloni]] na ukuaji wa [[miji]] mikubwa ya kikoloni ya Afrika, huku ukisababisha mabadiliko ya jamii pamoja na kiwango kikubwa cha [[uasherati]], uenezi wa [[ukahaba]] na matukio mengi ya [[vidonda vya viungo vya uzazi]] (kama vile [[kaswende]]) katika miji iliyochipuka.<ref name=Sousa2010>{{cite journal |last1=Sousa |first1=João Dinis de|last2=Müller |first2=Viktor |last3=Lemey |first3=Philippe |last4=Vandamme |first4=Anne-Mieke |last5=Vandamme|first5=Anne-Mieke |title=High GUD Incidence in the Early 20th Century Created a Particularly Permissive Time Window for the Origin and Initial Spread of Epidemic HIV Strains |journal=PLoS ONE |volume=5 |issue=4 |pages=e9936 |year=2010|pmid=20376191 |pmc=2848574|doi=10.1371/journal.pone.0009936|url=http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0009936|editor1-last=Martin |editor1-first=Darren P.}}</ref> 

Ingawa viwango vya uambukizaji wakati wa ngono ya kupitia [[uke]] viko chini katika hali ya kawaida, kuna ongezeko kubwa iwapo mmoja wa wapenzi hao ana [[ugonjwa wa zinaa]] unaosababisha vidonda vya [[viungo vya uzazi]]. Miji ya kikoloni ya [[Miaka ya 1900|miaka ya kwanza ya 1900]] ilijulikana kwa maambukizi ya viwango vya juu kutokana na ukahaba na [[vidonda vya viungo vya uzazi]], hivi kwamba, kufikia mwaka [[1928]], 45% ya [[wanawake]] wakazi wa mashariki mwa [[Kinshasa]] walidhaniwa kuwa makahaba. Kufikia mwaka [[1933]], takriban 15% ya wakazi wote wa mji huo walikuwa wameambukizwa aina mojawapo ya kaswende.<ref name=Sousa2010 />

Maoni mengine yanadokeza kuwa hatua zisizo salama za [[uuguzi]] barani Afrika katika miaka ya baada ya [[Vita vya pili vya dunia]], kama vile kutumia tena na tena [[sindano]] zisizosafishwa kuchanja [[umati]], [[antibayotiki]] na kampeni dhidi ya [[malaria]] ndizo njia za kwanza zilizoruhusu virusi hivyo kujibadilisha vikiwa ndani ya wanadamu kisha kuenea.<ref name=Marx2001 /><ref name=Chitnis2000>{{cite journal |last1=Chitnis |first1=Amit |last2=Rawls |first2=Diana |last3=Moore |first3=Jim|title=Origin of HIV Type 1 in Colonial French Equatorial Africa? |journal=AIDS Research and Human Retroviruses|volume=16 |issue=1 |pages=5–8 |year=2000 |pmid=10628811 |doi=10.1089/088922200309548}}(subscription required)</ref><ref name=McNeil>{{cite news |author=[[Donald G. McNeil, Jr.]] |coauthors= |title=Precursor to H.I.V. Was in Monkeys for Millennia |url=http://www.nytimes.com/2010/09/17/health/17aids.html?_r=1&src=me&ref=general|quote=Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s.&nbsp;... suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts.|work=[[New York Times]] |date=September 16, 2010 |accessdate=2010-09-17 }}</ref>

Visa vilivyonakiliwa vyema vya VVU katika mwanadamu ni vya mwaka [[1959]] katika eneo la nchi ya [[Jamhuri ya Kidemokrasia ya Kongo|Kongo]].<ref name=Zhu>{{cite journal|author=Zhu, T., Korber, B. T., Nahmias, A. J., Hooper, E., Sharp, P. M. and Ho, D. D.|title=An African HIV-1 Sequence from 1959 and Implications for the Origin of the epidemic|journal=Nature|year=1998|pages=594–7|volume=391|issue=6667|pmid=9468138|doi=10.1038/35400|url=http://www.nature.com/nature/journal/v391/n6667/full/391594a0.html|bibcode = 1998Natur.391..594Z }}</ref> Kuna uwezekano kuwa virusi hivyo vilikuwemo huko Marekani mwaka [[1966]],<ref>{{cite news | last = Kolata | first = Gina |title = Boy's 1969 Death Suggests AIDS Invaded U.S. Several Times | publisher = The New York Times | date = 28 October 1987 | url = http://query.nytimes.com/gst/fullpage.html?res=9B0DEFD6173AF93BA15753C1A961948260&sec=health&pagewanted=all | accessdate = 11 February 2009}}</ref>lakini maambukizi mengi yanayotokea nje ya [[Kusini kwa Sahara]] yanaweza kufuatiliwa hadi kwa mtu mmoja aliyeambukizwa na VVU katika nchi ya [[Haiti]] na kisha kuyapeleka maambukizi hayo nchini Marekani takriban mwaka [[1969]].<ref name="Thomas_Gilbert">{{cite journal |last1=Gilbert |first1=M. Thomas P. |last2=Rambaut |first2=Andrew |last3=Wlasiuk |first3=Gabriela |last4=Spira |first4=Thomas J. |last5=Pitchenik |first5=Arthur E. |last6=Worobey |first6=Michael |title=The emergence of HIV/AIDS in the Americas and beyond |journal=PNAS |date=November 20, 2007 |volume=104 |issue=47 |pages=18566–18570 |url=http://www.pnas.org/content/104/47/18566.full.pdf |format=PDF |doi=10.1073/pnas.0705329104 |pmid=17978186 |pmc=2141817 |bibcode=2007PNAS..10418566G |access-date=2017-04-01 |archive-date=2015-09-24 |archive-url=https://web.archive.org/web/20150924144548/http://www.pnas.org/content/104/47/18566.full.pdf |dead-url=yes }}</ref> Janga hili kisha lilienea kwa haraka katika vikundi vilivyo katika hatari kubwa ya kuambukizwa (mwanzoni ilikuwa ni wanaume waliofanya ngono na wanaume). Kufikia mwaka [[1978]], maambukizi ya VVU-1 katika mashoga wenyeji wa [[New York]] na [[San Francisco]] yalikadiriwa kuwa 5%, kuonyesha kuwa maelfu ya watu nchini Marekani tayari walikuwa wameambukizwa.<ref name="Thomas_Gilbert" />

==Uambukizaji==
VVU husambaa hasa kupitia njia tatu kuu: [[ngono]] (ikiwa ni pamoja na [[ulawiti]] na hata [[ngono ya mdomoni]]), kuingiliana na viowevu vya mwili vilivyoambukizwa (hasa [[kuongezewa damu]] au kudungwa [[sindano]]) na [[usambazaji wima|kutoka kwa mama hadi mtoto]] wakati wa [[ujauzito]], kuzaa au kunyonyesha<ref name=TransmissionM2007>{{cite book|last=Markowitz|first=edited by William N. Rom ; associate editor, Steven B.|title=Environmental and occupational medicine|year=2007|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6299-1|page=745|url=http://books.google.ca/books?id=H4Sv9XY296oC&pg=PA745|edition=4th}}</ref>Baadhi ya [[viowevu vya mwili]], kama vile [[mate]] na [[machozi]], havisambazi VVU.<ref name=CDCtransmission>{{cite web|publisher=[[Centers for Disease Control and Prevention]]|year=2003|url=http://www.cdc.gov/HIV/pubs/facts/transmission.htm|title=HIV and Its Transmission|accessdate=May 23, 2006|archiveurl=https://web.archive.org/web/20050204141148/http://www.cdc.gov/HIV/pubs/facts/transmission.htm|archivedate=2005-02-04}}</ref>

=== Kupitia ngono ===
Kufanya [[ngono zembe]] kumepelekea visa vingi zaidi vya maambukizi ya VVU kote ulimwenguni, huku mwingiliano baina ya watu wa [[jinsia]] tofauti ukichangia visa zaidi ya mwingiliano wa mashoga kote ulimwenguni (kwa sababu mashoga ni wachache zaidi).<ref name=TransmissionM2007/> Hata hivyo, mtindo wa usambazaji hutofautiana pakubwa baina ya mataifa mbalimbali. 

Nchini Marekani, visa vingi zaidi vya usambazaji wa kingono vilitokea katika [[wanaume]] wanaofanya ngono na wanaume (kwa sababu huko ushoga umeenea zaidi)<ref name=TransmissionM2007/>huku idadi hii ikichangia 64% ya visa vyote vipya.<ref name=TransmissionCDC2012>{{cite web|title=HIV in the United States: An Overview|url=http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm|work=Center for Disease Control and Prevention|date=March 2012}}</ref>

Kuhusu ngono zembe baina ya watu wa jinsia tofauti, makadirio ya hatari ya kusambazwa kwa VVU kwa kila kitendo cha ngono yanaonekana kuwa zaidi kwa mara 10 katika mataifa yasiyostawi kuliko mataifa yaliyostawi.<ref name=Boily2009/>Katika mataifa yasiyostawi, hatari ya usambazaji wa mwanamke hadi mwanamume imekadiriwa kuwa 0.38% kwa kila kitendo, huku usambazaji wa mwanamume hadi mwanamke ukiwa 0.30%; makadirio mbadala katika mataifa yaliyostawi ni 0.04% kwa kila kitendo katika usambazaji wa mwanamke hadi mwanamume, na 0.08% kwa kila kitendo katika maambukizi ya mwanamume hadi mwanamke.<ref name=Boily2009/> 

Hatari ya kuambukizwa kutokana na ngono ya kinyeo (ulawiti) iko juu sana, ikikadiriwa kuwa 1.4{{ndash}}1.7% kwa kila kitendo (katika ngono ya watu wa jinsia moja na tofauti pia).<ref name=Boily2009/><ref>{{cite journal|last=Beyrer|first=C|coauthors=Baral, SD; van Griensven, F; Goodreau, SM; Chariyalertsak, S; Wirtz, AL; Brookmeyer, R|title=Global epidemiology of HIV infection in men who have sex with men.|journal=Lancet|date=2012 Jul 28|volume=380|issue=9839|pages=367-77|pmid=22819660}}</ref> 

Ingawa hatari ya kuambukizwa kupitia [[ngono ya mdomoni]] iko chini, bado ipo. <ref>{{cite journal|last=Yu|first=M|coauthors=Vajdy, M|title=Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes|journal=Expert opinion on biological therapy|date=2010 Aug|volume=10|issue=8|pages=1181–95|pmid=20624114|doi=10.1517/14712598.2010.496776|pmc=2904634}}</ref>Hatari ya kila kitendo imekadiriwa kuwa 0{{ndash}}0.04% kwa ngono pokezi ya mdomoni.<ref name=Dosekun2010>{{cite journal|last=Dosekun|first=O|coauthors=Fox, J|title=An overview of the relative risks of different sexual behaviours on HIV transmission|journal=Current opinion in HIV and AIDS|date=2010 Jul|volume=5|issue=4|pages=291–7|pmid=20543603|doi=10.1097/COH.0b013e32833a88a3}}</ref><ref>{{cite book|last=Stürchler|first=Dieter A.|title=Exposure a guide to sources of infections|year=2006|publisher=ASM Press|location=Washington, DC|isbn=9781555813765|pages=544|url=http://books.google.ca/books?id=MWa5or3Xa9EC&pg=PA544}}</ref> kwa kuwa visa vichache vimeripotiwa.<ref>{{cite book|last=al.]|first=edited by Richard Pattman ... [et|title=Oxford handbook of genitourinary medicine, HIV, and sexual health|year=2010|publisher=Oxford University Press|location=Oxford|isbn=9780199571666|pages=95|url=http://books.google.ca/books?id=Jm1H4EeULmYC&pg=PA95|edition=2nd ed.}}</ref> 

Katika miktadha inayohusisha [[ukahaba]] kote ulimwenguni, hatari ya maambukizi ya mwanamke hadi mwanamume imekadiriwa kuwa 2.4% kwa kila kitendo, huku maambukizi ya mwanamume kwa mwanamke yakiwa 0.08% kwa kila kitendo.<ref name=Boily2009>{{cite journal|author=Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M |title=Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies|journal=The Lancet Infectious Diseases|volume=9|issue=2|pages=118–129|year=2009|month=February|pmid=19179227|doi=10.1016/S1473-3099(09)70021-0}}</ref>

Hatari ya kuambukizwa huongezeka katika wingi wa [[magonjwa ya zinaa]]<ref name=CochraneSTI2012>{{cite journal|last=Ng|first=BE|coauthors=Butler, LM; Horvath, T; Rutherford, GW|title=Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-03-16|issue=3|pages=CD001220|pmid=21412869|doi=10.1002/14651858.CD001220.pub3|editor1-last=Butler|editor1-first=Lisa M}}</ref> na [[vidonda vya uzazi]].<ref name=Boily2009/>Vidonda vya sehemu za uzazi vimekisiwa kuongeza hatari hadi mara tano. <ref name=Boily2009/> Maambukizi mengine ya zinaa, kama vile [[kisonono]], [[klamidia]], [[trikomoniasi]], [[vaginosi ya kibakteria]], huhusishwa na aghalabu ongezeko dogo la hatari ya kuambukizwa.<ref name=Dosekun2010/> 

[[Wingi wa virusi]] kwa mtu aliyeambukizwa ni suala kuu la hatari katika usambazaji wa kingono na pia wa kutoka kwa mama hadi mtoto.<ref>{{cite journal|last=Anderson|first=J|title=Women and HIV: motherhood and more|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=58–65|pmid=22156896|doi=10.1097/QCO.0b013e32834ef514}}</ref> Katika miezi 2.5 ya kwanza baada ya kuambukizwa VVU, uwezo wa mtu kuambukiza ni mara 12 zaidi kwa sababu ya wingi wa virusi. <ref name=Dosekun2010/> Iwapo mtu yuko katika awamu za mwisho za VVU, viwango vya kuambukizana ni takriban mara 8 zaidi.<ref name=Boily2009/>

[[Usadomasoki|Ngono shari]] inaweza kuwa suala linalochangia ongezeko la hatari ya kuambukizwa. <ref>{{cite journal|last=Klimas|first=N|coauthors=Koneru, AO; Fletcher, MA|title=Overview of HIV|url=https://archive.org/details/sim_psychosomatic-medicine_2008-06_70_5/page/523|journal=Psychosomatic Medicine|date=2008 Jun|volume=70|issue=5|pages=523–30|pmid=18541903|doi=10.1097/PSY.0b013e31817ae69f}}</ref> 

[[Ubakaji]] pia unaaminika kuongezeka hatari ya kusambaza VVU kwa sababu ni nadra [[kondomu]] kutumika, huwa na uwezekano wa kujeruhiwa ukeni au kinyeo, na pia kuna uwezekano wa magonjwa ya zinaa yanayoambatana na VVU. <ref>{{cite journal|last=Draughon|first=JE|coauthors=Sheridan, DJ|title=Nonoccupational post exposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: a review|journal=Psychology, health & medicine|year=2012|volume=17|issue=2|pages=235–54|pmid=22372741|doi=10.1080/13548506.2011.579984}}</ref> 

===Viowevu vya mwili ===
[[File:AIDS Poster If You're Dabbling in Drugs 1989.jpg|thumb|alt=Bango la rangi nyeusi na jipya la kijana wa Kiafrika akiwa na taulo kwenye mkono wa kushoto iliyo na maneno "Kucheza na madawa ni kucheza na maisha" juu yake|Bango la mwaka 1989 likisisitiza tishio la UKIMWI unaohusiana na kutumia madawa ya kulevya.]]
Njia ya pili maarufu zaidi ya usambazaji wa VVU ni kupitia kwa [[damu]] na mazao yake.<ref name=TransmissionM2007/> Usambazaji wa kupitia damu unaweza kuwa kupitia sindano inayotumiwa na watu wengi wanapoongezwa viowevu mwilini, majeraha ya sindano, kuongezwa damu chafu au mazao ya damu, au kudungwa kwa vifaa visivyotakaswa. 

Hatari inayotokana na kutumia sindano baina ya watu wengi wakati wa [[kudungwa dawa]] ni kati ya 0.63-2.4% kwa kila kitendo, wastani wake ukiwa 0.8%<ref name=Risk2006>{{cite journal|last=Baggaley|first=RF|coauthors=Boily, MC; White, RG; Alary, M|title=Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis|journal=AIDS (London, England)|date=2006-04-04|volume=20|issue=6|pages=805–12|pmid=16549963|doi=10.1097/01.aids.0000218543.46963.6d}}</ref> Hatari ya kuambukizwa VVU kwa sindano iliyotumiwa na mtu aliyeambukizwa VVU hukadiriwa kuwa 0.3% (takriban mara 1 kwa 133) kwa kila kitendo, ilhali hatari inayofuatia [[tando za ute]] kuingiliana na damu iliyoambukizwa ni 0.09% (takriban 1 kwa 1000) kwa kila kitendo.<ref name=AFP2007>{{cite journal|last=Kripke|first=C|title=Antiretroviral prophylaxis for occupational exposure to HIV|journal=American family physician|date=2007-08-01|volume=76|issue=3|pages=375–6|pmid=17708137}}</ref> Nchini Marekani, watu wanaodungwa dawa ndani ya [[misuli]] walichangia 12% ya visa vyote vipya vya VVU mwaka wa 2009, <ref name=TransmissionCDC2012/> huku 80% ya watu katika sehemu fulani wanaodungwa dawa wakiwa wameambukizwa VVU. <ref name=TransmissionM2007/>

[[Kuongezewa damu]] iliyoambukizwa huchangia maambukizi kwa takriban 93% ya visa vyote.<ref name=Risk2006/>Katika mataifa yaliyostawi, hatari ya kuambukizwa VVU kutokana na kuongezewa damu iko chini sana (chini ya 1 kwa 500,000) ambapo viwango vya juu vya kuchagua mtu atakayetoa damu na pia upimaji VVU hufanywa.<ref name=TransmissionM2007/> Kule Uingereza, hatari iliyoripotiwa ni 1 kwa milioni 5.<ref>{{cite web|title=Will I need a blood transfusion?|work=NHS patient information|year=2011|url=http://hospital.blood.co.uk/library/pdf/2011_Will_I_Need_English_v3.pdf|publisher=National Health Services|accessdate=August 29, 2012}}</ref> Hata hivyo, katika mataifa yenye mapato ya chini, [[nusu]] tu ya damu inayoongezwa huwa imepimwa vyema (kufikia mwaka wa 2008). <ref name=UN2011Seventy>UNAIDS 2011 pg. 60–70</ref>Inakadiriwa kuwa hadi 15% ya maambukizi ya VVU katika maeneo hayo hutokana na kuongeza damu au mazao ya damu yaliyoambukizwa, hii ikiwa ni asilimia 5 - 10 ya maambukizi ya ulimwengu mzima. <ref name=TransmissionM2007/><ref name=WHO070401>{{cite web |publisher=[[World Health Organization|WHO]] |year=2001 |url=http://www.who.int/inf-pr-2000/en/pr2000-25.html |title=Blood safety&nbsp;... for too few |accessdate=January 17, 2006 |archivedate=2005-01-17 |archiveurl=https://web.archive.org/web/20050117092135/http://www.who.int/inf-pr-2000/en/pr2000-25.html }}</ref>

Sindano za tiba zisizo salama huchangia pakubwa katika kueneza UKIMWI katika eneo la Kusini kwa Sahara. Mnamo 2007, kati ya 12% na 17% ya maambukizi katika eneo hilo yalichangiwa na matumizi ya sindano hizo.<ref>{{cite journal|last=Reid|first=SR|title=Injection drug use, unsafe medical injections, and HIV in Africa: a systematic review|journal=Harm reduction journal|date=2009-08-28|volume=6|page=24|pmid=19715601|doi=10.1186/1477-7517-6-24|pmc=2741434}}</ref> [[Shirika la Afya Duniani]] linakadiria hatari ya kuambukizwa kupitia sindano hizo barani Afrika kuwa 1.2%. Hatari kuu huhusishwa na taratibu vamizi, kusaidiwa kuzaa na utunzaji wa [[meno]] katika sehemu hii ya dunia.

Watu wanaochanja au kuchanjwa [[chale]], [[chale za mwili]] na [[kutia kovu]] hudhaniwa kuwa katika hatari ya kuambukizwa, ingawa hakuna visa vilivyothibitishwa ambavyo vimenakiliwa.<ref name=CDCBasics2012>{{cite web|title=Basic Information about HIV and AIDS|url=http://www.cdc.gov/hiv/topics/basic/|work=Center for Disease Control and Prevention|date=April 2012}}</ref> Haiwezekani [[mbu]] au wadudu wengine kusambaza VVU. <ref>{{cite web|url=http://www.rci.rutgers.edu/%7Einsects/aids.htm|title=Why Mosquitoes Cannot Transmit AIDS [HIV virus&#93;|publisher=Rci.rutgers.edu|date=|accessdate=2010-07-28|archiveurl=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm|archivedate=2014-03-29|=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm}}</ref>

Mtu anaweza pia kupata VVU kwa kuchanga [[sindano]] na wenzake. Hii ina maana ya kutumia sindano ambayo haijawahi kusafishwa baada ya mtu mwingine kuitumia. Baadhi ya watu ambao, kinyume cha [[sheria]], huchukua madawa ya kulevya kama [[heroin]] na [[cocaine]] huchukua dawa hizo kwa sindano. Baadhi yao wanachanga sindano moja. Kama mmojawao ana virusi ya UKIMWI na anashirikisha sindano yake, anaweza kuambukiza HIV kwa watu wengine.

=== Mama hadi mtoto ===
VVU vinaweza kusambazwa kutoka kwa mama hadi mtoto wakati wa ujauzito, kuzaa au kunyonyesha.<ref name=Mother2010/><ref name="fluids of transmission">{{cite web|url=http://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/|title=Fluids of transmission|date=1 November 2011|work=AIDS.gov|publisher=United States Department of Health and Human Services|accessdate=14 September 2012|archivedate=2013-04-03|archiveurl=https://web.archive.org/web/20130403053447/http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/}}</ref> Njia hii ni ya tatu kwa umaarufu wa kusambaza VVU kote duniani.<ref name=TransmissionM2007/> Bila matibabu, hatari ya kusambazwa wakati wa au baada ya kuzaliwa ni takriban 20%, na 35% kwa watoto wanaonyonya.<ref name=Mother2010/>Kufikia mwaka wa 2008, usambazaji wima ulichangia takriban 90% ya visa vya VVU katika watoto.<ref name=Mother2010/> 

Hatari ya kusambazwa kutoka kwa mama hadi mtoto inaweza kupunguzwa hadi 1% kwa kutumia matibabu mwafaka.<ref name=Mother2010/> Matibabu ya kukinga hujumuisha mama kutumia dawa za kudhibiti virusi wakati wa ujauzito na kuzaa, kuchagua [[kuzaa kwa kupasuliwa]], kutonyonyesha na kumpa mtoto dawa za kudhibiti VVU.<ref name=MTC2007>{{cite journal|last=Thorne|first=C|coauthors=Newell, ML|title=HIV|journal=Seminars in fetal & neonatal medicine|date=2007 Jun|volume=12|issue=3|pages=174–81|pmid=17321814|doi=10.1016/j.siny.2007.01.009}}</ref>Hata hivyo, idadi kubwa ya mbinu hizi hazipatikani katika mataifa yanayostawi.<ref name=MTC2007/> Iwapo damu itachafua [[chakula]] wakati wa mtoto kutafuna, itaongeza hatari ya kuambukiza.<ref name=CDCBasics2012/>

== VVU na UKIMWI ==
===Virusi vyenyewe===
[[File:HI-virion-structure en.svg|thumb|alt= Muundo wa duara ulio na miundo ya rangi ya waridi inayochipuka kutoka kwake, na michoro kadhaa ndani ya duara hii ikionyesha vipengele tofauti vya virusi |Mchoro unaoonyesha muundo wa virusi vya VVU]]
VVU ndivyo kisababishi cha mkusanyiko wa magonjwa yanayojulikana kijumla kama VVU/UKIMWI. VVU ni [[retrovirusi]] ambavyo hasa huambukiza vipengele vya [[mfumo wa kingamwili]] ya binadamu kama vile seli za CD4<SUP>+</SUP>T, [[makrofaji]] na [[seli za dendraiti]]. Virusi hivi huharibu seli za CD4<SUP>+</SUP> T moja kwa moja au vinginevyo.<ref name=Alimonti>{{Cite journal |author=Alimonti JB, Ball TB, Fowke KR | title=Mechanisms of CD4+ T lymphocyte cell death in human immunodeficiency virus infection and AIDS | journal=J. Gen. Virol. | year=2003 | pages=1649–1661 | volume=84 | issue=7 | pmid=12810858 |doi=10.1099/vir.0.19110-0}}</ref>

VVU ni mshirika wa [[jenasi]] ya ''[[Lentivirus]]'',<ref name=ICTV61.0.6>{{cite web | author=[[International Committee on Taxonomy of Viruses]] | publisher=[[National Institutes of Health]] | year=2002 | url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | archiveurl=https://web.archive.org/web/20060418135608/http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | title=61.0.6. Lentivirus | accessdate=2012-06-25 | archivedate=2006-04-18 }}</ref> sehemu ya [[Familia (biolojia)|familia]] ya [[Retroviridae]].<ref name=ICTV61.>{{cite web |author=International Committee on Taxonomy of Viruses |publisher=National Institutes of Health |year=2002 |url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |title=61. Retroviridae |archiveurl=https://web.archive.org/web/20060629180810/http://ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |accessdate=2012-06-25 |archivedate=2006-06-29 }}</ref> Virusi vyote vya lenti huwa na sifa sawa za [[mofolojia (bayolojia)|kimofolojia]] na [[biolojia]]. Spishi nyingi za [[mamalia]] huambukizwa na virusi vya lenti, ambavyo haswa huwa ndivyo visababishi vya maradhi ya muda mrefu yaliyo na [[kipindi cha kupevuka]] kirefu.<ref name=Levy>{{cite journal | author=Lévy, J. A. | title=HIV pathogenesis and long-term survival | journal=AIDS | year=1993 | pages=1401–10| volume=7 | issue=11 | pmid=8280406 | doi=10.1097/00002030-199311000-00001}}</ref>Virusi vya lenti husambazwa kama [[virusi vya RNA]] chanya za uzi mmoja [[hisia]] zilizo ndani ya kigamba. Inapoingia ndani ya seli iliyolengwa, [[jenomu]] ya [[RNA]] ya virusi hugeuzwa (hubadilishwa kinakala) na kuwa [[DNA]] ya nyuzi mbili ambayo husafirishwa pamoja na jenomu ya virusi katika chembe ya virusi vile. DNA ya virusi inayoundika huingia katika kiini cha seli ambapo huchangamana na seli ya DNA kwa kutumia [[integresi]] iliyofasiliwa kama virusi, na pia vipengele husika vya kiini kikuu.<ref name="JASmith">{{cite journal | author= Smith, Johanna A.; Daniel, René (Division of Infectious Diseases, Center for Human Virology, Thomas Jefferson University, Philadelphia)|title= Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses |journal=ACS Chem Biol|volume=1|issue=4 |pages= 217–26 |year= 2006 |pmid= 17163676 |doi=10.1021/cb600131q |url= }}</ref> Vinapochangamana na DNA ya seli, virusi hivi vinaweza kuingia katika [[kipindi cha kupevuka|awamu fiche]], hivyo kuwezesha virusi hivi pamoja na seli inayovipokea kuepuka kutambuliwa na mfumo wa kingamwili.<ref>{{cite book|last=Martínez|first=edited by Miguel Angel|title=RNA interference and viruses : current innovations and future trends|year=2010|publisher=Caister Academic Press|location=Norfolk|isbn=9781904455561|pages=73|url=</ref>

Aina mbili [[Aina ndogo za VVU|za VVU]] zimetambulika: VVU-1 na VVU-2. VVU-1 ni virusi vilivyotambulika kwanza (na ambavyo mwanzoni vilijulikana pia kama LAV au HTLV-III). Virusi hivi vina [[sumu kali]], vyenye [[uambukizaji|kuambukiza]],<ref>{{cite journal | title=Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal | last=Gilbert | first=PB |journal=Statistics in Medicine | date=28 February 2003| volume=22 |issue=4 | pages=573–593 | pmid=12590415 |doi=10.1002/sim.1342 | last2=McKeague | first2=IW | last3=Eisen | first3=G |last4=Mullins | first4=C | last5=Guéye-Ndiaye| first5=A | last6=Mboup | first6=S | last7=Kanki | first7=PJ |display-authors=1}}</ref> na ndivyo visababishi vikuu vya visa vingi vya maambukizi ya VVU kote ulimwenguni. Kiwango cha chini zaidi cha uambukizaji wa VVU-2 ikilinganishwa na VVU-1 huonyesha kuwa watu wachache zaidi walio katika hatari ya VVU-2 wataambukizwa kila wanapokumbana na virusi hivi. VVU-2 hupatikana zaidi [[Afrika Magharibi]] kwa sababu ya uwezo wake wa chini wa kuambukiza.<ref name="Reeves">{{cite journal | author=Reeves, J. D. and Doms, R. W | title=Human Immunodeficiency Virus Type 2 | journal=J. Gen. Virol. |year=2002 | pages=1253–65 | volume=83 | issue=Pt 6 | pmid=12029140 | doi=10.1099/vir.0.18253-0}}</ref>
[[File:HIV-budding-Color.jpg|thumb|alt= Kifaa kikubwa cha duara cha rangi ya buluu, na kifaa chekundu kilichounganishwa nacho. Vifaa vyote viwili vina madoa ya kijani yaliyotapakaa juu yake.|[[Darubini ya elektroni ya ukaguzi|Mikrografu ya elektroni ya ukaguzi]] wa VVU-1, vya rangi ya kijani, vinavyochipuka kutoka kwa [[limfositi]] iliyokaguliwa.]] 
Baada ya virusi kuingia mwilini, kuna kipindi cha [[kugawanyika kwa virusi]], hali inayopelekea wingi wa virusi katika damu ya pembeni. Katika kipindi cha kwanza cha maambukizi, kiwango cha VVU kinaweza kufika milioni kadhaa za chembe za virusi kwa kila [[mililita]] ya damu.<ref name=Piatak>{{cite journal | author=Piatak, M., Jr, Saag, M. S., Yang, L. C., Clark, S. J., Kappes, J. C., Luk, K. C., Hahn, B. H., Shaw, G. M. and Lifson, J.D. | title=High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR |journal=Science | year=1993 |pages=1749–1754 |volume=259 |issue=5102 | pmid=8096089 | doi=10.1126/science.8096089|bibcode = 1993Sci...259.1749P }}</ref> Mwitikio huu huandamana na kiwango kikubwa cha kushuka kwa idadi ya seli za CD4<sup>+</sup> T zinazozunguka. [[Viremia]] kali mara nyingi huhusishwa na kuwezeshwa kwa [[seli za T angamizi|CD8<sup>+</sup> seli za T]], ambazo huangamiza seli zilizoambukizwa VVU na kisha kuhusishwa na kuzalishwa kwa zindiko, au [[kuzalishwa kwa zindiko mpya]]. Mwitikio wa seli za CD8<sup>+</sup> T huchukuliwa kuwa muhimu katika kudhibiti viwango vya virusi, ambavyo hupanda na kushuka, huku viwango vya seli za CD4<sup>+</sup> T vikirejea. Mwitikio bora wa seli za CD8<sup>+</sup> T umehusishwa na kupungua kwa mwendo wa ugonjwa na pia prognosi bora zaidi, ingawa mwitikio huu hauondoi virusi.<ref name=Pantaleo1998>{{cite journal| author=Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS. | title=The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia | journal=Proc Natl Acad Sci U S A. | year=1997 |pages=254–258 | volume=94 | issue=1 | pmid=8990195 | doi=10.1073/pnas.94.1.254|pmc=19306|bibcode = 1997PNAS...94..254P }}</ref>

Pathofisiolojia ya UKIMWI ni tata.<ref name="pmid8040596">{{Cite journal| author=Guss DA| title=The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1| journal=J Emerg Med| volume=12| issue=3|pages=375–84| year=1994| pmid=8040596| doi=10.1016/0736-4679(94)90281-X}}</ref> Mwishowe, VVU husababisha UKIMWI kwa kuharibu [[seli T saidizi|CD4<sup>+</sup>seli za T]]. Hali hii hudhoofisha mfumo wa kingamwili hivyo kuwezesha [[mambukizi vamizi]]. Seli za T ni muhimu kwa mwitikio wa kingamwili, hivyo bila ya seli hizi, mwili hauwezi kukabiliana na maambukizi wala kuharibu seli za saratani. Utendakazi wa kuharibiwa kwa seli za CD4<sup>+</sup> T hutofautiana katika awamu kali na za muda mrefu.<ref name="pmid16679064">{{Cite journal|author=Hel Z, McGhee JR, Mestecky J |title=HIV infection: first battle decides the war |journal=Trends Immunol. |volume=27 |issue=6 |pages=274–81 |year=2006 |month=June |pmid=16679064|doi=10.1016/j.it.2006.04.007 |url=https://archive.org/details/sim_trends-in-immunology_2006-06_27_6/page/274}}</ref> Katika awamu kali, lisisi ya seli inayosababishwa na VVU, na pia kuangamizwa kwa [[seli za T angamizi]] huchangia katika kuharibiwa kwa seli za CD4<sup>+</sup> T, ingawa [[apoptosi]] pia inaweza kuchangia hali hii. Katika awamu ya muda mrefu, matokeo ya uwezeshaji wa kijumla wa kingamwili ukiandamana na udhaifu wa pole pole wa uwezo wa mfumo wa kingamwili kuzalisha seli mpya za T hukisiwa kuchangia kupungua kwa pole pole kwa idadi ya seli za CD4<sup>+</sup> T. <ref>{{cite book|author=Arie J. Zuckerman et al. (eds)|title=Principles and practice of clinical virology|year=2007|publisher=Wiley|location=Hoboken, N.J.|isbn=978-0-470-51799-4|page=905|url=http://books.google.ca/books?id=4il2mF7JG1sC&pg=PA905|edition=6th}}</ref>

Ingawa dalili za udhaifu wa kingamwili kama ulivyo katika UKIMWI hazitokei kwa miaka mingi baada ya kuambukizwa, kiwango kikubwa cha kuharibika kwa seli za CD4<sup>+</sup> T hutokea katika wiki za kwanza baada ya kuambukizwa, hasa katika ute wa utumbo, ambao huwa na kiwango kikubwa cha limfosaiti zote za mwili.<ref name="pmid15365095">{{Cite journal|author=Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M|title=Primary HIV-1 infection is associated with preferential depletion of CD4<sup>+</sup> T cells from effector sites in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6 |pages=761–70 |year=2004 |month=September|pmid=15365095 |doi=10.1084/jem.20041196 |url= |pmc=2211967}}</ref> Sababu ya kiwango hiki kikubwa cha kuharibiwa kwa seli za CD4<sup>+</sup> T ni kuwa kiwango kikubwa cha seli za ute za CD4<sup>+</sup> T huzalisha protini ya [[CCR5]] inayotumika na VVU kama [[kipokezi kishiriki]] ili kuweza kufikia seli hizo, ilhali kipande kidogo tu cha seli za CD4<sup>+</sup> T katika mkondo wa damu hufanya hivyo.<ref name="pmid15365096">{{Cite journal|author=Brenchley JM, Schacker TW, Ruff LE, Price DA, Taylor JH, Beilman GJ, Nguyen PL, Khoruts A, Larson M, Haase AT, Douek DC |title=CD4<sup>+</sup> T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6|pages=749–59 |year=2004 |month=September |pmid=15365096 |doi=10.1084/jem.20040874 |url= |pmc=2211962}}</ref> 

VVU hutafuta na kuharibu CCR5 inayotolesha seli za CD4<sup>+</sup> T katika awamu kali ya maambukizi. <ref name=Julio2011>{{cite book|last=editor|first=Julio Aliberti,|title=Control of Innate and Adaptive Immune Responses During Infectious Diseases.|publisher=Springer Verlag|location=New York, NY|isbn=978-1-4614-0483-5|page=145|url=http://books.google.ca/books?id=TKMpo5aINVIC&pg=PA145|year=2011}}</ref> Mwitikio mkubwa wa kingamwili hatimaye huyadhibiti maambukizi hayo kisha kuanzisha awamu fiche ya kiutambuzi. Seli za CD4<sup>+</sup> T katika tishu za ute husalia zikiwa zimeathiriwa sana. <ref name=Julio2011/> Ugawanyikaji endelevu wa VVU husababisha hali ya uwezeshaji wa kijumla wa kingamwili, ambao hudumu katika awamu yote ya muda mrefu.<ref name="pmid18161758">{{Cite journal|author=Appay V, Sauce D |title=Immune activation and inflammation in HIV-1 infection: causes and consequences|journal=J. Pathol. |volume=214 |issue=2 |pages=231–41 |year=2008 |month=January |pmid=18161758 |doi=10.1002/path.2276|url=https://archive.org/details/sim_journal-of-pathology_2008-01_214_2/page/231}}</ref> Uwezeshaji wa kingamwili, ambao hutambulika kwa ongezeko la uwezeshaji wa hali ya seli za kingamwili na kutoleshwa kwa [[saitokini]] inayosababisha inflemesheni, husababishwa na utendakazi wa [[zao la jeni]] na mwitikio wa kingamwili dhidi ya ugawanyikaji wa VVU unaoendelea. Uwezeshaji wa kingamwili pia huhusishwa na kuharibika kwa mfumo wa uchunguzi wa kingamwili wa kizuizi cha ute wa tumbo na utumbo, hali inayosababishwa na kuangamizwa kwa seli za CD4<sup>+</sup> T za ute katika awamu kali ya ugonjwa huu.<ref name="pmid17115046">{{Cite journal|author=Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, Kazzaz Z, Bornstein E, Lambotte O, Altmann D, Blazar BR, Rodriguez B, Teixeira-Johnson L, Landay A, Martin JN, Hecht FM, Picker LJ, Lederman MM, Deeks SG, Douek DC |title=Microbial translocation is a cause of systemic immune activation in chronic HIV infection |journal=Nat. Med. |volume=12 |issue=12 |pages=1365–71 |year=2006 |month=December |pmid=17115046|doi=10.1038/nm1511 |url=}}</ref>

Hivyo si kila mtu aliye na VVU ana UKIMWI. Wakati watu wanapata VVU, wanaweza kuwa na [[afya]] kwa miaka mpaka akakutwa na aina maalumu ya magonjwa na vipimo vya [[damu]] vikionyesha kuwa ina idadi ndogo sana ya [[seli nyeupe za damu]] ambazo ndizo zinazopambana na maambukizi.

Kuna maradhi ambayo kwa kawaida ni ishara kwamba mtu ana UKIMWI kwa kuwa watu wenye afya njema hawapati magonjwa haya, kwa sababu mfumo wa kinga mwilini una nguvu ya kutosha ya kupigana na magonjwa hayo. Hivyo kupata ugonjwa wa aina hiyo ni ishara kwamba mfumo wa kinga umeharibika. 

Baadhi ya magonjwa hayo ni:
* [[Sarkoma ya Kaposi]] - aina ya [[kansa]] ambayo kwa kawaida huathiri [[ngozi]] (mara nyingi husababisha vi[[donda]] vyekundu au [[zambarau]], au ma[[jeraha]] juu ya ngozi). Wakati mwingine huathiri tu ngozi, bali pia mifumo mingine katika mwili.
* [[Retinitis]] - [[virusi]] zinashambulia nyuma ya [[jicho]].
* [[Pneumocystis carinii]] ([[kifupi]] PCP) - aina ya [[pneumonia]], [[magonjwa ya kuambukiza]] ya [[mapafu]]. PCP ni maambukizi ya kawaida kwa wagonjwa wa UKIMWI.
* [[Toxoplasmosis]] - ugonjwa unaosababishwa na [[vimelea]], ambao unaweza kusababisha matatizo katika mifumo ya [[ubongo]] na mingine katika mwili.
* [[Kansa ya kizazi]] - ambayo huwa inaenea.

==Utambuzi==
[[File:Hiv-timecourse.png|thumb|alt=Grafu iliyo na mistari miwili. Mstari wa buluu unapanda kuelekea kulia kisha kushuka kuelekea kushoto huku ukipanda kidogo katikati. Mstari wa pili mwekundu unapanda kutoka sufuri hadi juu sana, kisha kushuka hadi chini halafu kupanda pole pole hadi juu tena |300px| Grafu ya ujumla ya uhusiano wa nakala za VVU (wingi wa virusi) na viwango vya seli za CD4<SUP>+</SUP> T katika wastani wa kipindi cha maambukizi yasiyotibiwa ya VVU.{{legend-line|blue solid 2px|CD4<sup>+</sup> T Lymphocyte count (cells/mm³)}} {{legend-line|red solid 2px|HIV RNA copies per mL of plasma}}]]
VVU hutambuliwa kupitia uchunguzi wa kimaabara kisha kuainishwa kiawamu kwa msingi wa uwepo wa dalili au ishara fulani.<ref name=WHOCase2007/> Watu walio katika hatari kubwa ya kuambukizwa hupendekezwa kupimwa VVU, ikiwa ni pamoja na mtu yeyote aliye na ugonjwa wa zinaa<ref name=Deut2010/> Katika maeneo mengi ya ulimwengu, 1/3 ya watu wenye VVU hutambua kuwa wameambukizwa katika awamu za mwishoni mwa ugonjwa huu wakati UKIMWI au ukosefu mkuu wa kingamwili umekuwa wazi.<ref name=Deut2010/> 

=== Uchunguzi wa VVU ===
Watu wengi walioambukizwa VVU huzalisha [[zindiko]] maalum (yaani [[uzalishaji zindiko mpya|kuzalisha zindiko mpya]]) katika wiki 3 hadi 12 tangu maambukizi ya kwanza. <ref name=M118/> Utambuzi wa VVU vya kimsingi hufanywa kabla ya kuzalishwa kwa zindiko mpya kwa kupima [[RNA]] ya VVU au [[antijeni ya P24 #vipimo vya antijeni|antijeni ya p24]].<ref name=M118/> Matokeo chanya yanayopatikana kwa kupima [[msururu wa athari za polima|MAP]] au zindiko huthibitishwa kwa zindiko au MAP tofauti.<ref name=WHOCase2007/>

Vipimo vya zindiko kwa watoto wa umri wa chini ya miezi 18&nbsp; kwa kawaida huwa kasoro kwa sababu ya uwepo endelevu wa [[Kingamwili Kimya ya Mama#Kingamwili kimya iliyopokezwa kiasilia|zindiko za mama]].<ref name=ChildDiag2010>{{cite journal|last=Kellerman|first=S|coauthors=Essajee, S|title=HIV testing for children in resource-limited settings: what are we waiting for?|journal=PLoS medicine|date=2010 Jul 20|volume=7|issue=7|pages=e1000285|pmid=20652012|doi=10.1371/journal.pmed.1000285|pmc=2907270}}</ref> Kwa hivyo, maambukizi yanaweza kutambulika tu kwa vipimo vya MAP vya VVU, RNA au DNA, au kupitia kupima uwepo wa antijeni ya p24.<ref name=WHOCase2007/>Sehemu kubwa ya ulimwengu haina uwezo wa kupata vipimo bora vya MAP huku watu wa sehemu nyingi wakisubiri hadi dalili za watoto wao kuendelea au watoto hao kukua hadi kuwa na uwezo wa kupimwa kikamilifu.<ref name=ChildDiag2010/> Kufikia mwaka wa 2007-2009 katika eneo la Kusini mwa Jangwa la Sahara, kati ya asilimia 30-70 ya watu walikuwa wakifahamu hali yao ya VVU.<ref name=UN2011Eighty>UNAIDS 2011 pg. 70–80</ref> Mnamo mwaka wa 2009, kati ya asilimia 4-42 ya watu hawa walipimwa. <ref name=UN2011Eighty/> Takwimu hizi zinaonyesha ongezeko kubwa kutoka miaka ya awali.<ref name=UN2011Eighty/>

===Uainishaji wa maambukizi ya VVU===
Mifumo miwili mikuu ya uainishaji hutumika kuainisha VVU na magonjwa husika kwa ajili ya [[uchunguzi wa magonjwa|uchunguzi]]: mfumo wa uainishaji wa magonjwa wa [[Shirika la Afya Duniani]],<ref name=WHOCase2007/> na [[mfumo wa VKM]] wa uainishaji wa maambukizi ya VVU.<ref name=CDCCase2008/> The [[Vituo vya Kukinga na Kudhibiti Magonjwa|VKM]] hutumika zaidi katika mataifa yaliyostawi. Kwa vile mfumo wa uainishaji wa SAD hauhitaji vipimo vya mahabara, mfumo huu ni mwafaka kwa mataifa yanayostawi ambayo kwa kawaida yana upungufu wa vifaa, ambapo unaweza pia kutumika kuongoza udhibiti wa kimatibabu. Ingawa mifumo hii miwili ni tofauti, yote huwezesha ulinganishaji kwa ajili ya malengo ya kitakwimu.<ref name=M121/><ref name=WHOCase2007/><ref name=CDCCase2008/>

Shirika la Afya Duniani lilipendekeza ufasili wa UKIMWI mara ya kwanza mwaka wa 1986.<ref name=WHOCase2007/> Tangu hapo, ufasili wa Shirika hili umedurusiwa na kurefushwa mara kadhaa, toleo la hivi karibuni likiwa la mwaka wa 2007. <ref name=WHOCase2007>{{cite book|title=WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children.|pages=6–16|url=http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf|format=PDF|year=2007|publisher=World Health Organization|location=Geneva|isbn=978-92-4-159562-9}}</ref> Mfumo wa SAD hutumia vikundi vifuatavyo:
* Maambukizi ya kimsingi ya VVU: Yanaweza kuwa bila dalili au yakihusishwa na sindromu kali ya retrovirusi. <ref name=WHOCase2007/>
* Awamu ya I: Maambikizi ya VVU huwa [[bila dalili]] yakiwa na kiwango cha seli za CD4<SUP>+</SUP> T (ambacho pia huitwa kiwango cha CD4) cha zaidi ya 500/uL.<ref name=WHOCase2007/> Maambukizi haya yanaweza kujumuisha kuvimba kwa tezi za mwili wote.<ref name=WHOCase2007/>
* Awamu ya II: Dalili ndogo zinaweza kuhusisha kiwango cha chini cha kudhihirika kwa [[tando za ute|za tando za ute]] na maambukizi yanayorejea ya [[sehemu ya juu ya njia ya pumzi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/>
*Awamu ya III: Dalili kuu zinazoweza kujumuisha hali ya [[kuharisha]][[ya muda mrefu (kimatibabu)|ya muda mrefu]] isiyo na kisababishi maalum kwa zaidi ya mwezi mmoja, maambukizi makali ya bakteria ikiwa ni pamoja na tiibii ya mapafu na pia kiwango cha seli za CD4 cha chini ya 350/uL. <ref name=WHOCase2007/>
*Awamu ya IV ya UKIMWI: dalili kali zinazojumuisha [[toksoplasmosi]] ya ubongo, [[ukungu]] wa [[umio]], [[Vetebra ya trakea|trakea]], [[bronkasi| bronkasi]] au [[mapafu]] na [[sakoma ya Kaposi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/>

Kituo cha Kukinga na Kudhibiti Magonjwa cha Marekani pia kilianzisha mfumo wa uainishaji wa VVU, kilichoudurusu mwaka wa 2008.<ref name=CDCCase2008>{{cite journal|last=Schneider|first=E|coauthors=Whitmore, S; Glynn, KM; Dominguez, K; Mitsch, A; McKenna, MT; Centers for Disease Control and Prevention, (CDC)|title=Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years--United States, 2008|journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control|date=2008-12-05|volume=57|issue=RR–10|pages=1–12|pmid=19052530}}</ref> Katika mfumo huu, maambukizi ya VVU yameainishwa kulingana na kiwango cha CD4 na dalili za kiutambuzi, <ref name=CDCCase2008/> nayo hueleza maambukizi kwa awamu tatu:
*Awamu ya 1: Kiwango cha CD4 cha seli ≥ 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI
*Awamu ya 2: Kiwango cha seli za CD4 200 hadi 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI
*Awamu ya 3: Kiwango cha seli za CD4≤ 200&nbsp;cells/uL au hali zinazoashiria UKIMWI.
*Tashwishi: iwapo habari iliyopo haitoshi kufanya uainishaji uliopo juu

Kwa sababu za kiuchunguzi, utambuzi wa UKIMWI hubakia iwapo baada ya matibabu kiwango cha seli za CD4<SUP>+</SUP> T kitapanda zaidi ya 200 kwa kila µL ya damu au iwapo maradhi mengine yanayoashiria UKIMWI yataponywa.<ref name="M121"/>

== Matibabu == 
Hakuna tiba au [[chanjo dhidi ya VVU|chanjo]]; hata hivyo, matibabu ya kudhibiti [[virusi]] yanaweza kupunguza mwendo wa ugonjwa huu na huenda yakapelekea [[urefu]] wa [[maisha]] kuwa karibu na kawaida. Ingawa [[matibabu]] ya kupunguza makali hupunguza hatari ya kifo na matatizo yanayotokana na ugonjwa huu, matibabu haya ni ya bei ghali, hivyo yanaweza kuhusishwa na madhara mbadala.

Kuna dawa za kusaidia watu wenye UKIMWI. Hizi zinaitwa ''dawa za kurefusha maisha''. Dawa za kurefusha maisha haziwezi kutibu UKIMWI. Hii ina maana kwamba haziwezi kufanya virusi vyote kuondoka mwili wa mtu. Lakini zinaweza kuwasaidia watu kupambana na virusi vya UKIMWI kwa mifumo yao ya kinga kufanya kazi vizuri zaidi. Hivyo dawa za kurefusha maisha si tiba kabili kwa virusi ya UKIMWI.

Watu wenye VVU/UKIMWI ambao huchukua dawa za kurefusha maisha wanaweza kuishi muda mrefu, bila kupata maradhi yanayothibitisha UKIMWI. 

Lakini baada ya muda mrefu, virusi za HIV zisizouawa na dawa hizo hujifunza jinsi ya kupambana nazo na hivyo zinakuwa ''sugu'' kwa dawa hizo. 

Wakati mwingine VVU ni sugu kwa dawa moja, lakini dawa nyingine inaweza kutumika. Ili kupunguza uwezekano wa upinzani kutokea, watu wenye UKIMWI huchukua dawa zaidi ya moja kwa wakati mmoja. Wanaweza kuchukua madawa 2-4 kwa mara moja. Hii wakati mwingine inaitwa ''cocktail'' ya UKIMWI. Lakini baada ya muda mrefu, VVU kujifunza kuwa sugu kwa dawa nyingi. Hapo hakuna zaidi ya kuwatibu. Hivyo [[wanasayansi]] kuendelea kujaribu kupata dawa mpya ya kupambana na VVU.

Dawa [[tano]] muhimu za wenye VVU ni:
* D4T (stavudine)
* 3TC (Lamivudine)
* NVP (nevirapine)
* AZT (zidovudine)
* EFZ (efavirenz)

Bila dawa hizo, kwa kawaida mtu mwenye VVU anaweza akaishi miaka 9-11.

== Njia za kujikinga na UKIMWI == 
[[Picha: Red Ribbon.svg|thumb|haki|Utepe mwekundu, ishara ya mapambano dhidi ya UKIMWI.]]
[[File:AIDS Clinic, McLeod Ganj, 2010.jpg|thumb|alt=Onyesho la jumba la ghorofa mbili lililo na mabango kadhaa yanayohusiana na kuzuia UKIMWI |Matibabu ya UKIMWI, [[McLeod Ganj]], Himachel Pradesh, India, 2010]]
Kuna njia nyingi za watu kupambana na [[janga]] hilo. Kuzuia maambukizi ya VVU, hasa kupitia [[kondomu]] na miradi ya kubadilishabadilisha sindano, ni mikakati mikuu inayotumika kudhibiti kuenea kwa ugonjwa huu. Lakini wengine wanahoji kwamba bila kubadili tabia, [[teknolojia]] peke yake haitaweza kushinda ugonjwa huo.

=== Chanjo ===
Njia bora ya kuzuia VVU ni wazo la kuwa na [[chanjo]]. Wanasayansi wengi wanatafuta [[chanjo ya VVU]] ili kuokoa [[uhai]] wa mamilioni ya watu, lakini kufikia mwaka [[2012]], hakuna chanjo mwafaka dhidi ya VVU/UKIMWI.<ref>{{cite news|title=The quest for an HIV vaccine|url=http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/|date=May 18, 2012|author=UNAIDS|accessdate=2017-04-01|archivedate=2012-05-24|archiveurl=https://web.archive.org/web/20120524051113/http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/}}</ref>Jaribio moja la chanjo ya [[RV 144]] iliyotolewa mwaka 2009 lilipelekea kupunguza hatari ya kuambukiza kwa takriban 30%, hivyo kuchochea matarajio ya jamii ya utafiti ya kutengeneza chanjo mwafaka zaidi.<ref>{{cite journal|last=Reynell|first=L|coauthors=Trkola, A|title=HIV vaccines: an attainable goal?|journal=Swiss medical weekly|date=2012-03-02|volume=142|pages=w13535|pmid=22389197|doi=10.4414/smw.2012.13535}}</ref> Majaribio zaidi ya chanjo ya RV 144 yanaendelea.<ref>{{cite web| author = U.S. Army Office of the Surgeon General| title = HIV Vaccine Trial in Thai Adults| publisher = ClinicalTrials.gov| date = March 21, 2011| accessdate = June 28, 2011| url =http://clinicaltrials.gov/ct2/show/NCT00223080}}</ref><ref>{{cite web| author = U.S. Army Office of the Surgeon General|title = Follow up of Thai Adult Volunteers With Breakthrough HIV Infection After Participation in a Preventive HIV Vaccine Trial| publisher = ClinicalTrials.gov| date = June 2, 2010| url =http://www.clinicaltrials.gov/ct2/show/NCT00337181}}</ref>

===Kondomu===
Vitendo vya kijinsia ni njia kuu ya kupata VVU. Kama watu wanatumia [[kondomu]] wanapofanya mapenzi, kuna nafasi ndogo zaidi ya kuambukizana VVU, lakini [[ukweli]] kamili ni kwamba hakuna [[ngono salama]] kwa hakika.

Matumizi ya [[kondomu]] ya kila mara hupunguza hatari ya kuambukizana UKIMWI kwa takriban 80% katika muda mrefu wa usoni.<ref>{{cite journal|last=Crosby|first=R|coauthors=Bounse, S|title=Condom effectiveness: where are we now?|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=10–7|pmid=22348628|doi=10.1071/SH11036}}</ref> Iwapo mwenzi mmoja ameambukizwa, kutumia kondomu kila mara hupelekea viwango vya chini ya 1% kwa mwaka vya huyo mwingine kuambukizwa.<ref name=WHOCondoms>{{cite web| publisher=[[World Health Organization|WHO]]| month=August |year=2003|url=http://www.wpro.who.int/mediacentre/factsheets/fs_200308_Condoms/en/index.html | title=Condom Facts and Figures|accessdate=January 17, 2006 }}</ref> 

Kuna ushahidi mdogo unaoonyesha kuwa [[kondomu za wanawake]] una kiwango sawa cha kinga.<ref>{{cite journal|last=Gallo|first=MF|coauthors=Kilbourne-Brook, M; Coffey, PS|title=A review of the effectiveness and acceptability of the female condom for dual protection|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=18–26|pmid=22348629|doi=10.1071/SH11037}}</ref> 

===Dawa za ukeni===
Kutumia mafuta ya ukeni yanaliyo na [[tenofovir]] muda mfupi kabla ya ngono hukisiwa kupunguza viwango vya maambukizi kwa takriban 40% miongoni mwa wanawake wa Kiafrika.<ref name=VagGel2012>{{cite journal|last=Celum|first=C|coauthors=Baeten, JM|title=Tenofovir-based pre-exposure prophylaxis for HIV prevention: evolving evidence|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=51–7|pmid=22156901|doi=10.1097/QCO.0b013e32834ef5ef|pmc=3266126}}</ref> Kinyume na hili, matumizi ya [[spemisidi]] [[nonoxynol-9]] yanaweza kuongeza hatari ya kuambukizwa kwa sababu ya uwezo wake wa kuleta mwasho wa uke na [[rektamu]].<ref>{{cite journal|last=Baptista|first=M|coauthors=Ramalho-Santos, J|title=Spermicides, microbicides and antiviral agents: recent advances in the development of novel multi-functional compounds|journal=Mini reviews in medicinal chemistry|date=2009-11-01|volume=9|issue=13|pages=1556–67|pmid=20205637|doi=10.2174/138955709790361548}}</ref> 

===Tohara===
[[Tohara]] katika eneo la [[Kusini kwa Sahara]] "hupunguza uambukizaji wa VVU katika wanaume wanaohusiana na wanawake kimapenzi kwa kati ya 38% na 66% kwa muda wa miezi 24". <ref>{{cite journal|last=Siegfried|first=N|coauthors=Muller, M; Deeks, JJ; Volmink, J|title=Male circumcision for prevention of heterosexual acquisition of HIV in men|journal=Cochrane database of systematic reviews (Online)|date=2009-04-15|issue=2|pages=CD003362|pmid=19370585|doi=10.1002/14651858.CD003362.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Kwa msingi wa tafiti hizi, mashirika ya SAD na UNAIDS yalipendekeza tohara kama mbinu ya kuzuia uambukizaji VVU kutoka kwa mwanamke hadi mwanamume mwaka 2007.<ref>{{cite web |title=WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention |publisher=World Health Organization |date=Mar 28, 2007 |url=http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html |accessdate=2017-04-01 |archivedate=2011-07-03 |archiveurl=https://web.archive.org/web/20110703140439/http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html }}</ref> Haijabainika wazi iwapo njia hii huzuia uambukizaji kutoka kwa mwanamume hadi mwanamke<ref>{{cite journal|last=Larke|first=N|title=Male circumcision, HIV and sexually transmitted infections: a review|journal=British journal of nursing (Mark Allen Publishing)|date=2010 May 27 – Jun 9|volume=19|issue=10|pages=629–34|pmid=20622758}}</ref><ref>{{cite journal|last=Eaton|first=L|coauthors=Kalichman, SC|title=Behavioral aspects of male circumcision for the prevention of HIV infection|journal=Current HIV/AIDS reports|date=2009 Nov|volume=6|issue=4|pages=187–93|pmid=19849961|doi=10.1007/s11904-009-0025-9}}(subscription required)</ref> na iwapo mbinu hii ina manufaa katika [[mataifa yaliyostawi]] na haijabainika miongoni mwa mashoga.<ref>{{cite journal|last=Kim|first=HH|coauthors=Li, PS, Goldstein, M|title=Male circumcision: Africa and beyond?|journal=Current opinion in urology|date=2010 Nov|volume=20|issue=6|pages=515–9|pmid=20844437|doi=10.1097/MOU.0b013e32833f1b21}}</ref><ref>{{cite journal|last=Templeton|first=DJ|coauthors=Millett, GA, Grulich, AE|title=Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men|journal=Current opinion in infectious diseases|date=2010 Feb|volume=23|issue=1|pages=45–52|pmid=19935420|doi=10.1097/QCO.0b013e328334e54d}}</ref><ref>{{Cite journal | last1 = Wiysonge | first1 = CS. | last2 = Kongnyuy | first2 = EJ. | last3 = Shey | first3 = M. | last4 = Muula | first4 = AS.|last5 = Navti | first5 = OB. | last6 = Akl | first6 = EA. | last7 = Lo | first7 = YR. | title = Male circumcision for prevention of homosexual acquisition of HIV in men | journal = Cochrane Database Syst Rev |volume = | issue = 6 | pages = CD007496 | month = | year = 2011 | doi = 10.1002/14651858.CD007496.pub2 | pmid = 21678366 | editor1-last = Wiysonge |editor1-first = Charles Shey }}</ref> Baadhi ya wataalamu wanahofia kuwa dhana ya kiwango cha chini cha hatari miongoni mwa wanaume waliotahiriwa inaweza kupelekea mienendo hatari zaidi, hivyo wanapinga faida ya mbinu hii katika kukinga.<ref>{{Cite journal|author=Eaton LA, Kalichman S |title=Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies |journal=Curr HIV/AIDS Rep |volume=4 |issue=4|pages=165–72 |year=2007|month=December|pmid=18366947|pmc=2937204 |doi=10.1007/s11904-007-0024-7}}</ref> Wanawake waliofanyiwa [[ukeketaji]] wana hatari zaidi ya kuambukizwa.<ref>{{Cite journal|author=Utz-Billing I, Kentenich H|title=Female genital mutilation: an injury, physical and mental harm |journal=J Psychosom Obstet Gynaecol|volume=29|issue=4 |pages=225–9|year=2008 |month=December |pmid=19065392 |doi=10.1080/01674820802547087 |url=}}</ref>

===Mawaidha na elimu===
Njia muhimu ya kuzuia VVU/UKIMWI ni [[elimu]] kwa kuwa hiyo inawezesha kuelewa maana ya [[jinsia]] na kukwepa sababu za maambukizi yake. Ni kwamba watu wanaweza kupata VVU kutokana na [[ngono]] na kutokana na [[damu]]. Watoto wanaweza pia kupata VVU kutoka kwa [[mama]] zao (wakati wa kukua ndani ya akina mama wajawazito na wakati wa kunyonya [[maziwa]] ya mama.)

Kuna baadhi ya watu ambao hawataki watu wajue kuhusu kondomu na sindano safi, au hawataki wawe na kondomu au sindano safi. Hao wanaamini kuwa watu wakijua kuhusu kondomu na kuwa na kondomu watafanya ngono zaidi na hivyo kuzidisha maambukizi badala ya kuyapunguza kwa sababu kinga hiyo si madhubuti. Vilevile wanaamini kuwa watu wakiwa na sindano safi watatumia dawa za kulevya zaidi. Wengi wa wanaodhani hivyo ni pia kwa sababu ya [[dini]] zao kukataza [[uzinifu]] na [[ulevi]] kama tabia zinazoharibu binadamu binafsi na jamii kwa jumla. Hao huhimiza [[upendo]] na [[uaminifu]] katika [[ndoa]], [[usafi wa moyo]] na utunzaji wa afya.

Miradi inayohimiza [[kujinyima ngono]] haijatambulika inaathiri vipi hatari ya kupata VVU.<ref>{{cite journal |author= Underhill K, Operario D, Montgomery P |title= Abstinence-only programs for HIV infection prevention in high-income countries |journal=Cochrane Database of Systematic Reviews |issue=4 |pages= CD005421|year=2008|pmid= 17943855|doi=10.1002/14651858.CD005421.pub2|url=http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD005421/frame.html|editor1-last= Operario|editor1-first= Don}}</ref> Ushahidi wa manufaa ya [[elimu ya rika]] pia hautoshi.<ref>{{cite journal|last=Tolli|first=MV|title=Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies|journal=Health education research|date=2012-05-28|pmid=22641791|doi=10.1093/her/cys055}}</ref> 

[[Elimu ya ngono]] inayotolewa [[Shule|shuleni]] inaweza kupunguza mitindo hatari,<ref>{{cite journal|last=Ljubojević|first=S|coauthors=Lipozenčić, J|title=Sexually transmitted infections and adolescence|journal=Acta dermatovenerologica Croatica : ADC|year=2010|volume=18|issue=4|pages=305–10|pmid=21251451}}</ref> lakini inaweza pia kuchochea wanafunzi wakajaribu wenyewe ngono. [[Vijana]] wengi wanajihusisha katika vitendo hatari licha ya kufahamu kuhusu VVU/UKIMWI, huku wakipuuza hatari ya kuambukizwa.<ref name="Patel2008">{{Cite journal| author=Patel VL, Yoskowitz NA, Kaufman DR, Shortliffe EH | title=Discerning patterns of human immunodeficiency virus risk in healthy young adults | journal=Am J Med | year=2008 | pages=758–764 |volume=121|issue=4 | pmid=18724961 |doi=10.1016/j.amjmed.2008.04.022 | pmc=2597652 }}</ref> 

===Dawa kabla ya hatari===
Asilimia 96 ya watu walikingwa dhidi ya maambukizi iwapo wenzi wao walioambukizwa walipata mapema dawa za kudhibiti VVU<ref>National Institute of Allergy and Infectious Diseases (NIAID),
[http://www.niaid.nih.gov/news/newsreleases/2011/Pages/HPTN052.aspx "Treating HIV-infected People with Antiretrovirals Protects Partners from Infection"], NIH News, 2011 May</ref><ref>{{cite journal|last=Anglemyer|first=A|coauthors=Rutherford, GW; Baggaley, RC; Egger, M; Siegfried, N|title=Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples|journal=Cochrane database of systematic reviews (Online)|date=2011-08-10|issue=8|pages=CD009153|pmid=21833973|doi=10.1002/14651858.CD009153.pub2|editor1-last=Rutherford|editor1-first=George W}}</ref> 

Proflaksisi ya kabla ya hatari pamoja na kipimo cha kila siku cha dawa ya [[tenofovir]] (ikiwa na au bila [[emtricitabine]]) ni mwafaka kwa vikundi fulani, ikijumuisha: mashoga, wachumba wa wenye VVU na vijana wa Afrika wanaovutiwa na watu wa jinsia tofauti. <ref name=VagGel2012/>

Hadhari za jumla katika mandhari ya utunzaji wa afya zinaaminika kufaulu kupunguza hatari ya VVU.<ref>{{Cite journal|title=Recommendations for prevention of HIV transmission in health-care settings|journal=MMWR|volume=36 |issue=Suppl 2 |pages=1S–18S |year=1987|month=August|pmid=3112554|url=http://www.cdc.gov/MMWR/PREVIEW/MMWRHTML/00023587.htm |author1= Centers for Disease Control (CDC)}}</ref> Matumizi ya dawa zinazodungwa mishipani ni kipengele muhimu cha hatari, hivyo mikakati ya [[kupunguza madhara]] kama vile [[miradi ya kubadilisha sindano]] na [[matibabu ya kubadilisha opioidi]] yanaonekana kufaulu kupunguza hatari.<ref name=Kurth2011>{{cite journal|last=Kurth|first=AE|coauthors=Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN|title=Combination HIV prevention: significance, challenges, and opportunities|journal=Current HIV/AIDS reports|date=2011 Mar|volume=8|issue=1|pages=62–72|pmid=20941553|doi=10.1007/s11904-010-0063-3|pmc=3036787}}</ref>

===Dawa baada ya hatari===
Vipimo vya dawa za kudhibiti VVU zinazotolewa kati ya saa 48 hadi 72 baada ya hatari kwa damu yenye VVU au viowevu vya uzazi hujulikana kama proflaksisi ya baada ya hatari.<ref name=Prevention2012/> Matumizi ya dawa moja ya [[zidovudine]] hupunguza mara tano hatari ya kupata VVU kutokana na jeraha la sindano.<ref name=Prevention2012>{{cite journal |author= |title=HIV exposure through contact with body fluids |journal=Prescrire Int|volume=21 |issue=126 |pages=100–1, 103–5 |year=2012 |month=April |pmid=22515138 |doi= |url= |author1= [No authors listed]}}</ref> Matibabu hupendekezwa baada ya [[ubakaji]] iwapo mshukiwa anatambulika kuwa na VVU lakini yanakumbwa na utata iwapo hali yake haijulikani.<ref name=NEJM2011Sex>{{cite journal|last=Linden|first=JA|title=Clinical practice. Care of the adult patient after sexual assault|journal=The New England Journal of Medicine|date=2011-09-01|volume=365|issue=9|pages=834–41|pmid=21879901|doi=10.1056/NEJMcp1102869}}</ref> Taratibu za matibabu ya sasa hutumia [[lopinavir/ritonavir]] na [[lamivudine/zidovudine]] au [[emtricitabine/tenofovir]] na yanaweza kupunguza hatari zaidi.<ref name=Prevention2012/> Kwa kawaida, muda wa matibabu huwa wiki nne <ref name=CochranePEP2007>{{cite journal|last=Young|first=TN|coauthors=Arens, FJ; Kennedy, GE; Laurie, JW; Rutherford, G|title=Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure|journal=Cochrane database of systematic reviews (Online)|date=2007-01-24|issue=1|pages=CD002835|pmid=17253483|doi=10.1002/14651858.CD002835.pub3|editor1-last=Young|editor1-first=Taryn}}</ref>na mara nyingi huhusishwa na athari kali (zidovudine ikiwa na takriban 70% ya visa, ikijumuisha 24% kichefuchefu, 22% uchovu, 13% mafadhaiko na 9% maumivu ya kichwa.<ref name=AFP2007/>

=== Kuzuia maambukizi ya mama kwa mtoto ===
Hatua za kuzuia kusambaza VVU kutoka kwa mama hadi mtoto zinaweza kupunguza kiwango cha maambukizi kwa asilimia 92-99.<ref name=Mother2010>{{cite journal|last=Coutsoudis|first=A|coauthors=Kwaan, L; Thomson, M|title=Prevention of vertical transmission of HIV-1 in resource-limited settings|journal=Expert review of anti-infective therapy|date=2010 Oct|volume=8|issue=10|pages=1163–75|pmid=20954881|doi=10.1586/eri.10.94}}</ref><ref name=Kurth2011/> Kimsingi, hatua hizi hujumuisha kutumia mwungano wa dawa za kudhibiti VVU katika ujauzito na baada ya kuzaa, na pia [[kunywesha kwa chupa]] badala ya [[kunyonyesha]].<ref name=Mother2010/><ref>{{cite journal|last=Siegfried|first=N|coauthors=van der Merwe, L; Brocklehurst, P; Sint, TT|title=Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-07-06|issue=7|pages=CD003510|pmid=21735394|doi=10.1002/14651858.CD003510.pub3|editor1-last=Siegfried|editor1-first=Nandi}}</ref>Ikiwa itakubaliwa kulisha, inafaidi, inawezekana kumudu gharama yake, na ni salama, kina mama hawapaswi kuwanyonyesha watoto wao. Hata hivyo, iwapo haiwezekani, kina mama hushauriwa kunyonyesha tu katika miezi ya kwanza.<ref>{{cite web |url=http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |format=PDF |year=2006 |accessdate=March 12, 2008 |title=WHO HIV and Infant Feeding Technical Consultation Held on behalf of the Inter-agency Task Team (IATT) on Prevention of HIV – Infections in Pregnant Women, Mothers and their Infants –Consensus statement |date=October 25–27, 2006 |archiveurl=https://web.archive.org/web/20080409065845/http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |archivedate=2008-04-09 |deadurl=no }}</ref> Ikiwa kunyonyesha pekee kutatekelezwa, kumpa mtoto proflaksisi ya kudhibiti VVU kwa muda mrefu zaidi hupunguza hatari ya kuambukizwa.<ref>{{cite journal|last=Horvath|first=T|coauthors=Madi, BC; Iuppa, IM; Kennedy, GE; Rutherford, G; Read, JS|title=Interventions for preventing late postnatal mother-to-child transmission of HIV|journal=Cochrane database of systematic reviews (Online)|date=2009-01-21|issue=1|pages=CD006734|pmid=19160297|doi=10.1002/14651858.CD006734.pub2|editor1-last=Horvath|editor1-first=Tara}}</ref>

===Dawa za kudhibiti virusi ===
[[File:Abacavir (Ziagen) 300mg.jpg|thumb|alt=Tembe mbili za manjano za umbo la mstatili ambapo mojawapo ya alama za GX623 inaonekana|''[[Abacavir]]'' – kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN)]] 
Kwa sasa hakuna tiba au [[chanjo ya VVU]] mwafaka. Matibabu hujumuisha dawa tendi za kudhibiti VVU za kiwango cha juu zinazopunguza mwendo wa ugonjwa huu.<ref name=LE2011>{{cite journal|last=May|first=MT|coauthors=Ingle, SM|title=Life expectancy of HIV-positive adults: a review|journal=Sexual health|date=2011 Dec|volume=8|issue=4|pages=526–33|pmid=22127039|doi=10.1071/SH11046}}</ref> Kufikia mwaka 2010, zaidi ya watu milioni 6.6&nbsp; wa nchi za mapato ya chini na ya kati walikuwa wakitumia dawa hizo.<ref name=UN2019Ten/> Matibabu pia huhusisha hatua za kuzuia na kutibu maambukizi nyemelezi.

Chaguo za kisasa za KNKN ni michanganyiko ya angalau dawa tatu za angalau aina au "vikundi" viwili vya ajenti za [[dawa za kudhibiti VVU]].<ref name=WHOTx2010Pg19/> Mwanzoni, matibabu kwa kawaida huhusisha kizuizi kisicho cha nukliosidi kinachozuia kugeuzwa kwa nakala (KKNKN) pamoja na vidonge viwili vya kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN).<ref name=WHOTx2010Pg19/> KNKN kwa kawaida hujumuisha: [[zidovudine]] (AZT) au [[tenofovir]] (TDF) na [[lamivudine]] (3TC) au [[emtricitabine]] (FTC).<ref name=WHOTx2010Pg19/> Mwungano wa ajenti zinazojumuisha kizuizi cha protisi (KP) hutumika utaratibu huu ukipoteza utendakazi.<ref name=WHOTx2010Pg19/>

Wakati wa kuanzisha matumizi ya dawa za kudhibiti VVU ni mada ambayo ingali inajadiliwa.<ref name=Deut2010/><ref>{{cite journal|last=Sax|first=PE|coauthors=Baden, LR|title=When to start antiretroviral therapy—ready when you are?|journal=The New England Journal of Medicine|date=2009-04-30|volume=360|issue=18|pages=1897–9|pmid=19339713|doi=10.1056/NEJMe0902713}}</ref> Shirika la Afya Duniani, miongozo ya [[Ulaya]] na pia Marekani hupendekeza dawa za kudhibiti VVU kwa vijana waliobalehe, watu wazima na kina mama wajawazito walio na kiwango cha CD4 cha chini ya 350/uL au walio na dalili, bila kuzingatia kiwango chao cha CD4.<ref name=Deut2010/><ref name=WHOTx2010Pg19>{{cite book|title=Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach|year=2010|publisher=World Health Organization|isbn=978-92-4-159976-4|pages=19–20|url=http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|access-date=2017-04-01|archive-date=2012-07-09|archive-url=https://web.archive.org/web/20120709184257/http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|url-status=dead}}</ref>Hali hii huwezeshwa na ukweli kwamba kuanzisha matibabu wakati huu hupunguza hatari ya kifo.<ref name=CochraneART2010>{{cite journal|last=Siegfried|first=N|coauthors=Uthman, OA; Rutherford, GW|title=Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults|journal=Cochrane database of systematic reviews (Online)|date=2010-03-17|issue=3|pages=CD008272|pmid=20238364|doi=10.1002/14651858.CD008272.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Isitoshe, Marekani imependekeza matibabu hayo kwa watu wote wenye VVU bila kuzingatia kiwango cha CD4 au dalili, ingawa inatoa pendekezo hili ikiwahofia watu wenye kiwango cha juu cha CD4.<ref name=Guidelines2009>{{cite book|last=Panel on Antiretroviral Guidelines for Adults and Adolescents|first=|title=Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents|url=http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf|date=2009-12-01|publisher=United States Department of Health and Human Services|page=i|access-date=2017-04-01|archive-date=2009-01-13|archive-url=https://web.archive.org/web/20090113181125/http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf|dead-url=yes}}</ref> Shirika la Afya Duniani pia linapendekeza matibabu kwa watu wenye maambukizi nyongeza ya kifua kikuu na [[hepatitisi B]] tendi ya muda mrefu.<ref name=WHOTx2010Pg19/> 

Matibabu yanapoanzishwa, inapendekezwa yaendelezwe bila "kupumzika".<ref name=Deut2010/> Watu wengi hutambuliwa punde tu baada ya wakati ambao matibabu yalipaswa kuanzishwa.<ref name=Deut2010/> Katika matibabu, matokeo yanayotarajiwa ni kiwango cha HIV-RNA ya plasma ya muda mrefu cha chini ya nakala 50/mL.<ref name=Deut2010>{{cite journal|last=Vogel|first=M|coauthors=Schwarze-Zander, C; Wasmuth, JC; Spengler, U; Sauerbruch, T; Rockstroh, JK|title=The treatment of patients with HIV|journal=Deutsches Ärzteblatt international|date=2010 Jul|volume=107|issue=28–29|pages=507–15; quiz 516|pmid=20703338|doi=10.3238/arztebl.2010.0507|pmc=2915483}}</ref>Viwango vya kuthibitisha ikiwa matibabu ni mwafaka hupendekezwa kwanza baada ya wiki nne na punde viwango hivi vinaposhuka chini ya nakala 50/mL. Vipimo vya kila baada ya miezi 3-6 kwa kawaida huwa mwafaka.<ref name=Deut2010/> Udhibiti usio mwafaka huchukuliwa kuwa zaidi ya nakala 400/mL.<ref name=Deut2010/> Kulingana na kigezo hiki, matibabu huwa mwafaka kwa zaidi ya 95% ya watu katika mwaka wa kwanza.<ref name=Deut2010/>

Manufaa ya matibabu hujumuisha upungufu wa hatari ya kuendelezwa kwa VVU na kupunguka kwa hatari ya kifo.<ref>{{cite journal|last=When To Start|first=Consortium|coauthors=Sterne, JA; May, M; Costagliola, D; de Wolf, F; Phillips, AN; Harris, R; Funk, MJ; Geskus, RB; Gill, J; Dabis, F; Miró, JM; Justice, AC; Ledergerber, B; Fätkenheuer, G; Hogg, RS; Monforte, AD; Saag, M; Smith, C; Staszewski, S; Egger, M; Cole, SR|title=Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies|journal=Lancet|date=2009-04-18|volume=373|issue=9672|pages=1352–63|pmid=19361855|doi=10.1016/S0140-6736(09)60612-7|pmc=2670965}}</ref>Katika mataifa yaliyostawi matibabu pia huboresha afya ya mwili na ya akili.<ref>{{cite journal|last=Beard|first=J|coauthors=Feeley, F; Rosen, S|title=Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review|journal=AIDS care|date=2009 Nov|volume=21|issue=11|pages=1343–56|pmid=20024710|doi=10.1080/09540120902889926}}</ref> Matibabu hupelekea kupunguza kwa 70% hatari ya kupata kifua kikuu.<ref name=WHOTx2010Pg19/> Manufaa ya nyongeza hujumuisha upungufu wa hatari ya kusambazwa kwa ugonjwa huu hadi kwa wenzi kingono, na upungufu wa kusambazwa kwa maambukizi kutoka kwa mama hadi mtoto. <ref name=WHOTx2010Pg19/>

Ubora wa matibabu hutegemea pakubwa maafikiano.<ref name=Deut2010/> Sababu za kutoafikiana hujumuisha: ufikiaji duni wa huduma za kimatibabu,<ref>{{cite journal|last=Orrell|first=C|title=Antiretroviral adherence in a resource-poor setting|journal=Current HIV/AIDS reports|date=2005 Nov|volume=2|issue=4|pages=171–6|pmid=16343374|doi=10.1007/s11904-005-0012-8}}</ref>huduma duni za kijamii, [[ugonjwa wa akili]] na [[uraibu wa madawa]].<ref>{{cite journal|last=Malta|first=M|coauthors=Strathdee, SA; Magnanini, MM; Bastos, FI|title=Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review|journal=Addiction (Abingdon, England)|date=2008 Aug|volume=103|issue=8|pages=1242–57|pmid=18855813|doi=10.1111/j.1360-0443.2008.02269.x}}</ref> Isitoshe, utata wa utaratibu wa matibabu (kufuatia idadi ya tembe na idadi ya marudio ya kumeza tembe) na [[athari kali]] zinaweza kusababisha kutoafikiana kwa kimakusudi.<ref>{{cite journal|last=Nachega|first=JB|coauthors=Marconi, VC; van Zyl, GU; Gardner, EM; Preiser, W; Hong, SY; Mills, EJ; Gross, R|title=HIV treatment adherence, drug resistance, virologic failure: evolving concepts|journal=Infectious disorders drug targets|date=2011 Apr|volume=11|issue=2|pages=167–74|pmid=21406048}}</ref>Hata hivyo, viwango vya uafikiano ni sawa katika nchi zinazostawi na zilizostawi<ref>{{cite journal|last=Nachega|first=JB|coauthors=Mills, EJ; Schechter, M|title=Antiretroviral therapy adherence and retention in care in middle-income and low-income countries: current status of knowledge and research priorities|journal=Current opinion in HIV and AIDS|date=2010 Jan|volume=5|issue=1|pages=70–7|pmid=20046150|doi=10.1097/COH.0b013e328333ad61}}</ref>

Matukio makuu huhusishwa na ajenti inayotumika.<ref name=Montessori2004/> Baadhi ya visa vinavyotokea mara nyingi hujumuisha: [[lipodistrofi inayohusishwa na VVU|sindromu ya lipodistofi]], [[dislipidemia]] na [[kisukari tamu]] hasa pamoja na vizuizi vya protisi.<ref name=M121/> Dalili zingine zinazotokea mara nyingi hujumuisha: [[kuhara]],<ref name=Montessori2004>{{cite journal| author=Montessori, V., Press, N., Harris, M., Akagi, L., Montaner, J. S. |title=Adverse effects of antiretroviral therapy for HIV infection | journal=CMAJ |year=2004 | pages=229–238 |volume=170 | issue=2 |pmid=14734438 | pmc=315530}}</ref><ref name="Burgoyne2008">{{Cite journal|author=Burgoyne RW, Tan DH|title=Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing act|journal=J. Antimicrob. Chemother. |volume=61 |issue=3 |pages=469–73|year=2008 |month=March|pmid=18174196|doi=10.1093/jac/dkm499</ref> na ongezeko la hatari ya [[ugonjwa wa moyo na mishipa]].<ref>{{cite journal|last=Barbaro|first=G|coauthors=Barbarini, G|title=Human immunodeficiency virus & cardiovascular risk|journal=The Indian journal of medical research|date=2011 Dec|volume=134|issue=6|pages=898–903|pmid=22310821|doi=10.4103/0971-5916.92634|pmc=3284097}}</ref> Hata hivyo, athari kali huwa katika matibabu mapya yaliyopendekezwa.<ref name=Deut2010/> Gharama huenda ikawa tatizo kwani baadhi ya dawa huwa ghali<ref>{{cite journal|last=Orsi|first=F|coauthors=d'almeida, C|title=Soaring antiretroviral prices, TRIPS and TRIPS flexibilities: a burning issue for antiretroviral treatment scale-up in developing countries|journal=Current opinion in HIV and AIDS|date=2010 May|volume=5|issue=3|pages=237–41|pmid=20539080|doi=10.1097/COH.0b013e32833860ba}}</ref>. Hata hivyo, hadi mwaka wa 2010, 47% ya watu waliohitaji dawa hizo walikuwa wakizitumia katika nchi zinazostawi na za mapato ya wastani<ref name=UN2019Ten/> Dawa fulani zinaweza kuhusishwa na [[ulemavu wa kuzaliwa]] hivyo hazifai kutumiwa na wanawake wanaopanga kupata watoto.<ref name=Deut2010/>

Matibabu yanayopendekezewa watoto hutofautiana kidogo na ya watu wazima. Katika nchi zinazoendelea, kufikia mwaka wa 2010, 23% ya watoto waliohitaji dawa hizi walikuwa wakizitumia.<ref name=UN2011ONESIXTY>UNAIDS 2011 uk. 150-160</ref> Shirika la Afya Duniani na Marekani inapendekeza matibabu kwa watoto wote wa umri wa chini ya miezi 12.<ref name=USKID2011/><ref name=WHOKID2010>{{cite book|title=Antiretroviral therapy for HIV infection in infants and children|year=2010|publisher=World Health Organization|isbn=978-92-4-159980-1|page=2|url=http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|access-date=2017-04-01|archive-date=2014-02-24|archive-url=https://web.archive.org/web/20140224081130/http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|dead-url=yes}}</ref>Marekani hupendekeza matibabu kwa watoto wa umri wa mwaka 1-5 walio na kiwango cha VVU-RNA cha zaidi ya nakala 100,000&nbsp;/mL na kwa walio zaidi ya miaka mitano watibiwe iwapo kiwango cha CD4 ni chini ya 500/ul.<ref name=USKID2011>{{cite web|title=Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection|url=http://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf|work=The Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children|format=PDF|date=Aug 11,2011|accessdate=2017-04-01|archivedate=2013-02-16|archiveurl=https://web.archive.org/web/20130216214548/http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf}}</ref>

===Kuzuia maambukizi nyemelezi===
Mikakati ya kuzuia maambukizi nyemelezi hufaa watu wengi wenye VVU/UKIMWI. Matibabu ya dawa za kudhibiti virusi huboresha na kupunguza hatari ya kupata maambukizi nyemelezi kwa wakati huo na baadaye.<ref name=Montessori2004/>[[Chanjo]] dhidi ya [[hepatitisi]] A na B hupendekezwa kwa watu walio katika hatari ya VVU kabla ya maambukizi, ingawa yanaweza kutolewa baada ya kuambukizwa.<ref name=Laurence>{{Cite journal | author=Laurence J | title=Hepatitis A and B virus immunization in HIV-infected persons | journal=AIDS Reader | year=2006 | pages=15–17 | volume=16 | issue=1|pmid=16433468}}</ref> Kinga ya [[Trimethoprim/sulfamethoxazole]] kati ya wiki 4-6 na kukoma kunyonyesha watoto waliozaliwa na mama mwenye VVU hupendekezwa katika sehemu zenye upungufu wa raslimali.<ref name=UN2011ONESIXTY/> Pia inapendekezwa kuzuia PCP kiwango cha CD4 kikiwa chini ya 200&nbsp;/uL na kwa wenye PCP au waliokuwa nayo awali.<ref name=PCP2011>{{cite journal|last=Huang|first=L|coauthors=Cattamanchi, A; Davis, JL; den Boon, S; Kovacs, J; Meshnick, S; Miller, RF; Walzer, PD; Worodria, W; Masur, H; International HIV-associated Opportunistic Pneumonias (IHOP), Study; Lung HIV, Study|title=HIV-associated Pneumocystis pneumonia|journal=Proceedings of the American Thoracic Society|date=2011 Jun|volume=8|issue=3|pages=294–300|pmid=21653531|doi=10.1513/pats.201009-062WR|pmc=3132788}}</ref> Watu wenye ugandamizaji wa kingamwili pia hushauriwa kupata kinga ya [[toksoplasmosisi]] na [[Kriptokokasi|Meninjitisi ya kriptokokasi]].<ref name=PEPpocketguide>{{cite web | publisher=[[United States Department of Health and Human Services|Department of Health and Human Services]] | date=February 2, 2007 | url=http://www.guideline.gov/summary/summary.aspx?ss=14&doc_id=6223&string=infected+AND+patients | title=Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. | accessdate=2017-04-01 | archiveurl=https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx | archivedate=2012-12-12 | =https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx }}</ref> Mikakati mwafaka ya kinga imepunguza kiwango cha maambukizi kwa 50% katika miaka 1992-1997.<ref name=InfectionBook2008/>

===Matibabu mbadala===
Takriban 60% ya watu wenye VVU nchini Marekani hutumia mbinu mbalimbali za [[matibabu mbadala]].<ref name="pmid18608078">{{Cite journal|author=Littlewood RA, Vanable PA |title=Complementary and alternative medicine use among HIV-positive people: research synthesis and implications for HIV care |journal=AIDS Care |volume=20 |issue=8 |pages=1002–18 |year=2008 |month=September |pmid=18608078 |pmc=2570227|doi=10.1080/09540120701767216 |url=https://archive.org/details/sim_aids-care_2008-09_20_8/page/1002}}</ref> Ubora wa matibabu hayo hata hivyo haujathibitishwa.<ref name="pmid15969772">{{Cite journal|author=Mills E, Wu P, Ernst E |title=Complementary therapies for the treatment of HIV: in search of the evidence |journal=Int J STD AIDS |volume=16 |issue=6 |pages=395–403 |year=2005|month=June |pmid=15969772 |doi=10.1258/0956462054093962 |url=}}</ref> Kwa kuzingatia [[Lishe na VVU/UKIMWI|ushauri wa kilishe na UKIMWI]], kuna ushahidi unaoonyesha manufaa ya nyongeza za [[virutubishi vidogo]].<ref name="Irlam"/> Ushahidi wa manufaa ya nyongeza za [[seleniamu]] unaonyesha kuwa manufaa yake si mengi sana.<ref>{{cite journal|last=Stone|first=CA|coauthors=Kawai, K; Kupka, R; Fawzi, WW|title=Role of selenium in HIV infection|url=https://archive.org/details/sim_nutrition-reviews_2010-11_68_11/page/671|journal=Nutrition Reviews|date=2010 Nov|volume=68|issue=11|pages=671–81|pmid=20961297|doi=10.1111/j.1753-4887.2010.00337.x|pmc=3066516}}</ref> Kuna ushahidi mdogo kuwa nyongeza ya [[vitamini A]] kwa watoto hupunguza vifo na kuboresha ukuaji.<ref name=Irlam/> Nyongeza ya [[vitamini]] nyingi kwa kina mama wajawazito wenye [[lishe duni]] na wanaonyonyesha imeboresha [[afya]] ya kina mama na watoto barani Afrika<ref name=Irlam>{{cite journal|last=Irlam|first=JH|coauthors=Visser, MM; Rollins, NN; Siegfried, N|title=Micronutrient supplementation in children and adults with HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2010-12-08|issue=12|pages=CD003650|pmid=21154354|doi=10.1002/14651858.CD003650.pub3|editor1-last=Irlam|editor1-first=James H}}</ref> Kutumia virutubishi vidogo ndani ya lishe katika viwango vya [[Kiwango cha Matumizi ya kila Siku|KMS]] kwa watu wazima wenye VVU kumependekezwa na [[Shirika la Afya Duniani]].<ref>{{cite journal|last=Forrester|first=JE|coauthors=Sztam, KA|title=Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?|journal=The American journal of clinical nutrition|date=2011 Dec|volume=94|issue=6|pages=1683S–1689S|pmid=22089440|doi=10.3945/ajcn.111.011999|pmc=3226021}}</ref><ref name='WHO_nutrients'>{{Cite book | last = [[World Health Organization]] | title = Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation | date = 2003-05 | location = Geneva | url = http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | id = | isbn = | accessdate = March 31, 2009 | archiveurl = https://web.archive.org/web/20090325030154/http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | archivedate = 2009-03-25 | deadurl = no }}</ref> SAD linasema kuwa [[takwimu]] kadhaa zimeonyesha nyongeza ya vitamini A, zinki na ayoni inaweza kuwaathiri pakubwa watu wazima walio na VVU.<ref name='WHO_nutrients' /> Hakuna ushahidi wa kutosha kuonyesha manufaa ya [[miti shamba]].<ref>{{Cite journal|author=Liu JP, Manheimer E, Yang M|title=Herbal medicines for treating HIV infection and AIDS |journal=Cochrane Database Syst Rev|issue=3 |pages=CD003937|year=2005 |pmid=16034917 |doi=10.1002/14651858.CD003937.pub2|url=|editor1-last=Liu|editor1-first=Jian Ping}}</ref>

==Matarajio ya kuishi==
[[File:HIV-AIDS world map-Deaths per million persons-WHO2012.svg|upright=1.3|thumb|Idadi ya vifo kutokana na UKIMWI kati ya watu milioni 1 mwaka 2012 {{refbegin|3}}{{legend|#ffff20|0}}{{legend|#ffe820|1–4}}{{legend|#ffd820|5–12}}{{legend|#ffc020|13–34}}{{legend|#ffa020|35–61}}{{legend|#ff9a20|62–134}}{{legend|#f08015|135–215}}{{legend|#e06815|216–458}}{{legend|#d85010|459-1,402}}{{legend|#d02010|1,403–5,828}}{{refend}}]]
[[File:HIV-AIDS world map - DALY - WHO2004.svg|thumb|Alt=Ramani ya ulimwengu ambapo sehemu yake kubwa ni ya rangi ya manjano au ya chungwa isipokuwa Kusini kwa Sahara ambapo kuna rangi nyekundu au nyekundu nzito|[[Miaka ya kulemaza]] ya VVU kwa kila wakaazi 100,000&nbsp; kufikia 2004.
{{Multicol}}
{{legend|#b3b3b3|<small>no data</small>}}
{{legend|#ffff65|<small>≤&nbsp;10</small>}}
{{legend|#fff200|<small>10–25</small>}}
{{legend|#ffdc00|<small>25–50</small>}}
{{legend|#ffc600|<small>50–100</small>}}
{{legend|#ffb000|<small>100–500</small>}}
{{legend|#ff9a00|<small>500–1000</small>}}
{{Multicol-break}}
{{legend|#ff8400|<small>1000–2500</small>}}
{{legend|#ff6e00|<small>2500–5000</small>}}
{{legend|#ff5800|<small>5000–7500</small>}}
{{legend|#ff4200|<small>7500-10000</small>}}
{{legend|#ff2c00|<small>10000-50000</small>}}
{{legend|#cb0000|<small>≥&nbsp;50000</small>}}
{{Multicol-end}}]]
Katika sehemu nyingi ulimwenguni UKIMWI umekuwa [[ugonjwa wa muda mrefu]], si ugonjwa mkali tu.<ref name=Knoll2007/> [[Prognosi]] ni tofauti katika watu mbalimbali, na kiwango cha CD4 pamoja na wingi wa virusi huwa muhimu katika kutabiri matokeo.<ref name=M118/> Wastani wa muda wa kuishi baada ya kuambukizwa unakadiriwa kuwa kati ya miaka 9-1&nbsp; bila matibabu, ikitegemea aina ya VVU.<ref name=UNAIDS2007>{{cite web| author = [[Joint United Nations Programme on HIV/AIDS|UNAIDS]], [[World Health Organization|WHO]]| month = December| year = 2007| title = 2007 AIDS epidemic update| url = http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf| accessdate = 2008-03-12| format = PDF| archivedate = 2008-05-27| archiveurl = https://web.archive.org/web/20080527201701/http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf}}</ref> Baada ya utambuzi wa UKIMWI, iwapo matibabu hayapo, uwezo wa kuishi huwa kati ya miezi 6-19.<ref name=Morgan2>{{Cite journal | author=Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA| title=HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? | journal=AIDS | year=2002 | pages=597–632 | volume=16 | issue=4 | pmid=11873003 |doi=10.1097/00002030-200203080-00011}}</ref><ref>{{Cite journal|title=Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis|author=Zwahlen M, Egger M|url=http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|format=PDF|year=2006|accessdate=March 19, 2008|version=UNAIDS Obligation HQ/05/422204|archiveurl=https://web.archive.org/web/20080409065844/http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|archivedate=2008-04-09|deadurl=no|journal=}}</ref> 

[[KKNKN]] na uzuiaji mwafaka wa Maambukizi nyemelezi hupunguza kima cha vifo kwa 80% na kuongeza matarajio ya urefu wa maisha hadi miaka 20-50 kwa mtu mzima wa kimo aliyetambuliwa na maambukizi karibuni.<ref name=Knoll2007>{{cite journal |journal= Int J Dermatol |year=2007 |volume=46 |issue=12 |pages=1219–28 |title= Current status of HIV infection: a review for non-HIV-treating physicians |author= Knoll B, Lassmann B, Temesgen Z|pmid=18173512|doi=10.1111/j.1365-4632.2007.03520.x}}</ref><ref name=LifeExpecr2008>{{cite journal |journal= Lancet|year=2008 |volume=372|issue=9635 |pages=293–9 |title=Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies | author= Antiretroviral Therapy Cohort Collaboration |pmid=18657708 |doi=10.1016/S0140-6736(08)61113-7 |pmc= 3130543 }}</ref><ref name=Schack2006>{{cite journal | author=Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE, Weinstein MC, Seage GR 3rd, Moore RD, Freedberg KA. |title=The lifetime cost of current HIV care in the United States | url=https://archive.org/details/sim_medical-care_2006-11_44_11/page/990 | journal=Med Care | year=2006 |pages=990–997 | volume=44 | issue=11 | pmid=17063130 |doi=10.1097/01.mlr.0000228021.89490.2a}}</ref> Hii ni kati ya 2/3<ref name=LifeExpecr2008/> na karibu na kiwango cha umma.<ref name=Deut2010/><ref>{{cite journal|last=van Sighem|first=AI|coauthors=Gras, LA; Reiss, P; Brinkman, K; de Wolf, F; ATHENA national observational cohort, study|title=Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals|journal=AIDS (London, England)|date=2010-06-19|volume=24|issue=10|pages=1527–35|pmid=20467289|doi=10.1097/QAD.0b013e32833a3946}}</ref> Matibabu huwa hayafaulu yanapoanzishwa yakiwa yamechelewa katika prognosi,<ref name=Deut2010/> kwa mfano, matibabu yakianzishwa kufuatia utambuzi katika kiwango cha UKIMWI, matarajio ya urefu wa maisha huwa miaka~10–40.<ref name=Deut2010/><ref name=Knoll2007/> Wasipotibiwa, nusu ya watoto wachanga wanaozaliwa na VVU hufa kabla ya miaka miwili.<ref name=UN2011ONESIXTY/>

Sababu kuu ya vifo vinavyotokana na VVU/UKIMWI ni [[Maambukizi nyemelezi]] na [[saratani]] ambayo mara nyingi hutokana na matatizo endelevu ya mfumo wa kingamwili.<ref name=InfectionBook2008>{{cite book|last=Smith|first=[edited by] Blaine T.|title=Concepts in immunology and immunotherapeutics|year=2008|publisher=American Society of Health-System Pharmacists|location=Bethesda, Md.|isbn=978-1-58528-127-5|page=143|url=http://books.google.ca/books?id=G46DrdlxNJAC&pg=PA143|edition=4th}}</ref><ref name=Cancer2005>{{cite journal|last=Cheung|first=MC|coauthors=Pantanowitz, L; Dezube, BJ|title=AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy|journal=The oncologist|date=2005 Jun–Jul|volume=10|issue=6|pages=412–26|pmid=15967835|doi=10.1634/theoncologist.10-6-412}}</ref> Hatari ya saratani huonekana kuongezeka ikiwa kiwango cha CD4 kitashuka chini ya 500/uL.<ref name=Deut2010/> 

Kiwango cha kuendelea kwa ugonjwa wa kiutambuzi hutofautiana pakubwa katika watu mbalimbali na kimedhihirika kuathiriwa na vipengele kadhaa, kama vile uhatarisho na utendaji wa kingamwili;<ref name=Tang>{{Cite journal | author=Tang J, Kaslow RA | title=The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy | journal=AIDS | year=2003 |pages=S51–S60 | volume=17 | issue=Suppl 4 | pmid=15080180 | doi=10.1097/00002030-200317004-00006}}</ref> uwezo wa kufikia [[huduma ya afya]] na uwepo wa [[maambukizi pacha]];<ref name=Morgan2/><ref name=Lawn>{{cite journal | author=Lawn SD |title=AIDS in Africa: the impact of co-infections on the pathogenesis of HIV-1 infection | journal=J. Infect. Dis. |year=2004 | pages=1–12 |volume=48 | issue=1| pmid=14667787</ref> pamoja na aina ya (au za) virusi husika.<ref name=Campbell>{{cite journal | author=Campbell GR |title=The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis | journal=J. Biol. Chem. | year=2004 |pages=48197–48204 | volume=279 | issue=46 | pmid=15331610 |doi=10.1074/jbc.M406195200 | author-separator=, |author2=Pasquier E | author3=Watkins J | display-authors=3 | last4=Bourgarel-Rey | first4=V | last5=Peyrot | first5=V |last6=Esquieu | first6=D | last7=Barbier | first7=P | last8=De Mareuil | first8=J | last9=Braguer |first9=D}}</ref><ref name=Campbell2>{{cite journal | author=Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA | title=The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells | journal=J. Biol. Chem. | year=2005 | pages=38376–39382 | volume=280 | issue=46 |pmid=16155003 | doi=10.1074/jbc.M506630200}}</ref>

Maambukizi pacha ya [[kifua kikuu]] ni mojawapo ya visababishi vikuu vya vifo vya watu wenye VVU/UKIMWI, huku yakipatikana katika 1/3 ya watu walioambukizwa VVU na husababisha 25% ya vifo vinavyohusiana na VVU.<ref>{{cite web|title=Tuberculosis|url=http://www.who.int/mediacentre/factsheets/fs104/en/|work=Fact sheet 104|publisher=World Health Organization|date=March 2012|accessdate=August 29, 2012}}</ref> VVU pia ni kipengele kikuu zaidi cha hatari ya kifua kikuu.<ref name=WHO2011>{{cite web|title=Global tuberculosis control 2011|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011|ISBN=978 92 4 156438 0|accessdate=August 29, 2012}}</ref> [[Hepatitisi C]] ni maambukizi mengine pacha yanayotokea mara nyingi, ambapo kila ugonjwa huongeza uendeleaji wa ugonjwa mwingine<ref>{{cite book|last=Pennsylvania|first=Editors, Raphael Rubin, M.D., Professor of Pathology, David S. Strayer, M.D., Ph.D., Professor of Pathology, Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania ; Founder and Consulting Editor, Emanuel Rubin, M.D., Gonzalo Aponte Distinguished Professor of Pathology, Chairman Emeritus of the Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,|title=Rubin's pathology : clinicopathologic foundations of medicine|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-60547-968-2|page=154|url=http://books.google.ca/books?id=wb2TzY9AgJ0C&pg=PA154|edition=Sixth|year=2011}}</ref> Saratani zinazotokea mara nyingi zaidi ambazo huhusishwa na VVU ni [[sakoma ya Kaposi]] na [[limfoma isiyo ya Hodgkin]].<ref name=Cancer2005/>

Hata wakitibiwa kwa dawa za kudhibiti VVU, watu walio na VVU huenda wakakumbwa na [[matatizo ya kiniuroni ya ufahamu]],<ref name="Woods2009">{{cite pmid|19462243 }}</ref> [[osteoporosi]],<ref name="Brown2006">{{cite pmid|17086056}}</ref> [[nuropathia ya pembeni|nuropathia]],<ref name="Nicholas2007">{{Cite journal|author=Nicholas PK|title=Symptom management and self-care for peripheral neuropathy in HIV/AIDS |journal=AIDS Care | volume=19|issue=2|pages=179–89 |year=2007 |month=February |pmid=17364396|doi=10.1080/09540120600971083|url=https://archive.org/details/sim_aids-care_2007-02_19_2/page/179|author-separator=,|author2=Kemppainen JK|author3=Canaval GE|display-authors=3|last4=Corless|first4=I. B.|last5=Sefcik|first5=E. F.|last6=Nokes|first6=K. M.|last7=Bain|first7=C. A.|last8=Kirksey|first8=K. M.|last9=Sanzero Eller|first9=L.}}</ref> saratani,<ref name="Boshoff2002">{{Cite journal| author=Boshoff C, Weiss R |title=AIDS-related malignancies | journal=Nat. Rev. Cancer | year=2002 | pages=373–382 | volume=2 | issue=5 |pmid=12044013 | doi=10.1038/nrc797 }}</ref><ref name="Yarchoan2005">{{Cite journal| author=Yarchoan R, Tosato G, Little RF | title=Therapy insight: AIDS-related malignancies – the influence of antiviral therapy on pathogenesis and management | journal=Nat. Clin. Pract. Oncol. |year=2005 | pages=406–415 | volume=2 |issue=8 | pmid=16130937 | doi=10.1038/ncponc0253 }}</ref><!-- Boshoff2002 and Yarchoan2005 cover cancer --> [[nefropathi]],<ref name="Post2009">{{cite pmid|19106702}}</ref> na [[ugonjwa wa moyo na mishipa]] baada ya muda mrefu.<ref name="Burgoyne2008" /> Haijulikani ikiwa hali hizi hutokana na kuambukizwa kwa VVU kwenyewe au ni athari kali za matibabu yake.

== Watu wangapi wana UKIMWI? ==
[[Picha: AIDS cases worldwide 1979-1995.png|haki|thumb|Idadi ya watu duniani wenye VVU miaka 1979-1995.]]
[[File:AIDS and HIV prevalence 2008.svg|thumb|upright=1.2|alt= A map of the world where most of the land is colored green or yellow except for sub Saharan Africa which is colored red|[[Asilimia]] ya watu wenye umri wa miaka 15–49 walioambukizwa nchi kwa nchi ([[2011]]).<ref>{{cite web|title=AIDSinfo|url=http://www.unaids.org/en/dataanalysis/datatools/aidsinfo/|work=UNAIDS|accessdate=4 March 2013}}</ref>{{Col-begin}}
{{Col-break}}
{{legend|#787878|<small>No data</small>}}
{{legend|#94bf8b|<small><0.10</small>}}
{{legend|#f4e2ba|<small>0.10–0.5</small>}}
{{legend|#eaca83|<small>0.5–1</small>}}
{{Col-break}}
{{legend|#f07568|<small>1–5</small>}}
{{legend|#ff4800|<small>5–15</small>}}
{{legend|#b00000|<small>15–50</small>}}
{{col-end}}]]
VVU/UKIMWI ni [[janga]] la kimataifa.<ref name=Cohen2008>{{cite journal|last=Cohen|first=MS|coauthors=Hellmann, N; Levy, JA; DeCock, K; Lange, J|title=The spread, treatment, and prevention of HIV-1: evolution of a global pandemic|journal=The Journal of clinical investigation|date=2008 Apr|volume=118|issue=4|pages=1244-54|pmid=18382737|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276790/|accessdate=17 September 2012}}</ref> Kufikia mwaka [[2018]] walau watu wapatao 37,900,000 walikuwa wakiishi na VVU<ref name=UN2019Ten>"Global HIV & AIDS statistics — 2019 fact sheet". www.unaids.org. UNAIDS. Archived from the original on December 4, 2019. Retrieved December 21, 2019.</ref> na kila mwaka watu milioni 2 wengine wanambukizwa<ref name=UNAIDS2015>{{cite web|title=Fact sheet 2015|url=http://www.unaids.org/sites/default/files/media_asset/20150901_FactSheet_2015_en.pdf|website=UNAIDS|accessdate=1 February 2016}}</ref><ref name=UN2013>{{cite web|title=UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001|url=http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/|work=UNAIDS|accessdate=October 7, 2013|archivedate=2013-10-01|archiveurl=https://web.archive.org/web/20131001090619/http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/}}</ref>. Zaidi ya nusu ni wanawake na milioni 2.6 ni watoto chini ya miaka 15.<ref name=UN2019Ten/> Hata hivyo watu wengi wenye VVU hawajui kuwa navyo<ref>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=June 3, 2011|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref>. Kwa sababu hiyo, idadi halisi ya watu wanaoishi na VVU haijulikani. Hali hii ilisababisha karibu vifo milioni 1.8 mwaka 2010 ikilinganishwa na milioni 3.1 katika mwaka 2001.<ref name=UN2019Ten/> Kwa jumla watu 32,000,000 wameshakufa kwa ugonjwa huo<ref name=UN2019Ten/>.

Wengi kati ya watu wenye VVU huishi Afrika kusini kwa Sahara (20,600,000). Wengi kati ya watoto ambao hufariki dunia kutokana na UKIMWI pia wanaishi barani Afrika. Katika mwaka wa 2010, kadirio la 68% (milioni 22.9&nbsp;) la visa vyote vya VVU na 66% ya vifo (milioni 1.2&nbsp;) vilitokea katika eneo hili.<ref name=UN2011Thirty>UNAIDS 2011 pg. 20–30</ref> Hii inamaanisha kuwa karibu 5% ya watu wazima wana virusi hivi<ref name=UN2011Fifty>UNAIDS 2011 pg. 40–50</ref> na vinaaminika kuwa kisababishi cha 10% ya vifo vyote vya watoto.<ref name=M117>Mandell, Bennett, and Dolan (2010). Sura ya 117.</ref> Wanawake wa eneo hili huchangia karibu 60% ya visa vyote tofauti na maeneo mengine.<ref name=UN2011Thirty/> [[Afrika Kusini]] ina idadi kubwa zaidi ya watu wenye VVU ulimwenguni kote, ikiwa ni watu milioni 5.9&nbsp;.<ref name=UN2011Thirty /> 

Kiwango cha [[matarajio ya urefu wa maisha]] kimepungua katika nchi zilizoathirika zaidi kutokana na VVU; kwa mfano, mwaka wa 2006, ilikadiriwa kuwa kiwango hiki kilipungua kutoka miaka 65 hadi 35 nchini [[Botswana]].<ref name=Kallings>{{Cite journal|journal= J Intern Med |year=2008|volume=263|issue=3|pages=218–43 |title= The first postmodern pandemic: Miaka 25 ya VVU |author= Kallings LO|doi=10.1111/j.1365-2796.2007.01910.x|pmid=18205765|url=http://doi.org/10.1111/j.1365-2796.2007.01910.x}}(subscription required)</ref>

[[Asia Kusini]] na [[Asia Kusini Mashariki|Kusini Mashariki]] ni eneo la pili lililoathirika zaidi; mwaka wa 2010, eneo hili lilikuwa na kadirio la visa milioni 4&nbsp; au 12% ya watu wote wanaoishi na VVU, hivyo kupelekea vifo vya takriban watu 250,000.<ref name=UN2011Fifty/> Takriban milioni 2.4&nbsp; ya visa hivi viko India<ref name=UN2011Thirty/> Ukithiri wa VVU uko chini katika maeneo ya Uropa Magharibi na Kati ikifikia 0.2% na [[Mashariki mwa Asia]] ikiwa na 0.1%.<ref name=UN2011Fifty/>

Mwaka wa 2008 nchini Marekani, takriban watu milioni 1.2 walikuwa wakiishi na VVU, hivyo kupelekea takriban vifo 17,500. Kituo cha Kudhibiti na Kuzuia Magonjwa kilikadiria kuwa, mwaka wa 2008, 20% ya Wamarekani waliokuwa na VVU hawakujua hali yao. <ref name=USAEPI2011>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=2011-06-03|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref> Nchini Uingereza, kufikia 2009 kulikuwa na takriban visa 86,500 vilivyopelekea vifo 516.<ref>{{cite book|title=HIV in the United Kingdom: Ripoti ya 2010|year=2010|url=http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1287145367237|author=Health Protection Agency|access-date=2017-04-01|archive-date=2011-01-19|archive-url=https://web.archive.org/web/20110119155546/http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287145367237|dead-url=yes}}</ref> Nchini Kanada, kufikia 2008 kulikuwa na visa 65,000 vilivyopelekea vifo 53.<ref>{{cite book|last=Surveillance|title=HIV and AIDS in Canada : surveillance report to December 31, 2009|year=2010|publisher=Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Surveillance and Risk Assessment Division|location=Ottawa|isbn=978-1-100-52141-1|url=http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|coauthors=riques, Risk Assessment Division = Le VIH et le sida au Canada : rapport de surveillance en date du 31 décembre 2009 / Division de la surveillance et de l'évaluation des|archiveurl=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|archivedate=2012-01-19|access-date=2017-04-01|dead-url=yes|=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf}}</ref>

==Jamii na utamaduni==
=== Unyanyapaa ===
[[File:Ryan White.jpg|thumb|alt=Mvulana baleghe akitabasamu akipigwa picha huku mkono wa mwingine ukiwa uemeegemeshwa begani mwake|[[Ryan White]] alipelekea kuwa [[mtoto wa uhamasisho]] wa VVU baada ya kufukuzwa shuleni kwa sababu alikuwa ameambukizwa.]]
[[Unyanyapaa]] dhidi ya watu walio na UKIMWI zipo kote ulimwenguni kwa namna mbalimbali, zikiwemo kutengwa, kukataliwa na jamii, ubaguzi na kuepuka watu walioambukizwa VVU, kulazimishwa kupimwa VVU bila [[idhini]] au ulinzi wa [[usiri]], vurugu dhidi ya watu walioambukizwa au waliodhaniwa kuambukizwa VVU; na [[karantini]] ya watu waliombukizwa VVU.<ref name=UNAIDS2006Ch4>{{Cite book|publisher =[[Joint United Nations Programme on HIV/AIDS|UNAIDS]]| year = 2006| title = 2006 Report on the global AIDS epidemic| chapter = The impact of AIDS on people and societies| chapterurl =http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH04_en.pdf| accessdate =June 14, 2006| format= PDF| isbn =92-9173-479-9}}</ref> Vurugu zinazohusiana na unyanyapaa au hofu ya vurugu huzuia watu wengi kupima VVU, kurudia matokeo ya vipimo na kutotafuta matibabu. Hali hizi hugeuza ugonjwa wa muda mrefu unaoweza kudhibitiwa kuwa hukumu ya kifo na kuendeleza ueneaji wa VVU.<ref name=Ogden>{{cite web | author = Ogden J, Nyblade L | publisher = [[International Center for Research on Women]] | year = 2005 | title = Common at its core: HIV-related stigma across contexts | url = http://www.icrw.org/docs/2005_report_stigma_synthesis.pdf | format = PDF | accessdate = February 15, 2007 | archiveurl = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts | archivedate = 2013-03-19 | = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts }}</ref>

Unyanyapaa dhidi ya watu wanaoishi na UKIMWI, umegawanywa zaidi katika vikundi vitatu kama ifuatavyo:

* ''Unyanyapaa Mkuu wa UKIMWI ''-mawazo ya woga na wasiwasi unaoweza kuhusishwa na ugonjwa wowote aunaoua au kuambukiza.<ref name=Herek1999>{{Cite journal| author=Herek GM, Capitanio JP| journal=American Behavioral Scientist| year=1999| url=http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| format=PDF| title=AIDS Stigma and sexual prejudice| accessdate=March 27, 2006| volume=42| issue=7| pages=1130–1147| doi=10.1177/0002764299042007006| archive-date=2006-04-09| archive-url=https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| dead-url=yes| =https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf}}</ref>
* '' Unyanyapaa wa kiishara wa UKIMWI ''-kutumia VVU/UKIMWI kuonyesha mitazamo fulani dhidi ya vikundi vya jamii au mitindo ya maisha inayohusishwa na ugonjwa huu.<ref name=Herek1999 />
* Unyanyapaa wa kihisani wa UKIMWI''- Unyanyapaa dhidi ya watu wanaohusishwa na suala la VVU/UKIMWI au watu walio na VVU.<ref name=Snyder>{{Cite journal|author=Snyder M, Omoto AM, Crain AL |title=Punished for their good deeds: stigmatization for AIDS volunteers |url=https://archive.org/details/sim_american-behavioral-scientist_1999-04_42_7/page/1175 |journal=American Behavioral Scientist | year=1999 | pages=1175–1192 | volume=42 | issue=7|doi=10.1177/0002764299042007009}}</ref>

Mara nyingi, unyanyapaa wa UKIMWI huonyeshwa pamoja na unyanyapaa wa aina moja au nyingine, hasa unyanyapaa unaohusiana na ushoga, [[uasherati]], ukahaba na kutumia dawa za kulevya.<ref>{{cite book|last=Sharma|first=A.K.|title=Population and society|publisher=Concept Pub. Co.|location=New Delhi|isbn=9788180698187|pages=242|url=http://books.google.ca/books?id=sE-VDhEuxmsC&pg=PA242}}</ref>

Katika nchi nyingi zilizostawi, kuna uhusiano kati ya UKIMWI na ushoga.<ref name=Herek2002>{{cite journal|last=Herek|first=GM|coauthors=Capitanio, JP; Widaman, KF|title=HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999|url=https://archive.org/details/sim_american-journal-of-public-health_2002-03_92_3/page/371|journal=American journal of public health|date=2002 Mar|volume=92|issue=3|pages=371–7|pmid=11867313|pmc=1447082|doi=10.2105/AJPH.92.3.371}}</ref><ref name=Herek1999/>Hata hivyo, njia kuu ya kuenea kwa UKIMWI ulimwenguni kote inabakia kuwa maambukizi kati ya wanaume na wanawake, kwa kuwa ndio ngono ya kawaida. <ref>{{cite journal|last=De Cock|first=KM|coauthors=Jaffe, HW; Curran, JW|title=The evolving epidemiology of HIV/AIDS.|journal=AIDS (London, England)|date=2012 Jun 19|volume=26|issue=10|pages=1205-13|pmid=22706007}}</ref>

=== Athari za kiuchumi ===
[[File:Life expectancy in some Southern African countries 1958 to 2003.png|thumb|alt=Grafu inayoonyesha mistari kadhaa inayopanda ikifuatiwa na kushuka kwa ghafla kwa mistari hii kuanzia miaka ya katikati mwa 1980 hadi miaka ya 1990|Mabadiliko katika matarajio ya urefu wa maisha katika baadhi ya nchi za Afrika zilizoathiriwa zaidi. {{legend-line|red solid 2px|Botswana}}{{legend-line|darkgreen solid 2px|Zimbabwe}}{{legend-line|blue solid 2px|Kenya}}{{legend-line|black solid 2px|South Africa}}{{legend-line|grey solid 2px|Uganda}}]]

VVU/UKIMWI huathiri [[uchumi]] wa watu na nchi.<ref name=M117/> [[Pato la ndani la uzalishaji]] la nchi zilizoathiriwa zaidi limepungua kufuatia ukosefu wa [[rasilimali ya kibinadamu]].<ref name=M117/><ref name="Bell-et-al-2003">{{Cite journal|author=Bell C, Devarajan S, Gersbach H|year=2003|url=http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|title=The long-run economic costs of AIDS: theory and an application to South Africa|accessdate=April 28, 2008|version=World Bank Policy Research Working Paper No. 3152|format=PDF|journal=|archive-date=2013-06-05|archive-url=https://web.archive.org/web/20130605151302/http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|dead-url=yes}}</ref>Bila [[lishe bora]], huduma za afya na dawa, watu wengi hufariki kutokana na matatizo yanayohusiana na UKIMWI. Kando ya kutoweza kufanya kazi, watu hao pia huhitaji kiwango kikubwa cha huduma za afya. 

UKIMWI hupunguza idadi ya watu wanaoweza kulipa [[ushuru]] Kwa kuwaathiri hasa vijana, hivyo kupunguza [[raslimali]] zilizopo za [[matumizi ya serikali|matumizi ya umma]] kama vile [[huduma za elimu]] na afya ambazo hazihusiki na UKIMWI. Hali hii husababisha upungufu wa [[pesa]] za nchi na wa ukuaji wa uchumi. Hali hii kisha hupelekea upungufu wa ukuaji wa msingi wa ushuru, athari ambayo huongezeka iwapo kuna matumizi zaidi katika matibabu, mafunzo (ili kuchukua nafasi ya [[wafanyakazi]] wanaougua), kuwalipa wafanyakazi wagonjwa na kuwatunza mayatima wa UKIMWI. Hali hii hutokea hasa iwapo ongezeko kubwa la vifo vya watu wazima litapelekea kubadilika kwa [[wajibu]] wa kuwatunza mayatima hawa kutoka kwa [[familia]] hadi kwa [[serikali]].<ref name=Greener />

Katika kiwango cha familia, UKIMWI husababisha upungufu wa mapato na pia ongezeko la matumizi katika huduma za afya. Utafiti katika nchi ya [[Côte d'Ivoire]] ulionyesha kuwa familia zilizo na mgonjwa aliye na VVU/UKIMWI zilitumia pesa mara mbili zaidi ya familia nyingine. Matumizi hayo ya ziada pia hupelekea kiwango kidogo zaidi cha mapato ya kutumia katika elimu au [[uwekezaji]] wa kibinafsi au wa kifamilia.<ref name="WBank">{{Cite journal| author=Over M| title=The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department| publisher=The World Bank| year=1992| url=http://www.worldbank.org/aidsecon/macro.pdf| format=PDF| accessdate=May 3, 2008| archiveurl=https://web.archive.org/web/20080527201655/http://www.worldbank.org/aidsecon/macro.pdf| archivedate=2008-05-27| deadurl=no| journal=}}</ref>

=== Mayatima ===
[[Picha: Africa HIV-AIDS 2002.png | haki | frame |Asilimia ya watu waliokuwa wanaishi na VVU katika Afrika miaka 1999-2001]]
[[Picha:Ukimwi Afrika 2011.png|350px|thumb|Asilimia ya watu waliokuwa wanaishi na VVU Afrika mnamo mwaka 2011]]
Watu wengi ambao wanakufa kutokana na UKIMWI, hasa katika [[Afrika]], huacha watoto ambao bado ni hai, na ambao wanaweza wanahitaji msaada na huduma. Inakadiriwa kuwa kufikia mwaka wa 2007, diadi ya watoto [[yatima kutokana na UKIMWI]] &nbsp;milioni 12.<ref name=M117/> Wengi wao hutunzwa na [[Bibi|nyanya]] na [[babu]] [[wazee]]. <ref name=Greener>{{Cite book| author = Greener R| year = 2002| title = State of The Art: UKIMWI na Uchumi| chapter = AIDS and macroeconomic impact| editor = S, Forsyth (ed.)| pages = 49–55| publisher = IAEN| url = http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| access-date = 2017-04-01| archive-date = 2012-10-12| archive-url = https://web.archive.org/web/20121012090520/http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| dead-url = yes}}</ref>

=== Dini na UKIMWI ===
Mada kuhusu dini na UKIMWI imekuwa ikikumbwa na utata mwingi katika miaka thelathini iliyopita, hasa kwa sababu baadhi ya viongozi wa dini wametangaza hadharani kwamba wanapinga utumiaji kondomu.<ref>{{cite web|url=http://www.news-medical.net/health/AIDS-Stigma.aspx |title=AIDS Stigma |publisher=News-medical.net|accessdate=November 1, 2011}}</ref>

Mashirika mengine ya dini yamedai kuwa maombi yanatosha kutibu VVU/UKIMWI. Mwaka 2011, BBC iliripoti kuwa baadhi ya makanisa huko [[London]] yalikuwa yakidai kuwa maombi yanatibu UKIMWI. Kituo cha Utafiti wa Afya ya Kiuzazi na VVU cha [[Manispaa ya Hackney, London|Hackney]] kiliripoti kuwa watu wengi waliachma kutumia matibabu, wakati mwingine kwa kushauriwa na [[wachungaji]] wao. Jambo hili lilipelekea vifo vya watu wengi.<ref name=BBC18102011>{{cite news|url=http://www.bbc.co.uk/news/uk-england-london-14406818|title=Church HIV prayer cure claims 'cause three deaths'|date=October 18, 2011|accessdate=October 18, 2011|publisher=BBC News}}</ref> [[Synagogue Church Of All Nations]] ilitangaza ''maji ya upako'' ili kuwezesha [[uponyaji]] kutoka kwa [[Mungu]], ingawa ilikana kuwa iliwashauri watu kukoma kutumia matibabu.<ref name=BBC18102011 />

===Katika vyombo vya habari===
Kimojawapo kati ya visa maarufu zaidi vya UKIMWI kilikuwa cha Mmarekani [[Rock Hudson]], [[muigizaji]] shoga aliyekuwa ameoa kisha kutalaki hapo awali. Hudson alifariki tarehe [[2 Oktoba]] [[1985]] baada ya kutangaza ana VVU tarehe [[25 Julai]] mwaka huohuo. Yeye alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1984.<ref>{{cite web|url=http://www.history.com/this-day-in-history/rock-hudson-announces-he-has-aids |title=Rock Hudson announces he has AIDS – History.com This Day in History – 7/25/1985 |publisher=History.com |accessdate=November 1, 2011}}</ref> 

Mgonjwa mashuhuri kutoka Uingereza mwaka huo alikuwa [[Nicholas Eden]] [[mwanasiasa]] shoga na [[mwana]] wa [[Waziri Mkuu]], [[marehemu]] [[Anthony Eden]].<ref>{{cite web|last=Coleman |first=Brian|url=http://www.newstatesman.com/blogs/brian-coleman/2007/06/lady-thatcher-gay-tory |title=Thatcher the gay icon|work=New Statesman |date=June 25, 2007 |accessdate=November 1, 2011}}</ref>

Tarehe [[24 Novemba]] [[1991]], virusi hivi vilipelekea kifo cha mwanamuziki wa aina ya [[muziki wa rock]], Mwingereza [[Freddie Mercury]]. Mercury, aliyeongoza [[bendi]] iliyojulikana kama [[Queen (bendi)|Queen]] alifariki kutokana na magonjwa yanayohusiana na UKIMWI baada ya kujulikana kuwa na ugonjwa huo siku iliyopita tu.<ref>{{cite news|url=http://news.bbc.co.uk/onthisday/hi/dates/stories/november/24/newsid_2546000/2546945.stm |title=November 24, 1991: Giant of rock dies |work=BBC On This Day |publisher=BBC News |date= |accessdate=November 1, 2011}}</ref> Hata hivyo, Mercury alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1987.<ref>{{cite web|url=http://www.nndb.com/people/521/000044389/|title=Freddie Mercury |publisher=Nndb.com |accessdate=November 1, 2011}}</ref> 

Kimojawapo kati ya visa maarufu zaidi vilivyotokana na ngono kati ya watu wa jinsia tofauti ni kile cha [[Arthur Ashe]], [[mchezaji]] [[tenisi]] Mmarekani. Ashe alitambuliwa kuwa na VVU tarehe [[31 Agosti]] [[1988]]; baada ya kuambukizwa alipokuwa akiongezewa damu akifanyiwa [[upasuaji wa moyo]] awali [[miaka ya 1980]]. Vipimo zaidi katika saa 24 baada ya utambuzi wa kwanza vilionyesha kuwa Ashe alikuwa na UKIMWI, lakini hakuwambia watu kuhusu utambuzi huu hadi Aprili [[1992]].<ref>{{cite web |last=Bliss |first=Dominic |url=http://www.itennisstore.com/Tennis-Latest-News/FROZEN-IN-TIME--ARTHUR-ASHE-by-Dominic-Bliss.aspx |title=Frozen In Time: Arthur Ashe |work=iTENNISstore.com |accessdate=June 25, 2012}}</ref> Ashe alifariki kutokana na UKIMWI akiwa na umri wa miaka 49 tarehe [[6 Februari]] [[1993]].<ref>{{cite news | url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html | title=Tributes to Arthur Ashe | location=London | work=The Independent | date=February 8, 1993 | accessdate=July 24, 2012 | archivedate=2013-03-19 | archiveurl=https://www.webcitation.org/6FEwqou9b?url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html }}</ref>

Picha ya [[Therese Frare]] ikionyesha [[mwanaharakati]] wa ushoga [[David Kirby]] akifariki kutokana na UKIMWI huku akizungukwa na familia yake, ilipigwa Aprili mwaka wa 1990. ''[[LIFE magazine]]'' ilisema kuwa picha hiyo ilikuja kufahamika kama picha ''maarufu zaidi kuwahi kuhusishwa na janga la UKIMWI/VVU.'' Picha hiyo iliyochapishwa na [[gazeti]] hilo ilishinda [[tuzo]] la [[World Press Photo]], kisha kupata umaarufu ulimwenguni kote baada ya kutumiwa na [[Benetton Group|United Colors of Benetton]] katika kampeni ya utangazaji ya mwaka 1992.<ref>{{cite web|last=Cosgrove|first=Ben|title=Behind the Picture: Picha Iliyobadilisha Sura ya Ukimwi|url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|work=LIFE magazine|accessdate=16 August 2012|archivedate=2013-03-19|archiveurl=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1}}</ref>

=== Ukanushaji, njama na hila ===
Kikundi kidogo cha watu kingali kinakana uhusiano wa VVU na UKIMWI, <ref name=Duesberg>{{cite journal|author=Duesberg, P. H.| title=HIV is not the cause of AIDS| journal=Science | year=1988 | pages=514, 517 | volume=241 |issue=4865| pmid=3399880 | doi=10.1126/science.3399880|bibcode = 1988Sci...241..514D }}{{cite journal| author=Cohen, J.| title=The Controversy over HIV and AIDS| journal=Science | year=1994 | pages=1642–1649 | volume=266 | issue=5191|url=http://www.sciencemag.org/feature/data/cohen/266-5191-1642a.pdf| format = PDF| doi=10.1126/science.7992043|pmid=7992043| accessdate=2009-03-31 | bibcode=1994Sci...266.1642C}}</ref> uwepo wa VVU au ubora wa vipimo vya VVU na njia za matibabu.<ref name=Kalichman>{{cite book|author=Kalichman, Seth|authorlink=Seth Kalichman|title=Denying AIDS: Njama Nadhira, Itikadi na Msiba wa Mwanadamu|publisher=Copernicus Books ([[Springer Science+Business Media]])|location=New York|year=2009|pages=|isbn=978-0-387-79475-4| url =http://books.google.com/?id=_mtDBCDwxugC&printsec=frontcover&q=}}</ref><ref name=SmithNovella>{{cite journal|author=Smith TC, Novella SP|title=HIV Denial in the Internet Era|journal=PLoS Med.|volume=4|issue=8|pages=e256|year=2007|month=August|pmid=17713982|doi=10.1371/journal.pmed.0040256|url=http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|accessdate=2009-11-07|pmc=1949841|archive-date=2008-05-06|archive-url=https://web.archive.org/web/20080506012410/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|dead-url=yes}}</ref>

Madai hayo, yanayojulikana kama [[ukanaji UKIMWI]], yamechunguzwa na kukataliwa na jamii ya kisayansi.<ref name=consensus>{{cite web| author=Various| publisher=[[National Institute of Allergy and Infectious Diseases]]|date=Last updated January 14, 2010|url=http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/HIVcausesAIDS.aspx| title= Resources and Links, HIV-AIDS Connection| accessdate = 2009-02-22}}</ref>Hata hivyo, madai hayo yana athari kuu kisiasa, hasa nchini [[Afrika Kusini]]. Hatua ya serikali ya nchi hiyo kukubali kirasmi ukanaji wa UKIMWI ilipelekea mwitikio usiofaa wa janga hili, na imelaumiwa kupelekea visa vingi vya maambukizi ya VVU na mamia ya maelfu ya vifo ambavyo vingeepukwa.<ref>{{cite journal |author=Watson J |title=Scientists, activists sue South Africa's AIDS 'denialists' |journal=Nat. Med. |volume=12 |issue=1 |page=6 |year=2006 |pmid=16397537|doi=10.1038/nm0106-6a}}</ref><ref>{{cite journal |author=Baleta A |title=S Africa's AIDS activists accuse government of murder |journal=Lancet |volume=361 |issue=9363 |page=1105 |year=2003 |pmid=12672319|doi=10.1016/S0140-6736(03)12909-1}}</ref><ref>{{cite journal |author=Cohen J |title=South Africa's new enemy|journal=Science |volume=288 |issue=5474 |pages=2168–70 |year=2000 |pmid=10896606|doi=10.1126/science.288.5474.2168}}</ref> 

[[Urusi]] ulianzisha [[Operesheni INFEKTION]], uhamasisho wa ulimwengu mzima kueneza habari kuwa VVU/UKIMWI ulitengenezwa na Marekani. Takwimu zinaonyesha kuwa idadi kubwa ya watu wanaamini na wanaendelea kuamini madai hayo.

Kuna aina nyingi za [[dhana potovu kuhusu VVU na UKIMWI]]. Dhana tatu kuu ni kwamba UKIMWI unaweza kusambazwa kwa kumgusa mtu, kuwa ngono na [[bikira]] itatibu UKIMWI na kuwa VVU vinaweza tu kuambukiza mashoga na watumiaji wa madawa. Dhana nyingine potovu ni kuwa tendo lolote la ngono ya kinyeo kati ya mashoga wasioambukizwa linaweza kupelekea maambukizi.<ref>{{Cite book| author=Blechner MJ| title=Hope and mortality: psychodynamic approaches to AIDS and HIV| url=https://archive.org/details/hopemortalitypsy0000unse|publisher=Analytic Press| location=Hillsdale, NJ| year=1997| isbn=0-88163-223-6| unused_data=ISBN status=May be invalid– please double check}}</ref><ref>{{Cite journal|author=Kirby DB, Laris BA, Rolleri LA |title=Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world |journal=J Adolesc Health |volume=40|issue=3 |pages=206–17 |year=2007|month=March |pmid=17321420 |doi=10.1016/j.jadohealth.2006.11.143 |url=https://archive.org/details/sim_journal-of-adolescent-health_2007-03_40_3/page/206}}</ref>

==Utafiti unavyoendelea==
Utafiti wa kuboresha matibabu ya kisasa unajumuisha kupunguza madhara ya ziada ya dawa zilizopo, kurahisisha kanuni za kutumia dawa na kuboresha ubora na kuamua utaratibu bora wa kanuni ili kudhibiti ukinzani wa dawa. Hata hivyo, chanjo pekee ndiyo inayodhaniwa kuweza kusitisha janga hili. Hii ni kwa sababu chanjo ni ya bei nafuu, hivyo [[Taifa linalostawi|mataifa yanayostawi]] yanaweza kuimudu, na haitahitaji matibabu ya kila siku.<ref name=Ferrantelli>{{cite journal|author=Ferrantelli F, Cafaro A, Ensoli B |title=Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccine|journal=Curr. Opin. Biotechnol. |volume=15 |issue=6 |pages=543–56|year=2004|month=December|pmid=15560981 |doi=10.1016/j.copbio.2004.10.008}}</ref> 

Hata hivyo, baada ya miaka 20 ya utafiti, imekuwa vigumu kupata chanjo dhidi ya VVU-1,<ref name=Ferrantelli/><ref>{{Cite journal|author=Karlsson Hedestam GB, Fouchier RA, Phogat S, Burton DR, Sodroski J, Wyatt RT |title=The challenges of eliciting neutralizing antibodies to HIV-1 and to influenza virus |journal=Nat. Rev. Microbiol. |volume=6 |issue=2 |pages=143–55 |year=2008|month=February |pmid=18197170 |doi=10.1038/nrmicro1819}}</ref> hivyo tiba bado haijapatikana.

=== Upandikizaji seli kuu===
Mwaka wa 2007, Timothy Ray Brown,<ref name=ghivberlin>{{cite news|title=German HIV patient cured after stem cell transplant|url=http://www.belfasttelegraph.co.uk/news/world-news/german-hiv-patient-cured-after-stem-cell-transplant-15030473.html|accessdate=December 15, 2010|newspaper=[[Belfast Telegraph]]|date=December 15, 2010}}</ref> mwanaume wa umri wa miaka 40 aliyekuwa na VVU, pia anayejulikana kama "the Berlin Patient" alipewa huduma ya [[upandikizaji seli kuu za damu|pandikizo la seli kuu]] kama mojawapo ya matibabu ya [[lukemia sugu ya mieloidi]] (LSM).<ref name = Blood>{{cite journal|last=Allers|first=K|coauthors=Hütter, G; Hofmann, J; Loddenkemper, C; Rieger, K; Thiel, E; Schneider, T|title=Evidence for the cure of HIV infection by CCR5Δ32/Δ32 stem cell transplantation|journal=Blood|date=2011-03-10|volume=117|issue=10|pages=2791–9|pmid=21148083|doi=10.1182/blood-2010-09-309591}}</ref>Pandikizo la pili lilifanyika mwaka uliofuata baada ya kuugua tena. Mfadhili alichanguliwa sio tu kwa kuwa ana [[antijeni ya leukositi ya binadamu|upatanifu wa kijeni]] lakini pia kwa kuwa alikuwa na [[utangamano]] wa kubadilika kwa [[CCR5-Δ32]] ambayo huwezesha ukinzani dhidi ya maambukizi ya VVU.<ref name="Wall Street Journal 2008">{{cite news | author=Mark Schoofs | title=A Doctor, a Mutation and a Potential Cure for AIDS | url=http://online.wsj.com/article/SB122602394113507555.html | accessdate=2008-11-09|publisher=The Wall Street Journal| date=November 7, 2008}}</ref><ref name=Huetter2009>{{cite journal |author=Hütter G, Nowak D, Mossner M, Ganepola S, Ganepola A, Allers K, Schneider T, Hofmann J, Kücherer C, Blau O, Blau IW, Hofmann WK, Thiel E |title=Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation |journal=N Engl J Med |volume=360 |issue=7 |pages=692–698 |year=2009 |pmid=19213682 |doi=10.1056/NEJMoa0802905 |url=http://content.nejm.org/cgi/content/abstract/360/7/692 |accessdate=2009-03-31 |archive-date=2009-02-13 |archive-url=https://web.archive.org/web/20090213112056/http://content.nejm.org/cgi/content/abstract/360/7/692 |dead-url=yes }}</ref> Baada ya miezi 20 bila matibabu ya dawa za kudhibiti VVU, iliripotiwa kuwa viwango vya VVU kwenye damu ya Brown [[uboho]] na matumbo vilikuwa chini ya kiwango cha kutambulika.<ref name=Huetter2009/>Virusi hivi vilibakia katika kiwango hicho kwa miaka mitatu baada ya upandikizo wa kwanza.<ref name=Blood/>Ingawa watafiti na baadhi ya wachambuzi wanasema kuwa matokeo haya ni tiba, wengine wao wanadokeza kuwa virusi hivi vinaweza kuwa vimejificha ndani ya tishu<ref name=NEJMLevy/>kama vile ubongo (unaotumika kama [[ufiche wa virusi|hifadhi]]).<ref>{{cite journal|last=Nath|first=A|coauthors=Clements, JE|title=Eradication of HIV from the brain: reasons for pause|journal=AIDS (London, England)|date=2011-03-13|volume=25|issue=5|pages=577–80|pmid=21160414|doi=10.1097/QAD.0b013e3283437d2f}}(subscription required)</ref> Matibabu ya seli kuu yamebakia chini ya [[utafiti wa kiafya |kuchunguzwa]] kwa sababu ya asili yake ya [[ushahidi wa kinadharia|kinadharia]], ugonjwa wenywe na hatari ya kufa inayohusishwa na upandikizaji wa seli kuu na ugumu wa kupata wafadhili mwafaka.<ref name=NEJMLevy>{{cite journal |author=Levy JA |title=Not an HIV Cure, but Encouraging New Directions |journal=N Engl J Med |volume=360 |issue=7 |pages=724–725 |year=2009 |doi=10.1056/NEJMe0810248 |url=http://content.nejm.org/cgi/content/full/360/7/724 |accessdate=2009-03-31 |pmid=19213687 |archive-date=2009-02-15 |archive-url=https://web.archive.org/web/20090215235206/http://content.nejm.org/cgi/content/full/360/7/724 |dead-url=yes }}</ref><ref>{{Cite pmid|21331536}}(subscription required)</ref>

=== Matibabu ya kuboresha kingamwili ===
Matibabu saidizi za kudhibiti uigaji wa virusi, [[matibabu ya kingamwili,|matibabu ya kingamwili]] zinazoweza kusaidia kuboresha mfumo wa kingamwili zilizochunguzwa awali, na juhudi zinazoendelea ni pamoja na [[Interleukin-2|IL-2]] na [[Interleukin-7|IL-7]].<ref name="Tincati-2009">{{cite journal|last=Tincati|first=C|coauthors=d'Arminio Monforte, A; Marchetti, G|title=Immunological mechanisms of interleukin-2 (IL-2) treatment in HIV/AIDS disease|journal=Current molecular pharmacology|date=2009 Jan|volume=2|issue=1|pages=40–5|pmid=20021444|doi=10.2174/1874467210902010040}}</ref>

Kutofaulu kwa chanjo kadhaa kukinga dhidi ya maambukizi ya VVU na kuendelea kwa UKIMWI kumepelekea mwelekeo mpya wa kuzingatia taratibu za kibayolojia zinazosababisha ufiche wa VVU. Kipindi kifupi cha matibabu ya kuunganisha dawa za kudhibiti VVU na dawa zinazolenga hifadhi fiche siku moja kinaweza kutokomeza maambukizi ya VVU.<ref name =Bowman>{{cite journal | author=Bowman MC, Archin NM, Margolis DM. | title=Pharmaceutical approaches to eradication of persistent HIV infection | journal=Expert Reviews in Molecular Medicine |year=2009| volume=11 | issue=e6 | pmid=19208267 |doi=10.1017/S1462399409000970 | pages=e6 }}</ref>Watafiti wamegundua [[abusaimu]] inayoweza kuharibu eneo la kufungia protini ya [[gp120]] CD4. Protini hii hupatikana katika aina zote za VVU kwa sababu ndiyo ncha ambapo [[seli za B|limfosaiti za B]] hujishikisha kisha kuafikiana kwa mfumo wa kingamwili.<ref>{{Cite journal|author=Planque S, Nishiyama Y, Taguchi H, Salas M, Hanson C, Paul S |title=Catalytic antibodies to HIV: Physiological role and potential clinical utility |journal=Autoimmun Rev |volume=7 |issue=6 |pages=473–9 |year=2008 |month=June|pmid=18558365|doi=10.1016/j.autrev.2008.04.002 |url= |pmc=2527403}}</ref>

== Tanbihi ==
{{Reflist}}

==Marejeo==
* {{cite book | editor1-last = Mandell | editor1-first = Gerald L. | editor2-last = Bennett | editor2-first =John E.| editor3-last = Dolin | editor3-first = Raphael |title=Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases | year=2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA|isbn=978-0-443-06839-3 | edition = 7th }}
* {{cite book|author=[[Joint United Nations Programme on HIV/AIDS]] (UNAIDS) |title=Global HIV/AIDS Response, Epidemic update and health sector progress towards universal access|year=2011|publisher=Joint United Nations Programme on HIV/AIDS|url=http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20111130_UA_Report_en.pdf}}

== Viungo vya nje ==
{{Commons category|AIDS}}
* {{Dmoz|Health/Conditions_and_Diseases/Immune_Disorders/Immune_Deficiency/AIDS/|HIV/AIDS}}
* [http://aidsinfo.nih.gov/ AIDSinfo] {{Wayback|url=http://aidsinfo.nih.gov/ |date=20110225133251 }} – HIV/AIDS Treatment Information, U.S. Department of Health and Human Services
* [Http://www.who.int/3by5/en/ Shirika la Afya Duniani Mashirika 3 na 5 Initiative]
* [Http://www.accessmed-msf.org/index.asp Médecins Sans Frontières: Kampeni ya upatikanaji wa madawa muhimu] {{Wayback|url=http://www.accessmed-msf.org/index.asp |date=20050812004522 }}
* [Http://www.who.int/hiv/en/ WHO Mpango wa VVU / UKIMWI]
* [Http://www.aegis.org/en/ Elimu UKIMWI Mfumo wa Taarifa za Global]
* [Http://www.aidsinfo.nih.gov/ Kutoka Taasisi ya Taifa ya Marekani ya Afya] {{Wayback|url=http://www.aidsinfo.nih.gov/ |date=20210322035857 }}
* [Http://content.nejm.org/cgi/content/full/353/8/749 New England Journal of Medicine Ibara "Ruhusu dhidi ya Wagonjwa? Kurefusha maisha Tiba katika India"] {{Wayback|url=http://content.nejm.org/cgi/content/full/353/8/749 |date=20090501234727 }}
* [Http://www.aidsportal.org AIDSPortal maarifa mtandao]
* [http://www.unaids.org/en/ Tovuti ya Shirika la Umoja wa Mataifa la Masuala ya Ukimwi, UNAIDS] {{Wayback|url=http://www.unaids.org/en/ |date=20130210215850 }}
* [http://hivinsite.ucsf.edu HIV InSite] {{Wayback|url=http://hivinsite.ucsf.edu/ |date=20191213225029 }}
* [http://www.sida.fr/ sida.fr • un centre pour les malades du SIDA • infos • tèmoignages • actualités]

[[Jamii:Dalili]]
[[Jamii:Ukimwi]]