Sajak “PENERIMAAN” by Chairil Anwar

PENERIMAAN

Kalau kau mau kuterima kau kembali
Dengan sepenuh hati

Aku masih tetap sendiri

Kutahu kau bukan yang dulu lagi
Bak kembang sari sudah terbagi

Jangan tunduk! Tentang aku dengan berani

Kalau kau mau kuterima kembali
Untukku sendiri tapi

Sedang dengan cermin aku enggan berbagi.

Maret 1943

The Origin and History of English Language

English is a Germanic Language of the Indo-European Family. It is the second most spoken language in the world.

It is estimated that there are 300 million native speakers and 300 million who use English as a second language and a further 100 million use it as a foreign language. It is the language of science, aviation, computing, diplomacy, and tourism. It is listed as the official or co-official language of over 45 countries and is spoken extensively in other countries where it has no official status. English plays a part in the cultural, political or economic life of the following countries. Majority English speaking populations are shown in bold.

 

• Antigua
• Australia
• Bahamas
• Barbados
• Belize
• Bermuda
• Botswana
• Brunei (with Malay)
• Cameroon (with French)
• Canada (with French)
• Dominica
• Fiji
• Gambia
• Ghana
• Grenada
• Guyana
• India (with several Indian languages)
• Ireland (with Irish Gaelic)
• Jamaica
• Kenya (with Swahili)
• Kiribati
• Lesotho (with Sotho)
• Liberia
• Malawi (with Chewa)
• Malta (with Maltese)
• Mauritius
• Namibia (with Afrikaans)
• Nauru (with Nauruan)
• New Zealand
• Nigeria
• Pakistan (with Urdu)
• Papua New Guinea
• Philippines (with Tagalog)
• Puerto Rico (with Spanish)
• St Christopher and Nevis
• St Lucia
• St Vincent
• Senegal (with French)
• Seychelles (with French)
• Sierra Leone
• Singapore (with Malay, Mandarin and Tamil)
• South Africa (with Afrikaans, Xhosa and Zulu)
• Surinam (with Dutch)
• Swaziland (with Swazi)
• Tanzania (with Swahili)
• Tonga (with Tongan)
• Trinidad and Tobago
• Tuvalu
• Uganda
• United Kingdom and its dependences
• United States of America and its dependencies
• Vanatu (with French)
• Western Samoa (with Samoan)
• Zambia
• Zimbabwe

This compares to 27 for French, 20 for Spanish and 17 for Arabic. This domination is unique in history. Speakers of languages like French, Spanish and Arabic may disagree, but English is on its way to becoming the world’s unofficial international language. Mandarin (Chinese) is spoken by more people, but English is now the most widespread of the world’s languages.

Half of all business deals are conducted in English. Two thirds of all scientific papers are written in English. Over 70% of all post / mail is written and addressed in English. Most international tourism, aviation and diplomacy is conducted in English.

 

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The history of the language can be traced back to the arrival of three Germanic tribes to the British Isles during the 5th Century AD. Angles, Saxons and Jutes crossed the North Sea from what is the present day Denmark and northern Germany. The inhabitants of Britain previously spoke a Celtic language. This was quickly displaced. Most of the Celtic speakers were pushed into Wales, Cornwall and Scotland. One group migrated to the Brittany Coast of France where their descendants still speak the Celtic Language of Breton today. The Angles were named from Engle, their land of origin. Their language was called Englisc from which the word, English derives.

An Anglo-Saxon inscription dated between 450 and 480AD is the oldest sample of the English language.

During the next few centuries four dialects of English developed:

• Northumbrian in Northumbria, north of the Humber
• Mercian in the Kingdom of Mercia
• West Saxon in the Kingdom of Wessex
• Kentish in Kent

During the 7th and 8th Centuries, Northumbria’s culture and language dominated Britain. The Viking invasions of the 9th Century brought this domination to an end (along with the destruction of Mercia). Only Wessex remained as an independent kingdom. By the 10th Century, the West Saxon dialect became the official language of Britain. Written Old English is mainly known from this period. It was written in an alphabet called Runic, derived from the Scandinavian languages. The Latin Alphabet was brought over from Ireland by Christian missionaries. This has remained the writing system of English.

At this time, the vocabulary of Old English consisted of an Anglo Saxon base with borrowed words from the Scandinavian languages (Danish and Norse) and Latin. Latin gave English words like street, kitchen, kettle, cup, cheese, wine, angel, bishop, martyr, candle. The Vikings added many Norse words: sky, egg, cake, skin, leg, window (wind eye), husband, fellow, skill, anger, flat, odd, ugly, get, give, take, raise, call, die, they, their, them. Celtic words also survived mainly in place and river names (Devon, Dover, Kent, Trent, Severn, Avon, Thames).

Many pairs of English and Norse words coexisted giving us two words with the same or slightly differing meanings. Examples below.

 

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Norse	English
anger	wrath
nay	no
fro	from
raise	rear
ill	sick
bask	bathe
skill	craft
skin	hide
dike	ditch
skirt	shirt
scatter	shatter
skip	shift

 

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In 1066 the Normans conquered Britain. French became the language of the Norman aristocracy and added more vocabulary to English. More pairs of similar words arose.

 

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French	English
close	shut
reply	answer
odour	smell
annual	yearly
demand	ask
chamber	room
desire	wish
power	might
ire	wrath / anger

 

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Because the English underclass cooked for the Norman upper class, the words for most domestic animals are English (ox, cow, calf, sheep, swine, deer) while the words for the meats derived from them are French (beef, veal, mutton, pork, bacon, venison).

The Germanic form of plurals (house, housen; shoe, shoen) was eventually displaced by the French method of making plurals: adding an s (house, houses; shoe, shoes). Only a few words have retained their Germanic plurals: men, oxen, feet, teeth, children.

French also affected spelling so that the cw sound came to be written as qu (eg. cween became queen).

It wasn’t till the 14th Century that English became dominant in Britain again. In 1399, King Henry IV became the first king of England since the Norman Conquest whose mother tongue was English. By the end of the 14th Century, the dialect of London had emerged as the standard dialect of what we now call Middle English. Chaucer wrote in this language.

Modern English began around the 16th Century and, like all languages, is still changing. One change occurred when the th of some verb forms became s (loveth, loves: hath, has). auxiliary verbs also changed (he is risen, he has risen).

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The historical influence of language in the British Isles can best be seen in place names and their derivations.

Examples include ac (as in Acton, Oakwood) which is Anglo-Saxon for oak; by (as in Whitby) is Old Norse for farm or village; pwll (as in Liverpool) is Welsh for anchorage; baile (as in Balmoral) is Gaelic for farm or village; ceaster (as in Lancaster) is Latin for fort.

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Since the 16th Century, because of the contact that the British had with many peoples from around the world, and the Renaissance of Classical learning, many words have entered the language either directly or indirectly. New words were created at an increasing rate. Shakespeare coined over 1600 words. This process has grown exponentially in the modern era.

Borrowed words include names of animals (giraffe, tiger, zebra), clothing (pyjama, turban, shawl), food (spinach, chocolate, orange), scientific and mathematical terms (algebra, geography, species), drinks (tea, coffee, cider), religious terms (Jesus, Islam, nirvana), sports (checkmate, golf, billiards), vehicles (chariot, car, coach), music and art (piano, theatre, easel), weapons (pistol, trigger, rifle), political and military terms (commando, admiral, parliament), and astronomical names (Saturn, Leo, Uranus).

Languages that have contributed words to English include Latin, Greek, French, German, Arabic, Hindi (from India), Italian, Malay, Dutch, Farsi (from Iran and Afghanistan), Nahuatl (the Aztec language), Sanskrit (from ancient India), Portuguese, Spanish, Tupi (from South America) and Ewe (from Africa).

The list of borrowed words is enormous.

The vocabulary of English is the largest of any language.

Even with all these borrowings the heart of the language remains the Anglo-Saxon of Old English. Only about 5000 or so words from this period have remained unchanged but they include the basic building blocks of the language: household words, parts of the body, common animals, natural elements, most pronouns, prepositions, conjunctions and auxiliary verbs. Grafted onto this basic stock was a wealth of contributions to produce, what many people believe, is the richest of the world’s languages.

Source : http://www.krysstal.com/english.html

Lessons of Life

Lessons of life  

By: Elle Est Belle <pearl.east15@ yahoo.com>

I feared being alone

Until I learned to like Myself.
 
************ ***
I feared failure

Until I realized that I only Fail when I don’t try.
 
************ ***

I feared success

Until I realized That I had to try In order to be happy With myself.
 
************ ***

I feared people’s opinions

Until I learned that People would have opinions About me anyway.
 
************ ***

I feared rejection

Until I learned to Have faith in myself.
 
************ ***

I feared pain

Until I learned that it’s necessary For growth.
 
************ ***

I feared the truth

Until I saw the Ugliness in lies.
 
************ ***

I feared life

Until I experienced Its beauty .
 
************ ***

I feared death

Until I realized that it’s Not an end, but a beginning.

************ ***

I feared my destiny,

Until I realized that I had the power to change My life.
 
************ ***

I feared hate

Until I saw that it Was nothing more than Ignorance.

************ ***

I feared love

Until it touched my heart, Making the darkness fade Into endless sunny days.
 
************ ***

I feared ridicule

Until I learned how To laugh at myself.
 
************ ***

I feared growing old

Until I realized that I gained wisdom every day.

************ ***

I feared the future

Until I realized that Life just kept getting Better.

************ ***

I feared the past

Until I realized that It could no longer hurt me.

************ ***

I feared the dark

Until I saw the beauty Of the starlight.

************ ***

I feared the light

Until I learned that the Truth would give me Strength.

************ ***
I feared change,
Until I saw that Even the most beautiful butterfly Had to undergo a metamorphos is Before it could fly.

Why do we need AIDS education in schools?

Many young people lack basic information about HIV and AIDS, and are unaware of the ways in which HIV infection can occur, and of the ways in which HIV infection can be prevented. Schools are an excellent point of contact for young people – almost all young people attend school for some part of their childhood, and while they are there, they expect to learn new information, and are more receptive to it than they might be in another environment.

Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV.

Other ways in which young people might access AIDS education may not be universal – not all young people will access the same media, for example, or access the same medical services. However, the school is a place where almost all young people can receive the same message. Other media by which young people are presumed to learn about sexual health may not exist in all cases or may be misleading.

Traditionally, the responsibility of teaching a young person about ‘the birds and the bees’ has been seen as being a parental one. In these days of HIV, however, this type of basic information about reproduction is insufficient and will not give young people the information they need to be able to protect themselves. Parents may not provide even this limited information because they are too embarrassed, or because their beliefs oppose it. Young people, too, may be embarrassed discussing sexual matters in a situation where their parents are present. At school they are in a situation where they are independent, and not subject to parental disapproval.

“ If I wouldn’t of learned about all the STD’s that I could get from being sexually active I might not be a virgin right now. ”

- Erika -

In some countries, young people may not be able to access family planning or sexual health clinics because of their age – or they may be able to access such services but think that their age precludes them from access. Young people often know that they require information, especially if they are becoming sexually active, but may feel too embarrassed to actively seek out sexual health information, or may fear that their parents may find out. In many parts of the world, the fear of ‘what if they tell my parents’ still prevents young people from approaching medical staff, especially family doctors who may know their parents.

The principal reason that AIDS education in schools is so important is that all over the world, a huge amount of young people still become infected with HIV. Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV. If they are to be enabled to protect themselves, they must be given the information that empowers them to do so.

Attitudes to AIDS education in schools

The main obstacle to effective AIDS education for young people in schools is the adults who determine the curriculum. These adults – parents, curriculum planners, teachers or legislators – often consider the subject to be too ‘adult’ for young people – they have an idea of ‘protecting the innocence’ of young people. This often occurs for moral or religious reasons, and can cause very heated debate.

There is also obstruction to adequate AIDS education from adults who are concerned that teaching young people about sex, about sexually transmitted infections, HIV and pregnancy – that providing them with this information will somehow encourage young people to begin having sex when they otherwise might not have done.

“ I come from a family who believes that having sex out of marriage is not the moral thing to do. I also don’t think sex ed. is something that young kids should be learning. Learning sex at a young age is like provoking more young people to have sex just for the fact they want to experience it for themselves instead of just getting information about it. ”

- Monica -

This attitude still prevents adequate HIV and sex education from being taught in schools, in spite of the fact that it is a view that the majority do not share. A study in America, for example, shows that the majority of Americans (55%) believes that giving teens information about how to obtain and use condoms will not encourage them to have sexual intercourse earlier than they would have otherwise (39% say it would encourage them)¹ .

The same study tells us that only 7% of Americans believe that young people should not receive sex education in schools. Many adults recognise that informing young people about the dangers of HIV is the best way to prevent them from becoming infected in later life. Many schools in many countries do provide adequate AIDS education – but many, sill, do not. Young people are rarely asked for their opinions by those adults who decide what they will study – but when they are asked, they almost always demand more comprehensive sex and HIV education.

“ I am a student, living in Johannesburg, South Africa. I believe that sex ed that is handled appropriately, and that is age-appropriate, will really empower kids to make healthier, informed and positive choices. ”

- Maire -

In some places, legislation may dictate the type and quality of AIDS education that schools are allowed to offer – some countries have no policies on AIDS education, allowing schools to include it or not, as they decide. Other countries may have policies that specifically preclude AIDS education, or certain types of AIDS education. Legislation allowing or inhibiting certain types of AIDS education often comes from the moral views of the voting majority – or reflects the religious attitudes of the government in power. The most commonly used types of AIDS education are discussed in our page on AIDS education and young people.

It is within the context of these attitudes and beliefs that teachers and educators must work to provide the most effective information and education they are able to.

When should young people start to be taught about AIDS?

There is no set age at which AIDS education should start, and different countries have different regulations and recommendations. In some areas this is a very sensitive subject, and some groups regard teaching young people how to protect themselves as a form of abuse. It seems obvious, however, that people should know how to protect themselves before they begin having sex, rather than after.

“ At school, my sex ed was pretty poor. It started in year 8 when we are about 12-13, which is kind of 2 late really. Quite a few of my friends had already had heterosexual sex and had not protected themselves at all. ”

- Laura -

Especially when educating young people, AIDS education often shares territory with sex education. Education which teaches about sex and sexuality can also teach about preventing pregnancy and STI infection.

“ I know by the time I was taught about sex it was too late, I had already made my mistake. ”

- Safiyyah -

AIDS education should start at about seven or eight years of age. When working with very young people, this type of education does not necessarily need to involve learning about sexual activities or drugs, but should at least teach children that ‘AIDS’ is not a pejorative term of abuse. Playground name-calling, to some extent, reflects attitudes in general society, but it can also grow up to become discrimination.

Planning a good curriculum

In an academic situation, especially with younger learners, some subjects fail to impart information to the students simply because the students are not interested, and do not pay attention. This is unlikely to be the case with AIDS education; the simple fact that AIDS education involves the discussion of sex – a topic of fascination for young people who are discovering their own sexualities – is likely to ensure at least initial attention. This attention will wane, however, if the information is not imparted in a lesson interesting enough to maintain students’ concentration. It is not only important to have AIDS education, but to provide AIDS education in the right way.

In addition to providing information, a good, class-based lesson where a pupil is amongst his/her peers can help to shape attitudes, reduce prejudice, and alter behaviour.

The following are a few of the important points to consider when planning an AIDS education lesson or curriculum.

Age of students

Is the material that you intend to cover appropriate to the age of the young people in the class? Education about HIV needs to commence early in childhood and develop through adolescence and into adulthood – starting before students are of an age at which they might encounter high-risk situations, but at an early age young people do not require detailed information. This information should be delivered gradually, as they grow older.

Classroom prejudices

School playgrounds often contain many prejudices, and you will probably have to deal with more than one in an AIDS-awareness lesson. HIV+ people, especially, face prejudice around the world that can lead to the continued spread of the virus. In some schools, the words ‘gay or ‘AIDS’ may be used as a term of abuse – this must be addressed, too. Certainly, the material covered in class must reflect the diversity of the community. Prejudices often result from ignorance. ‘Can I get it from toilet-seats?’ is a common question illustrating just such ignorance. This type of misunderstanding not only engenders prejudice, it also causes unnecessary anxiety.

Current knowledge

AIDS education can be targeted towards areas of informational need if you are aware of what young people already know about AIDS. The best way to find out this information is by asking them.

Active learning

It is not enough to simply give students information about HIV and AIDS for them to learn. The learning-by-rote approach common in traditional academic settings provides students with information but does not allow them to absorb the social and practical aspects of how this information might be put to use. AIDS education should never involve pupils sitting silently, writing and memorising facts.

Active learning offers an opportunity to make AIDS education lessons fun

‘Active learning’ approaches are now seen as the most effective way that young people can learn health-related and social-skills. Group-work and role-play are particularly important methods in which students might discover the practical aspects of the information they are given. These methods also allow pupils an opportunity to practise and build skills –saying “No” to sex, for example – and pupils retain information better if they are offered an opportunity to apply it.

Active learning, furthermore, offers an opportunity to make AIDS education lessons fun. AIDS education classes can be constructed to involve quizzes, games, or drama, for example – and can still be very effective learning sessions.

Involving parents and guardians

Many schools already have a good deal of input from parents and families of their pupils, and this input may go as far as being allowed to determine the content of the curriculum. If possible, it is usually advantageous to involve the parents and guardians in the planning process, before an AIDS education curriculum is decided – parents who have already agreed the content that their children will study are unlikely to complain about it being unsuitable. Furthermore, parents who are involved in the education of their children will be able to give additional support, if it is needed, outside the classroom.

Other sources

Outside agencies or organisations may also be able to make a positive contribution to an AIDS education curriculum in a way that the school’s internal resources will not. Some local health agencies will offer talks within a school, as will some local HIV organisations. Check out what is available. This has the additional advantage of building a bridge between the pupils and an external source of help or advice.

Legislation

Some areas and countries will have legislation covering what sex or AIDS education can or should be given. If this is the case, you will have to make sure that your curriculum conforms to local guidelines. Other legislative areas in which AIDS may effect your school are :

Bullying

– does your school’s anti-bullying policy adequately protect HIV+ and gay pupils?

Admissions

– does your school’s admissions policy contain measures to prevent discrimination against HIV+ pupils?

Health and Safety

– does your school’s health & safety policy include universal precautions policy?

Considering cultures

Planning an AIDS education syllabus should involve some consideration of the culture in which the learners live. Many cultures have a specific and well-defined set of views on human sexuality, and even at an early age, young learners will have been influenced by them.

The primary factor in determining what information is given to the class should be their age (see above), and cultural attitudes cannot be allowed to censor the information given. Most cultures frown, for example, on talking openly about HIV transmission routes, but this is a necessary part of the education process. AIDS education should provide this information and still remain sensitive, wherever possible, to cultural and religious sensibilities.

The culture of the learners is an ever-present factor in the classroom, and this culture provides the context in which AIDS education must take place.

What materials are already available?

In the years since the AIDS epidemic began, there have been many disparate efforts to prevent or reduce HIV infection by educating people about the dangers of AIDS, and enabling them to protect themselves from infection. A good deal of classroom material has been created, focusing on young people from cultures around the world. Too often, when an AIDS education curriculum is to be planned, the planners spend considerable time constructing a resource that is ultimately unnecessary as there are already materials available that would suffice. If necessary, spend time adapting existing resources for your class, but it should now never be necessary to produce completely new material.

Making it cross-curricular

HIV and AIDS education is often provided that deals only with medical and biological facts, and not with the real-life situations that young people find themselves in AIDS should also not be looked at from an entirely social perspective, either – effective AIDS education needs to take into account the fact that both scientific and social knowledge are vital to providing a pupil with adequate AIDS awareness. There is much more to HIV prevention than simply imparting the basic facts. Knowing how the virus reproduces, for example, won’t help someone to negotiate condom use. AIDS education must be a balance of scientific knowledge and social skills. Only if life skills are taught, and matters such as relationships, sexuality and the risks of drug use discussed, will young people be able to handle situations where they might be at risk of HIV infection. Furthermore, questions or comments about HIV may arise at unexpected moments, and teachers from a wide range of disciplines need to know how to answer them.

Are any students HIV+?

When dealing with any class of young people, you can’t make assumptions about their HIV status. In high-prevalence areas it is especially likely that one or some class-members will be HIV+, but this could be the case anywhere. Universal precautions should be taught as part of a HIV awareness lesson. AIDS education specifically tailored for HIV+ people is an important aspect of HIV prevention, but applies only in a class where every student is HIV+.

Sexuality of students

On average, at least one student in every class will be gay. You can’t make assumptions about the sexuality of the students in your class, or about the sexualities in the families that they come from – and for this reason, your HIV lessons need to include information about and for people of all sexualities.

Making it work in the classroom

The process of educating young people about AIDS can be a challenging one. Even if all the factors mentioned above are considered, a lesson can be unsuccessful if the teacher is inadequately prepared, uncomfortable or uncommitted. Anyone who has experienced the education system is aware that the atmosphere within a lesson is key to students retention of the course information.

Teaching the teachers

Teachers need to be clear on their own feelings and beliefs.

AIDS education necessarily involves some detailed discussion of sexual matters. If teachers are uncomfortable with this, they will convey this discomfort to the class – and the message that ‘sex is not nice to talk about ’ is the precise opposite of what AIDS education aims to convey. Before taking an AIDS education class, teachers need to be clear on their own feelings and beliefs as they relate to sex, death, illness and drug use.

Teachers also need to feel that they are entirely clear on the information that they will be passing on – they need to feel confident that they are able to answer any questions that might be asked. This necessitates an adequate level of teacher-training – something that is sadly lacking in many parts of the world. In India, for example, where estimates suggest that more than 2 million people are living with HIV, 70% of teachers have been given no training or information at all ².

Listening to the learners

Young people who have an input into their AIDS education have said that they want their AIDS education to take place in all academic years of their school, to use active learning methods, to include a balance of facts and social awareness, to be built on what pupils already know – and, crucially, to be a separate topic. Whilst Biology, Geography and English can – and should – mention AIDS in the context of their subject matter, young people specifically ask for syllabus time devoted to providing them with good, well-planned and balanced AIDS education.

It is also important to recognise that the young people who make up the class may be uncomfortable with the subject – for cultural or personal reasons. Learners cannot be compelled to feel comfortable, but can be induced. Some basic tips that can help to decrease discomfort are :

• Don’t expect a learner to speak in front of their classmates – unless they have volunteered to do so.
• Allow learners to consult and plan in groups before presenting any information to the class.
• Remember that some learners may have relevant personal issues that they will be reluctant to share – they may be gay, for example, of HIV+.
• Listen to the learners – allow the class to ask questions and to express what they want from an AIDS syllabus.

Last word

In spite of all the efforts that the past two decades have seen in AIDS prevention, the epidemic still presents a serious challenge to societies around the world. Every year, increasing numbers of people globally are infected with HIV, and people continue to die. AIDS education for young people is a crucial weapon in the HIV-prevention arsenal, young people are one of the main groups who must be targeted, and the school is the most important means of reaching them.

Still, however, schools in many countries around the world do not have adequate AIDS education curriculum. Although it is not a legislative requirement in all countries that AIDS education is provided, it remains a requirement of the global effort against AIDS. Every young person who passes through the school system anywhere in the world should come out knowing how to protect themselves from AIDS. This is not only the responsibility of every adult who is involved – it is the right of young people everywhere.

How do you have sex?

Sexual intercourse is sometimes called making love or having sex. The most common definition of sexual intercourse is an act that involves a man putting his erect penis inside a woman’s vagina. Sexual intercourse might also be used to refer to sex acts between two men or between two women.

Sexual intercourse between a man and a woman starts with them both getting sexually excited. This is sometimes referred to as foreplay, and might involve kissing and cuddling, touching each other and other sexual activities. Foreplay is important as it means a woman’s vagina begins to get moist and a man gets an erection. If the woman’s vagina does not get moist enough, then having sexual intercourse could be difficult or painful for her.

If a man and woman are having sexual intercourse, then using a contraceptive properly, every time, will prevent the woman becoming pregnant. There is more information on the contraceptive page.

If two people have sexual intercourse and one of them has a sexually transmitted disease (STD) then they could pass it on to the other person. Using a condom is the best way to prevent any infection from being passed from one person to the other.

If a couple are going to use a condom for protection against pregnancy or infections, they should put it on the man’s penis as soon as he gets an erection. Some men say they worry about using condoms in case they lose their erection or have difficulty putting the condom on. You could get some condoms and practice beforehand. Condoms come with instructions in words and pictures which show exactly how to use them.

After the condom is on, the man or woman can guide his penis into her vagina. The couple then move their bodies so that his penis moves up and down inside her vagina. This usually rubs the penis and makes the man sexually excited so that he has an orgasm. The movement might also rub the woman’s clitoris (or sensitive areas inside her vagina) so she can have an orgasm. But this depends on the position the couple are in when they have sexual intercourse.

Introduction to HIV types, groups and subtypes

Introduction to HIV types, groups and subtypes

HIV is a highly variable virus which mutates very readily. This means there are many different strains of HIV, even within the body of a single infected person.

Based on genetic similarities, the numerous virus strains may be classified into types, groups and subtypes.

What is the difference between HIV-1 and HIV-2?

There are two types of HIV: HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood, and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2.

Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.

How many subtypes of HIV-1 are there?

The strains of HIV-1 can be classified into three groups: the “major” group M, the “outlier” group O and the “new” group N. These three groups may represent three separate introductions of simian immunodeficiency virus into humans.

Group O appears to be restricted to west-central Africa and group N – discovered in 1998 in Cameroon – is extremely rare. More than 90% of HIV-1 infections belong to HIV-1 group M and, unless specified, the rest of this page will relate to HIV-1 group M only.

Within group M there are known to be at least nine genetically distinct subtypes (or clades) of HIV-1. These are subtypes A, B, C, D, F, G, H, J and K.

Occasionally, two viruses of different subtypes can meet in the cell of an infected person and mix together their genetic material to create a new hybrid virus (a process similar to sexual reproduction, and sometimes called “viral sex”).¹ Many of these new strains do not survive for long, but those that infect more than one person are known as “circulating recombinant forms” or CRFs. For example, the CRF A/B is a mixture of subtypes A and B.

The classification of HIV strains into subtypes and CRFs is a complex issue and the definitions are subject to change as new discoveries are made. Some scientists talk about subtypes A1, A2, A3, F1 and F2 instead of A and F, though others regard the former as sub-subtypes.

What about subtypes E and I?

One of the CRFs is called A/E because it is thought to have resulted from hybridization between subtype A and some other “parent” subtype E. However, no one has ever found a pure form of subtype E. Confusingly, many people still refer to the CRF A/E as “subtype E” (in fact it is most correctly called CRF01_AE).²

A virus isolated in Cyprus was originally placed in a new subtype I, before being reclassified as a recombinant form A/G/I. It is now thought that this virus represents an even more complex CRF comprised of subtypes A, G, H, K and unclassified regions. The designation “I” is no longer used.³

Where are the different subtypes and CRFs found?

The HIV-1 subtypes and CRFs are very unevenly distributed throughout the world, with the most widespread being subtypes A and C.

Subtype A and CRF A/G predominate in West and Central Africa, with subtype A possibly also causing much of the Russian epidemic.⁴

Historically, subtype B has been the most common subtype/CRF in Europe, the Americas, Japan and Australia. Although this remains the case, other subtypes are becoming more frequent and now account for at least 25% of new infections in Europe.

Subtype C is predominant in Southern and East Africa, India and Nepal. It has caused the world’s worst HIV epidemics and is responsible for around half of all infections.

Subtype D is generally limited to East and Central Africa. CRF A/E is prevalent in South-East Asia, but originated in Central Africa. Subtype F has been found in Central Africa, South America and Eastern Europe. Subtype G and CRF A/G have been observed in West and East Africa and Central Europe.

Subtype H has only been found in Central Africa; J only in Central America; and K only in the Democratic Republic of Congo and Cameroon.

Are more subtypes likely to “appear”?

It is almost certain that new HIV genetic subtypes and CRFs will be discovered in the future, and indeed that new ones will develop as virus recombination and mutation continue to occur. The current subtypes and CRFs will also continue to spread to new areas as the global epidemic continues.

The implications of variability

Does subtype affect disease progression?

A study presented in 2006 found that Ugandans infected with subtype D or recombinant strains incorporating subtype D developed AIDS sooner than those infected with subtype A, and also died sooner, if they did not receive antiretroviral treatment. The study’s authors suggested that subtype D is more virulent because it is more effective at binding to immune cells.⁵ This result was supported by another study presented in 2007, which found that Kenyan women infected with subtype D had more than twice the risk of death over six years compared with those infected with subtype A.⁶ An earlier study of sex workers in Senegal, published in 1999, found that women infected with subtype C, D or G were more likely to develop AIDS within five years of infection than those infected with subtype A.⁷

Several studies conducted in Thailand suggest that people infected with CRF A/E progress faster to AIDS and death than those infected with subtype B, if they do not receive antiretroviral treatment.⁸

Are there differences in transmission?

It has been observed that certain subtypes/CRFs are predominantly associated with specific modes of transmission. In particular, subtype B is spread mostly by homosexual contact and intravenous drug use (essentially via blood), while subtype C and CRF A/E tend to fuel heterosexual epidemics (via a mucosal route).

Whether there are biological causes for the observed differences in transmission routes remains the subject of debate. Some scientists, such as Dr Max Essex of Harvard, believe such causes do exist. Among their claims are that subtype C and CRF A/E are transmitted much more efficiently during heterosexual sex than subtype B.^{9 10} However, this theory has not been conclusively proven.^{11 12}

More recent studies have looked for variation between subtypes in rates of mother-to-child transmission. One of these found that such transmission is more common with subtype D than subtype A.¹³ Another reached the opposite conclusion (A worse than D), and also found that subtype C was more often transmitted that subtype D.¹⁴ A third study concluded that subtype C is more transmissible than either D or A.¹⁵ Other researchers have found no association between subtype and rates of mother-to-child transmission.^{16 17 18 19}

Is it possible to be infected more than once?

Until about 1994, it was generally thought that individuals do not become infected with multiple distinct HIV-1 strains. Since then, many cases of people coinfected with two or more strains have been documented.

All cases of coinfection were once assumed to be the result of people being exposed to the different strains more or less simultaneously, before their immune systems had had a chance to react. However, it is now thought that “superinfection” is also occurring. In these cases, the second infection occurred several months after the first. It would appear that the body’s immune response to the first virus is sometimes not enough to prevent infection with a second strain, especially with a virus belonging to a different subtype. It is not yet known how commonly superinfection occurs, or whether it can take place only in special circumstances.^{20 21}

Do HIV antibody tests detect all types, groups and subtypes?

Initial tests for HIV are usually conducted using the EIA (or ELISA) antibody test or a rapid antibody test.

EIA tests which can detect either one or both types of HIV have been available for a number of years. According to the US Centers for Disease Control and Prevention, current HIV-1 EIAs “can accurately identify infections with nearly all non-B subtypes and many infections with group O HIV subtypes.”²² However, because HIV-2 and group O infections are extremely rare in most countries, routine screening programs might not be designed to test for them. Anyone who believes they may have contracted HIV-2, HIV-1 group O or one of the rarer subtypes of group M should seek expert advice.

Rapid tests – which can produce a result in less than an hour – are becoming increasingly popular. Most modern rapid HIV-1 tests are capable of detecting all the major subtypes of group M.²³ Rapid tests which can detect HIV-2 are also now available.²⁴

What are the treatment implications?

Most current HIV-1 antiretroviral drug regimens were designed for use against subtype B, and so hypothetically might not be equally effective in Africa or Asia where other strains are more common. At present, there is no compelling evidence that subtypes differ in their sensitivity to antiretroviral drugs. However, some subtypes may occasionally be more likely to develop resistance to certain drugs. In some situations, the types of mutations associated with resistance may vary. This is an important subject for future research.

The effectiveness of HIV-1 treatment is monitored using viral load tests. It has been demonstrated that some such tests are sensitive only to subtype B and can produce a significant underestimate of viral load if used to process other strains. The latest tests do claim to produce accurate results for most Group M subtypes, though not necessarily for Group O. It is important that health workers and patients are aware of the subtype/CRF they are testing for and of the limitations of the test they are applying.

Not all of the drugs used to treat HIV-1 infection are as effective against HIV-2. In particular, HIV-2 has a natural resistance to NNRTI antiretroviral drugs and they are therefore not recommended. As yet there is no FDA-licensed viral load test for HIV-2 and those designed for HIV-1 are not reliable for monitoring the other type. Instead, response to treatment may be monitored by following CD4+ T-cell counts and indicators of immune system deterioration. More research and clinical experience is needed to determine the most effective treatment for HIV-2.²⁵

What are the implications for an AIDS vaccine?

The development of an AIDS vaccine is affected by the range of virus subtypes as well as by the wide variety of human populations who need protection and who differ, for example, in their genetic make-up and their routes of exposure to HIV. In particular, the occurrence of superinfection indicates that an immune response triggered by a vaccine to prevent infection by one strain of HIV may not protect against all other strains. The effectiveness of a vaccine is likely to vary in different populations unless some innovative method is developed which guards against many virus strains.

Inevitably, different types of candidate vaccines will have to be tested against various viral strains in multiple vaccine trials, conducted in both high-income and developing countries.

The Origin of AIDS and HIV

The origin of AIDS and HIV has puzzled scientists ever since the illness first came to light in the early 1980s. For over twenty years it has been the subject of fierce debate and the cause of countless arguments, with everything from a promiscuous flight attendant to a suspect vaccine programme being blamed. So what is the truth? Just where did AIDS come from?

The first recognised cases of AIDS occurred in the USA in the early 1980s (more about this period can be found on our history page). A number of gay men in New York and California suddenly began to develop rare opportunistic infections and cancers that seemed stubbornly resistant to any treatment. At this time, AIDS did not yet have a name, but it quickly became obvious that all the men were suffering from a common syndrome.

The discovery of HIV, the Human Immunodeficiency Virus, was made soon after. While some were initially resistant to acknowledge the connection (and indeed some remain so today), there is now clear evidence to prove that HIV causes AIDS. So, in order to find the source of AIDS, it is necessary to look for the origin of HIV, and find out How, When and Where HIV first began to cause disease in humans.

HOW?

What type of virus is HIV?

HIV is a lentivirus, and like all viruses of this type, it attacks the immune system. Lentiviruses are in turn part of a larger group of viruses known as retroviruses. The name ‘lentivirus’ literally means ’slow virus’ because they take such a long time to produce any adverse effects in the body. They have been found in a number of different animals, including cats, sheep, horses and cattle. However, the most interesting lentivirus in terms of the investigation into the origins of HIV is the Simian Immunodeficiency Virus (SIV) that affects monkeys.

So did HIV come from an SIV?

It is now generally accepted that HIV is a descendant of a Simian Immunodeficiency Virus because certain strains of SIVs bear a very close resemblance to HIV-1 and HIV-2, the two types of HIV.

HIV-2 for example corresponds to SIVsm, a strain of the Simian Immunodeficiency Virus found in the sooty mangabey (also known as the White-collared monkey), which is indigenous to western Africa.

The more virulent, pandemic strain of HIV, namely HIV-1, was until recently more difficult to place. Until 1999, the closest counterpart that had been identified was SIVcpz, the SIV found in chimpanzees. However, this virus still had certain significant differences from HIV.

What happened in 1999?

In February 1999 a group of researchers from the University of Alabama¹ announced that they had found a type of SIVcpz that was almost identical to HIV-1. This particular strain was identified in a frozen sample taken from a captive member of the sub-group of chimpanzees known as Pan troglodytes troglodytes (P. t. troglodytes), which were once common in west-central Africa.

The researchers (led by Paul Sharp of Nottingham University and Beatrice Hahn of the University of Alabama) made the discovery during the course of a 10-year long study into the origins of the virus. They claimed that this sample proved that chimpanzees were the source of HIV-1, and that the virus had at some point crossed species from chimps to humans.

Their final findings were published two years later in Nature magazine². In this article, they concluded that wild chimps had been infected simultaneously with two different simian immunodeficiency viruses which had “viral sex” to form a third virus that could be passed on to other chimps and, more significantly, was capable of infecting humans and causing AIDS.

These two different viruses were traced back to a SIV that infected red-capped mangabeys and one found in greater spot-nosed monkeys. They believe that the hybridisation took place inside chimps that had become infected with both strains of SIV after they hunted and killed the two smaller species of monkey.

They also concluded that all three ‘groups’ of HIV-1 – namely Group M, N and O (see our strains and subtypes page for more information on these) – came from the SIV found in P. t. troglodytes, and that each group represented a separate crossover ‘event’ from chimps to humans.

How could HIV have crossed species?

It has been known for a long time that certain viruses can pass between species. Indeed, the very fact that chimpanzees obtained SIV from two other species of primate shows just how easily this crossover can occur. As animals ourselves, we are just as susceptible. When a viral transfer between animals and humans takes place, it is known as zoonosis.

Below are some of the most common theories about how this ‘zoonosis’ took place, and how SIV became HIV in humans:

The ‘Hunter’ Theory

The most commonly accepted theory is that of the ‘hunter’. In this scenario, SIVcpz was transferred to humans as a result of chimps being killed and eaten or their blood getting into cuts or wounds on the hunter. Normally the hunter’s body would have fought off SIV, but on a few occasions it adapted itself within its new human host and become HIV-1. The fact that there were several different early strains of HIV, each with a slightly different genetic make-up (the most common of which was HIV-1 group M), would support this theory: every time it passed from a chimpanzee to a man, it would have developed in a slightly different way within his body, and thus produced a slightly different strain.

An article published in The Lancet in 2004³, also shows how retroviral transfer from primates to hunters is still occurring even today. In a sample of 1099 individuals in Cameroon , they discovered to ten (1%) were infected with SFV (Simian Foamy Virus), an illness which, like SIV, was previously thought only to infect primates. All these infections were believed to have been acquired through the butchering and consumption of monkey and ape meat. Discoveries such as this have led to calls for an outright ban on bushmeat hunting to prevent simian viruses being passed to humans.

The Oral Polio Vaccine (OPV) theory

Could production of the oral polio vaccine

have contributed to the spread of HIV?

Some other rather controversial theories have contended that HIV was transferred iatrogenically (i.e. via medical interventions). One particularly well-publicised idea is that polio vaccines played a role in the transfer.

In his book, The River, the journalist Edward Hooper suggests that HIV can be traced to the testing of an oral polio vaccine called Chat, given to about a million people in the Belgian Congo, Ruanda and Urundi in the late 1950s. To be reproduced, live polio vaccine needs to be cultivated in living tissue, and Hooper’s belief is that Chat was grown in kidney cells taken from local chimps infected with SIVcmz. This, he claims, would have resulted in the contamination of the vaccine with chimp SIV, and a large number of people subsequently becoming infected with HIV-1.

Many people have contested Hooper’s theories and insist that local chimps were not infected with a strain of SIVcmz that is closely linked to HIV. Furthermore, the oral administration of the vaccine would seem insufficient to cause infection in most people (SIV/HIV needs to get directly into the bloodstream to cause infection – the lining of the mouth and throat generally act as good barriers to the virus).⁴

In February 2000 the Wistar Institute in Philadelphia (one of the original manufacturers of the Chat vaccine) announced that it had discovered in its stores a phial of polio vaccine that had been used as part of the program. The vaccine was subsequently analysed and in April 2001 it was announced that no trace had been found of either HIV or chimpanzee SIV.⁵ A second analysis confirmed that only macaque monkey kidney cells, which cannot be infected with SIV or HIV, were used to make Chat.⁶ While this is just one phial of many, it means that the OPV theory remains unproven.

The fact that the OPV theory accounts for just one (group M) of several different groups of HIV also suggests that transferral must have happened in other ways too, as does the fact that HIV seems to have existed in humans before the vaccine trials were ever carried out. More about when HIV came into being can be found below.

The Contaminated Needle Theory

This is an extension of the original ‘hunter’ theory. In the 1950s, the use of disposable plastic syringes became commonplace around the world as a cheap, sterile way to administer medicines. However, to African healthcare professionals working on inoculation and other medical programmes, the huge quantities of syringes needed would have been very costly. It is therefore likely that one single syringe would have been used to inject multiple patients without any sterilisation in between. This would rapidly have transferred any viral particles (within a hunter’s blood for example) from one person to another, creating huge potential for the virus to mutate and replicate in each new individual it entered, even if the SIV within the original person infected had not yet converted to HIV.

The Colonialism Theory

The colonialism or ‘Heart of Darkness’ theory, is one of the more recent theories to have entered into the debate. It is again based on the basic ‘hunter’ premise, but more thoroughly explains how this original infection could have led to an epidemic. It was first proposed in 2000 by Jim Moore, an American specialist in primate behaviour, who published his findings in the journal AIDS Research and Human Retroviruses.⁷

During the late 19th and early 20th century, much of Africa was ruled by colonial forces. In areas such as French Equatorial Africa and the Belgian Congo, colonial rule was particularly harsh and many Africans were forced into labour camps where sanitation was poor, food was scare and physical demands were extreme. These factors alone would have been sufficient to create poor health in anyone, so SIV could easily have infiltrated the labour force and taken advantage of their weakened immune systems to become HIV. A stray and perhaps sick chimpanzee with SIV would have made a welcome extra source of food for the workers.

Moore also believes that many of the labourers would have been inoculated with unsterile needles against diseases such as smallpox (to keep them alive and working), and that many of the camps actively employed prostitutes to keep the workers happy, creating numerous possibilities for onward transmission. A large number of labourers would have died before they even developed the first symptoms of AIDS, and those that did get sick would not have stood out as any different in an already disease-ridden population. Even if they had been identified, all evidence (including medical records) that the camps existed was destroyed to cover up the fact that a staggering 50% of the local population were wiped out there.

One final factor Moore uses to support his theory, is the fact that the labour camps were set up around the time that HIV was first believed to have passed into humans – the early part of the 20th century.

The Conspiracy Theory

Some say that HIV is a ‘conspiracy theory’ or that it is ‘man-made’. A recent survey carried out in the US for example, identified a significant number of African Americans who believe HIV was manufactured as part of a biological warfare programme, designed to wipe out large numbers of black and homosexual people.⁸ Many say this was done under the auspices of the US federal ‘Special Cancer Virus Program’ (SCVP), possibly with the help of the CIA. Linked in to this theory is the belief that the virus was spread (either deliberately or inadvertently) to thousands of people all over the world through the smallpox inoculation programme, or to gay men through Hepatitis B vaccine trials. While none of these theories can be definitively disproved, the evidence given to back them up is usually based upon supposition and speculation, and ignores the clear link between SIV and HIV or the fact that the virus has been identified in people as far back as 1959.

WHEN?

During the last few years it has become possible not only to determine whether HIV is present in a blood or plasma sample, but also to determine the particular subtype of the virus. Studying the subtype of virus of some of the earliest known instances of HIV infection can help to provide clues about the time it first appeared in humans and its subsequent evolution.

Three of the earliest known instances of HIV infection are as follows:

1. A plasma sample taken in 1959 from an adult male living in what is now the Democratic Republic of Congo.⁹
2. HIV found in tissue samples from an American teenager who died in St. Louis in 1969.¹⁰
3. HIV found in tissue samples from a Norwegian sailor who died around 1976.¹¹

A 1998 analysis of the plasma sample from 1959 has suggested that HIV-1 was introduced into humans around the 1940s or the early 1950s; much earlier than previously thought. Other scientists have dated the sample to an even earlier period – perhaps as far back as the end of the 19th century.

In January 2000, the results of a new study presented at the 7th Conference on Retroviruses and Opportunistic Infections, suggested that the first case of HIV-1 infection occurred around 1930 in West Africa . The study was carried out by Dr Bette Korber of the Los Alamos National Laboratory. The estimate of 1930 (which has a 15 year margin of error) was based on a complex computer model of HIV’s evolution. If accurate, it means that HIV was in existence before many scenarios (such as the OPV and conspiracy theories) suggest.

What about HIV-2? When did that get passed to humans?

Until recently, the origins of the HIV-2 virus had remained relatively unexplored. HIV-2 is thought to come from the SIV in Sooty Mangabeys rather than chimpanzees, but the crossover to humans is believed to have happened in a similar way (i.e. through the butchering and consumption of monkey meat). It is far rarer, significantly less infectious and progresses more slowly to AIDS than HIV-1. As a result, it infects far fewer people, and is mainly confined to a few countries in West Africa.

In May 2003, a group of Belgian researchers led by Dr. Anne-Mieke Vandamme, published a report¹² in Proceedings of the National Academy of Science. By analysing samples of the two different subtypes of HIV-2 (A and B) taken from infected individuals and SIV samples taken from sooty mangabeys, Dr Vannedamme concluded that subtype A had passed into humans around 1940 and subtype B in 1945 (plus or minus 16 years or so). Her team of researchers also discovered that the virus had originated in Guinea-Bissau and that its spread was most likely precipitated by the independence war that took place in the country between 1963 and 1974 (Guinea-Bissau is a former Portuguese colony). Her theory was backed up by the fact that the first European cases of HIV-2 were discovered among Portuguese veterans of the war, many of whom had received blood transfusions or unsterile injections following injury, or had possibly had relationships with local women.

WHERE?

The question of exactly where the transfer of HIV to humans took place, and where the ‘epidemic’ officially first developed has always been controversial. Some have suggested that it is dangerous to even try to find out, as AIDS has frequently been blamed on an innocent person or group of individuals in the past. However, scientists remain keen to find the true origin of HIV, as most agree it is important to understand the virus and its epidemiology in order to fight it.

So did it definitely come from Africa?

Given the evidence we have already looked at, it seems highly likely that Africa was indeed the continent where the transfer of HIV to humans first occurred (monkeys from Asia and South America have never been found to have SIVs that could cause HIV in humans). In May 2006, the same group of researchers who first identified the Pan troglodytes troglodytes strain of SIVcpz, announced that they had narrowed down the location of this particular strain to wild chimpanzees found in the forests of Southern Cameroon¹³. By analysing 599 samples of chimp droppings (P. T. troglodytes are a highly endangered and thus protected species that cannot be killed or captured for testing), the researchers were able to obtain 34 specimens that reacted to a standard HIV DNA test, 12 of which gave results that were virtually indistinguishable from the reactions created by human HIV. The researchers therefore concluded that the chimpanzees found in this area were highly likely the origin of both the pandemic Group M of HIV-1 and of the far rarer Group N. The exact origins of Group O however remain unknown.

HIV Group N principally affects people living in South-central Cameroon, so it is not difficult to see how this outbreak started. Group M, the group that has caused the worldwide pandemic, was however first identified in Kinshasa, in the Democratic Republic of Congo. It is not entirely clear how it transferred from Cameroon to Kinshasa, but the most likely explanation is that an infected individual travelled south down the Sangha river that runs through Southern Cameroon to the River Congo and then on to Kinshasa, where the Group M epidemic probably began.

Just as we do not know exactly who spread the virus from Cameroon to Kinshasa, how the virus spread from Africa to America is also not entirely clear. However, recent evidence suggests that the virus may have arrived via the Caribbean island of Haiti.

Why is Haiti significant?

The AIDS epidemic in Haiti first came to light in the early 1980s, at around the same time that cases in the USA were being uncovered. Following the discovery of a number of Haitians with Kaposi’s Sarcoma and other AIDS-related conditions, medical journals and books began to claim that AIDS had come from Haiti, and that Haitians were responsible for the AIDS epidemic in the United States.

These claims, which were often founded on dubious evidence, fuelled pre-existing racism in the US and many Haitians suffered severe discrimination and stigmatisation as a result. A large number of Haitian immigrants living in the US lost their jobs and were evicted from their homes as Haitians were added to homosexuals, haemophiliacs and heroin users to make the ‘Four-H Club’ of groups at high risk of AIDS.¹⁴

The emotionally-charged culture of blame and prejudice that surrounded HIV and AIDS in the early years meant that it soon became politically difficult to present epidemiological findings in a neutral and objective way. For many years the link between Haiti and the US epidemic was therefore dropped as a subject.

In March 2007 however, it returned to the public eye at the Fourteenth Conference on Retroviruses and Opportunistic Infections (CROI) in Los Angeles. A group of international scientists presented data based on complex genetic analysis of 122 early samples of HIV-1, group M, subtype B (the most common strain found in the USA and in Haiti) showing that the strain had probably been brought to Haiti from Africa by a single person in around 1966; a time when many Haitians would have been returning from working in the Congo.¹⁵

Genetic analysis then showed that subtype B spread slowly from person to person on the island, before being transferred to the US, again probably by a single individual, at some point between 1969 and 1972. A paper published in October 2007 by Worobey and colleagues gave a 99.7% certainty that HIV subtype B originated in Haiti before passing to the US.¹⁶

It is possible that HIV had entered the US several times before subtype B took a firm hold (which would explain the infection of the St. Louis teenager in the early to mid-1960s), but it was the late 1960s / early 1970s transfer that is believed to be responsible for the widespread epidemic seen in the US today. Once the virus had established itself in the gay community, in would have spread fairly rapidly (anal intercourse carries a very high transmission risk), with transmission occurring within and between the US and Haiti, and internationally, until the original route taken by the virus was largely obscured.

Dr Michael Worobey, lead researcher in the study, claimed that his data was not intended to place any blame on Haiti, or on Central Africans, and stressed that none of the people who first transmitted HIV would have been aware they were infected. His work still received strong protests from one Haitian delegate at the CROI conference however, demonstrating the extent to which tracing HIV’s origins remains a politically sensitive exercise.

What caused the epidemic to spread so suddenly?

There are a number of factors that may have contributed to the sudden spread of HIV, most of which occurred in the latter half of the twentieth century.

Travel

International travel has undoubtedly played

a major role in the spread of HIV.

Both national and international travel undoubtedly had a major role in the initial spread of HIV. In the US, international travel by young men making the most of the gay sexual revolution of the late 70s and early 80s would certainly have played a large part in taking the virus worldwide. In Africa, the virus would probably have been spread along truck routes and between towns and cities within the continent itself. However, it is quite conceivable that some of the early outbreaks in African nations were not started by Africans infected with the ‘original’ virus at all, but by people visiting from overseas where the epidemic had been growing too. The process of transmission in a global pandemic is simply too complex to blame on any one group or individual.

Much was made in the early years of the epidemic of a so-called ‘Patient Zero’ who was the basis of a complex “transmission scenario” compiled by Dr. William Darrow and colleagues at the Centre for Disease Control in the US. This epidemiological study showed how ‘Patient O’ (mistakenly identified in the press as ‘Patient Zero’) had given HIV to multiple partners, who then in turn transmitted it to others and rapidly spread the virus to locations all over the world. A journalist, Randy Shilts, subsequently wrote an book¹⁷ based on Darrow’s findings, which named Patient Zero as a gay Canadian flight attendant called Gaetan Dugas. For several years, Dugas was vilified as a ‘mass spreader’ of HIV and the original source of the HIV epidemic among gay men. However, four years after the publication of Shilts’ article, Dr. Darrow repudiated his study, admitting its methods were flawed and that Shilts’ had misrepresented its conclusions.

While Gaetan Dugas was a real person who did eventually die of AIDS, the Patient Zero story was not much more than myth and scaremongering. HIV in the US was to a large degree initially spread by gay men, but this occurred on a huge scale over many years, probably a long time before Dugas even began to travel.

The Blood Industry

As blood transfusions became a routine part of medical practice, an industry to meet this increased demand for blood began to develop rapidly. In some countries such as the USA , donors were paid to give blood, a policy that often attracted those most desperate for cash; among them intravenous drug users. In the early stages of the epidemic, doctors were unaware of how easily HIV could be spread and blood donations remained unscreened. This blood was then sent worldwide, and unfortunately most people who received infected donations went on to become HIV positive themselves.

In the late 1960’s haemophiliacs also began to benefit from the blood clotting properties of a product called Factor VIII. However, to produce this coagulant, blood from hundreds of individual donors had to be pooled. This meant that a single donation of HIV+ blood could contaminate a huge batch of Factor VIII. This put thousands of haemophiliacs all over the world at risk of HIV, and many subsequently became infected with the virus.

Drug Use

The 1970s saw an increase in the availability of heroin following the Vietnam War and other conflicts in the Middle East , which helped stimulate a growth in intravenous drug use. This increased availability and together with the development of disposable plastic syringes and the establishment of ’shooting galleries’ where people could buy drugs and rent equipment, provided another route through which the virus could be passed on.

CONCLUSIONS

It is likely that we will never know who the first person was to be infected with HIV, or exactly how it spread from that initial person. Scientists investigating the possibilities often become very attached to their individual ‘pet’ theories and insist that theirs is the only true answer, but the spread of AIDS could quite conceivably have been induced by a combination of many different events. Whether through injections, travel, wars, colonial practices or genetic engineering, the realities of the 20th Century have undoubtedly had a major role to play. Nevertheless, perhaps a more pressing concern for scientists today should not be how the AIDS epidemic originated, but how those it affects can be treated, how the further the spread of HIV can be prevented and how the world can change to ensure a similar pandemic never occurs again.

For more information, you can visit this site: http://www.avert.org/origins.htm

Original page written by Annabel Kanabus & Sarah Allen. Updated by Bonita de Boer

Englisch-hilfen.de

For those who likes to learn English online, here is one of the English Learning Online websites, Englisch-hilfen.de. From its name, I think you can guess which country it is from. Yes, it’s a Germany websites.

You can find the most frequently used materials about English language in this site. Although it’s not too complete, but I think it’s getting better day after day, I see that they keep updating the materials in the site. So, if you are interested to learn English Online, then this is one of the site to visit.

You can see the link to this site on the LINKS menu.

I’ll add the other link soon.

Simple Present (Present Tense)

Present Tense or some call it “Simple Present” is used to describe:

1. Habitual or repeated actions. For example: I usually go to the office at 7 o’clock every morning.

2. General truth or things in general or facts. For example: The sun rises in the East.

3. Fixed arragements or scheduled events. This use is to describe future. (Present Tense/Simple Present is one of the future tenses – tenses which can be used to describe future actions/events). For example: The train leaves for Jakarta every Friday.

The forms: (+) Subject + Infinitive (we add -s/-es to the infinitive verb if the subject is he, she or it)

                  (-) Subject + do/does + not + Infinitive (do -> I, you, we, they  — does -> he, she, it)

                  (?) Do/does + Subject + Infinitive ?

do + not = don’t   — does + not = doesn’t

I + am = I’m — She + is = She’s — You + are = You’re

is + not = isn’t — are + not = aren’t — am + not = cannot be contracted (it stays the same)

To be in “Simple Present” : –> is, am, are

Note : we use “to be” in a sentence if the sentence doesn’t have a “verb“. For example : She is at home. There’s no “verb” in this sentence, that’s why we have to use “to be” instead.

Signals : Every ….. (every day, every week, every Monday, etc), often, always, sometimes, never.

Simple present, third person singular

Note:

1. he, she, it: in the third person singular the verb always ends in -s:
   he wants, she needs, he gives, she thinks.

2. Negative and question forms use DOES (=the third person of the auxiliary’DO’) + the infinitive of the verb.
   He wants. Does he want? He does not want.

3. Verbs ending in -y : the third person changes the -y to -ies:
   fly flies, cry cries
   
   Exception: if there is a vowel before the -y:
   play plays, pray prays

4. Add -es to verbs ending in:-ss, -x, -sh, -ch:
   he passes, she catches, he fixes, it pushes

See also Verbs -’Regular verbs in the simple present’, and ‘Be, do & have’

Examples:

1. Third person singular with s or -es

a. He goes to school every morning.
b. She understands English.
c. It mixes the sand and the water.
d. He tries very hard.
e. She enjoys playing the piano.

2. Simple present, form

Example: to think, present simple

Affirmative	Interrogative	Negative
I think	Do I think ?	I do not think.
You think	Do you think?	You don’t think.
he, she, it thinks	Does he, she, it think?	He, she, it doesn’t think.
we think	Do we think?	We don’t think.
you think	Do you think?	You don’t think.

The simple present is used:

1. to express habits, general truths, repeated actions or unchanging situations, emotions and wishes:
   I smoke (habit); I work in London (unchanging situation); London is a large city (general truth)

2. to give instructions or directions:
   You walk for two hundred metres, then you turn left.

3. to express fixed arrangements, present or future:
   Your exam starts at 09.00

4. to express future time, after some conjunctions: after, when, before, as soon as, until:
   He’ll give it to you when you come next Saturday.

BE CAREFUL! The simple present is not used to express actions happening now. See Present Continuous.

Examples:

1. For habits
   He drinks tea at breakfast.
   She only eats fish.
   They watch television regularly.
2. For repeated actions or events
   We catch the bus every morning.
   It rains every afternoon in the hot season.
   They drive to Monaco every summer.
3. For general truths
   Water freezes at zero degrees.
   The Earth revolves around the Sun.
   Her mother is Peruvian.
4. For instructions or directions
   Open the packet and pour the contents into hot water.
   You take the No.6 bus to Watney and then the No.10 to Bedford.
5. For fixed arrangements
   His mother arrives tomorrow.
   Our holiday starts on the 26th March
6. With future constructions
   She’ll see you before she leaves.
   We’ll give it to her when she arrives

SIMPLE PRESENT FOR FUTURE EVENTS

1. Form - see Simple Present section.
2. Simple present for future events – function

The simple present is used to make statements about events at a time later than now, when the statements are based on present facts, and when these facts are something fixed like a time-table, schedule, calendar.

Examples:

a. The plane arrives at 18.00 tomorrow.
b. She has a yoga class tomorrow morning.
c. The restaurant opens at 19.30 tonight.
d. Next Thursday at 14.00 there is an English exam.

Note the difference between:

a. The plane leaves in ten minutes (= statement of fact)
b. The plane’s going to leave in ten minutes (= prediction based on present situation, meaning “…and if you don’t hurry up you’re going to miss it!”)

Source : englisch-hilfen.de and English4Today