3. AIDS
Acquired immunodeficiency syndrome (AIDS) is a disease of
the human immune system caused by the human
immunodeficiency virus (HIV).
AIDS is now a pandemic. In 2007, it was estimated that
33.2 million people lived with the disease worldwide, and that
AIDS killed an estimated 2.1 million people, including 330,000
children.
Today, there are an estimated 33.4 million people living with HIV
and AIDS and each year around two million people die from
AIDS related illnesses.
4. HISTORY OF AIDS
The first recorded sample of HIV was discovered in 1959 in a blood
specimen obtained at Leopoldville (now Kinshasa) in the Belgian
Congo.
The HIV is thought to have originally affected chimpanzees.
All the early AIDS cases originated in the Central African states of
Congo, Rwanda or Burundi.
Monkeys harbor SIV or Simian Immunodeficiency Virus(SV-40 to be
more specific), is thought to be the ancestor of HIV.
The first cases of AIDS were reported in the United States in March
1981, when eight men in New York were diagnosed with a rare form of
Kaposi's sarcoma (a relatively benign cancer that usually occurs in
older people) and numerous cases of a rare lung infection called
pneumocystis carinii pneumonia (PCP) started popping up in New York
and California among homosexual men.
5. HIV Virus
• HIV is a retrovirus that attacks the immune system's
protective CD4 cells. When the immune system loses
too many CD4 cells, a person is less able to fight off
infection and can develop serious opportunistic
infections (OIs).
• A person is diagnosed with AIDS when there are less
than 200 CD4 cells and/or has one of 21 AIDS-defining
OIs.
6. Types of HIV
HIV has two major categories : HIV-1 and HIV-2.
HIV-1, currently has about 10 subtypes, is most
common worldwide and the only form found in the US.
HIV-2 is less virulent and though currently confined to
West Africa, it‟s spreading.
7. The different stages of HIV infection
HIV infection can generally be broken down into four distinct
stages:
1. Primary infection
2. Clinically asymptomatic stage
3. Symptomatic HIV infection
4. Progression from HIV to AIDS
8. Are HIV and AIDS the same thing?
HIV and AIDS is not the same thing. When the immune
system is weak because of HIV, a person becomes
susceptible to a number of severe illnesses, also known
as opportunistic infections. When this happens, along
with at least one of 26 other defining conditions, a
person is considered to have progressed to AIDS. It is
from these opportunistic infections, not the AIDS
diagnosis that people die. It is also important to note
that not all people with HIV will develop AIDS.
9.
10. Symptoms
The symptoms of HIV usually vary according to the
stage of the infection the patient is currently in.
The early symptoms resemble flu symptoms and
include fever, muscle aches, rash, swollen lymph nodes
and glands.
Symptoms of HIV in later stages, just before it
progresses to AIDS, involve the following:
• Easy bruising
• Fever
• Night sweats
• Chronic yeast infections
• Thrush or yeast infection of the mouth
• Fatigue and extreme exhaustion
• Unexplained weight loss
11.
12.
13. Susceptibility to Cancer
HIV – positive persons are susceptible to several types of
cancer, particularly Kaposi‟s Sarcoma (KS), an uncommon
form that occurs under the skin and in the mucous membranes
of the eyes, nose and mouth. Affected persons have lesions
that appear as dark – colored raised blotches. Though the
lesions are painless, once KS spreads to the lungs, lymph
nodes and digestive tract, the victim experiences difficulty in
breathing, gastrointestinal bleeding and painful swelling
around the lymph nodes, especially in the legs.
14.
15. HIV Test
– HIV tests are usually performed on venous blood. Many
laboratories use fourth generation screening tests which
detect anti-HIV antibody (IgG and IgM) and the HIV p24
antigen. The detection of HIV antibody or antigen in a
patient previously known to be negative is evidence of HIV
infection. Individuals whose first specimen indicates
evidence of HIV infection will have a repeat test on a
second blood sample to confirm the results.
– Routinely used HIV tests for infection in neonates and
infants (i.e., patients younger than 2 years), born to HIV-
positive mothers, have no value because of the presence
of maternal antibody to HIV in the child's blood. HIV
infection can only be diagnosed by PCR, testing for HIV
pro-viral DNA in the children's lymphocytes.
– HIV tests include :
• ELISA test
• SPOT test
• WESTERN BLOT (WB) test
• CD4 and Viral Load testing
16. How is HIV/AIDS transmitted?
1. Sexual transmission
– Heterosexual
– Homosexual
2. Blood and blood products
– IV drug use
– Transfusions
– Haemophilia
– Other (knives)
3. Vertical transmission
– During pregnancy
– During birth
– Breastfeeding
17.
18. Sexual transmission
– Sexual transmission occurs with the contact between
sexual secretions of one person with the
rectal, genital or oral mucous membranes of another.
The risk for transmitting HIV through unprotected anal
intercourse is greater than the risk from vaginal
intercourse or oral sex.
19. Exposure to blood-borne
–
pathogens
This transmission route is particularly relevant to
intravenous drug users, hemophiliacs and recipients
of blood transfusions and blood products. Sharing
and reusing syringes contaminated with HIV-infected
blood represents a major risk for infection with HIV.
– This route can also affect people who give and
receive tattoos and piercings.
– According to the WHO, the overwhelming majority of
the world's population does not have access to safe
blood and between 5% and 10% of the world's HIV
infections come from transfusion of infected blood
and blood products.
20. Perinatal transmission
– The transmission of the virus from the mother to the
child can occur in utero during the last weeks of
pregnancy and at childbirth. In the absence of
treatment, the transmission rate between a mother
and her child during pregnancy, labor and delivery is
25%.
– However, when the mother takes antiretroviral therapy
and gives birth by caesarean section, the rate of
transmission is just 1%.
– Breastfeeding also increases the risk of transmission
by about 4 %.
21. Injecting drugs
– Sharing injecting equipment is a very efficient way to
transmit blood-borne viruses such as HIV and
Hepatitis C. Sharing needles and “works”
(syringes, spoons, filters and blood-contaminated
water) is thought to be three times more likely to
transmit HIV than sexual intercourse.
22. Most common misconceptions regarding HIV/AIDS are:
• Sexual intercourse with a virgin will cure AIDS
• HIV can infect only homosexual men and drug users
• It is not passed through urine or saliva
• One cannot become infected through casual contact
such as hugging, kissing, sneezing, coughing,
sharing a toilet seat, or simply by living in close
contact with an infected person.
23. PREVENTION
“Library and information services cannot sit on the fence
when their nations’ young people are being decimated by
the enemy from within who strikes silently and in
darkness.”
Kingo J. Mchambu 2002
Reaching out to the most vulnerable
Why focus on prevention?
There is no vaccine for HIV/AIDS. As treatment still remains
unaffordable or inaccessible for many people in the world, for
now, prevention is the best approach to fight the pandemic.
24. ABC APPROACH
The ABC Approach to prevent sexual transmission of HIV
Abstain
Be faithful
Use a Condom
Limits of the ABC-Approach
Lack of resources
Gender inequality
Faithfulness of partners
25. EXPOSURE TO INFECTED BLOOD
Blood supplies
Screening of blood products reduces the risk of transmission
Accidents
Strategy of universal precautions
Injections and syringes
A needle or syringe used for injection should never be shared
with others.
26. PREVENT MOTHER-TO-CHILD-
TRANSMISSION (MTCT)
Preventing HIV infection among
prospective parents
Avoiding unwanted pregnancies
among HIV positive women
Preventing the transmission of
HIV from HIV positive mothers
to their infants during
pregnancy, labor, delivery and
breastfeeding.
27. TREATMENT
Antiretroviral drugs (ARVs)
Highly active antiretroviral therapy, or HAART is not a cure
Slow down the process of replication of HIV in the human
body
Prevent and treat Opportunistic Infections
Prevent mother-to-child-transmission
• During pregnancy and delivery
• Safer infant feeding
Access to services / availability of drugs
Availability, Coverage, Impact
28. TREATMENT
Important role of institutions (hospitals, clinics, VCT centres)
Conditions to support treatment
Medication adherence plan
Living positively
• Adopt a healthy diet
• Exercise regularly
• Avoid alcohol and tobacco, or certainly minimize their consumption
• Reduce stress
• Avoid all forms of infection (when possible) because they may compromise your
health and further weaken one’s immune system
• Don’t use drugs other than those prescribed by your doctor
• Visit the doctor regularly
29. Experimental and proposed treatments
Vaccination against hepatitis A and B is advised for patients
who are not infected with these viruses and are at risk of
becoming infected.
Researchers have discovered an abzyme that can destroy the
protein gp120 CD4 binding site. This protein is common to all
HIV variants as it is the attachment point for B lymphocytes and
subsequent compromising of the immune system.
30. Why do people still develop AIDS today?
Even though antiretroviral treatment can prevent the onset of AIDS in a
person living with HIV, many people are still diagnosed with AIDS today.
There are four main reasons for this:
In many resource-poor countries antiretroviral treatment is not widely
available. Even in wealthier countries, such as America, many individuals
are not covered by health insurance and cannot afford treatment.
Some people who became infected with HIV in the early years of the
epidemic before combination therapy was available, have subsequently
developed drug resistance and therefore have limited treatment options.
Many people are never tested for HIV and only become aware they are
infected with the virus once they have developed an AIDS related illness.
These people are at a higher risk of mortality, as they tend to respond less
well to treatment at this stage.
Sometimes people taking treatment are unable to adhere to, or tolerate the
side effects of drugs.
31. CASE STUDY
WORLD AIDS CAMPAIGN - 2004
Year 2004‟s World AIDS Campaign, which culminated on World
AIDS Day, December 1, 2004, explored how gender inequality
fuels the AIDS epidemic, and was conceived to help accelerate
the global response to HIV and AIDS by encouraging people to
address female vulnerability to HIV.
The campaign‟s slogan „Have you heard me today?‟ called for
action against the inequalities that not only put women and
girls at risk but whole communities.
Young women and girls are 2.5 times more likely to be HIV –
infected as their male counterparts.
32.
33.
34. Started on 1st December 1988, World AIDS Day is about raising
money, increasing awareness, fighting prejudice and improving
education.
World AIDS Day is important in reminding people that HIV has
not gone away, and that there are many things still to be done.
35. The Red Ribbon
The red ribbon is an international symbol of AIDS awareness
that is worn by people all year round and particularly around
World AIDS Day to demonstrate care and concern about HIV
and AIDS, and to remind others of the need for their support
and commitment.
36.
37. CONCLUSION
Remember AIDS does not discriminate
caste, creed, race, religion, educational or social status.
Prevention of AIDS is our joint responsibility. Education
and awareness is the only weapon in our hand. Let us
accept the challenge to fight against AIDS. We must
support and care for the people with HIV / AIDS with
compassion and understanding.