World AIDS Day World AIDS Day is held on 1 December each year. It raises awareness across the world and in the community about the issues surrounding HIV and AIDS. It is a day for people to show their support for people living with HIV and to commemorate people who have died.

1. Where We Went Wrong ?
Dr. Sujnanendra Mishra

2. UNPLEASING Concerns
• When did we started?
• Where are we now?
• What went wrong?
• May I Suggest a strategy?

3. AIDS is preventable.
AIDS is treatable.
And EVERYONE is acceptable.

4. https://www.avert.org/sites/default/files/Global%20statistics%20-%20people%20living%20with%20HIV.png

5. 2014 global HIV statistics
• Since 2000, 38.1 million people have become infected
with HIV and 25.3 million people have died of AIDS-
related illnesses.
• 36.9 million people were living with HIV (including 2.6
million children) – a global HIV prevalence of 0.8%. The
vast majority of this number live in under developed
countries.
• 1.2 million people died of AIDS-related illnesses.
• 25.8 million people living with HIV are in sub-Saharan
Africa, accounting for 70% of the global total.
• Only 54% of all people living with HIV know that they have
the virus.
http://www.avert.org/professionals/hiv-around-world/global-statistics#sthash.pGMGpx5p.dpuf

6. SCREENING
DESIGN INDIVIDUAL CASE MANAGEMENT

7. 60 percent of young people living with HIV are
unaware of their status. Centers for Disease Control (CDC)
• 26 percent of new HIV infections occur among people
between the ages of 13-24.
• Additionally, 60 percent of young people are unaware that
they are living with the virus.
• These people have a unrealistic fear and idea of risk of
infection
• Undiagnosed carriers have higher viral load than someone
who is aware of their status and on treatment.
• A higher viral load means a bigger risk.

8. 91 percent of new HIV transmissions are From
undiagnosed or never been treated CASES.
• More than 1.1 million people living with HIV
• 207,600 were undiagnosed and
• 519,414 knew they were HIV-positive but were not in
medical care.
• Compared to those who were undiagnosed, a person who
knew about their status but was not in medical care was
19 percent less likely to transmit HIV.
Jama Internal Medicine

9. A newly diagnosed person in their 20s can
expect to live an additional 51 years.

10. Only few people have the virus under
control.

11. Does it means to rebuild HIV prevention
programme.
SCREENING
• All Vulnerable
• All ANCs
TREATMENT
• All Positives
• Newborn as PPTCT
PrEP
CCC

12. Hope through Treatment
A Reality
People on treatment are less likely to transmit HIV than people who are
not on treatment?

13. Un undetectable viral load reduces the
chance of HIV transmission by 96 percent.
• An HIV-positive on antiretroviral therapy (ART) and has
achieved an undetectable viral load is 96 percent less
likely to transmit HIV.
• No HIV-positive person with a viral load of less than 200
copies per milliliter of blood transmitted the virus to their
uninfected partner.
• HIV treatment as prevention, or TasP, has been adopted
as a valid form of HIV prevention by both the CDC and the
World Health Organization (WHO)
PARTNER study of serodiscordant couples http://www.aidsmeds.com/articles/hiv_prevention_hptn_2636_20845.shtml
No-one with an undetectable viral load, gay or
heterosexual, transmits HIV in first two years of PARTNER
study

14. Prevention and treatment go together

16. emtricitabine and tenofovir as PrEP
has been reported to reduce HIV
transmission by 96 and up to 99 percent.
• To make sure Truvada is safe , One should be free from:
• liver or kidney disease;
• Osteopenia (low bone mineral density); or
• Hepatitis B infection.

17. U
A
Widespread
testing and
linking people
to care and
treatment
B
P
Broad support
for PLWHA
to engage—and
remain—in care
Universal viral
suppression to
reduce the
chance of
passing HIV to
others
Full access to pre-
exposure prophylaxis
(PrEP) people at risk
with daily medication

18. Goals of Teen Pregnancy Prevention
 Decrease pregnancies among
female teens
 Delay initiation of teen sexual
activity
 Increase use of effective
contraceptive methods
http://www.cdc.gov/winnablebattles/Goals.html

19. Health care providers can
• Test patients for HIV as a regular part of medical care;
• Discuss HIV risks and continued use of prevention methods,
including condom use, with all patients;
• Prescribe PrEP to patients without HIV who could benefit;
• Counsel patients who can benefit from PrEP on how to take it every
day and help them get free PrEP; and
• Schedule appointments for patients using PrEP every 3 months for
follow-up, including HIV testing and prescription refills.

20. Everyone can
• Get tested for HIV and know their status.
• Learn how HIV is transmitted and how it can be
prevented.
• Talk to their health care providers about HIV risk and
ways to prevent it, including
• PrEP,
• condom use,
• abstinence,
• drug treatment, and
• HIV treatment for people with HIV.

21. HIGHLY EFFECTIVE
HIV PREVENTION
EARLY TREATMENT
MEANS A LONGER LIFE
YOU CAN’TTREAT
THE UNDIAGNOSED

23. Final words
• DIAGNOSIS IN 20s.
• ART to Reduce VIRAL LOAD.
• Pre-Exposure Prophylaxis, or PrEP.
• Promotion of CONDOMS.