M ODES OF TRANSMISSION, A WARENESS & P REVENTION Dr. N. R. P. REDDY RESIDENT DEPARTMENT OF MICROBIOLOGY SVIMS
“ When you have sex with unknown strangers, you are having sex with everyone they have had sex with for the last ten years.”
Former Surgeon General
C. Everett Koop
Routes of Transmission of HIV
Sexual Contact: Male-to-male
Male-to-female or vice versa
Blood Exposure: Injecting drug use/needle sharing
Transfusion of blood products
Perinatal: Transmission from mother to baby
Transmission of HIV HIV is not transmitted by
Work or school contact
Sharing cups, glasses, plates, or other utensils
Mother-to-Child HIV Infections
2,000 new infections each day worldwide
Over 90% are in resource-poor settings
About 90% of HIV-positive pregnant women in resource-poor settings have no access to testing and do not know their HIV-status
Mode of Transmission of HIV In India
HIV in Body Fluids Semen 11,000 Vaginal Fluid 7,000 Blood 18,000 Amniotic Fluid 4,000 Saliva 1 Average number of HIV particles in 1 ml of these body fluids
Substance Use can increase HIV-risk behaviors and increases risk of mental disorders Mental Disorders may increase impulsivity and impair problem solving, increasing risk for substance use and HIV-risky behaviors HIV/AIDS can increase risk of mental Illness (depression, anxiety, sleep disorders) and substance use disorders COMPLEXITY
When 8% or more of a population becomes infected with HIV, the growth of the economy slows down, according to a World Bank study . This is because the labor force gets reduced and demands on the already overwhelmed government, economic and health care systems increase.
HIV/AIDS is not just a health problem, but also a development problem.
STRATEGIES OF HIV AND AIDS AWARENESS
The basic purpose of the Targeted Intervention program is to reduce the rate of transmission among the most vulnerable and marginalized populations.
Commercial Sex Workers
School and College students
Adolescents, Women and Youth
Other High Risk Groups
Behaviour Change and Communication is –
An interactive process with communities;
To develop messages and approaches using a variety of
Motivate people towards a positive behaviour in order to
promote and sustain behaviour change;
Trainers can be trained on Communication, Behaviour
change and Advocacy issues so that they can spread out into
the community making them aware on HIV and AIDS.
Communication, Advocacy and Behaviour Change
"AIDS is our number one enemy. This enemy can be defeated. While the research for a cure continues, four principles -- love, support, acceptance and care for those affected -- can make us winners." - Nelson Mandela Heroes Fight Against AIDS
HIV Testing Occurs in a Variety of Settings Prevent HIV Infections STI Clinics TB Clinics Hospitals T&C ANC Blood Banks Surveillance Provide care to HIV-affected persons Provide ARV treatment to HIV-infected persons
HIV AND AIDS PREVENTION STRATEGIES Interventions to Prevent Sexual Transmission of HIV
How to protect ourselves against HIV through Safer Behaviour?
Protecting by practicing safer physical activities such as dry kissing,
hugging, touching, and masturbation.
How to protect ourselves against HIV through Safest Behaviour?
Abstain from having sex and practice self- control
Having sex with only one partner (uninfected) and only that one partner
Prevention of Mother-to-Child Transmission - Suggest counselling on pregnancies among infected mothers . - Use of antiretroviral therapy (ART) - Whether breast feeding or not? Prevention of Blood borne Transmission
Implementation of blood safety practices .
Screening of donor’s blood
Prevention of HIV Transmission through infected needles and syringes - -Do not use drugs or share needles and syringes - Clean needles and syringes by bleaching powder PRACTICE UNIVERSAL PRECAUTIONS - For Health professionals - Family members of People Living With HIV and AIDS
3. Prevention of transmission from mother to child 2. Prevention of unwanted pregnancies among HIV+ women (family planning) 1. Primary prevention of HIV in young adults Four Integrated Strategies to Reduce Pediatric AIDS (WHO/UNICEF 4 Pillars of MTCT) 4. MTCT-Plus: care and support for HIV+ women, their infants, and families
Strategy 1: Primary Prevention of HIV Infection
Safe sexual behavior and condom use
Reproductive health services
Management of STIs
Voluntary Counseling and Testing ( VCT)
HIV prevention interventions aimed at pregnant and lactating women, and women of child bearing ages
Strategy 2: Prevention of Unintended Pregnancies in HIV+ Women
Strengthening family planning services
To prevent unintended pregnancies
To delay subsequent pregnancies
To replace the contraceptive effect of breastfeeding
Access to safe abortion services where allowed by law
VCT so that they know their HIV status
Strategy 3: Prevention of Transmission in HIV+ Women
Pregnancy and delivery
Antiretroviral therapy (ART)
Vaginal disinfection (little evidence of success and can increase inflammation)
ZDV + lamivudine 1 month, but in high risk (high viral RNA copies) a combination of ZDV + lamivudine + Indinavir
ZDV full dose, trimester 2 and 3 + 6 weeks to neonate reduces vertical transmission by 80%
ZDV restricted to intrapartum period/NEVIRAPINE-1 dose at onset of delivery + one dose to neonate
Symptomatic tx and antibiotics / antivirals / glucocorticoids / thalidomide / antifungals / metronidazole for bacterial, viral, autoimmune, fungal and parasitic infections.
The AIDS epidemic has taught us to be innovative and to invent new ways of doing things. We now have evidence of HIV prevention strategies that work!
However, despite our innovation, inventiveness and compelling evidence of effective strategies, the “killer virus” is still chasing and killing us!
Conclusion We should increase our speed and innovativeness to: identify HIV/AIDS prevention strategies with evidence of effectiveness or efficacy, fund them implement them carefully and meticulously evaluate them, to ensure they are effective in the chosen target groups. If necessary, adapt them to local conditions
First, Protect Yourself! This is your only life.
Teach Others To Protect Themselves.
Respect Those Who Are Infected.
Get Involved. The world can beat HIV/AIDS, but we need concerned citizens like you to get involved.