D.Dutta & Dr. S. Raksit presentation in college semenars

1. Dibyendu Dutta
Consultant (N.P.P.C.F)
Office of the C.M.O.H. Bankura.

2. A virus known as the Human
Immuno-Deficiency Virus
It causes disruption of immunity or
body defense mechanism

3.  HIV vs. AIDS
 Retrovirus->Lentivirus
 Lentivirus->Slow Virus->Takes long
time to develop symptoms
 HIV-1 (8-15 Yrs)
 HIV-2 (20-30 Yrs)

5. •No
•HIV is a virus and AIDS is the terminal stage of
HIV infection
•All AIDS cases are HIV infected but not all HIV
infected people have AIDS

6. Affects mostly young adults in prime productive
years
Occurs not randomly, but through risk behaviour
Long period of invisibility : 9–11 years
Prevention is important & cost-effective
Life long but high treatment cost, with no cure
Non-availability of effective HIV preventive vaccine
Associated with high level of social stigma

7. •Human is the only source as well as
only host
of the infection.
•Infection spread through mixing of
Body Fluid
•Once infected – infected for life
• Age group of 15 – 49 – most vulnerable

8.  HIV is transmitted through BLOOD,
SEMEN, VAGINAL FLUID, BREAST
MILK
 URINE, SPUTUM, SALIVA, TEARS,
SWEAT etc do not transmit HIV
infection

11. HIV Transmission Risk
Exposure Route HIV Transmission
Blood transfusion - %90 95
Perinatal - %20 40
Sexual intercourse . %0 1 to 10
Vaginal . - . %0 05 0 1
Anal . - . %0 065 0 5
Oral . - . %0 005 0 01
Injecting drugs use . %0 67
Needle stick exposure . %0 3
Mucous membrane . %0 09
, -splash to eye oro nasal

12. Dynamics of HIV spread
General Population
•Married women
•Babies and Children
•Youth
•Men
High-risk Populations
•Female Sex Workers
•Men who have sex with men
•Injecting drug users
Bridge Populations
• Clients of sex workers
• Partners of IDUs
• Migrant / mobile populations
• Truck drivers
• Population in conflict

13.  Sharing common toilets
 Touching, Hugging ,Kissing
 Insect Bites
 Coughing, Sneezing
 Sharing Food or Fomites
 Impure water

14. Weight loss > 10% of body weight
Chronic diarrhoea > 1 month
Prolonged fever > 1 month
Persistent cough > 1 month
Generalised pruritic dermatitis
History of herpes zoster
Oro pharyngeal candidiasis
Generalised lymphadenopathy
Disseminated herpes simplex infection

15. Exponential viral replication
Widespread systemic dissemination to the brain,
spleen, distant lymph nodes, etc. (5-11 Days)
HIV makes contact with cells located within the genital mucosa
Virus is carried to regional lymph nodes (1-2 Days)

16.  Dr. Luc Montagnier of Pasteur Institute of Paris-
Cause and routes of transmission of AIDS
 AIDS-Formally recognized as a new Infection on
June5,1981 when Centre for Disease Control
reported 5 LA men developed unexplained
immuno deficiency
 1st
AIDS case-San Fancisco man-recognized on
24th
April’1980
 Patient Zero-A canadian Flight Attendant-
reportedly infected as many as 250 men

17.  1st
case-among the sex worker in Chennai in 1986
 In the same year one case was reported from
Maharasthra
 1987-NACP launched
 By the end of 1987, 52987 people were tested out
of which 135 were tested positive and 14 were
diagnosed to have AIDS
 In 1992,NACO was set up and it was decided that
SACS will be set up in 25 states and 7 Uts.

18. Total: 33.2 (30.6 – 36.1)
million
Western &
Central Europe
760 000760 000
[600 000 – 1.1 million][600 000 – 1.1 million]
Middle East & North
Africa
380 000380 000
[270 000 – 500 000][270 000 – 500 000]
Sub-Saharan Africa
22.5 million22.5 million
[20.9 – 24.3 million][20.9 – 24.3 million]
Eastern Europe
& Central Asia
1.6 million1.6 million
[1.2 – 2.1 million][1.2 – 2.1 million]
South & South-East
Asia
4.0 million4.0 million
[3.3 – 5.1 million][3.3 – 5.1 million]
Oceania
75 00075 000
[53 000 – 120 000][53 000 – 120 000]
North America
1.3 million
[480 000 – 1.9 million]
Latin America
1.6 million1.6 million
[1.4 – 1.9 million][1.4 – 1.9 million]
East Asia
800 000800 000
[620 000 – 960 000][620 000 – 960 000]
Caribbean
230 000
[210 000 – 270 000]
Adults and children
Estimated to be living with HIV, 2007

19. Estimated number of People Living with HIV/AIDS:
2.3 million (1.8—2.9 million) in 2007
Six high prevalence states contribute more than
60% of PLHA
Women constitute 39% and Children 3.8%
Estimated Adult HIV prevalence : 0.34% (0.25%-0.43%);
Males: 0.44%, Females: 0.23%

20. High
Prevalence
Moderate
Prevalence
Highly
Vulnerable
Vulnerable
States
Tamil Nadu
Andhra
Pradesh
Maharashtra
Karnataka
Nagaland
Manipur
Gujarat
Goa
Pondicherry
Assam
Bihar
Delhi
Himachal Pradesh
Kerala
Madhya Pradesh
Punjab
Rajasthan
Uttar Pradesh
West Bengal
Chhattisgarh
Jharkhand
Orissa
Uttranchal
Arunachal Pradesh
Haryana
Jammu & Kashmir
Meghalaya
Mizoram
Sikkim
Tripura
Andaman &
Nicobar Islands
Chandigarh
Dadra & Nagar
Haveli
Daman & Diu
Lakshadweep

21. 156 A Category Districts
39 B Category Districts
14 Districts with HIV prevalence >
3% among ANC clinic attendees
Evidence of HIV positivity among
IDU in Punjab, WB and Orissa
Evidence of dual mode of
transmission in Manipur & Nagaland.

22. 22
Thank You

23. Dr. S. Rakshist
Medical Officer
Office of the CMOH Bankura

24. Basic Services :- ICTC, ICTC- ANC, STD Services & Condom
Promotion, HIV-TB Coordination Programme
Care, Support and Treatment : ART Centers, Link ART
Centers,
Community Care Centers , Drop in Centers
Blood Safety – Supports to Ensure safe Blood transfusion
Sentinel Surveillance – To know the current prevalence and
trend
of HIV infection in the State,
Monitoring & Evaluation - CMIS, Reporting

25. IEC, BCC - Hot line counseling, Mainstreaming, Youth
affairs, GIPA
Coordination
TI – Targeted Intervention through NGO & CBO
TSU – Technical support Unit
Training – Capacity development of Human resources

26. Early detection of HIV
Provision of basic information on modes of
transmission and
prevention of HIV/AIDS
Link people with other HIV prevention, care and
treatment
services

27. Pre-test and Post-test Counseling
Testing for HIV
ARV prophylaxis to mother-baby pairs
Counseling on infant feeding practice
Counseling on family planning
Referral for pre-ART registration and CD4 count
Post-natal follow-up of sero-reactive mothers and their exposed babies
Cotrimoxazole Prophylaxis
EID
Partner counseling
Cross referrals
Whole Blood Finger Prick test
Out Reach Activity

28. ICTCICTC
STI prevention
& treatment
Community support to
Mainstream HIV/AIDS
Early access to
medical care,
preventive therapy
other OIs and ARV
treatment
MCH services PPTCT
Access to
family planning
Counselling
For BCC &
Psychological support
Peer support from
PLHA Network Spiritual support
Material and financial
assistance
Legal services for
children and family
Access to condoms
Early management of
Opportunistic Infection

29.  Known as Anti Retroviral Therapy (ART)
 It suppresses HIV replication and reduces
infectivity
 Improvement of clinical condition and quality
of life
 Prolongation of life BUT NO CURE
 Management of opportunistic infection.
(Tuberculosis – commonest)

30.  Identify eligible persons with HIV/AIDS
requiring ART
 Provide free ARV drugs to eligible persons
with HIV/AIDS life long
 Provide counseling services for drug adherence
 Educate persons on nutrition, hygiene and
prevention
 Referral for specialized services or admission.
 Mechanism to tracking

31. ART
PPTCT
OI
Access to
condom
TI
Psychosocial
Support Service
CCC
Peer Support
group
STI Services
ICTC
TB / RNTCP

32.  Common STIs –
Syphillis,Gonorrhoea,Chanchriod,LGV,HIV
 Common presentation – genital ulcer,urethral
and vaginal discharge, swollen lymph node etc
 Screening, Syndromic treatment ,contact
tracing, treatment of partners – need to be done
 STI increases the risk of HIV transmission

33.  Awareness campaign-through IEC campaign in
local language
 Condom promotion
 Risk reduction, BCC
 Capacity building of the Health care personnel
 Promotion of HIV screening- possibility of
setting up ICTC in PPP mode

34.  Abstinence from Pre- marital & Extra marital
Sex
 Be faithful to Single Partner
 Condom

35. THANK YOU