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  • Dec 1

    2. 2. <ul><li>“ When you have sex with unknown strangers, you are having sex with everyone they have had sex with for the last ten years.” </li></ul><ul><ul><ul><li>Former Surgeon General </li></ul></ul></ul><ul><li>C. Everett Koop </li></ul>
    3. 3. Routes of Transmission of HIV <ul><li>Sexual Contact: Male-to-male </li></ul><ul><li>Male-to-female or vice versa </li></ul><ul><li>Blood Exposure: Injecting drug use/needle sharing </li></ul><ul><li> Occupational exposure </li></ul><ul><li> Transfusion of blood products </li></ul><ul><li>Perinatal: Transmission from mother to baby </li></ul><ul><li>Breastfeeding </li></ul>
    4. 5. Transmission of HIV HIV is not transmitted by <ul><li>Public baths </li></ul><ul><li>Handshakes </li></ul><ul><li>Work or school contact </li></ul><ul><li>Using telephones </li></ul><ul><li>Sharing cups, glasses, plates, or other utensils </li></ul><ul><li>Coughing, sneezing </li></ul><ul><li>Insect bites </li></ul><ul><li>Touching, hugging </li></ul><ul><li>Water, food </li></ul><ul><li>Kissing </li></ul>
    5. 6. Mother-to-Child HIV Infections <ul><li>2,000 new infections each day worldwide </li></ul><ul><li>Over 90% are in resource-poor settings </li></ul><ul><li>About 90% of HIV-positive pregnant women in resource-poor settings have no access to testing and do not know their HIV-status </li></ul>
    6. 7. Mode of Transmission of HIV In India
    7. 8. 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
    8. 10. 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
    9. 11. <ul><li>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. </li></ul>
    10. 12. <ul><li>HIV/AIDS is not just a health problem, but also a development problem. </li></ul>
    12. 15. TARGETED INTERVENTIONS <ul><li>The basic purpose of the Targeted Intervention program is to reduce the rate of transmission among the most vulnerable and marginalized populations. </li></ul><ul><li>Target Groups: </li></ul><ul><li>Truckers </li></ul><ul><li>Commercial Sex Workers </li></ul><ul><li>School and College students </li></ul><ul><li>Adolescents, Women and Youth </li></ul><ul><li>Prison Inmates </li></ul><ul><li>Armed Forces </li></ul><ul><li>Other High Risk Groups </li></ul><ul><li>General Population </li></ul>
    13. 16. <ul><li>Behaviour Change and Communication is – </li></ul><ul><li>An interactive process with communities; </li></ul><ul><li>To develop messages and approaches using a variety of </li></ul><ul><li>communication channels; </li></ul><ul><li>Motivate people towards a positive behaviour in order to </li></ul><ul><li>promote and sustain behaviour change; </li></ul><ul><li>Trainers can be trained on Communication, Behaviour </li></ul><ul><li>change and Advocacy issues so that they can spread out into </li></ul><ul><li>the community making them aware on HIV and AIDS. </li></ul>Communication, Advocacy and Behaviour Change
    14. 17. &quot;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.&quot; - Nelson Mandela Heroes Fight Against AIDS
    15. 18. 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
    16. 19. HIV AND AIDS PREVENTION STRATEGIES Interventions to Prevent Sexual Transmission of HIV <ul><li>How to protect ourselves against HIV through Safer Behaviour? </li></ul><ul><li>Protecting by practicing safer physical activities such as dry kissing, </li></ul><ul><li>hugging, touching, and masturbation. </li></ul><ul><li>Condom Promotion </li></ul><ul><li>How to protect ourselves against HIV through Safest Behaviour? </li></ul><ul><li>Abstain from having sex and practice self- control </li></ul><ul><li>Having sex with only one partner (uninfected) and only that one partner </li></ul>
    17. 20. 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 <ul><li>Implementation of blood safety practices . </li></ul><ul><li>Screening of donor’s blood </li></ul>
    18. 21. 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
    19. 22. 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
    20. 23. Strategy 1: Primary Prevention of HIV Infection <ul><li>Safe sexual behavior and condom use </li></ul><ul><li>Reproductive health services </li></ul><ul><li>Management of STIs </li></ul><ul><li>Voluntary Counseling and Testing ( VCT) </li></ul><ul><li>HIV prevention interventions aimed at pregnant and lactating women, and women of child bearing ages </li></ul>
    21. 24. Strategy 2: Prevention of Unintended Pregnancies in HIV+ Women <ul><li>Strengthening family planning services </li></ul><ul><ul><li>To prevent unintended pregnancies </li></ul></ul><ul><ul><li>To delay subsequent pregnancies </li></ul></ul><ul><ul><li>To replace the contraceptive effect of breastfeeding </li></ul></ul><ul><li>Access to safe abortion services where allowed by law </li></ul><ul><li>VCT so that they know their HIV status </li></ul>
    22. 25. Strategy 3: Prevention of Transmission in HIV+ Women <ul><li>Pregnancy and delivery </li></ul><ul><ul><li>Antiretroviral therapy (ART) </li></ul></ul><ul><ul><li>Vaginal disinfection (little evidence of success and can increase inflammation) </li></ul></ul><ul><ul><li>Improved obstetrical practices (avoid unnecessary invasive procedures, safer delivery) </li></ul></ul><ul><ul><li>Treatment of STIs </li></ul></ul><ul><li>Breastfeeding </li></ul><ul><ul><li>Good nutrition and good BF technique instruction </li></ul></ul><ul><ul><li>Short course ART for baby </li></ul></ul>
    23. 26. Strategy 4: MTCT-Plus <ul><li>Secondary HIV prevention </li></ul><ul><li>Clinical care (including ART) </li></ul><ul><li>Community care </li></ul><ul><li>Stigma reduction </li></ul><ul><li>Orphans and Vulnerable </li></ul><ul><li>Children (OVC –Services) </li></ul><ul><li>Impact mitigation </li></ul>
    24. 27. <ul><li>For needle stick: </li></ul><ul><li>ZDV + lamivudine 1 month, but in high risk (high viral RNA copies) a combination of ZDV + lamivudine + Indinavir </li></ul><ul><li>Pregnancy: </li></ul><ul><li>ZDV full dose, trimester 2 and 3 + 6 weeks to neonate reduces vertical transmission by 80% </li></ul><ul><li>ZDV restricted to intrapartum period/NEVIRAPINE-1 dose at onset of delivery + one dose to neonate </li></ul><ul><li>Symptomatic tx and antibiotics / antivirals / glucocorticoids / thalidomide / antifungals / metronidazole for bacterial, viral, autoimmune, fungal and parasitic infections. </li></ul>
    25. 28. 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!
    26. 29. However, despite our innovation, inventiveness and compelling evidence of effective strategies, the “killer virus” is still chasing and killing us!
    27. 30. 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
    28. 31. <ul><li>First, Protect Yourself! This is your only life. </li></ul><ul><li>Teach Others To Protect Themselves. </li></ul><ul><li>Respect Those Who Are Infected. </li></ul><ul><li>Get Involved. The world can beat HIV/AIDS, but we need concerned citizens like you to get involved. </li></ul>
    29. 32. World AIDS Day 2008
    30. 33. THANK YOU