This document provides information about HIV/AIDS, including: - HIV stands for Human Immunodeficiency Virus and is transmitted between humans. It causes AIDS by weakening the immune system. - AIDS stands for Acquired Immunodeficiency Syndrome and is the final stage of HIV infection where the immune system is severely damaged. - HIV is found in certain body fluids and transmitted most commonly through unprotected sex and sharing needles. It cannot be transmitted through casual contact. - Prevention methods include condoms, testing, treatment of other STIs, and education to reduce risk behaviors. While treatment can suppress HIV, there is currently no cure for AIDS.

1. BASIC Concept Of
HIV/AIDS:
A Major Public Health
Problems in Bangladesh
and the World
HIV & AIDS: Mode of
Transmission, Vulnerability,
Spread of infection, Control,
Prevention, Treatment & Care
[Dr] Amzad Ali
Email: ali.amzad@gmail.com
Skype: ali.amzad
Cell: +8801713 004696

2. What is HIV?
H -uman
Found only in humansFound only in humans
Transmitted among humansTransmitted among humans
Preventable by humansPreventable by humans
I -mmunodefiency
Body lacks ability to fight off infectionsBody lacks ability to fight off infections
V -irus
Type of germType of germ
Lives and reproduces in body cellsLives and reproduces in body cells

3. What is AIDS?
A -cquired; received, not inherited (does not runreceived, not inherited (does not run
in families)in families)
I -mmuno; protected from (in this case theprotected from (in this case the
system protects the body from disease)system protects the body from disease)
D -eficiency, -- a lack ofa lack of
S-yndrome; – a group of symptoms or– a group of symptoms or
diseasesdiseases

4. HIV IS FOUND IN BODY
FLUIDS
 Semen
 Breast milk
 Blood
 Vaginal fluid

5. How HIV is passed on?
 During unprotected (skin to skin) sex (anal,
vaginal or oral)
 Contact with HIV infected blood or blood
products
 Sharing IV drug needles of HIV positive people
 From HIV positive mother to child
 During breast feeding

6. Basics of HIV and AIDS
Cont…
Transmission of the virus occurs most
commonly through the exchange of body
fluids by:
1.Sexual contact with an infected person
2.Sharing infected needles, syringes or
other injection equipment with someone
who is infected.
3.Mother-to-child transmission
4.Transmission during blood transfusion
HIV enters the body through open cuts, sores, or breaks in the skin;
through mucous membranes, or through direct injection.

7. You CANNOT get HIV
from…
 Tears
 Saliva
 Sweat
 Urine
of an HIV infected person

8. Basics of HIV and AIDS
Cont…
HIV is NOT spread through:
• Casual / social contact
• Kissing and hugging
• Mosquito bites
• Using same utensils / towels, etc.
• Sharing the same wash-rooms
• By touching items that were touched by an
infected person

9. Window Period
 When a person gets infected it may take 6
weeks or up to 3 months before antibodies
to HIV are detected in the blood
 The HIV test looks for antibodies. When
these antibodies are detected the person is
diagnosed HIV positive
 A person can be positive and the test shows
negative because the test was done during
the window period

10. Why HIV rates not goingWhy HIV rates not going
down?down?
 Sex at an early age
 Little life-skills and sex education
 Little condom use
 Multiple partners
 Stigma and Discrimination
 Sex for money or sex for .....things
 Substance abuse: Ganja, cocaine, alcohol
 Men having sex with men & homophobia
 Gender inequity and gender roles

11. STI and HIV – The LinkSTI and HIV – The Link
 Persons with a history of STIs are more likely to get
HIV because:
 persons with STIs are more likely to have sores
and small breaks in the skin and lining of their
genitals.
 HIV can more easily enter the body through
these breaks.
 You can get an STI by having sex without a condom,
with an infected person.
 At the same time, you could be getting HIV which is
also contracted by having unprotected sex.

12. ALL STIs are
Preventable
Most STI’s are treatable
But
HIV/AIDS CANNOT BE CURED

13. Know Your Epidemic
HIV & AIDS Situation:
Global, Regional and
Bangladesh and Responses

17. State of the epidemic: Global and Asia-
Pacific
Global Asia-Pacific
People living with HIV 34,000,000
[31,400,000 – 35,900,000]
4,900,000
[3,900,000 – 6,100,000]
Women living with HIV 15,000,000
[13,900,000 – 15,700,000]
1,600,000
[1,200,000 – 2,100,000]
New HIV infections 2,500,000
[2,200,000 – 2,800,000]
370,000
[250,000 – 550,000]
Adult HIV prevalence 0.8 %
[0.7% – 0.8%]
0.2 %
[0.2% – 0.2%]
AIDS-related deaths 1,700,000
[1,500,000 – 1,900,000]
310,000
[240,000 – 400,000]
Source: Prepared by www.aidsdatahub.org based on HIV estimates and projections data for UNAIDS (2012). Global Report: UNAIDS Report on the Global AIDS Epidemic 2012

18. Bangladesh Situation
• First HIV case in Bangladesh was detected in 1989.
• Bangladesh is still a low prevalent country in the region with
< 0.1% prevalence among general Populations.
• Estimated number of PLHIV is 9,500
• Risk behaviors exist with high HIV bordering nations
• 5.3% HIV among Injecting Drug Users in Dhaka City
• Social stigma, discrimination and hidden HIV epidemic
• Poverty, Gender & Social norms

19. Bangladesh Scenario:25 years
Source: National AIDS/STD Programme, 2014
• Overall HIV prevalence <1%
• Estimated number of cases 9500
Reported no. of HIV cases- 2533
No. of AIDS cases - 1101
No. of death in AIDS - 325
0
500
1000
1500
2000
2500
3000
Total HIV+ Cases
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011

20. HIV is decreasing among Injecting Drug Users in Dhaka
Source: National HIV Serological Surveillance, 2011, NASP, Bangladesh

21. * Cumulative retention on treatment after 12 months of initiation of ART
** Number of patients initiating ART who are still on ART at 12 months and have VL of <1000copies/ml

22. HIV and AIDS Data Hub for Asia-Pacific
Latest!Latest!
22
Percent distribution of new HIV infections by age group
and gender, 2009
• By age group • By gender
Source: Prepared by www.aidsdatahub.org based on National AIDS/STD Programme. (2009). Bangladesh HIV data, 2009.

23. • HIV prevalenceHIV prevalence among male IDUs is 5.3% in Dhaka city
• Risk behaviors exists: UUnprotected commercial sex, Unsafe
injecting drug use, Unprotected sex between men with
multiple partners
• Low condom use among most at risk population and
bridging population
• Young People: Poor understanding, misconception, low risk
perception
• PopulationPopulation migration is high: internal and externalis high: internal and external
• GeographicalGeographical vulnerability is hvulnerability is higher (cross border with India,
Myanmar, Nepal & water routes with world!)
• Poverty, gender inequalities & social stigmaPoverty, gender inequalities & social stigma
Risks and Vulnerabilities

24. HIV and AIDS Prevention

25. National
HIV/AIDS
Program
Coverage with
expansion
Injecting Drug
Users, female Sex
Workers, Young
People and
Garement
Workers by
GFATM resources

26. Bachte hole Jante Hobe
The communication campaign has created impact

27. Programmatic Interventions: “Bachtehola Jante
Hobe” – A National campaign on HIV prevention

28. National Text Book included
HIV/AIDS (Grade VI-XII) in 2007
A total of 115,523 teachers
and 228,211 committee and
governing body members have
been trained and oriented
from over 15,000 institutions
It is expected that, nationwide
over 11 million students will be
receiving information on HIV
and AIDS through classroom
education on a sustained
manner each year

29. Continuum of elements of behavior change
programs
Enabling environment
Enabling Environment
UNAIDS/98044 15 June 1998

30. Key Results

31. Knowledge has increased in
HIV Prevention (2004-2008)
Source: Operation Research on Mass Media, ICDDR,B, 2008
*
*
*
*
*p<0.05
31

32. Condom use has increased among
most at risk populations
29.3
35.6
2.4
15.7
39.7
5.2
41.1
70.2
28.4
0
10
20
30
40
50
60
70
80
Percent of IDUs used condom during
last sexwith FSW in Central
Bangladesh
Percent of FSW reporting use of
condom during last sex with new
clients (National Brothel)
Consistent use of condom with new
clients over the rounds (National
Brothel)
Round IV, 2002 Round V, 2003-4 Round VII, 2006-7
Source: National HIV Sero-survelliance, 2007

33. Declined active syphilis in street based female sex
workers over the rounds (1990-2011)
Source: National HIV Serological Surveillance, 2011, NASP, Bangladesh

34. Prevention
 Talk with partner about HIV
 Use a condom with your regular and non-
regular clients, and partners every time
you have sex
 Reduce the number of main partners
 Get tested. Know your status

35. Who is most at risk for HIV?
 Anybody having sex without a condom.
 People with more than 1 partner who
don’t use a condom during sex
 People whose sex partner have sex with
other partners without using a condom

36. How You DON’T Get HIV
 You CANNOT get HIV by
hugging, touching,
living with or caring for
someone with HIV,
shaking hands or
kissing.
 You CANNOT get HIV
from eating out of the
same plate or cup or
utensils that an HIV
positive person uses.

37. Early Signs & Symptoms of AIDSEarly Signs & Symptoms of AIDS
 Fever
 Fatigue
 Night Sweats
 Loss of Appetite
 Diarrhea
 Swollen Lymph Glands
Remember these are symptoms of many other illnesses.

38. REMEMBER
 You CANNOT tell by looking if someone has
HIV.
 An individual can look and feel well for many
years and be HIV positive.
 The HIV positive person can pass the virus on to
someone else.

39. The AIDS epidemic has taught us to be innovative and
to invent, test and implement new interventions. We
now have evidence of HIV prevention strategies that
work!

40. However, despite our innovation, inventiveness
and compelling evidence of effective
strategies, the “killer virus” is still chasing
and killing us!

41. People Living with HIV