safety against VD

1. HIV & STI Prevention Module
Maritime Sector
Master Trainer Slides

2. Maritime Sector & HIV
Lesson 1

3. Why focus on the maritime sector?

4. Concerns identified by ILO in 2010
– Stressful environment
– Away from family and regular partners
– Ready access to sex work
– Peer pressure to engage with sex workers
– Tendency to have multiple partners
– Use of alcohol and recreational drugs that
Increase libido and reduce inhibitions
– Lack of ‘tailored’ HIV information

5. Who are key populations and why
do they matter?

6. What kind of targeted interventions
will work with the maritime sector?

7. India’s HIV/AIDS Prevention and
Control Act, 2017
• The requirement for HIV testing as a prerequisite for obtaining
employment or accessing health care is prohibited
• Every HIV-infected or affected person below the age of 18 will have the
right to live in a shared household, and enjoy household facilities
• Provision for appointment of an ombudsman by State/UT Governments to
address grievances related to violation of the Act and penal action in case
of non-compliance
• Provides an environment for enhancing access to health care services by
ensuring informed consent and confidentiality for HIV-related testing,
treatment, and clinical research. It also provides ground for penal action
for any health care provider, except a physician or a counsellor to disclose
the HIV positive status of a person to his or her partner
• Lists the various grounds on which discrimination against people living
with HIV is prohibited such as: (1) employment; (2) educational
establishments; (3) health care services; (4) residing or renting a property;
(5) standing for public or private office; (6) provision of insurance.

8. HIV Origins & Targets
Lesson 2

9. Where did HIV come from?

10. 1. Hunter Theory
2. Sexual Transmission Theory
SIV – Simian Immunodeficiency Virus

11. Punishment from God Theory

12. Man-MadeTheory

13. Go to - https://timeline.avert.org/

21. HIV Function
Lesson 3

22. What does HIV stand for?

23. What does HIV do to our bodies?

25. WHO Criteria for HIV Stage 1
•Asymptomatic
•Persistent generalized lymphadenopathy (the swelling or
enlargement of the lymph nodes) These are also referred
to as glands in common parlance, found below the ear,
and also under the arm and in the groin area.

26. WHO Criteria for HIV Stage 2
•Moderate unexplained weight loss (under 10% of presumed or measured
body weight)
•Recurring respiratory tract infections
•Herpes Zoster (shingles)
•Angular cheilitis (lesions at the corner of the mouth)
•Recurring oral ulceration
•Papular pruritic eruptions (skin rash possibly related to insect bites)
•Seborrhoeic dermatitis (a skin disorder that causes scaly, itchy, flaky skin)
•Fungal nail infections

27. WHO Criteria for HIV Stage 3
•Unexplained severe weight loss (under 10% of presumed or measured body weight)
•Unexplained chronic diarrhea lasting for longer than one month
•Unexplained persistent fever, either intermittent or constant
•Persistant oral candidiasis (yeast infection of the mouth)
•Oral hairy leukoplakia (a white patch on the side of the tongue with a hairy appearance)
•Pulmonary tuberculosis (contagious bacterial infection of the lungs)
•Severe bacterial infections (for example, pneumonia, meningitis, and empyema)
•Acute necrotizing ulcerative stomatitis (inflammation of the stomach mucous lining),
gingivitis (inflammation of the gums), or periodontitis (inflammation of the tissue that
supports the teeth)
•Unexplained anemia (lack of hemoglobin the blood cells), neutropenia (low number of a
certain type of white blood cell called neutrophil), and/or chronic thrombocytopenia (low
platelet count).

28. WHO Criteria for HIV Stage 4 (AIDS)
•HIV wasting syndrome
•Pneumocystis pneumonia (pneumonia caused by a yeast-like fungus)
•Recurrent severe bacterial pneumonia
•Chronic herpes simplex infection
•Esophageal candidiasis (yeast-like infection of the esophagus)
•Extrapulmonary tuberculosis
•Kaposi sarcoma (a tumor caused by human herpesvirus 8)
•Cytomegalovirus infection (an infection caused by human herpesvirus 5)
•Central nervous system toxoplasmosis (a parasite affecting the central
nervous system, including brain)
•HIV encephalopathy (a brain disorder)
•Extrapulmonary cryptococcosis including meningitis (fungal diseases)
•Disseminated non-tuberculous mycrobacteria infection
•Progressive multifocal leukoencephalopathy (the reactivation of a common
virus in the central nervous system)
•Chronic cryptosporidiosis (a parasitic disease)
•Chronic isosporiasis (a parasitic intestinal disease)
•Disseminated mycosis (a fungus that causes infection)
•Recurrent septicemia (also known as blood poisoning)

29. HIV = AIDS = DEATH

32. FEAR FAILED.
ONLY FACTS WILL WORK.

33. [Selinah AIDS Recovery Video]

34. NACO
ANNUAL
REPORT
2016/2017

36. What is a VIRAL LOAD test and
why is it important in 2019?

37. REMEMBER:
Only those who don’t know their HIV status
OR
those who are not effective treatment pass on
the virus.

38. HIV Transmission
Lesson 4

39. What are the 5 body fluids that
transmit HIV?

40. How is HIV transmitted?

41. What are the common activities
that can put people at risk?

42. NACO ANNUAL REPORT 2016/2017

43. #cantpassiton

44. NACO ANNUAL REPORT 2016/2017

45. HIV Prevention
Lesson 5

46. ABC of Prevention:
Abstinence
Being Faithful
Condoms

47. Prevention of sexual transmission

48. Prevention from blood transmission
“The HIV epidemic in India is predominantly
sexually-driven. However, injecting drug use
continues to contribute to infections in an
increasing number of geographical areas,
including the North-East, Punjab, Uttar Pradesh,
Bihar, Delhi and Uttarakhand. Risk behaviours
such as unprotected sexual encounters and
injecting drug use are increasingly
overlapping…”
“A study conducted in Tihar Jail in Delhi has
shown that 8% of prisoners were known to be
drug users. A more recent study of 466 inmates
in Delhi, Mumbai and Punjab prisons showed
that 63% reported to using illicit drugs”
National Strategic Plan 2017-2024 (NACO, India)

49. Prevention of parent to child transmission
“India started the Mother-to-Child Transmission of
HIV and syphilis programme in early part of the NACP
II in the year 2002. Using ‘single dose nevirapine (SD-
NVP) to both mother and child’, the programme
rapidly scaled up. More efficacious medicines for
eMPTCT were introduced under the programme in
2012-13.
In September 2012, Option B+ as a policy, which
states ensuring of lifelong ART for PMTCT for all HIV
infected pregnant women, was adopted.”
National Strategic Plan 2017-2024 (NACO, India)

50. Treatment as prevention – what
does t mean?

51. HIV Testing & Treatment
Lesson 6

52. Why should I get tested?
• The only way to know if we have HIV for sure is to get tested.
• An HIV test gives us the opportunity to put our mind at rest, and
address lifestyle changes that maybe required in the event the
result is negative.
• If the result is positive, then the test and subsequent post-test
counseling allows for us to understand our condition, and
prepare for treatment.
• Knowing your HIV status protects sexual partners and loved
ones from transmission.
• The HIV test is the beginning of a healthy positive life.
REMEMBER: ONLY those who don’t know their HIV status OR
those who are not effective treatment pass on the virus.

53. Where can I get tested?

55. ART as prevention

56. PrEP PEP
Pre-exposure prophylaxis (PrEP) is the
use of drugs to prevent HIV in people
who have not yet been exposed. The
term typically refers to the use
of antiretroviral drugs as a strategy for
the prevention of HIV.
E.G. Sero-Discordant Couples, i.e. where
one partner is HIV positive
PEP (post-exposure prophylaxis) means
taking antiretroviral medicines (ART) after
being potentially exposed to HIV to
prevent becoming infected.
E.G. Needle Stick Injury

57. Where can I access treatment?

60. HIV Related Stigma & Discrimination
Lesson 7

61. https://www.spectator.co.uk/2014/04/why-id-rather-have-hiv-than-diabetes/
19th April, 2014

63. Key Populations & Stigma

64. India’s HIV/AIDS Prevention and
Control Act, 2017
• The requirement for HIV testing as a prerequisite for obtaining
employment or accessing health care is prohibited
• Every HIV-infected or affected person below the age of 18 will have the
right to live in a shared household, and enjoy household facilities
• Provision for appointment of an ombudsman by State/UT Governments to
address grievances related to violation of the Act and penal action in case
of non-compliance
• Provides an environment for enhancing access to health care services by
ensuring informed consent and confidentiality for HIV-related testing,
treatment, and clinical research. It also provides ground for penal action
for any health care provider, except a physician or a counsellor to disclose
the HIV positive status of a person to his or her partner
• Lists the various grounds on which discrimination against people living
with HIV is prohibited such as: (1) employment; (2) educational
establishments; (3) health care services; (4) residing or renting a property;
(5) standing for public or private office; (6) provision of insurance.