HIV/AIDS

Acquired Immuno Deficiency Syndrome (AIDS), a pattern of devastating infections caused by a virus, which attacks and destroys certain white blood cells that are essential to the body’s immune (defense) system. As the virus attacks and causes destruction and weakening of the body’s immune (defense) system it is known as Human Immunodeficiency virus (HIV). AIDS represents the late clinical stage of HIV infection.

In fact when HIV infects a cell, it may lie inactive for years and most of the people infected with HIV does not show any symptoms or may show only minor illness for 7-10 years. These people are infected with HIV, they can spread the infection to others but still they do not have AIDS.

Gradually the virus becomes activated and breaks down the human body’s natural defense mechanisms leaving it a prey to other opportunistic infections (among which TB is the most common) and other conditions including cancers that characterize AIDS.

Till now there is neither any vaccine to prevent the AIDS nor any treatment to cure AIDS, presently available treatment can only extend life. So for the moment prevention of transmission of infection remains the only method of control.

A History of HIV/AIDS

How HIV is transmitted ?

The main modes of HIV transmission are through sexual intercourse, blood and from mother to child transmission (MTCT). Worldwide the most common route of HIV transmission is through unprotected sexual intercourse. Using anal route, presence of other sexually transmitted diseases (STD) (such as genital ulcers and discharges) and having multiple sex partners increase the risk of transmission. The risk increases four-six-fold particularly in presence of genital ulcer disease e.g. syphilis, chancroid or herpes. Blood borne HIV transmission occurs through contaminated blood or blood product transfusion, injections with contaminated needles and syringes, and the use of non-sterile instruments for piercing of ear, nose or skin. HIV is also transmitted from infected mother to their children during pregnancy; during childbirth or even through breast-feeding, chance of HIV transmission through breast-feeding is small.

a) During unprotected sexual contact

b) Through transfusion of contaminated blood or blood products

c) While sharing contaminated needles and syringes for injecting drugs (used by HIV infected person

d) while using contaminated blade, razor or instruments for piercing ear, nose or skin

e) from HIV infected mother to child

How HIV is not transmitted ?

The lack of knowledge about how HIV is not transmitted can often lead to irrational fears and tendency to stigmatize or discriminate against people living with HIV/AIDS.

There is no evidence that HIV is transmitted through everyday contact, hugging or kissing, caring of AIDS patients, food or drink or bites of mosquitoes or other insects

Sharing Toilet

Sharing Swimming Pool

Mosquito Bite

Coughing / Sneezing

Hand Shake

Eating Together

Sharing Clothes

Kissing

Sharing Comb

Caring for Infected Person

Living Together in the family

How HIV transmission can be prevented ?

By practicing healthy life style in every aspect, HIV transmission can be prevented. Every religion has guided its followers how to lead a risk free and healthy life including sexual life (e.g. avoidance of premarital and extramarital sex, and avoidance of anal and oral sex).

Modern medical science also supports those guidelines. In addition to that medical science teaches us how to practice risk free medical care (e.g. sterilization of medical & surgical equipments and screening of blood before transfusion). Now it depends upon us: if we want to stop HIV transmission we must follow those guidelines and practice those teachings.

AIDS can be PREVENTED

By being mutually faithful to your partner
By using only HIV screened blood or blood products when required
By using new Needles, Syringes, Blades, Razor
By avoiding injectable drugs and needle sharing

By using a condom for safer sex ( condom prevents unwanted pregnancy and spread of HIV & STDs)

Things to remember regarding condom use

Use good quality condoms
Avoid using condoms which are dry/brittle, sticky, discoloured or date expired
Store condoms in a cool, dry place out of direct sunlight.
It is not the condom on its won- it is the appropriate use of condom that produces benefit to the users;

There is a great and urgent need to promote behaviours which enable the population to practice safer sex, and to provide services such as condoms, STD treatment, and safe blood supply.

Impact of HIV/AIDS

Available behavioural and seroprevalence data indicate the high potential for a generalized epidemic in this region if effective intervention could not be in place. Because in the absence of effective interventions, even a low to moderate growth scenario would make AIDS the leading cause of death in the most productive age group (15-49) over the coming years. A generalized epidemic with high mortality in this age group would start a “vicious circle”. The impact of HIV/AIDS would increase poverty and vulnerability. Consequence of increased vulnerability would be more HIV infections and a higher impact. Besides the negative impact on socio-economic development and the loss of productive life, the burden of disease would put further stress on the health sector and local communities.

Impact of HIV on TB epidemiology and TB control

HIV increases the risk of infection with TB bacilli and when a person is infected with TB bacilli, HIV increases the progression of TB infection to disease. Evidence suggests that when a person is infected with TB bacilli only, his life time risk of developing TB disease is 5- 10 % but when the is infected with both TB bacilli and HIV virus, his life time risk of developing TB disease would be 50-60 %. As result there will be increased number of TB patients who will again transmit the disease to the community and health services will have to struggle to cope with the large and rising numbers of TB patients. This will lead to inadequate supervision of anti-TB chemotherapy, low cure rates, high mortality rates during treatment, high default rates because of adverse drug reaction and also due to lack op supervision, high rates of TB recurrence and increased emergence of drug resistance.

Impact on Health care services

With the increase number of AIDS patients health care cost will also increase and it will put added pressure to the already fragile health care services. Today’s HIV infected people will progress to HIV disease- the AIDS and will occupy the beds of already overburdened hospitals. HIV associated TB patients will also put additional burden on hospital services. The growing number of AIDS orphans and widows may create serious strain on social safety net programmes.

Social & Economic impact

HIV /AIDS is not just a health problem; it has grave social and economic consequences as well.

AIDS is primarily a sexually transmitted disease; it mainly strikes adolescents, young adults and those in early middle age, killing the very people on whom society relies for production and reproduction.
AIDS kills people in the prime stage of life, people who labour in the field and factories, who run important services like schools, hospitals, corporations and governments.
Growing absenteeism and replacements (usually by unskilled ones) due to death from AIDS among the workforce strike at the root of industrial productivity and profitability.
Actually HIV/AIDS is an important issue for workplace and challenge for development. See the box below:

How HIV/AIDS affects economic growth and social Development in work place

Reduced supply of labour
Loss of skilled and experienced workers
Absenteeism and early retirement
Stigmatization and discrimination against workers with HIV
Increased labour costs for employees, from health insurance to retraining
Reduced productivity leading to negative impact on economic growth
Social protection systems and health services under pressure
Loss of family income and household productivity, exacerbating poverty
Early entry of children into active employment
Pressure on girls and women to resort to providing sexual favours in order to survive

By the year 2000, the overall cost of on account of AIDS was estimated at US$ 11billion in India.

Impact on households/families

Toll of HIV/AIDS on households can be very severe:

Presence of HIV/AIDS will dissolve the family. As parents die children are sent to relatives for care and upbringing.
Loss of Family income: affected person cannot earn. Others person also has to divert more time and effort away from income generating activities.
Care related expenses and expense after death (funeral expense) push affected house deeper into poverty.
Household suffer from food security
Children (especially the girls) are removed from schools because of inability to bear the expenses of education and also to take care of the affected parents.