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BASIC INFORMATION ON HIV

What is HIV?

HIV means Human Immuno-deficiency Virus. It is a virus that destroys the human immunity (defense) system making the body vulnerable to all infections.

What is AIDS?

AIDS stands for Acquired Immuno-deficiency Syndrome. AIDS occurs 3-10 years after HIV infection when the human immunity system becomes severely weakened. This leads to various lives threatening conditions commonly referred to as opportunistic infections/diseases.

HIV/AIDS TRANSMISSION

·         Mother-to-child transmission (MTCT-10%)

·         Blood and blood products (10%)

§         Transfusion

§         Cultural practices

§         Invasive procedures

·         Sexual contact (80%)

§         Heterosexual

§         Homosexual

§         Lesbianism

Factors influencing spread

·         Socio cultural beliefs and practices

·         Socio economic factors

·         Presence of other STI's/STDs

·         Behaviour change influences e.g. drugs, alcohol

·         Unprotected penetrative sex

 How HIV is NOT spread

·         Living in the same household with an infected person

·         Shaking hands or hugging

·         Touching shared foods, plates and cups

·         Using the same public transportation

·         Insects bites like mosquitoes and bedbugs

·         Sharing bathrooms and toilets

Vulnerable groups to HIV infection

·         Youth: having sexual intercourse before sexual organs mature

·         People with high numbers of sexual partners, CSW.

·         People separated from regular sexual partners for long periods e.g. nature of employment, long distance truck drivers and uniformed personnel.

·         Women: sexual abuse of women and children

·         Poor negotiating skills for safer sex in marriage

What makes people vulnerable

·         Deliberate denial- refusing to admit there is a fatal disease spreading through behaviour patterns.

·         Being uninformed and or misinformation e.g. the incubation period and how long one can live with the infection.

·         Lack of education and access to information

·         Men and women on the margins; prisons, CSW and their clients, drug users etc

·         Young girls; gender, biological, cultural and economic factors

·         Violence against women

§         Violence at home

§         Sexual abuse of women and children

 Prevention of HIV/AIDS

·         Behaviour change interventions for those most likely to contract or transmit HIV (ABCs of Safer Sex)

·         Messages to combat HIV stigma and discrimination

·         Management and control of STDs

·         Control and or management of opportunistic infections

·         Voluntary Counseling and Testing (VCT).

·         Improvement of TB management

·         Prevention of mother-to-child transmission (PMTCT).

·         Home Based Care (HBC) for PLWHAs

·         Baseline risk behaviour studies e.g. sexual and cultural practices

1. SEXUAL TRANSMISSION

·         Primary abstinence – delay onset of sexual Intercourse

·         Abstinence

·         Being faithful to one un-infected partner

·         Condom use if one has more than one sexual   partner

2. PREVENTION OF MOTHER-TO-CHILD TRANSMISSION

·         Infected pregnant mothers have 30-40% chance of infecting their babies

·         Currently more than 100,000 children are living with HIV/AIDS in Kenya.

·         Transmission; ante-natal period, during labour or through breast feeding

·         All babies from infected mothers will have a positive antibody test at birth

Approaches for PMTCT

·         Counseling HIV+ women against becoming pregnant

·         Counseling HIV+ women not to breast feed their babies (consider poverty and hygiene)

·         Elective Caesarean Section to avoid risks

·         Use of anti-retrovirals – Nevirapine reduces 50-70% MTCT (Administered before onset of labour). One dose to the baby.

·         Routine haematenics supplements

·         Screen and treat STDs in pregnancy

·         Provide Malaria chemo-prophylaxis in endemic areas

·         Reduce maternal viral load using recommended anti- retroviral regimes.

·         Promote VCT before marriage and in pregnancy

·         Ensure HIV+ women have access to FP services

 PMTCT – breast milk transmission

·         Avoid breast feeding completely

·         If the mother opts to breast feed: -

• Encourage exclusive breast-feeding
• Ensure abrupt weaning
• Avoid mixed feeding
• Reduce duration of breastfeeding when mother has breast diseases
• Treat oral thrush or mouth ulcers in baby

 Bibliography

o  AIDS in Kenya, socio economic impact and policy implication; by U.S.A.I.D through FHI AIDSCAP

o      The impact of HIV/AIDS; by Wycliff Humphrey Odiwuor c/o Institute for International Education, Stockholm University, Sweden.

o    A comprehensive Guide for holistic care; CANADIAN ASSOCIATION OF NURSES IN AIDS CARE MODULE 3 – NURSING CARE

o        National AIDS manual on nutrition; by Cathy Hodgson, Clare Shadling & Keith Alcorm, British Dietetic Association, kings College Hospital, London.

o        Essence of effective communication; by Ron Ludlow & Fergus Panton

o        AIDS care volume 12, No.3 June 2000; by J. Catalan, B. Hedge, B. Coleman

o        Action for children Affected; by AIDS by WHO/Unicef

o        AIDS/STD Education & counselling in Africa; An AIDSTECH publication by FHI, USA

o        A Healthy Diet for better Nutrition; NAP publication, by Maguette Ndiaye, Nutrition Consultant, Dakar, Senegal

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Last updated: 04/18/06.