HIV/AIDS: AN OVERVIEW
National prevalence |
14% |
HIV infected over |
2 million |
HIV orphans |
1 million |
Deaths due to HIV infection |
1.5 million |
Mean and women affected equally BUT |
|
Infection in girls reach a peak at an earlier |
age (15-29) than boys (25-35) |
Top 15 sub-Saharan countries (1999)
Botswana |
35.8% |
Swaziland |
25.25% |
Zimbabwe |
25.06 |
Lesotho |
23.57% |
Zambia |
19.95 |
S.Africa |
19.94% |
Namibia |
19.54 |
Malawi |
15.96 |
Kenya |
13.95 |
Central African Rep |
13.84 |
Mozambique |
13.22 |
Djibouti |
11.75 |
Rwanda |
11.21 |
Burundi |
11.32 |
Cote d’Ivoire |
10.76 |
Global HIV/AIDS epidemic (2000)
Adults and children living with HIV/AIDS |
36.1 m |
Adults |
34.5m |
Children below 15 years |
1.6 m |
People yearly infected with HIV |
5.4 m |
Total AIDS deaths since beginning of epidemic |
18.8 m |
Adults |
15.0 m |
Children |
3.8 m |
Over 70% of the infections are in the sub-Saharan Africa |
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
AIDS in Kenya, socio economic impact and policy implication; by U.S.A.I.D through FHI AIDSCAP
The impact of HIV/AIDS; by Wycliff Humphrey Odiwuor c/o Institute for International Education, Stockholm University, Sweden.
A comprehensive Guide for holistic care; CANADIAN ASSOCIATION OF NURSES IN AIDS CARE MODULE 3 – NURSING CARE
National AIDS manual on nutrition; by Cathy Hodgson, Clare Shadling & Keith Alcorm, British Dietetic Association, kings College Hospital, London.
Essence of effective communication; by Ron Ludlow & Fergus Panton
AIDS care volume 12, No.3 June 2000; by J. Catalan, B. Hedge, B. Coleman
Action for children Affected; by AIDS by WHO/Unicef
AIDS/STD Education & counselling in Africa; An AIDSTECH publication by FHI, USA
A Healthy Diet for better Nutrition; NAP publication, by Maguette Ndiaye, Nutrition Consultant, Dakar, Senegal |
