Thursday, December 2, 2010

HIV transmission and testing

There are several ways in which one can get infection with HIV. It is very important to know the routes of HIV transmission. This will help us to avoid the spread of HIV. In other words, understanding how HIV passes from one person to another will enable us to protect ourselves. Various types of sexual activity and the risks involved in transmitting HIV during those acts. This is the most common form of sexual activity. Transmission of HIV from men to women and from women to men is well documented.
         Male to male transmission through anal intercourse occurs at the rate of one infection per 10 sexual acts. Usually penile-anal activity is not recommended even between a mutual faithful husband and wife on health grounds. It is against dignity for the man to force his wife to agree for penile-anal sex against her will. Virous is shed in the saliva. Almost half thr populations in most urban areas live in slums which comprise a small room without any privacy and safety. Husband and wife hardly talk to each other on sex and sexuality.
        Unlike several permissive societies in the world, the percentage of  homosexuals and lesbians in India are very insignificant. Kissing has been shown to pose a risk of transmission. It is always risky to have sex with Commercial Sex Workers (CSWs) in India. Reports indicate that most of the sex workers suffer from STDs and a large number of CSWs are also found to be HIV infected across the country. Different types of practices are grouped under four categories. Unsafe practices with high risk, unsafe practices with unclear risk, low risk practices with some risk an practices with probably no risk.
     There are various categories of persons who are vulnerable to HIV infection through sexual contacts. In every culture, and society one does come across sex workers. They are mostly women who sell their bodies for a price (money). Some men may also involve in male prostitution. Often they have to provide sexual satisfaction to several men in a day. Call girls are those who live a more comfortable life. They usually serve customers in their homes or hotels and earn handsome amount. Some sex sexual relationship are very high-risk activities. In case of anal sex, penetration becomes painful for both active and passive partners, as the anus can not receive an erect penis.
      There are some documented cases from various parts of the world where HIV has been transmitted through artificial insrmination. People who donate sperm can also pass on HIV if they are infected. There are several sperm banks located in various parts of the country. There are also reports of students from professional colleges and educational institutions who donate sperm for making additional posket money. HIV reproduces itself in the CD4 lymphocytes which circulate in the blood and other body fluids. All the forms of exposure to HIV, blood transfusion is the most effective means of transmitting the virus from person to person.
       Blood that is collected fromm a donor can be separated into different components using a cell seprator. HIV can be transmitted through infected organs. HIV is found in the blood as well as the tissue of an infected organ. Since an infected person's body fluids contain HIV it is essential that screening for HIV is carried in cases of organ transplantation of any kind such as kidney, bone marrow,  eyes, skin, semen etc. Patients who suffer from various blood disorders like various types of anemia, especially Thalassemia or Leukemia require multiple transfusions. Injecting drug users are potential channel for transmission of HIV. In India, injecting drugs users have a high incidence of the infection.
      The drug addicts often sell their blood to purchase drugs. The Supreme Court of  India has banned professional blood donation in the country. Blood donations and blood banks were started in India since 1941. During this period, the Second World War was in full swing. Today there are over a thousand registered blood banks all over the country. 75 percent of the Indian population lives  in villages. Blood is an essential component of the body which provides sustenance to life. The blood trade flourishes with poor people like unemployed, rickshaw pullers, and drug addicts selling their blood. The blood banks presently thrive on bleeding 4000 to 5000 regular professional donors in 18-20.

Wednesday, December 1, 2010

Basic facts about HIV/AIDS

The first case of HIV infection was reported in 1981 among the homosexuals in the United States of America. In India, HIV was first reported in 1986 among commercial sex workers from Chennai. The recent report from the joint United Nations programme of HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) estimated 37.8 million adults and 2.1 million children with HIV infections as on December 2003. The widespered prevalence of HIV/AIDS has to be seriously considered for any type of public health program. In 1990's, AIDS became an issue of global concern. In 1992, in Europe, most of the cases were reported from France, Spain, Germany and the United Kingdom. Certain coutries had higher retes of AIDS like Switzerland (65cases), France (66) and Spain (67  cases).
          HIV/AIDS epidemic has killed over 20 million people since the first case of AIDS was identified in 1981. The large populous countries of China, India, and Indonesia are of particular concern. Globally nearly half of all persons infected between the ages of 15-49 years are women. The report also affirms that HIV is still a challenge in industrialized countries due to the unsafe sexual behaviour of gay men. We shall focus on situation of HIV/AIDS with specific references to the various international regions. It is a home for 60 percent of HIV infected in the world. HIV in Africa has became a generalized epidemic. It is no longer confind to high risk groups. In Oceania an estimated 74000 people (45000-120000) are living with HIV. Although less than 4000 people are believed to have died of  AIDS in 2005, about 8200 persons are thought to have become newly infected with HIV.
        Diverse HIV epidemic are under way in Eastern Europe and Central Asia. About 1.6 million people (range: 920000-2.1 million) were living with HIV at the end of 2005, compared to about 160000 in 1995. Among young people aged 15-24, 0.6% of women (range: 0.4-0.8%) and 1.3% of men (range: 0.9-1.8%) were living with HIV by the end of 2003. A striking feature is the low age of those infected. More than 80% of HIV-positive people in this region are under 30 years of age . Bangladesh, the risk behaviour to acquire HIV infection is increasing. More men indulge in sex with commercial sex workers. Intravenous drug use is also increasing. A similar situation also prevails in Pakistan. Among young people 15-24 years of age, 0.4% of women and 0.6% of men (range:0.6-0.9%) were living with HIV in 2005 which was transmitted heterosexually. In western Europe, the number of reported deaths among AIDS patients also continued to decline-from 3373 in 2001 to 3101 in 2002.
      Data suggest that there have been some dramatic changes in the shape of Cambodia's epidemic. The incidence of new infection among both brothel based and non-brothel based sex workers as well as their clients showed a decrease by half between 1999 and 2002 and HIV prevalence among the former dropped from 43.1% in 1998 to 21% in 2003. In Thailand, the number of new infections has fallen from a peak of around 140000 a year in 1991, to around 21000 in 2003. However, Thailand's epidemic has been changing over the years. In Bangkok, over 15% of men who have sex with men who were tested in a 2003 study were HIV-positive, and 21% had not used a condom with their last casual partner. According to the Population Division of the United Nations, life expectancy at birth in Southern Africa was 59 years in the 1990's.
       HIV's impact on adult mortality is greatest on people in their twenties and thirties, and is proportionately larger for women than men. HIV is not evenly distributed throughout populations. Instead it primarily affects young adults, particulary women. The epidemic's impact on women and girls is especially marked. This means they bear the largest AIDS burden. Families may withdraw young girls from school to care for family members infected with HIV. In some of the worst-affected countries, before the AIDS epidemic even started having an adverse economic impact, the living standards of the poor were already deteriorating markedly. AIDS causes the loss of income and production of an HIV infected household member. AIDS creates extraordinary care needs that must be met (usually by withdrawing other household members from school or work to care for the sick).
    The epidemic's impact on education has far reaching implications for long-term development. Globally, AIDS is a significant obstacle to children achieving universal access to primary education by 2015. The epidemic weakness the quality of training and education, which means fewer people benefit from good standard school and university education. It also accelerates the impact of a pre-existing professional 'brain drain'. Many AIDS affected families may withdraw children from school to compensate for labour losses, increased care activities and competing expenses. Education quality may also suffer as more teachers succumb to the disease.