June 2012 HIV & AIDS-2 - MK-2012

PowerPoint Presentation: 

Dr Munawar Bcc SACP ENHANCED HIV/AIDS CONTROL PROGRAM Health Department, Govt. of Sindh Awareness Event For Health Sectors Professionals

PowerPoint Presentation: 

Dr Munawar Bcc SACP

HIV/AIDS: 

Dr. M. MUNAWAR KHAN PROVINCIAL BCC COORDINATOR ENHANCED HIV/AIDS CONTROL PROGRAM Health Department, Govt. of Sindh HIV/AIDS Dr Munawar Bcc SACP

ENHANCED HIV/AIDS CONTROL PROGRAM SINDH: 

ENHANCED HIV/AIDS CONTROL PROGRAM SINDH Dr Munawar Bcc SACP

Sindh AIDS Control Program: 

Sindh AIDS Control Program Objectives To create awareness of the seriousness of the disease Ensure that people of Sindh are equipped with knowledge and tools to protect themselves Reduce transmission of HIV and other STI infections through blood and blood products In case of infection, the patient should be encouraged to seek treatment Dr Munawar Bcc SACP

Infra Structure and Services on Ground : 

Infra Structure and Services on Ground Provincial Implementation UNIT (PIU) At I. I Depot, Rafique Shaheed Road near JPMC. Referral Lab Established for laboratory diagnosis and confirmation of HIV/AIDS Cases & Sexually Transmitted Infections. Voluntary Counseling & Testing centers 21 VCT Centers have been Established for screening of HIV/AIDS cases STIs clinics 46 STIs Clinics have been Established at teaching and DHQ hospitals for management of STI,s Establishment of Resource Center With Facilities of Digital Library. For trainees and projects staff PPTCT Centers 03 ( Prevention of Parents to Child Transmission ) Dr Munawar Bcc SACP

PPTCT Centers of Pakistan: 

Tertiary Hospitals: PIMS- Islamabad HMC- Peshawar Lady Wallingdon - Lahore Services- Lahore Civil- Karachi Qatar- Karachi Shaikh Zaid Hospital Larkano Sindamon - Quetta (nonfunctional) District Headquarter Hospitals: DHQ Hospital, Gujrat DHQ Hospital, DG Khan PPTCT Centers of Pakistan Dr Munawar Bcc SACP

Origin of HIV: 

Origin of HIV Dr Munawar Bcc SACP

African Simean [Green] Chimpanzee: 

African Simean [Green] Chimpanzee Dr Munawar Bcc SACP

PowerPoint Presentation: 

HIV came from a similar virus found in chimpanzees - SIV. HIV probably entered the United States around 1970 CDC in 1981 noticed unusual clusters of Kaposi’s sarcoma in gay men in NY and San Francisco, which led to the disease to be called GRID (Gay Related Immune Deficiency). By 1982 the disease was apparent in heterosexuals and was renamed AIDS (Acquired Immune Deficiency). Dr Munawar Bcc SACP

1981 History : 

1981 History 8 cases of KS among young gay men June 5, 1981: 5 cases of PCP( Pneumocystis Pneumonia ) in gay men Los Angeles, San Francisco and New York, who had developed PCP ... from UCLA (MMWR) Dr Munawar Bcc SACP

Key Dates in History of HIV Testing: 

Key Dates in History of HIV Testing 1981: First AIDS case reported 1984: Human immunodeficiency Virus (HIV) identified 1985: First test for HIV licensed (ELISA) 1987: First Western Blot blood test kit 1992: First rapid test 1993: CDC releases updated guideline on HIV testing 1994: First oral fluid test 1995: viral load testing available 1996: First home and urine tests 2002: First rapid test using finger prick 2003: Rapid finger prick test granted CLIA waiver 2004: First rapid oral fluid test (also granted CLIA waiver) 2006: CDC releases new U.S. guidelines recommending routine HIV screening of all adults in health care settings. * *Kaiser Family Foundation HIV/AIDS Policy Fact Sheet, June 2006. www.kff.org

PowerPoint Presentation: 

I n the period October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died. All 5 patients had laboratory-confirmed previous or current cytomegalovirus (CMV) infection and candidal mucosal infection. Morbidity and Mortality Weekly Report (MMWR) MMWR SEARCH Dr Munawar Bcc SACP

PowerPoint Presentation: 

Global summary of the AIDS epidemic  2009 33.3 million 30.8 million 15.9 million 2.5 million 2.6 million 2.2 million 370 000 1.8 million 1.6 million 260 000 Number of people living with HIV People newly infected with HIV in 2009 AIDS deaths in 2009 Total Adults Women Children (<15 years) Total Adults Children (<15 years) Total Adults Children (<15 years)

PowerPoint Presentation: 

Over 7000 new HIV infections a day in 2009 About 97% are in low and middle income countries About 1000 are in children under 15 years of age About 6000 are in adults aged 15 years and older, of whom: ─ almost 51% are among women ─ about 41% are among young people (15-24)

PowerPoint Presentation: 

Dr Munawar Bcc SACP

PowerPoint Presentation: 

HIV/AIDS in Pakistan Pakistan is going through a transition of the HIV epidemic; from a low Prevalence state to a concentrated epidemic. Although the estimated prevalence among the general population is less than 0.1% in the country, Recent surveillance results clearly indicate that the epidemic is becoming established among certain high risk groups (HRGs). Dr Munawar Bcc SACP

Epidemic: 

Epidemic HIV epidemic is still considered ‘low’ or ‘concentrated,’ confined mainly to individuals who engage in high risk behaviors, An epidemic is considered ‘ concentrated ’ when less than one per cent of the general population but more than five per cent of any ‘high risk’ group are HIV-positive An epidemic is considered ‘ generalized’ when more than one per cent of the population is HIV-positive. Dr Munawar Bcc SACP

PowerPoint Presentation: 

Pakistan’s HIV epidemic At present the most prominent face of Pakistan’s HIV epidemic are the IDUs. In this regards, Pakistan is following the Asian Epidemic Model , where the HIV epidemic first establishes among IDUs and then spreads to the rest of the population via sex workers who have sexual contact with IDUs. Dr Munawar Bcc SACP

SUGGESTIVE HISTORY & RISK FACTORS: 

SUGGESTIVE HISTORY & RISK FACTORS RISK FACTORS/RISK BEHAVIOURS People with multiple sexual partners People with recent or prior STDs Commercial sex workers & their partners Homosexuals Travelers to high prevalence areas Sexually active injection drug users Sexual partners of at risk persons Recipients of blood products prior to HIV screening Children born to HIV positive mothers Dr Munawar Bcc SACP

But HIV/AIDS does not discriminate: 

But HIV/AIDS does not discriminate Everybody is vulnerable. The virus is not restricted to any age group, race, social class, gender, or religion. In many countries of Asia and the Pacific HIV/AIDS has spread to the general population. Dr Munawar Bcc SACP

PowerPoint Presentation: 

A combination of risk factors is currently putting Pakistan at serious risk of further transmission from high to low risk groups through bridging populations. Pakistan’s HIV epidemic Dr Munawar Bcc SACP

Example of high risk sexual networks in a population: 

Example of high risk sexual networks in a population FSW Male Clients IDU General Population Women MSW

PowerPoint Presentation: 

Dr Munawar Bcc SACP

HISTORY OF HIV IN PAKISTAN : 

HISTORY OF HIV IN PAKISTAN 1986 – An African Sailor Died in Karachi 1987 – First Pakistani Citizen Diagnosed with AIDS in Lahore 1987 – First Husband-Wife-Child transmission of HIV occurred in Rawalpindi 1993 – First Breastfed Baby gets AIDS in Karachi 2003 First outbreak among Injecting Drug Users was identified in Larkano Dr Munawar Bcc SACP

HIV & AIDS in Pakistan : 

HIV & AIDS in Pakistan ( 2 nd Quarter 2010 ) Total Estimated Cases = 106000 Total reported HIV & AIDS cases in the country are = 7574 HIV Positive – 7049 AIDS Cases – 525 Dr Munawar Bcc SACP

HIV/AIDS IN SINDH PAKISTAN: 

HIV/AIDS IN SINDH PAKISTAN Dr Munawar Bcc SACP

SINDH: 

SINDH Upto March 31,2012 TOTAL CASES = 4704 HIV Asymptomatic Cases= 4499 Male = 4229 93.99% Child = 28 0.62% Female = 221 4.91% Child = 21 0.46% AIDS CASES = 205 Male = 174 (84.87%) Child = 01 (0.48%) Female = 29 (14.14%) Child = 01 (0.48%) Dr Munawar Bcc SACP

DEATH CASES TILL 31st March, 2012: 

DEATH CASES TILL 31 st March, 2012 DEATH = 157 Male = 139 88.5% Child = 02 1.27% Female = 10 6.36% Child = 06 3.82% Dr Munawar Bcc SACP

DECEMBER 2011 4th Round: 

DECEMBER 2011 4 th Round Sindh is in the concentrated phase of epidemic among : IDU’s = 42% Hijra Sex workers =15.45% Dr Munawar Bcc SACP

IDU’S: 

IDU’S Dr Munawar Bcc SACP

HIV/AIDS Surveillance Round – 2 & 3 results: 

HIV/AIDS Surveillance Round – 2 & 3 results Karachi Hyderabad Sukkur Larkana 2007 2008 2007 2008 2007 2008 2007 2008 Injecting Drug Users 30.1% 22.9% 29.8% 30.4% 5.3% - 16.5% 27.6% Female Sex Workers 0% - 0.2% - 0% - 0% - Hijras Sex workers 2.9% 3.6% 2% - 0% - 14% 27.3% Male Sex Workers 7.5% 2.9% 0% - 0% - 2.5% 0.5%

HIV/AIDS Surveillance Round-4 results: 

HIV/AIDS Surveillance Round-4 results IDU MSW HSW Total FSW HFSW BFSW SFSW KKFSW Beg FSW MFSW Karachi Total Tested 361 353 351 392 131 30 75 96 30 30 Positives 151 20 41 7 6 0 0 1 0 0 % Positives 42 6 12 2 5 0 0 1 0 0 Larkana Total Tested 363 359 373 378 285 47 19 27 0 0 Positives 68 11 53 7 1 2 2 2 0 0 % Positives 19 3 14 2 0 4 11 7 0 0 Sukkur Total Tested 334 209 166 178 125 0 33 20 0 0 Positives 58 1 6 1 0 0 1 0 0 0 % Positives 17 0 4 1 0 0 3 0 0 0 Dadu Total Tested 150 0 0 0 0 0 0 0 0 0 Positives 24 0 0 0 0 0 0 0 0 0 % Positives 16 0 0 0 0 0 0 0 0 0

AIDS: 

AIDS Dr Munawar Bcc SACP

Is HIV & AIDS the same thing ?: 

Is HIV & AIDS the same thing ? Dr Munawar Bcc SACP

PowerPoint Presentation: 

H I V Human Immunodeficiency Virus Dr Munawar Bcc SACP

HIV: 

HIV “ Human Immunodeficiency Syndrome” A specific type of virus (a retrovirus) HIV invades the helper T cells to replicate itself. No Cure Dr Munawar Bcc SACP

HIV ?: 

HIV ? HIV is different from most other viruses because it attacks the immune system The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell WBC (T cells or CD4 cells) that the immune system must have to fight disease. People can live a long healthy life with HIV without symptoms, even without medications. Once the immune system begins to break down over time, and the person develops more symptoms, This often means they have progressed to AIDS.

PowerPoint Presentation: 

Caused by immune deficiency virus HIV-1 HIV-2 Dr Munawar Bcc SACP

Genetic Subtypes of HIV: 

Genetic Subtypes of HIV Groups : HIV 1 , HIV 2 Genetic subtypes : Groups : HIV 1 - M(main),O(outlier),N (new) Subtypes( clades ) M(11 subtypes A-I,CRF) HIV 2 —Six subtypes A-F Dr Munawar Bcc SACP

PowerPoint Presentation: 

Dr Munawar Bcc SACP

PowerPoint Presentation: 

Dr Munawar Bcc SACP

PowerPoint Presentation: 

Dr Munawar Bcc SACP

DIFFERENCE B/W HIV-1 & HIV-2: 

DIFFERENCE B/W HIV-1 & HIV-2 HIV-1 and HIV-2 are closely related, they are thought to have jumped from primates to humans at different times (and from different species). HIV-1 is more easily transmitted , it also spreads more readily and therefore accounts for the vast majority of global HIV infections. HIV-2, is much less transmittable , is largely confined to West Africa (where it is thought to have originated) and to West African migrant communities in Europe. Dr Munawar Bcc SACP

DIFFERENCE B/W HIV-1 & HIV-2: 

DIFFERENCE B/W HIV-1 & HIV-2 HIV-1 also mutates more efficiently that HIV-2 and generally progresses to AIDS at a significantly faster rate than HIV-2 does. Also, HIV-2 has Vpr and Vpx proteins. HIV-1 has only Vpr . Differences between these proteins are actually on research. Dr Munawar Bcc SACP

HIV-1 and HIV-2 Infections: 

HIV-1 and HIV-2 Infections HIV-2 has the same genetic organization as HIV-1 but there are significant differences in the envelope glycoprotein Similar diseases associated with both HIV-1 and HIV-2 but most west Africans remain asymptomatic Progression from HIV to AIDS is faster in HIV-1 as compared to HIV-2, either it is less pathogenic or it has a long period of latency HIV-2 infected children have far better survival rates Dr Munawar Bcc SACP

VIROLOGY / LIFE CYCLE: 

VIROLOGY / LIFE CYCLE HIV is a retrovirus belonging to the family of Lentivirus Able to use the RNA and the host DNA to make viral DNA Long incubation period/Clinical latency Dr Munawar Bcc SACP

PowerPoint Presentation: 

THE HIV LIFE CYCLE CONTINUOUS VIRAL REPLICATION LEADING TO IMMUNODEFICIENCY IS THE HALLMARK OF THE DISEASE!! Dr Munawar Bcc SACP

The Immune System T Cells (CD4 Cells) = Part of body’s immune system : 

The Immune System T Cells (CD4 Cells) = Part of body’s immune system ! CD4 The average person has between 800 & 1500 CD4 cells per cubic millimetre of blood The immune system helps fight diseases Disease CD4 Disease KILLS DISEASE IMMUNE SYSTEM ATTACKS DISEASE Dr Munawar Bcc SACP

HIV and the Immune System : 

HIV and the Immune System When HIV enters the body it must enter a cell to live and reproduce. The HIV virus attacks CD4 cells, eventually killing them The newly produced HIV then moves into new CD4 cells and infects them. The body’s immune system tries to replace the lost CD4 cells, but over time it is unable to keep these levels up. HIV HIV HIV HIV CD4 HIV HIV Enters CD4 Cells HIV Replicates Kills CD4 Cells CD4 Dr Munawar Bcc SACP

HIV-Infected T-Cell: 

HIV-Infected T-Cell HIV Virus T-Cell HIV Infected T-Cell New HIV Virus Dr Munawar Bcc SACP

PowerPoint Presentation: 

VIROLOGY gp 120 & gp 41 have the major role to recognize CD 4 cells thus promoting attachment Dr Munawar Bcc SACP

HIV Replication: 

HIV Replication HIV is a retrovirus . Viral envelope protein gp120 and gp41 attach to the CD4 antigen complex on host cells CD4 found on T helper lymphocyte,B lymphocytes, monocytes and tissue macrophages . HIV uses RT to convert RNA to DNA HIV DNA enters nucleus of CD4 cell and integrates into host DNA. HIV DNA instructs cell to make copies of original virus . New virus particles are assembled and leave cell, ready to infect other CD4 cells.

PowerPoint Presentation: 

Dr Munawar Bcc SACP Dr Munawar Bcc SACP

PowerPoint Presentation: 

Reverse Transcriptase Inhibitor (red) Translation: RNA -> Proteins Viral Protease Protease Inhibitors Assembly and Budding Viral RNA yellow , DNA blue Attachmen t Entry of the Viral RNA Reverse Transcription Integration of Viral DNA Transcription: Back to RNA

HIV Transmission: 

HIV Transmission HIV enters the bloodstream through: Open Cuts Breaks in the skin Mucous membranes Direct injection Dr Munawar Bcc SACP

MODES OF TRANSMISSION: 

MODES OF TRANSMISSION Blood/Blood products, tissues, organs- More than 90% Sexual Intercourse - 0.1 to 1% (however frequency is high causing high rate of infection) IDU – 0.5 to 1 % Parent to child – 30%

HIV Modes of Transmission: 

HIV Modes of Transmission Sexual Infected blood and blood products Mother to Child Dr Munawar Bcc SACP

HIV Modes of Transmission Cont’d…: 

HIV Modes of Transmission Cont’d… 1.Sexual: Through sex with infected man or woman. Transmit by Heterosexual & Homosexual and Bisexual Practice Ulcerative STIs increases the risk of infection several folds Dr Munawar Bcc SACP

HIV Modes of Transmission Cont’d…: 

2. Infected blood and blood products Contaminated Blood/Blood Products transfer Organ/Tissue Transplants Use of Contaminated Syringes and Needles Tattooing Ear piercing etc. HIV Modes of Transmission Cont’d… Dr Munawar Bcc SACP

HIV Modes of Transmission Cont’d…: 

HIV Modes of Transmission Cont’d… 3. From mother to child (Vertical) Before Birth During Birth Postpartum After the birth Dr Munawar Bcc SACP

HIV/AIDS: 

HIV/AIDS Dr Munawar Bcc SACP

Press ad Option 1: 

Press ad Option 1 Dr Munawar Bcc SACP

HIV Transmission cont’d…: 

HIV Transmission cont’d… Common fluids that are a means of transmission: Blood Semen Vaginal Secretions Breast Milk Saliva Dr Munawar Bcc SACP

How you catch up HIV?: 

How you catch up HIV? HIV do spread in full sexual Intercourse that include penetration to female vagina or the rectum without the use of Condom, and that’s because its lives within the human fluids, as mention above . HIV also do spread by using common needle, because AIDS lives in the blood, due to that fact, drugs addict are extremely vulnerable for HIV infection . HIV is spreading by a breast feeding, because it can live within mother milks. Dr Munawar Bcc SACP

PowerPoint Presentation: 

? How can you get HIV? BREAST MILK VAGINAL SECRETIONS BLOOD SEMEN CERVICAL SECRETIONS 2. Through these acts: H INFECTED MOTHER: DURING 1. PREGNANCY 2. BIRTH 3. BREAST FEEDING UNPROTECTED PENETRATIVE INTERCOURSE (HOMOSEXUAL OR HETEROSEXUAL) WITH SOMEONE WHO IS INFECTED 1. INJECTION OR TRANSFUSION OF INFECTED BLOOD / BLOOD PRODUCTS 2. SHARING UNSTERILISED NEEDLES WITH SOMEONE WHO IS INFECTED 1. Through these bodily fluids Dr Munawar Bcc SACP

HIV in Body Fluids: 

HIV in Body Fluids Semen 11,000 Vaginal Fluid 7,000 Blood 18,000 Amniotic Fluid 4,000 Saliva 1 Average number of HIV particles in 1 ml of these body fluids Dr Munawar Bcc SACP

Body fluids & risk of exposure : 

Body fluids & risk of exposure High Low Poorly defined Blood/serum Cervical Amniotic fluid Semen Emesis CSF Sputum/phlegm Feces Pleural fluid Vaginal secretions Saliva Peritoneal fluid Sweat Pericardial fluid Tears Synovial fluid Urine Dr Munawar Bcc SACP

PowerPoint Presentation: 

RISK OF TRANSMISSION AFTER EXPOSURE 95% for blood and blood products 15-40% for vertical transmission 0.5% -1.0% for injection drug use 0.2-0.5% for for genital mucous membranes < 0.1% for non genital mucous membranes Needle stick injury : 1 in 300 World wide major route of transmission Heterosexual(70%) Dr Munawar Bcc SACP

Estimated PPTCT Rates: 

Estimated PPTCT Rates Without intervention During pregnancy 5–10% During labour and delivery About 15% During breastfeeding 5-20% MTCT infection rates = up to 40% Dr Munawar Bcc SACP

HIV Routes of Transmission: 

HIV Routes of Transmission Sexual Contact: Male-to-male Male-to-female or vice versa Female-to-female Blood Exposure: Injecting drug use/needle sharing Occupational exposure Transfusion of blood products Perinatal: Transmission from mother to baby Pregnancy, delivery and breastfeeding Dr Munawar Bcc SACP

HIV Infection and Antibody Response : 

HIV Infection and Antibody Response Infection Occurs AIDS Symptoms ---Initial Stage---- ---------------Intermediate or Latent Stage-------------- ---Illness Stage--- Flu-like Symptoms Or No Symptoms Symptom-free < ---- ---- Dr Munawar Bcc SACP

Natural History of HIV Infection: 

Natural History of HIV Infection Dr Munawar Bcc SACP

Window Period: 

Window Period This is the period of time after becoming infected when an HIV test is negative 90 percent of cases test positive within three months of exposure 10 percent of cases test positive within three to six months of exposure Dr Munawar Bcc SACP

Four Stages of HIV: 

Four Stages of HIV Dr Munawar Bcc SACP

Stage 1 - Primary: 

Stage 1 - Primary Short, flu-like illness - occurs one to six weeks after infection no symptoms at all Infected person can infect other people Dr Munawar Bcc SACP

Stage 2 - Asymptomatic: 

Stage 2 - Asymptomatic Lasts for an average of ten years This stage is free from symptoms There may be swollen glands The level of HIV in the blood drops to very low levels HIV antibodies are detectable in the blood Dr Munawar Bcc SACP

Stage 3 - Symptomatic: 

Stage 3 - Symptomatic The symptoms are mild The immune system deteriorates emergence of opportunistic infections and cancers Dr Munawar Bcc SACP

Stage 4 - HIV  AIDS: 

Stage 4 - HIV  AIDS The immune system weakens The illnesses become more severe leading to an AIDS diagnosis Dr Munawar Bcc SACP

Infections in relation to CD4+ cell count: 

AIDS Infections in relation to CD4 + cell count 400 300 200 100 50 Herpes Zoster Tuberculosis Oral Candidiasis Esophageal Candidiasis Mucocutaneous herpes PCP Toxoplasmosis Cryptococcosis (Mycobacterium avium complex ) MAC (Cytomegalovirus) CMV (Progressive Multifocal Leuko encephalopathy) PML Cryptosporiodiosis Time Dr Munawar Bcc SACP

AIDS: 

AIDS A I D S Acquired Immunity Deficiency Syndrome It destroys the immune system of infected person. Dr Munawar Bcc SACP

AIDS: 

AIDS Acquired Immunodeficiency Syndrome HIV is the virus that causes AIDS Disease limits the body’s ability to fight infection A person with AIDS has a very weak immune system No Cure Dr Munawar Bcc SACP

Opportunistic Infections associated with AIDS: 

Opportunistic Infections associated with AIDS Bacterial Tuberculosis (TB) Strep pneumonia Viral Kaposi Sarcoma Herpes Influenza (flu) Dr Munawar Bcc SACP

Opportunistic Infections associated with AIDS: 

Opportunistic Infections associated with AIDS Parasitic Pneumocystis carinii Fungal Candida Cryptococcus Dr Munawar Bcc SACP

PowerPoint Presentation: 

After HIV infection (without ARV) Most will develop AIDS 8-10 years later 5-10% will develop AIDS first few years 5-10% will not progress to AIDS for 15 or more years Dr Munawar Bcc SACP

HIV Risk Reduction: 

HIV Risk Reduction Avoid unprotected sexual contact Use barriers such as condoms Limit multiple partners by maintaining a long-term relationship with one person Dr Munawar Bcc SACP

Infectious: 

Infectious Aids can’t be spread in a full sexual intercourse with condom because the condom prevents infected body fluids. Dr Munawar Bcc SACP

Protected Sex Condom is the only tool for preventing infection : 

Protected Sex Condom is the only tool for preventing infection Use condoms (male or female) every time you have sex (vaginal or anal) Always use latex or polyurethane condom (not a natural skin condom) Always use a latex barrier during oral sex Dr Munawar Bcc SACP

When Using A Condom Remember To:: 

When Using A Condom Remember To: Make sure the package is not expired Make sure to check the package for damages Do not open the package with your teeth for risk of tearing Never use the condom more than once Use water-based rather than oil-based condoms Dr Munawar Bcc SACP

HIV Risk Reduction Cont’d…: 

HIV Risk Reduction Cont’d… Condoms: Using condoms is not 100 percent effective in preventing transmission of sexually transmitted infections including HIV Condoms = Safer sex Condoms ≠ Safe sex Dr Munawar Bcc SACP

HIV Risk Reduction Cont’d…: 

HIV Risk Reduction Cont’d… Condom Use: Should be used consistently and correctly Should be the responsibility of both partners for the protection of both partners Male and female condoms are available Dr Munawar Bcc SACP

Female initiated methods of prevention: 

Female initiated methods of prevention Female condoms : 97% effective yet currently only manufactured by one company and too expensive Microbicides : gel, film, sponge, lubricant or suppository. Still in development User controlled, protection against HIV/STIs, could be available in contraceptive and non-contraceptive forms . Researchers predict a microbicide that is only 60% effective could prevent more than 2.5 million infections within three years of its introduction. Currently in clinical trials and may be available over the counter within 5-7 years Dr Munawar Bcc SACP

Press ad Option 3: 

Press ad Option 3 Dr Munawar Bcc SACP

HIV Risk Reduction Cont’d…: 

HIV Risk Reduction Cont’d… Avoid drug and alcohol use to maintain good judgment Don’t share needles used by others for: Drugs Tattoos Body piercing Make sure GP is using a new syringe Avoid exposure to blood products Dr Munawar Bcc SACP

Drugs Alcohol and Aids : 

Drugs Alcohol and Aids What the connection between Drugs and Alcohol? Alcohol and drugs causing you for misjudgment, so if you drunk you can't better follow the rules of safe sex, and for drugs injections, can transpose the virus. Dr Munawar Bcc SACP

People Infected with HIV: 

People Infected with HIV Can look healthy Can be unaware of their infection Can live long productive lives when their HIV infection is managed Can infect people when they engage in high-risk behavior Dr Munawar Bcc SACP

How you know?: 

How you know? You can’t identify a person who carry HIV and in most cases, he/she himself doesn’t know about it . You can found out the virus only in HIV tests. A person can carry the virus for many years, he can be seen, feel and function as usual ,. Don’t hope from your partner to tell you , that he/she carry the HIV virus. Because most people living with the virus are feared from rejection and anger, even though you love each other. The responsibility defending your health is only in your hands! Dr Munawar Bcc SACP

HIV Exposure and Infection: 

HIV Exposure and Infection Some people have had multiple exposures without becoming infected Some people have been exposed one time and become infected Dr Munawar Bcc SACP

: 

Once a person is infected s/he is always infected Medications are available to prolong life but they do not cure the disease Those who are infected are capable of infecting others without having symptoms or knowing of the infection HIV AIDS Dr Munawar Bcc SACP

Suggested tips : 

Suggested tips To reduce the risk you have to… Avoiding from ejaculation in your mouth Avoiding sucking woman sexual organ during period. Avoiding from swallowing female secreting Make sure no active herpes wounds or others wounds Suggested not to brush your teeth two hours, because of gums sensitivity Dr Munawar Bcc SACP

Not Transmitted By: 

Not Transmitted By Shaking Hands HIV/AIDS doesn’t Spread in a hand shaking, because the virus doesn’t live in air or on skin . Dr Munawar Bcc SACP

Not Transmitted By Hugging: 

Not Transmitted By Hugging HIV/AIDS doesn’t Spread in a Hugging, because the virus doesn’t live in air or on skin. Dr Munawar Bcc SACP

Not Transmitted By KISS : 

Not Transmitted By KISS Because in the spittle they are enzymes that neutralized the virus. but…..? Dr Munawar Bcc SACP

infectious : 

infectious HIV/AIDS doesn’t spread by drinking from the same cup , glass, using, plate, spoons etc. because it can’t live in air or spittle. Dr Munawar Bcc SACP

PowerPoint Presentation: 

So we can live together and don’t Discriminate or Stigmatize the peoples leaving with HIV/AIDS. Dr Munawar Bcc SACP

HIV is NOT Transmitted via: 

HIV is NOT Transmitted via Casual contact Tears, sweat and saliva Coughing and sneezing Not transmitted via Mosquitoes, Fly, Bee, Buds etc. Dr Munawar Bcc SACP

Infectious: 

Infectious Aids doesn’t spread by a mosquito bite because mosquito can’t carry the human virus of HIV Dr Munawar Bcc SACP

HIV DOES NOT SPREAD IN THESE WAYS: 

HIV DOES NOT SPREAD IN THESE WAYS Dr Munawar Bcc SACP

Press ad Option 4: 

Press ad Option 4 Dr Munawar Bcc SACP

Challenges: 

Challenges Break the silence on HIV and AIDS End stigmatization and discrimination of PLWHA Dr Munawar Bcc SACP

Facts about AIDS: 

Facts about AIDS No Curative Treatment available. No Vaccine. BUT IT CAN BE PREVENTED Dr Munawar Bcc SACP

PowerPoint Presentation: 

Questions are Welcomed if ask

Guidelines for PEP: 

Guidelines for PEP Ideally, initiate PEP treatment within 2 hours of exposure, but no more than 72 hours after exposure. If patient is not infected with HIV, discontinue PEP and retest at 6 weeks, 3 months, and 6 months. If patient is infected with HIV, counsel, support, and refer healthcare worker for continued treatment. Dr Munawar Bcc SACP

Guidelines for PEP: 

Currently there is no single approved PEP regimen. Dual or triple drug therapy is recommended and believed to be more effective than a single agent. Expanded 3-drug regimen: Zidovudine 300mg BD Lamivudine 150mg BD Efavirenz 600mg (or Tenofovir 300mg) HS 28 Days Guidelines for PEP Dr Munawar Bcc SACP

PowerPoint Presentation: 

Dr Munawar Bcc SACP

PowerPoint Presentation: 

Dr Munawar Bcc SACP

PowerPoint Presentation: 

Thank you

PowerPoint Presentation: 

Awareness Event For Health Sectors Professionals ENHANCED HIV/AIDS CONTROL PROGRAM Health Department, Govt. of Sindh

STANDARD PRECAUTIONS: 

STANDARD PRECAUTIONS

HAND WASHINGS: 

HAND WASHINGS

PROTECTIVE CLOTHING: 

PROTECTIVE CLOTHING

HANDLING OF SHARPS: 

HANDLING OF SHARPS

Gather and review information: 

Gather and review information Research reports, Policy documents, Strategy formulations, Scientific papers on HIV/AIDS and education in your country Training manuals Find out more about the situation in your country and its specific needs - gather material such as

Look for partners within your Ministry/Department: 

Look for partners within your Ministry/Department Convince fellow Ministry/Department officials that it is crucial to Act now , that is before the epidemic takes hold Ensure common understanding about the nature of the epidemic and its impact Provide committed and informed leadership Ensure consistent political commitment Establish guidelines which clarify responsibilities Review and evaluate ongoing efforts Not allow efforts to stagnate

Work with partners outside your Ministry/Department: 

Work with partners outside your Ministry/Department National AIDS programes /Ministry of Health UN Agencies (UNESCO, UNAIDS, UNICEF, etc) NGOs such as Education International, CARE, Family Health International, or AIDS Alliance Other government sectors and departments The private sector Donor agencies Look for partners that share your interest and can help you reach your goals, such as