AIDS : A global public health issue

Dr Tasaduq Itoo
Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body’s ability to fight the organisms that cause disease.
According to the J&K State AIDS Control Society (JKSACS) statistics, a total of 4,175 HIV-positive patients, including 2,437 men, 1,484 women and 248 children, have been registered with the society in the Jammu region till May 2017.
In the Kashmir region, including Leh, the prevalence of HIV is quite low. The number of HIV patients there is 228, including 58 non-locals. However, the number of HIV patients has witnessed an increase, though there are some fluctuating figures.
SIGNS AND SYMPTOMS
The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat.
As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi’s sarcoma, among others.
MODES OF TRANSMISSION
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. You can’t become infected through ordinary contact — hugging, kissing, dancing or shaking hands — with someone who has HIV or AIDS. HIV can’t be transmitted through the air, water or insect bites. You can become infected with HIV in several ways, including:
By having sex with an infected partner. You may become infected if you have sex with an infected partner whose blood, semen or vaginal secretions enter your body. The virus can enter your body through mouth sores or small tears that sometimes develop in the vagina during sexual activity.
From blood transfusions. In some cases, the virus may be transmitted through blood transfusions from infected persons.
By sharing needles. HIV can be transmitted through needles and syringes contaminated with infected blood. puts you at high risk of HIV and other infectious diseases, such as hepatitis.
During pregnancy or delivery or through breast-feeding. Infected mothers can infect their babies. But by receiving treatment for HIV infection during pregnancy, mothers significantly lower the risk to their babies.
RISK FACTORS
Anyone of any age, race, sex or sexual orientation can be infected. Behaviours and conditions that put individuals at greater risk of contracting HIV include:
Having unprotected anal or vaginal sex.
Having another sexually transmitted infection such as syphilis, herpes, chlamydia, gonorrhoea, and bacterial vaginosis.
Sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs.
Receiving unsafe injections, blood transfusions, tissue transplantation, medical procedures that involve unsterile cutting or piercing.
Experiencing accidental needle stick injuries, including among health workers.
Key risk populations include: men who have sex with men(MSM), people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people.
PREVENTION OF HIV
There’s no vaccine to prevent HIV infection and no cure for AIDS. But it’s possible to protect yourself and others from infection. That means educating yourself about HIV and avoiding any behavior that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk — into your body. Also effective antiretroviral (ARV) drugs can control the virus and help prevent transmission so that people with HIV, and those at substantial risk, can enjoy healthy, long and productive lives. To help prevent the spread of HIV:
* Use a protective device. If you don’t know the HIV status of your partner, use a protective device like new condom every time you have sexual intercourse .Women can use a female condom.
* Consider the drug Emtricitabine-Tenofovir. Use of the new combination drug ‘emtricitabine-tenofovir’ can reduce the risk of sexually transmitted HIV infection in those who are at high risk. It is also used as an HIV treatment along with other medications.
* Use a clean needle. If you use a needle to inject drugs, make sure it’s sterile and don’t share it. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
* If you’re pregnant, get medical care right away. If you’re HIV-positive, you may pass the infection to your baby. But if you receive treatment during pregnancy, you can cut your baby’s risk significantly.
* Consider male circumcision. There’s evidence that male circumcision can help reduce a man’s risk of acquiring HIV.
* Get tested and know your partner’s HIV status. Talk to your partner about HIV testing and get tested before you have sex. Your partner need to be tested and to receive medical care if they have the virus. They also need to know their HIV status so that they don’t infect others. Use a testing locator from the Centers for Disease Control and Prevention (CDC) to find an HIV testing location near you.
* Avoid multiple sexual partners. The more partners you have, the more likely you are to have a partner with HIV whose HIV is not well controlled or to have a partner with a sexually transmitted disease (STD). Both of these factors can increase the risk of HIV transmission.
* Get tested and treated for STDs. Insist that your partners get tested and treated too. Having an STD can increase your risk of becoming infected with HIV or spreading it to others.
* Talk to your health care provider about pre-exposure prophylaxis. Pre-exposure prophylaxis (PrEP) can help prevent HIV infection in people who don’t have HIV but who are at high risk of becoming infected with HIV.PrEP involves taking a specific HIV medicine every day. PrEP is most effective when taken consistently each day. According to the Centers for Disease Control and Prevention (CDC), by taking PrEP every day, a person can lower their risk of getting HIV from sex by more than 90% and from injection drug use by more than 70%.
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