HIV AND Aids: Empowerement Technology
HIV AND Aids: Empowerement Technology
HIV AND Aids: Empowerement Technology
AND
AIDS
EMPOWEREMENT TECHNOLOGY
MEMBERS;
Maybel Abad
Arlie Quina
Chastine Arconada
Lander Marquina
11 Abm
Sir.Russel M. Catindoy
Inroduction:
The lack of knowledge in today’s world is a major issue. It is causing the spread of many
dangerous health problems. One in particular is AIDS, which stands for acquired immune
deficiency syndrome.
Yes, people hear about it; however, the spread continues. With higher knowledge of everything
that goes hand and hand with it, the spread can be put to a stop.
HIV/AIDS Awareness is the most effective way to end the worldwide spread of this killer
disease. Before getting into the deep details of HIV/AIDS, one must know and understand the
background behind it
Let's always remember that sexual contact is for the two opposite indoviduals,a male and a
female.It is for production, not for doing fun with our body organs.Spread love and respect by
acknowledging this statements and researches we have gathered.
AIDS/HIV Acronyms
In 1982 the occurrence of the disease in non-homosexuals led the Centre for Disease and
Prevention (CDC) to suggest AIDS (Acquired Immune Deficiency Syndrome) as an appropriate
name because people acquired the condition, which led to the deficiency within the immune
system. Still very little was known about transmission and public anxiety continued to grow. By
the end of 1982 many more people were taking notice of this new disease, as it was clearer that a
much wider group of people was going to be affected.
When it began turning up in children and transfusion recipients it was a turning point in terms of
public perception. Throughout 1982 there were separate reports of the disease occurring in a
number of European countries. In 1983 reports of AIDS among women with no other risk factors
suggested the disease might be passed on through heterosexual sex.
HISTORY OF HIV AND AIDS
KEY POINTS:
The history of the HIV and AIDS epidemic began in illness, fear and death as the world faced a
new and unknown virus. However, scientific advances, such as the development of antiretroviral
drugs, have enabled people with access to treatment to live long and healthy lives with HIV.
Here, we go through the key historical moments that have defined the HIV epidemic over the
past 30 years.
You can also explore our interactive timeline which features video, photos, data, audio and more.
Pre-1980
It is widely believed that HIV originated in Kinshasa, in the Democratic Republic of Congo
around 1920 when HIV crossed species from chimpanzees to humans. Up until the 1980s, we do
not know how many people were infected with HIV or developed AIDS. HIV was unknown and
transmission was not accompanied by noticeable signs or symptoms.
While sporadic cases of AIDS were documented prior to 1970, available data suggests that the
current epidemic started in the mid- to late 1970s. By 1980, HIV may have already spread to five
continents (North America, South America, Europe, Africa and Australia). In this period,
between 100,000 and 300,000 people could have already been infected.
1980s
1981
In 1981, cases of a rare lung infection called Pneumocystis carinii pneumonia (PCP) were found
in five young, previously healthy gay men in Los Angeles.2 At the same time, there were reports
of a group of men in New York and California with an unusually aggressive cancer
named Kaposi’s Sarcoma.
In December 1981, the first cases of PCP were reported in people who inject drugs.
By the end of the year, there were 270 reported cases of severe immune deficiency among gay
men - 121 of them had died.
1982
In June 1982, a group of cases among gay men in Southern California suggested that the cause of
the immune deficiency was sexual and the syndrome was initially called gay-related immune
deficiency (or GRID).
Later that month, the disease was reported in haemophiliacs and Haitians leading many to
believe it had originated in Haiti.
In September, the CDC used the term 'AIDS' (acquired immune deficiency syndrome) for the
first time, describing it as
A disease at least moderately predictive of a defect in cell mediated immunity, occurring in a
person with no known case for diminished resistance to that disease.
AIDS cases were also being reported in a number of European countries.
In Uganda, doctors reported cases of a new, fatal wasting disease locally known as 'slim'.
By this point, a number of AIDS-specific organisations had been set up including the San
Francisco AIDS Foundation (SFAF) in the USA and the Terrence Higgins Trust in the UK.
1983
In January 1983, AIDS was reported among the female partners of men who had the disease
suggesting it could be passed on via heterosexual sex.
In May, doctors at the Pasteur Institute in France reported the discovery of a new retrovirus
called Lymphadenopathy-Associated Virus (or LAV) that could be the cause of AIDS.
In June, the first reports of AIDS in children hinted that it could be passed via casual contact but
this was later ruled out and it was concluded that they had probably directly acquired AIDS from
their mothers before, during or shortly after birth.
By September, the CDC identified all major routes of transmission and ruled out transmission by
casual contact, food, water, air or surfaces
The CDC also published their first set of recommended precautions for healthcare workers and
allied health professionals to prevent "AIDS transmission".
In November, the World Health Organization (WHO) held its first meeting to assess the global
AIDS situation and began international surveillance.
By the end of the year the number of AIDS cases in the USA had risen to 3,064 - of this number,
1,292 had died.
1984
In April 1984, the National Cancer Institute announced they had found the cause of AIDS, the
retrovirus HTLV-III. In a joint conference with the Pasteur Institute they announced that LAV
and HTLV-III are identical and the likely cause of AIDS. A blood test was created to screen for
the virus with the hope that a vaccine would be developed in two years.
In July, the CDC state that avoiding injecting drug use and sharing needles "should also be
effective in preventing transmission of the virus."
In October, bath houses and private sex clubs in San Francisco were closed due to high-risk
sexual activity. New York and Los Angeles followed suit within a year.
By the end of 1984, there had been 7,699 AIDS cases and 3,665 AIDS deaths in the USA with
762 cases reported in Europe.
In Amsterdam, the Netherlands, the first needle and syringe programme was set up with growing
concerns about HTLV-III/LAV.
1985
In March 1985, the U.S Food and Drug Administration (FDA) licensed the first commercial
blood test, ELISA, to detect antibodies to the virus. Blood banks began to screen the USA blood
supply.
In April, the U.S. Department of Health and Human Services (HHS) and the World Health
Organization (WHO) hosted the first International AIDS Conference in Atlanta Georgia.
Ryan White, a teenager from Indiana, USA who acquired AIDS through contaminated blood
products used to treat his haemophilia was banned from school.
On 2 October, the actor Rock Hudson dies from AIDS - the first high profile fatality. He left
$250,000 to set up the American Foundation for AIDS Research (amfAR).
In December, the U.S. Public Health Service issued the first recommendations for preventing
mother to child transmission of the virus.
By the end of 1985, every region in the world had reported at least one case of AIDS, with
20,303 cases in total.
1986
In May 1986, the International Committee on the Taxonomy of Viruses said that the virus that
causes AIDS will officially be called HIV (human immunodeficiency virus) instead of HTLV-
III/LAV.
By the end of the year, 85 countries had reported 38,401 cases of AIDS to the World Health
Organization. By region these were; Africa 2,323, Americas 31,741, Asia 84, Europe 3,858, and
Oceania 395.
1987
In February 1987, the WHO launched The Global Program on AIDS to raise awareness; generate
evidence-based policies; provide technical and financial support to countries; conduct research;
promote participation by NGOs; and promote the rights of people living with HIV.
In March, the FDA approved the first antiretroviral drug, zidovudine (AZT), as treatment for
HIV.
In April, the FDA approved the western blot blood test kit, a more specific HIV antibody test.
In July, the WHO confirmed that HIV could be passed from mother to child during
breastfeeding.
In October, AIDS became the first illness debated in the United Nations (UN) General
Assembly.
By December, 71,751 cases of AIDS had been reported to the WHO, with 47,022 of these in the
USA. The WHO estimated that 5-10 million people were living with HIV worldwide.
1988
In 1988, the WHO declared 1st December as the first World AIDS Day.
The groundwork was laid for a nationwide HIV and AIDS care system in the USA that was later
funded by the Ryan White CARE Act
1989
In March 1989, 145 countries had reported 142,000 AIDS cases. However, the WHO estimated
there were up to 400,000 cases worldwide.
In June, the CDC released the first guidelines to prevent PCP - an opportunistic infection that
was a major cause of death among people with AIDS.
The number of reported AIDS cases in the USA reached 100,000.
1990s
1990
On 8 April 1990, Ryan White died of an AIDS-related illness aged 18.
In June, the 6th International AIDS Conference in San Francisco protested against the USA's
immigration policy which stopped people with HIV from entering the country. NGOs boycotted
the conference.
In July, the USA enacted the Americans with Disabilities Act (ADA) which prohibits
discrimination against those with disabilities including people living with HIV.
In October, the FDA approved the use of zidovudine (AZT) to treat children with AIDS.
By the end of 1990, over 307,000 AIDS cases had been officially reported with the actual
number estimated to be closer to a million. Between 8-10 million people were thought to be
living with HIV worldwide.
1991
In 1991, the Visual AIDS Artists Caucus launched the Red Ribbon Project to create a symbol of
compassion for people living with HIV and their carers. The red ribbon became an international
symbol of AIDS awareness.
On 7 November, professional basketball player Earvin (Magic) Johnson announced he had HIV
and retired from the sport, planning to educate young people about the virus. This announcement
helped begin to dispel the stereotype, still widely held in the US and elsewhere, of HIV as a
‘gay’ disease.
A couple of weeks later, Freddie Mercury, lead singer of rock group Queen, announced he had
AIDS and died a day later.
1992
The 1992 International AIDS Conference scheduled to be held in Boston, USA was moved to
Amsterdam due to USA immigration rules on people living with HIV.
Tennis star Arthur Ashe revealed he became infected with HIV as the result of a blood
transfusion in 1983.
In May, the FDA licensed a 10 minute testing kit which could be used by healthcare
professionals to detect HIV-1.
1993
In March 1993, the USA Congress voted overwhelmingly to retain the ban on entry into the
country for people living with HIV.
The CDC added pulmonary tuberculosis, recurrent pneumonia and invasive cervical cancer to
the list of AIDS indicators.
Over 700,000 people were thought to have the virus in Asia and the Pacific.
By the end of 1993, there were an estimated 2.5 million AIDS cases globally.
1994
In August 1994, the USA Public Health Service recommended the use of AZT to prevent the
mother-to-child transmission of HIV.
In December, the FDA approved an oral HIV test - the first non-blood HIV test.
1995
In June 1995, the FDA approved the first protease inhibitor beginning a new era of highly active
antiretroviral treatment (HAART). Once incorporated into clinical practice HAART brought
about an immediate decline of between 60% and 80% in rates of AIDS-related deaths and
hospitalisation in those countries which could afford it.
By the end of the year, there were an estimated 4.7 million new HIV infections - 2.5 million in
southeast Asia and 1.9 million in sub-Saharan Africa.
1996
In 1996, the Joint United Nations Programme on AIDS (UNAIDS) was established to advocate
for global action on the epidemic and coordinate the response to HIV and AIDS across the UN.
The 11th International AIDS Conference in Vancouver highlighted the effectiveness of HAART
leading to a period of optimism.
The FDA approved the first home testing kit; a viral load test to measure the level of HIV in the
blood; the first non-nucleoside transcriptase inhibitor (NNRTI) drug (nevirapine); and the first
HIV urine test.
New HIV outbreaks were detected in Eastern Europe, the former Soviet Union, India, Vietnam,
Cambodia and China among others.
By the end of 1996, the estimated number of people living with HIV was 23 million.
1997
In September 1997, the FDA approved Combivir, a combination of two antiretroviral drugs,
taken as a single daily tablet, making it easier for people living with HIV to take their
medication.
UNAIDS estimated that 30 million people had HIV worldwide equating to 16,000 new infections
a day.
1999
In 1999, the WHO announced that AIDS was the fourth biggest cause of death worldwide and
number one killer in Africa. An estimated 33 million people were living with HIV and 14 million
people had died from AIDS since the start of the epidemic.
2000s
2000
In July, UNAIDS negotiated with five pharmaceutical companies to reduce antiretroviral drug
prices for developing countries.
In September, the United Nations adopted the Millennium Development Goals which included a
specific goal to reverse the spread of HIV, malaria and TB.
2001
In June 2001, the United Nations (UN) General Assembly called for the creation of a "global
fund" to support efforts by countries and organisations to combat the spread of HIV through
prevention, treatment and care including buying medication.
After generic drug manufacturers, such as Cipla in India, began producing discounted, generic
forms of HIV medicines for developing countries, several major pharmaceutical manufacturers
agreed to further reduce drug prices.
In November, the World Trade Organization (WTO) announced the Doha Declaration which
allowed developing countries to manufacture generic medications to combat public health crises
like HIV.
2002
In April 2002, the Global Fund approved its first round of grants totalling $600 million.75
In July, UNAIDS reported that AIDS was now by far the leading cause of death in sub-Saharan
Africa.
Also in July, South Africa’s Constitutional Court orders the government to make the HIV drug
nevirapine available to all HIV-positive pregnant women and their newborn children following a
legal challenge by the Treatment Action Campaign.
In November, the FDA approved the first rapid HIV test with 99.6% accuracy and a result in 20
minutes.
2003
In January 2003, President George W. Bush announced the creation of the United States
President’s Emergency Plan For AIDS Relief (PEPFAR), a $15 billion, five-year plan to combat
AIDS, primarily in countries with a high number of HIV infections.
In December, the WHO announced the “3 by 5” initiative to bring HIV treatment to 3 million
people by 2005.
2006
In 2006, male circumcision was found to reduce the risk of female-to-male HIV transmission by
60%.81 Since then, the WHO and UNAIDS have emphasised that male circumcision should be
considered in areas with high HIV and low male circumcision prevalence.
2007
In May 2007, the WHO and UNAIDS issued new guidance recommending “provider-initiated”
HIV testing in healthcare settings. This aimed to widen knowledge of HIV status and greatly
increase access to HIV treatment and prevention.
2010s
2010
In January 2010, the travel ban preventing HIV-positive people from entering the USA was
lifted.84
In July, the CAPRISA 004 microbicide trial was hailed a success after results showed that
the microbicide gel reduces the risk of HIV infection in women by 40%.
Results from the iPrEx trial showed a reduction in HIV acquisition of 44% among men who have
sex with men who took pre-exposure prophylaxis (PrEP).
2011
In 2011, results from the HPTN 052 trial showed that early initiation of antiretroviral treatment
reduced the risk of HIV transmission by 96% among serodiscordant couples.
In August, the FDA approved Complera, the second all-in-one fixed dose combination tablet,
expanding the treatment options available for people living with HIV.
2012
In July 2012, the FDA approved PrEP for HIV-negative people to prevent the sexual
transmission of HIV.
For the first time, the majority of people eligible for treatment were receiving it (54%).
2013
In 2013, UNAIDS reported that AIDS-related deaths had fallen 30% since their peak in 2005.
An estimated 35 million people were living with HIV.
2014
In September 2014, new UNAIDS “Fast Track” targets called for the dramatic scaling-up of HIV
prevention and treatment programmes to avert 28 million new infections and end the epidemic as
a public health issue by 2030.
UNAIDS also launched the ambitious 90-90-90 targets which aim for 90% of people living with
HIV to be diagnosed, 90% of those diagnosed to be accessing antiretroviral treatment and 90%
of those accessing treatment to achieve viral suppression by 2020.
2015
In July 2015, UNAIDS announced that the Millennium Development Goal (MDG) relating to
HIV and AIDS had been reached six months ahead of schedule. The target of MDG 6 – halting
and reversing the spread of HIV – saw 15 million people receive treatment
In September, the WHO launched new treatment guidelines recommending that all people living
with HIV should receive antiretroviral treatment, regardless of their CD4 count, and as soon as
possible after their diagnosis.
In October, UNAIDS released their 2016-2021 strategy in line with the new Sustainable
Development Goals (SDGs), that called for an acceleration in the global HIV response to reach
critical HIV prevention and treatment targets and achieve zero discrimination.
2016
The number of people in Russia living with HIV reached one million. Newly released figures
also showed 64% of all new HIV diagnoses in Europe occurred in Russia.
UNAIDS announced that 18.2 million people were on ART, including 910 000 children, double
the number five years earlier. However, achieving increased ART access means a greater risk
of drug resistance and the WHO released a report on dealing with this growing issue.
AVERT marked its 30th anniversary - having provided HIV and AIDS information from the start
of the epidemic we continue our work to empower people through knowledge to avert HIV.
2017
For the first time ever, more than half of the global population living with HIV are receiving
antiretroviral treatment, a record of 19.5 million people.
Organisations around the world endorse “Undetectable = Untransmittable”(U=U). This anti-
stigma slogan launched by the Prevention Access Campaign is based on robust scientific
evidence that people who have adhered to treatment and achieved an undetectable viral load
cannot pass the virus on. In 2017 ‘U=U’ becomes a defining message of the HIV response in
many well-resourced countries, but fails to have the same impact in lower resource settings,
where viral-load monitoring is more difficult.
New infections have fallen by a third in East and Southern Africa over the last six years, with
particular decreases among young women and girls. It is thought that this is partly due to the
success of the DREAMS initiative, which aimed to reduce HIV infections among women and
girls in sub-Saharan Africa by providing them with economic opportunities as well as better HIV
services and education.
HIV and AIDS are not problems that exist only in Africa or in other parts of the world. The
Centers for Disease Control and Prevention estimates that more than 1.2 million Americans 13
years and older are living with HIV.
One in four people living with AIDS in the United States in 2014 was a woman. An estimated
128,778 women have died of AIDS since the beginning of the epidemic in 1981.
HIV is the virus that leads to AIDS. You have AIDS if your CD4 count drops below 200 or when
you have certain infections or cancers. You can have HIV for years without having AIDS. Being
infected with HIV does not mean you have developed AIDS.
Also, people with HIV who start treatment early in their infection, stay on treatment, and have an
undetectable viral load can stay healthy and prevent the disease from progressing to AIDS
You cannot know if your partner has HIV unless he or she is tested.
It can take years for you to see symptoms of HIV. This is called the latency period. The only way
to fully protect yourself from sexually transmitted HIV is to not have sex of any kind. Using a
condom correctly every time you have vaginal, oral, or anal sex can reduce the risk of passing
HIV by 80%.6 Male latex condoms offer the best protection against HIV, but female condoms
are also approved by the Food and Drug Administration to help lower your risk for HIV
infection.
Use a condom every time you have sex for two reasons. First, your partner might be infected but
not know it. Second, you cannot control your partner's risky behavior. You can know only your
HIV status and control only your own risk-taking.
You (or your partner) need to wear a condom during sex, even if you are both HIV-
positive.
If you and your partner have HIV, you still need to practice safer sex. Use a condom every time
you have vaginal, oral, or anal sex. Condoms can protect you from other sexually transmitted
infections (STIs).
Also, since there are different strains (types) of HIV, you can be infected a second time with a
different type than what you already have. Some forms of HIV are also more virulent, meaning
they progress to AIDS faster. You could become infected with a drug-resistant strain of HIV.
This can make it very hard for treatment to work.
A pregnant woman with HIV can lower the chance of passing HIV to her unborn baby to
less than 1%.
A woman who knows about her HIV infection early in pregnancy and gets antiretroviral (ARV)
medicine can lower the risk of passing HIV to her baby to less than 1%.7 Without treatment, the
risk of a mother with HIV passing it to her baby is about 25% (in the United States).
If you are pregnant, get tested for HIV. Also, do not breastfeed your baby until you and your
doctor are certain you don't have HIV.
Women of all ages, races and ethnicities, and sexual orientations can get HIV.
Any woman who has unprotected sex or shares needles or syringes with someone who is HIV-
positive or whose HIV status is unknown is at risk for HIV.
HIV is not just a disease of gay men. In fact, worldwide, most people living with HIV are
straight (heterosexual), and more than half of people living with HIV are women.8 In the United
States, women make up about one in four people living with HIV.2
Most women who are HIV-positive got HIV from unprotected sex with an HIV-positive
male. Learn more about women and HIV risk.
You can get HIV from sharing needles or getting tattoos or body piercings.
Sharing needles is the second most common way that HIV is spread to women in the United
States (sex is the most common way). Any woman who shares needles with someone who is
HIV-positive or whose HIV status is unknown is at risk for HIV. Learn more about HIV risk and
sharing needles.
It is also possible to get HIV from tattoo and piercing tools that are not sterilized correctly
between clients. Tools that cut the skin should be used once and then thrown away or sterilized
between uses.
Before you get a tattoo or have your body pierced, ask the right questions. Find out what steps
the staff takes to prevent HIV and other infections, like hepatitis B and hepatitis C. You also can
call your local health department to ask how tattoo shops should sterilize their tools. A new,
sterilized needle should be used for each person.
Many, but not all, states regulate and issue permits for tattoo parlors. Before getting a tattoo,
learn what regulations your tattoo parlor must follow and whether it has passed a health
inspection.
The Hunter Theory: It is the most commonly accepted theory. It is said that the virus (SIV) was
transferred to humans as a result of chimps being killed and eaten or their blood getting into cuts
or wounds on the hunter. SIV on a few occasions adapted itself within its new human host and
become HIV. Every time it passed from a chimpanzee to a man, it would have developed in a
slightly different way within his body, and thus produced a slightly different strain.
The Oral Polio Vaccine Theory: In this it is said that the virus was transmitted via various
medical experiments (iatrogenically) especially through the polio vaccines. The oral polio
vaccine called Chat was given to millions of people in the Belgian Congo, Ruanda and Urundi in
the late 1950s. Then it was cultivated on kidney cells taken from the chimps infected with SIV in
order to reproduce the vaccine. This is the main source of contamination, which later affected
large number of people with HIV. But it was rejected as it was proved that only macaque
monkey kidney cells, which cannot be infected with SIV or HIV were used to make Chat.
Another reason is that HIV existed in humans before the vaccine trials were carried out.
The Contaminated Needle Theory: African healthcare professionals were using one single
syringe to inject multiple patients without any sterilization in between. This could have rapidly
have transferred infection from one individual to another resulting in mutation from SIV to HIV.
The Colonialism Theory: The colonial rule in Africa was particularly harsh and the locals were
forced into labor camps where sanitation was poor and food was scare. SIV could easily have
infiltrated the labor force and taken advantage of their weakened immune systems. Laborers
were being inoculated with unsterile needles against diseases such as smallpox to keep them
alive and working. Also many of the camps actively employed prostitutes to keep the workers
happy. All these factors may have led to the transmission and development of AIDS as a disease.
The Conspiracy Theory: According to a survey, which was carried among African Americans
it was found that HIV was manufactured as part of a biological warfare programme, designed to
wipe out large numbers of black and homosexual people. There is no evidence to disprove it,
cannot be accepted as there were no genetic engineering techniques at that time of emergence of
AIDS.
How can I make sure I don’t give HIV to anyone during sex?
If you find out that you have HIV, try to stay calm. People living with HIV can have normal,
healthy relationships and sex lives. But it’s important to take precautions to help your partner(s)
stay HIV-free.
There are a few ways that you can avoid giving HIV to other people:
Always use condoms when you have vaginal and anal sex.
Start treatment for HIV as soon as possible, and keep taking your HIV medicine. When you take
it correctly, HIV treatment can lower or even stop your chances of spreading the virus to your
sexual partners (and help you stay healthy).
There’s a daily pill your partner can take to lower the risk of getting HIV, called PrEP.
Don’t share needles for shooting drugs, piercings, or tattoos.
Get tested and treated for other STDs besides HIV regularly. Having other STDs makes it easier
for you to spread HIV to others.
If you test positive for HIV, it’s important to tell your sexual partners about it so they can be
tested, too. Even if you’re really careful to not spread HIV, be honest with your future partners
about your status so you can both be informed and help each other stay healthy. Read more about
talking with your partners about HIV.
Prevention strategies
Pharmaceutical
Some commonly considered pharmaceutical interventions for the prevention of HIV might
include the use of:
Microbicides for sexually transmitted diseases
Pre-exposure prophylaxis
Postexposure prophylaxis
Circumcision (see also Circumcision and HIV)
Antiretroviral drugs
Condoms
Low dead space syringes
Of these, the only universally medically proven method for preventing the spread of HIV during
sexual intercourse is the correct use of condoms, and condoms are also the only method
promoted by health authorities worldwide. For HIV-positive mothers wishing to prevent the
spread of HIV to their children during birth, antiretroviral drugs have been medically proven to
reduce the likelihood of the spread of the infection. Scientists worldwide are currently
researching other prevention systems.[citation needed]
Increased risk of contracting HIV often correlates with infection by other diseases, particularly
other sexually transmitted infections. Medical professionals and scientists recommend treatment
or prevention of other infections such as herpes, hepatitis A, hepatitis B, hepatitis C, human
papillomavirus, syphilis, gonorrhea, and tuberculosis as an indirect way to prevent the spread of
HIV infection. Often doctors treat these conditions with pharmaceutical interventions.
As of September 2013, condoms are available inside prisons in Canada, most of the European
Union, Australia, Brazil, Indonesia, South Africa, and the US state of Vermont (on September
17, 2013, the Californian Senate approved a bill for condom distribution inside the state's
prisons, but the bill was not yet law at the time of approval).
Social strategies
Social strategies do not require any drug or object to be effective, but rather require persons to
change their behaviors to gain protection from HIV. Some social strategies which people
consider include:
Sex education
LGBT sex education
Needle-exchange programmes
Safe injection sites
Safe sex
Serosorting
Sexual abstinence
Immigration regulation
Each of these strategies has widely differing levels of efficacy, social acceptance, and acceptance
in the medical and scientific communities. Populations which receive HIV testing are less likely
to engage in behaviors with high risk of contracting HIV, so HIV testing is almost always a part
of any strategy to encourage people to change their behaviors to become less likely to contract
HIV.Over 60 countries impose some form of travel restriction, either for short- or long-term
stays, for people infected with HIV.
Sexual contact
Consistent condom use reduces the risk of heterosexual HIV transmission by about 80% over the
long-term. Where one partner of a couple is infected, consistent condom use results in rates of
HIV infection for the uninfected person below 1% per year. Some data support the equivalence
of female condoms to latex condoms, but the evidence is not definitive.[ The use of
the spermicide nonoxynol-9 may increase the risk of transmission because it causes vaginal and
rectal irritation. A vaginal gel containing tenofovir, a reverse transcriptase inhibitor, when used
immediately before sex, reduces infection rates by roughly 40% among African women.
Circumcision in sub-Saharan Africa reduces the risk of HIV infection in heterosexual men
between 38 and 66% over two years.[ Based on these studies, the World Health Organization
and UNAIDS both recommended male circumcision as a method of preventing female-to-male
HIV transmission in 2007. Whether it protects against male-to-female transmission is
disputed[14][15] and whether it is of benefit in developed countries and among men who have
sex with men is undetermined. For men who have sex with men there is some evidence that the
penetrative partner has a lower chance of contracting HIV. Some experts fear that a lower
perception of vulnerability among circumcised men may result in more sexual risk-taking
behavior, thus negating its preventive effects. Women who have undergone female genital
cutting have an increased risk of HIV.
Programs encouraging sexual abstinence do not appear to affect subsequent HIV risk in high-
income countries. Evidence for a benefit from peer education is equally poor. Comprehensive
sexual education provided at school may decrease high risk behavior. A substantial minority of
young people continue to engage in high-risk practices despite HIV/AIDS knowledge,
underestimating their own risk of becoming infected with HIV. It is not known if treating other
sexually transmitted infections is effective in preventing HIV.
Before exposure
Early treatment of HIV-infected people with antiretrovirals protected 96% of partners from
infection. Pre-exposure prophylaxis with a daily dose of tenofovir with or
without emtricitabine is effective in a number of groups, including men who have sex with men,
couples where one is HIV positive, and young heterosexuals in Africa.
Universal precautions within the health-care environment are believed to be effective in
decreasing the risk of HIV. Intravenous drug use is an important risk factor and harm
reduction strategies such as needle-exchange programmes and opioid substitution therapy appear
effective in decreasing this risk.
Needle exchange programs (also known as syringe exchange programs) are effective in
preventing HIV among IDUs and in the broader community.] Pharmacy sales of syringes and
physician prescription of syringes have been also found to reduce HIV risk. Supervised injection
facilities are also understood to address HIV risk in the most-at-risk populations. Multiple legal
and attitudinal barriers limit the scale and coverage of these "harm reduction" programs in the
United States and elsewhere around the world.
The American Centers for Disease Control and Prevention (CDC) conducted a study in
partnership with the Thailand Ministry of Public Health to ascertain the effectiveness of
providing people who inject drugs illicitly with daily doses of the antiretroviral drug tenofovir as
a prevention measure. The results of the study revealed a 48.9% reduced incidence of the virus
among the group of subjects who received the drug, in comparison to the control group who
received a placebo. The principal investigator of the study stated in the Lancetmedical journal:
"We now know that pre-exposure prophylaxis can be a potentially vital option for HIV
prevention in people at very high risk for infection, whether through sexual transmission or
injecting drug use."
After exposure
A course of antiretrovirals administered within 48 to 72 hours after exposure to HIV-positive
blood or genital secretions is referred to as post-exposure prophylaxis. The use of the single
agent zidovudine reduces the risk of subsequent HIV infection fivefold following a needle stick
injury. Treatment is recommended after sexual assault when the perpetrators are known to be
HIV positive, but is controversial when their HIV status is unknown. Current treatment regimens
typically use lopinavir/ritonavir and lamivudine/zidovudine or emtricitabine/tenofovir and may
decrease the risk further. The duration of treatment is usually four weeksand is associated with
significant rates of adverse effects (for zidovudine about 70% including: nausea 24%, fatigue
22%, emotional distress 13%, and headaches 9%).
Follow-up care
Strategies to reduce recurrence rates of HIV have been successful in preventing reinfection.
Treatment facilities encourage those previously treated for HIV return to ensure that the infection
is being successfully managed. New strategies to encouraging retesting have been the use of text
messaging and email. These methods of recall are now used along with phone calls and letters.
Mother-to-child
Programs to prevent the transmission of HIV from mothers to children can reduce rates of
transmission by 92-99%. This primarily involves the use of a combination of antivirals during
pregnancy and after birth in the infant but also potentially include bottle feeding rather
than breastfeeding. If replacement feeding is acceptable, feasible, affordable, sustainable and
safe mothers should avoid breast-feeding their infants; however, exclusive breast-feeding is
recommended during the first months of life if this is not the case. If exclusive breast feeding is
carried out the provision of extended antiretroviral prophylaxis to the infant decreases the risk of
transmission.
Vaccination
As of 2012, no effective vaccine for HIV or AIDS is known.[ A single trial of the vaccine RV
144 found a partial efficacy rate around 30% and has stimulated optimism in the research
community regarding developing a truly effective vaccine. Further trials of the vaccine are
ongoing.
Gene therapy
Certain mutations on the CCR5 gene have been known to make certain people able to catch
AIDS. Modifying the CCR5 gene using gene therapy can thus make people able to catch it
either.
Legal system
Laws criminalizing HIV transmission have not been found an effective way to reduce HIV risk
behavior, and may actually do more harm than good. In the past, many U.S. states criminalized
the possession of needles without a prescription, even going so far as to arrest people as they
leave private needle-exchange facilities. In jurisdictions where syringe prescription status
presented a legal barrier to access, physician prescription programs had shown promise in
addressing risky injection behaviors.[ Epidemiological research demonstrating that syringe
access programs are both effective and cost-effective helped change state and local laws relating
to needle-exchange program (NEP) operations and the status of syringe possession more
broadly. As of 2006, 48 states in the United States authorized needle exchange in some form or
allowed the purchase of sterile syringes without a prescription at pharmacies.
Removal of legal barriers to operation of NEPs and other syringe access initiatives has been
identified as an important part of a comprehensive approach to reducing HIV transmission
among injection drug users (IDUs). Legal barriers include both "law on the books" and "law on
the streets," i.e., the actual practices of law enforcement officers, which may or may not reflect
the formal law. Changes in syringe and drug-control policy can be ineffective in reducing such
barriers if police continue to treat syringe possession as a crime or participation in NEP as
evidence of criminal activity. Although most NEPs in the US are now operating legally, many
report some form of police interference.
Research elsewhere has shown similar misalignment between "law on the books" and "law on
the streets". For example, in Kyrgyzstan, although sex work, syringe sales, and possession of
syringes are not criminalized and possession of a small amount of drug has been decriminalized,
gaps remain between these policies and law enforcement knowledge and practice. To optimize
public health efforts targeting vulnerable groups, law enforcement personnel and public health
policies and practices should be closely aligned. Such alignment can be improved through
policy, training, and coordination efforts.
Quality in prevention
The EU-wide ‘Joint Action on Improving Quality in HIV Prevention’, is seeking to increase the
effectiveness of HIV prevention in Europe by using practical quality assurance (QA) and quality
improvement (QI) tools.
Referrences Links
https://www.avert.org/professionals/history-hiv-aids/overview
https://www.womenshealth.gov/hiv-and-aids/hiv-and-aids-basics/facts-about-hiv-and-aids
https://www.medindia.net/patients/aids/InitialTheories_Theories.htm
https://www.medindia.net/patients/aids/InitialTheories_Acronyms.htm
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids/how-can-i-prevent-hiv
https://en.wikipedia.org/wiki/Prevention_of_HIV/AIDS
https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids