HIV and AIDS Information
What is HIV?
HIV is the virus that causes AIDS. The virus infects cells that make up the immune system which protects the body from disease. When the cells are infected, the body’s immune system can become damaged and a person’s ability to fight off disease is reduced.
What is AIDS?
When HIV has damaged a large proportion of the cells in the body’s immune system, a person can no longer fight off illness. AIDS is usually diagnosed when an HIV infected person becomes unwell with one or more serious illnesses, known as opportunistic infections such as pneumonia, tuberculosis or skin cancer.
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How do people get infected? HIV can be passed from one person to another through;
Í Unprotected sex with a person with the virus. Í Pregnancy, childbirth and breastfeeding – the virus can be transmitted to the baby during these times if the mother has the virus.
Í Sharing of needles to inject drugs.
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Is there a cure? There is currently no cure for HIV. Huge advances in treatment have been made with drugs known as ‘antiretrovirals’ (ARVs) that can slow down the progress of HIV and thus slow down the damage to your immune system. As a result, HIV is now an illness that can be managed with proper medical treatment (like diabetes), and people living with the virus can live a near normal lifespan. Antiretroviral medicines are not prescribed for someone living with HIV until tests show that their immune system has become low as a result of the virus.
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How is sexual transmission of HIV prevented? Sexual transmission of HIV can be prevented by
Í Abstaining from sex Í Mutually faithful relationships where both parties are uninfected
Í Using protective measures Í ‘Treatment as prevention’ is an approach increasingly used among sero discordant
couples (where one partner is HIV positive and one is HIV negative). An HIV-positive person takes antiretroviral treatment to decrease their viral load and reduce the risk of transmitting HIV to their partner.
Í Post-exposure prophylaxis, is used where a person has been exposed to a risk of
HIV, for example, through a medical incident or rape, and can take antiretroviral treatment to reduce their risk of becoming infected with HIV. Post exposure prophylaxis must be taken within hours after exposure (but no later than 72 hours) to be effective
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How is sexual transmission of HIV prevented? Scientific trials have shown that male circumcision can reduce a man’s risk of becoming infected with HIV during heterosexual intercourse by up to 60 percent. Male circumcision involves removing the foreskin, a loose fold of skin that covers the head of the penis. The procedure can be carried out at any stage; during infancy, childhood, adolescence or adulthood.
7/22 It is estimated that up to a third of all men are circumcised, though rates vary widely around the world. Trials have shown that the foreskin acts as HIV’s main ‘entry point’ during penetrative sex between an uninfected man and an HIV-infected person. These findings have led to the decision by UNAIDS and the World Health Organization (WHO) to recommended circumcision as an important new element of HIV prevention. (Source: http://www.avert.org/circumcision-hiv.htm)
8/22 How HIV is transmitted 1. Sexual Contact – having unprotected sex is the most common way through which people contract HIV. 2. Blood Contact – sharing needles or other sharp objects contaminated with HIV-infected blood or through blood transfusion (although blood for transfusions is now tested so this is no longer a problem in most places). 3. Mother to Child Transmission – mothers can pass HIV to their babies during pregnancy, delivery or breastfeeding.
How HIV is not transmitted Í Saliva
Í Tears
Í Kissing
Í Swimming
Í Hugging Í Shaking hands Í Sharing a bed Í Sharing clothes Í Sneezing Í Coughing Í Sweating
pools
Í Mosquito bites Í Food utensils Í Drinking cups Í Straws Í Sharing cutlery Í Toilet seats
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How is mother to child transmission of HIV prevented? The use of anti HIV treatment, having a caesarean delivery (for mothers with detectable viral loads) and taking professional advice on whether or not to breastfeed your baby can reduce the risk of a mother passing on HIV to her baby to less than 1%.
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Global view of HIV 330,000 children were newly infected with HIV in 2011
Í 1.7 million people
died of AIDS related illnesses in 2011
Í 30 million people have died from AIDS related illnesses since 1981
34.2 million people are living with HIV (UNAIDS 2011) 3.4 million of these were children under the age of 15
Í 562,000 children 8 million people accessed ART which represents 54% of those who need it
were accessing ART in 2011 which represents 28% of children who need it
1.5 million people were newly infected with HIV in 2011
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Statistics in Ireland 320 people were newly diagnosed with HIV in Ireland in 2011.
42.5% of new diagnoses in Ireland in 2011 were among men who have sex with men.
34% of new diagnoses in Ireland in 2011 were among heterosexual couples. Of these 43% were among individuals originating from countries with generalised epidemics.
6,287 people have been diagnosed with HIV in Ireland since the 1980s.
The current prevalence rate in Ireland and in the UK is 0.2%. 5% of new diagnoses in Ireland in 2011 were among injecting drug users.
12/22 The map illustrates how Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world. An estimated two thirds of the global total of HIV infections occur in Sub Saharan Africa. In 2010 around 1.2 million people died from AIDS in subSaharan Africa and 1.9 million people became infected with HIV. Since the beginning of the epidemic 14.8 million children have lost one or both parents to HIV and AIDS. Sub-Saharan Africa faces a triple challenge:
Í Providing health care, antiretroviral
treatment, and support to a growing population of people with HIV-related illnesses.
Í Reducing the annual toll of new HIV infections by enabling individuals to protect themselves and others.
Í Coping with the impact of millions of AIDS deaths on orphans and other survivors, communities, and national development.
■ Sub-Saharan Africa
13/22 Issues Facing People Who are Living with HIV The social and economic consequences of the AIDS epidemic are widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general. The AIDS epidemic, particularly in sub-Saharan Africa continues to devastate communities, rolling back decades of development progress.
image from Brid
14/22 Issues Facing People Who are Living with HIV
Stigma People Living with HIV or AIDS can be subjected to prejudice, negative attitudes and abuse. This type of behaviour generally results from fear and ignorance. But the consequences of stigma and discrimination are wide-ranging. They include being shunned by family and friends, receiving poor health care treatment, feeling rejected and depressed. Fear of HIV related stigma makes people unwilling to come forward for testing. This creates a stumbling block in ensuring access to essential services.
15/22 Issues Facing People Who are Living with HIV
Poverty HIV can make poor people poorer. Ill health can be costly as money is required for transport to hospital, hospital fees, and some medicines. Ill health prevents people going to work and so they may lose income and possibly their job.
16/22 Issues Facing People Who are Living with HIV
Access to treatment For many people living with HIV in developing countries, access to treatment has been more difficult than for those living in wealthier countries. Health systems in developing countries are often short staffed, under resourced and struggling to cope with the impact of HIV on their services. Availability of drugs has also been an issue in many places. In 2011, over 8 million people were accessing ARV medicines. However, this represented just 54% of those who needed them. People living in rural areas often have to travel long distances to health centres and they struggle to pay the fees required by hospitals.
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The Impact of HIV and AIDS on Development HIV and AIDS have a huge impact on many developing countries, particularly in parts of Africa:
The Effect on life expectancy:
Average life expectancy has fallen by twenty years because of the epidemic in the worst affected countries. For example, life expectancy at birth in Swaziland, a small country in Southern Africa with the highest HIV prevalence in the world, is just
48.7 years
HIV and AIDS dramatically affect labour, setting back economic and social progress. The vast majority of people living with HIV are between the ages of 15 and 49 – in the prime of their working lives.
18/22 Effect on the economy:
AIDS damages businesses by squeezing productivity, adding costs, diverting productive resources, and depleting skills. Company costs for health-care, funeral benefits and pension fund commitments are likely to rise as the number of people taking early retirement or dying increases. Also, as the impact of the epidemic on households grows more severe, market demand for products and services can fall. The epidemic hits productivity through increased absenteeism. Comparative studies of
East African businesses have shown that absenteeism can account for as much as
25-54% of company cost.
Effect on health care:
HIV can overwhelm hospitals, doctors, nurses and health systems generally. People who are living with HIV are more vulnerable to other infections and need regular care. Many doctors and nurses can be living with HIV themselves which prevents them from going to work.
19/22 HIV and AIDS is a development issue Effect on families:
The effect of the HIV epidemic on households can be very severe, especially when families lose their income earners. It is estimated that more than 16 million children have lost one or both parents to AIDS, with most of these living in subSaharan Africa. Having to care for so many extra children can overwhelm families.
Effect on Women:
Women are disproportionately affected by HIV. They are at greater risk of contracting HIV biologically and because of their unequal status in many countries and communities. They are also more likely to bear a greater burden of care as women and girls are generally responsible for caring for the sick in a household. In some places, girls drop out of school in order to care for a sick parent.
(Figures from UNAIDS, Together We Will End AIDS, 2012)
20/22 Political Commitment to HIV and AIDS In 2001 the United Nations General Assembly called a Special Session on HIV and AIDS at which 189 countries recognized HIV as a ‘global crisis’ requiring ‘global action’ and signed a Declaration of Commitment on HIV/AIDS. The declaration set a wide agenda, but priorities included:
Í First, to ensure that people everywhere – particularly the young – know what to do to avoid infection;
Í Second, to stop perhaps the most tragic of all forms of HIV transmission – from mother to child;
Í Third, to provide treatment to all those infected; Í Fourth, to redouble the search for a vaccine, as well as a cure; and Í Fifth, to care for all whose lives have been devastated by AIDS, particularly more than 16 million orphans.
In 2006 and again in 2011, global leaders met and noted that that lack of recognition of human rights was not only causing unnecessary personal suffering and loss of dignity for people living with HIV but was also contributing directly to the spread of the epidemic as people are less likely to seek counseling, testing, treatment and support when it means facing discrimination or other negative consequences. They agreed to pursuing all necessary effort towards the goal of Universal Access to comprehensive prevention programmes, treatment, care and support on HIV.
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What Trócaire is doing? We support partners working on a wide range of HIV and AIDS interventions. For example:
In Ethiopia, Trócaire works with people affected by HIV helping them start up income generating activities to support themselves and their families.
In Honduras, Guatemala and El Salvador, Trócaire works on reducing gender based violence which is a key factor that increases women’s risk of acquiring HIV.
In Kenya, Trócaire supports a health centre which provides prevention of mother to child related services to people living in Mukuru slums of Nairobi.
In Malawi, Trócaire works with communities to reduce the vulnerability of women and girls to HIV as a result of social and cultural norms and behaviours that put them at higher risk and which need to change.
In Zimbabwe Trócaire works with support groups of people living with HIV who lobby for their own rights as HIV positive persons.
In Cambodia, Trócaire supports children living with HIV providing them with medicines, food, shelter, Cambodia: education and the and care they 2,407 counselling love and care visits to people need for happy living with HIV childhoods.
In Mozambique, Trócaire supports a network of community volunteers to respond to the needs of people living with HIV in remote rural areas of the country.
22/22 List of Acronyms AIDS ART ARV HIV PLHIV PMTCT WHO PEP OI OVC VCT
Acquired Immunodeficiency Syndrome Antiretroviral Therapy Antiretroviral drugs Human Immunodeficiency Virus People Living with HIV Prevention of mother to child transmission World Health Organization Post Exposure Prophylaxis Opportunistic Infections Orphans and vulnerable children Voluntary counselling and testing
Useful websites Trócaire: www.trocaire.ie/HIV Trocaire is The official overseas development agency of the Catholic Church in Ireland. Avert: http://www.avert.org/ AVERT is an international HIV and AIDS charity, based in the UK, working to avert HIV and AIDS worldwide, through education, treatment and care. Avert’s web site provides up to date information on HIV in a very accessible style. HIV Aware: http://www.hivaware.org.uk/ NAT (National AIDS Trust) is the UK’s leading charity dedicated to transforming society’s response to HIV.
‘Stop AIDS Campaign’: stopaidscampaign.org.uk Stop AIDS Campaign is a coalition of over 60 NGOs and trade unions working together to demand universal access to HIV prevention, treatment, care and support. It suggests actions you can take to contribute to this work. United Nations programmes on HIV and AIDS - unaids.org UNAIDS, the Joint United Nations Programme on HIV/AIDS, is an innovative partnership that leads and inspires the world in achieving universal access to HIV prevention, treatment, care and support. It provides up to date information and statistics on the AIDS epidemic in every country in the world. Useful Clip: This 2 minute video clip uses an AIDS patient’s dramatic recovery to demonstrate the effect ARV treatment can have on those battling the advanced effects of HIV/AIDS. When treated, a person on the verge of death can return to health in a matter of months. http://www.youtube.com/watch?v=v6zCNdEfm5w