dr akin moses chief consultant & head, family medicine, national

Dr Akin MosesChief Consultant & Head,Family Medicine,National Hospital Abuja.

What is HIV/AIDS?

HIV, a virus.

HIV=Human Immunodeficiency Virus

HIV and human immune cells

HIV positive

HIV/AIDS

AIDS is a medical condition

AIDS=Acquired Immunodeficiency Syndrome

Why is HIV dangerous?

Attacks the immune system itself.

Replicates and integrates into host’s genome.

Evasion by mutation.

HIV/AIDS dynamics

Time between HIV infection and AIDS

AIDS: depleted immune cells below the standard

AIDS:development of opportunistic infections

Patterns of HIV Disease Progression

HIV HIV InfectionInfection

Long-termLong-term Non-progressorsNon-progressors

Rapid ProgressorsRapid Progressors

Typical ProgressorsTypical Progressors

<3 years<3 years

7-10 years7-10 years

>10-15 yr>10-15 yr

Normal, Stable CD4Normal, Stable CD4

90 %90 %

<5 %<5 %

<10 %<10 %

When & where was HIV discovered? 1st reported in the USA in early

1980’s

Men that have sex with men

Earliest evidence was in Zaire,Congo in 1959

Myths about HIV/AIDS

1.Relatship btw HIV & AIDS HIV=AIDS=DEATH

HIV does not cause AIDS

Myths

2.HIV/AIDS treatment HIV is curable

Virgin cleansing.

Myths

• 3. HIV Infection• HIV cannot be transmitted via oral sex

• HIV is transmitted by mosquitoes

• Say a prayer b4 sex=No HIV

• Wash/shower after sex=No HIV

Myths

4.History of HIV/AIDS HIV from outer space

HIV was made for biological weapon

African monkeys & American women(SIV is similar to HIV)

Myths

5.AIDS Denial There is no AIDS in Africa

American Invention to discourage Sex(AIDS)

Epidemiology & StatisticsWorldwide: Over 22 million people have died

from AIDS. Over 42 million people are living with

HIV/AIDS, and 74 percent of these infected people live in sub-Saharan Africa.

Over 19 million women are living with HIV/AIDS.

Stats

By the year 2010, five countries (Ethiopia, Nigeria, China, India, and Russia) with 40 percent of the world's population will add 50 to 75 million infected people to the worldwide pool of HIV disease

Stats

There are 14,000 new infections every day (95 percent in developing countries). HIV/AIDS is a "disease of young people" with half of the 5 million new infections each year occurring among people ages 15 to 24

Stats

The UN estimates that, currently, there are 14 million AIDS orphans and that by 2010 there will be 25 million.

In Nigeria, Benue State has the highest incidence.

How is HIV transmitted?

Unprotected sexual intercourse with an infected person

Contact with infected blood Use of infected blood products Needle sharing,Needle stick accident Mother to child transmission(MTCT)

Ways HIV is not transmitted Sharing cutleries and cups Touching,hugging and shaking hands Eating food prepared by someone

with HIV Toilet seats,insect bites Social kiss Vs French kiss

Recognising symptoms & signs 1.Early symptoms:Flu-like illness

Appear within weeks to months

Very infectious stage

Symptoms & Signs

2.Later symptoms:8-10yrs Lack of energy(fatigue) Weight loss(>10% of normal body

weight) Persistent skin rashes Recurrent diarrhoeal stools Oral thrush

Herpes Zoster

Pruritic skin lesions

Seborrheic dermatitis

CHRONIC HERPES SIMPLEX

CRYPTOCOCCOSIS

Histoplasma

Mycosis Fungoides

There are over 25 AIDS defining conditions

None is an absolute pointer to the diagnosis of AIDS

High index of suspicion

How is HIV dignosed?

Screening tests:ELISA

Confirmatory:Western blot

Window period:1-6 months,PCR

Role of awareness campaigns Overview:successful e.g. Onyeka onwenu & Sunny Ade

adverts:if u love me,u go wait for me.

Femi Kuti:AIDS no dey show for face Zip up Banks can sponsor awareness

campaigns in their immediate locality(not expensive)

How do I go about awareness campaign? Education Make condoms freely accessible Promote openness to break stigma &

silence Encourage testing for everyone Make pple understand their rights &

treatment options

Risk & High Risk groups

Risk group:Everyone High risk group: Commercial sex workers Hospital workers Illicit drug users(needle sharing) Long distance drivers Pple with other STIs Business people.

Awareness & VCT

Location of Servises: PEPFAR Clinic,National Hospital

Abuja University of Abuja teaching Hospital Others:General

Hospitals,NGOs,Private hospitals & Laboratories may charge a fee.

Stigmatization & Workplace policy Self stigmatization:Deny diagnosis

and access to treatment.

Family stigmatization.

Workplace stigmatization.

Workplace Policy

FGN in 2007 approved a national workplace policy on HIV/AIDS.

Aim is to Tackle discrimination,stigmatization & exclusivity,protect the rights of job seekers and employment prospects.

Workplace policy

Stipulates that 1.No obligation will be placed on an

employee to reveal his/her HIV status to the employer.

2.Health insurance coverage would be available to employees regardless of HIV status.

3.That HIV screening would not be required of job applicants or persons in employment.

How do you prevent HIV progression to AIDS Regular clinic & laboratory attendance Healthy lifestyle:Exercise,good

nutrition,cessation of smoking,alcohol Practise safer sex Drugs if required Attend support group & seek

information Support those infected & affected.

General Law of prevention A,B,C(sexual transmission) Adequate blood screening b4

transfusion PMTCT program Avoid sharing

needles,sharps,Tattooing No effective vaccine.

Post-exposure Prophylaxis:0-72hrs Rape Needle Stick injuries Involves the use of HAART to prevent

infection.

Conclusion

HIV is not =AIDS No available cure as of today. HIV can be prevented & managed Importance of awareness campaigns

can not be overemphasized:Being aware solves half of the problem.

Everyone should be tested. Avoid employer discrimination We all can help curb this pandemic

For your patience.