dr akin moses chief consultant & head, family medicine, national
TRANSCRIPT
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Dr Akin MosesChief Consultant & Head,Family Medicine,National Hospital Abuja.
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What is HIV/AIDS?
HIV, a virus.
HIV=Human Immunodeficiency Virus
HIV and human immune cells
HIV positive
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HIV/AIDS
AIDS is a medical condition
AIDS=Acquired Immunodeficiency Syndrome
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Why is HIV dangerous?
Attacks the immune system itself.
Replicates and integrates into host’s genome.
Evasion by mutation.
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HIV/AIDS dynamics
Time between HIV infection and AIDS
AIDS: depleted immune cells below the standard
AIDS:development of opportunistic infections
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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 %
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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
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Myths about HIV/AIDS
1.Relatship btw HIV & AIDS HIV=AIDS=DEATH
HIV does not cause AIDS
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Myths
2.HIV/AIDS treatment HIV is curable
Virgin cleansing.
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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
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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)
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Myths
5.AIDS Denial There is no AIDS in Africa
American Invention to discourage Sex(AIDS)
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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.
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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
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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
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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.
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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)
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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
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Recognising symptoms & signs 1.Early symptoms:Flu-like illness
Appear within weeks to months
Very infectious stage
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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
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Herpes Zoster
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Pruritic skin lesions
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Seborrheic dermatitis
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CHRONIC HERPES SIMPLEX
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CRYPTOCOCCOSIS
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Histoplasma
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Mycosis Fungoides
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There are over 25 AIDS defining conditions
None is an absolute pointer to the diagnosis of AIDS
High index of suspicion
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How is HIV dignosed?
Screening tests:ELISA
Confirmatory:Western blot
Window period:1-6 months,PCR
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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)
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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
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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.
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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.
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Stigmatization & Workplace policy Self stigmatization:Deny diagnosis
and access to treatment.
Family stigmatization.
Workplace stigmatization.
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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.
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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.
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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.
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General Law of prevention A,B,C(sexual transmission) Adequate blood screening b4
transfusion PMTCT program Avoid sharing
needles,sharps,Tattooing No effective vaccine.
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Post-exposure Prophylaxis:0-72hrs Rape Needle Stick injuries Involves the use of HAART to prevent
infection.
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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
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For your patience.