Hiv aids

HIV/AIDS

Come forward…..Take Leadership…..Stop AIDS

Dr Naresh T Chauhan

Department of PSM

16/06/2010 Come Forward Take Leadership Stop AIDS

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“HIV/AIDS is one of the biggest challenges to development that we have ever faced. Our response must be Agency-wide. The HIV/AIDS pandemic is not just a health sector issue; it is the business of every officer in every sector in the Agency. […] The design of activities in all sectors should take into account the impact of the HIV/AIDS pandemic on human and institutional capacity in the sector.”

USAID Administrator Andrew Nations, 2001


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Where are we?

• Feminization of epidemic: in Sub-Saharan Africa women make 60% of HIV positive adults; globally this figure is 50% for the first time

• India: 95% of new infections in women were among married and monogamous in 2003

• Stigma & discrimination: Surveys reveal that majority of respondents do not want to work with people living with HIV/AIDS

• Lack of treatment: In Africa only 4% of PLWHA have treatment

• Vast secondary impacts: Orphans, basic social services, instability

Curtsey: UNDP


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Global summary of the AIDS epidemic, 2008

Total 33.4 million [31.1 – 35.8 million] Adults 31.3 million [29.2 – 33.7 million] Women (aged 15 and above)

15.7 million [14.2 – 17.2 million] Children under 15 years

2.1 million [1.2 – 2.9 million]

Total 2.7 million [2.4 – 3.0 million]Adults 2.3 million [2.0 – 2.5 million]Children under 15 years 430 000 [240 000 – 610 000]

Total 2.0 million [1.7 – 2.4 million]Adults 1.7 million [1.4 – 2.1 million]Children under 15 years 280 000 [150 000 – 410 000]

Number of people living with HIV in 2008

People newly infected with HIV in 2008

AIDS-related deaths in 2008


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Impact on Human development

• Kills young adults in their most productive years of their lives

• 40 million orphans by 2010• Poverty spreads and deepens• Brake on economic growth• Health and education achievements reversed


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Total: 33.4 million (31.1 – 35.8 million)

Western & Central Europe

850 000850 000[710 000 – 970 000][710 000 – 970 000]

Middle East & North Africa

310 000310 000[250 000 – 380 000][250 000 – 380 000]Sub-Saharan Africa

22.4 million22.4 million[20.8 – 24.1 million][20.8 – 24.1 million]

Eastern Europe & Central Asia

1.5 million 1.5 million [1.4 – 1.7 million][1.4 – 1.7 million]

South & South-East Asia

3.8 million3.8 million[3.4 – 4.3 million][3.4 – 4.3 million]Oceania

59 00059 000[51 000 – 68 000][51 000 – 68 000]

North America1.4 million

[1.2 – 1.6 million]

Latin America2.0 million2.0 million

[1.8 – 2.2 million][1.8 – 2.2 million]

East Asia850 000850 000

[700 000 – 1.0 million][700 000 – 1.0 million]Caribbean240 000

[220 000 – 260 000]

Adults and children estimated to be living with HIV, 2008


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Western & Central Europe

<100<100[<100 –– <200]

Middle East & North Africa33003300

[1600 – 5300][1600 – 5300]Sub-Saharan Africa

230 000230 000[120 000 – 350 000][120 000 – 350 000]

Eastern Europe & Central Asia

1400 1400 [<500 – 2700][<500 – 2700]

South & South-East Asia11 00011 000

[4900 – 17 000][4900 – 17 000]Oceania<100<100

[<100 –– <500]

North America<100

[<100 –– <200]

Latin America39003900

[2100 – 5700][2100 – 5700]

East Asia15001500

[<1000 – 2300][<1000 – 2300]Caribbean

1300[<1000 – 2100]

Estimated deaths of children (<15 years) due to AIDS, 2008

Total: 280 000 (150 000 – 410 000)


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0 10 20 30 40 50 60 70

Cambodia

Haiti

Mozambique

Rwanda

Côte d'Ivoire

Zambia

Kenya

South Africa

Zimbabwe

Botswana

Life expectancy at birth (years)

Predicted life expectancy

Predicted loss in life expectancy due to HIV/AIDS in children born in 2000

Loss in life expectancy due to HIV/AIDS


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Over 7400 new HIV infections a day in 2008

• More than 97% are in low- and middle-income countries

• About 1200 are in children under 15 years of age

• About 6200 are in adults aged 15 years and older, of whom:

— almost 48% are among women— about 40% are among young people (15–24)


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Silence and hopelessness

HIV/AIDS Epidemic

• SEX• FEAR• SHAME• DENIAL• ILLNESS• DEATH• STIGMA• DISCRIMINATION

3.97 m. IndiansLiving with HIV

1998

2002 2003

HIV Prevalence reaches 1% amongst general population in TN, AP & Karnataka

Gujarat remained in medium prevalence

Gujarat remained in medium prevalence

>1% Antenatal women >5 % High risk groups< 5 % High risk groups

19901986 1994

20012000

First case of HIV detected in Chennai

HIV Prevalence reaches over 5% amongst high riskgroup in Maharahtra & Manipur

HIV Prevalence reaches over 1% amongst women in Maharashtra & Manipur

EVOLUTION OF HIV EPIDEMIC–

INDIA 1986-2003

High level of HIV among ANC clinic attendants in Maharashtra & TN some sites reporting over 5%


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Natural History of HIV infection


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Progress of HIV


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Development of HIV/AIDS


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Transmission routes


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How testing is done?


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Pre and post test counseling


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Type of tests


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Lab diagnosis


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Lab diagnosis


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CHALLENGES IN THE BEGINNING

• Denial• Strong feeling about moral values.• Blame-Problem due to migrants from UP,

Bihar, Orissa, Rajasthan. • Rapid industrialization.• Longest coast line.• Border State.• Neighbor of high prevalent State-

Maharashtra, with close interaction of population from Gujarat.


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•Active involvement of multitude of partners • From Government• Municipal Corporations• Voluntary Organizations, • Community based organizations,• Involvement of corporate sector to Implement the targeted interventions and also in other programmes like Blood Safety, STDs, VCTCs, PPTCT, •School AIDS Education Programme etc.

DOING DIFFERENTLY


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MEDIAN PREVALENCE OF HIV IN GUJARAT(STD & ANC) SENTINEL SURVEILLANCE

12.76

3.604.484.145.76 4.03 5.14

0.50.50.380.58 0.38 0.38 0.130.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Years

Med

ian

Pre

vale

nce

STD 12.76 5.76 4.03 4.14 5.14 4.48 3.60

ANC 0.58 0.38 0.5 0.5 0.38 0.38 0.13

1998 1999 2000 2001 2002 2003 2004


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Life skills


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Albert Einstein said

“The world we have made as a result of the level of thinking we have done thus far creates problems that we cannot solve at the same level at which we have created them... We shall require a substantially new manner of thinking if humankind is to survive. .”


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Don’t EVER give up!

Hiv aids

Health & Medicine

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