Epidemiological Triad of HIV/AIDS: Agent

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Introduction

AIDS, the acquired immune-deficiency syndrome (sometimes called “Slim disease”) is a fatal illness
caused by a retrovirus known as the human immune-deficiency virus (HIV) which breaks down the
body’s immune system, leaving the victim vulnerable to a host of life – threatening opportunistic
infections, neurological disorders, or unusual malignancies. The term Aids refers only to the last stage
of the HIV infection.
There are at least two types of Human Immunodeficiency Virus (HIV): HIV-1 and HIV-2. HIV-1 is
responsible for most cases world-wide.
 Age: Most cases have occurred among sexually active persons aged 20-45 years.
 Incubation period: From few months to 10 years or even more.
 Source of infection: Blood, semen, Vaginal and other body secretions, CSF, breast milk.
 Some bodily fluids, such as saliva and tears, do not transmit HIV.
 Transmission: The basic method of transmission are-
i. Mucosal:
a) Sexual intercourse (vaginal or anal)
b) Perinatal - From mother to fetus while in utero, during delivery or postnatally by
breast feeding
ii. Parenteral:
a) Infected blood or blood products.
b) Contaminated needles.

Epidemiological triad of HIV/AIDS


Host genetics.
Stage of infection
RTI.
Male circumsion.
Contraception.
Menustration and pregnancy.

Host

HIV

Agent Environment

• HIV subtype(A,B,C,D,E) Social norms.


• Phenotypic differences. Average rate of sex-partner change.
• Genotypic diff. Probability of exposure.
• Antiretroviral resistance. Risk behavior.
HIV/AIDS Signs & Symptoms
HIV infection signs Major signs i. Weight loss ≥ 10% of body
weight.
ii. Chronic diarrhea > 1month.
iii. Prolonged fever > 1 month.
Minor signs i. Persistent cough> 1 month.
ii. History of herpes zoster.
iii. Oropharyngeal candidiasis.
iv. Herpes simplex infection.
v. Generalized lymphadenopathy.
HIV infection symptoms i. Fatigue
ii. Fever
iii. Malaise
iv. Weight loss.
v. Diarrhoea.

High risk groups for HIV infection

Sex workers are among the highest risk groups


for HIV. On average, sex workers are 13 times
more likely to become infected with HIV than
i. Sex workers adults in the general population. High-risk
behaviors, including anal sex, and group sex,
multiple partners and inconsistent condom use
etc. work behind their mass infection.
Risk-behaviors in both male sex workers and
ii. Male homosexuals (gay)/MSM (Male Hijra are very high. They also lacks in using
has sex with males), bisexuals and Hijra condom, practice anal and group sex and holds
(male transgender) multiple sex partners.

Sharing needles, syringes, or other injection


equipment to inject drugs puts people at risk for
iii. IDUs (injecting Drug Users) getting or transmitting HIV and other infections.
HIV can survive in a used needle for up to 42
days, depending on temperature and other
factors.
As the sex workers frequently involved in risky,
unprotected intercourse with multiple partners,
iv. Clients of sex workers they are very much prone to disseminate AIDS
pathogen to their clients.

Migration and sex work are often linked as


some migrants may turn to sex worker if they
v. Labor migrant / Transport workers cannot find an alternative means of making
money. The transport sector works as a vector
in the transmission of HIV/AIDS.
Partners of migrants / house wives, Street
vi. Other children, Health care workers, Hemophiliacs
and clients of STD.
Risks for transmission

Most HIV infection


Highest Lowest
occurs because of
risk risk
several risk factors

Unknown HIV status Known

Seroconversion Viral load Undetectable

High risk Low risk


Sexual activity

No condoms Condom use Using condoms

High viral load Low viral load


Oral sex

Exchanged Sexual fluid No contact

Hours Duration of sex Minutes

Rough How Vigorous Gentle

Vulnerable genes Genetics Protective genes

Un circuncised Male circumsion Circumcised

According to the latest UNIAIDS report 2017, globally 36.9 million and 5.1 million people in
the Asia Pacific region are living with HIV while only 2.4 million of Asian’s have access to
treatment. Bangladesh stands at the 10th position in HIV deaths among Asian countries and it
lost around 1,000 people in 2016 due to AIDS, says the report.

HIV prevalence (%) in Southeast Asian Region (Included BD.)

Source: http://www.searo.who.int/entity/health_situation_trends/data/mdg/hiv_prevalence/en/
Preventive Measures for HIV infection
i. Testing The first – and most
important – step in
1) Pharmaceutical preventing HIV infection is
stratigies to know one’s status.
ii. Taking Pre-exposure prophylaxis Pre-exposure prophylaxis,
(PrEP). is a medication that people
without HIV can take daily
to prevent infection. When
combined with other HIV
prevention methods, such
as regular testing and
condom use, it’ll
significantly reduce one’s
risk of HIV infection.
iii. Taking Post-exposure prophylaxis It is also an effective
(PEP). measure to limit HIV
infection
iv. Circumcision Male circumcision reduces
the risk of HIV
transmission from women
to men
v. Condoms HIV is spread through
bodily fluids like blood,
semen, and vaginal fluids.
When used properly,
condoms are an effective
way to prevent HIV
infection.
2) Social Sex education will concern
strategies i. Sex education the young adults, men and
women of reproductive age
about the mode of
transmission of HIV
infections, benefits of using
condoms, harm of having
multiple sex partners and
drug abuse etc. Which will
conclusively prevent HIV
infection in a great way.
o Avoidance of
ii. Safe sex indiscriminate sex.
o Avoidance of
penetrative sex &
o Use of condoms
can prevent HIV
infection.
This isn’t easy for most
iii. Sexual abstinence people, but it’s the one way
of making absolutely sure
that one doesn’t become
HIV positive as a result of
sexual contact.
Sex isn’t the only way HIV
is transmitted. Intravenous
3) Not to share drug use also puts you at
needles, razors risk, since HIV can be
and tooth spread through blood.
brushes Avoid injecting drugs and
never share needles.

i. Routine HIV testing in antenatal


clinics
ii. Learn How to Safely Conceive a
4) Perinatal Child
iii. Avoid passing the virus to baby
during pregnancy

Persuasive messages
delivered through health
advertising and social
5) Advertising and marketing campaigns which
campaigns are designed to educate
people about the danger of
HIV/AIDS and simple
prevention strategies are
also an important way of
preventing HIV/AIDS.
6) Regular venerological screening for high risk groups, e.g. prostitutes.
7) Targeting safe sex methods at sex works.
8) Control of STD.
9) Screening of donated blood, blood products and reduction of unnecessary blood
transfusions.

Management of HIV/AIDS
The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an
attempt to control HIV infection. The use of multiple drugs that act on different viral targets is known
as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV,
maintains function of the immune system, and prevents opportunistic infections.

Management of HIV/AIDS
Management Maintains and improves nutritional
status of a person with AIDS.
Good nutrition Delays the progression from HIV to
Good nutrition AIDS related disease.
Management HIV related complications Management of diarrhea, metabolic
A Management of HIV
disorder, malabsorption, lack of
appetite, weight loss etc.
I relate complications
Strengthening of the immune system Ability to fight HIV infection by
D maintaining healthy life style.
S Strengthening of Increased resistance of infection Diarrhea, Tuber Culosis,
the immune system respiratory infections.

Increased resistance
of infection
.

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