Q
How serious is the interaction between HIV and TB in South-East Asia?
A

Tuberculosis kills nearly 3 million people globally, of whom nearly 50% are Asians. The rapid spread of HIV in the region has further complicated the already serious situation. Not only is TB the commonest life-threatening opportunistic infection among patients living with AIDS, but the incidence of TB has now begun to increase, particularly in areas where HIV seroprevalence is high. Multi-drug resistant TB is also quite common in many areas.

Q

What efforts are being made to integrate HIV/AIDS/STD prevention and control activities into primary health care?

A

Integration into primary health care is a priority because it is necessary for ensuring sustainability. Two examples of an integrated approach are the implementation of HIV/AIDS care and STD prevention and control. For example, a continuum of HIV/AIDS care is being promoted as part of primary health care, with linkages to be established between institutional, community and home levels. In the area of STD prevention, and control, a syndromic approach to STD diagnosis is most suitable in the developing world as it does not require laboratory tests, and treatment can be given at the first contact with health services. WHO strongly advocates that all primary health care workers be trained in the syndromic approach to STD management.

Q
Is there a vaccine for HIV/AIDS? What is WHO's role in this regard?
A

While there is currently no vaccine for HIV/AIDS, research is under way. many candidate vaccines are presently undergoing either phase I or phase II clinical trials in various countries, including Thailand in South-East Asia. These will be followed by field trials in the community to determine efficacy, which is a time consuming process and will take another 3-5 years or more. Hence, a vaccine for general use is unlikely to be available in the near future. WHO's role is to assist in the development, evaluation and availability of vaccines. WHO has helped four countries - Brazil, Rwanda, Thailand and Uganda - to prepare a comprehensive plan for HIV vaccine research including strengthening of national epidemiological, laboratory and socio-behavioural research capabilities.

Q
Is there a treatment for HIV/AIDS?
A

All the currently licensed anti-retroviral drugs have effects which last only for a limited duration. In addition, these drugs are very expensive and have severe adverse reactions while the virus tends to develop resistance rather quickly with single-drug therapy. The emphasis is now on giving a combination of drugs including newer drugs called protease inhibitors; but this makes treatment even more expensive.
WHO's present policy does not recommend antiviral drugs but instead advocates strengthening of clinical management for HIV- associated opportunistic infections such as tuberculosis and diarrhoea. Better care programmes have been shown to prolong survival and improve the quality of life of people living with HIV/AIDS.

Q
How should governments share responsibility?
A

Governments are responsible for ensuring that enough resources are allocated to AIDS prevention and care programmes, that all individuals and groups in society have access to these programmes, and that laws, policies and practices do not discriminate against people living with HIV/AIDS. Governments of developed countries have a moral responsibility to share the AIDS burden of developing countries.

Q
Do people living with HIV/AIDS have special rights or responsibilities?
A

Since everyone is entitled to fundamental human rights without discrimination, people living with HIV/AIDS have the same rights as seronegative people to education, employment, health, travel, marriage, procreation, privacy, social security, scientific benefits, asylum, etc. Seronegative and seropositive people share responsibility for avoiding HIV infection/re-infection. But many people, including women, children and teenagers, cannot negotiate safe sex because of their low status in society or, lack of personal power. Therefore, men whether knowingly infected or unaware of their HIV status, have a special responsibility of not putting others at risk.

Q
Where did AIDS come from?
A

AIDS is caused by a virus called HIV, but where this virus came from is not known. However, as new facts are discovered about viruses like HIV, the question of where HIV first came from is becoming more complicated to answer. Moreover, such questions are no longer relevant and do not help in our eftorts to combat this epidemic. What is more important is the fact that HIV is present in all countries and we need to determine how best to prevent the further spread of this deadly virus.

Q
Where was AIDS first found?
A

AIDS was first recognised in the United States in 1981. However, it is clear that AIDS cases had occurred in several parts of the world before 1981. Evidence now suggests that the AIDS epidemic began at roughly the same time in several parts of the world, including the U.S.A. and Africa.

Q
But how can there suddenly be a disease that never existed before?
A

If we look at AIDS as a worldwide pandemic, it appears as if it is something new and rather sudden. But if we look at AIDS as a disease and at the virus that causes it, we get a different picture. We find that both the disease and the virus are not new. They were there well before the epidemic occurred. We know that viruses sometimes change. A virus that was once harmless to humans can change and become harmful. This is probably what happened with HIV long before the AIDS epidemic.
What is new is the rapid spread of the virus. It may be compared with a weed that someone brings home from a distant place. In its original environment the weed survives but does not spread much. However, once it takes root in the new environment, conditions may allow it to grow much better than it did before. It spreads, chokes out other plants, and becomes a nuisance.
The spread of HIV is somewhat similar. Researchers believe that the virus was present in isolated population groups years before the epidemic began. Then the situation changed; people moved more often and travelled more; they settled in big cities; and life-styles changed, including patterns of sexual behaviour. It became easier for HIV to spread through sexual intercourse and contaniinated blood. As the virus spread, the disease which was already in existence became a new epidemic.

Q
Are women at equal risk of getting infected with HIV?
A

Women are in fact more at risk of getting infected because of their increased vulnerability. In addition, their low status within the family and society further heighten their vulnerability to infection. It is therefore most important that every woman has access to information about HIV/AIDS to protect herself.

Q
Does AIDS affect children?
A

Yes. Children can be both infected and affected by AIDS. Over 2.7 million children below 15 years of age worldwide are now infected with HIV estimated till end of 2001 . If HIV continues to spread in all countries, there will be a great increase in deaths among infants and children. It is estimated that 5,80,000 children below 15 years of age died because of HIV/AIDS during 2001 . It was estimated that by the year 2000, 10 million children will have been orphaned as their parents die of AIDS.

Q
Who should provide care to HIV/AIDS affected persons?
A

Everyone in contact with an HIV/AIDS person is a potential care provider. In particular, this includes health care workers at various levels of the health care delivery system, social workers and counsellors, and close family members who are important care providers at home. Care basically involves clinical management, nursing care, counseling and social support.

 
¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨¨
 
Copyright © 2002 AIDS Prevention Society
Powered by Web.com(India) Pvt. Ltd.