Professional Documents
Culture Documents
Ans. HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. This virus
is passed from one person to another through blood, using shared needles and
sexual contact. In addition, infected pregnant women can pass HIV to their baby
during pregnancy or delivery, as well as through breast-feeding. People with HIV
have what is called HIV infection. Most of these people develop AIDS as a result of
HIV infection.
These body fluids have been proven to spread HIV:
• blood
• semen
• vaginal fluid
• breast milk
• other body fluids containing blood.
Other additional body fluids that may transmit the virus that healthcare workers
may come into contact with are:
• cerebrospinal fluid surrounding the brain and the spinal cord
• synovial fluid surrounding bone joints
• amniotic fluid surrounding a foetus.
Q. What is AIDS? What causes AIDS?
Ans. All the currently licensed antiretroviral drugs, namely AZT, DDL and DDC, 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. But how can there suddenly be a disease that never existed before?
Ans. 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. 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 traveled more, they settled in
big cities and lifestyles changed, including patterns of sexual behaviour. It became
easier for HIV to spread through sexual intercourse and contaminated blood. As the
virus spread, the disease which was already in existence became a new epidemic.
Q. Is it safe to work with someone infected with HIV?
Ans. Yes. Most workers face no risk of getting the virus while doing their work. The
virus is mainly transmitted through the transfer of blood or sexual fluids. Since
contact with blood or sexual fluids is not part of most people's work, most workers
are safe.
Q. What about working every day in close physical contact with an infected
person?
Ans. There are no risks involved. You may share the same telephone with other
people in your office or work side by side in a crowded factory with other HIV
infected persons, even share the same cup of tea, but this will not expose you to
the risk of contracting the infection. Being in contact with dirt and sweat will also
not give you the infection.
Q. Who is at risk while at work?
Ans. Those who are likely to come into contact with blood that contains the virus
are at risk. These include healthcare workers - doctors, dentists, nurses, laboratory
technicians, and a few others. Such workers must take special care against possible
contact with infected blood, as for example by using gloves.
Q. If a worker has HIV infection, should he or she be allowed to continue
work?
Ans. Workers with HIV infection who are still healthy should be treated in the same
way as any other worker. Those with AIDS or AIDS-related illnesses should be
treated in the same way as any other worker who is ill. Infection with HIV is not a
reason in itself for termination of employment.
Q. Does an employee infected with the virus have to tell the employer
about it?
Ans. Anyone infected, or thought to be infected, must be protected from
discrimination by employers, co-workers, unions or clients. Employees should not
be required to inform their employer about their infection. If correct information
and education about AIDS are available to employees, a climate of understanding
may develop in the workplace protecting the rights of the HIV-infected person.
Q. Should an employer test a worker for HIV?
Ans. Testing for HIV should not be required of workers. Imagine that you are a
worker with HIV infection and are healthy and able to work. As far as your work is
concerned, the information about the infection is private. If it is made public, you
could be a target for discrimination. If AIDS-related illness makes you unfit for a
particular job, you should be treated in the same way as any other employee with a
chronic illness. A suitable alternative job can often be arranged by the employer.
The employers in different parts of the world are beginning to deal with these
problems more humanely. Their associations and workers' unions can be consulted
for advice.
Q. What if you are already infected with HIV? Can you still travel?
Ans. If you are already infected, consult your healthcare provider for guidance well
before you plan to travel. Some immigration officials insist on an HIV free
certificate. Your travel counsellor will advise you.
Q. 'AIDS is mainly a problem of developing countries.' or 'No, AIDS is really
a problem of developed countries'. Which of these opinions is more
accurate?
Ans. Many people would like to claim that AIDS only affects others - other people or
other countries. AIDS breaks the patterns that we associate with major diseases,
for example, linking malaria with the tropics or perhaps heart disease with the
industrialised world. AIDS affects both developing and industrialised countries, both
cold and hot countries. HIV can spread anywhere where people live and have sex.
Q. How do AIDS problems in different countries relate to each other?
Ans. They are related in at least three ways. First, in every country, AIDS is always
spread by a virus transmitted through sexual intercourse and through blood.
Specific actions by people are therefore required for it to spread in all countries.
Second, AIDS can be prevented in all countries by people if they change their
sexual behaviour, by screening blood for transfusion, and by sterilising needles and
syringes.
Third, the prevention and control of AIDS bring most countries of the world
together in joint action. They have the same basic problems to solve. For example,
donated blood must be tested and everyone must benefit from the availability of
simple, reliable and cheap blood tests to detect the virus. Only joint international
action can make such tests widely available and affordable.
Q. If a person becomes infected with HIV, does that mean he has AIDS?
Ans. No, HIV is an unusual virus because a person can be infected with it for many
years and yet appear to be perfectly healthy. But the virus gradually multiplies
inside the body and eventually destroys the body's ability to fight off illnesses.
It is still not certain that everyone with HIV infection will get AIDS. It seems likely
that most people with HIV will develop serious health problems. But this may be
after many years. A person with HIV may not know he is infected but can pass the
virus on to other people.
Q. Is it true that male circumcision may provide protection against HIV
infection?
Ans. Yes, the interior side of the foreskin has a mucosal surface, which is more
susceptible to trauma than the tougher skin of the penile shaft or the glans. The
foreskin also contains high levels of HIV target cells such as Langerhan’s cells.
Recent study in Chicago has found out that foreskin mucosal tissue has a seven fold
greater susceptibility to HIV-1 than cells in cervical tissue under same condition.
Q. Is oral sex unsafe?
Ans. Oral sex (one person kissing, licking or sucking the sexual areas of another
person) does carry some risk of infection. If a person sucks the penis of an infected
man, for example, infected fluid could get into the mouth. The virus could then get
into the blood if you have bleeding gums or tiny sores somewhere in the mouth.
The same is true if infected sexual fluids from a woman get into the mouth of her
partner. But infection from oral sex alone seems to be very rare.
Q. What about getting AIDS from body fluids like saliva?
Ans. Although small amounts of HIV have been found in body fluids like saliva,
faeces, urine and tears, there is no evidence that HIV can spread through these
body fluids.
Q. Could I be at risk?
Ans. Unless they know someone who has HIV, many people think this disease can't
happen to them. Unfortunately, it can and does happen to all kind of people. By
looking at your current and past sexual and drug practices (and your transfusion
history), you can get a picture of your risk for HIV. Also you can figure out how you
can reduce your future risk for HIV infection.
Q. How can I tell if I have HIV infection?
Ans. The only way to know for sure if you have this virus is by taking a blood test
called the "HIV Antibody Test." Some people call it the "HIV Test" or the "AIDS
Test," even though this test alone cannot tell you if you have AIDS. The HIV test
can tell you if you have the virus and can pass it to others in the ways already
described. The test is not a part of your regular blood tests – you have to ask for it
by name. It is a very accurate test.
If your test result is "positive," it means you have HIV infection and could benefit
from special medical care. Additional tests can tell you how strong your immune
system is and whether drug therapy is indicated. Some people stay healthy for a
long time with HIV infection, while others develop serious illness and AIDS more
rapidly. Scientists do not know why people respond in different ways to HIV
infection. If your test is "negative," and you have not had any possible risk for HIV
for six months prior to taking the test, it means you do not have HIV infection. You
can stay free of HIV by following prevention guidelines.
Q. Should I take the HIV test?
For some people taking the HIV antibody test can be a scary decision. Some people
get tested every six months, even if they practice safer sex. No matter what the
reasons are, taking the HIV antibody test can be a good idea. Sometimes taking the
test is a way to make a new found commitment towards safer practices.
One thing that is important to remember is that getting tested for HIV will not
change your HIV status. It just tells you whether or not you have it. With all the
new treatments available, finding out your HIV status early on can extend your life.
To find out if you are at risk for HIV, ask yourself the following questions:
• Have you had unprotected vaginal, oral or anal sex (e.g., intercourse
without a condom, oral sex without a latex barrier)?
• Have you shared needles to inject street drugs or steroids or to pierce your
skin?
• Have you had a sexually transmitted infection (STI) or unwanted
pregnancy?
• Have you had a blood transfusion or received blood products before April,
1985?
The counselling that should be provided before and after testing provides a good
opportunity to learn more about HIV, discuss your risks and how to avoid infection.
If you are a woman who is planning on getting pregnant, or are currently pregnant,
you may want to consider getting tested. There are new treatments to help reduce
the transmission of HIV from mother to child.
Q. If I am HIV Positive, what should I do?
Ans. If you have tested positive for HIV, consider the following:
See a healthcare professional for a complete medical check-up for HIV infection and
advice on treatment and health maintenance. Make sure you are tested for TB and
other STDs. For women, this includes a regular gynaecological exam.
Inform your sexual partner(s) about their possible risk for HIV. Your local health
department has a partner notification programme that can assist you.
Protect others from the virus by following the precautions talked about on this page
(for example, always using condoms and not sharing needles with others).
Protect yourself from any additional exposure to HIV.
Avoid drug and alcohol use, practice good nutrition, and avoid fatigue and stress.
Seek support from trustworthy friends and family when possible, and consider
getting professional counselling.
Find a support group of people who are going through similar experiences.
Do not donate blood, plasma, semen, body organs or other tissue.
Q. Why do people who are infected with HIV eventually die?
Ans. When people are infected with HIV, they do not die of HIV or AIDS. They die
due to the effects that the HIV has on the body. With the immune system down,
the body becomes susceptible to many infections, from the common cold to cancer.
It is actually those particular infections, and the body's inability to fight the
infections that cause these people to become so sick, that they eventually die.
Q. How can I tell if I am infected with HIV? What are the symptoms?
Ans. The only way to determine for sure whether you are infected is to be tested
for HIV infection. You cannot rely on symptoms to know whether or not you are
infected with HIV. Many people who are infected with HIV do not have any
symptoms at all for many years.
The following may be warning signs of infection with HIV:
• rapid weight loss
• dry cough
• recurring fever or profuse night sweats
• profound and unexplained fatigue
• swollen lymph glands in the armpits, groin, or neck
• diarrhoea that lasts for more than a week
• white spots or unusual blemishes on the tongue, in the mouth, or in the
throat
• pneumonia
• red, brown, pink, or purplish blotches on or under the skin or inside the
mouth, nose, or eyelids
• memory loss, depression and other neurological disorders.
However, no one should assume he is infected if he has any of these symptoms.
Each of these symptoms can be related to other illnesses. Again, the only way to
determine whether you are infected is to be tested for HIV infection.
Q. How long after a possible exposure should I wait to get tested for HIV?
Ans. The tests commonly used to detect HIV infection actually look for antibodies
produced by your body to fight HIV. Most people will develop detectable antibodies
within three months after infection, the average being 25 days. In rare cases, it can
take upto six months. For this reason, the CDC currently recommends testing six
months after the last possible exposure (unprotected vaginal, anal or oral sex or
sharing needles). It would be extremely rare to take longer than six months to
develop detectable antibodies.
Q. If I test HIV negative, does that mean that my partner is HIV negative
also?
Ans. No, your HIV test result reveals only your HIV status. Your negative test result
does not tell you whether your partner has HIV or not. HIV is not necessarily
transmitted every time there is an exposure. Therefore, your taking an HIV test
should not be seen as a method to find out if your partner is infected.
Q. Can I get HIV from anal sex?
Ans. Yes, it is possible for either sex partner to become infected with HIV during
anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid
of a person infected with the virus. In general, the person receiving the semen is at
greater risk of getting HIV because the lining of the rectum is thin and may allow
the virus to enter the body during anal sex. However, a person who inserts his
penis into an infected partner also is at risk because HIV can enter through the
urethra (the opening at the tip of the penis) or through small cuts, abrasions or
open sores on the penis.
Having unprotected (without a condom) anal sex is considered to be a very risky
behaviour. If people choose to have anal sex, they should use a latex condom. Most
of the times, condoms work well. However, condoms are more likely to break
during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be
risky. A person should use a water-based lubricant in addition to the condom to
reduce the chances of condom breaking.
Q. Why is injecting drugs a risk for HIV?
Ans. At the start of every intravenous injection, blood is introduced into needles
and syringes. HIV can be found in the blood of a person infected with the virus. The
reuse of a blood-contaminated needle or syringe by another drug injector
(sometimes called "direct syringe sharing") carries a high risk of HIV transmission
because infected blood can be injected directly into the bloodstream.
In addition, sharing drug equipment (or "works") can be a risk for spreading HIV.
Infected blood can be introduced into drug solutions by:
• using blood-contaminated syringes to prepare drugs
• reusing water
• reusing bottle caps, spoons or other containers ("spoons" and "cookers"
• used to dissolve drugs in water and to heat drug solutions
• reusing small pieces of cotton or cigarette filters ("cottons") used to filter
out particles that could block the needle.
"Street sellers" of syringes may repackage used syringes and sell them as sterile
syringes. It is important to know that sharing a needle or syringe for any use,
including skin popping and injecting steroids, can put one at risk for HIV and other
blood-borne infections.
Q. Are patients in a dentist's or doctor's office at risk of getting HIV?
NGOs
Back to Top
Blood Safety
Q. Is there a National Blood Policy?
Ans. Yes, a National Blood Policy has been formulated and is now being
implemented with the mission to ensure easily accessible and adequate supply of
safe and quality blood collected from voluntary non-remunerated regular blood
donors.
Q. What are the infections for which blood is tested?
Ans. The Drugs & Cosmetics Act provides mandatory testing of blood for five major
infections viz. HIV, Hepatitis B, Hepatitis C, Syphilis & Malaria. Every unit of blood
is tested for all these infections.
Q. What does the term ‘Service Charge’ means in blood banks?
Ans. No charges for blood as such can be levied by any blood bank. However, the
blood that is collected from a donor at no cost, needs to be processed to make it
free of infection, to ensure that it has certain minimum quality standards. It also
needs to be stored and tested with recipient’s blood before transfusion. Besides all
these, establishment costs for the blood bank like infrastructure maintenance,
salaries etc. add to the overall costs of providing a safe unit of blood to the patient.
Blood banks attempt to recover these costs as service charge from the consumer.
Q. Is there some uniform service charge fixed for a blood unit?
Ans. There are some guidelines developed by the National Blood Transfusion
Council and circulated by NACO, on the amount of service charge that can be
charged by blood banks functioning in any sector in the country. These guidelines
specify that no blood bank will charge more than Rs.500/- for one unit of whole
blood. However, since these are mere guidelines and have no legal
Q. NBTC was constituted subsequent to Supreme Court judgment in 1996
with the focus of catering to Nation’s blood security. The prime objective
was to phase out professional donors and focus on voluntary donations.
How far has this policy been successful and how much voluntary blood is
collected in the country?
Ans. Soon after setting up of the National Blood Transfusion Council (NBTC) at the
Centre and State Blood Transfusion Councils (SBTCs) in each state/UTs, a complete
ban has been imposed on collection of blood from paid donors, with effect from 1st
January, 1998. A number of steps were taken by NBTC to keep a strict check on
exploitation of the blood users by commercial and private blood banks. SBTCs were
provided funds by NBTC to mobilise blood collection through voluntary blood
donations. Extensive awareness programmes for donor motivation through
Information, Education, Motivation, Recruitment and Retention of voluntary donors
was launched. Each state is given an annual target for collection of blood through
voluntary sources and this is regularly reviewed by NACO.
Q. Is the blood issued by blood banks safe?
Ans. Yes. As per the National Blood Safety Programme of NACO, it is mandatory on
the blood banks to test every unit of blood properly for grouping, cross matching
and testing for HIV, Syphilis, Hepatitis B & C and Malaria before it is issued for
transfusion. Facilities have been provided by NACO to all the government and
charitable blood banks like Red Cross to carry out these tests.
Q. Can one acquire HIV infection if one donates blood?
Ans. No, this is not possible as all materials used for collection of blood are sterile
and disposable. Donating blood is a noble gesture. People who are healthy should
come forward for donating blood voluntarily.
Q. Who can donate blood?
Ans. Only a healthy person between the age group of 18 – 60 years, weighing 45
kg or more with haemoglobin content of 12.5 gm per 100cc or more can donate
blood.
Q. Is there any inspection of blood banks?
Ans. Yes. The blood banks can only function if they are licensed by the Drug
Inspectors of the Food and Drug Administration of the respective states. The Drugs
& Cosmetics Act provides a legal framework under which the blood banks are
inspected and issued a proper license, which is renewed every alternate year. Every
blood bank has to prominently display its license for anyone to check.
Back to Top
Back to Top
Sexually Transmitted Infections/Reproductive Tract Infections
Q. Why no reduction has been noticed in the prevalence of Sexually
Transmitted Infections in India even though the STD Control Programme
has been in operation since 1949 ? Which activities are provided under STD
Control Programmes?
Ans. Precise data about the prevalence of STIs in India is not available. However,
from the limited number of studies conducted among the ‘High Risk Population’ or
‘Hospital Based Studies’, prevalence rate of STIs in India has been quoted to be
about five percent. Now, NACO has planned to ascertain the prevalence of STIs and
also health seeking behaviour of persons suffering from this group of diseases by
undertaking a country wide community based STI Prevalence Survey. STD Control
Programme is based on early diagnosis and prompt treatment of STIs and relies on
the health seeking behaviour of individuals with STD.
Health seeking behaviour of those suffering from STDs is directly related to the
stigma attached to the disease, because of which individuals with STI desire
anonymity. As a result, they seek alternate source of medical aid including self-
medication and only a small proportion report to public sector medical set-up.
Because of this attitude and behaviour of those suffering from STIs, they continue
to transmit infection to their multiple sex partners. This is the main obstacle in
converting infectious pool into non- infectious. Under the STD Control Programme,
the government has established STD clinics in each district hospital, all over the
country. The STI drugs are provided free of cost by the Government of India and
adequate confidentiality is ensured for those attending these clinics. Such clinics
are managed by experts trained to treat STIs. Another major activity of STD
Control Programme is Targeted Intervention under which, special facilities are made
available easily to commercial sex workers, truckers, migrant workers and other
marginalised segments of society. Partner notification, condom promotion and
imparting IEC activities through peer-educators are the interventions organised as
a part of the programme. STI management through syndromic approach has been
now practiced by trained medical officers at peripheral, middle and even at tertiary
levels of healthcare where adequate lab facilities are not available.
.Q. What is FHAC?
Ans. FHAC stands for Family Health Awareness Campaign. The campaign is carried
out for a period of 15 days once a year. The objectives of the campaign are:
• To raise the level of awareness on RTI/STI and HIV/AIDS in rural and slum
areas, and other vulnerable groups of the population
• To encourage health seeking behaviour in the general population for RTI
and STI
• To make the people aware about the services available in the public health
system for the management of RTI/STI
• To facilitate early detection and prompt treatment of RTI and STI by
mainstreaming the programme with the infrastructure available under the
primary healthcare system
• To strengthen the capacity of medical & paramedical professionals working
under healthcare system to respond to HIV/AIDS epidemic adequately.
Q. Does the presence of other sexually transmitted diseases (STDs)
facilitate HIV transmission?
Ans. Yes, every STD causes some damage to the genital skin and mucous layer,
which facilitates the entry of HIV into the body. The most dangerous are:
• Syphilis
• Cancroids
• Genital herpes
• Gonorrhoea.
Q. Why is early treatment of STD important?
Ans. High rates of STD caused by unprotected sexual activity enhance the
transmission risk in the general population. Early treatment of STD reduces the risk
of spread to other sexual partners and also reduces the risk of contracting HIV from
infected partners. Besides, early treatment of STD also prevents infertility and
ectopic pregnancies.
Back to Top
Antiretroviral Therapy
Q. Is the Government of India planning to introduce anti retroviral therapy
free of cost in government hospitals? Who will be eligible for the supply of
drugs?
Ans. Union Minister for Health & Family Welfare convened a dialogue with the
manufacturers of anti retroviral for HIV/AIDS, with a view to examine the feasibility
of procuring and delivering ARVs through the public health system. As a result, a
Working Group was constituted, chaired by Secretary Health, with the Director
General, Health Services and Additional Secretary & Project Director NACO as
members, together with CII, FICCI, and representatives of the different
manufacturers of anti retroviral. The Working Group has completed its
deliberations. If government does proceed to introduce anti retroviral through the
public health system, these will be delivered free of cost to the end consumer in
government hospitals. While we estimate over people living with HIV/AIDS at the
end of the year, we necessarily have to prioritise the beneficiary population which
include HIV positive mothers who access the government health system through
the Prevention of Parent to Child Transmission clinics, HIV positive children below
15 years of age, and full blown AIDS cases who seek treatment in government
hospitals.
Back to Top
Condom Promotion
Q. What is the government’s policy on condoms?
Ans. The government policy has been that condoms are an effective, protective
measure to prevent the spread of HIV. The government believes that it is necessary
to be focused in the promotion of condoms since a large number of infections occur
through unsafe sex. For the general population the dual use of condoms for
contraception and disease prevention is emphasised by both National AIDS
programme and Reproductive & Child Health programme. For the high risk groups,
targeted social marketing and free distribution of condoms is being promoted
through NGOs.
Q. How safe are condoms in preventing HIV?
Ans. Consistent and correct use of Latex condoms are fully effective in preventing
the spread of HIV through the sexual route.
Back to Top
HIV-TB Co-infection
Q. How does infection with TB affect the HIV/AIDS scenario?
Ans. TB shortens the survival of patients with HIV infection, accelerates the
progression of HIV to AIDS as observed by a six- to seven-fold increase in the HIV
viral load in TB patients and is the cause of death for one out of every three people
with AIDS worldwide. Effective treatment using DOTS not only prolongs the survival
of patients living with AIDS, but also improves their quality of life.
Q. What are the clinical features of TB and what type of TB is more
commonly seen in HIV positive individuals?
Ans. As the HIV infection progresses, the CD4 lymphocytes decline in number and
function. Therefore, the immune system is less able to prevent the growth and
spread of the TB bacilli. As a result, disseminated and extra-pulmonary TB disease
is more commonly seen in the later stages. Nevertheless, pulmonary TB is still the
most common form of TB even in HIV-infected patients. Many studies have shown
that pulmonary involvement occurs in 70-90 percent of all HIV/AIDS patients with
TB.
Q. How does treatment of TB differ in HIV infected and HIV uninfected
individuals?
Ans. In general, anti-TB treatment is the same for HIV-infected and HIV-uninfected
TB patients, with the exception of the use of thiacetazone. Thiacetazone causes
severe cutaneous reactions that may be fatal and hence should be avoided.
Patients who complete treatment show the same clinical, radiographic and
microbiological response to short-course treatment irrespective of whether they are
HIV positive or negative. Self-administration of treatment is associated with higher
case fatality rates. Directly Observed Treatment–short course (DOTS) is therefore
even more important for HIV-infected TB patients. Treatment with DOTS for HIV-
infected TB patients improves their quality of life, and also has been shown to
prolong their life span. DOTS can prevent emergence of MDR -TB and reverse the
trend of MDR-TB.
*******************************
Youth and HIV/AIDS
In India people in the age group of 15-29 years comprise almost 25 percent of the country’s population;
however, they account for 31 percent of AIDS burden. This clearly indicates that young people are at
high risk of contracting HIV infection.
**********************
Reaching youngsters at an impressionable age before they become sexually active can lay the foundation
for a responsible lifestyle, including healthy relationships and safe sex habits. NACO reaches out to youth
through specially developed Adolescent Education Programme focused primarily on prevention through
awareness building.
The Adolescent Education Programme was one of the key policy initiatives of NACP II. Ministry of HRD and
NACO collaborated to develop this school-based programme that is implemented across 144,409
secondary and senior secondary schools with the objective of reaching out to about 33 million students
within two years. AEP is implemented by the Department of Education in collaboration with the State
AIDS Prevention and Control Societies.
Under the programme, teachers and peer educators are trained, who, in turn, conduct the programme
amongst the student community. The programme covered 112,000 schools and trained 2,88,000
teachers. They have been provided reference material, which has been developed by NACO in
collaboration with Ministry of HRD and vetted by NCERT.
A large number of young people aged 10-25 years, belonging to diverse groups of several sub-sets in
terms of marital status and social background, are out of school in India. Their vulnerability to HIV/AIDS
is particularly high owing to their limited understanding of the infection. Since there is no proven model
for reaching out to ‘out-of-school youth’, a number of district-wide innovative programmes are initiated in
all the states.
An analysis of 80 such youth-centric HIV prevention programmes provides a menu of options and tools for
a scale-up for this target group. SACS are also implementing district-wide programmes on peer education
to ensure coverage of 80 percent out-of-school youth in 59 high prevalence districts of India. Apart from
this access to youth-friendly health services like counselling and treatment for STIs are being stepped up.
Greater dialogue is being generated through innovative formats and platforms. Relevant messages on
safe sex, sexuality and relationships are developed and disseminated for youth via posters, booklets,
panels, hoardings and printed material.
A youth network, Yuva, comprising seven youth organisations, Nehru Yuva Kendra Sangathan, National
Service Scheme, Indian Red Cross Society, National Cadet Corps, Bharat Scouts and Guides, Youth
Hostels Association of India and the Association of Indian Universities, under the auspices of the Ministry
of Youth Affairs and Sports and NACO is working towards equipping the young people with prevention,
education and life skills for promoting healthy and safe behaviour and practices amongst them. The
ultimate goal is to have an “AIDS prepared Campus, AIDS prepared Community and AIDS prepared
Country”.
Red Ribbon Club is a voluntary on-campus intervention programme for students in educational
institutions. It is initiated and supported by the SACS and implemented through multi-sectoral
collaboration, particularly using the services of cadre officers of the State’s NSS. The club is proposed to
be established in every school and college to provide youth with access to information on HIV/AIDS and
voluntary blood donation. The club also works towards promotion of life skills to bring about behavioural
change among the youth. Already RRCs are established in more than 16,000 schools and colleges.
AIDS is now a pandemic.[6] In 2007, it was estimated that 33.2 million people lived with
the disease worldwide, and that AIDS killed an estimated 2.1 million people, including
330,000 children.[7] Over three-quarters of these deaths occurred in sub-Saharan Africa.
[7]
According to UNAIDS 2009 report, worldwide some 60 million people have been
infected, with some 25 million deaths, and 14 million orphaned children in southern
Africa alone since the epidemic began.[8]
Genetic research indicates that HIV originated in west-central Africa during the late
nineteenth or early twentieth century.[9][10] AIDS was first recognized by the U.S.
Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the
early 1980s.[11]
Although treatments for AIDS and HIV can slow the course of the disease, there is no
known cure or vaccine. Antiretroviral treatment reduces both the mortality and the
morbidity of HIV infection, but these drugs are expensive and routine access to
antiretroviral medication is not available in all countries.[12] Due to the difficulty in
treating HIV infection, preventing infection is a key aim in controlling the AIDS
pandemic, with health organizations promoting safe sex and needle-exchange
programmes in attempts to slow the spread of the virus.
Economic Impact
HIV and AIDS affects economic growth by reducing the availability of human capital.
[180]
Without proper nutrition, health care and medicine that is available in developed
countries, large numbers of people suffer and die from AIDS-related complications.
They will not only be unable to work, but will also require significant medical care. The
forecast is that this will probably cause a collapse of economies and societies in
countries with a significant AIDS population. In some heavily infected areas, the
epidemic has left behind many orphans cared for by elderly grandparents.[181]
The increased mortality has results in a smaller skilled population and labor force. This
smaller labor force consists of increasingly younger people, with reduced knowledge
and work experience leading to reduced productivity. An increase in workers’ time off
to look after sick family members or for sick leave lowers productivity. Increased
mortality reduces the mechanisms that generate human capital and investment in
people, through loss of income and the death of parents.
By affecting mainly young adults, AIDS reduces the taxable population, in turn
reducing the resources available for public expenditures such as education and health
services not related to AIDS resulting in increasing pressure for the state's finances and
slower growth of the economy. This results in a slower growth of the tax base, an effect
that is reinforced if there are growing expenditures on treating the sick, training (to
replace sick workers), sick pay and caring for AIDS orphans. This is especially true if
the sharp increase in adult mortality shifts the responsibility and blame from the family
to the government in caring for these orphans.[181]
On the level of the household, AIDS results in both the loss of income and increased
spending on healthcare by the household. The income effects of this lead to spending
reduction as well as a substitution effect away from education and towards healthcare
and funeral spending. A study in Côte d'Ivoire showed that households with an
HIV/AIDS patient spent twice as much on medical expenses as other households.[182]
Sexual contact
The majority of HIV infections are acquired through unprotected sexual relations
between partners, one of whom has HIV. The primary mode of HIV infection
worldwide is through sexual contact between members of the opposite sex.[92][93][94]
During a sexual act, only male or female condoms can reduce the risk of infection with
HIV and other STDs. The best evidence to date indicates that typical condom use
reduces the risk of heterosexual HIV transmission by approximately 80% over the long-
term, though the benefit is likely to be higher if condoms are used correctly on every
occasion.[95]
The male latex condom, if used correctly without oil-based lubricants, is the single most
effective available technology to reduce the sexual transmission of HIV and other
sexually transmitted infections. Manufacturers recommend that oil-based lubricants
such as petroleum jelly, butter, and lard not be used with latex condoms, because they
dissolve the latex, making the condoms porous. If lubrication is desired, manufacturers
recommend using water-based lubricants. Oil-based lubricants can be used with
polyurethane condoms.[96]
Female condoms are commonly made from polyurethane, but are also made from nitrile
and latex. They are larger than male condoms and have a stiffened ring-shaped opening
with an inner ring designed to be inserted into the vagina keeping the condom in place;
inserting the female condom requires squeezing this ring. Female condoms have been
shown to be an important HIV prevention strategy by preliminary studies which suggest
that overall protected sexual acts increase relative to unprotected sexual acts where
female condoms are available.[97] At present, availability of female condoms is very low
and the price remains prohibitive for many women.
Studies on couples where one partner is infected show that with consistent condom use,
HIV infection rates for the uninfected partner are below 1% per year.[98] Prevention
strategies are well-known in developed countries, but epidemiological and behavioral
studies in Europe and North America suggest that a substantial minority of young
people continue to engage in high-risk practices despite HIV/AIDS knowledge,
underestimating their own risk of becoming infected with HIV.[99][100]
Randomized controlled trials have shown that male circumcision lowers the risk of HIV
infection among heterosexual men by up to 60%.[101] It is expected that this procedure
will be actively promoted in many of the countries affected by HIV, although doing so
will involve confronting a number of practical, cultural and attitudinal issues. However,
programs to encourage condom use, including providing them free to those in poverty,
are estimated to be 95 times more cost effective than circumcision at reducing the rate
of HIV in sub-Saharan Africa.[102]
Some experts fear that a lower perception of vulnerability among circumcised men may
result in more sexual risk-taking behavior, thus negating its preventive effects.[103]
However, one randomized controlled trial indicated that adult male circumcision was
not associated with increased HIV risk behavior.[104]
Studies of HIV infection rates among women who have undergone female genital
cutting (FGC) have reported mixed results; for details see Female genital cutting#HIV.