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HIV and AIDS Education
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Answer the following questions

(i) Explain briefly the transmission of HIV through Blood.
Ans. Transmission of HIV and other blood-borne viruses can occur during transfusion of blood components (ie,
whole blood, packed red cells, fresh-frozen plasma, cryoprecipitate, and platelets) derived from the blood of an
infected individual.
To produce plasma-derived products, plasma from 2,000 to 30,000 donors is pooled and processed into a single
batch (lot). One HIV-infected donor can contaminate an entire lot of product and consequently infect each of the
recipients if HIV is not neutralized by sufficient heat, cold ethanol, or other treatments during production. A variety
of different blood products can be manufactured by successive precipitation with increasing concentrations of cold
ethanol. Individual fractions are then further processed, during which time partially concentrated fractions from as
many as 100,000 donors may be combined.
Albumin and plasma protein (Cohn fractions IV and V) are extracted with the maximum concentration of cold
ethanol and are then pasteurized. They do not transmit HIV. Cohn fraction II products (ie, immune globulins such as
Rh immune globulin, gamma globulin, and hepatitis B immune globulin) are treated with somewhat lower
concentrations of cold ethanol and cannot be pasteurized without loss of activity. Nevertheless, HIV has not been
cultured from lots of Cohn fraction II products known to be positive for HIV antibody. The presence of high-titer
antibody to HIV in some lots of hepatitis B immune globulin has resulted in transient (<6 months' duration), lowtiter antibody to HIV in recipients and has raised questions about the safety of these products. There have been,
however, no documented cases of HIV disease as a result of their use. Over 4.5 million doses of Rh immune globulin
have been given since 1968, with no reported cases of HIV disease in recipients. Thus, although recipients of
hepatitis B immunoglobulin may become transiently HIV antibody positive by passive acquisition of antibodies
from the immunoglobulin preparation, there is no evidence that these individuals are actually infected.
Pooled plasma is also precipitated and processed into the factor VIII concentrates used to treat hemophilia A and
into factor IX concentrates used to treat hemophilia B. Before 1984, factor concentrates were not heat treated,
because heat treatment causes a loss of hemostatic activity. As a result, HIV was not inactivated, and roughly 80% of
treated hemophilia A patients and 50% of treated hemophilia B patients were infected with HIV-1. The severity of
hemophilia, and thus the amount of factor concentrate received, correlated directly with the probability of becoming
HIV seropositive. Lower rates of seroprevalence in hemophilia B patients compared to hemophilia A patients appear
to be related to the use of higher concentrations of ethanol in the manufacture of factor IX concentrate.
Since 1984, multiple methods for inactivating HIV have been developed and applied.(44, 38) Methods vary, but
all use both heat treatment and at least one other viral inactivation process. No HIV antibody seroconversions have



yet occurred among uninfected persons using factor products now on the market. Improved safety and purity of
plasma-derived concentrates does, however, result in a sixfold increase in the annual cost of clotting factor replacement.
(ii) Discuss moral and ethical issues related to HIV prevention.
Ans. At the outset, let us focus on the moral aspects of measures undertaken to contain the epidemic. The
topic is beyond comprehensive techniques and strategies. OECD has produced problem-based phylogenic tree
model. The stem of the tree projects its regional spin-off. The leaves and branches reflect the influence on the
people, the community and the society at large. The root cause stay on the scores of risk factors. Deep roots are its
sensitive factor. Social and sexual inequity, conflict, trade minus barriers and socio-cultural outlook has surfaced.
The influence of the strategy along with the inherent risks ought to be reduced. The social stigma needs to be
banished from public awareness.
Agencies working through multiple channels have to be roped in. A paradigm shift in containing the epidemic
is quite possible. It needs the people to work with one another without any racial difference. Geographical barriers
need to be redrawn. It wont need any ocean, sea, desert to isolate the humankind. The race has learnt lessons
through division on trial-and-error. The outcome of natural and manmade disasters has disturbed the flora and
fauna. The division between the races has distanced them from food security. Social inequity, terrorism and
economic slowdown has upset the society. Experts had to devise ways and means for some innovative programmes.
Lest they not forget the primary objectives while initiating debate on moral values. The individuals need to be
glorified for the cause. The epidemic could be contained voluntarily without efforts.
Epidemic at Local Level
It is widely known that infection spreads through breastfeeding, delivery of baby, internal blood transfusion,
and sexual intercourse. NACO-2004 surveyed untreated cases of AIDS. 85.69 per cent of the population has
contracted epidemic from unsafe sex. The percentage of babies born, users of defective needles, besides
contaminated blood and needle stood at 2.71, 2.24, and 2.57 respectively. The institution didnt identify 67.7 per
cent of the infected lot.


Increasing sexual divide

Loss of Education

Decline of professional/technical skills


Fiscal influence

Average longevity
Human Rights

Deportation of
Health Resources
Diseases, death, poverty,

Blood-Sexual Relation-From Mother-to-Baby

Political, Stigma

Economic deportation
Group/Social pressure

Legal, Political,
Religious, Cultural

Sexual torture

Sex and Alternative


Ignorance, Logic
Abuse Sexual

Personal Bankruptcy
(Local & N/S)

HIV Epidemic in India

Approximately 2.5 mn (2.0 mn-3.1 mn) people in India were living with HIV in 2006, with national adult HIV
prevalence of 0.36%. Although the proportion of people living with HIV is lower than previously estimated, Indias



epidemic continues to affect large numbers of people. The revised estimates are based on an expanded and improved
surveillance system, and the use of more robust and enhanced methodology. The inclusion of the results of the recent
national household survey (the National Family Health Survey, conducted in 2005-2006) in the estimation process
contributed significantly to the revised estimates.
Over 1,00,000 people were tested for HIV in the survey which was the first national population based survey
to include a component on HIV (NFHS-3, 2007). HIV sentinel surveillance system has increased in recent years
from 155 in 1998 to 1120 in 2006. The centres look after pregnant women, those contracting STDs, and high-risk
group people.
Reported adult HIV prevalence in six states included in the recent national population-based survey (NFHS3, 2007) varied from 0.07% in Uttar Pradesh, to 0.34% in Tamil Nadu, 0.62% in Maharashtra, 0.69% in Karnataka,
0.97% in Andhra Pradesh, and 1.13% in Manipur. Prevalence in other states together was 0.13%. An earlier
analysis showed the state of epidemic in southern states overall was five times higher than the northern states
(2000-04) 2006 sentinel surveillance showed the infected pregnant women in Tamil Nadu, Maharashtra, Karnataka
and Andhra Pradesh have stabilized, in comparison with female sex workers, injecting drug users and gays in a
few states.
New HIV infection that causes AIDS have halved in India over the joint UN programmes on HIV/AIDS.
Global report estimated HIV estimates to 2.5 mn (2006) from 5.7 mn (2005). New infections worldwide stood at
3.1 mn (1999-2000). It fell by 20 per cent (183 countries), or 45 to 31 incidents for every 1,000 people. It was 2.79
mn (2009) from 2.27 mn (2008).The infection stabilized in 56 countries. It was over 25 per cent in Ethiopia,
South Africa, Zimbabwe and Zambia. The corresponding figure in Asia was 4.9 mn. 3.1 mn people are getting
treatment. 2.4 mn needs treatment. Bangladesh, Philippines, Armenia have showed an increase in 25 per cent of
newly infected people. It was less than 25 per cent in other countries, according to Dr. Charles Gilks, the coordinator
for UN AIDS in South Asia.
The infections across India stood at 290,000 (2000) which got reduced to 1,20,000 (2009). The incidents have
considerably reduced in the states of Tamil Nadu, Andhra Pradesh, Karnataka and Maharashtra. Death from
blown-up cases of AIDS got reduced by 20 per cent (2005-10). Some 3,00,000 people are getting treatment in
India. 7,00,000 people are yet to get the treatment. Many are yet unaware that theyve contracted. They do not
realize that disease has advanced.
Moral Issues
Many developing countries believe the symptoms as preliminary cause. Moral diversity is widely apparent.
ABC (the acronym) observes to contain the epidemic uniquely. It is abstention from sex, fidelity among couple,
and condom use. It encourages sexual abstinence. Active men and women had to use condom during sex. It
proportionally reduces chances of risk. The people include unmarried and heterosexuals hunting for multiple
The decision to abstain from voluntary act in spite of awareness is called abstinence. Voluptuous were the
adolescent lot. The blend of personal, religious and moral values has moulded them so. The public behaviour, of
course, correlates with spiritual, moral, religious, political values and personal attitudes. Nobody in the society
discourage anybody to have sex. For, we are born out of sex. We should go for sex. Life rolls on sex. People
advice preferably teens to abstain from sex due to risk factor. It is so, to illustrate, the sudden tendency among
them to have free encounters, during puberty. Adult age could delay the maiden sex encounter. ABC observation
was appropriate for youth. Agenda reducing risk by increase in age among youth was successful. Abstinence
formula promotes unmarried people to abhor sex. It is the lonesome option to keep youth at bay from HIV/AIDS
infection. It is the most significant alternative before marriage. There is an urgent need to train youth and parents.
It helps them abstain from sex before marriage. It should be so, irrespective of peer pressure. It guides them in
refraining from indecent relation.



ABC prioritizes it as another gift. Loyalty hangs on between couple. It leads to safe conjugal relations. Youth
could select appropriate partner. It could be established as under:
(a) Through plan to reduce accidental sex,
(b) Reduce number of partners in progress,
(c) Entertain sequential sex between couple.
Globally, people mate with multiple partners. Uganda and Thailand reduced the number of such partners.
Maniac men encountered less women prostitutes (Thailand). Probably, they have preferred condoms. Media vigil
and organizations worked for the cause.
Condom is a thin sheath. It is worn on mans penis. It is used during sexual intercourse. It is normally made of
latex. It can prevent pregnancy, STDs, gonorrhea, syphilis and HIV. It is also called prophylactic sheath. For, people
with latex allergy, intestines of animals, such as sheep were made. Sheep-skin condoms transfer body warmth better.
But, they wont prevent diseases, as effectively as condoms. These have an expiry date. They should be disposed off
after use. It could fail in attempting to wear. Female condoms look like a sheath. They have a flexible ring on either
side of the sheath. It is attached to the vaginal door through rings. It covers the vagina and cervix. It prevents the
sperm entry into womans uterus. Female and male condoms should not be used at the same time. For, they rub
against each other, leading to failure.
Condoms regulate the risk of HIV/AIDS transmission (approximately 85 per cent). It reduces the risk of
gonorrhea for men (approximately 71 per cent). It doesnt cover alternative lesions present on the body surface,
viz. human papiloma virus (HPV), genital herpes simplex (HSV), cancroids and syphilis. Wrong usage leads to
failure. It might come off the penis during coition. The testing for microscopic holes involves the tested condom
overlapping another side of untested condom. Any failure of electric current between them makes them unfit.
Holes in condom are unlikely, provided theyre properly handled.
Demographical survey insists on regular use of condoms. It helps in reduction of accidental infection from
HIV. It is self-explanatory. It could prevent infection under honesty. How awareness helps in containing infection?
Yes, men use condom. It will definitely helps you in disbelieving myths, as under:
(a) to know whether outlawing sex could contain HIV infection,
(b) the importance of sustainable strategy,
(c) the myths of condom failure in protection,
(d) the prominent role of voluntary bodies in counselling.
Thailand has been successful in promoting condom use. Its policy planners might have realized the gravity of
the situation. It has influenced the youth, preferably those enrolling into defense services. The country squarely
relied on mandatory use of condom. Every sex worker in the red-light area was compelled to use condom or face
punishment. The campaign at the national level was reinforcing. Sonagachi (Kolkata) is the second red-light area
in South Asia. It has successfully contained increasing incidents through mandating the use of condoms.
Perhaps, the campaign has enforced users to influence the target sex works. Adult-literacy was behind the
campaign. The primary role of marketing agencies was subjected to task force (CSS). Evaluation of epidemic
contraction rests on region-specific socio-economic priorities.
How far dependable is condom use?
The dependence rests on the difference between its efficacy and strength. A bargain with its withstanding
energy leads to rupture or slid from penis of the users. Poor latex structure without tests of elasticity results in
rupture during coition. Industry has been made to explore through sustained research. Condom use was made
mandatory. NSS report explained the split strength of condom. The device withstood risks by 85 per cent. Some
countries have innovated marketing of good quality condoms and contraceptives.
A complete survey insists over the frequent use of condoms. It wont reduce the risk of transmission of virus
from infection. Sexually active Sierra Leone students have discouraged its public distribution. However, the rate
of unwanted pregnancy waned among the conscious partners.



CSM agenda needs to be targetted appropriately for stronger influence. It could have had the desired impact
on demography.
Sex prolongs human longevity. There is no doubt about it. It hones our thought system. It activates man
(woman) to hang on. Extraordinary sex leads to unnatural death. Unusual techniques could be the forte. Condom
could be the last resort. Infinitesimal difference between loyalty and abstinence fine-tunes sex. It could make
ABC formula practicable. The experiment was successful. Who shall bell the cat? How could the epidemic be
contained? It is a million dollar proposition. Policy planners, healthcare workers, voluntary bodies and the common
public could jointly involve in the exercise. They could frame something uncalled for in the days ahead.
Moral Values Blood Transfusion
The primary cause will be the use of drugs through defective needle. High-risk factors owes to it. Addicts
exchange needle among partners. District level pathologists have apprehended defective needle users and sex
coys as some confined group. It has not contacted the epidemic. Nearly five to 10 per cent of infection owes to
global users of defective needles. The authorities should dissociate users of defective needles. These should
include addicts of psychosomatic and narcotic drugs.
A national policy on epidemic control was enforced in Amsterdam (1984). Limited resources and frequent
political interference has retarded its progress among target beneficiaries. Some 46 areas were found to be country
and state-specific. At least one NEP was enforced in each of such country and states.
Availing fresh needles, syringes and equipment for safer injection of drugs was enforced. NEP has emphasized
over the use of single needle among target beneficiaries.
The regulation of drug addicts (injecting through defective needles) got subsequent endorsement. Specific
individuals were subjected to constant intervention. The programme convener got the support to contact, recommend
and coordinate with policy planners. The policy targetted to reduce the chances of risk in several phases among
equal age partners. It extended necessary support for needle users. The interface between NEP and needle users
was to reduce the risk factors. It helped in containing the infection to an optimum level. NEP was initially thought
of favouring addicts in availing them of drugs. A periodic survey declined to endorse the policy of discrimination.
The incidences of HIV, HBV and HCV infections were on the wane. Exchange of defective needles, use of
unsterilized syringes faded out. It has mobilized the infected to systematically enroll for treatment.
Drug addiction needs to be curbed. Addicts should be supported on programmes of self-reliance. Defective
needle users should be sent for VCT. Counselling should be done to appraise about their health status. These were
the resolutions adopted from various countries at UN AIDS recent meeting.
The people are entitled for basic privileges. They ought to be protected from availing basic services. The
doctors and healthcare workers are being obliged to extend treatment. The group needs to be screened for other
infectious diseases. They should be extended treatment at par with other patients. Medical science focused virtually
on healthcare and periodic reforms. Several latitude-based experiments have yielded some breakthrough. Nowadays,
every professional pledges to fulfil ethical requirements. We had to ensure the frequency of infection from HIV/
AIDS to be around 0.1-0.3 per cent. The percentage of people suffering from Hepatitis B and Hepatitis C stayed
at 6-30 and 1.8 per cent respectively. Healthcare from these workers seems to be confined. Theyre incapable of
extending treatment. They had to be trained for caring the PLWHA, as under:
(a) Psychic and interactive requirements.
(b) Comprehensive treatment for HIV/AIDS infection.
(c) Humane and legal clearance for such treatment, and
(d) Prevention through adequate strategies of risk-control.
Sero-positive should be availed of basic services. These should not be subjected to discrimination. The privileges
enshrined in HCW should be recognized for safety. The agenda needs to be fine-tined from time-to-time. It has
been experienced from risk factors galore. The after-effects was among treated lot. Suitable vaccine or single
drug should be developed. The practice of daily dosage of multiple medicines should be abandoned.



Education and Institutions

A few zero-positive students were isolated or were not enrolled.
Job-front and Workforce
The people were not hired or engaged for outsourced jobs. The jobs called for serious responsibilities.
Healthcare Facilities
High-risk group people were discouraged from getting comprehensive healthcare.
Religious Institutions
The people were disengaged in rituals. DSDs were seen from community perspective. Unknown myths persisted
about HIV/AIDS infection. People were silent in entertaining them. Following fears were observed about DSDs
for the people,
(a) Family or society to have virtually lost status or image,
(b) Loss of income and job,
(c) Their constant abandonment,
(d) Spread of infection among others, and
(e) Identification of the stigma from corrupt practices and sinful behaviour.
DSDs could be diminished in various ways. The people were to be trained and empowered to withstand.
Directives need be issued for availing education or employment at par with others.
Effective Measures against VCT and PLW
A few hypothesis need to be addressed for screening option:
(a) Screening of the public be mandated. The objective is to treat the infected and keep surveillance of public
health. It could contain the epidemic. The results should be made individual-specific in the common concern/
interest of the society.
(b) Voluntary counselling and screening benefits everybody. It empowers in hunting over scheduled alternatives.
VCT controls pre- and post- screening-cum-counselling. Pre-counselling makes the patients understand
about their personal risks. They shall be availed of every facility, besides innovative concepts. VCT
service facilitates them on the presence of HIV/AIDS as probable cause. It makes them understand to get
timely treatment. Public awareness could reduce the social stigma. Voluntary programmes need to be made
strictly confidential. Sero-positive or negative patients should be ensured of pre- and post-counselling.
Confidentiality and Professional Secrecy
Confidentiality adds spice to the issue. It is nothing but, maintaining of secrecy. The screening results of the
infected should be inaccessible, public and professionals, alike could make hue and cry. Most of the treated
people had to remain indoors. The factors of stigma, discrimination and social boycott haunt them. Sero-positive
people have every right to disclose the status of HIV infection. The following conditions are timely with respect
to secrecy and confidentially:
(1) The disclosure could:
(a) save others from infection, or
(b) reduce the risk for others in availing treatment for PLWHAs.
The chances of individual-specific treatment could emerge as mandatory.
(2) The disclosure should be confined to the responsible authorities. Ensure the disclosed data be utilized for
the cause by the third party. Lest the name of the individual be kept secret.
Sustained research and care of the PLWHA be made prominent. Let them produce common pharmacopeia drug or
single vaccine to be administered. Clear guidelines ensure mass production of such drugs/vaccine. It needs patent
clearance and adequate marketing strategy.
(c) Being a teacher in a school elaborate your role as a counsellor for HIV positive learner for prevention
Drug addiction and HIV.
Ans. The caregivers should lend their ears carefully. It makes them as counsellor-in-action. The dream could
turn into reality. The experienced could share about myths and misconceptions, ambiguities, and related practical
experiences. A good rapport between the field workers and them could yield good results.



Counselling: Adolescents
The training adolescents are pretty complicated. The factors includephysiological change, emotional
parameters, and group experience, ambitions of the parent, and the objectives of the institution and society. The
influence of media and peer pressure make the adolescents explore new horizons. It makes them enthusiastic
about something unheard of. It could influence them to addiction, sex and other anti-social activities. Caregiver
alone could guide the teacher and his community in ushering proper path to the waylaid people.
Counselling: Myths and Misconceptions
Our society has many myths and misconcep-tions on STD and infectious diseases. It has lead to the disaster
arising out of transmission of infection. It could be ignorance of removing the subject of conception from the
course material on sex education. The misconception need to be erased out by slotting the subject without any
hesitation. The banishment of HIV infected and the permanent isolation of blown-up AIDS need to be seriously
taken care of.
The course material and training skills should include psychological questionnaire for the volunteer. Their
performance need to be attended evaluated daily. Six-days of their field experience should be compensated in one
day through questionnaire. The information pooled in by the volunteer could form the content base. The
questionnaire prepared for the seventh day should include the practical knowledge. It enlightens other volunteers
in answering the questionnaire. They could express their opinion on the field riders. It is a continuous process. It
is based on psychological experiments while theyre moving around the area. The questionnaire should have
frequently asked questions, the cases of after-effects with the patients getting ART, and the medical community
involved in the job.
The counsellor should guide the teacher and his community to uphold confidentiality. The information derived
from any of the pupils or student infected should not be made public. The questionnaire can include questions
likeWhat is AIDS? How does it arise? the nature and characteristics of virus, the difference between HIV positive
and blown-up AIDS, preventive measure, and palliative care. It could have cascading effect in the society. It
resembles electing some representative on adult franchise. She (he) could serve anywhere on the experience
gained, votes polled, or sponsored political party. It could be the three-tier network, state legislative assembly,
Lok Sabha and Rajya Sabha etc.