Human Immunodeficiency Virus and other sexually transmitted infections - Assignment Example

?HIV and STI’s Ans1. Over the last three decades, the world has been facing the most challenging and complicated health problem in the history. HumanImmunodeficiency Virus (HIV) and other sexually transmitted infections(STI’s)which has come to be indicated not as an isolated syndrome, but as the serious materialization of clinical and subclinical cases. There are three primary modes for transmitting HIV: contact sexually (either homosexual or heterosexual) with an infected person, direct exposures to blood or body secretions such as semen or breast milk, sharing needles between intravenous drug users, and prenatally from HIV positive mothers to their babies. STI’s are transmitted sexually by body fluids. According to the World Health Organization (WHO) in 2009, 33.4 million people have been estimated as HIV positive. Same is the case with other sexually transmitted diseases according to WHO (2001) for the year 1999, there have been 91.89 million Chlamydia infections world wide which enhances the prevalence of HIV. Majority of these STI cases are women borne in developing countries. However in the countries like Philippines, Indonesia, Japan, South Korea, Bangladesh the prevalence rate is very low. In Philippines’ it is less then 0.001% and in 2001 no HIV positive donor was selected from 122000 tests. This is basically due to the lack of transmission of the HIV due to sexual intercourse and generally lower HIV risk behaviors present in Philippines as in other south Asian countries. Early recognition of HIV risks, enlistment of the relevant zone and various intervention programs such as programs which instruct the increase use of protections during sexual intercourse have helped to reduce the prevalence rate. Even though all of the risk factors are present in Bangladesh, based on limited data of the HSS surveys the estimated number of HIV infections and other STI’s seems to be satisfactory. It seems that most of the drug users smoke the drug rather then injecting it and although prostitution is frequent but their precise distribution is still unknown keeping the risk factors also unknown. prevalence in Japan remains well below 1% and most of these cases were the result of HIV infected blood samples imported for hemophilia patients and after men to men sex was the main reason of prevalence but the rate is still slow and low with the extent of anti HIV treatment provided in the country which is supported by its strong economy.(1) In South Korea HIV prevalence is 0.1% among the age group of 15 to 49% other then this no proper pattern of HIV prevalence is found. It shows improved intervention and proper behavioral approach against HIV.(2) Ans2) political economical and governmental factors are the key factors in HIV prevalence rate and its prevention approaches. Impression is that political unrest and mayhem can increase the transmission however this can not be proved by epidemiological data provided by various countries suffering from political unrest. the key factors for the spread of the disease during war and unrest are mainly influenced by governmental, economic and political factors, thses include Degree of political instability, degree of poverty, financial and economic crisis, lack of education and awareness, mobilization and family seperataion, rate of economic development or change, utilization of the resources for the health programs, access to these resources, attitude towards HIV prevalence and governmental concern, laws of HIV and their abiding, degree of discrimination among those at risk of HIV particularly drug abusers, sex workers or men having sex with men. During the past few years various countries suffered from bouts of political unrest which lead to unstable economic situations and caused a lot of women of the country to have sex for money to provide for their food and clothing and fulfill their children’s needs.clearly these political issues have a vast effect on the social, cultural and sexuall lives of the inhabitants.these same factors influence the transmission of HIV and STI’s to neighboring countries by trade, transport or travelling. During civil wars or peacemaking activities women suffer largely of sexual abuse and violence and they are exposed to higher risk of transmitting the disease to their newly borns through breast feed or during birth. For example soviet and post soviet Russia shows a great difference in its epidemiological figures and shows an outburst of Syphilis during the unrest period. Socio-cultural factors also influence the transmission of the disease. Govermental response is also very important in back tracking the tide of these diseases. Epidemic in East and southern Africa have not been controlled due to the lack of governmental response, says Caldwell. Where these diseases are the result of social cultural and sexual responses they also determine the governmental and community responses in this regard. Poverty is another basic cause of transmission because poor people have less knowledge, less resources for the prevention and treatment, less opportunities to save themselves from these lethal diseases. However in few cases wealth causes the liberal sexual cultures which leads to increased risk of transmission among the youngsters of the high society. For this re emergence of prostitution in China is the best example of declining economical and political stability and ascending HIV transmission rate. 3). In cases of STI’s and HIV prevention is the best medicine as compared to treatment because a lot of the patients suffering from the disease wont be able to access the treatment and health resources so with prevention they can lead a healthy life but to uphold a prevention program is not an easy task in itself mainly because of a lot of challenges faced by the organizations initiating and maintaining these programs. In many of the states population growth, urbanization, increased gap between rich and poor however underlining reasons are still the same that is religion, sexual culture and gender. Gender plays as a vital challenge against maintaining the HIV prevention in this treatment oriented world. Gender problems are basically visible from the unequal balance of opportunities among men and women to education, employments and other sources of financial security and as a result men have more control over the safe sex intervention as protected sexual activity and can easily avoid any kind of sexual violence and intimidation more then women and they are less victimized then women as a result women becomes the source of transmission and due to these social and gender inequalities it is much difficult to approach for women to seek prevention guidance. However during focusing on women we also have forgotten the role of men in transmitting the disease. Proper guidance for the treatment and prevention is costly and a lot of women don’t even know if they are having those symptoms of STI’s or sometimes they don’t even suffer from the symptoms at all. It creates a challenge for health organization to treat a disease where people don’t know even if it exists or they are suffering from it. Even if they do know something about their disease and symptoms expense prevents them to present themselves at health centers. That is also the reason they discontinue or ignore the importance of treatment because they lack the resources to get to the health centers and then spend money on test and medications. Religion as matter of fact have tended to stop the tide of sexual transmission of HIV and STI’s by making strict sexual morality and making strict rules against preying of older men against younger women and in a way influenced the governments to act as well. But to an extent and according to region and religion, this also creates obstacles in safe sex programs and treatments as well. For example they actively work against the use of condom either by ignoring sexual matters or some other issue. Rather then treatment people suffering from poverty believe on God or some other source to help them relieve from the disease. 4). To attain a good approach for control of prevalence, prevention and care various governmental and non governmental organizations are working all over the world and are publishing their relative materials in regard to the subject. Biological and behavioral surveillance data is important in controlling the prevalence rate of HIV and STI’s because IDU plays the key role in prevalence of the disease in countries like Burma, China, and Indonesia. Such data suggest that how much a disease is prevailed in the area and due to what reason and what interventions can be done to stop the tide of prevalence. The extent of behavioral surveillance among injecting drug users in Europe was examined using data collected through a questionnaire sent to all 31 countries of European Union focusing on behavioral data as opposed to the biological surveillance. Containing all the main points of sample size, target population, method of recruitment, geographical coverage and they were asked about STI’s and HIV and their modes of transmission and whether such programs occur for repeated collection of behavioral data.10 of the countries had no IDU surveillance data available. European countries have a system of collecting the data from the patients presenting themselves for treatment. National treatment demand indicator system is also being used by other countries to collect these data’s such as voluntary testing of hepatitis c, confidential testing of HIV or use of shared needles in last 30 days. this program focuses on drug use, injecting method hepatitis c and HIv prevalence and access to healthcare centre. But accessing population who inject drugs is very difficult, this needs convenience sampling approaches to be undertaken for data collection. Another difficulty in collecting the data this surveillance requires continues data for determining the prevalence rate which is very difficult to maintain as sample size vary.(3) 5).According to a survey there are currently 1 million people of China who are infected with HIV thus making 0.07% of the total population. (UNAIDS, 2002). Not all were infected through sexual intercourse but a high rise is observed due to lack of laws which restricts the commercial sex workers. This rise is due to increase in rural poverty, lack of job opportunities, migration from rural to urban areas, and tolerant behavior by the authorities. (Gil, 1996). Apart from these factors their awareness of HIV transmission is limited, the frequency of intercourse with the client and usage of condoms, their STI prevalence and their involvement drug infecting activities make them a likely candidate for HIV. e (McKeganey, 1994; Jackson, 1992). Myanmar is known for major drug trafficking route of China. Over here both commercial sex workers and drug injecting is common( both officially illegal). Because of the lack of viable STI policy, program and infrastructure most of the countries are still facing the epidemic rise. 1986 world health organization took the reins of supporting the campaigns against HIV, one of the main aims of this was to help countries with Aids strategy in collaboration with multisectoral action. United nations also recognized the devastating affects of STI and HIV and launched UNAIDS program in 1996. UNAIDS and its co-supporters are continuing their efforts and expanding their approaches to minimize the spread of the disease as UNAIDS website is their best shot at this. On national basis most of the countries are assisting comprehensive programs for the support of the control of the disease. Approaches like; abstinence studies and comprehensive sex education programs teaches the inhabitants of the country to maintain their sexual relationship with a safe partner and by a safe mode of sex. As well as these programs support the phenomena of sex after marriage or in delaying the age of initial sex of the individual which also an important approach in reducing the risky behavior towards HIV. Thses approaches also include new syringes to be use at the time of injection, condom promotion, HIV testing and counseling, health information and education. Australia is considered as th world leader in approach against HIV and STI’s because of its policy making and program development strategies. This aspect was supported by its strong governmental funding and political setting which included various national strategies and mobilization of gay community and creating partnership among health sectors and government. NGO’s are either loosely or completely dependent on Government support for funds, these NGO’s not only help In prevention education care and support against HIV and STI’s but also help in empowering human rights and social equality which are the basis of the prevalence in many regions of the world. So supporting NGO’s means supporting AIDS prevention programs.(4) Bibliography 1. http://www.jcie.org/researchpdfs/RisingTide/japan.pdf 2. http://www.searo.who.int/LinkFiles/HIV-AIDS_in_Asia_and_the_Pacific_Region_2003_2-3-country_status.pdf 3. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19960 4. http://www.sas.upenn.edu/~dludden/SexWorkAIDSChina.pdf Read More