HIV/AIDS

General Trends
- 33 million infected worldwide.
- 2 million die every year.
- 2.7 million infected every year.
- HIV is much more prevalent in Sub-Saharan Africa than anywhere else.
- Life expectancy of many African countries has decreased since AIDS
epidemic.
- In Eastern Europe/Central Asia most prevalent in injecting drunk users.
- In South Asia and Latin America most prevalent in injecting drug users and
sex workers.
- Caribbean and Sub-Saharan Africa most prevalent by heterosexual
transmission.
Feminisation of HIV
The process by which the overall percentage of woman with HIV has steadily
increased. This trend is most prominent in areas where heterosexual transmission is
prominent, however similar pattern seen among regions with injecting drug users,
mobile populations and prisoners.
Ethical Issues:
- Womans rights to safe sexuality and autonomy in decisions related to
sexuality are intimately related to economic stability. These rights are violated
where woman sell sexuality for a living.
- Also areas where womans rights are controlled by men this is a key issue
Prevention:
Until the scope of human rights is fully extended to economic security, womans
rights to safe sexuality cannot be achieved.
Key Issues!
- Gender inequalities in rules governing sexual relationships; condom use;
sexual abuse.
- Poverty leads to lack of knowledge of safe sex, and use reproductive health
services.
- Social norms and taboos.
- Stigma and discrimination that results in at risk population not seeking help.
- Respecting patient confidentiality and privacy.
- Difficulties for patient to inform partner.
Estimating Prevalence
- Sentinel surveillance systems undertaking surveys among specific populations
- Nation-wide surveys.
- Data from health services (Especially antenatal HIV+ prevalence)
- There is a now a relatively cheap test available.
Bias
- Prevalence in pregnant woman may not reflect prevalence of surround
community
- Data from antenatal clinics will not represent rural communities.
- People, who refuse to take part in household surveys, may have higher levels
of HIV.

Pacific and New Zealand

Pacific
- 90% of burden in Papua New Guinea.
- Largely heterosexual transmission
- Other pacific islands have low prevalence of HIV/AIDS but high prevalence
of other STDs
New Zealand
- 75% in males who sex with males
- 15% in men and woman in heterosexual relationships
- Antenatal screening for HIV and Prophylaxis are being implemented
-

Prevention and Control

Educational Approaches: Teachers, peers, workplaces, mass campaigns
Condoms: Promotion and marketing, reduced cost, increased availability
Screening blood products for HIV
Voluntary testing and counselling to reduce sexual transmission.
Prophylaxis to prevent mother-to-child transmission
Treatment, care and support for patients
Access to health services and other services to help patients
Mass media campaigns to reduce stigma and discrimination

Examples of initiatives
- International support and major philanthropic organizations (Gates
foundation)
- Reduced costs for Highly Active Anti-Retroviral Therapy (HAART)
- 3x5 Initiative by WHO