NAMA : THERESIA WITAYOSI NIM : FAA 111 0030

PROGRAM STUDI PENDIDIKAN DOKTER

SUMMARY SEMINAR ON BE OPPOSED TO HIV / AIDS Theme: "Say No To Free Sex" Sub Theme: "To Save Ourselves That We Can Save Others" Resource Persons: 1. Dr. Mikko Uriarampas, SpOG, Kes (IDI Chairman Palangkaraya) 2. Dr. Dawn Jum'atil MHltSc 3. Mirhan S. Pd (PKBI Executive Director of Central Kalimantan)

Material 1 By Dr. Mikko Uriarampas, SpOG, MKes AND REPRODUCTIVE HEALTH SYSTEM What is a Youth? According to WHO teenagers aged 12-14 years which is the transition from children. The young woman was physically resemble adult 10-19 years of age have not been married. The meaning of reproduction and health? Reproduction is a process to produce offspring and its sustainability. Adolescent Reproductive Health (KRS) is a condition of the reproductive system healthy adolescents. Healthy means free of disease, disability-free, mentally healthy. And young men / women must take responsibility for reproductive health. Why adolescent reproductive organs is very important? Every teenager knows his organ and every teenager should keep it because it's known in the world: -100 teen> teen abortions every day and the U.S. and Europe began to sex since the age of 15 years. Characteristics of Adolescents There are changes in body such as for male pubic hair grows, legs, mustache, chest, and for woments wet dream bumps arise for example in the chest. Teens also have a sex drive (hormone)> interest> want to get sexual satisfaction. Adolescent reproductive organs For girls there are 2 of externa and interna, but for the son is not divided and healthy reproductive system. External Genitalia female organs - Mons pubis: pubic symphysis anterior fat pad, hair - The labia majora: jar has two folds of skin and fat covered scrotum in the male homologous - The labia minora: having a thin fold of tissue, many blood vessels and nerve tissue, and very sensitive. - Clitoris: consists of the glans, corpus, and two crura, folded downward, erectile, and homologous with the penis. - Vagina: divided into 3 one-third above (servicovaginalis a.uterina), middle (a.vesicalis inferior), bottom (a.pudenda hemoroidalis internal and medial). - Perineum: sustained pelvic and urogenital diaphragm and perineal corpus is the main supporter of the perineum. Male reproductive organs Anatomical structure of the penis: there is a pair of corpus cavernous and corpus spongiosa Blood from a.kavernosa for the erection tdd sympathetic and parasympathetic nervous system somatic nerves of n.pudensus S 2 The mechanism of erection

Is a psychological and physical stimuli received SSP section thalamus, rhinencephalon and the limbic system, the parasympathetic system release the neurotransmitter, occurs relaxation of smooth muscle, dilation of sinusoids, the emphasis subtunika vein (venous occlusive mechanism), inhibition of blood coming out that makes the penis swell and harden. Breast There is a lobe of the gland tissue, milk ducts and connective tissue supporting lig Cooper 15-20 lobes of the lobules and alveoli of the secretory cells Having Progesterone stimulates the development of milk-producing cells Prolactin stimulates milk production Oxytocin stimulates contraction mioepitel Adolescent problems There are a variety of adolescent problems today is that deviant sexual behavior, abortion, extramarital pregnancy, STDs and HIV (AIDS), taking drugs, risk in childbirth. In sex and some are not safe due to pregnancy and depression and suicide. Examples of reproductive disease, namely in between Condyloma ACCUMINATA a LOW RISK, HPV TYPE 11, RARE (vulva: THE COMMON SITE), TH /: Electrosurgery / CAUTERIZATION. 3 FACTORS PREVENTING juvenile delinquency, namely: - Household, for example teenagers who lack parental attention - Schools - Social Environment Material 2 By Dr. Jum'atil Fajar MHltSc Human Immunodeficiency Virus (HIV) Factors affecting the spread is due to travel through the air faster, urbanization, practice sexual permissiveness, and drug use through injection trelarang. Phase evolution of the AIDS pandemic that is happening in the endemic villages are turning to the city's population, occurring dissemination and involve risk groups namely sex and drug use by injection, the escalation in the 1980s, and stabilization occurred in Western Europe, North America and Australia . In the late 20th century, there are >21 million died of AIDS, >34 million suffer from HIV infection, and >95% of people infected with HIV live in the amend country. In early 21th century, prevalence of HIV infection 0.8% (global), HIV prevalence-Ages 15-49 (%) - Indonesia, 95% of new HIV infections and deaths occur in developing countries, two thirds of people living with HIV infection live in sub-Saharan Africa, 15-24 years (45% of new infections HIV),> 50% of AIDS are women that resulted in infants with HIV so that productivity declined, life expectancy at the average person with a diagnosis of HIV infection increased from 10.5 years (1996) 22.5 years (2005). HIV transmission can be low when: - <5% of men visiting sex workers - Condom use high - The use of injection drugs with low

Biology of human immunodeficiency virus (HIV) HIV is caused by a retrovirus is the cause of AIDS is known in the 1980s that the RNA lentivirus family. Structure of viruses Have 2 RNA, approximately 9200 nucleotides with the enzyme, ie - Reverse trancriptase - Protease - Ribonuclease - integrase Having a fat envelope with 72 spikes, which contain - Gp120 - binds to the CD4 receptor - Gp41 - gp120 binds with the fat envelope Retroviruses can not replicate outside a living host cell and does not contain DNA Pathogenesis of HIV infection is a function of: - The life cycle of the virus - The host cell environment - The amount of virus in infected individuals HIV infections occur through: - Oropharynx - The cervix - Vaginal - The surface of the digestive tract mucosa Epidemiology of AIDS is to take several weeks to be seropositive and 8-10 years of signs and symptoms of AIDS. Symptoms of AIDS is some people experience flu-like illness, have a reddish, or enlarged lymph nodes in a short time after they are infected with HIV, often people who are infected with HIV have no symptoms at all, and it is important to remember that a person infected with HIV can transmit the virus soon after he was infected. Body fluids containing HIV there are 2, ie there is associated with transmission (blood and blood components, semen, vaginal fluids and breast milk) and are not berhibingan with transmission (saliva, urine, tears, sweat, and cerebrospinal fluid). Risk behaviors for HIV infection is sexual contact, blood exposure, and exposure to congenital. Sexual intercourse is an activity that caused lacerations, cuts, or denudation of the penis, vagina, rectum, or mouth epithelium, presence of genital ulcers, rectum, or mouth caused by other sexually transmitted diseases, performed without using a condom, and under the influence of alcohol or drugs interfere with the assessment and decision making.

Sexual intercourse is divided into : - Sexual intercourse through vaginal - Sexual intercourse through the anus - Sexual intercourse by mouth - Lesbian Sex, which include male partners in sexual activity and habits (eg the use of dildos) that enables the exchange of blood or vaginal fluids. Exposure to blood is with injection drug use with shared needles, jarung Use the "cleaned" with a disinfectant other than bleach, get a tattoo with a needle used together, a ritual of blood ("blood brothers"), and transfusion with blood or blood products are screened or are not adequately examined. Congenital exposure to infection is increased with the increase in CD8 + lymphocyte count in the mother, decreased percentage of CD4 + lymphocytes in the mother, maternal chorioamnionitis or funisitis, maternal fever is ongoing, and breast-feeding a baby. An important factor that is more heterosexual transmission of multiple sex partners, often change sex partners, unprotected sex, the presence of an additional sexually transmitted diseases, lack of male circumcision, the social vulnerability of women and youth, economic and political instability. Variable transmission through sex is through cement or vaginal fluids <gonorrhea or hepatitis B virus), the number of sex partners, and seroprevalen (number of infected individuals in a population). HIV transmission around 0.1% (1 infection per 1000 contacts) the average per-genital sexual contact with people infected with HIV, most infected after one sexual contact and others remained uninfected after hundreds of times a contact. HIV infection rates: Women - 0.1% - 10% in receptive vaginal intercourse Men - 0.1% - 1% for insertive vaginal intercourse Insertive anal intercourse: 0.1% - 1% receptive anal intercourse: 1% - 30%

Material 3 By Mirhan, S.Pd DANGER HIV / AIDS and prevention HIV is the cause of AIDS, which weakens the immune system and body protection while AIDS is a collection of some of the symptoms caused by the immune system caused by HIV. Cases of HIV / AIDS was first identified in the world in 1981 (in San-Francisco) in a Gay. Over time, the progression of HIV / AIDS continues to rise rapidly, especially in the poor countries and developing countries. World struggle against HIV / AIDS until now has been 30 years so that the theme of World AIDS Day 1st Warning Desemeber 2011 is "HIV is still here". The world's estimated 34 million people living with HIV / AIDS (PLWHA) increased 17% compared to the situation in 2001, but the number of people who died of AIDS began to fall to 1.8 million people (previously around 2.2 million inhabitants).

Globally, the decline in numbers was mainly in the 33 countries that succeeded in expanding the use of antiretroviral drugs (antiretroviral) in people infected with HIV. In 2010 the people infected with HIV globally around 2.7 million (down 21% compared to the peak epidemic of 1997). According to the calculation of the WHO (1992) not less than 3 people worldwide are infected with the AIDS virus every minute of it. Nationally, cases of AIDS, 1 April 1987 s.d. June 30, 2011, is 26 483 cases, 5056 people died. Impact of HIV / AIDS Life Against Social, Economic and Psychological is : 1. The figures above represent a major shift towards people who are infected with HIV, where if the first few years of HIV/AIDS cases pedominantly homosexual, but in the journey of HIV/AIDS began sweeping heterosexual, and more pathetic longer current HIV/AIDS has been extended to households with an indication of the increasing IRT and infant / toddler infected with HIV. 2. More concern in recent years of data are infected with HIV / AIDS is dominated by the productive age group. If this is allowed then it would threaten the stability and continuity of state (such as occurs in most countries of Sub-Saharan Africa who narrowly lost generation). 3. It is not beneficial to poor countries and developing countries, because it turns out when this happens quite rapidly increasing trend of HIV / AIDS cases precisely in those countries (Sub-Saharan Africa, Asia, and Latin America), while the rich countries in Europe , Australia, and the U.S. (the world's first discovered cases of HIV / AIDS) is already far declined. 4. Studies of the UNDP (United Nation Development Programme) states that direct and indirect costs to death spent $ 14 billion. Please note that ARV drugs currently cost about USD 2.5 to 3 million for a patient with HIV / months and consumed a lifetime, is still provided free by the government of Indonesia assisted by donors. 5. HIV / AIDS is a deadly dangerous disease, there is no cure and vaccine pencegahnya. 6. HIV / AIDS can affect all people indiscriminately, so that we are all vulnerable to HIV 7. Long incubation period of between 5 to 7 years, because it's usually people who possessed the HIV virus is not known by himself or others, that he suffered from the HIV virus, because he looked healthy and felt healthy. 8. The existence of window period of about 1-6 months to make people who received blood transfusions are still at risk of HIV infection. 9. ODHA are still under pressure psikhis in society because of stigma and discrimination against them is still strong, people tend to be isolated so that they generally kept to herself. 10. If ODHA are not given IEC mamadai, so that a healthy sexual behavior change, is likely to accelerate the dissemination of HIV infection to others. Prevention of HIV / AIDS by: A: Abstinence B: Be Faithfull C: Condom

D: No Drugs E: Education Perform VCT, PPTCT, PITC, CST, namely: - Voluntary counseling and testing is voluntary for individual tests with knowing one's HIV status. This test is a blood sampling and laboratory examinations on a voluntary basis which must be accompanied by counseling. - Prevention of Parent to Child Transmission (PPTCT) is a service which is devoted to parents who are infected with HIV. Every parent, especially pregnant women, HIVpositive status, a concern of this ministry. - Provider initiated testing and counseling (PITC) is a service blood tests to determine one's HIV status based on the initiative or the recommendations of health workers and patients receiving the advice. This usually happens in a medical setting. - Care Support and Treatment (CST) is associated with the provision of support services to people who have HIV status. This service will occur after a person through a blood test or when a person who has received their HIV status. The usefulness of knowing the status of VCT will facilitate early treatment planning, improve quality of life, thereby reducing morbidity and mortality (although not curable, the disease can be well controlled), breaking the chain of HIV transmission is widespread. But if the test results are negative, prevented by maintaining safe behavior, change the behavior of the risk to the safe behavior, maintaining a negative test result, the active elements and control of AIDS prevention activities for the group, society and environment.

Remove Stigma and Discrimination against ODHA

PLHIV Stigma namely: Negative attitudes are given to people living with HIV ("Cap Bad") Encourage the marginalization of PLHA and those vulnerable to HIV infection. Given the HIV and AIDS is often associated with sex, drug use and death, many people who do not care, do not accept and fear of this disease. Causing some PLHA and people vulnerable to HIV and AIDS become less valued and feel ashamed. While the other group to feel superior.

Discrimination PLWHA are: Discrimination occurs when the negative views of encouraging people or institutions to treat someone unfairly based on their prejudices to one's HIV status. Examples of discrimination: the hospital or prison staff refused to provide health services to people living with HIV; tops that lay off employees or prejudice based on the status of their HIV status, or family or people who refuse to believe they are living or living with HIV and AIDS.