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HIV and AIDS

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What is HIV and AIDS?

Human immunodeficiency virus (HIV) targets the immune system which disturbs the body’s ability to fight against infections. If the body’s immune system weakens and loses its ability to fight against infections, it may lead to multiple other diseases that can be fatal.  As HIV infection progresses, it can lead to acquired immunodeficiency syndrome (AIDS). It may take years for an untreated HIV infection to develop into AIDS depending on the individual.

HIV in Indonesia

In 2017, UNAIDS estimated that there are 630 000 people living with HIV with only 14% who are receiving antiretroviral therapy and only 270 000 who know their status. Newly infected cases with HIV increased from 2016 with 49 000 individuals and 39 000 deaths due to AIDS.

Only 13% of pregnant women living with HIV are receiving treatment to prevent transmission of HIV to their children. It is reported that there are still 3100 children aged 0 to 14 who are newly infected with HIV in 2017.

In 2012, it is reported that only 11.37% of young people aged 15-24 are well informed about HIV prevention.

Who can get HIV?

HIV holds a stigma and is usually only associated to gay men, drug users or sex workers but it is important to note that anyone can get HIV. Regardless of your gender and sexuality; you can contract HIV.

HIV is a bloodborne disease meaning that it is a disease that is caused when a virus enters the blood. HIV can be transmitted through contact with infected human blood and other bodily fluids.

There are 3 main modes of transmission of HIV:

  1. Sexual contact
  2. Blood transfusion
  3. Mother to child transmission
HIV can be transmitted by: HIV cannot transmitted by:
• Having sexual intercourse with an HIV-positive individual

• Sharing needles with an HIV-positive individual

• Sharing razors with HIV-positive individual

• Breastfeeding
• The air or water

• Sharing food or drink, and/ or cutleries with an HIV-positive individual

• Insects

• Sharing toilets with an HIV-positive individual

• Contact with saliva, sweat or tears of an HIV-positive individual

Understanding the mode of transmission of the virus, it is recommended that you consider HIV testing if you:

  • Have unprotected sex with more than one sexual partner
  • Are men who have sex with men
  • Intravenous drug user
  • Sex workers

It is also important that you consider getting tested if you have been sexually assaulted or planning to get pregnant.

Testing 

HIV testing should be voluntary and must follow the WHO-recommended principles known as the “5-Cs”: consent, confidentiality, counselling, correct test results and connection.

You can go to your healthcare provider or medical clinics to test for HIV. HIV is usually tested through a blood test depending on which test your provider provides. Certain tests can give you results in 20 minutes however, other tests require a week.

It is important to know that there are no HIV tests that can detect HIV immediately after infection because there is a window period before HIV can be detected. If you are certain you have been exposed to HIV in the last 72 hours, talk to your doctor about PEP.

Treatment options

The treating rate has been increasing over years resulting from the increased awareness, screening and understanding of the disease. Under the current guideline and recommendation, it is strongly recommended that all HIV infected individuals should initiate antiretroviral therapy (ART) as soon as possible.

ART is a therapy that could suppress HIV viral load to an undetectable level by multiple antiviral drugs. There are side effects in ART depending on which antiviral drugs used but usually mild and constitutional. More importantly, drug interaction with recreational drugs as a major risk group would be a serious problem affecting the safety of using drugs. It is also important to comply with the prescribed course of medication.

Prevention options

To prevent the spread of HIV there a number of things can be done. Telling your partner they may be infected is important to prevent getting HIV and stop other people from being infected.

There are different ways to prevent acquiring HIV including screening, physical barrier and medication.

  1. Safe sex and Condoms
    It is always good to practice safe sex either vaginal or anal sex which could prevent HIV infection as well as other STIs. Condoms are not only for preventing pregnancy, it is also to prevent STIs. Other than availability, consistent and correct use of condoms are as important with up to a 94% reduction in risk of transmitting HIV.
  2. Pre-exposure prophylaxis (PrEP)
    PrEP is now used to prevent acquisition of HIV by using antiviral drugs before the exposure to HIV. The official daily dosage guideline is currently under research and is varied across countries. It is important to follow the local prescription advice.
  3. Post-exposure prophylaxis (PEP)
    PEP refers to the use of antiviral drugs after the exposure to possible sources of HIV in order to prevent acquiring infection. The current recommended duration of PEP is 28 days with the first dose taken within 72 hours after exposure. Highly effective PEP is the only way to reduce risk of infection after exposure of HIV but it is not 100%. Therefore, primary prevention and risk prevention counselling are equally important.
  4. HIV testing and counselling
    It is essential to educate the public and let individuals know about HIV and their own HIV status in order for infected individuals to get proper treatment and care. Screening test of HIV is important to be accompanied with pre-test and post-test counselling service to provide individuals accurate information and implication of test results.

References

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