slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
SOIL AND SHOWER OF HIV / AIDS IN INDIA DISCUSSION FROM A DIFFERENT ANGLE Dr. A.K.AVASARALA, MD PROFESSOR & HEAD PowerPoint Presentation
Download Presentation
SOIL AND SHOWER OF HIV / AIDS IN INDIA DISCUSSION FROM A DIFFERENT ANGLE Dr. A.K.AVASARALA, MD PROFESSOR & HEAD

Loading in 2 Seconds...

play fullscreen
1 / 33

SOIL AND SHOWER OF HIV / AIDS IN INDIA DISCUSSION FROM A DIFFERENT ANGLE Dr. A.K.AVASARALA, MD PROFESSOR & HEAD - PowerPoint PPT Presentation


  • 306 Views
  • Uploaded on

HIV(seed) SOIL AND SHOWER OF HIV / AIDS IN INDIA DISCUSSION FROM A DIFFERENT ANGLE Dr. A.K.AVASARALA, MD PROFESSOR & HEAD DEPARTMENT OF COMMUNTIY MEDICINE AND EPIDEMIOLOGY PRATHIMA INSTIUTE OF MEDICAL SCIENCES, NAGUNUR, KARIMNAGAR ( A.P.), INDIA – 505417.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'SOIL AND SHOWER OF HIV / AIDS IN INDIA DISCUSSION FROM A DIFFERENT ANGLE Dr. A.K.AVASARALA, MD PROFESSOR & HEAD' - albert


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

HIV(seed)

SOIL AND SHOWER

OF

HIV / AIDS IN INDIA

DISCUSSION FROM A DIFFERENT ANGLE

Dr. A.K.AVASARALA, MD

PROFESSOR & HEAD

DEPARTMENT OF COMMUNTIY MEDICINE AND EPIDEMIOLOGY

PRATHIMA INSTIUTE OF MEDICAL SCIENCES,

NAGUNUR, KARIMNAGAR ( A.P.), INDIA – 505417.

E_mail : avasarala@yahoo.com

ENVIRONMENT (SHOWER)

HOST

(SOIL))

slide2

HIV INFECTION

  • NO DOUBT IT
  • INVADED
  • SETTLED
  • SPREADINGININDIA
  • UNAIDS FACT SHEET 2003
    • HETEROSEXUALS ( SEX WORKERS )-60-70%
    • ANTENATAL WOMEN - 1 %
    • HOMOSEXUALS – 27 % ( NACO, INDIA)
hiv aids in india heterogeneous distribution
HIV/AIDS IN INDIAHETEROGENEOUS DISTRIBUTION
  • GENRALIZED CONCETRATED
  • EPIDEMIC EPIDEMIC
  • >5% in high risk groups+ >1% (>5% IN HIGH RISK +<1% IN PREGNANT WOMEN PREGNANT WOMEN
  • MAHARSHTRA,TAMILNADU,KARNATAKA, GUJARATH,GOA,KERALA,WESTBENGAL
  • ANDHRA PRADESH,MANIPUR NAGALAND

LOW LEVEL

EPIDEMIC (<5% IN HIGH RISK+<1% IN PREGNANT WOMEN

UTTAR PRDESH,MADHYA PRADESH,BIHAR,RAJASTHAN

REST OF INDIA

vulnerable WITH HIGH

STD

PREVALENCE

hiv aids in india
HIV/AIDS IN INDIA
  • HR > 5 , PW > 1% MAHARASHTRA,TAMILNADU,KARNATAKA,ANDHRAPRADESH,MANIPUR
  • HR > 5% , PW < 1% GUJARATH, GOA, WESTBENGAL, NAGALAND
  • HR < 5% , PW < 1% UTTARPRADESH,MADHYAPRADESH,BIHAR, RAJASTHAN
slide5

SENTINEL SURVEILLANCE DATA

IN METROPOLITAN CITIES

slide6

RURAL SITUATION

ALSO NOT SATISFACTORY

MORE HIV SEEN

DUE TO POOR LITERACY & UNAWARNESS

AND LESS CONDOM USE

slide7

3 EPICENTRES

  • MEGHALYA, MANIPUR & MIZORAM
  • MAHARASTRA
  • 3. ANDHRA PRADESH & KARANATAKA,
  • AND TAMILNADU
slide8

EPICENTRE -1 (SOIL &SHOWER)

MEGHALAYA, MANIPUR AND MIZORAM

FERTILE SOIL(SUSCEPTIBLE HOST)

POOR AND UNEMPLOYED

YOUNG AND IMMATURE, ANTISOCIAL

TEMPTED TO INJECTABLE DRUG ABUSE

CALLOUS , HENCE CONTAMINATION OF NEEDLES

SHOWER (FAVOURABLE ENVIRONMENT)

FREE AVALIBILITY OF NARCOTIC DRUGS DUE TO

DRUG TRAFFICKING ACROSS THE MYANMAR BORDER and POLITICAL INSTABILITY favors HIV INFECTION

? CAN FREE SUPPLY OF STERILE NEEDLES

SOLVE THIS PROBLEM ? IS IT ETHICAL?

slide9

CONFOUNDING SITUATION

AT MIZORAM

POLITICAL INSTABILITY

VIOLENCE

FALSE SECURITY

FALSE COURAGE

UNEMPLOYMENT &

IDLE YOUTH

HALLUCINATIONS

DELUSIONS

DRUG ABUSE& HIV

FREELY AVAILABLE

DRUGS

slide10

EPICENTRES-2&3 (SOIL &SHOWER)

  • MAHARASTRA, ANDHRA PRADESH, TAMILNADU, KARANATAKA
  • SHOWER
  • POVERTY,
  • MUMBAI,PUNE,SATARA.CHENNAI,
  • VIJAYAWADA(AP)
  • WITH THEIR GROWING URBAN SLUMS AND MOBILE POPULATION,
  • COMMERCIAL SEX WORK(CSW)
  • LACK OF BROTHEL LICENCING,
  • LACK OF MEDICAL EXAM FOR CSW
  • SOIL
  • UNSAFE SEX , ILLEGAL SEX
  • COMMERCIAL SEX WORK
  • MULTIPLE SEX PARTNERS
  • LESS CONDOM USE
  • HUNGER, ILLITERACY,
  • CARELESSNESS, SEXUAL PERVERSIONS
slide11

EPICENTRES 2&3 DHABHAS

(WAYSIDE FEEDING CENTRES OF ILLFAME)

OTHER SIDE OF THE COIN

BIG BUSINESS

  • LONG DISTANCE
  • TRUCK DIVERS
  • CONTRACTORS ENOLL SEXWORKERS AND DROP THEM AT DHABHAS IN THE EVENING AND COLLECT THEM IN THE MORNING THEY COLLECT COMMISSION FROM CSW.
  • DHABHA OWNER IS ALSO BENFITED DUE TO MORE NUMBER OF CUSTOMERS WEAK ENFORCEMENT OF RESTRICTION OF IMMORAL TRAFFIC ACT IS ANOTHER FACTOR.
  • LEAVING THEIR
  • WIVES AT HOME

LONELINESS,

RESORT TO ILLICIT CHEAP SEX

AT DHABHAS

HIV

SEEDLING ALONG HIGHWAYS

slide12

WHY HIV INVADED&SETTLED INDIA

INDIAN SOCIETY CHANGED IN FAVOUR OF

HIV

-

slide13

5

HIV / AIDS IN INDIA

IS

NOT

JUST DUE TO

HIV ALONE(THE SEED)

slide14

SOCIETAL CHANGE (SHOWER)

  • ACCULTURATION EFFECTS
  • CULTURAL CHANGES--INCREASE IN -VE LIFE STYLES REGARDIG SEXUAL PRACTICES
  • DETERIORATED HUMAN VALUES
  • SEXUAL PERVERSIONS AND STD ON THE RISE
  • COSMOPOLITAN NATURE OF CITIES ENCOURAGING -VE LIFESTYLES
  • URBAN SLUMS & NIGHT CLUBS -MORE OPPORTUNITIES FOR ILLEGAL AND UNSAFE SEX
  • INCREASING MOBILE POPULATION AT BUSSINESS CENTRES AND CITIES FAVOURING THE SPREAD
  • COMPLACENCY ABOUT UNIVERSAL PRECAUTIONS &SEXUALLY TRANSMITTED DISEASES
slide15

DETERIORATION

MONOGAMY AT THREAT

HUMAN VALUES &VIRTUES AT LOW LEVEL

CELIBECY NOT PRACTICED

slide16

INCREASING SEX ABUSE

  • ESPECIALLY IN COSMOPOLITAN CITIES
  • DUE TO
  • FREE AVAILABILITY OF SEX
  • COMMERCIAL SEX WORK AND SEX MARKETTING
  • NIGHT CLUBS AND CALL GIRL SYSTEM
  • ILLEGAL SEX
  • MULTIPLE PARTNERS
slide17

SEXUAL PERVERSIONS

  • HIV IS A MAJOR BEHAVIORAL PROBLEM
  • HOMOSEXUALITY -- INCREASE IN
  • THE LONELY
  • ORAL SEX
  • ANAL SEX- CHILD ABUSE
slide19

SPREAD OF HIV

CLIENTS OF CSW,

STD PATIENTS,

PEERS OF I.D.USERS

GENERAL

POPULATION

CSW &INJECTABLE DRUG USERS(IDU)

(HIGH RISK)

(BRIDGE)

slide20

HIV (THE SEED)

WHY HIV IS PREFERRING T4 CELLS ONLY NOT OTHER CELLS

WHAT IN T4 CELLS THAT IS ATTRACTING HIV ?

CAN THAT SOMETHING CAN BE ELIMINATED OR NEUTRALIZED ?

slide21

LIFE STYLE MODIFICATIONS-TOP PRIORITY

“ MEND THE MIND MUST BE THE RULE AS HIV IS MAINLY A BEHAVIORAL DISORDER

LIFE STYLE MODIFICATIONS ARE NOT GIVEN ENOUGH STRESS AT PRESENT

ETHICAL VALUE OF SAFE SEX NOT MUCH EMPHASIZED

CHARACTER-BUILDING NOT ATTEMPTED

NO STRESS TO CURB DON’TS (-VE LIFE STYLES )

slide22

LIFE STYLE MODIFICATIONS

ONLY THE CHANGE OF BEHAVIOR CAN SOLVE THE HIV PROBLEM PERMANANTLY

IT IS NEITHER ADVISABLE NOR ETHICAL TO PROVIDE STERILE SYRINGES FREELY TO A DRUG ADDICT AND ASK HIM TO CONTINUE TO TAKE DRUGS NOR TO PROVIDE A CONDOM AND ASK TO VISIT A BROTHEL,BECAUSE IN BOTH THE STRATEGIES, BEHAVIOR AL CHANGE TO CURB RISKY BEHAVIOR WILL NOT OCCUR BUT WILL CONTINUE. .

slide23

MIZORAM HIV CONTROL

  • CONFOUNDING SITUATION
  • BRINGOUT THE BEHAVIORAL CHANGE AMONG HIGH RISK GROUPS ESPECIALLY THE YOUTH
  • USE DEADDICTED PATIENT FOR MOTIVATION OF NEW ADDICTS
  • SCHOOL CURRICULAM TO INCLUDE THE ADVERSE EFFECTS OF THE DRUG ABUSE AND CONTAMINATED NEEDLE USE
  • CONTROL DRUG TRAFFICKING ACROSS MYANMAR BORDER
  • REDUCE THE FREE ACCESSIBILITY AND AVAILABILITY OF DRUGS
  • UTILIZE PEERS (YOUTH ) TO BRING CHANGE IN YOUTH
slide24

MIZORAM HIV CONTROL

  • PROVIDE EMPLOYMENT FOR YOUTH
  • FREQUENT RECURRENT VIOLENCE LEADS TO INSECURITY ,DESPAIR AND THEREBY RESORTING TO DRUG ABUSE.
  • DRUG INDUCED HALLUCINATIONS GIVE FALSE SECURITY AND FALSE COURAGE WHICH INTURN BREEDS VIOLENCE-
  • STEPS TO REDUCE VIOLENCE BY EDUCATING THE PEOPLE ABOUT EPIDEMIOLOGY OF VIOLENCE
slide25

MIZORAM HIV CONTROL

  • CONTROLLING DRUG TAFFICKING ACROSS THE BORDER,
  • STRICT VIGILANCE OVER DRUG TRAFFICKERS,
  • INCOME GENERATING ACTIVITIES FOR UNEMPLOYED YOUTH,
  • PERSISTATANT PERSUAVASSIVE METHODS TO REDUCE IV DRUG USE
slide26

HIV CONTROL AT EPICENTRES 2&3

(MAHARASHTRA,ANDHRA PRADESH,

TAMILNADU &KARNATAKA)

COMMERCIAL SEX WORK AND HIV CONTROL

LICENCED BROTHELS WITH REGULAR SCREENING

AND TREATMENT FOR STD ,

INCOME GENERATING ACTIVITIES FOR CSW,

REHABILITATION OF THE CHILDREN AND DEPENDENTS

OF CSW,

STRICT ENFORCEMENT OF IMMORAL TRAFFIC

REGULATION ACT

slide27

STRICT VIGILANCE

AND SCREENING FOR HIV

AT

DHABAS &

NIGHT CLUBS

slide28

CONDOM USAGE

CONDOM USAGE IS A TEMPORARY INTERVENTION . IT IS ALSO NOT ETHICAL TO GIVE SOMEONE A CONDOM AND ASK HIM TOVISIT A BROTHEL . IN THE LONG RUN, IT WILL NOT HELP.

BUT IT IS A MOST PRACTICAL AND FEASIBLE INTERVENTION BUT

WHY IT IS USED LESS ?

WHY LESS ACCEPTABLE?

SEX WORKERS COMPLAINING THAT THEY ARE LOOSING THEIR BUSINESSIF THEY INSIST THEIR CLIENTS FOR CONDOM USE .HOW FAR IT IS TRUE?

HOW TO IMPROVE COMPLAINCE OF CONDOM USAGE?

I.E.C. ACTIVITIES HAVE TO BE MODIFIED TO ENHANCE CONDOM USAGE AND COMPLAINCE.PEER GROUP MOTIVATION MAY BE TRIED

CONDUCTING EXHIBITIONS SHOWING VARIOUS MODELS AND SPECIMENS OF SEXUALLY TRANSMITTED DISEASES MAY CREATE INTEREST IN THE PUBLIC AND BECOME SENSITIZED FOR CONDOM USE.

slide29

MCTC AND THROUGH INFECTED BLOOD

  • MOTHER TO CHILD TRANSMISSION (MCTC)
  • AS HIV IS HIGH IN ANTENATAL WOMEN (1%) ,
  • IT IS NECESSARY TO PREVENT MCTC.
  • PREVENTION TRIALS ARE UNDERWAY IN
  • ANDHRA PRADESH
  • HIV THROUGH INFECTED BLODD HAS COME DOWN
  • INDIA DUE TO
  • CLEARCUT TRANSFUSION POLICY
  • STRICT LICENCING OF BLOOD BANKS
  • AVOIDING BLOOD COLLECTION FROM
  • PROFESSIONAL DONORS
slide30

LESS EFFECTIVE CONTROL FIRST GENERATION STD

IN INDIA, CONTROL OF SEXUALLY TRANSMITTED DISEASES WAS NOT SERIOUSLY CONSIDERED THINKING THAT THEY ARE OF PERSONAL IN NATURE

CLINICS FOR VENEREAL DISEASES WERE STARTED VERY MODESTLY

HIGH LEVEL SECRECY WAS MAINTAINED REGARDING STD,HENCE POOR PUBLIC AWARENESS AND INTURN LEAD TO RUMORS AND SUPERSTITIONS

e.g. INTERCOURSE WITH A CHILD WILL RELIEVE STD &

OPEN AIR URINATION CAUSES GONORRHEA

TALKING ABOUT STD ITSELF USED AS A SIGN SOCIAL DEMORALISATION

SCREENING FOR STD IN HIGH RISK GROUPS AND TREATING THE CASES WILL REDUCE THE VULNERABILITY FOR HIV AND THEREBY HIV INCIDENCE

STD SYNDROMIC MANGEMENT SHOULD BE REALLY PRACTICED IN THE FIELD

STD CONTROL AS IT IS INCLUDED IN NATIONAL AIDS CONTROL IS NOT GETTING ENOUGH ATTENTION

.

slide31

AIDS CONTROL SOCIETIES

  • FOR COMMUNITY INVOLVEMENT
  • HOW FAR THEY ARE SUCCESSFUL
  • IN REDUCING THE HIV INFECTION?
  • COMMUNITY PARTICIPATION HAS NOT REACHED ITS DESIRED LEVEL .
  • AS EVIDENCED BY
  • INCREASE IN HIV INFECTION
  • POOR USAGE OF CONDOMS
  • POOR AWARENESS AMONG BOTH URBAN AND RURAL POPULATION
  • ENRICH AND JUVENATE COMMUNITY INVOLVEMENT EITHER BY INCENTIVES OR DISCENTIVES.OR BY STRICT LEGISLATION
  • COORDINATION COMMITTEES SHOULD NOT BE CONFINED TO PAPER.
  • REAL INTERSECTORAL COORDINATION WITH RESPOSIBILITIES,WHICH ARE ACCOUNTABLE AND MONITORABLE, TO BE FIXED ON ALL SECTORS
slide32

MASS MEDIA

STRONG POSITIVE ROLE ESSENTIAL

TV 9 CHANNEL INTERVIEWED CSW AT EAST GODAVARY DIST (AP) . CSW COMPLAINED THAT THEY ARE LOSING THEIR CLIENTS DUE TO HIV?

FLIMS -SOME MOVIES ARE GIVING FALSE MESSAGES ABOUT HIV TRANSMISSION THROUGH THE COMEDIANS. EVEN FOR JOKE, WRONG MESSAGES SHOULD NOT BE GIVEN AS THEY BREED RUMORS AND SUPERSTITIONS AS HALF OF THE INDIAN COMMUNITY IS ILLTERATE.

SUICIDES AFTER HIV POSITIVE DECLARATION ARE STILL HAPPENING.EFFECTIVE POST-TEST COUNSELLING IS IMPERATIVE

slide33

CONCLUSION

AS IT IS SECOND GENERATION STD, IT NEEDS TACKLING AT PERSONAL LEVEL FIRST

AS IT IS A LIFE STYLE DISEASE , LIFE STYLE MODIFICATIONS ARE ESSENTIAL

AS LONG AS FAVORABLE ENVIRONMENT AND SUSCEPTIBLE HOST IS AVAILABLE IT WILL BE SPREADING.HENCE NEED FOR STRESS ON LONG TERM STRATEGIES INSTEAD OF TEMPORARY BENEFITS

TREATING AIDS PATIENTS IS ONLY HALF OF THE ANSWER

AGRESSIVE HEALTH EDUCATION AT SCHOOL LEVEL (PRIMORDIAL PREVENTION ) IS RIGHT INTERVENTION BEFORE FIXED IDEAS DEVELOP.

.