Download 10. HIV

Plan
HIV/AIDS
© Plan
Life Expectancy Loss
Country/国家
Before AIDS/流行前
2010
Angola
41.3
35.0
Botswana
74.4
26.7
Average life expectancy in 11 African
Countries
Lesotho
67.2
36.5
Malawi
69.4
36.9
Mozambique
42.5
27.1
Namiba
68.8
33.8
Rwanda
54.7
38.7
South Africa
68.5
36.5
Swaziland
74.6
33.0
Zambia
68.6
34.4
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(age in years)
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What is AIDS
• When HIV enter the human body, it will attack the CD4
cells, a kind of white blood cell which is an integral part
of the human immune system. In this way it destroys
the immune response.
• It make the infected vulnerable to attack by virus and
bacteria, causing opportunistic infections, malignant
tumors and multi-system organ injury.
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Definition
AIDS:
HIV:
Acquired
Human
Immuno
Immunodeficiency
Deficiency
Virus
Syndrome
HIV infection
Advanced to AIDS
On average 8-10 years
Identified sickness
Looks normal
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HOW DO PEOPLE GET AIDS?
• UNPROTECTED SEX
• INFECTED NEEDLES
• FROM MOTHER TO CHILD
• INJECTION DRUG USE
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5
AIDS DOES NOT
SPREAD THROUGH
• SALIVA
• SWEAT
• AIR
• TOUCH
• FOOD
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How to prevent being infected
• IDU transmission : keep off
drugs, do not share needles,
sterilize needles
• Sex transmission: ABC principle
ABC
A: abstinence (100% effective)
B: be faithful (requires trust and
fidelity)
C: condom (less than 100%
Plan
effective)
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HIGH RISK GROUPS
• INJECTION DRUG USERS
• GAY MEN
• SEX WORKERS AND THEIR CLIENTS
BUT THE EPIDEMIC IS SPREADING FROM
HIGH RISK GROUPS TO THE GENERAL
POPULATION AND THERE IS A POTENTIAL
RISK THAT THE EPIDEMIC WILL SPREAD
FURTHER
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Some Notes
Window Period
• The period between the initial infection and the period in which
antibodies are detectable (which can be from 2 weeks to 6 months, but
is usually 3 months)
Latency Period
• The time period between becoming infected with HIV and developing
symptoms of AIDS is known as the latency period. The latency period
can last from 2-10 years.
• Before developing symptoms, people with HIV can look and feel
healthy. but they can still infect others through blood to blood or sexual
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contact.
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HIV/AIDS AWARENESS REMAINS
UNACCEPTABLY LOW, AND MANY PEOPLE
STILL DO NOT KNOW ENOUGH ABOUT
HOW TO PROTECT THEMSELVES AGAINST
HIV
Once infected, not only must you take drugs
and will you become ill, but you (and those
affected by you) will often be discriminated
against.
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AIDS Impacts …
On household:
• Loss of income and production of a household member
• Create extraordinary care needs
• Household expenditures rise
On labor and the workplace:
• Less labor supply
• Loss experienced workers
• Decreased productivity
• Increase cost of doing business (health insurance, recruit and train
new employees)
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History of HIV in China
1985:
First reported HIV/AIDS case in China
1989:
First HIV Epidemic among IDUs in Yunnan
1995:
First outbreak of HIV among commercial plasma
donors
1995:
First time HIV in IDU outside Yunnan
1998:
HIV reported in all 31 mainland provinces
2002:
HIV reported in IDUs in all 31 mainland provinces
2005:
650,000 cases estimated
2006:
Estimated to be close to 1m
2007:
Revised downwards to 650,000-750,000
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Reported HIV Case,
by Province (1985-2005)
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Background
Unique epidemic & unique opportunity
• Population size: 1.3 billion
• Estimated HIV infection: 650,000 (0.05%)
• Tripling HIV infection from 0.05% to 0.15%, will add 1.3
million infections
• Increase rate to 4%, will have 52 million infections
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New Infections in 2005
• 70,000 new infections
• i.e. approx. 192/day
• Among them:
• Sexual contact:
• Injecting drug use:
• Mother-to-child transmission:
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49.8%
48.6%
1.6%
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The Trends of Epidemic
By report and by estimated time of infection
Plasma Donation
2003/2004/2005
IDU & Sex
& Blood
Testing Campaign
50000
50000
40000
40000
30000
30000
20000
20000
10000
10000
0
0
AIDS
85-90 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
5
HIV(+) 492
3
5
23
29
216
261
274
531
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52
38
126
136
230
233
714
1028 6120 12652 7550
HIV
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
HIV 5
1
12
9 222 389 505 657 854 4500 16500 11000 3000 3900 5070 6591 8568 11139 14480 18825
1567 2649 3343 3306 4677 5201 8219 9732 21691 47606 36614
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Proportion of HIV
Infected, Tested and Managed
650,000 Infected
145,000
tested
Tested
22%
Managed
6%
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40,000 ±
managed
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Proportion of Tested vs Untested
by Risk Factors
Plasma/blood
IDU
Sexual
MTCT
Tested
Untested
Blood related
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Government Leadership
• Establishment of State Council
AIDS Working Group (2004)
and provincial AIDS Working
Committees
05
20
04
03
20
20
02
20
00
01
20
20
99
98
19
19
19
19
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97
120
100
80
60
40
20
0
96
• Promoting anti-stigma
US$ (millions)
• Substantial increase in
government funding
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Supportive Legislation
• “Four Free and One Care” Policy
•
•
•
•
•
free ARV drugs,
free prevention of mother-to-child transmission,
free voluntary counselling and testing,
free schooling for children orphaned by AIDS, and
care to people living with HIV/AIDS
• AIDS Regulations (promulgated on March 1, 2006)
•
•
Identifies responsibilities and necessary actions to control HIV transmission
Prohibits discrimination towards PLHA and their families
• Issued a new 5-year plan
• Infectious Disease Act
•
Protects confidentiality
• Blood Safety Law
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Surveillance and Testing
• 329 national sentinel surveillance sites
• >400 provincial surveillance sites
• >3,000 free VCT clinics
• 3,756 screening labs and 57 confirmatory labs
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Management Strategies
Chain from identification to follow-up services
AIDS
HIV
HIV
Testing
Follow-up
Treatment
Death
Monitor
Resist
Death
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GOAL in New Five-Year Action Plan
By 2010,
China will limit people living with HIV/AIDS
no more than
1,500,000
China Center for AIDS/STD Control and Prevention
Chinese Center for Disease Control and Prevention
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…
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