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HIV and AIDS – What are they and How are they related? Human immunodeficiency virus or shortened to HIV is a kind of virus that strikes the immune system, the defense system of the body. When a person’s immune system goes weak, it will have difficulty fighting against diseases. HIV is the name of both the infection and virus that it causes. The important aspect of the immune system is the white blood cells. HIV destroys the white blood cells referred to as CD4+ cells. If there are too many of this particular cells eliminated, the body doesn’t have the power to defend itself from infection. The final phase of the infection HIV is called acquired immunodeficiency syndrome or AIDS. People diagnosed with AIDS have very lower CD4+ cells, and they easily get infected with cancers or infections that rarely happens with healthy people. It is one of the most deadly diseases of the human body. However, just because you have HIV doesn’t always mean that you will have AIDS, too. Even if you don’t go to any treatment, it will take a long time for the HIV to turn into AIDS, which usually starts showing at the 10th or 12th year. When the person gets diagnosed with HIV before it turns into AIDS, medications are prescribed to slow down the progress or eliminate the damage it can do to the immune system. If AIDS does happen, the medication can also help return the immune system to its healthier state. People with HIV/AIDS that are cooperative with treatment and medications will be able to live longer and even more active lives. HIV comes in 2 types: the common cause of all AIDS cases in the world; HIV-2 is the one that causes illness so much like AIDS, but this type of infection is not common in North America. History of HIV One of the biggest epidemics in the world today is HIV, which is the same virus that develops into AIDS. The earliest case found regarding about HIV was a blood sample taken from a man coming from the Democratic Republic of Congo. In the records, the virus spread to the humans from the chimpanzees before the year 1931. It was likely at the time that “bush meat trading” flourished. Hunters would come into contact with the animal blood when they are out hunting the chimpanzees. Before the year the 80s decade, the researchers estimate between 100,000 and 300,000 people got infected with HIV. A 16 years old teenager was the first case confirmed with HIV in Robert Hayford, the year 1968. The teenager never even get out of Midwest or even got any blood transfusion. This record shows that the presence of AIDS and HIV was already around before the year 1966. But even before AIDS was defined, the illness was first seen like many other immunodeficiency cases like the Pneumocystis carinii pneumonia and the Kaposi sarcoma. One year after the scientists have discovered AIDS, they have also identified HIV. The beginning of an epidemic At first, the general populace believed that only a certain group of people were highly at risk for AIDS. The mainstream media referred to these groups as the “four-H club.” - Homosexual men – reported having higher incidences in regards to AIDS and HIV - Hemophiliacs – the ones that received transfusions wherein the blood is contaminated - Heroin users – and the people that use their drugs through injection - Haitian origin – a lot of AIDS cases were reported to be in Haiti However, in the long process of studying the disease, researchers did deeper research on how the disease spread further and by the year 1984, they got these additional data: - In the US, there were 3,064 diagnosed AIDS cases - Females can also acquire HIV through sexual intercourse - In these cases, 1,292 individuals died. The National Cancer Institute then identified HIV as the main cause of AIDS. The number of infected individuals continued going higher as the CDC made more refinement in their case study with the disease and so they have learned more about how the virus behaves. By the year 1995, records show AIDS is the leading cause of death among adults between ages 25 and 44 years. Around 50,000 Americans were reported to have died because AIDS. About 49 percent of this record was made up of African-Americans. However, the death rates started declining after various medications, and multidrug therapy sessions were made widely available. From the number 38,780 recorded in 1996, it dropped to more than a half in 2000 – 14,499. Causes of HIV The HIV infection’s cause is by the HIV itself. A person may have HIV through contact with infected vaginal fluids, semen or blood. - Majority of people that acquire the virus are usually those that engage in unsafe sexual intercourse with someone infected with HIV. - The virus can also get passed onto a baby from their mother during breastfeeding, birth or pregnancy. - Another way, and a common one, of acquiring HIV is by sharing needles with an individual infected with HIV. It can be through drug addiction or getting a tattoo. Keep note that HIV cannot survive well when it is outside the body. HIV does not spread when you share drinking glasses or make a casual contact such as kissing with a person infected with HIV. Symptoms The symptoms associated with HIV doesn’t appear first during its early stages. People that are infected and are experiencing symptoms may mistake them for mono or flu. The early symptoms include: - Sore throat - Fever - Headache - Skin rashes - Joint pain and muscle aches - Swollen glands or swollen lymph nodes These symptoms may appear starting for a few days up to several weeks when the individual gets infected with the virus. The early symptoms mostly go away within two to three weeks. After the first symptoms fade, the infected person may not experience the symptoms for another few years. Up to a certain point, the symptoms will appear again and will remain. These symptoms are: - Extreme tiredness - Swollen lymph nodes - Weight loss - Night sweats - Fever Diagnosis When a patient checks for any other reason for their symptoms to keep recurring and no other cause found, the doctor may turn to HIV and check if this is the case. They will ask the patient about any past behavior or lifestyle that may have contributed to getting an HIV. If the individual gets exposed to HIV, the immune system of the body will produce antibodies that will try to eliminate the virus. The doctors will use various tests to find the antibodies in the blood, saliva or urine. If either of these three tests shows positive of HIV infection, the patient will undergo a blood test to confirm whether the results are true or not. Majority of the doctors use two blood tests. One is Western blot while the other is ELISA. If the ELISA test shows positive results, another test will be conducted to be sure. Usually, it is the Western blot test that follows. The HIV antibodies mostly show in the blood in 3 months but can also be found within six months. If you believe that you are exposed to HIV, yet the tests show negative results: - Do the tests again. Get the tests at six weeks, another in 12 weeks and another at 24 weeks. It is to make sure that you are not infected. - At the same time, you should take the necessary steps to prevent the virus from spreading. It is in case you have the virus. The HIV testing is accessible and can be pricey, depending on which clinic you approach. They are available in most doctor’s offices, hospitals, Planned Parenthood clinics, and public health clinics. There is also available on the market an HIV home kit test by mail order or through a drugstore. Make sure that the FDA approves it. If the home test shows positive, bring it to your doctor to have the result confirmed and found out what you should do next. Treatment There is a standard treatment for HIV, and it is an integration of medicines referred to as the antiretroviral therapy. Shortened to ART, the medicines used in this treatment will slow down the rate that the virus multiplies. Taking the medicines designed for the HIV treatment will help reduce the amount of virus existing in the body and help keep the affected stay healthy. Professional experts recommend that the affected people must treat themselves for HIV as soon as they realize and know that they are already infected. Here are the following tests that must be done on a regular basis if you wish to monitor the movement of your HIV infection and the effect goes through the body’s immune system. The doctor will be the one to conduct the following tests: - Viral load is a test that shows the amount of virus found in the blood - The CD4+ cell count shows how well the immune system is functioning properly By the time you start with the treatment, it is very important that medicines are taken exactly as the doctor prescribed them. If the treatment doesn’t work, it is mostly due to how HIV turned to become resistant from the medicine. It happens when there is no proper intake of the medicines. How drugs and alcohol abuse increases the risk of HIV? When an individual gets too high or too drunk, they are vulnerable to make decisions that will place them in danger of acquiring HIV, like having sex without proper protection. Drinking alcohol, especially with binge drinking and at the same time using drugs such as cocaine or methamphetamine can alter one’s judgment, lower inhibitions and impair decisions about drug use and sex. The higher the possibility that you are going to engage in unprotected and unplanned sex and will have a difficult time using a condom each time you are having sex, getting more sexual partners and even use more drugs, like injecting drugs. Such behaviors can increase the risk of yourself exposing to HIV. When you already have HIV, this will only increase spreading the infection throughout the body. Being high or drunk affects the person’s ability in making safe choices. Recent development on preventing HIV As of July 2012, the Food and Drug Authority has approved the pre-exposure prophylaxis or PrEP. It is a kind of medication wherein it is shown to prevent HIV from being transmitted through needle use or sex. Such treatments need taking the needed medication on a daily basis. Doctors highly recommend getting the PrEP treatment, especially with people in a relationship with someone they know are infected with HIV. The results of using PrEP shows a risk reduction to more than 90 percent. Coping with HIV Although the majority of the population are aware of what HIV can do the body, some people have this negative perspective regarding people affected with it. For those infected with HIV, it is not only the physical condition that they have to look after. They also need to see to it that their mental health conditions are at normal levels. HIV infected patients usually develop depression and will only make treatment worse as this can affect the will of a person to live. Most people have very strong reactions if they ever find out get infected with HIV. These feelings can include anger, fear and even feel overwhelmed by it. They often feel helpless, anxious and sad about their condition. Such feelings are normal. However, with time, hopefully, these feelings will fade, especially when the patient got proper emotional support from people who accept them. It is best that HIV patients must talk about their feelings with supportive people – people they feel that they can trust. They must also engage in activities that will help them relieve their stress such as hobbies and exercises. Getting enough sleep will also help the body feel rested. It will also help the immune system work well as its fights against the spread of the infection.
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आज विश्व एड्स दिवस : नेपालमा दैनिक दुईजनाको मृत्यु, हटेन सामाजिक विभेद नेपालमा एचआइभी नियन्त्रणका कार्यक्रम सुरु भएको तीन दशक नाघिसकेको छ। नेपालमा ८० प्रतिशतभन्दा बढी असुरक्षित यौन सम्पर्कबाट एचआइभी संक्रमण सरेको अध्ययनले देखाएको छ। राष्ट्रिय एड्स तथा यौनरोग नियन्त्रण केन्द्रको तथ्यांकअनुसार हालसम्म २९ हजार ५ सय ३ जनामा एचआइभी संक्रमण भएको अनुमान छ। २३ हजार ६ सय २ जनामा असुरिक्षत यौन सम्पर्कबाट एचआइभी सरेको हो। केन्द्रले सार्वजनिक गरेको यो तथ्यांकले नेपालमा यौनकर्मीले बिनाकन्डम यौनसम्पर्क गरिरहेका कारण भाइरसको प्रशार भइरहेको निष्कर्ष निकालेको छ। केन्द्रका निर्देशक डा. सुधा देवकोटाका अनुसार सबैभन्दा बढी एचआइभी संक्रमणमा यौनकर्मी, तेस्रोलिंगी र सुईद्वारा लागूपदार्थ सेवन गर्नेहरू परेका छन्। ‘यौनकर्मी धेरैलाई ग्राहकले नै कन्डम नलगाइ असुरक्षित यौनसम्पर्क राख्न बाध्य बनाएका छन्,’ डा.देवकोटाले भनिन्, ‘सुईद्वारा लागूपदार्थ प्रयोग गर्ने र पुरुष समलिंगी यौनकर्मीमा एचआइभी संक्रमण दर अन्य जोखिम समूहभन्दा बढी छ।’ सन् १९८८ मा पहिलो पटक नेपालमा चार यौनकर्मीमा फेला परेको एचआइभीबाट अहिले हरेक दिन सरदर दुईभन्दा बढी संक्रमणमा पर्ने गरेको केन्द्रको तथ्यांक छ। आर्थिक वर्ष २०७६/७७ मा ७ सय ९० नयाँ संक्रमित पहिचान गरिएको थियो। पछिल्लो एक वर्षमा ७ सय ३९ एचआइभी संक्रमितको मृत्यु भएको केन्द्रले जनाएको छ। दैनिक सरदर दुईभन्दा बढीको एचआइभी संक्रमणका कारण मृत्यु हुने गरेको छ। १० हजार बढी संक्रमित उपचारको पहुँच बाहिर हाल २९ हजार ५ सय ३ जनामा एचआइभी भएको अनुमान छ। तर, सरकारी सेवामा आएर परीक्षण गराउनेमा भने जम्मा १९ हजार ४ सय १० मात्र छन्। सरकारी सेवा बाहिर रहेका १० हजार ९३ संक्रमित कहाँ छन्, स्वयं केन्द्रलाई पनि थाहा छैन। सेवा बाहिर रहेका ती संक्रमितले समेत रोग फैलाइरहेका छन्। एचआइभी संक्रमित रोगले होइन, लाञ्छना र विभेदले मरिरहेका छन् : डा. बास्तोला नेपालमा एचआइभी संक्रमितलाई हेलाको दृष्टिकोणले हेर्ने, विभिन्न अवसरबाट वञ्चित गर्ने, परिवार तथा साथीबाट पनि नराम्रो रूपमा हेर्नेलगायत कारण संक्रमित रगत परीक्षण गराउन आउन नसकेको शुक्रराज ट्रपिकल तथा सरुवा रोग अस्पतालका प्रमुख कन्सल्टेन्ट डा. अनुप बास्तोला बताउँछन्। एचआइभी एड्ससँग रहेको लाञ्छना, विभेद, अशिक्षाका कारण एचआइभी संक्रमित जोखिममा भए पनि परीक्षण गर्न डराउने गरेको उनले बताए। ‘अझै एचआइभी संक्रमित पत्ता लागे पनि लुकेर बस्ने गर्छन। सामाजिक हेँलाका कारण औषधी खान छाड्ने र लागूपदार्थ सेवन गर्नेजस्ता काम गर्छन्,’ डा. बास्तोलाले भने, ‘देशैभरि एआरटी साइड, घर नजिकै केन्द्र भए पनि कसैले देख्छ कि, थाहा पाउँछ कि, लाञ्छना, विभेद गर्छन कि, अथवा गरेका कारणले एचआइभी संक्रमित बाहिर गएर औषधी लिने गरेका कारण सरकारी पहुँचमा समावेश नभएका हुनसक्छन्।’ उनका अनुसार यसबीच बाँकी पहिचान भएका कहाँ गए, त्यसको खोजी हुनु जरुरी छ। औषधी सेवन गर्न आएका संक्रमित खान सुरु गरेपछि हराएका छन्। कोहीको मृत्यु भयो कि, विदेश पो गए कि, औषधी प्रयोग गर्नै छाडे कि, यसको तथ्यांक स्पष्ट हुनु जरुरी छ। पहिचान गर्ने जति पनि कार्यक्रम बनाएका छौं, तिनको युद्धस्तरमा स्थानीय तहसम्म कार्यान्वयन गर्नु जरुरी छ। ‘एचआइभी संक्रमितलाई निन्दा नगर्नुहोस्। एचआइभी भएको व्यक्ति अन्य स्वस्थ व्यक्तिसरह नै बाँच्नसक्छ,’ डा. बास्तोला भन्छन्, ‘जबसम्म हामी संक्रमितलाई लाञ्छना लगाउँछौं, विभेद गर्छौं, त्यतिबेलासम्म ऊ बाँचेर पनि मृत्युको मुखमा पुगेको फिलमा हुन्छ। एचआइभी एड्सका कारणले मानिस मर्दैन, समाजबाट पाएको लाञ्छना र भेदभावका कारण मनमनै मरिरहेको हुन्छ।’ एचआइभी संक्रमितले सन्तुलित खाना खाने गरे लामो समय बाँच्न सक्छ। उनका अनुसार एचआइभी÷एड्सबाट संक्रमित भएकामा रोग प्रतिरोधत्मक क्षमता कम हुने भएकाले पोषिलो खानेकुरामा ध्यान दिनुपर्छ। संक्रमितले स्वस्थ र तन्दुरुस्त रहन नियमित हलुका व्यायाम गर्ने, प्रशस्तमात्रामा आराम गर्ने, ध्यान गर्ने तथा पोषणयुक्त खाना खाने साथै बिहानको स्वच्छ हावामा हिँडडुल गर्ने बानी गरे आयु लम्ब्याउन सक्ने उनको भनाइ छ। यसवर्षको नारा : एचआइभी नियन्त्रण तथा रोकथामका लागि विश्वव्यापी ऐक्यबद्धता तथा साझा जिम्मेवारी प्रत्येक वर्ष डिसेम्बर १ मा मनाइने विश्व एड्स दिवस यस वर्ष नेपालमा ‘एचआइभी नियन्त्रण तथा रोकथामका लागि विश्वव्यापी ऐक्यबद्धता तथा साझा जिम्मेवारी’ भन्ने नारासाथ मनाइने भएको छ। ‘एड्सविरुद्ध विश्व अभियान’ कार्यक्रममा ऐक्यबद्धता जनाउँदै विश्वभरका सरकारी, गैरसरकारी तथा निजी संघसंस्था, नागरिक समाज, सञ्चारमाध्यमलगायत सबै क्षेत्र र वर्ग एकजुट भई मनाइने विश्व एड्स दिवस एचआइभी पत्ता लागेको सात वर्षपछि १९८८ देखि मनाउन थालिएको हो। एचआइभी र एड्स के हो? एचआइभी एक प्रकारको भाइरस हो। यही भाइरसले शरीरमा पार्ने गम्भीर प्रभावको अवस्था नै एड्स हो। यो अवस्थामा अरु सामान्य रोगले पनि मानिसको शरीरलाई निकै गलाउँछ। एचआइभी संक्रमित व्यक्ति एड्सको अवस्थामा पुग्न दसौं वर्ष लाग्छ। समयमै पहिचान भई उपचार भए एड्सको अवस्था आउँदैन। एचआइभी संक्रमणका कारण शरीरको रोगसँग लड्ने फेलुलर इम्युनिटी (सिडी कोषिका) ह्रास गराउँदछ। यसको संख्या ५ सयदेखि १ हजार ५ सयहाराहारी हुन्छ। यो संक्रमण भएको आठदेखि १० वर्षपछि सिडी४ कोषिका २ सयभन्दा कम भएको अवस्थामा एड्सका लक्षण देखिन थाल्छन्। यी कोषिकाले हाम्रो शरीरमा रोगसँग लड्ने एक किसिमको शक्तिका रूपमा काम गर्दछ। यो कम भएको अवस्थामा टिभी, पिसिपी निमोनिया, क्रिप्टोकोकल मेनिन्जाइटिस, क्रोनिक डाइरिया, मुख, घाँटी तथा आन्द्रामा क्यान्डिडा (ढुसी) को संक्रमण, लामो समयसम्म पखाला लाग्ने, शरीरको तौल घट्दै जाने, महिनौं दिनसम्म ज्वरो आउने, साह्रो किसिमका अन्य ब्याक्टेरियाको निमोनिया, सेप्टिसिनिया हुने र विभिन्न किसिमका सोलिड क्यान्सर, रक्तकोषिका क्यान्सर देखिन्छन्। कुनै व्यक्तिलाई एचआइभी संक्रमण भइसकेपछि त्यसका कारणले एड्सको अवस्थामा पुग्न १०औं वर्ष लाग्नसक्छ। यसबीच मानिस बिनालक्षणको हुने गर्छ। मानिस स्वस्थ देखिन्छ। यस अवधिमा विवाह गर्न सक्छ, अन्य पार्टनरलाई एचआइभी संक्रमण गराउन सक्छ। रूपरङ हेरेर एचआइभी छ कि छैन थाहा हुँदैन। जबसम्म रगत परीक्षण गराउँदैनौं, तबसम्म एचआइभी छ कि छैन थाहा हुँदैन। विशेष गरेर जोखिमपूर्ण व्यवहार भएका व्यक्ति (असुरक्षित यौनसम्पर्क गर्ने व्यक्ति, इन्जेक्सनमार्फत लागूऔषध लिने व्यक्ति) ले एचआइभी संक्रमणको जाँच समयमै गराउनुपर्छ। एचआइभी सर्ने माध्यम – असुरक्षित यौनसम्पर्क – एचआइभी संक्रमित रगत, रगतबाट बनेका पदार्थ तथा अंग लिँदा – सुईको साझा प्रयोग – संक्रमित आमाबाट बच्चामा बच्ने उपाय – सुरक्षित यौन व्यवहार अपनाउने – सधैं सही तरिकाले कन्डम प्रयोग गरी यौनसम्पर्क राख्ने – यौनरोगका लक्षण देखापरे तुरुन्त उपचार गर्ने – आफ्नो यौनसाथीलाई पनि उपचार गराउने – रगत दिँदा संक्रमण भए–नभएको पक्का गर्ने – आफूमा एचआइभी संक्रमण छ कि छैन भनेर प्रत्येक आमाले एचआइभी परीक्षण गराउने – सकेसम्म लागूऔषध प्रयोग नगर्ने