Psychological problems of HIV-infected. Features of nursing
Mental disorders at the stage of communicating the diagnosis of HIV infection can proceed according to the type of psychogenic reactions, such as anxiety about life expectancy and its quality, financial stability and employment; fears about impending loneliness, expected social isolation, sexual tension. The patient at this stage is characterized by a state of depression, anxiety, irritability, with simultaneous indecision and uncertainty.
After reporting the diagnosis of HIV infection, the patient may fall into a state of depression, accompanied by fear of excruciating death and infection of loved ones, anxiety about a violation of confidentiality. He is oppressed by the inability to change anything, the need to give an account of his intimate life, the impracticability of plans for the future, the possibility of losing physical attractiveness. The patient experiences a sense of guilt towards people who may have been infected, remorse for the behavior that led to the infection, aggressiveness towards the alleged source of infection.
The problems of patient adaptation due to the lack of full-time psychologists fall on the shoulders of doctors and nurses. Therefore, a nurse must have good communication skills, master the techniques of psychoanalysis, nursing pedagogy.
Two levels of psychotherapy are used in the work of the attending physicians and nurses:
- 1) the first level - the ability to interact with patients, which must be possessed by all medical professionals, including nurses. Interaction is part of the process of creating a sympathetic and receptive atmosphere for patients. This is a rather complex supportive therapy, which can also be called counseling, guiding action.
- 2) the second level implies the possession of skills, the acquisition of which requires certain special training. Here, the patient is given not only supportive consultation, advice, recommendation, but also his internal motivations and opportunities to change his lifestyle are discussed. For recommendations, it is important to be able to obtain information on the basis of confidential voluntarily conscious information obtained from the patient. But when consulting, one should not take on the functions of a psychotherapist and strive to solve all the patient's problems. It is important to help the patient decide who and how to tell about their disease and the treatment. To this end, during the conversation, it is necessary to tactfully make it clear to the patient that the diagnosis and cause of death may become known after his death.
The patient should be clearly aware that the further course of HIV infection will largely depend on his behavior and lifestyle. In particular, taking psychoactive drugs, alcohol should be considered not as a way to escape from reality, but as a factor aggravating the development of HIV infection and contributing to its more severe course. It is necessary to ask the patient to refer his sexual partner to counseling and help him overcome the difficulties associated with the possible reaction of the partner, who can both support the patient and reject him.
During the conversation, it should be emphasized that social and everyday contact, joint communication, the use of common tableware and utensils, swimming pools and toilets if they are properly processed, being in the same room does not pose a risk to anyone and allows you to maintain a sense of social cohesion.
An important psychological problem that HIV-infected people have to face is social isolation. Patients are fired from work, they are refused by relatives and friends. For these reasons, patients begin to feel like outcasts of modern society.
Children are especially hard hit, who in some cases are expelled from school, deprived of the opportunity to attend a general kindergarten and communicate with other children (therefore, in some cities with a high incidence of HIV infection, for example in Kaliningrad, kindergartens have been created that are attended only by children with established diagnosis).
During the period when a person learns about his diagnosis, family and friends, medical workers can and should provide him with psychological support.
Having experienced the first, most severe, reaction, the patient and his family members begin to wonder how dangerous an HIV-infected person is for others, whether it is possible to live with him, communicate with friends, etc. How to protect yourself, family members, including children, from this infection? How can an infected person be helped to maintain adequate vitality?
Nurses can and should teach HIV patients to behave correctly not only in the hospital, but also in the family and society. Patients who are adapted to their diagnosis retain social significance and a high standard of living.
Unfortunately, it is not always possible to solve the problem of patient adaptation.
Many problems can be identified in the process of working with HIV-infected patients. These will change throughout the day, and each issue may be prioritized by the patient at different times.
As the immunity deficit grows, concomitant infectious diseases join, and complications from internal organs develop in patients, physiological problems come to the fore:
1. With systemic damage to the skin and mucous membranes:
violation of the integrity of the skin;
violation of the cosmetic condition of the skin: dry skin, ulceration, the appearance of rashes; itching, burning;
defeat of the mucous membrane of the throat: pain, burning in the throat.
2. In case of damage to the organs of the gastrointestinal tract:
pain, burning sensation along the esophagus, in the epigastrium (including when eating); diarrhea; constipation; nausea; vomit; the inability to eat independently; pain when swallowing; decreased or lack of appetite.
3. In case of damage to the respiratory system:
dry or phlegm cough; dyspnea.
4. For disorders of the central nervous system:
confusion of thoughts; headache; pain, numbness, weakness in the limbs; weakness, malaise; insomnia.
5. For violations of the cardiovascular system:
heartache; interruptions in the work of the heart; dyspnea.
6. Changing the body scheme:
weight loss; violation of the constitution.
The main goal of nursing care is to help the patient adapt to his condition as much as possible, taking into account the identified problems throughout the entire period of HIV and AIDS.
A potential problem for patients is the risk of developing cancer and infectious complications.
Nursing interventions are aimed at solving both existing and potential health problems of the patient.
In this regard, the nurses of the diagnostic center have the following tasks:
- - elimination of factors that hinder adaptation processes throughout the entire period of HIV infection and stages of AIDS;
- - tactfully informing the patient about the disease and health status;
- - teaching adult patients self-care, control over their condition; relatives and close people - caring for patients in serious condition and prevention issues;
- - provision of qualified nursing care, including a clear implementation of the diagnostic process (interdependent nursing interventions) and the timely implementation of medical appointments (dependent nursing interventions).
The role of the nurse is especially important when performing complex, one-to-one treatment for HIV-infected patients. It should be remembered that the process of administering antiretroviral combination therapy can only be effective after discussing the treatment plan with the patient.
Dependent, interdependent and independent nursing interventions are included in the care plan.
When carrying out dependent (fulfillment of doctor's prescriptions) and interdependent (diagnostic, laboratory tests) interventions, nurses must ensure self-defense, as well as take measures to prevent both the spread of HIV infection and infection of the HIV-infected or AIDS patient himself.
Conducting independent nursing interventions for HIV-infected people at home has certain characteristics.
As the number of people living with HIV increases, it becomes more difficult to meet the demand for inpatient treatment. Home treatment has obvious advantages, such as a lower cost of treatment, an opportunity for the patient to be with the family, in a familiar environment. Therefore, the nurse has a great responsibility not only to provide quality nursing care at home, but also to educate the patient and his family members or people caring for the patient, the elements of proper care and precautions.
Introduction
Theoretical part .
Chapter 1: What are AIDS and HIV?
Chapter 2: Routes of HIV Transmission
Chapter 3: Origin and Evolution of HIV
Chapter 4: Living with HIV
Chapter 5: International Principles for HIV Prevention among Drug Users
Chapter 6: Baby living with HIV
Chapter 7: Preventing Mother-to-Child Transmission of HIV
Chapter 8: HIV / AIDS and Youth: Challenges and Solutions
Chapter 9: Who are AIDSophobes?
Statistics
Practical part
1. Justification of the problem
2. Object and subject of research
3. Objectives of the study
4. Research objectives
5. Hypotheses
6. Sample definition
7. Methods of collecting information
8. Toolbox
9. Logical analysis
10. Research results
11. Processing of results
12. Analysis of the obtained results
Conclusion
Bibliography
Introduction
In my opinion, the topic of my term paper is very relevant in our time. It is not for nothing that HIV / AIDS is called a global problem of modern mankind.
The urgency of the HIV / AIDS problem lies in the fact that the epidemic is not only a medical problem. Its distribution affects all spheres of society and concerns each of us. The view of the epidemic as a problem of asocial people (prostitutes, homosexuals, drug addicts) is a thing of the past. Currently, HIV infection has penetrated into all segments of the population, including those who are well-off, not classified as “risk groups,” but who practice risky behavior.
We live in a country with the world's fastest growing epidemic. By the beginning of 2008, 500 thousand HIV-infected people were officially registered in the country. If the pace of the epidemic continues, then by 2010 every 10 Russians will become HIV-infected. Already tens of millions of people around the world are living with HIV, they are surrounded by hundreds of millions of relatives and friends. The number of people affected by the epidemic is growing from year to year.
Unlike other diseases, the diagnosis of HIV infection is accompanied by many social and psychological problems, internal crises, stresses, difficulties in interpersonal relationships, which appear long before the moment when a person may need medical assistance. The problem of HIV / AIDS has been considered, considered and will be considered by: scientists, doctors, sociologists and representatives of other professions. Countless literature has already been written. This problem was touched upon in their works: from a medical point of view - E.E. Voronin, Zh.V. Terent'ev, from a scientific point of view - A.S. Shevelev, L.P. Koroleva and many others.
Theoretical part
What are AIDS and HIV?
AIDS stands for Acquired Immunodeficiency Syndrome.
Acquired- because this is a condition arising from infection, and not inherited by genetic means.
Immune- because it affects the immune (defense) system of the body, which fights disease.
Deficit- because the immune system stops working properly: its "insufficiency" sets in.
Syndrome- because patients have many different symptoms and opportunistic diseases.
Scientists who studied the first cases of AIDS came to the conclusion that its main feature is the predominant damage to the immune system, which manifests itself in the complete defenselessness of the patient's body against relatively harmless microorganisms, as well as malignant tumors ..
AIDS, apparently, is the first acquired immunodeficiency in the history of medicine associated with a specific pathogen and characterized by epidemic spread.
So, the term AIDS stands for acquired immunodeficiency syndrome. But there are many acquired immunodeficiencies, and AIDS is one ... Therefore, today it is more correct to say this: AIDS is an acquired immunodeficiency, which differs from others in the presence of a certain set of properties and a specific pathogen ..
We know AIDS is a disease, not just a combination of symptoms. The word "syndrome" usually refers to a collection of symptoms that does not have an easily explainable cause. This name was more appropriate 20 years ago, when doctors knew only about the late stages of the disease and did not fully understand the mechanism of its development. The more modern name for this condition, despite being diagnosed with AIDS, is HIV infection. This is a more accurate name because it refers to the causative agent that causes AIDS, and covers all stages of this condition, from infection to destruction of the immune system and the onset of opportunistic diseases. However, the word "AIDS" is still used by most people to refer to immunodeficiency caused by HIV.
HIV is a retrovirus first isolated by Luc Montagnier (France) and Robert Gallo (USA) in 1983. The peculiarity of retroviruses is that they reproduce their gene material in human cells. This means that infected cells remain so until the end of their existence.
HIV is characterized by extreme variability: it is 30-100 times higher than that of the influenza virus, and applies to virus strains isolated not only from different patients, but also at different times from the same patient. The feeling of anxiety among many scientists is due to the fact that they have established the tendency of the virus to be multifaceted - this property sharply complicates the possibility of obtaining an effective vaccine against AIDS. ...
As I said, the structure of the virus is very complex. But, fortunately, it is very unstable, sensitive to chemical and physical influences. At a temperature of 22 ° C, its activity remains unchanged for 4 days (both in dry form and in liquids). It loses its activity after treatment with 0.5% sodium hydrochloride solution or 70% alcohol for 10 minutes. Homemade whitening products (for example, "Whiteness") are fatal for him. He also dies under the direct influence of alcohol, acetone, ether. On the surface of intact human skin, the virus is rapidly destroyed by the body's protective enzymes and bacteria. It dies quickly when heated to temperatures above 57 ° C and almost instantly when boiled.
For many years, there has been a conviction in scientific circles that the necessary condition for the development of AIDS is the immunodeficiency virus. It is he who, in the opinion of the overwhelming majority of researchers, causes AIDS. At the same time, some experts are not convinced that HIV is the cause of AIDS. Others believe that HIV can lead to the development of AIDS only in the presence of some unknown concomitant factor ..
Initially, our body is programmed to survive and protect against all kinds of infections. Entering the cell, HIV rearranges this program, and the cell itself begins to produce more and more new viruses. However, a person, in whose body there is a struggle with a disease, most often does not even suspect about it, because he does not feel about it, because he does not feel any symptoms. Even an HIV test for a certain period (on average 3-6 months after infection) does not respond to the presence of the virus, and all this time HIV multiplies inside the body and is transferred to other people.
If a person is infected, this does not mean that he will immediately develop AIDS. The virus can remain in the body for up to 10 years or more before any symptoms of the disease appear. During this period, a person can look and feel completely healthy, continue to work, but still transmit the virus to others. Much depends on how strong a person's immune system is.
After the development of AIDS, serious health problems appear: a person can suddenly lose weight by 10% or more, have a constantly elevated body temperature for a long period (more than one month). Severe night sweats, chronic fatigue, swollen lymph nodes, persistent cough, and prolonged loose stools are also possible. Common illnesses take on such forms that a person dies ..
Ways of HIV transmission.
HIV is found in all body fluids, although in varying amounts. In a concentration sufficient for infection, the virus can be in the blood (including menstrual blood), semen, vaginal secretions, and breast milk. ...
The main routes of HIV transmission are:
· Unsafe anal or vaginal or oral sex (i.e. sex without a condom). Currently, unprotected sex accounts for the lion's share of HIV transmission cases. To protect yourself from HIV and in general from STIs (sexually transmitted infections), it is necessary to refrain from sexual intercourse or to use a high-quality condom at every sexual intercourse.
· Through the blood. The ingestion of the blood of an HIV-infected or AIDS patient into the body of a healthy person. The overwhelming majority of HIV-infected people are people who use or have used drugs intravenously, because they share a syringe and needle, which are never handled, and a drug solution that may contain HIV. In addition, infection can occur through transfusion of blood, as well as blood products from HIV-infected donors, or when using non-sterile, untreated medical instruments containing blood particles from infected people. But now the chances of getting infected in this way are very small. Blood products that are used to treat people are tested for the virus; disposable medical instruments are used.
· From mother to child. Infection of a child is possible: during pregnancy (when HIV crosses the placenta to the fetus); during childbirth (when, during the passage of the child through the birth canal of the mother, HIV, along with the blood, can enter the newborn's body through easily injured skin); when breastfeeding a child (when HIV from mother's milk enters his body through microtrauma in the child's mouth). An HIV-infected mother, with the timely use of special antiviral therapy, increases the likelihood of having a healthy baby.
It is impossible to get infected with HIV: by sharing a dish or toilet with an infected person; being with him in the bath or swimming in the same pool; shaking hands; hugging and kissing, etc. HIV infection is not transmitted in everyday life and is not carried by insects. ...
The origin and evolution of HIV
Various types of acquired, that is, not associated with unfortunate heredity, immunodeficiencies, developing, in particular, as a result of adverse environmental influences or after illness, were well known even before the discovery of HIV, but did not lead to death with such inevitability.
The discovery of the virus (neither before nor after the discovery of HIV) has never caused such a widespread public outcry. The direct consequence was the unprecedented high funding for development, prevention, treatment of people with HIV, as well as basic research. In the mid-1980s, outstanding scientists with a worldwide reputation and young specialists from many countries joined them. As a result, very soon much more was known about HIV than about some other long-described infections.
The study of HIV has made it possible to make many discoveries, and not only in virology, but also in related disciplines - in immunology, epidemiology, molecular biology. Nevertheless, there are still no drugs that can completely cure HIV-positive people, and the possibilities of vaccine prevention are still the subject of heated debate.
There are other "open" questions as well. One of them is when and how the human immunodeficiency virus appeared. Without reliable data on this and on the evolutionary paths of HIV, it is difficult to count on the creation of effective protection measures. In addition, there is a great risk of filling the "white spots" with unreliable facts. It is the lack of knowledge that can explain the appearance of publications that HIV is a new biological weapon created by the Americans (Russians), or that HIV has existed in the world for a long time, but has nothing to do with the development of AIDS. To resolve the issue of the origin of HIV, it is necessary to know which viruses of this type circulate in the human population, what mechanisms underlie their variability, are there any analogues of the AIDS causative agent in the world ..
Almost immediately after the first reports about HIV, information appeared about its extremely high variability - so high that in nature, apparently, there are no two absolutely identical HIV genes. Differences between viruses isolated in different countries sometimes reach 40-50%. Obviously, such large differences cannot affect approaches to vaccine development strategy.
The study of the variability of the genome of the virus, the patterns of distribution of its subtypes in different countries and vulnerable groups expands our understanding of the mechanisms and evolution of HIV. These studies are also useful in practical medicine, as they allow predicting the development of the epidemic. Knowledge of the HIV variants dominant in a given area is important for the development of future vaccines.
Where and when did HIV get into the human population? To answer this question, it is necessary to recall other primate lentiviruses, HIV-2, and numerous monkey immunodeficiency viruses (SIVs). Interestingly, SIVs do not cause AIDS in their hosts. Green monkeys, for example, do not get sick themselves, but they can infect monkeys of other species, in particular, when kept together in zoos. The natural reservoir of HIV-2 infection appears to be in the clouded mangobei population in West Africa. Moreover, there is evidence that the emergence of different subtypes of HIV-2 in humans is most likely associated with several introduction of SIV into the human population.
With HIV-1, the question still remains open, although by analogy it can be assumed: the virus got to people from some monkeys; the development of AIDS symptoms is due to the fact that a person is not the natural host of this virus. There are already four known cases of detection of viruses resembling HIV-1 in chimpanzees. Three viruses were isolated in West Africa, and the fourth in the United States, from a chimpanzee living in a zoo. Analysis of viral genomes allowed us to make an assumption: the natural reservoir of HIV-1 may be one of the chimpanzee subspecies inhabiting those countries of West Africa where representatives of all HIV-1 groups are simultaneously found ..
Interestingly, the earliest blood sample containing HIV-1 (group M) found in the city of Kinshasa (now the capital of the Democratic Republic of the Congo) is dated 1959. In 2001, American experts, having studied the genetic differences between the virus present in a blood sample forty years ago, and the modern representatives of the "M" group, expressed the following opinion: the common predecessor of all subtypes of this group could have entered the human population from chimpanzees somewhere around 1940 ... However, many scientists believe that the rate of evolution of HIV depends on a large number of different factors that have not been taken into account. Therefore, although the origin of HIV-1 from monkey "relatives" is not in doubt, the estimated date (1940) is not final and may be pushed back many years. The lack of older blood samples infected with HIV is easy to explain: the virus was circulating in African villages at that time, far from medical centers. It is unclear, however, why only four infected chimpanzees have been found so far.
Finally, the question remains, how exactly the virus got from the monkey to the person. In the case of HIV-2, everything is quite clear: in African villages, many mangobes are the same as Russian mongrels. Tamed monkeys constantly communicate with people, play with children ... Moreover, in some parts of West Africa, monkeys of this type are eaten. Chimpanzees, on the other hand, are quite rare, and their size and disposition do not dispose to friendly communication. We have to admit: either those chimpanzees - carriers of the virus - have not yet been caught, or a virus resembling HIV-1 got to them and humans from some other African monkeys (possibly already extinct) ..
Living with HIV
At the first moment upon receiving a diagnosis of HIV infection, most people experience a strong shock, and then they are faced with the question of how their future life will turn out, how long it will last and how this will all affect the people close to them. There is no typical or uniform response to this diagnosis; everyone perceives it differently. Many are seized by anger, depression, despair, fear for themselves or for those close to them. Some people think about suicide at the first moment. Others, on the other hand, are absolutely calm. Often, at first, a person does not believe his diagnosis ..
Knowing about one's HIV infection almost always leads to changes in a person's life. First of all, his / her ideas about HIV and AIDS, which exist in society, and therefore are present in the person himself, are changing. Having HIV does not make a person sick; he can stay healthy for many years. HIV infection does not make a person helpless: many people with HIV lead an active lifestyle, make important decisions for themselves, defend their rights and help others in this. The diagnosis no longer sounds like a death sentence, and healthy, asymptomatic life expectancy for HIV infection is continually increasing thanks to new treatments.
Although in many ways the AIDS epidemic is unique, one of its main lessons only repeats what has been known to mankind from time immemorial: the one who takes responsibility for his life and is not content with the role of victim is more likely to prevail over the disease and overcome a difficult situation. Many HIV-positive people are well aware of this and strive to learn as much as possible about HIV infection, about new drugs and methods of treatment, about their rights and ways of protection.
Almost inevitably, an HIV-positive person faces discrimination, negative attitudes in society, and violation of their rights. This affects the quality of life, relationships with others and the attitude towards oneself. HIV-positive people often feel fear for their loved ones. In discordant couples (heterosexual or homosexual couples in which one partner is HIV-positive and the other HIV-negative), there is a fear of transmitting the virus to the sexual partner. Many HIV-positive people worry that they will not be able to have children, because there is a risk of transmission of the virus from mother to child.
Despite numerous difficulties, the diagnosis of HIV infection does not mean that a person should give up his plans and interests, from study, work and entertainment, from love and sex. More and more people are finding solutions to their HIV-related problems, and many are discovering that their lives have not changed dramatically ..
The diagnosis of HIV infection is a serious crisis, which from the first day is accompanied by acute experiences. Most HIV-positive people have difficult periods, which are characterized by depression, anxiety, fear, sleep disturbances, nightmares, difficulty concentrating, feelings of helplessness, hopelessness, thoughts of death. Emotional crises interfere with taking care of your health and sometimes lead to hard-to-correct mistakes. There are several critical points in the life of an HIV-positive person:
· Getting a diagnosis.
· The appearance of the first manifestations.
· The need to start taking medications regularly.
· Serious painful symptoms and the need to go to the hospital.
· Serious illness or death of an HIV-positive friend.
At such moments in life, a person especially needs support. In addition, everyone may have their own crises, depending on the values and priorities of those threatened by HIV - study, career, personal relationships, creating or maintaining a family, hobby.
All of these crisis situations are associated with emotional losses and deep negative experiences. A person experiences anger, despair, guilt, anxiety, and the bitterness of loss. Many HIV-positive people are acutely aware of their own mortality and are afraid of losing their physical attractiveness, health, independence, or losing friends and family and being alone.
It is no coincidence that one of the most common problems in HIV-positive people is depression, and many do not know its symptoms and do not seek help, which is often absolutely necessary to overcome this condition. Depression is expressed in depressed mood lasting more than two weeks, loss of interest in most activities, persistent fatigue, excessive guilt, irritability, feelings of helplessness and hopelessness. Research shows that depression is associated with increased morbidity and mortality in people with HIV. ...
In a crisis, anyone tends to deal with stress in their usual way. If there was alcohol or drugs in this way before, then there is a risk that a person will return to them every time when social, psychological and interpersonal problems arise. It is known that addiction does not solve difficult situations, but only aggravates them and adds new ones. In addition, substance use can lead to serious health and legal problems. Therefore, for many HIV-positive, especially those infected through drug use, the diagnosis turned out to be a turning point that prompted them to look at life differently and helped to overcome their addiction.
The HIV / AIDS epidemic is not only a medical problem. It affects all spheres of social life and concerns each of us.
· Economy and demography.
World experience shows that the AIDS epidemic undermines the national economy: it reduces the number of people employed, skilled personnel are lost, and labor productivity decreases.
To prevent AIDS in only one HIV-infected person, it is necessary to spend 8-12 thousand dollars a year. Treatment of AIDS patients also requires a lot of money and costs. People living with HIV / AIDS (PLWHA) need not only treatment, but also support. Therefore, social workers and psychologists are required to work with them.
Young people aged 15-25 prevail among PLWHA. Currently, in Russia, only 10% of HIV-infected people receive the necessary treatment. But even those for whom modern medicines prolong life, die prematurely. Scientists have calculated that the losses of society from the epidemic are much higher than from local armed conflicts ..
· Social sphere and discrimination.
AIDS patients become disabled and need constant care. As a rule, care is provided by family members, depriving them of the opportunity to fully work. The main burden falls on the shoulders of women. The family budget is redistributed in favor of treating the patient.
Millions of children whose parents have died of AIDS become orphans. Families of PLWHA are experiencing a tragedy, the inevitability of the premature death of a loved one suffers from discrimination against PLWHA, including children. All this together leads to the disintegration of families.
Any epidemic creates tension in society, a feeling of loss of control over what is happening. Fears, suspicions arise, irrational behavior leads to panic and demands to take immediate and decisive measures against PLWHA.
Myths about HIV / AIDS become grounds for discrimination against PLWHA, expressed in violations of human rights, unprofessional actions of a specialist.
Discrimination translates into insults, accusations, refusal to hire, educational institutions, and sometimes refusal to provide assistance.
PLWHA lose their jobs and loved ones not because they are dangerous to others. Their illness is considered "indecent" or "deserved" in society. As a result, PLWHA are forced to hide the disease from others, hindering the prevention of the spread of the epidemic.
· Epidemic and risk behavior.
The spread of the epidemic is associated with risky behavior. Most often, infection occurs through unprotected sexual intercourse and intravenous drug administration with non-sterile needles. Each person is able to control these two types of risky behavior.
Research has shown that most sexually active people are aware of safe sex and believe that men and women are equally responsible for each other's health. However, many take risks contrary to their knowledge and beliefs.
Therefore, prevention remains the only means of containing the epidemic, its goal is to change the risk behavior of people. ...
International Principles for HIV Prevention amongdrug users.
"AIDS is not spread by drug addicts, but by dirty syringes" - this slogan of the French organization of drug users ASUD emphasizes that the persecution of drug users is not the solution to the problem of HIV spread. The real solution to the problem is to give everyone the opportunity to protect themselves from infection, no matter what situation the person is in at any given moment in their life.
More than 20 years of experience in the prevention of HIV infection around the world clearly shows that the spread of the virus through drug use can be reduced and even stopped if adequate and comprehensive preventive measures aimed at injecting drug users (IDU) are taken in a timely manner.
Recognizing the need to provide assistance to countries with rapidly evolving HIV epidemics, the World Health Organization, in collaboration with the Joint United Nations Program on AIDS (UNAIDS) and the Council of Europe, have prepared a document entitled “Basic Principles for Effective HIV Prevention among People Who Inject Drugs” , in which, based on the positive practical experience of various countries, the principles of effective prevention of HIV infection among IDUs are formulated.
The principles outlined in this document are broadly summarized as follows:
· Informing and educating the population and individual groups;
· Active work among IDUs;
· Provision of injecting drug users with sterile injecting instruments and disinfectant materials;
· Providing IDUs with an opportunity to receive substitution therapy.
The document notes that often effective prevention measures face resistance, misunderstanding and “inability to make decisions based on rational analysis, not influenced by emotions,” and emphasizes the importance of informing health leaders and other government officials about current trends, examples from practice and the latest scientific evidence in the field of effective prevention of HIV infection among IDUs. The World Health Organization, UNAIDS and the Council of Europe recommend that states:
· Bring the HIV prevention strategy in line with the principles set out in this document ”;
· Create interdepartmental coordinating bodies with the participation of representatives of state and public structures, experts and representatives of the target group to develop an action plan;
· Bring information about drug addicts and HIV infection, HIV transmission routes and risk reduction methods to local authorities so that they can take reasonable and effective preventive measures;
· Create networks that bring together health authorities in high-risk regions and in countries (cities) with a positive experience of HIV prevention among IDUs.
The prevention strategy proposed by the international community is based on the premise that it is unrealistic to demand immediate drug withdrawal from all drug addicts. It is believed that at a given point in time no more than 10% of all drug users in any country, city or community are morally and physically ready to give up drugs completely. To reduce the spread of HIV infection, injecting drug users need to be given a choice: either to stop using, or switch to safe forms (smoking, sniffing, swallowing), or injecting with sterile instruments. This is called a “drug use risk reduction” or “drug harm reduction” strategy.
The argument against the "harm reduction" strategy is often put forward that it allegedly does not reflect the intolerance of society and the state towards drugs and almost encourages their use. In fact, a “harm reduction” strategy confronts the destructive power of drugs and rescues drug addicts by enabling them to survive and return to normal life in the future. To prohibit real prevention among drug addicts means deliberately condemning to illness and death a thousand young people who could have been saved.
At the same time, the “harm reduction” strategy offers active educational work among the majority of young people in order to prevent “experimenting” with drugs and addiction to them.
The harm reduction program includes syringe exchange, informing drug addicts about safe methods of drug injection, in combination with a whole range of medical, social and drug treatment services.
According to international experts, needle exchange programs are a simple, cost-effective way to reduce the use of shared equipment, reduce the spread of HIV / AIDS, ensure the safe disposal of used needles, convey information to injecting drug users, help drug users prepare for drug addiction treatment, detoxification, and medical assistance. Most of the clients of syringe exchange programs report a decrease in risk behavior - they stop using shared injecting equipment or more often disinfect it, do not throw away used syringes. ...
Kid living with HIV
Usually, transmission of the virus to a baby occurs during pregnancy or childbirth. All babies are born with the mother's antibodies, so a baby born to an HIV-positive woman will test positive for HIV. To establish the HIV status of a child under one and a half years old, PCR tests, antigen and others can be used. For example, PCR analysis can be quite reliable in children older than 3 months. However, the final diagnosis can only be made by one and a half years, when the maternal antibodies disappear from the baby's body.
It is incredibly difficult for a mother to find out that her child has HIV. Many women experience severe depression, blame themselves for infecting their child, and are ashamed that the child is HIV-positive.
A child living with HIV is no different from a child with other chronic conditions. He needs care, love, upbringing, education. An HIV-positive child, if his health condition permits, should go to school, eat regular food and relax with his family. However, the child may have special emotional needs that are not found in either HIV-negative children or HIV-positive adults.
The immune system of children is not yet sufficiently developed, so HIV infection in a child can progress very quickly. In 20% of HIV-positive children, symptoms of opportunistic infections appear already in the first year of life. The risk of early AIDS depends largely on the mother's health during pregnancy, her immune status and viral load. In 80% of children, HIV infection develops similarly to HIV infection in adults. ...
HIV-positive children need regular medical examinations and various blood tests. There are special requirements for vaccination of HIV-positive children, it must be carried out in close cooperation with a doctor who knows the HIV status of the child. In order to prevent the development of opportunistic diseases in children, it is necessary to carefully monitor the cleanliness of the house and pay attention to any changes in the child's well-being. It is very important to make sure that the child regularly takes the prescribed drugs, teach him to follow the doctor's instructions from an early age. At the same time, care for the quality of life of the child, his communication with peers and the atmosphere in the family play no less role than treatment. ...
Prevention of mother-to-child transmission of HIV
AS research shows, the fetus can be infected with HIV as early as 8-12 weeks of gestation. However, in most cases, babies become infected during childbirth.
One of the major advances in HIV prevention over the past few years has been the development of methods to reduce the risk of HIV transmission from an infected mother to her child during childbirth. If, without special treatment, the average risk of having a child with HIV infection is 15-25% in Europe and the United States and 30-40% in Africa, then with the help of a preventive course of treatment with AZT and a cesarean section, the risk can be reduced to 1%. In this case, treatment is not carried out with the aim of achieving a stable improvement in the health of the mother, but in order to reduce the risk of having a baby with HIV.
Mothers with HIV are advised not to breastfeed their babies, as this increases the risk of HIV transmission. A long-term study conducted in Malawi by US specialists has shown that the risk of infection of a child through breast milk is 10% if breastfeeding for 2 years. However, in the case when the mother does not have the conditions for preparing infant formula (there is no clean drinking water, it is impossible to boil bottles and nipples), breastfeeding with HIV infection is considered less dangerous for the child's life than gastrointestinal infections. ...
HIV / AIDS and Youth: Problems and Ways to Solve Them
In July 2002, the report “Youth and HIV / AIDS: Opportunity and Crisis” was published, which reveals the alarming fact: although most people start having sex during adolescence, a significant proportion of young people around the world are not aware of how HIV is transmitted. and how to protect yourself from it. Developed by the United Nations Children's Fund, the Joint United Nations Program on AIDS and the World Health Organization, this report is the first detailed study of the behavior and knowledge of young people aged 15-24 in relation to the AIDS epidemic.
According to Carol Bellamy, Executive Director of the United Nations Children's Fund, there are two interrelated trends that largely determine the development of the HIV / AIDS epidemic. First, young people have sex, and the world must see this as a prerequisite for effective prevention programs. Secondly, young people do not have a sufficient level of knowledge to protect themselves. The tragic consequence of this is the disproportionately high number of young people falling prey to HIV. ...
As stated by Peter Piot, Director of the Joint United Nations Program on AIDS, “It is clear that young people do not have the information or the means to protect themselves from HIV. Every day 6 thousand young people are infected with HIV. Each of these cases can be prevented. Prevention is not expensive and affordable; only $ 8 per year is enough for one school graduate. In every country where the number of new HIV infections has decreased, the most tangible results have been achieved among young people. ”
The UN report draws a number of alarming findings:
· Young people do not have enough information about HIV / AIDS.
· In many countries with high numbers of HIV-positive boys and girls, they start sex before the age of 15.
The report identifies 10 measures that should become an integral part of prevention work with young people in all countries:
· End AIDS silence and reporting bias.
· Equip young people with the life skills necessary to apply the knowledge gained in practice.
· Create youth-oriented services.
· Promote voluntary and confidential HIV testing and HIV / AIDS counseling.
· Work with young people, encourage their participation in prevention activities.
· Involve young people living with HIV / AIDS in the work.
· Create a supportive environment.
· Reach the youth most supported at risk.
· Strengthen collaboration, celebrate successes. ...
According to research data, today's Russian youth begins to live a hollow life earlier and often change partners.
It has been established that by the age of 24, about half of sexually active young people at least once become infected with STIs, because they do not know how, and sometimes do not want to use protective equipment.
These factors increase the likelihood of a rapid spread of HIV infection among adolescents.
Conducted within the framework of the Useful Vaccination Program dedicated to HIV / AIDS prevention in 2004, a survey of Moscow high school students showed:
· 2/3 of adolescents regularly consume alcohol.
· One third of 16 - 17-year-olds have experience of sexual activity.
· 60% of them began sexual activity at the age of 14-15.
· Only one third of adolescents by the time of the survey had one sexual partner, the rest had two or more.
· One third used alcohol or drugs before the last intercourse.
· 15% did not use a condom the last time they had sex.
With the spread of HIV infection, young people turned out to be more vulnerable to HIV. This is confirmed by statistics: 80% of people with HIV are young people from 15 to 29 years old. Rising youth unemployment further exacerbates this situation. A young man who is unemployed is in a crisis situation and becomes a potential client of groups of risky behavior. All this makes us pay attention to unemployed youth. ...
Who are AIDS phobes?
Many people worry that they have HIV, even if they test negative and their behavior is not risky. Such people are called AIDSophobes in our country, and in the West they are called “worriedwell”. The word “healthy” in this case means that the person does not have HIV infection (although he / she may have other diseases).
The real problem of the “preoccupied healthy” is usually not of a medical nature, but of a psychological nature, for example:
· Depression;
· Increased anxiety;
• strong feelings of guilt;
• phobias, irrational fears;
· Compulsive (obsessive) behavior;
· other..
These psychological problems can only be identified and correctly diagnosed by a qualified psychologist or doctor. AIDSophobes or “preoccupied healthy” people are commonly referred to as people who:
· Are confident that any symptom they have is the primary manifestation of HIV / AIDS, although the analysis is negative, and the risk of infection is minimal or absent. They continue to be afraid of HIV / AIDS even after a well-reasoned explanation that they have no risk of infection.
· Are convinced of their infection and explain the negative result of the analysis by the inaccuracy of the test systems, the incompetence of doctors and other reasons, but not the absence of HIV. Therefore, they are tested again and again, including for PCR, viral load, immune status, antigens, HIV-2 and others, despite assurances that they do not need these tests. They fear that they have a rare type of HIV, which for some reason cannot be detected by conventional test systems.
· Because of their fear of HIV / AIDS, they systematically experience difficulties in everyday life, in relations with family, friends, partner, at work, in an educational institution.
A person for whom the above description is true should contact a psychologist or psychiatrist to find out if there is any serious psychological problem behind the irrational fear of HIV / AIDS.
Statistics
Today, more than 50 million people on earth are living with HIV or AIDS. Every day in the world about 15 thousand people are infected with HIV. About 80% of HIV infections worldwide occur through unprotected sex between a man and a woman.
Every minute more than five people aged 15 to 24 receive the immunodeficiency virus, and more than 6 thousand young people every day. Every hundredth inhabitant of the planet between the ages of 15 and 49 is infected with HIV. ...
The HIV / AIDS epidemic, which has claimed tens of millions of lives worldwide, has affected the Russian Federation relatively recently.
The first rise in the incidence occurred in 1996-1997, when the number of people infected with HIV for the first time crossed the thousandth line (early 1996) and increased sixfold in two years (more than 6000 at the end of 1997). Since then, until the end of 2001, the number of new HIV infections has doubled and even tripled annually. Russia has become the new epicenter of the global HIV / AIDS pandemic. In terms of the rate of spread of HIV infection, Russia came out on top in the world.
According to the Federal Scientific and Methodological Center for the Prevention and Control of AIDS of the Ministry of Health of Russia, since 2002 there has been a slight decline in the rate of growth of HIV incidence in the Russian Federation. So, in 2003, the number of newly diagnosed cases of HIV infection was 184.3 per 100 thousand examined against 217.6 in 2002. The number of new HIV infections in 2002 (52349) decreased compared to 2001 (88577) by 40.9%, and in 2003 (39699) - by 24.2% compared to 2002.
In the first half of 2004, the number of newly registered cases of HIV infection was 15201, and the total number of detected HIV-infected in Russia was 286108.
Against the backdrop of a general slowdown in the HIV epidemic, the increase in the proportion of women among HIV-infected is alarming. According to the Federal AIDS Center, since 2002, more than a third of new HIV infections have occurred in women. In the first half of 2004, for the first time, the proportion of women among newly diagnosed HIV-infected exceeded 40 5. At the time of detection, the proportion of women in the most active reproductive age (20-29 years) was 58.1% of the total number of HIV-infected women.
In the period from 1987 to December 2003, 26,676 women became infected with HIV through intravenous drug use, which amounted to 19.5% of all persons (men and women in total) who became infected by this route, or 36.4% of all registered HIV-infected women. In 2003, the proportion of women who contracted HIV through intravenous drug use was 21.6% of all HIV infections among women registered this year (3431 out of 15878).
With the increase in HIV-infected women, the number of children born to them has increased dramatically. According to the Federal AIDS Center, in 2002, 2,761 children were born to HIV-infected mothers - one and a half times more than in previous years, in 2003 - 3111 children, and in the first half of 2004 - another 1473. Thus, in June In 2004, the total number of children born in the Russian Federation to HIV-infected mothers reached 9139, which was 3.2% of all registered HIV cases in the country. ...
As of December 2003, 8,848 HIV-infected children aged 0 to 14 were living in the Russian Federation. During the period from 1997 to December 2003, 237 HIV-infected children of this age group died (5.6% of the number of all deaths of HIV-infected), of which 127 were diagnosed with AIDS (53.5% of the number of deaths or 18 % of all AIDS deaths). If among the deceased HIV-infected adults (15 years and older) the proportion of deaths from AIDS was 14.5%, then among the deceased children 0-14 years old - 53.5%, which confirms the fact of a more rapid progression of HIV infection to the AIDS stage in children.
The number of deaths of HIV-infected in the Russian Federation
In 2000, on average in the Russian Federation, the diagnosis of HIV infection was confirmed in 19.3% of children with perinatal HIV contact when they reached the age of deregistration (18 months - 3 years). According to preliminary data, in 2003 the mother-to-child transmission rate of HIV infection dropped to 9.5%. ...
Against the background of a fairly high rate of abandonment of newborns (about 14,000 cases annually in the country as a whole), cases of HIV-infected mothers abandoning their children began to be recorded since the mid-90s. Only in obstetric hospitals in 2000-2003 more than 700 official refusals of HIV-infected mothers from their newborns were registered. Many HIV-infected women from among drug users and other socially vulnerable groups left their children in the maternity hospital without official registration of child abandonment.
With the growth of sexual transmission of HIV infection and the involvement of a large number of "socially adapted" groups of the population in the epidemic process, the proportion of abandoned children among children with perinatal HIV contact decreased from 11.4% in 2000 to 4.8% in 2003 year (data from the Ministry of Health of Russia).
A decrease in the proportion of abandoned children with perinatal HIV contact indicates a growing conscious attitude of HIV-infected pregnant women towards motherhood and a decrease in the proportion of the asocial contingent among them.
The Government of the Russian Federation is implementing a number of initiatives aimed at combating negative trends in social development, including, since 2005, Russia has begun to pay much more attention to the problem of HIV / AIDS, both at the political level and in terms of financial investments. The state budget of the Russian Federation for the fight against AIDS has grown 20 times. A national high-level commission on HIV / AIDS was established, which included representatives of the government, nongovernmental organizations and people living with HIV.
According to official data, there are about 300 thousand HIV-positive people registered in the country. Every year 4,800 people die from AIDS and its complications. But according to the data provided by the researchers, in fact, these numbers are closer to 1 million and 13,000, respectively. In addition, in Russia, the proportion of people under 30 years of age among HIV-infected is more than 80%, while in other European countries this figure does not exceed 70%.
HIV infection / AIDS in the Altai Territory as of 01.02.2008.
HIV infection is registered in 11 cities and 56 districts of the Altai Territory.
In the capital of the Altai Territory - Barnaul, a little more than 100 HIV-infected are registered. Most of them are in places of deprivation of liberty.
In the 45 worst affected countries, 68 million people are projected to die prematurely from AIDS between 2000 and 2020. ...
Practical part
immunodeficiency virus youth
1. Rationale for the problem
Social problem.
The attitude of people towards HIV / AIDS is that the number of morbidity is currently increasing. Already tens of millions of people around the world live with HIV, they are surrounded by hundreds of millions of relatives and friends. The diagnosis of HIV infection is accompanied by many social and psychological problems. The Russian Federation has the highest rates of epidemic development in the world. If the pace of development of the epidemic continues, then by 2010 every 10 Russians will become HIV-infected.
Scientific problem.
It lies in the fact that people's views on this problem are reflected in scientific publications.
2. Object of study- AltSTU students, group SR - 71, 72.
The subject of research is, the attitude of young people to the problem of HIV / AIDS in modern society.
3. Research Objectives.
The aim of the research is to model the factors influencing attitudes towards the problem of HIV / AIDS in modern society.
1) Model of factors influencing the attitude of students towards HIV - positive people.
2) Model of factors that reveal the attitude of young people to the problem of HIV / AIDS in modern society.
3) Model of factors that consider the knowledge of young people about the ways of HIV transmission.
4) Model of factors influencing the attitude and knowledge of students about HIV testing.
4. Research objectives:
1) Determine the model of factors influencing the attitude of students towards HIV-positive people.
2) Identify the model of factors that reveal the attitude of young people to the problem of HIV / AIDS in modern society.
3) Determine the model of factors that consider the knowledge of young people about the ways of HIV transmission.
4) Expand the model of factors influencing the attitude and knowledge of students about HIV testing.
5. Hypotheses:
1) Suppose that the majority of the respondents consider the problem of HIV / AIDS to be a global problem of modern society, which affects every person.
2) Suppose that the majority of the respondents believe that people with HIV / AIDS are dangerous for society.
3) Suppose that a small percentage of the respondents are HIV-positive, a sense of charity.
5) Suppose that less than half of the respondents were tested for HIV / AIDS.
6) Suppose that the majority of the respondents know all the ways of HIV transmission.
7) Suppose that the majority of respondents believe that HIV-positive people should be prohibited from having children.
8) Suppose that a small percentage of the respondents have acquaintances infected with HIV / AIDS.
9) Suppose that the majority of the respondents believe that marriage with an HIV-positive partner should be prohibited.
10) Suppose that the majority of the respondents believe that the information that is disseminated in modern society about HIV / AIDS is not enough.
6. Sample definition.
The general population in this sociological study is students. We examine a randomly representative sample of 20 people.
7.Methods of collecting information.
The collection of information was carried out using a questionnaire survey. This is the fastest way to collect information. The survey will be individual and open. Each respondent will be offered a written questionnaire, in which options are offered for almost every question, as well as an opportunity to independently choose an answer.
8. Toolkit, is a written questionnaire consisting of 20 questions.
9.Logical analysis:
HIV is the human immunodeficiency virus.
AIDS is acquired immunodeficiency syndrome.
HIV - positive - a person infected with HIV.
10. Research results.
This sociological study showed the following results:
1) To question 1, 90% of the respondents answered that HIV / AIDS is a global problem that affects everyone, 10% answered that HIV / AIDS is a problem only for those infected with HIV / AIDS.
2) On the 2nd question, 45% of the respondents answered that they feel pity for HIV / AIDS-positive people; 5% feeling of charity; 35% desire to help them; 5% have nothing to do with HIV / AIDS - positive people; 5% feel about them the same way they feel about other people.
3) On the third question, 85% of the respondents answered that HIV is transmitted through blood; 95% recalled the sexual transmission of HIV; 25% also wrote that HIV can be transmitted from mother to child; 5% believe that HIV can be transmitted through a syringe; 5% believe that HIV is inherited.
4) On the 4th question, 15% of the respondents answered that it is possible to protect themselves from HIV by using disposable syringes; 90% believe that a condom will help them protect themselves from HIV; 5% are sure that infection will not occur if there is one sexual partner; 5% answered that the blood supply must be sterile.
5) On the 5th question, 55% of the respondents answered that they consider HIV-positive, like other parents, have the right to have children; 15% believe that children with HIV should be banned from having children; 30% refer to the birth of children from HIV-positive parents, which is good, because thanks to new drugs, HIV-infected parents can have healthy offspring.
6) On the 6th question, 25% of respondents answered that it is necessary to prohibit the creation of a family with an HIV-positive partner; 75% believe that creating a family with an HIV-infected partner should not be prohibited.
7) On the 7th question, 25% of the respondents answered that those infected with HIV / AIDS should be compulsorily treated; 60% believe that those infected with HIV / AIDS should be perceived as ordinary, safe people; 20% answered that HIV / AIDS patients should be forced to speak openly about their HIV-positive status.
8) On the 8th question, 10% of respondents answered that discrimination against HIV / AIDS patients is deserved; 85% believe that discrimination against HIV / AIDS - infected people is not deserved; 5% of respondents found it difficult to answer.
9) To question 9-1, 50% of the respondents answered that if they found out that their friend (s) is sick with HIV / AIDS, they would try to help them; 15% would stop communicating with him (her); 45% continued to communicate as before.
10) On the 10th question, 5% of respondents answered that only HIV-positive people should be tested for HIV; 10% believe that people who suspect HIV infection; 85% answered that everyone who is interested and worried about their health should do an HIV test.
11) On the 11th question, 40% of the respondents answered that they had been tested for HIV; 60% answered that they had not been tested for HIV.
12) On the 12th question, 25% of the respondents answered that they had been tested for HIV in the direction of a doctor; 5% out of curiosity; 5% for a company with a friend (girlfriend); 5% had an HIV test to check their health.
13) On the 13th question, 25% of the respondents answered that when receiving an HIV test they felt a sense of calm, because they are absolutely healthy; 15% were afraid of being HIV-infected.
14) On the 14th question 15% of the respondents answered that they have acquaintances with HIV / AIDS; 85% have no acquaintances with HIV / AIDS.
15) On the 15th question, 10% of the respondents answered that when they learned about the HIV-positive status of their acquaintance, they felt fear for their health; 5% felt sorry for him (her).
16) To the 16th question, 25% of the respondents answered that HIV-positive people should tell others about their status; 70% believe that HIV-positive people should not tell everyone about their status; 5% answered that let the HIV-infected speak and eat.
17) To the 17th question, 25% of the respondents answered that the population receives enough information about HIV / AIDS; 75% believe that the population does not receive enough information about HIV / AIDS.
11. Processing of results.
After conducting a sociological study, we came to the following conclusions:
1) Hypothesis 1 that the majority of respondents consider the problem of HIV / AIDS to be a global problem of modern society that concerns everyone, was confirmed, since 90% of respondents answered the first question that the problem of HIV / AIDS is a global problem that affects everyone.
2) Hypothesis 2 that the majority of respondents believe that people with HIV / AIDS are dangerous for society was not confirmed, since not a single respondent answered question 7 of the questionnaire that HIV-infected people should be isolated from society.
3) Hypothesis 3, that a small percentage of respondents feel a sense of charity towards HIV-positive, was confirmed, since only 5% of respondents answered question 2 of the questionnaire that they feel charity towards HIV-positive people.
4) Hypothesis 4 that the majority of respondents believe that HIV / AIDS infected people should speak openly about their status (HIV-positive), was confirmed, since 95% of respondents answered question 16 that HIV-positive people should tell others about their HIV-positive status.
5) Hypothesis 5 that a small part of the respondents were tested for HIV / AIDS was almost confirmed, since 40% of the respondents answered 11 questions that they did not test for HIV.
6) Hypothesis 6 that the majority of respondents know all the ways of HIV transmission was almost confirmed, since 95% answered question 3 that they know the sexual route of HIV transmission; 85% know about HIV infection through blood and 25% know about HIV infection from mother to child.
7) Hypothesis 7 that the majority of respondents believe that HIV-positive people should be prohibited from giving birth to children, was not confirmed, since 55% of respondents answered question 5 of the questionnaire that HIV-positive, like other parents, have the right to birth of children.
8) Hypothesis 8 that a small percentage of the respondents have acquaintances with HIV / AIDS was confirmed, since to the 14th question of the questionnaire, only 15% of the respondents answered that they have acquaintances with HIV / AIDS.
9) Hypothesis 9 that the majority of respondents believe that marriage with an HIV-positive partner should be prohibited was not confirmed, since only 25% of respondents answered question 6 that creating a family with an HIV-positive partner should be prohibited.
10) Hypothesis 10 that the majority of respondents believe that there is not enough information that is widespread in modern society about HIV / AIDS, was confirmed, since to 17 question of the questionnaire, 75% of respondents answered that the population does not receive enough information about HIV / AIDS.
12. Analysis of the obtained results.
The main goal of the work carried out was to identify the model of factors influencing the attitude towards the problem of HIV / AIDS in modern society. To achieve this goal, goals were put forward and a number of hypotheses were developed.
When determining the model of factors influencing the attitude of students towards HIV-positive people, the following results were obtained: 45% of the respondents answered that they feel pity for HIV / AIDS-positive people; 5% feeling of charity; 35% desire to help them; 5% have nothing to do with HIV / AIDS - positive people; 5% feel about them the same way they feel about other people.
When identifying a model of factors that reveal the attitude of young people to the problem of HIV / AIDS in modern society, the following results were obtained: 90% of respondents answered that HIV / AIDS is a global problem that affects everyone, 10% answered that HIV / AIDS is a problem only for those infected with HIV / AIDS.
When determining the model of factors that consider the knowledge of young people about the ways of HIV transmission, the following results were obtained: 85% of the respondents answered that HIV is transmitted through blood; 95% recalled the sexual transmission of HIV; 25% also wrote that HIV can be transmitted from mother to child; 5% believe that HIV can be transmitted through a syringe; 5% believe that HIV is inherited.
When disclosing the model of factors influencing the attitude and knowledge of students about HIV testing, the following data were obtained: 5% of respondents answered that only HIV-positive people should be tested for HIV; 10% believe that people are suspicious of HIV infection; 85% answered that everyone who is interested and worried about their health should do an HIV test.
The research results cannot be disseminated to all members of society, since only 20 respondents took part in the survey. To obtain more accurate data, it is necessary to increase the number of respondents or to conduct a re-survey.
By gender and age, girls prevail (90%) from 18-24 (60%).
Conclusion
I am almost sure that there is hardly a young man today who has not heard anything about HIV / AIDS. But many more adolescents, boys and girls do not know everything about how HIV is transmitted and how you can protect yourself from this deadly virus. But even those who know rarely think about the fact that HIV can affect them personally.
AIDS spread like wildfire in almost every country in the world in the 20th century. In an unusually short time, it became the number one problem for the World Health Organization and the United Nations, relegating cancer and cardiovascular diseases to second place.
Of course, AIDS is one of the most important and tragic problems facing humanity at the end of the 20th century. The point is not only that at present the World Health Organization (WHO) officially registered more than 50 million HIV-infected and tens of thousands of millions of deaths. And not even that we are already accustomed to the fact that December 1 has become International AIDS Day. And the fact that we still do not want to think that all this is directly related to each of us.
Anyone, at any age, regardless of gender, place of residence, religious beliefs and social status, can become infected.
Only knowledge about the ways of transmission and prevention of HIV infection and skills can protect each of us from infection.
It seems to me that it is important for every person to understand that AIDS is not just statistics.
These are not just numbers.
These are the fates of living people.
We all need to understand that today HIV is an objective reality, which is simply impossible to ignore. To know and constantly remember that the human immunodeficiency virus is already here, nearby, and not on the other side of the planet, is the only correct way out. It is important for each of us to be attentive to ourselves, our health and future.
List of used literature
1. HIV is a reality [Text] - Barnaul: ROO "Siberian Initiative", LLC Publishing House "Altaypress", 2003. - 9 p.
2. HIV in Altai [Text] - metroforum [AIDS] forum. metroland. ru /? showtopic =
3.63468 st = 20 - HIV / AIDS in Altai.
4. Voronin, E.E. Children, women and HIV infection [Text] / E.E. Voronin and others - M .: UNISF, 2004 .-- 64 p.
6. People and HIV [Teskt] - Kiev: Information Resource Center of the International HIV / AIDS Alliance, 2004. - 506 p.
7. Useful vaccination [Text]: a textbook on AIDS prevention. - M .: INFO-Plus, 2004 .-- 32 p.
8. Popularly about AIDS [Text] - M .: INFO-Plus, 2002. - 136 p.
9. Siberian Initiative [AIDS] [Text] - M., 2006. - www.sibin.ru/rus/?id = 79 - Russia underestimates statistics on HIV and AIDS.
10. AIDS in Russia [AIDS] [Text] - SPb., 2007. - aids.rusmedserv.com/weandyon/Regions/22.htm - Popularly about AIDS.
Annotation. HIV / AIDS remains a major global public health problem. HIV affects not only the health of an individual, but also society and the state as a whole. This article examines the problem of HIV / AIDS in the modern world. On the basis of the research carried out, the author provides a brief history and information about HIV / AIDS. This direction is complemented by a review of the activities of international organizations that are making efforts in the fight against HIV / AIDS, such as UNAIDS, WHO and UNICEF, etc. The author comes to the conclusion that the tendency to reduce the spread of HIV / AIDS has become positive, but in order to achieve a cure for this disease, the interest and efforts of many people are still needed in the future.
Keywords: HIV / AIDS, international organizations, UNAIDS, WHO, UNICEF, activities.
Abstract... HIV / AIDS remains to be one of the major global public health problems. HIV not only affects the health of the individual, but also has influence on society and the state as a whole. The problem of HIV / AIDS in the modern world was considered in this article. The short history and information on HIV / AIDS is provided on the basis of the research conducted by the author. This direction is also supplemented with the investigation of the international organizations which make efforts in fight against HIV / AIDS, such as UNAIDS, WHO and UNICEF, etc. And the author works out what kind of activity these international organizations develop for people suffering from HIV / AIDS. The author comes to a conclusion that the tendency of halting the distribution of HIV / AIDS proved to be positive but in the future attention and efforts of many people are necessary to defeat this illness.
Keywords: HIV / AIDS, International organization, UNAIDS, WHO, UNICEF, activities.
Introduction.
For more than 30 years since the day of the open epidemic, humanity has been fighting against HIV / AIDS, but this problem has not really been solved yet. The problem of HIV / AIDS emerged at the end of the 20th century. HIV (Human Immunodeficiency Virus) leads to the development of AIDS (Acquired Immunodeficiency Syndrome), which destroys human immunity. Now everyone knows that the problem of HIV / AIDS is not only a problem of one state, but also a global problem in the modern world. It links to other issues such as demographic, economic and social. It is one of the main challenges facing the world community. Life-threatening HIV / AIDS is most common in Africa and, to varying degrees, in Europe, Asia and America. According to WHO statistics, more than 35 million people living with HIV are officially registered in the world. More than five thousand people are infected every year, in 2013 there were 2.1 million new infections and 1.5 million people died from AIDS-related illnesses. But thanks to the fact that international organizations and states have made efforts to fight HIV / AIDS, compared with 2001, the number of new HIV infections has decreased by 38%, and over the past three years, the death rate from AIDS has dropped by five times. To this extent, their efforts have not only regulated the numbers, but also helped in part to overcome prejudice, led to awareness of the problem and the development of methods to combat this disease. I emphasize that in order to achieve the goal of “zero” by 2015, formulated by UNAIDS (“zero new HIV infections. Zero discrimination. Zero AIDS-related deaths”), responsibility, efforts and large funds from international organizations are required, or voluntary support of the people. Currently, several international organizations exist to combat HIV / AIDS. The leading role in this struggle is played by the Joint United Nations Program on HIV / AIDS (UNAIDS), the World Health Organization (WHO) and UNICEF, etc. They are trying to implement their programs and set their own goals.
Review of literature and documentary sources.
To write the article, documents of the World Health Organization and UNAIDS were used, such as reports, data and statistics, which are published on the website of the organizations themselves. Unfortunately, there is little literature that meets the objectives of this work. Mainly, I have used the Report on the Global Response to HIV / AIDS, published jointly by WHO, UNICEF and UNAIDS, which provides data on the progress made in the response to the HIV / AIDS epidemic in 2010 in the following areas: access to treatment, prevention and support and care in low- and middle-income countries. And UNAIDS Papers Accelerating: Ending the AIDS Epidemic by 2030.
Targets and goals.
Provide an overview of HIV / AIDS and explore the role of international organizations in the fight against HIV / AIDS such as UNAIDS, WHO and UNICEF.
Study.
In June 1981, American scientists reported AIDS - it was the first clinical case of this disease, which later became widely known. The underlying HIV was identified in 1983. HIV is found in body fluids of a person who has been infected - blood, semen, vaginal secretions, and breast milk. It can be transmitted through unprotected sexual intercourse. In addition, it has spread to people who inject drugs through non-sterile needles and untested blood products. It can spread from mother to child during pregnancy, childbirth or breastfeeding when the mother is HIV positive. While posing a threat to all mankind, AIDS is spreading very unevenly among different peoples. Most cases in Tropical Africa, many infected in the United States. There are significantly fewer patients in Europe and Latin America. In Asia, rare foci have recently appeared (in Hong Kong, Thailand, etc.), but in Asia it is spreading very rapidly. AIDS is coming to Russia as well. In the course of recent studies, one detail has become clear: among African peoples, with a huge number of HIV-infected people, there were relatively few active patients. Perhaps the body of Africans was able to adapt to AIDS. But despite the fact that HIV / AIDS is still considered a terrible epidemic throughout the world, now the situation has become positive. As mentioned above, the incidence and mortality of HIV / AIDS have declined. Globally, 35 million people are living with HIV. Compared to 2001, in 2013 the number of new HIV cases was 38% less. The number of AIDS-related deaths was also 35% lower than in 2005. According to research, HIV infection has gradually become less fatal as a result of its evolution. And the incubation period of the virus has become longer. According to media reports, the rate of spread of HIV / AIDS is gradually declining, and the virus has been modified to a form that survives for a long time inside the body. For example, 20 years ago, the incubation period of the virus for HIV-infected people in Botswana was almost 10 years, but has now increased by 12.5 years. That is, it means that the incurable disease "AIDS" has been modified into a chronic disease. Despite this state of affairs, many people on our planet are suffering from AIDS. People living with HIV in developed countries receive antiretroviral therapy (ART), which can help slow the progression of HIV disease and control AIDS. But still, patients in poor countries cannot receive the necessary medical care. According to WHO, in 2013 most of the 35 million people living with HIV live in Sub-Saharan Africa, but of these, only 11.7 million received the Asia-Pacific Region. In low-income and middle-income countries, among pregnant women who are infected, only 67% received drugs that prevent the fetus from contracting HIV. The number of children receiving antiretroviral therapy was 23%.
But, in addition to this problem, there are still social problems associated with HIV. Social problems such as stigma and discrimination that arise from a lack of information about HIV / AIDS and from insufficient government support. People think AIDS is scary because they were born in a society that was terrified of AIDS. In the early years of the spread of the epidemic, HIV was actually equated with death, because the virus was detected only at the AIDS stage. Therefore, the diagnosis caused blind fear and a feeling of complete helplessness. The history of AIDS has also contributed to the spread of discrimination, as the first cases of AIDS were identified among homosexuals, injecting drug users and commercial sex workers. Therefore, in the eyes of ordinary people, AIDS, and, consequently, HIV infection, looked like a disease of “bad people”. Stigma and discrimination in the context of HIV / AIDS is one of the main obstacles to the prevention and treatment of HIV infection. HIV-positive people live in society, have families, work in various specialties, and children with HIV go to schools. Naturally, in such a situation, additional efforts are required to educate the population in order, on the one hand, to enable everyone to live normally and enjoy all the rights of a citizen of their country, and on the other hand, to prevent new infections.
The problem of HIV / AIDS leads to an economic problem. The spread of AIDS has an impact on economic activities, for example, the death of members who accept the family budget hits the economy. Diseases and deaths from AIDS reduce the productivity of peoples' labor, increase the cost of treating peoples, reduce the savings and savings of the people, and reduce investment in labor capital. A lot of money is also spent on the fight against HIV / AIDS itself. According to the Joint United Nations Program on HIV / AIDS (UNAIDS), between 1996 and 2009, global spending on the fight against the disease increased from $ 300 million to $ 15.9 billion a year. The main sources of funds are government funding, international aid and private donations. International aid in 2009 accounted for $ 7.6 billion (a year earlier, $ 7.7 billion), of which $ 5.9 billion on a bilateral basis, $ 1.7 billion through international organizations. Among donor countries, the USA is in the lead, having allocated $ 4.4 billion to other countries (58% of all transfers). Other major donors are the UK ($ 779 million), Germany ($ 397.9 million) and the Netherlands ($ 381.9 million). The largest recipients are low-income countries, which are home to 71% of all HIV-infected: Uganda, Nigeria, Rwanda and others.
On World AIDS Day 2014, UNAIDS launched the 90-90-90 project to bridge the gap between infected and cured. The 90-90-90 project, which is planned to be implemented by 2020, includes: 90% of people living with HIV who know about their HIV status; 90% of people who are aware of their HIV-positive status who are on treatment; and 90% of people on treatment achieve viral suppression. To achieve this goal, the joint efforts of many people are needed. UNAIDS was created with the participation of 6 agencies (UNICEF, UNDP, UNFPA, UNESCO, WHO and the World Bank) to coordinate the fight against HIV / AIDS and to support the efforts of states and societies to fight the epidemic. UNAIDS guides, strengthens and supports the global response to the epidemic. She advocates an integrated approach that encompasses various areas of this struggle, including women's and children's health, education, improving legislation, combating drugs and reducing drug use, supporting the socio-economic development of countries and territories, and mobilizing resources.
WHO, in partnership with UNAIDS, works to prevent HIV infection in people - promotes behavior change to reduce the risk of HIV infection; expands access to prevention tools; supports programs to prevent mother-to-child transmission of HIV; contributes to the formation of safe blood supplies and the prevention of HIV transmission in health facilities; evaluates new prevention technologies; expands access to treatment; provides the best possible care for people living with HIV / AIDS and their families; expands access to and participation in HIV testing and counseling so that people can know their HIV status; strengthens health systems to provide quality and sustainable HIV / AIDS programs and services; and improves HIV / AIDS information systems, including surveillance, monitoring, evaluation and operational research.
Another international organization that works with UNAIDS, the United Nations Children's Fund (UNICEF), contributes to improving the quality of health care for HIV-infected women and children. It supports the education of young people in essential life skills such as critical thinking to help protect them from infection. UNICEF also supports youth friendly services, including providing access to voluntary counseling and testing. The greatest attention is paid to young people at risk, who find it most difficult to access these types of services. The UN Children's Fund supports programs for children and young people living with HIV to receive quality treatment and care. It also develops and implements measures to protect these children from social stigma and discrimination. UNICEF's regional HIV / AIDS strategy includes three areas: HIV prevention among adolescents and young people; prevention of mother-to-child transmission of the virus; protection and support of children and parents living with HIV. UNICEF is working with governments, civil society and other partners to ensure that every country in the region has a national HIV / AIDS policy that clearly identifies the roles of every agency and organization, civil society and young people themselves in HIV prevention.
The approach taken by UNAIDS emphasizes the need to focus on countries, cities and communities most affected by HIV, and recommends focusing resources on areas of greatest impact. This approach expresses the need for special action in 30 countries, which together account for 89% of new HIV infections worldwide. Implementing national responses using this approach in these 30 countries will require extensive mobilization of human resources, institutional and strategic international partners, and commitment from national and international funding sources. It also emphasizes the importance of treating people most affected by HIV as key to ending the AIDS epidemic, as well as ensuring access to HIV services for those who need them most.
Conclusion.
As you know, the problem of HIV / AIDS is serious - it affects social activities, the economy of one state, human rights, the destruction of family happiness, therefore, close cooperation of international and national institutions in this area is required. UNAIDS, UNICEF and WHO are working to meet the challenges of the global response to HIV / AIDS. Her projects include reducing the number of new HIV infections per year by more than 75%, to 500,000 in 2020, and ensuring zero discrimination. Thanks to active efforts, HIV is now less deadly than it used to be. Therefore, we can say that the fight against AIDS has almost come to an end. But special attention must be paid to bridging the gap between the infected and the cured. Although there is no cure for HIV infection, people receive antiretroviral drugs and can control the virus. But the availability of antiretroviral drugs varies greatly between rich and poor countries. If people in poor countries can receive ART on an equal basis with people in rich countries, then people with HIV worldwide will be able to have healthy and productive lives.
List of sources and literature:
Towards zero: the UNAIDS strategy 2011-2015.
Global Report: UNAIDS Report on the Global AIDS Epidemic 2013
Report on the global response to HIV / AIDS // WHO, UNICEF, UNAIDS. 11/30/2011
Fact sheet No. 360. WHO. 2013
Newsletter No. 18. UNAIDS. 2013
Maly VP, HIV / AIDS The latest medical reference book. M: Eksmo, 2009
Draft WHO strategy on HIV / AIDS 2011–2015, Executive Board. 23.12.2010
Accelerating: ending the AIDS epidemic by 2030. UNAIDS. 2014
Millennium Development Goal 6: http://www.who.int/topics/millennium_development_goals/diseases/ru/
Global summary of the HIV / AIDS epidemic, December 2013: http://www.who.int/hiv/data/epi_core_dec2014.png?ua=1
For more than thirty years the world has been living with the problem of fatal AIDS. This disease is still incurable, difficult to diagnose and insidious. And there are so many myths around HIV and AIDS! For example, about "safe sex" with a condom and about the fact that HIV is not transmitted through saliva. AIDS Day, which is celebrated on December 1, is another reason to talk about this disease.
HIV terrorist caught in Moscow
December 1 is World AIDS Day ohm. What is the situation with HIV and AIDS in Russia? Here are just some of the figures prepared for the landmark date by the Federal Scientific and Methodological Center for the Prevention and Control of AIDS.
By the end of this year, the number of HIV-infected people will reach a million, and the number of people infected in 2014, according to doctors, was 80 thousand. About 200 people are infected with HIV every day- half of them are young women aged 25-35.
The palm among the total number of people infected with HIV is held by "injecting" drug addicts- 57 percent. Almost everyone else is ordinary men and women with promiscuous sex lives.
It can be noted that the head of the aforementioned federal center, Academician of the Russian Academy of Sciences Pokrovsky, announced a change in the global strategy in the fight against AIDS. In short, the usual (and already a little sore) prevention measures in the form of promoting the use of condoms in developed countries are receding into the background.
Which, in general, is not surprising. If only because, despite the many sites devoted to AIDS, the likelihood of infection through the saliva of a patient is openly ridiculed - but the discoverer of a dangerous infection, Nobel laureate Luc Montagnier, had a completely different opinion on this matter.
And professional instructions for doctors in case of contact with saliva (or other biological fluids) of the patient in the eyes or on the mucous membranes categorically require them to immediately rinse them with disinfectant solutions. And then take antiretroviral drugs for several months - which is clearly being done taking into account the far from imaginary "safety" of the saliva of an HIV carrier.
When applied to ordinary lovers, this means that the condom only reduces the risk of HIV infection from a healthy partner from a sick partner. But the same passionate kiss (and even with a bite, which often happens at the height of passion) can lead to a fatal outcome, from which "product number 1" cannot save with all the desire.
Returning to the information of Professor Pokrovsky, the world is now focusing on the early diagnosis of HIV - and the earliest possible start of treatment for HIV-infected.
In general, in the non-medical press and forums, the terms HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) are often used interchangeably. But this is not always the case.
HIV is just a causative agent of the disease, and an HIV-infected person is a carrier of this virus... When clinically this carriage practically does not manifest itself in any way - except perhaps for the presence of antibodies to the virus in the blood, which, alas, are unable to cope with it radically.
But when the virus begins its destructive work to destroy the immune system, then this is manifested by AIDS. Who kills his victim at times for several years.
However, if you start taking antiretroviral drugs while you are carriers of HIV, AIDS may not develop at all. Or - in a very ripe old age. That, in general, is tantamount to an opportunity for a person to live an almost full life.
Stop for small - early diagnosis of HIV. And with this in Russia, alas, there are big problems.
Actually, the main problem is one - HIV testing is purely voluntary... Even in a hospital, upon admission of a patient from a "risk group" (the same drug addict, for example), doctors formally do not have the right to give him a blood test for HIV without his consent. And in the absence of this, they themselves are at risk of contracting HIV, because they do not know what precautions to use when dealing with such patients.
But when it comes to drug addicts, caution is usually the default. But after all, not every HIV-infected is a drug addict - among them there are people who are absolutely not involved in the addiction.
And take, for example, testing the most vulnerable groups - young people of marriageable age? So far, Chechnya and Ingushetia can boast of the best achievements, where all newlyweds are invited to take an HIV test before the wedding.
But there this initiative comes from the local clergy, and the local patriarchal traditions of reverence for elders are incomparable with the rest of Russia. Try not to follow the "recommendation". But in other Russian regions, if such a practice is introduced, it will clearly become not generally accepted.
In this regard, it is appropriate to recall that in Soviet times, in dermatovenous dispensaries, treatment of patients with much less dangerous syphilis began only when the patient honestly told the doctor about his sexual contacts: "when, with whom and where."
Not because doctors suffered from excessive curiosity - just as early as possible examination and preventive treatment of "objects of contact" made it possible to "chop off" the spread of this epidemic of venereal diseases.
But then glasnost, democracy, freedom, individual rights began, "anonymous treatment rooms" appeared - and the very effective fight against "love diseases" almost disappeared. And the victorious walking of AIDS is the result of this particular paradigm.
The tragedy of Russian society, including in terms of sexually transmitted diseases, was not least that "having left its native shore, it did not stick to another."
In general, infectious disease doctors and dermato-venereologists do not in vain ironically say that "the best cure for AIDS is" STI alone "and" STI at home "... That is, either do not have sexual intercourse at all, or have one partner, wife or girlfriend, and do not look for adventures on the side.
So after all, even during the war, German doctors examining Soviet girls taken to Germany for work, noted that almost all of them are virgins!
Yes, in the West there is a different tradition, "free love". But, for example, in the rather old American film "Love as a Deadly Sexually Transmitted Disease", the main characters, a guy and a girl in love, do not start having sex without a condom - until they have been examined for sexually transmitted diseases.
Well, we have our own way. Marriage contracts and analyzes are vulgar Western rationalism, it is not romantic for us. And to preserve virginity before marriage (and to be faithful in the marriage itself) is already "outdated". As a result, we have what we have, the AIDS epidemic and not only ...
It seems that the only measure capable of turning the situation around (except, alas, the fantastic hope for the revival of morality) is the introduction of mandatory periodic "prophylactic medical examination" for HIV infection... With the preservation of "medical confidentiality" and everything attached, but nevertheless.
The rest of the measures, like "promoting safe sex" (which simply cannot be such in principle, even with the most reliable condom) is to push water in a mortar. And they are not able to stop the spread of the "plague of the 21st century". The sooner both legislators and society as a whole understand this simple thing, the sooner a turning point in the fight against AIDS can come.