HIV stands for Human Immunodeficiency Virus, a virus that weakens the body‘s immune system.
AIDS (Acquired Immune Deficiency Syndrome) is a medical condition where one or more serious infections or cancers arising from the damage caused by HIV to the immune system have been diagnosed.
HIV/AIDS in Ethiopia
The first case of AIDS in Ethiopia was reported in 1986. The estimates of the magnitude of HIV epidemic are based on the surveillance data that is carried out since 1999. The epidemic continues to shift towards women and young people with an accompanying increase in vertical transmission and pediatric HIV. According to the 2011 EDHS, HIV prevalence is 1.9% for women and 1.0% for men with an overall prevalence of 1.5%. This is essentially unchanged from the HIV prevalence reported in 2005 (1.4%).
HIV prevalence is six and a half times higher among women living in urban areas (5.2%) than those living in rural areas (0.8%). HIV estimates vary by age, with HIV prevalence highest among women age 30-34 and men age 35-39. According to UNAID 2013 Global report, 760, 000 people are living with HIV/AIDS in 2012 in Ethiopia.
Modes of transmission of HIV/AIDS and the relationship with other Sexually Transmitted Infections (STIs)
HIV is found in many body fluids but its transmission mainly takes place through blood, seminal fluid, vaginal and cervical secretions and breast milk. Details about mode of transmission are listed in box below (box3.1).
Main modes of HIV transmission
- Unprotected sexual intercourse with infected people (accounts 84%)
- Increased rates of HIV infection through heterosexual contact have been associated with multiple sexual partners and the presence of one or more other sexually transmitted infection(s).
- A person infected with a STI has a much higher risk of acquiring HIV from an infected partner.
- A person infected with both HIV and another STI has a higher risk of transmitting HIV to another partner.
- Although not a direct factor, the use of alcohol or other recreational drugs often impairs judgment and may lead to unsafe sex and HIV exposure.
- Mother to child transmission
- During pregnancy through the placenta (before birth 5-10%).
- During labor and delivery (at the time of delivery 10-15%).
- At the time of breast-feeding (mainly through breast milk 5-20%).
- Through contact with infected blood or body fluid, tissue or organ
- Transfusion of infected blood and blood products.
- Use of contaminated instruments, e.g., syringes, circumcision knives, and scarification and tattooing equipment. Accidents or injuries with contaminated needles or knives.
- Grafting/Transplanting of infected tissue or organ.
Factors that could influence the risk of HIV infection
Here are many factors that have contributed to the spread of the epidemic. Below are a few of the most dominant societal factors that have driven this epidemic. These are the following;
i) Behavioral factors:- Level of awareness.
- Multiple casual sexual contact.
- Alcohol and drug use.
- Condom use.
- Poor health seeking behavior for the treatment of STI and HIV testing.
ii) Socio-economic and cultural factors:- Stigma and denial.
- Poverty and mobility.
- Cultural practices.
- Gender inequality.
- Conflict.
iii) Biological factors:- Presence in semen and genital secretions.
- Exposure to blood, for example, genital ulcers, trauma during sexual contact
- Lack of circumcision in heterosexual men.
- Sex during menstruation, increasing a woman‘s risk.
- Presence of an ulcerative or non-ulcerative STIs.
- Infectiousness of host.
- High viral load.
- Breastfeeding by a HIV-positive mother.
- Susceptibility of recipient.
- Inflammation or disruption of genital or rectal mucous.
- Sex during menstruation, increasing a woman‘s risk.
HIV prevention measures
The general interventions to prevent HIV/AIDS are Information, Education and Communication/Behavioral Change Communication (IEC/BCC), condom promotion and distribution, voluntary counseling and testing (VCT), management of sexually transmitted diseases, blood safety, infection prevention/universal precaution, and prevention of mother to child transmission of HIV (PMTCT).
The preventive measures that can be suggested by the health extension workers are the following:
- Abstain from sexual intercourse before and outside marriage.
- Sexual intercourse between two HIV/AIDS laboratory test free sexual partners must be based on absolute trust and sustained one to one relationship.
- Use condom properly, if for any reason or reasons sexual intercourse before and outside marriage is needed.
- Don‘t ever share cutting and sharp instruments for use. At home separate items used by adults and children such as blade, needles, traditional pliers etc.
- Refrain from harmful traditional practices that expose to HIV/AIDS.
- Advise and motivate suspected young individuals to go to health facilities and use HIV/AIDS counselling services.
- Provide support and care with affection to people living with HIV/AIDS and victims at family and community levels.