1. Let’s Think about HIV/AIDS

2. Jamaica’s Reality Estimated 28,000 Jamaicans living with HIV/AIDS. Estimated 28,000 Jamaicans living with HIV/AIDS. 8097 reported AIDS cases since the start of the epidemic. (59.8% -males; 40.2% females) 8097 reported AIDS cases since the start of the epidemic. (59.8% -males; 40.2% females) 5,125 children under the age of 15yrs have been orphaned due to AIDS. 5,125 children under the age of 15yrs have been orphaned due to AIDS. An average of 13 persons per week died of AIDS in 2002. An average of 13 persons per week died of AIDS in 2002.

3. St. Ann Clarendon Portland Trelawny St. Elizabeth St. Catherine St. Mary Manchester St. Thomas Westmoreland Hanover 85.1 - 95.5 95.5 - 149.7 149.7 - 203.5 203.5 - 217.1 217.1 - 552. 6 N EW S Summary of AIDS Cases by Parish in Jamaica 1982-2001 (Rate per 100,000 Pop.) AIDS/100,000 Pop.

4. Poverty & Ignorance Poverty & Ignorance Discrimination Discrimination Stigmatization Stigmatization Marginalization Marginalization Migration Migration Cultural myths & practices Cultural myths & practices Gender imbalance Gender imbalance Social Factors Driving the HIV/AIDS Epidemic in Jamaica Sexual practices Prostitution/sex work Homo/bisexuality Substance abuse Sexually transmitted infections Sex tourism Casual sex

5. HIV/AIDS – What is HIV? H uman I mmunodeficiency V irus

6. HUMAN  Found only in humans  Transmitted between humans  Preventable by humans IMMUNO DEFICIENCY  Body lacks ability to fight off infections VIRUS  Type of germ  Lives and reproduces in body cells

7. How the Immune System Works The immune system is made up of special cells which protect the body from infection. The immune system is made up of special cells which protect the body from infection. THE NORMAL RESPONSE TO A VIRUS: THE NORMAL RESPONSE TO A VIRUS: When a virus (germ) enters the body, the cells which make up the immune system in the body begin to work at once. These cells produce what are known as “antibodies”. The antibodies attack the germs and destroy the germ therefore helping the person to get better. When a virus (germ) enters the body, the cells which make up the immune system in the body begin to work at once. These cells produce what are known as “antibodies”. The antibodies attack the germs and destroy the germ therefore helping the person to get better.

8. How Is HIV Spread? HIV, the virus that causes AIDS, is spread through four bodily fluids:  Blood  Semen  Vaginal secretions  Breast milk The virus can only be spread from an infected person if his or her bodily fluids enter the bloodstream of an uninfected person.

9. Sexual Transmission Unprotected heterosexual and homosexual contact with an infected partner is the most common method of HIV transmission. Unprotected heterosexual and homosexual contact with an infected partner is the most common method of HIV transmission. Vaginal, oral and anal sex are not safe if done without proper protection Vaginal, oral and anal sex are not safe if done without proper protection

10. Vertical Transmission HIV infected mother can infect her baby:  At birth  Through breastfeeding

11. Blood to Blood Transmission Blood transfusion can also cause HIV- infection, if the donated blood is not tested. Blood transfusion can also cause HIV- infection, if the donated blood is not tested. In the Caribbean this could happen in rare cases In the Caribbean this could happen in rare cases

12. Transmission by Non-sterile Equipment Sharing non-sterilized needles or syringes (or razors) - may lead to infection! Needles used for:  Injecting narcotics  Injecting medicine  Tattooing  Piercing May carry HIV from the blood of an infected person, and be transmitted to you.

13. To get HIV …. HIV must be present HIV must be present HIV must be present in enough quantities to infect (blood, semen, vaginal fluids, breast milk) HIV must be present in enough quantities to infect (blood, semen, vaginal fluids, breast milk) HIV must go directly to the blood stream HIV must go directly to the blood stream

14. Who Can Get HIV? Anybody having sex without a condom. Anybody having sex without a condom. People with more than 1 partner who don’t use a condom during sex People with more than 1 partner who don’t use a condom during sex People whose sex partner has sex with other partners without using a condom People whose sex partner has sex with other partners without using a condom People who share IV drug needles that are not sterilized. People who share IV drug needles that are not sterilized. People with 1 sex partner can also get HIV People with 1 sex partner can also get HIV

15. ARE YOU AT RISK?

16. IT IS NOT WHO YOU ARE, BUT WHAT YOU DO THAT PUTS YOU AT RISK!!!!

17. with YOURSELF BE HONEST with YOURSELF Have I ever had sex? Have I ever had sex? Do I have more than one partner? Do I have more than one partner? Does my partner have more than one partner? Does my partner have more than one partner? Does my partner use a condom every time with all his/her partners? Does my partner use a condom every time with all his/her partners?

18. CHECK YOURSELF Do I use a condom every time? Do I use a condom every time? Do I know my partner (s) HIV status? Do I know my partner (s) HIV status? Do I know my HIV status? Do I know my HIV status?

19. TO DO WHAT IS RIGHT … YOU NEED TO DO WHAT IS TRUE.

20. More on HIV Infection  You can become infected from only one exposure  Once you are infected you can infect others  If you are HIV+ you can continue to live a healthy life

21. How HIV Cannot Be Transmitted HIV cannot be transmitted from an infected person to you through: HIV cannot be transmitted from an infected person to you through:

22. How HIV Cannot Be Transmitted HIV cannot be transmitted from an infected person to you: HIV cannot be transmitted from an infected person to you:

23. How HIV Cannot Be Transmitted HIV cannot be transmitted from an infected person to you: HIV cannot be transmitted from an infected person to you: Through sweat and tears Through sweat and tears By living or going to school with an infected child By living or going to school with an infected child Through everyday children’s fights or nosebleed Through everyday children’s fights or nosebleed

24. HIV – Signs? Can you look and tell if someone one has HIV? NO! People with HIV show no clinical signs. They look just like you and us.  A person can look and feel well for many years and be HIV positive.  The HIV positive person can pass the virus on to someone else.

25. HIV PROGRESSION The average asymptomatic period is 8-10- 12yrs. The average asymptomatic period is 8-10- 12yrs. About 10% of persons will rapidly progress to AIDS in 2-3 yrs. About 10% of persons will rapidly progress to AIDS in 2-3 yrs. 10% of persons will NOT progress to AIDS after 10yrs. 10% of persons will NOT progress to AIDS after 10yrs.

26. How To Tell Your Status Do the HIV test Do the HIV test  Rapid test or  Eliza test  This is the screening test. If the result is positive a second test is done to confirm the results. When both tests are positive, it means that antibodies to HIV have been found. Counselling before the test (PRE) Counselling after the test (POST)

27. The HIV Antibody Test  Indicates the presence of HIV antibodies only  Is accurate, especially when done at the right time  Can encourage follow-up treatment  Can lead to behavioural change

28. The Window Period  The window period is a period of roughly up to three months immediately after a person becomes infected with HIV, when it may not be possible to detect the infection with any test.  This is because the body has not produced enough antibodies which can be picked up by a test. The test results will therefore show a FALSE NEGATIVE.

29. The Window Period Any person who receives a negative test result should do a second test three months later to be absolutely sure of his/her HIV status. Any person who receives a negative test result should do a second test three months later to be absolutely sure of his/her HIV status. During the 3 month waiting period he/she should either abstain from sex or use a condom properly at all times so as not to risk exposure to the virus. During the 3 month waiting period he/she should either abstain from sex or use a condom properly at all times so as not to risk exposure to the virus.

30. Who Needs To Take An HIV Test Sexually active people Sexually active people People who have unprotected sex People who have unprotected sex If you were raped If you were raped If you got accidental needle sticks at work If you got accidental needle sticks at work People who have doubts that their sex partner is faithful People who have doubts that their sex partner is faithful

31. TREATMENT -HIV Anti-retroviral Anti-retroviral Healthy lifestyle practices Healthy lifestyle practices Strong support system Strong support system

32. AIDS Acquired – received, not inherited (does not run in families) Immune – protected from (in this case the system protects the body from disease Deficiency - a lack of Syndrome – a group of symptoms or diseases

33. What is AIDS? Acquired Immune Deficiency Syndrome  AIDS is the medical name for a combination of illnesses which result when – the immune system – that part of the body which protects it from infections and diseases, is weakened or destroyed

34. Signs and Symptoms AIDS AIDS – person is HIV positive and has at least 2 major and one minor opportunistic illnesses AIDS – person is HIV positive and has at least 2 major and one minor opportunistic illnesses

35. Key Prevention Messages R Respect the rights of infected and ill B Be faithful P Protect yourself and your partner A Abstinence T Talk before you act C Condoms

36. PREVENTION Cont’d. Do STI/HIV test at the onset of establishing new relationships Do STI/HIV test at the onset of establishing new relationships Practice the correct usage of condoms that guarantee greater safety (latex) Practice the correct usage of condoms that guarantee greater safety (latex) Avoid the usage of drugs that are non- medicinal. Avoid the usage of drugs that are non- medicinal.

37. PREVENTION (Cont’d) Avoid sharing needles (i.e. for any intravenous purposes) Avoid sharing needles (i.e. for any intravenous purposes) Avoid the use of substances -eg. Alcohol that can impair your judgement in a given situation. Avoid the use of substances -eg. Alcohol that can impair your judgement in a given situation. Practice universal precautions when handling blood, body refuse etc. Practice universal precautions when handling blood, body refuse etc.

38. PREVENTION UNIVERSAL PRECAUTIONS Rubber gloves, goggles, plastic aprons are used to protect those who work in labs from accidents such as needle stick or spillage of blood and other body fluids. Rubber gloves, goggles, plastic aprons are used to protect those who work in labs from accidents such as needle stick or spillage of blood and other body fluids. General hygiene – wash hands etc General hygiene – wash hands etc Proper disposal of contaminated wastes Proper disposal of contaminated wastes

39. Protection During Sex Use a rubber condom every time you have sex.

40. Developing A Healthy Attitude... Become Informed about STI/HIV Become Informed about STI/HIV Internalize Prevention Messages Internalize Prevention Messages Make informed Choices Make informed Choices Translate Theory into Practices Translate Theory into Practices

41. The Way Forward : The Decision is yours

42. Life Style The sexual choices you The sexual choices you decide to make will determine YOUR YOURFUTURE