The AIDS Handbook Revised

A guide to the prevention of AIDS and HIV

Jane Seymour

Due for publication early 2015, Macmillans


The aims of the book

AIDS was the most important new threat to world health to emerge during the last century. In the absence of an affordable and effective cure or vaccine health education directed at modifying risk behaviour is the only way in which the disease can be contained.

  This aim of this book is to prepare those who are becoming involved in AIDS education in their family, community and workplace. It is also intended to meet the needs of those wishing a basic introduction to the disease and how to reduce the risk of becoming infected. The emphasis in the book is on the special needs of those working in developing countries. Particular attention is directed at describing the pattern of AIDS and role of AIDS education in developing countries.

  The first priority for educating others is to learn about the disease ourselves so we can dispel the myths and rumours that surround AIDS and answer the searching questions that we will be asked by the community. The first four chapters will provide specific information on the disease, symptoms, extent of the problem, how it is transmitted. The factual chapters are followed by Chapter 5 which describe the actions to be take by communities to prevent the diseases and the role of UNAIDS and National AIDS Committees. Chapter six gives a brief review of counselling and its role in reducing risk behaviour and supporting those infected with HIV and AIDS. The final chapter provides guidelines on how to implement an action plan to run an AIDS education programme in your community.

  I have attempted to steer a middle path. I have avoided providing an over-simplified description with insufficient detail to help you deal with questions you may be asked. On the other hand I have tried to avoid too detailed and academic a treatment of what is a complex and rapidly changing subject. With topics surrounded by controversy and debate I have presented the current accepted view and have drawn heavily on discussions with the members of UNAIDS and their extensive series of technical memoranda. However, although some of the early experience on which this book is based was obtained while working as a consultant for the Global Programme on AIDS, this book represents my own views and not the official view of WHO or UNAIDS.

  At points in this book I have provided the names of specific drugs that are currently used to treat both AIDS and opportunistic diseases. You should consult your own national guidelines for details of current recommendations and specific doses. Many of the medicines should only be given under the supervision of health workers who are trained in their use. In addition you should always check expiry dates on medicines and specific instructions provided. 

  For those that wish to read more about AIDS, counselling and educational methods I have included a short bibliography as well as a list of WHO technical reviews. I have also included details of newsletters that will keep you up-to-date on new developments in this fast-moving field. AIDS is a topic that is particularly well served on the internet and I have included details of useful web sites.

  The stimulus for writing the book has been the expressed needs of my students at Leeds as well as participants on workshops and courses I have assisted in various countries in Africa. I would like to thank all of them for the ideas and suggestions that have contributed so much to this book.


Contents

Preface

Acknowledgements

 

 1 Introduction 

What is AIDS? - history;     How did it begin? The size of the problem - global level;  The global distribution of AIDS and HIV;   AIDS and development;  The cost of doing nothing

  2   The biology of the virus   

The Human Immunodeficiency Virus HIV; The immune system; Testing for HIV ;   Origins of HIV and AIDS

            3    Symptoms and disease         

Symptoms and disease progression;   Symptoms  Major signs  Minor signs  Diagnostic diseases; Other symptoms found in AIDS Patients; AIDS in children; Treatment and outcome; Treatment of HIV infection  Treatment of opportunistic infections including; TB, fungal and viral infections  Palliative and terminal care

4 Transmission          

Sexual transmission; Sexually transmitted diseases  Menstruation  Anal intercourse; Homosexuality; Masturbation, Blood route - Blood transfusions,Haemopheliacs and factor 8,  Injecting drug users,  Injections  Other practices involving skin piercing, Circumcision  Tissue and organ transplants; Mother to-child transmission,  Breast feeding; Oral route of infection; Saliva, ingestion through the mouth and kissing  Mouth-to-mouth resuscitation,Oral sex; Other routes by which HIV is not transmitted - Faeces and urine,  Transmission by insects,  Casual contact; Risks to health workers; Risk of transmission from health worker to patient, Risk to families of AIDS patients

5  Prevention     

Prospects for development of a vaccine; Changes in sexual lifestyles;  Reduction in number of partners  Low risk forms of sexual intercourse; Condoms; Safer sex;  Prevention of sexually transmitted diseases; Prevention of tuberculosis;   Making blood transfusion services safe; Prevention of transmission from mother-to-child; Voluntary counselling and testing for women; Injections and skin piercing procedures; Injections by injecting drug users; Promoting safe practices by health workers ; Public health measures; Testing and screening for HIV  Ethical issues, human rights and stigma of AIDS; AIDS and the law  National action for control of AIDS

6 Counselling and support for persons with HIV and AIDS           

The counselling process; The 'worried well' ; Pre-test counselling; Post-test counselling;  Voluntary counselling and testing (VCT) programme; Counselling women; The AIDS patient;; Hospitals and home-based care of persons with AIDS; The impact of AIDS on children and AIDS orphans; Organization of counselling services           

7  Action plan for AIDS Education      

Guidelines for effective education programmes; Encouraging a teamwork approach;  Choosing target groups; Involving the community;  Learning about your community; Choosing appropriate messages  How to put across your message; Planning educational programmes in the community; Reaching men;  Reaching women; AIDS education in the workplace; Reaching young people at school and colleges; Reaching young people out of school; Sex workers  AIDS education in prisons; Promoting condoms;  Using effective communication methods; Mass media: radio, television and newspapers printed materials; Person to person AIDS education; Advocacy; Evaluating your activities;  Sharing your experiences with others - building a global movement        

    Further information    

Details of key texts, newsletters and teaching materials, addresses of national and international agencies, some useful internet web sites

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