AIDS

Auto Immune Deficiency Syndrome

huge Public Health/Economic Development problem

Copenhagen Consensus paper by AnneMills

• A large proportion of HIV is transmitted through the Sex Industry (Prostitution), especially in areas where condom use is low. Without protection from condoms, individuals already infected by other sexually transmitted infections (STI-s/STD-s) are particularly vulnerable to HIV infection. This risk factor is especially important in sub-Saharan Africa, where 90% of HIV infections are transmitted through heterosexual sex.

• Stover and colleagues (100) designed a model to determine if the Declaration ofCommitment, made by the United Nations General Assembly Special Session (UNGASS) in June 2001, to reduce the prevalence of HIV/AIDS by 25% by 2010 could be met. From a review of literature on effectiveness, they evaluated a general package of Preventive Care interventions that should be implemented in low-and middle- income countries to combat the Epidemic.

  • School-based AIDS education

  • Peer education for out-of-school youth

  • Outreach programmes for commercial sex workers and their clients

  • Condom social marketing

  • Treatment for STI-s

  • Public sector condom promotion and distribution

  • Voluntary counselling and testing

  • Workplace prevention programmes

  • Prevention of mother-to-child transmission

  • Mass media campaigns

  • Harm reduction programmes

  • Outreach programmes for homosexual men

• A successful battle against the HIV/AIDS epidemic requires political and social commitment at all levels. This has been developing slowly - as evidenced by the high levels of prevalence in much of SSA (Sub Saharan Africa), and the relatively few countries which are known for their high commitment to control (such as Uganda and Senegal). HIV/AIDS confronts countries with a unique challenge, since major routes of transmission include those which are illegal, or at least judged morally unacceptable. To the extent that the transmission route has to be openly acknowledged in order for it to be addressed, this poses great challenges to countries reluctant to accept, for example, that homosexual relationships are widespread in prisons, or that all levels of society frequent sexworkers. Commitment can take the form of government support to Public Health workers, such as meetings set up by the police between public health workers and brothel owners (20), and clear public messages. It has been argued that the impact of these measures is greatest when the public is actively involved in spreading these messages through the community because people are more likely to internalise the message and change their behaviour (104).