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AIDS: Grim reality

HIV/AIDS has emerged as a global crisis since its discovery in 1981. It affects residents of all countries of the world, greater majority being the individuals residing in the developing countries.The global impact of the HIV epidemic has been so histrionic and distressing that it has been described as the “epidemic of our century”.

India is among 3rd highest HIV prevalence, and Karnataka among the top six states having the peak recorded cases of HIV. Mysuru district was ranked third in the state in the prevalence of HIV/ AIDS cases in 2008, possible reasons for this scenario could have been Mysuru’s tourist attraction, increased flowing population, major transport route connecting Tamil Nadu and Kerala, cosmopolitan life and lack of knowledge about the disease among the people.  Over the years, the situation in Mysuru has improved with a drastic slump in the number of HIV/AIDS cases.

HIV spreads through

  • Blood
  • Semen
  • Pre-seminal fluids
  • Rectal fluids
  • Vaginal fluids
  • Breast milk
  • Needles & syringes.

 

Oral manifestations of HIV:

Oral manifestations are the earliest and most important indicators of HIV infection, it not only indicates infection with human immunodeficiency virus (HIV), they are also among the early clinical features of the infection and can predict progression of HIV disease to acquired immunodeficiency syndrome (AIDS). Disease progression is characterized by an increased prevalence of oral candidiasis, oral hairy leukoplakia, ulcerative periodontal disease and xerostomia (dryness of mouth).

  • Lesions strongly associated with HIV infections are Candidiasis, Hairy Leukoplakia, periodontal disease (ulcerative gingivitis and ulcerative periodontitis), Kaposi sarcoma, Non-Hodgkin’s lymphoma.
  • Less commonly associated lesions are bacterial infections such as Tuberculosis, salivary gland disease, melanotic hyper pigmentation, ulcerative stomatitis. Viral infections like herpes simplex herpes zoster, varicella, and Human papilloma virus infections.

 

Self-examination of the oral health:

Check out for any abnormal change in color of the gums like red band surrounding the margins of gums with occasional bleeding  or the ulcerative lesion on gums, grayish white patch on buccal mucosa, and hairy patch on tongue, white patch in mouth which is scrape able. Any of these abnormalities detected, should be reported to the doctor.  

 

Actions taken for the slump in HIV cases in Myuru:

  • Screening of adult population in HIV testing centers opened in all PHCs in the district.
  • Travel allowance introduced for patients obtaining treatment at antiretroviral therapy centers.
  • A number of NGOs have been linked into spread awareness on how to prevent HIV infection. They have been educating HIV- positive patients on precautions to be taken. Sex workers are being educated on the precautions to avoid transmission of disease.
  • Prevention of vertical transmission of HIV in Mysore district highlights the integration of Prevention of parent to child transmission (PPTCT) and reproductive and child health (RCT). Karnataka has been one of the first states in India to integrate HIV services with RCH services and there by ensure universal availability of counselling, testing and treatment for all HIV positive pregnant women.

Preventive Measures at mass level-

  • Availability of Free condoms at public places like interstate bus stations, City bus stations, Railway station, Toll tax booths and hospitals.
  • Education to Use a condom correctly every time when you have vaginal, anal, or oral sex. (Wear & tear or rip of condoms).
  • Public education promotion programs on knowledge of sex education at secondary and Senior Secondary school level.
  • Type of” Touch” to all students to avoid child abuse & sexual harassment.
  • Education to Drug users about needle use. Harmful reduction in needle users to prevent AIDS. Needle users are one of the mode of spreading AIDS because they share their injectable syringes.
  • “World AIDS day” promotion programs
  • Dissemination and enlightenment (distribution of booklet about safe sex, etc.)
  • Production of AIDS prevention posters & distribution to all primary health care centre and institutions level.
  • Public education through videos at public waiting areas, etc
  • Discussion/evaluation of measures for AIDS control
  • AIDS prevention information center programs
  • Blood products safety information system.
  • Involvement of same minded voluntary organisations for reaching the grass root level.
  • AIDS control measures for young people
  • Sex education to unregistered sex workers and making them aware about the importance of Condoms, before establishing any kind of physical relations.

Doctor’s friendly step: Advice the patient to undergo blood test related to HIV & Hepatitis before performing any minor or major surgical procedure.  

– Dr  Sachin Sinha,  Dr Sobha Naik

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