Introduction

What is HIV and AIDS?

HIV or Human Immunodeficiency Virus is the virus that causes AIDS. The HIV infection will gradually destroy the body’s immune system, making it vulnerable to a whole range of infections and cancers.

AIDS stands for ‘Acquired Immunodeficiency Syndrome”. It is a collection of sysmptoms, signs. Infection and cancers resulting from the damage to immune system caused by the HIV. AIDS is the final stage and most severe from of HIV infection.

Based on UNAIDS estimates, the number of people living with living with HIV/AIDS worldwide in 2007 is estimated to be 33.2 million, with 2.5 million newly infected and 2.1 millions deaths.

HIV Transmission

How do people get HIV infection?

HIV is only infectious in body fluids such as blood, semen, vaginal secretion, breast milk. There are few ways HIV can be transmitted from any infected persons to others, such as through :

• Unprotected sexual intercourse with an infected partner (including vaginal, anal or oral)
• Sharing infected needles & syringes (common among drug users)
• Through transfusion with contaminated blood, blood products or organ transplants
• Transmission from infected mother to her baby during pregnancy, at birth or breast-feeding

How HIV cannot be spread?

HIV cannot survive outside human body and cannot be spread by :

• casual body contact such as sitting next to someone, shaking hands, hugging or working with people.
• sharing public facilities such as phones, swimming pools, public toilets and transportation.
• sharing food or utensils such as plates, glasses or cups.
• sneezing, coughing, sweating or through urine.
• insects such as mosquito bites.

Signs and symptoms

What are signs and symptoms of HIV infections?

Most people who are infected with HIV do not know that they have become infected. However, some people may develop fever, sore throat, rash, joint pain, fatigue and enlarged lymph nodes, for a brief period, usually one to six weeks after being infected with HIV.

Following that stage, an infected person may look healthy and normal altough the have HIV in his/her blood. Even though they have no symptoms and signs of HIV-related illness or AIDS for many years, they are able to transmit the virus to others. Probability of HIV test (to detected antibody to the virus) to be positive at this stage is high.

What is the presentation of AIDS?

When the immune system of a HIV-infected person becomes weaker, he/she the person may start to fall ill and have opportunistic infections or some cancers which are rarely accur among person with normal immune status. Majority of them, if not treated, develop signs of AIDS within 10-15 years of HIV infections.

Some of the common conditions of AIDS include :

• skin manifestations and prolong rashes
• fever and cough due to recurrent upper respiratory tract infections
• pulmonary tuberculosis and severe pneumonia (e.g Pneumocystis carinii pneumonia)
• chronic and prolong diarrhea
• infections of the brain (e.g toxoplasmosis)
• severe fungal infections (e.g candidiasis) of the oral cavity and alimentary tract
• certain rare form of cancers (e.g Kaposi’s Sarcoma)

On average, within 2 years at AIDS stage without treatment, the person may die from severe infections, weight loss and weakness.

Where can a person get HIV test and counseling?

Voluntary and confidential HIV tests to know one’s status is available in almost all government hospital and health clinics. An anonymous, free and quick HIV testing, with result in less than 15 minutes (using rapid HIV test kit), is also available.

Pregnant mothers attending government clinics for antenatal check-up are routinely screened for HIV. This is very important measures to detect positive mothers so that counseling, early treatment and other medical care can be provided to reduce HIV transmission to her baby.

Pre and post test counseling will be provided by the health staff whenever a HIV test is conducted. This counseling is very useful so that understanding about HIV/AIDS, risk reduction strategies and supportive advice can be given based on their test results.

Treatment and care

At present, there is no medication to cure HIV/AIDS completely. However, progression of the disease can be slowed down by the use of anti – retrovial (ARV) drugs, which will prolong and improve the quality of life.

For most patients, they may not require specific drug treatment in early phase of HIV infection, expect for regular monitoring on the infection progress. However, those with the following criteria are eligible and recommended for ARV treatment :

• who exhibit AIDS symptoms
• whose CD4 (a type of white blood cells) is lower than 200 cell/ml
• whose viral load is higher than 30,000 copies/ml, and
• who can adhere to treatment schedule (to prevent occurrence of drug resistance)

Recently, the Ministry of Health has started providing free first line regime of combination ARV drugs, called Highly Active Anti-Retroviral Therapy (HAART) to eligible patients. This treatment is provided in major government hospitals and few selected health clinics.

People living with HIV/AIDS may have a prolong and quality life through adherence to ARV treatment, medical care, good nutrition and also with positive attitude and strong support from the family and community.

Prevention

Preventive measures among high risk groups and general public are very important because there is no cure for AIDS and no vaccine to protect a person from HIV infection. Common measures to prevent HIV infection are shown below :

• Sexual transmission of HIV can be prevented through ABC approach :
  • abstinence or no sex (A)
  • monogamous relations between uninfected partners or being faithful (B)
  • practice safe sex, including use of condoms (C)
• Use new disposable needles and syringes and avoid sharing injecting equipments
• Mother-to-child transmission can be reduced by the use of ARV drugs during pregnancy and labour, delivery by caesarian section technique for delivery and avoid breastfeeding to newborn child
• Health-care workers must always practice standard precautions and prevent injuries caused by needles and other sharp instruments
• Those who think they have been exposed to HIV, should go for voluntary HIV testing and take precautions to prevent spread of HIV to others
• Healthy lifestyle guided by religious and moral values

Contacts

AIDS/STD Section
Disease Control Division
Ministry of Health
Level 4, Block E10, Parcel E
62518 Putrajaya
Tel : 03-88834387
Fax : 03-88834285 Website : http://dph.gov.my/aids

The Malaysian AIDS Council
No. 12, The Boulevard Shop Office
Jalan 13/48A, Off Jalan Sentul
51000 Kuala Lumpur
Tel : 03 – 4045-1033
Fax : 03 – 4042-6133
Email : contactus@mac.org.my
For counseling: Toll free line at 1-800-88 18 48 or email : counseling@mac.org.my

Persatuan Pengasih Malaysia (PENGASIH)
Tel : 03 – 6201 3179 / 0287
Fax : 03 – 6201 3013 / 5940
E-mail : ppm@pengasih.net Website : http://www.pengasih.net

Community AIDS Service Penang (CASP)
Tel : 04 – 229 9566 / 7412
Fax : 04 – 228 1624
E-mail : aidspg@tm.net.my

Federation of Family Planning Associations Malaysia (FFPAM)
Tel : 03 – 5633 7514 / 16 / 28
Fax : 03 – 5634 6638
E-mail : ffpam@po.jaring.my or ffpam2@tm.net.my

Islamic Medical Association of Malaysia (PPIM) wakekl@tm.net.my
Tel/Fax : 03 – 9172 1533
E-mail : abdhaq@pl.jaring.my or jeffrey@mail.hukm.ukm.my
Website : http://www.ppim.org.my

PT Foundation (PTF) Tel : 03 – 4044 4611 Fax : 03 – 4044 4622 E-mail: hishamhu@csd.tnb.com.my<
Sarawak AIDS Concern Society (SACS)
Tel : 019 – 857 9423
Fax : 03 – 4044 4622
E-mail : khaliku@normah.com

Women and Health Association of Kuala Lumpur (WAKE)
Tel : 03 – 2692 6861
Fax : 03 – 2692 6877
E-mail : wakekl@tm.net.my

Persatuan Perantaraan Pesakit-Pesakit Kelantan (SAHABAT)
Tel : 09 – 7472 119 / 012-9620656
Fax : 09 – 7502 504

Websites for further references and additional information

• http://dph.gov.my/aids/
• http://www.who.int/hiv/en/
• http://www.unaids.org/en/default.asp
• http://www.cdc.gov/hiv/dhap.htm