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Aids is an infectious disease spread by a virus. It is called syndrome because it consists of several signs and symptoms .The first case of AIDS were diagnosed in 1981. Since then there has been a rapid spread of the disease in North and South America, Europe, Africa and Asia. Cases are being reported from around the world, and most countries now have people with AIDS, or infected with the virus.
The First case of AIDS in India was diagnosed in Madras in 1986.Today in India there are about twenty thousand HIV positive cases and 4000 full blown AIDS patients.In Tamilnadu there are about 75000 cases of HIV positive carriers and about 500 full blown AIDS cases.
WHAT IS HIV?
HIV is a retrovirus, a group of virus that is still largely unknown. The virus enters the T-helper cells of the immune system. In the cells it destroys genetic material, and the damage is permanent. All body fluids contain T-helper cells.The concentration is high in BLOOD, SEMEN and VAGINAL SECRETION.
WHO IS A CARRIER?
Anybody who has the virus is a carrier and can infect others.Very Often the person does not know that she/he is a carrier. She/He has no symptoms of disease and the person who infected her/him may have had no symptoms, either.
A person can be a carrier unknowingly for many years before the virus had destroyed so much of the immune system that she/he falls ill and dies quickly.Some months after the infection, the body has produced antibiotics to the virus. These can be detected by a special test.
HOW DOES THE VIRUS SPREAD?
AIDS is spread when blood, semen or vaginal secretion of an infected person come in contact with the blood or mucous membranes of a healthy person.
The virus is spread by:-
  • Sexual intercourse (homosexual or heterosexual), when one of the partners is infected.
  • Contaminated needles and syringes.
  • Transfusion of infected blood.
  • An infected mother to her unborn child.
WAYS, THE VIRUS DOES NOT SPREAD:-

The virus is not spread through everyday social contact such as:
  • Shaking hands
  • Living together
  • Playing together
  • Eating together
  • Mosquito bites
WHO SHOULD KNOW ABOUT AIDS/HIV?
The virus is spread by:-
  • Everybody
  • Parents
  • Teachers
  • Women
  • Adolescents
  • School age children
  • Children in schools
  • Out of schools
WHAT IS A RESPONSIBLE LIFE STYLE?
The Aids virus is spread through semen, vaginal secretion and blood. Therefore: Refrain - from Sex before or Outside of Marriage
  • Have sex with only one faithful partner.
  • Use a condom if you know or suspect that you or your partner is infected.
  • Do not have sex with prostitutes or people who go with them.
  • Do not have an injection, Except in a recognized health institution, where you are sure, the instruments are sterilized . Instead use tablets.
  • Make sure, instruments for circumcision, ear or nose piercing or tatooing are boiled, or disinfected.
  • For blood transfusion accept only blood that has been duly tested negative for HIV / AIDS.
WHO IS AT RISK FOR INFECTION?
  • EVERYBODY
  • Everybody who is exposed to the infection But Especially:
    • Persons with venereal diseases and sores on their genital parts.
    • Persons who have many sexual partners.
    • Prostitutes (Commercial Sex Workers)
    • Patients receiving injections with non-sterile equipment.
    • Intravenous Drug addicts who share the needle.
    • Patients receiving untested blood from unknown donors.
AIDS AND PREGNANCY
  • AIDS can spread from the mother to her unborn child during pregnancy or delivery.
  • A woman who knows or suspects that she is an HIV - Carrier should avoid becoming pregnant.
  • Some hospitals can make a test to find out if a person is infected. A woman who is not sure and a baby should try to have the  test first, if she lives in area with many persons who have AIDS.
DOES AIDS SPREAD THROUGH BREAST - FEEDING?

The virus has been found in breast - milk in very low concentrations. It is not clear, if it is sufficient to transmit the infection.
Many women do not know if they are infected or not.
Since risks of bottle feeding are well known, while the risks of breast feeding by an infected mother has not been sufficiently established.

BREAST FEEDING SHOULD ALWAYS BE ENCOURAGED
AIDS AND IMMUNIZATION
  • To immunize, syringes and needles are used these can be a source of infection.
  • Every child should be immunized with a sterile needle and syringe. Make sure that they are boiled for 20 minutes.
  • Where disposable needles are used, they should be put into a closed container and buried later.
  • Blood should never be aspirated into needle and syringe.
  • The risk of spreading AIDS through immunization programmes is nill as long as needles and syringes are adequately sterilized.

WHAT THE HIV CARRIER SHOULD KNOW?
Persons who suspect or know that they are HIV - carriers should:
Avoid being re-infected by the AIDS virus, avoid spreading the infection by
  • not having sexual intercourse or
  • using a condom.
  • washing their soiled linen or clothes themselves.
  • not giving blood for transfusion.
TREAT OTHER INFECTIONS WITH PROPER TREATMENT AS THE CARRIER MAY HAVE SUCH AS:
  • Tuberculosis
  • Venereal diseases, etc.
HOW TO PREVENT A PERSON FROM AIDS?

Remember that these patients are in need of social contact and support, just as we are. Their skin or breathing does not transmit the infection and they need physical and psychological closeness, as all of us do.
These patients may know that they have a deadly disease, especially once they know the diagnosis. This can cause fear, anxiety and anger.
Health personnel and relatives need to be prepared for this. The AIDS patients need time and help to struggle with these feelings . They need somebody who is prepared to listen and support them. They need to be encouraged to continue to live and take part in daily activities, as much as they can.
Perhaps they want to talk to a counselor, or someone else, who can give them spiritual and emotional reassurance. The health worker should encourage this and help arrange it.
SIGN AND SYMPTOMS OF A PERSON WITH AIDS
Some persons pass through a first stage with  fever and throat infections and a bad cold. They can then be without symptoms for a time period.
For some period before the final diagnosis can be made, the patient might suffer from different symptoms of infection. They are grouped into what is called ARC (AIDS, related complex).
The manifestation of the disease varies widely in the world. Some signs and symptoms are more common in certain parts than in others. "Slim Disease" stressing the weight loss, is most common in Africa, while pneumonia is common in USA.
In India, CANDIDIASIS present in the mouth and throat or slim disease or T.B. or Skin Disease are the most common manifestation of Aids.
The symptoms of AIDS are the same as for many other infections and a final diagnosis can only be made by blood test.
DIAGNOSING AN ADULT WITH AIDS
To make the diagnosis the person should show at least 2 major and 1 minor signs
MAJOR SIGNS:
  • Loss of more than 10% of body weight.
  • Chronic diarrhoea for more than 1 month.
  • prolonged fever for more than 1 month
MINOR SIGNS:
  • Persistent cough for more than 1 month.
  • Generalized itchy skin disease.
  • Recurrent herpes zoster or shingles, a painful inflammation of a sensory nerve with live of blisters usually on the abdomen or back or on the face.
  • Chronic, generalized herpes simplex - blisters in genital region.
  • Thrust - white patches or sore in the mouth and throat.
  • Swollen glands.
  • Loss of memory.
  • Loss of intellectual capacity.
  • Peripheral nerve damage.
  • AIDS should be suspected, if the symptoms persist especially in an area with many people with AIDS.
DIAGNOSING A CHILD WITH AIDS
To make the diagnosis, the infant or child should show at least 2 major and 2 minor signs.
MAJOR SIGNS:
  • Weight loss or slow growth.
  • Chronic diarrhoea for more than 1 month.
  • Prolonged fever for more than 1 month.
MINOR SIGNS:
  • Generalized swollen glands.
  • Thrush in mouth and throat.
  • Repeated common infections.
  • Persistent cough.
  • Generalized skin disease.
Many children have these symptoms. The diagnosis is confirmed if one of the parents (or both) is also ill.
HOW TO TREAT A PERSON WITH AIDS?
There is still no drug available to cure AIDS. A few drugs such as AZT can help to slow down  the process but they are very expensive and in short supply everywhere.
Patients suffering from symptoms, because they cannot fight infections, should be given treatment to ease these symptoms as far as possible. Everything should be done to make them feel comfortable.
Where herbal medicines are traditionally used, their use should be encouraged to relieve pain, itching and fever, or any other symptoms.
SYMPTOMATIC TREATMENT
Diarrhoea is a common symptom, especially among children, As with other diarrhoeas, it is important to prevent dehydration.

Give

  • Oral re-hydration solution.
  • Home fluids.
  • Do not give antibiotic or anti-diarrhoeal drugs.
MOUTH AND THROAT PROBLEMS

Soreness in the mouth, usually accompanied by white patches and surrounding redness, not only in the mouth but possibly in the throat and oesophagus.
Rinse the mouth with warm salt water (half a teaspoon full of salt in a cupful of water) or with a mouthwash solution after eating and between meals.
THRUSH

Thrush is a fungal infection that causes tiny white patches on the inside of the mouth and tongue. The infection looks like milk curds.
Gently scrub the tongue and gums with a soft toothbrush at least three or four times a day. Then rinse the mouth with dilute mouthwash or warm saltwater or lemon water.
Apply  gention violet solution, three or four times a day.
FEVER
This is a common symptom in both adults and children.
Give:
  • More fluids.
  • Bath or cool rubbing.
  • Aspirin or paracetamol.
COUGH / PNEUMONIA / OTITIS
  • A course of antibiotics.
ITICHING SKIN
  • Antihistamine
  • Pain releiver
WHERE SHOULD A PERSON WITH AIDS BE TREATED?
  • HOSPITAL / HEALTH CENTRE
    Patients who suffer badly from fever, diarrhoea and pain may need to be cared for in a medical institution for a period of time. They will need symptomatic treatment and nursing care.
  • HOME
    Persons who can be cared for at home should be sent home. Families can better respond to the social, psychological needs of their sick members.

PATIENT CARE IN HOSPITAL / HEALTH CENTRE
  • ISOLATION
    There is no need to isolate AIDS patients, for the sake of protecting others from the infection. Sometimes, though it may be necessary to isolate a patient to protect her/him from surrounding infections.
  • PERSONAL HYGIENE
    AIDS patients should be helped with their personal hygiene, just as everybody else. This can normally be done without risk. But some things should be remembered:
    • Soiled to bloodstained linen can transmit the virus.
    • Bleeding or infected wounds can transmit the virus.
HOW TO HANDLE INFECTED EQUIPMENT?

The AIDS virus can spread through use of syringes, needles and instruments, which have been in contact with the blood of a person who is carrying the AIDS virus, even if he is not sick. It is therefore IMPORTANT to use only STERILE syringes, needles and instruments. The virus is very fragile and dies at only 56o C. or when soaked in common disinfections. 
There are four ways to sterilize equipments:
  • Boiling for 20 minutes.
  • Steam or Pressure cooking, autocalving.
  • Soaking for 20 minutes in disinfectant solution:
    • Chlorine 5 gr per litre, or 1 per household bleach in 10 parts of water.
    • Alcohol 700 gr. Ethanol in 1 litre water.
  • Solutions should be prepared fresh daily as they lose strength over time.
HOW TO HANDLE SOILED LINEN?
  • Laundry.
  • Soiled or bloodstained laundry should be handled with care.
To kill the virus, it should be either:
  • Soaked in a chlorine solution or
  • Boiled.
HOW TO CARE FOR A PERSON WITH AIDS AT HOME?
  • A patient with AIDS is in need of both psychological support and physical care. As there is no cure that the health services can provide, the best care can often be given by the relatives. At home the patient is in well known social surroundings, where she/he feels more secure.
  • The relatives should be informed about the disease, how it spreads and how it does not spread.
  • They should be taught how to protect themselves and how to care for the patient.
  • They should be given a disinfectant to use for cleaning clothes and utensils.
  • They should be informed that the patient can become emotionally and mentally disturbed.
  • The family needs support and should be visited, when possible.
WHAT THE RELATIVES SHOULD KNOW?
Before relatives take a patient home they should know:
  • AIDS is not spread through social contract.
  • AIDS is not spread by skin contact.
  • AIDS patients need nutritious food to provide energy, protein and vitamins.
  • AIDS patients need to be touched and caressed.
  • Sexual intercourse with an AIDS patient leads to HIV infection.
  • Blood, vaginal secretion and semen of an AIDS patient are contagious.
  • Clothes and utensils which have been in contact with body fluids of the patient should be:
    • Boiled.
    • Soaked in a disinfectant.