HIV PREVENTION &

CONTROL
-GROUP X RAY-
 WHY WE BOTHER TO PREVENT HIV?

• Number of people living with HIV in 2008

– Total 33.4 million [31.1 million–35.8 million]
– Adults 31.3 million [29.2 million–33.7 million]
– Women 15.7 million [14.2 million–17.2 million]
– Children under 15 years 2.1 million [1.2 million–2.9 million]

• People newly infected with HIV in 2008

– Total 2.7 million [2.4 million–3.0 million]
– Adults 2.3 million [2.0 million–2.5 million]
– Children under 15 years 430 000 [240 000–610 000]
Based on AIDS Epidemic Update 2009,UNAIDS and WHO
LEARNING OUTCOMES

a) Global Model to prevent HIV

b) Malaysia National Strategies

c) Antiretroviral Theraphy ( HAART) & PMCT

d) Universal Standard Precaution and post-

exposure prophylaxis
GLOBAL MODEL TO PREVENT HIV

• SAVE model of prevention

• ABC model of prevention

GLOBAL MODEL TO PREVENT HIV

SAVE model of prevention

• S -Safer Practices

• A -Available medication

• V -Voluntary counseling and testing

• E –Empowerment of the people living with

AIDS/HIV
GLOBAL MODEL TO PREVENT HIV

• S -Safer Practices

– covering all the different modes of HIV transmission.

– For example: safe blood for blood transfusion; barrier

methods for penetrative sexual intercourse; sterile

needles and syringes for injecting; and adoption of

universal medical precautions.

 GLOBAL MODEL TO PREVENT HIV
• A -Available medication

– Antiretroviral (ARV) therapy is by no means the only medical

intervention needed by people living with HIV.
– In order to start ART theraphy, some HIV-associated symptoms
have to be cured. Treating these infections results in better
quality of life, better health, and longer term survival.
– Every person needs good nutrition and clean water, and this is
especially true for people living with HIV and AIDS.
 GLOBAL MODEL TO PREVENT HIV

• V -Voluntary counselling and testing

– Individuals who know their HIV status are in a better position
to protect themselves from infection; and if they are HIV-
positive, from infecting another.
– Someone who is HIV-positive can be provided with
information and support to enable them to live positively.
– People who are ignorant of their HIV status, or who are not
cared for, can be sources of new HIV infections.
 GLOBAL MODEL TO PREVENT HIV

• E –Empowerment of the people living with AIDS/HIV

– Correct, non-judgmental information needs to be
disseminated to all.
– This will assist people to live positively - whatever their HIV
status - and to break down barriers which HIV has created
between people and within communities.
– Education also includes information on good nutrition, stress
management, and the need for physical exercise.
 GLOBAL MODEL TO PREVENT HIV

ABC model of prevention

• A : Abstinence

• B : Being Faithful

• C : Correct and Consistent Condom Wear

Source: 2004 Report on the global AIDS epidemic, UNAIDS
 GLOBAL MODEL TO PREVENT HIV
PRIMARY HIV PREVENTION
• ABC model of prevention
 GLOBAL MODEL TO PREVENT HIV

SECONDARY HIV PREVENTION

(PMCT- prevention of mother to child transmission)
• refers to early detection and prompt treatment of disease.
• Core interventions
1. HIV counseling and testing
2. ARV(antiretroviral) Prophylaxis
3. Safer delivery practices
4. Safer infant feeding practices
 GLOBAL MODEL TO PREVENT HIV

TERTIARY HIV PREVENTION

(care and support)
1. Prevention & treatment of opportunistic infections
2. ARV Treatment
> Standard antiretroviral therapy (ART) consists of the use of at
least three antiretroviral (ARV) drugs to maximally suppress the
HIV virus and stop the progression of HIV disease.
3. Palliative & non HIV care
4. Nutritional support
5. Reproductive healthcare
6. Psychosocial & community support
 MALAYSIA NATIONAL
STRATEGIES
• Provide information,education,and communication on
HIV
• Promotion of healthy lifestyle practice

• Early detection of HIV infection

• Screening of blood & blood product
• Infrastructure development and development of
medical assistance capacities, social and palliative care
of people living with HIV/AIDS, members of their
families and children affected by HIV/AIDS
MALAYSIA NATIONAL
STRATEGIES

• Extending coverage activities for voluntary

counselling and testing services in state medical
institutions and their development within the
framework of friendly youth health services
• Launched HIV or AIDS campaign
• Harm reduction for the vulnerable and at risk
group
 Prevention of Mother-To-Child
Transmission(PMCT)
• Introduced by Ministry of Health in 1998

• With this programme, the rate of vertical transmission of

HIV from HIV-infected mothers to children is about 4%

• The initial objectives of the programme are to detect HIV-

infected antenatal mothers and to provide interventions
as to reduced vertical transmission rate
 Prevention of Mother-To-Child
Transmission(PMCT)
• Ensure that maximal confidentiality of maternal HIV
status is maintained and obtain verbal consent.

• Wash infant with soap and water to remove maternal

blood or amniotic fluid prior to intramuscular injections
or blood sampling.

• Breast-feeding is NOT recommended irrespective of

maternal antiretroviral therapy (ART).
 Prevention of Mother-To-Child
Transmission(PMCT)
• Antiretroviral Drugs
• Breastfeeding Alternatives
– The chance of an HIV-infected mother transmitting
HIV to her newborn increases by up to half with
prolonged breastfeeding.
– Ideally, HIV-infected mothers should have access to
breastfeeding
– Alternatives, such as infant formula.

– Early weaning from breastfeeding may also help

minimize HIV transmission.
 Prevention of Mother-To-Child
Transmission(PMCT)
• Caesarean Delivery
– Caesarean delivery also significantly reduces the risk
of mother -to-child HIV transmission. However,
caesarean deliveries are often not available or practical
in developing countries, where many women lack
access to hospital birthing facilities.
 ANTIRETROVIRAL THERAPHY(HAART)

• Aggressive treatment regimen used to suppress

HIV viral replication and progression in HIV
patient.
 UNIVERSAL STANDARD PRECAUTION

• Standard precautions are considered the most

successful infection control in the health care
setting.
• Used for the care of all patients regardless of their
diagnosis and perceived infection status.
• Standard precautions apply to all patients who are
assume to be infectious
 STANDARD PRECAUTIONS PRACTICES

1. Hand washing
2. Appropriate use of personal protective equipment (PPE)
including gloves, mask, eye goggles, face shield and
gown.

3. Use of disposables and proper cleaning, disinfection

and sterilization of patient-care equipment.
4. Proper housekeeping and management of spillage.
5. Management of soiled/contaminated linen

6. Disposal of sharps and infectious wastes

Post-exposure Prophylaxis (PEP)

Following
Ocupational
exposure Following Non-
Ocupational exposure
(including sexual assault)

For children beyond

the perinatal period