EGERTON UNIVERSITY

COLLEGE OF OPEN AND DISTANCE LEARNING

E-CAMPUS

ZOOL 143: Biology of HIV/AIDS and Society

Topic 9 Handout

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Published 2020
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Topic Nine: Prevention of HIV/AIDS Disease

Introduction

Welcome to topic nine. Anybody can contract HIV and become infected. An
effective response in HIV prevention is anchored in three strategies, which are
highly inter-related. These are strategies against HIV transmission through: i)
mother-to-child, ii) blood and blood products and; iii) through sexual activity.
These form the focus of our discussion in this topic.

Learning Outcomes

By the end of this topic you should be able to:

i. Discuss HIV/AIDS disease prevention strategies anchored on

mother-to-child transmission.
ii. Describe HIV/AIDS disease prevention strategies anchored on blood
and blood products.
iii. Explain HIV/AIDS disease prevention strategies anchored on sexual
activity.

9.1 Prevention of Mother-to-Child Transmission (PMTCT) Strategies

Many children acquire HIV through Describe HIV/AIDS disease strategies

anchored on mother-to-child transmission. Mother-to-child transmission occurs
during pregnancy, labour and delivery, or as a result of breastfeeding. Prevention
of mother-to-child transmission (PMTCT) involves: giving birth in a health
facility to ensure no contamination; practicing non-breastfeeding; and giving
ARVs (Nevirapine and Zidovudine) to the newborn; Preventing OIs infections e.g.
STDs and malaria.

9.2 Strategies against HIV Transmission through Blood and Blood Products

a) Screening blood for transfusion

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 Blood safety is achieved through mandatory screening of donated blood,
relying on low-risk donors, promoting appropriate clinical use of transfused
blood.

b) Practicing no contact with injuries

Individuals must adhere to no contact with open wounds on infected

persons.

c) Controlling infection in health-care settings

Health-care workers adhere to ‘universal precautions such as assumes all

individuals are potentially infectious, hence wear gloves, use gowns, masks
and goggles

9.3 Strategies Against HIV Transmission Through Sexual Activity

a) Reducing Vulnerability

Vulnerability to HIV exposure is an individual or community’s inability to

control their risk of infection. Effective prevention requires policies that
help reduce the vulnerability of large numbers of people.

Initiatives that enhance economic and social development and empower

women and girls also contribute to effective AIDS responses. For example,
in South Africa, mining companies have built family houses to replace the
overcrowded, single-sex hostels for their migrant mine workers.
Eliminating school fees in Uganda and Kenya helps get new poor pupils
into school and keep young people, notably girls, in school. International
cooperation policies in preventing human trafficking for sexual exploitation
reduces the number of young people exposed to an extremely high risk of
HIV, violence and other human rights abuses.

Similarly, a fiscal policy with greater capacity to promote economic growth

and job creation will offer households a higher living standards and greater
access to resources and skills (Figure 9.3).

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Figure 9.1: An alternative macroeconomic strategy capable of breaking the
vicious poverty cycle

b) Preventing sexual transmission by combination prevention

The term ‘combination or comprehensive prevention’ refers to the

combination of strategies required to prevent sexual transmission. These
are often referred to as the ABCDs of combination prevention:

• A means abstinence - not engaging in sexual intercourse or

delaying sexual initiation. Whether abstinence occurs by delaying
sexual debut or by adopting a period of abstinence at a later stage,
access to information and education about alternative safer sexual
practices is critical to avoid HIV infection when sexual activity
begins or is resumed.
• B means being safer - by being faithful to one’s partner or
reducing the number of sexual partners. The lifetime number of
sexual partners is a very important predictor of HIV infection.
Thus, having fewer sexual partners reduces the risk of HIV
exposure.
• C means correct and consistent condom use - condoms reduce
the risk of HIV transmission for sexually active young people,
couples in which one person is HIV-positive, sex workers and
their clients, and anyone engaging in sexual activity with partners
who may have been at risk of HIV exposure.

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 • D means discuss HIV and AIDS - with friends, relatives and
family members. Counseling on safe sex practices so that
individuals are clear about what is and what is not safe, is
imperative. Safe sex is any form of sex in which HIV does not
pass from one person directly into another. This definition is
specific to HIV/AIDS and does not attempt to deal with other
STDs.

c) Creating awareness through AIDS education

Although the epidemic is well into its third decade, basic AIDS education
remains fundamental to the response. For effective behaviour-change
among low- to medium income groups, prevention programmes usually
include educational and communications components, using a range of
media, from traditional theatre and music, to global television and radio
networks. Clearly, as a prevention tool, HIV education alone has its limits.
Nevertheless, information is critical to helping people gain an accurate
understanding of how HIV is transmitted and how it can be prevented.

d) Behaviour change and maintenance programmes

Effective approaches for young people and children involve life-skills-

based education that promotes the adoption of healthy behaviours. These
include taking greater responsibility for their own lives, making healthy
choices, gaining strength to resist negative pressures and minimizing
harmful behaviours. Programmes to change HIV risk behaviour and sustain
healthy behaviour provide essential health information.

e) Controlling infection in health-care settings

incidences of transfusion with contaminated blood has declined due to

practices such as mandatory screening of donated blood, relying on low-risk
donors, and promoting appropriate clinical use of transfused blood. To
prevent transmission of HIV or other blood-borne diseases, health-care
workers adhere to ‘universal precautions’, an approach that assumes all
individuals are potentially infectious. This requires wearing gloves when
exposure to any bodily fluid is possible, and using gowns, masks and
goggles if splattering is likely.

f) Preventing and treating STIs

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 Untreated sexually transmitted infections (STIs) dramatically increase the
risk of HIV transmission through unprotected sex. Most of these sexually
transmitted infections can be prevented by using condoms. Moreover,
many bacterial sexually transmitted infections (e.g., syphilis, gonorrhoea
and Chlamydia) and parasitic infections (e.g., Trichomonas infection) can
be treated easily and inexpensively with antibiotics. Unfortunately, poor
diagnosis and treatment is hampering HIV prevention efforts.

g) Treating HIV/AIDS Infection

There is currently no vaccine or cure for HIV or AIDS. The only known
methods of prevention are based on avoiding exposure to the virus or,
failing that, an antiretroviral treatment directly after a highly significant
exposure, called post-exposure prophylaxis (PEP).

Current treatment for HIV infection consists of HAART. This has been
highly beneficial to many HIV-infected individuals since its introduction in
1996 when the protease inhibitor-based HAART first became available.

h) HIV Testing and Counselling

Many people in SSA do not know their HIV status since uptake of VCT has
been suboptimal. Provider-initiated counseling and testing (PICT) has been
introduced to ensure that HCT becomes the standard of care in all
consultations with health providers.

Topic Summary

In this topic, we have learned that:

• Several prevention strategies anchored on routes of transmission include

prevention of mother-to-child transmission, blood screening, combination
prevention, awareness creation, behaviour change and maintenance
programmes, HCT services, ART, prevention and treatment of OIs and
STIs.

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