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This book has been uploaded to Appropedia by [http://www.appropedia.org/User:P.A.Leslie Patrick Leslie], [http://www.appropedia.org/User:L.Crofoot Lisa Crofoot], [http://www.appropedia.org/User:Szimmerling Stephanie Zimmerling], [http://www.appropedia.org/User:Nate_Preston Nathaniel Preston] and [http://www.appropedia.org/User:Ayonshahed Ayon Shahed]. 
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Bibliographic Information: Rubenson, B. (1987)  ''What is AIDS? A manual for health workers''. Geneva, Switzerland: Christian Medical Commission.  
''This book has been uploaded to Appropedia by [[User:P.A.Leslie|Patrick Leslie]], [[User:L.Crofoot|Lisa Crofoot]], [[User:Szimmerling|Stephanie Zimmerling]], [[User:Nate Preston|Nathaniel Preston]] and [[User:Ayonshahed|Ayon Shahed]]''


<big><big><big>AT Reference Library</big></big></big>
Bibliographic Information: Rubenson, B. (1987) ''What is AIDS? A manual for health workers''. Geneva, Switzerland: Christian Medical Commission.


A project of Volunteers in Asia
Part of the [[AT Sourcebook]]


<br> <big><big>What is AIDS? Manual for Health Workers</big></big>
A project of Volunteers in Asia


By: Christian Medical Commission
== What is AIDS? Manual for Health Workers ==


<br> Published by: &nbsp; &nbsp;Christian Medical Commission  
By: Christian Medical Commission


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; World Council of Churches
Published by: Christian Medical Commission


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 150 Route de Ferney 1121 Geneva 20  
:World Council of Churches
:150 Route de Ferney 1121 Geneva 20
:Switzerland


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Switzerland
Available from: Christian Medical Commission


<br>
:World Council of Churches
:150 Route de Ferney 1121 Geneva 20
:Switzerland


Available from: &nbsp; Christian Medical Commission
Reproduced with permission


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; World Council of Churches
Reproduction of this microfiche document in any form is subject to the same restrictions as those of the original document.


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 150 Route de Ferney 1121 Geneva 20
<big><big><big>What is AIDS?</big></big></big> <big><big>A Manual for Health Workers</big></big>


&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Switzerland
Published by the Christian Medical Commission, 1987 – Birgitta Rubenson


<br>
Any parts of this book, including the illustrations may be copied, reproduced, or adapted to meet local needs, without permission from the author or publisher, provided the parts reproduced are distributed for free or at cost – not for profit. For any reproduction with commercial ends, permission must first be obtained from the author or publisher. The author would appreciate being sent a copy of any materials in which text or illustrations have been used.


Reproduced with permission
We are also in the process of producing the manual in French, Spanish and Portuguese.


Reproduction of this microfiche document in any form is subject to the same restrictions as those of the original document.  
We thank MacMillan Press (Nutrition and Families, by Jean Ritchie), MEDEX and VHAI foe permission to use their illustration and, Ingrid Hartig for her drawings.


<br> <big><big><big>What is AIDS?</big></big></big> <big><big>A Manual for Health Workers</big></big>
We also thank the Special Programme on AIDS at WHO for their cooperation in the preparation of this publication.


Published by the Christian Medical Commission, 1987 – Birgitta Rubenson
This small manual is written to help health workers learn about this new disease called AIDS. It is a new deadly infection, for which there is yet no cure, and no vaccine. It is a disease, which has spread to most countries around the world.


<br> Any parts of this book, including the illustrations may be copied, reproduced, or adapted to meet local needs, without permission from the author or publisher, provided the parts reproduced are distributed for free or at cost – not for profit. For any reproduction with commercial ends, permission must first be obtained from the author or publisher. The author would appreciate being sent a copy of any materials in which text or illustrations have been used.  
In June 1986 the World Council of Churches organized a consultation, to study how the churches could be involved in the AIDS crisis. The churches were called to respond to the crisis, in three areas: pastoral care, social ministry and education-prevention. In the WCC the Christian Medical Commission (CMC) is one of the three sub-units with the responsibility to support the churches in this task. This small manual is one of our contributions towards this.


<br> We are also in the process of producing the manual in French, Spanish and Portuguese.  
AIDS is a disease which is mainly sexually transmitted, and as such, is dependent on actions taken by the individual person. Education for prevention is the only possible way to control the spread. A change of risk-behaviour to responsible sexual behaviour is necessary. Sex must be seen as part of a long-term faithful relationship, not as a consumption of good, available when wanted, possibly for money. AIDS is related a great deal to the life style, but also depends on the health status at the time of exposure. The existence, or non-existence of reliable basic health services also influences the spreading of the infection. So, the activities to care for AIDS patients and to control the spread must be seen as an integral part of Primary Health Care.


We thank MacMillan Press (Nutrition and Families, by Jean Ritchie), MEDEX and VHAI foe permission to use their illustration and, Ingrid Hartig for her drawings.  
Health workers must care with love and compassion for these patients, who are sick and dying. They must know how to inform those who might be carriers of the virus and how not to spread it. And most of all, they must share with the community their knowledge about the disease and the responsibility to control its spread.


We also thank the Special Programme on AIDS at WHO for their cooperation in the preparation of this publication.  
The first cases were diagnosed in North American, Europe and Central Africa at about the same time. These have remained the regions with the highest number of cases, but 113 counties from all regions of the world are now reporting AIDS cases. The number of patients with AIDS is a reflection of the number of HUB-carriers, of whom the majority will develop the disease within 5 to 10 years. In North American and Europe, the disease is mainly spread among homosexual men and drug abusers, while in Africa, it is spread in all groups of society.


<br> This small manual is written to help health workers learn about this new disease called AIDS. It is a new deadly infection, for which there is yet no cure, and no vaccine. It is a disease, which has spread to most countries around the world.  
We hope that this manual will be useful in your work. If you have any suggestions or question, or need additional information, you can write to us at the Christian Medical Commission. If you need sterilization equipment, or syringes and needs and cannot receive it through normal channels of supply, we will try to help you.


<br> In June 1986 the World Council of Churches organized a consultation, to study how the churches could be involved in the AIDS crisis. The churches were called to respond to the crisis, in three areas: pastoral care, social ministry and education-prevention. In the WCC the Christian Medical Commission (CMC) is one of the three sub-units with the responsibility to support the churches in this task. This small manual is one of our contributions towards this.
More copies of this manual can be ordered from:


<br> AIDS is a disease which is mainly sexually transmitted, and as such, is dependent on actions taken by the individual person. Education for prevention is the only possible way to control the spread. A change of risk-behaviour to responsible sexual behaviour is necessary. Sex must be seen as part of a long-term faithful relationship, not as a consumption of good, available when wanted, possibly for money. AIDS is related a great deal to the life style, but also depends on the health status at the time of exposure. The existence, or non-existence of reliable basic health services also influences the spreading of the infection. So, the activities to care for AIDS patients and to control the spread must be seen as an integral part of Primary Health Care.
Christian Medical Commission


<br> Health workers must care with love and compassion for these patients, who are sick and dying. They must know how to inform those who might be carriers of the virus and how not to spread it. And most of all, they must share with the community their knowledge about the disease and the responsibility to control its spread.
World Council of Churches


<br> The first cases were diagnosed in North American, Europe and Central Africa at about the same time. These have remained the regions with the highest number of cases, but 113 counties from all regions of the world are now reporting AIDS cases. The number of patients with AIDS is a reflection of the number of HUB-carriers, of whom the majority will develop the disease within 5 to 10 years. In North American and Europe, the disease is mainly spread among homosexual men and drug abusers, while in Africa, it is spread in all groups of society.
150 Route de Ferney 1121 Geneva 20


<br>
Switzerland


We hope that this manual will be useful in your work. If you have any suggestions or question, or need additional information, you can write to us at the Christian Medical Commission. If you need sterilization equipment, or syringes and needs and cannot receive it through normal channels of supply, we will try to help you.
== What is AIDS? ==


<br> More copies of this manual can be ordered from:
It is Acquired Immune Deficiency Syndrome


Christian Medical Commission
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 was diagnosed in 1981. Since then there has been a rapid spread of the disease in North and South America, Europe and Africa. Cases are being reported from around the world, and most countries now have people with AIDS, or infected with the virus.


World Council of Churches
== What is HIV? ==


150 Route de Ferney 1121 Geneva 20
It is Human Immune deficiency Virus


Switzerland
HIV is a retrovirus, a group of virus that is still largely unknown. HIV was first described in 1983 in Paris. It has had several names during its short history, but HIV has now been accepted internationally.


<br>
The virus enters the T-helper cells of the immune system. In the cells it destroys genetic material, and the damage is permanent. All the body fluids contain T-helper cells. The concentration is high in BLOOD, SEMEN and VAGINAL SECRETION.


= What is AIDS? =
== Who is a Carrier? ==


It is Acquired Immune Deficiency Syndrome
Anybody who has the virus is a carrier and can infect others.


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 was diagnosed in 1981. Since then there has been a rapid spread of the disease in North and South America, Europe and Africa. Cases are being reported from around the world, and most countries now have people with AIDS, or infected with the virus.
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 him/her may have no symptoms, either.
 
<br>
 
= What is HIV?  =
 
It is Human Immune deficiency Virus
 
HIV is a retrovirus, a group of virus that is still largely unknown. HIV was first described in 1983 in Paris. It has had several names during its short history, but HIV has now been accepted internationally.
 
The virus enters the T-helper cells of the immune system. In the cells it destroys genetic material, and the damage is permanent. All the body fluids contain T-helper cells. The concentration is high in BLOOD, SEMEN and VAGINAL SECRETION.
 
<br>
 
= 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 him/her may have no symptoms, either.  


A person can be a carrier knowingly for many years before the virus has destroyed so much of the immune system that she/he falls ill.
A person can be a carrier knowingly for many years before the virus has destroyed so much of the immune system that she/he falls ill.


Some months after the infection the body has produced anti-bodies to the virus. These can be detected by a special tests.  
Some months after the infection the body has produced anti-bodies to the virus. These can be detected by a special tests.
 
<br>


= How does the virus spread? =
== 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.
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 not very active so the concentration o the virus in the fluid must be high to cause infection. Or the person must be exposed to the infection several times. The virus is spread
The virus is not very active so the concentration o the virus in the fluid must be high to cause infection. Or the person must be exposed to the infection several times. The virus is spread
*By sexual intercourse (homosexual or heterosexual) when one of the partners is infected
*By contaminated needles and syringes
*By transfusion of infected blood
*By an infected mother to her unborn child


<br>
* By sexual intercourse (homosexual or heterosexual) when one of the partners is infected
* By contaminated needles and syringes
* By transfusion of infected blood
* By an infected mother to her unborn child


= How does the virus '''not''' spread? =
== How does the virus '''not''' spread? ==


The virus is not spread through every day social contact such as:
The virus is not spread through every day social contact such as:
*Shaking Hands
*Living together
*Playing together
*Eating together


It is '''not''' spread by:  
* Shaking Hands
*Food
* Living together
*Water
* Playing together
*Communion cups
* Eating together
*Insects
 
*Toilet seats  
It is '''not''' spread by:
 
<br>
* Food
* Water
* Communion cups
* Insects
* Toilet seats


= How to Prevent the Spread of AIDS =
== How to Prevent the Spread of AIDS ==


There is no vaccine against AIDS.
There is no vaccine against AIDS.


HEALTH EDUCATION is very important. Everybody should know how to protect themselves from infection, by '''living responsibly'''. The whole community should be involved.  
HEALTH EDUCATION is very important. Everybody should know how to protect themselves from infection, by '''living responsibly'''. The whole community should be involved.
 
<br>


== Who Should Be Informed? ==
== Who Should Be Informed? ==


Everybody:
Everybody:
*Women
*Men
*School Children


<br>
* Women
* Men
* School Children


== What is a Responsible Lifestyle? ==
== What is a Responsible Lifestyle? ==
The AIDS virus is spread through semen, vaginal secretion, and blood.  Therefore:
*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 (male/female) 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
*Make sure instruments for circumcision are boiled


<br>
The AIDS virus is spread through semen, vaginal secretion, and blood. Therefore:


= Who is at Risk for Infection? =
* Have sex with only one faithful partner<ref>[http://www.gapminder.org/world/#$majorMode=map$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=f;st=f;nsl=t;se=t$wst;tts=C$ts;sp=10;ti=2007$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj1jiMAkmq1iMg;by=const$inc_y;mmid=YCOORDS;iid=pyj6tScZqmEfbZyl0qjbiRQ;by=const$inc_s;uniValue=8.21;iid=pyj6tScZqmEe1GaiYJX2qGA;by=ind$inc_c;uniValue=255;gid=CATID0;iid=pyj6tScZqmEfbZyl0qjbiRQ;by=ind$map_s;sma=49;smi=2.65$map_c;scale=lin$cd;bd=0$inds=; Gapminder: map on global spread of HIV</ref><ref>[http://www.gapminder.org/videos/ted-talk-2009-hans-rosling-hiv-facts/ Hans Rosling on the danger of having several partners in a same period]</ref>
* Use a condom if you know or suspect that you or your partner is infected
* Do not have sex with prostitutes (male/female) 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
* Make sure instruments for circumcision are boiled


Everybody who is exposed to the infection. But especially:
== Who is at Risk for Infection? ==
*Persons with venereal diseases and sores on their genital parts
*Persons who have many sexual partners
*Prostitutes (male/female) with many clients per day
*Patients receiving injections with non-sterile equipment
*Patients receiving untested blood from unknown donors


= AIDS and pregnancy  =
Everybody who is exposed to the infection. But especially:


AIDS can spread from the mother to the unborn child during pregnancy or delivery.
* Persons with venereal diseases and sores on their genital parts
* Persons who have many sexual partners
* Prostitutes (male/female) with many clients per day
* Patients receiving injections with non-sterile equipment
* Patients receiving untested blood from unknown donors


A pregnancy might cause the onset of AIDS.
== AIDS and pregnancy ==


A woman who know or suspects that she is an HIV-carrier should avoid becoming pregnant.  
AIDS can spread from the mother to the unborn child during pregnancy or delivery.


Some hospitals can make a test to find out if a person is infected. A woman who is unsure and wants a baby should try to have a test first. If she lives in an area with many persons with AIDS.  
A pregnancy might cause the onset of AIDS.


<br>
A woman who know or suspects that she is an HIV-carrier should avoid becoming pregnant.


== Does AIDS spread through breast-feeding?  ==
Some hospitals can make a test to find out if a person is infected. A woman who is unsure and wants a baby should try to have a test first. If she lives in an area with many persons with AIDS.


The virus has been found in breast-milk in low concentrations. It is not yet known if the small amount of virus in milk can infect the baby.
== Does AIDS spread through breast-feeding? ==


Many women do not know if they are infected or not.  
The virus has been found in breast-milk in low concentrations. It is not yet known if the small amount of virus in milk can infect the baby.


Since the risks of bottle-feeding are well-known, while the risks of breast-feeding by an infected mother remain unproven breast-feeding should always be encouraged.  
Many women do not know if they are infected or not.


<br>
Since the risks of bottle-feeding are well-known, while the risks of breast-feeding by an infected mother remain unproven breast-feeding should always be encouraged.


= AIDS and Immunizations =
== AIDS and Immunizations ==


To immunize, syringes and needles are used. These can be a source of infection.  
To immunize, syringes and needles are used. These can be a source of infection.


Everychild should be immunized with a sterile needle and syringe. Make sure that they are boiled for 20 mins.  
Every child should be immunized with a sterile needle and syringe. Make sure that they are boiled for 20 mins.


Where disposable needles are used, they should be put into a closed container and buried later.  
Where disposable needles are used, they should be put into a closed container and buried later.


Blood should never be aspirated into the need and syringe.  
Blood should never be aspirated into the need and syringe.


The risk of spreading AIDS through immunization programs is nil as needles and syringes are adequately sterilized.  
The risk of spreading AIDS through immunization programs is nil as needles and syringes are adequately sterilized.


<br>
== What the HIV-carrier should know ==


= What the HIV-carrier should know  =
Persons who suspect or know that they are HIV-carriers should:


Persons who suspect or know that they are HIV-carriers should:  
'''Avoid being reinfected by the AIDS virus''' '''Avoid spreading the infection by:'''


'''Avoid being reinfected by the AIDS virus''' '''Avoid spreading the infection by:'''<br> -not having sexual intercourse or<br> -using a condom<br> -washing their soiled linen or clothes themselves<br> -not giving blood for transfusion<br>
* not having sexual intercourse or
* using a condom
* washing their soiled linen or clothes themselves
* not giving blood for transfusion


'''Treat other infections as:'''<br> -tuberculosis<br> -venereal diseases, etc.<br>
'''Treat other infections as:'''


<br>
* tuberculosis
* venereal diseases, etc.


= How to care for a person with AIDS =
== How to care for a person with AIDS ==


Remember that these people 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.  
Remember that these people 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.


They may know 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. People with AIDS need time an 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 mush as they can.  
They may know 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. People with AIDS need time an 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 mush as they can.


Perhaps they want to talk to a pastor or counselor, or someone else, who can give them spiritual and emotional reassurance. The health worker should encourage this and arrange it.
Perhaps they want to talk to a pastor or counselor, or someone else, who can give them spiritual and emotional reassurance. The health worker should encourage this and arrange it.


<br>
== How to recognize a person with AIDS ==
 
= How to recognize a person with AIDS =


Some persons past through a first stage with fever and throat infections like a bad cold. They can then be without symptoms for a time period.
Some persons past through a first stage with fever and throat infections like a bad cold. They can then be without symptoms for a time period.
Line 236: Line 215:
The symptoms of AIDS are the same as for many other infections and a final diagnosis can only be made by testing.
The symptoms of AIDS are the same as for many other infections and a final diagnosis can only be made by testing.


<br>
== Diagnosing an adult with AIDS ==
 
= Diagnosing an adult with AIDS =


To make the diagnosis the person should show at least 2 major and 1 minor sign.
To make the diagnosis the person should show at least 2 major and 1 minor sign.


MAJOR SIGNS:
* MAJOR SIGNS:


-loss of more than 10% of body weight<br>
-loss of more than 10% of body weight
-chronic diarrhoea for more than 1 month<br>
-chronic diarrhoea for more than 1 month
-prolonged fever for more than 1 month<br>
-prolonged fever for more than 1 month


MINOR SIGNS:
* MINOR SIGNS:


-persistent cough for more than 1 month<br>
-persistent cough for more than 1 month
-generalized itchy skin disease<br>
-generalized itchy skin disease
-recurrent herpes zooster<br>
-recurrent herpes zooster
-chronic, generalized herpes simplex<br>
-chronic, generalized herpes simplex
-thrush in mouth and throat<br>
-thrush in mouth and throat
-swollen glands<br>
-swollen glands
-loss of memory<br>
-loss of memory
-loss of intellectual capacity<br>
-loss of intellectual capacity
-peripheral nerve damage<br>
-peripheral nerve damage


AIDS should be suspected, if the symptoms persist, especially in an area with many people with AIDS.
AIDS should be suspected, if the symptoms persist, especially in an area with many people with AIDS.


<br>
== Diagnosing a child with AIDS ==


= Diagnosing a child with AIDS  =
To make the diagnosis, the infant or child should show at least 2 major and 1 minor sign.
To make the diagnosis, the infant or child should show at least 2 major and 1 minor sign.


MAJOR SIGNS:
* MAJOR SIGNS:
 
-weight loss or slow growth
-chronic diarrhoea for more than 1 month
-prolonged fever for more than 1 month


-weight loss or slow growth<br>
* MINOR SIGNS:
-chronic diarrhoea for more than 1 month<br>
-prolonged fever for more than 1 month<br>


MINOR SIGNS:
-generalized swollen glands
-thrush in mouth and throat
-repeated common infections
-persistent cough
-generalized skin disease


-generalized swollen glands<br>
''Note from transcriber: Following side text (next paragraph) is missing content due to poor image quality.
-thrush in mouth and throat<br>
"Many children... have these sym... The diagnosis... confirmed if... of the parents... (or both) is a... ill."
-repeated common infections<br>
-persistent cough<br>
-generalized skin disease<br>
''
''
Note from transcriber: Following side text (next paragraph) is missing content due to poor image quality.''<br>
Many children ... have these sym... The diagnosis... confirmed if... of the parents... (or both) is a... ill.<br>
<br>


= How to treat a person with AIDS =
== How to treat a person with AIDS ==


There is still no drug available to cure AIDS. A few drugs such as ATZ can help slow down the process, but they are very expensive and in short supply everywhere.
There is still no drug available to cure AIDS. A few drugs such as ATZ can help slow down the process, but they are very expensive and in short supply everywhere.
Line 295: Line 269:
Where herbal medicines are traditionally used, their use should be encouraged to relieve pain, itching and fever, or any other symptoms.
Where herbal medicines are traditionally used, their use should be encouraged to relieve pain, itching and fever, or any other symptoms.


<br>
== Symptomatic Treatment ==
 
'''Diarrhoea'''
is a common symptom, especially among children. As with other diarrhoeas, it is important to prevent dehydration. Give:
-salt-sugar solution
-oral rehydration solution
-fluids
-Do '''not''' give antibiotics or antidiarrhoeal drugs


= Pages 27 to 32 =
'''Thrush'''
-paint with gentian violet
-rinse with mineral water


== Symptomatic Treatment ==
'''Herpes Zooster'''
-aspirin or paracetamol


'''Fever'''<br>This is a common symptom in both adults and children. Give: <br> -Much fluid<br> -Bath or cool rubbing<br> -Aspirin or paracetamol
'''Fever'''
This is a common symptom in both adults and children. Give:
'''Cough/Pneumonia/Otitis'''<br> -A course of antibiotics
-Much fluid
-Bath or cool rubbing
-Aspirin or paracetamol


'''Itching skin'''<br> -Antihistamine<br> -Pain reliever
'''Cough/Pneumonia/Otitis'''
-A course of antibiotics


<br>
'''Itching skin'''
-Antihistamine
-Pain reliever


== Where should a person with AIDS be treated? ==
== Where should a person with AIDS be treated? ==


'''Hospital/Health Centre'''
'''Hospital/Health Centre''' Patients who suffer badly from fever, diarrhea 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.
Patients who suffer badly from fever, diarrhea 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 and psychological needs of their sick member.


<br>
'''Home''' Persons who can be cared for at home should be sent home. Families can better respond to the social and psychological needs of their sick member.


== Patient care in the Hospital/Health Centre ==
== Patient care in the Hospital/Health Centre ==


'''Isolation'''
'''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.
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'''
'''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:
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:<br> -Soiled or bloodstained linen can transmit the virus<br> -Bleeding or infected wounds can transmit the virus
-Soiled or bloodstained linen can transmit the virus
<br>
-Bleeding or infected wounds can transmit the virus


WASH HANDS OFTEN
WASH HANDS OFTEN


<br>
== How to handle infected equipment ==
 
The AIDS virus can spread through the 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 only use STERILE syringes, needles and instruments. The virus is very fragile and dies at only 56ºC, or when soaked in common disinfectants.
 
There are four ways to sterilize equipment:


== How to handle infected equipment ==
# Boiling for 20 minutes
The AIDS virus can spread through the 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 only use STERILE syringes, needles and instruments. The virus is very fragile and dies at only 56⁰C, or when soaked in common disinfectants.
# Steam or pressure cooking, autoclaving
# Soaking for 20 minutes in disinfectant solution


There are four ways to sterilize equipment:<br><br> 1. Boiling for 20 minutes<br> 2. Steam or pressure cooking, autoclaving<br> 3. Soaking for 20 minutes in disinfectant solution<br>  - Chlorine: 5 gr per litre, or 1 per household bleach in 10 parts of water<br>  - Alcohol: 700 gr ethanol in 1 litre water<br><br>
- 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.
Solutions should be prepared fresh daily as they lose strength over time.
<br>


== How to handle soiled linen ==
== How to handle soiled linen ==


'''Laundry'''
'''Laundry''' Soiled or bloodstained laundry should be handled with care.
Soiled or bloodstained laundry should be handled with care.


To kill the virus, it should be either:<br><br>a) Soaked in a chlorine solution or<br> b) Boiled
To kill the virus, it should be either:


<br>
a) Soaked in a chlorine solution or
b) Boiled


== How to care for a person with AIDS at home ==
== How to care for a person with AIDS at home ==
A person 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 she/he is in well-known social surrounding where she/he feels more secure.


The relatives should be informed about the disease, how it spread and how it does not spread.  
A person 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 she/he is in well-known social surrounding where she/he feels more secure.
 
The relatives should be informed about the disease, how it spread and how it does not spread.


They should be taught how to protect themselves and how to care for the patient.  
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 given a disinfectant to use for cleaning clothes and utensils.


They should be informed that the patient can become emotionally and mentally disturbed.  
They should be informed that the patient can become emotionally and mentally disturbed.


The family needs support and should be visited, when possible.
The family needs support and should be visited, when possible.
== References ==
<references />
{{Page data
| type = Book
| published = 1987
| language = en
}}
[[Category:HIV]]
[[Category:Mech425]]

Latest revision as of 20:16, 9 June 2023

Content transfer completed on January 26th 2010

This book has been uploaded to Appropedia by Patrick Leslie, Lisa Crofoot, Stephanie Zimmerling, Nathaniel Preston and Ayon Shahed

Bibliographic Information: Rubenson, B. (1987) What is AIDS? A manual for health workers. Geneva, Switzerland: Christian Medical Commission.

Part of the AT Sourcebook

A project of Volunteers in Asia

What is AIDS? Manual for Health Workers[edit | edit source]

By: Christian Medical Commission

Published by: Christian Medical Commission

World Council of Churches
150 Route de Ferney 1121 Geneva 20
Switzerland

Available from: Christian Medical Commission

World Council of Churches
150 Route de Ferney 1121 Geneva 20
Switzerland

Reproduced with permission

Reproduction of this microfiche document in any form is subject to the same restrictions as those of the original document.

What is AIDS? A Manual for Health Workers

Published by the Christian Medical Commission, 1987 – Birgitta Rubenson

Any parts of this book, including the illustrations may be copied, reproduced, or adapted to meet local needs, without permission from the author or publisher, provided the parts reproduced are distributed for free or at cost – not for profit. For any reproduction with commercial ends, permission must first be obtained from the author or publisher. The author would appreciate being sent a copy of any materials in which text or illustrations have been used.

We are also in the process of producing the manual in French, Spanish and Portuguese.

We thank MacMillan Press (Nutrition and Families, by Jean Ritchie), MEDEX and VHAI foe permission to use their illustration and, Ingrid Hartig for her drawings.

We also thank the Special Programme on AIDS at WHO for their cooperation in the preparation of this publication.

This small manual is written to help health workers learn about this new disease called AIDS. It is a new deadly infection, for which there is yet no cure, and no vaccine. It is a disease, which has spread to most countries around the world.

In June 1986 the World Council of Churches organized a consultation, to study how the churches could be involved in the AIDS crisis. The churches were called to respond to the crisis, in three areas: pastoral care, social ministry and education-prevention. In the WCC the Christian Medical Commission (CMC) is one of the three sub-units with the responsibility to support the churches in this task. This small manual is one of our contributions towards this.

AIDS is a disease which is mainly sexually transmitted, and as such, is dependent on actions taken by the individual person. Education for prevention is the only possible way to control the spread. A change of risk-behaviour to responsible sexual behaviour is necessary. Sex must be seen as part of a long-term faithful relationship, not as a consumption of good, available when wanted, possibly for money. AIDS is related a great deal to the life style, but also depends on the health status at the time of exposure. The existence, or non-existence of reliable basic health services also influences the spreading of the infection. So, the activities to care for AIDS patients and to control the spread must be seen as an integral part of Primary Health Care.

Health workers must care with love and compassion for these patients, who are sick and dying. They must know how to inform those who might be carriers of the virus and how not to spread it. And most of all, they must share with the community their knowledge about the disease and the responsibility to control its spread.

The first cases were diagnosed in North American, Europe and Central Africa at about the same time. These have remained the regions with the highest number of cases, but 113 counties from all regions of the world are now reporting AIDS cases. The number of patients with AIDS is a reflection of the number of HUB-carriers, of whom the majority will develop the disease within 5 to 10 years. In North American and Europe, the disease is mainly spread among homosexual men and drug abusers, while in Africa, it is spread in all groups of society.

We hope that this manual will be useful in your work. If you have any suggestions or question, or need additional information, you can write to us at the Christian Medical Commission. If you need sterilization equipment, or syringes and needs and cannot receive it through normal channels of supply, we will try to help you.

More copies of this manual can be ordered from:

Christian Medical Commission

World Council of Churches

150 Route de Ferney 1121 Geneva 20

Switzerland

What is AIDS?[edit | edit source]

It is Acquired Immune Deficiency Syndrome

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 was diagnosed in 1981. Since then there has been a rapid spread of the disease in North and South America, Europe and Africa. Cases are being reported from around the world, and most countries now have people with AIDS, or infected with the virus.

What is HIV?[edit | edit source]

It is Human Immune deficiency Virus

HIV is a retrovirus, a group of virus that is still largely unknown. HIV was first described in 1983 in Paris. It has had several names during its short history, but HIV has now been accepted internationally.

The virus enters the T-helper cells of the immune system. In the cells it destroys genetic material, and the damage is permanent. All the body fluids contain T-helper cells. The concentration is high in BLOOD, SEMEN and VAGINAL SECRETION.

Who is a Carrier?[edit | edit source]

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 him/her may have no symptoms, either.

A person can be a carrier knowingly for many years before the virus has destroyed so much of the immune system that she/he falls ill.

Some months after the infection the body has produced anti-bodies to the virus. These can be detected by a special tests.

How does the virus spread?[edit | edit source]

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 not very active so the concentration o the virus in the fluid must be high to cause infection. Or the person must be exposed to the infection several times. The virus is spread

  • By sexual intercourse (homosexual or heterosexual) when one of the partners is infected
  • By contaminated needles and syringes
  • By transfusion of infected blood
  • By an infected mother to her unborn child

How does the virus not spread?[edit | edit source]

The virus is not spread through every day social contact such as:

  • Shaking Hands
  • Living together
  • Playing together
  • Eating together

It is not spread by:

  • Food
  • Water
  • Communion cups
  • Insects
  • Toilet seats

How to Prevent the Spread of AIDS[edit | edit source]

There is no vaccine against AIDS.

HEALTH EDUCATION is very important. Everybody should know how to protect themselves from infection, by living responsibly. The whole community should be involved.

Who Should Be Informed?[edit | edit source]

Everybody:

  • Women
  • Men
  • School Children

What is a Responsible Lifestyle?[edit | edit source]

The AIDS virus is spread through semen, vaginal secretion, and blood. Therefore:

  • Have sex with only one faithful partner[1][2]
  • Use a condom if you know or suspect that you or your partner is infected
  • Do not have sex with prostitutes (male/female) 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
  • Make sure instruments for circumcision are boiled

Who is at Risk for Infection?[edit | edit source]

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 (male/female) with many clients per day
  • Patients receiving injections with non-sterile equipment
  • Patients receiving untested blood from unknown donors

AIDS and pregnancy[edit | edit source]

AIDS can spread from the mother to the unborn child during pregnancy or delivery.

A pregnancy might cause the onset of AIDS.

A woman who know 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 unsure and wants a baby should try to have a test first. If she lives in an area with many persons with AIDS.

Does AIDS spread through breast-feeding?[edit | edit source]

The virus has been found in breast-milk in low concentrations. It is not yet known if the small amount of virus in milk can infect the baby.

Many women do not know if they are infected or not.

Since the risks of bottle-feeding are well-known, while the risks of breast-feeding by an infected mother remain unproven breast-feeding should always be encouraged.

AIDS and Immunizations[edit | edit source]

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 mins.

Where disposable needles are used, they should be put into a closed container and buried later.

Blood should never be aspirated into the need and syringe.

The risk of spreading AIDS through immunization programs is nil as needles and syringes are adequately sterilized.

What the HIV-carrier should know[edit | edit source]

Persons who suspect or know that they are HIV-carriers should:

Avoid being reinfected 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 as:

  • tuberculosis
  • venereal diseases, etc.

How to care for a person with AIDS[edit | edit source]

Remember that these people 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.

They may know 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. People with AIDS need time an 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 mush as they can.

Perhaps they want to talk to a pastor or counselor, or someone else, who can give them spiritual and emotional reassurance. The health worker should encourage this and arrange it.

How to recognize a person with AIDS[edit | edit source]

Some persons past through a first stage with fever and throat infections like a bad cold. They can then be without symptoms for a time period.

For some period before the final diagnosis can be made the person 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 the Africa, while pneumonia is common in the USA.

The symptoms of AIDS are the same as for many other infections and a final diagnosis can only be made by testing.

Diagnosing an adult with AIDS[edit | edit source]

To make the diagnosis the person should show at least 2 major and 1 minor sign.

  • 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 zooster
-chronic, generalized herpes simplex
-thrush in 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[edit | edit source]

To make the diagnosis, the infant or child should show at least 2 major and 1 minor sign.

  • 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

Note from transcriber: Following side text (next paragraph) is missing content due to poor image quality. "Many children... have these sym... The diagnosis... confirmed if... of the parents... (or both) is a... ill."

How to treat a person with AIDS[edit | edit source]

There is still no drug available to cure AIDS. A few drugs such as ATZ can help 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[edit | edit source]

Diarrhoea is a common symptom, especially among children. As with other diarrhoeas, it is important to prevent dehydration. Give:

-salt-sugar solution
-oral rehydration solution
-fluids
-Do not give antibiotics or antidiarrhoeal drugs

Thrush

-paint with gentian violet
-rinse with mineral water

Herpes Zooster

-aspirin or paracetamol

Fever This is a common symptom in both adults and children. Give:

-Much fluid
-Bath or cool rubbing
-Aspirin or paracetamol

Cough/Pneumonia/Otitis

-A course of antibiotics

Itching skin

-Antihistamine
-Pain reliever

Where should a person with AIDS be treated?[edit | edit source]

Hospital/Health Centre Patients who suffer badly from fever, diarrhea 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 and psychological needs of their sick member.

Patient care in the Hospital/Health Centre[edit | edit source]

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 or bloodstained linen can transmit the virus
-Bleeding or infected wounds can transmit the virus

WASH HANDS OFTEN

How to handle infected equipment[edit | edit source]

The AIDS virus can spread through the 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 only use STERILE syringes, needles and instruments. The virus is very fragile and dies at only 56ºC, or when soaked in common disinfectants.

There are four ways to sterilize equipment:

  1. Boiling for 20 minutes
  2. Steam or pressure cooking, autoclaving
  3. 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[edit | edit source]

Laundry Soiled or bloodstained laundry should be handled with care.

To kill the virus, it should be either:

a) Soaked in a chlorine solution or
b) Boiled

How to care for a person with AIDS at home[edit | edit source]

A person 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 she/he is in well-known social surrounding where she/he feels more secure.

The relatives should be informed about the disease, how it spread 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.

References[edit | edit source]

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