HIV/AIDS AMONG THE UNIFORMED PEOPLE

Introduction

            In the late 1970s, many individuals with rare types of cancers and infections started reporting to doctors in various part of USA.  It was found out that these patients were homosexuals whose immune systems have been weakened.  Such illness were also occurring in those with multiple sex partners, drug users and those receiving blood transfusions.  The evidence created suspicious that a germ carried in blood might be causing these diseases.  Within a few years, similar cases were reported from Africa, Australia, Europe and Asia.  Active research for defecting the germ responsible for the disease gathered momentum and the Human Immunodeficiency Virus (HIV) was first isolated in 1983 by Luc Montagavier in Paris.

The Modus Operndi of the Virus

            Like modern Guerilla the enemy (HIV), specializes in low intensity conflict (LIC).  Instead of frontal attack HIV infiltrates the Defense Forces of the human body, by entering and replicating with in the white Blood cells (the arms component of our immune system), and insidiously over a period of time with failing number of these vital immune cells, the body is left undefended against a host of bacteria, viruses and parasites present in the environment.  These take advantage of the weakened state of the body and lodge a frontal attack, causing a host of infections.  It is when these infections occur that a person is said to have AIDS.  That is why many of the illness that people with AIDS gets are called opportunistic infections.  It is like ravaging and plundering armies entering a country whose Defense Forces are in dismay due to unchecked Low Intensity Conflict over the years.

Major/Minor sings of AIDS

1.      The Major Signs of AIDS are

a)      Weight loss of more than 10% of body weight.

b)      Chronic diarrhoea of more than one month duration.

c)      Constant or intermittent fever of more than one month duration.      

2.      The Minor Signs of AIDS are

a)      Persistent cough of more than one month duration

b)      Generalized itching all over the body/skin

c)      Herpes Zoster seen as small blisters localized to small areas of skin.

d)      Oropharyngeal candidacies seen as whitish patches inside mouth and throat due to fungal   infection.

e)      Swelling of lymph nodes at many parts of the body.

A person is said to have AIDS when he/she has a positive blood test for HIV infection and the presence of at least two major signs along with at least one minor sign.  HIV like a true Guerilla doest not kill any body directly, but kills through other infections and cancers, which may affect any part of the body.  In India it has been noted that 83% of AIDS patients develop tuberculosis.

Entry Point of the HIV

There are three main ways the HIV enters the body.

1.      There are unprotected sexual intercourse with an infected person, ie., intercourse without a condom.Sexual intercourse refers to penetrative penis – vagina, penis – anus or oral sex.The highest risk is for receptive and intercourse with an HIV infected person.

2.   From exposure to blood, blood products or transplanted organs or tissues. Exposure to HIV infected blood may occur as a result of the transfusion of unscreened (untested) blood, the reuse of contaminated needles and syringes e.g. drug addicts.

3.      From infected mother to her baby, before, during or after birth.

HIV is not Transmitted By

1.      Ordinary Social Contact

(a)          Physical closeness (short of sexual intercourse)

            (b)        Staying in the same house/barrack

(c)          Breathing the same air, coughs & sneezes

(d)         At work

(e)          On the bus and while travelling together in other vehicles

(f)           At the market and other places where people get together

(g)          At School and other places where children get together

(h)          Playing together

2.      Touching

(a)          Shaking hands

(b)         Hugging

(c)          Kissing on the cheeks, hands or fore head etc.,

3.      Sharing

(a)          Toilet seats

(b)         Towels

(c)          Washing water, bath water

(d)         Swimming pools

(e)          Eating and drinking utensils

(f)         Work tools                                                                   

4.      By Bite of

(a)          Mosquitoes

(b)         Bed Bugs

(c)          Other insects

Global Estimates

As per the global estimates by the UNAIDS/WHO working group, the HIV/AIDS statistics at the end of year 1999 were as follows:

(a) People with HIV/AIDS – 34.4 million.

(b) AIDS death in 1999 – 2.8 million.

(c)  Cumulative AIDS death since the beginning of the pandemic – 18.8  

                  million 

(d) It has also been estimated that by the year 1999, there were 13.2

                  million AIDS orphaned in the world.

(e) The 1993 World Development Report of the World Bank ranked HIV as the forth    main cause of death among men and women aged 15-44 in the developing world.

Indian Scenario

(a)  Estimated HIV/AIDS cases at the National Level – 3.7 million.

(b) Surveillance findings from the states show that by June 2000 out of 3662969 persons  screened for HIV, 98451 were HIV positive giving positivity rate of 28.88 per thousand.

(c)  The cumulative number of AIDS cases in the country has risen to 12389
(d) It is realized that there is wide gap between the reported and estimated figures
              

            

What Needs To Be Done

           

Since HIV/AIDS is closely linked to Human Behaviors and has socio-economic implications for the affected persons, their families and the enemies, the whole problem should be viewed as an important developmental problem in the context of uniformed personal especially the Military community. The problem that can jeoparalise the armed forces readiness if not dealt with determination and perseverance.

The experience gained by various international and National Governmental and non governmental organizations in many countries of the world identifies some key factors for success of HIV/AIDS Control programmes.There are given below along with the explanations to the specific setting of the Armed forces.

1.Placing HIV/AIDS on the people agenda. HIV/AIDS should be on the commander’s agenda  who in turn could play a pivotal role in devising innovative ways to tackle the problem among their troop depending on the ethnic background of the unit.

2.Empowering people to deal with HIV/AIDS effectively – knowledge is power as Bacon said effective information, education and communication (IEC) activities will raise the common soldiers ability to discriminate effectively between potential routes of infection as a guide to the adoption of specific form of safer behavior.

3.Capacity building and strengthening people with leadership and communication skills in military units can be identified to impart peer group education.  The fight against AIDS needs effective leadership at junior levels also.

4.Targeted intentions, newly enrolled recruits, younger soldiers, troop separated from families, troop deployed in foreign lands are high risk of contracting HIV infections.  They should be targeted for IEC activities.

5.Creation of enabling environment for practicing prevention troops should feel free to communicate about sensitive topics like human sexuality, STD and AIDS. Winning their trust by accurate information on these aspects is essential, condoms should be easily available.

6.Training unit personnel.  Maximum number of unit personnel should be trained to communicate accurate information on HIV/AIDS to their peers specially new inductees.