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HIV/AIDS Prevention and Treatment in Thailand

HIV/AIDS Prevention and Treatment in Thailand. Kittipong Vairojanavong M.D. Nittaya Vairojanavong M.A. National Council for Women, Thailand. Avert.org commented.

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HIV/AIDS Prevention and Treatment in Thailand

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  1. HIV/AIDS Prevention and Treatment in Thailand Kittipong Vairojanavong M.D. Nittaya Vairojanavong M.A. National Council for Women, Thailand

  2. Avert.org commented • There are very few developing countries in the world where public policy has been effective in preventing the spreads of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndromes) on a national scale but Thailand is an exception.

  3. History • First case was found in 1984 • Next few years, increase in incidence among * gay men * sex workers * injecting drug users * tourists • WHO reported that Thailand had the highest infected rate of 10 folds within a few years in FIGO Congress in Montreal 20 years ago.

  4. HIV/AIDS Situation in Thailand • In March 2006, Total population = 63 millions • Infected cases= 288,672, • Death cases = 81,584 • In 1991, there were 143,000 new cases but in 2003, there were only 19,000 new cases • Incidence rate declines during the last 7 consecutive years • Most common among people of 20-39 years of age • Male to female = 2:1 • At age 15 – 19 , more among female than male

  5. HIV/AIDS Prevention • No sex without protection • Condom usage is a “MUST”

  6. Prevention in General Population • Ministry of Public Health initiated “ 100 percent Condom Program” for general population • Condoms were distributed free of charge, NGOs provided strong support to this program • Raised condom usage had decreased the prevalence of sexual transmitted infections dramatically

  7. Detection of HIV • In 2 – 3 weeks after infected, acute retroviral syndromeoccurred: fever, sore throat enlarged lymph nodes, flu like illness, viremia,. Antigenemia, and later anti-HIV antibody. • Window period is the period prior to detect antibody, may last from 8 weeks to 6 months

  8. HIV Check Up • Blood and serum recipient • Homosexual • Unprotect sex • Have sex with HIV case • Sex with drug user • Multiple sexual partners • Sexual transmitted disease patient • Drug addicted • Pregnant women

  9. Diagnosis of HIV/AIDS • Detection of anti-HIV antibody: • Screening test: ELISA and GPA (gelatin particle agglutination) • Confirmatory test: immunoblot (western blot) and immuno fluorescent • Antigen (p24 antigen) assay (IFA)

  10. HIV/AIDS Therapy • 1987 AZT (had been used since) • Drugs used in the developing countries • Anti-infective agents to prevent opportunistic infections • Palliative drugs for physical and mental discomfort such as analgesics, tranquilizer. • Antiretrovirals (ARVs): to prevent and kill HIV prior to invade immune system and prevent HIV from mother to fetus

  11. HIV/AIDS Therapy • Right procedure • Continuous • Regular

  12. HIV Transmission from Mother to Fetus • During pregnancy, HIV penetrates placenta to fetus. This is hard to prevent • One to two weeks prior to delivery and intra-partum period are highly sensitive period of transmission up to 50-60 percentใ Prevention by cleansing birth canal with antiviral antiseptics, reduce chance of contact of maternal blood during labor • HIV from maternal milk, incidence of 20 percent

  13. Prevention of Transmission from Mother to Fetus • AZT (zidovidine) therapy at 36 weeks and during labor reduces the infection down 50 percent • AZT therapy to both mother and fetus reduces infection rate from 25-30% to 9.2% • AZT plus 3TC (lamivudine) for short period to mother from 34 weeks reduces infected rate down to 2.83 %, (three timeslower)

  14. HIV/AIDS Therapy • No drug to cure this disease yet but there are drugs to prevent progression of the disease • Side effects of the drugs are anemia, nausea and vomiting • Vaccines are in investigational periods ad may need more than 10 years to confirm the effectiveness of the vaccine

  15. GPO-VIR • Local made regimen • Less expensive but effective • 3 in 1 combination (stavudine + lamivudine + nevirapine)

  16. GPO-VIR (Government Pharmaceutical Organization) • Combination of three antiviral drugs Stavudine (Zerit) 30-40 mg. Lamivudine (Epivin) 150 mg. Nevirapine (Viranme) 200 mg. • Dosage One tablet twice a day • Result: increase body weight, increase CD4 T-cell, decrease occurrence, no change of lipodystrophy (study in 2003-2004)

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