HIV/AIDS   

     Drug abuse treatment

     Needle-and-syringe exchange programmes
     Substitution treatment
Prevention and Control
     HIV testing and counselling
     Access to HIV care, support and antiretroviral treatment
Prevention  Access to prevention interventions, such as condom use and treatment of
sexually transmitted infections.
Although effective and cheap interventions to prevent HIV transmission exist and Condom use
have shown to reverse the HIV/AIDS epidemic when implemented on a large scale,  
the epidemic continues to spread. Almost two thirds of new HIV infections Persuading people at risk of HIV to use condoms is one of the primary strategies of
projected to occur globally between 2002–2010 could be prevented by increasing AIDS prevention programs throughout the world. It is scientifically undisputed that the
efforts to systematically scale-up prevention interventions. transmission of HIV and sexually transmitted infections during sexual intercourse can
be prevented when male condoms are used correctly and consistently.
HIV prevention interventions  
      Targeted HIV/AIDS prevention, care and treatment in sex work settings The female condom should also protect against HIV/AIDS, but more research is
needed to confirm this.
      Targeted HIV/AIDS prevention, care and treatment for injecting drug users  
      Condom use Most condom promotion programmes target high-risk groups, such as truck drivers,
military personnel, and those at commercial sex establishments. Such efforts to
      Prevention of sexually transmitted infections increase condom use have reduced infection rates in a few notable cases, especially
      Blood safety measures in the "100 percent" condom campaign among sex workers in Thailand.
 
      Prevention of mother-to-child transmission Consistent, sustained use of condoms requires behavioural change. Behaviour
change has increased condom use to 70%, such as in Thailand (100% condom use
program) and Tamil Nadu in India. Many types of efforts are being used to change
Targeted HIV/AIDS prevention, care and treatment in sex work settings sexual behaviours, with increased condom use as a primary strategy for reducing the
spread of all sexually transmitted infections and HIV. Increasing condom use will
Sex workers have been most vulnerable to and most affected by HIV since the require more government and cultural approval, increased availability of condoms,
beginning of the HIV/AIDS epidemic. There is a wide diversity of sex work settings, more information, increased skill on negotiating condom use, more promotion, and
ranging from well-established and visible brothel-based red-light areas to a looser better and more focused counselling.
collection of venues such as bars, hotels, marketplaces or roadside areas. These
settings are characterized by high rates of partner change, low rates of condom use, Prevention of sexually transmitted infections
unsafe sex and high rates for sexually transmitted infections and HIV. Consequently, Sexually transmitted infections are a major global cause of acute illness, infertility,
HIV can spread quickly through the sexual networks encompassing sex workers, long term disability and death among both men and women but particularly among
clients, regular and casual partners, spouses and children. Higher rates of HIV women. The WHO estimated that 340 million new cases of syphilis, gonorrhoea,
infections among sex workers compared to other populations have been detected in chlamydia and trichomoniasis have occurred globally in 1999 in men and women aged
nearly all South-East Asian countries. The experience of the Thailand “100% condom 15-49 years.
programme” has shown that targeting sex establishments with HIV prevention  
programmes can reverse the spread of the epidemic. STIs enhance the sexual transmission of HIV infection in particular ulcerative STIs.
The presence of an untreated STI can increase the risk of both acquisition and
transmission of HIV by a factor of up to 10. STI prevention and control are, therefore,
Harm reduction interventions a potent HIV prevention strategy.
 
Harm reduction is a comprehensive package of policies and programmes which The following are important components of STI control that are adopted by the
attempt primarily to reduce the adverse health, social and economic consequences of countries in the South-East Asia:
mood altering substances to individuals, drug user, their families and their      Information, education and communication strategies to improve awareness on
communities, and includes STIs, STI treatment seeking behaviour and promote condom use.
       Information, education and communication      Integration of STI treatment services into primary healthcare
       Peer counseling and education
     Improved case management of STI testing and counselling services as an entry point to care and antiretroviral
     Screening and presumptive treatment treatment in the context of WHO’s “3 by 5” initiative in both high and low burden
countries in the Region. For this, counselling and testing should be made a routine
     Targeted interventions to populations with high risk behaviour
part of the health care, such as in antenatal clinics, at diagnosis and treatment
     STI surveillance including laboratory surveillance and data management centres for tuberculosis and sexually transmitted infections.
   
WHO is working towards reducing the incidence of curable sexually transmitted Counselling enhances communication between the health care providers and
infections, such as syphilis, gonorrhea, chlamydia and trichomoniasis, by screening patients and is an important element of public health prevention programmes.
and treating those affected to reduce the incidence of HIV transmission. Effective counselling can help strengthen prevention efforts by encouraging
 
infected persons to avoid transmission and risk behaviours thereby reducing the
risk of sexually transmitted infections, including HIV.
Blood safety measures          
Voluntary counselling and testing is when an individual chooses to undergo HIV
Blood is a potent vehicle for the transmission of HIV, hepatitis B and C and other counselling so that they can make an informed decision whether to be tested for
transfusion transmittable infections. Use of unscreened blood has the potential for HIV. It has also been demonstrated to be effective for HIV prevention. VCT
infecting recipients with infections like HIV/AIDS, hepatitis B and C, and from many services can be utilized to assess individual risk behaviour and to inform about HIV
others. Though most of the countries are now screening donated blood for these
prevention.
organisms, yet greater efforts are needed to ensure continuous availability of safe
blood to entire population.  
Sex workers, drug users, pregnant women, migrants, prisoners etc are some
population groups that require targeted VCT because of their vulnerabilities to HIV
Prevention of mother-to-child transmission
infection and increased risk of transmission to others.
 
Mother to child transmission (MTCT) of HIV is the vertical transmission of HIV from an  
infected mother to her infant. Prevention of MTCT (PMTCT) aims to reduce this risk of High quality VCT is an important entry point to care as it enables and encourages
HIV transmission. A comprehensive approach is needed to prevent HIV transmission people with HIV/AIDS to access appropriate care. With the wider availability of
in infants. There are four elements to the comprehensive approach to PMTCT: antiretroviral treatment in SEAR countries, there is a greater need for VCT
     Primary prevention of HIV infection services. The SEAR office has sought to address this urgent need through the
     Prevention of unintended pregnancies in HIV infected women development and implementation of a standardized package for training of trainers
     Prevention of HIV transmission from women infected with HIV to their infants in VCT. The third intercountry training on VCT is scheduled for July 2005.
 
     Provision of treatment, care and support to HIV infected women, their infants and
WHO is giving high priority to expanding access to testing and counselling services
their families. in the Region to maximize opportunities to reach the whole population.
   
Without interventions, the risk of MTCT is 25–40%. Combination interventions stated HIV testing should be offered as standard practice but should be performed in
above can reduce the MTCT rate by up to 40% in breastfeeding populations.
  accordance with the guiding principles outlined by WHO. WHO’s stand on HIV
WHO is supporting comprehensive reproductive health programmes targetting women testing is based on informed consent of the person being tested. Read more about
of child-bearing age. This will help prevent unintended pregnancies in HIV-infected WHO’s guiding principles for counselling and testing and toolkit.
women. HIV-infected mothers will be encouraged to attend antenatal care clinics for
counselling and testing and receive preventive antiretroviral therapy and adopt safer
infant-feeding practices.

COUNSELLING AND TESTING

One of the major barriers for scaling up ART is how to identify those who are
infected with HIV. Knowing that one has HIV is a starting point for accessing HIV
care and support services. Therefore, it is important to scale up access to HIV