Slide Show

Battle Over the AIDS Memorial Quilt

The creator of the AIDS Memorial Quilt is locked in a legal tug of war with the quilt�s caretaker.

Video

Tracking the Spread of HIV

A U.N. report indicates that the number of people infected with H.I.V. may have stabilized globally since the 1990s, but the disease is still proliferating in several individual countries. (Produced by Emily B. Hager)

Albany: H.I.V. Tests for Rape Suspects

Rape suspects can be forced to undergo H.I.V. testing under a law signed yesterday by Gov. Eliot Spitzer. The measure gives rape victims the option of forcing an indicted suspect to be tested under a court order, with the results provided to the victim and the suspect. Supporters say it will let victims know quickly if they need treatment. Previously, victims could request and obtain such information only after conviction.

Washing After Sex May Raise H.I.V. Risk

A study in Uganda has come up with a surprising finding about sex and H.I.V. Washing the penis minutes after sex increased the risk of acquiring H.I.V. in uncircumcised men.

The sooner the washing, the greater the risk of becoming infected, the study found. Delaying washing for at least 10 minutes after sex significantly lowered the risk of H.I.V. infection, Dr. Fredrick E. Makumbi reported on July 25 at an International AIDS Society Conference in Sydney, Australia.

The researchers do not have a precise explanation for the findings, which challenge common wisdom and the teaching of many infectious disease experts who urge penile cleansing as part of good genital hygiene. Health experts have suggested that washing the penis after sex could prevent potentially infectious vaginal secretions from entering the body through the uncircumcised penis.

Washing the penis after sex is common in Africa. To determine whether washing could be recommended as an alternative to male circumcision, Dr. Makumbi’s team from the Makerere University Institute of Public Health studied 2,552 uncircumcised men in the Rakai district of Uganda.

The men, ages 15 to 49, were uncircumcised and not H.I.V. infected when they enrolled. Eighty-three percent said they washed with all sex partners.

The researchers asked about when and how the men washed after intercourse at enrollment and 6, 12 and 24 months later, including whether they washed with or without cloths.

Because of a slip-up, the researchers did not ask details of how the cleansing was done or directly about using soap, said Dr. Ronald H. Gray, a co-author from the Johns Hopkins Bloomberg School of Public Health. Some soaps used in Africa are more irritating than those used elsewhere.

Men who washed within three minutes had a 2.3 percent risk of H.I.V. infection compared with 0.4 percent among those who delayed washing for 10 or more minutes. The National Institute of Allergy and Infectious Diseases paid for the study.

The washing analysis was a secondary part of a study undertaken to determine the effectiveness of male circumcision against H.I.V. infection. Earlier reports had shown that circumcision was protective.

One message from the study, Dr. Gray said, “is that there ought to be a little time left for postcoital cuddling before you go and wash.”

“Don’t just finish and jump out of bed,” he said.

Dr. Makumbi and other AIDS experts said they did not know why the washing practice increased vulnerability to H.I.V. infection, but offered various explanations. One is that the acidity of vaginal secretions may impair the ability of the AIDS virus to survive on the penis. Delayed cleansing — and longer exposure to the vaginal secretions — may then reduce viral infectivity.

Another is that use of water, which has a neutral pH, may encourage viral survival and possible infectivity.

H.I.V. apparently needs to be in a fluid to cross the mucosa to infect cells, Dr. Gray said. If the H.I.V.-contaminated fluid dries, its infectivity may decrease. Adding water could resuspend H.I.V. to make it more infectious.

The study findings are counterintuitive, said Dr. Merle A. Sande, an infectious diseases expert at the University of Washington in Seattle, and “show why you have to do the studies, because until you do them, you just don’t know.”

Dr. Sande, who was not involved in the study, said, “There is still so much we don’t understand about the complex factors that influence H.I.V. transmission in the genital tract, but this important study will help.”

He also is president of the Academic Alliance Foundation, a group that trains health workers to treat AIDS and other infectious diseases in Uganda.

Video: The World Hasn't Moved On

AIDS was first recognized 25 years ago. Nicholas D. Kristof travels to the country hardest hit by the virus today.

AIDS Care in Africa

Sharon LaFraniere says cheaper drugs offer hope for children, but medical staff is scant.

Reference Material on AIDS/H.I.V.

HEALTH DICTIONARY:

AIDS (aydz)

Acronym for acquired immune deficiency syndrome, a fatal disease caused by the human immunodeficiency virus, or HIV. Believed to have originated in Africa, AIDS has become an epidemic, infecting tens of millions of people worldwide. The virus, which is transmitted from one individual to another through the exchange of body fluids (such as blood or semen), attacks white blood cells, thereby causing the body to lose its capacity to ward off infection. As a result, many AIDS patients die of opportunistic infections that strike their debilitated bodies. AIDS first appeared in the United States in 1981, primarily among homosexuals and intravenous drug users who shared needles, but throughout the world, it is also transmitted by heterosexual contact. Today, scientists are hopeful that AIDS can be managed by new drugs, such as protease inhibitors, and need not be fatal. (See AZT.)

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ALSO SEE: NYT Guide to Essential Knowledge, Dictionary, Columbia Encyclopedia, Essay

ABOUT HIV/AIDS

What is HIV?

HIV (Human Immunodeficiency Virus) is a virus that causes AIDS (Acquired Immunodeficiency Syndrome), a health condition in which a person is affected by a series of diseases because of poor immunity. HIV by itself is not an illness and does not instantly lead to AIDS. An HIV infected person can lead a healthy life for several years before s/he develops AIDS.

What is AIDS?

As the name, Acquired Immunodeficiency Syndrome indicates, AIDS is a health condition that results from the deficiency in the body's immunity following HIV infection. HIV attacks the human body by breaking down its immune system that is meant to fight diseases. Over a period of time, the immune system weakens and the body loses its natural ability to fight diseases. At this stage, various diseases affect the infected person.

Human Immunodeficiency Virus

TRANSMISSION

Unprotected sex:

If a person engages in sexual intercourse with an infected person without using a condom, s/he can get infected. The sexual act can be both vaginal and anal.

Sharing of needles:

If a person shares the needle or syringe used by/on an infected person, either for injecting drugs or drawing blood or for any other purpose involving piercing, s/he can get infected. Instruments used for piercing and tattooing also carry a small risk of infection.

Unsafe blood:

A person can get the infection, if he/she is given transfusion of infected blood.

Improperly sterilised hospital tools:

If surgical devices like syringes and scalpels, or even certain instruments, used on an infected person, are used on another person without proper sterilization, they can transmit the infection.

Parent to Child:

An HIV positive mother can transmit the virus to child during pregnancy or birth. Breast milk can also act as a transmission-medium. Theoretically oral sex without condom (on men) or barriers like dental dam, vaginal dams or plastic wrap (on women) can also transmit the infection.

DIAGNOSIS How is HIV diagnosed?

In the early stages of infection, HIV often causes no symptoms and the infection can be diagnosed only by testing a person's blood. Two tests are available to diagnose HIV infection - one that looks for the presence of antibodies produced by the body in response to HIV and the other that looks for the virus itself. Antibodies are proteins produced by the body whenever a disease threatens it. When the body is infected with HIV, it produces antibodies specific to HIV. The first test, called ELISA (Enzyme Linked Immunosorbent Assay), looks for such antibodies in blood.

If antibodies are present, the test gives a positive result. A positive test has to be confirmed by another test called Western Blot or Immunoflouroscent Assay (IFA). All positive tests by ELISA need not be accurate and hence Western Blot and repeated tests are necessary to confirm a person's HIV status. A person infected with HIV is termed HIV- positive or seropositive.

As ELISA requires specialized equipment, blood samples need to be sent to a laboratory and the result will be available only after several days or weeks. To cut short this waiting period, RAPID TESTS , that give results in 5 to 30 minutes, are increasingly being used the world over. The accuracy of rapid tests is stated to be as good as that of ELISA. Though rapid tests are more expensive, researchers have found them to be more cost effective in terms of the number of people covered and the time the tests take.

The HIV- antibodies generally do not reach detectable levels in the blood till about three months after infection. This period, from the time of infection till the blood is tested positive for antibodies, is called the Window Period . Some times, the antibodies might take even six months to show up. Even if the tests are negative, during the Window Period, the amount of virus is very high in an infected person. Hence, if a person is newly infected, the risk of transmission is higher.

If a person is highly likely to be infected with HIV and yet both the tests are negative, a doctor may suggest a repetition of the tests after three months or six months when the antibodies are more likely to have developed.

The second test is called PCR (Polymerase Chain Reaction), which looks for HIV itself in the blood. This test, which recognizes the presence of the virus' genetic material in the blood, can detect the virus within a few days of infection.

There are also tests like Radio Immuno Precipitation Assay (RIPA) , a confirmatory blood test that may be used when antibody levels are difficult to detect or when Western Blot test results are uncertain. Other available tests are Rapid Latex Agglutination Assay , a simplified, inexpensive blood test that may prove useful in medically disadvantaged areas where there is a high prevalence of HIV infection, and p24 Antigen Capture Assay . Click here for Services.

Are there any steps to be followed before and after the blood tests?

The process of getting tested for HIV can generate a variety of intense emotional reactions such as fear, anger and denial. Therefore, psychological counselling is essential to prepare individuals undergoing testing for the possible consequences. This is called Pre-Test Counseling and is unavoidable for anybody preparing to take a test.

If the test result is positive, it should not be disclosed without another round of counseling. This Post-Test Counseling is more crucial because of the enormous stress and the multitude of emotions that the infected person could undergo on learning his/her HIV status. A positive test has been linked to increased suicide ideas and attempts and emotional trauma, both at the time of knowing the positive result and also at the emergence of AIDS-defining symptoms.

As there is still considerable stigma and discrimination attached to HIV/AIDS, the decision whether to test or not itself should be preceded by considerable introspection and assessment of the possible outcome. The person to take test should be aware of the emotional trauma and the possible consequences a positive test could bring about. For these reasonse, pre-test counseling is very crucial. With the help of the counselor, the person taking the test should assess his/her personal setting and prepare himself/herself for the probable consequences.

On the other hand, one should also be aware of the positive advantages of learning one's HIV status. If the test turns out to be positive, one can have early access to treatment, take care of one's health better and plan the future. Early realization of the health condition can be very useful in a large number of cases. The counselor could help the infected individual win back his/her confidence and learn how to live a healthy and responsible life. The individuals should also be prepared how to deal with their relatives, friends, colleagues, classmates etc. If the test is negative, the person should be advised preventive methods. Click here to consult an expert.

SYMPTOMS What are the early symptoms of HIV infection?
Many people do not develop any symptoms when they first become infected with HIV. Some people, however, get a flu-like illness within three to six weeks after exposure to the virus. This illness, called Acute HIV Syndrome, may include fever, headache, tiredness, nausea, diarrhoea and enlarged lymph nodes (organs of the immune system that can be felt in the neck, armpits and groin). These symptoms usually disappear within a week to a month and are often mistaken for another viral infection.
During this period, the quantity of the virus in the body will be high and it spreads to different parts, particularly the lymphoid tissue. At this stage, the infected person is more likely to pass on the infection to others. The viral quantity then drops as the body's immune system launches an orchestrated fight.
More persistent or severe symptoms may not surface for several years, even a decade or more, after HIV first enters the body in adults, or within two years in children born with the virus. This period of "asymptomatic" infection varies from individual to individual. Some people may begin to have symptoms as soon as a few months, while others may be symptom-free for more than 10 years. However, during the "asymptomatic" period, the virus will be actively multiplying, infecting, and killing cells of the immune system.
Click here to consult an expert.
What Happens Inside the Body?
Once HIV enters the human body, it attaches itself to a White Blood Cell (WBC) called CD4. Also, called T4 cells, they are the main disease fighters of the body. Whenever there is an infection, CD4 cells lead the infection-fighting army of the body to protect it from falling sick. Damage of these cells, hence can affect a person's disease-fighting capability and general health.
After making a foothold on the CD4 cell, the virus injects its RNA into the cell. The RNA then gets attached to the DNA of the host cell and thus becomes part of the cell's genetic material. It is a virtual takeover of the cell. Using the cell's division mechanism, the virus now replicates and churns out hundreds of thousands of its own copies. These cells then enter the blood stream, get attached to other CD4 cells and continue replicating. As a result, the number of the virus in the blood rises and that of the CD4 cells declines.
Because of this process, immediately after infection, the viral load of an infected individual will be very high and the number of CD4, low. But, after a while, the body's immune system responds vigorously by producing more and more CD4 cells to fight the virus. Much of the virus gets removed from the blood. To fight the fast-replicating virus, as many as a billion CD4 cells are produced every day, but the virus too increases on a similar scale. The battle between the virus and the CD4 cells continues even as the infected person remains symptom-free.
But after a few years, which can last up to a decade or even more, when the number of the virus in the body rises to very high levels, the body's immune mechanism finds it difficult to carry on with the battle. The balance shifts in favour of the virus and the person becomes more susceptible to various infections. These infections are called Opportunistic Infections because they swarm the body using the opportunity of its low immunity. At this stage, the number of CD4 cells per millilitre of blood (called CD4 Count), which ranges between 500 to 1,500 in a healthy individual, falls below 200. The Viral Load, the quantity of the virus in the blood, will be very high at this stage.
Opportunistic infections are caused by bacteria, virus, fungi and parasites. Some of the common opportunistic infections that affect HIV positive persons are: Mycobacterium avium complex (MAC), Tuberculosis (TB), Salmonellosis, Bacillary Angiomatosis (all caused by bacteria); Cytomegalovirus (CMV), Viral hepatitis, Herpes, Human papillomavirus (HPV), Progressive multifocal leukoencephalopathy (PML) (caused by virus); Candidiasis, Cryptococcal meningitis (caused by fungus) and Pneumocystis Carinii pneumonia (PCP). Toxoplasmosis. Cryptosporidiosis (caused by parasites). HIV positive persons are also prone to cancers like Kaposi's sarcoma and lymphoma.
The Center for Disease Control (CDC), Atlanta has listed a series of diseases as AIDS-defining. When these diseases appear, it is a sign that the infected individual has entered the later stage of HIV infection and has started developing AIDS. The progression of HIV positive persons into the AIDS stage is highly individual. Some people can reach the AIDS stage in about five years, while some remain disease free for more than a decade. Measurement of the viral load and the CD4 count helps a doctor in assessing an infected person's health condition. Click here to consult an expert.
What are the later symptoms of HIV/AIDS?
Lack of energy Weight loss Frequent fevers and sweats A thick, whitish coating of the tongue or mouth (thrush) that is caused by a yeast infection and sometimes accompanied by a sore throat Severe or recurring vaginal yeast infections Chronic pelvic inflammatory disease or severe and frequent infections like herpes zoster Periods of extreme and unexplained fatigue that may be combined with headaches, lightheadedness, and/or dizziness Rapid loss of more than 10 pounds of weight that is not due to increased physical exercise or dieting Bruising more easily than normal Long-lasting bouts of diarrhoea Swelling or hardening of glands located in the throat, armpit, or groin Periods of continued, deep, dry coughing Increasing shortness of breath The appearance of discoloured or purplish growths on the skin or inside the mouth Unexplained bleeding from growths on the skin, from mucous membranes, or from any opening in the body Recurring or unusual skin rashes Severe numbness or pain in the hands or feet, the loss of muscle control and reflex, paralysis or loss of muscular strength An altered state of consciousness, personality change, or mental deterioration Children may grow slowly or fall sick frequently. HIV positive persons are also found to be more vulnerable to some cancers.

TREATMENT Is there treatment against HIV and AIDS?

Till today, there is no conclusive treatment to eliminate HIV from the body; however, timely treatment of opportunistic infections can keep one healthy for many years. The commonly available treatment for AIDS is the treatment against opportunistic infections. Normally standard treatment regimens, used against such infections in non-HIV patients, also work well with the HIV-positive persons. If properly treated, almost all the opportunistic infections can be contained.

However, during the last decade, researchers have developed powerful drugs that check the replication of the virus at various levels. Called Antiretroviral drugs, they are available in three classes and under various brands. Taken in combinations (called cocktail or combination therapy) under specialised medical advice, these drugs drastically reduce the viral load in blood. However, they do not permanently cure one of HIV. This line of treatment, called HAART (Highly Active Antiretroviral Therapy) has resulted in a huge reduction or AIDS-related deaths. Though many positive persons and caregivers have welcomed these drugs, others have experienced serious side effects. They are also very expensive and are out of reach for a majority of the infected people. But of late, the prices have been steeply falling.

The three classes of drugs are:

Nucleoside analogue Reverse Transcriptase Inhibitors (NRTIs). NRTIs were the first antiretroviral drugs to be developed. They inhibit the replication of HIV in the early stage by inhibiting an enzyme (which is necessary for viral replication) called Reverse Transcriptase. The drugs include Zidovudine (Retrovir, AZT), Lamivudine (Epivir, 3TC), Didanosine (Videx, ddI), Zalcitabine (Hivid, ddC), Stavudine (Zerit, d4T) and Abacavir (Ziagen). The major reported side effect of Zidovudine is bone marrow suppression, which causes a decrease in the number of red and white blood cells. The drugs ddI, ddC and d4T can damage peripheral nerves (peripheral neuropathy), leading to tingling and burning in the hands and feet. Treatment with ddI can also cause pancreatitis, and ddC may cause mouth ulcers. Approximately 5 percent of people treated with Abacavir experience hypersensitivity reactions such as a rash along with fever, fatigue, nausea, vomiting, diarrhea and abdominal pain. Hypersensitivity reactions can also occur without a rash. In either case, symptoms usually appear within the first 6 weeks of treatment and generally disappear when the drug is discontinued. If a person had a hypersensitivity reaction to Abacavir, he/she should avoid taking the drug again. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs). These drugs bind directly to the enzyme, Reverse Transcriptase. There are three NNRTIs currently approved for clinical use: Nevirapine (Viramune), Delavirdine (Rescriptor) and Efavirenz (Sustiva). A major side effect of all NNRTIS is a rash. In addition, people taking Efavirenz may have side effects such as abnormal dreams, sleeplessness, dizziness and difficulty concentrating. Protease inhibitors (PIs). PIs interrupt HIV replication at a later stage in its life cycle by interfering with an enzyme known as HIV protease. This causes HIV particles in the body to become structurally disorganized and noninfectious. Among these drugs are Saquinavir (Fortovase), Ritonavir (Norvir), Indinavir (Crixivan), Nelfinavir (Viracept), Amprenavir (Agenerase) and Lopinavir (Kaletra).

The most common side effects of PIs include nausea, diarrhoea and other digestive tract problems. They can also cause a significant number of side effects when they interact with certain other medications. That is because all PIs, to one degree or another, affect an enzyme system in the liver that is responsible for metabolising a large number of drugs. Newer side effects have also appeared with the continuing and widespread use of Protease Inhibitors. These include elevated triglyceride levels and problems with sugar metabolism that may sometimes progress to diabetes.

There may also be abnormalities in the way fat is metabolised and deposited in the body. Some people lose much of their total body fat while others gain excess fat on the back between their shoulders (buffalo hump) or in the stomach (protease paunch). Right now, no one knows exactly why these abnormalities occur. In fact, it is not even certain whether these problems are a direct result of treatment with protease inhibitors or due to some other cause that has yet to be identified. Similar metabolic abnormalities have occurred in people on antiretroviral therapy that does not include PIs. Although these body changes can be distressing, the possibility they may occur should not stop one from obtaining treatment for HIV/AIDS.

In simple combination therapy, some physicians prescribe a combination of RTIs. But in HAART, which in fact has made a dramatic change in AIDS treatment, a combination of RTIs and PIs is prescribed.

People respond differently to treatment and maintaining the drug schedule is extremely important. Indiscriminate treatment results in drug resistance and resurgence of the viral load. Therefore it should be taken only under expert medical advice. Click here to consult an expert.

What about vaccines?

More than a dozen HIV vaccines are currently being tested. As of now, there is no vaccine to prevent HIV infection.

What is Parent to Child Transmission?

Babies born to mothers infected with HIV may or may not be infected with the virus, but all carry their mothers' antibodies to HIV for several months after birth. If these babies lack symptoms, a definitive diagnosis of HIV infection using standard antibody tests cannot be made until after 15 months of age. By then, the babies are unlikely to still carry their mothers' antibodies and will have produced their own, if they are infected. New technologies to detect HIV itself are being used to more accurately determine HIV infection in infants between ages 3 months and 15 months. A number of blood tests are being evaluated to determine if they can diagnose HIV infection in babies younger than 3 months.

LIFE AFTER HIV The experience of infected people during the last two decades has shown that HIV is not the "end of the world" and that there is good quality life for several more years. Taking care of one's health, keeping in mind one's vulnerability to diseases, and a positive attitude have been found to be very useful. New drugs and vaccine efforts also offer considerable hope to infected and affected individuals and their families. Several NGOs/CBOs, government organisations, public and private institutions offer ongoing support to people in need. Click here for services. What should one do if found HIV positive?

Consult a clinician experienced in treating HIV/AIDS. Protect your sex partner(s) from HIV by following safe-sex guidelines. Inform sex partner(s) who may also be infected. Do not share needles. Get psychological support from a counsellor and/or join a support group for people with HIV. Get information and social and legal support from AIDS service organisations. Don't share your HIV status with people who do not need to know. Only tell people you can count on for support. Think about whom do you want to share your HIV status with. Maintain a strong immune system with a healthy lifestyle and regular medical examinations. Consider using antiretroviral therapies that may slow the progress of the infection in consultation with a qualified physician. Click here for Services.

PREVENTION Because there is no effective vaccine and no cure for HIV, the only way to protect oneself is prevention. People should either abstain from having sex or use latex condoms, during oral, anal, or vaginal sex. Only condoms made of latex should be used, and whenever necessary only water-based lubricants should be used. People who are allergic to latex can use polyurethane condoms. Although some laboratory evidence shows that spermicides can kill HIV, there is no conclusive evidence if it can preventtransmission. The risk of HIV transmission from a pregnant woman to her baby is significantly reduced if she takes AZT during pregnancy, labour and delivery, and her baby takes it for the first six weeks of life. Nevirapine is also found to be useful. But, one should seek expert medical assistance in such situations. Click here for Services. Having a sexually transmitted disease (STD) can increase manifold a person's chances of getting HIV through sexual contact. So, it is necessary to treat STD as soon as you suspect infection. Click here to consult a physician.

SAFE SEX GUIDE The Risk Chart - Practise Safe Sex

No risk or very low risk - No reported cases due to these behaviours

Masturbation - mutual masturbation Touching - massage Erotic massage - body rubbing Kissing Oral sex on a man with a condom Oral sex on a woman with a dental dam, glyde dam, plastic wrap, or cut-open condom Not sharing drug injecting, body piercing instruments, needles, syringes Using properly sterilised hospital tools

Low risk - Rare reported cases due to these behaviours

Deep kissing Oral sex Vaginal intercourse with a condom or female condom - Click here to learn the correct usage of a condom Anal intercourse with a condom (Try not to get semen or blood into the mouth or on broken skin.)

High risk - Hundreds of thousands of reported cases are associated with the following.

Vaginal intercourse without a condom Anal intercourse without a condom Sharing needles, syringes and other body piercing instruments

BLOOD SAFETY

The Human Immunodeficiency Virus (HIV), which causes AIDS, is easily transmitted through blood transfusions. In fact, the chances that someone who has received a transfusion with HIV blood will himself or herself become infected are estimated to be over 90 percent.

Blood transfusions will always carry certain risks, but HIV transmission through blood transfusion can virtually be prevented. One can do this by setting up and maintaining a safe blood supply and by using the blood appropriately. One should always ensure that the blood is screened for the presence of diseases causing viruses, bacteria, or other microorganisms, or for the presence of anti bodies produced against these agents.

All donated blood must be screened for HIV, as well as for hepatitis B and syphilis (and hepatitis C where ever possible). In addition, both doctors and patients must be aware that blood should be used only for necessary transfusion. While it is important to take necessary precautions, we also must keep in mind that if each individual is to donate blood once a year voluntarily, the total requirement of blood worldwide would be met.

Transfusion

Is it safe to have blood transfusion?

Blood transfusion saves millions of lives each year, but only if safe blood supply is guaranteed. Receiving transfused blood has increased the risk to being affected by HIV and a number of other infections. Diseases such as hepatitis B, hepatitis C and several Sexually TRansmitetd Diseases (STDs) can also be transmitted through transfusion.

Can I receive my own blood ?

Your own blood is the safest blood for your transfusion needs. A transfusion, after all, is a transplant of sorts, but instead of a kidney or liver, blood is the tissue a patient receives. When transfused with your own blood, you are not exposed to infectious disease and you are the perfect match. Your doctor will also carefully consider the benefits and effects your blood donations may have on you.

How do I ensure that the blood is actually HIV free?

The process of testing blood to see if it contains infectious agents capable of being transmitted to those who received the blood is known as screening. Majority of tests detect the presence of anti bodies to HIV and not the virus itself. Although HIV tests are very sensitive, there is a window period. This is the period between the onset of infection with HIV and the appearance of detectable anti bodies to the virus. In the case of most sensitive HIV tests the window period is about three weeks.

Voluntary Donation of Blood

Who can donate blood?

Every healthy individual with no known infection /disease can donate blood. It should still be done after having screened yourself. The donor should be in good health and should be f eeling well on the day they donate. He/she should weigh at least 110 lbs. (50 kg) or more, not on any prescribed medication that may affect the donor or recipient. There should be a gap of at least 56 days between donations.

How often can I donate blood?

Donating blood over thrice a year is not recommended. Excessive donation results in blood becoming substandard, for instance lacking in iron. It can also affect the donor's health.

Where can I donate blood?

One can donate blood at any licensed blood bank and blood donation camp.

Why should I donate blood?

The safest type of blood donor is the voluntary, unpaid donor. Such donor gives out of altruism, and is not under pressure to donate blood. On the whole, such donors are are more likely to meet the criteria for low risk donors. And they are also more likely to be willing to donate on a regular basis and at properly spaced intervals. This is important in maintaining a sufficient stock of blood.

How will it be used?

Blood is often used as a replacement of the quantity given to an individual by a medical practitioner. In this system, families of people needing a transfusion are asked to donate the same quantity as that given to their relative and this blood may be used directly, where compatible, or else put into the general pool.

Is blood donation harmful?

No, if it is at properly spaced intervals and is donated at licensed blood banks/camps it is not harmful. Many donors have given blood over 50 times, up to four times a year, without any harm to their health. If you are healthy, you can give blood every 56 days.

Can you get HIV by donating blood?

It is safe to give blood. You cannot contract any diseases through blood donation if the needle and other clinic materials used to take blood are new, sterile and used only once. If you are donating at licensed banks, these safety conditions will be definitely adhered to. The materials used are disposed after one use.

Rational Use

When?

Doctors and other medical staff should be educated to avoid prescribing inappropriate transfusion. Blood substitutes should be used only when it is appropriate. Simple alternatives to blood, such as crystalloids or colloids, will not transmit infection and can be obtained at a fraction of the cost of whole blood.

One of the reasons, which makes blood supply unsafe is shortage. This shortage can be addressed to a great extent by transfusing blood components instead of whole blood. Wherever whole blood is not needed, the appropriate component should be used.

The underlying reasons for blood transfusion should be addressed. A condition for which blood transfusions are often given is chronic anemia, which results from the lack of red blood cells that carry oxygen to the tissues. Chronic anemia can be caused by malnutrition, slow loss of blood and infection such as malaria. If the root cause of chronic anemia is attacked, we can manage the condition. Another condition where blood is often needed is childbirth-related emergencies. By taking proper care of women before and during delivery, we can decrease the need for transfusion.

Avoid unnecessary transfusion

Transfusion is not always necessary or appropriate. Avoid using single-unit transfusions.

Transfusion increases the risk of transmitting HIV, especially in places where there is no adequate screening of blood. Apart from that, it creates an unavoidable shortage in blood supply. This encourages professional donors to become more active, reducing the safety of the supply. For information regarding WHO's guiding principles for expanding testing and counselling, click here. For information regarding UNAIDS' technical update on counselling and HIV/AIDS, click here. UNAIDS/WHO Policy Statement on HIV Testing What is HIV/AIDS | Transmission | Diagnosis | Symptoms | Treatment Life after HIV | Prevention | Safe Sex Guide | Blood Safety | Frequently Asked Questions