HIV/AIDS
(SUBMITTED FOR SPEAKING SUBJECT AS A FINAL ASSIGNMENT)
By.
BAYANI AMRI PUTRI
12 050 117
III C
STKIP MUHAMMADIYAH PRINGSEWU LAMPUNG
2013
ACKNOWLEDGEMENT
Thanks to Allah the most merciful
who gives us guidance to finish this paper. I would like to express gratitude
to all those who help us to finished this paper, both morally and materially in
the form of encouragement, because I believe without the help and support of
them it is very difficult for us to finish it.
In addition, allow us to
gratitude for :
1.
Drs. Suhadi, S.Pd, M.Pd, as lecturer of Speaking III
2.
My beloved friends who always give a motivations and make me still spirit and also assisted me
in completing this paper.
I realize that in preparing this
paper is far from perfect, for that we
look criticism and suggestions that are built in this paper. We hope this paper
useful for the readers.
Pringsewu, December, 17th
2013
The Writer
TABLE OF CONTENTS
Preface
Table of Contents
1.
CHAPTER I INTRODUCTION
1.1
Background
1.2
…
1.3
…
2
CHAPER II DISCUSSION
2.1
…..
2.2
…
2.3
…
2.4
…
2.5
…
1.
CHAPTER
III CLOSING
3.1 Conclusion
3.2
Advices
REFERENCES
CHAPTER I
INTRODUCTION
1.1
Background
Human immunodeficiency virus infection / acquired immunodeficiency syndrome (HIV/AIDS) is a disease of the
human immune system caused by infection with human
immunodeficiency virus (HIV).
During the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a prolonged period
without symptoms. As the illness progresses, it interferes more and more with
the immune system, making the person much more likely to get infections,
including opportunistic infections and tumors that do not usually affect people who have working
immune systems.
HIV is transmitted primarily via unprotected sexual intercourse (including anal and even oral sex),
contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Some
bodily fluids, such as saliva and tears, do not transmit HIV. Prevention of HIV
infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the
disease. There is no cure or vaccine; however, antiretroviral treatment can slow
the course of the disease and may lead to a near-normal life expectancy. While
antiretroviral treatment reduces the risk of death and complications from the disease,
these medications are expensive and may be associated with side effects.
Genetic research indicates that HIV originated in west-central Africa
during the early twentieth century. AIDS was first recognized by the Centers for
Disease Control and Prevention (CDC) in
1981 and its cause—HIV infection—was identified in the early part of the
decade. Since its discovery, AIDS has caused an estimated 36 million
deaths (as of 2012). As of 2012, approximately 35.3 million people are
living with HIV globally. AIDS is considered a pandemic—a disease
outbreak which is present over a large area and is actively spreading.
HIV/AIDS has had a great impact on society, both as an
illness and as a source of discrimination. The disease also has significant economic impacts. There are many misconceptions about HIV/AIDS such as the belief that it can be transmitted by
casual non-sexual contact. The disease has also become subject to many controversies involving
religion. It has
attracted international medical and political attention as well as large-scale
funding since it was identified in the 1980s.
1.2 THEOLOGICAL
PROBLEM
Formulation of the problem is the formulation is prepared
to understand what and how the problem under study. In accordance with the
title of this paper, namely HIV/AIDS, So, I have several the formulations of
the problem are:
1. What is the definition and the
different between HIV and AIDS?
2. What is the history of HIV/AIDS?
3. What are
the Sign and Symptoms of HIV?
4. Where are the locations of the
HIV/AIDS epidemic in this world?
5.
How is HIV Transmitted?
6.
How prevent the HIV/AIDS?
7.
How the spreading of HIV/AIDS Indonesia and the ways
to prevent it?
CHAPTER II
DISCUSSION
2.1 HIV and
AIDS
2.1.1
The Definition for HIV and AIDS.
AIDS (Acquired immune deficiency
syndrome or acquired immunodeficiency syndrome) is a disease caused by a virus
called HIV (Human Immunodeficiency Virus). The illness alters the immune
system, making people much more vulnerable to infections and diseases. This
susceptibility worsens as the disease progresses.
HIV is found in the body fluids
of an infected person (semen and vaginal fluids, blood and breast milk). The
virus is passed from one person to another through blood-to-blood and sexual
contact. In addition, infected pregnant women can pass HIV to their babies
during pregnancy, delivering the baby during childbirth, and through breast
feeding.
Both the virus and the disease
are often referred to together as HIV/AIDS. People with HIV have what is called
HIV infection. As a result, some will then develop AIDS. The development of
numerous opportunistic infections in an AIDS patient can ultimately lead to
death.
2.1.2
The History of HIV/AIDS
Scientists
identified a type of chimpanzee in West Africa as the source of HIV infection
in humans. They believe that the chimpanzee version of the immunodeficiency
virus (called simian immunodeficiency virus or SIV) most likely was transmitted
to humans and mutated into HIV when humans hunted these chimpanzees for meat
and came into contact with their infected blood. Over decades, the virus slowly
spread across Africa and later into other parts of the world.
The
earliest known case of infection with HIV-1 in a human was detected in a blood
sample collected in 1959 from a man in Kinshasa, Democratic Republic of the
Congo. (How he became infected is not known.) Genetic analysis of this blood
sample suggested that HIV-1 may have stemmed from a single virus in the late
1940s or early 1950s.
We
know that the virus has existed in the United States since at least the mid- to
late 1970s. From 1979–1981 rare types of pneumonia, cancer, and other illnesses
were being reported by doctors in Los Angeles and New York among a number of
male patients who had sex with other men. These were conditions not usually
found in people with healthy immune systems.
In
1982 public health officials began to use the term "acquired
immunodeficiency syndrome," or AIDS, to describe the occurrences of
opportunistic infections, Kaposi's sarcoma (a kind of cancer), and Pneumocystis
jirovecii pneumonia in previously healthy people. Formal tracking
(surveillance) of AIDS cases began that year in the United States.
In
1983, scientists discovered the virus that causes AIDS. The virus was at first
named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy-associated
virus) by an international scientific committee. This name was later changed to
HIV (human immunodeficiency virus).
For
many years scientists theorized as to the origins of HIV and how it appeared in
the human population, most believing that HIV originated in other primates.
Then in 1999, an international team of researchers reported that they had
discovered the origins of HIV-1, the predominant strain of HIV in the developed
world. A subspecies of chimpanzees native to west equatorial Africa had been
identified as the original source of the virus. The researchers believe that
HIV-1 was introduced into the human population when hunters became exposed to
infected blood.
2.1.3 The World AIDS Day
2.2 Signs and symptoms
There are three main stages of HIV infection: acute infection, clinical
latency and AIDS.
a.
Acute
infection
The initial period following the contraction of HIV is called acute HIV,
primary HIV or acute retroviral syndrome. Many individuals develop an influenza-like illness or a mononucleosis-like illness 2–4 weeks post exposure while others have no
significant symptoms. Symptoms occur in 40–90% of cases and most commonly
include fever, large tender lymph nodes, throat inflammation, a rash, headache, and/or sores of the mouth and genitals.
Some people also develop opportunistic infections at this stage such as nausea, vomiting or diarrhea may occur,
as may neurological symptoms of .The duration of the symptoms varies, but is
usually one or two weeks.
Due to their nonspecific character, these symptoms are not often recognized as signs of HIV infection. Even cases that do get
seen by a family doctor or a hospital are often misdiagnosed as one of the many
common infectious diseases with overlapping symptoms. Thus, it is recommended
that HIV be considered in patients presenting an unexplained fever who may have
risk factors for the infection.
b.
Clinical
latency
The initial symptoms are followed by a stage called clinical latency,
asymptomatic HIV, or chronic HIV. Without treatment, this second stage of the natural history of HIV infection can last from about three years
to over 20 years (on average,
about eight years). While typically there are few or no symptoms at first, near
the end of this stage many people experience fever, weight loss, nausea,
vomiting or diarrhea and muscle
pains. Between 50 and 70% of people also develop persistent generalized lymphadenopathy, characterized by unexplained, non-painful
enlargement of more than one group of lymph nodes (other than in the groin) for
over three to six months.
c.
. Acquired
immunodeficiency syndrome/AIDS
Acquired immunodeficiency syndrome (AIDS) is defined in terms of either
a CD4+ T cell or the occurrence of specific diseases in association
with an HIV infection. In the absence of specific treatment, around half of
people infected with HIV develop AIDS within ten years..
Opportunistic infections may be caused by bacteria, viruses, fungi and parasites that are
normally controlled by the immune system. Which infections occur partly depends
on what organisms are common in the person's environment. These infections may
affect nearly every organ system.
People with AIDS have an increased risk of developing various viral
induced cancers including Kaposi's sarcoma, Burkitt's lymphoma, primary central nervous system lymphoma, and cervical cancer. Additionally, people with AIDS frequently have systemic
symptoms such as prolonged fevers, sweats
(particularly at night), swollen lymph
nodes, chills, weakness, and weight loss. Diarrhea is another common symptom
present in about 90% of people with AIDS. They can also be affected by diverse
psychiatric and neurological symptoms independent of opportunistic infections
and cancers.
2.3 Transmission
HIV is transmitted by three main routes: sexual contact, exposure to infected body fluids or tissues, and
from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission). There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are
contaminated with blood. It is possible to be co-infected by more
than one strain of HIV—a condition known as HIV super-infection.
a.
Sexual
The most frequent mode of transmission of HIV is through sexual contact
with an infected person. The majority of all transmissions worldwide occur
through heterosexual contacts (i.e. sexual contacts between people of the
opposite sex); however, the pattern of transmission varies significantly among
countries. In the United States, as of 2009, most sexual transmission occurred
in men who had sex with men, with this population accounting for 64% of all
new cases.
Commercial sex workers (including those in
pornography) have an
increased rate of HIV. Rough sex can be a factor associated with an increased risk of
transmission. Sexual assault is also believed to carry an increased risk of HIV
transmission as condoms are rarely worn, physical trauma to the vagina or
rectum is likely, and there may be a greater risk of concurrent sexually
transmitted infections.
b.
Body fluids
The second most frequent mode of HIV transmission is via blood and blood
products. HIV is transmitted in about 93% of blood transfusions involving
infected blood. Blood-borne transmission
can be through needle-sharing during intravenous drug use, needle stick injury,
transfusion of contaminated blood or blood product, or medical injections with
unsterilized equipment. The risk from sharing a needle during drug injection is between
0.63 and 2.4% per act, with an average of 0.8%. The risk of acquiring HIV from a
needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333)
per act and the risk following mucus membrane exposure to
infected blood as 0.09% (about 1 in 1000) per act. In the United States
intravenous drug users made up 12% of all new cases of HIV in 2009, and in some
areas more than 80% of people who inject drugs are HIV positive.
So, unsafe medical injections play a significant role in HIV spread.
People giving or receiving tattoos, piercings, and scarification are
theoretically at risk of infection but no confirmed cases have been documented.
It is not possible for mosquitoes or other
insects to transmit HIV.
c.
Mother-to-child
HIV can be transmitted from mother to child during pregnancy, during
delivery, or through breast milk. This is the third most common way in which
HIV is transmitted globally. In the absence of treatment, the risk of
transmission before or during birth is around 20% and in those who also
breastfeed 35%. As of 2008, vertical transmission accounted for about 90% of
cases of HIV in children. With appropriate treatment the risk of
mother-to-child infection can be reduced to about 1%. Preventive treatment
involves the mother taking antiretroviral during pregnancy and delivery, an
elective caesarean section, avoiding breastfeeding, and administering
antiretroviral drugs to the newborn. Many of these measures are however not
available in the developing world. If blood contaminates food during pre-chewing it may pose
a risk of transmission.
2.4 Classifications of HIV infection
The World Health Organization first proposed a definition for AIDS in
1986. Since then, the WHO classification has been updated and expanded several
times, with the most recent version being published in 2007. The WHO system
uses the following categories:
·
Primary HIV infection: May be either asymptomatic or associated with
acute retroviral syndrome.
·
Stage I: HIV infection is asymptomatic with a CD4+
T cell count (also known as CD4 count) greater than 500 per microlitre of
blood. May include generalized lymph node enlargement.
·
Stage II: Mild symptoms which may include minor mucocutaneous
manifestations and recurrent upper respiratory tract
infections. A CD4
count of less than 500/microlitre.
·
Stage III: Advanced symptoms which may include unexplained chronic diarrhea for longer
than a month, severe bacterial infections including tuberculosis of the lung,
and a CD4 count of less than 350/microlitre.
·
Stage IV or AIDS: severe symptoms which include toxoplasmosis of the
brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma. A CD4
count of less than 200/micolitre.
2.5 Epidemiology
HIV/AIDS is a global pandemic. As of
2012, approximately 35.3 million people have HIV worldwide with the number
of new infections that year being about 2.3 million. This is down from
3.1 million new infections in 2001. Of these approximately
16.8 million are women and 3.4 million are less than 15 years
old. It resulted in about 1.6 million deaths in 2012, down from a peak of
2.2 million in 2005.
Sub-Saharan Africa is the region most affected. In 2010, an estimated
68% (22.9 million) of all HIV cases and 66% of all deaths
(1.2 million) occurred in this region. This means that about 5% of the
adult population is infected and it is believed to be the cause of 10% of all
deaths in children. Here in contrast to other regions women compose nearly 60%
of cases. South Africa has the largest population of people with HIV of any
country in the world at 5.9 million.
South & South East Asia is the second most affected; in 2010 this region
contained an estimated 4 million cases or 12% of all people living with
HIV resulting in approximately 250,000 deaths. Approximately 2.4 million
of these cases are in India.
In 2008 in the United States approximately 1.2 million people were
living with HIV, resulting in about 17,500 deaths. The US Centers for Disease
Control and Prevention estimated that in 2008 20% of infected Americans were
unaware of their infection. In the United Kingdom as of 2009 there where
approximately 86,500 cases which resulted in 516 deaths. In Canada as of 2008
there were about 65,000 cases causing 53 deaths. Between the first recognition
of AIDS in 1981 and 2009 it has led to nearly 30 million deaths.
Prevalence is lowest in Middle East and North Africa at 0.1% or less, East Asia at 0.1% and
Western and Central Europe at 0.2%.
2.6 Stigma about HIV/AIDS
AIDS stigma exists around the world in a variety of ways, including ostracism, rejection,
discrimination and avoidance of HIV infected people; compulsory HIV testing
without prior consent or
protection of confidentiality; violence against HIV infected individuals or people
who are perceived to be infected with HIV; and the quarantine of HIV
infected individuals. Stigma-related violence or the fear of violence prevents
many people from seeking HIV testing, returning for their results, or securing
treatment, possibly turning what could be a manageable chronic illness into a
death sentence and perpetuating the spread of HIV.
AIDS stigma has been further divided into the following three
categories:
·
Instrumental AIDS stigma—a
reflection of the fear and apprehension that are likely to be associated with
any deadly and transmissible illness.
·
Symbolic AIDS stigma—the use of
HIV/AIDS to express attitudes toward the social groups or lifestyles perceived
to be associated with the disease.
·
Courtesy AIDS stigma—stigmatization
of people connected to the issue of HIV/AIDS or HIV-positive people.[206]
Often, AIDS stigma is expressed in conjunction with one or more other
stigmas, particularly those associated with homosexuality, bisexuality, promiscuity,
prostitution, and intravenous drug use.
In many developed countries, there is an association between AIDS and
homosexuality or bisexuality, and this association is correlated with higher
levels of sexual prejudice, such as anti-homosexual/bisexual attitudes. There
is also a perceived association between AIDS and all male-male sexual behavior,
including sex between uninfected men. However, the dominant mode of spread
worldwide for HIV remains heterosexual transmission.
In 2003, as part of an overall
reform of marriage and population legislation, it became legal for people
2.7 HIV/AIDS
in Indonesia
2.7.1
The Cases and Epidemic of HIV/AIDS in Indonesia
Indonesia’s first case of HIV was
reported in 1987 and between then and 2009, 3,492 people died from the disease.
Of the 11,856 cases reported in 2008, 6,962 of them were people under 30 years
of age, including 55 infants under 1 year old. There are a high number of
concentrated cases among Indonesia’s most at risk including injection drug users (IDUs), sex workers
their partners and clients, homosexual men and infants who contract the disease
through the womb or from being breast fed.
In the last 15 years, HIV/AIDS has
become an epidemic in Indonesia. The highest concentration areas are Papua, Jakarta,
East Java,
West Java,
Bali
and Riau
and all are considered to be zones that need immediate attention.
Due to the increasing number of
IDUs, the number of new infections has grown rapidly since 1999. Moreover, a
generalized epidemic is already under way in the provinces of Papua and West Papua, where a population-based survey
found an adult-prevalence rate of 2.4% in 2006.
The epidemic
in Indonesia is one of the fastest growing among HIV/AIDS in Asia.
The epidemic of injecting drug use continues to be the primary mode of
transmission, accounting for 59% of HIV infections, and heterosexual
transmission accounted for 41% in 2006. According to the Indonesian Ministry of
Health, recent surveys report that more than 40% of IDUs in Jakarta
have tested positive for HIV, and about 13% tested positive in West Java.
Many IDUs sell sex to finance their drug habits. Yet in 2005, 25% of IDUs in Bandung,
Jakarta,
and Medan.
The Indonesian archipelago
stretches more than 3,000 miles along the Equator. Cultural practices and
levels of urbanization have an impact on the HIV/AIDS
epidemic. For instance, a culture of paid and “transactional” sex among young
men and women aged 15 to 24 has been a driving factor in Papua. Among 15 to 24
year olds, HIV-prevalence rates were 3% in 2006, according to the Ministry of
Health. Prevalence rates among sex workers in Papua’s major urban areas ranged
from 9% in Timika to 16% in Sorong in 2004.
Numerous factors put Indonesia in danger
of a broader epidemic. Risky sexual behaviors are common. Only 54.7% of sex
workers and 56.5% of men who have sex with men
(MSM) use condoms
consistently, and just 18.5 percent of IDUs consistently use both sterile
needles and condoms, according to Indonesia’s 2006 report to the United Nations
General Assembly Special Session on HIV/AIDS (UNGASS).
Finally, since
1994 Indonesia established a National AIDS Commission to focus on preventing the spread of HIV,
addressing the needs of people living with HIV/AIDS, and coordinating
government, non-governmental organizations , private sector, and community
activities. The Government of Indonesia
signified its continued commitment to fighting HIV/AIDS in 2005 when it
budgeted $13 million to HIV/AIDS programs, an increase of 40 percent over the
amount disbursed in 2004.
2.7.2
The HIV/AIDS Awareness Program
In several provinces across Indonesia,
the HIV/AIDS epidemic is among the fastest growing in Asia. West Papua has the
largest population of people living with the AIDS virus — around 50 percent of
the country’s total number of cases (despite West Papua only accounting for 1
percent of Indonesia’s total population). In 2011 the Papua AIDS
Prevention Commission (KPA) reported a 30 percent growth in the number of
people living with HIV/AIDS in West Papua.
These extremely high rates are exacerbated
by the fact that many people are ignorant of HIV/AIDS and how it is spread. The
HIV/AIDS Awareness Program increases the knowledge and role of the communities
in Merauke in preventing the spread of HIV/AIDS by conducting group discussions
and community level training.
The program develops and distributes
materials such as posters, leaflets, video films, calendars and T-shirts as a
means of promoting messages on HIV/AIDS so that people in the community have
access to accurate information about the disease. The program is also using
radio and film to spread the message and is developing a network of
volunteers to educate and advocate about HIV/AIDS.
This program
works in cooperation with Church institutions, the local AIDS Commission (KPAD)
and local NGOs working on HIV/AIDS awareness rising in Merauke. As a result
there is growing local government recognition of HIV/AIDS as a social issue,
not just a health problem, and Caritas Australia partner, Yasanto, has been
recognised as a partner of the government in combating HIV/AIDS.
While
focusing on awareness rising about HIV-AIDS, Yasanto’s program also teaches
about related topics such as tuberculosis, sexually transmitted diseases in
general, and reducing alcohol related violence.
Much of BPKM
Yasanto’s work is in isolated villages which have minimal access to outside
knowledge to improve their livelihoods. To meet this need, and because BPKM
Yasanto has some staff with an agriculture background, in 2011 they widened the
program to include workshops on organic gardening. To summarize, the HIV/AIDS
awareness program in the city of Merauke, West Papua, increases people’s
knowledge and awareness about HIV/AIDS in order to help to prevent the spread
of the disease.
2.7.3
International Help for HIV/AIDS in
Indonesia
In 2007 Australia donated A$100
million to help contain the epidemic in Indonesia. The aim of the program is to
limit the number of people who contract the disease though education of at risk
groups, improve the quality of life for suffers, and reduce the socioeconomic
effects on Indonesia. Australia has been assisting Indonesia to tackle HIV/AIDS
for over 15 years and introduced the first methadone program to a prison in Asia
the program is now in 95 prisons across Indonesia.
America also supports Indonesia’s
National Aids Program, donating US$8 million annually. The program aims to
increase awareness of the risks and prevention methods and will work closely
with NGO’s and provincial governments to develop services in areas where the
spread is now considered to be an epidemic.
CHAPTER III
CLOSING
A.
CONCLUSION
God almighty, have the power to regulate everything
that exists on earth. He created the universe and everything in it. Likewise
with all the events that happen on earth such as: happiness, sadness of natural
disasters, births, deaths, etc. Comes the HIV/AIDS is one of the major events
in the history of human life.
HIV is a virus that lives in the human body, and can
cause the onset of AIDS, which destroys the human immune system, making the
body susceptible to disease and I am will eventually die, it is human nature to
always want to feel enjoyment regardless of the consequences, for example:
committed adultery, injection drug us, and soon. We mankind have known that
such actions are strictly prohibited, either according to their respective
religious teachings or rules applicable law. But from some of us still do these
things, for example: homosexuals, bisexuals, pimps, and people who often have
multiple sexual partners and sexual relations outside marriage. And dangerous
until now has not found a cure.
As for the symptoms that we can look at AIDS patients
are prolonged fever accompanied night sweats and cough, with drastic weight
loss, etc which will end with death. Therefore, we should shy away from things
that can cause AIDS, through prevention e.g.: not having sexual relations
freely, avoid injections drug use, and soon.
AIDS is an emergency trial or event the punishment of
God, which never is assumed by mankind. However, the weight given trial, the
lord almighty. Will always open the way for his people. So, thing that needed
now is the awareness for each people to always maintain their self to get life
with the comfortless and happiness.
B. ADVICE
1) We should always draw closer to God Almighty, and
tried to shy away from things that can cause AIDS.
2) Do not engage in sexual relations outside marriage
(adultery), and do not have multiple sexual partners.
3) For
woman who have baby, always check the condition of body to maintain the baby
from the threatening disease.
3) If the treatment by using a syringe, then make sure
first that the syringe is sterile or not and it
4) When doing a blood transfusion, ask through the
medical officer to check first the blood.
5) For young people, stay away from drugs, especially
narcotics through a syringe, tattoo equipment, piercing earrings, and the like
that could transmit AIDS, because the tools did not exist
REFERENCES
