2.2. what are the causes of HIV/AIDS ?Many researchs showed that HIV is caused by many reasons but it is transmitted by three main routes : sexual contact, significant exposure to infected body fluids and from mother to child during pregnancy, delivery or breastfeeding. HIV can be transmitted from one person to another through sexual contact, and in a limited number of other ways. HIV can be transmitted during sex when the blood, semen , pre-ejaculate vaginal or anal fluids of an infected person enter the body of an uninfected person.
Risk of transmission increases in the presence of many sexually transmitted infections and genital ulcers. Commercial sex workers have an increased rate of HIV . Rough sex can be a factor associated with an increased rick of 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 infection.
The second most frequent mode of HIV transmission is body fluids. HIV can also be transmitted by sharing needles and other injecting equipment, especially sharing 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. HIV is transmitted in about 93% of blood transfusions using infected blood. HIV is not only problem in Viet Nam but also in the world such as Africa.
In 2007, between 12% and 17% of infections in this region were attributed to medical syringe use. The World Health Organization estimates the risk of transmission as a result of a medical injection in Viet Nam and Africa at 1.2%.
Another cause of HIV is it can be transmitted from mother to child during pregnancy, during delivery or through breast milk, resulting in the baby also contracting HIV. However, the risk of perinatal transmission can be significantly decreased if the mother and/or the child are given antiretroviral drugs. The World Health Organization recommends either : mother and baby being treated with antiretroviral medication while breastfeeding being continued the provision of safe formula. Infection with HIV during pregnancy is also associated with miscarriage.2.3.
How does HIV/AIDS influence people ?First of all, one of the most frequently observed ways in which HIV/AIDS affects household and individuals is though the sudden and tragic loss of income and economic security as household earnings decline and medical expenses increase. Household resources erode quickly while exposure to economic risk is exacerbated by the stress of illness as first adults and then children become caregivers for sick family members. In responding to the needs of children who have lost one or both parents to HIV/AIDS, extended families become further impoverished and indebted. In Viet Nam, per capita consumption expenditure is low, with 59% allocated to food. Most households have no reserves to pay for a sudden increase in health care expenditures or to weather a sudden loss in income.
As the result, AIDS can cause poor household to dissolve and push nonpoor households into poverty. A 1999 survey conducted by Hanoi Research and Training Center for Community Development reports the following qualitative household wealth indicators described by respondents from among the poorest household in Viet Nam.Moreover, HIV/AIDS lead to stigma and discrimination that are serious problems for People who are living with HIV and people at higher risk of HIV: the majority of the 1,642 PLHIV surveyed for the 2011Stigma Index study said that their right to live free of discrimination had been violated. People with HIV and key population leaders at consultation meetings for the Investment Case were also vocal about the challenges they face.
Not only is being HIV-positive stigmatized, but so are risk behaviours. If people’sHIV status or risk behaviours are known, they may not only be ostracized by their friends and families, but also denied educational and employment opportunities. The understandable fear of disclosure and stigma and discrimination is a major barrier to accessing services, including harm-reduction services, but in particular regular testing and early initiation of treatment. Perceptions about a general lack of confidentiality and fear of stigma and discrimination make many people at high risk of HIV infection very afraid to learn their HIV status.
As a result the uptake of testing is still low , and people being diagnosed are still starting treatment very late. Poor linkages among various HIV services aggravate this problem. (Viet Nam Network of People Living with HIV (VNP+). Viet Nam Stigma Index. 2012)