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 Contents
• Introduction
• Basic facts about HIV/AIDS
• Social issues : Views of stigma and
discrimination against people living
with HIV/AIDS
• Why are women in Africa more
vulnerable to HIV/AIDS?
• What needs to be done to reduce the
rate of infection amongst university
students and young girls.

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Introduction
• HIV is the virus that gets passed from one body to the other, and AIDS is the
disease that later develops in people with HIV. Anyone can be at risk for
contracting HIV! HIV does not discriminate. It’s not who you are that puts you
at risk, it’s what you do. Anyone can be affected with HIV regardless of age,
gender, economic background, race, religion etc. Unfortunately, there is no
cure or vaccine for HIV. But it is possible to protect yourself and others from
the virus. That’s our aim, but how? This simple question helps us to focus on
the core aspects of our presentation which include;
• Basic facts about HIV and AIDS,
• Views of stigma and discrimination,
• Why women are vulnerable to HIV and AIDS?
• What needs to be done to reduce infection among university students?
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• (1981) AIDS is first identified among
homosexual men and intravenous users
in the United States in New York and
California. Shortly after, evidence of the
epidemic is found in the sub Saharan
Africa among heterosexual men,
women and children.
• (1983 – 1985) Cases of children with the
HIV infection are observed in clinical
services in the East African region. Basic facts about
• (1984) HIV is clearly demonstrated as a
causative agent of AIDS.
HIV/AIDS
• (1984) Studies of Mother to Child
Transmission begin in East Africa.
• (1985) First case of AIDS in Zimbabwe is
identified.
• (1987) AZT became the first drug to
gain approval from the U.S. Food and
Drug Administration for treating AIDS Contoso
leading to the antiretroviral therapy. Pharmaceuticals

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• The Human Immuno-deficiency Virus (HIV) is a virus that infects the blood and impairs the
immune system`s ability to fight diseases. It mostly affects the white blood cells (CD4 cells or
T-cells). Once inside the CD4 cell, HIV starts producing millions viruses that eventually kill the
cell and then go out to infect other cells. It is based on this that there is a correlation between
the CD4 cells count and the virus.
• As HIV infection progresses, the number of these cells declines. When the CD4 count drops
below 200, a person is diagnosed with AIDS. A normal range for CD4 cells is about 500-1,500.
Usually, the CD4 cell count increases when the HIV virus is controlled with
effective HIV treatment.
• One can carry the HIV virus for many years without knowing that they have it. They can feel
and look entirely healthy before they develop any signs of AIDS. HIV is the first stage f
infection and IDS the second stage, by which the time the body`s natural protection is low due
to loss of the while blood cells that have been destroyed by HIV.
• Types of HIV :
1. HIV-1 which is the primary cause of AIDS world-wide and sub-Saharan Africa. The most
common HIV virus responsible for 95% of infections.
2. HIV-2 found mostly in West Africa. It develops slowly and is less easy for people to transmit
than HIV-1. and the most common mode of transmission is heterosexual sex. It has a lower
mortality rate and people with HIV-2 may have a longer period without symptoms. Contoso
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• The Acquired Immune Deficiency Syndrome (AIDS) caused when the HIV virus has destroyed
most of the CD4 cells in the body, leaving the body unprotected from any disease causing
organisms which include viruses, bacteria and fungi amongst others. This explains why people
with AIDS develop serious infections and often cancer as well.
• The virus follows three stages

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Transmission of HIV/AIDS
• HIV can be transmitted through fluids namely blood, semen, vaginal fluids and breast milk. To
get infected, these fluids need a portal of entry or a door into one`s body. A portal can be a cut
sore, opening in the skin, the soft tissue called the “mucous membrane” located in the vagina,
the tip of the penis, the anus, the mouth, the eyes or the nose.
• Activities that can lead to exchange of such fluids include

• Other activities include unsterilised instruments in some traditional practices Contoso

such as circumcision, tattooing, manicure and using unsterilized clippers in Pharmaceuticals

barber shops. page 7

Antiretroviral Therapy (ART)
• Although there is no cure for HIV and AIDS, Antiretroviral Therapy drugs are
used to reduce the amount of HIV in ones body.
• Classes of Antiretroviral Drugs
1. Fusion/ Entry inhibitors: this drugs disrupts the HIV process by preventing
the virus from attaching to your cells
2. Protease inhibitors, reverse transcriptase Inhibitors: This drugs prevent the
creation, assembly and spread of new virus
3. Generally all ART drugs help in controlling the growth of the virus, slow or
stop symptoms and prevent transmission to others

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Treatments for opportunistic Infections

There are various medication used to treat opportunistic Infections e.g.

• Meningitis: intravenous antibiotics
• Pneumonia and Tuberculosis : Isoniazid antibiotics
• Chromic Diarrhea: antibiotics

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 Protecting oneself form HIV

Abstinence PrEP Condoms PMTCT Male

circumcision
Sexual abstinence or Pre-exposure A condom is a Prevention of Circumcision is the
sexual restraint is prophylaxis (or PrEP) sheath-shaped mother to child removal of the
the practice of are taken by people barrier device, used transmission foreskin from the
refraining from some at very high risk for during sexual (PMTCT) refers to human penis. It is an
or all aspects of HIV daily to lower intercourse to interventions to effective biomedical
sexual activity for their chances of reduce the prevent transmission intervention that has
medical, getting infected. probability of of HIV from an HIV- been proven to
psychological, legal, PrEP can stop HIV pregnancy or a positive mother to reduce the risk of
social, financial, from taking hold and sexually transmitted her infant during female-to-male HIV Contoso
philosophical, moral, spreading infection. There are pregnancy, labor, transmission by up Pharmaceuticals
or religious reasons. throughout your both male and delivery, or to 60 percent.
body. E.g. Truvada female condoms breastfeeding. page 10
Myths surrounding HIV/AIDS
• There are myths around how HIV is spread. The following activities do not spread the virus

• There are also myths surrounding the cure of HIV such as curing infection by washing after sex
with an infected person, having sex with a virgin, the pulling out method, spells and herbal
medicines, using the contraceptive pill amongst others.
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• Condoms and PrEP (Pre-exposure prophylaxis) used correctly and consistently protect you from Pharmaceuticals

HIV transmission during sex. page 11

Social issues : Views of
stigma and
discrimination against
people living with
HIV/AIDS

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• HIV-related stigma and discrimination refers to prejudice, negative attitudes and abuse
directed at people living with HIV and AIDS.
• Stigma and discrimination also makes people more vulnerable to HIV. Those most at risk to
HIV (key affected populations) continue to face stigma and discrimination based on their
actual or perceived health status, race, socioeconomic status, age, sex, sexual orientation or
gender identity or other grounds
• Stigma and discrimination manifests itself in many ways. Discrimination and other human
rights violations may occur in health care settings, barring people from accessing health
services or enjoying quality health care. Some people living with HIV and other key affected
populations are shunned by family, peers and the wider community, while others face poor
treatment in educational and work settings, erosion of their rights, and psychological damage.
These all limit access to HIV testing, treatment and other HIV services.
• The People Living with HIV Stigma Index documents the experiences of people living with HIV.
As of 2015, more than 70 countries were using the HIV Stigma Index, more than 1,400 people
living with HIV had been trained as interviewers, and over 70,000 people with HIV have been
interviewed. Findings from 50 countries, indicate that roughly one in every eight people living
with HIV is being denied health services because of stigma and discrimination.
• Stigma and discrimination is often directed towards key affected populations such as men who
have sex with men (sometimes referred to as MSM), people who inject drugs and sex workers. Contoso
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Why is there stigma around HIV and AIDS?
• Whenever AIDS has won, stigma, shame, distrust, discrimination and apathy was on its side.
Every time AIDS has been defeated, it has been because of trust, openness, dialogue between
individuals and communities, family support, human solidarity, and the human perseverance
to find new paths and solutions.
- Michel Sidibé, Executive Director of UNAIDS8
• The fear surrounding the emerging HIV epidemic in the 1980s largely persists today. At that
time, very little was known about how HIV is transmitted, which made people scared of those
infected due to fear of contagion.
• This fear, coupled with many other reasons, means that lots of people falsely believe:
• HIV and AIDS are always associated with death
• HIV is associated with behaviours that some people disapprove of (such as homosexuality,
drug use, sex work or infidelity)
• HIV is only transmitted through sex, which is a taboo subject in some cultures
• HIV infection is the result of personal irresponsibility or moral fault (such as infidelity) that
deserves to be punished
• inaccurate information about how HIV is transmitted, which creates irrational behaviour and Contoso
misperceptions of personal risk. Pharmaceuticals

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How stigma affects people living with HIV
• “My daughter refused to go hospital to receive medicines. My daughter died because of the
fear of stigmatization and discrimination.”
• HIV-related stigma and discrimination exists worldwide, although it manifests itself differently
across countries, communities, religious groups and individuals. In sub-Saharan Africa, for
example, heterosexual sex is the main route of infection, which means that HIV-related stigma
in this region is mainly focused on infidelity and sex work.
• Research by the International Centre for Research on Women (ICRW) outlines the possible
consequences of HIV-related stigma as:
1. loss of income and livelihood
2. loss of marriage and childbearing options
3. poor care within the health sector
4. withdrawal of caregiving in the home
5. loss of hope and feelings of worthlessness
6. loss of reputation.
HIV stigma and key affected populations
Contoso
• Stigma and discrimination is often directed towards affected populations such as men having Pharmaceuticals
sex with other men (sometimes referred to as MSM), people who inject drugs and commercial page 15
sex workers.
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What can we do about stigma?

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How stigma affects the HIV response
• UNAIDS and the World Health Organization (WHO) cites fear of stigma and discrimination as
the main reason why people are reluctant to get tested, disclose their HIV status and take
antiretroviral drugs (ARVs).
• One study found that participants who reported high levels of stigma were over four times
more likely to report poor access to care. This contributes to the expansion of the global HIV
epidemic and a higher number of AIDS-related deaths.
• An unwillingness to take an HIV test means that more people are diagnosed late, when the
virus may have already progressed to AIDS. This makes treatment less effective, increasing the
likelihood of transmitting HIV to others, and causing early death.
• For example, in the United Kingdom (UK), many people who are diagnosed with HIV are
diagnosed at a late stage of infection, defined as a CD4 count under 350 within three months
of diagnosis. Although late diagnosis of HIV has declined in the UK in the last decade, from
56% in 2005 to 39% in 2015, this figure remains unacceptably high.
• In South Africa, stigma stopped many young women involved in a trial on HIV prevention from
using vaginal gels and pills that would help them stay HIV free. Many reported being afraid
that using these products would lead them to being mistakenly identified as having HIV, and
so the fear of the isolation and discrimination that being identified as living with HIV would
bring led them to adapt behaviours that put them more at risk of acquiring the virus. Contoso
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• The epidemic of fear, stigmatization and discrimination has undermined the ability of individuals,
families and societies to protect themselves and provide support and reassurance to those affected. This
hinders, in no small way, efforts at stemming the epidemic. It complicates decisions about testing,
disclosure of status, and ability to negotiate prevention behaviours, including use of family planning
services.
• In 2015, WHO released new treatment guidelines that reflect the need to address stigma and
discrimination as a barrier to accessing HIV treatment.
Forms of HIV stigma and discrimination
• HIV and AIDS-related stigma can lead to discrimination, for example, when people living with
HIV are prohibited from travelling, using healthcare facilities or seeking employment.
a) Self-stigma/internalised stigma
• Self-stigma, or internalised stigma, has an equally damaging effect on the mental wellbeing of
people living with HIV or from key affected populations. This fear of discrimination breaks
down confidence to seek help and medical care.
• Self-stigma and fear of a negative community reaction can hinder efforts to address the HIV
epidemic by continuing the wall of silence and shame surrounding the virus. Negative self-
judgement resulting in shame, worthlessness and blame represents an important but
neglected aspect of living with HIV. Self-stigma affected a person's ability to live positively,
limits meaningful self agency, quality of life, adherence to treatment and access to health
services. Contoso
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• Similarly, a study of men in Tijuana, Mexico who have sex with men found that self-stigma was
strongly associated with never having tested for HIV, while testing for HIV was associated with
identifying as being homosexual or gay and being more ‘out’ about having sex with men.
• In countries that are hostile to men who have sex with men and other key populations,
innovative strategies are needed to engage individuals in HIV testing and care programmes
without exacerbating experiences of stigma and discrimination.

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Why are women in Africa
more vulnerable to
HIV/AIDS?

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• Since the start of the global HIV epidemic, women have been disproportionately affected by
HIV in many regions. Today, women constitute more than half of all people living with HIV.
AIDS-related illnesses remain the leading cause of death for women of reproductive age (15-
44) (AVERT 2018).
• High risk behavior such as unprotected sex with multiple partners, being part of sexual
network, injecting drug use and use of commercial sex can increase vulnerability to HIV.
• HIV disproportionately affects women and adolescent girls because of vulnerabilities created
by unequal cultural, social and economic status. There are also unaccommodating attitudes
towards sex outside of marriage and the restricted social autonomy of women and young girls
can reduce their ability to access sexual health and HIV services.
• Much has been done to reduce mother-to-child transmission of HIV, but much more needs to
be done to reduce the gender inequality and violence that women and young girls at risk of
HIV often face.
• Women are physically, socially and economically vulnerable to conditions that forces people to
accept the risk of HIV infection in order to survive.
• Social factors
1. Lack of access to healthcare services
2. Lack of access to education Contoso
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3. Poverty page 22
• Social factors (continued)
4. Gender based violence and intimate partner violence
5. Sugar daddy culture and transactional sex.
6. Child marriages.
• Biological factors
1) The vagina is an internal organ, women are less likely to know that they have sores from STIs
which could facilitate HIV transmission.
2) Women have a surface area of mucous membrane (portal of entry) that is greater in size than
that of men.
3) Women receive greater quantities of possibly infected fluids during a sexual encounter.
• Cultural factors
1) Lack of female controlled prevention methods such as female condoms.
2) Extreme poverty that encourages the exchange of sex for money, school fees or food.
3) Taboos related to speaking about sex
4) Gender roles that do not permit women to participate in sexual or reproductive decisions. Contoso
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What needs to be
done reduce the
rate of infection
amongst
university
students and
young girls?

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• According to an AVERT report, AIDS is the leading cause of death among young people (aged
10-24) in Africa, and second leading cause globally. Within this group, young women and girls
are twice as likely to acquire HIV as young men with A youth bulge in Africa threatening to
increase new HIV infections further.
• It is on this that there is need to reduce infections amongst university students and young girls.
• Encourage practice of safe sex : Unprotected sex is the most common route of HIV infection
among young people. As such there is need to emphasise practice of safe sex through use of
condoms and even ensuring they are easily accessible.
• Stop shunning sex education : There is also low HIV and sexual and reproductive health
knowledge as this is an avoided topic. This means the rates of infection will always be high
among young people because they are not properly informed.
• Emphasise the ‘life-cycle’ approach to HIV : A "lifecycle approach" to HIV prevention
recognizes the interconnectedness of the health of women, children and adolescents, and
prioritizes interventions that have benefits across these populations prevention can help
respond to the changing challenges people face at different ages. Finding best suited
interventions for each group means better crafted strategies for combating new infections.
• Better addressing issues of older sexual partners : Revisiting power dynamics in
relationships especially where women have older partners because intergenerational sex is
one of the main drivers of the HIV epidemic. There is need to remind women and young girls Contoso
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that there desires are still as important as their partners`.
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• Integrating all sexual-orientations in the education curriculum : Educating the transgenders
and homosexuals will also help greatly because these groups continue to suffer segregation
which means they also suffer from lack of information.
• Addressing issues surrounding drug abuse : Talking openly about drug abuse, offering
rehabilitation services and offering non-judgmental environment were drug users can get
clean will also help dramatically reduce infections through use of intravenous drugs.
• Educating youths on sex fetishes : The youths of today are very experimental and have come
up with a lot of fetishes with most of them posing health risks. Fetishes contribute generously
to the spread of the virus and educating youth about what they risk by indulging in some of
these will help them refrain.

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CONCLUSION

Get tested regularly Condomise, practise safe

sex
.

Integrated lifestyle PrEP

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Thank You
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