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Unit 1: The Global HIV/AIDS Situation. #1-1-1. Warm Up Questions: Instructions. Take five minutes now to try the Unit 1 warm up questions in your manual. Please do not compare answers with other participants. Your answers will not be collected or graded.
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Warm Up Questions: Instructions • Take five minutes now to try the Unit 1 warm up questions in your manual. • Please do not compare answers with other participants. • Your answers will not be collected or graded. • We will review your answers at the end of the unit. #1-1-2
What You Will Learn • By the end of this unit you should be able to: • describe the overall HIV/AIDS situation in the world • describe the HIV/AIDS situation in sub-Saharan Africa #1-1-3
Category Number Worldwide Sub-Saharan Africa (% of world total) Adults and children living with HIV/AIDS in 2004 39 500 000 24 700 000 (63%) Adults and children newly infected with HIV in 2004 4 300 000 2 800 000 (65%) Adult and child deaths due to AIDS in 2004 2 900 000 2 100 000 (72%) Children <15 years old living with HIV in 2004 2 300 000 Not Available Children <15 years old newly infected with HIV in 2004 530 000 Not Available Deaths in children <15 years old due to AIDS in 2004 380 000 Not Available Table 1.1. Worldwide Epidemic Source: UNAIDS, 2006 #1-1-4
Figure 1.1. HIV Prevalence among Adults in Africa, 2005 Source: UNAIDS, 2006 #1-1-5
Figure 1.2. Trends in HIV Prevalence Among ANC Attendees Source: WHO-AFRO, 2003 #1-1-6
Current HIV Situation in Ethiopia: • Based on surveillance results from antenatal clinics (so only includes pregnant women seeking health care services) • Data collected from 36 urban and 43 rural sites throughout the country • Left-over blood from syphilis testing is tested for HIV in unlinked and anonymous fashion • National, regional, urban/rural HIV prevalence estimates are then calculated with an Epidemic Projection Package • Separate computer software used to estimate the various impacts of HIV/AIDS. Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-7
Current Situation in Ethiopia: Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-8
Current Situation in Ethiopia: Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-9
1994 1997 Most recent West Africa Accra, Ghana 1.7% 2.2% 4.2% (2003) Cotonou, Benin 0.9% 4.4% 3.9% (2003) Southern Africa Francistown, Botswana 29.7% 42.9% 45.6% (2003) KwaZulu-Natal, South Africa 13.5% 26.9% 37.5% (2003) Harare, Zimbabwe 25.8% 30.4% 20.3% (2002) East Africa Addis Ababa, Ethiopia 20.3% 16.7% 11% (2003) Kampala, Uganda 22.3% 14.3% 10% (2002) Central Africa Yaounde, Cameroon ---- 5.6% 7.2% (2002) Table 1.2. Comparing 1994 and 1997 Prevalence Rates Source: WHO-AFRO, 2003 #1-1-10
Some Increase, Some Decrease • In southern Africa, HIV prevalence at ANCs in major urban areas has dramatically increased since the early 1990s, although rates appear to be levelling off now. • In some West African urban areas prevalence rates have remained low and stable (< 5%). • Uganda and a few other areas have experienced declines. #1-1-11
Figure 1.3. Urban versus Rural HIV Prevalence Source: WHO-AFRO, 2003 #1-1-12
Current Situation in Ethiopia: Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-13
Current Situation in Ethiopia: Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-14
High Prevalence Factors • High prevalence of other STIs increase the risk of acquiring and transmitting HIV • Limited access to STI management • Limited access to, or social non-acceptance of, condoms #1-1-15
High Prevalence Factors, Cont. • War or civil disturbance • Cultural or ethnic practices, such as polygamy and wife inheritance • Women’s low status and inability to influence their partner’s behaviour #1-1-16
High Prevalence Factors, Cont. • Low literacy rates • Increasing urbanisation, migration, mobilisation and separation of families as a result of poverty or other social circumstances • Low level of political commitment to the prevention and control of HIV/AIDS • Exposure to blood from unsafe medical practices and traditional practices #1-1-17
In Summary • By the end of 2004, there were almost 40 million people living with HIV/AIDS worldwide, including more than 2 million children. • The situation is especially serious in sub-Saharan Africa, which accounts for 64% of these infections. #1-1-18
Warm Up Review • Take a few minutes now to look back at your answers to the warm up questions at the beginning of the unit. • Make any changes you want to. • We will discuss the questions and answers in a few minutes. #1-1-19
Answers to Warm Up Questions 1. True or false? Almost 40 million people are infected with HIV worldwide. #1-1-20
Answers to Warm Up Questions, Cont. 1. True or false? Almost 40 million people are infected with HIV worldwide. True #1-1-21
Answers to Warm Up Questions, Cont. 2. What region of the world has been affected the most by HIV/AIDS, with an infection prevalence rate of over 30% in some countries? #1-1-22
Answers to Warm Up Questions, Cont. 2. What region of the world has been affected the most by HIV/AIDS, with an infection prevalence rate of over 30% in some countries? Sub-Saharan Africa #1-1-23
Answers to Warm Up Questions, Cont. 3. What region of Africa has been the most affected by HIV/AIDS? #1-1-24
Answers to Warm Up Questions, Cont. 3. What region of Africa has been the most affected by HIV/AIDS? Southern Africa #1-1-25
Answers to Warm Up Questions, Cont. 4. Some of the factors that account for the high prevalence of HIV/AIDS in sub-Saharan Africa include • extensive population mobility • women’s status and inability to influence partner’s behavior • war and civil disturbance • blood exposure from unsafe medical practices • all of the above #1-1-26
Answers to Warm Up Questions, Cont. 4. Some of the factors that account for the high prevalence of HIV/AIDS in sub-Saharan Africa include • extensive population mobility • women’s status and inability to influence partner’s behavior • war and civil disturbance • blood exposure from unsafe medical practices • all of the above #1-1-27
Small Group Discussion: Instructions • Get into small groups to discuss these questions. • Choose a speaker for your group who will report back to the class. #1-1-28
Small Group Reports • Select one member from your group to present your answers. • Discuss with the rest of the class. #1-1-29
Case Study: Instructions • Try this case study individually. • We’ll discuss the answers in class. #1-1-30
Case Study Review • Follow along as we go over the case study in class. • Discuss your answers with the rest of the class. #1-1-31
Questions, Process Check • Do you have any questions on the information we just covered? • Are you happy with how we worked on Unit 1? • Do you want to try something different that will help the group? #1-1-32