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PENCEGAHAN HIV/AIDS. Ns. IRA ERWINA, M. Kep , Sp. KepJ. Prevalensi hiv/aids. Akhir tahun 2010 tercatat bahwa : 34 juta jiwa hidup dengan HIV 2,7 juta jiwa kasus baru yang terinfeksi HIV 1,8 juta jiwa meninggal karena penyakit yang timbul akibat AIDS. PENDAHULUAN.
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PENCEGAHAN HIV/AIDS Ns. IRA ERWINA, M. Kep, Sp. KepJ
Prevalensi hiv/aids Akhir tahun 2010 tercatat bahwa : • 34 juta jiwa hidup dengan HIV • 2,7 juta jiwa kasus baru yang terinfeksi HIV • 1,8 juta jiwa meninggal karena penyakit yang timbul akibat AIDS
PENDAHULUAN • Terjadi penurunan angka infeksi HIV di seluruh penjuru dunia • Sekitar 26% jika dibandingkan dengan epidemi yang terjadi pada tahun 1997 • Tapi di negara di kawasan eropa timur dan asia tengah, kasus baru infeksi HIV meningkat • Sedangkan di daerah Oceania, timur tengah dan afrika utara, angkanya tetap
PENYEBAB TIMBULNYA PENURUNAN ANGKA INFEKSI HIV • Changes in sexual behavior • Reduce the number of sexual partners • Increase the use of condoms • Waiting longer before becoming sexually active • Increases of male circumcision
5 LANGKAH PENCEGAHAN HIV/AIDS • Provide leadership for a strong national response • Know your epidemic and current response • Prioritize and tailor your response to the epidemic • Set ambitions, realistic and measurable prevention targets • Use strategicinformation to stay on course (UNAIDS, 2008)
BAGAIMANA CARA UNTUK MENGURANGI RESIKO TERINFEKSI ? • Hindaritransmisimelaluicairan • Reduce your sexual risks • Don’t have sex • Be monogamous • Get test and know your partner’s status • Use condom consistenly and correctly • Jikapasanganandaterinfeksi HIV (mixed-status), • use condom and dental dam • Communication with your partner • Safer sex practice
BAGAIMANA CARA UNTUK MENGURANGI RESIKO TERINFEKSI ? • If you are injection drug : • Never use or share drug preparation equipment • Use a new equipment • Only use syringe from a reliable resource • Use sterile water to prepare drugs • Use a new or desinfected container and a new filter each time you prepare drugs • Before inject, clean the inject site with a new alcohol swab • Safely dispose of syringe after one use
BAGAIMANA CARA UNTUK MENGURANGI RESIKO TERINFEKSI ? • If you are prenant : • an HIV-positive mother receives antiretroviral drugs during pregnancy, labor, and delivery • Has a baby by caesarian section • Avoids breastfeeding • newborn babies are also given treatment after birth • Use blood tranfusion and organ donation that free from HIV • PEP (post exposure prophylaxis)
Post exposure prophylaxis (pep) Biasanyadigunakanpadaorang yang terpapar HIV. Adaduajenis PEP : • Occupational PEP (oPEP) seseorangygbekerjadipelayanankesehatanpotensialterpaparbahan yang terinfeksi HIV • Non-occupational PEP seseorangpotensialterpapar HIV diluar area kerja (mis : kondomygrusak, aniayaseksual)
Post exposure prophylaxis (pep) • PEP yang efektif harus dimulai dalam waktu 72 jam semenjak terpapar. • PEP terdiri dari 2-3 obat antiretroviral yang harus dikonsumsi selama 28 hari • Pengobatan dgn PEP memiliki efek samping yg berat, sehingga sangat sulit utk mengakhiri pengobatan • PEP TDK MENJAMIN SESEORANG YG TERPAPAR HIV TIDAK TERJANGKIT HIV
Tipe-tipe test HIV • Antibodi test • Enzyme immunoassay (EIA) tests use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take up to two weeks. • Rapid HIV antibody tests also use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take 10–20 minutes. If you get a positive result from either of these tests, you will need to take another test, called a Western blot test, to confirm that result. It can take up to two weeks to confirm a positive result.
Tipe-tipe test HIV • Antigen test can be used to diagnose HIV infection earlier—from 1-3 weeks after you are first infected with HIV. Antigen tests require a blood sample. • PCR test (polimerase chain reaction) • This test detects the genetic material of HIV itself, and can identify HIV in the blood within 2-3 weeks of infection. • Babies born to HIV-positive mothers are tested with a special PCR test, because their blood contains their mother's HIV antibodies for several months. This means they would test HIV-positive on a standard antibody test—but a PCR test can determine whether the babies have HIV themselves. • Blood supplies in most developed countries are screened for HIV using PCR tests. PCR tests are also used to measure viral loads for people who are HIV-positive.
FREKUENSI UNTUK TEST HIV • CDC merekomendasikan utk test HIV setiap melakukan medical check-up • 1 kali setahun, jika menggunakan jarum suntik bersama, punya riwayat IMS, have had unprotected sex with mutiple or anonymous partner • 1 kali dalam 3-6 bulan jika seorang memiliki resiko tinggi • Trimester pertama dan trimester ketiga jika hamil
TEST HIV SELAMA PERIODE JENDELA • Periode jendela (window period) adl masa dimana mulai terpapar HIV sampai positif menderita HIV • Biasanya selama 3-6 bulan • Rata-rata butuh waktu 2-8 minggu dari waktu terpapar utk mendapatkan hasil tes yg akurat
Pre-post test counseling • Pre test konseling : • Informasi ttg tes HIV • Informasi ttg penularan HIV dan bagaimana cara melindungi diri • Informasi ttg kerahasiaan hasil test • Penjelasan yg mudah dipahami ttg arti dari hasil test • Post test konseling : • Penjelasan ttg hasil test • Konseling pencegahan HIV jika hasil test negatif • Western blot test, jika hasil positif
Jika hasil test : positif • CARILAH DOKTER YANG BERPENGALAMAN DALAM MENANGANI HIV • JALANI PEMERIKSAAN UNTUK PENYAKIT LAIN, SEPERTI : IMS DAN TB • PERTAHANKAN GAYA HIDUP YANG SEHAT • SAFER SEX PRACTICE AND USE CONDOM CONSISTENLY AND CORRECTLY • TELL YOUR PARTNER(S) ABOUT YOUR HIV STATUS BEFORE YOU HAVE ANY TYPE OF SEXUAL CONTACT (VAGINAL, ANAL, OR ORAL) AND DON’T SHARE NEEDLES OR SYRINGES.
MITOS SEPUTAR HIV • If you have HIV, you can be cured if you have sex with a virgin. THERE’S NO CURE FOR HIV • Antiretrovirals will cure HIV/AIDS. medicines control the virus and slow the progression of HIV infectionNOT cure it • Drinking, bathing in, or douching with bleach will prevent HIV. Bleach will kill HIV on injection needles and other surfaces, but is not safe or effective to use it in your mouth or on/in other parts of your body • The U.S. government created HIV/AIDS. HIV came from nature, most likely from a particular species of monkey in Africa. HIV was probably transferred to humans when they hunted and ate the infected monkeys