New Delhi. HIV, Hepatitis B and Hepatitis C all can be
transmitted through blood and blood products and or by sexual route.
Though the prevalence of HIV is only 0.3% in the general population
the same of hepatitis C is up to 5%.
Addressing a press conference here on the occasion of World AIDS Day
Dr Naresh Chawla President, DMA, Dr Ashwini Dalmiya Secretary, DMA and
Dr KK Aggarwal President, Heart Care Foundation of India said that
getting injections from unqualified health care workers can spread HIV
NACO and the National Institute of Medical Statistics (a body under
ICMR) 2006 estimates suggest national adult HIV prevalence in India is
approximately 0.36 percent, amounting to between 2 and 3.1 million
people. If an average figure is taken, this comes to 2.5 million
people living with HIV and AIDS; almost 50 percent of the previous
estimate of 5.2 million.
More men are HIV positive than women. Nationally, the prevalence rate
for adult females is 0.29 percent, while for males it is 0.43 percent.
This means that for every 100 people living with HIV and AIDS (PLHAs),
61 are men and 39 women.
Prevalence is also high in the 15-49 age group (88.7 percent of all
infections), indicating that AIDS still threatens the cream of
society, those in the prime of their working life.
While adult HIV prevalence among the general population is 0.36
percent, high-risk groups, inevitably, show higher numbers.
Among Injecting Drug Users (IDUs), it is as high as 8.71 percent,
while it is 5.69 percent and 5.38 percent among Men who have Sex with
Men (MSM) and Female Sex Workers (FSWs), respectively.
The spread of HIV in India is primarily restricted to the southern and
north eastern regions of the country. In India the main factors which
have contributed to its large HIV infected population are extensive
labor migration, low literacy level in certain rural areas resulting
in lack of awareness and gender disparity.
In order to pass HIV from one person to another, HIV-infected internal
fluid from one person needs to get into the bloodstream of another
person. HIV is usually transmitted through: Sharing needles,
unprotected anal, vaginal, and sometimes oral sex, and from mother to
infant before or during delivery and while breast-feeding.
HIV can spread through unprotected sexual contact with multiple
partners, blood products, mother to baby (before or during, or through
breast milk) and sexual intercourse (vaginal and anal). In the
genitals and the rectum, HIV may infect the mucous membranes directly
or enter through cuts and sores caused during intercourse (many of
which would be unnoticed). Vaginal and anal intercourse is a high-risk
The mouth is an inhospitable environment for HIV (in semen, vaginal
fluid or blood), meaning the risk of HIV transmission through the
throat, gums, and oral membranes is lower than through vaginal or anal
membranes. There are however, documented cases where HIV was
transmitted orally, so we can’t say that getting HIV-infected semen,
vaginal fluid or blood in the mouth is without risk. However, oral sex
is considered a low risk practice.
An injection needle can pass blood directly from one person’s
bloodstream to another. It is a very efficient way to transmit a
blood-borne virus. Sharing needles is considered a high-risk practice.
It is possible for an HIV-infected mother to pass the virus directly
before or during birth, or through breast milk. Breast milk contains
HIV, and while small amounts of breast milk do not pose significant
threat of infection to adults, it is a viable means of transmission to
Effective strategy to prevent HIV?
Becoming educated about HIV and understanding the facts about
transmission are the first, and perhaps most important way to prevent
the spread of HIV.
Abstaining from sex particularly with multiple sexual partners and
needle sharing is the most effective way for people to protect
themselves from HIV and other sexually transmitted diseases. However,
when abstinence is not an option for people, using barrier protection
such as latex condoms (male or female) is the next best thing.
Three stages of prevention:
• Firstly, everyone should take steps to avoid contracting the infection,
• Secondly, infected person who does not know that he is infected
should be made aware of his condition through symptoms or thorough
• Finally, the already infected persons should be made aware of the
need for prevention of other diseases and be aware that he can infect
The most effective ways to prevent HIV Infection:
• Not having sex – whether vaginal, anal, or oral
• Sex only between two mutually monogamous, uninfected partners who
do not share needles or syringes with anyone.
• Not injecting non prescribed drugs
• Not sharing needles or syringes for any reason (when injected
illegal drugs, medications, vitamins, or steroid; tattooing; or body
• Not engaging in activities that involve exchange of blood, semen,
vaginal fluids, or breast milk.
Ways to reduce the risk of HIV Infection:
• Using a latex condom the right way every time during vaginal,
anal, or oral sex.
• Not using drugs or alcohol, which can impair judgment.
• Cleaning needles and syringes with chlorine bleach and water if
more effective prevention is not available.
• Using barrier protection (e.g. latex gloves) when coming into
contact with blood.
1. A new weapon of war, HIV kanya, HIV blood transfusions after
kidnapping, HIV positive syringes for extraction of money.
2. On Saturday, April 4 09, 52 year old Johnson Aziga was found
guilty of murder by a Montreal jury for not sharing his HIV status
with sexual partners, two of whom later died from AIDS-related
illnesses. According to prosecutors, this marks the first case in
Canada, and possibly the world, where an HIV-positive individual has
been convicted of murder for failing to inform partners of his status.
Aziga, a former government research analyst from Uganda, was found
guilty. He infected seven women; four other partners did not contract
the virus. The Crown argued that Aziga infected the women with
“‘slow-acting poison’ that destroyed their immune systems … leading to
their cancers and to their deaths.” The sex was not considered
consensual because the women were not aware he was HIV positive.
3. Infected hepatitis c, hepatitis b and HIV, combined blood is the
most deadly weapon ever possible.
Needle stick injury
1. The average risk of sero conversion after a needle stick injury is
about 3 per 1000 with no prophylaxis. It is estimated that this risk
is reduced at least 80 percent when post exposure prophylaxis (started
within 3 hours) is administered in a timely fashion. Infection is high
with hollow needle, high bore needle and if the needle is inserted in
the artery or the vein.
2. Prior to the widespread use of hepatitis B vaccine among health
care workers, the prevalence of hepatitis B virus markers was higher
among health care workers than the general public. In 1991 the
guidelines came that all health care workers be offered hepatitis B
vaccine. Recent studies suggest that this strategy has been highly
successful in reducing hepatitis b virus infection among health care
workers with a 95 percent decline in the incidence of hepatitis B
infection among them.
3. Hepatitis B virus is the most infectious of the three blood borne
viruses. It gets transmitted by percutaneous and mucosal exposures and
human bites. It has also been transmitted by fomites such as finger
stick devices used to obtain blood for glucose measurements, multi
dose medication vials, jet gun injectors, and endoscopes. The virus
can survive on counter tops for seven days and remain capable of
4. The prevalence of HCV infection among health care worker is similar
to that of the general population. Testing of health care workers for
hepatitis C virus HCV should be performed after needle sticks, sharp
injuries, mucosal, or non intact exposure to hepatitis C virus
positive blood. The average incidence of sero conversion to hepatitis
C virus after unintentional needle sticks or sharps exposures from an
hepatitis C virus positive source is 1.8 percent (range, 0-7 percent).
Transmission of hepatitis C virus from blood splashes to the
conjunctiva has been described. Hepatitis C virus has been
demonstrated to survive on environmental surfaces for at least 16
hours but not four or seven days.