WHO on...

30 WHO on ••• AIDS • What is AIDS? AIDS is the late stage of an infection caused by HIV, or human immunodeficiency virus. The virus slowly destroys the body's immune system, leaving the person increasingly defenceless against other infections and some cancers. • How long does AIDS take to develop? From the time a person is first infected with HIV, AIDS takes an average of ten years to develop. Experience to date shows that most if not all HIV -infected people will sooner or later develop AIDS. • Can HIV-infected people who do not have AIDS spread the virus? Yes, the virus can be transmitted even when there are no signs of disease. HIV -infected people usually go for many years without any signs of disease, and are often unaware of their infection. They may, therefore, unwittingly pass it to others. • How is HIV transmitted? AIDS is essentially a sexually transmitted disease which, like some others such as hepatitis B and syphilis, can also be transmitted through blood and from mother to child. Sexual intercourse. Semen and vaginal fluids contain the virus. HIV is mainly transmitted through vaginal, anal and also oral sex when a condom is not used. Sexual transmission can occur from man to woman, man to man, and woman to man. People who have many sexual partners are at highest risk. Those who have other sexually transmitted diseases, such as syphilis, are at increased risk of acquiring or passing on HIV infection. Blood and blood products. Transfusion of HIV -contaminated blood can infect the patient. An increasing number of countries systematically screen human blood intended for transfusion, and do not use blood containing HIV antibodies. Blood-clotting products for disorders such as haemophilia are treated to kill HIV. Shared needles. Users of illegal injected drugs are at high risk of HIV infection because many of them share unclean needles and syringes. But any unsterilized skin- piercing instrument- including ear-piercing or tattooing needles- can spread HIV from one person to another. Mother-to-child. A woman infected with HIV can pass the virus to her baby during pregnancy, during birth or shortly after birth. Pregnant women who are infected with HIV have on average a one- in-four risk of their baby being born infected with HIV. Most babies born with the virus die before they are five years old. In some cases the mother might also transmit the virus through breast- feeding. • How is HIV not spread? HIV is not spread through casual contact in school, at the workplace, on toilet seats, in the swimming pool or at the market. It is not spread by handshakes or hugs, by eating from the dish or drinking from the glass used by an infected person, or by food. Nor is it transmitted by mosquitos and other insects. There is no evidence that HIV spreads through kissing. World Health • Morch-Aprill992 • How can you protect yourself? There are only two sure ways of protecting yourself from sexual transmission: abstain from sex or maintain a monogamous relationship with your uninfected partner. You should avoid sex with people you do not know or who have engaged in high-risk activities, such as having multiple partners and using injected drugs. If you are not absolutely certain that both you and your partner are free from the virus, you must take protective measures. Either avoid all forms of intercourse or use a condom, which prevents contact between your semen or vaginal secretions and your partner's. Used correctly, and each time, condoms greatly reduce the risk of infection. Lubricate the condom only with special water-based lubricants; do not use oils, vaseline or creams which can cause the condom to break. Do not share razors, needles or any other skin-piercing instrument that could be contaminated with blood. What to do if you are infected with HIV - or think you are? If you suspect you are infected or if you or your partner have been involved in any of the high-risk activities described, seek medical advice. Your doctor may counsel you to have a blood test for HIV antibody. Inform your partner. Never donate blood for transfusion. Women of childbearing age who know they are HIV -infected, or suspect they might be, should discuss the matter with their partner and think carefully before having a child. Take advice from your midwife, nurse or doctor. • World Health • Morch-Aprill992 Alcohol Excessive use of alcohol is at the root of many diseases, traffic and work accidents, fires, violence and crime, as well as social and family problems. If you want to reduce the amount of alcohol you drink, without cutting out alcoholic drinks altogether, here are some useful tips. • Take smaller sips. Sip less often and take small sips. Count the number of sips it takes to finish a glass, and then try to increase the The Countess and the cinchona tree In the September-Dctober 1991 issue of World Health on malaria , the caption to a picture states that, in 1630, theCountessofChinchon cured her recurrent fever with a decoction from the bark of a Peruvian tree. Not so, says Jose Antonio Najera-Morrondo, the author of the article. Since discovery of the diary of the Countess of Chinchon, w hich gives a careful day-by-day account of the Chinchon family, it is well known that the Countess was blessed with amazing good health. Aside from a sore throat and a 'flux and cough on the lungs' she had no illness at all in Peru. The noble count himself w as frequently il l wi th malaria, but now here is it recorded that he experienced a dramatic cure by fever bark, nor is there any mention of the bark or of the 'Fever Tree' . (Russell , P.F., Man 's mastery of malaria, Oxford University Press, 1955). In the next issue "People have the right and duty to parti c ipate indi v iduall y and collectively in the planning and implementation of their health care." So states the Alma-Ata Declaration on Primary Health Care. The May- june issue of World Health will look into how individuals and communities work for better health . • number for the next glass, and so on. • Occupy yourself Do something else that is enjoyable while you drink, to help distract your attention from the glass, and drink more slowly. You could listen to music, play cards or a game, talk, and so on. • Change the drink. Changing the type of drink you take can help break old habits and reduce the amount you drink. • Drink for the taste. Drink more slowly and enjoy the flavour. • Imitate the slow drinker. Look round for someone who is drinking slowly and behave like a shadow, not picking up the glass until the other person does. • Put the glass down between sips. If you hold the glass you will drink from it more often. Do something else with your hands instead of lifting the glass to your lips. • Dilute spirits. Top up spirits with non-alcoholic mixers. • Reduce the amount you drink in "rounds". When drinking with groups of people buy your own drinks, or buy one round only. When it is your round, do not buy yourself a drink. Order non- alcoholic drinks every so often. • Eat. Eat before or while drinking. Eating slows down the absorption of alcohol, and the fact of doing something else may reduce the amount you drink. Did you enjoy this issue? 31 • Take rest days. Abstain from alcohol at least one day a week, or preferably two, three or even more days. Take up other forms of entertainment and relaxation. • Start later. Start drinking later than usual; for example, go later to the pub or bar. • Learn to refuse drinks. Rehearse ways of refusing drinks: "No thanks, I'm cutting down", for example, or "Not tonight, I've got a bad stomach", or "No thanks, I'm driving". The above tips, and many other practical suggestions on how to reduce alcohol use, are found in Management of drinking problems, by P. Anderson, published by the World Health Organization Regional Office for Europe, Copenhagen, 1990 (WHO Regional Publications, European Series No. 32, price Sw.Fr. 26). • Photo Credits frool <Over: Drawing by Ellice de looche Poges 3: WHO/I. Fm'<os Poge 4: WHO Poge 5: WHO/ Federol Minislly of Heohh of Nigeno Poge 6: WHO/W. lindwer Poge 7: WHO/ M. Senlis Poge 8: WHO/ G. Wolker Poge 9: WHO/W .. lindwer Poges 10 & 11: WHO/ M. C. Sloplelon Poge 11:WHO/ Minisl!re des Affoires sociole el de lo Solidonle, Assurance molodie · Secunl! sociole, Comil! fron(ois d'Ed ucotioo pour lo Son!!, Fronce Poge 13: WHO/ B. Iepoilli & WHO Poges 14 & 15: WHO/W. lindwer Poge 16-17: Design by Peter Dovies Poge 17: WHO/ M.Sentis; WHO/ E. Schwob; WHO/ A. Rulge~; WHO; WHO/D. Schwoger Poge 18: WHO/ D. Gibson & J. Hosfeldr Poges 19 & 10: WHO/f. lilllewood Poge 11: WHO/ P. Merchez Poge 11:WHO/ C. ~bert Poge 13: WHO/ M. Sentis Poge 14: WHO/ l. Coper Poge 15: l.Sirmon © Poge 17: WHO/ N. GoldS<hmidl Poge 19: WHO/ M. Senns Bock<Dver: WHO/ f. Hosfeldl Why nol lake oul o subscription to World Health and enjoy reading about lhe world's major health issues six times o year. 1992 subscription prices are listed below. WHO also offers its popular ' Health Horizons" subscription, a combined subscription lot a reduced rate) to World Health and the quarterly World Health Forum. Onl« form . 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