Advocacy means communication with policy makers and opinion makers to influence their behavior through various forms of persuasive communication.

The mother is prescribed a single dose of Nevirpine at the onset of labor and an oral dose to the newborn child within 72 hours of birth. The mother is advised to have a caesarian operation and is also advised not to breastfeed the baby for which other formula baby food are prescribed.

HIV/AIDS affects the most productive age group in a country and hence has several direct and indirect social and economic costs on the society. Hence the involvement of different sectors of the government, NGOs, and other social groups is very essentially in a coordinated manner in pooling resources in preventive work is required. This is being explained as intersectoral collaboration.

A KABP study/survey is at the heart of knowing the target audience. It stands for knowledge/skills that the target audience knows about program specific topics, attitudes i.e. what does the target audience feel about attitudes, beliefs i.e. what does the target audience believe about a program activity such as- condoms, practices i.e. what are the behavioral display of the target audience.

The basic behaviors are: the A, B, C, D of safe sex which stand for :
A- abstaining from penetrative sex,
B. being faithful to one's sexual partner(reciprocal),
C. use of condoms during sex consistently,
D. delaying sexual debut of adolescents, reducing the number of partners ; not using unclean needles.

It is a process by which an individual changes an attitude or behavior due to the knowledge gained, through exposure and personal experience.

Communication is the ability to organize and express ideas in writing and in speaking which involves the transfer of information. It is the attempt to bring about a common understanding. It is synonymous with the term IEC which stands for information, education and communication.

A change in behavior is usually preceded by a change in knowledge and in attitude. Communication is the process that brings in information and presents it depending on the audience level and their state of motivation.

HIV stands for Human Immuno - deficiency Virus. It is the name of the virus that causes AIDS. Viruses are the smallest and simplest living organisms. They are so small that they cannot be seen under a light microscope. One requires an electron microscope to see them. HIV causes reduction of body's capability to fight against various infections in human body. It makes the body weak and sick.

The word AIDS stands for Acquired Immuno Deficiency Syndrome. AIDS is a medical diagnosis for a combination of symptoms, which results from a breakdown of the immune system. 'A' stands for acquired which means that it is obtained or received by a person and is something, which is not genetically inherited. 'ID' stands for Immuno Deficiency which means there is deficiency in the immune system or that the immune system is weakened. 'S' stands for syndrome that stands to emphasize that AIDS is not just one disease or symptom but presents as a group of diseases or symptoms.

The immune system carries out the body's defense against infections produced by pathogenic (disease-causing) agents and it also destroys or eliminates foreign bodies. It is now known that HIV erodes the immune system by killing the cells, which compose it. The more cells that die as a result of HIV infection, the more difficult the body's struggle against infection becomes.

The cells that HIV preferentially attacks are known as CD4 cells or T4 lymphocytes. They are the most important cells for the body's defense. A count of these cells in the blood also serves as an index for monitoring the infection's progress: as infection progresses, the number of these cells lowers.

In persons who have AIDS, infections that occur as a result of HIV infection are also known as "opportunistic" because they are contracted only when the immune system fails to function adequately and the ability to fight disease-causing agents has been lost.   

HIV is the virus that causes AIDS. In other words HIV is the reason and AIDS is the result.

The AIDS virus is not a single entity, but consists of a number of strains that can be grouped into two distinct types, HIV -1 and HIV -2. HIV -2 is less virulent and is mostly restricted to populations in West and Central Africa. Although HIV -1 and HIV -2 are genetically distinct, they are related.

In the early 1980s it was demonstrated that AIDS results from an infection with HIV-1, the human immunodeficiency virus. Based on comparisons of HIV sequences from various sources, the origin of the AIDS virus can be pinpointed to Africa in the 1930s. These comparisons reveal that the earliest sample of HIV is from a blood sample drawn from an African in 1959. 

HIV-1 was identified in 1993 by Dr. Robert Gallo and other medical scientists at the National Cancer Institute in Bethesda, Maryland. At about the same time, Dr. Luc Montagnier of the Pasteur Institute in Paris isolated HIV-2 from AIDS patients. These two HIV viruses are distinguishable by their genome make-up today, but are believed to have had a common ancestor in Africa. Scientists think that HIV-2 was transmitted to humans from a simian source, probably the sooty mangabeys that are hunted for food in Senegal, Guinea, the Ivory Coast and Gambia.

HIV-1, which is much more lethal, is most closely related to SIVcpz, Simian Immunodeficiency Virus, and was transmitted from the Central African Chimpanzee, Pan troglodytes troglodytes. HIV-1 mutates very rapidly, and Simian Immunodeficiency Virus crossed over to humans (on at least three separate occasions) as Human Immunodeficiency Virus. As the result of mutation, 11 different subtypes of HIV-1 have been identified, and are designated as A through K.

HIV may be found in the blood cells, bodily fluids, and secretions of infected persons in varying quantities at different times. For instance, HIV may be easily isolated in semen, vaginal secretions, and blood. It also has been isolated in breast milk. The virus is transmitted from infected person to others through blood, semen, vaginal secretions, and breast milk.

HIV may be transmitted by

• Unprotected penetrative sex with an infected person
• Transfusion of infected blood from one person to another
• Through the use of un-sterilized needles and syringes
• From an infected mother to her child 

Through Unprotected Penetrative Sex

Sexual contact with an infected person is the most commonly found mode of HIV transmission till date, especially through unprotected sex, which stands for any sexual act involving penetration without a condom.

• One could get infected with HIV if he/she has sex with an infected man / woman without taking proper protection.
• One might get infected at the very first time he/she indulges in sex if the partner is already carrying the infection.
• If one indulges into sex with many partners, he/she has a high chance of getting infected with HIV as in that case, it becomes a tough task to know whether the partner is already infected or not. 

Through Infected blood

HIV can enter the body when blood that contain HIV is given to a person through blood transfusion.

Through Infected Needle

This mode of transmission includes the use of contaminated needles and syringes, transfusions involving HIV-infected blood, and transplants involving HIV-infected organs and tissues.

When an infected person injects intravenous drugs, the needle and the syringe used become contaminated with infected blood. If another person uses these implements without sterilizing them, the HIV-contaminated blood of the first user enters the bloodstream of the second.

HIV can also enter the body when sharp tools used to cut the skin (such as ear piercing) are not cleaned and sterilized properly.

From infected mother to the child

The chances of passing HIV to child from infected mother before or during birth are about one in four, or 25 percent, for each pregnancy while the mother is already infected to the virus.

The virus can be transmitted from infected mother to child

• During pregnancy
• During birth
• During breast-feeding

There are about 30 percent chances of passing the HIV infection from a mother to her child through breast milk.

It has three phases:

Window Period (Asymptomatic Stage): After the virus enters into body, it takes about 3-6 months to be detected by a blood test. This period during which the presence of HIV antibodies are not detectable in the blood is called a window period. During this period, a person may pass on the infection to others unknowingly. Or the person may pass on the infection if he has already tested his blood within three months after the exposure and has found to be negative.

Symptomatic Stage: After the window period is over, the virus start attacking the body's immune system. At this stage, the presence of HIV in the body manifests with some symptoms in the form of many opportunistic infections like flu, fever, diarrhea or tuberculosis. Most of them get cured after treatment. But the disease goes on progressing in the body rapidly depending on the personal hygiene, habits and nutritional status of the infected person.

Full-blown AIDS Stage: At this stage, the virus has completely overridden the body's immune system and many opportunistic infections occur repeatedly, or together. Some people develop AIDS a few years after becoming infected with HIV. Some people can be infected with HIV for 10 years or longer without developing AIDS.

After the window period is over, the virus start destroying the body's immune system. At this stage, the presence of HIV in the body presents with some symptoms in the form of many opportunistic infections like flu, fever, diarrhea or tuberculosis. Most of them get cured after treatment. But the disease goes on progressing in the body rapidly depending on personal hygiene, habits and nutritional status.

Primary HIV infection is the first stage of HIV disease, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by the body (usually 6- 12 weeks).

Some people newly infected with HIV experience some "flu-like" symptoms. These symptoms, which usually last no more than a few days, might include fevers, chills, night sweats and rashes (not cold-like symptoms). Other people either do not experience "acute infection," or have symptoms so mild that they may not notice them.

Given the general character of the symptoms of acute infection, they can easily have causes other than HIV, such as a flu infection. For example, if one had some risk for HIV a few days ago and are now experiencing flu-like symptoms, it might be possible that HIV is responsible for the symptoms, but it is also possible that he/she has some other viral infection.

A positive HIV test result means that the individual concerned is infected with HIV (Human Immunodeficiency Virus), the virus that causes AIDS (Acquired Immuno Deficiency Syndrome). Being infected with HIV does not mean that one gets AIDS right at the moment. However, if left untreated, HIV infection damages a person's immune system and can progress to AIDS soon.

Testing positive for HIV means that one carries the virus that causes AIDS. It does not mean that he/ she has AIDS, nor does it mean that the individual will die. Although there is no cure for AIDS, many opportunistic infections that make people sick can be controlled, prevented or eliminated. This has substantially increased the longevity and quality of life for people living with AIDS.

The shortest answer is yes! There are things that one can do to stay healthy after getting infected with HIV. Emotional support may be very important for HIV-positive people because it breaks the isolation and provides a safe way of sharing both feelings and practical information.

Medical Care: Once an infected person finds a doctor or clinic, his/ her main objective is to get an evaluation of the general health and immune function.

Many doctors do the following:

• Administer lab tests to evaluate the immune system.
• Determine if one has other diseases that might become problematic in future, including syphilis, TB, hepatitis-B, and toxoplasmosis.

If one is already infected with one or more of these other illnesses, there may be treatments or prophylaxis available to prevent it from becoming more serious or recurring in the future. If one's not already infected, doctors may be able to prevent future infection by:

• Administering vaccines. Many HIV positive people get a hepatitis-B vaccine and bacterial pneumonia vaccines, since contracting these diseases could be dangerous for immune suppressed people.
• Prescribing antiviral treatments and protease inhibitors when tests show immune system impairment.
• Scheduling regular checkups. Checkups may be scheduled every three to six months. Some people need more frequent check-ups, particularly when they are starting new antiviral drugs.

HIV weakens the immune system and allows other infections to get a foothold, and often it is these which actually produce the symptoms. The evidence shows that one is far more likely to get another infection, like TB, if he/ she is HIV infected than the non-infected people.

HIV can be transmitted from an infected person to another through:

Blood (including menstrual blood)

Semen

Vaginal secretions

Breast milk

Blood contains the highest concentration of the virus, followed by semen, followed by vaginal fluids, followed by breast milk.

One is safest of all if he/she does not indulge in penetrative sexual intercourse. One is also safe if he/she is not in a stable relationship where both the partners are free of HIV and neither of them has any other sex partners. Sex without penetration is another way to have safer sex that greatly decreases the risk of getting infected with HIV. One can have a great deal of stimulation and pleasure through caressing, hugging, kissing, and massaging different parts of the body. Safer sex also includes using a condom - but, using a condom correctly, and using that every time of having sex.

Oral sex: one needs to know that the AIDS virus is present in secretions, including the vaginal secretions of a woman and the semen (in both the pre-ejaculation lubricating mucus and the ejaculate, or "cum") of a man. This means that taking the partner's sexual secretions into the mouth can pose a risk of infection though the risk is not very high.

It is strongly advisable to carry out oral sex only with some kind of protection. One should use a condom on the erect penis, and place a thin rubber sheet or "dam" over the woman's genitals.

Anal Sex: AIDS virus more easily gets transmitted from an infected person to another person during anal sex than during vaginal sex.

In these circumstances, using a well-lubricated condom is absolutely essential for protection. Unlike the vagina, which produces secretions that lubricate vaginal sex, the anus does not produce lubricating secretions. Without such lubrication, the additional friction during anal sex can cause regular condoms to tear. In some places, it is possible to get condoms made especially for anal sex. If these are not available, one should really try to be on the safer side - look for other ways to have sexual satisfaction.

The sharing of injection implements by drug users is a major infection route for HIV. The term 'injection implements' includes syringes, needles and spoons. Such things may be shared for a number of different reasons; sometimes it is difficult to get hold of syringes and needles and sometimes the sharing may be a kind of ritual, which creates a sense of community. Thus, IDUs are more at risk of getting infected with HIV.

No, it has never been reported that HIV got spread through mosquito bites.  White blood cells and HIV are destroyed in the highly acidic environment of the mosquito's stomach. Mosquitoes do inject their saliva into their victims. Malaria is carried in the saliva and spreads in this way. Thankfully, HIV cannot get spread in this way, as HIV cannot exist in mosquito's saliva.

In order to dispel unnecessary fears, AIDS awareness programs must involve knowing how the disease is transmitted as well as how it is not. HIV is not transmitted through casual daily contact since the virus does not survive long in air, water. 

HIV does not spread…

• During casual contact, social mixing such as touching, handshaking, staying in the same house or sitting next to someone in a crowded bus or train.
• One should not worry about getting HIV from a colleague or co-worker by touching or being near to him or her. There is no evidence that sharing equipment like telephone, computer, typewriter, books, pen and other similar items spreads the virus.
• Playing together does not spread HIV. Scientists believe that the amount of HIV present in sweat or tears of an infected person is so low that it is not enough to infect others.
• HIV does not transmit by sharing of food, drinks, plates, and glasses and other items.
• HIV does not spread through toilet seats, washbasins, bathtubs or swimming pools.
• HIV does not spread through air so it does not get spread through sneeze or cough.
• HIV does not spread by mosquitoes, bed bugs or other insects.

• Because there is no effective vaccine and no cure for HIV, the only way to protect oneself is prevention.
• People should either abstain from indulging in penetrative sex or use latex condoms, during oral, anal, or vaginal sex. Only condoms made of latex should be used, and whenever necessary only water-based lubricants should be used. People who are allergic to latex can use polyurethane condoms.
• The risk of HIV transmission from a pregnant woman to her baby gets significantly reduced if she takes AZT during pregnancy, labor and delivery, and her baby takes it for the first six weeks of life. Nevirapine is also found to be useful. But, one should seek expert medical assistance in such situations.
• Having a sexually transmitted disease (STD) can increase the chance of getting infected with HIV mainly through sexual contact. So, it is necessary to treat STD as soon as one suspects infection.

To detect HIV antibodies in the blood, a number of different tests have been developed. Two of the most widely used tests are the ELISA (Enzyme Linked Immuno Sorbent Assay) and the Western Blot Kit Test.

HIV testing services are now available in most countries. There are many Voluntary Counseling and Testing Centers (VCTC). The referral and counseling services are mostly provided by the NGOs. In some places, there are collaboration between the NGOs and the government for referrals and linkages.

VCTC services have been extended rapidly in West Bengal during the last few years. Presently, 22 VCTCs including one community based VCTC are functioning in the state.

One major drawback of antibody tests is the "window" period: the time it takes the body to produce antibodies after infection has begun. The standard tests for HIV do not detect the virus itself, but the antibodies that the body produces in response of the infection. During the period before the antibodies are produced, a person can be infected with HIV and can infect others, but still test negative on the HIV antibody test.

At the moment there is no known cure for AIDS. But there are medicines that can help people living with HIV to fight the opportunistic infections that come with HIV. Antibiotics and other medicines can help people living with AIDS to feel much better and to live longer.

The antiretroviral agents combat at different levels and retard the growth of the virus to some extent. Many antiretroviral agents are available in different parts of the world. Antiretrovirals (ARVs) have also been used for post-exposure prophylaxix (preventive medication). A combination of ARVs is effective in suppressing the replication of HIV. This is reflected clinically in decreased incidence of OIs (opportunistic infections).

It is the number of new cases of a disease or condition that occur within a given time. For example, the yearly incidence of HIV infections or of AIDS diagnoses.

It is the number of people living with a disease or condition during a given time.

It is an ongoing process of information collection, analysis, interpretation, and dissemination to monitor the occurrence of specific health problems in populations. Surveillance is used to guide and evaluate public health policy and programs.

It has been defined as an undesirable, negative or discrediting attribute that an individual possesses, thus reducing that individual's status in the eyes of society. Stigma is a common negative human reaction to disease (leprosy, TB, STDs, etc.). HIV has been greatly associated with stigma due to the association with risky behaviors and so-called "high risk groups" which is further stigmatizing already marginalized groups.

It can negatively affect preventive behavior by creating a silence around the issue or by building up a prejudice against a perfectly positive behavior. For example, use of condoms is associated with prostitutes. It can negatively affect those who need to seek healthcare. For example, reluctance of STD patients to visit STD clinics to preserve confidentiality. It can negatively affect the quality of care given by health care providers who could be biased against the care seeker. It increases health costs overall because of denial of risk of risk of infection, increased infection rate, avoidance of testing, treatment of infections at an advanced stage, etc.

Stigma can be reduced by creating and enforcing supportive laws and policies that punish discrimination and support people living with HIV/AIDS(PLWHAs). Reducing the perception that PLWHAs are different from the general community is very important. Opinion leaders can play a central role in forming public opinion. Healthcare workers should be supported and trained properly. PLWHAs should be involved in the service delivery and program design.