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A paper from the Social
Responsibly Committee about AIDS following a meeting
with Dr James Bunn, a
Consultant Paediatrician working in Liverpool in
April 2004. Dr Bunn has a special interest in AIDS
and has worked in Malawi.
History of HIV/AIDS
1981 Epidemic of a rare pneumonia among the gay
community in Los Angeles.
1982 Case definition of AIDS when symptoms could
1983 Slim disease found in Uganda where healthy
adults were wasting away.
1983 Isolation of HIV virus in France when the
slim disease was recognised as being related to
1985 Blood test developed that could identify the
1987 World Health Organisation began a special
programme on AIDS realising it was widespread and
not confined to the gay community.
1989 Red Ribbon was launched.
1994 AZT was found to prevent MTCT (maternal to
child transmission) if given in last weeks of pregnancy
and during delivery. This has brought the risk
of infection in this way down to less than 2% in
1995 It was found that a combination of drugs can
work in adults to prolong life and its quality.
1995 Found that prevention of STI (sexually transmitted
infections) can also prevent transmission of HIV.
1996 The Global vaccine initiative was launched.
This has proved very difficult. 2000 UN Security
Council held its first meeting on a health issue
this was about the AIDS problem and the economic
problems it was causing in Africa.
2002 Anti-retroviral drugs became available at
subsidised prices for the poorest countries and
are now produced in India, South Africa and Brazil.
2003 3 by 5 initiative was launched. This was to
treat 3 million living with HIV in poor countries
by 2005. This is seen as a good aim but unlikely
to be achieved.
How many people?
World-wide there are approx 40 million people living
with the virus. Of these 37 million are adults
and 2.5 million are children under the age of 15.
5 Million people were newly infected with HIV in
2003, of these 4.2 were adults and 700,000 were
children under 15.
3 million people died of AIDS deaths in 2003, of
these 2.5 million were adults and 500,000 were
children under 15 and of these 330,000 were children
90% of children who are HIV positive are infected
from their mothers. Much of this mother to child
transmission is preventable. Last year every pregnant
woman in the UK was offered a test for HIV. Now
most of the children infected with HIV in this
country are children brought into the country as
The situation world wide
Numbers infected: -
Sub-Saharan Africa 25-28.2 million people infected.
SE Asia 4.6-8.2 million people infected.
Latin America 1.3-1.9 million people infected.
Western Europe - 520,000-680,000 people infected.
North America 799,000-1.2 million people infected.
Caribbean350,000-590,000 people infected.
Eastern Europe and Central Asia 1.2-1.8 million
New Zealand and Australia12,000-18,000 people infected.
India and SE Asia are seen as sitting time bombs
in terms of numbers and spread of HIV but they
do not seem to be addressing the problems they
Many countries do not declare their figures for
HIV for political reasons because they feel people
will not invest in countries that have a problem.
In some countries the numbers with HIV are hidden
because of social pressures eg in Cuba they used
to imprison people who were HIV positive so there
was a reluctance by people to be tested.
The Situation in Africa
In Botswana 40% of pregnant women are HIV positive.
In Zambia the women get HIV 10 years younger than
men do. This is because many young girls marry
older men who have had several partners. There
is also a prevalence of sugar-daddies who have
several girls that they keep for sex. There is
also an issue of abuse and rape. Urban areas have
larger prevalence than rural areas. It has also
been found it is more common on trucking routes
where the drivers take sexual favours on the route
and then they take the infection back to their
In the mining areas of South Africa where the men
live in mining communities and only go home to
their wives once or twice a year there is a greater
chance of infection because they tend to use prostitutes
and their wives back home find other partners.
However in Kampala, Uganda the numbers of people
infected with HIV is declining. This may be because
the President spoke about one of his relatives
dying from AIDS. This brought the problem out into
the open and people realised that if it could happen
to their President's family, it could happen to
them. It made them realise no-one was immune.
Cost to the Health Services
In Nairobi 39% of hospital beds are occupied by
HIV patients. In Zimbabwe 25% of all health spending
goes on HIV. In Rwanda 66% of all health spending
goes on HIV.
Cost to Society
Employers in the sugar plantations of Kenya have
found health care costs for their employees rose
by 10 times in the period of 1989-1997.
Absenteeism from work is increasing as families
attend more funerals and this is an added financial
burden to families. Families are facing the loss
of young adults and the loss of mothers which creates
a large number of orphans. The young adult may
also be the money earner for the family so there
is an increase in poverty. Life expectancy is decreasing.
In Southern Africa life expectancy was 44 in the
mid 1950s, 59 in the 1990s and is expected to be
down to the mid 40s again by 2010.
26% of all adult male deaths in South Africa are
HIV related. 34% of all female deaths in South
Africa are HIV related. 30% of all deaths in South
Africa are HIV related. Age of death of AIDS victims
is likely to be between 25 and 45 years.
In Western Europe the numbers of deaths from AIDS
declining although people are still being infected.
This is because they are given three drugs which
are changed periodically and may give people 20
or more years of active life. It is now hoped that
children who are HIV positive will live to adulthood
which means they may be able to work and be educated.
They cannot be cured but they can live with the
Mother to child transmission
Over 55% of those infected with HIV are women.
In some areas 40% of antenatal mothers are HIV
positive. Up to 45% of their infants will be infected.
This could be halved with ante-retroviral drugs
if administered at the right time.
How to prevent infection
a) Voluntary testing and counselling.
b) Maternal treatment during pregnancy and delivery.
c) Breastfeeding and infant feeding. In Africa
when babies are totally breastfed for 3-6 months
there is no greater chance of HIV infection than
for those fed on formula milk. However there seems
to be greater risk if they are fed with a mixture
of breast and formula milk or are weaned before
this time. This advice is different from advice
given in the UK where mothers who are HIV positive
would be advised to give formula milk. In Africa
a baby would be 6 times more likely to be infected
if not breastfed exclusively.
There is a need for monitoring the drugs given
to patients as these need to be changed regularly
as the virus becomes resistant to them. This monitoring
is not always available in Africa. There is also
a reluctance on behalf of parents to give the drugs
religiously every day to children especially when
the child appears well.
Prevention of infection in adolescents and adults
a) Abstinence from sex before marriage.
b) Be faithful to one partner
c) Change your lifestyle or use condoms.
Sometimes these are added:
d) Do not discriminate against people living with
e) Encourage people living with AIDS and give them
The use of condoms must be seen not just as a way
of preventing HIV but also as a way of preventing
all sexually transmitted diseases. There must be
voluntary treatment and counselling available to
all. Sterile needles must be used for injections
and for body piercing. There must be safety in
blood transfusions. Homosexuals must get advice
on safe sex and behaviour.
There must be post rape prophylaxis. This means
administering drugs immediately following the incident
which, hopefully, will prevent the transmission
of the disease.
In this country there is a great need to educate
children and adolescents to say NO to casual sex
and to know what constitutes abuse. Many adolescents
still believe that HIV cannot happen to them. They
seem unable to recognise the consequences of their
behaviour. Adolescents can be very difficult to
reach as they do not like being told what to do
by adults so there is a need for counsellors of
their own age and also they tend not to use the
Health Service until they are very ill.
Dr Bunn suggested two books for further information:
The AIDS Handbook published by McMillan ISBN -0-333-94576
Journeys of Faith Number 16 in a series called
Strategies for Hope. This book has several stories
in it of people who have worked among people suffering
There is also the Christian Medical Fellowship
HIV seems no newsworthy in this country because
people with the disease can be helped to live longer
and to have a better quality of life. It also seems
to have lost some of its stigma. However, as Christians,
we must be concerned about the devastating effect
that the illness is having on people everywhere
and particularly in Africa where countries that
are already poor are becoming poorer because most
of the people who die of the illness are at or
below working age.
If people do not know that they have the disease
they can not be helped so the British Province
of the Moravian Church sends AIDS testing kits
to Sikonge Hospital in Tanzania every month to
help with this problem. It is now routine for pregnant
women at Sikonge to be tested so that, if they
have the disease, their unborn child can be protected.
A prayer for those with HIV
Hear our Prayer, O God of mercy and love,
for all those who live with HIV or AIDS.
Grant them loving companions
who will support them in the midst of fear;
give them hope for each day to come,
that every day may be lived with courage and faith.
Bless them with an abundance of your love,
that they may live with concern for others.
Pour on them the peace and wholeness
which you alone can give.
Through Jesus Christ our Saviour,
who came to give abundant life. Amen.
Prayer written by Vienna Cobb Anderson (diocese
of teh Highveld, South Africa)
Paper written up by Sr Kathryn Woolford and adapted
by Sr Sarah Groves
pages within this Social Resonsibility
section represent the views of the committe
and not necessarily that of the Moravian