Budding baseball player in Havana Photograph courtesy of Robert Leon

Contamination If blood from a person infected by HIV gets into the blood stream of another person, it will infect them also with the HIV. This can happen: If contaminated instruments are used to pierce the skin during: injections circumcision scarrification ear piercing tatooing acupuncture (Infection can be prevented if the equipment used is brand new, or is carefully sterilized each time it is used.) From a blood transfusion with infected blood Blood transfusions may be necessary: after a bad accident, if someone has lost a lot of blood; during a hospital operation; after childbirth, if the mother has lost much blood; or if a person is anaemic due to bilharzia, hookworm or malaria parasites. If the blood or equipment used is contaminated with HIV, this will be transmitted to the person receiving the blood, and so they will also become infected. All equipment used for blood transfusions should be sterilized before it is used. In some countries all blood which has been donated is tested for HIV infection, and only non-infected blood is used. More and more countries are now trying to do this. There is no risk in donating blood if the equipment is new or properly sterilized. (For reading source, click here.)

How does AIDS affect the eyes? Cotton Wool Spots - AIDS can cause tiny amounts of bleeding and white spots in the retina. These white spots are called cotton wool spots. CMV Retinitis - A serious infection of the retina is caused by cytomegalovirus (CMV). About 20-30% of people with AIDS have CMV. Most infections happen when the number of T-cells gets dangerously low, usually under 40. CMV can damage the eyes permanently. Signs of CMV include: Floating Spots Flashing Lights Blind Spots or Blurred Vision Red Eye - People with AIDS sometimes have persistent infections. Detached Retina - Sometimes CMV causes the retina to separate from the back of the eye. A detached retina can cause a serious vision loss. Surgery is the only means of reattaching a detached retina. Kaposi's Sarcoma - Kaposi's sarcoma (KS) is a kind of tumor that looks like a bump on the eyelid or a spot on the white part of the eye. KS grows slowly and does not harm the eye. What are the treatments for AIDS eye problems? There are two drugs to fight CMV infections. These drugs do not cure CMV, only slow it down. It is important to see an ophthalmologist for regular eye exams in case CMV flares up. Early detection of CMV is vital to a positive outcome and if only one eye is infected, the patient can protect the other eye by taking anti-CMV medicines. Kaposi's sarcoma can be treated with radiation, laser surgery, freezing or surgery. Each disease has its own treatment. An ophthalmologist should be consulted for an accurate diagnosis.

Nutrition HIV/AIDS and malnutrition are interrelated. In fact, in Africa AIDS was initially known as 'slim disease' because of the wasting syndrome typically experienced by people with the disease. Research suggests that malnutrition increases the risk of progression of HIV infection, and it may also increase the risk of HIV transmission from mother to baby. In turn, HIV infection makes malnutrition worse through its attacks on the immune system and its impact on nutrient intake, absorption and the body's use of food. Malnutrition associated with HIV infection has serious and direct implications for the quality of life of people with HIV/AIDS. Weight loss is often the event that begins a vicious circle of increased fatigue and decreased physical activity, including the inability to prepare and consume food and reduced work productivity. In people with symptomatic HIV disease there are likely to be several overlapping processes taking place: Reductions in food intake This may be due to painful sores in the mouth. Fatigue, depression, changes in mental state and other psychological factors may also play a role by affecting a person's appetite and interest in food. Economic factors also affect food availability and the nutritional quality of food. Side effects from medications can also result in lower dietary intakes that can cause weight loss associated with HIV/AIDS. Nutrient malabsorption Malabsorption accompanies the frequent bouts of diarrhoea that affect people with HIV as a result of various infections. It is also believed that HIV infection itself may cause nutrient malabsorption. Metabolic alterations HIV infection results in increased energy and protein need as well as inefficient use and loss of nutrients. Changes in metabolism occur during HIV infection from severe reductions in food intake as well as from the immune system's response to the infection. When food is restricted, the body responds by altering insulin and glucagon production, which regulate the flow of sugar and other nutrients in the intestine, blood, liver and other body tissues. Over time, the body uses up its carbohydrate stores from muscle and liver tissue and it begins to break down body protein to produce glucose. This process causes protein loss and muscle wasting. Management of weight loss in HIV/AIDS is complicated by the fact that these three mechanisms are not mutually exclusive. Weight loss and wasting in people with AIDS may be the result of all three processes. For the first two causes of weight loss and wasting, malnutrition can be reduced by treating the immediate sources of the problem (e.g. oral thrush, mouth sores, other infections) and providing foods that are soft and well tolerated by the infected person. People with diarrhea should take plenty of fluids or use oral rehydration solutions to avoid dehydration and replace the lost fluids in the body. Also, if possible people with symptomatic HIV should try to eat as frequently as possible, even if the amounts of food are very small each time. Nutrition is an essential part of any HIV care package. Nutritional care and support includes many components, and particularly when a person is asymptomatic, it must include an adequate quantity and quality of food. But improved nutrition is not enough in itself to permanently keep people healthy. History provides evidence of this, as in the late 1980s many people with HIV in the United States and other countries, developed opportunistic infections, progressed to AIDS and died, even though they had an excellent diet. However, good nutrition may help prolong the period of time between HIV infection and the onset of OIs. In some communities affordable food supplementation may be feasible and it can have a positive impact on both body composition and weight. For example, The AIDS Support Organisation (TASO) has been distributing food to clients for 10 years as part of an overall community outreach response in Uganda. With regard to vitamins and minerals, it is unclear to what extent these are helpful in the early stages of HIV infection. Several studies have been published on the role of vitamins and mineral in HIV disease progression and mortality. Primary associations were initially promising and micronutrient supplementation has the potential in a resource poor country to be an affordable and relatively easy to deliver public health measure. But the findings from micronutrient supplementation trials have however been mixed. (For reading source, click here.)

Impure Water Those infected with HIV should make every effort to ensure that the water they drink is pure. As an individual infected with the HIV virus, one's immune system is more susceptible to contracting various infections and other diseases. Impure water is a source of where such infectious diseases may travel or originate; thus, it is ideal that HIV infected persons and AIDS patients drink water that is pure and free of such bacteria.

Contact with Animals As is the case with impure water, animals are carriers of various diseases and infections that HIV/AIDS patients are more susceptible to because of the weakness of their immune systems. As a result, it is in the best interest of such infected persons to be aware of the animals in their surroundings. Be sure not to exchange any bodily fluids with animals and to be aware of meats consumed. Again, it is not necessarily that you may contract HIV from the animals; it is the fact that they may carry various diseases and infections that you are likely to contract if you come in contact with them.

Guidelines for HIV Infected and Affected Children Guidelines Guidelines ( PDF) Please see the PDF file above for reference information on the wonderful organization who has provided these guidelines. The publications are designed for use by volunteer counselors, non-professional counselors, and professional counselors who do not extensive experience in counseling in the context of HIV and AIDS. The guidelines are the result of workshops organised under the SAT (School Without Walls), brining together professional counselors, people living with HIV or AIDS, staff of AIDS Service Organizations and people working in the field addressed by the publication. Much of this information came from a workshop on counseling children with HIV or children affected by HIV and AIDS, facilitated by Jonathan Brakarsh and Clare Rudd of the Family Support Trust (FST) fo Zimbabwe. These guidelines reflect the experiences of the counselors and activities who participated. Virginia Knight Tyson and Sarah Lee provided editorial assistance. Joel Chikwara drew the cartoons. To date, SAT has publisehd counseling guidelines in English and Portuguese on the following subjects: Disclosure of HIV Status Child Sexual Abuse Palliative Care and Bereavement Domestic Violence Survival Skills Basic Counseling Skills SAT is a project of the Canadian International Development Agency delivered by the Canadian Public Health Association. It has been at the forefront in supporting the community response to HIV and AIDS in Southern Africa since 1991. School Without Walls is an intiative to validate, promote and diffuse souther African experience and expertise in responsing to HIV and AIDS.