1. Modified Syndromic Approach Course
2. Course on Counseling and AIDS
3. HIV/AIDS training module for National Service participants
4. HIV/AIDS education for women, youth and children
5. ( and screening for HIV )
6. Outreach and HIV/AIDS education in fishermen village
7. ( and screening for HIV )
8. HIV/AIDS education for the marginalized community ;
9. sex workers, transgendered ( and screening for HIV )
10. HIV/AIDS education for Intravenous Drug Users and their partners
( and screening for HIV )
11. Workshop on Teenagers Counseling for Counselors in schools
12. HIV/AIDS workshop for Jabatan Penjara Pokok Sena &
Jabatan Penjara Alor Star
13. Camps and workshop for Teenagers
14. Health Carnival
15. PROSTAR
16. Course on Handling and disposal of corpses
17. HIV/AIDS education for religious leaders and other community leaders
HARM REDUCTION
Harm reduction = an act of decreasing the adverse effects or the level of harmfulness of a particular behaviour to decrease the risks and to save the individual’s life or the harm it poses to others.
In the context of Intravenous Drug Users, using clean and sterile needles/syringe will help to prevent the further spread of HIV, AIDS, Hepatitis B atau C instead of sharing the same syringe. Hence, clean sterile syringes will be provided to the intravenous drug users for free. However, the fact remains that this strategy actually provides a portal to identify and reach these individuals and further promoting various other things, including:
• Needle & Syringe Exchange Program, NSEP
• Information and health education on HIV/STDs and ways to decrease the risks of infection.
• HIV/STDs/TB screening tests
• Counseling on addiction and psychology.
• Drug substitution therapy eg. Methadone program
• Condoms usage promotion
• Training on living skills and behavioral change
• Medical treatment for drug addicts
• Care after treatment
• Appropriate referrals
Hence, harm reduction program aims at :
1. Preventing the spread of HIV/hepatitis etc
2. Decreasing drug addiction
3. Increasing the quality of life of drug addicts
In order to reach to these individuals, portion of the involved personnels are drug addicts themselves who have stopped such addition or at the verge of giving up.
Needle & Syringe Exchange Program, NSEP - ’One for One Exchange’
The major objectives of this program are:
• Intravenous drug users will have their own syringes, hence they will not share it with anyone else, hence preventing the spread of infection
• The used syringes will be disposed systematically and safely.
• It is easier to reach the intravenous drug users, enabling appropriate care and treatment to be given.
8 needles + 8 Syringes + Alkohol Swab / IDU / Week
Anonymous/Voluntary HIV screening
This HIV screening is made available in government health facilities to encourage those at high risk for HIV to come forward to undergo HIV testing. During the initial screening using a rapid test kit, the name of the individual undergoing testing is not recorded and therefore is assured of secrecy. If the test becomes reactive, the name of the person has to be recorded to enable referral for confirmation testing and to establish a link between the confirmation result and the individual. This is necessary for access to clinical therapy, follow-up and other services available to persons living with HIV/AIDS. Routine voluntary screening of drug users admitted to rehabilitation centers and other institutions was started in 1988.Other sub- group of populations that may be at increased risk for HIV transmission includes long distance truck drivers, commercial sex workers, fishermen are encouraged to have a voluntary screening test.
Notification of HIV/AIDS / deaths due to HIV/AIDS
AIDS has been gazetted as a notifiable infectious disease on 22 May 1985. Under section 10 of the ACT 342, Prevention and Control of Infectious Diseases Act 1988, HIV of all forms (HIV, AIDS and deaths) is listed in the part II of the first schedule which needs to be notified to the nearest Medical Officer of Health. Therefore, a person infected with HIV may need to be notified three times if he/she undergoes the three stages above which are HIV infection, AIDS case and AIDS death. Under section 10 subsection (2) of the act, ‘every medical practitioner who treats of becomes aware of the existence of any infectious disease in any premises shall, with the least practicable delay, give notice of the existence of the infectious disease to the nearest medical officer of health in the form prescribed by the regulations made under this act’
If there is a case of death due to AIDS, the district health office needs to be informed by phone, so that immediate measures can be taken for the burial arrangement. The purpose of notification is for surveillance of the disease and to monitor trend and identify the extent of the problem. This will enable the management to develop appropriate strategies and activities for future planning and management. Strict confidentiality is to be observed at all times.
Partner notification
HIV-infected person must inform his/her partner of his/her HIV status within 24 hours. Failing to do so, the Medical Officer of Health has the authority to inform the partner. The purpose for partner notification is to counsel and prevent spread of the disease to the partner.
Contact tracing
Contact tracing plays a major role in prevention and control of HIV/AIDS. It must be done as soon as possible in order to break the chain of infection and to identify all possible contacts where counseling is given in view of testing for HIV. By doing contact tracing, contacts who are still not infected can be protected. Those contacts that are already infected will be counseled and provision of care will be ensured.
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