lecture 11 travel medicine and hiv positive traveler
TRANSCRIPT
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
1/42
Travel Medicine and HIVpositive Traveler
Tuti Parwati MeratiDivision of Tropical and Infectious
Disease, Department of InternalMedicine,Faculty of Medicine, Udayana
University, Bali
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
2/42
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
3/42
Demographics of InternationalTravel in
HIV Infected PatientsPre-HAART
(Kemper et. al. 1992-93)
Survey in hospital-ased HIVclinic! "alifornia
#$% had traveled &ithin 'S(
)*% &ith foreign travel &ithin )years
+edian "D#,)*.mm/
Reason for travel0
/*% thought last chance to travel
hi
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
4/42
Post-HAART(Sherrard 1997-2007)
International Health "linic! 1tta&a! "anada
23% foreign orn0 travel to visit friends and
relatives #/% "anadian orn0 travel for vacation and
usiness
+edian "D# , ##*.mm/
Destinations0 4in order5 Su-Saharan Africa
"ariean
"entral America
South Asia
S6 Asia
Sherrard and McCarthy. Travel Medicine and Infectious Disease 2009;
7:29129!."e#$er et. al. % Travel Med 199!; 2: &!&&.
Demographicsof InternationalTravel in HIV
Infected Patients
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
5/42
Te purpose of tispresentation
!urrent "lo#al $ID% %ituation and HIVInfection
&is' of ac(uirin) HIV infection durin)international travel
$ddresses te issues of HIV screenin) ofinternational travelers
*ffers advice to prevent HIV infection
durin) international travel &ecommendation provided for medicalcounselin) of te prospective travelerwo is HIV positive + on ealt precaution,propylactic medication andimmuniation-
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
6/42
t t t
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
7/42
at s t e tr gger o ep em c nAsia 8
FemaleMale
75 million
Men in Asia had sexWith CSW
(2-20% adult male)
50 millionWomen married
With men who had
sex with CWS
10 millionMale !"
10 millionMSM
10 millionWomen sell
sex
n#ant $
Children
Asia population 0 /9 illion
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
8/42
1.6
7
8.8 8.5
12.414.5
15.2
20.5
22.5
0.25 0.24
2 24 4.1
6.1 7.2
0
5
10
15
20
25
2000 2001 2004 2005 2006 2007 2008 2009 2010
TR6:D 1; HIV PR6VA
71R?6RS
I:DIR6"T S7
%ource. Bali HealtDepartment
%
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
9/42
F$!T*&% *0 P/&I*D% *F TIM/ I0
I0D*0/%I$
Sumber : Laporan Triwulan Pengidap infeksi HI dan !asus "I#$ $ep%e&'er 2008
64.7
43.2
17.6
53.7
72.5
36.6
50.5
17.6
39.5
11.8
1.3
3.47.7
3.4
02.1
53.3
2.61.05 2.2 4.0
5.5
5.90 00
10
20
30
40
50
60
70
80
90
100
87-90 91-95 96-2000 2001- 2005 2006-skrg
Ta(un
Perse
n
Homosex Heterosex ID !"#$-%"#$ &"k '#ket"(u#
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
10/42
6)
71
6158
64
0
10
20
)0
40
50
60
70
80
2000 200) 2004 2005 2007
HIV PR6VA
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
11/42
)8)4
4)
66
7)
0
10
20
)0
40
50
60
70
80
2007 2009 2010
TR6:D 1; "1:D1+ 'S64I:T6RVI67 7ITH S6> 71R?6RS5
Percent al&ays use condom &ith clients in thelast &ee
Percent condom use last seB
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
12/42
"HA
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
13/42
SW
Children
Clients
Children
Clients
Clientswife
Sex workers/or
IDU
as the epicentrum
of HIVtransmission
Clients
wifeID
8
-
8/13/2019 Lecture 11 Travel Medicine and HIV Positive Traveler
14/42
"ountry HIV Positive Rateof ;S7 4%5
ID's 4%5
U%$ +Florida-U%$ +Miami and0ewar'-3ondon
Paris"ermanyItaly%witerland0eterlands
!entral, /astern,%outern$frica
4est $frica
$sia 5 Pacific
6 5 768
659659
:76 ; ; ?6
@ ; 7?
6 ; >
65