The following passage is adapted from the World Health Organisation's World Health Report – 1999.

HIV/AIDS control in South-East Asia: the challenge of expanding successful programmes.

The human immunodeficiency virus (HIV) was slower to emerge in South-East Asia than in other parts of the world, but is now a serious public health problem and a threat to development. The first patient from South-East Asia with AIDS was identified in 1984. Since then a total of 92 391 cases of the disease have been reported in this region up to 1st July 1997. However, because of under-reporting and under-diagnosis the reported cases only reflect a proportion of the true problem. The World Health Organisation estimates that there are currently more than 5.5 million people in South-East Asia who are infected with HIV – 18% of the global total.

    Question:

  1. State three ways in which HIV is transmitted.

    [3]
    Answer:

    sexual intercourse / in semen / vaginal fluid / AW; A 'sexual contact'

    reusing / sharing, (hypodermic) needles;

    from mother to fetus / across placenta / during birth;

    breast milk;

    (infected) blood transfusions / blood products;


    Question:

  2. Explain the problems that are encountered by governments, in places such as South-East Asia, in controlling the spread of HIV/AIDS.

    (In this question, one mark is available for the quality of written communication.)

    [7]
    Answer:

    problems with transmission / prevention / treatment

    providing enough condoms;

    encouraging people to use them;

    discouraging sexual promiscuity / prostitution;

    discouraging needle sharing;

    difficult to promote needle exchange schemes;

    cultural resistance to, education / campaigns, about 'safer sex';

    checking blood donations / blood donors;

    lack of money, to buy drugs / for treatment (to control AIDS);

    lack of a cure;

    lack of a vaccine;

    social and other health problems

    isolated rural areas / migration;

    poorly educated population;

    slums / shanties;

    poor health facilities;

    few health professionals;

    illiteracy;

    contact tracing;

    other named health problems (e.g. TB / malnutrition);

    ref under-reporting / misdiagnosis / unaware of HIV status / AW;

    civil war / political instability; max 6

    Q – legible text with accurate spelling, punctuation and grammar 1


    [Total : 10]