Healthyvives Health Blog

What is the meaning of reproductive tract infection? As answer we can say reproductive tract infection is an infection of the genital tract. The infection can affect uterus, cervix, vagina, vulva, tubes and ovaries in the woman. Infection of uterus and the tubes is usually known as pelvic inflammatory disease. It can occur even without producing symptoms. Pelvic inflammatory disease can result in infertility and in severe cases of pelvic inflammatory disease can spread to abdominal cavity leading even to death of the woman. These system can be impairs the ability to reproduce. Actually the reproductive tract infections are that affect the reproductive tract. Why the sexually transmitted infections occur? As answer we can say sexually transmitted infections occur for the sexual intercourse with the infected person, which results in genital ulcers and discharges. Untreated they can be a cause for spread of HIV/AIDS in the community. Sexual transmitted diseases are that passes one person to another person during sexual contact with the partners. We can reduce sexual transmitted disease by practicing safer sex and avoid risky sexual contact. Male and female condom may be use for prevention from sexual transmitted disease. Presence of Reproductive tract infection and sexually transmitted infections in any person may result in flare-up of infection following insertion of IUCD. Therefore IUCD in such patient is contra-indicated. In pregnancy the foetus may be affected by these infections. They may also be a cause for development of cervical cancer.
Common symptoms of reproductive tract infection and sexually transmitted infections are like as vaginal discharge with or without itching, genital ulcers, backache, and lower abdominal pain, woman whose husband or sexual partner has problem of urethral discharge with burning during urination or ulcers of genitals scrotal swelling or inguinal buboes. If any symptoms in any persons found then we have to consult with concerning physician’s immediately.

STDs are not discussed openly because of the shame and stigma associated with them. They are in fact referred to by some people as ‘private’ or ‘secret’ diseases. It is wrongly believed that STDs happen to “bad” people or women in prostitution. Due to these reasons persons, with STDs do not seek treatment. However, STDs can not only cause much pain and discomfort but also have many damaging consequences. Counselors need to be sensitive to these perceptions. They need to demonstrate acceptance and a non-judgmental attitude to clients. Every attempt should be made by them to safeguard the privacy and confidentiality of their clients.

When counseling someone with a STD, the following points should be attended to:

• What STDs are, and how they are contracted?

• The common symptoms and signs of STDs in men and women. Counselors need to emphasis that there may not always be symptoms; or, they may be so slight that they do not bother the patient. Women especially, often do not have any symptoms at all. However, without treatment, the patient is and will remain infectious and can unknowingly pass on the disease.

• Myths about STD (myths regarding the mode of spread as well as means of cure) Consequences of not treating an STD, especially for pregnant women.

• The relationship between STDs and HIV. Where a person can go for further information and tests: primary health centers, STD departments in government hospitals, dermatologists (specialists in skin and sexually transmitted diseases), gynecologists, family physician (who may treat and/or refer) etc.

• Diagnosis and treatment. The importance of early treatment and compliance needs to be stressed to ensure complete cure. STD patients should be counseled to take all medication as prescribed even if the symptoms disappear or they feel better.

Need and importance of counseling of the HIV/AIDS victims
Conveying a positive HIV result to an affected person is a very serious matter. A positive test result is like passing a death sentence on that person. It is also like passing a moral judgment on that person. As the commonest mode of acquiring this infection is through the sexual route, morality of the affected person is very often judged. There is stigma attached to this disease in the society. Hence, the test results may upset the patient.
A patient may have varied reactions to a positive test result. He may be shocked. He may not believe the report (denial). He may become anxious about his future, become scared, depressed or angry. Sometimes these reactions can have bad consequences, so that he/she may decide to end his life or become careless and spread the disease to other persons. A patient will have different coping mechanisms to counter the shock. He/she may like his/her family and friends to know about the disease or he/ she may like to hide the fact. Before the test is conducted the mind set of the patient has to be tuned such that he/she is able to cope up with the test result.
HIV transmission through intravenous drug use (IVDU)
Intravenous drug use acts as a source of transmission of HIV because drug users frequently share syringes and needles to inject drugs. These instruments are not sterilized before use. Small volumes of contaminated blood remains inside previously used needles and syringes thereby providing opportunities to transmit the virus via their blood contents. In the early years of the epidemic, studies found links between HIV drug users and male homosexuals who were already infected with HIV. The overlap of these two groups facilitated in the introduction of HIV into drug using population and then to the sex partners of the drug users.
Consumer Protection Act, 1986 and HIV/AIDS
Today, we have a well-developed medical jurisprudence. Damages can be sought for unethical, deficient or negligent Medicare. Medical negligence can be brought before the courts for damages under the Consumer Protection Act, 1986. This Act can also be used to fight AIDS. If contaminated blood is supplied, the amount paid can be got refunded along with the compensation. In the same manner, tattooing, faulty blood testing, side effects from medicines, misleading medical or Para-medical publications or teachings, etc. are all actionable under law.
Chlamydia
Chlamydia is yet another common STD prevalent among both men and women. Very often it occurs in conjunction with gonorrhea. In many cases, the infection does not produce any symptoms at all. In women, complications of Chlamydia infection include pelvic inflammatory disease, entopic pregnancy and infertility. It can affect newborn children at the time of the birth if the mother is infected. In these newborns it can cause infection in the eye, throat, urethra and rectum. It can also cause pneumonia in children from the age of 1 to 3 months.
Prisoners and HIV
Until recently prisoners were tested for HIV/AIDS without their consent and segregated if they tested positive. But at least in theory this has changed now. Condoms are not generally available in prisons where unprotected sex is part of the environment. Needles and other implements affiliated with drug injection are prohibited.
HIV/AIDS policy for prisons and institutions are the same as applied to the general public. Testing is done voluntarily. Segregation of HIV infected prisoners is not permitted. Various ministries provide counseling care and support. There is no special HIVIAIDS policy for work places and policies with regard to sick leave; disability supports, occupational health safety etc. and similar like other diseases.

The relationship between STD and HIV infection is manifold.
1. First of all STD and HIV infection are associated with the same risk behaviours, that is sexual intercourse with multiple partners. Thus the same measures that prevent STD also prevent sexual transmission of HIV infection. The presence of STD has been found to facilitate the acquisition and transmission of HIV infection. It is believed that for those STDs associated with genital ulcer disease such as syphilis, cancroids and herpes, the risk of HIV transmission increases ten-fold. Ulcer diseases have a break in the mucosa. There is a rich collection of CD4 cells on the broken mucosa. The virus easily enters the broken mucosa and infects the CD4 cells. Presence of ulcerative disease increases the risk of acquiring HIV infection ten fold.
2. For those STDs associated with discharge such as Gonorrhea, Chlamydia and Trichomoniasis the risk of HIV disease is four-fold. Thus early diagnosis and the treatment of STD can contribute significantly to a reduction in HIV transmission. Other routes of transmission of HIV and STDs are also similar. In addition to sexual transmission, HIVIAIDS also be transmitted through blood, blood products, donated organs or tissue, and from mother to newborn infant.
3. Many of the measures for preventing the sexual transmission of both HIV infection and STDs are the same. Therefore STD clinical services are important access points for persons at high risk for both HIV and STD, not only for diagnosis and treatment but also for education for prevention.
Adherence Counseling
Today there is treatment available for HIV infected persons. This treatment is known as highly active antiretroviral therapy (HAART) Combinations of three different drugs are used. These drugs may be given as individual drugs or may be formulated into a single tablet. The drugs suppress the virus improve the quality and prolong the life of HIV infected patients. These drugs have to be started at an opportune time and have to be taken life long. If these drugs are taken irregularly the virus will become drug resistant and the disease will progress faster. Resistant strains will be seen in the community. While for other chronic diseases 80% adherence may prevent the progression of the disease, HIV requires more than 95% adherence. Even missing a single dose in a month can bedeleterious to the patient.
Adherence involves change in behaviour so that the patient is disciplined and conditioned to take medication, Adherence counselling should start from the time the diagnosis of HIV is made. Patients should be told about the availability of HAART, the cost of treatment and that it will be started at an appropriate time. The Government of India has set up free antiretroviral treatment (ART) centers. Find a centre in your area. Patients taking HAART must always be monitored by a physician to see the effect of the drug. Hence constant and regular attendance at medical centre is needed. All these aspects have to be stressed during the post test counselling. Once the patient has been started on treatment, check about the drug intake during every counselling session. Enquire about the side effects. Find out of the patient has any difficulties in procuring the drug supply. Encourage the patient to continue the drug therapy. If patients have missed their drugs, ask about the reasons for missing the drugs. Very often patients may forget to take the drug, Help them to overcome this difficulty by using pill organiser, reminders or by using other family members to remind them to take the medication.

Chronologically speaking, the origin of HIV may be traced from the 1950′s. At the end of World War 11, only a handful of viruses were f known. Hundreds more have been discovered since, partly as a result of advanced techniques for culturing them in the laboratory. Viruses are parasites which infect almost every form of life, from single-called bacteria up to humans. The roughly simultaneous appearance of AIDS in the United States, Europe, Africa and Haiti prompted the question. Had AIDS been around for some time, unnoticed? After combing through medical histories of past patients, investigators found a small number of probable cases of AIDS going back over thirty years over three continents. Working back in time, they found AIDS-like symptoms in patients as early as 1959.
The first case of HIV in USA was reported in 1981: In 1979 a forty-four ‘ year old homosexual man died with Kaposi’s sarcoma in New York City. Kaposi’s sarcoma is a kind of cancer found very common among AIDS patients in the West. In 1977, a twenty seven year old Rwandan mother developed the immuno deficiency symptoms and died. In the same year a thirty four year old Zaiean woman, who sought treatment in Belgium later died of opportunistic infection in Kanishasa in 1978. In 1975 a previously healthy seven-month-old black infant from New York had pneumocystis and succumbed. In 1969 a fifteen year old black US boy’ with Kaposi’s sarcoma and opportunistic infection died in St. Lousis. Earlier in 1959 a British sailor with Kaposi’s sarcoma and pneumocystis died in Manchester.

NDPS Act, 1989
The NDPS 1985 Act was amended in 1989. The statement of objects and reasons appended to the Bill was as follows: In recent years, India has been facing a problem of transit traffic in illicit drugs. The spillover from such traffic has caused problems of abuse and addiction. The Narcotic Drugs and Psychotropic Substances Act, 1985 provides deterrent punishment for drug trafficking offences. Even though the major offences are non- bailable by virtue of the level of punishments on technical grounds, drug offenders were being released on bail. In the light of certain difficulties faced by the enforcement of the Narcotic Drugs and Psychotropic Substances Act 1985, the need to amend the law to further strengthen it has been felt.
The 1989 Amendment sought to provide for the following:
1) To constitute a National Fund for Control of Drugs Abuse to meet the expenditure incurred in connection with the measures for combating illicit traffic and preventing drug abuse;
2) To bring certain controlled substance which are used for manufacture of narcotic drugs and psychotropic substances under the ambit of Narcotic Drugs and Psychotropic Act and to provide deterrent punishment for violation there of;
3) To provide that no sentence awarded under the Act shall be suspended, remitted or commuted;
4) To provide for pre-trial disposal of seized drugs;
5) To provide death penalty on second conviction in respect of specified offences involving specified quantities of certain drugs;
6) To provide for forfeiture of property and a detailed procedure relating to the same; and
7) To provide that the offences shall be cognizable and non-bailable.
Scope of the Act
This Act has 83 sections and one schedule giving the list of psychotropic substances. These can be classified as under:
1) Sections 15 to 27A, concerned with punishment of various offences.
2) Residuary penal provision – section 32.
3) Section 28 to 30 (attempt, abetment and preparation)
4) Enhanced punishment after conviction – Sections 31 and 31A (Section 31A provides death penalty for certain offences).
5 ) Offences by companies – section 38.
6) Prohibition against suspension of sentences etc. and release on probation – Sections 32A and 33)
7) Security – Section 34.
Presumption of culpable mental state – Section 35 (also 53A 54 and 60) and
9) Special courts – Sections 36 to 36 D
Authorities and Officers
The Central Government is authorized to take measures for preventing and combating abuses of and illicit traffic in narcotic drugs etc. These measures includes:
1) Coordination of action between authorities/state governments etc.
2) Meeting obligations under international conventions.
3) Assistance to concerned authorities in foreign countries and other international organisations to facilitate coordination and universal action for prevention and suppression of illicit traffic.
4) Identification, treatment, education, after care, rehabilitation and social re-integration of addicts.
5) Such other matters for effective implementation of the provisions of this Act.

Section 4 empowers the Central Government to take measures for preventing and combating (a) abuse of and (b) illicit traffic in narcotic drugs and psychotropic substances. The Narcotics Control Bureau was constituted under this section in March 1986.

Under Section 5 of the Act, the Central Government appoints a Narcotics Commissioner and such other officers and they exercise all powers and perform all functions relating to the superintendence of the cultivation of the opium poppy and production of opium.

Under Section 6 of the Act, the Central Government constitutes an advisory Committee called The Narcotic Drugs and Psychotropic Substances Consultative Committee to advise the Central government on such matters relating to the administration of this Act.

Section 7 gives similar powers to the State Governments to appoint such officers as necessary for the purposes of this Act. National Fund for Control of Drug Abuse Section 7 A gives authority to the Central Government to constitute a Fund called the National Fund for Control of Drug Abuse. This fund is to be applied to meet the expenditure incurred in connection with the measures taken for combating illicit traffic in, or controlling abuse of narcotic drugs and psychotropic substances.
Under Section 7 B, the Central Government is to give an annual account of the activities financed under this fund.

Prohibition, Control and Regulation
Section 8 of the NDPS Act prohibits the following operations. It is stated that no person shall:

• Cultivate any coca plant or gather any portion of coca plant; or
• Cultivate the opium poppy or any cannabis plant; or
• Produce, manufacture, possess, sale, purchase, transport, warehouse, use, consume, import inter-state, export inter-state, import into India, export from India or transship any narcotic drug or psychotropic substance except for medical or scientific purpose and in the permitted manner (under license and in accordance with the terms and conditions of such license, permit or authorization).
Possession requires two elements: (a) physical control or ability to exercise physical control; and (b) knowledge that a thing is in one’s custody or under one’s physical control. Thus the physical element (custody or control) as well as the mental element (Knowledge), have to be proved against an accused before he can be punished under this section.

There are various issues related to mother-to-child transmission, which are still debatable. Some of the debatable issues are:
1) Whether HIV positive women should be encouraged to have a child or not?
2) Whether HIV-positive in others should not breast-feed their infants?
3) Should every person undergo HIV counselling and testing routinely?
4) Should HIV positive men and women marry among themselves or not?

1) Should HIV- positive women be encouraged to have children or not?
It is every .women’s fundamental right to decide for herself, without coercion, whether she should have children or not. This is enshrined in the International Human Rights Conventions. It is the responsibility of the Government and health services to provide HIV- positive women and their partners with comprehensive information and education about the risks associated with child bearing as part of routine public information about HIV/AIDS. The health services should ensure that they have real choices of action and respect and support the decisions that they reach.

2) Whether HIV- positive mother be told to breast-feed her baby?
Breast-feeding has been the corner stone of child health and survival strategies for the past two decades and has played a pivotal role in reducing infant mortality rate in many countries. Even in the era of AIDS, breast-feeding remains the best possible nutrition for the great majority of babies. As against this there is another view. You may recall that the transmission of HIV through breast milk is about 14 per cent. If the mother has received prophylaxis to prevent mother to child transmission, then it is illogical to recommend breast-feeding.

3) Whether each and every reproductive population should undergo confidential HIV counselling and testing or not is an ethical consideration. This is very much essential, as it becomes a global concern in terms of its magnitude and severity. It is very much needed for pregnant and married women and their male counterpart.
For pregnant, women to take advantage of measures to protect their off spring from HIV infection they need to know whether or not they are infected. Hence, voluntary counselling and testing services are an essential part of any programme for the prevention of mother-to-child transmission of HIV. Ideally, however, every one should have access to such services since there are clear advantages to know one’s sero-status. People who know they are HIV infected are likely to be motivated to look after their health, perhaps with behaviour and life-style changes and to seek early medical attention for problems. They can take wise decisions about sexual practices, child bearing and infant feeding and be steps to protect partners who may still be infected. And those whose test results are negative can be counselled about how to protect themselves, their partners and their children from infection.

4) Whether HIV-positive men and women can marry among themselves or not is another debatable question?
As far as right of a human being is concerned, HIV-positive men and women may marry among themselves,

The broad introduction on myths and misconceptions of HIV/AIDS/STDs deals effectively with the inaccurate information, which is quite often believed and passed on without the authenticity of the source. In this light, you have to focus on the various routine activities that are done with the anticipation of getting infected by HIV/AIDS person out of shear fear, ignorance, anxiety etc.
Handshake (shaking hand)
The chances of getting infection through a ‘shake hand’ is minimal, as long as the skin is intact without any breaks because in adults the virus is mainly transmitted through the transfer of blood or sexual fluids. Since there is no contact of blood or sexual fluids during a casual shake hand, there are no risk involved. Sharing the same telephone with other people in your office or working side by side in a crowded factory with other infected persons and even sharing the same cup of tea, cannot transmit the infection. These acts will not expose a person to the risk of contracting the infection. Being in contact with the sweat will not transmit the infection. Extensive tests have failed to detect HIV in sweat.
Sharing a Toilet / Bathroom etc.
The chances of getting infection through the toilet seat are very remote. For this to happen there would have to be fresh infected blood on the toilet seat in contact with breaks in the skin or genitalia of the next user. Proper and clean use of the toilet can prevent this. Saliva contains HIV virus in minute amounts. Saliva also contains an enzyme that inhibits the growth of the virus. A small amount of saliva is highly unlikely to transmit the virus. It has been shown that sharing of a toothbrush or a towel is unlikely to spread the virus.
Kissing Embracing
There is no harm in kissing, embracing or caressing an infected person provided it is a normal dry kiss or a gentle hold. Risk from a dry kiss, is almost zero.
Are Contact Sports Safe?
For somebody to get infected through contact sports, blood from an infected player’s body would have to be rubbed into a wound of an uninfected player. This is extremely unlikely.
Swimming Pool/Ponds are Safe
The only way you could possibly catch HIV at a swimming pool or a pond would be if someone carrying the virus gets injured due to an abrasion caused by a hard surface and left a puddle of blood, which you stepped in, causing an injury, on the same surface.
Circumcision
There is currently no evidence linking female circumcision as a risk factor to HIV infection. The society for women and AIDS in Africa (SWAA) reports that in areas where this practice is still carried out, the prevalence of HIV is low.
Can One Get WIV on Being Raped?
Yes, it is possible. The risk can be higher because the violence used can make abrasions and bleeding more likely, creating entry points for the virus.
Can One Get HIV by Giving Blood?
No, Some people are afraid and are staying away from this noble cause to donate blood. In order to make up and fill the growing demand for blood everyday, there is an urgent need to go for voluntary blood donation. There is no risk for the donor at all, so long as all the needles are sterile.
Can One Get HIV by Receiving Blood?
The efficacy of HIV transmission through infected blood is very high (90 to 95 per cent) but transmission through this route is responsible for only about 5 per cent of the global infection. The chances of infection through blood donation is almost completely eliminated from the developed countries, due to routine testing of blood donors, coupled with the voluntary exclusion from blood donation by persons practicing high risk behaviours. It is a problem mainly in under developed countries where professional blood donation continues to exist.
Safer Sex
There is still no clear picture about the concept of ‘safer sex’ within context of HIV/AIDS/STDs among high-risk groups and general population. Abstinence from sexual activities before marriage and being j faithful to his/her spouse after marriage is the tradition of living in I Indian context. Safer sex is any sexual practice that reduces the risk of passing (transmitting) HIV from one person to another. The best 1 protection is obtained choosing sexual activities that do not allow semen, fluid from the vagina of the partner to touch the skin of the partner / where there is an open cut or sore. Sex involving a mutually faithful husband and wife is usually known as “Safe Sex” in the Indian context.
Breast Milk
A pregnant woman who has HIV in her body can pass the infection onto the baby in the womb or during birth, Experts are of the opinion that one out of three babies born to infected mothers are likely to be born infected with HIV. There has been evidence that these babies do not live longer than two to five years.
How Safe it is to go to a Dentist?
It is safe to go to a dentist. A dentist usually sterilizes or disinfects equipment after each intervention and consultation. The risk is much more for the dentist than for the patient. Every time the Dentist gives an injection or
extracts teeth there is a slight risk that they will puncture their own skin.
Living Together
A person with AIDS is in need of both physical care and psychological support from his/her family/neighborhood/society. Family members and relatives can often give the best care. At home, he/she is in well-known surroundings where he/she feels secure. The family members and relatives should be informed about the disease, how it spreads and how it doesn’t spread and should know that people with AIDS need to be touched and cared for. Families can better respond to the social and psychological needs of their infected member. In our country, the familiar bondage is very strong such that the family members and relatives take care of their sick member irrespective of diseases.

The fear generated by the HIV epidemic has not helped the cause of HIV/AIDS patients. Sex workers, gay men and drug users who are the first to be infected by HIV are already targets of punitive legal provisions’.

Protective and Supportive Legal Framework
The law can and must be used to establish a protective and supportive framework for people affected by the epidemic and not a punitive one.

• The element of collaboration and mutual support that emphasizes the common interest between the infected and the uninfected and between the government and individuals is essential. Creating a supportive legal environment can involve both negative and positive legal interventions.

The negative interventions arise from the need of an absence of law in some contexts. The laws which we do not need are the laws that discriminate against the people with HIV, which distance them from their communities and which makes it less likely that people will share in the common interests to reduce the effects of the epidemic.
Then there are positive legal interventions that can actively promote the supportive environment. These legal interventions include:

• Human rights laws that give legal effect to rights such as the right to privacy, the right to protection against unlawful search and seizure and rights to protection against unlawful detention.
• Anti-discrimination laws that will provide redress in the event of discrimination, housing, access to health care, etc., against people with HIV or their family or friends.
• Legal provisions that protect the confidentiality of a person with HIV status.
• Laws compelling a person’s consent to be taken before HIV testing is undertaken.
• Laws that encourage appropriate workplace practices, e.g, infection control procedures and HIV education for employees.
Ethics and Law
It has become common to talk about law and ethics in the context of HIV policy. This is done for obvious reasons because the ethical dilemmas that arise are invariably played odt in legal terms. Nonetheless, the blurring of the distinction between law and ethics can sometimes obscure the fact that tensions may exist between ethical imperatives and legal obligations. It is, therefore, worthwhile considering the interaction between law, ethics and HIV.

Several countries have made legal provision to deal with issues arising out of HIV.
Sri Lanka
There are no HIVIAIDS specific laws in Sri Lanka, The three prevailing laws under which the epidemic can be dealt wit11 are: Contagious Diseases, Ordinances No. 8 of 1996 Venereal Diseases Ordinance No. 27 of 1938, and Quarantine and Prevention of Diseases Ordinance No. 3 of 1897 The Contagious Diseases Ordinance of 1966 requires every case of small pox, cholera or other disease which may from time to time be named to be notified to a police officer or other officials. AIDS related issues may be covered under the clause ‘other diseases’. Venereal Diseases Ordinance of 1938 permits only registered or authorised medical practitioners to treat venereal diseases. The most important one in the context is the Quarantine and Prevention respect of Diseases Ordinance of 1897. It gives powers to the health authority in respect of identification and control of contagious diseases. Under this law the doctor is to report a case of HIV infection with all particulars of the patient. Segregation of the infected person is authorized. There is no provision for confidentiality of the information provided.
Thailand
Thailand has a disproportionate number of HIV/AIDS patients and it has great socio-economic, political and legal consequences. Poverty discriminations, budgetary demand etc. indicated that HIVIAIDS is no more a medical disease but it is also a socio-economic and political disease. Form the angle of law; HIVIAIDS is equally a legal disease for Thailand. The National Plan for the Prevention and Control of AIDS (1992-96) established a more enlightened framework for action on HIV/AIDS.
Family and Law
AIDS is a contributing factor towards family break-up. As the number of infected persons goes up, pressure is building up on the families. There is no law to provide subsidies to families. There is also no provision for social security to help the poor. However such facilities are advocated under the National Plan on AIDS.
Employment
The National Plan for the Prevention of AIDS rejects compulsory testing for employment. But rejections of potential employees on the bases of HIV/AIDS and dismissals of actual employees due to the same are very common. Though there are a number of labour laws with implications for HIV/AIDS, the dismissed employees do not approach the courts due to the fear of exposure of their identity
Criminal Law
According to the criminal code liabilities arises from intentional acts, but negligence may also give rise to liability. A key concern in Thailand is the suppression of drugs trade. The provisions of the Dangerous Drug Act, 1979 can be used to detain those with HIV/AIDS where they are the Prostitution Suppression Act, 1960 and Entertainment Places Act, 1966. Prostitution is illegal in Thailand, but it is a rampant. There are also a men, women and children. Courts have powers to send prostitutes having HIV/AIDS to rehabilitation programmes. Prostitution is the most closely linked factor for the spread of AIDS in Thailand.
Malaysia
The Ministry of Health has prepared a Plan of Action that provides guidelines for the surveillance, prevention and control of HIVIAIDS in the country. The main statute in this area is the Prevention of Infectious Diseases Act, 1988. HIV is the only disease included in Part 2 or the Schedule; Section 2 of the Act deals with surveillance while section 3 provides for the confidentiality.
AIDS was first notified as an infectious disease in May 1985. Section 10 of the Act requires all those who come to know the existence of AIDS to notify the officer in charge. Doctors who treat AIDS patients are to notify the same. Persons running boarding houses are to inform if they come to h o w of any of the inmates infected with HIV. Failure to notify is an offence under section 10 (5) of the Act,
Indonesia
The first case of AIDS was recorded in 1987 as a foreign tourist died in Bali. Legal approach to AIDS is based on the Basic Constitution of 1945, Epidemic Law, Quarantine Law, the Health Law etc, Surveillance and notification of AIDS is being done. Testing and counselling are implemented voluntarily. Confidentiality of the HIV status is guaranteed. Compulsory treatment is not applied. Preventive measures like quarantine is not allowed for HIV/AIDS cases. There exist no brothel laws, as prostitution is illegal in Indonesia. Normally medical information is confidential unless asked for by patients or their families. There is no special law dealing with the right of people living with HIV/AIDS. Though there is no legal discrimination against HIV/AIDS patients; it exists for cultural and religious reasons. The duty to treat AIDS cases has been applied to all government hospitals. People living with HIV/AIDS have the same rights as other people in accommodation, employment, school etc.
Singapore
There are few laws, policies and regulations enacted specifically to deal with AIDS in Singapore. Amendment in Infectious Diseases Act, 1985 is meant to deal with epidemic. The Act calls for notification, testing, isolation and quarantine as well as penal provisions. Under the Act, the penal provisions would deter the infected persons from coming forward to be identified.
Every blood donor is required to complete a statutory declaration before he donates blood about his practicing safe sex. This declaration also perpetuates the myth that homosexuals are more disposed to AIDS. Every work permit holder is required to undergo HIV tests to get the permit renewed. The Singapore national employer’s federation has declared HIV infection to be contracted outside the workplace and not their responsibility. Termination of an HIV infected employee is permissible if a number of other employees refuse to work with him. Singapore’s political culture based on Confucian ethics places community interests above all else. The tendency therefore is to curb the rights of the infected individuals and the politicians are accused of playing to popular ignorance.