On 1st December each year, the World AIDS Day aims to spread awareness on a disease which caused an estimated 770,000 deaths worldwide in 2018 only. This is an issue concerning all people and those working onboard ships as well. Due to the nature of their work, seafarers bear a great risk since the constant traveling increases probabilities of sexual activity with casual partners all over the world.
As such, this day is a great opportunity to focus on the issue of Sexually Transmitted Infections (STI), as the presence of an untreated STI can increase the risk of becoming infected with HIV among others, the virus causing AIDS.
It is estimated that nearly a million people get a Sexually Transmitted Infection (STIs) every day!
But lets us take things from the beginning.
The human immunodeficiency virus (HIV) targets the immune system and weakens people’s defence systems against infections and some types of cancer. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take from 2 to 15 years to develop if not treated, depending on the individual.
Anyone can get HIV; it can happen to both men and women. The HIV virus is transmitted in blood and body fluids and so infection mostly arises from:
- sexual contact,
- needle sharing in drug users and
- contamination during medical procedures.
HIV cannot be transmitted by normal social contact, via insects, via normal skin contact or via toilets.
A glimpse of statistics
- There were approximately 37.9 million people living with HIV at the end of 2018.
- Approximately 1.1 million people in the US are living with HIV today.
- Over 61% of people dying from HIV-related causes in 2018 were in Africa.
- In 2018, 1.7 million people were newly infected.
- At the end of 2018, an estimated 79% of people living with HIV knew their status.
In general, unprotected sexual intercourse carries the highest risks for the most dangerous sexually transmitted infections. There are specific tests that check for those in health clinics. In any case, if someone is worried that he/she might have HIV or any other STI, it is important to get tested as soon as possible.
If the person with HIV is not on good treatment they can give HIV to someone else by having sex without using a condom and / or sharing needles with other people. HIV can be also passed from a mother to her baby during pregnancy if she is not on treatment.
There are many ways to keep yourself safe from HIV. People will not get HIV from touching, kissing, sharing things like knives and forks, glasses and cups.
There is no cure for HIV but there are medicines that can keep people healthy, meaning that the person with HIV cannot give it to someone else. In particular, people with HIV who are diagnosed in good time and take their medication can live long and healthy live like everybody else. For these reasons, there are many people and places that can help.
Why is the risk of Sexually Transmitted Infections increased for seafarers?
As part of its Seafarers Health Information Programme, ISWAN identified four factors increasing the risk for seafarers:
- Working and living away from spouses and partners.
- Single sex working and living arrangements dominated by men.
- Lack of information about risk and preventive measures.
- Enhanced probability of sex with casual partners due to travelling.
Note that there is no risk of acquiring any sexually transmitted infection from casual day-to-day contact onboard.
HIV/AIDS is a maritime issue. Not only because it affects the workforce, but also because ships have a role to play in the wider struggle to limit the spread and effects of the epidemic,
Which are the main Sexually Transmitted Infections?
HIV is only one of the most common STIs. Many people do not develop any symptoms when they first become infected with HIV, while others get a flu-like illness within three to six weeks after exposure to the virus. The only way to know if you are HIV-positive is to have a test. Over time, infection with HIV weakens the immune system leading to difficulty fighting off certain infections, leading to AIDS. While there is no cure for AIDS, drugs can be used to suppress the HIV virus and preserve the immune system for as long as possible.
Other Sexually Transmitted Infections include:
- Chlamydia / Treatment: Antibiotics
- Genital warts/ Treatment: Painting them with a liquid or freezing them with a spray
- Genital herpes/ Treatment: There is no treatment, but antiviral drugs may relieve symptoms
- Gonorrhoea / Treatment: For the early stage, antibiotics
- Syphilis / Treatment: For the early stage, antibiotics
- Hepatitis B / Treatment: It exists but is expensive and debilitating
- Non-specific urethritis / Treatment: Antibiotics
- Trichomoniasis / Treatment: Antibiotics
- Pubic lice / Treatment: Special shampoos, creams or lotions.
How can shipping companies reduce the risk of Sexually Transmitted Infections?
- Offer information: Encourage and stimulate the crew members to prevent STIs and practice safe sex. Pay attention to prevention of STIs in meetings, at medical checkups etc. Use a broad approach to inform and motivate the seafarers onboard.
- Offer protection: Condoms have to be available free of charge onboard, especially when arriving in port for seafarers who go on land. The officer in charge of medical care onboard has to make sure that seafarers have access to free condoms in a discrete way, with respect to their privacy.
- Make a systematic plan: Behavioral changes take several months, and benefits may take even longer to become measurable. Make a systematic plan of what you want to achieve in respect of prevention of STIs onboard and over what period of time. ISWAN suggests the following steps:
- Involve key persons and link the plan to a company policy on health,
- Budget the programme,
- Announce the planning and changes, organize an event to celebrate the start of the plan,
- Provide information (posters or leaflets) on the prevention of STIs all over the ship.
- Ask crew members to participate and give comments on the campaign,
- Fill out questionnaires,
- Give crew members the possibility to make suggestions on prevention activities.
Concluding, taking into consideration that pre-employment HIV testing is illegal in many jurisdictions, responsibility for HIV testing lies within the individual.
In any case, HIV is not a condition for obtaining employment. It may lead to discrimination against the person either by denial of employment or harassment by other workers.
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About World AIDS Day 2019
The theme of this year’s World AIDS Day is “Communities make the difference”, to highlight that power in fact rests in the hands of the people, as can be seen in countless local, national and international movements to redistribute power and bring greater attention to neglected issues.