HIV Basics What is HIV Human Immunodeficiency Virus
HIV Basics
What is HIV? �Human Immunodeficiency Virus ◦ Two Strains �HIV-1 �HIV-2 �Kills special blood cells that help fight off infections ◦ CD 4+ �Virus that can lead to Acquired Immune Deficiency Syndrome
AIDS �Final stage of infection by the HIV virus �Defined by the number for CD 4+ cells ◦ Absolute count < 200 cells/m. L or ◦ If CD 4+ cells < 14% total lymphocytes OR �Hallmark infections ◦ Examples: Kaposi’s sarcoma, pneumocystis pneumonia
NOT TRANSMITTED BY: �Air or water. �Insects, including mosquitoes. ◦ CDC studies say no �Saliva, tears, or sweat. ◦ There is no documented case of HIV being transmitted by spitting. �Casual contact like shaking hands or sharing dishes. �Closed-mouth or “social” kissing.
Living with HIV/AIDS Worldwide: 34 million
Living with HIV/AIDS Worldwide: 34 million US-1. 1 million people
Living with HIV/AIDS Worldwide: 34 million US-1. 1 million people Washington~ 11, 000
Living with HIV/AIDS Worldwide: 34 million US-1. 1 million people Washington~ 11, 000 Clark County 456
Is spread by: �Sex ◦ Not all sex has the same risk �Exposure to an infected persons blood ◦ Sharing needles & works �Mom to Baby ◦ Pregancy, birth, & breastfeeding
WHAT IF:
History �Where did HIV come from? ◦ Monkeys ◦ Most likely from hunting & handling the meat �US Patient Zero Theory ◦ Rumor/unfounded �Patient zero was a flight attendant who got AIDS by having sex with a monkey in Africa ◦ Likely part of a group of highly sexually active men who participated in spreading the disease
Citation: Auerbach, . D. Darrow W, Jaffe, H. Curran, J. Cluster of cases of the acquired immune deficiency syndrome. The American Journal of Medicine Volume 76, Issue 3 , Pages 487 -492
TRENDS IN ANNUAL AGE-ADJUSTED* RATE OF DEATH DUE TO HIV INFECTION BY SEX, UNITED STATES, 1987− 2009 Note: For comparison with data for 1999 and later years, data for 1987− 1998 were modified to account for ICD-10 rules instead of ICD-9 rules. *Standard: age distribution of 2000 US population
Why Stigma At the Beginning • Gay Related Immune Deficiency (GRID) • Gay Cancer �Initially untreatable and transmission method unknown
Who gets HIV now? �Bring up CDC slide
HIV infections by risk group �HIV Demographics
Why Stigma Now? �Promiscuous �Drug users �People who make bad decisions and their partners �Race
HIV infections �The new infection rate among blacks/African americans was 7. 9 times higher than whites. ◦ 50% of these infections are MSM ◦ Fastest increasing group is black females �The new infection rates in Latino/Latinas was 3 times higher ◦ ~70% of these infections are MSM
US AIDS Spread Map Dot Map
Is the risk of contracting HIV equal with all sexual encounters equal?
Spread & Risk �Not using a condom when having sex with a person who has HIV. All unprotected sex with someone who has HIV contains some risk. However: ◦ Unprotected anal sex is riskier than unprotected vaginal sex. ◦ Among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.
Spread & Risk �Unprotected oral sex can also be a risk for HIV transmission, but it is a much lower risk than anal or vaginal sex.
Sex Risk Hierarchy �Unprotected Receptive Anal Sex>Unprotected Insertive Anal Sex �Unprotected Insertive Anal Sex~= Unprotected receptive Vaginal Sex �Unprotected receptive Vaginal sex>Unprotected insertive vaginal sex �Unprotected Oral Sex Vaginal Sex> Unprotected
Spread & Risk �IDU ◦ ◦ Sharing Needles Syringes Rinse water, “Works” other equipment used to prepare illicit drugs for injection.
CDC, 2002 report
Spread & Risk �Multiple sex partners or the presence of other sexually transmitted diseases (STDs) can increase the risk of infection during sex.
Spread & Risk �Being born to an infected mother—HIV can be passed from mother to child during pregnancy, birth, or breastfeeding.
Detection of HIV �HIV is detectable in body ◦ 2 weeks to 6 months after infection �In US 25 days average
Testing �Primary Testing ◦ Antibody Test �Rapid Oral Swab �Blood �Confirmatory Testing ◦ Western Blot �Separates proteins
HIV Testing and Counseling �Trained �This Professionals class does NOT prepare you to do this
So what is your responsibility? �Brief Risk Intervention �Endangering Behaviors Reporting
Endangering Behaviors �Knowingly exposing other to HIV through behaviors ◦ Sex ◦ Sharing injection drug works, needles
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