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No One Is Immune To HIV… James R. Ginder, MS,NREMT,PI,CHES,NCEE Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov HIV and AIDS Information ---PAGE BREAK--- The Reader Will Be Able To • List three ways HIV can be transmitted. • Recall three ways HIV can be prevented. • Explain how HIV develops into AIDS. • Identify two types of HIV testing. • Locate where a person can find a testing site. ---PAGE BREAK--- General Information • What year was HIV first diagnosed? 1981 • What states was HIV first seen in? New York and California • When (year) was the blood supply first tested? 1985 ---PAGE BREAK--- What Is HIV? • H – Human – This virus can only infect people • I – Immunodeficiency – HIV weakens the immune system by destroying important cells that fight disease and infection. • V – Virus – A virus can only reproduce itself by taking over a cell in the body of its host. HIV ---PAGE BREAK--- What Is AIDS? • A – Acquired – AIDS is not something a person inherit from their parents. A person acquires AIDS after birth. • I – Immune – The body's immune system includes all of the organs and cells that work to fight off infection or disease. • D – Deficiency – A person develops AIDS when the immune system is "deficient," or isn't working the way it should. • S – – A is a collection of and signs of disease. ---PAGE BREAK--- Where Did HIV Come From? • Three theories: • Came in contact with chimpanzee blood • Bit by a chimpanzee • Ate uncooked chimpanzee meat Source: CDC Green Monkey ---PAGE BREAK--- HIV Data • CDC estimates that more than one million people are living with HIV in the United States • One in five (21%) of those people living with HIV is unaware of their infection. • It is estimated 56,300 Americans becoming infected with HIV each year. Source: CDC ---PAGE BREAK--- HIV Data • People who don't know they have HIV have a higher risk of serious medical problems and early death. • People who don't know they have HIV can also pass the virus on to others without knowing . ---PAGE BREAK--- Every Day • Every 9 1/2 minutes, someone in the U.S. is infected with HIV! Source: CDC ---PAGE BREAK--- AIDS Data • More than 17,000 people with AIDS still die each year in the U.S. • Through 2008, more than 617,000 people with AIDS in the U.S. have died since the epidemic began. Source; CDC ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- Indiana Data ---PAGE BREAK--- North American 1.3 MILLION Caribbean 200,000 Latin American 1.5MILLION Australia New Zealand 54,000 South and South East Asia 4.0 MILLION East Asia and Pacific 790,000 Eastern Europe and Central Asia 1.5 MILLION West Europe 840,000 Sub-Saharan Africa 22.9 MILLION North Africa and Middle East 470,000 Adults and Children Infected with HIV in 2010 TOTAL 34.0 Million Source: UNAIDS 2010 ---PAGE BREAK--- How HIV Works INFECTION OF HOST CELL HIV binds to the receptor on the surface of the host cell. HIV’s genetic core and enzymes are injected into the host cell. INTEGRATION INTO HOST CELL HIV’s DNA is inserted into the host cell’s nucleus, the site of it’s DNA. Source :http://www.bavarian-nordic.com ---PAGE BREAK--- How HIV Works ACTIVATION OF THE VIRUS The host cell is now infected. And HIV is formed in the infected cell. BUDDING AND FURTHER INFECTION The newly-formed HIV then “buds” out and is released from the infected host cell to repeat the same process of infection in other cells. Source :http://www.bavarian-nordic.com ---PAGE BREAK--- HIV- 2 • HIV-2 has the same modes of transmission as HIV-1 and is associated with similar opportunistic infections and AIDS. • HIV-2, develops more slowly and tends to be milder. Those with HIV-2 are comparatively less infectious early in the course of infection. • HIV-2 is more common in Africa then here in the United States. ---PAGE BREAK--- Source: ARC Need to wait 3 months after an exposure to be tested. ---PAGE BREAK--- WHY DOES THE INTERNET PLAY A ROLE IN HIV TRANSMISSION? ---PAGE BREAK--- Bodily Fluids That Transmit HIV • Blood products • Semen • Vaginal secretions • Breast milk • Saliva in dental settings • Any body fluid that is visibly contaminated with blood ---PAGE BREAK--- Blood Supply And HIV • The U.S. blood supply is among the safest in the world. • Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year HIV testing began for all donated blood. • All blood donors and organ donors are screened for their risk of HIV. • All donated blood and organ s are tested. • All blood and organs that test positive for HIV are destroyed. ---PAGE BREAK--- How Is HIV Spread? • By having oral, vaginal and anal sex with a infected person. • Blood to blood. • By sharing needles or syringes and drug equipment with an infected person. • Sharing tattoos and body piercing equipment. • Mothers to infants, during pregnancy. ---PAGE BREAK--- Public Health Law • Indiana Code IC-16-41-7-2. • A person who tests positive for HIV MUST tell his or her sex and needle sharing partner. • They can not donate blood, organs, or any other body fluid (sperm, breast milk). • If the person does not disclose the information they will be arrested. ---PAGE BREAK--- HIV + Person Person E Person B Person G Person D Person H Person P Person Q Person M Person F Person N Person L Person O Person I Person R Person K Person J Person To Person ---PAGE BREAK--- A Greenwood man is in jail for allegedly not telling the women he dated he is HIV-positive. The man's ex-girlfriend now fears for her life and the health of others. "I will never be right again because of this monster," the woman said. Tony Perkins, 47, was arrested after the ex-girlfriend turned him in for what he didn't tell her. "At this time, we have the names of 11 women he had sexual relations with," said Greenwood Police Chief Joe Pitcher. Although diagnosed in 2004, investigators say Perkins broke the law by not informing the women he slept with that he was HIV-positive. The ex-girlfriend believes "hundreds" of women may be affected. Perkins was twice warned by the state health department that it was his duty and the law to inform partners of his condition. The victim who came forward told police Perkins often meets women on a dating web site Source: WTH 2/20/10 Greenwood Man Arrested For Not Disclosing His HIV Positive Diagnosis ---PAGE BREAK--- How Is HIV Not Transmitted? • Causal contact • Eating after someone • By mosquitoes • Saliva • Sweat • Tears • Using the bathroom after someone • Drinking after someone • Hanging out with someone as long as there is not drugs or alcohol ---PAGE BREAK--- Alcohol And Drugs • Cause a person to make unhealthy choices. • Can lower a persons immune system. • May cause a person not to use a latex condom. • Sharing needles/syringes and drug equipment increases the risk of HIV ---PAGE BREAK--- Of HIV • Coughing & shortness of breath • Fever • Severe & persistent diarrhea • Weight loss & extreme fatigue • Difficult or painful swallowing • Nausea, abdominal cramps & vomiting ---PAGE BREAK--- HIV To AIDS • A person who is HIV + must have three things to move to AIDS: • CD4 and T-Cells (white blood cells) must be below 200 to move to AIDS. • A person without HIV usually has a CD4 and T-Cell count of 800 to 1,200 or more.(NIH) • The person must also have TWO of the opportunistic infections to move to AIDS ---PAGE BREAK--- Opportunistic Infections ---PAGE BREAK--- Opportunistic Infections Kaposi's Sarcoma Source: www.cdc.gov Candidacies Esophageal ---PAGE BREAK--- HIV Test • The most commonly used HIV tests detect HIV antibodies – the substances the body creates in response to becoming infected with HIV. • There are tests that look for HIV's genetic material or proteins directly; these may also be used to find out if someone has been infected with HIV. HIV Antibodies ---PAGE BREAK--- HIV Testing • Blood test: • One tube of blood is taken and sent to the lab. • Oral Testing • Cells are taken from the inside of the mouth and are tested for HIV (if this test is reactive, a blood test must be done to confirm the test. ---PAGE BREAK--- Anonymous HIV Testing • No name is used. • A number given only (10001234). • If the test is positive, the person will have to have a confidential test done. • This test is given at the Hamilton County Health Department 100002557398 Op Scan Number ---PAGE BREAK--- Confidential HIV Testing • Records the person's name with the test result. • Records are kept locked from everyone except medical personnel, or in some states, the state health department. • Individuals should ask who will know the results and how the record will be stored. • If the HIV antibody test is confidential, a release form can be signed to have the test results sent to the individual's physician. • At some centers, however, such as doctor offices or clinics, test results may become part of the individual's medical record and may be seen by health care workers, insurers, or employers. • This test is performed at the Hamilton County Health Department ---PAGE BREAK--- ELISA & Western Blot • ELISA (Enzyme Linked Immunoassay): • A screening test for the diagnosis of HIV antibodies. • If the ELISA is negative, the person is negative for HIV. • If the test is positive a second ELISA is done with a new sample. If the second sample is positive a confirmatory test is done called the Western Blot. • Western Blot: • More specific and will confirm if someone is truly HIV positive ---PAGE BREAK--- Testing Terms • Negative or Non Reactive Results: • No HIV antibodies were found in the sample. • Positive or Reactive Results: • Antibodies were found in the sample. The person is then said to be HIV • Indeterminate Result: • The person is not negative or positive. A new sample should be taken in two weeks. Negative Or Non Reactive Positive Or Reactive ---PAGE BREAK--- Who Should Be Tested? • Have you injected drugs or shared equipment (such as needles, syringes,) with others? • Have you had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners? • Have you exchanged sex for drugs or money? • Have you been diagnosed with or treated for hepatitis, tuberculosis (TB), or a sexually transmitted disease or infection (STD/STI) • Have you had unprotected sex with someone who could answer yes to any of the above questions? ---PAGE BREAK--- Treatment For HIV/AIDS • There are 31 antiretroviral drugs (ARVs) approved by the Food and Drug Administration to treat HIV infection. • These treatments do not cure people of HIV or AIDS. • Rather, they suppress the virus, even to undetectable levels, but they do not completely eliminate HIV from the body. ---PAGE BREAK--- Treatment For HIV/AIDS • By suppressing the amount of virus in the body, people infected with HIV can now lead longer and healthier lives. • However, they can still transmit the virus and must continuously take antiretroviral drugs in order to maintain their health quality. ---PAGE BREAK--- HIV And Hepatitis C • 50%-90% of people who have HIV also have Hepatitis C • Can lead to liver damage more quickly • Hepatitis C is more severe in a person who is HIV + • of Hep. C are more severe • Co - infection will affect treatment of HIV & Hep. C ---PAGE BREAK--- HIV And Syphilis • 70 % of people who tested positive for Syphilis in Indianapolis, also tested positive for HIV in 2010. Source: ISDH Syphilis of brain. This person did not get treated for the infection. ---PAGE BREAK--- How To Stop HIV Transmission? • Abstinence ( Not having sex). • Do not get a tattoo or body piercing at a “tattoo party”. • Use a latex condom correctly for every sexual act. • Stop using drugs. • Use clean needles and drug equipment every time. ---PAGE BREAK--- Risk Reduction Information • How To Use A Male Condom • How To Use A Female Condom • Dental Dam Information • How To Clean Syringes • Syringe Disposal Program In Hamilton County Click On The Links For More Information ---PAGE BREAK--- FREE HIV/STD/STI Testing Available at the Hamilton County Health Department Call or E-mail For An Appointment [PHONE REDACTED] [EMAIL REDACTED] Test Results Given In 20 Minutes Pre-test and post-test counseling will be given to every client ---PAGE BREAK--- Where To Find Testing Click on the red ribbon to find a HIV testing site close to you. ---PAGE BREAK--- Course Evaluation Please Click On The Picture To Complete The Course Evaluation ---PAGE BREAK--- Reference • AIDS.gov • www.AIDS.gov • Centers For Disease Control and Prevention • www.cdc.gov • Indiana State Department of Health • http://www.in.gov/isdh • National Institute of Allergy and Infectious Diseases • www.niaid.nih.gov/pages/default.aspx?wt.ac =tnHome • UNAIDS • www.unaids.org