Download Chapter 16

Chapter Sixteen
HIV and AIDS
HIV/AIDS
•
Human Immunodeficiency Virus (HIV)
– Immune system deficient, cannot resist disease
– Virus responsible for Acquired Immune Deficiency
Syndrome (AIDS)
•
Acquired Immune Deficiency Syndrome
(AIDS)
– Descriptive of the infection and it’s progression
– First observed in U.S. cities in early 1980s
– Young, healthy men dying of rare diseases
Conditions Associated with AIDS
•
Opportunistic infections
– Pneumocystis carinii pneumonia (PCP)
– Mycobacterium avium intracellulare
•
Clinical conditions
– Wasting syndrome
•
Cancers
– Kaposi’s sarcoma
•
Other infections
– Candidiasis
– Herpes and cytomegalovirus
Symptoms of HIV Infection and
AIDS
•
•
•
•
•
•
Unexplained persistent
fatigue
Fever, chills, night
sweats
Unexplained weight
loss
Swollen lymph nodes
Pink, red, purple, or
brown blotches
Persistent dry cough
•
•
•
•
•
•
Persistent, fuzzy, white
spots in mouth, tongue,
or throat
Memory loss or
depression
Abnormal pap smears
Persistent vaginal
candidiasis
Abdominal cramping
(due to Pelvic
inflammatory Disease)
Persistent Diarrhea
The Immune System and HIV
•
•
Leukocytes – white blood cells
Macrophages
• Engulf foreign particles
– Antigens
• Stimulate immune system, react with antibodies
– Antibodies
• Inactivate antigens, mark them for destruction
•
B cells and T cells
– Lymphocytes
– Helper T cells
The Virus
•
•
•
•
•
•
Protein coated package of genes
Spherical
GP 120
Reverse transcriptase
Retrovirus
Effect on T cells
How the Disease Progresses
•
•
•
•
•
T cell (CD4) count
Viral load counts
Phases of infection
– Months to years
– Early flu-like symptoms
AIDS
Death
Epidemiology and
Transmission of HIV
•
•
•
Epidemiology – Study of incidence,
process, distribution, and control of a
disease
World Health Organization reports 25
million people have died from AIDS
Estimated that 40.3 million people are
living with HIV
Epidemiology and
Transmission of HIV
•
•
•
•
Global increases in number of people
living with AIDS
African continent the largest
concentration
2/3 of all AIDS cases are in Sub-Saharan
Africa
77% of women living with AIDS are in
Sub-Saharan Africa
Epidemiology and Transmission of
HIV in the United States
•
•
•
•
944, 306 individuals living with AIDS
40,000 annual new HIV infections
Changes in current transmission modes
Changes across ethnic groups
Modes of Transmission
•
•
•
•
Sexual contact
Sharing needles
Transfusions
Passing virus from mother to fetus
Modes of Transmission
•
•
•
•
Breastfeeding from HIV-positive mother
Sharing sex toys
Accidental contamination with infected
blood
Contaminated blood transfusions or
organ transplants performed before
April 1, 1985
Myths about Transmission
•
•
•
•
•
•
Non sexual contact – touching a person
Touching a surface – toilet seat
Social contact – kissing, biting or tears
Insect bites
Accidental contact in sports
Donating blood
Sexual Transmission
•
•
•
•
Anal intercourse
Vaginal intercourse
Oral sex
Sex toys
Injection Drug and Substance
Use
•
•
•
Sharing needles
Sharing other paraphernalia
Recreational use resulting in poor
decision making
Mother to Child Transmission
•
•
Peri natal transmission
Greatly reduced by use of ZDV (AZT)
– Mother takes ZDV from week 14 to 34
– Infant takes ZDV
Minority Races and Ethnicities
and HIV
•
•
•
In the early 80s, was viewed as a
disease in Whites and gays
Currently identified in all ethnic groups
Occurs in groups with
– Poverty
– Lack of access to or willingness to use
health care
– Substance abuse
Minority Races and Ethnicities
and HIV
•
•
•
•
African Americans
Hispanics
Asian/Pacific Islanders
American Indians and Alaska Natives
The Gay Community
•
•
•
•
•
•
•
Men who have sex with men
Stigma slowed prevention efforts
Special consideration of ethnic groups
Psychological long term effects
Increased risk taking
Other STIs
U.S. AIDS Demographics by Race
Other Groups and HIV
•
•
•
•
Children
Teens and college students
Older adults
Geographic region
Prevention and Treatment
•
Protecting ourselves
– Be aware that alcohol and drug use
increases risky behaviors
– Develop communication skills to be able to
discuss risks and prevention with partners
– Use HIV testing and make appropriate
decisions
– Use condoms
Prevention and Treatment
•
Saving lives through prevention
– Reduced new infections from 150,000/year to
40,000/year
•
Obstacles to education: blame and denial
– AIDS seen as disease of marginalized group,
not “us”
•
•
Needle exchange programs
HIV testing
HIV Testing
•
•
Tests should be taken 12 weeks after highrisk behavior, repeated 6 months after an
uncertain result
Types of tests
– ELISA - enzyme-linked immunosorbent assay
– Western blot –rechecks ELISA results
– Viral load tests measure HIV in bloodstream
•
•
Getting tested
Partner notification
Treatment
•
•
Usually initiated with the diagnosis of AIDS
Antiretroviral medications
–
–
–
–
•
Nonnucleoside reverse transcriptase inhibitors
Nucleoside reverse transcriptase inhibitors
Protease inhibitors
Fusion Inhibitor
HAART – Highly Active Antiretroviral Therapy
– Combination of three or more medications
– Reduces HIV in blood to undetectable levels
Living with HIV or AIDS
•
•
•
•
If you are HIV positive
Taking care of your health
Addressing your other needs
If you are caring for someone with HIV or
AIDS
Summary
•
•
•
•
•
What is AIDS?
The epidemiology and Transmission of HIV
AIDS demographics
Prevention and Treatment
Living with HIV or AIDS