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IT Electives The Fundamental Knowledge on HIV and AIDS Learning Objectives The following objectives are aiming at enabling learners: • To understand general concept of HIV and AIDS • To have an understanding of the current statistic status of HIV • To understand methods of HIV transmission • To understand how HIV causes disease • To understand different approaches to diagnosing and testing HIV • To understand how HIV can be prevented • To understand how HIV can be treated • To understand possible strategies of communicating HIV @ UMP - ICT Electives 2016 2 Learning Objectives continues……. • To understand ethical Issues about HIV/AIDS • To understand the issues of HIV/AIDS stigma • To understand the role of culture in the HIV/AIDS epidemic • Understand how HIV/AIDS affects the economy @ UMP - ICT Electives 2016 3 HIV/AIDS Concepts According to Health Research Council Report (2010), HIV/AIDS are two acronyms that are closely related to each other. Most of common people who doe not have medical background confuses the use of these terms/words. • AIDS stands for Acquired immunodeficiency syndrome • It is the stage of infection that occurs when your immune system is badly damaged and you become vulnerable to opportunistic infections. It is the final stage of HIV infection • HIV stand for Human immunodeficiency virus • It attacks the immune system of the body by attacking cells that protects body from different diseases (T cells also known as CD4 cells). It destroys the fighting cells until the body cannot fight any infections if left not treated. When the body cannot fight for itself it results to AIDS, which is the final stage of critical sickness. @ UMP - ICT Electives 2016 4 HIV/AIDS Concepts continues…… • HIV/AIDS Epidemic – The widespread of HIV/AIDS is referred to as epidemic, whereas scientists mainly talk about epidemiology which refers to the tracking of occurrences, distribution and control of a disease. The scientist also use specific calculations to determine these frequencies in order to promote the health of the population (Munro, 2016) • The scientific calculations helped the government to understand the different stages and conditions of people who are infected. These calculations also prepares the government for the distribution of medication for different categories of infected HIV patients. @ UMP - ICT Electives 2016 5 History of HIV According to Munro (2016), • it is still not confirmed when the HIV started, however since the virus growing very fast the debate of HIV evolution must be re-directed on how this killer disease can be cured. • it was captured that HIV was identified to be similar to the Simian Immunnodeficiency virus (SIV) common amongst ape population in Central Africa. The spread of SIV could have been resulted through the cross species transfer of the virus. • It is also recorded that the medical network became aware of the challenge in 1981 when the unusual lung infection was seen in menwho-have-sex-with-men in United State. @ UMP - ICT Electives 2016 6 History of HIV continues…….. • it was further discovered in 1982 that people who were diagnosed with this unusual infection have developed another unusual infections and tumours and the kind of infections were named Acquired Immunodeficiency Syndrome (AIDS). is still not confirmed when the HIV started, however since the virus growing very fast the debate of HIV evolution must be re-directed on how this killer disease can be cured. • it was further captured that scientist and medical practitioners investigated the root cause of the virus using a molecular clock indicators and have established that the evolution of the virus started in 1968 as HIV-1 virus. The tracking of the virus became possible in the 1980s and 1990s. • It is also captured that HIV was observed in Africa Congo 1959. The assumption is that this virus was transferred through monkeys and chimpanzees meat hunted in West Africa. @ UMP - ICT Electives 2016 7 History of HIV continues…….. • it was observed that outbreak of HIV was already found in other African countries. The spread increased due to various methods such as colonisation, urbanisation, increased sexual behaviour, increase of use of needles during the new antibiotic era and vaccination era. @ UMP - ICT Electives 2016 8 How does the person gets HIV continues……. • HIV infection is not transferred like a cold or the flu. One does not need to observe the precaution actions like washing hand often, covering your sneezes and the like will not protect you from getting the HIV virus. It cannot be transferred by hugging or holding the hand of, sitting together at a place of worship, selling at the market, sharing a school bus or classroom with, or visiting the home of someone who has HIV (eSchooltoday). @ UMP - ICT Electives 2016 9 How does the person gets HIV continues……. • There are three scientific methods identified as HIV transmitters namely: o Sexual transmission It mostly transmitted when one is having sexual contact with a person who has HIV. This also includes men that have sex with men (Gays). In fact, research confirms that all forms of sex, anal, vaginal, oral and even sharing sex toys can highly transmit the virus. o Blood borne transmission This can be transmitted through blood transfusion with infected blood, sharing of contaminated injection equipment (people who use needles for injecting drugs), tattooing, skin-piercing tools and surgical equipment. o Vertical transmission This can be transmitted through mother to child (pregnant mother pass it to the unborn child), during child birth, and through breastfeeding. @ UMP - ICT Electives 2016 10 How HIV cannot be transmitted Amongst the things that cannot transmit HIV virus are the following: • Contact with other bodily secretions Saliva, urine, tears, sweat (unless contaminated by blood) • Vaccination Vaccination even those who are manufactured with blood since they have been screened and purified. • Blood sucking insects Blood sucking insects like mosquitoes cannot be infected by HIV and do not carry the virus in their blood and also do not inject blood into the next person they bite. @ UMP - ICT Electives 2016 11 Viral load and CD4 Count • Viral load is the term used to describe the amount of HIV in your blood. The more HIV is in your blood (and therefore the higher your viral load), then the faster your CD4 cell count will fall, and the greater your risk of becoming ill because of HIV. • A CD4 count is a lab test that measures the number of CD4 T lymphocytes (CD4 cells) in a sample of your blood. In people with HIV, it is the most important laboratory indicator of how well your immune system is working and the strongest predictor of HIV progression (https://www.aids.gov/hiv-aids-basics/just-diagnosedwith-hiv-aids/.../cd4-count/ ) @ UMP - ICT Electives 2016 12 Antiretroviral therapy (ART) and Viral Load • Antiretroviral therapy (ART) is the combination of several antiretroviral medicines used to slow the rate at which HIV makes copies of itself (multiplies) in the body. A combination of three or more antiretroviral medicines is more effective than using just one medicine (monotherapy) to treat HIV. • If you are on treatment, then your viral load should go down to undetectable level (less than 50 copies/mL). Once your viral load goes down, then slowly your CD4 count will increase, although not to the level before infection. @ UMP - ICT Electives 2016 13 HIV control: Antiretroviral therapy (ART) continues.. • An undetectable viral load means that the level of HIV in your blood is below the threshold needed for detection by this test. A viral load test is a measurement of the amount of HIV in your body. The measurement is given in the number of copies in millilitre. • CD4 counts are reported as the number of cells in a cubic millimeter of blood. A normal CD4 count is from 500 to 1,500 cells per cubic millimeter of blood. It is more important to pay attention to the pattern of results than to any one test result. In general, HIV disease is progressing if the CD4 count is going down (www.webmd.com/hivaids/cd4-count-what-does-it-mean). @ UMP - ICT Electives 2016 14 Antiretroviral therapy (ART) and CD4 Count • An undetectable viral load means that the level of HIV in your blood is below the threshold needed for detection by this test. A viral load test is a measurement of the amount of HIV in your body. The measurement is given in the number of copies in millilitre. • CD4 counts are reported as the number of cells in a cubic millimeter of blood. A normal CD4 count is from 500 to 1,500 cells per cubic millimeter of blood. It is more important to pay attention to the pattern of results than to any one test result. In general, HIV disease is progressing if the CD4 count is going down (www.webmd.com/hivaids/cd4-count-what-does-it-mean). @ UMP - ICT Electives 2016 15 HIV & Other Transmitted Diseases (STI) • Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of contracting or transmitting HIV infection. Other viral infections, such as herpes simplex virus type 2 (causing genital ulcer) or human papillomavirus (causing cervical cancer) are becoming more prevalent (www.who.int/ith/diseases/hivaids/en/). • Although all STIs are treatable, only some can be cured through treatment and completely cleared from the body. STIs that can be cured through treatment include gonorrhoea, chlamydia, syphilis and Trichomonas vaginalis. STIs that can be managed through treatment, but not cured, include HPV, herpes and HIV. @ UMP - ICT Electives 2016 16 HIV Diagnosis and Testing According to Munro (2016) Testing and diagnosis is important against HIV since: • Almost half of those living with HIV do not know their status • Early diagnosis results in early treatment with better and healthier life • Knowing your status can reduce transmission of HIV by reducing viral loads with appropriate treatment • The prevention of mother to child transmission is improved if pregnant mothers know their status Watch these clip on youtube and summarise it not less 250 words but not more than 300 words: https://www.youtube.com/watch?v=Kw_e_O6MdM4 @ UMP - ICT Electives 2016 17 HIV Diagnosis and Testing Continues……….. Different approaches to testing (Munro, 2016) • Voluntary counselling • Provider initiated testing • Compulsory testing • Community based testing • Self testing @ UMP - ICT Electives 2016 18 HIV Diagnosis and Testing Continues……….. Different testing methodologies (Munro, 2016) • Antibody testing ELISA, Western Blot, rapid screening • Antigen testing Blood test to identify the presence of part of the capsid of the virus (p24 antigen) • Nucleic acid testing This test is accurate that target specific sequences in HIV genes. It is relatively expensive form of testing and is usually used after other screening has been carried out. This method is also frequently used at birth for early infant testing and diagnosis. Refer to this clip for further explanation: : https://www.youtube.com/watch?v=Kw_e_O6MdM4 @ UMP - ICT Electives 2016 19 Symptoms of HIV / AIDS An HIV-positive person will eventually begin to feel sick. Signs you may see include: • • • • • • Swollen lymph nodes Weight loss Fevers that come and go Diarrhea Infections in the mouth Feel tired for no reason all of the time. @ UMP - ICT Electives 2016 20 HIV Prevention There are several ways of preventing HIV that include but not limited to: • Biomedical interventions o Prevention of mother-to-child transmission o Pre-exposure prophylaxis o Condom use o Female Microbicides o Voluntary medical male circumcision o Voluntary counselling and testing o Testing and treatment for STIs o Blood screening o Needle exchange programmes and Opioid substitution therapy @ UMP - ICT Electives 2016 21 HIV Prevention continues…….. • Behavioural interventions (reducing risky behaviour) o Sex education, safer sex practices, consistent condom usage, HIV awareness o Behavioural change communication o Counselling / psych-social support o Adherence support o Cash incentives for certain behaviour • Structural interventions (reducing vulnerability) o Addressing gender, economic and social inequalities o Decreasing vulnerability o Civil society and community system strengthening o Addressing stigma and changing punitive laws Second set of presentation slides to be posted later…………….. @ UMP - ICT Electives 2016 22