Download Everything one must know about hiv/aids.

Brianna Loeck
HIV-Human Immunodeficiency Virus
AIDS-Acquired Immune Deficiency Syndrome
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 Scientists identified a type of chimpanzee in West
Africa as the source of HIV infection in humans
 They believe the chimpanzee version (Simian
Immunodeficiency Virus or SIV) was most likely
transmitted by humans hunting these chimpanzees
for meat and had come in contact with their
infected blood (CDC, 2011)
 Over decades, the virus slowly spread
across Africa and later into other parts
of the world
Currently, 33.4 million people globally, are living
with HIV/AIDS and more than 25 million people
worldwide have died of AIDS since the first case
reported in1981 (AIDS.gov, 2012)
 About 97% of people living with HIV are low and
middle-income countries such as sub-Saharan
Africa (AIDS.gov, 2012)
 At the end of 2009, an estimated
1,148,200 people aged 13 and older
were living with HIV in the United States
(CDC, 2012)
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Gay and bisexual men (2% of
the population) remain the
population most heavily
affected by HIV in the United
States (accounted for more
than 50% of HIV infections)
(CDC, 2012)
African Americans (14%
population, 44% HIV
infections) and
Hispanics/Latinos (16%
population, 20% of HIV
infections) are the
racial/ethnic groups most
affected by HIV (CDC, 2012)
Unprotected sex with an infected person
 Having multiple sex partners or the presence of other
sexual transmitted diseases (STDs)
 Using unsterile needles or syringes for drug use
 Being born by an infected mother which can be passed
through child birth or breast-feeding
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 A few low risk ways for HIV to be contracted but are not
common are: receiving blood transfusions, open-mouth
kissing, contact of broken skin or wounds, and/or being
bitten by an infected person
 HIV is not transmitted in the following ways: air or water,
insect bites, saliva, tears or sweat, casual contact and
closed mouth kissing
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 Most
common, high-risk way to contract HIV
 HIV is detected through a person’s semen,
blood and vaginal fluids, therefore by engaging
in unprotected sex with an infected person puts
one at high risk of contracting it also (NIAID,
2009)
 One simply cannot tell by looking at someone if
they have HIV, so that is why it’s extremely
important to take precautions to protect yourself
 Unfortunately
many people do not believe it is
necessary to be tested if they show no signs or
symptoms
 The NIAID strongly recommends getting tested
regularly, practicing abstinence, remaining
faithful to your partner, proper use of condoms,
and not sharing needles
 Currently research is being done on more ways
to help stop the transmission of HIV to others
that are not infected such as antivirals, topical
creams and vaccines (NIAID, 2009)
The second most common risk of HIV infection
 The most common illegal drugs that are injected
are cocaine, heroin, and methamphetamine
 Why? Because it gives them satisfaction, creates
alertness, increased in sensitivity, and to be able to
relax (AVERT, 2011)
 There are other ways of consuming drugs however
people like to inject them because it’s more likely
to cost-efficient and a rapidly acting method
(AVERT, 2011)
 According to AVERT (2011), “stigma and
discrimination against drug users need
to be tackled so they can access treatment
and reduce the risk of being exposed to HIV”
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When children are born with HIV and the mother’s
did not use treatment, their life expectancy is
usually a couple of years due to the rapidness of
the virus spreading (UNICEF, 2011)
 “Expanding HIV testing and counseling among
pregnant women is critical for identifying those in
need of follow-up care and increasing coverage of
subsequent interventions to reduce the risk of
mother-to-child transmission of HIV,” states UNICEF
(2011)
 According to UNICEF (2011), the
goal of the Global Plan for children
is to eliminate new HIV infections
by the year of 2015 and keeping
their mothers alive
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Throughout the years, CDC has a Division of
HIV/AIDS Prevention (DHAP) that “has developed a
comprehensive program of HIV surveillance to
collect, analyze, and disseminate data of HIV
infection and AIDS” (CDC, 2012)
2 MAIN WAYS DATA IS COLLECTED
 Passive reporting is defined as, “combinations of
health practitioners, hospitals, clinics and
laboratories report cases of HIV/AIDS to state and
local health department” (CDC, 2012)
 Active reporting is defined as “state and local
health department surveillance personnel collect
information by contacting health care practitioners
and reviewing medical records in hospitals and
clinks” (CDC, 2002)
Demographic characteristics such as:
 gender
 race
 age
 locality
 mode of exposure of HIV
 opportunists illnesses and virologic and
immunologic status
 supplemental information such as prescription of
antiviral’s and other therapies
 use of medical and substance abuse treatment
services and health insurance coverage
monitor the incidence and prevalence of HIV and
AIDS
 monitor HIV-related morbidity and mortality in the
population
 estimate incidence of HIV infection
 identify changes in trends of HIV transmission and
identify populations at risk
 target prevention interventions and evaluate their
effectiveness
 allocate funds for social and health services
 to facilitate access to health, social and prevention
services, including medical treatment (CDC, 2002).
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Biological factors associated with HIV transmission
are numerous and complicated
 A type of biological characteristic would be the type
of bodily fluid one comes in contact with:
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“Characteristics on which a determination of the
probability of sexual transmission depends include
the concentration of HIV in the fluid, the integrity or
relative vulnerability of involved mucous
membranes (such as those inside the anus, vagina,
or mouth), the duration of exposure, and the strain
of virus transmitted” Remedy Health Media (1998)
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Another biological characteristic would be the route of transmission,
“HIV-infected bodily fluids can be swallowed, accepted into the
vagina or rectum, or injected directly into the bloodstream” (Remedy
Health Media, 1998)
Epidemiologists have studied and researched the risk level of
becoming infected with HIV based off of both biological
characteristics recently mentioned
Ex.) hugging or shaking hands with someone whom is infected is not
associated with any risk of contracting HIV
However, sharing needles with someone who has HIV is very high risk
because of the transmissions of bodily fluids being exposed (Remedy
Health Media, 1998)
Other risks are sexual contact, but depending on what type of contact
is done it each has its own risk levels
Example of low risk transmission is oral sex, followed by vaginal
intercourse being higher of a risk, then anal sex being the highest
risk of all due to semen coming in contact with abrasions in the anal
wall
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HIV is known to be a spherical shape 
made up of two main parts: the
envelope and the core.
The envelope or membrane, is the
outer coat of the virus that is
“composed of two layers of fatty
molecules called lipids, taken from
the membrane of a human cell when
a newly formed virus particle buds
from the cell” (NIAID, 2012).
Throughout the envelope are proteins
from the host cell as well as an
average of 72 copies of complex HIV
protein known as Env
Within the Env is a particle called the
‘virion” which spike through the
surface of the virus
“Env consists of a cap made of three
molecules called glycoprotein 120
(gp120), and a stem consisting of
three molecules called gyclcoprotein
41 (gp41) that anchor the structure
in the viral envelope” (NIAID, 2012)
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Within the viral envelope there is a bullet-shaped core known as the
capsid, which is made up by the protein p24
Inside the core are three enzymes required for HIV replication called
reverse transcriptase, integrase and protease (Avert 2011)
Also within the capsid are two strands of RNA
HIV has several genes, which “produce proteins that control the
ability of HIV to infect a cell, produce new copies of the virus, or
cause disease” (NIAID, 2012)
RNA has a very similar structure to DNA. However, small differences
between the two molecules mean that HIV's replication process is a
bit more complicated than that of most other viruses (Avert, 2011)
HIV treats genes in the same way as human genes, which is why HIV
replicates itself and can result into AIDS if not treated at the
beginning stage of infection
That is why there are antiviral medication to be taken to help slow
down the replication of HIV to prevent it from causing AIDS
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According to Schneider (2011) Humans are social creatures, and
their behavior is strongly affected by their social environment
There are quite a few of behavioral factors that play into HIV/AIDS,
one being the lack of knowledge about HIV/AIDS
AMFAR (2010) states, “American youth today are growing up at a
time when AIDS is considered to be a treatable disease and
complacency is widespread, young people may be more likely to
have misconceptions about HIV/AIDS, including modes of
transmission and preventive measures”
Since antiviral’s became available to those who are infected with HIV
research has shown that the youth is at greater
risk of engaging in risky sexual activity
There is also evidence that proves since
HAART (highly active antiretroviral therapy)
became available, the prevalence of
unprotected sex has increased in the general
population (AMFAR, 2012)
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Another behavioral factor is substance use
When people are experimenting with alcohol and drugs,
there is an increased risk of risky behavior
AMFAR (2012) states, “Substance abuse may lead to
inconsistent condom use and selection of high-risk
sexual partners by both young men and women”
The use of ecstasy, methamphetamine and amyl nitrites
and other illegal drugs have been linked with
unprotected sexual activity, particularly among young
MSM (males that have sex with males) (AMFAR, 2012)
Along with these behaviors associated with HIV/AIDS
are mental health issues, socials norms and sexual
networks, homophobia, stigma and discrimination, and
relationship dynamics, sexual coercion, and sexual
abuse
A behavioral factor is sexual behavior
 Engaging in risky sexual activities is the primary
mode of HIV transmission
 According to a CDC survey in 2009, 46% of all high
schools students have engaged in sexual
intercourse and 34% of them did not use a condom
the last time they had sex
 African Americans were at 65.2%, Hispanics at
49.1%, and Caucasians at 42% (AMFAR, 2012)
 Educational interventions were then targeted to the
youth who were not sexually active yet to highlight
the importance of providing sexual health and risk
reduction information (AMFAR, 2012)
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Depending upon the country, subpopulations and
communities are at higher behavior risk due to several
reasons such as occupation, migration status, sexual
orientation, geographic location, education and income
(UNAIDS, 1998)
AIDS disproportionately affects different parts of the
country due to higher populations, such as Miami and
Jacksonville FL, Baton Rouge, LA, New York City, NY, and
Washington DC (CDC, 2012)
Stigma and discrimination still continue to be a serious
issue in today’s society despite our knowledge and/or
little knowledge about this disease
People have created a social stigma against people
whom are HIV positive and continue to discriminate
towards them based on their status
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The transtheoretical model applies to HIV/AIDS based on an
individual participating in unhealthy behaviors such as unprotected intercourse with multiple people or sharing needles
with other drug users.
The individual has no desire to change their unhealthy
habits, such as continue to use infected needles and
engaged in sexual risky behaviors
They increase their awareness and learn the difficulties of
those changes, yet are not ready to make those changes
The person chooses to try to change their unhealthy
behavior by reaching out and reading more information and
risks involved
Taking action; such as using clean sterile needs instead of
used ones and by using condoms during sexual activity
Continue to practice safe and healthy behaviors such as
always using a condom during sexual activity and to
hopefully stop utilizing drugs completely
“More awareness is needed so that no one with HIV/AIDS is stigmatized or discriminated against” - President Obama (2011)
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President Obama created the National HIV/AIDS Strategy in 2010, to address
the stigma and discrimination of people who are positive with this virus
Obama states, “The United States will become a place where new HIV
infections are rare and when they do occur, every person regardless of age,
gender, race/ethnicity, sexual orientation, gender identity or socio-economic
circumstance, will have unfettered access to high quality, life-extending care,
free from stigma and discrimination” (White House, 2012)
The Strategy included three primary goals: reducing the number of people
who become infected with HIV, increasing access to care and improving
health outcomes for people living with HIV, and reducing HIV-related
disparities (Healthy People, 2012)
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The Strategy also has four major steps needing to reduce the
stigma and discrimination of people living with HIV/AIDS.
First is to engage communities to support people with
HIV/AIDS such as faith communities, businesses, schools &
community-based organizations
Promote public leadership of people living with HIV such as
governments, HIV services organizations, and other
institutions
Promote public health approaches to HIV prevention and
care, for example, state legislatures should consider
reviewing HIV-specific criminal statutes to ensure that they
are consistent with current knowledge of HIV transmission
Strengthen enforcement of civil rights laws by having The
Department of Justice and Federal agencies enhance
cooperation to facilitate enforcement of Federal antidiscrimination laws (White House, 2012)
Obama’s Strategy for HIV/AIDS is a great example of the Ecological Model. The
Ecological Model consists of “five levels of influence that determine healthrelated behaviors; each level is a potential target for health promotion
intervention” (Schneider, 2011)
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 Intrapersonal-one will learn about education, knowledge, and their beliefs
about HIV/AIDS and carry that will them throughout life.
 Interpersonal-one will learn behaviors from family, friends or co-workers,
whether it be positive or negative. For example, a teen engaging in risky
sexual behaviors which can stem off of peer pressure or other risky behaviors
such as drug and alcohol use. One then makes their own discussions not
necessarily thinking about the consequences.
 Institutional-which falls under schools and work places. Relating to Obama’s
HIV/AIDS Strategy, this would be the step of engaging communities to support
people with HIV/AIDS
 Community-which can be a huge influence on behavior. Organizations can
join together in helping promote and support HIV individuals. The more
organizations and businesses involved help promote more awareness
 Public policy-which is developing and enforcing state and local policies that
can increase health behaviors. Obama’s public policy for his program is to
“strengthen enforcement of civil rights laws by having The Department of
Justice and Federal agencies enhance cooperation to facilitate enforcement
of Federal anti-discrimination laws” (White House, 2012)
Obama also created the Emergency Plan for AIDS
Relief (PEPFAR) which was designed to help save
people’s lives suffering from HIV/AIDS
Some of PEPFAR’s goals:
 transition from an emergency response to
promotion of sustainable country programs
 strengthen partner government capacity
 expand prevention, care, and treatment
 integrate and coordinate programs to maximize
impact on health systems
 invest innovation and operations research to
evaluate impact
 improve service delivery and maximize outcomes
(State Department Office, 2011)
HIV is a preventable disease
 One must be knowledgeable about this particularly
disease along with the risk factors and prevention
 It is extremely important to regularly get tests for
HIV/STD’s to prevent transmission to others
 Local health departments and clinics offer
information and HIV/STD testing's for anyone
 As the number of HIV infections grow, it is
important to increase prevention, interventions and
programs so people are aware
 We, as a nation, can only hope that soon there will
be a vaccine or cure created to end this pandemic
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AIDS.gov. (2012, July 6). U.S Statistics. Retrieved from http://aids.gov/hiv-aids-basics/hiv-aids-101/statistics/
AMFAR. (2010, September). Youth and HIV/AIDS in the U.S: Challenges and Opportunities for Prevention. Retrieved from
http://www.amfar.org/uploadedFiles/In_the_Community/Publications/Youth.pdf?n=5282
AVERT. (2011). Injecting Drugs, Drug Users, HIV & AIDS. Retrieved from http://www.avert.org/injecting.htm
AVERT. (2011). The Structure of HIV. Retrieved from http://www.avert.org/hiv-virus.htm
Center for Disease Control and Prevention. (2012, April 11). Basic Information about HIV and AIDS. Retrieved from
http://www.cdc.gov/hiv/topics/basic/
Center of Disease Control and Prevention. (2012, September 24). Surveillance Systems Supported by the Division of HIV/AIDS Prevention. Retrieved from
http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/surveillance.htm
Center of Disease Control and Prevention. (2002, March 1). HIV/AIDS Surveillance Methods. Retrieved from
http://www.cdc.gov/hiv/topics/surveillance/resources/slides/methods/index.htm
Healthy People. (2012, September 6) HIV. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22
National Institute of Allergy and Infectious Diseases. (2009, March 25). HIV/AIDS. Retrieved from
http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/Pages/riskFactors.aspx
National Institute of Allergy and Infectious Disease. (2012, April 3). HIV/AIDS. Retrieved from
http://www.niaid.nih.gov/topics/hivaids/understanding/biology/Pages/structure.aspx
Remedy Health Media. (1998). The Complete HIV/AIDS Resource. Retrieved from http://www.thebody.com/content/art14042.html
Schneider, M. J. (2011). Introduction to public health (3rd Ed) Mississauga, Ontario: Jones and Bartlett Publishers Canada
State Department Office of the U.S. (2011, January 7). About PEPFAR. Retrieved from http://www.pepfar.gov/about/index.htm
The White House: Office of the Press Secretary. (2012, July 21). HIV/AIDS-Related Stigma and Discrimination. Retrieved from
http://www.whitehouse.gov/the-press-office/2012/07/21/fact-sheet-hivaids-related-stigma-and-discrimination
UNAIDS. (1998, May). Meeting the Behavioral Data Collection Needs of National HIV/AIDS and STD Programs. Retrieved from
http://www.unaids.org/en/media/unaids/contentassets/dataimport/publications/irc-pub03/meetingbehavdata_en.pdf
UNICEF. (2012, September). Monitoring the Situation of Women and Children. Retrieved from http://www.childinfo.org/hiv_aids_mother_to_child.html
United Nations. (1998, November 10). The Demographic Impact of HIV/AIDS. Retrieved from
http://www.un.org/esa/population/pubsarchive/hivmtg/aidsrep.pdf
World Health Organization. (2012, July). HIV/AIDS. Retrieved from http://www.who.int/mediacentre/factsheets/fs360/en/index.html