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Chapter Sixteen: HIV and AIDS Copyright, Corey E. Miller, 2002, 2003 1 What Is AIDS? • AIDS is an acronym for acquired immunodeficiency syndrome – A - acquired, because it is not inherited – I - immuno, because it affects the immune system – D - deficiency, because the body lacks immunity – S - syndrome, because the symptoms occur as a group Copyright, Corey E. Miller, 2002, 2003 2 Conditions Associated with AIDS • Opportunistic infections: – – – – – Pneumocystis carinii pneumonia Mycobacterium avium intracellulare Mycobacterium tuberculosis Bacterial pneumonia Toxoplasmosis Copyright, Corey E. Miller, 2002, 2003 3 Cancers Associated with AIDS – – – Kaposi’s sarcoma Lymphomas Invasive cervical cancer Copyright, Corey E. Miller, 2002, 2003 4 Clinical Conditions Associated with AIDS • Wasting syndrome – severe weight loss, with weakness and diarrhea • HIV encephalopathy – AIDS dementia • Other infections – – – candidiasis herpes simplex Cytomegalovirus – infect brain, retina, lungs Copyright, Corey E. Miller, 2002, 2003 5 The Immune System and HIV • • Antigens – markers on invader cells Types of White Blood Cells – – – – Leukocytes Macrophages Antibodies B cells and T cells – specifically programmed to certain antigens Copyright, Corey E. Miller, 2002, 2003 6 AIDS Vaccine • Developed by Vax-Gen of CA • Clinical trial for FDA approval • 5,400 subjects – (95% Men Who Have Sex W/ Men) • Overall only reduced rate of infection by 3.8% • For African-Americans reduced rate 78.3% • For Asian reduced 68% – Only 314 and 77 in trial, respectively Copyright, Corey E. Miller, 2002, 2003 7 Copyright, Corey E. Miller, 2002, 2003 8 Measures • Seroconversion – process by which person develops antibodies • HIV negative serostatus means no HIV antibodies are detected • T-cell count – number of CD4 cells Copyright, Corey E. Miller, 2002, 2003 9 Epidemiology of HIV • • • Epidemic - rapid and wide spreading of a contagious disease Worldwide, over 36 million people have been infected with HIV In the U.S., about 40,000 new people a year are infected with HIV – – – Total of 700,000 + AIDS + 120,000 tested for HIV Estimated HIV infection 650,000 – 900,000 Copyright, Corey E. Miller, 2002, 2003 10 Copyright, Corey E. Miller, 2002, 2003 11 Modes of Transmission • • • • • • • Intercourse Sharing needles Passing virus from mother to fetus Breast-feeding from HIV-positive mother Sharing sex toys Accidental contamination with infected blood Before April 1, 1985, from contaminated blood or organs Copyright, Corey E. Miller, 2002, 2003 12 Percentage of U. S. AIDS Cases • • • • • Men who have sex with men Injection drug users Heterosexually Blood transfusions Other • Women 47% 25% 10% 2% 16% 23% Copyright, Corey E. Miller, 2002, 2003 13 Copyright, Corey E. Miller, 2002, 2003 14 Copyright, Corey E. Miller, 2002, 2003 15 Copyright, Corey E. Miller, 2002, 2003 16 Copyright, Corey E. Miller, 2002, 2003 17 Sexual Transmission • • • • Anal intercourse Oral sex Vaginal intercourse Sex toys Copyright, Corey E. Miller, 2002, 2003 18 Uncommon Modes of Transmission • • • Nonsexual contact Accidents Blood transfusions and organ donations Copyright, Corey E. Miller, 2002, 2003 19 Prevention • • • • Be aware that alcohol and drug use increases risky behaviors Develop communication skills to be able to discuss risks and prevention Be aware of information on HIV testing Become familiar with condoms Copyright, Corey E. Miller, 2002, 2003 20 Education about HIV/AIDS • Obstacles to education: blame and denial • HIV/AIDS education in schools • Outreach programs – – – – Heterosexual adults Men who have sex with men Youths Drug users Copyright, Corey E. Miller, 2002, 2003 21 Treatments • • • Therapies to treat symptoms and infections Drugs that affect virus in some way Treatments designed to bolster immune system’s natural responses Copyright, Corey E. Miller, 2002, 2003 22