Download STD Update - Calvert County Health Department

HIV/AIDS AND STI/STD UPDATE
Calvert County Health Department
Kristen Craft
Adolescent Health Coordinator
A little history…
1978…Strange sickness among gay men
AIDS deaths = 31
1981…Kaposi Sarcoma and Pneumonia; Failing immune systems
AIDS deaths = 234
1982…CDC links new disease to blood; Acquired Immune Deficiency
Syndrome (AIDS) is named; Opportunistic infections
AIDS deaths = 853
1983…CDC warns blood banks; France finds human
immunodeficiency virus (HIV)
AIDS deaths = 2304
1985…FDA approves HIV antibody test; blood banks start testing
blood; Ryan White/Rock Hudson; 1st International AIDS
conference
AIDS deaths = 5636
A little history…
1986…U.S. Surgeon General Koop reports on AIDS and calls for sex
education and use of condoms
Cumulative AIDS deaths = 26,710 with 42,355 known cases
1987…AZT approved; AIDS Memorial Quilt; Condom labels; Violence
against AIDS victims; HIV+ immigrants and travelers banned
AIDS deaths = 4135
1988…FDA allows non-approved treatments; CDC mails AIDS info to
all homes; Women/African Americans fastest growing in
epidemic
AIDS deaths = 4855
1989…First World AIDS Day; cost of drugs reduced
AIDS deaths = 14,544
A little history…
1990…Americans with Disabilities Act; Ryan White dies
Cumulative AIDS deaths = 159,818 with 257,607 known cases
1991…HIV 10 million worldwide (1 million in U.S.); Restrictions on
HIV+ healthcare workers; Magic Johnson
AIDS deaths = 20,454
1992…Multiple drug trials accelerated; Top killer of men ages 25-44
in U.S.; Political events
AIDS deaths = 23,411
1993…Female condom; Blood bank investigations/prosecutions;
Arthur Ashe/Rudolf Nureyev
AIDS deaths = 41,920
A little history…
1994…Orasure saliva test kit; leading cause of death for all Americans
ages 25-44; Mother/child transmission; Elizabeth Glaser
AIDS deaths = 32,330
1995…Combination drug therapies; Greg Louganis
AIDS deaths = 48371
1996…United Nations HIV/AIDS program; HIV cocktails; vaccine
initiative
Cumulative AIDS deaths = 386,046 with 611,325 known cases
Worldwide AIDS deaths = 6,400,000 with 22,000,000 HIV+
1997…Significant drop in AIDS deaths but report shows HIV able to
hide in body
AIDS deaths = 21,399
A little history…
1998…AIDS increasing in African Americans; Supreme Court rules
HIV+ protected by ADA; Vaccine testing
First known AIDS death was African man 1959
First U.S. case was teen prostitute with Kaposi Sarcoma 1969
2000…UN Security Council considers AIDS global security threat
2001…AIDS drugs for developing countries through United Nations
Cumulative AIDS deaths = 479,983 with 819,779 known cases
2005…Rise in HIV+ rates at college campuses; STD rates increasing
again (especially HPV, herpes, syphilis, and gonorrhea)
Worldwide 40.3 million living with HIV/AIDS with 4.9 million newly infected
2006…Cumulative AIDS deaths = 559,000 with 1,025,000 AIDS cases
Now…
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CDC estimates 40,000 persons become infected
with HIV each year in the U.S.

2 people under the age of 25 get infected
with HIV every hour, every day!
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African Americans (12% of U.S. population)
account for almost half of HIV/AIDS cases
Advances in treatment have slowed the
progression of HIV infection to AIDS
Increased emphasis on testing
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Now…
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Greatest increase in HIV/AIDS in China
and India
African countries still lead the world in
the number of AIDS deaths
Abstinence vs. Condoms
AIDS prevention and treatment reaching
billions of dollars for developing
countries
HIV Infection and Spread
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Blood
Sexual contact: semen and vaginal fluids (anal,
oral, vaginal)
Sharing needles (IV drug users)
Breast milk
Found in tears, saliva, urine but NO transmission
Highest risk groups are men who have sex with
men (MSM) and IV drug users (IDU)
Greatest increase in infection seen in heterosexual
women
HIV Testing
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Tests the level of HIV antibodies in your
blood, saliva, or urine (not as accurate)
Develop antibodies in 3 to 6 months after
exposure
97% of those tested develop antibodies in
3 months
Fact or Fiction?
You can get HIV from a mosquito bite.
Fiction
HIV is not transmitted by insects.
Fact or Fiction?
You can get HIV by having oral sex with
an infected person.
Fact
Any type of sexual activity (where
bodily fluids are exchanged) with an
infected person is a risk of HIV
transmission.
Fact or Fiction?
HIV survives well in the environment, so
you can get it from toilet seats and door
knobs.
Fiction
Scientists and medical authorities
agree that HIV does not survive
well in the environment - so forget
about those toilet seats!
Fact or Fiction?
You can get AIDS by hugging a person
with HIV who is sweating.
Fiction
Contact with saliva, tears, or sweat
has never been shown to result in
transmission of HIV.
Fact or Fiction?
You can get HIV by kissing someone who
is HIV infected.
Fiction
Casual contact through closed-mouth
or "social" kissing is not a risk for
transmission of HIV.
Fact or Fiction?
Condoms aren't really effective in
preventing HIV transmission.
Fiction
Studies have found that even with
repeated sexual contact, 98-100% of
those people who used latex
condoms correctly and consistently
did not become infected.
Fact or Fiction?
There is a connection between other
STDs and HIV infection.
Fact
Having a sexually transmitted
disease (STD) can increase a
person's risk of becoming infected
with HIV.
The Unknown Can Be a Real Killer
Accounting for:
~25%
Unaware of
Infection
~54%
of New
Infections
~75%
Aware of
Infection
~46%
of New
Infections
People Living with
HIV/AIDS: 1,039,0001,185,000
New Sexual
Infections Each
Year: ~32,000
HIV/AIDS by Transmission Category
33 States, 2001–2004
MSM/IDU Other 1%
5%
Other 3%
Heterosexual
17%
IDU
21%
IDU
16%
MSM
61%
Males
(n ≈ 112,000)
Heterosexual
76%
Females
(n ≈ 45,000)
Prevalence of HIV Antibody
HIV Prevalence 1999-2002
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
White White Black Black Hispanic Hispanic
M
F
M
F
M
F
White White Black Black Hispanic Hispanic
M
F
M
F
M
F
Age 18-39 years
Age 40-49 years
Maryland
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HIV testing is not reportable (expected
to change 2008)
HIV testing now routine part of prenatal
care
Now ranked 3rd among states for AIDS
cases
Baltimore-Towson area ranked 2nd for
AIDS cases among metropolitan areas in
U.S. (DC is ranked 1st)
Calvert County
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Currently low number of HIV/AIDS cases
reported*
Growing concern regarding the increase of
STD’s in Southern Maryland counties
Testing and treatment of adolescents for STD’s
is on the rise
STD’s provide an open doorway to HIV/AIDS
Several cases of antibiotic resistant strain of
Gonorrhea now present in the county
Calvert County STD Totals
Chlamydia
2000
2001
2002
2003
2004
2005
2006
<15
2
1
5
5
6
3
*
15-19
21
53
79
73
76
74
*
Total Teens
23
54
84
78
82
77
*
Total Cases
118
108
167
163
179
181
163
Gonorrhea
2000
2001
2002
2003
2004
2005
2006
<15
0
1
0
0
0
0
*
15-19
8
14
6
12
5
10
*
Total Teens
8
15
6
12
5
10
*
Total Cases
51
21
20
35
16
38
17
Age Distribution of Chlamydia & Gonorrhea in Maryland, 2005
Chlamydia
Gonorrhea
8,000
7,000
Number of Cases
6,000
5,000
4,000
3,000
2,000
1,000
0
10-14
15-19
20-24
25-29
30-34
35-39
Age-group
40-44
45-54
55-64
65+
STD’s in America
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The American Social Health Association (ASHA)
estimates there are nearly 19 million NEW cases of
sexually transmitted diseases in the United States
each year.
It is important to consider that some STD’s cannot
be cured while others use antibiotics at such a rate
that they are becoming drug resistant. Another key
point is the lack of symptoms in many infected
persons that leads to increased transmission when
multiple partners are involved.
STD’s in America
Viral STD
HIV/AIDS
Incidence*
40,000
Hepatitis B
Herpes
HPV
81,000
1.6 million
6.2 million
*Number of new cases each year
Viral infections CANNOT be cured. The only protection
against a virus is through vaccination. Currently, only two
STD’s (Hepatitis B and HPV) have a vaccine available.
STD’s in America
Bacterial/Parasitic STD
Syphilis
Incidence*
37,000
Gonorrhea
718,000
Chlamydia
2.8 million
Trichomoniasis
7.4 million
*Number of new cases each year
Bacterial and parasitic infections CAN be treated with
medication. Any damage that occurs to the body during the
period of infection is permanent. Constant re-infection can
occur if both (all) partners are not treated. Drug resistant
forms of gonorrhea are becoming a problem.
Sources
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Maryland AIDS Administration
Maryland Department of Health and
Mental Hygiene/Division of Sexually
Transmitted Diseases (MHDH)
Centers for Disease Control and
Prevention (CDC)
National Center for HIV, STD, and TB
Prevention