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[ Know [ Know [ Know [ Know AIDS, No No No No AIDS ] ] ] ] December 1 December 1 , World AIDS Day , World AIDS Day

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Started in 1988, World AIDS Day is not just about raising money, but also about increasing awareness, fighting prejudice and improving education. World AIDS Day is important in reminding people that HIV has not gone away, and that there are many things still to be done. ~avert.org

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Page 1: Know Aids No Aids

[ Know [ Know [ Know [ Know AIDS, No No No No AIDS ]]]]December 1December 1, World AIDS Day, World AIDS Day

Page 2: Know Aids No Aids

How much are you How much are you How much are you How much are you Aware????

Page 3: Know Aids No Aids

HIV TransmissionTransmissionTransmissionTransmission?

HIV enters the bloodstream through:enters the bloodstream through:enters the bloodstream through:enters the bloodstream through:

Open CutsOpen CutsOpen CutsOpen CutsBreaks in the skinBreaks in the skinBreaks in the skinBreaks in the skin

Mucous membranesMucous membranesMucous membranesMucous membranes

Direct injectionDirect injectionDirect injectionDirect injection

Page 4: Know Aids No Aids

HIV HIV HIV HIV Transmission????

Common fluids that are a means of Common fluids that are a means of Common fluids that are a means of Common fluids that are a means of transmission::::

BloodBloodBloodBlood

SemenSemenSemenSemen

Vaginal SecretionsVaginal SecretionsVaginal SecretionsVaginal SecretionsBreast MilkBreast MilkBreast MilkBreast Milk

Page 5: Know Aids No Aids

Semen

11,000 Vaginal Fluid7,000

Blood

18,000

Amniotic

Fluid4,000

Saliva

1

Average number of HIV particles in 1 ml of these body fluids

HIVHIVHIVHIV in Body Fluids?

Page 6: Know Aids No Aids

Routes of Transmission Routes of Transmission Routes of Transmission Routes of Transmission of of of of HIV????

• Sexual ContactSexual ContactSexual ContactSexual Contact: Male-to-male

• Male-to-female or vice versa

• Female-to-female

• Blood ExposureBlood ExposureBlood ExposureBlood Exposure: Injecting drug use/needle sharing

• Occupational exposure

• Transfusion of blood products

• PerinatalPerinatalPerinatalPerinatal: Transmission from mom to baby

• Breastfeeding

Page 7: Know Aids No Aids

HIVHIVHIVHIV

VirusVirusVirusVirusTTTT----CellCellCellCell

HIV InfectedHIV InfectedHIV InfectedHIV InfectedTTTT----CellCellCellCell

New HIVNew HIVNew HIVNew HIV

VirusVirusVirusVirus

HIV----Infected Infected Infected Infected TTTT----CellCellCellCell

Page 8: Know Aids No Aids

This is the period of time after becoming infected when an HIV test is negative

90 percent of cases test positive within three months of exposure

10 percent of cases test positive within three to six months of exposure

Window PeriodPeriodPeriodPeriod?

Page 9: Know Aids No Aids

6 month ~ Years ~ Years ~ Years ~ Years

Virus

Antibody

InfectionInfectionInfectionInfectionInfectionInfectionInfectionInfectionOccursOccursOccursOccursOccursOccursOccursOccurs

AIDS Symptoms

---Initial Stage-------------------Intermediate or Latent Stage--------- ---Illness Stage-

Flu-like SymptomsOr

No SymptomsSymptom-free

<<<<

----

----

HIV Infection and Infection and Infection and Infection and AntibodyAntibodyAntibodyAntibodyResponseResponseResponseResponse

Page 10: Know Aids No Aids

Importance of Early of Early of Early of Early TestingTestingTestingTesting and and and and DiagnosisDiagnosisDiagnosisDiagnosis????

Allows for early treatment to maintain and stabilize the immune system responseDecreases risk of HIV transmission from mother to newborn babyAllows for risk reduction education to reduce or eliminate high-risk behavior

Page 11: Know Aids No Aids

HIV testingtestingtestingtesting?

Requires a blood or oral fluid sampleHIV test detects the body’s antibody response to HIV infectionThe test does NOT detect the HIV virus

Page 12: Know Aids No Aids

HIV testingtestingtestingtesting?Those recently exposed should be retested at least six months after their last exposureScreening test (EIA/ELISA) vs. confirmatory test (IFA)

EIA/ELISA (Reactive)

Repeat EIA/ELISA (Reactive)

IFA (Reactive)

Positive for HIV

Page 13: Know Aids No Aids

HIV testingtestingtestingtesting?EIA/ELISATest

PositiveNegative

Run IFAConfirmation

RepeatPositive

Positive

End Testing

Repeat ELISAEvery 3 months

for 1 year

Negative

PositiveNegativeIndeterminate

Repeat at2-4 months

Repeat at 3 weeks

No HIV ExposureLow Risk

HIV ExposureHigh Risk

NegativeHIVHIVHIVHIV++++

Repeat every 6 months for continued

High risk behavior

Page 14: Know Aids No Aids

law forlaw forlaw forlaw for HIV testingtestingtestingtesting?

Requires informed consentNo premarital testing requirementPrenatal testing not required but recommendedSchool notification not required for positive staff or students (universal precautions)

Page 15: Know Aids No Aids

HIV HIV HIV HIV AIDSAIDSAIDSAIDS

Once a person is infected they are always infected.Medications are available to prolong life but they do not cure the disease.

Those who are infected are capable of infecting others without having symptoms or knowing of the infection.

Page 16: Know Aids No Aids

HIV risk reductionrisk reductionrisk reductionrisk reduction?

Avoid unprotected sexual contact Use barriers such as condoms and dental dams

Limit multiple partners by maintaining a long-term relationship with one person Talk to your partner about being tested before you begin a sexual relationship

Page 17: Know Aids No Aids

HIV risk reductionrisk reductionrisk reductionrisk reduction?

Avoid drug and alcohol use to maintain good judgmentDon’t share needles used by others for:

DrugsTattoos

Body piercingAvoid exposure to blood products

Page 18: Know Aids No Aids

CONDOMS

Using condoms is not 100 percent effective in preventing transmission of sexually transmitted infections including HIV

Condoms = Safer sexCondoms = Safer sexCondoms = Safer sexCondoms = Safer sex

Condoms = Safe sexCondoms = Safe sexCondoms = Safe sexCondoms = Safe sex

Page 19: Know Aids No Aids

CONDOM useuseuseuse

Should be used consistently and correctlyShould be either latex or polyurethaneShould be discussed with your partner before the sexual act beginsShould be the responsibility of both partners for the protection of both partners Male and female condoms are available

Page 20: Know Aids No Aids

People Infected with People Infected with People Infected with People Infected with HIV

Can look healthyCan be unaware of their infectionCan live long productive lives when their HIV infection is managedCan infect people when they engage in high-risk behavior

Page 21: Know Aids No Aids

HIV Exposure and Exposure and Exposure and Exposure and InfectionInfectionInfectionInfection

Some people have had multiple exposures without becoming infectedSome people have been exposed one time and become infected

Page 22: Know Aids No Aids

When you have sex with someone, you are having sex with everyone they have had sex with for the last ten years.

Former Surgeon General

C. Everett Koop

Page 23: Know Aids No Aids

HIV and and and and Sexually

Transmitted DiseasesTransmitted DiseasesTransmitted DiseasesTransmitted Diseases

Page 24: Know Aids No Aids

HIV and SexuallyTransmitted Diseases

STDs increase infectivity of HIVA person co-infected with an STD and HIV may be more likely to transmit HIV due to an increase in HIV viral sheddingMore white blood cells, some carrying HIV, may be present in the mucosa of the genital area due to a sexually transmitted infection

Page 25: Know Aids No Aids

STDs increase the susceptibility to HIVUlcerative and inflammatory STDs compromise the mucosal or cutaneous surfaces of the genital tract that normally act as a barrier against HIVUlcerative STDs include: syphilis, chancroid, and genital herpes

Inflammatory STDs include: chlamydia, gonorrhea, and trichomoniasis

HIV and SexuallyTransmitted Diseases

Page 26: Know Aids No Aids

HIV and SexuallyTransmitted Diseases

The effect of HIV infection on the immune system increases the risk of STDs, this canIncrease the reactivation of genital ulcers

Increase the rate of abnormal cell growth Increase the difficulty in curing reactivated or newly acquired genital ulcersIncrease the risk of becoming infected with additional STDs

Page 27: Know Aids No Aids

HIV Post Exposure Prophylaxis

Page 28: Know Aids No Aids

Review facility policy and report the incidentMedical follow-up is necessary to determine the exposure risk and course of treatmentBaseline and follow-up HIV testingFour week course of medication initiated one to two hours after exposure Liver function tests to monitor medication toleranceExposure precautions practiced

HIV Occupational Occupational Occupational Occupational ExposureExposureExposureExposure

Page 29: Know Aids No Aids

No data exists on the efficacy of antiretroviral medication after non-occupational exposuresThe health care provider and patient may decide to use antiretroviral therapy after weighing the risks and benefitsAntiretroviral should not be used for those with low-risk transmissions or exposures occurring more than 72 hours after exposure

HIV nonnonnonnon----Occupational Occupational Occupational Occupational ExposureExposureExposureExposure

Page 30: Know Aids No Aids

Evaluate HIV status of patient and risk history of source patientProvide necessary medical care and counselingEvaluate risk event and factors for exposureDetermine elapsed time from exposureEvaluate potential for continuous HIV exposureObtain informed consent for testing and treatmentEvaluate pregnancy status of females

HIV nonnonnonnon----Occupational Occupational Occupational Occupational ExposureExposureExposureExposure

Page 31: Know Aids No Aids

Time toTime toTime toTime to think positivethink positivethink positivethink positive

1111stststst December, World AIDS DAY | December, World AIDS DAY | December, World AIDS DAY | December, World AIDS DAY | [email protected]@[email protected]@live.com