HIV Prevention In Utah Heather E. Bush HIV/STD/Viral Hepatitis Prevention Education Specialist Communicable Disease Prevention Program Utah Department of Health

HIV Infection Classification System HIV Infection, Stage 1 CD4+ T-lymphocyte count of >500 cells/µl (>29%) HIV Infection, Stage 2 CD4+ T-lymphocyte count of 200-499 cells/µl (14-28%) HIV Infection, Stage 3 (AIDS) CD4+ T-lymphocyte count of <200 cells/µl (<14) or AIDS-defining condition HIV Infection, Stage Unknown No CD4+ T-lymphocyte count and percentage

People Living with HIV Infection in Utah

People Living w/ HIV Infection, Utah, 2011* Stage 1 Stage 2 Stage 3 (AIDS) Stage Unknown Total 206 (7.9%) 771 (29.6%) 1,406 (53.9%) 223 (8.6%) 2,606 -Stage 3 (AIDS) and Unknown decreased from 2010 -Stage 2 increased by 2% from 2010 *By end of December 31st, 2010

HIV/Syphilis Co-Infection Co-infections are common among syphilis and HIV. Fluctuates year to year. We are starting to see an increase in syphilis cases with a previous diagnosis of HIV. Indicates HIV+ not changing any behavior after they are notified about their HIV infection.

Utah State Education Code 53A-13-101. (1)(b) That instruction shall stress the importance of abstinence from all sexual activity before marriage and fidelity after marriage as methods for preventing certain communicable diseases. (2) (a) Instruction in the courses described in Subsection (1) shall be consistent and systematic in grades 7 through 12. Teachers will comply with the parental consent requirements. Schools will instruct students in community and personal health, physiology, personal hygiene, and prevention of communicable disease.

Utah State Education Code The following may NOT be taught: The intricacies of intercourse, sexual stimulation, or erotic behavior; The advocacy of homosexuality; The advocacy or encouragement of contraceptive methods or devices; The advocacy of sexual activity outside of marriage.

Minor Consent Law Minors 14-17 may be tested and treated for STDs without parental or guarian consent or permission

Prevention Theory Behavior Change Theory Social Cognitive Theory Theories of Reasoned Action Stages of Change Model Health Action Process Approach

Harm Reduction Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use and sexual behaviors that lead to risk of HIV and other diseases. Harm reduction incorporates a spectrum of strategies from safer use or sex, to managed use, to abstinence to meet high-risk individuals “where they’re at,” addressing conditions of risk along with the risk itself.

Historical of HIV Prevention “ABC Prevention” Abstinence (not engaging in sex, or delaying first sex) Being safer, by being faithful to one's partner or reducing the number of sexual partners Correct and consistent use of condoms Awareness Campaigns

Names Project- The AIDS Memorial Quilt Nominated for a Nobel Peace Prize in 1989 Remains the largest community art project in the world. “Common Threads: Stories From The Quilt” won the Academy Award as the best feature-length documentary film of 1989. Funds Raised by The Quilt for Direct Services for People with AIDS: over $4,000,000 (U.S.) Number of visitors to the Quilt: more than18,000,000 Number of names on the Quilt: more than 94,000 Size: 1.3 million square feet.To see the entire Quilt spending only one minute per panel – over 33 days

The AIDS Memorial Quilt

HIV Prevention Activities Education “AIDS 101” Testing Conventional Rapid Outreach condom distribution Behavioral interventions Scientifically proven Targeted to high risk populations High impact, high expense

National HIV Prevention Strategy Vision for the National HIV/AIDS Strategy “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.”

National HIV Prevention Strategy The purpose of the National HIV/AIDS Strategy is to provide a roadmap for public and private stakeholders to better address the serious, ongoing HIV epidemic in the United States. The three primary goals focus on: 1. reducing the number of people who become infected with HIV, 2. increasing access to care and optimizing health outcomes for people living with HIV, and 3. reducing HIV-related health disparities.

Future of HIV Prevention PreP/PEP Condom Distribution Testing Linkage to care Prevention with positives