HIV 101 DSC AIDS Task Force Adapted from curriculum by Tucson Interfaith HIV/AIDS Network

HIV/AIDS Info & History First documented case occurred in June 1981 In first world countries, AIDS is now a chronic disease, but this was not the case in the past AIDS is 100% preventable, and yet there are 40,000 new infections each year in the U.S. alone

AIDS Doesn’t Discriminate!

From Terminal to Chronic Life Expectancy 3 Months 1980’s Today 27 Years … and Counting!! Infection

Statistics Over 1 million people in the U.S. are HIV+ (CDC 2008) Over 11,600 people in AZ are HIV+ (AZ Dept of Health, 2007) Over 2,000 people in Pima County are HIV+ (AZ Dept of Health, 2007) Over 33.2 million people worldwide are living with HIV (UNAIDS, WHO, 2007) 0 have been cured

Ground Rules Be honest Use non-judgmental communication Do not censor yourself Maintain confidentiality Use “I-statements” It’s okay to pass Use language with which you are comfortable Step up or stand back

Risk Quiz Please do not respond aloud. Do you have or have you ever had unprotected sex? Do you have multiple partners, meaning more than one person in a year? Do you share or use needles? Have you ever had sex with someone who shares needles? How do you know? Have you ever had an Sexually Transmitted Disease or Sexually Transmitted Infection? Do you use alcohol or drugs?

HIV 101 Pre-Survey Please use a code that is significant to you You will use this same code for the post-test This is to evaluate the presenter, not you

Definitions H - I - V - Human Immunodeficiency Virus

Definitions A - I – D- S – Acquired Immune Deficiency Syndrome

The Immune System Key players WBC T-4 Antibodies Bacteria/Virus HIV Virus

White Blood Cell (a.k.a. Intel) Function: Continuously looks out for signs of disease

T-4 Cell (a.k.a. General) Function: Key to immune system and core to adaptive immunity. Search and destroy invaders.

Antibodies (a.k.a. Soldiers) Function: Immune system identifies and uses these to neutralize foreign objects (i.e. bacteria/virus)

Bacteria or Virus (a.k.a. Intruder) Function: To make one sick (attacks the immune system)

Human Immunodeficiency Virus (a. k. a Human Immunodeficiency Virus (a.k.a. Sniper) Function: This makes people sick, but the cell is like a shape shifter, it goes undetected and attacks the immune system, eventually taking it over.

Mission Success! “Intel” “General” “Soldiers” Intruder “Intel” identifies an “Intruder” and notifies the “General”. The “General” sends a command out to the “Soldiers” to attack and destroy the “Intruder”. Mission complete. Mission Success!

Mission Compromised! “Intel” “General” “Sniper” “Soldiers” Intruder When the “Sniper” goes undetected, it will take out the “General” before the “Soldiers” can do anything about it. Eventually, the “Sniper” takes over and multiplies until the “General” cannot support any longer, causing it to spread. Mission Compromised!

What’s the difference between HIV and AIDS? HIV, a virus, eventually causes AIDS, a syndrome Ineligible for disability benefits until AIDS diagnosis has been made Fix color spectrum to accentuate different stages. Infection Spectrum of HIV Possible Minor Symptoms Healthy, HIV+ Symptomatic HIV/AIDS Seroconversion

Criteria for AIDS: A CD4 cell count of 200 or less or 1 opportunistic infection

Opportunistic Infections Mycobacterium Avium Complex Salmonellosis Syphilis and Neurosyphillis Tuberculosis Bacillary angiomatosis Aspergillosis Candidasis Coccidioidomycosis Cryptoccal Meningitis Histoplasmosis Kaposi’s Sarcoma Systemic Non-Hodgkin’s Lymphoma Primary CNS Lymphoma Cryptosporidiosis Isosporiasis Microsporidiosis Pneumocystis Carinii Pneumonia Toxoplasmosis Cytomegalovirus Hepatitis Herpes Simplex Herpes Zoster Human Papiloma Virus Molluscum Contagiosum Oral Hairy Leukoplakia Progressive Multifocal Leukoencephalopathy AIDS Dementia Complex Peripheral Neuropathy Apthous Ulcers Malabsorption Depression Diarrhea Thrombocytopenia Wasting Syndrome Idiopathic Thrombocytopenic Purpura Listeriosis Pelvic Inflammatory Disease Burkitt’s Lymphoma Immunoblastic Lymphoma Valley Fever MRSA Source: AIDS Education Global Information System

T Cell Count If 1,200 or higher, the individual has an uncompromised immune system If 800 or less, immune system is compromised If 200 or less, AIDS diagnosis Once you’re diagnosed with AIDS, you are always categorized as having AIDS, even if your T-cell count goes up

Fluids and HIV Transmission

Fluids that DO NOT transmit HIV: How did you do? Fluids that DO transmit HIV: Blood Semen Vaginal Fluid Breast Milk (in order of highest concentration of HIV) Fluids that DO NOT transmit HIV: Saliva Tears Mucus Urine Sweat Feces

The Biggest and Best Organ is… SKIN Epidermis Dermis Subcutaneous

Transmission - Risk Continuum As a group, classify activities as: Theoretical Risk No Risk Low Risk High Risk Discuss. Key Questions: What is the fluid? Is there a way into the body?

Key Concepts (Refer to detailed Risk Continuum) High: sharing needles, unprotected sex, breast feeding Low: protected sex, any opportunity for exchange of four body fluids No risk: casual contact Theoretical examples: deep kissing, drugs and alcohol

Universal Precautions Wash your hands! Disinfect utensils and living space. Use barriers – preferably latex. HIV cannot be spread through casual contact, but these are good practices for preventing opportunistic infections.

Barriers include: Latex Gloves Latex Condoms Latex Dental Dams Anything that protects your skin from a fluid

Remember – If it’s wet, sticky, and not yours, don’t touch it!

Prevention What is the only 100% effective way to prevent HIV infection? What does abstinence include?

Other Options If not abstinence, barriers can greatly reduce the risk of HIV transmission. Use latex condoms and water-based lubricants or dental dams.

Testing For antibodies, not virus Can take up to 3 months to produce antibodies Negative test may mean recent infection Possible to infect others during this stage Get tested 3 months after last possible exposure to be sure

Timeline Test Date 3 month window from 1st exposure 1 2 3 month window from 2nd exposure New Test Date

Real Life Application Today! Get tested in 3 months! At a party 3 months ago, I engaged in some high risk behaviors … When should I get tested? Before I came here today, I got high with a used needle… now what do I need to do? Today! Get tested in 3 months!

The ONLY way to know is to get TESTED! Find a Testing Site Near You! Go to www.hivtest.org Enter your zip code Instantly receive list of all HIV testing sites in your area

Treatment Today, in the United States, HIV/AIDS is a chronic disease Antiretroviral drugs are used in combination, known as Highly Active Anti-Retroviral Therapy (HAART) Side effects are severe Cost of treatment is very high

Estimated Cost of Treatment COST PER MONTH (estimates) Agenerase $772 Aptivus $1117.50 Combivir $752.64 Crixivan $570.96 Emtriva $347.11 Epivir 300mg Epzicom $813.55 Fortovase $263.35 Fuzeon $2315.40 Hivid $273.00 Invirase $748.50 Kaletra $796.26 Lexiva $658.99 Norvir $321.46 Rescriptor $316.35 Retrovir $405.59 Reyataz $892.91 Sustiva 600mg $499.43 Trizivir $1164.35 Truvada $867.99 Videx EC 400mg $346.04 Viramune $442.45 Zerit $385.88 Ziagen $466.44 Estimated monthly cost of care is $2,100 Estimated annual cost of care is $25,200 Estimated total cost of care for a 24 year period is $618,000 Source: Cornell Medical College Source of HIV Medication Table is About.com

Sites of Action for Antiretroviral Drugs Source: University of Arizona’s Biology Department

Call to Action What can I do to protect myself? What can I do to help or protect others? What can I do to my community and the world we live in?

Q & A Time

Post-Test Please use the same code as for the pre-test. Remember, this is to evaluate the presenter, not you.

Evaluation Your honest feedback will help us to improve!

Thank You! www.desertsouthwestconference.org Please visit www.desertsouthwestconference.org and view the AIDS Task Force webpage for more information and resources!