2. HIV/AIDS Minnesota Department of Education HIV/AIDS Prevention Program

3. HHuman IImmunodeficiency VVirus

4. A Acquired IImmuno D Deficiency S Syndrome

5. HIV Transmission HIV enters the bloodstream through: –Open Cuts –Breaks in the skin –Mucous membranes –Direct injection

6. HIV Transmission Common fluids that are a means of transmission: –Blood –Semen –Vaginal Secretions –Breast Milk

7. HIV in Body Fluids Semen 11,000 Vaginal Fluid 7,000 Blood 18,000 Amniotic Fluid 4,000 Saliva 1 Average number of HIV particles in 1 ml of these body fluids

8. Routes of Transmission of HIV Sexual Contact:Male-to-male Male-to-female or vice versa Female-to-female Blood Exposure: Injecting drug use/needle sharing Occupational exposure Transfusion of blood products Perinatal: Transmission from mom to baby Breastfeeding

9. HIV-Infected T-Cell HIV Virus T-Cell HIV Infected T-Cell New HIV Virus

10. Window Period 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

11. HIV Infection and Antibody Response InfectionOccurs AIDS Symptoms ---Initial Stage-------------------Intermediate or Latent Stage-----------------Illness Stage--- Flu-like Symptoms Or No Symptoms Symptom-free < ----

12. Importance of Early Testing and Diagnosis Allows for early treatment to maintain and stabilize the immune system response Decreases risk of HIV transmission from mother to newborn baby Allows for risk reduction education to reduce or eliminate high-risk behavior

13. HIV Testing Requires a blood or oral fluid sample HIV test detects the body’s antibody response to HIV infection The test does NOT detect the HIV virus

14. HIV Testing in Minnesota Confidential vs. anonymous testing Testing offered free-of-charge at state- funded HIV test sites for those at risk Test results are available within a week or sooner For a list of HIV test sites in Minnesota call 1.800.248.AIDS or visit www.health.state.mn.us Search: Getting Tested for HIV www.health.state.mn.us

15. HIV Testing Those recently exposed should be retested at least six months after their last exposure Screening test (EIA/ELISA) vs. confirmatory test (IFA) EIA/ELISA (Reactive) Repeat EIA/ELISA (Reactive) IFA (Reactive) Positive for HIV

16. EIA/ELISA Test Positive Negative Run IFA Confirmation Repeat Positive End Testing Repeat ELISA Every 3 months for 1 year Negative PositiveNegativeIndeterminate Repeat at 2-4 months Repeat at 3 weeks HIV Testing No HIV Exposure Low Risk HIV Exposure High Risk Negative HIV + Repeat every 6 months for continued High risk behavior

17. Minnesota Law for HIV Testing Requires informed consent No premarital testing requirement Prenatal testing not required but strongly recommended School notification not required for positive staff or students (universal precautions)

18. Minnesota Law for HIV Testing (cont.) Allows testing of individuals: –Regardless of age without parental consent (MN Statute144.343) –Without consent of patient if blood exposure to an Emergency Services provider (MN Statute 144.74) –By court order for sex offenders (MN Statute 611A.19) or a prison inmate (MN Statute 241.332)

19. 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 HIV AIDS

20. HIV Risk 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

21. HIV Risk Reduction Avoid drug and alcohol use to maintain good judgment Don’t share needles used by others for: Drugs Tattoos Body piercing Avoid exposure to blood products

22. Condoms Using condoms is not 100 percent effective in preventing transmission of sexually transmitted infections including HIV Condoms = Safer sex Condoms ≠ Safe sex

23. Condom Use Should be used consistently and correctly Should be either latex or polyurethane Should be discussed with your partner before the sexual act begins Should be the responsibility of both partners for the protection of both partners Male and female condoms are available

24. People Infected with HIV Can look healthy Can be unaware of their infection Can live long productive lives when their HIV infection is managed Can infect people when they engage in high-risk behavior

25. HIV Exposure and Infection Some people have had multiple exposures without becoming infected Some people have been exposed one time and become infected

26. HIV and Sexually Transmitted Diseases

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

28. HIV and Sexually Transmitted Diseases STDs increase the susceptibility to HIV –Ulcerative and inflammatory STDs compromise the mucosal or cutaneous surfaces of the genital tract that normally act as a barrier against HIV –Ulcerative STDs include: syphilis, chancroid, and genital herpes –Inflammatory STDs include: chlamydia, gonorrhea, and trichomoniasis

29. HIV and Sexually Transmitted Diseases The effect of HIV infection on the immune system increases the the risk of STDs A suppressed immune response due to HIV can: I ncrease the reactivation of genital ulcers Increase the rate of abnormal cell growth Increase the difficulty in curing reactivated or newly acquired genital ulcers Increase the risk of becoming infected with additional STDs