1. Chapter Sixteen
HIV and AIDS 1

2. HIV/AIDS Human Immunodeficiency Virus (HIV)
Immune system deficient, cannot resist disease
Virus responsible for Acquired Immune Deficiency Syndrome (AIDS)
Acquired Immune Deficiency Syndrome (AIDS)
Descriptive of the infection and it’s progression
First observed in U.S. cities in early 1980s
Young, healthy men dying of rare diseases

3. Conditions Associated with AIDS
Opportunistic infections
Pneumocystis carinii pneumonia (PCP)
Mycobacterium avium intracellulare
Clinical conditions
Wasting syndrome
Cancers
Kaposi’s sarcoma
Other infections
Candidiasis
Herpes and cytomegalovirus 3

4. Symptoms of HIV Infection and AIDS
Unexplained persistent fatigue
Fever, chills, night sweats
Unexplained weight loss
Swollen lymph nodes
Pink, red, purple, or brown blotches
Persistent dry cough
Persistent, fuzzy, white spots in mouth, tongue, or throat
Memory loss or depression
Abnormal pap smears
Persistent vaginal candidiasis
Abdominal cramping (due to Pelvic inflammatory Disease)
Persistent Diarrhea 6

5. The Immune System and HIV
Leukocytes – white blood cells
Macrophages
Engulf foreign particles
Antigens
Stimulate immune system, react with antibodies
Antibodies
Inactivate antigens, mark them for destruction
B cells and T cells
Lymphocytes
Helper T cells 7

6. The Virus Protein coated package of genes Spherical GP 120
Reverse transcriptase
Retrovirus
Effect on T cells

7. How the Disease Progresses
T cell (CD4) count
Viral load counts
Phases of infection
Months to years
Early flu-like symptoms
AIDS
Death

8. Epidemiology and Transmission of HIV
Epidemiology – Study of incidence, process, distribution, and control of a disease
World Health Organization reports 25 million people have died from AIDS
Estimated that 40.3 million people are living with HIV 9

9. Epidemiology and Transmission of HIV
Global increases in number of people living with AIDS
African continent the largest concentration
2/3 of all AIDS cases are in Sub-Saharan Africa
77% of women living with AIDS are in Sub-Saharan Africa 9

10. Epidemiology and Transmission of HIV in the United States
944, 306 individuals living with AIDS
40,000 annual new HIV infections
Changes in current transmission modes
Changes across ethnic groups 9

11. Modes of Transmission Sexual contact Sharing needles Transfusions
Passing virus from mother to fetus 10

12. Modes of Transmission Breastfeeding from HIV-positive mother
Sharing sex toys
Accidental contamination with infected blood
Contaminated blood transfusions or organ transplants performed before April 1, 1985

13. Myths about Transmission
Non sexual contact – touching a person
Touching a surface – toilet seat
Social contact – kissing, biting or tears
Insect bites
Accidental contact in sports
Donating blood

14. Sexual Transmission Anal intercourse Vaginal intercourse Oral sex
Sex toys 11

15. Injection Drug and Substance Use
Sharing needles
Sharing other paraphernalia
Recreational use resulting in poor decision making 11

16. Mother to Child Transmission
Peri natal transmission
Greatly reduced by use of ZDV (AZT)
Mother takes ZDV from week 14 to 34
Infant takes ZDV 11

17. Minority Races and Ethnicities and HIV
In the early 80s, was viewed as a disease in Whites and gays
Currently identified in all ethnic groups
Occurs in groups with
Poverty
Lack of access to or willingness to use health care
Substance abuse 11

18. Minority Races and Ethnicities and HIV
African Americans
Hispanics
Asian/Pacific Islanders
American Indians and Alaska Natives 11

19. The Gay Community Men who have sex with men
Stigma slowed prevention efforts
Special consideration of ethnic groups
Psychological long term effects
Increased risk taking
Other STIs
U.S. AIDS Demographics by Race

20. Other Groups and HIV Children Teens and college students Older adults
Geographic region

21. Prevention and Treatment
Protecting ourselves
Be aware that alcohol and drug use increases risky behaviors
Develop communication skills to be able to discuss risks and prevention with partners
Use HIV testing and make appropriate decisions
Use condoms 14

22. Prevention and Treatment
Saving lives through prevention
Reduced new infections from 150,000/year to 40,000/year
Obstacles to education: blame and denial
AIDS seen as disease of marginalized group, not “us”
Needle exchange programs
HIV testing 14

23. HIV Testing
Tests should be taken 12 weeks after high-risk behavior, repeated 6 months after an uncertain result
Types of tests
ELISA - enzyme-linked immunosorbent assay
Western blot –rechecks ELISA results
Viral load tests measure HIV in bloodstream
Getting tested
Partner notification 15

24. Treatment Usually initiated with the diagnosis of AIDS
Antiretroviral medications
Nonnucleoside reverse transcriptase inhibitors
Nucleoside reverse transcriptase inhibitors
Protease inhibitors
Fusion Inhibitor
HAART – Highly Active Antiretroviral Therapy
Combination of three or more medications
Reduces HIV in blood to undetectable levels

25. Living with HIV or AIDS If you are HIV positive
Taking care of your health
Addressing your other needs
If you are caring for someone with HIV or AIDS

26. Summary What is AIDS? The epidemiology and Transmission of HIV
AIDS demographics
Prevention and Treatment
Living with HIV or AIDS