1. BCCO PCT #4 PowerPoint AND HIV/AIDS & Viral Hepatitis In the Criminal Justice Profession TCOLE Course # 3804 UNIT ONE Texas Commission On Law Enforcement and Texas Department of State Health Services

2. ADMINISTRATIVE Please complete the BCCO PCT #4 Registration form and turn it in now. Make sure you sign TCOLE Report of Training (PID#, Full Name and DOB). All cell phones off please – pay attention to course materials and show common respect & courtesy.

3. About Your Instructor Course Facilitator - Mentor George D. Little A.S. & B.S. Criminal Justice & Sociology B.S.CJ Wayland Baptist University, San Antonio M.S. Criminology & Counter-Terrorism University of the State of New York 2012 T.C.L.E.O.S.E. Professional Achievement Award Certified Crime Prevention Specialist (C.C.P.S.) TCLEOSE Basic Instructor Certificate 1984 TCLEOSE Master Peace Officer 1991 MP Special Operations Operator Counter-Terrorism 1988 Graduate Drug Enforcement Administration Academy 1977 43- years Law Enforcement Experience 40-Years Teaching & Instructor Experience

4. COURSE/LESSON OVERVIEW The purpose of this course is to educate individuals on matters pertaining to communicable diseases such as HIV/AIDS, HBV, and HCV which impacts the criminal justice profession.

5. Learning Objectives Learning Objective 1.0 Learning Objective 1.0 : The participant will be able to understand and explain relevant terms and definitions of HIV/AIDS, HBV and HCV Learning Objective 1.1 Learning Objective 1.1 :The participant will be able to write general statements regarding HIV. Learning Objective 1.2 Learning Objective 1.2 :The participant will be able to to list and describe the general stages of HIV infection.

6. Learning Objective 1.3 Learning Objective 1.3 :The participant will be able to write general statements regarding AIDS. Learning Objective 1.4 Learning Objective 1.4 :The participant will be able to describe in writing, the relationship between HIV and AIDS. Learning Objective 1.5 Learning Objective 1.5 :The participant will be able to write general statements regarding Hepatitis A (HAV). Learning Objective 1.6 Learning Objective 1.6 :The participant will be able to write general statements regarding Hepatitis B (HBV). Learning Objectives

7. Learning Objective 1.7 Learning Objective 1.7 :The participant will be able to describe the relationship between acute and chronic HBV infection. Learning Objective 1.8 Learning Objective 1.8 :The participant will be able to write general statements regarding HCV. Learning Objective 1.9 Learning Objective 1.9 :The participant will be able to describe the relationship between acute and chronic HCV infection. Learning Objectives

8. FORWARD The occurrence of communicable diseases has dramatically affected every part of the justice system worldwide; Legal, law enforcement and custody issues. HIV, AIDS, hepatitis, and other sexual transmitted diseases (STDs) are big problems in the judicial system.

9. Acknowledgement This course is developed by the Texas Commission on Law Enforcement (TCOLE) for presentation to any individual associated with or employed by any entity of the criminal justice system.

10. Unit One 1.0Functional Area 1.0Functional Area : This section will introduce the participant to HIV/AIDS, HBV, and HCV. The participant will master an understanding of the relevant terms and definitions of HIV/AIDS, HBV and HCV.

11. Learning Objective 1.1Learning Objective: 1.1Learning Objective: The participant will be able to write general statements regarding HIV.

12. A. What is HIV? H = ________ I = _________________ V = __________ 1.1 General Statement (HIV)

13. 1.1 General Statement (HIV) Cont’d B.Virus that causes _________ C.Once a person is infected, they can immediately transmit ____ to another person

14. D.Destroys the body's ability to ________ infections and certain cancers by killing or damaging cells of the body's immune system E.A person ________ may remain without symptoms for a long period of time 1.1 General Statement (HIV) Cont’d

15. F.There is no cure for _____. Once an individual becomes infected with HIV the person is infected for life. _______ to fight both HIV infection and its associated infections and cancers are currently available. 1.1 General Statement (HIV) Cont’d

16. G.Increased understanding of HIV ________ progression, refinement and acceptance of holistic therapies, availability of sophisticated testing, ability to prevent or reduce the impact of opportunistic infections, and potent treatment therapies have made HIV an increasingly manageable chronic disease. 1.1 General Statement (HIV) Cont’d

17. 17 DEFINE & PROCESS Process: Define 1.1: Define 1.1: Write four out of seven general statements regarding HIV

18. Learning Objective 1.2 Learning Objective: The participant will be able to list and describe the general stages of HIV infection.

19. 1.2 General Stages of HIV Infection. A. A. There are general ________ of HIV infection that one may go through before AIDS develops.

20. B. B. Infection. The earliest stage is right after ______________ with HIV. HIV can infect ______ and copy itself before the immune system has started to respond. Individuals may feel _____-like symptoms during this time. 1.2 General Stages of HIV Infection…Cont’d

21. Infection HIV enters the _______________ and begins to take up residence in the cells. People with HIV are considered to be _________ immediately after infection with the virus. 1.2 General Stages of HIV Infection…Cont’d

22. Although some studies suggest that the level of infectivity varies over time depending on the stage of the disease in which the person is, it is not ____________ for most HIV-infected people to find out what their level of infectivity is. A person with ____ is infectious at all times. Infection – Cont’d 1.2 General Stages of HIV Infection…Cont’d

23. symptoms Also, a person does not need to have symptoms or look sick to have HIV. HIV In fact, people may look perfectly healthy for many years despite the fact that they have HIV in their bodies. antibody The only way to find out if a person is infected is by taking an HIV antibody test. Infection – Cont’d 1.2 General Stages of HIV Infection…Cont’d

24. C. C. Response. The next stage is the _______ responds to the virus. Even if a person doesn’t feel any different, their body is trying to fight the virus by making ___________ against it. This is called _____-____________, when a person goes from being HIV negative to HIV positive. 1.2 General Stages of HIV Infection…Cont’d

25. D. D. No symptoms. HIV infected individuals may enter a ________ in which they have no symptoms. This is called __________ infection. They still have _____ and it may be causing damage that they can’t feel. 1.2 General Stages of HIV Infection…Cont’d

26. E. E. Symptoms. Symptomatic HIV infection is when symptoms are developed, such as certain infections, including _____. F. F. AIDS. AIDS is diagnosed when you have a variety of symptoms, infections, and specific test results. There is no ________ test to diagnose AIDS. 1.2 General Stages of HIV Infection…Cont’d

27. Primary HIV infection FACTS Primary HIV infection is the first stage of HIV _______, when the virus first establishes itself in the body. 12 Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by body (usually ___- 12 weeks). 1.2 General Stages of HIV Infection…Cont’d

28. - _______________ ____________ Within the first 72 hours after exposure, ______ - _______________ ____________ (PEP) may be possible. Up to 70% of people newly infected with HIV will experience some "flu-like" symptoms 1.2 General Stages of HIV Infection…Cont’d

29. These symptoms, which usually last no more than a few days, might include: __________ __________, ________ __________ ________ __________ and____________ not cold-like symptoms (not cold-like symptoms). 1.2 General Stages of HIV Infection…Cont’d

30. The remaining percentage of people either do not experience "acute infection," or have symptoms so _____ that they may not notice them. Given the general character of the symptoms of acute infection, they can easily have causes _______ than HIV, such as a flu infection. 1.2 General Stages of HIV Infection…Cont’d

31. For example, if you had some risk for HIV a few days ago and are now experiencing flu-like symptoms, it might be possible that HIV is responsible for the symptoms, but it is also possible that you have some other _______ __________ 1.2 General Stages of HIV Infection…Cont’d

32. During acute HIV infection, the _____ makes its way to the lymph nodes, a process which is believed to take three to five days. Then HIV actively reproduces and releases new virus particles into the _______________. This burst of rapid _____ replication usually lasts about two months. 1.2 General Stages of HIV Infection…Cont’d

33. Scientists disagree about whether anti-____ treatment is useful during primary HIV infection, and there is little information from clinical trials. Most HIV specialists believe that early highly active ______________ therapy (HAART) is useful, and that its benefits likely outweigh the disadvantages of no treatment. 1.2 General Stages of HIV Infection…Cont’d

34. Some doctors are treating newly HIV- infected people with a combination of anti-HIV drugs. While many researchers are optimistic about early anti-HIV treatment, they are also concerned about ______ side effects, long-term effects and the possibility of developing drug-resistant virus if people use powerful anti-HIV drugs before they become ill due to HIV disease

35. Some researchers think that if HIV replication can be slowed down early in the course of disease, it will take longer before a person develops AIDS

36. Several studies have shown that low blood viral load levels in the early stages of HIV disease are associated with less severe illness and slower disease progression. Some even think that it might be possible to eradicate, or completely kill off HIV, if treatment is started very early.

37. So far, though, complete HIV eradication has not occurred, and most doctors recommend that anti-HIV treatment should be continued indefinitely once it is started.

38. 38 DEFINE & PROCESS Process: Define 1.2: Define 1.2: List and describe general stages of HIV infection.

39. Learning Objective 1.3 1.3 Learning Objective: The student will be able to write general statements regarding AIDS.

40. 1.3What is AIDS? 1.3 What is AIDS? A = ____________ - I = ______________ - D = ____________ S = ____________

41. 1.3 General Statements (AIDS) A. A. __________ is the common abbreviation for Acquired Immunodeficiency Syndrome B. AIDS B. The term AIDS applies to the most advanced stages of ______ infection

42. C. C. AIDS is the result of the natural progression of HIV ____________ D. D. The acquired immunodeficiency syndrome (AIDS) was first recognized in __________ 1.3 General Statements (AIDS) – Cont’d

43. 43 DEFINE & PROCESS Process: Define 1.3: Define 1.3: Write general statements regarding AIDS

44. Learning Objective 1.4 Learning Objective: The participant will be able to describe in writing, the relationship between HIV and AIDS

45. 1.4 Relationship Between HIV and AIDS A. A. Individuals don’t transmit _______ they transmit HIV. B. B. As a result of HIV, _________ that are allowed because of the immune system breakdown are called “opportunistic infections.” These infections generally do not affect healthy people.

46. C. C. The definition or diagnosis of AIDS includes all HIV-infected people who have fewer than _____ CD4+ T cells per cubic millimeter of blood. (Healthy adults usually have CD4+ T-cell counts of 1,000 or more.) Or a diagnosis of two or more of 26 clinical conditions that affect people with advanced HIV disease. 1.4 Relationship Between HIV and AIDS – Cont’d

47. D. D. Common opportunistic infections associated with HIV are: 1. _______________ __________ ____________ (PCP) 2. ____________ Sarcoma (KS) 3. __________________ (TB) 1.4 Relationship Between HIV and AIDS – Cont’d

48. E. E. HIV infection progresses in each individual ______________; individual immune systems, health behaviors, resources, and chance all contribute to the course of infection. 1.4 Relationship Between HIV and AIDS – Cont’d

49. F. F. How would I know if I have HIV? 1. The only sure way to know your status is to be __________ 2. The most common test is an ____________ test 3. The antibody test (EIA) detects _____________ in most persons within 6 weeks to 3 months 1.4 Relationship Between HIV and AIDS – Cont’d

50. F. F. How would I know if I have HIV? 4. Any positive antibody test must be confirmed with a second type of test, the ______________ Blot 5. Both tests (EIA and Western Blot) must be _________ for someone to be told s/he has HIV 1.4 Relationship Between HIV and AIDS – Cont’d

51. Split Decision

52. Split Decision Video Split Decision intends to open the lines of communication in relationships as it relates to the rapidly spreading HIV virus. This is a five minute short film of a longer piece of work directed by Sanedria Arne’ Porter, writer/director originally from Winston-Salem, N.C. currently

53. residing in Atlanta, Georgia. This short film was written by Sanedria Arne' Potter & Kirk A. Moore. VIDEO NOT AVAILABLE

54. 54 DEFINE & PROCESS Process: Define 1.4: Define 1.4: Describe in writing the relationship between HIV and AIDS.

55. Learning Objective 1.5 1.5 Learning Objective: The participant will be able to write general statements regarding Hepatitis A (HAV).

56. 1.5 General Statements Regarding Hepatitis A (HAV) A. A. ___________ is a disease that causes inflammation of the liver B. B. The _________ is an organ that helps your body digest food and acts as a filter for poisons or anything toxic in the body

57. C. C. The liver is it located in the upper right quadrant of the abdomen, tucked up under your rib cage. D. D. Hepatitis A (HAV) is a _______ disease caused by the Hepatitis A virus 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

58. E. E. __/__ of Americans have evidence of past HAV infection F. F. It is found in the ______ (feces) or persons infected with HAV 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

59. G. G. It is usually spread when a person eats food or drinks water that has been contaminated with the _______ of someone with HAV H. H. It is important to wear _______ when handling inmate linen or clothing 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

60. I. I. Signs & Symptoms of HAV: 1. Persons may not have any _____________ (older persons are more likely to have symptoms than children). 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

61. I. I. Signs & Symptoms of HAV: 2. If symptoms are present, they usually occur quickly and may include fever, tiredness, and loss of appetite, nausea, abdominal discomfort, ____________ and dark urine 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

62. I. I. Signs & Symptoms of HAV: 3. The average incubation time from exposure to symptoms is ____ days (15-50 days) 4. Symptoms usually last less than ___ months 1.5 General Statements Regarding Hepatitis A (HAV) – Cont’d

63. 1.5 Signs and Symptoms Long Term Effects of HAV There is no chronic (long-term) infection One you have had hepatitis A, you __________ get it again There is a ____________ for hepatitis

64. If you have been exposed, Immune globulin can be given to prevent infection (within ____ days of exposure) % About ____% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period 1.5 Signs and Symptoms Long Term Effects of HAV

65. SYMPTOMS Review If symptoms are present, they usually occur quickly and may include: FeverTiredness Loss of appetiteNausea Abdominal DiscomfortJaundice Dark urine

66. 66 DEFINE & PROCESS Process: Define 1.5: Define 1.5: Write general statements regarding Hepatitis A (HAV)

67. Learning Objective 1.6 Learning Objective: The student will be able to write general statements regarding Hepatitis B (HBV).

68. 1.6 general statements regarding Hepatitis B (HBV) A. HBV A. HBV is the common abbreviation for hepatitis ___ virus. B. Hepatitis B B. Hepatitis B is an inflammation of the _____ caused by infection with the hepatitis B virus

69. C. HBV C. HBV has both acute (new, short- term) and ________ __________ (ongoing, long-term). D. severity of the disease D. The severity of the disease can range from mild or unapparent to severe or even ________. 1.6 general statements regarding Hepatitis B (HBV) – Cont’d

70. E. Hepatitis B vaccination E. Hepatitis B vaccination is recommended for all unvaccinated ______________, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. 1.6 general statements regarding Hepatitis B (HBV) – Cont’d

71. F. Transmission F. Transmission: 1. Contacting blood/body _____ containing blood if you are not immune (via vaccine/ prior infection) 2. Having sex with an ________ person without using a condom 3. Sharing __________ to inject drugs or “works” (spoons, cotton, water) 1.6 general statements regarding Hepatitis B (HBV) – Cont’d

72. G. Symptoms G. Symptoms: 1. ____________ (eyes and/or skin), loss of appetite, nausea, vomiting, fever, stomach or joint pain and fatigue lasting weeks or months 2. The average incubation period (from exposure to symptoms) is approximately ____ months 1.6 general statements regarding Hepatitis B (HBV) – Cont’d

73. Review What is Hepatitis B? Hepatitis B is an inflammation of the liver caused by infection with the hepatitis B virus (HBV) Hepatitis B is spread through contact with infected blood (usually through sex or sharing needles/works) HBV has both acute (new, short-term) and chronic stages (ongoing, long-term) The severity of the disease can range from mild or unapparent to severe or even fatal

74. 74 DEFINE & PROCESS Process: Define 1.6: Define 1.6: Write general statements regarding Hepatitis B (HBV)

75. Learning Objective 1.7 Learning Objective: The student will be able to describe the relationship between acute and chronic HBV infection.

76. 1.7 the relationship between acute and chronic HBV infection. A. A. Acute hepatitis B occurs ________ after exposure to the virus. B. B. Chronic hepatitis B is an infection with HBV that lasts longer than ___ months. Once the infection becomes chronic, it may never go away completely.

77. C. % C. About ____ % of people who are infected are able to fight off the virus so their infection never becomes chronic. D. D. The younger you are when you become infected with the hepatitis B virus, the more likely you are to develop __________ hepatitis B. 1.7 the relationship between acute and chronic HBV infection…Cont’d

78. Relationship between Acute & Chronic HBV Acute hepatitis B occurs shortly after exposure to the virus Chronic hepatitis B is an infection that lasts longer than 6 months About 85% of people who are infected are able to fight off the virus so their infection never becomes chronic The younger you are when you become infected with the hepatitis B virus, the more likely you are to develop chronic hepatitis B 1.7 the relationship between acute and chronic HBV infection…Cont’d

79. The Hepatitis B vaccine is the best protection against HBV Immune globulin can be given within 7 days if you are exposed to HBV and not vaccinated. You should also be given the first dose of HBV vaccine Three doses are needed for complete protection (0, 1-2, 4-6 months) 1.7 the relationship between acute and chronic HBV infection…Cont’d 1.7 the relationship between acute and chronic HBV infection.

80. 1.7 HBV Vaccine Most young adults and children have been vaccinated against HBV by the age of 2 (or 12- 18 years of age if not vaccinated as a child) The CDC, the National Commission on Correctional Health Care and the Society of Correctional Physicians recommend that correctional officers and correctional health care workers be vaccinated against HBV 1.7 the relationship between acute and chronic HBV infection…Cont’d

81. 81 DEFINE & PROCESS Process: Define 1.7: Define 1.7: Describe the relationship between acute and chronic HBV infection

82. Learning Objective 1.8 Learning Objective: The student will be able to write general statements regarding Hepatitis C (HCV).

83. 1.8 General Statements regarding HCV A. A. HCV is the common abbreviation for hepatitis ___ virus. B. B. Hepatitis C is an inflammation of the ______ caused by infection with the hepatitis C virus.

84. C. C. HCV is the most common chronic ______ borne viral infection in the United States. D. D. HCV is the #1 cause of chronic _______ disease and liver transplants. 1.8 General Statements regarding HCV…Cont’d

85. E. E. HCV has both ________ and ________ stages. F. F. There is no vaccine to prevent hepatitis ___. 1.8 General Statements regarding HCV…Cont’d

86. G. G. Symptoms: 1. Most persons with HCV do not have ____________ 2. Many persons with chronic HCV have mild to moderate liver damage but do not feel ________ 1.8 General Statements regarding HCV…Cont’d

87. G. G. Symptoms – Cont’d: 3. Some people with an acute infection will have _________ (skin and/or eyes) or mild flu-like symptoms 4. Most people with chronic HCV will only have mild to moderate ________ disease 1.8 General Statements regarding HCV…Cont’d

88. G. G. Symptoms – Cont’d: 5. Symptoms may include ____________, ____________, loss of ____________ and ____________ 1.8 General Statements regarding HCV…Cont’d

89. 89 DEFINE & PROCESS Process: Define 1.8: Define 1.8: Write general statements regarding HCV

90. Learning Objective 1.9 Learning Objective: The student will be able to describe the relationship between acute and chronic HCV infection.

91. 1.9 relationship between acute and chronic HCV infection A. A. Most persons with acute infection experience few, if any, symptoms and are unaware they’re infected. B. B. There is no treatment for acute hepatitis ___.

92. C. C. Out of 100 persons infected with HCV, approximately 15-25 will spontaneously __________ the virus without treatment. The other 75-85 go on to develop chronic infection. 1.9 relationship between acute and chronic HCV infection…Cont’d

93. D. D. Over time HCV may cause your liver to stop working and a new liver from a ___________ may be needed. E. E. Antiviral ___________ for chronic hepatitis C are available. 1.9 relationship between acute and chronic HCV infection…Cont’d

94. Natural History of HCV Infection 100 People Resolve (15) 15% Chronic (85) 85% Cirrhosis (17) Stable (68) 80% 75% Stable (13) Mortality (4) 25% Time 20% Leading Indication for Liver Transplant

95. BloodBorne Pathogens for Law Enforcement (Length: 19 minutes) This video is strictly for visual aid and is not required to teach this course. It is a good tool that can help gain a better understanding of the material. If your agency is a member of the Texas Municipal League Intergovernmental Risk Pool (TML), you can contact them at 1-800-537-6655 to acquire this video. If your agency is a member of the Texas Association of Counties (TAC), you can contact them at 1-800-456- 5974.

96. 96 DEFINE & PROCESS Process: Define 1.9: Define 1.9: Describe the relationship between acute and chronic HCV infection.

97. Questions?

98. SOURCES All Course Sources and/or Resources are listed in your Participant Handout HIV-AIDS & Viral Hepatitis in CJ Profession TCOLE Course # 3271 Bexar County Constable Office PCT#4

99. “Knowledge is “POWER” Stay informed, stay SAFE, stay Vigilant & stay Alive”

100. UPCOMING TRAINING Current TRAINING Schedule of Courses offered by Bexar County Constable’s Office PCT#4 Racial Profiling Course – TCOLE Course #3256 (4-hrs) 4-hrs on Saturday October 4 th, 2014 from 10:30 am to 2:30 pm. Racial Profiling Course – TCOLE Course #3256 (8-hrs) on Friday October 10, 2014 from 11:00 am to 3:00 pm Eye Witness Evidence Course – TCOLE Course # 3286 (4-hrs) Saturday October 11, 2014 from 10:30 am to 2:30 pm Eye Witness Evidence Course – TCOLE Course # 3286 (4-hrs) Sunday October 12 th, 2014 from 11:00 am to 3:00 pm. Eye Witness Evidence Course – TCOLE Course # 3286 (4-hrs) Friday October 17 th, 2014 from 1:00 pm to 5:00 pm. 100 Bexar County Constable’s Office PCT#4 TRAINING SCHEDULE 2014

101. 101 Advanced TCOLE Instructor Course – TCOLE #1017 (40hrs), Day One Saturday November 1 st,2014 from 11:00 am to 6:00 pm (Deputy Chief George D. Little and Deputy Constable Roland Berg) Day Two Advanced TCOLE Instructor Course – TCOLE #1017, Day Two Sunday November 2 nd,2014 from 11:00 am to 6:00 pm (Deputy Chief George D. Little and Deputy Constable Roland Berg) Day Three Advanced TCOLE Instructor Course – TCOLE #1017, Day Three Friday November 7 th,2014 from 9:00 am to 6:00 pm (Deputy Chief George D. Little and Deputy Constable Roland Berg ) Lesson Presentation preparation time. Instructors available Day Four Advanced TCOLE Instructor Course – TCOLE #1017, Day Four Saturday November 8 th,2014 from 11:00 am to 6:00 pm (Deputy Chief George D. Little and Deputy Constable Roland Berg)

102. 102 Day Five Advanced TCOLE Instructor Course – TCOLE #1017, Day Five & Grad Sunday November 9 th, 2014 from 11:00 am to 6:00 pm – Presentations, Final Test & Graduation (Deputy Chief G. D. Little and Dep. Constable R. Berg ) HIV-AIDS & Viral Hepatitis in Criminal Justice Profession Course – TCOLE # 3804 (8-hrs) 8-hrs on Saturday November 15 th, 2014 from 10:00 am to 6:00 pm. HIV-AIDS & Viral Hepatitis in Criminal Justice Profession Course – TCOLE # 3804 (8-hrs) 4-hrs on Thursday December 4th, 2014 from 1:00 am to 5:00 pm HIV-AIDS & Viral Hepatitis in Criminal Justice Profession Course – TCOLE # 3804 (8-hrs) 4-hrs on Friday December5th, 2014 from 1:00 am to 5:00 pm KNOWLEDGE IS POWER

103. TAKE A 15-MINUTE BREAK