1. Interventions for Clients with HIV/AIDS and Other Immunodeficiencies

2. HHuman IImmunodeficiency VVirus

3. A Acquired IImmuno IImmuno D Deficiency S Syndrome S Syndrome

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

13. 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) EIA/ELISA (Reactive) Repeat EIA/ELISA (Reactive) IFA (Reactive) Positive for HIV

14. 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

15. Four Stages of HIV ► Stage 1 – Primary ► Stage 2 – Asymptomatic ► Stage 3 – Symptomatic ► Stage 4 - HIV  AIDS

16. Stage 1 - Primary ► Short, flu-like illness - occurs one to six weeks after infection ► no symptoms at all ► Infected person can infect other people

17. Stage 2 - Asymptomatic ► Lasts for an average of ten years ► This stage is free from symptoms ► There may be swollen glands ► The level of HIV in the blood drops to very low levels ► HIV antibodies are detectable in the blood

18. Stage 3 - Symptomatic ► The symptoms are mild ► The immune system deteriorates ► emergence of opportunistic infections and cancers

19. Stage 4 - HIV  AIDS ► The immune system weakens ► The illnesses become more severe leading to an AIDS diagnosis

20. Opportunistic Infections associated with AIDS ► Bacterial  Tuberculosis (TB)  Strep pneumonia ► Viral  Kaposi Sarcoma  Herpes  Influenza (flu)

21. Opportunistic Infections associated with AIDS ► Parasitic  Pneumocystis carinii ► Fungal  Candida  Cryptococcus

22. Modes of HIV/AIDS Transmission

23. Mother-to-Baby ► Before Birth ► During Birth ► Postpartum  After the birth

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

25. HIV Occupational Exposure HIV Occupational Exposure ► Review facility policy and report the incident ► Medical follow-up is necessary to determine the exposure risk and course of treatment ► Baseline and follow-up HIV testing ► Four week course of medication initiated one to two hours after exposure ► Liver function tests to monitor medication tolerance ► Exposure precautions practiced

26. HIV/AIDS ► HIV classifications include:  A person in clinical category A is HIV positive.  A person in clinical category B is infected with HIV.  A person in clinical category C has AIDS.

27. Health Promotion and Illness Prevention ► Education is the best hope for prevention. ► HIV is transmitted most often in three ways:  Sexual  Parenteral  Perinatal

28. Collaborative Management ► Assessment ► History ► Physical assessment and clinical manifestations  Infections: opportunistic, protozoal, fungal, bacterial, viral  Malignancies: Kaposi’s sarcoma, malignant lymphomas  Endocrine complications

29. Other Clinical Manifestations ► AIDS dementia complex ► Wasting syndrome ► Skin changes

30. Laboratory Assessment ► Lymphocyte counts ► CD4/CD8 counts ► Antibody tests ► Enzyme-linked immunosorbent assay (ELISA) ► Western blot, viral culture, viral load ► Quantitative RNA assays ► p24 antigen assay