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Public Health 150 > 17b. HIV/AIDS 12/2 > Flashcards

17b. HIV/AIDS 12/2 Flashcards

1
Q

HIV/Aids

A

is a human retroviruses

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2
Q

Adults and children estimated to be living with HIV 2011

A

34.2 million

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3
Q

Adults and children estimated to be infected with HIV 2011

A

2.5 million

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4
Q

AIDS deaths in 2011

A

1.7 million

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5
Q

Over 7000 new HIV infections a day in 2011

A

About 97% are in low and middle income countries

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6
Q

HIV/AIDS – USA 2009

A

Living with HIV/AIDS = 1.2 million
Incidence = 56,000/year
MSM = 53%
Heterosexuals = 31%
IDUs = 12%
Ethnicity
African-American = 45%
African-American women vs European/Caucasian women = 15:1
Hispanic-Americans vs European-Americans = 3:1
Percent unaware and potentially transmitting = 20%
Cost per lifetime treatment = $355,000

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7
Q

MODES OF TRANSMISSION

A

Blood
Semen/genital secretions
Vertical

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8
Q

RISK ACTIVITIES THAT PROMOTE TRANSMISSION OF HIV (1)

A

Receiving blood contaminated with HIV
Being born to an HIV-infected mother
Engaging in anal intercourse with an HIV-infected partner
Engaging in vaginal intercourse with an HIV-infected partner

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9
Q

RISK ACTIVITIES THAT PROMOTE TRANSMISSION OF HIV (2)

A

Engaging in oral-genital intercourse with an HIV-infected partner
Sharing needles with an HIV-infected individual
Being exposed to HIV-infected material; e.g., health or laboratory worker

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10
Q

RISK GROUPS

A 
Homosexual/bisexual
Intravenous drug users
Promiscuous heterosexuals
Spouses of promiscuous persons
Blood product and organ recipients
Children of infected individuals
Health/laboratory workers
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11
Q

RISK OF HIV TRANSMISSION (1)

A 
Transfusion of 1 unit of blood		90-95%
From mother to fetus/infant		7-39%
During birth					10-20%
During breastfeeding			5-15%
In utero						5-10%
ART at delivery				6-8%
With HAART 4th-9th months		<1%
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12
Q

RISK OF HIV TRANSMISSION (2)

A 
Sexual intercourse*
Receptive anal intercourse		1-30%
Insertive anal intercourse		0.1-10%
Vaginal intercourse – female		0.1-10%
Vaginal intercourse – male		01-1%
Oral-genital					<1%
*STDs multiply risk
Other
Accidental exposure (laboratory	0.09%
  or clinical worker) per exposure
Injection drug use (per sharing	0.67%
  episode)
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13
Q

The major force maintaining the epidemic

A

The major force maintaining the epidemic is persons who do not know they are infected

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14
Q

Impact of the HIV/AIDS EpidemicOn the Individual

A 
Uncertain future
Contemplating painful death
Stigmatization and social isolation
Loss of employment
Limited access to health care
Loss of self-esteem
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15
Q

Impact of the HIV/AIDS EpidemicOn the Family

A

Potential infection of spouse and children
Loss of economic support of family
Ostracism and social isolation
Children become orphans

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16
Q

Impact of the HIV/AIDS Epidemic On Society

A

Loss of productive segment of society
Increased number of dependents
Breakdown of family structure
Sense of fear and distrust

17
Q

Impact of the HIV/AIDS Epidemic on Developing CountriesIncreased Health Care Costs

A

Diversion of funds from other urgent health problems

Issues and costs of care and hospitalization

18
Q

Impact of the HIV/AIDS Epidemic in Developing CountriesAlteration of the Producer:Dependent Ratio

A 
Decreased productivity due to illness
Removal of producers by death
Increased number of dependents:
Sick babies
Increased number of orphans
19
Q

Impact of the HIV/AIDS EpidemicOn the Economic and Political Well-Being of the Nation

A

Alteration of the producer:dependent ratio
Increased health care costs
Social impact
Political impact

20
Q

Impact of the HIV/AIDS Epidemic in Developing CountriesPolitical impact

A

Political instability

Increased dependency on rich nations

21
Q

Key Elements for Successful Intervention (1)

A 
Mobilization of political will and commitment
Good surveillance
Learn and adapt from past experiences
Unified national planning
Multisectoral response
Rapid implementation
22
Q

Key Elements for Successful Intervention (2)

A

Focused intervention; e.g., involve marginalized and high-risk groups
Assure access to intervention tools; e.g. condoms, testing, drugs
Early education
Community involvement
Combining of interventional strategies

23
Q

Key Elements for Successful Intervention (3)

A 
Reduce barriers to intervention
Address restrictive cultural norms (e.g. refusal to acknowledge sexuality)
Stigmatization
Promote testing (opt out)
Treatment
Adults
Pregnant women
Development of effective vaccine
24
Q

Key Elements for Successful Intervention (4)

A

Development of an effective microbicide
Issues of testing i.e. mandatory condom use
Recognition of risk by participants
Adherence
Drug resistance for anti-HIV microbicides
Irritation of vaginal mucosa
Same microbicide for low- and high-risk women?
Efficacy of tenofovir – 43%

25
Q

HIV/AIDS PREVENTIONS THAT WORK (CDC) (1)

A

Surveillance for HIV
HIV testing
Counseling of persons living with HIV/AIDS
Condom promotion and availability
Partner services/notification
Reaching populations in need; e.g., pregnant women

26
Q

HIV/AIDS PREVENTIONS THAT WORK (CDC) (2)

A 
Harm reduction for IDUs
Needle exchange
Methadone maintenance
Antiretroviral therapy
Circumcision
Screening and treatment of STDs
Tenofovir prophylaxis for MTCT
Treatment (as prevention)
Prep
Pep
27
Q

FORECASTING THE EPIDEMIC (1)

A

Increase in homosexual transmission
Decrease in pediatric cases (depends on screening efforts and treatment)
Improved, cheaper treatments increase survival
Increased costs to society as survival increases
Increasing incidence of HIV-related cancers

28
Q

FORECASTING THE EPIDEMIC (2)

A

Aging is accelerated
Conversion to an endemic disease
Greater impact on poor countries
Countries capable of social, cultural and economic change survive
Dependence of developing countries on “rich” countries (economic colonialism)
Development of vaccine will impact
primarily developing countries

29
Q

FORECASTING THE EPIDEMIC (3)

A

Treatment issues in developing countries:
1. Need for greater acceptance of testing
2. Need for infrastructure for clinical management
3. Need for inexpensive low-tech markers of
disease progression/remission
4. Finding HIV+ persons
5. Assuring continuum of care
Need to plan for sustaining programs when foreign
support is withdrawn

Public Health 150 (19 decks)

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