HIV

Question 1

Subtypes of HIV

Answer 1

HIV-1 and HIV-2

Question 2

Predisposing factors for HIV

Answer 2

• Age 25-34
• MSM
• IV drug users
• multiple sexual partners
• unprotected sex
• sex tourism/sex workers

Question 3

How is HIV transmitted

Answer 3

• Unprotected sexual contact
• Unscreened blood products & organ transplantation
• Needle sharing
• Mother to child
• Needle sticks

Question 4

Incubation period of HIV

Answer 4

2 – 4 weeks

Question 5

Where does HIV infection occur

Answer 5

• Infection occurs worldwide in every country/continent except Antarctica.
  -↑↑ risk: Sub-Saharan Africa, Eastern Europe, Central & Southeast Asia.

Question 6

What is the acute phase of HIV infection called

Answer 6

Acute Retroviral Syndrome (ARS).

Question 7

Present similarly to infectious mononucleosis or influenza, but the clinical features are highly variable.
(a) Commonly includes fever, maculopapular rash, arthralgia, myalgia, malaise, lymphadenopathy, oral ulcers, pharyngitis, and weight loss.
(4) The presence of fever and rash have the best positive predictive value

Answer 7

Acute Retroviral Syndrome (ARS)

Question 8

HIV – Laboratory Testing

Answer 8

(1) Screening test OraQuick ADVANCE Rapid HIV-1/2 Antibody Test
(2) Confirmatory testing performed via 4th Gen HIV immunoassay

Question 9

PrEP (Pre-exposure prophylaxis) Guidelines

Answer 9

DHA IPM 18-020: Guidance for HIV (PrEP) for Persons at High Risk.

Question 10

Do we initiate PrEP in a deployed environment?

Answer 10

No

Question 11

Initiation of PrEP requires

Answer 11

1) Negative 4th gen HIV Ag/Ab test within 7 days if
infection is NOT suspected.
2) Negative 4th gen HIV Ag/Ab test & documented
negative Nucleic Acid Amplification Test (NAAT),
ideally within 7 days, if infection IS suspected.

Question 12

When to use nPEP (Nonoccupational Post-exposure Prophylaxis)

Answer 12

1) Sexual Assault
2) Unprotected sexual contact with high-risk contact

Question 13

When to contact MedAdvice and/or routine MedEvac for HIV

Answer 13

a) Positive screening with Oraquick rapid HIV test.
(b) Positive confirmatory testing utilizing 4th generation HIV Ab/Ag.
(c) High clinical suspicion of ARS.
(d) Needle Stick/bloodborne exposure to high-risk individual.

Question 14

HIV instruction for military members

Answer 14

DoDI 6485.01: HIV in Military Service Members

Question 15

How often are clinical evaluations required after positive HIV test

Answer 15

at least every 6 to 12 months after diagnosis