HIV/AIDS

Question 1

Population at highest risk of HIV

Answer 1

• men who have make sexual partners
• people from sub Saharan Africa
• children of people living with HIV
  -people who inject drugs
• people who have transactional sex

Question 2

HIV Testing

Answer 2

• tests antigen and HIV antibody
• window period 45 days
  -can do rapid tests or finger prick tests as well

Question 3

Primary HIV infection

Answer 3

• six weeks after patient acquire HIV, will get Primary HIV or Seroconverison
• body’s immune system is providing a big immune response to the virus
  -symptoms: fever, sore throat, feeling fatigue, rash, swollen lymph glands
• can be mistaken for glandular fever, secondary syphilis

Question 4

Blood tests for HIV

Answer 4

HIV viral load
- marker of how much HIV is present in the blood. Aim to maintain an ‘undetectable viral load’ <200-20 copies/ml

CD4
- type of white blood cell, calculated from total lymphocyte count
- stops HIV from replicating and destroying CD4

Question 5

HIV Treatment

Answer 5

• reduces morbidity and mortality
  -reduces risk of onward transmission
  -aim of treatment is VL (viral lode) suppression and CD4 recovery

Question 6

HAART- Highly Active AntiRetroviral Treatment

Answer 6

• usually triple therapy: 2 nucleoside reverse transcriptase inhibitors and 1 drug from another class
  -guided by patients choice/ drug resistance

Question 7

Challenges with Antiretroviral Therapy

Answer 7

-good adherence essential (need to take drugs everyday)
- psychological impact
-short term side effects
-long term toxicities
-drug-drug interactions (topical/inhaled drugs)

Question 8

HIV prevention

Answer 8

-condoms
- treatment as prevention (TasP)
- pre exposure prophylaxis (Prep)
- post exposure prophylaxis (pep)
- prevention of mother to child transmission (PMTCT)
-harm reduction measures eg. Needle exchange

Question 9

PEP vs PrEP

Answer 9

PEP
- post exposure prophylaxis
Based on exposure type and risk of contact

PrEP
- pre exposure prophylaxis
- for people at higher risk of HIV through sexual transmission
- long term effect on kidneys and bones

Question 10

Prevention of mother to child HIV transmission

Answer 10

• ART for mother during pregnancy minimises risk at delivery
• PEP for baby
• avoid breast feeding
• universal antenatal HIV screening

Question 11

Social dimension of HIV/AIDS

Answer 11

• high prevelance in many counties with low GDP
  Provision of ART and clinical monitoring
• often affects people from marginalised populations
  At risk of further marginalisation
• high rates of psychological ill health in people living with HIV
  -stigma and isolation

Question 12

Social dimension of HIV/AIDS

Answer 12

• high prevelance in many counties with low GDP
  Provision of ART and clinical monitoring
• often affects people from marginalised populations
  At risk of further marginalisation
• high rates of psychological ill health in people living with HIV
  -stigma and isolation