HIV/AIDS Flashcards
HIV
enters cell, binds to DNA, replicates itself, destroyed cell, repeat => increased TC4 count which means more symptoms
-spread through unprotected sex, needles, intravenous drug use, blood/organ transmission, mother-baby
Official History
1980s: cluster of disease in gay men in SF (focus on emergence in west; Homosexuals, Hookers, Heroin-users, Hatians; Gaetan Dugas = patient 0?)
AIDS History
1890s-1920: jumped between chimps and humans in Kinshasa, Democratic Republic of Congo
- virus entered humans: cut hunter theory: transmitted through cut on hunter through infected monkey, in a case, the virus jumped to humans and mutated
- spread through 1930s-1960s for the first time (1940s: mobile population bc colonialists building railway line)
- 1960s social change due to fight for independence => urbanization = disrupted family life => increase in sex work, public health campagins
- also Congo won independence from Belgium, but no trained doctors bc durring occupation Congos were barred from getting degrees => employed French-speaking Hatians (HIV-1 brought back to Haiti)
- early 1970s: Miami plasma-donation clinic buys plasma from Haiti
- 1981: first reports of disease among gay men in New York and California (clusters of extremely rare diseases like cancer, incurrable pnemonia, autoimmune disease)
- 1983: France researchers at Pasteur Institute isolate retrovirus. In USA, Robert Galloo finds virus HTLV-III. it’s the same virus, both HIV, named so in 1986
- 1985: Canadian blood scandal
1985: Rock Hudson is the first major celebrity to openly die of AIDS. People start talking about HIV, drugs are developed to stop the virus from reproducing
1987: FDA approved AZT as treatment for AIDS
1990s: increased queer activism begins to reduce HIV rates in gay men
1990: Ryan White dies at age 18, sued the state bc he was kicked out of school. Bad at calculating drug dosages at this point.
1991: red ribbon introduced
AIDS in Africa
prevelance rates vary greatly: south africa affected worst, west and east africa has less affect bc they experienced less social destruction
-Botswana moved money away from war and towards medicine. Highest rates of government funding for medicine. Decreased HIV rates significantly.
HIV in Body
STAGE 1: HIV primary infection, lasts 2 weeks-6 months. Flu-like symptoms.
STAGE 2: Virus creating a resevoir, no symptoms, highly infectious bc of high viral load
STAGE 3: clinically asymptomatic, 6-8 years, viral load is fairly level. In SK, can last only 2-3 years bc different strain? background infections?
STAGE 4: symptomatic stage, weight loss, shingles, respitory tract infection, pnemonia
STAGE 5: HIV becomes AIDS. Cancers, tuberculosis, diseases that ppl would usually fight off become more lethal. When CD4 count drops from 1000/ml of blood to 200/mll, considered AIDS
treatment of HIV
antiretroviral therapy (ART): reduces viral multiplication, reduces risk of transmission. Has side effects, drug interactions, poor adherance => drug resistance and therapy failure -why is there no universal treatment? expenses, when to start, side effects differ, food and water requirements, ARTs have to be balanced and adjusted thus medical follow-up needs to be available
Mother-Child Transmission of HIV
- during preganacy, during labour, during delivery, or during breast-feeding
- HIV+ mothers can have HIV- babies with HIV medication during pregnancy, Caesarean section, baby on ARTs for 1-6 weeks reduces risk by 75%, not breastfeeding (formula/clean water accessibility?)
- all together, <5% risk of transmission, without treatment, 15-45% risk of transmission
- in SK, 2011-2014, no babies were born HIV+
Male circumcision and HIV prevention
- inner foreskin contains cells that are easily penetrated by HIV
- small tears and genital ulcers increase HIV risk
- only protects men who have vaginal sex => 50-60% reduction
- WHO recommends in countries with heterosexual HIV epidemics, or HIV prevelance >15%
Criminalization of nondisclosure of HIV status
+deterrant? (does criminalization actually deter people tho?)
+punishment
-prison doesn’t prevent HIV transmission
-prevention is more effective than punishment
-fear of prosecution may deter testing
-creates false sense of security?
-adds to stigma and discrimination (burden of preventing HIV transmission on HIV+ people, portrays HIV+ people as criminals)
-gender and power inequality (HIV+ women cannot always insist on condom use, fear of violence after disclosure)
HIV in Saskatchewan
- 1985: first case, from man who visisted SF
- number of new cases almost triple the national average
- most of SK cases = through drug use (most other provinces primarly through MSM)
- on reserve infection rates nearly 11x national average
Characteristics of Spread of HIV
- networks along which disease can spread (migrant labourers, travel to access service, commercial sex workers or multiple sexual partners)
- lack of access to health care (asymetrical health systems e.g. on or off reserve == lack of resources, inability to access specialists, diagnostics, lab services, follow-up services easily)
- high prevelance of untreated infectious diseases which make people more suceptible to HIV
- lack of mental health and addictions services (trauma from residential schools, 60s scoop, MAMIW)
- services are not seen as ‘culturally safe’ (culturally appropriate care, history of abuse)
