Lecture 31 HIV/AIDS Flashcards

1
Q

Why is HIV/AIDS a problem?

A

Although the epidemic has lasted many decades, it is still very prevalent in the world (most problematic non communicable disease)

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2
Q

How did HIV/AIDS first spread?

A

It first spread among homosexual men, leading to them becoming advocates to health policies

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3
Q

What do we know about HIV?

A
  • There are several modes of transmission, this has helped with facilitating prevention
  • There are now cheap and reliable HIV specific screening tests
  • We know that HIV/AIDS is caused by HIV
  • There are now better treatment options which improves life expectancy for those with AIDS
  • There is still not a vaccine
    40 million people have died from the disease
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4
Q

What is the rates of HIV/AIDS globally?

A

Most cases are in sub-Saharan African countries/ low income countries which means access to treatment is low (only 1/3 have access compared to 2/3rds in european countries)

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5
Q

How did HIV/AIDS affect the change in life expectancy for countries in Africa

A

Life expectancy was originally increasing, however due to HIV/AIDS it plummeted by about 10-20 years. With treatment now, life expectancy is increasing again

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6
Q

What is the prevalence of new cases and deaths from HIV/AIDs globally?

A

Deaths from HIV are going down due to better treatment, new infections are going down because we know the modes of transmission and high risk groups, however prevalence is increasing because people are not dying from it

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7
Q

What are factors shaping the epidemic?

A

Nearly 15% of people with HIV don’t know their status, most people living with or at risk of HIV do not have access to HIV prevention, treatment and care, about 95% of affected live in LMICs, to reduce the burden of HIV/AIDS, it is essential to tailor the response and interventions to local circumstances and prevalent risk factors

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8
Q

What are recent global trends?

A
  • Heterosexual transmission has become the dominant mode of transmission
  • Young people account for a significant and rapidly growing percentage of the population
  • Of new infections for people aged 15+, 40% are in the 15-24 age group (mostly female, in sub saharan)
  • AIDS related illnesses is the leading cause of death for women of reproductive age worldwide
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9
Q

What is the feminization of the HIV epidemic

A

increasing proportions of new infections are among women primarily due to heterosexual transmission of the infection

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10
Q

What proportion of the population affected by HIV/AIDS are female

A

only around 20% in NZ but in african countries its 70-80%

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11
Q

Which age group has the greatest deaths for HIV/AIDS

A

those aged 15-49 years (mostly females)

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12
Q

Who are the high risk groups for unprotected sexual intercourse with an HIV+ person?

A

Homosexual men, heterosexual people and sex workers

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13
Q

What are the high risk groups for sharing un-sterilized injections and needles?

A

Injecting drug users, those receiving injections with unsterilized needles (generally in low resource settings)

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14
Q

Who are most at risk for mother-child transmissions

A

infants born to or breast fed by untreated HIV+ mothers

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15
Q

Who are the high risk groups for blood borne transmissions?

A

Anyone receiving unscreened blood products or organs (generally in countries with inadequate screening)

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16
Q

What are social determinants of the HIV epidemics among women in terms of harmful power dynamics?

A
  • Ability for women to negotiate condom use
  • Gender based violence/sexual abuse (women who experience virus are more at risk of HIV)
  • Problems with disclosure of HIV status, partner notification and confidentiality
  • Stigma and discrimination
17
Q

What are social determinants of the HIV epidemics among women in terms of early school drop out, poverty and financial dependence?

A
  • Lack of education leads to lack of safe/well paid jobs, also lower health literacy leading to problems in accessing healthcare
  • Lack of resources leads to women doing things that put them at risk of HIV (sex work,
18
Q

What are social determinants of the HIV epidemics among women in terms of lower access to health services

A

Women face barriers in accessing HIV prevention, treatment and care
- denied access, need parental consent, low health literacy

19
Q

What is the relationship between human rights and gender inequity

A

HIV is driven by gender inequity but entrenches gender inequity, leaving women more vulnerable

20
Q

What does the WHO say in terms of human rights, women and HIV/AIDS?

A
  • womens rights to safe sexuality and to autonomy in all decisions relating to sexuality is closely related to economic independence.
  • The scope of human rights needs to be extended to economic security or a womens right to safe sex will not be achieved
21
Q

What are interventions for the prevention and control of HIV around gender inequities and harmful social norms?

A
  • Empower women, educate men
  • Enable opportunities for education and financial independece
  • Change social norms around harmful dynamics, gender based violence, stigma and discrimination
  • improve health literacy
  • improve access to sexual and reproductive health services
22
Q

What are interventions for the prevention and control of HIV around safer sex?

A

Media campaigns around wider policy strategies to reduce stigma and discrimination
Educational approaches
Condoms: can promote use, increase availability and reduce cost

23
Q

What are interventions for the prevention and control of HIV around safer products

A

Screen blood products for HIV, needle and syringe exchange programs for IV drug users, protect against needle stick injuries

24
Q

What are interventions for the prevention and control of HIV around increasing access to healthcare

A
  • voluntary testing and counseling to reduce risk of sexual transmission
  • treatment, care and support for HIV+ people
  • treatment of STI and provision of family planning services
  • Antenatal screening and treatment for HIV to orevent mother-child transmission of HIV
25
Q

What are the details about mother to child transmission

A
  • With no treatment, 1/3rd of children born to women HIV+ will get infected.
  • Risk is reduced by screening pregnant mothers and treating HIV+ with retroviral drugs
  • Sub saharan africa is home to 91% of pregnant mothers needing treatment
26
Q

Is providing anti-retroviral drugs to pregnant mothers infected with HIV a primary/secondary prevention of AIDS?

A

For child it is a primary prevention because it prevents the biological onset, for the mother is is a secondary prevention because it reduces disease progression in HIV+ mother

27
Q

What is the HIV/AIDS situation in NZ?

A

Deaths have come down drastically, however still more people getting infected so prevalence is increasing. 20% were unaware of their HIV status

28
Q

What are lessons we have learnt from the HIV pandemic?

A
  • Surveillance, investigation of risk factors and health promotion were crucial in establishing prevention effors well before the virus was discovered
  • Treatment doesn’t replace importance of prevention
  • If HIV+ people are unaware of their status, prevention and treatment efforts will be hampered
29
Q

What are three major challenges for the future?

A

Global resources for prevention and care for HIV fall short of needs
Successful efforts for prevention need to combat stigma and discrimination
Inequities in resources and access to healthcare make it essential to address the social determinants of health/human rights, especially among women, low SE groups and young people