Partner notification and HIV Flashcards
Which diseases should partner notification take place for and what is the point?
Any STI as the aim is to break the chain of infection and reduce the complications resulting from untreated STIs
What does a partner notification discussion usually involve?
- Nature of the infection
- Importance of sexual abstinence until patient and all partners have completed treatment
- Importance of informing any partners
What are the two ways that partners are typically informed?
Patient referral - can involve giving them anomolous contact slips to give to the partner
Provider referral - patient gives names and addresses of partners so healthcare provider contacts them
How does HIV typically present in the seroconversion phase?
This is symptomatic in 60-80% of patients and typically presents as a glandular fever type illness. Typically 3-12 weeks after infection Features: -Sore throat -Lymphadenopathy -Malaise -Myalgia -Arthralgia -Diahorrhoea -Maculopapular rash -Mouth ulcers
How and when is an HIV test done?
Antibody HIV test:
-99% will have the antibodies by 3 months after infection
-PCR
p24 antigen test:
- usually positive from 1 week to week 3 or 4 after infection
Who should HIV testing be offered to?
Almost everyone
Any at risk populations
e.g. STI clinic, Infectious disease clinics, any A and Es
What should the pre test discussion for HIV testing involve?
- Risk assessment (sexual history)
- Discussion of benefits of testing
- Explaination of window period (p24 antigen test 1-4 weeks, HIV antibody test after 3 months)
- Details of how the result will be given and preperation for positive result
What are the benefits of knowing HIV status?
- Medical advances - particularly in antiretroviral therapy - improved length and quality of life in most people
- For mothers greatly reduces the risk of transmission to baby to almost zero
- Supports behaviour change to reduce onward transmission
- Allows appropriate treatment of oppoutunistic infections
What is the affect of HIV status on relationships and insurance?
Many people continue in their existing relationships
Very few regret their decision to test
For life insurance there is no difficultly in accessing however may have higher premiums
What are the features of HIV seroconversion and when does this occur?
Typical features glandular fever type illness: -Sore throat -Lymphadenopathy -Malaise -Diarrhoea -Mouth ulcers Occurs at 3-12 weeks
What testing is available for HIV and when does this work?
There is p24 antigen test for HIV which postitve from week 1 to week 3
After this must wait until after 3 months when HIV antibodies have developed and can be found on ELIZA testing
What is the physiology behind Post exposure prophylaxis for HIV?
Once the HIV crosses the mucosal barrier it can take up to 72 hours before HIV can be detected within regional lymph nodes. The PEP works by inhibiting viral replication and preventing it from entering the blood
When is the most likely time for HIV transmission?
During serconversion
What medications make up the post exposure prophylaxis regime?
Truvada (tenofivir) once daily and and reltegravir twice daily for 28 days
What are the factors that effect efficacy of post exposure prophlaxis?
Delay in administration
Drug resistance
Adherence
Completion
