WEEK 2: HIV INFECTION AND PUBLIC HEALTH Flashcards
What is public health?
Its “the science and art of preventing disease, prolonging life and promoting health through organized efforts and informed choices of society, organizations, communities and individuals. “
Public health is the science and practice of promoting and protecting the health and well-being of entire populations.
It focuses on threats to health based on population health analysis (a population can be small as a handful of people, or as large as all the inhabitants of several continents e.g., in pandemics)
State the 8 key concepts of public health.
Key aspects of public health include:
- Disease Prevention: Public health experts develop strategies and interventions to prevent the spread of diseases. This can include immunization campaigns, health education, and disease surveillance.
- Health Promotion: Public health initiatives aim to encourage healthy behaviors and lifestyles among the population. This includes promoting physical activity, good nutrition, and smoking cessation.
- Epidemiology: Epidemiologists study the patterns and causes of diseases in populations. They investigate disease outbreaks and work to prevent their recurrence.
- Environmental Health: Public health professionals assess and manage environmental factors that can impact health, such as air and water quality, sanitation, and occupational hazards.
- Health Policy and Management: Public health experts work on healthcare policy, healthcare system management, and resource allocation to ensure the effective delivery of healthcare services.
- Community Health: Community health workers and professionals work directly with communities to assess needs and provide healthcare services, education, and support.
- Global Health: Public health efforts are not limited to individual countries. Many public health initiatives address global health challenges, such as infectious disease outbreaks, pandemics, and health disparities.
- Research and Data Analysis: Public health relies on data and research to inform decision-making and measure the impact of interventions and policies.
Public health plays a crucial role in preventing and controlling health issues on a population level, from infectious diseases like COVID-19 to chronic conditions like heart disease and cancer. It involves the collaboration of various professionals, including epidemiologists, biostatisticians, healthcare administrators, health educators, environmental health experts, and policymakers.
Public health agencies, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), are responsible for guiding public health efforts, monitoring health trends, and responding to public health emergencies.
Public health is a vital field that has made significant contributions to increasing life expectancy and improving the overall health of communities worldwide.
What does HIV stand for?
What is HIV?
Describe how HIV result in AIDS.
What does AIDS stand for?
What is AIDS?
HIV – Human Immunodeficiency Virus
A virus that causes AIDS (the most common cause of AIDS to date).
The human immune system cannot fight HIV thereby weakening with time.
It replicates in and then kills the T cells.
As it destroys more host cell the immune system weakens to the point where it ca no longer fight infection (immunosuppression).
Once Opportunistic infections and Diseases take over then the host is consider having AIDS.
AIDS (acquired immunodeficiency syndrome) it is characterized by deficient immune responses…
Describe the structure of HIV.
- Envelope: HIV has an outer envelope composed of lipids (fats) taken from the host cell’s membrane during the budding process.
This envelope contains viral glycoproteins, including gp120 and gp41, which are critical for the virus’s ability to attach to and enter host cells.
- Capsid: Inside the viral envelope is a protein coat called the capsid, which houses the viral RNA genome.
The capsid is made up of many protein subunits, and it protects the genetic material within.
- RNA Genome: Unlike many other viruses that use DNA as their genetic material, HIV’s genome is composed of RNA. It contains the genetic instructions needed for the virus to replicate.
This RNA genome is single-stranded and relatively simple, encoding the viral proteins and enzymes required for the viral life cycle.
- Reverse Transcriptase: This enzyme plays a crucial role in the virus’s life cycle by converting its RNA genome into DNA.
This is a unique characteristic of retroviruses, and the newly synthesized DNA becomes integrated into the host cell’s genome.
- Matrix Protein: Surrounding the viral RNA, there is a matrix protein that helps to stabilize the viral structure. It plays a role in the assembly and release of new viral particles.
- Integrase: Integrase is another viral enzyme that plays a pivotal role in the integration of the viral DNA into the host cell’s DNA.
This integration step is essential for the virus to persist in the host cell.
- Protease: HIV also encodes a protease enzyme, which is essential for the virus to mature and become infectious.
It cleaves long precursor proteins into smaller functional components that are necessary for the viral particle to be fully formed and functional.
Understanding the structure and function of HIV is crucial for the development of antiretroviral therapies and vaccines to manage and prevent HIV infection and its progression to AIDS (Acquired Immunodeficiency Syndrome).
Describe the HIV life cycle.
HIV primarily targets CD4+ T lymphocytes (a type of immune cell) and macrophages.
The virus attaches to the surface of these cells via the interaction of its gp120 glycoprotein with the CD4 receptor and a co-receptor (usually CCR5 or CXCR4).
Once attached, the virus fuses with the cell membrane, allowing the viral RNA to enter the host cell.
HIV’s complex life cycle involves the reverse transcription of its RNA genome into DNA, integration into the host cell’s genome, and the production of new viral particles, which can then infect other host cells.
State the methods of HIV transmission.
- Unprotected Sexual Contact: HIV can be transmitted through vaginal, anal, or oral sex when there is direct contact with the mucous membranes or breaks in the skin.
Using latex or polyurethane condoms and dental dams correctly and consistently during sexual activity can significantly reduce the risk of transmission.
- Sharing Needles or Syringes: HIV can be spread when people share needles or syringes for injecting drugs. This is a particularly high-risk behavior.
- Mother-to-Child Transmission: HIV can be transmitted from an HIV-positive mother to her child during pregnancy, childbirth, or breastfeeding.
However, antiretroviral treatment during pregnancy and delivery, as well as avoiding breastfeeding, can significantly reduce the risk of mother-to-child transmission.
- Blood Transfusions and Organ Transplants: While the risk is extremely low in regions with rigorous screening of blood and organ donations, there have been cases of HIV transmission through transfusions and transplants from HIV-positive donors.
- Occupational Exposure: Healthcare workers can be at risk of HIV transmission through needlestick injuries or exposure to HIV-infected blood or other body fluids while providing care.
Universal precautions and post-exposure prophylaxis are used to minimize this risk.
- Sharing of Tattoo or Piercing Equipment: If equipment is not properly sterilized or if needles are reused without proper sterilization, there is a risk of HIV transmission.
- Sexual Assault: Individuals who experience sexual assault may be at risk of HIV transmission if the perpetrator is HIV-positive and there is unprotected sexual contact.
How many were PLWHA globally at the end of 2019.
How many NEW HIV infections were at the end of 2019?
How many were AIDS related deaths in 2019?
38 million PLWHA globally at the end of 2019.
SSA remains most severely affected region accounting for nearly 70% of the PLWH worldwide (UNAIDS 2020).
1.7 million new HIV infections in 2019.
> Half million (690 K) AIDS related Deaths in 2019
HIV Prevalence varies greatly between regions within SSA – worst affected -Southern African.
Which country has the highest adult HIV prevalence in the world at 25% (UNAIDS, 2020)?
Which country has the largest no. of PLWHIV in the world 7.2 million people (2020)?
HIV prevalence in West and East Africa is low - 0.5% in _____to 6% in _____.
__________came 3rd after Lesotho & Swaziland (20.7%)
*Swaziland has the highest adult HIV prevalence in the world at 25% (UNAIDS, 2020).
*South Africa hast the largest no. of PLWHIV in the world 7.2 million people (2020).
*HIV prevalence in West and East Africa is low - 0.5% in Senegal to 6% in Kenya.
*Botswana came 3rd after Lesotho & Swaziland (20.7%)
When was the 1st HIV case identified in Botswana.
When was The MASA ART programme launched?
Botswana mounted a strategic response to the HIV epidemic in three phases:
-1st phase response (1987 – 1989)
-2nd Phase (1989- 1997) –
-3rd (1997- 2002)-
– 4th (2016)
1st HIV case identified in 1985 in Botswana.
The MASA ART programme was launched in 2002.
Botswana mounted a strategic response to the HIV epidemic in three phases:
-1st phase response (1987 – 1989) – Blood screening before transfusion
-2nd Phase (1989- 1997) – IEC programme (Health facility based)- stigma arose
-3rd (1997- 2002)- Education, Prevention, Comprehensive care and provision of ART by eligibility criteria, CD4: 200 & 350(2012).
– ? 4Th Treat all (2016)
What is “Treat All” strategy?
When did Botswana adopt the “Treat All” strategy?
When did it start including non-citizens?
Botswana launched the new “treat all” Treatment guidelines that involve starting ART on every HIV positive patient despite the level of the CD4 count.
On the 1st of June 2016.
In 2019.
What is disclosure?
The word disclose means to:
Reveal, make known, Share or Make public.
In pediatrics context, disclosure means telling a child or an adolescent that he or she has HIV.
What is discrimination?
What is stigma?
Unfavorable attitudes, beliefs, and policies directed toward people.
Stigma fuels myths, misconceptions and affects choices, impacting people’s HIV education and awareness.
It is a treatment of individual or group with partiality or prejudice.
What is the difference between stigmatization and discrimination?
Stigmatization reflects to an attitude while discrimination is the behavior aligned with the attitude or perception of something.
State the 3 main types of stigma.
- Self-Stigma (Internalized Stigma):
Self-stigma refers to the internalized negative beliefs, attitudes, and feelings that individuals may develop about themselves based on societal or cultural stigmatization.
It occurs when individuals with a particular condition or identity begin to believe and internalize the negative stereotypes and discrimination they face, leading to feelings of shame, self-blame, and reduced self-esteem.
For example, someone with a mental health condition may start to believe that they are “less than” others due to societal stigma, resulting in self-stigma.
- Perceived Stigma (Public Stigma):
Perceived stigma is the awareness of the negative attitudes, stereotypes, and discrimination held by others in society or a specific community.
Individuals who perceive stigma may anticipate that they will be treated unfairly or face bias because of their condition or identity.
This perception of stigma can lead to various emotional and behavioral responses, such as fear of disclosure, social withdrawal, and reluctance to seek help or support.
- Structural Stigma (Institutional or Systemic Stigma):
Structural stigma, also known as institutional or systemic stigma, involves the discrimination and bias that are embedded within societal structures, institutions, and policies.
This type of stigma is not limited to individual attitudes but is perpetuated by laws, regulations, and practices that lead to unequal access to opportunities, resources, and services for stigmatized groups.
Structural stigma often perpetuates and reinforces public and self-stigma by creating an environment where discrimination is entrenched and accepted at a societal level.
Why is counselling needed in people living with HIV and AIDS?
Give 4 reasons.
-To assist the client to understand and manage their present situation more effectively.
-To empower the client to cope better with the illness and develop a positive attitude towards life.
-To empower patients to manage their future problems more effectively.
-To motivate clients to adhere to their medications.
