April 23 2012 handout 2 of 2 spectrum of hiv disease
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April 23, 2012 Handout 2 of 2 Spectrum of HIV Disease PowerPoint PPT Presentation


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April 23, 2012 Handout 2 of 2 Spectrum of HIV Disease. ACUTE STAGE Flu like symptoms – 1 to 2 weeks ASYMPTOMATIC PERIOD No physical symptoms – 8 to 11 years HIV ILLNESS Night sweats, fatigue, diarrhea, fever, yeast infections, swollen lymph nodes AIDS

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April 23, 2012 Handout 2 of 2 Spectrum of HIV Disease

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April 23 2012 handout 2 of 2 spectrum of hiv disease

April 23, 2012Handout 2 of 2Spectrum of HIV Disease

ACUTE STAGE

Flu like symptoms – 1 to 2 weeks

ASYMPTOMATIC PERIOD

No physical symptoms – 8 to 11 years

HIV ILLNESS

Night sweats, fatigue, diarrhea, fever, yeast infections, swollen lymph nodes

AIDS

Opportunistic Infections, CD4<200

1


Hiv test

HIV TEST

HIV Antibody test

Looks for antibodies

Accuracy of the test

99.9%

Types of tests

Standard test – results will be known in 1 week

Rapid test – results will be known in 20 minutes

Test settings

Anonymous

Confidential

2


Hiv diagnosis testing

HIV Diagnosis (Testing)

Antibody tests

EIA (or ELISA)

Western Blot

Rapid Tests

OraQuick Advance *

Unigold *

Clearview Stat Pak & Stat Pak Complete *

* These tests are “waived” under CLIA


Hiv diagnosis testing1

HIV Diagnosis (Testing)

Other tests

p24 antigen test

Viral load tests

Proviral DNA

PCR RNA

Home kits


Hiv test1

HIV TEST

Informed Consent

12 yrs of age or older

Benefits of Testing……..

Where to test?

Private medical doctor

County clinic

Community-based organizations

www.hivla.org

5


California s willful exposure law 1998 aka recalcitrant behavior

California’s “Willful Exposure” Law (1998)/aka “Recalcitrant Behavior”:

Willfully exposing another to HIV through unprotected sex

  • 8 years of imprisonment

  • Intention to infect others with HIV through sex

    To be prosecuted under the law, one would have to do ALL of the following:

  • Have anal or vaginal sex

  • Know that they are HIV +

  • Fail to disclose their HIV status

  • Fail to use a condom

  • Have a specific intent to infect another person

    Actual knowledge of HIV infection without more evidence of “specific intent” is insufficient for prosecution.

6


Confidentiality laws

CONFIDENTIALITY LAWS

  • Disclosing a person’s HIV+ status to a third party without the individual’s specific signed consent, is illegal;

  • Penalties and damages for unauthorized disclosure of HIV status is a $5,000-$10,000 fine and/or jail sentence.

7


Federal anti discrimination laws

FEDERAL ANTI-DISCRIMINATION LAWS

Rehabilitation Act of 1973 and American with Disabilities Act (ADA) 1990

Prohibits discrimination against a person with a disability, including HIV disease or AIDS. infection. infection.

This prohibits discrimination with regards to employment, public services, public accommodations, and medical care.

Housing Discrimination

Care Discrimination

A doctor or dentist cannot refuse to treat an HIV+ person

California Anti-Discrimination Laws

Fair Employment and Housing Act (FEHA) and Unruh Civil Rights Act

8


Prevention

PREVENTION

“It is not who we are but what we do that puts us at risk for HIV infection”

  • Abstinence

  • Safer Sex

    Male Condom (Activity)

    Female Condom

    Dental Dams

  • Needle use

    Not Sharing Needles

    Cleaning Needles (3x3x3 Method)

    Needle Exchange

  • Harm reduction

9


Prevention1

PREVENTION

Universal Precautions

“Infection control measures that reduce the risk of transmission of blood-born germs from patients to health care workers”

  • Wash hands thoroughly

  • Wear latex gloves

  • Use masks and eye protection

  • Wear a gown

  • Carefully handling and disposing of sharp instruments during and after use.

10


Prevention2

PREVENTION

POST–EXPOSURE PROPHYLAXIS (PEP)

Exposure to HIV within the prior 72 hours

Approve for 13 yrs of age or older

For more information call 213-351-7699

PRE-EXPOSURE PROPHYLAXIS (PREP)

It refers to anti-HIV medication used daily or before

sexual encounters

Start prior to potential exposure

Prep should never be seen as the first line of defense against HIV

BREAST FEEDING

It is recommended that HIV+ women do not breastfeed

Infants.

11


Treatment

TREATMENT

Goals of HIV/AIDS treatment;

  • Reduce HIV-related morbidity and prolong survival,

  • Improve quality of life,

  • Restore the immune system,

  • Suppress the viral load, and

  • Prevent vertical HIV transmission (mother to child).

12


Treatment1

TREATMENT

  • What are Anti-retrovirals (ARVs) ?

    Drugs that interrupt HIV replication & preserve immune system.

  • When to start ARVs?:

  • There are severe symptoms of HIV infection or

    diagnosis of AIDS with a CD4 count of < 350 cells/mm3

  • Patient has CD4 count less than 500 /mm3

  • Recommended for pregnant women who otherwise do not meet criteria to halt vertical transmission

  • Regardless of CD4 count, treatment is recommended for all pregnant patients, and patients with HIV-associated nephropathy (a kidney disorder) or those who need treatment for hepatitis B.

  • Treatment is considered optional for patients with CD4 counts over 500.

13


Current classes of anti hiv medications

Current classes of Anti-HIV medications

  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

  • Non-Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

  • Protease Inhibitors

  • Entry inhibitors

  • Fusion inhibitors

  • Integrase inhibitors

14


Who pays for treatment

Who Pays For Treatment?

  • HMO insurance

  • Medi-Cal

  • Medicare Part D

  • ADAP

  • Shared cost

15


Recent advancements

Recent Advancements

  • Immune based therapies

  • Maturation inhibitors

  • Multi-class Combination Products

  • Gene Therapy

  • Vaccine

16


Treatment as prevention

Treatment as Prevention

  • Science Magazine named 'HIV Treatment as Prevention' as the breakthrough of 2011

  • The HIV Prevention Trials Network (HPTN)

    052 study of 1,700 sero-discordant couples reported that ARVs reduced the risk of heterosexual transmission by 96%.

17


Complementary therapy

Complementary Therapy

  • General Health Maintenance

  • Psychological Well-Being

  • Spiritual Well-Being

  • Social Well-Being

18


For more information contact

For More Information Contact

  • Jason Dawson, MPH

    [email protected]

    213-351-8043


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