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MNGN 3680 Introduction to Fundamentals of HIV, Part I. UNAM Faculty HIV Orientation Workshop January & February, 2010. Objectives. Identify epidemiological trends of HIV infection around the world and in Namibia Explain how HIV is transmitted Identify methods for HIV testing

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mngn 3680 introduction to fundamentals of hiv part i

MNGN 3680Introduction to Fundamentals of HIV, Part I

UNAM Faculty HIV Orientation Workshop

January & February, 2010

objectives
Objectives
  • Identify epidemiological trends of HIV infection around the world and in Namibia
  • Explain how HIV is transmitted
  • Identify methods for HIV testing
  • Recognize common misunderstandings and myths about HIV
  • Identify global milestones in the history of the HIV pandemic
adults and children estimated to be living with hiv aids end 2005
Adults and Children Estimated to be Living with HIV/AIDS, end 2005

38.6 million people [33.4‒46.0 million] living with HIV, 2005

http:http://www.unaids.org/en/HIV_data/Epidemiology/epi_slides.asp

2.4

slide6

Impact of AIDS on life expectancy in five African countries, 1970–2010

70

65

60

Botswana

55

South Africa

Life

expectancy

at birth

(years)

50

45

Swaziland

40

35

Zambia

30

Zimbabwe

25

20

1970–1975

1980–1985

1990–1995

2000–2005

1975–1980

1985–1990

1995–2000

2005–2010

Source: United Nations Population Division (2004). World Population Prospects: The 2004 Revision, database.

4.1

why does africa have such a large number of people living with hiv aids
Why does Africa have such a large number of people living with HIV/AIDS?

With Permission, Jeanne Raisler. Durban AIDS Conference, 2001

why does africa have such a large number of people living with hiv aids1
Why does Africa have such a large number of people living with HIV/AIDS?
  • Migration, transport, and sexual networking
    • Back and forth migration between rural areas and cities
    • Work-related, mining industries,,shipping and trucking
    • War, refugees
  • Poverty
    • Lack of access to prevention information
    • Economic vulnerability and low status of women reduces opportunities to negotiate safer sex
  • Delayed national and international response
    • Lack of timely change of societal norms
  • Biologic factors
    • High prevalence of ulcerative STIs including HSV
  • Social behaviour and cultural practices (similar to other continent settings)
    • Unwillingness to use condoms
    • Inability to negotiate condom use
    • Multiple sexual partners
  • Other unknown factors
hiv sentinel surveys in namibia
HIV Sentinel Surveys in Namibia
  • Special surveys done according to WHO standard methodology
  • Provide estimate of number of cases within Namibia
  • Performed every 2 years
  • Anonymous blood testing done on women between ages of 15-49 years attending antenatal clinics
hiv prevalence rate in pregnant women biannual surveys 1992 2004 namibia
HIV Prevalence Rate in Pregnant Women, Biannual Surveys 1992-2004, Namibia

Report of the 2004 National HIV Sentinel Survey, Republic of Namibia Ministry of Health and Social Services, page 10.

hiv prevalence in namibia among anc attendees by site 2004
HIV Prevalence in Namibia among ANC attendees by site (2004)

Report of the 2004 National HIV Sentinel Survey, Republic of Namibia Ministry of Health and Social Services, page 7.

what is the impact of hiv aids on namibia1
What is the impact of HIV/AIDS on Namibia?
  • Effect on Population
    • Shortened life expectancy
    • Population decrease
  • Increased Number of Orphans
    • Loss of one or both parents
    • Children removed from school
  • Effects on Workforce
    • Loss of workforce, including skilled workers, e.g. teachers, healthcare professionals
    • Decreased food production on family farms
    • Healthcare workers overwhelmed by number of HIV cases; decreased morale
slide15

Projected reduction in African agricultural labour force

due to HIV and AIDS by 2020

Namibia

Botswana

Zimbabwe

Mozambique

South Africa

Kenya

Malawi

Uganda

UR Tanzania

Central African Republic

2020

2000

Côte d’Ivoire

Cameroon

0

Projected labor force loss (%) by year

5

10

15

20

25

30

Sources: ILO (2004). HIV/AIDS and work: global estimates, impact and responses

4.8

how is hiv transmitted
How is HIV Transmitted?
  • Contact with infected blood or body fluids, e.g. blood transfusion
  • Unprotected sexual contact with an infected partner
    • Through infected vaginal secretions, semen
    • May be transmitted via oral, vaginal or anal intercourse
    • Major route of transmission worldwide
  • Sharing needles
  • From a mother to baby during pregnancy, delivery or breastfeeding
hiv testing
HIV Testing
  • Health care providers may look at patients and try to guess if they have HIV infection
  • Only way to identify if an individual is positive is through Voluntary Counseling and Testing for HIV (VCT)
  • Blood tests that detect HIV antibodies are the most commonly used HIV test
    • Antibody tests include: Rapid tests, ELISA
    • Can also detect virus directly with PCR technology, but more expensive and not widely available
interpreting antibody test results
Interpreting Antibody Test Results
  • What does a Positive test mean?
    • Antibodies for HIV were found in the blood, meaning that the person is infected with HIV
    • ELISA = Highly sensitive test
    • Rare occasion to get a false positive HIV test
  • What does a Negative test mean?
    • That HIV test is actually negative
    • OR the person may be in a “window period” of HIV infection
window period
Window Period
  • Time from initial infection with HIV until antibodies are detected by a test
  • Can take anywhere from 2-12 weeks before HIV antibodies are produced in the blood
  • During this window period, patients can test as false negatives for HIV
  • Can still pass the virus to others during this period
  • For this reason it is very important to counsel all HIV negative patients, especially at high risk for HIV infection, to return to the clinic for repeat HIV testing
slide22

Activity: What do you know about HIV?

1.) STI’s, including HIV, are generally more easily transmitted from men to women than from women to men

2.) One can generally identify a person with HIV infection by

looking at him or her

3.) A person can get HIV infection from French or tongue

kissing

4.) Once a patient starts ARV treatment, she or he can no

longer transmit HIV infection to others

5.) If a woman is HIV-infected then it means the partner is HIV-infected

dispelling myths about hiv
Dispelling Myths About HIV
  • HIV cannot be transmitted:
    • By casual contact, e.g. shaking hands
    • Eating at the same table as someone with HIV
    • Hugging
    • Through toilet seats
    • Insect bites
slide24

25 years of AIDS

People

living

with HIV

50

1 First cases of unusual immune deficiency are identified among gay men in USA, and a new deadly disease noticed

9 In 1991-1993, HIV prevalence in young pregnant women in Uganda and in young men in Thailand begins to decrease, the first major downturns in the epidemic in developing countries

45

Million

2 Acquired Immune Deficiency Syndrome (AIDS) is defined for the first time

40

3 The Human Immune Deficiency Virus (HIV) is identified as the cause of AIDS

10 Highly Active Antiretroviral Treatment launched

35

4 In Africa, a heterosexual AIDS epidemic is revealed

11 Scientists develop the first treatment regimen to reduce mother-to-child transmission of HIV

5 The first HIV antibody test becomes available

30

6 Global Network of People living with HIV/AIDS (GNP+) (then International Steering Committee of People Living with HIV/AIDS) founded

11

Children

orphaned

by AIDS in

sub-Saharan

Africa

12 UNAIDS is created

25

13 Brazil becomes the first developing country to provide antiretroviral therapy through its public health system

7 The World Health Organisation launches the Global Programme on AIDS

20

8 The first therapy for AIDS – zidovudine, or AZT -- is approved for use in the USA

14 The UN General Assembly Special Session on HIV/AIDS. Global Fund to fight AIDS, Tuberculosis and Malaria launched

15

12

10

15 WHO and UNAIDS launch the "3 x 5" initiative with the goal of reaching 3 million people in developing world with ART by 2005

5

9

1

2

4

6

8

5

13

14

15

16

7

10

3

16 Global Coalition on Women and AIDS launched

0

2005

1980

1985

1990

1995

2000

1.1

key points
Key Points
  • HIV & AIDS is a global crisis
  • Namibia has been significantly impacted with a high HIV prevalence rate
  • HIV can be transmitted via infected blood or bodily fluids, sexual contact, contaminated needles, from mother to infant during pregnancy, labour or breastfeeding
  • The most common form of HIV testing in Namibia is antibody testing
  • Though many important strides have been made around the world to combat HIV, numbers of those becoming infected and numbers of children becoming orphans continue to rise. HIV prevention is still a key priority for the world
ad