HIV 101: The Basics Trainers: Sonia Rastogi & Jane Dalugdugan Immune System HIV Disease HIV Transmission HIV Prevention Overview 1
The Immune System Protects the body from infectious agents Keeps critters (germs, viruses, bacteria) out Attacks and fights critters that get inside Parts of the immune system include: Skin Lymph nodes White blood cells Bone marrow Tonsils Thymus Factors that affect Immune System Stress Lifestyle Factors (e.g.: addiction, sleeping habits, exercising, etc ) Nutrition Other infections and sexually transmitted diseases 2
CD4+ Cells Also known as: T-cells, Helper T-cells Lieutenants of the immune system Direct other white blood cells to fight off infection CD4+ Cell Count Generally, the higher the count, the stronger the immune system Healthy range is 500-1,500 cells/cubic mm Less than 200/cu.mm person is considered immune compromised and is at increased risk for serious infections and death HIV Disease HIV = Human Immunodeficiency Virus Causes a weakening of the immune system Primarily infects CD4+ cells and uses the cells machinery to replicate Eventually, destroys the CD4+ cell and our bodies lose the ability to fight infection E.g.: Our army has lost its lieutenant! AIDS = Acquired Immune Deficiency Syndrome Advanced stage of HIV disease Must be diagnosed by a medical provider Not everyone with HIV has AIDS 3
HIV Testing and Detection HIV Antibody Test Detects the presence of antibodies to HIV Viral Load Testing Measures amount of free-floating HIV in the blood Also called PCR, bdna, or Q-PCR Higher the number, greater risk of disease progression Low = less than10,000 copies; High = more than 100,000 copies Undetectable = amount of virus is too low to be detected by the testing method Acute HIV Infection Estimate up to 90% people experience symptoms in the first 1-4 weeks after infection Early symptoms are flu-like Loss of appetite Sweating Sore throat Swollen lymph nodes Fever Sore muscles Fatigue 4
Spectrum of HIV Disease Source: www.thebody.com Seroconversion & Acute Infection 140 120 100 80 60 HIV viral load CD4 count 40 20 0 0 0.5 1 1.5 2 2.5 3 5
Common Symptoms Can occur at any time during course of HIV infection: Diarrhea Weight Loss Fever Fatigue Anemia Common Opportunistic Infections Thrush (Oral Candidiasis) Pneumocystis Pneumonia (PCP) Tuberculosis Kaposi s Sarcoma Shingles Yeast Infections (women) HPV/Cervical dysplasia (women) 6
HIV Transmission Four bodily fluids Blood Semen (including pre-cum) Vaginal fluids Breast milk NOT transmitted through: Saliva, sweat, tears, urine, feces Most infectious Least infectious HIV Risk Behaviors Unprotected Sex Anal, vaginal, oral Receptive partner is at greater risk, but insertive partner is also at risk Injection Drug Use/Sharing Needles Through the blood the remains in syringes Includes cookers, cotton, other drug paraphernalia Blood can remain in water used for mixing drugs Includes needle sharing for injection of steroids, hormones, etc 7
HIV Risk Behaviors Drug/Alcohol Use Including non-injection drugs Increases the likelihood of engaging in risky behaviors that lead to HIV transmission Impairs judgment Mother-to-Child (Vertical Transmission) During pregnancy (in utero) During birth process (most common) Breast feeding Behaviors that are NOT risky Casual contact (shaking hands, hugging) Toilet seats Sharing eating utensils or drinking glasses Food/objects handled by an HIV+ person Sharing common space with an HIV+ person Donating blood Mosquito/insect bites 8
HIV Prevention Sexual Transmission Using barriers during EVERY sexual act Proper lube (without Non-oxynol-9) Reduces the chance of tissue tearing Open communication between partners Transmission through needles Do not share needles/drug equipment Needle exchange! Use clean needles HIV Prevention Mother-to-Child Transmission Good pre-natal care AZT during pregnancy Cesarean-section, instead of natural birth Bottle-feeding, or HIV- breast milk donor 9
Transmission is NOT reduced by Hormonal birth control methods without latex/polyurethane condoms Spermicideswithout latex/polyurethane condoms Emergency Contraception or the morning after pill Non-latex/non-polyurethane condoms (i.e. lamb skin) Harm Reduction Reduces risk of HIV infection, but won t eliminate it: Barrier or barrier/spermicide combination without latex/polyurethane condoms Using condoms only some of the time Withdrawal method 10
Harm Reduction Definition: meeting clients where they are at to reduce risk Example: Client: I never use condoms because my partner does not like them and they are uncomfortable for me. Harm reduction solutions: pulling out, using more lube, trying different types of condoms to see if there are certain brands/types that work better than others HIV Treatment Anti-retroviral therapy (ART) Different classes of drugs Act to stop the virus from reproducing (viral loads stay low) Complementary therapies Overall health maintenance (e.g.: exercising, eating well) Positive social support Spiritual support 11
Questions 12