Because there is no cure or magic bullet presently available to destroy HIV/AIDS, knowlege and preventive/risk reduction behavioral practices remain our greatest weapons against its continued global spread.

 

HIV and AIDS

   What is HIV?

• HIV stands for Human Immunodeficiency Virus.

• Human  - refers to who is infected.

• Immunodeficiency – refers to the body system effected, immune system, and how it is negatively effected.

• Virus – refers to what type of pathogen causes the infection

    What is AIDS?

• AIDS stands for Acquired Immune Deficiency Syndrome. It is the most advanced stage of HIV infection.

• Acquired – refers to the reality that there are specific ways in which an individual can “get” the virus. Except for the unborn, something must be done, some activity must be engaged in for the virus to enter the body. This is an empowering reality. It lets us know that just as one must do something, engage in some type of behavior, for the virus to enter the body, one can also choose to do something, engage in behaviors that prevent or reduce the opportunity for HIV to enter their body.

• Immune - refers to the effected body system, the immune system. The immune system is responsible for protecting the body against foreign bodies such as bacteria, protozoa, fungi, and viruses that cause infections, illness and disease.

• Deficiency – refers to the virus’ effect on the immune system. HIV attacks the immune systems healthy fighter cells (white blood cells also called CD4, T4 or T-helper cells), rendering them useless and in the process takes them over to replicate itself. Overtime the immune system is overwhelmed, resulting in the body having more HIV antibodies than CD4 cells. This reduces the body’s ability to fight off infections, illness, disease and neurological problems. It is the body’s inability to protect itself against opportunistic infections that ultimate lead to death.

• Syndrome – a collection of symptoms, illnesses, diseases or infections

       AIDS Definition - A change from a diagnosis of HIV positive

       to AIDS is given when an HIV infected individual has

• a CD4 count < 200, or
• 1 CDC AIDS case defined Opportunistic Iinfection, or
• 3 non-defined CDC AIDs case OIs

 

                            HIV Progression to AIDS Continum

Progression of HIV Infection

The progression of HIV varies from person to person  and depends several factors, including the idividual's health status and health-related behaviors

Point of Infection - HIV antibodies can not be detected however the virus can be transmitted; disease most readily spread during this period; typically last weeks to 3 months

Window Period - the time frame from point of infection to the development of  detectable  antibodies (seroconversion); typically last weeks to 3 months.

Immune System Decline - asymptomatic phase of HIV infection

AIDS - Results from a compromised immune system in an HIV infected individual; a  state of health in which the immune system is no longer able to fight off various illnesses and other health conditions that it once could. In effect, as HIV destroys CD4 cells the immune system begins to weaken and the viral load increases,overtime making HIV positive individuals more susceptabile to illnesses and dissease that otherwise would not have been a problem for the body to fight off.

HIV LIFE CYCLE

          How does HIV multiply in the body?

For HIV to thrive in the body it must reproduce itself. Over time as it replicates itself the immune system's CD 4 count decreases reulting in a weaken immune system.

• HIV Replication
• HIVLife Cycle  Fact Sheet/Diagram

          HIV Replication and Therapy  Animations

The purpose of HIV therapy is to interuppt the virus' replication process so that it does not reproduce itself. See Treatment

• HIV Life Cycle Video Clip
• Targeting HIV Replication

 

TREATMENT       

         Can HIV/AIDS be treated?

While there is no cure for HIV/AIDS there is therapy, antirectroal virals (ARV). They function to slow down the weakening of the immune system by interfering with HIV replication within the body.

Effective therapy strives to:

• Reduce viral load as much as possible for as long as possible.
• Restore or preserve the immune system.
• Improve the patient's quality of life.
• Reduce sickness and death due to HIV infection .

HIV medications fall into 4 classes with each effecting the HIV replication process differently. Each class of drugs has both risks and benefits. ARV drug classes are:

• Nucleoside/Nucleotide Reverse Transcription Inhibitors
• Non-Nuceoside Reverse Transcription Inhibitors
• Protease Inhibitors
• Fusion Inhibitors

       2006 ARV Guidelines

 

TRANSMISSION 

          How is HIV transmitted?

HIV is transmitted through behaviors/activities with an HIV infected person that allow for an exchange of certain body fluids. These fluids are:

• Blood
• Semen, including pre-seminal fluid (pre-cum)
• Vaginal Secretions
• Breast Milk

Of the four listed fluids, blood and semen have the highest concentrations of HIV.

 

ACTVITIES THAT PLACES ONE AT RISK OF HIV INFECTION:

          Are there any specific activities that place you at risk   

          of  becoming HIV infected?

I t is most important to keep in mind that it's not who you are but what you do that places you at risk of becoming HIV infected. Any activity becomes risky where there is an opportunity for the exchange of body fluids. Therefore, the question one must ask before engaging in a particular activity is, "If I do this, is there a possiblity that there will be an exchange of body fluid(s) - blood, semen, vaginal secretions, breast milk?" If the answer is yes, that activity is risky and risk reduction strategies should be utilized..

Activities place one at riskof HIV exposure fall into three primary categories:

    

1. Unprotected Sexual Contact With an HIV Infected Person

• This includes same sex and heterosexual activity
• With respect to vaginal sex, there is a greater risk of transmission from  male to female than female to male
• Anal Sex - risker for the receptive partner

2. Vertical Transmission (mother to child transmission)

     HIV antibodies pass from HIV infected mother to child

• In utero
• During birthing process
• Through breastfeeding

3. Sharing Needles/Syringes/Injection Equipment- IDU

• This includes occupational exposure to sharps

HOW IS HIV NOT TRANSMITTED?

      HIV is not spread through casual contact , such as

• Huggging
• Shaking hands
• Touching objects an HIV positive person has touched
• Sleeping in the same bed (no sexual activity)
• Eating from the same dish
• Sitting next to a HIV positive person

 

PREVENTION & HARM REDUCTION: 

         Is there anything a person can do to reduce their risk               of HIV infection or re-infection?

There are steps an individal can take to prevent or reduce their risk of becoming HIV infected; or in the case of an HIV positive person to prevent or reduce their risk of transmitting the virus to another. These include:

Sexual Activity

• Abstinence/celibacy
• Mutually monogomous realtionship between two uninfected partners
• Use of latex/polyurethane dental dams, male and female condoms.

                 Male and Female Condom Use

                 CDC Statement on Nonoxynol-9 Spermicide

                 CDC Statement on Nonoxynol-9 Study Results              

• No sharing of sex toys without disinfection

Center fof Disease Control and Prevention Protocol "The ABCs of Smart Behavior" to avoid or reduce the risk of HIV                   A - abstinence                   B - be faithful; mutullay monogomous relationship, or                   C - condom use consistently and correctly

       

Vertical Transmission (Mother to Child)

• Seek medical care from OB/GYN perferrably before becoming infected
• If mother to be is HIV positive under OB/GYN care begin therapy
• Do not breastfeed if HIV positive

Sharing Needles/Syringes/Injection Equipment- IDU

• Seek drug treatment to discontinue use
• No sharing of works
• Clean works
• Change drug of choice to non injecting drug

     Occupational Exposure

• Use of universal precautions

TESTING   

     How do you know if you're HIV infected?

The only way to know if you are infected with HIV is to be tested. for the presence of HIV antibodies.

     HIV Antibody Testing

• Elisa -The traditional blood test; usually performed in a clinic, doctor’s office, or other testing site; involves a needle drawing blood from a vein which is tested in a lab; results are available within a few days - 2 weeks, depending on where the blood was sent to be tested

• Rapid Tests - use either oral mucosa tissue cells or blood to detect HIV antibodies; results are available within 20 minutes. If positive,  test is sent to a lab for a Western blot confirmation.

• Home Testing Kits - specimen collected in privacy of home; kit is mailed to a central laboratory. results,  individual calls a 1-800 number and  for a recorded message or a live counselor.

 

ADDITIONAL INFORMATION ON HIV/AIDS

         CDC Fact Sheet

         Common HIV/AIDS Questions and Answers