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HIV-AIDS
 

HIV-AIDS

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Read my Blog: http://iambetterthanthebest.blogspot.com

Read my Blog: http://iambetterthanthebest.blogspot.com
AIDS - Prevention is the only cure....

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    HIV-AIDS HIV-AIDS Presentation Transcript

    • HIV/AIDS North Dakota Department of Health HIV/AIDS Program
      • H Human
      • I Immunodeficiency
      • V Virus
      • A Acquired
      • I Immuno
      • D Deficiency
      • S Syndrome
    • HIV Transmission
      • HIV enters the bloodstream through:
        • Open Cuts
        • Breaks in the skin
        • Mucous membranes
        • Direct injection
    • HIV Transmission
      • Common fluids that are a means of transmission:
        • Blood
        • Semen
        • Vaginal Secretions
        • Breast Milk
    • HIV in Body Fluids Semen 11,000 Vaginal Fluid 7,000 Blood 18,000 Amniotic Fluid 4,000 Saliva 1 Average number of HIV particles in 1 ml of these body fluids
    • Routes of Transmission of HIV
      • Sexual Contact: Male-to-male
      • Male-to-female or vice versa
      • Female-to-female
      • Blood Exposure: Injecting drug use/needle sharing
      • Occupational exposure
      • Transfusion of blood products
      • Perinatal: Transmission from mom to baby
      • Breastfeeding
    • HIV-Infected T-Cell HIV Virus T-Cell HIV Infected T-Cell New HIV Virus
    • Window Period
      • This is the period of time after becoming infected when an HIV test is negative
      • 90 percent of cases test positive within three months of exposure
      • 10 percent of cases test positive within three to six months of exposure
    • HIV Infection and Antibody Response Infection Occurs AIDS Symptoms ---Initial Stage---- ---------------Intermediate or Latent Stage-------------- ---Illness Stage--- Flu-like Symptoms Or No Symptoms Symptom-free < ---- ----
    • Importance of Early Testing and Diagnosis
      • Allows for early treatment to maintain and stabilize the immune system response
      • Decreases risk of HIV transmission from mother to newborn baby
      • Allows for risk reduction education to reduce or eliminate high-risk behavior
    • HIV Testing
      • Requires a blood or oral fluid sample
      • HIV test detects the body’s antibody response to HIV infection
      • The test does NOT detect the HIV virus
    • HIV Testing in North Dakota
      • Confidential vs. anonymous testing
      • Testing offered free-of-charge at state-funded HIV test sites for those at risk
      • Test results are available within a week
      • For a list of HIV test sites in North Dakota call 1.800.70.ndhiv or visit www.ndhiv.com
    • HIV Testing
      • Those recently exposed should be retested at least six months after their last exposure
      • Screening test (EIA/ELISA) vs. confirmatory test (IFA)
      • EIA/ELISA (Reactive)
        • Repeat EIA/ELISA (Reactive)
        • IFA (Reactive)
        • Positive for HIV
    • EIA/ELISA Test Positive Negative Run IFA Confirmation Repeat Positive Positive End Testing Repeat ELISA Every 3 months for 1 year Negative Positive Negative Indeterminate Repeat at 2-4 months Repeat at 3 weeks HIV Testing No HIV Exposure Low Risk HIV Exposure High Risk Negative HIV + Repeat every 6 months for continued High risk behavior
    • North Dakota Law for HIV Testing
      • Requires informed consent
      • No premarital testing requirement
      • Prenatal testing not required but recommended
      • School notification not required for positive staff or students (universal precautions)
    • North Dakota Law for HIV Testing (cont.)
      • Allows testing of individuals:
        • 14 years of age or older without parental consent
        • Mandatory testing for prison inmates in grade 1, grade 2, regional facilities, and the state penitentiary as defined in NDCC:23-07-07.5
        • Court ordered testing for defendants charged with a sex offense as defined in NDCC: 23-07.7-01
      • Once a person is infected they are always infected
      • Medications are available to prolong life but they do not cure the disease
      • Those who are infected are capable of infecting others without having symptoms or knowing of the infection
      HIV AIDS
    • HIV Risk Reduction
      • Avoid unprotected sexual contact
      • Use barriers such as condoms and dental dams
      • Limit multiple partners by maintaining a long-term relationship with one person
      • Talk to your partner about being tested before you begin a sexual relationship
    • HIV Risk Reduction
      • Avoid drug and alcohol use to maintain good judgment
      • Don’t share needles used by others for:
          • Drugs
        • Tattoos
        • Body piercing
      • Avoid exposure to blood products
    • Condoms
      • Using condoms is not 100 percent effective in preventing transmission of sexually transmitted infections including HIV
      • Condoms = Safer sex
      • Condoms ≠ Safe sex
    • Condom Use
      • Should be used consistently and correctly
      • Should be either latex or polyurethane
      • Should be discussed with your partner before the sexual act begins
      • Should be the responsibility of both partners for the protection of both partners
      • Male and female condoms are available
    • People Infected with HIV
      • Can look healthy
      • Can be unaware of their infection
      • Can live long productive lives when their HIV infection is managed
      • Can infect people when they engage in high-risk behavior
    • HIV Exposure and Infection
      • Some people have had multiple exposures without becoming infected
      • Some people have been exposed one time and become infected
      • “ When you have sex with someone, you are having sex with everyone they have had sex with for the last ten years.”
          • Former Surgeon General
      • C. Everett Koop
    • HIV and Sexually Transmitted Diseases
    • HIV and Sexually Transmitted Diseases
      • STDs increase infectivity of HIV
        • A person co-infected with an STD and HIV may be more likely to transmit HIV due to an increase in HIV viral shedding
        • More white blood cells, some carrying HIV, may be present in the mucosa of the genital area due to a sexually transmitted infection
    • HIV and Sexually Transmitted Diseases
      • STDs increase the susceptibility to HIV
        • Ulcerative and inflammatory STDs compromise the mucosal or cutaneous surfaces of the genital tract that normally act as a barrier against HIV
        • Ulcerative STDs include: syphilis, chancroid, and genital herpes
        • Inflammatory STDs include: chlamydia, gonorrhea, and trichomoniasis
    • HIV and Sexually Transmitted Diseases
      • The effect of HIV infection on the immune system increases the the risk of STDs
        • A suppressed immune response due to HIV can:
          • I ncrease the reactivation of genital ulcers
          • Increase the rate of abnormal cell growth
          • Increase the difficulty in curing reactivated or newly acquired genital ulcers
          • Increase the risk of becoming infected with additional STDs
    • HIV Post Exposure Prophylaxis
    • HIV Occupational Exposure
      • Review facility policy and report the incident
      • Medical follow-up is necessary to determine the exposure risk and course of treatment
      • Baseline and follow-up HIV testing
      • Four week course of medication initiated one to two hours after exposure
      • Liver function tests to monitor medication tolerance
      • Exposure precautions practiced
    • HIV Non-Occupational Exposure
      • No data exists on the efficacy of antiretroviral medication after non-occupational exposures
      • The health care provider and patient may decide to use antiretroviral therapy after weighing the risks and benefits
      • Antiretrovirals should not be used for those with low-risk transmissions or exposures occurring more than 72 hours after exposure
      PREVENTION --- FIRST
    • HIV Non-Occupational Exposure
      • Provider Considerations:
        • Evaluate HIV status of patient and risk history of source patient
        • Provide necessary medical care and counseling
        • Evaluate risk event and factors for exposure
        • Determine elapsed time from exposure
        • Evaluate potential for continuous HIV exposure
        • Obtain informed consent for testing and treatment
        • Evaluate pregnancy status of females
        • Monitor for drug toxicity and acute infection