Basic information about AIDS, HIV infection and how to manage it. it will be good for basic learners to improve fundamental knowledge about HIV infection.

1. Managing HIV Infection in Work Place
Dr. Anil Sharma, PhD(N)
Principal, Manikaka
Topawala Institute of
Nursing-CHARUSAT,
Changa
Accredited Grade “A” with
NAAC & KCG

2. Objectives
To understand meaning of AIDS
To illustrate the prognosis of AIDS
To describe meaning of pre-exposure prophylaxis
To explain post-exposure prophylaxis
To understand barrier nursing
To illustrate challenges for nurses role
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

3. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

4. Introduction of AIDS
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
What is HIV
•Human: Infecting human
beings
•Immunodeficiency: Decrease
or weakness in the body’s
ability to fight off infections
and illnesses
•Virus: A pathogen having the
ability to replicate only inside a
living cell
What is AIDS
.Acquired: To come into
possession of something new
.Immune Deficiency:
Decrease or weakness in the
body’s ability to fight off
infections and illnesses
.Syndrome: A group of signs
and symptoms that occur
together and characterize a
particular abnormality

5. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

6. Basic Term
Antigen: A substance which is
recognized as foreign by the immune
system. Antigens can be part of an
organism or virus, e.g., envelope, core
(p24) and triggers antibody
production.
Antibody: A protein
(immunoglobulin) made by the
body’s immune system to recognize
and attack foreign substances
Disease Progression
• Severity of illness is determined by amount of virus
in the body (increasing viral load) and the degree of
immune suppression (decreasing CD4+ counts)
• As the CD4 count declines, the immune function
decreases.
Window Period
• Time from initial infection
with HIV until antibodies
are detected by a single test
• Usually 3-8 weeks before
antibodies are detected
• May test false-negative for
HIV antibodies during this
time period
• Can still pass the virus to
others during this period

7. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Difference Between HIV and
AIDS
• HIV is a virus and AIDS is
disease
• HIV develops into AIDS
• AIDS is deficiency in the
body’s defense mechanism or
immune system
• AIDS is acquired not
hereditary
How does HIV make a
person Sick?
• Immune suppression
leads to opportunistic
infections
• Direct infection of major
organs
 Brain (HIV
encephalopathy)
 Kidney (HIV
nephropathy)
 Heart (HIV
cardiomyopathy)

8. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

9. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
HIV Transfer
HIV “NOT” transfer by
• Coughing and sneezing
• Insect bites
• Touching , hugging
• Water, food
• Kissing
• Public baths
• Handshakes
• Work or school contact
• Using same telephone
• Sharing cups, glasses,
plates, or other utensils

10. 36.9 million
34.3 million
17.4 million
2.6 million
2.0 million
1.8 million
220 000
1.2 million
1.0 million
150 000
Number of people
living with HIV
People newly infected
with HIV in 2014
AIDS deaths in 2014
Total
Adults
Women
Children (<15 years)
Total
Adults
Children (<15 years)
Total
Adults
Children (<15 years)
Global Summary of the AIDS Epidemic2014
Data: UNAIDS
10
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

11. WHO HIV/AIDS Classification System
Stage I
Asymptomatic
Stage II
Minor Symptoms
Stage III
Moderate
Symptoms
Stage IV
AIDS

12. HIV Estimates in India 2015
HIV Estimate in 2015: 21 Lakhs
12

13. Routes of HIV Transmission, 2014-15
94%
1%
0.1%
0.9%
3% 1%
*Source : SIMS data 2014-15
Hetero sexual
Homo/Bisexual
Blood & blood
products
Infected syringe and
needles
Parent to child
Not specified
Parent to child is Transmission rate decreased
from 5% to 3% during 2012-13 to 2014-15
13

14. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Why HIV Rates not going Down
 Sex at an early age
 Little life-skills and sex education
 Little condom use
 Multiple partners
 Stigma and Discrimination
 Sex for money or sex for .....things
 Substance abuse: Ganja, cocaine,
alcohol
 Men having sex with men &
homophobia
 Gender inequity and gender roles

15. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Magnitude of HIV/AIDS
• First HIV case in India was reported from Chennai in
1986
• First AIDS case ws reported from Mumbai in 1987
• Approximately 2.27 million PLHIV in India
• HIV cases are now reported from all states of India
• All districts are classified into categories A, B, C and D
based on prevalence in antenatal women and high risk
groups

16. NACP I
(1994-1999)
Initial
interventions
NACP II
(1999-2006)
Decentralisation
to states
Limited
coverage of
services
NACP III
(2007-2012)
Massive scale
up with quality
assurance
mechanisms
>50% reduction
in new
infections
achieved
NACP IV
(2012-17)
Consolidate
gains
Focus on
emerging
vulnerabilities
Balance with
growing
treatment
needs, Quality
assurance
Evolution of India’s National AIDS Programme
16

17. Pre-Exposure Prophylaxis (PrEP)
Meaning
•Pre-exposure Prophylaxis: A pharmacologic HIV prevention
intervention for persons at high risk of becoming infected with
HIV.
•An HIV-uninfected individual takes antiretroviral medication(s)
before potential HIV exposure
•The use of medication for prophylaxis is well established:
–Use of contraceptive methods to prevent pregnancy
–Use of antimalarial medications before traveling to endemic
areas
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

18. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Use of Antiretrovirals for HIV Prevention
•Prevention of mother-to-child transmission
–Antiretrovirals given to the mother during
pregnancy, labor, and delivery and to the infant
postpartum[1]
–PMTCT has nearly eliminated perinatal HIV infection
in the US and other developed countries
•Post-exposure prophylaxis
–Antiretrovirals given within hours of a known or
suspected HIV exposure (eg, needle stick injury, rape,
unprotected sexual intercourse with someone whose
HIV status is unknown )
1. DHHS. Perinatal Guidelines. 2014. 2013;34:875-892. 2. MMWR. 2005;54(RR-2):1-20.

19. Pre- Vs Post-exposure Prophylaxis
• After exposure to HIV,
infection may become
established
• Postexposure
prophylaxis (initiated
soon after exposure)
reduces the chance of
infection
• Pre-exposure prophylaxis
begins treatment earlier
(before exposure)
HIV
infection
0 hr 36 hrs 72 hrs
HIV
exposure
1 mos 3 mos 5 mos
Post-exposure
prophylaxis
Pre-exposure
prophylaxis

20. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

21. Post-exposure Prophylaxis
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Meaning
It refers to the use of
Antiretroviral
Prophylactically to prevent
HIV infection following an
occupational exposure
General Guideline
• Potential benefits weighed
against potential risks and to
inform the staff
• Adherence and adverse
effects be monitored
• Baseline HIV test of staff
with counseling
• Follow-up:
Counseling and HIV
testing
Monitor for drug toxicity

22. Steps for Post EP
• Assess nature of exposure
• Assess HIV status of source of
exposure
• PEP evaluation
• PEP Regimens-Drugs and Dosage
for PEP
• Follow up
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

23. Algorithm for evaluation and treatment of possible non-occupational HIV exposures

24. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

27. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

28. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG
Barrier Nursing
• Aseptic technique
• Hand hygiene
• Use of Personal Protective
equipment's
• Safer handling of sharps
• Linen handling and disposal
• Handling biological spills
• Risk assessment
• Staff health

29. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

30. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

32. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

33. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

34. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

35. Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

36. Reference Available on Request @
anilsharma.nur@charusat.ac.in
Charotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG

37. Thank You All
For Patience
Listening and your
AttentionCharotar University of Science & Technology
Accredited Grade “A” with NAAC & KCG