The document discusses the history and epidemiology of HIV. It describes how HIV is transmitted through sexual intercourse, blood transfusions, needle sharing, and from mother to child. Landmark events in HIV management included the identification of HIV in the 1980s and the introduction of HAART therapy in 1996, which drastically reduced mortality rates in western countries. Globally in 2017, there were 36.9 million people living with HIV, with the highest rates of transmission being receptive anal intercourse. In the Philippines, HIV rates continue to rise and regions 4A, 3, and NCR have the highest rates of new cases.

1. HIV History and
Epidemiology
Karl Evans R. Henson, MD, FPCP
Section of Infectious Diseases, UP-PGH

2. Module Objectives
• At the end of the session, the participants should
be able to
• Describe the characteristics of HIV and how it is
transmitted.
• Identify landmark events in the history of HIV
management and describe how these events changed
the way we manage HIV today.
• Describe current global and local HIV epidemiology.

3.  Human
immunodeficiency virus
(HIV)
 Family Retroviridae
 Subfamily lentivirus
 HTLV 1 & 2
 HIV 1 & 2

5. Transmission
• Sexual intercourse
• Heterosexual
• MSM
• Oral
• Blood and blood products
• Transfusion
• Injection drug use (needle sharing)
• Mother-to-child
• Intrapartum
• Perinatal
• Breast milk
• Occupational

7. Historical Perspective

16. Epidemiology

18. Global Epidemiology
• In 2017 (the latest data available)...
• 36.9 million people globally were living with HIV in
2017.
• 21.7 million people were accessing antiretroviral
therapy in 2017.
• 1.8 million people became newly infected with HIV in
2017.
• 940 000 people died from AIDS-related illnesses in 2017.
• 77.3 million people have become infected with HIV
since the start of the epidemic.
• 35.4 million people have died from AIDS-related
illnesses since the start of the epidemic.

23. Summary
• HIV is an RNA virus capable of establishing a persistent,
chronic infection in humans.
• The highest risk of transmission of HIV is with blood
transfusion followed by receptive anal intercourse
• The HIV epidemic began in the early 1980s, rapidly
spreading across the world in a few years
• In 1996, doctors started treating HIV using HAART,
drastically reducing mortality and morbidity rates in the
Western world.
• In the PHL, HIV rates are still rising, most commonly
transmitted by anal receptive intercourse. NCR and
regions 4A and 3 have the highest rates of new HIV
cases.

24. Questions?

25. 5 Questions
1. Which among the following is the most effective
way to transmit HIV?
a) Kissing
b) Unprotected fellatio
c) HIV-positive woman, HIV-negative man
d) HIV-positive woman, HIV-negative woman

26. 2. Beginning in 1996, a drastic reduction in HIV-
related morbidity and mortality was described in
Western countries. This reduction was due to
which of the following:
a) Pre-exposure prophylaxis
b) Discovery of the Western Blot Assay
c) Discovery of HIV vaccine
d) HAART therapy

27. 3. Which of the following landmark studies paved
the way for treating all HIV patients regardless of
CD4 count and clinical status?
a) MMWR report, June 1982
b) INSIGHT START study
c) PROUD study
d) PARTNER study

28. 4. Which of the following age groups has the
highest rates of new HIV cases, as of June 2018?
a) 15-24 year olds
b) 25-34 year olds
c) 35-49 year olds
d) 50 years old and above

29. 3. TRUE OR FALSE: Injection drug use is the second
most common mode of HIV transmission locally
in recent years.
a) True
b) False