Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Hiv & intimate partner violence
1.
2. • “The social determinants of health are the conditions in which
people are born, grow, live, work and age. These circumstances
are shaped by the distribution of money, power and resources
at global, national and local levels.”
• World Health Organization
• An individual’s position in social hierarchy can influence health
outcomes
• Underlying drivers of HIV risk and vulnerability
3.
4. • What are some social determinants related to HIV?
• Conditions for early childhood development
• Education
• Employment, income, job security
• Access to food
• Access to health services
• Housing
• Transportation
• Social exclusion
• Stigma
• The extent to which each of these vary among different racial, ethnic,
religious, social-economic status, sexual identity, gender identity, physical
and mental disability populations
5. • People living with HIV often highly stigmatized
• Negative outcomes of stigma:
• Reduced likelihood of testing and treatment
• Financial and work difficulties
• Social isolation
• Minority Stress Theory
• High, constant stress
• Poorer mental health
• Poorer physical health
7. • T or F: AIDS is a disease without a cure, spread mainly by
unprotected sex or sharing needles with someone who has HIV.
• True
8. • T or F: New HIV/AIDS drug treatments have lowered the
number of AIDS-related deaths in the United States.
• True
9. • T or F: Only drug users and gay men need to worry about
becoming infected with HIV.
• False
10. • You can become infected with HIV by ...
A. sharing utensils with or drinking from the same cup as someone
with HIV
B. mosquito bites
C. hugging someone with HIV
D. none of the above
11. • If you were infected with HIV, you might show symptoms ...
A. within a few weeks
B. within a year
C. in 10 or more years
D. any of the above
12. • HIV is not present in ...
A. semen and vaginal secretions
B. sweat
C. blood
D. breast milk
13. • Other myths:
• HIV is airborne at close range
• Possible transmission from a toilet
• 100% chance of transmission from needle sharing with HIV+ person
• Transmission through touching HIV+ blood
• Transmission through saliva
• Undectable viral load = safe to have sex
• A mother can’t transmit HIV to child
• You can’t have a child if you are HIV+
• There is a low survival rate for HIV
• HIV originated from sex with monkeys
• Others?
14. • Human (affects humans)
• Immunodeficiency (attacks the immune system)
• Virus (unlike bacterial infections)
• AIDS is advanced stage of HIV
• Acquired
• Immuno-
• Deficiency
• Syndrome
15. • Virus that attacks T Cells in immune system
• Overtime, kills off T Cells
• Decreases ability to defend against other infections
16. • Estimated 1,148,200 people over 13 years living with HIV in US
• Most common: large cities, and the south
• African Americans and MSM are disproportionately affected
• 1/5 people with HIV do not know
• Estimated 19,100 cases of HIV in Michigan, 7,040 in Detroit
• HIV infection prevalence on the rise in Detroit
• Number of new cases slowly dropping
• Young people—new cases not dropping
17.
18.
19.
20. 6%
3% 2%
89%
Prevalence
White
Black
Hispanic
Asian/PI
American Indian/AN
Multi-Racial/Other/
Unknown
26. • Sex with person living with HIV
• Vaginal
• Anal
• Oral
• Condomless sex greatly increases likelihood of transmission
• Using needles used by person with HIV
• IDU
• Tattoo (rare)
• Childbirth
• Breastfeeding
• Blood transfusion (rare)
28. • Abstinence
• Condoms
• Not sharing needles/using used-needles
• Sero-sorting
• PrEP
• Limiting partners or monogamy
• Sperm washing & antiretroviral therapy (for vertical transmission)
• Testing, dialogue, and sexual planning
• Discussion and negotiation necessary for almost all methods
• How are these methods potentially affected by IPV?
29. • Window Period—6 weeks to 3 months; depends on test!
• Rapid testing—finger prick, results in 20min
• Usually free (free @ AIDS Service Organizations)
• Private
• For more information or to find a testing center near you, call
Michigan HIV/AIDS Hotline 1-800-872-2437
30. • No cure… but treatment is available to EVERYONE!
• Life-long medication
• Stay healthy
• Reduce chance of transmission
• Side effects
• Life-long medical supervision
• Potential lifestyle changes
31. • Labs & Providers must report HIV status to local health dept.
• Health depts. prohibited from keeping roster of names
• Otherwise, HIV-related info is strictly confidential
• But when might we accidently disclose HIV information?
• Findings: discreteness, isolation or privacy, crowdedness, public, locale
size, privacy procedure, discussion of anonymous testing, forced
explanations
32. Why do you think violence
may put individuals at
increased risk for HIV?
33. • Intimate partner violence as a risk and
consequence of HIV infection.
• Individuals who have violent partners are less likely
to negotiate condom use and more likely to be
abused when they do.
• Various adverse health effects related to intimate
partner violence compromise women’s immune
systems in a way that increases their risk of HIV.
34. • 12% of HIV/AIDS infection among women in romantic
relationships are due to intimate partner violence
(Sareen, et al., 2009)
• Women who experience intimate partner violence
were over 3 times more likely to have a diagnosis of
HIV/AIDS (Sareen, et al., 2009)
• The prevalence of intimate partner violence among
women at risk for HIV may be as high as 67% (Cohen,
et al., 2000)
35. • Violent or coerced sex increases individual’s risk for HIV through
physical trauma:
o Bleeding and tearing of genital area creates passageways for HIV.
• Violence and threats of violence:
o Limit negotiating power for safer sex.
o Limit ability to leave/end a relationship.
• Sexual abuse as a child:
o Leads to high HIV risk behaviors as an adult (multiple partners,
unprotected sex).
• Disclosure of HIV status:
o Could result in increased violence (emotional, physical, sexual, economic).
36. • Many service providers lack of understanding
of the link between IPV and increase in HIV risk.
• Not enough resources or skills.
• Many service providers discomfort discussing
IPV and risky behaviors for HIV.
• Lack of coordination and referrals with other
services.
• Contrary beliefs, biases, attitudes.
37. • Understanding of the link between IPV and HIV.
• Staff training and cross-training as needed.
• Adequate policies and procedures that encourages
integration of HIV and IPV services.
• Good risk-related information for clients.
• Increased collaboration and referral between
violence and HIV agencies.
38. • Potential indicators:
• Engaging in risk behaviors for HIV (multiple sexual
partners, condomless sex, etc.).
• Reluctant to get tested for HIV.
• Resistant to disclosing a positive test result to a partner.
• Unable to adhere to an HIV medication regimen.
• How to:
• Avoid judgmental/accusatory language
• Actively listen
• Provide information, not correction
• Sensitively relate risk-reduction to individual’s life-goals
• Offer referrals, when appropriate
39. • HIV Testing
• Michigan HIV/AIDS Hotline 1-800-872-2437
• StatusSexy.com
• APM (Fisher Bldg), CHAG, Horizons Project, MAC, Teen Hype
• YAC
• Wayne County Dept. of Public Health 734-727-7078
• Oakland County Health Division 248-858-5416 or 888-350-0900 ext.
85416
• Macomb County Public Health 586-465-8434
• IPV Services
• Statewide Domestic Violence Linkline at 1-800-897-LINK
• National Domestic Violence Hotline at 1-800-799-SAFE
• National Sexual Assault Hotline at 1-800-656-HOPE
• Women’s Justice Center, Detroit (313) 962-4945; (313) 864-6989 Hotline
• YWCA Interim House, WC Safe, SASHA Center, LaVida, VOCA, Turning Point,
Inc. (Macomb County), HAVEN (Oakland County), First-Step (Wayne County)
40. • What can we do, in our professional settings, to be more
sensitive to issues surrounding HIV & IPV?
• What can we do to assist in HIV testing & care?
• What can we do to assist in IPV services?
