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“TheOdysseyof HIVEpidemic”
FromDespair& Death to Longevity& Life
TAHSEEN J. SIDDIQUI, M.D
Infectious Disease Specialist
Medical Director, Infectious Disease/Infection Control
Vice Chair, Department of Medicine
Clinical & Teaching Faculty
Norwegian American Hospital, Chicago
Medical Director of Clinical Excellence
Saint Bernard Hospital, Chicago
Infectious Disease Consultant
Advocate Illinois Masonic Hospital, Chicago
Jackson Park Hospital & Medical Center, Chicago
Roseland Community Hospital, Chicago
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)
“The HIV epidemic not only affects
the health and life of individuals, it
impacts households, communities,
and the development and economic
growth of entire nations”
Thirty years ago the world was just
becoming aware of a new epidemic
called the Acquired Immune Deficiency
Syndrome or AIDS, caused by HIV virus.
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)
HIV in the United States:
At A Glance
In 2015
39,513 people were diagnosed with
HIV infection in the United States
From 2005 to 2014
The annual number of new
HIV diagnoses declined 19%.
• In 2015:
• Gay and bisexual men accounted for 82% (26,375) of HIV diagnoses among
males and 67% of all diagnoses.
• From 2005 to 2014:
• Diagnoses among all heterosexuals declined 35%,
• And among people who inject drugs, diagnoses declined 63%.
HIV in the United States
Diagnoses of HIV Infection and Population
by Race/Ethnicity, 2014—United States
Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data
have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
a Hispanics/Latinos can be of any race.
Diagnoses of HIV Infection among Adults and Adolescents,
by Sex and Race/Ethnicity, 2014—United States and
6 Dependent Areas
Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been
statistically adjusted to account for reporting delays, but not for incomplete reporting.
a Hispanics/Latinos can be of any race.
From 2005 to 2014:
Diagnoses among all women declined 40%,
and among African American women, diagnoses declined 42%.
HIV in the United States by Geographic Distribution
Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT
Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI
South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV
West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY.
• African Americans continue to experience the greatest burden of HIV
• Hispanics/Latinos are also disproportionately affected by HIV. In 2015:
• African Americans represented about 13% of the US population, but
accounted for 45% (17,670) of HIV diagnoses.
• Hispanics/Latinos represented about 17% of the US population, but
accounted for 24% (9,290) of HIV diagnoses.
From 2005 to 2014:
• Among white gay and bisexual men, HIV diagnoses dropped steadily,
declining 18% overall.
• Although diagnoses among African American gay and bisexual men,
who accounted for the largest number of HIV diagnoses in U.S,
increased 22%, they have leveled off in the past 5 years
• Among Hispanic/Latino gay and bisexual men, diagnoses rose by 24%.
HIV in the United States
The Demographic Disparities
Impact of HIV on Hispanic/Latino Community
• Hispanics/Latinos are disproportionately affected by HIV.
• About 7 in 10 new HIV diagnoses among Hispanics/Latinos occur in gay
and bisexual men.
• Only about half of Hispanics/Latinos diagnosed with HIV are retained in
HIV care.
• Higher rates of sexually transmitted diseases (STDs).
Hispanics/Latinos have relatively high rates for STDs compared to some other
races/ethnicities, including chlamydia, gonorrhea, and syphilis.
Presence of another STD makes it easier to become infected with HIV.
Impact of HIV on Hispanic/Latino Community
• In 2014, Hispanics/Latinos accounted for 24% (10,887) of the estimated
44,784 new diagnoses of HIV infection in the United States and 6 dependent
areas.
• Of those, 86% were in men, and 14% (1,490) were in women.
• Gay, bisexual, and other men who have sex with mend accounted for 84%
(7,893) of the estimated HIV diagnoses among Hispanic/Latino men in 2014.
• Among Hispanic women/Latinas, 86% (1,282) of the estimated HIV diagnoses
were attributed to heterosexual contact.
From 2005 to 2014
– Diagnoses among Hispanic women/Latinas declined steadily (35%).
– Diagnoses among all Hispanic/Latino gay and bisexual men increased (24%).
– Diagnoses among young Hispanic/Latino gay and bisexual men (aged 13 to 24)
increased (87%).
– If current rates continue, 1 in 4 Hispanic/Latino gay and bisexual men will
be diagnosed with HIV in their lifetime.
In 2014, an estimated 4,689 Hispanics/Latinos were diagnosed with AIDS. (CDC)
Diagnoses of HIV Infection among Adult and Adolescent
Hispanics/Latinosa, by Sex and Transmission Category
2014—United States and 6 Dependent Areas
Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have
been statistically adjusted to account for reporting delays and missing transmission category, but not for incomplete
reporting.
a Hispanics/Latinos can be of any race.
b Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
c Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
Rates of Diagnoses of HIV Infection among Adult and
Adolescent Hispanics/Latinosa, 2014—United States
N = 10,182 Total Rate = 24.2
Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have
been statistically adjusted to account for reporting delays, but not for incomplete reporting.
a Hispanics/Latinos can be of any race.
STIGMA, DISCRIMINATION AND HIV
• HIV-related stigma and discrimination refers to prejudice,
negative attitudes and abuse directed at people living with
HIV and AIDS.
Key Elements of HIV-Related Stigma
• Lack of awareness (HIV and AIDS are always associated
with death/HIV is only transmitted through sex, which is a
taboo subject in some cultures)
• Fear of contagion-casual contact stemming from
incomplete knowledge about HIV transmission
• Linking HIV to improper or immoral behavior (like
homosexuality, drug use, sex work or infidelity)
HIV Stigma
• Research by the International
Centre for Research on Women
(ICRW) found the possible
consequences of HIV-related
stigma to be:
• Loss of income and livelihood
• Loss of marriage and
childbearing options
• Poor care within the health
sector
• Withdrawal of caregiving in the
home
• loss of hope and feelings of
worthlessness
• Loss of reputation and self
prestige
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)
What Can I Do to Stop HIV Stigma?
• Break the silence surrounding HIV stigma in our
community. Talk about your experiences, fears and
concerns about getting HIV or transmitting HIV with
friends, a counselor, or a sexual partner.
• Challenge attitudes, beliefs and behaviors that contribute
to HIV stigma.
• Don't be a silent witness to it when it happens around
you.
• Take responsibility for the prevention of HIV.
• Get informed about how to protect yourself and others
from HIV.
• Treat people with HIV with respect, empathy, and
compassion.
Who Can/Cannot Get HIV Infection?
You Won’t Get HIV From:
• Touching, hugging, shaking hand, or social contact, such as
schools and offices.
• Casual kissing- risky only if you both have large open sores
or bleeding gums and blood is exchanged
• Coughing, sneezing or spitting from an infected person
• Sharing drinking glasses or exposure to infected person’s
saliva, sweat, tears, urine, or feces.
• Sharing toilet seats, faucet handles, tables, door handles,
cutlery, towels
• Swimming pools, baths, shower areas or from drinking
fountains.
• Oral sex, used condoms, mutual masturbation ( if you use
sex toys make sure you use a new condom on them when
switching between partners)
• Tattoos and piercings
• In the U.S, HIV does not spread by blood transfusion, organ
transplants, vaccines, surgical/dental procedures etc.
• HIV does not spread by insects/mosquitoes/animal bites.
How Can I Prevent Being Infected?
It is easy to protect against HIV
Use condoms correctly every time you have sex.
Don’t inject drugs. If you do, use only clean
needles and equipment and don’t share your
equipment with others
PrEP
Pre-Exposure Prophylaxis
• People who are HIV-negative and at very high
risk for HIV can take daily medicine to prevent
HIV before gets exposure.
• Truvada reduces the risk of injection drug
users and uninfected partners acquiring HIV
by up to 92%
• Remember- Only condoms can help protect
against other STDs.
PEP
Post Exposure Prophylaxis
• Taking antiretroviral
medicines(Truvada/Isentress) after being
potentially exposed to HIV to prevent
becoming infected
• Must be started within 72 hours after a
possible exposure to HIV and continued for
28 days
• PEP is effective in preventing HIV, but not
100%
• PEP is NOT a morning after pill!
Know Your HIV Status
HIV Testing is Really Simple & Important
• Testing is an integral part of HIV prevention
• 21% of the infected Americans are not aware that they are infected
• Identify HIV infection early:
- Improve health status of the individual
- Increase life expectancy
- Decrease the risk of transmission to others
- Decrease risk of progressing from HIV to AIDS
- Helps decrease high risk behavior
- - Offer access to needed health services and life saving medications
• Testing is only the entry point.
• Linkage to Care.
• To date, more than 75% of persons who tested positive for the first
time were linked to medical care, and nearly 80% received partner
services to help notify and ensure that their partners get tested.
HIV Tests
• HIV tests may be performed on blood, oral fluid, or urine.
• It can take 3 to 12 weeks for an HIV-positive person’s body to make
enough antibodies for a screening test to detect HIV infection.
(window period)
• OraQuick Rapid HIV Test-involves taking an oral fluid sample by
swabbing the mouth and use a kit to test it. Results are available in
20 minutes.
• Home Access HIV-1 Test System is a home collection kit, which
involves pricking your finger to collect a blood sample, sending the
sample by mail to a licensed laboratory, and then calling in for
results as early as the next business day. This test is anonymous.
• If you use any type of antibody test and have a positive result, you
will need to take a follow-up blood test to confirm your results.
Being HIV-positive does not mean you have AIDS. AIDS is the most
advanced stage of HIV disease. HIV can lead to AIDS if not treated.
Where Can I Get Tested?
What Should I expect When I go In for HIV Test?
• At Vida SIDA, (NAH), a health care provider will perform rapid HIV/HCV
screening tests on blood/oral fluid, and you may be able to wait for the test
results
• If the test comes back negative, and you haven’t had an exposure for 3
months, you can be confident you’re not infected with HIV.
• If the test is negative, and you had an exposure within 3 months, a follow up
HIV test to be repeated after 3 months.
• If your HIV test result is positive, you will be referred to HIV specialist for
confirmatory tests/ treatment and follow-ups.
• Your health care provider or counselor may talk with you about your risk
factors, answer questions about your general health, and discuss next steps
with you, especially if your result is positive.
• It is important that you start medical care and begin HIV treatment (ART) as
soon as you are diagnosed with HIV.
Will Other People Know My HIV Test Results?
• If you take an anonymous test, no one but you will know the
result.
• If you take a confidential test, the results will go in your
medical record and may be shared with your health care
providers and your health insurance company.
• Your results are protected by state and federal privacy laws, and
they can be released only with your permission.
• If you test positive for HIV, the test result and your name will
be reported to the state or local health department to help public
health officials get better estimates of the rates of HIV in the
state.
• The state health department will then remove all personal
information about you (name, address, etc.) and share the
remaining non-identifying information with CDC
Should I Share My Positive Test Results With
My Partners?
• It’s important to disclose your HIV status to your sex partners even if you’re
uncomfortable doing it.
• Many resources can help you learn ways to disclose your status to your
partners.
• Partner Notification Services. Health departments do not reveal your name to
your partners. They will only tell your partners that they have been exposed to
HIV and should get tested.
• At least 35 states have criminal laws that punish HIV-positive people for
exposing others to the virus, even if they take precautions such as using a
condom.
• The state of Illinois makes it a crime (Class 2 felony offense-3-7 yrs prison
time, up to $25,000 fines, probation, and other penalties) for anyone who
knows that he or she carries, or is infected by HIV virus to engage in sexual
activity or intimate contact with someone else; nor can they donate blood,
semen, bodily tissue, organs, or other bodily material to someone else.
• Also, a person with HIV cannot legally exchange non-sterile drug
paraphernalia with others.
Should I Share My Positive Test Results with
Family & Friends?
• Your family and friends will not know your test results unless you tell
them yourself.
• Disclosure to close and trusted friend/family member or coworker
actually has benefits to your emotional and mental health and may
help you cope and begin to work HIV treatment into your life
• If you are a minor, aged 12 – 18 yrs, living in IL, you may consent to
confidential testing, treatment, and counseling for sexually transmitted
infections (STIs including AIDS, HIV ).
• Providers must report positive results to the Department of Health or
the local board of health, where the report will remain confidential.
• Providers are encouraged, where appropriate, to involve a minor’s
family in the minor’s treatment for STIs, but must first obtain the
minor’s consent.
• If a minor tests positive for HIV, it is up to the discretion of the
provider to determine if it’s in the minor’s best interest to notify a
parent.
Will My Employer Knows About My
Positive Test Result?
In most cases, your employer will not know your HIV status unless you
tell them.
• Your employer does have a right to ask if you have any health
conditions that would affect your ability to do your job or pose a
serious risk to others.
• If you have health insurance through your employer, the insurance
company cannot legally tell your employer that you have HIV.
• But it is possible that your employer could find out if the insurance
company provides detailed information to your employer about the
benefits it pays or the costs of insurance.
• All people with HIV are covered under the Americans with Disabilities
Act. This means that your employer cannot discriminate against you
because of your HIV status as long as you can do your job.
Does HIV Infection Always Associated with Immoral
Behavior (Homo/bisexuality/Infidelity)?
Is HIV a “Gay’s Disease”
• Everyone is at risk of HIV if you get HIV into your bloodstream.
• Some people have a higher risk of getting HIV because they engage in
certain activities (e.g. injecting drugs) that are more likely to transmit
the virus, or they have lots of sex partners and don’t use a condom.
• Previously –many acquired infection via contaminated blood
transfusion ( Ryan White- Hemophiliac), and other non sexual ways.
• The notion that HIV is a consequence of a person’s sexual orientation
was discounted just over a year after the disease was first identified.
• AIDS is a global issue affecting different groups in different countries
in different ways.
• Globally, most new infections are now transmitted heterosexually
If I have HIV Does It Mean My
Life Is Over?
No-HIV Doesn’t Have To Be A life Sentence
• People diagnosed with HIV in the early 1980’s were lucky to
survive 8 years since there were no effective drugs to treat.
• But now there are dozens of highly active drugs available to
treat HIV very effectively (HAART)
• If these drugs are started early, taken regular and consistently,
then the chances of developing AIDS are dramatically reduced.
• AIDS-related deaths have fallen by 45% since the peak in 2005.
• In fact, people with HIV are likely to have a life-span generally
the same as uninfected people, and are more likely to die of
other causes, such as heart conditions or cancer
Thanks To HAART Medications
More and More People Are Living with HIV Instead of Dying
If I Get Infected!
Can I Be Treated Successfully?
• Absolutely. HIV infection can safely and effectively be
treated with HAART medications.
• These medications reduce the amount of virus in the
body (viral load), prevents illness by keeping the
immune system functioning and ensure healthy life.
• They also prevent HIV transmission to others through
sex, needle sharing, and from mother-to-child during
pregnancy and birth.
• When taken consistently, ART can reduce the risk of
HIV transmission to a negative partner by 96%.
How Safe and Effective HIV Medications Are?
• All FDA approved HIV medications
(HAART) are safe, well tolerated, allow
simple once daily dosing, with minimal
drug-food interactions.
• If one regimen doesn’t suit or work for you,
there are plenty of other options.
HIV Medications (HAART)
Truly Saves Lives
How Accessible Life-Saving
HIV Medications Are?
People living with HIV
• In 2015, there were 36.7 million people living with HIV Worldwide
People living with HIV accessing antiretroviral therapy
• As of June 2016, 18.2 million people living with HIV were
accessing antiretroviral therapy, up from 15.8 million in June 2015
and 7.5 million in 2010.
• In 2015, around 46% of all people living with HIV had access to
treatment.
• In 2015, some 77% of pregnant women living with HIV had access
to antiretroviral medicines to prevent transmission of HIV to their
babies.
In U.S.A-Everyone has access to HIV Care and
Medications
How Can I Afford HIV Testing/Treatment Costs?
• Vida/Seda and several other agencies offers free HIV (and HCV)
Testing & Counseling.
• HIV screening is covered by health insurance without a co-pay, as
required by the Affordable Care Act.
• If you have health insurance, your insurer is required to cover
some medicines used to treat HIV.
• If you don’t have health insurance, or you’re unable to afford your
co-pay or co-insurance amount, you may be eligible for
government programs that can help through Medicaid, Medicare,
the Ryan White HIV/AIDS Program, ADAP, and community
health centers.
• If your insurance does not cover the full amount of the drug,
generic versions of HIV drugs can be up to 30% cheaper than the
branded version
Living With HIV Doesn’t Mean A Life-Time of Monitoring
• See your doctor every 3-6 months during first 2
years of ART or if viremia develops while patient
on ART or CD4 count <300
• Thereafter once every 12 months with consistent
viral suppression, and your CD4 counts are >500
AIDS Is Not Over, But It Can Be !
• Huge progress has been made since
2000 and millions of lives have been
saved.
• But there are still important milestones
to reach, barriers to break and frontiers
to cross.
• The world has agreed to meet a set of
global targets by 2020 as part of
UNAIDS Fast-Track strategy to end the
AIDS epidemic as a public health
threat.
Thank You
• Questions?
• Comments!
• Concerns #

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Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA)

  • 1. “TheOdysseyof HIVEpidemic” FromDespair& Death to Longevity& Life TAHSEEN J. SIDDIQUI, M.D Infectious Disease Specialist Medical Director, Infectious Disease/Infection Control Vice Chair, Department of Medicine Clinical & Teaching Faculty Norwegian American Hospital, Chicago Medical Director of Clinical Excellence Saint Bernard Hospital, Chicago Infectious Disease Consultant Advocate Illinois Masonic Hospital, Chicago Jackson Park Hospital & Medical Center, Chicago Roseland Community Hospital, Chicago
  • 3. “The HIV epidemic not only affects the health and life of individuals, it impacts households, communities, and the development and economic growth of entire nations” Thirty years ago the world was just becoming aware of a new epidemic called the Acquired Immune Deficiency Syndrome or AIDS, caused by HIV virus.
  • 7. HIV in the United States: At A Glance In 2015 39,513 people were diagnosed with HIV infection in the United States From 2005 to 2014 The annual number of new HIV diagnoses declined 19%.
  • 8. • In 2015: • Gay and bisexual men accounted for 82% (26,375) of HIV diagnoses among males and 67% of all diagnoses. • From 2005 to 2014: • Diagnoses among all heterosexuals declined 35%, • And among people who inject drugs, diagnoses declined 63%. HIV in the United States
  • 9. Diagnoses of HIV Infection and Population by Race/Ethnicity, 2014—United States Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting. a Hispanics/Latinos can be of any race.
  • 10. Diagnoses of HIV Infection among Adults and Adolescents, by Sex and Race/Ethnicity, 2014—United States and 6 Dependent Areas Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting. a Hispanics/Latinos can be of any race. From 2005 to 2014: Diagnoses among all women declined 40%, and among African American women, diagnoses declined 42%.
  • 11. HIV in the United States by Geographic Distribution Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY.
  • 12. • African Americans continue to experience the greatest burden of HIV • Hispanics/Latinos are also disproportionately affected by HIV. In 2015: • African Americans represented about 13% of the US population, but accounted for 45% (17,670) of HIV diagnoses. • Hispanics/Latinos represented about 17% of the US population, but accounted for 24% (9,290) of HIV diagnoses. From 2005 to 2014: • Among white gay and bisexual men, HIV diagnoses dropped steadily, declining 18% overall. • Although diagnoses among African American gay and bisexual men, who accounted for the largest number of HIV diagnoses in U.S, increased 22%, they have leveled off in the past 5 years • Among Hispanic/Latino gay and bisexual men, diagnoses rose by 24%. HIV in the United States The Demographic Disparities
  • 13. Impact of HIV on Hispanic/Latino Community • Hispanics/Latinos are disproportionately affected by HIV. • About 7 in 10 new HIV diagnoses among Hispanics/Latinos occur in gay and bisexual men. • Only about half of Hispanics/Latinos diagnosed with HIV are retained in HIV care. • Higher rates of sexually transmitted diseases (STDs). Hispanics/Latinos have relatively high rates for STDs compared to some other races/ethnicities, including chlamydia, gonorrhea, and syphilis. Presence of another STD makes it easier to become infected with HIV.
  • 14. Impact of HIV on Hispanic/Latino Community • In 2014, Hispanics/Latinos accounted for 24% (10,887) of the estimated 44,784 new diagnoses of HIV infection in the United States and 6 dependent areas. • Of those, 86% were in men, and 14% (1,490) were in women. • Gay, bisexual, and other men who have sex with mend accounted for 84% (7,893) of the estimated HIV diagnoses among Hispanic/Latino men in 2014. • Among Hispanic women/Latinas, 86% (1,282) of the estimated HIV diagnoses were attributed to heterosexual contact. From 2005 to 2014 – Diagnoses among Hispanic women/Latinas declined steadily (35%). – Diagnoses among all Hispanic/Latino gay and bisexual men increased (24%). – Diagnoses among young Hispanic/Latino gay and bisexual men (aged 13 to 24) increased (87%). – If current rates continue, 1 in 4 Hispanic/Latino gay and bisexual men will be diagnosed with HIV in their lifetime. In 2014, an estimated 4,689 Hispanics/Latinos were diagnosed with AIDS. (CDC)
  • 15. Diagnoses of HIV Infection among Adult and Adolescent Hispanics/Latinosa, by Sex and Transmission Category 2014—United States and 6 Dependent Areas Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays and missing transmission category, but not for incomplete reporting. a Hispanics/Latinos can be of any race. b Heterosexual contact with a person known to have, or to be at high risk for, HIV infection. c Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
  • 16. Rates of Diagnoses of HIV Infection among Adult and Adolescent Hispanics/Latinosa, 2014—United States N = 10,182 Total Rate = 24.2 Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting. a Hispanics/Latinos can be of any race.
  • 17. STIGMA, DISCRIMINATION AND HIV • HIV-related stigma and discrimination refers to prejudice, negative attitudes and abuse directed at people living with HIV and AIDS. Key Elements of HIV-Related Stigma • Lack of awareness (HIV and AIDS are always associated with death/HIV is only transmitted through sex, which is a taboo subject in some cultures) • Fear of contagion-casual contact stemming from incomplete knowledge about HIV transmission • Linking HIV to improper or immoral behavior (like homosexuality, drug use, sex work or infidelity)
  • 18. HIV Stigma • Research by the International Centre for Research on Women (ICRW) found the possible consequences of HIV-related stigma to be: • Loss of income and livelihood • Loss of marriage and childbearing options • Poor care within the health sector • Withdrawal of caregiving in the home • loss of hope and feelings of worthlessness • Loss of reputation and self prestige
  • 20. What Can I Do to Stop HIV Stigma? • Break the silence surrounding HIV stigma in our community. Talk about your experiences, fears and concerns about getting HIV or transmitting HIV with friends, a counselor, or a sexual partner. • Challenge attitudes, beliefs and behaviors that contribute to HIV stigma. • Don't be a silent witness to it when it happens around you. • Take responsibility for the prevention of HIV. • Get informed about how to protect yourself and others from HIV. • Treat people with HIV with respect, empathy, and compassion.
  • 21. Who Can/Cannot Get HIV Infection? You Won’t Get HIV From: • Touching, hugging, shaking hand, or social contact, such as schools and offices. • Casual kissing- risky only if you both have large open sores or bleeding gums and blood is exchanged • Coughing, sneezing or spitting from an infected person • Sharing drinking glasses or exposure to infected person’s saliva, sweat, tears, urine, or feces. • Sharing toilet seats, faucet handles, tables, door handles, cutlery, towels • Swimming pools, baths, shower areas or from drinking fountains. • Oral sex, used condoms, mutual masturbation ( if you use sex toys make sure you use a new condom on them when switching between partners) • Tattoos and piercings • In the U.S, HIV does not spread by blood transfusion, organ transplants, vaccines, surgical/dental procedures etc. • HIV does not spread by insects/mosquitoes/animal bites.
  • 22. How Can I Prevent Being Infected? It is easy to protect against HIV Use condoms correctly every time you have sex. Don’t inject drugs. If you do, use only clean needles and equipment and don’t share your equipment with others
  • 23. PrEP Pre-Exposure Prophylaxis • People who are HIV-negative and at very high risk for HIV can take daily medicine to prevent HIV before gets exposure. • Truvada reduces the risk of injection drug users and uninfected partners acquiring HIV by up to 92% • Remember- Only condoms can help protect against other STDs.
  • 24. PEP Post Exposure Prophylaxis • Taking antiretroviral medicines(Truvada/Isentress) after being potentially exposed to HIV to prevent becoming infected • Must be started within 72 hours after a possible exposure to HIV and continued for 28 days • PEP is effective in preventing HIV, but not 100% • PEP is NOT a morning after pill!
  • 25. Know Your HIV Status
  • 26. HIV Testing is Really Simple & Important • Testing is an integral part of HIV prevention • 21% of the infected Americans are not aware that they are infected • Identify HIV infection early: - Improve health status of the individual - Increase life expectancy - Decrease the risk of transmission to others - Decrease risk of progressing from HIV to AIDS - Helps decrease high risk behavior - - Offer access to needed health services and life saving medications • Testing is only the entry point. • Linkage to Care. • To date, more than 75% of persons who tested positive for the first time were linked to medical care, and nearly 80% received partner services to help notify and ensure that their partners get tested.
  • 27. HIV Tests • HIV tests may be performed on blood, oral fluid, or urine. • It can take 3 to 12 weeks for an HIV-positive person’s body to make enough antibodies for a screening test to detect HIV infection. (window period) • OraQuick Rapid HIV Test-involves taking an oral fluid sample by swabbing the mouth and use a kit to test it. Results are available in 20 minutes. • Home Access HIV-1 Test System is a home collection kit, which involves pricking your finger to collect a blood sample, sending the sample by mail to a licensed laboratory, and then calling in for results as early as the next business day. This test is anonymous. • If you use any type of antibody test and have a positive result, you will need to take a follow-up blood test to confirm your results. Being HIV-positive does not mean you have AIDS. AIDS is the most advanced stage of HIV disease. HIV can lead to AIDS if not treated.
  • 28. Where Can I Get Tested? What Should I expect When I go In for HIV Test? • At Vida SIDA, (NAH), a health care provider will perform rapid HIV/HCV screening tests on blood/oral fluid, and you may be able to wait for the test results • If the test comes back negative, and you haven’t had an exposure for 3 months, you can be confident you’re not infected with HIV. • If the test is negative, and you had an exposure within 3 months, a follow up HIV test to be repeated after 3 months. • If your HIV test result is positive, you will be referred to HIV specialist for confirmatory tests/ treatment and follow-ups. • Your health care provider or counselor may talk with you about your risk factors, answer questions about your general health, and discuss next steps with you, especially if your result is positive. • It is important that you start medical care and begin HIV treatment (ART) as soon as you are diagnosed with HIV.
  • 29. Will Other People Know My HIV Test Results? • If you take an anonymous test, no one but you will know the result. • If you take a confidential test, the results will go in your medical record and may be shared with your health care providers and your health insurance company. • Your results are protected by state and federal privacy laws, and they can be released only with your permission. • If you test positive for HIV, the test result and your name will be reported to the state or local health department to help public health officials get better estimates of the rates of HIV in the state. • The state health department will then remove all personal information about you (name, address, etc.) and share the remaining non-identifying information with CDC
  • 30. Should I Share My Positive Test Results With My Partners? • It’s important to disclose your HIV status to your sex partners even if you’re uncomfortable doing it. • Many resources can help you learn ways to disclose your status to your partners. • Partner Notification Services. Health departments do not reveal your name to your partners. They will only tell your partners that they have been exposed to HIV and should get tested. • At least 35 states have criminal laws that punish HIV-positive people for exposing others to the virus, even if they take precautions such as using a condom. • The state of Illinois makes it a crime (Class 2 felony offense-3-7 yrs prison time, up to $25,000 fines, probation, and other penalties) for anyone who knows that he or she carries, or is infected by HIV virus to engage in sexual activity or intimate contact with someone else; nor can they donate blood, semen, bodily tissue, organs, or other bodily material to someone else. • Also, a person with HIV cannot legally exchange non-sterile drug paraphernalia with others.
  • 31. Should I Share My Positive Test Results with Family & Friends? • Your family and friends will not know your test results unless you tell them yourself. • Disclosure to close and trusted friend/family member or coworker actually has benefits to your emotional and mental health and may help you cope and begin to work HIV treatment into your life • If you are a minor, aged 12 – 18 yrs, living in IL, you may consent to confidential testing, treatment, and counseling for sexually transmitted infections (STIs including AIDS, HIV ). • Providers must report positive results to the Department of Health or the local board of health, where the report will remain confidential. • Providers are encouraged, where appropriate, to involve a minor’s family in the minor’s treatment for STIs, but must first obtain the minor’s consent. • If a minor tests positive for HIV, it is up to the discretion of the provider to determine if it’s in the minor’s best interest to notify a parent.
  • 32. Will My Employer Knows About My Positive Test Result? In most cases, your employer will not know your HIV status unless you tell them. • Your employer does have a right to ask if you have any health conditions that would affect your ability to do your job or pose a serious risk to others. • If you have health insurance through your employer, the insurance company cannot legally tell your employer that you have HIV. • But it is possible that your employer could find out if the insurance company provides detailed information to your employer about the benefits it pays or the costs of insurance. • All people with HIV are covered under the Americans with Disabilities Act. This means that your employer cannot discriminate against you because of your HIV status as long as you can do your job.
  • 33. Does HIV Infection Always Associated with Immoral Behavior (Homo/bisexuality/Infidelity)? Is HIV a “Gay’s Disease” • Everyone is at risk of HIV if you get HIV into your bloodstream. • Some people have a higher risk of getting HIV because they engage in certain activities (e.g. injecting drugs) that are more likely to transmit the virus, or they have lots of sex partners and don’t use a condom. • Previously –many acquired infection via contaminated blood transfusion ( Ryan White- Hemophiliac), and other non sexual ways. • The notion that HIV is a consequence of a person’s sexual orientation was discounted just over a year after the disease was first identified. • AIDS is a global issue affecting different groups in different countries in different ways. • Globally, most new infections are now transmitted heterosexually
  • 34. If I have HIV Does It Mean My Life Is Over? No-HIV Doesn’t Have To Be A life Sentence • People diagnosed with HIV in the early 1980’s were lucky to survive 8 years since there were no effective drugs to treat. • But now there are dozens of highly active drugs available to treat HIV very effectively (HAART) • If these drugs are started early, taken regular and consistently, then the chances of developing AIDS are dramatically reduced. • AIDS-related deaths have fallen by 45% since the peak in 2005. • In fact, people with HIV are likely to have a life-span generally the same as uninfected people, and are more likely to die of other causes, such as heart conditions or cancer
  • 35. Thanks To HAART Medications More and More People Are Living with HIV Instead of Dying
  • 36. If I Get Infected! Can I Be Treated Successfully? • Absolutely. HIV infection can safely and effectively be treated with HAART medications. • These medications reduce the amount of virus in the body (viral load), prevents illness by keeping the immune system functioning and ensure healthy life. • They also prevent HIV transmission to others through sex, needle sharing, and from mother-to-child during pregnancy and birth. • When taken consistently, ART can reduce the risk of HIV transmission to a negative partner by 96%.
  • 37. How Safe and Effective HIV Medications Are? • All FDA approved HIV medications (HAART) are safe, well tolerated, allow simple once daily dosing, with minimal drug-food interactions. • If one regimen doesn’t suit or work for you, there are plenty of other options.
  • 39. How Accessible Life-Saving HIV Medications Are? People living with HIV • In 2015, there were 36.7 million people living with HIV Worldwide People living with HIV accessing antiretroviral therapy • As of June 2016, 18.2 million people living with HIV were accessing antiretroviral therapy, up from 15.8 million in June 2015 and 7.5 million in 2010. • In 2015, around 46% of all people living with HIV had access to treatment. • In 2015, some 77% of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their babies. In U.S.A-Everyone has access to HIV Care and Medications
  • 40. How Can I Afford HIV Testing/Treatment Costs? • Vida/Seda and several other agencies offers free HIV (and HCV) Testing & Counseling. • HIV screening is covered by health insurance without a co-pay, as required by the Affordable Care Act. • If you have health insurance, your insurer is required to cover some medicines used to treat HIV. • If you don’t have health insurance, or you’re unable to afford your co-pay or co-insurance amount, you may be eligible for government programs that can help through Medicaid, Medicare, the Ryan White HIV/AIDS Program, ADAP, and community health centers. • If your insurance does not cover the full amount of the drug, generic versions of HIV drugs can be up to 30% cheaper than the branded version
  • 41. Living With HIV Doesn’t Mean A Life-Time of Monitoring • See your doctor every 3-6 months during first 2 years of ART or if viremia develops while patient on ART or CD4 count <300 • Thereafter once every 12 months with consistent viral suppression, and your CD4 counts are >500
  • 42. AIDS Is Not Over, But It Can Be ! • Huge progress has been made since 2000 and millions of lives have been saved. • But there are still important milestones to reach, barriers to break and frontiers to cross. • The world has agreed to meet a set of global targets by 2020 as part of UNAIDS Fast-Track strategy to end the AIDS epidemic as a public health threat.
  • 43. Thank You • Questions? • Comments! • Concerns #

Editor's Notes

  1. The pie chart on the left illustrates the percentage distribution of diagnoses of HIV infection in 2014 by race/ethnicity in the United States. The pie chart on the right shows the percentage distribution of the population in the United States by race/ethnicity in 2014.   In 2014, blacks/African Americans made up approximately 12% of the population of the United States, but accounted for 44% of diagnoses of HIV infection. Whites made up 62% of the population of the United States, but accounted for 27% of diagnoses of HIV infection. Hispanics/Latinos made up 17% of the population of the United States, but accounted for 23% of diagnoses of HIV infection.   Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data are estimates. Estimated numbers resulted from statistical adjustment that accounted for reporting delays, but not for incomplete reporting.     Hispanics/Latinos can be of any race.   More information on the epidemiology of HIV in the United States and HIV prevention among blacks/African Americans and Hispanics/Latinos is available in CDC fact sheets at http://www.cdc.gov/hiv/resources/factsheets/index.htm.
  2. In 2014, of the 36,138 diagnoses of HIV infection among adult and adolescent males in the United States and 6 dependent areas, 40% were black/African American, 29% were white, and 26% were Hispanic/Latino. Approximately 2% each were males of multiple races and Asian, and less than 1% each were American Indian/Alaska Native and Native Hawaiian/other Pacific Islander.   Of the 8,471 diagnoses among adult and adolescent females in 2014, the percentages were 61% for blacks/African Americans, 18% for Hispanics/Latinos, and 18% for whites. Approximately 2% each were females of multiple races and Asian, approximately 1% were American Indian/Alaska Native, and less than 1% were Native Hawaiian/other Pacific Islander.   Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data are estimates. Estimated numbers resulted from statistical adjustment that accounted for reporting delays, but not for incomplete reporting.   Hispanics/Latinos can be of any race.
  3. This slide shows the percentage distribution of diagnoses of HIV infection among adult and adolescent Hispanics/Latinos in 2014 by sex and transmission category in the United States and 6 dependent areas. The pie chart on the left shows the distribution by transmission category among Hispanic/Latino males and the pie chart on the right shows the distribution by transmission category among Hispanic/Latino females.   Among Hispanic/Latino males in 2014, an estimated 84% of diagnosed HIV infections were attributed to male-to-male sexual contact, 8% were attributed to heterosexual contact, and 5% were attributed to injection drug use. Approximately 3% of diagnosed HIV infections among Hispanic/Latino males were attributed to male-to-male sexual contact and injection drug use, and less than 1% were attributed to other transmission categories.   Among Hispanic/Latino females in 2014, 86% of diagnosed HIV infections were attributed to heterosexual contact, 13% were attributed to injection drug use, and 1% were attributed to other transmission categories.    Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data are estimates. Estimated numbers resulted from statistical adjustment that accounted for reporting delays and missing transmission category, but not for incomplete reporting.   Hispanics/Latinos can be of any race.   Heterosexual contact is with a person known to have, or to be at high risk for, HIV infection.   Other transmission categories include hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
  4. In 2014, the overall estimated rate of diagnoses of HIV infection for adult and adolescent Hispanics/Latinos was 24.2 per 100,000 population in the United States. The rates of diagnoses of HIV infection for adult and adolescent Hispanics/Latinos ranged from 0.0 per 100,000 population in North Dakota and Vermont to 49.7 per 100,000 population in Louisiana, and 63.5 per 100,000 population in the District of Columbia. The District of Columbia (i.e., Washington, DC) is a city; use caution when comparing the HIV diagnosis rate in DC with the rates in states. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data are estimates. Estimated numbers resulted from statistical adjustment that accounted for reporting delays, but not for incomplete reporting.   Hispanics/Latinos can be of any race.