Started in 1988, World AIDS Day is not just about raising money, but also about increasing awareness, fighting prejudice and improving education. World AIDS Day is important in reminding people that HIV has not gone away, and that there are many things still to be done. ~avert.org

1. [ Know AIDS, No AIDS ]
December 1, World AIDS Day

2. How much are you
Aware?

3. Transmission?
HIV Transmission
HIV enters the bloodstream through:
Open Cuts
Breaks in the skin
Mucous membranes
Direct injection

4. HIV Transmission?
?
Common fluids that are a means of transmission:
Blood
Semen
Vaginal Secretions
Breast Milk

5. HIV in Body Fluids?
Blood Semen
18,000 11,000 Vaginal
Fluid Amniotic
7,000 Fluid
4,000
Saliva
1
Average number of HIV particles in 1 ml of these body fluids

6. Routes of Transmission
?
of HIV?
• Contact:
Sexual Contact Male-to-male
• Male-to-female or vice versa
• Female-to-female
• Exposure:
Blood Exposure Injecting drug use/needle sharing
• Occupational exposure
• Transfusion of blood products
• Perinatal:
Perinatal Transmission from mom to baby
• Breastfeeding

7. HIV HIV Infected New HIV
T-Cell
Virus T-Cell Virus
HIV-Infected T-Cell
-

8. Period?
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

9. HIV Infection and Antibody
Response
---Initial Stage----
---------------Intermediate or Latent Stage--------- ---Illness Stage-
Flu-like Symptoms
Or Symptom-free AIDS Symptoms
No Symptoms
----
Infection Virus
Occurs
Antibody
----
< 6 month ~ Years ~ Years ~ Years ~ Years

10. Importance of Early
Testing and Diagnosis?
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

11. testing?
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

12. testing?
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

13. testing?
HIV testing
EIA/ELISA
Test
Negative Positive
No HIV Exposure HIV Exposure Repeat
Low Risk High Risk Positive
Negative Repeat ELISA
Positive Run IFA
Every 3 months
Confirmation
for 1 year
Repeat every
6 months for continued
High risk behavior Indeterminate Negative Positive
Repeat at Repeat at
End Testing Negative 3 weeks 2-4 months
HIV
+

14. testing?
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)

15. HIV AIDS
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.

16. reduction?
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

17. reduction?
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

18. CONDOMS
Using condoms is not 100 percent effective in preventing
transmission of sexually transmitted infections including
HIV
Condoms = Safer sex
Condoms = Safe sex

19. 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

20. 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

21. HIV Exposure and
Infection
Some people have had multiple exposures without
becoming infected
Some people have been exposed one time and become
infected

22. “ 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

23. HIV and Sexually
Transmitted Diseases

24. 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

25. 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

26. HIV and Sexually
Transmitted Diseases
The effect of HIV infection on the immune system
increases the risk of STDs, this can
Increase 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

27. HIV Post Exposure
Prophylaxis

28. 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

29. HIV non-Occupational
non-
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
Antiretroviral should not be used for those with low-risk
transmissions or exposures occurring more than 72
hours after exposure

30. HIV non-Occupational
non-
Exposure
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

31. 1st December, World AIDS DAY | abhishek.shah@live.com
Time to think positive