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Cara presentation
1. A Community of people living with HIV
HIV Awareness
Aidan Hanrath
Buddy Scheme Volunteer
aidan.hanrath.10@ucl.ac.uk
2. HIV
Aims
Assess our current knowledge, and increase our
understanding of HIV: its global and social contexts, its
consequences and the therapy available.
Gain an overview of the human immune system and
the effect of HIV
Dispel some of the many damaging myths surrounding
this condition.
8. HIV in the UK
There are about 90 thousand people in the UK with HIV. It‟s
likely that around a quarter of these people in the UK do
not know they have it.
In the UK about two thirds are men, and a third are
women.
Gay and bisexual men and black African heterosexuals are
the groups who are most affected.
10. The immune system
First defence (physical): skin and barriers in GI tract
Second defence (innate): automatic and unspecific
Third defence (adaptive): specialised but destructive
11. T Helper Cell
T T
CD4 CD8
Kill infected cells
Coordinate defence
Innat
B e
Release antibodies Cause inflammation and clear debris
14. Stigma and discrimination
Stigma: the shame or disgrace attached to something
regarded as socially unacceptable.
Types of stigma
• Self-stigma: self-hatred, shame, blame; people feel
they are being judged by others so they isolate
themselves. People who practise self-stigma isolate
themselves from their families and communities.
• Felt stigma – perceptions or feelings towards others.
• Discrimination – enacted stigma; attitudes or
thoughts put into action.
15. Stigma is a process that:
• points out or labels differences – “He is different from
us: he coughs a lot”
• attributes differences to negative behaviour – “His
sickness is caused by his sinful and promiscuous
behaviour”
• separates „us‟ and „them‟, e.g. shunning, isolation,
rejection
• creates loss of status, and discrimination (loss of
respect, isolation).
16. Try and think of a time in your life when you felt
isolated or rejected for being seen as different from
others.
How does it feel for that to happen to you? Did you try
to ignore it, or fight it, or find talked to others about
it? What impact might it have it have for your self
confidence?
18. Morality – view that people living with HIV are sinners,
promiscuous, unfaithful, sleeping around. People‟s
beliefs about pollution, contagion, impurity. Fear of
infection, of the unknown, of death.
Ignorance – lack of knowledge and misconceptions
makes people fear physical contact.
Misconceptions. Inferiority and superiority complex.
Gender and poverty – women and poor people
more stigmatised than men/rich people.
Prejudice. Tendency to judge others.
19. How might people living with HIV experience stigma or
discrimination?
20. Name-calling. Scapegoating. Finger-pointing. Teasing.
Ridicule. Labelling.
Blaming. Shaming. Judging. Backbiting. Rumour.
Gossiping. Making assumptions. Suspecting.
Neglecting. Rejecting. Isolating. Separating.
Not sharing utensils. Hiding. Staying at a distance.
Harassment. Physical violence. Abuse. Self-stigma –
blaming and isolating oneself. Stigma by
association – whole family or friends also affected
by stigma. Stigma by looks/appearance.
Associated stigma – family and friends also affected
by stigma
21. What might be the consequences of people living
with HIV feeling stigmatised?
22. Shame. Denial. Self-isolation. Loneliness. Neglect. Loss of hope.
Depression. Death. Alcoholism. Isolation. Self-rejection – give up on
yourself. Self-blame. Self-pity. Self-hatred. Anger. Violence. Withdraw from
public activities, e.g. church membership. Become very quiet. Commit
suicide or start thinking about suicide. Die alone, without love. Feel
unproductive/useless/not contributing. Forced to leave community. Family
disruption. Divorce or separation. Kicked out of family. Fired from work.
Loss of promotion, scholarship opportunities, rented accommodation.
Decline in school performance or dropout from school. AIDS orphans and
street kids. Abuse or poor treatment by relatives. Deprived of medical care –
health staff argue that this is a “waste of resources”. Sent back to the
village and property grabbing. Quarrels within the family – argue over who
is responsible for this situation and who will take care of the sick PLHIV.
Stop making use of clinics, voluntary counselling and testing programme,
and home-based care programme. Reluctance to take medication. No
treatment. Spread of infection.
23. Do only drug users and
gay men need to know
about HIV?
24. Do only drug users and
gay men need to know
about HIV?
No
HIV, unlike human beings, does not discriminate against
drug users, gay men, women, Africans, British, Baptists,
Roman Catholics or Atheists. Every member of the
Human Race can be affected by this virus.
25. If I were infected with
HIV would I feel sick?
26. If I were infected with
HIV would I feel sick?
Not necessarily
Although many people get flu-like symptoms in the
first few weeks after infection (sometimes called
seroconversion illness) some do not, and the virus can
take as long as 10 years to reveal itself. An HIV test is
the only way of diagnosing infection.
30. Can you become infected
with HIV through oral sex?
Yes
The risk is very remote (0.01% for the person performing
oral sex, 0.005% for the person receiving it) but may be
increased by sores in the mouth or pre-existing
immune suppression
31. HIV is a devastatingly effective virus in many ways, but
it is relatively ineffective at transmitting itself from
person to person. Apart from a direct blood
transfusion (and birth without prophylactic treatment),
the risks of infection are perhaps surprisingly low.
32. Exposure Route Risk per exposure to an
infected source
Blood transfusion 90%
Mother to child without treatment 25%
Mother to child with treatment and other measures 1 – 2%
Needle sharing in drug use 0.67%
Needle stick through the skin 0.3%
Receptive anal intercourse 1.7%
Insertive anal intercourse (uncircumcised men) 0.62%
Insertive anal intercourse (circumcised men) 0.11%
Vaginal intercourse male to female 0.1%
Vaginal intercourse female to male 0.05%
Performing oral sex 0.01%
Receiving oral sex 0.005%
36. Is HIV/AIDS not a
problem now that we
have a cure?
False
There is no cure for HIV currently or in the foreseeable
future – it is a lifelong condition. However the virus and
thus the symptoms can be controlled with
antiretroviral therapy.
38. Is HIV present in male
semen?
Yes
The semen of infected men is the perfect medium for
HIV transmission, as well as blood and vaginal fluids of
infected women.
39. Is it safe for an HIV
positive woman to
breastfeed her baby?
40. Is it safe for an HIV
positive woman to
breastfeed her baby?
No
Unfortunately, breastfeeding can also transmit HIV, so
in „developed‟ countries where formula milk is
available and safe it should be used instead. In this
instance breast is not best.
45. Is AIDS another name for
HIV?
No
Acquired Immunodeficiency Syndrome is a term used
to describe an advanced stage of HIV infection. AIDS
is typically diagnosed in HIV patients with a very low
level of circulating CD4 T cells (<200 per mm3 of
blood) and one or more characteristic opportunistic
infections and cancers which would otherwise be
stopped by the immune system. Some of these are
almost unheard of in the general population.
46. Opportunistic infections
System Examples of infection/cancer
Repiratory Pneumocystis jirovecii pneumonia (PJP)
Tuberculosis
Gastro- Cryptosporidiosis
Intestinal Candida
Cytomegalovirus
Nervous Toxoplasmosis
System Cryptococcosis
Non Hodgkin’s lymphoma
Skin Herpes simplex
Kaposi’s sarcoma
HIV is a virus (not a moral condition!) which attacks and weakens the immune system, making it difficult to fight off other infections. People cannot die of HIV, but they can die of other diseases which take the opportunity to attack. The immune system is also vital for fighting cancers, and so cancers are also more common in people infected with HIV.