International Health Exam 2: Pt. 8

Front 1

Epidemiology

Back 1

>35 million living 2/ HIV; higher than before.

Decrease in # of deaths per year from 2005

Increasing prevalence in SA

Women have HIGHER prevalence w/ 1/3 pregnant women infected

Front 2

Risk for Transmission

Back 2

Paid sex, unprotected sex

Substance abuse

Sex that may cause trauma (anal)

Sources of exposure: blood, semen, vag secretion, breast milk

Front 3

Biomedical HIV Prevention Interventions

Back 3

Male circumcision (65%)

Highly Active Antiretroviral Therapy (70%)

Prevent mother to child transmission (1-35%)

Condoms (90%)

Treatment of STI's (40%)

HIV vaccine (promising evidence in Thailand)

Microbicides & cervical barriers (30%)

Front 4

ARV Successes

Back 4

19% decline in deaths from HIV

Incidence falling in countries

Global instability spurred western world to help AIDS peidemic

Front 5

Leading Causes of Infectious Disease

Back 5

1. Acute respiratory infection

2. AIDS

3. Diarrheal

4. TB

5. Malaria

Front 6

Major route of transmission in SA

Back 6

Maritial sex!

Front 7

Vienna Declaration

Back 7

scientific statement calling for incorporation of scientific evidence into illicit drug policies to improve community health & safety

Front 8

HPV Vaccine in Men

Back 8

Effective in decreasing risk of other genital problems (HIV transmission, cancer, etc)

Front 9

Millenium Development Goals

Back 9

Eradicate, achieve, promote, reduce, etc.

NOT mutually exclusive

Front 10

Symptoms of HIV

Back 10

Acute infections: fever, fatigue, pharyryltis

Established infection: herpes, shingles, diarrhea, CMV, TB

Front 11

History of AIDS

Back 11

Incidence & mortality rate DECLINING but prevalence is INCREASING.

Incidence = function of behavior change, primary prevention.

Mortality = function of retroviral drug

More rapid decline in mortality than incidence

Front 12

Risk Groups

Back 12

Gay white male = most prevalent (most new infections)

Now AA women at highest risk (heterosexual)

Black gay at more risk than white gay. Same number of both with HIV, BUT there are more white gay than black gay.

Front 13

Incidence

Back 13

Males infected by other males the most

Females infected by heterosexual contact

Women more at risk b/c vagina can get bruised and has greater surface area during sex.

Front 14

Post-Exposure Prophylaxis

Back 14

Pros: good for high risk, may prevent primary infection

Cons: false security, risk assessments problematic, unfavorable risk-benefit ratio, needs to be given quickly, appropriate for certain occupational settings only.

COMMON PROBLEM IS NOT THAT IT MUST BE GIVEN 72 HRS POST EXPOSURE

Front 15

AIDS & Age

Back 15

AIDS has decreased expected amount of people living in all age groups.

Front 16

General trends

Back 16

Condom promotion reduces HIV & STIs

Sex education reduces HIV prevalence

Front 17

Barriers to Vaccine Development

Back 17

Sequence variation

Lack of adequate animal model to study effect

Latency & integration of HIV into host genome

Transmission by cell-associated virus

Limited knowledge

Financial support

Ethical issues

Front 18

# of people infected/dying

Back 18

# of people infected increased from '90s

# of people dying decreased from 2000's

Front 19

Risk of Vertical & Horizontal Transmission

Back 19

NOT threatening cumulative number of children estimated to have been orphaned by AIDS

Front 20

Vertical Transmission

Back 20

Placental exchange & breast milk

Front 21

Highest risk of HIV transmission

Back 21

Deep injury & exposure to the source

Front 22

Acute Febrile Syndrome w/ high level viremia

Back 22

Developed by 30-50% of those infected

Front 23

Ebola v AIDS

Back 23

Ebola CANNOT kill more people than AIDS virus over a period of time.