HIV/AIDS
Elaine Kauschinger PhD, MS, ARNP, FNP-BC
Assistant Professor of ClinicalLead Faculty, Family Nurse Practitioner Program
University of MiamiSchool of Nursing & Health Studies
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Objectives Discuss the epidemiology of HIV/AIDS at the
international, national and state level Describe HIV-infected patients in terms of age,
gender, ethnicity, and sexual orientation Discuss modes of transmission of HIV Identify clinical management and treatment Discuss counseling and testing Describe prevention & infection control Identify risk factors associated with occupational
exposure
License Requirements FS381.004.5
1 hour on HIV/AIDS CE requirement to be completed prior to the first renewalPart 1: Epidemiology & transmissionPart 2: Counseling & TestingPart 3: Clinical management & treatmentPart 4: Prevention & infection control
HIV/AIDS: Part I Epidemiology &
Transmission
HIV/AIDS: Basic Definitions Human Immune
Deficiency Virus
Acquired Immune Deficiency Virus
Opportunistic Infections (OIs)
CD4 count & viral load
HIV vs AIDS AIDS definition:
• Candida Pulmonary Esophageal Not thrush
• PCP• Coccidiodomycosis –
extrapulmonary• Cervical cancer• CMV• HIV encephalopathy• Chronic HSV infections• Kaposi’s sarcoma• Lymphoma
• Mycobacterium TB MAC
• PML• Recurrent pneumonia• Toxoplasmosis• Wasting syndrome• CD4 < 200 or < 14%
lymph• Cryptosporidium• Isospora• Recurrent bacterial
infection• Recurrent pneumonia
History of HIV/AIDS
History of HIV/AIDS epidemic in the U.S. is very recent.
June 1981: the first description of what would soon be referred to as AIDS appeared in the Center for Disease Control’s (CDC) Morbidity and Mortality Weekly Report.• Florida reported its first AIDS case in
1981
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Initial Reports
June 5, 1981: 5 cases of PCP in gay men from UCLA (MMWR)
July 3, 1981: 26 additional cases
Dec 10, 1981: 3 NEJM papers describe cases
Gottlieb MS NEJM 2001;344:1788-91
Introduction
CDC (2009) estimates 1.2 million people in the United States (US) are living with HIV infection. • About 33 million people living with HIV worldwide
One in five (20%) of those people are unaware of their infection.
Despite increases in the total number of people in the US living with HIV infection in recent years, the annual number of new HIV infections has remained relatively stable. • New infections continue at far too high of a level, with
approximately 50,000 Americans becoming infected with HIV each year.
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Total: >40 million
N. America
~1 million
Caribbean 440,000
Latin/South America
1.5 million
W. Europe
570,000
N. Africa & Middle East 500,000
Sub-Saharan Africa
29.5 million
E. Europe/C. Asia 1.2 million
E. Asia/Pacific 1.2 million
SE Asia
6.0 million
Australia 15,000
Modes of Transmission
Sexual• Anal>vaginal>oral
Perinatal• Intrapartum• Labor & Delivery• Breastfeeding
Blood• IVDU• Occupational exposure• Transfusion & blood products
Prevention of Transmission
Avoidance of direct contact with sexual fluids
Abstinence
Safer sex & condom use
Infection control practices
Safer blood supply
Mother-to-child (MTC)
IVDU
Please continue to part 2