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Explore the basics of HIV/AIDS, symptoms, transmission, testing, treatment, and global impact. Learn ways to reduce risk and access testing locations. Stay informed to prevent the spread of HIV/AIDS.
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HIV/AIDS:An Overview Andrea A. Howard, MD, MS Montefiore Medical Center
Overview • 3rd decade of the epidemic • 60 million have been infected • 20 million have died • Half of newly infected under age 25 • HIV is preventable
What is HIV? • Human Immunodeficiency Virus • Causes AIDS • Harms the immune system • Attacks helper T cells (CD4+ cells)
What is AIDS? • Acquired Immunodeficiency Syndrome • Most advanced stage of HIV disease • Immune system very weakened by HIV • Opportunistic Infections—take advantage of weakened immune system • Cd4+ count falls to <200 cells/mm3
How does someone get HIV? • Unprotected sexual contact • Sharing a needle to inject drugs • Pregnancy, delivery, and breast milk • Blood products (unlikely) • NOT by hugging, shaking hands, coughing, toilets, water fountains…
Signs and Symptoms • Acute Retroviral Syndrome • Clinical latency • Constitutional symptoms • AIDS
Rash Kahn and Walker, N Engl J Med 1998; 339:36.
Clinical Latency • No signs and symptoms • Viral replication • T helper cell destruction • 8-10 years without meds • Reservoirs of latently infected cells
Constitutional Symptoms • Swollen glands (neck, underarm, groin) • Fevers, night sweats • Rapid weight loss • Fatigue • Diarrhea, poor appetite • White spots in mouth
AIDS • Infections • Neoplasms • Neurologic manifestations • Wasting • CD4+ count <200 cells/mm3
Pneumocystis pneumonia http://aidshistory.nih.gov/first_encounters/rayx.html
What are ways to reduce the risk of getting HIV? • Choose not to have sex • Agree to be faithful with HIV- partner • Use latex condoms, dental dams • Get prenatal care • Do not share needles or syringes • Get Tested! Ask partners to do the same.
HIV & other Sexually Transmitted Diseases (STDs) • Increases risk of contracting HIV • Increases risk of transmitting HIV
HIV Testing • HOW? • HIV test is quick, free, confidential • WHY? • Know your status • Keep yourself and others safe • Get treated
WHAT does an HIV test tell you? • Positive test • Person is infected with HIV • Person can infect others • Does not mean person has AIDS • Negative test • Probably not infected • Does not mean person can’t get infected
HIV Testing: WHERE? • 718-881-TEST • BRONX • Montefiore 718-882-0023 • BROOKLYN • Project HEAT 718-467-4446 • MANHATTAN • GMHC 800-AIDS-NYC • Mt Sinai 212-423-2971 • NY Presbyterian 212-342-3201
How is HIV treated? • No cure • No vaccine • Highly Active Antiretroviral Therapy (HAART) • keep infected persons healthy longer • Dietary requirements • Side effects • Importance of adherence
HIV/AIDS in the US • >500,000 Americans have died • 1 million are living with HIV • One-quarter do not know they are HIV+ • 40,000 new infections each year • # deaths down since the mid 1990’s, but has remained steady in recent years
HIV/AIDS in the Young • Half of new infections in those under 25 • Most infected through sex • People of color represent the majority of: • New HIV infections • New AIDS cases • People living with AIDS • Survival after AIDS is lower among African Americans
HIV/AIDS in Women • 8% of AIDS in 1985, to 27% in 2003 • New AIDS cases among women in 2003 • 67% African American • 16% Latina
Global HIV/AIDS Epidemic • 40 million people living with HIV/AIDS • 20 million have died • Sub-Saharan Africa • 2/3 of people with HIV/AIDS • 3/4 of deaths • Next wave • Russia (860,000) • India (5.1 million) • China
For more information • ahoward@montefiore.org • 1-800-342-AIDS (CDC AIDS Hotline) • 1-800-458-5231 (National AIDS Information Clearinghouse) • www.AdolescentAIDS.org • www.GettinBusy.org
Eastern Europe & Central Asia 1.4 million [920 000 – 2.1 million] Western & Central Europe 610 000 [480 000 – 760 000] North America 1.0 million [540 000 – 1.6 million] East Asia 1.1 million [560 000 – 1.8 million] North Africa & Middle East 540 000 [230 000 – 1.5 million] Caribbean 440 000 [270 000 – 780 000] South & South-East Asia 7.1 million [4.4 – 10.6 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] Latin America 1.7 million [1.3 – 2.2 million] Oceania 35 000 [25 000 – 48 000] People living with HIV, end 2004 Prevalence (range) • 39.4 M living with HIV/AIDS; 50% women • 4.9 M new HIV infections in 2004 • 3.1 M deaths due to HIV/AIDS in 2004 Source: UNAIDS
Distribution of 50,886 PersonsLiving with AIDS in NYC (2004) Staten Island 2% Queens 15% Manhattan 34% Brooklyn 27% Bronx 22%
Structure of HIV Particle capsid matrix Adapted from http://osms.otago.ac.nz/main/bursary/hiv.html