HIV/HCV 101

1. HIV/HCV 101 Developed by: Positive Living North Society No khēyoh t’sih’en t’sehena Society

2. Human Can be transferred from human-to-human only Immunodeficiency The inability of the body to produce an adequate immune response to fight disease Virus A microscopic, parasitic agent that can only replicate inside a host cell HIV Stands For...

3. Acquired Something you have Immune Immune System protects the body from illness Deficiency Immune System is deficient; cannot protect itself from illness Syndrome A collection of symptoms; all people with this illness will not experience the same symptoms. AIDS Stands For...

4. HIV and the Immune System Different types of white blood cells form the immune system The immune system fights off diseases and illnesses HIV targets white blood cells called CD4 cells or T-helper cells CD4 cells help organize the body’s defense against viruses and illnesses

5. HIV is a retrovirus, this means it needs a host cell to be able to make copies of itself because it is missing some components The HIV virus attaches itself to a receptor (nub on outside of cell wall) of a CD4 cell and begins to fuse itself with that cell Once inside the CD4 cell the HIV virus begins making copies of itself inside the infected cell (like a factory) The copies of the virus then leave the CD4 cell and try to infect other healthy CD4 cells

6. HIV HIV HIV HIV HIV CD4 Cell HIV RNA HIV HIV HIV HIV HIV HIV DNA The HIV particle enters a healthy immune cell through it’s receptors Once inside the CD4 call the RNA from the HIV particle combines with the DNA and the immune cell begins to produce HIV particles. Once the HIV particle has been replicated inside an immune cell it sends the newly formed HIV particles out of the cell to go destroy other immune cells Food for Thought: HIV is considered a retrovirus due to it’s ability to transform RNA into DNA

7. HIV Continuum HIV AIDS Acute Infection Window Period Asymptomatic Stage Symptomatic Stage Point of Infection

8. Stages of HIV Point of Infection When HIV enters the blood stream Acute Infection May experience intense flu-like symptoms 1-6 weeks after the point of infection Window Period 3 month period beginning at Point of Infection and ending when the body is producing enough HIV- specific antibodies to be detected through a blood test

9. Asymptomatic Infection Period of time from Point of Infection to Symptomatic stage Other than flu-like symptoms, no symptoms are present This stage can last for a long time...5 years...10 years... The length of time that someone stays in this stage depends largely on their lifestyle, and whether or not he/she has access to the determinants of health

10. Symptomatic Infection When noticeable signs and symptoms begin to appear. Some common symptoms include, but are not limited to: • Chronic fatigue • Chronic fever • Swollen lymph nodes • Diarrhea • Nausea • Night Sweats • Weight loss • Changes in Menstruation • Thrush • Yeast Infections (recurring) • Pneumonia • Dental problems/gum disease • Fungal/bacterial infections • Abnormal PAP smears Note: having a couple of these symptoms does not necessarily mean you have HIV

11. Symptomatic Infection

12. AIDS A combination of a low immune system Presence of severe opportunistic infection(s) A CD4 cell count below 200 per microliter of blood Must be diagnosed by a medical doctor through a blood test Note: A person does not technically die from AIDS, but rather from one of the opportunistic infections that AIDS allows to take over the body. Examples of Severe Opportunistic Infections: Tuberculosis; Cancers; Pelvic Inflammatory Disease

13. Body Fluids You Can get HIV from: Blood Breast Milk Semen/Pre-ejaculate Vaginal/Cervical Fluid • You Cannot get HIV from: • Saliva/Mucous • Sweat/Tears • Urine/Feces • Vomit • An easy way to remember: • HIV is found in the “Life Giving” fluids • The fluids that support life or aide in procreation • HIV is NOT found in the “Waste” fluids • The fluids that are expelled from the body as waste 3 Second Rule: If HIV has been exposed to oxygen for at least 3 seconds the virus will die; oxygen kills HIV

14. Body Openings HIV enters the body through body openings Eyes, Nose Mouth (when swelling or abrasion are present) Open cuts/scrapes (fresh, not scabbed over) Urethra Anus Vagina Veins Note: Receptors cells/mucous membranes pull viruses directly into the blood stream

15. Risk and No Risk Activity Please wait for instruction...

16. Risk Activities • Unprotected sex: • Vaginal • Oral • Anal • Sharing needles: • Injection drug use • Steroid use • Needle prick in the workplace • Sharing drug equipment • Tattooing and Body Piercing • Mother (HIV+) to baby • Breast feeding • Birth

17. Low/No Risk Activities Hug Kiss Masturbation Protected sex- using a condom is safer, but never 100% Share clothes Share utensils/cutlery/cups/dishes Share a bathroom/toilet Swimming Unshared sex toys Donating blood Socializing- talking, sitting in same chair Petting/Phone sex

18. CD4 cell count is the amount of immune cells in the body If the CD4 cell count is high you should feel good- this means your immune system is strong Viral Load tells us how much virus is in the body If your Viral Load is high you will not feel very well If you are HIV+ you want your CD4 Cell Count to be high and your Viral Load to be low If you are HIV+ you may have an Undetectable Viral Load- this means the virus can not be found in your body, but you are still HIV+ CD4 Cells and Viral Loads?

19. Treatment There are different forms of treatment for HIV Antiretroviral Therapy Complementary Therapy Treatment increases: Quality of life Length of life It is possible for two people who are HIV+ to infect each other with different strains of the virus, which could mean a stronger more resistant strain

20. Antiretroviral Therapy Lowers the rate at which HIV replicates inside the body This aides in: Keeping the CD4 cell count up (immune cells) Repairing damage to the immune system Important to take Antiretrovirals at same time each day to prevent virus from resisting medication

21. Complementary & Holistic Therapy The practice of therapies that do not fall within “Western” medicine, including: Mind-body therapies- meditation; sweats Touch therapies- acupuncture; massage Therapies comprised of physical agents that are eaten, drank, inhaled or rubbed on skin- herbal therapy Many people find that alternative therapies: Helps ease symptoms Manage side effects of Antiretrovirals Increase general-well being

22. Condom DemonstrationsPlease wait for instruction…

23. Global Statistics

24. Global Statistics As of December 21st, 2008 (approximate): • Sub-Saharan Africa 23.9 million • North Africa and Middle east 420, 000 • Asia 5 million • Oceania 87, 000 • Latin America 1.84 million • Caribbean 250, 000 • Eastern Europe and Central Asia 1.61 million • North America, Western and Central Europe 2.81 million More than 25 million people have died from AIDS since 1981

25. Canadian Statistics As of December 21st, 2008: Approx. 64, 000 people have tested positive for HIV in Canada Most common methods of infection in Canada: Anal sex Injection drug use Vaginal sex

26. Statistics- Close to Home Vancouver currently has the highest rate of HIV infection in BC with a rate of 30.7 Currently, the Northern Interior has the second highest rate of HIV infection in BC with a rate of 16.0 Note: Rates per 100,000 population

27. Aboriginal People & HIV/AIDS • The rates of infection in northern BC are currently highest among Aboriginal people • In BC, one Aboriginal person a week becomes infected with HIV • Studies show that there is direct link between the affects of Colonization & rates of infection in Aboriginal people

28. Hepatitis C What does Hepatitis mean? Hepa- means liver titis- means inflammation What does the liver do? The liver has many functions in the body We cannot live without a liver

29. The Liver • What does the liver do? • The liver has many functions in the body, we cannot live without a liver • Makes nutrients • Clears out harmful things (drugs, alcohol) • Helps with clotting of blood • Hormones • Keeps your body healthy

30. How Can You Get Hep C? • You can get Hepatitis C infected blood products • Activities that can put you at risk for getting Hep C include: • Sharing items that may have someone else's blood on it- like nail clippers, razors, toothbrushes, ect • Sharing needles • Sharing tattooing/piercing equipment • Having unprotected sex with someone who is infected

31. Hep C is a much stronger virus than HIV • Hep C can survive outside the human body up to 14 days • It can survive in a pool of dried blood • There is no cure for Hep C, there is also no vaccine for Hep C • Approximately 25% of people who get Hep C will naturally get rid of it • Antiretroviral treatment can often help rid the body of the virus, but it does not work for everyone (works for about 60% of infected people)

32. Where Can I Get Tested? • Doctor’s offices or medical clinics • Needle exchange programs (if available in your community) • Health Unit • Community Health Nurse • Sexual Transmitted Infections Clinic (if available in your community) • Hospital Note: STI testing is confidential for anyone over the age of 12

33. Thank you for listening. Stay Safe!