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