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HIV/AIDS in the United States Gwendolynn Barger - Aya Baligod - Michael Buie Kelsey Watson - Katherine Kodros:

HIV/AIDS in the United States Gwendolynn Barger - Aya Baligod - Michael Buie Kelsey Watson - Katherine Kodros

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Human immunodeficiency virus (HIV) is a sexually transmitted infection that causes acquired immune deficiency syndrome (AIDS), which is potentially deadly. Pathophysiology

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HIV infection causes progressive destruction of the cell-mediated immune system, primarily by eliminating CD4 + T helper lymphocytes. HIV virus attacking a healthy cell Pathophysiology

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HIV cells attack healthy t-cells and uses them to make copies of itself, destroying the healthy cells in the process

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HIV is transmitted through direct contact of the mucous membrane or the bloodstream with bodily fluid containing HIV . Pathophysiology

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There are four distinct stages of HIV infection. I: Primary Infection II: Clinically Asymptomatic Stage III: Symptomatic HIV infection IV: Progression from HIV to AIDS Pathophysiology

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Pathophysiology Phase I: Primary HIV infection O ccurs 1-6 weeks after initial HIV infection Symptoms are similar to the flu HIV circulates peripheral blood, which triggers an immune system response of HIV antibody and cytotoxic lymphocytes production. This process is known as seroconversion . A test for HIV antibodies during this time period may not be positive.

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Pathophysiology Phase 2: Clinically asymptomatic stage After seroconversion , virus levels are low and replication continues slowly. This stage generally has no major symptoms and may last for years The level of HIV in peripheral blood drops, but individuals still are able to infect other individuals during this time.

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Pathophysiology Phase III: Symptomatic HIV infection Symptoms begin appearing as the body fails to replace destroyed T-helper cells and the lymph nodes are damaged. Individuals may experience extreme weight loss, chronic diarrhea, and persistent fever. Symptoms are caused by opportunistic infections, which the body would normally be able to fight off if it was not immuno -compromised. Opportunistic infections can include bacterial, viral, and fungal infections such as pneumonia, yeast infections, and herpes simplex. Treatments during this phase are generally aimed at curing opportunistic infections.

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Pathophysiology Phase IV: Progression from HIV to AIDS As the body fails to fight off opportunistic infections, it gets weaker and more damaged. Clinical criteria for an AIDS diagnosis is a CD4 + T cell count below 200 cells/mm3. There are generally signs of life-threatening infections and unusual tumors. HIV positive baby with herpes (opportunistic infection)

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Prevalence of HIV infection is at an all time high in the United States. Incidence & Prevalence

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The CDC estimates that 1.2 million people in the U.S. are living with HIV infection. 1 in 5 of these individuals do not know they are infected. Incidence & Prevalence

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The CDC estimates approximately 50,000 people are newly infected with HIV every year in the U.S. Incidence & Prevalence Incidence rates are disproportionate across gender, race, and geographic location in the U.S.

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Men have significantly higher rates of HIV infection than women. Incidence & Prevalence HIV rates by Gender, CDC 2006

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AIDS in the U.S. by Geographical Distribution Incidence & Prevalence

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AIDS in the U.S. by Race and Geographical Distribution Incidence & Prevalence

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Gay and bisexual men remain the population most heavily affected by HIV in the U.S. Incidence & Prevalence CDC, high-risk populations MSM: Men who have sex with men IDU: Injection drug users The CDC estimates the men who have sex with men (MSM) population represents 2% of the U.S. population, but account for more than 50% of all new HIV infections.

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Pathophysiology African Americans and Hispanic/Latino are the racial groups most affected by HIV. African Americans represent 14% of the U.S. population, but accounted for 44% of all new cases in 2009. Hispanic/Latinos represent approximately 16% of the total U.S. population, but accounted for 20% of all new cases in 2009. Estimates of New HIV infections in the U.S., 2009, CDC

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AIDS Diagnoses, Deaths, and Persons Living with AIDS 1985-2009 Trends Over Time As medications & diagnostic tools improve, we are observing more individuals being diagnosed with AIDS. Deaths due to AIDS have largely plateaued because of antiretroviral medications.

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AIDS Diagnoses among Adults and Adolescents, by Race, 1985-2010 Trends Over Time Until the early 1990s, AIDS diagnoses rose steeply for White and Black/African American individuals. In 1994 the number of AID diagnoses of Black/African American individuals surpassed White individuals

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Deaths of Adults and Adolescents with AIDS, by Race, 1985-2009 Trends Over Time For the first time in 1996, the number of deaths of adult and adolescent blacks/African Americans with AIDS exceeded that of whites. Since 1996, the annual number of deaths of blacks/African Americans with AIDS has continued to be higher than all other races/ethnicities.

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You may be at risk for HIV if you: Don’t use a condom during sexual intercourse Have multiple sex partners Have other sexually transmitted diseases, which may increase the risk of infection during sex Share needles, syringes, rinse water, or other equipment used to prepare illicit drugs for injection * HIV can be passed from mother from child during pregnancy, birth, or breast-feeding. A child is at increased risk of developing HIV if their mother is HIV positve . Risk Factors

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Mortality An estimated 17,774 people with AIDS died in 2009, and nearly 619,400 people with AIDS in the U.S. have died since the epidemic began.

Costs of HIV:

Costs of HIV Burden to Health Care System The cost of new HIV cases in 2002 was $36.4 billion, including $6.7 billion in direct medical costs and $29.7 billion in productivity losses. Direct medical costs and productivity losses of HIV/AIDS resulting from infections diagnosed in 2002 are substantial. Productivity losses far surpass direct medical costs and are disproportionately borne by minority races/ethnicities.

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Measures for prevention and control Prevention of HIV Behavioral interventions – educate and motivate individuals to understand HIV and sexual health HIV Testing – prevent the spreading of HIV by making sure people know if they are infected Condom use Testing and counseling for HIV and STIs Elimination of mother-to-child transmission of HIV Harm reduction for injecting drug users Needle-replacement programs for drug users

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Controlling HIV Pre-exposure prophylaxix ( PrEP ) for HIV-negative partners & post-exposure prophylaxis (PEP) may reduce the risk of transmission of HIV if used quickly. There is no cure for HIV. Some medications are available to fight HIV and lessen its effects. Measures for prevention and control

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Local Resources for Prevention McKinley Health Center Offers testing free of charge for students Planned Parenthood Offers testing at a fee Has behavior counseling Measures for prevention and control

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Centers for Disease Control and Prevention . Centers for Disease Control and Prevention, 11 Apr. 2012. Web. 23 Nov. 2012. <http://www.cdc.gov/hiv/topics/basic/>. "AIDS Surveillance-Trends." Centers for Disease Control and Prevention . Centers for Disease Control and Prevention, 16 July 2012. Web. 26 Nov. 2012. "Sexual Risk Factors." Sexual Risk Factors .N.p ., 18 June 2012. Web. 23 Nov. 2012. <http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/sexual-risk-factors />. http://www.news-medical.net/health/AIDS-Pathophysiology.aspx http://www.medical-library.net/hiv_aids.html http://www.cdc.gov/hiv/topics/surveillance/incidence.htm http://www.cdc.gov/hiv/topics/surveillance/resources/slides/mortality/ http://www.kff.org/hivaids/upload/3029-12.pdf http://stdpreventiontraining.jhmi.edu/docs/Fleming%20et%20al_HIVPrev_Seattle_CROI_2002.pdf http://jama.jamanetwork.com/article.aspx?articleid=182334 http:// en.wikipedia.org/wiki/HIV/AIDS_in_the_United_States http:// www.who.int/mediacentre/factsheets/fs360/en/index.html http://www.prezista.com/patients/hiv-background-treatment/hiv-can-be-treated?utm_source=google&utm_medium=cpc&utm_campaign=HIV+General+New_Broad&utm_term=hiv%20and%20aids&utm_content=HIV+General+-+High+CTR|mkwid|sW6cxaSSG|pcrid|15440248750&gclid=CPS57ZWc3LMCFcU-Mgod5DYA1Q http://www.cdc.gov/hiv/resources/factsheets/us.htm

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