True or False?

Anyone can get HIV.

Magic Johnson
  • HIV and AIDS are the same thing.
  • About 1 out of every 300 Americans are living with HIV.
  • People with HIV/AIDS have just a few years to live.
  • Magic Johnson is “undetectable,” so he must be cured.

Timeline

  • Pre-1980: chimp-human crossover in the Congo
  • 1981: opportunistic infections in gay men in NY, CA
  • 1982-83: CDC uses “AIDS,” transmission identified, thousands of deaths worldwide
  • 1985-86: first test, Rock Hudson, Ryan White, Reagan first mentions AIDS, 40,000 cases in 85 countries, “HIV” coined
  • 1987-89: AZT, Liberace, Robert Mapplethorpe, Keith Haring
  • 1991-92: Magic Johnson, Freddie Mercury, Arthur Ashe, red ribbon
  • 1993-94: AIDS #1 cause of death in US aged 25-44, US visitor ban, Pedro Zamora
  • 1995-96: 23 million cases globally, HAART → US diagnoses decline, Greg Louganis, Eazy-E
  • 2001-02: Global Fund created, generic drugs, rapid test, HIV leading cause of death in Sub-Saharan Africa
  • 2009-10: Obama calls for Nat’l HIV/AIDS Strategy, lifts travel/immigration ban, PrEP, one pill a day
  • 2015: 37 million cases globally, Charlie Sheen

What body fluids transmit HIV?

  • Blood 
  • Semen
  • Vaginal Fluid
  • Breast Milk (trace amounts)

What body fluids do NOT transmit HIV?

  • Spit, Mucus 
  • Sweat, Tears
  • Urine, Feces
  • Vomit 

Modes of Transmission

  • Anal and vaginal sex
  • Only 2% of new HIV diagnoses in MN relate to IV drug use
  • No babies born with HIV in Minnesota over the past several years
HIV Life cycle

Ways to Lower Your Risk

  • Universal Precautions
    • Treat all human blood and infectious body fluids as if they could carry HIV and other pathogens.
  • Post Exposure Prophylaxis (PEP)
    • The “morning after” equivalent - within 72 hours of exposure
    • One month of HIV meds (must be 95% adherent)
    • Covered by public health insurance
    • Over 90% effective in preventing HIV transmission
  • Pre Exposure Prophylaxis (PrEP)
    • Like birth control, but for HIV
    • For high risk HIV- people: MSM, serodiscordant couples, sex workers
    • 1x/day Truvada (must be 95% adherent)
    • Covered by insurance
    • Up to 99-100% effective in preventing HIV
  • Condoms
    • Must be used consistently and correctly
      • Storage
      • Expiration date
      • Correct lubrication
      • Putting it on correctly (reservoir tip!!)
      • Latex or non-latex alternative
Treatment-as-Prevention
  • HIV+ people on medication who are “undetectable” are 96% less likely to transmit HIV (studies ongoing, transmission risk may even be ZERO)
TESTING
  • Why Get Tested?
    • Most common symptom of STIs is NOTHING (feeling fine and having no symptoms)
    • It’s free, confidential, and quick.
    • You’re protecting yourself and your partner.
    • It’s better to know! If you know your HIV status, you can do something about it. If you are negative, great. If you are positive, start treatment and go on with your life.
Anyone who has ever had sex or used injection drugs should get screened regularly.
HIV in the World
  • 36.9 million people around the world are living with HIV, including 2.6 million children
  • 70% of global total in sub-Saharan Africa
  • 22 million people with HIV do not have access to treatment
  • HIV is responsible for 39 million deaths since the early 1980s
HIV Medications
  • Goal of treatment: suppressed or “undetectable” viral load of less than 50 copies/ml
  • Adherence: cannot skip more than 1 dose/month
  • Early treatment means 41% fewer HIV-related illnesses and reduces transmission by 96%
  • What are reasons some people living with HIV don’t take medications?