HIV and Its Implications

Introduction

• HIV (Human Immunodeficiency Virus) is a severe STI with no cure.
• Untreated HIV can lead to death.
• Focus of discussion:
  • HIV's effect on the body.
  • Different levels of risk associated with various forms of intercourse.
  • Disproportionate risk between males and females.
  • Effectiveness of current treatments and prevention strategies.
  • Who should get tested for HIV.

Understanding HIV

• HIV is a retrovirus, using RNA to encode genetic information.
• Targets the immune system, specifically CD4 (helper T) cells.
• Transmission: contact with infected bodily fluids (blood, semen, vaginal fluids, breast milk).
• Non-transmission: casual contact (shaking hands, hugging, kissing, sharing utensils).

Risk of Transmission

• Highest risk: receptive anal intercourse (1 in 72 acts).
  • Higher risk due to thinner mucosal lining of the rectum.
• Insertive anal intercourse: 1 in 909 acts.
• Receptive penile-vaginal intercourse: 1 in 1250 acts.
  • Higher risk for females due to larger vaginal surface area and prolonged exposure to infected semen.
• Insertive penile-vaginal intercourse: 1 in 2500 acts.
• Low risk: receptive/insertive penile-oral intercourse (0-4 in 10,000 acts).
• Female-to-female transmission is rare.
• Bloodborne exposure risks:
  • Blood transfusion: 1 in 10.
  • Needle sharing: 1 in 150.
  • Percutaneous needle sticks: 1 in 435.
  • Mucous membrane exposure: 1 in 1,000.

Factors Increasing Risk

• Discordant couples (one partner has HIV, the other does not).
• Multiple sex partners and non-monogamous relationships.
• Higher viral load during acute phase of HIV increases transmission risk.
• Risk assessment should consider consequences (e.g., 2-3% chance of contracting cold vs. HIV, with vastly different outcomes).

Importance of Testing and Treatment

• Testing is crucial for early detection and treatment.
• Let's Get Checked: Virtual care company providing home test kits, including HIV tests.
• Significance of kidney function tests, especially during National Kidney Month.
• Chronic kidney disease often asymptomatic; testing can detect important markers.

Early Stages of HIV Infection

• Initial infection often asymptomatic or with mild, flu-like symptoms:
  • Fever, headache, sore throat, muscle aches, fatigue, rash, diarrhea, weight loss, ulcerations.
  • Symptoms appear 2-4 weeks after exposure and typically resolve on their own.
• Importance of CD4 cells (immune system regulators).
• Acute phase: high viral load, easier transmission.
• Chronic HIV: few to no symptoms but declining CD4 cells.

Progression to AIDS

• AIDS (Acquired Immunodeficiency Syndrome) occurs when CD4 cells drop below 200 cells/µL (normal: 500-1,400 cells/µL).
• Opportunistic infections become life-threatening.
• Untreated progression to AIDS takes about 8-10 years.

Anti-Retroviral Therapy (ART)

• Effective in slowing disease progression.
• Combination of HIV medications taken daily.
• Reduces viral load, maintaining CD4 count.
• Undetectable viral load reduces transmission risk.

Pre-Exposure and Post-Exposure Prophylaxis (PrEP and PEP)

• PrEP: Pre-exposure prophylaxis for high-risk individuals (multiple sex partners, IV drug users, discordant couples).
• PEP: Post-exposure prophylaxis within 72 hours of high-risk exposure (known contact with infectious fluids/tissue).

Testing Recommendations

• Routine testing for anyone with known exposure or symptoms.
• Pregnancy screening.
• Health care workers after accidental needle sticks.
• Healthy, low-risk individuals should get tested at least once in their lifetime.

Preventive Measures

• Safe sex practices, sterile needles, universal precautions.
• PrEP for high-risk individuals.
• Importance of initiating ART early for HIV-positive individuals for long, healthy lives.

Conclusion

• Emphasized importance of testing and preventive measures.
• Encouragement for those with HIV to seek treatment.
• Promo for kidney and STI tests via Let's Get Checked.

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