MicroBio1st Edition Lecture 24 Outline of Last Lecture I Main Symptoms II Viral and Host Factors Influence the Progression to AIDS III New AIDS Definition IV The CDC s Definition of AIDS V Stages of HIV Infection VI Rapid Progression to AIDS VII Set Point VIII Viral Load and Progression to AIDS IX AIDS Onset X Opportunistic Infections XI The Virus cycle between Malnutrition and AIDS Outline of Current Lecture I Transmission of HIV II How HIV enters the body III HIV Transmission Trends IV Modes of Transmission in Adults V Documented Cases VI Routes of Exposure These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute VII Condom Use and HIV Transmission VIII Drug Use Alcohol and HIV Infection IX Criminal Deliberate and Reckless HIV Transmission X People who attempt to contract HIV XI HIV Transmission Risk and Sexual behaviors Current Lecture Common transmission of HIV Unprotected sex with an infected partner Sharing needles with infected person Almost eliminated as risk factors for HIV Transmission from infected mother to fetus Infected from blood products How the HIV can enter the body 1 Doesn t have to have a tear it can get on a thin layer of skin with blood vessels the HIV can move around those cells and into the bloodstream The HIV virus can penetrate the outer surface of fragile skin rectal or vaginal lining then the virus enters the bloodstream 2 The HIV virus can enter the body through a cut sore or needle puncture then the virus enters the bloodstream 4 Bodily Fluids semen vaginal fluid blood breast milk HIV Transmission Trends US Transmissions rate in heterosexuals so low that they must have been lying about it o Because of this at first they believed it could have only been transmitted by needle or homosexuals Now heterosexuals have a large portion other forms of transmission have dropped Modes of Transmission in Adults they check hospital records when did they become infected and how do they think they became infected Homosexuals 15 Injections Drug abuse 7 Blood Blood products 5 Other unknown 2 Heterosexual 71 Documented Cases of HIV Transmission Among Health Care Workers 1981 2002 57 confirmed cases 139 possible cases Nurses 42 1 Lab workers 33 3 Other 7 Surgical technicians 3 5 Housekeeping and maintenance 3 5 Physicians 10 5 o No new documented cases of occupationally acquired HIV AIDS have been reported in the US since December 2001 o New standardized precautions What activities could you be doing to put you at risk Routes of Exposure and Risk of Transmission Sexual Transmission Female to male transmission 1 700 to 1 3 000 Males to female transmission 1 200 to 1 2 000 Male to male transmission 1 10 to 1 1 600 Fellatio 0 6 Parenteral Transmission Transfusion of infected blood 95 100 Needle sharing 1 150 Needle stick 1 200 Needle stick AZT PEP 1 10 000 Transmission from mother to infant Without AZT treatment 1 4 With AZT treatment less than 1 10 Sexual Transmission of HIV Seroconversion Acute Infection 3 weeks when you are first infected may or may not have symptoms most infected risk of transmitting is very high so you are likely to transmit the infection Asymptomatic Infection there is still risk 1 10 000 even if you are on medication still infective HIV Progression As the HIV virus begins to defeat your system you become more infectious again AIDS When you have transitioned into AIDS you are back up to 1 1 000 Condom Use and HIV Transmission one partner is HIV positive the other is HIV negative the risk is calculated Always consistent 9 Sometimes inconsistent 5 1 Never nonuse 6 5 o Male condoms effectiveness for pregnancy and HIV Best cases Pregnancy 97 HIV 96 Typical cases Pregnancy 86 HIV 87 Drug Use Alcohol and HIV Infection Alcohol use is associated with high risk sexual behaviors and IV drug use two major modes of HIV transmission o Nobody really pays attention to the fact that alcohol really has a higher odds ratio for being a risk factor for transmission of HIV You can bring in used needles in exchange for a needle exchange pack if they are an IV drug user they are trying to at least protect them from using infectious needles Drugs lower your inhibitions you are then more likely to do things that you wouldn t normally do In young people it has shown that alcohol and drug use are associated to HIV Criminal Deliberate and Reckless HIV Transmission More countries have HIV laws an increasing number of countries are applying criminal laws to prosecute HIV transmission or exposing it to another person a new report found Countries with laws criminalizing the spread of HIV many about half have laws or considering adopting laws that criminalize HIV transmission or exposure if you don t tell your partner that you are HIV positive and transmit HIV to your partner you can go to jail o Use needles or other implements to intentionally infect others with HIV o HIV people who have had sex with the primary purpose of transmitting the virus to their partner considered grievous bodily harm or reckless endangerment People who intentionally try to contract HIV Bug chasers bug hunters Private sex clubs invitations When they receive the bug they think of it of have gotten a gif Myth about it being a chronic and manageable disease Couples feel that both partners having the infection it is romantic HIV Transmission Risk and Sexual behaviors Transmission depends on HIV viral load and type of sexual behavior The relative risk for HIV transmission varies from 100 for receptive anal sex 20 for receptive vaginal sex 13 for insertive anal sex 10 for insertive vaginal sex to 2 for receptive fellatio versus 1 for insertive fellatio HIV Transmission by oral sex between men has been reported HIV transmission is reduced by approximately 80 with condom use
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