MicroBio 160 1st Edition Lecture 26Outline of Last Lecture I. Testing for HIVII. What do CD4+ Cell Counts MeanIII. Purpose of Viral Load TestsIV. Routine TestsV. Interventions Against HIVVI. Goals of HIV TreatmentVII. Major Classes of Anti-retroviral DrugsVIII. Combination TherapyIX. HAART CombinationsX. AtriplaXI. Mother to Child Transmission (MTCT)XII. Goals/ Quality of Life IssuesXIII. When is it time to Change Therapies?Outline of Current Lecture I. FactsII. Diagnosis of HIV infectionIII. Persons Living with Diagnosed or Undiagnosed HIV infection HIV Care Continuum OutcomesIV. The Public’s Experience with HIV TestingV. Facts Worldwide VI. Different Countries ExperiencesVII. Another Success StoryThese 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.VIII. AIDS OrphansCurrent LectureFacts in the US:- Since the epidemic began, an estimated 1,155,792 people in the United States have been diagnosed with AIDS - Approximately 636,000 of those people have died- Currently, 1,201,100 persons aged 13 years and older are living with HIV infection, and almost 1 in 7 (14%) are unaware of their infection- Gay, bisexual, and other MSM, particularly young black/African American MSM, are most seriously affected by HIV- By race, blacks/African Americans face the most severe burden of HIVDiagnosis of HIV Infection and Population by Race/ Ethnicity 2013 USDiagnosis of HIV infection: - The pie chart on the left illustrates the percentage distribution of diagnoses of HIV infection in 2013 by race/ethnicity in the United States; The pie chart on the right shows the percentage distribution of the population in the United States by race/ethnicity in 2013- In 2013, blacks/African Americans made up approximately 12% of the population of the United States, but accounted for 46% of diagnoses of HIV infection—Whites made up 63% of the population of the United States, but accounted for 28% of diagnoses of HIV infection—Hispanics/Latinos made up 17% of the population of the United States, but accounted for 21% of diagnoses of HIV infectionDiagnosis of HIV Infection and Population among Adolescents by Race/Ethnicity 2011:- Black/African American adolescents aged 13 to 19 years have been disproportionately affected by HIV—In 2011, in the United States, 15% of adolescents were black/African American, yet an estimated 67% of diagnoses of HIV infection in 13 to 19 year olds werein black/African American adolescentsAIDS Classifications among Persons Aged 13 years and older with HIV Infection, by Race/Ethnicity and Age Group 2011—US and 6 Dependent Areas:- This slide compares the racial/ethnic percentage distributions of stage 3 (AIDS) classifications in adolescents 13-19 years of age, young adults 20-24 years of age, andadults 25 years and over diagnosed during 2011 in the United States and 6 dependent areaso In all three age groups, blacks/African Americans had the largest percentage of stage 3 (AIDS) classifications, although the percentage decreased as age group increased: 66% in persons aged 13 to 19 years, 64% in persons aged 20 to 24 years, and 48% in persons aged 25 years and overo Hispanics/Latinos accounted for relatively similar percentages of stage 3 (AIDS) classifications in all three age groups, they represented the second largest percentage of persons 13-19 years (21%) and persons 20-24 years (18%) and the third largest percentage of persons among adults over 25 years of age (21%) The percentage of stage 3 (AIDS) classifications among whites in 2011 increased as age group increased: 10% in persons aged 13 to 19 years, 13% in persons aged 20 to 24 years, and 27% in persons aged 25 years andoverPersons Living with Diagnosed or Undiagnosed HIV infection HIV Care Continuum Outcomes 2009, 2010, 2011 US and Puerto Rico:- Four HIV care continuum outcomes: HIV diagnosis (based on data from the National HIV Surveillance System) and receipt of HIV medical care, antiretroviral prescription, and viral suppression— the denominator is the estimated number of persons aged ≥13 years with diagnosed or undiagnosed HIV infection in the United States. - Percentages of persons who were diagnosed with HIV infection, received HIV medical care, were prescribed ART, and who achieved viral suppression were relatively stable from 2009 to 2011 - National HIV Surveillance System: Estimated number of persons aged ≥13 years with diagnosed or undiagnosed HIV infection (denominator) who were alive at the end of the specified year— estimated number of persons aged ≥13 years with diagnosed HIV infection (numerator) who were alive at the end of the specified year; calculated as part of the overall prevalence estimate.- Medical Monitoring Project: Estimated number of persons aged ≥18 years who received HIV medical care January to April of the specified year, whose medical record contained documentation of antiretroviral therapy prescription, or whose most recent VL in the previous 12 months was undetectable or <200 copies/mL—United States and Puerto RicoDiagnosis of HIV infection among Children aged <13 years by age at diagnosis, 2008-2011 US and 6 Dependent Areas: - During 2008 through 2011 in the United States and 6 dependent areas, approximately 36% of children (aged <13 years) diagnosed with HIV infection were diagnosed within the first year of life, and 30% within the first 6 months—This distribution could change ifmore HIV-infected childbearing women become aware of their HIV status and seek medical care early in their pregnancyThe Public’s Experience with HIV Testing:- 14% of individuals that have HIV or AIDS do not know they are infected - 48% have been tested either in the last 12 months or more- 50% have never been testedFacts Worldwide:- There were 35.0 million people living with HIV in 2013, up from 29.8 million in 2001, the result of continuing new infections, people living longer with HIV, and general population growth- The global prevalence rate (the percent of people ages 15-49 who are infected) has leveled since 2001 and was 0.8% in 2013- 1.5 million people died of AIDS in 2013, a 35% decrease since 2005. Deaths have declined due in part to antiretroviral treatment (ART) scale-up o HIV is a leading cause of death worldwide and the number one cause of death in Africa- New HIV infections globally have declined by 38% since 2001. In 27 countries with sufficient
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