1. A Global Glance at HIV/AIDS Epidemic HuffPost; Healthy Living; September 3, 2012  ___________people live with HIV/AIDS worldwide. The vast majority are in low- and middle-income countries.  An estimated 2.7 million people were newly infected with the virus in __________.  HIV/AIDS is the world’s leading____________killer.  About __________have died to date. An estimated 1.8 million people die ___________from HIV/AIDS.  An estimated 3.4 million children are living with HIV/AIDS According to 2010 figures most of the children live in _____- __________ and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Almost 1,100 children become newly infected with HIV each day. The number of children receiving ART (_________________) increased from about 75,000 in 2005 to 456,000 in 2010.

2. A Global Glance at HIV/AIDS Epidemic  48% of adults with AIDS _____________.  80% of all AIDS cases were caused ______________(male- female) intercourse.  HIV is the strongest risk factor for developing active TB disease. In 2010, more than _____________deaths from tuberculosis occurred among people living with HIV. That is one fifth of the estimated 1.8 million deaths from HIV in that year. The majority of people living with both HIV and TB reside in sub-Saharan Africa (about _____of cases worldwide).  A year's supply of antiretroviral drugs cost less than $_________per person per year for the least expensive regimen recommended by the U.N. In 2000, it cost more than $__________. ABS-CBN.COM Factbox 7/19/2012

3. A Glance at HIV/AIDS Epidemic in the USA  Since the AIDS epidemic began in __________, 1.7 million Americans have been infected with HIV and 641,976 have died of AIDS-related causes.  1.1 million Americans are living with ____________.  An estimated 18% of people living with HIV are ______________.  Every _______ ________, someone in the U.S. is infected with HIV.  Gay and bisexual men continue to bear the greatest burden of HIV infection, accounting for an estimated _______ of new HIV infections.

4. A Glance at HIV/AIDS Epidemic in the USA  African-Americans and Latinos are disproportionately affected by HIV and AIDS. _______-________ accounted for 44% of new HIV infections in 2009 yet they make up only ______of the U.S. population. Latinos account for ______ of new infections yet comprise 16% of the U.S. population. Whites represent 32% of new infections and account for __________ of the total population.  Young _______ and teens between 13 and 29 represent ______of new HIV infections, the largest share of any age group. Black teens are disproportionately affected, representing ______ of reported AIDS cases among 13 to 19-year-olds in 2010; Latino teens represented 19%.  Over 15,000 teenagers are HIV positive between the ages of 13 to 24. Most don't know that they are_______. Most don't believe that they are at risk (Source: CDC).

5. A Glance at HIV/AIDS Epidemic in the USA Sources: Kaiser Family Foundation Fact Sheet: The HIV/AIDS Epidemic in the United States, July 2012.  Women now account for _______ of HIV infections, with nearly 280,000 women living with HIV and AIDS. African- American women accounted for ______of new AIDS cases among women in 2010 and the _______ share of new HIV infections (57%).  New infections due to _________ drug use have declined by about 80% since the mid-to-late 1990s, accounting for _____ of new infections in 2009.  64% of all AIDS cases reported since the beginning of the epidemic are concentrated in ____ _______ or territories. While the District of Columbia has the highest AIDS case rate (112.5 per 100,000 in 2010), the states of California (12.6%), New York (11.9%), and Florida (10.9%) have the most cumulative AIDS cases.

6.  STD/STI: Sexually ______ Disease/Infection  HIV: Human Immunodeficiency Virus  _____________: infected without symptoms  AIDS: Acquired Immune Deficiency Syndrome Infection results in the progressive deterioration of the __________ system, breaking down the body's ability to fend off infections and diseases. AIDS (Acquired Immune Deficiency Syndrome) refers to the most advanced stages of HIV infection, defined by the occurrence of any of more than __________ opportunistic infections or related cancers. Acronyms and Abbreviations

7.  AIDS is a term with a _________ meaning. For a person to “have AIDS,” s/he must have: 1.HIV infection and one of the following two (2) conditions 2.an “AIDS indicator condition” (or) 3.__ _______count below 200 (normal count is between ______ and ______) A T-cell is a type of blood cell. T-cells belong to a group of white blood cells (WBCs) called lymphocytes. WBCs protect the body from infection. The main job of T-cells is to fight infection. There are a number of different types of T-cells that act in many ways to identify, directly attack and destroy infectious agents. Along with other WBCs, they play a major role in the immune system, which guards the body against infection.

8.  T-cells are a type of ___________ (white blood cell). They are an important part of the immune system. There are two main types of T-cells. T-4 cells, also called CD4+, are "helper" cells. They lead the attack against infections. T-8 cells, (CD8+), are “_____________" cells that end the immune response. CD8+ cells can also be "killer" cells that kill cancer cells and cells infected with a virus.  Researchers can tell the T-cells apart by specific ___________ on the cell surface. A T-4 cell is a T-cell with CD4 molecules on its surface. This type of T-cell is also called "CD4 positive", or CD4+. What Are T-Cells? http://www.aids.org/factSheets/124-T-Cell-Tests.html

9.  When HIV infects humans, the cells it infects most often are CD4+ cells. The virus becomes part of the cells, and when they ________ to fight an infection, they also make more copies of HIV.  When someone is infected with HIV for a long time, the number of CD4+ cells they have (their T-cell count) goes down. This is a sign that the immune system is being weakened. The lower the T-cell count, the more likely the person will get sick.  There are millions of different families of T-cells. Each family is designed to fight a specific type of germ. When HIV reduces the number of T-cells, some of these families can be totally wiped out. You can lose the ability to fight off the particular germs those families were designed for. If this happens, you might develop an opportunistic infection. Why Are T-Cells Important In HIV?

10. In our bodies, we carry many ___________ (bacteria, protozoa, fungi, and viruses). When our immune system is working, it controls these germs. But when the immune system is weakened by HIV disease or by some ____________, these germs can get out of control and cause health problems. Infections that take advantage of weakness in the immune defenses are called “opportunistic infections.” The phrase is often shortened to "OI". In the early years of the AIDS epidemic, OIs caused a lot of sickness and deaths. Once people started taking combination antiviral therapy, however, a lot fewer people got OIs. In ________, health problems in the vaginal area may be early signs of HIV. These can include pelvic inflammatory disease and bacterial vaginosis, among others. What Are Opportunistic Infections? http://www.aids.org/factSheets/500-Opportunistic-Infections.html

11. The most common OIs are listed here, along with the disease they usually cause, and the T-cell count when the disease becomes active:  Candidiasis (Thrush) is a _________ infection of the mouth, throat, or vagina. T-cell range: can occur even with fairly high T-cells. Candidiasis (Thrush)  Cytomegalovirus (CMV) is a _________infection that causes eye disease that can lead to blindness.T-cell range: under 50. Cytomegalovirus (CMV)  Herpes simplex viruses can cause oral herpes (cold sores) or genital herpes. These are fairly common infections, but if you have HIV, the outbreaks can be much more frequent and more severe. They can occur at any T-cell count.  _______________is common in the developing world. It is more common and more severe in people with HIV infection.  Mycobacterium avium complex (MAC or MAI) is a bacterial infection that can cause recurring fevers, general sick feelings, problems with digestion, & serious weight loss. T-cell range: under 75. Mycobacterium avium complex (MAC or MAI) What Are The Most Common OIs?

12.  Pneumocystis pneumonia (PCP) is a fungal infection that can cause a fatal pneumonia. T-cell range: under 200. Unfortunately this is still a fairly common OI in people who have not been tested or treated for HIV. Pneumocystis pneumonia (PCP)  Toxoplasmosis (Toxo) is a protozoal infection of the brain. T-cell range: under 100. Toxoplasmosis (Toxo)  Tuberculosis (TB) is a bacterial infection that attacks the lungs, and can cause meningitis. T-cell range: Everyone with HIV who tests positive for exposure to TB should be treated. Tuberculosis (TB)  Immune System - The natural ___________ defense mechanisms of the body where certain cells and proteins in the blood and other body fluids work together to get rid of foreign invaders, such as viruses and bacteria. (The body system that fights infection).

13.  HIV infected people may not get symptoms for years. You cannot tell if someone is infected simply by looking at them. When people with HIV infection come down with certain serious diseases, they are said to have AIDS. People with AIDS may develop any number of the following symptoms: fever that last longer than ________ month loss of weight without dieting extreme fatigue diarrhea for longer than ______month swollen lymph glands loss of ability to think clearly/_________ term memory loss loss of sense of balance Frequent fevers and sweats Persistent or frequent yeast infections (oral or vaginal) Persistent skin rashes or flaky skin PID in women that does not respond to treatment

14.  sex  ______/syringes/intravenous drugs 2 Main Health Behaviors That Spread HIV 1._________ 2.semen 3.vaginal fluid 4.________ __________ 4 Body Fluids That Can Transmit HIV

15.  the amount of HIV present in the body fluid;  what conditions the fluid is subjected to. The length of time HIV can survive outside the body depends on: Scientists and medical authorities agree that HIV does not survive well outside the body, making the possibility of environmental transmission remote. HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears. To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these unnatural concentrations of HIV can be kept alive for days or even weeks under precisely controlled and limited laboratory conditions, CDC studies have shown that drying of even these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of

16. HIV-infected human blood or other body fluids reduces the _____________ risk of environmental transmission to that which has been observed–essentially zero. Incorrect interpretations of conclusions drawn from laboratory studies have in some instances caused unnecessary alarm. Results from ____________ studies should not be used to assess specific personal risk of infection because (1) the amount of virus studied is not found in human specimens or elsewhere in nature, and (2) no one has been identified as infected with HIV due to contact with an environmental surface. Additionally, HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host. http://www.cdc.gov/hiv/resources/qa/transmission.htm

17.  fluid surrounding the _______ and the _________ cord  fluid surrounding _______ joints  fluid surrounding an _______ ______ These are additional body fluids that may transmit the virus that health care workers may come into contact with:

18. Which of the following can/does transmit HIV?  hugging  holding hands  using a public toilet  eating in a restaurant  sharing food  visiting a friend who has AIDS  using a public telephone  being sneezed on  drinking from a water fountain  being in a school with a teacher who has AIDS  swimming in a public pool  mosquito bites

19.  getting a manicure  getting your ears pierced 1 2 3 41234  getting a tattootattoo  going to the dentist  giving first aid  giving CPR  giving/donating blood  blood transfusion/receiving blood (tested since 1985)  hemophilia―blood coagulation disorder (all blood clotting products now heated to destroy HIV) hemophilia  sports  kissing

20.  using LSD  getting drunk or stoned  using heroinheroin  breast feeding  sex

21. 1.penis-anus 2.penis-vagina 3.oral (mouth to vagina/penis/anus) Forms of sexual contact that can transmit HIV (all are high risk):

22. Mother to infant transmission (30 - 50% become positive; AZT lowers risk dramatically): 1.during ___________ 2.during _________ (mid-wife concerns) 3.breast feeding (public breast feeding / engorgement) Three reasons to breast-feed:  best __________ for baby  strengthen baby’s immune system  shrink _________ faster for mom

23. Relationship to HIV cases and sexual orientation: (Magic Johnson, Wilt Chamberlain) 1.gay men 2.straight men 3.straight women 4.gay women

24. Health behavior choices and their risks: 1.abstinence 2.monogamy (involves relationship, not individual / promiscuous) 3.condom (American, Latex)  98% vs. 90% effective against pregnancy (consistently & correctly vs. inconsistently and incorrectly)  husband / wife study  parents’ concerns (permission to have sex vs. education)

25. A blood test can be used to determine whether a person has the HIV virus. When people develop AIDS, their bodies defenses are too weak to fight off diseases, and they get sick with diseases that often do not bother most other people. One of these diseases is Kaposi Sarcoma(KS), a rare type of skin cancer. Another is a type of pneumonia called PCP (Pneumcystis Carinii Pneumonia). People may look and feel well or sick with both HIV and AIDS. Good medical care for people with HIV and AIDS will improve both the quality and the length of life. How is AIDS/HIV diagnosed?

26.  Antibody - A protein in the blood made by the body to protect it against a foreign invader, such as a virus.  ELISA - Enzyme Linked ImmunoSorbent Assay. An early screening test used to detect antibodies to HIV in the blood.  Western Blot - A test to determine whether antibodies to HIV are in a person’s blood. It is usually used to double check positive ELISA tests. It works better than the ELISA, but is harder and more expensive to do.  Anonymous vs. Confidential Testing (People involved in high risk behaviors should be tested every 6 months)  Confidentiality vs. Right to Know

27. Where did HIV come from? http://www.cdc.gov/hiv/pubs/faq/faq3.htm http://www.cdc.gov/hiv/pubs/faq/faq3.htm The earliest known case of HIV-1 in a human was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggested that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s. We know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of male patients who had sex with other men. These were conditions not usually found in people with healthy immune systems.

28. In 1982 public health officials began to use the term "acquired immunodeficiency syndrome," or AIDS, to describe the occurrences of opportunistic infections, Kaposi's sarcoma (a kind of cancer), and Pneumocystis carinii pneumonia in previously healthy people. Formal tracking (surveillance) of AIDS cases began that year in the United States. In 1983, scientists discovered the virus that causes AIDS. The virus was at first named HTLV-III/LAV (human T- cell lymphotropic virus-type III/lymphadenopathy- associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).

29. For many years scientists theorized as to the origins of HIV and how it appeared in the human population, most believing that HIV originated in other primates. Then in 1999, an international team of researchers reported that they had discovered the origins of HIV-1, the predominant strain of HIV in the developed world. A subspecies of chimpanzees native to west equatorial Africa had been identified as the original source of the virus. The researchers believe that HIV-1 was introduced into the human population when hunters became exposed to infected blood. Where did AIDS really come from?

30.  International travel  The Blood Industry  Drug Use What caused the epidemic to spread so suddenly?

31. Is Anyone Immune to HIV/AIDS? YES: Those who possess a mutation in the CCR5 gene called “delta32” are immune if they have inherited this gene from both parents. For more on CCR5-delta32 visit:  http://www.thetech.org/genetics/news.php?id=13 http://www.thetech.org/genetics/news.php?id=13  http://www.science-frontiers.com/sf119/sf119p05.htm http://www.science-frontiers.com/sf119/sf119p05.htm

32. Community Resources for AIDS support and information:  parents  clergy  family physician/medical professionals  schools  public health agencies  AIDS hotlines Free Testing at:  OCHD (Orange County Health Department)  AIDS Related Community Service  Planned Parenthood (for women who are patients)