1. HIV, Drug Addiction, Sex Work
XXX Threat
HIV, Drug Addiction, Sex Work

2. Certified HIV Tester and Counselor At Philadelphia FIGHT
Nancy Gunnarson
Certified HIV Tester and Counselor At Philadelphia FIGHT
I am a certified HIV Tester and Counselor
At Philadelphia FIGHT
1998 I was Diagnosed HIV+ in Jail
2003 I was told I have AIDS, HepC, after Boyfriends Death
I was Homeless , suffered Mental Health Issues due to Drug Use
I have been off Methadone for close 7 yrs of 400mg
I’ve been clean from all drugs except Cigarettes I AM A Survivor
We CAN recovery and we’re all miracles in progress!

3. AGENDA TALK ABOUT HIV HIV/AIDS Myths/Fact’s
Importance of Getting an HIV Test
Importance of Needle Exchange Programs
Sex Workers Rights

4. WHAT IS HIV It’s a virus Transmitted from person to person
Damages the immune system
human immunodeficiency virus (HIV). HIV is a virus that is transmitted from person to person through the exchange of body fluids such as blood, semen, breast milk and vaginal secretions. Sexual contact is the most common way to spread HIV AIDS, but it can also be transmitted by sharing needles when injecting drugs, or during childbirth and breastfeeding. As HIV/AIDS reproduces, it damages the body's immune system and the body becomes susceptible to illness and infection. There is no known cure for HIV infection.

5. HIV facts at a Glance People are still contracting or transmitting HIV
If you think it will not happen to you it can
The only way not to contract HIV is Safe Sex
( Condoms, Dental dams ) Don’t share works and cooker, cotton, water
Get Tested Know. Your Status
STIGMA around HIV still exist –But through Support & Education STIGMA can be greatly minimized
Funding for prevention/education programs are being cut

6. TRANMISSION of HIV 4 Body Fluids only
Blood, Semen, Vaginal Fluids, Breast Milk
Unprotected Sex ( Anal, Vaginal, Oral )
Sharing Needles ( Drugs, Tattoo’s, Hormone's, Piercings )
Mother to Child ( if not in Care)
NOT SPIT, TOIELTS, TEARS, HUGS, EATING UTENCILS, ECT

7. Difference Between HIV and AIDS
HIV destroys a certain kind of blood cells—CD4+ T cells (helper cells)--which are crucial to the normal function of the human immune system.  In fact, loss of these cells in people with HIV is an extremely powerful predictor of the development of AIDS.  Studies of thousands of people have revealed that most people infected with HIV carry the virus for years before enough damage is done to the immune system for AIDS to develop.  However, recently developed sensitive tests have shown a strong connection between the amount of HIV in the blood and the decline in CD+4 T cell numbers and the development of AIDS.  Reducing the amount of virus in the body with anti-HIV drugs can slow this immune destruction.

8. What is the difference between HIV and AIDS?
Acquired: because it’s a condition one must acquire or get infected with; not something transmitted through the genes
Immune: because it affects the body’s immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
Deficiency: because it makes the immune system deficient (makes it not work properly)
Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections.
Human: because this virus can only infect human beings.
Immune-deficiency: because the effect of the virus is to create a deficiency, a failure to work properly, within the body’s immune system.
Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.

9. HIV and AIDS
Myths and Facts

10. MYTHS There is a cure for HIV. Kissing / causal contact
None of this is true!
MYTHS
There is a cure for HIV.
Kissing / causal contact
“ I’m just a carrier.”
You can tell that someone has HIV just by looking at them.
HIV does not affect me.
HIV infection is a death sentence.
It won’t happen to me.

11. FACTS There is NO cure for HIV infection.
All of this is true!
FACTS
There is NO cure for HIV infection.
You don’t get HIV by casual contact.
You can still give HIV to another person even if your viral load is undetectable.
You cannot tell who has HIV by looking at them.
HIV affects all of us.
HIV is NOT a death sentence. There is effective treatment for HIV infection.
Anyone could get HIV.
Over 30 medications today that work
Hiv cannot be transmitted thru casual contact (hiv is only found in blood,semen,vaginal fluids,breast milk) these fluids need to enter into the blood stream in order for transmission.
A carrier is someone who has hiv antibodies present and is hiv positive and can still transmitte to other’s
You cannot tell someone has hiv by looking at them.People can look and feel good with hiv.Appearance is not good enough.
Hiv affects all of us, there are 33.3 million living with hiv, that not to say the ones who don’t know their status, abd other 2 million infected each year
People can live a full life span if they are in treatment

12. Importance of Getting
an HIV Test

13. HIV Test Who needs to get HIV Test ? We encourage people to get tested
Know your Status
What if test is Positive ?
What you need to Know if Positive Results
Ways to stay Negative
How not to Transmit or Contract

14. Who Needs to Get HIV Test
Anyone that has unprotected sex
Share I.V. Needles, Drugs, Cooker, Water Cap
Men that have Sex with Men
Baby born to HIV Positive Mom (not in Care)
People who have Multiple Sex Partners
Tattoo’s or Piercing at Party’s/Jail
Pregnant Women
Remember HIV only Transmits through
Blood, Semen, Vaginal Fluids, Breast Milk and needs an opening to enter it your blood stream

15. HOW DO WE TEST for HIV
ORAL is a swab that look for HIV antibodies in the mucus membrane
RAPID is a finger stick that collects a small amount of blood in collector then with solution in test
BLOOD when you have labs done that can be sent away
If POSITIVE Test a Confirmatory test is Needed then that is sent away and ELISA WESTERN BLOT would be performed

16. When someone tests Positive
What a positive result means

17. Life after a Positive Diagnosis
BREATH
Process the Feeling
Next Steps to Take
Learn the Facts
Create a Support Network
We Do Recover
Guilt
Denial
Anger
Revenge
Shame
Stigma

18. Living with HIV Avoid Contracting STI’s Have Regular Check-Ups
Find a Knowledgeable Health Provider
Understand your Medications
Seek Advice on family planning methods
Be aware of Risk’s
Women ask for Cervical screening’s
Ask to have Blood work explained
Stay Informed
Stay up to Date
Be aware of how you’re Feeling
YES YOU CAN LIVE WITH HIV

19. WHAT IS AN AIDS DIAGNOSIS
CD4 level below 200
It is possible for someone to be diagnosed AIDS when a developed an opportunistic infection.
2 or more OI’s
AIDS can be diagnosed when the number of immune system cells (CD4 cells) in the blood of an HIV positive person drops below a certain level.
A person is diagnosed with AIDS when they have developed an AIDS related condition or symptom, called an opportunistic infection, or an AIDS related cancer. The infections are called ‘opportunistic’ because they take advantage of the opportunity offered by a weakened immune system.

20. Needle Exchange and HIV
Funding for the Needle Exchange Program an Mobil Unit will help bring service’s to those who Use IV Drug, By having access to free needle echange program this can lessen the HIV n HepC infection rate in the community.

21. Why we need Needle Exchange
One-third of all AIDS cases are linked to injection drug use.
For women, 64 percent of all AIDS cases are due to injection drug use or sex with partners who inject drugs.
Injection drug use is the source of infection for more than half of all children born with HIV.
More than a million people in the United States inject drugs
Drug use costs to society (in health care, lost productivity, accidents, and crime) more than $50 billion a year.
People who inject drugs imperil their health and that of their needle sharing partners, sexual partners and offspring.

22. Needle Exchange Reduces HIV Risks
Though rehab is a better choice, not all drug injectors are ready to quit.
Those who cannot or will not stop injecting drugs can avoid spreading HIV by suing a sterile needle for each injection.
Users who share needles should disinfect their injection equipment thoroughly with bleach
Though it’s not as safe as always using a sterile needle and syringe.
Even those who are highly motivated may find few drug treatment services available.
Drug treatment centers frequently have long waiting lists and fewer than 15 percent of IVDUs are in treatment at any given time.
Finally, needle exchange programs can act as a bridge to:
drug treatment
HIV testing and counseling
primary medical care
tuberculosis and sexually transmitted disease screening
Talk about HepC too.

23. However…
IDUs often struggle with multiple health risks due to social, economic and psychological factors. HIV prevention may not be their top concern since they face other more pressing daily challenges such as addiction, poverty, incarceration, homelessness, stigma, guilt, shame depression, mental illness and past trauma.

24. Sex Work and HIV
As well as Hep C and other STIs

25. The Unique Issues Multiple partners and inconsistent use of condoms
Legal issues
Criminalization of HIV
No legal recognition as a profession
Social and economic factors
Drug use
Migration, mobility and trafficking

26. HIV prevention amongst sex workers: what works?
An increased level of condom use and safer sex amongst sex workers and their clients.
Increased sex worker involvement and control over their working and social conditions.
A reduction in the number of sexually transmitted infections occurring amongst sex workers.
Thailand: 100% condom programme
One of the best ways to prevent sex workers becoming infected with HIV is to foster an environment in which they are willing and able to use condoms. The 100% condom programme established in Thailand in the early 1990s is held up as a prime example of how this can be achieved. This government-run campaign aimed to enforce condom use in all of Thailand’s brothels and massage parlours, by distributing free condoms and making it a legal requirement for establishments to make clients use them. Under this programme, condom use amongst sex workers rose from 14% in 1989 to over 90% after 1992, and Thailand’s HIV prevalence declined substantially.16
India: Sonagachi and Avahan
The Sonagachi programme in India is named after the central district of central Kolkata (Calcutta) where it is based. Started in 1992 with the aim of helping sex workers to overcome HIV and AIDS on their own terms, the Sonagachi project has been based around the ‘three R’s’: ‘respect’ for sex work and those involved in it; ‘reliance’ on sex workers to run the programme; and ‘recognition’ of sex workers’ rights. As well as encouraging condom use, the project has addressed the wider social and economic challenges facing sex workers. In doing so it has achieved impressive results. Condom use amongst sex workers in the area rose dramatically, from 27% in 1992 to 86% by HIV prevalence amongst sex workers in the area also fell significantly as a result of the project.18
Another example is the Avahan programme, aimed at sex workers across six high-prevalence states in India. This programme demonstrated that substantial gains can be made when prevention programmes are delivered to this high risk group. Since the India Avahan programme started in 2003, condom use has increased by 18 percent and HIV prevalence has declined by 4 percent in Karnataka.19 20
Brazil: reducing stigma
The government of Brazil, and non-governmental organisations working in the country, have put a lot of effort into preventing HIV infections amongst sex workers. These interventions have taken a tolerant, respectful approach, with the government often referring to sex workers as ‘partners’ in Brazil’s fight against AIDS. HIV prevention campaigns have focused on reducing stigma, and encouraging sex workers to look after their sexual health. In one well-known campaign, a cartoon character known as ‘Maria without shame’ was placed on posters, leaflets and stickers in women’s toilet facilities, with the message: “You need have no shame, girl. You have a profession.”21
Kenya
In the Kenyan capital of Nairobi, HIV prevention campaigns aimed at sex workers were strengthened during the 1990s, including pe

27. Thailand Thailand: 100% condom program
Government-run campaign aimed to enforce condom use in all of Thailand’s brothels and massage parlors

28. India: Sonagachi and Avahan
As well as encouraging condom use, the project has addressed the wider social and economic challenges facing sex workers.