1. 1 KNOW Washington State Department of Health HIV prevention and Education Services KNOW Curriculum – 6 th edition HIV Prevention Education

2. 2 We are now in our 3 rd decade of the HIV pandemic and although we have made giant steps to arrest the movement in terms of reducing the infection rates, in many ways we have began to move backwards by believing multiple myths associated with who Is “At risk” and refusing to pay attention. Overview: We have come a long way baby, but… HIV is not over yet!!

3. 3 Overview cont. By the end of this session you will fully understand how to work with those living with or affected by HIV/Aids and utilize your skills to assist, educate and maintain safety standards.By the end of this session you will fully understand how to work with those living with or affected by HIV/Aids and utilize your skills to assist, educate and maintain safety standards. Advocacy and resources are key to supporting individuals, family and community; learning to pinpoint those areas and collect resources will be an essential part of changing health outcomesAdvocacy and resources are key to supporting individuals, family and community; learning to pinpoint those areas and collect resources will be an essential part of changing health outcomes

4. 4 Definitions: According to the Center for Disease Control and Prevention, American Red Cross and the Health Departments, this virus can be classified in four categories: According to the Center for Disease Control and Prevention, American Red Cross and the Health Departments, this virus can be classified in four categories: What it IS, What it IS, What it’s NOT, How you Get IT and….. How you Don’t!

5. 5 Definitions cont. What it IS: Clinically defined as a Human Immunodeficiency Virus and only transmitted from Human to Human contact What it’s Not: Not transmitted through monkeys, dogs, cats, mosquitoes etc...

6. 6 Definitions cont. How you get IT: How you get IT: Transmission occurs primarily through infected: Blood, semen vaginal secretions or breast milk Transmission occurs primarily through infected: Blood, semen vaginal secretions or breast milk

7. 7 HIV Definition Cont. How you DON’T: The virus is not capable of transmitting through: The virus is not capable of transmitting through: Sweat, tears, saliva, urine and feces

8. 8 AIDS Definition: Using the same formula AIDS is defined as an: Acquired Immunodeficiency (Sometimes Immune Deficiency) Syndrome It is Not, acquired through genetics or hereditary, nor passed casually from one person to another. It must enter the bloodstream in order to infect someone.

9. 9 AIDS Definition cont. Immunodeficiency: This is when the immune system is rendered defenseless and it’s ability to fight off infectious disease is challenged. Over time, a person with a deficient immune system may become vulnerable to infections by disease causing organisms such as bacteria and virus, thus causing life threatening illnesses. Immunodeficiency: This is when the immune system is rendered defenseless and it’s ability to fight off infectious disease is challenged. Over time, a person with a deficient immune system may become vulnerable to infections by disease causing organisms such as bacteria and virus, thus causing life threatening illnesses.

10. 10 AIDS Definition cont. Virus: Defined as the smallest infectious agents, many of which cause disease A simple way to define the difference between a bacteria versus a virus is: Bacteria = Cure and….Bacteria = Cure and…. Virus = No cure, meaning once a person is infected with a viral infection, You have now inherited a “Lifetime companion”Virus = No cure, meaning once a person is infected with a viral infection, You have now inherited a “Lifetime companion”

11. 11 Transmission and Infection Control Section Necessary Conditions for Infection with HIV: HIV is a relatively fragile virus and not spread by casual contact: Three conditions must occur in order to transmit HIV, there must be: An HIV SourceAn HIV Source Anyone infected with the virus is potentially a source of HIV infection…. And once you are infected…. You will remain infected!

12. 12 Transmission and Infection control cont: A sufficient dose of virus:A sufficient dose of virus: This involves the concentration and amount of HIV necessary for infection to occur. Access to the bloodstream of another personAccess to the bloodstream of another person This involves behaviors or circumstances that place someone at risk for infectious fluid entering their bloodstreams

13. 13 “At Risk” Behaviors Blood:Blood: Unprotected sexual intercourse (anal, vaginal, oral) with an infected person Use of contaminated injection equipment for use in injecting drugs (Sharing needles) Other sources for transmission:Other sources for transmission: Tattooing, piercing, blood brother rituals and Infected women breastfeeding their infant Needle stick injuries or splashing blood into eyes. A transfusion prior to 1986 Needle stick injuries or splashing blood into eyes. A transfusion prior to 1986

14. 14 At Risk Behaviors Cont. In extremely rare casesIn extremely rare cases Sharing razors or toothbrushes if infected blood were deposited on the surfaces and the blood were to enter into an open membrane of another person. At Risk Populations: At Risk Populations: Injection Drug Users (IDU’s)Injection Drug Users (IDU’s) Men having sex with Men )MSM’s)Men having sex with Men )MSM’s) Women and men in the sex industry (Prostitutes)Women and men in the sex industry (Prostitutes)

15. 15 At Risk Populations Cont. Having multiple sex partners and unprotected sexHaving multiple sex partners and unprotected sex Those already infected with other STD’s (STI’s such as Chlamydia, syphilis, gonorrhea etc.)Those already infected with other STD’s (STI’s such as Chlamydia, syphilis, gonorrhea etc.) Use of other substances, including alcohol and non- injected street drugs which tend to impair your judgmentUse of other substances, including alcohol and non- injected street drugs which tend to impair your judgment Those with empowerment issues and lack the ability to insist on protectionThose with empowerment issues and lack the ability to insist on protection Health, Safety and public service WorkersHealth, Safety and public service Workers

16. 16 AIDS Definition cont. Syndrome: A collection of symptoms, diseases and infections. Case Definition: Assigned to a person living with the virus after T-cells drop below 200 allowing for opportunistic infections to invade the body. The term AIDS applies to the most advanced stages of an HIV infection.

17. 17 Lifestyle, behavior and risk Remember: “It’s not who you ARE, It’s What You DO!

18. 18 Diagnosis In order to diagnose AIDS a positive HIV antibody test is required or the evidence of HIV infection and the appearance of some very specific conditions/diseasesIn order to diagnose AIDS a positive HIV antibody test is required or the evidence of HIV infection and the appearance of some very specific conditions/diseasesRemember: ALL people diagnosed with AIDS have HIV, BUT… not all people with HIV have reached an AIDS diagnosis. ALL people diagnosed with AIDS have HIV, BUT… not all people with HIV have reached an AIDS diagnosis.

19. 19 Case Definition: In 1993 AIDS Surveillance Case Definition for Adolescents and Adults, which is the most current definition is comprised of a 3x3 staging system. In this definition, any person who is HIV infected and has either an AIDS indicator condition or a CD4+ (T-cell count) less than 200 cells/mm or less than 14%, is considered to have AIDS.In 1993 AIDS Surveillance Case Definition for Adolescents and Adults, which is the most current definition is comprised of a 3x3 staging system. In this definition, any person who is HIV infected and has either an AIDS indicator condition or a CD4+ (T-cell count) less than 200 cells/mm or less than 14%, is considered to have AIDS.

20. 20 Apply your knowledge: What are the necessary conditions for infection of HIV?

21. 21 Apply Your knowledge: Answer Three conditions must occur in order to transmit HIV, there must be: An HIV sourceAn HIV source A sufficient dose of virusA sufficient dose of virus Access to the bloodstream of another personAccess to the bloodstream of another person

22. 22 Window Periods This is the period of time between when the body first becomes infected with HIV and when the body is able to produce antibodies to HIV. It may take between two weeks to three months for antibodies to develop and during this time the person is infectious. This means s/he can pass the virus to someone else and will remain infectious throughout life. Some infected people are able to produce antibodies as early as two weeks after infection.

23. 23 Window Period cont. The window is the time when a person may not produce sufficient antibodies to be detectable on an HIV antibody test. The window is the time when a person may not produce sufficient antibodies to be detectable on an HIV antibody test. This means a person can get a negative test result and actually be positive, therefore a newly infected person can infect a partner before antibodies develop. This means a person can get a negative test result and actually be positive, therefore a newly infected person can infect a partner before antibodies develop.

24. 24 Apply your knowledge: AIDS is defined as what and considered as what for medical support?

25. 25 Apply your Knowledge: Answer An acquired Immunodeficiency (Sometimes Immune deficiency) Syndrome The immune system is rendered defenseless and it’s ability to fight off infectious disease is challenged. As a medical indicator, defined as a: Case definition

26. 26 Risk Reduction Methods Sexual Abstinence = Not engaging in anal, vaginal or oral intercourse or other sexual activities where blood semen or vaginal fluid can enter the body; completely safe and 100% effective method for preventionSexual Abstinence = Not engaging in anal, vaginal or oral intercourse or other sexual activities where blood semen or vaginal fluid can enter the body; completely safe and 100% effective method for prevention Monogamous relationships = Having sex with only one person who has sex with you and neither partner is at risk of exposure to HIV and STD’s; both partners must be free of disease and both partners must remain monogamous.Monogamous relationships = Having sex with only one person who has sex with you and neither partner is at risk of exposure to HIV and STD’s; both partners must be free of disease and both partners must remain monogamous.

27. 27 Risk Reduction Methods cont. Safer sex practices:Safer sex practices: Latex condoms when used correctly and consistently during sexual intercourse are highly effective with prevention methods. To prevent tearing of condoms, use only water base lubricants. Polyurethane condoms are made of soft plastic, look like latex condoms but are thinner. Lab test show sperm and viruses cannot pass through and also mad specifically for female protection also; this called the female condom or insertive and can utilized in both the vagina or anus.

28. 28 Risk Reduction Methods cont. Animal skin condoms can be used when a person has a allergic reaction to latex or polyurethane however must be placed on first against the skin and covered with a latex as added protection. Animal skin has pores and allows for breakage or risk of the virus getting through.Animal skin condoms can be used when a person has a allergic reaction to latex or polyurethane however must be placed on first against the skin and covered with a latex as added protection. Animal skin has pores and allows for breakage or risk of the virus getting through. Dental Dams/other barriers may be used to provide a barrier to reduce the risk of HIV transmission during oral intercourse on a female.Dental Dams/other barriers may be used to provide a barrier to reduce the risk of HIV transmission during oral intercourse on a female.

29. 29 Risk Reduction Methods cont. Avoidance of injection drug use is another way to stop the risk of transmission or if not possible, use a clean needle and do not share. If not able to get into to treatment, become part of a needle exchange program until you are ready to make those changes in your life. Also, using bleach and water to clean syringes will kill the HIV inside it.Avoidance of injection drug use is another way to stop the risk of transmission or if not possible, use a clean needle and do not share. If not able to get into to treatment, become part of a needle exchange program until you are ready to make those changes in your life. Also, using bleach and water to clean syringes will kill the HIV inside it.

30. 30 Occupational Exposure to Bloodborne Pathogens Rule Scope: WAS 296-823, Occupational Exposure to Blood-born Pathogens, Provides requirements to protect employees from exposure to blood or other potentially infectious materials (OPIM) that may contain blood-born pathogensRule Scope: WAS 296-823, Occupational Exposure to Blood-born Pathogens, Provides requirements to protect employees from exposure to blood or other potentially infectious materials (OPIM) that may contain blood-born pathogens Occupational ExposureOccupational Exposure Exposure incidentExposure incident Occupational Groups - Include but not limited to:Occupational Groups - Include but not limited to: Health care employees, law enforcement, fire, ambulance and other emergency & public service employees.

31. 31 HIV Counseling with HIV Testing Oregon and Washington Law (WAC 246-100-207 and 209) requires all HIV testing be accompanied with counseling first. Yet, the law states that person who refuses counseling should not be denied an HIV test and the person conducting the HIV test does not have to provide the counseling themselves.Oregon and Washington Law (WAC 246-100-207 and 209) requires all HIV testing be accompanied with counseling first. Yet, the law states that person who refuses counseling should not be denied an HIV test and the person conducting the HIV test does not have to provide the counseling themselves. The person providing the test and counseling to clients should direct the counseling towards increasing the clients understanding of their own risk of acquiring/transmitting HIV; motivating the client to reduce their risk and assisting the client to build skills to reduce their riskThe person providing the test and counseling to clients should direct the counseling towards increasing the clients understanding of their own risk of acquiring/transmitting HIV; motivating the client to reduce their risk and assisting the client to build skills to reduce their risk

32. 32 Testing Confidentiality Information about a person’s HIV test and results is confidential information and must not be shared with others. Those who perform HIV counseling and testing in public health departments or health agencies must sign strict confidentiality agreements.Information about a person’s HIV test and results is confidential information and must not be shared with others. Those who perform HIV counseling and testing in public health departments or health agencies must sign strict confidentiality agreements. Test results are kept in locked files, with only a few appropriate staff members having access to them.Test results are kept in locked files, with only a few appropriate staff members having access to them. HIV Testing is NOT MANDATORY and no one can be forced to submit a test without their consent.HIV Testing is NOT MANDATORY and no one can be forced to submit a test without their consent. Health care providers caring for pregnant clients are required by Washington law to ensure HIV counseling and testing for each pregnant woman who is seeking prenatal care.Health care providers caring for pregnant clients are required by Washington law to ensure HIV counseling and testing for each pregnant woman who is seeking prenatal care.

33. 33 Other Areas of Testing and Procedures: Sexual AssaultSexual Assault AssailantAssailant Six month follow-up retestSix month follow-up retest Window periodsWindow periods Partner NotificationPartner Notification Reporting requirementsReporting requirements

34. 34 Negative Results Remember, If the test results is negative, it means one of two things 1.Either the person is not infected with the virus or ……. 2.The person became infected recently and has not produced enough antibodies to be detected by the test. If concerned about a recent incident…test 3 months from the date of their last possible exposure

35. 35 Apply your knowledge A 27 yr old women went to the doctor to get the results of her HIV test and only took the test because her new job requested their employees to do so. The women has been married for 5 years and has 2 children; one 4 years old and the other 6 months. After receiving her test results she is shocked to find out she positive for HIV. What are some of the next steps that should be considered?

36. 36 Apply Your Knowledge-Answer A 27 yr old women went to the doctor to get the results of her HIV test and only took the test because her new job requested their employees to do so. The women has been married for 5 years and has 2 children; one 4 years old and the other 6 months. After receiving her test results she is shocked to find out she positive for HIV. What are some of the next steps that should be considered? Answers 1.Request a retest and talk to tester/epidemiologist 2.List partner notification (Names reporting) 3.Encourage contact of family members 4.Schedule testing for Husband and children 5.Schedule follow up appointment 6.Provide referrals to medical and other support services 7. Get started on anti-retroviral drugs as soon as possible

37. 37 Positive outcomes: Partner notification: A voluntary service provided to HIV positive people and their sex and/or injection equipment sharing partners. This service is provided using a variety of strategies to maintain the confidentiality of both the HIV-Infected client and the partners.Partner notification: A voluntary service provided to HIV positive people and their sex and/or injection equipment sharing partners. This service is provided using a variety of strategies to maintain the confidentiality of both the HIV-Infected client and the partners. When partners are notified, they are notified of their exposure, provide counseling and information, and offer HIV testing without informing the partner who tested positive. Reporting Requirements: HIV and AIDS are both reportable conditions for all State Health BoardsReporting Requirements: HIV and AIDS are both reportable conditions for all State Health Boards

38. 38 Other testing results Indeterminate or inconclusive Results: Western blot is used as a confirmatory test and usually might relate to recently engaging in behaviors that put them at risk for getting HIV…could also mean they are newly infected and developing antibodies.Indeterminate or inconclusive Results: Western blot is used as a confirmatory test and usually might relate to recently engaging in behaviors that put them at risk for getting HIV…could also mean they are newly infected and developing antibodies. False positives: Earlier testing found to be an issue with Orasure and required double testing or retesting using blood specimensFalse positives: Earlier testing found to be an issue with Orasure and required double testing or retesting using blood specimens

39. 39 Clinical Manifestations and Treatment The Natural History/Disease Progression of HIV Infection: Untreated HIV infection will experience several stages in infection, these include:The Natural History/Disease Progression of HIV Infection: Untreated HIV infection will experience several stages in infection, these include: 1.Viral transmission 2.Primary HIV Infection 3.Seroconversion 4.Asymptomatic HIV Infection 5.Symptomatic HIV infection 6.AIDS

40. 40 Disease Progression: Viral Transmission: This is the initial infection with HIV. They will probably have the virus circulating in the bloodstream and may become infectious to other within five days and may be infectious before the onset of any symptoms.Viral Transmission: This is the initial infection with HIV. They will probably have the virus circulating in the bloodstream and may become infectious to other within five days and may be infectious before the onset of any symptoms. Primary HIV infection: The first few weeks of HIV infection, the infected person has a very high amount of virus in their bloodstream. Unfortunately during this time many people are unaware that they are infected. Most common symptoms are; fever, swollen glands, in the neck, armpits and/or groin, rash, fatigue and a sore throat. Sometimes called “seroconversion syndrome or “seroconversion sickness. These symptoms unfortunately resemble and common with many other illnesses. They tend to go away in a few weeks but individual continues to be infectious to others.Primary HIV infection: The first few weeks of HIV infection, the infected person has a very high amount of virus in their bloodstream. Unfortunately during this time many people are unaware that they are infected. Most common symptoms are; fever, swollen glands, in the neck, armpits and/or groin, rash, fatigue and a sore throat. Sometimes called “seroconversion syndrome or “seroconversion sickness. These symptoms unfortunately resemble and common with many other illnesses. They tend to go away in a few weeks but individual continues to be infectious to others.

41. 41 Disease Progression cont. Primary Infection: It is important that healthcare providers consider the diagnosis of HIV primary infection if an individual has behaviors which put him at risk for HIV and is presenting with the above symptoms.Primary Infection: It is important that healthcare providers consider the diagnosis of HIV primary infection if an individual has behaviors which put him at risk for HIV and is presenting with the above symptoms. Seroconversion: The time that it takes from infection to the production of antibodies, which would show positive on an HIV test.Seroconversion: The time that it takes from infection to the production of antibodies, which would show positive on an HIV test. Asymptomatic HIV Infection: During this time a person has no noticeable signs or symptoms. They may look and feel healthy but can still pass the virus to othersAsymptomatic HIV Infection: During this time a person has no noticeable signs or symptoms. They may look and feel healthy but can still pass the virus to others

42. 42 Disease Progression cont. Symptomatic HIV Infection: During this period, a person begins to have noticeable physical symptoms that are related to HIV infection. Although there are no symptoms that are specific Only to HIV infection, some common symptoms are: 1.Persistent low grade fever 2.Pronounced weight loss that is not due to dieting 3.Persistent headaches 4.Diarrhea that last more than one month 5.Difficulty recovering from colds and the flu 6.A person becomes sicker than normal 7.Women have recurrent vaginal yeast infections

43. 43 Disease Progression cont. AIDS: An AIDS diagnosis can only be made by a licensed health care provider, However both county and statewide health organizations refer to both State and County Epidemiologist for results and reportingAIDS: An AIDS diagnosis can only be made by a licensed health care provider, However both county and statewide health organizations refer to both State and County Epidemiologist for results and reporting

44. 44 AIDS Indicator Conditions: Candidiasis of esophagus, trachea and lungsCandidiasis of esophagus, trachea and lungs Cervical cancerCervical cancer Cryptosporidiosis with diarrhea greater than one monthCryptosporidiosis with diarrhea greater than one month Herpes simplexHerpes simplex HIV associated dementiaHIV associated dementia Kaposi’s sarcomaKaposi’s sarcoma TuberculosisTuberculosis Pneumocystic Carinii pneumoniaPneumocystic Carinii pneumonia

45. 45 Treatment and the impact of new Drug therapies on HIV Clinical Progression Access to quality medical care is important and essential for continued wellness. To date, Drug therapies have greatly improved and HIV is now considered a disease of maintenance and not necessarily a death sentence. Side affects of HIV medications include: Nausea, diarrhea, neuropathy, osteoporosis, lipodystrophy, diabetes and changes in glucose, high cholesterol and damage to the nervous system

46. 46 Legal and Ethical Issues: Are HIV/AIDS reportable?: Both are reportable conditions in Washington State and Oregon since 1984, this assist local an state officials in tracking the epidemicAre HIV/AIDS reportable?: Both are reportable conditions in Washington State and Oregon since 1984, this assist local an state officials in tracking the epidemic Are HIV positive results from an anonymous test reportable? Positive HIV results obtained through anonymous testing are not reportable. However if a patient with positive results seek medical care for conditions related to HIV/AIDS, the provider is required to report the case to the local and state health departments.Are HIV positive results from an anonymous test reportable? Positive HIV results obtained through anonymous testing are not reportable. However if a patient with positive results seek medical care for conditions related to HIV/AIDS, the provider is required to report the case to the local and state health departments.

47. 47 Confidentiality Unless a person signs a release of information form, medical information may not be disclosed. There are some exceptions and can be disclosed under certain conditionsUnless a person signs a release of information form, medical information may not be disclosed. There are some exceptions and can be disclosed under certain conditions 1.When it is given from one health provider to another health care provider for related on going medical care of the patient 2.In a life death emergency 3.To a third party payor (insurance provider) 4.In case of reporting notifiable conditions to the local health jurisdiction Violation of these laws is a misdemeanor and may result in civil liability actions for reckless or intentional disclosure up to 10,000.00 or actual damages.

48. 48 Confidentiality cont. Why are there additional confidentiality protections for HIV, mental health, substance abuse and other selected records? Why are there additional confidentiality protections for HIV, mental health, substance abuse and other selected records? It has been determined that there exist a level of prejudice, fear an discrimination directed at people with these medical conditions. Therefore, there is a balance between civil protection and information access.

49. 49 Psychosocial Issues Difficult realities that are faced by persons living with HIV and families: Even with retroviral drugs, persons with AIDS still die prematurelyEven with retroviral drugs, persons with AIDS still die prematurely MSM’s and IDU’s who are already stigmatized and subjected to social and job related discrimination, may encounter even more pressure and stressMSM’s and IDU’s who are already stigmatized and subjected to social and job related discrimination, may encounter even more pressure and stress 90% of all adults with AIDS are in the prime of life and may not be prepared to deal with death and dying90% of all adults with AIDS are in the prime of life and may not be prepared to deal with death and dying Certain medication can diminish and disfigure the bodyCertain medication can diminish and disfigure the body People living with HIV face the need to practice safer sex and take medications for the remainder of their lives.People living with HIV face the need to practice safer sex and take medications for the remainder of their lives.

50. 50 Psychosocial Issues cont. Losses due to HIV: Loss of physical strength and abilitiesLoss of physical strength and abilities Loss of mental abilitiesLoss of mental abilities Loss of income and savingsLoss of income and savings Loss of health insuranceLoss of health insurance Loss of jobLoss of job Loss of housing, personal possessionsLoss of housing, personal possessions Loss of emotional support from family, friends, co-workerLoss of emotional support from family, friends, co-worker Loss of self sufficiencyLoss of self sufficiency Loss of self esteemLoss of self esteem

51. 51 Special populations Although HIV/AIDS is like all diseases, “An Equal Opportunity Employer”; some groups have been significantly affected by the epidemic more than others. Listed are some as follows: Men who have sex with men (MSM’s)Men who have sex with men (MSM’s) Injection Drug Users (IDU’s)Injection Drug Users (IDU’s) HemophiliacsHemophiliacs WomenWomen People of ColorPeople of Color

52. 52 People of COLOR African Americans and Hispanics specifically have disproportionately higher rates of AIDS cases in the U.S., despite the fact that there are no biological reasons for the disparities. Fact: African American and Hispanic women make up 25% of the total population, but account for 77% of all reported AIDS cases in women. African Americans make up about 12% of the population, but account for 37% of all AIDS cases and Hispanics being 13% in population, but account for 20% of AIDS cases. In some areas disparities also exist in Native American AIDS cases.

53. 53 Apply your Knowledge: People of COLOR cont. With some of the previous statistic given for infection/mortality rates, what are some of the co-factors and barriers impacting the conditions that could cause higher disparities in these populations?With some of the previous statistic given for infection/mortality rates, what are some of the co-factors and barriers impacting the conditions that could cause higher disparities in these populations?

54. 54 Co-factors and Barriers that cause higher disparities with people of color/culture PovertyPoverty EducationEducation Racism/discriminationRacism/discrimination Access/InsuranceAccess/Insurance Fear/MistrustFear/Mistrust Advocacy skillsAdvocacy skills Support or lack of resourcesSupport or lack of resources

55. 55 Pandemic World View=Total Adults & Children living with HIV at end of 2006 Sub-Saharan Africa 25.8 million (23.8 to 28 mil.) South & Southeast Asia 7.4 million (4.5 to 11 mil.) Latin America 1.8 million (1.4 to 2.4 mil.) E. Europe, Central Asia 1.6 million (990,000 to 2.3) North America 1.2 million (650,000 to 1.8) East Asia 870,000 (440,000 to 1.4 mil) West & Central Europe 720,000 (570,000 to 890,000) North Africa, Middle East 510,000 (230.000 to 1.4 mil) Caribbean 300,000 (200,000 to 510,000) Oceania (Pacific Islands) 74,000 (45,000 to 120,000)

56. 56 African Mother & Babies with HIV 20% of pregnant women in 6 African countries have HIV Those countries are: Botswana, Lesotho, Namibia, South Africa, Swaziland & Zimbabwe In Swaziland, nearly 40% of all pregnant women have HIV Over 1/3 of babies whose mothers have HIV will acquire infection too, if prevention is lacking. 60% of these HIV-infected infants die before age 2 Source: Global Health Council, 2007

57. 57 In 2006, the news got a little better in Africa The overall number of Africans taking anti-retroviral drugs increased more than 200% during 2006 1 in 6 HIV-positive Africans had begun receiving anti-retrovirals by end of 2006 200 Kenyan clinics had HIV meds in 2005 In South Africa, there were about 190,000 people taking HIV meds at end of 2005, up from under 5,000 people in early 2005 At least half of infected people in some African countries are now being treated with HIV meds. Those countries include Botswana and Uganda. But, in other countries, only 10% of infected people are getting treatment.

58. 58 AIDS in AFRICA 96% of those with HIV are from poor countries. Most of them live in sub-Saharan Africa. Almost 1, million people in that region were newly infected with HIV from 2003 to 2005. In some African nations, 75% of those with HIV are women. Many have had only 1 sexual partner Only 1 in 10 people who needed anti-retro-virals received them in many African countries in 2005. 5to6 million people in low-and middle income countries around the world will die within 2 years, unless they get HIV medications. Source: Global Health Counsel, 2007

59. 59 HIV/AIDS Resources Cascade AIDS Project (CAP)Cascade AIDS Project (CAP) Multnomah County Health Department – HIV Services (testing and needle exchanges)Multnomah County Health Department – HIV Services (testing and needle exchanges) Department of Health Services – State programsDepartment of Health Services – State programs Inside Out (Youth services)Inside Out (Youth services) Unity Project aka Brother to BrotherUnity Project aka Brother to Brother Project QuestProject Quest Our HouseOur House Esther’s PantryEsther’s Pantry Partnership ProjectPartnership Project Ainsworth Community ChurchAinsworth Community Church Africa Aids ResponseAfrica Aids Response

60. 60 Know HIV Prevention and Education End of Topic