LEC6_PREVENTION_2011

LEC6_PREVENTION_2011 - PreventionofHIV/AIDS November17,2011

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Prevention of HIV/AIDS November 17, 2011
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Outline for today’s class 1)  Connection between treatment and prevention of HIV 2)  HIV Infection Rates:  Prevention successes or failures? 3)  Shift to Positive Prevention (CDC, 2003) also refer to assigned reading 5)  HIV prevention by mode of transmission 6)  Current challenge(s) in the United States 
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Treatment and Prevention:  the connection Antiretroviral therapy benefits prevention Therapy reduces mother-to-child transmission (MTCT) Post-exposure prophylaxis (PEP) reduces HIV infection  from needle stick injuries  (e.g. in a hospital) Therapy reduces viral load, lowering risk of sexual  transmission
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Knowledge and Disease  Prevention Disseminating HIV/AIDS info. is crucial But, it is typically not enough Most people are resistant to change Even when people are not resistant  to change, barriers  (e.g. political)  may limit prevention What are the  infection rates  today in the U.S.?
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Hall et al. JAMA 2008; 300 (5): 520-529
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Hall et al. JAMA 2008; 300 (5): 520-529
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Early Prevention Efforts Early prevention programs targeted  (via mass media,  peer-education approaches):    general population, groups at higher risk but did not  intentionally target HIV+ persons Approach may have been appropriate due to: Stigma associated with HIV+ status Limited HIV testing
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Shifts in Prevention Efforts Positive prevention focuses interventions on  persons who are HIV+   A fundamental shift after 22 years; CDC officially  endorsed positive prevention in 2003 Consistent with principles of infectious disease  epidemiology  Aim is to reduce their risk of transmission 
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Positive Prevention Recommended by the Joint United Nations  Program on HIV/AIDS   Is implemented in industrialized nations Should be implemented in regions with high  prevalence of HIV/AIDS. 10 recommendations for Africa  (refer to reading)  
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Implementing Positive  Prevention Knowledge of HIV status Most HIV+ persons in Africa don’t know HIV status Knowledge of HIV+ status  ↑ preventive behavior Make HIV testing a routine part of medical care Encourage testing in non-traditional settings e.g. mobile, door-to-door testing programs 
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Prevention Disclosure of HIV status to partners Positive aspects:  Prevention of sexual transmission of HIV  (e.g. condom use) Increase adherence to treatment  (nothing to hide)
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LEC6_PREVENTION_2011 - PreventionofHIV/AIDS November17,2011

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