The Basics of HIV: What? Who? How?

Mauda Monger, MPH

Director, Health Education (AETC)
Division of Infectious Diseases
University of Mississippi Medical Center

(content from PowerPoint presentation)

Objectives

• Define HIV/AIDS
• Epidemiology Overview
• Who Is at Risk
• How Is It transmitted
• Facts and Fiction

Mississippi Stats

• Mississippi had the 6th highest HIV diagnosis rate in 2015
• 78% of the new HIV cases documented in 2014 were African-American with diagnosis rates 7 times higher than Whites.
• Jackson had the 4th highest HIV and 1st highest AIDS diagnosis rates in 2015 of any US metropolitan statistical area (MSA) with a population 500,000 or greater

Data based on 2013 MSDH Surveillance reports

Lifetime Risk of HIV Diagnosis by State (image source)

Source: Centers for Disease Control and Prevention

What is HIV?

The Human Immunodeficiency Virus (HIV) is a virus that enters a person's body and attacks their immune system.  The virus kills cells in the immune system that protects us from infections.  When this happens, the body is left weakened  and defenseless against infections.

• H - Human: a person's body
• I - Immunodeficiency: when the immune system lacks some elements and breaks down
• V - Virus: a group of tiny cells that multiply in the body and cause diseases

What is AIDS?

Acquired Immunodeficiency Syndrome (AIDS) is a group of infections and diseases that occur because of the breakdown in the body's immune system.

• A - Acquired: something you are given or get
• I - Immuno: the body's defense system which normally protects us from disease
• D - Deficiency: lacking or not enough
• S - Syndrome: a group of diseases

FACT CHECK

HIV and AIDS – there is a difference…

• HIV does not equal AIDS:
• HIV is a virus.
• AIDS is a disease.
• AIDS is a result of HIV infection.

WHO IS AT RISK?

Who is at Risk for HIV/AIDS?

EVERYONE is at risk…

Highest Risk –

• Gay/Bisexual Men (African American and Hispanic Men)
• African Americans (men and women)
• Youth

Gay/Bisexual Men (African American and Hispanic Men)

• 1 in 6 gay and bisexual men will be diagnosed with HIV in their lifetime
  • 1 in 2 Black/African American gay and bisexual men
  • 1 in 4 Hispanic/Latino gay and bisexual men,
  • 1 in 11 white gay and bisexual men

In Mississippi, more than 70% of those diagnosed with HIV in 2015 were AA men.

Race

• HIV Diagnoses in the United States for the Most-Affected Subpopulations, 2015 - chart interpretation:
  • Black MSM: 10,315
  • White MSM: 7,570
  • Hispanic/Latino MSM: 7,013
  • Black Women, Heterosexual Contact: 4,142
  • Black Men, Heterosexual Contact: 1,926
  • Hispanic/Latina Women, Heterosexual Contact: 1,010
  • White Women, Heterosexual Contact: 968
• HIV incidence among blacks was almost eight times higher than that of whites
• Source: HIV Surveillance Report 2016;27. Subpopulations representing 2% or less of HIV diagnoses are not reflected in this chart. Abbreviation: MSM, men who have sex with men.

Youth

• Young people ages 13 to 24 accounted for more than 1 in 5 new HIV diagnoses in 2014. Most of those occurred among young gay and bisexual males.
• From 2010-2014, HIV diagnoses increased 19% among 15-24 year olds in Mississippi.
• HIV prevalence rates by census track area in Jackson metropolitan area (cases per 100,000 population) - map interpretation: Highest number of cases in ZIP codes 39201 and 39217 (additional data by county - PubMed external link)

HOW IS HIV TRANSMITTED?

Modes of Transmission

HIV enters the bloodstream through:

• Open Cuts
• Breaks in the skin
• Mucous membranes
• Direct injection

Body fluids that spread HIV:

• Vaginal Fluids
• Semen
• Blood
• Breast Milk

HIV infection:

• Unprotected sexual intercourse with an infected partner
• Vertical transmission (from mother to child)
  • in utero
  • during delivery
  • breast milk
• Injection drug use (rare: infected blood/blood products)

Modes HIV is NOT Transmitted

HIV is not transmitetd by...

• Insect bites
• Toilet seats
• Kissing
• Sharing cutlery
• Touching

Ways HIV Cannot be Spread

• Recreational or toilet facilities
• Swimming in the same pool
• Accepting served food
• Sleeping in the same room

You can't get HIV through casual contact.

Getting Tested

What should you know…

• Testing is the only way to be sure
  • An HIV test is the only way you can know your status
• Cost
  • You can get tested for free at multiple locations
• Accurate
  • Tests are 97-99% right when done correctly
• How often
  • You should be tested once a year
• Testing is easy
  • Rapid tests only take 1-20 mins to get results

FACT CHECK

• You cannot tell if someone has HIV or AIDS by the way they look
• There is an HIV home test kit
• Testing is easy, simple and doesn't take a long time
• Your results are only shared with you and  your health care provider

Fighting Stigma

Stigma

• Negative feelings, beliefs, and behaviors directed toward an individual or group due to a particular label or characteristic
• HIV/AIDS Stigma: Negative feelings, beliefs, and behaviors directed toward individuals, groups and communities that are associated with HIV/AIDS

What do you think is the root cause of stigma?

• Judgment
• Ignorance
• Fear
• Moral Bias
• Prejudice
• Misunderstanding
• Discrimination

Root Causes of Stigma

• Lack of awareness of what stigma looks like and why it is damaging
• Fear of casual contact stemming from incomplete knowledge about HIV transmission
• Values linking people with HIV to improper or immoral behavior (implicit bias)

Stigma and Students (YouTube video - external link)

Stigma Outcomes

• Delayed/late testing
• Don't go the doctor
• No support system
• Constant Fear
• Death

Facts and Fiction

Guess the right answer:

• Only (all) people who are gay have HIV/AIDS
• "It's my job as a health care professional or educator to inform family, coworkers and other students if a student is HIV positive."
• "The government and pharmaceutical companies have a cure for AIDS but are making too much money to release it."
• "A lot of information about AIDS is being held back from the public."
• The HIV virus can get to an undetectable level in the body.
• If a person is clean, they can't have HIV
• HIV/AIDS is a not death sentence.
• Straight or Gay, I am still at risk for HIV/AIDS.

Got a question…call me

• Mauda Monger
  (601) 984-5542
  mmonger@umc.edu