HIV 101: The Basics HHS Game Jam September 26, 2014

1. HIV 101: The BasicsHHS Game JamSeptember 26, 2014 Susan Robilotto, DO-- Clinical Advisor Marlene Matosky, MPH, RN -- Nurse Consultant HIV/ AIDS Bureau Health Resources and Services Administration U.S. Department of Health and Human Services

2. AIDS – Acquired Immunodeficiency Syndrome ART – Antiretroviral Therapy CD4 – or T-helper lymphocyte HIV – Human Immunodeficiency Virus PEP – Post-exposure prophylaxis PLWH – Persons living with HIV PrEP – Pre-exposure prophylaxis STD/STI – Sexually transmitted diseases/ infections Acronyms

3. HIV stands for Human Immunodeficiency Virus. It is the virus that causes Acquired Immunodeficiency Syndrome, or AIDS. A virus is a very small infective agent that is able to multiply only within the living cells of a host. Unlike some other viruses, the human body cannot get rid of HIV. That means that once you have HIV, you have it for life. (There is no cure.) What is HIV?

4. This is the stage of infection that occurs when the immune system is badly damaged and one becomes vulnerable to infections and infection-related cancers called opportunistic illnesses. When the number of CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), a person is considered to have progressed to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3 in adults/youth.) People with AIDS need medical treatment to prevent death. AIDS

5. About 50,000 people in the United States get infected with HIV each year. About 1.1 million people were living with HIV at the end of 2010, the most recent year this information was available. Of those people, about 16% do not know they are infected. In the United States, about 15,500 people with AIDS died in 2010. The South has the highest number of individuals living with HIV. HIV in the United States

6. The only way to know ifone is infected with HIV is to be tested! Of the available HIV tests, some may become positive within 2 weeks of a person becoming infected while others may not turn positive for up to 90 days. One cannot rely on symptoms to know whether HIV is present. Many people who are infected with HIV do not have any symptoms at all for 10 years or more Some people who are infected with HIV report having flu-like symptoms (often described as “the worst flu ever”) 2 to 4 weeks after exposure (known as primary infection). Symptoms of primary infection can include: Fever Enlarged lymph nodes Sore throat Rash These symptoms can last anywhere from a few days to several weeks. How can one tell if he/she is infected?

7. Where can a person get tested? Public clinics Private doctors’ offices and clinics Home testing kits Types of tests Oral Swabbing of cheek Blood sample Finger prick Venous blood sample (blood draw) HIV Testing

8. Anyone who has had sex Special populations including: Men who have Sex with Men (MSM) [more than 60% of all new HIV diagnoses] African-Americans (8 times greater risk than whites) Hispanic/Latino (3 times greater risk than whites) Youth/Adolescents (26% of all new HIV infections, African American youth 2 times greater risk than other youth) Substance abusers including Injection Drug Users (IDU), crack cocaine, methamphetamine Who can be infected by HIV in the U.S.?

9. In the United States, HIV is spread mainly by having sex (vaginal/anal) or sharing injection drug equipment such as needles with someone who has HIV. HIV can be transmitted by only 6 fluids from an HIV-infected person Blood Semen (cum) Pre-seminal fluid (pre-cum) Rectal fluids Vaginal fluids Breast milk These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to possibly occur. Mucous membranes can be found inside the rectum, the vagina, the opening of the penis, and the mouth. How is HIV Transmitted?

10. HIV is not spreadby day-to-day contact in the workplace, schools, or social settings. HIV is not spreadthrough shaking hands, hugging, or a casual kiss. One cannot become infected from a toilet seat, a drinking fountain, a door knob, dishes, drinking glasses, food, cigarettes, pets, or insects. HIV is not spread through the air, and it does not live long outside the body. There is no evidence of HIV transmission from mosquitoes or any other insects—even in areas where there are many cases of HIV and large populations of mosquitoes. Unlike organisms that are transmitted by insect bites, HIV does not reproduce (and does not survive) in insects. How HIV is Not Transmitted!

11. Primary Prevention --Means Preventing HIV infection through Safer sex Not sharing needles Abstinence PrEP(Pre-Exposure Prophylaxis) PEP (Post-Exposure Prophylaxis) Secondary Prevention of HIV -- Means reducing the risk of giving HIV to other people by maximizing health outcomes of Persons Living with HIV (PLWH) through Anti-Retroviral treatment (ART) to suppress the virus Risk screening & reduction methods Partner notification Pre-conception & Perinatal care HIV Prevention

12. PLWH who take antiretroviral therapy (ART= HIV medication) and suppress HIV (“undetectable” levels in the blood) greatly reduce the risk of giving the virus others. Those who do not take ART as prescribed (non-adherence) are at risk to (1) not control HIV in their body, (2) have their HIV mutate and become drugresistant. Both of these situations can lead to a higher risk of giving HIV (and possibly drug resistant strains) to sexual partners and needle-sharing partners. HIV Care and Treatment

13. Contact Information Susan Robilotto, DO Clinical Advisor/ Medical Officer HHS/ HRSA/ HAB 1-301-443-6554 srobilotto@hrsa.gov