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Update 2005

Update 2005. PALAU AND HIV. EPIDEMIOLOGY: prevalence 14.4/100,000. Epidemiological projection. GENDER. MODES OF TRANSMISSION. Case of HIV/AIDS 1993-2004. Incidence of STI 1989-2000. Multiple sex partners reported by 32.4% males,8.1% females 44% m/ 15% f travel abroad had sex encounters

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Update 2005

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  1. Update 2005 PALAU AND HIV

  2. EPIDEMIOLOGY: prevalence 14.4/100,000

  3. Epidemiological projection

  4. GENDER

  5. MODES OF TRANSMISSION

  6. Case of HIV/AIDS 1993-2004

  7. Incidence of STI 1989-2000

  8. Multiple sex partners reported by 32.4% males,8.1% females 44% m/ 15% f travel abroad had sex encounters IVD –2.3% m,.5% f,38% reported sharing needles 21.1% m,4.8% f had tatoos 4.3% m are gay Palau Health Survey

  9. Behavioral Risk • Condom Use Among Those with Extra-Marital Sex= 8%M 6%F • Sexual Activity While Traveling Abroad= 44%M 15%F • Multiple Sexual Partners in Past Year= 32%M 8%F (Sources: ROP HIV Program Report, 2000 and Palau Health Survey, 1999)

  10. Re-introduction of Syphilis to ROP (Source: ROP Communicable Disease Program Report, 1999)

  11. Problem Drinking, Marijuana and “Ice” Use By Age Group (Source: SANA survey, 1998 [n=802 residents >10years])

  12. Drug and Alcohol Use, ROP, in Preceding 12 Months, by Sex *(“Problem Drinking”= Drink 5 or more drinks at a sitting at least once/month and have job, legal, or home problems caused by their drinking) **( “Ice” use not reported by sex) (Source: SANA survey, 1998 [n=802 residents >10years])

  13. Patient care:b3-CD4 above 400,on HAART,fatty liver,increased MCV B4,B6- Husband and wife: b4-cd4 under 200 symptomatic,B6 assympt,cd4 above400 B5-CD4 under 27, with pancreatic mass,admitted for PCP , in and out of Palau Surveillance on availability of hand washing material improved from 20 to 70% FU surveillance on practice of universal precaution to be done- To be done after teaching of IPCC curriculum New Infection Control Manual currently in printing HIV Protocol in progress Death certificate issue resolved Improvement of blood safety Formation of HCV registry Since the last conference: clinical progress

  14. REVIEW OF LAB LOG BOOKS 2.2.2001-12.18.04 /MEDICAL RECORDS • 5,775 tests for bld donorscreening,ANC,diagnostics • 9/128 double entries,4/128 dead, 6/128 wrong entries • 128 logged positive @ lab log book Had their charts reviewed for HCV results and history of risky behavior • 63/128 reviewed

  15. gender • Total= 63 • Males= 39 • Females= 24

  16. Age distribution • 1970-1979=15 • 1960-1969=22 • 1950-1959=14 • 1940-1949=1 • 1980-1989=5 • 1930s=1

  17. HX DRUG USE • Alcohol-20 • IVDU-18 • ICE-12 • MJ-10 • Unknown-10

  18. HX DRUG USE • Alcohol-20 • IVDU-18 • ICE-12 • MJ-10 • Unknown-10

  19. OTHER RISK FACTORS • BTF before march01 – 7 • Tatoos-9 • STI-14 • MSP-15

  20. Training Program • Thursday lunch with CDC/Clinical nurses- HIV specific issues- nil since Sep 2004 • CME for hot-line managers • Involvement in womens’ conference • Radio-talkback shows

  21. Prospective • Increased Tendency to see patients presenting in AIDS • The risk factors for HIV are hot and increasing • Geographical situation- 1 stop away from Asia • Will be seeing HIV in children soon • Got to prepare for the worse

  22. Prospective: be prepared for the worst case scenario • A 24 yr old pregnant un-booked mum came in labor, dx HIV positive on ELISA.The index case was her partner.Their son was positive

  23. Contd. • Train attendants to cope with the worst case scenario • Attendants in low prevalence areas at a disadvantage- should have attachments at high prevalence areas periodically. • Video-Teleconference are useful when technology works

  24. Internal Medicine Primary Care Pediatrician Obstetrician Social Worker Clinical Nursing Staff Psych Nutritionist Trained/Yet to be trained

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