Week 7: HIV 2

I.              Control

a.    Need

                                              i.     Pandemic in >15 years

                                            ii.     25-30 years reduced lifespan in Africa

                                          iii.     95+ infections in developing world

                                           iv.     Most productive age group most affected

                                             v.     U.S. growing mostly in African American women

b.    Why it continues:

                                              i.     Poverty

                                            ii.     Limited access to healthcare

                                          iii.     Lack of diagnostics

                                           iv.     STDS

                                             v.     Endemic diseases

                                           vi.     Norms

                                         vii.     High risk behaviors

c.    Predictions vs. Reality

                                              i.     Not matching up

                                            ii.     Worse than expected

d.    Strategies

                                              i.     ABC Model

                                            ii.     Prevention

1.    Barrier

                                          iii.     Treatment

                                           iv.     PEPFAR

1.    Goals

a.    Prevent 7 million infections

b.    ARV to 2 million

c.    Care for 10 million

2.    Funding

a.    39 Billion HIV

b.    4 Billion TB

c.    5 Billion malaria

3.    Wording allows conscience clause and sex worker clause

a.    Both neglect most at risk populations

                                             v.     Challenges

1.    Vertical Transmission

a.    In utero

b.    Labor

c.    Breast milk

d.    Guidelines

                                                                                                    i.     Breastfeeding still recommended

                                                                                                  ii.     Preventative therapy techniques not feasible

                                                                                                iii.     In developed countries, more possible

                                           vi.     HIV TB

1.    TB = leading cause of death

2.    1/3 HIV deaths

3.    14 million co infected

4.    Promotes TB disease

5.    Increased transmission to others

                                         vii.     Gender

1.    Many married with one partner

2.    Africa and the Carribean = highest prevalence

3.    Societal/cultural imbalance

4.    Immature reproductive tracts

5.    Menstruation

6.    Small tears in tissue