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Topic: Combating HIV

Introduction to HIV/AIDS
The first cases of acquired immunodeficiency syndrome (AIDS) were reported in the United States in the
spring of 1981. By 1983 the human immunodeficiency virus (HIV), the virus that causes AIDS, had been
isolated. Early in the U.S. HIV/AIDS pandemic, the role of substance abuse in the spread of AIDS was clearly
established. Injection drug use (IDU) was identified as a direct route of HIV infection and transmission among
injection drug users. The largest group of early AIDS cases comprised gay and bisexual men (referred to as
men who have sex with men (or MSMs). Early cases of HIV infection that were sexually transmitted often were
related to the use of alcohol and other substances, and the majority of these cases occurred in urban,
educated, white MSMs.
Currently, injection drug users represent the largest HIV-infected substance-abusing population in the United
States. HIV/AIDS prevalence rates among injection drug users vary by geographic region, with the highest
rates in surveyed substance abuse treatment centers in the Northeast, the South, and Puerto Rico. From July
1998 through June 1999, 23 percent of all AIDS cases reported were among men and women who reported
IDU practices are quick and efficient vehicles for HIV transmission. The virus is transmitted primarily through
the exchange of blood using needles, syringes, or other IDU equipment (e.g., cookers, rinse water, cotton) that
were previously used by an HIV-infected person. Lack of knowledge about safer needle use techniques and
the lack of alternatives to needle sharing contribute to the rise of HIV/AIDS.
Another route of HIV transmission among injection drug users is through sexual contacts within relatively
closed sexual networks, which are characterized by multiple sex partners, unprotected sexual intercourse, and
exchange of sex for money). The inclusion of alcohol and other non injection substances to this lethal mixture
only increases the HIV/AIDS caseload). A major risk factor for HIV/AIDS among injection drug users is crack
use; one study found that crack abusers reported more sexual partners in the last 12 months, more sexually
transmitted diseases (STDs) in their lifetimes, and greater frequency of paying for sex, exchanging sex for
drugs, and having sex with injection drug users.
Following are the key concepts about HIV/AIDS and substance abuse disorders that influenced the creation of
this TIP:

Substance abuse increases the risk of contracting HIV. HIV infection is substantially associated with
the use of contaminated or used needles to inject heroin. Also, substance abusers may put themselves
at risk for HIV infection by engaging in risky sex behaviors in exchange for powder or crack cocaine.
However, this fact does not minimize the impact of other substances that may be used (e.g.,
hallucinogens, inhalants, stimulants, prescription medications).
Substance abusers are at risk for HIV infection through sexual behaviors. Both men and women
may engage in risky sexual behaviors (e.g., unprotected anal, vaginal, or oral sex; sharing of sex toys;
handling or consuming body fluids and body waste; sex with infected partners) for the purpose of
obtaining substances, while under the influence of substances, or while under coercion.

Substance abuse treatment serves as HIV prevention. Placing the client in substance abuse
treatment along a continuum of care and treatment helps minimize continued risky substance-abusing
practices. Reducing a client's involvement in substance-abusing practices reduces the probability of

HIV/AIDS, substance abuse disorders, and mental disorders interact in a complex fashion. Each
acts as a potential catalyst or obstacle in the treatment of the other two--substance abuse can
negatively affect adherence to HIV/AIDS treatment regimens; substance abuse disorders and HIV/AIDS
are intertwining disorders; HIV/AIDS is changing the shape and face of substance abuse treatment;
complex and legal issues arise when treating HIV/AIDS and substance abuse; HIV-infected women with
substance abuse disorders have special needs.

Risk reduction allows for a comprehensive approach to HIV/AIDS prevention. This strategy
promotes changing substance-related and sex-related behaviors to reduce clients' risk of contracting or
transmitting HIV.

but even to date. because HIV-infected people generally are asymptomatic for years. but it is spreading most rapidly among women and adolescents. high rate of unprotected sexual contact with multiple partners. tracking data reveal only how many individuals have AIDS.. their children. The CDC estimates that between 650. the most recent CDC data show that the decline is slowing (CDC. The researchers believe that the virus crossed over from monkeys to humans when hunters became exposed to infected blood. 1997c). semen. 1997a).000 people in the United States currently are living with HIV (CDC. particularly in African American and Hispanic communities. In general. while the much larger portion. AIDS occurs late in HIV disease. and vagina are mucosal surfaces that can contain infected human body fluids and because these surfaces can be easily injured. HIV/AIDS is still largely a disease of MSMs and male injection drug users. and low access to health care. Female-tofemale transmission of HIV apparently is rare but should be considered a possible means of transmission because of the potential exposure of mucous membranes to vaginal secretions and menstrual blood (CDC. known as combination therapy. is submerged out of sight. not how many have HIV. and marginalized communities of injection drug users. they might not be tested or included in the count.. HIV is a virus that thrives in certain ecological conditions. In 1996. high viral load. HIV. . 1998). Sexual contact is also an effective transmission route for HIV because the tissues of the anus. These ecological conditions exist to a large degree among urban. Zhu et al. those with the best access to good.) This can occur in childbirth as well as through blood transfusions or organ transplants prior to 1985. such as blood. HIV can be passed from a woman to a man during intercourse. However.Origin of HIV/AIDS Of the many theories and myths about the origin of HIV. the virus responsible for the global AIDS pandemic. and there is strong evidence that HIV and SIV are closely related (Simon et al. The counted AIDS cases are like the visible part of an iceberg. known as SIV (simian immunodeficiency virus). ongoing HIV/AIDS care increase their chances of living longer. the number of new AIDS cases (not HIV cases) and deaths from AIDS began to decline in the United States for the first time since 1981. Using injection equipment that an infected person used is another direct way to transmit HIV. high HIV seroprevalence within the community. The decline can be attributed to advances in treating HIV with multiple medications. high prevalence of STDs. A recent study (Gao et al. However. Thus. vaginal secretions. 1999) identified a subspecies of chimpanzees native to west equatorial Africa as the original source of HIV-1. Tracking of the disease in the United States began early after the discovery of the pandemic. substance abuse. The most effective means of transmitting HIV is by direct contact between the infected blood of one person and the blood supply of another. allowing the virus to enter the body. A person is about five times more likely to contract HIV through anal intercourse than through vaginal intercourse because the tissues of the anal region are more prone to breaks and bleeding during sexual activity A woman is eight times more likely to contract HIV through vaginal intercourse if the man is infected than in the reverse situation (Center for AIDS Prevention Studies. 1999b). Many States are counting HIV cases now that positive results are to be gained by treating the infection in the early stages and because counting only AIDS cases is no longer sufficient for projecting trends of the pandemic. Deaths from AIDS have decreased since 1996 in all racial and ethnic groups and among both men and women (CDC. 1998). or breast milk.. 1999a). The latter can be attributed to improved services for people with HIV and access to health care.000 and 900. (See Figure 1-1 for an illustration of the structure of the virus. and a reduction in the HIV infection rate in the mid-1980s prior to the introduction of combination therapy. which means an infected person develops a very weak immune system and becomes vulnerable to contracting life-threatening infections (such as Pneumocystis carinii pneumonia). MSMs and African American and Hispanic women. poor. 1998. HIV must be transmitted directly from one person to another through human body fluids that contain HIV-infected cells. rectum. Monkeys can carry a virus similar to HIV. AIDS is caused by HIV infection and is characterized by a severe reduction in CD4+ T cells. but this is less likely because the skin of the penis is not as easily damaged. The following will lead to higher infection rates: a more potent virus. treatments to prevent secondary opportunistic infections. and adolescents within these communities are at greatest risk HIV Transmission HIV cannot survive outside of a human cell. the most likely explanation is that HIV was introduced to humans from monkeys.

41% (3. Sexual contact accounted for 464 cases and 250 of them were due to homosexual contact and 146 due to bisexual contact. Saliva seems to have some effect in helping prevent transmission of HIV.147) were infected through heterosexual contact. Philippines . <1% (20) through blood transfusion and needle prick injury <1% (3). if a person has infections or injuries in the mouth or gums. A total of 134 of them were aged 15 to 24.” the DOH said. 20 through blood transfusion and three through needle prick injury. with less than 0. From 2007 there has been a shift in the predominant trend of sexual transmission from heterosexual contact (20%) to males having sex with other males (80%) DOH: 460 HIV cases in Pampanga By Ferth Vandensteen Manaysay Tuesday.A total of 5. Cumulative data shows 33% (3. 2015 – 12:00am MANILA. and 26% (2.750 of them belonged to the 15 to 24 age group.Oral intercourse also is a potential risk but is less likely to transmit the disease than anal or vaginal intercourse.502 the number of cases since January this year and to 22. January 13.637) were infected through sexual contact. Twenty-eight cases were injecting drug users who shared infected needles.514 HIV positive cases reported from 1984 to 2013. The DOH said the 492 cases are 28 percent higher than the 384 cases recorded in November 2013. Records showed that 20. HIV/AIDS in the Philippines Prevalence Officially. 4% (420) through needle sharing among injecting drug users. No data is available for 4% (375) of the cases.018 since 1984. the Department of Health (DOH) AIDS Registry in the Philippines reported 10. 66 through mother-to-child transmission.534) through bisexual contact. “Males having sex with other a male (85 percent) was the predominant type of sexual transmission… Eightythree of the new HIV cases came from the National Capital Region. DOH records 500 new HIV cases in 1 month By Sheila Crisostomo (The Philippine Star) | Updated January 5. Region 2 and Region 11. Region 4-A.The province of Pampanga now has 460 people living with Human Immunodeficiency Virus (HIV). However. and the oral tissues are less likely to be injured in sexual activity than those of the vagina or anus. Based on the registry prepared by the DOH’s National Epidemiology Center. 1. including 40 cases of acquired immunodeficiency syndrome (AIDS). there were 492 new cases of HIV.519 cases were infected through sexual contact.956) through homosexual contact. Means of transmission Of the 10.011 developed AIDS while 1. The new cases brought to 5. while 69 were below 15 years old. the Philippines is a low-HIV-prevalence country.514 people living with HIV/AIDS. then the risk of contracting HIV through oral sex increases. 1% (59) through mother-to-child transmission.Almost 500 new cases of human immunodeficiency virus (HIV) infections were documented in November 2014. Of the 22. There were 10 deaths. 2.1 percent of the adult population estimated to be HIV-positive. according to the Department of Health (DOH) Philippine HIV and Acquired Immune Deficiency Syndrome (AIDS) Registry. As of January 2013.018 cases. . two-thirds of whom were aged 15 to 24 and mostly infected through sexual contact. 2015 ANGELES CITY -.035 through needle sharing among injecting drug users. 92% (9.101 have died.

“We have been very active in raising the awareness of the people about HIV-AIDS. the registry said the top five provinces in the region which registered the most number of HIV cases were: Bulacan (13). What can you say about this? 3. many people still hesitate to take the test because of the social stigma it entails. Since 1984. We interview some Doctors and nurses. Earlier. this figure is 2. the city government helps the citizens in the form of free voluntary HIV counseling and testing service. “We can say that this is not an accurate figure of how many people in the country are living with HIV or AIDS. Nueva Ecija (54). some of our respondents are familiar about Human Immunodeficiency Virus but the other they just know that this virus can kill a person. How Do You Get HIV or AIDS? SURVEY Based on our survey. Health experts. Are you familiar about the Human Immunodeficiency Virus (HIV)? 2. In the Philippines. the Angeles City has registered a total of 233 HIV cases. and Zambales (25). nevertheless. and Aurora (4). community assemblies and forums to reduce stigma. among others. but they know the cause and effect of the virus.Lenario Santos. The AIDS-Free Philippines (AFP) also previously listed Angeles City as one of the metropolitan areas with the most number of HIV cases in the country along with Metro Manila and Metro Cebu. Is it true that if you are going to use contraceptives can really prevent the virus? 6. For the 2014 data. which registered the most number of HIV cases along with Metro Manila. meanwhile. Nueva Ecija (150). Bataan (71). What types of contraceptives do you know? 5. How can you prevent this? 4. the DOH reported that Central Luzon recorded 359 cases out of the 5. 018 HIV cases that have been recorded in the country from 1984 to January 2015. Central Luzon. Calabarzon. noted that the figure is just based on the number of people who have “willingly” undergone the HIV-AIDS test. and Southern Mindanao. Tarlac (106).” Santos said. Others are having the same answers or opinion about the HIV virus but some are not yet familiar. Questions: 1. and building to improve sexually-transmitted infections and HIV proficiency training. Tarlac (33).1 percent of the 22. Of the 1478 cases in the region. Central Visayas.” said Angeles City health officer Dr. most were reported from the province of Bulacan (519) followed by Pampanga (460). which accounted for at least 50 percent of the total cases in the province. 502 new cases of HIV in the Philippines from January 2014 to November 2014. Pampanga (95). hope to mitigate the impacts of the disease to the victims by working closely with non-government organizations. The local health officers. In fact. Zambales (168). Can this lessen the chance of people that can get this virus? . based on the latest tally. was among the top five regions.According to the January 2015 Philippine HIV and AIDS Registry report.

pills. 6. Proper use of IV transfusions. It is an Immunodeficiency that cannot be threatened. 2. FPSVI MEDICAL OFFICER IV HEALTH SERVICES OFFICE Answers: 1. Condoms. Very risky and not curable.Answers: 1. Yes. 2. 6. Avoid in contact to homosexuals and proper use of IV injections. 4. 3. Contraceptives. 3. 5. NANCY G. because the only solution to prevent or lessen the chance of acquiring HIV is through abstinence. UNKNOWN FACULTY AT NURSING DEPARTMENT . Safe sex and monogamous partners. No. No. Yes. 4. 5. 6. MD. Using contraceptives. No. 2. injectibles. Yes. Yes. jelly and injectibles. discard Synge after use. Natural contraceptives. CELIA FLOR C. cream. birth control pills. and jelly. Condoms. sometimes not effective. PHSAE. 4. It is a transferrable disease by contact. 5. MANALO NURSE BAGUIO GENERAL HOSPITAL Answers: 1. 3. It can help but it depends to the person if they use it in a proper way. BRILLANTES.