HIV / AIDS symposium: The global impact of HIV

Question 1

Who is most at risk of HIV?

Answer 1

• Sex workers and their clients
• Transgender people
• Prisoners
• Men who have sex with men
• Heterosexual women
• Injecting drug users
• Heterosexual men
• Truck drivers
• Migrant workers

Question 2

Who do 50% of all new infections occur in worldwide?

Answer 2

in 15-24 year olds

Question 3

What is the difference in HIV transmission efficiency of female to male and male to female?

Answer 3

Male to female HIV transmission is 2-3x as efficient as female to male transmission

Question 4

What are the 5 commitments and targets for 2015?

Answer 4

1. Reduce sexual transmission of HIV by 50%
2. Reduce transmission of HIV among people who inject drugs by 50%
3. Eliminate new HIV infections among children and substantially reduce AIDS-related maternal deaths
4. Reach 15 million people living with HIV with lifesaving antiretroviral treatment
5. Reduce TB deaths in people living with HIV by 50%

Question 5

What are the 3 routes of transmission for paediatric HIV-1 infection?

Answer 5

• In utero: transplacental, mostly during the third trimester
• Intra partum: exposure to maternal blood and genital secretions during delivery
• Breast milk: ingestion of large amounts of contaminated milk

Question 6

How is mother-to-child transmission preventable?

Answer 6

• Mother: First line antiretroviral therapy
• Breastfeeding infants: daily Nevirapine or AZT from birth until 4 to 6 weeks after cessation of breastfeeding

Question 7

What are 4 ways to prevent HIV-1 transmission?

Answer 7

1. Consistent condom use (80 – 90% effective)
   - Male circumcision (60% reduction in infection – no benefit to female partners)
   - Removing the foreskin reduces the ability of HIV to penetrate due to keratinization of the inner aspect of the remaining foreskin
   - The inner part of the foreskin contains many Langherhans cells (tissue DCs expressing CD4) which are prime targets for HIV
2. Harm reduction as an evidence-based approach to HIV prevention e.g. needle and syringe programmes
3. How to reduce mother to child transmission
4. Antiretroviral treatment – awareness, adherence, clinical services