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N304 > HIV > Flashcards

HIV Flashcards

1
Q

which area of the world is most greatly affected by HIV?

A

sub-Saharan africa

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2
Q

A pregnant women is HIV positive, what treatment does she get?

A

antiretroviral prophylaxis

has seen almost a complete decrease in xfer from mom to baby

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3
Q

What age group is most at risk for HIV?

A

15-24 y/o

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4
Q

Describe the UN aids new plan

A

Goal set for 2020

90-90-90 percent plan
90 of ppl know there dx
90 of ppl have access to tx
90 of ppl are virologically suppressed

If it is in place by 2020, estimates put eradication of aids by 2030

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5
Q

What is the total number of affected ppl in Canada and the prevalence rate?

A

75500

approx. 0.3 percent

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6
Q

what group of people account for 50 percent of new transmissions?

A

those who are unaware of their status

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7
Q

in order of ranking, what people groups attribute to new transmissions?

A

MSM (men who have sex with men) at 54

Heterosexual activities at 32

IV drug users at 10

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8
Q

what is the trend in rates among young gay men

A

increasing

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9
Q

Which city is leading the new diagnosis rate and why?

A

Vancouver because of high amounts of IDU (iv drug users)

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10
Q

In which provinces do MSM constitute half of new infections?

A

BC, Ontario, Quebec, and atlantic provinces

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11
Q

In which provinces does heterosexual activity account for half of transmission?

A

Alberta and Manitoba

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12
Q

In which province does IDU account for 70 percent of new infections?

A

Saskatchewan

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13
Q

Who was patient 0?

A

thirty six y/o, white, heterosexual male presented to a Toronto hospital in 1959

Had PCP, got really sick and died.

Because it was so mysterious, they froze a tissue sample. Once testing was available, they tested it and it was positive.

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14
Q

what is the trend of new diagnosis among whites and Asians?

A

decreasing in whites

increasing in asians

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15
Q

What population groups are most at risk in Canada?

A 
MSM
IDU
Women
Aboriginal
Youth
Mentally ill
Older adults
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16
Q

What is the highest risk sexual activity in HIV transmission?

A

Anal intercourse

17
Q

Describe the trend of HIV status and infection rate in the MSM group

A

Rate of HIV was declining for several years, but now has increased

In Vancouver, 18 percent of gay men are infected and 14 percent of those are unaware

18
Q

Describe the trend of HIV in women

A

Are increasingly represented in the stats with increasing rates.

Primarily from unprotected sex (often coerced sex)

19
Q

Why are women at such a high risk for HIV?

A

male to female transmission is 2 to 2.5 times more effective.

20
Q

Why are younger women especially vulnerable to HIV?

A

Immature genital mucosa (19-20 y/o)

Decreased mucous production (dec lubrication)

Undiagnosed/untreated STIs and inflamm disorders of the genital tract

21
Q

What are some psychosocial factors that contribute to women being vulnerable to HIV?

A

first sexual encounters are often with older men

first encounters may be non consensual

Social determinants; poverty, inequality, power imbalances, fear, violence

22
Q

Describe the trends of HIV in aboriginal women

A

Increased rates (3.5x)

pregnancy transmission is 10x higher

higher IDU

23
Q

what percent of people with HIV have a mental health condition?

A

80

24
Q

Explain why older adults are at risk for HIV?

A

lower index of suspicion for HIV infection

25
Q

What is a predictor of HIV risk in older adults?

A

Viagra

26
Q

Explain why the risk of reception so much higher

A

because the rectum does not naturally lubricate and it is lined with CD4 receptors.

27
Q

About how long does it take for the T cells to become depleted to the point where you are immunocompromised in the chronic stage?

A

8-15 years

28
Q

What percent of CD4 cells are lost in the early stage of acute infection?

A

80

29
Q

Explain how HIV leads to chronic diarrhea and malabsorption

A

it increases gut permeability increasing microbial translocation and immune activity

30
Q

What biomarkers are associated with HIV?

A

inflammatory markers such as D-dimer and IL-6

31
Q

Describe the four stages of infection for HIV

A

Primary Acute: symptoms of seroconversion illness 2-4 weeks after infection (flu-like)

Chronic Asymptomatic: generalized lymphadenopathy, thrombocytopenia

Chronic Symptomatic: wt loss, fatigue, diarrhea, candidiasis, herpes simplex and zoster

AIDS: AIDS defining ilnesses

32
Q

Explain the difference between non-nominal and nominal HIV testing?

A

nominal testing uses their real name

Non-nominal uses a pseudonym or initials

Either way, there is follow up by public health. Helps preserve confidentiality

33
Q

Is HIV a reportable condition and what does this mean?

A

yes it is

means positive test results must be reported to the local medical health officer for follow-up by the local public health nurse or HCP

Testing HCP is responsible to ensure that partner notification is initiated

34
Q

What five topics should be covered in pretest counselling?

A

1) emphasize confidentiality and understanding of non-nominal testing
2) review transmission risks and prevention strategies
3) describe partner notification process
4) explore psychological preparedness, coping, and support mechanisms
5) emphasize need to return for result

35
Q

What is ELISA?

A

it is the initial screening test looking for HIV antibodies.

Has a high sensitivity and low specifity

first test is a third gen EIA and then goes to fourth if positive to confim. if pos, get a western blot

36
Q

What is a Western Blot test?

A

antibody test to confirm reactivity; high sensitivity and specifity of 99.9

if it is non reactive can have NAAT that looks for RNA and if it is positive, they are in acute infection phase

37
Q

What is a pooled NAAT?

A

it is a test that can be done with increased accuracy over 4th gen Elisa. Targets clinics with a large MSM population

do it pooled because it is expensive. if positive, test each individually after.

38
Q

Explain the important points to cover in the post test counselling for NEGATIVE results.

A

INTERPRET:
means either no infection or too early to test. Risks within the past 3-6 months dictate need for retesting 3 months after the last possible exposure

REINFORCE:
reduction of risk

N304 (4 decks)

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