HIV / AIDS

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HIV / AIDS

• People Taking Care of People...
•              Together we can do anything

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Objectives

• Define HIV and AIDS
• Identify transmission of the HIV virus
• Discuss the continuum of care for HIV/AIDs
  patients in Long Term Care
• Discuss measures to prevent transmission of the
  virus in the healthcare setting specific to Long
  Term Care

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Define HIV/AIDs

• HIV Human Immunodeficiency virus
• AIDS Acquired Immune Deficiency Syndrome

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HIV Break it down

• H Humans only
• Immunodeficiency immune system deficit
• Virus can only reproduce itself by taking over
  a cell as its host

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HIV

• HIV is a virus (the flu chickenpox are also a
  virus)
• Difference?
• Body clears other virus
• Cant clear the HIV virus
• Research is still seeking the why to this
• The virus hides in the human cells destroying
  the T-Cells /CD4 Cells which are responsible for
  fighting off infections and disease

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AIDS

• A Acquired not inherited, must acquire it
• I Immuno- affecting the immunity organs
• D Deficiency -doesnt work like it should
• S Syndrome- a collection of diseases not just a
  single symptom

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AIDS

• Is Diagnosed when
• One or more specific infections called
  opportunistic infections (such as
  Cytomegalovirus, Oral Candida, Pneumocystis
  Carnii Pneumonia)
• Certain cancers (Lymphoma, Kaposis Sarcoma)
• Or very low CD4/T cell counts
• normal CD4 count can range from 500 cells/mm3 to
  1,000 cells/mm3.
• CD4 count of fewer than 200 cells/mm3 is one of
  the qualifications for a diagnosis of AIDS.

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Transmission of HIV/AIDs

• Sex with an infected partner
• IV drug users
• HIV positive women to their baby
• Needle sticks (accidental)
• (very rare) Blood transfusions and donor tissue

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HIV Cannot be Transmitted by

• Coughing or Sneezing
• Toilet seats
• Door knobs
• Holding hands
• Hugging
• Casual kissing
• Clothes, sheets, towels

• Being around or working with someone with HIV or
  AIDS
• Sweat
• Sharing meals, drinking glasses
• Pets
• Insect bites
• Donating blood

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Is there a cure for HIV/AIDS?

• No
• However, with the advent of anti-retroviral
  drugs, and methods of treatment (known as HAART
  or cocktails), people with HIV and AIDS are
  living longer, active, and productive lives!

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Elder Care HIV/AIDs

• In 2005, people over the age of 50 accounted for
  
• 15 percent of new HIV/AIDS diagnoses
• 24 percent of people living with HIV/AIDS
• 35 percent of all deaths of people with AIDS
• (Department of Health Human Services website)

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Elder Care Risk

• Many people mistakenly assume that older
  Americans are not sexually active and therefore
  not at risk for HIV infection.
• A 2007 national survey of Americans ages 57 to 85
  found that the majority of older Americans are
  sexually active. This is particularly true for
  healthy older Americans.
• However, older Americans do not always realize
  that they may be at risk for HIV infection.
• Many came of age in the decades before AIDS and
  did not receive the information about HIV
  prevention that younger generations did.
• Others were married or in long-term relationships
  for many years and tuned out information about
  HIV.
• they may be less knowledgeable about HIV/AIDS and
  therefore less likely to protect themselves.

(Department of Health Human Services website)
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Continuum of Care

• The need for long-term care may continue to grow
  for patients who do not respond fully to current
  antiretroviral therapies
• Those with significant neuropsychiatric co-
  morbidities.
• This level of care may be increasingly important
  in reducing lengths of stay in the hospital
• Act as a bridge to community-based residential
  options in the emerging chronic disease phase of
  the AIDS epidemic.

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CHRONIC HIV/AIDs

• Increased life expectancy
• Better treatments/drug regimes to extend life
• Baby boomers bulge
• (See next slide) The middle of the bulge is
  about 60 years old today. They are just coming
  into the early elder years.
• Fewer caregivers for homecare
• Will see more in LTC

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Baby Boomers Bulge moves up
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What is the Risk for Health Care Workers?
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Body Fluids Known to Transmit HIV

• Blood
• Semen
• Vaginal Secretions
• Breast Milk
• Synovial Fluid (fluid around the joints)

• Cerebral Spinal fluid
• ( Fluid around the brain and spinal cord)
• Amniotic Fluid (fluid around a fetus)
• Any body fluid that contains visible blood

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Through December 2001, there were 57documented
cases of occupational Through December
2001, there were 57documented cases of
occupational HIVtransmission to health care
workers in theUnited States, and no confirmed
cases havebeen reported since 1999
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The risk of health care workers being exposed to
HIV on the job is very low, especially if they
carefully follow universal precautions (i.e.,
using protective practices and personal
protective equipment to prevent HIV and other
blood-borne infections. - Centers for Disease
Control and Prevention
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Reduce Transmission

• Treat all body fluids as if known to be
  infectious
• Universal Precautions with every patient every
  time!
• Hand Hygiene!
• PPEs (Face guards, gloves, etcappropriate to
  the task)
• Work practice controls
• - Use of Safety Needles/Dont recap needles
• - dont re-use razors!
• - handy sharps containers,
• - blood spill kits,
• - use proper housekeeping and dietary
  disinfecting procedures

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What Happens if I have an accidental exposure to
blood or body fluids?

• Immediate First Aid (flush the site with water)
• Notify your supervisor immediately
• Incident Accident Report

• Prompt, confidential medical evaluation (attempt
  within 2 hours)
• Post Exposure
• Prophylaxis HIV antibody testing(confidential)
• Follow up screening and counseling

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• Know and Follow the Infection Prevention and
  Control Plan for Blood borne pathogens in Long
  Term Care
• Discuss any concerns with your supervisor
• These are only words unless YOU put them into
  practice for your job role in your department. Be
  safe.

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Congratulations!

• You have completed this session on HIV/AIDS
• Thank you!
• Questions?