Blood and Airborne Pathogens

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Blood and Airborne Pathogens

• HIV/AIDS/STDs/Hepatitis
• TB/SARS/Influenza

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Is the Greatest Political Disease in the US

• Issues and consequences of past and current
  politics have had and continue to have huge
  Impacts.
• Has huge Social Impacts
• Has huge World-Wide Impacts
• Has World-Wide implications for Societies
• Has World-Wide implications for the development
  of other diseases
• May become the Black Death of our Time

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Some Topic Areas

• Introduction
• Epidemiology and Social Issues Associated with
  HIV
• What is HIV / AIDS
• Associated Disorders and Related Diseases
• Substance Abuse
• STDs, Hepatitis, TB
• Treatment Issues
• Substance Abuse Issues related to HIV
• Risk Behaviors
• Counseling Issues/Homophobia
• Brief Interventions

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• Prevalence - The number of people with a
  disorder in a population
• Estimate - Estimated number of people with
  a disorder in a population
• Incidence - Extent or rate of new occurrences
  of a disease in a population

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Sources

• CDC.gov
• WHO.org
• UNAIDS.org

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Dot Maps
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General Trends In HIV/AIDS
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Proportion of AIDS Cases among Female
Adults and Adolescents, by Exposure Category, 2002
United States
Sex with
Heterosexual
injection drug user
transmission
15
68
Sex with men of
other or

unspecified risk
Injection drug use
53
29
Other/not identified
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Note. Data adjusted for reporting delays and for
redistribution of cases in persons initially
reported without an identified risk.
Includes heterosexual contact with a bisexual,
a person with hemophilia, a transfusion
recipient with HIV infection or HIV-infected
person, risk not specified.
Includes hemophilia, blood transfusion,
perinatal, and risk not reported or not
identified.
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Proportion of AIDS Cases among Female
Adults and Adolescents, by Exposure Category and
Age at
Diagnosis, 2002, United States
Age at diagnosis (in years)
Exposure category
20-24
13-19
25-34
35-44
45





Injection drug use
14
19
24
33
31
79
61
74
65
66
Heterosexual contact
Other/not identified
3
2
2
3
25
No. of Persons (in thousands)
Note. Data adjusted for reporting delays and for
redistribution of cases in persons initially
reported without an identified risk.
Includes hemophilia, blood transfusion,
perinatal, and risk not reported or not
identified.
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Estimated Number of AIDS Cases among Female
Adults
and Adolescents Attributed to Injection Drug Use
and
Heterosexual Contact, by Region, Cumulative
through 2002
United States
40
36,941
Injection drug use
N65,394
35
33,788
Heterosexual contact
N80,677
29,487
30
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Number of cases (in thousands
21,178
20
15
(in thousands)
Number of cases
10
7,642
6,607
5,562
4,866
5
0
Midwest
South
West
Northeast
Region
Note. Data adjusted for reporting delays.
Excludes persons from Puerto Rico and US
dependencies, possessions and associated nations.
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World HIV / AIDS Statistics
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Global Summary of the HIV and AIDS December 2004
Number of people living with HIV in 2004 Total
39.4 million
(35.9 44.3 million) Adults
37.2 million (33.8 41.7 million)
Women 17.6
million (16.3 19.5 million) Children under 15
years 2.2 million (2.0 2.6
million) People newly infected with HIV in 2004
Total 4.9
million (4.3 6.4 million) Adults
4.3 million (3.7 5.7
million) Children under 15 years 640 000
(570 000 750 000) AIDS deaths in 2004 Total
3.1 million (2.8
3.5 million) Adults
2.6 million (2.3 2.9 million) Children
under 15 years 510 000 (460 000 600 000)
The ranges around the estimates in this table
define the boundaries within which the actual
numbers lie, based on the best available
information.
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Regional HIV and AIDS Statistics and Features,
End of 2004
2.3 million 2.1 2.6 million
7.4 6.9 8.3
3.1 million 2.7 3.8 million
25.4 million 23.4 28.4 million
28 000 12 000 72 000
0.3 0.1 0.7
92 000 34 000 350 000
540 000 230 000 1.5 million
490 000 300 000 750 000
0.6 0.4 0.9
890 000 480 000 2.0 million
7.1 million 4.4 10.6 million
51 000 25 000 86 000
0.1 0.1 0.2
290 000 84 000 830 000
1.1 million 560 000 1.8 million
0.6 0.5 0.8
95 000 73 000 120 000
240 000 170 000 430 000
1.7 million 1.3 2.2 million
36 000 24 000 61 000
2.3 1.5 4.1
53 000 27 000 140 000
440 000 270 000 780 000
60 000 39 000 87 000
0.8 0.5 1.2
210 000 110 000 480 000
1.4 million 920 000 2.1 million
6 500 lt8 500
21 000 14 000 38 000
610 000 480 000 760 000
0.3 0.2 0.3
16 000 8 400 25 000
0.6 0.3 1.0
44 000 16 000 120 000
1.0 million 540 000 1.6 million
700 lt1 700
0.2 0.1 - 0.3
5 000 2 100 13 000
35 000 25 000 48 000
3.1 million 2.8 3.5 million
1.1 1.0 - 1.3
4.9 million 4.3 6.4 million
39.4 million 35.9 44.3 million
The proportion of adults 15 to 49 years of
age living with HIV in 2004, using 2004
population numbers
The ranges around the estimates in this table
define the boundaries within which the actual
numbers lie, based on the best available
information.
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Global Estimates for Adults and Children end 2004

• People living with HIV
• New HIV infections in 2004
• Deaths due to AIDS in 2004

39.4 million 35.9 44.3 million 4.9 million
4.3 6.4 million 3.1 million 2.8 3.5
million
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Adults and Children Estimated to be Living with
HIV End 2004
Eastern Europe Central Asia 1.4 million 920
000 2.1 million
Western Central Europe 610 000 480 000 760
000
North America 1.0 million 540 000 1.6 million
East Asia 1.1 million 560 000 1.8 million
North Africa Middle East 540 000 230 000 1.5
million
Caribbean 440 000 270 000 780 000
South South-East Asia 7.1 million 4.4 10.6
million
Sub-Saharan Africa 25.4 million 23.4 28.4
million
Latin America 1.7 million 1.3 2.2 million
Oceania 35 000 25 000 48 000
Total 39.4 (35.9 44.3) million
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Estimated number of adults and childrennewly
infected with HIV during 2004
Eastern Europe Central Asia 210 000 110 000
480 000
Western Central Europe 21 000 14 000 38 000
North America 44 000 16 000 120 000
East Asia 290 000 84 000 830 000
North Africa Middle East 92 000 34 000 350
000
Caribbean 53 000 27 000 140 000
South South-East Asia 890 000 480 000 2.0
million
Sub-Saharan Africa 3.1 million 2.7 3.8 million
Latin America 240 000 170 000 430 000
Oceania 5 000 2 100 13 000
Total 4.9 (4.3 6.4) million
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Estimated Deaths from AIDS during 2004
Western Central Europe 6 500 lt8 500
Eastern Europe Central Asia 60 000 39 000
87 000
North America 16 000 8 400 25 000
East Asia 51 000 25 000 86 000
North Africa Middle East 28 000 12 000 72
000
Caribbean 36 000 24 000 61 000
South South-East Asia 490 000 300 000 750
000
Sub-Saharan Africa 2.3 million 2.1 2.6 million
Latin America 95 000 73 000 120 000
Oceania 700 lt1 700
Total 3.1 (2.8 3.5) million
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Children (lt15 years) estimated to be living with
HIV as of end 2004
Eastern Europe Central Asia 8 800 7 100 13
000
Western Central Europe 6 200 4 900 7 900
North America 11 000 5 600 17 300
East Asia 9 400 3 300 27 000
North Africa Middle East 24 000 7 100 82 000
Caribbean 23 000 12 000 49 000
South South-East Asia 170 000 95 000 320
000
Sub-Saharan Africa 1.9 million 1.7 2.3 million
Latin America 26 000 21 000 43 000
Oceania 700 lt 2 500
Total 2.2 (2.0 2.6) million
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Estimated deaths in children (lt15 years) from
AIDS during 2004
Eastern Europe Central Asia 1 100 800 2
200
Western Central Europe lt 100 lt 200
North America lt 100 lt 200
East Asia 2 400 900 6 900
North Africa Middle East 5 600 1 700 19 000
Caribbean 5 300 2 700 11 000
South South-East Asia 37 000 22 000 70
000
Sub-Saharan Africa 450 000 400 000 540 000
Latin America 6 000 4 800 9 800
Oceania lt 200 lt 600
Total 510 000 (460 000 600 000)
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Estimated number of children (lt15 years) newly
infected with HIV during 2004
Western Central Europe lt 100 lt 200
Eastern Europe Central Asia 1 800 1 200 3
700
North America lt 100 lt 200
East Asia 4 100 1 500 11 000
North Africa Middle East 9 100 2 800 30 000
Caribbean 6 100 3 100 13 000
South South-East Asia 51 000 30 000 95
000
Sub-Saharan Africa 560 000 500 000 650 000
Latin America 6 800 5 400 11 000
Oceania lt 300 lt 1 000
Total 640 000 (570 000 750 000)
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About 14 000 new HIV infections a day in 2004

• More than 95 are in low and middle income
  countries
• Almost 2000 are in children under 15 years of age
• About 12 000 are in persons aged 15 to 49 years,
  of whom
• almost 50 are women
• about 50 are 1524 year olds

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End-2004 global HIV and AIDS estimates Children
(lt15 years)

• Children living with HIV
• New HIV infections in 2004
• Deaths due to AIDS in 2004

2.2 million 2.0 2.6 million 640 000 570 000
750 000 510 000 460 000 600 000
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Other STDs
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Chlamydia Rates United States, 19842003
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Chlamydia Rates by Sex United States,
19842003
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Chlamydia Rates by Region United States,
19842003
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Chlamydia Rates by State United States and
outlying areas,
2003
Note The total rate of chlamydia for the United
States and outlying areas (Guam, Puerto Rico and
Virgin Islands) was 301.3 per 100,000 population.
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Chlamydia Rates by County United States,
2003
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Gonorrhea Rates United States, 19702003
Note The Healthy People 2010 target for
gonorrhea is 19.0 cases per 100,000 population.
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Gonorrhea Rates by State 2003
Note The total rate of gonorrhea for the United
States and outlying areas (Guam, Puerto Rico and
Virgin Islands) was 114.7 per 100,000 population.
The Healthy People 2010 target is 19.0 cases per
100,000 population.
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Gonorrhea Rates by Region United States,
19812003
Note The Healthy People 2010 target for
gonorrhea is 19.0 cases per 100,000 population.
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Gonorrhea Rates by Sex United States, 19812003
Note The Healthy People 2010 target for
gonorrhea is 19.0 cases per 100,000 population.
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Gonorrhea Rates by Race and Ethnicity United
States, 19812003
Note The Healthy People 2010 target for
gonorrhea is 19.0 cases per 100,000 population.
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Gonococcal Isolate Surveillance Project (GISP)
Percent of gonorrhea cases that occurred among
MSM, 1988 2003
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Syphilis Cases by Stage of Infection United
States, 19412003
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Primary and Secondary Syphilis United States,
19702003
Note The Healthy People 2010 target for PS
syphilis is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Rates by State
2003
Note The total rate of primary and secondary
syphilis for the United States and outlying areas
(Guam, Puerto Rico and Virgin Islands) was 2.5
per 100,000 population. The Healthy People 2010
target is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Rates by County
2003
Note The Healthy People 2010 target for PS
syphilis is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Rates by Region
19812003
Note The Healthy People 2010 target for PS
syphilis is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Rates by Race and
Ethnicity 19812003
Note The Healthy People 2010 target for PS
syphilis is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Rates by Sex
19812003
Note The Healthy People 2010 target for PS
syphilis is 0.2 case per 100,000 population.
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Primary and Secondary Syphilis Age-specific
rates among women 10 to 44 years of age
19812003
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Primary and Secondary Syphilis Age-specific
rates among men 10 to 44 years of age 19812003
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Primary and Secondary Syphilis Male-to-Female
Ratios 19812003
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Chancroid 1981 2003
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Genital Herpes 1966 2003
SOURCE National Disease and Therapeutic Index
(IMS Health)
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Genital Warts 1966 2003
SOURCE National Disease and Therapeutic Index
(IMS Health)
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Trichomoniasis and Other Vaginal Infections
19662003
SOURCE National Disease and Therapeutic Index
(IMS Health)
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Chancroid Reported cases United States,
19812002
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Gonococcal Isolate Surveillance Project (GISP)
Percent of gonorrhea cases that occurred among
MSM, 1988-2002
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Idaho Statistics
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