This session was planned to give newly diagnosed participants the chance to learn all about HIV. Robert and Susan began by explaining that HIV is a retrovirus that places its genes inside a cell’s own genes and it infects key immune cells (CD4 cells). The different stages of infection were highlighted along with the definition of AIDS, which results from damage to the immune system. The basic monitoring tests that newly diagnosed people can expect are the CD4 and viral load tests.
Often newly diagnosed people are very worried about how infectious they may be and what risk they may expose other people to, and so Robert and Susan outlined the main ways that transmission occurs (sex, blood transfusion, mother-to-child, sharing needles). Less common routes of transmission were also discussed (oral sex, occupational risks, tattooing). They also discussed some of the myths about transmission and explained that HIV is not transmitted from:
Toilet seats
Sharing cups/cutlery
Social contact with people with HIV
Unbroken healthy skin
Animal or insect bites
Contact with dried blood
Some of the other myths that people may hear were also discussed:
HIV is man-made
Only gay men, Africans, drug users and ‘tarts’ get HIV
HIV/AIDS is a death sentence
People living with HIV can’t have children
None of these are true; however, in the UK people living with HIV have access to treatment, but elsewhere in the world it is not the case.
People living with HIV 37.8 million
New HIV infections in 2003 4.8 million
There were about 14,000 new infections a day in 2003. More than 95% of these were in low and middle income countries and almost 2,000 were in children under 15 years of age. About 6,000 were women and 6,000 were 15-24 year olds.
Since 1982 almost 65,000 people have been diagnosed with HIV in the UK and currently over 50,000 people are estimated to be living with HIV in the UK . One third do not know they are HIV positive. In 2003 57% of new diagnoses were in heterosexual people; two-thirds were women (in 2001 more women were diagnosed with HIV in the UK than gay men). 45% of new diagnoses were made in London . Diagnoses in people who inject drugs remain low (107 people were diagnosed in 2003).
The majority of gay men (84%) acquired their infection in the UK. 81% of heterosexuals acquired their infection in African countries, 8.7% in other parts of the world. Around 10% of heterosexuals living with HIV acquired their infection in the UK .
The rate of new AIDS diagnoses has declined since the mid 1990s. In 1994, 1853 new AIDS diagnoses were made but by 2003 this had declined to 705. In 2003 77% of the AIDS diagnoses were made at the same time as the HIV infection was diagnosed. The annual death rate has declined from 1700 deaths in 1994 to 462 deaths in 2003.
1987 AZT is licensed for treatment of AIDS
1994 AZT is shown to reduce mother-to-baby HIV transmission
1994 A study shows there is no benefit of the early use of AZT
1995 Two drug therapy has a clinical benefit over one drug therapy
1996 Viral load testing becomes available
1996 First protease inhibitor (PI) studies
1998 Efavirenz is a potent alternative to PIs
2000 Calls for global access to HIV treatment
2004 Over 20 antiretroviral drugs from 5 classes now available in the UK
2004 Global access remains limited
2005 World Health Organisation plan to have 3 million people on HIV therapy
Robert and Susan then informed participants about the current approved antiretrovirals and the move towards ‘simpler’ regimes that can be tolerated.
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