HIV/AIDS

Presentation Outline
I. What is HIV?
II. Key Facts
III. Where did HIV come from?
IV. What are the stages of HIV?
V. How do I know if I have HIV?
 Signs and symptoms
 Transmission
 Risk factors
 Diagnosis
VI. How can HIV be prevented?
VII. Is there a cure for HIV?
What is HIV?
 The Human Immunodeficiency Virus (HIV) targets
the immune system and weakens people's defense
systems against infections and some types of
cancer. As the virus destroys and impairs the
function of immune cells, infected individuals
gradually become immunodeficient. Immune
function is typically measured by CD4 cell count.
Immunodeficiency results in increased
susceptibility to a wide range of infections, cancers
and other diseases that people with healthy
immune systems can fight off.
What is HIV?
 The most advanced stage of HIV infection is
Acquired Immunodeficiency Syndrome (AIDS),
which can take from 2 to 15 years to develop
depending on the individual. AIDS is defined by
the development of certain cancers, infections, or
other severe clinical manifestations.
Key Facts
 HIV continues to be a major global public health issue, having claimed
more than 35 million lives so far. In 2015, 1.1 (940 000–1.3 million) million
people died from HIV-related causes globally.
 There were approximately 36.7 (34.0–39.8) million people living with HIV
at the end of 2015 with 2.1 (1.8–2.4) million people becoming newly infected
with HIV in 2015 globally.
 Sub-Saharan Africa is the most affected region, with 25.6 (23.1–28.5) million
people living with HIV in 2015. Also sub-Saharan Africa accounts for two-
thirds of the global total of new HIV infections.
 HIV infection is often diagnosed through rapid diagnostic tests (RDTs),
which detect the presence or absence of HIV antibodies. Most often these
tests provide same-day test results; essential for same day diagnosis and
early treatment and care.
Key Facts
 There is no cure for HIV infection. However, effective antiretroviral (ARV)
drugs can control the virus and help prevent transmission so that people
with HIV, and those at substantial risk, can enjoy healthy, long and
productive lives.
 It is estimated that currently only 60% of people with HIV know their
status. The remaining 40% or over 14 million people need to access HIV
testing services. By mid-2016, 18.2 (16.1–19.0) million people living with
HIV were receiving antiretroviral therapy (ART) globally.
 Between 2000 and 2015, new HIV infections fell by 35%, AIDS-related
deaths fell by 28% with some 8 million lives saved. This achievement was
the result of great efforts by national HIV programs supported by civil
society and a range of development partners.
 Expanding ART to all people living with HIV and expanding prevention
choices can help avert 21 million AIDS-related deaths and 28 million new
infections by 2030.
Key Facts - Philippines
Where did HIV came from?
 Scientists identified a type of chimpanzee in
Central Africa as the source of HIV infection in
humans. They believe that the chimpanzee version
of the immunodeficiency virus (called simian
immunodeficiency virus, or SIV) most likely was
transmitted to humans and mutated into HIV when
humans hunted these chimpanzees for meat and
came into contact with their infected blood. Studies
show that HIV may have jumped from apes to
humans as far back as the late 1800s. Over decades,
the virus slowly spread across Africa and later into
other parts of the world. We know that the virus
has existed in the United States since at least the
mid to late 1970s. 
What are the stages of HIV?
When people get HIV and don’t receive treatment, they will
typically progress through three stages of disease. Medicine
to treat HIV, known as antiretroviral therapy (ART), helps
people at all stages of the disease if taken the right way,
every day. Treatment can slow or prevent progression from
one stage to the next. It can also dramatically reduce the
chance of transmitting HIV to someone else.

Stage 1: Acute HIV infection

Stage 2: Clinical latency (HIV inactivity or dormancy)
Stage 3: Acquired immunodeficiency syndrome (AIDS)
What are the stages of HIV?
Stage 1: Acute HIV infection
 Within 2 to 4 weeks after infection with HIV, people may

experience a flu-like illness, which may last for a few weeks.

This is the body’s natural response to infection. When people
have acute HIV infection, they have a large amount of virus in
their blood and are very contagious. But people with acute
infection are often unaware that they’re infected because they
may not feel sick right away or at all. To know whether
someone has acute infection, either a fourth-generation
antibody/antigen test or a nucleic acid (NAT) test is necessary.
If you think you have been exposed to HIV through sex or
drug use and you have flu-like symptoms, seek medical care
and ask for a test to diagnose acute infection.
What are the stages of HIV?
Stage 2: Clinical latency (HIV inactivity or dormancy)
 This period is sometimes called asymptomatic HIV infection or chronic HIV
infection. During this phase, HIV is still active but reproduces at very low
levels. People may not have any symptoms or get sick during this time.
For people who aren’t taking medicine to treat HIV, this period can last a
decade or longer, but some may progress through this phase faster.
People who are taking medicine to treat HIV (ART) the right way, every
day may be in this stage for several decades. It’s important to remember
that people can still transmit HIV to others during this phase, although
people who are on ART and stay virally suppressed (having a very low
level of virus in their blood) are much less likely to transmit HIV than
those who are not virally suppressed. At the end of this phase, a person’s
viral load starts to go up and the CD4 cell count begins to go down. As
this happens, the person may begin to have symptoms as the virus levels
increase in the body, and the person moves into Stage 3.
What are the stages of HIV?
Stage 3: Acquired immunodeficiency syndrome (AIDS)
 AIDS is the most severe phase of HIV infection. People

with AIDS have such badly damaged immune systems

that they get an increasing number of severe illnesses,
called opportunistic illnesses.
 Without treatment, people with AIDS typically survive

about 3 years. Common symptoms of AIDS include chills,

fever, sweats, swollen lymph glands, weakness, and
weight loss. People are diagnosed with AIDS when their
CD4 cell count drops below 200 cells/mm or if they
develop certain opportunistic illnesses. People with AIDS
can have a high viral load and be very infectious.
How do I know if I have HIV?
 Signs and symptoms
 Transmission
 Risk factors
 Diagnosis
How do I know if I have HIV?
Signs and symptoms
◦ The symptoms of HIV vary depending on the stage of
infection. Though people living with HIV tend to be
most infectious in the first few months, many are
unaware of their status until later stages. The first few
weeks after initial infection, individuals may
experience no symptoms or an influenza-like illness
including fever, headache, rash or sore throat.
How do I know if I have HIV?
Signs and symptoms
◦ As the infection progressively weakens the immune
system, an individual can develop other signs and
symptoms, such as swollen lymph nodes, weight loss,
fever, diarrhoea and cough. Without treatment, they
could also develop severe illnesses such as
tuberculosis, cryptococcal meningitis, and cancers
such as lymphomas and Kaposi's sarcoma, among
others.
How do I know if I have HIV?
Transmission
◦ HIV can be transmitted via the
exchange of a variety of body
fluids from infected
individuals, such as blood,
breast milk, semen and vaginal
secretions. Individuals cannot
become infected through
ordinary day-to-day contact
such as kissing, hugging,
shaking hands, or sharing
personal objects, food or water.
How do I know if I have HIV?
Risk factors
Behaviours and conditions that put individuals at greater risk of
contracting HIV include:
• having unprotected anal or vaginal sex;
• having another sexually transmitted infection such as syphilis,
herpes, chlamydia, gonorrhoea, and bacterial vaginosis;
• sharing contaminated needles, syringes and other injecting
equipment and drug solutions when injecting drugs;
• receiving unsafe injections, blood transfusions, tissue
transplantation, medical procedures that involve unsterile
cutting or piercing; and
• experiencing accidental needle stick injuries, including among
health workers.
How do I know if I have HIV?
Diagnosis
 Serological tests, such enzyme-linked immunosorbent assay
(ELISA or EIAs), detect the presence or absence of antibodies to
HIV-1/2 and/or HIV p24 antigen. When such tests are used
within a testing strategy according to a validated testing
algorithm, HIV infection can be detected with great accuracy. It is
important to note that serological tests detect antibodies produced
by an individual as part of their immune system to fight off
foreign pathogens, rather than direct detection of HIV itself.

 However Western Blot Test is done to confirm the presence of an

antibody and help diagnose HIV.
How can HIV be prevented?
1. Male and female condom use
2. Testing and counselling for HIV and STIs
3. Testing and counselling, linkages to tuberculosis care
4. Voluntary medical male circumcision
5. Antiretroviral (ARV) drug use for prevention
6. Harm reduction for injecting drug users
7. Elimination of mother-to-child transmission of HIV
(EMTCT)
How can HIV be prevented?
1. Male and female condom use
 Correct and consistent use of male and female condoms
during vaginal or anal penetration can protect against
the spread of sexually transmitted infections, including
HIV. Evidence shows that male latex condoms have an
85% or greater protective effect against HIV and other
sexually transmitted infections (STIs).
How can HIV be prevented?
2. Testing and counselling for HIV and STIs
 Testing for HIV and other STIs is strongly advised for all people

exposed to any of the risk factors. This way people learn of their
own infection status and access necessary prevention and treatment
services without delay. WHO also recommends offering testing for
partners or couples. Additionally, WHO is recommending assisted
partner notification approaches so that people with HIV receive
support to inform their partners either on their own, or with the
help of health care providers.
How can HIV be prevented?
3. Testing and counselling, linkages to tuberculosis care
 Tuberculosis (TB) is the most common presenting illness

and cause of death among people with HIV. It is fatal if

undetected or untreated and is the leading cause of death
among people with HIV- responsible for 1 of every 3 HIV-
associated deaths. Early detection of TB and prompt
linkage to TB treatment and ART can prevent these
deaths. TB screening should be offered routinely at HIV
care services. Individuals who are diagnosed with HIV
and active TB should be urgently started on TB treatment
and ART. TB preventive therapy should be offered to
people with HIV who do not have active TB.
How can HIV be prevented?
4. Voluntary medical male circumcision
 Medical male circumcision, when safely provided

by well-trained health professionals, reduces the

risk of heterosexually acquired HIV infection in
men by approximately 60%. This is a key
intervention supported in 14 countries in Eastern
and Southern Africa with high HIV prevalence
and low male circumcision rates.
How can HIV be prevented?
5. Antiretroviral (ARV) drug use for prevention
 5.1 Prevention benefits of ART

◦ A 2011 trial has confirmed if an HIV-positive person

adheres to an effective ART regimen, the risk of
transmitting the virus to their uninfected sexual partner
can be reduced by 96%. The WHO recommendation to
initiate ART in all people living with HIV will contribute
significantly to reducing HIV transmission.
How can HIV be prevented?
5. Antiretroviral (ARV) drug use for prevention
 5.2 Pre-exposure prophylaxis (PrEP) for HIV-negative

partner
◦ Oral PrEP of HIV is the daily use of ARV drugs by HIV-uninfected
people to block the acquisition of HIV. More than 10 randomized
controlled studies have demonstrated the effectiveness of PrEP in
reducing HIV transmission among a range of populations including
serodiscordant heterosexual couples (where one partner is infected
and the other is not), men who have sex with men, transgender
women, high-risk heterosexual couples, and people who inject
drugs.
◦ WHO recommends PrEP as a prevention choice for people at
substantial risk of HIV infection as part of combination prevention
approaches.
How can HIV be prevented?
5. Antiretroviral (ARV) drug use for prevention
 5.3 Post-exposure prophylaxis for HIV (PEP)

◦ Post-exposure prophylaxis (PEP) is the use of ARV drugs

within 72 hours of exposure to HIV in order to prevent
infection. PEP includes counselling, first aid care, HIV
testing, and administering of a 28-day course of ARV
drugs with follow-up care. WHO recommendsPEP use
for both occupational and non-occupational exposures
and for adults and children.
How can HIV be prevented?
6. Harm reduction for injecting drug users
 People who inject drugs can take precautions against becoming

infected with HIV by using sterile injecting equipment, including

needles and syringes, for each injection and not sharing other drug
using equipment and drug solutions. A comprehensive package of
interventions for HIV prevention and treatment includes:
◦ needle and syringe programmes;
◦ opioid substitution therapy for people dependent on opioids and other
evidence based drug dependence treatment;
◦ HIV testing and counselling;
◦ risk-reduction information and education;
◦ HIV treatment and care;
◦ access to condoms; and
◦ management of STIs, tuberculosis and viral hepatitis.
How can HIV be prevented?
7. Elimination of mother-to-child transmission of HIV (EMTCT)
 The transmission of HIV from an HIV-positive mother to her child

during pregnancy, labour, delivery or breastfeeding is called

vertical or mother-to-child transmission (MTCT). In the absence of
any interventions during these stages, rates of HIV transmission
from mother-to-child can be between 15-45%. MTCT can be nearly
fully prevented if both the mother and the child are provided with
ARV drugs throughout the stages when infection could occur.
 WHO recommends options for prevention of MTCT (PMTCT),

which includes providing ARVs to mothers and infants during

pregnancy, labour and the post-natal period, and offering life-long
treatment to HIV-positive pregnant women regardless of their CD4
count.
How can HIV be prevented?
7. Elimination of mother-to-child transmission of
HIV (EMTCT)
 In 2015, 77% (69–86%) of the estimated 1.4 (1.3-1.6)

million pregnant women living with HIV globally

received effective ARV drugs to avoid transmission
to their children. A growing number of countries are
achieving very low rates of MTCT and some
(Armenia, Belarus, Cuba and Thailand) have been
formally validated for elimination of MTCT of HIV.
Several countries with a high burden of HIV
infection are closing in on that goal.
How can HIV be prevented?
7. Elimination of mother-to-child transmission of
HIV (EMTCT)
 In 2015, 77% (69–86%) of the estimated 1.4 (1.3-1.6)

million pregnant women living with HIV globally

received effective ARV drugs to avoid transmission
to their children. A growing number of countries are
achieving very low rates of MTCT and some
(Armenia, Belarus, Cuba and Thailand) have been
formally validated for elimination of MTCT of HIV.
Several countries with a high burden of HIV
infection are closing in on that goal.
Is there a cure for HIV?
 No effective cure currently exists for HIV. But with
proper medical care, HIV can be controlled. Treatment
for HIV is called antiretroviral therapy or ART. If taken
the right way, every day, ART can dramatically prolong
the lives of many people infected with HIV, keep them
healthy, and greatly lower their chance of infecting
others. Before the introduction of ART in the mid-1990s,
people with HIV could progress to AIDS (the last stage
of HIV infection) in a few years. Today, someone
diagnosed with HIV and treated before the disease is far
advanced can live nearly as long as someone who does
not have HIV.
Sources/ References
 WHO HIV/AIDS Updated Fact sheet November 2016
retrieved at:
http://www.who.int/mediacentre/factsheets/fs360/en/
 HIV Basics by Center for Disease Control and Prevention
retrieved at: https://
www.cdc.gov/hiv/basics/whatishiv.html
 HIV cases rise by 18% in 2016 – DOH By Yvette Morales,
CNN Philippines retrieved at: http://
cnnphilippines.com/news/2017/02/01/HIV-cases-increas
e-2016-DOH.html