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• Human Immunodeficiency Virus (HIV)


  The virus, of the type called retrovirus, which infects cells of the human immune system, and destroys or impairs the cells' function. Infection with HIV results in the progressive deterioration of the immune system leading to immune deficiency.
• HIV


  • Condition in humans in which the virus invades the CD4-positive T lymphocyte (cells that are associated with making our immune response)
  • The virus makes the infected person vulnerable to various opportunistic life-threatening infections and cancers due to progressive failure of the immune system
• Acquired Immune Deficiency Syndrome (AIDS)


  Deficiency of immune system that stems from infection with the Human Immunodeficiency Virus or HIV, making an individual susceptible to opportunistic infections.
• AIDS


  • STAGE 3 HIV which predisposes our body to other opportunistic infections
  • Opportunistic infections (OI) – infections and malignancies that rarely occur in the absence of severe immunodeficiency
  • CD4 lymphocyte count below 200 cells per microliter or a CD4 lymphocyte percentage below 14% are considered to have AIDS
  • 500-1400 cells = NORMAL
  • Below 500 = an indication of HIV infection
  • Preventable and manageable BUT NOT CURABLE (no established treatment up to this day)
• Opportunistic infections at different CD4 counts

  • CD4 500 and below: Bacterial infections, Tuberculosis (TB), Herpes Simplex, Herpes Zoster, Vaginal candidiasis, Hairy leukoplakia, Kaposi's sarcoma
  • CD4 200 and below (parasitic infections): Pneumocystis carinii, Toxoplasmosis, Cryptococcosis, Cocciodioidomycosis, Cryptosporidiosis, Non-Hodgkin's lymphoma
  • CD4 50 and below: Disseminated Mycobacterium avium complex (MAC) infection, Histoplasmosis, CMV retinitis, CNS lymphoma, Progressive multifocal leukoencephalopathy, HIV dementia
• Modes of HIV transmission


  • Unprotected sexual intercourse
  • Blood transfusion
  • Sharing of contaminated intravenous needle
  • Pregnancy, delivery, and breastfeeding

  
• Primary prevention: 5 ways to protect yourself

  • Abstinence
  • Monogamous Relationship
  • Protected Sex
  • Sterile needles
  • New shaving/cutting blades
• Safer sex practices


  Choices and behaviors adopted by a person to minimize the risk of acquiring an HIV infection

  
• Safer sex practices


  • Postponing sexual debut
  • Non-penetrative sex (frottage, touching, mutual masturbation, kissing, and cuddling)
  • Correct and consistent use of male or female condoms
  • Reducing the number of sexual partners
• HIV testing


  Any laboratory procedure done on any individual to determine the presence or absence of HIV infection
• HIV positive


  Presence of antibodies
• HIV negative


  Absence of antibodies
• Window period


  The period of time, usually lasting from two weeks to six (6) months during which an infected individual will test "negative" upon HIV testing but can actually transmit the infection
• HIV testing procedures


  • Screening Test (HIV-1 & HIV-2) - screened using the test kits (principle used: enzyme-linked immunosorbent assay (ELISA))
  • Confirmatory Test - test performed on samples that tested reactive in a screening test to find out if the results were true positive or not (uses Western blot techniques)
• Blood detection tests


  • HIV enzyme-linked immunosorbent assay (ELISA) - Screening test for HIV, Sensitivity > 99.9%
  • Western blot - Confirmatory test, Specificity > 99.9% (when combined with ELISA)
  • HIV rapid antibody test - Screening test for HIV, Simple to perform
  • Absolute CD4 lymphocyte count - Predictor of HIV progression, Risk of opportunistic infections and AIDS when <200
  • HIV viral load tests - Best test for diagnosis of acute HIV infection, Correlates with disease progression and response to HAART
• Anti-retroviral therapy


  Treatment given to HIV and AIDS-positive patient to stop the replication of the virus
• Anti-retroviral drugs


  • Nucleoside Reverse Transcriptase inhibitors: Azidothymidine (Zidovudine)
  • Non-Nucleoside Transcriptase inhibitors: Viramune (Nevirapine)
  • Protease inhibitors: Norvir (Ritonavir)
• Differences between HIV-1 and HIV-2

  • HIV-1: Found around the world, Immunodeficiency is faster, Shorter incubation period, Highly infectious in early stages (increased risk of transmission)
  • HIV-2: West Africa, increasing cases in the US, Immunodeficiency develops more slowly, Longer incubation period, Less infectious in early stages; much infectious as the virus develops
• RA 8504: "Philippine AIDS Prevention and Control Act of 1998" consists of 9 articles and 52 sections, approved on February 13, 1998 by President Fidel V. Ramos
• RA 11166: "Philippine HIV and AIDS Policy Act" consists of 8 articles and 57 sections, approved on December 20, 2018 by President Rodrigo R. Duterte

  
• Declaration of policies in RA 11166

  • Responding to the country's HIV and AIDS shall be anchored on the principles of human rights upholding human dignity
  • Policies and practices that discriminate or hamper the enjoyment of basic human rights and freedoms are deemed inimical to national interest
  • Respect, protect, and promote human rights as the cornerstones of an effective response to the country's HIV and AIDS situation
  • HIV and AIDS education and information dissemination should form part the right to health
  • Inclusion and participation of persons directly and indirectly affected by the HIV and AIDS situation, especially persons living with HIV, are crucial in eliminating the virus
  • Confidentiality and non-compulsory nature of HIV testing and HIV-related testing shall always be guaranteed and protected
  • Ensure the delivery of non-discriminatory HIV and AIDS services
  • Develop redress mechanisms for persons living with HIV to ensure that their civil, political, economic, and social rights are protected
  • Establish policies and programs to prevent the spread of HIV and deliver treatment, care, and support services to Filipinos living with HIV
  • Adopt a multi-sectoral approach in responding to the country's HIV and AIDS situation
  • Ensure access to HIV- and AIDS-related services by eliminating the climate of stigma and discrimination
  • Positively address and seek to eradicate conditions that aggravated the spread of HIV infection (poverty, gender inequality, marginalization, and ignorance)
• Definitions of terms in RA 11166

  • Anti-retroviral Therapy (ART)
  • Bullying
  • Civil Society Organizations (CSOs)
  • Compulsory HIV Testing
  • Discrimination
  • Gender Expression
  • Gender Identity
  • Health Maintenance Organizations (HMO)
  • High-risk Behavior
  • HIV Counseling
  • HIV and AIDS Counselor
  • HIV and AIDS Monitoring
  • HIV and AIDS Prevention and Control
  • HIV-Negative
  • HIV-Positive
  • HIV Testing
  • HIV Testing Facility
  • Informed Consent
  • Laboratory
  • Mature Minor Doctrine
  • Medical Confidentiality
• Compulsory HIV testing is unlawful unless otherwise provided by the law
• HIV Testing


  Any facility-based, mobile medical procedure, or community-based screening modalities that are conducted to determine the presence or absence of HIV in a person's body
• HIV Testing Facility


  DOH accredited on-site or mobile testing center, hospital, clinic, laboratory, and other facility that has the capacity to conduct voluntary HIV counseling and HIV testing
• Informed Consent


  Voluntary agreement of a person to undergo or be subjected to a procedure based on full information, whether such permission is written or conveyed verbally
• Laboratory


  Area or place, including community-based settings, where research studies are being undertaken to develop local evidence for effective HIV response
• Mature Minor Doctrine


  Legal principle that recognizes the capacity of some minors to consent independently to medical procedures, if they have been assessed by qualified health professionals to understand the nature of procedures and their consequences to make a decision on their own
• Medical Confidentiality


  Core duty of medical practice where the information provided by the patient to the health practitioner and his/her health status is kept private and is not divulged to third parties. The patient's health status can, however, be shared with other medical practitioners involved in the professional care of the patient, attending physician, consulting medical specialist, nurse and medical technologist, and all other health workers or personnel involved in any counseling, testing or professional care of the patient
• Opportunistic infections


  Illnesses caused by various organism, many of which do not cause diseases in persons with healthy immune system
• Partner Notification


  Process by which the "index client", "source", or "patient" who has a sexually transmitted infection (STI) including HIV, is given support in order to notify and advise the partners that have been exposed to infection
• Person Living with HIV (PLHIV)


  Any individual diagnosed to be infected with HIV
• Pre-exposure Prophylaxis


  Use of prescription drugs as a strategy for the prevention of HIV infection by people who do not have the HIV and AIDS. It is an optional treatment, which may be taken by people who are HIV-negative but who have substantial, higher-than-average risk of contracting an HIV infection

  
• Pre-test Counseling


  Process of providing an individual with information on the biomedical aspects of HIV AIDS, and emotional support to any psychological implications of under going HIV testing and the test result itself before the individual is subjected to the test

  
• Post-exposure Prophylaxis


  Preventive medical treatment started immediately after exposure to pathogen (HIV) in order to prevent infection by the pathogen and the development of the disease
• Post-test Counseling


  Process of providing risk-reduction information and emotional support to a person who submitted to HIV testing at the time the result is released
• Prophylactic


  Any agent or device used to prevent the transmission of an infection
• Redress


  Act of compensation for unfairness, grievance, and reparation
• Sexually Transmitted Infections (STIs)


  Infections that are spread through the transfer of organisms from one person to another as a result of sexual contact
• Sexual Orientation


  Direction of emotional, sexual attraction, or conduct towards people of the same sex (homosexual orientation) or towards people of both sexes (bisexual orientation) or towards people of the opposite sex (heterosexual orientation) or to the absence of sexual attraction (asexual orientation)