Odds Of Getting Hiv From One Encounter – The World Health Organization recognizes HIV as a global health problem. There are over 100,000 people living with HIV in the UK; 6,000 new cases are diagnosed each year and there is a relentless transmission rate among men who have sex with men (MSM). Healthcare providers are increasingly likely to encounter patients living with HIV and need to be familiar with HIV, HIV treatment, and specific high-impact prevention strategies used to reduce HIV transmission. Health workers may also work to reduce the spread of HIV by promoting HIV testing, post-exposure prophylaxis treatment, and the routine use of condoms during sex. This article aims to provide an overview of HIV in the UK population.
The Human Immunodeficiency Virus (HIV) is one of the most devastating viruses in the world, and it is estimated that more than 35 million people have died from HIV Acquired Immunodeficiency Syndrome (AIDS) since it was discovered in the 1980s (UNAIDS, 2014). HIV AIDS has become the leading cause of death in sub-Saharan Africa and a global health problem (Rao et al., 2006; World Health Organization, 2015). Currently, more than 100,000 people in the United Kingdom (UK) are known to be living with HIV; about 6,000 new cases are diagnosed each year, and there is an undecreased rate of HIV transmission among men who have sex with men (MSM) (Skingsley et al., 2015; Terrence Higgins Trust, 2015). Therefore, paramedics are more likely to encounter patients with HIV in their clinical practice; they should feel they can have safer sex conversations, refer high-risk patients to HIV testing facilities or services, encourage adherence to HIV medication and offer post-exposure prophylaxis services, ideally as part of a well-rounded HIV prevention strategy. This article will give healthcare professionals an overview of the Human Immunodeficiency Virus, but will focus specifically on HIV-1, the most common HIV subtype in the UK population.
Odds Of Getting Hiv From One Encounter
Around 6,000 new cases of HIV are diagnosed in the UK each year, adding to more than 100,000 people known to be living with HIV (Skingsley et al., 2015; Terrence Higgins Trust, 2015). Estimating the exact number of people living with HIV is difficult, as approximately one in five people living with HIV are unaware of their positive HIV status, a public health problem (National Institute for Health and Care Excellence [NICE], 2014). ; Kingsley et al., 2015). HIV is more common among men who have sex with men (MSM) in the UK, with around 1 in 18 MSMs being HIV positive; It rises to 1 in 8 London boroughs (National AIDS Trust [NAT], 2014). Blacks have the second highest incidence and account for two-thirds of HIV infections in the heterosexual HIV-positive population, with a prevalence of 56 per 1000 aged 15-59 years (Public Health England, 2014). HIV is more common especially among men than women, and women who have sex with women have the lowest HIV transmission rates (Kwakwa and Ghobrial, 2003).
Hiv And Occupational Exposure
HIV can be transmitted when the blood, semen, pre-ejaculate fluid, vaginal mucus, anal mucus, or breast milk of a person with HIV enters the body of an unprotected person. However, it is usually transmitted via:
HIV does not develop outside the human body and is rarely transmitted through saliva or little-known non-blood contact (Simon et al., 2006: Public Health England, 2014). Therefore, ambulance clinicians are unlikely to be exposed to a significant risk of HIV transmission in their routine clinical practice (Health and Safety Executive, 2016).
The Human Immunodeficiency Virus (or HIV) is a retrovirus that specifically targets CD4+ T lymphocyte cells in the immune system of an infected host. CD4+ T cells normally generate the immune response to infection by recognizing foreign antigens and then generating an antibody response. These cells become rapidly ineffective in patients with HIV, their immune systems are dangerously weakened if left untreated, and they are susceptible to serious infections from organisms that are usually harmless. HIV binds to a receptor on a CD4+ T cell and, after binding, incorporates RNA into the host cell’s DNA through the process of reverse transcription. The newly infected CD4+ T cell then copies its DNA to regenerate HIV in large numbers within the host, which is released into the bloodstream with a cascading effect (Touloumi and Hatzakis, 2000; Faulhaber and Aberg, 2009).
The severity of HIV infections can be measured by the amount of virus present in the host, commonly known as the ‘viral load’ figure (Terrence Higgins Trust, 2016). Patients with high viral loads overcame HIV infections, which resulted in rapid destruction of CD4+ T cells and a low ‘CD4+’ count (<350 per microliter) (Faulhaber and Aberg, 2009). HIV is divided into three stages of infection called the main stage of infection, the mild stage, and the pronounced stage of AIDS. 1 (Simon et al., 2006; Faulhaber and Aberg, 2009).
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Acquired Immunodeficiency Syndrome (AIDS) is caused by HIV infection, which, if left untreated, leads to severe compromise in the immune system, which subsequently leads to infectious disease, malignancy, and degeneration of the nervous system. With ineffective immunity, patients develop chronic and recurrent disease and develop tuberculosis (TB), pneumonia and severe fungal infections. Advances in HIV treatment have reduced the incidence of AIDS in the UK, although it remains a significant burden in many parts of the world (Faulhaber and Aberg, 2009).
HIV testing is essential to reduce the rate of transmission in the UK. It is known to affect sexual behavior, accelerate access to certain HIV treatments, and reduce the likelihood of accidental transmission following rapid HIV diagnosis (British HIV Association, 2008). Currently, almost half of all new HIV infections are thought to come from patients unaware of their HIV-positive status, which leads to late clinical diagnosis (NAM, 2013). These patients face up to ten times higher mortality rates than patients with rapid HIV diagnosis and early viral suppression, posing a greater threat to public health (NAT, 2015; Kingsley et al., 2015). Paramedics can help reduce the number of people diagnosed late and prevent the unintentional spread of HIV through accurate and informed navigation to HIV testing facilities. HIV testing is a cost-effective part of a long-term HIV prevention strategy; this means that testing is becoming more and more accessible and remains relatively inexpensive. Patients can now access HIV testing in primary care centers, community settings, Lesbian Gay Bisexual and Transgender (LGBT) Pride events, and at home testing kits (Manavi et al., 2012).
‘HIV is divided into three stages of infection known as the primary infection stage, the latency stage, and the pronounced AIDS stage’
Despite the undeniable benefits of HIV testing, testing for HIV is not recommended for every patient each time they come in contact with a healthcare professional (HCP), but certain patients should be offered testing. The British HIV Association (2008) offers the following guidance to healthcare professionals, including paramedics, to help identify patients who exhibit social or sexual behavior considered to be at higher risk of HIV transmission. It includes:
Hiv In Children And Teens
Similarly, patients who are pregnant, starting dialysis or donating blood should have routine testing (British HIV Association, 2008).
Patients with HIV require lifelong treatment because there is no known treatment or vaccine to prevent it. The discovery of antiretroviral therapy (ART) and its use in the treatment of HIV is considered one of the greatest achievements of modern medicine; It remains an effective treatment option for HIV infections (World Health Organization, 2016). ART aims to reduce the viral load of the host to undetectable levels (<40 copies per microliter) to prevent HIV replication and prevent immune system damage to prevent disease progression. It is often prescribed as combination therapy (CART), which has greater viral suppression. There are more than 20 types of ART therapy, divided into six different categories and illustrated in Figure 1. 2.
The British HIV Association (2015) has recently updated its treatment guidelines for primary and chronic HIV infection with significant changes in the use of antiretroviral therapy after initial diagnosis. To achieve rapid viral suppression and target a healthier immune status, antiretroviral therapy should be initiated as soon as possible after diagnosis, regardless of the host viral load or CD4+ count. Following this change in guidelines, patients will benefit from fewer HIV and non-HIV infections, as well as less likely to transmit HIV in the early stages of the disease (Churchill et al., 2015; Skinsley et al., 2015). A robust randomized trial published by the INSIGHT START working group confirmed the many benefits of early ART therapy in HIV patients, adding to the growing evidence base (Lundgren et al., 2015). Patients with a previously low CD4+ count only (<350 per microliter); terrible infection; Hepatitis B or Hepatitis C coinfection; HIV-related brain involvement or non-AIDS malignancy requiring chemotherapy or radiotherapy immunosuppression has been recommended for receiving ART (Williams et al., 2014).
It is recommended that patients who have not previously entered ART be started with a combination of NNRTIs and
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