HIV-RISK FACTORS AND TRANSMISSION ..nursesoutlook

DEFINITON

Acquired immunodeficiency syndrome (AIDS) is a disease of human immune system caused by Human Immunodeficiency Virus (HIV), characterized by progressively reduces the effectiveness of the immune system and leaves susceptible to opportunistic infection and other disease

HIV-RISK FACTORS AND TRANSMISSION

It is a fragile virus that can be transmitted only under specific condition. It transmitted from human to human through infected blood, semen, vaginal secretions, and breast milk. If this infected fluids are introduced to an uninfected person’s body the potential for transmission occur. The HIV infected individual can transmit HIV to others starting a few days after initial infection. After that the ability to transmit HIV is lifelong. Transmission of HIV is subject to the same requirements as other microorganisms. Duration and frequency of contact, quantity of inoculants, virulence of organism, and most immune defense capability all affect whether infection will actually occur after exposure.

HIV is not spread casually: it cannot be transmitted through hugging, kissing, shaking hands, sharing eating utensils, or attending school with and HIV infected person. It is not transmitted through saliva, tears, or sweat. In addition, there is no evidence that the virus can be transmitted by insects. The health care worker has a low occupational risk of acquiring.

Sexual transmission

Sexual contact with an HIV infected partner is the most common method of transmission. Sexual activity provides an opportunity for contact with semen, vaginal secretions, and blood. Although the homosexual initially accounted for most cases of HIV in the United States, heterosexual transmission is becoming more prevalent, and is now the most common method of infection in women. The most important variable is whether HIV is present in one of the sexual partner and not whether the couple is homosexual or heterosexual. The intercourse can be in the form of anal, oral or vaginal. The most risk from of sexual intercourse is unprotected anal intercourse. Although many people associated anal intercourse exclusively with homosexual men, many heterosexuals’ couples also use this form of sexual expression. Anal intercourse frequently results in trauma to the rectal mucosa; rectal trauma increases the likelihood of HIV infection because tearing of the mucous membrane provides a portal of entry for the virus. Sexual intercourse with one partner who is HIV infected creates a risk. Where as sexual intercourse with multiple uninfected partners results in no risk. Sexual activities that involved blood, such as during menstruation or as a result of trauma to tissue, also increase the risk of transmission.



Contact with blood and blood product

HIV  is transmitted by exposure  to contaminated blood through the accidental or intentional sharing of injection equipment. Sharing equipment to inject drugs is a major means of transmission for both sexes in many large metropolitan areas, and used equipment becoming more common in smaller cities and rural areas. It is important to remember that equipment used to inject drug such as insulin, vitamin B₁₂ and clotting factors, as well as narcotic drugs such as steroids are also contaminated after use. Used equipment is potentially contaminated with HIV and should not be shared.

Transfusion of infected blood and blood products has caused AIDS. Routine screening of blood donors was implemented to identify individual at risk and to test the blood for the presence of HIV antibodies, thereby improving the safety of the blood supply. HIV infection now unlikely but still not be positive for HIV antibodies on testing.

HIV has been transmitted to heath care workers, after exposure to HIV-infected fluids through percutaneous injury and into open wounds on the skin and mucus membrane. The greatest  risk of occupational transmission of HIV occur through puncture wounds. Those the syrnge which used for Perinatel transmission The intramuscular and subcutaneous injection which is less risk than the blood filled needle.Transmission from an HIV infected mother to an infant can occur during pregnancy, at the time of delivery, after the birth through the breast feeding.

ETIOLOGY

The origin of HIV is unknown. Evidence appears to supports the hypothesis of an African origin. Since an AIDS like illness in central Africa has been known to exist since the early of 1960s. it further hypothesized that the most likely source of human infection was from nonhuman primates.

The causative agent of HIV infection and AIDS is the human immunodeficiency virus, a retrovirus that belongs to the lentivirus subfamily. Several human retroviruses have been identified. Two of them are HIV-1 and HIV-2 associated with T4 –helper cell depletion and subsequent loss of cellular immunity.HIV-1 is predominant cause of HIV infection in both developing and developed countries, according for more than 80% of AIDS cases worldwide.



HIV-2 seems to be limited in geographic distribution and is most prevalent in West Africa. Although there has been scientific and clinical progress and development of new treatments and comprehensive models of care, HIV disease remains an incurable disease

RISK FACTORS

Sexual practice

• Unprotected sex


• Multiple sexual partners


• Anal or oral sexual activity


• Improper condom use or condom breakage


• Open sore, lesions, or irritation in the genital area

Contaminated blood

Contaminated needle

Occupational exposure

• All health care workers- acute care, long term care, and home care.

• Dental workers


• Perinatal exposure ( during pregnancy, birth, or breast feeding)