HIV/AIDS AND STD RISK ASSESSMENT EDUCATION COUNSELING AND REFERRAL

  1. Recovery Works provides education, risk assessment, and counseling for HIV/AIDS and other sexual transmitted diseases for each of its clients upon entry into the program.

  2. A Risk Assessment Battery (Exhibit B)

  3. For Recovery Works clients at risk, testing for HIV and other sexually transmitted diseases is available by referral.

  4. Patients referred for testing are informed about the purpose, nature of the blood test, the expected benefit of the test, and have an opportunity to have any questions about the blood test answered(Exhibit A).

  5. The physician who orders the test, or his/her designee, is responsible for explaining the results of the test to the patient.

  6. The physician who orders the test shall direct plans and advise on any public health advisements as required by law or indicated otherwise as permitted by law.

Exhibit A

HIV Information Sheet

What are HIV and AIDS? HIV, or human immunodeficiency virus, is the virus that causes AIDS. HIV attacks the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell that is vital to fighting off infection. The destruction of these cells leaves people infected with HIV vulnerable to other infections, diseases and other complications. AIDS is the final stage of HIV infection. A person infected with HIV is diagnosed with AIDS when he or she has one or more opportunistic infections, such as pneumonia or tuberculosis, and has a dangerously low number of CD4+ T cells (less than 200 cells per cubic millimeter of blood).

Quick Facts About HIV Transmission

  • HIV cannot survive for very long outside of the body

  • HIV cannot be transmitted through routine daily activities such as using a toilet seat, sharing food utensils or drinking glasses, shaking hands, or through kissing.

  • The virus can only be transmitted from person to person, not through animals or insect bites

  • People infected with HIV who are taking antiretroviral therapy can still infect others through unprotected sex and needle-sharing

HIV Risk Factors: HIV is found in the blood, semen, or vaginal fluid of someone who is infected with the virus. You may be at increased risk of becoming infected with HIV if you:

  • Engage in anal, vaginal, or oral sex with men who have sex with men, multiple partners, or anonymous partners without using a condom

  • Inject drugs or steroids where needles/syringes are shared

  • Have a sexually transmitted infection, such as syphilis, genital herpes, chlamydia, gonorrhea, bacterial vaginosis, or trichomoniasis

  • Have been diagnosed with hepatitis, tuberculosis, or malaria

  • Exchange sex for drugs or money

  • Are exposed to the virus as a fetus or infant before or during birth or through breastfeeding from a mother infected with HIV

  • Received a blood transfusion or clotting factor in the United States anytime from 1978 to 1985

  • Engage in unprotected sex with someone who has any of the risk factors listed above

Early Symptoms: In the first stages of HIV infection, most people will have very few, if any, symptoms. Within a month or two after infection, they may experience a flu-like illness, including:

  • Fever

  • Headache

  • Tiredness

• Enlarged lymph nodes in the neck and groin area

These symptoms usually disappear within a week to a month and are often mistaken for another viral infection, such as flu. However, during this period people are highly infectious because HIV is present in large quantities in genital fluids and blood. Some people infected with HIV may have more severe symptoms at first or those that last a long time, while others may have no symptoms for 12 years or more.

Later Symptoms: During the late stages of HIV infection, the virus severely weakens the immune system, and people infected with the virus may have the following symptoms:

  • Rapid weight loss

  • Recurring fever or profuse night sweats

  • Extreme and unexplained tiredness

  • Prolonged swelling of the lymph glands in the armpits, groin, or neck

  • Diarrhea that lasts for more than a week

  • Sores of the mouth, anus, or genitals

  • Pneumonia

  • Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids

  • Memory loss, depression, and other neurologic disorders.

Each of these symptoms can be related to other illnesses. The only way to find out if you are infected with HIV is to get tested.

HIV Testing: HIV testing involves taking a blood sample. Of the estimated 1.1 million Americans currently living with HIV, 21 percent do not know they are infected. People who have been infected recently with HIV often have few to no symptoms yet are extremely infectious and may unknowingly transmit the virus to others. Therefore, the Centers for Disease Control and Prevention (CDC) recommends HIV testing for adults, adolescents, and pregnant women during routine medical care.1 Regular HIV screenings allow healthcare providers to identify people who are not aware that they are infected with HIV, so that they can be counseled on the need to avoid high-risk behaviors, instructed on safe-sex practices, and given information about starting antiretroviral therapy. HIV testing can also be performed anonymously if a person is concerned about confidentiality.

Types of HIV Tests: Healthcare providers can test a sample of blood to see if it contains human antibodies (disease-fighting proteins) specific to HIV. The two key types of HIV antibody tests are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. However, these antibody tests may not detect HIV antibodies in someone who has been recently infected with HIV (within 1 to 3 months of infection). In these situations, healthcare providers can test the blood for the presence of HIV genetic material. This test is extremely critical for identifying recently infected people who are at risk for unknowingly infecting others with HIV.

HIV Testing in Infants: CDC recommends that all pregnant women get tested for HIV before and/or during delivery. Knowing the HIV status of the mother allows physicians to prevent mother-to-child HIV transmission by providing antiretroviral treatment to both mothers infected with HIV and their newborn infants. However, it is difficult to determine if a baby born to a mother infected with HIV is actually infected because babies carry their mothers’ HIV antibodies for several months. Today, healthcare providers can conduct an HIV test for infants between ages 3 months and 15 months. Researchers are now evaluating several blood tests to determine which ones are suitable for testing babies younger than 3 months.

Treatment of HIV Infection: In the early 1980s when the HIV/AIDS epidemic began, people with AIDS were not likely to live longer than a few years. Today, there are 31 antiretroviral drugs (ARVs) approved by the Food and Drug Administration to treat HIV infection. These treatments do not cure people of HIV or AIDS. Rather, they suppress the virus, even to undetectable levels, but they do not completely eliminate HIV from the body. By suppressing the amount of virus in the body, people infected with HIV can now lead longer and healthier lives. However, they can still transmit the virus and must continuously take antiretroviral drugs in order to maintain their health quality.

HIV/AIDS Treatment Research: Current research is focused on finding new and more effective therapies, drug classes, and antiretroviral drug combinations that can extend and improve the quality of life for people living with HIV/AIDS. These efforts support research that advances our understanding of HIV and how it causes disease, thereby unlocking new targets for drug development. Promising medicines are then tested in human clinical trials to determine whether they are safe and effective. This process usually takes several years to complete before a new therapy is available to the public.

Prevention: Consistent use of male latex condoms can help protect against HIV infection (Credit: NIAID). Currently, there is no vaccine to prevent HIV infection nor is there a cure for HIV/AIDS. To reduce your risk of becoming infected with HIV or transmitting the virus to others:

  • Get tested regularly for HIV

  • Remain faithful to your spouse or partner

  • Consistently use male latex or female polyurethane condoms

  • Never share needles