In order to accomplish this study, the researcher used two different methods to make the investigation more informative, accurate, and successful. Aside from gathering information through internet, the researcher gathered information through statistics and observation from people who experienced HIV. IV. Results and analysis HIV-1 is transmitted in body fluids containing HIV and/or infected CD4+ (or CD4) T lymphocytes. These fluids include blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk.
Mother-child transmission of HIV-1 may occur in utero, at the time of the delivery, or through breastfeeding, but transmission frequency during each period has been difficult to determine (Nduati et al. , 2000). Any behavior that results in breaks in the skin or mucosa results in the increased probability of exposure to HIV (chart 1). Since HIV is harbored within lymphocytes, a type of white blood cell, any exposure to infected blood results in a significant risk of infection.
The amount of virus and infected cells in the body fluid is associated with the risk of new infections. Chart 1 Risk Factors for HIV Infection and AIDS In the United States, most people with HIV? AIDS have engaged in high-risk behaviors, such as the following: • Intravenous or injection drug use (the term “intravenous drug user” has been replaced by the term “injecting (or injection) drug user”). This term includes people who inject drugs intravenously as well as those who inject drugs intradermally.
This method is sometimes referred to as “skin popping. ” • Sexual relations with infected individuals (both male and female) Also at risk are people who received blood or blood products contaminated with HIV (especially before blood screening was instituted in 1985) and children born to mothers with HIV infection. Until an effective vaccine is developed, preventing HIV by eliminating or reducing risk behaviors is essential.
Primary prevention efforts through effective educational programs are vital for control and prevention. HIV is not transmitted by causal contact. Effective educational programs have been initiated to educate the public regarding safer sexual practices to decrease the risk of transmitting HIV-1 infection to sexual partners (Chart 2). Latex condoms should be used during vaginal or anal intercourse. Non-latex condoms are available for people with latex allergy.
A condom should be used for oral contact with the penis, and dental dams (a piece of latex used by dentists to isolate a tooth for treatment) should be used for oral contact with the vagina or rectum. As a result of a clinical trial that found female sex workers who used a nonoxynol-9 (N-9) gel intravaginally in addition to condoms were 50% more likely to be infected with HIV than those who did not use N-9 gel, The CDC issued the recommendation that intravaginal application of N-9 should no longer be recommended as an effective means of HIV prevention (AIDS Institute, 2000).
Other topics important in preventive education include the importance of avoiding sexual practices that might cut or tear the lining of the rectum, penis, or vagina and avoiding sexual contact with multiple partners or people who are known to be HIV positive or injection drug users. In addition, people who are HIV positive or use injection drugs should be instructed not to donate blood or share drug equipment with others. Increasingly, needle exchange programs are available to enable injection drug users to obtain sterile drug equipment at no cost.
Extensive research has demonstrated that needle exchange programs do not promote increased drug use; on the contrary, they have been found to decrease the incidence of blood-borne infections in persons who use injection drugs (Trzcianowska & Mortensen, 2001). In the absence of needle exchange programs, injection drug users should be instructed on methods to clean their syringes and to avoid sharing cotton and other drug use equipment. Chart 2 Health Promotion and Illness Prevention Safer Sex and Safer Behaviors • Practice abstinence.
• Reduce the number of sexual partners to one. • Always use latex condoms; if allergic to latex, use female condoms (nonlatex). • Do not reuse condoms • Do not use cervical caps or diaphragms without using a condom as well. • Always use dental dams for oral female genital or anal stimulation. • Avoid anal intercourse because this practice may injure tissues. • Avoid manual –anal intercourse (“fisting”). • Do not ingest urine or semen. • Engage in nonpenetrative sex such as body massage, social kissing (dry), mutual masturbation, fantasy, and sex films.
• Inform prospective sexual and drug-using partners of your HIV-positive status. • Notify previous and present sexual partners if you learn that you are HIV seropositive. If you are afraid for your safety, many states have established mechanisms through the public health department in which professionals are available to notify exposed people. • If you are HIV seropositive, do not have unprotected sex with another HIV –seropositive perspon, because cross-infection with another HIV strain can increase the severity of the disease.
• Do not share needles, razors, toothbrushes, sex toys, or other blood-contaminated articles. • If you are HIV seropositive, do not donate blood, plasma, body organs, or sperm. V. Discussion Because HIV infection in women usually occurs during the child-bearing years, family planning issues need to be addressed. Attempts to achieve pregnancy by couples in which one partner has HIV and the other does not expose the unaffected partner to the virus. Efforts at artificial insemination using processed semen from an HIV-infected partner are underway.
Studies are needed because HIV has been found in the spermatozoa of patients with AIDS, with possible HIV replication in the male germ cell. Women considering pregnancy need to have adequate information about the risks of transmitting HIV infection to themselves, their partner, and their future children and about the benefits of antiretroviral agents in reducing perinatal HIV transmission. Other than abstinence, the condom has been the only method that has proved to decrease the risk of sexual transmission of HIV infection.
Certain contraceptive methods may pose additional health risks for women. Estrogen in oral contraceptives may increase women’s risks for HIV infection. In addition, women infected with HIV who use estrogen oral contraceptives have shown increased shedding of HIV in vaginal and cervical secretions. The intrauterine contraceptive device (IUD) may also increase the risk for HIV transmission because the device’s string may serve as a means to transmit HIV infection.
It also can cause penile abrasions. The female condom is as effective in preventing pregnancy as other barrier methods, such as the diaphragm and the male condom. Unlike the diaphragm, the female condom is also effective in preventing the transmission of HIV infection and sexually transmitted diseases (STDs). The female condom has the distinction of being the first barrier method that can be controlled by women. o Standard Precautions
In 1996, efforts were made by the CDC and its Hospital Infection Control Practices Advisory Committee (HICPAC) to standardize procedures and reduce the risk for exposure through development of Standard Precautions incorporate the major features of Universal Precautions (designed to reduce the risk of transmission of blood-borne pathogens) and Body Substance Isolation (designed to reduce the risk of transmission of pathogens from moist body substances); they are applied to all patients receiving care in hospitals regardless of their diagnosis or presumed infectious status.
Standard Precautions apply to blood; all body fluids, secretions, and excretions, except sweat, regardless of whether they contain visible blood; nonintact skin; and mucous membranes (Hospital Infection Control Practices Advisory Committee [HICPAC], 2001). The primary goal of Standard Precautions is to prevent the transmission of nosocomial infection. The first tier, referred to as Standard Precautions, was developed to reduce the risk for all recognized or unrecognized sources of infections in hospitals.
A second tier for infection control precautions for specified conditions, called Transmission-Based Precautions, was designed for use in addition to Standard Precautions for patients with documented or suspected infections involving highly transmissible pathogens. The three types of transmission-Based Precautions are referred to as Airborne Precautions, Droplet Precautions, and Contact Precautions.
They can be used singularly or in combination, but they are always to be used in addition to Standard Precautions (HICPAC, 2001). Large-scale studies of exposed health care workers continue to be conducted by the CDC and other groups. In November 2000, the Needlestick Safety and Prevention Act became law, mandatory health care facilities to use devices to protect against sharps injuries (Worthington, 2001).