MIC314 Final Exam
What is the base rate when calculating HIV transmission?
.1
What is the transmission multiplier if an HIV positive person is circumcised?
.5x
What is the transmission multiplier if an HIV positive person is the insertive partner?
.5x
About 1 in __ people in Tanzania are HIV positive.
1 in 20
What is the rate of new infections and youth in US?
1 in 4 new HIV infections occur in youth ages 13-24
Amount of time HIV takes to fully infect the vagina: After _ hours, HIV has already infected the ______ After __, HIV has moved on to infecting the ___ __________ Finally, after __ hours, HIV has worked its way down to the _____ ______.
1, mucosa 12, sub epithelium 18, lymph glands
Exposed Infant Routine Testing: 1. _ weeks 2. _ month 3. _ months 4. _-_ months 5. __ months
1. 2 2. 1 3. 4 4. 6-9 5. 18
What is the testing order for HIV in low income countries?
1. ELISA 2. Second ELISA
What is the testing order for HIV in high income countries?
1. ELISA 2. Western Blot 3. Viral Load 4. Virus Genotyping
3 steps of HIV Infection
1. GP120 binds to CD4 2. Co receptor binding 3. GP41 harpoons a cell and makes contact
List the 5 layers of the vagina in order. Hint: LEMSSP (lemons pee)
1. Lumen 2. Mucous Layer 3. Multilayered squamous epithelium 4. Sub epithelium 5. Proximal lymph node
What 4 things do viruses need?
1. Virus Blueprint for reproduction 2. Somewhere safe to guard their blueprint- RNA 3. An address of where to go with their blueprint 4. Tools for infection
How many people were living in the US with HIV in 2016?
1.2 million
How long is a Viral Load test valid after infection?
10 days
In HIV positive individuals you have a __% risk per year of re-activating TB?
10%
What is the transmission multiplier if an HIV positive person has another STI?
10x
What is the transmission multiplier if an HIV positive person has unprotected anal intercourse?
10x
What is a healthy CD4 count for someone without HIV?
1100
What year was HIV the leading cause of death in the US?
1993
What are some examples treatment orders in high income countries?
1st Line; HAART 2nd Line; HAART with different protease inhibitor 3rd, 4th, 5th line; keep switching out the drugs
What is the transmission multiplier if an HIV positive person has unprotected vaginal intercourse?
1x
What is the transmission multiplier if an HIV positive person is in the quiet period phase?
1x
What percentage of people don't know that they are HIV positive?
20%
When you fall between _________ CD4 cells, that means that you have contracted AIDS.
200
What percent of the homeless population has experienced sex trafficking?
25%
How soon must PEP start for the best likely HIV resistance?
3 days after infection
How long must someone wait to get a western Blot post infection?
3 weeks
When will the viral load peak after infection?
3 weeks
How long can a Western Blot be administered and still be accurate after HIV is contracted?
30 days
What is the transmission multiplier if a partner is in the acute phase of HIV?
30x
How many people are living in Africa with HIV or AIDS?
35 million
How many people worldwide are living with HIV/AIDS?
36.7 million people
Black, heterosexual women have a _ times greater chance of contracting HIV than white women.
4
How many babies in Arizona have been infected with HIV this year?
4 babies have been infected, 2 due to breastfeeding
How many new HIV infections are there per year in the US?
50,000
How much virus can a Viral Load test detect in your blood?
50viruses /ml
How does mental health play a role in sex trafficking?
78% of 108 screened trafficked youth had PTSD qualifying symptoms
What percent of US victims of sex trafficking are citizens of the US?
84%
What percent of US victims of sex trafficking are female?
94%
What is the Bill Holt clinic?
A Phoenix based pediatric HIV/AIDS clinic. They currently see 85 children.
What is a b cell?
A cell responsible for producing antibodies
What is a specific b cell?
A cell responsible for producing specific antibodies
How do we define an HIV subtype?
A change in type of transmission changes the subtype.
What is a Nucleoside?
A compound commonly found in DNA and RNA linked to sugar.
What is a pathogen?
A disease causing agent
What is an autoimmune disease?
A disease in which the body's immune system attacks healthy cells.
What is a zoonotic transmission?
A disease jumping from one species to another
What is an integrase inhibitor?
A drug used to block the process of integrase. -Raltegravir
Is it better to have a false positive or a false negative?
A false negative is more dangerous because it creates a sense of security in people who actually are infected, giving them the opportunity to infect more people because they think that they're clean.
What are the first reports of an "unknown pathological agent" aka HIV?
A group of gay men in with an uncommon pneumonia in 1983. New York, and Chicago around similar times.
What are macrophages?
A phagocytic cell that acts as a mobile white blood cell to sites of infection
What is CCR5
A protein on the surface of white blood cells that is involved in the immune system as it acts as a receptor for chemokines.
What is Serodiscordant couple?
A relationship where one person is HIV positive and one person isn't.
What is AZT?
A reverse transcriptase inhibitor that is the first drug administered after a positive HIV test.
What is meant when you hear "HIV Prevalence"?
A snapshot at a given time of the proportion of the population infected.
What is an enzyme?
A substance produced by a living organism that acts as a stimuli to bring about a specific biochemical reaction.
CD4 + Lymphocyte Count
A test that counts the amount of CD4 cells in the body. The test is used to figure out how the body and immune system is handling the progression of the HIV
What is a Viral Load test?
A test that measures the amount of virus in your blood. A Viral Load test often acts as a confirmatory test that is administered after a Western Blot or ELISA. This is also the test used to diagnose newborns.
What is a protease inhibitor?
A toxic drug that binds to protease and blocks its action -Ritonavir
What is a phagocyte and what does it do?
A type of cell within the body capable of engulfing and absorbing bacteria and other small cells and particles - Basically, the phagocyte eats bacteria and antigens.
What are the ABC's of safe sex?
Abstinence Be faithful Condoms!
What is the definition of Discrimination?
Acting on a stigmatized belief
Why has it been difficult to educate people about HIV in Africa?
African people are seriously uneducated about HIV and are skeptical of people, especially westerners, coming in trying to educate them.
When would a viral load or CD4 test be administered?
After positive test results on the ELISA and Western Blot
What is an ARV?
Also known as a Non-Nucleoside Analogue Reverse Transcriptase Inhibitor (NNRTI), an ARV binds to reverse transcriptase, inhibiting it from making copies. -Nevirapine
What is integrase?
An enzyme produced by a retrovirus that allows viral genetic material inside of the enzyme inside of DNA
What is reverse transcriptase?
An enzyme that turns viral RNA into DNA
What are some problems associated with PrEP?
An increase in unsafe sex Increase in other STIs Expensive-condoms cost less Need a consistent daily dosage in order for it to be effective
What is an opportunistic infection?
An infection which the parasite takes advantage of hosts weak, immune suppressed state. Often the result of a high viral load, and the last thing that happens before AIDS is fully contracted.
What is the outside of a cell like?
An oily membrane
What is ART?
Antiretroviral Treatment, (HAART)
What is the law defining minors in commercial sex in Arizona?
Any minor under 18 engaging in commercial sex even if voluntary is considered a victim of human trafficking
What is a chemokine?
Any of a class of cytokines, a chemical secretion from cells, with functions that include attracting white blood cells to sites of infection.
What is a retrovirus?
Any of a group of RNA viruses that insert a DNA copy of the virus into the host cell in order to replicate
Without treatment, how long is someone likely to live with HIV?
Around 18 months is the best case scenario.
What is the Scramble for Africa?
At the end of the 19th century and the beginning of the 20th, Africa went from being 10% dominated by Europe, to 90%. It is believed that a Chimpanzee's infected blood got into a wound of a hunter during this time, and once the Scramble was in full force, and Europeans began their domination through the African continent, the disease began to spread feverishly.
What happens if HIV could infect CD20 cells?
B Cells would be compromised because CD20 makes antibodies.
Name some factors that increase the risk of vaginal infection
Bacteria infections (yeast infection) Drying Inflammation Trauma STIs
Why do public health departments tell people who test negative for HIV to come back for another test after 3 months post-exposure?
Because 99% of people begin seroconversion after 3 months.
Why is HAART made up of 3 drugs?
Because HIV is capable of forming a resistance to 1 drug in 3 weeks.
Why do most public health departments perform a venous blood draw for HIV testing when the ELISA test only requires a few drops of blood?
Because people who are being tested for HIV likely won't go back to the hospital for a second round of blood drawing, so the doctors get all of the blood they need the first time for tests down the road.
Is there a period during the progression of HIV in which the Western Blot test isn't accurate?
Before 3weeks/seroconversion (need antibodies to be accurate)
What kinds of bodily fluids can be used for an ELISA?
Blood or saliva
List all 5 fluids.
Blood, Semen, Pre-Ejaculate, Vaginal Secretion, Breast Milk
List the types of chemokines
CC, CXC
What receptor is on a macrophage?
CCR5
List the types of chemokine receptors
CCR5, CXCR4
What immune receptors are on a macrophage?
CD4 and CCR5
What does HIV target in the body?
CD4 and T Helper Lymphocytes, and marophages
What does a CD4 cell do?
CD4 cells are white blood cells that fight infection, that play an important role in your immune system. (same as T-Helper Cells)
How does HIV initially enter the body?
CD4 receptors on cells
What must a cell have in order for HIV to enter?
CD4, CXCR4, or CCR5
What kind of receptor is on a T Killer Cell?
CD8
What happens when the flu enters the body?
Cells notice the double stranded RNA viruses, and begins making copies of chemokines
What is a Memory T Cell?
Cells that keep a memory of how to respond during an immune response.
What are cytokines?
Chemical secretions by immune system cells that regulate inflammatory responses, and cells around them, creating communication between leukocytes. them to send out signals to come to the site of an infection.
What are the classes for HIV1M, and which is the most common in the world?
Classes A-J. Class C is the most common worldwide.
How quickly does seroconversion occur in HIV positive people?
Commonly occurring in the first month of becoming infected, 99% of people seroconvert in the first 3 months.
Name some active forms of intervention.
Condoms Sex ABCs
What does CD20 do?
Creates antibodies
What part of the cell is the machinery?
Cytoplasm
What are the roadblocks to an HIV vaccine?
Diversity and lack of protection correlation
Name the kinds of HIV tests that test for antibodies
ELISA, Western Blot
What is concurrent sexuality?
Engaging in sex with multiple partners at the same time, very popular and common in Africa.
What are some ways HIV positive people are discriminated against in Africa?
Expulsion from homes Disownment from family Ejection from generational land owned by family Inability to get a job (40-50% unemployment in Tanzania) Trouble getting health care
What is the rate of false positives when using the ELISA test, and what steps do doctors take to avoid this?
False positive rate = 1/1000 In order to avoid this, doctors often administer 2 ELISA tests, making the false positive rate 1/1,000,000.
True or False: A macrophage needs a lymphokine signal.
False!
True or False: The majority of physician can easily identify a sex trafficked individual.
False!
True or False: Oral sex falls under the umbrella of abstinence from an HIV Transmission perspective.
False! Any kind of penetrative sex is not considered abstinent from the transmission perspective.
True or False: In countries where prostitution is legal, such as Amsterdam, condoms are not required.
False! Condom use is always negotiated in countries like Amsterdam, and is accepted as a norm.
True or False: Disclosure of HIV for children with HIV in schools is mandatory in order for them to attend.
False! Disclosure is completely up to the family and child. In fact, the social workers at the Bill Holt Clinic advise families not to disclose. Disclosure often is the beginning of social stigma as well.
True or False: Group C is the most common group for subtype M worldwide, and is also the most studied.
False! Even though group C makes up about 50% of the HIV world population, group B is the most commonly studied, making up 12% of infections.
True or false: Mothers that don't take HAART during pregnancy and while breastfeeding doesn't effect their child. The medication can start once the baby is older.
False! HAART during birth and while breastfeeding drops the transmission rate to less than 1%.
True or False: HIV1 and HIV2 are related on the phylogenic tree.
False! HIV1 and HIV2 derived from different kinds of SIV, and are not even in the same clade on the phylogenic tree.
True or False: IDU is a driving force of HIV in Africa.
False! IDU isn't very common in Africa because drugs are expensive and money will usually be used for other things.
True or false: If a mom develops a life long immunity to a flue virus before she has a baby, the immunity would be passed on to the baby and it wouldn't be able to get that disease.
False! Immune systems are completely separate from mother to child. Breastfeeding does help the immune system of the baby though.
True or False: HIV and AIDS has not effected life expectancy in Africa, as new drugs have gotten many people healthy and leading normal lives.
False! In a study of 5 african countries, life expectancy is down due to HIV and AIDS. Even WITH the rise of better medicine, in places such as Botswana, life expectancy is down 30 years, going from 65 to 35 at one point.
True or False: In Africa, accurate sexual health education is adequate in preventing HIV.
False! In order for HIV numbers in Africa to decrease, a behavioral change is necessary.
True or False: Reverse transcriptase is native to the human body.
False! It is brought in by viruses.
True or False: It is possible for HIV to be airborne.
False! It is very unlikely, and has never happened.
True or False: The most at risk community for HIV in the United States are men who have sex with men (MSM).
False! Only in Europe are MSM the highest-risk group. Everywhere else in the world the highest-risk group are heterosexual couples.
True or false: Natural or organic condoms provide the same amount of protection as their latex counterparts.
False! Only latex condoms should be used, as they provide a 10 Fold level of protection!
True or False: By 1997 HIV treatment was available to everybody.
False! Poor people were still not able to get the drugs they needed.
True or False: Scared straight HIV programs have been shown to work.
False! They are shown to have numbers decline in the beginning, but after a few weeks, behavior goes back to normal. These kinds of programs also breed stigma.
True or False: HIV treatment begins with HAART, eventually moving on to first line treatment, and then second line treatment. This is the case for high and low income countries.
False! This is only true for high income countries. Low income countries will administer HAART, and if HAART stops working, AIDS is likely to develop becaus that is their only option.
What is a false negative?
Far more dangerous than a false positive is when the vulnerability scanner misses a vulnerability and fails to alert the administrator to the presence of a dangerous situation. This error is known as a false negative report.
What is a nucleus made out of?
Fats and proteins
What is FACS?
Fluorescence Activated Cell Sorting
What does a virus need to be infectious?
GP120 or gp41
What do T Killer Lymphocytes do?
Give your cells permission to kill your own cells that are infected.
What are the subtypes of HIV1 and which is the most common?
Groups: M,N,O. Subtype M is the most common worldwide.
What is the definition of stigma?
Having a discriminatory belief
What effects has HAART had on children?
High levels of HAART has shown to stop children from producing HIV antibodies.
What is HAART therapy?
Highly Active Antiretroviral Therapy, is a 3 drug cocktail which acts to suppress viral load.
What are HEPS women?
Highly Exposed Persistently Seronegative women. These are rare cases of sex working women who have been largely exposed to HIV multiple times, but still test negative. These women's cells are studied for HIV research. The cells in the lumen and epithelium of their vagina tend to be stronger. Although, if a HEPS goes a long time without having sex, and then fornicates with an HIV positive person many years later, it has been shown that HIV can be contracted.
What are benefits of beginning HIV treatment as early as possible?
If treatment can start before HIV has fully developed, and if viral load is suppressed enough, HIV can potentially become non transmitable
How do fluids and doors transmit HIV?
In order for HIV to get into the body, a fluid from one person must come into contact with a door from another person.
How do Genetic immunizations work?
Inject patient with DNA to make the viral proteins needed to stimulate an immune response. Once the immune response starts the DNA will begin producing HIV proteins, and will also begin making antibodies to rid of the HIV.
How do live pathogens work?
Inject patient with live pathogen and if you survive you are immune
Why have we not been able to cure people of HIV?
Integrase gets viral DNA into nonviral DNA, and we are unable to get it out.
What is a CCR5 Interaction Inhibitor?
It binds to and blocks CCR5, a protein on the surface of white blood cells that is involved in the immune system as it acts as a receptor for chemokines. -Maraviroc
What is a fusion inhibitor?
It binds to and blocks gp41, the glycoprotein that harpoons the cell in order to make contact and allow virus to get in easier -Enfurvirtide
What are some common misconceptions people in Africa have about HIV?
It can be spread by mosquitos Condoms give people HIV Westerners want to kill African babies via HIV
When is it estimated that HIV entered the human population, and what path did it take to get around the world?
It is estimated that HIV entered the human population some time around 1900-1920. After that it moved to Hati in the 60's and the US in the late 60's, and then to Europe, Australia, etc. from there.
What do CC chemokines do?
Listen to the CXC chemokines and follow the orders.
What are the 4 types of immunogens?
Live pathogen Live attenuated vaccine Purified protein Genetic immunization
What is the Brain Drain?
Locally trained doctors in Africa going to practice in Europe and the US, resulting in shortages of Doctors in African countries.
What are the three closest things to protection correlates that we have for HIV?
Long term non processors, HEPS women, and Animal Models.
What are lymphokines?
Lymphokines send out signals to macrophages and lymphocytes in order to get them to the site of an infection to help.
What is a general response?
Macrophages looking for outside material.
What is majority status and how does it apply to African Women?
Majority status is the right to own property, pass that property to heirs, and open a case in court. Even though this is written in many countries laws as a right for everyone, women are still often denied the right.
What do T Cells do after activation?
Makes copies of itself
Name some social concerns for HIV positive children.
Making friends in school, disclosure, non adherence, regular adolescent life.
Name some passive forms of intervetion
Male circumcision
Where can people get tested for HIV in Arizona?
Maricopa county std/HIV public health clinic
What form of health care is lacking all over the world?
Mental health care
What are common reasons for sex trafficking?
Money, food, a place to stay
What are the 2 most common forms of HIV transmission in Africa?
Mother to child, and unprotected sex (concurrent sexuality)
How to live attenuated vaccines work?
Mutate a live pathogen for an animal so it is less reproductive and inject it in a human, and it will get a (weaker) immune response.
List all 6 classes of ARVs.
NRTI, NNRTI, Protease Inhibitors, Fusion Inhibitors, CCR5 Inhibitors, Integrase Inhibitors
Are feces a fluid?
No
Is sweat a fluid?
No
Why is lack of protection correlation a roadblock to an HIV vaccine?
No survivors of HIV to study and learn off of makes it difficult to try to find something that works.
Are tears, urine, or saliva a fluid?
No, but they are very weakly infections.
Is the mouth considered a door?
No, unless there are open sores inside of it
What is a Nucleoside analog?
Nucleoside Analogs are used instead of the actual nucleoside, because the chain is terminated and the next nucleoside in the chain is unable to bond to the analogue
What are some examples treatment orders in low income countries?
Only first like treatment is available in low income countries, of one cocktail. After that line of HAART no longer works, AIDS is developed in the patient.
List all 4 doors.
Open Wounds, Vagina, Anus, Tip of Penis
What is of my own?
Organization that focuses on empowerment for children who have experienced sexual trafficking, enables youth to create a new view of themselves
What percent of US victims of sex trafficking are under 18?
Over 25%
What is the most common opportunistic infection in the US?
PCP
What is a common opportunistic infection to be at risk for with a CD4 count of under 200?
PCP, TB
What is the rural-urban divide?
People living in more urban places have an easier time getting the ARVs they need, with only about 10% not able to get what they need for their treatment. Whereas people living in more rural areas have a much harder time getting their treatment, around 80% not being able to meet their treatment needs.
What are some positives and negatives of Ritonavir?
Positive: When taken with other HIV drugs, it allows them to be effective for longer periods of time. Negative: If the patient is addicted to drugs like heroin or other amphetamines, they are more likely to overdose if they take Ritonavir.
What is PEP?
Post-exposure prophylaxis. This is a medication taken by someone who has reasonable suspicion that they may have contracted HIV. (sharing needles, unprotected sex with an HIV positive person, emergency situations etc.) and can be taken before the HIV status is truly know.
What is PrEP?
Pre-exposure prophylaxis is a HAART cocktail taken by someone who is not HIV positive, and wants to prevent infection. For example, in a serodiscordant couple, the partner who is HIV negative would take PrEP. Often administered to serodiscordant couples with high-risk behavior.
Example: A boyfriend who is in the primary stage of HIV wants to have unprotected anal intercourse with his partner. What is the approximate chances of his partner contracting HIV?
Primary stage: 30 Anal Intercourse: 10 Insertive Partner: .5 30x10x.5= 150x greater chance of HIV transmission.
What is PNI?
Psychoneuroimmunology: an interdisciplinary science that studies the interactions among psychologic, neurologic, and immune responses.
What is RNA polymerase and how does it apply to the Viral Load Test?
RNA Polymerase is a form of testing where doctors make copies of a strand of RNA, and highlight the virus in the RNA tested in order to see the amount of virus in the blood.
What is transactional Sex?
Refers to sexual relationships where giving gifts or services is an important factor
What are the some factors of HIV stigma in Africa?
Religion, culture, silence, education, fear
What does HIV do to t helper lymphocytes?
Replicates and kills
What does HIV do to macrophages?
Replicates but does not kill, tricking the macrophage into thinking HIV is the right thing to have, and breaking down the macrophage's defense.
What is the relationship between SIV and HIV?
SIV (simeon immunodeficiency virus) is where HIV1 derived from via a chimpanzee.
What do T helper cells do once activated?
Secrete lymphokines
Who is PrEP usually administered to?
Serodiscordant couples with high risk behavior.
What oil company paid members of an African Government for inside information about oil bids, therefore taking money away from African citizens?
Shell to the Nigerian government- this is the reason for so much poverty in Africa who is in the face of so many natural resources.
What is the cycle of HIV stigma?
Silence -> Ignorance -> Fear -> Stigma -> Discrimination -> Silence -> Ignorance.....
What is a specific response?
T and B cells reporting for response
What is the most common opportunistic infection worldwide?
TB
What is polymerase chain reaction?
Technique used to create many copies of a DNA segment
What are some issues with Western Blot testing?
Test is very time consuming, expensive, and depending on the person who is administering the test, the accuracy varies. Because the test is so expensive, it is often not preformed in low income countries.
When was the first available HIV treatment?
The 1990's
What theory explains why people get sick?
The Basic Germ Theory states that poor immune response allows for bacteria and viruses to enter a cell and get into the body.
When are the earliest samples of HIV dated at?
The Democratic Repulic of Congo, and Camaroon has some dated back to the 1960's, and Tanzania in the 1970's.
Explain the Fast Track Cities Initiative. (90-90-90)
The Fast Track Cities Initiative is a collaboration with the City of Phoenix, as well as Paris, France and others that is setting a goal for 90% of people with HIV to know their status, 90% of people diagnosed to be on ART, and 90% on ART to achieve viral suppression. With a final goal of 0% stigma, all by 2020.
What is PEPFAR and it's effects?
The Presidents Emergency Plan for AIDS Relief in Africa was a fund set up by George W. Bush. Through a $15 million donation from the Bush administration, the money was sent to Africa. Unfortunately, most of the money was donated to churches in Africa, which only educate, if at all, with abstinence only education, as well as being known to miseducate Africans about HIV. A lot of the churches in Africa also have close ties with the government, making them more corrupt and money driven.
What is the Ryan White Care Act?
The Ryan White Care Act was established by the government in order to aid citizens infected with HIV who cannot afford the drugs. Named for a young boy who was expelled from his middle school because of his HIV infection.
What is the Ricky Ray Act?
The act was put in place because of careless pharmaceutical companies who would pay anyone for their blood in order to get factor for hemophiliacs, but realized that much of the blood contained HIV, resulting in many Hemophiliacs also contracting HIV because of the carelessness of the companies.
What is happening during Anaphylaxis?
The bodies immune system is using its last possible resources in order to try to protect the body.
How do vaccines speed up immune responses?
The body builds up t memory cells from contact with the vaccine to fight real virus
What is immune response?
The body's defensive reaction to invasion by bacteria, viral agents, or other foreign substances.
What is a virion?
The complete, infective form of a virus outside a host cell, with a core of RNA or DNA and a capsid. Metabolically inactive, located in the blood stream. What viral load testing tests for.
What is seroconversion?
The point at which you can detect antibodies to HIV. Usually takes 1-6 weeks to start seroconverting, the symptoms of seroconversion are similar to a heavy cold or flu.
What is serial monogamy?
The practice of engaging in a succession of monogamous sexual relationships.
What is a molecular clock?
The rate of change of mutation of a particular gene.
What is meant when you hear "HIV Incidence"?
The rate per year at which people are being infected.
Explain the graph with triangles and squares on the lines.
The triangle line shows viral load going up over the lifetime. The line with the squares shows CD4 count going down over time, the result is AIDS at the end of the graph. There is a blue like that shows until after 3 weeks, HIV antibodies begin producing and don't die off until the person starts contracting AIDS.
Why are high-income countries more likely to have autoimmune diseases?
The water has been cleaned to the point that our immune systems don't have anything to do. When your immune system finally begins acting again, it is too weak or overactive, weakening it overall.
Why is diversity a roadblock to an HIV vaccine?
There is too much of a diversity in the virions found in an HIV positive person, making it difficult to make a one stop shop vaccine
What is a T helper cell?
They help regulate immune response. (same as CD4 cells)
What happens to non adherent HIV positive children who don't want to regularly take their medication?
This results in monthly doctor visits, unlike healthy children who go every 3 months, and this also results in a CD4 test, usually showing a much higher viral load, which is how the doctors can also spot non adherence.
When would a viral genotyping test be administered?
This test would be administered if the person receiving treatment was non adherent, resulting in the HIV becoming resistant to their current medication, and the test finding what the HIV has grown to become resistant to.
What is the job of receptors on the outside of a cell? (CD4 etc.)
To communicate information through the membrane to the nucleus.
What is the job of the immune system in a body?
To manage and monitor growth levels of all bacteria inside of your body
What is the job of CXC chemokines?
To speed up the process and take the lead of identifying proper receptors.
What does treatment as prevention mean?
Treatment as prevention refers to the idea that those who are HIV positive can greatly reduce the risk of transmitting HIV to their partner if they are being treated and are virally suppressed
True or False: 1 in 6 runaways are at risk for being sex trafficked.
True
True or False: 1/5 of American adults said they "feared" persons with AIDS 1/6 admitted to feelings of "disgust" related to persons with AIDS
True
True or False: A single dose of Nevirapine 48-72 hours before child birth can reduce the chance of HIV transmission from mother to child to less than 4%.
True
True or False: ARVs target reverse transcriptase
True
True or False: Africa has the lowest number of physicians worldwide.
True
True or False: After 1995 there was a decline in deaths due to ARVs.
True
True or False: Because of HIV stigma, in Iran, the number of HIV positive people committing suicide is higher than the number of people killed by HIV itself.
True
True or False: DNA is the master blueprint of a cell.
True
True or False: Disclosure of the child often means disclosure of the parent.
True
True or False: Every 3 weeks, an HIV positive person basically has a new virus because the HIV adapts to the medicine
True
True or False: Every 9.5 minutes someone in the US gets infected with HIV.
True
True or False: HIV and AIDS are the fastest and most devastating STD in America, and around the world.
True
True or False: HIV and AIDS is the leading cause of death for women worldwide.
True
True or False: HIV must infect a macrophage before anything else in the body
True
True or False: Heterosexual men and women living below the poverty line are 2x as likely to contract HIV.
True
True or False: Human skin provides virtually 100% protection against HIV.
True
True or False: If an ARV is obtained within 72 hours of coming into contact with HIV, there is less than a 1% chance of becoming HIV positive
True
True or False: In 9 African countries, HIV prevalence in sex workers is higher than the countries own national average of HIV prevalence.
True
True or False: In Africa, HIV positive children often do not get to finish their educations
True
True or False: In some parts of Africa, being gay, or even knowing a gay person is a crime, punishable by death in some places.
True
True or False: In the US, African-American youth, ages 13-19 account for 68% of new HIV infections.
True
True or False: In the United States, serial monogamy is practiced.
True
True or False: It takes about 18 hours for HIV to completely infect the vagina. Within an hour already infecting the mucosa, and the sub epithelium after about 12. Finishing off with the lymph glands.
True
True or False: Macrophages cannot disply HIV on their surface
True
True or False: Medication for HIV in children depends on their weight, and children fluctuating often in weight requires a lot of doctors visits in order to keep the medication in check.
True
True or False: Minority groups are the fastest body of people contracting HIV
True
True or False: PreP reduces viral load and therefore leads to lower transmission.
True
True or False: Proteins function as track shoes to move immune cells to the site of an infection.
True
True or False: Racial and ethnic minorities represent the majority of new infections in the US
True
True or False: Retroviruses rewrite DNA to match its needs.
True
True or False: Sex workers in Africa are 12x more likely to contract HIV
True
True or False: Some issues sex workers face are being raped by the police, not having enough condoms, inability to negotiate condom use, and being sterilized against their will.
True
True or False: Stable Heterosexual couples are the biggest driving force of HIVin Southern Africa.
True
True or False: TB can occur at any CD4 count.
True
True or False: The literacy rate among women in Africa seriously effects the ability to obtain majority status, and overall ability to educate about HIV.
True
True or False: The molecular clock tells us that viruses evolve at a mathematically predictable rate.
True
True or False: The virus of HIV, if outside of the body can be killed with something as weak as hand soap.
True
True or False: There is a 95% reduction in transmission to partner form an HIV + partner if using treatment as prevention.
True
True or False: Truck drivers are a high risk group in regards to HIV in Africa due to often being away from their homes.
True
True or False: Women in Africa have described their relationships with different men as "having a boyfriend that I love, and a boyfriend that takes care of me."
True
True or false: An HIV test that detects HIV1 may not detect HIV2
True
True or false: PrEP allowed for condomless sex and no transmission in very high numbers.
True
True or false: Sub-saharan africa has the highest prevalence of HIV in the world.
True
True or false: The HIV prevalence in Africa is close to 40% in some areas.
True
True or false: When only considering the area of the continent of Africa, you can fit The United States, China, India, and most of Europe.
True
True or false: There is a 30% higher chance of transmission if HIV is left untreated
True
True or False: Stable, heterosexual couples are the most responsible for HIV transmission.
True 60-80% of cases.
True or False: Concurrent sexuality in Africa has a very negative effect on women.
True As unprotected sex, and sex trafficking are also very common, this combined with concurrent sexuality leaves women in a bad spot, often having trouble supporting themselves, and relying on their male counterparts, forcing them into a vulnerable position.
True or False: The literacy rate among women in Africa is 50%
True Every other women you talk to in Africa will be illiterate.
True or False: HIV makes mistakes when copying the virus.
True HIV makes 1 mistake on average. Supressing the replication of HIV with drugs makes drug-resistance less likely because there is less of a chance for HIV to make a mistake in the right place.
True or False: An antigen presenting cell puts some of the bacteria on its own surface in order to present it to the t-helper cell.
True Macrophages fall under this category.
True or False: First Maricopa, with Pima second were the counties with the highest HIV incidence rate in Arizona.
True Maricopa had 14 infections per 100,000 people.
True or False: In Africa, men will take young girls from their families with promise of the girl doing work at a factory or something similar, and will be able to send the money back to the family. The families realize that this was a lie when their child does not return, and often times the child has been tricked into sex work.
True This is a common way for African men to get girls to do sex work for them.
True or False: Black men are the most infected race in the United States, even though they are not the highest populated race.
True This is the sign of a health disparity.
True or False: Many African sex workers are not literate enough to even attempt to negotiate condom use
True With an illiteracy rate of 50% among African women, they are often unable to negotiate condom use.
True or False: Marriage is also a stigma for women in Africa.
True Women with husbands probably have even less of an ability to negotiate condom use, and husbands are often higher risk than wives.
True or False: Water based lubricants should be the only lubricants used for the safest possible sex. Oil and silicon lubricants are not as safe when it comes to STD transmission.
True!
True or False: African countries are still very young despite it being the 21st century.
True. Between government corruption, trying to money, and in the face of an HIV epidemic, it has made things harder and slower for African countries to gain some form of independence.
True or False: Reverse transcriptase is a good target for ARVs.
True. Reverse transcriptase makes a lot of mistakes, and is very abundant in the human body once a virus brings it in.
How many doctors per person are there in the US? Africa?
US: 1:300 Africa: 1:5000
What is an undetectable viral load?
Under 50virions/ml
What are the three most common modes of HIV transmission?
Unprotected sex, sharing needles (IDU), mother to child
Is a penis or vagina more likely to get infected with HIV?
Vagina
What is virus genotyping and when is it used?
Virus Genotyping is a test that figures out which drugs HIV is resistant to in a person. This is a non adherence test, meaning that it is administered to someone who has not properly taken their medication.
Where is the only place HIV2 is found?
West Africa
What are some different challenges regarding HIV for Southern, Western, and Eastern Africa?
Western Africa isn't able to give a lot of HIV data. Concurrent sexuality, and stable hetero couples are very responsible for a lot of Eastern and South African HIV.
What is antigen dependent proliferation?
What allows our immune systems to develop. Only a small amount of bacteria is needed to create an amplification of copies of the cell.
What does T Cell Activation do?
When T Cell Activation happens, a T Cell is on alert, sending out alerts and orders to activate the immune system.
What is a health disparity?
When a minority carries a vast majority of all cases.
How do purified proteins work?
When the proteins are injected, the macrophges respond in a more relaxed way, and an adjuvant is what creates that worthwhile immune response.
Are sexual and domestic violence victims more likely to contract HIV?
Yes
Is a chemokine a phagocyte?
Yes
Should 2 HIV positive sex partners use a condom?
Yes because their viruses can recombine
What does the placebo effect have to do with PNI?
You can get real effects from nothing if you think you are given an effective substance. The idea where people tell us you "can't think yourself happy" but that contradicts with knowing that stress makes people sick without a specific reason.
What is an Antibody?
a blood protein produced in response to and counteracting a specific antigen
What is an adjuvant?
a chemical additive that increases the effectiveness of vaccines by mimicking the dangers of a virus, and adds urgency to an immune response
What is a false positive?
a test result which incorrectly indicates that a particular condition or attribute is present.
What is a protease?
an enzyme that breaks down proteins small enough to get inside of cells and infect them with a virus. Cleaves the safe off of Reverse Transcriptase allowing it to be infections and get inside of the cell.
In order for HIV numbers in Africa to decrease, a _________ ______ is necessary.
behavioral change
As the rate of _________ increase, the number of ___________ also increases.
diagnoses, undiagnosed
What is an Antigen?
foreign substance that gets into the body and stimulates an immune response
What is the function of gp41?
gp41 harpoons the cell in order to make contact and allow virus to get in easier
What percent of people who came into contact with HIV, but get an ARV within 72 hours become HIV positive?
less than 1%
You look inside your patient's throat and they have oral thrush, what CD4 count can you assume they have?
low
What do B cells do?
produce antibodies
What is a catalyst?
substance that activates a chemical reaction in the body (synonym: stimuli)
The three tests that yield information about the "status" of a person's confirmed HIV infection are...
viral load testing, CD4+ lymphocyte count, and viral genotyping.
What are leukocytes?
white blood cells
What are lymphocytes?
white blood cells in the lymphatic system