This Florida HIV-AIDS Initial Licensure course for Salon Professionals contains 4 hours of continuing education. To complete click the Purchase and Complete for Credit button at the top right of the screen.
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HIV/AIDS Initial Licensure for Salon Professionals
4 Hours $21.00
This course meets Florida’s HIV/AIDS initial licensure requirement
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4 HOUR HIV/AIDS COURSE FOR INITIAL LICENSURE
HIV/AIDS, Tuberculosis, and Hepatitis Communicable Disease Education
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This course will cover definitions, transmission, and treatment of HIV/AIDS and common communicable diseases to increase awareness and education for Florida cosmetologists. The topics covered are critical for the health and safety of the professional and their clients.
Final Examination Answer Sheet
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©2025: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Colibri Healthcare, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge in the areas covered. It is not meant to provide medical, legal or professional services advice. Colibri Healthcare, LLC recommends that you consult a medical, legal or professional services expert licensed in your state. Colibri Healthcare, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing, but does not represent or warrant that it will apply to your situation or circumstances and assumes no liability from reliance on these materials. i HIV/AIDS COURSE FOR INITIAL LICENSURE Book Code: CFL0425
Frequently Asked Questions How much will it cost? Course Title
Hours
Price
HIV/AIDS, Tuberculosis, and Hepatitis Communicable Disease Education
4
$21.00
How do I complete this course and receive my certificate of completion? See the following page for step-by-step instructions to complete and receive your certificate. Are you a Florida board-approved provider? Colibri Healthcare, LLC is an approved provider with the Florida Board of Cosmetology (Provider #0008051). Courses are approved by the Florida Board of Cosmetology and completions are reported to the Florida Department of Business and Professional Regulation. Are my credit hours reported to the Florida board? Yes. We report your hours electronically to the Florida Department of Business and Professional Regulation (DBPR) within one business day after completion. What information do I need to provide for course completion and certificate issuance? Please provide your license number on the test sheet to receive course credit. Your state may require additional information such as date of birth and/or last 4 of Social Security number; please provide these, if applicable. Is my information secure? Yes! We use SSL encryption, and we never share your information with third-parties. We are also rated A+ by the National Better Business Bureau. What if I still have questions? What are your business hours? No problem, we have several options for you to choose from! Online at EliteLearning.com/Cosmetology you will see our robust FAQ section that answers many of your questions. Simply click FAQs at the top of the page, email us at office@elitelearning.com, or call us toll-free at 1-855-769-9888, Monday - Friday 9:00 am - 6:00 pm, EST and Sat. 10:00 am - 4:00 pm EST. Important information for licensees: Always check your state’s board website to determine the number of hours required for renewal, mandatory subjects (as these are subject to change), and the amount that may be completed through home study. Also, make sure that you notify the board of any changes of address. It is important that your most current address is on file. Disclosures Resolution of conflict of interest Colibri Healthcare, LLC implemented mechanisms prior to the planning and implementation of the continuing education activity, to identify and resolve conflicts of interest for all individuals in a position to control content of the course activity. Sponsorship/commercial support and non-endorsement It is the policy of Colibri Healthcare, LLC not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
L icensing board contact information: Florida Department of Business and Professional Regulation (DBPR) Division of Professions I Board of Cosmetology 2601 Blair Stone Road I Tallahassee, Florida 32399 I Phone: (850) 487-1395 | Fax: (850) 488-8040 Website: https://www2.myfloridalicense.com/cosmetology/
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Book Code: CFL0425
HIV/AIDS COURSE FOR INITIAL LICENSURE
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iii
HIV/AIDS COURSE FOR INITIAL LICENSURE
Book Code: CFL0425
HIV/AIDS, Tuberculosis, and Hepatitis Communicable Disease Education 4 Hours
Course overview This course will cover definitions, transmission, and treatment of HIV/AIDS and common communicable diseases to increase awareness and education for Florida cosmetologists. The topics covered are critical for the health Learning objectives After completing this course, the learner will be able to: Explain the difference between HIV Infection and AIDS. Identify routes of HIV transmission. Describe ways to test for HIV/AIDS. Discuss prevention techniques to reduce the spread of HIV/AIDS.
and safety of the professional and their clients. Time for course completion will vary depending on the student’s previous knowledge base. The course is organized into four chapters, and concludes with a final exam.
List common risk factors and prevalence statistic for HIV/ AIDS for the state of Florida and the U.S. Explain HIV/AIDS treatment. Describe tuberculosis (TB) and the five types of hepatitis virus (HV). Identify how TB and viral hepatitis are prevented, transmitted, and treated.
CHAPTER 1: BLOODBORNE PATHOGENS: WHAT ARE THEY AND HOW ARE THEY TRANSMITTED? Chapter overview This chapter will provide definitions and background answers to questions about HIV infection to differentiate it from AIDS.
knowledge to begin the study of microorganisms that cause disease. Routes of transmission will be discussed along with Chapter objectives After completing this chapter, the learner should be able to: Explain the difference between HIV Infection and AIDS.
Identify how HIV is transmitted.
BLOODBORNE PATHOGENS
Bloodborne pathogens are microorganisms, such as viruses or bacteria that are carried in the blood and can cause disease in humans. There are many different bloodborne pathogens, including malaria, syphilis, and brucellosis, but hepatitis B virus (HBV) and the human immunodeficiency Modes of transmission Bloodborne pathogens, such as HBV, HCV and HIV, can be transmitted through contact with infected human blood and other potentially infectious body fluids such as: ● Semen. ● Breast milk.
virus (HIV) are the two diseases specifically addressed by the OSHA (Occupational Safety & Hazard Administration) bloodborne pathogen standard. Hepatitis C virus (HCV) is another virus that has dramatically increased in the United States. ● Eyes. ● Nose. ● Mouth. For example, a splash of contaminated blood to your eye, nose or mouth could result in transmission.
● Vaginal secretions. ● Cerebrospinal fluid.
HIV/AIDS QUESTIONS AND ANSWERS
What is HIV? HIV stands for human immunodeficiency virus. HIV destroys certain white blood cells called CD4+ T cells. These cells are critical to the normal function of the human immune system, which defends the body against illness. When HIV weakens the immune system, a person is more susceptible to developing a variety of cancers and becoming infected with viruses, bacteria, and parasites.
What is AIDS? AIDS stands for acquired immunodeficiency syndrome. A person who tests positive for HIV can be diagnosed with AIDS when a laboratory test shows that his or her immune system is severely weakened by the virus or when he or she develops at least one of about 25 different opportunistic infections – diseases that might not affect a person with a normal immune system but that take advantage of damaged immune systems.
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How is HIV detected? Several different types of laboratory tests can be used to determine whether a person is HIV-positive. It is impossible to look at someone and know whether he or she is HIV- positive. Most tests used to screen for the virus detect HIV antibodies – proteins the body produces to fight off the infection in blood or oral fluid samples – such as:
● Any sort of damaged or broken skin, such as sunburn or blisters. Bloodborne pathogens may also be transmitted through the mucous membranes of the:
● Eyes. ● Nose. ● Mouth. How does HIV cause AIDS?
● Synovial fluid. ● Pleural fluid. ● Amniotic fluid. ● Saliva (in dental procedures).
HIV destroys CD4+ T cells that are important to the normal function of the human immune system. As the virus destroys these cells, HIV-positive people are susceptible to illnesses that generally do not affect people with healthy immune systems. According to studies comprised of thousands of people, most HIV-positive people are infected with the virus for years before it does enough damage to the immune system to make them susceptible to AIDS-related diseases. Tests are available to measure the amount of HIV in the blood – the viral load – and those with higher viral loads are more likely to develop AIDS-related diseases and to experience a decline in their CD4+ T cells. Reducing the amount of virus in the body with antiretroviral medications can dramatically slow the destruction of a person’s immune system and the progression of illness. Why do some people make statements that HIV does not cause AIDS? The HIV/AIDS pandemic has attracted much attention both within and outside of the medical and scientific communities, possibly because of the many social issues related to HIV/AIDS, including sexuality, drug use and poverty. Although the scientific evidence is overwhelming and compelling that HIV is the cause of AIDS, the disease process is still not completely understood. This incomplete understanding has led some people to make statements that AIDS is not caused by an infectious agent or is caused by a virus that is not HIV. This is not only misleading but may have dangerous consequences. Both the U.S. National Institutes of Health and UNAIDS offer explanations of why HIV leads to AIDS.
● Any body fluid that is visibly contaminated with blood. HBV, HCV, and HIV are most commonly transmitted through:
● Sexual contact (less likely for HCV). ● Sharing of hypodermic needles.
● From mothers to their babies at/before birth. ● Accidental puncture from contaminated needles, broken glass, or other sharps. ● Contact between broken or damaged skin and infected body fluids. ● Contact between mucous membranes and infected body fluids. In most work situations, transmission is most likely to occur due to accidental puncture from contaminated needles, broken glass, or other sharps like scissors; contact between broken or damaged skin and infected body fluids; or contact between mucous membranes and infected body fluids. For example, if someone infected with HBV cut his or her finger on a piece of glass, and then you cut yourself on the now- infected piece of glass, it is possible that you could contract the disease. Anytime there is blood-to-blood contact with infected blood or body fluids, there is a slight potential for transmission. Unbroken skin forms an impervious barrier against bloodborne pathogens. However, infected blood can enter your system through: ● Open sores. ● Cuts. ● Abrasions. ● Acne.
HOW HIV CAUSES AIDS AND THE EVIDENCE THAT HIV CAUSES AIDS
How long does it take for HIV to cause AIDS? The time between HIV infection and progression to AIDS differs for each person and depends on many factors, including a person’s health status and their health-related behaviors. With a healthy lifestyle, the time between HIV infection and developing AIDS-related illnesses can be 10 to 15 years, sometimes longer. Antiretroviral therapy can slow the progression of HIV to AIDS by decreasing the amount of virus in a person’s body. There also are other medical treatments that can prevent or cure some of the illnesses associated with AIDS, although the treatments do not cure HIV or AIDS. As with other diseases, early detection of HIV infection allows for more options for treatment and preventive health care.
What are some of the symptoms of HIV infection and AIDS? Once infected with HIV, a person may or may not experience any symptoms. People who do experience symptoms might have a flu-like illness within one or two months after infection. Symptoms can include fever, headache, tiredness, and/or enlarged lymph nodes. These symptoms usually disappear within a week to a month and are often mistaken for the symptoms of more common viral infections, like a cold. More persistent or severe symptoms might not appear for several years after a person is first infected with HIV. This period of “asymptomatic” infection is highly individual. Some people might begin to have symptoms within a few months, while others might be symptom-free for more than 10 years. As the immune system is weakened by HIV, several complications and symptoms could begin to occur. These symptoms might be made worse if the HIV-positive person is not getting the care and services they need. For many people, the first signs of infection are enlarged lymph nodes, or “swollen glands,” that may be inflamed for several months.
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How is HIV transmitted? Simply said, HIV is transmitted by contact with blood and through sexual contact. HIV transmission can occur when blood, semen, pre-seminal fluid, vaginal fluid, or breast milk from an HIV-positive person enters the body of an HIV- negative person. HIV can enter the body through a vein, the lining of the anus or rectum, the lining of the vagina and/or cervix, the opening to the penis, the mouth, other mucous membranes – such as the eyes or inside of the nose – or cuts and sores. Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria. Worldwide, the most common way that HIV is transmitted is through sexual transmission, including anal, vaginal or oral sex with an HIV-positive person. HIV also can be transmitted by sharing needles or injection equipment with an injection drug user who is HIV-positive, or from an HIV-positive woman to her infant before or during birth or through breastfeeding after birth. HIV also can be transmitted through receipt of infected blood or blood clotting factors. Which body fluids transmit HIV? Blood, semen, vaginal fluid, breast milk, and other body fluids containing blood taken from HIV-positive people can contain high concentrations of HIV. The virus also might be present in the fluid surrounding the brain and the spinal cord, fluid surrounding bone joints and fluid surrounding a fetus of an HIV-positive pregnant woman. HIV has been found in the saliva and tears of some HIV- positive people but in very low quantities. A small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-positive people. Contact with saliva, tears, or sweat has never been shown to result in HIV transmission. How is HIV not transmitted? HIV is not easily passed from one person to another. The virus does not survive well outside of the body. HIV cannot be transmitted through casual or everyday contact such as shaking hands or hugging. Sweat, tears, vomit, feces, and urine do contain small amounts of HIV, but they have not been reported to transmit the disease. Mosquitoes and other insects do not transmit HIV. How can HIV transmission be prevented? The best way to avoid HIV infection is to avoid behaviors that would involve exposure to infected body fluids, including unprotected sexual intercourse or sharing needles to inject drugs. If avoiding such behaviors is not possible, numerous health organizations have determined that the use of latex condoms during vaginal, anal or oral intercourse can significantly reduce the risk of HIV transmission; HIV- positive pregnant women can take medications that can reduce the risk of HIV transmission to her child; and injection drug users should not share needles or injection equipment.
Other symptoms that HIV-positive people might experience months to years before receiving an AIDS diagnosis include: ● Lack of energy. ● Weight loss. ● Frequent fevers and sweats (sometimes known as “night sweats”). ● Persistent or frequent yeast infections (oral or vaginal). ● Persistent skin rashes or flaky skin. ● Pelvic inflammatory disease in women that does not respond to treatment. ● Short-term memory loss. Both men and women experience many of the same symptoms from HIV infection. However, women also experience unique complications that are primarily gynecologic. These could include recurrent vaginal yeast infections, severe pelvic inflammatory disease (PID) or human papillomavirus (HPV) infections. Other vaginal infections might occur more frequently and with greater severity in HIV-positive women (compared with HIV-negative women), including bacterial vaginosis and common sexually transmitted infections such as gonorrhea, chlamydia, and trichomoniasis. HIV-positive women also might experience disruptions or other irregularities in their menstrual cycles. The signs and symptoms of HIV/AIDS are similar to the symptoms of many other illnesses. The only way to determine HIV infection is to be tested. Is there a cure for HIV/AIDS? There is no known cure for HIV/AIDS. There are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. Researchers are testing a variety of preventive and curative vaccine candidates, but a successful vaccine likely is years away. What is the link between HIV and tuberculosis? The HIV epidemic is largely responsible for the growing number of TB cases in many parts of the world. HIV weakens the cells in the immune system that are needed to fight TB; up to half of all people living with HIV/AIDS eventually develop TB. Worldwide, TB is the leading cause of death among HIV-positive people. What is the link between HIV and sexually transmitted diseases? People with a sexually transmitted disease are far more vulnerable than others to becoming infected with HIV. For example, genital ulcers caused by herpes create an entry point for HIV. Even when the STD causes no breaks in the skin or open sores, the infection can cause an immune response in the genital area that can make HIV transmission more likely. In addition, HIV-positive people are more vulnerable to acquiring sexually transmitted diseases than HIV-negative people because their immune systems are weakened. If an HIV-positive person is infected with another STD, that person is three to five times more likely than other HIV- positive people to transmit HIV through sexual contact.
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How effective are latex condoms in preventing HIV? Latex condoms, when used consistently and correctly, are highly effective in preventing transmission of HIV. Laboratory studies have found that HIV does not pass through intact latex condoms even when they are stretched or stressed, according to the World Health Organization. Prospective studies looking at couples in which one partner is HIV-positive and the other is not have shown that, with consistent condom use, less than 1% of the HIV-negative people became infected annually. In 2000, representatives of four U.S. government agencies (U.S. Agency for International Development, Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health) concluded in a report that, based on an analysis of published studies, male condoms significantly reduce the risk of HIV transmission for both men and women during vaginal intercourse when used correctly in every encounter. Why is injection drug use a risk for HIV transmission? At the start of every injection, blood is introduced into the needle and syringe. Therefore, a needle and syringe that an HIV-positive person uses can contain blood that contains the virus. The reuse of a blood-contaminated needle or syringe by another drug injector carries a high risk of HIV transmission because infected blood can be injected directly into the bloodstream. Sharing other drug-using equipment also can be a risk for spreading HIV. Infected blood can be introduced into drug solutions through using blood-contaminated syringes to prepare drugs; reusing water; reusing bottle caps, spoons, or other containers used to dissolve drugs in water and to heat drug solutions; or reusing small pieces of cotton or cigarette filters used to filter out particles that could block the needle. Trends in HIV transmission in the United States The CDC provides the most current information on trends in the United States in its 2020 online report titled, “HIV in the United States and Dependent Areas.” Key points are provided below using the most current available data: ● In 2018, 37,832 people received an HIV diagnosis in the United States and dependent areas. From 2010 to 2017, HIV diagnoses decreased 11% among adults and adolescents in the 50 states and District of Columbia. However, annual diagnoses have increased among some groups. ● Though HIV/AIDS is no longer among the 15 top killers in the U.S., it is still the ninth leading cause of death among adults ages 25-44. In the non-Hispanic black population, HIV/AIDS is the ninth leading cause of death among those ages 20-24 and ranks eighth among those ages 25 thru 54. ● Gay, bisexual, and other men who have sex with men are the population most affected by HIV. In 2018, gay and bisexual men accounted for 69% of the 37,832 new HIV diagnoses and 86% of diagnoses among males. ● Heterosexuals continue to be affected by HIV. In 2018, heterosexuals accounted for 24% of the 37,832 new HIV diagnoses.
Can HIV be transmitted through casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or sneezing and coughing)? HIV is not transmitted through day-to-day contact in workplaces, schools, or social settings. HIV is not transmitted through shaking hands, hugging, or casual kissing. A person cannot become infected from touching a toilet seat, a drinking fountain, a doorknob, dishes, drinking glasses, food, or pets. HIV is not an airborne or foodborne virus, and it does not live long outside the body. HIV can be found in blood, semen, or vaginal fluid of an HIV-positive person. Can HIV be transmitted through mosquitoes? No, mosquitoes do not transmit HIV. When mosquitoes feed on blood from a person, they only inject their saliva, which serves as a lubricant and allows the insect to draw blood more easily. In addition, HIV does not reproduce or survive inside mosquitoes, unlike organisms that are transmitted via insect bites. How well does HIV survive outside the body? HIV does not survive for very long outside of the human body. HIV is unable to reproduce outside its living host, except under laboratory conditions. Therefore, it does not spread or maintain infectiousness outside its host.
● Heterosexual men accounted for 7% of new HIV diagnoses. ● Heterosexual women accounted for 16% of new HIV diagnoses. ● People who inject drugs (PWID) accounted for 7% of the 37,832 new HIV diagnoses in 2018. ● Men who inject drugs accounted for 4% of new HIV diagnoses. ● Women who inject drugs accounted for 3% of new HIV diagnoses. ● Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV in 2018. ● Blacks/African Americans accounted for 42% of new HIV diagnoses and 13% of the population. ● Hispanics/Latinos accounted for 27% of new HIV diagnoses and 18% of the population. ● HIV diagnoses are not evenly distributed regionally. In 2018, the population rates (per 100,000 people) of people who received an HIV diagnosis were highest in the South (15.7), followed by the U.S. dependent areas (12.7), Northeast (10.0), West (9.3), Midwest (7.2).
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CHAPTER 2: HIV/AIDS: TESTING, RISK FACTORS, AND PREVALENCE
Chapter overview This chapter describes testing to determine the prevalence of HIV/AIDS and risk factors that may determine which individuals will develop disease from bloodborne pathogens. Identifying risk factors and testing procedures Chapter objectives List common risk factors and prevalence statistic in HIV/ AIDS.
that increase prevalence are the first steps in preventing these diseases. Statistics throughout Florida and the United States will be compared.
Describe ways to test for the disease and prevent the spread of HIV/AIDS.
WHERE DID HIV COME FROM?
In 1999, scientists reported that they had discovered the origin of HIV-1. They identified a subspecies of chimpanzees native to West Equatorial Africa as the original source of the virus. The virus most likely was introduced into the human How many people have HIV/AIDS? UNAIDS estimates that 37.9 million people were living with HIV/AIDS worldwide at the end of 2018, the most current statistic given. UNAIDS provided the following statistics on its Global HIV & AIDS Statistics — 2019 Fact Sheet: Global HIV statistics: ● 24.5 million [21.6 million–25.5 million] people were accessing antiretroviral therapy (end of June 2019). ● 1.7 million [1.4 million–2.3 million] people became newly infected with HIV (end 2018). ● 770,000 [570,000–1.1 million] people died from AIDS- related illnesses (end 2018). ● 74.9 million [58.3 million–98.1 million] people have become infected with HIV since the start of the epidemic (end 2018). ● 32 million [23.6 million–43.8 million] people have died from AIDS-related illnesses since the start of the epidemic (end 2018). People living with HIV: ● In 2018, there were 37.9 million [32.7 million–44.0 million] people living with HIV: ○ 36.2 million [31.3 million–42.0 million] adults. ○ 1.7 million [1.3 million–2.2 million] children (<15 years). ● 79% [67–92%] of all people living with HIV knew their HIV status. ● About 8.1 million people did not know that they were living with HIV. People living with HIV accessing antiretroviral therapy: ● As of end of June 2019, 24.5 million [21.6 million–25.5 million] people were accessing antiretroviral therapy. ● In 2018, 23.3 million [20.5 million–24.3 million] people living with HIV were accessing antiretroviral therapy, up from 7.7 million [6.8 million–8.0 million] in 2010. ● In 2018, 62% [47–74%] of all people living with HIV were accessing treatment: ○ 62% [47–75%] of adults aged 15 years and older living with HIV had access to treatment, as did 54% [37–73%] of children aged 0–14 years. ○ 68% [52-82%] of female adults aged 15 years and older had access to treatment; however, just 55% [41-68%] of male adults aged 15 years and older had access. ● 82% [62– >95%] of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2018.
population when hunters were exposed to the infected blood of non-human primates. More information about the origin of HIV is available from the National Institute of Allergy and Infectious Diseases. New HIV infections: ● New HIV infections have been reduced by 40% since the peak in 1997. ● In 2018, around 1.7 million [1.4 million–2.3 million] were newly infected with HIV, compared to 2.9 million [2.3 million–3.8 million] in 1997. ● Since 2010, new HIV infections have declined by an estimated 16%, from 2.1 million [1.6 million–2.7 million] to 1.7 million [1.4 million–2.3 million] in 2018. ● Since 2010, new HIV infections among children have declined by 41%, from 280,000 [190,000–430,000] in 2010 to 160,000 [110,000–260,000] in 2018. AIDS-related deaths: ● AIDS-related deaths have been reduced by more than 56% since the peak in 2004. ● In 2018, around 770,000 [570,000–1.1 million] people died from AIDS-related illnesses worldwide, compared to 1.7 million [1.3 million–2.4 million] in 2004 and 1.2 million [860 000–1.6 million] in 2010. ● AIDS-related mortality has declined by 33% since 2010. 90–90–90: ● In 2018, 79% [67–92%] of people living with HIV knew their status. ● Among people who knew their status, 78% [69–82%] were accessing treatment. ● And among people accessing treatment, 86% [72–92%] were virally suppressed. ● Of all people living with HIV, 79% [67-92%] knew their status, 62% [47-74%] were accessing treatment, and 53% [43-63%] were virally suppressed in 2018. Women: ● Every week, around 6,000 young women aged 15–24 years become infected with HIV. ● In sub-Saharan Africa, 4 in 5 new infections among adolescents aged 15–19 years are in girls. Young women aged 15–24 years are twice as likely to be living with HIV than men. ● More than one-third (35%) of women around the world have experienced physical and/or sexual violence at some time in their lives. ● In some regions, women who have experienced physical or sexual intimate partner violence are 1.5 times more likely to acquire HIV than women who have not experienced such violence.
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Key populations: ● Key populations and their sexual partners account for: ○ 54% of new HIV infections globally. ○ More than 95% of new HIV infections in Eastern Europe and Central Asia. ○ 95% of new HIV infections in Middle East and North Africa. ○ 88% of new HIV infections in Western and central Europe and North America. ○ 78% of new HIV infections in Asia and the Pacific. ○ 65% of new HIV infections in Latin America. ○ 64% of new HIV infections in Western and central Africa. ○ 47% of new HIV infections in the Caribbean. ○ 25% of new HIV infections in eastern and southern Africa.
● The risk of acquiring HIV is: ○ 22 times higher among men who have sex with men. ○ 22 times higher among people who inject drugs. ○ 21 times higher for sex workers. ○ 12 times higher for transgender people. HIV/Tuberculosis (TB): ● TB remains the leading cause of death among people living with HIV, accounting for around one in three AIDS- related deaths. ● In 2017, an estimated 10 million [9 million-11.1 million] people developed TB disease; approximately 9% were living with HIV. ● People living with HIV with no TB symptoms need TB preventative therapy, which lessens the risk of developing TB and reduces TB/HIV death rates by around 40%. ● It is estimated that 49% of people living with HIV and tuberculosis are unaware of their coinfection and are therefore not receiving care.
HIV IN THE UNITED STATES: AT A GLANCE
Fast facts from CDC ● Approximately 1.1 million people in the U.S. are living with HIV today. ● About 14% of them (1 in 7) don’t know it and need testing. ● During 2010-2017, the annual number of new HIV diagnoses in the U.S. decreased 9%. ● HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay and bisexual men. ● Blacks/African Americans accounted for 42% (16,067) of HIV diagnoses and 13% of the population. HIV diagnoses among Black/African American gay and bisexual men remained stable. ● Gay and bisexual men accounted for 69% of all HIV diagnoses in the United States and 86% of diagnoses among males. HIV diagnoses among white gay and bisexual men decreased 19%. ● HIV diagnoses among Hispanics/Latino gay and bisexual men increased 17% at 7,543. ● HIV diagnoses among white gay and bisexual men decreased 19% (6,423). ● Heterosexuals accounted for 24% of HIV diagnoses. Heterosexual men accounted for 7% of HIV diagnoses, and heterosexual women accounted for 16% of HIV diagnoses. ● An estimated 38,000 new HIV infections still occur in the United States each year. These infections can be prevented. HIV/AIDS statistics in Florida Florida has the third highest rate of new HIV diagnosis, surpassed only by Washington, D.C., and Georgia. Over 115,000 Florida residents have HIV, which represents 12.5% of cases in the United States. An estimated 15%, 19,200 people, do not know they have the disease and therefore are not receiving treatment as noted in a CDC report from 2019. Of the 48 counties identified by the federal government as the highest priority due to case numbers, more than half of all cases identified are located in seven Florida counties. These counties include Miami-Dade, which has had the highest number of cases for many years, as well as the highest rate of AIDs and end stage disease. Because these individuals carry a high rate of viral load, they are more apt to spread the disease and die from it.
● HIV diagnoses are not evenly distributed across states and regions. More than 50% of new diagnoses occurred in 48 counties; Washington, D.C.; and San Juan, Puerto Rico, in 2016 and 2017. ● By age group, between 2010–2016, the annual number of HIV infections decreased among persons aged 13–24 and 45–54 but increased among persons aged 25–34. The number of infections remained stable among persons aged 33–44 and ≥55 years. ● By race/ethnicity, between 2010-2016, the annual number of HIV infections decreased among blacks/ African Americans, whites, and persons of multiple races and remained stable for Asians and Hispanics/Latinos. ● By sex, between 2010-2016, the annual number of new HIV infections decreased among females but remained stable among males. ● By HIV transmission group, between 2010-2016, the annual number of HIV infections decreased among people who use injection drugs and among heterosexuals. New HIV infections remained stable at about 26,000 per year among gay and bisexual men, who account for most (about 70%) of new infections each year. ● In 2018, 17,032 people in the U.S. and six dependent areas received a stage 3 (AIDS) diagnosis. (The late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.) (CDC, 2020b) Miami-Dade is followed by Broward, Palm Beach, Orange, Hillsborough, Pinellas, and Duval in terms of the highest HIV diagnoses. Several factors influence Florida’s high rates of HIV/AIDs including stigma, poverty, lack of access to care, language barriers, and the high rate of immigrants who may be unfamiliar with sources of care or afraid to access care due to their immigration status.
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Florida statistics by county The data below is provided by the Florida Department of Health, Division of Public Health Statistics & Performance Management: HIV Cases, Per 100,000 Population, 2018 County Count
Denom
Rate 23.4 16.3*
MOV (+/-)
Florida Alachua
4,906
20,957,705
0.7 4.9
43
263,753 27,488 182,218 28,083 584,050
Baker
2
7.3
Bay
34
18.7 17.8
6.3
Bradford Brevard Broward Calhoun Charlotte
5
15.6
68
11.6* 34.7*
2.8 2.6
661
1,903,210
2 7
15,315 175,413 145,164 213,565 367,471 69,566
13.1
4*
3
Citrus
11 29 38 10
7.6*
4.5 4.9 3.3 8.9 2.4
Clay
13.6* 10.3* 14.4* 43.6*
Collier
Columbia
Miami-Dade
1,224
2,804,160
DeSoto
1 0
35,940 16,767 954,454 317,051 108,481 12,360 48,173 17,578 13,193 16,235 14,706 27,436 39,682 185,421 103,317
2.8
Dixie Duval
0
296
31*
3.5 4.6 5.7
Escambia Flagler Franklin Gadsden Gilchrist
56 10
17.7*
9.2*
1
8.1
13
27
14.7
1 3 1 4 2 9
5.7
Glades
22.7
Gulf
6.2
Hamilton
27.2
Hardee Hendry
7.3
22.7 9.2* 5.8* 22.8
14.8
Hernando Highlands
17
4.4 4.6 2.5
6
Hillsborough
323
1,419,285
Holmes
1
20,404 152,079 50,689 14,725
4.9
Indian River
10
6.6* 9.9*
4.1 8.6
Jackson Jefferson Lafayette
5 1 1
6.8
8,367
12
Lake
53 77 81
342,356 721,053 290,223 41,550
15.5* 10.7*
4.2 2.4 6.1
Lee
Leon Levy
27.9
4 1 5
9.6
Liberty
8,781
11.4 25.7
Madison Manatee
19,420 381,071 355,325 155,705
22.6
45 41 15
11.8* 11.5*
3.5 3.5 4.9
Marion Martin
9.6*
Page 7
Book Code: CFL0425
EliteLearning.com/Cosmetology
HIV Cases, Per 100,000 Population, 2018 County Count
Denom 76,534 83,125 198,409 41,492
Rate 23.5 9.6* 9.1*
MOV (+/-)
Monroe Nassau Okaloosa
18
10.9
8
6.7 4.2
18
Okeechobee
2
4.8
Orange Osceola
500 104 298
1,370,447
36.5*
3.2 5.5 2.3 2.9 2.7 3.1
360,426
28.9
Palm Beach
1,442,281
20.7* 11.4* 18.7* 16.6*
Pasco
59
518,639 971,022 681,691 73,422 241,545 304,743 175,552 415,896 463,627 125,779 45,123 22,258 15,966 532,926 32,350 67,926 25,243
Pinellas
182 113
Polk
Putnam St. Johns St. Lucie
14
19.1 3.7*
10
9
2.4 4.6 3.2 2.7 3.7
51
16.7*
Santa Rosa Sarasota Seminole
8
4.6* 7.7*
32 75
16.2*
Sumter
4 1 2 2
3.2 2.2
Suwannee
Taylor Union
9
12.5
Volusia Wakulla Walton
86
16.1*
3.4
3 1 2
9.3 1.5 7.9
Washington
DOC/FCI 97 Data Source : Florida Department of Health, HIV/AIDS Section. These data represent new diagnoses by year of diagnosis, as of June 30, 2019. The next update is scheduled for July 2020. * Denom: Abbreviated for denominator. **MOV: Measure of variability: Probable range of values resulting from random fluctuations in the number of events. Not calculated when numerator is below 5 or denominator is below 20 or count or rate is suppressed. The MOV is useful for comparing rates to a goal or standard. For example, if the absolute difference between the county rate and the statewide rate is less than the MOV, the county rate is not significantly different from the statewide rate (alpha level = 0.05). When the absolute difference between the county rate and the statewide rate is greater than the MOV, the county rate is significantly different from the statewide rate. MOV should not be used to determine if the rates of two different counties, or the county rates for two different years, are statistically significantly different. In the rate column, * indicates the county rate is statistically significantly different from the statewide rate. DOC/FCI = Department of Corrections/Federal Correctional Institution. Number of new Florida HIV diagnoses, 2008 – 2017
● 2012: 4,398 ● 2013: 4,315 ● 2014: 4,498 ● 2015: 4,598 ● 2016: 4,708 ● 2017: 4,783
Data below is presented in 2020 by Emory University’s Rollins School of Public Health in partnership with Gilead Sciences, Inc. and the Center for AIDS Research at Emory University (CFAR):
● 2008: 5,840 ● 2009: 5,073 ● 2010: 4,661 ● 2011: 4,597
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Book Code: CFL0425
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HIV disease: United States vs. Florida CDC Comparison of Top 10 States New HIV Diagnoses Among Adults and Adolescents by Top 10 States, 2018 State Number of Diagnoses Florida 4,683 Texas 4,483 California 4,398 Georgia 2,552 New York 2,470 Illinois 1,352 North Carolina 1,200 New Jersey 1,044 Pennsylvania 1,002 Louisiana 986 Note . CDC, 2019C
CDC Comparison of HIV diagnoses, 2018 Ages 13 years and older | All races/ethnicities | Both sexes | All transmission categories | United States Geography Cases Rate per 100,000 Population District of Columbia 208 34.6 601,238 Georgia 2,552 29.2 8,737,682 Florida 4,683 25.6 18,271,712 Louisiana 986 25.5 3,864,525 Nevada 508 20.0 2,536,932 Maryland 979 19.3 5,079,641 Mississippi 479 19.3 2,481,945 Texas 4,483 19.2 23,369,741 South Carolina 719 16.8 4,291,438 Puerto Rico 438 15.7 2,796,214 New York 2,470 14.9 16,615,927 Alabama 572 13.9 4,109,359 New Jersey 1,044 13.9 7,523,799 North Carolina 1,200 13.7 8,745,091 Arizona 806 13.4 5,996,296 California 4,398 13.3 33,089,613 Tennessee 759 13.3 5,691,344 Illinois 1,352 12.6 10,713,681 Virginia 867 12.1 7,174,624 Arkansas 281 11.2 2,508,847 Delaware 91 11.1 821,504 Massachusetts 654 11.0 5,941,124 U.S. Virgin Islands 9 10.2 88,013 Ohio 984 10.0 9,844,655 Kentucky 360 9.6 3,744,646 Pennsylvania 1,002 9.2 10,927,119 Indiana 510 9.1 5,574,116 Missouri 446 8.7 5,139,738 Colorado 409 8.5 4,791,744 Michigan 718 8.5 8,468,998
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Book Code: CFL0425
EliteLearning.com/Cosmetology
CDC Comparison of HIV diagnoses, 2018 Ages 13 years and older | All races/ethnicities | Both sexes | All transmission categories | United States Geography Cases Rate per 100,000 Population Rhode Island 76 8.3 913,274 Connecticut 250 8.2 3,065,086 Washington 503 8.0 6,325,104 Oklahoma 234 7.2 3,251,579 New Mexico 121 6.9 1,751,920 Oregon 230 6.5 3,563,199 Kansas 154 6.4 2,403,453 Minnesota 283 6.1 4,672,696 North Dakota 36 5.8 625,978 Hawaii 66 5.5 1,196,330 West Virginia 85 5.5 1,546,902 Guam 7 5.5 12,729 Nebraska 79 5.0 1,583,601 Utah 121 4.9 2,487,739 Iowa 116 4.4 2,630,539 Wisconsin 210 4.3 4,907,884 South Dakota 28 3.9 722,303 Alaska 20 3.3 602,095 Vermont 18 3.3 545,217 New Hampshire 36 3.1 1,178,301 Idaho 37 2.6 1,436,081 Montana 23 2.6 896,526 Wyoming 12 2.5 480,114 Northern Mariana Islands 1 2.5 40,394 Maine 28 2.4 1,162,948 American Samoa 0 0.0 38,072 Note . CDC, 2019c
The Florida Department of Health provides the following information on HIV/AIDS released in 2020: ● In 2018, Florida identified 4,906 new HIV diagnoses. ● The HIV case rate per 100,000 population decreased from 24.1 in 2017 to 23.4 in 2018. ● Rates among blacks decreased from 64.1 per 100,000 in 2017 to 50.9 per 100,000 in 2018. ● Rates among Hispanics increased from 29.9 per 100,000 in 2017 to 30.9 per 100,000 in 2018.
The Florida Department of Health has identified reducing transmission of HIV as one of its seven priority goals. To achieve this goal, Florida has adopted a comprehensive strategic approach to prevent HIV transmission and strengthen patient care activities which will greatly reduce the risk of further transmission of HIV from those diagnosed and living with HIV.
GENDER DIFFERENCES
Why are young women at a higher risk of HIV infection than young men?
What factors make women more vulnerable? A combination of biological, social, cultural, and economic factors contribute to women’s increased vulnerability to HIV infection. In particular, gender inequalities prevent women from asserting power over their own lives and controlling the circumstances that increase their vulnerability to infection, particularly in the context of sexual relationships (CDC, 2019c). Women are also physiologically more susceptible to becoming infected with HIV than men.
Many young women lack information about sexual and reproductive health and disease prevention. In countries with generalized epidemics, the majority of women ages 15 to 24 do not have access to information or resources about reproductive health and HIV/AIDS. Young women may also lack access to health care and education. In addition, young women are among the most vulnerable because their genital tracts have less mature tissue, which may be more easily torn, and they are often victims of coercive or forced sex (CDC, 2019c).
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What biological factors make women more vulnerable? Researchers believe that women are biologically more susceptible to HIV infection from heterosexual sex than men. The female genital tract has a greater exposed surface area than the male genital tract, therefore, women may be prone to greater risk of infection with every exposure.
Male-to-female HIV transmission is estimated to be twice as likely as female-to-male transmission in a single act of vaginal intercourse. Younger women might be even more biologically vulnerable to HIV infection because they have less mature tissue and are often victims of coercive or forced sex.
TESTING
What types of tests are used to determine the presence of HIV?
health care provider or test counselor about the window period for the test you’re taking: ○ A nucleic acid test (NAT) can usually tell you if you have HIV infection 10 to 33 days after an exposure. ○ An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure). ○ Antibody tests can take 23 to 90 days to detect HIV infection after an exposure. Most rapid tests and self- tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid (CDC, 2019b). Where can I get tested for HIV infection? Many places provide testing for HIV infection. Common testing locations include local health departments, offices of private doctors, hospitals, and sites specifically set up to provide HIV testing. To find a testing site, visit: gettested.cdc.gov , or call 1-800-CDC-INFO (232-4636). Home testing kits: ● Can be purchased in most pharmacies or online. There is currently only one FDA-approved self-test (Oraquick) (CDC, 2019b): ○ For a self-test, you have to swab your own mouth to collect an oral fluid sample and use a kit to test it. You will be able to get a result in about 20 minutes. It is important to follow the directions as described in the instructions or the test will not work properly. There is a phone number included with a HIV self- test for anyone to call to get help with conducting the test. Rapid tests: ● A rapid test is a screening test that produces very quick results, in approximately 20 minutes. In comparison, results from the other more commonly used HIV antibody screening test, the enzyme immunoassay (EIA), are not available for several days to a few weeks. Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made.
The CDC provides the following information on HIV testing: ● There are three types of tests available: Nucleic acid tests (NAT); antigen/antibody tests; and antibody tests. HIV tests are typically performed on blood or oral fluid. They may also be performed on urine: ○ A NAT looks for the actual virus in the blood and involves drawing blood from a vein. The test can either tell if a person has HIV or tell how much virus is present in the blood (known as an HIV viral load test ). While a NAT can detect HIV sooner than other types of tests, this test is very expensive and not routinely used for screening individuals unless they recently had a high-risk exposure or a possible exposure and have early symptoms of HIV infection. ○ An antigen/antibody test looks for both HIV antibodies and antigens. Antibodies are produced by your immune system when you’re exposed to viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. This lab test involves drawing blood from a vein. There is also a rapid antigen/antibody test available that is done with a finger prick. ○ HIV antibody tests only look for antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid. Most rapid tests and the only currently approved HIV self-test are antibody tests. (CDC, 2019b) How long after a possible exposure should I wait to get tested for HIV? According to the CDC: ● The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called the “window period.” The window period varies from person to person and depends on the type of test used to detect HIV. Ask your
RISK FACTORS
Alcohol and HIV/AIDS People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives. Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. Concerns about HIV have increased as recent trends suggest a resurgence of the epidemic among men who have sex with men, as well as dramatic increases in the
proportion of cases transmitted heterosexually. In persons already infected, the combination of heavy drinking and HIV has been associated with increased medical and psychiatric complications, delays in seeking treatment, difficulties with HIV medication compliance, and poorer HIV treatment outcomes. Decreasing alcohol use in people who have HIV or who are at risk for becoming infected reduces the spread of HIV and the diseases associated with it.
Page 11
Book Code: CFL0425
EliteLearning.com/Cosmetology
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