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HIV AND AIDS IN

THE CARIBBEAN
PREPARED BY DR.BENJAMIN AND NURSE
BAIN THOMAS
PRESENTED
BY
NURSE BAIN THOMAS
RN. MW
The Human Immunodeficiency Virus belongs to
a group known as the Retrovirus family.

There are two main types of HIV – HIV-1 (the


most common) and HIV-2 (relatively uncommon
and less infectious).
 HUMAN- found in humans, transmitted
between humans and preventable by humans

 IMMUNO – DEFICIENCY: body lacks ability to


fight off infections, “constitution” weakens,
other germs cause illnesses.

 VIRUS - types of germ lives and reproduces


in body cells
 The HIV incubation period may refer to
either the time between exposure to the
human immunodeficiency virus (HIV) and the
first appearance of symptoms, or the period
of time between exposure to HIV and
progression to full-blown Acquired
Immunodeficiency Syndrome (AIDS). It is
important to understand the incubation
period because a person who has been
infected with the disease can pass it on
almost immediately, even before symptoms
appear.
1. BINDING (also called attachment) the HIV
binds or attached itself to the receptors of a
CD4 cell.
-CCRS Antagonist
-Post attachment inhibitors

2. FUSION the HIV envelope and the CD4 cell


membrane fuse (join together) which allows
the HIV to enter the CD4 cell
-Fusion Inhibitors
3. Reverse Transcription; Inside the CD4 cell
releases and uses reverse transcriptase (an HIV
enzyme) to convert its genetic material HIV
RNA into HIV DNA
The conversion of HIV DNA- HIV RNA allows
the HIV to enter the CD4 Cell Nucleus and
combined with the cell genetic material cell-
DNA
Non Nucleoside reverse transcriptase
inhibitors –NNRTI’s
Nucleoside reverse transcriptase inhibitors-NRTI’s
4. Integration; inside the CD4 cell nucleus HIV
releases Integrase (an HIV enzyme) HIV uses
Integrase to insert (integrate) its viral DNA into
the DNA of the CD4 cells.
Integrase Inhibitors

5. Replication; once integrated into the CD4


cell DNA HIV begins to use the machinery of
the CD4 cells to make long chains of HIV
protein. The protein chains are the building
blocks for more protein.
6. Assembly; New HIV proteins and HIV RNA
move to the surface of the cells and
assemble into immature ( non
infectious)HIV.
7. Budding; Newly formed immature (non
infectious) HIV pushes itself out of the host
CD4 cell.
The new HIV releases Protease ( an HIV
enzyme). Protease acts to break up the long
protein chains that form the immature virus. The
smaller HIV proteins combined to form mature
(infectious) HIV. -Protease Inhibitors-PI’s
 In the Caribbean, the cultural norm of young
women (aged 15-24) having sexual
relationships with older men increases their
risk of HIV infection. In Haiti, for example,
HIV prevalence among young women is more
than double that among young men. Between
9% and 24% of young women in the region
reported having sex with a man at least 10
years older than themselves within the last
12 months. Other risk factors, such as
multiple sexual partners and inconsistent
condom use, compound the risk of age
mixing in these countries.
 In the Caribbean, gay men and other men
who have sex with men accounted for nearly
a quarter of new infections in 2017. In total,
key populations and their sexual partners
represented two thirds of new infections.
 Transgender women are highly affected by
HIV in the Caribbean. HIV prevalence among
this group is thought to be 49 times higher
than among the general population.
 Transgender people in the region have fewer
educational and social opportunities, often
resorting to sex work for an income. Country-
level data collected between 2011 and 2015
also shows much higher HIV prevalence
among transgender women sex workers
compared to other sex workers. Transgender
people also face high rates of violence.
 Across the region, particularly in the
Caribbean, sex workers experience a range
of human rights violations and social
injustices, including the denial of access to
healthcare, poor working conditions,
violence and harassment by law
enforcement. Sex workers are also
frequently marginalized by social and
religious institutions and subject to
discrimination. For these reasons, many
people who engage in sex work do so
covertly.
 Young people in the Caribbean, especially
those who are from key populations, are
disproportionately at risk of HIV infection.
One factor contributing to this are the
barriers to accessing prevention services.

 However, a few countries in the Caribbean


have developed policies allowing minors to
access HIV testing without parental consent,
either allowing it at any age (such as in
Guyana) or above the age of 14 (as in
Trinidad and Tobago).
According to UNAIDS 2017 report:

 310,000 persons tested positive for HIV

 230,000 persons know their status (80,000)

 180,000 persons are on medication

 130,000 persons are virally suppressed


 There has been moderate progress made on
both prevention and treatment in the
Caribbean. The annual number of new HIV
infections among adults in the Caribbean
declined by 18% between 2010 and 2017, and
deaths from AIDS-related illness fell by 23%.
In this part of the region, there was a large
gap in awareness of HIV status at the start of
the HIV testing and treatment cascade.
 In 2017, 73% of people living with HIV in the
Caribbean were aware of their HIV status, an
increase from 66% in 2016. About 181,000
people were accessing ART, equivalent to 57%
of people living with HIV. The proportion of
people living with HIV who were virally
suppressed increased from 37% in 2016 to
40% in 2017.
 Mostcountries in the Caribbean provide
comprehensive sexuality education (CSE) in
primary and secondary schools, which
includes topics beyond the reproductive
system to include HIV, sexually transmitted
infections, sexuality, gender identity and
gender equality.
 Seven countries and island states in the
Caribbean have been validated as having
eliminated mother- to-child transmission of HIV:
Anguilla, Antigua and Barbuda, Bermuda, the
Cayman Islands, Cuba, Montserrat, and Saint
Kitts and Nevis. The rate of mother-to-child
transmission (including breastfeeding) in the
Caribbean in 2017 was 13.3%. This is significantly
lower than the 18.7% rate in 2010. PMTCT
treatment coverage was 75% in 2017, and almost
half (48%) of HIV-exposed infants received an
early infant diagnosis before eight weeks of age.
 Asa result, new HIV infections among
children (aged 0-14 years) have declined
across the Caribbean. Progress was greatest
where new infections among children fell
from an estimated 2,300 in 2010, to 1100 in
2017.
QUESTIONS
Finally it doesn't matter how much
you know, what is important, is what you do
with what you know to make a difference in
your life and the life of others.