HIV Prevention: HSCI 225 BY Mutua Moses Mulu

HIV
PREVENTION
HSCI 225
BY
Mutua moses mulu
Activity
What would you do if you were

raped or sodomised ? (God forbid)
• ___________________________________
• ___________________________________
• ___________________________________
• ___________________________________
What do you do if raped ?
 Do not resist –avoid violence and trauma
 After the ordeal do not ;-
 Throw away torn pant /underware
 Have a bath or a vagina douch
 Contact friend spouse to assist
 Seek medical attention .Give all details a thorough
assessment will be done
 The clinician will do the following :-
 Treat all the injuries
 Obtain vaginal secretion , torn under pants and
specimen of pubic hair-to be used as forensic evidence
 Pretest counselling
 Test for HIV and Pregnancy
 If both are negative then Commenced on ARVs for a
month-should be started within 72 hours
 Administer emergency contraceptive
Postino 11
 Will fill the P3 form with the evidence handed over
to police
STATUS OF THE RAPIST
In high HIV prevalence populations such as the

sub sahara African region, ‘rapists should be
assumed to be HIV positive unless proven
otherwise’ in which case the assaulted patient is
deemed to be at a high risk of acquiring HIV
Pre-exposure prophylaxis PrEP
• Is used when people at high risk for HIV take
ARVs daily to lower their chances of getting
infected.
• Its known to be highly effective for preventing
HIV if used as prescribed.
• Daily PrEP reduces the risk of Getting HIV
from sex by 90%
• Among IDU’s risk is reduced by 70%
CTN…..
• The risk is further reduced when PrEP is
combined with condoms.
• PrEP is not like a vaccine, as you take the
pill daily to prevent risk of transmission.
CTN…
• PrEP is ideal for:
• Sero-discondant couple
• Men who have sex with men
• Transgender women
5. Post-exposure prophylaxis
 Main mode of HIV transmission is
heterosexual and homosexual contact
 Transmission may also occur due to:
 Occupational exposure Health professionals
are in contact with patients and infected
clinical material
 They can get infection thro ’injury by
contaminated needles and scapels or with
infected body fluids
 Non-occupational modes of transmission ;
 Sexual assault e.g. Rape or sodomy
 Sharing needles by Intravenous drug users
 Road Traffic accidents
What is PEP ?
This is the use of Anti-retroviral drugs for a
short time to prevent likelihood of HIV
infection following exposure.Involves;
 Avoiding exposure
 Using drugs once exposed
Activity
Imagine a scenario whereby you accidentally get a

needle prick while handling a HIV positive patient, or
you are sexually assaulted by A HIV positive
stranger . Would this mean that you are definitely
(100%) infected with HIV?
Risk per exposure
 The risk of HIV transmission is not always 100% after
exposure
 The risk varies depending on type and nature of exposure
 Contaminated needle-out of 1000 exposed 3 will get HIV
 Non intact skin exposure –out of 1000 exposed 1 will get HIV
 IVDU –Out of 1000 sharing contaminated needles 7 will get
HIV
 Insertive vaginal-out of 10,000 exposed 3-9 will get HIV
 Receptive vaginal – out of 10,000 exposed 5-15 will get HIV
 Receptive anal – Out of 1000 exposed 8-32 will get HIV

Risk after sexual Assault
 Risk of HIV transmission after sexual assault not 100 %
 Consensual sex with HIV positive partner risk is 0.1-3 % per
episode
 In rape and sodomy risk is higher Why ?
 Trauma due to forceful penetration
 No Lubrication
 Disease status of the rapist-High viral load and presence of STI’S
increases the risk
 ARVS-TENOFOVIR AND LAMIVUDINE both taken twice
daily
 The victim will also require follow-up care and counselling

Steps in post exposure prophylaxis
• Assessment: eligibility for PEP,HIV testing,provide first AID
• Counselling: risk of HIV, risk and benefits of PEP, side effects,
adherence
• Prescribe: relevant drugs for 28days
• Follow up: test HIV after 3 months, prevention intervention
7. Blood safety
Why do people require transfusion ?

____________________________________________________
___________________________________________________________________
_____________________________________
___________________________________________________________________
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Need for transfusion
1. After massive blood loss i.e loss >40 %
 Road traffic accidents
 Bleeding after child birth
 Trauma due to assault
2. Coagulation problems –Blood does not clot
3. Severe malnutrition-body cannot make blood at all
4. Breakdown of red blood cells in the body due to infections e.g
septicaemia , Malaria
5. Haemolytic disease of the newborn
Process of Transfusion
1. Establish need
2. Take a sample from client for grouping
3. Grouped client blood sample is cross matched with
donor sample
4. If they do not react then client blood is considered
safe
5. Giving set is inserted on the client and transfusion
commenced
6. Monitoring is done regularly for any reaction
Transfusion infections
1. Hepatitis B , C
2. HIV
3. Treponema pallidum-causes syphilis
4. Other blood parasites like plasmodium –causing malaria

Transfusion precautions
1. Accept blood transfusion if it is absolutely necessary
2. Ask if there is an alternative to transfusion
3. Ensure the blood is screened for Hepatitis and HIV
4. Take the minimum needed to be safe e.g two or three pints

•Any questions?
THE END

HIV Prevention: HSCI 225 BY Mutua Moses Mulu

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HIV

What would you do if you were

In high HIV prevalence populations such as the

Imagine a scenario whereby you accidentally get a

 Receptive vaginal – out of 10,000 exposed 5-15 will get HIV

 Receptive anal – Out of 1000 exposed 8-32 will get HIV

 The victim will also require follow-up care and counselling

Why do people require transfusion ?

3. Treponema pallidum-causes syphilis

4. Other blood parasites like plasmodium –causing malaria

3. Ensure the blood is screened for Hepatitis and HIV

4. Take the minimum needed to be safe e.g two or three pints

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