HIV and AIDS

1
HIV and AIDS

• A School Health Perspective

2
What is HIV/AIDS?

• HIV (human immunodeficiency virus)/AIDS (acquired
  immunodeficiency syndrome) is an infectious
  disease caused by a virus that progressively
  destroys the bodys immune system.
• Video 1
• Video 2

3
What are the signs and symptoms?

• Children with HIV infection may show few signs or
  symptoms. Some may have
• Failure to grow and develop well
• Enlarged lymph nodes
• Swelling of salivary glands
• Enlargement of the liver
• Frequent infections, including pneumonia,
  diarrhea, and thrush (i.e., yeast infection on
  the surfaces of the mouth)

4
What are the incubation and contagious periods?

• Incubation period If the infection is acquired
  before or during birth from infected mothers,
  infants typically develop signs or symptoms
  between 12 and 18 months of age, although some
  remain symptom-free for more than five years.
• Contagious period Infected individuals can
  transmit the virus throughout their lifetime.

5
How is it spread?

• Contact of mucous membranes or openings in the
  skin with infected blood and body fluids that
  contain blood, semen, and cervical secretions
  also spread from mother to infant through
  breastfeeding.
• Contaminated needles or sharp instruments.
• Mother-infant transmission before or during
  birth.
• Sexual contact.
• HIV is not spread by the type of contact that
  occurs in child care and school settings, such as
  typical classroom activities, or with surfaces
  touched by infected people. It is not spread
  through saliva, tears, stool, or urine.

6
How can I control it?

• Standard precautions should be followed when
  blood or blood-contaminated fluids are handled.
  For blood and blood-containing substances, these
  are the same precautions described by the
  Occupational Safety and Health Administration
  (OSHA) as universal precautions

7
How can I control it? Cont.

• Wear disposable gloves
• Absorb as much of the spill as possible with
  disposable materials put the contaminated
  materials in a plastic bag with a secure tie.
• Clean contaminated surfaces with detergent, soap,
  and water.
• Rinse with water.
• Sanitize the clean surface by wetting the entire
  surface with a spray application of freshly
  diluted domestic bleach (1/4 bleach in 1 gallon
  water equals 1 tablespoon to a quart) and leaving
  this solution in contact with the surface for at
  least 2 minutes.
• Dispose of all soiled items in plastic bags with
  secure ties.

8
How can I control it? Cont.

• Admit children who are known to be infected with
  HIV whose health status makes their participation
  acceptable for their health status makes their
  participation acceptable for their health and the
  health of the others of the group, judged on a
  case-by-case basis by collaborative decision
  making involving the program director or school
  principal and a health professional who is
  knowledgeable about HIV.
• If the child has one or more potential risk
  factors for transmission of BBP, such as a skin
  rash or bleeding problems, the child should be
  assessed by the childs doctor, the child care
  program director or school principal to see
  whether the risk factors can be managed to allow
  the child to participate in the program or
  preclude contact with other children.

9
What are the roles of the teacher and family?

• Parent(s) do not have to share their childrens
  HIV status. If they choose to do so, this
  information should not be disclosed to staff
  without written permission of the
  parent(s)/guardian(s).
• Parent(s) of all children, including those with
  HIV, should be notified immediately if a case of
  a highly contagious disease, such as measles or
  chickenpox, occurs in group care settings.
• Parent(s) of children with HIV should consult
  with their childrens health professional when
  their children have been exposed to a potentially
  harmful infectious disease.
• All staff should receive annual education about
  standard precautions, which include OSHA
  requirements for universal precautions.

10
Exclude from group settings?

• The child has fever or behavior change.
• The child has weeping skin lesions that cannot be
  completely covered.
• The child has bleeding problems.
• The child meets other exclusion criteria

11
Conditions for Exclusion

• The illness prevents the child from comfortably
  participating in school activities.
• The illness results in greater need for care that
  the staff determine they can provide without
  compromising care for other children.
• The child appears severely ill, has a fever above
  101 (oral), 102 (rectal), or 100 (armpit), has
  diarrhea, blood in stool, vomits more than twice
  in 24 hours, abdominal pain for more than 2
  hours, mouth sores with drooling, rash with
  fever, Conjunctivitis, Tuberculosis, Impetigo,
  Strep, Head lice, Scabies, Chickenpox, Pertussis,
  Mumps, Measles, or Hepatitis A.

12
Readmit to Group Setting?

• A child who is known to have HIV and has been
  excluded because of risk can return when the
  childs health professional determines it is safe
  for the child to return.
• When skin lesions are dry or covered.
• When the child is able to participate and staff
  determine they can provide care without
  compromising their ability to care for other
  children.

13
HIV and AIDS in Louisiana

• Perinatal HIV/AIDS surveillance is the ongoing
  and systematic collection of information on HIV
  infected pregnant mothers and perinatally-exposed
  and HIV-infected children.
• As of December 31, 2006, a cumulative total of
  26,354 HIV/AIDS cases have been reported in
  Louisiana, including 294 pediatric cases.
• As of December 31, 2006, a cumulative total of
  17,591 AIDS cases have been diagnosed in
  Louisiana, including 132 pediatric cases.
• The cumulative number of deaths, among persons
  diagnosed with HIV/AIDS, reported to the
  Louisiana Office of Public Health through
  December 31, 2006 is 10,891, including 98 deaths
  among pediatric cases.

14
HIV and AIDS in Louisiana

• Although the number of women living with HIV in
  Louisiana has risen in recent years, perinatal
  transmission rates have dropped dramatically due
  to increased screening of pregnant women and
  increased use of antiretroviral therapy by
  pregnant women with HIV and their infants.

15
HIV/AIDS and Monroe

• 1238 cumulative cases have been detected in
  Region 8, including 14 pediatric cases.
• 497 cumulative deaths among persons in Region 8
  with HIV/AIDS have occurred, including 4
  pediatric deaths.
• 791 persons are currently living with HIV/AIDS in
  Region 8.
• Persons living with HIV 386
• Persons living with AIDS 405

16
HIV/AIDS Prevention in La.

• Department of Health and Hospitals
• Louisiana Department of Education