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How Did HIV Spread?. Cities. dirty needles, unsafe blood transfusions. more sexual partners . greater mobility. How Did HIV Spread?. Jet travel. How Did HIV Spread?. How was the Epidemic Discovered?. HIV spread silently around the world for fifty years. 1930s. 1981.

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Cities

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  1. How Did HIV Spread? Cities • dirty needles, unsafe blood transfusions • more sexual partners • greater mobility

  2. How Did HIV Spread? Jet travel

  3. How Did HIV Spread?

  4. How was the Epidemic Discovered? HIV spread silently around the world for fifty years 1930s 1981

  5. How was the Epidemic Discovered? June 5, 1981 • Five cases • Los Angeles • pneumocystis pneumonia 30 Morbidity and Mortality Weekly Report 250 http://www.cdc.gov/mmwr/preview/mmwrhtml/00043494.htm

  6. = APB all points bulletin

  7. How was the Epidemic Discovered? November 5, 1982 • Just 17 months after the first LA cases • Similar pattern: hepatitis B • Possible cause: • unidentified bloodborne agent 31 Morbidity and Mortality Weekly Report at 577 http://www.cdc.gov/mmwr/preview/index82.html

  8. How was the Epidemic Discovered? December 10, 1982 • 1 month later • Infant: multiple blood transfusions developed AIDS • Donor had developed AIDS 31 Morbidity and Mortality Weekly Report at 652 http://www.cdc.gov/mmwr/preview/index82.html

  9. How was the Epidemic Discovered? And six months later?

  10. How was the Epidemic Discovered? June 1983 • French announce: • New bloodborne pathogen

  11. How was the Epidemic Discovered? 2008 The Nobel Prize in Physiology or Medicine Françoise Barré-Sinoussi Luc Montagnier

  12. How was the Epidemic Discovered? ARV HTLV-III LAV

  13. How was the Epidemic Discovered? HIV Human Virus Immunodeficiency

  14. How was the Epidemic Discovered? June 1981 June 1983 24 months

  15. HIV is bloodborne

  16. The Law Discrimination: People living with HIV & AIDS have the same civil rights as all persons living with serious illness. Mainstreaming Principle

  17. The Law Workplace Safety: Treat all blood, Universal precautions: at all as if it is infectious. from all sources, times, How We Protect Others

  18. The Law Privacy and Confidentiality: to protect Heightened privacy protections people living with HIV & AIDS from other people’sfear and stigma. How -- and Why -- We Specially Protect People with HIV

  19. The Law Discrimination Privacy and Confidentiality Workplace Safety HIV is Bloodborne

  20. AIDS/HIV Epidemics • contagious 1955 - 1981 • new BriefGolden Age • stigma of Infectious Disease Control • sexuality • race • death

  21. Case Study #1: Paramedics Should HIV information be broadcast?

  22. Case Study #1: Paramedics Discrimination Workplace Safety

  23. Case Study #1: Paramedics Privacy and Confidentiality Workplace Safety

  24. Case Study #1: Paramedics Privacy and Confidentiality Discrimination

  25. Case Study #2: Dentists Can dentists refuse to treat persons with HIV because of therisk to others? • Dentist • Staff • Other patients

  26. Case Study #2: Dentists Workplace Safety: Universal precautions: Treat all blood, at all times, from all sources, as if it is infectious.

  27. Case Study #2: Dentists What if there’s an accident??? But . . . • Cut off your hand? • Jump out the window?

  28. Case Study #2: Dentists Early 1980s: 200 HCWs died each year HBV seroconversion rate 1: 2.5 Late 1980s: HIV seroconversion rate 1: 250 “remote risk” lowered further by post-exposure prophylaxis (PEP)

  29. Case Study #2: Dentists US Supreme Court: School Board of Nassau County v. Arline 480 U.S. 273 (1987) “significant risk” “remote risk”

  30. Case Study #2: Dentists US Supreme Court: Bragdon v. Abbott 524 U.S. 624 (1998) Courts should defer to the reasoned judgement of public health officials, not the unsupported judgment of a single dentist.

  31. © 2002 - 2009 CITY OF LOS ANGELES

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