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HIV (Contact Mx (If exposed within 72 hrs, PEP via SHS or ED :red_flag:,…
HIV
Contact Mx
If exposed within 72 hrs, PEP via SHS or ED :red_flag:
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Definition: sexual contact, childbirth, breastfeeding, sharing injecting equipment, organ transplantation, blood transfusion, occupational exposure.
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Case Management
Confirm case
Case definition: newly acquired, unspecified and paed
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Western blot is definitive, but can be negative if virus present, depending on timing
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Case management
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Education: information, jurisdiction specific legal requirements, safe sex practice, inform not to donate blood
Special circumstances: HCW, sex worker
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PreP: taken by HIV- person to prevent risk, TasP taken by HIV+ person to prevent transmitting to others
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Point of care testing
Combination Ab/Ag test, results in 30 mins, requires follow-up testing, not recommended in low prevalence populations. Appropriately trained personnel.
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Transmission: vertical, blood borne, sexual. Viral load most important determinant of onwards transmission
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Guideline: SoNG, ASHM resources (Aus Soc for HIV Medicine)
PH priority: implications of late diagnosis, increases co-tranmission of other STIs, preventable. Most at risk in Aus: MSM and hetero who have sex with partner from high prevalence countries
90 90 90 targets: diagnosis 90% of people living with HIV, have 90% of those dx on ART, and 90% with an undetectable viral load
Routine prevention activities; education around safe sex, regular testing, safe injecting, antenatal testing, treating STIs that may increase liklihood of co-infection, universal precautions in HC settings, TasP
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Epi: Incidence in Aus stable, main t/mission MSM sexual contact (70%) > heterosexual sex (20%). Age-stdised HIV incidence 2x greater in Aboriginal vs. non-Aboriginal