Transcript Women’s Health Issues HLTH 25

Paradox of Risk
• Its not who you are - it’s what you do
• On an individual level this is true
• The anus is an equal opportunity site for
HIV infection transmission
• AND
Disparities in HIV Distribution
• HIV is NOT equally distributed in the US or
internationally
• Some communities bear a heavier burden
of HIV infection
• On a population level-who you are does
make a difference in risk
Basic Prevention
Sexual
• Not taking blood, semen, pre-ejaculate or
vaginal secretions into mouth, vagina, anus.
Contact w/eyes, open cuts, wounds to be
avoided
• Avoid breast milk (greatest risk is for infants)
• Presence of another STD increases risk of
transmission
• “Safer Sex”- can reduce or eliminate risk
• Insertive partner at less risk than receptive
partner (though insertive partner can still be
infected)
Seroadaptation
• a range of HIV risk reduction strategies
undertaken based on one’s own and one’s
partner’s serostatus.
• Seroadaptation includes a range of HIV risk
reduction practices and refers to the selection of
sexual partners, practices and positions based
on one’s own and one’s partner’s serostatus, in
order to reduce the risk of contracting and/or
transmitting HIV.
• Serosorting is an example of seroadaptation
Basic Prevention
Shared Needles/Injection Equip.
• To completely eliminate risk, avoid sharing
needles or other equipment exposed to HIVinfected blood
• Dispose of used equip. at pharmacies and
needle exchange; access sterile equip at same
locations.
• Clean equip w/bleach to lower risk. Hard liquor,
rubbing alcohol, hydrogen also may lower risk of
infection. Soapy water may help reduce transmi
Basic Prevention
Perinatal (mother->fetus or newborn)
• Medical treatment during labor/birth
reduces risk of transmission; prenatal care
also reduces risk
• Sensitivity and referrals—choice to
conceive, carry, or abort a pregnancy
always remains with the individual woman
Basic Prevention
Blood Contact
• Universal precautions: wear gloves, goggles,
face masks and protective clothing when
performing procedures involving blood; dispose
of needles/sharps; wash hands after patient
contact
• Precautions w/blood and body fluids containing
blood
• Blood transfusion risk very low
• Casual contact with clients does not require
wearing protective gear
Biomedical Approaches to
Prevention
• Post-Exposure Prophylaxis (PEP)
-within 72 hrs of exposure to HIV,
medications may be accessed to try to
keep exposure from leading to infection
Pre-Exposure Prophylaxis (PREP)
-researchers still developing safe and
effective use guidelines-initial studies saw
average of 44% reduction in HIV
transmission in MSM in US w/ other
strategies including; monthly HIV testing,
condom provision, counseling, &
management of other STI’s
Harm Reduction
A public health strategy or set of strategies to
reduce physical, social, emotional, and
economics harms (individuals and communities)
from activities that may result in HIV infection or
other injury by reducing the risk of an activity;
while working to increase overall health and
well-being.
-Strategies determined by client
-Supported without judgment
Harm Reduction
• Meet clients “where they’re at”
• Works to minimize harmful effects rather than
ignore or condemn
• Acknowledges continuum of behavior from
severe abuse to total abstinence
• Establishes quality of life for
individual/community as criteria for successful
interventions and policies
• Non-judgmental/non-coercive provision of
resources and services
Harm Reduction
• Clients have a voice in creation of
policies/programs and affirms them as the
primary agents of reducing the harms of their
behavior
• Recognizes realities of race, class, poverty,
trauma, etc. affect people’s vulnerability to and
capacity for dealing with harm
• Does not minimize or ignore real harm and
danger associated with behaviors
Community Assessment-Mapping
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Deficits
Viewing a neighborhood as an endless list of needs and
problems undermines community wisdom and makes
development of solutions more difficult-denies wisdom of
communities
Directs funding to service providers, not to residents
Have to denigrate local leadership and community in
order to attract resources
Encourages perception that only outsiders can provide
help
Things must get worse in order for funding to continue
Doesn’t tap into energy of a community
Can never lead to serious change
Community Assessment-Mapping
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• Assets
The gifts and skills of individuals, households &
families
Citizen associations—religious, athletic, cultural,
recreational
Formal institutions: schools, libraries, parks,
police & fire stations, non-profits, social svcs.
Physical Characteristics-land, buildings,
infrastructure
Asset Mapping
For Next Time
-http://fog.ccsf.edu/jmarinof/
-Readings
-Do Definitions Assignment for Next Time (to
turn in)