Reiki Center of Venice

HIV, AIDS, and Hygiene

2 CE Hours

#20-405749

Reiki Center of Venice

Francine Milford, LMT

www.ReikiCenterofVenice.com

FrancineMilford@cs.com

HIV, AIDS and Hygiene by Paul Milford, MSW and Francine Milford, LMT

Updated 2014 Edition

Updated 2023 Edition

Directions: The estimated time to complete this course is 2 hours.

To Complete this Course

Read this study guide and complete the open-book test that was included in this course.
Mail-or email-your answers to me at FrancineMilford@cs.com. Or you can mail in your answers to Reiki Center of Venice, P.O. Box 554, Venice, FL. 34285.
Mail, or email, your course evaluation to address listed above.
Please keep a copy of your answer sheet for your own records.

Disclaimer

Neither the author of this study guide, nor the Reiki Center of Venice, School of Massage Therapy and Bodywork, assumes any liability for the learner’s application of the information contained herein. This course is NOT intended for use in prescribing treatments, therapies or recommendations of any kind.

Course Instructor

Francine Milford, LMT, NCTMB is a massage therapist, personal trainer and owner/instructor at the Reiki Center of Venice, School of Massage Therapy and Bodywork. She is the author of 45 manuals and more than a dozen home study courses. She resides in Lakeland, Florida where she continues to teach onsite classes at the Center.

Paul C. Milford, MSW, is the author of published research in the field of infant development and the mother-infant relationship. He has a Master’s Degree in Social Work with an emphasis in Maternal and Child Health at the University of South Florida.

HIV, AIDS and Hygiene

© Reiki Center of Venice, LLC. 2011

Massage Provider# 50-9690

NCBTMB Provider# 31046-00

Objective

This course is designed to provide students with an understanding of HIV, AIDS, how they are transmitted, how HIV/AIDS affect the human body, and the risk factors associated with infection. You will be presented with recent statistics from the Centers for Disease Control (CDC) as well as information and graphs that help paint the picture of HIV and AIDS in America.

Unless otherwise stated, the figures and representations in the following course relate to HIV prevalence in the United States only. Additional information on global HIV/AIDS prevalence may be found online at the CDC’s website.

This course is part of a state-approved curriculum and is designed to convey the information necessary to be eligible for the state licensure exam in massage therapy. This course may also be used as part of a program designed to award certain Continuing Education (CE) credits in the state of Florida.

Learning Outcomes

You will learn the history of the AIDS/HIV infection in the United States
You will be able to implement safety precautions to control the spread of the virus
You will be able to identify key safety recommendations from the CDC to limit exposure
You will be able to identify key risk factors in the spread of the disease
You will be able to apply the Scope of Practice to sample cases
You will be able to set performance standards and expectations
You will be able to implement safety systems at your work station

What is HIV?

The human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. If left untreated, this virus can lead to AIDS (acquired immunodeficiency syndrome). Currently, there is no effective cure for HIV but with proper medical care, people with HIV can live otherwise healthy normal lives and protect their partners and children.

Where did HIV come from?

HIV came from a chimpanzee in Central Africa that jumped from chimpanzees to humans in the late 1800s. This chimpanzee version of the virus is called simian immunodeficiency virus and when it jumped to humans, it became the human immunodeficiency virus (HIV). Over the years, HIV spread across Africa and then to the rest of the world, hitting the United States in the 1970s.

How do I know if I have HIV?

The only way to know if you have HIV is to get tested so that you can precent getting AIDS or transmitting the HIV virus to others.

What are the symptoms of HIV?

For many people there may no symptom all but for others, the first illness to appear will be flu-like symptoms within 2-4 weeks after being infected. The symptoms may last only a few days or several weeks.

Additional symptoms may include a fever, swollen lymph nodes, sore throat, a rash, muscle aches, night sweats, mouth ulcers, chills, and fatigue.

Having these symptoms does not mean you have HIV because several other illnesses have these same symptoms, but if you have a fear of infection, then you should get tested.

Stages of HIV

There are 3 stages to the progression HIV.

Stage 1-Acute HIV Infection

In Stage 1, people have a large amount of the HIV in their blood stream and are considered highly contagious. People in this stage may have flu-like symptoms and if you do, please get tested.

Stage 2-Chronic HIV Infection

Stage 2 is also called asymptomatic HIV infection or clinical latency since the virus is still active and continues to reproduce in the body, but the individual may not have any symptoms or be aware that they are sick. The individual can still transmit the disease in this stage. If the individual receives HIV treatment, they may never have to move into Stage 3 (AIDS).

Stage 3-AIDS

Stage 3 is the most severe stage of HIV infection and is now called AIDS. Individuals with AIDS have a high viral load and can easily transmit HIV to other people. Because of a weakened immune system, people with AIDS often fall prey to opportunistic infections and illnesses. Without proper treatment, the survival rate of a person infected with AIDS is typically three years. (1)

(1). Content source: Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. June 30, 2022

How many people receive an HIV diagnosis each year?

In the United States, an estimated 1,189,700 people had HIV at the end of 2019. Of that number, only 87% of the people knew they had HIV. Each year, some 30,635 people receive an HIV diagnosis in the United States and other countries.

Does HIV affect different groups of people?

To some extent, HIV does affect some groups of people more than others. In 2020, male-to-male contact accounted for 68% of all new HIV diagnosis while heterosexual contact accounted for 22% of HIV diagnosis.

By race and ethnicity, it is noted that Black/African American people are most affected accounting for 42% of all new HIV diagnosis while Hispanic/Latino people account for 27% of all new HIV diagnoses.

By age, young people aged 13-24 are most affected by HIV accounting for 20% of all new HIV diagnoses.

Some 18,489 deaths occur among people with HIV.

Be region, HIV is largely an urban disease with most cases occurring in areas with 500,000 or more people. The South has the highest number of people living with HIV while the Northeast has the highest rate of people living with HIV. (2)

(2) https://www.cdc.gov/hiv/basics/statistics.html. June 21, 2022

U.S. Statistics

Content From: HIV.gov•Updated:October 27, 2022

Fast Facts

Approximately 1.2 million people in the U.S.^a have HIV. About 13 percent of them don’t know it and need testing.
HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay, bisexual, and other men who have sex with men.
In 2019, an estimated 34,800 new HIV infections occurred in the U.S.
New HIV infections declined 8% from 37,800 in 2015 to 34,800 in 2019, after a period of general stability.
In 2020, 30,635 people received an HIV diagnosis in the U.S. and 6 dependent areas—a 17% decrease from the prior year, likely due to the impact of the COVID-19 pandemic on HIV prevention, testing, and care-related services.
HIV diagnoses are not evenly distributed across states and regions. The highest rates of new diagnoses continue to occur in the South.

New HIV Infections (HIV Incidence)

HIV incidence refers to the estimated number of new HIV infections during specified period (such as a year), which is different from the number of people diagnosed with HIV during a given year. Some people may have HIV for some time but not know it, so the year they are diagnosed may not be the same as the year they acquired HIV.

According to the latest estimates from the Centers for Disease Control and Prevention (CDC), approximately 34,800 new HIV infections occurred in the United States in 2019. Annual infections in the U.S. have been reduced by more than two-thirds since the height of the epidemic in the mid-1980s. Further, CDC estimates of annual HIV infections in the United States show hopeful signs of progress in recent years. CDC estimates show new HIV infections declined 8% from 2015 to 2019, after a period of general stability.

Much of this progress is likely due to larger declines among young gay, bisexual, and other men who have sex with men (MSM) in recent years. From 2015 to 2019, new infections among young MSM (ages 13-24) dropped 33% overall, with declines in young men of all races, but Blacks/African American and Hispanics/Latino MSM continue to be severely and disproportionately affected.

Key Points: HIV Incidence

HIV incidence declined 8% from 2015 to 2019. In 2019, the estimated number of HIV infections in the U.S. was 34,800 and the rate was 12.6 (per 100,000 people).

By age group, the annual number of HIV infections in 2019, compared with 2015, decreased among persons aged 13–24 and persons aged 45-54, but remained stable among all other age groups. In 2019, the rate was highest for persons aged 25-34 (30.1), followed by the rate for persons aged 35-44 (16.5).

By race/ethnicity, the annual number of HIV infections in 2019, compared with 2015, decreased among persons of multiple races, but remained stable for persons of all other races/ethnicities. In 2019, the highest rate was for Blacks/African American persons (42.1), followed by Hispanic/Latino persons (21.7) and persons of multiple races (18.4).

By sex at birth, the annual number of new HIV infections in 2019, as compared to 2015, decreased among males, but remained stable among females. In 2019, the rate for males (21.0) was 5 times the rate for females (4.5).

By HIV transmission category, the annual number of HIV infections in 2019, compared with 2015, decreased among males with transmission attributed to male-to-male sexual contact, but remained stable among all other transmission categories. In 2019, the largest percentages of HIV infections were attributed to male-to-male sexual contact (66% overall and 81% among males.) In 2019, among females, the largest percentage of HIV infection was attributed to heterosexual contact (83%).

CDC, 2019 National HIV Surveillance System Reports, May 27, 2021

For more details on recent HIV incidence statistics, see Estimated HIV Incidence and Prevalence in the United States, 2015-2019.

HIV Diagnoses

HIV diagnoses refers to the number of people who have received an HIV diagnosis during a year, regardless of when they acquired HIV. (Some people can live with HIV for years before they are diagnosed; others are diagnosed soon after acquiring HIV.)

According to the latest CDC data, in 2020, 30,635 people aged 13 and older received an HIV diagnosis in the U.S.—a 17% decrease from the previous year, likely due to the impact of COVID-19. Trends varied for different groups of people.

COVID-19 Impact

CDC data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state and local jurisdictions.

Key Points: HIV Diagnoses

In 2020, MSM were the population most affected by HIV in the U.S.:

In 2020, MSM accounted for 71% of new HIV diagnoses in the United States.
In 2020, Black/African American MSM accounted for 26% (8,064) of new HIV diagnoses and 39% of diagnoses among all MSM.
In 2020, Hispanic/Latino MSM made up 21% (6,359) of new HIV diagnoses and 31% of diagnosis among all MSM.
From 2016 to 2019, HIV diagnoses decreased 7% among gay and bisexual men overall. But trends varied for different groups of gay and bisexual men.

Transgender people accounted for approximately 2% (635) of the 30,635 new HIV diagnoses in 2020.

Transgender women accounted for 2% (638) of new diagnoses.
Transgender men accounted for less than 1% (40) of new diagnoses.
By age, in 2020, the largest percentage (28%) of diagnoses of HIV infection among transgender persons was for transgender women aged 25-29 years, followed by transgender women aged 20-24 years (21%).

People who acquired HIV through heterosexual contact made up 22% (6,626) of HIV diagnoses in the U.S. in 2020.

People assigned male sex at birth who acquired HIV through heterosexual contact accounted for 7% of new HIV diagnoses.
People assigned female sex at birth who acquired HIV through heterosexual women accounted for 15%.
From 2016 to 2019, HIV diagnoses from heterosexual contact decreased 13% overall.

People who inject drugs (PWID) accounted for 7% of new HIV infections in the U.S. and 6 dependent areas in 2020.

Men who inject drugs accounted for 4% (1,198) of new HIV diagnoses.
Women who inject drugs accounted for 3% (857) of new HIV diagnoses.

By race/ethnicity, Blacks/African Americans and Hispanics/Latinos continue to be disproportionately affected by HIV:

In 2020, Blacks/African Americans represented 12% of the U.S. population but accounted for 42% of new HIV diagnoses (12,827).
Between 2016 and 2019, diagnoses among Blacks/African Americans ages 13 and older decreased 8%.
In 2020, Hispanics/Latinos represented 19% of the U.S. population but accounted for 27% of new HIV diagnoses (8,285).
Between 2016 and 2019, diagnoses among Hispanics/Latinx remained stable.

By age group, in 2020 people aged 13 to 34 accounted for more than half (57%) of new diagnoses. People aged 25 to 34 represented 37% (11,336) of those newly diagnosed.

By region of residence, HIV diagnoses are not evenly distributed. In 2020, 51% of those newly diagnosed with HIV lived in the South; 21% lived in the West; 14% lived in the Northeast; 13% lived in the Midwest; and 1% lived in U.S. dependent areas.

Most diagnoses are now highly concentrated in certain geographic areas. More than 50 percent of new HIV diagnoses in 2016 and 2017 occurred in 48 counties, Washington, D.C., and San Juan, Puerto Rico. These 50 jurisdictions are prioritized in Phase I of the Ending the HIV Epidemic in the U.S. initiative, along with seven states with a disproportionate occurrence of HIV in rural areas.

Living with HIV

At year-end 2019, an estimated 1.2 million people in the United States aged 13 and older had HIV in the U.S., the most recent year for which this information is available.

According to the latest CDC data:

About 13% of people with HIV in the U.S. don’t know it and so need testing. Early HIV diagnosis is crucial. Everyone aged 13-64 should be tested at least once. People at higher risk of acquiring (or exposure to) HIV should be tested at least annually. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3-6 months).
According to another CDC report, of the estimated 1.2 million people with HIV (diagnosed and undiagnosed) in 2019, about 65.9% received some HIV care, 50.1% were retained in care, and 56.8% were virally suppressed or undetectable. Having a suppressed or undetectable viral load protects the health of a person living with HIV, preventing disease progression. There is also a major prevention benefit. People with HIV who take HIV medicine (called antiretroviral therapy or ART) as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex.

Deaths

In 2020, there were 18,489 deaths among adults and adolescents with diagnosed HIV in the United States and 6 dependent areas. These deaths may be due to any cause, including COVID-19.

Need More?

For information about how HIV affects your state or county, visit America’s HIV Epidemic Analysis Dashboard (AHEAD), an interactive dashboard that lets you examine Ending the HIV Epidemic in the U.S. indicator data for all 50 states with a focus on 57 priority areas. Tracking this data at the community level serves to highlight our progress as a nation.

To learn about the United States response to the HIV epidemic, view the National HIV/AIDS Strategy. The Strategy provides stakeholders across the nation with a roadmap to accelerate efforts to end the HIV epidemic in the United States by 2030. The Strategy reflects President Biden’s commitment to re-energize and strengthen a whole-of-society response to the epidemic while supporting people with HIV and reducing HIV-associated morbidity and mortality.

Notes

^a Unless otherwise noted, the term United States (U.S.) includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the U.S. Virgin Islands.

^b Data for 2020 throughout this fact sheet should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and surveillance activities in state and local jurisdictions. For more information, view CDC's report commentary.

^c The term male-to-male sexual contact is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This web content uses the term gay, bisexual and men who have sex with men (MSM).

^d The term Black/African American is used in CDC surveillance systems. Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for people of African descent with ancestry in North America.

^e Hispanics/Latinos can be of any race.

^f This includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors)

^g The term transgender woman is used in CDC surveillance systems. Transgender woman includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender.

^h The term transgender man is used in CDC surveillance systems. Transgender man includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.

ⁱ This page uses the regions defined by the U.S. Census Bureau and used in CDC’s National HIV Surveillance System:
Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT
Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI
South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV
West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY.

Bibliography

CDC. Diagnoses of HIV Infection in the United States and Dependent Areas, 2020. HIV Surveillance Report 2021; 33.

CDC. Estimated HIV incidence and prevalence in the United States, 2015-2019. HIV Surveillance Supplemental Report 2021; 26(No. 1)

CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Dependent Areas, 2019. HIV Surveillance Supplemental Report 2021;26(No. 2).

HHS. America’s HIV Epidemic Analysis Dashboard (AHEAD). Accessed September 26, 2022.

PEPFAR

On September 30, 2020, the CDC supported the use of antiretroviral treatment for 10.5 million people living with HIV. This number represents only one third of all people on treatment worldwide. The support in conjunction with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

To date, the U.S. government has invested nearly $100 billion in the response to the HIV/AIDS disease making it the largest commitment by any nation to address this disease which has no cure to date.

PEPFAR also wants to increase the quality of life for people living with HIV and to stop the spread of the virus, early diagnosis of the infection is paramount. A person who is put on antiretroviral treatment can hope for a reduction of the HIV in their body to undetectable levels which may eliminate transmission of the virus to sexual partners.

Some of the HIV prevention strategies that the CDC supports in addition to HIV treatment include:

Prevention of mother-to-child transmission by keeping the mother on antiretroviral treatment from birth to the end of breastfeeding thus suppressing her viral load and practically eliminating HIV transmission to the child. Because of this, the new infant HIV infections declined by 50% and in 2019, 85% of pregnant women with HIV were on antiretroviral treatment to prevent transmission of HIV to their children.
Encourage the HIV-negative individual to take antiretroviral medicine daily to lower their risk of acquiring HIV through sexual intercourse.
Encourage male circumcision that may lower HIV transmission by up to 60%.

The CDC also supports HIV prevention, testing and treatment services for key population. This populations include:

Men who have sex with men
People who inject drugs
Female sex workers
Incarcerated populations

In 2019, the CDC shows that 67% of new HIV infections in the sub-Saharan Africa among young people are occurring in adolescent girls and young women.

According to WHO, the World’s Health Organization, Tuberculosis was the leading killer of people with HIV. (WHO.org, 26 October 2022)

What Care should you take as a Care Worker

Should someone else’s blood get on you, it’s important to stay calm. If your skin is unbroken (no sores, cuts, burns, or wounds) then the infected blood will not travel through the skin. However, it is still important to thoroughly wash the area with soap and warm water.

Massage therapists, energy workers, and other bodyworkers have little to no risk of exposure to HIV during typical practice. However, should the client have an open wound, sore, or burn, it is best to avoid the affected area. It may even be appropriate to suggest that the client return once they have healed. If, during a session with a client, they should have a bloody nose, cut themselves, or vomit blood-it is important to stop the treatment. If you have been exposed to the client’s blood, immediately wash the affected areas with soap and warm water. You can provide the client first aid, if necessary, only after placing latex gloves on your hands.

It is not unusual for an individual infected with HIV to also be infected with another sexually transmitted infection (STI). In fact, having HIV increases the chances of becoming infected with another virus. Recently, health professionals have noted an increased rate of co-occurring HIV and Hepatitis C infections. Hepatitis C is typically transmitted through blood and is a virus that affects the body’s liver. This infection, like HIV, is not curable. The presence of both of these viruses in the body is a cause for concern, as both can cause serious health problems and lead to serious disease. Screening for all sexually transmitted infections is available and recommended at least once per year for any individual who is sexually active or at increased risk for infection.

Treatment and Support

Though there is still no cure for HIV or AIDS, research continues to advance new medications and therapies that help to fight the symptoms of the virus.

A combination of medications is often recommended when treating HIV. This treatment, sometimes called a “drug cocktail” has been found to be the most effective way of fighting the virus’ replication in the body. Since each individual case is unique, it is important for the patient to meet with their doctor regularly to ensure the effectiveness of their medications. It is not unusual for certain medications to be added or removed or their dosages adjusted.

Currently there are five classes of anti-HIV drugs, and each of these classes blocks the virus by a different method. Some of these drugs block infected cells from replicating the virus’ genetic material, while others prevent the virus from attaching to new cells. It is recommended that those receiving antiretroviral therapy (ART) take at least three medications from two of the different classes of drugs. This helps to reduce drug-resistant strands of the virus from thriving in the body and allows for the best results for the patient.

Continuous monitoring by the individual’s healthcare team is necessary to determine the effectiveness of the medications and the progression of the virus. This is done by testing the patient’s CD4 levels and viral load. CD4 levels in the range of 600 – 1,500 are said to be normal and healthy. If a person with HIV has a CD4 count that falls below 200, they are diagnosed with acquired immunodeficiency syndrome (AIDS). The viral load is also monitored because a lower viral load is associated with the better outcomes. Levels lower than 50 are optimal for the health of the HIV infected individual, though the number can be as high as 30,000 for women and 60,000 for men. Regular treatment by the healthcare team is also needed to treat the side effects of the medications, screen for any new symptoms or illnesses, and ensure that the patient is sticking to their treatment plan.

Lifestyle changes are also recommended for those infected with HIV. Though medications are an important part in the individual’s treatment plan, they can’t do all the work. The individual must make adjustments to their diet and exercise habits. This includes reducing the intake of “junk food” and eating healthy options such as fruits, vegetables, grains, and proteins. Avoiding raw eggs, meats, fish, and unpasteurized milk are also recommended to decrease exposure to food-borne illness. Being active will also help strengthen the body’s immune system and increase the individual’s overall health.

In addition to medication, lifestyle changes, and continued monitoring with a healthcare team, it is crucial that those living with HIV/AIDS have a support network. This network can include friends, family members, or coworkers. Discussing one’s HIV status with others is often a highly sensitive and emotional subject. This type of disclosure requires a higher level of trust and comfort. Should someone share such information with you, the most important thing to do is to listen. Often, doctors may advise that HIV infected individuals should speak to a specialized psychotherapist. This treatment can help the individual cope with the psychological and social impacts that the virus carries. Additionally, a therapist may be able to recommend local support groups and resources that the client may not have otherwise known about.

The Power of Touch

For those of us in the health care or fitness industry, the power of touch is something we can all relate to. For those suffering from the stigma of HIV or AIDS, that touch may mean so much more.

In 1996, the Touch Institute took 29 men with HIV and offered them massage therapy services. The men in the study showed an improvement in their overall health as it related to improvements in their immune system.

In 2000, the Touch Institute tried another study, this time using HIV infected teenagers ages 13 through 19. The Institute took have of the group of teenagers (12 of them) and gave them seated relaxation massage twice a week for 20 minutes. The other group of teenagers was given just a guided relaxation exercises twice a week for 20 minutes. At the end of the study, the massage group showed an increase in T-cells and noted that they had less anxiety.

If you have HIV or AIDS and would like to add massage therapy to your current program, then it is important for you to find a therapist that is both skilled and knowledgeable about working with people who are infected. It is important that your therapist feels comfortable about your condition. By informing your therapist of your disease, they will be able to take precautions in case an accident occurs.

If you are a therapist, you should never work on someone with HIV or AIDS when you are sick. When a client has a suppressed immune system, your illness puts them at risk of becoming ill and even opens them to developing more severe and serious illnesses.

As far as massage go, you don’t have to work hard to give your client much needed body work. A gentle massage can reduce anxiety, tension, and stress. It can also help to ease muscle aches and pains, bring oxygen to organs and tissue, increase circulation and overall well-being.

Hygiene for Massage Therapist and Body workers

One of the most effective methods to prevent the transfer and spread of pathogens during massage is through hygienic hand washing techniques. Not only should you wash your hands before and after a massage, but you should also wash your hands during a session if you are planning on touching the face after massaging the feet.

The Hygienic Hand Washing Technique is a nine-step process.

Adjust water so that it is not too hot or too cold. Be sure that a sufficient stream of water is coming out of the tap to wash away any pathogens.
First wet the forearms and hands moving from the elbows down to the fingertips. You should always keep your hands lower than the elbows so that the water will flow off your fingertips.
Be sure you own a nail brush and use it to scrub the nails both on the outside of the nail as well as under the nail.
With soap, create lather and spread the soap from the hands to the elbows. It is best to use a liquid soap over a bar soap as the bar soap must be cleaned after each use. Don’t forget to wash in between the webs of your fingers and thumb.
Rub the soap over your skin for at least 2 minutes.
Rinse the soap off completely from fingertips to elbows (just like a surgeon). The water will flow off your forearms and elbows.
Dry your hands and forearms with a clean paper towel.
Use the same paper towel to turn off the faucet and to open the door handle to exit the area.
Be sure to toss the used paper towel in the waste basket.

At this point, be away that you have not cleaned your pump bottle or the doorknobs leading in to, and out of, your massage room and bathroom. If you touch any of these items with your cleaned hands you will only serve to contaminate them again. In fact, I have seen massage therapists wash their hands and then go back into the massage room when the client leaves to take off the dirty sheets, wash down the massage table and reset the table with new sheets. The entire time they are doing this, there is any number of contact points for them to come in to contact with pathogens.

So, what should you do?

To provide a safe and effective environment for you to work in, you must first give yourself ample time to properly take care of yourself and your massage equipment. That means that I will leave the room and wait for the client to exit the room. After they have left, I would strip down the massage table and wipe down the table and any equipment that I used during the session, including the massage lotion pump bottle. Then I would wipe down the doorknobs both inside and outside of the room. With the disinfected paper towel in my hand, I would use that towel to open the door to the rest room where I would then perform the Hand Washing techniques discussed earlier.

Too many places do not give you enough time to provide adequate and healthy techniques to your massage sessions. This is unfortunate and could be dangerous to you and your family. So, insist on at least 10 minutes between clients to properly prepare your room for clients.

Another item often overlooked is your hands. If you have any scrapes, cuts or wounds on your hands or forearms then you should cover them before coming in contact with your client. You can use finger cots, gloves, or even liquid skin to help put a barrier between you and your client. Your room should always have a pair of disposable gloves on hand just in case you come in contact with blood or other body fluids during your session.

Be aware that carpeted areas in a massage room are breeding grounds for pathogens of all kinds. Unless you are steam cleaning your rugs after each client, chances are your carpets are very unhealthy. If you drop a pillowcase, Kleenex, etc. on the floor-do not pick it up and use it. Treat it as contaminated and follow standard procedures for removing it from the room. I have already seen a therapist drop a face cradle cover on the floor, pick it up, and put in back on the face cradle for her client. What was worse was seeing a waitress dropping a sheet of paper on the floor in the kitchen of a restaurant, pick it up and put it inside of a food basket where the client’s order was then put in to and served. If possible, your floors should be tiled or wooden.

All massage therapists and body workers should follow simple rules to insure an optimal healthy working environment.

Keep your nails cut. The longer the nail-the greater the opportunity for you to harbor dead skin cells and pathogens.
Do not wear jewelry during sessions. Jewelry can harbor dead skin cells and pathogens.
Wear short sleeves. Be sure that no part of your clothing comes in contact with your client. Long sleeves can harbor dead skin cells and pathogens which you can then pass on to your next client or bring home to your family.
Be sure to practice good hand washing protocols.
Keep disposable gloves on hand in case of emergency.
Cover all cuts, wounds and scrapes with gloves, finger cots or liquid skin.
Take a shower before you go to work and again when you are finished with work
Be sure that the clothes that you wear in your session are clean when you begin your day and place in the dirty hamper at the end of the day. To be on the safe side, bring a change of clothes to work with you so that you can change before going home.
Be sure to sterilize your equipment in between each client. Do this not only for your own wellbeing but for the wellbeing of your client.
Wear disposable gloves when cleaning out the bathrooms and other surfaces to protect yourself against contaminated secretions. Discard the gloves when finished.
Wash all skin that comes in to contact with contaminated body fluids with a bleach solution of 1 part bleach to 10 parts waters (or other disinfecting solution).
Be sure to wash contaminated linens in hot water with bleach added (or throw them away).

Exercise and the HIV/AIDS individual

Exercise is an important component to the health of the HIV/AIDS individual offering those opportunities and group activities and socialization. Individuals, who can maintain their health while undergoing a regimen of drug therapy for their disease, will be better able to cope both physically and mentally with their situation.

Another component of the fitness regime is that it offers the infected individual with a more positive body image. Keeping physically fit will go a long way to keeping up the hopes and positive attitudes of infected individuals.

Just 30 minutes of exercise at least 3-5 days a week will help to maintain good health benefits. These exercises could include swimming, walking, aerobics, dancing, weight training and more. It is important to work within the client’s ability to perform an exercise routine. Some days will just be better than others. Stretching is an important part of the exercise routine and should be done before and after any exercise activity chosen.

Be aware that having HIV can increase the risk of developing foot pain, fatigue, dizziness, and other symptoms unique to the individual. Should your client develop any of these symptoms while under your supervision, be sure that they stop the activity and rest. Have your clients stay properly hydrated by drinking plenty of water before, during and after the exercise activity.

Some HIV/AIDS medications can cause lipodystrophy. This is a condition where the arms and legs lose their fat stores and instead fat starts to accumulate in the breast and abdomen area. Having your client add resistance training to their exercise routine may help to correct this condition.

How much activity your client will be able to do will be totally up to your client’s current health condition. Give these individuals enough time to complete their exercises at their own pace.

Hygiene for Fitness Specialists

All fitness specialists should follow simple rules to insure an optimal healthy working environment.

Keep your nails cut. The longer the nail-the greater the opportunity for you to harbor dead skin cells and pathogens.
Do not wear jewelry during sessions. Jewelry can harbor dead skin cells and pathogens.
Wear short sleeves. Be sure that no part of your clothing comes in contact with your client. Long sleeves can harbor dead skin cells and pathogens which you can then pass on to your next client or bring home to your family.
Be sure to practice good hand washing protocols.
Keep disposable gloves on hand in case of emergency.
Cover all cuts, wounds and scrapes with gloves, finger cots or liquid skin.
Take a shower before you go to work and again when you are finished with work
Be sure that the clothes that you wear in your session are clean when you begin your day and place in the dirty hamper at the end of the day. To be on the safe side, bring a change of clothes to work with you so that you can change before going home.
Be sure to sterilize your equipment in between each client. Do this not only for your own wellbeing but for the wellbeing of your client.
Wear disposable gloves when cleaning out the bathrooms and other surfaces to protect yourself against contaminated secretions. Discard the gloves when finished.
Wash all skin that comes in to contact with contaminated body fluids with a bleach solution of 1 part bleach to 10 parts waters (or other disinfecting solution).
Be sure to wash contaminated linens in hot water with bleach added (or throw them away).

2017-2019 Update on HIV-infected patients

In the United States, the life expectancy of an HIV-infected person has improved more than 10 years thanks in part to antiretroviral treatment (ART) drugs, at least for those patients who started taking them in 2008. Now, a 21-year-old person who started ART treatment in 2008 can expect to live to 79 years, and live healthier lives than those who started treatment in earlier years. All of this is thanks in part to more modern drugs, fewer toxic side-effects, and better treatment protocols.

Reference

Agence France-Presse. First Published: May 11, 2017, 18:19 IST. Updated May 11, 2017. “10-year lifespan gains for some HIV-infected patients: study, The life expectancy of HIV-infected people in Europe and the United States has been boosted by 10 years since anti-AIDS drugs became accessible in the mid-1990s.” Hindustantimes. Accessed on the website at https://www.hindustantimes.com/fitness/10-year-lifespan-gain-for-some-hiv-patients-study/story-GY8RivNAtKgF2q7oDBhuPK.html on Sunday, August 11, 2019

The discovery of antiretroviral therapy (ART) and using these drugs in combination with each other, has led to an increase survival rate among people living with HIV. But there still exists a small, but persistent gap in the lifespan between HIV-positive and HIV-negative individuals in certain populations. If you are an individual who is not white, has a history of injection drug use, or started ART treatment with low CD4 cell counts, then you may not see a reduction in mortality of see improvements in your life expectancy.

In The Lancet HIV, the Antiretroviral Therapy Cohort Collaboration (ART-CC), surmises that life expectancy remains lower in people living with HIV than in the general population, and there is little evidence of a mortality reduction in people who inject drugs.

References

Katz, Ingrid T and Maughan-Brown, Brendan (2017). Improved life expectancy of people living with HIV: who is left behind? Published online on May 10, 2017. DOI: https://doi.org/10.1016/S2352-3018(17)30086-3. © 2017 The Author(s). Published by Elsevier Ltd. Accessed from the website https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30086-3/fulltext on August 8, 2019.

For information on MPOX vaccines, etc., visit https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/monkeypox

FINAL EXAM

Open Book Test for HIV, AIDS, and Hygiene

Name__________________________________________________ Date ________________

Address______________________________________________________________________

MA #_________________________ Other License Number ___________________________

Email Address ________________________________________________________________

Contact Number _______________________________________________________________

After reading this course, choose the ONE best answer for each question and circle it. Remit test for grading to Francine Milford, 3230 Prairie Dunes Circle W, Lakeland, FL 33810, or email just the answers to FrancineMilford@cs.com.

Review Exam

1.) Recently, HIV infection has been found to be co-occurring with what other illness?

Meningitis
Hepatitis C
Schizophrenia
Hypertension

2.) HIV stands for which of the following?

human immune virus
human immunodeficiency virus
human intravenous virus
none of the above

3.) Where did HIV come from?

A chimpanzee in Central Africa
A bat in China
A human in the United States
None of the above

4.)) How many stages of HIV are there?

Two
Three
Four
Five

5.) It is estimated that how many new HIV infections occur each year in the United States alone?

10,000-15,000
15,00-25,000
25,000-30,000
30,000-35,000

6.) In 2020, this group of people accounted for 68% of all new HIV diagnosis.

Male-to-Male contact
Male-to-Female contact
Female-to-Female contact
None of the above

8.) In the United States, the highest rate of new diagnoses occurs in this region.

North
South
East
West

9.) At the end of 2019, there were how many people in the U.S. living with HIV?

1.2 million people
1.5 million people
2 million people
3 million people

10.) Which of these bodily fluids can transmit HIV?

blood
semen
vaginal fluid
breast milk
all of the above

11.) Which of these fluids do NOT transmit HIV?

sweat
tears
urine
all of the above

12.) HIV infection can be transmitted through which of the following activities?

handshakes
hugging
oral sex
showering

13.) Antiretroviral medications have side effects that include which of the following?

anemia
nausea and or vomiting
pain and damaged nerves
none of the above
all of the above

14.) As a massage therapist, or other body worker, HIV infection can be prevented by:

never touching open or bleeding wounds, burns, or other conditions.
using gloves to clean any areas that may have been exposed to infected bodily

fluids.

thoroughly washing hands if exposure to bodily fluids occurs.
all of the above.

15.) If a client in a treatment session should get a nosebleed, you should:

Stop the treatment
Continue treatment as though nothing happened
Hand client a tissue and continue with treatment
None of the above.

Cost: $10 for HIV, AIDS, and Hygiene-2 ce's.