Introduction
Acquired Immune Deficiency Syndrome (AIDS) is the fifth leading cause of death in the United States among persons between the ages of 25 and 44. AIDS is caused by Human Immunodeficiency Virus (HIV). Once considered a disease solely affecting high risk groups, it has in the past two decades spread to rural America; in 2001 7.6 percent of the reported cases of AIDS in the U.S. were from rural settings. The initial symptoms of AIDS begin when the victim's CD4 cell count - also called "T-cells," a type of immune cell - fall below a bench mark of 200. While treatment of the disease is possible to varying degrees of success, prevention is the key, mainly through education as well as other strategies, according to the National Rural Health Association. Through early intervention and education, city officials, teachers, community activists, and health care providers can work together to mitigate this devastating disease.
Frequently Asked Questions
Tools
AIDS Education and Training Centers (AETC) National Resource Center (NRC)
Web site
Web site provides training materials, clinical information resources, news and other resources related to providing healthcare to patients with HIV/AIDS.
AIDSinfo
Hotline/Toll Free Telephone
Provides information in Spanish and English on HIV/AIDS treatment, prevention, and research. AIDSinfo Information Service is available Monday through Friday between the hours of 12:00 p.m. and 5:00 p.m. Eastern Time.
Call 1-800-448-0440 or 1-301-519-0459 (International) or 1-888-480-3739 (TTY/TDD). Send email to: ContactUs@aidsinfo.nih.gov.
Binational Directory of HIV/AIDS Services
Web site
Provides information on available HIV/AIDS
services to Migrant workers that travel throughout the United States.
CDC - HIV/AIDS
Web site
Provides information and resources including fact sheets, Question and Answers section, journal articles, reports, prevention and testing documents.
CDC - HIV/AIDS - Contact Us
Hotline/Toll Free Telephone
1-800-CDC-INFO (232-4636)
An AIDS hotline with Spanish Service and TTY Service that takes calls from people with questions about prevention, risk, testing, treatment and other HIV/AIDS- related concerns. Information Specialists are available 24 hours a day, 7 days a week, and can answer questions, provide referrals, and send free publications through email and postal mail. Formerly called the CDC National AIDS Hotline.
CDC National Prevention Information Network (NPIN)
Web site
A service of the CDC National Center for HIV, STD, TB Prevention. Provides an extensive collection of information and resources on HIV, STD and TB prevention.
Foundation Funding Guide: HIV/AIDS
Web site
Lists state and national foundations with an interest in HIV/AIDS.
HIV and AIDS: Medicines to Help You
Web site
A guide to help HIV/AIDs patients talk to their doctor about the HIV medicines they are taking. Provides basic facts about the HIV medicines that have been approved by the FDA.
HIV InSite
Web site
A gateway to in-depth information about particular aspects of HIV/AIDS and provides links to many authoritative sources.
HIV/AIDS
Web site
Provides data and information on the HIV/AIDS epidemic, including policy reports, fact sheets, and survey data, and HIV/AIDS initiatives in South Africa.
HIV/AIDS Awareness Days
Web site
Provides information to educate, motivate, and mobilize local communities in their fight against HIV/AIDS.
HIV/AIDS Bureau (HAB)
Web site
Formed to consolidate all programs funded under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act was signed into law on August 15, 1990 to improve the quality and availability of care for people with HIV/AIDS and their families.
HIV/AIDS Glossary
Web site
A glossary of HIV/AIDS terms designed to help health professionals, researchers, and people living with HIV/AIDS and their families and friends.
HIV/AIDS in the U.S.: The Basics
Web site
Contains links to key research, policy analysis, and the latest data and statistics on HIV/AIDS policy.
HIV/AIDS Information
Web site
Publications providing the latest news, data and statistics, prevention and treatment information, funding, and publications.
HIV/STD Prevention Guidelines for Native American Communities: American Indians, Alaska Natives, and Native Hawaiians
Web site
Guidelines to provide a framework to create HIV/STD prevention programs tailored to Native Americans, reflecting the unique culture of Native communities and a starting point for program development at the local level.
Know HIV/AIDS
Web site
Provides facts, free materials and a search tool for finding local testing sites for HIV/AIDS via the U.S. Centers for Disease Control and Prevention.
National HIV/AIDS Clinicians' Consultation Center
Hotline/Toll Free Telephone
Expert advice for health care providers caring for persons with HIV/AIDS or managing occupational exposures. Provides consultation that is:
current in the latest developments, customized, comprehensive (utilizing multi-disciplined team of healthcare providers), confidential, cost free, and toll free hotline available 24 hours.
National Minority AIDS Council: Tools and Resources
Web site
Provides a wide variety of resources and tools to assist with HIV/AIDS assistance. Includes a searchable database of community-based organizations providing HIV/AIDS assistance, HIV/AIDS hotlines, and a consultant database.
New Mexico AIDS InfoNet
Web site
An international resource for information on HIV/AIDS services and treatments easily accessible in both Spanish and English. Contains an index of fact sheets.
Rural Health Research: AIDS and HIV
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of AIDS and HIV, produced by the Office of Rural Health Policy's funded rural health research centers.
Supporting Networks of HIV Care (SNHC)
Web site
Provides free assistance to non-profit, community and faith-based organizations with the development or improvement of their ability to provide primary health care and support services to people of color living with or affected by HIV/AIDS.
Technical Assistance Resources, Guidance, Education, and Training (TARGET) Center
Web site
A central source of technical assistance information for the Ryan White Community, focused on the health needs of people living with HIV/AIDS.
U.S. - Mexico HIV/AIDS Service Providers
Print publication
Directory of HIV/AIDS service providers. Information available in Spanish.
Regulations, Forms & Other Useful Documents
Addressing HIV/AIDS: Latino Perspectives & Policy Recommendations
This policy document contains recommendations that can be used by governors, legislators, national partners, health departments and AIDS directors to address the challenges associated with HIV/AIDS in Latino communities. Discusses how the HIV/AIDS epidemic among Latinos is
shaped by ethnic/cultural differences, migration, socioeconomic status, regional differences (Border States, Puerto Rico) and geography (rural vs. urban), as well as behavioral risk.
Behavioral Interventions for Reducing Sexual Risk Behavior
Sponsoring organization: Rural Center for AIDS/STD Prevention
Identifies prevention activities developed or implemented to promote positive changes in behaviors to reduce HIV transmission and infection.
Clinical Manual for Management of the HIV-Infected Adult
Sponsoring organization: AIDS Education and Training Centers National Resource Center
This manual is intended for use by HIV primary care providers in collaborative practice models, for example, those involving medical, nursing, physician assistant, dental and pharmacy staff.
Date: 2006
Disparities in Care for HIV Patients: Results of the HCSUS Study
Sponsoring organization: RAND Corporation
Discusses the results of the HIV Costs and Services Utilization Study (HCSUS). This is the first comprehensive U.S. survey of health care
use among a nationally representative sample of HIV positive persons who were in care for their HIV.
Date: 2006
Fact Sheet: Black Americans and HIV/AIDS
Sponsoring organization: Kaiser Family Foundation
Highlights the epidemic's impact on African Americans, providing current data and trends over time.
Date: 05 / 2008
Fact Sheet: HIV/AIDS Epidemic in the United States
Sponsoring organization: Kaiser Family Foundation
Provides the latest data on the U.S. epidemic, including key trends over time, impact by region and population, and data on the U.S. government's response.
Date: 11 / 2006
Fact Sheet: Latinos and HIV/AIDS
Sponsoring organization: Kaiser Family Foundation
Fact sheet with the latest data on the impact of the epidemic on Latinos in the United States.
Date: 05 / 2008
Fact Sheet: Women and HIV/AIDS in the United States
Sponsoring organization: Kaiser Family Foundation
Highlights the impact of HIV/AIDS on women in the United States, providing current data and trends over time.
Date: 05 / 2008
Fact Sheets About Farmworkers: HIV/AIDS
Sponsoring organization: National Center for Farmworker Health
Brief information and statistics about HIV/AIDS and the migrant farmworker population.
HIV and AIDs
A unit (Unit 6) specifically on HIV and AIDs from the Rediscovering Biology Web site. Provides an overview of the human immune system and the viral life cycle; explores recent developments in the study of HIV/AIDs, the future global impact of current infection levels, and ethical issues surrounding current research and treatment.
HIV Education, Prevention, and Outreach Programs in Rural Areas of the Southeastern United States
Author(s): Miguel A. Zuniga, Robert J. Buchanan, Bonnie J. Chakravorty
Sponsoring organization: Rural Center for AIDS/STD Prevention
This study describes HIV education, prevention, and outreach activities, including barriers to providing these services, to clients in rural areas of Alabama, Louisiana, Mississippi, North Carolina, and South Carolina.
Date: 2005
HIV/AIDS Epidemic in the United States
Sponsoring organization: Kaiser Family Foundation
Provides the current data on the U.S. epidemic, including key trends over time, impact by region and population, and data on the U.S. government's response.
Date: 03 / 2008
HIV/AIDS in Rural America
Sponsoring organization: U.S. Department of Health and Human Services
Of the estimated 860,037 Americans diagnosed with AIDS through 2003, 52,375 live in rural areas with fewer than 50,000 people. About 7.6 percent of AIDS cases reported in 2003 were in rural areas, up from 5 percent in 1995.
HIV/AIDS Prevention and Treatment Services for American Indians and Alaska Natives
Sponsoring organization: Government Accountability Office
Discusses HIV/AIDS prevention services and education that was provided in all areas in a variety of settings, such as IHS-funded facilities, schools, and health fairs. Discusses rural populations as well.
Date: 12 / 2007
HIV/STD Prevention Guidelines for Native American Communities: American Indians, Alaska Natives, and Native Hawaiians
These guidelines provide a framework to create HIV/STD prevention programs
tailored to Native American persons, reflecting the unique culture of Native communities.
The guidelines provide a starting point for program development at the
local level.
Date: 2004
Improving US Global AIDS Policy for Young People: Assessing the President's Emergency Plan for AIDS Relief
Author(s): Naina Dhingra
Discusses the major shortcomings of the President’s Emergency Plan for AIDS Relief (PEPFAR) and Office of the Global AIDS Coordinator (OGAC) in addressing HIV/AIDS and young people.
Date: 05 / 2007
Living With AIDS: Students Tell Their Stories of Stigma, Courage and Resilience.
Author(s): Rebecca C. Jones
Sponsoring organization: National School Boards Association
Presents the stories of children who have AIDS and includes additional comments by their parents.
Date: 2006
National ADAP Monitoring Project: Annual Report
Author(s): Alicia L. Carbaugh, Jennifer Kates, Beth Crutsinger-Perry, Britten Ginsburg, Murral C. Penner
Sponsoring organization: National Alliance of State and Territorial AIDS Directors
Detailed data on the state AIDS Drug Assistance Programs (ADAPs), a part of the Ryan White Program, that provides HIV medications to low-income people with HIV/AIDS who have limited or no prescription drug coverage.
Date: 04 / 2008
Older Adults and HIV/AIDS (Fact sheet 17)
Author(s): April Winningham
Sponsoring organization: Rural Center for AIDS/STD Prevention
Discusses the characteristics and statistics of the older adult population that is infected with HIV/AIDS.
Date: 2006
Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
Author(s): Bernard M. Branson, H. Hunter Handsfield, Margaret A. Lampe, Robert S. Janssen, Allan W. Taylor, Sheryl B. Lyss, Jill E. Clark
Sponsoring organization: Centers for Disease Control and Prevention
These revised recommendations for human immunodeficiency virus (HIV) testing are intended for all health-care providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance abuse treatment clinics, public health clinics, community clinics, correctional health-care facilities, and primary care settings.
Date: 09 / 2006
Rural Methamphetamine Use and HIV/STD Risk (Fact sheet #18)
Author(s): Susan Dreisbach
Sponsoring organization: Rural Center for AIDS/STD Prevention
Discusses issues related to methamphetamine use in rural communities, including how it increases the risk of HIV/AIDs.
Date: 2006
State HIV Testing Laws
A compendium of State HIV laws that describes the policies, rules and regulations for standard and rapid HIV testing.
Date: 08 / 2007
Stigma as a Barrier to HIV Prevention in the Rural Deep South
Sponsoring organization: Rural Center for AIDS/STD Prevention
Discusses how the stigma of HIV can be a barrier to prevention methods in the Deep South.
Date: 2005
VIH/SIDA en los Hispanos
Sponsoring organization: HHS Office of Minority Health
Date: 06 / 2006
What is Retroantiviral Therapy (ART)?
Sponsoring organization: New Mexico AIDS Education and Training Center
Provides a definition of antiviral therapy for the treatment of HIV/AIDS. Includes an extensive list of approved drugs and their characteristics.
Organizations
AIDS Education and Training Centers National Resource Center (AETC)
National organization
The AIDS Education and Training Centers (AETC) Program of the Ryan White CARE Act currently supports a network of 11 regional centers that conduct targeted, multi-disciplinary education and training programs for health care providers treating persons with HIV/AIDS.
Mountain Plains AIDS Education and Training Center (MPAETC)
State/regional organization
Mission is to educate health care providers about HIV infection, including prevention, diagnosis, treatment and psychosocial issues. Serving
Colorado, Kansas, Nebraska, New Mexico, North Dakota, South Dakota, Utah, and Wyoming.
National Alliance of State and Territorial AIDS Directors (NASTAD)
National organization
Represents the nation's chief state health agency staff who have programmatic responsibility for administering AIDS health care, prevention, education and supportive service programs funded by state and federal governments. State AIDS Directors in all 50 U.S. states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific Islands are represented by NASTAD with an office in Washington, DC. Programs administered by NASTAD members serve every population affected by and infected with HIV. NASTAD has expertise in identifying community needs and responding to the challenges of the HIV epidemic nationwide.
National Association of People With AIDS (NAPWA)
National organization
Founded in 1983, the National Association of People with AIDS is a non-profit membership organization that advocates on behalf of all people living with HIV and AIDS in order to end the pandemic and the human suffering caused by HIV/AIDS.
National Minority AIDS Council (NMAC)
National organization
Dedicated to developing leadership within communities of color to address the challenges of HIV/AIDS.
National Native American AIDS Prevention Center (NNAAPC)
Tribal organization
A network of concerned Native people promoting HIV Prevention education by and for Native Americans. Mission is to stop the spread of HIV and related diseases among American Indians, Alaskan Natives, Native Hawaiians, and to improve the quality of life for those infected and affected by HIV/AIDS. Provides current information on HIV/AIDS, statistics, events, resources, and links to other sites.
National Network of STD/HIV Prevention Training Centers (NNPTC)
National organization
A CDC-funded group of regional training centers created in partnership with health departments and universities dedicated to increasing the knowledge and skills of health professionals in the areas of sexual and reproductive health. Provides health professionals a spectrum of educational opportunities, including experiential learning with an emphasis on prevention.
National Pediatric AIDS Network (NPAN)
National organization
A nonprofit organization that supports the work for children and adolescents with HIV/AIDS around the world. A resource for information about children and adolescents with HIV/AIDS.
Topics include: treatment; clinical trials;
services for children and adolescents with HIV/AIDS; conferences; publications and other information resources; educational resources.
New Mexico AIDS InfoNet
State/regional organization
A project of the New Mexico AIDS Education and Training Center in the Infectious Diseases Division of the University of New Mexico School of Medicine. The InfoNet was originally designed to make information on HIV/AIDS services and treatments easily accessible in both English and Spanish for residents of New Mexico. It has become an international resource for information on HIV/AIDS.
Promo-Vision
National organization
Works to strengthen community capacity to reduce HIV infection rates among Latinos by promoting and supporting promoters as agents of change. Promoters increase social capital that is invested in AIDS prevention, gender equity, and sexual health promotion.
Proyecto/Project IDEAS
State/regional organization
Srives to improve HIV prevention services for Latino/Hispanic populations living in Colorado, Iowa, Kansas, North Dakota, South Dakota, Missouri, Montana, Nebraska, Utah and Wyoming. Focuses on adapting and tailoring CDC-approved interventions that are culturally, linguistically and educationally appropriate. This is a capacity building assistance program for community-based organizations and state and local health departments.
Rural Center for AIDS/STD Prevention (RCAP)
National organization
The major focus of the Rural Center for AIDS/STD Prevention (RCAP) is the promotion of HIV/STD prevention in rural America, with the goal of reducing HIV/STD incidence.
Supporting Networks of HIV Care by Enhancing Primary Medical Care (SNHC)
National organization
A national technical assistance and capacity building project designed to develop, improve, and expand comprehensive HIV primary medical care and treatment service delivery in racial/ethnic minority communities severely impacted by HIV/AIDS through providing technical assistance, intensive capacity building, and regional meetings to primary medical care sites.
World Education
International organization
Works internationally in environmental education, community development, maternal and child health, school governance, integrated literacy, small enterprise development, HIV/AIDS education and prevention and care, and refugee training. Also works to strengthen literacy and adult basic education programs in the United States.
Terms & Acronyms
Acquired Immunodeficiency Syndrome (AIDS) "Acquired" means it is infectious, "immune deficiency" means the body has a weakness in its system to fight diseases, and "syndrome" means a group of health problems make up the AIDS disease. Technically, AIDS is the severe manifestation of the Human Immunodeficiency Virus or HIV. The Centers for Disease Control and Prevention (CDC) lists numerous infections and cancers that, in the presence of HIV infection, comprise an AIDS diagnosis. In 1993, CDC expanded the criteria for an AIDS diagnosis
in adults and adolescents to include CD4+ T cell count at or below 200 cells per microliter in the presence of HIV infection. In persons
(age five and older) with normally functioning immune systems, CD4+ T cell counts usually range from 500 - 1, 500 cells per microliter.
Persons living with AIDS often have infections of the lungs, brain, eyes, and other organs, and frequently suffer debilitating weight loss,
diarrhea, and a type of cancer called Kaposi's Sarcoma.
CD4 (T4) or CD4+ Cells A type of T cell involved in protecting
against viral, fungal, and protozoal infections. These cells normally direct the immune response, signaling other cells in the immune
system to perform their special functions. Also known as T helper
cells.
Clinical Trial A scientifically designed and executed
investigation of the effects of an intervention (drug, vaccine, biologic
or behavioral) administered to human subjects. The goal is to define
the safety, clinical efficacy, and pharmacological effects (including
toxicity, side effects, incompatibilities, or interactions) of the drug.
The U.S. government, through the FDA, requires strict testing of all
new drugs and vaccines prior to their approval for use as therapeutic
agents.
Co-receptors A group of proteins that have been found to
block the entry of HIV into immune cells.
Complete Blood Count (CBC) A frequently ordered
blood test that provides the white count, red blood cell count, red
cell indices, hematocrit, and hemoglobulin in a microliter of whole
blood.
End-stage Disease Final period or phase in the course of a
disease leading to a person's death.
Epidemic A disease that spreads rapidly through a demographic
segment of the human population, such as everyone in a given
geographic area; a military base, or similar population unit; or
everyone of a certain age or sex, such as the children or women of a
region. Epidemic diseases can be spread from person to person or
from a contaminated source such as food or water.
Epidemiology The branch of medical science that deals with
the study of incidence and distribution and control of a disease in a
population.
Human Immunodeficiency Virus (HIV) The virus that causes AIDS. This virus attacks and breaks down the body's immune system that fights off infections and disease. During the initial infection with HIV, the virus comes in contact with lymphoid tissue and finds susceptible T cells (see T cells.) This is the site where there is massive production and wide spread of the virus to lymphoid organs. The resulting immune response to suppress the virus is only partially successful and some virus thrive. Eventually, this results in high
viral turnover that leads to destruction of the immune system. HIV
disease is characterized by a gradual deterioration of immune functions. During the course of infection, crucial immune cells, called CD4+ T cells, are disabled and killed, and their numbers
progressively decline.
Immune System The body's complicated natural defense
against disruption caused by invading foreign agents (e.g., microbes,
viruses).
Latency The period when an infecting organism is in the body
but is not producing any clinically noticeable ill effects or symptoms.
In HIV disease, clinical latency is an asymptomatic period in the
early years of HIV infection. The period of latency is characterized
in the peripheral blood by near-normal CD4+ T cell counts. Recent
research indicates that HIV remains quite active in the lymph nodes
during this period. Cellular latency is the period after HIV has
integrated its genome into a cell's DNA but has not yet begun to
replicate.
Lymphoid Organ Includes tonsils, adenoids, lymph nodes,
spleen, thymus, and other tissues. These organs act as the body's filtering system, trapping invaders (foreign particles, e.g., bacteria
and viruses) and presenting them to squadrons of immune cells that congregate there. Within these lymphoid tissues, immune activity is
concentrated in regions called germinal centers, where the thread-like tentacles of follicular dendritic cells (FDCs) form networks that trap
invaders.
Ryan White C.A.R.E. Act Through the Ryan White
Comprehensive AIDS Resources Emergency (C.A.R.E.) Act, health
care and support services are provided for persons living with HIV/
AIDS. Health Resources and Services Administration (HRSA)
administers this Act. The metropolitan areas most affected by the
HIV epidemic are awarded Title I grants to improve and expand health care. Title II grants to states and territories support health care and support services for persons living with HIV/AIDS. Title III(b) supports early intervention in clinical settings. Title IV supports services for women, children, adolescents, and families affected by
the HIV epidemic. Part F of the Act supports Special Projects of National Significance (SPNS) and AIDS Education and Training
Centers (AETCs).
T Lymphocytes (T Cells) T Lymphocytes (T cells) are white blood cells derived from the thymus gland that participate in a variety of cell-mediated immune reactions. Three fundamentally different types of T cells
are recognized: helper, killer, and suppressor. They are the immune
system's "border police," responsible for finding infected or cancerous cells. The killer T cell receptors (TCR) bind to an infected
cell's distress signal - a combination of one of the cell's own proteins
and a tiny fragment of the invader's protein. The bits of foreign protein are made with the help of enzymes inside the infected cell that break down the pathogens into protein fragments, which are then picked up and carried through the cell membrane.
Window Period (for HIV) The time after a person first becomes infected with HIV and when the HIV test can detect that infection. 90% of HIV cases test positive within three months of exposure and remaining 10% test positive within three - six months of exposure.
Contacts
Information for patients:
CDC INFO
provides information specialists 24 hours a day, 7 days a week, who can answer questions, provide referrals, and send free publications through e-mail and postal mail.
1-888-232-4636 (CDC-INFO)
1-888-232-6348 (TTY/Deaf Access)
E-mail: cdcinfo@cdc.gov
Web site: http://www.cdc.gov/hiv/contact.htm
AIDSinfo is a web-based information center that operates a telephone service from 12:00 p.m. to 5:00 p.m. Eastern Time, Monday through Friday. English and Spanish-speaking health information specialists are available to answer questions about HIV/AIDS, treatment options, and navigating the website.
1-800-HIV-0440 (1-800-448-0440)
International: 301-519-0459
TTY/TDD: 1-888-480-3739
E-mail: ContactUs@aidsinfo.nih.gov
Web site:
http://aidsinfo.nih.gov
NIAID Intramural AIDS Research Program provides information about federal and private clinical trials conducted on HIV/AIDS.
1-800-243-7644
Web site: http://clinicaltrials.gov Information for clinicians/health care providers:
National HIV Telephone Consultation Service (Warmline) offers physicians and other health care providers up-to-the-minute HIV clinical information, and individualized expert case consultation across the broad range of clinical HIV/AIDS problems.
1-800-933-3413
Web site: http://www.ucsf.edu/hivcntr/Hotlines/Warmline.html
National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline) offers treating clinicians up-to-the-minute advice on managing occupational exposures to HIV, hepatitis and other blood-borne pathogens.
1-888-448-4911
Web site: http://www.ucsf.edu/hivcntr/Hotlines/PEPline.html
National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) provides free 24-hour clinical consultation on preventing perinatal transmission of HIV from mother to infant. Consultation focuses on the management of HIV-infected pregnant women and exposed infants as well as indications and interpretations of rapid HIV testing in pregnancy.
1-888-448-8765
Web site: http://www.ucsf.edu/hivcntr/Hotlines/Perinatal.html
Prevention Information:
CDC National Prevention Information Network
P.O. Box 6003
Rockville, Maryland 20849-6003
1-800-458-5231
E-mail: info@cdcnpin.org
Web site: http://www.cdcnpin.org/scripts/index.asp
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