HIV & AIDS Resource Guide

HIV & AIDS Resource Guide

HIV & AIDS Resource Guide A guide for Macy s, Inc. associates This guide is designed to educate, inform and create awareness of HIV and AIDS. Through education and awareness, we can help increase the number of people nationwide who get tested and know their status, so they can live longer, healthier lives. Please Note: This is an informational resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This material is intended to be basic patient education. You should consult with your health care provider before making any healthcare decisions or for receiving diagnosis of, or guidance about, a specific medical condition. Designed to enhance the lives of Macy s, Inc. associates and their families. Live Healthy provides inspiration, incentives, and tools to create healthier lifestyles. 2 May 2017

Table of Contents Understanding Human Immunodeficiency Virus (HIV)... 4 Acquired Immune Deficiency Syndrome (AIDS)... 5 Facts HIV and AIDS... 5 Terminology Frequently Used... 6 HIV Symptoms and Next Steps... 6 Treatment... 9 Frequently Asked Questions... 10 Resources Available through the Macy s, Inc. Cigna Medical Plans... 12 3 May 2017

Understanding Human Immunodeficiency Virus (HIV) What is HIV? The Human Immunodeficiency Virus, or HIV, is the virus that causes an HIV infection. During an HIV infection, the virus attacks and destroys the infection-fighting CD4 cells of the body s immune system. Loss of CD4 cells makes it difficult for the immune system to fight infections. Here s an overview to help you understand more about what HIV is: H Human: This particular virus can only infect human beings. I Immunodeficiency: HIV weakens your immune system by destroying important cells that fight disease and infection. A "deficient" immune system can't protect you. V Virus: A virus can only reproduce itself by taking over a cell in the body of its host. HIV is a lot like other viruses, including those that cause the flu or the common cold; however, there is an important difference: over time, your immune system can clear most viruses out of your body, but that isn't the case with HIV. The human immune system cannot seem to rid the body of the virus and scientists are still trying to figure out why. HIV can hide for long periods of time in the cells of your body and attack your T-cells and/or CD4 cells a key part of your immune system. Your body must have these cells to fight infections and disease, but HIV invades them, uses them to make more copies of itself (the virus), and then destroys them. Over time, HIV can destroy so many of your CD4 cells that your body can no longer fight infections and diseases. When that happens, HIV infection can lead to Acquired Immunodeficiency Syndrome, or AIDS. How is HIV Transmitted? HIV is transmitted, or spread, through the blood, semen, genital fluids, or breast milk of a person infected with HIV. Having unprotected sex or sharing drug injection equipment (such as needles and syringes) with a person infected with HIV are the most common ways HIV is transmitted. You can t get HIV by shaking hands, hugging, or closed-mouth kissing with a person who is infected with HIV. And you can t get HIV from contact with objects such as toilet seats, doorknobs, dishes, or drinking glasses used by a person infected with HIV. Even though it may take years for symptoms of HIV to develop, a person infected with HIV can spread the virus at any stage. Detecting HIV early after infection and starting treatment with anti-hiv medications before symptoms of HIV develop can help people with HIV live longer, healthier lives. Treatment can also reduce the risk of transmitting HIV. 4 May 2017

Can treatment prevent HIV from advancing to AIDS? Yes. Treatment with anti-hiv medications prevents the virus from multiplying and destroying the immune system, which helps the body fight off life-threatening infections, cancers and prevents HIV from advancing to AIDS. While it may take many years, without treatment, HIV infection can advance to AIDS. Acquired Immune Deficiency Syndrome (AIDS) What is AIDS? Acquired Immune Deficiency Syndrome (AIDS) is the disease caused by HIV, which weakens the body s immune system until it can no longer fight off the simple infections that most healthy people s immune system can resist or control (such infections are called opportunistic infections ). Facts HIV and AIDS Only 10 percent of people who may be HIV positive actually know their HIV status. Only after people know their HIV status, do they take ownership of managing this condition. As with any chronic illness, early detection is the key to living longer. Numbers are increasing worldwide, especially in high-risk populations such as youth, women, and children. Effective treatment means more people with HIV in the workplace. Social implications of HIV (i.e., stigma and discrimination, legal issues) are still areas of concern, especially in low prevalence settings. Every day, more than 7,000 people around the world will be newly infected with HIV and join the 34 million already living with this disease. In the U.S., nearly 50,000 people are newly infected with HIV each year. Why is Macy s, Inc. bringing up HIV/AID at work right now? Macy s, Inc. wants to ensure your workplace is safe, supportive, confidential, and stigma-free. As a Macy s, Inc. associate, it is important to be aware of our Workplace Policy, which focuses on these areas: Environment: We offer a workplace that s supportive, non-hostile, and free of discrimination. At Macy s, Inc., we treat our co-workers with respect and dignity. There is zero tolerance for discrimination, harassment or workplace violence whether verbal, written, physical or sexual of any kind or form. Employment: We follow hiring practices that are fair, appropriate, and evenly-applied. Confidentiality: We enforce absolute confidentiality of all associate health information. How Can You Help Turn the Tide on HIV? Learn the facts Get tested and know your status Stop the stigma 5 May 2017

Terminology Frequently Used HIV antibody test: An HIV test that checks for HIV antibodies in a person s blood, urine, or fluids from the mouth. HIV antibodies are a type of protein the body produces in response to HIV infection. Mother-to-child transmission of HIV: The passing of HIV from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. Plasma HIV RNA test (viral load test): A test that measures the amount of HIV in the blood. This test is used to detect recent HIV infection or to measure viral load at any stage of HIV infection. Rapid HIV antibody test: An HIV antibody test that can detect HIV antibodies in blood or oral fluids in less than 30 minutes. Transmission of HIV: The spread of HIV from a person infected with HIV to another person through the infected person s blood, semen, genital fluids, or breast milk. Unprotected sex: Sex without using a condom. Viral load: The amount of HIV in the blood. One of the goals of antiretroviral therapy is to reduce viral load. Incubation period: The time between infection and the appearance of symptoms. Western blot: A type of antibody test used to confirm a positive HIV antibody or plasma HIV RNA test. Window period: The time period between when a person is exposed to HIV to the time they test positive for HIV antibodies can be up to 3-6 months. HIV Symptoms and Next Steps Symptoms can occur around a week to 10 days after HIV infection takes place, symptoms which are the result of the body reacting to HIV infection (clinically referred to as seroconversion ). The most common symptoms of recent HIV infection are severe flu-like symptoms, including a sore throat and fever, and a rash on the chest. Other symptoms can include fatigue, nausea and diarrhea. Around 70-90 percent of people recently infected with HIV experience these symptoms, and they are unusual in otherwise healthy people so these symptoms should indicate the need for an HIV test if they occur within six weeks of sex without a condom (especially with a new or casual partner). After two to three weeks these symptoms will disappear, and even if you see a doctor they may fail to recognize the signs of early HIV infection. A person with HIV may then live for many years without any further symptoms or indications that they are HIV positive. What should I do if experience symptoms of recent HIV? If you experience these symptoms of early HIV infection and you have recently put yourself at risk (had sex without a condom or shared injecting needles or drug equipment) then you should have an HIV test. 6 May 2017

Are there any other symptoms of HIV infection? The first stage is recent infection which is discussed above. The second stage of HIV infection is the 'asymptomatic' stage, and as the name suggests there are generally no symptoms, often lasting for as long as 10 years. The third stage of HIV infection is the symptomatic stage, where the body's immune system has become so damaged that it becomes susceptible to a range of opportunistic infections that would normally be prevented by the body's natural defenses (opportunistic means the infections take advantage of the weakened immune system in a way they wouldn't normally be able to in an otherwise healthy person). These infections include bacterial diseases such as tuberculosis, pneumonia and blood poisoning, fungal diseases such as oral thrush, and viral diseases. An AIDS diagnosis takes place at such a late stage of infection when one or more of the most commonly experienced illnesses linked to HIV occur (known as an AIDS-defining illness). Highly effective HIV medication will prevent the HIV infection from damaging the immune system so severely and can stop opportunistic infections or AIDS-defining illnesses. If I don t have any symptoms, can I assume I don t have HIV? No. If you have put yourself at risk, then you should still get tested for HIV and other STIs, regardless of whether you experience symptoms. You can find details of your local sexual health clinic here: http://www.fpa.org.uk/findaclinic. Can you test for HIV and AIDS? There is no such thing as an AIDS test as AIDS is simply a term which refers to a certain level of HIV progression, usually only occurring if HIV goes undiagnosed and untreated for some time. When should I take an HIV test? You should get an HIV test if you think you have exposed yourself to risk for example, if you have had sex without a condom with someone whose HIV status you do not know, or if you have shared injecting needles or drug equipment. If you are a sexually active gay or bisexual man, it is recommended to have an HIV test at least once a year, and more regularly if you have unprotected anal sex with new or casual partners. HIV tests are also recommended as part of a routine sexual health checkup. If you have recently had sex without a condom, and you experience severe flu-like symptoms (sore throat and fever) plus a rash on the chest, this could be symptoms of recent HIV infection and you should get tested as soon as possible. How soon can I get an accurate result from an HIV test? After a person has been infected with HIV, there is a gap commonly referred to as a window period where the virus will not be detected by a test. After this window period, you can then get a reliable test result telling you whether you are HIV positive or negative. If your test comes up positive, a confirmatory laboratory test may be recommended again after three months. If you think you have been exposed to risk of HIV infection, you should not wait for the four week window period to pass before seeking help. You should contact your local sexual health clinic or GP immediately and discuss your options. What types of HIV tests are available? Most HIV tests involve taking a blood sample which is then sent off to a laboratory for testing, but you can also get rapid tests which use a finger-prick or saliva sample. 7 May 2017

Where can I get an HIV test? You can get a test at your local sexual health clinic. You should also be able to get an HIV test when you visit your primary care physician, and they are also increasingly available in community settings. Go here to find a testing location near you: http://hivtest.cdc.gov/. How long will I have to wait for a test result? Rapid tests (using a pin-prick or saliva sample) can return results in less than 15 minutes. If you have a blood test which is then sent to a laboratory, the results can take up to two weeks, but are very often available sooner. 8 May 2017

Treatment What is the treatment for HIV? Antiretroviral therapy (ART) is the recommended treatment for HIV infection. ART involves taking a combination (regimen) of three or more anti-hiv medications daily. ART prevents HIV from multiplying and destroying infection-fighting CD4 cells. This helps the body fight off life-threatening infections and cancer. ART can t cure HIV, but anti-hiv medications help people infected with HIV live longer, healthier lives. What is the most common HIV test? The most common HIV test is the HIV antibody test. HIV antibodies are a type of protein the body produces in response to HIV infection. The HIV antibody test checks for HIV antibodies in a person s blood, urine, or fluids from the mouth. Generally it takes the body about three months from the time of infection to produce enough antibodies to be detected by an HIV antibody test. (For some people, it can take up to six months.) The time period between infection and the appearance of detectable HIV antibodies is called the window period. Because HIV antibodies are not detectable yet, the HIV antibody test isn t useful during the window period. What does it mean to test HIV positive? A diagnosis of HIV is made on the basis of positive results from two HIV tests. The first test can be either an HIV antibody test (using blood, urine, or fluids from the mouth) or a plasma HIV RNA test (using blood). The second test (always using blood) is a different type of antibody test called a Western blot test. A positive Western blot test confirms that a person has HIV. If I test HIV positive now, will I always test HIV positive? Yes. There s no cure for HIV at this time. Because you will always be infected with the virus, you will always test HIV positive. But treatment with anti-hiv medications can help you live a longer, healthier life. 9 May 2017

Frequently Asked Questions 1. Is HIV and AIDS the same thing? A: No. When someone is described as HIV positive, they have the HIV virus in their body. A person is considered to have developed AIDS when the immune system is so weak it can no longer fight off a range of diseases. 2. How can I get HIV? A: There are only four ways that HIV is spread: 1. Having unprotected sex 2. Sharing needles 3. Being born to an infected mother- HIV can be passed from mother to child during pregnancy, birth, or breastfeeding 4. Receiving transfusion of HIV-infected blood - In the U.S., all blood donations are tested for HIV/AIDS, and the risk of infection with HIV in the United States (through receiving a blood transfusion or blood products is extremely low) 3. Can I get HIV if there is dried blood on my equipment at work? What if blood splashes into my eye, or I get some in my mouth? A: No, you can t get HIV by touching dried blood. This is because HIV is inactive in dried fluids. The risk of getting HIV through blood splashes in the eye is extremely low. Blood in the mouth carries an even lower risk. If you think you are at risk, consult a health professional. 4. What should I do if a colleague or a customer cuts themselves and there is blood everywhere? I want to help but I m scared of getting HIV? A: Immediately contact anyone who is trained in proper health and safety procedures. It s always good practice to be safe, so you should assume that blood and other body fluids from any colleague or customer in this situation is potentially infectious. Therefore, use gloves and immediately wash hands and other skin surfaces after contact with blood or body fluids. With gloves, you don t have to worry about HIV transmission. 5. Can I get HIV from a mosquito bite? A: No. HIV does not reproduce in insects, so the HIV virus will not survive in a mosquito. When mosquitoes bite, they take blood from someone, but do not inject blood from any previous person. So no transfer of blood occurs. The mosquito does inject its own saliva however, which can spread infections like yellow fever and malaria- two illnesses that are not common in the U.S. 6. I hear a lot about knowing my status and getting tested, how do I know if and when I should have an HIV test? What do I have to do to get the test? A: The Centers for Disease Control recommends that HIV screening be a part of routine clinical care for all people aged 13-64. In other words, you should have an HIV test during a medical check-up, just like you have your cholesterol or blood sugar checked. In spite of that recommendation, however, most people are tested on the basis of their risk factors for getting HIV. You should get tested for HIV at least every year if you: Share needles/syringes or other equipment for injecting drugs Have a history of sexually transmitted diseases (STDs) Have had unprotected sex (vaginal, anal or oral) with multiple or anonymous partners Or, if you have had unprotected sex with a partner who did not know their own HIV status you should consult your health care provider to see how often you should be tested 10 May 2017

7. What if I test positive for HIV? A: If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well and live a long life. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health: See a licensed health care provider, even if you do not feel sick. Try to find a health care provider who has experience treating HIV. There are now many medications to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities. Have a TB (tuberculosis) test. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early. Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as methamphetamines) can weaken your immune system. There are programs available that can help you stop or reduce your use of these substances. Get screened for other sexually transmitted diseases (STDs). Undetected STDs can cause serious health problems. It is also important to practice safe-sex behaviors so you can avoid getting STDs. 8. Can I continue working if I have a positive status? A: Yes. Most people with HIV, and many with AIDS, are able to carry on working normally. HIV can be managed, and a person infected by the virus can continue to contribute to their community and continue working. Working can be very important to people who have a life-threatening illness. It can take their mind off some of the fear caused by the illness and, for many, may also be a matter of financial necessity. Returning to the routine of work is important to one s psychological well-being. 9. If I get an HIV test, do I have to inform my manager of my HIV status? A: No. Associates are not required to tell co-workers or managers about their HIV-status. In fact, it is a violation of Macy s, Inc. policies for a manager or associate to disclose any personal health information of any associate without their consent. 10. Would I be treated differently if I am HIV- positive? A: Macy s, Inc. strives to treat all of our associates equally, regardless of their HIV status. This means: Associates who are HIV-positive are managed no differently than colleagues with other health issues, such as diabetes or cancer. This includes the option to take time off if they are ill, as they would for any other illness. Associates who are HIV-positive are eligible to be promoted at Macy s, Inc. Associates cannot be dismissed by Macy s, Inc. from their jobs solely because they are HIVpositive. 11. What if I hear rumors that an associate has HIV? A: Inform your manager promptly of rumors, and you ll play a pivotal role in eliminating HIV-related stigma and discrimination from the workplace. Spreading rumors is unacceptable. All associates have the right to keep their medical information confidential, including HIV status. 11 May 2017

Resources Available through the Macy s, Inc. Cigna Medical Plans Preventive Screenings Preventive screenings are a key factor to early detection of any cancer or illness. When visiting your doctor to receive your preventive screenings, you are taking steps that could lead to prevention and early detection of health issues. Associates and spouses enrolled in a My Choice Plan medical option can each earn a $50 preventive care incentive for completing an approved preventive screening. Additionally, these annual preventive screenings are covered at 100% if you are enrolled in a Companysponsored medical option and visit an in-network doctor. For more information on the preventive services that are covered at 100%, please contact Cigna at the number listed on your ID card. For more information on preventive care and available screenings, visit the Helpful Tools page of My Benefits on My IN-SITE. Using Cost and Quality Tools to Select a Provider Visit www.mycigna.com to shop around and compare the costs for services in advance to get a true estimate of your payment responsibility based on the medical plan you are enrolled in. When looking for mental health providers look for the quality designation that is only given to providers that have met specific clinical performance and efficiency standards. 24-Hour Health Information Line Cigna participants can access support 24/7 when you need answers to your health care questions or help understanding treatment options. The 24-Hour Health Information Line number is listed on the back of your medical ID card; your call is always confidential and no-cost to you. Employee Assistance Program (EAP) The Cigna Employee Assistance Program (EAP) provides confidential 24/7 support for those everyday challenges, more serious problems and everything in between at no-cost to you. This program is available to associates (and their household members) who average a 20-hour work week. And, you don t have to be enrolled in a Cigna medical option. Through the EAP, you can access help and resources for situations such as: chronic condition support; securing credit and financial counseling; managing marital issues; depression; parenting and/or work-related stress; and coping with the loss of a loved one. You may receive this assistance over the telephone, or make arrangements to meet face-to-face with a licensed clinician in your area, and receive up to five covered visits. To access the EAP: 1-800-558-8361 or visit www.cignabehavioral.com. Under the I want to section, click log on to access your benefits, then enter macys for the Employer ID. 12 May 2017

Express Scripts, Inc. (ESI) Express Scripts is the prescription drug administrator for the My Choice Plans and the HMSA medical options. Plus, if you re enrolled in a My Choice Plan medical option, you have access to great pharmacy benefits such as no-cost and deductible waived medications! The annual deductible applies when you need to get most prescriptions, but for brand-name diabetes medications and supplies (including injectables), the deductible is waived and you just pay the 20% coinsurance. If you take a preventive, maintenance and/or diabetic prescription medication that is used to manage health care conditions such as high blood pressure, cholesterol and diabetes, review the prescription drug listings (available on the Helpful Tools page of My IN-SITE) and talk to your doctor about switching to one of the no-cost or deductible-waived medications to save your money! To access this cost-saving benefit from your My Choice Plan medical option, simply fill a 90-day supply prescription at a Walgreens or Duane Reade, or through Express Scripts convenient home-delivery service! 1-877-603-8396; www.express-scripts.com Accredo Accredo, an Express Scripts specialty pharmacy provides specialty medications and related services for patients with certain complex and chronic conditions. Specialty medications treat chronic illness (cancer, immune deficiency, multiple sclerosis etc.), and include injectable and other complex high-cost medication. For a complete list of conditions or more information please visit www.accredo.com or call 1-888-608-9010. Financial Assistance: Specialty medications can be very costly. If you have a financial hardship and need assistance with paying your specialty copayment, contact Accredo to find out more information about the various programs they may be able to help you with. Nurse Advisor Program The Nurse Advisor program is available to all Cigna participants and offers personalized support for complex or chronic conditions. The Nurse Advisor team includes trained nurses, coaches, nutritionists, clinicians and counselors who will listen and understand your needs and help you find solutions even when you are not sure. If you suffer from certain uncontrolled conditions such as diabetes, cardiovascular disease, metabolic syndrome, or you have health risks identified through Know Your Numbers and/or pharmacy and medical claims, a Cigna Nurse Advisor can help; nurses may reach out to you directly about the Disease Management Program. Associates and covered spouses, enrolled in a Macy s, Inc. Cigna medical option can actively engage in disease management coaching sessions that address specific health risks and goals to be eligible for a $100 incentive.* In order to receive the incentive, participants must complete program goals, including a preventive screening. *Only one incentive per enrolled participant per plan year Cigna: 1-800-558-8361; www.mycigna.com 13 May 2017

Additional Resource Links Centers for Disease Control and Prevention (CDC) National HIV and STD Testing Resources www.hivtest.cdc.gov Provides national HIV and STD testing locations and STD vaccines around the United States. Remedy Health Media The Body- The Complete HIV/AIDS Resource www.thebody.com/ The largest source of HIV and AIDS information. Read, listen or watch the latest HIV/AIDS news, research and resources. U.S. Department of Health & Human Services www.aids.gov Provides basic information about HIV/AIDS, HIV prevention, and HIV testing. For those just diagnosed with HIV, find information on what to do next. Learn how to stay healthy while living with HIV. WebMD HIV & AIDS Support & Resource Center www.webmd.com/hiv-aids/guide/aids-hiv-support-resources Provides help, support, and advice on living with HIV, living with an HIV positive partner, and on caring for someone with AIDS. Know Your Status June 27 is National HIV Testing Day www.knowyourstatustoday.com December 1 is World AIDS Day www.worldaidsday.org Sources: United States Centers for Disease Control and Prevention, The Join United Nations Programme on HIV and AIDS (UNAIDS), Terrence Higgins Trust and WebMD 14 May 2017