HIV/AIDS UPDATE 10
  Text: Substance Abuse Treatment for Persons With HIV/AIDS: TIP 37
               By: Steven L. Batki, MD and Peter A. Sewyn, MD, MPH
                                  Exam Copyright © 2000 by:
                              Institute of Addiction Awareness
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A. INTRODUCTION TO HIV/AIDS

01. Researchers believe the virus responsible for AIDS crossed over from 
________________ to humans when hunters were exposed to infected
blood.
a. monkeys        
b. chimpanzees
c. sheep
d. none of the above

02. In _____________ the number of new AIDS cases and deaths from
AIDS began to decline in the US.
a. 1981
b. 1996      
c. 1999
d. none of the above

03. A woman is _____________ times more likely to contract HIV though
vaginal intercourse if a man is infected than the reverse situation.
a. two
b. four
c. eight      
d. none of the above

04. Circumcision:
a. plays a protective role in preventing HIV infection.
b. can actually increase the rate of HIV transmission.
c. both a. and b. above       
d. none of the above

05. The ___________________ between the time of infection and the
time when an ELISA test for HIV becomes positive are called the
"window period".
a. 1 - 2 weeks
b. 6 - 12 weeks      
c. 6 - 12 months
d. none of the above

06. HIV prevalence is higher among:
a. African Americans.   
b. Hispanics.
c. Caribbean immigrants.
d. none of the above

07. The highest HIV and AIDS rates among at risk populations are:
a. men who have sex with men.        
b. intravenous drug users.
c. sex workers.
d. the homeless.

08. The ________________ region of the United States had the most AIDS cases.
a. Northeast     
b. North
c. South
d. Midwest

09. A recent study reported that the confirmed rate of AIDS cases among
incarcerated people in State and Federal prisons is more than
______________the general population.
a. twice as high as
b. four times higher than
c. six times higher than in    
d. none of the above

B. MEDICAL ASSESSMENT AND TREATMENT

10. Most enter medical care ______________________ of receiving
positive test results.
a. 3 days
b. 3 weeks
c. 3 months      
d. 1 year

11. __________________ theory describes the necessity that an
individual believe not only that an action will achieve its desired goal but
also that he will be able to perform the action effectively. 
a. Expectancy
b. Compliance
c. Self-efficacy         
d. none of the above

12. Postexposure Prophylaxis is administered _________ after exposure
to  HIV.
a. 24 hours
b. 48 hours
c. 72 hours        
d. none of the above

13. A normal CD4+ T cell count ranges from:
a. 5 to 14.
b. 50 to 140.
c. 500 to 1400.    
d. none of the above

14. The average yearly decline of CD4+ T cell counts in HIV-infected
clients is _________________  cells per year.
a. 10 - 30
b. 30 - 60
c. 30 - 90     
d. none of the above

15. In 1998 the prevalence of depression among HIV-infected persons
was estimated at ___________ percent.
a. 10 - 20
b. 20- 30
c. 30 - 40       
d. none of the above

16. The validated protocol for HIV/AIDS pain therapy is the
_____________ protocol.
a. American Society of Addiction Medicine
b. Department of Public Health
c. World Health Organization
d. none of the above      

C. MENTAL HEALTH TREATMENT

17. In some studies of substance abusers, the lifetime prevalence of
mental disorders is as high as ______ percent. 
a. 51     
b. 55
c. 79
d. none of the above

18. The percentage of HIV-infected substance abusers with psychiatric
disorders _________ percent.
a. 51
b. 55
c. 79
d. none of the above      

19. One study found ______________ of HIV-infected injection drug
users in treatment required psychiatric consultation.
a. 51
b. 55
c. 79       
d. none of the above
 
20. There is some evidence that certain psychiatric disorders such as
depression and antisocial personality disorder may be ______________
among HIV-infected persons with substance abuse disorders than among
HIV-infected gay men.
a. more common       
b. less common
c. equally common
d. unknown

21. Generally, dementia is most likely to occur in clients with CD4+ T cell
counts below __________.
a. 50
b. 100
c. 200          
d. none of the above

22. In a study of HIV-positive heterosexuals, depression was observed in
________ percent of study participants.
a. 14
b. 36
c. 40       
d. none of the above 

23. In a study of HIV-positive heterosexuals, anxiety was observed in
________ percent of study participants.
a. 14
b. 36      
c. 40
d. none of the above 

24. In a study of HIV-positive heterosexuals, suicidal ideation was
observed in ________ percent of study participants.
a. 14     
b. 36
c. 40
d. none of the above

D. PRIMARY AND SECONDARY HIV PREVENTION

25. Primary HIV prevention:
a. reduces the prevalence and severity of the disease.
b. reduces the incidence of transmission of the disease.     
c. none of the above 

26. Seconday HIV prevention:
a. reduces the prevalence and severity of the disease.       
b. reduces the incidence of transmission of the disease.
c. none of the above

27. A comprehensive approach to HIV prevention includes all of the
following goals EXCEPT:
a. Living substance free and sober.
b. Slowing or halting the progression of HIV/AIDS.
c. Reducing HIV risktaking.
d. Reducing the tranmission of HIV.        

28. Risk reduction counseling includes all of the following goals EXCEPT:
a. Maintaining abstinence.            
b. Help the client understand the need for behavioral change.
c. Provide psychological support for behavioral change.
d. Assist the client in developing the appropriate skills to sustain
behavioral change.

E.    INTEGRATING TREATMENT SERVICES

29. Efforts to develop integrated treatment for substance disorders and
HIV/AIDS should include all of the following components EXCEPT:
a. Maintaining individual program philosophies.       
b. A strong case management model.
c. Social services at the core of the treatment plan.
d. Cooperative eligibility determinations, which ofter are a key barrier to
achieving integrated care.

30. The Public Health Model is sometimes called the:
a. abstinence model.
b. risk-reduction model.      
c. none of the above

F.    ACCESSING AND OBTAINING NEEDED SERVICES

31. Case management is the term used for coordinated care of the HIV
infected substance abuser and involves all of the following EXCEPT:
a. monitoring abstinence.       
b. attempting to meet the multiple psychosocial needs of the client.
c. attempting to meet the multiple physical needs of the client.
d. none of the above

32. The signs that the team is not working effectively include all of the
following EXCEPT:
a. The needs of the client are being met.     
b. There is uneven or unequal participation.
c. One person dominates the discussions
d. Members do not show up for meetings.

33. Persons with HIV can have multiple prescriptions, and drug costs
may exceed $___________ per month.
a. 1000      
b. 1500
c. 2000
d. 3000

G.   COUNSELING CLIENTS WITH HIV AND SUBTANCE ABUSE DISORDERS

34. The interrelated challenges of both substance abuse and HIV
include all of the following EXCEPT:
a. both disorders are considered to be chronic, lifelong.
b. both are considered to be primary illnesses.       
c. a diagnosis of HIV infection or related conditions can be a stressor for
an individual already in recovery from a substance abuse disorder.

35. Overt homophobia:
a. includes violence, verbal abuse, an name-calling.      
b. includes social standards and norms requiring heterosexuality.
c. is acceptance and integration by lesbians and gays of the negative
attitudes expressed by society toward them.
d. is the system of advantages bestowed on heterosexuals. 



36. Cultural competence:
a. can be obtained by reading.
b. can be obtained by attending a workshop.
c. can be obtained by being a member of a minority group.
d. is a developmental process.        

H.    ETHICAL ISSUES

37. The Duty To Treat includes the healthcare workers right to refuse to
treat under certain situations.
a. True
b. False       

38. The Duty To Warn may supercede legal restrictions.
a. True
b. False       

39. When the client is facing End Of Life issues, the counselor should:
a. report all suicide threats.      
b. provide information on Hemlock Society and Compassion and Dying.
c. both a. and b. above
d. none of the above

40. Which of the following is not part of the Step-by-Step Model for
Making Ethical Decisions:
a. Identify the legal issues.
b. Identify the ethical issues.
c. Identify responsible parties.        
d. Follow up and evaluation.

I.    LEGAL ISSUES

41. Substance abusers with HIV/AIDS are protected from discrimination
based on disability by the:
a. Federal Rehabilitation Act.
b. Americans With Disabilities Act.
c. both a. and b. above      
d. none of the above

42. Current abusers have the same protection against discrimination in
the workplace, provided they are "qualified" and do not pose a "direct
threat" to others in the workplace.
a. True
b. False      

43. The Federal regulations regarding consent are required to contain
each of the items below EXCEPT:
a. The clients diagnosis.       
b. The name or title of the individual or organization that will receive the
disclosure.
c. The name of the client who is the subject of the disclosure.
d. The purpose or need for the disclosure.

44. Federal regulations permit the client to revoke consent:
a. at any time.
b. even if not in writing.
c. both a. and b. above       
d. none of the above    

45. Duty to warn is:
a. a matter of State law.       
b. a matter of Federal law.
c. both a. and b. above
d. none of the above

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