June 9, 2003
Select the best answer for the multiple choice questions. There are 75 questions and 13 pages on
the examination. Each question will count one point. Notify the instructor if your examination
does not have 9 pages. Clearly indicate on the scan form the one best answer to each question
among the answers provided. Be sure that you have selected your choice correctly on the scan
form. Be sure that you have entered your name and identification number on the scan form and
filled out the columns for the letters of your name and numbers of your identification number
correctly (see front and back). Use a #2 pencil and fill all circles completely.
14476. What is the cost per confirmed HIV infection of testing for HIV in a population of one
million persons if the sensitivity of the Elisa test is 99.8% and the specificity is 99.9%, and
the sensitivity of the Western blot test is 99.8%? The unit cost of counseling plus the Elisa
test is $60, and the unit cost of the Western blot is $120. The total cost of the Elisa test
and counseling for the one million persons is $60,000,000, and for the Western blot test of
the Elisa test positives is $1,317,600. Nine hundred and eighty eight (988) persons were
confirmed to be HIV-infected:
a. 60,000,000 + 1,317,000 988 = $62,062
b. 60,000,000 - 1,317,000 988 = $59,396
c. 60,000,00 x .998 + 1,317,000 x .999 988 = $61,939
d. 60,000,000 + 1,317,000 1,000,000 = $61
e. Predictive value positive - predictive value negative x $60 x $120
14477. Individuals who test positive at home using the rapid test for HIV should first:
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Immediately start HAART treatment
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Initiate treatment first with nevirapine
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Get a confirmatory test
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Notify their sexual partners
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Write a will
14478. If all persons in the United States were tested for HIV using an Elisa test with a sensitivity
of 99.8% and a specificity of 99.9%, there would be:
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More false positives than true positives
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More true positives than false positives
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More false negatives than true negatives
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More false negatives than false positives
1
2
14479. Which of the following was NOT a social impact of the HIV epidemic on the Agay@
community?
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Men initially decreased the number of different sexual partners
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Men started practicing Asafer sex@
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There was an increase in the number of Agay@ support groups
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Most men switched to having sex with women
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There was an emergence of Agay families@
14481. Men of color are at increased risk of becoming HIV-infected because of their fear of
homophobia in their communities:
. True
. False
14482. What is the proportion of HIV Ag+ positive donors who are HIV Ab-?
. 1 per 100,000
. 1 per 500,000
. 1 per million
. 1 per 4 million
. 1 per 9 million
14484. The three guiding principles of ethical research involving humans are:
. Empathy, caution and truthfulness
. Respect for persons, beneficence and justice
. Respect for human dignity, compensation and integrity
. Beneficence, legal recourse and reimbursement
3
. Legal recourse, justice and compensation
4
14485. The most important component of human subjects protection is:
. Compensation
. Informed consent
. Taking only 10cc=s of blood
. Not asking personally embarrassing questions
. Providing the telephone number of the principal investigator
5
14491. The success of individual level interventions depends on:
. Reaching the riskiest individuals
. Reaching enough of the riskiest individuals
. Having an intervention that is sufficiently intensive
. All of the above
. a. and c. above
14492. The proportion of AIDS cases associated with injection drug use is higher among men
than among women in the U.S.:
. True
. False
14493. Party drugs such as ASpecial K@, GHB, Poppers and Ecstasy:
. Are associated with injection drug use
. Are associated with increased sexual transmission risk
. Are equally associated with both
. Are associated with neither
14495. In the U.S., which of the following drugs is most often associated with increased
unprotected sexual intercourse among men-who-have-sex-with-men?
. Heroin
. Cocaine
. Methamphetamine
. G-MA
. ASpeed ball@ (dual)
14496. Needle exchange programs have NOT been shown to reduce HIV prevalence:
. True
. False
14497. Methadone maintenance is associated with decreased injection and sex-related risk
behaviors in most studies:
. True
. False
6
14498. Injection drug users in many parts of Asia are easier to target for prevention and
intervention because:
. They usually remain part of their family
. They usually remain part of their community
. They tend to congregate in urban areas in countries like China
. All of the above
. a. and b. above
14499. Drug rehabilitation centers are a cost-effective strategy for controlling drug addiction
among young men in Asia:
. True
. False
14501. The major key to the success of the Multicenter AIDS Cohort Study (MACS) has been:
. The skill of the principal investigator
. The qualifications of the staff
. The significant amount of funding from the National Institutes of Health
. The commitment of the participants
. The sexual orientation of the staff
14502. Which of the following groups identified in the MACS is likely to provide key information
for development of a vaccine to prevent HIV infection?
. Long-term non-progressors
. High-risk seronegatives
. Low-risk seronegatives
. Long-term survivors with less than 50 CD4 cells
. Rapid progressors
7
14504. The diffusion of innovation strategy suggests targeting first the:
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Early innovators
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Middle innovators
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Late adopters
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The laggards
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All of the above
14506. With the use of highly active antiretroviral therapy given to the mother beginning in the
second trimester of pregnancy and to the infant for one week after birth, the risk of
transmission from mother to child can be reduced to:
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Less than 20%
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Less than 10%
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Less than 5%
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Less than 2%
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0%
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The risk is equal during all stages of pregnancy and delivery
14508. Factors which increase the risk of transmission from mother to infant include:
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The phenotype of the virus
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The stage of HIV disease in the mother
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The level of HIV in the mother
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All of the above
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b. and c. above
14509. Mixing/alternating breast feeding with formula feeding reduces the risk of HIV infection:
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True
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False
9
14510. Delivering the baby by C-section is recommended for mothers who are on highly active
antiretroviral therapy:
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True
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False
14511. Protease inhibitors do not reduce the risk of HIV transmission in infants because they do
not cross the placental barrier:
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True
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False
14512. The rate of HIV disease progression is highest in babies who were infected:
. In-utereo
. During the birth process
. During breast feeding
. The rate of progression is the same in all three of the above
14513. A slower rate of progression of HIV disease in the baby is associated with:
. The presence of high levels of neutralizing antibody in the mother
. The presence of high levels of neutralizing antibody in the baby
. Early appearance of HIV diversity in the baby
. All of the above
. b. and c. above
14514. The most important step in effective national control of HIV/AIDS is:
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Mobilization of political will and commitment
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Focused interventions to marginalized groups
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Reduction of stigmatization
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Identification of risk groups
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Suppression of risk groups
10
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All of the above
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a. and c. above
14516. The major barrier to the development of an HIV vaccine has been:
a. The cost of developing the drug
b. The lack of demonstrated natural immunity following HIV infection
c. The presence of two types of HIV: CD4-tropic and macrophage-tropic
d. The lack of political commitment for the development of a vaccine
e. Concerns about the safety of the vaccine
14517. The following are requirements for an effective HIV vaccine EXCEPT:
a. Must be safe
b. Must elicit a protective response
c. Must stimulate a cytotoxic lymphocyte response
d. Must stimulate IgM antibodies
e. Must be practical to produce, transport and administer
43. Current risk of getting infected with HIV through blood transfusion in the United States
is:
a. 1 per 1, 800,000
b. 1 per 1, 600,000
c. 1 per 9,000,000
d. 1 per 63,000
44. Which one of these is NOT a layer of safety implement in blood safety
in the United States?
a. Self exclusion in response to written material
b. Health history interview
c. Laboratory testing
d. Viral inactivation
e. Partner notification
45. The pool nucleic acid technology (NAT) testing used in the American
Red Cross will eliminate what proportion of the remaining viremic
window?
a. 10%-20%
b. 30%-50%
c. 60%-80%
d. 100%
11
b. HIV- clients
c. Sexual partners of HIV+ clients
d. Needle-sharing partners of HIV+ clients
12
48. Minimal risk is defined as one of the following:
a. The risk of an additional procedure performed solely for research
purposes, such as an additional CT scan
b. The risk encountered in daily life during the performance
of routine physical or psychological examinations or test
c. A procedure that may result in a little harm relative to the
standard procedures
d. The low probability that a subject will feel sick after participating
50. One of several factors that may be attributed to the resurgence of the
HIV epidemic among men who have sex with men in the United States
is:
a. Discrimination against men who have sex with men
b. Changes in beliefs regarding the severity of HIV disease
c. There are few intervention programs for men who have sex with
men
51. Recent CDC HIV testing guidelines state that all pregnant women in
the United States must be tested for HIV as a routine part of prenatal
care:
a. True
b. False
54. The two known types of HIV (HIV-1 and HIV-2) belong to a family of:
a. Lentiviruses
b. Oncoviruses
c. Spumaviruses
56. The type of first antiretroviral drug to show an effect in humans was:
a. Reverse transcriptase inhibitors
b. Protease inhibitors
c. Integrase inhibitors
d. gp120 blockers
e. A combination of the three above
58. The rate of new HIV infections is probably declining in which one of the
following Asian countries:
a. China
b. India
c. Vietnam
d. Myamar
e. Cambodia
62. In 2002, worldwide, the number of adults and children NEWLY infected
with HIV is:
a. 2 million
b. 3 million
c. 4 million
d. 5 million
64. During 2002, the highest number of HIV/AIDS cases occurred in which area?
a. Sub-Saharan Africa
b. Southeast Asia
c. China
d. Russia and the former Soviet Union
e. United States
65. The highest proportion of HIV-infected persons in the United States were in which risk
group?
a. Men-who-have-sex-with-men
b. Heterosexuals
c. Injection drug users
d. Plasma donors
e. Hemophiliacs
66. The risk group with the greatest rate of decline in the proportion of AIDS cases in the
United States has been:
a. Men-who-have-sex-with-men
b. Heterosexuals
c. Injection drug users
d. Plasma donors
e. Hemophiliacs
67. The advantages of using the saliva test include all of the following EXCEPT:
a. It is non-invasive
b. It is more acceptable to most people than giving a blood specimen
c. As many as five specimens can be pooled for testing
d. It is not necessary to keep the specimens cold during transport
e. It does not require sterile needles and syringes
70. Immune deficiency causing an inability of the immune cells to respond to infection occurs
immediately after HIV infection of the individual:
a. True
b. False
71. Which component of the HIV virion first attaches to the CD4 cell?
a. P24
b. GP41
c. GP120
d. The lipid envelope
e. Pol proteins
72. The major characteristics of adaptive immunity are all of the following EXCEPT:
a. Antigen specificity
b. Diversity
c. Memory
d. Self/non-self recognition
e. Immediate protection
73. The most effective cell of the immune system response to HIV is which of the following?
a. CD4 cells
b. CD8 cells
c. B cells
d. NK cells
e. Plasma cells