Epidemiology: HIV&AIDS in the United States
According to the HIV.gov website, more than 1 million people in the United States are currently infected with HIV, and one out of every seven people is not aware of their disease (U. S. statistics, 2018). Therefore, the purpose of this paper is to profoundly and elaborately analyze the current situation with HIV/AIDS in the United States. In order to achieve the identified goal, the essay will discuss the basic characteristics of the disease, its relation to the determinants of health and the epidemiological triangle as well as the role of community health nurse and national organizations in reducing the negative effects of the disease. Also, global implication of HIV spreading will be discussed.
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Description of the Disease Causes It is appropriate to begin the description of the disease with the discussion of its causes. First of all, it is essential to differentiate between HIV and AIDS since acquired immunodeficiency syndrome (AIDS) is a chronic condition, which is caused by the human immunodeficiency virus (HIV) (HIV/AIDS, 2018). According to the information provided on the Mayo Clinic website, HIV destroys white blood cells (CD4 T cells), which are responsible for maintaining the adequate strength and proper functioning of the person’s immune system (HIV/AIDS, 2018). Thus, the virus under consideration lowers the concentration of white blood cells in the organism and the immune system becomes weaker. When the concentration of CD4 T cells decreases to a certain point, a chronic condition is developed, which is known as AIDS. Symptoms It is possible to observe that the symptoms of infecting with HIV have considerable differences depending on the stage of the disease. However, they still share some common characteristics. According to the Mayo Clinic website, there are four primary phases: primary infection (acute HIV), clinical latent infection (chronic HIV), which has a symptomatic HIV infection stage, and later the disease progresses to AIDS (HIV/AIDS, 2018). The symptoms of primary infection appear within two months after the virus enters the organism, and they are the following: fever, headache, joint pain, muscle aches, rash, sore throat and swollen lymph glands (HIV/AIDS, 2018). The symptoms might be so mild that people often do not pay enough attention to reporting the disease. Chronic HIV stage may last for decades without extreme manifestations; however, in addition to previously mentioned signs, the following symptoms might occur as well: fatigue, diarrhea, weight loss, mouth infections and shingles (HIV/AIDS, 2018). If the chronic HIV is not treated properly, it progresses to AIDS. This condition is characterized by severely damaged immune system, and thus previously mentioned symptoms manifest themselves in extreme forms. Also, people with AIDS are at the risk of developing opportunistic infections and cancers, which are not likely to develop in people with healthy immune system. Modes of Transmission The virus is transmitted through various modes. First of all, HIV is a sexually transmitted disease, which means that it could be acquired from semenal and pre-semenal fluids as well as vaginal secretions. This means that vaginal, oral, and anal types of sexual interaction are all modes of transmission. The virus can be acquired from mouth sores or small tears, which sometimes develop in vagina and rectum during sexual interaction (HIV/AIDS, 2018). Another mode of transmission is represented by various kinds of blood transfusions. This mode includes not only direct blood transfusion, but also sharing items of personal hygiene (most notably, toothbrushes since they can also produce small tears in mouth). It is essential to mention that sharing needles and syringes used for injection of intravenous drugs is also put an individual at a high risk of acquiring HIV (HIV/AIDS, 2018). Finally, mothers infected with the virus can pass it to their babies during the period of pregnancy.
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Complications In addition to the symptoms, which were previously mentioned, it is also possible to identify several other complications caused by the infection. Due to the virus’ severe damage for the organism (primarily to the immune system), an infected individual develop a higher risk of acquiring other diseases. First of all, people with HIV are easier infected with tuberculosis, which is a leading cause of death among individuals with HIV (HIV/AIDS, 2018). Also, the Mayo Clinic website mentions the following opportunistic diseases for HIV-infected people: cytomegalovirus, candidiasis, cryptococcal meningitis, toxoplasmosis and cryptosporidiosis (HIV/AIDS, 2018). Such infections as cytomegalovirus, candidiasis, cryptococcal meningitis are normally less prevalent in healthy individuals and they does not produce such severe effects (HIV/AIDS, 2018). Toxoplasmosis and cryptosporidiosis are diseases acquired from parasites, which are spread by animals (HIV/AIDS, 2018). It is also of high importance to mention kaposi’s sarcoma and lymphoma as two types of opportunistic cancers, which are not normally acquired by people not infected with HIV (HIV/AIDS, 2018). Other complications include wasting syndrome, damage to the neurological system, and kidney disease (HIV/AIDS, 2018). Treatment It should be observed that there is no treatment that can cure HIV-infected people completely. However, the development of medicine in recent decades has significantly improved the tools for fighting the disease. Currently, people who are diagnosed with HIV at early stages and who receive an adequate treatment, can live relatively normal life (HIV/AIDS, 2018). According to the WebMD website, there are various approaches to treatment of HIV and AIDS, and antiretroviral therapy (ART) is mentioned to be among the most efficient and widespread means of reducing the effects of the disease (“How do you treat HIV?” 2018). It is also mentioned that antiretroviral drugs are numerous, and thus they are categorized into six main types. According to the website, the best approach to using ART is to combine medications from various categories. These drugs can cause various side effects; however, in the most cases they go away as soon as the body of the patient is adjusted to them (How do you treat HIV? 2018). The Demographics of Interest Further, it is of high importance to discuss the demographics of the disease. Firstly, it is appropriate to mention that statistics indicate increasing number of people infected with HIV: in 2014, 37,600 people in the United States were diagnosed with HIV, and in 2016, the number was 39,782 (U. S. Statistics, 2018). Also, various statistical data indicates that gay and bisexual men are the most affected demographic category, and whiting this category, young African American gay and bisexual men are at the highest risk (U. S. Statistics, 2018). Geographically, it is indicated that southern states account for 50% of new infections in 2014, being the most affected area in the United States (U. S. Statistics, 2018). Intravenous drug abusers comprise 9% of HIV diagnosis in the United States (U. S. Statistics, 2018). Heterosexual people are less affected by the disease, but they also comprise a considerable part of the infected population. Question of Reporting The question of reporting appears to be highly important in the context of the disease under discussion due to its high epidemiological potential. However, it is also appropriate to mention that HIV-infected people are also suffering from socially perceived stigma surrounding HIV (Turan, Budhwani, Fazeli, Browning, Raper, Mugavero, & Turan, 2017). Therefore, the surveillance and reporting data should be operated with caution.
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Thus, CDC issued the document that regulates the use of surveillance data about HIV in order to minimize the risk of breaking the individual’s confidentiality yet to contribute to the public health (“Data security and confidentiality guidelines for HIV”, 2011). This document represents the collection of guidelines concerning data collection, storage, share and use of information about HIV-infected individuals. The Determinants of Health and Their Contribution to the Development of the Disease It could be hardly doubted that the connection of the determinants of health and the disease under discussion is apparent. According to the article by Santos, Pedrosa, Aquino, Lima, Cunha, and Galvão (2018), the most important aspect of reducing the effect of HIV spreading in the public health sector is social support. Therefore, it is essential to primarily consider social determinants of health, which are defined by the authors as “a set of social, economic, cultural, psychological, ethnic/racial and behavioral factors that influence health” (Santos et al., 2018, p. 626). Also, it is of high importance to mention physical determinants of health as they also have a direct influence on the disease’s spreading. Among these determinants, it is possible to note such factors as beliefs about sexual behavior and sexual hygiene, personal hygiene, and health practices. The Disease in the Context of the Epidemiological Triangle Further, it is essential to observe the HIV infection in the context of its relations with the epidemiological triangle. The epidemiological triangle is a highly recognized and widely used framework to identify the potential risks of a particular disease to acquire epidemic status. The model consists of the analysis of relationships between three primary factors, which are agent, host, and environment factors. In the case under discussion, agent is the human immunodeficiency virus, which causes the disease. The virus is developed within its host, which is the human body. Environmental factors in this case can be considered to be the most contributing and diverse area of the epidemiological triangle. As it was previously stated in the paper, there are various ways through which a person can be infected by the virus. Even though HIV does not spread through water, air, and ordinary human contacts such as handshaking, kissing, hugging, etc., its epidemiological potential is significantly high. It is identified in this essay that gay and bisexual men as well as people who use intravenous drugs are at higher risk of acquiring the disease. Therefore, the environment, that surrounds the identified social groups are to be considered the primary sources of the disease’s spreading. Thus, it is essential to primarily focus on the environmental factors of the epidemiological triangle model. The Role of the Community Health Nurse It could be stated with certainty that the role of community health nurse in reducing and resolving of the issue under consideration is immense. As it is mentioned in the article by Bradley-Springer, Stevens, and Webb (2010), nursing professionals should clearly understand the importance of their contribution to fighting HIV and AIDS. It is apparent that nurses are the direct agents of the public health sector, who have primary influence on such aspects of maintaining public health as case finding, reporting, data collecting, data analysis, and follow-up. Each of these aspects was already mentioned in the paper at least to some extent; however, it is of immense importance to observe these responsibilities in the context of the nursing professional work. It is evident that case finding and reporting appear to be the most difficult yet the most important stages of reducing the effects of HIV because reporting and diagnosing of the disease on the early stages guarantees that the infected person will receive the adequate and timely treatment, which will be significantly efficient.
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Data collecting and analysis is another important step for every nurse who works with HIV patients. As it was previously mentioned, the disclosure of the patient’s personal information can cause social complications for the patient since HIV-related stigma is highly prevalent in the contemporary society. Therefore, it is every nurse’s responsibility to employ high ethical standards when working with the patient’s information. Finally, the aspect of follow up is of immense importance since the disease under discussion could not be completely cured. Thus, every HIV-infected individual needs constant follow-up and monitoring of his or her state of health. It is possible to observe that there are various interventions and approaches to follow-up in this context. Therefore, a community health nurse should be aware of their employment peculiarities and choose the follow-up practices, which are the most suitable for every particular situation. National Organizations Contributing to the Reduction of the Disease’s Spreading Due to the immense significance of the disease, there are numerous organizations in the United States, which aim to reduce the negative effects of the disease’s spreading. It is possible to exemplify AIDS United as one of the largest and most prominent organizations in this sphere. Their mission is to eliminate the HIV epidemic in America by “strategic grantmaking, capacity building, policy/advocacy, technical assistance and formative research” (“About AIDS United”, 2018). It is mentioned on the organization’s website that AIDS United has directly funded more than $104 million to local communities, and also the organization took part in partial sponsirings of various anti-HIV programs by danting more than $117 million to these initiatives (About AIDS United, 2018). Global Implications of the Disease According to the HIV.org website, global implications of HIV spreading are considerably serious. It is mentioned that at the end of 2016 approximately 36.7 million people worldwide are currently living with HIV/AIDS (Global HIV/AIDS Overview, 2018). It is also suggested that only 60% of the infected individuals are aware of their status (Global HIV/AIDS Overview, 2018). By the end of 2016, the overall number of people across the world who died from HIV had reached 35 million (Global HIV/AIDS Overview, 2018). Conclusion Epidemiological diseases represent one of the most evident and concerning threats to public health due to their immense for potential for affecting a large portion of the country’s population, and HIV appear to be one of the most important threats to American public health. It is apparent that this issue affects a considerable amount of the United States population, and various public health sector stakeholders are involved. In conclusion, it is possible to observe that this paper conducted a profound analysis of the current situation with HIV and AIDS. References About AIDS United. (2018). Web. Bradley-Springer, L., Stevens, L., & Webb, A. (2010). Every nurse is an HIV nurse. AJN The American Journal of Nursing, 110(3), 32-39. Data security and confidentiality guidelines for HIV, viral hepatitis, sexually transmitted disease, and tuberculosis programs: Standards to facilitate sharing and use of surveillance data for public health action. (2011). Web. Global HIV/AIDS overview. (2018). Web. HIV/AIDS. (2018). Web. How do you treat HIV? (2018). Web. Santos, V. D. F., Pedrosa, S. C., Aquino, P. D. S., Lima, I. C. V. D., Cunha, G. H. D., & Galvão, M. T. G. (2018). Social support of people with HIV/AIDS: The social determinants of health model. Revista Brasileira de Enfermagem, 71, 625-630. Turan, B., Budhwani, H., Fazeli, P. L., Browning, W. R., Raper, J. L., Mugavero, M. J., & Turan, J. M. (2017). How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS and Behavior, 21(1), 283-291. U.S. statistics. (2017). Web.