Human Immunodeficiency Virus Infection, Research Paper Example

Introduction

The words Human Immunodeficiency Virus (HIV) causes people to gain a whole new perspective on life in general. This is a word that strikes fear into anyone who is diagnosed with the virus. HIV also causes anxiety and prejudice in those who are exposed to anyone that is diagnosed with the disease. The misconception is that HIV is a killer and easily transmitted. However it is neither. HIV is a viral infection that can results in a disease termed AIDS which can lead to death (Policy, 2010). The virus can be transmitted in a variety of fashions, the most common being sexual contact. However it can be transmitted to the fetus during pregnancy and even through blood transfusions if the donor is not regulated. However HIV can be controlled with the correct preventative measures.

The disease was thought to have originated in Africa although there is no conclusive proof to this statement. HIV was first discovered in healthy homosexual males in the USA and Europe in 1983. Since that time the disease has been labeled an epidemic by the World Health Organization (WHO). Until 2006 WHO reported that AIDS had killed more than 25 million people while HIV infected 0.6% of the world’s population. Approximately 22.5 million people of the global HIV population live in sub-Saharan Africa (Chirwa et al, 2010).

The first real identifiable case of HIV occurred in Los Angeles in 1983 when there was a sudden increase in the treatment of lung disease in healthy homosexual males. When the virus was isolated it was cross matched to cases in Europe that had the same profile and the term human immunodeficiency virus was born (CDC, 2000). Since this first case more than 1,400,000 people in the US have been diagnosed with the virus or have lost their lives to AIDs (CDC, 2011). At present the incidence of new patients has reached 58,000 people per year (CDC, 2011).

The state of Massachusetts has a percentage of people living with aids (17,400) that ranks it in the top twenty of all the fifty states in the USA (Massachusetts Department of Public Health, 2011). The demographics of the virus are split between the rural areas and the townships in and around the city of Boston. The incidence rate for the virus has been falling since the deployment of prevention programs and the number of deaths related to the disease has been dramatically reduced (Massachusetts Department of Public Health, 2011).

One set of cases and studies that has caught national attention of authorities that deal with HIV is the issue of the virus in the community from Lynn, Massachusetts. The age demographic was chosen to be 20 to 35 years of age (Youth and HIV/AIDS in the United States: Challenges and Opportunities for Prevention, 2010). The total number of cases in Massachusetts was found to be 19,244 and of those 420 were residents of Lynn (Massachusetts Department of Public Health, 2011). This is a relatively high percentage of the population, 0.65%, and studies showed it is a much higher number than similar suburban communities (Massachusetts Department of Public Health, 2011). In order to fight the disease a number of local programs were set up that would help in the prevention of the virus and also treat those patients already diagnosed with the disease (Regional HIV/AIDS Epidemiologic Profile of Lynn, Massachusetts: 2011, 2011).

This paper is an attempt to examine the contributing factors of the disease and the control and prevention methods used from the viewpoint of the Public Health Nurse. It focuses on the work and methods of the public health nurses that work on an individual basis with the patient and the key role they play in the disease prevention for the local population (Cook et al, 2010). In summary the paper will examine the data from a global, national, state and local standpoint and review the objectives of organizations to control the disease. Emphasis is given to the approaches adopted in the Lynn, Massachusetts area.

Epidemiology of HIV/AIDS Joseph – these headings need to follow APA format for font size and color.

The first set of symptoms of the diseases called human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) were recorded in the USA in the early 1980’s. This was due to a drastic rise in the treatment of lung diseases particularly of those in young to middle aged homosexual males who were considered otherwise healthy. The virus was identified after health agencies in the USA and Europe found similar symptoms in a vast demographic sample and research showed that the disease although prevalent in homosexuals was much more widespread. Due to these findings and a global explosion of the disease the World Health Organization declared the outbreak of the disease an epidemic and preventative measure were put in place.

Since the epidemic label was placed on the virus the more developed countries in the world have started programs that offer the individual advice and on the disease to prevent it’s spreading and also treatment for those that have been diagnosed with the disease. However the overall success of the plan of the World Health Organization is dependent in the strategy being implemented in the more under developed nations particularly in the countries in the sub-Saharan region of Africa that makes up 22% of the worlds infected population and the incubation hotbed for the disease (World Health Organization, 2010).

Figure 1: Global data for the number of people living with HIV and percentage of HIV prevalence (World Health Organization, 2010)

The chart shows that since the implementation of the World Health Organization program the prevalence of the infection has leveled off although the number of people is still increasing. This is primarily due to death rate of the HIV virus being reduced. During 2010 an estimated 2.65 million people were diagnosed with the virus including 400,000 children who contracted the disease while in the womb, through breast milk or during the labor process (World Health Organization, 2012). The number of deaths peaked in 2005 and the reduction has been credited with the introduction of antiretroviral therapy.

Figure 2: Number of people living with HIV and the number of newly reported cases in the United States (CDC, 2011)

The drop in the number of people newly infected offers a real sign of hope that the preventative programs are working at reducing the new incidences. Also as the number of those living with the disease is increasing and this signifies that the number of fatalities associated with HIV and AIDs has been dropping. This is mainly due to the availability and administration of drugs (Buchbinder, 2011: Hall, Song & Rhodes, 2008). It was also reported that an estimated 48.079 adults and adolescents were diagnosed with the disease in 2010. The breakdown revealed that the 79% of those newly diagnosed were males. There is no breakdown into homosexual and heterosexual types of sexual activities? (National Centre for HIV/AIDs Prevention, 2011).

Healthy People 2020

December 2010 was the launch date of the Healthy People 2020 campaign by the Department of Health and Human sciences. A number of epidemic classified diseases were identified to be studied and prevented strategies used to reduce diagnosed patients. The campaign had four defining points:

• Attain higher quality of live free of preventable disease.
• Achieve equity in health for all demographic groups.
• Create an environment that promotes good health.
• Promote quality of life across all stages of the disease or infection.

The program has very specific targets for the HIV/AIDS disease

Table 3: Targets of the Healthy People campaign (HealthyPeople.gov, 2012)

Each of the identifiable targets will be explained further in the section on prevention strategies.

Web Causality

The web of causation is defined as the interrelationships of several factors that can contribute or precipitate to the occurrence of a disease (Mosby, 2008). The disease is dependent on variables that are identified in the following figure. The exposure directly affects the occurrence of the disease but other factors can influence the manner in which the exposure can occur. These factors can be grouped into two categories; non-modifiable and modifiable. However it should be noted that the web changes between a global and national standpoint.

Figure 3: Web Causality dependencies. Each of the inputs to the disease is characterized as non-modifiable and modifiable. (Joseph Muiruri, 2012) Why have you not simply put the title of your unpublished paper here like you were asked to do?

Non-Modifiable factors

Non-Modifiable factors for are those situations or risk that cannot be truly affected by any outside intervention but may be altered. These include age, gender and race.

Age

In the case of the HIV/AIDs virus age is a very important factor in the prevention of the disease. Adolescents who are at the start of an active sex life are a very important demographic to target as an education program directed at them can cut down the incidence of the disease. It also follows that the highest incidence of the virus is in the age groups 20 to 49, the age when humans are at their most sexually active, either heterosexually or homosexually.

Sex/gender

The largest rate of incidence is the male population, both homosexual and heterosexual. Most of the prevailing and new cases are due to male sexual activity that is unprotected, the use of injectable drugs or both. These are the major contributing factors to the increase of patients diagnosed with the disease as these transfer mechanisms account for 60% of the total cases nationally and locally.

Race/ethnicity

Approximately 86% of the patients diagnosed with the disease are from the three main races, white, black (African American) and Hispanic. However the non-white communities have been disproportionately affected by both HIV and AIDs. It is also important to know that that most of the increase in the new cases of the virus has been in these two groups. In order to successfully prevent the disease from spreading emphasis must be placed on these two groups (CDC, 2009).

Genetics

HIV and AIDs are not genetic diseases. If a list of risk factors were drawn up influencing the disease genetics would have a no ranking. However it is important to study the genetics of patients that have the disease and that have varying effects of control. Genetics are critical to understanding the development of new drugs and treatment programs. If the genetics of individuals that have HIV but do not develop AIDs can be understood then it would be beneficial in the fight to combat the disease.

Family History

Although there is no proof in the genetic transfer of the HIV virus there may be some form of secondary influence in the form of family history of certain types of behavior. It has been well documented that certain “mental” diseases can be transferred through the family tree. These include alcoholism, smoking and gambling. It should also be noted that sexual promiscuity can also be related to the behavior of family members. Also the homosexual tendencies cannot really be transferred from parents to children.

Modifiable factors

There are several modifiable factors that can be included in the web for the HIV/AIDs virus.

Sexual Activity and Preferences

This is the largest factor in the fight against the epidemic as the main cause of transfer is through both heterosexual and homosexual sex. Around 80% of the national cases have been reported to be due to sexual activity and state and local levels back up this data. The practice of safe sex can dramatically reduce the incidence level of the disease and therefore access to condoms whether free or cheaply can help in the control of the disease (CDC, 2009)

Formal Education

People with a higher education level can be made aware of the dangers of the disease through lectures, advertisements and reviews. It was shown by the United Nations that HIV and illiteracy go hand in hand. Therefore the population with lower education levels will obviously be at risk. This is also related to race where it is thought, incorrectly as there is no data to prove this, that African American males are more likely to drop out of education program and therefore spike the incidence level of the virus. Pamphlets and articles, whether online or published can educate the population on the main aspects of prevention. However access may be limited to those parts of the population that are below a certain poverty level. The distribution of literature that appeals to all age groups can be achieved via meetings, lectures schools or door to door distribution in particularly highly affected areas.

Access to preventative services

This is vital to the prevention strategy. Screening for the virus and the distribution of drugs and preventative devices, such as condoms, is critical. The number of clinics and healthcare facilities that have specialists in the disease is also extremely important. Health insurance may also be a factor as some carries may view the disease as a preexisting condition and refuse to pick up the costs of treatment.

Income/economic

The population that is at a low income level will not have the education or the means to practice preventative methods. The segment of the population that has a high income level has more chance to be exposed to recreational drug use, especially injectable drugs like heroine. In this instance the same needle can be used for several individuals. This is also the case for hard core addicts that cannot afford to buy new hypodermic equipment and continually use the same needles.

Occupation and Unemployment

The availability of health insurance has always been related to the level of employment or occupation that individuals undertake. In certain cases the health insurance that is provided by the employer may not be enough to cover the expenses associated with the treatment of HIV if the person is not at a high enough level Unemployed people can get assistance from the government but this can only be for a set length of time. A nurse or care worker could assist the unemployed by referring them to the various organizations where they could get financial support for the treatment of the virus.

The unemployed person also has a significant amount of time on their hands and can resort to activities that can increase the exposure risk of the virus, for example experimenting with drugs (Cichocki, 2006)

Environment

Substandard living conditions such as government housing projects and subsidized buildings can affect the transfer of HIV. In certain cases the use of reuse of needles for injectable drugs is a problem. The public health nurse has to visit these locations and help in the educational aspects of the prevention and distribute any free material.

Risky Behavior

The incidence level of the disease increases when certain risky actions take place. The major transfer mechanism of the disease is through unprotected sex. The use of needles to perform homemade tattoos, or ear piercing can be a high source of the virus. Another item that can be called risky is the increase in popular sports that involve violence, such as Mixed Martial Arts. In lower income areas these sports have become popular but have no precautions in scrutinizing the health condition of the participants (Cichocki, 2006). The nurse would play a vital role in providing education and creating awareness on how HIV is passed from one person to another.

Religion

Religious belief, such as the catholic churches condemnation of condoms, can influence the level of incidence of the disease. This may also be true for other religions (Aaron, Yates, and Criniti, 2011). It is also known that certain religions take a very negative view on homosexuality and this can contribute to individuals being afraid to come forward and ask for screening services.

Legal

Interestingly this is a factor that people tend to forget about or just ignore. The prison population has been known to be a hotbed for homosexual activities that do not use any protection as most of the activity and be classified as male rape (avert.com, 2011) the victim of the rape is therefore infected and can transmit the virus additionally in the prison or when they are released from the facility. Another transfer mechanism in prison is the manufacturing of illegal tattoos using established by using dirty infected needles (Wohl, 2006). This type of transfer is very difficult to prevent (Wohl, 2006).