HIV Epidemiology Paper Discussion

Write a paper in which you apply the concepts of epidemiology and nursing research to HIV communicable disease. Refer to \”Communicable Disease Chain,\” \”Chain of Infection,\” and the CDC website for assistance when completing this assignment. Epidemiology Paper Requirements 1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc. 2. Describe the social determinants of health and explain how those factors contribute to the development of this disease. 3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population? 4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community. 5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease. 6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example. A minimum of three peer-reviewed or professional references is required. HIV Epidemiology Paper Discussion

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Causes

The HIV virus causes infection with HIV and humans get infected after the retrovirus gains entry into the body and weaken the CD4 and immune system of an individual. This virus resides in breast milk, sexual fluids, and human blood.

Symptoms

Primary HIV infection ha the symptoms of headache, swollen lymph glands, joint pain, rash, flu-like illness, fever, painful oral sores, muscle aches, and a sore throat. These symptoms may be very mild and difficult to notice. In the later stages of latency infection, the lymph nodes may swell without other clinical symptoms (Maartens, Celum & Lewin, 2014). During the symptomatic period, HIV patients begin to experience shingles, diarrhea, fatigue, fever, weight loss, and oral thrush.

Mode of Transmission

The principal mode of HIV transmission is by contacting body fluids such as blood or semen that are infected. Unprotected sexual intercourse with a person who is infected is the main transmission mode although blood transfusion with infected blood also leads to infection with HIV. Another risk of transmitting the infection is the sharing of sharp and piercing objects such as knives, razor blades, and needles with an infected person (Maartens, Celum & Lewin, 2014). An unborn fetus may also acquire HIV from the mother through vertical transmission during pregnancy. The child may also acquire HIV during delivery or breastfeeding though such modes of transmission may be mitigated through ARV intake. HIV Epidemiology Paper Discussion

Complications

The major complications of HIV in the advanced form of the disease are the HIV wasting syndrome, tuberculosis, toxoplasmosis, candidiasis, cytomegalovirus, cryptococcal meningitis, Kaposi’s sarcoma, and lymphomas.

Treatment

Currently, there is no cure for HIV. However, regular intake of antiretroviral therapy reduces viral replication by boosting CD4 count and enhancing the immune system. ARV’s maybe in the form of protease inhibitors, reverse transcriptase inhibitors, fusion inhibitors or integrase inhibitors (Maartens, Celum & Lewin, 2014). These drugs are taken in a combination of 3 to increase their effectiveness. However, most patients currently prefer fixed-dose combinations due to the reduced number of pills that the patients are required to take.

Demographic of Interest (mortality, morbidity, incidence, and prevalence)

By the year 2018, the CDC estimated that PLWH were 37 million hence, HIV is considered to be a global pandemic. The prevalence of HIV is 0.8% among adults. However, since the first incident of HIV infection, over 77 million people have been affected so far and about 35.4 million have lost their lives out of illnesses related to HIV and AIDS (Huang et al., 2016). Over 950,000 patients reportedly died of HIV in 2017, indicating a significant drop from the 1.4 million deaths reported in 2010. Unfortunately, middle and low-income families, especially in the developing nations, constitute a majority of these statistics. Sub-Saharan Africa constitutes 65% of this total statistics.

HIV/AIDS as a reportable Disease

In the United States, HIV is classified as a notifiable disease which is supposed to be reported to the Director of Public Health at the point of diagnosis (Huang et al., 2016).  The U.S believes that this early reporting facilitates easy identification of any outbreaks of the disease within a precise time when measures can be taken. Making early reports of new cases enables close monitoring and initiation of appropriate intervention measures to lessen the burden of the disease.

The Social Determinants Of Health And Their Contribution To The Development Of HIV

There are specific socio-economic determinants of HIV which promote the spread and development of HIV. For instance, poverty-stricken areas that are commonly found in resource-limited settings of low-income countries have a high incidence and prevalence rate of HIV. The majority of those residing in these areas frequently engage in commercial sex or other risky sexual behaviors to earn income and this increases their risk of infection with HIV (Huang et al., 2016). Besides, poverty limits access to knowledge and education which leads to high levels of illiteracy.  This is a major source of stigma and discrimination which prevents people from seeking both primary and secondary prevention services.

Numerous social and cultural norms promote the spread of HIV. These social practices are commonly observed in community settings within the Sub-Saharan region. The most perfect example is the social practice of polygamy and wife inheritance. An HIV infected and inherited wife is more likely to transmit the virus to all partners that she has unprotected sex with.  With regards to polygamy, currently, existing evidence reveals that most partners tend to be unfaithful which thus have extramarital affairs increasing their risk of being infected with HIV.

Lack of essential primary healthcare resources as commonly observed in developing countries also promotes the transmission of HIV. For instance, pregnant women may lack ante-natal and post-natal care among other maternity services during delivery that helps to prevent HIV vertical transmission.  Other HIV infected women may opt to deliver with the help of traditional birth assistants increasing the risk of transmission. In the general population, people may lack professionally trained healthcare providers to educate them or provide HIV testing and treatment services.

            Security is a major social determinant of health and directly contributes to the development of HIV. Lack of security limits the presence and access to health services since healthcare providers cannot work in highly insecure environments which are characterized by conflicts and civil wars. As highlighted by Huang et al., (2016), people living in insecure regions experience abuse of human rights, sexual violence, and mass displacement. Most of them are left poor and are forced to turn to commercial sex to survive. In this case, commercial sex increases the risk of HIV.

HIV Epidemiologic Triangle and Major Considerations For The General Population and Community HIV Epidemiology Paper Discussion

The epidemiological triad is an essential epidemiological tool used to understand the occurrence of a disease in terms of its causative organism and the conditions which promote its spread and reproduction (agent, host, and environment). This knowledge can later be used to investigate the spread of infectious disease and measures of combating it.

Agent

            As a viral infection, the HIV virus primarily aims attacks the immunity of an individual increasing one’s vulnerability to infections. Its mode of transmission is through direct contact with infected body fluids, sharing contaminated needles as commonly observed among injecting drug users and unprotected sex with those infected (Maartens, Celum & Lewin, 2014).

Host

            It is theorized that HIV initially resided in the chimpanzee. Those who hunted it for food and got contaminated with its blood were immediately infected since the virus or underwent mutation.  As explained by Maartens, Celum & Lewin (2014), the transmission of HIV can occur when infected body fluids such as blood come to direct contact with tissues that are damaged or mucous membranes.

Environment

            The spread/transmission of HIV is directly impacted by specific socio-economic factors in the community and general population settings. For instance, populations with high cases of STIs and low reporting incidences either due to limited resources or other factors enhance the spread of HIV.  Communities or families of low socioeconomic status are limited to treatment and care access and this can either be linked to lack of knowledge on HIV which promotes discrimination and instills fear amongst people who end up not seeking for care.

The Role Of The Community Health Nurse (CHN)

CHN perform individual, family and community health assessments to identify potential gaps in knowledge about HIV. They later plan for primary and secondary prevention programs where individuals and communities are educated on its causes, signs and symptoms, mode of transmission, prevention, and treatment. For secondary prevention, they administer anti-retroviral therapy for improved health outcomes and to prevent potential complications (Mwai et al., 2013). They make a close follow-up for those already enrolled in treatment to enhance their adherence to treatment for improved health outcomes.

            HIV/AIDS has psychosocial, emotional and physical implications to individuals, families, and communities. Community-health nurses have an integral role in assisting those infected and affected to overcome the aforementioned effects in resource-rich and resource-limited settings. They also initiate testing programs to find new HIV cases at the community level.  For those whose results are positive, community health nurses ensure that they are enrolled in care.

Community health nurses collect and analyze HIV incidence, prevalence, mortality and morbidity data and make necessary follow-ups. As explained by Mwai et al. (2013), they are required to make an official report to the relevant authorities for communities with high rates as this will influence the implementation of treatment and prevention measures.

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            HIV is a viral disease with wide-ranging socio-economic, physical and mental effects such as stigma, discrimination, lack of financial resources to care for oneself, depression and low self-esteem among others. These effects have been associated with poor health outcomes among those with HIV/AIDS such as a low CD-4 count and a high viral load. To promote health, community health nurses link people infected with HIV with community support programs, NGOs and even faith-based organizations.

Organization That Addresses HIV To Resolve/Reduce Disease Impact

            The agency of choice for this discussion is the AIDS Healthcare Foundation (AHF), an international Los-Angeles based NGO. The agency was formed the year 2015 with Michael Weinstein as its founder. Today, AHF has extended its services in HIV testing, prevention and treatment to more than 40 countries across the globe and 16 states in the US. For it to function more efficiently, it has not only sought strategic partners but also established numerous pharmacies, clinics, and chains of stores to facilitate the enactment of new population health programs to expand HIV care and promote action through policy development. It should also be noted that AHF funds HIV research initiatives which have promoted the successes gained in reducing the impacts of HIV resulting in more successful health outcomes. HIV Epidemiology Paper Discussion

Global Implication of HIV/AIDS

Even though it is considered to be a global issue, some areas are the most affected such as Sub-Saharan Africa as compared to others. According to CDC statistics, up to 20 million people have died of HIV and its related complications. The implications of HIV on the socio-economic system and population structure are well documented.  Those infected and face stigma and discrimination at work may resign, close family members can also resign to care for those infected and need assistance performing activities of daily life, which leads to lost labor. The CDC approximates that up to 3 million individuals will be unable to work by the year 2020 and this figure will either double or triple by the year 2030 (Huang et al., 2016).

The economic implications of HIV can be linked to the impact of indirect care which doubles the HIV burden direct impact on families. The majority of those in the labor force or are self-employed are forced to resign from work and actively care for close relatives with HIV.  This is a trend that is commonly observed in Asia, Africa, and Latin America and implies that, if 2 million people cannot work due to HIV, an additional 2 million cannot work as they will be caring for those infected.

Different measures have been taken by different nations to address the global implications of HIV. For instance, in the United States, laws and regulations have been enacted and are frequently revised to protect the rights of people living with HIV especially at the workplace. Besides, as highlighted by Huang et al., (2016), through federal funding and research, the focus has been shifted to improve efforts in prevention and treatment through sensitizing communities, developing policies, providing treatment at the workplace and enhancing behavior change.

References

Huang, M. B., Ye, L., Liang, B. Y., Ning, C. Y., Roth, W., Jiang, J. J., & Liang, H. (2016). Characterizing the HIV/AIDS epidemic in the United States and China. International journal of environmental research and public health, 13(1), 30.

Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), 258-271.

Mwai, G. W., Mburu, G., Torpey, K., Frost, P., Ford, N., & Seeley, J. (2013). Role and outcomes of community health workers in HIV care in sub‐Saharan Africa: a systematic review. Journal of the International AIDS Society, 16(1), 18586. HIV Epidemiology Paper Discussion