HIV or Human Immunodeficiency Virus is a communicable pathogen majorly responsible for the prevalence of AIDS or Acquired Immune Deficiency Syndrome in a majority of the population. According to the report generated by WHO (2013), there were over 35 million people infected with HIV. When compared to the general populations, the virus is most common in gay and bisexual men, Caribbean and African communities, Aboriginal populations, women and people injecting illicit drugs . HIV is present in the semen, blood, breast milk or vaginal fluid of the infected individuals. While the likelihood of contracting HIV through the casual environment is remote, the virus often gets transmitted directly from one individual to another individual by means of sexual contact and sharing needles. The virus rapidly binds to the cells present in the penile, cervical, vaginal, rectal and urethral mucosa . While the infectious agent of HIV is virulence, the susceptible host is immunity. HIV belongs to the family of Retroviridae and replicates itself into several copies after entering human body.
The symptoms of HIV commonly appear within two to twelve weeks of acquiring the infection as the virus rapidly takes control of the immune system in the blood. Some of the common symptoms of HIV include fever, fatigue, diarrhea, night sweats, joint pains, weight loss, yeast infections, headache, rash and many others . Although the symptoms disappear within a week to one or two months, they might return more often. It takes three months to detect the presence of HIV in the bloodstream through a blood test. The virus infects the brain and causes dementia. The diagnosis of HIV involves two tests, namely a preliminary test and a confirmatory test. While the preliminary test determines the presence of HIV antibodies in the blood by testing the viral load, CD4 count and drug resistance, the confirmatory test confirms whether or not an individual is HIV positive . When the preliminary test shows negative, it is not necessary to perform a confirmatory test.
Since HIV weakens the immune system, the body becomes susceptible to several other diseases, including tuberculosis, candidiasis, cytomegalovirus, cryptosporidiosis, meningitis, a variety of cancers and neurological complications . While there is no permanent cure for HIV, one of the most effective treatments for HIV is HAART, also known as “highly active antiretroviral therapy”. It is an anti-HIV medication, which minimizes the amount of the virus present in the blood, thereby improving the immune system. Other common drugs used for the treatment of HIV include Protease inhibitors, NRTIs and NNRTIs, integrase inhibitors and many others . The dosage and timing of medication plays a major role in the treatment of HIV. The treatment is a muse for patients with severe symptoms, opportunistic infections, HIV-induced kidney diseases, hepatitis, pregnancy and many others.
According to the statistics of 2013, the prevalence of HIV, which refers to the number of individuals living with the infection at a given period, was 29.2 million across the globe and 1.3 million within the US . Incidence, which refers to the number of new HIV cases, was 2.3 million across the world and 50,000 within the US. Over two-thirds of the newly acquired HIV infections occurred in bisexual and gay men, while African Americans also reported higher cases of HIV at an estimate of over eight times when compared to the whites. An estimate of over 914,826 individuals lives with diagnosed HIV infection in the US . In 2012, the death rate among HIV-infected individuals was 13,712 within the US, while the cumulative estimate is 658,507, which is death rate among HIV individuals due to any cause. The global statistics show the death rate as 1.5 million in 2013, while the morbidity of HIV in 2012 is 47,989 .
The determinants of health include a wide range of social, economic, personal and environmental factors, which influence the status of health. The classification of the determinants of health into seven categories includes genetics, education, income, gender, health services, physical environment, and social support and status . The determinants of health contribute to the development of HIV to a great extent. Vulnerability and progression of HIV is highly dependent on economic status, education, power imbalance, social exclusion, discrimination, cultural differences, child abuse, sexism, heterosexism, racism and many others . Awareness about HIV, social inclusion, proper employment and shelter increase the likelihood of the prevention of HIV. The healthcare system of a country and integration of interdisciplinary approaches equally play a significant role in the prevention of HIV.
The epidemiologic triangle is a conventional model for an infectious disease and consists of an agent, a host and an environment that connects the agent and host together . The agent is an external pathogen, such as a virus, bacterium or microbe. In HIV, the agent is a virus, which causes several chemical and physical changes in human blood and weakens the immune system. A host refers to humans who acquire the disease. The determination of host depends on a multitude of factors, such as an individual’s susceptibility to infection, exposure, response to causative agent and many others . In HIV, the host is dependent on certain opportunities for exposure, which include hygiene and sexual practices, while susceptibility is dependent on genetic composition, immunologic status, presence of disease, response to medications and many others . The environment refers to the external factors that impact the agent and create an opportunity for exposure. In HIV, the environment includes socioeconomic and physical factors of an individual.
Community health nurses assume various responsibilities in responding to infectious diseases, such as the HIV. They play a significant role in understanding the epidemiology of HIV, including latest test recommendations, advancement in screening technology, aging implications of HIV and many others . Community health nurses perform the role of case finding, which refers to identifying the number of individuals benefited from the early intervention of the disease and relies on testing the presence of HIV in individuals. Case reporting refers to reporting the number of HIV-infected cases to the CDC to enhance prevention efforts, improve treatment and evaluate the impact of HIV prevention programs. Data collecting provides information about the course of the infection and the impact of HIV treatment over time . Large collection of data helps to reach a fundamental conclusion about the progress of the disease. Community health nurses could collect data either during initial registration of patients or during ongoing monitoring through clinical data. Data analysis is an important role of a community health nurse as it helps to evaluate possible solutions for promoting disease prevention across the community . Finally, follow-up is another crucial role of a community health nurse as it subsequently examines HIV infected patients by monitoring the earlier treatment. Through follow-up, nurses would be able to identify the progress of the disease and effect of medication in the patients.
The Department of Health and Human Services is one of the significant federal agencies in the US, which protects the health of the Americans by offering necessary human services, particularly for the vulnerable populations. The HHS implements the national HIV/AIDS Strategy and offers the widest scope of HIV-related activities when compared to other federal agencies . The HHS collaborates with local and state governments and covers a broad spectrum of HIV prevention activities, which majorly focus on care, treatment and prevention of the disease. The HHS is responsible for spanning HIV education across the US across its 11 operating divisions. After the issuance of an executive order by President Obama, the HHS has accelerated its efforts of increasing HIV testing, treatment plan and care to deal with the drop-offs in the HIV-care continuum . The vision of the federal action plan developed by the HHS is to minimize the number of HIV cases irrespective of the race, age, gender, ethnicity, socioeconomic status, sexual orientation and gender identity . The HHS strives to offer a high quality health care directed at preventing HIV through long-term actions. It plans to implement new strategies with the collaboration of new educational agencies and professional organizations. The HHS aims at making a big difference in terms of HIV prevention by 2020 by formulating a roadmap, which functions as a blueprint for the implementation of new projects and ongoing activities. It identifies a list of priorities and measurable outcomes to achieve the goals of HIV prevention. The HHS offers comprehensive healthcare through widespread HIV testing and expansion of its efforts through an evidence-based approach . It educates the Americans with scientifically accessible and accurate information about the risks and transmission of HIV infection.
References
CDC. (n.d.). Introduction to Epiemiology. Retrieved 01 30, 2016, from Centers for Disease Control and Prevention: http://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section8.html
CDC. (n.d.). Statistics Overview. Retrieved 01 30, 2016, from Centers for Disease Control and Prevention: http://www.cdc.gov/hiv/statistics/overview/
HHS. (2015). National HIV/AIDS Strategy for the United States. Washington: Federal Action Plan.
Sonenklar, C. (2011). AIDS. Minneapolis, MN: Twenty-First Century Books.
Tomori, C., Risher, K., Limaye, R. J., Van Lith, L. M., Gibbs, S., Smelyanskaya, M., et al. (2014). A role for health communication in the continuum of HIV care, treatment, and prevention. Journal of Acquired Immune Deficiency Syndromes, 66, S306-S310.
WHO. (n.d.). The determinants of health. Retrieved 01 30, 2016, from World Health Organization: http://www.who.int/hia/evidence/doh/en/index1.html
