Response to Question One
Many United States citizens affected by HIV have received assistance from aid programmes available in the country. People currently living with HIV in New York have received support for their basic and secondary needs. Most of the aid granted to People Living with HIV (PLWH) have been through the Special Need Plan (SNP) (World Health Organization, 2014). Only PLWH and their dependants can join the HIV SNP. SNP provides mainstream managed care to the registered members. It also has the mandate of coordinating various forms of aid and supporting in the best way people living with HIV(Dutta, Wirtz, Baral, Beyrer, & Cleghorn, 2012).
Medical assistance is granted to PLWH in three major ways, AIDS drugs assistance programmes (ADAP), Medicaid card, and Medicare. The ADAP programme is aimed at helping the uninsured and underinsured. This service is available mainly to individuals with low income and wealth. It is offered to HIV key population in four different ways, which include the two ADAP programmes that covers prescription on drugs and payment for doctors (Peitzmeier, Grosso, Bowes, Ceesay & Baral, 2015). Other branches of the programme include the ADAP plus that covers payment for doctors’ visits and tests in the lab and the ADAP programme that pay for private insurance premiums (Risher, Mayer, & Beyrer, 2015).
Medicaid card is a programme initiated by the federal government and operates under department of Human Resource Administration in New York. It is also limited to low income people who may be adult or children. Some of the functions of this programme are HIV related lab tests, OBRA case management of AIDS and Adult day Health Care (ADHC), Methadone Maintenance Treatment Programme (MMTP) and selected substance abuse treatment, and mental health services (World Health Organization, 2014).
Medicare card is mostly for senior citizens above 65 years and the disabled in the society who cannot foot their medical bills. It is available for both HIV positive people and those who are not infected. Medicare covers primary care provided by primary care providers. According to the program, the primary care provider should continue to offer services to an individual who has decided to leave Medical plan for up to 90 days (Risher, Mayer, & Beyrer, 2015). .
Other benefits available for HIV positive people in New York include supplementary nutrition assistance programmes, financial assistance that is given on monthly basis, emergency transitional housing and rental assistance, and home care and home making services (Duttaet al., 2012). The infected people also receive social security under two programmes, social security disability programme for people who pay taxes and supplementary security income for people who have little income and low resources (World Health Organization, 2014).
Response to Question Two
Various geographical locations in United States of America have different lifestyles which can be attributed to varying living standards, different levels of income, and different social practices. The US population may also be categorised into various groups, for example, the African Americans and the White Americans. HIV key population are individuals who due to high risk behaviours have an increased chance of being infected by HIV. They engage socio-cultural behaviours that increase their vulnerability to HIV (Risher, Mayer, & Beyrer, 2015).
The Southern part of the United States forms the geographical region that has the highest prevalence of people infected with HIV. This location is mostly occupied by black Americans and it also forms the region with highest number of HIV key population. Key populations found in southern US include Men who have Sex with Men (MSM), people who inject drugs, commercial sex workers, people in prisons and other enclosed areas, women, and children (Risher, Mayer, & Beyrer, 2015).
MSM, mostly common in the south, have recorded increased number of new HIV infection. Records indicate that two thirds of new infections are from MSM (Peitzmeier et al., 2015). Injection of drugs also contributes heavily to new HIV infections. In particular, women are at risk because of the practices related to their drug use. An example is the use of Hepatitis C Virus which is a co-infection of HIV. In addition, women from minority ethnic groups have high chances of contracting HIV. This is due to low health literacy level and the fact that they may participate in commercial sex activities (Peitzmeier et al., 2015).
Response to Question Three
Health literacy is defined as the ability to understand and act on health information and make information available to everyone in the society. Unfortunately, many people in America still do not have adequate knowledge on health matters. Improper communication with health care providers such as clinicians, nurses and physicians is one of the major causes of this problem. The communication barriers arises due to poor understanding of HIV related terms, limited knowledge on HIV infections, causes and prevention mechanisms and understanding new emerging information on HIV prevention and care (Risher, Mayer, & Beyrer, 2015). .
Health literacy is very crucial among members of the key population. People who inject drugs should be aware of implementation needle and syringe programmes and opioid substitution therapy (NSPs and OST). This knowledge enhances access to HIV specific services such as testing and counselling and antiretroviral therapy. The service for HIV prevention and Treatment provided in prisons and other enclosed settings are a form of health literacy programs (Peitzmeier et al., 2015). This can help reduce HIV prevalence in this key population.
Close examination has been made to current policies that relate to access and uptake of HIV related services. Suggestions have been made to reduce age related barriers in uptake of HPV vaccinations. These can form basic part of health literacy that will aim at reducing HIV prevalence among adolescents. In addition, legislations and laws that support use of condoms should also be made public to young people.
There should be good and supported structural changes that create legal and social environment to facilitate equitable access to HIV prevention and treatment to all. In order to reduce HIV infections among transgender people, activities such as targeted internet based information; social marketing strategies should be used. Moreover, there should be implementation of both individual-level behavioural interventions and community level behavioural interventions (Dutta et al., 2012).
Response to Question Four
The vulnerable population also forms HIV key population. These are people vulnerable to HIV infections because of their particular social setting. They include the adolescents, orphans, street children and people with disabilities, mobile workers and old people.
Girls, especially those from sub Saharan Africa have high chances of contracting HIV. This is because of forced marriages and female circumcision (Peitzmeier et al., 2015). In equal measure, street children may easily contract HIV. They engage in social practices like drug abuse and sharing of sharp unsterilized objects such as needles. Mobile workers may be hijacked in crime prone areas and engaged in forceful, unprotected sex. Old people also tend to ignore information concerning safe sex and may engage in risky acts such as unprotected sex.
References
Dutta, A., Wirtz, A. L., Baral, S., Beyrer, C., &Cleghorn, F. R. (2012). Key harm reduction
interventions and their impact on the reduction of risky behaviour and HIV incidence among people who inject drugs in low-income and middle-income countries. Current Opinion in HIV and AIDS, 7(4), 362-368.
Risher, K., Mayer, K. H., &Beyrer, C. (2015).HIV treatment cascade in MSM, people who
inject drugs, and sex workers. Current Opinion in HIV and AIDS, 10(6), 420-429
Peitzmeier, S. M., Grosso, A., Bowes, A., Ceesay, N., &Baral, S. D. (2015). Associations of
stigma with negative health outcomes for people living with HIV in the Gambia: Implications for key populations. JAIDS Journal of Acquired Immune Deficiency Syndromes, 68, S146-S153.
World Health Organization. (2014). Consolidated guidelines on HIV prevention, diagnosis,
treatment and care for key populations. World Health Organization.
