Background to Interview and Interviewee
One of the most threatening challenges the healthcare industry faces today is that of providing treatment to terminal diseases. When the disease or the health condition is further associated with a sense of taboo, the provision of healthcare services and addressing the health issue becomes furthermore difficult . HIV/AIDS is one such healthcare evil which is spreading rapidly and alarmingly throughout the global society as more and more people are being tested positive for the condition. This presentation focuses on the healthcare service providers who are engaged in the field of providing treatment to patients suffering from HIV/AIDS.
The objective of the presentation is to provide a real world insight to the issues and challenges faced by healthcare practitioners, and as a result of which it highlights the interview and responses of a 46 year old lady HIV prevention counselor with the US Department of Health. For privacy concerns the name of the interviewee is not disclosed in the presentation. The interview questions are mostly related to her healthcare practices over the years. It also needs to be noted that throughout the rest of the report, she will be referred to as Ms. J. The questions and responses are presented in the following section.
Interview Questions and Responses
Q1. Give a brief about your academic and professional background.
Response: Ms. J has completed her Bachelor’s Degree in Nursing from University of Pittsburgh in the year 2004. She had been then associated with two public healthcare organizations for two and four years respectively. She further pursued a Master’s Degree in Human Services/Social Work from Boston College in Massachusetts, which she completed in the year 2012. Shortly thereafter, she has been associated with the Department of Health of United States of America. Presently she is working as the HIV prevention counselor, a position she is holding late 2014. She is also the recipient of HIV/AIDS Prevention Education Certification from the American Red Cross in the year 2015.
Q2. Why this line of work?
Response: Ms. J replies that much of the yearning for selecting this line of work was influenced by the way society treated her very close childhood friend, who was found to be HIV positive in his late teens. She remembers the physical and more importantly mental agony he had been subjected to by his friends and even family members and that sadly, four years later, after his death even his family members did not provide him an honorable last rite. She states that it pained her to see her friend being treated as a taboo of the society and as days passed, he became more and more isolated due fewer, and then almost no visits from friends and family members. According to Ms. J, her friend was not the only one to have gone through such pain as this attitude is sadly quite common in case of many HIV positive patients as she had observed during her career as a nursing staff. She is of the opinion that no one voluntarily decides to become infected by the virus and in most cases; it is lack of awareness and education about the prevention. Even then, the patients become isolated and abandoned in society. Furthermore, till date there is no medical cure for HIV positive patients, as a result of which it is very crucial to spread awareness and prevent the spread of the virus altogether.
Q3. What is your outlook to reason(s) behind people becoming infected?
Response: She highlights that unprotected sexual intercourse – vaginal, anal and even oral continues to be the most common cause behind spread of the virus among humans. The second most common cause behind the spread of the virus is exposure to infected blood and tissue and also perinatal transmission which includes even breast feeding. Another source of spread of the virus is through sharing injections, especially by drug addicts which is not as common as the first, yet a highly critical factor when it comes to spread of the virus. She specifically highlights that presence of open tissue pores such as ulcers, lesions and abrasions highly increases the risk of spread of HIV virus.
Q4. Do you believe there is an acute lack of awareness about the issue?
Response: Ms. J highlights in her career as a nursing staff as well as a counselor, she has developed a two pitched perception about this notion. She states that while she has seen quite a number of patients who were poor, from rural areas or from uneducated backgrounds, there were an equal number of cases involving patients who were apparently from affluent backgrounds. This observation has led Ms. J to conclude that while for patients belonging to poor and uneducated backgrounds it is more likely to have less education/awareness about the virus and its spread, individuals from affluent backgrounds were more prone to taking risks when it came to being infected by the virus. Given the educational and social background of the affluent patients, it was surprising to Ms. J that they contracted the disease. She states that one of the main reasons behind the infections among the affluent was unprotected sexual intercourse – even with the knowledge of the risks associated with it.
Q5. According to you, how critical is the role of unprotected sexual intercourse in the spread of HIV/AIDS?
Response: Ms. J’s response to this question is absolutely straightforward – she replied that unprotected sex accounts for nearly half of all HIV infections. She straight away highlights the influence of lifestyle and its contribution to the spread of the disease. She highlights that in many cases, the virus is being spread through unprotected sex which seems to have become common among consenting adults. She believes that young people are more prone to this risk taking behavior and it is also not uncommon to find and individual to be engaging in unprotected sexual intercourse with multiple partners. Unwilling sexual intercourse such as rape is also one of the ways in which the virus is being spread. Another very important factor she brings to the discussion is that of unsafe sex which is practiced among members of the same sex i.e. homosexual relationships. While for gay men, anal penetration without the use of condoms is very dangerous, sharing of sex toys among lesbian women constitutes another risky activity which may lead to spread of the virus. She mentions that it is saddening to find so many patients from educated and well to do backgrounds, especially due to the reason that they have the knowledge and awareness at their disposal which is not the case for individuals belonging to poor and underprivileged societies. She candidly states that in places such as many African countries, most of the people have very little or no knowledge at all about the risks associated with unprotected sex. In such cases it is difficult to contain the spread of the virus among individuals.
Q5. Which are the main responsibilities of your professional role?
Response: Ms. J is quick to highlight that unlike other individuals and institutions, she does not believe in only one particular HIV prevention counseling model. Rather she combines the aspects of many to ensure that her professional role as a HIV/AIDS prevention counselor helps her to focus on sessions aimed at reducing HIV risks of her clients. She adds that the main objective is to prevent the spread of the disease among individuals. As a result, her clients – which include numerous individuals throughout the course of the day – are provided an in depth personalized risk assessment, clarifications about critical and general misconceptions associated with the virus, promoting a behavior-change routine aimed at minimizing threat from HIV. Apart from these, often she has to counsel individuals with newly identified HIV infections and their friends and family, providing guidance to individuals regarding evaluation for intermediate and repeat HIV testing and also assessment and guiding healthcare workers who become subjected to occupational exposure to the virus.
Q6. What is your opinion of the overall attitude of the healthcare industry towards patients with HIV/AIDS?
Response: While she states that she is happy with the attitude of the medical and healthcare industry to responding to the life threatening virus and its spread, she believes that extension of allied services such as insurance cover to the affected ones need to be introduced. She further highlights that even though the Affordable Care Act (ACA) of 2010 has been introduced with good intentions to help the ones in need, accessing and claiming the services still requires major improvement, mainly due to the mixed attitude of the industry in general which still needs to improve its outlook of HIV/AIDS as a taboo.
Q7. Provide us an insight about the biggest challenges associated with your line of work.
Response: Ms. J does not hesitate to straight away name attitude of the people associated with both patients and healthcare service providers as the biggest challenge in the line of work. She elaborates that as far as the patients are concerned, for every one individual turning up at healthcare establishments for evaluation and/or treatment, there are four infected individuals who become isolated and recluse. She insists this is largely due to the stigma associated with such a ‘taboo’ which the society views these individuals to be. Such infected individuals usually try to disappear from all their acquaintances to lead a lonely and solitary life in a sort of self-imposed exile. However, there is a greater risk which is associated with this behavior as such an individual becomes more likely to spread the virus to another – and it has been reported to take place either with or without the knowledge and awareness of the infected person that he/she is transmitting the virus to another through sexual intercourse, sharing of needles or such other occurrences. So, in her opinion, all the measures to treat and care for the infected may be successful with the changes brought in to the availability of medical services. However, when it comes to prevention of the spread of HIV/AIDS, society is doing more harm than good with the way it currently treats an HIV positive patient.
Q8. Can you give us some examples where you faced any ethical dilemmas you might have encountered?
Response: Ms. J states that so far in her professional experience she has not faced any ethical dilemmas in providing her services to the patients.
Q7. Can you recall any rewarding moments or experiences in your work?
Response: She states that though it is difficult to highlight any one particular rewarding moment in her career, she states that the satisfaction which she gets currently on being a counselor with the Department of Public Health as there has been major improvements in both the attitudes and responsibility shown by family members of affected individuals. Also, the fact that more and more people are concerned and approaching various healthcare services for evaluation and awareness is a welcome sight especially compared to the time she started her career in 2004.
Q8. What advice do you have for the public about HIV/AIDS?
Response: She mentions that the first and foremost requirement is for people to change the outlook when it comes to HIV/AIDS prevention. The general public needs to take lesser risks when it comes to sexual intercourse and other activities which can cause infection of the virus and at the same time society needs to be more accommodating so that individuals with the disease can be more comfortable to approach healthcare establishments rather than suppressing the presence of the virus in their bodies.
Q9. What advice would you give to someone looking forward to work in your line of work?
Response: She mentions that the most important requirement is to be able to take utmost precaution when providing healthcare services to individuals who have already been infected by the virus. At the same time, there will be a lot of emotionally challenging instances in the provision of healthcare services which calls for the presence of a very strong mind and will power. At the same time, it is important to ensure that healthcare personnel providing treatment to patients is not having any prejudice against patients suffering from HIV/AIDS in the first place – that they are in need of help and not a curse in society.
Important Reflections from the Interview
The reflections obtained from the interview of Ms. J clearly highlights that even though government and the Department of Public Health is putting in the best of efforts towards healthcare service provision, the attitude of the society needs to change rapidly. Even though it is difficult to prioritize aspects, in case of HIV/AIDS, prevention of the spread of the virus is far more important than provision of healthcare services to the infected – especially due to the fact that till date there is no cure from the condition. From the entire interview, the learning to take away should be to contain further spread of the disease.
References
Gorbach, P.M., Drumright, L.N., Daar, E.S. and Little, S.J. (2011). Transmission behaviors of recently HIV-infected men who have sex with men. Journal of Acquired Immune Deficiency Syndrome , 49 (1), 68-76.
US DEpartment of Health and Human Services. (2016, April 2). The Affordable Care Act and HIV/AIDS. Retrieved July 5, 2016, from AIDS Gov: https://www.aids.gov/federal-resources/policies/health-care-reform/
