Professional Documents
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HIV/AIDS
Caitlin Harvey RN
April 3, 2017
HIV/AIDS Research Paper 2
Abstract
This paper discusses HIV/AIDS related to global health. HIV/AIDS has such a global
impact on health it is important that we look at this disease and how to implement interventions
worldwide. With the health topic of HIV/AIDS medical professionals take a look at
education, and future interventions. Also, within this paper there is a focus on professional
Introduction
When examining social injustice and its impact on healthcare one, of the most notable
disease processes in current society can be found, HIV/AIDS. Human immunodeficiency virus
more commonly known as, HIV, is a viral infection that attacks and weakens the immune
system. Specifically this, disease targets and attacks the white blood cells known as T-Helper or
CD4 cells. The destruction of these cells impairs the body's ability to fight infection and can lead
Basics, 2014).
When HIV has matured in the body and the immune system has become weakened to the
point where it is unable to fight off disease, the HIV carrier is considered to have Acquired
Immune Deficiency Syndrome (AIDS). AIDS itself is not a viral illness; instead, it is a set of
symptoms caused by the targeted destruction of the CD4 cells, leading to a weakening of the
immune system. Currently, there is no known cure for HIV or AIDS, however with early
detection and proper medical treatment the HIV can be controlled (HIV/AIDS Basics, 2014).
HIV/AIDS is a current global epidemic. This disease currently affects more than 36.7
Million people worldwide (HIV/AIDS Basics, 2014). Of these, more than 1.8 million infected
are children (<15 years of age) (HIV/AIDS Basics, 2014). It is estimated that more than 2.1
Million new individuals are infected with the virus every year (HIV/AIDS Basics, 2014). A
nations (HIV/AIDS Basics, 2014). The most affected area of the world is sub-Saharan Africa
(HIV/AIDS Basics, 2014). It is estimated that more than 66% of all new HIV infections
worldwide in 2015 were transmitted in the sub-Saharan region of Africa (HIV/AIDS Basics,
2014).
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HIV/AIDS is believed to have claimed more than 35 million lives since the epidemic was
noted (HIV/AIDS Basics, 2014). This number continues to rise, as many of those who are
infected do not have access to proper testing to make a diagnosis. These undiagnosed cases of
HIV contribute to many of the new cases of the virus. It is believed that as many as 40% of all
infected individuals with the disease, do not know that they are infected (HIV/AIDS Basics,
2014).
Socioeconomic Factors
Some of the greatest factors contributing to spread of the HIV are socioeconomic in
nature. The vast majority of HIV-infected individuals are typically seen in lower-income nations.
There are many factors to be considered when assessing why these socioeconomic issues factor
into the spread of the disease. Generally, in these lower-income countries, access to education is
limited when compared to a more developed country. This lack of education, towards prevention
and treatment leads to an increase in the spread of the disease. Another factor to consider is the
lack of access to qualified healthcare providers. In many of the lower income nations, high
quality healthcare is not available to all of their citizens. Even when healthcare is available,
many of the citizens of these lower income countries are unable to afford the care they require to
maintain their health. This lack of access to quality health care coupled with limited education is
a recipe for the increased transmission of the HIV (HIV/AIDS Basics, 2014).
One of the most effective ways to help make a large-scale impact on health, in general, is
to make default decisions easier so that individuals can be healthier. This can be obtained by
making critical preventative measures easily accessible. To decrease the prevalence of HIV,
HIV/AIDS Research Paper 5
healthcare organizations need to collaborate and make access to many of these measures more
condoms and other prophylactic devices, it is easier for the population to make the right decision
when it comes to safe sex practices. By increasing safer sex practices, the prevalence of this
sexually transmitted disease would decrease significantly. Another critical resource that could be
made more accessible would be free HIV screenings. By giving increased access to these
screenings, the 40% of infected individuals who are unaware they are infected will likely be
drastically decreased (HIV/AIDS Basics, 2014). Increased knowledge of infection will allow
these individuals to make healthier decisions to help prevent the further transmission of the
disease.
developing nations, this procedure is not readily available. By increasing the population's access
to such a procedure, it has been shown to drastically decrease the transmission of HIV/AIDS
(Male circumcision for HIV prevention, 2017). Another key factor is to increase the early
detection of the disease. With the early detection of HIV, the disease is much more medically
manageable. With the decreased viral loads seen in the early stages of the disease, treatment is
found to be more effective and can reduce the likelihood of retransmission (Adherence to ART |
HIV positive early, it also limited the number of sexual partners they may have unprotected sex
with compared to if they were not made aware that they were HIV positive (HIV/AIDS, 2016).
HIV/AIDS Research Paper 6
Clinical Interventions
An important step in impacting the health of the HIV population can be in clinical
interventions. One of the most important and often overlooked clinical interventions in the
even more important that these individuals have a healthy balanced diet in order to make sure
their bodies have the nutrition needed to help fight any secondary infection that may
arise(HIV/AIDS Basics, 2014). Another consideration for nutrition is that many HIV patients
may end up with an oral fungal infection known as thrush. This infection can be especially
painful and lead to decreased oral intake, which in turn can affect a patient nutritional status
Another major clinical intervention the nurse can assist in is in infection prevention. As
mentioned previously the HIV attacks the infected individual's immune system, targeting the
cells that help fight off infection. With this decreased immune system a patient is more likely to
obtain secondary infections, which can lead to life-threatening complications. The nurse can
intervene by educating the patient the importance of such infection prevention techniques as
A third clinical intervention to in the treatment of HIV is supporting the patient through a
many factors need to be considered. The healthcare team should do a thorough evaluation of the
patients knowledge and ability to succeed on such a regime. Many factors can influence the
likelihood of success on a regime. For example, patients who are prescribed a once-daily
medication regime show significantly better medication compliance when compared to those
who are prescribed a twice-daily regime (Adherence to ART | Adult and Adolescent ARV
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Guidelines | AIDSinfo, 2014). Other factors for the nurse to consider when the patient is being
assessed for the initiation of a new medication regime is to assess the patient's current knowledge
about HIV as well as any psychosocial challenges such as substance abuse, levels of support at
home and any history of mental illness. Once the determination is made to initiate a patient on a
new medication regime, the focus of the nurse turns towards education and access. The nurse
should provide the patient with resources to obtain drug coverage and provide them with
education on self-monitoring for potential side effects of the medication. The nurse will also
continuously monitor the patient on subsequent visits for signs of medication compliance as well
as assess the patient for any potential issues with compliance. This will consist of surveying the
patient about compliance and providing any assistance the patient may need to remain compliant.
The last step in the health impact pyramid is counseling and education. At this level, the
impact is more individualized and directed to provide specifically targeted education to high-risk
populations to make a difference. The main target populations for HIV/AIDS education would be
homosexual men, African Americans, and low-income populations (HIV/AIDS Basics, 2014).
According to the Centers for Disease Control and Prevention, gay and bisexual men
account for an estimated 54% of individuals who are diagnosed with AIDS in the United States
(HIV/AIDS, 2016). The prevalence of HIV/AIDS in the homosexual community has taken a
major toll. It is estimated that current 4.5 million gay and bisexual men are living with HIV
(HIV/AIDS, 2016). Of this population, it is believed that 1 out of 7 homosexual men in the
United States who has HIV is unaware they are infected (HIV/AIDS, 2016). These statistics,
along with the increased risk from unprotected anal sex, makes this population the most likely to
contract HIV. With this is mind, it is important for this population to be at the top of the list in
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targeted populations for education and counseling. Education should be placed around safer
sexual techniques including the use of proper prophylactic devices. With the ever present threat
of homophobia as well as the stigma that is attached to homosexuality, homosexual men are at a
higher risk for developing concurrent mental health issues that can benefit from counseling from
the nurse.
Other groups that the nurse can help provide targeted education to are low-income
populations. This population has seen increased level of HIV infections (HIV/AIDS Basics,
2014). The disease in these lower income populations perpetuates itself through a vicious cycle.
As individuals become infected with the disease, they become ill. As these individuals become
ill, they are unable to maintain gainful employment. With the lack of funds from inadequate
employment, these patients find it difficult to be able to obtain adequate nutrition, which
advances the disease process. Another key impact to low-income populations is the lack of
access to adequate healthcare and educational resources. Many lower income populations either
do not have access to education or leave education early in order to provide for their families.
This once again perpetuates the cycle of health risks. Nurses can help combat this by providing
education to these lower income populations. By entering the nations and communities where
education is lacking and providing this targeted education, nurses can have an impact at a
localized level.
Future Interventions
One of the keys to lowering the health impact of HIV/AIDS is through innovations in
future interventions. One of these key innovations revolves around developing and increasing the
availability of low-cost diagnostic testing for rural countries. The two main aspects of this sector
that are being developed are rapid point of care testing (RPOCT) and mobile testing laboratories.
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The development of RPOCT has recently been backed and funded by such organizations as the
World Health Organization (WHO), the Bill and Melinda Gates Foundation and the Clinton
Foundation (Stevens, Gous, Ford, & Scott, 2014). With such an interest from large-scale donors,
the science of RPOCT has made incredible strides in recent times. The ability to rapidly and
effectively provide point of care testing will allow for larger scale testing operations in remote
Another innovation that will aim at increasing access to quality and reliable HIV testing
is mobile laboratories. Recent pilot programs have been conducted in areas of Zimbabwe, South
Africa, and Thailand. Dubbed Project Accept this intervention mobilized multidisciplinary
teams to go into rural areas of previously underserved populations and not only test but also
provide post-test support services to patients who tested positive (Project Accept Study Group,
2013). The increase in projects like this will allow for greater access in these rural areas to
testing as well as the social support needed after diagnosis. This outreach to the community helps
spread the message of education and helps fight may of the stigmas attached to a diagnosis of
HIV/AIDS. The goal is to help change behaviors of infected patients thus decrease the spread of
the disease.
Finally, the most anticipated future innovation directed at diminishing the health impact
of HIV/AIDS is being made in the research and development of a potential HIV vaccine.
Recently released preliminary research shows that HIV requires a specific chain of amino acids
in the bloodstream in order to replicate (Yuani et al., 2017). Scientists have recently been able to
replicate a fake version of that amino acid, which in turn, stops the replication of the virus
(Yuani et al., 2017). It is believed that this may be the first step in developing an effective HIV
vaccine to diminish the virus' ability to replicate and stop the replication at the cellular level.
HIV/AIDS Research Paper 10
There are many great opportunities for growth with a career in the global health field.
These opportunities can include policymakers, health care ambassadors, and researchers. Each of
these fields is currently growing at an incredible rate and offers a rewarding career experience.
The need for policymakers has come to a head in recent years. With many national and global
health care reforms this is an extremely desirable career opportunity. Policy makers can utilize
their nursing knowledge and experience to help drive the future of global health.
Another great opportunity within the global health field is that of a health care
ambassador. These individuals travel to underserved regions of the world and help share their
knowledge and experience and help drive global education to targeted populations around the
world. These ambassadors can act as front line educators and practitioners. They may also act as
teachers and mentors for future leaders in healthcare. The health care ambassador promotes
Potentially, the opportunity in the global health field that has the potential ability to make
the greatest impact to the largest population is in global health research. With a recent focus from
many major philanthropists, on the importance of making an impact in global health, the need for
innovative researchers has never been higher. These individuals can make major impacts with
such breakthroughs as vaccines, pharmacological interventions, and ultimately, cures for many
HIV/AIDS Research Paper 11
References (E)
Adherence to ART | Adult and Adolescent ARV Guidelines | AIDSinfo. (2014, May 1).
guidelines/30/adherence-to-art
http://www.who.int/hiv/topics/malecircumcision/en/
Project Accept Study Group. (2013, July 1). Project Accept (HPTN 043): A phase III
Results, and Post-Test Support for HIV in Sub-Saharan Africa and Thailand. Retrieved
from http://www.cbvct.med.ucla.edu/protocol.pdf
Stevens, W., Gous, N., Ford, N., & Scott, L. E. (2014, September 08). Feasibility of HIV point-
of-care tests for resource-limited settings: challenges and solutions. Retrieved from
http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0173-7
Yuan, Z., Wang, N., Kang, G., Niu, W., Li, Q., & Guo, J. (2017, January 20). Controlling