The problem of HIV as a severe communicable disease that significantly affects the population of the United States could hardly be overlooked. As it is stated on the HIV.gov website, an estimated 1 million people in the country are currently infected with HIV. Also, one out of every seven infected people is not aware of his or her condition. Thus, it is apparent that this communicable disease represents an evident threat to the American public health sector. This study aims to investigate HIV from the perspective of epidemiology, addressing various issues related to the selected disease, including its causes, symptoms, modes of transmission, complications, treatment, the impact of the determinants of health, the role of community health nurse, and several others.
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The Disease’s Description
It is essential to understand the relationship between HIV and AIDS, as the human immunodeficiency virus (HIV) is causing a severe condition that is referred to as acquired immunodeficiency syndrome (AIDS) (“HIV/AIDS,” 2018). The causal mechanism of the disease is the following: the virus destroys white blood cells (CD4 T cells), which have a critical significance for the proper functioning of the immune system (“HIV/AIDS,” 2018). Therefore, when the concentration of white blood cells lowers, the immune system becomes weaker, and thus AIDS is developed.
Symptoms of the selected communicable disease are numerous, and they largely depend on the particular stage of the condition’s development, which could be the following: primary infection (acute HIV), latent clinical infection (chronic HIV), symptomatic HIV infection stage, and AIDS is the final stage (“HIV/AIDS,” 2018). Fever, headache, joint pain, muscle aches, rash, sore throat, and swollen lymph glands are the most common symptoms that appear in the initial stage of the disease (“HIV/AIDS,” 2018). Fatigue, diarrhea, weight loss, mouth infections, and shingles, as well as opportunistic infections and cancers, are added to the symptoms list as the condition progresses (“HIV/AIDS,” 2018).
Modes of Transmission
There are three principal categories of the ways in which the disease is transmitted: sexual intercourse, blood transfusion, and pregnancy. The first mode includes the majority of various types of sexual interaction. Particularly, vaginal, oral, and anal sex could all serve as a mode of transmission. The second type of the disease’s spreading is represented by sharing such items of personal hygiene as toothbrushes, sharing needles and syringes, and direct transfusions of blood. Finally, during the period of pregnancy, HIV is easily transmitted from mother to child as they are directly connected.
Since it was identified previously that HIV is primarily damaging the human’s immune system, it is apparent that various complications could be caused by this damage. The most evident complication is that an infected person develops a higher risk of acquiring other illnesses and conditions such as tuberculosis, which is a leading reason for mortality among the HIV-infected population (“HIV/AIDS,” 2018). Cytomegalovirus, candidiasis, cryptococcal meningitis, toxoplasmosis, cryptosporidiosis are opportunistic diseases that are not normally acquired by people not infected with HIV, but they are easily developed when an individual has AIDS (“HIV/AIDS,” 2018). It is also important to mention such opportunistic cancers as Kaposi’s sarcoma and lymphoma as they are also not typical for HIV-negative people (“HIV/AIDS,” 2018).
AIDS is a condition that could not be cured completely. Nevertheless, the progress of contemporary medicine made it possible for HIV-infected individuals to live a relatively normal life and fight the disease’s symptoms, especially if the condition is diagnosed at early stages and treated appropriately. Among various approaches to treating AIDS, antiretroviral therapy (ART) is considered to be the most efficient method (“How do you treat HIV?” 2018). There are six types of antiretroviral drugs, and the best option is to combine medications from different categories in order to achieve a cumulative positive effect. The side effects of these drugs could be present, but in the majority of cases, they disappear as soon as the patient is adjusted to them (“How do you treat HIV?” 2018).
Mortality, Morbidity, Incidence, and Prevalence
Statistically, there is a slight negative tendency regarding the incidence rates of HIV. It is reported that in 2014, 37,600 people in the United States were diagnosed with HIV, and in 2016, the number was 39,782 (“U. S. Statistics,” 2017). In particular, it is essential to observe that the disease is significantly more prevalent in the population of gay and bisexual men. Young African American gay and bisexual men are at the highest risk of acquiring the infection in this category. Concerning the geographical aspect, it is worth mentioning that southern states contributed 50% of new HIV infections in 2014 (“U. S. Statistics,” 2017). Intravenous drug addicts account for 9% of HIV diagnoses in the United States, and this population group, along with tuberculosis-infected HIV-positive individuals, comprise most of the mortality rate (“U. S. Statistics,” 2017).
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Question of Reporting
The issue of reporting is highly important in the context of HIV due to two primary reasons. First of all, HIV has a very high epidemiological potential, which could be easily determined by the communicable disease chain framework. The second aspect is the ethical aspect of the problem since the disclosure of information about the HIV infection can significantly affect the person’s social life negatively. As Turan et al. (2017) argue, HIV is surrounded by the socially perceived stigma that impacts the lives of HIV-infected people to a large extent. Due to the importance of both mentioned reasons, CDC issues the document that establishes norms for the use of surveillance data on HIV to provide confidentiality for a patient and also to contribute to the prevention of the disease from spreading (“Data security and confidentiality guidelines for HIV,” 2011).
The Impact of the Determinants of Health on the Development of the Disease
Determinants of health are the area of concern that is directly connected with the prevalence of HIV in the American population. In the article by Santos et al. (2018), the high significance of social support as the leading instrument that could positively contribute to the prevention of HIV infection is discussed. Accordingly, social determinants of health, which are defined by the authors as “a set of social, economic, cultural, psychological, ethnic/racial and behavioral factors that influence health,” should be primarily considered by the public health sector when planning the prevention strategies (Santos et al., 2018, p. 626). However, physical determinants of health are also significant since they include such factors as personal hygiene, sexual behavior, and substance abuse. Therefore, they could easily contribute to the spreading of the disease as modes of transmission or as portals of exit (in communicable disease chain terminology).
The Disease and the Epidemiological Triangle
Due to the previously identified high epidemiological potential of the disease, it is essential to investigate it from the perspective of the epidemiological triangle (ET) framework and also to compare it with the discussion of the communicable disease chain (CDC) framework. ET could be considered to be one of the most common and efficient approaches to identifying the epidemiological potential of the particular disorder. The ET framework is based on categorizing risks into three principal groups, which agent, host, and environmental factors. Regarding the topic of this paper, the agent in this framework is the human immunodeficiency virus, and the host is the human body in which the disease is developed. The category of environmental appears to be the most important in this particular case since it was previously identified that numerous social determinants of health (which largely contribute to the development of a particular social environment) are considered important in the context of HIV infection.
Additionally, it is highly significant to discuss the CDC framework because this method for estimating the epidemiological potential and possible outcomes of a communicable disease’s spreading is very applicable and widely recognized. The communicable disease chain consists of the infectious agent, susceptible host and reservoirs (human, animal, plants), portals of exit and re-entry, and means of transmission. It could be noted that the CDC framework represents a more diversified and complex version of the epidemiological triangle since it includes more aspects relates to the disease’s spreading.
The Contribution of the Community Health Nurse
It could hardly be doubted that community health nurses contribute to the prevention and treatment of HIV infection to a significantly large extent. Nursing professionals should clearly understand their roles and responsibilities regarding the overall public health sector’s efforts to minimize the negative effects of HIV spreading. Bradley-Springer, Stevens, and Webb (2010) argue in their article that community health nurses are one of the most important agents in this sector who are responsible for such actions as case finding, reporting, data collecting, data analysis, and follow-up. As it was previously mentioned, case finding and reporting are difficult due to the complexity of the ethical aspect of the issue. Therefore, the community health nurse should be very responsible while performing these actions since the patient’s confidentiality is of high significance. Another reason for the importance of case finding and reporting is that HIV is considerably easier to treat when it is diagnosed at the early stages of development. Thus, nurses are responsible for spreading awareness about the disease’s symptoms in order to facilitate access to proper treatment.
Data collecting and analysis are directly connected to two previous aspects of the community health nurse’s work. Collecting statistical data about the disease is of high importance because it provides the public health sector with relevant and actual information about such aspects as morbidity, mortality, prevalence, and incidence of HIV. When statistical data is analyzed, it is easier to predict the tendencies of the disease’s development and to acquire a profound understanding of the factors that contribute the most to the prevalence of the condition under discussion. Moreover, the aspect of follow-up could be considered as one of the most important responsibilities of community health nurses since they can effectively and positively impact the patients’ quality of life.
National Organizations and Global Implications of the Disease
It is apparent that there are numerous organizations on the national level that are concerned with addressing problems related to the disease. AIDS United is the example of one of the most efficient and prominent national organizations that contribute to the prevention and treatment of HIV. “Strategic grantmaking, capacity building, policy/advocacy, technical assistance, and formative research” are the primary instruments employed by the organization in order to minimize the epidemiological potential of HIV in the United States (AIDS United, 2018). It is estimated that AIDS United has contributed more than $221 million by direct funding to local communities and sponsoring various anti-HIV programs (AIDS United, 2018).
Additionally, it could be stated with certainty that HIV has serious global implications. As of the end of 2016, an estimated number of 36.7 million people in the world are infected with HIV (“Global HIV/AIDS Overview,” 2017). Among these people, only half of them are aware of their infection and its complications, as well as possible ways of diagnosing and treatment (“Global HIV/AIDS Overview,” 2017). The mortality rate worldwide is also significantly worrying since 35 million people died from HIV as of the end of 2016 (“Global HIV/AIDS Overview,” 2017). Also, it is stated on the HIV.org website that HIV is highly endemic to the area of sub-Saharan Africa (“Global HIV/AIDS Overview,” 2017). The majority of new infections in this area are transmitted by pregnant women to their children, and this problem is among the most important issues that are addressed by the global community.
This paper attempts to analyze HIV from the perspective of communicable disease with strong epidemiological potential. The facts and statistical data that were observed in this study justify the current status of HIV as one of the most severe epidemic diseases. A large amount of the United States population, as well as individuals across the world, are affected by this condition, and thus an evident threat to the public health sector is presented. However, it is worth mentioning that considerable efforts are made to minimize the negative impact of the disease, and it is essential to make continuous progress in this area of concern.
AIDS United. (2018). About.
Bradley-Springer, L., Stevens, L., & Webb, A. (2010). Every nurse is an HIV nurse. AJN The American Journal of Nursing, 110(3), 32-39.
Data security and confidentiality guidelines for HIV, viral hepatitis, sexually transmitted disease, and tuberculosis programs: Standards to facilitate sharing and use of surveillance data for public health action. (2011).
Global HIV/AIDS Overview. (2017).
How Do You Treat HIV? (2018).
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Santos, V. D. F., Pedrosa, S. C., Aquino, P. D. S., Lima, I. C. V. D., Cunha, G. H. D., & Galvão, M. T. G. (2018). Social support of people with HIV/AIDS: The Social Determinants of Health Model. Revista Brasileira de Enfermagem, 71, 625-630.
Turan, B., Budhwani, H., Fazeli, P. L., Browning, W. R., Raper, J. L., Mugavero, M. J., & Turan, J. M. (2017). How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS and Behavior, 21(1), 283-291.
U.S. Statistics. (2017).