Nursing has developed into a unique profession that combines medical techniques with humanitarian and leadership skills. Advocacy for vulnerable populations and social justice is a fundamental aspect that defines nursing practice. It is the ethical duty of nurses to advocate for equitable health care and develop a vision of healthy communities. Health care remains a fundamental human right that should be provided to everyone. Nurses are at the forefront of supporting the principle of equitable health care which emphasizes timely access to high-quality, affordable, and culturally competent to medical services, including preventive care (Matthews, 2017). The African-American population is experiencing a disproportionate morbidity rate of the HIV/AIDS virus and failing to receive the necessary health care services that become critical social issues for which nurses should advocate.
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Population Health Disparity
African Americans, also known as Blacks, are both an ethnic group and an official racial designation for any persons identifying themselves as having origins or ancestry from Africa. Approximately 40.7 million people or 12.7 percent of the US population identify as African Americans. They are the second-largest minority population (U.S. Census Bureau, 2010). The chosen population has a troubled socio-economic history which makes it a vulnerable minority population.
The Human Immunodeficiency Virus (HIV) is an incurable disease that weakens the immune system. If untreated, it can lead to Acquired Immune Deficiency Syndrome (AIDS) which is fatal. The virus is transmitted via sexual activity or blood contact (causing widespread prevalence amongst drug addicts reusing the same syringe). A population is more vulnerable to the HIV/AIDS virus due to sexual activity, risk behaviors, and geographic location (Centers for Disease Control and Prevention, 2017). Despite a significant process in the prevention and treatment of HIV, it remains a critical health issue within the United States and the Black population.
African Americans account for a large percentage of HIV/AIDS diagnoses in the United States. The statistical occurrence of the disease in the racial group makes it an ongoing health disparity. The community faces a greater risk of infection due to a lack of awareness of HIV status and the tendency of sexual encounters within the same racial group. There are a number of socio-economic issues that place African Americans with the worst outcomes on the HIV continuum of care. Social issues relating to stigma, homophobia, and discrimination are contributing factors limiting access to proper preventive care and treatment. It is part of numerous federal health programs, including Health People 2020 to reduce the prevalence of the HIV/AIDS virus within the population, particularly vulnerable groups such as African-Americans through education, prevention, and access to equitable health care (Centers for Disease Control and Prevention, 2017).
In 2009, the prevalence rate of HIV was 952 per 100,000 people amongst African Americans, 6.6 times more likely to be living with a diagnosis compared to the white majority. Such statistics place the HIV/AIDS health disparity for African-Americans at the level of a full-fledged epidemic (Vaughan, Rosenberg, Shouse, & Sullivan, 2014). By 2012, 47% of new diagnoses and 43% of those living with the HIV infection identified as African-Americans. The population experiences a tremendously low 3-year survival rate after diagnosis. The mortality rate dropped from 28.4 per 1,000 persons in 2008 to 20.5 in 2012 after high-impact national interventions. However, it remains 13% higher than the mortality rate for whites (Siddiqi, Hu, Hall, Centers for Disease Control and Prevention, 2015). It is evident that statistically there is a significant disparity in prevalence and mortality rates of HIV amongst African Americans.
The health disparity can be based on geographical factors. For example, 49% of HIV diagnoses in 2011 occurred in the Southern United States which contains only 37% of the total US population. This region has stated with the highest HIV diagnosis rate as well as the highest mortality and morbidity rates in the country. The majority of African Americans reside in the South and are disproportionately affected by HIV. More than 56% of diagnosed individuals are African Americans. Some of the consistent evidence supports the link between the impact of HIV on the population and their level of income. African Americans experience are afflicted with the population poverty rate twice that of the White demographic. Poverty causes some social issues which may be interconnected with the HIV epidemic and results in limited health care access (Reif et al., 2013). Poverty results in inequitable health care in African-American communities leading to a lack of prevention, education, and treatment programs as reflected by the statistical data.
There is an urgent necessity to provide equitable health care in racial and ethnic minority communities suffering from HIV/AIDS disparities. Such populations are most vulnerable as they have been historically marginalized and medically underserved. There practical and impactful solutions available through public health interventions. The most viable programs were assiduously developed by nurses to address the specific needs of the targeted minority through a culturally competent approach. There are a number of models that can address specific barriers to the prevention, assessment, and cultural sensitivity of a minority to the HIV/AIDS disparity (Minority Nurse, 2013).
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The Association of Nurses in AIDS Care supported by the American Nurses Association holds the position statement that HIV/AIDS should be addressed as a health disparity for minorities. Everyone should have access to equitable health care, including specialized HIV treatment. Culturally and linguistically competent services have to be integrated within health care organizations in collaboration with the targeted communities. Further, health care providers should create a safe environment based on openness and trust in order to establish dialogue and overcome cultural barriers that may arise (Association of Nurses in AIDS Care, 2009).
The personal position statement states that nurses should advocate for providing equitable health care of the HIV/AIDS virus for the African-American ethnic and racial minority due to the disproportionate morbidity and mortality rate of the virus in the population. The minority’s access to health care should be broadened by addressing affordability, program financing, and quality of care in the most impacted areas. The focus should be made on education and preventive care through culturally competent intervention programs to address social issues that are causing the widespread infection rate of the HIV/AIDS virus. Furthermore, it is necessary to conduct continuous research in the cultural implementation of health care as well as affordable medical treatments to maintain a normal quality of life if the virus is acquired. Overall, nurses should advocate for holistic care for African-Americans at risk or exposed to the HIV/AIDS virus by establishing a collaborative effort of health planning and participation. Through the involvement of government and provider agencies, reforms can be made to the standards of quality, access availability, and health care values in order to eliminate the HIV/AIDS virus disparity within minority communities.
Association of Nurses in AIDS Care. (2009). Position statement: Health disparities. Web.
Centers for Disease Control and Prevention. (2017). HIV among African Americans. Web.
Matthews, J. (2017). Overview and summary: Healthcare reform: Nurses impact policy. Online Journal of Issues in Nursing, 22(2). Web.
Minority Nurse. (2013). Nurses vs. HIV/AIDS disparities: Creating culturally competent interventions. Web.
Reif, S., Whetten, K., Wilson, E., McAllaster, C., Pence, B., Legrand, S., & Gong, W. (2013). HIV/AIDS in the Southern USA: A disproportionate epidemic. AIDS Care: Psychological and Socio-medial Aspects of AIDS/HIV, 26(3), 351-359. Web.
Siddiqi, A.E., Hu, X., Hall, H.I., & Centers for Disease Control and Prevention (CDC). (2015). Mortality among blacks or African Americans with HIV infection- United States, 2008-2012. Morbidity and Mortality Weekly Report, 64(4), 81-86. Web.
U.S. Census Bureau. (2010). The Black Population: 2010. Web.