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HIV: Epidemiology Research

Introduction

In 1981, in the United States, when collecting data on registered diseases, many rare diseases were discovered, the development of which was usually associated with a decrease in immunity. This unusual decrease in the body’s defenses has been called “acquired immune deficiency syndrome.”

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The cause of the decrease in immunity could not be determined for a long time, but in 1985 a virus was discovered, infection with which, after several years, leads to the development of AIDS. Since the first AIDS patients in the United States were discovered in 1978, simple calculations suggest that the HIV epidemic began in the early 70s. Most researchers believe that HIV in its modern form appeared on the planet no more than 100 years ago. This paper analyzes the symptoms and consequences of the disease, demographic data, the treatment of the infection, and the organizations specializing in it.

Description

HIV infection is a slowly progressive infectious disease resulting from infection with the human immunodeficiency virus. The disease affects the immune system, resulting from which the body becomes highly susceptible to various secondary infections and malignant tumors, eventually leading to the death of the patient. AIDS (Acquired Immune Deficiency Syndrome) is the final or terminal stage of the disease. The source of infection is a person infected with a virus, a virus carrier, or an AIDS patient. Virus carriers often consider themselves healthy, unaware that they are infected since they may show no signs of the disease for several years.

Infection can occur: through sexual contact, contaminated blood transfusion, or through instruments contaminated with blood, with injections, which is typical for intravenous drug addicts; possible transmission of the virus from mother to child during pregnancy and childbirth.

HIV is not transmitted: through food, water, household use – when using a shared bathroom, toilet, dishes; there was not a single case in the world of infection while caring for HIV-infected and AIDS patients; transmission of this virus by mosquitoes, horseflies, and other blood-sucking insects is impossible.

The incubation period lasts from 2-3 weeks to 3 months. Then, a third of infected people develop an acute phase of the disease (fever, sore throat, swollen lymph nodes, a rash, general weakness), which disappears after 2-4 weeks without any treatment. In 2/3 of the infected, this period is latent. After that, for a long time, there may be no visible manifestations of the disease. In the future, several clinical signs appear to allow doctors to suspect HIV infection in a person.

On average, from the onset of infection to the terminal stage, HIV infection, being intermittent, lasts 10-15 years. Although in some cases the disease transforms into AIDS within months, in others – many years. The immediate cause of death is most often opportunistic infections and Kaposi’s sarcoma and tuberculosis in drug addicts with HIV / AIDS. The diagnosis of HIV infection is made based on the results of a particular blood test, which in most cases gives the result three months after infection. HIV testing can be done anonymously.

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Demographic Data

Demographic data allow disease tracking within specific regions and countries and compare with similar data from other regions and comparative analysis, identifying various social, cultural, and other determinants of its occurrence. This kind of awareness plays a vital role in making plans for disease control, prescribing treatment, and understanding the mechanisms of infection. An estimated 1.2 million people in the United States are infected with HIV, with about 13 percent of them unaware of it and in need of testing (HIV GOV, 2019). New infections and diagnoses are decreasing every year, which shows a positive trend in the fight against the disease.

The relative incidence rates are also declining annually. With nearly 35,000 cases in 2019, the country’s relative incidence per 100,000 dropped below 13 (HIV GOV, 2019). The US authorities plan to end the HIV epidemic by 2030, leaving no more than two to three thousand infections. Sufficiently detailed statistics prove that HIV is a reportable disease. All states are required to report new cases and symptoms of AIDS and HIV.

Reporting is facilitated by health workers who must report it to health departments at the local level. State differences exist regarding the anonymity of new cases, detection methodology, and patient demographic information requested from the patient (CDC, n.d.). The mortality rate from HIV has a downward trend in statistics, but it is still a relatively large number – more than fifteen thousand people infected with HIV died in 2019 (HIV GOV, 2019). The causes of death can be completely different, but the effect of infection on the human immune system certainly plays a role.

Social Determinants

Many factors can contribute to the risk of contracting HIV. The environment, political situation, and social status are the main determinants and tend to act complexly. Among the social determinants, most prevalent in women are sexual violence, gender inequality, stigma, marital status, legal status, and regional status (Edwards & Collins, 2014). Positive dynamics can be seen with improvements in living conditions, financial standing, and other social indicators of success that promote confidence and reduce the risk of mental disorders. In part, it is the ability to support oneself economically, reducing the negative impact of other social determinants that contribute to infection.

More HIV cases are diagnosed among men. The main reason is sex between men. Research is also now focusing more on social and behavioral determinants that were not previously identified as separate groups. These include smoking, the presence of other chronic diseases, alcohol consumption, lack of personal freedom, overcrowded regions, unemployment, and other economic factors mentioned above (Duarte et al., 2018). The environment, airflow, and high stress in the workplace also contribute to developing a predisposition to infection in men.

Epidemiologic Triangle

Analysis of demographic data allows for the prevention of outbreaks in certain regions, as information appears on how high the risk of predisposition is and which determinants this particular region is at risk. For such a warning, experts use the so-called epidemiological triangle – a model to explain the disease of the organism and the conditions of distribution and reproduction (Barroso & Paloma, 2015). The model consists of an agent, an environment, and a host. Typically, the host is a human, the agent is an infectious organism, and the environment is an external factor that promotes or prevents infection.

According to this model, the agent is HIV, an infection that affects the human immune system, making it especially dangerous. The human body cannot entirely fight this infection. It is transmitted by direct contact with body fluids, usually through sexual contact or shared needles. The owner is a human, but historically it is believed that this disease was transmitted to humans from chimpanzees while hunting. Transmission can also occur through mucous membranes such as open wounds. Finally, the environment, as indicated above, is described by socio-economic determinants. The high susceptibility of the community to sexually transmitted diseases and the low reporting of new infections also contribute to the flourishing of the disease. Discrimination and psychological barriers keep many people from being recognized.

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Health education about HIV infection in the United States is pretty well developed. One of the main conditions for this education is to create a predisposition for people to recognize new cases and create a favorable environment for their existence without discrimination, mental disorders, and other ailments. Timely treatment can help reduce risk and enable a person to live a dignified life without harming others. In addition, there are many points of free and anonymous HIV testing, support telephones, and help centers. It is necessary to remind more often and more about this disease and its leading causes of occurrence in schools. The general public should never forget that many authorities offer professional, sometimes free, help in the event of an infection.

Community Health Nurse Role

While demographic data is not collected in all states, it is critical to understanding the spread of infection. Community health nurses perform multiple roles in HIV programs, referring and communicating about testing, engaging citizens in care, accompanying clinic appointments, providing psychosocial support, and referral to other necessary services (Busza et al., 2018). It requires a comfortable working environment for nurses, including personal protective equipment, supportive supervision, equal load distribution, constant availability of consumables and equipment, and respect from patients.

At the local level, demographic data can indicate a high-risk group of people by age, gender, and other characteristics. This data can adjust the work of programs in which nurses are involved, directing their activities specifically to the identified risk group. Nurse motivation also depends on understanding the community in which she works to build a high enough level of trust. Consequently, the collection of demographic data can affect itself, as many people are afraid of recognition. The role of a nurse may differ from region to region, and only one common goal unites all community health nurses.

Agencies and Organizations

In the United States, there are many human rights, educational, information, international, and medical organizations fighting HIV and AIDS at various levels. For example, the activities of human rights organizations are aimed at protecting the rights of various groups of the population in health authorities in order to defeat infections. As a rule, these organizations prevent structural racism, discrimination, abuse of power so that people can get help no matter what. Such organizations are most often non-profit organizations. Among them are AIDS United, Treatment Action Group, and National AIDS Treatment Advocacy Project (NATAP).

Organizations focused on youth and sexual minorities have their specific work and are usually educational. However, most of them conduct their activities not only fighting directly against the spread of infection but also identifying the main social determinants that contribute to increased risk. Their struggle is aimed, among other things, at these determinants, which often affect the predisposition to the disease of children and sexual minorities. Moreover, these groups are particularly susceptible to mental disorders, and therefore need to be fenced off from manifestations of discrimination and other ailments of society. Such organizations include Keep a Child Alive, dance4life, Lambda Legal, and the Genders & Sexualities Alliance Network.

There are also centers for free and anonymous testing, needle exchange, and harm reduction: The Body: HIV Testing, CDC: Syringe Services Programs, Drug Policy Alliance. Individual organizations represent the interests of women and people of color in the country: API Wellness, National Minority AIDS Council, UN Women, The Well Project. Information sources include independent and federal: A&U, HIV Positive, NAM, AIDSinfo. Finally, many international organizations are active in the United States as well: WHO, The Global Fund, UNAIDS.

Global Consequences

All over the world, the problem is of equal importance. More than thirty million people are infected with HIV as of 2020 (Joob & Wiwanitkit, 2020). Unfortunately, not everyone can get qualified help from specialists. However, researchers and leaders of international organizations are striving for indicators of the continuum of care 90-90-90, which means that 90% of people will know about their status, receive treatment, and suppress the virus (HIV GOV, 2019). Achievements in this area are distinguished because it is possible to maintain a stable drop in infection cases, including during transmission from mother to child.

In other countries, the problem is also advertised with the help of the media, and local organizations are working. The most vulnerable region in southern Africa, where HIV infection affects more than twelve percent of the region’s total population. Swaziland and Botswana have rates of about 30% of infected residents, hundreds of times more than other continents (Dwyer-Lindgren et al., 2019). With the help of the international organization UNAIDS, it is planned and carried out the supply of diagnostic consumables and treatment to such regions to stop the disease’s growth.

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Even though South Africa is a relatively developed country, it is home to about six million people infected with HIV, which is almost 15% of the country’s total population. The most significant risk of HIV infection exists among the poor, living in unsanitary conditions, promiscuous sex, and injecting drug users. At least two million HIV-positive people live in Mozambique. It is tough to calculate the exact number due to the conditions developed in this country today. Many researchers estimate that more than five and a half million people are living with HIV there. Many people are living with HIV in Kenya – more than one and a half million people. Most of them are women at risk of infection due to their position in society.

Conclusion

Over the years of the fight against HIV infection, humanity has taken many steps towards identifying symptoms, analyzing the disease, treating it, preventing and diagnosing it. However, there is still a reasonably large number of people infected and at risk of infection, in connection with many organizations around the world of different profiles – from educational to human rights. Identification of social determinants and demographic data allows for a deeper analysis of the disease and prevention of its foci in different regions. People have fewer symptoms every year, so health education in all countries should include regular HIV testing to avoid harmful and even tragic consequences. The global nature of the problem is confirmed by the interest of such organizations like WHO and The Global Fund. However, only by joint efforts, both organizations and states, and their residents, a positive vector of infection control is possible.

References

Barroso, C. J. V., & Paloma, Z. B. (2015). Spatial Epidemiological Pattern of HIV. Asia Pacific Journal of Social and Behavioral Sciences, 12, 9-9.

Busza, J., Dauya, E., Bandason, T., Simms, V., Chikwari, C. D., Makamba, M. & Ferrand, R. A. (2018). The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe. Health Policy and Planning, 33(3), 328-334.

CDC. (n.d.) HIV Infection Reporting — United States. Web.

Duarte, R., Lönnroth, K., Carvalho, C., Lima, F., Carvalho, A. C. C., Muñoz-Torrico, M., & Centis, R. (2018). Tuberculosis, social determinants and co-morbidities (including HIV). Pulmonology, 24(2), 115-119.

Dwyer-Lindgren, L., Cork, M. A., Sligar, A., Steuben, K. M., Wilson, K. F., Provost, N. R. & Hay, S. I. (2019). Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017. Nature, 570(7760), 189-193.

Edwards, A. E., & Collins Jr, C. B. (2014). Exploring the influence of social determinants on HIV risk behaviors and the potential application of structural interventions to prevent HIV in women. Journal of Health Disparities Research and Practice, 7(SI2), 141.

HIV GOV. (2019). U. S. Statistics. Web.

Joob, B., & Wiwanitkit, V. (2020). SARS‐CoV‐2 and HIV. Journal of Medical Virology. Web.

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