Introduction
The human immunodeficiency virus (HIV) is a pathogenic retrovirus that provokes the acquired immunodeficiency syndrome (AIDS) and related comorbidities (cacer, lung, liver, and cardiovascular conditions) (Lorenc et al., 2014). It is usually transmitted through sexual contacts, as well as maternal-infant exposure, and percutaneous inoculation. As stated by Shaw and Hunter (2012), HIV transmission is followed by “an orderly appearance of viral and host markers of infection in the blood plasma” (p. a006965). Moreover, in the acute phase of infection, exponential replication, and random diversification of the virus takes place, which facilitates the molecular identification of HIV genomes. Modern medicine cannot cure HIV/AIDS, yet its progression can be slowed down in case a patient receives an antiretroviral treatment (ART).
Determinants of Health and Host Factors
Despite the availability of ART, the global prevalence of the virus has drastically increased. In 2014, the total number of people living with HIV comprised 36,9 (Bhatti, Usman, & Kandi, 2016). The incidence is higher among the female population − in 2014, it equaled 17,4 million on average (Bhatti et al., 2016). Additionally, it is observed that “the mortality and morbidity rates related to HIV infections remain high in developing countries largely due to food insecurity and malnutrition” (Bhatti et al., 2016, p. e515). The given assumption suggests that such determinants of health as an unfavorable physical environment may trigger the rapid development of HIV-related comorbidities in HIV-positive individuals as their immune system cannot respond to its influences efficiently. For instance, malnutrition and exposure to unhygienic conditions largely increase the risk of anemia development and consequent occurrence of metabolic disruptions, muscle wasting, etc. (Duggal, Chugh, & Duggal, 2012).
Nevertheless, such determinant of health as behavior remains the primary contributor towards infection and dissemination of HIV. For example, Sampson (2015) states that a lot of young African American women − who are especially vulnerable towards infection among all other US women from diverse racial backgrounds − often associate HIV with homosexuality and have a fear of HIV testing. Such attitudes interfere with early identification of HIV and increase their propensity to infection because these women tend to engage in risky behaviors more often. At the same time, it is valid to presume that individual characteristics are interconnected with socio-cultural and economic environment influencing sexual behaviors and health beliefs that largely define the vulnerability of individuals to HIV.
Overall, the evidence provided above indicates that although HIV can affect any person regardless of his/her gender, age, and ethnicity, as both HIV agents (HIV-1 and HIV-2) similarly lead to AIDS, some subpopulations may still be exposed to higher risks. Along with African American women, such US minority populations as gay and bisexual men, Hispanics, and transgender women are more likely to be infected due to their risk behaviors and exposure to the environment where the prevalence of HIV/AIDS is higher.
Conclusion: Role of FNP
According to Bhatti et al. (2016), “long-term concomitant sexual relationships and high infectivity during the early phase of HIV infections” are the major factors determining wide dissemination of infection across all population groups (p. e515). This factor indicates the significance of early identification of HIV in patients, their control, and follow-up. Nurses may play one of the primary roles in leading HIV prevention efforts. To achieve positive results, health practitioners may practice prioritized intervention and data analysis in specific neighborhoods and populations (e.g., low-income households, drug-users, homosexuals, etc.); attempt to enhance linkage of individuals at risk to HIV testing and ART; and engage in community education (Carey et al., 2015). Since the given FNP activities take into account both host and environmental factors of HIV infection, they may help nurse practitioners achieve better outcomes through direct work with those who need HIV prevention services most. They may also help improve individuals’ perception of infection risk, develop trust in the efficacy of medical services, and, to some extent, reduce HIV stigma.
References
Bhatti, A. B., Usman, M., & Kandi, V. (2016). Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy. Cureus, 8(3), e515.
Carey, J. W., LaLota, M., Villamizar, K., McElroy, T., Wilson, M. M., Garcia, J., … Flores, S. A. (2015). Using high-impact HIV prevention to achieve the national HIV/AIDS strategic goals in Miami-Dade County, Florida: A case study. Journal of Public Health Management and Practice: JPHMP, 21(6), 584–593.
Duggal, S., Chugh, T. D., & Duggal, A. K. (2012). HIV and malnutrition: Effects on immune system. Clinical and Developmental Immunology, 2012, 784740.
Lorenc, A., Ananthavarathan, P., Lorigan, J., Jowata, M., Brook, G., & Banarsee, R. (2014). The prevalence of comorbidities among people living with HIV in Brent: A diverse London Borough. London Journal of Primary Care, 6(4), 84–90.
Sampson, B. J. (2015). Factors that influence HIV testing among African American college women.
Shaw, G. M., & Hunter, E. (2012). HIV Transmission. Cold Spring Harbor Perspectives in Medicine, 2(11), a006965.