HIV and sexually transmitted diseases (STDs) are a prevalent community health concern in Miami. The identified causes are insufficient sexual education, rising cases of substance abuse, and potential transfers of HIV from mothers to children. It has been noted that the community does not offer proper facilities or educational curriculums to address the knowledge gaps in the population regarding HIV/STDs transmission resulting in irresponsible or detrimental behavior or lifestyle choices. The prevalence of STDs in the United States is rising, often hitting record levels and threatening health.
Cases of syphilis, gonorrhea, and chlamydia have increased by as much as 14% with a combined 2.45 million cases nationwide, with congenital syphilis resulting in newborn deaths has increased by 40% (CDC, 2018). There are 1.1 million people with HIV in the United States and 37.9 million globally, with up to 15% being unaware that they are infected (HIV.gov, 2019).
The economic burden of this issue in the United States is significant with lifetime total medical costs exceeding $16 billion for chronic conditions and $742 million annually for treatable STDs, with potentially hundreds of millions of dollars in a ripple effect on the economy due to lost time and productivity (CDC, 2013). HIV and STDs are highly impactful on community health and can be difficult to treat while being easily preventable, with community resources focusing on improving educational awareness in the population.
Advanced Practice Roles and Management Strategies
Advanced practice roles of a nurse to create community change lies in competent leadership. The biggest impact can be achieved through two domains, patient-focused leadership and organizational and systematic leadership. Through practice nurses can build trusting relationships with community members and focusing on managing patient-centered care to achieve exemplary outcomes through clinical expertise and advanced nursing knowledge. This allows for proper advocacy and education towards the patient capitalizing on teachable moments and facilitation responsible choices.
Meanwhile, from an organizational standpoint, the quality of care and education can be improved by facilitating advanced nursing knowledge to identify gaps in the system and beginning to use resources of the health care spectrum to integrate knowledge to the patient. Furthermore, it is critical to enhance professional nursing practice by emphasizing professionalism and competency. Also, it is vital scan and analyze the community environment to determine which best evidence-based practices may be fitting in order to facilitate healthcare improvements and population outcomes (Lamb, Martin-Misener, Bryant-Lukosius, & Latimer, 2018).
Community and Social Resources and Services
A significant community resource in this issue is public education which begins to provide the fundamentals of sexual education to individuals starting with school. However, this aspect is often underfunded and does not have up-to-date resources and information to instill proper STD prevention education in adolescents that consist of more than a third of all STD patients. Local providers and public health departments also can contribute to STD prevention by engaging in a public health campaign helping to spread accurate information.
Furthermore, a community service which has been helpful to manage STDs in population is screenings and treatment for free or reduced cost which can help individuals identify if they have an STD and prevent further spreading.
Promotion of personal health and community wellness is vital by promoting screening coverage and vaccination when applicable. Social resources focusing on helping those struggling with poverty and substance abuse where HIV/STD rates are high can benefit the community by also offering screening services and potentially introducing programs such as needle exchanges to mitigate transmission by blood. It is necessary to implement enhancements and funding for all the listed community services as well as remove policy barriers to facilitate partnerships with local private and public organizations that can aid in spreading information and offer appropriate care to those at risk (ASTHO, 2014).
Strategic Plan
The strategic plan will take a two-fold approach of reducing the burden of STDs in the community and improving the health status while also providing management and education tools for prevention in the future. Reducing the rate of STDs can be achieved by providing free screening programs in the community through health providers and clinics that will allow individuals to confidentially find out their STD/HIV status and be directed towards appropriate treatment. This will seek to decrease health disparities by providing access to vital health screenings to all population groups, including the lower ends of the socioeconomic spectrum.
General statistics will be gathered regarding participants and diagnoses rates and re-examined after time. The prevention aspect will focus on education by implementing a community-wide educational initiative for STD/HIV prevention and transmission. It will focus primarily on schools to ensure future generations are aware of risks. However, public health information will be distributed on government agency and provider websites, advertisements, pamphlets, and billboards. A public awareness campaign is the most effective. Relevant facilities and services for mothers who may pass STDs to their child or those suffering from substance-abuse will also provide educational resources to individuals.
Conclusion
HIV and STD prevalence in the Miami area is high and has significant community health impacts. It is the goal of the strategic plan to reduce incidence of STD and HIV diagnoses in the long-term by improving public education on the topic and provide access to community services that contribute to prevention of the diseases. Challenges may include political barriers, the uncomfortable nature of the topic of sexuality, and difficulty of informational penetration to some levels of the community.
However, with competent implementation of the strategic plan and services, it is possible to see positive outcomes. The effect will not be seen immediately but will require annual reevaluation. It is however necessary to see an increase of utilization in screening services and health provider treatments of STDs as well as increase in educational programs on the issue.
References
ASTHO. (2014). STD prevention resources.
CDC. (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Web.
CDC. (2018). Reported STDs in the United States, 2018.
HIV.gov. (2019). The global HIV/AIDS epidemic.
Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 5(3), 400-413. Web.