Introduction
Transmission of sexually transmitted diseases has become a significant issue in the twenty-first century and has to be discussed. Studies have shown that most of the infections can be traced to the drug-addictive populace and sex workers. Whereas there are effective methods of controlling the spread amongst non-addicts, the treatment of the addicted proves to be difficult. This is a result of much utilization of syringes and a high number of partners with regard to sex workers. This paper draws a hypothesis suggesting that preventive techniques need to specifically target drug addicts and sex workers to combat the STD epidemic and offer interventions to reduce sexual risk behaviors and drug use.
Review of Literature
Sustained Viral Suppression in HIV Treatment
HIV-1 has caused a pandemic that has stimulated an extreme search for new antiretroviral drugs for the treatment of the disease. The period between 1994 and 1998 marked the rise of another new class of NNRTIs or antiretroviral drugs named non-nucleoside reverse transcriptase inhibitors (Crepaz et al. 335). Since they are easier and cheaper to produce than protease inhibitors, they aided in scaling up the ARV therapy in resource-limited settings. Identifying novel drug targets has been significant in the discovery as well as the development of other ARV drug classes. For instance, since the 80s, researchers have believed that a molecule named CD4 is the main receptor for HIV in immune cells (Crepaz et al. 335). In the same period, they reported the finding of a co-receptor referred to as CXCR4, which is needed for the entry of particular HIV strains into immune cells.
The discovery motivated scientists and researchers to search for other co-receptors. Numerous groups, such as NIAID scientists, believed that another receptor named CCR5 is the actual primary co-receptor utilized by the disease to infect immune cells. This established the basis for the development of the CCR5-blocking drug maraviroc, which was approved by the FDA in 2007. Another significant ARV drug class arose in 2007 with the approval of the same body called integrase inhibitor raltegravir (Crepaz et al. 336). Raltegravir rapidly became a valued part of combination antiretroviral treatment. However, HIV can seek numerous pathways to develop resistance to the medicine. Its variants that are resistant to raltegravir may as well be resilient to elvitegravir, another integrase inhibitor of the first generation.
Dolutegravir, which was approved by the FDA in 2013, is an integrase inhibitor too, but of the second generation and seems to possess a high barrier to HIV drug resistance’s development. In clinical experiments, dolutegravir was great for individuals infected with HIV who had not undergone the therapy previously and for those who had experienced the treatment (Wagner et al. 988). The latter includes people in whom the integrase inhibitors of the first generation were ineffective. Other benefits of the dolutegravir consist of convenience in terms of once-daily dosing, relatively low production cost, and good safety profile (Crepaz et al. 337). It is now included in two of the initial line regimens that the United States Department of Health and Human Services medical practice guidelines suggest for infected adults. Recently, it was added to the WHO policies as an optional first-line agent for grown people.
Statistics suggest that treatment with ARVs slows the occurrence of AIDS, and betters the condition as well as the survival of patients. Nevertheless, in the drug-addict populace, the viral suppression therapy effect was greatly lower than in other groups as a result of repetitive transmission prior to the therapy has had a positive impact. Drug-addict and sex workers have low access to viral suppression therapy since most lack insurance, food and accommodation and have a poor level of life. Identifying and sustaining treatment has to be a prerogative in handling an STD situation (Crepaz et al. 338). The utilization of a single or more medication for drug addicts is related to a high rate of disease progression as well as the emergence of virus resistance. Nowadays, three or more ARVs are used at the same time for the purpose of treating HIV infection. Trials to induce virus suppression with multiple ARV drugs and then maintain the accomplished impact with only two drugs resulted in an unacceptably high frequency of disease return.
Risks of STD Development
There are various risks of STD development in sex workers and drug-addict groups as a result of how they live. This can be divided into individuals, such as the relationship between the addicted and non-addicts and environmental factors (Abad et al. 1710). The combination of the two groups determines the high level of infections in the particular populace. The first group consists of the structure of drug-dealing networks whereby all new members are actively encouraged to abuse drugs. This is usually done on the individual relations level via the real or feigned relationship, attachment, or love.
Whereas creating relationships with personal network members, the dangerous pattern of behavior such as sharing syringes or having unprotected sex may be practiced. Childhood abuse, as well as violent relations, often lead to trauma that pushes people to prostitution or drugs and, thus, greatly increases individual-level risk factors (Crepaz et al. 338). Environmental factors consist of the availability of needles, poor level of life, and inefficient law enforcement practices.
Syringes are practically available at all drugstores and can be acquired without the need for a prescription. Food shortage and lack of accommodation contribute to feeling hopeless which may result in people abusing drugs or participating in prostitution (Wagner et al. 989). It is important too to note that when it comes to drug abusers, even substances such as alcohol, methamphetamine, crack cocaine, and inhalants are associated with high rates of infections.
Excessive consumption of alcohol can be an essential risk factor for HIV since it is connected to dangerous sexual behaviors and among those already infected, can negatively impact the treatment outcomes. Abuse of opioids, which is a drug class that aims to minimize pain, has been linked as well with the growth of the number of infections. Research shows that the majority of sex workers prefer using this group of substances since they are readily available even in the streets (Abad et al. 1712). Due to the restrictions and regulations guiding prescription in hospitals, individuals have opted for cheaper forms that are more dangerous.
Meth, which is also called methamphetamine, is associated with unhealthy sexual behaviors that put individuals at a greater danger of contracting HIV. With the use of an injection, one can induce it into their body (Lansky et al. 1). As mentioned earlier, the syringes or needles utilized in such occurrences are a quick way of transmitting the disease from one infected person to a non-infected. Crack cocaine and inhalants are the other drugs that rank high on the list of substances that can lead to unsafe decisions (Arasteh et al. 3318). The former refers to a stimulant that has the ability to create a cycle whereby people quickly exhaust their resources and turn to other ways to obtain the drug. This includes having sex to get the money they can use to buy what they need (Pufall et al. 262). Lastly, for a long time, amyl nitrite, which is an inhalant, has been connected to careless behaviors when it comes to sex.
Prevention Factors of STD Development
The two primary ways of spreading STDs include repetitive and common utilization of syringes as well as unprotected sex with numerous partners. To prevent such practices, measures need to be taken to monitor distributive syringe sharing and syringe services programs among addicted individuals (Adams et al. 3306). Furthermore, more governmental measures must be adopted to avoid issues such as prostitution, for instance, minimizing factors that lead to it, for example, poverty, childhood abuse, violence in families, and criminal activities.
Distributive syringe sharing (DSS) and syringe services programs (SSP) are aimed at controlling the use of syringes by drug addicts. These initiatives proved to be effective in curbing the spread of HIV and hepatitis C since they allow the exchange of used needles for clean ones (Adams et al. 3307). The programs are financed by states and non-profit organizations and provide guidelines for drug addicts on how to avoid STD infections.
The problem of poverty in the United States is solved with the help of state government and social and philanthropic organizations. Moreover, the assistance is not always monetary, as at times, states provide free access to laundry services, movies, and educational programs. Employment services play a significant role in providing citizens with an opportunity to find a job or some employment. Moreover, they give free medical insurance for the poor; the range of services covered depends on the government.
Sex education plays a significant role in the prevention of STD. It is a system of measures of pedagogical impact on children and adolescents in order to promote understanding of the essence of the relationship between the sexes and norms of behavior in sexual life. Addressing the spread of SDT requires a versatile social approach to this problem, the promotion of moral values, and comprehensive education of the younger generation. Younger people must be aware of the diseases that can be transferred through unprotected sex and assume responsibility for their own health and the health of their partners.
The United States government, through various agencies, has done a great job of ensuring that sex education is integrated into the school work of a student. When younger, children consume different pieces of information and grow up knowing that they may be right. Instilling the right knowledge in kids at a young age is great as it ensures they continue living their lives in a manner that does not put them into risk.
Conclusion
The paper has drawn a hypothesis suggesting that preventive techniques need to specifically target drug addicts and sex workers to combat the STD epidemic and offer interventions to reduce sexual risk behaviors and drug use. Through its contents, one can understand that HIV-1 is the cause of a pandemic that has intensified the search for new antiretroviral drugs for the treatment of the disease. It is approximated that in the mid-90s, there emerged a new class of NNRTIs or antiretroviral drugs named non-nucleoside reverse transcriptase inhibitors. As a result of being easier and cheaper to produce than protease inhibitors, they aided in scaling up the ARV therapy in resource-limited settings.
The paper has shown that recognizing novel drug targets has been critical in the discovery as well as the development of other ARV drug classes. For instance, a researcher, since the 80s has believed that a molecule named CD4 is the primary receptor for HIV in immune cells. In the same period, they reported the finding of a co-receptor referred to as CXCR4 which is needed for the entry of particular HIV strains into immune cells. Additionally, treatment with ARVs slows the occurrence of AIDS, and betters the condition as well as the survival of patients. Nevertheless, in the drug-addict populace, viral suppression therapy effect was greatly lower than in other groups as a result of repetitive transmission prior to the therapy has had a positive impact.
Lastly, drug addicts and sex workers have low access to viral suppression therapy since most lack insurance, food and accommodation and have a poor levels of life. Identifying and sustaining treatment has to be a prerogative in handling an STD situation. The utilization of a single or more medications for drug addicts is related to a high rate of disease progression as well as the emergence of virus resistance. Nowadays, three or more ARVs are used at the same time for the purpose of treating HIV infection. The two primary ways of spreading STDs include repetitive and common utilization of syringes as well as unprotected sex with numerous partners. To prevent such practices, measures need to be taken to monitor distributive syringe sharing and syringe services programs among addicted individuals. Furthermore, more governmental measures must be adopted to avoid issues such as prostitution, for instance, minimizing factors that lead to it, for example, poverty, childhood abuse, violence in families, and criminal activities.
Works Cited
Abad, Neetu, et al. “A Systematic Review of HIV and STI Behavior Change Interventions for Female Sex Workers in the United States.” AIDS and Behavior, vol. 19, no. 9, 2015, pp. 1701–1719. Web.
Adams, Monica, et al. “Distributive Syringe Sharing and Use of Syringe Services Programs (SSPs) among Persons Who Inject Drugs.” AIDS and Behavior, vol. 23, no. 12, 2019, pp. 3306–3314. Web.
Arasteh, Kamyar, et al. “Injection and Heterosexual Risk Behaviors for HIV Infection among Non-Gay Identifying Men Who Have Sex with Men and Women.” AIDS and Behavior, vol. 23, no. 12, 2019, pp. 3315–3323. Web.
Crepaz, Nicole, et al. “Racial and Ethnic Disparities in Sustained Viral Suppression and Transmission Risk Potential among Persons Aged 13-29 Years Living with Diagnosed HIV Infection, United States.” JAIDS Journal of Acquired Immune Deficiency Syndromes, vol. 83, no. 4, 2016, pp. 334–339.
Lansky, Amy, et al. “Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and Hepatitis C virus infections.” PLoS ONE, vol. 9, no. 5, 2014, pp. 1. Web.
Pufall, E. L., et al. “Sexualized drug use (‘chemsex’) and high‐risk sexual behaviors in HIV‐positive men who have sex with men.” HIV medicine, vol. 19, no. 4, 2018, pp. 261-270. Web.
Wagner, Karla D., et al. “Place of residence moderates the relationship between emotional closeness and syringe sharing among injection drug using clients of sex workers in the US-Mexico border region.” AIDS and Behavior, vol. 19, no. 6, 2015, pp. 987–995. Web.