The Human immunodeficiency virus (HIV) remains to be a leading public health issue in society. Since the outbreak of this epidemic, approximately 32 million individuals have died from HIV-related illnesses, and about 75 million are living with the virus (United Nations, n.d). High cases and mortality rates have been reported in sub-Saharan Africa, accounting for over half of infections worldwide. Other regions, such as the United States, South America, and Asia, have also continued to record several cases and incidences of HIV-related deaths.
Causes, Symptoms, Mode of Transmission, Complications, Treatment, and the Demographic of Interest
HIV is known to debilitate individuals’ immune systems, increasing the propensity and impact of other infections. The virus destroys the CD4 cells and hinders the body’s ability to fight against other ailments and anomalies. A weakened immune system makes people susceptible to opportunistic infections and some cancer forms (Centers for Disease Control and Prevention [CDC], 2021a). If left untreated for a prolonged period, HIV may develop into a severe condition known as Acquired Immunodeficiency Syndrome (AIDS). A study indicates that a healthy adult has a CD4 count of 500 to 1500 per cubic millimeter (Awoke Ayele et al., 2019). Therefore, anyone whose CD4 count falls below this range may develop AIDS, a chronic and life-threatening condition.
The symptoms of HIV depend on the stage of infection. The first stage is the acute primary infection phase, covering two to four weeks after contracting the virus. The period is characterized by mild fever, sore throat, muscle pains, headache, rash, cough, weight loss, and muscle and joint pain (Letizia et al., 2022). The second phase is the asymptomatic stage, where a patient’s immune system becomes acutely impaired, increasing the likelihood of contracting opportunistic infections, such as tuberculosis, pneumonia, and chronic diarrhea.
There are multiple ways through which people can contract HIV infection. Some of the modes of transmission include sexual contact and sharing syringes and needles, especially among drug users. The virus can also be acquired during pregnancy, delivery, or breastfeeding from a mother to a child (Adachi et al., 2018). People may also contract this virus through blood transfusion, premastication, and sharing of unsterilized tattoo equipment.
HIV weakens the immune system, making the body susceptible to various health complications. These include candidiasis, pneumocystis pneumonia, cryptococcal meningitis, toxoplasmosis, and herpes (United Nations, n.d). It also causes kidney, and liver diseases, neurological problems, lymphoma, and Kaposi sarcoma. Although no cure exists for HIV, various treatment options can alleviate major symptoms and prolong life expectancy. These include antiretroviral drugs vital in stopping the virus’s progression and lowering the risk of transmission.
The HIV epidemic continues to have disproportionate effects on different populations across the world. According to a report, around 1.2 million Americans are HIV-positive, and 13% were unaware they had the infection (U.S Statistics, 2021). In 2019, out of the 37,968 new HIV infections, 81 % were men. 69% of the new infections among males were linked to bisexuals and gays (U.S Statistics, 2021). The highest rate of new cases was among the African-Americans, followed by the Latinos. In 2018, HIV infections reduced among individuals aged 13 to 24, and the highest rates were recorded among the age groups of 24 to 25 years (CDC, 2022). The reported number of fatalities in the country was estimated to be 11,975. Although HIV remains a significant public health concern in the United States, substantial progress has been made toward ending the epidemic.
HIV as a Reportable Disease
HIV has been classified as a reportable infection that requires close monitoring. Reporting all cases helps keep track of new infections and determine whether people diagnosed with HIV receive the care they need. Similarly, information about HIV also provides insights into why some individuals get infected, and others do not. Therefore, data collection is mainly for statistical purposes to demonstrate how often HIV occurs and provide intervention to control its spread. Hospitals that order HIV tests and laboratories have a legal requirement to report basic information about people diagnosed with this infection and how they get infected (Healthy People, 2022). Patients’ data is collected utilizing standard confidential case reports and are conveyed directly to the department of health (DOH) in various states or to the CDC without personal identifiers.
Social Determinants of Health and How They Contribute to HIV
The social, economic, and environmental factors directly impact the spread of HIV among various populations. Research shows that lack of access to education, healthcare services, and low-income increase the susceptibility to this disease (Singh et al., 2017). Education promotes awareness about the disease, enabling individuals to adopt protective measures to guard themselves against the virus. People may get tested or avoid risky behaviors, such as sharing injection needles and breastfeeding newborns, especially when they are HIV-positive. Also, limited access to healthcare services contributes to a high mortality rate due to late diagnosis, which may hinder patients from getting timely medications and other support services (Naik et al., 2020). Poverty also promotes risky behaviors, such as prostitution, and further exacerbates the challenges of living with this disease.
The Epidemiologic Triangle As It Relates To HIV
The epidemiologic triangle is fundamental in understanding why HIV spreads within a population. The model consists of three pillars: the agent, a susceptible host, and the environment. The agent is the human immunodeficiency virus or HIV, which weakens the immune system. HIV enters the body through contact with semen or blood from an infected person. The virus targets the immune system and depletes CD4 cells. This makes it difficult for the body to combat infections, leading to AIDS (Awoke Ayele et al., 2019). HIV is traced from primates, such as chimpanzees, which initially carried the virus. However, it was later transmitted to humans when chimpanzees were hunted for meat (CDC, 2021b). People became infected with a mutated form of the virus. However, the spread of HIV among humans is through bodily fluids, such as when the blood comes into contact with damaged tissue or mucous membrane.
HIV, like other reportable diseases, thrives within a complex social environment. In this case, social norms and practices can determine the infection rate. These include certain sexual practices, such as commercial sex, anal-receptive intercourse, practices that encourage multiple sexual partnering, and abuse of substances that reduce sexual inhibitions. Moreover, in places where discrimination and social pressure are rife, patients may be discouraged from being tested or seeking treatment (Fauk et al., 2021). Consequently, this increases the prevalence of sexually transmitted infections and reduces reporting incidences, promoting its spread. Socioeconomic conditions or environment for both the host and agent also influence the transmission of HIV and make a population more vulnerable to the infection. High levels of the poverty limit access to care and treatment.
Special Considerations or Notifications for the Community, Schools, or General Population
High priority needs to be given to identifying vulnerable communities and linking them to HIV-related services. These include individuals living on the streets, orphans, adolescents who are sexually exploited, girls engaging in sex with older men, or those in concurrent sexual partnerships. The screening, testing, and other essential resources should be channeled toward these groups to prevent them from engaging in health risk behaviors and help curtail the spread of the virus. While HIV in schools is a concern, sex education can create awareness about how the infection spreads to promote healthy sexual behavior or delay sexual initiation to promote safety (Rabbitte & Enriquez, 2018). Therefore, building cognitive skills can provide students with a comprehensive understanding of their health status and empower them to abstain or refuse unwanted sexual activities.
The Role of the Community Health Nurse
Community health nurses are always at the forefront in helping patients fight the adverse effects of HIV. Healthcare professionals’ roles include case finding or detection, where they identify occurrences or individual cases of HIV requiring services. They can organize gatherings and conduct HIV screenings and testing. Such initiatives enable nurses to identify all cases in a given community, administer treatments and educate patients about their status and how to protect HIV-negative members from the infection (Wood et al., 2018). The screenings also allow the nurses to collect data about the prevalence of HIV and report it to the relevant health departments in order to evaluate the appropriate interventions for the affected community.
Nurses also follow up on the infected people’s health status and advise accordingly. They can answer patients’ questions and check their progress with the prescribed treatment plan or make further assessments and adjust treatments. HIV demographic data in communities helps monitor the trends or identify whether there is a rise or decline in the number of infections. The information guides the health professionals and state DOH on the appropriate interventions to continue curbing the spread of the diseases (Wood et al., 2018). Therefore, the information is needed to determine the future needs for healthcare services and source funding to continue offering prevention and treatment for HIV.
A National Agency That Addresses HIV and How It Resolves the Impact of the Disease
The CDC is a federal agency that collaborates with all its stakeholders to address the HIV epidemic. CDC uses a High-Impact-Prevention (HIP) approach to lower the infection rates in the United States (CDC, 2017). The agency’s commitment to HIP is evident through public health guidelines, funding decisions, research, and surveillance. CDC has, over the years, continued to increase testing and diagnosis for HIV. In addition, the organization funds health departments and CBOs to make HIV testing accessible and routine. It has also developed recommendations concerning emerging testing technologies such as the antigen/antibody combination tests to allow earlier detection of HIV and quick linkage to care. The testing and diagnosis target all populations with special efforts on African-Americans, Latinos, bisexual men, and gays (CDC, 2019). CDC has developed evidence-based interventions to enhance the linkage to care, maintenance of care, and medication adherence by inventing resources that support services, such as the Every Day and Every Dose toolkit (Byrd et al., 2019). The toolkit is a mobile app that provides details on the dosage, refill, and medical appointment reminders.
The organization funds health departments and CBOs to provide access to condoms, especially to people living with HIV and those with a higher risk of becoming infected. Similarly, CDC is engaging in multiple fronts to increase awareness about Pre-exposure prophylaxis (PrEP) and ascertain that it is provided to all eligible individuals (CDC, 2019). Thus, the CDC’s efforts aim to suppress the virus and allow patients to have productive lives.
The Global Implication of HIV and How It Is Addressed in Other Countries or Cultures
The HIV epidemic has continued to impact communities differently around the world. Since its beginning, over 76 million individuals have been diagnosed with HIV (Kaiser Family Foundation, 2021). In addition, over 770 000 individuals have died of HIV-linked causes, and about 1.7 million people are newly infected with this disease. By the end of 2018, an estimated 37.9 million individuals around the globe were living with this infection. (Kaiser Family Foundation, 2021)). The global prevalence of HIV among persons aged 15-49 was 0.7 percent in 2019. Children also account for about 1.8 million patients living with the diseases. HIV also remains a leading cause of death globally among women of reproductive age (Kaiser Family Foundation, 2021). Since the first cases were reported decades ago, recent data shows that the rate of new infections and HIV-related deaths has decreased significantly. This decline is attributed to numerous prevention interventions that exist to combat its spread.
Different cultures have continued to employ various methods to reduce HIV infections. Some prevention strategies include condoms use, behavior change programs, blood donation safety, harm reduction efforts for injecting drug users, HIV screening and testing, and male circumcision. Antiretroviral therapy (ART) and medications have also enabled HIV-positive people to reduce transmission. Also, PrEP is being used by HIV-negative people at a higher risk for HIV infection to prevent them from acquiring it (CDC, 2021c). While much progress has been made, this has been unequal within and between countries. The pace of decline differs by sex, age group, and region. The study shows Sub-Saharan African countries are the most affected regions, accounting for about 65% of HIV infections worldwide (Joint United Nations Programme on HIV/AIDS, 2021). Some of these countries include Nigeria, Kenya, Malawi, Uganda, and Ethiopia. This high rate of HIV infections is attributed to socio-cultural barriers and economic factors that allow the disease to thrive in these nations. For example, there is inadequate education offered to youth about the virus and a lack of proper and timely treatments. Different sexual customs that permit individuals to have multiple long-term sexual partners, high prostitution due to low economic empowerment, female genital mutilation, and stigmatization are barriers to treatment. Limited resources also hinder access to services to fight HIV infections. All these problems might explain the high HIV infection rate in sub-Saharan Africa.
Since the outbreak of HIV, the disease has claimed over 32 million lives. According to the statistics, thousands of people live with the virus in sub-Saharan Africa, accounting for over half of all cases worldwide. However, much progress has been realized in suppressing the diseases’ adverse impacts and empowering patients to live productive lives. CDC and State DOH have continued to employ prevention strategies, such as condoms use, behavior change programs, HIV screening and testing, ART, and medications to enable HIV-positive patients to manage their symptoms and reduce transmission. PrEP is also used by individuals at a higher risk of HIV infection to prevent them from acquiring the disease. Community health nurses have been at the forefront in linking patients with resources to reduce the mortality rate. They also educate individuals about the infection and promote community awareness and protect HIV-negative members from getting infected.
Adachi, K., Xu, J., Ank, B., Watts, D., Camarca, M., & Mofenson, L. et al. (2018). Congenital cytomegalovirus and HIV perinatal transmission. Pediatric Infectious Disease Journal, 37(10), 1016-1021.
Awoke Ayele, T., Worku, A., Kebede, Y., Zuma, K., Kasim, A., & Shkedy, Z. (2019). Model-based prediction of CD4 cells counts in HIV-infected adults on antiretroviral therapy in Northwest Ethiopia: A flexible mixed effects approach. PLOS ONE, 14(7), e0218514.
Byrd, K., Hou, J., Hazen, R., Kirkham, H., Suzuki, S., & Clay, P. et al. (2019). Antiretroviral adherence level necessary for HIV viral suppression using real-world data. Journal of Acquired Immune Deficiency Syndromes, 82(3), 245-251.
Centers for Disease Control and Prevention. (2017). High-impact HIV prevention: CDC’s approach to reducing HIV infections in the United States.
Centers for Disease Control and Prevention. (2019). CDC’s approach to public health – High-Impact Prevention (HIP).
Centers for Disease Control and Prevention. (2021a). AIDS and opportunistic infections.
Centers for Disease Control and Prevention. (2021b). About HIV.
Centers for Disease Control and Prevention. (2021c). Pre-Exposure Prophylaxis (PrEP).
Centers for Disease Control and Prevention. (2022). HIV and men.
Fauk, N. K., Hawke, K., Mwanri, L., & Ward, P. R. (2021). Stigma and discrimination towards people living with HIV in the context of families, communities, and healthcare settings: A Qualitative study in Indonesia. International Journal of Environmental Research and Public Health, 18(10), 5424.
Healthy People. (2022). National HIV surveillance system. Web.
Joint United Nations Programme on HIV/AIDS. (2021). Fact sheet-World AIDS day 2021.
Letizia, A., Eller, L., Bryant, C., Dawson, P., Nitayaphan, S., & Kosgei, J. et al. (2022). Clinical signs and symptoms associated with acute HIV infection from an intensely monitored cohort on 2 continents. Medicine, 101(5), e28686.
Naik, P., Yavuz, M., & Zu, J. (2020). The role of prostitution on HIV transmission with memory: A modeling approach. Alexandria Engineering Journal, 59(4), 2513-2531.
Rabbitte, M., & Enriquez, M. (2018). The role of policy on sexual health education in schools: Review. The Journal of School Nursing, 35(1), 27-38.
Singh, G., Daus, G., Allender, M., Ramey, C., Martin, E., & Perry, C. et al. (2017). Social determinants of health in the United States: Addressing major health inequality trends for the nation, 1935-2016. International Journal of MCH and AIDS, 6(2), 139-164.
U.S Statistics. (2021). Fast facts.
United Nations. (n.d). AIDs.
Wood, E., Zani, B., Esterhuizen, T., & Young, T. (2018). Nurse led home-based care for people with HIV/AIDS. BMC Health Services Research, 18(219), 1-13.