Essay Example on Living with HIV: A Look at Antiretroviral Treatment

Introduction

HIV is a disease that at least abstemiously prognostic of a defect in human cell arbitrated immunity, that occurs in people with an unknown case of reduced resistance to infections. Its origin still being debated, the first records of HIV were during the mid- to late 1960s, and by 1980, it is believed that the virus had spread across all the five continents. Over three decades later, over half of the world's population is currently living under the Antiretroviral, an HIV treatment. In the United States, the HIV epidemic may have found its way during the 1960s; however, it was noticed after the discovery of a cluster of pneumocystis pneumonia and Kaposi's sarcoma among gay men living in New York, Los Angeles, and San Francisco by a doctor in 1981.

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Although a decrease in the number of deaths due to the HIV/AIDs pandemic I the United States, approximately 1.1 million Americans above the age of 13 years are living with HIV infection, 14% of whom are unaware of the virus. Furthermore, bisexual and gay men, Latinos, and African Americans are still disproportionately affected by the pandemic in the United States. This research paper will address HIV has affected African Americans living in Southern United States by focusing on the population's demography, the affected percentage, the social factors that influence the burden of the disease, and provide methods that healthcare systems should assist the Community in combating the epidemic.

Although the United States is one of the most significant contributors of funds globally in response to HIV, the country recorded a shocking 38,700 new infections in 2017. The presence of discrimination and sigma continue to hinder people from accessing HIV tests, preventions, and treatments services, thus fueling the cycle of new infections. Southern United States records the highest rates of HIV infections. At the same time accounting to approximately half of new infections per annum, despite accounting for 37% of the country's population.

In 2018, former U.S. President Barack Obama created the National HIV/AIDs strategy, which was the country's first. The program was updated five years later in 2015 and will run until the end of 2020. The National HIV/AIDs Strategy was structured around four central cores aiming at; inhibiting new infections, improving care access and increasing health outcomes among people infected with the virus, decreasing HIV-associated inequalities and health disparities, realizing coordinated epidemic response nationwide The White House (2015). After President Trump's election into office in 2016, there have been increased concerns over his administration's approach of the epidemic, domestically as well as globally. The Director of National AIDs Policy post in 2017 became vacant as is still is up-to-date. The position exists to assist in the coordination of efforts in the implementation of the National HIV/AIDs Strategy. The President in 2019, using the State of Union address to declare his intention to eradicate the HIV epidemic in the USA within ten years. President Trump's approach to the pandemic was targeting a 75% decrease in the number of new infections within five years, and by the end of the ten years, a 90% decrease of the new cases International AIDs Society, (2019).

Population Mostly Affected by HIV in Southern US

Ethnic Group- In the Southern United States, the HIV epidemic largely impacts certain groups more than others. These largely impacted groups are identified as key populations and may be categorized using transmission category, race, and ethnicity. People of colour, African Americans are significantly exposed to increased rates of HIV infections compared to other ethnic groups in the South. In the Southern United States, African Americans are more affected and infected with HIV more compared to other groups. In 2017, African Americans accounted for 43% new infections despite being only 12% of the total population Centers for Disease Control and Prevention (2019). By late 2015, approximately 468,800 African Americans had been infected with HIV, with only one in seven being uninformed of their status. Within the diagnosed African Americans with HIV, the significant portion is men who are sexually involved with other men, in which they account approximately 6 out of 10 diagnoses Centers for Disease Control and Prevention, (2018). From 2010 to 2016, there was a 12% decrease in the number of HIV diagnoses among African American. Although there was a variation in various groups within this ethnic population. Within this timeframe, diagnosis among African Americans who were heterosexual men and women dropped by a quarter. Even though the number of new diagnoses is higher in comparison to the rates of diagnoses among heterosexuals in other ethnic groups, with women accounting for 4000 and men 1700 new diagnoses in 2017.

Sexual Orientation -MSM are men who are sexually involved with other men; they account for the most infected and affected by HIV in the Southern United States. MSM roughly make up for at least 2% of the total population but accounts for over 66% of new cases of infections. By late 2015, almost 632,000 men who are sexually involved with other men were infected with HIV. From 2010 to 2016, the number of new HIV infections among MSM stood at a constant rate of 26,000 annually Centers for Disease Control and Prevention (2019). But, these trends vary depending on ethnicity and age. For instance, among African Americans, new infections among MSM was overall constant at a rate of 10,000 new cases, 38% accounting for all men having sex with men. However, the number increased by 65% among MSM group between 25 and 34 years of age.

In 2016, it was predicted that if the recorded rates of diagnoses continued, then, 1 in every six men in the United States would be infected with HIV in their life course. This figure would translate to 1 in every 2 African American men sexually involved with men. The Centers for Disease Control and Prevention in the U.S. carries out studies every three years focusing on sexual risk behaviours, especially among MSM within certain parts of the country. The recent data from these studies indicated that there is an increase in the number of MSM having raw anal sex. In 2008, this number was at 13.7% and in 2014 the number rose to 15.7%. By 2017, 21% of men not infected with HIV and 24% of men infected with HIV who have sex with other men reported performing the act without protection three months prior to the interview Centers for Disease Control and Prevention (2019).

Transgender People- There are approximately 1 million individuals who referred to themselves as transgender in the United States. Between 2009 and 2014, approximately 2,350 transgender individuals were infected with HIV, women making up a staggering 84%. This figure almost equated to 14% of all transgender women in the U.S. diagnosed with HIV in this period. Almost half of people who identified as transgender were the recipient of HIV diagnosis within this period came from the Southern States. The prevalence of HIV infection is particularly high among African American women; with an estimate of 44% living with the infection. In most cases, individuals who identify as transgender go through increased stigma, abuse, discrimination, and violence, all these factors contributing to the increased risk of HIV exposure.

Prisoners- Globally, the United States has the largest number of prisoners compared to another nation. There are about 2.1 million people incarcerated either in closed settings or in prisons. In 2015, approximately 17,150 inmates in the U.S. were HIV positive; this figures equated to around 1% of the general inmate population. The general majority being male accounting for 15,920 HIV positive prisoners and 1,220 HIV positive female inmates. Between 2010 and 2015, the number of inmates who were HIV positive decreased by 14% and 31% among males and females inmate, respectively. In the Southern United States, there are many African Americans who are incarcerated among which are more likely to be diagnosed with HIV compared to other ethnic groups. Even before being imprisoned, the majority of African American inmate are HIV positive, with one research approximating that 1 in 7 people diagnosed with HIV in the United States goes through the correctional system each year. Other prisoners acquire the infection while imprisoned, for instance, during unprotected sexual encounters.

Young People-Countrywide, in 2017, young people accounted for 41% of new infections; aged 13-29 while those between 13-24 accounted for 21%, that is near to 1 in 5 new cases. The most affected in this group include MSM and African American aged between 14 and 34.

Social Factors that May Influence the Burden of HIV

Freedom of speech- the current existence of freedom of speech that is experienced in the South has allowed political activism to play a key role in response to HIV. However, this was not always the case; in the past, HIV activism was often associated or linked to gay communities. Furthermore, in the South, there was a decline in grassroots activism as antiretroviral treatment was introduced in the early 1990s. However, due to concerns over reproductive health rights and gay, lesbian, bisexual, intersex, and transgender rights, Trump's administration has brought about an increase in the number of activism.

Stigma and discrimination- there is an impending need to address the issue of stigma and discrimination around the HIV epidemic for the South to practically deal with this infection. Infected individuals often face guilt and negative self-blame due to their status, social and institutional discrimination, especially in healthcare facilities. The existing uneven healthcare provision especially in the South brings about dire clinical outcomes, especially for people living with HIV. The existing poverty line and poor healthcare access ignite the high numbers of HIV infections. Therefore, there is a need to accept people as they are first, despite their sexual orientation, HIV status, and socioeconomic status.

Ethical issues that are factors in developing and implementing prevention and intervention program for HIV.

Community participation- there is a need to ensure ethical standards are met, especially during the scientific intervention of the HIV epidemic. The intervention needs to remain relevant in the South and be acceptable by the Community. Thus, before conducting any medical intervention, people need to be consulted and be involved in meaningful participation that will involve them fully. For instance, the introduction of the ARV treatment, the South should have been involved during the conception of the idea, design, development, implementation, and monitoring of the process for effectiveness.

Recruitment of participants- several studies to investigate the rate of infection or HIV prevention trials among certain sample have been done, however, for such studies to remain ethical, individuals who participate should be under voluntary circumstances. Also, the selection of the participants also needs to be fair and justified.

Children and Adolescents- there is a need to include them in clinical trials for efficacy and safety verification. Researchers have to make sure that design efforts and biomedical implementation for HIV prevention programs consider legal obligations that are relevant to adolescents and children rights, thus safeguarding them.

Healthcare Components to Deal with the HIV Epidemic

In an attempt to mitigate the high negative impact of HIV infection in the USA, the CDC came up with a new fund cycle amounting to 339 million dollars. The grants were granted to health departments that proved to have the capacity...