Human Immunodeficiency Virus is a single-stranded RNA retrovirus that causes Acquired Immunodeficiency Syndrome (AIDS) (Freed, 2001). The virus is transmitted from one person to another through bodily fluids like blood and semen. Any means that contribute to exchange of body fluids like injections and blood transfusion directly lead to the transmission of the virus that causes AIDS. This disease is the most important sexually transmitted infection and poses the highest public health challenge. After the acquisition of the virus, a window period of about three months follows in which the body shows no observable symptom (Freed, 2001). During the window period, the virus replicates actively and causes mass destruction of the cellular immunity. After the three months period, a patient shows a febrile illness, fever, and adenopathy. Tuberculosis and other respiratory infections later set in. As the disease progresses to AIDS, the patient suffers other opportunistic infections that manifest in different ways. Complications of AIDS include hepatopathy, renopathy, and widespread lymphadenopathy. Treatment of HIV involves a combination of antiretroviral therapy called Highly Active Antiretroviral Therapy (HAART). Antivirals that comprise HAART include Zidovudin, lamivudine, and Indinavir. Currently, the burden of HIV in the US stands at 1.2 million. Out of these, 1 in every 8 person does not know about their HIV status. Gay and Bisexual African American men are most affected by the disease in the United States (Grov, Rendina, & Parsons, 2016).
Determinants of disease are the factors that affect the occurrence of an ailment on a population (Park, 2007). They include man, host agent relationships, and the intrinsic characteristics of an infectious agent. Man represents the host in which the agent spends all or some of its lifecycle. The occurrence and perseverance of disease in man depends on the host susceptibility and behaviors. For example, people with an existing sexually transmitted infection are more likely to contract a disease that those without an STI. Furthermore, underage sexually active persons, rape victims, and homosexual are more predisposed to HIV. There are various social and economic factors that affect contraction of HIV. Poverty, for instance, drives women and men to practice prostitution which increases their risk to infection. The interaction of man and the infectious agent also determines the length of disease persistence in the community. The intrinsic characteristics of the agent that determine its disease causation tendency are pathogenicity and resilience, which are in turn affected by the organisms anatomical and biochemical makeup. The HIV genome is encapsulated in a lipid envelope and protein matrix that protects it from destruction by physical and chemical agents. HIV has the ability to replicate inside the host cells using the hosts replication mechanism (Freed, 2001). The virus produces high copy numbers over a short time. These two factors make HIV control difficult, and as a result the organism persists in the body for a lifetime.
HIV infection follows the epidemiological triad. The host factors that determine the contraction of the virus are sexual orientation, number of sexual partners, and host genetics. Gay men are more likely to acquire the disease more than heterosexual men (Grov, Rendina, & Parsons, 2016). At the same time, the rate of infection increases with the increase in the number of sexual partners. Some people are predisposed to the virus but fail to develop the disease due to their genetic makeup. Agent factors that determine infection include pathogenicity, serotype, and drug resistance. Some HIV serotypes are more infectious than others. The high rate of viral replication makes the control of HIV a challenge to health practitioners. The development of multi-drug resistance HIV serotypes renders the conventional antiretroviral drugs inactive, prompting for new research and development with a move to come up with more efficacious medicines. This endeavor is both costly and time-consuming, and is always a drawback to the global health community. Finally, there are several environmental factors that determine the risk and prevalence of HIV. The most important factor is the local rates of infection. High prevalence rate of HIV translates to an equally high incidence of the disease. Also, social factors that predispose one to HIV include poverty, social exclusion, and commercial sex working.
Community health workers are pivotal in the creation of awareness, control of the infection, and follow-up of infected individuals among others. Community nurses are the first people who identify a new case of infection in the community. A patient might present in health center with an illness that a nurse might diagnose as the early stages of the disease. Therefore, community nurses are involved in case finding. Nurses may also apply snowballing to track the trail of infection from one case. For instance, the nurse may encourage a partner to an infected individual to come for testing, which leads to the identification of another case. Secondly, nurses establish a reporting channel that ensures that all positive cases are documented and compiled with the national statistics. Nurses also make recommendation to the national agencies concerned with the control of the disease depending on the observed prevalence of HIV in a specific locality or population group. In an epidemiological study involving HIV infection rates, patients profile or drug resistance, community health nurses form a part of the bigger team in the data collection in the field and in the hospital. They are also crucial role players in the analysis of collected data and in the making of conclusion from the data analysis. As a part of nursing core competencies, HIV positive patient follow-up is the responsibility of community health nurses because they are closely connected with the patients.
United States Center for Disease control is always in the frontline to address HIV/AIDS on a national and international platform. The CDC compiles the national statistics for HIV to inform the government and the general population of the burden of disease in the country. The organization also carries out research and development in and out of the country to come up with the best methods of HIV prevention and treatment. It also collaborates with other international scientific bodies to develop anti-HIV vaccine aimed at protecting the community against the disease. It has website in which it updates the latest information on the disease through regular newsletters.
Another US agency that deals with HIV and HIV patients is the United States President's Emergency Plan for AIDS Relief (PEPFAR). PEPFAR works alongside other national and international agencies to combat the HIV pandemic by improving care for HIV patients and supporting the efforts of other like-minded outfits in the fight against the disease. In the country, the efforts of PEPFAR are complemented by the Department of State, Department of Labor, Department of Defense, Peace Corps, Department of Commerce, and the Department of Human and Health Services.
Freed, E. O. (2001). HIV-1 replication. Somatic cell and molecular genetics, 26(1-6), 13-33
Grov, C., Rendina, H. J., & Parsons, J. T. (2016). How different are men who do not know their HIV status from those who do? Results from an US online study of gay and bisexual men. AIDS and Behavior, 1-11.
Park, K. (2007). Park's textbook of preventive and social medicine.
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