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HIV/AIDS

Dana Weisbrot

Chamberlain College of Nursing

NR503: Population Health Epidemiology and Statistical Principles

October 2019

In the past, Acquired immunodeficiency syndrome (AIDS) used to be a cause of death 100% of the time. As a matter of fact, AIDS continues to be chronic health condition caused by human immunodeficiency virus (HIV) without a cure. The virus destroys CD4 T cells, which play a major role in helping human body fight disease and infections. The fewer the CD4 T cells, the weaker a person’s immune system. A person can have HIV infection for a long period of time before it turns into AIDS. An individual is said to have acquired AIDS when his or her CD4 T cell count drops to less than 200 or if a person has AIDS defining complications. The individual's immune system gets damaged as the virus disrupts with the body’s capability to destroy the disease’s causing organisms (Felman, 2018).

HIV is a sexually transmitted infection, highly contagious, that spreads through the contact of bodily fluids such as breast milk, vaginal secretions, semen, anal fluids and blood. The major reasons of fluid transfer include, in the United States: unprotected sex, whether with anal or vaginal penetration with HIV infected individuals as well as sharing injectable equipment with infected persons. The most predominant early signs of HIV infection include: tremors, fever, joint pain, enlarged glands, muscle aches, sore throat, sweating during night, fatigue, rashes, unintentional weight loss and thrush (Felman, 2018).

Some of the late symptoms of HIV symptoms of human immunodeficiency syndrome are as follows: night sweats, blurred vision, 37 degree Celsius oral temperature, persistent and chronic diarrhea, and permanent tiredness. Other symptoms are difficulty breathing, swollen glands, oral thrush, and loosing weight without trying. With regards to complications, HIV/AIDS weakens a person’s immune system thereby increasing the likelihood of developing numerous infections such as tuberculosis, herpes, candidiasis (thrush), kaposi’s sarcoma, lymphoma, and toxoplasmosis among others (Felman, 2018).

African Americans make up for the largerst percentage of new HIV diagnoses and persons living with human immunodeficiency virus from all other races in the United States. African Americans represented at least 13% of the United States population in 2017, which accounted for 43% of more than 38,700 new HIV diagnoses in the country and dependent regions. From those, the percentage of adult and teenage African Americans who received HIV diagnoses 73% were men and 26% were women. At least, 60% of African Americans newly diagnosed with HIV were homosexual men. In addition, from those homosexual African American men, 41% were aged between 25 and 34 years. In 2016, more than 6,800 African Americans died due to HIV-related complications (CDC, 2018).

Determinants of Health

Determinants of health encompasses a broad spectrum of economic, personal, and social, as well as environmental factors influencing health condition. Determinants of health are classified into the following factors: individual behavior, policy-making, social factors, health services, and biology and genetics. Policies at federal, state as well as local levels are responsible for shaping the health of an individual and the entire population. For instance, increasing taxes on tobacco products can reduce the amount of individuals consuming tobacco products thereby improving population health. Social determinants of health commonly indicate social factors plus other conditions of the environment in which an individual is born, living, playing, working, and age. Social factors also affect a wide range of health, quality of living, as well as functioning outcomes. Some examples of social determinants of health include social support and social interactions, social norms and attitudes, socioeconomic conditions, exposure to crime, and exposure to mass media (Healthy People, 2019).

Access to health services plus quality of health of health services can affect health. Lack of access to health services greatly affects a person’s health status. For instance, when people are less likely to take part in preventive care and delay medical treatment when they lack health insurance. Barriers to health service accessibility include: lack of availability, high cost, lack of insurance coverage, and limited language access. The aforementioned barriers can lead to unmet health needs, delays in receiving necessary care, inability to receive preventive services, and increased hospitalization (Healthy People, 2019).

Individual behavior also determines health outcomes. For instance, a person is likely to reduce risk of having lung disease by quitting smoking. Diet, physical activity, alcohol and cigarette use, and hand washing are some common examples of individual behavior health determinants. In regards to biological and genetic factors, these tend to implicate specific populations more often than others. Older people are physically prone to poor health than teenagers because of physical plus cognitive impacts of aging. A very common genetic determinant of health is Sickle cell anemia. Genetic and biological determinants of health are age, sex, inherited conditions such as family history of heart disease, hyperlipidemia, migranes and more (Healthy People, 2019).

Epidemiological Triad

The epidemiological triangle is made from three components: namely agent, host, and environment. The disease in question is caused by a microorganism, the Agent. It could be bacterial, viral, fungal, or parasitic (Hueffer, O'Hara & Follmann, 2015). HIV is a viral infection that impacts an individual’s immune system, subjecting it to other forms of infection. Hueffer, O'Hara and Follmann (2015) indicate that the agent, in the case of HIV, a virus, needs a host to infect, which is the disease carrier. A host can carry the agent without portraying outward symptoms of a disease. A host carries an agent due to the fact that some part of his or her physiology is hospitable. Scientists theorize that human immunodeficiency virus was originally found in chimpanzees and that people who hunted these animals for meat got infected with a mutated virus upon contact with the animal’s blood. Environment, according to Hueffer, O'Hara and Follmann (2015), refers to outside factors affecting an epidemiological outbreak. Factors found within the environment that impact the spread of disease that are not important parts of the host and/or the agent. Regarding HIV/AIDS, there are numerous socioeconomic factors impacting the spread of the condition within a community. Communities with higher levels of sexually transmitted diseases plus lower reporting incidences due to social pressure allow human immunodeficiency virus to flourish.

Role of Nurse Practitioner

The American Association of Nurse Practitioners (2018) has defined the nurse practitioners as nurses focused on managing other people’s health conditions and disease prevention who are autonomous and licensed. The responsibilities of nurse practitioners depend on the state in which they practice in addition to the nurses' specialization. Nurse practitioners provide primary, acute, plus specialty healthcare services to various populations. Thanks to achieving an advanced training, nurse practitioners can diagnose diseases, treat conditions, as well as educate patients based on evidence based health education. With regards to management of infectious diseases, Buttaro et al. (2016) indicate that nurse practitioners conduct surveillances, provide primary, secondary, and/or tertiary interventions, and report disease prevalence. They also collect disease prevalence data, conduct data analyses, and engage in follow up activities.

References

American Association of Nurse Practitioners. (2018). What’s a nurse practitioner? https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner

Buttaro, T. M., Polgar-Bailey, P., Sandberg-Cook, J., & Trybulski, J. (2016). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Elsevier Health Sciences.

Centers for Disease Control and Prevention. (2018). HIV and African Americans. https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html

Felman, A. (2018). Explaining HIV and AIDS. Medical News Today. https://www.medicalnewstoday.com/articles/17131.php

Healthy People. (2019). Determinants of health. https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of- Health

Hueffer, K., O'Hara, T. M., & Follmann, E. H. (2015). Adaptation of mammalian host-pathogen interactions in a changing arctic environment. Acta Veterinaria Scandinavica, 53(17), 1- 8.

HIV/AIDS

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