Chosen Chronic Illness and Rationale for Choice
Human immunodeficiency virus (HIV) and related health conditions are of critical concern in the United States. The disease is continuously spreading and taking away thousands of lives annually. According to the latest statistical data, more than 1 million people in the United States have HIV, and approximately 15% of them do not know that they are infected (Office of Disease Prevention, 2020). It is not yet possible to fully cure HIV, which means that the only way to decrease the number of cases is to develop an effective prevention strategy (Cummins & Badley, 2015). It is, however, possible to manage the illness and prolong the lives of diseased individuals (Office of Disease Prevention, 2020). The rationale behind choosing HIV patients as the group of interest is because of the disease’s implications in the context of mental health. HIV’s incurability may make individuals feel anxiety and become depressed. Such conditions often lead to mental health issues and deteriorate a person’s life quality. These psychosocial considerations make HIV even more critical to address.
Morbidity of the Disease
The number of new HIV diagnoses per year has been slowly declining. In 2012, there were 41180 new cases of HIV, but in 2017, there was a small decrease – the total number was 38281 (Center for Disease Control, 2018). However, because the number is changing in a fluctuating manner, it is currently not possible to use morbidity data to assess the efficacy of prevention strategies. There is a significant gap between the number of male and female patients. In 2012, there were 32711 new cases among men, and 8228 new diagnoses among women (Center for Disease Control, 2018). The proportion has not changed significantly for the last decade.
Analyzing which age groups are diagnosed with HIV more often may provide insights into what population group should the prevention strategy target. The virus is most prevalent among individuals between 20 and 29 years old. Coincidentally, this age group is considered to be the most vulnerable to mental health conditions (National Institute of Mental Health, 2019). This connection elevates the significance of preventative measures aimed at addressing HIV.
Besides mental health issues, HIV results in several other comorbidities. Prevalence is generally higher among aging individuals, which provides additional complications when treating older patients (Gallant et al., 2017). The landscape of comorbidities has been changing since 2003, and these dynamics should be considered when developing a prevention strategy. The list of most common comorbidities includes cardiovascular issues, renal impairment, osteoporosis, hypertension, diabetes, obesity, and hyperlipidemia. Cardiovascular events include myocardial infarction, ischemic stroke, deep vein thrombosis, peripheral vascular diseases, and coronary artery surgery (Gallant et al., 2017). While the proportional difference in the prevalence of each comorbidity has stayed the same since 2003, the has been a significant increase in the total number of comorbidity cases (Gallant et al., 2017). For instance, there has been a two-fold increase in the number of hypertension cases (Gallant et al., 2017). This data helps attain a more accurate picture of how HIV impacts the overall health of the nation.
Impact on National Health
HIV impacts all races and ethnicities and is a heavy burden on public health in the United States. The number of new cases is slowly decreasing each year, but the total number of people living with HIV is increasing due to the incurability of the disease (Office of Disease Prevention, 2020). Therefore, there is a significant impact of HIV on national health. As the total quantity of HIV cases rises, the prevalence of comorbidities will also increase, further disrupting the national healthcare system. The significant majority of transmissions occur from individuals that have not been previously diagnosed (Office of Disease Prevention, 2020). It means that the spread of the disease is out of control, and currently, the healthcare system cannot make any significant intervention to decrease the number of new cases. A comprehensive strategy should accommodate means for informing individuals about HIV early in their lives and providing them with necessary resources for timely diagnosis of HIV to prevent further spread.
Healthy People 2020 Goals
There are several objectives of Healthy People 2020 about HIV. The overall goal is to prevent HIV and related health issues, including mental conditions (Office of Disease Prevention, 2020). This aim is divided into several more detailed objectives, one of which is increasing access to care and improving health outcomes (Office of Disease Prevention, 2020). This goal is vital to consider because it encompasses possible psychosocial issues of individuals diagnosed with HIV. Increasing access to care means not only providing HIV treatment options but also helping patients cope with the illness and ensuring that the diagnosis does not prevent individuals from living fulfilled lives. To achieve this objective, it is essential to understand the needs and desires of patients with HIV. In other words, there should be a comprehensive data collection strategy to identify the most common concerns that HIV patients have. Understanding these items will allow healthcare providers to devise a holistic plan to prevent and treat HIV and associated conditions. Appendix A is a proposed questionnaire to collect relevant information to create a comprehensive treatment plan for people diagnosed with HIV.
Center for Disease Control and Prevention. (2018). Human immunodeficiency (HIV) diagnoses [PDF document]. Web.
Cummins, N. W., & Badley, A. D. (2015). Can HIV be cured, and should we try? Mayo Clinic Proceedings, 90(6), 705-709.
Gallant, J., Hsue, P. Y., Shreay, S., & Meyer, N. (2017). Comorbidities among US patients with prevalent HIV infection – A trend analysis. The Journal of Infectious Diseases, 216(12), 1525-1533.
National Institute of Mental Health. (2019). Mental illness. Web.
Office of Disease Prevention and Health Promotion. (2020). HIV. Healthy People. Web.
HIV Patient Questionnaire
|Question||Yes||No||Not willing to answer|
|Was it your initiative to get tested for HIV?|
|Did anyone accompany you when getting tested for HIV?|
|Do you have unobstructed access to HIV-related resources?|
|Did you feel anxiety and/or anger after being diagnosed with HIV?|
|If yes, was it a one-time occurrence?|
|Is the confidentiality of the test results crucial to you?|
|Do you consider HIV to be a severe health condition?|
|Do you have anyone you trust and can speak with about your diagnosis?|
|Were you given any further instructions after being diagnosed?|
|Do you personally know anyone with a positive HIV test?|
|Do you have any idea regarding how you may help this person?|
|Do you have paid medical insurance?|
|Do you have unprotected sex only with a regular partner?|
|Did you have any issues with getting a meal last week?|
|Do you have a stable job?|
|If yes, do you consider your job to be well-paid?|
|Do you have stable housing?|
|Did you have any issues with paying for your bills last month?|
|Are any other family members working?|
|If yes, do they have a well-paid job?|
|Do you have a concise plan regarding your further treatment?|
|Are you willing to consider comprehensive treatment offered by your medical provider?|
|Would you accept an offer to receive psychological support?|