Introduction
Human Immunodeficiency Virus (HIV) interferes with a person’s immune system by making it unable to fight infection and diseases. HIV leads to life-threatening conditions called Acquired Immunodeficiency Syndrome (AIDS). It is spread through contact with infected blood, sexual contact from mother to child during pregnancy or birth, sexual contact, and breastfeeding (Justiz & Gulick, 2019). HIV takes some period, even without medication, to weaken the immune system to the point that a person has AIDS. This study will analyze the epidemiology of HIV using different components of the communicable disease chain and chain of infection.
Causes of HIV
HIV is caused by the Human Immunodeficiency Virus, which is spread through illicit injection, sexual contact, contact with infected blood, sharing needles and from mother to child during pregnancy or birth. When the virus attacks the immune system of a human, it weakens it making it unable to fight other diseases. Once the immune cells become so less, the person then develops AIDS, which is a more advanced stage of HIV.
Symptoms of HIV
Within two to four weeks from the day of infection with HIV, some people may start experiencing flu-like symptoms such as chills, fever, or rash. These symptoms may stay for weeks, and the patient may start experiencing other symptoms such as sore throat, fatigue, muscle aches, night sweats, mouth ulcers, and lymph nodes (Justiz & Gulick, 2019). The more manifestations of HIV take up to a year to reveal themselves. These may include weight loss, chronic diarrhea, and other opportunistic infections such as those related to cancer (Justiz & Gulick, 2019). The main modes of transmission of HIV include semen, blood, vaginal fluids, breast milk, rectal fluids, and pre-seminal fluids.
HIV Complications
When HIV weakens a person’s immune system, they are more likely to develop other as infections and cancers. One of the infections is Pneumocystis pneumonia, a fungal disease that leads to severe illness in the patient (Currier, 2018). Another complication is candidiasis, leading to inflammation and a white coating on the tongue, mouth, esophagus, and vagina. HIV can cause tuberculosis, a respiratory disease that is very opportunistic for individuals with HIV (Currier, 2018). Tuberculosis has been ranked as the number one killer of persons with AIDS.
HIV Medication
Although HIV has no cure, there are medications called antiretroviral therapy or ART, which help reduce the amount of HIV in the blood. This medication helps keep the viral load significantly low to less than 200 copies of HIV per milliliter of blood (Currier, 2018). ART contains a combination of two or more medications that help to block the virus differently. The main components include non-nucleoside reverse transcriptase inhibitors (NNRTIs), which stops the production of proteins that HIV needs to multiply (Justiz & Gulick, 2019). Protease inhibitors (PIs) deactivate HIV protease, which is needed to make copies (Justiz & Gulick, 2019). Entry or fusion inhibitors stop HIV from entering CD4 cells, while integrase inhibitors disable the genetic entry material of HIV into CD4 cells called intergrase.
World Demographic of HIV
Mortality
HIV is a dangerous disease that has killed many people, and there are 38.4 million living with it globally. In 2021, 650,000 deaths were related to HIV, a significant decline of 68% since 2004, when two million people died, and in 2010 when 12.4 million people succumbed to the virus (UNAIDS, 2022). This shows that although the world has managed to reduce the number of deaths, HIV is still claiming a significant number of lives.
Morbidity
HIV is still a major global issue that is affecting many people. There is 5,000 death per population of 100,000 across the world (UNAIDS, 2022). The mortality rate was higher in males, with 44 deaths per 1,000 populations compared to 38 deaths per population for females (UNAIDS, 2022). This shows that more men than women succumb to the disease, which can be attributed to various social norms and behaviors.
Incidence
HIV incidence demonstrates the estimated number of new infections in a specific period, such as a decade or year. There has been an 8% incidence decline in the number of HIV between 2015 to 2019 (UNAIDS, 2022). A significant decrease in infections has been found in age groups 13-24 and 45-54 and remained the same in all other groups (UNAIDS, 2022). This shows that there was no significant reduction in the number of HIV cases during the period for most of the population.
Prevalence
Prevalence checks common statistics about a disease at a given time. There are approximately 38 million people in the world who are HIV positive. 0.7% of the global adult population between 15-49 years live with HIV, although the statistics vary between countries (UNAIDS, 2022). Africa is the hardest hit by the endemic of HIV, while other countries like the US and Europe are least affected.
Is HIV a Reportable Disease?
HIV has been a reportable disease since 2002, and all 50- states of Colombia demand that new cases of HIV be reported. Collecting data about HIV has been very helpful in providing a better understanding of the disease. It helps healthcare practitioners to understand some trends about the disease and why some people may be infected while others are not. HIV is reportable to the HIV/AIDS Surveillance Program in the Department of Public Health (Currier, 2018). Healthcare providers who order HIV tests at the lab are responsible for reporting all new HIV cases.
Social Determinants of HIV
One of the social determinants of HIV is gender inequality, whereby women are at a higher risk of contracting the disease than males. Women are subject to barriers to negotiating for safer sex due to the power imbalance with men (Beltran et al., 2022). In addition, sexual violence is common among women increasing their risk of HIV transmission. The other factor is marital status, whereby it was found that unmarried people had twice the risk of contracting HIV than those who are married (Beltran et al., 2022). This is because unmarried people are likely to have sex with multiple partners, increasing their risk of HIV.
Another social determinant is geographical location, whereby HIV has concentrated in some areas compared to others. African people are at a higher risk of contracting HIV than elsewhere, such as in Europe. This is because there is a high HIV prevalence in Africa, which increases the chances of contracting the virus for the people living there (Beltran et al., 2022). The social stigma of HIV is a social determinant that affects how people will take the disease and respond to treatment. Societies which stigmatize HIV are more likely to have more people not seeking treatment for HIV; hence more deaths and advanced cases often lead to AIDS. This implies that societies should not have negative attitudes and prejudice towards HIV because it may affect the ability of those with it to seek treatment.
Epidemiologic Triangle of HIV
The epidemiological triangle is a model used to explain a disease and its spread. The first element is the agent, whereby HIV is a viral disease that affects the Human Immune System. Therefore, this virus prevents the body from other diseases called agents (Kteily-Hawa et al., 2022). Additionally, the body becomes unable to fight HIV itself, which enables the virus to multiply in the body. The disease is transmitted through contact between the host and recipient and this is mainly through sexual intercourse.
The host describes the organism the agents infect for the virus to spread. These hosts are most attractive or vulnerable to the virus, so the agents choose them to transmit the disease. According to scientists, HIV host was chimpanzees via their infected meat and blood that led to the transmission of HIV to people (Kteily-Hawa et al., 2022). However, the disease is currently shared when some body fluids come into contact.
The environment generally describes the outside forces that lead to the disease’s spread. These may include certain atmospheric conditions such as temperatures or humidity. HIV is significantly impacted by socioeconomic factors, including gender, geographical location, poverty, the stigma of society, and poor access to healthcare services (Kteily-Hawa et al., 2022). In addition, there are specific social norms such as anal-receptive sex, contraceptive choices, and the number of sexual partners. Thus, it is important to highlight and notify the community about safe social practices so that they cannot indulge in activities that may lead to the spread of HIV.
Role of Community Health Nurse in (Case Finding, Reporting, Data Collection, Data Analysis, and Follow-Up)
Community health nurses have a direct and indirect role in the fight against HIV. Community health nurses must refer people to HIV testing to know their status (Knettel et al., 2021). In addition, they should link those with HIV to care and accompany them to clinic appointments to ensure they get the necessary treatment. Community health nurses should ensure that they provide psychosocial support to their patients and refer them to other services they may need.
Community health nurses should ensure that they report all cases of HIV as it is a reportable disease. They should collect relevant information about the persons who have been found with HIV and send the data to HIV/AIDS surveillance Program Department (Knettel et al., 2021). The information in the report should include name, race, sex, ethnicity, and the method that the person was infected with the virus. The patient’s name is taken to ensure they are not counted twice.
Why Demographic Data Are Necessary To the Health of the Community
The demographic data on HIV is essential in understanding and combatting the spread of HIV. HIV data surveillance was started in 1987, and since then, it has provided useful information about the disease, which has helped curb its spread (Knettel et al., 2021). The data collected helps identify patterns of the disease which help the healthcare providers, academics, and other stakeholders to establish trends and patterns of the disease. This information is critical to decision-makers and other stakeholders, especially those in developing countries, who have to plan and choose the appropriate policies to safeguard their citizens.
UNAIDS
United Nations Programme on HIV/AIDS (UNAIDS) is an organization that was founded in 1996 with the major aim of combating the global spread of HIV. The organization is a major pillar in coordinating global efforts in delivering care, treatments, and support for those living with HIV/AIDS (UNAIDS, 2022). It has unveiled a strategy to combat the spread of HIV, which starts with ending poverty. The first strategy is economic empowerment to impoverished societies to reduce their vulnerability to HIV. The second strategy is to end hunger by using integrated systems to provide nutritional support for people living with HIV (UNAIDS, 2022). This move has helped them become more immune to the virus, increasing their body’s ability to fight it.
The third strategy has been to ensure healthy lives by providing HIV-sensitive universal health coverage and fighting for health equity among societies. This has helped reduce the number of children who contract HIV through breastfeeding or birth (UNAIDS, 2022). The fourth goal is to promote education equality so that both male and female students can access quality education on sexuality. The fifth strategy was to achieve gender equality, and the organization has implemented transformative HIV programs that address issues such as gender violence, women’s rights, and empowerment (UNAIDS, 2022). Finally, the UNAIDS has helped to fight inequality in society, such as income inequality, stigmatization, and access to justice for people who want to claim their rights in accessing HIV services. This led to the introduction of a Global Commission on HIV and the Law, an independent body that addresses legal-related cases of HIV.
The Global Implication of HIV
Despite efforts to combat the spread of HIV, it is still a major cause of death in some parts of the world. Globally, HIV is still one of the leading causes of death, with more than 650,000 deaths annually (Centers for Diseases Control and Prevention, 2019). This shows that despite significant progress in combating its spread and providing treatment, more works need to be done. Some countries, such as the US, have significantly curbed the spread levels while others, such as those in central and west Africa, have still been recording increasing numbers.
How Other Countries Have Responded to the Disease
Two South African countries, Zimbabwe and Lesotho, have surpassed their targets in controlling HIV and made remarkable positive gains. In a country like Zimbabwe, they have made intensive campaigns on the importance of knowing one’s status. This has led to high testing rates whereby 86% of the people with the virus are aware of it, and 97% are taking the treatment for the disease (Centers for Diseases Control and Prevention, 2019). In Lesotho, 90% of the population with HIV knows their status, and 97% of those are taking their medication (Centers for Diseases Control and Prevention, 2019). These two countries have made progressive moves towards curbing the spread and mortality of people with HIV.
Is HIV Endemic to A Particular Area?
HIV is endemic in Africa as many people still die of the disease on the continent. In addition, the number of infected persons per year is significantly higher than in other places worldwide. It is worth noting that over half of all global HIV cases are in Africa, which shows that HIV is still endemic in the region (Justiz & Gulick, 2019). In addition, Africa accounts for two-thirds of all new HIV infections.
Conclusion
Although the world has made significant progressive steps in curbing the spread of HIV, it is still one of the leading causes of death. The most common method of contracting HIV is through sexual intercourse. Some social determinants for HIV include gender, sexual violence, geographical location, land social stigma. This shows that there is still a need for more efforts if the world is ever going to achieve zero HIV.
References
Beltran, R. M., Holloway, I. W., Hong, C., Miyashita, A., Cordero, L., Wu, E., Burris, K., & Frew, P. M. (2022). Social determinants of disease: HIV and COVID-19 experiences. Current HIV/AIDS Reports, 13(2), 1–12.
Centers for Diseases Control and Prevention. (2019). Global health – Newsroom – HIV. Www.cdc.gov. Web.
Currier, J. S. (2018). Management of Long-Term Complications of HIV Disease: Focus on Cardiovascular Disease. Topics in Antiviral Medicine, 25(4), 133–137. Web.
Justiz, A. A., & Gulick, P. G. (2019). HIV disease. Nih.gov; StatPearls Publishing. Web.
Knettel, B. A., Fernandez, K. M., Wanda, L., Amiri, I., Cassiello-Robbins, C., Watt, M. H., Mmbaga, B. T., & Relf, M. V. (2021). The role of community health workers in HIV care engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania. Journal of the Association of Nurses in AIDS Care, 32(6), 682–692.
Kteily-Hawa, R., Hawa, A. C., Gogolishvili, D., Al Akel, M., Andruszkiewicz, N., Vijayanathan, H., & Loutfy, M. (2022). Understanding the epidemiological HIV risk factors and underlying risk context for youth residing in or originating from the Middle East and North Africa (MENA) region: A scoping review of the literature. PLOS ONE, 17(1), e0260935.
UNAIDS. (2022). Millions of lives at risk as progress against AIDS falters. Www.unaids.org. Web.