HIV infection is caused by the human immunodeficiency virus that attacks the immune system of the body. It is a severe condition that affects millions of people around the globe. It found its way into the United States in 1960, and since then, it has taken millions of lives throughout the country (Centers for Disease Control and Prevention, 2019c). This paper aims to review this communicable disease, analyze its social determinants and its epidemiological triangle, as well as focus on the role of healthcare workers and national agencies in its prevention and treatment. Additionally, the paper concerns the global implications of HIV and its demographic of interest.
A person can get infected only by direct contact with the fluids of the person who already has HIV. These fluids include blood, breast milk, semen, vaginal, pre-seminal, rectal fluids. Thus, HIV is transmitted by having unprotected sexual contact with someone who has HIV or by using the same drug needles with an already infected person (Centers for Disease Control and Prevention, 2019b). It can also happen that a mother transmits the virus to her baby while pregnancy, giving birth, or breastfeeding. Often people do not even suspect that they have HIV as the symptoms may not be present for many years. However, the initial symptoms usually occur within the first few days or even weeks since getting infected. They are similar to flu symptoms and include fever, sore throat, rash, headaches, muscle aches, swollen glands, chills, tiredness. Then, the symptoms may go away after a few weeks and not come back for years. However, when they reoccur, they remain and include fever, swollen lymph nodes, tiredness, night sweats, and weight loss.
There are three stages of HIV infection – initial, chronic, and AIDS. The last stage is the most severe, as the virus damages the immune system to the point where the sick person easily gets severe illnesses or infections called opportunistic infections. People develop AIDS within about 8-10 years after entering the initial stage if no treatment was introduced (Centers for Disease Control and Prevention, 2019a). With treatment, AIDS can be delayed and even prevented, and the infected person can have an everyday healthy life. However, once a person develops AIDS, they have about three years left, as the opportunistic infections attack the body and prevent it from normal functioning to sustain life. Thus, the person can be exposed to such conditions as candidiasis, toxoplasmosis, pneumocystis pneumonia, tuberculosis, cytomegalovirus, cryptococcal meningitis, liver or kidney disease, lymphoma, Kaposi’s sarcoma, some neurological complications.
As mentioned above, modern medicine possesses an effective treatment against HIV infection. The most effective medications are antiretrovirals, which are combined differently for antiretroviral therapy (ART). It aims to control the virus in the body and allows the infected person to live a normal life. However, the combination of medicines must be matched carefully in order to effectively inhibit the virus and reduce negative side effects, which can be rather intense (Centers for Disease Control and Prevention, 2019c). Thus, many cases of developing AIDS are effectively prevented. Unfortunately, the statistics can be dismal. As for the end of 2018, about 1.2 million people older than 13 had HIV in the United States, including 161.800 people whose condition was not diagnosed (U.S. Department of Health & Human Services, 2020). In 2018, 37.968 people were diagnosed with HIV in the United States and dependent areas (U.S. Department of Health & Human Services, 2020). At the end of 2018, 1.040.352 adults and adolescents were diagnosed with HIV in the United States and dependent areas (U.S. Department of Health & Human Services, 2020). Therefore, it is as important to educate people on how to protect themselves as it is to treat the already existing cases.
Social Determinants of Health Contributing to HIV
Human Immunodeficiency Virus, as any other medical condition, does not exist in a vacuum. It is affected by the range of different social factors, which are called social determinants of health. They are the conditions of places where people live, study, and work, which influence different risks and outcomes associated with health (Office of Disease Prevention and Health Promotion, 2020). These determinants include economic stability, education, social and community context, health and healthcare, neighborhood, and built environment. They define people’s health in connection with their access to financial and educational resources, healthcare services, transportation, food and water supplies; their level of involvement in the community; exposure to crime, violence, and discrimination.
As a rule, these social determinants of health are accountable for inequalities connected to healthcare distribution to different population sectors. Moreover, they heavily boost the HIV epidemic throughout the world due to the social and economic marginalization of particular groups of people. Those groups marginalized before the HIV epidemic became the ones at the highest risk of being infected when it started to spread. It happened because of low income, food insecurity, housing stability, the lack of education, stable work placement, and access to decent healthcare services. Thus, people who struggle from such social inequities are more likely to get HIV infected due to poor lifestyle conditions. By acknowledging this inequality and spreading social awareness of the issue, it is possible to change the situation and help people access health education and sustainable treatment.
Epidemiological Triangle of HIV Infection
According to epidemiology, to prevent the infectious disease from spreading, first, it is necessary to examine how it spreads and what to expect from its development. Thus, using the epidemiological triangle is of great help. It is a model that identifies the microorganism, causing the given infection and the conditions that allow it to multiply and spread (Rivier University, 2017). To determine these factors, the epidemiological triangle has three constituents: agent, host, and environment. The agent is what causes the disease. The host is an organism that may be exposed to this agent. Notably, the exposed organism does not necessarily get sick but can transmit the agent to others. The environment is the external conditions that influence the agent’s spread.
Applying this model to the HIV infection, the agent is the virus called Human Immunodeficiency Virus. Concerning the host constituent of the epidemiological triangle, scientists suggest that chimpanzees were the original carriers of the HIV infection (Centers for Disease Control and Prevention, 2019b). By haunting chimpanzees for meat and contacting their blood, humans got infected and carried the disease from Africa to other continents. The last constituent, the environment for the HIV spread, includes a range of socio-economic factors such as poverty, discrimination, unemployment, and others associated with them. When people are exposed to these factors, their access to testing and treatment is limited, which creates the fertile ground for the infection to spread further.
Community Health Workers’ Role in HIV Prevention
When encountering a communicable disease, the healthcare workforce is one of the most important constituents of the process of testing, treating, and providing both physiological and mental support to the infected people. The role of community health workers (CHW) in caring for HIV positive people lies in supporting care and ensuring the community members are referred for testing, provided with the appropriate treatment, accompanied to the doctor appointments, and given other necessary services (Busza et al., 2018). Thus, the CHW links the community members in need of assistance and the health or social services that provide it. Not less important is the CHW’s duty to improve the treatment’s adherence by holding educational sessions for the community members. This is made in order to explain the main functions and side effects of the treatment to improve the life quality of the patients.
HIV is a reportable disease, the cases of which must be registered and reported in a timely manner. It is required from healthcare providers to report new cases of people being infected with the Human Immunodeficiency Virus, as well as with the Acquired Immunodeficiency Syndrom. CHW are usually responsible for the systematic collection of data to develop the clinical landscape of the disease and provide the appropriate healthcare services for the population, thus preventing the infection from further spreading (Busza et al., 2018). When new cases are reported to the public health authorities, it enables them to counsel the newly infected people on the options of their treatment and provide them with it. In addition, the authorities get a clear statistical picture of the incidence and prevalence of the infection.
National Agencies and Organizations for HIV and AIDS
To fight a strong communicable infection, there must be governmental organizations that address the disease, provide necessary services to the infected, and make sure no one is being left out. Then, the condition is taken under control, and the fight becomes systematic and determined towards a clear goal. In the United States, there exist over 19000 organizations providing services connected to HIV and AIDS, as well as STDs and TB. Many of them have come together to confront HIV and AIDS and their consequences the infected people have to deal with. These organizations deal with the whole spectrum of duties, from collecting data and conducting research to assisting other countries financially to help prevent the disease on a global scale.
The largest organizations that play a significant role in combating HIV complement each other and provide help to millions of infected Americans. The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is one of the largest Centers for Disease Control and Prevention (CDC). The National Center has four fundamental departments, each focused on one specific disease (U.S. Department of Health & Human Services, 2018). Together, they are responsible for conducting preventative research and public health surveys and accounting programs against HIV and AIDS, other STDs, TB, and viral hepatitis. Another widely recognized organization is the Department of Veterans Affairs (VA), which is the largest single-handed provider of medical help to people with HIV and AIDS in the country. They provide high-quality testing and screening for HIV, educate the infected people and their families, ensure the best clinical care, and support research in the field.
The Office of the US Global AIDS Coordinator and Health Diplomacy coordinates the US President’s Plan for AIDS Relief (PEPFAR), which helps save the lives of people infected by HIV worldwide. Over the past seventeen years, PEPFAR has saved more than eighteen million lives by making cost-effective, transparent investments (U.S. Department of Health & Human Services, 2018). The program effectively targets the populations that are in most need of HIV and AIDS relief and makes sure that these people receive enough funds and resources for healthy living without the disease. More than fifty countries have received the help of PEPFAR that successfully took control over the epidemic situations in the areas. The Department of State (DoS) supports the Office of the Global AIDS Coordinator (OGAC) in providing them with workspace, technology, communication, and HR services, alongside tracking budgets through their accounts and transferring funds to other agencies.
Global Implications of HIV
The HIV epidemic has completely changed the world’s picture since scientists discovered the virus responsible for it. Millions of people have been affected or passed away, and there seems to be no actual cure that can kill the virus once and for all. It has been a huge step forward once the effective medicines were developed that help people live with HIV, have families, children, and decent lifestyles. However, millions of people will never be the same, as the virus planted its roots deep into society and each sphere of life. Now, HIV is one of the most severe challenges concerning public health. The world’s community has come together to help the infected people and prevent the virus from spreading further. It is a tremendous quest that people have to overcome to live without fear of the evil disease.
As for 2019, there were about 38 million people with HIV or AIDS throughout the world, 1.8 of whom were children before 15 years old. The same year, 1.7 million more people got infected with HIV, 150.000 of them being children aged less than 15 years old (U.S. Department of Health & Human Services, 2020). Despite evident advances in scientific research, treatment, and prevention activities, too many people do not know that they are infected — many of those who have no access to medical care and substantial treatment. Millions of people die from AIDS and opportunistic infections; households and families struggle from significant losses and lack of information on what to do next and how to protect themselves. National economics of many countries suffer from the horrible endemics that create chaos and social instability.
As a result of the lack of food, water, decent healthcare, and other socio-economic factors, the world’s regions suffering the most are East and South Africa. Here lives the largest number of about 20.7 million people infected with HIV as for the year of 2019 (Avert.org., 2020). This number is continuing to increase, however, the attempts to control this process are growing as well. As mentioned before, the world community is working hard on providing treatment for those who need it, especially in such critical locations as East and South Africa. Unfortunately, people living there still have many prejudices and stereotypes concerning sexual behavior and HIV itself. The infected people are placed under constant discrimination, and it is difficult to educate the local population on the specifics of safe sexual experience due to the many traditional and legal barriers in these countries. Despite these apparent complications, however, organizations around the world, with the help of volunteers, are doing their best to change the situation for the better.
To summarize, HIV has revolutionized modern medicine, as well as people’s views on sexually transmitted infections. What is even more important is that it has drawn the public’s attention towards social inequality as it is the primary determinant of the HIV continual spread. However, even though there is still no cure for this disease, it can be successfully prevented with the help of efficient medicines. Moreover, the world community is working hard to find solutions and protect those who do not have any access to testing or treatment. With time, experience, and partnership, humanity will find the way out of the HIV vicious cycle.
Avert.org. (2020). HIV and AIDS in East and Southern Africa region overview. Web.
Busza, J., Dauya, E., Bandason, T., Simms, V., Chikwari, C. D., Makamba, M., Mchugh, G., Munyati, S., Chonzi, P., & Ferrand, R. A. (2018). The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe. Health policy and planning, 33(3), 328–334. Web.
Centers for Disease Control and Prevention. (2019a). AIDS and opportunistic infections. Web.
Centers for Disease Control and Prevention. (2019b). HIV transmission. Web.
Centers for Disease Control and Prevention. (2019c). HIV treatment. Web.
Office of Disease Prevention and Health Promotion. (2020). Social determinants of health. Web.
Rivier University. (2017) What is the epidemiologic triangle? Web.
U.S. Department of Health & Human Services (2018). U.S. Government global HIV/AIDS activities. Web.
U.S. Department of Health & Human Services (2020). U.S. statistics. Web.