AIDS (Acquired Immunodeficiency Syndrome) is defined by the Mayo Clinic as “A chronic, potentially life-threatening condition which is caused by the human immunodeficiency virus (HIV).
HIV damages the immune system, and interferes with the ability the body has to fight the disease causing organism” (Mayo Clinic, 2014).
HIV is an infection transmitted sexually. Another mode of transmission for HIV is by exposure to infected blood, or it could also be transmitted from the mother to the unborn child during the course of pregnancy, at childbirth or through breastfeeding. It may take several years for the HIV virus to weaken the immune system enough that the patient will develop AIDS (Mayo Clinic, 2014).
The symptoms of HIV vary, depending on which phase of infection is in. The majority of the population who is infected with HIV usually presents flu-like symptoms approximately 1-2 months after contracting the virus. Possible signs and symptoms include: sore throat, rash, chills, diarrhea, headache, fever, muscle aches, ulcers in the mouth or genitals, pain in the joints, swollen lymph glands, and night sweats. Clinical latent infection usually can last anywhere from 8-10 years. It is possible for some people to remain in this stage even longer than 10 years. Some other people may progress to a more serious stage sooner than this time frame. In order to become infected with HIV, body fluids or secretions such as semen, blood, or vaginal secretions need to enter the body. Vaginal, oral, or anal sex with a person infected is also means of transmission for this virus.
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Rectal or vaginal tears, and mouth sores are also ways the virus can enter the body. HIV can also be transmitted from blood transfusions, by sharing contaminated needles and syringes, and during pregnancy, delivery of the baby or through breastfeeding. The mother can significantly reduce the chances of her baby becoming infected by receiving treatment for HIV infection during pregnancy. HIV makes the immune system weak; therefore, making the person more susceptible to develop many types of infections and also some cancers. Some of the infections that could be present in HIV infected people include: TB, toxoplasmosis, meningitis, cytomegalovirus, amongs many others. Kidney disease and neurological complications could present as complications in people infected with HIV (Mayo Clinic, 2014).
A cure has not yet been discovered for HIV, but there are different drugs that can be combined for controlling the virus. The best way of treatment is to combine at least 3 drugs from 2 different classes. The different classes of drugs for controlling the HIV virus include: Non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, protease inhibitors, entry or fusion inhibitors, and integrase inhibitors (Mayo Clinic, 2014).
The CDC estimates that and average of 50,000 people in the United States are infected with HIV every year. The CDC reports that in 2010, there were approximately 47,500 new people infected with HIV. 2/3 of these happened in bisexual or gay males. Women and African American men were also reported to be affected greatly. By the end of the year 2010, it was estimated that 1,144,500 people 13 years old and older were infected with HIV in the USA. 180,900 of these people had not been diagnosed yet. The CDC also reports an average of 13,834 people who died with a diagnosis of AIDS in the year 2011 (CDC, 2014).
The Commission on Social Determinants of Health (CSDH) defines the social determinants of health as “the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness” (CSDH, 2008).
Determinants of health include: Socio-economic and environmental factors: Education, power, wealth, gender equity and discrimination. Living and working conditions: Access to healthcare, quality of healthcare, housing conditions, job security and working conditions. Community networks: Relationships with family, friends , neighbors, partners, and other members of the individual’s social and sexual network. Biology and genetics: Sex, gender, sexual orientation, race/ethnicity.
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Various studies show evidence that link the relationship between social determinants of health and the risk for HIV. Interrelated social determinants of health can create a context of vulnerability and risk for HIV. It is very important to be able to recognize the interrelation components of HIV risk in order determine the HIV prevention response that is the most effective. For instance, research shows that HIV rates are significantly higher in Black men who have sex with men (MSM) than for MSM of other races. These rates, which are very disproportionate, are not attributable to a higher frequency of sexual risk behaviors. To appropriately address risk for MSM of different races, it is imperative to understand the process of disease transmission among these populations, in other words, the social determinants of health that are involved, such as access to healthcare (CHLA, 2012).
The epidemiologic triangle is composed of, the agent, the host, and the environment. The International Partnership for Microbicides (IPM) describes the HIV as causative agent for AIDS. According to the IPM, “the most common type is known as HIV-1 and is the infectious agent that has led to the worldwide AIDS epidemic. There is also an HIV-2 that is much less common and less virulent, but eventually produces clinical findings similar to HIV-1. The HIV-1 type itself has a number of subtypes (A through H and O) which have differing geographic distributions but all produce AIDS similarly” (IPM, 2011).
When HIV gets to a cell and infects it, it attaches to the host cell. Once it attaches to the host cell, the viral RNA converts into DNA. It is then when the virus uses the host cell to replicate. These replicas of HIV then abandon the host cell and move on to infect more cells with the virus (IPM, 2011).
Reducing the risk of HIV in the communities that are affected requires addressing economic, social and environmental factors. For example, poverty can limit a person’s access to getting healthcare, medications, testing, etc. In addition, patients who cannot afford the basic necessities are more prone to end up in situations that increase their risk of HIV. Discrimination, and homophobia, may prevent people from seeking treatment, testing and prevention services (CDC, 2014).
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The role of a community health nurse entails working with communities and with different populations. The main focus is on primary prevention and health promotion. The community health nurse uses her knowledge and competency skills, which allows her to take a leadership role. The community health nurse assesses the needs of a community, implements a plan, offers solutions and evaluates the outcomes. The solutions proposed by the community health nurse can have a tremendous positive impact in the health of the community. This includes families, groups, neighborhoods, communities, and broader populations. Community health nurses also help the epidemiologist with investigating outbreaks of a communicable disease in the community. Another important role of the community health nurse is educating the population in regards to prevention of the communicable disease. Providing immunizations, screening services and follow up care are also part of the care community health nurses provides (Meadows, 2009).
The AIDS Institute (TAI) is a national nonprofit organization that promotes action for social change through public policy research, advocacy and education. TAI has several programs that contribute to reducing the impact of HIV. Some examples of these programs are: Education and training program, National HIV/AIDS and Aging awareness program, HIV/AIDS research program and Global Advocacy program (TAI, 2011)
Centers for Disease Control and Prevention. (2014, November 25).
CDC – HIV in the United States – Statistics Overview – Statistics Center – HIV/AIDS. Retrieved from http://www.cdc.gov/hiv/statistics/basics/ataglance.html
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HIV Prevention at the Structural Level. The Role of Social Determinants of Health & HIV. Retrieved from http://www.chla.org
CSDH. (2008) Closing the gap in a generation: Health Equity Through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization
International Partnership for Microbicides. (2011).
How HIV Infects a Cell. Retrieved from http://www.ipmglobal.org/how-hiv-infects-cell
Mayo Clinic. (2014, May 20).
HIV/AIDS Treatments and drugs – Diseases and Conditions. Retrieved from http://www.mayoclinic.org
Meadows, P. (2009).
Community Health Nursing. American Journal of Nursing, 109, 19. Retrieved from http://journals.lww.com
The Aids Institute. (2011).
the Aids Institute. Retrieved from http://www.theaidsinstitute.org