Epidemiology and Demographic Statistics on HIV/AIDS

Description

Background information

AIDS (Acquired Immunodeficiency Syndrome) is a global pandemic that has caused millions of deaths. It was first described in 1981 in the United States of America. Its causative agent is HIV (Human Immunodeficiency Virus). HIV is a viral disease classified under retroviruses in the Retroviridae family, Lentivirus genus. This disease causes progressive and gradual destruction of the CD4+ lymphocytes of the Cell-mediated Immunity. Due to the compromise to the Immune system, opportunistic infections and tumors set in alongside the destruction of various body organs. In untreated cases, the rate of fatality is about 100%.

According to the World Health Organization (WHO), AIDS is a leading infectious cause of adult death globally (WHO 2018). Hence AIDS is a communicable killer disease. However, in patients receiving treatment, the disease is well contained and they lead a normal life (Maartens, 2010). AIDS is a communicable disease which caused by HIV. HIV is the infectious viral agent. Its reservoir is the body’s immune system especially the lymphocytes white blood cells. Its place of exit or entry is contaminated blood, penile or vaginal fluids. The Hosts are human beings and anyone involving in risk behavior is susceptible to contracting the disease.

Cause and Transmission.

HIV is a virus that AIDS. It is a variation of Simian Immunodeficiency virus in African Chimpanzees. HIV is a blood-borne virus and thus can be transmitted when a person gets in contact with an infected individual’s blood or body fluids like semen, vaginal fluid and breast milk which contain high viral load. The major way of transmitting HIV is by unprotected sexual contact. This includes oral, anal and vaginal sex. The risk of contracting HIV increases when a sexual partner has an ulcer or lesion in the path of sex. Sharing of contaminated needles and syringes, breastfeeding in case of an infected mother or during delivery, sharing sex toys with an infected individual, and blood transfusion are among other ways the virus can be transmitted. Organ transplant in cases where the donor is infected can lead to transmission (Maartens, 2010). Some of the ways in which HIV can’t be transmitted are Skin-skin contact, Hugging, Kissing, and Shaking Hands, Sharing the toilet, sharing food, sharing beddings, sharing clothes with the infected person as well as mosquito bites.

Symptoms

Early signs are acute seroconversion which manifests as a flu-like illness with a general rash and malaise. Fever, Sore throat, Body rash, Tiredness, Joint pain, Muscle pain, and swollen glands (Generalized lymphadenopathy). Immune system compromise leads to the following symptoms: Weight loss, chronic diarrhea, Night sweats, Skin conditions, recurrent infections. In later phases, opportunistic infections set in.

Complications

1. Opportunistic infections such as Tuberculosis.
2. AIDS Wasting syndrome
3. Lipodystrophy- Fat redistribution
4. Pneumocystis Pneumonia (PCP)
5. Cytomegalovirus (CMV)
6. Dementia.
7. Non-Hodgkin’s Lymphoma
8. Kaposi’s sarcoma

Demographics

According to the WHO statistics in 2018, 36.9 million people globally live with HIV of this 1.8 million are children below the age of 15. The numbers varied in different world regions. Africa is the leading with about 25.7 million victims, America has about 3.4 million victims, South East Asia has about 3.5 million victims, Europe has 2.3 million victims, and Eastern Mediterranean has about 350,000 victims and Western Pacific about 1.5 million victims. 21.7 million People out of the 36.9, are receiving antiretroviral treatment. Approximately 0.8% of adults aged between 15-49 years are living with HIV globally and about 4.1% of Adults in Africa. About 1 million people die annually due to HIV-related illness. This is a big reduction from the previous years. This is due to medical advancements and antiretroviral therapy available to the victims. About 129 countries have had about 150 million being tested for HIV. By 2017, about 75% of the people were aware of their HIV status.

Although new infections have been recorded recently, about 1.8 million. Overall, the numbers of people who have ever been infected by the disease are about 74 million since the epidemic broke, with about 35 million deaths. Much progress has been made to reduce mother to child transmission alongside keeping the mothers alive. About 80% of infected mothers in 2017 were able to access antiretrovirals hence preventing transmission of HIV to the newborn. Although effective prevention tools, methods, and programs have been set, new infections among adults have not reduced significantly (WHO 2018).

Treatment

a) Pre-exposure prophylaxis (PEP) - this medication prevents one from contracting HIV on exposure. It is administered after exposure to a high risk especially when a sexual partner is known to be infected. Drugs used are Tenofovir, Emtricitabine, Zidovudine, and Lamivudine.

b) Antiretroviral drugs- these medications prevent the viral load from growing by inhibiting viral replication in the body. They include all drugs used as PEP and Atazanavir, Fosamprenavir, Indinavir, Nelfinavir, and Efavirenz.

Social Determinants of Health and HIV

Social determinants of health are the conditions in which given people are born, live, grow, and work. These conditions influence and shape daily life. Besides these basic set up conditions, some forces and systems contribute to the way people live such as social and political systems of a given land. According to these facts, four major social determinants of health that affect the development of HIV are poverty status, Education level, Average household income and Employment status (Dean, 2010). Poverty- HIV is more prevalent in areas where locals live below the average poverty level according to the Centre for disease control and Prevention (CDC) report. This is because people in poor settings take it as a cheap form of entertainment available and is more likely to get involved in transactional sex in order to earn a living.

As per WHO demographics, Africa is leading in cases of HIV. This can be related to poverty. This poverty can result in early marriages and polygamy which serves as a channel to transmit the disease (Dean, 2010). Education- the level of education affects HIV contraction in such a manner that those with a low level of education are more likely to contract HIV as compared to those with a higher level of education i.e. above High School. The low levels of literacy hinder a person from employing effective prevention measures. They also are ignorant concerning medications to prevent the disease (Dean, 2010). House Hold Income- as Household income decreases, the prevalence of HIV increases simultaneously according to the CDC report. People who have low incomes do not access health care due to costs.

In cases of delivery, mothers are likely to transmit the infection to the newborn due to poor health conditions. These women do not access prenatal test and care. This as well predisposes the newborn to the risk of contracting HIV. Employment status- the rates of HIV case are high in populations where the residents are unemployed as compared to the regions where most residents are employed. The employed class usually has access to good health care and is engaged to work and thus have minimal time to engage in risky practices that lead to the contraction of the disease.

Epidemiological triangle of HIV. This is the epidemiological triad consisting of the causative agent of a disease, the Host and the intrinsic factors that influence the host’s exposure, susceptibility and their response to the causative agent and the Environment which influence the opportunity for exposure and influence the causative agent. The causative agent, in this case, is HIV. A microorganism is the retrovirus class. HIV targets a person’s immune system invades and destroys it, making it more vulnerable to subsequent forms of infection especially opportunistic infections and some virally related cancers. Since it debilitates the immune system, the body cannot fight the disease on itself and thus external treatment is needed.

The disease is transmitted when a person comes in direct contact with infected body fluids, mainly blood, vaginal and penile fluids. Genetic factors influence HIV transmission to some extent. Individuals lacking CXCR4 and CCR5 co-receptors are not in risk of contracting HIV. However, this condition is very rare. The polymorphism of CCR5 co-receptor also protects against HIV 1 and the progression of the disease. The Host of the Disease is usually Humans, but scientists have theorized it that humans who hunted chimpanzees and ate their meet, became infected with Simian Immunodeficiency Virus (SIV) which mutated to form HIV. When infected blood comes into contact with the mucous membrane or an open wound, the virus is then transmitted. The environmental factors influencing HIV are usually social economic factors. In communities where reporting or disclosing one’s HIV status is discouraged, the disease incidences are high. In low income and poor residents who have limited access to health care and treatment, the rates of HIV infections are high. In crowded urban settlements where low income earning group and the unemployed stay, high rates of crime and risky sexual behaviors result in high incidences of HIV infection.

In secondary and High school setting, HIV can be transmitted easily due to social pressure. The peer groups encourage each other to engage in unprotected sex as well as the use of some injected drugs. For the university, ladies usually engage with older partners in order to get some financial benefit hence making sex transactional in nature (Strathdee, 1998). Availability of Health care is one of the environmental factors that influence HIV epidemiology. In areas with quality health cases HIV cases are low as compared to areas with poor medical services.

Role of the community health nurse

1. Case finding

Community nurses are medical detectives who conduct investigations in order to understand a given medical condition in their quest to provide treatment and medical services to the people of a given community. Nurses identify the primary causes of disease and initiate measures to treat and manage the conditions. Research nurses ensure that the patient has given all the required information and conduct screenings to determine potential participants in a given research or clinical trials.

2. Reporting

Since nurses take a big role in the medical field, they are involved in various clinical trials and perform many roles in the management of these trials. These usually involve the clinical trial nurse. Most community-based nurses usually conduct research and thus have a role of reporting the findings hence their skills and experience in safety reporting. This involves ethical principles and the integration of their knowledge.

3. Data Collection

Community-based nurses can serve as the only physician at some health care centers. They are therefore endowed with the responsibility to collect all the data from the individuals who visit the health center. In cases they are involved in a clinical trial, they ought to collect the data store it and provide it in cases when it is required. They have a responsibility of ensuring that all the data collected is accurate and are up to date (Brookes, 2007).

4. Data Analysis

Community based nurses are researches in most cases, as they conduct clinical research to ascertain causes and related conditions to some medical conditions. Effective health service must entail research and in events f research, the presented data must be well analyzed. After the analysis of the data, the community nurse uses the evidence to execute some positive changes that improve health care provision in the community (Brookes, 2007).

5. Follow-ups

This is one of the vital roles that community nurses perform. They make up a follow-up program for the patients. Visit the elderly, disabled and vulnerable who cannot come to the clinic continually. They take the task of monitoring treatment for various individuals who come to the health care centre, especially those with diseases that deserve attention such as diabetes, HIV/AIDS and Hypertension.

Importance of demographic data to the community health

Demographic data is essential in a community as it enables the government to make decisions on how a given community is going to be catered for in terms of health care provision and resources allocation. Other non-governmental funding institutions usually would like to have the demographics of a given community before giving their support. Demographic data is essential in determining the cause of a given disease in the community. This can be used also to monitor the effectiveness of treatment. Additionally, the data can be used to assess the risk factors of a given disease, by evaluating gender relationship, age, weight, height, and other demographic parameters. Demographic data is also used in assessing quality improvement in quest to provide quality health services. Innovators of medicines also use these demographics to develop their products in clinical trials.

UNAIDS organization.

The Joint United Nations Program on HIV/AIDS (UNAIDS) has offices in 70 countries. It has global partners which have assisted in launching diagnostic initiatives that help reduce the spread of HIV, as most people who are infected do not know whether they are infected as they lack access to diagnostic facilities. The improved laboratories and high-quality treatment are also among their major focus. These quality laboratories in various countries have multiple testing tools and employ different strategies for monitoring treatment and diagnosing HIV. This organization provides strategies, coordination, support, and leadership to deliver-life saving HIV services. It collects epidemiological data on HIV in order to devise ways to reduce its impact and spread. Alongside this, they provide finances for HIV management in various countries. Most importantly they have a mobilized development of strong health systems in various countries as well as influencing political frameworks towards creating healthy societies. This organization has various sensitization programs to sensitize the public on HIV prevention method and have influenced the development of rights for people living with HIV.

Global Implications of HIV/AIDS

HIV is an epidemic that has hit all countries globally, with the disease affecting Africa to a great extent. About 25.7 million are cases of victims from Africa who are infected. This infection due to its debilitating nature, it has impacted the economy of most countries where is a big impact. This is because the disease deprives the country of the labor supply and productivity; this reduces the exports and imports and thus reduces the National Economic growth. High amounts of money and resources used to manage the disease and conduct research impacts the economy (Haacker, 2004).

The disease has left a large number of orphans, especially in Africa in very poor conditions. Some of these resort to cities and start engaging in crime. This impacts the local and even global security (Piot, 2001). Different countries deal with AIDS differently. In poor African countries, the expensive antiretroviral drugs may be focused to economically productive groups, unlike the economically dormant group. However, developed countries provide efficient medical care for the victims.

Conclusion

HIV is a retrovirus that causes AIDS. This is a debilitating communicable disease that is mainly transmitted by sexual contact. It can, however, be managed by Antiretroviral therapy as well as chemotherapy in certain stages. Due to the disease’s nature, it is a global concern and it impacts on the economy of various countries. One the organization that deals with the epidemic in order to contain it globally is called UNAIDS.