Introduction
The problem of HIV is considered from the point of view of increasing the spread of the disease by modern epidemiology. The number of infected people is growing every year; if the epidemic danger is not eliminated, in ten years, the number of infected people may increase several times. The main challenge in combating HIV infection is that its spread can be provoked by the negligent attitude of medical workers to their duties: unchecked donated blood and poorly sterilized instruments can cause infection. An equally serious problem is the stigmatized attitude toward those infected with HIV. To resolve the situation, the participation of the world medical community is necessary.
Causes
Currently, HIV infection is considered a completely incurable disease by the global medical community. Concerning this infection, preventive measures and early diagnosis make it possible to receive courses of treatment that significantly prolong life expectancy. With a long stay of the virus in the body, the final, terminal stage of infection – AIDS – is formed. The disease is caused by two types of viruses: HIV-1 and HIV-2 (Pépin, 2021). When it enters the body, it mainly affects immune cells – CD4 lymphocytes, which leads to the formation of immunodeficiency states (Pépin, 2021). The virus is active in biological fluids and quickly dies outside the body. It is sensitive to many disinfectants, ultraviolet light, and alcohol.
Symptoms
The difficulty in detecting infection lies in the length of the incubation period. Among the first signs, it is difficult to identify specific symptoms. External signs and complaints and clinical manifestations are similar to many other infections. The most characteristic symptoms are an increase in groups of lymph nodes, a rise in body temperature to subfertile values, skin rashes of various localization, the appearance of severe weakness, and headache (Gostin, 2021). The duration of clinically significant symptoms varies greatly; on average, manifestations persist for up to 2-3 weeks, after which all complaints and external signs disappear (Gostin, 2021). There are no more typical and specific manifestations in women or men, therefore, it is possible to know for sure about the presence of HIV infection only by the results of the tests. For early detection of the disease and the identification of hidden carriers during any preventive examinations, the patient is given a referral for a blood test for HIV.
Mode of Transmission
The main route of entry of the virus into the body is the blood, the virus is also found in semen. HIV infection can be contracted through sexual contact with an HIV-infected person. One of the timeliest ways of getting an infection is unprotected sexual contact; sexually transmitted diseases increase the risk of contracting HIV. Infection can spread through artificial insemination, skin and organ transplantation, and blood transfusion. It is possible to get infected through the use of needles and syringes used by an HIV-infected person. In addition, the infection is transmitted from mother to child during pregnancy, childbirth, and breastfeeding. Unsterile medical procedures can lead to infection; the likelihood of transmission of HIV infection increases in the presence of damaged skin. It is possible to become infected with HIV from patients to medical staff who have contact with the blood and other fluids of patients with HIV or AIDS if they do not comply with sanitary and hygienic rules.
Treatment and Complications
To date, no treatment provides full recovery from HIV infection. Therefore, all the efforts will be aimed at suppressing the activity of the virus and maximizing the life of the patient. Firstly, people are registered in HIV centers, they are treated under the supervision of an infectious disease specialist. Antiretroviral therapy is usually carried out with a combination of several drugs, taken for life and daily, strictly on the recommendation of a doctor. These measures reduce the activity of the virus to almost zero. Fungal infections, chronic bacterial processes, herpetic infections, and tumors are considered the most frequent complications of HIV (Su et al., 2019). Since the virus affects the cellular link of immunity, various infections and processes that occur against the background of an immunodeficiency state can be distinguished among the complications.
Demographic of Interest
Vulnerable segments of the population who are considered to be at risk of contracting HIV are teenagers, pregnant women, homeless people, migrants, couples in whom one of the partners meets high-risk populations, and healthcare workers. No one is immune from the risk of contracting HIV infection, despite the presence of a vulnerable population. That is why it is necessary to regularly undergo diagnostic tests, even for those who are not in risk groups.
Mortality, Morbidity, Incidence, and Prevalence
HIV is a major public health threat due to high rates of infection. At the end of 2021, an estimated 38.4 million people were living with HIV worldwide (UNAIDS, 2021). In 2021, 650,000 people died from HIV-related causes, and 1.5 million new HIV infections were reported (UNAIDS, 2021). Efforts must be redoubled to avert a worst-case scenario in which HIV-related deaths reach 7.7 million over the next ten years (UNAIDS, 2021). HIV infection rates rise as a result of interruptions in HIV care during the COVID-19 pandemic and a slowdown in the fight against HIV in public health.
Reportability of the Disease
Primary information about the results of testing a sample for HIV infection is stored in the laboratory, immune blotting, and molecular biological studies. The information must be sent to the institution that examined the patient and to an authorized specialized medical organization that carries out organizational and methodological work. Information about the identification of a new patient with HIV is reprinted immediately after the confirmation of the result as soon as possible. The territorial AIDS Center collects additional information about each HIV-positive person. If HIV infection is suspected while providing medical care, the territorial government body conducts an epidemiological investigation and anti-epidemic measures in the prescribed manner with the involvement of the territorial AIDS Center. Information about an HIV case is stored at the institution that made the diagnosis and forwarded to the data collection or analysis organization. The presence of a clear system for collecting and storing information allows monitoring and forecasting of the epidemiological situation, as well as planning preventive measures and methods to provide medical care to patients.
The Social Determinants of Health
The main determinants of health in HIV are the socioeconomic factors of the population. First of all, the lack of medicine due to the poverty of the region is the main risk factor. The low level of medical literacy of the population is also decisive, arising as a result of social inequality and discrimination. The social rejection of HIV-infected people and stigmatization of the disease is a serious risk of spreading the infection throughout the world.
The Epidemiologic Triangle and Communicable Disease Chain
The principle of studying the chain of infection suggests that infectious diseases result from the interaction of an agent, host, and environment. The epidemiological triangle is necessary to understand why the epidemiological situation in one region may be more difficult than in another. Epidemic risks are associated with the occurrence of more cases of the disease over a certain period. The pathogen, bacterium, virus, or parasite is meant by the agent. The pathogen infects the host, that is, the organism that carries the disease. Hosts become ill or carry the pathogen because some part of their physiology is hospitable or attractive to the pathogen. External factors can also influence an epidemiological outbreak; collectively, they are called the environment. The environment includes any factors that influence the spread of a disease but are not directly part of the pathogen or host.
Host Factors
Scientists suggest that HIV was originally carried by chimpanzees. Humans who hunted these chimpanzees for meat contracted the mutated form of the virus through contact with chimpanzee blood (Pépin, 2021). HIV can be transmitted when bodily fluids, such as blood, come into contact with mucous membranes or damaged tissue. The danger is represented by open wounds in the mouth or on the mucous membranes. The host may not be aware of the presence of HIV infection, being an active carrier. Outbreaks of diseases due to the specifics of the carrier are associated with regions with low medical literacy the population.
Agent Factors
HIV is a viral infection that poses a threat to the human immune system. The virus targets the immune system, which makes the body unable to fight the infection effectively on its own. HIV is transmitted through direct contact with the body fluids of an infected person and is mainly spread through sexual contact. In addition, one of the main modes of transmission is blood. Contact may occur through transfusion use of shared medical instruments. Due to the specifics of the virus, the most dangerous situation may arise in poor sanitary areas.
Environmental Factors
Several socioeconomic factors can influence the spread of HIV in a community. Communities with higher concentrations and fewer reports of sexually transmitted diseases allow HIV to flourish. This factor is associated with the low literacy of the population and the stigmatization of the disease due to widespread myths. Poverty limits access to care and treatment, and discrimination can prevent people from getting tested or seeking help.
Considerations for the Community, Schools, and General Population
Prevention of HIV should become the main means of struggle. Prevention is associated with the spread of reliable ways to protect against infection. Regular HIV testing of both partners can reduce the spread of infection. Refusal to accept drugs and use only disposable syringes and needles is a basic criterion for health care (CDC, 2019). The use of personal hygiene products: such as razor and manicure accessories, reduce the risk of infection (CDC, 2019). Barrier contraception for any sexual intercourse should become strictly mandatory. It is necessary to promote these precautions among all members of society, especially children and adolescents.
The Role of Community Health Nurse
The community nurse should be familiar with the symptoms of HIV and help identify cases. In addition, professional duties may include collecting data on incidence in the region and reporting to AIDS centers since the nurse is often the first contact with new cases of infection. In addition, the community nurse carries out further monitoring of the course of the disease, providing the necessary care. People living with HIV need ongoing support and a non-stigmatized attitude. In addition to helping the infected, nursing prevention is also necessary. Thus, the role of nurses may be to participate in activities dedicated to the fight against the spread of HIV.
The Importance of Demographic Data
Demographic data is important for understanding risk groups, and the rate of increase in incidence and helps develop preventive measures. Across age groups, the annual number of HIV infections decreased among those aged 13–24 but remained stable among all other age groups (Crepaz et al., 2019). Disaggregated by race or ethnicity, the annual number of HIV infections has decreased among people of several races but has remained stable among people of all other ethnic groups (Crepaz et al., 2019). By sex at birth, the annual number of new HIV infections has declined among men but has remained stable among women (Crepaz et al., 2019). By transmission category, the annual number of HIV infections has decreased among men, with transmission associated with male-to-male sexual contact, but has remained stable among all other transmission categories (Crepaz et al., 2019). Sexual contacts remain the main mode of HIV transmission.
Organizations Addressing the Problem of HIV
WHO makes a significant contribution to the fight against HIV and supports those infected. In strategies for 2022–2030, joint action in countries on specific diseases is recommended (WHO, 2022). They promote learning in a variety of disease areas and create opportunities to use innovation and new knowledge for an effective response to HIV. The strategies call for special attention to the people most affected and at risk of disease, aimed at redressing inequalities. The strategic goals for the next decade are to collect objective data that will indicate the rate of disease and mortality.
There is currently a federal initiative in the US to end the HIV epidemic. The program aims to reduce the number of new HIV infections by at least 90% over the next decade (HIV.GOV, 2019). Almost 200 private and public medical centers operate under this initiative (HIV.GOV, 2019). The main goal of the federal initiative is to provide patients with access to care and treatment. In addition, clinics provide preventive measures by educating patients about the risks and ways to avoid the disease.
Global Implication
Currently, HIV is acquiring the proportions of a global epidemic. The most dangerous situation is in South Africa, where the HIV epidemic has led to a sharp reduction in life expectancy (Niehaus, 2018). Countries with a lower quality of life and higher levels of poverty are at the greatest risk. Attitudes towards HIV also vary across countries and cultures, depending on the level of health literacy among the population. In regions with low medical accessibility and high ignorance of the population, for example, in African countries, HIV is not taken seriously. In Europe and the United States, despite high awareness of the disease, not all people regularly undergo preventive testing. Even though people in the United States are quite educated about HIV infection, there is still stigmatization of the disease in society, making it difficult for those infected to seek medical help.
Conclusion
The HIV epidemic is a major public health threat in the modern world. The most common way of infection transmission is through unprotected sexual contact. Prevention measures should be aimed at increasing the medical literacy of the population to avoid discrimination against people with HIV. The stigmatization of the disease is a factor contributing to the spread of infection. Global and local organizations are addressing this issue as HIV has become one of the most common diseases of the 21st century.
References
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Gostin, L. O. (2021). Global health security: A blueprint for the future. Harvard University Press.
HIV.GOV. (2019). What is “Ending the HIV Epidemic: A Plan for America”? Federal Response. Web.
Niehaus, I. (2018). AIDS in the Shadow of Biomedicine: Inside South Africa’s Epidemic. Bloomsbury Publishing.
Pépin, J. (2021). The origins of AIDS. Singapore: Cambridge University Press.
Su, H. C., Jing, H., Angelus, P., & Freeman, A. F. (2019). Insights into immunity from clinical and basic science studies of DOCK 8 immunodeficiency syndrome. Immunological reviews, 287(1), 9-19.
UNAIDS. (2021). Global HIV & AIDS Statistics. 2020 Fact Sheet. Web.
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