HIV Epidemiology

HIV is a disease that has affected millions of people worldwide. From the wealthy to the poor, this virus has had devastating effects on the lives of families and individuals. According to the AIDS Institute, HIV was first discovered in a patient from West Africa. It is believed that chimpanzees carried the “simian immunodeficiency virus (SIV)” which transferred to humans when they came into contact with the infected animals’ blood after the animal had been caught while hunting. SIV then developed into HIV once in the human blood stream. HIV “has existed in the United States since at least the mid- to late 1970s.

” (AI, n. d. ) There is no cure for the virus. HIV is transferred through body fluids: blood, semen, fluids from the vagina and/or rectum, and breast milk. The virus is transmitted when bodily fluids come in contact with a mucous membrane or from direct entry into the blood stream such as an intravenous injection. The highest rates of transmission are anal sex, vaginal sex, and “sharing needles, syringes, rinse water, or other equipment (works) used to prepare injection drugs with someone who has HIV. ” (CDC, 2014).

Additional ways that the virus may be spread that are less common are from mother to infant during birth or pregnancy, through blood transfusions, or by suffering a needle stick while at work. According to the CDC, the stages of the virus are: acute infection, which occurs 2-4 weeks after the patient has been infected. The patient will present with symptoms similar to the flu. “During this period of infection, large amounts of HIV are being produced. The virus uses important immune system cells called CD4 cells to make copies of itself and destroys these cells in the process. ” (CDC, 2014) The next stage is the dormant or inactive stage. During this stage the virus is still active but at lower levels.

The patient may be asymptomatic. The virus can be dormant for several years with the usage of antiretroviral medications. AIDS is 2 Epidemiology and Nursing Research: HIV the final stage. In this stage, the patient’s immune system is severely compromised which leaves the body susceptible to infections. “When the number of your CD4 cells falls below 200 cells/mm3, you are considered to have progressed to AIDS. ” (CD4, 2014) The opportunistic infection that attacks the patient’s body once they have progressed to AIDS ultimately results in death within 1-3 years. Throughout all three stages, the virus can be transmitted to another person.

Per the CDC, African Americans and Caucasians between the ages of 20-50 have the highest rates of infection. African Americans have an incidence rate that is close to 8 times higher than the incidence rate in Caucasians. “CDC estimates that approximately 50,000 people in the United States are newly infected with HIV each year. In 2011, the estimated number of deaths of persons with diagnosed HIV infection classified as AIDS in the United States was 13,834. ” (CDC, 2014) In order to gain control of the spread of this disease, the epidemiologic triangle must be examined and studied.

“Communicable disease investigation involves five steps: identifying the disease, isolating the causative agent, determining the method of transmission, establishing the susceptibility of the populations at risk, and estimating the impact on the population. ” (Maurer, Smith, 2013) The agent in this disease is the virus HIV. Once exposure takes place, the virus targets cells in the human body that have CD4 receptor sites and attacks the patient’s immune system, reducing their ability to fight infection, resulting in death. Environmental factors that contribute to the spread of the disease are multiple sex partners, engaging in unprotected sex, risky sexual behavior such as prostitution, lack of education about the disease, drug abuse, and poverty level which would result in reduced means of being able to purchase contraceptives.

Once the agent has an environment in which to transmit, the agent then needs a host to infect. Factors that may increase the chances of a person becoming infected with HIV are if the infected 3 Epidemiology and Nursing Research: HIV person is at the beginning or late stages of HIV infection when viral loads are at their peak, if the host is menstruating at the time of intercourse, presence of lesions secondary to a STD at the time of intercourse, and if the host is not being compliant with their antiretroviral medication regimen.

Ways that nurses can break the chain of infection are by teaching drug abusers that “needles contaminated with HIV- infected blood can transmit HIV. A weak bleach solution will kill the virus, altering the environment and reducing the risk to a potential host. ” (Maurer, Smith, 2013) Additional information that can be taught by nurses is that “using barrier method precautions during sexual contact (dental dam, condoms, or nonoxynol-9 jelly) will contain or kill the virus. ” (Maurer, Smith, 2013).

According to the World Health Organization, the determinants of health include: the social and economic environment, the physical environment, and the person’s individual characteristics and behaviors. The continent with the highest prevalence of HIV is Africa. In Africa, particularly the southern region, there are high poverty levels and limited access to medical care. With poverty comes lack of education. It is very difficult to provide education to entire countries when the primary form of teaching is through word of mouth due to high illiteracy levels.

Many participate in promiscuous sexual behaviors that include multiple sexual partners, homosexuality, and engaging in unprotected sex. In order to survive, many succumb to prostitution as a means of income. In order to escape the reality of living in squalor and poverty, many turn to drug abuse. These behaviors contribute to the determinants of health in communities highly infected with HIV/AIDS.

The role of the community health nurse first starts with case finding. “The purpose of case finding is to identify every case of disease and to provide swift treatment for new cases. ” (Maurer, Smith, 2013) With HIV/AIDS, all sexual partners of the infected person have to be 4 Epidemiology and Nursing Research: HIV tracked down and identified. This information is obtained through a careful interview process. Primary prevention can help reduce the rate of infection.

The community health nurse can provide education regarding the usage of contraceptives, abstinence, and not engaging in promiscuity. The next step of preventing the spread of the disease is through secondary prevention. The nurse will be required to obtain blood samples from individuals to help determine their HIV status. Strict specimen collection protocols must be followed.

The community health nurse must be aware of laws regarding the reporting of communicable diseases to the proper government agencies and report accordingly. Nurses may be required to communicate test results to patients under the order of a physician. After the results are provided, the community nurse would then assist the patient in arranging follow up appointments, educating the patient regarding the disease, and helping to ensure medication regimen compliance through home visits if needed. The last step is tertiary prevention.

The community health nurse will follow up with the patient as scheduled or needed to help with management of living with the disease. A national agency that addresses HIV/AIDS is the Centers for Disease Control and Prevention. Through this agency, they provide information about statistics of the disease, basic information regarding testing and transmission, living with the disease, and ways to prevent the contracting of HIV/AIDS. The “CDC has provided funding to HIV partners to help implement programs that will help curb the increase of HIV infections. ” (CDC, 2014)

The CDC has also gone to cities that have high rates of HIV infections and have worked with the cities to create programs and policies to reduce the rate of infection. 5 Epidemiology and Nursing Research: HIV.

References The AIDS Institute. (n. d. ) Where did HIV come from?

Retrieved from: http://www. theaidsinstitute. org/node/259 Centers for Disease Controal and Prevention. 2014. HIV/ AIDS. Retrieved from: http://www. cdc. gov/hiv/basics/index. html Maurer, Frances, Smith, Claudia. 2013. Community/Public Health Nursing Practice. 5th Edition. Saunders. World Health Organization. 2014. The Determinants of Health. Retrieved from: http://www. who. int/hia/evidence/doh/en.

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