HIV in Africa: International Health Problem Intervention Twenty years after the initial reports of AIDS and some 18 years; since it was first observed in Africa, the HIV epidemic has spread throughout the continent to devastating effect. As of the end of 2001, there are an estimated 28. 1 million adults and children living with HIV in sub-Saharan Africa. Over the course of 2001 an estimated 3. 4 million Africans became infected under the age of 15. In 2001, there were an estimated 2.
3 million deaths due to AIDS in sub-Saharan Africa, and sub-Saharan Africans account for some three quarters of the total global toll of 20 million AIDS deaths since the epidemic began. AIDS has become the leading cause of death in Africa. Across sub-Saharan Africa, the average prevalence of HIV in adults aged 15 to 49 is 8. 8%. East Africa once had the highest infection rates on the continent but has now been overtaken by the southern cone (Essex, 2002 p. 200). The latest count of HIV/AIDS in Sub-Saharan Africa as of 2005 involves adults aging from 15-49 with rates of 22.
4 million. The prevalence rate of adults possessing the illness during the same year exceeds up to 5. 9%. Women aging 15-49 with HIV/AIDS accounts to 13. 3 million, while the children accounts for 2 million. There are also 12 million orphans that possess the condition from age 0-17. In addition, the deaths from the condition AIDS of the same year accounts for 2. 1 million, which is lesser compared to the previous years (Mondaini and Dilao, 2006 p. 153). Methodology: Precede-Proceed Framework
The conceptual framework of precede-proceed model exemplifies the formulation of intervention standards in accordance to various diagnostic data gathered. The theoretical framework employed in this concept establishes an organized factual cognition. Phase 1: Social Diagnosis The occurrence of AIDS/HIV prevalence in Africa has caused tremendous social stigma that remains evident up until today. The stigma has produced substantial effect on the health care management being administered to these individuals. Moreover, the conditions of HIV/AIDS in Africa have caused wide stigma and fear over the communicability of this disease.
Misconceptions and wrong notions, such as false information especially about modes of transmission, impaired awareness about the disease itself, and anxiety of familial shame, have caused the build-up of a great society dilemma towards the disease (Essex, 2002 p. 200). The idea and perspective of care given to these HIV patients before are strictly less and in some cases, are not even accepted in other hospital because of the impact of AIDS/ HIV stigma. Phase 2: Epidemiologic Diagnosis The epidemiologic condition of AIDS occurrence in Africa is evidently decreasing with rates of 28.
1 million adults and children prevalence rate of HIV/AIDS on Sub-Saharan Africa to 22. 1 million of the same population setting (Kalipeni, 2004 p. 16). The case maybe decreasing; however, risks of transmission outside the local settings are increasing with evident ratings from 33. 6 million adults and children of 1999 to 38. 6 million in 2005 (Libman and Makadon, p. 345). The increasing rate has been pointed due to the increasing transmission of the infection globally; hence, attention should be redirected on the point source of infection.
Phase 3: Behavioral and Environmental Diagnosis Many patients with HIV infection have engaged in “stigmatized” behaviors. Due to the occurrences of this behavioral challenge, some traditional religious and moral values, health care providers may feel reluctant to care for these patients. In addition, health practitioners and the public themselves may still have fear and anxiety about disease transmission despite education concerning infection control and the low incidence of transmissions.
Another postulated cause of a shorter survival period in older individuals is the risk for the invasion of OI of Opportunistic Infections. It has been hypothesized that these types of infection occur less frequently with younger patients. However, it has been shown that there is no significant difference between those over and less than 40 years of age in the percentage of cases with pneumocystic carnii pneumonia, Candida esophagitis, or Kaposi’s sarcoma as their initial AIDS-defining diagnosis.
Moreover, it is noted that the severe depression of environmental status induces further progression of HIV/AIDS complication, which can lead to further mortality and morbidity increase (Reichart and Philipsen, p. 22). Phase 4: Educational and Organizational Diagnosis Educational and information settings are mainly inadequate as manifested by the stigma occurring in the area itself and the neighboring local and international settings.
The condition of discrimination has initiated vast effects on health care management of these patients. However, organizations managing and regulating the conditions of these HIV/AIDS patients are widely known and actively conducting different programs both locally and internationally. Although, awareness expansion is gradually increasing, still, evidence suggests the misconceptions are dramatically occurring particularly on depressed areas, such as rural communities (Kalipeni, 2004 p. 16). Phase 5: Administrative and Policy Diagnosis
Every two years, experts from around the world convene at an international AIDS conference to present the newest information about prevention and treatment of HIV infection. The implicit, and often explicit, assumption of AIDS policy is that differences in behavior adequately determine differences in HIV prevalence between populations. The policy, in fact, has focused greatly on sexual behavior, which is viewed as the prime source of HIV/AIDS infection. Phase 6 to 9: Implementation and Evaluation Health education is dependent on the values and philosophies of practitioners.
The effectiveness of health education is only assessed if a change in perspective followed by a change in concepts, principles and lastly, behavior changes occur in the person. Behavior change is only possible if programs focus on specific behavioral goals, provide sufficient training and support for teachers, and use an age-appropriate and gender-sensitive design (Libman and Makadon, p. 345). The following health education concepts are needed to be taught by the health care providers to the patients. Practitioners need to assess their level of reception after the health education.
Preventive-Rehabilitative Teaching: The teaching type covers patients who currently possess the disease itself, and currently engaged in direct manifestations of the disease. Goals for the patient may include achievement and maintenance of skin integrity, resumption of usual bowel habits, absence of infection, improved activity tolerance, improved thought processes, improved airway clearance, increased comfort, improved nutritional status, increased socialization, expression of grief, increased knowledge regarding disease prevention and self-care, and absence of complications (Libman and Makadon, p.345).
Preventive Teaching for High-risked Individuals: The teaching involves the individuals who are high-risked of acquiring the disease, primarily homosexuals, injection-users. Safer sex may be defined as sexual contact that poses the least risk of sharing potentially infectious body fluids. The safest sex is abstinence. The Public Health Service recommends condom use, which reduce transmission risk under potentially at-risk situations. The polyurethane female condom has been found to be effective against a variety of sexually transmitted diseases, such as HIV (Karim and Karim, 2005 p. 31).