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The HIV/AIDS epidemic has spanned the past three-and-a-half decades so far. To fight against it, researchers and governments have mobilized and fundamentally altered the course of the disease and transformed the prognosis for millions of individuals living with HIV/AIDS. Now the frontier in the fight against HIV/AIDS has shifted to preventing the infection. Thus, HIV/AIDS has been chosen for this investigation as an especially relevant health issue presently. This research aims at highlighting the latest information on HIV/AID prevalence and mortality worldwide, its etiology and pathophysiology, as well as the prognosis about the epidemy and preventive measures that can be taken to avoid the infection.
Today, the Human Immunodeficiency Virus (HIV) continues to be a severe public health issue on a global scale, having claimed 35 million lives so far (World Health Organization [WHO], 2019). According to WHO, about 940 000 people around the world died from HIV-related causes in 2017 (2018). The fact sheets show that about 36.9 million people worldwide are presently living with HIV/AIDS (WHO, 2018). Approximately 1.8 million children across the globe are living with HIV, and most of them were infected by their HIV-positive mothers (WHO, 2018). WHO reports that the African region is the most affected one as, in 2017, there were registered around 25.7 million people living with HIV (WHO, 2018). It was estimated that two-thirds of the total new HIV infections occur in Africa (WHO, 2018). The vast majority of people living with HIV are in low- and middle-income countries.
AIDS stands for Acquired Immunodeficiency Syndrome, and it refers to the most advanced stage of HIV infection, which can take up to 15 years to develop depending on an individual. HIV is a retrovirus and may be transmitted via blood, blood products, sexual fluids, other fluids containing blood, and breast milk. Mostly, individuals are infected through sexual contact, during pregnancy, childbirth, or breastfeeding. When the virus gets into the bloodstream, it enters T-helper lymphocytes by attaching itself to a receptor site on the cell membrane known as CD4 (Centers for Disease Control and Prevention [CDC], 2019). Usually, when any virus infects the T-helper lymphocyte, the cell sends signals to other cells, which produce antibodies. However, HIV hijacks and destroys the T-helper lymphocytes so that they cannot signal for antibody production. This leads to the eventual decline of the immune system.
HIV infection passes through a series of stages before it turns into AIDS. Acute HIV infection is the first stage of HIV disease, during which the virus is establishing itself in the body, but the body has not started to produce antibodies yet (CDC, 2019). So, the infection cannot be diagnosed by any HIV tests at this stage. Typically, the phase is characterized by mononucleosis-like symptoms (fever, swollen glands) and lasts for a few weeks.
The next stage is referred to as clinical latency or asymptomatic HIV infection (CDC, 2019). This phase may last for up to a decade, during which HIV is active, but people may have no symptoms. They can transmit the infection to others, although people who take HIV medicine as prescribed stay virally suppressed and have almost no risk of transmitting HIV (CDC, 2019). AIDS is the last stage and the most severe phase of HIV infection. This stage is characterized by serious immunodeficiency, and individuals get an increasing number of grave illnesses, called opportunistic illnesses (CDC, 2019). Also, patients with AIDS can have a high viral load and be very infectious.
HIV infection can be diagnosed through rapid diagnostic tests (RTDs), which detect the presence or absence of HIV antibodies. There is no cure for HIV infection, although antiretroviral drugs can control the virus and help prevent transmission (WHO, 2018). Another essential point is qualified nursing care for HIV/AIDS patients. First of all, nurses must have knowledge about treatment options, the efficacy of treatment, and the scheduling of medications. They have to be able to advise their patients on the best options for their lifestyle and needs, explain the importance of adherence in treatment success, and inform them about potential side effects. Nurses need to plan and enact strategies that will support their patients’ adherence. They also ensure the patients are engaged with their primary care practitioners and understand the importance of routine follow-up.
In spite of the fact that the “general opinion agrees on the Test & Treat strategy which recommends continuous treatment as soon as HIV infected patients are identified, treatment interruptions are still a controversial topic” (Mancini et al., 2018, para. 2). Scientists disagree on two points: the risks associated with the voluntary interruption of treatment and the need to stop combined antiretroviral therapy (cART) to improve the natural immune response to HIV and to restore viral drug susceptibility.
The way to prevent infection by the virus is to avoid behaviors that put one at risk, such as sharing needles or having unprotected sex. Testing for HIV is recommended for all people exposed to any of the risk factors. The risk of HIV transmission from a pregnant woman to her baby is significantly reduced if the mother takes antiretroviral therapy (ART) during pregnancy and delivery and her child takes ART for the first six weeks of life.
The United Nations aims to end AIDS include the “90-90-90” targets based on presently available health technologies that can diagnose HIV infection and suppress viral replication. This program focuses on the following goals: by 2020, 90% of all people living with HIV know their HIV status, 90% of people with diagnosed HIV receive ART, and 90% of all people on HIV treatment achieve viral suppression (WHO, 2018). However, a lot of work should be done to enable fair access to these services for key populations and those who remain outside the traditional health services.
References
Centers for Disease Control and Prevention. (2019). About HIV/AIDS. Web.
World Health Organization. (2018). HIV/AIDS. Web.
Mancini, E., Quax, R., De Luca, A., Fidler, S. Stohr, W., & Sloot, P. M. A. (2018). A study on the dynamics of temporary HIV treatment to assess the controversial outcomes of clinical trials: An in-silico approach. PLoS ONE, 13(7). Web.
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