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Introduction
Diseases that are known to be communicable are infectious diseases that results from growth of pathogenic agents Communicable diseases are those diseases that can be spread from one person to another such as spread through contact, airborne or can be spread through, mosquito bites, droplet, body fluids or blood products. There are several examples of communicable diseases, some require reporting to the appropriate health departments or local agencies. Examples of communicable diseases include HIV, Hepatitis A, B and C, Measles, TB, Flu, Salmonella and blood-borne illnesses.
Definition of HIV
Human immunodeficiency virus (HIV) is a virus that weakens a person’s immune system by destroying important immune system that fight disease and infection. There is no cure for the disease, if it is not treated early, it may lead to AIDS. This disease affects the immune system and it kills CD4 Helper cell or T cell. After destroying CD4 Helper cell o T cell, it becomes hard for the body to fight off other inections easily. The number of CD4 counts represents how well the immune system is working. The CD4 must be within certain ranges for the immune system to function well. The normal range for CD4 cells is between five hundred to one thousand five hundred . Since there is no known effective cure for HIV, anyone diagnosed with the disease must be on medication and treatment compliant for proper medical care.
Stages, Symptoms, and Complications of HIV
The acute stage of Human Immunodeficiency virus is usually within two to four weeks after contracting the infection. The symptoms at this stage are as follows: When people have acute HIV infection, they have a large amount of virus in their blood and are very contagious. People with acute infection are often unaware that they’re infected because they may not feel sick right away or at all (CDC, 2019). People may experience flu-like symptoms after they have been infected and this may last for a few weeks. People with acute infection are mostly unaware that they are infected because they may not feel sick right away. The second stage of HIV infection is called the clinical latency, which also means HIV inactivity or dormancy. This stage is also called asymptomatic HIV infection because at this stage, HIV is active but it reproduces at a very low level. People may not have any symptoms during this time. It is also possible to transmit HIV to others during this stage. People who follow a treatment program may remain in this stage for many decades, or for the rest of their lives, as drug therapy reduces viral activity. Without treatment, the clinical latency stage lasts around 10 years.
Stage three is the most severe phase of HIV infection. “Acquired immunodeficiency syndrome (AIDS) is a term which applies to the most advanced stages of HIV infection. It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers” (WHO, 2018). People with AIDS have damaged immune system and they get a number of severe illnesses. Without treatment, people with AIDS survive for about three years. The common symptoms of AIDS include fever, chills, sweats, weakness, weight loss and swollen lymph glands. People are diagnosed with AIDS when their CD4 cell count drops below 200 cells. People with AIDS can be very infectious. Opportunistic infections are infections that occur more frequently, they are more seen in people with weakened immune systems, especially people living with HIV. Examples of oppurtunistic infections are Candidiasis of bronchi, trachea, esophagus or lungs, invasive cervical cancer, coccidiodomycosis, cryptococcosis, cryptosporidiosis, herpes simples and Histoplasomosis (CDC, 2019)
Methods of Transmission
HIV can be transmitted from infected individual to uninfected person through specific activities. Certain body fluids -blood, serum, rectal fluids, and breast milk from a person who has HIV can transmit HIV. In the United states, HIV is spread mainly by having anal or vaginal sex with someone who has HIV, without using condom. The use of the unclean needle is another common method of HIV transmission among illicit drug users. Sharing needles, syringes or other equipments used to prepare drugs for injections for an infected person can transmit the disease. HIV can live in a used needle for up to 42 dyas, depending on the temperature and other living factors. According to CDC, there are less common way HIV may spread from mother to child during pregnancy, being stuck with an HIV contaminated needle or other sharp object. In extremely rare cases, HIV can be transmitted by oral sex, receiving blood transfussions, organ /tissue transplants that are contaminated with HIV, eating food by a person with HIV and deep open-mouth kissing if both partners have sores and blood from the HIV positive partner (CDC, 2019).
Prevalence of HIV
HIV is a virus that causes AIDS and it is one of the world’s serious public health challenges. HIV affects people regardless of age, gender and race, but they mostly affect gay, Africans-Americans and bisexual men. There were approximately 37.9 million people across the globe with HIV/AIDS in 2018. Among these people, 1.6 million were 15 years and older while 160, 000 infections were among children ages 0-14. African Americans account for a higher propotion of HIV. In 2018, 42% of African Americans accounted for the new HIV diagnosis in the United States and dependent areas (CDC, 2020). Approximately 1.1 million of people in the United States live with HIV. It has an impact on certain populations, especially on ethnic minorities, gay and bisexual men. In 2018, 37, 832 people received an HIV diagnosis in the United States. In the United States, ga and bisexual men are the population most affected by HIV. In 2017, adult and adolescent gay and bisexual men accounted for 70% of the HIV in the United States and dependent areas. The HIV epidemic affected households, communities and development and economic growths of nations.
Social Determinants of Healths
According to Green, Social Determinants Of Health are “conditions of living, such as housing, socioeconomics, transportation needs, quality of education, that directly impact health and access to health care needs.” (2018). SDOH are conditions that contribute or hamper a person’s well-being. Evidence has shown that poverty and low income adds enormously in a high prevalence of HIV. The extreme poverty drives most of the young women to get into risky behavior to simply make money for survival. Sub-Saharan African has sixty-two percent of the world population of people living with HIV and also home to seventy percent of the world’s poorest people (Mbirimtengerenji, 2007). A better standard of living means that people can have proper medication, good nutrition, and social amenities, but it is the opposite for the people of Sub-Saharan Africa where people lack basic life amenities like water and food. Poverty acts as an underlying driver of human immunodeficiency virus infection in Sub-Saharan Africa.
In the United States, blacks or African Americans have a higher percentage of new cases of HIV and the number of people infected with HIV compared to other races. sixty percent of African Americans that were diagnosed with HIV in 2017 were gay or bisexual men. In 2018, 42% of African Americans accounted for the new HIV diagnosis in the United States and dependent areas. There are several social determinants of health that contributed to the prevalence of HIV among African Americans. Some of the challenges include lack of HIV awareness, poverty, limited access to healthcare and a higher rate of crime.
HIV Epidemiologic Triangle
HIV has no cure but there are available treatments. Stricts adherence to anti-retroviral therapy can dramatically slow down the disease’s progress and prevent secondary infections and also prolong life. According to World Health Organization, standard antiretroviral therapy(ART) consists of the combination of antiretroviral (ARV) drugs to suppress and stop the progression of the HIV diseases. WHO recommends ART for people with HIV as soon they have been diagnosed (WHO, 2020).
Apart from using ART or ARV, there are other preventive ways to stop HIV from spreading. People having sex should use condoms right away everytime before having sex. Reducing numbers of sexual partners can lower the chances of having a sex partner who will transmit HIV. The more partner one has, the more chances of having a partner with HIV. Gay and bisexual men are more at risk. It is recommended that gay or bisexual men who has had anal sex without a condom should test for a HIV. Receptive anal sex and Vaginal sex are risky type of sex for getting HIV, even though receptive anal sex is riskier than vaginal sex. It is also important to talk to one’s health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who are HIV negative but are at the risk of getting infected with HIV.
Role of Community Health Nurses
Community health nurses played a major role to play during the worldwide public effort in response to the HIV pandemic. Community health nurses perform various function in HIV programmes, which inlcudes reporting cases, testing, linking patients to care, accompanying them to clinic appointments, advocate, health educator, program coordinator and providing psychosocial supports as well as making referrals (Busza, 2018). Community health nurses contributed positively to the HIVcase in midwestern U.S suburban comminuty. The community health nurses involved developed HIV programs which were implemented to help the patients in need. The initiatives used by the community health nurses resulted in positive feelings about the health department and enhanced the image of community health nurses as facilitators of change.
National Agency or organization
National Institute of Health (NIH) is a primary federal aganecy for conducting and supporting medical research and also the lead federal agency for biomedical research on HIV and AIDS. NIH also researched opportunistic infections, co-infections and malignances. The research made led to a better understanding of the basic biology of HIV/AIDS. The NIH supports an international research and training portfolio that encompasses more than 90 countries. In 1989, NIH researchers made several discoveries about how the Human immunodeficiency virus destroys the immune system and leads to AIDS. In 1996, NIH funded scientists discovered a new drug known as protease inhibitors. In combination of other AIDS drugs, these medications attack HIV in several ways and extends the lives of HIV infected patients. This discovery turned HIV from a death sentence into a chronic disease. The NIH continues their research on HIV/AIDS, complications, and as well as develop test drugs (NIH, 2015)
Global implication of HIV disease
The scale of HV/AIDS epidemic exceeded all expectations 20 years ago. According to world Health organization and Joint United Nations Programme on HIV/AIDS, at the end of 1999, an estimate of 34.3 million of people were living with HIV/AIDS. Most of these people are from developing countries. Africa is the continent that has been mostly affected with HIV/AIDS. Sub-Saharan Africa has the highest infection level, they have the low access to care and least economic stability. Sub-Saharan Africa has the most population with 70% of people infected with HIV/AIDS. Out of the 6000 new cases of infection that occurs globally, two out of three are sub-saharan women (Kharsany & Karim, 2016).
Conclusion
HIV was once an epidemic that raged through the world in the 1980s, killing millions of people. HIV is still a threat to humans regardless of age, gender or ethnic group. Even though there are no known cure for HIV/AIDS,with the help of national agencies like NIH and other agencies around the world, there are preventive measures to make diagnosed people live longer.
References
- Busza, Dauya, Bandason, Simms, Chikwari, Makamba, Mchugh, Munyati, Chonzi, & Ferrand, (2018). The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe, Health Policy and Planning, Volume 33, Issue 3, April 2018, Pages 328–334, https://doi.org/10.1093/heapol/czx187. Retrieved March 29, 2020 from https://academic.oup.com/heapol/article/33/3/328/4788356
- CDC. (2019). How does a person get diagnosed with AIDS?. AIDS and Oppurtunistic Infections. Retrieved March, 27, 2020 from https://www.cdc.gov/hiv/basics/whatishiv.html
- CDC. (2020). HIV and African Americans. The Numbers, HIV Diagnosis. Retrieved March 28, 2020 from https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html
- CDC. (2017 May 06). The National Institute for Occupational Safety and Health. Communicable diseases. Retrieved March 28, 2020 from https://www.cdc.gov/niosh/topics/aircrew/communicablediseases.html.
- Dean, H. D., & Fenton, K. A. (2010). Addressing social determinants of health in the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. Doi: 10.1177/00333549101250S401Public Health Rep. 2010; 125(Suppl 4): 1–5. Retrieved March 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882967/#__ffn_sectitle.
- Kharsany, A. B. M., & Karim, Q. A. (2016, April 8). HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities. Retrieved March 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893541/
- Mbirimtengerenji N. D. (2007). Is HIV/AIDS epidemic outcome of poverty in sub-saharan Africa?. Croatian medical journal, 48(5), 605–617.
- National Institute of Health., 2015. HIV/AIDS. (2015, October 7). Retrieved March 29, 2020, from https://www.nih.gov/about-nih/what-we-do/nih-turning-discovery-into-health/hiv/aids
- U.S. Department of Veterans Affairs. (2018). HIV/AIDS. Retrieved March 29, 2020 from https://www.hiv.va.gov/patient/diagnosis/labs-CD4-count.asp
- World Health Organization. (2018). Treatment and Care Retrieved March 29, 2020 from https://www.who.int/hiv/topics/treatments/
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