HIV: Populations and Factors that Affect Its Control, Prevention, and Treatment

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Introduction

In the present day, human immunodeficiency virus (HIV) may be regarded as one of the most serious health issues all over the world. This infection attacks the persons immune system and weakens it against severe chronic and even terminal diseases. The appropriate and time0sensitive treatment of HIV prevents its transmission to other individuals. It goes without saying that not all communities and cultures are equally vulnerable to HIV infection, and there are multiple factors that influence the diseases perception, acquisition, control, prevention, and treatment. The purpose of this paper is to investigate what populations traditionally face the most substantial risk of HIV infection and how HIV is affected by economic, social, and legislative variables. According to the findings of this study, migrant sex workers and people from poor communities may be regarded as the most vulnerable populations. In addition, socioeconomic status, control models, and current legislation have a substantial impact on HIV control and treatment.

Vulnerable Population

Migrant female sex worker may be regarded as one of the most vulnerable population that is affected by a considerable risk of HIV and other sexually transmitted diseases. In general, women who are involved in the sex industry face unique structural vulnerabilities and health-related harms, including poverty and debt, poor healthcare access, social isolation, discrimination, stigma, unsafe and inappropriate working conditions (Goldenberg, et al., 2016). In turn, migrant workers face substantial issues related to insecure legal status, immigration status, legislation that may criminalize sex work, and language barriers (Goldenberg, et al., 2016). Their health is traditionally shaped by various structural factors such as economic factors, housing, work environments, community participation, collectivization, stigma, and criminalization.

The main modes of HIV transmission include unprotected heterosexual contact, injection drug use, and male-to-male sexual contact. That is why peoples age, socioeconomic and insurance status, race and ethnicity, and gender are traditionally considered when conducting researches related to HIV transmission, control, prevention, and treatment. It is, therefore, possible to determine that black men were seven times more likely than whites to have heterosexual versus male-to-male sexual contact (Brawner, et al., 2017, p. 716). In addition, uninsured citizens were more likely to have injection drug use than male-to-male sexual contact and 10 times more likely to have heterosexual contact than male-to-male sexual contact (Brawner, et al., 2017, p. 716). In general, such factors as the persons financial state, place of living, and occupation have a prevalent influence on the possibility of HIV infection.

In addition, young Black men who live in resource-poor rural environments and are affected by adverse childhood experiences are considerably vulnerable to sexual risk behavior and HIV (Kogan, et al., 2016). In general, according to the findings of Kogan et al. (2016), racial disparities in rates of sexually transmitted diseases in rural areas are equal to and, in some cases, exceed those found in densely populated inner cities (p. 813). In areas when men have multiple sexual partnerships with inconsistent condom use, the spread of HIV is disproportionately extensive.

The Influence of Control, Power, and Money on HIV and Its Treatment

Models for HIV Control, Prevention, and Treatment

Optimal control over HIV transmission has a highly positive effect on its perception and treatment as well. Saha and Samanta (2019) suggest a compartmental model for HIV control and prevention that include pre-exposure prophylaxis (PrEP) and treatment. This model predominantly focuses on the impact of the persons individual behavioral response to PrEP information that may prevent uninfected individuals from HIV acquisition in the future (Saha & Samanta, 2019). Moreover, it aims to minimize disease fatality and be cost-efficient through the appropriate choice of PrEP information for short-term control and treatment for a longer period of time. According to the scholars research, the simultaneous use of treatment and PrEP as control interventions is more useful than any single applied control policy (Saha & Samanta, 2019, p. 280). This strategy helps to optimize expenditures related to control and disease burden and substantially reduce the number of HIV-infective individuals.

The investigation of the potential influence of structural determinants related to HIV and its treatment substantively contribute to the development of other control models as well. Shannon et al. (2015) use a deterministic transmission model for the control of HIV acquisition among female sex workers. This model is designed for HIV control and prevention through structural changes in regions with concentrated and generalised epidemics and a high prevalence of HIV among sex workers (Shannon, et al., 2015, p. 55). In addition, scholars state that the decriminalization of sex work will have the greatest impact on the HIV perception, control, treatment, and the course of this diseases epidemics all over the world (Shannon, et al., 2015). On the basis of this preferable policy, well-structured and community-led interventions may be regarded as highly essential for HIV prevention and treatment and the promotion of female sex workers human rights.

Influence of Legislation on HIV

Current legislation connected with immigration and sex work inhibits the effective control and prevention of HIV. In general, migrant workers experience significant social inequities they fill low-paying positions, work informally, and face unsafe working conditions, insecurity, and limited access to health care (Goldenberg, et al., 2016). Migrant sex workers are frequently disproportionately vulnerable to punitive policy and legal consequences, such as arrest or deportation, and their human rights are considerably abused by government authorities (Goldenberg, et al., 2016). At the same time, migrant women represented in the sex industry are completely unprotected against violence, sexually transmitted diseases, and HIV without an opportunity to receive appropriate treatment. In recent years, multiple researches dedicated to this issue have been organized in order to develop appropriate models and strategies for HIV control and prevention. However, due to current policies that criminalize sex work and support inequities related to migration, sex workers have a fear of communicating with scholars in order to contribute to comprehensive researches.

Impact of Socioeconomic Status on HIV Treatment and Prevention

At the same time, peoples socioeconomic status has a substantial influence on the treatment of HIV. It goes without saying that IV may be generally regarded as a disease embedded in economic and social inequity. It affects impoverished neighborhoods and families with low income at disproportionately high rates (Wiewel, et al., 2017). According to the results of the research conducted by Wiewel et al. (2017), residents of high- or very-high-poverty neighborhoods were less likely than residents of low-poverty neighborhoods to maintain suppression of HIV (p. 3557). Socioeconomic status determines not only the persons vulnerability to HIV but the quality of treatment and life after the diseases acquisition.

Periods of homelessness, limited economic opportunities, poor and adverse childhood have been traditionally associated with drug and alcohol consumption, and risky sexual practices. Desperate people frequently practice unprotected sex in exchange for housing, money, and safety and place themselves at risk for various sexually transmitted diseases and HIV. Such factors as high crime rates and unemployment are associated with the vulnerability to HIV infection as well. In addition, despite the fact that HIV is predominantly associated with urban life, a substantial number of rural residents are infected as well. According to Kogan et al. (2016), the representatives of rural communities and small towns in southern Georgia, Alabama, South Carolina, and North Carolina are considerably affected by HIV and other sexually transmitted diseases.

Conclusion

It goes without saying that not all communities and cultures are equally vulnerable to HIV infection that may be regarded as one of the most dangerous infections within the context of the everyday world. There are multiple factors that influence the diseases perception, acquisition, control, prevention, and treatment, such as the persons socioeconomic status, place of living, and employment, the effectivity of control models, and current legislation. While optimal control over HIV transmission has a highly positive effect on its perception and treatment, current legislation related to immigration and sex work inhibits the diseases effective prevention. At the same time, peoples socioeconomic status has a substantial influence on the treatment of HIV that affects impoverished neighborhoods and families with low income at disproportionately high rates. Migrant female sex workers may be regarded as one of the most vulnerable populations affected by a considerable risk of HIV and other sexually transmitted diseases due to their discrimination, limited access to health care, human rights violation, and inappropriate working conditions.

References

Brawner, B. M., Guthrie, B., Stevens, R., Taylor, L., Eberhart, M., & Schensul, J. J. (2017). Place still matters: Racial/ethnic and geographic disparities in HIV transmission and disease burden. Journal of Urban Health, 94, 716-729.

Goldenberg, S. M., Brouwer, K. C., Jimenez, T. R., Miranda, S. M., & Mindt, M. R. (2016). Enhancing the ethical conduct of HIV research with migrant sex workers: Human rights, policy, and social contextual influences. PLOS ONE, 11(5).

Kogan, S. M., Cho, J., & Oshri, A. (2016). The influence of childhood adversity on rural black mens sexual risk behavior. Annals of Behavioral Medicine, 50, 813-822.

Saha, S., & Samanta, G. P. (2019). Modelling and optimal control of HIV/AIDS prevention through PrEP and limited treatment. Physica A: Statistical Mechanics and its Applications, 516, 280-307.

Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., Reza-Paul, S., Lau, J., Deering, K., Pickles, M. R., & Boily, M. C. (2015). Global epidemiology of HIV among female sex workers: Influence of structural determinants. The Lancet, 385(9962), 55-71.

Wiewel, E. W., Borrell. L. N., Jones, H. E., Maroko, A. R., & Torian, L. V. (2017). Neighborhood characteristics associated with achievement and maintenance of HIV viral suppression among persons newly diagnosed with HIV in New York City. AIDS and Behavior, 21, 3557-3566.

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