Prominent Aspects
According to Center for Disease Prevention and Control, HIV is a health condition that stands for human immunodeficiency virus. HIV/AIDS is a virus contracted through body fluids such as blood, rectal, virginal and pre-seminal fluids (cdc.gov, n.d). The virus invade the CD4 T cells leading to deprivation of the body’s potency to resist infections. Destruction of CD4 special cells makes a person’s body vulnerable to opportunistic infections by other diseases that permeate the already frail immune system. HIV has three typical diseases stages; Acute HIV infection that lasts for two to four weeks after infection. The second phase is regarded as Clinical latency or HIV dormancy/inactivity, a stage where no symptoms manifest. Acquired immunodeficiency syndrome ensues and is the most severe phase of the infection where patients experience weakened immune system which exposes them to opportunistic illnesses.
Studies trace the source of HIV to be in Kinshasa, the democratic republic of Congo where the virus crossed to humans from Chimpanzees around 1920. The first HIV infection case was reported in Congo in 1959 whereas subsequent infections occurred in the United States in 1980s when the US recorded the first HIV patient.
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Current Data and Statistics
According to Healthy People 2020, an estimated 1.2 million US inhabitants live with HIV virus while about one in eight people are unware that that they have contracted the disease. The United States register approximately 38,000 new HIV cases each year. Statistics indicate that in 2018, about 37,832 individuals tested positive for HIV/AIDS in the US and in 6 dependent regions. According to Linley et al., (2018), between 2010 and 2017, the annual new HIV diagnoses plummeted by 9% in the United States. The US recorded 15,820 HIV/AIDS fatalities which included both adolescents and adults. The African American population registered the highest number of HIV diagnoses standing at 16,002, followed by Latino and whites each registering 10,246 and 9,560 respectively. Male to male sexual contact transmission category according to CDC ranks as the number one contributor of new HIV infections standing at 24,993 cases followed by injection drug use at 2,492 and heterosexual contact at 9,008 (cdc.gov, n.d).
Global statistics reported by Health People 2020 indicated that approximately 1.7 million HIV diagnoses were made in 2018 worldwide. In 2018, as estimated 770,000 people succumbed to HIV opportunistic infections. Since the advent of the epidemic, about 770,000 HIV related fatalities have been reported globally (healthypeople.gov, n.d). Sub-Saharan Africa reports the most HIV and AIDS cases worldwide followed by Asia, Pacific and Latin America.
Health Disparities
HIV/AIDS continues to affect some people more than others despite the prevention efforts due to a rise in health disparity. According to Healthy People 2020, African American inhabitants in the USA are disadvantaged in respect to receiving standard HIV care, antiretroviral drugs, monitoring of immune functioning and outpatient appointments in comparison to White patients (healthypeople.gov, n.d). In the US, the Latino community also contend with significant health disparities. Relative to Whites and African American, the Latinos experience greater delays in initiating HIV/AIDS care. The health disparities are precipitated by factors such as discrimination, privilege and prejudice. The HIV health disparities also cuts across gender dimensions as women living with the disease were found to be less likely to receive antiretroviral drugs relative to males ( Howe, 2017) . Women of color are disadvantaged in respect to receiving HIV care due to high levels of poverty, lack of economic opportunities and lower literacy which leads to delayed entry to care and non-adherence to recommended health improving behaviors.
Prevention Strategies
Male circumcision as cited by Reddon et al., (2019), is an effective strategy that significantly reduces risk of infection. Based on adult male circumcision trials, the strategy was found to reduce risk of heterosexual men HIV infection by 50%. Second, Pre-Exposure Prophylaxis (PrEP) can greatly reduce risk of HIV infection among negative persons. A research by Reddon et al., (2019) reported that consistent uptake of PrEP at least 4 times per week reduces the risk of contracting HIV by around 99%. Among people who inject drugs (PWID), daily intake of PrEP lead to significant reduction of HIV/AIDS infection by approximately 74-84%. Third, ART or Antiretroviral Therapy has been established to be an effective prevention strategy for HIV transmission among HIV positive persons. Uptake of ART among positive heterosexual males and females greatly reduces HIV transmission risk to a HIV negative individual. Medical Marijuana, physical body therapies such as yoga, herbal medicine and relaxation techniques such as visualization and meditation are increasingly being adopted to improve the immune system of HIV infected individuals.
Contemporary research and clinical studies
A clinical study by Rodger 2016 on men who have sex with men reported that regular taking of ART decreases the probability of acquiring HIV infection by a negative partner. Based on several trials and observational research by Reddon et al., (2019), circumcision among adult males was found to be effective in reducing the risk of HIV contraction by heterosexual women during sex. Contemporary research on HIV transmission among heterosexual men and women found that effectiveness of PrEP oral intake is dependent on PrEP adherence, with optimal effectiveness attained when taking PrEP daily.
Pathophysiologic effects of Stress
Stress is an aggravating factor that makes HIV medical situation worse. A study by American journal of Psychiatry reported that men who have contracted HIV progress to AIDS rapidly when exposed to stressful life events ( Yew et al., 2018) . Exposure to social stressors pave way for numerous complications coupled with an increase in opportunistic ailments. Among people with HIV, stress is associated with high rates of clinical depression and post-traumatic stress disorder.
References
cdc.gov (n.d). HIV, https://www.cdc.gov/hiv/default.html
Linley, L., Johnson, A. S., Song, R., Wu, B., Hu, S., Singh, S., ... & Morgan, M. S. (2018). Estimated HIV incidence and prevalence in the United States 2010–2015.
healthypeople.gov (n.d). HIV, https://www.healthypeople.gov/2020/topics-objectives/topic/hiv
Howe, C. J. (2017). Reducing HIV racial/ethnic disparities: what’s good data got to do with it?. Epidemiology , 28 (2), 221-223.
Reddon, H., Marshall, B. D., & Milloy, M. J. (2019). Elimination of HIV transmission through novel and established prevention strategies among people who inject drugs. The Lancet HIV , 6 (2), e128-e136.
Yew, W. W., Chan, D. P., Singhal, A., Zhang, Y., & Lee, S. S. (2018). Does oxidative stress contribute to adverse outcomes in HIV-associated TB?. Journal of Antimicrobial Chemotherapy , 73 (5), 1117-1120.
