HIV and AIDS Content Knowledge for Dental Professionals:
HIV Defined and the History of HIV
Research Methodology, Statistical Data Analysis and Study Limitations
THE DIFFERENCES IN THE LEVEL OF HIV AND AIDS CONTENT KNOWLEDGE FOR DENTAL PROFESSIONALS:
Infectious diseases, whether hepatitis, flu, herpes, HIV, AIDS, impetigo, encephalitis, measles, Rocky Mountain Fever, or a host of others have plagued mankind for centuries. Without doubt new infectious diseases will appear in the world's population for centuries to come. However, no disease has been more detrimental to populations all over the world that than of HIV and AIDS. Although this paper is not intended to moralize, theorize, pontificate, or set moral standards on the HIV and AIDS issue it is extremely important to know that the epidemic affects citizenry all over the globe. As such all individuals alike, wherein no known cure is available, must take precautionary measures to limit exposure and infection. To these ends professions that are directly involved in treating HIV infected or AIDS patients must be ever vigilant when treating those afflicted. At the same time the helping professions must not refuse treatment because of fear, lack of epidemiological knowledge, or stigmatic impressions. The remainder of this paper will concentrate on one helping profession, i.e., dentistry, with respect to dental service and HIV infection and control. The intended purpose of the paper is to set into motion, by way of a research proposal, a study to determine whether or not the dental profession is effectively delivering dental services to vaccinated people infected with the HIV virus.
History of HIV in the U.S. And HIV Defined. Before any attempt is made to present a historical accounting of HIV and AIDS there must first exist a clear understanding as to what is HIV and what is AIDS. Broadly defined HIV is the virus and AIDS is the resulting disease (Stebbing, Gazzard & Douek, 2004). As such HIV destroys the human body's immune system and develops into AIDS, thus making the body susceptible to other diseases. What must be kept at the forefront discussion is that all people who are HIV positive do not necessarily have the AIDS disease. This is important to remember as the general public consensus is that HIV and AIDS are one in the same thing.
The first AIDS cases were reported in 1981 through 1996 more than 510,000 AIDS cases and more than 315,000 deaths have been reported in the United States alone (Holmberg, 1996). This is only the beginning of the HIV infection as it is estimated that nearly 1 million Americans have been infected with the virus through the mid-1990s but had not yet developed clinical symptoms (UN, 1998). No cure or vaccine has been invented to cure AIDS and many of those infected with HIV may not even be aware that they carry and can spread the virus. Scientists and doctors are constantly being challenged, as the HIV virus and AIDS disease are one of the most intense public-health problems in the world today.
The reported total number of aids cases in the United States is increasing explosively. What is more, public health experts believe that the actual cases of aids are only a small fraction of the total problem, and that is the part that is visible. Not so obvious but just as real are the much larger numbers of people who are infected with aids but have not yet developed any symptoms. Some of these individuals may never realize they have been infected. Many, however, will be the new aids cases in the years to come and all of those infected, even if they do not have any symptoms, can spread the disease to others. In fact we might well be on the verge of a new plague rivaling the influenza epidemic that swept throughout the world at the end of World War 1, or the dreaded Black Plague of the Middle Ages.
A third frightening factor about aids is its deadliness. Over 60% of those in whom aids was diagnosed have died; the majority die within two years of diagnosis. Though it can kill quickly, this new disease can also produce great suffering. Disfiguring sores, pneumonia that leave the patient gasping for breath, an endless series of infections that can strike almost any organ or system of the body, and, even progressive blindness. Any or all of these may accompany the development of aids (Lerman-Golomb, 1995).
When aids first appeared on the United States, it seemed to be confined to only a few small groups of the population, contracting in a few large cities. Since then, it has spread to every state of the union penetrating in cities, towns, and rural areas. Aids and HIV have been reported in virtually every country in the world; the World Health Organization (WHO) estimates between five and ten million are already infected. Aids strikes men, women, and children and has no race barrier. No longer confined to the original narrow "risks groups," among these homosexual men, people having multiple sex partners and intravenous drug users, it has gradually found a way of spreading into every level of society and striking people from groups that were once believed to be "safe."
The medical epidemic of aids has given rise to another epidemic, the epidemic of fear. In some cities, parents are fearful that their children may catch aids form classmates and some have boycotted the school, keeping the children at home. People have abandoned dear friends and loved ones suffering from the disease for fear of getting it themselves (Myer & Sussser, 2003). In addition, many of the helping professions silently refuse treatment of HIV infected or AIDS' patients for fear of contacting the virus or disease.
The work of medical researchers has been an encouraging chapter in the ongoing stories of aids and HIV. Considering the disease was recognized only a few years ago and that its agent, HIV, is one of the most complex and baffling organisms on earth, the achievement is an astonishing" (Silverstein, 1999). In a brief span of time, researcher have found the cause of the disease and learned much about it and the ways it is passed from one person to another. They have found many effective treatments for many of the infections that accompany aids and drugs that can also slow the process of the disease and enable people with it to live longer and feel better. Medical researchers are how searching for more effective means of treating aids and working on vaccines, to prevent it (Lerman-Golomb, 1995).
Because there is no effective vaccine or therapy, education and risk reduction are the best ways by which to combat the epidemic. Avoiding behaviors that place people at risk could practically stop the further spread of AIDS. This can be achieved through education and the involvement of local community groups, statewide organizations, and national governments. The focus of the intended research, therefore, will be on the educational variable with respect to the dentistry profession.
Research Question and Hypothesis
Of the nearly 168,000 dentists and 112,000 dental hygienists practicing in America today all are subject to the HIV virus by the very nature of their work. On a day-to-day basis both dentists and hygienists are confronted with an array of potential HIV transmitting vehicles, whether needle pricks, bites, aerosol and splatters, and other patient materials (Kohn, et al., 2003). As such dentists and their staff must be ever vigilant with respect to the manner in which they service their patients. Attempting to control the possibility of spreading the HIV virus all dental practices must formulate a safety procedure that is preemptive of disease infiltration. To this end Pascoe, McDowell & Springer, (2002) advocate that the first step in dealing with AIDS in a dental office is to recognize the symptoms and/or manifestations through a patient's history and their observable physical conditions followed by various precautionary examination and treatment steps. However, no matter the seriousness of any infectious disease the issue of whether or not dental professionals followed needed protocol is of importance as well. According McCarthy, Koval, John, & MacDonald (1999) the majority of dentists and hygienist do but the need still exist for mandatory continuing education to apprise dental professionals of new developments.
With respect to preventative measures in a dental practice the ADA makes the following practice components for dealing with HIV situations:
1. Use of personal protection gear.
2. Instrument sterilization.
3. Disinfecting of all surfaces and equipment.
4. X-ray asepsis.
5. Dental laboratory asepsis.
Not only should dental offices be vigilant and cautious when treating HIV patients but the patient has a responsibility as well. Although dentists are the first to notice the clinical changes that signal the onset of the HIV virus makes them pivotal to helping HIV individuals maintain maximum health in the arena of diversity. Unfortunately all too frequently the relationship between patient and dentist is adversarial. Patients, usually out of fear hide their medical status…