Communicable Disease - HIV The early history of HIV was a story of misunderstanding, governmental neglect, suffering and death. However, through the efforts of medical professionals and activists, global and national understanding, funding, research and patient support have grown considerably in the decades since HIV was first identified. Despite the developments, HIV remains a significant health issue, currently affecting approximately 33.3 million people living with HIV worldwide and 1.1+ million people living with HIV in the United States. Consequently, federal, state and local programs are focused on decreasing and ultimately eliminating HIV/AIDS through education, testing, increased access to high quality medical care and preventive measures. In this context, a nurse's role in education and prevention stems from his/her core value of becoming a knowledgeable, effective advocate for the highest attainable quality of patient care. Nurses can support this core value by becoming educated about HIV-related issues, making his/her voice heard and forming an alliance with individual patients to educate, treat and enhancing preventive behaviors in patients. Clearly, the medical community, including but not limited to nurses, perform vital functions for the reduction and ultimate elimination of HIV/AIDS. Finally, numerous community programs, organizations and support groups exist, for example in San Francisco, to enhance the lives of people living with HIV/AIDS and their families. As research shows, the history of HIV/AIDS has developed from a story of undertreated devastation to a concerted and aggressive effort to contain, treat, prevent and ultimately eliminate HIV/AIDS.
Communicable Disease - HIV
Since its discovery as a wasting disease, "gay-related immune deficiency" and "slim" in the mid-1980's, HIV has posed a significant health problem for the United States and the World. Initially considered mysteriously devastating, HIV ultimately caused the deaths of hundreds of thousands, yet failed to attract sufficient funding and attention. Through the efforts of health professionals and activists, HIV was finally accorded the funding and attention it deserved. Today, HIV is addressed globally, federally and locally through multiple well-funded programs/groups and agencies.
History of HIV
According to the AIDS Healthcare Foundation, blood analysis showed that the HIV virus existed in humans as early as the 1940's and that HIV-1 -- the most common viral strain -- was transmitted from chimpanzees to humans at some point in the early to mid-20th Century (AIDS Healthcare Foundation, n.d.). In the early 1980's medical professionals noticed that a "wasting disease" was spreading in Uganda and that numbers of gay men in California and New York had rare types of cancer and pneumonia (AIDS Healthcare Foundation, n.d.). In 1984, HIV was identified as the cause of "gay-related immune deficiency" and/or "slim" (AIDS Healthcare Foundation, n.d.). By 1985, cases were reported worldwide (AIDS Healthcare Foundation, n.d.). HIV / AIDS was devastating both medically and socially, as early patients were discriminated against in housing and employment, and died with inadequate treatment (AIDS Healthcare Foundation, n.d.).
As recognition of HIV's seriousness and widespread devastation deepened, treatment progressed. The first needle exchange program was introduced in Amsterdam and the first blood test for HIV was approved in 1985 (AIDS Healthcare Foundation, n.d.). In 1986, AZT was successfully tested as a treatment and remained the only treatment for AIDS through most of the 1990s (AIDS Healthcare Foundation, n.d.). In 1996, medical "cocktails" including protease inhibitors were prescribed to control HIV, significantly improving the lifespan and life quality of HIV / AIDS patients. Since that time, antiretroviral therapy has continually advanced and health care professionals focused on expanding access to the included medications and on universal access to prevention through the use of condoms, testing and treatment (AIDS Healthcare Foundation, n.d.).
Global / National / State / County Statistics on HIV
Though worldwide efforts and progress are being made against HIV, the virus is still a significant health issue. Globally, approximately about 33.3 million people are now living with HIV (AIDS Healthcare Foundation, n.d.). As of the July 13, 2010 release of the National HIV / AIDS Strategy on July 13, 2010, more than 575,000 Americans died from AIDS, more than 56,000 people in the U.S. were infected with HIV yearly, and 1.1+ million people in America lived with HIV (U.S. Department of Health and Human Services, 2010). Perhaps the most accurate State and County statistics on HIV are collected by the San Francisco AIDS Foundation, which reports for the State of California: that almost 200,000 Californians have contracted HIV / AIDS and almost 90,000 have died since the early 1980's; approximately 109,000 Californians are HIV-positive, with 69,728 of that number living with AIDS; there are as many as 7,000 new HIV infections yearly in California (San Francisco Aids Foundation, 2012). The same organization reports for the County/City of San Francisco, from the beginning of the epidemic in the 1980's to December 31, 2010: 28,793 residents were diagnosed with AIDS; 19,341 died; 15,861 were living with HIV, of whom 9,452 were living with AIDS; there were 399 newly diagnosed HIV cases for 2010, down from 460 in 2009 and 492 in 2008 (San Francisco Aids Foundation, 2012).
Current Prevention Efforts
As stated above, professionals are currently focusing on universal access to prevention through the use of condoms, testing and treatment (AIDS Healthcare Foundation, n.d.). Prevention interventions in the form of testing and education are being used to identify, inform and change the behavior of people with HIV to reduce the risk of transmitting HIV to their sex/drug partners (U.S. Department of Health and Human Services, 2012). Health care professionals have also found that improving access to high quality health care for populations traditionally highly affected by HIV, including nonwhite and gay/bisexual men, educating/encouraging HIV patients to stay in treatment, and providing preventive measures to the partners of HIV patients are all fundamental preventive strategies (U.S. Department of Health and Human Services, 2012). Through education, testing, treatment access/continuation and preventive measures, the health care industry is directly confronting the significant crises posed by HIV / AIDS.
Future Goals for Prevention
The ultimate goal of health care professionals and agencies dealing with HIV is the prevention of HIV and related illness and death (U.S. Department of Health and Human Services, 2012). To that end, the National HIV / AIDS Strategy has established 3 primary goals: lowering the number of people becoming infected with HIV; raising health care access and enhancing treatment outcomes for HIV patients; lowering health disparities related to HIV (U.S. Department of Health and Human Services, 2012). Mirroring and aggressively enhancing measures currently used by health care professionals are believed to be the most effective goals/measures for prevention of HIV / AIDS.
Nurse's Role in Education and Prevention
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