Topic 2: Epidemiology and Communicable Diseases

Communicable diseases, including tuberculosis, HIV/AIDS, and influenza, have a considerable effect on the global population. Factors such as globalization significantly impact the spread and severity of communicable diseases. For example, the constant changes in the status of human interactions affect the spread of infectious diseases globally. Nurses and other healthcare providers have the essential role of minimizing the spread and impact of communicable diseases in their populations. They utilize primary, secondary, and tertiary health promotion methods to empower the affected and those at risk to transform their lifestyles and behaviors. They also select best practice interventions that optimize care outcomes, including safety, quality, and efficiency. Therefore, this research paper explores the epidemiology of HIV/AIDS.

Description of the Communicable Disease

HIV/AIDS is the chosen communicable disease. HIV/AIDS is a viral infection attributed to the human immunodeficiency virus. It attacks the immune system of the body. Lack of treatment leads to viral progression to acquired immunodeficiency syndrome (AIDS). People affected by HIV/AIDS experience various symptoms during its symptomatic phase. They include fever, chills, night sweats, rash, muscle aches, swollen lymph nodes, fatigue, sore throat, oral ulcers, and diarrhea that last for a week (Dumais, 2017). Patients also report rapid weight loss, pneumonia, skin blotches, and neurological disorders, including depression and memory loss.

The main transmission mode of HIV/AIDS is through contact with infected fluids, including semen, breast milk, blood, or vaginal secretions. Direct transmission also occurs during the utero life, where the mother transmits the virus to the fetus during pregnancy and delivery. Behaviors such as having multiple sexual partners, injectable drugs, unprotected sex, and a history of sexually transmitted diseases predispose to HIV/AIDS. HIV/AIDS is associated with several complications. They include tuberculosis, cytomegalovirus, toxoplasmosis, cryptococcal meningitis, candidiasis, and pneumocystis pneumonia. Patients are also increasingly predisposed to non-AIDS-related cancers, liver disease, frailty, renal disease, and diabetes (Capriotti, 2018; Dumais, 2017). HIV/AIDS does not have a cure. However, patients are treated with antiretroviral medications that suppress the viral load in the body. Symptomatic treatments for conditions such as oral candidiasis, meningitis, and pneumonia are also used to prevent further immune suppression.

The existing statistics show HIV/AIDS as a national and global health concern. Statistics show that 34800 new HIV/AIDS cases were reportedin 2019. It represented a decline of 8% in the incidence rate. The rate of infections was highest among people aged 45-54 years, followed by those aged 35-44 years. Overall, about 1.2 million people in the USA  have HIV/AIDS, with 13% not knowing their status. The minority groups, including bisexual, gay, and other men that have sex with men, lead in the populations affected by HIV/AIDS in the USA (HIV.GOV, 2021). HIV/AIDS is a reportable disease. Healthcare institutions report diagnosed cases of HIV/AIDS to the CDC’s National HIV Surveillance System and the respective departments of health in different states. The cases are reportedafter they are diagnosed.

Social Determinants of Health

Social determinants of health refer to modifiable factors that contribute to health inequalities. Factors evident in places where people are born, live, work, and thrive act as social determinants of their health. HIV/AIDS is associated with several determinants of health. One of them is ethnicity (Hogan et al., 2021). HIV/AIDS is high in ethnic minorities, including African Americans. Socioeconomic status or poverty is also another social determinant of health. Accordingly, the rate of HIV/AIDS is high among individuals from socio-economically deprived families. Factors such as engagement in risky sexual activities predispose them to sexually transmitted infections, including HIV/AIDS.

Employment status is also another social determinant of health in HIV/AIDS. Employment status influences an individual’s socioeconomic status, access, and care affordability. The rate of HIV/AIDS tends to be higher among unemployed individuals than employed due to their increased predisposition to risky behaviors, including drug abuse and prostitution. The level of education is also a critical social determinant of health in HIV/AIDS. High rates of HIV/AIDS have been reported in populations with a low level of education (Friedman et al., 2018). Level of education influences constructs such as level of awareness, employment, and socioeconomic status of the population. Access to care also acts as a source of inequality in individuals affected by HIV/AIDS. Populations with limited access to healthcare due to lack of medical insurance coverage and unaffordability of care are likely to report high cases of HIV/AIDS. Factors such as delays in early diagnosis and initiation of treatment contribute to poor outcomes in HIV/AIDS management. Low access to healthcare services also affects the knowledge of the population about the prevention of the spread of HIV/AIDS (Santos et al., 2018). Therefore, it is important that interventions that address the social determinants of health in HIV/AIDS be implemented to promote the population’s health.

Epidemiological Triangle

An epidemiological triangle is a tool used to develop a deeper understanding of the mechanism of an infectious disease in the population. It provides insights into the relationships between agent, host, and environment in infectious disease. The agent refers to the microorganism causing the disease. Concerning HIV/AIDS, the agent causing the infection is a virus. The commonest type of virus causing HIV/AIDS is HIV-1 (Gopalappa et al., 2017). HIV-2 is less common with low virulence and similar symptoms to HIV-1. Factors related to HIV influence its ability to cause infection to the host. They include virulence or pathogenicity and dose. Virulence is the ability of a disease-causing microorganism to cause disease. HIV has a high level of virulence, as it can invade and multiply itself in the host. The dose refers to the amount or concentration of a disease-causing microorganism (Gopalappa et al., 2017). Often, HIV exists in high doses with an enhanced ability to invade and multiply in the host. HIV spreads through hosts’ direct contact with infected fluids, including semen, vaginal secretions, and blood.

Host in the epidemiological triangle refers to the carrier of the disease. It refers to the individuals affected by HIV/AIDS. Several host factors influence their ability to be affected by HIV and the development of AIDs. One of them is immune status. The risk for HIV infection is high in individuals with lowered immunity. The rate of viral invasion, multiplication, and further suppression is high. The other host-related factor is individual behaviors. Behaviors such as engaging in unprotected sex, having multiple sexual partners, and using injected drugs with sharing needles increase the risk of host exposure to the agent (Mahdavi et al., 2021). Pregnancy is also another host-related factor for HIV/AIDS. Pregnant mothers infected with HIV/AIDS have an increased risk of infecting their unborn babies through mother-to-child transmission or during delivery and breastfeeding. Individuals suffering from existing medical conditions are also increasingly predisposed to HIV/AIDS. Co-existing comorbidities low immune status of the patients, hence, their vulnerability to the agent. Patients on existing treatments for malignancies also have a high risk of HIV infection due to their suppressed immunity (Joas et al., 2018). Patients receiving blood transfusions or involved in road accidents are also at risk due to contact with contaminated fluids.

Environment refers to the external factors that affect the epidemiologic outbreak. Environmental factors affect the spread of the disease,not attributed to the host and agent. The environmental factors in HIV/AIDS include communities with a high rate of sexually transmitted diseases and a low level of reporting (Dumais, 2017). Such conditions contribute to the flourishing of HIV/AIDS. Socioeconomic factors such as poverty also contribute to the spread of HIV/AIDS by limiting access to the needed treatment. Social discrimination or isolation of individuals affected by HIV/AIDS also discourages the populations from utilizing screening and treatment services (Dumais, 2017). Consequently, they contribute to the increased spread of the disease in the population.

Role of the Community Health Nurse

Community health nurses have several roles in the epidemiological management and prevention of HIV/AIDS. One of the roles is case finding. Case finding entails the identification of cases affected by HIV/AIDS and the populations at risk. The community health nurse screens the population to identify the cases. She also determines the vulnerable populations, including sex workers, transgender persons, substance and drug abusers, and individuals with multiple sex partners and engaging in unprotected sex (Mottiar& Lodge, 2018). The nurse educates the vulnerable population about the preventive measures against HIV/AIDs and the importance of screening and early treatment for the identified cases.

The community health nurse also reports identified cases to the respective authorities. Reporting is important to determine HIV/ the prevalence, incidence, and severity of HIV/AIDS in specific populations. The data aids in distributing resources for HIV/AIDS to the population. The nurse also collects data related to HIV/AIDS in the population (Knettel et al., 2021). The data provide insights into the severity, spread, and patterns of the disease in the population. The nurse analyzes the collected data to provide an accurate picture of the population’s disease pattern, spread, and burden. The nurse also disseminates the analyzed data to the population, healthcare providers, and public health officials to stimulate action. Dissemination approaches, including community presentations, journal publications, conference presentations, and new policies based on the outcomes, are effective. The community health nurse also undertakes follow-up of cases. Follow-up aims to ensure adherence to treatment by the infected and determine other needs that may affect the treatment outcomes (Knettel et al., 2021). Therefore, community health nurses play crucial roles in the epidemiological management of HIV/AIDS.

National Agency

UNAIDS is a national agency that addresses HIV/AIDS in the USA and other global states. UNAIDS is a global effort initiated to drive efforts to end HIV/AIDS by 2030 as part of the global Sustainable Development Goals. The agency prides itself in inspiring regional, global, national, and local leadership in addressing HIV/AIDS (UNAIDS,2021). The agency acts as a global problem solver by incorporating the populations affected by HIV/AIDS in decision-making. It also delivers and monitors the response initiatives against HIV/AIDS. The agency collaborates with countries and communities to develop appropriate interventions to ending HIV/AIDS and advocate the adoption of measures to address policy and legal barriers to HIV/AIDS response. UNAIDS benefit patients affected by HIV/AIDS in several ways. First, it advocates for access to treatment and preventive services by the affected populations and those at risk (UNAIDS,2021). An example is seen from expanding the access to antiretroviral drugs for HIV/AIDs patients. UNAIDS also advocates the rights of HIV patients. It ensures the prioritization of their needs in policy planning and implementation. It also supports programs to enhance the quality of life of HIV patients, including education, gender-based, and social protection of their rights.

Global Implication

HIV/AIDS has adverse global implications. Statistics show that HIV/AIDS affects about 38 million people globally. It acts as a source of disease burden since most of the affected globally do not access preventive and treatment services. HIV/AIDS affects the quality of life of the affected patients and their significant others. Patients require frequent hospitalizations for opportunistic infections, which can take a toll on them and their significant others (Navon, 2018). The need for frequent hospital visits and hospitalizations also result in declining productivity among the patients and their families.

HIV/AIDS also has huge financial implications for the global states. For example, the USA spent more than $34.8 billion in 2019 treating and combating HIV/AIDS (KFF, 2021). According to Dieleman et al. (2018), there was an increase in the annualized rate of healthcare spending per capita due to HIV/AIDS from 1995 to 2015. The largest growth was reported in upper-middle-income countries and low-middle-income countries. The increase led to $9.1 trillion spent on healthcare globally in treating and combating HIV/AIDS.

HIV/AIDS also contributes to a high percentage of mortalities globally. For example, the UNAIDS report that 47.8 million have died due to HIV/AIDS-related illnesses since its start as a global epidemic. In addition, 680000 people died due to HIV-related illnesses in 2020(UNAIDS, n.d.-a). UNICEF (2021) reports that about 330 children globally died due to HIV/AIDS-related illnesses daily in 2020. Factors such as inadequate access to HIV treatment and prevention contributed to most children’s mortalities.

Countries have adopted several interventions to address HIV/AIDS. One of the interventions adopted in most countries is increasing access to treatment by ensuring free antiretroviral drugs. Access to treatment prolongs the life of the affected and improves their overall quality of life (Chenneville et al., 2020; Mandsager et al., 2018). Screening services for HIV/AIDS are also free. The population can access free HIV testing and health educational services. The population also receives support in nutritional aid to address nutrition-related deficiencies.

Conclusion

HIV/AIDS is an epidemic with a high disease burden globally. Epidemiological analysis shows the presence of the host, agent, and environmental factors that influence its spread globally. The community health nurse plays several roles in addressing HIV/AIDS. The roles include case finding, data collection, analysis, dissemination, and follow-up of patients. HIV/AIDS has several complications, which increase the need for timely treatment of identified cases. Vulnerable populations should be prioritized in policy decision-making to minimize the spread and impact of the disease in them. Agencies such as UNAIDS play vital roles in addressing HIV/AIDS. Countries should collaborate in implementing interventions that reduce the incidence and prevalence rate of HIV/AIDS to promote the health of the public.

References

Capriotti, T. (2018).HIV/AIDS: An Update for Home Healthcare Clinicians.Home Healthcare Now, 36(6), 348–355. https://doi.org/10.1097/NHH.0000000000000706

Chenneville, T., Gabbidon, K., Hanson, P., & Holyfield, C. (2020).The Impact of COVID-19 on HIV Treatment and Research: A Call to Action.International Journal of Environmental Research and Public Health, 17(12), 4548. https://doi.org/10.3390/ijerph17124548

Dieleman, J. L., Haakenstad, A., Micah, A., Moses, M., Abbafati, C., Acharya, P., Adhikari, T. B., Adou, A. K., Kiadaliri, A. A., Alam, K., Alizadeh-Navaei, R., Alkerwi, A., Ammar, W., Antonio, C. A. T., Aremu, O., Asgedom, S. W., Atey, T. M., Avila-Burgos, L., Awasthi, A., … Murray, C. J. L. (2018). Spending on health and HIV/AIDS: Domestic health spending and development assistance in 188 countries, 1995–2015.The Lancet, 391(10132), 1799–1829. https://doi.org/10.1016/S0140-6736(18)30698-6

Dumais, N. (2017). HIV/AIDS: Contemporary Challenges.BoD – Books on Demand.

Friedman, E. E., Dean, H. D., &Duffus, W. A. (2018). Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Reports, 133(4), 392–412. https://doi.org/10.1177/0033354918774788

Gopalappa, C., Farnham, P. G., Chen, Y.-H., &Sansom, S. L. (2017).Progression and Transmission of HIV/AIDS (PATH 2.0): A New, Agent-Based Model to Estimate HIV Transmissions in the United States.Medical Decision Making, 37(2), 224–233. https://doi.org/10.1177/0272989X16668509

HIV.GOV. (2021, June 2). U.S. Statistics. HIV.Gov. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

Hogan, J. W., Galai, N., & Davis, W. W. (2021).Modeling the Impact of Social Determinants of Health on HIV.AIDS and Behavior, 25(2), 215–224. https://doi.org/10.1007/s10461-021-03399-2

Joas, S., Parrish, E. H., Gnanadurai, C. W., Lump, E., Stürzel, C. M., Parrish, N. F., Learn, G. H., Sauermann, U., Neumann, B., Rensing, K. M., Fuchs, D., Billingsley, J. M., Bosinger, S. E., Silvestri, G., Apetrei, C., Huot, N., Garcia-Tellez, T., Müller-Trutwin, M., Hotter, D., … Kirchhoff, F. (2018). Species-specific host factors rather than virus-intrinsic virulence determine primate lentiviral pathogenicity. Nature Communications, 9(1), 1371. https://doi.org/10.1038/s41467-018-03762-3

KFF. (2021). U.S. Federal Funding for HIV/AIDS: Trends Over Time. 6.

Knettel, B. A., Fernandez, K. M., Wanda, L., Amiri, I., Cassiello-Robbins, C., Watt, M. H., Mmbaga, B. T., &Relf, M. V. (2021). The Role of Community Health Workers in HIV Care Engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania.Journal of the Association of Nurses in AIDS Care, 32(6), 682–692. https://doi.org/10.1097/JNC.0000000000000267

Mahdavi, F., Shams, M., Sadrebazzaz, A., Shamsi, L., Omidian, M., Asghari, A., Hassanipour, S., &Salemi, A. M. (2021). Global prevalence and associated risk factors of diarrheagenic Giardia duodenalis in HIV/AIDS patients: A systematic review and meta-analysis.Microbial Pathogenesis, 160, 105202. https://doi.org/10.1016/j.micpath.2021.105202

Mandsager, P., Marier, A., Cohen, S., Fanning, M., Hauck, H., & Cheever, L. W. (2018).Reducing HIV-Related Health Disparities in the Health Resources and Services

Topic 2: Epidemiology and Communicable Diseases Objectives:

1. Apply the principles of epidemiology to community health nursing.
2. Explain the value of demographic data in community health.
3. Apply the epidemiology triangle to a communicable disease occurring at a global level.
4. Evaluate the communicable disease chain model.
5. Discuss the impact of global health issues on public health systems.
6. Explain how social determinants of health contribute to the development of disease.

Topic 2 DQ 1- Topic 2: Epidemiology and Communicable Diseases

What are social determinants of health?  Explain how social determinants of health contribute to the development of disease.  Describe the fundamental idea that the communicable disease chain model is designed to represent. Give an example of the steps a nurse can take to break the link within the communicable disease chain.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

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Topic 2 DQ 2- Topic 2: Epidemiology and Communicable Diseases

Select a global health issue affecting the international health community. Briefly describe the global health issue and its impact on the larger public health care systems (i.e., continents, regions, countries, states, and health departments). Discuss how health care delivery systems work collaboratively to address global health concerns and some of the stakeholders that work on these issues.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

Epidemiology Paper- Topic 2: Epidemiology and Communicable Diseases

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza

Epidemiology Paper Requirements

1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.