The World Health Organization has defined acquired immunodeficiency syndrome (AIDS) as “the most advanced stage of human immunodeficiency virus (HIV) infection”, and it can take anywhere from ten to fifteen years for an HIV-infected person to develop AIDS (WHO, 2014). There are antiretroviral drugs that can aid in slowing down the process, these treatments also come with many side effects and complications. HIV can be characterized as a “retrovirus that infects the cells of the immune system, destroying or impairing their function”.
The immune system becomes weakened and unable to protect itself as it normally would, and thus causes the person or its “host” to be more susceptible to other infections. One of the probable modes of transmitting HIV is through unprotected sexual contact with an infected person either vaginally or anally. HIV can also be transmitted by contact with infected blood from either transfusion, contaminated needles or directly from mother to infant, during pregnancy, childbirth or breastfeeding (WHO, 2014).
AIDS was identified as a new disease in the United States when providers began to notice a rise in cases of pneumocystis carinii pneumonia (PCP) and Kaposi’s sarcoma (KP) in young gay males who were not immunosuppressed. The first medical report that alerted the world was in June of 1981, which described five gay gentleman with PCP living in Los Angeles with a few weeks later a report of twenty-six homosexuals both living in New York and San Francisco who had KP and PCP (Osmond, 2003).
These individuals all shared a common immunodeficiency which also showed a depletion of CD4-positive, or T-helper, lymphocytes. For a short time frame the disease was even referred to as gay-related immunodeficiency syndrome (GRIDS) but by September of 1982 the Center for Disease Control (CDC) published and clarified it as acquired immune deficiency syndrome (Osmond, 2003). The CDC also reported 34 cases of KP as well as other opportunistic infections in non-homosexual Haitian’s throughout the United State (Osmond, 2003).
The distinction of homosexual men and intravenous drug users in the earliest cases of AIDS led researchers to discover that it was blood borne as well as transmitted with sexual contact. The etiology of AIDS in the early years led researchers to believe that patients were immunosuppressed because they had a history of high risk behavior such as drug use and multiple sexual partners.
AIDS was not recognized as a new disease until 1981, but medical research identified cases that fit the AIDS criteria preceding 1950 and 1960 (Osmond, 2003). Frozen tissue and serum samples from a teen who died of an aggressive KS, were HIV-antibody positive on Western blot and antigen positive on ELISA. The teen had not traveled outside the country so it was evident that there other cases of HIV in the United States as early as 1960.
Tracking the epidemic heavily relied on public health departments reports of AIDS diagnosis’s by all fifty states. Because of new multi-drug regimens in the 1990’s, there was a significant decline in the number of reported AIDS diagnoses. Although the multitude of cases that were first reported were primarily gay men, in recent years the epidemic has become increasingly of non-white populations including minority women, adolescents, and heterosexuals.
The CDC reported in 1993, that AIDS was the leading cause of death amongst twenty-five to forty-four year olds. Since the peak number of deaths in 1995, there has been a significant decline in AIDS mortality (Osmond, 2003). Because the immune system is so weakened, the following are the most common complications that individuals suffering with HIV/AIDS encounter as defined by the Mayo Clinic: -Pneumocystis Pneumonia 1 / 3 – Tuberculosis – Kaposi’s Sarcoma – Candidiasis – Cytomegalovirus -Toxoplasmosis The immune system is weak because HIV attacks and destroys CD4 cells, which are white blood cells that aid the body in fighting disease.
Individuals with HIV progress to AIDS when their CD4 count drops below two hundred, or they experience an AIDS related complication as defined above. The Mayo Clinic also referred to HIV/AIDS as incurable but with aggressive antiretroviral treatment people are now able to live with HIV and lead somewhat normal lives. One of the most common forms HIV is transmitted through is sexual contact. Unprotected vaginal, oral or anal sex, when semen, blood or vaginal secretions enter the body. The body can also have unseen mouth sores or tears in the rectum or vagina that are caused during sex in which the virus can enter (Mayo Clinic, 2014).
Another mode of transmission is through a contaminated blood transfusion. This risk has reduced because hospitals now have strict protocols when it comes to transfusing blood, the blood is also screened for HIV-antibody in blood banks. Intravenous drug users who share needles can come in contact with contaminated blood. These drug users also put themselves at high risk for other diseases such as hepatitis. Lastly, an HIV positive mother can transmit the virus to her unborn child during pregnancy and with breastfeeding.
With strict adherence to the antiretroviral treatment a pregnant woman can reduce the risk of transmitting the virus to her child. Despite the advances in treatment for HIV/AIDS, it continues to be a global health problem. Much success has been made in controlling new infections amongst high risk groups including men who have sex with men (Kirton, 2007). One of the contributing factors to this continuing epidemic is that amongst those individuals infected with HIV/AIDS, there is no regular engagement in treatment, prevention interventions or even seeking medical treatment.
Additionally, an estimated twenty-five percent of patients who are HIV-positive do not know and continue to spread the disease unintentionally (Kirton, 2007). Furthermore, those infected who live outside of the United States who have little to no access to healthcare are unable to be monitored and have the opportunity to receive AIDS treatment and antiretroviral drugs, whereas individuals in developed countries are able to get the treatment they need.
The role of the community health nurse is vital to those living with HIV/AIDS as well as those who are at risk for being infected. The Association of Nurses in AIDS Care (ANAC) is an organization that consists of HIV/AIDS nurses who are working together to make an effective change. Anne Sliney is one of the many influential nurses in this organization who is working to provide education to the nursing workforce in other countries specifically in caring for individuals with HIV/AIDS.
Training and education are one of the many ways that nurses are making a difference. Scientists including nurse scientists dedicate themselves to understanding the virus, how the drugs have an impact on the viral and cellular level, as well as how patients cope with suffering from this long term condition. Understanding these findings can help determine how nursing interventions will work with this patient population.
Nurses can teach their patients about the disease, its complications, medications as well as practicing safer sex. Nurses can also become AIDS certified (ACRN) and join thousands of experts in improving the quality of care for those living with HIV/AIDS. By implementing routine HIV testing in the healthcare setting, preparing for issues in HIV such as liver disease and elder care, and assisting HIV patients in routine treatment nurses can highly impact their communities and those who are infected (Kirton, 2007).
In conclusion, HIV/AIDS continues to be a worldwide health problem despite the latest in treatments, prevention education, and interventions. Those who are infected with HIV/AIDS can have a good quality of life when being monitored and treated with the appropriate medications. High risk individuals should be educated on safer sex practices, needle exchange programs and 2 / 3 treatment for pregnant women to prevent the spread to the child.
The following are links for more information on HIV/AIDS as well as support for those who are at risk or those infected: www. nsna. orgwww. aidshealth. orgwww. unicef. orgwww. aidsalliance. org.
Diseases and Conditions: HIV/AIDS. Retrieved on October 20, 2014 from www. mayoclinic. org/diseases. Kirton, C. (2007). Nurses at the Forefront of a Pandemic: HIV/AIDS Nurses. Retrieved on October 20, 2014 from www. nsna. org. Osmond, D. (2003). Epidemiology of HIV/AIDS in the United States. Retrieved on October 20, 2014 from hivinsite. ucsf. edu POWERED BY TCPDF (WWW. TCPDF. ORG).