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PUBH6304 Global Health Persp Cmmty and Pub Service

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Questions:

For this assessment, develop an APA-formatted research review article that covers one global health topic of your choice. In this assessment:


  • Identify your topic. Provide background information and statistics on the topic, including the global areas most affected by the topic and the types of health care issues most often associated with the topic.
  • Describe the factors that impact health and health care delivery in the global areas most affected by the topic you selected. These factors may include not only culture and tradition, but also politics, economics, and social attitude.
  • Explain the influence of altruistic organizations (Peace Corps, Project Hope, religious and non-religious missions, and so on) on health and health care practices in the global area specifically associated with the topic.
  • Describe the interventions implemented to address the health care issues associated with the topic. Include both conventional and unconventional interventions.
  • Explain how the health care decisions and practices at the local level (the area most impacted by the topic) relate to health and health care delivery in other global areas. This is not limited only to best practices, but could include poor health care decisions and practices.
  • Identify evidence-based interventions that are effective, efficient, cost-effective, and equitable for promoting wellness and disease prevention in the specific area and population.

Answers:

Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) is the spectrum of medical conditions caused due to human immunodeficiency virus (HIV) following which the patient suffers from a series medical complications due to suppression of the immune system of the body. With the progression of the disease, the patient is likely to suffer from a wide range of infections like tuberculosis and other opportunistic infections. These symptoms arising late in due course are known as AIDS. HIV is spread mainly through unprotected sexual intercourse, contaminated hypodermic needles, blood transfusion, from mother to child or breastfeeding. The disease is a major public health issue as the mortality rate due to AIDS is high, the reason being no proper treatment for the disease. The disease has no vaccine or cure. However, antiviral treatment may slow down the course of the disease (Liamputtong, 2015).

In the year 2015 around 36.7 million people had been reported to be suffering from HIV, and the resulting deaths were around 1.1 million. Most of the individuals who are affected by this disease are from the sub-Saharan Africa. The reason for this is that there is lack of health care resources for the individuals. Moreover, the population in this region suffers from lack of nutrition. Education level is also low for most of the population. A large section of the population are not aware of the preventive measures of the disease. For example, according to UNESCO's Regional overview on sub-Saharan Africa, in the year 2000, 52% of children were enrolled in primary schools, the lowest enrollment rate of any region. AIDS was first recognised by the Centre for Disease Control and Prevention (CDC), United States, in the year 1981. Between the time of its discovery and 2014, it is estimated that AIDS has resulted in around 39 million deaths worldwide. In 2015, around 40,000 people were diagnosed with HIV infection in the United States. Gay and bisexual men were the population to be most affected by the disease in the year 2015 (avert.org, 2016). USA has approximately 1.2 million HIV-infected individuals at present. The epidemic’s size may be small in comparison to the total population of the country. However, it is heavily concentrated among many prime affected populations. Till date, around 675,000 deaths have been reported in the US due to AIDS related illness (cdc.gov, 2016). As opined by Liamputtong (2015), HIV/AIDS has a major impact on the society, as a source of discrimination and as an illness. The economic impact of the disease is high, and the disease is a subject to many controversies involving religious views. It has drawn the attention on social workers and medical researchers alike who work towards lowering the social and health burden of the disease.

According to Mondol and Shitan (2013) the prevalence of HIV/AIDS is known to be a faltering stone in the prosperity of human culture. The global HIV prevalence is significantly correlated with a number of social factors like density of physicians, the rate of contraceptive prevalence, adolescents, the proportion of certain religions, schooling and education levels. Edwards and Collins (2014) stated that from a global point of view, black women are more at risk of getting HIV infections  partially due to social determinants faced within their cultures that act as barriers. The social determinants that affect the vulnerability of women include the major disadvantages arising due to race, gender, geographic locations, economics and ethnicity. Moreover, the barriers often are found to be overlapping for providing unique results that hold the potential to have a major impact in sexual and general behaviours and decision making attitude. Social science researches have highlighted that behavioural changes have weakened the attempts to keep the infection at bay and that individual behaviours towards high risk of infection are due to complex cultural and social contexts. Cognitive processes and rational factors that change the decision-making patterns of the individuals include cultural beliefs, emotions and peer pressure that put the communities at high risk.

The healthcare delivery for HIV/AIDS is a topic of debate as a number of barriers hinder the progression of the adequate care services among the areas that are badly affected by the disease. A number of health care organisations have a frontline role in the prevention activities and intervention activities against HIV. However, these organisations are faced with formidable challenges in the way of effective delivery of services that include lack of sufficient funding, client characteristics, limited resources and insufficient healthcare workers. Though some organisations hold a well position to cater to the needs of the patients, an area in which the others lag is the proper communication with the values and beliefs of the communities they serve. Sociocultural, individual, organisational and structural patient factors form to be barriers in the path of delivery of care and prevention services. The challenges need immediate technical assistance (Benton, 2015).

Morgan et al., (2013) brought into focus the role of faith-based organsiations or altruistic organisations in providing mitigation services and prevention services for HIV. Altruism refers to the set of motivations, values and practices undertaken regarding the sexual behaviour of an individual arising out of concerns for others. This includes protection of one’s partners from the infection and showing concern for the family, friends and community. As per the authors, such organsiations apply social theories for bringing changes in the individual’s behaviours. Though the tradition of such practices of altruistic organisations goes long back in time, the overall responses have been highly controversial. This is mostly in relation to the prevention and rejection of the use of condoms that conflict with the national HIV/AIDS responses. One organisation that has been making a mark on global circuit for working for HIV/AIDS prevention is Peace Corps. Peace Corps volunteers are present in around 140 countries, and for the last five decades, they have been demonstrating creativity and ingenuity to address major health concerns, including HIV/AIDS. The organisation has become a significant contributor to the response to HIV. Volunteers work across 9,000 communities and till 2011 have worked with 1.3 million HIV-infected individuals. The organisation works to have an AIDS free generation by combining global efforts. They partner with countries for a joint venture. They are responsible for managing and implementing responses. They work with bilateral and multilateral partners for increasing mobilisation. The organisation celecbrates World AIDS Day to spread awareness and education. In the year 2011, the Peace Corps was responsible for utilising funds from the President’s Emergency Plan for AIDS Relief (PEPFAR) to extend the impact of its work in HIV in 47 countries. Peace Corps posts in these countries use appropriate resources for enhancing their HIV/AIDS programming.  Another important organisation is the Project HOPE (HIV/AIDS Outreach Prevention Education) the aims to improve the lives of individuals living with HIV and those who are at risk. The services provided include prevention education, medical case management and diagnostics (Abara et al., 2015).

Organisations across the globe have implemented a number of interventional strategies that aim to halt the fast transmission of HIV. These interventions are implemented either to protect the individuals and the communities or are made as public health policies. Initially, the preventive programs had the primary focus on prevention of sexual transmission through behavioural changes. However, with a rich pool of evidence indicating that there is a need to consider economic, political and socio-cultural factors, interventional strategies now focus on a combination of structural interventions, biomedical interventions and behavioural interventions. Such combinational prevention strategies advocate for a holistic approach in which the needs of the communities and individuals are addressed (Magidson et al., 2017).

Cross and Whiteside (2016) state that the health care practices regarding HIV/AIDS in the sub-Saharan areas, mainly Africa, where the incidences of HIV/AIDS is high, have differences with those of other areas of the world. Both Africa and other countries like the US have generated policies for improving the quality of life and have handled the crisis in a nearly similar manner. However, the development and advanced resources available in other countries have left countries of Africa behind them in the walk towards better prevention of HIV. If the countries of the sub-Saharan area had the same level of resources, treatment of HIV would have been a better process.

Watkins-Hayes (2014) outlines some best evidence that are cost-effective, equitable and promises to be effective against HIV. The priority intervention is enabling the individuals know their HIV status. This can be achieved through client-initiated counselling and HIV testing, partner and family counselling, children and infant counselling, blood donor counselling and testing and adequate laboratory services. Maximising the contribution of the health sector towards prevention of HIV would be another significant strategy. Promotion of condom use and education on family planning and contraceptive would be the key points to cover. Nutritional support for those in need would be another very beneficial step towards decelerating the spread of HIV. This can be provided with regular assessments of nutritional status and diet and simultaneous education on these aspects. It is to be mentioned that suitable interventions can only be possible when adequate research is conducted to understand the association between health and socio-economic parameters and HIV status.

Coming to the end of the article we see that the prevalence of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) across the globe has become a barriers in progress of human civilisation. The disease is a big concern and a burning health issue worldwide. The high prevalence of the condition across the world indicates that there is a need of adequate address of the issue. International organisations must increase the number of care workers in the countries affected most by the disease and support through training and education for reducing the impact of HIV/AIDS.

References

Abara, W., Coleman, J. D., Fairchild, A., Gaddist, B., & White, J. (2015). A faith-based community partnership to address HIV/AIDS in the southern United States: Implementation, challenges, and lessons learned. Journal of religion and health, 54(1), 122-133.

Benton, A. (2015). HIV exceptionalism. University of Minnesota Press.

Cross, S., & Whiteside, A. (Eds.). (2016). Facing Up to AIDS: The socio-economic impact in southern Africa. Springer.

Edwards, A. E., & Collins Jr, C. B. (2014). Exploring the influence of social determinants on HIV risk behaviors and the potential application of structural interventions to prevent HIV in women. Journal of health disparities research and practice, 7(SI2), 141.

HIV and AIDS in the United States of America (USA) | AVERT. (2016). Avert.org. Retrieved 26 February 2017, from https://www.avert.org/professionals/hiv-around-world/western-central-europe-north-america/usa

HIV in the United States | Statistics Overview | Statistics Center | HIV/AIDS | CDC. (2016). Cdc.gov. Retrieved 26 February 2017, from https://www.cdc.gov/hiv/statistics/overview/ataglance.html

Liamputtong, P. (2015). Stigma, Discrimination and Living with HIV/AIDS. Springer.

Magidson, J. F., Gouse, H., Psaros, C., Remmert, J. E., O’Cleirigh, C., & Safren, S. A. (2017). Task Shifting and Delivery of Behavioral Medicine Interventions in Resource-Poor Global Settings: HIV/AIDS Treatment in sub-Saharan Africa. In The Massachusetts General Hospital Handbook of Behavioral Medicine (pp. 297-320). Springer International Publishing.

Mondal, M. N. I., & Shitan, M. (2013). Factors affecting the HIV/AIDS epidemic: an ecological analysis of global data. African health sciences, 13(2), 301-310.

Morgan, R., Green, A., & Boesten, J. (2013). Aligning faith-based and national HIV/AIDS prevention responses? Factors influencing the HIV/AIDS prevention policy process and response of faith-based NGOs in Tanzania. Health policy and planning, czt018.

Watkins-Hayes, C. (2014). Intersectionality and the sociology of HIV/AIDS: Past, present, and future research directions. Annual Review of Sociology, 40, 431-457.

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