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Scenario for Part 2 of Course Project Explore how determinants of health impact your identified global health issue. Instructions In essay format, do the following: (use these as headers and the answer below them to help clearly understand explanation Identify and describe the global health issue of HIV (One pg) Identify and discuss at least three determinants of health and how they impact the global health issue of HIV (0ne-two pg) Discuss at least three ways to address the determinants of health to positively impact the global health issue of HIV (1 pg) the essay should be Three-Four pg. APA for citations and references. Below is section one of the project to be used as a reference to go off of (Please do not use for the answer) The Human Immunodeficiency Virus (HIV) is a major global health issue that affects the lives of millions of people worldwide. HIV weakens people’s defense against many infections by attacking the immune system. As the virus destroys and compromises the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take many years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe long-term clinical manifestations. There is no cure for HIV infection. However, with increasing access to effective HIV prevention, diagnosis, treatment, and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives. The HIV rates of infections have been in existence since the pandemic started in the 1920s, and was discovered in the 1980s. It is believed that the HIV pandemic started in the Democratic Republic of Congo in Africa. The disease has led to many fatalities worldwide, and no cure has yet been found. However, treatments for the virus have been effective for the last decade (Boyd et al., 2020). HIV continues to be a major global public health issue, having claimed 36.3 million [27.2-47.8 million] lives so far. Population According to the WHO (2021), there are anywhere between 30.2-45.1 million people living with HIV at the end of 2020 throughout the world, and over two-thirds (25.4 million) of those infected are in the WHO African Region. In 2020, key populations (sex workers and their clients, gay men and other men who have sex with men, people who inject drugs, transgender people) and their sexual partners accounted for 65% of HIV infections globally: 93% of new HIV infections outside of sub-Saharan Africa. 39% of new HIV infections in sub-Saharan Africa. The risk of acquiring HIV is highest among people who inject drugs (35% more at risk), transgender women (34% more at risk), sex workers (36% more at risk), gay men, and other men who have sex with men (25% more at risk). Every week, around 5000 young women aged 15-24 years become infected with HIV. In sub-Saharan Africa, six in seven new HIV infections among adolescents aged 15-19 years are among girls. Young women aged 15-24 years are twice as likely to be living with HIV than men. As of 2019, 56% of people living with HIV in the US contracted it through male-to-male sexual transmission Around 4200 adolescent girls and young women aged 15-24 years became infected with HIV every week in 2020. More than one-third (35%) of women around the world have experienced physical and/or sexual violence by an intimate partner or sexual violence by a non-partner at some time in their lives. In some regions, women who have experienced physical or sexual intimate partner violence are 1.5 times more likely to acquire HIV than women who have not experienced such violence. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2020. People who belong to Low-income countries are affected by HIV the most. The eighth leading cause of death in low-come countries is HIV/AIDS, this is due in part to the lack of testing for the disease, treatments, and lack of access to healthcare. HIV is a disease that is embedded in social and economic inequity (Pellowski, Kalichman, Matthews, & Adler, 2013), as it affects those of lower socioeconomic status and impoverished neighborhoods at a disproportionately high rate. A lack of socioeconomic resources is linked to the practice of riskier health behaviors, which can lead to the contraction of HIV. These behaviors include substance use, which reduces the likelihood of using condoms The burden of HIV/AIDS has profound implications on many different sectors such as of global health, socioeconomic status, households, and the economy. The HIV epidemic not only affects the health of individuals, but it also impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems. Infection with HIV/AIDS leads to numerous bodily, mental and social issues that affect the individual and impacts on their families and communities at large. The effects of HIV on physical and mental functioning can make maintaining regular employment difficult. Patients with HIV infection may also find that their work responsibilities conflict with their health care needs. Disease severity and self-reported HIV-related work discrimination place HIV-positive women and individuals with low education at risk for employment loss. Limited economic opportunities and periods of homelessness have been associated with risky sexual practices, such as exchanging sex for money, drugs, housing, food, and safety. Ultimately, these practices can place individuals at risk for HIV (Riley, Gandhi, Hare, Cohen, & Hwang, 2007). Living in poverty can also result in food insufficiency, which can contribute to HIV/AIDS infection. Lacking food can result in transactional sex and power differences in sexual relationships, which can place an individual at risk of infection. Further, individuals may continue to face hunger after contracting HIV (Kalichman et al., 2011). Impoverished urban areas have been found to have HIV prevalence rates equivalent to many low-income countries with generalized epidemics (Buot et al., 2014). Studies of urban health have found that factors such as level of poverty and unemployment, vacant buildings and high crime rates are all associated with increased risk of HIV infection. These factors are all highly correlated, however, making it difficult to isolate the mechanisms that promote HIV infection (Latkin, German, Vlahov, & Galea, 2013). Another impact of HIV is the stigma and discrimination against persons living with HIV/AIDS. Apart from having to endure treatment with severe side effects, they constantly have to cope with rejection and social discrimination. People with HIV/AIDS have to put with being labelled as “victims” a term that implies defeat, helplessness and dependence upon help from others The major burden of caring for the people living with AIDS rests with the family and the health care providers. In the era before anti-retroviral therapy, this used to be an immensely stressing task because most of times the health of the infected patients deteriorated rapidly, they were bedridden and has to be taken care of. The advent of HAART has greatly improved the need for round the clock help since the patient can now lead a healthier life without need for much help. Important caregivers are mainly the family, close friends and health workers. References Betancourt, T. S., Ng, L. C., Kirk, C. M., Munyanah, M., Mushashi, C., Ingabire, C., Teta, S., Beardslee, W. R., Brennan, R. T., Zahn, I., Stulac, S., Cyamatare, F. R., & Sezibera, V. (2015). Family-based prevention of mental health problems in children affected by HIV and AIDS. AIDS, 28(Supplement 3), S359-S368. https://doi.org/10.1097/qad.0000000000000336 Boyd, D. T., Waller, B., & Quinn, C. R. (2020). Understanding of personal agency among youth to curtail HIV rates. Children and Youth Services Review, 116, 105179 Centers for Disease Control and Prevention (CDC). (2021). HIV in the United States and Dependent Areas | Statistics Overview | Statistics Center | HIV/AIDS | CDC. CDC. https://www.cdc.gov/hiv/statistics/overview/ataglance.html Dumitru, G., Irwin, K., & Tailor, A. (2017). Updated Federal Recommendations for HIV Prevention With Adults and Adolescents With HIV in The United States: The Pivotal Role of Nurses. Journal of the Association of Nurses in AIDS Care, 28(1), 8-18. https://doi.org/10.1016/j.jana.2016.09.011 Heuveline, P. (2014). Impact of the HIV epidemic on population and household structure. AIDS, 18(Supplement 2), S45-S53. https://doi.org/10.1097/00002030-200406002-00006 Office of Disease Prevention and Health Promotion (ODPHP). (2020). HIV | Healthy People 2020. Healthypeople.Gov. https://www.healthypeople.gov/2020/topics-objectives/topic/hiv Rouleau, G., Richard, L., Côté, J., Gagnon, M. P., & Pelletier, J. (2019). Nursing Practice to Support People Living With HIV With Antiretroviral Therapy Adherence: A Qualitative Study. The Journal of the Association of Nurses in AIDS Care: JANAC, 30(4), e20-e37. https://doi.org/10.1097/JNC.0000000000000103 Selik, R. M. M., Mokotoff, E. M. D., Branson, B. M., Owen, S. P. M., Whitmore, S. D., & Hall, H. P. I. (2014). Revised Surveillance Case Definition for HIV Infection — the United States, 2014. Centers For Disease Control And Prevention (CDC). https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm Simoni, J. M., Amico, K. R., Pearson, C. R., & Malow, R. (2008). Strategies for promoting adherence to antiretroviral therapy: a review of the literature. Current infectious disease reports, 10(6), 515-521. https://doi.org/10.1007/s11908-008-0083-y

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