HIV in the United States of America - Essay Example

? HIV/AIDS in USA HIV in the United s of America can be traced to 1968 when it is believed to have been brought to the country by an immigrant from the Mediterranean region. In the late 1970’s and early 1980’s when the sign and symptoms of the disease began to manifest themselves, it was usually associated with old men of Mediterranean origin, however, with time, medical institutions started seeing sign and symptoms of the disease among men who had sex with other men (Spaulding et al, 2009). As more research was carried out on the disease, it was found that the disease did not only affect men who had sex with other men but also patients who received blood transfusion, intravenous drug users, heterosexuals, bisexuals and new born babies were also being affected by the disease (Perrin, Kaiser & Yerly, 2003). This essay will look at HIV/AIDS in United States of America, the levels of risk involved in transmission, the various stakeholders in HIV/AIDS and the cosponsors in fighting HIV?AIDS AIDS is transmitted from one individual to another when a person without the virus comes into contact with the body fluids of an infected person; this is through several ways, which are discussed below (Sigal et al, 2011). Unprotected sexual contact with an infected person is one of the ways in which individuals contract the disease; when an individual has anal or sex without using a condom with a person who is either HIV positive or does not know his status accounts for a large number of infections especially in United States (Sonenklar, 2011). Other forms of sexual practises such as masturbation and oral sex have been found not to contribute to the spread of the virus. Vaginal sex is the most common mode of transmission of HIV in America with more women being infected through this method than men. This pattern can be attributed to the fact that women have a larger surface area of mucosa tissue and a higher number of immune cells than men with their penises do (Mah & Halperin, 2010). Another practise that has leads to spread of HIV in America is the sharing of syringes, needles and other piercing tools with an individual who is infected. With the rampant drug use and body piercing among the young generation in America, there is an increased risk that individuals belonging to drug abusing gangs are more likely to share piercing objects and needles in the spirit of comradeship and trust among themselves. This has the effect that most members of gangs and peer groups have spread the virus among themselves (Osmanov et al, 2002). Mother to child infection during childbirth or through the process of breast-feeding is another way that the HIV virus is spread in America. Mothers who are infected with the virus can pass the same to their children before or during birth, in addition, during breast-feeding, the virus, which is usually present in breast milk can be passed from the mother to the child (Mishra et al, 2009). Transmission of the HIV virus can also occur in health care settings where health care givers have been infected with or infected patients with the virus. However, these cases are rare and in the United States, only six cases have been reported which involved the same dentist who was HIV positive (Kalichman, Pellowski & Turner, 2011). HIV virus has also been detected in saliva, urine and tears, however, the concentrations in these fluids is very small, therefore there has not been any case of infections resulting from them (Mishra et al, 2009). Men who have sex with other men in America have been found to be at a higher risk of contracting the disease than heterosexuals or other groups. Among adolescents between 13 and 19 years, 91 percent of all HIV infections can be attributed to individuals who have sex with people from the same gender (Fryer et al, 2010). The large contributing factor to these statistics among gays and bisexuals is that most of them do not know their infection status especially those who are in the lower age brackets; this makes them less likely to take precautionary measures when having anal sex. In addition, studies conducted by CDC show that 80 per cent of all gay persons did not have adequate access to HIV interventions, which are thought to be the most effective in curbing the spread of the virus. The education program that is there regarding HIV prevention does not take in to account the sexual orientation of individuals therefore it overlooks the specific issues that affect the minority sexual groups such as gays and bisexuals (Dieffenbach & Fauci, 2011). Another factor that has increased the infection rates among the gays and bisexuals is the complacency about risks associated with HIV (Walker, Reid & Cornell, 2004). This has been contributed by improvements in management of HIV virus which has made people with the virus to live longer and healthier lifestyles therefore making young gays undermine the dangerous consequences of contracting HIV virus and hence complacence in taking risks. Mental health consequences of stigma and discrimination such as bullying, isolation and sexual violence among others causes the gays and bisexuals to have a low self-esteem and feelings of shame, which leads to distress, suicide attempts or risky sexual behaviour (Higgins, Hoffman & Dworkin, 2010). The level of risk in transmission of HIV depends on the method of transmission and the stage at which the virus has reached, the highest risk of transmission usually occurs during the early stages of infection and in the late stages when the concentration of the virus in the body is highest (Dieffenbach & Fauci, 2011). In quantifying the risk involved in sexual transmission of HIV, several challenges are experienced, however, all the studies that have been conducted shows that anal sex has the highest risk followed by vagina sex then oral sex with the least risk of transmission. In addition, there is also increased risk with receptive sex both anal and vaginal as compared to penetrative sex. The risk estimates for transmission f HIV and AIDS varies widely ranging from 0.5 per cent to 3.38 per cent with mid range estimates of 1.4 per cent to 1.69 per cent for receptive anal intercourse; transmission risk lies between 0.06 per cent to 0.16 per cent for insertive anal sex. For receptive vaginal sex, the transmission risk lies between 0.08 per cent to 0.19 per cent and 0.05 per cent to 0.1 per cent for vaginal insertive sex (HIV, 2012). The risk of transmission that is associated with unprotected oral sex has been found to be lower than all other forms of sex, however, it has also been found to have a none zero probability of transmission, the risk of transmission for the receptive partner also increases with ejaculation from the insertive partner (Shuper et al, 2011). For individuals who use drugs that require use of syringes and other piercing objects, the risk of transmission of HIV virus ranges between 0.7 per cent and 0.8 per cent, however, studies conducted on abandoned needles shows that the percentage is a low; this is due to the viability of the virus living outside the body (Tran et al, 2012). Sharing ancillary injecting equipments such as filters and cookers during drug use has also been found to increase the risk of transmission considerably (Mellins et al, 2011). In addition, people who use drugs that are not injected in the body are also at a risk of contracting the disease especially when they are under the influence of the drug, this is because drug use increases the risk taking to engage in sexual activities while some drugs have been found to be independent factors (Shuper et al, 2011). In absence of any preventive measures, mother to child risk of transmission ranges from 15 per cent to 45 per cent depending on whether there are other breastfeeding alternatives that are available to the mother (Espejo, 2012). As it is with the other modes of spread, the plasma viral load of the parent will determine the level of risk of spreading to the kid. In addition, obstetric events such as prolonged rapture of membranes and intrapartum use of fetal scalp electrodes or fetal pH sampling have also been found to increase the risk of transmission of the HIV virus. The probability of transmission through breastfeeding ranges between 9 percent and 15 percent , however, this may rise or decrease depending on the combination of other factors such as period and patterns of breast feeding, the health of the mother’s breasts and the plasma viral load in the breast milk (Mishra et al, 2009). The united states of America government through the ministry of health has been at the forefront in helping LGBT community to reduce infection rates among themselves. The main objectives for the participation of the government has been to reduce risky behaviours that put homosexuals at the risk of contracting HIV and encouraging them to learn about their HIV status since most of the individuals who know their HIV status take less risks. In the fight against HIV/AIDS, the department of health in united states has combined several measures, some of the most effective measure that the government has used includes treatment of drug addiction, implementing community based outreach testing and linkage to care for HIV and other infections. In addition, a combination of pharmacological and behavioural treatment for individuals involved in drug abuse has also been used to reduce the likelihood of drug users to engage in risky sexual behaviour The government, through the centre for disease control (CDC) has put the following measures to protect pregnant women and infants against infection by HIV virus. CDC in conjunction with the council of state and territorial epidemiologists and American academy of paediatrics have recommended universal perinatal exposure to HIV testing to ensure that all expectant women receive all the attention they need to avoid infecting their unborn babies or themselves with the virus. In addition, CDC has also been involved in educating all health practitioners who handle pregnant women on the need for prenatal testing to reduce the risk of HIV infection. In order to prevent HIV infection through blood transfusion, the department of health introduced sensitive HIV screening tests, donor deferral and more conservative use of the donated blood. The various stakeholders in HIV have their own positions, which determine the level, and ways in which they participate in prevention and mitigation of effects of the disease (Vitoria et al, 2009). For instance, infected and affected persons are among those who are targeted by measures and policies relating to HIV/AIDS, the donors are responsible for funding of the projects and programs, health care workers are responsible for helping the affected people overcome stigma that s associated with the disease in addition to treating the infected persons (WHO & Unicef, 2011). The community and traditional leaders are also responsible for helping the victims overcome stigmatization, in addition, they are also responsible for doing away with traditional practises that increases the risk of infection such as female genital mutilation (FGM) and failing to circumcise the male population in the society (Van Howe & Storms, 2011). Academic institutions are responsible for carrying out research on HIV, which will in turn help government and organizations to formulate policies and programs that will be effective in tackling the menace associated with HIV/ AIDS. NGO’s, FBO’s and CBO’s are responsible for reaching out to the victims of HIV and their relatives to help them in taking care of the sick persons and overcoming stigma. In addition, these organisations are also responsible for encouraging people to go for voluntary counselling and testing, they also take part in educating the masses about HIV and how to reduce the risks of infection (Kalichman, Pellowski & Turner, 2011). One of the institutions that funds HIV program is the World Bank, the institution being the one of the largest financial institution in the world is tasked with the responsibility of supporting developmental and health programs in countries that need the help (Bongaarts & Over, 2010). The world bank started financing aids program during emergency and has continued supporting AIDS programs and projects in line with the millennium development goal 6 that aims to stop and begin to reverse the spread of HIV/ AIDS through prevention, care, treatment, and mitigation services for the people affected by the virus (Komatsu, 2010). The World Bank offers financing, technical support and knowledge to countries for productive prevention of new infections and for treatment of people already living with the virus. Another partner in financing HIV related projects and research is the international labour organisation (ILO) which mainly deals with HIV related cases in the work place, because of its structure, it is able to mobilise governments, employers and workers in all its member states to support AIDS related programs. The world food program (WFP) is another financier of HIV/ AIDS program although it mainly deals with the dietary aspect of the disease (Schwartlander et al, 2011). UN Women is responsible for bringing gender perspectives and equality in to AIDS pandemic; it is responsible for sponsoring programs that reduce discrimination and unequal power relations between men and women (Biesma et al, 2009; Rubin, Colen & Link, 2010). 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