Population Group Vulnerable to Ill Health - Essay Example

Title: Population group vulnerable to ill health Student name: Student ID: Institution: Date: 14/05/2013 People living with HIV/AIDS Introduction Vulnerable populations to ill health are groups of people who due to their ethnic, age, cultural, health, social or economic characteristics are not included in the health care system of the society. These groups can include the young, women, elderly, people living with HIV/AIDS and the disabled (Scalon & Lee, 2007). Vulnerable populations have a higher than average risk of developing health problems. AIDS is caused by a virus (Human Immune deficiency Virus) which can be passed from one person to another through sexual intercourse, blood or other body fluids. Majority of the infections are transmitted through sexual intercourse between men and women. Other groups particularly affected are injection drug users, sex workers and homosexuals. These groups have worries of accessing health care and in addition this behavior is criminalized in many governments hence making it more difficult for these groups to access health services1. Death of the infected people leads to loss of skills, work force and loved ones. HIV infected women tend to be more vulnerable as compared to HIV infected men (Van Servellen, Aguirre, Sarna & Brecht, 2002). Gender differences among people infected with HIV/AIDS also exacerbate their response to the illness. Men tend to abandon their medication and this makes the women more vulnerable not only to the disease but also to the family reaction. AIDS has become one of the most devastating diseases ever faced by human kind. Since this deadly epidemic began, more than 60 million people have been infected with 30 million deaths reported. AIDS has been reported to be the number six in causing death globally. According to research that has been done, there is a decline in the number of new infections and people dying of HIV related causes. This can be attributed to the antiretroviral therapy which makes the victims live longer. Factors influencing the health outcomes of people infected with HIV Socio economic status Socio economic status is measured as a combination of income, occupation and education background. Variation in distribution of wealth, access to resources and income distribution are all factors that affect the society as a whole. Socio economic status highly affects people living or infected with HIV/AIDS. This illness affects the people of lower socio economic class at a higher rate as compared to those of a higher socio economic class (Perry, 1998). Perry (1998) further argues that, a person’s socio economic class affects the likelihood of contracting the virus therefore becoming a major factor in determination of the person’s quality of life after the infection. Besides, people in the lower socio economic class have fewer resources and are characterized b y poverty which makes them have limited access to treatment. Lack of socio economic resources is also linked to riskier behaviors as far as health is concerned and can lead to contraction of the virus. Examples of these behaviors are: engagement in sexual activity at an early age and lack of protection, among others (Adler, 2006). Women with stress experiences and at a lower social class are at more risk of contracting the HIV virus. Individuals who are in unstable environments or housing conditions are also at a higher risk of HIV infection according to Culhane, Gollub, Kuhn & Shpaner (2001). On the other hand, HIV/AIDS infection has an impact on the socio economic status. This is because it strains on the individuals’ ability to work hence affecting their income. Rabkin, McElhiney, Ferrando, Van Gorp & Lin (2004), in their research, argues that 45% of people living with HIV/AIDS are unemployed. Individuals with this illness are also discriminated in the work force hence have little chances of finding employment In addition people with a low socio economic status often have little access to treatment and this reduces their survival chances (Joy, Druyts, Brandson, Lima, Rustad, McPhil & Hogg 2008). They also have a high mortality rate due to faster progression of the HIV infection as compared to those in a higher socio economic class (Joy et al., 2008). Another major contributor of health disparities between individuals in the low socio economic class and those in the high socio economic class is decreased access to preventive services. Individuals with a higher income are likely to have the health coverage (Wood, Montaner, Chan, Tyndall, Schechter, Bangsberg & Hogg 2002). Patient retention Patient retention can e measure in terms of the number of visits made to the medical care centre at certain intervals. A previous research classified people living with HIV infection into three in order to assess patient retention; regular users, sporadic users and non-engagers. Regular users complete their medical appointments within six months and in case of any cancelled appointment, they reschedule and complete. Sporadic users complete at least one appointment in a year and use HIV urgent care clinic at least once in a year. Non-engagers only complete initial visits and never return (Mugavero, Lin & Willig, 2009). This classification of patient retention brings out the understanding that patients’ participation is along a continuum of engagement with the health care system and the health outcome will also vary along the same. This classification also allows for different interventions for the different categories of patients hence coming up with the best measures for the patient and a patient-doctor relationship is established (Israelski, Gore-Felton, Powe, Wood & Koopman, 2001). According to Israelski et al (2001), it is important for the health care assistant to identify which patients have the greatest risk for not being retained. This helps him/her in coming up with intervention efforts for the particular patients. Missed appointments are sometimes associated with demographic characteristics like age, race and marital status. Others are less engagement with the health care provider, less social support from the family and the society at large and history of treatment. Policy implications The fight against HIV/AIDS is mostly being driven by decisions made by the funding agencies of the program ad not the particular government of the country involved. Targeting HIV/AIDS is rather a more narrow approach which does not address wider determinants which are common in other public health illnesses like malaria (Stillwaggon, 2000). According to Stillwaggon (2000), efforts to improve on the health outcome of HIV infection have failed in many cases due to over emphasis on the social factors and failing to look at other supportive social processes that empower the people to protect them. Many projects that are related to HIV infection treatment and prevention fail in treating people as targets rather than as agents in their own development. Members involved must therefore participate fully in designing and execution of their own projects since they have full knowledge of the challenges as well as the local conditions. HIV testing and counseling coverage Counseling services play a critical role the care of HIV/AIDS. Actually, the major starting point for information related to HIV infection is counseling and testing which helps in providing psychological support (Wasti, Simkhada, Randall, & Teijlingen, 2009). There are many people who die with HIV/AIDS yet they never knew their status. Public health facilities are also few and are further not equipped with laboratory services, essential equipments and trained personnel. Challenges that people living with HIV/AIDS face Social and cultural challenges Australia is a multicultural society hence the socio-cultural norms are themselves challenging in mitigating the impact of HIV/AIDS. The illness deals with sex issues in the society therefore seen as disrespectful bearing in mind that sexual behavior is not discussed openly in the public Wasti, Simkhada, Randall, & Teijlingen (2009). Besides, there are so many people living with HIV/AIDS who do not know their status yet they still engage in unsafe sexual activities. The society perceives the HIV infection negatively hence some people living with the virus fear to go and seek medical treatment. In addition, there is also impact from the mass media which reinforces on the negativity of the infection. All these socio-cultural aspects facilitate the spread of the virus infection and hinder the treatment and prevention of the HIV/AIDS (Wasti et al, 2009). Stigma and discrimination HIV related stigma impacts significantly on the testing, attitude towards the health assistants and adherence to treatment. This leads to people failing to undergo HIV test or seeking treatment. Individuals fear being discriminated by their friends and families and also the sculpturing by the media (Wasti et al, 2009). According to Wasti et al (2009), measures that enhance stigmization and discrimination include: forcing people living with the HIV infection to go for screening and testing, notification of AIDS cases using force, preventing them from certain occupations and isolating them from the rest of the society. Financial constraints Financial resources are major challenges among people living with HIV infection. The illness burdens their economic life and that of the country at large (Wasti et al, 2009). Poverty is key in propagation of the virus and many high risk behaviors that expose or facilitate HIV infection are related to poverty. Besides, HIV/AIDS requires a life time commitment due to lack of cure therefore drains all the financial resources not just for the infected but also for the affected people too who take care of them. There is also a management problem in allocation of adequate financial resources for the medical services of the people living with HIV/AIDS infection. Mental health HIV infection has a major impact on the individual’s mental health. The chronic disorder brings about stress factors like discomfort, physical deterioration, financial dependence and the prospect of the untimely death (Stillwaggon, 2000). According to Stillwaggon (2000), other factors like isolation, stigma and discrimination and social rejection lead to the psychological torture which brings about mental illness. This problem of mental illness can occur at any stage of HIV infection. The groups that are at risk have higher chances of mental illness contraction. These include injecting drug users, sex workers, prisoners, refugees and immigrants. If the illness is not treated, the problem can lead to less life span, low quality of life and difficulty in adhering to HIV care and treatment. Besides, the role that mental health plays in HIV prevention should not be ignored since it is significant. Conclusion Under most clinical circumstances, highly active antiretroviral therapy (HAART) is preferred as it lowers the viral load to undetectable levels. The decision to introduce antiretroviral therapy to the patient is based on a medical evaluation of the health provider and a thorough discussion with the patient involved with the major goal being long term disease control. Besides highly active antiretroviral therapy, other treatments include prophylaxis, nutritional therapy and immunization. The disease also has enormous social implications besides affecting many organs in the body. It therefore requires a multidisciplinary approach in management. This therapy should only be done by physicians who are qualified and competent in management of HIV/AIDS infection. Implementation research is needed to better understand the process by which patients infected with HIV fall out of care and the strategies which should be put in place to bring them back on track. There is also additional research that embraces continuous care and shows its link to improvement of patients’ health outcome is needed to give more information on patient retention at the health care system level. Improving the patient retention will help in reducing the rate of mortality and morbidity leading to better health of both the patients and the population. It is important to reduce stigma and discrimination among people living with HIV infection and especially the most vulnerable groups like the women and children. The government should therefore develop programs that are culturally upright in order to overcome this challenge of stigma and discrimination. The use of safe or protective measures in sexual activity such as use of condoms, adequate testing and counseling as well as change in behavioral through a social-cultural change are among the most important prevention measures of this vulnerable group. Several issues need to be looked at in better provision of services to the HIV infected group; infrastructure, trained personnel, quality of services, maintaining privacy and confidentiality when dealing with the patients and availing counseling and testing services. References Adler, N. E. (2006). Overview of health disparities. In G. E. Thompson, F. Mitchell, & M. Williams (Eds.), Examining the health disparities research plan of the National Institutes of Health: Unfinished business (pp. 129–188). Washington: National Academic Press. Culhane, D. P., Gollub, E., Kuhn, R., & Shpaner, M. (2001). The co-occurrence of AIDS and homelessness: Results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. Journal of Epidemiology and Community Health, 55, 515-520. Israelski, D., Gore-Felton, C., Powe, R., Wood, M.J. & Koopman, C. (2001). 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