The AIDS Epidemic - Case Study Example

RISK ASSESMENT AND EPIDEMIOLOGY PART: 3 Analytical studies on epidemiology are more focused on the disease and the pathogen than the descriptive studies. As far as AIDS is concerned, the investigation of the causes of the disease and how often it becomes a potential risk factor are done. Two types of analytical studies are done. They are experimental/interventional and observation studies. Experimental studies are important as there is no effective treatment or cure for AIDS. Similarly observational studies are also equally important because the epidemiologist can effectively investigate the disease conditions, occurrence and the effect of a particular disease within a population. (Fan, Conner and Villarreal, 2007). Among the many risk groups of AIDS, the Hispanics/ Latinos are found to have a greater risk. Ethnicity Based on ethnicity, we can analyze the level of HIV infection among the Hispanics. The Hispanics constitute about 21% of the general population. But, they make up 59% of the AIDS cases in USA. And also they constitute about 80% of the cases associated with injection drug use. It is also the fact that the Hispanics and the Afro-American have a higher frequency of AIDS, which is three to five times more than the general population. AIDS is found to be the leading cause of death among the Hispanic women in the age group of 25-34, and among Hispanic men in the age group of 35-44. The AIDS epidemic has had a very high impact on Hispanics and African American. (Fan et. al, 2007). Picture 1:AIDS cases by ethnicity in the United States (1981-2004) – (Fan et. al, 2007) HIV infections and AIDS among Hispanics The HIV risk groups are mainly classified as 1. Men has Sex with Men (MSM), 2. Injection drug users (IDU) 3. Heterosexuals and 4. Youth/adolescents. In a national study conducted in US, it was found that among the total MSM found to be positive for HIV, 15% of them are Hispanics. (Darbes, Kennedy, Peersman, Zohrabyan and Rutherford, 2002). Hispanics account for 18 % of the total population of AIDS patients among men and 20% of the AIDS patients among women. It is found that the Hispanics differ in the percentage of infection from one region to another. The percentage of HIV infected Hispanic individual in various regions are US (29%), Puerto Rico (27%), Mexico (10%), South America (7%) and Cuba (2%) respectively. Among the risk groups the HIV infection is found at a greater level among the men sex with men group (MSM). These HIV infected Hispanics live in large cities. (Darbes et. al, 2002). Transmission categories and country of birth of Hispanics/Hispanics with AIDS diagnosed in the United States during 2005 Central/South America (n = 861)% Cuba (n = 182)% Mexico (n = 1,488)% U Puerto Rico(n = 1,536)% USA(n = 2,809)% Male-to-male sexual contact 51 52 59 17 44 Injection drug use 11 13 11 42 24 Male-to-male sexual contact and injection drug use 2 8 4 4 5 High-risk heterosexual contact 34 27 25 36 26 Othera 1 0 2 1 2 Risk Factors and Barriers to prevention A number of cultural, social, and health related risk factors contributes to HIV among the Hispanics in USA. The behavioral risk factors vary from region to region and also differ by the country of birth. It was found through studies that the Hispanics of Puerto Rican origin are more likely to be infected with HIV. The higher prevalence was due to injection use and the high risk heterosexual contact in Puerto Rico. (sfaetc.ucsf.edu). Whereas in South American countries, Cuba and Mexico, the Hispanics are mainly infected with HIV through same sex activities. 1. Men sex with Men (MSM) The MSM are the high risk group among Hispanics in US. The gay network or clubs are less common among the Hispanics and hence the awareness about HIV is less common. This accounts for the greater risk of AIDS. 2. Youth Adolescents The infection with HIV occurs mostly during the adolescence stage. The increased risk is due to their lack of perceived vulnerability. 21% of Latino women and 14% of Latino men were infected with HIV during 13-24 years of age. (Darbes et. al, 2002). 3. Injection Drug users It was found that 19% of the cumulative HIV infection among Latino men was due to injection drug users. (Darbes et. al, 2002). 4. Heterosexual contact This is the fastest growing mode of infection. About 33% of the new infections are due to hetero sexual contact only. (Darbes et. al, 2002). Analysis by exposure category The proportion of AIDS among the heterosexual Hispanics was 38.7 % and homosexuals were 20%. The risk of HIV transfusion through blood was also comparatively 2.5 times greater among Hispanics. (Selik, Castro and Pappaioanou, 1988). Analysis by Geographic Area The Hispanics are mainly concentrated in the North East of USA and least populated in the west. In the North East, the heterosexual HIV infection was found to be higher than other modes of infection and also than other regions of US. (Selik et. al, 1988). Analysis by time of Diagnosis It was found that in 1980s, the incidence of AIDS was very high among the Hispanics. It dropped by 5% in 1987. (Selik et. al, 1988). Later it was found that it increased again in 1991 by few percentages and dropped again by 1996. (Fan et. al, 2007). Reasons for High Risk factors Hispanics are a diverse group of people ‘originating’ from various countries and have multigenerational presence in USA. The cultural differences among Hispanics have made prevention methods more complicated, as awareness and prevention efforts have to be targeted for different group. The other barrier was their lower educational status. The less educated Hispanics had great difficulty in understanding the prevention efforts. The other barriers are poverty, language, lack of health insurance and cultural issues. These barriers prevent them from receiving positive health information, HIV counseling and testing as well as relevant care. These barriers have to be removed, so that Hispanics benefit from all the preventive measures, undertaken for the prevention of HIV. Reference: Darbes, L. A., Kennedy, G. E., Peersman, G., Zohrabyan, L and Rutherford, G. W. (2002, April). Systematic review of HIV Behavioral Prevention Research in Hispanics. HIV insite base chapter. Retrieved June 22, 2009 from http://hivinsite.ucsf.edu/InSite?page=kb-07-04-11 sfaetc.ucsf.edu. (2007, August). HIV /AIDS among Hispanics/ Hispanics. CDC HIV AIDS fact sheet. Retrieved June 22, 2009 from http://www.sfaetc.ucsf.edu/resources/PDF/hispanic.pdf Selik R. M., Castro K. G., and Pappaioanou, M (1988, December). Racial /Ethnic differences in the risk of AIDS in United States. American Journal of Public Health. 78, 539-1545. Retrieved June 22, 2009 from http://www.ajph.org/cgi/reprint/78/12/1539?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=hispanic+aids&searchid=1&FIRSTINDEX=10&sortspec=relevance&resourcetype=HWCIT Fan, H., Conner, R. F. and Villarreal, L. P. (2007). AIDS: Science and Society. 5th ed. Sudbury, MA: Jones and Bartlett Publishers. Read More