Community Project about HIV - Essay Example

? Community Project about HIV of Identification of the Problem Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immunodeficiency Syndrome (AIDS). The main ways by which HIV is transmitted from one person to another are through sexual contact with infected people and blood-to-blood contact (Beletsky et al., 2011). HIV affects its victims by rendering their immune system weak or ineffective. In fact, the immune system becomes so weak that many infections start attacking the victims. AIDS diagnosis is done when these attacking diseases worsen. Although HIV/AIDS can be treated, no cure has been discovered (Beletsky et al., 2011). However, scientists are working extra hard to find a cure. The enormity of the effects of HIV/AIDS attests to the fact that it continues to be a huge global health and social problem. According to the UNAIDS’s World AIDS Day Report of 2011, about 34 million people had HIV, indicating a growth of up to 17 percent since 2001. In 2010 alone, the UNAIDS reported that new infections stood at 2.7 million people. Besides being a health issue, HIV/AIDS is a huge social, cultural and development problem, which is spreading rather fast among women, young people and working-age adults. Thus, HIV/AIDS negatively impinges on the economy, society, family and schooling in a country hence, weakening the entire world. Whenever a portion of the population contracts HIV/AIDS, the economical growth and status of the world is negatively affected. The scourge thus reduces the labour force while demands on already overwhelmed governments and economic and health care systems increase (Gardner et al., 2013). The other reasons HIV/AIDS is particularly a big problem in poor and vulnerable countries and communities are lack of resources to treat and help HIV/AIDS patients, overburdened health care systems, expensive and inaccessible HIV/AIDS medication, and cost of HIV/AID treatment compares unfavorably with the GDP of most poor countries (Gardner et al., 2013). Resources for campaigning and educating the public on HIV/AIDS and on risky behaviors are also scarce. Finally, many people and societies are quite reluctant to discuss risky behaviors and HIV/AIDS, which are considered taboos in certain communities. Citizens, corporate organizations, local and state governments, NGOs, and the international community should thus combine effort to thwart the scourge. Through this project, stakeholders will create HIV/AIDS treatment and response health policies, expand care and treatment, improve teacher training, AIDS education, and social programs, protect children, and do further research on HIV/AIDS an its effects (Gardner et al., 2013). HIV/AIDS Statistics for Miami-Dade County Miami-Dade County, also referred to as the Greater Miami is situated in the southeastern portions of Florida. Dade is the most populous county in Florida with the population standing at 2,496,435 as of the 2010 census. In fact, it is the seventh most populous county in the U.S. With a land area of 1,946 square miles (5,040 km2), Dade has the third largest land area in Florida and has an estimated half of the Miami metropolitan area's population and several of Florida’s largest cities. With 35 incorporated cities and many unincorporated areas, many parts of the northern, central and eastern regions of the county are heavily urbanized. Agricultural land constitutes nearly a third of Miami-Dade County's inhabited land area. Unlike the densely populated urban areas in the county’s northern sections, the agricultural areas are sparsely populated. According to the U.S. Census Bureau’s 2012 Ethnic/Race Demographics, White Americans constitute about 77.6% out of whom16.3% are Non-Hispanic Whites. On the other hand, African Americans constitute 19.2%, Asian: 1.7%,1.2%, American Indian and Alaska Native: 0.3%, Hispanics or Latinos of any race: 64.3%, and Native Hawaiian and Other Pacific Islander: 0.0%. A county-by-county analysis of the FloridaCharts.com reveals that Broward, Palm Beach and Miami-Dade are the top four counties for HIV and AIDS related deaths in the state. Currently, the HIV/AIDS death rate in Miami Dade stands at 23,000 people while about 1,000 to 2,000 people get infected with HIV in Miami-Dade County annually. This HIV/AIDS community project targets Miami-Dade County given the prevalence of the scourge in the county and its environs. In fact, the Miami-Dade County currently ranks the highest in HIV prevalence, reporting the highest number of HIV/AIDS cases per capita in the country. In addition, Florida is third in the U.S. in the number of people living with HIV/AIDS and second in the number of pediatric HIV/AIDS cases. Statistics also reveals that about one in about 100 White males and one in every 29 Black American in the county has HIV/AIDS. Compared to the larger Florida in which one in every 336 White male adult and one in every 49 Black adults has HIV/AIDS, it is evident that the prevalence of the scourge in the Dade County is higher than it is in the larger Florida. To date, the local public health response has not controlled the epidemic. The approaches by which these interventions have been motivated in recent years, which are based on collaboration among the capital's community and faith organizations, public health organizations, and research institutions, could be enlightening for other groups keen on addressing or combating HIV/AIDS. This community HIV/AIDS project seeks to ensure that poor, marginalized, and vulnerable neighborhoods in Miami Dade County access safe and affordable HIV/AIDS care to alleviate their suffering and to arrest the runaway prevalence of the scourge on these communities. Nursing Tests and Diagnosis The program focuses on certain test and diagnostic approaches to help identify the most vulnerable in the community and ensure that quality and safe HIV/AIDS care is accessible and available for them. In many case, HIV/AIDS will be diagnosed by testing the participants’ blood and saliva. These tests will seek to identify the antibodies to the HIV in these body fluids. Although it usually takes three months for these antibodies to be produced in victims’ bodies, there are cases in which it could take six months for a HIV test to be positive (Lewin, 2011). Also to be used in the program is the newer test, which checks for the virus’ antigen. The advantage of this test is that it shows the presence of the virus immediately one is infected or in a matter of days. The nurses will also use various testing methods to determine the stages of victims’ HIV/AIDS status. These tests include CD4 count, viral count, drug resistance, and tests for complications. In the CD4 count test, these white cell type that specifically target and destroy HIV. In healthy persons, the CD4 count ranges between 500 and 1000 whereas as HIV becomes AIDS, the CD4 count decreases to 200. The viral load test checks the amount of the HIV in one’s blood. Drug resistance on the other hand is a test that determines the strain of the virus in one’s blood and its possible resistance to certain medications. Finally, the complications that will be tested in the program are tuberculosis, hepatitis, toxoplasmosis, sexually transmitted infections, liver or kidney damage, and urinary tract infection (Gardner et al., 2013). Planning of the Project The implementation and the success of program will depend on the execution of the plan that has been outlined. First, the mission, vision, values, and the strategies of the program will be understood by all stakeholders. While the vision outlines what the program would want to be, its mission defines the purpose for its formation and the mechanism by which it intends to achieve its objectives. The beliefs shared by its stakeholders are referred to as values while the strategies are the goals the program pursues or the road map via which the vision will be realized. In planning the program’s activities, a strategic planning process will be strictly followed. First, the current HIV/AIDS situation in the target population and the causes of this scenario will be evaluated. Second, the target or goals will be defined followed by the establishment of possible paths to follow. Below is a summary of the two strategic plans for the program. The Situation-Target-Proposal Approach In this approach, the situation is characterized by expensive, unsafe, and inaccessible HIV/AIDS health care for vulnerable victims while the target is to make HIV/AIDS health care accessible, affordable, and safe for vulnerable groups. To achieve this target the proposed strategies include reaching out to private, communal, government, NGOs, and corporate donors for support of outreach programs and care for vulnerable groups in the community. In the Draw-See-Think-Plan approach, the drawn desired situation entails affordable, free, safe, and accessible HIV/AIDS health care for vulnerable diseases. The seen current situation is characterized by vulnerable groups that are increasingly suffering due to unsafe, expensive, and inaccessible HIV/AIDS care. Finally, the thought course of action is to reach out to communities, solicit for funds, collaboration, subsidies on treatment and the planned resources for implementing the course of action include funds, local capacity to address HIV/AIDS, physical facilities (hospitals) and services (transportation) (Aral, 2013). The SWOT analysis tool of strengths, weaknesses, opportunities, and threats will also be instrumental in the analysis of the internal strategic factors, strengths, and weaknesses affecting the program will be accounted for in the plan. Similarly, the external factors such as threats and opportunities that the program might face will be determined and the correct measures put in place. Nursing Interventions Nurses have been directly involved with HIV/AIDS since the disease was first identified among men who sleep with men in the U.S. in the last 1970s. In fact, even before antiretroviral therapy was discovered, nurses across the cities and states cared for HIV/AIDS patients not only in hospitals but also in their homes. In the past, nurses would even form groups to provide care, information, and education for other nurses to better handle HIV/AIDS victims (Gardner et al., 2013). Thus nurses were quite instrumental in the past as they are in the current circumstances in giving the much needed care for HIV/AIDS patients. However, as retroviral therapy changes the face and management of HIV/AIDS, nurses and nursing should also change just as the way the public views nursing and nurses has also changed. First, the true spirit of care should not leave nurses and the profession. Importantly, nurses should take an expanded role and scope as first line care givers for HIV/AIDS patients (Sonenklar, 2010). In fact, it is the nurses who provide antiretroviral therapy. Senior and experienced nurses should train and educate their juniors, thus help in expanding access antiretroviral therapy, especially in inaccessible and remote areas of the county. As a matter of fact, areas rarely accessed or visited by physicians or those healthcare providers ignore should be the focus of the project. Nurses are also expected to task-shift or task-share. What is more, the project seeks to encourage nurses to work with local communities and to practice at the best and fullest extent of their license and abilities. In other words, this community project will seek to provide nurses with an expanded scope of practice. A nurse-midwife program is the other intervention that the project emphasizes. In this nurse-midwifery program, pregnant women with HIV will be tracked and followed to ensure that they have access to care and are provided with safe child-birthing services. The program will also evaluate the nurse case management and nurse-initiation for HIV/AIDS patients. Identification of risk factors such as depressed immune system, broken skin, traumatized tissues, chronic diseases, and malnutrition will be emphasized in the project. Short-Term Goals The following short-term objectives will be quite instrumental in the achievement of the long-term goals of the project. 1. To change the manner in which HIV/AIDS screening is always carried out in the city 2. To modernize and rationalize HIV/AIDS diagnosis and linkage to care 3. To develop site-specific programs to constantly deliver quality services across participating pilot sites 4. To address the health factors that negatively influence the health of people living with HIV and AIDS 5. To initiate, implement and engage in a collaborative process, which will foster learning from other stakeholders 6. To transform and turn HIV./AIDS knowledge and information into practice Long-Term Project Goals The following are the long-term goals of the project: 1. To ensure the timely access of safe and quality HIV/AIDS care and treatment in the city 2. Reduce the impact of HIV/AIDS through effective screening and early detection 3. To achieve and demonstrate system and cost optimization 4. To lower the number of new HIV/AIDS diagnoses in the city 5. To improve patients’ experiences in every step of their journey with HIV/AIDS Evaluation of the Project The limited resources such as funding for this program will require that sound and effective evaluation mechanisms are put in place. Evaluation will not only make the project and its stakeholders accountable but it will also verify the program’s impact on the target population, thus serving as a justification for future funding and support (Fetterman & Vandersman, 2011). The evaluation will also ensure that vulnerable members of the community bearing the biggest burden of HIV receive the necessary services and support. In this project, the goals, progress, impact, and outcome will be the basis of the evaluation of the project’s impact. The Geographical Information System (GIS) will be used to evaluate the project. In essence, GIS will involve the comparison of the affected and target areas and population and service distribution. GIS will this help in highlighting the shortfalls as well as the changes due to the program’s intervention. In addition, the GIS analysis will identify the focus program actions and help in the decision making processes. During the evaluation, the needs of the local community, the program’s theory, the implementation, the effectiveness or impact, outcomes, and efficiency will be assessed. Second, the causation of the problem will be determined to help in establishing the validity, reliability, and sensitivity of the project evaluation approach adopted. The challenges likely to be encountered during the evaluation include data, time, budget, and methodological constraints. Core during the evaluation will be the establishment of the mission, the taking of stock, and planning for the future. Teaching and Recommendations There is a broad range of guidelines, protocols, and recommendations that nurses and other caregivers of HIV/AIDS victims may use to offer safe, accessible, and affordable care to their clients. These are some of the recommendations enlisted in this community project for HIV/AIDS. The main area targeted by these recommendations is antiretroviral treatment (ART), which substantially lowers the risks of HIV transmission (Perelson & Ribeiro, 2008). Hence, ART should be initiated for all HIV/AIDS patients with CD4 count of less than 500 cells per milliliter. ART should also be used for preventive purposes. The importance of ART for the success of treatment is shown in those who adhere to the therapy. Among the benefits of such an adherence is reduced mortality. Failure to fully adhere to ART may result in viral resistance and other more complex therapy options. Testing, retention, linkage, and referral are the other areas that need recommendations. First, early commencement of HIV treatment is highly recommended to help optimizing the outcomes. Similarly, it pays to assess the needs of people living with HIV/AIDS so that the right steps such as referrals are made for the required treatment and psychosocial and support services. Mother-to-child transmission is the other sensitive area that health care providers should pay attention on. The following interventions are thus recommended: antiretroviral treatment, prophylaxis, scheduled cesarean delivery, avoidance of breastfeeding, and prenatal and perinatal HIV testing. The recommended partner services for HIV/AIDS care. Partner services are a range of services people living with HIV and their partners ought to enjoy. These include partner notification by public health professionals. Such a notification increases the chance of identifying people at risk of contracting HIV not to mention HIV-positive persons who may not be aware of their status. The importance of preventive services cannot be overemphasized. Thus, campaigns should be organized to educate and inform health care givers about the importance of giving preventive services to the public. The availability and accessibility of key resources for HIV/AIDS training and technical assistance is also important in the fight against the scourge. HIV/AIDS training and education centers should also be established. In this regard, more focus should be directed at minority and the most vulnerable groups. A national consultation and resource centers for all concerned health care providers should also be established. Other recommendations are the diffusion of evidence based interventions projects, harnessing partnership opportunities and other information resources, and use of health resources and services administration (Mertens & Wilson, 2012). Resources Available In the Community There are several resources that the project will utilize to achieve its short- and long-term objectives. Key among these resources is finances. Besides NGOs, government agencies and private donation, the project will rely on fund from well wishers from within and outside the city. Education and skills are the other resources that will be exploited during the lifetime of the project, not to mention the infrastructure of the city. The other resources to be used in the project are documents. Hence, proper and clear documentation should be developed and availed for use. Code books and user guides will be developed to outline the mission, vision, objectives, and operations of the project to the local people as well as to the professional participants. An instrumental resource will be the local community, which will be involved throughout the process, especially in decision-making processes and program implementation (Brabeck & Brabeck, 2009). The role and importance of the community’s HIV/AIDS workforce cannot therefore be overemphasized. The local peoples’ capacity to implement the project’s prioritized interventions will thus be a crucial resource for the project. Thus, the resources to be employed by the project include the people who will be useful in organizing others into workable forums or groups such as church leaders, local politicians and administrators. Physical structures and places such as schools, churches, hospitals, recreation parks, social clubs, and libraries will be the other resources available in the community. Community services such as public transportation, educational centers, and community sports facilities will also form part of the resources. Importantly corporate or business organizations, which may come in to support the project will be a vital component of the local resources to be sought. The local population and professionals with different skills and talents, knowledge, information, support, materials, and equipment will form part of the workforce for the project. Conclusion HIV/AIDS continues to affect the human population in rather numerous ways including economically, socially, culturally, and developmentally. To this effect, more projects and programs should be initiated and implemented to help reduce the extremity of the consequences of this scourge. Particularly affected by HIV/AIDS are the minority and the vulnerable groups such as children, women, the poor, the disabled, and the underdeveloped communities in big cities such as Miami Dade County for which this program will be quite useful in addressing the HIV/AIDS-related plight of the poor and the marginalized people of the target neighborhoods. The importance and roles of nurses in this program is rather crucial since it is nurses who take care of patients and are in constant contact with their loved ones. Interventions such as ART, counseling, and preventive services are among the highly recommended activities by which the prevalence and effects of the scourge may be realized. Importantly, all stakeholders ought to collectively use their resources to help address the HIV/AIDS menace. The stakeholders in this sense encompass patients, their families, health care providers, NGOs, CBOs, corporate groups, citizens, and local, state and federal governments. Without collaboration, individual effort may not cover much ground in alleviating the plight of HIV/AIDS victims and their families. References Aral, S. (2013). The new public health and STD/HIV prevention: personal, public and health systems approaches. Springer. Beletsky, L. G., and White, E. B., and Heimer, R. (2011). The Roles of Law, Client Race and Program Visibility in Shaping Police Interference with the Operation of US Syringe Exchange Programs. Addiction, 106(2): 34. Brabeck, M., and Brabeck, K. (2009). Feminist perspective on research ethics. Thousand Oaks, CA: Sage. Fetterman, D. M., and Vandersman, A. (2011). Empowerment evaluation principles in practice. New York: Guilford Press. Gardner, E. M., McLees, M. P., Steiner, J. F., Del Rio, C., and Burman, W. J. (2013). 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