HIV Health Problem in the United States - Essay Example

HIV in United States Name Institution Abstract This paper is written with the aim of providing a detailed look at the HIV status in the United States of America. The paper features an overview of the HIV problem in the country which mainly features the severity of the problem, the number of people affected by HIV infections and proposed bill regarding HIV in the United States. The paper also provides an overview of the bill with regards to the specific provision in it, what the bill will do and the stakeholders who will be affected by the bill being passed. Also the promises and the expected outcome of the bills on health. The paper will also take a look at the parties and groups who are opposed to the bill and provide a look at the efforts they are making in order to ensure that the bill does not go through. Unintended consequences and any negative impact that could arise from the passage of the bill will also be looked at. Overview of the HIV Health Problem Basing on the latest statistics provided by the Centers for Disease Control, it is estimated that more than 1.2 million people in the United States have been infected with HIV and an eighth of these infected population do not know that they actually have the disease. Most of the infected persons are bisexual and gay men – the young African American bisexual and gay men to be more specific. The statistics also indicate that the number of new persons being infected by HIV every year has reduced by 19%[HIV16]. To break down the statistics and be more particular, 83% of all males who were found to have HIV in the United States were bisexual and gay men, the black bisexual, and gay men being the most. Women account for about 19% of the infected population. The infection in the female gender is highly attributed to their interactions with heterosexual men or use of injection drugs. The diagnosis among women recorded a 40% decline, and 35% decline among the heterosexuals. The Latinos and the African Americans are the most infected in the United States despite them accounting for a smaller percentage of the entire United States population. Looking at the statistics of the persons infected basing on age, majority of the infected persons are aged between 20 and 29 years while the age brackets with the least infections being of between 13-19 years and those over 60 years who account for 4% of the total number of infected persons each[HIV16]. Severity of the HIV Health Problem The United States has been hit by the HIV menace the hardest among the developed countries in the world. More people have died of HIV in the United States as compared to Germany which also has big cities, gay men and sex workers[Mic16]. Apart from the huge number of gay men in the United States, the other major factor that has contributed to the spread of then disease among the member of the American population is the clustering of the high-risk population. The United States has a significantly higher number of people as compared to other European countries, more mobility that in turn results in a higher number of gay men, heterosexuals, and intravenous drug users. The intravenous drug use and policies that had been set against it have played a great role in promoting the spread of new infections. The United States, unlike its developed counterparts in Europe, declined to allocate funds for needle exchange and to fund research into their effectiveness. The Federal funding was banned by US politicians, arguing that that is another way of encouraging drugs to find a way to the communities[Mic16]. The HIV transmission patterns have taken on a shift over the years. Most infections occur through sexual interaction between men. This number accounted for 63% of the infections in 2010. Heterosexual sex has also been a huge contributor to the spread of the disease accounting for 25% of the Infections in 2010. Infections that occur as a result of intravenous infections, on the other hand, recorded a significant decline, accounting for only 8% of the total infections basing on the statistics conducted in 2010[The161]. Ten of then forty five American states accounted for approximately two-thirds of the entire HIV diagnosis in the United States in 2011. The 81% of infected persons were based in the large metropolitan areas, the top cities being Los Angeles, Miami, and New York. Young adults and teenagers below 35 years of age accounted for 56% of all new HIV infections in 2010[The161]. Mostly is the black and Latinos who account for a greater number in this portion. The same is reflected when a comparison of the infections based on gender and sexual orientation is made. The United States government has made huge efforts aimed at curbing the prevalence of the HIV disease. In 2014, it allocated a total of $29.5 billion to combat the disease with funds being meant for providing care, assistance in terms of cash and housing, prevention and research. It also initiated programs aimed at providing health insurance coverage, support, and care for persons infected with HIV in the United States. Federal and state-supported services aimed at preventing the spread of HIV infections were also initiated in community organizations and local health departments. A National HIV/AIDS strategy was released in July 2010 with the goal of reducing the number of new infections, increase care access and health outcomes and reduce health disparities that are related to HIV. In 2013, President Barrack Obama ordered the establishment of HIV Care Continuum Initiative, and also outline recommendations and mark progress made by the initiative towards the goals set[The161]. These efforts have played a great role reducing the number of new HIV cases recorded. It has also granted the infected persons an opportunity to access better health care and support services, hence being able to lead normal lives. If these efforts would not have been made, then the statistics would indicate a worsening situation as the risk of new infections would have been significantly increased. The number of deaths resulting from HIV would also record a significant rise. HIV Bill and its Specific Provisions The Sacramento, California lawmakers passed and emergency bill SB-1408 in May that allowed for a man who is HIV positive to get organ transplants from a second party before it becomes highly risky. The federal government had also authorized HIV-infected organ transplants to persons who are already infected with HIV earlier in February courtesy of HIV Organ Policy Equity (HOPE) Act PL 11-51 that had been introduced to the two housed of congress, with President Barrack Obama signing the legislation back in the year 2013. The Human and Health Services department approved the safety regulations for this procedure. The bill was sponsored by Barbara Lee as the second iteration of the REPEAL HIV Discrimination Act aimed at modernizing laws and eradicate the discrimination of people who are infected with HIV among other purposes. This, however, still remained illegal under the laws of California state[htt16]. With the passage of the bill, HIV patients in California who are willing to receive organ transplants from persons either living or deceased with HIV. Also, the wait time for one to receive an organ transplant could be significantly reduced from years to possibly 6 or even a shorter period. One of the four United States hospitals that have been authorized to perform HIV-infected organ transplants is that of The University of California, San Francisco Medical Center. As per May 28, 2016, there were 65 patients who had the HIV virus waiting in line for liver or kidney transplants[htt16]. Promises and Expected Outcomes from the Bill In the United States, an estimated 121000 persons are in line waiting for organ transplant. The Santa Monica Democrat senator, Ben Allen who was the person who wrote the SB-1408 bill for the state of California stated that the legislation was going to save many lives in the coming months and years. That was also among the benefits the bill passed by the houses of congress hoped to accomplish. Other benefits that were expected to be drawn courtesy of the HIV Organ Policy Equity Act PL 113-51 being passed by the houses of congress were an expected 1000 lives being saved every year and saving of taxpayers money. It was estimated that the enactment of the bill would save the taxpayers $500000 Medicare savings for every patient who undergoes the organ transplant procedure. Also, the bill provides a chance to more patients infected with HIV to be referred to life-saving transplants without being a cause for more burden to those patients who are already waiting for a transplant[HIV161]. Problems and Unintended Consequences Arising from Passage of the Bill In as much as the SB-1408 bill is expected to yield some positive outcomes, there are several limitations that come with the bill. The field of organ transplants involving HIV-infected persons has not had extensive research done on it. It is not until February of 2016 that the first successful HIV-infected transplant was successfully conducted at John Hopkins Hospital[Ela16]. However, from the knowledge and resources that are available at the moment, the true risk that comes with using organs from persons and donors who are infected with the HIV is still yet to be established. There is a great need for better understanding of the risks of superinfection - a new infection that occurs in a patient who already has a preexisting HIV infection[Med16]. There is also the limitation of the kind of organs that can be transplanted. The current statistics indicate that more than 80 percent of HIV patients in line waiting for organ transplants are waiting for either liver transplants or kidney transplants[Med16]. In as much as kidney failure and liver failure are the main causes of mortality and morbidity in patients who have been infected with the HIV disease, failure of other body organs as a result of the infection can also lead to diseases. Cardiovascular disease has also emerged to be among the leading causes of deaths among persons who have the HIV infection. In the case of an urgent situation, the provisions of the act allow for organs from HIV-infected individuals to be transplanted to uninfected individuals. In as much as this is aimed at saving the life of the individual in subject, it promotes and raises the risk of the uninfected person being infected with HIV. This is one of the downsides of the Act. Recommendations The SB-1408 bill and the HOPE Act PL 113-51 as they are at the moment provides a chance for HIV-infected individuals to live longer lives. The time period in which one has to wait for organ transplants has also been significantly reduced curtesy of the bill and the HOPE Act. In order to achieve even greater strides towards achieving the goals envisioned when the bill was created, amendments to the bill should be done to include a clause touching on the research aspect of HIV-infected organ transplants to broaden the kind of organ transplants that can be conducted. At the moment, the number of organ transplants that can be carried out among HIV infected individuals is in some way limited since the mortality and morbidity causes are not only limited to failure of the common liver and kidney failures. It is also clear that the risk of superinfection has not been fully examined. More research needs to be conducted to fully evaluate the full risks that come with conducting organ transplants among HIV-infected persons. The bill could review the aspect of budget allocations for HIV research and have the set amount increased to promote further studies research with regards to HIV-infected organ transplants. The clause on organ transplant involving no infected persons receiving organ transplants from HIV-infected persons should also be reviewed and strengthened further. This will go a long way in ensuring that the persons who are not infected with HIV are at minimal risk of being infected as a result of the transfer. References HIV16: , (HIV in the United States: At A Glance, 2016), Mic16: , (Hobbes, 2016), The161: , (The HIV/AIDS Epidemic in the United States, 2016), htt16: , (California lawmakers quickly pass emergency HIV-organ transplant bill, 2016), HIV161: , (HIV Positive Organ Donation and Transplantation, 2016), Ela16: , (Mendus, 2016), Med16: , (Medical and Transplant Information, 2016), Read More