MOJ ISSN: 2379-6383MOJPH

Public Health
Public Policy
Volume 2 Issue 6 - 2015
Combating HIV/AIDS through an Integrative Approach to Curb, Control and Ultimately Eradicate the Disease
Anna Scrimenti*
Georgetown University, USA
Received: October 19, 2015 | Published: November 30, 2015
*Corresponding author: Anna Scrimenti, Georgetown University, 37th and O Sts NW Washington, DC 20057, USA, Tel: 2025916959; Email:
Citation: Scrimenti A (2015) Combating HIV/AIDS through an Integrative Approach to Curb, Control and Ultimately Eradicate the Disease. MOJ Public Health 2(6): 00046. DOI: 10.15406/mojph.2015.02.00046

Abbreviations

HIV: Human Immunodeficiency Virus; AIDS: Acquired Immune Deficiency Syndrome; UMC: United Medical Center; CDCP: Center for Disease Control and Prevention; DOH: Department of Health

Introduction

Human Immunodeficiency Virus (HIV) along with Acquired Immune Deficiency Syndrome (AIDS) remains a public health problem in the United States. The current rates of these diseases are uncharacteristically high in certain regions of the nation, probing state and federal officials alike to create measures promoting the education of HIV/AIDS, while ensuring sustainable, affordable and available treatments to individuals living with HIV/AIDS [1]​. This arduous task can be achieved through regional and local programs, which target specific, high-risk populations. At present, underserved communities are not receiving reliable education or treatment of HIV/AIDS [2-5]. ​Moreover, even with decreased deaths from HIV, transmission of this disease and the number of new cases continue to rise, posing a continual public health threat, especially to high-risk communities [6-9]. ​In order to stop the spread and reduce new cases of HIV/AIDS in the United States, education and basic, minimum health care needs must be addressed.

The most affected states are those in the South and the Northeast, which boast the highest rate of HIV/AIDS in the U.S. [10]. Two metropolitan areas located within these regions are Washington, D.C. and Baton Rouge, L.A. Unfortunately; these two American cities have perpetually high rates of HIV/AIDS [11]. The nation’s Capitol embarrassingly possesses a rate higher than some sub-Saharan African countries, while Baton Rouge is leading the U.S. in new AIDS cases per year [9]. Both metropolitan areas ​ seem to serve as clusters for disease. Due to the nature of HIV, which is not only asymptomatic in beginning stages, but also remains dormant for several years, it allows significant disease progression to go undetected [2,10]​. As a result, thousands of infected individuals are unaware they have the disease [2]. Therefore, populations with high numbers of HIV positive individuals living in isolated communities, must be taught properly and treated efficiently and quickly in order to control the HIV epidemic in the U.S. [6]. However, a commonality seen amongst health disparity populations is the inefficient (or non-existent) participation in education, health care, or both [5]. Early detection and treatment are vital to containment, yet if cooperation is lacking, HIV/AIDS will continue to spread. It has been determined that within health disparity populations, several factors such as: environment, socioeconomic status, race, ethnicity, gender, sex and stigma, contribute significantly to the mentality [9,10] and reasoning of individuals who do not consistently seek treatment for HIV/AIDS. The daily inadequacies faced by health disparity populations, dramatically exacerbates problems for individuals seeking HIV/AIDS education or treatment [2].

The health disparities found in Washington, D.C. and Baton Rouge, L.A. are partially responsible for the consistently high disease rates of HIV/AIDS [9]. Although technological and medicinal advances have drastically improved the lives of HIV positive patients, the number of newly diagnosed HIV cases continues to remain at a high level in Washington, D.C [5]. ​The HIV rate in Washington, D.C. is the highest in the United States [9]. In D.C., African Americans over the age of 12 make up 46% of the District population. Within this population, 75% of individuals are living with HIV. Furthermore, HIV positive women that live in Washington, D.C. are at high risk. African-American women living with HIV in D.C., make up 34% of the HIV positive population. Taking solely female cases of the HIV positive population in Washington, D.C., African-American women account for 92.4 percent [5].

Yet the highest risk populations in the District are men between 40-49 years of age and black males. They hold the distinction of having the highest rates of HIV in Washington, D.C. [6]. ​The majority of HIV/AIDS cases arise in Ward Eight of Washington, D.C [5]. ​This location, as all wards in​ the District, have drastically different socio-demographics. Within Ward Eight, large health disparities exist [5]. ​For example, higher poverty rates of this ward reduce the chances for available and adequate health care [6]. ​As a result, residents of Ward Eight do not seek treatment [9]. ​By doing so, this increases the chances that HIV will continue to go undetected, enabling it to spread drastically throughout this population [5].​ Ward Eight already has higher incidence and prevalence rates of HIV/AIDS than anywhere else in the District. In 2009, 3.1% of Ward Eight residents were HIV positive. Although this percentage itself does not seem large, it accounts for approximately 2,200 people out of 70, 7012 residents [6].

Additionally, the lack of health care access in Ward Eight is far from being solved. With only one hospital east of the Anacostia River, this population has hardly anywhere to turn for proper, available and adequate health care. For example, over the past 13 years, United Medical Center (UMC) has held a consistent occupancy rate of 70-75%. With a capacity of 234 beds, UMC cannot adequately take care of 70,000 residents, especially when there are only 59-70 beds truly available on any given day or night [5].

The D.C. Department of Health (D.C. DOH) is trying to improve the current treatment options for their residents. Yet, there is only one Sexual Health clinic located somewhat close to this area. The DC DOH offers testing and treatment for HIV/AIDS, yet limited hours and long lines tend to deter an already skeptical population from receiving care. HAHSTA, a division of the DC DOH is attempting to take the appropriate measure and most effective approaches to encourage individuals to seek treatment. Through the implementation of hands-on educational seminars, which provide screenings, local high school students in Washington, D.C. can bring about a much-needed change for their communities. Success of these programs relies not only on their Implementation, but also on the cooperation, active participation of community members [6].

Faced with a similar problem, Louisiana has the fourth highest rate of HIV in the U.S [5,10]. ​Even with antiretroviral medications, AIDS is still quite prevalent in the United States [2]. ​Baton Rouge, in particular, must take on the challenge of consistent and continual treatment of HIV, because it leads the nations with the highest number of new AIDS cases in the U.S. Furthermore, approximately 55% of HIV positive cases in Louisiana have an AIDS diagnosis [2]. ​It therefore comes as no surprise that the south accounted for nearly half (45%), of the nation’s new AIDS cases in 2010 [5,9].

New Orleans and Baton Rouge are located in State Regions I and II, respectively. Neither of these regions has HIV services readily available from the state [2]. People must travel to a neighboring region in order receive services provided by the state. Again, due to health disparity populations, it is extremely difficult for an individual to seek treatment within her own neighborhood [2]. ​Consequently, many individuals do not even attempt to seek treatment. Without access to proper care, the first step (actually physically attaining treatment) will not be achieved. An even larger burden is then placed on individuals within the community, for, how is it possible to sustain treatment if one does not seek it? As a last resort, the state utilizes funds from the Ryan White HIV/AIDS Treatment Modernization Act in order to treat HIV patients living in Regions I and II. ​However, these funds do not guarantee an adequate and available health care for populations suffering from health disparities.

Regions I and II are very similar to Ward Eight in Washington, D.C., in that resources for HIV/AIDS patients are far and few between. One can easily see how health disparities are a determining factor for specific populations. Nationally, the U.S. has seen overall decreases of deaths due to HIV. ​From 2000 to 2010, HIV disease death rates have dropped significantly (about 70%) for both black and white men 25-44 years old. ​For older black men, aged 45-54, rates decreased by 53% and white males in this age range had a reduction of 34 percent. The Center for Disease Control and Prevention, (CDCP) also found an alarming difference between the HIV disease death rates for these ethnicities. ​During this decade, black men were at least six times more likely to die from HIV than white men. With the sustained treatment of HIV/AIDS through antiretroviral medication, mortality rates have decreased, however to reduce the overall rates, incidence, and prevalence of HIV/AIDS in the United States, there are still several steps necessary to decrease the overall rate of HIV/AIDS and to improve access to care for patients nationally.

References

  1. ​HIV​ surveillance report (2010) Center for Disease Control and Prevention.
  2. Center for Disease Control and Prevention (2012).
  3. HIV direct services (2012) Department of Health & Hospitals. Baton Rouge: State of Louisiana.
  4. Basic​ information about HIV/AIDS (2012) Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. Center for Disease Control and Prevention.
  5. Annual report 2011 department of health HIV/AIDS, hepatitis, STD, and TB epidemiology in the District of Columbia (2011). Government of the District of Columbia, Department of Health, Government of theDistrict of Columbia Department of Health.
  6. Gresenz CR (2009) Health & health care in the district of Columbia [Community Demographics and Access to Health Care among U.S. Hispanics]. ​ Health Serv Res 44​(5p1): 1542-1562.
  7. Louisiana HIV/AIDS facts(Factsheet) (2013) Louisiana Public Health Institute.
  8. Georgetown working to reduce health disparities (2012) Georgetown University Medical Center.
  9. Wallington S (2012) Addressing racial and ethnic disparities in HPV knowledge awareness and vaccine uptake. Washington, Georgetown University Medical Center.
  10. Center for Disease Control and Prevention, Vital statistics data (2012) National Center for Health Statistics.
  11. ​ Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (2014) ​Center for Disease Control and Preventio
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