I. Description of the Health Issue
Acquired immunodeficiency syndrome (AIDS) can be considered to be one of the most prevalent health and social problem that the world is facing now. This infection spreads because infected people do not tend to take precautions and safety measures seriously or because of badly organized health services. This study aims to determine the problems that HIV/AIDS patients go through and to bring forward some programs that are generated to cater to their needs.
The United Kingdom, however, has a comparatively small population of people with HIV which can be estimated to be 100,600 people in 2017 but the small number might indicate the decrease in diagnosis among gay or bisexual men (Mayer et al, 2018). HIV has a tremendous impact on the health of an individual as once it enters the body, it Directly attacks the immune system. The speed of progression of the virus depends upon the age, overall health, and the diagnosis of an individual. HIV tends to target the type of cells that under normal circumstances would fight off this invader. But after the virus replicates, it damages the infected CD4+ cell and thereby continues to produce more viruses to infect more of these cells. Without proper treatment, the cycle will continue until the individual's immune system is severely compromised posing a threat to your body and inviting other illnesses. In the beginning, the symptoms are usually mild but after one or two months the individual may face a flu-like sickness for a few weeks. This is often referred to as the first stage and is termed as “Acute infection Stage”. Other acute symptoms may include fever, chills, night sweats, diarrhoea, headaches, muscle aches, sore throat, swollen lymph glands, etc. The next stage is termed as Clinical Latent Infection state which lasts from 8 to 10 years or longer in some cases (DiClemente & Patel 2016). As the virus spreads, the CD4+ count keeps on decreasing considerably. This leads to symptoms like fatigue, cough, cold, fever, weight loss, etc. HIV also makes the body more prone to influenza, pneumonia, pulmonary arterial hypertension, and tuberculosis. Also, other common infections related to HIV are oral thrush and oral hairy leukoplakia. There are various neurological complications related to AIDS. It causes associated dementia or AIDS dementia complex which acutely affects cognitive function along with memory impairment, anxiety, and severe depression. HIV can most likely make an individual prone to skin conditions like eczema, seborrheic dermatitis, scabies, and skin cancer.
II. Selection and Analysis of Program Services
HIV Prevention Programmes are interventions that focus on stopping the transmission of HIV. They are put into action to both protect an individual and the community. In the beginning HIV prevention programs primarily aimed at preventing the sexual transmission of HIV (Brown et al, 2018). For several years the ABC approach (Abstinence, Be Faithful, Use a condom) was put into action because of the growth of this epidemic in sub-Saharan Africa. Similarly, HIV prevention in England is the national HIV prevention program for England. it’s based on HIV prevention and works with UK based Afro-American people along with gay men/ MSM. It helps campaigns, online services, local meetings, and policy work and works in collaboration with NHS clinics, local authorities, and Public Health England. HPE is funded by the Nation and Public Health England and is a part of Terrence Higgins Trust. Its goal is to increase HIV testing, promotion of condom use, promotion of other biomedical HIV interventions, raising awareness of the role of STIs, and reducing the level of HIV related stigma (Mayer, K. H., Chan, P. A., Patel, R., Flash, C. A., & Krakower, D. S. (2018). The positive side of the program is its social marketing approach, system leadership development, a high number of briefings every year, local activation, sector development, and lastly good monitoring.
AHF UK gives anonymous, instant HIV tests in areas of Croydon, south London, with the help of its testing site. AHF UK also collaborates with local health care services, community organizations, and small businesses that help in offering HIV and sexual health information, free condoms, free testing, etc. However, the AHF UK program doesn’t provide treatment to people already affected with HIV but AHF works closely with NHS and other community providers to help people diagnosed with HIV into treatment and support services.
Several United States government agencies have united in the effort of turning the tide against HIV/AIDS. They work in coordination with PEPFAR. The U.S Global AIDS Coordinator is answerable to the Secretary of the State only. Also, the Joint United Nations Programme on HIV/AIDS works towards stopping the spread of new HIV infections, ensures that everyone has the access to its treatment, helps in promoting human rights, and helps in inspiring the world to achieve its goal of zero HIV infections (Medlock et al, 2017).
These programs have various strengths and they strongly encourage that all HIV/AIDS programming should be up to date. They help in spreading valuable information about HIV to the citizens of the state. They acknowledge the communities that are especially impacted by HIV and therefore focus more on those areas. These programs and treatments are affordable and accessible (Levi et al, 2016). However certain problems like the design deficiencies lead to early termination of certain trials because of inadequate and poor research before the trial begins, bad site preparation, poor community engagement. Low participation rate acts as a hurdle in the success of these preventive programs which thereby leads to low knowledge about HIV and poor rates of diagnosis.
III. The future of HIV/AIDS
In 2015, UNAIDS prepared a target to end AIDS as an epidemic by 2030 and aimed that no child will be born with HIV and any person already infected will receive treatment. It was noticed that the most common route of transmission of the infection was through sex and sharing needles but this can now be reduced to a great extent with antiretroviral medicines. In the year 2016 in the UK, four healthcare centers saw a 40% decrease in new HIV infections among gay men. There exist hopes to have a cure for HIV and the leading strategy that is recommended to be followed is ‘kick and kill’; which aims to kick HIV out of cells and then kill the virus. Many researchers and doctors are of the view that the strategy of testing, treating, and preventing is the right way to end this epidemic because we have the tools, the drugs, and the tests and if we push these resources, we will be able to control it.
For local services, the directors of public health and HIV clinicians should get together for ensuring efficient system leadership to acquire stakeholders for the development of future HIV services. Local HIV services should then develop a good relationship with other services for patients with long-term conditions like cancer to come together and promote mutual learning.
For National bodies, firstly the Department of Health should update the pre-existing framework for sexual health and offer an overall Strategic direction. After collaboration with NHS England, action should be taken to eradicate the stigma that is associated with HIV and increase its awareness in public. It must also ensure that the fixed roles of the Department, NHS England, and Public Health England concerning HIV are clear. The Health Education England should try to engage with HIV services with the help of its regional offices and make sure that workforce implications, development requirements, and chances for innovation across local authorities are identified.