NURS3008 Community Health Nursing
Question:
Give a summary of access problems for at risk populations
Discuss the community nursing roles in promoting access to health services for key populations at risk of exposure to HIV (men who have sex with men, IV drug users, sex workers, people in prisons, transgender people) to reduce their risk of exposure to HIV.
Answer:
Introduction:
The prevalence of HIV, AIDS and sexually transmitted diseases are on the hike in and around the remote areas (Liamputtong, 2015, p.27). This could be primarily because of the major lacuna in spreading effective education and awareness about the fatal effect of HIV and the negative response it is capable of eliciting in the body (Connell, Crawford, Dowsett & Kippax, 2013, p. 47). It should also be crucially noted that the lack of education and awareness in this field have been correlated with the reduced access to health care facilities and avenues in order to combat the infections interlinked with the infections and disorder. It is extremely important to substantially make the general public aware about the HIV infection and the manner in which it can possibly be transmitted from one body to another (Campbell et al., 2013, p. 120). This essay would deal with the factors that are responsible for causing disorders pertaining to improper maintenance of sexual hygiene such as HIV and AIDS. It would also focus on the role that the community nurses could play in order to ease the access of community health care facilities and effectively reduce the ill effect of the infectious disorders.
Discussion:
In order to maintain health and wellness of a concerned proportion of population, it is vital to ensure that the population has adequate access to the health care facilities (White, 2015). Access to healthcare not only helps in the reduction of the incidence of the infectious disease but also ensures prevention of premature death and at the same time helps in devising prevention and managing the symptoms of the disease (WHO, 2016). Scientific papers have revealed that there are three most important aspects that must be considered while providing access to health care facilities across a wide range of population (Chang et al., 2013, p. 880). The three vital components have been enlisted as, medical claim and insurance coverage, accessibility to medical health facilities and the time frame that must be considered in order to promote speedy recovery (White, 2015). Access to health care can thus be defined as the potential and timely utilisation of personal medical services available so as to attain positive health outcome and maintain complete wellness. Access to health care is important in order to stay away from the negative impact of infection and can be achieved in a step wise manner (Allender et al., 2013, p. 70).
The negative impact of not having ease of access to the health care facilities can be defined as the social barriers associated that hinder the accessibility (Frieden, Foti & Mermin, 2015). Some of the social barriers that can be enlisted would include, high expenditure involved with care, unavailability of insurance coverage, major lacuna in the providence of facilities and lack of professionals trained in cultural competency to deal with the clients belonging to diverse cultural background (White, 2015,p.105). Literary evidences have revealed that sexually transmitted diseases have been categorised as the most widely spread form of infectious disease that affect people belonging to the remote areas of the city (Shannon et al., 2015,p. 58).
HIV can be defines as the ‘Human Immuno-deficiency Virus’ that has been categorised as a subgroup of retro virus that is primarily responsible for causing a detrimental auto immune disorder known as the acquired immuno-deficiency disorder, most commonly known as AIDS. Sexual transmission has been listed as the common subtype of transmitting the infection. Once the virus affects the system of the body, it is estimated that within a time period of a minimum 9 to 11 years the auto immune capacity of the body is destroyed and the body becomes easily susceptible to any form of infection (WHO, 2016). Typically, it has been stated that the infected body elicits poor immunological response or supressed immunological response to allergies and petty cold and flu infections. Statistical evidences have significantly pointed out that the most widespread form of sexually transmitted disease is AIDS (Karrigan et al., 2015, p.183). It has also been stated that the major affected population group is the community of sex workers and drug IV users. On delving deeper into the root cause of the hike in the incidence of AIDS among the sex workers it has been discovered that there is a major problem associated with the maintenance of sexual health practice among the sex workers (Lim, Brown & Jones, 2013, p.199). The frequency of unprotected sex and not utilising methods of contraception can be considered as the factors that make this set of population vulnerable to develop the infection (Williams et al., 2013, p. 488). The social determinants such as the lack of awareness connected with maintaining sexual hygiene, regular use of contraceptives, indulging in unprotected sex, improper sanitation facilities and poor social income have also been tightly linked with the cause of infection (Wu & Li, 2013,p.40). In addition, it can also be stated that the proportion of population, primarily the adolescence group engaging in drug IV abuse, use infected needles to inject the drug intravenously inside the body. The main scientific explanation that has been delivered in this regard is basically the manner in which the drug abusers use the similar needle to inject drug inside the body. The needle might be in contact with the blood of a HIV positive patient and blood being the universal carrier has the potential to carry the infection from the body of a HIV infected patient to a normal and healthy patient and disrupt the autoimmune mechanism of the healthy body and weaken the antibody expression. The common use of syringes contaminated with the infected blood of the HIV patient leads to an increased risk of introducing the infection in a healthy person and continue the transmission at a rapid rate. Hence, it should be ensured on a mandatory basis that the contaminated syringes are not reused by the people without sterilising and proper washing. Research studies have stated that the use of the same needles must not be entertained at any cost between two or more individuals even after proper cleansing and sterilisation. The common standardised method that has been internationally prescribed in order to avoid the transmission of infection through contaminated syringes is to use disposable syringes that are disposed-off immediately after administering the injection (Sajadi et al., 2013). This reduces the probability of any possible transmission procedure of the infection into the body of a healthy living being. HIV has been widely reported to be transmitted with the help of body fluids, hence any form of activity that involves the exchange of body fluids has been highlighted as risk involving activities that lead to the development of the infectious disease. For instance, involving in sexual intercourse involves the exchange of body-fluids or genital lubricants that possess the infectious unit of the viruses and invade a healthy immune system of a normal person and leads to infection. The exchange of blood through needles and syringes also witness the exchange of body fluid between a HIV infected person and a normal healthy adult. The transmission of the infection can be prevented by educating people about the concept of safe sex. A common myth associated with safe sex includes the notion of avoiding pregnancy. However the idea of ‘safe sex’ is the prevention of infection which could be achieved by the use of condoms and dental dams. The responsibility of imparting education and awareness about the disastrous effect of HIV and other sexually transmissible diseases primarily relies with the community nursing professionals (Van Boekel et al., 2013, p. 24).
The community nursing professionals are a group of nursing professionals who are entrusted with the responsibility of reducing the incidence and prevalence of sexually transmissible diseases with the help of education and empowerment. In addition to this, the community nursing professionals must also be able to effectively analyse the epidemiological data and population trend in order to understand the incidence of STIs in a set of population and correlate it with the causative agents that can be held responsible for the transmission of the infection. The key populations that have been compared in the essay include the proportion of sex workers and young adolescent population engaging in unfair and illegal drug abuse practices (Guzys, Brown, Halcomb & Whitehead, 2017,p.88). The affected proportion of population is not only restricted to these sub groups but extend to other category of people such as members belonging to the homosexual community especially in cases when men are involved with men and members belonging to the transgender community. Scientific studies have also found the prevalence of AIDS in people who are convicted and have been in isolation imprisoned for a long period of time also develop the disease (Gunthard et al., 2016). A primary reason that has been associated with the advent of the disease in the convicts is the minimal exposure to the outside world that does not include the provision to include hygienic measure to lead a healthy life style (Guzys, Brown, Halcomb & Whitehead, 2017,p.118). Primarily it has been witnessed that the scenario of sexually transmitted diseases and associated poor sexual hygiene is a common phenomenon in the developing countries.
Nursing interventions that could be undertaken in order to spread awareness about the fatal implications and consequences of the disease could include imparting education about the disease and an elaborate explanation related to the cycle in which the disease transmits itself from an infected individual to a healthy individual. The education could be dispensed with the use of informative brochures and leaflets at schools and offices and inclusion of compulsory and free of cost HIV testing to identify the proportion of the vulnerable victims (Zanoni & Mayer, 2014,p.129). The community nursing professionals could effectively deliver information about the manner in which the risks involved with the infection can be avoided and also popularise the use of infection transmission barriers such as condoms for men and dental dams for women (Frieden, Foti & Mermin, 2015). While condoms form an effective rubber covering to the penis that ejaculates and carries the virus, dental dams and condoms for women can also be used (Guzys, Brown, Halcomb & Whitehead, 2017,p.119). It is also pivotal to spread awareness about the options that could be undertaken in case an individual tests positive for AIDS (Guzys, Brown, Halcomb & Whitehead, 2017,p.115). A major issue that has been related to the prevalence of the disease is the associated societal stigma and the perceptions of the society towards individuals who test positive. A stigmatized approach of the professional workers towards the patient have also been recorded in the literatures. Hence, professionals through effective training must make the common people aware about the myths associated with the disease and the burst the superstitions such as the disease could spread if an infected person shakes hands or sits next to a healthy person (Guzys, Brown, Halcomb & Whitehead, 2017,p.121). It should be evaluated that testing positive for HIV in itself is a major challenge and brings with itself a wide range of obstacles in personal as well as the professional field (Shannon et al., 2013, p. 57). Hence, care should be taken so as to sympathise with the patients and counsel them so that they are able to avail the facilities available in favour of the treatment and deal with the complications. Counselling can be conducted in a synchronised step-wise manner where in the nursing professionals could take down the details of the sexual history of the affected patient (Guzys, Brown, Halcomb & Whitehead, 2017,p.111). This would help in reaching out to the people who are at a risk of developing the disease and this is known as the process of contact tracing. A thorough physical examination known as the ‘pap smear test’ helps in the detection of structural changes in cell types and the probability of developing cancer in women (Gunthard et al., 2016). This is done with the sample smear collected from the rectum, vagina and the cervix (Guzys, Brown, Halcomb & Whitehead, 2017,p.111). Urine tests and blood tests also help in the detection of HIV in patients, however the test is conducted after obtaining consent from the patients (Gunthard et al., 2016). Inclusion of sexual education to educate the elderly group of people and making them aware of the risk factors associated with STIs is equally important.
Conclusion:
Hence to conclude, it should be stated that a wide prevalence of sexually transmitted diseases such as HIV have been found to affect a major proportion of the population on a global scale. The major sect of population that is affected with the incidence of HIV has been recorded to be the members of the homosexual community, sex workers and young individuals engaging in drug abuse activities. It should be noted that so far the prevalence and the percentage of incidence have not been controlled because of the limited and restricted access to the public health care facilities. In addition a major set of societal myth and superstitions have also been tightly linked to the cause and consequences related with the disease. Therefore it can be said that the community nursing professionals can effectively play an important role in controlling the incidence rate of the disease and with the effective medium of education reduce the stigmatized belief of the society associated with the disease. Hence, it can only be expected that with the onset of effective implementation of training, awareness and education procedures the risk issues linked to the prevalence of the disease can be controlled to a considerable rate.
References:
Allender, J., Rector, C., Rector, C., & Warner, K. (2013). Community & public health nursing: Promoting the public’s health. Lippincott Williams & Wilkins, pp. 70
Campbell, C., Scott, K., Nhamo, M., Nyamukapa, C., Madanhire, C., Skovdal, M., … & Gregson, S. (2013). Social capital and HIV competent communities: the role of community groups in managing HIV/AIDS in rural Zimbabwe. AIDS care, 25(sup1), S114-S122.
Chang, L. W., Njie-Carr, V., Kalenge, S., Kelly, J. F., Bollinger, R. C., & Alamo-Talisuna, S. (2013). Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: a mixed methods study. AIDS care, 25(7), 874-880.
Connell, R. W., Crawford, J., Dowsett, G. W., & Kippax, S. (2013). Sustaining safe sex: Gay communities respond to AIDS. Routledge, pp. 47
Frieden, T. R., Foti, K. E., & Mermin, J. (2015). Applying public health principles to the HIV epidemic—how are we doing?.
Günthard, H. F., Saag, M. S., Benson, C. A., Del Rio, C., Eron, J. J., Gallant, J. E., … & Gandhi, R. T. (2016). Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2016 recommendations of the International Antiviral Society–USA panel. Jama, 316(2), 191-210.
Guzys, D., Brown, R., Halcomb, E., & Whitehead, D. (2017). An Introduction to Community and Primary Health Care. Cambridge University Press.
Kerrigan, D., Kennedy, C. E., Morgan-Thomas, R., Reza-Paul, S., Mwangi, P., Win, K. T., … & Butler, J. (2015). A community empowerment approach to the HIV response among sex workers: effectiveness, challenges, and considerations for implementation and scale-up. The Lancet, 385(9963), 172-185.
Liamputtong, P. (2015). Stigma, Discrimination and Living with HIV/AIDS. Springer, pp. 27
Lim, F. A., Brown, D. V., & Jones, H. (2013). Lesbian, gay, bisexual, and transgender health: fundamentals for nursing education. Journal of Nursing Education, 52(4), 198-203.
Sajadi, L., Mirzazadeh, A., Navadeh, S., Osooli, M., Khajehkazemi, R., Gouya, M. M., … & Haghdoost, A. A. (2013). HIV prevalence and related risk behaviours among female sex workers in Iran: results of the national biobehavioural survey, 2010. Sex Transm Infect, 89(Suppl 3), iii37-iii40.
Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., … & Boily, M. C. (2015). Global epidemiology of HIV among female sex workers: influence of structural determinants. The Lancet, 385(9962), 55-71.
Van Boekel, L. C., Brouwers, E. P., Van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug and alcohol dependence, 131(1-2), 23-35.
White, F. (2015). Primary health care and public health: foundations of universal health systems. Medical Principles and Practice, 24(2), 103-116.
Williams, A. B., Wang, H., Burgess, J., Li, X., & Danvers, K. (2013). Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China. International journal of nursing studies, 50(4), 487-494.
World Health Organization. (2016). Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations–2016 update. World Health Organization.
Wu, L., & Li, X. (2013). Community-based HIV/AIDS interventions to promote psychosocial well-being among people living with HIV/AIDS: a literature review. Health Psychology and Behavioral Medicine: An Open Access Journal, 1(1), 31-46.
Zanoni, B. C., & Mayer, K. H. (2014). The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. AIDS patient care and STDs, 28(3), 128-135.
Use the following coupon code :
SAVE10