Epidemiologic Analysis and Preventing the Spread of Human Immunodeficiency Virus (HIV) Human Immunodeficiency Virus (HIV) perspective

In the decade since the human immunodeficiency virus (HIV) was discovered, the epidemic has grown steadily each year. According to the Global Health Council (2006) by 2005, the number of those infected has grown to more than 40 million, double the number in 1995. By the end of 2005, 40.3 million people were living with HIV/AIDS world wide, including 17.5 million women and 2.3 million children under the age of 15. Without prevention efforts, 35% of children born to an HIV positive mother will become infected with HIV. San Francisco std testing At least a quarter of newborns infected with HIV die before age one, and up to 60% will die before reaching their second birthdays. World-wide, only one in ten persons infected with HIV has been tested and knows his/her HIV status (Global Health Council, 2006). As the HIV/AIDS epidemic in the United States has progressed, strategies that are associated with the prevention, treatment and monitoring of the disease are important in controlling the spread of the epidemic. Epidemiology plays an important role in decision making strategies by monitoring data which can give insights into the infection rates of HIV in various segments of the population. The uses of epidemiologic data is crucial in the surveillance of the decrease in overall HIV incidence, the substantial increase in survival after AIDS diagnosis and the continued disparities among racial/ethnic minority populations. This paper will discuss the role and uses of epidemiologic data relating to HIV evolution, definition and refinement of a disease management programs. Disease management of HIV According to Wright (2005) the number of Americans living with HIV who are over 45 years old grew by 60 percent between 1999and 2002. The epidemic aging is a sign of success: "We have learned how to keep people alive with HIV. As individuals grow old with HIV, the treatment for the virus will begin to collide with treatment for a host of other health concerns that plague aging individuals. There are about 20 antiretroviral drugs available in the U.S. to stop the loss of natural defenses in HIV infection. What is so troubling for individuals with HIV/AIDS is that protease inhibitors are associated with diabetes, heart disease liver and kidney disorders (Wright, 2005). Epidemiologic analyses/data in a hospital setting can be use to identifying these disorders in the population that are a result of the treatment of HIV/AIDS. The use of epidemiologic data can lead to a more effective care planning for individuals that will be effected by the prolong uses of antiretroviral medication. HIV/AIDS surveillance According to Fos and Fine (2005) most healthcare organizations have in place surveillance programs charged with the responsibility to monitor key indictors, such as infection rates. The focus of these surveillances is to target infections that are frequent and preventable, and that generate high treatment cost or serious effects on either morbidity or mortality (Fos and Fine, 2005 p.167). Organizations that seek to prevent HIV infection must utilize HIV surveillance to provide timely and accurate data that is relevant to the ever changing demographic, cultural and social economic spectrum of HIV/AIDS disease.

The Centers for Disease Control and Prevention (2006) indicate the HIV epidemic has continued to expand in the United States; at the end of 2003, approximately 1,039,000--1,185,000 persons in the United States were living with HIV/AIDS, an estimated 24%--27% of whom were unaware of their infection. In the United States there are an estimated 252,000--312,000 persons unaware that they are infected with HIV and, therefore, are unaware of their risk for HIV transmission. Analysis of data collected by the National HIV Behavioral Surveillance System, which surveys populations at high risk for HIV to assess prevalence and trends in risk behavior, HIV testing, and use of prevention services, revealed that of at risk population surveyed in five U.S. cities, 25% were infected with HIV and of those, 48% were unaware of their infection (Center for Disease Control and Prevention, 2006). These results underscore the need to increase HIV testing and prevention efforts among populations at high risk. With in a hospital or community-based health care setting primary prevention is vital in the efforts to stop the spread of HIV/AIDS. The Center for Disease Control and Prevention (2006) indicates early studies of HIV counseling and testing observed considerable reductions in risk among persons who learned that they were HIV seropositive. A shift in client-centered counseling that emphasized increasing the client's perception of risk and developing a personalized risk-reduction plan substantially increased condom use and decreased new sexually transmitted diseases (STDs) among HIVseronegative patients at STD clinics (Center for Disease Control and Prevention, 2006). Since the HIV/AIDS epidemic was first recognized, there has been geographic clustering of AIDS cases with the United States. Morse, Lessner, Medvesky, Glebatis and Novick (1991) suggest clustering is related to pools of HIV infected individuals and to risk behavior activities which occur most frequently in metropolitan areas and states with large populations at risk. Identification of geographic clusters of cases can be useful in focusing preventive efforts and allocation of health care resources (Morse et. Al, 1991). std testing San Francisco Epidemiologic surveys Surveys often provide reliable, in-depth, population based data on specific groups. According to Whitmore, Zaidi, and Dean (2005) epidemiologic surveys may be cohort, case control, longitudinal, or cross sectional studies. These studies are not considered a part of routine public health surveillance but help health care decision-makers identify populations at greater risk for HIV infection (Whitmore, Zaidi, & Dean, 2005). The unique feature about an epidemiologic survey is the collection of data comes directly for the population. This information can be compared to other collected epidemiological data such demographic or geographic indicators to provide a descriptive evaluation of morbidity and risk in the community. The inclusion of multiple data sources using epidemiologic information enables planners in hospitals to know the strengths and limitations of the services provided.