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HIV/AIDS: Prevention, Control, Treatment
Human immunodeficiency virus (HIV) is a global issue that can have a negative impact on healthcare and social dynamics. It leads to the development of acquired immunodeficiency syndrome or AIDS, which emerged during the last decades of the 20th century. It is a major epidemiological disease that severely damages an individuals immune system. It can be manifested in a wide range of complications, such as malignant neoplasms or lesions. The given socio-medical problem is further complicated by the absence of effective medications that could protect or partly replace the immune systems functional dimension. Another major pitfall is the lack of HIV targeted vaccines that could help people build a certain degree of immunity to the viral agent.
Moreover, HIV/AIDS is a social problem that impacts a specific set of vulnerable population groups. The latter includes drug addicts, female sex workers, homosexual males, African American males, and neighborhoods with high levels of poverty indicators. Therefore, one should be aware that AIDS is not the sole issue of medical experts but also policy makers, sociologists, and economists. The current approach of combatting the spread of the AIDS epidemic is based on the notion of treatment as prevention. The latter methodological framework primarily focuses on addressing a wide range of ramifications of the virus and ensuring safety among the vulnerable groups. Health education should be the main focus of healthcare organizations. From an epidemiological point of view, AIDS is an infectious disease of an anthropologic nature with contact and vertical transmission mechanisms. The source of infection is an infected person at any stage of the disease, that is, regardless of the clinical signs of the disease. The most intense transmission of the virus occurs during sexual contact with patients and virus carriers. Therefore, it is critical to understand the HIV from a medical and social perspective and derive plausible preventative measures.
Reworked Informative Papers
Medical Aspect
HIV is an agent that primarily targets specific cells of the human immune system, making the latter highly vulnerable to a wide range of other infections. It destroys the body by eliminating CD4+ T-helper lymphocytes, which are critical for the normal functioning of the immunity (Mandal, 2019). The effect of the virus can be observed throughout the body, where it disrupts ones well-being. AIDS can be a key contributing factor to health issues, such as dementia, tongue trouble, seizures, depression, anxiety, kidney damage, diarrhea, or heart strain (Pietrangelo & Cherney, 2020). Therefore, it is evident that HIV is a unique virus that set a conditional risk of a person, where he or she might not directly suffer from the virus itself, but its ramifications.
It is important to note that virological research methods are used to detect the virus. The latter includes inoculation of blood or other material in tissue culture, electron microscopy, polymerase chain reaction (PCR). In practice, ELISA and immunoblotting reactions are widely used (Rushing, 2018). HIV is found in many cellular elements and fluids of sick and infected people, and blood and semen occupy a special place among them. Blood is the main springboard, where the processes that lead to the suppression of immunity, the main pathogenic mechanism of HIV infection, unfold. In addition, blood is known to play a leading role in the transmission of disease. HIV is found both in blood cells, mainly in lymphocytes, and in plasma and its fractions. Sperm is the main carrier of the virus in the spread of HIV infection. Until now, the possibility of HIV transmission by airborne droplets, through food or in any other way possible through close everyday communication, has not been proven (Rushing, 2018). The hypothesis of transmission by blood-sucking insects, expressed by some researchers, was not confirmed by verification work in the United States and Africa.
Transmission
The recognized modes of transmission of the disease are direct sexual contact, regardless of the method of its implementation, and blood and its preparations from infected donors, objects. In addition, the infection can pass through blood-contaminated sources of disease in the presence of small defects on the skin and mucous membranes. Vertical transmission is manifested through infections from the mother with AIDS and breast milk to the child. HIV transmission is also possible through intramuscular, intravenous and subcutaneous injections, medical scarification, and tattoos. Theoretically, it is possible to transmit the virus by airborne droplets, contact-household, oral-fecal, transmissible routes. The rare ways of spreading the virus include its transmission during ritual manipulations.
Social Aspect
It is important to understand that AIDS more of a social problem rather than a medical. The main reason is the lack of effective treatment procedures and vaccines, which only leaves the preventative options as a method of combatting the virus. HIV/AIDS epidemic has a severe negative impact on the economic growth of a nation due to the elevated level of spending on vulnerable groups and social instability. It is stated that HIV can become a major hindrance to the economic growth of West Africa (Dauda, 2018). In other words, AIDS is a major economic issue for both developed and developing nations due to the heaviness of the burden of having a large segment of the population infected by HIV. In addition, works devoted to the consideration of the political and legal context of the development of the HIV/AIDS epidemic in the world are important (Singer, 2018). The main reason that properly targeted policies and legislative procedures can reduce the risk factor among the vulnerable population.
Policymakers can design a wide range of programs that ensure the safety of these groups through the active provision or raising awareness through education. This is necessary not only for understanding the social processes associated with AIDS, but also for the development of effective prevention programs. Such activities can take the form of both general or group-specific manifestations, where the latter addresses pressing prevention issues of a particular group.
AIDS as a Social Problem
Social problems are an integral part of the social life of any society, and they are integrated into the social space and largely determine the vector of social development. In sociology, a whole independent direction has developed, associated with the analysis and understanding of social problems. Within the framework of the issue, one should focus on the concept of the social issues, which overcomes the contradictions between the objectivist and subjectivist directions in the theory of social problems and can serve as the basis for understanding the HIV/AIDS epidemic as a social problem. First, the concept of a social problem can be applied to social processes and conditions, which are perceived by the majority of the population as undesirable or threatening the basic values of society, such as social order, legality, moral norms, the stability of social institutions.
Secondly, accepted social agreements can be perceived as social problems if they contradict the interests of specific social, socio-demographic groups. Thirdly, social issues can be viewed as a sense of collective guilt caused by the awareness of public disregard for specific social phenomena and conditions, which, as a result, led to a negative impact on certain sectors of society. Fourth, the concept of social problems is applicable to physical, biological, and other natural phenomena, if adequate preventive measures are not taken to prevent destructive natural events. In addition, this is relevant if measures to eliminate the consequences of these phenomena are assessed by society as a whole or by individual communities as unsatisfactory. In addition, a distinctive feature of social problems is the possibility, at least potential, of its solution, and usually the responsibility for solving social issues are assigned to the state. Within the framework of this concept, it is possible to identify the conditions for classifying the phenomenon as a number of social problems. There is an identifiable social origin, a real or potential threat to social values and interests, and the possibility of resolving a problem situation.
If one observes AIDS from these positions, it becomes evident that AIDS is a social problem, and AIDS is characterized by all the variety of manifestations of social issues. The spread of HIV/AIDS threatens the basic value, that is, human life. In addition, the AIDS epidemic negatively affects the demographic and economic situation. Due to the disease, many legal and social norms have required revision. For example, the latter applies to groups such as homosexuals, drug users, and sexuality education, including schooling. In addition, female sex workers are among the most vulnerable groups due to their capability to infect individuals both vertically and horizontally (Shannon et al., 2015). The state and society as a whole are responsible for the spread of HIV infection, especially for the appearance of children with HIV-positive status. In this regard, evidently, there should be a sense of collective guilt because the state is responsible for combating the epidemic.
When considering HIV/AIDS as a social problem, it is necessary to say a few words about the constructionist approach to the obstacle of AIDS. However, for all the weaknesses of targeted civil society institutions in relation to AIDS, the situation was not so clear-cut. The construction of AIDS as a social problem took place with active participation, including financial, from the international community and international structures (Rushing, 2018). The activities not only drew attention to the AIDS problem but also contributed to the creation of a significant number of non-governmental organizations in the country.
Current Social Structure
Such actions are aimed at the implementation of preventive projects and have a gradual impact on the change in the states position on the prevention of HIV/AIDS. This is particularly relevant in relation to syringe exchange for drug users. Of course, the mass media controlled by the authorities can misinterpret the AIDS problem. Many sites are devoted to HIV/AIDS, and therefore, it should be taken into account that the Internet occupies a significant place in the information space of modern society (Rushing, 2018). In addition, it can be argued that from a constructionist standpoint, despite the strategies used to de-problematize the situation with the spread of HIV infection, it is also a social problem.
The variety of social issues related to the AIDS phenomenon, in turn, requires a multifaceted preventive work. In this regard, it is quite legitimate to talk about the social prevention of HIV/AIDS, meaning by it a change in the risky behavior of an individual. In addition, it is important to change group norms that encourage risky behavior and create a social structure. The latter concerns specifically social rules, legal framework, socio-economic conditions that support HIV/AIDS-safe behavior. Understanding the social problems associated with HIV/AIDS refers to contemporary sociological discussions (Rushing, 2018). They most often unfold around the transformation of society from modernity to developed modernity or postmodernity. In other words, it is a transformation from an industrial to a post-industrial society. This shift is associated with the transition from a community of certainty and rationality inherent in modernity to a culture of relativity and uncertainty that postmodernity presupposes. The basis of postmodernism in science has become a critical attitude to knowledge and relativism not only of scientific knowledge but also of value and normative structures.
Moreover, the factor of health and attitude to health also becomes structure-forming. The presence or absence of certain types of diseases becomes the basis of social differentiation. Moreover, these can be both socially acceptable and socially disapproved diseases. For example, conditions of the musculoskeletal system are accepted in society, and people with disabilities form a separate social stratum for which a whole infrastructure is being created and developed. Diseases associated with socially disapproving behavior in the public mind also affect the social structure of modern society. HIV has become a kind of structure-forming factor, singling out the community of HIV-infected people into an independent social community of contemporary society.
Community and Risk
The peculiarity of modern society is in the threat of danger, which does not recognize the protection zones and differentiation of todays world. The continuation of life and the recognition of risk come into conflict with each other, and this circumstance gives existential acuteness to disputes about the results of measurements and limit values, about short-term and long-term consequences. In order to remove the restrictions due to origin, and give a person the opportunity to make decisions for himself or herself and by the labor to secure a place in the social structure, a new variety appears in the developed modernity. AIDS, along with human-made risks, belongs to the group of threats and dangers that, although unevenly distributed in the global social context, nevertheless, for them, the borders of national states are transparent, permeable, and surmountable. The community of fear based on risk is a new socio-psychological community, a neighborhood of world social movements, and an adequate policy should be the only interstate.
Awareness of all this prompts many modern social analysts to evaluate the post-industrial society that is emerging as a society of risk. The risk of HIV infection is one of the main dangers today. At the same time, despite the fact that HIV infection threatens the entire population in a risk society, it is quite legitimate to talk about risk groups, more precisely about groups vulnerable to HIV infection. In other words, these are risk behavior groups in which HIV-risk behaviors are regularly practiced, namely, injecting drug use or unprotected sexual relations.
Prevention
The AIDS epidemic does not spread equally, and there are a number of groups who are affected in a disproportionate manner. One should be aware of the fact that the majority of HIV infections take place through two main activities. The latter includes drug injection and sexual contact, where both involve the transmission of HIV infected fluids, such as blood and sperm (Brawner et al., 2017). In other words, the preventative measures need to utilize behavioral interventions, which are specifically targeted at reducing the occurrence rate of risk behaviors. In such cases, society sooner or later has to abandon outdated stereotypes of thinking and change prohibitive legislation and discriminatory policies that hinder the fight against the epidemic in order to save the lives of its citizens (Saha & Samanta, 2019). The objective and procedural components include supporting the vulnerable groups education and training.
Primarily, actions that are required by the AIDS epidemic conflict with existing ideas about public health and morality. It can also be supplemented by a wider and more generalist approach, such campaigns designed to raise awareness regarding the AIDS epidemic. High poverty neighborhoods tend to suffer from the AIDS epidemic more severely compared to other locations (Wiewel et al., 2017). It is stated that the only approach to stop the overall spread of HIV is based on the concept of treatment as prevention (Schwetz & Fauci, 2019). The latter statement means that without an effective vaccine or treatment process, the only plausible solution is the prevention of the spread by making people avoidant of risk behaviors that lead to transmission of HIV.
However, one should note that it is highly intricate and challenging to change the behavioral pattern of drug users and sexually active individuals. The former problem mainly involves a certain form of addiction, whereas the latter intervenes in one privacy and intimacy. The preventative barriers can also emerge at different levels, such as individual, community, society, religion, culture, and government policy. All these factors further complicate the issue by making each location unique and requiring more specific steps. For example, education and prevention efforts aimed at the heterosexual transmission of HIV should also take into account the sexual culture of heterosexual men.
Drug Use
It is highly important to change risky behavior, where the task of prevention is to convince people voluntarily and for a long time to change their behavior, making it safer. There are a number of psychological patterns of behavior change. Voluntary abandonment of stable habits, as a rule, does not occur immediately but is a more or less lengthy process, during which a person goes through several stages. To reduce the spread of HIV infection, injecting drug users must be given choices. One needs to either stop using or switch to strategies to reduce the risk of drug use or reduce the harm caused by drugs.
It should be noted that it is unrealistic to demand that all drug addicts immediately give up drugs. At each stage, the person changing their behavior needs appropriate information and support. This area of prevention is especially important for countries with an opioid crisis, as most new HIV infections occur through injecting drug use. A significant proportion of infections occur in the sexual partners of drug users, as well as in children born to HIV-positive mothers who have used drugs or become infected from a drug-dependent partner.
Prisoners represent a mixed group at increased risk of HIV infection, who also pose a group with restrictions on access to health care and information. Along with these contingents, some other population groups are at increased risk of infection. These include, for example, people who constantly change their place of stay, that is, various kinds of travelers and migrants. These same groups may have limited access to prevention activities compared to local populations. Men who have sex with men have historically been considered particularly vulnerable to HIV infection. In addition to homosexual men who have sex exclusively with men, this group also includes bisexual men who have both homosexual and heterosexual relationships.
Stigma and Support
Stigma and discrimination against this group are common factors that hinder effective prevention. Any elements of homophobia that penetrate information materials can lead to the fact that such people will react negatively to information useful to them. Traditionally, it is believed that the greatest effect in the field of HIV prevention among LGBT people can be achieved by attracting representatives of the group themselves, acting directly in this closed community, to this work.
All citizens of the country, regardless of belonging to a particular social group, must be guaranteed access to preventive services, medical care, care, and support for HIV infection. Prevention and treatment of HIV infection among representatives of vulnerable groups such as drug addicts, sex workers, convicts serving sentences in prisons are also aimed at improving public health in general (Goldenberg et al., 2016). In addition, African American males living in rural regions are also prone to get infected with HIV (Kogan et al., 2016). In order to successfully combat the spread of HIV infection among injecting drug users, it is necessary to combine preventive measures with ensuring broad access to antiretroviral therapy for vulnerable groups. This is done in conjunction with medical and social support, harm reduction, and treatment adherence programs. In order to reach such hard-to-reach social groups as injecting drug users, various activities are carried out within the framework of harm reduction programs. The latter may include information and counseling for injecting drug users, including peer educate peer education and the provision of free condoms.
In addition, there is an exchange of used injecting equipment for sterile needles and syringes, as well as facilitated access to health care and social services. Reaching outreach to injecting drug users is usually undertaken by health care professionals and community organizations, with the involvement of peer educators. They provide direct contact with the target group during street social work. This work helps to attract clients to harm reduction programs, provides information on safe practices to those who do not attend such programs. To offer all needy injecting drug users with the necessary assistance in harm reduction projects, health, and social services for this category are provided with low thresholds. In other words, they are easily accessible services where the client receives assistance in the most convenient form, depending on his or her needs. The organization of low-threshold services is based on principles such as anonymity and convenient working hours. In addition, a convenient location, free provision of services, and respect and friendly attitude towards the client from the staff are important.
Provision
The provision aspect of AIDS prevention is focused on reducing the instances of risky behaviors, such as needle sharing among drug injectors. It is critical to provide the given group of the vulnerable population proper access to sterile equipment. The latter ensures that one will not transmit HIV through blood elements, where the virus resides. Although there are syringe and needle provision programs in many nations, they need to be expanded in scale through funding and more deliberate approaches (Rushing, 2018). In other words, despite having such programs, the current awareness and accessibility level is low. The vulnerable group is most likely to be unaware of this support network or they do not have access to the provided benefits.
Most of those in need of treatment is outside the field of vision. These are mainly injecting drug users, for whom access to medical services is difficult. There is no effective coordination between various structures in the procurement of medicines in the regions; stability of supply is not always ensured. Infrastructure development, such as specialized health care facilities, is lagging behind the increased needs and capacity to provide treatment.
Mechanisms of interaction between various medical and social programs are not debugged. For example, these are AIDS prevention and control centers, drug treatment dispensaries, tuberculosis dispensaries, and harm reduction programs. In light of the above facts, it is necessary to focus efforts on HIV prevention and treatment among vulnerable groups in some areas. It is important to understand the coordination of efforts and partnerships and funding for human rights. A number of international projects working in the country were called upon to change the HIV situation. It is challenging to convey life-saving information to those to whom it is intended, and even more difficult to induce these people to change their habitual behavior. For this, campaigns are held, preventive materials are issued, and comprehensive programs are developed. One-off events, such as a charity concert or telethon, are valuable because they draw public attention to an issue and enable famous, popular, and powerful people to express their feelings about it. Successful campaigns help raise funds to fight the epidemic. However, such an action is not able to really change the daily behavior of people. This requires a long-term and targeted prevention program.
Conclusion
In conclusion, the human immunodeficiency virus is an agent that weakens an individuals immune system by eliminating T-helper cells. Such an occurrence leads to the development of AIDS, which is a condition where a person has severely hindered immunity to the majority of infections. Although HIV does directly kill an affected body, it creates a situation where a number of different health complications emerge. It is important to understand that there are a limited number of ways HIV can be transmitted between individuals. The latter includes both vertical, such as mother to child, and horizontal transmission types, such as unprotected sexual intercourse and blood-to-blood contact. Therefore, the vulnerable groups include female sex workers, homosexual males, African American males, communities with a high degree of poverty, and, most importantly, drug users. The latter group is primarily affected due to needle or syringe sharing, which directly transfers blood particles from one individual to another.
The overall prevalence of AIDS among drug injectors can be prevented through a wide range of social programs that imposed targeted policies. Such programs need to be focused on provision measures, such as providing sterile needles and syringes to drug addicts in order to slow down the HIV spread. In addition, unprotected sex and other transmission types can be addressed through an educational approach, which can be comprised of deliberate training. Mass campaigns designed to raise awareness among the public can also be effective at delivering the critical message of risks regarding AIDS and its connection with unprotected sex.
Lastly, the most intricate issue is the vertical transmission of HIV from mother to child. It requires special attention because there is a strong need for cooperation between social workers and women affected by AIDS. The preventive measures should utilize monitoring procedures, where the target group is constantly accompanied by relevant specialists, such as experts from AIDS control and prevention centers and obstetrician-gynecologists. Therefore, one can clearly observe that AIDS is a socio-economic problem that needs a substantial budget or resource allocation.
References
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Dauda, R. S. (2018). HIV/AIDS and economic growth: Evidence from West Africa. The International Journal of Health Planning and Management, 34(1), 324-337.
Goldenberg, S. M., Brouwer, K. C., Jimenez, T. R., Miranda, S. M., & Mindt, M. R. (2016). Enhancing the ethical conduct of HIV research with migrant sex workers: Human rights, policy, and social contextual influences. PLOS ONE, 11(5).
Kogan, S. M., Cho, J., & Oshri, A. (2016). The influence of childhood adversity on rural black mens sexual risk behavior. Annals of Behavioral Medicine, 50, 813-822.
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Rushing, W. A. (2012). The AIDS epidemic: Social dimensions of an infectious disease. Sage.
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Schwetz, T. A., & Fauci, A. S. (2019). The extended impact of human immunodeficiency virus/AIDS research. The Journal of Infectious Diseases, 219(1), 6-9.
Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., Reza-Paul, S., Lau, J., Deering, K., Pickles, M. R., & Boily, M. C. (2015). Global epidemiology of HIV among female sex workers: Influence of structural determinants. The Lancet, 385(9962), 55-71.
Singer, M. (2018). The political economy of AIDS. Routledge.
Wiewel, E. W., Borrell. L. N., Jones, H. E., Maroko, A. R., & Torian, L. V. (2017). Neighborhood characteristics associated with achievement and maintenance of HIV viral suppression among persons newly diagnosed with HIV in New York City. AIDS and Behavior, 21, 3557-3566.
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