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Epidemiology and Communicable Disease - Essay Example

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George Washington University
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The term epidemiology characterizes the analysis and study of determinants of health as well as disease conditions and their distribution in defined populations. Additionally, it is measured as the cornerstone of the public health sector, because it shapes policy decisions as well as evidence-based practice. Also, this is by identifying the risk factors for various ailments or various diseases as well as the right targets for essential preventive health care. Furthermore, a communicable disease characterizes an ailment which can be spread from one individual to another via a variety of methods such as contact with blood or bodily fluids, being bitten or stung by an insect, and breathing an airborne virus among others. Today, the reporting of communicable disease cases is imperative in the plan as well as evaluation of the ailment prevention or management programs. Moreover, reporting also aids in seeking the appropriate and effective medical therapies and also facilitates the detection of the communicable disease outbreaks. This essay is a comprehensive epidemiological analysis of the human immunodeficiency virus (HIV), its determinants of health, its epidemiological triangle, the role of community health nursing due to HIV, and national agency dealing with HIV.

Description of the Communicable Disease

Causes, Symptoms, Mode of Transmission

HIV is transmitted via semen, as blood, as well as vaginal fluids. Additionally, this is from an infected individual to another persons body usually via sharing of needles when using injecting drugs or through sexual contact. The symptoms of HIV include vomiting, diarrhea, weight loss, joint pain, nausea, muscle aches, breath shortness as well as chronic coughing among others. Furthermore, full-blown HIV can manifest symptoms of short-term memory loss, as well as mental confusion among the infected persons.


The massive destruction of the CD4 cells in an HIV infected person leads to the development of Acquired Immune-Deficiency Syndrome (AIDS). Additionally, AIDS is measured to be the most severe phase of the HIV infection. Also, persons with AIDS have a severely damaged immune system, and as such, they are prone to acquiring a large number of severe illnesses, which are also called opportunistic infections. Additionally, when the number of a persons CD4 cells falls under the scale of 200 cells per cubic millimeter of blood (200 cells per millimeter cubed), the individual is considered to have a progressed level of AIDS Stewart, 2016). Ordinarily, a healthy persons CD4 count ranges between 500 1600 cells per millimeter cubed (Stewart, 2016). Ultimately, an individual with HIV is measured to have progressed AIDS if he/she develops multiple opportunistic illnesses, irrespective of his/her CD4 count.

Without proper treatment, persons with HIV progress to AIDS in approximately 3 years. Additionally, death due to AIDS occurs when the HIV infected person attain dangerous opportunistic illnesses such as Tuberculosis (TB) among others. Additionally, in such a situation, the life expectancy of the HIV infected person reduces to approximately 1 year. However, the use of ARVs can be beneficial to persons with AIDS when diagnosed in early stages of infection. Moreover, the use of ARVs can help in sustaining the life of persons with AIDS for a significant period. Nevertheless, starting the usage of ARVs at an early stage of HIV infection facilitates a timely recovery of patients with minimal challenges compared to persons who start the ARVs when they have full-blown AIDS.


According to the Joint United Nations Programme on HIV and AIDS (UNAIDS) organization, an estimated 20.9 million persons were receiving ARV treatment in 2017. Additionally, the common ARV drugs that were being employed for the treatment of the condition included Tenofovir (TDF), Lamivudine (3TC), Emtricitabine (FTC) as well as Efavirenz (EFV). Additional, the HIV Infected persons were receiving Antiretroviral therapy (ART), which is a treatment form that slows the rate at which the HIV replicates itself in a persons body. Also, the treatment of HIV is more effective when a patient uses a combination of 3 or more antiretroviral drugs. Ultimately, HIV/AIDS cannot be classified as a reportable disease. This is because it is not a contagious disease that requires the administration of urgent interventions to treat the condition. Nevertheless, HIV/AIDS can only be ranked as a reportable disease if an infected person donates blood or body tissues.

Demographic of Interest

HIV/AIDS has prevailed to be a core public health care issue in the world. Additionally, in 2016, it was projected that approximately 36.7 million persons in different parts of the world live with HIV infection (UNAIDS, 2018). Furthermore, among these HIV infected people, there were approximately 1.8 million infected children. Furthermore, the global HIV prevalence rate among adults was estimated to be 0.8% (UNAIDS, 2018). Also, around 30% of the infected persons do not know that they are infected with the virus (UNAIDS, 2018). Moreover, since the onset of the HIV/AIDS epidemic, it is estimated that approximately 70 million persons have become infected (WHO, 2018).

Additionally, 35 million persons have succumbed to AIDS-related ailments (WHO, 2018). Furthermore, in 2016, approximately 1 million persons succumbed to opportunistic diseases related to AIDS (WHO, 2018). Also, the large proportion of persons living with HIV are situated in low as well as middle-income nations. Moreover, it is estimated that 25.5 million persons living with HIV are situated in Sub-Saharan Africa (IWACU, 2017). Additionally, among this grouping, 19.4 million people are situated in East and Southern Africa which is a region that recorded 44% of all the new HIV infections that occurred in the world in 2016 (IWACU, 2017).

Determinants of Health

These are personal, social, environmental as well as economic factors that influence an individuals health status. Additionally, the determinant of health factors affects a persons recovery or access to proper healthcare interventions. Also, three social factors influence the spread of HIV among persons.

Social Factors

Social determinants have a primary role in influencing the rate of HIV infection. Additionally, social determinants also affect the ability of persons living with HIV to seek and acquire; treatment, care as well as healthcare support. Moreover, some examples of social determinants include promiscuity which significantly elevates the risk of an HIV infected person in re-contracting the virus. Also, sexual practices have also been associated with an elevated risk of HIV/AIDS transmission between persons. Additionally, such sexual practices may include homosexuality and lesbianism. Furthermore, cultural practices are also considered as social determinants that promote an elevated risk of HIV/AIDS virus transmission between persons. Moreover, this occurs as a result of practicing various cultural practices such as circumcision as well as infibulation among others.

Economic Factors

Various economic factors around peoples environment can influence them to contract HIV/AIDS infection. Additionally, the highest contributing economic factors include poverty and lack of employment. For instance, poor persons, especially in the third world nations, result in prostitution in search of money. Subsequently, a significant number of such persons eventually contract HIV, particularly if they do not use protection when having intercourse. Furthermore, lack of employment can result in poverty, which if persistent can make persons partake in HIV risk activities such as prostitution.

Cultural Factors

Cultural factors also play a significant impact in promoting the new transmission and spread of HIV/AIDS virus. For instance, polygamy which is an act of marrying many spouses is widely practiced in some communities around the globe. Additionally, this is mostly in African and Asian nations. In such situations, an infected person can easily transmit the HIV to his/her spouses or marriage partners. Also, emergent cultural trends such as homosexuality have also significantly elevated the risk of HIV transmission among persons in the United States and other parts of the world (Pellowski et al., 2013). For instance, the LGBT community in the United States has the highest prevalence of HIV infection in the nation (Friedman et al., 2014; Wallace, Li & McDaid, 2014). Consequently, ultimately, without proper provision of interventions to address the spread of HIV infection among such cultural societies, the prevalence rate of HIV infection and transmission is significantly increased.

Epidemiological Triangle

This is the traditional model that is used in the description of an infectious disease. Additionally, the epidemiological triangle consists of three key factors, which are also known as the triad, and they constitute an external agent, susceptible host, as well as an environment that unites the host and agent.

Agent Factors

In the epidemiological triangle, the term agent characterizes an entity or a microorganism with the potential to cause disease. For instance, it describes a virus or bacterium, which is capable of causing an ailment. Additionally, as a general rule, the agent must exist for the disease or ailment to occur. Nevertheless, the mere existence of an agent does not always qualify as a sufficient factor for the disease to occur. Ultimately, this is because the agent may require interacting with other factors inside an organism for it to cause disease.

Host Factors

The term host characterizes an organism such as a human, which is capable of attaining an infection by the action of a specific agent. Additionally, there is a variety of intrinsic factors that could influence a persons exposure, susceptibility as well as response to a prevailing disease causative agent. Moreover, such factors could include socio-economic factors, psychological characteristics, lifestyles as well as behaviors among others.

Environmental Factors

The term environment in the triad characterizes all the factors that are external to the host. Additionally, the environmental factors are considered to be extrinsic factors which affect the agent at the same time creating an opportunity for exposure. Furthermore, they could be physical factors such as climate, biological factors such as insects, as well as socio-economic factors such as sanitation and the access to health care services, among others. Below is a summary of the factors that influence HIV summarized in an epidemiological triangle.


Figure 1: The diagram of an epidemiological triangle for HIV infection via sexual transmission. The image was retrieved from the Pan American Health Organization (2018) (PAHO, 2018).

Role of Community Health Nursing

Today, community health nursing is focused on promoting the wellness of persons, families as well as communities that are affected by various health care issues such as HIV/AIDS. Additionally, at the same time, the community health nurses acknowledge their unique characteristics, abilities as well as diversity. Moreover, in respect to HIV/AIDS, community health nursing is keen on promoting the awareness of the disease among the public through offering sex education and HIV prevention contraceptives. Moreover, community health nurses support persons infected with HIV/AIDS b...

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