NRS 410 Discuss characteristic findings of immune dysfunction for either hypersensitivity reactions or AIDS
NRS 410 Discuss characteristic findings of immune dysfunction for either hypersensitivity reactions or AIDS
According to the United States Government the new diagnosis of HIV has declined in the United States and even more so globally, (HIV.gov, 2022). They also stated that AIDS related deaths are in a decline too, (HIV.gov, 2022). I attribute the decline and agree with the information provided from HIV.gov regarding the increased access to anti-retroviral therapy (ART) worldwide along with other preventative measures that that have been put into place. I believe educating people on the transmission has also played a part of the decrease with new diagnoses as it is a blood born pathogen spread most often through sexual contact or needle sharing. The ART medication regimens have decreased viral loads thereby decreasing the chances of spreading the disease when engaged in risky behaviors. With all this said I do tend to believe that the HIV virus will increase in frequency again as viruses mutate and people become more relaxed about prevention. I do not think this is a virus that will ever go away, although it would be a huge blessing if it did.
HIV.gov. (2022, July 19). U.S. statistics. HIV.gov. https://www.hiv.gov/hiv-basics/overview/data-and
Amanda, do you feel the stigma is still there, even though the rates are declining; or is the stigma declining as well?
I have no doubt the stigma is still there, but I do think people are trying to overcome that stigma. In a 2018 study it states that patients are “stigmatized as being poor, having a high number of sexual partners in their lifetime, and frequently engaging in other risky sexual behavior”, (Geter et al., 2018). I imagine that drug use is another stigma that floats around too. I used to work with a guy who lived with HIV, and he told me he never wanted anyone to know because patients would request not to get cared for by him. At the time he was in a monogamous relationship with another man but had gotten infected by a previous same gender sexual relationship. This history he shared did not help the stigma that existed with the disease but having the open conversation gave me an empathy I did not have previously. He was my friend, and I did not want that to change so I decided not to be afraid or to judge. I think talking about it helps with stigma and the modern acceptance for different lifestyles I imagine will foster more understanding of the disease.
Geter, A., Herron, A. R., & Sutton, M. Y. (2018). HIV-related stigma by healthcare providers in the United States: A systematic review. AIDS Patient Care and STDs, 32(10), 418–424. https://doi.org/10.1089/apc.2018.0114
Overall, the incidence of HIV has decreased since its peak in the mid-’80s. However, a study by Govender et al. (2021) found a concerning rise in the incidence of HIV in the U.S., South America, and Europe. In the United States, new HIV infections are mainly attributed to key populations such as men having sex with men, followed by heterosexual contact, and to a lesser extent, injection-drug use (Govender et al., 2021). The number of new HIV infections increased from 48,175 per year in 2010 to 67,000 in 2019, and the rates are forecasted to continue rising (Govender et al., 2021). HIV rates are climbing in underserved populations, such as rural areas in the U.S South. “Ongoing disparities in HIV in the South are probably driven by the restricted expansion of Medicaid, health-care provider shortages, low health literacy, and HIV stigma” (Sullivan et al., 2021). The COVID epidemic also caused challenges as there was less access to testing and medical care. HIV.gov (2021) says the incidence has declined by 8% from 2015 to 2019 yet increased for people ages 13-24 and 55 years and over. The decline in overall incidence can be attributed to education, primary and secondary prevention programs, condom availability, pre-exposure prophylaxis medications, and antiretroviral treatment (ART) for HIV-positive mother-to-child transmission (Govender et al., 2021). More people can live longer after an HIV diagnosis with successful treatment regimens of ART, shifting HIV into a chronic disease with increasing numbers of people having near normal life expectancy (Govender et al., 2021).
Govender, R. D., Hashim, M., Khan, M., Mustafa, H., & Khan, G. (2021). Global epidemiology of hiv/aids: A resurgence in north america and europe. Journal of Epidemiology and Global Health, 11(3), 296. https://doi.org/10.2991/jegh.k.210621.001
HIV.gov. (2021, June 2). U.s. statistics. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
Sullivan, P. S., Satcher Johnson, A., Pembleton, E. S., Stephenson, R., Justice, A. C., Althoff, K. N., Bradley, H., Castel, A. D., Oster, A. M., Rosenberg, E. S., Mayer, K. H., & Beyrer, C. (2021). Epidemiology of hiv in the usa: Epidemic burden, inequities, contexts, and responses. The Lancet, 397(10279), 1095–1106. https://doi.org/10.1016/s0140-6736(21)00395-0
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Studies show a significant decrease in incidences of HIV over the last decade. While considerable progress has been made in preventing and treating HIV, there is still much to do. HIV remains a persistent public health problem in the United States (Bajema et al., 2020). Scientists and communities have partnered to drive progress and improve the scientific process of defeating HIV. Involving affected districts in the planning and implementation of research and care is a vital component that has helped reduce the incidences of HIV. Community engagement, technological advancement, and stakeholder collaboration have contributed to this decrease.
Bajema, K. L., Nance, R. M., Delaney, J. A., Eaton, E., Thibaut, D. M., Karris, M. Y., & Kitahata, M. M. (2020). Significant decline in heavily treatment-experienced persons with HIV with limited antiretroviral treatment options in the US, 2000-2017. AIDS (London, England), 34(14), 2051. https://doi.org/10.1097%2FQAD.0000000000002679
In the 1980s, knowledge about the disease was rising, but people were ruled by fear, ignorance, and stigma when it came to HIV and AIDS. At that time, the outlook for people with HIV was pretty grim because there were no treatment options. When World AIDS Day was first established in 1988, the world looked very different to how it is today. Now, we have easily accessible testing, treatment, a range of prevention options, including pre-exposure prophylaxis of PrEP (a daily medicine that can reduce one’s chances of getting HIV), and services that can reach vulnerable communities. As committed as the global health community was, the dedication of HIV activists and advocates in pushing for patient-driven care, improving access to new drugs, and expanding funding for both HIV care and research, has been unparalleled in almost any other disease field, according to The World Health Organization (WHO), and the movement was characterized by public rallies awareness campaigns (2022).
There is still a lot of work to do, and it is on-going, but I would say that the strides that have been made in the area of HIV and AIDS. The CDC records that annual infections in the U.S. have been reduced by more than two-thirds since the height of the epidemic in the mid-1980s. “Further, CDC estimates of annual HIV infections in the United States show hopeful signs of progress in recent years. CDC estimates show new HIV infections declined 8% from 37,800 in 2015 to 34,800 in 2019, after a period of general stability” (2021). I do believe that these reductions in the incidence of HIV and subsequent AIDS are due to the many advances that have been made in testing and treatment.
Centers of Disease Control and Prevention. (2021). HIV in the United States and dependent areas. https://www.cdc.gov/hiv/statistics/overview/ataglance.html#:~:text=In%202019%2C%2036%2C801%20peoplea,(US)%20and%20dependent%20areas.&text=From%202015%20to%202019%2C%20HIV,the%20US%20and%20dependent%20areas.
The World Health Organization. (2022). Why the HIV epidemic is not over. https://www.who.int/news-room/spotlight/why-the-hiv-epidemic-is-not-over
Acquired immunodeficiency syndrome (AIDS) comes from the viral infection human immunodeficiency virus (HIV), where the virus attacks CD4+ lymphocytes and causes the lymphocyte to reproduce more HIV virus (Randall, 2018). This in return causes a suppression of the immune system response and leads to the development of AIDS (Randall, 2018). In the early stages of HIV/AIDS there can be no symptoms to non-specific flu-like symptoms, as AIDS progresses the immune system wanes and the infected individual becomes very susceptible to diseases and illnesses (Randall, 2018). If AIDS progresses to the last stage, it can be very hard to treat.
Living with AIDS can be hard for the patient and family. Getting this diagnosis can be life-changing as this takes lifelong management (HIV.gov, 2021). Family may need to support their loved ones through the diagnosis to seek and comply with treatment (HIV.gov, 2021). Patients with AIDS must be educated on the importance of testing, long-term relationships, and how the disease is transmitted (HIV.gov). The diagnosis of HIV/AIDS can be stressful for the patient and family, and nurses should do their best to provide support and empathy during this time.
HIV.gov. (2021, April 8). Supporting Someone Living with HIV. HIV.Gov. https://www.hiv.gov/hiv-basics/overview/making-a-difference/supporting-someone-living-with-hiv
Randall, J. (2018). Cellular and Immunological Complexities. Grand Canyon University (Ed), Pathophysiology Clinical Applications for Client Health. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/4
Sara, thanks for your post on HIV/AIDS; it was moving and to me to do a little thinking about HIV and AIDS. It is so different than it used to be. Although there still is, there used to be a time when it was very uncomfortable to speak about it. I remember a time when HIV/AIDS was such a taboo subject. We, as nurses, have an important role to play in helping to reduce stigma associated with HIV. We do this by acting as role models and raising awareness, and by providing non-judgmental care, using universal precautions, and challenging prejudice.
HIV stigma is particularly complex, fueled by racial, homophobic and drug related prejudice and discriminatory behavior. It is also a way for people to cope with irrational fears of catching the condition. HIV is also a self-stigmatizing condition. People with the virus often report feelings of guilt and self-loathing, internalizing society’s views that they are at fault or deserving of retribution for risk taking and “immoral behaviors”.
Although it is well-intentioned and may be necessary to prioritize prevention messages for those considered to be at high risk of infection, messages that only target certain communities can bring their own problems (Relf et al, 2021). They can add to the stigmatization of people in these groups and make them reluctant to admit risk or reveal their HIV status. This targeting may also give people outside these groups a false sense that they are not themselves at risk of HIV provided they avoid the targeted groups.
Relf, M.V., Holzemer, W.L., Holt, L., Nyblade, L., & Ellis, C. (2021). A review of the state of the science of HIV and stigma: Context, conceptualization, measurement, interventions, gaps, and future priorities. Journal of the Association of Nurses in AIDS Care, 32(3), 392-407. doi: 10.1097/JNC.0000000000000237
I love that you brought up the importance of families being involved in compliance of HIV treatment. I can’t imagine how hard it is for a family member to learn their loved one must live with this lifelong disease. In a study I found they incorporated families into the home centered care of persons living with HIV (PLWH). They found that through a home centered program it improved family attachment, improved awareness within the family, and families provided more care need by the PLWH, (Larki & Lagifnejad Roudsari, 2020). I don’t know if it is as scary today as it was years ago to live with someone with HIV but having a better understanding of the needs of the affected person and how the disease is transmitted would likely decrease the fear and improve empathy.
Larki, M., & Latifnejad Roudsari, R. (2020). Home-Based Care, the Missing Link in Caring of Patients Living with HIV/AIDS and Their Family Members: A Narrative Review. International journal of community based nursing and midwifery, 8(3), 190–208. https://doi.org/10.30476/ijcbnm.2020.82771.1085
Acquired immunodeficiency Syndrome is a chronic, and life-threatening disease caused by the Human Immunodeficiency Virus. This disease impairs the body’s ability to fight disease and infections by damaging the immune system. HIV infection occurs in phases, and the final phase manifests as acquired immunodeficiency syndrome. This infection is transmitted through various modes; sexual contact (oral sex, vaginal sex, anal sex), from mother to child during parturition, during breastfeeding, through sharing intravenous needles, and blood transfusions. When the HIV infection is left untreated, it develops into AIDS within 10 years (Waymack & Vidya Sundareshan, 2019). HIV infection has since been regarded as a global pandemic. It affects all ages, and about 25 million people live with HIV. The purpose of this paper is to discuss characteristic findings of immune dysfunction for AIDS and explain the symptomology the patient would exhibit and how these symptoms may complicate daily living and relationships.
Characteristic Findings of Immune System Dysfunction in AIDS
The level of immune function in AIDS is severely decreased and is characterized by a progressive weakening of the immune system, persistent unhealthy amplification of anti- or pro-inflammatory cytokines, and a continuous inflammatory state. These patients primarily present with characteristically low levels of CD4+ T cell counts (cells that are primarily infected by HIV, and function in the cell-mediated immunity defense system). Secondary events include; high levels of inflammatory cytokines such as IL-10 and IL-6, decreased chemotaxis of monocytes, activation of polyclonal B-cells, impaired functioning of macrophages, and the regulatory -helper CD4+ cells (Schwetz & Fauci, 2018). This state of immune disorderliness allows malignancies and opportunistic infections to attack the body.
AIDS Symptomatology and their Complications to Daily Life and Relationships
HIV infection progresses in phases, and each phase has its defining symptoms. The defining symptoms of AIDS are mainly due to other opportunistic infections or malignancies, that indicate a severely immunocompromised state. These include; unexplained weight loss, prolonged generalized lymphadenopathy, yeast infections of the vagina, throat, or mouth, frequent fatigue, prolonged fevers, dyspnea, and prolonged diarrhea among others. These symptoms affect social relationships through stigma, concern over rejection, and transmitting the infection to other people. These individuals are affected emotionally as they get depression, inferiority complexes, and anxiety (Shao et al., 2018). These symptomatologies affect their functioning capacity and they cannot do their daily activities or earn any income.
Patients with AIDS face psychological and physical symptoms that lower their quality of life. This prompts close monitoring and appropriates effective treatment to avert these undesired effects. The current treatment recommendations have aided in reducing AIDS symptomatology. Pharmacotherapy and psychosocial therapy have proven to modulate and abate this cause, and have, therefore, improved the quality of life of patients living with AIDS.
Schwetz, T. A., & Fauci, A. S. (2018). The Extended Impact of Human Immunodeficiency Virus/AIDS Research. The Journal of Infectious Diseases, 219(1). https://doi.org/10.1093/infdis/jiy441
Shao, B., Song, B., Feng, S., Lin, Y., Du, J., Shao, H., Chi, Z., Yang, Y., & Wang, F. (2018). The relationship of social support, mental health, and health-related quality of life in human immunodeficiency virus-positive men who have sex with men. Medicine, 97(30), e11652. https://doi.org/10.1097/md.0000000000011652
Waymack, J. R., & Vidya Sundareshan. (2019, June 16). Acquired Immune Deficiency Syndrome (AIDS). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537293/
Reactions of hypersensitivity take place when the body has an excessive response to a foreign substance, such as a pollen particle or a food protein. Examples of such substances are allergens and foods.
The body produces histamine and other chemicals, which can cause symptoms such as skin rashes, hives, difficulty breathing, and swelling of the face, lips, or tongue. These symptoms can be brought on by an allergic reaction.
HIV, also known as the human immunodeficiency virus, is the causative agent of the disease known as AIDS (HIV). The virus that causes AIDS, HIV, disrupts the immune system of the body, which can eventually result in full-blown AIDS.
AIDS symptoms can vary greatly from one individual to the next and can be as mild as moderate or as severe as severe. Weight loss, exhaustion, fever, and nighttime sweats are some of the most typical symptoms.
Fatigue is the immunological illness that affects people the most frequently. This can make it difficult to keep a regular sleep schedule, which in turn can lead to problems with focus and memory. Other typical symptoms include the following:
• Frequent infections
• Autoimmune disorders
• Chronic inflammation
It is possible for a person who suffers from an immunological illness to be required to go through a significant number of medical examinations and appointments.
They could also need to take medication, which comes with its own set of potential negative effects. Because of this, going to work or school could be challenging. The additional time and effort that is required to manage the disease might put a strain on relationships because of the condition.
when someone suffer from an immunological problem, consulting his/her physician about the best way to treat symptoms is an absolute must. In addition, there are a lot of different support groups that one can join that will help connect with other people who are struggling with problems that are similar.
Randall, J. (2018). Cellular and Immunological Complexities. Grand Canyon University (Ed.), Pathophysiology clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/4