Healthy People 2020′ initiative (HP2020) greatly emphasizes social health determinants, health inequity factors, and income and educational goals. Further, it adopts a broader perspective of the health effects of natural and manmade environments. The National Prevention and Health Promotion Council, by building on this initiative, offers a new means to implement a government-wide ‘health in every policy’ approach. Several NPS (National Prevention Strategy) interventions will extend across sectors and departments, influencing various health results (Fielding, Teutsch, & Koh, 2012). Numerous HIV / AIDS-linked clinical characteristics may be attributed to the intense immune deficiency developing among infected individuals. Immune system breakdown by the human immune virus causes opportunistic infection, and greater vulnerability to malignancy and autoimmune diseases. Moreover, there may be HIV-connected disease manifestations; for instance, in the course of the primary ailment surfacing within a few weeks after the individual’s first HIV exposure, clinical signs are seen in about half the patients, often as ‘mononucleosis syndrome’. Complications associated with HIV are rare among individuals whose immunity is preserved (Lloyd, 1996).
Understanding HIV
HIV-affected persons are leading longer, more active and healthier lives in this age, where increasingly efficient HIV treatments exist. HIV-related deaths in America have decreased appreciably since the nineties. With growth in the share of HIV-affected individuals, increasing HIV care and prevention interventions is salient (healthypeople.gov, 2016). Fresh HIV cases reveal racial, sexual, and ethnic disparities:
• About three-quarters of newly-infected HIV patients are males.
• Over 50% cases occur among bisexual and gay males, irrespective of ethnicity/race.
• Of the fresh HIV cases, 45% are witnessed among African-Americans, 35% among White population members, and 17% among Hispanics (healthypeople.gov, 2016).
Improved quality care access for groups that are highly susceptible to HIV (e.g., bisexual and gay males, non-Whites, etc.) represents an important HIV prevention-focused public health approach (healthypeople.gov, 2016). Individuals seeking HIV-related care may receive:
• HIV prevention services
• Antiretroviral therapy
• Mental healthcare
• Miscellaneous health services
• Sexually transmitted disease testing and treatment (healthypeople.gov, 2016)
Emerging Issues in HIV
With growth in the share of HIV-infected individuals who know of their HIV+ status, HIV-targeted prevention approaches are gaining importance (healthypeople.gov, 2016). HIV-related prevention efforts revolve around:
• Joining and continuing treatment.
• Providing HIV-affected individuals’ partners with preventive services
• Increasing continuous HIV prevention intervention availability
• Fostering broader holistic service availability for HIV-affected persons and their spouses/partners via partnerships between health divisions, community-centered bodies, and social service and healthcare workers (healthypeople.gov, 2016)
US public perception regarding HIV’s acuteness has recently deteriorated. Evidence exists of a rise in risky behaviors in uninfected individuals, particularly bisexual and gay males. Continuous social and media campaigns aimed at the public, as well as preventive interventions for those not infected as yet but engaged in risky activities, are essential (healthypeople.gov, 2016).
Stigma in the HIV / AIDS Epidemic
While stigma is deemed to be a significant obstacle to effectively responding to HIV / AIDS, endeavors to reduce stigma are downgraded as one among the last priorities of the AIDS program. HIV / AIDS epidemic’s associated stigma has a complexity that is frequently regarded as the chief reason for restricted response to it. Researchers have methodically analyzed HIV / AIDS-linked stigma for recording the existing research state, determining gaps in existing evidence, and highlighting approaches that have a potential to deal with stigma. The main challenges addressed are: definition, measurement, and reduction of HIV / AIDS-connected stigma, and assessment of stigma’s effects on HIV treatment and prevention initiative success (Mahajan, et al., 2010).
Interventions
Complications associated with, and treatments, for HIV, may result in muscle wastage, metabolic complications, and bone mineral density loss. HIV+ individuals experience lower flexibility, impairment of aerobic capacity, lower maximum consumption of oxygen, insulin resistance, lipodystrophy, and reduced muscular strength, owing to the infection, treatments, or both. A comparison of a once-a-month workshop and a recently-performed RCT (randomized clinical trial) on HIV+ adults — a supervised gym class of one-hour duration, thrice a week, with nutritional counseling organized once a month — was made to study the significance of nutrition and physical exercise (Botros, Somarriba, Neri, & Miller, 2012).
Limited but sound evidence exists to point at the advantages of routine physical exercise for HIV+ individuals. Exercise regimen-compliant individuals’ fitness, overall function, metabolic endpoints, and quality of life are boosted. But conformity to a routine fitness regimen is a great challenge for a number of individuals, and tactics are required for ensuring patient engagement in physical exercise (Botros, Somarriba, Neri, & Miller, 2012). Exercise and nutritional counseling are effective means of treating obesity, metabolic abnormalities, and fat redistribution. Physical exercise interventions boost strength and fitness and enhance the body composition of HIV+ persons. Evidence taken collectively indicates that better results can be achieved through a proactive physical exercise and nutrition strategy, interventions, and guidance. These activities facilitate the abrogation of HIV and associated therapies’ negative metabolic, psychological, and cardiovascular consequences. For malnourished and food-insecure HIV+ persons, nutritional supplements administered in sufficient quantities prove effective. Higher-risk HIV+ groups are active infection-diagnosed persons, expectant mothers, lactating mothers, and kids (Botros, Somarriba, Neri, & Miller, 2012).
Conclusion
HIV-affected persons are now leading longer, more active and healthier lives, owing to increasingly efficient HIV treatments. HIV-related deaths in America have decreased appreciably since the nineties. However, racial, sexual, and ethnic disparities are apparent in fresh cases, and improved quality care access for groups that are highly susceptible to HIV is imperative. HIV-targeted prevention approaches are gaining importance in the present day. But stigma is a significant obstacle to effectively responding to and preventing HIV / AIDS, and endeavors to reduce stigma are downgraded as one among the last priorities of the AIDS program. Nutrition and physical exercise have been identified as beneficial interventions for HIV+ individuals. Through such interventions, HP2020 goals of reducing health disparities, in this case, for HIV / AIDS, may be realized.
Bibliography
Botros, D., Somarriba, G., Neri, D., & Miller, T. (2012). Interventions to Address Chronic Disease and HIV: Strategies to Promote Exercise and Nutrition Among HIV-Infected Individuals. Curr HIV / AIDS Rep., 351 — 363.
Fielding, J., Teutsch, S., & Koh, H. (2012). Health Reform and Healthy People Initiative. Am J. Public Health, 30 — 33.
healthypeople.gov. (2016, October 13). HIV. Retrieved from Healthy People: https://www.healthypeople.gov/2020/topics-objectives/topic/hiv
Lloyd, A. (1996). HIV infection and AIDS Med J., 174-80.
Mahajan, A., Sayles, J., Patel, V., Remian, R., Ortiz, D., Szekeres, G., & Coates, T. (2010). Stigma in the HIV / AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, S67 — S79.
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