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Critical Literature Review On HIV

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Critical Literature Review On HIV Critical review of the literature on ONE emerging or re-emerging communicable disease threat (choose from list below); should include role of agent, host and environmental factors, potential policy responses. Zika Virus MERS (Middle East Respiratory Syndrome) – Ebola HIV MDR/XDR Tuberculosis   Answer: HIV is one of the most dreadful disorders that have affected huge number of individuals all over the world and it had resulted in huge number of deaths in the nation of Australia. In the year 2017, it was estimated that about 27545 people are living with HIV in Australia. Of these 27545 number of people, about 89% of the individuals wee diagnosed with the disorders by the end of 2017 (Coyle et al., 2016). Present day researches also show that about 95% of them are accessing care. About 875 of the individuals who are accessing the care, about 875 are receiving HIV treatments. It was also found that those people who are on the treatment, 95% of them had an undetectable viral load. Therefore, it shows the importance of healthcare professionals to be more aware about the disorder and take necessary interventions for prevention of the disorders among the present day population (Mpango et al., 2018). They also have the duty to ensure effective care to the people who are already affected with the disorder in proper ways so that they can lead proper quality life. The assignment would be mainly based on the critical reviews of the literature of the different aspects of the HIV infection. It would also show the different interventions that the healthcare professionals need to undertake so that they can provide evidence based care to the patients who are effected with the disease. In order to find out articles that align with the different aspects of treatment for the patients infected by HIV, authentic databases are needed to be researched. In this assignment, articles will be collected from CINAHL, COCHRANE, MEDLINE as well as PUBMED. The search terms which were utilized are “HIV and treatments”, “ HIV and its transmission modes”, “HIV and social impact”, HIV and combination therapies, “HIV drugs”, “HIV and nursing interventions” and many others. Boolean operators were used for combining the search terms and these included “AND”, “NOR” and “OR”. McKinney & Marconi (2016) had discussed about the mode of infection of the HIV in the human beings. HIV is a virus that attacks cells of the immune systems that are actually the natural defenses against the different illness. The virus destroys a specific type of white blood cells in the immune system called the helper T cells and makes copies of itself inside these cells. T helper cells are also called the CD4 cells. As HIV is seen to destroy more than CD4 cells and makes more copies of itself, it is seen to gradually weaken the immune system of the person. This means that the person who is having HIV and is not taking any form of antiretroviral treatment would find it harder to fight off any other infection and disorders. Raj et al. (2016) had conducted a research on the progression rate of the HIV when left untreated in the individuals. They have found that if HIV is left untreated, it might take for about 10 to 15 years for the immune system to be so severely damaged that it can no longer defend itself at all. However, the authors have been also quoted stating that the rate at which HIV might progress may vary among different individuals depending on their general health, age as well as background. It is important to understand the various ways by which HIV is spread from person to person. Woods et al. (2016) had stated that the two most common ways by which HIV is transmitted are through improper sexual behavior and incorrect use of needle and syringes. The researchers have stated that only certain body fluids  like that of the blood, semen (cum), pre-seminal fluid (pre-cum), vaginal fluids, rectal fluids as well as breast milk from an already infected HIV individual can result in transmission of the HIV. However, the researchers have also mentioned of important conditions that ensure infection of the normal healthy human being by the aforementioned fluid transmission (Vos et al., 2015). These fluids need to meet the mucous membrane as well as the damaged tissues of need to be directly injected in the blood stream with the help of a needle of a syringe for the occurrence of transmission. The mucous membranes are present inside the penis, vagina as well as the mouth and rectum,.   Authors like Fogarty et al. (2016) had discussed in details about the life cycle of the HIV virus in details helping readers to understand the steps that the virus goes through before showing reactions and outcomes on the health of the patients. After entering into the blood stream, free virus are seen to circulate in the bloodstream. HIV is seen to attach to the cells of the human beings and are seen to empty their contents in the cell. The reverse transcriptase enzyme for building up of the HIV DNA mainly uses the genetic material of the HIV virus (which is actually the RNA). This DNA is then inserted into the chromosome of the cell by the HIV integrase enzyme. This helps in establishing the HIV infection in the cells. Researchers have opined that this step mainly contribute to establishment of the HIV infection in the cells. When the infected cell goes through reproduction, it helps in the activation of the HIV DNA cells. This helps in making the raw materials for the new HIV viruses. This then is followed by formation of the packets for the development of new virus. The immature viruses are then seen to push out of the infected cells of the human being into the procedures that are named as budding. Then the immature virus is seen to break free of the infected cells (Morin et al., 2016). The new virus then goes through maturation stages where the raw materials are cut by the protease enzymes. These get assembled into a functioning virus ready to affect new cells. This paper is found to be important for the present day researchers as well as for the healthcare professionals. Understanding the lifecycle of the virus will help them to develop knowledge about how the virus gradually overcomes the barriers of the immune system and weakness the immune system. This would also help researchers to develop various educations that would act in the vulnerable steps of the viral development to stop the virus from reproducing new individuals and their succeeding maturation stages (Muhib et al., 2016). Several papers have been published which had worked on the importance of the anti-retroviral therapies. Winkelman et al. (2016) had stated that these therapies are actually medications which help in the treatment of the HIV. These drugs do not skill or cure any form of virus. However, when they are taken in combination with different form of drugs, they can prevent the further growth of the different viruses. The effect of the HIV becomes less severe as the virus is slowed down. Crawford et al. (2016) had stated that HIV medications help in preventing HIV from multiplying and making copies of itself. This helps in reduction of the amount of the HIV in the body. Researchers are of the opinion that when HIV becomes less in the body, it gives immune systems the chances to recover gradually. Although the infections still persists in the body, the immune systems become strong in fighting off infections as well as different HIV related cancers. Side effects from the medications can vary depending upon the medicines as well as the persons taking the medications. Researchers like Orza et al. (2015) have seen through randomized controlled trial that people taking the same medication might face different side effects. Some of the side effects, which are not much serious, may include headaches and occasional dizziness. Researchers have also noticed that harmful side effects like swelling of the throat and tongue as well as other liver damage. This can include liver damage which can be life threatening. Different HIV medications are also seen to interact with other HIV medications in the HIV regimen. They are also seen to interact with other medications, vitamins, nutritional supplements and even different herbal products. Drug interaction can result in the reduction as well as increase in the effects of the medicine of the body. Such interacts can also result in causing different unwanted side effects (Gimmens et al., 2014). An interesting aspect of the antiretroviral therapy is that it shows maximum outcome when used in combination of three or more drugs from more than one class. This is called the combination therapy (Palacio et al., 2016). This therapy helps in the prevention of the drug resistances. It is important for the healthcare professionals providing care to the patients to effectively understand the drug-resistance issues and the ways combination therapies can help in the m overcome the drug resistances. When the HIV virus are seen to undergo multiplication, many of the new copies also go through the procedures of mutations. They become slightly different from the original mother copies. Often there have been different debates as well as perspectives of different healthcare professionals regarding the HIV medications that are included in the HIV regimens. The HIV medications are mainly found to be grouped into seven drug classes according to how they fight HIV. The initial HIV regimen mainly should include there HIV medications from at least two HIV drug classes. Authors like Brennan et al. (2017) had stated that selection of HIV regimen mainly depends on several important factors. These are seen to include different possible side effects of the HIV medications as well as potential drug-drug interactions between the medications. Researchers have noticed that many of the mutant viruses keep on undergoing multiplications even when the affected individual is taking ARV drugs. During such occurrences, the virus are seen to develop drug resistance to the drugs and the anti-retroviral therapy might stop working on the affected individual. Researchers Kwan et al. (2016) are of the opinion that when only one or two drugs are used, it becomes easier for the viruses to develop resistance towards the medications. Therefore, the researchers are of the opinion that using one or two drugs should not be the standards practice of the healthcare professionals. They have found that when more than two or three drugs are utilized, a successful mutant would have to get around all of the drugs at the same time. Using of the combination therapies would ensure that the viral infection takes much longer for the resistance to develop. Therefore, using of the combination therapy had become one of the most recommended standards of the practices for treating individuals who are affected with the disorder.   Another author like Ching et al. (2017) had classified the transmission modes into three distinct categories which make it much easier for the readers to understand the modes of transmission. The first one is the sexual transmission that occurs when there initiates a contact with the infected sexual fluids like rectal, genital as well as the oral mucous membranes. This can take place when an individual get involved in sex without a condom that might include vaginal, oral as well as anal sex. The second form of transmission is the perinatal transmission, where a mother can transmit HIV to her child during the times of childbirth as well as during pregnancy and even during breastfeeding sessions. The third mode is called the blood transmission that involves the risk for transmitting HIV through the procedures of blood transfusion (Ralph et al., 2015). One important area where the authors have also focused on is the risky behavior of the drug users who use and reuse syringes to inject drugs along with sharing of the syringes with similar individuals. This enhances the risk for those individuals to be affected with the disorder. One of the most interesting features of this paper is that the author had used very simple terms and had written the paper in a simple language that makes it easier for the readers to develop a vivid picture of the transmission modes than fidgeting about the issues throughout the paper. Hence, this becomes one of the best feature and selection criteria for reviewing the paper.    One important paper had been found out through the searches of the databases that had handled on one of the most concerning aspect of HIV infection in most of the nations of the world. Kaufman et al. (2014) had discussed in details about the concept of HIV stigma. The paper is unique in the sense that the author had put more focus on the sociological perspectives associated with HIV when most authors of the generation had set their goals on the biological attributes of HIV. Therefore, in a way, the author had been able to put forward to the readers the conditions of the people who had been already living with the viral infection and the quality of the lives they lead. HIV related stigma mainly refers to the negative beliefs as well as feelings and attitudes towards people living with HIV, their families and even the people who are seen to work with them like the HIV service providers. The authors have also talked about an important concept called the HIV discrimination (Kahn et al., 2016). This approach taken by the authors have been praise-worthy as it would help a large number of healthcare professionals to provide person-centered care to the affected individuals. It had helped the professional to understand that only caring for the biological symptoms would not ensure them better quality living until the attributes of social exclusion, discrimination and prejudices are handled from the core. HIV discrimination mainly refers to the unfair as well as unjust treatment of someone that remains solely based on the real as well as perceived HIV status. HIV discrimination can be also fueled by the different myths of casual transmissions of the HIV as well as the different pre-existing biases against certain groups, certain social behaviors, drug use and fear arising from illness and even deaths. Therefore, healthcare professionals can be benefitted from this paper and advocate for institutionalization for discrimination through laws, practices and policies.   Another important paper had been derived from the searches where researchers have talked about the metabolic capacities of the HIV infected persons and the diets that should be advised to them by the healthcare professionals. Gustafson et al. (2016) have found that people who are suffering from the HIV might ace various issues that can affect their scale of the nutrition. These include modifications in the metabolism of the body as well as medicines that can upset the stomach. Even instances of the opportunistic infections causing issues with swallowing and eating like the different oral candidiasis and Kaposi sarcoma have been also observed in many individuals. Even many foods like raw meats and fish can affect the antiretroviral therapy. Therefore, these foods need to be avoided. These different problems have the capability of affecting the ability of the body to absorb different nutrients that are highly necessary for staying in the good health (Conway et al., 2015). Therefore, in the recommendations the authors have provided detailed information about the healthy eating of the affected individuals so that they can absorb the nutrients necessary for the staying in good health. Four important criteria need to e maintained while developing the diet chart for affected HIV individuals. Foods need to be chosen that provides nutrients and energy that the body requires for fighting HIV as well as other infections. The foods should also ensure maintaining a healthy weight of the individuals. The foods should also manage HIV symptoms and medications effectively. The foods should also improve the absorption of the different types of medicines that can help in managing the side effects. This paper is therefore found to be extremely helpful for the dieticians as well as the nursing professionals who are providing palliative acre to the affected patients or those individuals who are present in the long-term care. They can follow the suggestions of the authors of this paper and thereby set up food items for the affected individuals so that the four criteria of the choosing of correct foods are maintained. This would help in healthy living of the affected individuals. Authors of paper Dockrell (2017) had also been similar in approach to that of the previous paper where they have mentioned the importance of exercises on the health of the affected HIV individuals.  Exercise offers benefits that can help in maintenance of the good physical and the mental health. Exercises can also cause increase in the strength, endurance as well as the fitness and thereby this helps in the immune systems in working better to the fight various infections. People with HIV can the similar types of exercises as people who are not affected by HIV. Therefore, nursing professionals can follow this paper, educate the affected patents as well as family members, and encourage them to undertake exercise regimens that develop the quality of the health.   One important paper has been found which had discussed the effects of smoking to a person who had been affected by HIV. Legoupil et al. (2017) had discussed how smoking increases the risk of developing lung cancer as well as other cancers, heart disorders  and even chronic obstructive pulmonary disorders, asthma and even other disorders. It also reduces the lifespan of the individuals affected by HIV by further by few years. Smoking has several negative health impacts on the people who are suffering from the HIV infection. A number of observations are made in the paper by the authors. They have stated that in case of HIV, percentage of the affected individuals who smoke are higher in number than the proportion of the general population who smokes. Such affected individuals who smoke remain at a greater vulnerability for developing lung cancer as well as head and neck cancer, cervical as well as anal cancers and many other forms of cancer. They are also seen to develop bacterial pneumonia, COPD as well as heart disorders and even Pneumocystis jiroveci pneumonia. They are also seen to remain at a higher chances of developing conditions that affect the mouth like that of the oral candidiasis like thrush and even others like the oral hairy leucoplakia. They are also seen to have poorer response to the antiretroviral therapies. Therefore, this paper can be extremely helpful for the healthcare professionals who provide care to the HIV affected individuals. They can understand the ill impacts of smoking on the health of the HIV affected individuals. Therefore, they can arrange either health promotion programs or health education session for the affected individuals and their families. These would help in ensuring better health quality lives of the affected individuals. From the above discussion, it can be seen that HIV is a communicable disorders that can be transmitted through sexual activities as well as from mothers to babies and even through blood transfusions. Present day treatment that is seen to provide effective results are anti-retroviral treatments that are provided in form of combination therapies. This approach prevents the virus from developing drug resistance. However, different drug interactions and side effects are also present and therefore the nursing professionals need to be careful about them and take necessary precautions. However, nurses also need to know that the patients suffer from stigmatization and discrimination that have negative mental impacts on their health. Therefore, nurses need to educate people and make people develop knowledge on the disorder so that they do not harbor prejudices. They also should make them careful about unsafe practices that make them vulnerable.  The nurses also need to be aware about the food, exercises and smoking behaviors of the patients that reduce their lifespan when already affected by the viral infection. One of the gaps found is that very few researchers have tried to identify the social determinists for the disorder and had fewer researches on the sociological concerns faced by the affected patients. More researches are needed so that nurses can also provide effective care that would also involve caring for the social determinists of health so that patients can develop better quality lives.   References: Brennan, A. T., Bonawitz, R., Gill, C. J., Thea, D. M., Long, L., & Fox, M. P. (2017). Prioritizing health outcomes of HIV-exposed, uninfected children in low and middle-income countries: response to Powis et al. Aids, 31(2), 317. Chong, E. S., Mak, W. W., Tam, T. C., Zhu, C., & Chung, R. W. (2017). Impact of perceived HIV stigma within men who have sex with men community on mental health of seropositive MSM. AIDS care, 29(1), 118-124. Conway, D. P., Holt, M., Couldwell, D. L., Smith, D. E., Davies, S. C., McNulty, A., … & Sydney Rapid HIV Test Study. (2015). Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney. Journal of the International AIDS Society, 18(1), 20221. Coyle, K., Basen-Engquist, K., Kirby, D., Parcel, G., Banspach, S., Collins, J., … & Harrist, R. (2016). Safer choices: reducing teen pregnancy, HIV, and STDs. Public health reports. Crawford, N. D., Dean, T., Rivera, A. V., Guffey, T., Amesty, S., Rudolph, A., … & Fuller, C. M. (2016). Pharmacy intervention to improve HIV testing uptake using a comprehensive health screening approach. Public Health Reports, 131(1_suppl), 139-146. Dockrell, D. H. (2017). Facing new challenges to promote long-term health for people living with HIV. Current opinion in infectious diseases, 30(1), 1-3. Fogarty, L. A., Heilig, C. M., Armstrong, K., Cabral, R., Galavotti, C., Gielen, A. C., & Green, B. M. (2016). Long-term effectiveness of a peer-based intervention to promote condom and contraceptive use among HIV-positive and at-risk women. Public Health Reports. Gimenes, F., Souza, R. P., Bento, J. C., Teixeira, J. J., Maria-Engler, S. S., Bonini, M. G., & Consolaro, M. E. (2014). Male infertility: a public health issue caused by sexually transmitted pathogens. Nature Reviews Urology, 11(12), 672. Gustafson, D. R., Shi, Q., Thurn, M., HOLMAN, S., Minkoff, H., Cohen, M., … & Gandhi, M. (2016). Frailty and constellations of factors in aging HIV-infected and uninfected women-the women’s interagency HIV study. The Journal of frailty & aging, 5(1), 43. Kahn, J. G., Zhang, X., Cross, L. T., Palacio, H., Birkhead, G. S., & Morin, S. F. (2016). Access to and use of HIV antiretroviral therapy: variation by race/ethnicity in two public insurance programs in the US. Public Health Reports. Kaufman, M. R., Cornish, F., Zimmerman, R. S., & Johnson, B. T. (2014). Health behavior change models for HIV prevention and AIDS care: practical recommendations for a multi-level approach. Journal of acquired immune deficiency syndromes (1999), 66(Suppl 3), S250. Kwan, C. K., Rose, C. E., Brooks, J. T., Marks, G., & Sionean, C. (2016). HIV testing among men at risk for acquiring HIV infection before and after the 2006 CDC recommendations. Public Health Reports, 131(2), 311-319. Legoupil, C., Peltier, A., Henry Kagan, V., Segouin, C., Alberti, C., de Massé, L., … & Krastinova, E. (2017). Out-of-Hospital screening for HIV, HBV, HCV and Syphilis in a vulnerable population, a public health challenge. AIDS care, 29(6), 686-688. McKinney, M. M., & Marconi, K. M. (2016). Delivering HIV Services to Vulnerable Populations: A Review of CARE Act—Funded Research. Public Health Reports. Morin, S. F., Sengupta, S., Cozen, M., Richards, T. A., Shriver, M. D., Palacio, H., & Kahn, J. G. (2016). Responding to racial and ethnic disparities in use of HIV drugs: analysis of state policies. Public Health Reports. Mpango, R. S., Kinyanda, E., Rukundo, G. Z., Osafo, J., & Gadow, K. D. (2018). Exploration of the understanding and etiology of ADHD in HIV/AIDS as observed by adolescents with HIV/AIDS, caregivers and health workers-using case vignettes. African Health Sciences, 18(3), 488-495. Muhib, F. B., Lin, L. S., Stueve, A., Miller, R. L., Ford, W. L., Johnson, W. D., … & Community Intervention Trial for Youth Study Team. (2016). A venue-based method for sampling hard-to-reach populations. Public health reports. Orza, L., Bewley, S., Logie, C. H., Crone, E. T., Moroz, S., Strachan, S., … & Welbourn, A. (2015). How does living with HIV impact on women’s mental health? Voices from a global survey. Journal of the International AIDS Society, 18, 20289. Palacio, H., Kahn, J. G., Richards, T. A., & Morin, S. F. (2016). Effect of race and/or ethnicity in use of antiretrovirals and prophylaxis for opportunistic infection: a review of the literature. Public Health Reports. Raj, A., Amaro, H., Cranston, K., Martin, B., Cabral, H., Navarro, A., & Conron, K. (2016). Is a general women’s health promotion program as effective as an HIV-intensive prevention program in reducing HIV risk among Hispanic women?. Public Health Reports. Ralph, L. J., McCoy, S. I., Shiu, K., & Padian, N. S. (2015). Hormonal contraceptive use and women’s risk of HIV acquisition: a meta-analysis of observational studies. The Lancet infectious diseases, 15(2), 181-189. Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., … & Duan, L. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386(9995), 743-800. Winkelmann, M., Sorrentino, J. N., Klein, M., Macke, C., Mommsen, P., Brand, S., … & Zeckey, C. (2016). Is there a benefit for health care workers in testing HIV, HCV and HBV in routine before elective arthroplasty?. Orthopaedics & Traumatology: Surgery & Research, 102(4), 513-516. Woods, S. P., Iudicello, J. E., Morgan, E. E., Cameron, M. V., Doyle, K. L., Smith, T. V., … & Ellis, R. J. (2016). Health-related everyday functioning in the internet age: HIV-associated neurocognitive disorders disrupt online pharmacy and health chart navigation skills. Archives of Clinical Neuropsychology, 31(2), 176-185

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