Learning about one’s HIV status can be scary, which has led to many people avoiding going for the test. Knowing that one is HIV positive now becomes the most challenging burden one can carry, and one is left with many questions lingering in their mind. People forget that being positive does not end fulfilling and happy lives. When one adheres to medications and receives counseling from a professional, they might live as long as an average person would. People are different, and how one will proceed with their life after the diagnosis will differ from the other person.
When an infected person fails to follow the medication procedures as guided by the physician, it may cause the body to lose its resistance to some infections such as flu. When HIV is left untreated, minor infections including common cold can be severe and affect the individual. It is crucial for people who have recently been diagnosed with HIV to be encouraged to be on medication without failure and follow the doctor’s diet. Failure to take these medications or follow the instructions prescribed may lead to body changes that may affect people’s self-esteem leading to indulgence in alcohol and substance abuse.
Legal and Ethical Issues
The state provides statutory laws to an individual regarding their choices to be tested for the virus or not and protect their right to autonomy. Such privileges significantly impact the lives of people living with the disease, making them have the courage to stand up and fight for their rights. Persons living with the virus have secured jobs in places where society never thought they would, created a self-awareness association to reassure individuals living with the same condition. These associations have played a major role in supporting authorities in encouraging people stigmatized by society to come together and fight back. Persons with the infection have proven they are not what the public see them to be. HIV/AIDS has caused so many deaths that the international health organizations have teamed with local organizations trying to control the pandemic. Some basic ethical principles that are meant to protect the rights of the people discriminated against by the community include individuals’ autonomy, non-maleficence, justice, and beneficence.
Legal institutions have developed ways to help the infected population access affordable medical care for their patients. Health insurance provides people living with HIV with appropriate medical care, especially the antiretroviral therapy that assists people living with the disease in staying healthy and educating them on preventing the transmission of the virus to other people. Some measures to ensure improved access to medical care for these people include affordable medical coverage for people with established conditions. In the past, people with preexisting conditions such as asthma, HIV, and cancer were denied access to proper care. Still, lately, things have changed, caused by the intervention of the Affordable Care Act (ACA). With this Act in place, now people with existing infections can get the medical coverage they can afford. The introduction of lower prescription drugs has been of major impact as most individuals went without prescription due to their high cost.
Doctors have come up with different ethical and legislative standards when handling people living with HIV. They have come up with different ways to help these patients, and where they do not have the necessary skills, they see to it that the patient has been helped by a professional. State and federal laws and ethical issues have been put across to prevent hospital staff from discrimination and protect workers from harsh working conditions.
Prevention and Treatment of Substance Abusers with HIV/AIDS
People living with HIV should be encouraged to avoid substance use at any cost as it is harmful to their body and brain and interferes with the ability to stick to their dosage. If it is hard for them to avoid substance use, it is advisable to access substance use programs that will help them in treatment and counseling. Managing problems arising from substance use by people infected with HIV is becoming challenging for both practitioners and law enforcers in many regions. Additionally, in many parts of the country, access to treatment services and prevention incentives for people living with the virus is limited. Injection drug use has driven the rise of HIV/AIDS, and managing this problem is quite challenging. Access to injection drug use is becoming complicated due to the fear of prosecution, negative attitudes from caregivers, stigmatization, and sometimes leads to a chaotic lifestyle. Injecting drug use has led to the rise of HIV infections as people share needles without sterilization, increasing the rate of transmitting the infections.
Access to treatment has been made easier as antiretroviral medications and therapy are readily available in many institutions. However, access to these services is limited to many more impoverished regions. World Health Organizations are advocating the essence of providing education and treatment programs to vulnerable groups. The majority of individuals benefiting from these programs are from well-developed nations; hence, those living in underdeveloped nations are left vulnerable.
Science frameworks for generating actionable and critical evidence are crucial in understanding the facilitators and barriers in integrating substance use disorders and HIV treatment. At the community and personal level, the barriers to effective treatment are stigma associated with substance abuse, lack of social support, varying levels of motivation, making the individual lose hope, and loss of follow-up exercises. According to Lancaster et al., (2018), organizational and provider barriers towards effective treatment of substance users with the virus include shortage of personnel, lack of enough knowledge on how to handle the issue and enough skill providers, few diagnostic pieces of equipment, and exposure to environments that facilitate the spread of the virus. He continues to argue that lack of systematic systems that can monitor and control comprehensive and coherent substance abuse policies that support integrated care models can facilitate an increase in the spread rate of the virus (Deren et al., 2019). Additionally, the older population living with HIV has a higher rate of indulging in substance abuse as compared to the younger generation.
Integrated Treatment Programs
Integration of HIV treatments and drug supply has led to improved HIV prevention and regression and decreased infection while enhancing support and social services amidst substance users. A combination of behavioral and pharmacological drug use treatments has shown success in minimizing behaviors that increase HIV risks and improving observance of antiretroviral therapy between people who abuse substance use and are HIV positive (Nguemo et al., 2020). Substance use treatment has proven to be essential in encouraging users to reduce drug dependence while endorsing taking HIV tests, starting up on antiretroviral therapy, and treatment adherence.
Integrating addiction treatment and providing HIV services has spread widely around the world in the recent past. Researchers have come up with several models used in the integration process, including integration of HIV services at substance use facilities with services like screening of the virus, counseling, and treatment if the disease is found. Integration of treatment services is not an easy task as it is accompanied by several barriers, especially during start-up. Such barriers can affect how the patient interacts with the care provider, organizations providing the care, how community and social systems respond to the issue. Occasionally, researchers utilize the information they receive from integration treatment providers to identify barriers and facilitators that can impact service integration (Nguemo et al., 2020). Information derived from substance use integration is not substantial in providing for effective implementation strategies.
Several studies have been conducted and have been paramount in advancing the treatments for HIV infections and preventing more cases. Preventive strategies like preexposure prophylaxis and postexposure prophylaxis have proved to be more effective in preventing new cases of HIV infections between people that are more exposed to the risks of acquiring the virus. According to Fauci et al. (2019), research shows that HIV has declined from 2010 to 2015 at an 8% rate, motivating policymakers worldwide to join hands in the Getting to Zero initiative to terminate the virus. The decline was influenced by the technological advancements in the health care sector to curb the disease.
Social Issues Related to Assessment and Treatment
Stigma and discrimination are often brought by the lack of knowledge and understanding on how HIV is spread, access to treatment, the fact that AIDS has no cure, and inadequate media coverage on the issue. If people are adequately educated on the issue, there would be no discrimination against people with HIV. The media should be well versed with the issue and come up with ways to enlighten society on how people should act upon realizing their status.
Discrimination to these people can lead to various consequences, including limited or denial of education to affected children, limited access to equal health care to infected persons, and denial of employment opportunities. Having this in mind, an infected person may fail to come out and speak up on their status with the fear of being discriminated against. Additionally, people may fail to come out and get tested due to internalized stigma as they will experience difficulties as they try to adjust to their new status. Stigmatization leads to people losing hope in planning their plans and may end up indulging in substance abuse. Substance abuse has adverse effects on people living with HIV as it reduces their life span, which in the short future led to leaving orphans with no economic future.
To combat social discrimination and stigmatization, all society levels should be included in talking about issues of the pandemic. The legal systems should make efforts in educating society on ways of avoiding and, if infected, encourage the affected to seek medical attention. Also, they should ensure rights of the people living with the infection are protected at international and national levels. In so doing, people will come out to take the test and will handle the results positively. Education systems should incorporate programs that teach the mass about ways the virus is transmitted, prevent it, and obtain treatment. This will have a significant impact in fighting discrimination and stigma.
Cultural Issues Related to Assessment and Treatment
Culturally, the infection has a massive impact not on the individual himself but also on the whole nation. Initiatives to come up with a cure for the virus have borne no results, and the hope and energy to do further research in fighting the virus have been deemed futile. The silence of the pandemics causes massive damage to the individual, the family, and the nation’s economy at large. This has wielded rejection more so in the poor population as they have been brought up knowing being a carrier of the disease as a taboo. People have taken up different approaches to fighting through the infection. In handling such issues, cultural norms and human rights should be respected more when breaking the silence about the pandemic is overbearing.
Cultural beliefs are sometimes responsible for the menace as children are not fully educated on matters about sex education. It is believed that what children are taught at a young age from their caregivers about their cultures tend to follow that and pass it to future generations. More HIV risks are on the rise when the population is not well equipped with appropriate skills that educate on measures to contain the virus. Children born in poor populations that have high poverty in substance abuse lack the know-how on how to protect themselves from various infections to which they unknowingly are exposed to.
Community engagement is vital for assessing community knowledge and beliefs, identifying and mitigating risks, providing education and information that will help in the research process, and adapting plans and procedures that will involve norms and practices of the particular community. According to Dawson et al. (2020), involving the community is also essential in that it will look for ways to correct the previous failures that the previous research did not achieve.
Government Initiatives Related to Assessment and Treatment
The government has come up with different initiatives composed of four pillars that will aid in ending this pandemic. According to Fauci et al. (2019), the pillars include diagnosing all infected individuals with the virus, detecting and responding to a new treatment to reduce the emergence of new transmissions. Additionally, preventing at-risk individuals from getting the infection and treating infections as soon as possible and effectively sustaining it entirely are inclusive of the strategic initiatives. Research carried by different clinics has led to significant advances in the treatment of the infection. This has made people living with the infection achieve a normal lifespan. These advances have proven that if the virus is contained in early stages and treatment made accessible to all persons living with HIV can be eradicated and minimized (Peter et al., 2017). These strategies can only be effective if all governing bodies like state, federal, non-governmental organizations, and local health departments work in harmony. Geographic and demographic factors need to be considered to control the spread of HIV in the states.
Practicians have come up with ways to prevent substance abusers with HIV/AIDS from spreading and lowering the virus’s risks. Some of the guidelines put across for substance users to prevent contracting the virus include the use of sterile needles, advising people against sharing needles, using sterile water to fix drugs, and cleaning the skin with new alcohol swabs available in clinical outlets strategically located in different regions.
Several public health strategies like (Data to Care) have been put across that utilize surveillance other sources of data to improve the care provided to persons living with HIV. As Sweeney et al. (2019) stated, these strategies work by identifying the people in need of specific medical services and directing them to the responsible body that can handle their issues. The primary goal of such strategies is to ensure there is an increased number of people living with HIV that are involved in the care.
Primary and Secondary Prevention
There are various ways that substance users can use to prevent getting the infection. One of the primary aspects of prevention is protection. When one is sleeping with multiple partners, it is always advisable to protect you and your partner from contracting the disease. Such protection involves having a monogamous partner, abstinence from sex, and if you need to have an outside partner, it is good to use a latex condom. If one cannot use a condom, it is recommended, they are tested before they do the act. In most instances, primary measures aim to prevent the total spread of the disease to the community as a whole. That is why condoms will be distributed at different convenient stores and hospitals to prevent sexually active males from contracting HIV.
Most HIV infections have been associated with bisexual individuals. Several individual and social factors are responsible for the high rise in the number of HIV infections in gay individuals, especially men having sex with other men. These factors include mental health, stigma, substance use, and incarceration. Mental health influences the cognitive behaviors of a person, making them indulge in unwanted practices. Gamarel et al. (2019) stated that, predictably, many people are more likely to have condom-less anal sex with their primary associates as compared to their casual partners. This puts each partner at a very high risk of contracting the disease.
Secondary prevention measures are intended to prevent people who are living with HIV from transmitting to people that are HIV negative. Secondary HIV prevention aims to attain goals such as enlightening people living with HIV on the reduction of risk practices like substance use and sexual activities. Also, they support the patients and guide them in adhering to their medications, informing them of the repercussions of failure to take the medications, and educating them on how they can reduce the risk of transmission to healthy people. Prevention measures that can occur in health settings include counseling on issues like how to negotiate for safer sex and encourage people to disclose their status to their partners, providing pre-exposure prophylaxis referrals for drug injecting partners, prescribing condoms to people that are HIV positive, and educating people on safe sex practices. Prevention interventions for the disease are starting to recognize the role relationships play in shaping the risks of HIV.
To conclude, sensitizing the community to avoid being infected with HIV should be a conjoined effort starting from the family to the government. Failure to educate the society on some cultural aspects will not educate the members about sex matters and prevent the virus’s contraction and will discriminate those affected, causing stigmatization. People born with the virus should not hide but instead, seek medical interventions as early as possible to enable them to become productive members of society. Substance users should be discouraged to refrain from the unwanted behaviors but rather adapt to taking medication prescribed by the specialist. This will help them in attaining an average lifespan and will be able to provide for the family. The government’s legal and ethical issues should be enacted in all institutions to ensure equality in all sectors.
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Nguemo, J., Djiadeu, P., Mbuagbaw, L., Njoroge, I., Nelson, L., & Kahan, M. (2020). Individuals’ experiences of the integration of substance use/addiction and HIV/AIDS services in community settings: A qualitative systematic review protocol. JBI Evidence Synthesis, 18(12), 2687-2693. Web.
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