“Every 9.5 minutes someone in the United States is infected with Human Immunodeficiency Virus (HIV).” According to the Center for Disease Control (CDC), there are approximately 1.5 million people living with HIV, and one out of five is not aware they are infected (CDC, 2011). The first documented case of HIV was from a blood sample retrieved in 1959 from an individual residing in the Democratic Republic of the Congo. There is no information on how this individual became infected or how it was believed to have arrived in the United States in 1969. There are a number of stories on how this life-threatening disease came about and how it made it to the United States. There is also a story of hunters eating a contaminated chimpanzee in the western part of Africa. Recent studies show HIV may have traveled from monkeys to humans as far back as the late 1800s.
In 1981 the CDC received reports of a rare cancer among the gay men in New York and California, called Kaposi’s sarcoma. Doctors began treating and caring for these young gay men for the cancer. Kaposi’s sarcoma is a cancer found in the Mediterranean heritage among elderly men with weakened immune systems. Gay and bisexual men of all races are ranked highest affected by HIV. A total of 270 cases of severe immune deficiency among gay men were reported in the closing of 1981 and 121 have died. In June, the CDC created the Task Force on Kaposi’s sarcoma and Opportunistic Infections (KSOI) to recognize the risk factors and to develop awareness for coast-to-coast observation. This marked the beginning of HIV. It is understood that HIV can go undetected for a long time within the body’s cells. During this time it is attacking the CD4 cells (needed for the body to fight infections and diseases) by using them to duplicate itself and destroying the cells. Once HIV has destroyed numerous CD4 cells, and the body can no longer fight off infections and diseases, it can lead to Acquired Immuno Deficiency Syndrome (AIDS).
The first cases of HIV were later acknowledged and referred to as AIDS in 1982. In January 1982, San Francisco established the first American AIDS clinic, and the Gay Men’s Health Crisis, was founded in New York City and is first community-based AIDS service provider in the United States. Currently there are 31 Food and Drug Administration (FDA) approved anti-retroviral (ARV) medications to treatment and help manage HIV. Individuals can live longer lives with the use of highly active antiretroviral therapy. With the widespread use of this drug, the epidemiology of the disease has shifted. People living with HIV/AIDS, 50 years and older have risen in numbers over the past years.
This change has put a new focus on the importance of primary care in the diseases management. In the United States, these numbers have increased from 65,445 in 2001 to 115,871 in 2005 (Valenti, 2008). A decrease in mortality rates within the HIV/AIDS population and the causes of death are also changes in HIV/AIDS epidemiology. Although there is no cure for HIV/AIDS there are numerous medications and treatments, which are relieving individuals of the painful symptoms and helping to slow the disease’s progress down. The HIV/AIDS rate in the United States is constantly rising, which is causing the need for more health care resources such as clinics, hospitals, and centers focusing on the disease.
On July 13, 2010 the National HIV/AIDS Strategy (NHAS) was released by President Obama. The purpose of NHAS is to refocus efforts and deliver better results. The United States needs increased public attention to the HIV/AIDS epidemic. Possessing the knowledge and necessary tools to slow the spread of HIV has improved the health of those living with HIV. The public’s actions in fighting the disease are declining. In 1995 about 45% of the public indicated HIV/AIDS was the most ultimately important health issue the nation faced, compared to about 6% in March 2009. Transmission rates have decreased enormously over time as people are living longer and more prolific lives. About 56,300 individuals are infected per year resulting in more Americans with HIV than ever before.
The goals of the NHAS are to reduce new HIV infections by 25% by 2015. This will be done by educating Americans, especially teens, about the life-threatening disease HIV/AIDS and how to prevent it. Another goal is increasing access to care and improving health care outcomes for people living with HIV/AIDS (Valenti, 2008). This will entail creating a system to connect people to continual and coordinated quality care once aware of infection. The last goal of the NHAS is to reduce HIV related health disparities. This includes access to prevention and care services to Americans. In addition, the NHAS aims to increase the proportion of HIV diagnosed gays, bisexual men, Blacks, and Latinos with undetectable viral load by 20% (Valenti, 2008).To reduce these disparities the NHAS will have to use community level strategies to reduce the HIV infection in high risk communities. The Health Care Reform will have a positive impact on persons living with HIV/AIDS. President Obama just signed the Health Care Reform legislation. According to the Health Care Reform, people living with HIV will not have to wait for the infection to progress to AIDS to be eligible for Medicaid.
This helps the AIDS Drug Assistance Programs (ADAP) by expanding access to Medicaid. The Medicare Part D donut hole will be phased out to permit ADAP to pay true-out-of-pocket expenses. Presently, once the coverage limit of $2,510 is obtained they are mandated to pay $4,550 true-out-of-pocket (TrOOP) before catastrophic coverage kicks in (HIV Law Project, n.d.). Individuals living with HIV/AIDS will have increased access to private health insurance because there is no longer a discrimination based on health status or the chance of gender and health status causing them to be charged differently. The Health Care Reform will increase coverage for mandated benefits packages that will include prescription drugs, preventive care, chronic disease management, and substance abuse, and mental health treatment. Subsidies will be offered to families and individuals with incomes between 133 – 400% of the Federal poverty level, which will increase affordability.
Under the Health Care Reform $75 million is being invested in evidence-based sex education programs. Some of the invested money will go toward prevention and wellness initiatives, public health infrastructures, and community health centers servicing exposed populations (HIV Law Project, n.d.). Investing in prevention and wellness initiatives will help to promote good helth and reduce health care costs. Evidence-based and cost-effective remedies are a productive and successful way of preventing HIV/AIDS. The United States has made a tremendous progress against HIV/AIDS averting new infections and helping people live longer healthier lives with effective treatments and medications. Although antiretroviral therapy has slowed the progress of the disease, and has given the infected population hope, it has also put an increased strain on those working in health care. Providing antiretroviral therapy takes a large amount of time. HIV prevention will save time and money.
Some successes are the annually number of infected reduced from 130,000 in 1985 to approximately 50,000 in 2012. The mother to child infections has been reduced from approximately 2,000 to about 200 in 2012, and there is an increase in the population of those who are aware of possessing HIV/AIDS from 75% in 2003 to 80% in 2012. It is estimated that more than $125 billion in direct medical costs has been saved from 1999 – 2006 (Farnham, Holtgrave, Sansom, 2010). It is important every HIV prevention dollar is spent wisely and effectively. Because of this the CDC is committed to using its HIV resources for high-impact prevention such as cost-effective and scientifically proven interventions aimed toward specific populations in specific geographic areas. The CDC has a host of prevention tools for the targeted areas such as HIV testing, connections to care, access to condoms, sterile syringes, risk reduction programs (for both infected and non-infected individuals), antiretroviral therapy for infected persons, and screening and treatment for other sexually transmitted diseases or infections (STDs/STIs).
AIDS.gov. (n.d.). Federal Resources. Retrieved from http://aids.gov/
Center for Disease Control, (2011). HIV/AIDS Questions and Answers. Retrieved from
Center for Disease Control, (August, 2008). Estimates of New HIV Infections in the US.
Retrieved from http://kff.org/kaiserpolls/upload/7889.pdf
HIV Law Project. (n.d.). How Does Health Care Reform Impact People Living With HIV/AIDS?
Retrieved from http:.//hivlawproject.org/stayinformed
Valenti, W. (2008). Impact of Changing Demographics of HIV/AIDS on Role of Primary Care.
Retrieved from http://www.theaidsreader.com/display/article/1145619/1319584