NRS 428 Week 2 Assignment Epidemiology Paper

NRS 428 Week 2 Assignment Epidemiology Paper

NRS 428 Week 2 Assignment Epidemiology Paper

Epidemiology is the scientific study of how frequently diseases occur in different groups of people and why. It is based on two fundamental assumptions. Firstly, it assumes the occurrence of the disease is not random because several factors concomitantly influence the likelihood of developing the disease (Stover et al., 2021). Further, it assumes the study of populations facilitates the recognition of the causes and preventive factors analogous with the disease. Communicable diseases refer to infectious diseases caused by different microorganisms such as bacteria, viruses, fungus, and parasites that can be spread directly or indirectly from one individual to another. Many infectious diseases can be transmitted via bites from insects, while others are caused by ingesting contaminated substances such as food or fluids. Although several infectious diseases pose serious health risks to communities, HIV can never be underestimated. The purpose of this paper is to discuss HIV and apply epidemiology and nursing research concepts to this communicable disease.

Description of HIV as Chosen Communicable Disease

HIV is a retrovirus that destroys cells of the human immune system (mainly CD4-positive T-cells and macrophages), which are the cellular immune system’s critical components, and kills or impairs their role. Infection with this virus results from the progressive depletion of the immune system, leading to immunodeficiency (UNAIDS, 2021). The Human Immunodeficiency Virus comprises two strands of RNA, 15 types of viral proteins, and a few proteins from the last host cell it infected, all surrounded by a lipid bilayer membrane. There are two categories of HIV, HIV-1 and HIV-2. HIV-1 can be found worldwide, but HIV-2 is almost exclusively limited to West Africa. HIV-1 is transmitted more easily than HIV-2(UNAIDS, 2021). The advanced level of HIV infection is acquired immunodeficiency syndrome (AIDS). AIDS is determined by developing certain malignancies, conditions, or other acute continuing clinical indications. HIV-1 infection progresses more rapidly to AIDS compared to HIV-2.

Causes of HIV

A virus causes HIV through sexual contact or blood. In addition, transmission can occur from mother to child during pregnancy, childbirth, or breastfeeding. When the virus enters the blood, it destroys the white cells that provide the body with the ability to fight infections and disease (UNAIDS, 2021).


The symptom of HIV varies and is determined by the phases of infection. Several people infected with HIV may manifest flu-like symptoms a few weeks after the entry of the virus. The likely symptoms at the acute stage may include fever, headache, skin rash, sore throat, and painful mouth sore. Similarly, swollen lymph glands, especially on the neck, muscle aches, joint pains, and diarrhea may manifest. In addition, the person could also manifest coughs, weight loss, and night sweats (UNAIDS, 2021). As the pathogen mutates in the blood and destroys the white cells at the symptomatic stage, the following symptoms may manifest Pneumonia, herpes zoster, thrush or oral yeast infection, fatigue, and fever. Furthermore, when the virus progresses to the stage of AIDS, the mentioned symptoms would manifest to be persistent and severe (UNAIDS, 2021).

Mode of Transmission

The predominant mode of HIV transmission is through unprotected sexual contact with an infected partner. In addition, exposure of broken skin or wound to infected blood or body fluids. Similarly, transfusion with HIV-infected blood is another avenue for transmission (Stover et al., 2021). Moreover, when an individual is injected with contaminated objects like needles and unsterilized syringes or razorblades, the virus is likely to be transmitted. Furthermore, transmission can also occur from mother to child during pregnancy, birth, or breastfeeding (UNAIDS, 2021).

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Complications               People infected with HIV who do not get proper treatment for HIV/AIDS develop a wasting syndrome accompanied by diarrhea, fever, and chronic weakness. In addition, individuals are likely to develop neurological complications as the virus reduces mental functioning. The difficulty includes kidney disease, such as the inflammation of kidney filters that remove excess fluid and waste from the blood to the urine. Similarly, there is the liver complication (UNAIDS, 2021).The other common infectious complications related to or due to HIV comprise Pneumonia that causes severe illness. The difficulty of thrush or candidiasis causes inflammation on various body parts, i.e., the mouth, tongue, and esophagus. Similarly, the other problematic condition is Tuberculosis, especially in developing countries(Mahy et al., 2021).Treatment               HIV has no cure but can be controlled through antiretroviral therapy. The treatment entails taking medicine that lessens the viral load in the blood. The medicine for HIV therapy is called antiretroviral (UNAIDS, 2021).The treatment involves a combination of everyday medications that prevent the virus from multiplying. The treatment aids protect the CD4 cells, keeping the immune system strong enough to combat infection and disease. The ART lowers the viral load and reduces the chance for transmissions from one person to another ((Mahy et al., 2021)Demographic- Prevalence

The global prevalence of HIV, according to UNAIDS (2021), estimates that about thirty-eight million people living with HIV. Women accounted for fifty-three percent of the number, while men accounted for forty-seven percent. Furthermore, two million are children between zero to nineteen years of age. In addition, data indicate that women aged fifteen years up to twenty-four years globally acquire HIV. Furthermore, Sub-Saharan females account for sixty-three percent of the newly acquired HIV infection. Women accounted for fifty –three percent. Similarly, in 2020, 1.5 million people contracted HIV globally (UNAIDS, 2021).

According to the UNAIDS report, the most affected populace with HIV is from developing countries. For instance, in 2020, east and southern African countries had twenty-seven million people infected with HIV, accounting for fifty-five percent of global infection. Moreover, Asia and Pacific regions had six million people infected, accounting for fifteen percent of global infection. In addition, western and central Africa had five million infected, accounting for thirteen percent. Moreover, North America and Central Europe had two million, accounting for six percent of the global infection prevalence (UNAIDS, 2021).

Reporting of HIV

The primary object for reporting is for public health authorities to know where several diseases are found in a population. The information helps them take steps to mitigate the spread of infectious diseases and safeguard the community’s health. Further, it ensures linkage of care for any newly infected patients or continuation of care for earlier diagnosed patients(Stover et al., 2021). Moreover, timely monitoring presents trends in the epidemic and secures proper funding for local treatment and prevention services.HIV is a reportable condition that medical practitioners and pathology services must notify within five days of diagnosis to the HIV is reported only to the HIV/AIDS Surveillance Program at the Department of Public Health.

Determinants of Health and Explanation of How Determinants Contribute to Disease Development

Social health factors are the conditions in which people are born, grow, live, work and age. The social determinant includes factors like socioeconomic status, education, neighborhood, physical environment, employment, social support networks, and access to health care(Stover et al., 2021) The social factors of health can influence a person’s likelihood of acquiring HIV through influences on improper behavior, limited access to preventive measures, and limited access to healthcare providers or testing sites.

Studies show that abuse drugs such as alcohol, cocaine, marijuana have exacerbated the risk of HIV infection. Similarly, the use of drugs leads to confinement. The individuals under detention are reported to be engaging in unprotected sex leading to a high rate of HIV infection. Further, the social-economic status has contributed to the prevalence of HIV. The economically poor are more likely to get into unwarranted behaviors, e.g., indulging in commercial sex, thus risking and enhancing the infection of the virus (Mahy et al., 2021). Economically vulnerable women experience the scarcity of health-related resources in poor, under-served communities or villages where access to health care and condoms are not readily available(Mahy et al., 2021). These compounding social health determinants extrapolate the prevalence and the risk of acquiring the virus.

The Epidemiologic Triangle

The Epidemiologic Triangle is a tool that researchers employ in addressing the three constituents that contribute to the spread of infections or disease. The triple components comprise an external agent, a susceptible host, and an environment that brings the agent and host together (Mahy et al., 2021).The triangulation of HIV (causative agent) refers to factors and attributes of the virus that concomitantly aids its infection and spread on the host. Firstly, the nature of the subtype of the HIV Virus determines the extent of infection and spread. Studies show that HIV-I is easily transmitted due to its biological and chemical characteristics. To underscore, HIV-1 RT is a heterodimer composed of p66 and p51 subunits, with p66 harboring two functional, active sites: an N-terminal RNA- and DNA-dependent DNA polymerase and a C-terminal RNase H that digests the RNA component of RNA–DNA hybrids (De Almeida et al., 2021). Due to its nature, HIV -1, therefore, binds more efficiently and faster than HIV 2 with the receptor molecule CD4 on the cell surface.; thus having a higher capability to infect and spread rapidly. Similarly, the other exacerbating factors include having a sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis that enhance chances for infection.

The host triangulation characterizes the host (human) factors as those that help enhance infection and spread the virus. The factors include having unprotected sex, having a frequent change of partners or having sexual activity for financial gain, peer pressure, drug and substance abuse (Hershow et al., 2019). These behaviors aid in enhancing HIV infection and spread. Similarly, urban health studies have found that poverty and unemployment, vacant buildings, and high crime rates are concomitant with an increased risk of HIV infection. The Social economic factors such as lack of access to care, discrimination, stigma, homophobia, and poverty enhance higher rates of HIV infection. Studies from cosmopolitan and urban areas indicate that poverty, unemployment, and high crime rates increase the risk of HIV infection and spread (Hershow et al., 2019). In addition, viral load increases in the infected occur for reasons such as not taking antiretroviral medication consistently due to lack of access to ART.

Special Consideration

There are special considerations or notifications for the community regarding the triangulation of HIV. Communities affected by HIV usually do risky behaviors, including sexual activities without protection and sharing paraphernalia that contribute to HIV infection. HIV education can aid learners in schools and the community develop and maintain safer behaviors and reduce stigma and discrimination towards people affected by and living with HIV (Hershow et al., 2019).

Role of the Community Health Nurse and Importance of Demographic Data

Nurses play vital roles in educating patients about HIV, providing support for treatment adherence, and assisting with navigation of care delivery. APRNs, further, are positioned to provide ART directly, consistent with their state practice authority.The community health nurse has professional technical skills and knowledge that the community populace may not have; thus, the nurse has the role in ensuring the quality of community-based care(Stover et al., 2021). They form a significant component in delivering quality HIV services, including counseling, adherence support, development of a referral framework, and dissemination of information. They also have the role of reporting and HIV data collection.

Demographics are essential since they offer an exhaustive comprehension of a population’s various features. The provided information is particularly vital to government organizations and institutions for making crucial policy decisions concerning the people(Stover et al., 2021). Similarly, demographics data is critical as it gives the health authorities andpopulace information they need to strategies and implements future investments and services; data from sources such as the CDC and the US Census aids in determining where assistance programs need to be directed (UNAIDS, 2021)

National Agency or Organization That Works to Addresses Communicable Disease

The USAID is one of the major federal agencies that implement the PEPFAR core mandate. The USAID’s Office of HIV/AIDS reinforces country-led efforts to combat the complex challenges of HIV in over fifty countries around the globe. The agency avails global leadership in developing projects and plans of actions that amplify impact. Similarly, it reinforces country-led programs and policies while at the same time administering USAID’s elaborate health and development skills and particularized HIV/AIDS technical capability(Stover et al., 2021). Further, the organization applies research, technology, and change to encourage cost-effective, sustainable, and judicious integrated HIV/AIDS interventions.

Global Implication of HIV

Notwithstanding the existence of treatment that can manage and mitigate the progression of HIV viral transmission, the virus remains a major leading cause of death and a health risk to millions globally. HIV is non-endemic; it is widespread globally. Different countries have put various strategies to mitigate the infection surge among their population. Techniques like the use of male and female condoms are encouraged by various governments. Further, voluntary medical male circumcision is agitated across the globe to minimize the chances of infection. (UNAIDS, 2021).Moreover, many countries use antiretroviral drugs to prevent mother-to-child transmission, pre-exposure prophylaxis, post-exposure prophylaxis, and treatment as prevention. Similarly, sex and reproductive health services are used to inform the population on the crucial knowledge that helps reduce infection of the virus (Stover et al., 2021).


HIV is a retrovirus that destroys cells of the human immune system, specifically the CD4-positive T-cells and macrophages. There are two types of HIV, namely HIV-1 and HIV-2. HIV-1 can be found worldwide. In addition, the infection is non-endemic but widely spread. Further, it is caused by a virus that enters the blood and impairs the white cells. Moreover, the primary mode of HIV transmission is through contact with infected blood body fluids. In addition, people infected with HIV who do not get proper medication for HIV/AIDS develop diarrhea, fever, and chronic weakness. In addition, they are likely to develop complications like neurological malfunction, kidney, and liver, among others. UNAIDS 2021 report reveals that about thirty-eight million people live with HIV, of whom women are the majority with infection. Similarly, regionally, the Sub-Saharan countries lead with an infection of about twenty-seven million, accounting for 53% of the world infection as of 2020. Moreover, the condition is modifiable to the health authorities to help mitigate the spread of infectious diseases and safeguard the community’s health.


De Almeida, S. M., Rotta, I., Tang, B., Vaida, F., Letendre, S., Ellis, R. J., & HNRC Group. (2021). IgG intrathecal synthesis in HIV-associated neurocognitive disorder (HAND) according to the HIV-1 subtypes and pattern of HIV RNA in CNS and plasma compartments. Journal of Neuroimmunology, 355, 577542.

Hershow, R. B., Gonzalez, M., Costenbader, E., Zule, W., Golin, C., & Brinkley-Rubinstein, L. (2019). Medical providers and harm reduction view on pre-exposure prophylaxis for HIV prevention among people who inject drugs. AIDS Education and Prevention, 31(4), 363-379.

Mahy, M. I., Sabin, K. M., Feizzadeh, A., & Wanyeki, I. (2021). Progress towards 2020 global HIV impact and treatment targets. Journal of the International AIDS Society, 24, e25779.

Stover, J., Glaubius, R., Kassanjee, R., & Dugdale, C. M. (2021). Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates. Journal of the International AIDS Society, 24, e25778.

UNAIDS (2021) epidemiological estimates.

Topic 2 DQ 2

Select a global health issue affecting the international health community. Briefly describe the global health issue and its impact on the larger public health care systems (i.e., continents, regions, countries, states, and health departments). Discuss how health care delivery systems work collaboratively to address global health concerns and some of the stakeholders that work on these issues.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

A global health issue that has affected the globe recently is the COVID-19 pandemic. The pandemic has had devastating impacts on the economic, social, and personal lives of individuals. The health care system was the most impacted as clinicians were the first responders to the pandemic and provided the much-needed first intervention. The public health care system was affected by the lack of vaccinations and the need to engage in contact tracing. Quarantines were established to help prevent the further spread of the virus. Research had to be conducted on how to break the communicable chain of infection. Handwashing and social distancing became critical in helping prevent the spread of the virus (Kitson et al., 2021). Various stakeholders across the globe had to work together to effectively address the pandemic. Given the impact it had on the globe, it became hard for a nation to deal with the pandemic on its own. Global travel and the interconnection between nations further made it challenging to contain the virus spread (Stratton, 2020).  Vaccine distributions became important with countries supporting each other with regard to resource mobilization and distribution. Public health systems across different nations had to work together to prevent mass loss of lives and to allow the world to go back to normal. The impacts of the pandemic were severe on the health care system but also provided key learning lessons.


Kitson, A., Huisman-de Waal, G., & Muntlin, A. (2021). Lessons from COVID. Journal of Advanced Nursing, 77(7), e7-e9. 10.1111/jan.14844

Stratton, S. J. (2020). COVID-19: Not a simple public health emergency. Prehospital and Disaster Medicine, 35(2), 119-119.


I enjoyed reading your post; COVID-19 has affected many lives worldwide. Many lost loved ones who were unexpectedly affected by this pandemic. According to (World Health Organization (WHO), 2020) COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems, and the world of work. The disruption of COVID-19 on our economic and social lives caused by the pandemic is devastating. Tens of millions of people are at risk of falling into extreme poverty (World Health Organization (WHO), 2020). Healthcare workers responded efficiently to the cries of our tired fellow co-workers when COVID was at its peak. The response from multiple countries and our government were good at trying to contain the pandemic by laying out safety regulations to prevent the spread of COVID. Which it continues to be affecting many but with progress in the distribution of vaccines, it’s not as deadly as before. Community health nurses and stakeholders have developed great educational tools and resources in reference to COVID-19. In facilities, we continue to educate on the prevention of COVID.



World Health Organization (WHO). (2020, October 13). Impact of COVID-19 on people’s livelihoods, their health, and our food systems. Retrieved from World Health Organization (WHO):

Dian, great post. Although we are 2 years into Covid, we are still seeing many cases within in the community. The levels are not as high and the mortality rates are lower due to vaccinations and the different strains of the virus. We are now starting to see the after effects of Covid. Many health care workers have left the bedside due to burnout rates, high stress levels of high acuity patients, and low staffing ratios. The rates of mental health issues among the health care workers increased due to the pandemic. It is worth considering that in epidemic contexts HCWs are first in line facing the clinical challenges intrinsically linked to the course of the disease while under the constant personal threat of being infected or representing a source of infection ((Carmassi et al., 2020). Although Covid is still affecting many individuals, we as a community must be able to rebuild ourselves and help care for ourselves as we care for our patients.

Carmassi, C., Foghi, C., Dell’Oste, V., Cordone, A., Bertelloni, C. A., Bui, E., & Dell’Osso, L. (2020, July 20). PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Research. Retrieved September 11, 2022, from