B721 Adult Nursing : Opioid Assessment Answer

Reflective and critical analysis of hiv health care system in uk and south Africa.
What is HIV, why is it important,
Examine some Demographics
You should demonstrate a critical understanding of HIV /AIDS, this will require you to present some facts and figures, make comparisons, and examine the key issues from a UK and global perspectives. You need to support your work with good references from reliable sources.
Second paragraph
Compare & contrast the Hiv health system in uk and south Africa
By Global Health you may want to briefly consider some worldwide facts & figures but the focus and critical discussion between South Africa (SA) and uk on hiv health .
Why do differences occur in Hiv health care system in these two countries. think about health economies, education, staffing, power, resources etc
Is there anything that one country can learn from the other ?

HIV is a virus that is usually found to attack the immune system that protects our body form different foreign organism which creates diseases in our bodies. This virus is mainly responsible for the destruction of different immune cells in the body like mainly the T Helper cells which are also called the CD4 cells. With the gradual increase of the copies that it continuously keeps on replicating, it breaks down the immune system. A situation arises when the person’s body is not even able to protect the body from common cold or flues and leads to death. The situation that it gives rises to can be clustered and can be referred to as AIDS (Tanser et al. 2013). A statistical analysis conducted in the year 2015 shows that Western and southern Africa had been the most affected form this dangerous disorder with about 19 million people being suffering from the symptoms. With gradually decreasing order the nations can be arranged as the next being Western and Central Africa, then Asia Pacific. They are then followed but Western and Central Europe as well as North America. Then comes Latin America and Caribbean with 2 million aids patients and Eastern Europe and central Asia accounting to 105 million. Middle East and North Africa has 230,000 patients suffering in aids. Hence, it can be seen that indeed a large number of people have been facing the threats of deaths for proper meditational advancements in the field of cure form aids have not been discovered yet. Moreover, it was also found that initiatives and measures taken to spread awareness and decrease the rate of occurrences of new infection have often varied with some nations successfully achieving the goal by decreasing the rate of occurrences by 50% in the last decade whereas many nations have failed miserably in establishing a strong foothold in preventive and awareness programs. Since the year 205, US$ 19billion have been allocated for different programs in low and middle income countries and about 57% of the total HIV resources being administered form the domestic budgets (Gibbs et al. 2015). Therefore many analyses have shown that due to the rising number of infections in many countries, a total of about US% 26.2 million will be required in order to provide effort for mitigation of aids in the year 2020 with US$ 23.9 billion to be spent in 2030 (Bor et al. 2013).

In South Africa, about 7 million people are found to be living with aids in the year 2015 with a prevalence of 19.2% Of HIV is found among adults. In the same year about 380,000 new cases of infections were reported with 180,000 being reported number of deaths in aids. 48% of adults are present on antiretroviral treatment which shows that still 52% of the people are yet not under treatments ensuring that the huge initiative that had been taken y the government for the mitigation of the problem has yet not become successful. In United Kingdom, numbers are much less. In comparison about 102,200 people are affected with only 0.16% prevalence and only 6095 new infections being reported. Moreover only 594 patients have been reported to die with about 96% of adults on retroviral therapy. In South Africa, the main victims of the disorder cover a wide number of professions and backgrounds like men who have sex with men, sex workers who avoid the use of condoms for customer satisfaction and others. People who inject drugs are also high in number and they mainly include utilization of used syringes, used injecting equipments as well as half reused needles. High number of orphans abandons due to being carrier of HIV is often forced into sex trade which carried forward the chain of HIV infection (Bradshaw et al. 2016). Moreover women and adolescent girls have many safety issues in the nation and studies in 2012 showed that infections in women were higher than males. Government had initiated counseling and testing program which showed more number of people turning towards testing. They have developed a program called the PMTCT program that enables women to test the present of HIV in antenatal appointments (McCormack et al. 2016). Moreover HCT revitalization also was a successful program. However, some issues have been noted by researchers that help us in solving the puzzle of higher rate of infection in spite of many initiatives by the government. The researchers have found that there exists a link between the socio-economic background and their awareness of testing for HIV test. They have found that people who are undergoing testing are mostly belonging to the category of individuals with higher education, employment, accurate HIV knowledge and at a higher perception of risk (Okoror et al. 2014). This suggests that those individuals who are low on health literacy, not well educated and are belonging to not well off families are skipping the tests which in turn is increasing the chances of increasing the number of victims who are going unreported (Dos Santos et al. 2014). Another reason that had to be mentioned is that people who love in the rural areas are half as likely to be tested in comparison to their counterparts in urban areas. It denotes the fail of the government to include rural areas under the programs marking the reason for the unsuccessful initiative. However in United Kingdom, it can be seen that more or less 87% of people are aware of the disease with 94% of being virally suppressed with treatments. Although here also same sex categories have higher number of victims and people injecting drugs but the fate of the orphans and the safety of women are not compromised (Raymond, Hill and Pozniack 2014). Hence the number of aids victims is much lesser than South Africa. Moreover the testing coverage for HIV in UK was found to be wide and almost covered all important healthcare clinics so that accessibility of people o testing was higher. Even home sampling kits to conduct test in home was also provided online increasing the frequency of testing. However, although testing was conducted in South Africa but no widespread programs were conducted by the healthcare centers unlike UK. The healthcare systems of UK had proposed Needle and syringe programmes (NSPs), Opioid substitution therapy (OST), and others to increase widespread awareness among different socio-economic backgrounds (Williams et al. 2014). UK promoted awareness by school education, public programs, advertisements, mass media and others resulting in success of making people aware which was not the case for South Africa (Whiteside 2016). The differences can also be accounted for the only 20% of the finance coming from international sources and rest from the domestic budget which is quite lower as South Africa is a developing country in comparison to s developed country like UK. Poverty level is quite high with minimal resources for the healthcare centers to be allocated for chronic disorders. Staffing and trained doctors also do not match the numbers of UK (Nosyk et al. 2014). However conditions are promised to get better which had resulted South Africa to align with many programs helping in development of the situation.

The main factor that leads to the difference in the statistical figures in HIV related patients, awareness, deaths, prevalence and others is the absence of a systematic approach to a particular problem. By closely analyzing the approach, it can be seen that UK had been successful in creating awareness to a vast extent which had covered and all over 95% of people in comparison to only 48% of the South Africa. As a result testing was higher in UK which covered a large portion of population in comparison to the other. Moreover advertisements, social marketing as well as publication of policies backed up the process which was also not stronger in South America (Punyacharoensein et al. 2015). As the financial strength in South Africa was restricted, they had less scopes of conducting mass based research which reflected in their attempts. Moreover the strategies and programs taken by UK was evidence based and was innovative like the Needle and syringe programmes (NSPs), Opioid substitution therapy (OST), and others but similar such programs are not found in south America. Moreover, the healthcare centers of South Africa has not been successful in recruiting competent healthcare professions who are expert in handling the westernized method of treatment and therefore they had not been able to bring a large number of patients under retroviral therapy like the United kingdom. The professionals do not follow evidence based practice and moreover lack of financial resources does not allow innovative program introduction, online home kits, coverage of healthcare in rural systems and many others. Moreover mandatory reporting by nurses require skills of proper identification of symptoms, educating patients, making them aware and others which if not done properly may impose threat on patients (Birrell et al. 2013). Proper policy development and social marketing campaigns help in developing awareness of people belonging to every age cohort which is indeed necessary for making programs more successful for mitigation of the issue in South Africa (Birrell et al. 2013). Therefore, as a professional health care staff, I will try to influence each and every of my patient to be aware of the ill effects and recommend patients to go for HIV testing in order to understand the status and also influence them to undergo vaccination or their children if certain symptoms are found in the patients in heir antenatal period specially if they come from other nations. Patient education is believed to be the best weapon to treat the dangerous disorder and prevent them from engaging in any activity that may increase the chance of the spread of the diseases (Tostevin et al. 2017).

Hence, the entire discussion shows that in order to approach a critical issue like creation of awareness and decreasing the rate of AIDS in patients of a nation, the healthcare sectors of the nation need to be organized and plan the financial resources properly. Testing programs conducted on a large scale will not bring out proper results until awareness is created on a wide scale that would include both urban as well rural levels in a developing country there would be financial constraints and therefore programs should be planned in a ways that it would cover all the aspects like social marketing, advertisement, free HIV testing and others in systematic approach. Proper policy planning is also an important aspect in eradication of the diseases from the base level followed by competent health care nurses who play a big role in making patient develop health literacy and guide them to take appropriate steps for their safety.

References:

Bennett, J.E., Dolin, R. and Blaser, M.J., 2014. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Elsevier Health Sciences.

Birrell, P.J., Gill, O.N., Delpech, V.C., Brown, A.E., Desai, S., Chadborn, T.R., Rice, B.D. and De Angelis, D., 2013. HIV incidence in men who have sex with men in England and Wales 2001–10: a nationwide population study. The Lancet infectious diseases, 13(4), pp.313-318.

Bor, J., Herbst, A.J., Newell, M.L. and Bärnighausen, T., 2013. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science, 339(6122), pp.961-965.

Bradshaw, D., Msemburi, W., Dorrington, R., Pillay-van Wyk, V., Laubscher, R., Groenewald, P. and South African National Burden of Disease Study team, 2016. HIV/AIDS in South Africa: how many people died from the disease between 1997 and 2010?. Aids, 30(5), pp.771-778.

Dos Santos, M.M., Kruger, P., Mellors, S.E., Wolvaardt, G. and Van Der Ryst, E., 2014. An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index. BMC Public Health, 14(1), p.80.

Gibbs, A., Campbell, C., Akintola, O. and Colvin, C., 2015. Social contexts and building social capital for collective action: three case studies of volunteers in the context of HIV and AIDS in South Africa. Journal of Community & Applied Social Psychology, 25(2), pp.110-122.

McCormack, S., Dunn, D.T., Desai, M., Dolling, D.I., Gafos, M., Gilson, R., Sullivan, A.K., Clarke, A., Reeves, I., Schembri, G. and Mackie, N., 2016. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. The Lancet, 387(10013), pp.53-60.

Nosyk, B., Montaner, J.S., Colley, G., Lima, V.D., Chan, K., Heath, K., Yip, B., Samji, H., Gilbert, M., Barrios, R. and Gustafson, R., 2014. The cascade of HIV care in British Columbia, Canada, 1996–2011: a population-based retrospective cohort study. The Lancet infectious diseases, 14(1), pp.40-49.

Okoror, T.A., BeLue, R., Zungu, N., Adam, A.M. and Airhihenbuwa, C.O., 2014. HIV positive women's perceptions of stigma in health care settings in Western Cape, South Africa. Health Care for Women International, 35(1), pp.27-49.

Punyacharoensin, N., Edmunds, W.J., De Angelis, D., Delpech, V., Hart, G., Elford, J., Brown, A., Gill, N. and White, R.G., 2015. Modelling the HIV epidemic among MSM in the United Kingdom: quantifying the contributions to HIV transmission to better inform prevention initiatives. Aids, 29(3), pp.339-349.

Raymond, A., Hill, A. and Pozniak, A., 2014. Large disparities in HIV treatment cascades between eight European and high-income countries–analysis of break points. Journal of the International AIDS Society, 17(4).

Tanser, F., Bärnighausen, T., Grapsa, E., Zaidi, J. and Newell, M.L., 2013. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science, 339(6122), pp.966-971.

Tostevin, A., White, E., Dunn, D., Croxford, S., Delpech, V., Williams, I., Asboe, D., Pozniak, A., Churchill, D., Geretti, A.M. and Pillay, D., 2017. Recent trends and patterns in HIV?1 transmitted drug resistance in the United Kingdom. HIV medicine, 18(3), pp.204-213.

Whiteside, A., 2016. HIV & AIDS: A Very Short Introduction. Oxford University Press.

Williams, I., Churchill, D., Anderson, J., Boffito, M., Bower, M., Cairns, G., Cwynarski, K., Edwards, S., Fidler, S., Fisher, M. and Freedman, A., 2014. British HIV Association guidelines for the treatment of HIV?1?positive adults with antiretroviral therapy.