Assessing and Addressing Health Need of HIV Population

Running head: ASSESSING AND ADDRESSING HEALTH NEED
Assessing and Addressing Health Need of HIV Population
Name of the Student
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Author Note

1ASSESSING AND ADDRESSING HEALTH NEED
Table of Contents
Part One..........................................................................................................................3
Introduction................................................................................................................3
Background Research.................................................................................................3
Prioritising the Health Needs.....................................................................................6
Part Two.........................................................................................................................7
Aims & Objectives.....................................................................................................7
Health Promotion Activities.......................................................................................8
Activity 1- Health Persuasion....................................................................................8
Description.............................................................................................................8
Justification............................................................................................................9
Activity 2- Legislative Action....................................................................................9
Description.............................................................................................................9
Justification............................................................................................................9
Activity 3- Personal Counselling...............................................................................9
Description.............................................................................................................9
Justification..........................................................................................................10
Activity 4- Community Development......................................................................10
Description...........................................................................................................10
Justification..........................................................................................................10
Resources.................................................................................................................11

2ASSESSING AND ADDRESSING HEALTH NEED
Evaluation................................................................................................................11
Action Plan...............................................................................................................11
Conclusion....................................................................................................................12
References....................................................................................................................14

3ASSESSING AND ADDRESSING HEALTH NEED
Part One
Introduction
Acquired Immunodeficiency Syndrome or AIDS is the most advanced stage of the
infection caused by Human Immunodeficiency virus, which destroys the immune system’s
infection fighting cells known as CD4 cells. Gradual destruction of the human immune
system leads to advancement of AIDS. HIV in children and adolescents is a growing concern
globally. According to UNICEF Data, 2019, over 1.6 million adolescents were suffering from
Human Immunodeficiency Virus infection. UNICEF Data (2019), confirms that the current
trend will lead to 183,000 new cases of HIV in adolescents by the year 2030. This health
concern is required to be extensively assessed and addressed. To complete this objective, the
following sections of the paper aims to assess the health condition of HIV in target
population of children and adolescents and develop an action plan to address this issue.
Background Research
According to a study conducted by Sohn, Vreeman, and Judd (2017), the global
epidemic of adolescents HIV is growing rapidly, with the most affected age group is children
of 14-19 years of age. However, according to the authors, the primary focus of the
interventions should be to address the young generation who have acquired HIV in
childhood, followed by the adolescents who have acquired HIV infection due to their
behavioural outcomes. The authors state that globally, paediatric health care providers have
failed immensely to provide effective care of chronic disease in children and are accused of
‘taking too long’ to address the health issues in this population. In low and middle-income
countries, it is unlikely to find a specialist paediatric HIV clinic and the adolescents are
intended to visit the all-age family-centered HIV clinics, which might lead to social issues of
accepting HIV positive status openly and not visit the clinic at the very first place. The
primary focus of the paper is the transition of adolescents from paediatric clinic to adult HIV

4ASSESSING AND ADDRESSING HEALTH NEED
care clinics. Improvement of quality of care can be achieved with proper intervention of the
healthcare providers in the adult care setting. However, the transition to adult care setting has
been criticised highly for several reasons. This includes the holding of patients by the
paediatrics for too long, as they feel uncomfortable to address their issue in the new adult
care setting. Greater focus on the transition should be an important clinical consideration and
optimisation of the use of clinical data collection systems in present is the most efficient way
of monitoring the outcome changes. The primary goal of smoothening the transition is to
maintain the patient retention and ensure the patient continues to get treatment without any
interruption. This can be summed to say smoother transition tends to maintain or improve the
medical adherence rate of the adolescent age group suffering from HIV as they tend to shift
to adult care settings for accessing further health care.
In another study conducted by Le Prevost et al. (2018), it was found out that the
children and adolescents suffering from HIV infection are at greater risk of acquiring HIV-
driven anxiety and depressive symptoms. According to the paper, uncontrollable life events
such as HIV infection increases the vulnerability of the anxiety in the adolescent population
and might lead to subsequent development of depression in this population. The research
study design method makes use of cohort as prospective study to evaluate the impact of ART
(antiretroviral) exposure and in young people living with perinatal HIV. The researchers
measured the depression and anxiety scores with the help of Hospital Anxiety and Depression
Scale (HADS), which has scaling of 0-21, the higher the scores, greater were the indication of
anxiety and depression in the person. The researchers used linear regression for data analysis.
According to the general statistics from the study, over 50% of the sample population of
adolescents living with HIV were suffering from depressive and anxiety symptoms in
comparison to only quarter of sample population of adolescent without HIV. This highlights
the need of identifying and support the adolescents living with HIV to prevent them from

5ASSESSING AND ADDRESSING HEALTH NEED
developing anxiety and depressive symptoms. According to this research study, the
etiological model suggest that the children and adolescents, that is, the young population
suffering from perinatal HIV infection are at greater risk of attaining anxiety and depressive
symptoms in comparison to rest of the population from the same age group. This is due to the
biomedical and psychosocial issues that is associated with chronic illnesses such as Human
Immunodeficiency Virus infection. According to the authors, to provide appropriate support
to this age group, it is important to get a better understanding of the risk factors and
prevalence of HIV in children and adolescents and making a comparison with the adult group
suffering from the same disease.
To find out the epidemiological situation of Europe in context to children and
adolescents suffering from perinatal HIV, Judd et al. 2015 conducted a study. The researchers
found out that it is important to plan out adolescent health services, for which accurate
ascertainment of the population living with HIV is required. According to the authors, HIV in
children and adolescents is a major public health issue. In this research study the authors used
online survey of HIV cohort studies as data collection method. According to their study,
around 1,000 to 2,000 of perinatal patients in HIV cohorts in United Kingdom were found to
be present by the end of 2013. The authors conclude that the descriptive number of diagnoses
of perinatal HIV in adolescents as per the cohort data might be significantly lower than the
actual data or true number of cases as per the World Health Organization. The United
Kingdom has better coverage of new diagnosis reporting in comparison to the other European
countries. In this research study, the researchers highlight the need of adult care providers to
increase their efficiency in identifying the perinatally infected HIV adolescent population.
Moreover, the researchers also put greater emphasis on the need of maximising retention of
the adolescent HIV population while in transition to adult care system and monitor the health
needs of this target population to improve the health outcomes.

6ASSESSING AND ADDRESSING HEALTH NEED
Prioritising the Health Needs
Proper analysis of the above three mentioned research articles in context to HIV in
adolescents and children, the primary health needs that can be pointed are improving the
transition of adolescents suffering from HIV from paediatrics to adult care settings,
identifying and supporting this target population to refrain them from attaining anxiety &
depressive symptoms, and increasing the efficiency of adult health care providers in
identifying the adolescents suffering from HIV infection and promoting health care services
to them to increase the retention rate of the population while in transition. Analysing the
above research studies revealed these three health needs to be the most important in
addressing the health issue of HIV in adolescents and children.
The most unmet need of the target population is support for their health in all stages
of life. Children and adolescents living with HIV tend to have low-esteem and shy out issues,
which refrains them from publicly accepting their HIV positive status. These issue is also
affected by other social determinants. Maslow’s hierarchy of health need theory in
psychology is a motivational theory and can be effectively used to analyse following health
need which requires a person’s basic needs including safety, love, self-actualization, esteem
and physiological.
Prioritising the health needs in context to the topic of HIV in adolescents and children
is important to attain the perfect chronology of health care intervention to address the issue
effectively. The first priority of the action plan should be to address the issue of anxiety and
depression in population of adolescents and children suffering from HIV infection. This is
due to the fact that increasing anxiety and depression in this population can refrain them of
attaining health care services from providers (Vreeman, McCoy & Lee 2017). The next
health need to be addressed is the increase of efficiency in identification of the adolescents
and children suffering from HIV by adult health care providers. Improvement in this health

7ASSESSING AND ADDRESSING HEALTH NEED
needs can significantly support the next health need of improving the transition of target
population from paediatrics care to adult care settings. The target population, that is, children
and adolescents suffering from HIV. Require smoother transition to ensure the gap of care
transition is bridged and efficient retention of target population is achieved (Newman et al.
2014).
Part Two
Aims & Objectives
The aim of the following study paper is to address the above recognised health need
to HIV in adolescents and children and to address these issues effectively with the help of a
health action plan.
To prepare the action plan for addressing health needs, SMART (Specific,
Measurable, Achievable, Realistic and Timely) goals will be developed corresponding to
each of the three health need. The study will follow Beattie’s model of health promotion
activities to ensure proper achievement of the SMART goals mentioned below.
1. Reducing the prevalence rate of anxiety and depression in population of
adolescents and children living with HIV to 20% within two years.
2. Upgrading the clinical records available with the adult care settings of children
and adolescents living with HIV and reducing the gap of detected and undetected
HIV in target population to zero within the next one year.
3. Achieving 100% transition rate of adolescents living with HIV from paediatrics
clinic to adult health care clinics with retention rate of over 80% for duration of
three years or more.
The above three mentioned SMART goals are required to be achieved in time to
address the health needs of the population of adolescents and children living with HIV
effectively. These SMART goals will be achieved with the help of Beattie’s model of health

8ASSESSING AND ADDRESSING HEALTH NEED
promotion to determine activities that will address the each particular need and ensure better
health outcome of the targeted population.
Health Promotion Activities
Health promotion acknowledgement by the Beattie’s model of health promotion is
achieved by its complex analytical framework. With the help of Beattie’s model of health
promotion, health promotion strategies from the past and present time can be analysed
effectively, which substantially helps to develop resources based on the analysis conducted
and create new strategies to achieve successful health promotion and health need fulfilment
(Thompson 2014). This model of health promotion consists of four quadrants separated by
two axes. The ends of the two axes have ‘mode of intervention’, with authoritative and
negotiated on the vertical. The horizontal axis denotes the ‘focus of intervention’ and can be
individual or collective. The first quadrant represents activities denoting health persuasion
techniques, the second quadrant focuses on legislative actions, the third quadrant represent
personal counselling for greater control on intervention specifically meant for an individual
and the fourth quadrant denotes the community development as part of collective focus of
intervention (Upton 2017).
The following sections of the paper will discuss each of the four approaches as
mentioned in the Beattie’s model of health promotion and offer activities for health
promotion corresponding to each approach.
Activity 1- Health Persuasion
Description
The activity based on this approach of health promotion would be to conduct
education and awareness campaigns for HIV prevention in children and adolescents. This
will be conducted in association of the HIV care settings with the educational institutions. A
week of HIV awareness campaign will be conducted in several schools and other educational

9ASSESSING AND ADDRESSING HEALTH NEED
institutions. These campaigns will focus on normalizing the issue of accepting the HIV
positive status in public and encouraging students to provide emotional support to other
children suffering from HIV infection. Such campaigns will aim at encouraging all the
children and adolescents to get checked up for their HIV status.
Justification
Spreading awareness regarding HIV and normalizing its relevant health issues is
extremely critical in reducing the social determinants and increase the support for people
living with HIV infection. According to Shinde et al. (2017), this will ensure that greater
population of children and adolescents get checked for their HIV status and accept their HIV
positive status publicly with greater confidence and support from others.
Activity 2- Legislative Action
Description
A proposal will be kept with the state legislation and policy makers to ensure a
mandatory HIV status check for all children and adolescents up to the age of 21. Further
specifications like mandatory health checkup in schools will be added while designing the
policy. This activity will be conducted in association with the authoritarians from the local
legislative bodies.
Justification
Undiagnosed HIV in children and adolescents creates a huge gap and leads to late
detection of the infection, which often advances to the health condition of AIDS (Acquired
Immunodeficiency Syndrome). Better detection rates will help the health care providers to
intervene early and generate the best strategies for the patient to ensure positive health
outcome (Hussen et al. 2014).
Activity 3- Personal Counselling
Description

10ASSESSING AND ADDRESSING HEALTH NEED
Personal counselling session of children and adolescents living with HIV infection in
the pediatrics clinic in the presence of a member from the adult health care setting. Pediatrics
clinics in the local region will be visited and counselling will be conducted for few
adolescents having confirmed HIV positive status after taking proper consent from them.
Justification
Children and adolescent living with HIV often have lower self-esteem and lose
confidence due to social insecurity caused by the critical health condition (Nöstlinger et al.
2015). This leads to development of anxiety and depressive symptoms in them. Personal
counselling is the best way to address this issue. With the help of personal counselling, the
health status of the person remains confidential, which encourages them to open up more to
the counsellor, and help the health care providers to motivate the person at more personal
level (Cho et al. 2018). With this activity, the health care providers can ensure that the
children and adolescents continue to receive health care services while transitioning from
pediatrics clinic to adult health care setting.
Activity 4- Community Development
Description
The age group of 14-19 years old of adolescents suffering from HIV infection and
receiving treatment from pediatricians will be addressed in groups on the health issue of HIV
by the health care professionals from adult care settings. Post the completion of personal
counselling sessions, previous participants will be taken informed consent to participate in
the community program and group discussions.
Justification
The clinical data of the children and adolescents with HIV receiving treatment in the
pediatrician clinic should be passed on to the adult care settings taking care of HIV patients
on regular basis. This will help to ensure 100 % transition rate of adolescents to adult care

11ASSESSING AND ADDRESSING HEALTH NEED
settings, which will lead to better health outcomes of the targeted population (Hussen et al.
2014). Retention rates of the people receiving treatment of HIV in adult care settings can be
significantly improved by addressing the younger affected population and making them,
aware of the importance of receiving treatment for HIV to prevent the advancement of AIDS,
which is a lethal chronic illness (Ryscavage et al. 2016).
Resources
To help achieve the objectives of the study and perform activities mentioned in the
action plan smoothly, several resources are required. Several institutions from different fields
are required to be contacted in order to proceed with the said action plan. These include
educational institutions and schools, government and local legislative bodies, paediatrician
clinics, and adult health care settings. To achieve successful interaction with these
communities, high distinction of communication skills is required, which will help to
persuade these institutions to be a part of this noble action plan (Kennedy et al. 2014).
Moreover, high level of clinical data and health knowledge on the topic of HIV and
AIDS is required to increase the efficiency of community meetings with the affected
population.
Evaluation
Several evaluation criteria will be used to evaluate the efficacy of the action plan and
undertaken activities. The primary health need that needs to evaluated are the depression &
anxiety scores of the individuals, clinical record and data updating efficiency by the adult
care settings and the transition and retention rate of the adolescents while moving from
paediatrician clinic to adult care settings to access health care services for HIV infection.
Action Plan
Following Gantt chart shows the timeline in which the action plan and the study will
be conducted:

12ASSESSING AND ADDRESSING HEALTH NEED
Activities 1st to
3rd
Week
4th to
10th
week
11th to
13th
Week
14th to
17th
Week
18th to
21st
Week
22nd to
23rd
Week
24th
Week
Selection of the topic 
Data collection from
secondary sources
 
Literature review 
Activity 1   
Activity 2 ✓
Activity 3 ✓ 
Activity 4 
Evaluation of the
Activities

Conclusion
HIV is a global burden and over 1.6 million population of children and adolescents
are suffering from it. It is important that this issue is addressed with greater emphasis to
prevent the unimaginable increase of numbers in the foreseen future. With the help of
suitable action plan and activities, the affected population of children and adolescents can be
made aware of this chronic health condition to help reduce the induction and prevalence rate.
The primary focus of this paper is to address the health need of children and adolescents
living with HIV. Such chronic illness have shown to induce anxiety and depressive symptoms
in the target population, which leads to reduction in the transition rates of such individuals to
adult care settings with the fear of social anxiety. Proper intervention can help improve the

13ASSESSING AND ADDRESSING HEALTH NEED
transition rate and ensure higher retention rate of affected population receiving treatment of
HIV from health care providers.

14ASSESSING AND ADDRESSING HEALTH NEED
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