HIV as a Public Health Concern in Brent Borough: Interventions and Effectiveness

This essay discusses the impact of HIV as a public health concern in Brent Borough, including the interventions and effectiveness of various policies. It highlights the importance of awareness and education in preventing the spread of HIV and reducing stigma. The role of nursing professionals in educating patients and inducing behavioural change is also discussed.

In the modern-day world, the number of people affected by HIV is increasing day by
day. HIV has become a public health concern that stands for Human
immunodeficiency virus. This virus harms an individual by attacking their immune
systems. In the human body, predominantly white blood cells known as CD4 are
responsible for the body's immunity against diseases, referred to as T cells. These
cells are killed when HIV is not adequately treated, making the body vulnerable to
dangerous conditions, such as various types of cancer. With the advancements of
medicines and technology, Government can tackle HIV effectively. However, despite
all these advancements, there is still considerable stigma associated with HIV. Along
with its impact, the cure of this condition has not yet been ascertained. It has
enabled the country to deliver integrated HIV care to patients who will be effective
and used in the future. In this essay, health care policy will be discussed, and how
HIV it is a public concern in Brent Borough and the Government's uses various
interventions. In the later part of the essay, will look at the effectiveness of
intervention applied. Health educators and health promoters play vital roles within
the interprofessional team control in this condition.
Policy objective- to prevent diseases, prolong life and promote health among the
population.
The steps was taken about the despite significant in public health and disparities
exist about the leading to population that are the working affected by diseases. This
population may have the limited access to affordable healthcare, putting them with
greater risk for developing the HIV diseases.
Health economics have the branch of economics concerned and this could related to
efficiency, effectiveness, behaviours and values at their production and consumption
of healthcare and health.
Behavioural change model- It is approaches and that focuses on the lifestyles
behaviour and also has the impact on health. It might be seeks to persuade the
individual for adopting the health lifestyles behaviours and try to use the preventive
health services. Along with this also take responsibility for their own health. The

behavioural change model might be based on health which providing the people
information about changes their beliefs, attitude and behaviours.
The health promotion is models that keep focus on helping people achieving their
high levels of well-being. This also keep encourages about the health professional
that provides the positive resources and help their patients for achieving the
behaviour with particular changes. Along with this also having the individuals strive
that controls about their own behaviour and work for improving themselves and their
environment. This model also help the nursing for keep their focus on improving the
work for their patients and ensure them for working with some effective concepts.
HIV is one of the most dangerous diseases that an individual can contact. The main
issue with the disease is that it directly impacts the immune system, and there is no
measure for it (Brown et al., 2018). Due to the lack of awareness about this disease,
a massive stigma around HIV has made it difficult for people to survive in society
(WHO, 2021). Recent research on HIV in Brent has brought to light that many
individuals were accessing HIV and treatment services, which can be understood
when considering that the prevalence diagnostic of HIV in Brent was 2.1 per 1000.
Compared to the UK rate, 1.3 per 1000, it is an outstanding amount, inclusive of
undiagnosed prevalence (Daskou, et.al., 2022). Many people in Brent belong to this
undiagnosed section, and they can contribute to 27 per cent of people in the UK
unaware of themselves being affected (Lorenc et al., 2014). The sexual health report
of Brent borough shows the high spread of HIV transmission through sexual
activities in this region. More than 29% of sexually transmitted diseases have been
found between man and man, and 62% between men and women (Hoorenborg et
al., 2019). The report also includes that the positive cases of HIV in Brent are
partially black among the black and minority ethical groups. The reason for these
substantial differences was that the individuals affected by HIV in Brent were
influenced by other health problems, such as mental health issues, diabetes, CVD
etc. It counted for 29% of all cases, but over all cases in the UK, didn't have
individuals affected with such illness before their HIV infection, which shows that
there is also a physical aspect play (NAT, 2021). But surprisingly, most cases are the
product of male and female sex in Brent, while in the UK, more registered cases are
where the ones brought about because of male-to-male sex. It is mainly due to their
limited knowledge of HIV in general and less education of the risks involved in sexual

activities, both male to male and male to female (Nwokolo et al., 2017). The census
in Brent reveals that 68% of HIV positive people live in Stonebridge Park, Dollis Hill,
and Kilburn region (Brent.gov.uk, 2014).
The UK government already has the existing call for action on HIV, working
effectively in five key areas. This strategy focuses on more funding and bridges the
significant gap between committed and needed factors (Singh et.al., 2022). The
funding is available on a long-term basis (Kirby, 2020). The policy has a more
substantial political direction acknowledged by local and federal governments. In the
case of Brent borough, some HIV services are commissioned by Brent audit social
care and some by NHS Brent. These two segments provide some important areas of
commissioned service. It includes prevention, testing, treatment, and social support
(Pegu et.al., 2022). The pan-London HIV prevention programme consisted of 30
other PCTs within London (Pyper and Brodie, 2011). The organisation initiates
different prevention activities. The community's health action trust supports the
programme, because these prevention activities require culturally sensitive primary
HIV prevention for the black African community. The treatment process is more
related to the guideline set by the London HIV consortium commission HIV treatment
service. These services are more related to antiretroviral therapy for the borough of
London. In addition, one-stop shop services initiated and managed by the HIV
coordinator situated in Monks Park canals will be mentioned (Brown, Gill and
Delpech, 2013). This services always treat HIV positive patients to assess the
ranges of voluntary and statutory sector services.
The Government adopts various interventions and the policy discussed here also
discusses various interventions which will help mitigate this problem. The first step is
to increase awareness about this condition among the people (Barhoum., 2015).
When the people are unaware of this condition, they cannot take necessary
precautions to prevent this condition. With awareness, people will take care of many
factors, which will play a vital role in the mitigation of this problem. People can also
be involved in early intervention, and this intervention will prevent the spread of this
condition (Landovitz et.al., 2021) . A range of educational, peer-group, motivational
and peer-group approaches should be adopted (Tso et al., 2016). The policy also
discusses expanding HIV testing. Everyone will be informed about HIV status and

any prevent if needed. The Governments attempting to set free home testing all year
round and regular tests in the hospital. People living in any part of the country will
have access to this treatment, support service and other treatment plan so they can
have a healthy life. The entire stigma and discrimination related to this condition also
need to be addressed. This can also be controlled with awareness and educating
among people (Jaspal and Nerlich, 2020). Behavioural interventions are also
adopted and are the key to prevent transmissions, as they target drug-using and
sexual behaviour, which puts them at risk. This intervention provides knowledge and
skills and influences the people's motivation capacity to enact behaviour change (de
Bruin et.al.,2021) . People should be educated to delay the onset of first intercourse;
the number of sexual partners should be reduced. Some behavioural interventions
included in the protected sexual act should be increased, and people should be
provided with testing and counselling for HIV (Leung et al., 2019). People should
also be encouraged to adopt biomedical strategies to prevent HIV transmission.
Other than this, sharing of needles and syringes should also be decreased.
All the interventions adopted to reduce stigma or mitigate HIV are useful and help
control the situation. Stigma related to HIV needs to be addressed when people are
made aware of the problem, and stigma will be reduced (Jewell et.al., 2020) . People
will be more sympathetic about the problem, and they will wisely communicate with
the people (Parks and Smallwood, 2021). People present in the community will be
more supportive than stigmatized about the issue. All the seminars and campaigns
organised will help people be more aware of the problem, they will understand the
intensity of the problem and reduce the number of cases presented (Globerman et
al., 2017). All the interventions adopted help to reduce cases. With all the
programmes and campaigns adopted, it helps reduce cases. When early testing of
the people is done, it will help identify any health problem, and the early steps can be
taken accordingly, and the problem can be prevented. As people are educated about
the ways to prevent HIV as education, then those steps can be adopted to reduce its
prevention (Jiang et.al., 2020) . These measures help reduce the HIV prevalence
and supply of needles, condoms, and other essential items to prevent HIV (Moreno
et al., 2014). Various resources which are required, and which help prevent infection

of disease and control the situation. The health policy helps increase funding for HIV
prevention. This can only be done when people are aware of prevention strategies
and about the issue (Dehne et al., 2016). The policy also allows increasing support
for people living with HIV, who have access to treatment, support, and mental health.
The nursing profession has in depth knowledge of the medical outcome of HIV
disease. With a newly detected patient, the registered nurse accesses them for a risk
related element to their lifestyle and educates the healthcare process. They also
discuss the treatment decisions, including medication and laboratory works. They
provide emotional encouragement, such as referring them to counselling according
to the agreeable patient (Blanco et.al., 2020) . Overall, they play a role in creating
awareness about the disease and how they are transmitted gradually (Rouleau et al.,
2019). The prevention activities are not in the hands of nursing professionals, by
they can only educate the potentially effected member with possible methods. They
play a role in promoting health policies among community members at risk. Nursing
professionals align their skills with the challenging availability of resources and
maintained improved service methods every time. The nurse has already developed
reputation and values (Rajan-Brown And Mitchell 2020) . This is the reason they
have become an effective health educator and health promoter (Frain, 2017). The
patients need to book an appointment so they can visit to consult physicians. Health
education, especially related to HIV, is available in this hospital, making the services
more patient orientated and effective. The patient can be convinced by a nursing
professional compared to the other health educator. Therefore, more information is
the campaign to achieve zero HIV zero transmission by 2030. The nursing
professional in these hospitals in Brent borough has the knowledge of emergency
HIV drug and laboratory support, which empowers the patient already suffering from
the disease to recover quickly. The goal of zero transmission can only be
implemented with the support of a nursing professional, otherwise it can take time
and effort to create health related awareness. The health educator can reach rural
and remote areas, and enhanced health literacy among people, but the same
activities performed by the nurse will achieve more targets. It is easy for them to
convince community members to have behavioural change. The care provider
develops a reliable relationship with the patient and can be pointed out their
perspectives to learn about HIV disease. In addition, contraceptive services are

available in Brent borough (Brent.gov.uk., 2021). The common people can visit the
walk-in clinic of Wembley centre for health and care. As many care centre and
Hillside primary care centre. There are several GPs to deliver a range venue so that
poverty-stricken communities like outreach workers, homeless people, and black
communities with less educational qualification. The authorities of this borough have
also started a website to provide all round facilities to the citizen. The citizen under
20s gets a free condom card. So that transmission of this disease through
unprotected teenage sex is reduced (NHS, 2021). Along with thus, contraceptive
service has also included vulnerable young people.
In the essay HIV in Brent borough has been discussed, it has been observed that
many populations have been affected by this condition. The prevalence rate is
around 3.1 in 1000, which implies that about 94% of people are affected by these
conditions. The government adopted various ways to prevent the spread of this
condition. Different interventions are adopted, and behavioural changes are also
introduced to mitigate it. People have stigmatised this condition, and they do not talk
freely about it. Therefore, it is necessary to raise awareness of this condition so that
they can easily adapt to the changes. Various educational campaigns and
awareness should be organised, and they help create awareness. Nurse educators
also play a vital role in educating patients. They are the first point of contact with the
patient; hence they can establish a therapeutic contact with the patient and educate
them about various steps which can be used to prevent the spread of this condition.
Nurses also help induce behavioural intervention, which helps the patient change
behaviour about various things, and can be used to prevent disease. People can
adopt various steps and try to incorporate various habits which will prevent the
spread of this disease.

References
Brent.gov.uk. 2021. Brent Council - London is the first city to top global target for
tackling HIV. [online] Available at:
<https://www.brent.gov.uk/council-news/press-releases/fast-track-cities/>
(Accessed 25 November 2021).
Bakhoum, A. (2015). HIV/AIDS, hepatitis and sexually-transmitted infection
prevention among Egyptian substance users. [online] Ueaeprints.uea.ac.uk.
Available at:
<https://ueaeprints.uea.ac.uk/id/eprint/59677/1/Bakhoum_thesis_06_Aug.pdf>
(Accessed 26 November 2021).
Brent.gov.uk. (2014). Sexual Health and HIV services in Brent. [online]
Democracy.brent.gov.uk. Available at:
<https://democracy.brent.gov.uk/documents/s3298/Sexual-health-and-HIV-
services-in-Brent.pdf> (Accessed 26 November 2021).
Brown, A., Gill, O., and Delpech, V.(2013). 'HIV treatment as prevention among men
who have sex with men in the UK: is transmission controlled by universal
access to HIV treatment and care?', HIV Medicine, 14(9), pp.563-570.
Brown, A., Nash, S., Connor, N., Kirwan, P., Ogaz, D., Croxford, S., De Angelis, D.,
and Delpech, V. (2018). 'Towards elimination of HIV transmission, AIDS and

HIV-related deaths in the UK', HIV Medicine, [online] 19(8), pp.505-512.
Available at:
<https://onlinelibrary.wiley.com/doi/full/10.1111/hiv.12617>( Assessed 20
October 2021).
Dehne, K., Dallabetta, G., Wilson, D., Garnett, G., Laga, M., Benomar, E., Fakoya,
A., Baggaley, R., Nelson, L., Kasedde, S., Bermejo, A., Warren, M., and
Benedikt, C. (2016). 'HIV Prevention 2020: a framework for delivery and a call
for action', The Lancet HIV, 3(7), pp.e323-e332.
Frain, J.(2017). 'Preparing every nurse to become an HIV nurse', Nurse Education
Today, 48, pp.129-133.
Hoornenborg, E., Coyer, L., Achterbergh, R., Matser, A., Schim van der Loeff, M.,
Boyd, A., Van Duijnhoven, Y., Bruisten, S., Oostvogel, P., Davidovich, U.,
Hogewoning, A., Prins, M., and de Vries, H.( 2019). 'Sexual behaviour and
incidence of HIV and sexually transmitted infections among men who have
sex with men using daily and event-driven pre-exposure prophylaxis in
AMPrEP: 2 year results from a demonstration study', The Lancet HIV, 6(7),
pp.e447-e455.
Jaspal, R., and Nerlich, B. (2020). 'HIV stigma in UK press reporting of a case of
intentional HIV transmission', 'Health: An Interdisciplinary Journal for the
Social Study of Health, Illness and Medicine' [Online}Available at
https://pubmed.ncbi.nlm.nih.gov/32772595/ (Accessed 13 October 2021).
Kirby, T. (2020). 'Three in five over 50s receiving late HIV diagnoses in the UK', The
Lancet HIV, 7(4), p.p226.
Lorenc, A., Ananthavarathan, P., Lorigan, J., Banarsee, R., Jowata, M., and Brook,
G. (2014). 'The prevalence of comorbidities among people living with HIV in
Brent: a diverse London Borough', London Journal of Primary Care, 6(4),
pp.84–90.
Leung, H., Shek, D., Leung, E., and Shek, E. (2019). 'Development of Contextually-
relevant Sexuality Education: Lessons from a Comprehensive Review of
Adolescent Sexuality Education Across Cultures', International Journal of
Environmental Research and Public Health, 16(4), p.621.
Moreno, R., Nababan, H., Ota, E., Wariki, W., Ezoe, S., Gilmour, S., and Shibuya, K.
(2014). 'Structural and community-level interventions for increasing condom
use to prevent the transmission of HIV and other sexually transmitted
infections', Cochrane Database of Systematic Reviews.[online] Available at
https://pubmed.ncbi.nlm.nih.gov/25072817/ (Accessed 24 November 2021).
NHS.UK. (2021). HIV and AIDS - Causes. [online] Available at:
<https://www.nhs.uk/conditions/hiv-and-aids/causes/> (Accessed 25
November 2021).
Network address transition (NAT). (2021). HIV and migration: Understanding the
barriers faced by people born abroad living with HIV in the UK. [online]
Nat.org.uk. Available at:
<https://www.nat.org.uk/sites/default/files/publications/FINAL%20HIV%20and

%20migration%20report%20June%202021.pdf> (Accessed 26 November
2021).
NHS. (2021). Condoms. [online] nhs.uk. Available at:
<https://www.nhs.uk/conditions/contraception/male-condoms/> (Accessed 26
October2021).
Nwokolo, N., Hill, A., McOwan, A., and Pozniak, A. (2017). 'Rapidly declining HIV
infection in MSM in central London', The Lancet HIV, 4(11), pp.e482-e483.
Parks, F., and Smallwood, S. ( 2021). 'Courtesy stigma and self-care practices
among rural HIV/AIDS healthcare providers', Journal of HIV/AIDS & Social
Services, 20(2), pp.136-143.
Pyper, C. and Brodie, C. (2011). 'Pan London HIV Prevention Programme Needs
Assessment Evidence Review'. [online] Jsna.info. Available at:
https://www.jsna.info/sites/default/files/04PanLondonHIVPreventionProgramm
eNeedsAssessment-EvidenceReview.pdf (Accessed 21 November 2021).
Rouleau, G., Richard, L., Côté, J., Gagnon, M. and Pelletier, J. (2019) 'Nursing
Practice to Support People Living with HIV With Antiretroviral Therapy
Adherence', Journal of the Association of Nurses in AIDS Care, 30(4), pp.20-
37.
Tso, L., Tang, W., Li, H., Yan, H., Yan, H. and Tucker, J., (2016). ‘Social media
intervention to prevent HIV: a review of intervention and methodological
consideration’, Current Opinion in Psychology, 9, pp.6-10
World Health Organization (2021). HIV/AIDS. [online] WHO. Available at:
https://www.who.int/news-room/fact-sheets/detail/hiv-aids (Accessed 18
October 2021).
Daskou, M., Mu, W., Sharma, M., Vasilopoulos, H., Heymans, R., Ritou, E., ... &
Kelesidis, T. (2022). ApoA-I mimetics reduce systemic and gut inflammation in
chronic treated HIV. PLoS pathogens, 18(1), e1010160.
Singh, G., Seufzer, B., Song, Z., Zucko, D., Heng, X., & Boris-Lawrie, K. (2022). HIV-
1 hypermethylated guanosine cap licenses specialized translation unaffected
by mTOR. Proceedings of the National Academy of Sciences, 119(1).
Pegu, A., Xu, L., DeMouth, M. E., Fabozzi, G., March, K., Almasri, C. G., ... &
Mascola, J. R. (2022). Potent anti-viral activity of a trispecific HIV neutralizing
antibody in SHIV-infected monkeys. Cell reports, 38(1), 110199.
Landovitz, R. J., Donnell, D., Clement, M. E., Hanscom, B., Cottle, L., Coelho, L., ...
& Grinsztejn, B. (2021). Cabotegravir for HIV prevention in cisgender men and
transgender women. New England Journal of Medicine, 385(7), 595-608.

de Bruin, M., Black, N., Javornik, N., Viechtbauer, W., Eisma, M. C., Hartman-Boyce,
J., ... & Johnston, M. (2021). Underreporting of the active content of
behavioural interventions: A systematic review and meta-analysis of
randomised trials of smoking cessation interventions. Health Psychology
Review, 15(2), 195-213.
Jewell, B. L., Mudimu, E., Stover, J., Ten Brink, D., Phillips, A. N., Smith, J. A., ... &
HIV Modelling Consortium. (2020). Potential effects of disruption to HIV
programmes in sub-Saharan Africa caused by COVID-19: results from
multiple mathematical models. The Lancet HIV, 7(9), e629-e640.
Jiang, H., Zhou, Y., & Tang, W. (2020). Maintaining HIV care during the COVID-19
pandemic. The Lancet HIV, 7(5), e308-e309.
Blanco, J. L., Ambrosioni, J., Garcia, F., Martínez, E., Soriano, A., Mallolas, J., &
Miro, J. M. (2020). COVID-19 in patients with HIV: clinical case series. The
lancet HIV, 7(5), e314-e316.
Rajan-Brown, N., & Mitchell, A. (2020). The NMC Code and its application to the role
of the midwife in antenatal care: a student perspective. British Journal of
Midwifery, 28(12), 844-849.