University: Community Nursing and HIV/AIDS in At-Risk Populations

This essay examines the critical role of community nursing in addressing the HIV/AIDS epidemic, particularly within vulnerable populations. It begins by highlighting the access problems faced by at-risk groups, including sex workers and drug users, and how social determinants like stigma and lack of awareness exacerbate these challenges. The essay then delves into the definition of access to healthcare, its significance, and the negative consequences of its absence. It also provides an overview of HIV, its transmission, and impact. The core of the essay focuses on the specific roles community nurses play in promoting access to health services, including education, contact tracing, and counseling. The essay emphasizes the importance of tailored interventions, cultural competency, and the need to combat societal stigma. It also explores the practical steps community nurses can take to disseminate information, promote safe practices, and support individuals living with HIV/AIDS. Finally, the essay stresses the significance of community nursing in improving public health outcomes and reducing the burden of HIV/AIDS.

Running head: COMMUNITY BASED NURSING
COMMUNITY BASED NURSING
Name of the Student:
Name of the University:
Author Note:

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Introduction:
The prevalence of HIV, AIDS and sexually transmitted diseases are on the hike in and
around the remote areas (Liamputtong, 2015, p.27). This could be primarily because of the
major lacuna in spreading effective education and awareness about the fatal effect of HIV and
the negative response it is capable of eliciting in the body (Connell, Crawford, Dowsett &
Kippax, 2013, p. 47). It should also be crucially noted that the lack of education and
awareness in this field have been correlated with the reduced access to health care facilities
and avenues in order to combat the infections interlinked with the infections and disorder. It
is extremely important to substantially make the general public aware about the HIV
infection and the manner in which it can possibly be transmitted from one body to another
(Campbell et al., 2013, p. 120). This essay would deal with the factors that are responsible for
causing disorders pertaining to improper maintenance of sexual hygiene such as HIV and
AIDS. It would also focus on the role that the community nurses could play in order to ease
the access of community health care facilities and effectively reduce the ill effect of the
infectious disorders.
Discussion:
In order to maintain health and wellness of a concerned proportion of population, it is
vital to ensure that the population has adequate access to the health care facilities (White,
2015). Access to healthcare not only helps in the reduction of the incidence of the infectious
disease but also ensures prevention of premature death and at the same time helps in devising
prevention and managing the symptoms of the disease (WHO, 2016). Scientific papers have
revealed that there are three most important aspects that must be considered while providing
access to health care facilities across a wide range of population (Chang et al., 2013, p. 880).
The three vital components have been enlisted as, medical claim and insurance coverage,
accessibility to medical health facilities and the time frame that must be considered in order

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to promote speedy recovery (White, 2015). Access to health care can thus be defined as the
potential and timely utilisation of personal medical services available so as to attain positive
health outcome and maintain complete wellness. Access to health care is important in order
to stay away from the negative impact of infection and can be achieved in a step wise manner
(Allender et al., 2013, p. 70).
The negative impact of not having ease of access to the health care facilities can be
defined as the social barriers associated that hinder the accessibility (Frieden, Foti & Mermin,
2015). Some of the social barriers that can be enlisted would include, high expenditure
involved with care, unavailability of insurance coverage, major lacuna in the providence of
facilities and lack of professionals trained in cultural competency to deal with the clients
belonging to diverse cultural background (White, 2015,p.105). Literary evidences have
revealed that sexually transmitted diseases have been categorised as the most widely spread
form of infectious disease that affect people belonging to the remote areas of the city
(Shannon et al., 2015,p. 58).
HIV can be defines as the ‘Human Immuno-deficiency Virus’ that has been
categorised as a subgroup of retro virus that is primarily responsible for causing a detrimental
auto immune disorder known as the acquired immuno-deficiency disorder, most commonly
known as AIDS. Sexual transmission has been listed as the common subtype of transmitting
the infection. Once the virus affects the system of the body, it is estimated that within a time
period of a minimum 9 to 11 years the auto immune capacity of the body is destroyed and the
body becomes easily susceptible to any form of infection (WHO, 2016). Typically, it has
been stated that the infected body elicits poor immunological response or supressed
immunological response to allergies and petty cold and flu infections. Statistical evidences
have significantly pointed out that the most widespread form of sexually transmitted disease
is AIDS (Karrigan et al., 2015, p.183). It has also been stated that the major affected

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population group is the community of sex workers and drug IV users. On delving deeper into
the root cause of the hike in the incidence of AIDS among the sex workers it has been
discovered that there is a major problem associated with the maintenance of sexual health
practice among the sex workers (Lim, Brown & Jones, 2013, p.199). The frequency of
unprotected sex and not utilising methods of contraception can be considered as the factors
that make this set of population vulnerable to develop the infection (Williams et al., 2013, p.
488). The social determinants such as the lack of awareness connected with maintaining
sexual hygiene, regular use of contraceptives, indulging in unprotected sex, improper
sanitation facilities and poor social income have also been tightly linked with the cause of
infection (Wu & Li, 2013,p.40). In addition, it can also be stated that the proportion of
population, primarily the adolescence group engaging in drug IV abuse, use infected needles
to inject the drug intravenously inside the body. The main scientific explanation that has been
delivered in this regard is basically the manner in which the drug abusers use the similar
needle to inject drug inside the body. The needle might be in contact with the blood of a HIV
positive patient and blood being the universal carrier has the potential to carry the infection
from the body of a HIV infected patient to a normal and healthy patient and disrupt the
autoimmune mechanism of the healthy body and weaken the antibody expression. The
common use of syringes contaminated with the infected blood of the HIV patient leads to an
increased risk of introducing the infection in a healthy person and continue the transmission
at a rapid rate. Hence, it should be ensured on a mandatory basis that the contaminated
syringes are not reused by the people without sterilising and proper washing. Research
studies have stated that the use of the same needles must not be entertained at any cost
between two or more individuals even after proper cleansing and sterilisation. The common
standardised method that has been internationally prescribed in order to avoid the
transmission of infection through contaminated syringes is to use disposable syringes that are

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disposed-off immediately after administering the injection (Sajadi et al., 2013). This reduces
the probability of any possible transmission procedure of the infection into the body of a
healthy living being. HIV has been widely reported to be transmitted with the help of body
fluids, hence any form of activity that involves the exchange of body fluids has been
highlighted as risk involving activities that lead to the development of the infectious disease.
For instance, involving in sexual intercourse involves the exchange of body-fluids or genital
lubricants that possess the infectious unit of the viruses and invade a healthy immune system
of a normal person and leads to infection. The exchange of blood through needles and
syringes also witness the exchange of body fluid between a HIV infected person and a normal
healthy adult. The transmission of the infection can be prevented by educating people about
the concept of safe sex. A common myth associated with safe sex includes the notion of
avoiding pregnancy. However the idea of ‘safe sex’ is the prevention of infection which
could be achieved by the use of condoms and dental dams. The responsibility of imparting
education and awareness about the disastrous effect of HIV and other sexually transmissible
diseases primarily relies with the community nursing professionals (Van Boekel et al., 2013,
p. 24).
The community nursing professionals are a group of nursing professionals who are
entrusted with the responsibility of reducing the incidence and prevalence of sexually
transmissible diseases with the help of education and empowerment. In addition to this, the
community nursing professionals must also be able to effectively analyse the epidemiological
data and population trend in order to understand the incidence of STIs in a set of population
and correlate it with the causative agents that can be held responsible for the transmission of
the infection. The key populations that have been compared in the essay include the
proportion of sex workers and young adolescent population engaging in unfair and illegal
drug abuse practices (Guzys, Brown, Halcomb & Whitehead, 2017,p.88). The affected

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proportion of population is not only restricted to these sub groups but extend to other
category of people such as members belonging to the homosexual community especially in
cases when men are involved with men and members belonging to the transgender
community. Scientific studies have also found the prevalence of AIDS in people who are
convicted and have been in isolation imprisoned for a long period of time also develop the
disease (Gunthard et al., 2016). A primary reason that has been associated with the advent of
the disease in the convicts is the minimal exposure to the outside world that does not include
the provision to include hygienic measure to lead a healthy life style (Guzys, Brown,
Halcomb & Whitehead, 2017,p.118). Primarily it has been witnessed that the scenario of
sexually transmitted diseases and associated poor sexual hygiene is a common phenomenon
in the developing countries.
Nursing interventions that could be undertaken in order to spread awareness about the
fatal implications and consequences of the disease could include imparting education about
the disease and an elaborate explanation related to the cycle in which the disease transmits
itself from an infected individual to a healthy individual. The education could be dispensed
with the use of informative brochures and leaflets at schools and offices and inclusion of
compulsory and free of cost HIV testing to identify the proportion of the vulnerable victims
(Zanoni & Mayer, 2014,p.129). The community nursing professionals could effectively
deliver information about the manner in which the risks involved with the infection can be
avoided and also popularise the use of infection transmission barriers such as condoms for
men and dental dams for women (Frieden, Foti & Mermin, 2015). While condoms form an
effective rubber covering to the penis that ejaculates and carries the virus, dental dams and
condoms for women can also be used (Guzys, Brown, Halcomb & Whitehead, 2017,p.119). It
is also pivotal to spread awareness about the options that could be undertaken in case an
individual tests positive for AIDS (Guzys, Brown, Halcomb & Whitehead, 2017,p.115). A

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major issue that has been related to the prevalence of the disease is the associated societal
stigma and the perceptions of the society towards individuals who test positive. A stigmatized
approach of the professional workers towards the patient have also been recorded in the
literatures. Hence, professionals through effective training must make the common people
aware about the myths associated with the disease and the burst the superstitions such as the
disease could spread if an infected person shakes hands or sits next to a healthy person
(Guzys, Brown, Halcomb & Whitehead, 2017,p.121). It should be evaluated that testing
positive for HIV in itself is a major challenge and brings with itself a wide range of obstacles
in personal as well as the professional field (Shannon et al., 2013, p. 57). Hence, care should
be taken so as to sympathise with the patients and counsel them so that they are able to avail
the facilities available in favour of the treatment and deal with the complications. Counselling
can be conducted in a synchronised step-wise manner where in the nursing professionals
could take down the details of the sexual history of the affected patient (Guzys, Brown,
Halcomb & Whitehead, 2017,p.111). This would help in reaching out to the people who are
at a risk of developing the disease and this is known as the process of contact tracing. A
thorough physical examination known as the ‘pap smear test’ helps in the detection of
structural changes in cell types and the probability of developing cancer in women (Gunthard
et al., 2016). This is done with the sample smear collected from the rectum, vagina and the
cervix (Guzys, Brown, Halcomb & Whitehead, 2017,p.111). Urine tests and blood tests also
help in the detection of HIV in patients, however the test is conducted after obtaining consent
from the patients (Gunthard et al., 2016). Inclusion of sexual education to educate the elderly
group of people and making them aware of the risk factors associated with STIs is equally
important.
Conclusion:

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Hence to conclude, it should be stated that a wide prevalence of sexually transmitted
diseases such as HIV have been found to affect a major proportion of the population on a
global scale. The major sect of population that is affected with the incidence of HIV has been
recorded to be the members of the homosexual community, sex workers and young
individuals engaging in drug abuse activities. It should be noted that so far the prevalence and
the percentage of incidence have not been controlled because of the limited and restricted
access to the public health care facilities. In addition a major set of societal myth and
superstitions have also been tightly linked to the cause and consequences related with the
disease. Therefore it can be said that the community nursing professionals can effectively
play an important role in controlling the incidence rate of the disease and with the effective
medium of education reduce the stigmatized belief of the society associated with the disease.
Hence, it can only be expected that with the onset of effective implementation of training,
awareness and education procedures the risk issues linked to the prevalence of the disease can
be controlled to a considerable rate.

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References:
Allender, J., Rector, C., Rector, C., & Warner, K. (2013). Community & public health
nursing: Promoting the public's health. Lippincott Williams & Wilkins, pp. 70
Campbell, C., Scott, K., Nhamo, M., Nyamukapa, C., Madanhire, C., Skovdal, M., ... &
Gregson, S. (2013). Social capital and HIV competent communities: the role of
community groups in managing HIV/AIDS in rural Zimbabwe. AIDS care, 25(sup1),
S114-S122.
Chang, L. W., Njie-Carr, V., Kalenge, S., Kelly, J. F., Bollinger, R. C., & Alamo-Talisuna, S.
(2013). Perceptions and acceptability of mHealth interventions for improving patient
care at a community-based HIV/AIDS clinic in Uganda: a mixed methods
study. AIDS care, 25(7), 874-880.
Connell, R. W., Crawford, J., Dowsett, G. W., & Kippax, S. (2013). Sustaining safe sex: Gay
communities respond to AIDS. Routledge, pp. 47
Frieden, T. R., Foti, K. E., & Mermin, J. (2015). Applying public health principles to the HIV
epidemic—how are we doing?.
Günthard, H. F., Saag, M. S., Benson, C. A., Del Rio, C., Eron, J. J., Gallant, J. E., ... &
Gandhi, R. T. (2016). Antiretroviral drugs for treatment and prevention of HIV
infection in adults: 2016 recommendations of the International Antiviral Society–
USA panel. Jama, 316(2), 191-210.
Guzys, D., Brown, R., Halcomb, E., & Whitehead, D. (2017). An Introduction to Community
and Primary Health Care. Cambridge University Press.

9COMMUNITY BASED NURSING
Kerrigan, D., Kennedy, C. E., Morgan-Thomas, R., Reza-Paul, S., Mwangi, P., Win, K. T., ...
& Butler, J. (2015). A community empowerment approach to the HIV response
among sex workers: effectiveness, challenges, and considerations for implementation
and scale-up. The Lancet, 385(9963), 172-185.
Liamputtong, P. (2015). Stigma, Discrimination and Living with HIV/AIDS. Springer, pp. 27
Lim, F. A., Brown, D. V., & Jones, H. (2013). Lesbian, gay, bisexual, and transgender health:
fundamentals for nursing education. Journal of Nursing Education, 52(4), 198-203.
Sajadi, L., Mirzazadeh, A., Navadeh, S., Osooli, M., Khajehkazemi, R., Gouya, M. M., ... &
Haghdoost, A. A. (2013). HIV prevalence and related risk behaviours among female
sex workers in Iran: results of the national biobehavioural survey, 2010. Sex Transm
Infect, 89(Suppl 3), iii37-iii40.
Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., ... &
Boily, M. C. (2015). Global epidemiology of HIV among female sex workers:
influence of structural determinants. The Lancet, 385(9962), 55-71.
Van Boekel, L. C., Brouwers, E. P., Van Weeghel, J., & Garretsen, H. F. (2013). Stigma
among health professionals towards patients with substance use disorders and its
consequences for healthcare delivery: systematic review. Drug and alcohol
dependence, 131(1-2), 23-35.
White, F. (2015). Primary health care and public health: foundations of universal health
systems. Medical Principles and Practice, 24(2), 103-116.
Williams, A. B., Wang, H., Burgess, J., Li, X., & Danvers, K. (2013). Cultural adaptation of
an evidence-based nursing intervention to improve medication adherence among

10COMMUNITY BASED NURSING
people living with HIV/AIDS (PLWHA) in China. International journal of nursing
studies, 50(4), 487-494.
World Health Organization. (2016). Consolidated guidelines on HIV prevention, diagnosis,
treatment and care for key populations–2016 update. World Health Organization.
Wu, L., & Li, X. (2013). Community-based HIV/AIDS interventions to promote
psychosocial well-being among people living with HIV/AIDS: a literature
review. Health Psychology and Behavioral Medicine: An Open Access Journal, 1(1),
31-46.
Zanoni, B. C., & Mayer, K. H. (2014). The adolescent and young adult HIV cascade of care
in the United States: exaggerated health disparities. AIDS patient care and
STDs, 28(3), 128-135.