Reducing HIV Prevalence and Related Diseases

HIV Prevalence and Related Diseases among Women and Adolescents Girls in Low-to-Middle Income Countries

Over the recent years, commitment to contain the spread of the HIV/AIDS pandemic has intensified significantly. Significant scientific milestones have been made in understanding the virus life-cycle, mode of transmission, host immune response, and viral adaptation of the immune reactions. The progress in the scientific understanding of the virus has led to the development of advanced and reliable diagnostic testing approaches, biomedical prevention technics, and various treatment options, contributing to a significant decline in HIV prevalence and related diseases and deaths globally. However, the virus spreads increasingly particularly women and adolescents in low to middle-income countries, despite global and community-based intervention.

HIV Prevalence among Women and Adolescents Girls

Women account for 50% or even more of the number of people living with HIV globally. Young women aged between 10 and 24-year-old have twice higher chances of contracting the virus than men of a similar age group. HIV disproportionally impacts women and adolescent girls in low-income countries due to the vulnerability created by disproportionate social and cultural values and economic status. About 19.2 million women and adolescent girls live with HIV globally, and about 51% of this population reside in Africa, particularly South Africa (Hanley, Moodley & Naidoo, 2021). The study shows that young people living with behaviorally and socially acquired HIV infections has escalated over time, with a study in 2019 shows that young people aged between 15 and 24 years accounted for approximately 28% of new infections. Young women and adolescent girls accounted for up 75% of the new infections. HIV prevalence during early adulthood and adolescence presents a significant problem to young people’s emotional and social development. The majority of young women and girls living with HIV have struggled to establish romantic relationships (Mkumba, Nassali, Benner & Ritchwood, 2021). They also experience discrimination and stigma and fear disclosing their HIV status.

Adolescence is also linked to a high desire for independence and an increase in sexual exploration and expression, and young people with or without HIV are likely to begin engaging in sexual activities at this stage. Mkumba, Nassali, Benner & Ritchwood (2021) explains that with inadequate access to reproductive and sexual healthcare services and inadequate sexual health knowledge in low to middle-income nations, the rate of HIV infections rises among the group.

HIV Related Diseases Prevalence

Young women and adolescent girls living with HIV in low-income to middle-income nations also face additional complications and diseases on top of the virus. In South Africa, young women battle with a twofold prevalent of HIV and obesity. This has placed such women at a higher risk of other complications, including cardiovascular diseases (CVD) (Hanley, Moodley & Naidoo, 2021). Study shows that significant steps have been made to increase access to antiretroviral therapy (ART) to HIV-infected women, leading to a speedy decrease in AIDS-related deaths. However, CVD has significantly escalated in South African and other low-income nations because of epidemiologic transitions and the associated rise in conventional risk issues. Globally, CVD is the foremost cause of mortality and disabilities, with a substantial burden in low-income to middle-income economies, pointing to the need for a unified approach to prevent and manage chronic non-communicable and communicable diseases in low-income to middle-income economies (Hanley, Moodley & Naidoo, 2021). Impaired renal function is another complication linked to the prevalence of HIV infections in a population, particularly in low-to-middle income economies.

Research shows that non-infectious and contagious risk issues have been linked to the prevalence of impaired renal functions (IRF) in Sub-Saharan Africa. The spread of impaired renal function among the Sub-Saharan African population, a region where about 75% of HIV-infected people live, is expected to witness a significant rise (Kavishe et al., 2021). The expected rise is because of the direct abuse of HIV on human kidneys or due to the negative side effects of antiretroviral therapy (ART). Unlike in high-income economies where kidney diseases are common in elderly or middle-aged people because of diabetes and hypertension, the case is different in sub-Saharan African countries where IRF is more prevalent in the young population and is linked to glomerulonephritis or hypertension (Kavishe et al. 2021). According to Mkumba et al. (2021), structural barriers, including poverty, limited access to health education and services, are among the factors contributing to a high prevalence of HIV and related complications among women and girls in low-to-middle income countries.

Steps to Address Prevalence of HIV and Related Diseases among Women and Adolescent Girls

Efforts have been made globally to reduce the prevalence of HIV and related diseases among young women and adolescent girls, with much attention directed towards low-to-middle income countries where the virus is still predominant. Globally, sexual reproductive health (SRH) is cited as a health priority and area of research towards reducing the occurrence of HIV and related diseases among women and girls and young people in general. However, the study shows that most low-to-middle income counties have challenges promoting SHR among the young population. Adequate sexual and reproductive health knowledge can significantly reduce HIV prevalence among young women and adolescents (Mkumba et al., 2021). Sexual education is necessary as early as senior primary school and secondary school to equip young people with knowledge to promote desirable SRH outcomes, condom use, serostatus disclosure, and enhance healthcare providers’ capacity to provide SRH services to their clients in the pre-existing HIV clinical care (Mkumba et al. 2021). Increasing HIV testing is another step towards reducing HIV prevalence among women and adolescent girls.

Community-centered HIV testing services have been cited as an effective approach to reducing the HIV epidemic by a significant percentage by 2030. The approach can work well in low-to-middle income countries where people take fewer initiatives to get tested. Delivering mobile HIV testing services has proven effective in cost and has successfully targeted the population who are unlikely to undertake testing in mainstream healthcare services. Mobile HIV testing units provide the testing through outreach groups of health care personnel working within the community settings to access the hard to reach and underserved populations, including rural communities. A study in South Africa shows that mobile HIV testing programs have a high reach and high performance targeting young people (Mabuto et al., 2021). HIV testing alongside sex education is key strategies to reduce HIV prevalence among young women and girls. 

Nursing Diagnosis and Rationales–Health Promotion

Nursing Diagnosis	Rationale
Assess weight-based on premorbid weight. Compare anthropometric measurements and serial weights.	A pointer of nutritional sufficiency of intake.
Observe drug side effects	HIV medications can have significant side effects impacting nutrition. Bactrim can lead to glucose intolerance, cause anorexia or glossitis.
Plan diet with your patients	Including the patient in diet, planning provides a sense of control of health and environment, enhancing intake.
Encourage physical activity	May improve the feeling of well-being appetite
Administer medications
Antibiotics such as prochlorperazine	Reduce nausea and enhance oral intake
Vitamins	Correct vitamin deficiency caused by decreased food intake.
Antibiotic therapy	Prevent and treat infections

Overall, HIV prevalence is still high, particularly in low to middle-income countries, posing public health problems. Young women and adolescent girls are at higher risks of contracting HIV infection than men and boys. The prevalence of HIV also presents additional complications, including cardiovascular diseases and impaired renal functions. Sexual and reproductive health education and rapid HIV testing can help curb the virus respreads across the population.

References

Hanley, S., Moodley, D., & Naidoo, M. (2021). Obesity in young South African women living with HIV: A cross-sectional analysis of risk factors for cardiovascular disease. Plos one, 16(11), e0255652.]

Mkumba, L. S., Nassali, M., Benner, J., & Ritchwood, T. D. (2021). Sexual and reproductive health needs of young people living with HIV in low-and middle-income countries: a scoping review. Reproductive health, 18(1), 1-14.

Kavishe, B. B., Kweka, B. V., Nitsch, D., PrayGod, G., Jeremiah, K., Faurholt-Jepsen, D., … & Peck, R. (2021). Risk factors for impaired renal function in HIV-infected and HIV-uninfected adults: a cross-sectional study in North-Western Tanzania. BMC nephrology, 22(1), 1-12.

Mabuto, T., Setswe, G., Mshweshwe-Pakela, N., Clark, D., Day, S., Molobetsi, L., & Pienaar, J. (2021). Findings from a novel and scalable community-based HIV testing approach reduce the time required to complete point-of-care HIV testing in South Africa. BMC health services research, 21(1), 1-7.