HIV Infection Among the Black Population in England

Introduction

HIV stands for Human Immunodeficiency Virus. The immune system is attacked by this virus, which can eventually lead to acquired immunodeficiency syndrome (AIDS). AIDS stands for acquired immunodeficiency syndrome (Carlisle, C., 2000). It is a medical condition caused by HIV. AIDS occurs when the immune system becomes severely damaged and cannot fight off diseases and infections any longer. AIDS was first recognized as a medical condition in 1981, while HIV was first identified in 1983. The virus originated from a chimpanzee that carried a similar virus called the Simian immunodeficiency virus (SIV) in Central Africa (Hemelaar, J., 2012). The virus is thought to have been transmitted to human beings through the consumption of infected animals that they hunted. HIV is a pandemic that is global today and affects millions of people worldwide. Antiretroviral therapy (ART) has been developed to help slow the virus’s progression and manage it since there is no cure for HIV/AIDS. HIV can be spread through contact with infected blood, vaginal fluids, or semen. HIV/AIDS remains a significant public health concern among the black community in the United Kingdom. Black people are disproportionally affected by HIV despite the advances in HIV treatment and prevention strategies. According to recent estimate suggestions in 2019, 106,890 people living in the U.K. are living with AIDS. Five thousand one hundred fifty of these do not know they are HIV positive since they are undiagnosed. London, England, continues to have higher HIV rates. In 2020, 37% of new HIV diagnoses were in England residents, with most of the infected people being black or men who have sex with other men (Wilton L et al.,2009). 38% of people infected with HIV went for care and lived in London. In the U.K., out of 4,139 people infected with AIDS in 2019, 41% were bisexual or gay men, and 37% were black (Bhaskaran, K et al.,2021). Several factors contribute to this higher prevalence of HIV/AIDS among the black population in England. These include discrimination, stigma, cultural barriers to HIV treatment and prevention services, poverty among black people, and poor access to healthcare. Among the Black population in England, the HIV impact is particularly severe, with an increased rate of new diagnoses and people accessing care. This can lead to significant social and economic consequences, including increased costs of healthcare, reduced workspace, and discrimination (Dougan S, et al.,2005). HIV weakens the body, and one can not carry out heavy tasks or duties and hence depend on other people for basic needs, leading to economic and social failure. In this essay, we will critically analyze and evaluate ways in which epidemiologic methods would be used to assess the levels of HIV, identify potentially effective interventions, and support the planning and effective implementation of a public health initiative.

HIV/AIDS in England

HIV/AIDS has four stages (Pathak, 2021), which are;

1. Acute or Primary HIV infection occurs within 2 to 4 weeks after exposure to the virus and is the first stage. In this stage, one might experience flu-like symptoms such as rash, sore throat, or fever, but not all people experience these signs.
2. Asymptomatic Stage: The virus then enters a dormant stage, causing no noticeable signs and symptoms for several years. But the virus still damages the immune system since it is active.
3. Symptomatic HIV infection Stage: The immune system continues being damaged by the virus, and symptoms like fatigue, loss of weight, lymph nodes that are swollen, and fever may begin to appear.
4. AIDS is the last and most advanced stage after the immune system has been damaged severely. People with AIDS are at risk of developing cancers or infections that cause a threat to life and are difficult to treat.

HIV can be transmitted through needle sharing, unprotected sex, and from mother to child during breastfeeding, childbirth, or pregnancy. HIV is a public health concern in England, mostly among the black population. In England, it is estimated that people with the highest HIV infections are the black communities, with an estimated 1 in 13 living with this virus (Rice, 2013). This is much higher than the overall prevalence in England, which is 1 in 200 people. To address the HIV spread among black people in England, public health intervention must promote health equity and address the root causes of health disparities among these people (Levy, 2014). This includes promoting awareness and educating on HIV treatment and prevention to reduce its spread. Similarly, they can improve access to education, healthcare centers, and prevention services and address poverty among the black population in England.

The immune system is attacked by HIV, making it difficult for the body to fight illness and infections. This leads to a weakened immune system over time and can result in many complications, including neurological disorders, cancers, and opportunistic infections. HIV progresses to AIDS, a life-threatening threat because of a lack of appropriate care and treatment. The impact of AIDS in England among the black population and the overall population can lead to significant social and economic consequences. These consequences include; discrimination, stigma, reduced workforce participation, and increased healthcare costs.

Interventions

What methods can be used for identifying the relevant interventions taking into account?

Various techniques can be used to find the most appropriate solutions to deal with the high rates of HIV transmission among the Black population in England. Literature reviews, discussions with stakeholders and experts, and involvement in the community are a few examples.

Conducting a comprehensive literature examination is a crucial step in finding pertinent therapies. To discover interventions that have been demonstrated to help lower HIV transmission among Black communities, a thorough search of published and unpublished studies is required (Randolph, 2009). Identifying pertinent initiatives can also benefit from a consultation with stakeholders and experts. Understanding their viewpoints and experiences may entail talking with healthcare professionals, local authorities, policymakers, and HIV-positive individuals.

Identifying pertinent interventions also requires using effective community involvement techniques. Learn about the needs and preferences of the Black community for HIV prevention and education; this may entail collaborating with community-based groups and interacting with Black community members. It is crucial to consider aspects like cultural sensitivity, accessibility, and acceptance among Black populations in England while choosing appropriate solutions. Community involvement and the involvement of culturally and linguistically diverse stakeholders can help achieve this (Wu, 2013). Discovering pertinent solutions is possible by utilizing a participatory method, which entails active participation and collaboration with community people. This strategy can aid in ensuring that solutions are responsive to the needs and preferences of Black communities and are culturally appropriate.

The specific context and population being addressed will determine the approach used to discover pertinent interventions. For instance, different techniques may be needed for Black women or those who inject drugs than for Black guys who have sex with men. It is crucial to consider the larger social and structural factors that contribute to HIV transmission among Black communities when choosing appropriate therapies. This might involve problems including healthcare access, discrimination, and poverty.

What epidemiologic designs and how does the hierarchy of evidence concept inform the choice of intervention for HIV infection among the black population in England?

The effectiveness of treatments for lowering HIV transmission among Black communities in England can be assessed using various epidemiological methodologies (Beyrer, 2012). These methodologies include observational studies, randomized controlled trials, and community-based participatory research.

The gold standard for assessing the efficacy of therapies in randomized controlled trials. In this research, participants are randomly assigned to either an intervention or a control condition, and the results of the two groups are compared (Silverman, 2009). The efficacy of interventions can also be assessed through observational research, such as cohort studies and case-control studies. In these studies, a group of people is monitored over time and the outcomes of those who received the intervention and those who did not are compared.

To find and implement interventions, community-based participatory research actively engages and collaborates with community members (Duke, 2020). This strategy can aid in ensuring that solutions are responsive to the needs and preferences of Black communities and are culturally appropriate. According to the hierarchy of evidence, evidence from randomized controlled trials is more reliable than observational studies. Cultural and environmental factors may influence the success of interventions; therefore, this hierarchy is only sometimes suitable or relevant.

When assessing the efficacy of treatments in the instance of HIV transmission among Black communities in England, it is crucial to take cultural and contextual aspects into account (Kaihlanen, 2019). For instance, if interventions do not consider cultural ideas, values, and behaviors, they may not be effective in Black groups, even in other populations. Mixed approaches, which include qualitative and quantitative data, can be used to evaluate the efficacy of treatments. The factors that lead to HIV transmission in Black communities may be better understood using this technique.

The exact intervention being evaluated and the population being studied will determine the epidemiological design to be used. Randomized controlled trials may not be practical or acceptable for evaluating interventions for structural or community-level changes. It’s crucial to assess the acceptability and viability of treatments among Black populations in England and their effectiveness. Consultation with community members and stakeholders may be necessary to ascertain their preferences and points of view regarding various interventions.

How can the characteristics, views, and discerning of stakeholders be obtained and used to inform the choice and implementation of the intervention?

It is crucial to comprehend the viewpoints and traits of the stakeholders engaged in identifying efficient solutions to address the high levels of HIV spreading in the Black population in England. Healthcare professionals, community leaders, policymakers, and HIV-positive people may all be considered stakeholders.

Focus groups or interviews are one method for learning about the perspectives and traits of stakeholders (Rustagi, 2015). These techniques enable a thorough investigation of people’s experiences, convictions, and attitudes regarding HIV prevention and treatment. Utilizing this data will allow initiatives to be specifically tailored to the requirements of England’s Black population.

Having cultural sensitivity is equally essential when creating interventions for England’s Black population (Wilson, 2003). Understanding and respecting the cultural practices and beliefs of the community is necessary for this, as is making sure that treatments are specifically designed to address these cultural demands. It is critical to evaluate the social determinants of health that contribute to HIV disparities in the Black community in addition to getting stakeholder viewpoints. These may include, among other things, poverty, racism, and discrimination. It could be important to address these fundamental problems in order to lower HIV transmission successfully.

Collaboration between various stakeholders is crucial for the creation and execution of successful initiatives (Piot, 2015). To ensure that interventions are thorough and fulfill the needs of everyone involved, this may entail collaborating with healthcare professionals, community organizations, policy officials, and people living with HIV. The effectiveness of interventions must also be ensured through evaluation and monitoring. To ascertain the impact of interventions on HIV transmission rates and other pertinent outcomes, continual data collection and analysis are required. Finally, it’s critical to make sure that initiatives are long-term sustainable. As a way to foster community ownership of initiatives and create capacity, this may entail collaborating with neighborhood associations and groups.

Interventions on How to Reduce the Spread of HIV Infection among black people in England

The HIV/AIDS spread among black people in England has become a significant public health challenge. According to (Bhaskaran, K et al.,2021), black people are disproportionately affected and infected by HIV, leading to a higher HIV preference rate among the black community in England. As the lead epidemiologist in the public health organization, I take this issue very seriously. It is clear that this is a multi-faceted and complex problem that requires evidence-based and comprehensive intervention.

Proposed Intervention:

My proposed intervention is to develop an HIV/AIDS program that is comprehensive and puts its focuses on improving HIV/AIDS awareness and knowledge among the black population in England. The program aims to increase access to HIV prevention, testing, and treatment services through community-based interventions, including outreach programs, peer-led support, and education. (Williams, M.V et al.,2011)The program will also include the promotion of pre-exposure prophylaxis and the provision of HIV self-testing kits which are effective HIV prevention tools.

Procedures and Methods.

The intervention proposed above will have the following methods and procedures:

Identification of high-risk groups: Identification of high-risk groups among the black population in England is the first step in implementing this HIV prevention program. These groups may include sex workers, people who inject drugs, or men who have sex with men. The groups will then be educated on HIV awareness, prevention, and control to help reduce the spread of HIV/AIDS (Williams M.V. et al.,2011).

Community engagement and mobilization: Community mobilization and engagement will be involved with this program to help promote HIV prevention and awareness. This will be achieved through the engagement of peer educators to promote HIV testing and disseminate information and through partnership establishment with community organizations.

Outreach programs will be organized to reach high-risk groups likely to have access to conventional healthcare services. Outreach programs will provide support, HIV testing services, and education on HIV.

Providing self-testing kits: For individuals who may want to access conventional testing kits, the program will provide them with self-testing kits. This will help increase the number of people who know their HIV status in England and help reduce its spread through sex, drug injection, etc.

Linkage and Follow-up to care: Individuals who test HIV positive will be provided with the appropriate and necessary support and treatment and will also be linked to care. This program will also include follow-up services to ensure that individuals receive the necessary support and adhere to their treatment regimens.

Provision of PrEP: Pre-exposure prophylaxis will be promoted as a more effective tool among high-risk groups. This will involve having access to PrEP services and being educated on the PrEP benefits.

Evaluation and Monitoring: The program will be evaluated and monitored to assess its effectiveness in HIV spread reduction among the black population in England. This will involve using indicators such as the number of people who initiate PrEP, the number of people tested for HIV, and the number of people linked to care (Auerbach, J.D et al.,2011).

Benefits of the intervention

1. The uptake of HIV testing will increase while the number of undiagnosed cases will reduce.
2. Awareness of HIV/AIDS is increased among the black population in England (Brock, C. and Alexiadou, N., 2013).
3. Access to treatment services, HIV testing, and prevention is improved.
4. Health equity for the black population in England will be improved.
5. The spread of HIV among high-risk groups is reduced.
6. The health outcome of people living with AIDS will be improved.
7. The stigma associated with HIV/AIDS will be reduced.

Challenges

The intervention proposed above may face several challenges, including;

1. Access to care: Individuals living in areas with limited individuals to tame care of them or limited healthcare resources are most likely to face the challenge of access to care.
2. Limited Funding: For this program to reach its target audience, it may require significant funding, and securing adequate funds may be a major issue.
3. Stigma: Stigma associated with HIV/AIDS may limit the effectiveness of outreach programs and may make it challenging to engage high-risk groups (Yilmaz, V. and Willis, P., 2020.)

Implementation of the Intervention.

This involves monitoring and evaluating the effectiveness of my intervention.

Primary Health Outcomes

The following are primary health outcomes that would evaluate the effectiveness of my intervention;

1. The proportion of people getting tested for HIV will increase.
2. Incidences of new HIV infections will reduce among the black population in England (de-Graft Aikins, A. et al.,2010).
3. The proportion of individuals with viral suppression will increase.
4. Increase in the proportion of individuals adhering to antiretroviral therapy.

Secondary Health Outcomes

1. Reduction in HIV-related discrimination and stigma.
2. Increase in safer sex practices such as condom use.
3. Reduction in HIV-related mortality and morbidity.
4. The quality of life of people living with HIV improves.

To evaluate the changes in secondary and primary health outcomes in the reduction and prevention of HIV spread among the black population in England after the intervention to develop an HIV/AIDS program that is comprehensive and puts its focus on improving HIV/AIDS awareness and knowledge among the black population in England. The combination of these epidemiological methods would provide a comprehensive evaluation of the effectiveness of the HIV/AIDS program in improving HIV/AIDS knowledge and awareness among the black people living in England and reducing the spread of HIV. The following epidemiological methods could be used (Prince M et al.,2007).

1. Cohort Studies.

These studies could be conducted among individuals living with HIV in England to evaluate changes in viral suppression rates, HIV-related mortality, and morbidity after the intervention and adherence strictly to ART. A cohort study involves having recruited a group of individuals living with AIDS and doing a follow-up on them over some time in order to be able to evaluate their health outcome changes. The method would greatly impact and help reduce HIV-related mortality and morbidity after evaluating HIV/AIDS program’s impact.

2. Sentinel surveillance.

Sentinel surveillance involves monitoring trends in HIV prevalence and incidence among high-risk groups, including the black population in England. This method would be useful in evaluating the HIV/AIDS program’s impact on reducing HIV spread. Prince, M.

3. Pre- and post-intervention surveys.

This method involves collecting data through surveys before and after the intervention to evaluate changes in HIV awareness, attitudes, practices, and awareness among the black population. This method would be useful in the evaluation of the impact of the HIV program on increasing promoting safer sex practices, HIV testing, and reducing HIV-related discrimination and stigma.

4. Qualitative Studies.

These studies could be conducted among people living with HIV to explore the changes in their quality of life and experience of stigma and discrimination after the intervention. This method would be useful in improving the quality of life of people living with HIV.

5. HIV incidence studies.

These studies could be conducted to monitor the incidence of new infections of HIV among the black population in England. This method would be useful in evaluating the impact of the HIV/AIDS program on reducing the incidence of new infections of HIV/AIDS.

Conclusion

In conclusion, HIV infection remains to be a significant public health issue among black people in England. The level of HIV infection among this population can be accessed by epidemiological methods, which are essential for this function. These methods provide critical insights into the risk factors, prevalence, and incidences associated with the disease. The methods can provide valuable information to healthcare providers, policymakers, and health officials in implementing and designing interventions to help control and prevent HIV spread among this population. With the right strategies and interventions, reducing the HIV infection burden among the black population in England will be made possible, and improving the health outcomes of the people infected will be easy. In this essay, we decided to focus on improving HIV/AIDS awareness and knowledge among the black population in England. We aim to educate, provide access to treatment and testing, address cultural and social factors contributing to the spread of HIV, and address inequality and poverty. Black people in England should get tested, and those infected should seek medical help and avoid spreading the disease.

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