HIV IN THE UNITED STATES INTRODUCTION HIV continues to be one of the most pressing health challenges all over

the world. Collectively, having a coordinated response to this challenge remains one of the priorities of government from all over the world, as they continue to seek for the a robust strategy in order to present prevention and treatment options for this (Spicer, et al., 2010). In the United States, HIV is also being considered as one of its greatest challenges in the field of health. Many of their foreign policies were directed towards HIV in the global landscape. In fact, the country is considered as the largest donor when it comes to HIV initiatives, including the funds that are being given by the government to other countries in order to pay attention to the problems associated with HIV (Kendall, 2012). In the remaining parts of this report, the author will discuss HIV in the United States, with particular emphasis on its impact on public health, etiology, clinical features, diagnosis, treatment, and control programs. IMPACT ON PUBLIC HEALTH One of the most significant impacts of HIV on public health would be the fact that it has called upon the presence of more robust health policies and initiatives in order to address the problem and to have it prevented from worsening in the future and affecting a greater fraction of the general population. It is said that there was never a point in history wherein there was a disease like that of HIV, which has created significant impact on global health initiatives (Battle, 2009). However, it is also important to point out that while it has caused more consciousness on

the part of the government to address such problem, another impact of HIV in public health is that it has been a cause for discrimination to those people who have been affected by such disease. Many of them have reported that they are no longer treated fairly by the society because of their condition (Valdiserri, 2002). There were various HIV-related restrictions that have been imposed by governments of various countries, which, limits the entry, stay, and residence of those people who are affected by this condition. This has led into significant human right implications, which again, has been a cause of discrimination (Amon and Todrys, 2008). ETIOLOGY To date, there is still a growing debate with regards to the etiology of HIV, although two of the most common school of thoughts regard the origin of the virus from the African monkeys, while the other, traces its origins to accidents that have occurred inside laboratories (Ayim, 2007). A person who is infected with HIV can transmit the virus to another person, and hence, will cause the spread of such condition. In the experience of the United States, however, it has been noted that there has been a significant decline in the number of transmission from another person who has the virus. In fact, in 2006, it has been reported that about 95% of the people infected with HIV in the United States were not able to have it transmitted to other people during the said year. This is a significant achievement, which could have been attributed to the increase in awareness about this pandemic and the commitment of the people and the government to address the issue related to HIV (Centers for Disease Control and Prevention, 2012). However, in spite of such decline, it cannot be denied that here were continuous efforts, such as in terms of policies, which are being initiated by the government in order to prevent the transmission of HIV through humans who carry such condition, with the goal that it will be able to lower the cases of HIV in the United States.

CLINICAL FEATURES In a report that has been completed by Giles and Workman (2009), the authors have noted that HIV infection, upon its discovery, has been associated with nausea, anrthralgia, diarrhea, sore throat, headache, lethargy, fever, sweats, malaise, and anorexia, among others. The clinical features of HIV are different in every stage of the infection. For instance, during the stage of acute infection, there will be no clue that indeed what is being experienced by the patient has the possibility to lead into HIV. There are also lymph nodes that enlarge for a period of up to 6 months. The people who are infected with HIV enter a period that is known as clinical latency, which is basically the time between the primary infection and the period at which advance immunodeficiency is developed. Typically, the clinical latency lasts for a period of 10 years. In addition, during this period, many of the patients who are infected with HIV die because of opportunities pulmonary diseases (Saraf, 2006). DIAGNOSIS In the United States, as part of the effort of the government to address the issue on HIV, testing is considered as an essential component of medical care, which makes it possible to have people diagnosed early on, even before the virus would cause more detrimental effects on their health (Fenton, 2007). The diagnosis of HIV would typically begin with a clinical assessment and will then be followed by a series of tests in order to validate findings. During the assessment, patient history is checked in order to properly diagnose the condition of the individual. The physical examination that is conducted includes examination of the skin, lymph nodes, mouth, and throat. To make diagnosis easier, the World Health Organization has developed a set of criteria that will help in the evaluation of the possibility of the presence of the virus in both children and adults. This will prove to be an important factor for people who do not have access

to antibody tests for the possibility of diagnosing their condition, or the possibility of being infected with the virus (Van Dyk, 2008). TREATMENT The different standards for treatment of HIV in the United States have proven its effectiveness and successfully led into increased survival rate of people who were affected with the virus and the lessen development of the resistance of the virus. One of the treatment options made available is the antiretroviral therapy, which is basically directed towards being able to reduce the load of the virus to a level that can no longer be detected and to do so in the absence of interruption. There were medications that are available for this, such as protease inhibitors and nucleotide analogues (American Psychiatric Association, 2000). More so, there was a Treatment Modernization Act in the United States that provide assistance to those people who cannot afford to be engaged in the testament of the virus (Kates and Levi, 2007). It also calls for early intervention in terms of treatment, and being able to address associated health conditions, such as opportunistic illnesses (Gardner, et al., 2011). CONTROL PROGRAMS Increase in public awareness is one of the control programs associated with HIV in the United States. Aside from increasing knowledge of people on such, there were also policies enacted, such as testing and treatment options, in order to make sure that the virus will not spread and will not affect a bigger fraction of the general population. By making testing and treatment options available for many people, it can also be better controlled. More so, the heightened response in the national level, with the high involvement of the government, also included increased funding in research to control this disease (Sutton, et al., 2009).

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American Psychiatric Association, 2000. Practice guideline for the treatment of patients with HIV/AIDS. Washington, DC: American Psychiatric Association. Amon, J.J., and Todrys, K.W., 2008. Fear of foreigners: HIV-related restrictions on entry, stay, and residence. Journal of the International AIDS Society, 11(8). Ayim, U., 2007. HIV/AIDS: How experts spread the virus. Morrisville: Lulu.com Battle, C., 2009. Essentials of public health biology: A guide for the study of pathophysiology. London: Jones and Bartlett Publishers Centers for Disease Control and Prevention, 2012. HIV in the United States: An overview. [online] Available at:
http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview. htm [Accessed 25 October 2012].

Fenton, K.A., 2007. Changing epidemiology of HIV/AIDS in the United States: Implications for enhancing and promoting HIV testing strategies. Clinical Infectious Diseases, 45(4), pp.213-220 Gardner, E.M., McLees, M.P., Steiner, J.F., Del Rio, C., and Burman, W.J., 2011. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases, 52(6), pp. 793-800 Giles, M., and Workman, C., 2009. Clinical manifestations and the natural history of HIV. In: J. Hoy and S. Lewin, eds. 2009, HIV management in Australasia: A guide for clinical care. Australia: Australasian Society for HIV Medicine Kates, J., and Levi, J., 2007. Insurance coverage and access to HIV testing and treatment: Considerations at individuals at risk for infection and for those with undiagnosed infection. Clinical Infectious Diseases, 45(4), pp.255-260 Kendall, A.E., 2012. U.S. response to the global threat of HIV/AIDS: Basic facts. Washington, DC: Congressional Research Service Saraf, S., 2006. Textbook of oral pathology. New Delhi: Jaypee Brothers Publishers Spicer, N., Aleshkina, J., Biesma, R., Brugha, R., Caceres, C., Chilundo, B., and Harmer, A., 2010. National and subnational HIV/AIDS coordination: Are global health initiatives closing the gap between intent and practice? Globalization and Health, 6(3)

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