HIV stands for human immunodeficiency virus. This is the virus that causes AIDS that means acquired immune deficiency syndrome. HIV is different from most other viruses since it attacks the immune system of the host. The immune system has many components to fight infections, and T lymphocytes of the variety CD4 are very important members of the group. HIV finds and destroys these cells to lead to severe infections from other organisms in the host. AIDS is the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach the stage of florid AIDS.
HIV is a fragile virus that fails to live very long outside the body. As a result, the virus is not transmitted through day to day activities. It is primarily found in the blood, semen, or vaginal fluid of an infected person. The transmission of HIV happens in three ways, having sexual intercourse, anal, vaginal, or oral with someone infected with HIV; sharing needles and syringes with someone infected with HIV; and being exposed (fetus or infant) to HIV before or during birth or through breast feeding. As a result there are certain risk factors that predispose a person to have increased risk of HIV (Chopra, M. and Ford, N. , 2005).
Those who have injected drugs or steroids during which the equipment, such as, needles, syringe, water, or cotton and blood were shared with others; those who have had unprotected vaginal, oral, or anal sex without using condoms with men who have sex with men, multiple partners, or anonymous partners; those who have exchanged sex for drugs or money; those who have been given a diagnosis of or been treated for hepatitis, tuberculosis, or a sexually transmitted disease such as syphilis; those who receive blood transfusions or clotting factors; or those who have sex with partners having these risk factors are at increased risk (de Colombani, P.
,Banatvala, N. , Zaleskis, R. , and Maher, D. , 2004). Problem Statement: The inexorable rise of HIV/AIDS and the resurgence of many other infections and noninfectious diseases associated with HIV/AIDS have finally led to the recognition that there is a need for large-scale public health response. Initiatives to scale the response up in a sustained manner in efficient healthcare systems like USA are present and necessary, but it is essentially insufficient.
Lessons from essential health programs suggest that even with adequately functioning health systems that have strong foundations on primary health care, the results can be disappointing mainly because of the lack of health promotional engagement in the communities (Li, X. et al. , 2004). This has special implications in case of HIV/AIDS where lack of an effective HIV vaccine means prevention through behaviour change is the most important available strategy to reduce new infections.
Research has consistently shown that an effective response to this epidemic will have to move beyond the supply of condoms, health messages for safe sex, and other epidemiologic parameters and start to tackle issues, such as, stigma, power networks, and kinship systems. Communication strategies in the form of promotional programs need to be put in place to better engage and support patients and families and communities in preventing disease and optimize caring.
This research proposes to design, implement, and evaluate an HIV/AIDS health promotion program for inpatients in a non-profit hospital in Los Angeles, California over a period of 18 months. Existing studies and literature shows presence of community-based and primary care based promotional programs, but there is hardly any in the inpatients in the hospital care setting (Wang, S. , Moss, J. R. , and Hiller, J. E. , 2006). Subproblems: Many people living with AIDS/HIV find it challenging to attend to activities of daily living and to participate in moderate to vigorous physical activities.
They usually lack sufficient energy or vitality to engage in an active social life while managing HIV/AIDS. As a result, the functional quality of life comprising of physical functioning, energy/fatigue, social functioning, role functioning, and overall health are compromised in chronic illness such as AIDS. Fatigue and a CD4 T cell count of less than 500 are associated with physical limitations and disability. Among HIV-positive patients, disease progression is related to decreasing energy and increasing difficulties with daily activities and pain.
Age has been associated with quality of life and pain. Worse quality of life in the domains of physical and social functioning has been attributed to older age among people living with HIV/AIDS (Vosvick, M. et al. , 2003). Typically health promotion programs that transmit health education messages are transmitted to target audiences in time-bound campaigns through various means. One that is very effective in sending the message is structured interpersonal communication.
There is increasing evidence that even when high level of knowledge or education have been achieved through behavior change messages, individual practice may not change accordingly. The unidentified factors that prevent individuals from acting on rational information on the face of their own suffering and high costs of treatment may well be the social and cultural practices embedded in communities. The question is whether the education obtained through promotional program is influenced by the length or duration of the infection in the individual.
Since social stigma has nothing to do with age, mental maturity, suffering, and level of health education, the above factor seems irrelevant, although continuous attempts to promote health would continue despite barriers. Stigma has been identified as an important barrier to effective community engagement on HIV/AIDS issue. Health promotion campaigns to counteract stigma have made little to no impact to date as they underplay not only the deeper cultural and social norms and almost completely ignore the social structural determinants of stigma.
For example many women lack social standing or convincing power to their male partners to wear a condom. This research aims to assess the AIDS/HIV knowledge of the inpatient admission to this hospital in Los Angeles, California and promote safe behaviors to prevent HIV/AIDS (Merakou, K. , Costopoulos, C. , Marcopoulou, J. , and Kourea-Kremastinou, J. , 2002). Methodology: The participants will be any patient admitted to the hospital during the period of research, 18 months. Regulatory clearance and consent will be obtained from the appropriate authority, and written informed consent from each of the participants will be obtained.
A questionnaire entitled AIDS Knowledge Inventory will be compiled from the current studies. The principal AIDS knowledge and attitude parts will be adapted from the scales used in United States National Health Interview Survey. The individual characteristics will be surveyed in terms of gender, age, ethnicity, physical health from the hospital records, basic education, and profession. Family characteristics will be assembled by direct interviews that would include parental education, perceived family socioeconomic status, and family type.
The participants will be asked about their perceived AIDS knowledge that would include the nature of the disease and risk factors that predispose to the disease. Apart from the media sources, the participants will be asked about the personal sources of information and with whom they will discuss if they have questions about AIDS/HIV. The AIDS knowledge will be assessed by true/false/do not know questions on knowledge of definition and causation, modes of transmission of HIV/AIDS, and a 5-point Likert scale questions on AIDS symptoms and preventive measures.
Individual sexual practices will also be recorded and classified. The assessment would lead to the theory, and that would lead to effective behavioral interventions. Sample: There are a total of 30 items in the questionnaire, and they would be reorganized into 2 categories of AIDS knowledge and individual sexual practices. The AIDS knowledge section would include 5 subcategories of AIDS definition and symptoms, 5 items; true transmission modes, 5 items; false transmission modes, 10 items; clinical outcomes, 3 items; and treatment/prevention, 5 items.
The individual sex practice would be further subcategorized into knowledge about safe sexual behavior by using condoms, faithfulness to a single partner, prevention of adolescent sex, prohibition of sex with unknown partner by three questions in each subcategory. Instrumentation: Two kinds of instrumentation will be involved in this research, one the interview questionnaire is a diagnostic instrument designed from existing research, and two, the correlates of knowledge, age, and other demographic parameters will be established by the screening test for AIDS/HIV.
This might detect few positive cases in the groups segregated as high-risk groups. All groups will be advised on AIDS prevention and behavior modification, and the positive cases will be referred for treatment. Data Collection: All these data will be recorded by the researchers and other health personnel in a form created and approved for this research. Percent of correct answers will be used as a composite score for each category. The high-risk group will be identified, and all participants will be offered a test for HIV/AIDS while in the hospital.
The results of the test can be correlated with the knowledge, behavior, and attitude pattern of the participants. Data Analysis: Differences in the individual and the family characteristics by gender, age, physical health, and basic education will be examined using analysis of variance for continuous variables and the chi-square test for categorical variables. The AIDS awareness will be examined by using the chi-square test. The most reliable ranking for media or public sources will be calculated using percentage of endorsement for each of the categories.
AIDS knowledge will be examined overall and according to different demographic categories using chi-square test at item level and analysis of variance for composite score. The perceived knowledge and actual knowledge and actual incidence of HIV by test will be compared for each of the categories using analysis of variance. Multivariate analysis of variance will be employed to assess the differences in knowledge and behavior subscales; main effects and their interactions will be examined simultaneously in the same model.
Pillais F test will be utilized to evaluate multivariate significance, and the conventional F test will be used for univariate testing with individual subscales. Summary: Data will be collected from inpatients admitted to the nonprofit hospital in Los Angeles, California over an 18-month period to assess the overall levels of AIDS knowledge and sexual behaviour. This would identify the groups of people with inadequate or inconsistent knowledge in relation to demographic variables such as age, gender, ethnic groups, or baseline education.
All participants will be subjected to AIDS/HIV test to detect seropositivity status and those can be correlated to the analysis of knowledge. All participants will be educated on personal measures to prevent AIDS/HIV. This proposal is a straightforward document due to following reasons. AIDS is problem that originates in our ignorance. Healthcare facilities, however sound it might sound, would never be adequate to prevent AIDS/HIV unless the population creates a mandate to prevent it.
Ignorance on AIDS/HIV and the social stigma associated with it predisposes to the disease for which the best strategy would be preventative. Knowledge would guide safe sexual practices and not to indulge in risky sexual behavior that would go a long way to prevent HIV/AIDS. This promotional research has been designed in such a way as to assess the knowledge of hospital inmates that would culminate in promotional activity, and this kind of research, as studied from recent literature, has not been done in the hospital setting.
This proposal document sets forth both the exact nature of the matter to be investigated and the detailed account of the methodology to be employed. In addition, this proposal contains materials supporting the importance of the topic selected in the reference section and the appropriateness of the research methods to be employed (Solomon, J. , Card, J. J. , and Malow, R. M. , 2006). This proposal will also serve as the plan of action during this 18-month period of research in the California nonprofit-based hospital.
This proposal consists of careful, systematic, and preplanned observations of the knowledge, behavior, and social stigma associated with AIDS/HIV. The acceptability of the results will be judged exclusively from adequacy of the methods deployed in making, recording, and interpreting the planned observations. As a result, the plan for observation and implementation with its supporting arguments and explanations will serve as the basis on which the research and its implications will be judged.
The proposal has set forth the plan of action in detail in a stepwise fashion. The proposal document is straightforward and relatively obvious in stating the problems, raising the thesis question, mentioning the literature reviews, describing the best ways to standardize, quantify, and record observations (May, M. , 2004). This does not involve the subtle and complex problems of design and data management. This document is a straightforward proposal since the sketch of the research plan has been documented with simplicity, clarity, and parsimony.
References Chopra, M. and Ford, N. , (2005). Scaling up health promotion interventions in the era of HIV/AIDS: challenges for a rights based approach. Health Promotion International; 20: pp. 383 – 390. de Colombani, P. ,Banatvala, N. , Zaleskis, R. , and Maher, D. , (2004). European framework to decrease the burden of TB/HIV. European Respiratory Journal; 24: pp. 493 – 501. Li, X. et al. , (2004). HIV/AIDS knowledge and the implications for health promotion programs among Chinese college students: geographic, gender and age differences.
Health Promotion International; 19: pp. 345 – 356. May, M. , (2004). Commentary: Still dying of ignorance? Human immunodeficiency virus (HIV) prevention strategies revisited. International Journal of Epidemiology; 33: pp. 549 – 550. Merakou, K. , Costopoulos, C. , Marcopoulou, J. , and Kourea-Kremastinou, J. , (2002). Knowledge, attitudes and behaviour after 15 years of HIV/AIDS prevention in schools. European Journal of Public Health; 12: pp. 90 – 93. Solomon, J. , Card, J. J. , and Malow, R. M. ,(2006).
Adapting Efficacious Interventions: Advancing Translational Research in HIV Prevention. Evaluation and Health Professions; 29: pp. 162 – 194. Vosvick, M. et al. , (2003). Relationship of Functional Quality of Life to Strategies for Coping With the Stress of Living With HIV/AIDS. Psychosomatics; 44: pp. 51 – 58. Wang, S. , Moss, J. R. , and Hiller, J. E. , (2006). Applicability and transferability of interventions in evidence-based public health. Health Promotion International; 21: pp. 76 – 83.