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Preventing the Proliferation of AIDS in Wappingers Falls

 

Based on the previous Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) data that I have collected of my hometown, Wappinger’s Falls, (zip code 12590) there was no serious HIV/AIDS threat. However, it is only obligatory that actions are taken now before the issue of AIDS in Wappingers Falls poses a horrific epidemic threat. In order to create an effective solution to prevent the AIDS epidemic from taking over Wappingers Falls, I decided to focus on the living HIV cases data because the data is more current. I believe that it is just more relevant to focus on current numbers rather than old numbers, so that I will be able to put a stop the rise of the infections. There are 17 living HIV cases in Wappingers Falls  and the living HIV rate is 50.71 per 100,000 (see table 1b). Though there is a low living HIV cases and HIV rate in my hometown of Wappingers Falls, it is still essential that something is done now to prevent an increase in HIV infections and to simply provide the community with a deeper understanding of HIV/AIDS.

 Before I began my proposed solution, it was important to determine my targets in terms of gender, race and mode of transmission. With regards to gender, males had a higher percentage for cumulative AIDS cases, living AIDS cases and living HIV cases in Wappingers Falls (see table 2, 2a, 2b). As for race, Blacks are more at risk in Wappingers Falls with regards to the cumulative AIDS cases, living AIDS cases and living HIV cases in Wappingers Falls (see table 3, 3a, 3b).  As for mode of transmission, Intravenous Drug Users (IDU) posed the highest risk in Wappingers Falls with regards to the cumulative AIDS cases data and living AIDS cases data in Wappingers Falls (see table 4, 4a, 4b). However, the focus on mode of transmission is concentrated more on heterosexual contact because the living AIDS cases data for Wappingers Falls displays an increasing in this mode of transmission, over passing the percentage of mode of transmissions for Intravenous Drug Users (IDU) and men having sex with men (MSM) (see table 4b). In order to focus on creating a solution that will help out the particular targets in terms of gender, race and mode of transmission of AIDS in Wappingers Falls, the best application or approach is to instill in the community with a more effective AIDS awareness and education along with an conscientious approach for condom use. There will be a HIV/AIDS main center that will be found in the village of Wappingers Falls, which will involve HIV/AIDS intervention sessions and HIV testing and counseling sessions. It will be located in the village because it is easy to get there. It will be open 6AM-12AM; therefore morning people can make use of their time visiting the HIV/AIDS center and night people can also have their time to visit the center.  The visits would be free in order to attract more people and to show that the help being provided in the HIV/AIDS center is straight from the heart and care of the individual educators and counselors in the HIV/AIDS center.

Aside from the HIV/AIDS center, there will be a required HIV/AIDS education and proper condom usage course held in the local high school; Roy C. Ketcham High School. The phone numbers of Roy C. Ketcham High School is 298-5100. Through this course, students will be able to increase the depth of their knowledge about HIV/AIDS (1). There will be a required HIV/AIDS course for high school students during the day and at night there will also be a session for parents. A study was conducted about the perception of learning of students through participation in a problem-based course on HIV and the study showed that the students acquired an understanding of HIV (1). I strongly believe that addressing students in high school is a necessary start. It is necessary to start in high school because people should learn at an early age about HIV/AIDS and high school is an appropriate time because students are exploring their sexual desires. In addition, high school students are mature enough to discuss these topics and they are smart enough to grasp the concepts.

According to a health education research, study was conducted to test the efficacy of school based AIDS education program for secondary school students were implemented. It compared the knowledge, attitude and sexual risk behaviors of 233 senior students who received inclusive health education intervention with 217 controls.  The results showed that intervention students exhibited greater knowledge about HIV/AIDS transmission and prevention. The intervention students were found to be tolerant of people living with AIDS. Subsequent to the intervention, the mean number of reported sexual partners among the experimental students significantly decreased from 1.51 to 1.06, while it increased from 1.3 to 1.39 among the controls. Also, as a result, the intervention students increased in consistent use of condoms and the use of the condoms in their last sexual encounter. In conclusion, it was discovered that students could benefit from specific education programs that send out important information necessary to prevent risky behavior, and improve knowledge and attitudes on HIV/AIDS (2). 

Due to the success of the specific education programs that sends out important information regarding HIV/AIDS to high school students, all high school students will be required to take a course that strictly concentrates on HIV/AIDS and condom usage in Roy C. Ketcham High School and John Jay High School. This particular course would be taught by an instructor who has undergone rigorous training on HIV/AIDS education. The training will help the teacher understand the fine points and necessary information about HIV/AIDS like how a person can get AIDS, where to get tested, how to get tested, etc. The instructor will also learn to teach the students how to minimize the impact of HIV/AIDS on the education part and maximize the impact of preventive education on easing the spread of HIV/AIDS (3). In addition to learning what to teach students about AIDS, the instructor will also be exposed and taught how to handle the behaviors of high school students in order to have an effective course on HIV/AIDS. As for the students, they will receive engaging lessons where the teacher will have a more hands on approach on teaching AIDS and movies concerning AIDS will also be provided. Students will also be given readings from newspapers and magazines involving HIV/AIDS. Newspapers and magazines are effective sources of getting information about HIV/AIDS. In a study of the awareness of HIV/AIDS among students, students have reported that the newspapers and magazines are good sources of information concerning HIV/AIDS (14). I am a firm believer that people in general do not understand the impact of AIDS simply just by hearing stories about people with AIDS. As an alternate approach to this barrier of not being able to fully understand the impact of AIDS, special guest speakers who are infected by AIDS will come in to speak of their own experiences. In this manner, the students will get to see an actual AIDS infected person in front of them and they will be exposed to the life of an AIDS infected person. In my own personal experience, when I first saw an AIDS infected individual face to face, I was hit with reality and I was stunned to see the AIDS infected person in front of me. It also broadened my horizons by making me think about other HIV/AIDS infected individuals around my community and the world.

 In terms of condom usage, students will learn how to properly use condoms and how affective they are. Students will partake in the water test, where the condom will be filled with water to check the condom’s strength and elasticity, particularly at the tip, which is the vital part of the condom since it is subject to the highest strain during intercourse (4). Under the New York State Education Department policy, parents can have their children “opt-out” of HIV/AIDS education. As a way to keep as many students in the course, parents will also be able to the class too. There will be a night program where parents can come in alone or bring their kids in with them. The parents will learn the same lessons that the students are learning during the normal school hours.

It must be addressed that in Wappingers Falls, men have a higher percentage of HIV/AIDS infectivity than women. In order to help these men, the proper use of condoms must be stressed. Studies have shown that condoms are highly effective in preventing HIV/AIDS transmission when the condoms are used in a proper manner (6). These studies investigated uninfected people in sexual relationships with HIV-infected partners and the studies uncovered that even with repeated sexual contact, 98 to 100% of those people who used condoms properly and consistently did not become infected (6). This is a reality check that everyone should take advantage of. Also, a study was conducted testing the efficacy of the male latex condoms as barriers to semen during intercourse. The study showed that participants returned 700 male condoms and reported that male condom breakage in nine uses was 1.3% and complete slippage in 15 uses was 2.1% (5). These mishaps are attributed to the incorrect use of the male condom. Male participants reported incorrect use donning/partial use in 19% of the uses (5). It was reported that the man withdrew the condom without holding the rim of the condom in 41% of the uses and after losing erection in an additional 9% (5). To prevent these mishaps, the course previously introduced would be able to help men like those who do not know how to properly use the condom. The course will have a special class where a male instructor will show the proper way to put on and withdraw a condom off the penis. To prevent the stigma on sex education or condom use education, the class will be practiced in secrecy.

As for the mode of transmission, heterosexual contact was the highest risk according to the living HIV cases data. Heterosexual contact transmission of HIV is a growing problem for women, but many women do not know how their partners acquired HIV (7). Studies have shown that bisexual activity is common among black-infected MSM, few are identify themselves as heterosexuals, and their female partners may not know of their bisexual activity (7).  The sexual behavior of bisexual men in relation to HIV transmission revealed that about 1/3 of these bisexual men engaged in unprotected penetrative sex with male partners, and 2/3 engaged in unprotected penetrative sex with female partners (8).  Since females are not aware of the danger they face with these men on the "down-low", females should practice more careful sexual behaviors. Females can get help from the HIV/AIDS center in the village of Wappingers Falls, where counselors will instill in females the importance of the use of condoms. I strongly believe that condoms are important in preventing further female HIV transmission. Two alternatives to the male condom that have given the greatest promise as female-controlled methods of HIV/STD prevention are female condoms and vaginal microbicides (11). While instructors in the HIV/AIDS center will show some females how to properly use a condom, there will also be a counseling center where the counselors will persuade and urge females to fully trust their partners first before having sex. In addition, there will also be an HIV testing center so that in order for women to know if their partners are infected with HIV, they can have them take the test before have sex with each other. There was a study of sexual practices investigating the last heterosexual encounter respondents took past in. Respondents were asked whether at their last sexual encounter they gave or received manual stimulation and oral sex and had vaginal intercourse or anal intercourse. Vaginal intercourse was the dominant practice.  95% of encounters included vaginal intercourse while of the 64 possible combinations of these practices, 13 accounts for 93% of encounters: vaginal intercourse alone (12%), vaginal + manual stimulation of the man's and/or woman's genitals (49%), and vaginal intercourse + manual + oral (32%) (9). In order to protect women who are sexually active and perform wide varieties of sexual practices, specific counseling sessions will be held which focuses on the goal of decreasing sexual behavior that puts HIV-positive women at risk for sexually transmitted infections and puts others at risk for HIV transmission. In a study, three components were implemented that I wish to include in my session because they proved effective. The three main components are a brief HIV prevention messages delivered by clinicians in the form of routine medical visits; a group-level intervention (GLI) delivered by a Health Educator; and a Peer-led support group (10). Females will come to appreciate the programs offered in the HIV/AIDS center because the number one priority of the Health Educators, counselors, clinicians, [etc...] in the HIV/AIDS center is providing genuine care and desire to help the females.

 As for the Black community, I believe that the best way to approach this community in preventing HIV transmission is by providing counseling sessions with the Black community. In the counseling sessions, Blacks will learn to discover the truth behind HIV and they will lose any stigma they came with. One on one counseling will take place in the center and the topics would include rectifying the conspiracy beliefs about HIV, such as doctors putting HIV in condoms and the government withholding a cure of HIV (12). In addition to the talking sessions, there will also be a condom education session where the focus would be on the importance of condoms on the prevention of HIV. Black individuals will be given condoms and they will also be taught the proper way to use a condom. After undergoing the counseling sessions, conspiracy beliefs will no longer serve as barriers to HIV prevention among the Black community. Even other risk factors and barriers to prevention of HIV like sexual risk factors, substance use, lack of awareness of HIV and sexually transmitted diseases are among the conspiracies that the Black community shares that will get expunged (13). The HIV/AIDS center will serve to assist Blacks with genuine care and love, so the Black community will feel welcome opening the doors of the HIV/AIDS center and feel confident and content in closing any doors to HIV/AIDS infection.

             As I have realized, Wappingers Falls did not have a high living HIV cases. But since prevention of the proliferation of HIV/AIDS is of priority, I have come to find out where to place the focus on. According to my previous datas, graphs and maps, I have learned that men posed higher risks than women, Blacks posed the highest threat among the other races, and the mode of transmission that is rising to be the highest risk is heterosexual contact. My solution is simply to create a comfortable, accessible and accommodating service to the people of Wappingers Falls. I plan to create a HIV/AIDS center where there will be effective and useful counseling, HIV testing, proper condom usage. Also, there will be a mandatory course for high school students to take in high school and a night session for parents. The goal is to improve the HIV/AIDS awareness and to attain more knowledge about HIV/AIDS in order to prevent the proliferation of HIV/AIDS in Wappingers Falls.

 

 

 

 

 

 

 

Works Cited:

1)      Solomon, P. Salvatori, P. Guenter, D. “An interprofessional problem based learning course on rehabilitation issues in HIV.” Med Teach no. 4 (2003) July 25. 408-413.

2)      Fawole, I.O. Asuzu, M.C. Oduntan, S.O. Brieger, W.R. “A schoolobased AIDS education programme for secondary school students in Nigeria: a review of effectiveness.” Health Education Research. Vol. 14, no 5 (1999) October.675-683.

3)      “Education and HIV & AIDS Programme.” United Nations Education Scientific and Cultural Organization. http://www.harare.enusco.org/hivaids/strategy.asp.

4)      “How RFSU Test Condoms.” CondomX. http://www.condomx.com/home/rfsu/q_test/

5)      “Efficacy of the Male Latex Condoms and of the Female Polyurethane Condom as Barriers to Semen during intercourse: A Randomized Clinical Test.” American Journal of Epidemiology. Vol. 166 no. 1 (2007) 88-96.

6)      SImbayi, C. Leikeness. Kalichman, Seth. Strebel, Anna. Cloete, Allanise. Heda, Nomvo. Mqeketo, Ayanda. “Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa.” Social Science and Medicine. Vol. 64 Issue 9, (2007) May. 1823-1831.

7)      Montgomery, JP. Mokotoff, ED. Gentry, AC. Blair, JM. “The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care. No. 6 (2003) December 15. 829-837.

8)      Boulton, M. Hart, G. Fitzpatrick, R. “The Sexual Behaviour of Bisexual Men in Relation to HIV. Transmission.” AIDS Care. (1992) no. 4 165-175.

9)      Richters J, Visser, R. Rissel, C. Smith, A. “Sexual pratices at last heterosexual encounter and occurances of orgasm in national survey.” J Sex Res. (2006) (217-226)

10)  Teti, M. Rubinstein, S. Llyod, L. “The protect and respect program: a sexual risk reduction intervention for women living with HIV/AIDS.” AIDS Behavior. (2007)

11)  Miller, Lynn Carol. “Heirarchial messages for introducing multiple HIV prevention options: promise and pitfalls.” AIDS Education and Prevention. (2004) 509-525.

12)  Bogart, M Laura. Thorburn, Sheryl. “Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans.” Epidemiology and Social Science. Vol. 38. (2005) 213-219.

13)  “HIV/AIDS Among African Americans.” The Body. http://www.thebody.com/content/whatis/art17002.html

14)  Chakraborty, J. Purohit, A. Shah, S, Kalla, S. “ A comparative study of the awareness and attitude of HIV/AIDS among students living in India and migrants to the United States. J Assoc Physicians India. Vol. 4  (1996) 237-239