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St. Thomas University

NUR 421 AP1

Milien, Cassandre

Abstract

The paper that I am writing about is based on one of the Healthy People 2030 area of concerns.

Its main objectives will be on sexual transmitted infections with the focus on HIV and the

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population and groups it is affecting the most. I will be explaining the negative affects its has on

health populations, as well as plans and actions to possibly decrease the rate of infections within

this high risk groups.

Introduction

Healthy People 2030 works by using evidence-based practice, to create goals to improve health

and well-being over a ten-year span. For goals to be created, we must build on framework that

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explains the main ideas and main functions to provide a context and rational for dealing with

these ideas, as well as communicating the principles that support these decisions about Healthy

People 2030 (Barna, 2020). This will help with access to facts and statistics that can promote

changes in the health affairs of the U.S. population, which can help with goals and objectives for

next decades to come. The priority will always be the most serious issues affecting health and

wellbeing in general terms, that can be improved in the long run by using all available

knowledge on the issue at hand.

Healthy People 2030 health issue: Sexual Transmitted Infection

Many sexual transmitted infections (STIs) can be prevented and cured, with abstinence and

treatment. One STI that is preventable and treatable, but unfortunately does not have a cure now

is, Human Immunodeficiency Virus (HIV). There are more than 20 million estimated new cases

of STIs in the United States and there are currently 1.2 million people living with HIV (Healthy

People, n.d.). Healthy People 2030 goals regarding STIs, including HIV, is preventing, treating,

and improving the health and well-being of people who have them.

We will be focusing on HIV and the affects it has on different groups and communities.

To have an understanding on the topic we must know how it came about. HIV presented itself

around 1981, it was noticed in a couple of gay males, who before the virus, were overall healthy

adults. The men presented with Pneumocystis Carinii Pneumonia (PCP), a rare lung infection

that researchers later linked to acquired immunodeficiency syndrome (AIDS). Studies later found

out that HIV, when left untreated can cause AIDS, with an average life span of 8 to 10 years

without treatment. HIV can present itself with flu-like symptoms, such as: fever, chills, night

sweats, and even unexplained rashes. If you test positive for HIV you can receive antiretroviral

therapy (ART), it can bring the viral load to undetectable and prevent AIDS.

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Contrast causes of disparities related to this health issues within populations

We have come a long way since 1981 with HIV/AIDS crisis. We now know so much more than

we knew back then, but there are still communities that has an unfair number with this disease.

Many reasons that can cause this unfair number are things like race, sexual orientation, and

poverty can unfortunately increase the risk of infection in a community. Access to good

healthcare, cultural beliefs, stigma, homophobia, and systematic racism, can all cause infections

like HIV to spread through a community (Myhre & Sifris, 2021). These groups are more at risk

for infection and not getting treated. As mentioned before, around 1.2 million people are living

with HIV in the United States, with over 36,800 new infections happening every year, the

communities at the greatest risk being, men who have sex with men, people of color, women and

those that inject drugs.

Poverty has shown to increase the risk of infection, unless there are programs like

community outreaches, health education, and test provided to help the impoverished more aware

of the risk of infection, otherwise they remain vulnerable to it. Compared to wealthier

communities that has more access to education and facilities that offer education and treatment.

No less than 76% of people living with HIV in the United States have a household income of less

than $20,000 annually, of this number 39% are unemployed, while 18% report homelessness

(Myhre & Sifris, 2021). Racism in the United States has inevitably led to disparities between

people of color. People of color has a double risk factor of having a higher number of HIV

infection and high rates of poverty. The poverty rate for Black people currently is at 18.8%,

compared to Whites whose rate stands 7.3% (Myhre & Sifris, 2021). According to the CDC

(2022), in 2020 there were 30,635 new HIV diagnosis, among this number 42% were Blacks and

27% are Latinos, compared to Whites who made up 26% of the new cases. It is said possibly due

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to Blacks and Latinos, who are more likely to live in areas that are racially separated, because

these areas have a higher rate of poverty, crime, drug use, and STIs, all of which can increase the

risk of HIV infections. Poverty is not the only factor with this group, but also medical mistrust,

homophobia, and the stigma of having HIV is very high in the Black community. Only 48% of

Blacks with HIV remain in care after they are diagnosed, while only half of that number reach a

level of undetectable viral load, compared to the White and Latino communities which numbers

are drastically lower (Myhre & Sifris, 2021). Men who have sex with men make up a huge part

of HIV cases. This is hugely due to the way they have sex; the risk is 18 times greater of getting

the virus from unprotected anal sex, compared to having unprotected vaginal sex (Myhre &

Sifris, 2021). Men who have sex with men also face various stigma and homophobia, which

increases their risk for infection, because of the fear of being outed they may not get tested.

Women, especially Black women are more susceptible to the virus because the area of the vagina

has a larger surface area than the men’s penis. In a lifetime a Black women’s risk of HIV is 15

times greater than that of white women and 5 times greater than Latino women (Myre & Sifris,

2021). Injecting drug users make up a small amount of HIV cases, but they are still at a higher

risk because of the potential of sharing needles and syringes with an infected person. It can also

be very hard to manage HIV and an addiction at the same time. Compared to injection users that

seek treatment, like methadone, are more likely to stick with their HIV regimen than those that

don’t seek treatment.

Propose a public health communication strategy to reduce disparity and promote

health

Health communication deals with verbal and written strategies that effect and give authority to

people, populations, and communities to make better and healthier choices. By taking the data

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that we know and the populations most at risk, we can start there. I would propose community

outreaches in impoverished areas, which include free STI and HIV testing. Also, health

brochures with pictures and few words, to cater to various educational background and free

condoms. We also need to consider where in the rural areas has the heaviest traffic of people, to

reach as many as we can. Also, posting advertisement about reminders of taking your HIV

treatment to prevent the spread of infection and AIDS.

Outline a plan for the communication

We should first set goals to reach as many as possible but putting a number on it will allow us to

properly evaluate our efforts more efficiently. Our key audience will be those who live in rural

areas, people of color, men who have sex with men, and injection drug users, these groups make

up a high number of HIV infection rates. Our key message will be prevention and treatment from

the virus. As mentioned before, setting up billboards within high risks areas and personally

handing out brochures and condoms, also giving out free STI/HIV testing. We need to develop

material not only about HIV, but also staying culturally aware of what group of people is around

outreach, so making sure to provide bilingual staff and literature in the language that they are

familiar with, to effectively get the message across. Setting a specific timeframe is crucial, to

evaluate the effectiveness of our plan. Host an outreach party in the community to communicate

to our audience the results of our outreach.

Describe an evaluation plan for the communication

To assess the strategies effectiveness we must look at our goals and our proposed

indications. We need to first evaluate the staff members that were sent to the areas of risk, , if

they were efficiently getting our message across to our target audience, by again testing their

knowledge of the virus. We want to include the number of material and test given out and

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percentage of people that viewed the billboards. Lastly, we can evaluate the decrease of the

infection in the targeted community since the outreach.

Create targeted communication for each population

To make our HIV awareness more convenient and effective, we need to place our

communication methods in effective places, so our target audience will have more of a chance to

see it. As mentioned before a large portion of Black people and drug addicts live in rural areas,

many of these rural areas have local convivence stores they are likely to visit, so placing posters

on or around convivence stores in the area may help to bring awareness to this group. Placing

pamphlets in women’s clinics, especially those that service high volume of Black women clients

and possibly a pop-up shop outside those clinics to give further education and referrals for

testing. Men who have sex with men usually have an area exclusively for them, setting up free

testing sites and education on prevention and treatment around those areas, can help them receive

the message. For our younger at-risk group, social media will probably be the best

communication outreach, using things like; Facebook, Twitter, and Instagram can be highly

communication tools for this group.

Reflect on learning through this project

If I didn’t understand Healthy People 2030 existence, doing research on this particular

health issues has made me so much more knowledgeable about HIV/AIDS, and how me came

such a long way since 1981 when we first found out about the disease. Things like PrEP (pre-

exposure prophylaxis) medication that reduces the risk of HIV through sex by about 99% and

74% if you inject drugs (CDC, 2020). But there are still communities that need our help, due to

lack of knowledge and limited resources, they might feel they can’t afford it or just an all-around

stigma towards HIV. We must break those barriers of communication and bring the knowledge

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to those that need it most. The black community especially needs to be educated; the numbers

have shown that almost half of all new cases comes from this group. I know in large part that it

comes from the number of health disparities the Black community has. I feel we as healthcare

providers have to find away to build trust in this community, in order to see drastic change in the

number cases we see, not only in the Black community, but all high-risk groups.

References

Barna, M. (2020). Healthy People 2030 charts a new course for the nation: Newest edition shares

355 measurable, streamlined objectives. The Nation’s Health, 50(8), 1.

CDC. (2020, June 4). Pre-Exposure Prophylaxis (PrEP) | HIV Risk and Prevention | HIV/AIDS |

CDC. Www.cdc.gov.

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https://www.cdc.gov/hiv/risk/prep/index.html#:~:text=Pre%2Dexposure%20prophylaxis

%20(or%20PrEP

HIV Diagnoses | HIV in the US | HIV Statistics Center | HIV | CDC. (2022, September 2).

Www.cdc.gov. https://www.cdc.gov/hiv/statistics/overview/in-us/diagnoses.html

Myhre, J., & Sifris, D. (2021, October 21). Health Disparities in HIV. Verywell Health.

https://www.verywellhealth.com/health-disparities-in-hiv-5204764

Sexually Transmitted Infections – Healthy People 2030 | health.gov. (n.d.). Health.gov.

https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-

transmitted-infections