Today, more than ever before, sexually transmitted diseases (STDs) are increasingly becoming a fundamental global health priority because of their devastating consequences on the health, social and economic wellbeing of infected and affected populations (Bryan, 2009). The HIV/AIDS epidemic, in particular, has demonstrated many serious and wide-ranging consequences not only for the infected persons, but also for the whole community (Desmond, 2009). The present paper employs the community-as-partner model to evaluate the health consequences of HIV/AIDS.
Extant literature demonstrates that community-as-partner model is a systems approach that provides directions to the types of community systems requiring to be evaluated when undertaking a community evaluation (Lundy & Jones, 2009). The concepts in the model, according to these authors, include “the community core, eight interacting community subsystems, community stressors and boundaries titled normal level of defense, flexible line of defense, and lines of resistance” (p. 38). Below, an assessment of the health consequences of HIV/AIDS in XYZ community is done using the model
The core of the community basically entails the people residing in the community of practice, implying that assessment of health implications will be done based on demographic characteristics as well as the values and beliefs of community members (Lundy & Jones, 2009). Hospital data shows that out of 1200 families residing in the community, an estimated 200 people have the disease and 100 families are affected either directly or indirectly.
The values and beliefs held by community members still stigmatizes persons with HIV/AIDS in terms of viewing them as sexually irresponsible and as people with loose morals. The stigmatization brings negative health outcomes for people with HIV/AIDS in terms of elevated stress and depression levels.
In assessing the eight interacting community subsystems, it can be argued that the physical environment of the community encourages promiscuous behavior due to the large presence of entertainment facilities and night joints. In terms of health and social services, it can be argued that although HIV/AIDS-infected persons within the community have access to antiretroviral therapy provided by the two public health facilities, there are other additional health challenges associated with antiretroviral therapy, including adverse toxic effects, living with the virus for a long time and hence spreading it to more people, and emergence of other diseases associated with increased uptake of antiretroviral drugs (Pitts et al., 2005).
Assessment of the economic subsystem demonstrates that people living with HIV/AIDS are often unable to take healthy diets since most of them are not economically productive when they suffer from other opportunistic diseases. Lack of healthy diets only serves to increase the disease burden within the community. In the safety and transportation subsystem of the model, it is clear that safety of people living with HIV within the community is always guaranteed by the close proximity of the health facilities, and individuals can seek for medical attention almost immediately using available modes of public transport.
Assessment of the politics and government subsystem of the model shows that there exist various community based organizations (CBOs) that extend support services and HIV/AIDS care to community members. However, in the communication subsystem, people with HIV/AIDS within the community receive few resources that can empower them to positively live with the scourge in the absence of CBOs. Lack of adequate and proper information on dealing with the disease has led to several mortalities and morbidities among a sizeable proportion of the infected people within the community, implying an increase in adverse health outcomes for their children and dependents (Desmond, 2009).
These children do not receive proper care and therefore end up burdening the healthcare system with myriad diseases that could be avoided if their parents have the capacity to provide care. The last two subsystems include education and recreation (Lundy & Jones, 2009). As already mentioned, the presence of many recreational facilities within the community has exacerbated the spread of the scourge, and this has been compounded by lack of educational resources on the disease.
Upon assessing the community stressors, it is evident that people living with HIV/AIDS within the community often face behavioral and health consequences, including post-traumatic stress disorder, depression, and alcohol and substance abuse. Additionally, they demonstrate elevated high-risk sexual and drug use behaviors ostensibly targeted at helping them forget their problems, but which end up increasing the risk of double infection and transmitting the disease to others (Pence et al., 2012).
Lastly, in the normal line of defense component of community-as-partner model, it has been assessed that although the mortality and morbidity levels arising from HIV/AIDS are going down, focused efforts need to be targeted at dealing with the many health consequences associated with the disease. For example, under the flexible line of defense component, stakeholders need to provide reading materials and also conduct awareness programs to assist HIV/AIDS patients and their families deal with the stigma, stress and depression associated with the disease. Community mobilization against the twin problems of alcohol/drug abuse and engagement in high-risk behaviors is also needed.
The established strengths of the community, which fall under the lines of resistance component of the model, include well established public health facilities, existing HIV-related CBOs offering social support to people with AIDS, and collaboration among various stakeholders interested in fighting the scourge (Bryan, 2009).
References
Bryan, J. (2009). Engaging clients, families, and communities as patients in mental health. Journal of Counseling & Development, 87(4), 507-512.
Desmond, C. (2009). Consequences of HIV for children: Avoidable or inevitable? AIDS Care, 21(51), 98-104.
Lundy, K.S., & Jones, S. (2009). Community health nursing: Caring for the public’s health. New York, NY: Jones & Bartlett Publishing.
Pence, B.W., Shirey, K., Whetten, K., Agala, B., Hemba, D., Adams, J…Shao, J. (2012). Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults. PLoS ONE, 7(5), 1-10.
Pitts, M., Grierson, J., & Misson, S. (2005). Growing older with HIV: A study of health, social and economic circumstances for people living with HIV in Australia over the age of 50 years. AIDS Patient Care and STDs, 19(7), 460-465.