Selasa, 18 Desember 2007

Epidemiologic Analysis and Preventing the Spread of HIV

Epidemiologic surveys

Surveys often provide reliable, in-depth, population based data on specific groups. According to Whitmore, Zaidi, and Dean (2005) epidemiologic surveys may be cohort, case control, longitudinal, or cross sectional studies. These studies are not considered a part of routine public health surveillance but help health care decision-makers identify populations at greater risk for HIV infection (Whitmore, Zaidi, & Dean, 2005). The unique feature about an epidemiologic survey is the collection of data comes directly for the population. This information can be compared to other collected epidemiological data such demographic or geographic indicators to provide a descriptive evaluation of morbidity and risk in the community. The inclusion of multiple data sources using epidemiologic information enables planners in hospitals to know the strengths and limitations of the services provided.

Prevention planning

Fos and Fine (2005) suggest rational efforts to prevent disease and disability are rooted solidly in clinical epidemiology. In fact, preventive practices not supported by clinical epidemiologic evidence may be dangerous or costly, or both. Epidemiology is critical to our understanding of the prevalence of any disease and its natural history (Fos & Fine, 2005 p. 244). Preventing and treating HIV/AIDS over a long period of time can be problematic in an era of limited health care resources. According to Whitmore, Zaidi, and Dean (2005) effective HIV prevention planning should be an evidence-based process.

Epidemiologic profiles and assessments of community services are primary sources of that evidence. In the past, epidemiologic profiles have emphasized HIV/AIDS surveillance data because of its universal availability and high quality. An ideal intergraded epidemiologic profile describes the effect of the HIV/AIDS epidemic in terms of social demographic, geographic, behavioral, and clinical characteristics for decision-makers to make informed decisions (Whitmore, Zaidi, and Dean, 2005). Epidemiologic data can aid in the decision-making processes in a hospital or community-based health care setting by developing a comprehensive picture of the HIV/AIDS epidemic in the community.

Data that describes the sociodemographic characteristics of the general population can provide a baseline for comparing educational status, poverty level, and insurance coverage of individuals infected with HIV. Epidemiologic data can also identify populations for whom HIV risk behavior or HIV/AIDS prevalence information is needed. Community-base organizations can use epidemiologic data to identify which racial/ethnic groups are at risk and to focus interventions appropriately. The use of epidemiologic data in a health care setting allows health care decisions-makers to identify which populations are receiving HIV primary medical care.

Conclusion

HIV prevention and care involves planning between health departments and HIV-affected communities. The inclusion of multiple data sources in the decision making process enables decision makers to optimize the strength and validity of finding presented in epidemiologic analyses/data. HIV/AIDS surveillance data along with social demographic, geographic, behavioral, and clinical characteristics must all be included in the decision making process to paint a three dimensional picture of HIV/AIDS epidemic.

Epidemiologic data has refine disease management by further describing the socialdemographic characteristics of persons infected with HIV and comorbid conditions, such as tuberculosis, hepatitis and other STDs. The application of epidemiologic analyzes/ data must continuously be developed and used to lead health care providers to more effective prevention and care planning for individuals infected with HIV. Fos and Fine (2005) suggest epidemiological data can help health care decision makers to identify, evaluate and select alternatives. Epidemiology can help decision makers set criteria on which solution in an epidemic will be the most cost effective utilization of health care resources (Fos & Fine, 2005). A health care decision maker can use epidemiological data to prioritize and focus prevention and care services to specific subpopulations. Data on STD morbidity, HIV and tuberculosis comorbidity, mortality data, seroprevalence studies may provide a more comprehensive picture of the HIV epidemic.

At present there is little known about the long-term effects of any of the anti-HIV medications now on the market. Even more alarming are the effectives that risk behaviors have on the transmission of HIV. In the future hospitals and community -based health care setting may one day use epidemiological data to answer some of these questions in the search for preventing and treating HIV/AIDS epidemic.

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