Missed Doctors’ Visits And Increased HIV/AIDS Mortality RatesWhen beginning any course of treatment for a chronic yet manageable disease such as HIV and AIDS it is important for one to follow their HIV specialists advice, maintain a regular schedule of appointments, and strictly adhere to the pharmaceutical treatment regimen. These three practices establish early on a life-time of disciplines that one will require to effectively manage living with the HIV/AIDS virus. If ever there was doubt as to the importance of regular visits with one’s HIV/AIDS health care practitioner, those doubts can now be put to bed. A study has recently surfaced which has identified a causal link between missed doctors’ visits, and an increased mortality rate. This analysis focused retrospectively within a group of HIV clinical patients who had established their initial outpatient treatment for HIV infection at the University of Alabama HIV/AIDS Clinic. All of the 543 study participants were evaluated between 2000 through to 2005. Patients who missed visits within the first year after initiating outpatient treatment were shown to have twice the rate of long-term mortality when compared with those patients who maintained regular visits, and attended all of their regularly scheduled appointments. The results of the analysis showed that among those 543 HIV patients participating in the study, 60% of them missed a visit within the first year. The mortality rate in those patients who missed visits within the first year was 2.3 deaths per 100 person years. In contrast, the mortality rate for those who attended all scheduled visits and appointments with their HIV/AIDS practitioner was 1 death per 100 person years. Other factors such as age, overall health, and CD4 counts were all taken into account when comparing the risk factors and determining the overall mortality rate. One thing is clear when reading the results of the study, and that is that mortality rates increase when skipping or missing regularly scheduled appointments. However, it is worthwhile to note the study’s authors posit that the nearly doubling rate of mortality is not a direct consequence of missing those appointments, but rather, are identifiers of those HIV patients who are more likely to exhibit behaviors which can lead to increased mortality earlier in life. Causes Symptoms and Treatments Of HIVCauses of HIV The spread of HIV inside the body is in such a way that the virus splits the inherent cryptogram of the cells which are utilised by the immune system, especially cells called ‘CD4 cells’ and further utilizes the natural inherent matter in order to create replicas of itself. The body is able to create more of the’CD4′ cells, but sooner or later the virus HIV would bring down the number of the ‘CD4′ cells to a very low level which in turn would end up in stopping the functioning of the immune system. The spreading of the virus HIV outside the system is due to transmission of fluids from the body, like blood or semen. Thus this virus could be transmitted due to sexual intercourse, which would include even anal and oral sex. The risk of the transmission of HIV is there also in case of the sharing of needles while injecting illegal drugs. HIV can also be transmitted by the mother to the baby. But nowadays there are medications available wherein the possibility can be brought down. HIV is also transmitted by blood transfusions. Symptoms of HIV The first stage of the infection is called the ‘primary HIV infection’. The persons infected by this virus, about more than half of the people develop the symptoms, generally in about 15 to 45 days of the infection. The symptoms would comprise of pain in the joints, fever, muscle pain, sore throat, and swelling in the glands, getting tired out faster than usual and appearance of a spotty rash on the chest. Generally the symptoms are quite mild and you would tend to link them to some other problem like fever or cold. These symptoms do not show any increment for a long period. This is called ‘Asymptomatic HIV infection’. This virus is internally growing and even damaging the immune system. If the virus is left and not treated, it in turn will bring down the number of the CD4 cells in the body to a very low level and this would cause the immune system to stop functioning. This damage caused to the immune system generally happening in over a period of ten years. This in turn would inexorably result in growing into a severe infection. The symptoms of a severe infection would be, night sweats, dry cough, inexplicable loss of weight, high fever which would be enduringly long, vision would start getting blur, the mouth or the tongue would develop white spots, shortness in breath, constant diarrhea or even glands tend to swell up and this condition would continue for three or more months. Treatment of HIV The first step would be getting referred to a HIV clinic and getting counseled. Then blood tests would be done regularly, these tests would be to keep a check on the viral load and the CD4 cell count. There is no vaccine or medication available which can cure HIV completely. But there are medications like HAART available in order to slow down the speed of the virus and also giving you a longer life span. There are also various therapies done alone and also in combination with medication to give the sufferer a better life. HIV AIDS and WomenAround the world, women now make up half of all people living with HIV, the human immunodeficiency virus, and AIDS, acquired immunodeficiency syndrome. In the U.S., more than 25 percent of new infections are in women. Women of color are especially impacted by the disease. HIV/AIDS is the leading cause of death for African American women aged 25 to 34. Although most of the cases reported early in the epidemic were men, it was not long before AIDS in women was identified. Women contracted the disease primarily by sex with bisexual men or infected drug-using men or through sharing contaminated needles with infected injection drug users. The proportion of all AIDS cases that were women and adolescent girls increased from 8% in 1986 to 26% in 2001. The first symptoms of HIV infection are very much the same in men and women, although they may be more pronounced in women. They are similar to those of other acute viral illnesses: fever, joint pain, muscle ache, diarrhea, vomiting and lymphadenopathy. Weight loss, sore throat, rash and oral ulcers are also common. Women also experience HIV-associated gynecologic problems, many of which occur in uninfected women but with less frequency or severity. Vaginal yeast infections, common and easily treated in most women, often are particularly persistent and difficult to treat in HIV-infected women. Other vaginal infections may occur more frequently and with greater severity in HIV-infected women, including bacterial vaginosis and common STIs such as gonorrhea, chlamydia, and trichomoniasis. Severe herpes simplex virus ulcerations, which are sometimes unresponsive to therapy with the standard drug acyclovir, can severely compromise a woman’s quality of life. Idiopathic genital ulcers, with no evidence of an infectious organism or cancerous cells in the lesion, are a unique manifestation of HIV infection. HPV infections, which cause genital warts and can lead to cervical cancer, occur more frequently in HIV-infected women. A precancerous condition associated with HPV, called cervical dysplasia, is also more common and more severe in HIV-infected women and more apt to recur after treatment. PID appears to be more common and more aggressive in HIV-infected women than in uninfected women. Menstrual irregularities frequently are reported by HIV-infected women too. Women whose HIV infections are detected early and receive appropriate treatment survive as long as HIV-infected men. Although several studies have shown HIV-infected women to have shorter survival times than men, this may be because women are less likely than men to be diagnosed early. In an analysis of several studies involving more than 4,500 people with HIV infection, women were 33 percent more likely than men to die within the study period. The investigators could not definitively identify the reasons for excess mortality among women in this study, but they speculated that poorer access to or use of health care resources among HIV-infected women as compared to men, domestic violence, homelessness, and lack of social supports may have been important factors. |
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