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Following Assignment Will Aim To Address And Relevant Issues

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Question:

Assignment Will Aim To Address And Discuss Relevant Issues?

 

Answer:

Introduction

The following assignment will aim to address and discuss relevant issues pertaining to the impact of two public health interventions or programs that have been utilized to mitigate the public health concern related to the outbreak and spread of HIV/AIDS amongst the people who inject drugs (PWID) in Australia. Discussions will be carried out with respect to the definite public health programs that were applied in the health scenario of the defined region for ameliorating the spread of HIV/AIDS in the concerned population. Lessons learnt from the interventions that hold the potential to inform future public health actions and steering positive outcomes will be addressed as well. Critical analysis of the interventions with mention about the strengths and limitations will be done to provide succinct overview on the topic. A comprehensive synopsis of the measurable impact of the interventions will be provided alongside detailed description of the intervention or program. Prior to the detailed analysis and description of the interventions, the pertinent issue, the population and population group in addition to the identified risks and determinants of health will be incorporated to offer an insight on the interventions. The public health interventions comprising of the Needle and Syringe Program and the Condom Social Marketing Program will be explained in course of the assignment.

Brief Overview

People who inject drugs (PWID) have been found to possess greater propensity of being infected by HIV/AIDS in contrast to their general counterparts who do not engage in such activities. However, a contradictory observation in this respect suggests that because of the stigmatization and criminalization of the actions presented by the PWID they are more likely to be deprived of the basic access to healthcare services, subsequent treatments and preventive measures related to the HIV. The presence of societal stigma and preconceived notion about them are largely responsible for making it more vulnerable for them to encounter discriminating and health inequity while suffering from AIDS like condition. The reaching out to the population is another challenging task for the healthcare workers and other associated team members that further aggravates the situation making it more difficult to intervene. Thus, pertinent information and succinct knowledge related to the multifaceted and various health factors as well as health behaviors that account for the spreading of HIV among the PWID population is desirable (Mathers et al., 2013). The most prominent factors that paved the way for resulting in the spread and outbreak of HIV among the PWID population encompass several crucial issues. The health related risk factors identified that are intimately associated with the harboring of AIDs like condition in PWID include, sharing of needles, sex work practice. Other factors that are indirectly related as potential agents for culminating in the emanation of AIDS like symptom refer to the marginalization and criminalization under the jurisdiction of law, unemployment and poor socio-economic background in conjunction with threats of imprisonment and detention. PWID encompass individuals belonging to diverse backgrounds and genders including women, transgender women, sex workers, Aboriginal and Torres Strait Islander people. The faulty healthcare practices as well as the apprehensions of the PWIDS are the major identified reasons that are responsible for the inability of holistically addressing the HIV/AIDS issue among the concerned population. Ignorance about the correct health procedure, dearth of knowledge on matter concerning the pathogenesis and possible routes of transmission of HIV are some of the vital reasons that have lead to the onset of the diseased symptoms. However amongst the identified factors, the issue of sharing needles is considered particularly threatening as the vulnerable groups are more likely to resort to sharing the needles due to inability and regulatory restrictions of buying syringes for some other purposes other than the medical ones (Rowe & Berger, 2015). Thus, the need to invest in taking initiatives that will effectively mitigate the issue is required to offer best possible resolution for combating the ill effects and adverse outcomes due to such possibilities and confounding factors are necessary. Holistic interventions are required in this respect to cope up with the ensuing condition. Two of the implemented methods that accounted for combating the condition prevalent because of HIV/AIDS encompassing Needle and Syringe Program in addition to Condom Social Marketing Program amongst the PWID in Australian context will be discussed for understanding their potential benefits and efficacy in terms of tackling the thwarting situation.

 

Identified intervention programs

  1. Needle and Syringe Program (NSP)
  2. Condom Social Marketing Program (CSMP)

Critical analysis of the intervention

  1. The NSP introduction in the Australian scenario has been found to generate mostly positive outcomes whereby the PWID have been largely benefited from such interventions. The community based outreach intervention in the form of NSP has lead to producing utilities that further helped to improve the condition of the PWIDs. The risk reduction services have been particularly fruitful in terms of rendering holistic education and recommending strategies that might curb the rates of HIV incidences allaying the risky behavior in the vulnerable population. Those individuals who are more predisposed to be infected by HIV and acquire AIDS have been carefully included in the program regime so that adequate measures may be employed in tackling their condition. Prompt and adequate impetus was sent for taking forward the AIDS prevention remedies among the population at large following the introduction of NSP. The discrimination and marginalization of the PWID was reduced drastically that further strengthened the decision making and policy implementation procedure for the concerned authorities. As part of the comprehensive HIV prevention strategy, the NSP initiative was particularly important as it paved the way for further scaling up and sustenance of the HIV prevention outreach. However, the limitation of the program may be identified to be the need for constant strengthening and advocacy to account for the correct implementation of the program thereby leading to fulfillment of the desired objectives. Repeated evaluation and constant monitoring is essential to procure the necessary benefits from observing the NSP strategy (Needle et al., 2005).
  2. The era of the biomedical advancements has witnessed crucial changes in the political and social contexts as well. The importance of working with the socially vulnerable groups have been emphasized in the programs who are essentially designated as the key populations have been further stressed upon for eliciting positive outcomes. Community participation  and imparting of holistic education has been greatly linked to harboring good results. The threats posed in HIV prevalence has been seen with respect to lack of condom use. Hence, it is considered as an essential step to introduce the use of condoms as part of the safe sex strategy to abate the possibility of contracting HIV and other blood borne viral disease. However amidst all the advantages of using condoms, there still remain doubts in the minds of many regarding the use of condoms as a means of rendering effective protection against HIV/AIDS (Paiva et al., 2015).

Measurable impact of interventions

  1. The impact of the timely intervention of the Needle and Syringe Program in Australia has been largely studied in researches. The rates of prevalence among the PWID following such intervention has been investigated in order to determine the possible correlation among the associated factors over the certain timeframe. Data relevant to 15 years of surveillance carried out with respect to people who inject drugs suggested that HIV prevalence among the NSP attendees remained low and relatively stable thereby suggestive of the efficacy of such interventions in the greater perspective. Further for eliciting drug policy, NSP may be considered as a novel and recommendable approach of HIV surveillance among the PWID in settings where such programs are commonly reckoned as integral constituent of public health approach. Evidence based suggestions in the global scenario as well is suggestive of the fact that NSP is effective in mitigating the HIV prevalence among the PWID and timely and widespread introduction of the program might help in tackling with the global epidemic and health burden due to HIV/AIDS (Topp et al., 2011).
  2.  A study conducted to evaluate the efficacy of the projected HIV preventive strategies among the PWID have also suggested the additional benefits obtained from using condoms in the vulnerable group. Significant reductions in the rates of HIV/AIDS highlighted the importance engaging in such behaviors where the chances of transmission of the virus gets drastically reduced because of the safe sex practice that limit the transfer of infection. The PWIDS apart from using the sterilized needles are likely to derive the optimal bebefits from using such devices as a means of protection and prevention from the sexually transmitted disease (Abdul-Quader et al., 2013).
 

Description of intervention program

  1. The Needle and Syringe Program conducted in the Australian context aimed to provide increased support for rendering the appropriate and feasible counseling, education and referral services to the vulnerable population by virtue of community based interventions to curtail the rates of HIV prevalence and incidences. The widely accepted and acknowledged policies and programs that fall under the Australia’s harm minimization strategy forms the foundation of the National Drug Strategy. In this connection a wide range of integrated approaches are found to be integral in maintaining a balance and synergy between the demand reduction, supply mitigation and harm abatement. The early and vigorous HIV prevention mechanisms that were pursued in Australia targeted for the injecting drug users resulted for exhibiting the low and stable rates of prevalence of HIV among the concerned vulnerable groups. The primary agendas of such interventions addressed on enhancing the access to treatment and support, improving and increasing the reach of both education and prevention initiatives along with improvement of the current HIV and hepatitis C surveillance system. Thus, the PWID are likely to be benefited by such initiatives through inclusion of them into the main program for the sake of reducing the rates of spread of infection (health.gov.au, 2017).
  2. The Condom Social Marketing Program (CSMP) has been strategized in the Australian context to mitigate the HIV/AIDS issue from spreading due to improper transmission and infective routes among the PWID. The application of the commercial marketing techniques to achieve a social goal is commonly referred to as the social marketing program. The program aimed to make condoms more affordable and accessible. Simultaneously the said program highlighted on spreading the use of condoms among the target population for increasing the acceptance of condoms among the vulnerable population. Specific condom brand is developed and marketed with a promotional campaign to sell the product to the target audience. Availability and use pertaining to the use of condoms are thereby increased by means of employing such program. The behavioral, psychological and biological outcomes related to HIV prevention are likely to be impacted by the condom application. Since its first introduction among the gay communities, the condom use has received much attention for safe sex advocacy. Similar and effective responses have also been received from the PWID community thereby suggestive of its efficacy in controlling the HIV prevalence (Aggleton & Kippax, 2014).
 

Lessons learned

  1. The NSP program and its efficacy is not only limited to the prevention of HIV/AIDS, but the uses may be further expanded to other blood borne viral diseases that are generally transmitted through sharing of injecting equipment. Thus, associated benefits from following this program may be obtained by means of reducing other harms related to the injected drug use. The recommendations from NSP may be extrapolated to other health conditions by means of providing advice on safer injecting practices, providing suggestion on reducing he harm provoked by drugs thereby accounting for procedure for avoidance and management of drug overdose. Moreover, knowledge and adequate training is provided with respect to the safe handling and disposal of the injecting equipment. Encouragement is given to resorting to safer drug taking practices thereby curbing the possibility of addiction in addition to fostering of other health and welfare services such as that of using condoms as part of safe sex practice (Wilson et al., 2014).
  2. The CSMP has been found to be quite effective in terms of rendering complete protection against HIV/AIDS. It further accounted for making the future HIV interventions that are essentially comprehensive and integrative. The intervention groups comprising of the men and women are likely to be benefited b such interventions. Focus is laid not only to regulate the individual behavior but also the societal norms that often pose hindrances o effective implementation of  the intervention programs (MacArthur et al., 2014).
 

Conclusion

The growing volumes of evidences with respect to the interventions undertaken for handling the public health concerns associated with the transmission and prevalence of HIV/AIDS among the people who inject drugs in Australia revealed the efficacy of prudent and pragmatic approaches to safeguard the health of the concerned population. Adequate attention being conferred on the harm reduction because of the presence of HIV/AIDS has been found to harbor optimum outcomes. Significant and situation appropriate measures adopted by the relevant organization with sufficient support and cooperation from the government has lead to the generation of adequate awareness and responsiveness among the vulnerable individuals thereby paving the way for a better tomorrow. The chances of being infected by the HIV pathogens have been drastically reduced as consequence of the relevant interventions (Madden & Wodak, 2014). Further empirical findings have brought to the forefront, the positive outcomes of the interventions that demonstrated an extremely low and sustained rate of HIV incidence over the past two decades with the timeframe of 1995-2012, among the PWID. The reason for such holistic outcomes may be attributed to measures following the early establishment and up-gradation of the needle and syringe program with subsequent contribution from other interventions such as that of Condom Social Marketing Program (Iversen et al., 2014). Hence, it may be well commented that abidance with these potential intervention programs are highly successful and effective strategies to deal with the public health issue as observed in case of HIV/AIDS among the concerned population.

 

References

Abdul-Quader, A. S., Feelemyer, J., Modi, S., Stein, E. S., Briceno, A., Semaan, S., ... & Des Jarlais, D. C. (2013). Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject drugs: a systematic review. AIDS and Behavior, 17(9), 2878-2892.

Aggleton, P., & Kippax, S. (2014). Australia's HIV-Prevention Response: Introduction to the Special Issue. AIDS Education and Prevention, 26(3), 187-190.

Health.gov.au. (2017). Retrieved 22 May 2017, from https://www.health.gov.au/internet/main/publishing.nsf/content/83AAED699516CE2DCA257BF0001E7255/$File/evid.pdf

Iversen, J., Wand, H., Topp, L., Kaldor, J. and Maher, L., 2014. Extremely low and sustained HIV incidence among people who inject drugs in a setting of harm reduction. AIDS, 28(2), pp.275-278.

MacArthur, G. J., van Velzen, E., Palmateer, N., Kimber, J., Pharris, A., Hope, V., ... & Rhodes, T. (2014). Interventions to prevent HIV and hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness. International Journal of Drug Policy, 25(1), 34-52.

Madden, A., & Wodak, A. (2014). Australia's response to HIV among people who inject drugs. AIDS Education and Prevention, 26(3), 234-244.

Mathers, B. M., Degenhardt, L., Bucello, C., Lemon, J., Wiessing, L., & Hickman, M. (2013). Mortality among people who inject drugs: a systematic review and meta-analysis. Bulletin of the World Health Organization, 91(2), 102-123.

Needle, R. H., Burrows, D., Friedman, S. R., Dorabjee, J., Touzé, G., Badrieva, L., ... & Latkin, C. (2005). Effectiveness of community-based outreach in preventing HIV/AIDS among injecting drug users. International Journal of Drug Policy, 16, 45-57.

Paiva, V., Ferguson, L., Aggleton, P., Mane, P., Kelly-Hanku, A., Giang, L. M., ... & Parker, R. (2015). The current state of play of research on the social, political and legal dimensions of HIV. Cadernos de saude publica, 31(3), 477-486.

Rowe, R., & Berger, I. (2015). Patterns of performance and image enhancing drug use among men accessing needle and syringe programs in Sydney, Australia. Drug & Alcohol Dependence, 156, e194.'

Topp, L., Day, C. A., Iversen, J., Wand, H., Maher, L., & Collaboration of Australian NSPs. (2011). Fifteen years of HIV surveillance among people who inject drugs: the Australian Needle and Syringe Program Survey 1995–2009. Aids, 25(6), 835-842.

Wilson, H., Brener, L., Mao, L., & Treloar, C. (2014). Perceived discrimination and injecting risk among people who inject drugs attending Needle and Syringe Programmes in Sydney, Australia. Drug and alcohol dependence, 144, 274-278.

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