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PHHE 669 Midterm

Jackson County HIV Rates

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PHHE 669 Midterm

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  1. Increasing HIV rates in Jackson County, Illinois Sarah Kaitlin Jordan PHHE 669 Northern Illinois University

  2. Jackson County Demographics (2014) (United States Census Bureau, 2014)

  3. Problem Description: HIV HIV (Human Immunodeficiency Virus) is a virus that is transmitted through bodily fluids such as blood, vaginal and rectal secretions, and breast milk. Once transmitted, the virus attacks the body’s immune system, making it difficult for the body to fight off infections and disease. Once the body can no longer fight off infection and disease, the virus develops into AIDS (Acquired Immunodeficiency Syndrome)(Centers for Disease Control and Prevention,2015). Causes: Unprotected sex, Sharing needles, and Stages of pregnancy Including birth and breastfeeding (Centers for Disease Control and Prevention, 2015). Consequences: Opportunistic infections, Death (Centers for Disease Control and Prevention, 2015).

  4. Significance of HIV National Scope & Public Health Significance • People living with HIV in the U.S. (2012): 1.2 million people • New HIV cases in the U.S. (2010): 45,000 cases annually • Percentage of people unaware of their HIV status: 12.8% (Centers for Disease Control and Prevention, 2015). Economic Costs • Lifetime HIV treatment cost (2010): $379,668 (Centers for Disease Control and Prevention, 2013). Quality of Life (QOL) • Antiretroviral Therapy (ART) has extended the average life span for those living with HIV. • Social problems such as stigma, poverty, depression, substance abuse, and cultural beliefs can negatively affect HIV patients QOL (Basavaraj, Navya, & Rashmi, 2010).

  5. Subgroups at Risk The following chart developed by the CDC illustrates that MSM (men who have sex with men) and African Americans are the most at risk for contracting HIV. (Centers for Disease Control and Prevention, 2015)

  6. Epidemiological Studies • Distribution Study: Estimated HIV Incidence in the United States, 2006–2009 • Largest HIV incidence increase among persons aged 13-29 years (Prejean J, Song R, Hernandez A, Ziebell R, Green T, et al., 2011). • Among persons aged 13-29 years, MSM (men who have sex with men) had highest increase in incidence of HIV rates, specifically African American MSM (Prejean J, Song R, Hernandez A, Ziebell R, Green T, et al., 2011). • Protective Factors Study: Value of Consistent Condom Use: A Study of Sexually Transmitted Disease Prevention Among African American Adolescent Females • Outlines importance of correct and consistent use of condoms. • Among adolescents reporting 100% condom use, 17.8% were still diagnosed with STDs or HIV (Crosby R, DiClemente R, Wingood G, Lang D, & Harrington K, 2003) • Researchers believe condoms were used incorrectly or inconsistently • Impact Study: Impact of Psychiatric Conditions on Health-Related Quality of Life in Persons With HIV Infection • Individuals with HIV in this study were more likely to report comorbid psychiatric conditions than individuals without HIV (Sherbourne C, Hays R, Fleishman J, Vitiello B, Magruder K, Bing E, et al., 2000). • Psychiatric conditions and behaviors included depression, anxiety, and substance abuse (Sherbourne C, Hays R, Fleishman J, Vitiello B, Magruder K, Bing E, et al., 2000).

  7. Distributions, Trends, and Impacts • Increase in HIV cases since 2010: September 2010: 2 new cases September 2011: 3 new cases September 2012: 4 new cases September 2013: 7 new cases (Illinois Department of Public Health, 2013). • No data available for new cases of HIV 2014-2016. • Article posted on the Jackson County Health Department Website from The Southern Illinoisan describes an increase in HIV rates in the 19 counties that make up southern Illinois (Duncan, 2014).

  8. Existing Resources • Jackson County Health Department • Southern Illinois HIV Care Connect

  9. Target Population • More than half of the cases are people age 24 and younger that graduated from local high schools (Duncan, 2014). • Program will target young adults, age 24 and younger, that live in and around Jackson County, Illinois. • Program will target about 20% of the population (persons under the age of 18 make up 18% of the population). (United State Census Bureau, 2014)

  10. Program Needs • Normative: Determine number of new HIV cases per 100 people from 2014-2016 and aim to align amount of new cases with HealthyPeople2020 goal of 3.5 new HIV cases per 100 people (Office of Disease Prevention and Health Promotion, 2014). • Perceived: Increase in HIV testing/education privacy & confidentiality and decrease awkward feelings regarding discussing sexual matters and HIV (Centers for Disease Control and Prevention, 2011). • Relative: More information is necessary to compare services/resources available in Jackson County with neighboring Perry, Union, and Franklin counties. • Expressed: More information is necessary to determine how many people have sought help/services. Contacting Paula Clark, the division director at the Jackson County Health Department, may be beneficial for finding such information. Considering the social stigma, there are most likely individuals that need help but have not sought services (Duncan, 2014).

  11. Theories & Models Stages of Change Model (Transtheoretical Model) • This model states that behavior change occurs in the following six stages: 1) Pre-contemplation 2) Contemplation 3) Preparation 4) Action 5) Maintenance 6) Termination • Many individuals diagnosed with HIV fall into the first two stages because they are either not aware of the risks of their sexual behavior or they are aware of the risks of their sexual behavior, but they are not committed to changing their sexual behavior (National Cancer Institute, 2005).

  12. Theories & Models • Health Belief Model – health behaviors depend on perceived susceptibility, perceived severity, perceived benefits of performing a behavior, and perceived barrier of performing the behavior. • Communicate to at risk population (adults 24 and younger) that they are susceptible to contracting HIV, a disease without a cure. By practicing safe sex (performing the behavior), they are protecting themselves from contracting the virus. (National Cancer Institute, 2005) • Diffusion of Innovation Model – looks at how new ideas are communicated to and accepted by a population. • Utilize HIV + members of the community such as Mr. Wyatt (Duncan, 2014). (National Cancer Institute, 2005)

  13. Priorities & Hypothesis • Ensure comprehensive sex education classes are being offered in Jackson County Public Schools; replace existing abstinence-based sex education classes with comprehensive sex education classes. • Update the Jackson County Health Department website to include easily accessible information & reflect open views regarding HIV. • Inform Jackson County residents that HIV testing & counseling are confidential. Program Hypothesis: If comprehensive sex education is offered in schools and the Jackson County Health Department openly discusses HIV, adults age 24 and younger will feel more comfortable discussing and practicing safe sex.

  14. Goals • To increase discussion of sexuality and safe-sex among at-risk adolescents in Jackson County. • To decrease the incidence of HIV in recent Jackson County high school graduates.

  15. Outcome Objectives • Decrease feelings of anxiety & discomfort related to discussing sex among Jackson County high school students by 50% during the first year of the program. • Increase HIV testing among adolescents 15-24 years old living in and around Jackson County by 25%. • Increase condom use among Jackson County high schools students and recent graduates by 25%.

  16. Process Objectives • By September 1, 2016, 3 HIV+ individuals will be recruited to speak to high school students in Jackson County about their HIV status & safe sex. • By May 31, 2017, all Jackson County schools will be teaching comprehensive sex education classes quarterly. • By December 31, 2016, a press release will be sent to the local news station discussing the increase in HIV rates among young adults with information regarding testing locations. • By December 31, 2016, the homepage of the Jackson County Health Department will be updated to reflect information regarding testing locations and free condom locations throughout the county.

  17. References • Basavaraj, K. H., Navya, M. A., & Rashmi, R. (2010). Quality of life in hiv/aids. Indian Journal of Sexually Transmitted Diseases, 31(2), 75–80. http://doi.org/10.4103/0253-7184.74971 • Centers for Disease Control and Prevention. (2015). About hiv. Retrieved fromhttp://www.cdc.gov/hiv/basics/whatishiv.html • Centers for Disease Control and Prevention.(2015). Basic statistics. Retrieved from http://www.cdc.gov/hiv/basics/statistics.html • Centers for Disease Control and Prevention. (2013). Hiv cost-effectiveness. Retrieved from http://www.cdc.gov/hiv/prevention/ongoing/costeffectiveness/ • Centers for Disease Control and Prevention. (2011). Jackson county health department. Retrieved from https://npin.cdc.gov/featured-partner/jackson-county-health-department • Duncan, D. (2014). HIV case are on the rise in Southern Illinois, The Southern Illinoisan. Retrieved from http://www.jchdonline.org/jdownloads/HIV/hivcasesareontheriseinsouthernillinois.pdf

  18. References Cont. • Illinois Department of Public Health. (2013). HIV/AIDS statistics [Data File]. Available from http://www.idph.state.il.us/aids/stats.htm • Jackson County Health Department. (2015). HIV/AIDS. Retrieved fromhttp://www.jchdonline.org/index.php/66-hiv-services/hiv-services/145-hiv-aids • National Cancer Institute. (2005). Theory at a glance: a guide for health promotion practice. Retrieved from https://webcourses.niu.edu/bbcswebdav/pid-4132978-dt-content-rid-27191076_2/courses/20162-PHHE-669----P1/Theory%20at%20a%20Glance%281%29.pdf • Office of Disease Prevention and Health Promotion. (2014). Healthy People 2020 Goals [Data File]. Available from https://www.healthypeople.gov/2020/topics-objectives/topic/hiv/objectives • PrejeanJ, Song R, Hernandez A, Ziebell R, Green T, et al. (2011). Estimated HIV Incidence in the United States, 2006–2009. PLoS ONE 6(8): e17502. doi: 10.1371/journal.pone.0017502 • Richard A. Crosby, Ralph J. DiClemente, Gina M. Wingood, Delia Lang, and Kathy F. Harrington.  Value of Consistent Condom Use: A Study of Sexually Transmitted Disease Prevention Among African American Adolescent Females. American Journal of Public Health: June 2003, Vol. 93, No. 6, pp. 901-902.doi: 10.2105/AJPH.93.6.901

  19. References Cont. • Sherbourne C. D., Hays R. D., Fleishman J. A., Vitiello B., Magruder K. M., Bing E. G., et al. . (2000). Impact of psychiatric conditions on health-related quality of life in persons with HIV infection. Am. J. Psychiatry 157, 248–254. 10.1176/appi.ajp.157.2.248 • United State Census Bureau. (2014). QuickFacts – Jackson County, Illinois [Data file]. Retrieved from http://quickfacts.census.gov/qfd/states/17/17077.html

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