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Assessment of Community-Level Barriers
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Institutional Affiliation(s)
Author Note
Assessment of Community-Level Barriers
The African American community is faced with a number of issues concerning the Human Immunodeficiency Virus (HIV). The community lacks adequate education about HIVs symptoms, risks and causes in general while there are little awareness programs available for the community. Nearly half of the community remains undiagnosed of the condition until it reaches its last stage (Edward, 2019). To address some of these issues, a community level program was proposed that would help spread HIV awareness by conducting helpful sessions that target the African American population suffering from HIV. Additionally, the barriers to HIV treatment and interventions to address these barriers are examined alongside noting ethical, regulatory, and accreditation requirements for the program.
Recap of the Model Program
The program will involve People with HIV (PLHIV) to register themselves in support groups in order to obtain critical psychological help. These support groups will involve sharing experiences, enhancing coping skills of patients, encouraging disclosure, improving their psychosocial functioning, reducing stigmatization, and assisting them in medication adherence. The program will particularly target pregnant women, couples, and men who have sex with men (MSM) within the African American community (Bateganya, Amanyeiwe, Roxo, Dong, 2016). The program will further involve conducting fundraising galas on a yearly basis that will collect funds to offer financial help to individuals who cannot afford medication and treatment. HIV tests would be further conducted on a regular basis, working alongside healthcare professionals, and patients would be recommended with appropriate care plans, while setting up telephone assistance helplines to aid HIV patients in case of an emergency (Mcallon, 2018).
Critical Barriers to Wellbeing
A number of barriers impede progress in eliminating the HIV endemic among the African American community. At the micro level, financial barriers serve as a major obstacle since antiretroviral drug therapy remains expensive while patients with immune systems compromised require longer and, thus, costly treatment at hospitals. In addition, private health insurance market is rife with inequalities and discrimination against individuals diagnosed with HIV either by limiting coverage, charging higher premiums, or screening them for pre-existing conditions (Paying for Healthcare, 2019).
Secondly at the macro-level, barriers that reduce access to appropriate care include social and structural factors which impact the African American community at the wider level. A lack of access to adequate prevention and treatment services stems from institutionalized discrimination, lower socio-economic status, a general lack of social support, and HIV-associated stigma. Inequalities in healthcare funding as well as welfare support for families together contribute to these barriers wherein race intersects with gender, sexuality, and poverty to create social exclusion and disadvantage for the community (Geter, Sutton, McCree, 2018).
Another critical barrier in this regard is geography which contributes to HIV-associated disparities among the African-American community. The geographical factor occurs as a result of regional disparities and residential segregation which raises the burden of disease on the marginalized community. In particular dense urban poverty areas with a substantial black population are less likely to receive HIV treatment and prevention services owing to the environmental and geographical stressors of the neighborhood (Meditz, et al., 2011). The remoteness of these neighborhoods from quality screening services and an overall higher community viral load means that an Individual from this location has a higher chance of contracting the disease from the same behavior compared to an individual hailing from a more affluent neighborhood.
Interventions and Solutions to Address Barriers
At the micro-level, public payer programs are necessary to bear the medical costs of the community members suffering from HIV. This involves expanding Medicaid and Medicare coverage to include the affected population without limiting benefits for antiretroviral therapies and other co-morbidity treatment costs. Furthermore, universal health coverage should be encouraged under an Integrated health system that provides HIV treatment, diagnosis, and prevention services at the community level (Robinson Moodie-Mills, 2012). In this regard, supporting the Affordable Care Act is important to ensure adequate access to care and insurance coverage for African Americans suffering from HIV.
To address structural and social barriers at the macro-level, it is important to train physicians in engaging patients from ethnic and racial minorities in an empowering and non-stigmatizing way. Additionally, culturally appropriate care and active follow-ups would reduce social stigmatization and encourage African American individuals to seek treatment and strengthen their engagement with health services. Funding should be directed to expanding research on the intersection of various structural factors that increase risk among the communitys sexual networks and use the research to inform policies (Geter, Sutton, McCree, 2018). Additional funding should be directed to addressing the communitys unmet needs such as employment, housing, or childcare by increasing social and peer support.
Furthermore, housing opportunities for individuals with AIDs should be provided by funding and facilitating stable housing as a preventive step. Any intimidation and discrimination with regards to housing on the basis of ethnicity, gender identity, or sexual orientation should be prohibited alongside providing appropriate investigative power to law enforcement in this regard (Robinson Moodie-Mills, 2012).
Ethical, Accreditation, and Regulatory Requirements
The legal environment, state regulations, and federal policies considerably influence a communitys access to HIV-associated services and programs. In this respect, non-discrimination provisions bar any form of discrimination against marginalized or vulnerable populations in order to encourage individuals to seeks HIV-associated services more openly. These provisions ensure that our program will remain open and accessible to the entire community. In addition, the program involves testing and financing HIV treatments, which would require adhering to confidentiality requirements. Any participants in the program should be notified of their right to confidentiality to comply with federal regulations and gain their trust. Disclosures can only be made in exception to medical personnel in case a particular condition immediately threatens the health of the programs participant (CSAT, 2000).
Since the program encourages African-American community members for screening, it is ethically and legally mandatory to receive informed consent from them or someone authorized to consent on behalf of them. It would involve advising the participant with sufficient information regarding the HIV-related test (NY Gov, 2015). Furthermore, Individuals conducting the HIV tests are ethically responsible to conduct it in adherence with quality management system principles and ensure the highest accuracy and quality. The testing sites should be accredited by an appropriate authority and providers should meet regulatory standards with regards to training and testing SOPs to perform the procedure (WHO, 2015).
Finally, since the program involves fundraising, it is important to accredit it as a community foundation by the NSCF. This would involve submitting assessment documentation to confirm that all requirements are met according to the National Standards, and including the registered charity number, address, and company name in all promotional materials (Gonzalez, 2019). This would, in turn, provide donors with confidence in the programs operations and ensure transparency in the program.
References
Bateganya, M., Amanyeiwe, U., Roxo, U., Dong, M. (2016). The Impact of Support Groups for People Living with HIV on Clinical Outcomes a systematic review of the literature. Journal of acquired immune deficiency syndromes, 680(0-3), S368-S374. doi10.10972FQAI.0000000000000519
CSAT. (2000). Substance Abuse Treatment for Persons with HIV/AIDS. Rockville, MD Center for Substance Abuse Treatment.
Edward, S. (2019). Who Is at Risk for HIV Infection and Which Populations Are Most Affected National Institute on Drug Abuse, 21-34.
Geter, A., Sutton, M. Y., McCree, D. H. (2018). Social and structural determinants of HIV treatment and care among black women living with HIV infection a systematic review 20052016. AIDS Care, 30(4), 409-416. doi10.10802F09540121.2018.1426827
Gonzalez, C. (2019). National standards for u.s. community foundations. Retrieved July 3, 2019, from Council on Foundations https//www.cof.org/national-standards-us-community-foundations
Mcallon, J. (2018). HIV Programs Services. Regional HIV/AIDS Connection, 190-198.
Meditz, A., MaWhinney, S., Allshouse, A., Feser, W., Markowitz, M., Little, S., . . . Collier, A. (2011). Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection. The Journal of infectious diseases, 203(4), 442-451.
NY Gov. (2015). HIV Related Testing. Retrieved July 4, 2019, from New York Department of Health https//www.health.ny.gov/diseases/aids/providers/regulations/testing/section_2781.htm
Paying for Healthcare. (2019). In Chapter 5.1. Ashford.
Robinson, R., Moodie-Mills, A. C. (2012). HIV/AIDS Inequality Structural Barriers to Prevention, Treatment, and Care in Communities of Color. Berkeley, CA Center for American Progress.
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