Abstract

In the current world, sexually related behavior and reproductive health of young people typically determine the society’s future. Additionally, HIV which is associated with sexual acts among others still affects over 18000 people Baltimore and the most affected group of people is MSM. Given the condition in the region, an additional HIV prevention program is necessary; therefore, a program was developed to address the issue. MAP-IT is the program plan framework for this program. The primary activities of the program include educational and training events, and behavior modification activities. The target population which is majorly adolescents and young adults form the involved stakeholders among institutions such as the Maryland Health Care Commission, healthcare facilities in Baltimore, community health service providers and other educators. This paper provides an overview of HIV and its prevention in Maryland. It provides demographic and epidemiologic data regarding risk factors, mortality rates and disparities that provide evidence on the frequency of incidence and prevalence of the issue.

Additionally, it provides a social justice rational justification of the HIV prevention programs Maryland has embraced. The goal of the plan is to prevent new cases of HIV in Baltimore, Maryland. To achieve the goal the following three objectives are met: 1. Reduce the number of new HIV infections among adolescents and young adults between the age of 15 and 29 by 40% by December 2020.

2. Increase the percentage of individuals living with HIV and are aware of their status by 50% by December 2020. 3. Increase the rate of sexually active individuals who use condoms by 75% by December 2020.

Goal and Objectives

HIV is a worldwide pandemic that has claimed many lives over the years. There has been significant progress in the prevention and management of the disease; however, this is not to mean that there are no new infections. Thus it is essential to focus on the prevention and particularly to the one of the most vulnerable group of people which is the youth. Engaging in sexual relationships is widespread among young people and old alike; however, the possibility of young individuals contracting HIV is significantly higher because they also participate in other activities which increase their risk of contracting the disease. Engaging in drug and alcohol abuse may lead one to make an uninformed decision which places them at a higher risk of getting HIV. Hence, HIV prevention is necessary for the progress and future of a nation.

The goal of the HIV prevention program in Baltimore, Maryland is to prevent new cases of HIV in Baltimore, Maryland. Therefore, to meet the stated purpose, the program will address the following objectives:  1. Reduce the number of new HIV contaminations amongst young adults and adolescents between the age of 15 and 29 by 40% by December 2020. This can be achieved through campaigning for people to get tested to know their HIV status. Moreover, individuals should be advised to engage in less risky sex. Lastly, the individual should be notified of the importance of using condoms during sexual intercourse. 2. Increase the percentage of individuals living with HIV and are aware of their status by 50% by December 2020. This can be done by educating more people and advising them to get tested. 3. Increase the percentage of sexually active individuals who use condoms by 75% by December 2020. This can be achieved by availing condoms in familiar places such as dispensaries and hospitals and reducing condom costs. Furthermore, education on the importance of using condoms should be spread to ensure that most people are aware of the benefits of using condoms during sexual intercourse.

Challenges that face HIV prevention include lack of rigorous evaluations and lack of prevention and care coverage. Lack of coverage and prevention methods can be improved by easing access to facilities and prevention services such as condoms, AIDS education, and voluntary testing and counseling. Lack of rigorous evaluation can be enhanced by increasing research on the field of HIV and AIDS to reliably evaluate the virus and seek ways of stopping the disease or preventing.

HIV Prevention in Baltimore, Maryland

The HIV prevention program will employ the MAP-IT framework to guide the planning and evaluation of the program in the described community. The health department of Baltimore is one of the key stakeholders to be mobilized by the program. People living with HIV aids in the community are also needed as well as other people who are not infected. Certain risk factors increase the rate of HIV infection in Baltimore. People falling within the risky categories will also need to be mobilized since they are fundamental in preventing the spread of the disease.

The HIV pandemic is a persistent menace in Baltimore with the city among the leading metropolitan regions with high levels of HIV contaminations. The rate of HIV infections is particularly high amongst Men Who Have Sex with Men MSM, and at the same time, viral suppression within this group of people is deficient (Schwartz et al., 2017). Therefore, the risk of infection increases given that viral suppression is significantly inadequate. Ensuring that the MSM population is directly involved in the program will enable the program to make significant strides in promoting HIV prevention.

A demographic factor which informs about HIV Prevalence rate in Baltimore is a race. African-Americans continue to be disproportionately impacted by HIV infections. They, however, form the largest population in Baltimore so it is statistically expected that a higher percentage of people living in the city will be African-Americans. Nevertheless, despite the high prevalence rate of HIV among people in this group, the number of new infections is slightly decreasing while that of Hispanic and white is steadily rising. As such, when mobilizing relevant groups, it is essential to include African Americans as they are the most affected population.

The age group between the age of 15 and 29 is particularly needy because the rise in HIV infection is observed to be highest within this age bracket with 33% of new diagnoses in Baltimore belonging to this age group (Buchbinder, & Liu, 2018). Hence, there is a need to consider young people of this age when implementing the program.

To achieve the three objectives, many activities which are aligned with the goals will be implemented. The first objective seeks to reduce HIV infection among adolescents and young adults. The activities are leading to achieving this goal deal with behavior modification. Young adults and teenagers often engage in sexual intercourse with many partners, and they usually do not use condoms, which explain the high rate of infection within this age group (Wong et al., 2017). Other than irresponsible sexual activity, adolescents and young adults engage in other behaviors which increase the risk factors for HIV infection. Having sex for drugs, drug injection and males having sex with males are among the actions leading to increased infections.

By concentrating on the views and outlooks of a person, the health belief model can predict the health behavior of an individual. As such, the model guides the activities that will lead young adults and adolescents towards achieving the first objective. Therefore, to meet the primary goal through a behavioral model, the involved population must demonstrate self-efficacy and cues that they are capable of performing the health actions that allow them to avoid an adverse health condition. The key stakeholders involved are educators, community health service providers, young adults, and adolescents. Health education programs focusing on behavior change is a significant activity that can help achieve the objective. Education should emphasize the proper use of condoms and the benefits of using them.

Teaching about abstinence is another essential aspect of the activity as it is one of the surest ways of preventing sexual transmission of disease. In the US, 25% percent of HIV positive people contracted the infection in their teenage years (Wang et al., 2015). Thus, promoting the concept of abstinence is crucial as it zeros out the possibility of getting HIV through sexual intercourse. The health education program will be implemented through community training centers where the participants get to interact and share their perspectives towards sexual behavioral change. They will also identify behaviors that are difficult to let go and receive advice on how to get rid of unhealthy sexual behaviors.

The second objective directs that the number of people who get tested for HIV needs to increase so that the proportion of positive people who know their status may increase by 2020. One of the activities that lead to the accomplishment of the objective is an increase in the number of testing and HIV awareness programs. Additionally, making HIV testing part of a healthcare routine will see that many people get tested.

The Health Belief Model (HBM) is a psychological ideal which attempts to forecast and elucidate health behaviors. This is achieved by centering on attitudes and beliefs of people. The model is founded on the understanding that a person will take a health-linked action if an individual feels that HIV can be avoided (Tarkang, & Zotor, 2015). An individual can also use the model if an individual has expectations that by taking a recommended action, they can avoid HIV. Moreover, the model says that an individual can take action if they believe they can successfully take recommended health actions such as using condoms with confidence and comfortably.

Health organizations working in Baltimore will immensely contribute to the success of the program as it covers a wide geographical area. The Maryland Health Care Commission is one of the major organizations to be involved in the program. It is mandated with the duty of collecting, reporting and releasing health data; therefore, it is vital for providing statistics about the present state of HIV in Baltimore. Collaboration with healthcare facilities within Baltimore is also essential as HIV testing treatment, and the record of new infections is often done in healthcare facilities. The project will, therefore, be useful because of the many support from stakeholders including organizations which will be involved in the plan. Additionally, the selected interventions are likely to yield good results which meet the goal of the program.

The development of every objective will be tracked to ensure that all the activities aimed at achieving the goal of the HIV prevention program. Evaluation of every activity specific to each objective will inform if the project is headed in the right direction. The first objective is primarily attained through educational methods, an assessment of the teaching strategies and their effectiveness will inform if they have an impact on the intended population. Based on the fact that the activity is a continuous process, the objective will be considered to be achieved when HIV infections among young adults and adolescents are reduced by at least 40%.

An assessment of the second objective will be done by evaluating the number of HIV testing programs and the number of people who have tested. An increment of 50 percent in those who know their HIV status and are also positive will be estimated by identifying an increase in the number of those who have been tested. If the value is statistically significant than the previous number of people tested then, the second objective is considered attained. Objective number three is achieved by increasing the number of people using condoms 75%; at this rate many sexually active adults will be using protection which is crucial in preventing the spread of HIV.

Conclusion

HIV prevention is a significant activity which is achievable through different strategies. Among the objectives identified for preventing HIV infection is reducing the number of young adults and adolescents who contract the disease since they are among the groups of people at high risk. Increasing the number of HIV positive people who know their status is also essential in preventing HIV. By knowing one’s condition, a positive person can prevent the spread of the disease and also inform their partner and protect them from infection. HIV prevention program also works by increasing the number of sexually active people who use condoms. The achievement of these objectives is done through various activities which are distinct for each purpose. Educational programs which enlighten the public about HIV prevention measures are among the activities which promote the goal of the program. Collaborating with other departments and health care facilities also drive the success of the program because the geographical scope requires the involvement of many different parties.

References

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Tarkang, E. E., & Zotor, F. B. (2015). Application of the Health Belief Model (HBM) in HIV prevention: a literature review. Central Afr J Public Health, 1(1), 1-8. Wang, H., Wolock, T. M., Carter, A., Nguyen, G., Kyu, H. H., Gakidou, E., …& Coates, M. M. (2016). Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. The Lancet HIV, 3(8), e361-e387.

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