- Problem Description and Pilot Program
- Technology Solution
LGBT community constitutes the most easily identifiable and, perhaps, the most obvious position of the risk group for HIV diagnosis. Both in the United States and worldwide, HIV remains to be a serious public health concern. Despite the fact that huge scientific advancements have made it simpler than ever to prevent and treat HIV, there is still no vaccine or cure, and tens of thousands of individuals get HIV each year (Sriningsih et al., 2020). A combinatory program is required to reduce the rates of HIV transmission, improve the prevention techniques against the virus and ensure the early-stage diagnosis procedures are as effective as possible. With this goal in mind, a pilot program was designed on the basis of behavioral and biomedical prevention mechanisms. These mechanisms, the target population and the technological element of said program, namely the use of telemedicine, are discussed in this paper.
Problem Description and Pilot Program
Although the height of the HIV epidemic has passed, the issue remains acutely relevant and dangerous, among the LGBT community in particular. The widespread problem has both medicinal and social roots, with the LGBT patients being more likely to experience financial marginalization, leaving them vulnerable to various diseases. Additionally, the element of social stigma continues to remain strong in relation to sexually transmissive diseases, and HIV in particular (Meldine et al., 2017). The aftermath of the AIDS epidemic maintains the sense of social isolation and prejudice attached to those with the virus, despite the healthcare system continuously developing transmission-reducing drugs and vaccines. This paper presents the details of a pilot program that aims to reduce the rates of HIV transmission and introduce more effective preventive measures. The theoretical basis behind the prevention program relies on the concept of combination prevention aided by a technological tool described later in the paper.
Combination prevention argues for a comprehensive approach to HIV prevention that includes the use of multiple behavioral, biological, and structural preventive methods rather than a single intervention (such as condom distribution). Combination prevention programs take into account variables unique to each location, such as infrastructure, local culture and customs, and HIV-infected people. Individuals, communities, and populations can all benefit from them. UNAIDS has advocated for the scaling-up of integrated HIV prevention measures in order to re-energize the global response and have a long-term influence on global HIV incidence rates (Flowers et al., 2017). The combination prevention approach can be defined as rights-based, evidence-informed, and community-owned programs that use a mix of biomedical, behavioral, and structural interventions, prioritized to meet the current HIV prevention needs of specific individuals and communities, with the goal of having the greatest long-term impact on reducing new infections. The pilot program proposed might be divided into behavioral, biomedical and structural elements.
By targeting hazardous behaviors, behavioral treatments aim to lower the risk of HIV transmission. Intensive methods incorporating a variety of activities to target various objectives, such as information, risk perception, norms, skills, sexual behaviors, and HIV care demand, are common in these programs. A behavioral intervention might seek to reduce the number of sexual partners people have, improve HIV treatment adherence, enhance the use of clean needles among injecting drug users, or boost the consistent and proper use of condoms (Flowers et al., 2017). The pilot program proposed, however, should also consider the social bias existing worldwide that exists in favor of unrealistic abstinence promotion. The recommendations made in relation to the change in sexual behavior must therefore be balanced and facts-based to avoid perpetuating the existing stigma, especially among LGBT patients.
To decrease the rate of HIV transmission, biomedical treatments combine clinical and medicinal methods. Biomedical treatments are seldom utilized alone and are frequently used in combination with behavioral interventions to be effective (Flowers et al., 2017). Recent medical innovations, such as Antiretroviral Treatment, included in the pre-exposure prophylaxis initiative aimed at the high-risk groups, such as LGBT patients. Telehealth can factor into this element of the program, combining medicine and technology to maximize the efficiency of treatments.
Finally, structural interventions that aid the reduction of HIV transmission and the prevention of the virus in general often concern large-scale societal changes. For example, the criminalization of same-sex relationships contributes to the transmission of the virus by virtue of marginalization attached to certain forms of sex. This marginalization results in higher risks of STIs due to the lack of appropriate sex education and the stigmatization of the topic in general (Flowers et al., 2017). In a similar manner, countries with the highest rates of sexual assault are notorious for high levels of HIV infections as well, as the former often correlates with increased sexual vulnerability of women.
LGBT people were chosen as the target population for the HIV pilot prevention program due to their general vulnerability in the context of sexual health, as well as the increased social stigma. The program is aimed at the members of the LGBT community aged between 18 and 60. This paper admits the issues of HIV and sexual health among underage individuals but will not include any propositions that involve research among minors due to the complex ethics associated with the subject. The principles of simple random sampling and statistically representative distribution, among other factors of influence within the target group, must be considered when testing the program and choosing the sample. The factors of influence include major variables that affect a person’s vulnerability to HIV and medical history in general, outside of LGBT status, such as race, ethnicity, and class (Santos et al., 2021). The representative distribution of these factors within the sample taken from the target group is required for the successful testing of the pilot program’s efficiency.
The program is estimated to take a total of six months, with the additional month allowing for potential complications along the way. The initial stage planned involves the research and literature review on the topic of combination prevention factors to design telemedical solutions within the behavioral and biomedical approaches. Afterward, the sample is to be recruited among the LGBT patients of different ethnic, racial and economic backgrounds. The telemedical practices must be tested on the research group and the control group for an extended period of time. Although the focus of the program is centered on prevention, Telehealth’s efficiency in case management and self-diagnosis might also be assessed for comparison purposes (Yelverton et al., 2021). The evaluation is then conducted on the basis of whether Telehealth improved the rates of HIV prevention and early diagnosis compared to LGBT people who haven’t used it. A mix of quantitative and qualitative research methods are suggested as the evaluation tool for the success of the project, since quantitative surveys allow for the large-scale coverage while in-depth interviews are more appropriate for culturally sensitive topics.
Telehealth as a tool refers to the remote diagnosis and treatment of patients by the means of telecommunication technology, which can be used in a variety of different medical scenarios. Currently it is recognized as an essential tool in the objective of reducing the number of new HIV infections by 90% by 2030 (“Telehealth for HIV Prevention and Care Services | Treat | Effective Interventions | HIV/AIDS | CDC”, 2021). The use of technology for the aims of the pilot program can be categorized into four groups: Prevent, Diagnose, Treat and Respond.
One of the key benefits telemedicine provides for LGBT patients that wish to get tested for HIV lies in its capacity to provide privacy and protect the identity of a patient. The reluctance of people to receive HIV screening in public locations has been one of the main issues in the matter of preventing the virus and reducing the number of new cases (Santos et al., 2021). However, remote consultations on the subjects of prevention and, if necessary, screening resolve this problem while increasing the levels of patients’ comfort.
Additionally, the most recent post-COVID-19 studies indicate that willingness to engage with technology in the medical sense has increased among all age demographics. Particularly with the use of PrEP and self-testing kits, telemedicine was recognized as effective and satisfactory by the majority of patients surveyed (Smith & Badowski, 2021). Its efficiency for the pilot program is further intensified by the way it is capable of being factored into all three of the factor groups of combination prevention approach (Santos et al., 2021). Behavioral interventions might be provided to patients remotely in the form of private online consultations, absolving them from the embarrassment often associated with public talks on the matter (Dandachi et al., 2020). Biomedically, telemedicine can be used for self-diagnosis, counseling, and risk-reduction appointments. And, finally, the already mentioned privacy of the telemedical treatment may be used to work around existing limitations.
In conclusion, pilot program proposed affects all three of the major areas of HIV prevention and risk reduction. It takes into account the vulnerability and increased social stigma towards LGBT patients, who comparatively would benefit from private telemedical appointments the most (Hillman, 2017). Finally, the use of telemedicine for the program would currently be more effective than ever due to the aftermath effects of COVID-19 and increased acceptance of casual use of technology.
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