Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and
nursing research to a communicable disease. Refer to “Communicable Disease Chain,”
“Chain of Infection,” and the CDC website for assistance when completing this assignment.
Communicable Disease Selection
Hepatitis B

Epidemiology Paper Requirements
Describe the chosen communicable disease, including causes, symptoms, mode of
transmission, complications, treatment, and the demographic of interest (mortality,
morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details
about reporting time, whom to report to, etc.
Describe the social determinants of health and explain how those factors contribute to the
development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have
selected. Include the host factors, agent factors (presence or absence), and environmental
factors. Are there any special considerations or notifications for the community, schools, or
general population?
Explain the role of the community health nurse (case finding, reporting, data collection,
data analysis, and follow-up) and why demographic data are necessary to the health of the
Identify at least one national agency or organization that addresses the communicable
disease chosen and describe how the organizations contribute to resolving or reducing the
impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or
cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located
in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment
to become familiar with the expectations for successful completion.


HIV/AIDS as a communicable disease
HIV is an infection transferred from person to person using specific body fluids where
the viruses target immune cells majorly the lymphocytes (CD4 cell count (CDC. 2019). A period
after the initial infection of the virus, HIV compromises substantial numbers of T-cells;
therefore, the body’s immunity cannot fend off diseases and acute ailments. T-cells are
exceptionally at the front-line of fighting-off infection. If not well managed, HIV markedly
decreases the quantity of CD4 cells count within an immune framework (CDC. 2019). Damage
to the immune framework continuously makes it daunting for the body to contain acute
infections and new threats. Malignant tumors and opportunistic ailments exploit an
exceptionally feeble immunity level; at this stage, the individual is categorized as suffering from
AIDS (Hernandez, & Sherman, 2011).
Origins, causes, and mode of transmission of HIV
Scientists distinguished a kind of primate within the central region of Africa as being a
wellspring of HIV contamination to humanity (Hernandez & Sherman. 2011). The hypothesis
points out that specific chimpanzees had a type of immune deficiency viruses (known as SIV). It

was likely zoonotic, and hence transmission to human species occurred then mutated to HIV as
humans were chasing infected animals for their meat and were in contact with chimpanzee
infected bodily fluids. Research shows that HIV was zoonotically transmitted from gorillas to
humans as early as during the late part of the 19th millennium (Habtemariam et al. 2011). In
years, HIV was progressively transmitted across Africa and overtime to different regions
globally. Scientists realized that the infection has been in existence within the U.S. as of the late
20th century.
HIV viruses can be found in cellular fluids, including and transmitted though:
breastfeeding, contact with infected blood, semen, and vaginal discharges, among infected
individuals. HIV is likewise found in sweat, salivary contents, and tears, however not insufficient
levels to transmit the infection from person to person. There are no recorded instances of human
contamination of HIV through wheezing, shaking hands, or from latrine seats or insect biting
(CDC, 2019).
The two most basic approaches to be contaminated with HIV in regions of North
America are unprotected intercourse and needle-sharing, especially among drug addicts. HIV
might be transmitted through unprotected among heterosexuals, gay, anal, and oral sex. Even
though the danger of disease is lower with oral sex, it is as yet critical to practice safe and
protected oral sex, for example, a dental dam (a bit of latex layering placed on the vagina during
oral sex) and condoms (Habtemariam et al., 2011). Globally, HIV is mainly transmitted through
unprotected sexual contact, bodily fluids such as blood, especially among drug addicts or even
during the process of blood transfusion. HIV can likewise spread through perinatal
contamination, where expectant mothers infected with HIV are at danger of transmitting the
ailment to the child during birth (Habtemariam et al., 2011). The prevalence of perinatal cases is

declining with new medications and improved management. Breast milk can also transmit HIV
to the infant.
When HIV enters the blood circulatory system, it assumes control over the immune cells,
specifically the lymphocytes (CD4 cells). The infection at that point embeds its qualities into the
cell, changing them into miniature cellular facilities that produce more duplicates of viruses.
Gradually, the viral load goes up, and the numbers of functioning CD4+ cells declines. The
decimation of CD4+ cells negatively affects the body’s capacity to contain and fight
contaminations, tumors, and different ailments (Hernandez & Sherman. 2011).
Symptoms and stages
Indications of HIV contamination can be noticed from 2 to 12 weeks after exposure to the
virus. It starts quickly during the early onset of the infection period, assuming control over-
resistant cells in the blood. Symptoms of this stage are influenza-like and incorporate fever,
headache, sweating at night, losing weight, skin rash, pain at the joint, lymphadenopathy, acute
diarrhea, and yeast infections.
Stage 1
At the point when signs and symptoms start to show up, the individual with HIV is at a
highly infectious phase. The manifestations typically subside after seven days to a month, and
the individual will appear to be healthy. In most cases, the events may often reemerge from time
to time. Symptomatic manifestations of HIV mimic other viral contaminations. The best way to
surely know whether you are HIV-positive is to undergo testing (Norval. 2014). After exposure
and getting infected with HIV, it takes around three weeks for antibodies to the infection to be
recognizable in the blood, even though for specific individuals, the antibodies are not perceivable

for as long as three months. The period during which antibodies create and show up in the blood
is called seroconversion. After seroconversion, the infection can be recognized by testing a blood
sample (Norval, 2014).

Stage 2 and 3
When the initial manifestations leave the body, the immune framework attempts to
control the infection. A functional immune system can manage control over the virus for some
time, yet it cannot dispose of it. Numerous individuals will feel normal for a more extended
period before their immunity levels debilitate and eventually get into the AIDS phase. Without
treatment, averagely half of the HIV-infected individuals progress to the AIDS stage in 10 years
on getting infected. Few persons get to AIDS in a couple of years after being infected
(Nakagawa, May, & Phillips (2013). Minimal numbers of those termed as long-haul non-
progresses, do not develop AIDS until much later on. In rare circumstances, few persons are
known as controllers” can control the infection for a considerable length of time and rarely
progress to AIDS. Numerous variables influence the period over which AIDS develops,
including genetic factors, disease virulence, medical treatment, and the person’s general
wellbeing and way of living.
Stage 4
AIDS is usually used to define an advanced state of HIV infection. The stage is
characterized as having HIV and a particular kind of contamination (opportunistic diseases)

regularly connected to AIDS. These contaminations can be caused by bacteria, viruses, fungal,
and parasitic infections. These infections are like the toxoplasmosis, Pneumocystis jerovicii
pneumonia, and Cryptococci meningitis. With the utilization of better prescriptions to treat HIV,
the danger of the above diseases has dropped significantly throughout the years (Norval. 2014).
Treatment prevention and complications
Currently, scientists have not managed to develop a cure for HIV. In any case,
antiretroviral management alters the progression of the condition and permits the vast majority
living with HIV the chance to have a viably long and healthy living. Beginning antiretroviral
medication early enough curbs and reduces the rate of transmission significantly. This improves
one’s longevity and decreases the danger of transmission, as per the WHO’s rules from June 2013
(Hernandez, & Sherman, 2011). An individual living with HIV can diminish their viral levels to
such an extent; viruses are not recognizable in a blood test.
On the off chance that an individual acknowledges they have been exposed to HIV most
recently as of 3 days, the anti-HIV drugs are prescribed, post-exposure prophylaxis, PEP, are at
times able to fight off the infection. PEP is a treatment enduring a sum of 28 days, and doctors
will keep on checking for HIV once the procedure is complete (Nakagawa, May, & Phillips.
Individuals who develop AIDS and get no treatment or progressively worsen are
additionally bound to suffer malignant tumors, mainly targeting the immune cells (lymphomas).
Another complication of AIDS is Kaposi\’s sarcoma, a sort of malignant growth that causes pale
blue red knobs on the legs, and that spreads to the lymph framework. Females with AIDS are
inclined to complicate and get cervix cancers (Nakagawa, May, & Phillips. (2013). Gay men

with HIV have a higher rate of getting infected by human papillomavirus (HPV), an infection
connected to anal tissue malignancy. Finally, death occurs in individuals whose immune system
has been ruined over by the viral replications and is too weak for its regular functioning, and
hence the whole body is wrecked.

Demographics on HIV/AIDS
Roughly 1.1 million individuals in America live with HIV presently. Around 14 percent
of them (1 of every 7) do not know that they are infected and hence do not perceive any need for
testing. An expected 38,000 cases of infection occur yearly within the U.S. HIV keeps on being a
significant worldwide morbidity and mortality cause (HIV.gov. 2018). In 2018 around 37.9
million persons were confirmed to be HIV infected (with the inclusion of 1.7 million children),
globally HIV predominance is at 0.8% in grown-ups. 21% of those who do not possess the
foggiest idea about their status on the infection (HIV.gov. 2018).
Over 74.9 million Individuals are the estimated number of those categorized as having
been infected with HIV and have led to the death of 32 million individuals and mainly due to
AIDS-related sicknesses (UNAIDS. 2018). As per 2018, the mortality statistic on AIDS caused
death figures were at 770,000, which was a 55% decrease since the highest rates of 1.7 million in
the year 2004 versus 1.4 million by 2010. There has been concern towards the yearly number of
new infection rates among grown-ups that have stayed static as of late. 1.7 million newly
infected HIV cases were recorded as per 2018, indicating a decline from 1.8 million persons in
2017 (UNAIDS, 2018).

While new HIV diseases among youngsters all around have likewise decreased in figures,
from 280,000 of every 2010 to 160,000 out of 2018, a 41% decrease, records show this as being
minimal advancement actualized in the recent suspected cases. There is significantly more that
should be done to ensure the information on HIV and HIV testing in teenagers and youthful
grown-ups (UNAIDS, 2018).

Social determinants of health
Scientific investigations keep on showing significant social determinants influencing the
capabilities and adequacy of a person’s role in their practices regarding safe intercourse. In the
cases of those having stable housing facilities, HIV-infected persons were illustrated as
practicing positive redirection regarding risky behaviors (Gibbs et al., 2012). Improved housing
permanently diminished the dangers of illicit drug usage, needle use and sharing, and unsafe
intercourse. Additionally, social parameters, including cultural and strategic factors of the social
status, tend to reduce instances of being HIV infected. In societies where there is less
stigmatization have been recorded to a higher number of voluntary testing and hence better
outcomes of HIV prevalence and less mortality (Aidala et al., 2015).
Social determinants might be tended to through structurally created provisions, which
have been characterized as those counteraction intercessions that incorporate physical, cultural,
social, authoritative, monetary, and policies (Gibbs et al., 2012). Essential interventions take care
of public medical issues in the setting of socio-economic and political policies which regularly
able to broaden or expand the impacts of individual-level or community-level by joining

intercessions that ensure and keep up conditions that empower people to perform preventive
practices reliably.
The Epidemiological Triangle of HIV
HIV epidemiological triangle is arranged methodologically to be utilized to inform on the
basics of HIV/AIDS transmission. The leading group of three is made out of three columns: an
agent, host, and environmental factors. The subsequent version consists of three columns: 1)
therapeutics/management, 2) (preventive/control measures, and 3) healthcare
upkeep/advancement. Each pillar is interconnected to every three triads group and breaks down
into its particular factors and parameters (Habtemariam et al., 2011).
An agent point recognizes the causative operator (HIV) and its attributes. The host
column acknowledges and describes the host (human). An Environmental column portrays the
physical, organic, and financial situations for both the host and agent. The medical management
column considers the treatment choices for HIV/AIDS. The preventive/control column discusses
anticipation and control measures. Lastly, the health upkeep/wellbeing advancement column
weighs measures for the wellbeing support of the infected populace. Each mainstay of every
triad is connected and breaks down into its particular factors and steps.
Nursing Role
There are more than 13 million nursing attendants globally. ICN keeps on preparing those
giving HIV care and treatment; nurses majorly affect the arrangement and execution of
HIV/AIDS. Nursing roles included assessment of new patients and routinely surveying stable
patients already on treatment inclusive of adherence support, psychosocial care, sexual wellbeing

screening, and healthcare advancement exercises. Nursing records proposed that all-
encompassing consultations had added to support productivity and acceptance.
The nursing workforce throughout the years has conveyed an expanding extent of HIV
care has empowered a few administrations to satisfy limited developing needs and to improve
accessibility. A study on sexual health administrations over the U.K. revealed that 47% of those
giving HIV care were working in nursing-led facilities (Habtemariam et al., 2011). Data
collected from these clinics is significant in compounding the prevalence, existing cases,
treatment, and mortality rates. Ultimately these statistics are indicative of the effectiveness of
implemented measures to reduce rates of transmission and mortality and also show progress or
regression in the eradication of HIV/AIDS.

National organization
HIV.gov is a federal agency whose main agenda is to expand HIV testing and care among
individuals most in danger for or living with, HIV, by utilizing rising correspondence
methodologies to give access to government HIV data, strategies, projects, and assets (HIV.gov.
The global implication of HIV/AIDS
Numbers of HIV/AIDS infections have progressively exceeded scientific expectations
since being recognized almost 40 years ago. Universally, around 79 million persons are presently
categorized as HIV infected, and approximately 37.9 million persons have died as a result of the

disease, with the highest numbers within sub-Saharan Africa (UNAIDS, 2018). HIV infection
and transmission has been more prominent than initially anticipated, and also its effects on socio-
economic policies, community structures, and monetary funding. Management of AIDS on
scales proportionate with the scourge is a planetary objective through use viable and well-
understood measures (Aidala et al., 2015).
Medical mechanisms such as antiretroviral drugs have substantially diminished the HIV
related deaths for those populaces ready to manage the cost of access and have had a significant
effect on forestalling mother-to-child transmission rates. Globally the disease has a widespread
impact on societies with most improvements noticed in developed countries and with the
developing nations left behind to deal with most of the detrimental effects of the disease.



Aidala, A., Cross, J. E., Stall, R., Harre, D., & Sumartojo, E. (2015). Housing status and HIV
risk behaviors: implications for prevention and policy. AIDS and Behavior, 9(3), 251-
Centre for Disease Control website (CDC), 2019.
Gibbs, A., Willan, S., Misselhorn, A., & Mangoma, J. (2012). Combined structural interventions
for gender equality and livelihood security: a critical review of the evidence from
southern and eastern Africa and the implications for young people. Journal of the
International AIDS Society, 15, 1-10.
Habtemariam, T., Yu, P., Oryang, D., Nganwa, D., Ayanwale, O., Tameru, B., & Robnett, V.
(2011). Modeling viral and CD4 cellular population dynamics in HIV: approaches to

evaluate intervention strategies. Cellular and molecular biology (Noisy-le-Grand,
France), 47(7), 1201-1208.
Hernandez, M. D., & Sherman, K. E. (2011). HIV/HCV coinfection natural history and disease
progression, a review of the most recent literature. Current Opinion in HIV and AIDS,
6(6), 478.
HIV.gov, US Statistics (2018).
Nakagawa, F. May, M., & Phillips, A. (2013). Life expectancy living with HIV: recent estimates
and future implications. Current opinion in infectious diseases, 26(1), 17-25.
Norval, D. A. (2014). Symptoms and sites of pain experienced by AIDS patients. South African
Medical Journal, 94(6), 450-454.
Unaids, J. (2018). Fact sheet—latest global and regional statistics on the status of the AIDS
epidemic. Geneva: UNAIDS.

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