HIV Infection in Papua New Guinea

Introduction

Papua New Guinea (PNG) is a country faced with an array of diseases with malaria being one of its mascot epidemic as the tropical Climate facilitates external breeding environment for malarial parasites. However, HIV has gained rapid popularity since the first recorded case of an infected patient diagnosed in 1987 (The Virus Spreads, 2014). Human Immunodeficiency Virus or commonly referred to as HIV is a type of virus that weakens the immune system by attacking the CD-4/ T-Helper Cells of White Blood Cells that protect our body from disease causing pathogens.

[image: Image result for HIV virus]Once HIV effectively weakens the immune system, the host’s body is left in a condition called Acquired Immune Deficiency Syndrome (AIDS). Thus, the patient is susceptible chiefly to developing TB and Pneumonia. HIV was reported to have infected 75 million people and killed about 32 million people globally by World Health Organization (HIV/AIDS, 2017). But, the essay will scope out few of the many characteristics; like its signs and symptoms and diagnostic tests, treatment options and practical measures that prevent its spread. And also discuss why HIV is a public health issue and the role of a physiotherapist in the management of a diagnosed patient’s management.

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Characteristics

Signs & Symptoms and Diagnostic Tests

Firstly, an infected patient with HIV is referred to as a carrier. A carrier might be infected with either one of the two types of HIV; HIV-1[footnoteRef:1] or HIV-2. Regardless of the type of virus the host will experience common signs and symptoms: [1: HIV-1 is more common than HIV-2

HIV-2 is more genetic; it is specific to people in parts of West Africa ]

SIGNS SYMPTOMS

• Fatigue -Fever
• Swollen Lymph Nodes -Ulcers in the mouth/tongue
• Weight loss -Abdominal pain
• Chronic Diarrhea & persistent vomiting -Opportunistic diseases

Doctors access obvious signs and symptoms but it’s not that simple to determine whether its HIV due to the fact that Cholera and TB display similar signs and symptoms. Saliva and Blood is collected for Enzyme-Linked Immunosorbent Assay (ELISA) Test for a more precise result. A positive ELISA Test usually indicates that the patient is positive with identifiable antibodies in the blood that were produced by the virus upon infection.

Treatment Options and Prevention

There’s no cure for HIV/AIDS because it is a retro-virus. A retro-virus only has RNA and an enzyme called reverse transcriptase that facilitates its conversion into a DNA strand inside the host’s cells. The DNA strand cunningly incorporates itself into the host’s DNA, where more of the virus is produced. In this advanced science and medical age, far better treatment is available for patients to increase life expectancy[footnoteRef:2] and live healthy and normal lives. The main anti-retroviral regiment available for HIV patients are a group of medicine taken in combination which is collectively called Antiretroviral Therapy (ART). ART is administered by specialists like Infectious Disease Doctors or General Practitioners to suppress the growth and infection rate of the virus. [2: Life Expectancy: average number of years a person is expected to live. It varies in different countries. ]

Overtime, doctors and scientists have ultimately come to know and understand more about the disease than ever before. The search for the cure has been so long and yet, doctors and scientists are persistent and diligent in the laboratories currently trying to come up with even more improved treatments and possibly a cure.

Moreover, studies in 2010 have shown that the number of deaths by HIV/AIDS has declined from 1993-2000 mostly because of preventive measures applied by both infected and non-infected within a given population (Brady, 2010). Health Promotion and HIV/AIDS awareness plays a vital role. HIV is almost all the time transmitted via unprotected sex with an infected partner but there are other ways HIV is viable to be transmitted, thus preventive measures are fundamentally important.

Preventive Measures

• Get tested for HIV and STDs
• Refrain from risky sexual behaviors
• Have one sexual partner
• Use Condoms
• Use sterile needles & razors

There are also ways that you cannot contract HIV where most people are so sensitive about and always end up discriminating and stigmatizing an infected person. HIV is not transmittable through sharing of eating utensils, kissing, dry humping and hugging or even cough because it is not an airborne disease.

HIV a Public Health Issue

Secondly, PNG was distinctively ranked 145 out of 177 countries in the world infected with HIV/AIDS in 2008 (Dinnen, Vicki Luker and Sinclair, 2009) . HIV/AIDS has caused a havoc socioeconomically and spiritually in a developing country who is trying to keep up with the ever changing world. With lack of basic health services in the remote areas with little to no access by roads, geographically mountainous and the only way to deliver health services is by small cargo-planes. As a consequence, ART Treatment is usually at one major town or city. Therefore, an infected person is vulnerable to spread the disease between the imbalance of ART availability and access. The Highlands Region of PNG has the largest HIV/AIDS population with Enga Province leading the prevalence rate[footnoteRef:3]. [3: Prevalence rate is the proportion of persons in a population who have a particular disease at a specified point in time or over a specified period of time]

Certain cultural practices also encourage the steep infection rate where in some provinces like Chimbu, young people usually come together in a ceremony colloquially known as ‘kukim nus’ to dance in sitting position beside the fire and then have sex with one or two partners at a time. The people of Oro, Central and Sepik Province have long been known for their initiation tattoos which the virus can be transferred from the needles. All aspects considered, HIV/AIDS is a major public health issue in the country.

On the other hand, first world countries like Australia, have much lower prevalence rate and have a sense of control over the disease. ART and testing clinics for HIV and common STDs are strategically placed in every rural areas as well as in major cities, towns and suburbs.

Patient Management by Physiotherapists

Thirdly, the need for Physiotherapists and Rehabilitation for the management of diagnosed HIV/AIDS patients have never been realized until recently. Besides the common symptoms arthritis, sloppy gait, osteoporosis & dyspnea are obvious areas where a physiotherapist can correct. Patients are referred to a physiotherapist after stable treatment that shows the patient’s positive progressive recovery.

A physiotherapist help improves the patient’s gait by having the patient walk on treadmills and doing simple muscle strengthening exercises like stepping-over objects, climbing stairs and lifting small weights. Patients are also advised to do push-ups and squats for joint compression. Dyspnea can be a long term symptom for HIV/AIDS patients however, breathing lessons can reduce some extent of the difficultness.

Proper diet for sufficient bone growth and healthy bone rehabilitation is best recommended by a physiotherapist.

Conclusion

Finally, to conclude, HIV is a very unique communicable disease and cunning that even our immune system is fooled. By the time the immune system realizes its presence, its already too late. HIV/AIDS is killing and infecting millions of people world-wide however, ART has proven to have prolonged the life of infected patients and live healthy normal lives.

Since HIV is present in blood, semen and vaginal fluid, it is recommended that a person should have only one sexual partner and avoid unsterilized razors & needles to avoid contracting the virus. HIV is crippling the county, especially the highlands region that maybe due to the fact that they have cultural practices that make it vulnerable for young people to contract the disease.

Physiotherapists were thought to have no significance in the rehabilitative management of HIV/AIDS patients but now play a vital role in getting patients to live healthy lives. Patients are encouraged by physiotherapists to do simple activities and exercises to improve gait, dyspnea and weak joints.

References

1. Brady, M. T. (2010, January 1st). doi:10.1097/QAI.0b013e3181b9869f
2. Dinnen, Vicki Luker and Sinclair. (2009, March 12th). (V. L. Dinnen, Ed.) Retrieved Febuary 23rd, 2020, from https://press-files.anu.edu.au/downloads/press/p94091/pdf/book.pdf
3. Fact file: The AIDS problem in Papua New Guinea. (2014, December 11th). Retrieved February Tuesday 17th, 2019, from RMIT ABC: Fact Check: https://www.abc.net.au/news/2014-12-11/the-aids-problem-in-papua-new-guinea-fact-file/5936666
4. Steyl, T. (2015, April). doi:10.4102/sajp.v71i1.286
5. World Health Organiztion. (2017, January). Retrieved February Friday 21st, 2020, from HIV/AIDS: https://www.who.int/gho/hiv/en/ & https://www.who.int/gho/hiv/hiv_text/en/