The impact of HIV/AIDS on the African American woman and child: epidemiology, cultural and psychosocial issues and nursing management.

Abstract: The approach to understanding the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) must include the African American woman and children as persons at high risk. This information must be documented in all epidemiology, cultural and psychosocial aspects of care, and nursing management reports. Approximately twenty years after it was first recognized, AIDS is still traveling across the globe at full speed, with very little brake power. In the United States, the African American heterosexual woman continues to be the fastest growing group of persons with the acquired immunodeficiency syndrome. The proportion of cases increased drastically in the period from 1993 to October 1995, with women totaling 18 percent of the total cases (Newman & Wofsy, 1997). The impact that cultural and psychological issues have had on women and children living with HIV or AIDS is immense, involving not only the potential burdens of physical deterioration, but also the stress of accompanying lifestyle and role changes. These issues involve processes in adjusting and adapting to HIV infection that are important not only because of their centrality to the coping individual, but because they directly affect the success of treatment and prevention (Jaccard, Wilson & Radecki, 1995). KEY WORDS: HIV/AIDS, African American Woman, Children, Epidemiology, Cultural Psychosocial, Nursing Management The psychosocial aspects of care given to women and children infected with HIV/AIDS must include nurturing the emotional trauma, such as, guilt, hopelessness, anger, resentment, physical harm, and public rejection. How nurses approach the challenging issues facing women with HIV/AIDS will often be key in the management of client satisfaction, and the ability of those clients to follow through with the many treatment demands during the course of the illness (Sherr, 1995). Guidelines for the treatment of HIV infection in children were recently released by the U.S. Department of Health and Human Services (CDC, 1997). Identification of HIVinfected women before or during pregnancy is critical to providing optimal therapy for both infected women and their children and preventing perinatal transmission. The impact of HIV/AIDS on children depends wholly on the modes of transmission, diagnostic evaluation, nursing management, economic and social problems, and education of the parents. The HIV/AIDS pandemic has created enormous problems economically and socially around the world. Economically, the costs for medical care, and damage to the society and culture, are basically untouched by traditional HIV/AIDS educational messages. If these messages were readily available to African American women, they could have more important implications for more focused and targeted nursing intervention. There are no measurements as to how much damage this pandemic is causing to the HIV - infected children who contracted the disease from infected mothers, and those children who are orphaned as a result of AIDS-related deaths of parents. It is estimated that in Africa alone, more than one million children are infected with the AIDS virus. In the United States, the picture is more optimism. Fewer children are now becoming infected with HIV because there are more medications available (http://www.kron.com/nc4/ healthbeat/stories/world-aids.html). EPIDEMIOLOGY African American children accounted for 58 percent of the pediatric AIDS cases in the United States as of December 1997 (National Minority AIDS Council [NMAC], 1998). As a result of improved treatments for pregnant HIV-positive women, mother-to-infant transmission of HIV has decreased 50 percent among white infants compared to a 42 percent decrease among African American infants during the period between 1992 - 1996. In 1997, African American children accounted for 60 percent of the total number of children with perinatally-acquired AIDS cases (NMAC, 1998). …