Select a contemporary health issue and explore existing management from a global perspective.

Reflect on how your profession contributes to address the issue and how you collaborate with
other health care professionals.

37.7 million people are currently suffering from Acquired Immunodeficiency Syndrome (AIDS)
(UNAIDS, 2021) and complete eradication of human immunodeficiency virus (HIV) in human bodies
is impossible currently. The UNAIDS has been proposing different goals in the management of AIDS.
An overview of the current management of AIDS is as follows:

Though no vaccines are available for the reduction in risk of HIV infection, existing education
through mandatory talks in schools and dissemination of information on government websites
facilitates people’s understanding of AIDS and adoption of proper preventive practices. As for
diagnosis, most of the diagnosed cases are individuals who actively request HIV testing and a
majority of AIDS patients are left unidentified at the early stage of AIDS (Girardi et al., 2007). Those
who are diagnosed are mostly offered ART or highly active ART (HAART), or less commonly gene
therapy and immunotherapy, to suppress the development of HIV (Mamo et al., 2010). Proceeding
to rehabilitation, “self-management education”, “dietary management”, “exercise
management“ and “psychosocial intervention” could be facilitated by occupational therapists and
physiotherapists (Alebel and Wagnew, 2017).

While AIDS remains incurable, learning how to live with it has become particularly important. As
AIDS progresses, patients may suffer from permanent physical disabilities. Occupational therapists
train them to perform their daily activities even under such constraints (Entwistle, 2017).
Modifications of patients’ living and working environments, and tools are supervised and created
respectively to facilitate patients’ self-care and adapt to changes caused by AIDS more easily and
swiftly (Fish and Rudman, 1998). As for patients who suffer from mental stress due to the
incapability to perform daily activities and widespread stigma in society, occupational therapists may
provide counselling services to patients to facilitate their management of negative emotions and
reintegration into society (Fish and Rudman, 1998).

However, the engagement of occupational therapists alone is not likely to promote sustained
physical and psychological well-being among patients. With uniprofessional care, part of the
patients’ conditions may be overlooked or mistakenly diagnosed due to limited expertise. In light of
this, interprofessional collaboration (IPC) could be introduced to facilitate holistic care for the
patients in the four stages of the provision of healthcare services, including prevention, diagnosis,
treatment and rehabilitation.

Speaking of prevention, narrative health messages have become more and more effective in
promotion campaigns to discourage certain misbehaviour like smoking (M. Hecht, personal
communication, October 18, 2021). They could be deployed in medical campaigns to encourage the
public to avoid inappropriate practices that may heighten their risk of HIV infection. Early diagnosis
of HIV followed by a timely treatment could significantly lower the morbidity and mortality
rate(Girardi et al., 2007). For instance, radiologists may facilitate AIDS patient screening by referring
patients with tuberculosis, which indicates immune suppression, to HIV testing (Girardi et al., 2007).
Under HIV testing, patients’ samples are examined by medical laboratory scientists to identify AIDS
patients. As for treatments, doctors are responsible for prescribing medication to suppress viral
replication while psychiatrists are responsible for providing individualised treatments to cure certain
mental health conditions of patients. For patients with more severe conditions, bedside care is
provided by nurses, and rehabilitation programmes are designed by physiotherapists and
occupational therapists to facilitate patients’ ability to perform instrumental activities of daily living.
Concerted efforts of HCP are required to improve patient’s adherence. Poor adherence to
treatments is not uncommon due to lifelong medication for AIDS (Richman et al., 2009; Chun, 1999;
Marsden and Zack, 2008). Augmenting subjective observations and quantitative analysis made by
different professionals, a more comprehensive review of patients’ conditions could be obtained and
treatment plans could be formulated accordingly. Though conflicts may emerge due to the diverse
points of view, a more informed consensus could be reached through active discussion and the
aforementioned benefits of IPC outweigh its potential drawbacks.

To conclude, despite a fall in the mortality rate of AIDS due to the advent of antiretroviral therapy
(ART) (Granich et al., 2015), it should be noted that continuous and concerted efforts are needed
before we eventually come to an era that AIDS and HIV are completely eradicated with the use of
preventive vaccines and effective drugs.

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UNAIDS. (2021). Fact Sheet 2021.

https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf