Disease in the News Critical Appraisal

There has been a rise in the number of cases of HIV/AIDS in men who have sex with men in the US. Trends suggest that between the years 2001 to 2004, the number of HIV/AIDS cases is rising in African American and Hipic populations compared to the White population. The survival rates after 3 years were the lowest for men belonging to the African American and the Hipic community compared to the White community. Since, the year 1999, there has been a rise in the number of cases of HIV/AIDS especially in men who have sex with other men.

The article is a thoroughly peer-reviewed journal suggesting that the information is current, evidence-based, validated and researched carefully. The authors of the article include Hall, H. I. , Byers, R. H. , Ling, Q. , and Espinoza, L. They work for the Division of HIV/AIDS Prevention, which is a unit of the Center for Disease Control and Prevention (CDC), Atlanta, US. The journal has given the details including the contact address and the email ID of the authors thus permitting clearance of queries and doubts. The authors are well versed and experienced in the field of HIV/AIDS.

Hall and Byers have completed their PhD, Ling has done MS, and Espinoza has completed DDS. The authors are from various groups, and hence they would express the problems of these groups in their work. Each of the authors has played a different role in bringing out the journal. The writing, origin of the study, designing of the study, review and the interpretation has been done by Hall. Major contributions of the writings and modeling of the data has been done by Byers. Ling has performed analysis of the data and the data progression details.

Espinoza has done the interpretation and discussion of the data. As this study was just about collecting data and not performing a clinical trial, it did not involve following a protocol. The article has been broken into various subtopics including abstract, introduction, methods, results, discussion, conclusion and references. Credential web sites such as Pub med and the CDC have also cited the article. The article is about the diagnosis of HIV in the male homosexual population, and determining the rate at which the disease progresses.

The researchers are interested on working with this topic as highly active antiretroviral therapy (HAART) has seemed effective in delaying the symptoms of the disease and the development of fatal outcomes from the disease. In the 1990’s, there was a reduction in the mortality rates arising from AIDS, due to development of HAART. This therapy is able to reduce the viral load. Since the year 1999, there has been a rise in the number of cases of HIV/AIDS due to the increase in homosexual men amongst certain segments of the population.

Another indicator of the trend of men having sex with other men was the rise in the number of cases of syphilis in the male homosexual population. The cases of HIV/AIDS were especially high in men below the age of 30 years. In other parts of the world, the results obtained from similar studies were different. For example, in the UK, it was found that the high incidences of HIV/AIDS were observed in men who had sex with men between the ages of 25 to 44. The incidences of HIV/AIDS increased in higher numbers in the African-American and Latin populations compared to the Whites.

It was about 10 and 3 times higher. Before this study was conducted, HIV/AIDS was not detected in a high proportion of the study model. The Whites were more aware of their HIV status compared to the Hipics and the African-American population. This suggests that the Whites are more likely to start HAART faster and develop better outcomes with the disease. The data was collected for this study by the HIV surveillance system in place. Several statistical methods such as Poisson regression was utilized to determine the HIV diagnosis rates.

The study demonstrated that higher rates of HIV/AIDS were observed in homosexual men belonging to African-American and Hipic background compared to other segments of the population. Besides, the survival rates after 3 years was also lower the same populations. HIV progressed faster in Hipics and African population. The article talks about a specific population, namely the homosexual men. The geographical area of this study was limited to the United States. However, the results of the study were compared to other countries such as the United Kingdom.

The various ethnic groups that were studied included Hipics, African-American and Whites. The CDC performed the study. The article does make claims of the treatment. In this case, it is HAART to treat HIV/AIDS. HAART plays a major role in reducing the mortality and morbidity from HIV. The study picks up some evidence available from 1996-1999 in which HAART was utilized to reduce the transmission of HIV infection. This may be in the fact that HAART helps to reduce the viral load in infected people.

The article speaks of the ongoing emphasis given to the Governments Healthy People 2010 policy, and the need to reduce the transmission of HIV infection. The article also aims to reduce the transmission of HIV/AIDS in the homosexual male population especially. There are various strategies suggested for treatment including prevention, early diagnosis, HAART therapy, etc. The article has used about 48 current and relevant journals written by authors whose credentials are also good. The user can access the abstract of the references by clicking on the link provided.

References:

Espinoza, L., Hall, H. I., Campsmith, M. L. et al (2005), “Trends in HIV/AIDS Diagnoses — 33 States, 2001—2004,” CDC MMWR, 54(45), 1149-1153. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5445a1.htm

Hall, H. I., Byers, R. H., Ling, Q. et al (2007), “Racial/Ethnic and Age Disparities in HIV Prevalence and Disease Progression Among Men Who Have Sex With Men in the United States.” AJPH, 97(6), 1060-1066. http://www.ajph.org/cgi/content/full/97/6/1060