The Efficacy of Group Work to help HIV Smokers to Reduce Smoking
1.1 Background on HIV and Smoking
Human Immunodeficiency Virus (HIV) is a retrovirus that leads to the development of Acquired Immuno-Defiency Syndrome (AIDS). The virus erodes a victim’s immune response system thus rendering him or her vulnerable to other opportunistic infections. The first case of HIV draws back to 1981 and since then, it has been a major health challenge in most countries especially in Africa. In addition, the World Health Organisation (WHO) considers it a pandemic. By 2006, the virus had claimed over 25 million lives. Arguably, close to 2.6 million new infections were reported by the year 2009 which is quite alarming. The inception of ARV medication has had a positive impact which has seen a remarkable reduction in HIV/AIDS related deaths via boosting the patient’s immune system thus making the stronger.
According to the New York State Department of Health AIDS Institute, Smoking is more prevalent among HIV positive individuals. In this regard, this is estimated that over 50% of HIV-infected persons are smokers. However, medical research (done in 1992 by doctors in Seattle) indicates that smoking does not increase HIV progression in a patient neither does it increase ones CD4 cell count. On the other hand, smoking increases the patient’s vulnerability to opportunistic infection by as much as three times compared to infected non smoker (Jeanne, 1998: 67). It also known that pregnant women smokers have high possibility of passing the virus to their unborn child. With this in mind, health experts have taken a step further of encouraging smoking HIV patients to quit smoking as an avenue of aiding in the boost of their immune system. Very low CD4 cell count actually means the patient has almost no immunity against foreign bodies.
1.2 Statement of the Study Problem
HIV has been the prime cause of cases of children orphaning especially in assorted developing countries. The menace is considered a major threat to any country’s working generation since infected workforce both for the civil service as well as the private sector may be lost and as a result; loss of skilled and qualified labour. Eventually, this retards the economic development of the affected country thus leading to escalation of poverty levels and probable high illiteracy levels. This has pushed most governments to develop strategies of cutting down on the rates of HIV infections in order to minimize on deaths among its people.
1.3 Justification of the Study
The incumbent question can be on what the governmental and nongovernmental sectors are doing to curb HIV spread among patients who smoke. In light of this, it is evident that most health facilities have embarked on creating work groups targeting the smoking HIV patients as a way of helping them to quit the act in order to lengthen their lifespan. With this in mind, questions have arisen on whether such strategies are quite effective. Two possibilities can be postulated pinned on the aforementioned cases. These are: one; work groups are an effective way of reducing cases of smoking among HIV positive patients or two; it is not an effective way of cutting down on the preference of HIV positive smokers. According to Drach, work groups do not actually help to reduce the rate of smoking among HIV.
This proposed study aims at assessing and evaluating the effectiveness of work groups, the impact of group work on participants’ behaviour as well as the probable changes on their attitudes towards smoking and any other health benefits that may come from their participation in the work groups.
HA: Work group is an effective strategy of reducing smoking behaviour among HIV positive cases who are smokers.
HO: Use of work groups among HIV positive cases who are smokers does not reduce the rate of smoking
1.5 Research Questions
i. Is work group an effective strategy that can aid HIV positive smokers to minimize smoking?
ii. Do HIV persons who smoke feel that their behaviour, attitude and addiction can change after participating in group work as compared to non-smoker victims?
1.6 Aims and Objectives
The general aim of this study will be to establish if group work is an effective way of reducing smoking cases among HIV positive persons by comparing the available data to patients who do not participate in group work.
2.0 ‘A brief overview of the relevant literature in the field’
There is need to assess the effectiveness of the participation of HIV positive patients who smoke in the work group. In her review, Janine K. Harris, points out the need to research on efficacy of the measures taken by most health related organizations to reduce smoking cases among people living with HIV/AIDS. She underpins on this gap in research work by asserting that much of the completed research has been limited principally to focus on the relationships between HIV and smoking rather than assessing the effectiveness of the strategies in place to cut down these cases. Her article points out that health effects of smoking on HIV patient have been extensively exploited thus need for researchers to shift their focus and evaluate the effectiveness of the proposed methods that can aid the victims to quit smoking.
In addition, Judith McCoyd and Kwong argue that smoking is a common undertaking among most HIV positive individuals than the cases in the general population. To underpin this assertion, both cite stumpy economic status, diminutive educational background as well as alcohol use as the major factors that propel smoking among the HIV patients. And as a result, most victims are exposed to other opportunistic infections due to their vulnerability. In addition, smoking undermines a patient’s response to antiretroviral treatment. The best alternative of curbing such intricate cases is by encouraging the victims to stop smoking.
According to Kaptein study on the effectiveness of group work among the elderly people, group work is presented as a successful strategy that can also be applied in HIV studies. Arguably, when one participant quits smoking, a colleague is encouraged to follow suit.. His research used the already available facilities to make it a success. Comparing his research to one on HIV patients it is clear that HIV research will be complicated as one has to deal with the problem of keeping the patients anonymous to avoid discrimination.
It is evident that much of the research works have unravelled the effects of smoking on HIV patients. What is imminent is that smoking predisposes victims into being more vulnerable to other infections. The best option is for the victims to quit smoking. The incumbent question is how and how effective is the strategy. As a strategy already in place, work groups can be assessed to ascertain their effectiveness. This proposal seeks to fill this gap by evaluating the efficacy of work groups as fur as smoking and HIV are concerned.
This section briefly describes the manner in which the proposed study will be executed. A direct observation will be adopted during the proposed study. In addition, questionaries will be administered to the participants hereunder on a weekly basis. After six months of data collection, data from health experts and professionals will be acquired. The choice of the health centre will depend on its specialization in HIV treatment and care.
100 volunteers living with the virus will be sampled. Of this, fifty must be participating in work groups and the reaming fifty not. For gender satisfaction, 25 in each group will be women. The identity of the participants will be protected and all they will have codes for identity rather than their real names. The age bracket of the participants should be between eighteen years and fifty five years. They should not travel away from the area within the period of research and that will interfere with data collection.
Literature on smoking cessations will be needed to help the participants learn more about quitting smoking. Medicines like ARVs will be required as the participants must remain on medication. A room where the group work will be held will also be needed. Money for their drinks and to pay instructors will also be needed.
The participants will first be selected; they will then be divided into the two groups. The room for group work will then be equipped with necessary facilities and questionaries for different stages prepared. Instructors will then take the participants through the research and he or she must assure medical tests are done frequently and that the timetable for the research is followed strictly. Collected data will then be tabulated and analysed to see if the aim of the research is achieved.
Tables are to be prepared to help in organising the data collected with each participant having a file to his name. The instructors should be qualified medical doctors with wide knowledge on HIV and also be a person with research history. The data should be monitored closely and any participant who develops serious conditions during the study should be referred to hospitals for special care. Results of the research will be sending to the government and other health organization which might require the data for further studies.
4.0 Project Timeline
The research is to be held over a period of six months to enable enough time for accurate data to be collected from the 100 people samples. The time schedules must be followed strictly and as it will serve as the basis on data analysis and help to establish foundation for future researches. Throughout the duration of the research it should be ensured that the participants are on correct diet and they should also try as much as possible to avoid stress as this would interfere with results on data collected as stress weakens ones immunity greatly.
The participants not in group work are to be given literature that can educate them on quitting smoking and their success should also be noted down accurately.
It is evident the HIV AIDS is with us and the only way out is to cut down on its prevalence. Literatures indicate that extensive research has been done on HIV infections as well as the role of smoking on propelling this menace. However, strategies should be adopted that can minimize smoking among HIV positive persons. In light of this, work group has been advocated by many as an apt tool to cutting down smoking. However, the incumbent question is whether this approach is indeed effective as it is perceived. This study proposes to evaluate the efficacy of work groups in HIV infections in line with smoking habits. Results developed here will be invaluable to policy makers and resource planners in allocating funds to sustain such groups not mentioning building a health population globally.