One of the objectives outlined in Healthy People 2020 is the prevention of transmission of sexually transmitted infections among which are the female genital herpes. Genital herpes infection is one and STD, which can be classified into two main types: HSV-1 and HSV-2. This paper, however, will focus on the second type of HSV (HSV-2) which manifests itself as blistering of sexual muscles within the genital areas typically exposed during sexual intercourse/contact. It should be noted, however, that both types have the capacity to affect the genital areas. HSV-2 is recurrent and it is estimated that one out of possible six persons within the country suffers the infection especially within the age bracket of persons aged 14-49 years.
Genital herpes in women
Though genital herpes infects men as well as women, this paper focuses on female herpes, since statistics show that genital herpes is more severe in women than in men, and that women are more at risk of contracting the disease. Among other signs of the female herpes are aching ulcers and sores within private areas. In addition, some women develop fever while others experience itching sensation within the genital areas while still others develop body aches. In some others, the lymph nodes swell, and in many cases of female herpes, these symptoms come and go over a lifetime. Vaginal discharge a well as swollen abdomens in women may indicate the possibility of such an infection (Stöppler, 2014). Currently, there are various tests designed and applied to women to diagnose and confirm the presence of sexual infection in women, and they include viral cultures, HSV genome material amplification as well as the physical examination of skin color change within the genital areas.
Such tests are done to inform on the rightful diagnosis to be administered in such cases of infections. It that while HSV-2 among women has no cure and therefore should be diagnosed with the seriousness it deserves and be understood as so. However, there are anti-viral medications that can be used to contain both the severity and frequency of the symptoms among women. For example, during pregnancy, the GYN doctors administer oral antiviral medications in order to manage effectively the infection and care for the pregnancy until it is mature. The fact that female herpes lacks cure explains the recurrent nature of the symptoms of the disease among women. It is however observed that the recurrence varies in severity as well as in frequency. Caution is to be observed when handling the underwear of an infected person as clothing may carry the virus.
Besides, it is advised that protected sex be emphasized to prevent the transmission of the virus, which is easily transmitted through contact with the genitals or fluids from genital ulcers. Moreover, oral sex and other physical contact between a healthy person and a carrier of the virus are known to cause transferring of the virus and hence transmitting HSV-2. The rampant rise in the cases of infections of herpes in the US as stated within the general objective of preventing sexually transmitted infection in Healthy People 2020 that presents the main challenge in realizing the objective. Many new infections are experienced annually, especially within the sexually active population, because despite protective measures being adopted, any simple contact with genitals of an infected person may ultimately lead to transmission of the virus.
Target Population and Setting
This research study focuses on studying genital herpes among women, especially those within the age bracket between 14-49 years of age. The reason for selection of this segment of the population is that this age bracket is very active sexually, and is therefore at higher risk of contracting the infection. It is an ascertained fact that adolescent girls as well as young women run a higher risk of developing long term and adverse effects from STIs (‘healthy people 2020’, 2011).
The limitation of resources as well as time necessitates this study to be conducted using a rather narrow sample population. This paper therefore focuses on young adults within the home-based care centers as well as within nursing homes. The young women within such settings are more susceptible to contracting the genital herpes infection due to their sexual activity. Young people in the modern generation are becoming sexually active at alarmingly young ages and this increases the risk of them contacting the disease. Besides, according to a report by the CDC, women easily contract STI during sexual intercourse especially the penetrative as compared to the rate of transmission from women to men (Center for disease control and prevention, 2013).
In fact, statistics show that in the US, one among five women within the age bracket stated has contacted genital herpes while one among nine men has contracted the disease. These statistics therefore explain the focus of this study on young women, especially those within the tertiary level of education. Sexual activities are typically rampant within the institutions of higher learning and hence our focus on the primary health care services of such institutions. Often, upon the diagnosis of herpes virus in individuals, the primary health care service providers assume the responsibility of management of the condition in order to control and prevent incidents of re-infection and new infections within a given population. For instance, nurses offer prenatal health care advice and monitoring in order to reduce the risks of the infected parent infecting the newborn. In fact, at advanced cases of infection, natural deliveries are replaced with a c-section in order to prevent the child from infection. Besides, primary health care workers provide counseling as well as health education to reduce the likelihood of contacting the virus; they campaign for positive behavior change in young adults as well as taking an active role in management of already existing cases of infections.
Application to Advanced Practice Role
Nurses in advanced services are therefore seen to play a critical role in the delivery of primary health care. Advanced practice nurses and students are trained and prepared to offer the following services among others. They are responsible for finding the underlying cause of a health issue suffered by a patient and this entails establishing the medical history as well as conducting tests as necessary in order to confirm the diagnoses. They are also trained to order as well as interpret lab findings on a disease as well as to conduct diagnostic studies of a disease. Furthermore, nurses and students develop and adopt therapeutic care plan(s), diagnose various conditions, maintain records for patients, provide supportive patient/family education as well as arrange for referrals and/or consultations for the patient. Finally, participating in and conducting research studies as well as evaluating response plan(s) for a patient and modifying them as appropriate are equally fundamental responsibilities of advanced nursing practitioners or students.
Concerning genital herpes, this study focuses on, failure to cooperate with the practitioner and possible lack of information would inhibit the effective delivery of advanced services within the primary health care system. Sexually transmitted infections are often associated with stigma and this usually leads to failure to disclose the accurate information as well as failure to cooperate with the practitioners. Genital herpes in particular presents a strategic challenge in realization of the Healthy People 2020 objectives in that the infection is often considered less troublesome when compared with other STIs. The failure to appreciate the severity of the disease causes any people to continuously be infected, even when with proper guidance from the advanced nursing practitioner the situation would be contained. Moreover, it is problematic in that the symptoms of the disease are not universal, and, therefore, the infection may undetected for long periods. Promiscuity and failure to practice safe sex are also some of the strategic challenges that genital herpes presents to practitioners at the advanced level in primary health care.
Review of Literature
In a report on community health, Maurer confirms that HSV-2 virus causes genital herpes, which is commonly transmitted through sexual contact or other physical contact with genital parts of an infected person. Other modes of transmission include a contact with oral or genital fluids of an infected person. Besides, unmonitored delivery may lead to mother-child infection and hence explains this contact as another means of transmitting the disease. Maurer’s report, however, points out that often the viruses are dormant within the body, but at the trigger of other stressors or illnesses, eruptions occur. However, the severity of the recurrence subsides with time, though this does not imply that the disease is cured, as there is no cure at all for genital herpes. Nevertheless, antiviral drugs are usually used to control and/or suppress the symptoms and severity of their recurrence in a patient. Left untreated, the disease may also lead to such complications as meningitis as well as encephalitis among others (Maurer, nd).
“Healthy People 2020 Objectives” is a collection of basic targets that the US has set to have attained by the year 2020 in the health sector. Among these are responsible sexual behaviors, which are meant to control the rates of transmission of sexually transmitted diseases, including genital herpes infections. Other sexually transmitted infections covered by the objectives are gonorrhea among men and women, syphilis among all persons as well as unwanted early pregnancies among the adolescents. Such efforts and initiatives within the US in the 21st century are necessary because undiagnosed sexually transmitted infections are among the most costly issues that the government must continuously invest in. It is therefore necessary that measures are put in place and adopted towards curbing that rising menace and one way through which this is being addressed is through these objects.
The 2020 objectives have been crafted with the sole mission of providing interventions that would in help to overcome challenges faced in management of sexually transmitted infections. The sexually transmitted genital herpes infection would therefore be accommodated within the objectives that span a duration of ten years after 2011. The sexually transmitted infections are however grouped into such categories as Bacterial STIs and disabilities, viral STIs and disabilities, female STD complications, newborn/fetus STD complications as well as health services at personalized level. The issue of genital herpes, therefore, being a viral infection has strategically been addressed within the set objectives (“Sexually transmitted diseases,” nd).
Health Promotion Guideline
This paper proposes a comprehensive research study that would target women between the age of 14 and 25, which encompasses young persons who are college bound or are recent college graduates and who form the bulk of sexually active persons. It is an ascertained fact that adolescent girls as well as young women run a higher risk of developing long term and adverse effects from STIs (‘healthy people 2020’, 2011). The objective of the study should be to analyze the effect of the awareness created through publicizing the “Healthy People 2020 Objectives” in the USA on the management of genital herpes among women. Besides, the paper tries to establish whether the publication of these objectives had any effect on behavior change. How can the government use the objectives for management of a healthy population? Finally, what incentives should be adopted in order to have people and especially women adopt behavioral change in order to lower incidences of genital herpes? A qualitative as well as quantitative study would therefore provide answers to these questions and therefore would facilitate policy formulation and direct future research on this topic.
Outcomes
This paper will be guided by the need to establish the rates of HSV-2 infections among women in the USA, particularly in the advent of the policy of ‘Healthy People 2020’. These findings will be instrumental for advanced primary health care and will allow practitioners to make informed strategic decisions when managing cases of genital herpes at the primary care level. The study will also offer an evaluation of the current government standards addressing sexual behavior, and will serve as a guide for those involved in academic curriculum development. It will also assist in promoting public awareness of the effects of STIs on the economy and on the need to control them. This study will also develop and propose effective intervention mechanism for reducing the risks of genital herpes infection among women.
Evaluation Plan
The efficacy of the proposed intervention will be evaluated through a number of tools. Among these tools will be a through comparison of the statistics of infections in women before and after the intervention procedures. We would also test the efficacy of the intervention plan through evaluation of such behavior patterns as multiple sexual partners, observance of safe sex, as well as possible change of behavior to embrace abstinence. The paper also proposes an evaluation mechanism by analyzing the resources channeled towards managing STIs in a stipulated time as revealed through the budgetary processes. Effectiveness of an intervention plan will be evaluated based on the outcome as against the anticipated outcomes. For instance, when a plan is employed with an aim of reducing new transmissions of the STIs among a certain target age group, an evaluation should be done to determine whether this has been realized or not. When new infections are recorded to be higher than prior to the intervention, then the policy should be reevaluated.
References
Center for disease control and prevention, (2013). Genital Herpes – CDC Fact Sheet. Retrieved from < http://www.cdc.gov/std/herpes/stdfact-herpes.htm>
‘healthy people 2020’, (2011). Sexually Transmitted Diseases – Healthy People. Retrieved from < http://www.hhdw.org/cms/uploads/Data%20Source_%20Other%20Reports/HP2020/STD_Healthy%20People.pdf>
Maurer F. A.,(nd). Chapter 8: communicable diseases. Retrieved from < http://www.elsevieradvantage.com/samplechapters/9781455707621/Maurer%205e%20Chapter%208.pdf>
‘Sexually transmitted diseases’, (nd). Chapter 25: sexually transmitted diseases. Retrieved from < http://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review_focus_area_25.pdf>
Stöppler M. C., (2014). Genital Herpes in Women. Retrieved from < http://www.medicinenet.com/genital_herpes_in_women_overview/article.htm>
