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HIV, AIDS Prevention: Sonagachi Project

Introduction

Any complete program on health ought to educate people on the need to take proper care of it by living a healthy lifestyle. An effective health program aspires to manage the health of people by ensuring quick access to affordable health care. Until recently, the concept of HIV prevention has been directed towards healthy people who ignore those infected with HIV (HAD 2001). This is because many ignore the fact that people infected with HIV engage in sexual activities. A strong health promotion program seeks to prevent HIV, for which is vital to start by curbing onward transmission.

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Taking into account the results of the case study conducted by Cornish and Ghosh, the instances of people getting infected with the HIV virus in India have increased recently, which gave reasons for conducting a research known as the Sonagachi Project. This essay gives the background to the HIV epidemic and the necessary prevention methods. Later, it compares the Sonagachi project on sustainable community intervention programs to components of a quality health promotion.

HIV

HIV stands for Human Immunodeficiency Virus which has now become a global epidemic (Ali, Wassie & Greblo, 2012, 121). HIV specializes in attacking the human body by lowering its level of immunity, therefore making it vulnerable to other diseases. HIV can go undetected for a long time with mild symptoms such as common cold, fever and cough. After a series of attacks from other common diseases HIV builds itself to the level of Acquired Immune Deficiency syndrome (AIDS). AIDS is the last stage of HIV (Elizabeth, 2012). Statistics done in 2010 estimated the number of people currently living with HIV in the world to be 34 million, 50% of whom were women. New infections per year totaled to an alarming 11.4%. The total number of deaths was 1.8 million per year (UNAIDS, 2010). It goes without saying that HIV remains the plague of the XXI century. Analyzing the key HIV determinants and figuring out the specifics of the Sonagachi Project, one will possibly find out the probable health promotion practices which can reduce the number of HIV/AIDS contractions.

The literature review

Before dealing with the HIV prevention program and the issues concerned, it is necessary to deal with the research which has been done so far on the issue concerned. To start with, it is important to consider the paper by Cornish & Ghosh. Exploring the HIV prevention, they offer a specific case study, i.e., the study of HIV prevention in India. According to the results of the research, “Over the course of its 14 years, the Sonagachi Project has empowered many sex workers with new skills, confidence and legitimacy” (Cornish & Ghosh, 2004, 505). Therefore, it can be suggested that successful HIV prevention is possible once people’s awareness is raised.

In respect of the Sonagachi Project, it is necessary to mention that the latter is not the only attempt at defining the HIV/AIDS determinants and establishing HIV/AIDS preventive measures. Analyzing the research conducted by Shannon & Montaner (2012), one must admit that there are considerable measures established for the HIV prevention, especially at work. It is quite important, though, that the authors of the research focus rather on the research of the problem than on the search for the solutions; in the end, Shannon & Montaner (2012) provide a detailed account of the world statistics on the male and female HIV contractions at work, yet the only solutions which the authors offer are to enhance the health promotion without specifying the types of the latter or the methods if its implementation. Hence the need for such a research as Sonagachi Project arises.

However, to give credit where it belongs, Shannon & Montaner (2012) did a very good job not only on the statistical data on the male/female HIV contractions, but also offered the HIV contractions geographical data. The given research can be viewed both on its own and at the same time as a continuation of the Sonagachi Project. According to the authors, these are the Asian regions where HIV has taken over the greatest amount of the population (Shannon & Montaner, 2012, p. 501). The information offered by Shannon & Montaner (2012) is extremely useful for the further research.

Another significant contribution to the means of preventing HIV with the help of health promotion practice, the paper written by Jana, Basu, Rotherham-Borus, & Newman (2004) helps to dive deeper into the peculiarities of the aforementioned Sonagachi Project. Describing its goals and showing its specifics rather graphically, the authors have managed to convey the essence of the campaign and outline its results concisely. The last, but not the least, the paper by Evans & Lambert (2008) deals with the issues of condom use. Quite essential for the prevention of the HIV contractions, this is the research that provides a practical approach to the health promotion practice, which, according to the Sonagachi Project, must focus on informing people about the HIV/AIDS.

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Hence, it can be considered that the key HIV/AIDS determinants are poverty and the lack of sexual education among the population of the state. Therefore, it can be suggested that at present, there are three basic health promotion practices concerning the HIV issues, which are the Sonagachi Project, informing people directly concerning the means to prevent the HIV and informing people on the proper use of various protectants like condoms. Learning the common HIV determinants will help define the key strategy for making the rates of HIV contractions lower, as well as check if providing the information concerning HIV/AIDS can possibly help solve the issues among sex workers in India.

HIV determinants and strategies for HIV prevention

Learning the basic HIV determinants will help to figure out the best way to prevent HIV. On the one hand, the key determinants for HIV were outlined quite a long time ago, and nowadays every single person knows that sharing needles, as well as promiscuous sexual relationships are the shortest way to get HIV/AIDS. However, it is still worth keeping in mind that, with the development of civilization, new determinants of HIV appear, which means that new measures of precaution must be applied to apply an efficient health promotion.

According to the Sonagachi Project, the social issues are also to be considered, especially when dealing with the sphere of sex workers: “As an outcast group, there was little societal value of sex workers or acknowledgment of the important social role played by the women” (Jana, Basu, Rotherham-Borus, & Newman, 2004, p. 410). As Gerbi, Habtemariam, Robnett, Ngwana, & Tameru (2012) explain, religion used to be the shield that protected people from HIV/AIDS for quite long time; indeed, it seemed absurd that a person who has devoted his/her life to serving God and following His Commandments, as well as the key principles of the teachings of Christ as they are explained in the Bible, can possibly choose the track of life that will lead him/her to HIV/AIDS. However, as Gerbi, Habtemariam, Robnett, Ngwana, & Tameru (2012) claim, religious beliefs no longer mean that one is completely safe from getting HIV/AIDS: “Studies mentioned previously have identified religion as a possible protective factor against HIV infection. However, religious affiliation and attendance of religious do not always correlate with HIV protective behaviors” (Gerbi, Habtemariam, Robnett, Ngwana, & Tameru, 2012, p. 137). However, according to the research conducted by Kownaklai, Rujkorakarn, Tanwattananon, & Williams (2012), drugs and promiscuous sexual relations still remain the key determinants in the HIV contraction:

The study findings are consistent with the UNAIDS report that AIDS infected persons are in the working/reproductive age group, and the risk factor of infection from sexual intercourse is most common (UNAIDS and WHO, 2009). Most persons in this study also had low incomes, and needed money for daily needs and for health care. (Kownaklai, Rujkorakarn, Tanwattananon, & Williams, 2012, p. 117)

In addition, it is essential that people should know as much as possible about the threats of HIV/AIDS and the means to avoid it, which is, unfortunately, a huge problem in some communities. According to the research conducted by Fawole, Ogunkan, & Adegoke (2011), “lack of communication between parents and child about sexually; high level of illicit sexual; high incidence of campus prostitution, poverty or hash economic conditions among other factors” (Fawole, Ogunkan, & Adegoke, 2011, p. 65) predetermine the increase of the instances of HIV contractions considerably.

Thus, it can be considered that at present, the key determinants of HIV/AIDS are still promiscuous sexual relations and drugs, which makes the Sonagachi Project all the more important, given the fact that the sex workers are in the limelight of the research. However, the aspect of low income has been added; moreover, according to the research, most of the people contracted with HIV are those working in the office and having families. Hence, it is no longer instability that determines the desire to do drugs or to have promiscuous sexual relations and, hence, leads to HIV contraction, but the social status and, probably, insecurity which can be either the result of immigration (Ramsden & Hopkins, 2012) or any other change in one’s personal life. In addition, the aspect of learning about the basic ways to avoid HIV/AIDS contraction have also been highlighted; as it turns out, one of the most significant HIV determinants in the present-day world is the lack of information about its threats among the people under age. Thus, it is crucial that people should understand that the more they know about HIV/AIDS and the more preventive measures they take to make the threat as little as possible, the less chances they have to get contacted with HIV/AIDS. Therefore, it seems that the key strategy in health promotion will be offering the required information about the threats of HIV/AIDS, about the ways people get contracted with it, and about the means to avoid the disease, which is exactly what the Sonagachi Project offers. The researchers involved in the Sonagachi Project are moving in the right direction; once people are informed, they are armed against the HIV.

Health promotion practices

It is worth mentioning that in the current strategy of HIV prevention, there are certain serious flaws, which the Sonagachi Project outlines as well. It seems that, because of the wrong issues that the current strategy focuses on, the problem still remains unresolved. Indeed, according to what Mongkuo, Mushi & Thompson (2010) claim, the tendency to blame mainly sexual relationships between men has aged and is no longer true: “prevention messages tailored only to MSM or non-MSM individuals may not reflect the current state of sexual behaviors” (Mongkuo, Mushi & Thompson, 2010, 33). Therefore, it is obvious that a new strategy of health promotion must be adopted; it is important to add that the new health promotion strategy must focus on keeping the Indian sex workers informed about the threats of HIV/AIDS. It is essential that the Sonagachi Project offers the ways to improve the existing health promotion practices.

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Alemayehu & Aregya (2012) offer another peculiar approach worth considering. According to the authors, it is essential not only to increase the awareness of the HIV/AIDS contraction among the healthy population, but also offer all the required information both on how to prevent the HIV infection from developing further on and on how to sustain life in a person who has AIDS, among the people who are already contracted with the virus.

Another possible idea for the health promotion practice that one can suggest is, according to the innovative research offered by Ali, Wassie & Greblo (2012) is to use the human resources more efficiently. Considering the number of instances of the HIV/AIDS contractions among the workforce of the Asian countries, the authors offer a peculiar health promotion program that can possibly change people’s perception of HIV/AIDS and the people carrying the virus. As the authors claim, “The human resource is the first and foremost important aspect of any disease control programme and thus for HIV/AIDS and other disease control initiatives” (Ali, Wassie, & Greblo, 2012, p. 122). Therefore, according to the authors, one of the most obvious solutions to increase people’s awareness of the dangers and threats of the HIV infection, as well as to help those who have already been infected, the authors suggest a better trained staff. Indeed, it seems that in the sphere of HIV/AIDS prevention and treatment, there is an increasing need for professionals who can offer people decent help and verified information. The last, but definitely not the least, the idea of promoting health is giving enough information on all sorts of barrier devices for preventing sexually transmitted diseases, starting with condoms, as Dutta & Maiga (2011) stress.

Conclusion

Therefore, it is clear that at present, there is no panacea for HIV. Despite all the attempts to cure the disease, the virus is still uncontrollable and can spawn AIDS syndrome at literally any point, which means that there is still a lot of work to be done. Nevertheless, it seems that with the help[ of the research mentioned above, certain strategies concerning the HIV treatment can be worked out, which will bring people one step closer to providing the solution for the given problem.

Hence, it can be considered that a good health promotion includes a number of various elements, such as providing the necessary information on the current health issues. Moreover, good health promotion goes beyond offering the exercises to train and a specific diet to keep with. In addition to good nutrition rules and healthy lifestyle, good health promotion also involves the instructions on the most topical health problems, as well as the recommendations on how to avoid the most dangerous diseases and, in case of the contraction, the most up-to-date means of curing these diseases. With the help of the ideas introduced in the Sonagachi Project, one will be able to bring down the rates of HIV/AIDS contractions.

Reference List

Alemayehu, B, & Aregya, A, 2012, ‘Desire to procreate among people living with HIV/AIDS: Determinants in Ethiopia: a cross-sectional study’, Journal of AIDS and HIV Research, vol. 4 no. 5, pp. 128-1356.

Ali, F, Wassie, B, & Greblo, A, 2012, ‘HIV/AIDS control programmes in developing countries: the role of human resource’, Journal of AIDS and HIV Research, vol. 4 no. 5, pp.121-127.

Cornish, F & Ghosh, R, 2007, ‘The necessary contradictions of ‘community-led’ health promotion: a case study of HIV prevention in an Indian red light district’, Social Science & Medicine, vol. 64, no. 2, pp. 496-507.

Dutta, A, & Maiga, M, 2011, An assessment of policy toward most-at-risk populations for HIV/AIDS in West Africa. Accra, Ghana, Action for West Africa (AWARE-II) Project.

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Evans, K & Lambert, H, 2008. ‘The limits of behaviour change theory: condom use and contexts of HIV risk in the Kolkata sex industry’, Culture, Sex & Sexuality: An International Journal for Research, Intervention and Care, vol. 10 no. 1, pp. 27-41.

Fawole, A O, Ogunkan, D V, & Adegoke, G S, 2011, ‘Sexual behaviour and perception of HIV/AIDS in Nigerian tertiary institutions: University of Ilorin, a case study’, Global Journal of Human Social Science, vol. 11 no. 1, 65-71.

Gerbi, G B, Habtemariam, T, Robnett, V, Ngwana, D, & Tameru, B, 2012, ’The association between religious affiliation and frequency of attendance at religious services on HIV risky behaviors among people living with HIV/AIDS’, Journal of AIDS and HIV Research, vol. 4 no. 5, pp. 136-143.

Jana, S, Basu, I, Rotherham-Borus, M J, & Newman, P A 2004, ‘The Sonagachi Project: a sustainable community intervention program’, AIDS Education and Prevention, vol. 16 no. 5, pp. 405–414.

Kownaklai, J, Rujkorakarn, D, Tanwattananon, W, & Williams, P D, 2012, ‘Disclosure of information by patients about HIV/AIDS infection in Northeastern Thailand’, Journal of AIDS and HIV Research, vol. 4 no. 5, pp.113-120.

Mongkuo, Y M, Mushi, R J, & Thompson, R, 2010, ‘Perception of HIV/AIDS and socio-cognitive determinants of safe sex practices among college students attending a history black college and university in the United States of America’, Journal of AIDS and HIV Research, vol. 2 no. 3, pp. 32-47.

Ramsden, H, & Hopkins, S, 2012, ‘An exploration of human immunodeficiency virus (HIV) knowledge gaps among male migrant workers in Singapore’, Journal of AIDS and HIV Research, vol. 4 no. 5, pp. 144-151.

Shannon, K & Montaner, J S G, 2012, ‘The politics and policies of HIV prevention in sex work’, The Lancet, vol. 12 no. 7, pp. 500-502.

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