AIDS (Acquired Immunodeficiency Syndrome), the deadly disease caused by HIV (human immunodeficiency virus) has plagued the Sub-Saharan African countries more than any other region in the world. From the statistical reports of 2006, it was found that almost two-thirds of the total HIV infected population of the world and three-fourth of the total deaths due to AIDS are from this region. It is also reported that in 2006 alone, 1.9 million people were added to the list of those infected with the deadly retrovirus. The economic instability, the lack of education, and improper health care facilities all attribute to the spread of the epidemic in the region which is set to rise in the coming years. The disease in return would reciprocate its own deadly consequences upon the social and economic conditions of the region (Robson, 2006).
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The AIDS virus is not able to penetrate the skin therefore the basic mechanism of AIDS spreads only when it is exposed to the flesh or blood. Therefore it could be concluded that the activation and infection of the AIDS virus are only possible through blood as it is the only medium through which it is transmitted and not by the means of saliva, tears, or sweat. But there is enough evidence that the virus can be transmitted via body fluids like breast milk, semen, vaginal fluids, and obviously blood (Kumaranayake, 2003).
One of the major factors contributing to the prevalence of AIDS in the region is poverty. Poverty-related factors account absolutely for the majority of the AIDS-infected population. The poor community is generally characterized by the dearth of financial and human resources, such as illiteracy, lack of marketable skills, unhygienic living conditions, poor health status, and low productivity. Poor nutrition levels or malnutrition, again due to poverty leads to poor health and vulnerability to the deadly retrovirus. (Robson, 2006) Improper, damp housing and an unhygienic lifestyle is an important factor in causing disease such as TB which is related to HIV. The socially excluded groups, which are harder to reach, remain unaware and unenlightened about the STDs (sexually transmitted diseases) which they may carry due to their sexual behaviors. There is a rise in the number of prenatal transmissions of HIV from mothers to babies. HIV is also transmitted to babies through breast milk (Kumaranayake, 2003).
Information, Education, and Communication (IEC) activities regarding HIV/AIDS play a vital role in creating awareness among the people of the region. They do so by a number of activities such as conducting street plays and role-play skits, involving high profile celebrities in creating awareness, displaying hoardings and posters, conducting discussions on radio and televisions. However, these messages are highly irrelevant to the poverty-stricken people as they do not have the resources to do what they are urged to do. Thus, unless the socio-economic conditions of the poor are not realized and improved their behaviors are unlikely to change.
Prenatal transmission of HIV/AIDS is avoidable by the usage of AZT drugs and the appropriate mode of delivery. However, these drugs and other necessary infrastructure are unavailable to most African women. Transmission of the disease through breast milk can also be prevented by baby formula with clean water. Neither clean water nor the resource for buying the baby formula is available to the poverty-stricken African women (Robson, 2006).
Modern medicines have come out with anti-retroviral drugs (ARVs) which slow down and reverses HIV infection, delaying the onset of AIDS by more than twenty years or more. ARV also reduces the HIV quantity in the blood and reducing the danger of transmission but an infected person has to continue the drug used for the rest of his life. However, these ARV drugs are expensive and hence, out of reach of the economically restrained African communities. Thus, we can conclude that poverty directly influences the spread of HIV/AIDS in Africa (Kumaranayake, 2003).
Another major driving force for AIDS is the high rate of unsafe heterosexual intercourse. The large numbers accounting for the children with HIV are evident of the high rate of sexual transmission of the retrovirus. AIDS is highly concentrated among heterosexuals because of the increasingly high rate of female genital mutilation, leading to higher rates of oral and anal intercourse, and culturally accepted extramarital sexual activity, including widespread prostitution. Female genital mutilation is a cultural practice in Africa according to which the removal of female genital parts completes a woman and grants them womanhood. According to the survey reports of Burkina Faso, Cameroon, Ghana, Kenya, and the United Republic of Tanzania (sub-Saharan region), two-thirds of the HIV-infected couples were serodiscordant. Serodiscordant means that among the infected couple, one of them was infected. Among the serodiscordant couples surveyed, it was found that women accounted for 30% to 40%, explaining that more than half of the surveyed women were infected by someone other than their partner (Gould, 2005).
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Condoms play an important role in restricting and preventing HIV infection. Considering the spread of HIV infection in the Sub-Saharan region, and because of its easy availability and cost-effectiveness, condoms can be considered as the most viable option in restricting the spread of the epidemic. However, according to a survey in Burkina Faso, 90 % of the cohabiting couples said they practice unprotected sex. (Robson, 2006) A number of social and cultural practices and customs attribute to the restricted use of condoms in the region. Among many tribes of Africa, unprotected sexual intercourse is prescribed by, and a part of, religious customs. Lack of awareness among the people in the region about safe sexual practices is another factor attributing to the non-usage of condoms.
Prostitution and sex work is another vital factor contributing to the increasing rise of AIDS in the region. More than 35% of the sex workers in the sub-Saharan region are living with HIV. (Robson, 2006) Age-old dogmas of the tribes of “selling off the girl child” contribute to the rise of the number of child sex workers. The myths that sexual intercourse with a child would cure AIDS not only contribute to the increasing number of child sex workers but also add to the spread of HIV infection (Kumaranayake, 2003).
In the recent surveys, the issue of unprotected anal sexual intercourse between men contributing to the HIV infection was brought to light. It was found that one in three men who have sex with men tested positive for HIV-positive. The type and frequency of sexual intercourse among homosexuals is the perfect mechanism of spreading the body-fluid-borne retrovirus. A typical homosexual is polygamous engaging in sexual activities with more than one partner and hence, further increasing the incidence of spreading the epidemic.
Another major form of transmission is drug abuse by using infected syringes. Drugs junkies, and abusers, usually use the same syringe to inject the drug in a group, thus enabling direct transmission of the HIV virus. In some parts of the sub-Saharan region, the use of contaminated injections is the major form of transmission of the deadly virus (Putzel, 2004).
Furthermore, the health and care system in Africa is very poor and lacks proper adequate infrastructure. Proper care is not taken when handling the medical equipment. The same syringes are used, again and again, the surgical equipment is not properly sterilized and cleaned and the surroundings are kept unhygienic creating perfect conditions for the spread of the virus. HIV along with its biological consequences also brings about certain social restrictions. HIV-related stigma is an enormous barrier to the fight against AIDS. The HIV-infected community is scared to admit their HIV status publicly due to their fear of discrimination and thus preventing them from getting tested and seeking proper treatment (Robson, 2006).
One major social reason for the advent of HIV in Africa is the lack of education, especially among the girl child. Due to improper educational infrastructure where the teacher-student ratio is near 1:120 the schools have to turn away the students. Poverty too again restricts the children from attending schools and look for jobs. HIV orphaned children are also discriminated against and stigmatized at schools leaving them isolated and hence leading them to leave the schools. The additional stress over these children by HIV/AIDS like nursing one’s parents, or earning food and money for the family contribute to resulting consequences such as lack of concentration, incompletion of homework, or discrimination from other students. This explains the large number of absentees among those children who are indirectly affected by HIV (Gould, 2005).
The lack of education not only restricts awareness of HIV/AIDS but also deprives them of skills and labor productivity, thus creating an unending cycle between illiteracy, poverty, and hence, HIV/AIDS. These children are the next generation of the poor and low productive mass intensifying the dangerous situation in Africa. They also represent the future of Africa and its challenge for sustained productivity growth and development.
Tackling HIV/AIDS in Africa is a long and tedious task that requires an enormous amount of sustained effort and rigorous planning. There have been numerous international policies and funds which have been created to restrict the growth of HIV infection by improving the prevention campaigns and the treatment and care for those living with HIV. In recent years, the funding from the developed and other developing countries has increased significantly and the awareness of the plight of the sub-Sahara African people is more global. However, the massive scale of the AIDS epidemic requires even more money. (Putzel, 2004)
In conclusion, it can be stated that domestically, HIV treatment and prevention programs have to be upped. The country’s health, education, communications, and other infrastructure has to be developed for the cause of the HIV epidemic. The government needs to address policies and programs to efficiently improve the basic infrastructure of the country especially education, and sustain resources. More and more AIDS awareness and prevention campaigns that would render knowledge about the disease and its transmission and conduct checkups need to be undertaken. The social issue of HIV-related stigma and discrimination also needs to be addressed. Another major step that needs to be highlighted is the issue of helping the women, educating them, and making them aware of the situation.
- Gould, W. T. S. (2005). Vulnerability and HIV/AIDS in Africa: from demography to development. Population, Space and Place, 11(6), 473-484.
- Kumaranayake, L. (2003). Resource allocation and priority setting of HIV/AIDS interventions: addressing the generalized epidemic in sub-Saharan Africa. Journal of International Development, 13(4), 451-466.
- Putzel, J. (2004). The global fight against AIDS: how adequate are the national commissions? Journal of International Development, 16(8), 1129-1140.
- Robson, E. (2006). Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa. Population, Space and Place, 12(2), 93-111.