Although the issue of HIV/AIDS has been researched extensively over the past few decades, it still remains one of the key factors affecting the increase of the death toll in a range of states. Based on the 2013 estimation, 35,000,000 people have HIV/AIDS (Global statistics, 2014). Statistical data shows that of all areas, the Sub-Saharan Africa regions have been affected the most due to certain environmental, economic, and social factors, the number of HIV/AIDS patients estimating to a total of 24,700,000 people (Global statistics, 2014). In Kenya, a 5.6 prevalence of HIV and a 0.4 incidence thereof was registered in 2014 (Global statistics, 2014).
While, compared to the previous records, there is a minor tendency for the HIV incidence to decline, the situation still beyond atrocious. As far as the key determinants of HIV/AIDS contraction in Kenya are concerned, heterosexual transmission and the disregard for the HIV status of the partner deserve to be mentioned first as the key source of the disease: “In Kenya, Uganda and Malawi, over 80% of all unprotected sex acts by HIV-infected persons occur with spouses or cohabitating partners” (Kaiser et al., 2011, p. 1).
Age as Risk Factor
As the study by Kaiser et al. (2011) shows, the people, who have reached the age of consent, are the most vulnerable denizens of the Kenyan population. The specified age group includes both men and women, aged 18 (Legal/statutory marriage in Kenya, 2015). However, seeing that the age of sexual activity in Kenya is 16 (Legal/statutory marriage in Kenya, 2015), the specified risk group should include men and women aged 16–17 as well. One should also mention that the children of the Kenyan married couples are also under a major threat due to the vertical HIV/AIDS transmission (Forbes et al., 2012).
Compare
While the issue of HIV/AIDS contraction in Kenya is clearly becoming increasingly more significant, compared to some of the European states, Kenya seems to be showing a rather positive tendency. To be more accurate, while being the state with the highest rate of HIV/AIDS patients, Kenya has still been displaying certain progress over the past few years, including the aforementioned reduction in the number of HIV/AIDS contractions. Some of the European states, in their turn, have been showing a dangerous downgrade in HIV/AIDS prevention. For instance, in 2011, 1,300 incidents of HIV/AIDS-related deaths were registered (European HIV and AIDS statistics, 2011). Although the specified statistics are barely significant compared to the mortality rates enhanced by the HIV/AIDS issue in Kenya ( correspondingly), France could make much better use of the technological advances that are at the disposal of the French healthcare services.
Conclusion
Nevertheless, when comparing the data without attributing it to the level of economic development within the state, the social issues, and the financial concerns, one still has to admit that the difference between the Kenyan and the French HIV/AIDS statistics is rather drastic. While in France, there are thousands of people that have HIV/AIDS in Kenya, there are millions; therefore, the situation in Kenya is obviously much more deplorable than in any European or American state.
It would be wrong, however, to detach the data from the economic and political factors entirely. A closer look at the problem will reveal that the poverty issue and the unavailability of healthcare services aggravate the situation. For instance, the aforementioned issue regarding marriages could be addressed by spreading awareness concerning the significance of an HIV/AIDS test and the threat of conceiving children when one of the partners is HIV positive.
Reference List
European HIV and AIDS statistics. (2011). AVERT. Web.
Forbes, J. C., Alimenti, A. M., Singer,J., Brophy, J. C., Bitnun, A., Samson, L. M., Money, D. M., Lee, T. C. K., Lapointe, N. D. & Read, S. E. (2012). A national review of vertical HIV transmission. AIDS, 26(6), 757–763. Web.
Official Country Name: United Kingdom of Great Britain and Northern Ireland
Continent and Region: Europe and Western Europe
Neighbouring States: France and Ireland
Governmental System: Constitutional Monarchy
Economic System: Liberal service based economy
Head of State: Prime Minister David Cameron (CIA, 2010)
Member of International Political Organizations (e.g. NATO)? NATO- a founding member and also the Commonwealth. A Security Council member of the UN. It also belongs to the G-8, IMF, Paris Club , Australia Group, IFC and many others such as Interpol.
Member of International Economic Organizations (e.g. ASEAN)? OECD, IEA, G-20, ILO, IMO, EAPC and BIS
Member of Other International Organizations? It is in the European Union. Nonetheless, it has chosen not to implement some of the issues surrounding the Monetary or Economic Issues.
Total population. 61, 284, 806
Average Life Expectancy. 79.16 years
Literacy rate (%). 99
Official Language. English
Major religion(s). Christianity accounting for 71.6%, Islam -2.7% and Hindu-1%
Allies. US, France and Ireland
Major trade partners. US (Biggest trading partner), France, Germany, Belgium, Spain, Netherlands and Ireland
Countries with which your Country has friendly/adverse relations. Conflicted with Spain over autonomy, Argentina over Island territories, Iraq, Afghanistan and other Arab Nations over involvement in the US led 2002 invasion of Afghanistan and Iraq.
Former Colonial Powers (if applicable). Not applicable
Former Colonies (if applicable). India, South Africa, Zimbabwe, Nigeria, Uganda, Tanzania, Kenya, Ghana, Egypt (CIA, 2010)
History of United Kingdom
Early history. England was in place from 10TH C, It then joined forces with Wales in 1284 and then included Scotland in 1707. In 1801, Ireland was made part of Great Britain but was later partitioned in 1921 to leave only Northern Ireland as part of the UK.
Recent history. The country has recently been fighting for constitutional reform. It has also been at the forefront of instating devolutions. Its involvement in the EU has made a continental and hence a global force intended on influencing other nations’ foreign policy. The UK enjoyed high economic growth in the last half of the twentieth century and the early twenty first, however, the global economic recession tool a toll on them. It has also been struggling with territorial defences over assemblies by Northern Ireland. (CIA, 2010)
HIV/AIDS
Four major threats affecting my state
The United Kingdom is confronted with a series of challenges. Obesity has become a serious cause for concern. This has permeated across all major age groups, including the youth and members of the older population. Several awareness campaigns have been launched through the media and other concerns in order to reduce obesity and hence the other health complications that arise from it. Secondly, crime is a pressing problem as well.
This is especially common in the major cities like London. Matters have been worsened by high immigration rates which have been linked to this trend in subsequent times. (Weild, 1998) In order to solve the problem, police and prison reforms have been instated. Mental illness as a social challenge has also taken on centre stage. Concerns over providing proper medical care to these groups of individuals has been raised. Teenage pregnancies are also another crucial issue as well. (Pickett & Wilkinson, 2009)
AIDS statistics
In the United Kingdom, there are currently eighty three thousand HIV positive and AIDS infections; it was found that out of this number, three quarter knew of their status while the rest did not.
This represents a percentage of about 0.3 of the entire UK population. Statistics show that the latest infection rates were 7, 928 newly infected persons. Out of the total number of people infected, 593 died in 2005. This compares to a total of 1, 720 deaths in 1995. Therefore, mortality rates for the disease have dramatically reduced in this time frame (HPA, 2009)
Percentage of those infected who are women
The latest statistics on HIV/ AIDS prevalence in the UK demonstrate that approximately, 32, 833 women out of the 105, 625 HIV cases are women. This represents about 31.09% of the infection rates within the population. Part of this disparity could be brought on by the fact that one of the common infection routes i.e. male-male intercourse is accountable for a high percentage of infection rates in the state.
In this regard, 44, 537 of the 105, 625 HIV cases in the country were caused by male-male intercourse. Furthermore, heterosexual relations also involve males; in the end, men happen to fall in the two categories and will eventually report higher prevalence rates than their female counterparts who mostly belong to the heterosexual transmission route. (Dougan, 2007)
Percentage of young people infected and possible explanations
For persons under the age of 15, it was found that they represent 2% of the infection. Those between the ages of 15-19 also represented a fairly small percentage i.e. 2.1% percent. The individuals between 20-24 represent 10% of infection rates while the age group with the highest infection rates is 30-34 years (Avert, 2010).
The latter accounted for 22%. Those between 25-29 years represented 19.9% of the population. It can be said that the lower prevalence rates among those below age 20 occur because few of them engage in heterosexual relations. The latter transmission route is accountable for the highest number of HIV infections. Furthermore, male – to male intercourse and drug use are also highest on the middle age bracket which is 30-34 so younger people are not engaging in these activities and have therefore been spared from transmission.
The country’s principle reasons for transmission
Sex between males is one of the major routes of transmission within the UK. This is perpetuated by practising unsafe behaviour such as having more than one partner and the lack of condom use. The tendency to engage in risky behaviour within this group has been denoted by the fact that sexually transmitted diseases are highly prevalent. The other route (which accounts for the highest infection rates) is heterosexual relations.
Engagement in risky behaviour within this group has also been reported to be a major reason for infection. Some individuals tend to have more than one partner. (Elam, 2006). Furthermore, others actually acquire it from other countries that are known for relatively high infection rates during periods of travel. Lastly, drug use has also been cited as an important factor in transmission. (UK collaborative HIV and STI surveillance group, 2004)
Risky behaviour amongst gays has been targeted by the government and other HIV initiatives during the nineties and this resulted in lower cases. However, it seems as though the campaign momentum was not sustained and it led to a plummeting of infections in subsequent years.
Needle exchange programs for drug users were also introduced and this accounted for a decrease in infections from the latter group. Political will does exist and has contributed to lower rates. (Department of Health, 2001). Nevertheless, more needs to be done in terms of reinforcing safe sex messages as risky behaviour accounts for most of the issues.
Extent of effectiveness of local and national prevention initiatives
Prevention initiatives within the UK seem to be working because HIV diagnoses over the past ten years have risen. (Brown et al, 2006). Consequently, this has ensured that counselling of uninfected partners has occurred. Furthermore, there has been a continual emphasis on recently infected HIV patients who are counselled on preventing further infections.
Also, mother to child infection rates have been reduced to the bare minimum so this is definitely a step in the right direction (Townsend, 2008). However, there are still challenges in the drug taking sector because the state has moved towards needle exchange programs in pharmacies (Hope, 2005), (Hope et al, 2002). This may put the latter group at a higher risk of infection because counselling may not occur in such settings.
Progress made within the country in terms of international agreements
The sixth Millennium development goal is to combat HIV, Malaria and other diseases. (Department for International Development, 2010) The target would be to reverse HIV spread in five years time i.e. by 2015. An analysis of the HIV infection rates in UK demonstrates that there is no consistent rate of infections over the past ten years.
In 2002, new infection rates accounted for 6,322. This increases to 7,373 and 7,849, 7,975 in 2003, 2004 and 2005 respectively. The latter were patterns of increase. On the other hand, the numbers started dwindling after 2005, to 7,608, 7,495, 7,298 in 2006, 2007 and 2008 respectively. Statistics for 2009 are yet to be published (Sullivan, 2005). The country needs to maintain the trend over the last four years and if does then it will be working towards achievement of the millennium goals.
References
CIA (2010). United Kingdom. Web.
Pickett, K. & Wilkinson, R. (2009). Spirit level: why more equal societies almost always do better. London: Allen lane.
Dougan, S. (2007). HIV Diagnosis among men and HIV testing. Sexually transmitted infections journal, 83(2), 56.
Health protection agency (2009). HIV in the UK – 2009 report. Web.
Avert (2010). UK statistics summary. Web
Sullivan, K. (2005). Newly diagnosed HIV infections-Ireland and UK review. British medical Journal, 330(5), 1301.
Townsend, C. (2008). Mother to child HIV transmission, AIDS journal, 22(5), 8.
Hope, V. (2005). HIV prevalence amongst drug users in England and Wales from 1990 to 2003. AIDS journal, 3(21), 19.
Department of Health (2001). National sexual health and HIV strategy. London. Department of health.
UK collaborative HIV and STI surveillance group. (2004). Focus on prevention: HIV and sexually transmitted infections in UK. London, Health protection agency centre for infections.
Hope, V., Rogers. P. & Jordan, L. (2002). Increase in needle and syringe sharing in England and Wales. AIDS journal, 16(2), 2494.
Department for International Development. (2010). Millennium Development Goal Six. Web.
Weild, A. (1998). HIV prevalence and associated risks. International AIDS conference.
Brown, A., Logan, L. & Fenton, K. (2006). Monitoring effectiveness of HIV prevention initiatives in Great Britain. Sexually transmitted Infections journal, 82(4), 4-10.
Elam, G. (2006). Barriers to voluntary HIV testing among Africans in England. HIV medicine journal, 7(1), 28.
In contemporary times, AIDS has become manageable courtesy of discovery of lifesaving drugs in 1996. Since then, AIDS death casualties have been on the decrease with life expectancy taking the opposite direction. Actually, an AIDS victim today may live to average of 65 years of age and this is commendable.
Unfortunately, this good news have been stained with misconceptions that AIDS is not a big issue. Consequently, people, especially youth have gone out to experiment with all forms of sexual activities most of which are unprotected hence unsafe. As a result, there has been a sharp increase in new infections amongst youth, gay men, and intravenous drug addicts.
Moreover, this misconception has allowed AIDS to take its toll on African-American women, a forgotten demographic. Studies indicate that, AIDS remains the top cause of death amongst African-American women aged between 29 and 34. On the other hand, as aforementioned, life expectancy is on the rise as evidenced by ageing. These intriguing facts make AIDS management an area of great interest and this paper expounds these facts.
‘Manageable’ AIDS
As aforementioned, AIDS is manageable in contemporary times. This came with the introduction of lifesaving drug regimen in 1996. Introducing the lifesaving drug initiative, the chair of Stop AIDS campaign said, “Innovative initiative will be operating within a year helping to deliver vital drugs and save millions of lives…the pool should help to save the lives of millions living with HIV across the developing world who are unable to access the life-saving medicines they need” (Walker, 2009). True to these words, the fight against AIDS has borne significant fruits.
Life expectancy has been on the increase; an AIDS victim today would live to age of 65 years. The lifesaving drug regimen constitutes use of combination therapy whereby, patients use more than one antiretroviral drug. The common antiretroviral drugs include zidoduvine, lamiduvine, lopinavir, tenofovir, and staduvine among others.
The combination of these drugs offers better management of AIDS. “Combinations of antiretroviral drugs create multiple obstacles to HIV replication, which keeps the number of offspring low hence reducing the possibility of a superior mutation” (Dybul, Fauci, Barlet, Kaplan & Pau, 2002, p. 381).
This option of combined therapy therefore makes AIDS management a reality. There has been extensive research in this field and with improving technology; researchers have formulated guidelines of AIDS management. This includes determination of viral load and CD4 cell count.
It is well known that, if a person starts treatment therapy before CD4 cell count goes below 350/uL, this person is likely to live until sixties. Therefore, AIDS management is surmountable in contemporary times and people are benefiting from it. There are few drawbacks presented by AIDS management by use of retroviral drugs; however, the benefits outweigh the drawbacks hence helping AIDS victims greatly.
Increased Infections amongst Vulnerable Groups
Unfortunately, there have been misconceptions about AIDS management. People have presumed AIDS management means AIDS cure; consequently, they have involved themselves in risky sexual behaviors like unprotected sex. This has led to increased new infections. Among the most vulnerable groups, include youths, gay men, prostitutes, and drug addicts who use intravenous drug administration.
According to Hall, Ruinguang and Rhodes (2008), “An estimated 4,883 young people received a diagnosis of HIV infection or AIDS, representing about 13% of the persons given a diagnosis during 2004…81% of persons aged 15–24 , 70% of persons aged 13–14; 61% of all person” (p. 525). This shows that even though AIDS is manageable, many youth opt to contract it to manage it later.
This fact is disheartening, as youth seem to have forgotten the old adage that, prevention is better than cure. The increase in number of new infections stems from the misconstrued belief that if AIDS its manageable; therefore, one can contract it. This is risky especially given the fact that, as aforementioned there are challenges facing AIDS management by use of retroviral drugs. Who knows, in future, the challenges may be insurmountable meaning that many will die young due to misconception.
Homosexuality is another area rocked by increase of new infections. According to Centers for Disease Control and Prevention (2003), “Till now; 75 to 85 percent of AIDS cases reported are related to homosexual activity, promiscuous heterosexual sex and Intravenous drug abuse” (p. 68). This signals danger in matters concerning AIDS. The fact is the announcement that AIDS was manageable, heralded new trend whereby these groups of people, which happen to be the most vulnerable, went out and engaged in all forms of dangerous sexual activities.
Finally, even though there are claims that AIDS prevalence is low amongst prostitutes, researches indicate that, “High rates of HIV have been found amongst individuals who sell sex in many different and diverse countries…where HIV prevalence is low amongst this group; it is usually higher than the rate found amongst the general adult population” (Kakar & Karkar, 2001, p. 31).
This discovery is disturbing. The fact is that, commercial sex workers are at a high risk of contracting HIV because they are exposed to this virus often. Despite the fact that they claim to use protection, there are many issues involved here like doing the business under the influence of drugs. On the other side, drug addicts using intravenous form of drug administration risk contracting AIDS because it can be transmitted via shared syringes.
AIDS amongst African-American Women
As aforementioned, AIDS remains the greatest cause of deaths amongst African-American women. Apparently, this group seems to be a forgotten demographic. AIDS prevalence amongst these individuals has nothing to do with skin color or ethnicity; on the contrary, it is based on numerous challenges that stand in the way of African Americans in obtaining proper health care. These barriers include sexually transmitted diseases, health beliefs, and poverty among others.
Study carried out by CDC indicates that, “even African Americans account for about 13% of the US population, they account for about half (49%) of the people who get HIV and AIDS. Blacks with AIDS often do not live like people of other races and ethnic groups with AIDS…for African Americans and other blacks; HIV/AIDS is a leading cause of death” (CDC, 2005, p. 41). Moreover, misconceptions about AIDS management have not spared this forgotten demographic.
Additionally, health issues among African-American women have always been an issue of contention. Many people do not differentiate between being big and being healthy. Due to this fact, when women in this category get AIDS, they die quickly because of poor health. A study carried out in 2005 across thirty-three states, “64 percent the infected were black” (CDC, 2005, p. 35). These numbers are alarming and they confirm the fact that AIDS among African-American women is catastrophic and calls for attention.
The difference between the infection and death of African-American women and their white counterparts can also be attributed to culture. Some cultural practices like those of having multiple sex partners are pronounced amongst the blacks and this may explain this difference. However, the primary reasons go back to the barriers discussed earlier on in this paper.
Ironically, these increased mortality rates amongst African-American women come amidst claims that AIDS is manageable. This indicates that there is breakdown of information transfer including misconceptions coupled with sheer ignorance to take responsibility.
Conclusion
AIDS is manageable in these contemporary times. After the initiation of lifesaving drug regiment in 1996, managing AIDS has become a reality by use of these drugs. These management strategies have led to increased life expectancy. Actually, an individual diagnosed with HIV today may live up to mid sixties.
This is good news for victims of this scourge. Unfortunately, this news have been mistaken and misconstrued amongst the most vulnerable groups in society viz. youth, homosexual men, prostitutes, and intravenous drug addicts. Individuals in these groups have taken advantage of the fact that AIDS is manageable to engage in dangerous unprotected sexual activities.
This is unfortunate because prevention is better than cure. Other victims of AIDS scourge is African-American women who have suffered greatly under this calamity. Many have lost their lives to the scourge and this is attributed to the numerous challenges that they face in accessing medical services coupled with some cultural practices. It is ironical that, instead of getting the anticipated improvements that would come with AIDS manageability; the opposite has been realized with new infections and deaths being reported everyday.
References List
CDC. (2005). HIV/AIDS Surveillance Report, 2004. Atlanta: US Department of Health and Human Services. 16(2): 1–46.
CDC. (2003). HIV/STD Risks in Young Men Who Have Sex with Men Who Do Not Disclose Their Sexual Orientation—Six US Cities. Morbidity and Mortality Weekly Report. 52(2): 81–85.
Dybul, M., Fauci, A., Bartlett, J., Kaplan, J., & Pau, A. (2002). Guidelines For Using Antiretroviral Agents among HIV-Infected Adults and Adolescents. Ann. Intern. Med. 137 (5): 381–433
Hall, I., Ruiguang, S., & Rhodes, P. (2008). Estimation of HIV Incidence in the United States. Journal of the American Medical Association. 300(4):520-529.
Kakar, D., & Kakar, S. (2001). Combating AIDS In the 21st Century Issues And Challenges. New York; Sterling Publishers Private Limited.
Walker, R. (2009). Stop AIDS Campaign Celebrates Creation of Life-Saving HIV Patent Pool. Retrieved From,
HIV/AIDS is a disease that is easily transmitted through sexual intercourse, blood transfusion, and pregnancy. The HIV virus weakens the victim’s immune system and after some point the disease becomes the medical condition known as AIDS. At this point the body can no longer counter the effects of infection.
But the worst part of all is the fact that there is no known cure. Thus, the disease can spread from one village to the next and from one city to the next to overwhelm local governments and health officials. It will eventually become an epidemic if nothing can be done to stop the spread of the disease.
It is a lethal medical condition that once infected the carrier of the virus is expected to die but this does not have to be the case for most people, if only they can have access to treatment that can mitigate the impact of the disease.
Dimensions of the Problem
The problem with HIV/AIDS is not only limited to the mortality rate and the epidemiology of the disease but also the social problems that it brings. First of all AIDS can easily shorten the life expectancy of the patient. This is especially true in places where there is no adequate healthcare system that can help in mitigating the impact of HIV/AIDS.
In addition to the healthcare aspect of the problem there is also the social side of the issue. In the early years of its history, HIV was linked to homosexuals and drug addicts. Thus, when the community finds out that a person has AIDS then the inevitable isolation and persecution can occur.
In addition there is still widespread ignorance of the disease and therefore the fear of infection is high even if scientifically speaking it is impossible for a person to get infected unless specific conditions are met.
Evaluating Evidence
The study used scientific data as well as historical data. The study traced the emergence of the disease as well as the response of different nations. There was a section that provided an overview of the organizations and the personalities involved in the fight against HIV/AIDS.
Aside from science and history the study also used textual evidence, specifically literature, to show that the concern for AIDS/HIV has gone global. The study highlighted an advertising campaign with the catchphrase “Don’t Die of Ignorance” and it was printed on a leaflet that was distributed in every household in Great Britain (Whiteside, p.103). The study also mentioned the use of multimedia to enhance the campaign against the deadly disease.
The study was carefully put together and as a result there is almost no way to misinterpret what the author tried to convey. It is clear that the cause of the problem is HIV/AIDS and that the impact of the disease is the reason why other issues emerged such as poverty, gender inequality, corruption in government etc.
However, if one will ask why there were so many preventable deaths then there is indeed another side to the story. The reason is not just the virus but other social forces as well that help exacerbate the problem.
The widespread impact of AIDS/HIV especially in Third World countries cannot be solely blamed on the epidemiology of the virus but also on the social conditions that exist in a particular nation or geographic area that help explain the spread of the disease and the high mortality rate.
This is the major focus of the study. Although the discovery of a cure is the most important issue when it comes to HIV/AIDS, the need to improve preventive measures and how to enhance treatment has occupied the thoughts of many people including those that have the resources and influence to make an impact in the fight against HIV/AIDS. It has become very clear that the problem is no longer local but global.
Conclusion
There are three major issues when it comes to HIV/AIDS. First of all there is inequality when it comes to access to information and treatment that could easily reduce the impact of the disease. Secondly, the HIV/AIDS epidemic cannot be contained by quarantine or other measures that can prevent the spread of the virus (Fee & Fox, p.67). And finally, the disease can be treated in such a way that it can help prolong the life of the individual.
Inequality is the result of poverty and therefore it is not surprising to find out that Third World countries suffer greatly from the impact of HIV/AIDS simply because of ignorance.
There is a need to pool resources and to increase cooperation between national leaders and aid agencies in order to increase knowledge about the disease and how it can be prevented.
It is also important to understand that HIV/AIDS does not respect borders simply because a person can be a carrier without manifesting any symptoms. It is therefore crucial to develop a global initiative because everyone is involved. It is also alarming to consider the possibility of refugees moving into another country because the social structure in their homeland has been weakened by the absence of human resources due to shortened life expectancies.
Finally, treatment must be made available to those infected with HIV/AIDS. When it comes to treatment the challenge is always about money. The drugs can be very expensive and yet senseless deaths could have been easily prevented if there is just a way for infected people to access treatment. The most important thing to do is to find a way to make drugs affordable, especially to those living in poverty-stricken nations.
Works Cited
Fee, Elizabeth and Daniel Fox. AIDS: The Burdens of History. CA: California University Press, 1988.
Whiteside, Alan. HIV/AIDS: A Very Short Introduction. New York: Oxford Press, 2008.
HIV/AIDS has been ranked as one of the main killer diseases globally. It is mainly “transmitted through unprotected sex and blood transfusion” (CDC 2010). It destroys the CD4 cells and this limits the body’s ability to protect itself from infections. The use of condom has been proposed as an effective way of curbing the spread of the disease.
Despite its effectiveness in reducing the prevalence of HIV/AIDS, condom use has not been fully accepted due to socio-economic factors. This paper highlights the current situation and recommendations in regard to response and acceptability of condom usage.
The Situation
Most countries in the world have adopted a “national condom usage program in order to control the spread of HIV/AIDS and other sexually transmitted diseases” (Schmiedl 2004, vol. 20, p. 17).
Such programs include creating awareness about condom and its benefits. They also involve the provision of condoms at no costs or at reduced costs. There is a positive response to condom use as people realize its effectiveness in preventing HIV/AIDS.
The promotion of condom use is more focused on the vulnerable groups rather than the general public. Thus condom is mostly associated with deviants such as sex workers and drug addicts (Bedimo & Clark 1998, vol. 9, p. 50). This causes stigmatization in regard to condom use.
The government and private agencies that are in charge of the condom usage programs usually conduct the procurement and distribution activities at the head-office level. Thus there is little involvement of the civil society in decision-making (CDC 2010). This causes alienation and underutilization of the programs.
The abstinence campaign programs are also reducing the popularity of condoms. Those who support abstinence especially religious leaders believe that condoms encourage immorality (Bourne, Charles & Francis 2010, vol. 20, p. 65). This discourages the use of condoms.
Recommendations
In order to eliminate the stigma associated with the use of condoms, the programs should focus on the general public. Instead of targeting only the vulnerable groups, the governments should create the impression that condom use is meant for everyone (Cohen & Clark 2003, vol. 87, p. 975).
The civil society and opinion leaders should be involved in the programs especially when making decisions. This will facilitate the acceptance of the programs by the majority (CDC 2010). Besides, there should be more funding to support awareness programs as well as availability of condoms.
Finally the governments should focus on evidence-based strategies for preventing HIV/AIDS. This includes widespread use of condoms (Hocking, Turk & Ellinger 2002, vol. 22, p. 357). Counter-productive programs such as abstinence should be avoided since their effectiveness is not easy to measure.
Conclusion
HIV/AIDS can be easily controlled through the use of condoms since it is sexually transmitted (Bedimo & Clark 1998, vol. 9, p. 5). However, a 100 percent condom usage rate is yet to be achieved due to socio-economic barriers as discussed above. Consequently, there should be more funding and intensification of condom use awareness activities.
References
Bedimo, L & Clark, R 1998, ‘Understanding barriers to condom usage among HIV infected African American women’, Journal of the Association of Nurses in AIDS Care, vol. 9, no. 3, pp. 48-58.
Bourne, P, Charles, C & Francis, C 2010, ‘Psychosocial correlations of condom usage in a developing country’, Open Access Journal of Contraception, vol. 20, no. 1, pp. 64-75.
CDC 2010, Condom distribution as a structural level intervention. Web.
Cohn, S & Clark, R 2003, ‘Sexually transmitted diseases, HIV and AIDS in women’, Medical Clinics of North America, vol. 87, no. 5, pp. 971-995.
Hocking, J, Turk, D & Ellinger, A 2002, ‘The effects of partner’s insistence of condom usage in perception of the partner, the relationship and the experience’, Journal of Adolescence, vol. 22, no. 3, pp. 355-365.
Schmiedl, R 2004, ‘School-based condom availability programs’, Journal of School Nursing, vol. 20, no. 1, pp. 16-21.
Evaluation questions form the basis on which a health promotion program is driven (Issel, 2009). The following questions have been refined to ensure they provide significant feedback on the program’s quality, utility and impact on the target population
Process evaluation examines the delivery of a program to its target population (Nutbeam, 2009). In this regard the following questions have been formulated:
Has the program been implemented as planned?
What factors influenced the implementation (negative and positive)
What proportion of the target group received the program?
Impact evaluation
This type of evaluation is aimed to assess the immediate effect of the health promotion program on the priority population (Farell, et al., 2002). Such effects may include levels of knowledge acquired, skills, attitudes and change in behavior. Key questions here are:
Have the program impacts been achieved?
What difference did the program make on populations facing the greatest risk?
Have all strategies been appropriate and effective in achieving the impacts.
Outcome evaluation
Outcome evaluation is normally carried out at the maturity stage of a program. It seeks to assess long term outcomes such as mortality, morbidity, quality of life and equity (Silva-Sanigorski, Bolton, & Meloni, 2009). Questions prepared for outcome evaluation are:
To what extent were intermediate outcomes achieved?
How were the intermediate outcomes achieved?
Did the primary target group receive the greatest benefits of the program?
STD/HIV Health Promotion Evaluation Plan
Goal
The primary goal of this program is to reduce prevalence of STD/HIV in men who have sex with other men (MSM).In the case of this program MSM group comprise of gay and bisexual men. Recent Data by CDC, indicate that gay and bisexual men though making up only about 2% of US population, account for most new HIV infections(61% in 2009) (Prejean,et al.,2011; CDC,2011).
Target populations
The primary target population is men who have sex with men (MSM) (gays and bisexuals between 20 and 40 years of age without any racial exclusion) living in urban centers. Others are health service provider of gay and bisexual men, gay and bisexual right groups as well as family and friends of gay and bisexual men).
Consistent with best practices and laid down guidelines of similar programs, the objectives of the program are:
Discover behaviors likely to contribute to reducing incidences of new infection of STD/HIV in MSM.
Increase rates of condom use in gay and bisexual men.
Increase STI and HIV testing in MSM.
The desired outcomes of the Health Promotion Program are:
Condom culture in gay and bisexual men is developed and maintained.
Condom use among gay and bisexual men is increased.
Condom use is supported by those who influence sexual activity-porn stars.
Regular condom users maintain healthy behavior.
Testing and testing services and accessibility to testing is increased.
Adoption of healthy sexual behavior that will promote good health.
Activities
Activities are the operations that are necessary in order to achieve the objectives and overall goal of a health promotion program (Holt, 2009 ; Mckenzie, Neiger, & Thackeray, 2009).
Outcome: Adoption of healthy sexual behavior that will promote good health
Key activities:
Sponsorship and participation in gay and bisexual community events.
Celebrity modeling of behaviors i.e. endorsement from prominent gay figures.
Interaction and engagement with key community leaders e.g. religious leaders.
Sponsorship of gay events or related social activities to communicate safe sex behaviors messages.
Mass communication targeting the gay and bisexual men on safe sex.
Outcome: Promote and increase access to HIV/STI testing services for MSM
Key activities:
Increase access to testing services online and offline.
Rewards for testing.
Social movement to encourage testing, text reminders, viral online marketing.
Promote “bring your partner” testing schemes.
Outcome: Increase condom use between MSM
Key activities:
Media campaign countering unprotected sex in pornography.
Promote condom culture through organizations highly influential among MSM.
Use of mass communication channels to promote condom use.
Partnership with key health providers for gay and bisexual men.
Primary evaluation questions
The primary evaluation questions for this program are:
Have all the program impacts been achieved?
Was the program implemented as planned?
These questions will be used to assess whether all the desired short term and intermediate outcomes have been achieved within the stipulated time and whether the program has remained on course as planned. These questions are important because they ultimately determine the preliminary success and/or failure of the program.
Process , Impact and outcome variables/indicators
An indicator is a measurable variable of a program activity (Keleher, Marshall, Murphy, & Round, 2003 ; The Health Communicaton Unit (THCU), 2007. The measureable variables of the program are outlined below:
Process evaluation measurable variables
Participation: Number of gay and bisexual men absorbed into the program.
Resources distributed: Number of condoms distributed within a particular period.
Training session held: Number of training sessions conducted for priority groups.
Reach: Number of gay and bisexual men reached per month.
Client/staff satisfaction: Benefit /challenges of the program reported by the target population and implementation staff.
Impact evaluation (Immediate impact variables)
Levels of Improved health knowledge on gay sexuality. Assessed through knowledge test at the end of a discussion session/discussion. Program aims scores of over 60%.
Levels of Improved protective skills and confidence as reported by participants in open-ended questionnaires. Program aims for high improvements in these areas.
Participants report on their quality of life through survey questionnaires. Project aims for Improved quality of life in the target group.
Outcome evaluation: short term impact variables
Organizational development: Policy changes, reward systems, number of legislations, made in favor of promoting the health of gay and bisexual men.
Benefits to participants; participant to report at least five benefits.
Participants’ satisfaction; program aims for high satisfaction among the respondents.
Barriers to participants. As few as possible should be reported.
Increase in number of people reached -Target is an increase of about 10% /month.
Intermediate outcomes (impact measures)
Changes in service utilization: the rate of condom use and positive change in testing numbers in gay and bisexual men.
Changes in sexual behavior in gay and bisexual men in pre/post introduction of the program. Change should favor adoption of safer sex practices.
State of knowledge, skills or attitudes; assessed through observation and demonstration of skills and self-report records.
The extent of policy implementation. New policies enacted during on implementation.
Outcome evaluation: long term
New infection rate and mortality rate of gay and bisexual gay men. Programs targets double digit decrease in new infections by the completion of the program.
Morbidity/mortality: Death related to HIV/STI positive gay and bisexual men before and after the program.
The quality of life according to participants own views.
Evaluation design
The evaluation will be largely process and impact-based and will be executed using a mix of descriptive/non experimental and experimental designs. Process evaluation will emphasize on quality and suitability of the interventions and approaches of the program. A critical aspect of process evaluation will be to determine and track the ‘reach’ of the program.
Impact assessment will be carried out to determine the immediate effects of program’s interventions on the priority population. The evaluation will not involve comparison of the target with control groups as this approach is simply unethical. The choice of this design model is due to the fact that such designs are easier to implement and least expensive (Mckenzie, Nieger, & Thackeray, 2009; Victoria Department of Health, 2009).
The benefits of the program will be measured before and after implementation of the programs. The program will employ a number descriptive evaluation methodology such as case study, cross-sectional design as well as correlational design and will borrow significantly from established protocols to accelerate implementation and meet reliability and validity requirements.
Methods of data collection
Individual and community level impacts will be measured using a mix of qualitative and quantitative methods. Qualitative methods entail gathering detailed information that is contextual in nature (Issel, 2009). Quantitative methods present quantifiable result with high degree of generalizability (K.Farell, et al., 2002). The quantitative methods to be used in the program include: mail/telephone surveys, process tracking records, analysis of large datasets as well as direct measure of health indicators mainly STI/HIV.
Some of the qualitative methods expected to be used include: focus groups, in-depth interviews, open-ended survey questions, dairies, consensus building as well as forums/discussion groups/audio/video recording.
Actual collection of information will entail questionnaire, surveys, interview conducted in person, by telephone or email, analysis of documents or records to obtain opinion, practices, or belief from the target population. The questionnaires will used to access individual level impacts of sexual behavior, sexual health literacy and quality of life.
Measurement tools
Measurement tools expected to be developed and used in the evaluation program include questionnaires, moderators guide for forum sessions, recording forms, observation forms, dairies, survey software, audio recording systems, and government health statistics. Screening tools for STI/HIV will need to be developed to enable on-site assessments. Focus groups, in-depth interviews and observation will be used gather data with behavioral dimensions such as attitudes, opinions, knowledge and skills.
Sampling
Cluster sampling will be employed as the program aims to cover a large geographical area. Survey areas will be picked from county clusters in target areas. Random sample will be made from these cluster and all individuals included in the survey.Based on funding, the program expects to reach as many gay and bisexual men as possible in major urban cities.
A sample size, sufficiently large enough to produce significant changes will be selected. The sample population will be recruited via online campaign and through gay and bisexual organization. The timeframe for sample recruitment will be defined before embarking on the exercise.
Strength ,Weaknesses & Threats to reliability and validity of measurements
Strengths: The program will be run by highly skilled and knowledgeable coordinators to ensure realization of its intended goals. The program also boasts of a clear goal and objectives augmented with necessary procedure and policy guidelines.
Weakness: Potential weaknesses are limited funding and time constraint. The absence of a control in the program, owing to the nature of the program, means that results will be open to different interpretations.
There are several possible confounding factors that may affect the reliability and validity of the measurements. History may serve to confound the findings when other events occur between the first and the second measurement. Others are changes in instrument calibration, non-response and changes in participants or values between successive measurements.
The program coordinator will ensure that all interview themes are approved by statutory vetting agencies. Interview and focus groups will be analyzed by an independent research fellow who will not be involved in other affairs of the program.
Poor response rate are a common problem in many programs (Round, Marshall, and Horton, 2005). Counter measure for poor response include: providing stamps for mail surveys, reward schemes as well as SMS and emails reminders. The program will also favor the use of widely used quality-proven existing data collection tools rather than developing new ones.
Application of evaluation results
The evaluation results will be used for:
Making progress decision such as abandoning the less successful interventions while concentrating and sustaining the more receptive and successful ones.
Device best ways to enhance service utilization.
Making necessary changes so as to spearhead realization of the desired impacts.
Providing accountability for program funding.
References
CDC (Centre for Disease Control). (2011). Fact Sheet: Estimates of new HIV infections in the United States.
Holt, L. (2009). Understanding program logic. Web.
Issel, L. (2009). Health Program Planning and Evaluation. A practical systematic approach for. Sudbury, Massachussets: MA. Jones and Bartlett Publishers.
Farell,K., Kratzmann, M., McWilliam, S., Robinson,N., Saunders,&.,Ticknor,J. (2002). Evaluation Very easy Accessible ,and Logical. Atlantic centre of excellence for women’s health, Halifax.
Keleher, H., Marshall, B., Murphy, B., & Round, R. (2003). Evaluation Report: Victorian DHS Short Course in Health Promotion. Melbourne: Deakin University.
Mckenzie, J., Neiger, B., & Thackeray, R. (2009). Planning, Implementing, and Evaluating Health Promotion Programs:A Primer (5th Edition ed.). San Francisco: Pearson Benjamin C.
Nutbeam, D. (2009). Program management guidelines for health promotion. Sidney: Lindwall and Ward Pty Ltd.
Prejean J et al. (2011). Estimated HIV incidence in the United States. 2006-2009. PLos ONE, 6(8), 433-487.
Round, R, Marshall, B & Horton, K. (2005). Planning for effective health promotion evaluation. Melbourne. Australia: Victorian Government Department of Human Services.
Silva-Sanigorski, A. d., Bolton, K., & Meloni, L. (2009). Evaluation plan for Health Promoting Communities. Geelong: D e a k i n U n i v e r s i t y.
Because HIV care for marginalized populations often entails combining medical services with ancillary or social services not only to stabilize life situations but also remove barriers to care (Chin et al., 2009), the present paper aims to critically discuss one of such ancillary services within the realms of HIV/AIDS care, known as case management.
Case management is primarily concerned with the provision of numerous functions, including stabilizing life situations for people with HIV/AIDS, removing barriers to ensure more consistent participation in medical care, linking HIV-positive patients to other critical services, and enhancing physical and mental health-related quality of life indicators for people living with the disease (Chin et al., 2009). Additionally, as suggested in the literature, case management is often seen as beneficial in supporting integrated care for people with HIV/AIDS owing to its fundamental objective of helping “clients in negotiating, gaining, and maintaining access to health care and social service systems as their disease progresses” (Magnus et al., 2001 p. 137). The key personnel involved in running case management programs include case managers, medical doctors, nurses, social workers, community workers, psychologists, and behavior change experts (Conover & Whetten-Goldstein, 2002; Magnus et al., 2001).
Within the domain of people living with HIV/AIDS, it can be argued that the HIV/AIDS case management department is often supported by departments providing other ancillary services such as peer advocacy and counseling (Naar-King et al., 2007), departments providing social services such as ceasing substance use and entering stable housing for people with HIV/AIDS (Chin et al., 2009), and also by departments providing clinical care in the context of monitoring CD4 cells (viral load), treating infections as well as providing reproductive care and primary care (Naar-King et al., 2007). These support systems are complimentary, implying that the case management department also supports the other mentioned departments with critical data and best practices in management paradigms used on people with HIV/AIDS.
Trends having an Impact on Case Management
One of the most significant trends affecting case management programs for people living with HIV/AIDS is that retention into these programs has been found to decrease with age, suggesting that young adults are most at risk (Naar-King et al., 2007). Although little has been published about the retention in care of HIV-positive youth, a study reported by these authors found that “HIV-positive youth attended approximately 66% of appointments in a comprehensive adolescent HIV clinic over a three- to six-month period” (p. 248). Retention into case management programs has also been found to be gender-specific because the needs of HIV-infected women are substantially diverse from those of their male counterparts (Magnus et al., 2001). The second trend having a direct impact on case management programs for people with HIV/AIDS concerns the fact that comprehensive care is now needed more than ever before not only due to the increasing complexity of the disease but also because of the fact that classification of HIV has shifted from a terminal illness to that of a chronic infectious disease (Magnus et al., 2001).
Impact of the Trends on Case Management
The impact of the first trend, which relates to the low retention levels depending on age group, is that young adults are most at risk owing to low retention levels in HIV/AIDS case management programs (Naar-King et al., 2007). Available literature demonstrates that case-managed HIV-positive individuals have fewer hospital admissions, lower costs related to HIV management, and report satisfaction in the way their needs are met in healthcare settings (Magnus et al., 2001). Consequently, it can be argued that the youth will continue to be adversely affected by HIV/AIDS because the case management approaches currently available do not support or encourage sufficient retention levels among the youth.
The impact of the second trend, which is the increasing complexity of the disease coupled with the fact that the classification of HIV has shifted from a terminal illness to that of a chronic infectious disease (Magnus et al., 2001), lies in increased budgetary allocations to treat and manage the ever-increasing population of HIV patients particularly in the developing countries (Lo et al., 2002), and the resurgence of higher HIV infection rates as infected persons are now living much longer (Chan et al., 2002). Owing to the many success stories in HIV/AIDS case management not only in the United States but also globally, governments and health agencies are expected to commit more financial resources to provide for the ever-widening population of HIV-infected persons. However, the dark side of the success stories is that many people may be at increased risk of contracting HIV if adequate measures are not put in place because HIV/AIDS is no longer a terminal illness but rather a chronic infectious disease.
Improving Operation & Bottomline Performance
To enhance the retention of young adults in case management services, Naar-King et al (2007) suggest that this ancillary service should be age-specific as “youth in a comprehensive, youth-specific program may have better retention than youth in adult services” (p. 250). Consequently, as a healthcare administrator, it is imperative that case management services for people living with HIV/AIDS be developed around the needs of specific age groups of the population. Using this approach, it is possible to capitalize on this trend with the view to developing a case management program/unit that meets specific perceived and unmet needs for diverse groups of the population. For example, to enhance the bottom line performance of HIV/AIDS case management programs, relevant stakeholders could develop age-specific priorities that should be used to encourage various groups of the population not only to join but also to follow through the programs. This way, more people across various age-groups and gender will be able to demonstrate higher retention levels and thus benefit directly from the case management programs in terms of increased access to care, linking families to available resources in the community, and empowering HIV-infected persons to become self-sufficient (Magnus et al., 2001; Lo et al., 2002).
Available literature demonstrates that “HIV disease is no longer a critical short-term illness but a chronic condition giving rise to more clients requiring ongoing medical care” (Chan et al., 2002 p. S73). Because there have been steady advances in the management and treatment of HIV, hence delaying disease progression and prolonging survival rates of HIV-infected persons, it is possible to capitalize on this trend by introducing targeted case management approaches that ensure participants are educated on preventing new and repeat infections. Additionally, to improve the bottom line performance of available case management strategies, it is important to liaise with relevant government agencies as well as donors to increase their budgetary allocations for these programs to coincide with the increasing number of HIV-infected persons requiring case management services. In the context of this particular trend, it is important to trigger positive behavior change among HIV-positive individuals in case management programs to ensure the prolonged survival rates of already infected persons do not translate into new infections.
References
Chan, D., Absher, D., & Sabatier, S. (2002). Recipients in need of ancillary services and their receipt of HIV medical care in California. AIDS Care, 14(1), S73-S83.
Chin, J.J., Botsko, M., Behar, E., & Finkelstein, R. (2009). More than ancillary: HIV social services, intermediate outcomes and quality of life. AIDS Care, 21(10), 1289-1297.
Conover, C.J., & Whetten-Goldstein, K. (2002). The impact of ancillary services on primary care use and outcomes for HIV/AIDS patients with public insurance coverage. AIDS Care, 14(1), S59-S71.
Lo, W., MacGovern, T., & Bradford, J. (2002). Association of ancillary services with primary care utilization and retention for patients with HIV/AIDS. AIDS Care, 14(1), S45-S57.
Magnus, M., Schmidt, N., Kirkhart, K., Schieffelin, C., Fuschs, N., Brown, B., & Kissinger, P.J. (2001). Association between ancillary services and clinical and behavioral outcomes among HIV-infected women. AIDS Patient Care and STDs, 15(3), 137-145.
Naar-King, S., Green, M., Wright, K., Outlaw, A., Wang, B., & Liu, H. (2007). Ancillary services and retention of youth in HIV care. AIDS Care, 19(2), 248-251.
The HIV pandemic is considered as among the most destructive of health crises of the 20th and 21st century. The death toll from this scourge continues to rise as the search for a cure continues. The South Saharan Africa is among the hardest hit with up to 6.1 percent of the adult population living with the virus.
This percentage represents the infected population alone (Lori 1). The number of affected individuals include more men, women and children who depend or rely on the infected for livelihood.
This saddening state of affairs is the foundation of my research that seeks to evaluate the HIV AIDS scourge as a human security concern. I will give specific regard to South Africa where at least 5.6 million people are living with the virus with an annual death toll of at least 310,000 adults.
This makes South Africa among the most affected countries in the world. Among the middle-aged adults between the age of 15 and 49, the prevalence is up to 17.8 percent (Strode and Kitty 7). This has trapped the state between the local need to maintain and provide treatment for the infected and the international and global campaign to eradicate the disease.
This has led to the formulation, implementation and adaptation of the various measures aimed at securing medical treatment and social acceptance of the victims while maintaining a margin of economic growth and social confidence.
From the simplistic approach of human security, human sanctity and social responsibility, this research is inspired to take an analytical and critical approach in combating HIV and AIDS in South Africa as a human security concern. This approach provides for the individual role, duty and responsibility to safeguard and maintain a conducive livelihood (Parsons Pp. 1-83).
Literature Review
The human security concept is considered as being a historical as well as a contemporary concept that has survived the various eras and ideological regimes by undergoing through three main phases. The first was the simplistic and physical conception of weaponry and military hardware. This was motivated by the climax of the industrial revolution and the need to safeguard territory and boundary.
It was characterized by the two World Wars that saw an extensive destruction of property and human life. This negative side of the warfare led to the re-interpretation of human security on the onset of the Cold War that ushered in the second phase of the human security approach.
This second phase was centered on capitalist ideology and post communism concepts. Human security was then considered as a representation of the value attached to social balance and coexistence amidst economic competition and differences. This era saw the signing of numerous treaties concerning various sectors and fields of interest for nations and states.
It was characterized by the commencement and end of the Cold War along with the various anti weaponry campaigns that culminated in the Geneva conventions. This phase was however short lived as the focus suddenly changed to embrace the emerging contemporary concerns such as terrorism and pandemics. The interstate disputes were no longer a center of interest as more pressing concerns came up.
Terrorism, poverty and civil conflict took the center stage and became the focal point for nations and international organizations. This change is fundamentally motivated by democracy and the need to enforce the principle of natural justice and rule of law across administrative regimes.
However, there can never be a specific comprehensive approach that fully explains the concept of human security and the change in goal posts by the various theorists and research scientists. Though, there are pertinent commonalities and similarities in the various proposed approaches.
Majority take a physical security approach to the human security concept advocating for the physical safety of members of society as being the correct interpretation of human security while others employ the dignity approach that advocates for security beyond the physical structural security of the person.
The dignity approach suggests that it is the economic, social and political harmony that amounts to human security and ultimately social dignity (Donnelly pp. 85-111).
A harmony of these two arguments, appropriately reconciles the conflict between them since it is imperative that it is not enough to build a fortress around a city. There is a subsequent need to ensure that the political, social and economic aspects of the territory being protected are worth the trouble.
In the various respects, therefore the human security concept can be reconciled to be a balance between the military, physical, economic as well as the socio-cultural aspects that represents the development of dignity and ultimate prosperity.
This balance is specifically exemplified by the South African history that dates back to the apartheid rule that sought to begin with physical security at the expense of the social and economic security.
However, the lack of economic and political security slowly motivated the rise of civil unrest making it clearly insecure even for the physically secured areas. The liberation struggle marked the need for political and economic stability. This clearly the inadvertent interdependence between the two approaches to human security (Held pp. 53-72).
Subsequently, the state has been left with little option but to operate under the compromise of both approaches. This has motivated the signing of the various peace agreements and treaties that have not only maintained political but social security as well as physical security by safeguarding economic growth.
Modern research scientists take the concept further by advocating for the use of economic means to facilitate and secure human development and sanctity. This goes contrary to the capitalist adaptation that has seen human needs adjust to serve economic interests.
They advocate for adjusting economic opportunities to serve human development. In this, pretext the individual access to reliable and cost effective healthcare facilities along with equitable access to opportunities for economic profitability locally and regionally builds up to the human security concept.
This line of argument sets the stage for the presentation of AIDS as a human security concern. It interferes and hinders the enjoyment of the fundamental precepts of human dignity. It causes a human resource shortage and limits the market potential of the available remaining human resource. This acts to hinder and deter the physical as well as the broader concept of human security.
The human sanctity premise provides that every citizen has an equal intrinsic value. The premise proposes that every citizen has an equal talent value and is therefore entitled to an equal opportunity to contribute to social life. Human security on the other hand offers protection of the physical self and furthers the self-expression presupposition centered on human integrity.
AIDS infects an individual but the community at large feels its effects. The failure or lack of effective measures by the government to control the spread of the pandemic amounts to a compromise of their duty to maintain physical security and by extension human security. It should therefore be the case that AIDS compromises human security in numerous respects (Booysen Pp. 125-144).
Purpose of Research
The primary goal of this research is to establish a connection and relationship between AIDS as a pandemic and human security. Human security will be approached from a personalized approach by discussing the obligation of individual institutions and persons such as the government, corporations and individuals.
To achieve this, the research will establish a case for the relationship between the premise of human sanctity and human security as the link between the actors of HIV and AIDS and the responses to these actors in the context of the fight against the disease in South Africa. This will also offer a basis for the making of quantified conclusions and recommendations in policy and practice.
Undeniably, the need for viable and justifiable policies and procedures for sustainable human security continues to increase with the increase in the number of people infected with the virus.
It comes at a time when South Africa continues to counter the effects of declining state sovereignty and increasing local demand for a stable political environment. This study therefore aims at providing a reliable solution to the procurement and protection of human security (Patton and Sawick Pp. 21-73).
Research Question
The limited access to sustainable livelihoods has become a serious motivator of the increasing number of cases of HIV infections. It leads to subsequent social structural instability that diminishes the standards of human security and sanctity. This study investigates the place of HIV/ AIDS as a human security concern in the context of the HIV AIDS scenario in South Africa.
Research method
This research engages secondary information that has been accumulated for two years on the HIV AIDS pandemic in South Africa and the human security concept. The data draws from reports on interactions with citizens in various townships and cities in the greater Johannesburg Pretoria that were made by researchers in the various reports and researches.
The secondary information is interrogated in the order of relevance and the appropriate citations made to support the various opinions and suggestions. An analysis of the various proposed arguments along with personal input on the subject of human security and the HIV/AIDS pandemic will offer a diverse and holistic argument for the security of sanctity and the sanctity of security.
The HIV /AIDS is portrayed as a justification for the need to employ this argument in the development and drafting of the various policies and procedures that the government of South Africa adopts and implements (Terrblanche 98).
Limitations of the research
Human security like all other concepts has the capacity to accommodate al individuals and nations. This in effect leads to a strong limitation in the maximum possible scope that can be covered by a single report since it would be infeasible to attempt to accommodate all these players.
A further limitation exists in the fact that the research is limited to secondary information that is chosen based on the availability and accessibility of the information. This could lead to a considerable amount of bias (Harvey pp. 53-72).
Results and discussion
The focal point of this discussion and research are three questions. The first concerns what exactly is security while the second is what exactly sanctity is. The final question goes to ascertain the relationship between AIDS sanctity and security.
Human sanctity
Sanctity is a representation of the humane individuality in a person. It is an aspect of the person that is considered inherent and an articulation of fulfillment of the person. From an enlightment perspective, sanctity is a representation of the capability of the human to be rational. It is considered to exist as an end to human beings as opposed to being a means.
This approach interrogates sanctity as an end as well as a means for a livelihood to the person. The modernist rationalist as well as the intrinsic human dignity arguments motivates the contrast between these two conceptions as portrayed in the concept of globalization. The responsibility lies in every human to safeguard and protect individual actualization and actively participate in maintaining such actualization.
The responsibility of the individual lies in protecting and developing dignity. The individual is under a duty to maintain the economic political and social duty to develop, enable and maintain a suitable economic environment for the livelihood and life beyond living.
The individual, the state and corporations have an interdependent duty to create a favorable environment for the development of the intrinsic worth of human life (Hemmati pp. 39-72).
Sanctity and freedom
Freedom is the ultimate measure of social security and forms the basis. It is an indication of the effectiveness of initiatives undertaken by the individual, corporations and the state in maintaining social security. Security of society by extension offers security to the individual. Social effectiveness therefore presents opportunity for the improvement of the individuals well being.
This approach however faces several challenges arising from globalization. The globalization approach disputes individualization of the responsibility to maintain social security and advocates for the need for unified effort for the common good (Sacks 45). This therefore limits the extent to which the individual can exercise their personal freedom without necessarily considering the opinion and of others in the same issue.
In the alternative, the individual responsibility can be considered as a social commitment. There exists a collective responsibility to the individual to react to problems of society such as poverty, hunger, inflation, famine as well as the infringement of others socio-political and economic freedoms.
By this we recognize the relationship between the personal freedom and the economic social and political balance(Lukes pp. 83-139). The key purpose of this freedom is to guarantee a sustainable livelihood. This therefore creates the individual agency obligation and duty to the various stakeholders to individually cooperate with the collective effort of society to safeguard human security (Stiglitz 78).
Human security
The basic theme in the relationship between sanctity and security is that sanctity acts as a prerequisite of security while in the alternative; there lies a duty of security to safeguard sanctity. Dignity in this context is considered as an intrinsic sanctity that should be secured at all costs.
From a different approach, the need for human security arises due to the lack of such security or otherwise the existence of insecurity. In the contemporary context, there are numerous emerging instances of insecurity majority of which are motivated by economic interests as well as related industrial and technological changes. AIDS falls one among these.
The technological revolution has stimulated the rate of change and increased the speed at which societies are flourishing. Human beings on the other hand adapt readily to these changes, a capacity that is fully invested in the human ability to develop and modify their dignity through constant change of their environment and surroundings.
Even so, the greater and more intense forces of political and economic pressure more often than not lead to the limitation of access to resources. The mobile modernity continues to worsen this state of affairs by increasing the pressures to the overstretched human security situation.
These pressures continue to increase faster than trade its self-taking advantage of globalization. This can be adequately represented by the rate at which AIDS is spreading in South Africa (Nyamnjoh pp. 1-18)
Security and development
Human development differs greatly from human security in several respects. While human security operates on the paradigm of human freedom and the capacity for self-actualization. Human development tows the argument for the extrinsic capacity of the individual to modify their environment and surrounding to improve their livelihood as well as that of others (Leftwich pp. 605-624).
Human security “recognizes the conditions that menace survival, the continuation of daily life and the dignity of human beings” (Human Security 10). Human development provides a platform for an increase in the social status of an individual and the elimination of any pertinent un-freedoms. It operates on the premise of an equity-motivated growth in benefits and resources available to the society.
It furthers the optimistic conception of self-actualization and the ability to take advantage of opportunity for individual and common good. Despite these varying arguments the human security and human development, there exist a cautious but zealous objective to maintain human security (Toulmin 39).
AIDS, Sanctity and Human Security in South Africa
From the basic understanding and interpretation, AIDS is a viral disease of the body and has detrimental effects on its victims. It is considered among the worst health crises of the modern world and has to its name a heavy death toll that continues to increase by the day.
In South Africa, it continues to spread faster than a bushfire. Innovative attempts have led to the development and manufacture of a retroviral alternative that serves as a temporary resolve for the infected. This however is not a preventive mechanism but rather maintenance of the situation.
Researchers propose a continued increase in the statics in South Africa despite the increasing number of protective measures and investment in the prevention campaign (Polu and Whiteside 67).
The virus is transmitted mostly through intimate human interactions that are more common in South African heterosexual society. Motivated by ignorance and lack of adequate information, the number of virus infections among the adult population continues to increase with a considerable portion of these persons passing the disease to their young ones leading to a continuous cycle of infection (Tutu 57).
However, a medical condition, HIV and AIDS appeals to the human capacity to safeguard their dignity and to remain cautious to the destructive potential of the disease to both physical as well as the intrinsic security. From the economic realm, AIDS impedes the capacity and ability of workers to produce and limits the labor resource (Nicholson pp. 163-177).
In South Africa AIDS is estimated to reduce the Gross Domestic Product by at least 17 percent by 2020 (Monteiro pp. 1-26). In response to this security concern, the government has instigated contingency measures by securing antiretroviral drugs (Dunn pp. 137-188). This however falls short of the eminent food security and medical treatment concerns that come with the increase in the infections.
Conclusions And Recommendations.
The burden of infection or living an infection free life calls to an individual responsibility. It is apparent that the onset and influence of the Apartheid regime set the stage for the severe increase and prevalence of the HIV and AIDS scourge.
All researches interrogated acknowledge a relationship between human sanctity human security and more importantly the place that HIV and AIDS has as a human security demotivator. In effect, the individual has a responsibility to act on and react to HIV and AIDS information to prevent the spread of the virus.
In this same spirit, the various stakeholders such as the South African government, individuals and corporation have a duty to act as agents in the common goal and fight to maintain human security by eradicating and the disease (Grindle and Thomas Pp. 95-120).
Corporations on their part have duty to provide their employees with adequate access to information on the prevention treatment and control of the disease both for the security of their interests in terms of productivity and profitability as well as the security of the employees.
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According to Webber (1), the communicable disease is one that can easily be passed on from one person or animal to another directly or through an intermediate host. Ostensibly, the transmission of communicable diseases depends on an individual being vulnerable to imminent attacks.
A communicable disease differs from a non-communicable disease because of the presence of an organism involved in the transmission process. By and large, communicable diseases spread through body fluids or the air.
This paper presents a discussion about HIV/AIDS, a communicable disease that is widespread in the present-day society.
HIV/AIDS
HIV is an acronym for human immunodeficiency virus. Drawing from a study by Ngatchou (9), the choice of the word human is linked to the fact that the virus only causes disease in human beings. Similarly, the word immunodeficiency was selected because the body’s immune system responsible for shielding an individual from illness is weakened. HIV is a minute organism that transmits illness to living creatures and makes replicates itself.
The Organism that Causes HIV/AIDS
HIV is the virus that causes acquired immune deficiency syndrome (AIDS). The study by Ngatchou (9) further indicates that AIDS is a group of illnesses that come about due to an individual’s weak immunity. Generally, people with HIV appear healthy during the first few years after being infected with a virus. Later, the HIV viruses in their bodies lead to AIDS. As noted by Jamison (238), AIDS was first considered to be a disease during the 1980s and later spread very fast to become one of the world’s killers diseases.
How HIV/AIDS is transmitted
In most cases, HIV is spread when an individual is involved in unprotected sex with an infected person. Arguably, this makes it very difficult to control the disease associated with HIV (Jamison 238). However, HIV can also be transmitted through blood transfusion or using dirty medical equipment. To avoid transmission as a result of blood transfusion, patients should donate their blood days or weeks before a scheduled operation.
Symptoms of HIV/AIDS
Common symptoms of HIV/AIDS include but are not limited to fever, sweat, fatigue, loss of appetite, loss of weight, nausea, vomiting, diarrhea, cough, and short breaths (Chopra, Niyogi, and Katyal 66). However, these symptoms are not specific. They may also be encountered by people suffering from illness other than HIV/AIDS. According to Sonenklar (10), people with HIV often display flu-like symptoms a few days after being infected.
Symptoms Appear how Long after Someone is Infected with HIV/AIDS
As has been explained in the preceding section, HIV/AIDS symptoms appear a few days or weeks after one has been infected. Based on a study by Kalichman and Evian (32), most people infected by HIV/AIDS seem to be alright during the first five to ten years. After a lengthy period of HIV infection without notable symptoms, a person later becomes sick. The earliest signs may include fever and fatigue.
Short and Long Term Complications of HIV/AIDS
By damaging the body’s immune system, HIV slowly weakens the ability of the body to fight off infections. An infected person thus becomes vulnerable to what are commonly known as opportunity infections. Eventually, a person’s condition progresses to AIDS. Short term complications include tiredness, nausea and vomiting, sleep problems, and sexual problems among others. The long term complications of HIV/AIDS include the presence of abnormal fat deposits in a person’s body and development of heart disease.
Works Cited
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Sonenklar, Carol. AIDS. Minneapolis, MN: Twenty-First Century Books, 2011. Print.
Webber, Roger. Communicable Diseases: A Global Perspective. Boston, MA: CABI, 2016. Print.
The issue of Human Immunodeficiency Virus (HIV) spread and infections is an international concern with nations across the globe endeavouring to provide a long-term sustainable solution in combating this pandemic. The HIV issue has been a constant problem that has elicited national debates and called for serious interventions to secure the world’s population against HIV-related fatalities.
Within Sub-Saharan Africa, Swaziland is one of the most rigorously HIV-affected nations with approximately one out of three adults infected by HIV. By 2005, the HIV prevalence rates among expectant women were estimated to be 43% and approximately 75-80% of TB patients co-infected with the HIV. Despite interventions showing a significant reduction in prevalence rates, the HIV infection is continually becoming a constant problem in Swaziland.
This paper thus provides a five-year strategic plan for HIV prevention and health promotion to provide long-term sustainable HIV response. The strategic plan entails procedural, steady, and successive approaches towards establishing the prevalence rates and levels of HIV infection coupled with providing a long-term sustainable response plan that also involves strengthening the connection between health care systems and HIV intervention plans.
Strategy Development
For years, HIV/AIDS infections have been part of the global healthcare discussions, as nations across the world endeavour to find potential strategies to avert this impediment to public health. Mermin (2011) notes that with the looming danger imposed by the growing cases of HIV/AIDS infections across the world, HIV forms one of the international calamities as one of the issues that should get considerable attention within the health care sector.
According to World Health Organisation (WHO) (2005), Swaziland is currently one of the most severely HIV-affected nations, with the first case in this country reported in 1987. In Swaziland, by 2005, more than one individual in three grown persons suffered from this infection, with the HIV prevalence rates in expectant women estimated to approximately 43% (WHO 2005).
Therefore, further infection would probably be detrimental to Swaziland’s health care sector. Central to avoiding further spread, this five-year strategic plan for HIV prevention and health promotion will provide a long-term sustainable HIV response.
Health refers to the degree of wellness in human or a state of mental, physical, or social fitness (Whitehead 2001). Health promotion is the process that enables persons to enhance control, management, and/or eradication of an infection by increasing control on the determinants of health (McQueen 2000).
Health promotion is doubtlessly the most fundamental efficient, ethical, sustainable, and effective approach towards attaining good health. Health promotion strategies notably engage families and communities in preventing ailments, optimising care, and holding accountable healthcare providers (Delaney 1994; McQueen 2000).
The majority of the health promotion theories normally develop from the behavioural and societal sciences where the relationship amongst knowledge, behaviour, and social norms becomes a major factor that influences the health care phenomena. Davies and MacDowall (2006) recognise a theory whose model of health promotion hinges upon increasing control on the determinants of health where health education, health protection, and health prevention are significant factors in promoting good health.
Outline of strategy plan
The entire plan entails a comprehensive strategic framework that seeks to provide an effective, efficient, and most appropriate solution to the underlying HIV/AIDS infection pandemic in Swaziland. This five-year HIV prevention and health promotion strategic plan encompasses a broad framework of an analysis that also entails comprehensive responses on various essential determinants of heath from individual, family, and community levels (WHO 2009).
The framework of the strategic plan identifies essential aims and objectives, principles, and values that would guide the achievement of positive outcomes in combating HIV infection and promoting healthcare. Concerning core objectives, the strategic plan employs the SMART (Specific, Measurable, Achievable, Relevant, Time-bound) criterion, which is renowned in personal development, project management, and performance management.
As Mermin (2011) recommends, the framework will also provide a comprehensive list and description of core interventions for each approach as well as activities involved in the interventions. Finally, the strategic plan will propose mechanisms imperative in the monitoring and evaluation approaches.
Aims and Objectives
Contemporarily, the government of Swaziland has expressed extensive commitment towards fighting HIV/AIDS and there is a need to enhance knowledge economy as part of supporting the government (Xaba 2011; Curtis 2000).
The main intent of the strategic five-year HIV prevention and health promotion plan is to provide a comprehensive healthcare intervention approach that will significantly champion efforts in reducing HIV/AIDS infection in Swaziland. The strategy herein will aim at endorsing a long-term and sustainable HIV/AIDS response through a series of interventions that will eventually aid in achieving good health in the country.
As essential health elements of healthcare, the strategic plan will analyse and embark on social determinants of health that propel infection rates and hampers responses (Corsi & Finlay 2011). Since it is a five-year strategic plan aimed at enhancing the community’s response to HIV/AIDS infection, this plan seeks to improve the health and social welfare condition of the Swaziland populace through providing precautionary services that will eventually improve the healthcare system in the country.
The five-year (2013-2018) response to HIV/AIDS prevention and health promotion strategy will have a number of objectives, as stated below, which will include jointly supportive strategic directions towards achieving the stated aim.
Objective 1: By the year ending 2018, the plan will reduce new infections of HIV/AIDS by 50% particularly in youthful generation aged between 15-24 years.
Objective 2: In the five years stipulated timeframe, the intended strategy will help in reducing the annual number of new infections by 35%.
Objective 3: By the end of the year 2018, the strategy will increase the percentage of individuals diagnosed with HIV at early stages of the disease by 35%.
Objective 4: By the end of 2018, cases of mother-to child transmissions will reduce by 80% and approximately 50% of infected pregnant mothers will have received education of prenatal precautions. By 2018, the health care system should reduce sexual transmission of HIV by 60% and reduce by 50% the number of HIV-diagnosed persons who report having unprotected sexual intercourse.
Strategy & Implementation Plan
In a bid to achieve an effective response towards eliminating HIV pandemic and reducing significant infections annually, the national ministry of health should follow the aforementioned four strategic directions that will eventually enable responders to achieve substantive results. The approaches or strategic directions articulated herein will help in achieving the goals and measurable objectives stipulated in the five-year strategic plan.
The first strategy will entail community needs assessment and diagnosis of HIV to ascertain the extent of infection and provide a backdrop to the work plan on how to approach the issue. The second strategy will involve optimising HIV protection, treatment, and care approaches through HIV-specific interventions and approaches.
The third strategic direction will involve developing or leveraging broader health outcomes by integrating effective HIV responses and enhancing support by seeking other potential support initiatives. The fourth strategy will entail building strong and sustainable platforms and systems in an effort to reduce vulnerability, risk factors, and strengthening of health systems.
Strategy 1: Community assessment and HIV diagnosis
Any meaningful attempt towards comprehensive healthcare approach begins with the assessment process and in the case of this HIV prevention and health promotion strategic plan, community assessment will be imperative (Watson 2001). This assessment will enlighten the strategic plan on addressing social determinants of health and most significantly, those associated with HIV vulnerability and risks.
Determinants of health may include general socio-economic, cultural, and environmental conditions, societal and community lifestyles, or individual lifestyle factor (Davies & MacDowall 2006). The assessment process should involve comprehensive research process to assemble data on the extent of HIV infection with the communities and HIV prevalence rates coupled with identifying the underlying social and economic determinants of health and other HIV vulnerability and risk elements.
Summerside and Davis (2001) posit, “Increased prevalence, in itself, is widely understood as a key factor in increased incidence of new HIV infections” (p.2). This knowledge will act as the background to the analysis of the causal and contributing factors surrounding HIV pandemic within communities.
Strategy 2: Optimising HIV protection, treatment, and care approaches
After examining the prevalence rates and determining the social determinants of health that significantly drive the epidemic and hinder the response, the plan will embark on optimising HIV protection, treatment, and care approaches. The core elements involved in this phase of the strategy include integrating and improving the effectiveness, quality, and coverage of HIV-specific intercessions, as well as identifying new interventions prior to emerging evidences (Sidibé 2012).
Optimising HIV protection will entail processes of diagnosis to increase the percentage of persons diagnosed with HIV that determines prevalence rates, identify most-at-risk populations, and provide health care support to victims including regular testing and counselling to avoid stigmatisation among victims (Valdiserri 2002; Schulden et al. 2008).
It will also involve struggling to eliminate HIV infections in newborns, preventing sexual transmissions of HIV, and eliminating new infections in children and youth through diversified HIV testing and counselling approaches. Through treatment and care programs, the response team will engage in diagnosis and treatment of opportunistic infections to help in removing co-morbidities and co-infections among victims of HIV.
Strategy 3: Developing or leveraging broader health outcomes
The third strategic direction will involve developing HIV optimising programs that significantly connect between HIV and other crucial health areas. Over the years, HIV programs have lacked consistent support following inadequacy human and financial capital, and thus strengthening the connection between HIV prevention programs and other healthcare initiatives can provide long-term sustainable solution.
According to WHO (2011), “linking programs and integrating HIV into other health services have the potential to improve the efficiency and effectiveness of both HIV-specific and broader health investments” (p.19). This approach assists significantly in expanding the coverage of improved antenatal care services, helps in reducing infection cases involving mother-to-child transmissions of the disease, as well as enhancing effective HIV programs that reduce co-morbidities and co-infections.
This collaborative approach towards HIV pandemic and other health programs should alleviate program coordination, guarantee consistency across guidelines, and support program targets. From the county levels, practitioners at this stage should strengthen collaborative HIV response activities, address sexual health rights, and link HIV treatment with injection safety programs.
Strategy 4: Building strong and sustainable platforms and systems
Since HIV is a chronic infection and protection lapses emerge, there is a need to ensure a continuous process of HIV prevention through finalising the process by building sustainable systems. The progress made in the initial stages of promoting good health and preventing populations from HIV infection should not be a seasoned process, but a continuous procedural strategy that will commence in successive sessions.
The health care system in Swaziland system has been serving in splintered vision towards handling the HIV pandemic, and thus strengthening the national health systems will significantly help in enhancing victims’ access to healthcare services. According to Edejer et al. (2005), HIV related investments would translate to improvement in financing strategies in healthcare and help in integrating chronic disease management programs within areas suffering from limited resources.
WHO (2011) affirms that building strong and sustainable health system will include intensification of the six building blocks of the health system that include effective service delivery, well-trained sufficient workforce, strong health-information system, access to medical products and technologies, ample health financing, as well as strong governance and leadership.
Implementation process
The strategy would require a substantive approach in executing the plan for maximum performance and achievement of the desired goals and targets. According to WHO (2011), “the effective implementation of the strategy depends on concerted action by all stakeholders in the health sector response to HIV” (p. 31). As part of ensuring that the strategy achieves its targets and objectives, developing an autonomous implementation committee to oversee the processes and execution of the programs would be imperative.
In the beginning of the process, this autonomous implementation commission will engage in ensuring that healthcare practitioners work systematically in collecting, analysing, and integrating data towards monitoring HIV epidemic as stated in the strategic directions (1-4). The implementation agency will ensure that participants strictly follow the procedures of handling the prevention and health promotion strategy as stipulated.
The committee will be responsible for connecting the workforce with other supportive groups as well as ensuring effective communication and collaborative working that will channel the activities in the most desirable manner. Overseeing activities of the workforce in the county levels will require this implementation committee since the workforce training, recruitment, replacement, and task-shifting strategies would require sensitive management approach (McLeroy et al. 2003).
Financing programs is very critical in national HIV responses as funds may cause divisions among participants, hence the implementation committee will responsibly supervise funding of the projects and payment of the workforce.
Patient-monitoring systems will require the implementation agency where the committee will ensure data quality, support patient retention, ensure positive outcomes, and support achievement of quality of patient care. The committee will ensure that the national HIV response observes important elements of gender equity, human rights, and health laws and regulations.
Evaluation Plan
Monitoring and evaluation mechanisms will include comprehensive follow-up of the progress of the strategy implementation from the initial phase to the end of the five-year period. According to Idoko (2010), “monitoring and evaluation (M&E) system serves to provide the data needed to guide the planning, coordination, and implementation of the HIV response; assess the effectiveness of the HIV response; and identify areas for program improvement” (p.60).
Apart from having an autonomous implementation committee, this aspect might not provide the exact results of the strategy achievement, and thus the formation of an appraisal agency to make an overall assessment of the implementation committee will be imperative (Levey 2007).
The appraisal committee as recommended by Evans et al. (2005), will have sovereignty over collecting individual monitoring and evaluation research data regarding the progress of the HIV response strategy and finally combine, analyse, and interpret the results relative to those assembled by the implementation committee. The monitoring and evaluation framework will ensure an assessment of HIV response interventions and report the results to the higher national levels including Swaziland’s Ministry of Health.
Summary of Plan
The strategic plan for HIV prevention and health promotion would seek to promote a long-term sustainable HIV reaction plan in addressing this menace in Swaziland. In achieving effective results towards combating HIV infection, the national ministry of health should follow the aforementioned four strategic directions in the five-year stipulated period.
The first strategic direction will involve undertaking community assessment and HIV diagnosis to ascertain the level of infection and analyse the prevalence rates of HIV, as well as examining social determinants of health influencing HIV spreading and hampering its response. The second strategic direction will involve optimising HIV protection, treatment, and care approaches as well as removing co-morbidities and co-infections among victims of HIV.
The third strategic direction will involve creating a collaborative approach towards HIV that will include a connection between HIV and other crucial health areas to enhance HIV approach within the health care systems. The last strategic direction will involve building strong and sustainable platforms and systems to enhance the six building blocks of the healthcare system.
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