The Human Immune Deficiency has continued to kill more people in the United States even when people are aware of how it’s transmitted and how it can be avoided. This report analyses a report (Satcher et. al., 2010) that was posted by the Center for Disease Control and Prevention (CDC).
The regular test for HIV is being encouraged because recent medical reports indicate that there are many people who are infected by this virus but they are not aware. Most people ignore the evaluation process when they are not experiencing any health problems. They only get examined at a later stage when the situation has already worsened.
Early discovery can prevent further spread of the virus into AIDS. The majority of people who have been tested were not willing to get examined hence they were tested because of other reasons such as during blood donation where it is mandatory for the donor’s blood to be examined (Taubes, 2007).
CDC relied on the information provided from the survey conducted by National Health Interview between 2001 and 2009 to establish cases of early discovery of HIV. Additionally, this information was used to determine the geographical locations that had the highest infection rate. CDC also obtained information from the national HIV surveillance system which was useful in identifying the number of people who voluntarily availed themselves for the examination.
The information from these findings suggest that HIV affects homosexuals than men who are have straight sexual orientation. Besides that African-Americans are more prone to this virus than other races. Urban centers were found to have the highest number of infected persons. Of late most people are being discovered early enough because most people want to know their status.
The CDC report indicates that more men suffer from HIV than women. Rothan (2002) argues that this could be due to their polygamous nature. If HIV is discovered early the patient has higher chances of living longer than when examination has not taken place. When one knows that he/she is infected with HIV, he/she may avoid spreading the virus to uninfected persons.
For instance, pregnant women are forced to take HIV evaluation because if they are infected they will extend this virus to their new born babies hence when they are found to be positive they are discouraged from breast feeding the child once it’s born. This test has led to decline in child mortality. Incase a person tests positive he/she is introduced to retroviral medicine which is meant to decline the multiplication of the virus which in return prevents the virus from advancing into AIDS.
In the past decades many people were dying because of this disease because they could only get tested in health clinics and most people were afraid of going for the examination because they felt that they would die earlier due to stress of living with the stigma. Nowadays more people are being tested and there are few cases of people who realize they have this virus at a later stage.
The major advantage of early testing is that the patient will be aware of his/her condition and thus will be able to maintain his/her health (Rothan, 2002). That’s why nowadays people who die from HIV look very healthy as opposed to earlier on when people suffering from HIV used to look very thin.
In conclusion, the data collected by CDC is essential in planning for health care in areas most prone to HIV and in setting policies that can reduce the pandemic. CDC has been campaigning for early and voluntary examination in most countries from all over the world and thus more testing centers have been established.
The media is also being used to sensitize people on the importance of knowing one’s status because if one is negative he/she has to retain that status because the status is not permanent. More efforts are being made towards discovering people living with HIV because those who are not aware of their status are the ones who spreads the virus unintentionally. In some states testing is done in residential areas from door to door because many people argue that they are very busy to go for the test.
References
Rothman, K.J. (2002). Epidemiology: An introduction. New York: Oxford University Press.
In the New York state prisons, urgent attention is needed to reduce the HIV/ AIDS epidemic. From a survey done in the recent years, it has shown that the HIV infected inmates are increasing each year.
The inmates do not get enough and fair health care while in the prison. They should be educated and given prevention programs so that the transmission rate can reduce in the prisons as well as the community (Boutwell& Rich, 2004). The inmates are at a very high risk of contracting the virus and then they go back to the society with little idea of the disease; how it is spread and prevented. Therefore, the prisons have become breeding places for HIV/AIDS which then spreads to the community.
The health department in US intends to expand testing of HIV to the inmates because they found that twenty percent of the inmates are HIV positive (Mutter et al, 1994). The health department has initiated a program called pilot program that allocates the coordinators for patient care to HIV-infected inmates in the same jail. The program targets all the jails and aims at connecting all the HIV- positive inmates to the community care after they get released from the prison.
Efforts made to prevent transmission of HIV/AIDS in the New York prisons
HIV rates are very high among the African American prisoners and it is six times that of the population in general. In the year 2008, more than twenty thousand inmates were HIV positive; the female inmates were the most affected with 1.9% while the male inmates were 1.7% (Boutwell& Rich, 2004).
The local facilities determine the medical care of any prison or jail. Generally, the inmates do not receive adequate health care that meet the standards of public health. In New York, there is a constitutional right for the healthcare of the prisoners. If care is not provided to them, then this is termed as an unusual punishment (Krebs, 2006). On the other hand, the inmates need to support their own care by understanding their illnesses and making sure that they obtain suitable care in the prison or jail.
The AIDS Institute’s Criminal Justice Initiative (CJI) was created to respond to the prevention and services for the HIV positive inmates in the New York State. Its main goal is to offer a complete, unified range of excellent HIV prevention and helpful services to individuals as well as those going back to the society. The services are usually made to reduce the transmission of HIV in the prisons and to enhance good health and happiness of the individuals who already have the disease.
Factors that lead to the spread of HIV/ AIDS in the New York prisons
Since there is a great increase in the number of inmates getting infected with HIV/AIDs, the setting in the prisons should be a focus in addressing such epidemics. The inmates should be tested more often so that those infected with the disease are identified, and given adequate care while still in prison so that primary and secondary prevention goals are achieved (Krebs, 2006). Resources for carrying out routine testing should be available as well as provision of complete HIV care so that the epidemic is stopped.
HIV transmission among the New York prison inmates mainly occurs due to sex between two males or two females. Tattooing in the prisons also increases HIV transmission thus the need for HIV prevention programs in these prisons (Mutter R. et al, 1994).
It is apparent that HIV is transmitted in prisons due to the behaviors that occur among the inmates. From a survey done in the New York state prisons, the characteristics of the inmates who are likely to contract the disease while still in prison are: black and younger inmates, inmates who have been imprisoned due to sexual crimes and those inmates who have stayed in prison for a longer time.
The last three decades bear testament to the devastating effects of HIV and AIDS on all spheres of society. No society has gone untouched by the epidemic. While poorer countries have the highest infection and casualty rates, richer countries continue to devote significant resources towards research and financing of the fight against the virus.
San Francisco represents the developed world while sub-Saharan Africa represents one of the worst hit regions by HIV. The goal of this paper is to compare the impacts of the epidemic on these two regions by looking at the driving factors and the intervention efforts by the church.
San Francisco holds an important place in California. It was once the largest settlement in the east coast of the United States. It played a significant role in the Second World War by acting as an exit point for troops headed towards the pacific.
This city became the heart of civil liberties movements in the United States after the war. The movements set out to expand the traditional definitions of marriage and to mainstream same-sex unions. Therefore, it comes as no surprise that the largest community living with HIV in the city is gay (San Francisco AIDS Foundation).
Another factor driving up infection rates in the city is drug use characterized by sharing of syringes. As the drug problem spread out in America, San Francisco took its share of the burden, resulting in a large community of addicts. Access to syringes has improved over time but it remains a controversial intervention in the control of the spread of HIV.
The HIV case in Sub Saharan Africa lies in the larger issues of poverty, tradition, and ignorance (Umunna 25). This part of the world provides case studies on absolute poverty (WHO and UNAIDS 20). As a region, Sub Saharan Africa is home to majority of the worlds poor and has some of the most deplorable health care systems. Because of poverty, the infection rates have soared since most people do not have access to credible information because there is no infrastructure to relay the information (WHO and UNAIDS 20).
Traditions amongst the people living in sub Sahara Africa also contributes significantly to the spread of HIV. Some of them promote practices such as wife inheritance, communal circumcision using the same set of knives and polygamy. All these are risk factors in enhancing the spread of the virus. Ignorance makes it impossible for the people to know how to conduct themselves to avoid infection such as mother to child transmission.
A keen look at the factors driving the spread of HIV in both areas reveals that the same basic elements are responsible for the spread of infection. Sharing of needles and knives both use the same transmission mechanism of sharing infected instruments. The major mode of HIV transmission, which is sex with an infected partner, plays a big role in both places where people have multiple sex partners.
In San Francisco, they are mainly same sex couples while in sub Saharan Africa, traditions allow for polygamy and wife inheritance, which both amount to sharing multiple sex partners. In the event that one person in the pool contracts the virus, then all the people involved end up infected.
The main difference between the nature of infection in San Francisco and in Sub Saharan Africa comes from the economic divide that characterizes the two locations. San Francisco is relatively wealthier and better connected than Sub Saharan Africa. It is easier to use community-based programs in San Francisco to control infection rates in San Francisco because of the infrastructural outlay already available.
However, in sub Saharan Africa, limited communication infrastructure delays transmission of information and materials for use to prevent the spread on HIV. In conclusion, the social and economic disposition of a region influences how HIV spreads and influences the results of the efforts to control it (Umunna 27).
The church is one of the important players in the fight against HIV. The church has certain unique characteristics that place it strategically as a key institution in the fight against HIV. The church is an outward looking entity with a mission that seeks to engage with its immediate community.
Normally, church outreach efforts target the less privileged and the vulnerable in society. These segments of the society suffer most from the impact of HIV in both San Francisco and in Sub Saharan Africa. Churches have programs to help widows, orphans, the sick, and drug addicts by offering practical help and hope.
One such church is the Metropolitan Community Church of San Francisco which felt firsthand the devastating impact of the virus in the mid eighties when there was no effective means to manage the epidemic (MCCSF). This church developed mechanisms to support members affected by the disease. It meant taking care of widows, providing emotional and spiritual support for orphans and sensitizing the community on the impacts of the virus.
In sub Saharan Africa, a large segment of the population is religious. This means that there is a favorable disposal by the communities to the messages given by clerics. Primarily, churches concern themselves with the moral issues sorrounding sex and as such, they are able to dissuade sexual relations outside marriage and sex with multiple partners because of the spiritual ramifications.
In addition, the churches, just like in San Francisco, are part of the community efforts in taking care of AIDS orphans, widows, and patients. Some of them run hospitals where medical care is available for HIV patients. The key message that the church has towards the world is compassion and this is the key requirements for dealing with the aftermath of the epidemic.
However, the church does not promote the full range of measures available for prevention of the spread of HIV since some of them go against the principles that the church stands for. The most significant issue in this regard is the condom debate.
On one hand, research reports indicate that there is a significant reduction in the chances of infection by using a condom when having sex. However, churches cannot embrace this approach because of the moral issues surrounding sex between unmarried parties. The Catholic Church actually rejects the condom in total because it goes against the natural philosophy that it believes ought to govern sexual relations.
The fitting conclusion is that the church has assets and presence in both sub Saharan Africa and in San Francisco which are vital in the fight against AIDS. However, it is impractical to expect the church to abandon its traditional values to embrace the full range of options available in the fight. Therefore, the best thing is to allow the church to play the roles that suits it best in the fight against HIV without interfering with its core message.
Works Cited
MCCSF. History of Metropolitan Community Church San Francisco. 2011. Web.
San Francisco AIDS Foundation. Statistics. 2011. Web.
Umunna, Gregory Ejiogu. HIV/AIDS: Political Will and Hope. USA: Xlibris Corporation, 2011.
WHO and UNAIDS. AIDS Epidemic Update: December 2009. Geneva: WHO Regional Office Europe, 2009.
HIV/AIDS continues to be a leading cause of alarm globally. New infections and deaths due to HIV/AIDS related complications are major issues that need to be dealt with urgently. It is particularly alarming in the sub-Saharan Africa where an average of 10% HIV prevalence in adults has been recorded. This is very high compared to the global average of 1%. The Southern Africa region accounts for about 40% of the global population living with HIV.
However, the female gender is more affected by the pandemic with women and girls accounting for about 60% of this population. Although the records indicate optimistic results, there is still need to enhance the campaign. In San Francisco, the new infections and death tolls may be on a down slope but the marginalized groups are still at a risk and this needs to be addressed. In this paper the key drivers of HIV/AIDS in Southern Africa and San Francisco will be discussed.
HIV/AIDS in Sub Saharan Africa
The extent of the HIV/AIDS pandemic in the region can be attributed to such things as; Sexual behavior-many men and women in the region have different sex partners concurrently; these may be in cases of polygamy, small houses (side partners apart from spouse) and prostitution.
Many of them do not use condoms consistently meaning that safe sex practice has not been cultivated in them (Jana et al, 13-16). Secondly, male circumcision is practiced in very low levels and as we know, male circumcision is a major boost in the prevention efforts so lack of it is on the contrary. A third driver is the stigma associated with infection. This lack of acceptance by the individual and the community forces an infected person to keep their status secret which leads to further spread of the virus.
In some cases some people do not want to know their status for fear of stigmatization and this brings down the efforts of treating the infected persons. Also many sexually transmitted infections go untreated mainly due to this fear and they are a factor that encourages HIV infection. Male attitudes towards gender related issues such as reproductive health is also another contributing factor.
Men do not involve themselves in such issues and therefore many of them lack the knowledge to curb the pandemic. They involve themselves in intergenerational sex, gender based violence and sexual violence. This means that the women and girls are the major victims of the men’s ignorance hence the high number of infections in females (Expert Think Tank Meeting on HIV Prevention in High-Prevalence Countries in Southern Africa 5-7).
HIV/AIDS in San Francisco
In San Francisco, the efforts of prevention and treatment have born fruits since the number of new infections and HIV/AIDs related deaths is on a downward trend. The reduction in these numbers can be highly attributed to the change of sexual behavior in heterosexual men and women and non-injecting drug users.
Cases of new infections in these groups of people are very rare. However, there are still other driving forces in the spread of the disease and these include; Homosexual behavior; men who have sexual relationships with other men are at a major risk of infection. Transfemales are also another group of people who are on the higher side of the risk and hence their behavior is a key driver for the epidemic.
Injection drug use is another major driving force. HIV transmission among this group of people is very likely and so the risk of new infections is unacceptably high. Disparities and unequal treatment for different groups of people may have been a major drawback on the efforts but it is now on the downward slope. This is as a result of the efforts by different care groups to involve representation of all the communities; including the marginalized groups, in the decision making process (San Francisco HIV Prevention Plan 1).
Comparison between the key Drivers in the two regions
The driving forces in these two regions are very different since they are driven by the people’s lifestyles which in these cases are worlds apart. As a comparison of the key drivers in these regions, we look at the drivers the way they affect the efforts made to eradicate the disease.
As we have seen in the discussion earlier, the major driving forces in the sub Saharan Africa can be attributed to the regions position in terms of development. Most countries in the region are developing countries; and factors such as gender and sexual violence, poverty which leads to intergenerational sex and prostitution especially in women are inherent in these countries.
This makes the prevention and treatment processes very hard since some people are driven to the wall by circumstances; meaning that they may be willing to change their ways but the situations they are in cannot allow that.
In San Francisco however, the major driving force is the sexual orientation of individuals as well as drug and substance abuse. These can not be attributed to under development, therefore, the efforts to curb the epidemic can only be strengthened by the people’s willingness to change their ways.
If the high risk groups of people are willing, they can put in their efforts; for instance, the gay community can accept to learn and use preventive measures, the drug users can accept rehabilitation plans or in extreme cases they should take precautions in their sharing.
The Response of the Church to the Key Drivers of HIV/AIDS
The church has made a lot of efforts in the fight against HIV/AIDs; However, this has not prevented the spread of the disease. This continued deterioration can be attributed to the churches’ ethical, liturgical and ministerial practices. These have encouraged the spread of the disease both passively and actively. These factors include the lack of an open, realistic way of involvement due to the shyness in addressing sex education and sexuality issues which are involved in prevention of HIV spread.
Exclusion, theological interpretation of scriptures and definition of sin have contributed to increase stigmatization and suffering. A plan has been put forward to add an ecumenical dimension to the church’s effort and if implemented, it is bound to yield better results (Global consultation on the ecumenical response to the challenge of HIV/AIDS in Africa 9)
In the US, the church’s involvement is mainly through faith based organizations. These have continually offered support to the infected and affected in terms of medical care, food supplies, cancelling and the general support needed morally and spiritually. They have also offered care to the care givers and education to the communities on the risk factors and prevention services.
The government has since supported these organizations through federal funding. Laws have also been put down to prevent discrimination against such organization, the beneficiary or volunteer on the basis of religion. Also, it ensures that nobody should be forced to get involved in any religious activity involuntarily. These partnerships ensure that the church’s efforts are delivered painlessly and the beneficiaries are satisfied.
Conclusion
From these findings, we can conclude that the spread of HIV is highly dependent on a people’s lifestyle. This covers the level of development, the cultural beliefs and religious beliefs. The Church and the various arms of government can play a major role in the effort to curb the pandemic especially when they work together.
Works Cited
“Expert Think Tank Meeting on HIV Prevention in High-Prevalence Countries in Southern Africa.” SADC 2006: 5-10. Web.
“Global consultation on the ecumenical response to the challenge of HIV/AIDS in Africa.” The Ecumenical Response to HIV/AIDS in Africa 2001: Web.
Jana Mere, Nkambule Paul and Tumbo D; One Love: Multiple and concurrent Sexual Partnerships in Southern Africa: A Ten Country Research Report. 2008:13-36 Web.
“San Francisco HIV Prevention Plan.” San Francisco HIV Prevention Planning Council 2010: 1-3. Web.
Key Drivers of HIV and AIDS in Sub-Saharan Africa and San Francisco
Disease epidemics are largely caused by specific historic, political, economic, and cultural aspects. In this respect, the infection spread is often regarded as a social rather than biological process. The plague of the twenty-first century is AIDS that have been caused by a complex of cultural, economic and political conditions. Specifically, gender inequalities, genocide, poverty, and many other factors have had a destructive impact on the situation in developing countries (Kalipeni 15).
Due to the lack of resources, consistent infrastructures, and effective governance, these economies have been struck by the Human Immunodeficiency Virus and AIDS. The African continent has undergone the worst shifts, particularly its Sub-Saharan region. However, poverty is only one of the key drivers of disease epidemic because there are many cultural, moral, and ethnic determinants influencing the situation.
To enlarge on this issue, the rate of people suffering from HIV/AID is significant. Irrespective of local conditions and geographical peculiarities, the reasons for HIV/AIDS emergence are rooted in a complex mix of political, social, and economical factors that drive the epidemic in Sub-Saharan Africa and San Francisco. The nature of these factors is different, but refers to the common categories.
The most tangible of epidemic in Sub-Saharan Africa is strongly associated with gender issues. Specifically, such problems as gender inequalities and gender vulnerabilities, violence, and many other gender-related challenges are on the South African agenda (Gender and Inequalities and HIV n. p.).
Gender inequalities are more related to masculinity implying that males are likely to have more sexual partners. This is of particular concern to men having relationship with much younger women. Further, force sex and violence of physical and emotional character are experienced by women who are less resistant to these threats. What is more threatening is that women have a lesser access to HIV/AID prevention plans causing restrictions to a decision-making process.
Poverty and migrations are also among the core reasons for spread of the dangerous epidemic. Specifically, HIV prevention programs are often halted due to the lack of funding. These socioeconomic obstacles prevent the population from receiving sufficient financial, moral, and social support from developed countries (Kalipeni 205).
This also explains why AIDS pandemic is still the major threat to our plant (Kelly 26). Despite the fact that many scientific and technological advances directed at preventing the disease have been introduced, the evidence shows that they have little impact on the developing countries having much lesser access to financial resources.
Cultural believes, morale, and ethics are decisive in defining the underpinnings of increased rates of HIV/AIDS in South Africa. While attaining much importance to cultural forces, it should be noted that educational and information reforms must be introduced to increase the population knowledge and promote generally accepted educational standards (Kalipeni 17). Lack of information and responsiveness explains the inefficiency of prevention plan because cultural constraints determine the results.
Although the United States belong to one of the most developed economies, the rate of AID/HIV creates a serious challenge to the US government. The problem is of particular concern to San Francisco region where the epidemic is also on the rise. The contributing factors involve sexual orientation issues, injection drugs problems, and racial discrepancies. Heterosexuality can be largely associated with psychological, behavioral, and ethical patterns that are strongly associated with homosexuals (Kelly 45).
Injection drugs are also toughly connected with the development of AIDS/HIV because they reflect the behavioral and psychological patterns that are typical of citizens (Rao and Svenkerud 86). In this respect, the prevention programs should be culturally sensitive and oriented on shaping new cultural patterns.
Finally, racial discrepancies influence greatly the situation with AIDS increased rate as far as immigration issues are concerned. To be more precise, African Americans have higher rates of reported HIV cases among which are such categories as MSM and trans-persons are included (San Francisco HIV Prevention Plan 3).
In conclusion, the analysis of social, cultural and political situations in Sub-Saharan region and San Francisco has revealed that that there are a great number of factors contributing to the spread of the epidemic.
In particular, the key driving factors of HIV/AIDS in Sub-Saharan African involve gender inequality, poverty and migration, and cultural beliefs. In its turn, San Francisco high rates are largely predetermined by sexual orientation, injection drugs proliferation, and racial discrepancies. All these factors can be embraced into a complex mix of social, cultural, and economical issues.
Differences and Similarities of Factors Driving HIV/AIDS in Sub-Saharan Africa and San Francisco
The identification of factors triggering the rise of HIV/AIDS in the regions has uncovered a number of distinctive differences and similarities. Before analyzing those, it should be stressed that pandemic is a social process that touches upon many political, ethnic, racial, cultural, and economical issues, which is the explicit similarity related to issue.
Another common feature refers to the sexual orientation problem, particularly to homosexual males who have greater risk of being infected by the disease. Hence, due to male gender prevalence in South Africa, men are more likely to be sexually promiscuous.
Despite similarities, there are obvious distinctions predetermined largely by economical and political conditions. Specifically, the level of poverty is different and, as a result, the causes of pandemic differ as well. South African region refers to developing economies whereas San Francisco in much more advanced in these terms. In addition, there are also discrepancies in cultural beliefs and perceptions. Lack of education and deficiency in understanding the problem prevents African people from embracing the seriousness of the issue.
Church’s Response to AIDS Pandemic
Today, African religious institutions are primarily considered as healing ministries. This tendency has come to the forth when it comes in Christian traditions in African region as far as the problem of AIDS spread is concerned.
The analysis of religious background of churches in Zimbabwe and other countries of Southern region have revealed that religion considers AIDS as a deviation of behavior and rejection to follow the main principles of religion (Dube 27). The church reaction on the epidemic, therefore, can be considered through wider applications of religion to AID/HIV problem.
Judging from the above, Churches in African places an emphasis on moral dimension to eliminate spiritual and physical suffering that people endeavor because of the disease.
In this respect, the Christian communities are more presented as mentors and teachers encouraging people to fight with the pandemic and resort to pre-caution methods. Their actions are directed at increasing people’s awareness and promoting specific educational programs based on the Biblical principles. The reforms concern both the infected people and the one who face this threat.
Works Cited
Dube, Lilian et al. African Initiatives in Healing Ministry, South Africa: UNISA Press, 2011. Print.
“Gender and Inequalities and HIV”. Gender, Women and Health. World Health Organization. 2011. Web.
Kalipeni, Ezekiel, et al. HIV and AIDS in Africa: Beyond Epidemiology, New Jersey: Blackwell Publishing, 2006. Print.
Kelly, Michael. HIV and AIDS: A Social Justice Perspective. Nairobi, Kenya: Paulines Publications, 2010. Print.
Rao, Nagesh, and Peer J. Svenkerud. Effective HIV/AIDS prevention communication strategies to reach culturally unique populations: lesson learned in San Francisco, U. S. A and Bangkok, Thailand. International Journal of Intercultural Relations. 22.1 (1998): 85-105. Print.
San Francisco Prevention Plan. Introduction. SFHIV. 2010. Web.
HIV is the short form of human immunodeficiency virus. When the person is infected with HIV, it is more likely that the acquired immunodeficiency syndrome (AIDS) will develop. HIV is a terrible condition because it cannot be cured. Once one has HIV, he or she will have to live with it for the rest of life. The virus infects T cells or CD4 cells. These cells are essential for the efficient functioning of the human immune system.
HIV destroys these cells and makes the human body vulnerable to various kinds of diseases. An infected individual can live up to ten years until HIV develops into AIDS. When the final stage occurs, the human immune system is too weak to resist even the slightest illnesses. As a result, one can die of the usual disease. The most common way of HIV/AIDS transition is the unprotected sexual contact. There is no cure for HIV. However, particular medicines can prolong the life of infected people (HIV Basics n.d.).
Nowadays, AIDS is regarded as the most urgent issue on the global level. The number of HIV-infected people is immense in South Africa. The virus is the public health threat. For instance, more than thirteen thousand residents died of AIDS in the U.S. in 2012. More than one million people died of AIDS in the world in 2014 (Basic Statistics n.d.). These rates prove the fact that HIV is the plague of the twenty-first century. Public health safety should be of primary concern.
HIV and AIDS rapid distribution resulted in million deaths of people. This epidemic also has changed the society drastically. The statistics showed that HIV was more often diagnosed in men who had sex with men. Due to this fact, people all over the world became extremely prejudiced against homosexual communities. Almost eighty countries in the world consider homosexuality illegal. Individuals who display the belonging to some of the GLBT communities can be even punished. Fowler (2014) writes that in some countries being a gay is like being a Jew in Nazis Germany.
In my opinion, the government should react timely and adequately to such issues as HIV/AIDS. President Barack Obama established the National HIV/AIDS Strategy in 2010. This program was the first comprehensive step towards fighting the problem (HIV/AIDS: Moving Forward n.d.).
The strategy was aimed at increasing the level of population’s awareness concerning the ways of HIV transmission. The results show that the level of HIV-infected people decreases every year in America (HIV in the United States: At a Glance n.d.). This situation can be explained by the fact that Obama’s administration improved the situation in term of public health safety.
Numerous institutions aim at providing the best health care and prevention services. The roles of medical professional and public health expert in HIV/AIDS treatment differ. According to Gebbie, Rosenstock, and Hernandez (2003), public health professionals aim at improving the health condition on the level of population.
They can work in schools or organizations. The task of the public health professional is to educate citizens, make as many people as possible aware of potential threats. Medical professional works with the individual. The medical nurse takes care of the particular patient and makes every effort to improve his or her health condition or prevent the risk. That is the primary difference between responsibilities of the public health professional and the medical professional.
It is evident that the Aids epidemic is a globally potential threat. This means that it is an epidemic of an infectious deadly disease, which threatens the lives of many people globally. In addition to this, Aids is also an epidemic of meanings or signification. This means that people often identify the epidemic with certain people, beliefs and occurrences. If medical practitioners and the public continue to see Aids as a transmissible disease only, then various meanings or signification will continually multiply (Treichler, 264).
The issue of Aids as an epidemic of meanings is very crucial for its identification and management. These meanings or signification include cultural or racial difference, which is the main concern of this paper. The paper will argue that, Aids has meanings or signification in relation to cultural and racial difference. For instance, the epidemic is more prevalent in Black Americans as well as Haitians.
In late 1986, the Center for Disease Control produced a list of the highly susceptible groups in relation to Aids infection. This list included the homosexuals, black immigrants and Heroin Addicts.
This list revealed that being a particular kind of a person rather than practicing certain practices was a major factor in Aids infection. The implication here is that racial or cultural difference plays a significant role in susceptibility to Aids infection (Treichler, 217).
Various studies have recorded that in the United States, the genetic difference between Native Americans and immigrants, especially black Americans, plays a significant role in the vulnerability of Aids infection. Some of these studies have revealed that Native Americans and other people of European origin have a tiny genetic mutation that renders their immune systems resistant to HIV infection.
This then implies that people of the African origin and the Haitians are more susceptible to Aids infection since they do not have the genetic mutation.
Other studies have offered the premise that the infection of Aids is not highly prevalent in females. Rather, these studies indicate that males are at higher risk of spreading the infection, especially the homosexuals. However, some exceptions are clear especially for women of African origin. Owing to their sexual practices and other internal factors, these women are highly susceptible to the Aids infection. This indicates that there is a connection between Aids infection and cultural or racial background (Treichler, 270).
In addition to genetic difference and other internal factors, poverty also plays a significant role in offering significance to Aids epidemic in relation to racial differences. For instance, among African Americans and the Haitians, poverty depicts some unhealthy sexual patterns, which increase their susceptibility to Aids infection.
Poverty often causes young people to lack good upbringing and quality education hence rendering them susceptible to drug abuse and unhealthy sexual behaviors. This does not however mean that young people who are not of African origin do not engage in unhealthy sexual behaviors. The difference is that since Aids is more prevalent amongst the African Americans, the possibility of its spread is therefore very high.
It is evident that Aids is an epidemic of meanings or significance rather than just being an epidemic of a lethal infectious disease. This issue of meanings of significance is very important in identifying and managing the epidemic. The epidemic has significance in relation to racial and cultural differences. For instance, several studies have associated Aids with people of African and Haitian origin. This means that the epidemic is highly prevalent in these groups due to various factors including genetic variance, sexual behaviors as well as poverty.
The prevalence rates of HIV/AIDS vary from on ethnic group to another in the United States. The epidemiology of this global menace has evolved with time since it started by affecting the white people and is now affecting the black people. Epidemiological data indicates that in the modern society, black people have high prevalence rates of HIV/AIDS.
One of the many ethnic groups experiencing worst cases of this disease is the African Americans because they have high prevalence rates when compared to other ethnic groups. For example, this disease is more prevalent among African Americans than among Asian Americans and Hispanic Americans.
Stone, Ojikutu, Rawlings, and Smith (2009) record that within a period of 20 years, viz.1985 – 2005, the rate of infection of HIV/AIDS doubled from 25 per cent to 50 per cent among African Americans.
This change means that more African Americans are contracting the disease, living with it, or are under treatment than ever before. Additionally, statistics indicate that HIV/AIDS infections have gender orientation, as rates of infections are higher among women than among men (National Alliance of State & Territorial AIDS Directors, 2008).
Overall, a number of reasons might explain this scenario; for instance, drug abuse, sexual behaviors, and socioeconomic factors. The American government has come up with a number of programs to combat this problem. Therefore, this paper explores the potential causes of the disparity in HIV/AIDS and examines the efficacy of the programs that have been established to help in combating this menace.
Overview of HIV/AIDS in the US
Beyond 1980s, the white people had a higher number of people living with HIV/AIDS when compared to the blacks. Drug abusers and homosexuals defined the group of people among the whites who had a high prevalence of the disease. However, as cases of HIV/AIDS infections increased among the Americans, Africans Americans started to experience higher rates of infections than other ethnicities.
Between 1985 and 2005, the infection rates doubled among African Americans from about 25 per cent to approximately 50 per cent (Stone, Ojikutu, Rawlings, & Smith, 2009). In 1985, the population of African Americans formed about 12 per cent and during 2005, their population comprised 13 per cent.
The increase in population by 1 per cent does not justify the doubling of the disease cases. The increase was quite shocking because infection rates among other ethnic groups remained considerably low. Currently, the cases of infections among African Americans are still increasing exponentially. The disproportionate impact of the disease on the Americans indicates that many factors, which mediate infection, exist among varied ethnicities and communities.
In the United States, the population of people living with the disease has been increasing exponential in the last three decades. The people at risk of getting HIV/AIDS infections belong to the ages of 13 and 34 years because they are sexually active. Stone, Ojikutu, Rawlings, and Smith (2009) indicate, “At the end of 2008, 322, 796 persons were living with AIDS, nearly twice the number of those at the end of 1994” (p. 2).
The exponential increase of the people living with the disease occurs due to change of lifestyles in the society coupled with other factors related to sexual behaviors. The government thus supported the introduction of treatment regimes and increased the number of prevention strategies.
Although the treatment regimes and prevention strategies enabled stemming of HIV/AIDS amongst the whites, cases of the infections continued to increase among African Americans. As the cases of the disease continued to increase unabated among African Americans, the government and health care system had to revise their preventive strategies to help in combating the epidemic. From 1980s, it gradually became evident that African Americans had numerous predisposing factors that cause high rates of infections.
Surveillance studies indicate that HIV/AIDS infections have both geographical and gender orientations. Stone, Ojikutu, Rawlings, and Smith (2009) note that surveillance data provided an interesting epidemiological aspect of HIV/AIDS epidemic, viz. “It was concentrated in specific geographical areas: the Northeast, the South, the Mid-Atlantic and the West coast” (p.3).
The geographical aspect of the disease distribution indicates that there are social, economic, and cultural factors that contribute to the dominance of the disease in one region than other regions.
Moreover, the occurrence of HIV/AIDS among African Americans has gender orientation. African American women have higher cases of infections than their men counterparts do. “African American women comprise only 12 per cent of the female population in the United States, yet they accounted for 64 per cent of women living with HIV/AIDS at the end of 2006” (National Alliance of State & Territorial AIDS Directors, 2008, p. 1).
This observation means that gender-based factors predispose African American women to the disease. In this view, the presence of many predisposing factors to the disease is responsible for the disproportionate distribution of HIV/AIDS cases amongst American ethnic groups.
Potential Causes
Drug Abuse
The prevalence of HIV/AIDS infections among African Americans is higher when compared to the general population of the United States because they form a significant population of drug abusers. Given that African Americans have low socioeconomic status, they tend to abuse drugs as a way of dealing with stress and other life challenges.
Laurencin, Christensen, and Taylor (2008) posit, “Illicit drug use is an important primary risk factor for HIV/AIDS infection among African Americans, which is also noted as the second leading cause of HIV infection for both black men and black women” (p.38). Drug abuse predisposes African Americans to the disease because they share needles that they use when injecting drugs into their bodies.
Since drugs that people abuse are illegal, they abuse them in secret places where they cannot access extra needles in the event that they attempt to avoid sharing. Lack of extra needles and the addictive nature of the drugs compel the drugs users to share needles, thus predisposing them to the disease. Hence, if one of the drug users has HIV/AIDS, the entire group of drug users would contract it.
Moreover, drug abuse predisposes African Americans to unprotected sexual intercourse because drugs influence one’s rational judgment. Usually, sober individuals are unlikely to participate in unprotected sexual activities because they still have the rational capacity of protecting themselves during sexual intercourse.
In contrast, drug users are unable to protect themselves either during consented sexual intercourse or from rape. When a drug user is under intoxication, the chance that he/she can consent to perform sexual intercourse with protection is minimal. Hence, most sexual intercourse activities that occur among intoxicated drug users are unprotected.
McCree, Jones, and O’Leary (2010) assert that drug abuse is responsible for high cases of HIV/AIDS among drug users because they are vulnerable to sexual abuses. Drugs users are vulnerable to abuses such as rape, sodomy, and gang rape because they do not have the capacity to protect themselves from such abuses. Eventually, victims contract the disease and continue to transmit to other people whom they abuse drugs together.
Drug abuse also influences adherence to antiretroviral medication and other related medications. When infected people abuse drugs, they forget to take their medication, thus increasing viral load in their bodies.
Increased viral load increases the chances of HIV/AIDS transmission during unprotected sexual intercourse. “A study of female cocaine users, predominantly African American women, showed that substance users were less likely than nonusers to take their antiretroviral therapies exactly as prescribed” (Laurencin, Christensen, & Taylor, 2008, p. 38).
Thus, drug abuse among African Americans contributes to poor adherence to prescribed medication and increases transmission of HIV/AIDS within population. Additionally, some illegal drugs impede efficacy of antiretroviral drugs for the normal dose of medication does not have the intended impact on the viral load. Reduced efficacy of the antiretroviral drugs implies that the medication does not help in management of the disease. Therefore, among drug abusers, antiretroviral drugs are not significantly helpful.
Sexual Behaviors
The nature and type of sexual behaviors that Africa Americans practice put them at risk of contracting HIV/AIDS. Significant cases of infections occur through heterosexual contacts. African Americans nurture the social behavior of trusting each other while mistrusting other ethnic groups.
The National Alliance of State and Territorial AIDS Directors (2008) posit, “African American women are less likely than other women to date men outside their racial/ethnic group” (p.1). Essentially, African American women tend to have sexual intercourse with African American men, thus restricting transmission of HIV/AIDS within their ethnic circle. Hence, heterosexual contact within the community explains why African Americans have a high prevalence of the disease when compared to other ethnic groups.
Lower marriage rates among African Americans contribute to the increase in the cases of HIV/AIDS transmission. Owing to low rates of marriage, African Americans prefer having multiple sexual partners. Given that most young people are single, they indulge in heterosexual intercourse with many partners, thus increasing the rate of transmission of HIV/AIDS. Moreover, sex-ratio imbalance has given men the advantage of having many sexual partners because women seem to be desperate in competing for the few available men.
“The sex-ratio imbalance in African American communities can give rise to women’s difficulties in discussing and negotiating condom use with male sexual partners” (National Alliance of State & Territorial AIDS Directors, 2008, p. 4). Thus, African American women succumb to demands of their partners, hence increasing their vulnerability to the disease. Ultimately, since men have multiple sexual partners, they increase the rate of transmission of HIV/AIDS among African Americans.
Homosexual behaviors among African American men also contribute to the disproportionate occurrence of the disease. Among African American men, male-to-male sexual contact is responsible for the occurrence of high incidences of HIV/AIDS. Studies have shown that homosexuals have increased in the past decade due to recognition of their rights in the society. Hence, homosexuals have contributed to the increase in the prevalent rates of the disease among African Americans.
According to Laurencin, Christensen, and Taylor (2008), survey conducted across the United States indicated that clubs, cafes, bars, parks, gyms, gay pride events, and social organizations are places where homosexuals interact and propagate their sexual activities. Since most African American men are dominant in such places, they are vulnerable to HIV/AIDs because they interact with people from various backgrounds.
Sexually transmitted diseases predispose people to HIV/AIDS. The disproportionate occurrence of the disease among African Americans is due to the high incidences of sexually transmitted diseases. In 2005, “African Americans were 18 times as likely as whites to have gonorrhea and approximately five times as likely to have syphilis” (Laurencin, Christensen, & Taylor, 2008, p. 38).
Gonorrhea cases formed about 58 per cent of the total cases while cases of syphilis comprised 41 per cent. Sexually transmitted diseases such as gonorrhea cause inflammation on genital areas and increases susceptibility to the disease.
Susceptibility to HIV/AIDS increases because white blood cells concentrate on an inflamed genital tract thus causing the viral load to increase (Friedman, Cooper, & Osborne, 2009). Syphilis is an ulcerative sexually transmitted disease, which enhances entry of viruses through mucosal ulcerations. Therefore, high prevalence of sexually transmitted diseases among African Americans has contributed to the disproportionate occurrence of the disease.
Socio-economic status
Socio-economic status is a factor that determines the susceptibility of people to HIV/AIDS. The low socio-economic status amongst African Americans has contributed to high incidences of the disease. Women under low socioeconomic status are prone to sexual abuse because they are unable to defend themselves.
Therefore, they become subjects of sexual abuse, thus predisposed to HIV/AIDS. Friedman, Cooper, and Osborne (2009, p.1003) argue, “Infections are not simple product of behavior alone”, but a complex of social and economic factors that affect the lives of African Americans. Hence, differences in socio-economic status between the whites and blacks have contributed to the high incidences of the disease among African Americans.
Additionally, low socio-economic status determines access to healthcare, and thus relates to the incidences of HIV/AIDS cases among the African Americans. “Limited access to high-quality healthcare, housing, and HIV/AIDS prevention and education programs both directly and indirectly increase the risk factors for HIV infection” (Laurencin, Christensen, & Taylor, 2008, p. 38).
In the year 2000, approximately 25 per cent of African Americans lived in poverty, which means that they could not access essential healthcare services. Historically, African Americans faced social and economic marginalization, which increased their vulnerability to drug abuse, homelessness, incarceration, and risky sexual behaviors. Hence, poverty and social alienation prevent African Americans from accessing critical healthcare services, which translates to increased HIV/AIDS prevalence.
Government Programs
Community mobilization to increase awareness about HIV/AIDS is one of the strategies that the United States has applied in reversing trends of the epidemic among African Americans. Issues to deal with increased awareness of the disease and its associated risk factors such as drugs and sexual behaviors have significantly reduced the rate of infections among African Americans and the general population. Mobilization of communities to enhance awareness of the disease has changed perceptions and norms about the disease.
Through awareness, stigma has reduced, people have diagnosed HIV/AIDS early, patients have adhered to treatment plans, and the entire population has transformed their lifestyles for healthy behaviors (Stone, Ojikutu, Rawlings, & Smith, 2009). Hence, community mobilization has made tremendous reductions in the rate of HIV/AIDS infection among African Americans for they have avoided drug abuse and risky sexual behaviors.
Adherence to medication is a major problem that influences management of HIV/AIDS. The government employs an educational program where healthcare providers offer patients with essential information to enhance adherence to antiretroviral drugs.
The United Nations Educational, Scientific, and Cultural Organization (2007) indicate, “Preparing patients through treatment education and providing ongoing need-based education help persons with HIV to manage their treatment and HIV-related diseases” (p.1). Treatment education enables patients to manage their condition by adhering to medication and improving their CD4 counts.
Treatment education at the community level aims at encouraging people to check their HIV status and take the appropriate healthcare measures. Eventually, the community becomes responsive to the needs of patients and thus reduces the stigma associated with the disease. Hence, treatment education is an effective program that is helpful in promoting adherence to medication.
Enhancement of socio-economic status of the African Americans is a strategy that the government has employed in combating the high incidences of HIV/AIDS. Enhancement of socio-economic status of African Americans enables them to access healthcare services they could not afford before.
The government has made significant progress in enhancing accessibility of healthcare services. It has collaborated with various stakeholders such as Medicaid and Medicare in providing affordable healthcare to the poor people, who are mainly African Americans.
The government has also used comprehensive approach in empowering African Americans to reverse trends of HIV/AIDS infections. “One strategy to create such a vast change involves merging HIV/AIDS prevention with efforts against racism, homophobia, joblessness, sexual violence, homelessness, substance abuse, mental illness, and poverty” (Laurencin, Christensen, & Taylor, 2008, p.41). Hence, comprehensive approach is appropriate in combating HIV/AIDS among African Americans.
Conclusion
The disproportionate occurrence of HIV/AIDS among African Americans indicates social, economic, and health disparities that exist in the United States. Though African Americans represent about 13 per cent of the population, they have about 50 per cent cases of HIV/AIDS.
The major causes for the disproportionate occurrence of the disease among African Americans include drug abuse, sexual behaviors, and low socio-economic status. Hence, the government has set up programs such as community mobilization, treatment education, and enhancement of socio-economic status via comprehensive approach to combat HIV/AIDS among African Americans.
References
Friedman, S., Cooper, H., & Osborne, A. (2009). Interventions strategies for HIV/AIDS Prevention among African Americans: Structural and social contexts of HIV risk among African Americans. American Journal of Public Health, 99(6), 1002-1008.
Laurencin, C., Christensen, D., & Taylor, E. (2008). HIV/AIDS and the African-American Community: A state of Emergency. Journal of the National Medical Association, 100(1), 35-43.
McCree, D., Jones, K., & O’Leary, A. (2010). African Americans and HIV/AIDS: Understanding and addressing the epidemic. New York, NY: Springer.
National Alliance of State & Territorial AIDS Directors. (2008). The landscape of HIV/AIDS among African American: Women in the United States. Web.
Stone, V., Ojikutu, B., Rawlings, M., & Smith, K. (2009). HIV/AIDS in U.S. communities Of color. New York, NY: Springer.
United Nations Educational, Scientific, and Cultural Organization. (2007). Current Research and good practice in HIV and AIDS treatment education. Retrieved from https://unesdoc.unesco.org/ark:/48223/pf0000149722
According to Carlisle (2003), there is an alarming trend of increasing HIV infections among adolescent groups and youths. It is also very unfortunate that these adolescents and youths form the future population of all countries in the world. Unfortunately, the future generation of such countries faces extinction from HIV deaths. Various studies reveal that the increasing cases of HIV infections in adolescents are mainly due to maltreatment that people inflict of the youths and adolescents. Some of the exploitations that adolescents and youths face include sex trafficking, sexual abuse, sex workers, prostitution, sex trade, and transactional sex (Carlisle, 2003). As a result, this paper explores the appropriate techniques of HIV treatment and prevention among adolescents who are at risk of succumbing from increasing HIV infections.
Research question
Is there any effective means of HIV treatment and prevention among adolescents and young adults who are at risk of succumbing from the increasing HIV infections?
Problem statement
The essentiality of this paper is to explore the means of HIV treatment and prevention among youths and adolescents who are at risk of succumbing from the increasing HIV infections.
Impacts of HIV on public health
Currently, HIV is a global pandemic. HIV pandemic has a variety of adverse effects in the countries where HIV is prevalent. Unfortunately, the developing countries feel the most pinching effects of HIV pandemic since these countries lack enough resources to aid in fighting and controlling new HIV infections. Although many countries intensified their fight towards controlling the spread of HIV, there is still an increasing trend in the spread of HIV in these countries (Patel, Yoskowitz, Kaufman, and Shortliffe, 2008). Numerous studies in this field still show that HIV pandemic is still prevalent in many countries in the world. As a result, new infections of HIV still occur in these countries. There is also an increasing number of deaths resulting from HIV from countries in the world (Askew and Berer, 2003).
Importance of the research
Unfortunately, researchers started to note the increasing trend of HIV infection among adolescent groups in most countries (Patel, Yoskowitz, Kaufman, and Shortliffe, 2008). Adolescents and youths always form the future population of all countries in the world. If the current society does not take necessary initiatives to control and stop new HIV contractions among young adults and adolescents, it will be very unfortunate that the future generation of the society will succumb from HIV/AIDS.
The research will aid in coming up with an informed decision-making process concerning the spread and control of new HIV infections more so in young adults. The research will also find out the impacts of the current HIV spread control mechanisms. At the end of the research, many people will understand that the HIV pandemic is real. Finally, the research aims at finding and exploring new relevant and effective mechanisms that will aid in coming up with new appropriate means of HIV treatment and prevention among adolescents and young adults who are at risk of succumbing from the increasing HIV infections.
Conclusion
Most youths are at a vulnerable state of contracting HIV infections. The increasing rate of HIV infections in most countries causes large deaths of youth (Askew and Berer, 2003). It deprives most countries of their strong and energetic generation that will take over after the current adult generation. The research aims at finding and exploring new relevant and effective mechanisms that will aid in coming up with new appropriate means of HIV treatment and prevention among adolescents and young adults who are at risk of succumbing from the increasing HIV contractions.
References
Askew, I. and Berer, M. (2003). Contribution of Sexual and Reproductive Health Services to the Fight against HIV/AIDS. Reproductive Health Matters, 11(22), 51-73.
Carlisle, D. (2003). Africans Are Dying of AIDS without Pain Relief. British Medical Journal, 327(7423), 1069-1070.
Patel, V., Yoskowitz, N., Kaufman, D., and Shortliffe, E. (2008). Discerning patterns of human immunodeficiency virus risk in healthy young adults. Am J Med, 121(4), 759–764.
The HIV/AIDS epidemic was first identified in Kenya in the early 1980s among commercial social worker population (US Census Bureau 2). Since then, the epidemic has spread to other parts of Kenya, including remote, marginalized areas. The Kenyan government had declared AIDS a national disaster in the year 1999. It is noteworthy that HIV/AIDS control and campaign programs have been relatively successful because of declines in prevalence rates have been noted across the country in both low and high-risk individuals, as well as in urban and remote parts of the country. In addition, population-targeted HIV testing has also shown the decline in the rates of new infections among the public (US Census Bureau 2).
Latest data provided by the Population Reference Bureau & UNAIDS (United Nations Program on HIV/AIDS) in 2012 have noted that 1.6 million Kenyans are living with HIV/AIDS. Kenya currently has 44 million people in which 820,000 women aged 15 years old and over have tested HIV/AIDS positive while nearly 200,000 children live with HIV/AIDS based on figures obtained in the year 2012. The HIV/AIDS prevalence rate in “the country is 6.1 percent while deaths related to HIV/AIDS were 57,000 in the year 2012” (Regents of the University of California 1).
Although marginal declines in the prevalence rate have been noted over the years, further studies have revealed that new, increased cases of infections have been identified among married couples who were initially not targeted in the health promotion campaigns. This, in turn, affects progresses made and could explain why the prevalence rate has remained the same (6%) since the year 2008 to 2012.
A summary of the mini-needs assessment conducted to determine a priority HIV/AIDS in Kenya
Studies have established that married couples and other people in more stable relationships have contributed to the highest number (more than 44%) of new HIV/AIDS infection in Kenya (Omanje, Bosire and Mwenda 73). Nevertheless, the UNAIDS report of 2010 had demonstrated that a decline in the rate of new HIV infections in the last decade was generally attributed to behavior changes, changes in social norms and enhanced knowledge on HIV/AIDS.
It is estimated that for every ten couple, a partner is most likely to be living with HIV/AIDS. In these marriages and relationships, some couples are not infected. Nevertheless, knowledge of HIV/AIDS among couples in relationships has been a significant source of concern. In addition, most of these couples have multiple sexual partners in marriage. While some couples are aware of their partners HIV status, “not all couples have this knowledge” (Omanje et al. 73). Moreover, a consistent use of condom is not common among married couples whose status remain unknown to their partners. Thus, most HIV transmission cases among married couples and those in stable, long-term relationships have resulted from ignorance of partner’s or self HIV/AIDS status (Omanje et al. 73).
Discordant, married or cohabitating couples remain at significantly higher risk for new HIV infections in the country. Moreover, couples who are in “acute phase of new infection are also critical source of risk for subsequent spread of the virus to their partners within or outside marriage” (Omanje et al. 73).
Therefore, without appropriate interventions, a large percentage of HIV infected individuals will infect their partners with HIV.
Until recently, the current prevention efforts have largely failed to account for couples (married, discordant or coexisting). Rather, most prevention strategies and campaigns have focused on casual relationships and youth. Thus, lack of knowledge has been a factor contributing to new HIV infections among couples in stable, long-term relationships. In this case, one can observe that lack of knowledge also implies a lack of awareness about risks of contracting the virus in such relationships. In addition, failure to use condom or low usages could be responsible for the widespread HIV/AIDS and other sexually transmitted diseases among population at risk.
A description of the primary socio-ecological factors related to HIV/AIDs in Kenya
Several major socio-ecological factors have been attributed to HIV/AIDS in Kenya. First, individual factors such as multiple sexual partners are responsible for several cases of new infections. These factors are influenced by community practices, beliefs and policies among others (University of Ottawa and Ontario Ministry of Health 1). Second, societal factors, including systemic discrimination and stigma affect the spread of the disease. People living with HIV/AIDS may fail to pursue interventions because of stigma. Third, socioeconomic and political factors show that HIV/AIDS is now common among marginalized, poor sections of Kenya.
Inequalities and gender influence risks of contracting HIV/AIDS. Fourth, cultural practices in Kenya could also be responsible for the spread of HIV. Practices such as wife inheritance and attributing HIV/AIDS to curse or witchcraft have affected any intervention efforts in such communities. Fifth, gender factors also influence the spread of HIV. In Kenya, for instance, it has been noted that women are more vulnerable to infections relative to men. In addition, coercive sexual practices and violence against women have exposed many women to HIV/AIDS. Sixth, generally, Kenya lacks robust healthcare infrastructures to cater for many people living with HIV/AIDS or implementing any effective health promotion programs. HIV/AIDS can only be controlled when healthcare infrastructures are working effectively.
Finally, government policies also influence HIV/AIDS outcomes. For instance, countries that have recorded success in fighting HIV/AIDS have favorable political environments and well-formulated policies. Policies should ensure that all stakeholders, including patients, political leaders, religious leaders, not-for-profit organizations and civil societies take active role in the fight against HIV/AIDS.
Types of resources and community stakeholders
Resources required for the target population, specifically married and cohabitating couples. They should aim to provide information on risks associated with HIV/AIDS in marriage or long-term relationships. Mass and local media should be used to offer consistent messages about HIV/AIDS and are the best channels for most Kenyans in rural areas.
Posters, leaflets, public announcements, printed articles and messages on radio and televisions have proved to be effective in Kenya. In addition, interpersonal communication conducted by leaders, physicians and other individuals of authority should reinforce the message.
All messages must be accurate, fact based, easy to comprehend and consistent among the target population.
HIV/AIDS programs in Kenya involve a wide range of diverse stakeholders, including people living with HIV/AIDS, policymakers, cultural leaders, religious leaders, civil societies, funders, regulatory agencies, care providers and international partners. In Kenya, only prominent stakeholders such as Ministry of Health, Kenya; National AIDS Control Council, Kenya; National AIDS/STD Control Program, Kenya; not-for-profit making organizations; and international organizations are recognized as useful. Thus, other stakeholders largely remain unaccounted for during stakeholder identification.
These stakeholders should participate in all processes involving HIV/AIDS intervention programs, including program implementation and outcomes. This approach normally enhances the relationship among stakeholders, evaluates their levels of engagement and focuses on HIV/AIDS concerns in a community.
A description of the stakeholder collaboration strategy and its appropriateness
A stakeholder collaboration strategy for the health promotion should be shared ownership for community health. Generally, as identified above, there are diverse stakeholders with different expectations from health promotion campaigns. It should be asserted that public health should be a priority for every member of the community, and not just healthcare providers or governments. A consultation process would bring together all representatives of all stakeholders in HIV/AIDS issues. It is expected that stakeholders would have divergent views but would share common concerns about HIV/AIDS infection in Kenya (Desclaux, Kouanda and Obermeyer S79).
Through consultation processes rooted in shared ownership for community health, all stakeholders would ensure that they create population health capacity over time. For instance, experts would provide knowledge for best practices on HIV/AIDS control and management. The process will ensure that stakeholders with diverse views develop a shared agenda, evaluation metrics, structured procedures and jointly funded health promotional campaigns to achieve one goal of reducing rates of new infections (Barnett 1).
Stakeholders must be represented across all phases of the HIV/AIDS programs. However, it is observed that not all stakeholders can play similar roles in the process. Therefore, experts in various fields may take multiple roles based on their professional skills in HIV/AIDS management in Kenya and other parts of the world. All members involved in the implementation of the campaign must address any issues that may hinder progress through effective consultation and collaboration processes.
Program goal and objective
Health promotion goal is to use comprehensive strategies to create awareness about new increasing rates of HIV infections among married, cohabitating couples and other people in long-term sexual relationships in Kenya. Thus, the promotion will engage married, cohabitating and discordant couples and the public across various continua of stages to ensure acquisition of knowledge and behavior change about HIV/AIDS spread among identified population at risk. This would strive at reducing the rates of new infections among sexual partners. It would also be imperative to collaborate with various stakeholders, including local, national and international agencies to identify and obtain external resources that could assist in HIV/AIDS health promotion campaigns.
The objective of the promotion on HIV/AIDS is to inform, educate and empower married, cohabitating and discordant couples and the public about new cases of infection among the target population. Thus, it is expected that by the end of the health promotion, at least 80 percent of the couples will have acquired knowledge on HIV/AIDS transmission among couples and demonstrate behavior change through changes in sexual behavior practices, use of condom and knowing partners’ HIV status among others. The target population may be contacted within three months to determine outcomes of the health promotion.
The theory used to guide development of the intervention
The Theory of Planned Behavior (TPB) has been effective for interventions (Foy et al. 207) because of the following reasons. TPB predicts behaviors with regard to factors considered for change such as belief systems, sexual behavior practices and potential external difficulties. TPB has been evaluated and found to be effective in various settings, and it recognizes that violations may occur because people to do not have absolute control over their actions (Foy et al. 207).Based on TPB, attitudes toward behavior is imperative, and a person’s view could be a subjective norm while perceived social pressure or views of others and alleged behavioral factors that include belief systems and self-efficacy (confidence in performing and achieving a given goal) and a wide range of environmental factors have profound effects on promoting or inhibiting performance. The theory also focuses on attitudes that show perceived outcomes and emotional attitudes. That is, TPB considers whether couples will benefit, be harmed after disclosing their status or healthcare professionals would feel discomfort while evaluating the disclosed behaviors. Thus, the theory will make it possible to predict changes related to sexual practices and acquisition of knowledge about HIV infections in marriage and long-term sexual relationships.
An appropriate intervention strategy that targets one of the socio-ecological factors associated with HIV/AIDS condition and target population
Behavioral intervention would be adopted in health promotion campaigns to change behaviors and sexual practices of married and cohabitating couples. It is imperative to recognize that most of these couples are now more informed about HIV/AIDS with the exception of few couples in marginalized, remote areas of the country. Education and behavioral skills to reduce exposure risk for infection and a focus on individual factors that hinder change would be appropriate intervention for Kenyan married couples.
Behavioral interventions accompanied by counseling and testing would be effective for many married couples who are at high risks of contracting HIV.
Specific Program Activity
Behavioral change will focus on couples HIV counseling and testing so that couples can know HIV status of their partners and change their sexual practices. Couples HIV counseling and testing would be effective because studies have shown that knowledge of HIV/AIDS alone does not necessarily lead to behavior change (Kanekar 10).
Couples HIV counseling and testing activity in this population at risk will aim at enhancing benefits of engaging in safe sex among couples. They must however undergo counseling and testing to change poor behaviors and reinforce their knowledge. Health promotion must ensure that counselors understand the relevance of interpersonal skills when engaging participants. In addition, they must demonstrate other practices such as constant use of male condoms during sexual intercourse. Counselors should also stress the risk of pleasure seeking by engaging in sexual intercourse with multiple partners outside marriage or stable relationships.
Counseling and testing for couples should also address individual factors related to unsafe sex such as low knowledge or poor perception of risks, abuse and inequalities in marriages and relationships.
It is believed that couple counseling will enhance risk perception through social interactions in which couples are encouraged to engage in meaningful conversation related to HIV/AIDS risks. This is most likely to lead to behavior change by ensuring regular and correct use of condoms and remaining faithful to only one partner.
A Logic Model for the Health Promotion Program for Couples
A Logic Model for the Health Promotion Program.
Works Cited
Barnett, Kevin. Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential. 2012. Web.
Desclaux, Alice, Seni Kouanda and Carla Makhlouf Obermeyer. “Stakeholders’ participation in operational research on HIV care: insights from Burkina Faso.” AIDS 24 (2010): S79–S85. Print.
Foy, Robbie, Jillian Francis J, Marie Johnston, Martin Eccles, Jan Lecouturier, Claire Bamford and Jeremy Grimshaw. “The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia.” BMC Health Services Research 7 (2007): 207. Print.
Kanekar, Amar Shireesh. “HIV/AIDS Counseling Skills and Strategies: Can Testing and Counseling Curb the Epidemic?” International Journal of Preventive Medicine 2.1 (2011): 10–14. Print.
Omanje, Thadeus S, Sheillah Bosire and Samwel Mwenda. “Knowledge and Perceptions of HIV/AIDS among Married Couples in Kenya.” Public Health Research 5.3 (2015): 73-78. Print.
Regents of the University of California. HIV/AIDS in Kenya. 2014. Web.
University of Ottawa and Ontario Ministry of Health. Socio-ecological assessment: HIV/AIDS in Kenya project. 2009. Web.
US Census Bureau. HIV/AIDS Profile: Kenya. 2008. Web.