Category: AIDS

Introduction/Background

HIV/AIDS stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome or AIDS if not treated (About HIV/AIDS. (2019, August 14). The HIV/AIDS epidemic has been an issue within the United States for as early as 1960 but it was first noticed after doctors discovered sign of clustes of Kaposi’s sarcoma and pneumocystis pneumonia in gay men in Los Angeles, New York, and San Francisco in 1981 and it is still a prominent issue within the the LGBTQIA+ and the black community; it especially impacts the black LGBTQIA+ community. Clinical depression is the most commonly observed mental health disorder among individuals who have been diagnosed with HIV; the most common emotions after being diagnosed with HIV/AIDS is sadness and grief. Many patients will not seek treatment because they think that this feeling of sadness and despair is a normal side effect of their diagnosis and this in fact incorrect. This topic is an important topic to discuss due to many patients who have this disease will committ suicide due to the fact that they are feeling sad and have a lot of grief because they are dealing with this disease. When someone tests positive for HIV/AIDS it is like your whole world can change in an instant; from who you associate yourself, having to get new healthcare providers, watching your immune system, and of course having to figure out how to now live your life knowing that you have HIV/AIDS; all these factors can make anyone start having obtaining symptoms of depression. This feeling of sadness and grief could make a person want to distant themselves from the world or even take their lives. People who find themselves living with HIV/AIDS have higher rates of rates of suicidal behavior than those who do not battle with this disease. We need to educate these individuals who have this disease that it is not the end of the world for them just because they have HIV/AIDS; that life continues to go on and so should them. This research paper would provide adequate research on the topic that can open doors to limiting this percentage of people having depression and committing suicide because they have this disease. Society tries to keep people who have HIV/AIDS in their own little world and tries to separate them socially from everyone else. The mindset that world has on HIV/AIDS and on people who has HIV/AIDS needs to be alter or the number of suicide rates among this group will continue to increase and it is not fair that these individuals have to deal with having this terrible disease and having to deal with mistreatment from their peers. Conducting more research on this connection between HIV/AIDS and depression is important because it is not often talked about and it needs to be talked about due to it being a real issue that real people have to deal with everyday and it needs to be talked about more. In people living with HIV, misery may decline existing ailment states and lead to more unfortunate wellbeing results. Earlier research has uncovered that downturn is not just connected with higher HIV viral loads and lower CD4 cells tally yet additionally rushes the movement to AIDS and lifts the danger of mortality. Moreover, wretchedness has been accounted for to lessen adherence to antiretroviral treatment (ART), debilitate its helpful impacts, and bargains the prescription results at both individual and populace scale.

Methodology

Methods

This study was conducted by reviewing ten articles on HIV/AIDS and the disease connection with depression and other mental illness such as anxiety and paranoia. The information was obtained by conducting an extensive search on the electronic resources and databases provide by Tennessee State University. The primary search engines that were used to conduct research for this study are Google and Proquest; the initial key words used in these search engines include HIV, AIDS, depression, paranoia, anxiety, mental illness… From this search over 44,000,000 articles then returned with possible matches, although with further review for adequacy and relevancy and brought down this number to ten articles. These ten articles will be the source of information for this paper.

Results

The stigma associated with HIV/AIDS represents a mental test to individuals living with HIV/AIDS. We speculated that the results of shame related stressors on mental prosperity would rely upon how individuals adapt to the pressure of HIV/AIDS shame. 200 members with HIV/AIDS finished a self-report proportion of authorized shame and felt disgrace, a proportion of how they adapted to HIV/AIDS shame, and proportions of discouragement, uneasiness, and self esteem. When all is said in done, increments in felt disgrace (worries with open frames of mind, negative mental self view, and divulgence concerns) combined with how members revealed adapting to shame (by withdrawing from or connecting with the disgrace stressor)

anticipated self-announced melancholy, uneasiness, and confidence. Increments in felt shame were related with increments in tension and melancholy among members who revealed generally significant levels of separation adapting contrasted with members who detailed moderately low degrees of withdrawal adapting. Increments in felt disgrace were related with diminished confidence, however this affiliation was lessened among members who revealed generally significant levels of commitment control adapting. The information additionally proposed a pattern that increments in ordered shame anticipated increments in tension, however not sadness, among members who detailed utilizing greater separation adapting. Emotional wellness experts working with individuals who are HIV positive ought to think about how their customers adapt to HIV/AIDS shame and think about fitting current treatments to address the connection between disgrace, adapting, and mental prosperity. Rates of current despondency among people with HIV have been assessed to be two to multiple times higher than paces of despondency among people who are HIV pessimistic, and rates are as much as multiple times higher among ladies with HIV than ladies without HIV (Bing et al., 2001; Ciesla and Roberts, 2001; Morrison et al., 2002). Individuals with HIV meet the criteria for summed up nervousness issue at a rate just about multiple times higher than a relative U.S. test (Bing, et al., 2001). Individuals with HIV/AIDS likewise report sentiments of self-question, reluctance, adverse assumptions regarding relational communications, and sentiments of sadness and depression identified with their sickness (Kelly et al., 1993; Kylma, Vehvilainen-Julkunen, and Lahdevirta, 2001).

Discussion

The hypothesis of this was paper was thoroughly supported; In this examination, I found a positive relationship between’s apparent separation and sorrow. In 2011, an investigation of the pervasiveness of oppression HIV/AIDS patients in nine nations in Asia showed that patients in every nation detailed a conspicuous degree of disguised separation. The government and department of health should strengthen publicity and education about AIDS to deepen society’s understanding. Family support is crucial for patients with HIV/AIDS because of course it provides warmth and care and decreases the stress faced by individuals affected this chronic disease. But, unfortunately only 57% of patients had a good relationship with their family and this of course leads to social and separation anxiety. Very few studies have investigated the impact of family support on depression in patients with HIV; however, it has been proposed that poor family support is associated with an increased incidence of depression. From this study the researcher was able to determine that more extensive matters need to be set in tone to help those individuals facing with HIV/AIDS learn how to cope with positive measures. If more preventive matter does not get set in place the suicide rates among people with this chronic disease will continue to grow up. People with HIV/AIDS deserve to live happy care free lives like everyone else, they need to learn that life does not stop just because they have this chronic illness. From this study I learned by next year according to the UNICEF estimates that worldwide by 2020 approximately 40 million children will have lost one or both parents to HIV/AIDS and this estimate was made six years ago and this estimate is a combination of deaths from due to the disease and from suicide.

Conclusion

This present study displays the relationship between HIV/AIDS and depression and other forms of mental illness such as anxiety and paranoia. This topic is an important topic to discuss due to many patients who have this disease will committ suicide due to the fact that they’re feeling sad and have a lot of grief because they’re dealing with this disease. When someone tests positive for HIV/AIDS it’s like your whole world can change in an instant; from who you associate yourself, having to get new healthcare providers, watching your immune system, and of course having to figure out how to now live your life knowing that you have HIV/AIDS; all these factors can make anyone start having obtaining symptoms of depression. Without more preventive measures being taken in place by the government and any health programs the stigma of individuals who have HIV/AIDS dealing mental illness will continue to rise which will lead to suicide rates among this community will just continue increase. The articles that were used to determine the factors behind this study were factual and provided evidence to the hypothesis listed at the beginning of this research paper. The future of HIV/AIDS will be bright if more research, like the one within this paper, takes place; this conversation needs to be discussed if the solution has yet to be revealed. HIV/AIDS patients deserve happy fulfilled lives and this will not happened if they are not educated and everyone around them is not educated on this topic; they need to be informed that their lives do not stop because they have this disease. More support groups need to be implemented and the government needs to stop trying to hide away from the conversation.

References

1. Bhatia, M. S., & Munjal, S. (2014, October). Prevalence of Depression in People Living with HIV/AIDS Undergoing ART and Factors Associated with it. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253251/.
2. Depression and HIV. (n.d.). Retrieved from http://www.aidsinfonet.org/fact_sheets/view/558.
3. Gebrezgiabher, B., Berhe, Abraha, H., Hailu, Getachew, Abay, … Teklit. (2019, February 3).
4. Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study. Retrieved from https://www.hindawi.com/journals/drt/2019/3250431/.
5. HIV and Depression. (n.d.). Retrieved from https://www.poz.com/basics/hiv-basics/hiv-depression.
6. Lieber, A. (n.d.). HIV AIDS & Depression – A Challenging Downward Spiral for The Afflicted. Retrieved from https://www.psycom.net/depression.central.hiv.html.
7. Mental Health. (2019, August 6). Retrieved from https://www.cdc.gov/hiv/basics/livingwithhiv/mental-health.html.
8. Patients who suffer from both diabetes and depression have a higher risk of dying. (2006). PsycEXTRA Dataset. doi: 10.1037/e556152006-020
9. Mental health and HIV/AIDS: the need for an integrated… : AIDS. (n.d.). Retrieved from https://journals.lww.com/aidsonline/Fulltext/2019/07150/Mental_health_and_HIV_AIDS__the_need_for_an.1.aspx.
10. Preidt, R. (2019, April 4). Depression Plus HIV Can Turn Deadly. Retrieved from https://www.webmd.com/hiv-aids/news/20190404/depression-plus-hiv-can-turn-deadly.
11. TheBodyPro. (2016, June 22). High Depression Rates With HIV — and Its Scathing Clinical Impact. Retrieved from https://www.thebodypro.com/article/high-depression-rates-with-hiv–and-its-scathing-c.

Do you know how health experts are always on people to eat good and balanced meals? Well, that is so they can live a happy and healthy life. There are a lot of things you stand to benefit from eating right; one of them is a strong and functional immunity to diseased. It is extremely important for fighting infections and toxins that may want to break down the normal body functions.

Despite having a strong immunity to diseases, there are some viruses the immune system cannot fight. We’ll be talking about one of them, the different forms in which it manifests, and the disparities between those forms. On that note, let’s get right into the difference between HIV and AIDS. But first, their definitions.

DEFINITION OF HIV

HIV is defined as a microscopic infective agent that can cause the deterioration of the human immune system. Its full meaning is Human Immunodeficiency Virus. From the title, you can tell that it has something to do with immunity and human.

The difference between AIDS and HIV is that in this case, a person living with this virus would most likely suffer from many other diseases seeing as the immune system is no longer functional enough to fight against unhealthy foreign bodies. At a slow but steady rate, this deterioration continues to go on until it is fully blown and sets into the next phase – which is very deadly. It takes about 10 to 15 years for it to get to this point.

Here is another point to take note of when answering the question – what is the difference between HIV and AIDS? – You can do something to prevent this ailment from getting fully blown and out of hand. With the help of prescribed treatments and a good nutritional plan, one can manage the infection and still get a chance at living a normal life.

One may not be sure he or she is infected with this disease. The only way to be sure for real is to get tested. Some symptoms of HIV are

• Acute rash
• Fever
• Mouth ulcers
• Fatigue
• Sore throat
• Chills
• Night sweats
• Muscle aches

Again, it is important to get tested before making conclusions. It is wrong to assume one has this disease just because they show one or any combination of the symptoms stated above. In a case where the result is positive after a test, the best thing to do is to see a doctor immediately to start treatment. However, everyone who is infected should really learn what’s the difference between HIV and AIDS. This will help them manage their health as they go through the phases of this infection. At the earliest stage, also known as the acute stage, the rate of transmission from one person to another is usually very high. The virus multiplies at a very rapid rate in this stage, and care should be taken to avoid transmitting it to other people.

DEFINITION OF AIDS

AIDS is defined as the result of a severely damaged immune system based on untreated HIV infection. It is an acronym which stands for Acquired Immunodeficiency Syndrome. Basically, this condition is still HIV, only in this case, it is more developed and severe, which is the difference betweenn HIV and AIDS.

If you contact the virus and you make it a point of duty to take the required treatments, then you don’t have to bother about this condition. But if you’re not placed on treatments, the virus will weaken your immune system to the point that it becomes Acquired Immunodeficiency Syndrome.

Another note that explains what the difference between HIV and AIDS is can be seen in the way the symptom manifest. At the earlier stage of this virus, one may not know that he or she is infected. This is because there may be no symptoms at this time until much later. This is not the case with AIDS; the symptoms are always present in this case and it is very easy to tell that a person is infected by physically observing their health condition and appearance. Despite that, it is always important to carry out a test before drawing a conclusion.

Some of the symptoms that are associated with this phase are

• Depression
• Rapid weight loss
• Pneumonia
• Sores
• Blotches
• Profuse night sweats
• Extreme tiredness
• Recurring fever

As the virus increases, the risk of developing “opportunistic infection” increases. These are diseases that based off of weakened immune systems. The more the virus is present without treatment, the more it damages the immune system, giving way for as many opportunistic infections as possible at the same time.

Another way to tell what is the difference between AIDS and HIV is based on life expectancy. Although this virus can be managed at its earlier stage, the life expectancy of the infected person drops significantly if it ever turns to AIDS. This is why it is always very important that people get tested very often to find out their status. If one’s status is positive and discovered on time, one can start taking treatment and the virus would never develop to Acquired Immunodeficiency Syndrome.

CONCLUSION

In a lot of cases, these two terms are used interchangeably, which is wrong. Strictly speaking, the HIV and AIDS difference is glaring and as such, should not be used in place of the other. These two are not the same diagnosis and they are not the same condition.

Health care professionals use antibody and blood tests to diagnose this virus. If the result is positive, the person is expected to be screened for additional diseases. This will help the professionals to draw a conclusion regarding the phase of the infection. Right after this, the next thing is to place the patient on proper treatment and medication managed by an infectious disease consultant.

The difference between HIV positive and AIDS as well as their similarities and how they react in the human body can be overwhelming. Prevention of the risk factors that result in the transmission of the virus should be avoided at all cost. Do not have unprotected sex with an infected person, do not share sharp objects like needles, care should be taken during blood transfusion to ensure it is free before use, etc.

Currently, this virus can be managed at the earlier stage, but cannot be cured. Although, research has been ongoing for a while now, so far, there has been no solid results in this regard.

Abstract

Kenya is a low-income country located in east Africa. Although Kenya has been making slow strides in trying to end poverty, it is still a low-income country that is facing both communicable and noncommunicable diseases. Kenya’s income per capita is about $1,640. With an income this low it makes it hard to get proper treatment and sustain good health. The outbreak of HIV in Africa started around 1960. The first case of HIV in Kenya was around 1984. Then by the mid- 1900s, HIV was the leading communicable disease followed by other diseases such as malaria. Kenya has been working with the Center of Disease Control (CDC) to help prevent more people from contracting HIV. Out of Kenya’s 8 Millennium Development Goals, “combating HIV/AIDS, malaria and other diseases,”(.nd.) is goal number 6 on the list. Kenya’s first goal is to eradicate extreme poverty and hunger. Kenya does have an educational system with primary and secondary schooling but “over a quarter of young people have less than a lower secondary education and one in ten did not complete primary school”(Clark, 2018). Kenya does have a healthcare system but with recent corruption in the government funding for this health care system got cut. Currently, in Kenya, the life expectancy for women is 65 years old and 60 years old for men. The infant mortality rate is 39/1,000 live births. (CDC Global, n.d.).

Scope of the problem

According to the Global burden of disease, Kenya contains more communicable diseases than non-communicable diseases. Kenya has a population of about 49.7 million people, 1.6 million of whom are living with HIV. There have been about 25 thousand deaths due to AIDS in 2018 alone and about 46 thousand new HIV cases. In 2018, only 69% of adults and only 61% of children who already have HIV in Kenya were receiving treatment. Not everyone has access to the required treatment because of high amounts of stigma and discrimination against people with HIV. “As of 2015, 660,000 children were recorded as being orphaned by AIDS.”(HIV, 2019). Studies have also shown that in 2015, “almost half of the new HIV infections in Kenya were among girls and young women aged 15 to 24 years.”(Manguro, 2019). Not only is Kenya facing problems with diseases but they are facing problems with their health services. There is not an abundance of doctors or nurses in Kenya and that makes it extremely hard for people who are ill to receive the proper help they need “Kenya is one of the countries listed by the WHO as having a critical shortage of healthcare workers. Nationally, there is one doctor for every 10,000 people.” (Mwoka, 2017). (HIV, 2019).

Key Change Drivers

The reason why HIV spreads so rapidly through Kenya is because of the way the virus is contracted. It is transferred through the exchange of bodily fluids. HIV can be transferred through sexual activities, the sharing of used needles, and can even be transferred through breastfeeding. Not only does the majority of the population in Kenya have the risk of being afflicted with HIV, they are also more susceptible to catching diarrheal disease and Tuberculosis. If a person is already HIV positive then they are more at risk of exposure to other communicable diseases because there body is already weak and vulnerable from the HIV virus. This is not to say that if a person that does not have HIV is then immune to communicable diseases like diarrheal disease because they still can become infected, they just aren’t as susceptible as those people who have already contracted HIV..

Financial Strategies

Kenya has worked with different partners and programs that have allowed them to reduce not only the spread of HIV and other communicable diseases throughout Kenya. The Center for Disease Control and Prevention (CDC) played a huge role in treating people who have HIV and treating the people who do not have HIV but are at high risk of contracting it. “The CDC Kenya, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), has worked with multiple stakeholders, including the Kenya Ministry of Health (HOM) and local partners, to support and strengthen prevention and control efforts for HIV and TB” (“CDC Kenya’s,” n.d.). With these other stakeholders helping prevent more new cases, it is causing the HIV rates to decrease. ChildFund International has also taken part in making sure there is access to clean water and nutritious foods, expecially to families that have children under the age of 5. (Kenya, n.d).

Actions Taken/ Accomplishments

One of Kenya’s main priorities was to implement an HIV surveillance system and programs that monitor people’s health. Kenya also has support from the CDC for accreditation and training, HIV and TB testing, ext. The CDC also is supporting interventions for pregnant women. There is also a new treatment in Kenya called antiretroviral therapy (ART), “which focus on TB and other opportunistic infections in HIV infected adults and children.” Almost 600 thousand people living with HIV that are doing ART “nearly 90% of adults and 80% of children on ART are virally suppressed.” This has been one of the huge accomplishments that the CDC has helped Kenya overcome. Also, the CDC states that “overall mother to child transmission of HIV has reduced from 11% in 2011 to 3.6% in 2018.”

Recommendations

I would first recommend trying to keep kids in school by adding more programs that teach them about these harmful diseases and how to stay sanitary. If kids were taught more about HIV/AIDS and other communicable diseases while in school they might make healthier choices when it comes to having sexual interactions with other people and being aware of how easy it is to contract such a harmful disease. I would also suggest that the CDC, Kenya Ministry of Health (HOM) or ChildFund International, find a way to supply better health care and or health services because, with such a large population and such a small about of professional help, something needs to be done. They could do this by training teachers at school that way they are more aware of problems and could try to stop anything before it could spread.

References

1. (n.d.). Retrieved from https://www.indexmundi.com/kenya/millennium-development-goals.html
2. CDC Global Health – Kenya. (n.d.). Retrieved from https://www.cdc.gov/globalhealth/countries/kenya/
3. CDC Kenya’s Global HIV & TB Program – Infographic. (n.d.). Retrieved from https://www.cdc.gov/globalhealth/countries/kenya/infographics/hiv-tb-infographic.html
4. Clark, N. (Ed.). (2018, December 17). Education in Kenya. Retrieved from https://wenr.wes.org/2015/06/education-kenya
5. HIV and AIDS in Kenya. (2019, August 23). Retrieved from https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/kenya
6. Kenya. (n.d.). Retrieved from https://www.childfund.org/kenya/
7. Manguro, G. (2019, June 3). Kenya embraces new prevention efforts to reduce HIV infection. Retrieved from http://theconversation.com/kenya-embraces-new-prevention-efforts-to-reduce-hiv-infection-80483
8. Mwoka, M. (2017, October 26). Kenya’s Struggling Health System – Health is Global Blog. Retrieved from https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/kenya-s-struggling-health-system/5083982/860

HIV/AIDS is a precedent setting epidemic faced by humanity. This epidemic is dually medical and social in nature. Medically, it is a serious, fatal disease with numbers far greater than the norm. Socially, it is an event that disrupts the life of communities. The epidemic of Acquired Immune Deficiency Syndrome (AIDS) was first recognized in the United States in 1981 (Sahistory.org.za, 2011). South Africa today has the highest HIV profile in the world, with an estimated 7.7 million people living with HIV in 2018. To combat this, South Africa also has the largest antiretroviral treatment (ART) programme in the world. HIV prevalence however remains high (20.4%) among the general population (Avert, 2019). HIV/AIDS prevention campaigns have so far been key to limiting the advancement of this epidemic however more can be done using anthropological techniques. Many of the barriers that prevent South Africans from accessing information and much needed services can be attributed to culture. Culture influences perceptions such as practical knowledge, value systems and health seeking behaviours. An anthropological ethnography is therefore important to understand the various social and cultural traditions that reinforce vulnerability to HIV/AIDS in South Africa.

According to Olivia Rose-Innes from Media24 (Rose-Innes, 2016), the following sociocultural factors have been identified as responsible for the rapid spread of the disease:

• Gender inequality
• Religious beliefs and cultural assumptions
• Poverty
• Violence and sexual violence
• Political transition and the legacy of apartheid
• Stigma and discrimination
• Commercialisation of sex
• Lack of knowledge and misconceptions about HIV/Aids

Due to the limitations set for this assignment, only the first three factors will be critically examined.

Gender inequality

South African culture is a patriarchy. This behaviour stems from the earliest stages of humanity. Men in these early societies were the primary hunters. Women stayed close to camp and foraged while taking care of the child rearing. These roles were based on capability. One was not viewed as “better” than the other. These roles influenced the evolution of man including brain development. Many tasks completed by female were monotonous e.g. collecting water, gathering fuel, and cooking. They could be interrupted and returned to without total disruption. Female’s brains have as much as 10 times more white matter as men (Gur et al., 1999). This arguably results in women’s ability to both switch between tasks without trouble and multi-task with ease. Approximately 12 000 years ago however, agriculture came into being and changed the world (nationalgeographic.com, 2016). Hunting was no longer necessary. Humans mostly ceased their nomadic lives. Mark Dyble, an anthropologist who led a study at the University College of London, wrote: “Our brains are still wired for that primitive pre-agriculture lifestyle” (Dyble et al., 2015). Instead, men became hunters of land, money, riches whilst women continued to be conditioned to bear and rear children. Governments developed. Political debates ensued. Men mostly engaged in these concepts. Unfortunately somewhere along the lines, men became conditioned to believe that women had set roles and natures. In South Africa the resulting unequal power relations, particularly when negotiating sexual encounters, increases women’s vulnerability to HIV infection and thereby accelerating the epidemic. Women’s perceived inferior status affords them little or no power to socially protect themselves. Many women also lack economic power and feel they cannot risk losing their partners even in the face of sexual abuse. Entrenched ideas about suitably “masculine” or “feminine” behaviour also enforce sexual double standards and lead to unsafe sexual practices. Abstinence and monogamy are often seen as unnatural for men, who try to prove themselves “manly” by frequent sexual encounters, and often the aggressive initiation of these. These views serve to justify men’s sexual behaviour to some extent. South Africa is a diverse ethnic potjiepot. In most homes, a women’s respectability is derived from the traditional roles of wife, home-maker and mother. Childbearing and satisfying the husband, sexually and otherwise, are key expectations for a wife – even if she is aware that her husband is unfaithful. Refusing a husband sex can result in separation and sometimes violence. The low status accorded to a woman without a male partner may be an additional reason for making women less likely to leave an abusive relationship. Being a well-informed woman is seen as a sign of immorality. Whilst outspoken married females may be suspected of having extra-marital affairs or of accusing their husbands of being unfaithful.

Religion and Cultural Assumptions

Religion in particular holds sway over the masses. Some religions saw the epidemic as a divine punishment for sinfulness in general with the single sin of male homosexuality. Despite the general acceptance of modern science the concept of divine punishment has not been entirely abandoned (Blumberg, 2019). The use of contraceptives such as condoms also have strong overtones of unfaithfulness and the promotion of sexual activities. Certain sexual practices, such as dry sex (where the vagina is expected to be small and dry), and unprotected anal sex, carry a high risk of HIV because they cause abrasions to the lining of the vagina or anus (Kun, 1998). In many traditional African cultures where virginity is a strict marriage condition, young females may protect their integrity by engaging in unprotected anal sex. The importance of fertility in African communities may hinder the practice of safer sex. Siring many progenies is also seen as a sign of virility however this increases the risk of HIV transmission.

Poverty

According to StatsSA, it costs between R527 to R670 to feed a single person nutritionally for the month. A child support grant is only R420 a month and an old age grant is R1,780 (often the only income in a family) (Statistics South Africa, 2019). These amounts only factor the cost of food and not all the other necessities in life like rent, transport, electricity, education and clothing. Therefore it is hardly surprising to find that for poor people, the daily struggle for survival overrides any concerns about contracting HIV.

Fortunately, governments are relying more and more on anthropological research. A technique called Participant Observation was developed by a Polish anthropologist called Bronislaw Malinowski (Shah, 2017). He basically set the standard for ethnography with a wide-angled vision. With this technique, an anthropologist actively participates in the daily lives of the people and thereby are in a better position to improve circumstances. People driven by poverty will participate in extreme acts such as “survival” sex-work and other abuses thus making them particularly vulnerable to the spread of HIV/Aids. Poverty is generally associated with low levels of formal education and literacy. Knowledge about poverty and HIV in context of the actual challenges faced by poor communities is therefore invaluable.

In conclusion

Since the beginning of the epidemic, anthropologists have contributed to better understandings of cultural beliefs and local practices that place people at risk for HIV/AIDS, advocated for equitable access to care and treatment, and promoted culturally appropriate strategies for prevention. Anthropology actively promotes state, social and religious dialogue in a systematic non subjective manner whilst still focusing on the issues at hand. Ethnography, with its holistic focus and its long-term approach for fieldwork, plays an important role in dismantling the various perspectives, practices and power relations that have come to shape the views, actions and experiences with regard to HIV/AIDS.

The, diseases contracted in human bodies are responsible for interfering with the homeostatic immune mechanisms in the body and this decrease with age. AIDS and STIs are viral diseases that weaken the body immune response and are transfused by direct sexual intimacy between partners. Currently, they are the most frequent diseases among the seniors due to a number of factors as discussed below.

A research conducted by Susan et al., (2017), indicated that, among the population of entire Americans, older people are highly susceptible to contracting STIs and HIV. The increase in divorce and sexual active nature among them has enhanced the high rate of transmission. This increase is aided by indulgence in unprotected sexual behaviors as compared to their younger counterparts. They fail to understand that they are also vulnerable to these diseases and this is because they were never educated about condom being part of sexual life. Moreover, after menopause in women, virginal tissue thin and lubrication decreases increasing the risk of tear and of transmission of diseases (Juliane et al, 2017).

The methods showing various sexual positions as illustrated in the video “PSA: safe sex for seniors” best illustrate the common practice among the elderly. However, these methods contribute to high risk of contracting STI and HIV because most causes friction which lead to breakage of the membrane creating open surfaces for the entry of antigens causing diseases. However, I agree with the last part of the video which emphasizes the use of condoms as one of the safe way towards preventing HIV and other sexually transmitted infection among the sexually active elderly population. It’s for this reason that the aged need to be educated on basic education on safe sex in order to identify the signs and the important of the use of condom, doctors should seek to know more about the sexual activities among seniors in order to advise them accordingly, and finally distribute condoms to locations where the elderly reside and congregates (Lyons et al, 2017).

In conclusion, sexual risk behaviors among the elderly require appropriate measures which aim at reducing this norm that make them more susceptible to STI and HIV. These may include targeted education campaigns, intervention and also health practitioners need to keep the record of sexual history of the elderly as this will improve knowledge about risks and need to espouse safe sexual behaviors such as the use of condoms and refrain from rough sex.

Introduction

Many communicable diseases have been evolving around the world resulting in millions of deaths and no cure. Communicable diseases are infectious diseases that can spread easily through direct contact such as human immunodeficiency virus (HIV). HIV is an infection that causes AIDS and can weaken the immune system. It has become a global and public health concern causing approximately 35 million deaths worldwide (WHO, 2018). HIV is the leading cause of death in Africa. It has had the most impact in Sub Saharan Africa where people live in poverty and don’t have access to medications, technologies or condoms, resulting in high death rates and short life expectancies. It’s known as the ‘silent’ disease because its symptoms tend to show up after a few weeks, which can be difficult to treat later. HIV/AIDS is a type of disease that doesn’t have a fixed cure, it can only be prevented or controlled by medications and technologies.

It is assumed that HIV first developed in apes around the 1900s, and its first encounter was with a hunter who had contracted the disease through direct contact with its blood. In 1981, it became headlines that five gay men were fighting a life-threatening infection called ‘PCP pneumonia’ that kills those with HIV/AIDS. Centers for Disease Control and Prevention decided to name this disease ‘acquired immunodeficiency syndrome’ and started to warn people of the spread of the disease through sexual and mother-to-child contact. The spread of AIDS started to occur in some parts of Africa in the early 1980s. In the same year, researchers Luc Montagnier and Francoise Barre-Sinoussi discovered a virus in a lymph gland of an AIDS patient, therefore confirming that HIV causes AIDS in people over time (Canadian Foundation for AIDS Research, 2016). Many researchers such as Mark Wainberg have contributed to the prevention and treatment of HIV/AIDS.

HIV can be classified through two distinct areas: microbiology and transmission. Microbiology focuses on different types of micro-organisms such as bacteria, virus, fungi, parasites and many more. This area classifies the type of microbe or agent the communicable disease is. In the case of HIV, it is a type of virus that can be treated by vaccines to prevent growth, but no cure to eliminate. Transmission looks at how the communicable disease can be transmitted to humans or animals. HIV can be transmitted through direct and indirect contact (blood, semen, body fluid), as well as perinatal contact, during pregnancy or breastfeeding.

HIV/AIDS is a global disease burden due to its high rates of death around the world. The case definition stated by WHO (2007) can help individuals with their illness at all stages: a suspected case would be a person presenting signs or symptoms such as fever, rash, swollen lymph nodes, and weight loss; a confirmed case would include adults and children 18 months or older who has had a second positive HIV antibody test or positive virological HIV (HIV-RNA or HIV-DNA) test and children younger than 18 months who have a positive virological HIV test that is confirmed the second time taken after four weeks of birth are diagnosed with HIV (Appendix A). The burden of disease also looks at the morbidity and mortality rates of a communicable disease. In Canada, the estimated incidence cases for HIV/AIDS were 2,165 in 2016, whereas the prevalent cases were 63,110 which has decreased from 2014. This decrease isn’t good because more people are dying which raises questions on whether the treatments aren’t good enough (Government of Canada, 2016). Risk factors for HIV/AIDS include unprotected sex, needles, contaminated blood, other infections such as chlamydia.

Study Designs

An article by T. Qi et al. (2016) is a cross-sectional study based on the etiology and clinical features of bloodstream infections among Chinese HIV/AIDS patients. This study took place at Shanghai Public Health Clinical Center (SPHCC) in Mainland, China between September 2009 through December 2014. The researchers evaluated 2442 HIV patients and amongst those, 229 patients had at least one positive blood culture (22.7% cryptococcus neoformans, 18.8% penicillium marneffei, 15.3% mycobacterium tuberculosis and 14.8% non-tuberculosis mycobacterium). Those patients who presented contaminants such as S. aureus were excluded from the study. A cross-sectional study design was used to measure the disease and exposure at the same time, also known as the ‘prevalence.’ In this study, the researchers found that penicillium marneffei (fungi) contributed to bloodstream infections much more than the other blood cultures and can be an emerging fungal infection in China. As a result, bloodstream infections are an important morbidity factor due to the prevalence of 9.38%, which led to poor prognosis in these HIV/AIDS patients.

Slabbert, N. F., et al. (2015) performed a cohort study on HIV/AIDS patients who may be influenced by antidepressant treatment within the major depressive disorder (MDD) population. MDD is highly associated with people who have HIV/AIDS because the disease puts a type of burden on the individual such as shame and their poor lifestyle choices which are mostly seen in women that can further affect their health and progression of the disease. This six-year prospective study took place in South Africa and included two main objectives: to determine the prevalence of MDD and HIV/AIDS patients and its impact on gender and how the compliance of antidepressants is affected in these patients who also have MDD. The researchers looked at two groups: 12, 270 patients with only MDD (comparison group) and 127 patients with both MDD and HIV/AIDS to compare which group would or wouldn’t comply to antidpressant treatment. At the end of the study, it was found that those who had both HIV/AIDS and MDD were associated with a decrease compliance of antidepressant treatment than those who did not have HIV/AIDS. It was predicted in the start of the study that people with infectious or chronic diseases don’t usually correlate with antidepressant treatments and that most women tend to have higher risks of MDD than men.

Epidemiological Triangle

The epidemiological triangle is based on the complex relationships between the agent, host, and the environment that can be used towards explaining the HIV/AIDS pandemic. The agent in this case is the virus, HIV because it’s the cause of disease. The agent then comes in contact with the host which can be influenced by its factors such as age, sex, and behaviours. Humans are the host because HIV can be transmitted through broken skin, cuts, and mucus by risk factors including blood, sex and breastfeeding which is why even babies from the womb may have the disease. Early-like symptoms includes fever, headaches, and rashes, whereas severe symptoms can lead to opportunistic infections such as tuberculosis or cancer tumors. HIV has no cure yet, which is why treatments such as antiretroviral therapy (ART) can slow the process over time to avoid complications (AIDS info, 2018). The environment is where the agent and host interact causing either an increase or decrease of the disease. HIV lives in the cells of the human body which can be influenced by factors outside the body. Lifestyle choices such as avoiding drugs and alcohol, eating healthy, being active can lead to a better outcome, along with HIV medications and technologies. On the other hand, poor sanitation and stigma can result in AIDS development or early death (Appendix A).

Chain of Infection

It is important to break the chain of infection because it can prevent the spread of the disease to another person and eliminate it forever. Since HIV has been a result of a big percentage of deaths around the world, it is necessary to eliminate it so that death rates can decrease, and one major disease is out of the picture. The chain of infection starts with the infectious agent which is the human immunodeficiency virus which is part of the retroviridae family. HIV has a high pathogenicity and virulence because it can cause AIDS overtime if the individual has not been treated or hasn’t taken initiative to prevent the disease which can lead to severe outcomes such as death. When HIV comes into contact with a human, it becomes its reservoir. A person with HIV can be an asymptomatic carrier because the symptoms don’t show up for about a few weeks or even a month. HIV then leaves the human through a portal of exit which can be either the skin through cuts and needles, during pregnancy or breastfeeding from a mother to its baby, and body fluids such as semen or blood. The modes of transmission associated with HIV are direct contact through sexual intercourse, vertical transmission from a mother to its baby, as well as indirect contact by vehicle borne transmission such as blood and fomites. The way HIV leaves the host is similar to the way it enters a new host through the portal of entry which includes the placenta, semen, and skin (Skerrat, 2018). Lastly, individual factors and choices can determine how HIV will influence the person. Thus, if the individual avoids having sex, alcohol, and drugs, it can help control the growth of HIV in the cells of the body.

Natural History of Disease

The natural history of disease shows the individual’s disease progression overtime when they are not being treated. In the preclinical phase, the individual infected with HIV may not even know they have the disease which is known as the latent period. During the incubation period, individuals will start to show early symptoms such as fever, headache and cough after 2-4 weeks. HIV treatments such as antiretroviral therapy (ART) can help produce seroconversion to avoid growth overtime which allows patients to live longer (CDC, 2018). In the clinical phase, the infectious period is where people with HIV can transmit the disease through sexual intercourse, needle-sharing, or even pregnancy which can spread directly or indirectly from one person to another. During the symptomatic period, people will start showing signs and symptoms of HIV so if they don’t continuously get treatment then they may develop AIDS early on. AIDS don’t usually develop until about 10 years, but may result in opportunistic infections such as tuberculosis, cancer or death (CDC, 2018). It is important to understand the natural history of HIV/AIDS because it can help recently infected individuals take precautionary steps to treat and control the disease, along with living longer and healthier. In addition, it can change their individual lifestyle choices and motives in life.

Preventing and Controlling HIV/AIDS

Prevention and control are important actions to take in reducing the pandemic of HIV/AIDS. In epidemiology terms, agent control (HIV) can be prevented through antiretroviral therapy. This treatment involves the use of medications to help treat patients and reduces the growth of HIV in the body (AIDS info, 2018). Though most effective, low-income countries may not have access or enough money to get any type of services or medications. In addition, governments may not have optimal allocation due to limited resources in these health sectors. Therefore, organizations and the people need to work together to create a policy or program that can tackle this issue. Route of transmission control can include methods such as the use of condoms to prevent infected semen, to reduce needle-sharing to avoid blood to blood contact, and breastfeeding. All these methods prevent the transmission of HIV, but also promote safe sex, open injection sites, and other alternatives (Bertozzi et al., 2006). In addition, screening and testing is important to understand what stage the individual may be at to avoid the risks that can occur overtime and how to prevent and control it on time. Lastly, environmental control such as surveillance, vaccines and behavioural choices are steps towards preventing HIV/AIDS. These include monitoring, good nutrition, staying active, and avoiding alcohol and drugs. Education programs, counselling, and support groups can also promote awareness, and motivate people to take action, along with tackling other issues including stigma or depression (Appendix A).

Socio-political-globalization factors associated with HIV/AIDS

Since the HIV/AIDS pandemic, many organizations have stepped up to reduce and eradicate the disease that is causing millions of deaths around the world. The Joint United Nations Programme on HIV/AIDS (UNAIDS) was formed in 1996 with a goal to end AIDS. This organization works towards creating new policies, advocating, and working with governments to help deliver and monitor the communicable disease (UNAIDS, 2019). In addition, it works directly with countries that are mainly affected to provide funds and other resources to improve the health of their people. As of now, this organization is aiming to end AIDS by 2030. Furthermore, a study done by Saki et al. (2015) provides insight on a social issue that people diagnosed with HIV/AIDS go through: stigma and discrimination. Stigma is a structural barrier that puts an extra burden on the individual’s choices and health which further leads to discrimination. It can coincide with other health issues such as depression or isolation that can hinder the spread of disease and access to treatment. Thus, educational programs for example can provide knowledge on HIV/AIDS and can lead towards reducing stigma and discrimination.

References

1. AIDS info. (2018). HIV/AIDS: The basics. Retrieved from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/19/45/hiv-aids–the-basics
2. Bertozzi, S., Pandian, S. N., Wegbreit, J., DeMaria, M. L., Feldman, B., Gayle, H., . . . Isbell, T. M. (2006). HIV/AIDS prevention and treatment. In disease control priorities in developing countries (18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK11782/
3. Canadian foundation for AIDS research. (n.d.). HIV and AIDS history. Retrieved from https://canfar.com/hiv-and-aids/history-of-hiv/
4. Centers for Disease Control and Prevention. (2018). About HIV/AIDS. Retrieved from https://www.cdc.gov/hiv/basics/whatishiv.html
5. Public Health Agency of Canada. (2018). Summary: Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2016. Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/summary-estimates-hiv-incidence-prevalence-canadas-progress-90-90-90.html
6. Qi, T., Zhang, R., Shen, Y., Liu, L., Lowrie, D., Song, W., . . . Lu, H. (2016). Etiology and clinical features of 229 cases of bloodstream infection among Chinese HIV/AIDS patients: A retrospective cross-sectional study. Eur J Clin Microbiol Infect Di, 35, 1767-1770. doi10.1007/s10096-016-2724-7
7. Saki, M., Kermanshahi, K. M. S., Mohammadi, E., & Mohraz, M. (2015). Perception of patients with HIV/AIDS from stigma and discrimination. Iran Red Crescent Med J, 17(6) doi: 10.5812/ircmj.23638v2
8. Skerrat, S. (2018). Chain of infection/Disease transmission [PowerPoint slides]. Retrieved from http://carlin.uit.yorku.ca/faculty/relay/2017-18Winter/sskerrat/IHST3100M/Chain_of_Infection_-_20180107_163413_33.html
9. Slabbert, F. N., Harvey, B. H., Brink, C. B., & Lubbe, M. S. (2015). The impact of HIV/AIDS on compliance with antidepressant treatment in major depressive disorder: A prospective study in a South African private healthcare cohort. AIDS Research and Therapy, 12 doi:10.1186/s12981-015-0050-2
10. UNAIDS. (2019). About UNAIDS. Retrieved from http://www.unaids.org/en/whoweare/about
11. WHO. (2007). WHO care definitions of HIV for surveillance and revised clinical stating and immunological classification of HIV-related disease in adults and children. Retrieved from https://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf

Introduction

Human Immunodeficiency Virus (HIV) is a global disaster for people all over the world. According to a report by UNAIDS, as of 2018, the Eastern and Southern Africa region remains the most affected by the HIV epidemic, accounting for 45% of the world’s HIV infections, and makes up 53% of people living with HIV globally. (UNAIDS, 2018)

In Kenya, HIV continues to be a major challenge, with the national prevalence estimated at 1.6 million Kenyans living with HIV, according to the Kenya HIV and AIDS research Agenda of 2014/15-2018/19. (National AIDS Control Council, 2014)

According to the UNESCO website, the United Nations defines the “youth” as those persons between the ages of 15 and 24. The youth in today’s society are at increased risk of HIV infection due to the various developmental, psychological, social, and structural transitions that occur during this period of their lifespans. In fact, half of the 15 to 19-year-olds who are living with HIV in the world live in just six countries: South Africa, Nigeria, Kenya, India, Mozambique and Tanzania. (AVERT, 2018)

The youth are most disadvantaged in the fight against HIV for the following reasons:

Lack of awareness

The World Health Organization reports that a considerable portion of HIV-positive youth are unaware of their status, and many of those who are aware of their status do not receive effective, long-term antiretroviral treatment. (World Health Organization, 2018)

A great lack of awareness exists among youth, especially in African culture, whereby questions about sexuality are considered taboo. This causes them to shy away from asking their elders about the risks of engaging in sexual activity, and end up taking part in these acts without appropriate knowledge.

Most adults also do not have the essential information to equip the youth with knowledge on how to prevent the spread and transmission of HIV/AIDS. A survey of schools in Zimbabwe in 2016 reported that many teachers lacked the proper knowledge on sexual and reproductive health issues. I.e. knowledge about HIV, how to talk to students about HIV, etc. (Campbell et al., 2016) . Therefore many students lack access to proper knowledge about HIV/AIDS in schools, making them more disadvantaged to others in society.

Drug abuse

Drug abuse is one of the many addictions that begins among the youth. This is because, at this age, there is a fairly high chance of experimentation among peer groups. People who share needles and syringes for injecting drugs are at a very high risk of contracting HIV. “If a needle has been used by a HIV-positive person, infected blood in the needle can be injected into the next person that uses the needle” (AVERT, 2017)

It is also reported that fewer HIV prevention programs focus on reaching out to vulnerable youth to prevent them from starting to abuse drugs, or end their addiction. This makes them the most disadvantaged among society.

Children orphaned by HIV/AIDS

Children orphaned by HIV/AIDS are those under the age of 18 who have lost one or both parents to the disease. Among those orphaned, are the youth. They face discrimination, stigmatization, and depression due to their situations, which are beyond their control. They are more vulnerable than other youth to abuse, prostitution, beggary, and drug abuse. Therefore, these youth are the most advantaged in the fight against HIV, due to their exposure to such harsh living situations. (Naswa & Marfatia, 2010)

Early sexual debut

The age at which young people are having sex is slowly rising, exposing more youth to the disease. Adolescence and early adulthood is a vital period of development where significant physical and emotional changes occur. This is a time for exploring and navigating peer relationships, sexuality, and gender norms. (AVERT, 2018)

It is at this young age that the youth begin to explore their sexuality. They begin to derive pleasure from experimenting with drugs, alcohol, and even sex. This period of exploration and curiosity, coupled with a lack of awareness on the disease, can highly expose youth to the spread of HIV/AIDS.

The WHO believes that people need to know how to protect themselves from HIV infection, and must have the means necessary to do so. (World Health Organization, 2018) If the youth are given access to comprehensive education on the spread and transmission of HIV/AIDS, they will be more likely to make informed decisions regarding their experiences in the outside world.

The youth already infected with HIV/AIDS must also have affordable access to antiretroviral treatment. Parents and schools must also be encouraged to engage in the fight against HIV/AIDS. This will aid the youth in making conscious decisions about their lives, when given proper advice by their elders.

The first case of HIV in Kenya was detected in 1984. By the mid-1990s, HIV was one of the major causes of illness in the country, putting huge demands on the healthcare system as well as the economy. In 1996, 10.5% of Kenyans were living with HIV, although prevalence has almost halved since then, standing at 5.9% by 2015. This progress is mainly due to the rapid scaling up of HIV treatment and care. (Ministry of Health Kenya & National AIDS Control Council, 2014). As of 2018, 75% of people living with HIV were on treatment, 63% of whom were virally suppressed. (UNAIDS, 2018)

Although the first case of HIV/AIDS was diagnosed, the epidemic was not considered a serious problem until the late 1980’s when the Government of Kenya launched a comprehensive five-year Medium-Term Plan (MTP) under the AIDS Programme Secretariat (APS) to control HIV/AIDS. This plan focused on prevention of HIV infection by screening blood, promoting safer sexual practices, and early diagnosis of STDs (Sexually Transmitted Diseases). It also developed national public awareness programmes, as well as training health care workers in the management of the HIV/AIDS patients. (Juma, 2001)

This participation by the government gave way for additional government spending and participation in the fight against HIV/AIDS. Donors such as the World Bank and other non-governmental organizations (NGOs) have been actively participant in the fight against the disease. (Nyaga & Kenya Institute for Public Policy Research and Analysis., 2004)

Impact on the household sector

During a study carried out on The Economic Impact of AIDS in Kenya in 1999, it was discovered that the disease had a major impact on the Kenyan economy. The Kenyan households were most affected. Smaller rural households lost between 58-78 percent of household income following AIDS-related deaths of an economically active adult in the household. In the urban household was ranging between 54-66 percent.(Bollinger, Stover, & Nalo, 1999)

By 1996, it was estimated that 300,000 children had been orphaned by AIDS. Majority of communities, as well as the government, had been forced to bear the brunt of looking after these orphans, while other orphans had to drop out of school to start engaging in child labour. (Bollinger et al., 1999)

Impact on the agricultural sector

During this period, agriculture was the largest sector in the Kenyan economy, accounting for a large portion of production as well as a key source of employment. In the report carried out on The Economic Impact of AIDS in Kenya, as explained above, the firm surveyed commercial agro-estates in Nyanza, Rift Valley and Eastern. It was reported that, in these estates, medical expenses had significantly increased in response to opportunistic diseases arising from HIV/AIDS cases among employees. Additionally, due to the absenteeism faced when the ill employees had to take days off, the healthy employees had to work extra hours to compensate for the time lost by their colleagues. This led to healthy employees being overworked and drained. (Bollinger et al., 1999)

Impact on the health sector:

A study on The Direct and Indirect Costs of HIV/AIDS estimated that in 1990, the cost of hospital care for all AIDS patients was an estimated Ksh. 480 million. This high cost proves that the country spent very large expenditure to care for and treat AIDS patients. (Bollinger et al., 1999)

Government response to the AIDS epidemic

Recognizing the seriousness of the epidemic, the Government of Kenya came up with various policy initiatives to stem the plague. The Sessional Paper No.4 of 1997 on AIDS in Kenya recognized the main response measure by the government as the establishment of the National AIDS Committee, and development of strategic plans to deal with the plague.

In 1985, the government also established the AIDS Programme Secretariat (APS), which later in 1987 became the Kenya National AIDS Control Programme. The programme emphasised the need for creating awareness about AIDS, blood safety, clinical management of AIDS, and capacity building for management of AIDS at a national level.

Conclusion

Based on these reasons, it is plausible to conclude that the HIV/AIDS pandemic greatly affected the Kenyan economy, making it the “most painful times” in the history of the country. Today, however, many changes are being made toward the prevention and treatment of the disease.

REFERENCES

1. AVERT. (2017). People who inject drugs, HIV and AIDS. Retrieved from https://www.avert.org/node/386/pdf
2. AVERT. (2018). Young people, HIV and AIDS. Retrieved from https://www.avert.org/node/389/pdf
3. Bollinger, L., Stover, J., & Nalo, D. (1999). The Economic Impact of AIDS in Kenya The POLICY Project. Retrieved from http://www.policyproject.com/pubs/SEImpact/Kenya.pdf
4. Campbell, C., Andersen, L., Mutsikiwa, A., Madanhire, C., Nyamukapa, C., & Gregson, S. (2016). Can Schools Support HIV/AIDS-Affected Children? Exploring the ‘Ethic of Care’ amongst Rural Zimbabwean Teachers. PLOS ONE, 11(1). https://doi.org/10.1371/journal.pone.0146322
5. Juma, M. (2001). Coping with HIV/AIDS in Education: Case Studies of Kenya and Tanzania (1st ed.). London: Commonwealth Secretariat. Retrieved from https://books.google.co.ke/books?id=QLTdre6je80C&printsec=frontcover&dq=hiv+kenya&hl=en&sa=X&ved=0ahUKEwijrsWBj8_gAhWjzoUKHQ5HDZA4ChDoAQgtMAE – v=onepage&q&f=true#v=onepage&q=hiv kenya&f=false
6. Ministry of Health Kenya, & National AIDS Control Council. (2014). KENYA AIDS STRATEGIC FRAMEWORK – 2014/15 – 2018/19. Nairobi. Retrieved from http://www.undp.org/content/dam/kenya/docs/Democratic Governance/KENYA AIDS STRATEGIC FRAMEWORK.pdf
7. Naswa, S., & Marfatia, Y. S. (2010). Adolescent HIV/AIDS: Issues and challenges. Indian Journal of Sexually Transmitted Diseases and AIDS, 31(1), 1–10. https://doi.org/10.4103/0253-7184.68993
8. National AIDS Control Council. (2014). Kenya HIV and AIDS Research Agenda 2014/15 – 2018/19. Nairobi. Retrieved from https://nacc.or.ke/wp-content/uploads/2015/10/HIV-AND-AIDS-RESEARCH-AGENDA-2014-2019-2909201502.pdf
9. Nyaga, R. K., & Kenya Institute for Public Policy Research and Analysis. (2004). HIV/AIDS in Kenya : a review of research and policy issues. Nairobi: Kenya Institute for Public Policy Research and Analysis. Retrieved from https://www.researchgate.net/publication/254401648_HIVAIDS_in_Kenya_A_Review_of_Research_and_Policy_Issues
10. UNAIDS. (2018). UNAIDS DATA 2018. Retrieved from http://www.unaids.org/sites/default/files/media_asset/unaids-data-2018_en.pdf
11. World Health Organization. (2018). Adolescents: health risks and solutions. Retrieved February 23, 2019, from https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions

Diverse processes of undervaluing, tagging, with stereotyping bring loss of status, unfair and unjust treatment, and social exclusion of persons or groups are contextually entrenched at every level. These manifest in different forms of stigma – stigma from racism; HIV-related stigma; sexism and gender related stigma; homophobia and transphobia related stigma as pathways of oppression (Logie et al, 2011). These different types of stigma occur and there is then HIV-related stigma that intermingles with other forms stigma related with the social identities ascribed (Ritter, 2017) to African women: race, gender, immigration experiences, and even their sexuality. This is called intersectional stigma, defined as, “a concern with the multiple, simultaneous and dynamic interchanges among categories of social difference as it interlinks with power and privilege, and systemic oppression and its operation at the micro (interpersonal, intrapersonal), meso (community, social networks, social norms and practices) and macro (cultural institutions, societal structures) levels (Logie et al, 2011; Loufty et al, 2105; Parker& Aggletion, ). Social exclusion is a consequence seen with stigma related social hierarchies with manifestations as psychosocial, physical and mental health factors including social isolation, anxiety, depression, suicidal ideation and harmful effects on physical and mental health as detrimental outcomes (p.19836). Loufty et al, (2015) found out that minimal interventional approaches were directed to intersectional stigma experienced by African women despite their disproportionate affectation by the HIV epidemic. Multi-level intersectional stigma intervention becomes a necessity for this group for a reduction in the burden of their health inequities. Their marginalization becomes widened, coping strategies become minimized as the barriers they face from intersectional stigma prevents them from accessing vital socio-structural supports needed for their sustaining existence.

Secondly, the interdependent and mutually constitutive relationships are experienced between the different forms of racism – intrapersonal, internalized and institutional social identities and a structural inability to access SDOH that bring mostly oppressions. These oppressions become mutually constitutive with her other identities making it almost impossible for her to the access social and health goods at multi-levels of their lives (Logie et al, 2011). In their study in Ontario, the experiences of stigma for African women at the micro-level has shown that participants hide their HIV sero-status from their parents and sexual partner for fear of disappointment and rejection due to intense shame and internalized HIV stigma; at the meso-level, the community beliefs and social norms that have expressed African woman as sexually immoral and loose as a symbolic form of HIV related stigma and a participant from Africa was able to surmise her experience at the macro level of the health care system as thus: ‘‘I was in crisis—I had to go see a doctor. When she came in she had three pairs of gloves and yet it wasn’t even a problem related to HIV! She kept her distance and could barely touch me. When she finally came closer I said: ‘If you do not remove your gloves you do not touch me!” (p.6).

Stigma and discrimination exists as principal drivers that influence the lived experience of the SSA WLHA; invariably fueling and contributing to the continuing and widespread occurrences of HIV in Canada. Women’s human rights through their life cycle are an inalienable, integral and indivisible part of universal human rights (UN, 1995); and health is a fundamental human right (WHO, 2015). Institutionalized, personalized and internalized forms of stigma with any direct and/or indirect system of advancement becomes an indignity and injustice to the lives of people living with the HIV disease, more so, for these African women that are based on socially ascribed hierarchies, her achievements contextually are limited because their social identities limit her. Her status is a function of the sum of their ascribed and achieved actions. Furthermore, elimination of AIDS as a public health threat is being undermined as the achievement of UNAIDS (2014) 90-90-90 target that by 2020; 90% of all people living with HIV know their status, 90% of those diagnosed receive antiretroviral treatment, and 90% of those on treatment achieve viral suppression is being compromised by stigma: An ascribed social status. At the end of 2014, PHAC, (2016), reports that an estimated 80% (73% to 87%) of persons living with HIV were diagnosed, 76% (70% to 82%) of persons diagnosed with HIV were on treatment, and 89% (84% to 93%) of persons on treatment had suppressed viral load. Stigma, possibly, drives this as challenges associated with social determinants of health and access and retention in health services are encumbered (Logie et al, 2011; PHAC, 2016).

The extent of the social integration of African women against the backdrop of their well-being becomes an unjustifiable challenge. Even with their HIV sero-positivity, her gender relations and roles which are socially constructed are a rote for the developmental processes (Wangari, ) needed for their survival in their host country. For the most part, they are the original migrant and known as the first-generation migrant while the children are known as the second-generation migrants (Anthias, 2012). There can arise issues of challenging concepts of transnational framework and social integration for her progenies due to negative capabilities as the primary care giver (p. 103). Highlighting a qualitative study of WLHA in Ontario, PHAC, (2013) elucidated the fears of a parent to losing custody of their children to social welfare,

“I was very depressed, I was upset. Because like children and family services said ok, you’re sick and if you don’t have family how are you going to take care of your daughter? And how are you going to take care of your son? And that really bothered me because when I was diagnosed they didn’t care and then when I got sick all of a sudden, my daughter was taken away from me and then my son and that really hurt me” (p. 35).

This can reduce the level of social attachment of these African women to social institutions as structural attitudes, societal beliefs and norms with values cannot govern their life due to an inherent internalized fear and stigma. It is obvious that the impact of a child’s life course due to detachment from her main primary care-giver, may institute a life pattern of barrage of emotional instability. Though some level of fluidity exists in social identities; such as migration status, education or housing but fixed situations; such as race, early child experiences of an adult (Anthias, 2012; Piggott & Orkin, 2018).

Even with the violence and social profiling, these women are expected by the originating culture to keep silent and take it in their stride (Brown-Speights et al, 2017; Etowa et al 2007; Etowa et al, 2017). In addition to their gender, the complex intersections with her diverse identities deleteriously heightens these women’s daily experiences and impinge on her well-being. As women, and potentially mothers and/or care-givers, these mutually constituted vulnerabilities oppressively manifest as racism, gender inequality, classism and HIV-related stigma; impacts to their access to social and health care with a poor quality of care that translates to poor individual and population health outcomes (Caiola, 2014). With the sensitivity and stigmatizing challenges associated with HIV (Worthington et al, 2013) for Africans; it worsens further their ability, as African women, to access to social products and resources (trainings, health, education, legal services, police services, jobs, and earnings for savings potentialities, social supports – both internally with her nuclear and extended families and network of communities) intersects with these social influences to impact on their life as immigrants. These social influences intersect with their immigration experiences to determines her social locations, quality of health status and their life (Hankivsky et al, 2010). Understanding these intersecting webs of complex social problems are related to inequities and disparities she experiences daily. These intersectional SDOH are meant to aid their settlement and integration as immigrants; such as accessibility, affordability and availability of health care services like mental health services, counselling sessions; social support; access to socio-economic opportunities that will aid education, economy and job opportunities; access to public community spaces for promotional and communication processes with safety, neighborhood exclusion; and availability of economic resources to meet their daily needs like affordable quality housing and cost-effective nutritious foods. Nevertheless, their inaccessibility to these social determinants of health shows socio-structural marginalization due to social policies that constrains them due to their immigration status and experiences.

Executive Summary

The HIV incidence in Bhutan has seen increasing over last decade ever since the first detection of HIV case in the year 1993. Since then, HIV was given the due attention with the establishment of the National STI and HIV/AIDS Control Programme in 1988, even before the first case of HIV was detected. This rise has been attributable to increasing prevalence of Sexually Transmitted Infections, strengthened HIV detection services with improved infrastructures and nevertheless the improved public awareness on the importance of getting oneself tested. Until July 2011, we have 246 total HIV cases throughout the country.

The implementing agency of this project was Ministry of Health where main objectives was to determine the geographical spread of HIV infection, monitor the trend of HIV epidemic in the country, provide information for estimates and future projections of HIV/AIDS in the country and to provide useful data for planning and implementation of HIV/AIDS prevention and control program activities with the total budget of US$ 5.94 million funded by world bank and non-world bank. The motive behind implementing this project was to reduce the risk of HIV and STI transmission among the general population, in particular among groups with high risk sexual behaviors.

The project consists of four components, each one having their own budget allocation and aims. More over project management framework, log frame, key stakeholder and their expectation has been discussed. Finally in conclusion it talks about weak integration of STI and HIV/AIDS services and institutional coordination and staffing issues during implementation leading to the unsatisfactory outcome of the project.

Introduction

Over the past 30 years HIV infection has been one of the most chronic diseases which have infected our society. The disease has claimed million of lives around the world. It is a global deadly disease with over 37 million people estimated to be infected across the globe, not leaving even the most isolated country like Bhutan. The country has remained isolated from the outside world until 1960s. However Bhutan has slowly started opening its doors to the outside world after it became a member of the United Nations in the year 1971.

The first case of HIV infection in Bhutan was detected in 1993. Since then, the number of cases has been on rise year after year. While the number of reported cases seems small compared to other countries in the region with very high burden of infection, it is still of public health concern given the small size of its population. Its two immediate neighbors are China, with an estimated 0.7 million people living with HIV (PLHIVs), and India with which Bhutan shares an open border with over 2.1 million PLHIVs. Therefore, HIV was given the due attention with the establishment of the National STI and HIV/AIDS Control Programme in 1988, even before the first case of HIV was detected within its border (Tshering, Lhazeen, Wangdi & Tshering, 2016).

Bhutan, though isolated geographically is not impervious to HIV. However increasing numbers in cross-broader movement and international travel combined with behavioral risk factors such as unprotected sex, injection drug use (IDU) and men having sex with men makes Bhutan much more exposed to the spread of HIV. According to the UNAIDS estimates, Bhutan is low HIV prevalence country with an estimated HIV of 0.2% among adult aged 15-45 years in 2012. The HIV prevalence among male and female aged 15-24 was 0.1% for both sex. Furthermore, the 2013’s Annual Health Bulletin of the Ministry of Health in Bhutan revealed an increase of HIV cases detected from 38 in 2000 to 297 in 2012. Almost 90% of these HIV infections were attributed to unsafe sexual practices (World Bank, 2011)

Problem identification

At the time of assessment, only 45 cases of HIV had been detected in Bhutan, but there were rising concerns over the increasing number of new infections detected every year. The maximum of new infections were acquired through unprotected sex, with the main behavioral factor being non-paid casual sex among long-distance drivers, members of the armed forces, migrant workers, and drug users. And also one of reason is due to high mobility across the borders (Half of the reported cases were from Thimphu and Phuentsholing which are on the border with India).

The inclusion of groups engaging in risk behaviors in the statement of the project’s objective was therefore highly relevant. The estimated number of STIs in the country was significantly higher than the number of HIV /AIDS cases, which another factor is contributing to HIV exposure in Bhutan (Tshering, Lhazeen, Wangdi & Tshering, 2016). Therefore, even though Bhutan has low HIV prevalence the challenge for the country is to continue this low prevalence with the occurrence of modernization and globalization.

This component has supported in:

• i) Improving access to and use of condoms through condom social marketing and strengthening logistics and information systems to ensure timely distribution of condoms in public health facilities, and to all implementing agencies including NGOs
• ii) Elevating political and societal leadership and commitment to HIV/AIDS and STI prevention and control through advocacy
• iii) Increasing knowledge about HIV/AIDS and STIs and positive attitudes toward prevention and safer sexual behaviors among the general public through mass media and targeted interventions specifically designed to reach the local populations in addition to training of village health workers, traditional healers, and public health staff, and innovative initiatives to be undertaken by other sectors
• iv) Promoting behaviors that reduce the risk for HIV infection among priority groups through peer education, innovative outreach and communications strategies, and provision of voluntary counseling and testing, and STI treatment. In addition to priority subpopulations including the armed forces, mobile populations (drivers), sex workers and out-of-school youth

Component 2 – Institutional Strengthening and Building Capacity has supported in:

• (i) strengthening laboratory services by instituting a national quality assertion for all laboratories, establishing an information system, ensuring sufficient equipment and reagents, and training technicians to ensure improvement in HIV and STI diagnostics and treatment
• ii) Improving blood transfusion services through policy development, training of technicians and health workers, and campaigns to increase clinical and safe use of blood and blood products and voluntary donation
• iii) Enhancing management, technical, and implementation capacity of the National AIDS Control Program, and implementing agencies and strategic planning through formulation of a National Policy on HIV/AIDS, local and foreign training, and technical assistance.

Component 3 – Care, Support and Treatment of AIDS and STIs has supported in:

• (i) Increasing access and use of voluntary counseling and testing (VCT) services through establishment of five VCT centers in key areas and facilities, training of counselors, outreach services for difficult to reach populations, and demand generation for VCT services.
• (ii) strengthening management of AIDS and Opportunistic Infections and establishing care and support for people living with HIV/AIDS (PLWHA) through development of national treatment guidelines for a comprehensive care and support approach, including anti-retroviral treatment as indicated; establishing and training district level clinical teams; improving laboratory support; instituting a drug information systems; and innovative grants or subprojects to involve PLWHA.
• (iii) Improving management of STIs through routine screening of ANC syphilis at district and army hospitals, updating existing STI syndromic management guidelines, improving syndromic treatment of STIs including antibiotic susceptibility studies, widespread dissemination of updated treatment guidelines to pharmacies and health facilities, and training of health care providers.
• (iv) Reinforcing waste management and infection control through training of health personnel, monitoring, and procurement of equipment and supplies (a national waste management plan was developed during project preparation).

Component 4: Strategic Information for HIV/AIDS and STI has supported in:

• (i) Enhancing management information systems and use of information technology to promote evidence based decision making and strategic planning through development of IT infrastructure and training on management and use of data.
• (ii) Strengthening operational research capacity, especially to carry out social and behavioral research through training
• (iii) Establishing second generation surveillance and monitoring and evaluation systems, which include conducting assessments, population survey and special studies, obtaining technical assistance, and providing foreign training. (World Bank, 2004)

With an objective of this project, a team has established to provide management and administrative support to the implementing agencies by testing acceptability and feasibility of the project. Stakeholders, program implementers and health care providers were in agreement with the need of IBBS survey. And one of the participants reported a high level of trust in MOH resulting in their willingness in participating in the project. Therefore, PMT has the following role and responsibilities:

• (i) coordinate and manage implementation of project activities (e.g., MOH departments and divisions, other sectors, Dzonghkags, MSTFs, and NGOs);
• (ii) regularly supervise, monitor, evaluate, and report on project activities to the relevant government agencies and to the Bank;
• (iii) oversee financial management and procurement of goods, civil works, and consultancies; and
• (iv) Interact with the Bank on a regular basis on all project-related activities, including planning and preparation of missions. Technical Committee: The Technical Committee would ensure that preparation and implementation by NACP, PMT staff and consultants is in conformity with the objectives of the project and is carried out according to the terms of reference for specific components/activities.

The Technical Committee will be chaired by the Director of the Department of Public Health and would comprise PMT staff, NACP program manager, component coordinators, and representatives of relevant institutions and programs. This Committee would also provide an entry point for input from donor agencies. Responsibilities of this committee include:

• (i) ensure coordination between the project, MoH, the health authorities and other public entities;
• (ii) coordinate the activities of different donors in order to increase the efficient use of resources;
• (iii) approve work-plans submitted by public institutions;
• (iv) approve subprojects submitted by NGOs and other civil society organization;
• (v) ensure that the Project Operational Manual (OM) are developed and maintained updated;
• (vi) ensure that the hiring of the Technical Assistance and all training activities are timely prepared and organized and will also ensure that communications and coordination and reporting links with the related stakeholders are established and well conducted;
• (vii) Coordinate Bank and other Donors’ supervision missions, and carry out the mid-term review of the project;
• (viii) Ensure that implementation is in consistency with the objectives of the project and is carried out according to the terms of reference for specific objectives/ activities.

Implementation mechanisms- The project would employ three types of implementation mechanisms: work plan, subprojects, and contracts. The type of implementing agency and type of intervention would determine the mechanisms.

i) Work plan

Prepare an annual work plan for project activities, following the existing annual planning mechanism and according to the cycle and criteria established in the OM. Funds would be disbursed based on utilization certificate and results achieved.

ii) Subprojects

NGOs and private institutions would be eligible based on selection criteria, would develop a proposal and financing plan for a subproject, and upon approval of the proposal by PMT and the Technical Committee, including NACP, the implementation agency (IA) would sign a legal agreement with the Project Coordinator and funds would be disbursed based on utilization certificate and reporting on progress and results.

iii) Contracting

Implementing Agency (e.g., suppliers, contractors, private sector,MOH) would be recruited and hired based on IDA Guidelines and Standard Bidding Documents and, upon selection, IA would sign a contract with the Project Coordinator. Payment would then be released upon meeting the specified indicators and deliverables (World Bank, n.d)

M&E implementation was a challenge for the project till end. Schedule data associated to project activities were not collected systematically. There were no standard reporting formats or reporting schedule for implementers to report project activities back to the Project Management Team (PMT). There was no information system in the PMT to keep track of project activities either. In 2005, the project team added 20 new process indicators for the purpose of activity monitoring, although such indicators were not processed formally to be part of the official Results Framework. While the project could benefit from additional process indicators, the number of such indicators was extreme and formed an extra burden on the implementing agency which failed to monitor them in a systematic manner.

Consequently, it fell on the Bank to take the lead in coordinating M&E and data collection during each mission. The project made little headway in introducing a culture of information-based planning and decision making. For example, the results of surveys implemented under the project were not widely circulated to all implementers as inputs for their work plans. It was only toward the end of the project that a factsheet was set by the MOH to provide information on key survey findings. Although a large number of program officers, managers and health workers (641 in total) were trained in the use of data for management, routine M&E data were not used for providing feedback to implementers for supervision purposes. So only the following were carried out: –

• One round of the HIV/AIDS General Population Survey (GPS) in 2006;
• One round of HIV/AIDS Behavioral Surveillance Survey (BSS) for high risk groups in 2008;
• The first round of the Health Facility Survey (HFS) in 2009; and
• The second round of the HFS for a subset of facilities in 2011.

A rapid assessment on sexual networks was conducted in Thimphu (2010) and Phuntsholing (2011) and demonstration study on the risk factors of HIV/AIDS infections in Bhutan was also carried out in 2011. All the surveys were implemented late in the project cycle, so they could not serve as start-of-project baselines. Some key project indicators could have been monitored by the surveys, but they were not included in the survey instruments. However, the surveys have appreciably improved the information base on HIV/AIDS in Bhutan so far as they have established baseline data for Bhutan for the first time. They also provided useful inputs for the development of the 2012-2016 National HIV/AIDS Strategic Plan in Bhutan (World Bank, 2011).

Conclusion and observations

The main aim of this article was to study the profile of HIV in Bhutan as well as to describe the progress made. Based on the available data we can conclude that the country has a low HIV prevalence. A timely intervention by the Government and its partners has ensured the persistence of this low prevalence over the last two decades.

However, the increasing number of cases being detected remains a cause for concern. Major HIV epidemics often transition from an initial low prevalence with a slow growth. Existing risk factors such as high STI rates, multiple sexual partners and increasing number of cross border movements can fuel a large HIV epidemic. Furthermore, the limited data and information available, especially among key populations at risk of acquiring HIV infection, is a major limitation. Building evidence would be the key to inform the future strategic direction of the national response. Efforts to gather and use data to advocate, mobilize resources and design evidence-based programmes relevant to the country‘s specific needs and epidemiological pattern are of crucial importance to attempt to maintain the present low HIV prevalence status of the country.

Despite a slow start, project was on track until mid 2007. An evaluation was conducted in November 2006 which did not identify major issues other than the need to strengthen M&E. From early 2008 to closing, the project became a problem project at several points in time. Although there was no formal project change or restructuring, the work plan was significantly modified in 2009 to avoid duplication with the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) activities. As the result, most of the multi-sectoral activities were no longer supported by the project. So the overall rating of the project is unsatisfactory due to weak integration of STI and HIV/AIDS services and institutional coordination and staffing issues during implementation.

References

1. Ministry of Health, (2009). Technical Strategy for Prevention and Control of sexually Transmitted Infections. Thimphu: Bhutan
2. Tshering, P., Lhazeen, K., Wangdi, S., & Tshering, N. (2016). Twenty-two years of HIV infection in Bhutan: epidemiological profile. Journal of Virus Eradication, 2, 45-48.
3. World Bank, (2011). Implementation Completion and Result Report For HIV/AIDS and STI Prevention and Control Project. Retrieved from http://www.documents.worldbank.org
4. World Bank, (2004). Project Appraisal Document For An HIV/AIDS And STI Prevention And Control Project. Retrieved from http://www.worldbank.org/infoshop
5. World Bank, (n.d). Project Information Document (PID) Appraisal Stage. Retrieved from http://www.documents.worldbank.org

The revelation of the human immunodeficiency infection (HIV) as the causative living being of (AIDS) and the powerlessness of present day drug to discover a solution for it has set HIV as a standout amongst the most feared pathogens of the 21st century. (AIDS) is an ailment brought about by the human immunodeficiency infection (HIV). HIV contamination is an extremely present danger and can without much of a stretch is named as revile upon humankind. Mainstream researchers originally saw and perceived the nearness of AIDS as a genuine illness following an expansion in the rate of exceptionally uncommon astute contamination and malignant growths among generally solid gay men.

The future of an individual who conveys the HIV infection is presently moving toward that of an individual that tests negative for the infection, as long as they hold fast to a mix of prescriptions called antiretroviral therapy (ART) on a progressing premise. Imperceptible HIV is the point at which the measure of HIV in the body is low to the point that a blood test can’t recognize it. Individuals might almost certainly accomplish imperceptible dimensions of HIV by firmly following the recommended course of treatment. Affirming and normally checking imperceptible status utilizing a blood test is essential, as this does not imply that the individual never again has HIV. Imperceptible HIV depends on the individual holding fast to their treatment, just as the viability of the treatment itself.

There are an expected 650,000 individuals living with HIV/AIDS (PLHA) in China. HIV contamination impacts PLHA as well as their entire family. Given the family-situated structure of Chinese society, HIV can devastatingly affect Chinese families. Numerous PLHA are guardians and parental figures who should take care of the necessities of their youngster; they need to adapt to their very own physical wellbeing indications, complex drug regimens, shame, and dread of AIDS-related passing, and should likewise think about their families. The mental weight and stress influence their generally emotional well-being, and melancholy is basic among guardians and parental figures as they battle with monetary impediments. Numerous parental figures find that they can never again function as the ailment advances and their wellbeing disintegrates, and joblessness prompts extraordinary monetary hardships.

There are right now more than fifty substantial NGOs associated with AIDS control. These extensive associations can be partitioned into two gatherings. The primary gathering is made out of mass associations; for example, entomb alia, the All China Women’s Federation, the All China Youth League, the Red Cross, the All-China Federation of Trade, and the Chinese Working Committee for Caring for the Younger Generation. Every one of these associations has branches at various dimensions all through China, and the vast majority of their work is finished by expert social specialists.

Chinese NGOs have completed numerous shared projects on AIDS counteractive action and control with universal partners. These NGOs effectively partake in universal AIDS meetings. Likewise, they took an interest in the AIDS meeting for Northeast Asian Countries in November, 2000. Those in participation shared encounters in battling the infection and reinforced their soul of collaboration and normal reason.

At the UN Special Assembly on AIDS on 2 June 2005, Vice-Minister Wang Long-de commended the commitments made by Chinese NGOs and other people who are buckling down against AIDS on the terrain. He urged the all areas to take an interest in the fight. He expressed that China is at a basic crossroads in the fight against AIDS, and Chinese NGOs are key players in the exertion. To be sure, he inferred that Chinese NGOs are ‘turning into a key power in AIDS aversion and control.

In 1997, United States President Bill Clinton declared the test to build up an AIDS immunization by 2007. Since 1997, the AIDS Vaccine Advocacy Coalition (AVAC) has distributed yearly reports on the worldwide status of the push to comply with Clinton’s time constraint. A year ago’s report, entitled ‘Guides Vaccine Trials—Getting the Global House all together,’ authoritatively closes the commencement. Saying that ‘we are on a long haul mission,’ AVAC reasons that there won’t be a sheltered and productive immunization in 2007, and that we have to ‘center around the whole deal and set a motivation for supported and manageable activity that extends well past 2007.’ It isn’t that there are no antibody applicants in clinical preliminaries, yet there is little expectation that any of the present hopefuls will end up being a shoddy and safe immunization that bears long haul security.

San Francisco was one of the epicenters in the soonest periods of the HIV plague, and where probably the most essential support started and created. Commending its 37th year in 2019, San Francisco AIDS Foundation (SFAF), a non-benefit association headed by CEO Joe Hollendoner, utilizes in excess of 200 staff giving administrations to individuals in danger for and living with HIV/AIDS, and attempts to end the scourge in the USA. SFAF is additionally assuming a key job with accomplices crosswise over San Francisco in the Getting to Zero activity.

As the wellbeing emergency developed to scourge extents and spread into new populaces, the San Francisco AIDS Foundation correspondingly developed and reacted to new difficulties. Expanding upon its unique mission to teach, the AIDS Foundation included thorough administrations for individuals living with HIV malady and AIDS and a forceful open approach segment to propel bureaucratic and state governments to address the developing plague.

HIV can likewise affect connections between relatives. Constant disease in the parent can change family jobs causing outrage or blame. Relatives can end up disconnected. The capacity of HIV-positive guardians and parental figures to think about their kids is additionally disabled, as neediness actuated by HIV/AIDS builds the danger of ailment and demise among youngsters.

HIV/AIDS can likewise influence kids’ ordinary youth. Youngsters from families living with HIV/AIDS regularly need to manage psycho social pressure, an evil guardian, diminished child rearing limit, a move in family structure, money related hardship, and disgrace and separation. These difficulties can prompt passionate and social changes in youngsters, for example, gloom and wrongdoing. Past examinations have recorded that youngsters from HIV-influenced families are increasingly inclined to creating issue, for example, social change and consideration issues, and wretchedness.

References

1. Felman, A. (2018, November 29). HIV and AIDS: Overview, causes, symptoms, and treatments. Retrieved from https://www.medicalnewstoday.com/articles/17131.php
2. Browse HIV/AIDS. (n.d.). Retrieved from https://www.nejm.org/medical-research/hiv-aids
3. AIDS fight: 7 organizations making a difference. (n.d.). Retrieved from https://www.pri.org/stories/2012-12-02/aids-fight-7-organizations-making-difference
4. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. (2007, March 02). Retrieved from https://www.sciencedirect.com/science/article/pii/S0277953607000184