The Pope An Condoms And Aids

Every day, around us are policies implemented by the government that keeps us safe without us ever even noticing. We were fortunate enough to have learned that such things are normal and often are taken for granted. We bathe in clean water, eat at restaurants that have safe food thanks to health inspectors, we flush toilets and use septic systems to minimize spread of infection and for sanitary reasons. All these policies and more were created for the safety of the general population. “The Health and Human Services Policy and Planning Division leads a number of policy and planning teams aimed at improving the delivery of health care, long-term services and supports and human services in the state.” Policy Development and Planning Division. (n.d.)

The U.S. Department of Health & Human Services has created an updated plan to combat the spread of HIV and minimize AIDS related deaths. “Federal Action Plan: To implement the National HIV/AIDS Strategy for the United States: Updated to 2020, Federal agencies and offices developed a detailed Action Plan outlining the specific steps they will take to implement the priorities set forth by the Strategy.” Federal Implementation. (2017) Such plan includes goals such as: Reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, reducing HIV-related disparities and health inequities, and achieving a more coordinated national response to the HIV epidemic.

Such policies have elongated the life expectancy of millions in America due to resources such as PrEP (pre-exposure prophylaxis) or PEP (post-exposure prophylaxis), ARV/ART (Antiretroviral Therapy) and Planned Parenthood that fosters counseling educating people to avoid sharing needles, practice safe sex by maintaining monogamy and the importance of the use of condoms. America however isn’t where most of the problems lies. “More than two-thirds – 67% – of the global total of 32.9 million people with HIV live in sub-Saharan Africa.” Butt, R. (2009) Due to its size, substantial population, lack of education and resources greatly impact the African community.

While it is a well-known fact that condoms can prevent the transmission of Sexually Transmissible Infections, “[Pope] Benedict [XVI] said that distribution of condoms would not resolve the AIDS problem but, on the contrary, would aggravate or increase it.” The Pope on Condoms and AIDS, (2009). The Catholic Church has long been against contraceptives (including condoms) and promotes abstinence until marriage. Yet, the Catholic religion continues to make false claims regarding the spread of this deadly infection. “In 2007, Archbishop Francisco Chimoio of Mozambique announced that European condom manufacturers are deliberately infecting condoms with HIV to spread Aids in Africa.” Goldacre, B. (2010).

“HIV & AIDS advocates have long maintained that the Catholic ban on condom use, though largely ignored in the West, has led to devastating results in developing countries dependent on humanitarian aid, which is often filtered through Catholic or other religious groups. Because Catholic leadership discourages the use of condoms, or religious relief organizations block their distribution, hundreds of millions are left more exposed to disease.” Joyce, K. (2019)

References

  1. Butt, R. (2009, March 17). Pope claims condoms could make African Aids crisis worse. Retrieved from https://www.theguardian.com/world/2009/mar/17/pope-africa- condoms-aids.
  2. Joyce, K. (2019, February 23). The Catholic Church, Condoms, and HIV & AIDS in Africa. Retrieved from http://churchandstate.org.uk/2012/12/the-catholic-church- condoms-and-hiv-aids-in-africa/
  3. Federal Implementation. (2017, January 31). Retrieved from https://www.hiv.gov/federal-response/national-hiv-aids-strategy/federal- implementation.
  4. Goldacre, B. (2010, September 11). Pope’s anti-condom message is sabotage in fight against Aids | Ben Goldacre. Retrieved from https://www.theguardian.com/commentisfree/2010/sep/11/bad-science-pope- anti-condom.
  5. Policy Development and Planning Division. (n.d.). Retrieved from https://portal.ct.gov/OPM/PDPD/PDPD/Policy-Development-and-Planning- Division
  6. The Pope on Condoms and AIDS. (2009, March 18). Retrieved from https://www.nytimes.com/2009/03/18/opinion/18wed2.html.

The Features of HIV and AIDS in Haiti

HIV/AIDS has caused many epidemics in rural areas and communities across Haiti. HIV/AIDS pandemic, we examine the association between declining natural capital and engaging in risky sexual behaviours, as potentially another livelihood strategy. HIV/AIDS can be transmitted through several factors. Environmental, social, cultural, and political factors affect the spread of infectious disease. For instance, when we look at HIV/AIDS, it has dramatically altered the population of Haiti. When there is a lack of knowledge, technology, health care and education theses factors can cause the disease to spread more rapidly. Haiti requires more infrastructure to extract and send resources to other places in Haiti. Indeed, Haiti is the most heavily HIV/AIDS affected nation in the region, with an estimated 94,000 adults living with HIV/AIDS. The idea of natural resources being accessible to different individuals and household levels. Laws and regulations in hospitals are essential to follow and waiting rooms to execute how clean the environment is. People in Haiti need to be more disciplined when it comes to access to knowledge.

Social factors are another cause of the spread of this infectious disease. Large-scale social forces, such as racism, sexism, political violence, poverty and other social inequalities, are rooted in historical and economic processes and sculpt the distribution and outcome of HIV/AIDS(. We tend to refer to these social forces as structural violence. Social effects can affect the way hospitals are run in Haiti. Street’s article describes hospitals in this way “the public hospitals had emerged as a place of invisibility and failure by accepting the arrival of development”. Often, public health experts recommending policy for developing countries believe that the high cost of treatment, the lack of infrastructure and the lack of patients’ adherence to treatment render disease control and treatment impossible and that’s why HIV/AIDS spread across Haiti. Poverty is a significant factor for why HIV/AIDS spread, and governments such as NGO don’t want to help fund and cure HIV/AIDS.

In the 1980s the AIDS epidemic was known worldwide and involved a political stance to HIV/AIDS through protests. Western countries had a big fight for the AIDS epidemic to influence HIV. Context and history matter, colonialism had a significant effect on HIV/AIDS. Most adults are unemployed, and more than 70% live in U.N.-defined extreme poverty. Safe drinking water and sanitation facilities are lacking for most people. Furthermore, inadequate shelter and food insecurity can be observed in 40% of Haitian households. The admixture of these conditions with a turbulent history of political instability, violent conflict, and natural disaster presents a new reality to be faced by the citizens and political leaders of Haiti as well as by the broader global public health community.

HIV/AIDS can also be seen in a cultural context. HIV/AIDS are mainly derived from sexuality or having sexual behaviours. In Haiti, sexualised bodies and gay bodies are at a higher risk of this disease. The type of clothing, makeup worn to attract males. Gender disparity is a formidable barrier, marked by recent sharp increases in sexual violence against women and gang rape. HIV/AIDS is caused by heterosexual transmission. HIV/AIDS caused legacy worth of segregation and post-colonialism. Robert Lorway described homosexuality as a criminal and postcolonial problem. HIV/AIDS impacts gender inequality, high levels of sexual violence, biological vulnerability, and the gendering of poverty. Infectious diseases are increasingly concentrated among the poor, who live under the tremendous weight of structural violence, and whose social and economic rights, are consistently violated. We need to know how these co-infections affect HIV pathogenesis and public health and clinical/community services when natural disasters become a part of the social environment. These are several factors that affect how HIV/AIDS are spread throughout Haiti.

The Importance Of First Aid Training

I am writing this essay to get across my point of why I think everyone should be trained in basic first aid and why it is important to me and should be a big thing in everyone’s lives as well. First aid is something that most people don’t think too much into and always just rely on the people of the community that are trained, I think this is a bad thing because it is a lot of responsibility on that one person when it is easy to become trained at a low cost.

I think everyone should be trained in basic first aid because it would be so much easier to get a job. Most people think that employers don’t look out for First Aid trained on CVs but in actual fact they do, first aid plays a big part in the employers decision making on the person they which to employ. The reason for this is because people will feel a lot safer at work and out in public and it takes a big responsibility off the few people that are trained. Another reason having first would make it easier to get a job is if there was a minor accident at work or out on the street and everyone about knew first aid then someone at the scene would be able to help rather than calling an ambulance when it is not needed, this would also save a lot of money and time. There are so many incidents that ambulances get called too where they are not particularly needed and a trained first aider would be able to take care of themselves but yet that’s another example of not enough people being trained.

If everyone knew basic first aid then it could potentially be the difference between life and death. An example of this is, if a member of the public or someone you know is in a critical condition and waiting for an ambulance to arrive, then being trained could mean someone nearby will be able to keep them stable until help comes, part of the reason why help takes so long to come is because ambulances often get called out to incidents that are not particularly urgent but because everyone panics there first thought is to phone for help but if there were many people around that are trained then this would not be the case. Another reason being trained in basic first aid is good is because if there is an emergency everyone will feel a lot safer and will be a lot calmer and the emergency can be solved a lot quicker. If someone nearby tries to help and are not trained in first aid then it could potentially worsen the situation which means that the person that’s being dealt with doesn’t feel safe and everyone should have the right to feel safe where ever they are.

I have collected Evidence to show how being trained in first aid could be the difference between life or death. This is a quote I found when a member public quotes about how they feel about the matter, “basic first aid can mean the difference between life and death and can massively improve the canes of someone’s recovery, the amount of time that person spends in hospital and the amount of pain the patient is in “. It shows that there are so many reasons why it should be brought out for everyone to be trained and it’s not just a few of us that think so for example here is another quote I found about someone supporting the support for life first aid training. This is a quote from Boris Johnston the former mayor of London, “Anything that could help save a life or reduce the severity of an injury should be encouraged and that’s why I fully support First Aid for Life and the tailored training they are offering”. I also think it would be a good idea to see more campaigns and company’s being brought about to show that people do care about First Aid Training and want something to be done about it.

In conclusion, I think that being trained in first aid is a good idea and I think a lot more people should think about getting the training because it doesn’t cost a lot and is a great opportunity so people should take the chance while they get it. Having more people trained could potentially save lives, money and help people feel a lot safer in public. There are so many reasons why everyone should be trained because it would make peoples life a lot easier and happier.

Situation Analysis of HIV/AIDS in Malawi

Malawi is one of the poorest nations in the world and one of the 10 countries most affected by AIDS worldwide (USAID 2005). Malawi’s HIV prevalence is ranked 8th highest worldwide (DFID 2005). The adult HIV prevalence in Malawi is estimated to be 14.1% and approximately 70,000 new HIV/AIDS cases are reported each year and there are approximately 110,000 new HIV infections each year (USAID 2005). AIDS is one of the leading causes of death among Malawian adults. In fact, AIDS accounts for the majority of deaths amongst Malawian Adults; with more than 80,000 deaths annually attributed to it (NAC 2003; USAID 2005).

The impact is not limited to the adult population only; the children are affected by either contracting the disease from their mothers at birth or by losing a parent or both to the disease. At the end of 2005, an estimated 91,000 children in Malawi were living with HIV and more than half a million had been orphaned by AIDS (USAID 2008). This has given rise to child-headed homes as the traditional extended family system has been overwhelmed by the situation and the children have no extended family to rely on following the death of their parents (ibid).

The HIV/AIDS epidemic in Malawi is having a devastating impact on the country’s productivity. In 2002, Malawi suffered its worst food crisis for over fifty years, with HIV recognised as one of the factors that contributed most significantly to the famine (AVERT 2009). This is because farmers could not provide food, children could not attend school and workers could not support their families, either because they were infected with HIV or because they were caring for someone who was (ibid).

Furthermore, Malawi faces a critical shortage of public health workers, health care providers, facilities, equipment, and medicines; and the active labor force is becoming too small to support the needs of the young, the old, and the chronically ill. Patients with HIV/AIDS-related conditions currently occupy over 70% of hospital beds (USAID 2005). The spread of HIV has resulted in an increase in the number of tuberculosis (TB) cases. A 1999 survey showed an HIV seroprevalence of 77% among TB patients (DFID 2005; USAID 2005). There are significant geographical differences with respect to HIV prevalence in Malawi.

HIV prevalence is significantly higher in urban areas compared to rural areas where about 80% of the population lives (USAID 2008). In the southern region, where roughly half of the country’s population lives, HIV rates for both urban and rural areas are much higher than in other regions.

Malawi’s AIDS epidemic is feminized; around 60% of adults living with HIV in Malawi are female (AVERT 2009). The 2004 Demographic and Health Survey (DHS) demonstrated that HIV prevalence was higher for women than men, at 13 percent and 10 percent respectively (USAID 2008). Furthermore, HIV prevalence among young women, 15 to 24 years old, in Malawi is much higher than among men of similar age: 9 percent compared with 2 percent overall, and, in urban areas, 13 percent compared with less than 1 percent (ibid).

HIV/AIDS is still stigmatized in Malawi, hindering the flow of information to communities, hampering prevention efforts, and reducing use of HIV/AIDS services (AVERT 2009; USAID 2008). As a result, few people living with HIV make their status known, many have difficulty discussing the subject with their families, and some support groups do not meet openly (AVERT 2009). Other barriers to prevention, treatment, and care and support include the limited coverage of behavioral change communications, inadequate empowerment of women, limited access to services, insufficient focus on pediatric cases, inadequate laboratory services, lack of trained staff, and limited capacity for home-based care.

AIDS as a Life-Threatening: Descriptive Essay

You receive a call from the Red Cross, the blood you donated tested positive for HIV/AIDS. How did you receive this virus? AIDS is an extremely widespread virus that poses a health threat for millions around the world. Both strains of HIV, HIV-1 and HIV-2, plague so many people around the globe, and these people have a high possibility of getting AIDS if the HIV virus isn’t contained. Statistically, homosexuals contract AIDS at a higher rate than heterosexuals, and only a small percent of these people will receive life-lengthening drugs, such as ART, that can help maintain the virus and help to prevent HIV from changing into AIDS. Altogether the AIDS crisis is a horrible pandemic, and we could do everything we can to end it.

AIDS is a life-threatening virus and poses a threat for everyone, including women, even though it’s widely believed that only homosexual men can get the virus. When women get tested positive for AIDS there isn’t the same quantity of drugs available for them as there is for men( Cozic 33 ). Through many types of research conducted, it has been found that women die quicker from AIDS. This may be from the lack of response to women in the AIDS crisis, as many see it as a virus that is spread from man to man, another possibility is that they simply overlook women and put them into the minority(Cozic 34). Once a woman gets diagnosed with AIDS they may be isolated and reduced to only another person in a hospital, never receiving the life-changing medication they need. In 1989, 9% of AIDS cases were women, this would definitely put them in the minority in almost anyone’s eyes, and on top of this many women will never get tested for AIDS, as they may also think that only men can spread the virus(Cozic 38). AIDS is currently spreading like wildfire in the homosexual community, this is for both men and women, and many don’t know how widespread it is. Whichever way you look at this virus, you can see that women are in the minority when it comes to the AIDS crisis.

Homosexuals make up more than HALF of all AIDS cases, and most of the homosexuals getting AIDS are receiving it through sexual contact, and unfortunately, some believe you can get it just from casual contact. In just three years the number of homosexual AIDS cases had risen by 400%, this is absolutely crazy, and from this, we can deduce that many homosexuals have multiple partners, and do not practice safe sex(Opheim 15). In fact, one homosexual man said: “safe sex is unexciting sex” (Opium 25). Many doctors encourage people to practice safe sex, and many homosexuals are practicing unsafe sex, which undoubtedly is the reason why the AIDS epidemic is so widespread. Sadly, some unfortunate individuals believe AIDS can be spread through casual contact, like using the same sink or drinking out of the same cups, but in fact, the ONLY way to get AIDS is through blood, sexual contact, and birth(Opheim 15). Dr. Gerald H. Friedland of Montefiore Medical Center in the Bronx, New York, studied 145 people who had close contact with people who tested positive for AIDS. Some of the people even lived with the infected, and some shared personal items, but never had sexual contact with the infected. Out of these 145, only one had also tested positive for AIDS, a young girl whose parents had both tested positive for AIDS before she was born, and she likely contracted AIDS when she was being birthed(Opheim 14). In another report, researchers studied 300 people that worked closely with persons who had close contact with AIDS patients, this included doctors, nurses, and orderlies. Out of the 300, only 14 tested positive for AIDS, and those 14 were homosexuals who were sexually active(Opheim 14). There have also been NO cases where a person did get AIDS from casual contact, because as I said before, its transmitted through blood, birth, and sexual contact. In conclusion, homosexual makes up a large portion of AIDS-infected individuals, and you cannot get AIDS from sexual contact.

In some large cities, AIDS has become the leading cause of death for people under the age of 40, and we need to provide more drugs for these people. Over 65% if people with AIDS are homosexual or bisexual males, and they without a doubt have interrupted the transmission of AIDS, causing it to spread more rapidly. “The needs of the HIV-infected highlight inequalities in our economy and health care system” (Cozic 18) This is because of astigmatism around homosexuals, and how many believe they are “morally wrong”. We also need to provide more experimental drugs for all AIDS patients. Only 90% of AIDS patients are currently receiving any type of drug to help combat the virus, and in all honesty, they should create more treatments targeted at helping to contain AIDS (Opheim 19). Many cancer patients are given hope that they have treatments that can possibly cure their cancer, or at least a longer life. This means that AIDS patients should also be given the same hope as cancer patients. Also, by treating these patients you help the family and the community, you give them hope that their loved ones can be helped and that if they possibly get this virus, they have the possibility of living a longer life (Cozic 18) (Cozic 19). All in all, we need to give AIDS patients more opportunities to live longer life.

There is only one that can lead to AIDS, and that is HIV. There are two strains of HIV, HIV-1, and HIV-2, both of which developed from SIV, the Simian Autoimmune Virus, but originally came from different breeds of primates. HIV-1 mutated from SIV found in chimps, while HIV-2 mutated from SIV found in the sooty mangabeys, the difference in the strains of HIV has become a problem when trying to combat the virus, because you can’t just make one frug and hope it cures everyone (How it Began). HIV-1 is divided into 3 groups, all with their own nicknames. First, it is HIV-1 M, also known as the “major: group, makes up more than 90% of HIV infections globally, let me remind you, HIV has been scientifically proven to become AIDS when untreated, so this 90 % of people should be given adequate drugs, but sadly many aren’t (How it Began). HIV-1 O is also known as the “outlier” group, and HIV-1 N is commonly referred to as the “new” group (How it Began). These three different strains of HIV-1 and one strand of HIV-2 are constantly intertwining with one another, creating an even more complicated virus that would require even more time and effort to cure. There are a few theories on how SHIVA got into humans and mutated into what we know today as HIV/AIDS. One of the most popular, and most plausible theories is, when hunters went out hunting for “bushmeat”, what they also call chimp-meat, they unintentionally killed chimps/monkeys that had SIV in their meat and blood. Upon killing these primates the hunters got infected with SIV, by either eating the raw meat, or getting the infected blood into cuts or scrapes, the SIV then started to mutate and began to spread through sexual contact, blood, and birth (How it Began). Another theory is that, in 1957-1960, at the height of the Polio epidemic, millions of Africans were given the Oral Polio Vaccine. Unknowingly they ingested a vaccine that was grown in chimp cells that were infected with SIV (How it Began). Both theories are plausible, but HIV most definitely did not become what it is today through anal sex with chimps, also known as bestiality (How it Began). To sun this up, there are a few different strains of HIV and multiple theories on how SIV mutated into HIV.

In 2016, there were 1.8 million new HIV infections and 1 million AIDS-related deaths, to end this pandemic we need to optimize the treatment and prevention for those at risk. Currently, there are more than 30 FDA approved for treating HIV and HIV-related co-infections (Ending). This is amazing considering we new near to nothing about this virus 30 years ago, but there is still room to expand the number of treatments available for HIV-positive individuals. Over 19.5 million people are currently receiving some form of ART, also known as Antiretroviral Therapy (Ending). Of the millions of people taking ART, 44% had completely suppressed the virus and were expected to live to about 53 years if they began the therapy at around 20. Considering that in 1981, when the virus was first recognized as HIV, the life expectancy of anyone was 1-2 years at most (Ending). Statistically, there has been a 96% reduction in HIV transmission when the HIV-infected partner began ART when they first discovered they had contracted HIV (Ending). After approximately 58,000 condomless sex acts among HIV-serodiscordant couples, there was NO transmission of HIV when the partner was receiving ART. Also, way to prevent the transmission of HIV is through pre-exposure prophylaxis (Ending). This is a drug that is taken orally and can reduce the chance of receiving HIV by 95%, considering condoms are only about 80% effective in preventing the transmission of STDs, this seems like a pretty good idea (Ending). From this, we can ultimately conclude that ART helps people with AIDS, and the amount of drugs we have to combat HIV is absolutely stunning.

In conclusion, the HIV/AIDS crisis is extremely widespread and affects millions around the world, both directly and indirectly. Homosexuals are at a higher rate of contracting HIV, but with drugs, such as ART, AIDS is something people can live with now.

Essay on Global HIV/AIDS Epidemic

Introduction

The Human Immunodeficiency Virus and Acquired Immuno-Deficiency Syndrome (HIV and AIDS) epidemic has become one of the most important public health concerns in recent times and it is a matter of concern in the Philippines because the number of cases has increased intensely. According to the Joint United Nations Program on HIV and AIDS, since the beginning of the HIV epidemic, approximately 78 million people have been infected with HIV, with approximate 35 million people dying due to AIDS-related illnesses and an estimated 36.7 million people living with HIV worldwide by the end of 2015 (UNAIDS, 2018). In 2017 the number of people newly infected with HIV and the number of people who died from AIDS-related illnesses was approximately 2.1million and 1.1 million, respectively (Foundation for AIDS Research, 2018).

In the latest data from the Philippines AIDS registry of the Department of Health (DOH), as of July 2019, there are 1,111 newly confirmed HIV-positive individuals were reported which is 29 % higher as compared to the same month last year (n=859). Of the newly diagnosed ninety-four percent (n=1048) were male with a median age of 28 (age range is 6-64 years old) whose mode of transmission is by a male to male sexual contact (n=699). While twenty-three percent (n=254) reported having sex with both males and females and thirteen percent (n=146) have sex with both males and females. Another mode of transmission includes sharing of infected needles accounting to 1%, mother to child transmission is less than 1%. Of the newly diagnosed18% were already in HIV stage 3 and 4 advanced infections. Thirty-four percent 34% were from National Capital Region (NCR), sixteen percent (16%) were from Region 4A and followed by Region 3 twelve percent (12%), Region 7, eight percent (8%), and Region 11 five percent (5%). This data comprised a total of 69,512 HIV and AIDS cases in the Philippines from Jan 1984 (when the first case was reported) to July 2019. Based on needlestick injury only 3 cases from 1984 to the present.

With this trend, stigmatizing attitudes to these people could increase and documenting it would be very difficult and the extent of workplace discrimination is difficult to ascertain, which is more health-related wherein HIV clients are denied for health services. Stigmatizing attitudes against people living with HIV/AIDS has been documented since the beginning of the HIV epidemic, both related and unrelated to healthcare provision.

This means tackling stigma in its many forms by removing punitive laws, policies, and practices that undermine key populations and other vulnerable groups or block their access to good quality healthcare services. At the same time, it is important to ensure that healthcare workers, in their workplace, are enjoying their labor rights free from stigma and discrimination and are in a protective environment that allows them to exercise their roles, rights, and responsibilities, and to protect themselves from occupational exposure. By continuing to put people first and ensuring that no one is left behind in the AIDS response, ending the AIDS epidemic in every region, in every country, and in every community and population are possible as HIV and AIDS-related issues usually evoke strong emotional reactions including anxiety and withdrawal, the healthcare workers’ knowledge of such issues may indicate their level of preparedness in caring for people living with HIV and AIDS. Given that, healthcare workers are expected to provide care and accurate information on this subject matter to patients and their relatives, as well as to the general public, they must have credible and accurate knowledge of the disease.

Knowledge, attitude, and practices regarding HIV and AIDS are one of the cornerstones in the fight against the disease. Adequate knowledge about HIV and AIDS is a powerful means of promoting positive attitudes and engaging in safe practices. Many prevention programs have focused on increasing knowledge on transmission to overcome misconceptions that could prevent behavioral change towards safe practices and reduce the stigma against people living with HIV and AIDS. Stigmatizing attitudes have shown to be strongly associated with misconceptions about HIV transmission and are negative attitudes towards people living with HIV and AIDS.

Looking at the Philippines data, there has been no systematic study on the attitude and behavior of healthcare workers toward PLHIVs. Most of the information gathered was just based on anecdotal pieces of evidence and the occasional media reports on print and online. An unfavorable attitude of healthcare workers toward PLHIVs is a public health issue as it will bring repercussions in the provision of quality healthcare service to these people. At the same time, it would hinder the rights of people HIV and AIDS to health care.

To address this gap, this study aims to determine and collect information about the knowledge, attitude, and practices on HIV and AIDS of the different healthcare workers in Region IV-A. The results of the study could be a basis for effective and non – discriminatory patient interaction in the future thru policy enhancement.

Statement of the Problem

This study aims to determine the level of knowledge, attitude, and practices of healthcare workers in Level II government health facilities in Region IV-A towards people living with HIV and AIDS.

It will specifically address the following:

  1. What is the profile of the respondents in terms of?
    1. Profession;
    2. Length of years in service;
    3. Training/Seminars attended for the last 3 years
  2. What is the extent of knowledge of the respondents in terms of?
    1. Personal Knowledge;
    2. Health Care situation;
    3. Policy on the health facility
  3. What is the attitude of the respondents towards patients living with HIV/AIDS in terms of?
    1. Blame for infection;
    2. Desire for separation;
    3. Sympathy and equality of care
  4. What are the practices of the respondents in terms of?
    1. Confidentiality;
    2. Patient Handling
  5. Is there any significant difference in the knowledge, attitude, and practices of the respondents in HIV and AIDS when their profile is considered?
  6. Is there any significant relationship between the knowledge, attitude, and practices of the respondents in HIV and AIDS?
  7. What policy can be proposed to enhance the program in HIV and AIDS?

Hypotheses of the Study

  1. There is no significant difference in the extent of knowledge of the respondents regarding HIV and AIDS when their profile is considered.
  2. There is no significant difference in the attitude of the respondents regarding HIV and AIDS when their profile is considered.
  3. There is no significant difference in the practices of the respondents regarding HIV and AIDS when their profile is considered.
  4. There is no significant relationship between knowledge, attitude, and practices HV and AIDS when their profile is considered.

Significance of the Study

The result of this study will benefit the following:

  • Patients. The study result will be of importance to patients with HIV and AIDS (specifically if the result will be the bases of policy enhancement on HIV and AIDS in the healthcare setting) wherein stigma and discrimination will be avoided.
  • Healthcare Workers. The study result will be the basis of strengthening health programs and activities in the promotion of health, particularly on HIV and AIDS.
  • Educational Sector. The result of the study can be used by the academic sector specifically colleges offering medical programs to evaluate them programs with the possibility of incorporating the correct attitude in handling patients with HIV and AIDS.
  • Stakeholders. Local and international development partners and organizations can utilize the result of the study to provide funding to address identified gaps and needs. And Civil Society Organizations (CSOs) and Non-government Organizations (NGOs) can also utilize the result to make project proposals and implement activities to address unmet needs.
  • Policymaker. The study result will be the basis of promulgating laws policies or guidelines to enhance and upgrade the policies and programs of the different organizations.
  • Medical and Allied Professional Organization. Medical institutions and professional organizations like the Philippine Medical Association (PMA), the Philippine Association of Medical Technologists (PAMET), the Philippine Nurses Association (PNA) and other medical organizations. These organizations can utilize the result of the study to enhance or align seminars, discussions, symposiums, and orientations to address the need for information about HIV and AIDS.
  • Hospital Administrator. With consideration of the study result, hospital administration can use this to serve as an eye-opener for private and public hospitals and clinics to ensure that their health personnel are equipped with the right knowledge, practices, and values on how to handle patients with HIV and AIDS without discrimination and prejudicing their confidentiality.
  • Researcher. Knowledge and experience to be gained from this study will enhance the researcher’s ability to better address and support healthcare workers.
  • Future Researchers. The study results will be beneficial among researchers and other further researchers as reference material.

Scope and Limitation of the Study

The study determined the knowledge, attitude, and practices towards people living with HIV and AIDS of the following healthcare workers namely, doctors, dentists, nurses, medical technologists, physical therapists, midwives, x-ray technicians, laboratory technicians and nursing aide who have direct interaction with people living with HIV and AIDS. Selected healthcare workers from selected government health facilities in Region IV-A are the target of the study. Excluded in the study are medical specialists or consultants and nutritionists.

The respondent has knowledge in HIV and AIDs such as personal knowledge, and healthcare situation, while attitude towards patients living with HIV and AIDS and practices include confidentiality, medical records keeping and patient handling. The study also investigated if there are existing policies on handling HIV and AIDS in their respective hospitals, finding if differences in knowledge, attitude and practice on HIV/AIDS and if there is a relationship between their knowledge, attitude, and practices. The study has been conducted from November 2019 to February 2020.

Definition of Terms

  • Attitudes. It deals with how healthcare workers treat patients in them interactions during clinical encounters and how healthcare workers relate to and communicate with the patients.
  • Confidentiality. It is the right of the patients to have personal, identifiable medical information kept private. Such information should be available only to the physician of record and other health care and insurance personnel as necessary.
  • Healthcare situation. Relates to the knowledge of the respondents in terms of high risk and low risk in HIV infection.
  • Healthcare workers (HCW). Operationally defined as professionally trained health caregivers including doctors, nurses and laboratory scientists/workers, occupy a potential vanguard position in AIDS preventative programs and the management of diagnosed patients.
  • HIV/AIDS. A global epidemic and is considered one of the greatest public health problems both in the developed and developing world.
  • Level II health facility. Are non-departmentalized hospitals that provide clinical care and management on prevalent diseases in the locality?

Level I Health facility.

  • Medical Record Keeping. Refers to any relevant record made by the Healthcare workers at the time of after, a consultation or application of health management among PLHIV.
  • Patient Handling. Refers to a program that reduces the risk of injury for both healthcare workers and patients while improving the quality of patient care.
  • Knowledge. It refers to the understanding of the healthcare workers concerning transmission, and protection against HIV/AIDS.
  • Practices. This refers to what they do or do not do on the aspect of HIV and AIDS such as handling and confidentiality and patient recording.

Chapter 2. Review and related literature

This chapter will review the related literature and studies that will give direction to the study. Included is the conceptual framework and theoretical framework that will be used in this study.

HIV and AIDS

It is known globally that HIV is a virus that is spread through certain body fluids that attacks the body’s immune system, specifically, the CD4 cells, often called T cells. Over time, HIV can destroy most of these cells (CD4) that the body’s immune system can’t fight off infections and disease. Because these cells help the immune system fight off infections. Since no treatment is yet available, but only to suppress the multiplication of the virus, HIV reduces the number of CD4 cells in the body which is crucial for immunity. Due to this, opportunistic infections take benefit of a very weak immune system. If this happens, the person is considered to have AIDS (CDC, 2014).

Several scientists concluded that the virus that causes AIDS came from a type of chimpanzee in Central Africa as the source of HIV infection in humans. This simian immunodeficiency virus or SIV could have been transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and met their infected blood. Studies show that as far as 1800, HIV may have jumped from apes to humans. Over the decades, the virus slowly spread across Africa and later into other parts of the world. It is said that the virus has been in the United States since at least the mid to late 1970s (CDC, 2014).

Medicine was given to HIV patients, antiretroviral therapy (ART), helps people slow down the progression of the disease from one stage to the next if taken the right way, every day. According to WHO (2018), it can also dramatically reduce the chance of transmitting HIV to someone else.

According to WHO (2018)), stage 1 is the acute HIV infection wherein 2 to 4 weeks after infection, people may experience a flu-like illness, which may last for a few weeks. This is the body’s natural response to infection. When people have acute HIV infection, they have a large amount of the virus in their blood and are very contagious. But people with acute infection are often unaware that they’re infected because they may not feel sick right away or at all. To know testing must be done with a fourth-generation antibody/antigen test or a nucleic acid (NAT) test. Stage 2 is the clinical latency (HIV inactivity or dormancy). This is sometimes called asymptomatic HIV infection or chronic HIV infection according to WHO. During this phase, HIV is still active but reproduces at very low levels. The reason why people may not have any symptoms or get sick during this time. Different people will have different manifestation in this stage. For some, even with the medication of ART, this period can last a decade or longer, but some may progress through this phase faster. It’s important to remember that people can still transmit HIV to others during this phase, although people who are on ART and stay virally suppressed (having a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed (WHO, 2014). At the end of this phase, a person’s viral load starts to go up and the CD4 cell count begins to go down. As this happens, the person may begin to have symptoms as the virus levels increase in the body, and the person moves into Stage 3 (WHO, 2014).

Stage 3 is acquired immunodeficiency syndrome (AIDS). This stage is the most severe phase of HIV infection. HIV patients can get an increasing number of severe illnesses, called opportunistic illnesses. Without medication, people with AIDS typically survive for about 3 years. Common symptoms of AIDS according to WHO (2014), include chills, fever, sweats, swollen lymph glands, weakness, and weight loss. People are diagnosed with AIDS when their CD4 cell count drops below 200 cells/mm or if they develop certain opportunistic illnesses. People with AIDS can have a high viral load and be very infectious. The only way to know for sure whether you have HIV is to get tested. Knowing your status is important because it helps you make healthy decisions to prevent getting or transmitting HIV. Some people may experience a flu-like illness within 2 to 4 weeks after infection (Stage 1 HIV infection). But some people may not feel sick during this stage. Flu-like symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, or mouth ulcers. These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others. These symptoms, that doesn’t HIV because it can also be caused by other illnesses. But, the only way to determine whether you are infected is to be tested for HIV infection.

No effective cure currently exists for HIV. But with proper medical care, HIV can be controlled. Treatment for HIV is called antiretroviral therapy or ART. If taken the right way, every day, ART can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS (the last stage of HIV infection) in a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly if someone who does not have HIV (CDC, 2017)

Global HIV/AIDS Epidemic

According to UNAIDS, since the beginning of the epidemic, more than 70 million people have been infected with HIV and about 35 million people have died of HIV. Globally, 36.7 million [30.8–42.9 million] people were living with HIV at the end of 2016. An estimated 0.8% [0.7-0.9%] of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 25 adults (4.2%) living with HIV and accounting for nearly two-thirds of the people living with HIV worldwide. As reported by UNAIDS in their global report (2017), 36.9 million people worldwide are currently living with HIV, and AIDS 2. 1 million children worldwide are living with HIV. There were approximately 36.7 million people worldwide living with HIV and AIDS at the end of 2016.

Essay on Social Impact of HIV and AIDS

Background

The earliest known cases of human HIV infection have started in Western equatorial Africa, presumably in Southeast Cameroon where a group of the central common chimpanzee lives. Phylogenetic analysis has disclosed that all HIV-1 groups M, N and O were so closely related to just one of these SIV Cpz lineages which were found in p.t troglodytes. It is surely suspected that the disease has spread to humans from the butchering of Chimpanzees for human consumption. Current hypotheses has also included that once the virus from Chimpazees or other apes to human, medical practices of the 20th century helped HIV to become confirmed in the human population by 1930.

Introduction

HIV is a virus that attacks cells that help the body to fight infection, it makes a person to be more vulnerable to other infections and diseases. It is spread through contact with certain bodily fluids of a person with HIV, more especially during unexpected sex or through sharing injection drug equipment. If the can be left untreated, HIV can surely lead to a disease of AIDS, this is the stage of HIV infection that usually occurs when the body`s immune system is badly damaged because of the virus. Sub-Saharan Africa is the region that is mostly affected by the HIVAIDS pandemic, in this essay Im going to discuss the social and economic impact of HIVAIDS in Sub-Saharan Africa.

The diversity of populations together combined with destitution, political and economic instability and hunger, has led to a number of strategies for combining the disease in Sub-Saharan. These include voluntary counseling and testing, community involvement, facilitating behavior modifications, which include consistent and correct use of condoms, reduction in the number of sexual partners, increasing antiretroviral availability and the involvement of non-governmental organizations in prevention, treatment, care and support of the infected population.

About 49,7 million HIV infections had taken place worldwide by late 1999, 72% were in Sub-Saharan Africa., 84% of AIDS death, 91% of childhood infections and 94% of child Aids deaths worldwide have occurred in Africa. Of the children that were orphaned by AIDS throughout the world, 95% seemed to have occurred in Africa where the number of orphans will continue to rise through the next decade and have reached 40 million by 2010

At the end of 2003, it was estimated that globally 40 million people were living with HIVAIDS and 2.5 million of those people were children under the age of 15. In 2003, there were 5 million new cases of HIV and over 3 million deaths due to the disease (1). Of the 40 million HIV-positive individuals, 26 million (65%), were living in Sub-Saharan Africa. In Sub-Saharan Africa, women seem to be the most affected group, they represented about 58% of all the infected adults in 2001 whereas 10% were the children under the age of 14. The disease has made over 11 million children to be orphaned in the region because they lost their parents due to this disease and the orphan burden has serious consequences for all of society.

The morbidity and mortality which are associated with the HIVAIDS pandemic has major economic and social implications, poverty and hunger are on the rise, children have also increasingly become vulnerable due to the HIVAIDS pandemic, the education sector has surely become deteriorated, people are suffering from AIDS-related isolation and life expectancy of those living with the diseases is decreasing.

The Social impact of HIVAIDS in Sub-Saharan Africa

The social impact of HIVAIDS looking at the Nigerian case study revolves centrally around the stigmatization and discrimination of the person who is infected as well as higher immediate members. Stigma as defined by Goffman (1963) is an undesirable or discrediting family attribute that an individual possesses, thus reducing the individual`s status in the eyes of Society. When it comes to AIDS-related stigma referred to prejudice and discrimination which is directed at people who are living HIVAIDS, infected people tend to suffer from different types of social stigma that could be in the form of isolation, rejection and social discrimination, marital instability and divorce, loss of respect and family responsibility which include the socialization and care for the children.

Therefore family structure and social life is affected, the stigma of HIVAIDS in Nigeria tends to involve negative attitudes, beliefs and policies towards people who are living with HIVAIDS by their families, friends, social groups and also their communities. This kind of stigma is through discrimination and it has spread speedily while it was spreading anxiety and prejudice against the group that is infected as well as the people living with HIVAIDS. HIVAIDS-related discrimination is still a huge barrier to people who are looking for HIVAIDS treatment or from disclosing their HIVAIDS status in public.

Discrimination and stigmatization have been expressed as some of the primary social consequences of HIVAIDS and stigmatization is be of the opinion that it causes a person with HIVAIDS to face social isolation, increased emotional stress, loss of social and economic support and increase in violence against women in Nigeria and it also prevents non-HIVAIDS positive people to avoid being tested for their HIVAIDS status. Most people who are infected often suffer from rejection from their families, loved ones, and also their communities, they suffer from loss of family responsibility due to shame, and sometimes these people tend to experience discrimination from the health care providers within the heath setting.

Education as one of the biggest and most important social service sectors is also an indispensable foundation for social and economic development in human societies. HIVAIDS constitutes a threat to this sector. Education as a vehicle of societal progress and development has been adversely affected with the emergence and spread of HIVAIDS. At the community level in Nigeria where the population is decreasing as a result of the HIVAIDS epidemic, the number of potential beneficiaries, in particular children, for school enrolment also declines. In addition, there is also a decline in school attendance by children who have become orphans as a result of which they cannot afford school fee and other expenses. For some children, attending schools has become disrupted because they might have been turned into caregivers for their infected parents. According to Future Group International (FGI), HIVAIDS has an impact on the education sector in many ways,

Remarriage is potentially another way of emotional and social and social losses resulting from the death of a spouse. In some societies, there are strong traditional expectations that widows will remarry, and widows’ and children`s access to property and other resources may depend on remarriage. If the death was due to AIDS, however, the surviving spouse may be infected, and remarriage poses a grave risk of spreading the disease. Little is known, however, about how marriage practices are actually changing in the face of this k. In Malawi, divorced or widowed women were less likely to remarry if their husbands had been HIV-positive, but the partner`s HIV status did not affect the likelihood that men would remarry (Floyd and others, 2003). Studies from Uganda in the early 1990s indicated that the practice of widow inheritance was in decline. But results also suggested that many people were basing their decisions about risks of remarriage on the appearance of health, and many of those who appeared healthy are likely in fact to have been infected by HIV.

HIVAIDS is at the same time cause and outcome of poverty as poverty increases the risk of HIVAIDS when it propels the unemployed into unskilled migratory labor pools in search of temporary and seasonal work, which increases their risk of HIVAIDS. Poverty also drives girls and women to exchange sex for food, and to resort to sex work for survival when they are excluded from formal sector employment and all other work options are too low-paying to cover their basic needs. Abject poverty often leads to a casual, day-to-day existence dominated by survival needs, and at the extreme, poverty fosters a fatalistic attitude that manifests itself in indifference to high-risk sexual and other behaviors. In these circumstances, individuals are poorly motivated and poorly equipped to take the necessary steps to protect themselves from HIV. South Africa and Botswana are the most economically developed in the region of contradicts the poverty

Economic Impact of HIVAIDS in Sub-Saharan Africa

The economic effects of HIVAIDS have been liked with the rising morbidity and mortality rates for certain age groups, in particular the sexually active youth and adults, including children who are infected at birth. Most of the people infected with HIVAIDS in Nigeria fall within the age category of 15-49 years, this is the group that constitutes the highest proportion of the labor force-academia, scientists, doctors, administrators, and entrepreneurs, as well as unskilled laborers. The epidemic has the implication of cutting short the productive lives of this critical age group, reducing their saving level and increasing health care expenditures. The rise in morbidity leads to a negative labor productivity effect and a positive health care expenditure.

The HIVAIDS pandemic has an effect on the Agricultural sector in Nigeria, Majority of the Nigerian population are farmers who had engaged themselves in farming as their primary occupation, though a significant number engage in other occupations as secondary sources of income. Agriculture is a major production sector and the largest employer of labor in Africa, studies which have been done in Nigeria, Tanzania and other African countries have revealed that AIDS will have adverse effects on agriculture which will result in the loss of labor supply and income remittance and the reduction of the size of the harvest. Loss of agricultural labor compels farmers to switch from export crops to food crops. Hence HIVAIDS could affect the production of crops as well as food crops. In a study of seventeen different states in Nigeria, it was discovered that there were on average 8-10 AIDS infections per week in the rural areas.

HIVAIDS also has an impact in Ethiopia as the male head of the household is responsible for specific tasks, such tasks involve oxen cultivation, harvesting, threshing and farm management. One study has revealed that the effect of an AIDS death varied by region and could have the most severe effect on harvesting teff in Nazareth, digging holes for transplanting enset plants in Atat, on plowing millet fields in Baherdar and on picking coffe in Yirgalem. Women on the other hand are responsible for transporting produce and household duties hence the death of a wife can it difficult for other household members to carry out these tasks as well as care for children. The death of a family member because of AIDS can also lead to a reduction in savings and investment, the stock of food grain can be depleted to provide food for mothers.

The HIVAIDS pandemic also have an impact on the public and private industries in Nigeria, many of the employees die from AIDS and other associated illness. This results in a serious implication on industries as it increases expenditure and reduces revenues, expenditure tends to increase due to health care expenses for the infected worker, burial fees and costs of the recruitment and training of new and inexperienced workers to replace the dead one. In addition, revenues may decrease due to the time spent on training, and absenteeism from work because of illness, as a result of most of the Sub-Saharan countries, the industries are left to manage with inexperienced workers that are less productive and this is bad for the economy.

HIVAIDS is also affecting most of Sub-Saharan Africa`s health facilities because it constitutes a great financial burden to the health sector it does not only increase the number of people seeking medical treatment in public hospitals, but it also increases the expenditure of the sector because treatment of AIDS patients is very much expensive. In Nigeria, the cost of treatment for AIDS is estimated to be about N55, 000 which many Nigerian people cannot afford. In 1994, a study has estimated that the health care costs in Ethiopia due to AIDS for the period of 1994 under two scenarios, low and high where under the low-cost scenario the total outpatient treatment would equal US$34 million, at a cost of $42.28 per patient, per year and then under the high-cost scenario, for the same period total cost for outpatient treatment was estimated to be US$206 Million and in this case also many Ethiopians could not afford it still.

As a result of labor force losses, the epidemic is an important factor in slowing the pace of economic growth at the national level. This in turn undermines efforts to reduce poverty, critically locking some populations – especially in the poor and least developed countries – into their poverty and greater exposure to HIVAIDS.

Strategies to prevent HIVAIDS

People who are not affected can take steps to protect themselves from HIVAIDS. Firstly they must choose less risky sexual behavior, use condoms every time they have sex, limit the number of sexual partners, get tested for STDs and don`t inject drugs

Conclusion

HIVAIDS continues to pose an array of concerns for sub-Saharan Africa. The spread of HIVAIDS further strains the fragile relationship that has long existed between the local environment, social infrastructure, and rural livelihood. Changing population dynamics and a growing dependency on the environment and its resources are at the center of this crisis. Nevertheless, plausible solutions to overcome some of these problems do exist. If implemented, rural communities of sub-Saharan Africa can effectively work toward environmental preservation. At the same time, the number of AIDS patients is expected to double over the next years for some of the countries considered here.

Essay on the Origin of HIV and AIDS

The origin of HIV and AIDS is largely veiled in obscurity, despite a large body of literature on the subject matter, several controversial theories regarding the genesis of HIV and AIDS exist. There exist spurious and valid speculations by a theorist who points to Africa as the cradle for the virus conversely, others detail the origin of the virus as a biological weapon manufactured in the laboratory. In evaluating the theories on the origins of HIV and AIDS, it can be pointed out, that varied theories which include but not limited to, Zoonosis theory, Serial passage theory, Oral polio vaccine theory, Hepatitis B vaccine theory, Contractors theory, and Duesberg theory, have been used to explain the genesis of the virus. These theories will be evaluated to understand the possible origins of HIV and AIDS virus. It however will be explained that these theories are not foolproof and are not a panacea in establishing an accurate origin of HIV and AIDS. All of the aforementioned facets shall be explained in the following write-up.

Human Immunodeficiency Virus (HIV) belongs to a subgroup of a retrovirus called lentivirus which causes infection and progresses over time to Acquired Immune Deficiency (Gilma, 2018). Conversely, Acquired Immune Deficiency Syndrome represents a lengthy period of HIV infection (Gilma, 2018). The zoonosis theory has been used to explain the origins of HIV and AIDS, by attributing the origins of HIV to animal sources such as gorillas, chimpanzees, and monkeys (Lu et al.,2016). In corroboration, Hunt (1994:160) asserts that the theory usually starts with monkeys, in equatorial Africa. The green monkeys are infected with a simian Immuno-virus also known, as the simian immunodeficiency virus (SIV). This SIV is pointed as causing an AIDS-like illness, which might have been a precursor for HIV-1 in humans. As this is not convincing, further explanation of the crossover of the virus from animals to humans is elaborated by Hunt (1994: 160) who asserts that

It is generally speculated that the crossover from monkeys to humans occurred due to some sort of cultural sexual practice in the equatorial regions of Africa. In its most lurid presentation, this crossover occurs because of voodoo or shamanistic sexual practices, such as the injection of monkey blood from the green monkey to enhance sexual performance, pleasure, and excitement by some groups of Africans.

Furthermore, it is argued that primates eating human beings ferried the SIV and it progressed into HIV, moreover it is indicated that there exists a strong phylogenetic correlation between SIV and HIV ( Lu,2016). All the highlighted arguments tend to point to the origin of HIV and AIDS with emphasis to Africa, where primates are assumed to be commonly eaten (Gulma, 2018), this again is used as supporting evidence for this hypothesis. However convincing the theory might be, its veracity has been questioned, Marx et al.(2004) refutes the theory and opines that the zoonosis theory has never been proved and should be questioned. Marx et al (2004) further opined that if AIDS was a zoonosis, evidence of direct transmission from animals should be provided for instance in animal species as in rabies, a disease acquired directly from animals. Lu (2016) questions the theory based on time frame, if HIV and AIDS originated in Africa were primate-eating humans existed ever since time immemorial, why then did the virus only manifest in the 20th century (AD 1981) and not earlier? It should be pointed out that, if animal eating was the cause of the origin of HIV, this epidemic would have occurred hundreds of years ago. One can argue that the theory has a lot of gaps and is not based on veracity, but rather on eurocentrism views. Although so, it explains the assumed origins of HIV and AIDS.

  • The Serial passage of SIV into HIV theory has been used to explain the origin of HIV infections in humans. Lu et al.(2016) opine that the virus may not have emerged from outside sources as assumed in the zoonosis hypothesis. Katrak (2006:8) claims that
  • The process of serial passage commences when a person exposed to SIV, through retroviral zoonosis, receives an injection. When the same needle is used to inject another individual, the SIV gets transferred and infects the second person.

This process is re-repeated and the SIV adapts and grows stronger in the immune system (Katrak, 2006). According to Katrak (2006), inadequate resources led to the re-use of syringes and needles, in which from 1917-1919 six syringes were used to vaccinate 90, 000 people. As such the use of these unsterile needles exponentially exacerbated the opportunity for serial human passaging. Marx, Alcabes, and Drucker (2001) have highlighted in their studies that, SIV became 1000 times more exponentially pathogenic when it was passed to monkeys. Therefore it is probable that in humans it could have the same ripple effect. Although so, Lu (2016) assumes that the change of SIV to HIV was facilitated by genomic mutations of the virus, evolutions, and translocation. Biology Online (2021) notes that mutation is any change in the nucleotide sequence, in which such a change occurs in a chromosome or gene. In other words, the argument in this theory is that the SIV in infected human immune systems, through time and process of transference, to other human immune systems changed, became severely pathogenic, and resulted in HIV and AIDS. This transformed virus became virulent enough to be transmitted through sexual contact and originated the HIV and AIDS epidemic (Katrak, 2006).

Adding to the above paragraph, one can point out that this theory is the most probable and more practical compared to the zoonosis hypothesis, which needs ample verification. Although so, the serial passage theory does not go without criticism, as it fails to provide evidence of how SIV in monkeys metamorphosed as HIV and AIDS in humans. If syringes and unsterile needless were responsible for passage and mutations why did it take so long for the transformation to occur, a tremendous population of 90 000 or more from 1917-1919 were administered with unsterile needless (Katrak, 2006). Why then did the virus become manifest only in 1981, after 70 years, when the pathogenic level in SIV is argued to exponentially increase 1000 times more after every three transference? Moreover, the studies carried by Marx, Alcabes, and Drucker (2001) were on monkeys, and it needs to be highlighted that the evidence from this experiment cannot entirely be supported as foolproof and relevant to the human species. However, this theory remains an ‘educated assumption’, which has find more acceptance in explaining the origin of the virus.

Furthermore, the oral polio vaccine (OPV) theory assumes that HIV and AIDS pandemic originated from polio vaccines that were grown in chimpanzee cultures of kidney cells and were infected with the SIV virus (Hooper,1999 in Gulma, 2018). Worobey (2004) further authenticates that HIV-1 may have been passed into humans as a result of the contamination of the oral polio vaccine. However, it also needs to be questioned if the polio vaccine developed before 1981 had been contaminated. Gelin, Modlin, and Plotkin (2001) assert that these mass oral polio vaccination campaigns were undertaken in the northeastern Congo region, from February 1957, where polio infections were manifest. In light of such arguments, proponents of this theory ascertain that this could have resulted as the source of HIV-1 in Central Africa. The above claims have sincerely been used as a justification pointing to the inception of the HIV and AIDS virus.

In as much as it is so, the oral polio vaccine has not been spared on its deficits and weakness in explaining the origins of the virus, it has been questioned on several facets, which makes it shallow if not narrow to understand. The first counter-argument was provided by Koprowski (2001) who dismiss Edward Hooper’s book (The river) which is the backbone of the oral polio vaccine theory. According to Koprowski (2001: 831) ‘The book the river, is based on assumptions and not facts. The argument points that there is no link between oral polio vaccine and the human immunodeficiency virus. Gulma (2018) further highlights that this hypothesis was one of the earliest theories on the origin of AIDS which tried to link HIV with OPV falsely. As this is not convincing, an analysis of some 5 samples of OPV in storage at the Wistar Institute could not find any HIV or SIV sequences or even components of a chimpanzee cellular (Gulma,2018). This led the Journal of ‘ Nature’ (2004) to label Edward Hooper’s hypothesis as ‘refuted.’

Additionally, Hepatitis B Vaccine (HBV) theory has also been used to explain the origins of the HIVAIDS pandemic. Horowitz (2001 cited in Gulima, 2018) through an article titled ‘Early Hepatitis B Vaccines and the ‘ Man-Made’ origin of HIVAIDS’ argued that the HB vaccine theory is the strongest and most probable theory relating to the genesis of HIV. In support Cantwell (2011) asserts that the AIDS virus epidemic first began in the US, after a short hepatitis B vaccine experiment from 1978-1981, in these experiments homosexual men were used. Cantwell (2011) further denies that the virus jumped from animals to human beings through chimpanzees. In providing evidence for his claims, Cantwell (2011) notes that the hepatitis B vaccine was administered to 30 homosexual men in Manhattan who had been infected with Hepatitis B, soon after this, the first cases of AIDS appeared in Manhattan. Gulma (2018) assumes that HIV could have been introduced into the population through the hepatitis B vaccine which was being used to treat infected individuals. Whilst others insist that the US government intentionally injected bisexual men with the virus during 1978 hepatitis B experiments (Time, 2019). The assumption is that the hepatitis B vaccine was contaminated with HIVAIDS. Cantwell (2011) cited in Gulma (2018) further corroborates the claims that the United States government scientists had manufactured HIV, and later the virus got its passage through HBV experiments.

In as convincing as the above theory is, one needs to question the veracity of the theory, for instance, the presence of HIV after the experiments could have been a mere coincidence that occurred, as HIV-1 and HIV-2 had arguably been present from other sources such as animal-human passage. Heller (2015) notes that these are part of conspiracy theories, in which evidence to implicate the authorities is lacking. The theorist also fails to provide evidence of the contaminated Hepatitis B vaccines, but only assumes that they could have been there on the mere presence of HIV cases in Manhattan after the HBV experiments. One can argue that this theory represents a body of knowledge that justifies the genesis of HIVAIDS, though lacking veracity. Although so the theory has aided as an alternative viewpoint on understanding the possible genesis of HIVAIDS.

As this is not enough, the contractor’s theory has been used to explain the origins of HIVAIDS. The contractor’s theory includes two theories that explain the origins of HIVAIDS, implicating the US government. The first theory explains the genesis of HIVAIDS by implicating the US government, as key in making the virus. Gulma (2018) is of the view that Jakob Segal (1911-1995), outlined that 2 viruses were split to produce HIVAIDS. The two viruses were Visna and HTLV-1 manufactured at a U.S. military Fort Detrick. According to Jakob Segal in Gulma (2018) notes that the virus was manufactured around 1977 and 1978 and was tested on prison inmates who in exchange could be compensated with an early release. It is further highlighted that through these prisoner volunteers, the virus spread exponentially to the broader population. The problem with this hypothesis is that Jakob Segal was linked with the Russian KGB Officers in operation Operation Infektion’ (Gulma,2018). Therefore Segal could have devised this hypothesis through orders as a way to discredit the US government, which would mean that the theory could be biased. Guller (2018:18) further questions this hypothesis by noting ‘One thing confusing is that it was not known whether Jakob Segal proposed his hypothesis based on orders or he did that independently’. In such light of the argument, it would be suicidal to accept the origin of HIVAIDS as entirely based on the aforementioned Jakob Segal hypothesis.

Adding to the above, the second contractor’s theory was by Leonard Horowitz (1996). He expressed that HIV was a by-product of Litton Bionetics (Defense contractors for the U.S. Government), with the intent of serving as a bio-warfare and population control strategy. It is further asserted that HIV was deliberately designed in U.S. military laboratories since 1970 for genocidal purposes (Gulma,2018). Of interest was that the theory was neither proven correct or wrong by the U.S. government or the U.S. army. It then gave ample room for people to assume and embrace this allegation as realistic. In as much as it is so, Africa update (2002) notes that it is impossible to determine the truth about biological warfare in the engineering of HIVAIDS, as a scientist involved are sworn to secrecy and silence. Contrary Heller (2015) points that it is difficult to debunk the reality of these theories, as they could be conspiracy theories. Although so this theory explains the origins of HIVAIDS as bio-warfare which was meant to reduce population. However, these theories need not be relegated into oblivion as they could be explaining in truth the genesis of the HIVAIDS virus, at the same time they need to be taken with deep caution as they might be biased in explaining the origins of HIVAIDS virus.

Lastly, the Duesberg hypothesis has been used to explain the origins of HIVAIDS, though very controversial theory as it is backed up from HIV denial perception. The hypothesis is named after Professor Peter Duesberg of the University of California. He ascertained that AIDS was a result of non-infectious factors, though not limited to recreational drug use (Heller,2015). In this theory, HIV is considered to be a ‘harmless passenger virus’ which does not correlate whatsoever to AIDS, this claim insinuates that HIV is a harmless virus that is incapable of causing AIDS. Therefore the genesis of AIDS is a result of the use of drugs, such as Zidovudine. In corroboration, Duesberg reiterated that anti-HIV drugs such as Zidovudine (AZT) were responsible for causing AIDS (Gulima,2018). Therefore the continued use and dependency on anti-retroviral drugs to enhance the immune system, contrary leads to HIVAIDS infection. However, the verdict was disproved through placebo-controlled studies which proved that AZT when used as a drug for HIVAIDS, produced continued and short-lived improvements, thereby weakening opportunistic infections from developing (Gulima, 2018). The theory is controversial and assumed to be a product of cherry-picking subjective scientific data while relegating evidence in the role of HIV in AIDS (Gulma,2018). Though, provides a unique point in the origins of HIVAIDS.

In conclusion, a myriad range of theories on the origins of HIVAIDS is present, from the most probable to the list probable. These theories remain controversial and unable to holistically detail the genesis of the pandemic. In the above write-up, it has been evaluated that the zoonosis theory, serial passage theory, oral polio vaccine theory, hepatitis B vaccine, contractors, and Duesberg theories are among the prominent theories to account for the origin of HIVAIDS. Although so there are not exhaustive, foolproof, or panacea to solve the myth of HIVAIDS origin, which has perplexed the scientific community.

HIV/AIDS in Madagascar: Analysis of Low Prevalence Rates

Located off the South-Eastern coast of sub-Saharan Africa, sits the fourth largest island in the world: Madagascar. It’s a country of just over 25 million people with too many questions and too few answers. With a GDP per capita of just over 450 dollars, a 64 percent literacy rate, and 70 percent poverty rate, we might expect this country to share the same health problems that other poor sub-Saharan countries have. Possibly the largest health issue many of these countries face is the widespread prevalence of HIV/AIDS. Why then, does a country so poor have the same HIV/AIDS prevalence rate as the United Kingdom at 0.3 percent? This analysis seeks out factors that help explain why this is. As it turns out, geographical location, failure to gather thorough statistics, and its poverty all contribute to the low prevalence rate. The latter, most surprisingly, is uniquely true for Madagascar and we will find out why.

First, geographical isolation plays an enormous role in preventing a tidal wave of disease transmission, as Southern African countries have the highest prevalence rates on the planet. South Africa, Mozambique, Tanzania, Swaziland, and Zimbabwe all have prevalence rates from 15-37% of the entire population! There is an abundance of workers that travel for days on end to work in other countries. To an extent, many engage is frivolous behavior while away for work and then come back to their hometowns, only to spread it to others. In Madagascar, virtually no mixing of migrant workers with Malagasy, allows AIDS to remain at bay.

In addition to its isolation as an island, Madagascar’s low prevalence rate could stem from low urbanization. There is just one city with a population above one million: Antananarivo (Facts About Madagascar, World facts). The population density of the country is 118 people per square mile (Madagascar: Economy, Population…). There are approximately 3200 people per square mile at Holy Cross, for reference. This is relevant because HIV is transmitted most rapidly in highly urbanized, industrial hubs. A high concentration and large movements of people contribute to the spread of diseases. For Malagasy, this is not the case. This is how their impoverished state actually plays to their benefit in terms of diseases spreading. Without highly desired resources or educated people, there is little demand for counties to engage in trade with Madagascar or invest in any sort of manufacturing plant. Many other cheaper options exist for foreign interests that are closer and cheaper. Therefore, work stays local. A large focus of recently-elected president Andry Rajoelina is an attempt to increase productivity among the workforce (AfricaNews). His goal could result in a higher likelihood of transmission of HIV if awareness is not increased. The suspicion that the prevalence rate is already underreported leads to even more concern as to what would happen if workers from surrounding countries became more in contact with Malagasy. Since one of the largest ways in which the disease is spread is through traveling workers, increased exports and economic activity may bring about an epidemic the country is unprepared for. This is especially true if the vast majority of the population is unaware that there is even an issue. There is no consistent internet connection, no newspapers that reach out into the rural areas, resulting in virtually no way for the average family to even learn what AIDS is. The new administration has promised to change that, as we will see later.

To address my second point, statistical analysis of other STDs in Madagascar make us raise a brow, too, as prevalence rates of both gonorrhea and syphilis are among the highest on the planet (Chepkemoi, Joyce, Countries with the highest rates of HIV/AIDS). Sex work is not an unfamiliar profession in Madagascar, and as many as 20 percent of all women have at one point been sex workers (Madagascar Makes Progress Against HIV/AIDS, NBC News). Also on the island, only 12 percent of men engaged in sexual activity have ever used protection (Chepkemoi, Joyce, Countries with the highest rates of HIV/AIDS). It’s quite astonishing that with such negligence we still see HIV/AIDS being kept at bay, or is it? As we will see, there are a plethora of factors that make gathering statistics in Madagascar nearly impossible, making it likely that the prevalence rate we see is only an educated guess — and in fact HIV/AIDS is more common than what’s reported, despite its isolation as an island.

Over 65 percent of Madagascar is rural (Facts about Madagascar, World facts). If an individual living on a farm believes to have contracted an illness, how would they even get to a testing site? According to a recent analysis of Madagascar’s infrastructure conditions, only 5,700 kilometers of the 49,800 kilometers of roads in the country are paved (Facts about Madagascar…). These figures are probably optimistic, the source says, as many of Madagascar’s ‘paved roads are in terrible shape, filled with potholes and or wide enough for only a single vehicle (How to Explain Madagascar’s Low HIV/AIDS…). Cyclones and other weather conditions often wipe out roads and bridges making travel even more difficult. Even if the Malagasy wanted to get to a hospital for testing, they most likely couldn’t. Most of the sick individuals in rural Madagascar visit the local medic in their town, often to see someone who doesn’t have formal training. Usually, its an individual who relies on knowledge passed down from previous medics to try to help people. Formal testing of any disease requires leaving work, leaving family, and leaving potential income behind to make a several-day journey to a facility. Only thirteen HIV/AIDS hospitals are available on the entire Island (How to Explain Madagascar’s Low HIV/AIDS…). With a country that’s 1,800 miles long and 750 miles wide, finding the time and energy to make a journey like this just is not an option for many people.

Another large issue in Madagascar has attempted to remedy in recent years is increasing education and awareness. The current government is modeling its approach to that taken by South Africa (AfricaNews, “Madagascar President…). As mentioned before, South Africa has faced many issues pertaining to the prevalence of HIV/AIDS, but in recent years, has implemented full-fledged education and prevention awareness programs that have seemed to work well. Their “90, 90, 90” program is one that serves as a benchmark for which struggling countries strive for (Encyclopedia Brittanica). They aim to see 90 percent awareness, 90 percent treatment rates, and 90 percent virally suppressed. Currently, 90 percent of the population living with HIV/AIDS in South Africa have been tested and know they have it. Of that 90 percent, 68 percent are receiving treatment. Of that 68 percent, 87 percent are virally suppressed and are able to return to normal life (Barbière, Cécile. “Madagascar’s AIDS Epidemic Rages Undetected…). Programs and setting attainable goals like in South Africa could serve Malagasy well. Looking at the island’s statistics, we see nearly the opposite right now. An astonishing 90 percent of Malagasy have never been tested for HIV/AIDS. Of the 10 percent that has, only two percent are receiving treatment (Barbière, Cécile. “Madagascar’s AIDS Epidemic Rages Undetected). A combination of poor education, poor means of transportation, and stigma are three key factors if the government wants to improve their situation.

The stigma of going through the treatment process for HIV/AIDS is one reason why many Malagasy who do have access to testing facilities find themselves not going. A case study interviewing a former prostitute tells us the story of her very personal struggle with trying to educate others and was recently published by NBC News. The setting is on a back street in one of Antananarivo’s poorer neighborhoods. A woman named Saholy clutches at the hood of her blue jacket, pulling it down against the light rain. She prepares herself for more verbal abuse from her fellow streetwalkers on the corners. So holy is 39, a single mother of three teenagers, a (former) prostitute ashamed of her life and, for the last couple of years, a weapon in Madagascar’s war on AIDS. Several nights a week, she dons a blue uniform and white badge and tries to convince prostitutes to have only protected sex and get regular medical checkups. A quote from Saholy in the article reads, ‘the other sex workers insult us and try to drive us away because we are interfering with their work,’ said Saholy, who does not want to be identified further for fear her children will learn what she does. ‘We leave but keep coming back. Eventually, they will listen to what we have to say” (NBC News) Her work is valuable, but more education is key. Many men pay a lot more if they don’t have to use a condom, too. It is difficult for a sex worker who makes little money to resist, she says in the article. And many men believe they can cure themselves of a sexually transmitted disease by passing it on to a prostitute through unprotected sex (NBC News). This insight into the mindset of current sex workers and those who use their services show the initial hesitancy of any willingness to accept change pertaining to their behavior at their jobs. However, stigma cannot be conquered overnight. The work of Saholy using personal experience to try to help others is key for the movement’s eventual success.

Other African countries are making some headway against the disease, too. The number of new infections in Uganda and Kenya has dropped after persistent widespread public campaigns (UNIAIDS.org). But most Malagasy live far from any large city. Despite this, the current administration in Madagascar is taking AIDS awareness seriously, more so than ever in the past. Since Rajoelina took office last year, more than “100 screening centers have been set up”, and mobile testing units are “sent to remote areas” (UNAIDS.org). In addition, old decrepit billboards in Antananarivo have been replaced with educational information about AIDS. The government hopes to “distribute 400,000 HIV test kits by the end of the year” (UNAIDS.org).

Furthermore, in many rural villages, hundreds of local AIDS councils take action in their own ways. The village of Maroambihy, for example, held a carnival sponsored by AIDS awareness, which showed “films and organized home visits reaching more than 8,000 people” (NBC News). Young players in the football club were taught to carry condoms, and women were taught the dangers and risks of a life of sex work. Groups considered “high-risk” get special attention, including young people aged 19 and under who make up half the population of Madagascar. Thousands of teachers are trained in how to convey the AIDS prevention message to their students. Young people can get check-ups at a discount, and training kits are passed out to scout troops so they can talk about AIDS (NBC News).

The response to AIDS starts at the top, as we’ve seen some of the steps president Rajoelina has taken to implement more AIDS tests for the public. Healthcare lately has been a priority in Madagascar and the national AIDS office is actually in the presidential palace (NBC News). A quote from Dr. Fanjaniaina who runs the AIDS office said, ‘The AIDS campaign is a personal initiative from the president — he himself negotiates with the donors. The president tells me to go and see out in the country — he wants to see the impact of his policies’ (NBC News). Because of his deep care for this issue, this president hopes that more donors will be willing to give money as they are more confident their financial contributions will yield tangible results. Although international contributions have not spiked dramatically in the past few years, the government hopes it has given enough proof of action that the hesitancy for donors is removed.

In conclusion, Madagascar’s recent all-out attack on AIDS comes from the fear that HIV will arrive along with a more open economy and an influx of foreign workers. The island has been protected so far largely by its isolation, but it has only to look across the water to Southern Africa to see the killer wave headed its way. Nine of the world’s ten most HIV-ridden countries are in southern Africa, with infection rates of more than 37 percent in Botswana and Swaziland (World Atlas). If AIDS takes hold in Madagascar, it could ruin the country completely.

Works Cited:

  1. AfricaNews. “Madagascar President Andry Rajoelina Sworn into Office.” Africanews, Africanews, 19 Jan. 2019, https://www.africanews.com/2019/01/19/ Madagascar-president-Andry-Rajoelina-sworn-into-office//.
  2. Barbière, Cécile. “Madagascar’s AIDS Epidemic Rages on Undetected.” Www.euractiv.com, EURACTIV.com, 16 June 2016, https://www.euractiv.com/ section/health-consumers/news/Madagascar-aids-epidemic-rages-on- undetected/.
  3. Chepkemoi, Joyce. “Countries With the Highest Rates of HIV/AIDs.” WorldAtlas, 12 Apr. 2017, https://www.worldatlas.com/articles/countries-with-the-highest- rates-of-HIV-aids.html.
  4. Facts About Madagascar, http://worldfacts.us/Madagascar.htm.
  5. “Global Health: Madagascar.” U.S. Agency for International Development, 6 Nov. 2015, https://www.usaid.gov/madagascar/global-health.
  6. “How to Explain Madagascar’s Low HIV/AIDS Rate?” Ärzte Für Madagaskar E.V., https://www.doctorsformadagascar.com/project/madagascars-low-hiv-rate/.
  7. “Madagascar.” Madagascar Economy: Population, GDP, Inflation, Business, Trade, FDI, Corruption, https://www.heritage.org/index/country/madagascar.
  8. “Madagascar Makes Progress against HIV/AIDS.” NBCNews.com, NBCUniversal News Group, 17 Dec. 2007, http://www.nbcnews.com/id/22286835/ns/world_news/t/ Madagascar-makes-progress-against-hiv/aids/#.XbRWDi8pCfA.
  9. Encyclopedia Britannica. “Antananarivo.” Encyclopædia Britannica, Inc., 20 Feb. 2019, https://www.britannica.com/place/Antananarivo.
  10. Unaids.org. “Newly Elected President of Madagascar Commits to Overcoming the AIDS Epidemic.” UNAIDS, UNAIDS, 17 Apr. 2014, https://www.unaids.org/en/ resources/press centre/feature stories/2014/april/20140417madagascar.
  11. Why Is Madagascar so Poor?, 12 Aug. 2011, https://www.wildmadagascar.org/ overview/FAQs/why_is_Madagascar_poor.html.

The Movie ‘And the Band Played On’ and Its Connection to the Bahamas’ Response to the HIV and AIDs Pandemic

Politics, people and the AIDS epidemic is the major theme in the 1993 film ‘And the Band Played On’ directed by Roger Spottiswoode. This film is set in the early 1980’s with an epidemiologist by the name Don Francis becoming growingly aware of the increasing number of deaths from unexplained sources among gay men in Los Angeles, New York City and San Francisco. This prompted an in-depth investigation of the possible causes and reasons for the outbreak. With little to no governmental funding, political support or updated equipment Francis reached out for assistance. During the course of pursuing his theory Francis that AIDS is caused by a sexually transmitted virus on the exemplary of feline leukemia, he finds his efforts are resisted by the Centre of Disease Control, which opposes the theory to prove that the disease is transmitted through blood, and competing French and American scientists, chiefly Dr. Robert Gallo. These medical researchers quarrel about who should obtain recognition for discovering the virus as the deaths from the disease increase significantly.

Much of what shapes national and global responses to the HIV/AIDS pandemic is shaped by political factors, however there has been little dissection of the political dynamics and motivations (Rau & Collins, 2005). Likened to the film, the Bahamas is no different to this statement it’s political responses to HIV/AIDS pandemic is very limited as well. One reason for this is the primary focus of HIV/AIDS in the Bahamas has been on inter-personal, service delivery and already marginalized groups. Social changes that have magnified the spread and impacts of HIV/AIDS as well as the socioeconomic and political changes to control the epidemic are addressed more than research in this field. This analysis will answer questions in a review of the movie ‘And the Band Played On’ and its connection to Bahamian response to the HIV and AIDS pandemic.

Many of the researchers’ and doctors in the film ‘And the Band Played On’ played a significant role in the progression of the spread of HIV/AIDS due their poor response. This poor response time was due to the fact that many of these researchers and doctors had values, special interests and stereotypes that played a major effect on the development of policy and resources available to deal with the spread of AIDS. For example, because the disease was viewed as a ‘gay cancer’ or ‘gay plague’ among the homosexual community many policy makers did not acknowledge it. It was not until the disease spread to the heterosexual community, the American government and Congress allowed for funds and research to be conducted. Like the film, in the Bahamas persons look at HIV as a condemnation for homosexuals, persons living promiscuous lifestyles or Haitian immigrants. This can be noted as the Bahamian government did not look closely into the HIV/AIDS pandemic until ten years after its first diagnosis in the early 1980’s, this was mainly due to the fact that persons who contracted the disease were marginalized persons such as homosexuals or immigrants so much concern was not given (Craton & Saunders, 2000). However, like the film it was not until heterosexuals and pregnant women contracted the disease policies were made and changed to deal with the spread of AIDS. Many of these policy makers were of Christian value system and stereotyped persons living with HIV/AIDS as ‘gays’. While special interest groups such as the lesbian, gay and bisexual community used the plight of HIV/AIDS in the film to lobby for anti-discriminatory laws and status quo (Cigler, Loomis, & Nownes, 2016). Due to the values, special interest group and stereotypes development of HIV/AIDS policies and resources were delayed.

“Common sense however, rarely carried much weight in the regard to AIDS policy” refers to the idea that policy makers were more concerned about their own values, beliefs, stereotypes and gains as oppose to making provisions to help those ill and dying from HIVAIDS. Merriam-Webster defines the phrase ‘common sense’ refers to a basic ability to perceive, understand, and judge things, which is shared by nearly all people and can reasonably be expected of nearly all people without any need for debate. So, when the speaker said the above-mentioned line, he may have been referring to the idea that perceived judgement was not evident throughout the formation of the AIDS policy because, the policy would help thousands of people infected and protect others from being infected. But the policy was delayed.

A study, published in the American Journal of Medicine in 1984, traced many early HIV infections to an HIV/AIDS infected gay male flight attendant named Geatan Dugas. Dugas, should have been made accountable for his actions of promiscuity and nonchalant virus transmission. One way he could have been accountable would be taking part in a mandatory HIV/AIDS study where would have to comply with biological and sociological study. This would help to further investigation in the root of the infection. Some ethical issues that arise by his behavior are the wrongness of knowingly transmitting a disease. A legal issue that arises by Dugas’ behavior is presented in the fact that he knowingly engaged in sex with other males while infected with HIV without informing the other person. The Centre for Disease Control (2016) mentions HIV Specific Laws that govern the action of persons living with the disease such as the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Which funds AIDS treatment and care while requiring states to establish criminal laws adequate to prosecute any HIV infected individuals who knowingly exposed uninfected persons to HIV (Public Law, 1990).

The government’s response to the HIV/AIDS epidemic during the early 1980’s was slow-moving. Had they known what they know now the transmission of HIV could have been less aggressive. Some actions the government would have taken were testing all blood transfusion. During the early period of AIDS discovery many persons who received blood transfusion were later diagnosed with HIV/AIDS. Promoting safe sex practices such as proper condom use and abstinence is another way government of that day could have help prevent the transmission of HIV. While promoting safe sex practices, the government could have dismantled stereotypes of the disease such as the label of ‘gay plague’, etc. Educating the wider public about the cause, transmission and treatment of AIDS is another initiative the government could have established if they had known what they know now about the disease. Drug users like medical professionals would have been educated on the importance of not sharing needles or sterile needle use. One way to implement most of the above-mentioned initiatives greater funding would be needed to establish these initiatives.

The events detailed in the film serves as a prototype for enlightening the lives of person’s living with HIV, primarily by drawing attention to the many faults made during the early period the AIDS pandemic. The film clearly reveals how holistic support politically, socially and economically is a major requirement for managing an epidemic. Stereotypes, lack of adequate funding, stigmas and knowingly exposing unaffected persons to the virus by infected persons are all challenges recognized in the film that are challenges social works face today. Some prominent challenges that effect social workers in healthcare setting are economics of care and continuous stereotyping (Poindexter, 2010). Marginalized groups such as homosexual men and migrants face stereotyping through stigma and discrimination leading to health disparities such as antiretroviral drugs (Stirrat & Gordon, 2005).

Counteracting, the above-mentioned challenges require a myriad of initiatives by social workers and policy makers (government). The social worker gains skills needed to help improve service delivery. These skills include adherence counselling for treatment and emotional support for infected persons, empathy with infected persons and knowledge of the disease or condition affecting the population served as well as educating the masses about the facts of HIV would be help social workers with the vexing challenges (Poindexter, 2010). Risk reduction counselling (assessing an individual’s risk of engaging in unhealthy behaviors that may affect him/herself) and assessing barriers to that disrupt accessing care of persons living with HIV are additional skills social workers can apply to help the effect of HIV.

As a healthcare provider I recognize that HIV/AIDS is not a life sentence and those living with HIV/AIDS are human beings with feelings and should be treated as such. I vow to maintain a non-judgmental, non-discrimination and non-prejudice stance when caring for person’s living with HIV/AIDS. This stance on HIV/AIDS is as follows:

  • Non-discrimination: I will not discriminate against persons living with HIV or AIDS;
  • Confidentiality: I will protect and maintain confidentiality of those seeking healthcare;
  • Inform: I will inform persons living with HIV or AIDS with sensitive accurate and up to date information on risk reduction in his/her life;
  • Awareness: I will assist in raising HIV/AIDS awareness programs;
  • Access to treatment and care: I will help those who test positive to HIV to obtain necessary treatment and care and referral to relevant agency to ensure this.

There are many ways to implement the policy to advocate and strengthen HIV/AIDS strategies in the Bahamas. Two ways to advocate the policy in the Bahamas healthcare system is through updated training and workshops for persons in the helping profession; lobby rights for greater equality among persons living with HIV/AIDS. Firstly, training and workshops provides an effective ground for information and awareness of HIV policy. Not only will professionals be exposed to updated relevant information on the topic of HIV and AIDS, but they will gain knowledgeable information to help within their field. One important reason for this is the fact that HIV and AIDS is an evolving disorder, treatment, development and management of the disease is ever changing (Poindexter, 2010). So, persons working along with infected persons should evolve educationally to better assist clients biologically and emotionally. In addition, professionally should be exposed to reinforced guidelines and policy analysis on caring for persons living with HIV/AIDS and mandatory annual workshops will help. Various Bahamian agencies should take part in this initiative to advocate the HIV policy: all healthcare workers, social workers, support staff and councilors/therapist.

Another way the policy can be advocated in the Bahamas is through lobbying the rights of persons living with HIV/AIDS. At present there are no concrete laws in the Bahamian constitution that protect person’s living with HIV/AIDS. The only act that mentions AIDS is the Bahamas’ Employment Act, which prohibits discrimination on the basis of HIV/AIDS (Bahamas Employment Act, 2006). Support groups on social media, non-violent protest and letters to all ministers in the House of Assembly could avenues used to get the government assistance in creating laws that protect persons living with HIV/AIDS from discrimination. In addition, these outlets can also be used to request government increase funding for avenues of research, HIV/AIDS awareness and prevention and strengthening privacy measures for persons requesting testing or treatment for HIV/AIDS.

In conclusion, the frame of the global management of HIV/AIDS is shaped by political stance. One major reason for this is government provides the laws that govern what we can and cannot do as well as provide funding for the HIV/AIDS research. It is no surprise that the political arena played a major effect in the movement of HIV/AIDS discovery and management. In the 1993 film ‘And the Band Played On’, directed by Rodger Spottiswoode, viewers see first-hand how the AIDS pandemic started and progressed. The film provides a platform for the realistic challenges that many face at the start of this pandemic and how slow responses policy makers returned unfavorable results. Despite, the not so good start on the AIDS pandemic by researchers, scientist and government the disease management as evolved into a progressing study of ongoing treatment, diagnosis, prognosis and platform for persons living with the disease.