The impact of HIV/AIDS on women from South Africa and the United States
Compare and contrast the impact of stigma/discrimination and healthcare systems on women in South Africa and the United States.
Impact of Stigma, Discrimination, and Healthcare Systems on Women in South Africa and United States
HIV /AIDS is a social issue that has been encouraged by the existing mistakes of the society and has exposed new mistakes within the society. The HIV pandemic exposes the reality of patriarchy, gender inequality, and exploitation of young people. The pandemic has also been encouraged hypocrisy of our societies. Cultural and societal misconceptions such as HIV as a gay cancer and death sentence are gradually changing but they still contribution to the stigmatization of people living with HIV. More so, the nature of HIV and its transmission has created mistrust between the people, health care systems, and governments and created fear of seeking treatment as well as poorly funded HIV related programs.
Impact of social determinants of HIV infection among women
In 2011, 24 million people in the world were infected with HIV, of which 49 percent were women. Globally, HIV prevalence is higher in colored women than Caucasian women are, partly because social barriers they face within their locations and cultures. For example, despite the number of HIV infections falling by 21 percent among African American women between 2008 and 2011, HIV positive African American females are 20 times more than white women are and 4 times more than the Hispanic women are. In the sub-Saharan Africa, 60 percent of people living with HIV are females (Edwards & Collins Jr, 2014). These statistics are an indication that gender, race, geographical locations and ethnicity interact to influence the vulnerability of women to HIV, specifically, their sexual behavior. Vulnerability of women to HIV either emanates from their ability to protect themselves from infection or increased exposure to contracting HIV. Gender inequality affects the women’s economic participation and their ability to obtain basic needs. Factors such as high stress levels, marital status limits opportunity for women to meet their economic needs and consequently their ability to make empowered decisions on their health and life in general. For instance, women who are not economically empowered and are dependent on their male partners have little power to insist on condom use upon knowing that their partners have multiple sexual relations. Women’s economic dependence translates to poor decisions on obtaining prenatal care, sexual choices, and health care. Similarly, women in underserved communities have limited access to condoms and health care.
Change in response to HIV
Thirty years after the first diagnosis of the HIV/AIDS, there is denial, stigma and little government intervention. There has been an increase in the infections in the western world and Asian community but the sub-Saharan, which constitutes 15 percent of the world’s population, has 70 percent of HIV infections. Joint United Nations Programme on HIV/AIDS (UNAIDS) developed a high level and global response to the pandemic that addresses drug use, public health and sexuality. Regional governments are constantly looking for donor funding on HIV/AIDS related projects as well as community training on gender equity, HIV prevention, treatment, and care. Prominent figures are more open to endorsing HIV campaigns to fight against HIV stigma more than ever before. Despite the amount of resources devoted to combating HIV since the beginning of the pandemic, the infection rates continue to rise (Joint United Nations Programme on HIV/AIDS, 2014). However, the provision of treatment for the management of HIV has provided better results in the fight against HIV compared to prevention measures such as counseling and testing.
In the late 1970s, there was a misconception that HIV is a ‘gay cancer’ since it was discovered first among homosexuals. However, the name Acquired Immune Deficiency Syndrome let people know that anyone is at risk of getting the virus and not all homosexuals were HIV positive. However, this misconception continues to be a barrier towards treatment of gay people with HIV. HIV is no longer a death sentence anymore because people living with HIV with access to Anti Retroviral Treatment are expected to live a normal life. Before the ART, 78 percent of people living with HIV died from AIDS and this made HIV infections a death sentence. However, with the ART treatment, the number of people that die from AIDS is approximately 5 percent. Therefore, an individual that starts HIV treatment early enough is expected to live a normal, full life. More so, the development of Pre-Exposure Prophylaxis has allowed prevention of HIV infection in at-risk populations. In the past, one out of every five people living with HIV contracted tuberculosis and eventually died (Clair, Daniel & Lamont, 2016). People living with HIV have a weak immune system and are more susceptible to tuberculosis than other people do, and development of tuberculosis treatment has helped to prolong the lives of HIV positive individuals.
Comparison of HIV/AIDS in United States and South Africa
After the first HIV epidemic, both South Africa and United Stated developed a hostile attitude towards HIV. President Reagan’s administration made many policies that improved the lives of Americans and the fight against HIV was not one of them. When the Center for Disease Control proposed measures to curb the crisis such as provision of funds for HIV treatment and research, Reagan was disinterested partly because of the society’s homophobia (Padamsee, 2017). However, this decision not to take action against HIV/AIDS was not out of ignorance of the effects of the disease. On the other hand, the delay in taking action against HIV in South Africa was because of the leaders. Thambo Mbeki was an ‘AIDS denialist’ who publicly made remarks such as HIV did not lead to AIDS (Kalichman, 2017).
The United States’ society is more accommodating of people living with HIV than the South African society. People living with HIV in South Africa are often excluded from the society thus creating an unhealthy family dynamic where children mock their ill parents, and partners hide their HIV status from each other. Mistrust between people in South Africa leads them to seeking medical assistance to manage HIV. Seventy five percent of the people in South Africa visit traditional healers. South African people believe that HIV is a punishment for sin and they blame people with HIV for contracting the virus. This view makes it hard for HIV patients to seek treatment from hospitals because they fear losing respect from the society (Okoror, BeLue, Zungu, Adam & Airhihenbuwa, 2014). A progressive view on combating the pandemic is yet to emerge in the south African society.
On the other hand, the United States society is more progressive in the sense that the United States is taking more steps in reducing the hostility towards gay individuals and people with HIV. The government is enacting policies that reduce HIV prevalence despite the late start. In 1990, the congress passed Ryan White Comprehensive AIDS Resources Emergency Act that required the government to fund HIV related programs. The inception of U.S. National HIV/AIDS strategy was in an effort to control HIV/AIDS (Cahill, Mayer & Boswell, 2015). However, the funds allocated to HIV programs are not sufficient for implementation of these policies. The nature of HIV/AIDS has created hostility towards people living with HIV in both nations. Judiciary reforms and social developments have allowed the U.S to reform while stigma prevails in South Africa because of societal views on the pandemic.
The prevalence of HIV in the United States continues to increase despite the country having the possession of the antiretroviral drugs. This is because the drugs are useless due to improper use caused by stigma and its long incubation period. At-risk populations have the highest percentage of HIV cases and most people living with HIV do not have a strong cooperative relationship with their doctors. As a result, patients are more likely to stop treatments and increase their chances of death. On the other hand, South Africa’s public hospitals are poorly resourced and most young and financially challenged women lack enough access to anti retroviral drugs, and information on healthy lifestyles that prolong life, which consequently prevents them from realizing full benefits of ARV treatment (Boulle, et.al, 2014). In both countries, HIV prevention, treatment, and care has continually depleted the resources available by governments and increased the spread of HIV.
Physical and sexual abuse, poverty, stigma, homelessness, unemployment, mental health issues, lack of choice, lack of social support, powerlessness and lack of legal resident status play a major role in HIV infection as well as the ability of women living with HIV to access treatment and support. For example, poverty creates powerlessness in marital relationships, low self-esteem in the dependent females and alienation from the society. These factors affect a woman’s judgment and reduce her ability to protect herself from contracting HIV regardless of their countries of origin. However, if the United States had resources that United States has, treatment of HIV would be more accessible to the dependent women with financial constraints. Prejudices of the society make it harder in the past and present for leaders to allocate funds or create policies that help in prevention and treatment of the disease because of the nature of the disease.
Boulle, A., Schomaker, M., May, M. T., Hogg, R. S., Shepherd, B. E., Monge, S., … & Garone, D. (2014). Mortality in patients with HIV-1 infection starting antiretroviral therapy in South Africa, Europe, or North America: a collaborative analysis of prospective studies. PLoS Med, 11(9), e1001718.
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Okoror, T. A., BeLue, R., Zungu, N., Adam, A. M., & Airhihenbuwa, C. O. (2014). HIV positive women’s perceptions of stigma in health care settings in Western Cape, South Africa. Health Care for Women International, 35(1), 27-49.
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