Epidemiology for the Social Determinants of Health - Essay Example

Epidemiology for the Social Determinants of Health Introduction The paper explores the history, incidence and prevalence ofAcquired Immune Deficiency Syndrome (AIDS) within Australia by exploring current statistics and the demographic patterns of people who suffer from the disease. It also explains the sociological perspectives for the people suffering from the disease within the country. This has been done through the use of two sociological perspectives that are essential in explaining the causes and effects of suffering from the disease within a population. It additionally provides a brief literature review addressing the sociologist’s view of the disease and a conclusion describing the current situation of the disease in Australia. AIDS is a viral syndrome caused by the Human Immunodeficiency Virus (HIV), affecting a person’s immune system making the body susceptible to opportunistic infections (Ostrow, 2009). The opportunistic infections are generally harmless to people who are in good health but threaten the lives of the people who have been infected with the AIDS virus (Brady, 2004). The disease currently has no cure, although there are drugs that are being used to prolong the life of the victims and improve quality of that life. HIV is transmitted via contact with contaminated body fluids, most commonly through sexual intercourse with infected persons, and blood transfusion (Francouer & Francouer, 2004). 2. Epidemiology The history of, AIDS in Australia is quite unique. This is because Australia’s past ruling regimes became acquainted with the disease early and responded to the disease by utilizing several swift measures in an attempt to control its spread (Spencer, 2006). Australia currently has among the best prevention and education programs concerning the disease in the world (Willis, Reynolds & Helen, 2008). This has enabled the country’s government to maintain among the lowest rates of infection from the disease in the world (Spencer, 2006). The disease as first reported in the country in 1982, though it claimed its first victim in the year 1983 in Melbourne (Brady, 2004). The most instrumental groups of people in the fight against the disease came from the homosexual communities who were fearful of the disease’s prevalence within their networks (Smith, 2008). They helped in establishing the first councils in the country that were responsible for fighting the disease. These councils began as early as 1983 with many of them being formed in regions like the south and western areas of Australia. In the regions of Victoria, Tasmania along with Queensland the councils came up in the year 1983. All the councils currently found in the country are controlled by the Australian federation for AIDS organizations (Miller, Vandome, & McBrewster, 2010). As at December 2010, over 21,390 people had been diagnosed as living with the HIV virus within the country. Since the disease became an epidemic in the country, there have been reportedly over 31,486 people who have been diagnosed with the disease with over 6,700 deaths being recorded (Brady, 2004). The following table shows the number of males and females respectively who have been diagnosed with the HIV and AIDS since it became known over the years (Willis, Reynolds & Helen, 2008). Table 1. Number of people diagnosed with HIV and AIDS since 1987-2010 (Australian Bureau of Statistics, 2007) HIV AIDS YEAR MALES FEMALES TOTAL MALES FEMALES TOTAL From 1987 and before 6,846 236 7,116 762 35 797 From 1988 to 2010 19,927 2,065 28,633 9,080 533 9,649 TOTALS 26,773 2,301 29,395 9,842 568 10,446 The infection rates within the country have steadily risen since the year 1987 though in between the years the infection rates have been gradually reducing in the recent past (Brady, 2004). This has been facilitated by the efforts being applied by the AIDS councils previously established in preventing and educating the masses concerning controlling the disease. This includes their antiretroviral therapies and their stressing on maintaining healthy feeding habits along with abstinence from unprotected sex (Miller, Vandome, & McBrewster, 2010). The annual number of cases diagnosed with the disease rose steadily in the year 1994 reaching a total of 953 cases but reduced to around 216 cases in the year 1999 (Smith, 2008). However, the infection rates among the men living in the country have been higher than their women’s infection rates. This is mainly because the disease is mainly spread among homosexuals (Willis, Reynolds & Helen, 2008). Among the newly diagnosed people, 65% of them are homosexuals whereas 28.7% of them are heterosexuals. An additional 2.3% of these people have been infected through the use of infected syringes when injecting drugs into the bodies whereas 3% of this population has been infected due to both their drug use activities and homosexuality (Smith, 2008). This activities help in explaining why the disease prevalence rate is higher in the men living in Australia as compared to their women (Brady, 2004). The following table shows the distribution of the prevalence rates of the people living with HIV and AIDS in Australia according to the regions they hail from. Table 2. HIV/AIDS cases according to State/Territory as at December 2010 (Australian Bureau of Statistics, 2007) State/Territory HIV AIDS MALE FEMALE TOTAL MALE FEMALE TOTAL Australian Capital 283 36 319 95 10 105 New South Wales 14,398 999 15,657 5,513 265 5,796 Northern Territory 155 30 185 48 6 54 Queensland 3,211 354 3,574 1,094 76 1,172 South Australia 1,056 120 1,177 422 32 455 Tasmania 127 15 142 55 4 59 Victoria 5,944 459 6,447 2,145 124 2,282 Western Australia 1,385 256 1,648 457 47 506 TOTAL 26,559 2,269 29,149 9,829 564 10,429 The regions found to have the highest prevalence of AIDS are New South Wales followed by Victoria, the Australian Capital Territory, Northern Territory and Queensland respectively (Willis, Reynolds & Helen, 2008). The total number of cases diagnosed per capita between the indigenous along with the non-indigenous communities varies a little. There are, however, differences that are significant in their transmission routes. Among the Aboriginal and the Torres Strait Islander population, between 2005 and 2009, only 46% of the people who were diagnosed with HIV were reportedly infected through their engagement in homosexual activities (Miller, Vandome, & McBrewster, 2010), whereas, the non-indigenous people infected with the HIV virus through engagement in homosexual activities were 71% of their entire population. Heterosexual activities were responsible for 46% of the total number of people infected with the virus among the indigenous population whereas 15% of the non-indigenous communities were infected through similar activities (Power, 2011). The number of individuals among the indigenous community that were infected through the use of contaminated syringes in their drug abuse activities was 20% of their infected population whereas for the non-indigenous society the value stood at only 3% of their infected population (Willis, Reynolds & Helen, 2008). The total number of infected women among the infected indigenous population stands at 26% of their population while the number of infected women among the non-indigenous society stands at 32%. The following table shows the number of AIDS cases reported and the respective deaths based on various age groups as at the end of December 2010 (Miller, Vandome, & McBrewster, 2010). Table 3. Number of AIDS Cases Reported and the Respective Deaths Based on Various Age Groups (Australian Bureau of Statistics, 2007). Age Cases Deaths MALE FEMALE TOTAL MALE FEMALE TOTAL 0-12 32 22 54 23 12 35 13-19 28 6 34 15 3 18 20-29 1,465 127 1,607 695 50 756 30-39 3,983 207 4,202 2,489 110 2,608 40-49 2,855 110 2,970 2,081 61 2,144 50-59 1,074 51 1,129 829 34 864 60+ 392 41 433 313 37 350 TOTAL 9,829 564 10,429 6,445 307 6,775 Within the Australian continent, improved therapies in the disease have greatly helped in prolonging the lives of AIDS victims since the disease is diagnosed. The time prolonged for the victims increased from 19 months to 69 months in during the period from 1998 to 2002 (Smith, 2008). The country’s policies on health emerge from the grassroots level and involve great cooperation between governmental along with non-governmental stakeholders. The ability of these two groups to effectively respond to the disease has led to a low rate of infection among the citizens (Andrews & Curtis, 2008). This has been largely facilitated by the fact that these groups believe that the people’s social actions play a vital role in countering the prevalence and effects of the disease (Norberry & Gaughwin, 2010). The government has greatly utilized media campaigns in conveying their messages to the population concerning the disease. This has also contributed greatly to the reductions witnessed in the rates of infection among their population. The Australian government has also facilitated the exchange of syringes for drug users who are intravenous for the purpose of reducing the infection rates (Andrews & Curtis, 2008). Despite their efforts of availing syringes to the drug users, they have been heavily criticized for facilitating the activities of the drug users within the country (Smith, 2008). Since the year 2000, there have been over 15,000 in Australia living with the virus, which includes a small population among their women though their numbers are also rising (Miller, Vandome, & McBrewster, 2010). The AIDS victim’s chance of survival within Australia in the course of time has been increased through the utilization of antiretroviral therapies. However, the prevalence of the disease within the country has increasingly continued to bring challenges to the community and their government (Brady, 2004). This is because most of the people who suffer from the disease in regions like the New South Wales live far below the poverty line. The victims of the disease have also encountered challenges in getting employment and accommodation facilities due to discrimination (Spencer, 2006). Reports indicate that many of the heterosexuals living in the country who are infected with AIDS have acquired the disease from foreign visitors from Asia or Africa. The increase in the number of people being infected with the virus on an annual basis has led to the government initiating various steps towards sensitizing the people on the disease. They have recently been focusing on increasing awareness through advertisements presented in the media (Andrews & Curtis, 2008). Finally, the prevalence of the AIDS virus in the country has been identified with an increase in socially unacceptable behaviours among the citizens of Australia and foreigners coming into the country (Miller, Vandome, & McBrewster, 2010). 3. The Sociological Explanation The sociological theorists applicable in the AIDS situation in Australia are namely the functionalist and symbolic interactionism theories (Abbott, Wallace & Tyler, 2005). The functionalist theories analyse the effects of the disease on the basis of their effects on the entire nation whereas the symbolic interactionists analyzeit on an individual basis (Miller, Vandome, & McBrewster, 2010). The functionalists would focus on the effects of the disease on various components of the society and how they would, in turn, adopt new ways to cope with it. On the other hand, the symbolic interactionists would concentrate on the interactions that exist between those who are affected and those who are not (Minichiello & Plummer, 2002). They would focus on the people’s behaviours in their effort of explaining what makes them indulge in bad and immoral behaviours that eventually lead them to being infected. The functionalists would alternatively consider what the government is doing to improve the people’s living conditions to enable them prevent their people from indulging in risky behaviours (Power, 2011). The social factors that affect the AIDS victims living within Australia range from discrimination to stigmatization among other acts (Campbell, 2001). Male homosexual behaviours have been reported to be the greatest cause of increases in the number of people being diagnosed with the disease on an annual basis (Condon & Sinha, 2008). These groups have been consistently urged to practice safe sexual practices and their perception of the disease so that those suffering from the disease can continue leading positive lives (Campbell, 2001). The interactionists would perceive the changes that have led to the high prevalenceof the disease to the changes in sexual behaviours that have been witnessed in the country since the early 1970’s (Power, 2011). These changes were aggravated by the legalization of the contraceptive pills along with the liberation of sexual movements in the country. In addition, about 72% of the women in Australia found across all age groups reportedly have sex before they attain an average age of eighteen years (Miller, Vandome, & McBrewster, 2010). However, the high prevalence rate of the disease among males has been attributed to the fact that the males in Australia usually indulge in sexual activities earlier and more frequently than females (Condon & Sinha, 2008). Previous studies have indicated that approximately about 10% of the male population indulges in sexual activities before they have attained the age of sixteen. This is unlike their females who minimally indulge in the activities before they are mature enough (Lewis, 2003). Two thirds of the people living within the country have generally been said to live to have indulged in risky sexual practices at least once in their lives before they attained the age of fifteen (Palmer & Short, 2000). Their attitudes towards marriage have been adversely affected by the freedoms given to sexual movements in the 1970’s thereby making most of them indulge in immoral activities such as homosexuality (Abbott, Wallace & Tyler, 2005). The interactionists would attribute the high prevalence rates of the disease to the people changes in behaviour, attitudes, knowledge, along with awareness of the disease (Malinowska-Sempruch & Gallagher, 2004). Their awareness has had a positive impact on them since it has helped in controlling the number of people who are being infected on an annual basis (Lewis, 2003). The nature of relationships that exist between the different genders has greatly changed with immorality, separations, divorces and cases of unfaithfulness being constantly on the increase (Miller, Vandome, & McBrewster, 2010). A study carried out on 400 women revealed that more than half of them had engaged in sexual intercourse before attaining the age of sixteen and 80% of them by the time they attained the age of eighteen (Palmer & Short, 2000). 32% of the women respondents additionally claimed to have been unfaithful to their husbands whereas about 20% claimed their sexual partners were unfaithful. Out of the 400 women interviewed, only 7% claimed to have had one night sexual encounters with strangers whereas about 27% of them claimed they regularly used condoms (Andrews & Curtis, 2008). Homosexual behaviours are also on the rise in the country with over 70% of the females and 80% of the males in the country being perceived to have indulged in the behaviours on an annual basis (Lewis, 2003). Among the young males along with females, 25% and 9% respectively had indulged in sexual activities with multiple partners within a span of three months (Celentano & Beyrer, 2008). These behaviours have been attributed to the high prevalence rates of the disease since its discovery in 1982 to the year 2010 (Malinowska-Sempruch & Gallagher, 2004).In addition, over 90% of the country’s adult population had indulged in homosexual activities during their lifetime with 80% and 81% of the men and women respectively admitting to have indulged in homosexual activities on an annual basis(Australian Bureau of Statistics, 2007).The symbolic interactionists would have perceived these behaviours as having a close relationship with the increased prevalence of AIDS in Australia (Higgins & Norton, 2010). The Australian government has in turn illegalized the discrimination that people suffering from the disease have been undergoing in the past (Lewis, 2003). This move has enabled the people to avoid stigmatization when interacting with other members of their community (Andrews & Curtis, 2008). The government has also been among the first in the globe to authorize the screening of all their blood donors in case their blood may contain the HIV antibodies (Miller, Vandome, & McBrewster, 2010). This move has greatly assisted in reducing the number of people who have been affected by the disease through blood transfusion. The move was initiated in 1985 and they have, in turn, witnessed minimal infections through the transfusion of blood (Norberry & Gaughwin, 2010). The interactionists would additionally perceive the disease to be having adverse effects on the relationships between individuals and their abilities of achieving success in their endeavours (Spencer, 2006). This is because the disease weakens their bodies thereby making them less productive in their activities (Malinowska-Sempruch & Gallagher, 2004). It also uses a lot of their finances since they have to obtain medication while some are admitted in various medical facilities at the terminal stages of the disease (Celentano & Beyrer, 2008).In addition, many victims tend to lose their jobs due to the weakness that their bodies have which also implies that they lose their sources of income (Lewis, 2003). Their inability to afford life’s basic commodities would eventually lead to their living in poor conditions which will increase the number of deaths resulting from the disease within the country on an annual basis (Chall, 2004). The government on the other hand would suffer the loss of revenue through taxes when their population is not working (Andrews & Curtis, 2008). They should come up with measures that will help in improving the living conditions for the individuals suffering from the disease to ensure their lives are prolonged (Patel, 2009). Issues of discrimination and stigmatization for the patients suffering from AIDS should also be addressed by sensitizing their population on how they should treat the victims of the disease (Miller, Vandome, & McBrewster, 2010). The functionalists would be concerned with relationship that exists between the victims of the disease, the effects of the disease on their activities and the resultant losses that the country’s systems would suffer from (Sendziuk, 2003). Due to the increase in the number of people who are becoming infected with the disease in Australia, the country might experience several problems in various sectors of their economy (Lewis, 2003). When many people die due to the disease, the country loses human capital which therefore implies that they end up having a slow growth in their economy (Chall, 2004). The country’s productivity would also be on the decline since they will lose many professionals and other skilled personnel who have been working in different institutions across their economy (Sendziuk, 2003). The functionalists in the country should focus on establishing programs along with other initiatives that will help in improving the nutrition and medication for the people suffering from the disease (Patel, 2009). This should be done within their boundaries and on the international scene because there are reports concerning many infections arising from their citizens’ indulgence in sexual activities with tourists from certain regions across the globe. This includes some of the regions that are found in the sub Saharan region of Africa and Asia (Lewis, 2003). According to the functionalists in Australia, the inability of their workers to work will lead to increased unemployment rates and a smaller population of professionals working in the different sectors of their economy (Sherr, 2007). Through the large number of deaths that the country could experience when victims lack proper nutrition and medical care, the country will lose a lot of taxable income (Abbott, Wallace & Tyler, 2005). These taxes are usually vital for steering development efforts in other sectors of the country’s economy. They are utilized for purposes of satisfying the public needs on education and the provision of health services (Miller, Vandome, & McBrewster, 2010). With a low prevalence rate in the disease, Australia however has not experienced a slow growth in their economy. This is because their government had previously invested financially, along with other resources, in the fight against AIDS (Spencer, 2006). Reports indicate that their government accepted the disease to be a reality in the past and undertook several measures on educating people (Sankaran, Volkwein-Caplan & Bonsall, 2009). The education provided concerned how they can prevent themselves from being infected along with other safe practices that should be utilized (Jackson & Jackson, 2009). The country’s gross domestic products have been consistent though the government has persistently failed to ensure the issue of homosexuality is dealt with by ascertaining minimising the harm it causes and ensuring safe lifestyle practices aimed at minimising the risk of transmission. (Sherr, Hankins & Bennett, 2006). This is despite the fact that their practices are considered to be a threat to the diseases low prevalence rates within the country (Tettey, Puplampu & Berman, 2006). Functionalists would perceive the changes in the people’s behaviour, attitudes along with values to be responsible for the country’s inability to control the spread of the disease (Mahmud, 2004). Reports indicate that many people in the country’s population are increasingly indulging in unsafe sexual activities (Sherr, 2007). The functionalists view the criminalization of a person’s intention to transmit the disease as vital in helping to control the spread of the disease (Bennett & Lie, 2009). The Australian government has not however enacted specific laws that are responsible for handling the issue (Sankaran, Volkwein-Caplan & Bonsall, 2009). There are however several convictions that have been made in the recent past in regard to the intentional transmission of the disease by some victims. These convictions havegreatly helped in deterring other victims from performing similar acts (Higgins & Norton, 2010). For instance, in the year 2009 during the month of January, Mr. Michael Neal, from Melbourne was convicted and jailed for a period of eighteen years for his deliberate effort of infecting other people he was engaged to without their prior knowledge (Bonsall, 2004). The accused performed this action despite the fact that he had received many warnings from the Human services department in Victoria (Miller, Vandome, & McBrewster, 2010). In conclusion, the paper has analysed the cause along with the prevalence of AIDS in the Australian continent. It analysed the trends of the disease across different regions and races for the purpose of establishing the effects it was having on their population along with their economy. It finally considered two sociological perspectives that are utilized within the country in trying to understand the problem and its effects. The government of Australia should continue investing heavily in the fight against the disease since it could adversely affect their economy (Webber, 2007). They should also come up with the most appropriate legislation that will help in controlling the people’s sexual activities since they are perceived to be the major causes of the diseases spread (Francouer & Francouer, 2004). References Abbott, P, Wallace, C & Tyler, M, 2005, An Introduction To Sociology: Feminist Perspectives, Routledge, New York. Andrews, K & Curtis, M, 2008, Changing Australia: Social, Cultural And Economic Trends Shaping The Nation, Federation Press, Melbourne. Australian Bureau of Statistics, 2007, Australian Social Trends, Australian bureau of statistics, Brisbane. Bennett, R. J & Lie, J, 2009, Sociology: Your Compass For A New World, The Brief Edition, Cengage Learning, London. Bonsall, G, 2004, Handbook Of Social Problems: A Comparative International Perspective, SAGE, New York. 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Willis, E, Reynolds, L & Helen, K, 2008, Understanding The Australian Health Care System, Elsevier, Australia Read More