AIDS Pandemic Issues - Essay Example

One of the most prominent issues that have taken center stage in a lot of national, regional and international forums is the much talked about HIV AIDS pandemic reportedly causing deaths on a large scale especially in sub-Saharan Africa. The use of the term ‘pandemic’ or ‘epidemic’ with regards to a particular communicable disease normally conjures images of large scale infections and deaths and particularly from the 1980s when reports of outbreaks of HIV AIDS ‘hit’ the media, such fearful images of death and epidemic have been associated with HIV AIDS. Official Statistics of global HIV infections in the 1980s provided by the World Health Organization (WHO) for example were put at between 5 million to 10 million (“James Chin”), a figure which sent shockwaves globally as there was increasing talk about the ability of infections to reach epic proportions if prompt and serious interventions are not made to address the supposed looming global epidemic. Evidently, such a looming global health disaster required scientific research and study into its causes and popular modes of transmission and reports published by international bodies like WHO and UNAIDS have become an almost unquestionable truth. This essay will attempt a presentation of five popularly held conceptions (or misconceptions) about HIV AIDS that have been perpetuated by international organizations like UNAIDS and WHO and which have been accepted as the unquestionable consensus. According to James Chin one major misconception about HIV AIDS is the assertion that: “Virtually everyone is at almost equal risk of infection with HIV”. This fuelled the perception that “in the absence of aggressive prevention programs directed to the general population, especially the youth, it is only a matter of time before epidemic heterosexual HIV transmission will break out in populations where HIV prevalence is low” (“James Chin”, 165). This conception has proved to be false. Barry Schoub has for instance said concerning the HIV virus that “in terms of its ability to transfer itself from one host to another, it ranks as one of the least efficient of viruses.” (91) This is because unlike an airborne virus like the influenza virus, the HIV virus cannot adapt to environments “outside of the warm nurturing intra-cellular location in the human body” (“Barry Schoub”, 91). Thus: “The venereal route is ideally suited” for its transmission (“Barry Schoub”, 91). Notably, HIV transmission is to a large extent effected through sexual intercourse (vaginal or anal), though other mediums of transmission like contact with HIV infected blood (e.g. through the sharing of sharp objects like blades or injection needles) also result in transmission. James Chin further states that: “All published sex partner studies show the risk of HIV transmission from any single coital act is very low – about 1 per 1000 or less” (164). It is thus worthy of note that though a sexually transmitted disease (STD) like syphilis (which is caused by a bacteria agent) is by far more infectious than HIV with regrdas to per coital contact, no STD experts have made claims of it spreading on epidemic proportions like have been made concerning HIV AIDS. The persistence of alarmist claims concerning the scope of risk of HIV infection by official sources from places like the WHO and UNAIDS appears to push a political correctness agenda and not an agenda supported by empirical scientific evidence. Evidently, the claim that “Virtually everyone is at almost equal risk of infection with HIV” has not been dispelled by these officialdoms as there is the perception that doing so would embolden people to take more risks in their sexual behaviours and by so doing increase their probability of being infected by the HIV virus. Consequently, political correctness has held sway against scientific evidence. One of the areas of concern (and rightly so) in the fight against the spread of HIV infections is in sub-Saharan Africa (SSA) majority of reported cases pertain. Consequently, research into how the HIV virus is transmitted in SSA has been considered key in the fight against the spread of HIV on the continent. However, according to Stuart Brody and John Potterat, there is a wrong perception public health authorities who “have long believed that almost all cases of AIDS in African adults are attributable to ‘heterosexual transmission’ a rubric tacitly understood to refer to penile-vaginal intercourse” (431). In spite of this conventional view, there is empirical basis for speculating that homosexual and heterosexual anal intercourse is more prevalent in Africa than was thought to be. The conventional view that homosexual practices have not pertained in African societies have historically been fostered by European biases that held Africans to be primitive and as such ‘natural’ in their sexual preferences (“Stuart Brody and John Potterat”). Thus even though there is proof of homosexual practices among some indigenous African tribes as far back as the 19th century, such reports were thought to be a result of foreign (European and Arab) influences. Stuart Brody and John Potterat for instance report that “anthropologists when confronted with the reality of homosexuality in Africa, deliberately avoided reporting it for fear of undermining European preconditions” (431). Daniel Halperin even widens the scope with regards to the taboo of addressing homosexuality and HIV transmission to a global level. (717) He argues that: “most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission” (717). Halperin further opines that: “The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Despite the above observations by Brody and Potterat, and Halperin on the taboos of addressing HIV transmission and homosexuality (especially in Africa), James Chin appears to present a quite different opinion. He asserts that: “There has and continues to be some sort of fixation about anal intercourse that is also not warranted. There is nothing exceptional or mysterious about anal intercourse compared with vaginal intercourse with regards to the risk of transmission” (167). He however notes further that anal sex generally has a higher risk of HIV transmission due to a higher likelihood of “tissue trauma” in comparison to vaginal intercourse. (167) From the above it appears that Chin’s assertion does not point towards a taboo with regards to homosexuality and HIV AIDS, but rather an over fixation with the emphasis on the link between homosexuality and HIV AIDS. It must be noted however that he makes this claim in a generalised term and thus did not specifically address the issue of misconceptions of homosexuality taboos in Africa. A third commonly held misconception about HIV AIDS has to do with the causative factors for its prevalence in certain demographic populations the world over. James Chin sums up this misconception thus: “Poverty, discrimination, and lack of access to healthcare are major determinants if high HIV prevalence” (169). The above stated assertion is held by bodies like the UNAIDS and other mainstream AIDS agencies and many social activist though such a belief is without epidemiological support. Chin asserts that “the primary determinants of epidemic HIV transmissions are risk behaviors that include having unprotected sex with multiple and cucurrent partners and/or routinely sharing injecting equipment” with other injecting drug users (164). Though documented studies support this assertion, the UNAIDS, some social activists, and AIDS agencies have used legitimate social issues like poverty, discrimination, and lack of access to healthcare as a medium for addressing the HIV AIDS issues. It is obvious that where such social handicaps exists, they can become obstacles to HIV AIDS prevention and treatment however, these factors of themselves are not causative factors of epidemic HIV transmissions. Studies for instance show that “persons in the top 20 percent for income in Kenya and Tanzania have HIV infection rates of 2 to 3 times higher compared to persons in the lowest 20 percent” (“James Chin”, 169). It has been speculated that the cause of this high infection rate among top 20 percent income earners may probably be “because the wealthiest persons, both males and females, have a greater number of sex partners” (“James Chin”, 169) High risk behaviors like sexual promiscuity is thus the main causative factor in HIV transmission and among populations of injecting drug users, the sharing of injecting needles coupled with commercial sex work that is used to finance drug habits become the major factors of HIV transmission. Despite the apparent empirical support of the fact that high risk behaviour patterns rather than poverty, discrimination, and inaccessibility to healthcare remain the main cause of epidemic HIV transmission, it must be noted that other factors like condom use even among the sexually promiscuous significantly mitigates the likelihood of infection. Consequently, the perception that: “All high HIV risk behaviours will result in HIV epidemics” is erroneous. (“James Chin”, 167) In the Philippines for instance, despite the prevalence of commercial sex networks, HIV infection rates have been low. Its has be found that HIV transmission “risk has been very low in those networks where partner exchange rates are not the highest” (“James Chin”, 167) The last misconception that will be considered is the belief that transmission of HIV through anal intercourse pertain only among homosexuals. Daniel Halperin for instance observes that: “Anal intercourse is often thought to be primarily an act of male homosexuals. However, numerically speaking, far more heterosexual couples engage in this activity than homosexuals …” (718). It is also worthy of note that “many homosexual men have not had experience with this type of sexual behaviour” (“Daniel Halperin”, 718). The misconception about the absence of anal sex practice among heterosexuals has led to a situation where HIV prevention messages targeted at heterosexuals do not mention the risk of infection through anal sexual intercourse. However in a 1992 “representative US population survey (n=3432) 23% of respondents reported practicing heterosexual anal intercourse”. (“Daniel Halperin”, 718). Evidently, the usual taboos associated with anal sex informs the above stated misconception and thus accounts for the silence about the risk of HIV transmission through heterosexual anal intercourse. This essay has considered five main misconceptions about HIV transmission – “virtually everyone is at almost equal risk of infection with HIV”; “almost all cases of AIDS in African adults are attributable to ‘heterosexual transmission”; “poverty, discrimination, and lack of access to healthcare are major determinants if high HIV prevalence”; “all high HIV risk behaviours will result in HIV epidemics”; and “anal intercourse is often thought to be primarily an act of male homosexuals”. As argued above, these misconceptions are without any empirical scientific basis and in most cases represents political correct values of officialdom. Move towards addressing the HIV transmission problem from a scientific point will go a long way in helping to tackle the problem and possibly reduce its spread. Works Cited Brody, Stuart, and Potterat, John, J. ‘Assessing the Role of Anal Intercourse in the Epidemiology of AIDS in Africa’, International Journal of STD & AIDS, 14: 431-436, 2003 Chin, James. The AIDS Pandemic: The Collision of Epidemiology with Political Correctness, Oxford, Radcliffe Publishing Halperin, Daniel, T. ‘Heterosexual Anal Intercourse: Prevalence, Cultural Factors, and HIV infection, and Other Health Risks, Part I’, AIDS Patient Care and STDs, 13: 12, 1999 Schoub, Barry. AIDS & HIV in Perspective: A Guide to Understanding the Virus and its Consequences, 2nd ed. Cambridge, Cambridge University Press Read More