HIV and AIDS Infection in South African Youth - Research Paper Example

HIV/AIDS Infection among the Youth in South Africa and the Role of the Faith Community Human immunodeficiency virus (HIV) has been causing a major spur in Africa for some time now. HIV/AIDS has been an epidemic in the world for some time now. However, the sub-Saharan region has experienced the greatest loss due to the epidemic. In this region, there are the highest new infection rates, greatest number of people living with HIV and has recorded the highest number of deaths from HIV related cases. South Africa is one of the countries in this region that has suffered the adverse effects of HIV1. In the region, there are notably high infection rates among the young adults and women. South Africa has been battling to control infection rates among the youth that were the highest in the region. Different factors contribute to the high infection among the youth. Different sectors have taken the responsibility of contributing positively towards eradication of HIV. The role played by the faith community in South Africa in curbing HIV spread is of interest to this paper. In addition, a comparison of the youth infection rates between South Africa and Uganda will receive attention in the paper. South African Statistics on HIV Prevalence among Youth Since the first cases of HIV/AIDS in the 1980s, the disease has been a major threat to the global health organization. Although discovered among gay people in America, HIV/AIDS spread to heterosexuals in a short time span. Towards the 1990s, HIV/AISDS was spreading into the entire globe. In South Africa, there were reported cases in early 1980s but these were mostly white gay men2. Later, the virus started spreading to the heterosexual community. The number of new infections in South African youths reached alarming rates in the post 2000 period. In 2003, an extensive research seeking to establish the rates of infection among youth and other factors that were contributing to the fast spread of HIV. In 2010, general prevalence to HIV was 10.5%3. Results from the research revealed that a great number of the youth between 15-24 years were sexually active. About 67% of the youth interviewed admitted that they were sexually active and this confirmed the increased risk factor and new infections4. In addition, the research proved that girls were more prone to the risk of contracting HIV, as they were relatively more sexually active. The researchers realized that South African youth ventured into sex at an average age of seventeen, a factor that contributed to the prevalence of HIV5. However, there were 15 year olds who were sexually active. In 2007, new infection among youth measured up to 45%6. According to the findings, more men risked having multiple partners and only 52% admitted using condoms during their last sexual activity. Only 33% reported constant condom use7. Other statistics indicate that between 2006 and 2010, HIV was highly prevalent among youth of ages 20-35. In 2010, there was 42.6% prevalence among youth aged 30-34 years. The rates seemed to be increasing from 37% prevalence in 2006. Youth ranging from 25-29 were at a great risk too of about 37.3% in 2010 compared to 38.7% in 2006. In 2008, young women were at the greatest risk of contracting the virus at a prevalence of 32.7% at ages 25-29. At age 30-34, the prevalence in women measured at 29.1%. It is worth noting that the prevalence rate among 15-24 year olds showed a slight decrease from 10.3% in 2005 to 8.6% in 20088. Sexual debut at an early age contributes to the increasing prevalence rates among youth in South Africa9. In addition, increase of intergenerational sex involving older men and younger girls contributes to the high risk among the youth. Concurrent relationships forming networks of sexual partners among youth increase the risk of infection. Research reveals that most youth do not realize the potential risk of contracting HIV and often feel that they are at minimal risk. Ugandan Statistics on HIV Prevalence among Youth The Ugandan HIV story among the youth is not very different. HIV hit Uganda so hard in the years just before the 1990s at a prevalence rate of 18%. However, the Ugandan government laid down efficient strategies to curb the tragedy before it blew out of proportion. The nation was the first in sub-Saharan Africa to announce HIV as an epidemic. Due to the efforts made by the government, the prevalence rate declined to about 6%. Over the recent years, it has remained constant. However, just like other sub-Saharan countries, the Ugandan youth aged 15-24were at great risk of contracting the disease. Until 2000, the prevalence of HIV was very high among adolescents, higher than all other age groups. The prevalence in teenage girls was six times higher than that in boys. The sex debut age contributed greatly to the increasing prevalence just as in South Africa. Adolescents admitted having ventured into sex before the age of 15. Although condom use was rampant among the youths, consistency and effective use was lacking. In Uganda, it is alarming that most youths assume that they are under no risk or under minimal risk but are actually under moderate or high risk. Risk perception blinds the young people exposing them more to higher infection. Due to the wrong perception of the risk, they display continued exposure to unprotected sex. Uganda has set an example worth emulating in sub-Saharan region for its triumph in reducing HIV prevalence rates. When HIV appeared in Uganda, it devastated the nation. However, the nation put up measures to control the situation and the prevalence rates declined. Despite the success story, the infection rate among young people is the nation’s cause of concern. The cause of worry is due to the circumstances surrounding the youth that expose them to great risks of contracting the disease. Ugandan youth venture into sexual activity, birth, and marriage at relatively early ages. The youth also have multiple partners who put them at a greater risk10. Young men are more likely to have several partners. In addition, there is a high rate of single girls who are sexually active. In the period between 1994 and 2002, there was a marked increase of multiple partner relationships and an emerging high number of non-marital relationships. More youth engage in sex at an earlier age11. Low contraception use among the youth is a cause of worry. Sexually active women who are not yet married commonly use condoms. Younger married women do not use any contraceptives even when there is a risk of infection. Despite the potential risk of the virus contraction, youth do not seem to be making positive behavioral changes to prevent infection. Most of the youth do not know enough of what they should concerning sexuality and this is a contributing factor in high prevalence among Ugandan youth. On interview, most young people confess that they have little knowledge on sexually transmitted infections. However, different circumstances compel them to indulge in sex. Most of the adolescents are in intimate relationships and are sexually active. Others indulge in sex because of material gain because of the prevailing social problems. These problems include poverty, low education, and coercion. Young girls are at a higher risk of contracting HIV because of having sexual partners who are much older. Since older men are at a higher prevalence of contracting HIV, this puts the young girls at a high risk. Response of the Faith Community in Addressing HIV In South Africa, about 162 faith-based organizations seek to address the HIV epidemic12. A great percentage of these are interdenominational. About 14% of these organizations work under the Catholic Church while 11% originate from the Pentecostal church. Another 6% work under the Anglicans, 6% Methodist, 11% Dutch reformed and 8% from the other varied denominations. In addition, there are Muslim and Hindu based organizations working towards control and prevention of the fatal disease. The faith-based organizations have different operational protocols and operate from different levels. Some of them reach out to a village, others to a town or city while others address provincial and national issues. Most of the organizations are actively involved in creating awareness, providing care and support, HIV counseling and testing programs and advocating behavior change. Other activities include food provision, taking care of orphans, training programs, medical care, and a few advocate condom uses. The figure below shows the level to which faith based organizations participate in these services13. Although most of the organizations were in existence long before the emergence of HIV, they took the epidemic seriously and expanded their programs to address the disease that was causing the highest mortality in society. HIV epidemic in South Africa has many implications and the government alone could not address the issue effectively. When the disease emerged in the country, some religious leaders arose to condemn those infected with the disease as immoral. However, other religious leaders realized then need of the victims and decided to give them the necessary support. In addition to support, they initiated programs to educate the people on the cause and transmission modes of HIV. In South Africa today, the faith-based organizations in collaboration with other sectors are making crucial contribution to the response to HIV. They are actively involved in awareness forums as well as provision of spiritual and material support14. In other cases, they offer emotional support. The following is the account of one of the organizations under the Catholic Church and its contribution in fighting HIV in South Africa and neighboring countries. The Catholic Church has been making immense contribution to the response to HIV through the ‘Choose to Care’ initiative. The Catholic Church coordinates its activities through the parish and diocesan system with the AIDS office Southern African Catholic Bishop’s Conference being the central coordinator. When the Catholic Church started, they had small-scale community programs that sought to address the needs of the community resulting from the HIV epidemic15. By scaling up the different small-scale services, they have been able to impact society through their activities. The society confesses of the impact of the ‘choose to care’ programs. The Catholic Church carries out its activities through two boards. These include the catholic medical mission board (CMMB) and the southern African Catholic Bishop’s Conference (SACBC) AIDS Office. The Catholic Medical Mission Board has earned international recognition in capacity building in dispensaries, churches, hospitals, and other community based organizations in issues related to health. The board collaborates with other organizations to provide quality treatment, prevention, and care. It participates in both national and provincial health projects and delivering health education at these levels. It also contributes to projects geared at stigma reduction among people living with HIV. The board has been in existence for along time and marked 75 years of its service in 2003. At that time, the board sought to address the needs of women and children who were highly vulnerable to HIV16. The board activities conform to the national guidelines and strategies of addressing HIV as well as the World Health Organization protocols. On the other hand, the Southern African Catholic Bishop’s Conference (SACBC) AIDS Office acts as a coordinator of HIV/AIDS response in countries in the southern region of Africa and these include Botswana, South Africa, and Swaziland. Some of its projects extend to Lesotho and Namibia through collaborations with their bishop’s conferences. In the organization‘s first initiatives, it organized HIV response programs such hospices, home-based care and education17. However, these programs lacked proper organizations. In 1999, the participating agencies convened and identified HIV as the issue that was exerting adverse effects in society and settled for the southern African Catholic Bishop Conference AIDS Office in 2000. The agencies involved included Catholic Institute of Education (CIE), Development and Welfare Agency (DWA) and Catholic Health Care Agency (CATHCA).They had many objectives when they formed the AIDS office. The office would coordinate AIDS response projects and raise necessary funds for projects at all levels. In addition, the office would work towards expanding the existing small-scale projects and facilitate relevant training. In areas where no projects had been se t up, the office would initiate projects in such regions18. The office would also provide support in monitoring and evaluation forums. Other objectives involved sharing models that depict the best practice particularly in HIV prevention and care. The office would extend its services to addressing the needs of families affected by HIV as well as the needs of orphans resulting from HIV mortality. Lastly, the office targeted to act as an advocate for issues dealing with children and budgetary reforms. In 2000, the Catholic Medical Mission Board (CMMB) and the Southern African Catholic Bishop’s Conference AIDS Office merged their efforts and formed the ‘choose to care’ initiative. The initiative was to receive funding from the Bristol-Myers Squibb and Bristol-Myers Squibb Foundation, which had volunteered to respond positively to the devastating effects of HIV in Africa. The foundation has established the ‘Secure the Future’ initiative already and ‘Choose to Care’ would work in conjunction with it. The CMMB and SACBC AIDS office proposed projects that received funding from the Bristol-Myer Squibb Foundation on approval. The collaboration produced positive impact in the society because 2006 statistics revealed that choose to acre had reached thousands of people through the staff network and projects. In South Africa, the ‘Choose to Care’ initiative reaches about 98% of the dioceses with projects on HIV education and home-based care. On realization of the high prevalence of HIV among youths, the initiative has ensured that 45 schools from all provinces have HIV education integrated into their curriculum. The initiative lasted five years and managed to achieve most of its objectives. The two organizations involved did not stop after the five years of the secure the future cosponsoring. On the contrary, the organizations have been seeking new sources of funds in order to drive more projects in the region19. In accordance to the mission-vision statements of the CMMB and SACBC AIDS Office, their projects aim at reaching the grass root level. Due to their Christian faith, they take care of the less fortunate and those accorded little value in society. The staff reaches out to victims of HIV even in the remotest areas. Their response projects to victims of HIV are from all levels. This includes individuals, small groups of the laity and parish projects. One of the programs run by ‘Choose to Care’ initiative addresses the most crucial issue of high HIV prevalence among the youth. The initiative seeks to carry out prevention campaigns that are holistic and based on values. These prevention campaigns target the highly vulnerable youth. The initiative develops activities that help develop positive attitudes among the youth. Positive attitudes will help the youth take personal responsibility in the HIV issue. Such attitudes are likely to influence the lifestyle choices of the youth20. The prevention campaigns also seek to make youths aware of the potential risk of contracting HIV and dissuade them from irresponsible behavior. In addition, such campaigns dissuade youths from engaging in behavior that increases gender disproportions. The initiative staff urges youth to take up behavior that will enhance gender equality21. By doing this, the gender disproportion in HIV prevalence will decrease. The program also seeks to empower youth and provide them with jobs in order to reduce poverty that is a key contributor in the increasing HIV prevalence. The initiative identified factors that increased the prevalence rate among the youth. They discovered that the apartheid system broke family bonds through labor migrations. The breakage of the family unit implies that children grew up without proper guidance from their parents. In addition, poverty compels some of the families to opt for sex work to earn a living. The high prevalence in young people is a result of children raising their siblings after the death of their parents. Those who take up the responsibilities of breadwinning are likely to indulge in irresponsible behavior. In addition, older individuals are likely to take advantage of the younger girls and this increases their chances of contracting the virus. Interventions to the Infected and Affected Individuals The faith community indulges in varying activities as those enumerated above22. The organizations realize that both the infected and affected individuals need attention, love, and care. Some services seek to address the needs of the people living with AIDS (PWA). These people need medical care and management in order to lengthen their lifespan and protection from rampant opportunistic diseases. Affected individuals include family members who have to take care of the sickly, breadwinners in HIV stricken families, orphaned children resulting from parents succumbing to the disease and vulnerable groups23. Faith based organizations realize the varying needs and carry out different activities to cover a wider scope of the needs in society as a result of HIV. One of the infected and affected groups in South Africa is children below 15 years of age. Children in this country feel the social impacts of HIV even if they are negative. Some of the children are unfortunate enough and contract the virus during birth. Most of the children born to HIV positive mothers succumb to the disease at an early age. Those who do not contract the virus lack proper care from HIV positive mothers. They cannot breast feed and need nutritional supplements. Other children lack education opportunities because they come from families affected by HIV and poverty making the situation unbearable. Other children grow under the care of the elderly who lack sufficient resources. Most of the children losing parents through HIV and those living in families where one or more family members are ailing suffer emotionally. These children do not seem to understand anything that is happening in their lives. They cannot grow as emotionally fit individuals and suffer numerous social challenges. Other children feel neglected, abandoned, and live in the streets. These children need love and care. Those who are infected need specialized medical and nutritional care. HIV has immense effects on children and these compel the faith community in conjunction with other organizations to act and save children. Most of the faith-based organizations have programs that target children. Projects include identification of such needy children and enrolling them to projects that seek to improve their welfare. Some organizations provide food supplies to the families of such children. Others enroll them to education support programs24. The remarkable effort done by most of the organizations is opening up children homes where the children can receive housing, education, clothing, emotional and spiritual support. Children homes enroll orphans who lack a caregiver, street children, and any of the categories above. The staff works towards developing a favorable environment for the growth of these children. In these homes, infected children receive the required medical support specialized nutrition. Women and girls form the other group of vulnerable individuals in South Africa. Faith based organizations carry out different intervention programs to improve the welfare of the feminine gender. Since most of the organizations provide links to medical services, those infected receive regular medical check-ups and get a timely introduction to the anti-retroviral therapy depending on the stage of infection. In addition, there are training programs geared towards making infected women and girls accept their status and live positively. Other projects empower women economically to sustain themselves despite their status. Other programs empower women as caregivers in the society. Since they are nurturers, they need understanding on the management of the disease at several stages. Training of effective use of the antiretroviral therapy use is available to many of the women and girls. In addition, creating awareness of the risks of infection among women and girls who are very vulnerable is essential and forms a great percentage of the activities of the organizations. The staffs enlighten women on the issue of gender and the epidemic in order to empower women to prevent further infections. Training on sexuality among young girls and prevention measures are available. Women also receive guidelines on measures of risk reduction to reduce HIV prevalence. Other interventions target to minimize stigmatization against HIV positive people. These people undergo motivational and training programs and receive relevant empowerment to live positively and in acceptance. The staffs of the organizations encourage these people to start change from within them25. Other programs indulge the whole community and train them on the importance of accepting the infected individuals as part of the society. Stigmatization hinders any positive progress towards management of the disease. When the disease emerged, most of the religious leaders denied the fact that HIV could affect anyone in society. Religious leaders received accusation of condemning the infected. However, with time, the reality of the disease dawned on them and majority of them call for portrayal of love and care to people living with HIV. Maternal medical care that addresses the epidemic is a necessity in the country. Faith based organizations have risen to participate positively by providing additional services in dispensaries and local hospitals that screen expectant mothers and give them relevant advice according to their status. Most of the mothers begin the relevant medication in order to minimize chances of mother to child transmission. These mothers receive regular check-ups in order to improve their health status in preparation for the baby. Other faith-based organizations address the issue from a different point of view. They advocate for abstinence among the highly vulnerable group26. Abstinence is a sure way of prevention since the common mode of transmission in South Africa is through heterosexual relationships. They train the youth to indulge in worthwhile activities focusing on their future aspirations. The youth receive training on facts about the epidemic from the trained staff. These organizations dissuade youth from indulging in sexual activity at tender ages. They urge the youth to concentrate on career building and spiritual matters that will keep them away from the risk of infection. The highly vulnerable group receives capacity-building programs for behavior change and responsible behavior. Other forums disseminate relevant information on the use of condoms as a preventive measure. Although religious groups opposed the use of condoms in the first place, they have come to realize that youth are sexually active and need to protect themselves. Some organizations distribute condoms in rural areas where people lack access of condoms and other contraceptives. Youth receive training on effective use of contraceptives although the key preventive measure is abstinence27. Other faith based organizations and churches concentrate on rebuilding the values of the family unit whose breakage has resulted to higher vulnerability among different groups. Youth growing up in broken families are likely to indulge in sexually risky behavior because they lack parental guidance. The family unit disintegrated greatly in South Africa because of the apartheid labor migration. Restoration of the family unit will rebuild society generally. Restored families will provide love, care, and guidance to children and this will protect them from the disease. Restored families will provide care to those who are terminally ill. Other organizations realize the contribution of substance abuse and alcohol use in the HIV epidemic. They work in conjunction with relevant partners to raise campaigns against irresponsible alcohol use among young people. Alcohol and substance abuse make the South African youth more vulnerable to HIV. Under substance influence, the youth cannot make rational decisions and are at a higher risk of indulging in irresponsible sexual behavior. The church and faith based organizations urge the youth to stop substance abuse and assume healthier lifestyles. Other organizations provide youth with relevant support to triumph over drug abuse. Most of the organizations and faith community encourage people to undergo testing, as this will enable them plan for their future on informed grounds28. Some organizations offer testing and counseling sessions that empower people to make informed choices before getting into relationships and marriages. The faith community encourages people to abstain in order to maintain their negative status. Those found positive on testing receive proper counseling and medical supports to enable them manage the condition effectively preventing further spread of the disease. The church and faith community and faith-based organizations indulge in a wide scope of activities that relate to the HIV epidemic29. Although the first impression of victims was greatly negative, the reality of the devastating situation has changed their view. The church intensified the stigma against HIV victims at first but it has learned to commit to caring for those infected and affected by the disease30. The United Nations recognizes the role of faith-based organizations in curbing and fighting spread of HIV in the South African community and appreciates that they are doing remarkable work. Testimonies from people benefiting from the available services confess the impact of faith-based community projects. HIV/AIDS remains a devastating tragedy in South Africa. The rates of prevalence and new infections have not changed greatly and the great nation has the worst scenario in Africa. The high prevalence among the youth causes more concern and worry as the future of the nation is at the verge of collapse. Comparison with Ugandan statistics paints the picture of HIV prevalence in Sub-Saharan Africa. The region is at great risk. The success story of Uganda reveals that South Africa can triumph over the epidemic if all government sectors commit to fight HIV. The faith-based community has set the pace for other sectors in addressing the issue. Their projects and programs in addressing the epidemic are making a difference in society31. Work Cited Birdsall, Karen. Faith-based responses to HIV-AIDS in South Africa. Web, 11 April 2012 from http://www.cadre.org.za/files/FBO-Report.pdf Human Sciences Resource Council. South African National HIV prevalence, incidence, behavior and communication survey, 2008. Web, 11 April 2012 from http://www.mrc.ac.za/pressreleases/2009/sanat.pdf Karim, S. Abdool and Karim, A. Q. HIV/AIDS in South Africa. (Cambridge: Cambridge University Press, 2010), 306-315. Kibombo, Richard et al. Perceptions of risk to HIV infection among adolescents in Uganda: Are they related to sexual Behaviour? Africa Journal of Reproductive Health 11(3), 2007 from http://www.guttmacher.org/pubs/journals/reprints/AJRH.11.3.168.pdf Lehohla, P. Statistics South Africa. Web, 11 April 2012 from http://www.statssa.gov.za/publications/P0302/P03022010.pdf Lekhraj, Om. Role of faith-based organizations in mitigating HIV/AIDS-related stigma in religious communities. Web, 11 April 2012 from http://pluralism.org/international/spotlight_images/om.pdf Motsoaledi P. Country progress report on the declaration of commitment on HIV/AIDS. Web, 11 April 2012 from http://data.unaids.org/pub/report/2010/southafrica_2010_country_progress_report_en.pdf Poul Rohleder et. al. HIV/AIDS in South Africa 25 Years On: Psychosocial Perspectives. (New York: Springer, 2009), 359-365. Reproductive Health Research Unit. HIV and sexual behavior among young South Africans: a national survey of 15-24 year olds. Web, 11 April 2012 from http://www.kff.org/southafrica/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=34051 Sherrod R. Lonnie. Youth Activism: An International Encyclopedia, Volume 1 (Greenwood Publishing Group, 2006), 62-70. USAID/SOUTHAFRICA, HIV/AIDS health profile. Web, 11 April 2012 from http://www.usaid.gov/our_work/global_health/aids/Countries/africa/southafrica_profile.pdf Read More