Combating HIV/AIDS in South Africa - Case Study Example

Running Head: Combating HIV/AIDS in South Africa Combating HIV/AIDS in South Africa Name Course Lecturer Date Introduction HIV/AIDS is one of the leading causes of death in South Africa. About 5.7 million individuals were living with the disease in the country by 2011. This is the highest number ever recorded in any particular country. Still, in the same year more than 550,000 were reported to die as a result of diseases that are related to AIDs. Despite the fact that the estimation mirrors the huge number of people that have succumb as a result of the diseases, of importance to note is the fact the number is estimated to be 100,000 less as recorded in the previous years. This indicates that there are many lives that have been saved since 2001. It is currently established that more than 5 million of the population are living with HIV/AIDs and this represent approximately 12 per cent of the whole population in the country. Statistics indicate that 1 in about 4 individual is infected with the virus between the age of 16 to 49 (Peltzer et al., 2009). Indeed, the has created a challenge in meeting the 8 goals as set by the United Nations in relation to the Millennium Development Goals (Medecins Sans Frontieres, 2005). It is important to note that combating HIV/AIDS in the country is under MDG 6. This paper focuses on understanding how south Africa is doing to combat with the high rates of HIV/AIDs as a way of achieving their MDGs. It is important to note that despite the fact the country has a negative response to HIV/AIDs over the past years which is attributed to the government response to the epidemic (most leaders in the government doubted the real science behind ARVs and HIV/AIDS thus they did not take timely measures to curb its spread) in the recent years, however, the government has showed its readiness to mitigate the spread of the epidemic in order to cover the country’s MDGs and this has made South Africa to be one of the leading countries which has introduced massive programs on the treatment of HIV. As a result, even the country’s life expectancy has increased by five years. However, the country has not been able to achieve its goal on accessing the ARV treatment by the year 2010. As such, it will have a long way o go before achieving the expected MD of revering and halting the spread of HIV by the end of 2015. At the moment HIV prevalence among the general population is about 17 per cent but the percentage varies according to regions. Despite this, the most important issue is the commitment of the government in fighting the epidemic in all regions and it has done so through outlining various factors including historical, cultural and structural to ensure the epidemic has reduced significantly (Andrews et al., 2007). Combating HIV/AIDS HIV has had a major impact on the population and this has been seen through its dramatic change in the mortality rates in the general population. 1997 and 2006 recorded the highest number of death among adults depicting the burden the HIV had o the population. It is important to note that those who feel the burden of the epidemic are young adults whereby most women between the ages of 25 to 29 being the most hit as compare to men of the similar age bracket. As such, the disease has caused a devastating impact among the children. Not only as a result of the death of their parents at a young age but also as a result of the premature death due to HIV. As records have it, the number of premature death has risen significantly from approximately 40 per cent to about 74 per cent in 2010 (Jewkes 2009). The rising number of orphan has placed the country in a hard economic situation given the fact that these children are mostly left in the hand of the old grandparents who may lack the means of taking care of the children. As such, the government is expected to step in order to assist. This depicts that the government has to set aside some funds, which could have been used in other in other significant programs in the country, to cater for such situations. Poverty has also been experienced in regions where the epidemic is rampant. Particular group in South Africa are more at risk of contracting the disease such as sex workers, gay men and people who abuse drugs. Others include people who live in low status in the society, people who do not attend schools and those who are physically challenged and prone to sexual abuse. Among the gay men, about 9 per cent of new infection of HIV has been reported. However, prevalence among the group varies according to the geographical nature and some regions have recorded a high percentage of infection among this group such as Johannesburg (Dolan et al., 2007). Given the fact that many gay men are unlikely to disclose their sexuality, it is hard to curb HIV in the group. However, services are being tailored to target such issues through training health care how to handle such sensitive issues. It is important to note the country is one of the few countries in the world that have legalized homosexuality and therefore, it is given a priority in the mitigation of HIV (Herget, 2006). According to Wohl et al. (2006) the sex workers contribute to about 19.8 per cent of the new infections recorded in the country in 2010. Notably, sex workers are the most exposed group to HIV in the country. This is attributed to the fact that some of them live in poverty, are exposed to gender based violence and they take drugs. Police harassment has in a way been a barrier in exposing the sex workers to HIV prevention services. There are various historical factors that have been targeted in combating the high rate of infection in the country. For instance polygamy, female genital mutilation and infibulations have played a significant role in the increase of new infection among the women as compared to men in South Africa. As most medical practitioners have realized most young women in the country are at higher risk of contracting HIV due to the aforementioned factors and other such as poverty. For example in 2005, among people between the ages of 15 to 24 who had been infected 16 per cent were women while 4 per cent were men. Apart from the named factors that; the high number of infection among women is also as a result of biological susceptibility. For instance one of the biological is the fact that many young women who are sexually active are at a tender age and their immature cervix is susceptible to the entry of the virus. Others include abnormal vaginal flora, pregnancy and hormonal contraceptives (Wohl et al., 2006). As earlier seen the historical practice of genital mutilation has also played a significant role in the spread of the epidemic. This is attributed to the fact during the ceremony the tools used are shared among many people without sterilizing them (Chatterji et al., 2005). However, the health sector has adopted various measures to curb the practice as not only does it result to the spread of HIV but also play a major role in affecting the sexual life of a woman. Polygamy is an accepted practice among various communities in the country. This practice indeed, offers a platform where HIV may thrive in a particular polygamous family given the fact that it is hard to for a man to control sexual activities of every wife (Lopman et al., 2007). There are various cultural factors that are being targeted in combating the spread of HIV/AIDS in the country. These include lack of male circumcision, rape, intergenerational sex, gender inequality and incarceration. In South Africa the rate of male circumcision is said to be low and most of the men who circumcised underwent the rite through traditions set ups. However, given the fact that circumcision has been discovered to be one of the ways of reducing HIV infection among men, it is therefore, disturbing to realize that this is not embraced in the country. Of most important to note is the fact that where male circumcision is practiced, the rate of women infection with HIV is also reduced. The government, however, has undertaken measures to utilize male circumcision in dealing with HIV in the country. It is providing circumcision to young and adolescent men in the country. In doing so, the health sectors has scaled the age at which circumcision should be carried out, assent and consent issues and the basic safety issues that should be considered during the practice (Kober & Van Damme, 2004). Most researchers have argued that incarceration as a factor that result tor the increase of HIV infection has been under recognized in the country. This has resulted to the increase in infection among blacks who are imprisoned. It is therefore, important for the government to lay working strategies that will address the spread HIV among the incarcerated people in the country (Thomas & Torrone 2006). Notably, the government developed important resources in the treatment, support care of people living with HIV in prisons. It has provided free antiretroviral therapy to the incarcerated individuals as these groups of people are likely to miss the treatment if the government does not step into the situation. In addition, the health sector is also able to provide intervention programs among same sex intercourse incarcerated people as they are limited legal barriers (Simooya & Sanjobo, 2006). Rape and violence among is some of the outdated practice in some communities and has indeed played a huge role in increasing the rate of infection among women. It is recorded that 1 woman is raped in a given second in South Africa. The fact that rape is likely to be unsafe and in the likely of a condom may tear, it becomes a thorny issue faced by not only women but also the health sector which needs to come up with measure s that will reduce new infection after a rape case. Gender violence is rampant in the country. Many women in South Africa have faced physical violent from an intimate partner. However, there are various interventions that have been introduced to curb these situations. One of these interventions is Refentse which is a model for post rape support and care, therefore, providing assistance to women who have faced the aforementioned situations. This service has indeed improved access to emergency referrals and contraception and counseling to the victims. Similarly, structural factors have recorded a significant role in relation to various approaches to HIV in South Africa. These include education inequality among the citizens, insufficient medical attentions, and increase in the rate of unemployment and poverty in various communities. In these communities, there are limited programs and health workers involved in the treatment of HIV. As such, there is a need to distribute health workers evenly in order to mitigate the spread of HIV (Herget, 2006). Poverty has continued to be associated with the prevalence of HIV in the country. Poor communities lack the required social infrastructure resulting to the promotion of infection. Poor people due to lack of other alternatives to make end meets may indulge themselves in unsafe sexual practices which may result to new infection. This is true as most researchers have found out that the highest percentage of HIV infection is among low socio-economic population (Bärnighausen et al., 2007). Generally, there are many interventions may carried out by the government in order to reduce HIV transmission in the country. This is attributed to the fact that it has continued to affect the realization of the country’s MDGs. These programs aim at promoting the use of condoms, preventing intergenerational sex and delaying sexual debut, distributed more ARVs to the communities and group of people most affected. Some structures are also designed under the ABC guidelines. The health sector is also working closely with communities in order to emphasize the need of undergoing HIV testing and subsequent treatment in case of infection. In support of this, various national campaigns have launched to emphasize the need of voluntary counseling and testing among individuals. In addition, it has been able to reduce the transmission through mother to child, increase in HIV awareness education. Recommendations and Conclusion However, in order to meet the country’s MDGs in relation to good health, there is a need for the health sector in conjunction with the communities to continue emphasizing safe sex in the population. Still, this should be accompanied with more campaigns that emphasize the need of having voluntary counseling and testing. The government should also increase the rate at which it is distributing ARVs especially o the marginalized people n the society. The government should also address issued related to unemployment as it is a root cause of poverty, drug abuse, criminal cases that are all related to the spread of HIV in the community. Finally, the health sector needs to work with various NGOs that are assisting communities in addressing the epidemic. Essentially, despite the fact that there are still new cases of HIV in South Africa, it is evident that the government is putting place measures that will result to positive actions towards the epidemic and achieve its set MDGs in relation to health. However, as seen, the country has not yet its set MDGs level on some issues such as distribution of ARVs in the country. However, it has been able to reduce the spread of HIV through mother to child transmission by introducing effective strategies, implementation of voluntary counseling and testing, introduction of dual therapy and in the distribution of condoms. However, despite the success in the intervention, there is more to be done to continue mitigating the HIV/AIDS infection in the country. References Medecins Sans Frontieres .(2005). 'The TB/HIV time bomb: A dual epidemic explodes in South Africa' . AIDS; 21(Suppl 7):57–66. Lopman B, Lewis J, Nyamukapa C, Mushati P, Chandiwana S, Gregson, S. (2007). HIV incidence and poverty in Manicaland, Zimbabwe: is HIV becoming a disease of the poor? AIDS; 21(Suppl 7):57–66. Chatterji, M, Murray N, London D, Anglewicz P. (2005). The factors influencing transactional sex among young men and women in 12 sub-Saharan African countries. Soc Biol. 52:56–72 Kober K, Van Damme W. (2004).Scaling up access to antiretroviral treatment in southern Africa: who will do the job? Lancet 364:103–7 Herget G. (2006).Namibia: anti-homosexuality law undermines HIV prevention in prisons. HIV AIDS Policy Law Rev. 11:34–6. Simooya, O & Sanjobo N.(2006). HIV/AIDS is still a double sentence in prisons. BMJ. 332:119–20 Thomas,J & Torrone E. (2006). Incarceration as forced migration: effects on selected community health outcomes. Am J Public Health. 96:1762–5 Wohl ,A, Rosen, D & Kaplan A. (2006). HIV and incarceration: dual epidemics AIDS. Dolan K, Kite B, Black E, Aceijas C & Stimson V. (2007). Reference Group on HIV/AIDS Prevention and Care among Injecting Drug Users in Developing and Transitional Countries. HIV in prison in low-income and middle-income countries. Lancet Infect Dis.7:32–41 Bärnighausen T, Bloom, D & Humair S. (2007).Human resources for treating HIV/AIDS: needs, capacities, and gaps. 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