Controlling the Spread of HIV / AIDS

HIV/AIDS Introduction HIV/AIDS is among the most devastating diseases and infections of present times. The disease has been responsible for close to 35 million deaths as of 2011 since it was first diagnosed in the early 1980s. The most troubling aspect of the disease is that as of yet, there still exists no cure for it and contracting the disease had over time normally amounted to a death sentence. The scourge of HIV/AIDS has been debilitating on certain groups of people in the population. These groups include the homosexuals, in-vitro drug users, and persons engaging in unprotected sex.

The nature of spread of HIV is common among these individuals since individuals in these groups engage in risky behaviors, thus making prevalence among them exceptionally high. In terms of countries and worldwide prevalence, the third world countries of Sub-Saharan Africa, South-East Asia, Caribbean states, and Latin America are hard hit by high infection rates.

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On the other hand, the infection rates in most of the developed countries of Europe and North America are comparatively lower. Having identified the threat that HIV/AIDS poses, based on the neorealist perspective, various governmental and non-governmental initiatives have come together in the past two and a half decades with the aim of completely eliminating the disease (UNAIDS, 2011). To this effect one of the most successful strategies has been the adoption of a liberal perspective on matters HIV/AIDS by viewing the freeing of individuals from the scourge as a basic human right. Therefore, in order to effectively minimize infection and mortality rates, access to preventative measures and treatment for the disease ought to be treated as basic human rights. Significant strides have been achieved in minimizing infections and preventing deaths by use of antiretroviral (ARV) therapy. This paper looks at the role played by major players in terms of prevention and sensitization efforts. To this effect, this paper examines the impacts that the United States has had, and the progress that a sub-Saharan country, Uganda, has had in dealing with the disease over time.

America The threat of HIV/AIDS in the United States is not significant, especially when contrasted to other diseases such as cancer and cardiovascular ailments (NPIN, 2012). According to World Health Organization data for 2009, the United States ranked 64th worldwide in terms of adult (aged 15-49) prevalence, with 0.6% of this group infected (UNAIDS, 2011). However, the disease represents a significant threat to the lives of the minority groups and other high risk individuals such as drug users and alternate sex individuals. Unlike in most parts of the world, such as Sub-Saharan Africa, where heterosexual activities accounts for close to three quarters of the infections, the case of the US is quite the opposite. In America, homosexual activities

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account for nearly two thirds of the infections reported annually, with drug use coming in second and heterosexual activities following closely behind (NPIN, 2012). Based on these statistics, it goes without saying that a majority of the American prevention strategies are largely focused on homosexuals and drug users.

The American HIV/AIDS prevention strategy is largely driven by the Department of Health and Human Services and the various agencies operating under the department. Among the most active agencies operating in the US are the Centers for Disease Control and Prevention (CDC) and the National Prevention information Network (NPIN) (NPIN, 2012). These agencies have had substantial success in their prevention efforts within the US. For instance, the infection rates for HIV/AIDS have gone down from an all time high of 150,000 in the early to mid 1980s to about 55,000-58,500 annually as of 2011 (CDC, 2012). This is a significant trend in the reduction of infections since this drop in infections over a period of two decades represents one of the world’s most significant drops. However, poor handling of the problem during the initial years of first diagnosis of HIV/AIDS represented a poor judgment call on the part of countries like the US. Countries did not view the disease as being a global challenge but rather an individual problem to be dealt with internally (UNAIDS, 2011). The result of this was that the disease ended up spreading like world fire in the 1980s up until the early 1990s. Based on neoliberal perspective, nations realized that HIV/AIDS represents a common challenge that negatively affects all regardless of race or status.

America’s success in dropping infection rates is not coincidental; rather, it is as a result of hard work that was undertaken in terms of sensitization campaigns (UNAIDS, 2011). Such campaigns have involved the nation making tough moral choices such as the recognition of gay rights and acceptance of their way of life. Initially, the widespread condemnation and judgment

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against homosexual behavior was credited for the astronomically high infection rates among homosexuals. Change in perception by those driving the prevention agenda, and the realization that it is imperative to work with, rather than against, the homosexual community to limit infections has borne fruits (UNAIDS, 2011). Another strategy that has borne fruits is that of involving social workers in educating drug users and supplying needles and injections. This is to discourage the sharing of the needles which may contribute to infections. The ethical question of such a strategy abounds especially with the morality attached to supplying objects that inadvertently end up promoting drug use. The results of the initiatives, however, cannot be faulted since the initiatives have resulted in lesser infections.

The introduction of anti- retroviral therapy (ARV) use in the US has had a significant impact on not only on the drop in deaths related to HIV/AIDS, but also in prevention (CDC, 2012). The prevention aspect of ARV use has largely been as a result of the complementary benefits that arise from persons actively seeking treatment. On regularly receiving drugs for treatment, the infected individuals also end up getting counseling and advice on how to minimize re-infection and super infection. Initially, what was credited for the high death rates of HIV/AIDS were the additional risks that continual engagement in risky behavior had on the already compromised immune system. The re-infection from other infected persons and/or super infection by a different strain of the virus can render an ARV remedy ineffective (CDC, 2012).

Uganda Perhaps nowhere in the world has the HIV/AIDS pandemic been felt more than in SubSaharan Africa. The severity of the disease is such that, according to the WHO, the top twenty countries with the highest prevalence rate are all from sub-Saharan Africa. What contributed to this trend was the nature of how nations dealt with the disease initially. The approach that saw

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individual nations take self responsibility for managing the disease saw the developing nations greatly loose the battle. A combination of factors, such as a lack of resources, restrictive culture and lack of technical know-how all contributed to the astronomical infection rates that developing countries faced (UNAIDS, 2011). Based on 2009 WHO statistics, Uganda is 10th in the world in HIV prevalence, with approximately 6.5% of its population aged between 15 and 49 years being infected (UNAIDS, 2011). Despite these worrying statistics, the East African country has made significant strides in curbing its prevalence rates. Unlike other sub-Saharan African nations, where despite various prevention efforts the infection rates increase continually, the case of Uganda has been quite different with the infection rates, instead, going down. During the 1980s and early 1990s, Uganda was among the worst hit nations in terms of HIV infection rates and the number of deaths resulting from HIV/AIDS related illnesses and infections. In Uganda, the highest risk groups happened to be heterosexual couples, with pregnant women being particularly susceptible to infection.

In Uganda, much like in most of Sub-Saharan Africa, transmission of HIV/AIDS as a result of in-vitro drug use and homosexuality accounts for less than 10% of the infections.

Instead, those who are at a greater risk in the continent happen to be women, who in Uganda happen to be nearly 30% more prone to infection (WHO, 2012). This scenario can largely be credited to cultural practices that have seen matters of sex being the prerogative of the males.

Although over time western style modernization has resulted in women having increasingly more say in sexual matters, culture is still heavily entrenched in this society. For instance, polygamy and continued engagement in unprotected sex has been credited to increased infection rates, especially in rural areas. However, leading international organizations such as the USAID and several UN agencies tasked with poverty eradication, community development and health maters

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have helped Uganda significantly in HIV prevention. These agencies have been helpful in providing the Ugandan government and NGOs working in the country assistance to run HIV/AIDS prevention programs (UNFPA, 2009).

The result of this cooperation has been the introduction of programs that are targeted at the most at risk groups in the country (WHO, 2012). For instance, aid in the health sector has enabled the Ugandan government provide free or significantly subsidized prenatal care to expectant mothers. The net result of this initiative has been a drop in mother-to-child transmission. This is significant considering that in 1993, 31% of pregnant women visiting health centers were HIV+ (WHO, 2012). The introduction of condom use has also been a successful campaign as it has significantly reduced infection rates. The USAID has been instrumental in providing funds for supplying condoms within Uganda (UNFPA, 2009). The result has been an increase in condom use from 7% nationwide in the early 1990s, to over 50% and 85% in rural and urban areas respectively by 2011. Other successful initiatives that have resulted from combined force between the Ugandan government and donor groups has been the setting up of volunteering counseling and testing (VCT) services (UNFPA, 2009). The penetration of these VCT services has been instrumental in increasing the access of infected persons to ARV medication and in gauging the country’s progress in HIV/AIDS prevention.

Conclusion HIV/AIDS represents one of the greatest challenges of the 21st century of which all countries in the global community have to come together so as to deal with. The lack of a cure, coupled with the several transmission avenues present an extremely difficult challenge in terms of treatment and prevention. In the developed nations such as America, the nations have managed to reduce the infection rates significantly among the main risk groups of homosexuals

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and in-vitro drug users However, the initial pursuance of self interests in terms of dealing with the scourge over time turned out to be the wrong call. The most successful steps with regards to fighting the disease have been the cooperation among states. Third world nations, and particularly Sub-Saharan nations, such as Uganda continue to bear the heaviest burden of the HIV/AIDS scourge. This is due to a combination of factors, such as poverty and cultural issues that make dealing with the pandemic a serious challenge. However, with the combined efforts between the government and donor agencies, Uganda has shown the rest of the Sub-Saharan continent that it is possible to decrease HIV infection rates significantly.

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Centers for Disease Control and Prevention (CDC). (2012). Effect of antiretroviral therapy on risk of sexual transmission of HIV infection and super infection. Retrieved on 1st October 2012 from http://www.cdc.gov/hiv/topics/treatment/resources/factsheets/art.htm National Prevention Information Network (NPIN). (2012). HIV prevention today. Retrieved on 1st October 2012 from http://www.cdcnpin.org/scripts/hiv/prevent.asp UNAIDS. (2011). World AIDS day report|2011. How to get to Zero: Faster. smarter. better.

New York, NY: UN Publications.

UNFPA. (2009). Donor support for contraceptives and condoms for STI/HIV prevention 2009.

New York, NY: UN Publications.

World Health Organization (WHO). (2012). Uganda reverses the tide of HIV/AIDS. Health a key to prosperity: Success stories in developing countries. Retrieved on 1st October 2012 from http://www.who.int/inf-new/aids2.htm