Social Aspects of HIV/Aids, Education & Community Mobilisation
HIV/AIDS is a slow progressing disease, which may exhibit different symptoms from different people. Oropeza, Bradley and Johnson (2006, p.6) opined that these symptoms are identified by the stage of development. At the initial stages, the symptoms are few or none at all. After a longer duration, it is manifested through decreased immunity and frequent opportunistic infections. HIV/ AIDS crises have raised a lot of concern among many nations in the world. Armstrong (2003) observed that the HIV scourge is growing at an alarming rate as noted in the 20th century. It has even affected some nations’ economies. Brady (2004, p. 46) argues that in Australia, the most common means of HIV transmission was Homosexuality, but in recent times, heterosexuality has also become a significant contributor in HIV transmission. This is common among the indigenous communities, while homosexuality is common among the urban residents. The continuous increase in the rate of transmission has prompted the media and social organizations in Australia to provide HIV awareness and education. This is in an effort to control the rate of transmission and keep it at the lowest point possible.
Ward, Akre andKaldor (2010), indicate that the number of infected people has grown, and this is a threat to infections if preventive measures are not taken. HIV and Aids has been a significant cause of premature deaths among the Australian community. Initially the issue of Aids was not given the relevant attention as a life threatening condition until the situation got worse when indigenous communities started getting infected. This was attributed to lack of knowledge and the remote access to health services that they had.
Ward, Akre andKaldor (2010), state that the issue of HIV/AIDS has increased the cases of health problems among many communities in the world. This includes the remote people, who may not have easy access to health services. This paper will discuss the health issues associated with HIV/AIDS, and their transmissions. It will discuss HIV/AIDS among the homosexual community and the indigenous people in Australia. It will further discuss the preventive measures that have been adopted to curb this problem and minimise the cases of transmission.
HIV/AIDS Health Issues among Men and Indigenous people of Australia
Robinson (2008 p. 46) argued that the homosexuals have the greatest risk of HIV transmission than any other group in the world. This also includes other Sexually transmitted diseases like Syphilis and gonorrhoea among others. Elford et al (2004) further observed that, in most cases, homosexual men infected with HIV do not know the status of their partners before infection. They assumed that their partners had a similar status. This assumption and lack of information on the risk of engaging with partners whom status is not known contributed to increased infections. Mansergh et al (2001) argued that, events that promote the gay culture like the case of circuit parties in North America are also contributing factors to increased HIV transmission. According to a study done about the activities of the circuit parties, it was discovered that gay men use drugs and engage in unprotected sex. This exposure makes peoplemore prone to HIV than other people because of nature in which they practice unsafe sex. Stall et al (2003) states that in Australia, homosexuality was the first form of HIV sexual transmission. Men with sexual relationships with fellow men experienced more health problems associated with HIV as compared to other HIV positive straight men. This is because these people are not only homosexual, but have also been known to abuse drugs and experience psychological distress. This stress makes people vulnerable to HIV infection because they abusedrugs and engage in risky sexual activities.
Thompson, Greville andParam (2008), observed that homosexuals who use drugs are ranked among the most vulnerable groups to contracting HIV. They belong in the same category as sex workers. The health problems associated with HIV tend to be interlinked with the social habits that people engage in. In the case of HIV positive homosexuals, their condition is worsened by the fact that they are not accepted in the community. This gives them psychological distress because once they are infected they feel that the society blames them for their status. Stress affects the level of immunity of a person, this coupled with the HIV result to premature deaths. It has been observed that those people who die of AIDS especially in the past was not only because of the virus but also the stigma associated with the disease.
Snoek Et al (2005), states that discrimination has contributed to the increased HIV related deaths, and has also frustrated the efforts to fight this disease. People avoided disclosing their HIV status to their immediate families and friends in the fear that they may be ridiculed and blamed for their current status. This resulted into advanced health conditions due to the concentration of the virus which could have otherwise been avoided through drugs.
Thompson, Greville andParam (2008), argued that, for the indigenous people, the subject of health care provision has been divided due to the cultural differences and the economic strain among these people. This has resulted in underutilization of medical services, thus poor health. This can be regarded as a form of injustice to these people because they are disadvantaged, unlike the gay society which has been given a lot of attention. They have the notion that HIV is a homosexuals’ and city dwellers’ disease. There have seen a considerable number of them getting infected. Alcohol abuse has also contributed to the increased cases of HIV infection among the indigenous community. The neglect of this community made people vulnerable to HIV transmission due to their little knowledge. The rate of HIV is higher among the aboriginal communities because of their culture that does not prohibit extra marital affairs.
Ward, Akre and Kaldor (2010), discussed the Aboriginal community’s health status as poor, and this is similar to their socioeconomic status. The leadership of this community has separated itself from the government, which has resulted to them getting little health support. The support that they require from the government has not been adequately received over the past. They insisted on running the health activities separately, thus they were neglected because of this separation. This strategy only served to solve short term health problems and may not be as effective as the government initiated plans which look into the future. Thus, the Aborigines’ have partly contributed to their current health problems especially in HIV/AIDS. Thompson, Greville and Param (2008), argue that their leadership and culture separated them from the urban culture, and they were denied equal access to health care services enjoyed by the urban communities.
Ward, Akre andKaldor (2010) observed that since the late 1980s, this attitude changed when cases of ordinary people contracting this virus increased. It was realized that anyone has the potential of getting the infection whether belonging to the high risk groups or not. HIV was viewed as one of the chronic conditions unlike earlier when it was regarded considered a “death sentence”. In the 1990’s drugs that could suppress the effect of this virus were introduced which was a vital step towards overpowering this disease. There is, however, a concern that these medicines meant to improve the quality of life could have a negative effect. This is because their introduction made the HIV infection become a matter of less concern based on the assumption that after all the disease could be treatable. The fear expressed in the past became less, and guard against it was not as strong as before.
Snoek et al (2005) argues that Casual sex is the main cause of HIV transmission among both the gay and heterosexual communities of Australia. Unlike past assumptions that the city gay males were the ones contracting the virus, any person engaging in casual sex was exposed to the risk of infection. For the homosexuals, HIV transmission rate rose, not because they were not aware of the dangers, but because of ignorance and the assumption that the casual partners were not infected. However, for the indigenous community, the rate of infection is attributed to lack of HIV knowledge with cases of people who had not heard of this virus. The homosexuals were affected by the frequent casual sex contact while the indigenous people had no objection to extra marital activities.
Stereotypes about HIV have also affected the people who are living with the virus. Persson and Newman (2009) stated that there have been assumptions that some people are innocent while others are guilty of their infection. The HIV positive people’s attitude towards their health and healthy living is determined by the perception they receive from the society. Those labelled guilty tend to accept that it is their fault that they are experiencing the health challenges which makes their situation worse. They assume that they do not fit in the society and may not take care of their bodies, thus the virus overpower them. Those labelled innocent get support from the society but live in self-pity. Acceptance to them is a big challenge because they feel that it was the other party’s carelessness or inconsideration that exposed them. The blame that they have for their partners makes them not progress towards fighting the virus to live longer. These stereotypes cause division among families and friends. Feelings of betrayal for the innocent and guilt for those that infected their partners make it impossible for them to assist one another. This serves to deteriorate their health conditions because they lack peace and acceptance that is required in fighting the virus.
Perssonand Newman (2009) further argued that there are many cases of uninfected women who have infected partners in Australia. Gender imbalance has been identified as a reason for this situation which makes women extremely vulnerable to infection. This is common among the indigenous community who have cultural practise that allow men to be sexually involved with more than one partner. This situation has led to men being infected, and this has caused high risk to the lives of their main partners. If such situations occur, the women do not have the power to control the probability of HIV infection. This depends on their partners’ status and is risky because they cannot trust these partners to protect them from HIV infection.
Snoek et al (2005) identified another cause of increased HIV related deaths as the duration that people take before they finally get tested to receive treatment. For most people, they seek medical attention when the disease has progressed considerably, and the immune system is damaged. Jamieson, Peterson and Robinson (1999), argue that late diagnosis may not be as helpful as compared to when people seek treatment at the initial stages. Seeking treatment earlier helps in prevention of the possible opportunistic infections.
Satpathy (2003, p. 92) noted that reporting HIV in Australia was a highly controversial issue which was received with resistance. This is because it required contact with the infected individuals who were not comfortable when giving this information. However, in 1992 the Australian Government gave a procedure in which only coded data could be availed to the public. When reporting was introduced, many infected people came out and were assisted. This reporting system is a preventive measure because the people were educated on how to live positively with HIV and avoid infecting those around them. This confidentiality has helped a great deal because now HIV is reported in all the states. The data have helped people to know the progress of their fight for this infection. Many people are aware that a good number of the nationals are infected and, therefore, they have taken an initiative to protect themselves from infection. This has seen Australia progress remarkably well in reducing the HIV infection in that country.
University of Pretoria (2008, p.277) found out that the issue of HIV was rising at an unusually high rate in the 1980’s in Australia. The government initiated programs to curb this problem. It first identified the leading cause of transmission which was homosexuality. Approximately 85 per cent of the new HIV infections between 1999 and 2003 in Australia were associated with homosexuality. This prompted the government to address this issue by campaigning on safe practices among this community. This included the Aboriginals and the gay islanders, as well. Health care, education and support was given to these gay men. Resources have been directed towards HIV education and prevention efforts to fight this disease.
Drug use and injections have also been integrated in this education because they are closely related to HIV transmission. Condon andSinha (2008, p. 56) discussed a program dabbed “Needle and Syringe” initiated by the Australian government. It worked in keeping the infection rate of HIV as low as possible. Fresh needles were availed to all drug users even in community health centres and churches. This worked effectively, and the infection rate went as low as 5 per cent.
The HIV pandemic has been declared a global crisis because many countries have experienced a growth in numbers of new HIV infections. Snoeket al (2005), argues that, in Australia, this occurred even after the introduction of ant retroviral drugs because people tended to be concerned about HIV infection. Plummer and Irwin (2006) suggest that Australia should revisit the preventive measures that it used in the 1990s. This follows the rising HIV infections that have been noted lately. First funding towards HIV education and prevention done earlier has been reintroduced; this will ensure intensive campaigns towards this cause. It will enable the government to provide as much HIV education as possible. The strategy of Community mobilization in attending clinical services worked well especially among the gay people.
Romero et al (2006) stated that programs have been designed to empower women when it comes to economic independence and their social lives. This enables them to have control over their sex lives and minimise the chances of getting HIV infections. They cease to be the vulnerable group that can be sexually exploited by their partners who risk infecting them. This has been effectively accomplished through increasing knowledge about HIV transmission and prevention among women, establishing the socio economic challenges faced by women and assisting them in planning to counter these weaknesses. These plans include empowering women psychologically, teaching them on self-efficiency and also instilling in them a community sense. This will help them work together and encourage communication among themselves which will lead to increased awareness. Dialogue is a key tool that helps women communicates the issues that they go through especially sex issues which risk HIV infection. Talking to their families and partners will help establish whether engaging in sexual activities with these people is exploitive and risky. When women have the power to make decisions, they are safe from abuse and exposure to HIV that comes with lacking empowerment.
Plummer and Irwin (2006) argued that the Australian government has dealt with the stigma and discrimination directed at the HIV positive gay community. Crepaz et al (2006) argue that reduced discrimination had resulted in cooperation from the gay community unlike the past when this was a challenge. After continued education and awareness, they are slowly beginning to accept the various solutions offered to them about safe sex. Dolan, Lowe and Shearer (2004), identified condom use as effective in safe sex especially in prisons where homosexuality is common. This together with education for the gay men who are in denial has helped in minimising health issues associated with HIV/AIDS. The approach adopted in addressing HIV among the gay community is good and effective. It requires that these people are included in decision making and allowed to initiate their behavioural change in the efforts to prevent HIV. Scotland(2000) suggested that the gay community should be viewed as able to control and fight against HIV and not as a threat to transmission. Condoms have been encouraged for use among this community for them to practice safe sex.
The social and cultural practices that Australians engage in considerably contribute to their safety when it comes to HIV infection. Homosexuality is a social practice associated with civilized city dwellers. It lures the youth into believing that it is fashionable and acceptable among the enlightened community. This is not the case. The traditional, cultural practises overlook the fact that everyone is vulnerable to HIV infection. They assume that only the groups labelled as high risk can be infected. The society’s perception of HIV as a death monster is also another factor that is of concern; it should be viewed as a challenge that can be dealt with. Blame and discrimination are not solutions; they only make the situation worse. The introduction of drugs is a vital step in solving the HIV scourge; it should be used as a solution to the infected people to improve their health condition. The notion that HIV is no longer a life threatening condition because of the drugs introduced is wrong. People should protect themselves from infection because these drugs only serve to reduce the effects of the disease but do not cure it. The preventive measures available for the gay community can only be effective if the rest of the community and the government support them. Discrimination is the leading cause of cooperation; therefore the process not only involves the gay and the infected but the community as a whole. It should be noted that anyone bears the risk of contamination whether belonging to the high risk group or not. Each and every individual have an obligation towards fighting the growth of HIV/AIDS.
Armstrong, F.(2003). International Nurses Day 2003: Fighting the Stigma OF HIV/AIDS. Australian Nursing Journal,19(10), pp. 22-25.
Brady, M. (2004). Indigenous Australia and alcohol policy: Meeting difference with indifference. Sydney: UNSW Press. Print
Condon, B. J., &Sinha, T. (2008).Global lessons from the AIDS pandemic: Economic, financial, legal, and political implications. Berlin: Springer. Print
Crepaz N. et al. (2006), Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials.AIDS .20.pp. 143-157.
Dolan K. Lowe D. & Shearer J.(2004).Evaluation of the Condom Distribution Program in New South Wales Prisons, Australia.Journal of Law, Medicine & Ethics. 32. 124-128.
Elford J., Bolding G., Davis M., Sherr L & Hart G. (2004). Trends In Sexual Behaviour Among London Homosexual Men 1998-2003. Implications for H.I.V prevention and sexual health promotion.10, pp. 451-454.
Jamieson M., Peterson K. & Robinson K. (1999). A Profile Of The Clients of Male Sex Workers in Three Australian Cities. Australian And New Zealand Journal Of Public Health. 23(5), pp. 511-517.
Mansergh, G. et al.(2001).The Circuit Party Men’s Health Survey:Findings and Implications for Gay and Bisexual Men. American Journal of Public Health.91(6),953-958.
Oropeza L., Bradley L. & Johnson S. (2006).HIV Prevention, Early Intervention,and Health Promotion: A self-study Module for Health Care Personnel Serving Native Americans. Springer.Mountain plains AIDS Education and Training center. 22
Persson A. & Newman C. (2009).Fear, complacency and the spectacle of risk: the making of HIV as a public concern inAustralia.Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine.13 (1), pp. 7-23.
Plummer, D. & Irwin, L. (2006).Grassroots activities, national initiative and HIV prevention: Clues to explain Australia’ssuccess in controlling the HIV epidemic. International journal of STD & AIDS. 17,pp. 787-793.
Robinson, S. (2008). Homophobia: An Australian history. Annandale, NSW: Federation Press. Print
Romero et al. (2006) Woman to Woman: Coming together for Positive Change Using Empowerment and Popular Education to Prevent HIV in Women. AIDS Control and Prevention. 5(18), p. 390.
Satpathy, G. C. (2003). Prevention of HIV/AIDS and drug abuse. Delhi: Isha Books. Print
Scotland. (2000). Report of the HIV Health Promotion Strategy Review Group. Edinburgh: Scottish Executive. Print
Snoek E. M. et al (2005).Incidence of Sexually Transmitted Diseases and HIV Infection Related to Perceived HIV/AIDS:Threat Since Highly Active Antiretroviral Therapy Availability in Men Who Have Sex With Men.Sexually Transmitted Diseases. Vol. 32(3), pp. 170-175.
Stall R. et al (2003).Association of Co-Occurring Psychosocial Health Problems and Increased Vulnerability to HIV/AIDS. Among Urban Men Who Have Sex With Men. American Journal of Public Health. 930(6),pp. 939-942.
Thompson, S. C., Greville H. S., &Param R. (2008). Beyond policy and planning to practice: Getting sexual health on the agenda in Aboriginal communities in Western Australia.Australia and New Zealand Health Policy,5(3).
University of Pretoria.,& University of Pretoria. (2008). Compendium of key documents relating to human rights and HIV in Eastern and Southern Africa. Pretoria: Pretoria University Law Press. Print
Ward J., Akre S. P. &Kaldor J.M. (2010).Guarding against an HIV epidemic within an Aboriginal community and cultural framework; lessons from NSW.NSW Public Health Bulletin, 21(4), pp. 78-82.