HIV/AIDS in Africa

Introduction 

In Africa, HIV/Aids features prominently both as a current and an emerging problem. The subject is current because it continues to ravage African populaces with a vast number of children born with the HIV currently attaining adulthood and commencing families of their own. The issue is also emerging since HIV infection rates almost all over the world are reducing exponentially, but in some African countries, the numbers continue to increase. In most of the developed world including the USA, HIV/AIDS can be considered an issue that is gradually being relegated to the past. Non-communicable diseases such as cancer, diabetes, and hypertension form the core of public health considerations. WHO. (2018) is a report dubbed The African Regional Health Report: The Health of the People . Within this report, hypertension and diabetes only get a casual mention while cancer is not mentioned at all. Instead, the report focuses on the problem of HIV and AIDS, both as a current and emerging problem. The magnitude of the subject is captured in the statement: “ HIV/AIDS continues to devastate the WHO Africa Region, which has 11% of the world's population but 60% of the people with HIV/AIDS ” (WHO, 2018). The world is winning the war against HIV and AIDS, but Africa seems to be losing it, a fact that reflects how cultural differences act as a bearing factor on public health issues. 

Background of the Issue 

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) are a variety of conditions that begin when an individual is infected with the HIV . Most infections occur through unprotected sex with an already infected person (Jaskiewicz et al. , 2016). However, a child may contract the HIV from the mother during the process of birth and sometimes through breastmilk. Exposure of contaminated material with the blood through the sharing of blades or needles or even blood transfusion can also lead to an HIV infection. The way an infected person is handled determines whether or not HIV becomes a serious health issue or not. Secondly, the way a community or populace handles the HIV pandemic determines whether HIV becomes a serious public health issue or not. If an infection is discovered early enough and the patient placed on highly active antiretroviral therapy (HAART), the patient can leave a healthy and normal life (Jaskiewicz et al. , 2016). Proper use of HAART coupled with healthy behavior nutritionally and socially also exponentially chances of the patient infecting other people with AIDS. On the other hand, if the infected person does not get tested and therefore, receives no HAART, and doesn’t commence healthy behavior, chances of poor health, opportunistic infections and exposure to infection to the other members of the community will ensure. 

HIV and AIDS as a Current and Emerging Public Health Issue in Africa 

The preceding begs the question of whether WHO is justified in considering HIV and AIDS as a key public health problem in Africa and giving it priority over all other public health issues that Africa currently faces. According to AVERT a UK-based organization that specializes in HIV and AIDS research, the statistics of HIV and AIDS in Africa as compared with the rest of the world are troubling. In entire Western Europe, combined with entire Northern America, only 2.1million people are living with HIV (AVERT, 2017). In East and Southern Africa alone, there are 19.4 million people and 6.1 million more in Western and Central Africa. These statistics are reflective of a region that has an inordinately high level of HIV and AIDS. From an emerging issue perspective, approximately 66% of all new HIV cases are taking place in Sub-Saharan Africa only. Therefore, approximately 34% of all infections are spread across the entire world including North Africa. Africa, therefore have an exponentially higher level of HIV and AIDS prevalence and rate in new infections (AVERT, 2017). The HIV and AIDS problem in Africa is thus bad at the moment and gradually getting worse through the new infections. These confirm HIV and AIDS as a major current issue within Africa and also a major emerging issue going into the future. 

Ground for HIV and AIDS being A Predicament in Africa 

Culture 

From its very advent, HIV has been a cultural issue since its main avenue of transmission is through sexual activities. Across the globe, sexual activities vary from community to community-based mainly on cultural issues such as traditions and religion. Among the main ground for the early spread of HIV and AIDS was homosexuality resulting in the disease being considered as being limited to the gay community. It was to be later realized that although heterosexual vaginal intercourse results in lower chances of HIV transmission than anal intercourse, the chances are still high enough to result in a pandemic. In Africa, levels of homosexuality are lower than the rest of the world. However, heterosexual promiscuity is exponentially higher (Sovran, 2013). In some cultures, wife sharing is a common custom where a respected visitor will not only be allowed a place to sleep but also one of the host's wives as a companion. This custom was traditionally practiced to ensure that every family got a wider genetic pool thus in the case of an epidemic, some children might have a chance of survival. In a country like Malawi, there is a culture that compels every girl to lose her virginity to a designated member of the village as a form of culture. This member of the village has to be a male prostitute by profession (Dean, 2016). In the case the individual contracts HIV, every girl in the village will be doomed to be infected with the virus at a very tender age, then through cultural promiscuity continue infecting other power. 

Another tradition that drives HIV infection, mainly in the rural areas is rites of passage which include one form of initiation or the other. Male circumcision mainly involves the removal of the entire foreskin. In most African communities, a traditional expert will use the same tools to circumcise several boys at the same moment (Sovran, 2013). If any of the boys have the HIV , any other boys circumcised after stands a very high chance of getting infected. For the girls, female genital mutilation is common with the sharing of tools also increase chances of HIV and AIDS infection. Almost all other rites of passage will involve a form of bloodletting such as cuts to the skin or removal of teeth which increased chances of HIV infection. 

Some modern myths about HIV and AIDS have also contributed to the spread of HIV and AIDS. Key among this myths is the suggestion that having sex with a virgin can cure HIV and AIDS which has led to the increased rape of little girls by HIV positive men. Within urban centers, most of this traditions are not adhered to, but prostitution is highly prevalent. Indeed, the rates of infection in the urban centers are much higher than in the rural areas, because prostitution and promiscuity are higher in the urban centers (Sovran, 2013). The use of condoms as a form of protection is frowned upon by many leading to the high rates of infection. Traditions drive infection in the rural areas while imported practices in the name of civilization drive infection rates in the urban centers. Both causes of infection are directly related to culture. 

Lack of Proper Management of HIV patients 

Lack of Testing 

The first step in HIV and AIDS management is testing whether or not the results will be positive. A positive result will enable the patient to commence treatment and healthy behavior to lead a healthy life and reduce chances of infecting other people. On the other hand, a negative result will lead to a re-evaluation of behavior and chances of a more responsible life which may include abstinence from sex, faithfulness to one sexual partner or the use of condoms. Unfortunately, the rates of HIV testing in Africa are very low with a lot of campaigns being made to encourage people to go for HIV tests not bearing fruits. Among the world-famous campaigns for HIV testing took place in Kenya where former US president Barack Obama has paternal roots. To contribute to the campaign, Senator Obama as he then was and his wife publicly undertook HIV tests in a bid to encourage the locals to do the same. Fear and myths, however, discourage many from undertaking these crucial test. 

Poor HIV Management 

Proper management of HIV positive individuals is crucial to their well-being individually and public health in general as it reduces the chances of spreading the disease. Further, disease management from a public health perspective takes a pecuniary angle. Proper management at an early stage reduces the chances for exacerbation of the infection and the advent of opportunistic diseases, key among them being tuberculosis. Failure to spend on handling HIV earlier on lead to higher spending when the patient develops full-blown HIV and opportunistic infections. The higher amounts necessary to treat one patient suffering full-blown AIDS and TB can treat several patients if managed earlier. Lack of testing is one of the causes for poor management of HIV patients who get tested when the disease has already advanced. Another cause is corruption which leads to misappropriation of government and non-governmental monies meant for HIV and AIDS management (Jaskiewicz et al. , 2016). It is also because of corruption that counterfeit drugs are on the rise in Africa. These counterfeit drugs exacerbate the situation as they fail to contain the infection within the patient even as they cause secondary problems such as liver problems. Finally, poverty is another cause of poor HIV and AIDS management in countries that do not have government programs for managing the disease. A careful evaluation if HIV trends in Africa will show that prevalence is highest in the poorest and most corrupt countries key among them being Zimbabwe, Lesotho, and Swaziland. 

Possible Solution to the Issue 

Among the principal causes of the instant issue is negative cultural practices. History has proven that education and enlightenment are among the main cures for negative cultures. Proper but dangerous cultural practices such as male circumcision can be amended to improve hygiene thus making them safe for initiates. Negative cultures such as female genital mutilation can be eliminated by criminalizing them. The same should apply to any culture that involves sexual activities with girls of minority age. Education and enlightenment can be used to reduce or eliminate sexual promiscuity, and where it cannot be eliminated , the use of condoms can stem the spread of HIV and AIDS. Regarding disease management, there is a need for funding from the developed world to ensure that testing and management of HIV and AIDS is free of charge for everyone. Measures should also be taken to reduce or eliminate corruption. 

Conclusion 

As the western world continues to relegate HIV and AIDS as a serious public health issue, the same cannot be said about Africa and general and particularly Sub-Saharan Africa. As WHO reports, in spite of decades of effort to stem the disease, it continues to exacerbate. Due to its communicable nature and cost of management. HIV and AIDS is a major public health issue. Culture is at the center of the issue since behavior is among the leading causes of its spread. Lack of finances for drugs including the crucial HAART caused by poverty and corruption is also another bearing factor. The totality of the above reflects how cultural differences can also result in public health differences amongst different communities. 

References 

AVERT. (2017, September 01). Global HIV and AIDS statistics. Retrieved January 24, 2018, from https://www.avert.org/global-hiv-and-aids-statistics 

Dean, S. (2016, July 22). HIV infected man is paid £3 to take girls virginity as part of sexual cleansing ritual in Malawi. Retrieved January 24, 2018, from http://www.dailymail.co.uk/news/article-3703122/HIV-infected-man-paid-3-girls-virginity-sexual-cleansing-ritual-Malawi.html 

Jaskiewicz, W., Oketcho, V., Settle, D., Frymus, D., Ntalazi, F., Ezati, I., & Tulenko, K. (2016). Investing in the health workforce to increase access to and use of HIV and AIDS services in Uganda.  AIDS (London, England) ,  30 (13), N21 

Sovran, S. (2013). Understanding culture and HIV/AIDS in sub-Saharan Africa.  SAHARA: Journal of Social Aspects of HIV/AIDS Research Alliance ,  10 (1), 32-41 

WHO. (2018). The African Regional Health Report: The Health of the People. Retrieved January 24, 2018, from http://www.who.int/bulletin/africanhealth/en/