Human immunodeficiency virus (HIV) affects white cells responsible for fighting diseases and infections, making an individual's body more vulnerable to infections and diseases. HIV is mostly transmitted through contact with the bodily fluids of individuals with the virus. If an individual acquires HIV, it progresses to acquired immunodeficiency syndrome (AIDS) if left untreated. AIDS occurs in the last HIV infection stage when the virus has seriously damaged the body’s immune system. According to Power (2015), 10% of the overall population living with HIV/AIDS are women, while most individuals living with HIV/AIDS in Australia are men. Generally, only a small population of Australians live with HIV/AIDS. In contrast, Swaziland is among the most HIV-affected countries globally. HIV/AIDS prevalence rate in Swaziland among women is high, and it is estimated that 43% of women are infected. Social determinants of health (SDOH) affect HIV/AIDS prevalence in any given country; such SDOH include education and stigma, and discrimination. This paper is structured to explore HIV/AIDS and SDOH (education and stigma and discrimination) on women living in Australia and Swaziland.
Vulnerable Group Situation
HIV/AIDS situations and their risk factor among women in Australia and Swaziland vary. Swaziland's first HIV/AIDS case was reported in 1987; however, according to the statistics, in 2005, more than one person in three adults is affected, and Swaziland faces a generalized HIV/AIDS endemic (WHO, 2005) . The most vulnerable group affected by HIV/AIDS in Swaziland is women between the ages of 20 and 24. A survey conducted by Swaziland’s ninth HIV seroprevalence indicated that 56 percent of pregnant mothers between ages 25-29 were infected with HIV/AIDS. Moreover, the prevalence rate in Swaziland is evenly distributed across the country. The HIV/AIDS endemic has been fueled by conservative religious, poverty, migration, unemployment, and traditional beliefs against contraceptive and frequent multiple sexual partners, which has affected the economy and society. In Australia, the prevalence rate among women is relatively low compared to Swaziland; according to statistics by HIV Australia, in 2010, only 14% of adult/adolescent women were diagnosed with HIV against the total number of infected people in the country ( Mey et al., 2017) . However, over the past few decades, the number of women infected with HIV has increased significantly, where are about 44 percent more women diagnosed with HIV. Research indicates that women living with HIV in Australia are between 21 to 74 years ( Mey et al., 2017) . The high rate of infection among women in Australia is most common among the indigenous Australians
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Stigma and Discrimination
The occurrence of HIV/AIDS- connected stigma and discrimination has been broadly documented. Stigma and discrimination is the belief or attitude about a group of people that shame or discredits them. HIV positive women are often perceived to be injecting drug users or sex workers, and their stigmatization is compounded if they do have a history of drug use or sex work or come from a marginalized group ( El Kamla, 2018) . Swaziland has the world's highest prenatal HIV prevalence rate, and it has been ranked among the most stigmatizing countries ( El Kamla, 2018) . However, the government has included an anti-HIV stigma platform in its multi-sectoral HIV/AIDS policy.
Unlike Swaziland, in Australia, only ten percent of HIV-positive individuals are women ( Cameron & O'Keefe, 2016) . Due to stigmatization and discrimination, the small number of women in Australia who are HIV positive do not reflect the actual impact that the disease has and might have on Australia's women, and this is so because they fear rejection, and most treatment is based at home ( Cameron & O'Keefe, 2016) . According to the report by human rights, ethical issues, and HIV/AIDS epidemic, HIV positive women are stigmatized and discriminated against, which results in the epidemic being fueled underground, leading to the unmatched spread of infection.
Generally, stigma and discrimination are common for individuals with HIV/AIDS in the world. Stigma and discrimination occur when individuals tend to isolate themselves or become isolated by others due to their HIV/AIDS status. Often, this stigma and discrimination make many individuals avoid being tested due to the fear of being discriminated against by their peers. In Swaziland, there are high levels of stigmatization and discrimination because of the many HIV/AIDS cases. Unlike Swaziland, the levels of discrimination and stigmatization in Australia are lower as only 13% of individuals with HIV/AIDS are women. However, regardless of the number of women with HIV/AIDS, discrimination and stigmatization are real issues that need to be addressed. Women fail to get tested for HIV/AIDS due to the fear of being discriminated against if found positive, resulting in further HIV/AIDS spread.
Education
The differences in the HIV rates between Swaziland and Australia can be attributed to education. Education is a significant determinant of health, particularly HIV/AIDS. According to the World Food Program, there is a negative correlation between education attainment and HIV infection rates (WFP, 2015). The results are even more significant among women and young girls. From the beginning, women in Australia have been underprivileged when in all fields of education. In the past few years, Australia has made efforts to ensure that most girls get educated. According to Australians, educating girls is the best investment that the world will make ( Tran, 2019) . Education has positive implications, including the reduction of HIV/AIDS incidences.
Educated individuals understand the steps to take to avoid contracting HIV/AIDS, such as using condoms or abstaining, resulting in a lower infection rate. 1n 2018, the proportion of HIV/AIDS positive females above the age of 15 was 12.1% ( Tran, 2019) . However, Swaziland's positivity rates are significantly higher, stirring a deliberation on whether educational attainment could be a determinant of HIV/AIDS prevalence. In Swaziland, HIV/AIDS is prevalent in females above 20 years; it accounts for more than half of the total cases ( Pettifor et al., 2018) . Swaziland, being a small developing country in Southern Africa without a proper education structure, education for both genders has been detrimental and relatively insufficient. Research shows that about 97 percent of girls enroll in primary schools at some points, but 38 percent proceed to secondary education, and approximately 5.5 percent manage to enroll in tertiary education (Yan, 2019) . In Swaziland, girls are disproportionately affected by health issues. For instance, there is a big gap between HIV positive girls (10 to 14 years) and boys in the same age group ( Whiteside et al., 2017) . Girls are twice likely to contract the virus than boys.
Education is a significant determinant of health. From the evaluation of Australia and Swaziland, it is clear that the level of education determines the prevalence of HIV/AIDS among women. Australia is a developed country whose population is very literate compared to Swaziland, a developing country, whose population is less literate than that of Australia. Due to the high literacy levels in Australia, only 10% of the population is infected with HIV AIDS than Swaziland, where about 56% of pregnant women are found with HIV/AIDS. Education helps individuals understand precautionary measures to avoid contracting HIV/AIDS, such as using condoms and abstaining from sex. Therefore, it is fair to say, the higher the level of education in a country, the lower the prevalence of HIV/AIDS, while the lower the level of education, the higher the prevalence of HIV/AIDS.
Recommendation
Adapting with various and complex impacts of stigma and discrimination is not easy for women, especially where their social status in already low. The most appropriate measure to address this concern is creating support groups, such as peer support groups, to help women living with HIV/AIDS accept their situations and cope with discrimination. Participation in support groups has been associated with reducing depression, apprehension, isolation, and illness ( Kontomanolis, 2017) . Support communities provide a supportive environment for HIV positive women to express their frustrations, experiences, and suppressed feelings in women experiencing the same condition. Governments should focus on improving the educational systems to reduce vulnerability to HIV/AIDS contraction in women and young girls. Research proves that women who are educated are likely to delay sex, childbearing, and marriage, reducing the probability of contracting HIV/AIDS. In a study involving 21 countries, educated girls were likely to delay their sexual intercourse involvement and use condoms ( Pettifor et al., 2017). Therefore, countries need to ensure that young girls and women get an education to help them understand HIV/AIDS dynamics and avoid contracting the virus and disease.
Conclusion
This paper focused on education, stigma, and discrimination as SDOH among women living with HIV/AIDS. The selected vulnerable group was women in Swaziland and Australia. Stigma and discrimination significantly determine the rates of HIV/AIDS infection and the extent to which it can spread. Discrimination instills fear of being tested, which further leads to the spread of the virus. Discrimination does not have a cause and effect relationship with HIV/AIDS rates, but it is a significant determinant of health. Education, on the other hand, has a direct relationship with the prevalence of HIV/AIDS. In a country such as Swaziland, where the education system is inadequate, HIV/AIDS prevalence among women is high compared to Australia, which has a well-developed education system. Among the many recommendations, support groups can be used to provide a platform for women to narrate their experiences and develop solutions on how to cope with discrimination. Improving educational systems will also ensure that young girls delay sexual involvement, reducing HIV/AIDS incidences.
References
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