HIV and South Africa
In the early 1980's the world became aware of an epidemic; this epidemic was nothing that had ever been seen before. Unlike the infamous bubonic plague of the 14th century, this virus takes longer to be fatal, has very few outward signs (until the later stages), and is not carried by rats. The epidemic in question in is the Human Immunodeficiency Virus (HIV). HIV is a retrovirus that attacks T cells in the human immune system and can lead to Acquired Immune Deficiency Syndrome (AIDS). There are two subtypes of HIV, HIV-1 and HIV-2; HIV-2 is primarily attributed to being in Africa, while the rest of the world primarily has HIV-1. HIV is believed to have been around since the 1930's with at least one fatality in the 1950's. There is a high concentration of the HIV-2 strain in Africa with approximately 5.5 million people infected. The virus is continuing to spread throughout South Africa at an alarming rate, and it needs to be slowed. The number of infected people has been attributed to different reasons including: lack of education, cultural beliefs, and improper or non-use of protection during sexual intercourse. There are several different organizations in place whose goals are to aid in the education of South Africans about HIV, how the virus is spread and the steps needed to prevent spreading the virus to others. These same organizations strive to provide medical care for those who have already tested HIV positive. Even with the amount of HIV in South Africa there is still a stigma related to being HIV positive, which has led to a lack of willingness to discuss a positive status, leading to further spread of the virus.
In the early years of the epidemic, 1983-1987, HIV was limited to certain groups of people, mainly homosexuals, blood transfusion recipients, intravenous drug users and hemophiliacs. Not until 1989 did studies confirm that the virus had entered into the heterosexual community (Karim). Once the virus entered into the heterosexual community the number of infected quickly surpassed the number infected in the homosexual community. After the realization was made that HIV was transmitted by blood transfusions, the South African government put into place a protocol to screen donated blood for the markers associated with the virus. Putting forth this protocol did not slow the overall spread of the virus, but has slowed the spread through blood transfusions. HIV is spread through the transfer of bodily fluids; this not only includes blood, but also seminal fluid, vaginal discharge, and breast milk. There has been no documentation of the virus being spread through urine and saliva, or tears. This shows that the chances of someone encountering the virus without performing some type of knowingly risky activity highly unlikely.
HIV affects 1 in 5 South African adults, ages 15-49, affectively mostly young females and older males (HIV and AIDS statistics for South Africa). This possibly represents the culture of South Africans, believing that older men should marry younger women in order to guarantee the continuation of their bloodlines. As late as 2003, approximately 23% of all pregnant women in South Africa tested positive for HIV, this means there is a large number of South African children born with HIV or acquire HIV during or shortly after birth (HIV and AIDS statistics for South Africa). Since HIV can be transferred through breast milk, children with HIV positive mothers, even those that manage to go through the 9 month gestation period without contracting the virus, have a greater risk of acquiring the virus during the time of their lives that they breastfeed (HIV and AIDS statistics for South Africa). With the growing number of younger women being infected by the virus, it is safe to assume that there will be a growing number of small children with the virus, leading to an exponential growth of the infection rate once these children become sexually active.
Early in the epidemic a lack of education about the virus and the various ways of contracting the virus, led to its rapid spread. Currently there are several organizations set into place to properly educate the people of South Africa on how to prevent contracting the virus. Even with these organizations in place, there is still an ignorance of the virus in more rural areas of South Africa. It has been observed that subjects who are educated, both on a purely academic level as well as directly about HIV have a better chance of not contracting the virus, and if they already have already tested positive for the virus they are more apt to take, the precautions needed to prevent the spreading of the virus to others. In contrast, the subjects of South Africa that have only been educated about the virus still tend not to use protection during sexual intercourse (HIV and AIDS statistics for South Africa). In recent years, there has been an onslaught of media related public service announcements bringing to light the prevention and the facts about HIV. While for the most part this publicity has helped, it has also hurt in some ways. With HIV being a very prevalent virus in South Africa, the carriers are generally accepted by society and not treated differently. There are a surprising number of individuals in South Africa who, although they have been told about how to avoid contracting the virus, go to an extreme and will refuse to eat meals with or sleep in the same room as someone who is HIV positive. There are groups that believe that the infected should be ashamed of their HIV status, regardless of how they contracted the disease, and consider them to be "dirty" (Hutchinson, Mahlaela and Yukick).
The spread of HIV through sexual contact is still a common occurrence in South Africa, regardless of the mass media public service announcements. Like most countries, females who try to initiate condom use during sexual intercourse are generally ridiculed. It has been shown that if condoms are more readily available to the public, females are more likely to use them. For most men, neither the knowledge of how the virus is spread nor the availability of condoms seems to influence their use of condoms with every sexual partner. Studies have shown that women are more likely than men to openly discuss a positive HIV result, with friends, family and potential sexual partners (Hutchinson, Mahlaela and Yukick). This leads to the thought that women are more conscious about the virus, or that they are merely more concerned with protecting themselves than men are.
The mass media attempts that were mentioned earlier are noble, in their attempts to educate the people of South Africa. Although their intentions are good, and the media has put forth a great effort at publicizing HIV, they have also made HIV positive subjects feel ostracized. With an increase in knowledge also comes an increase in fear, leading some to treat HIV positive subjects like second-class citizens by refusing to eat meals with them or even sleep in the same from with them (Hutchinson, Mahlaela and Yukick). There needs to be more effort to debunk the myths of how HIV is spread and be more matter of fact about the virus. This can be done by revamping the current public service announcements, to include the truths about HIV and directly discussing the myths that have been perpetrated by previous public service announcements, and those that are passed down as truths in families and throughout the community. A step that could be taken is having open forum discussions in public areas with question and answer sessions, led by someone who is properly educated about HIV and knows the myths that are considered truths in the particular communities in which they are holding these sessions.
It has been shown that the subjects in South Africa with at least some secondary education seem to have a smaller chance of contracting HIV(Karim). With this in mind, it is reasonable to assume that, using the organizations that are already in place, the funding to make public school mandatory could be found. By requiring and providing education starting at an early age, possibly 5-6 years of age, there is a greater chance of properly educating citizens about the risks and preventative measures associated with HIV. At early ages, children are more likely to grasp new ideas and be able to put those ideas into practice. Even if the children of South Africa are not required to go to school for a full 13 years like the children of the United States, there will still be many opportunities to stress the seriousness of HIV. When being taught to young children and young adults, the discussions regarding HIV should be tactful and to the point, because it is harder to grasp concepts when they are presented in an off-handed fashion. Since there is a large population, who is already infected or still at risk for being infected, and are considered to be past the age of attending school, some form of education should also be provided to them. This program should be similar to the G.E.D. program of the United States, but geared towards the education needs of the people in South Africa. Regardless of the age of the person being taught, it is extremely important to have curriculum focused on teaching the proper ways to protect themselves and others in regards to HIV.
Along with better education, there is a need for more readily available healthcare for those infected, and those who wish to remain HIV negative. When school is required for children, HIV screening should be the first thing required before entrance. Not to say that HIV positive children should be segregated from HIV negative children, or that they should be kept from school, but being aware of the HIV status of Children in a learning facility aids in how the child would be dealt with if by chance they are injured while at said learning facility. In addition, a child being aware of their HIV status would aid in leading discussions with the HIV positive and HIV negative children, since they would be required to put into practice some of the techniques they would be taught on how to prevent the spread of the virus. Screening should also be provided to all adults, with the option of keeping the results private since there is still a stigma related to being HIV positive (Hutchinson, Mahlaela and Yukick). With any positive result, the patient should be given the option to attend classes on how to cope with having the virus, the appropriate treatment for HIV and how to protect their children, spouses, and sexual partners. Any pregnant woman should be screened for HIV in order to have the option to take the appropriate anti-anti-retrovirals during their pregnancy to prevent the spread of HIV to their unborn child. Along with the ante partum anti-anti-retrovirals, HIV positive mothers should also be provided artificial milk for their child after the child is born, to further protect the child from the possibility of contracting the virus from its mother's breast milk. Retroviral should be provided for all HIV positive subjects after they have been properly tested. Providing anti-anti-retrovirals for the HIV positive subjects of South Africa is not enough, there also needs to be a more readily available supply of condoms and dental dams. Studies have shown that women are more likely to insist on the use of protection if they have it readily accessible (HIV and AIDS statistics for South Africa). With these forms of protection, there also needs to be provided instruction on the proper use of these items, be it in a pamphlet or in a classroom type setting. Removing the taboo from the use of these means of protection could go a long way in preventing the spread of HIV.
HIV is a serious concern for the people of South Africa, but by lifting the taboo, and brining to light the truths about the virus, the spread of the disease can be slowed further. It is necessary to not only provide better medical care for those infected with the virus but also educate the infected and uninfected on the proper ways to protect themselves and the people around them. Once everyone in South Africa is properly educated about HIV and has the supplies that they need in order to protect themselves, it is plausible to believe that the spread of HIV could be stopped.
Work Cited
HIV and AIDS statistics for South Africa. May 2009 http://www.avert.org/safricastats.htm.
Hutchinson, P.L., X. Mahlaela and Josh Yukcik. "Mass media, stigma, and disclosure of HIV
test results: multilevel analysis in the Eastern Cape, South Africa." AIDS Education and
Prevention 19.6 (2997): 489-510.
Karim, S.S. Abdool. HIV/AIDS in South Africa. New York: Cambridge University Press, 2006
