There are high rates of chronic infections among many cultures around the world. The Human Immunodeficiency Virus, otherwise known as HIV, is one of the leading infections that can be transmitted in numerous ways affecting children, heterosexual’s, and homosexual’s, via blood transfusions, semen, vaginal fluids, rectal fluids, breast milk, accidents in a healthcare setting, blood from used injection needles, etc., (AIDS, n.d.). Symptoms of HIV include: flu like symptoms, fever, chills, night sweats, rashes, and some acute infections (Cunningham et al., 1998). HIV infects cells in the body called TH cells, and if the body doesn’t have enough TH cells it can no longer fight off infections and illness (Weiss, 1993). HIV can be either asymptomatic or symptomatic. An individual who is HIV positive and asymptomatic contracts the virus, but doesn’t experience any symptoms for perhaps years, while an individual who is HIV positive and symptomatic contracts the virus will experience symptoms (Santrock, 2007). This virus can also lead to a disease called Acquired Immunodeficiency Syndrome, AIDS, which can result in death (Weiss, 1993). Places like Botswana, a country found in Africa, suffer from high population rates of HIV. The purpose of this essay is to identify and describe all the aspects of the HIV epidemic in homosexuals of Botswana, and to create a prevention plan to help with addressing the needs of the affected population.
Culture Characteristics
Background
Botswana is located in South Africa, with 603,200 square kilometers of land (. It is a landlocked nation, which means that is has no coastline or seaport because it is majority surrounded by land, so it is dependent of South Africa for access to ocean ports (. Botswana has a multiparty political system, as it is part of the British Commonwealth (. Over half of its population identifies as being part of the Tswana heritage (. Originally the people of Botswana we referred to as Basarwa, commonly known as Bushmen, and they were hunters and gatherers who adapted well to harsh environments (. They developed more ingenious techniques to extract what the land offered (. They had very little, no crops, or domesticated animals, and they only had a few possessions which were portable and necessary for everyday life (.
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Healthcare
Botswana is predominantly composed of urban areas, which is one reason why the population has high HIV and AIDS affliction (McDonald, 1996). The World Health Organization (2016), WHO, found the life expectancy for the entire population to be around 69.9 years of age, which is a dramatic increase from 2000 where it was 39.9 years. Homosexuality is illegal in Botswana, which makes it very difficult for men who have sexual relations with other men to receive HIV services (McDonald, 1996).
Importance
It is important to facilitate health care prevention plans for the Tswana culture because current rates of HIV in Botswana are extremely high. The number of individuals living with HIV is 380,000, and adult prevalence of HIV in individuals ranging from age 15-49 is 22.8% (UNAIDS, 2018). Adult males have lower statistics of knowing that they are infected, receiving treatment, and being virally suppressed (UNAIDS, 2018). The policy in Botswana does cover some key concerns and questions in regard to HIV testing. It is not mandatory to get HIV testing done before marriage, is solely based on voluntary and informed consent, but for certain age groups it is mandatory, and there is routine viral load testing done for antiretroviral therapy for adults, adolescents, and children who suffer from the virus (UNAIDS, 2018).
Facets of a Prevention Plan
HIV-related Stigmas
Three components lead to HIV-related stigmas in health facilities: Fear of casual contact due to being uneducated on how HIV is transmitted, association of HIV with improper or immoral behavior, and lack of awareness of health workers knowing what a stigma is and why it is harmful (Nyblade, Stangl, Weiss, & Ashburn, 2009). Because of these stigmas, individuals who suffer from HIV tend to seek testing and treatment services late in the progression of their disease, which is often beyond their ability to receive drug intervention (Nyblade et al., 2009). Individuals who do receive antiretroviral medications in Botswana have been found to grind their drugs into powder so that they aren’t seen taking medication in the presence of others, which can produce inconsistencies in their doses (Nyblade et al., 2009). Since healthcare professionals in Botswana struggle with self-stigma regarding potential HIV diagnosis, and fears of stigmatizing attitudes and behaviors from colleagues, this can lead to lack of HIV testing and early treatment if it is needed (Nyblade et al, 2009).
Sex Workers
Cultural attitudes and behaviors towards sex workers exist in Botswana, and because of the country’s experience with poverty and inequalities in wealth and income, sex work is a controversial topic that has caused for sex workers to be blamed as the main cause for transmission of HIV and AIDS (McDonald, 1996). Individuals who participate in this act do not define the individuals that they interact with as being ‘clients,’ instead they refer to them as partners or boyfriends (McDonald, 1996). There are a number of homosexual men working as male sex workers because they need money to eat, who have unprotected anal sex (McDonald, 1996). The number of youths who have admitted to having sex without use of condoms in exchange for money, gifts, or favors ranges between 8-15% (McDonald, 1996).
Presence of STDS
Transmission of HIV in Botswana is also associated with presence of other sexually transmitted diseases which are considered to have high influence in facilitating HIV (McDonald, 1996). This is also seen as the main factor of the spread of HIV in Botswana given the number of high incidence rates of contracting sexually transmitted diseases (McDonald, 1996).
Psychological Principles
Implementing and educating the population of the use of condoms would be implemented to help with protecting themselves and others from potentially contracting an STD, since prevalence of HIV in Botswana is linked to having other forms of STDs. Condoms should be distributed in a classroom setting to help with limiting the number of youths having unprotected sex. Educating this population would be ideal with preventing future generations from having exceedingly high rates of STDs because they would understand the importance of not having unprotected sex which could lead to numerous health concerns. This would differ from existing HIV prevention programs in Botswana because currently knowledge on HIV and other STDs is low due to how they are culturally and socially viewed. This would also help with challenging the cultural beliefs and stigmas of preventing HIV and transmitting it, also with being open to the idea of talking about it and receiving treatment. Overcoming these obstacles will take time because of the negative connotation already associated with even the idea of HIV in Botswana, but the more that the population because open with being educated on it, the more that they can prevent it from occurring in high percentages. This doesn’t mean that no one will get the virus because there are outlying factors like addiction that may lead to transmitting the disease, but it will lower the rates and help with healthcare providers also being more intuitive when it comes to the illness and its risk factors.
References
- Acquired immune deficiency syndrome learning center. (n.d.). Retrieved from http://www.healthline.com/channel/hiv-aids.html
- Cunningham, W. E., Shapiro, M. F., Hays, R. D., Dixon, W. J., Visscher, B. R., George, W., Ettl, M. K., & Beck, C. (1998). Constitutional symptoms and health-related quality of life in patients with symptomatic HIV disease. The American Journal of Medicine, 104(2), 129-136. doi:10.1016/s0002-9343(97)00349-5
- McDonald, D. S. (1996). Notes on the socio-economic and cultural factors influencing the transmission of HIV in Botswana. Social Science & Medicine, 42(9), 1325-1333. doi:10.1016/0277-9536(95)00223-5
- Nyblade, L., Stangl, A., Weiss, E., & Ashburn, K. (2009). Combating HIV stigma in health care settings: What works? Journal of the International AIDS Society, 12(1), 15. doi:10.1186/1758-2652-12-15
- Santrock, J. W. (2007). Adolescence (11th ed.). Boston, MA: McGraw-Hill.
- UNAIDS (2018). ‘Country progrss report’, Botswana: UNAIDS
- Weiss, R. A. (1993). How does HIV cause AIDS? American Association for the Advancement of Science, 260(5112), 1273-1279. Retrieved from https://doi.org/10.1126/science.8493571
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