Human immunodeficiency virus (HIV) is a recurring health issue with flu-like symptoms that continues to affect millions of people around the world, transmitted through bodily fluids and sexual contact. Additionally, the virus has the ability to progress into acquired immunodeficiency syndrome (AIDS). This sexually transmitted disease (STD) originated from a chimpanzee carrying the Simian Immunodeficiency Virus (SIV), known to be closely related to HIV, in West Africa in the 1920s. The virus was then crossed to humans as a result of the Africans hunting and consuming the animal, damaging their immune systems and thus, making it difficult to fight off infections (Origin of HIV and AIDS, 2019). As of today, only treatments exist for HIV and an effective cure has yet to be discovered, continuing to be a major global concern to the public’s health.
East and South Africa are the most HIV affected regions with 20.6 million people infected as of 2018, including young women, homosexuals, and sex workers. Moreover, there were 800,000 new cases of HIV infections based in these regions, which is just under half the global total. Young women at 15-24 years of age are more than double HIV prevalent than men in 2018, due to excessive levels of age-disparate sexual relationships and transactional sex. Furthermore, studies have shown that young women married to men who were 16 or over years older are three times more vulnerable and 50% more likely, if faced with sexual violence, to contract HIV (HIV and AIDS in East and Southern Africa, 2019).
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In the present day, HIV continues to globally spread, with approximately 37.9 million people living with the STD and 21% unaware of their status as recorded in 2018 (Global HIV and AIDS Statistics, 2020). Mortality and morbidity are ultimate indicators to track the quality of HIV care for those who have been diagnosed. This is reflective of the number of cases reducing from the start of the epidemic with 32 million illnesses related to AIDS resulting in death, to 770,000 in 2018. In the same year, specifically looking at Eastern and Southern Africa, several countries have seen a decrease by approximately 20,000 in their case numbers of new HIV infections as a result of treatment. Africa’s mortality rate has been able to achieve a decrease of 40% since 2010 (Ford & Spicer, 2012). However, other countries such as Angola, Madagascar and South Sudan, are progressing poorly and giving rise to an increase in illnesses. Living and working conditions play a major role in one’s vulnerability to HIV/AIDS and thus, low- and middle-income countries often have a higher HIV prevalence with approximately 68% of people living in sub-Saharan Africa.
56% of more than 9 million orphans in sub-Saharan Africa have lost at least one of their parents due to HIV/AIDS, resulting in a number of negative consequences that heavily impact these children. Namely, a lack of education and family support leads orphans to be at a higher risk of being sexually abused and thus, more likely to contract the infection (Raymond & Zolnikov, 2018). Moreover, those who live in rural areas also have a greater HIV prevalence, for example, Ethiopia and Uganda, due to unsafe sexual contact, early sexual debut and marriage. Many countries within the Eastern and Southern region of Africa do not have access to health care services and therefore, have an increased probability of having the virus transmitted to them through bodily fluids and sexual contact. Sub-Saharan Africa’s social factors play a significant role in the region’s HIV prevalence, including sexual violence, poverty, lack of education, poor health facilities and the low societal status of women (Shao & Williamson, 2012). Additionally, behaviour would also be considered as an important factor regarding the number of HIV cases, such as, the use of condoms, early sexual debut and frequency of intimate relations.
Although there is no vaccine effective enough to cure HIV, treatments and prevention mechanisms exist to minimise the likelihood in contracting the virus. Despite the fact that sub-Saharan Africa is considered ‘disadvantaged’, few countries within this region have access to Antiretroviral (ARV) drugs, which enables their immune systems to continue to function and impede illnesses. Approximately 16.3 million Africans have access to this treatment, which fights against the transmission of HIV from mother-to-child, sexual intercourse, sharing of needles and breastfeeding (Olakunde et al., 2019). Additionally, another form of prevention from picking up the STD is the use of condoms and since the 1980s, approximately 50 million HIV infections have been prevented (Evans et al., 2018). This mechanism is considered to be 98% effective and acts as a barrier from any sort of STDs that can be found in bodily fluids (Corlis, 2015). In spite of the fact that all countries within this region fail to meet the global target regarding condom use, there is slow improvement in sub-Saharan Africa (Smith, 2018). Furthermore, HIV programmes have been implemented as “a combination of behavioural, biomedical and structural interventions” (HIV Prevention Programmes, 2019). For example, the mechanism behind this prevention strategy emphasises on the fact that young children who are vulnerable to the virus should be provided with education regarding sexual health. In addition, they should also have access to health services without economic barriers in relation to excessive costs and structural barriers, such as parental consent. Other than condoms being a biomedical intervention, voluntary medical male circumcision was another option and proven to have reduced HIV prevalence by 60% in the mid-2000s (Voluntary Medical Male Circumcision, 2019). Whilst research continues to progress in finding a cure to HIV, there are a number of treatments available to help prevent people from contracting the virus.
With no vaccine to eliminate HIV, the STD continues to be a global health issue that affects many people, with its highest rates in sub-Saharan Africa. Those under poor living and working conditions typically have a greater risk becoming infected with the virus, especially orphans who lack education and start their sexual debuts at an early age. Fortunately, treatments and preventative programmes have been implemented to assist in minimising the number of death cases, as well as new infections.
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