1. Factors that contribute to the HIV/AIDS epidemic is Botswana
A. Gender Inequalities, Social/Historical
One strong factor that still assist in the AIDS epidemic are the gender equalities in Botswana. The two most contributing factors are biologically women will more likely be infected with HIV/AIDS than men as well as women unfortunately having less control in their relationships (Phaladze and Tlou, 2006).
Women are more biologically susceptible to contract HIV/AIDS than men through unprotected sex (Phaladze and Tlou, 2006). There are simple precautions to prevent STIs and unwanted pregnancies however due to the gender inequalities in Botswana it was harder for women to ask for safer sex such as using male condoms (Phaladze and Tlou, 2006). Partly because of age gaps in marriage younger women generally marry older men who may have already contracted the virus, and, many women are dependant economically on their male partner often having lower paying jobs such as fronts desks jobs or working domestically in the home (Phaladze and Tlou, 2006).
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Overall if women can negotiate safer sex in their marriages and in short term relationships there would be more decline in the spread of HIV, including protecting the next generation of children from contracting HIV/AIDS from their mothers.
B. Stigma and Discrimination, Social/Political
Stigma is a mindset of belittling and shaming others for their association or diagnosis with HIV/AIDS. This also applies to the affected patient who is afraid or being discriminated in their community more commonly known as Internalized Stigma (Ogasawara, 2009). In 2007 an Epidemiological Fact Sheet on HIV/AIDS found that approximately 11,000 people including children died from HIV/AIDS related causes, yet HIV and Stigma do not only affect community health but also lead to mental and social complications (Ogasawara, 2009).
The vicious social norms in Botswana have led to women and other minority groups being discriminated and shamed as HIV/AIDS is transmitted mainly through unprotected sex and Botswana is primarily as Christian country (Ogasawara, 2009). Even children who transmitted HIV through their parents face social stigma (Ogasawara, 2009). There is also discrimination against homosexual males and female sex workers, unfortunately there are no laws to help/protect sex work (prostitution) and Homosexuals, and sex workers and homosexuals (MSM Male with Male sex) are illegal in Botswana (Ogasawara, 2009). Ultimately, stigma and discrimination have made it harder for some to speak up about the treatment they need, and the governments policies also prevent a large minority from speaking up and preventing more HIV prevention (Ogasawara, 2009).
2. Responses to the HIV/AIDS crises
Both government and non-government organisation have responded to the HIV crises for over a decade now, and results have shown decline in HIV for children and adults, yet the number still remains high with approximately 800,000 of the population still infected (40%) (Soschildrensvillages.ca, 2007).
A. Non-Government
Many non-government agencies have joined to spread awareness and education for youth about HIV and how to stay safe. UNAIDS, UNICF, UN Women, UNDP, WHO and other organisations are working in correlation to Sustainable Development goals to achieve “Zero new infections” and “Zero aids related deaths ending the AIDS epidemic by 2030” (Unaids.org, 2019).
Educating the Botswana population especially adolescents and young adults if important to efficiently canton HIV infection. USAID, United States Agency for International Development recommend the ABC method to prevent infection Abstain, Be Faithful, Wear a Condom, this is a simple method that helps all age groups people from being infected and has been effective in preventing new infections (Soschildrensvillages.ca, 2007).
More HIV prevention is being aimed towards young people to help future generation from contracting HIV. For example, on Worlds AIDS Day 2016, Tune Me (bw.tuneme.org 2019) educates younger people on their sexual health and rights and how to stay safe; their website has categories about puberty/menstruation, safe sex, and consent, helping young women become equal to their male partners to use contraception (bw.tuneme.org 2019). Additionally, 11,150 condoms were provided for both males and females on World AIDS day 2016 (Unaids.org, 2019).
B. Government
The Government of Botswana have created a “Zero New Infection by 2016” action plan. Although it was unsuccessful improvements have been to the HIV epidemics (Soschildrensvillages.ca, 2007).
Internationally HIV/AIDS has only decreased by almost 20% in the past seven years. In Botswana life expectancy fifteen years go was 35 years on average, in 2011 life expectancy rose to 55 years (Gov.bw, 2011) (Cia.gov, 2019).
Firstly, during the early outbreak of HIV/AIDS in the 1980s the Government of Botswana concentrated on checking/screening blood to stop spread to be eliminated through blood transfusion (AVERT, 2018). Then, treatment was aimed for all of Botswana’s citizens, including providing those most affect with anti-retroviral medication (AVERT, 2018). The plan was unsuccessful because the government didn’t have enough workers or facilities to accommodate their goals; yet, the government has received more funding approximately 340 million (USD) in 2008 (AVERT, 2018). The government has spent this money to spread awareness and resources about HIV/AIDS, such as Billboards, media (radio/tv) (Gov.bw, 2011); evident between 2001 and 2009 HIV rates between 15-19-year olds has decreased from 25% to 13% (Unaids.org, 2010).
3. SWOT analysis of HIV/AIDS crises responses
Non-Government NGOs
Strengths
- Provides youth with education with accessible resources
- Helps the UNs’ sustainable living goals “Zero New [AIDS] infections”
Weakness
- Non-Government relies heavily on donations and volunteers
- Opposing values between GOs and NGOs, example religious values of no contraception whether Tune Me belies in contraception.
Opportunities
- More research to end the HIV/AIDS epidemic and prevent it from remerging in the future
- This new information can help future disease and present HIV cases globally.
Threats
- More urgent cases of HIV need more attention and funding.
- Lack of funding will lead to the cycle starting over again with rising infections and myths of Aids.
Government GOs
Strengths
- Effective blood screening to prevent dangerous transfusions
- Citizens values and government values align e.g strict religious ideas
Weakness
- The government doesn’t have enough funding on their to sustain there goals
- The government has had unsuccessful plans previously and have had lots of assistance from NGOs.
Opportunities
- The government has longer term plans and a healthy population has higher economic success.
- The government can be sustainable and wont need to rely on NGOs once the HIV/AIDS epidemic concludes
Threats
- The HIV/AIDS crises will not end if help isn’t provided to Sex Workers and MSM (homosexual male couples) as its illegal and condemned in their society
- Without gender equality HIV between women and their children will only increase as they cant negotiate protected sex.
4. Evaluation and Justification of responses
Both Non Government organisations and government organisations have different yet effective approaches to tacking the HIV epidemic. However, based on results it indicates Non government organisations are providing more assistance and results for the people of Botswana. The Government of Botswana is also having blood screening for safe blood transfusions while also keeping the citizens values conscious. In addition, the Non-Government agencies also assist in social issues helping minorities although it may clash with the government policies, as shown when government agencies treat MSM and educate about sexual health opposing strict Christian values.
Overall, its clear non-government organisations have shown longer term responses to HIV/Aids and inequalities in Botswana, providing education and resources for sexual health has helped decrease HIV cases including in newborns and adolescents. A decline in new infections can’t be achieved if minority groups such as sex workers and homosexual males are illegal and shamed, and if gender equality is reached women will have the power to argue for safer sex and prevent themselves and their future children from being infected by HIV/Aids. More education for all citizens will help improve gender equality and provide understanding, with decreased social stigma for everyone to feel safe to speak up about HIV and receive equal treatment.
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