Wednesday, February 15, 2012

HIV / AIDS the number 1 infectious disease in the world

What is HIV and AIDS?
Human immune deficiency virus (HIV) the virus that causes AIDS (acute immune deficiency syndrome) has caused havoc all over the world. Over the years the disease has claimed many lives all over the world. Scientists, researchers and medical practitioners are trying different ways to find the cure for the disease.  One major breakthrough in the past decades was the discovery of anti-retroviral drugs that have helped to slow down the replication of the virus thereby prolonging the life of the person carrying the virus.
HIV and AIDS is rated as the number 1 most dangerous infectious disease in the world.
The first case of HIV was discovered in Malawi in 1985. From the 2010 Malawi Demographic and Health Survey (MDHS) it is estimated that there are about 920,000 adults and children living with HIV in Malawi as of 2009.

Malawi and HIV

What are the major factors of HIV transmission in Malawi?
According to the 2010 MDHS these are some of the major factors contributing to HIV transmission in Malawi include:
·         Poverty
·         Low literacy levels
·         High levels of casual  and transactional unprotected sex in the general population particularly among youth between the ages of 15-24
·         Low level of male and female condom use
·         Cultural and religious factors
·         Stigma and discrimination
In an effort to address these factors the National AIDS Commission (NAC) was established in 2001.  In 2003, a National AIDS and HIV policy was launched by the Malawi Government through the office of the president and cabinet (OPC).  The policy was developed a consultative process involving:
·         Civil society organizations
·         Public and private sector
·         Media
·         Persons living with HIV
In 2004, a National AIDS and HIV framework (NAF) was established as a tool to mobilize response to the HIV epidemic. Some of the goals of NAF are;
1.    To prevent the spread of HIV.
2.    To provide access to treatment for people living with HIV.
3.    Mitigate the health and socioeconomic and psychosocial impact of HIV on individuals, families, communities and the nation.
4.    Impact mitigation.
5.    Main streaming, partnerships and capacity building.
6.    Research and development.
7.    Monitoring and evaluation.
8.    Resource mobilization and utilization.
9.    Policy coordination.
10. Programme planning.
I have talked about the government efforts to combat the disease but what about the Malawian population in general? Is there any knowledge of HIV and AIDS and prevention?
To reduce sexual transmission, a model for behavior change was set up; this comprised of three attributes:
1.    Sexual abstinence.
2.    Mutually faithful monogamy between HIV negative partners.
3.    Condom use for people not practicing abstinence.
Despite having the efforts from the government and other stakeholders providing civic education regarding the disease, there are several misconceptions that are held by the communities.

Common misconceptions about HIV and AIDS

To begin with, maybe it’s a good idea to understand what we mean by misconceptions. A misconception can be defined as simply an ideology or belief that does not reflect the true facts OR A view or opinion that is incorrect because based on faulty thinking or understanding.
Here are some of the common misconceptions in Malawi:
1.    A healthy person does not have AIDS.
2.    HIV is transmitted by mosquito bites.
3.    HIV is transmitted through supernatural means.
4.    AIDS is transmitted through sharing food with a person who has HIV or AIDS.
As funny as these may sound, these misconceptions present a problem in the knowledge and understanding of the disease and its transmission.
In this article I am not going to dwell on the methods of transmission of the disease but more on some of the major factors that I mentioned earlier that contribute to the transmission of HIV and AIDS.
A widespread stigma and discrimination against people who are HIV positive has generated fear, anxiety and prejudice against people living with HIV. Despite this, there are still attitudes and practices that people still indulge in which are risky and may propagate the spread of HIV and AIDS.
Here are some of the practices;
Attitudes towards condom use
Some people believe that sex education and condom use for the youth promotes early sexual initiation. In as much there could be some truth in this what is better; let the youth contract HIV and AIDS blindly or educate them so they have a chance to make the right decision regarding their sexuality?
It has also been suggested that condom use between married couples or sexual partners is a challenge. How do you negotiate with your partner for safer sex? According to the 2010 MDHS, it was reported that over 90% of men and women believe that a wife is justified taking some action to protect herself from HIV either by refusing sexual intercourse or by requesting that her husband or partner use a condom. In as much as this is the belief but is this what takes place in reality?
Culture and tradition have always been respected in most communities and societies, as such, there are some underlying issues regarding how a wife should behave towards her husband and or partner which makes it difficult for some women or wives to say no or ask them to use a condom even when they have evidence that their husbands have a sexually transmitted infections (STIs) or have been promiscuous. This has led to spread of STIs including HIV and AIDS.

Multiple sexual partners

As unreal as it may sound but there is a growing tendency where people think that having multiple partners makes you more clever or “cool”. Some have multiple partners because they want to make some extra money but on the other hand for some it is just a habit which could be costly.
There are two types of partnerships that I want to shed some light on with regards to multiple sexual partners. These are concurrent and serial sexual partnerships.
1.    Concurrent sexual partnerships: this is where a person has multiple partners and has sexual intercourse with one partner  between two acts of intercourse with another partner (overlapping partnerships) (UNAIDS 2009).
2.    Serial sexual partnership (serial monogamy): this is the opposite of concurrent partnerships, an individual may have multiple sexual partners without any overlapping partnerships.

Payment for sex

This is also known as transactional sex, where there is exchange of money, gifts or favours for sexual intercourse. This practice is fast growing and a cause of concern especially among the youth. Before it used to be older men enticing young girls with money and gifts but now it is also older women enticing young boys with the same. This practice is really dangerous as there is an unseen sexual networks which are formed as the young girls or boys that are involved with older partners for favours also have other sexual partners (of their own age or other older people) and if one of them is infected with HIV or STIs this is becomes a network for spreading the diseases.
So with this knowledge what can we do to help the youth in our society?

HIV and AIDS related knowledge for the youth

Earlier on I mentioned the need for sexual education for the youth and pointed out some views regarding this in Malawi. When I say youth, I mean individuals between the age of 15-24years. With the initial age for first sexual intercourse being between 15 and 18 years for both boys and girls, it is my view that there is a strong need of sex education and condom use.
The youth need comprehensive knowledge of HIV and AIDS, as this is crucial for their survival and future. So what is considered as comprehensive knowledge in this case?
According to the 2010MDHS report, this is what is considered as comprehensive knowledge;
1.    Knowing that abstinence, condom use and having just one HIV-negative faithful partner can reduce the chances of contracting HIV.
2.    Knowing that a healthy looking person can have HIV.
3.    Rejecting the most common misconceptions about HIV transmission.

AIDS continues to cause havoc around the world so let us work together to combat this disease and help others know more about HIV and AIDS.

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