HIV/AIDS IN SUB-SAHARAN AFRICA

1. HIV/AIDS IN SUB-SAHARAN AFRICA ELIAS KIMA, MPH STUDENT WALDEN UNIVERSITY PH 6165-3 INSTRUCTOR: DR. JALAL GHAEMGHAMI WINTER, 2009

2. What is Sub-Saharan Africa? • A geographical expression used to describe countries of the African continent located south of the Sahara desert. • It is made up of forty-eight countries with a population of 836 million in 2008. University of California, San Francisco, Center for HIV Information, (2009, July).

3. Significance of The Disease • 22 million Sub-Saharan Africans lived with HIV/AIDS in 2007 • 1.5 million deaths and 1.9 million new cases were reported in the same year. University of California, San Francisco, Center for HIV Information, (2009, July).

4. Effects of The Disease • Health Care Sector: • HIV/AIDS has caused enormous strain on the needy health care sector. • Patients are admitted into hospitals only at later and more complicated stages of the disease. Schneider, 2006

5. Effects of The Disease Cont’d b) Economic Sector: • HIV/AIDS has ruined the Sub-Saharan African economy. • It has reduced the supply of labor and scared foreign investors. Dixon, McDonald, & Roberts, 2002

6. Effects of The Disease Cont’d c) Educational Sector: • HIV/AIDS decreases both the availability and quality of education. • Many young adults still lack the basic knowledge of sexually transmitted diseases. UNAIDS, 2009

7. Factors That Can Impact Mortality of HIV/AIDS-Infected Persons • Factors that can influence the death of HIV/AIDS patients include; * Environmental * Behavioral * Psychosocial Cohen, Chavez, & Chehimi, 2007

8. Environmental Factors • Family: • Family composition is associated to sexuality . • Many young adults have lost their parents to HIV/AIDS. • Living alone encourages risky sexual behaviors, often with multiple partners. Rwenge, 2000

9. Environmental Factors Cont’d b) Socioeconomic Status: • Low standard of living encourages sexuality • Financial pressure to meet basic needs obliges young school girls to engage in dangerous sexual activities. Bohmer & Kirumbira, 2000

10. Behavioral Factors • Age-mixing and Gender Differences: • Adolescent women engage in sexual relationships with older and more experienced men. • These younger females cannot propose safer sex practices to their partners. Luke & Kurz, 2002

11. Behavioral Factors Cont’d b) Sexual Promiscuity: • Many males have multiple female sexual partners. • This is either for sexual gratification or gain of social status Urassa, Moshiro, Chalamilla, Mhalu, & Sandstrom, 2008

12. Behavioral Factors Cont’d c) Low Rates of Condom Use: • The predominantly Christian population overtly preaches against the use of contraceptives during sexual encounters • Many young adults have never used condoms during sexual intercourse. Wodi, 2005

13. Behavioral Factors Cont’d d) Lack of Motivation to Seek Care: • Many patients do not seek help even in the presence of HIV/AIDS symptoms. • Others seek care weeks after the presence of symptoms. Meyer-Weitz, Reddy, Borne, Kok, & Pieterson, 2002

14. Psychosocial Factors • Stigmatization: • Local communities attribute shame and worthlessness to HIV/AIDS patients • They believe casual contact causes cross-infection • Patients are discouraged from seeking help at the clinics Timberg, 2005

15. Psychosocial Factors Cont’d b) Self-inefficacy: • Young females consider themselves powerless in romantic relationships. • They can neither implement safer sex practices nor refuse requests to have sex. Wodi, 2005

16. Key Learning Goals At this juncture every reader should be able to; • adopt new behaviors to help reduce the number of new cases of HIV/AIDS. • decrease stigmatization of infected persons and encourage timely testing for the disease. • appropriately direct preventive and control interventions to maximize efficiency.

17. REFERENCES Bohmer, L., & Kirumbira, E. K. (2000). Socio-economic context and the sexual behavior of Ugandan out of school youth [Abstract]. Culture, Health, & Sexuality, 2(3), 269-285 Cohen, L., Chavez, V., & Chehimi, S. (2007). Prevention is primary: Strategies for community well-being. San Francisco: Jossey-Bass. Dixon, S., McDonald, S., & Roberts, J. (2002). The impact of HIV and AIDS on Africa’s economic development. British Medical Journal, 324(7331), 232-234 Luke, N. & Kurz, K. (2002). Cross-generational and transactional sexual relations in Sub-Saharan Africa: Prevalence and implications for negotiating safer sexual practices. Washington, DC: International Center for Research on Women. Meyer-Weitz, A., Reddy, P., Borne, H. W. V. D., Kok, G., & Pietersen, J. (2002). The determinants of health care seeking behavior of adolescents attending STD clinics in South Africa [Abstract]. Journal of Adolescence, 23(6), 741-752 Rwenge, M. (2000). Sexual risk behaviors among young people in Bamenda, Cameroon. International Family Planning Perspectives, 26(3), 118-123 Schneider, M. J. (2006).Introduction to public health (2nd ed.). Sudbury: MA. Jones and Bartlett

18. REFERENCES Cont’d Timberg, C. (2005, January 14).In S. Africa, stigma magnifies pain of AIDS. Many still see disease as fatal, shameful. The Washington Post. Retrieved January 23, 2010, from http://www.washingtonpost.com/wp-dyn/articles/A7822-2005Jan13.html University of California, San Francisco, Center for HIV Information. (2009, July). Sub-Saharan Africa. Retrieved January 22, 2010, from the HIV InSite Web site: http://hivinsite.ucsf.edu/global?page=cr09-00-00 UNAIDS. (2009, April 16). UNICEF working to teach AIDS prevention to young people in Guinea. Retrieved January 23, 2010, from http://www.unaids.org/en/KnowledgeCenter/Resources/FeatureStories/archive/2009/20090416_UNICEF_Guinea.asp Urassa, W., Moshiro, C., Chalamalla, G., Mhalu, F., & Sandstrom, E. (2008). Risky sexual practices among youth attending a sexually transmitted infection clinic in Dar es Salaam, Tanzania. BioMed Central Infectious Diseases, 8(159) Wodi, B. E. (2005). Gender issues in HIV/AIDS epidemiology in Sub-Saharan Africa. Wagadu, 2.