Benchmark – Cancer, Chronic Illness and/or Disease Paper – HIV/AIDS
This assignment focuses on HIV/AIDS prevention and reduction among the KwaZulu-Natal Community province black community in South Africa. HIV/AIDS is a viral disease that weakens the immune system of a person by destroying essential cells that are meant to fight infection and disease. According to 2013 statistics, about 35 million people in the world are living with HIV. Among them, Sub-Sahara Africa accounts for 71% of HIV infection global burden, despite being a home of just 12% of the world population. South Africa is among the Sub-Sahara countries highly affected by HIV, accounting for 25% of all cases in the region (Kharsany & Karim, 2016).
According to 2018 statistics over 7.5 million people in South Africa are living with HIV. The country however demonstrates considerable spatial variation in the HIV epidemic, with more cases being reported in the eastern part of the country between KwaZulu-Natal and Limpopo provinces (Kim et al., 2021). The HIV prevalence in KwaZulu-Natal based on 2017 statistics was 27%. Various studies from KwaZulu-Natal persistently demonstrate high HIV prevalence and young women incidence, proposing that the HIV burden continues unabated (Kharsany et al., 2019).
Background of the Selected Community
KwaZulu-Natal is a province in the coastal region of South Africa. The province has a population of about 11.1 million, where around 86.8% are Black Africans, 1.4% are colored, 7.4% are Asian or Indians and 4.2% are whites. The region is said to have more women than men, with women accounting for 55% of the population, while men account for 45%. The rate of infection is found to be high among Black Africans, especially women aged between 15 and 24 years. Like many other African regions, the KwaZulu-Natal community is characterized by a low level of literacy, with the majority having just the basic education, with only 31.2% managing to get tertiary education. The province record a high rate of unemployment, with the majority living in subjective poverty of below $2 a day. Low level of education, poverty, age, and self HIV status assessment are some of the factors that facilitate HIV spread among Black Africans in KwaZulu-Natal province (Statssa.gov, 2011).
Besides poor socioeconomic status, the Black Africans in the region have embraced some cultural practices that encourage the spread of HIV in the region. KwaZulu-Natal Black Africans do practice wife inheritance tradition commonly regarded as Kungena, where windows are remarried by the brothers to the deceased man. Some people in the community do practice polygamy, though fail to observe the original values embraced in this kind of marriage culturally. Modern polygamy is characterized by a high level of infidelity subjecting most members of such marriages to HIV risks. Virginity testing and early marriage are other cultural practices facilitating the spread of HIV in the region. Young girls are married to older men, who may have been involved with other women, including commercial sex workers before the marriage. This exposes young girls to HIV. The virginity testing tradition was anticipated to fight engagement in sex, though it facilitated prejudice of young girls exposed to sexual abuse. Also some weird believes like having sex with a virgin may cure HIV among some people exposes those girls to sexual abuse (Mswela, 2009).
Black African living in KwaZulu-Natal are highly impacted by HIV that started infecting people in the region in the early 2000s. As a result, most kids are orphaned by the time they get to their 18th birthday. This continues pushing more people to poverty, subjecting more girls to early marriages. The high rate of infection also increases the number of live birth among women living with HIV (Moyo et al., 2020). This increases the number of children born with HIV, especially among women who pay little medical attention during pregnancy. The black African culture has also contributed a lot to the spread of the disease. This Makes KwaZulu-Natal among the most infected regions in the country and the regions with great need of prevention and reduction plans to control further spread of the disease.
Components of HIV/AIDS Prevention and Reduction Plan
The main cause of HIV infection spread among the black people in KwaZulu-Natal include their cultural practice, lack of proper knowledge about the disease, and poverty. Addressing these issues will play a great role in preventing further spread and enhancing healthy living among those already infected. The most effective way to handle this is by employing multiple strategies (Detels, Wu & Wu, 2019). The first component to HIV spread prevention and reduction will be education. Education will focus on improving people’s knowledge on what HIV/AIDs is, how it is transmitted, its impact on society, and how it can be prevented. Education will target all in the society especially teenage girls who are at a higher risk of contracting the disease. The training will aim at enlightening those girls on how to prevent themselves from getting infected, the danger of early sex, the need of using contraceptives (condoms) while engaging in sex, the danger of having multiple partners, and the need for testing before engaging in sex with a new partner (Kharsany & Karim, 2016).
The second component will be establishing a campaign to promote the safe practice of cultural practices that encourage the spread of HIV in the community. This will involve the collection of data to prove the contribution of the cultural practice to HIV spread, and deaths in the community, and enlightening people on how they can practice their culture safely; without spreading HIV. The targeted cultural practices will include wife inheritance, early marriages, and polygamy. The campaign will encourage the testing of the two partners before marriage or remarriage. It will also discourage wife inheritance when the husband’s cause of death is HIV/AIDs, and restrict those marriages to two positive partners if a must. The campaign will also encourage faithfulness and ethical behaviors in a polygamous relationship. The campaign will integrate local leaders and community elders to enhance their effectiveness (Detels, Wu & Wu, 2019).
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The other component will involve a testing campaign with the encouragement of treatment compliance for those found positive. This will be a mobile campaign, issuing people with personal test kits or offering people free testing services and counseling across the region. The campaign will also include the provision of ARVs among those found positive and their enrollment in the medical care program. The campaign will focus on surpassing the current 90-90-90 strategy (Kim et al., 2021). The campaign will help in ensuring more diagnosis, and provision of antiretroviral therapy. The campaign will also involve the distribution of free condoms both male and female to encourage people to take precautions and encourage all women to have prenatal care at the nearby hospital. Hospitals will also establish an HIV tent to offer these services at a deeper length.
The proposed prevention methods are based on the philosophy that a thorough understanding of the disease typologies, populations affected, and transmission mode intensifies prevention activities. Knowing this informs the level to which evidence-based modalities can be combined and customized to lower HIV transmission substantially, which is essential in progressive alteration of the disease trajectory (Kharsany & Karim, 2016). The prevention method is also based on the belief that gradual change is more acceptable and effective than complete abrupt change.
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Some of the KwaZulu-Natal cultural practices need to be completely abandoned. However, this may not be easy, encouraging them to practice them more safely may be more acceptable than advocating their complete abandonment. For improved results, education programs will target schools both primary and high school. They will also target social groups including churches and other community gatherings such as youth groups and sports clubs. Campaigns will be done in different places including markets along a busy street and different sociocultural groups. A special tent will also be raised in all public hospitals across the regions offering education, testing, and treatment plans.
Obstacles to the Implementation HIV/AIDS Prevention and Reduction Plan
The plan is considerably expensive as it needs enough personnel for the campaigns and resources to offer mobile campaigns and training camps. The other obstacle is resistance to change. Some of the major factors contributing to the disease are culturally built. It would be hard to abandon these cultures even with proper education or make an adjustment. While some people may be willing to make changes, those facilitating such cultures may refuse the integration for change and advocate safe measures. The inferior position of women in society, and poverty may make it hard for women to adhere to the change, even when they want to due to lack of power and societal support.