Aids Essay Research Paper AIDS By anonymous – Summary


By: anonymous

As recently as
1990, there were some regions of the world that had remained
relatively unscathed by AIDS. Today, however, there is not a single
country around the world which has wholly escaped the AIDS epidemic.
As the epidemic has matured, some of the developed nations which were
hard hit by the epidemic in the 1980s such as the United States have
reported a slowing in the rate of new infections and a stabilization
among existing cases with lower mortality rates and an extension of
post-diagnosis lifespan. However, despite the changing face of the
global AIDS pandemic, one factor remains unchanged: no region of the
world bears a higher AIDS-related burden than sub-Saharan Africa.
This paper examines the demographic effects of AIDS in Africa,
focusing on the hardest-hit countries of sub-Saharan Africa and
considers the present and future impact of the AIDS epidemic on major
demographic measures such as fertility, mortality, life expectancy,
gender, age, and family structure. Although the sub-Saharan region
accounts for just 10% of the world’s population, 67% (22.5 million)
of the 33.4 million people living with HIV/AIDS in 1998 were
residents of one of the 34 countries of sub-Saharan Africa, and of
all AIDS deaths since the epidemic started, 83% have occurred in
sub-Saharan Africa (Gilks, 1999, p. 180). Among children under age 15
living with HIV/AIDS, 90% live in sub-Saharan Africa as do 95% of all
AIDS orphans. In several of the 34 sub-Saharan nations, 1 out of
every 4 adults is HIV-positive (UNAIDS, 1998, p. 1). Taxing
low-income countries with health care systems inadequate to handle
the burden of non-AIDS related illnesses, AIDS has devastated many of
the sub-Saharan African economies. The impact of AIDS on the region
is such that it is now affecting demographics – changing mortality
and fertility rates, reducing lifespan, and ultimately affecting
population growth. Although Africa is the region of the world hardest
hit by AIDS, and although no country has entirely escaped the virus,
prevalence rates vary dramatically between regions, countries, and
even within countries. In general, the southern region is the most
affected, with Botswana, Namibia, Swaziland and Zimbabwe showing the
highest rates, while West Africa has been less affected. In almost
all countries, the HIV/AIDS prevalence rate is significantly higher
in urban areas than in rural areas. Within the general population,
the highest prevalence rates are found among the sexually active
adult (15 to 49 years old) population. Women tend to get infected at
earlier ages than males for a variety of biological and sociocultural
reasons. In recent years an intensive government-sponsored HIV
prevention campaign focusing on use of condoms and changes in sexual
behavior has produced impressive results. Researchers however, have
yet to satisfactorily explain the broad variation in HIV
seroprevalence between Western and Eastern sub-Saharan Africa. As
Gilks (1999) observes, in some of the countries of Western Africa
such as Senegal, low levels of HIV prevalence in adults have been
maintained for about a decade, despite many circumstances highly
conducive to appreciable and sustained transmission (p. 181). In some
Western African nations, early and sustained prevention programs may
be responsible for the differences, although other reports indicate
that comparatively low transmission rates prevail in most of the
Western countries regardless of programs designed to encourage safer
sex (UNAIDS, 1998, p. 2). Reports also show that differences in the
rate of HIV spread between East and West Africa cannot be explained
by differences in sexual behavior alone. AIDS researchers typically
make a distinction between concentrated and generalized transmission
patterns of the virus. In a concentrated transmission pattern,
infection tends to be concentrated within vulnerable groups such as
homosexual men, prostitutes, and IV drug users. In the generalized
pattern, infection is diffused broadly through the population,
typically by means of heterosexual transmission. In sub-Saharan
Africa, where heterosexual transmission predominates, the pattern is
that of generalized transmission. Compared to the U.S. little HIV
transmission in Africa is related to IV drug use or unprotected
homosexual sex. In addition to heterosexual transmission,
transmission via transfusion and through contaminated medical
equipment is not uncommon in sub-Saharan Africa. Africans infected
with HIV die much sooner after diagnosis than HIV-infected persons in
other parts of the world. Studies in industrialized countries that
were conducted prior to the introduction of treatment with multiple
antiretroviral drugs, found that the survival time following the
diagnosis of AIDS ranged from 9 to 26 months. However, in Africa the
survival time of patients with AIDS ranged from 5 to 9 months
(Unaids, 1998, p.2). A number of factors have been cited to explain
the shorter survival times in African which include lower access to
health care, poorer quality of health care services, poorer levels of
baseline health and nutrition, and greater exposure to pathogens
likely to result in opportunistic infection and early death (UNAIDS,
1998; UNAIDS, 1999; Gilks, 1999). Mortality & Life Expectancy.
There is now compelling evidence drawn from two decades of AIDS
epidemic data in central and east Africa that the AIDS epidemic has
had a dramatic and negative impact upon mortality rates and life
expectancy in this region. The most substantial increases in the
mortality rate have occurred among adults aged 20 to 40 in the
southern and eastern regions of sub-Saharan Africa, with more modest
mortality rate increases shown for children within this region. The
probability that a male adult in Zimbabwe would die between the ages
of 15 and 60 jumped from 0.181 in 1979 to 0.325 in 1992, while the
probability that a female adult would die between these ages during
this time period jumped from 0.248 to 0.419 (Timaeus, 1998, p. S21).
The increased mortality rates have had a substantial impact on life
expectancies in the affected regions. A study in rural Uganda found
that life expectancy dropped from just under 60 years to 42.5 years
during the past two decades (Boerma, Nunn & Whitworth, 1998). In
late 1998, the UN Population Division released figures suggesting
that AIDS has taken an average of seven years off the average life
expectancy at birth of a baby born in any of the 29 most affected
African countries. On average, in the absence of AIDS, life
expectancy for these 29 countries would have averaged 54 years; now,
however, the average has dropped to 47 years. Fertility. A number of
studies have now documented that HIV infection significantly reduces
the fertility levels of HIV+ women in the sub-Saharan African
countries. Studies on fertility changes in 20 sub-Saharan African
countries found a 25% to 40% decline in fertility among HIV+ women
versus their HIV-negative counterparts in the same country.
Researchers note that HIV decreases fertility among HIV+ women as a
consequence of both biological (impact on fecundity) and behavioral
factors. On the biological level, there is an increase (among HIV+
women) in menstrual disorders, miscarriages, other STDs, and partner
mortality – all of which negatively impact fertility. On the
behavioral level, HIV+ status may prompt increased divorce and
separation, increased use of condoms and/or other barrier
contraceptives, and reduced sexual frequency (Zaba & Gregson,
1998; Gregson, et al., 1999). Biological and behavioral factors among
HIV+ men may also impact the fertility rates. In general, researchers
have noted that biological factors, including reduced sperm count and
reduced frequency of sexual activity related to physical illness,
have been more important than behavioral factors (condom use, etc.)
when examining males contributions to the declining fertility rates
(Zaba & Gregson, 1998). Orphanhood & Early Childhood
Mortality. The data on child mortality and AIDS are more confusing.
There is no doubt that AIDS has had a devastating impact on children
in Africa. The majority of the world’s estimated 1.1 million HIV+
children live in the hard-hit sub-Saharan African nations (Boyle,
1998, p. 1). Most children become infected in utero through
maternal-to-fetus transmission or soon after birth through
breast-feeding. The risk of breastfeeding-related HIV transmission is
very high – estimated at 29% to 34% if primary HIV infection of the
mother occurs during lactation (Boyle, 1998, p. 1). By the end of the
year 2000, some 13 million children will have been orphaned by AIDS;
95% of these orphans live in sub-Saharan countries (Altman, 1999b, p.
1). As of 1997 11% of all children in Uganda, 9% of children in
Zambia and 7% of children in Zimbabwe were AIDS-related orphans,
having lost both parents to AIDS (Altman, 1999b, p. 2). At this
point, most analysts view orphanhood as a more serious problem in
sub-Saharan Africa than increases in child mortality. Children who
are the victims of double orphanhood often place an impossible
financial and social burden on elderly grandparents and are at high
risk for labor exploitation and/or recruitment into gangs and
militias. Gender Effects: The Case of Women. In the developed nations
of the world, women constitute about 20% of all HIV-positive adults
(Altman, 1999a, p. 4). This gender imbalance is primarily related to
the concentrated pattern of transmission where the greatest number of
cases are among male homosexuals and IV drug users. However, in
sub-Saharan Africa, the gender pattern is much different. Researchers
have long observed a fairly even gender distribution among African
AIDS cases which is attributed to the generalized pattern of
heterosexual transmission. Recently released official data has
revealed that 12.2 million or 55% of the 22.3 million HIV+ adults in
sub-Saharan Africa are female (Altman, 1999a, p. 1). The African HIV
gender disparity is particularly dramatic at the younger ages. In
many sub-Saharan African countries, the incidence of HIV infection
among girls between the ages of 15 and 19 years old is six to eight
times that of their male counterparts (Reuters Health, 1999a, p. 1).
A number of social and cultural factors are responsible for this
discrepancy, including the high rates of rape in many African
countries, the low age of sexual initiation among females, and the
age disparity between young women and their first male sexual
partners who alot of times are middle-aged men seeking virgins as
sexual partners to ward off AIDS. Population-Wide Effects. Over time,
higher-than-expected mortality rates and lower-than-expected
fertility rates will have an impact on population growth. To date,
hard data on the population-wide impact of AIDS have been limited.
Preliminary data from some of the hardest-hit countries suggest that
AIDS has already begun to effect population growth rates. A 1998 UN
the report found that the high AIDS-related mortality rate in Zimbabwe
had depressed population growth during the late 1980s and early
1990s. Between 1980 and 1985, Zimbabwe’s population grew at 3.3% per
year. By 1998, the annual growth rate had dropped to 1.4% and was
projected to fall to less than 1% beginning in 2000 (Ibrahim, 1998,
p. 1). In conclusion the AIDS epidemic is devastating African
society. Historically, few epidemics have resulted in such
widespread, devastating demographic effects. Thus far, the AIDS
epidemic in sub-Saharan Africa has decreased fertility rates,
increased mortality rates, shortened average life expectancy,
increased the rate of orphanhood, and disrupted family structure. It
is now poised to decimate population growth rates and alter the
gender ratio. The epidemic may well change the social and economic
fabric of sub-Saharan Africa in ways that are not yet understood or
anticipated. An International Labor Office report released in October
of 1999 warned that HIV/AIDS has now become the single most important
obstacle to social and economic progress in many countries in Africa
and noted that the epidemic in the region has shifted from being
primarily a health problem to being a development problem with
potentially ominous consequences (Reuters Health, 1999b, p. 1).
Preliminary studies suggest that the economic consequences of the
AIDS epidemic will be no less devastating than the demographic
consequences. Direct economic consequences include the costs of
medical care and social programs related to the epidemic while
indirect consequences include factors such as dwindling labor
productivity as the young, economically productive population takes
ill and/or dies. Solving the development problem of the AIDS epidemic
in sub-Saharan Africa will require not only massive amounts of
foreign aid and expertise, but also a massive social transformation.
Through AIDS-prevention programs aimed at increasing condom use,
reducing high-risk sexual behaviors, improving HIV screening,
promoting alternatives to breastfeeding, and reducing social stigma
associated with AIDS there can be a positive and measurable impact on
HIV prevalence or else the Aids Epidemic will continue to claim the
lives of millions and millions of Africans.

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