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Week#3 “Impact of HIV on Society”

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Impact of HIV on Society
“Impact of HIV on Society”
Rolando Ramirez-Rivero
Dr. Lise-Pauline Barnett
English 101
7 November 2020
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Impact of HIV on Society
The human immunodeficiency virus/acquired immunodeficiency syndrome
(HIV/AIDS) pandemic is one of the most serious contemporary sexual health related
issue affecting the human race today. By the end of 2009, it was approximated that 34
million people were living with the HIV virus and deaths related to AIDS were about 1.8
million people. HIV/AIDS has been the worst pandemic since its discovery; having
claimed over twenty-five million lives by 2005 (Douek, Roederer & Koup, 2009).
Human immunodeficiency virus (HIV) is a retrovirus that causes acquired
immunodeficiency syndrome (AIDS). AIDS is a human disease in which there is gradual
failure of the body’s defense system thereby leading to severe and fatal opportunistic
infections and cancers (Douek, Roederer & Koup, 2009). Infection with HIV occurs
through coming in contact with infected body fluids such as blood, breast milk, and
sexual fluids such as pre-ejaculate, semen, and vaginal fluids. The key modes of
transmission are unsafe sex with infected person-both heterosexual and homosexual,
contaminated items such as needles and razors, breastfeeding, and infected mothers
infecting the newborn during birth. HIV eventually progresses to AIDS; the individuals
mostly succumb to opportunistic infections or malignancies resulting from progressive
weakening of the immune system. Different individuals infected with HIV develop AIDS
at different rates depending on the host, viral, and environmental factors; many develop
to AIDS within ten years but in some it may be earlier or later. There is no cure for
HIV/AIDS; treatment involves life-long use of a combination of anti-retroviral drugs and
a cocktail of other drugs to treat any opportunistic infections (Douek, Roederer & Koup,
2009).Al Infection with HIV/AIDS leads to numerous bodily, mental, and social issues
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Impact of HIV on Society
that affect the individual and impacts on their families and communities at large. In the
contemporary society, the definition of a family shifts from the traditional structure of
biologically related members to include socially chosen relationships, for instance, close
friends, partners, and close external family relationships such as homosexual men
(Green, 2011). Before the discovery of anti-retroviral drugs, infection with HIV meant
death within a short period of time. However, after the invention of HAART over a
decade ago, there has been a gradual decline on the number of individuals succumbing
to AIDS-related diseases in Australia, Europe, and the United States. Currently, families
have to deal with HIV infection as a chronic disease to be coped with for the life span of
the infected individuals (Zuniga, Whiteside and Ghaziani, 2008). The requirement to
take complex regime of many drugs is the foremost burden for the HIV-infected
individual; many patients suffer anxiety, frustration, depression and hopelessness
especially when the drugs do not accomplish or maintain the perceived benefits
expected from the treatment regime. This could be due to virus mutation and individual
resistance to the drugs (Zuniga, Whiteside and Ghaziani, 2008).The impact of the HIV
treatment is further aggravated by other factors such as worry about employment,
sexuality, the prospects of relationships, and the social reactions of other community
members. HAART has numerous side-effects, such as cardiovascular diseases and
several of which have psychosocial consequences like lipodystrophy (Zuniga, Whiteside
and Ghaziani, 2008). Members of the family may also be burdened by giving care to the
infected as the disease advances, and they may be distressed by the stigma often
associated with HIV infection. Another impact of HIV is the stigma and discrimination
against persons living with HIV/AIDS. Apart from having to endure treatment with
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Impact of HIV on Society
severe side-effects, they constantly have to cope with rejection and social
discrimination. People with HIV/AIDS have to put with being labelled as “victims” a term
that implies defeat, helplessness, and dependence upon help from others (Matic,
Lazarus & Donoghoe, 2006).The forms of stigma and discrimination vary
geographically. Many nations have regulations that control the travel, entry and
residence of persons living with HIV/AIDS. By the end of 2010, individuals living with the
virus were restricted on long stays of over three months in sixty countries and eighteen
of these even applied limitations on short term residence (Stutterheim et al, 2009) In
healthcare sector, the common examples of stigma and discrimination experienced are
being denied access to facilities and drugs, mandatory HIV testing without individual
consent, and breach of confidentiality over the person’s status. In the workplace, stigma
from employers and fellow workers include social isolation and mockery, or experience
biased practices, such as dismissal or denial of employment (Stutterheim et al, 2009).
Other instances include denial of entry into a country, forced eviction from residence by
their families and rejection by colleagues and friends. Stigma and discrimination
associated with HIV/AIDS greatly hinders efforts to successfully battle the HIV and AIDS
pandemic. This fear of discrimination frequently averts individuals from seeking
treatment and management of AIDS or from publicly disclosing their HIV status. On
numerous occasions, the stigma associated with HIV/AIDS can extend to the family and
siblings of the infected individual, creating an emotional burden on those left behind.
HIV/AIDS-related stigma modifies over time as infection levels, understanding of the
disease and treatment availability vary. For instance, in the Netherlands, the community
response to persons with HIV/AIDS is quite positive; understanding of HAART was
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Impact of HIV on Society
linked to perception of lower risk, with a positive attitude towards gay people, less fear,
and a greater readiness to have personal contact with people with HIV/AIDS. However,
in Eastern Europe, discrimination may be more severe, particularly of specific groups,
such as gays (Stutterheim et al, 2009). HIV/AIDS has had the greatest negative effect
on the economies of many countries all over the world. The pandemic has been
devastating for many nations where it has caused deep poverty both to the individual,
families, and community. The magnitude of economic and demographic impact of
HIV/AIDS infection in third world countries is pronounced due to the fact that it affects
persons in the most economically able and productive age. Besides, it is also weighing
down on the economic and health gains made in the last few decades. People with
HIV/AIDS create a profound burden for public finances, especially in the sector of
health. In a number of Caribbean countries, HIV/AIDS patients take up as many as a
quarter of existing hospital beds (Green, 2011).The sub-Saharan Africa is the most
affected with southern Africa leading with the effects of the virus. The World Bank
approximation shows that gross domestic product (GDP) of South Africa reduced by
twenty percent in 2010 due to the effects of the deadly virus (Salinas & Haacker,
2006).Many other countries are using huge portion of their economic resources in
providing treatment and care for people with HIV/AIDS. A research carried out by the
University of the West Indies shows that the GDP of countries such as Trinidad and
Tobago will drop by over five percent and that of Jamaica by 6.4 percent as a result of
HIV/AIDS. The economic impact is poverty, a reduction in investments and savings, and
rise of unemployment in vital industries such as agriculture and manufacturing (Salinas
& Haacker, 2006).The economic impact of HIV is greatly felt by the individual and their
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Impact of HIV on Society
families. HIV/AIDS in many cases results in loss of income of the breadwinners and
increase in expenditures as a result of caring for the infected. Families affected by HIV
deplete their savings and assets in order to cope with increased expenditure and
income shocks. Firm profits, savings and investments may reduce due to increase
AIDS-related expenditure and lower labor productivity (Whiteside, 2008). According to
ILO estimates, close to thirty-seven million persons worldwide who are engaged in
productive economic activities are HIV-positive. The mortality of these adults leaves the
children as orphans and in cases where they were the sole bread winners; the children
are left destitute (Green, 2011) The development of HAARTs has had an impact on
pregnancy planning among people living with HIV. In the pre-HAART era, HIV-positive
women were faced with their HIV status and the expected bleak outcome of death. The
number AIDS-related deaths, however, has drastically gone down in women living with
AIDS due to HAART; they now live longer healthier lives. Among the women in the
reproductive age who are living with HIV, the decision about pregnancy is becoming an
important one; this due to reduction of the risk of vertical transmission of the virus to the
newborn (Noroski, 2009). Gains in prevention of mother to child transmission have led
to emergence of new dimensions in the way communities view parenthood. Parenthood
in HIV infected people is still eliciting many physical and social effects especially due to
stigma and discrimination associated with the virus. Noroski (2009) outlines that
concerns that might determine parenting decisions among people living with AIDS are
the aspiration for parenthood, religious beliefs, children one had before, the position of
spouse and health care providers, and apparent spouse capacity to parent successfully.
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Impact of HIV on Society
HIV/AIDS has greatly changed parenthood. Research findings shows that
close to seventy percent of all HIV infected parents regarded their family planning to be
over, since they did not plan bear any more children, sixteen percent were undecided,
while fourteen percent had an explicit longing to have more children (Wacharasan and
Homchampa, 2008). Children who are infected with HIV either during birth or later
through breast milk now have a chance to survive up to adolescence owing to better
treatment regimes. This means that more adolescents increasingly have to cope with
the virus. Children living with HIV/AIDS have a high risk of death from opportunistic
infections. The virus affects the children psychologically and leads to neurological
impairment; as a result, they have pronounced cognitive insufficiency or diminished
cognitive abilities, have behavioral difficulties, and have a general low-quality life.
Children living with HIV may also experience challenges in leading a normal life due to
the medication they must use regularly as well as problems that result from disclosure
of their HIV status (Noroski, 2009). The other main impacts of HIV on motherhood are
ethical concerns about the possible danger of spreading the virus to the newborn, the
socioeconomic impact, concerns and stigma associated with bringing up a child by a
parent who has a potentially fatal disease. The HIV/AIDS pandemic has greatly
contributed to increase in the number of orphans universally. In Africa alone, there are
over twelve million children orphaned by AIDS pandemic. The children are left destitute;
at times, the elder adolescents have to take up the parenting roles while majority are
taken care of by their extended family members or foster parents. This long-term care
causes economic difficulties as financial resources are strained. The children become
fully deprived of the care, guidance and protection of their parents and social problems
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Impact of HIV on Society
begin to crop up. The children find themselves prematurely out of school. Statistics
show that many of these children have to drop their education due to lack of resources,
stigma, and discrimination or simply to take up the role of premature parenting resulting
from death of their parents. These effects are more pronounced especially after death of
both parents. HIV/AIDS in the long term leads to numerous social impacts on the
community such increase in crime rates, poverty, drug abuse, illiteracy, reduced
productivity, and eventual collapse of social system. The major burden of caring for the
people living with AIDS rests with the family and the health care providers. In the era
before anti-retroviral therapy, this used to be an immensely stressing task because most
of times the health of the infected patients deteriorated rapidly, they were bedridden and
has to be taken care of. The advent of HAART has greatly improved the need for round
the clock help since the patient can now lead a healthier life without need for much help.
Important care givers are mainly the family, close friends, and health workers. The
major impact of HIV on the caregivers is stigma; usually referred to as secondary stigma
or stigma by association. Parents of people living with HIV may be held responsible for
the ‘immoral’ behavior that led to infection of their children with HIV. Wacharasan and
Homchampa (2008) reported stigmatization as a primary concern for the caregivers.
Rather than face stigmatization, caregivers may try to conceal their care giving activities
by withdrawing from social relationships. In clinical practice, family caregivers may
exacerbate demands of care giving by driving long distances to avoid community
awareness of their care recipient’s HIV status. Some informal caregivers even avoid
employing the professional home services of home health care, infusion therapy
hospice, and hospice providers to avoid HIV/AIDS disclosure in their communities.
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Impact of HIV on Society
Nurses working with informal caregivers fearful of status disclosure must be sensitive to
the family’s caregiver’s fear of discrimination and stigma (Wight et al, 2006). Nurses,
knowledgeable of ‘HIV friendly’ referral agencies with well-established histories of
providing confidential services can play a role in meeting the need for professional
home-centered services and bringing solace to an informal caregiver fearful of HIV
stigmatization. Caregivers of HIV-infected children also face stigma. Thampanichawat
(2008) found primary caregivers of children with HIV infection dealt with the stigma of
AIDS while managing their anxiety and fear of loss. Bore much burden of care and
faced many difficulties because of limited resources. Similar studies report increased
financial difficulties, problems in childcare and support and compromised help-seeking
due to stigma. These findings emphasize the need to develop interventions to enable
caregivers to seek out and identify financial resources and childcare to support and
empower caregivers to deal with stigma. Health care providers also may fear
stigmatization in their work with HIV-positive patients. Caregivers, both formal and
informal, commonly experience stigma from their association with HIV/aids and people
living with it. This stigma may influence their willingness to work with those with
HIV/AIDS or make their work more difficult.Annually, across Australia and the world,
many individuals get infected with HIV; thousands living with HIV develop AIDS. The
impact of contracting and living with this virus hugely challenging and depends on the
society the infected person lives in. The impact may determine the effectiveness of the
management program, adherence to the treatment regimen and prevention of new
infections. The major challenges are to encourage HIV testing for the risk groups,
encourage status disclosure, availing a timely and effective management and care to all
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Impact of HIV on Society
people living with HIV/AIDS, to endeavor in developing contemporary prevention
methods that consider the variable patterns of the pandemic, and to eradicate the
economic, physical and psychosocial impacts of HIV infection. Policies should
incorporate the needs of individuals, families, and the community in order to effectively
address the impact of HIV on various sectors.
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Impact of HIV on Society
References
Douek, D. C., Roederer, M., & Koup, R. A. (2009). Emerging concepts in the
immunopathogenesis of AIDS. Annual review of medicine, 60, 471–484.
https://doi.org/10.1146/annurev.med.60.041807.123549
Williford, S., Marcarelli, P., Pearson, M. (Producers), & Williford, S. (Director). (2011).
The Green [Motion Picture]. USA: Table Ten Films.
Zuniga, José & Whiteside, A. & Ghaziani, Amin & Bartlett, J.G.. (2009). A Decade of
HAART: The Development and Global Impact of Highly Active Antiretroviral Therapy.
10.1093/acprof:oso/9780199225859.001.0001.
Matic S, Lazarus JV and Donoghoe MC, Hiv/Aids in Europe. Moving from death
sentence to chronic disease management, world health organization, Geneva, 2006,
274 pp., ISBN 92‐890‐2284‐1
Stutterheim, S. E., Pryor, J. B., Bos, A. E., Hoogendijk, R., Muris, P., & Schaalma, H. P.
(2009). HIV-related stigma and psychological distress: the harmful effects of specific
stigma manifestations in various social settings. AIDS (London, England), 23(17), 2353–
2357. https://doi.org/10.1097/QAD.0b013e3283320dce
Salinas, Gonzalo E. and Haacker, Markus, Hiv/Aids: The Impact on Poverty and
Inequality (May 2006). IMF Working Paper No. 06/126, Available at SSRN:
https://ssrn.com/abstract=910691
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