Impact of HIV on Society
ANSWER
The pandemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is one of the most serious modern sexual health issues affecting the human race today. By the end of 2009, it was estimated that 34 million people were infected with HIV, and 1.8 million people died due to the disease. HIV/AIDS has been the deadliest pandemic since its discovery, claiming over 25 million lives by 2005, with Sub-Saharan Africa bearing the brunt of the toll (Douek, Roederer & Koup, 2009). This paper focuses on the psychosocial, cultural, and economic effects of HIV/AIDS and related sexual health problems on individuals and communities. HIV/AIDS has a significant impact on the infected person’s family unit as well as the community in which they live. The impact is determined by the mode of transmission of the virus (and whom it infects), the diagnosis of infection, and the community setting in which the individual and family live.
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Introduction
HIV is a retrovirus that causes acquired immunodeficiency syndrome (AIDS) (AIDS). The virus has been classified into two strains: HIV-1 and HIV-2. AIDS is a human disease in which the body’s defense (immune) system gradually fails, resulting in severe and fatal opportunistic infections and cancers (Douek, Roederer & Koup, 2009). Infection with HIV occurs when infected body fluids such as blood, breast milk, and sexual fluids such as pre-ejaculate, sperm, and vaginal fluids come into contact. The most common modes of transmission are unsafe sex with infected people—both heterosexual and homosexual—contaminated items such as needles and razors, breastfeeding, and infected mothers infecting their newborns during birth. Screening for HIV in blood and blood products has greatly reduced infection transmission via infected blood and transfusions. HIV eventually leads to AIDS; most people die from opportunistic infections or malignancies caused by a progressive immune system weakening. Individuals infected with HIV develop AIDS at varying rates, depending on host, viral, and environmental factors; many develop AIDS within ten years, but some may develop it sooner or later. There is no cure for HIV/AIDS; treatment entails taking anti-retroviral medications for the rest of one’s life and a cocktail of other medications to treat opportunistic infections (Douek, Roederer & Koup, 2009).
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HIV infection typically has a significant physical, mental, social, and economic impact on infected individuals, their families, and the community in which they live. Stigmatization by other community members exacerbates this impact; it impedes HIV prevention and management, as well as social support and disclosure of HIV status. Family units with low socioeconomic status, such as drug users, asylum seekers, and emigrants, are the most affected by the HIV pandemic. The long-term effects of living with HIV have evolved and changed many social aspects such as parenthood, disclosure of HIV status, and the long-term effects of HAART use on the individual due to the invention of better HIV care and management such as HAART (Highly Active Anti-Retroviral Therapy). Another effect of HIV is the inequality and discrimination that people living with HIV face when it comes to obtaining or retaining employment and vital services such as life insurance. Children, particularly orphans and HIV-infected children, have been known to bear the greatest burdens of HIV. The number of orphans has steadily increased due to AIDS-related deaths of guardians, and HAART allows infants born with HIV to live with the virus until adolescence or beyond. All these factors impact the community around them socially and economically.
HIV’s Physical, Psychological, and Social Effects on Individuals and Families
Infection with HIV/AIDS causes many physical, mental, and social problems affecting individuals, their families, and communities. In modern society, the definition of a family expands beyond biologically related members to include socially chosen relationships such as close friends and partners and close external family relationships such as homosexual men (Green, 2011). Before the discovery of anti-retroviral drugs, HIV infection meant death in days. However, since the development of HAART more than a decade ago, there has been a gradual decrease in the number of people dying from AIDS-related diseases in Australia, Europe, and the United States. Currently, families must deal with HIV infection as a chronic disease that must be managed for the duration of the infected person’s life (Zuniga, Whiteside, and Ghaziani, 2008). The requirement to follow a complex regimen of many drugs is the most significant burden for the HIV-infected individual; many patients experience anxiety, frustration, depression, and hopelessness, especially when the drugs fail to achieve or maintain the perceived benefits expected from the treatment regimen. This could be due to virus mutation and individual drug resistance (Zuniga, Whiteside, and Ghaziani, 2008). Even when the treatment is effective, patients experience other types of uncertainty and distress.
Other factors, such as concern about employment, sexuality, relationship prospects, and the social reactions of other community members, exacerbate the impact of HIV treatment. HAART has numerous side effects, including cardiovascular disease and several with psychosocial consequences, such as lipodystrophy (Zuniga, Whiteside, and Ghaziani, 2008). Family members may be burdened as the disease progresses by providing care to the infected and may be distressed by the stigma often associated with HIV infection.
Another effect of HIV is stigma and discrimination against HIV/AIDS patients. They must constantly deal with rejection, social discrimination, and enduring treatment with severe side effects. People living with HIV/AIDS must live with the stigma of being labeled as “victims,” a term that implies defeat, helplessness, and reliance on others for assistance (Matic, Lazarus & Donoghoe, 2006). Stigma and discrimination take different forms depending on where you live. Many countries have laws governing the travel, entry, and residence of people with HIV/AIDS. Individuals infected with the virus were restricted from staying in sixty countries for more than three months by the end of 2010, with eighteen of these also imposing restrictions on short-term residence (Stutterheim et al., 2009). Common examples of stigma and discrimination in the healthcare sector include denial of access to facilities and drugs, mandatory HIV testing without individual consent, and breach of confidentiality regarding a person’s status. Stigma from employers and coworkers includes social isolation, mockery, and discriminatory practices such as dismissal or denial of employment (Stutterheim et al., 2009). Other examples include being denied entry into a country, being evicted from their home by their families, and being rejected by colleagues and friends.
The stigma and discrimination associated with HIV/AIDS impede efforts to successfully combat the pandemic. Fear of discrimination frequently prevents people from seeking AIDS treatment and management or publicly disclosing their HIV status. On numerous occasions, the stigma associated with HIV/AIDS can extend to the infected individual’s family and siblings, creating an emotional burden on those left behind. HIV/AIDS stigma evolves as infection rates, disease understanding, and treatment availability change. In the Netherlands, for example, the community response to people living with HIV/AIDS is quite positive; understanding of HAART was linked to a perception of lower risk, with a positive attitude toward gay people, less fear, and a greater willingness to have personal contact with people living with HIV/AIDS. However, discrimination may be more severe in Eastern Europe, particularly against specific groups such as gays (Stutterheim et al., 2009).
HIV’s Economic Impact
HIV/AIDS has had the most devastating impact on the economies of many countries worldwide. The pandemic has devastated many nations, causing extreme poverty in individuals, families, and communities. The magnitude of HIV/AIDS infection’s economic and demographic impact in third-world countries is pronounced because it affects people at their most economically capable and productive age. Furthermore, it undermines the economic and health gains made in recent decades. People living with HIV/AIDS significantly strain public finances, particularly in the health sector. HIV/AIDS patients occupy up to a quarter of available hospital beds in several Caribbean countries (Green, 2011). Sub-Saharan Africa is the most affected, with southern Africa leading in virus effects. According to World Bank estimates, South Africa’s GDP decreased by 20% in 2010 as a result of the effects of the deadly virus (Salinas & Haacker, 2006). Many other countries spend a significant portion of their economic resources on HIV/AIDS treatment and care. According to a study by the University of the West Indies, HIV/AIDS will reduce the GDP of countries such as Trinidad and Tobago by more than 5% and Jamaica’s GDP by 6.4%. Poverty, a decrease in investments and savings, and unemployment in critical industries such as agriculture and manufacturing are the economic consequences (Salinas & Haacker, 2006).
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HIV has a significant economic impact on individuals and their families. In many cases, HIV/AIDS causes breadwinners to lose income and increases expenditures due to caring for the infected. HIV-affected families deplete their savings and assets to deal with increased expenses and income shocks. Firm profits, savings, and investments may suffer due to increased AIDS-related spending and lower labor productivity (Whiteside, 2008). ILO estimates that nearly 37 million people worldwide who work in productive economic activities are HIV-positive. When these adults die, their children become orphans, and the children become destitute in cases where they are the sole breadwinners (Green, 2011).
The Influence of HIV on Parenthood and Children
The development of HAARTs has impacted HIV-positive women’s pregnancy planning. HIV-positive women in the pre-HAART era were confronted with their HIV status and the bleak prospect of death. However, the number of AIDS-related deaths in women living with AIDS has decreased dramatically as a result of HAART; they now live longer, healthier lives. The decision about pregnancy is becoming more important among HIV-positive women of reproductive age, owing to the reduced risk of vertical transmission of the virus to the newborn (Noroski, 2009). Gains in mother-to-child transmission prevention have resulted in new dimensions in how communities view parenthood. Parenthood in HIV-infected people continues to have many physical and social consequences, owing to the virus’s stigma and discrimination. According to Noroski (2009), concerns that may influence parenting decisions among people living with AIDS include aspiration for parenthood, religious beliefs, previous children, the position of spouse and health care providers, and apparent spouses’ capacity to parent successfully.
HIV/AIDS has had a significant impact on parenthood. According to research findings, nearly seventy percent of all HIV-infected parents considered their family planning to be over because they did not intend to bear more children, sixteen percent were undecided, and fourteen percent had an explicit desire to have more children (Wacharasan & Homchampa, 2008). Children infected with HIV during birth or later through breast milk have a better chance of surviving adolescence, thanks to improved treatment regimens. This means that more adolescents have to deal with the virus. Children who have HIV/AIDS are at a high risk of dying from opportunistic infections. The virus has a psychological impact on the children and causes neurological impairment; as a result, they have pronounced cognitive insufficiency or diminished cognitive abilities, behavioral difficulties, and generally low quality of life. Children living with HIV may face difficulties leading a normal life due to the medication they must regularly take and issues arising from disclosing their HIV status (Noroski, 2009). Other major effects of HIV on motherhood include ethical concerns about the risk of transmitting the virus to the newborn, the socioeconomic impact, and the stigma associated with raising a child by a parent with a potentially fatal disease.
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The HIV/AIDS pandemic has significantly contributed to an increase in the number of orphans worldwide. The AIDS pandemic in Africa alone has orphaned over twelve million children. The children are abandoned; at times, older adolescents must assume parental responsibilities, while the majority are cared for by extended family members or foster parents. Because financial resources are stretched, long-term care causes economic difficulties. Children are completely deprived of their parent’s care, guidance, and protection, and social problems emerge. The children are forced to drop out of school. Statistics show that many of these children are forced to drop out of school due to a lack of resources, stigma, and discrimination or to take on the role of early parenting due to their parents’ deaths. These effects are more pronounced, especially after both parents have died. HIV/AIDS has a wide range of social consequences for the community, including increased crime rates, poverty, drug abuse, illiteracy, decreased productivity, and the eventual collapse of the social system.
HIV’s Impact on Caregivers and the Healthcare Sector
The family and healthcare providers bear the majority of the burden of caring for people living with AIDS. Before anti-retroviral therapy, this was extremely stressful because most infected patients’ health deteriorated rapidly; they were bedridden and needed to be cared for. The introduction of HAART has greatly reduced the need for around-the-clock assistance because the patient can now live a healthier life without requiring much assistance. Family, close friends, and health professionals are the most important caregivers.
The most significant impact of HIV on caregivers is stigma, also known as secondary stigma or stigma by association. Parents of HIV-positive children may be liable for their children’s HIV infection due to their ‘immoral’ behavior. According to Wacharasan and Homchampa (2008), stigmatization is a major concern for caregivers. Caregivers may try to conceal their caregiving activities by withdrawing from social relationships rather than facing stigma. In clinical practice, family caregivers may exacerbate the demands of caregiving by driving long distances to avoid bringing their care recipient’s HIV status to the community’s attention. To avoid HIV/AIDS disclosure in their communities, some informal caregivers avoid using professional home services such as home health care, infusion therapy, hospice, and hospice providers. Nurses working with informal caregivers afraid of disclosing their status must be sensitive to the family caregiver’s fear of discrimination and stigma (Wight et al., 2006). Nurses familiar with ‘HIV friendly’ referral agencies and with a long history of providing confidential services can play a role in meeting the need for professional home-centered services and solace to an informal caregiver who is afraid of HIV stigma.
Caregivers of HIV-infected children face stigma as well. Thampanichawat (2008) discovered that primary caregivers of HIV-infected children dealt with the stigma of AIDS while also managing their anxiety and fear of loss. Because of limited resources, they bore a heavy burden of care and faced numerous challenges. Similar studies report increased financial difficulties, child care, support difficulties, and hampered help-seeking due to stigma. These findings highlight the importance of developing interventions that enable caregivers to seek out and identify financial resources and child care to support and empower caregivers in dealing with stigma. Healthcare providers may also be concerned about stigma in their work with HIV-positive patients. Caregivers, formal and informal, frequently face stigma due to their association with HIV/AIDS and people living with it. This stigma may influence their willingness to work with HIV/AIDS patients or make their job more difficult.
Conclusion
Many people become infected with HIV each year in Australia and around the world, and thousands of people living with HIV develop AIDS. The impact of contracting and living with this virus is extremely difficult and depends on the society in which the infected person lives. The impact may influence the management program’s effectiveness, adherence to the treatment regimen, and the prevention of new infections. The major challenges are to encourage HIV testing for high-risk groups, to encourage status disclosure, to provide timely and effective management and care to all people living with HIV/AIDS, to work on developing modern prevention methods that take into account the pandemic’s variable patterns, and to eliminate the economic, physical, and psychosocial consequences of HIV infection. In order to effectively address the impact of HIV on various sectors, policies should take into account the needs of individuals, families, and the community.
