Lecture 31: Case study: HIV/AIDS Flashcards
what are the factors that shape the epidemic?
deaths related to aids are decreasing, and people are living longer with hiv due to improved treatment and access to treatment/care
- nearly 15% of people with hiv+ do not know their hiv status
- ## most people living with or at risk for HIV do not have access to hiv prevention, treatment and care
high risk groups and major modes of HIV transmission
unprotected sexual intercourse with hiv+ person
- homosexuals
- heterosexuals
- sex workers
sharing un-serilised injections and needles
- injecting drug users
- those receiving injections with un-serilised needles (in low resource settings)
mother to child transmission
- infants born to or breast fed by untreated hiv+ mothers
blood-borne
- anyone receiving un-screened blood products, organs (generally in countries with inadequate screening
global trend
- heterosexual transmission = dominant mode of transmission
- 95% were in low and middle income countries
- of new infections, 40% were 15-24 (majority female/from sub-saharan africa
what is the definition of feminisation of the HIV epidemic?
refers to the observation that increasing proportions of new infections are among women, primarily due to heterosexual transmission of the infection
leading cause of death of women of reproductive age 15-49
women are more likely to…
- face barriers in accessing hiv prevention, treatment and care services
- to face barriers to education
- to experience poverty
what are the social determinants of hiv infection/gender inequities
- harmful social norms that promote harmful power dynamics
- rules governing sexual relationships, negotiating condom use
- problems with disclosure of hiv status, gender based violence
- partner notification and confidentiality
- stigma and discrimination - early school drop out, poverty and financial depdencnce
- lack of education leads to lack of safe/well paid jobs
- lack of resources –> do things that put them at risk of HIV (sex work, intergenerational sex, early marriage, and relationships that expose them to violence and abuse) - lower access to health services
- denied access, low health literacy, young women need parental consent to access reproductive health services.
human rights, women + hiv/aids
- safe sexuality + autonomy in all decisions is very related to economic independence. right is violated the most in places where women exchange sex for survival as a way of life </3
- not ab prostitution but a basic social/economic arrangement bt sexes which results from
- poverty affecting women
- male control over women’s lives in a context of poverty
hiv prevention + control
HAS TO ADDRESS SOCIAL DETERMINANTS OF HIV INFECTION
gender inequities and harmful social norms
- empower women, educate men
- enable opportunities for education + financial indepdence
- change social norms around harmful power dynamics, gender based violence, stigma and discrimination
- improve health literacy
- improve access to sexual + reproductive health services
extra hiv prevention and control
- safer sex
- media campaigns + wider policy strats to reduce stigma
- educational approaches
- condoms; promote use through social marketing campaigns, increase availability, reduce cost - safer products + related practices
- screen blood products for HIV
- needle and syringe exchange programs for IV drug users
- protect against needle-stick injuries - increase access to healthcare:
- voluntary testing and counselling to reduce risk fo sexual transmission
- treatment, care, and support for HIV+ people
- treatment of sexually transmitted infections, and provision of family planning services
- antenatal screening and treatment for HIV to prevent mother-to-child tranmsmission of hiv
mother-to-child transmission
without treatment, about 1/3 children born to women who are hiv+ will become infected
3 major challenges for the future
global resources for prevention + care for HIV fall well short of the needs
- successuful efforts for prevention need to combat stigma and discrimination
- inequities in resources and access health care, make it essential to address the social determinants of health + human rights, esp women, low se groups and young people.
