It is hard to define the original date of the emergence of the human immunodeficiency virus (HIV) in the world. However, having started at the beginning of the 1980s in the United States, it has obtained a global pandemic character currently. Terrifying statistics of AIDS-infected individuals and deaths caused by the deadly virus have stirred society into action. All over the world, there is hardly a person who does not know what AIDS is. No matter the social activity in terms of preventing and combating the acquired immune deficiency syndrome, the quantity of infected persons of different ages and social statuses keeps increasing. Currently, the acquired immune deficiency syndrome epidemic is the accepted truth. Still, society should never stop the activity-oriented at AIDS control and prevention.
According to AIDS medical investigators, the cause of the disease is the human immunodeficiency virus (Fan, Conner, & Villarreal, 2011). However, originally AIDS was discovered by its effects on the immune system. The most prominent symptom of HIV was lung infection or pneumonia caused by Pneumocystis, which is rare among healthy individuals. In addition to pneumonia, HIV is associated with a variety of other infections caused by numerous protozoa, bacteria, fungi, and other viruses. In most cases, abovementioned secondary infections cause death of an AIDS patient. Additionally, cancers are frequently developed in infected individuals, not mentioning damage of brain cells and further loss of mental function. Despite the majority of primary and secondary symptoms of AIDS, medical investigators have obtained the full amount of information concerning the spread of the disease. It has become common knowledge that HIV is transmitted by means of a close contact. Sexual contact, blood, and birth are currently known as the only possible ways of acquired immune deficiency syndrome transmission. It is impossible to become infected with HIV through casual contact.
As a rule, epidemics come unexpectedly. The first cases of HIV were observed before June 1981, which is considered the official date of the AIDS epidemic beginning. Initially, the cases of AIDS took their origin from incurable, strange, and inexplicable conditions of men, women, and children in the late 1970s. Infected people belonged to different age and social groups. According to Bayer and Oppenheimer (2002):
The initial cases of HIV left physicians perplexed, sometimes disturbed. Only gradually, as they told their colleagues about what they had seen and began to hear about other cases, did the realization begin to take hold than something unusual and worrisome was occurring. (p.12)
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In 1985, the epidemic of AIDS entered a new phase. Recognition of its seropositivity resulted in recognition of social dimensions of HIV. Eventually, it resulted in introduction of serious medical, ethical, and legal problems associated with the complexity of the disease. Additionally, the African focus began to reveal other epidemiological facets of AIDS, which appeared to be even more disturbing than those of the American focus. The most dismal prognoses were confirmed all over the world. The exponential increase of the number of seropositives along with a rapid and intensive geographical extension of the infection took on the proportions of an international catastrophe (Grmek, 1993). From this time on, AIDS has been a true pandemic.
Since the time of its identification, the pandemic virus has caused more than sixty million cases of infection and twenty-five million deaths during almost thirty years. As a disease, AIDS was first identified in the United States. However, in the world perspective, HIV infections in America and Western Europe represent a small fraction of total cases. In sub-Saharan Africa, AIDS is a major health problem. The character of AIDS epidemic in Africa is compounded because of limited financial abilities for offering medical care to infected individuals. Sharp and Hahn (2011) stated:
Developing countries have experienced the greatest HIV/AIDS morbidity and mortality, with the highest prevalence rates recorded in young adults in sub-Saharan Africa. Although antiretroviral treatment has reduced the toll of AIDS- related deaths, access to therapy is not universal, and the prospects of curative treatments and an effective vaccine are uncertain. (para. 2)
The authors concluded that the virus would keep on posing a considerable threat to public health for decades.
Centers for Disease Control and Prevention in Atlanta, Georgia (2013), indicated the total number of 1,155,792 AIDS cases in the United States starting from 1981 up to 2011 (CDC, 2013). Of these cases, about 620 thousand people, which makes 55% of infected individuals, have died. As much as 20 % of infected persons aged 13 years and older are unaware of their disease. According to the CDC (2013): Over the past decade, the number of people, who live with HIV has increased. At the same time, the annual number of new HIV infections has remained relatively stable. Still, the pace of new infections continues at far too high a level - particularly among certain groups. Sexually active homosexual males represent the major afflicted group of individuals infected with AIDS, which makes about 46% of the reported cases. Male or female users of injection drugs make 24% of the cases. Another 7 % belong to male homosexual drug users. Finally, heterosexual transmission, birth, and blood transfusion make the last 23 % of the reported HIV cases.
The UNAIDS (2014) provides the latest statistical data in terms of global distribution of the human immunodeficiency virus among different groups of people in 2013. Estimated number of adults and children living with HIV is 35,000,000 individuals. The prevalence of adults between fifteen and forty nine years comprises 0.8 %. The incidence rate within this group of adults is about 0.05%. 1,500,000 children and adults have died because of their infection. 2,100,000 individuals comprise the group of newly affected HIV children and adults. Estimated number of adults living with HIV is 31,800,000 individuals. Among them, the number of women living with HIV is 16,000,000 people. There are 1,900,000 adults who were newly infected with HIV in 2013. Among them, the prevalence of young women aged 15-24 comprises 0.4 %, while the prevalence of men of the same age is 0.3 %. Globally, estimated number of newborn babies and children until the age of fourteen living with HIV comprises 3,200,000 individuals. Estimated number of orphans due to AIDS makes 17,700,000 children. The number of newly infected HIV children until the age of fourteen years, including newborn babies, amounts to 240,000 individuals (UNAIDS, 2014).
The number of people infected with the acquired immune deficiency syndrome varies in different countries. Shao and Williamson (2010) state:
Today, Africa still shoulders the greatest burden of the epidemic, harboring >68% of all infections despite accommodating only 13% of the worlds population. The last five years have seen the epidemic reaching a peak in Latin America, the Caribbean, Africa, and most parts of Asia. However, transmission rates are still rising in Central Asia and Eastern Europe. (para. 2)
According to the UNAIDS (2014), estimated number of children and adults living with HIV in Western and Central Europe and North America in 1990 was 1,200,000 individuals. As of 2013, their number increased to 2,300,000 persons. In 1991, Asia and Pacific had 460,000 HIV patients. In 2013, their number reached 4,800,000 people. The territory of the Caribbean region reported 160,000 AIDS patients in 1990. Their number in 2013 was 250,000 individuals. Estimated number of children and adults living with HIV in Eastern Europe and Central Asia was 57,000 persons in 1990 and 1,100,000 individuals in 2013. In 1990, there were 580,000 infected with HIV in Latin America. In 2013, their number increased to 1,600,000 people. The region of Middle East and North Africa had 13,000 HIV patients in 1900 and 230,000 individuals in 2013. The number of persons infected with AIDS in Sub-Saharan Africa has increased from 6.000,000 people in 1990 to 24,700,000 individuals in 2013.
Still, there is good news relating to AIDS distribution. Usually, statistics represents the cumulative experience with HIV since the initial stages of the epidemic. At the same time, distribution of the virus within risk groups changes with time. Distribution of the infection changes with different rates of changing movement of the infection within a definite population. For five years since the beginning of the epidemics, bisexual and homosexual men represented 73% of all reported cases of AIDS. By 2007, this group made up 51% of the cumulative AIDS cases. This change proves the fact that relative to other risk groups, distribution of HIV infection among bisexual and homosexual men during the 1980s and early 1990 increased slowly.
As mentioned earlier, there are three possible ways of catching HIV. However, some of the ways prevail in different regions. In Africa, HIV epidemic is caused by heterosexual transmission. The areas of the Caribbean and Latin America are infected with AIDS by means of homosexual contacts and injection drug use. Officially, the epidemic in these regions started in 1970s and early 1980s. Outside the sub-Saharan Africa, the Caribbean had the second prevalence of adult population living with HIV by 2000. In the late 1980s, AIDS was first reported in Asia, particularly in India, Thailand, and China. Later, the HIV epidemic spread to other Asian countries and population through injection drug use, heterosexual transmission, homosexual contacts, and mother-to-child transmission.
A number of factors that are responsible for distribution of the epidemic include the following issues: poor health and social infrastructure, poverty, lack of education, social and political instability, sexual violence, low status of women, lack of political commitment, low control response, as well as ineffective preventive measures at crucial periods of local HIV epidemic. Here also belong some behavioral factors such as the number of casual sexual partners, age of sexual debut, condom usage, concurrency, sexual networks, and intergenerational sex (Shao & Williamson, 2012). The combination of mentioned above factors has contributed to the varying intensity of the epidemics.
The terrifying statistics of individuals infected with HIV within various social groups and different age, including newborn babies, has stirred the society into action. There exists a great variety of AIDS-related factors, which has caused reformation of the overall attitude towards the deadly virus. Complex political, social, cultural, and economic factors have changed the AIDS epidemic responding theory and practice (Parker, 1996). Additionally, the models of prevention of the HIV infection have shifted recently. Previously, they were aimed at an individuals risky behavior, while current leading models of anti-AIDS activity are focused on the idea of community mobilization. At the initial stages of anti-AIDS social activity, information-based campaigns were emphasized. Currently, empowerment of the society has become the focus of the collaboration. According to Parker (1996), The changes are a result of a new awareness of the relationship between public health and human rights, and to a new understanding of the process of social change and the structures of inequality and intolerance (p.30).
Low and middle-income countries have the highest number of citizens who live with the human immunodeficiency virus. Economic and social factors play a paramount role in terms of collaboration with AIDS in the area. As a rule, mentioned above factors often compromise current control measures. Distinct AIDS epidemics have been observed in different geographical locations. They differ in terms of viral strains that cause the infection, severity of its distribution, the target audience, and associated risk behaviors. Additionally, the high burden of HIV infection has considerably contributed to economic and social development of countries it affects.
Human responses to contagious diseases have come down to a considerable change in community behavior, mainly in the direction of panic and mass flight from epidemics. Together with superstition, fear, and ignorance, the discrimination comes, as well as victimization and persecution that are typical for a stressed human behavior. A communicable or infectious disease is a humankind phenomenon, which combines needs of the community and rights of an individual. Diseases that are potentially transmitted to other individuals no longer cover only personal and private interests of the individual. From now on, personal civil liberties have to be restricted and limited for the benefit or protection of the society (Schoub, 1999).
Many of the public health laws that govern control of communicable diseases were proclaimed toward the end of the 18th and early 20th centuries. Further regulations, statuses, and court decisions have contributed to framing of measures that limit the spread of infectious diseases. Ordinary regulations have appeared to be ineffective in terms of AIDS. However, there is a common feeling that the only way to cultivate the epidemic would be to use similar measures that are used in case with other infectious diseases and sexually transmitted diseases. In Cuba, routine quarantining of infected individuals into special sanatoria is used, which may contribute to the social effort to stop transmission of the deadly virus. In the context of HIV, quarantining presupposes life-long restraint or incarceration accompanied with medical support.
Information Communication Technology offers interactive technologies as tools of HIV prevention. Such interventions improve knowledge of an individual about HIV/AIDS and the ways of its prevention. Besides, they assist an individual in creating a healthy sexual behavior and adopting necessary skills for preventing possible contacts with AIDS. At the same time, a number of mediators influence effectiveness of HIV interventions. Here belong relationship characteristics, which presuppose the usage of condoms and prevalence of long-term relationships. Familial mediators comprise a parental sexual guidance, parental role models of AIDS prevention, and appropriate family environments that influence adoption of preventive measures and behaviors. Positive peer influence may contribute to the effectiveness of AIDS intervention.
From the above, it is also clear that social mobilization plays an essential role in terms of prevention and combat of distribution of the human immunodeficiency virus. Community or interpersonal interventions should change the negative attitude of both or one of the partners towards condom use. Besides, reinforcing positive peer influence and addressing negative ones can assist in adoption and maintenance of preventive measures (Musiimenta, 2012). Economic interventions play a crucial role in empowerment of young girls. Economic interventions enable girls to avoid commercial sex, actively participate in safe sex negotiations, and reduce the threat of sexual abuse. The aim of social, cultural, and religious intervention is the change of values and norms associated with encouragement and reinforcement of risky sexual behaviors within families, sexual relationships, peer and religious groups. It includes the following interventions:
- addressing HIV tolerant social norms in risky practices of men;
- dealing with females condemning norms as for condom buying and negotiating such practices for prostitution;
- addressing issues that are religiously incompatible, such as condom advocacy and condom use;
- reinforcing religious recommendations aimed at promotion of sex after marriage, especially within teenagers who are not sexually active;
- reinforcing partners faithfulness through religious values within sexually active teenagers.
Even though the pandemic of the human immunodeficiency virus has turned into a diverse epidemic around the world, there is a progress observed in the sphere of expanding access to treatment. At the end of 2010, an estimated number of individuals on antiretroviral therapy comprised 6.6 million people. At the same time, prevention efforts were still highly recommended for 2.6 million newly infected people in 2009. While the demand for treatment is increasing, the funding is getting scarcer together with waning activism. Despite some progress signs, the global humanity is far from overcoming the disease. In order to take a critical look at the global situation relating to AIDS, the UNAIDS (the Joint United Nations Program on HIV/AIDS) established an independent forum AIDS 2031 that took place in 2007. The forum engaged policy-makers, scientists, and social activists. It considered directions and character of the epidemics and was aimed at revealing ways how to achieve better outcomes in 50 years after AIDS first recognition.
AIDS has existed for more than three decades already. During this period, it has taken millions of lives. Anti-AIDS social, medical, and political activity considers control of the disease from the global perspective. There are two main social reasons for the disease control. First, individuals infected with HIV all over the world develop identical immunodeficiency and an equivalent amount of sufferings. Second, it is in the self-interest of developed countries to combat communicable infections as HIV no matter the place of its occurrence. In the age of rapid transportation, any infectious disease is an airplane ride away from any place in the world. Thus, it is in everyones personal interests to combat distribution of HIV on any continent.
Anti-AIDS social activity is an effective tool for combating the virus. However, the number of infected individuals has increased. It can be concluded that the virus combating activity should be changed. There are three key dimensions relating to the issue of transforming prevention. They include creation of incentives and stimulation of the preventing demand, customization of preventive combinations, including local peculiarities, for maximum effectiveness, and measurement of HIV infection incidence to evaluate programs. In general, current redesigning of the prevention activity moves from the global approach to global learning in order to combat highly heterogeneous local epidemics.
Unfortunately, there is no silver bullet for beating the deadly virus. Prevention approaches like safe sex, partner limitation, male circumcision, antiretroviral treatment, and others should be combined and tailored to each location or setting. Besides, evaluation and monitoring can assist in the creation of the most effective preventive packages for each community. Finally, it should be stressed that universal access to HIV prevention can hardly be universal in every setting. The most effective prevention interventions should recognize the need of some settings for significantly more investments than for others. Additionally, prevention interventions are effective if they are targeted at where they are most needed.
To conclude, during three decades of its existence, the human immunodeficiency virus has become a global pandemic taking millions of lives every year. At the same time, a lot is done in the sphere of combating the virus. Unfortunately, there is still no cure for HIV. However, the society should never stop the activity aimed at decreasing the scope of distribution of AIDS all over the world, especially in regions with the highest rate of infected individuals.