World Health Issues: HIV Prevention Approach
United States of America, India, and China
Introduction
The world is facing different problems, specifically in terms of achieving optimum health. It can be said that one of the most significant world health issue is human immunodeficiency virus or HIV. It has been noted that HIV epidemic is a tragedy, a tragedy of unfathomable proportion, in the lives people in the global community. Millions of people throughout the world have died of AIDS in little more than ten years, and it is estimated that there were 32.8 million people who are living with HIV and 2.5 million have been newly infected with HIV at the end of 2007 (Shah, 2008). One thinks of HIV disease first and foremost as a profound medical problem affecting a person’s health and longevity.
A central consideration of people living with HIV disease, therefore, often concerns progress in the prevention, containment, and cure for this disease, as well as issues about their immediate health and health care. Primarily, the main goal of this paper is to discuss the different prevention programs used by various countries in dealing with the HIV. For this the nations that will be given emphasis includes the United States of America, China and India.
Human Immunodeficiency Syndrome
Throughout the years, the devastating effects of infection human immunodeficiency (HIV), the virus which causes Acquired Immune Deficiency Syndrome (AIDS), seemed inevitable. Human immunodeficiency (HIV) is a virus that destroys the human immune system by incorporating its genetic material into specific immune system cells, thereby destroying the cells designed to protect us from disease. HIV disease is a term used to refer to an entire spectrum of infection with HIV — from the initial infection through the development of full-blown AIDS. Evidence of HIV infection has been found in more than 150 countries worldwide.
The extent of the public health crisis occasioned by HIV disease is enormous — it is estimated that, as of 1995, as many as 20 million people worldwide are infected with human immunodeficiency. Human immunodeficiency (HIV)–of related illness was first described in the United States by doctors treating gay men in Los Angeles, New York City, and San Francisco in 1981. By 1983, the virus causing these illnesses had been identified and isolated, and by 1985, a test had been developed that could determine whether an individual had developed antibodies to HIV and was thus infected with the virus. Nonetheless, little is still known about the manner in which HIV destroys the human immune system, few effective treatments have been developed, and a vaccine or cure is not in sight.
Although the disease (AIDS) itself has no cure, remarkable progress has been made in extending the life expectancy of individuals with HIV infections (Whitney, Cataldo & Rolfes, 2002). In the United States, deaths from AIDS declined from a high of over 50,000 in 1995 to just 16,000 in 1999 (Centres for Disease Control and Prevention, 2000). Without a cure however, the best course is still prevention.
HIV Prevention Initiative for USA, India, and China
It has been mentioned that HIV remains one of the most deadly chronic disease in the world. In this regard, prevention of HIV infection needs a continued commitment from the individual’s at risk, those infected, and the entire global society. It is said that the prevention efforts should be kept in pace with this epidemic. Realising the importance of the prevention of HIV, USA, China, and India has their way of preventing this deadly disease.
Consequently, the prevention of HIV is noted as the best way to stop individual becoming ill and dying with this chronic disease. Being the first country to identify AIDS, the USA has been able to recognise quickly the demand for efficient approaches to prevention. But, the US prevention approach has not always been able to achieve their goal and there are more people who are living with HIV in the country.
In the USA, there are various forms of prevention approach and the approach used depends on the specific group being addressed. Herein, some of the most usual prevention approach includes the campaign of using condoms, the prevention of mother-to-child transmission, and lastly harm reduction with drug users. Along with these approaches is the context of education. Through education, the understanding of Americans regarding HIV and how it is transmitted are enhanced. The context of educating people regarding AIDS, ant its consequences so that people can make informed choices is the core of the federal government’s HIV prevention approach which is known as the Advancing HIV Prevention (CDC, 2005). This approach also features potentially in the US Centers for Disease Prevention and Control (CDC) HIV Prevention Strategic Plan to 2010. The Centers for Disease Prevention and Control is the main institution which coordinates the prevention approach in the entire USA. The overarching HIV prevention objective of CDC in 2001 is the total reduction of the number of new HIV infections and to eliminate ethnic and racial disparities in line with the HIV counseling promotion, testing as well as referral activities and by encouraging HIV preventions for both the individual living with the virus and those individuals who are at high risks of having the disease. However, in April 2003, the CDC announced major transformation in its HIV prevention approach. Herein, the new HIV prevention initiative is now known as Advancing HIV Prevention: New Strategies for a Changing Epidemic (CDC, 2005). This initiative is consisted of four approaches which have been recommended by the CDC to local or state health departments, community-based organisations and individual clinics which received federal support.
These include the creation of voluntary HIV testing as a routine part of medical care, the implementation of new models for testing individuals for HIV outside medical situations, preventing new infections by working with individual diagnosed with HIV and their partners and the reduction of the rate of HIV transmission from mother to child using opt-out testing from the mother and a routine testing of any child whose mother was not tested.
As mentioned, the previous aim of the CDC is to prevent HIV at persons at risk of being infected with the virus by giving funds for different programs which aims on reducing drug-using and sexual risk behaviour (CDC, 2005). On the other hand, the new HIV prevention approach or the AHP mainly focused on people who already have the virus. Herein, part of their program is to provide substantial amount for programmes prioritizing AHP.
It can be said that Education has played on important part for the HIV prevention programme of the United States. Herein, the federal government has allowed school organisations to widen the campaign for HIV prevention by teaching and informing the students regarding HIV and its risks.
After knowing the initiatives of US in preventing HIV, this part of the paper will give emphasis on discussing the HIV prevention approach of India. According to UNAIDS, there is an estimated 5.6 million individuals in India that lives with HIV as of 2006. This indicates that there are more people who are HIV positive India that any other nations in the world (UNAIDS, 2006), however this result was opposed by NACO and claimed that the actual number of people with HIV is lower (NACO, 2006). In year 2007, both organisation have estimated that there were between 2 million-3.6 mullion Indian who live with HIV putting the country behind Nigeria and China in terms of numbers of people living with HIV (UNAIDS, 2007).
The prevalence of HIV in India is said to grow dramatically in the earlier times of the epidemic, however, there is a study which has been released that mentioned that the HIV infection rate has decreased in Southern India, the Area which has been highly affected by the infection and AIDS (Kumar et al, 2006). Furthermore, NACO has provided new figures which suggest that the number of people living with the virus has reduced (NACO, 2007). These claims are considered as the result of the intensive HIV prevention approaches in India, specifically with the increase used of Condom.
One of the approaches used by India is the education approach. Accordingly, educating the society regarding HIV/AIDS and how this disease can be prevented is complex in the country because of the language factors. This indicates that even if some HIV/AIDS prevention and education can be provided at the national degree, many if not most of the government efforts are best carried out at the local and state level. In India, the government has let each state to have their own HIV and AIDS Prevention and Control Society. This group carried local initiatives with the assistance from NACO. In the second state of the Indian’s National AIDS Control Programme, which ended last March 2006, the government has provided funding for state AIDS control societies for blood safety checks, youth campaigns, as well as HIV testing among other HIV prevention programmes. Different public platforms were also considered to enhance the awareness of the people regarding the epidemic which includes radio dramas, concerts, TV Spots with famous Indian celebrities and a voluntary blood donation day. Furthermore, part of their prevention approach is to give messages to young individuals through education. Herein, teachers as well as peer educators have been trained to teach about the HIV/AIDS, and students has been educated through active learning sessions which includes role playing and debates (NACO, 2006).
Part of the HIV prevention program is their provision of US.5 billion budget which will be used for fighting HIV and AIDS, and most of these are used for prevention programmes. The government of India believed that their campaign will place a strong emphasis on the use of condom. The government has supported the installation of over 11,000 condom vending machines as part of their HIV prevention programme in various places such as road-side restaurants, colleges, hospitals and gas stations and hospitals. The United States Agency for International Development (USAID) has been supporting the HIV prevention programme of India and the Indian government has also implemented a campaign which is known as ‘Condom Bindas Bol!’ that includes public events, advertising, and celebrity endorsements. The main goal of this campaign is to break the notion which presently surrounds the use of condom in India, and to influence people that they should not be ashamed of buying or using it.
If the United States of America and India has their own HIV prevention programme, China is never an exemption. Accordingly, it is very complex to overstate the suffering in which HIV has caused in China. Accordingly, because of the failure of the government to educate the people regarding AIDS in the 80s and the 90s, the government are trying to initiate an approach which will lessen the prevalence of this chronic disease. In 2003, the Chinese government has been able to initiate HIV prevention to increase the awareness of the disease, decrease stigma and prevent a generalised HIV epidemic in the nation. This include the HIV testing outreach projects, educational campaigns and targeting high-risk groups as well as prevention of mother to child transmission.
In the country, the Chinese Education Ministry established the Basic Requirements for Health Education as early as the 90s. Such documents noted that the sexual morality as well as self-discipline must be taught so as to prevent HIV and AIDS (Chinese Ministry of Education). Throughout the year, the government of China with the Chinese Education Ministry has been able to provide guidelines and policy documents which have been continually issued for reinforcing the need for HIV and AIDS education in schools (People’s Daily, 2003). In 2004 the State Council Document Number 7 have instructed all local governments to combine HIV/AIDS into the routine government agenda as an essential item and the local government must effectively and urgently respond to HIV/AIDS which is a priority connection to the benefit and interest of the Chinese people.
Part of their HIV prevention approach were the mass education campaigns for the general public to teach individuals how to prevent infection and to counter stigma and discrimination among those individuals infected with the disease (State Council Document, 2004). However, it can be said that despite of the Chinese government’s frequent educational regulations, it is still not clear on how much HIV education local authorities are presently implementing this campaign. It is said that there is still an immediate need for public HIV education in the country. In a survey conducted in 2005, it has been found that 63% of participants perceived that it would be not safe to work in the same office with an individual infected with HIV, and 74% perceived that those people living with HIV should be banned from public places including public swimming pools(Yimin et al, 2005). The negative perceptions of people individuals with HIV/AIDS have also been recorded. Herein it shows that 44% of participants revealed that that most individuals with HIV are promiscuous and that 21% felt that these people were merely receiving the punishment that they deserve (Lau & Tsui, 2005).
Part of the HIV prevention programme is the prevention of mother to child transmission of the virus. It is noted that China has significantly few HIV cases which is relevant to mother to child transmission and an entirely low prevalence of HIV infection among pregnant women (BMJ, 2005). Nevertheless, as the epidemic of HIV and AIDS spreads to the general public, the percentage of infected women have a tendency to rise, as well as mother-to-child-transmission. In this regard, the government of China has been able to develop national guidelines and has been able to train number of health workers to prevent mother-to-child-transmission. The main objective of this programme is to assure that all pregnant women in high prevalence regions have access to HIV testing, HIV counselling and most especially HIV-preventive services (UNICEF, 2008). However, even if this has been considered UNAIDS have reported that in 2006 only 1.3% of those pregnant Chinese women received treatment in preventing mother-to-child-transmission(UNAIDS, 2006).
It has been noted that one of the hindrances of having an effective HIV prevention is that the majority of individuals infected with the disease in the country are not aware of their positive HIV status. In this regard, the HIV testing approach is also essential for the infected individuals to seek treatment and to prevent transmission to other people.
In the global context, a survey of low and middle income nations in 2005 have been found that HIV prevention programmes have been able to reach 50% of sex works, 9% of men who have sex with men, 20% of injecting drug users and only 9% of HIV positive pregnant women has received drugs to prevent infection or transmission of the disease to their child. Globally, there is an estimate of 9% condom used for sex acts with a non marital situation and non-co-habiting partner in 2005. It has also been noted that the global supply of general public condoms is less than half of what is required to assure adequate condom coverage (UNAIDS/WHO, 2006).
Based on these statistics, it can be said that the HIV prevention all over the world still needs much development and improvement. In some areas, progress is slowly being considered but there is still a very long path to travel. As national government and other institutions try to develop better programme to better HIV, these countries should do well in adapting the successful approaches made by some nations.
Conclusion
The world is facing intensive problems in terms of health of each individual, specifically in the growth of people infected with HIV. In this regard, different countries are trying to impose HIV prevention programme that will provide all the needs and assistance of their citizen in terms of awareness and prevention of this chronic disease. In this regard, it can be said that United States, India, and China has been able to initiate HIV prevention programmes to reduce and eliminate the danger of HIV among their people. Herein, the government of the USA, India and China and other health agencies are collaborating with each other to prevent, treat, and control the spread of this infectious disease which affects the lives of each individual. It has been revealed that one of the most common approaches used by these three countries include the use of condom as part of their prevention programme. In addition, education was considered as a vital approach for making people aware of HIV and AIDS and how these can be prevented.
It can be said that there is not singe best strategy or method to prevent HIV, herein, the response should be designed to fit the local situation as well as the state of the epidemic. However, most of the successful approaches whether in US, China and India do have at least three features in common. First, such HIV prevention programmes encourage open communication regarding HIV and AIDS and the activities that put individual at risk of infection while at the same instance fighting stigma and discrimination. On the other hand, these approaches can be considered to be pragmatic. Instead of trying to eliminate specific types of sexual behaviour or drug use, they identify that some individual will continue to do such things, and that they should be assisted to do so in a safety manner. And lastly, these health prevention approach involved the affected communities or individuals designing the programme and in initiating such HIV prevention programme.
It can be said that in order to ensure HIV prevention programme success, strong leadership is important to have a long-term and sustained impact. This indicates that religious leaders, politicians and other authority must be actively involved in the response and must assure that this received sufficient resources. All in all, it can be said that HIV prevention programme is a continuous endeavour that each country should be considered. HIV prevention programmes such as that of the United States, China and India should be measured for its effectiveness to ensure that the goals and objectives are being attained.
References
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