AGNES MUNGA (04823) Vulnerabilities of Hiv/Aids in African population The AIDS epidemic is one of the most destructive health

crises of modern times, ravaging families and communities throughout the world. By 2005, more than 25 million people had died and an estimated 39 million were living with HIV. Sub-Saharan Africa has been hardest hit, other regions also face serious AIDS epidemics and a great number of people infected and the effects on their families, communities, and Countries are still staggering. Poverty The relationship between poverty and HIV/AIDS is bidirectional in that poverty is a key factor in the transmission, and HIV/AIDS can impoverish people in such a way as to intensify the epidemic itself. Poverty leads to poor nutrition, which weakens the immune system, making poor populations more susceptible to infectious diseases such as tuberculosis. In addition, people infected with HIV are likely to fall into poverty due to lack of work and the high cost of treatment. Because of their reproductive role and their place in society, African women suffer the greatest burden of HIV. Poverty-stricken people focus more on their daily survival than their health and are stymied by a crushing sense of powerlessness which leads to hopelessness and, in some cases, to risky behaviors, including prostitution. These economic hardships intensified poverty, destabilized families, and increased peoples movements between countries. The situation widened the web of sex networking, and in this way facilitated the early rapid spread of HIV. a risk factor, poverty is associated with weak endowments of human and financial resources such as low levels of education, low levels of literacy and few marketable skills, generally poor health status and low labor productivity . The inability to attract endowments, through engaging in income generating activities by adults, as a result of HIV infection, morbidity and mortality sinks poor households into even deeper poverty. With the rising costs of medical care/treatment, and an increased need for nutritious foods. With the progression of the illness, the demand for care also rises. Children are often withdrawn from schools to care for sick adults, further compromising their basic right to education. The deprivation of education could place the household at further long-term risk for poverty, lack of skills and disempowerment. The latter results in a cycle of household impoverishment that may take decades to reverse. Poverty is associated with vulnerability to severe diseases like HIV, through its effects on delaying access to health care and inhibiting treatment adherence. The costs incurred while seeking diagnosis and treatment for HIV/AIDS are common causes of delays in accessing health care especially for the poor. Poor households may not necessarily have the financial resources to seek help from health centers, nor food security to enable members to adhere to their treatment. The lack of these resources is significant cause of the delays in accessing health services by poor households. Culture Culture has been shown to have both positive and negative influences on health behaviors. Indeed, culture is often shown to be a factor in the various ways that HIV/AIDS has impacted on the African population. These factors range from beliefs and values regarding sexuality including

when to become sexually active and the number of sexual partners and condom use in South Africa In many cultures, the importance of a male heir leads to unequal resource allocations in favor of a boy, making it difficult for girls to manage their own vulnerability. Some community or village, kin networks or community-based organizations often determine the allocation of resources such as employment, gifts, loans or access to occupation-related information based on different factors such as mutual reciprocity, fulfillment of obligation or the status and socioeconomic position of households. In times of crises, these organizations and networks could be sources of support. However, it is the very lack of organization and social cohesion within communities that is considered to reduce their opportunities to manage their vulnerability when it comes to hiv/aids

Polygamy. In Africa, polygamy is a social practice used to ensure the continued status and survival of widows and orphans within an established family structure n urban settings and other areas where traditional polygamy is no longer the norm, men tend to have many sexual partners and employ the services of sex workers men who have 3 or more wives were at a high risk of engaging in extramarital sex, reinforcing the belief that men are biologically programmed to need sexual intercourse with many women. It has been proclaimed by proactivists that it is the only way to sustain equity of resources in poverty stricken societys .it is the relatively recent emergence of polygamy that has facilitated the spread of HIV among polygamous family circles. Infidelity has become the hallmark of polygamy, which is outside the norms of the original African tradition of polygamy, and puts the whole family unit in a high-risk category for catching HIV/AIDS. Polygamy behavior lends itself to families or the male of the family migrating to cities (where HIV/AIDS is more prevalent) in search of employment. While there, the male may engage in sexual activity with HIV infected women, and subsequently pass the infection onto their wives upon their return home. Stigmatization Stigma and discrimination remain a major fact of life for the estimated 29.4 million people with HIV in sub-Saharan Africa and for the more than 11 million children who have lost one or both parents to AIDS. Whether it is a worker afraid of being fired from a job or a woman terrified of losing her children and her home, well-founded fears exist for many with the virus. But despite agreement that stigma and discrimination must be overcome to turn the tide on the epidemic, communities and governments in Africa as elsewhere continue to struggle to protect people's rights and dignity. The driving forces behind HIV-related stigma include lack of knowledge, distorted beliefs or fears about HIV transmission, and collective denial that stigma exists. As a consequence, stigma is manifested on three different levels: -Individual (guilt, isolation, shame, denial of HIV positive status) -Programmatic (condemnation, expelling HIV+ children from school, HIV screening tests for job applicants, loss of job), and -Social (punishment, exclusion, rejection, violence) especially in the health sector, stigma and discrimination against HIV-infected people and most vulnerable populations is serious. The health sector should therefore be one of the first places where concrete interventions against stigma and discrimination are undertaken. Education awareness revealed much diversity in levels of HIV understanding and awareness among the sample. Those with visual impairments had more education and greater HIV knowledge than their physically impaired counterparts. Overall, males were also more

knowledgeable than females. Two participants had 'never heard of HIV/AIDS'. Notably, some representatives from disability organizations also demonstrated incomplete knowledge and a lack of awareness of HIV and appropriate prevention strategies. When prompted to identify HIV transmission risks, most informants mentioned needle sharing. Unprotected sex was less commonly cited, and no one mentioned male-male sex. Some of their more worrying misconceptions hark back to myths popular in the epidemic's early days, e.g., 'mosquitoes transmit HIV', and the 'greater' risk of infection from 'having sexual contact with unknown persons' . Some saw risk in sharing of utensils and clothing, or contact with menstrual blood, while one spoke of the role of divine intervention: 'We should go to the church and the healing power can. There was some evidence that HIV education about transmission via blood has been conflated with traditional Manipuri concepts and terminology, where 'blood group' indicates degree of relationship. The Need for Comprehensive Responses As HIV continues to spreadand neither vaccine nor cure existsprevention remains the key strategy for curbing the epidemic. The most common mode of HIV transmission is sexual contact; thus, HIV prevention is closely linked to mens and womens sexual behavior and reproductive health. Effective prevention programs include interventions that promote abstaining from sex, delaying the onset of sexual activity, staying with one mutually faithful partner, limiting the number of sexual partners, consistently and correctly using condoms, and counseling and testing for HIV.The most effective mix of these interventions depends on the characteristics of the groups infected with HIV. Effective programs also consider the social, economic, and cultural factors that influence peoples behavior Reference 1. Bachmann, M.O. & Booysen, F.L.R. Relationships between HIV/AIDS, Income and Expenditure Over Time in Deprived South African Households. AIDS Care 2004. 16 (7): 817-826.