• Subject Name : Nursing

Social Determinants of Health - HIV/AIDS



HIV/AIDS and the Vulnerable Group (Situation)

Social Determinant Health (Education)

Social determinant Health (Gender)




Introduction to Understanding Global HIV Stigma and Discrimination

The Human Immunodeficiency Virus (HIV) is the pathogen, responsible for spreading Acquired Immunodeficiency Syndrome (AIDS) wherein the human body loses control over its immune system and the virus takes a toll over the immunity of the body. AIDS has certainly resulted in the devastation of several families, society, and most importantly human health. The degradation of human health is accompanied by several social determinants. According to the World Health Organisation, Gender is one of the most crucial social determinants of health. It can be addressed by two categories, firstly, where gender inequality takes place and can subsequently degrade female health worldwide. Secondly, these gender issue norms must be addressed to recognize and understand the flaws that could lead to a constructive society. AIDS was said to be the gay man’s disease but in the recent past, there has been a considerable amount of increase in the number of women diagnosed with AIDS, both in Australia and in Eswatini. Apart from gender, Education also comes up to be a significant social determinant of health. It is evident that graduate high school population of Australia and Eswatini are less prone to AIDS and has a better course of a lifetime with less mortality. Estimated, there have been 2, 00,000 people diagnosed with HIV/AIDS in Eswatini in last year, while there were about 937 open cases reported in Australia in 2019. (Niemeyer Hultstrand et al., 2020 p10)

HIV/AIDS and the Vulnerable Group (Situation)

Women being the most likely to be discriminated and have a history of ongoing discrimination is the most susceptible to health issues. Even after the diagnosis of AIDS, the issue is not addressed. Rather, they are subdued with discrimination and hatred. It was observed that in the previous year, women were diagnosed with 13 per cent infections of HIV/AIDS. In the past, the average age for diagnosis of women used to be 30 years in Australia. The reports demonstrated that 30.2% were naturally sick, 12.9 per cent women were diagnosed due to highly affected Communities and the rest were diagnosed due to their partners being tested HIV positive. (Beattie et al., 2020) Women in Australia were not vigilant onto disclosing their health issue due to lack of knowledge and socio-cultural discrimination. Even the doctors and professionals look down upon the women who wish to get pregnant with AIDS or after the diagnosis. The women are being considered immoral and unethical. Out of the whole population of Eswatini, 35.1 per cent of women have been living with AIDS and the diagnosed cases remain 19.3 per cent for men. Even after prolonged protests against the stigma and gender discrimination, a Bill was passed. This was the biggest achievement in Eswatini against gender biases. Though, the evil persists. (Thornton et al., 2016 p1421)

Social Determinant Health (Education)

The relationship between wellbeing and training has been more than once tried on account of the limit of the last to set up various degrees of social delineation. Populace bunches characterized by a low instructive level show a more noteworthy detriment as far as wellbeing, even though there are contrasts between nations as indicated by their specificities concerning wellbeing practices and public arrangements. People with the most reduced instructive level have been reliably found to report the more awful wellbeing. For sure, instruction has been appeared to impact a person's wellbeing at various life-course arranges (from adulthood to higher age), just as to intervene in the drawn-out impact of early-life conditions on wellbeing. People must be aware to address their issues and come with a resolution. Lack of education accompanies unawareness, disclosure, sensitivity to society, and addressing health incorrectly. In Eswatini, there have been campaigns for awareness amongst the youth and the adults about HIV/AIDS. Schools and institutions have been teaching and acknowledging the issue with great attention (Assari & Caldwell, 2018 p24).

Instructive contrasts in wellbeing across Australia are very much archived, with an overall example of huge varieties in the size of the differentials across nations. When all is said in done, an elevated level of social exchange is required to lessen introduction to hardship, and this could be converted into decreases in the wellbeing drawback of ineffectively taught gatherings. For example, for a particular community with a low instructive level found a higher pervasiveness of certain way of life markers, such as tobacco and liquor utilization and an inactive way of life, notwithstanding more prominent issues in performing everyday exercises. Also, the greatness of the impact of instruction on wellbeing contrasts among ladies and men. As indicated by the asset replacement hypothesis, the nonattendance of at least one financial asset can be supplanted by a more prominent impact from different assets. As a result, lower female support in the work market, just as the sex wage hole, has fortified the significance of instruction for wellbeing among females (Assari, 2017 p156).

Social Determinant Health (Gender)

Sex has been progressively perceived as significant determinants of wellbeing for males and female (UN, 2010; WHO, 2010). Past the natural contrasts, sex jobs, standards and conduct have an impact on how ladies, men, young ladies and young men access health and medical administrations and how medical frameworks react to their various needs. The unique and frequently inconsistent capacities of ladies, men, young ladies and young men to secure and advance their wellbeing require acknowledgement so suitable wellbeing intercessions can be arranged (Ministry of Women's Affairs, 2008; Walston, 2005; WHO, 2010). The World Health Organization perceives that sex is a significant determinant of wellbeing in two measurements: 1) sex disparity prompts medical hazards for females and young girls all around the world; and 2) tending to sex standards and jobs prompts a superior comprehension of how the social development of personality and uneven force relations among people influence the dangers, wellbeing chasing conduct and wellbeing results of people in various age and social gatherings (Tran et al., 2019 p1899).

In Eswatini the infections of HIV is more abundant in women than in men. This is predominantly due to female sex workers. As such an act is against the law in Eswatini, the females do not disclose their medical history. A survey demonstrated that out of 328 participants, the female sex workers, 75 per cent knew about their medical issues and were still working. But only 40 per cent of them were ready for treatment. Due to gender inequality, the transmission of HIV/AIDS has been considerably affected. Although measures have been opted to stop transmission of HIV from mother to infant. In Australia, the ratio between men to women infections of HIV/AIDS has been decreasing. Soon, the gap would be negligible. The government has come up with several acts and laws supporting gender equality and giving women their rights. Gender as a social determinant of health has been significant. (Smeaton et al., 2020 p1303) It states how most females suffer inhuman behaviour and are subdued while they disclose their medical history. This leads to an increase in HIV/AIDS cases due to the transmission through syringes, parental, inter-genital, and blood transfusion. Pregnant women do not feel safe in a discriminative society. Due to the cultural stigma and taboo, they are considered immoral and impure. In Australia, HIV/AIDS was diagnosed in amongst 27,545 people as per the statistics from the year 2017. Out of these people, 25 per cent patients were reportedly had heterosexual intercourse, 8 per cent were infected due to drug use, while a huge mass of 63 per cent patients revealed that they were in sexual contact between men. There was 3 per cent of unspecific cases (Adler, Glymour, & Fielding, 2016 p1642).

Recommendation on Understanding Global HIV Stigma and Discrimination

According to the World Health Organisation, HIV/AIDS should be addressed with the utmost attention. It cannot be neglected. The Social Determinants of health play a crucial role in acknowledging the subject. Apart from Gender and Education, the other Social Determinants of health are neighbourhood, economic stability, food, housing, Environment, and transportation. All of these must be addressed to eliminate and hereby, eradicate the spread of HIV.

In Eswatini awareness campaigns must be established for spreading knowledge and a better understanding of the issue. Women must receive a safer environment and socio-cultural surrounding to be able to disclose their medical issues and receive proper treatment. Testing for the women of any age should be accessible and made available for every economic and social background. Due to lack of testing also, risks of spreading HIV increases. Counselling therapy and sessions must be conducted for early age women who are infected with HIV. Sex education amongst schools and educational institutes must be mandatory for both, Eswatini as well as Australia. Prevention is better than cure and hence, any medical issue as serious as HIV/AIDS must be tried to be prevented.

Conclusion on Understanding Global HIV Stigma and Discrimination

The research paper includes various Social determinants like gender and education focusing more on the vulnerable sections of the society. Specifically pondering on the female health issues and their situation, this could be changed through proper socio-cultural norms. The social determinants of health revolve around the accessibility of the patients infected with the virus causing AIDS. Education being the first Social Determinant of Health signifies the need for better implementation of educational practices in the counties.

Gender inequality raises several medical issues with discriminating females at a level that they are considered unethical and shameful.

References for Understanding Global HIV Stigma and Discrimination

Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642.

Assari, S. (2017). Social determinants of depression: the intersections of race, gender, and socioeconomic status. Brain Sciences, 7(12), 156.

Assari, S., & Caldwell, C. H. (2018). Social determinants of perceived discrimination among black youth: Intersection of ethnicity and gender. Children, 5(2), 24.

Beattie, T. S., Smilenova, B., Krishnaratne, S., & Mazzuca, A. (2020). Mental health problems among female sex workers in low-and middle-income countries: A systematic review and meta-analysis. PLoS medicine, 17(9), e1003297.

Beattie, T. S., Smilenova, B., Krishnaratne, S., & Mazzuca, A. (2020). Mental health problems among female sex workers in low-and middle-income countries: A systematic review and meta-analysis. PLoS medicine, 17(9), e1003297.

Mutemwa, M., Peer, N., de Villiers, A., Faber, M., & Kengne, A. P. (2020). Tobacco smoking and associated factors in human immunodeficiency virus-infected adults attending human immunodeficiency virus clinics in the Western Cape province, South Africa. Southern African Journal of HIV Medicine, 21(1).

Niemeyer Hultstrand, J., Omer Abuelgasim, K., Tydén, T., Jonsson, M., Maseko, N., & Målqvist, M. (2020). The perpetuating cycle of unplanned pregnancy: underlying causes and implications in Eswatini. Culture, Health & Sexuality, 1-16.

Smeaton, L. M., Kacanek, D., Mykhalchenko, K., Coughlin, K., Klingman, K. L., Koletar, S. L., ... & Collier, A. C. (2020). Screening and Enrollment by Sex in Human Immunodeficiency Virus Clinical Trials in the United States. Clinical Infectious Diseases, 71(5), 1300-1305.

Thornton, R. L., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R. (2016). Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8), 1416-1423.

Tran, B. X., Phan, H. T., Latkin, C. A., Nguyen, H. L. T., Hoang, C. L., Ho, C. S., & Ho, R. (2019). Understanding global HIV stigma and discrimination: are contextual factors sufficiently studied? (GAPRESEARCH). International journal of environmental research and public health, 16(11), 1899.

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