Origin

The stigmas associated with HIV/AIDS is largely related to the story of origin. Acquired Immune Deficiency Syndrome was first recognized as an emerging disease in 1981 when young homosexual men became victim to unusual infections (Sharp). Ever since HIV-1 was initially discovered, the cause of its sudden birth and spread have been studied intensely.  In an article published by anatomy research students from the University of California on SexInfoOnline, the origin on HIV/AIDS is discussed in detail. The study begins by discussing the first reported cases of AIDS in the United States, going on to account for the infamous “patient zero” of this virus. In this, a report was claimed to blame the spread of the HIV/AIDS on the sexual relationships between homosexual men. According to the student’s gatherings, patient zero, later identified as Gaetan Dugas, was tied to about sixteen percent of the first reported cases in the United States. For this reason, hysteria surrounding AIDS in the United States was primarily against homosexual men.

But, as research progressed it is found that scientists deem the first strain of the virus was transmitted from monkeys to humans. According to The AIDS Institute, the earliest known case of infection with HIV was a man from the Democratic Republic of the Congo – where hunters became exposed to infected blood as early as 1960. (AIDS institute). A first inkling came about in 1986 when a similar virus was found to cause AIDS in patients in western Africa (Clavel et al). Through hunting and close interaction with monkeys carrying the virus, it is believed to have been transmitted by means of ingestion. Surprisingly, these viruses appeared to be quite harmless in their natural hosts, whereas very deadly in humans (Sharp). Developing countries have experienced the greatest HIV/AIDS cases and mortality, with the highest prevalence rates in young adults found in sub-Saharan Africa (UNIAIDS).   

Though for South Africa specifically, HIV/AIDS came about in 1983 , two patients were found to have carried the disease (Sharp). Just three years later, almost fifty additional cases of AIDS were diagnosed (Sharp). Initially the spread of the disease, like in the United States, was determined to be much more prevalent within the homosexual community – but as the years went on, the infection began to reach pandemic levels (Sharp). This can be widely correlated with lack of knowledge for the disease, as means of infection and treatment were being discovered as the disease spread. Currently, South Africa is home to the largest HIV prevalence in the world, with more than three-quarters of Aids related deaths occurring in South Africa (UNIAIDS). Based on a study done by Shula Marks, the spread of this disease can be based on both historical and social contexts. 

HSRC-Figure 1: HIV prevalence by age and sex, South Africa, 2012

 

 

 

 

 

 

Spread

Shula Marks, a professor at the University of London publishes an article in which she expounds upon the various aspects through which HIV/AIDS has spread. In this, Marks begins by comparing the spread of past diseases with our current way of life. “Epidemic disease has always accompanied long-distance movement, but the numbers of people traveling around the world today, and the speed at which they are doing so, is surely on a scale beyond conception of our grandparents.” (Marks) In this, it is clear that the worldwide spread of this disease occurs through travel. And in Africa specifically, with such a large population and innate human behavior, it does not take much to correlate the pandemic with migration.

It is also noted, that the way in which the world has grown politically, has a large effect on the disease as well.  In most developing countries, such as South Africa, impoverishment is connected to the influx and use of monetary value. As the world’s poorest countries are paying millions in debt, less that a third of that money is returned for uses such as foreign aid (Marks). Given the impoverishment of Africa, and its political and military instability as the years have progressed, it is perhaps not surprising that the continent has been hardest hit by AIDS (Marks). More focus should be placed upon the systematic debt and impoverishment that these countries are in,  as compared to other ‘’developed’’ countries. As human beings, the population of Africa, more specifically sub-Saharan and South Africa, is being plagued with a virus that can be controlled. Years ago, Zwi and Cabral posed that we should identify a term to denote the range of social, economic and political forces that put such groups at particularly high risk of infection with HIV/AIDS.

The migrant labor system in South Africa, in which individuals frequently move from place to place for seasonal employment is fairly prevalent. This system brings forth large numbers of men to industrial mining centers for a means of work. They almost always abandon their families, seeing them infrequently, and are housed in single rooms. (Zwi and Cabral) These men often seek a means of companionship with women nearby – subsequently posing a risk for sex with multiple partners and the spread of sexually transmitted diseases and HIV/AIDS. On the other hand, the women left behind may resort to commercial sex in order to fill the void of financial dependency as well as affection. (Zwi and Cabral) This cycle of sexual partners is the main means through which HIV is spread. There are said to be over 1,500 new infections everyday in South Africa alone, most of them young women. (Marks) 

 

The Women

According to South Africa’s Human Sciences Research Center, one in three women is a victim of some kind of abuse and the medical research council says that one South African women is killed by an intimate partner every six hours. Alex Mattews, writes a post in which he addresses the atrocity that has been going on and continues to go on in South Africa. Thousand of rapes are reported in South Africa annually, and little has been done by those in power to improve the lives of these women. Misogyny and patriarchy are instilled cultural normalities among men in this country (Mattews). As young women grow up to see there mothers being beaten, they know no better, so the cycle continues. 

A study done in done in the Eastern Cape province of South Africa show the correlation between gender power inequity and intimate partner violence. Research focusing on the quality of life in South Africa show that the patriarchal nature of society and masculinity standards are based on control of women, which in turn celebrates male toughness (Jewkes, et al). This allows for men to have multiple sexual partners and to be in control of their sexual encounters (Jewkes et al).  

Figure. Pathways through which gender-based violence and gender and relationship power inequity might place women at risk of HIV infection

Apartheid has left South Africa with an odd ideal for family structure. Traditional marriage is more-so a socially arranged relationship between families, through payment, wheres as most South Africans never marry (Morell et al). Though families are typically headed by women, with the father being absent. The male-dominant hierarchy allows for the constant abuse and ill treatment of women, leading to greater detrimental effects (Morell et al).  

Effects

Oftentimes, the stigmatizing beliefs that associated with HIV/AIDS are the consequence of various social factors (Simbayi, Leickness C., et al.). These stigmas include the common belief that people infected with HIV/AIDS are tainted, they are often deemed as less than or contaminated. Sociologist Erving Goffman writes a novel in which he composes an analysis how how a person feels about themselves and  their relationship to others. These feels are based on what society deems as normal. Three features of stigma that are characteristic of HIV/AIDS include flaws of personal character, damaged social identity, and physical deformity or defects. (Goffman). In this, many women, as well as men, that are infected with HIV/AIDS feel somewhat cast out of societal norms. Infection with HIV/AIDS can lead to others looking at those infected in a degrading manner, as there is an immediate denounce of character/integrity once infected. Furthermore, with narrow-minded views of the disease, people infected are often looked down upon by peers and civilians, leading to a decrease of social interaction and dealings. This, as well as the physical deformities associated with the sickness, often make it easy for others to see that one had fallen ill. These interpersonal stigmas cause further means of depression and sadness in those infected.   

HIV/AIDS stigmas also often reproduce inequity amongst class, race, and gender. People with HIV/AIDS infection are often ascribed responsibility for their condition due to the fact that it is usually contracted through mannerisms that are considered avoidable, specifically unprotected sexual relations and drug use practices (Herek et al). While in South Africa, however, many of these mannerisms are not necessarily avoidable. As women are usually placed in abusive situations from a young age, they don’t usually have a say when it comes to the man in control wanting sex. Of this, one may wonder why, in South African environments, is there still a stigma placed upon this disease, but its as simple as to say that its apart of human interaction and implicit hierarchy. AIDS ignominy is also inescapably tangled with other stigmas paired with risque behavior such as sexual promiscuity, homosexuality, and explicit drug use (Novick).  Unsurprisingly, those that have contracted the illness by means of injection drug practices or multiple sex partners are blamed more than those that have contracted the infection by having only one sex partner (G.M. Herek et al.) 

In the study conducted by Simbayi, it was predicted that with a general population having such a high HIV/AIDS infection rate, stigmas would be associated with depressive symptoms (Simbayi et al). The surveys were completed by over four hundred HIV-positive men, and and over six hundred HIV-positive women in Cape Town, South Africa. The Republic of South Africa has one of the world’s worst HIV/AIDS epidemics, as five and a half million people suffer from the virus (UNIAIDS). In the study, a survey was given with questions regarding whether or not they have been treated differently since disclosing status of infection, and further queries regarding the seven internalized stigmas items (Simbayi et al).   

Thirty percent of the general South African population reported feeling depressed in the past year compared to Forty-two percent of people living with HIV/AIDS (O. Shisana et al). It was found that thirty percent of the people in the study, admitted to having depression within the past week (O. Shisana et al). This rates of depression have a lot to do with environmental factors in terms of living among the illness and in impoverishment in certain areas.

Internalized stigmas were prevalent in the sample of people living with HIV/AIDS. More than one in three men and women endorsed AIDS-related self-abasing views. In fact, people living with HIV infection have internalized AIDS stigmas to a far greater extent than these beliefs are held in the broader community (S.C. Kalichman et al).  

Support groups can be used as a starting place for the development of social support interventions. However, the ultimate solution to AIDS stigmas does not lie in the hands of people living with HIV/AIDS. 

Lack of Education

As it relates to most epidemics, education plays a large role in terms of prevention and possible eradication. Given this, it is common in many traditional African cultures for individuals to attribute illness to spirits and supernatural forces (AC van).

As it relates to HIV/AIDS, about four percent of South Africans believe that AIDS is cause by witchcraft and about fourteen percent are unsure (O. Shisana et al). These beliefs are typically more present in rural areas where traditions are upheld. The study conducted in the Kalachiman study are quite shocking. Results of the study found that individuals that believed that HIV/ADS is caused by spirits/supernatural forces had significantly less years of formal education, were more likely to be unemployed, and were less likely to be married. These individuals were also less likely to use condoms (S.C Kalchiman).

Placing the cause of HIV/AIDS on ancestral spirits leads directly to narrow-minded, stigmatizing beliefs about people with HIV/AIDS being that they are believed to have brought this condition upon themselves and their community (Goffman). This ideals however, are typically maintained in rural traditional areas and cannot account for entire country. 

Within Sub-Saharan Africa, a significant amount of adolescents are sexually active, leading these young people to account for half of all new HIV infections (Corneli et al). In this, it is imperative that something is done to educate the youth on substantive measures of which to not become infected. These early and unsafe sexual behaviors are associated with high school dropout, which pulls at the need for prevention programs aimed towards earlier grades. (Corneli et al)

While there have been attempts to implement education into schools, many problems arise in terms of how to implement education in to curricula as well as how to go about teaching it. (Ahmed). According to The curricula seemed to have a positive effect of students’ knowledge of HIV,  but they do not necessarily meet the goals of national policy in terms of promoting long term mental and physical lifestyles (Visser). 

 

The Problem(s)

Throughout these multiple factors, it is evident that the cause and further spread of the disease goes hand-in-hand. It is quite sad to see that this epidemic has been becoming more and more of a problem in South Africa. There should be more urgent and direct aid sent to help those in need. In the continuation of this analysis, there will be a different perspective in terms of these factors as it relates to another culture.