Social Determinants Of Health

Introduction to Understanding the Modes of Transmission Model

According to Whiteside et al. (2017), the acquired immunodeficiency syndrome is a potentially chronic and life-threatening conditionthat is caused by a virus named human immunodeficiency virus (HIV). The transmission of viruses is through vaginal fluids, semen, or infected blood. Soon after the infection, the symptoms that occur are fatigue, sore throat, fever, night sweats, and a few others. These lead to 4 stages: infection, asymptomatic, symptomatic, and AIDS. The following sections of the report will discuss the vulnerable group which is Eswatini women and the comparison is made between the women of Australia and the vulnerable group. The following sections will discuss the prevalence and trends of HIV/AIDS in women along with social determinants like education and gender impacting the disease.

According to Siefried et al. (2020), the vulnerable group discussed in this report is Women Eswatini and it is found that this group accounts for 12,000 or 63.14 % of HIV affected women population and the women are more infected than men. Only 49 % of the women knew the correct method of prevention of sexual transmission of HIV. Therefore, it is required to target this vulnerable group. Whereas, 27,545 of the population in Australia were affected by HIV/AIDS.In Australia, there has been a 7 % decrease in diagnosed cases of HIV/AIDS in Australian women. The target group of Women Eswatini is found to face problems of sexual violence in their lifetime like wife inheritance and polygamy, and various other harmful cultural practices result in the contribution of AIDS. The main mode of transmission is heterosexual sex in both countries.

HIV/AIDS and The Vulnerable Group – the Situation:

According to UNICEF Eswatini(2019), in 2016, in Australia, 1,013 cases were reported for HIV/AIDS diagnoses, 937 cases were reported for HIV/AIDS diagnosis in 2017 and 833cases were reported for HIV/AIDS diagnosis in 2017. In 2018, 210,000 women Eswatini were living with HIV/AIDS and 78,000 were found to be newly affected with the transmission of the virus. In 2019, 200,000 women Eswatini were living with HIV/AIDS and 4,500 were found to be newly affected with the transmission of the virus. The similarity between both the countries isin their mode of transmission, that is, the commonest mode of virus transmission is through heterosexual sexual contact. It is found in Australia that 20 % is due to heterosexual contact, 3 % due to drug injections only, 5 % due to injecting drug and men contact, and 68 % due to sexual contact between men; whereas in Eswatini, 94 % accounts for HIV/AIDS infection due to heterosexual sex and rest of the percentage accounts for sex works and multiple partners leading to HIV/AIDS transmissions (Becker et al., 2020).

Education

According to UNAIDS (2019), in Eswatini, people lack knowledge on how to prevent the transmission of HIV/AIDS. This is because they have poor education and only 49 % of the women have sexual education on this ground. The government had released various programs in secondary schools like the Comprehensive Life-Skills Education (CLSE) Programme, these helped in spreading the awareness and messages about sexual education and knowledge about prevention from HIV/AIDS. However, only 29 % were aware of televisions, this is because there were fewer televisions due to poor education and economic status of the people. As there are comparatively fewer efforts and organizations involved in spreading the messages for HIV/AIDS as in Australia, so, much better results are observed in Australia. According to the Australian Federation of AIDS Organization (2020), in Australia, there are nationally coordinated health promotions, huge investments in community-led HIV organizations, various local implementations, and many others. These efforts at school levels are spreading awareness about sexual education and HIV/AIDS prevention and the education policies including public discussions or debates for awareness are also contributing to the same. Whereas, in South Africa, it was found that due to pregnancy the women dropped out from schools were very high, but The Ministry of Health and Social Welfare is implementing policies like national policy on HIV/AIDS for educators and learners and many others, for framing education strategies for HIV/AIDS prevention. If the people are educated about safe sexual intercourse, safe injection usage, safe contact practices, and other skills then the transmission rates can be decreased to a great extent (Teasdale et al., 2020).

Gender

According to the World Health Organization (2020), in Eswatini, the women face food insecurity and poverty, as a result, they take sex working jobs and get affected with HIV/AIDS due to poor education on the prevention of virus transmission. The women face economic powerlessness and violence with various other restrictions that ultimately lead to a contribution to AIDS infection. Due to cultural beliefs, women face various issues like post-partum abstinence which is only applied to women and not to men. Various old myths and practices are also contributing to increased prevalence among women in South Africa. According to Lin et al. (2017), with increased testing rates in Australia, the rate and prevalence are getting low, and awareness among women is increasing. It was found that the Australian women stopped performing sex due to their HIV status but the women in Eswatini continued due to their sex jobs to feed their family. All these are the major factors related to unawareness and poor education. Moreover, if women are involved in health promotion then they can stop spreading the disease and transfer the same information within family or society as well. 

I chose Eswatini women as vulnerable group in comparison to women in Australia, but it is found that the women in Australia are not included or considered as a vulnerable group. This is so because, as much of the Australian women have a good education and are also well employed. According to the Australian Federation of AIDS Organization (2020), it is found that more than 45 % of Australian women are well employed as female workforce and more than 90 % of the females are educated with year 12 education or a formal qualification at Certificate II or above. In Australian, access to free health care services is easy due to government policies and strategies whereas in South Africa or Eswatini the women do not effective free access to health care services or receive delayed heath care services. In South Africa, only nursing mothers and children below 6 years of age can have free health care services access (South African Government, 2020). 

Recommendations and Conclusion on Understanding the Modes of Transmission Model

It is recommended that there is effective education or awareness among the women of Eswatini because they face various social and cultural complications only due to poor education of the women. This can be achieved by encouraging the governmental and non-governmental organization to comeup with various schemes or programs that ensure sex education in school, rural and remote areas for women or in public places in form of pamphlets and brochures that are simple to understand and get aware about HIV/AIDS and safe sexual practices. If the women areeducated then the society will automatically get uplifted and well organized (Das, 2020). The government should ensure that women are educated either through oral, written, or schooling modes. There should be programs in radio, televisions, or other media forms to spread awareness on a large scale. Women should be educated about their rights and equality. The society or community should be taught to let women step toward and engage in healthy practices and participate in activities. Campaigns should be organized for the women and men so that education and information are transferred to both the sexes of the society (Rothwell et al., 2019). As Australia is a well-developed country, so there should be the use of game-based or e-modes to spread awareness and encourage women. It will ensure a well-aware and well-educated family. There should be jobs based on skills and education for housing women so that they can earn money through a respectful job rather than getting involved as unsafe sex workers. There should be free distribution of condoms with the aim to spread awareness about safety to prevent HIV/AIDS, safe blood transfusion practices, and all precautions so that more people do not get affected. Moreover, the affected people should be encouraged to inform the health professionals and others about their health status and prevent the spreading of the virus at individual levels. Not only the campaign but the school teachers should educate the students about ways to prevent the transmission of viruses. According to Das (2020), print or electronic media, and games help in creating greater influence on the minds of the user.Therefore, using them can help in targeting a large scale population effectively.

References for Understanding the Modes of Transmission Model

Australian Federation of AIDS Organization.(2020). Australia. Retrieved from: https://www.afao.org.au/australia/

Becker, N., Cordeiro, L. S., Poudel, K. C., Sibiya, T. E., Sayer, A. G., &Sibeko, L. N. (2020). Individual, household, and community level barriers to ART adherence among women in rural Eswatini. PloS One15(4), e0231952.https://doi.org/10.1371/journal.pone.0231952

Das, J. (2020). Education and women empowerment: an overview. Journal of Education and Development10(19), 107.http://www.journaledudev.in/journal/Vol-10%20June%202020.pdf#page=121

https://www.gov.za/about-sa/health

Lin, C. A., Roy, D., Dam, L., &Coman, E. N. (2017). College students and HIV testing: Cognitive, emotional self-efficacy, motivational and communication factors. Journal of Communication in Healthcare10(4), 250–259. https://doi.org/10.1080/17538068.2017.1385575

Rothwell, E., Johnson, E., Wong, B., Rose, N. C., Latendresse, G., Altizer, R., &Botkin, J. R. (2019). The use of a game-based decision aid to educate pregnant women about prenatal screening: A randomized controlled study. Journal of Perinatology36(3), 322.https://dx.doi.org/10.1055%2Fs-0038-1667371

Siefried, K. J., Mao, L., Kerr, S., Cysique, L. A., Gates, T. M., McAllister, J., & PAART study investigators. (2017). Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression. PLoS One12(4), e0174613.https://doi.org/10.1371/journal.pone.0174613

Teasdale, C. A., Tsiouris, F., Mafukidze, A., Shongwe, S., Choy, M., Nhlengetfwa, H., & Dale, H. (2020). Birth testing for infant hiv diagnosis in Eswatini: Implementation experience and uptake among women living with HIV in Manzini Region. The Pediatric Infectious Disease Journal39(9), e235-e241.https://doi.org/10.1097/INF.0000000000002734

UNAIDS.(2019). Overview. Retrieved from:https://www.unaids.org/en/regionscountries/countries/swaziland#:~:text=In%20Eswatini%20in%202018%3A,49%20years)%20was%2027.3%25.

unicefEswatini. (2019). HIV/AIDS. Retrieved from:https://www.unicef.org/eswatini/hivaids

Whiteside, A., Vinnitchok, A., Dlamini, T., &Mabuza, K. (2017).Mixed results: The protective role of schooling in the HIV epidemic in Swaziland. African Journal of AIDS Research16(4).South African Government.(2020). Health.https://doi.org/10.2989/16085906.2017.1362016

World Health Organization. (2020). Understanding the modes of transmission model of new HIV infection and its use in prevention planning. Retrieved from: https://www.who.int/bulletin/volumes/90/11/12-102574/en/

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