South Africa constitutes one of the countries whose economies are assuming an elevated niche in the global economy. Currently, it assumes one of the top ten positions in the global stock market. With regard to wealth and standards of living, it is among the top fifty countries on a global scale. However, there are inherent disparities in its economic growth and development. Some of its areas are under developed, impoverished and suffer immensely from the negative implications of HIV/AIDS. The major areas that have experienced persistent growth in South Africa include Johannesburg, Port Elizabeth, Durban and Cape Town.
Compared to the rest of the population, the Black population faces more challenges and is the most affected by HIV and AIDS. This is attributed to the lengthy period of social and political oppression that was experienced during apartheid. Notably, relative conditions left a significant 80% of the Black populations vulnerable to AIDS infection and without any means to either treat or prevent the disease. Population studies indicate that the Blacks grapple with wide ranging social problems such as unemployment, lack of education and poverty. Close to 60% of the South African population resides in towns or urban regions while the remaining 40% reside in rural areas. Both regions have areas that are affected by poverty and whose populations lack electricity, clean water, access to healthcare and other social amenities that are instrumental in enhancing their holistic wellbeing.
According to CIA (2000), South Africa has the highest rate of AIDS related deaths and is the second highest with respect to the rate of individuals living with AIDS. This implies that an estimated 350,000 individuals die from AIDS in the country each year. Further, close to 5.7 million are currently living with this disease. Notably, the segment of the population that is sexually active is at most risk of contacting the disease. The individuals that are aged between 15 and forty nine years are the most affected and have an infection rate of a significant 18%. Statistical evidence indicates that pregnant women are at a higher risk of being infected.
Currently, the rate of infection in this segment of the population is close to 29%. The high rates are attributable to the attitudes that the population hold towards gender roles and sexuality. The men are very chauvinistic and populations generally hold patriarchy in high regard. Monogamy is hardly practiced in the country (Benatar, 2004). Usually, men leave for lengthy period of time and demand for their spousal rights upon return. This increases the risk of women contracting the disease. Further, unmarried men are sexually aggressive and often believe they have a right to be given sexual favors from any woman at any time. Reportedly, the women that make efforts to resist are often raped (Nattrass, 2004).
Millennium Development Goals constitute a list of distinct goals that were developed by the United Nations in a bid to address and combat various health as well as social disparities that the global population is currently grappling with. The sixth goal of the Millennium goals focuses on combating HIV/AIDS. The goal constitutes two targets that include halting and reversing the spread of HIV/AIDS by 2015 and attaining Universal access to HIV/AIDS treatment by 2010. Statistical evidence indicates that the number of infections has decreased significantly. However, the number of AIDS related deaths continues to soar. Current trends indicate that while new infections have decreased, the incidences have not and HIV/AIDS continues to affect a significant percentage of the population. It is therefore unlikely that the Millennium Development Goals in this regard would be successful.
The efforts that are geared towards combating HIV/AIDS in South Africa have been compounded by various challenges. Benatar (2004) indicates that stigmatization is one of the problems that have undermined the efforts to fight HIV/AIDS. This constitutes preexisting prejudices as well as stereotypes that perceive the victims as being immoral. They are blamed for their position and considered to be responsible for their infection. In most cases, AIDS is considered a justified punishment for their presumed immoral ways. The inherent prejudices and biases continue to hurt the victims and enhance the spread of the disease. Regardless of the fact that the Millennium Development Goals are unlikely to be met, the entire healthcare fraternity needs to continue making efforts to prevent the spread of the disease in the region. To attain optimal output, relative efforts need to be pursued at each level.
At the primary level, Gilbert and Walker (2002) affirm that the government of South Africa has initiated viable plans that are also outlined in its national Strategic Plan. Specific objectives entail reducing AIDS incidence by a significant 50% by 2011 and providing access to antiretroviral therapy to the facets of the population that are eligible. Notably, these goals are in line with the provisions of the MDGs. Relative efforts are also being furthered by various non profit making organizations that have established operations in the region. Specifically, these undertake education and awareness creation in an attempt to inform the public about important preventive measures. Women are also taught how to negotiate for power as well as control that enables them to face their abusive men (Gilbert & Walker, 2002).
At this primary level, awareness creation strategies place great emphasis on the ABC strategy. In particular, populations are encouraged to abstain from sexual relations until they get in marriage; to maintain faithfulnesses in marriage and to use condoms whenever they get themselves in a compromising situation. The populations are also encouraged to reduce the number of sexual partners that they have. This has been coupled by government initiatives of availing sufficient condoms for the population. Efforts have also been undertaken to prevent TB infections that increase the vulnerability of the affected individuals to opportunistic infections (Gilbert & Walker, 2002).
The biggest challenge that efforts at this level are facing pertains to the difficulty in changing behaviors especially for those already with the disease or those that are at risk of contracting the disease. Seemingly, populations are reluctant to change because of a lack of a vested interest in the respective change. Nonetheless, education and awareness creation efforts would probably yield results after a certain period of time. Also, relative efforts have been compounded by cultural stereotypes that promote unacceptable behavior. The population holds the cultural practices and beliefs in high regard and is reluctant to change. Finally, transportation problems have made it difficult for the personnel to effectively penetrate the interior that comprises of the most affected percentage of the population.
Efforts related to the secondary level of prevention need to focus on detecting the disease in a timely manner and taking practical efforts to prevent its transmission. Individuals in this regard are encouraged to visit voluntary counseling and testing centers in order to undergo tests. It can not be disputed that early detection is important because it makes management of the disease easier. The affected individuals at this point need to be informed about the importance of assuming low risk behaviors. They should be provided with vital information regarding the nature of this disease and the importance of retarding its further progression (Pettifor, Measham, Rees & Padian, 2004).
One of the challenges facing this level pertains to a lack of desire by the population to change its behaviors. In addition, limited health facilities especially in the rural areas have made it difficult for a significant percentage of the population to access ART. This is further compounded by poverty negative cultural practices and low levels of literacy.
The tertiary level should then place great emphasis on addressing the far reaching implications of the disease. The main aim of this is to enhance the living potential of the victims. Seemingly, opportunistic infections pose the greatest challenge to relative efforts. Most efforts are directed at the patients, care partners and healthcare professionals that interact with the affected individual in different ways. Furthermore, the government has put in place distinct measures geared towards rehabilitating the children that are orphaned by the disease. In most instances, these children tend to suffer detrimentally especially considering that the society is very hostile.
The challenges that are faced at level stem from the social as well as economic status of the affected individuals. The individuals with access to important social amenities are usually in a better position to prevent the opportunities infections than their counterparts. Comparatively, the populations in the rural areas suffer the most because of lack of access to important social amenities. Another challenge pertains to the high incidences of poverty. In this respect, poverty has made it difficult for the affected individual to maintain healthy lifestyles. Some are compelled by the poor conditions to engage in high risk behaviors such as prostitution. Further, most of them in the rural areas can not access antiretroviral drugs because of poor transportation systems.
Nurses have various responsibilities to the individuals that suffer from HIV/AIDS both on the local and global level. At the local level, nurses can educate the South Africa locals about the dismal future of those infected with the disease. The nurses that are able to travel to South Africa should individually participate in the efforts by providing the needed expertise. Such experiences would also be instrumental in hanging the practices of the nurses abroad. Also, nurses can engage in initiating change by setting best examples. Just like transformational leaders, they can motivate and encourage the affected individuals to assume best practices that can enable them to reduce the risk of infection. Sustainable results in this regard can be attained if they set examples by practicing health living and helping the infected individuals. Acting as role models would enable them to inspire various facets of the local and global populations that have been infected or affected. AIDS is a killer disease that will probably not be cured in the near future. For this reason, nurses should take the initiative to personally involve themselves in prevention efforts in a bid to reduce infection rates as well as incidences.
References
Benatar, S. (2004). Health care reform and the crisis of HIV and AIDS in South Africa. The New England Journal of Medicine, 351 (1), 81-92.
CIA. (2010). World Fact Book. Retrieved Feb. 5, 2011 from https://www.cia.gov/library/publications/the-world- factbook/geos/sf.html
Gilbert, L. & Walker, L. (2002). Treading the path of least resistance: HIV/AIDS and social inequalities- A South African case study. Social Science Medicine, 54, 1093-1110.
Nattrass, N. (2004). The moral economy of AIDS in South Africa. Cambridge: University Press.
Pettifor, A., Measham, D., Rees, H & Padian, N. (2004). Sexual power and HIV risk, South Africa. Emerging Infectious Diseases, 10 (11), 1996-2004
