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Essay on AIDS for Students and Children

500+ words essay on aids.

Acquired Immune Deficiency Syndrome or better known as AIDS is a life-threatening disease. It is one of the most dreaded diseases of the 20 th century. AIDS is caused by HIV or Human Immunodeficiency Virus, which attacks the immune system of the human body. It has, so far, ended more than twenty-nine million lives all over the world. Since its discovery, AIDS has spread around the world like a wildfire. It is due to the continuous efforts of the Government and non-government organizations; AIDS awareness has been spread to the masses.

AIDS – Causes and Spread

The cause of AIDS is primarily HIV or the Human Immunodeficiency Virus. This virus replicates itself into the human body by inserting a copy of its DNA into the human host cells. Due to such property and capability of the virus, it is also known as a retrovirus. The host cells in which the HIV resides are the WBCs (White Blood Cells) that are the part of the Human Immune system.

HIV destroys the WBCs and weakens the human immune system. The weakening of the immune system affects an individual’s ability to fight diseases in time. For example, a cut or a wound takes much more time to heal or the blood to clot. In some cases, the wound never heals.

HIV majorly transmits in one of the three ways – Blood, Pre-natal and Sexual transmission. Transfusion of HIV through blood has been very common during the initial time of its spread. But nowadays all the developed and developing countries have stringent measures to check the blood for infection before transfusing. Usage of shared needles also transmits HIV from an infected person to a healthy individual.

As part of sexual transmission, HIV transfers through body fluids while performing sexual activity. HIV can easily be spread from an infected person to a healthy person if they perform unprotective sexual intercourse through oral, genital or rectal parts.

Pre-natal transmission implies that an HIV infected mother can easily pass the virus to her child during pregnancy, breastfeeding or even during delivery of the baby.

AIDS – Symptoms

Since HIV attacks and infects the WBCs of the human body, it lowers the overall immune system of the human body and resulting in the infected individual, vulnerable to any other disease or minor infection. The incubation period for AIDS is much longer as compared to other diseases. It takes around 0-12 years for the symptoms to appear promptly.

Few of the common symptoms of AIDS include fever , fatigue, loss of weight, dysentery, swollen nodes, yeast infection, and herpes zoster. Due to weakened immunity, the infectious person falls prey to some of the uncommon infections namely persistent fever, night sweating, skin rashes, lesions in mouth and more.

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AIDS – Treatment, and Prevention

Till date, no treatment or cure is available for curing AIDS, and as a result, it is a life-threatening disease. As a practice by medical practitioners, the best way to curb its spread is antiretroviral therapy or ART. It is a drug therapy which prevents HIV from replicating and hence slows down its progress. It is always advisable to start the treatment at the earliest to minimize the damage to the immune system. But again, it is just a measure and doesn’t guarantee the cure of AIDS.

AIDS prevention lies in the process of curbing its spread. One should regularly and routinely get tested for HIV. It is important for an individual to know his/her own and partner’s HIV status, before performing any sexual intercourse activity. One should always practice safe sex. Use of condoms by males during sexual intercourse is a must and also one should restrict oneself on the number of partners he/she is having sex with.

One should not addict himself/herself to banned substances and drugs. One should keep away from the non-sterilized needles or razors.  Multiple awareness drives by the UN, local government bodies and various nonprofit organizations have reduced the risk of spread by making the people aware of the AIDS – spread and prevention.

Life for an individual becomes hell after being tested positive for AIDS. It is not only the disease but also the social stigma and discrimination, felling of being not loved and being hated acts as a slow poison. We need to instill the belief among them, through our love and care, that the HIV positive patients can still lead a long and healthy life.

Though AIDS is a disease, which cannot be cured or eradicated from society, the only solution to AIDS lies in its prevention and awareness. We must have our regular and periodical health checkup so that we don’t fall prey to such deadly diseases. We must also encourage and educate others to do the same. With the widespread awareness about the disease, much fewer adults and children are dying of AIDS. The only way to fight the AIDS disease is through creating awareness.

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• Essay on AIDS

HIV (human immunodeficiency virus) is an infection that causes cells in the body that help it fight infections, making a person more susceptible to other infections and diseases. Interaction with certain bodily secretions of an HIV-positive individual, most commonly during unprotected intercourse (sex without the use of a condom or HIV treatment to prevent or treat HIV), or sharing injection drug equipment spreads the virus.

If HIV is not treated, it can progress to AIDS (acquired immunodeficiency syndrome). HIV cannot be eradicated by the human body, and there is no effective HIV cure. As a result, whether you have HIV, you will have it for the rest of your life.

Long and Short AIDS Essay in English

There are many diseases causing microorganisms, like bacteria, viruses, fungi etc. The symptoms of the diseases depend on the type of microorganism that is spreading it. It can vary from mild to severe. AIDS which stands for Acquired Immunodeficiency Syndrome is a viral disease that is rampant in growth. It was only in the last century that this viral disease has proved to be lethal and fatal, taking away about twenty million lives globally. The awareness about the disease and the virus causing it which is HIV or Human Immunodeficiency Virus is more now compared to earlier. In this HIV AIDS essay, we can go through the important information about it and burst some myths.

Below are different ways to write an AIDS essay in English. The essay on HIV AIDS can be of 2 formats, a long essay on HIV AIDS or a short AIDS essay.

Short Essay on Aids

This AIDS essay is a brief one and will cover the important notes about the disease and the ways one can prevent it.

The way of occurrence of this disease is in the name itself, AIDS stands for Acquired Immunodeficiency Syndrome. The disease is acquired via the virus which is called Human Immunodeficiency Virus. It is not an auto-immune disease in the early stages of infection where the immune system in the body fights off infection to protect the body from diseases that go against itself. The virus enters from an outside source and destroys the efficiency of our immune system.

AIDS is transmitted through contact. The contact with infected blood of the HIV OR AIDS patient in any form can easily transfer this viral disease. It can also be transmitted through contact with semen or vaginal fluids of the infected person. This occurs in the case when one is sexually exposed to a person with HIV.

HIV once enters the body, invades and conquers the immune system making the body susceptible to other diseases. It is then very easy for the simple flu or cold infection to be severe as the immune system is no longer fit to fight it.

When detected in the early period can be battled with, but more often than not people assume the symptoms to not be AIDS so it spreads and kills the individual. To be protected when having sex and not sharing any form of toiletries with others is the way to prevent and keep this deadly virus at bay.

Long Essay on AIDS

This is the long format of an essay on HIV AIDS where its workings, causes and effects and remedies are discussed.

There are some diseases that have been borne by the living in this world which has created a ruckus in human history and the struggle to find a permanent cure still exists. AIDS is one such disease. Acquired Immunodeficiency Syndrome is the name of the disease which is also shortened as AIDS.

It has since only the 20 th century affected the human race and many people lost their lives, more than 20 million of them. The virus that aids in the transmission of this disease is Human Immunodeficiency Virus or also called HIV. Due to the same property of immunodeficiency, it is referred to as HIV/AIDS.

Since it affects the immune system severely, the cells and the workings of it in our body must be clearly understood. The immune system’s role in the body is that of a soldier wherein it identifies any sort of anomalies that enters or infiltrates the body and prepares antibodies against it. And kills them in order to prevent infection that has the probability of causing a harmful disease.

Since the cells of the immune system have already created the antibodies, the cell memory is activated when the entry occurs again and the immune system fights and destroys such foreign and harmful matter.

What Happens when HIV Enters the Body?

When a person is infected with the Human immunodeficiency virus, it directly attacks the immune system making the cells weak and incapable of creating antibodies for this particular virus. As they become weak their function to perform the task of defending against other microorganism entrants is also weakened.

When the fighter in our bodies becomes weak, we are more likely to fall ill. The illness can be a simple flu or an allergy and our body cannot fight any further. The symptoms once infected will start to appear within the first two weeks. The symptoms are very flu-like for instance, one will be more tired than usual and fatigue will be more frequent and regular. Other symptoms include sore throat and fever. The risk of opportunistic infections like tuberculosis and herpes also increases. Some people however remain asymptomatic even for longer periods after being infected with the virus.

Cause of HIV/AIDS

The main and only cause of this dreadful disease is the contact through blood, semen, pre-seminal fluid, vaginal fluids, rectal fluids and breast milk. The semen and vaginal fluids are transferred through sex and rectal fluids through anal sex. When people have multiple partners, and they have unprotected sex the transmission is highly likely. The contact through blood can also be via the unhygienic practice of sharing an infected person’s razors, blades. Even unsterilized syringes while taking drugs or even a tattoo parlor where they use unsterilized machines on the body can transmit the virus easily. The transmission means are endless so one must proceed with utmost caution to keep themselves safe either way.

What is the Life Expectancy for the Patients Carrying HIV or AIDs with Them?

Many factors can affect the life expectancy of people living with HIV. Depending on these factors there are many differences in the outcomes between people, and other factors. The factors on which life expectancy depend are:

Access to effective HIV treatment and quality health care.

Start HIV treatment as soon as possible after HIV infection, before your CD4 cell count drops to a low level. The sooner you are diagnosed and start HIV treatment, the better your long-term chances are.

Having serious HIV-related illnesses in the past. This may occur before HIV is diagnosed and/or before HIV treatment is started. These diseases have a detrimental effect on life expectancy.

Results one year after starting HIV treatment. Studies show that life expectancy is better for people who respond well within a year of starting treatment than people who do not respond. In particular, people with a CD4 count of at least 350 and an undetectable viral load during the year have a much better chance long-term.

Year of Diagnosis - HIV treatment and medical care have improved over the years. People who have been diagnosed in recent years are expected to live longer than people who were diagnosed long ago.

Heart diseases, liver diseases, cancer and other health conditions are more likely to be the cause of death than HIV or AIDs.

Injecting drug use - Life expectancy is short for people with HIV who inject drugs, due to drug overdose and viral infections.

Social and Economic Conditions - there are significant differences in life expectancy depending on where you grew up, your income, education, social status and more.

Gender – Men are supposed to live for a shorter period of time than women.

Genetics - you may have certain conditions if close relatives have.

Mental and Emotional Well-being - high levels of stress are associated with reduced life expectancy.

Lifestyle - longevity for people who eat a balanced diet, are physically active, maintain a healthy weight, avoid alcohol abuse or use drugs, and stay in touch with the community. Avoiding smoking is very important in life.

There are a few myths surrounding this disease. It is believed earlier that AIDS can spread even through contact or touch without any exchange of fluids. Like through a hug or just by being near the infected person. That myth has been debunked and it is absolutely untrue. One can freely hug an AIDS patient without worry.

The other one was when kissing, there is an exchange of saliva which is also a fluid and AIDS can spread through kissing, which also proved to be untrue. And HIV always means AIDS that is fatal was another rumor or myth, and this myth is proven wrong where many people have lived longer with HIV by medication and taking care of their health.

There is no permanent cure yet for treating HIV/AIDS, so it is our responsibility to look out for ourselves. The way one can first prevent themselves from being infected is by getting vaccinated. It is important to get tested in your adult life if you have multiple sexual partners and also get your partner tested for the same. The other way is being monogamous. The most used form of prevention is having protected and safe sex and using condoms that creates a barrier for transmission. Do check for sterilized needles in case you decide to get a tattoo or injected.  Lessen the use of alcohol and drugs as that is anyway weakening and altering the immune system.

According to the estimates of the Indian government  2.40 million Indians are living with HIV wherein, the infected ones fall in the age group of 15-49, and 39 %of them that is 9,30,00 of them are women. The numbers are alarming and the rate of increase is not slowing down anytime soon. We as a country must break the traditions and conversations about sex should be open and safe. It is high time we lose our lives to this disease which can be prevented.

FAQs on Essay on AIDS

1. Is AIDS an Autoimmune Disease?

In the early stages of HIV infection that leads to AIDS, the immune system only weakens so it is not an auto-immune disease. But during the later and final stages, the workings of the immune system are similar to that of an auto-immune system where it works against itself. And in such cases, the body of the individual is susceptible to many more diseases. AIDS, a disease found in immune deficiency disorder, is caused by HIV and weakens the human immune system. Autoimmune diseases, on the other hand, are where the immune system turns, attacking healthy cells.

2. Does one die from HIV Infection?

The HIV infection results in many symptoms that make the body weaker day by day. But some do not even suffer those symptoms and they may live longer than the ones showing severe symptoms. In any case, it is important to take medications that are prescribed to reduce the severity of symptoms and live a little longer. The best way is to keep healthy and lead an active lifestyle as much as possible. Although the death toll from AIDS has dropped dramatically around the world, this situation increases the risk of contracting a fatal disease — potentially leading to death. No treatment or cure is present for HIV.

3. What method was adopted by the hospitals to report HIV or AIDs cases?

The doctors took the active initiative for the reporting and diagnosis of HIV or AIDs cases all over the world. The methods that all the French hospital wards were known for, for their role in controlling HIV infection, were asked to report the 2000 deaths among HIV-positive adults. The causes of death were recorded using a standard questionnaire. The Mortality 2000 study was launched to explain the distribution of the leading causes of death of HIV-positive people at the national level in France in the year 2000.

4. What is the way of determining the root cause of death in AIDs patients?

Following the International Classification of Diseases, 10th Revision (ICD-10) to death, the information contained in the questionnaire was used to determine the single cause of death. The causes of AIDS were categorized as one cause of death, followed by definitions of AIDS-related diseases. If a standard questionnaire was lost, summarized quarter notices were used to determine the underlying cause of death, if possible. Determination of the AIDs cases was set to the most important things in the list, which was done from the abstracted quarterly notifications from the questionnaires.

5. Is Vedantu a reliable website for knowing about AIDs disease?

Vedantu is the most reliable website for referring to information about AIDs disease. Being one of the most dangerous diseases in the world with no proper treatment or cure, the world's physicians are still under pressure to decipher the way to save a person from this disease. The Vedantu website contains authentic or updated information about this disease and thus the readers and viewers can rely on this source of information for perfect knowledge about the disease and its prevention also.

Short & Long Essay on AIDs in 100, 250, and 500 Words

Essay on aids.

The essay on AIDS (HIV) is written in simple English and has easy words for children and students. This (Essay on AIDS or HIV) English essay mentions AIDS, how it originated, and why we should know about it. Students are often asked to write an essay on AIDS in their schools and colleges. And if you are also looking for the same, then we have given an essay on AIDS in 100 – words, 250 – words, and 500 – words.

Short & Long Essay on AIDs

Essay – 100 words.

Acquired Immune Deficiency Syndrome, also known as AIDS, is a fatal and fatal disease. Caused by AIDS (HIV) or human immunodeficiency virus. It is one of the deadliest diseases of the 20th century that attacks the immune system of the human body. AIDS has spread like wildfire around the world and has so far caused the death of more than twenty-nine million people all over the world.

Awareness about AIDS has been spread among the people by the government and non-governmental organizations. It is not only a disease but is seen as a stigma and discrimination in the society. We need to instill in them the belief that HIV-positive people can live healthy and long lives.

Essay – 250 Words

Introduction

AIDS which stands for Acquired Immune Deficiency Syndrome. It is not a congenital disease. It means an immune system deficiency acquired during a person’s lifetime. The disease has spread throughout the world, killing more than 29 million people.

Due to coming in contact with this, the immunity of the patient becomes so low and he becomes unable to protect himself from these infections. A widely used diagnostic test for AIDS is the enzyme-linked immunosorbent assay (ELISA).

Reason for Spread of AIDS

AIDS is caused by the Human Immune Deficiency Virus (HIV). Transmission of HIV infection generally occurs in the following ways:-

(a) By coming into sexual contact with an infected person,

(b) by transfusion of contaminated blood and blood products,

(c) by sharing infected needles, and

(d) From an infected mother to her child through the placenta.

Therefore, people who are at higher risk of contracting this infection include those who are drug addicts, those who have multiple sexual partners, or those who require frequent blood transfusions.

AIDs Treatment

There is no cure for AIDS in the world, so prevention is the best option. HIV infection often spreads due to a lack of information. Government and other organizations are running awareness campaigns and other programs for its prevention and information.

AIDS is a disease which has no treatment and cannot be cured but it can be prevented only through awareness. Others should also be encouraged and educated to prevent it.

Essay – 500 Words

Acquired immune deficiency syndrome (AIDS) is a widespread and fatal disease caused by HIV or human immunodeficiency virus. There is no cure for it in the world yet, although there are medicines to slow down the virus. AIDS is seen as a stigma in society which ensures that there is still a lack of information among the people in the society.

Origin and History of AIDS

Human immunodeficiency virus (HIV) first originated in non-human primates in West and Central Africa. The most serious type of the virus, called HIV-1, was discovered in the Democratic Republic of the Congo in 1920. It was causing many deaths in the United States in the 1970s, so in 1981 the US Centers for Disease Control officially recognized AIDS infection when found in a woman.

How is AIDS (HIV) Spread?

The HIV virus can spread from one infected person to another in several ways as given below.

1. Unsafe blood transfusion

There is a risk of spreading the HIV virus when a doctor or hospital transmits blood from one person to another without properly testing the blood. Any blood must be tested for the presence of HIV and other viruses before it is transfused.

2. Unprotected sex

The HIV virus can spread from one infected person to another healthy person when they exchange sexual fluids during unprotected sex.

3. Sharing unsafe needles

The virus can also be spread by sharing infected needles. The use of such contaminated needles can lead not only to HIV infection but also to other high-risk infections such as hepatitis and septicemia.

4. During pregnancy/childbirth or breastfeeding

An infected woman can also pass the virus to her baby during pregnancy, delivery, or breastfeeding. However, if the woman receives proper treatment during pregnancy, the risk of infection is reduced to a great extent.

AIDS (HIV) Treatment

At present no country has any cure for AIDS or HIV. HIV is a retrovirus that replicates by replacing the host cell’s DNA with copies of its own DNA, so the best way to stop it from spreading is ART or antiretroviral therapy which stops the virus from replicating and slows its progression. Gives or withholds. It is best to start treatment at an early stage as soon as the infection is detected so that there is less damage to the immune system. Its treatment can then be combined with those preventive medicines.

AIDS (HIV) is a deadly disease that spreads slowly. So awareness is really the key to stopping the spread of AIDS. Although this infection is now under control, it has not been completely eradicated. We can prevent it by making more and more people aware of it.

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Essay on AIDS for Students & Children in English [500+ Words]

January 15, 2021 by Sandeep

Essay on AIDS: Acquired Immunodeficiency Syndrome is a deadly disease contracted when a person infected with HIV (Human Immunodeficiency Virus). It destroys the person’s immune system to such an extent that the patient cannot resist even minor illnesses. The CD4 cells of the host system are totally weakened, and the patient’s physical and mental condition becomes vulnerable. There has been no permanent cure for AIDS to date.

Essay on AIDS 500 Words in English

Below we have provided AIDS Essay in English, suitable for class 6, 7, 8, 9 & 10.

Can you believe that around 38 million people in the world are, currently, suffering from a disease, which had already taken the lives of around 35 million in the past! “Dangerous” is the first word that we associate with this disease from these figures; but still, what is more dangerous, is that, despite being such a deadly disease, it is one of the most “taboo” diseases of the world! This disease is called “AIDS”. Its name may mean ‘to help’, but it just helps a person to die!

AIDS, a short-form for Acquired Immune Deficiency Syndrome, is one of the world’s fatal diseases. AIDS is caused by a virus named HIV, i.e. Human Immunodeficiency Virus. We can get an idea about this virus’s work from its name itself. It weakens our immune system by getting into White Blood Cells (WBCs), which are involved in protecting our body from infectious diseases and foreign invaders, and then destroying WBCs and the T-helper cells (T-helper cells helps other cells in our immune system to fight off the invading viruses). This results in weakening the body’s immune system, which becomes more susceptible or likely to catch other diseases too! Eventually, as the body cannot fight off the diseases, it leads to the final stage of this disease, AIDS.

The first cases of AIDS were found in the Western parts of Africa, and the Democratic Republic of Congo. It later on spread outside of Africa, during the early 20th century, when the urbanisation was at its peak in Africa. Later on, when some deaths were reported late 20th century in America, it was taken as a serious issue. There are two types of HIV: HIV-1 and HIV-2. HIV-1 contributes to 90% of the cases, while HIV-2 is very rare. Hence, generally, when we are referring to HIV, we are talking about HIV-1.

Generally, HIV transmits in one of the three ways

• Blood:  The transfusion of HIV through blood was very common in its initial spread. By reusing of needles, we can transmit this virus from an infected person to a healthy one. But nowadays, stricter norms have led to fewer cases due to this reason.
• Prenatal: Prenatal transmission is possible through an infected mother to her child while breastfeeding, during delivery of a baby or even during pregnancy.
• Sexual Transmission:  Sexual transmission occurs through body fluids while having sexual activity or unprotected sexual intercourse through oral, genital, or rectal parts.

According to the UN, “India has the 3rd largest number of people living with HIV in the world,” i.e. around 2.1 million at the end of 2013.

Symptoms of AIDS

As HIV attacks on the WBCs of the body, the overall immune system of the human body is reduced, and due to that, the infected person is at risk of catching other diseases very easily. Normally, it takes 0-12 years for symptoms to appear rapidly, and the common symptoms are fever, fatigue, loss of weight, dysentery, swollen nodes, etc.

Hence, a person can live with this disease for around 10 years, without knowing that he/she is suffering from it! Also, this disease doesn’t just affect a person’s health life, but its social life too! The social stigma and trauma that follows this disease are also worse.

AIDS – Prevention and Treatment

Currently, there’s no cure for this disease. But its growth and spread in the body can be controlled by a drug therapy called ART or Anti-Retroviral Therapy. Still, a person has to learn to live with this virus. December 1st, is known as World AIDS Day, to spread awareness of this disease, as this is the only way to fight off this disease. As more awareness will make people take medicine in the early stage of this disease itself. The governments of various countries and the World Health Organisation (WHO), have taken various steps to increase the awareness of this disease, globally.

Prevention and Treatment of HIV/AIDS Expository Essay

Introduction.

HIV/AIDS has become a concern to everybody in the world. Many countries and individuals have found it very hard to deal with it because of the lack of funds. Therefore, organizations have come up to help them handle this problem. Notable organizations that have offered their support include WHO, PEPFAR, the Clinton’s AIDS Initiative, the Gates Foundation and the Global Fund.

WHO HIV/AIDS Treatment and Prevention Program Policy

The World Health Organization Department of HIV/AIDS provides normative and policy support to its members basing on enough evidence ( WHO | Guidelines, 2014). The purpose of this support is to improve the treatment, care provision and prevention services ( WHO | Guidelines, 2014).

The global vision of WHO is to eradicate HIV infections, deaths and discrimination against infected people. It aims at attaining universal and comprehensive HIV prevention, treatment and care. It also aims at combating HIV/AIDS, malaria and other diseases ( WHO | Guidelines, 2014). WHO developed strategic directions that health units should adopt in achieving its goals. They are:

• Optimizing the prevention, diagnosis and provision of care for HIV victims ( WHO | Guidelines, 2014)
• Leveraging wider outcomes in health through appropriate response to HIV ( WHO | Guidelines, 2014)
• Reducing susceptibility and getting rid of barriers to accessing services ( WHO | Guidelines, 2014)

The World Health Organization also proposes treatment and preventive methods that are specific to the needs of individual countries. Among the methods it proposes for the countries include the use of male and female condoms, male circumcision, antiretroviral therapy, prophylaxis and behavior change counseling ( WHO | Guidelines, 2014).

WHO also volunteered to expand HIV prevention methods in every country ( WHO | Guidelines, 2014). Currently, it has plans to develop a HIV prevention strategy based on national evidence and push for the creation of better prevention methods and interventions.

The Role of other Organizations

Global fund.

The Global Fund partners with governments, civil societies, the private sector and victims of AIDS, Tuberculosis, and malaria in 140 countries worldwide ( HIV/AIDS-The Global Fund, 2014). It spends over $4 billion every year on these partnerships. This support has greatly accelerated the rate at which the prevalence of AIDS reduces.

The fund was developed with the purpose of giving HIV victims financial support to reduce the rate of infections ( HIV/AIDS-The Global Fund, 2014). In addition, the Global Fund ensures that all infected people in the world can access antiretroviral therapy. By last year, the fund had helped 6 million victims of HIV get access to ARV ( HIV/AIDS-The Global Fund, 2014).

Its efforts have largely depended on the realization that ARV reduces the chances of HIV transmission by close to 90%. The Global Fund concentrates its services and support in areas where the effects of HIV/AIDS are more prevalent. It looks for geographic and demographic information, making it easier to focus on certain countries and populations around the world. It mostly focuses on stigmatized groups such as women, girls, drug users, migrant workers and inmates.

Gates Foundation

The main objective of the Gates Foundation is “to reduce the incidence of HIV infection and extend the lives of people living with HIV” ( HIV, 2014, par. 4). The organization offers support to all the efforts of reducing worldwide transmission of HIV. It also helps the victims of the virus live long and healthy lives.

The organization mainly focuses on populations living in Sub-Saharan regions of Africa. HIV has greatly affected the population in these regions ( HIV, 2014). These regions are very poor and cannot afford HIV medication without support. The foundation gives grants to organizations that fight HIV. It also offers financial support to the Global Fund.

So far, it has given approximately $2.5 billion to organizations in all countries and $1.4 billion to the Global Fund ( HIV, 2014). The foundation also advocates sustainability and increase in funding programs that aim at reducing HIV/AIDS prevalence.

The fund also supports the search for a HIV vaccine. It invests in research that aims at coming up with the vaccine. It partners with private institutions, individual researchers and governments in researching on several types of possible vaccines. It also provides antiretroviral therapy and other products such as vaginal rings and injections to the victims.

In addition to other activities, the foundation provides tools for carrying out voluntary male circumcision in 14 Sub-Saharan countries ( HIV, 2014). It also supports efforts by governments and other private institutions to diagnose and measure the prevalence of HIV.

Clinton’s AIDS Initiative

The Clinton Health Access Initiative was established with the purpose of helping all victims of HIV get access to medication and reduce its cost ( HIV/AIDS , 2014). Since its inception, the number of people accessing HIV medication has risen from 200, 000 in 2002 to over 8 million today ( HIV/AIDS , 2014).

In addition, the cost of the treatment has fallen from $ 10, 000 to approximately $100. The initiative has partnered with many countries around the world in formulating programs aimed at fighting HIV/AIDS ( HIV/AIDS , 2014). The best example of such partnerships includes the partnership with Ukraine.

This partnership aimed at increasing the access to HIV/AIDS treatment. President Clinton and Preval’s agreement to expand HIV/AIDS services and strengthen health systems in Haiti and the partnership with UNITAID that focused on reducing the prices of important AIDS medicine were also part of this initiative ( HIV/AIDS , 2014).

The main goal of PEPFAR is to save many lives through upgrading existing strategies and supporting efforts by different countries to improve their people’s health ( The U.S. President’s Emergency Plan for AIDS Relief, 2014). In 2008, the president of America signed an act that authorized the use of $ 48 billion in the fight against HIV, malaria and TB.

PEPFAR also aims at promoting sustainable AIDS eradication programs ( The U.S. President’s Emergency Plan for AIDS Relief, 2014). This initiative also supports countries in responding to HIV because of the belief that fighting AIDS is more effective when countries take charge of their affairs ( The U.S. President’s Emergency Plan for AIDS Relief, 2014). PEPFAR also focuses on other challenges that come with HIV/AIDS such as stigma and opportunistic diseases.

Recommendation

The organizations should provide more material support compared to money since most countries misuse the funds they receive.

Many countries in the Sub-Saharan Africa are too poor to provide good preventive and treatment methods of HIV/AIDS to their citizens. Close to 18% of their population is infected with the virus.

This situation has prompted many private and international organizations to come to their rescue. WHO, PEPFAR, the Clinton’s Organization and the Gates Foundation have provided support in these regions for a long time.

Private and International organizations have been very supportive in the fight against HIV/AIDS. Many countries and individuals could not afford the HIV/AIDS prevention and treatment without the support of PEPFAR, WHO, Clinton’s AIDS Initiative, Gates Foundation and other organizations. These organizations have invested lots of money and material support in regions with the most prevalent cases of HIV/AIDS.

HIV/AIDS (2014). Web.

HIV/AIDS – The Global Fund to Fight AIDS, Tuberculosis and Malaria (2014). Web.

HIV – Bill & Melinda Gates Foundation (2014). Web.

The U.S. President’s Emergency Plan for AIDS Relief: Five-Year Strategy (2014). Web.

WHO | Guidelines: HIV (2014). Web.

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Bibliography

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• Malaria in Women and Children in Sub-Saharan Africa
• Key Drivers of HIV and AIDS in Sub-Saharan Africa and in San Francisco and Church’s Response to the AIDS Pandemic
• Duties of Health Care Professionals During Pandemic of Highly Contagious Diseases
• Prevention and Treatment of Tuberculosis
• Epidemiology: Genetics-Related Programs
• Leishmaniasis: Causes & Treatment
• HIV and AIDS Prevention Among the Youth in Asia

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National Research Council (US) Committee on AIDS Research and the Behavioral, Social, and Statistical Sciences; Turner CF, Miller HG, Moses LE, editors. AIDS: Sexual Behavior and Intravenous Drug Use. Washington (DC): National Academies Press (US); 1989.

AIDS: Sexual Behavior and Intravenous Drug Use.

• Hardcopy Version at National Academies Press

The human immunodeficiency virus (HIV), now known to be the cause of acquired immune deficiency syndrome, or AIDS, is only one element of the complex problem that is commonly called the AIDS epidemic. The spread of HIV infection and, consequently, AIDS is the product of human behaviors enacted in social contexts. Both the behaviors and the circumstances in which they occur are conditioned and shaped by culture and larger social structures. The epidemic is thus as much a social and behavioral phenomenon as it is a biological one.

Understanding how HIV infection is spread, encouraging behavioral change so as to retard this spread, and coping with the social consequences of the epidemic raise questions that lie within the domain of the social, behavioral, and statistical sciences. Following publication of the 1986 report on AIDS of the Institute of Medicine/National Academy of Sciences, 1 the present committee was established in the fall of 1987 to provide a focus for AIDS activities within these disciplines at the National Research Council. At the request of the Public Health Service (PHS) and with additional support from the Rockefeller and Russell Sage Foundations, the committee has begun its work by reviewing the contributions that can be made by the paradigms, data, and methods of the social, behavioral, and statistical sciences 2 in mounting an effective national response to the HIV/AIDS epidemic. 3

The committee's report is divided into three parts. The first part presents evidence on the current extent of HIV infection in the U.S. population ( Chapter 1 ) and on the patterns of sexual behavior and drug use (Chapters 2 and 3 ) that spread HIV infection. The second part describes intervention strategies and principles that hold promise for producing behavioral change to slow the spread of HIV infection ( Chapter 4 ) and methods for evaluating the effectiveness of such interventions ( Chapter 5 ). The third part (Chapters 6 and 7 ) discusses some of the barriers that impede effective research and intervention programs. The organization of this summary follows that of the report, and it includes some of the report's key recommendations. (All of the committee's recommendations are listed in Appendix A .)

At the outset of its report, the committee believes it is important to comment on the term epidemic , which is sometimes misunderstood in connection with HIV/AIDS. During an epidemic, the occurrence 4 of new cases of a disease in a community follows a well-known pattern: it may increase dramatically in a short period of time, peak, and then decline. During the course of an epidemic, there may be cycles of rise and decline in the number of new cases.

In 1989 the United States stands at the base of a rapidly rising curve of AIDS cases and deaths. Barring a dramatic breakthrough in treatment, it is projected that more than 50,000 Americans will die of AIDS during 1991. The number of deaths during this 12-month period alone will exceed the total number of deaths in this country from the beginning of the epidemic through 1988.

Such rapid growth in the occurrence of a disease is the defining characteristic of an epidemic, but it is important to recognize two further points about the HIV/AIDS epidemic.

First , the occurrence of AIDS cases lags behind the spread of HIV infection. Several years typically elapse between the time an adult is infected with HIV and the appearance of clinical signs sufficient to warrant the diagnosis of AIDS. The contemporary spread of HIV cannot therefore be discerned from the current counts of new AIDS cases. So, for example, in the absence of therapies that retard the progression from HIV to AIDS, the epidemic of AIDS cases will continue to rise for several years after the spread of HIV infection begins to decline in a population. Similarly, a sharp decline in the occurrence of new AIDS cases in a given year would not preclude the possibility that the occurrence of new HIV infections had increased during that same year. Unfortunately, the barriers that impede tracking of the spread of HIV infection exceed those that impede tracking of the spread of AIDS cases. Hence, currently available information about the spread of HIV infection is considerably less reliable than information about the occurrence of AIDS cases.

Second , the committee would emphasize that a decline in either the spread of HIV infection or the occurrence of new AIDS cases (or both) would not signal that the danger has passed. HIV is already substantially seeded in the U.S. population—the number of people who are now infected may surpass I million—and the virus is likely to continue to spread, if not in epidemic form, then in a persistent, more stable ''endemic" form (literally, "dwelling with the people"). The threat of epidemic and endemic disease will be most serious for those groups that are most heavily seeded with HIV infection, including IV drug users and men who have sex with men, as well as for their sexual partners and offspring. Currently available data also indicate that the black and Hispanic populations of the United States are experiencing a disproportionate burden of AIDS cases (in particular, cases associated with IV drug-use, heterosexual, and mother-infant transmission). The AIDS case data suggest that these populations may be more heavily seeded with HIV infection than are other ethnic groups and may be disproportionately threatened with further spread of the virus.

Our committee is concerned with understanding and reducing the spread of HIV infection, whether this spread be epidemic or endemic in character.

• Monitoring The Spread Of HIV And Aids

The overall dimensions of the current HIV/AIDS epidemic in the United States (or anywhere) are hard to determine because the most observable component—people who have AIDS—is only a small part of the total epidemic. The largest component by far is composed of all those who have been infected by HIV, but the magnitude of this component is difficult to estimate because most infected persons are asymptomatic for several years after their infection.

A key first step in controlling the spread of HIV infection and AIDS is the collection of reliable data on the prevalence and incidence of HIV infection and AIDS in the population. A further step requires an understanding of the sexual and IV drug-use behaviors that spread HIV from one person to another and thereby produce changes in HIV prevalence and incidence. The committee believes that more reliable systems must be developed for tracking the course of the epidemic. It also wishes to emphasize—in the strongest possible terms—that the development of such systems is a prerequisite for mounting a fully effective and efficient national response to AIDS.

Statistics On Aids

Weekly data from the Centers for Disease Control (CDC) report past and current cases of AIDS. As of November 14, 1988, 78,312 cases of AIDS had been reported to CDC, and 44,071 people had died as a result. Such statistics are important, and the panel recommends that the system for collecting them be maintained and strengthened. Yet the committee concludes that a fully adequate system for monitoring the course of the epidemic must go beyond the current system for reporting AIDS cases and deaths: it must also provide reliable monitoring of the prevalence and incidence of HIV infection in the U.S. population. Developing accurate statistical systems to monitor HIV infection is critical for several reasons.

• Counts of AIDS cases are out-of-date indicators of the present state of the epidemic because there is a long, asymptomatic latency period between HIV infection and the development of AIDS. For example, most adults who will be counted as new AIDS cases in 1989 were probably infected with HIV prior to 1986.
• The lives of a substantial proportion of persons infected with HIV will be substantially shortened as a result of that infection. However, these people do not always manifest sufficient symptoms to be captured by the AIDS reporting system.
• All HIV-infected individuals have the potential to transmit the infection and thereby spread the epidemic.

Statistics On HIV Infection

At present, there are no reliable data on the current prevalence of HIV in the United States, although rough estimates have been constructed using two quite different methods. One method aggregates estimates of the size of each major risk group (e.g., the number of persons who regularly inject IV drugs) multiplied by estimates of the HIV prevalence rate for that group. The second method exploits the necessary mathematical links among three time series: (1) the cumulative cases of AIDS to a given time; (2) the cumulative number of cases of HIV infection to that time; and (3) the distribution of the lengths of time that may elapse between infection with HIV and the appearance of AIDS (the latency, or incubation, period).

These two methods agree that the most plausible estimates of prevalence lie in the vicinity of 1 million infected persons (with a range of 0.5-2 million). Admittedly, both of these estimation methods are vulnerable to many sources of uncertainty. These uncertainties are of very different kinds, however. The first method is subject to uncertainties about, for example, the number of persons who regularly use IV drugs. The second method is subject to uncertainties about the probabilities that an HIV-infected person will develop AIDS (i.e., 1, 2, 3, . . . n years after infection). Confidence in the rough estimate produced by the two methods is strengthened by the fact that the uncertainties affecting each method are quite different. The committee concludes, nonetheless, that more reliable data on HIV prevalence are needed.

In recommending that reliable systems be developed for tracking the course of the HIV/AIDS epidemic, the committee wishes to reiterate its firm belief that such systems are prerequisites for mounting an effective and efficient national response to AIDS. Without better information on the incidence of new HIV infections in the population, the United States will lack adequate means for determining whether current strategies for controlling the spread of the virus are working. Without better information on the prevalence of HIV infection, the nation will be unable to prepare adequately for future demands for hospital beds and other health care services. Without better data, scientists and the American public can anticipate endless debates about whether the disease is spreading ''rapidly" or "slowly." To the extent that opposing sides in these debates produce "evidence'' from convenience samples, 5 inconsistency in conclusions is to be expected, and there is no basis for an informative scientific debate. Reliable assessment of the prevalence of HIV infection in a population requires drawing a sample from that population, obtaining a blood specimen from each person in the sample, and accurately testing the specimens for the presence of HIV.

The validity and hence the usefulness of such HIV prevalence data depend critically on how the sample is chosen from the population. Fifty years of theory and practice have provided a valuable statistical tool for this purpose: probability sampling. Drawing probability samples of U.S. households is a well-developed art; drawing probability samples of populations of special interest (for example, clients of sexually transmitted disease clinics and drug treatment centers) is also within the reach of current statistical technology. 6 The use of such methods will allow the monitoring of prevalence over time and the estimation of the incidence of infection, not only for the national population but for specific geographic areas and for groups defined by demographic characteristics and behavior.

Cdc's Family Of HIV Seroprevalence Surveys

CDC has launched a program to survey HIV prevalence among several population groups, including clients of drug treatment centers, clinics for sexually transmitted diseases (STDs), tuberculosis clinics, and clinics serving women of reproductive age; patients at general hospitals; and newborn infants. With the exception of the newborn survey, the clinics, centers, and hospitals that will furnish data in this survey program have been purposively selected to facilitate public health management of the epidemic, and many survey sites have been chosen because they serve populations that are presumed to be especially vulnerable to infection. Such purposive selection, however, compromises the usefulness of the data for estimating prevalence and incidence in any well defined population of interest. With the exception of the survey of newborns, the committee finds that none of these surveys (as currently designed) will provide estimates of HIV prevalence that can be generalized with known margins of error to the population groups of interest (e.g., all clients of STD clinics or patients at general hospitals). 7 It is likely, however, that some or all of these surveys can be augmented so as to become probability samples. In such augmented surveys, the present sample elements (the clinics or hospitals included in the present surveys) would constitute one stratum in a stratified probability sample of the populations of general hospitals, STD clinics, and so on.

The committee recommends that efforts be made to reformulate the CDC family of seroprevalence surveys as probability samples. The committee recognizes that these surveys may serve other purposes, and it acknowledges the difficulties and effort involved in such a reformulation and the operational constraints that undeniably weigh heavily on CDC. Nevertheless, the committee believes that wider, if not total, use of probability samples is feasible. Greater involvement of the National Center for Health Statistics (which has recently been made a part of CDC) in the design and execution of these surveys may be helpful in achieving this objective.

One component of the family of seroprevalence surveys tests blood specimens from newborn babies, and the committee considers this effort to be a very promising enterprise. Because data are obtained from all newborns, the survey is free of many kinds of bias. In addition, this survey provides a basis for monitoring the seroprevalence of childbearing women, a substantial and important component of the sexually active adult population. 8 The committee recommends that the newborn infant seroprevalence survey be extended to include all children born in the United States.

Supplementing the newborn survey with surveys of probability samples of women who have abortions would provide a more complete picture of HIV prevalence among sexually active women of reproductive age. The committee recommends instituting a continuing anonymous probability survey of the HIV serostatus of women who are clients of clinics that provide abortion services . This survey will be most valuable if the universe surveyed includes all women who have abortions.

National Seroprevalence Survey

A seroprevalence survey based on a national probability sample of households is currently undergoing feasibility testing at CDC's National Center for Health Statistics. The idea of such a survey has much appeal, but there are formidable barriers that will have to be overcome before implementation could proceed. A pilot test in Washington, D.C., was recently canceled after protests from the community and the city health department. This experience suggests the extreme sensitivity of all such data collection programs; it also underscores the need to fully inform and involve local communities, public health departments, and all groups that might be at risk if the confidentiality of the data collections were to be compromised.

The greatest technical barrier to obtaining an accurate estimate of HIV prevalence is the possibility of bias from selective nonresponse. This kind of bias can plausibly occur if, for example, individuals who belong to groups with elevated HIV prevalence rates (e.g., gay men, IV drug users) are more likely than people in other segments of the population to refuse to supply a blood specimen.

Although the obstacles to conducting a national seroprevalence survey are substantial, they are not necessarily impossible to overcome, and success, if obtained, would be rewarding indeed. Thus, the committee commends the exploratory spirit in which CDC has begun the development of this survey, and it applauds the strategy of using pilot experiments to test the survey's capacity to provide useful direct estimates of prevalence—and, ultimately, of trends in prevalence. The outcome of these experiments should play a decisive role in the final decision of whether to go forward with the national survey.

Assuring Confidentiality

Much of the information needed to understand and cope with the spread of HIV infection is obtainable only with the consent Of a person who may be harmed if confidentiality is breached. Thus, guaranteeing confidentiality helps protect individual respondents, and it also serves society's interest in obtaining statistical information to help combat the disease.

To maintain confidentiality, safeguards to prevent both deliberate disclosure and inadvertent "deductive" disclosure must be put into place. Deductive disclosure can be precluded by coarsely grouping, modifying, or withholding part of the information before releasing or publishing the data. The committee believes that policies for sharing statistical data on HIV and AIDS must provide absolute protection of confidentiality and should seek to provide this protection at the least practical cost in information.

Three additional strategies can help in this regard. First, confidentiality can be buttressed with legal penalties in the event of a breach. Second, legal protection against discrimination based on HIV status can be established. Third, anonymous testing can be conducted so that the identity of the donor is neither known nor traceable to the blood specimen. 9 The committee believes that each of these strategies should be vigorously pursued.

Sexual Behavior And Aids

The need to control the spread of HIV infection has forced a recognition of the underdeveloped state of sex research in the United States. Information about sexual conduct is necessary to understand both the epidemiology of the spread of the disease and the social processes that are involved in behavioral change. Yet current understanding is fragmentary, and the underlying research data are often unreliable.

Alfred Kinsey and his colleagues pioneered the use of social science techniques to document the sexual behavior of Americans in the 1940s. The defects of this work are widely known: for example, respondents were disproportionately drawn from the Midwest and from college campuses, and the research did not use probability sampling. Still, there can be no denying the crucial historical importance of that work in ushering in a new era in which social science has played a larger role in understanding human sexuality.

Since the original Kinsey studies were published in 1948 and 1953, there has been an uneven effort in sex research, in terms of volume and quality, and especially in research relevant to the behaviors that are known to spread HIV. The paucity of solid research contributes to the dilemma now faced by scientists and policy makers who are trying to develop intervention strategies to retard the spread of the virus. Studies are especially lacking on at least five topics:

sexuality outside of marriage;

sexuality with persons of the same gender;

sexuality with persons of both genders;

sexual contacts for pay; and

variations in sexual techniques among the various types of sexual partnerings.

In the past, federal agencies have supported some behavioral research on sexual practices, but much of it has been focused on the sexual behavior of female adolescents, with the goal of preventing teenage pregnancies. The committee believes such research is a valuable and necessary part of the federal research portfolio, but basic knowledge of human sexual behavior is needed in many other areas as well. The committee recommends that the Public Health Service support vigorous programs of basic social and behavioral research on human sexual behavior, particularly through such agencies as the National Institutes of Health; the Alcohol, Drug Abuse, and Mental Health Administration; and the Centers for Disease Control.

Same-Gender Sex Among Men

Because the initial spread of the HIV epidemic was first identified among men who have sex with other men, there has been an upsurge of interest in the number of such men, their sexual practices, and the organization of their social life. The relationship of persons with same-gender sexual orientation to the larger U.S. society has been undergoing substantial change during this century, and that change in itself has affected the sexual and social lives of these men.

Estimates of the number of men who engage in same-gender sexual behavior figure prominently in the attempts (mentioned earlier) to calculate HIV prevalence. The estimates used in those attempts were derived from Kinsey's studies on male sexual behavior in the period 1938-1948. In addition to the defects in that work that were noted above, the committee finds that the Kinsey studies are not an adequate base on which to formulate estimates of the number of persons in the contemporary population who have sexual relations with persons of the same gender.

New data, however, are available from two national surveys conducted in 1970 and 1988. These studies have their own methodological difficulties, but data from both of them suggest that a minimum of 2-3 percent of American men have sex with other men with some frequency during adulthood. Data from the 1970 survey also suggest that a minimum of 20 percent of adult American males had at least one sexual experience to orgasm with another male during their lives, and 7 percent of men have such an experience in adulthood (age 20 or older).

The long history of social intolerance toward same-gender sexuality introduces considerable uncertainty about the accuracy of these estimates, which are derived from self-reports obtained in two national surveys. The committee believes that the foregoing estimates are best treated as setting "lower bounds" on the actual number of men who have such experiences. This conclusion follows from the assumption that the number of men in a survey who will conceal the homosexual experiences they have had is greater than the number of men who will report homosexual experiences that never actually occurred.

Although our understanding of AIDS in the male homosexual population is far from complete, longitudinal studies initiated during the early years of the epidemic have provided a rich and expanding data base on patterns of HIV transmission and sexual behavior. Early studies among gay men, including the Multicenter AIDS Cohort Studies (MACS), established AIDS as a sexually transmitted disease and identified important risk factors for its spread, including multiple sexual partners and unprotected anal intercourse.

In addition to the longitudinal studies that have delineated the risk factors and natural history of AIDS, other studies have been following cohorts of gay men to compile detailed behavioral data over time. These studies offer some indication that behavioral changes to reduce the risk of HIV infection have been occurring in many groups of gay men. Significant decreases in the prevalence of unprotected anal intercourse have been reported in studies undertaken in such urban areas as San Francisco, New York City, Chicago, and Boston. In addition, significant declines in numbers of sexual partners have been reported in numerous studies of gay male sexual behavior as it relates to AIDS. Unfortunately, changes in risk-associated behavior have not been universal: high rates of unprotected anal intercourse have been reported in areas that are not foci of the epidemic (e.g., upstate New York and New Mexico).

Identifying the factors responsible for behavioral change among gay men is methodologically and conceptually complex. The factors responsible for initial reductions in risk-associated behavior may not be the same factors that are involved in maintaining those behaviors.

Studies have suggested that initial behavioral change is facilitated by knowledge about AIDS and HIV transmission, a supportive social environment, and personal experience with someone who has developed AIDS.

The data gathered during the early days of the epidemic indicate that gay men are making changes in specific sexual practices instead of adopting monogamy or eliminating sexual contact altogether. Geographic variation in infection rates and in the acceptance of safer sex behaviors, however, point to the need for continued behavioral studies in diverse regions of the country.

Teenage And Adult Heterosexuals

Understanding the sexual conduct of young people is also important for an understanding of HIV transmission. Evidence from national studies of contraception and teenage pregnancy suggests that young people are not particularly skilled in managing their sexual lives. Other evidence from those studies indicates two additional patterns: (1) a steadily increasing proportion of young people begin heterosexual intercourse in their mid-teens and (2) an increasing proportion begins intercourse very early in their teenage years. In addition, there is evidence that this earlier onset of heterosexual intercourse has been accompanied by an increase in the number of heterosexual partners people have before marriage. (No reliable data are available on trends in homosexual experience among adolescents, but the evidence cited earlier in the discussion on same-gender sex suggests that such experiences are not uncommon.)

Changes in the sexual behavior of young persons have two implications for the transmission of HIV. First, there is a large group of heterosexually active and relatively inexperienced young people with some tendency toward risky conduct. Second, there is little understanding of how to encourage change in the risky sexual behaviors many of them practice. Sexual intercourse now seems to be a recognized fact in the lives of the majority of young people. Intercourse is no longer linked to marriage or to forming a permanent couple, and such intercourse is often undertaken with inadequate precautions to forestall unwanted pregnancies or to prevent sexually transmitted diseases.

Increases in sexual activity and in the number of heterosexual partners among teenagers have been paralleled by similar changes in sexual activity among older individuals. The rise in the age of

Americans at first marriage and the increase in cohabitation among persons in their early to mid-20s have resulted in a greater rate of turnover in coupled relationships during what was, for many individuals in the past, a period of marriage and family formation. Another change is the increase in divorces (the rate of which now approaches 50 percent of all first marriages). There is little evidence on the acquisition of new sexual partners during the period after a divorce, but what little there is suggests that some individuals are relatively sexually active "in between" more permanent relationships.

Finally, the committee finds very little information about sexual relationships maintained concurrently with an apparently monogamous coupled relationship. That such relationships occur is apparent, but there are few reliable data from representative samples on their rate of occurrence or other relevant aspects of these relationships.

The impact of programs promoting "safer sex" for sexually active segments of the population—both teenagers and adults—is currently unknown. Given present levels of sexual activity, such programs—in particular, promotion of the use of condoms and spermicides—appear to be important areas on which to focus educational efforts and resources. The committee recommends that local public health authorities ensure that condoms are readily available to all sexually active persons . Promotion of condom use might be facilitated if condoms were sold in a wider variety of retail outlets, including supermarkets, convenience stores, and vending machines placed in diverse locales. Furthermore, because there is evidence suggesting that STDs may play a role as cofactors in the transmission of HIV, it is important to offer STD treatment as part of HIV/AIDS prevention efforts and to make that treatment as attractive as possible to those who need it. The committee recommends that local public health authorities ensure that treatment for all sexually transmitted diseases is readily available to all persons who may seek such treatment.

The committee recognizes that programs to promote safer sex practices are still hampered by a lack of knowledge about the actual effectiveness of those practices. Condom failure rates for contraception are known to vary, with some groups of users experiencing high failure rates. The committee believes more research is needed to understand the reasons people do or do not use condoms and spermicides and to determine the factors associated with their improper use. The committee recommends that the Public Health Service immediately begin a research program to determine the extent to which the use of condoms and spermicides reduces the risk of HIV transmission. This program should include investigations of the current use of these products, how that use might be modified, and—equally important—how these products themselves may be modified to encourage uses compatible with human skills and dispositions.

Female Prostitution

Many female prostitutes are at high risk of HIV infection because of their use of IV drugs, their associations with IV drug users, their large number of sexual partners, and their increased likelihood of contracting other sexually transmitted diseases. Yet despite a general consensus about their high level of risk, little research has focused on prostitution: there are few data on female prostitutes and virtually no scientifically adequate data on male prostitutes. Even the size of these groups is unknown. Although estimates have occasionally been made of the number of female prostitutes in the United States, the committee finds that the lack of careful research to support these estimates makes them unreliable guides to the actual number of women in this group.

Despite the lack of data on the number of female prostitutes, however, available data suggest that the majority of prostitutes who have become infected with HIV in the United States have not become infected through sexual behavior. Most AIDS cases among women in the United States have occurred in women who use IV drugs. Although it is seldom possible to disentangle completely the effects of sexual transmission from drug-related transmission, the fact that there are relatively few women with HIV infection who are not IV drug users suggests that shared injection equipment—rather than sexual activity—has been the most significant transmission factor among female prostitutes.

Research And Data Needs

The committee finds that the long history of unfunded and underfunded research on human sexual behavior in this country has resulted in deficiencies in substantive knowledge, in the appropriate tools for scientific investigation of this topic, and in researchers who are expert in this area. Yet now, the nation is confronted with an epidemic that requires such knowledge, such tools, and such people. In its report, the committee details a number of specific research needs.

The committee recommends that the Public Health Service support research in those subsets of the population that are at increased risk of HIV infection. Research should include prostitutes and their clients, minorities, young gay men, gay men living outside the current epicenters of the epidemic, socially vulnerable adolescents, the different groups that make up the heterogeneous IV drug-using population, and the sexual partners of IV drug users. It is particularly important to obtain information from the people in these groups because of their potential role as conduits for the spread of HIV—through sexual activity—from groups with higher rates of prevalence to groups with lower rates.

It can be expected that some of the groups will be difficult to reach and count. It is also likely that it will be difficult to elicit the cooperation of these groups in data collection efforts and to obtain valid information concerning sensitive (and sometimes illicit) behaviors. The committee recommends that resources be invested in methodological research to develop better procedures to obtain information from hard-to-reach groups.

There is also a pressing need for greater sharing of the sexual behavior research data that do exist. The value of any data set can be effectively multiplied by making it available to other researchers for secondary analysis; consequently, the sharing of research data has become a standard practice in many disciplines. The committee recommends that funding agencies, both public and private, encourage the sharing of data relevant to HIV infection and AIDS that have been gathered by federal and extramural researchers, within the limits set by scientific priority and confidentiality. To facilitate such sharing, the committee recommends that a data archive be established to support secondary analyses of these data. The resources of this archive and the documentation accompanying the archived data sets should be sufficient to allow future researchers to understand the limitations of the archived data.

Data On Sexually Transmitted Diseases

The behaviors that favor or inhibit the transmission of HIV also favor or inhibit the transmission of other STDs. As a result, other things being equal, the transmission rates for STDs other than HIV should respond to the same behavioral interventions that are being designed to reduce HIV transmission.

Reliable data on the incidence of other STDs might also be useful for validating time-series measurements derived from surveys of individual sexual behavior. Unfortunately, statistics on STDs have been a subject of concern for many years. Underreporting is known to be quite common (particularly for cases diagnosed by private physicians), and this situation may have been exacerbated in recent years by the diversion of public health resources from tracking syphilis and gonorrhea to AIDS (thereby reducing the numbers of new cases of gonorrhea and syphilis that are counted). Improving these statistics would be a sound investment, given the potential usefulness of STD statistics as a surrogate measure of the behavioral changes that will ultimately reduce the number of AIDS cases. The committee recommends that an independent review of STD data collection systems be undertaken and sufficient resources provided to undertake any improvements that may be required.

IV Drug Use And Aids

Since AIDS was first recognized, there has been growing appreciation of the critical role played by IV drug use in the spread of HIV infection. As of November 14, 1988, 20,752 cases of AIDS—approximately one quarter of all cases—had been diagnosed in individuals who reported using IV drugs.

The main factor in the spread of infection by this group is the practice of sharing injection equipment, which acts as a vector for HIV-contaminated blood. Sharing occurs for a variety of economic, cultural, and practical reasons, but whatever the individual causes of the behavior, almost all IV drug users report ''needle-sharing'' 10 at some time during their drug-use "careers."

HIV infection among IV drug users also poses a threat to their sexual partners and offspring, as well as to persons with whom they share injection equipment. Nearly 70 percent of the reported cases of heterosexually acquired AIDS in the United States have been associated with IV drug use, and almost 75 percent of pediatric AIDS cases have been diagnosed in cities with high seroprevalence rates among IV drug users. These data, combined with the potential (through needle-sharing) for the rapid spread of HIV infection among IV drug users, define a problem whose solution requires both immediate action and long-term research. The current state of knowledge suggests that there will be no immediate resolution to the problem of IV drug use itself; nevertheless, existing research provides a basis for establishing programs to slow the spread of HIV infection among those who inject drugs.

Obviously, primary prevention of drug use could be an extremely effective prevention strategy for drug-associated HIV transmission. Relying on primary prevention alone is not realistic, however, given the uneven record of past efforts to control drug use and the threat of a continued epidemic of HIV transmission in the United States among persons who inject drugs, their sexual partners, and their children. The committee recommends that the nation adopt a three-pronged strategy to control the spread of AIDS through IV drug use.

First, drug treatment programs should be available to all who desire treatment. Several studies conducted prior to the advent of AIDS show that treatment can reduce IV drug use. Moreover, studies conducted during the AIDS era have shown that entering and remaining in drug treatment programs are factors associated with significant reductions in the rates of HIV infection among IV drug users.

Second, the committee concludes that, regardless of the availability of treatment opportunities, a substantial number of people in the United States will continue to inject drugs, at least in the short run. Consequently, the committee also recommends expanding programs for "safer injection" (including sterile needle and syringe exchanges and the promotion of injection equipment sterilization using bleach). None of the current studies on safer injection programs has shown increased IV drug use. Indeed, it appears that safer injection programs may indirectly encourage IV drug users to seek treatment. Furthermore, although results are still preliminary, many studies indicate that such programs do reduce the risk of HIV transmission among IV drug users. Finally, action should also be taken to provide a better understanding of the effects of these programs. The committee recommends that well-designed, staged trials of sterile needle programs, such as those requested in the 1986 Institute of Medicine/National Academy of Sciences report Confronting AIDS , be implemented .

Thus, the committee believes it is necessary to establish better data collection systems to monitor current AIDS prevention efforts for IV drug users. The quality of existing data on IV drug use is not adequate to answer the difficult questions AIDS poses. Assessing the scope of the problems associated with HIV transmission among IV drug users is difficult when neither the number of IV drug users nor the seroprevalence rate is known with any certainty. Current estimates rely on data that were collected for other purposes and that were acquired through efforts intended to measure only crude trends.

In sum, the committee recommends that the appropriate government authorities take immediate action to

provide drug treatment upon request for IV drug users throughout the country;

sustain and expand current programs that provide for "safer injection" to reach all current IV drug users in the nation on a continuing basis and with appropriate research evaluation; and

establish data collection systems for monitoring present AIDS prevention efforts for IV drug users.

The IV drug-using population is also at risk of acquiring and spreading HIV infection through unprotected sexual behaviors. Little is known about the sexual, contraceptive, and childbearing practices of IV drug users, although early studies indicate that more risk-reducing change has occurred in injection practices than in sexual behaviors. The committee recommends that high priority be given to studies of the sexual and procreative behavior of IV drug users, including methods to reduce sexual and perinatal (mother-infant) transmission of HIV.

Although the committee urges that more basic behavioral research be undertaken to improve understanding of risk-associated behaviors and how to change them, it also finds that the implementation of intervention programs cannot wait upon the findings of such research. The severity of the AIDS epidemic demands innovative approaches to prevent the spread of infection among IV drug users, with special attention to collecting good evaluation data. Reaching and serving IV drug users will require innovative methods and additional resources. 11 Slowing the spread of HIV infection in this country depends on the ability to find new ways to reach and influence this population. Planned variations of intervention strategies, accompanied by sound evaluation measures, will enable a determination of which kinds of programs are most successful in facilitating change in risky behaviors in this population.

• Limiting The Spread Of HIV Infection

Facilitating Change In Health Behaviors

Preventing the spread of HIV infection will require changing those behaviors that are known to transmit the virus and then maintaining those changes over time. Whether these goals can, in fact, be accomplished will depend in large part on the effectiveness of the intervention strategies that are brought to bear on the problem.

Providing accurate, appropriate information is a logical starting point for any intervention program, although information by itself is unlikely to be sufficient to alter risk-associated behavior. Yet even the accomplishment of this prologue to more complex efforts requires an understanding of the target audience in order to formulate and deliver persuasive messages. To produce action (in this case, behavioral change), a message must reach the appropriate audience and be understood. The committee recommends making information available in clear, explicit language in the idiom of the target audience. Furthermore, the committee recommends that sex education be available to both male and female students and that such education include explicit information relevant to the prevention of HIV infection.

Health education campaigns of the past, notably those to prevent STDs and drug use, have tended to rely on fear to motivate those at risk. Research has shown, however, that fear alone is unlikely to succeed. Fear-arousing health promotion messages must also provide specific information on the steps that can be taken to protect an individual from the threat to his or her well-being. The excessive fear generated by heightened perceptions of seriousness and susceptibility can be offset by providing assurances that there is, indeed, something that can be done to prevent infection. Therefore, AIDS prevention messages should strike a balance in the level of threat that is conveyed: the level should be sufficiently high to motivate individuals to take action but not so high that it paralyzes them with fear or causes them to deny their susceptibility.

The mass media can play an important role in providing information about risk, as well as in molding both the skills and behavior of individuals and the norms of the community to support that behavior. The committee recommends that television networks present more public service messages on those behaviors associated with HIV transmission and practical measures for interrupting the spread of infection. The committee further recommends that television networks accept condom advertisements. Efforts should be made to link media representatives with local public health agencies to ensure that the messages are appropriate for the local audiences and that well-designed evaluations of media efforts are conducted.

Although public information campaigns are a sound first step for prevention programs, they are generally insufficient on their own to induce widespread behavioral change. For people to initiate changes in their behavior, they must be motivated, they must believe that the changes being proposed will do some good, and they must believe they have a reasonable chance of successfully accomplishing those changes. Past research on behavioral change indicates the following:

• Changes that are consistent with an individual's existing beliefs and values are more likely to be adopted.
• For some people, modifying behavior through incremental changes is easier to achieve than a global change in life-style.
• Offering alternative courses of behavior from which an individual can choose is preferable to dictating one "appropriate" behavior.
• For those who believe in the efficacy of a particular behavior but do not believe they can successfully execute it, skills training can be helpful.
• Most people need assistance and support to change unhealthy behaviors, and most will not be completely successful in adhering to new patterns.

AIDS prevention programs should also incorporate what is already known about the adoption and diffusion of new ideas. For example, opinion leaders of target populations should be identified and used to maximize a program's credibility and persuasiveness with the target audience and to shape more effective messages and programs. Also to be considered is the community context in which a prevention program is implemented. If they are to be successful, new programs should be carefully reviewed before being implemented for characteristics that might impede their acceptance in the community.

Targeting programs to the community rather than to individuals may bring additional benefits. Community-level programs have two important points of impact: (1) they can reach a critical mass of individuals to provide information, motivation, and skills training; and (2) by working through a variety of community agencies, they can foster changes in the norms that stipulate appropriate behavior for community members.

One further approach to facilitating behavioral change is the use of HIV antibody testing, an approach that has been found to be helpful in changing behaviors in some groups. The committee recommends that anonymous HIV antibody testing with appropriate pre-and posttest counseling be made available on a voluntary basis for anyone desiring it. However, to maximize the usefulness of antibody testing in facilitating behavioral change, more knowledge is needed about why individuals seek testing, how testing affects behavioral change in different populations, and how it affects psychiatric morbidity. The committee also emphasizes that HIV testing is not a substitute for broader efforts in education and intervention.

Evaluating Interventions

The role of evaluation is to allow a determination of which strategies actually change people's behavior and which do not. Making these determinations requires a systematic process that produces a reliable account of a program's effectiveness. Indeed, preparing for an evaluation can often increase program specificity and quality at the outset. Program innovations that are informed by feedback from careful (and prompt) evaluations can lead to the more rapid discarding of poor ideas and the adoption of good ones. The eventual result is a more effective intervention program.

The committee recommends that the Office of the Assistant Secretary for Health take responsibility for an evaluation strategy that will provide timely information on the relative effectiveness of different AIDS intervention programs . Such a strategy should consider both short-and long-term benefits and should be applied to a variety of programs.

When possible, for at least each major type of intervention and each major target population, a minimum of two intervention programs should be subjected to rigorous evaluations that are designed to produce research evidence of the highest possible quality. Variants of intervention programs should be developed for and tested in different populations and in different geographic areas using random assignment strategy accompanied by careful evaluation. When ethically possible, one of the variants should be a nontreatment control.

Randomized Field Experiments

One of the most crucial aspects of evaluation involves inferring whether an intervention has had an effect on the target population. To determine such effects, one must compare what did happen with what would have happened if the intervention had not taken place. Because it is not possible to make this comparison directly, inference strategies turn to various proxies—for instance, extrapolating a trend from past history (before treatment) or using comparison groups. Frequently, however, no similar comparison group can be defined or recruited. Moreover, although adjustments can be made for known differences between two groups, such adjustments may be difficult to make, and there is no way to account for unrecognized differences in two differently constituted groups.

The remedy for this problem is to establish a singly constituted group in which to assess treatment effects. To be included in the group, a person must satisfy the criteria for inclusion in the program. Then, a subset of that one group is randomly chosen to receive the intervention, thus producing two comparable subgroups that are not identical but are as alike as two random samples drawn from the same population.

To maintain the comparability of the two groups, outcome measurements must be performed symmetrically for all program participants (treated and untreated). This idea underlies randomized clinical trials and randomized field experiments. The design is a powerful tool, although there will be some cases in which it cannot be applied. The committee recommends the expanded use of randomized field experiments for evaluating new intervention programs on both individual and community levels.

Resources For Evaluation

Carrying out evaluations that produce reliable data about the effectiveness of interventions to stop the spread of HIV infection requires creative leadership on the part of the management of an organization and an attitude among its staff that evaluation is positive and constructive. In addition, priorities must be set, and adequate resources must be made available for evaluation activities. Unfortunately, there are seldom enough dollars, expert people, or time to evaluate everything in detail. The selection of a particular intervention for in-depth evaluation should depend on several criteria: the importance of the intervention, the extent of the knowledge already in hand, the perceived value of additional information, and the estimated feasibility of the assessment. To use available program evaluation resources most efficiently, the committee recommends that only the best-designed and best-implemented intervention programs be selected to receive those special resources that will be needed to conduct scientific evaluations.

There is also a need to upgrade the capacity for evaluation at the local level. Producing quality data that will allow program planners to learn from ongoing intervention efforts will require additional resources, including appropriately trained personnel. Individuals with expertise in program evaluation need to be identified and brought into the AIDS prevention arena. Unfortunately, many state and local agencies have few connections with individuals in this field and will need assistance to identify appropriate people and recruit them. The committee believes it is critical that technical assistance for evaluation activities be made available. The committee recommends that CDC substantially increase efforts, with links to extra-mural scientific resources, to assist health departments and others in mounting evaluations. CDC (and any other agency that undertakes AIDS prevention programs) should assign to some administrative unit the responsibility for ensuring the use of planned variants of intervention programs and for overseeing a system of evaluation.

• Overcoming Barriers To Research And Intervention

Much needs to be done to improve available knowledge about the behaviors that transmit HIV and to control further spread of the infection. The committee finds, however, that some of the needed actions have encountered and will continue to encounter resistance. Some obstacles arise from the structure of the scientific disciplines involved and the historical lack of support for the kinds of research that are now urgently needed. Other barriers come from within our culture, and they find practical expression in political decisions that restrict the types of AIDS education and intervention activities that governments are willing to fund or permit.

Barriers To Research

Although there is growing appreciation of the need for behavioral and social research related to HIV transmission, the personnel to conduct such efforts are currently in short supply at agencies involved in AIDS activities. CDC, for example, is managing more than $150 million of AIDS behavioral research and intervention programs with a small and severely overextended cadre of people trained in relevant disciplines. Of approximately 4,500 total employees at CDC's Atlanta facility, fewer than 40 are Ph.D.-level behavioral and social scientists, and only a few of those individuals are working on AIDS-related projects. The committee recommends that the number of trained behavioral and social scientists employed in AIDS-related activities at federal agencies responsible for preventing the spread of HIV infection be substantially increased.

Since the early years of the epidemic, CDC has had primary responsibility for AIDS data collection. Some surveys have involved only the collection of physical specimens (e.g., blood) along with a very restricted set of demographic characteristics (e.g., age, sex, residence). At present, CDC's Atlanta staff does not include a sampling statistician. The agency's recent acquisition of the National Center for Health Statistics (NCHS) can provide some of the needed statistical expertise, but the role of NCHS in CDC's data collection programs is still being defined. The committee recommends that the CDC AIDS program increase its staff of persons knowledgeable about survey sampling and survey design, and that it exploit the methodological expertise of the National Center for Health Statistics. Finally, in addition to experienced survey scientists, CDC needs technical assistance to evaluate currently funded intervention programs.

The committee recognizes that it may be difficult to attract a sufficient number of senior scientists to Atlanta on a permanent basis. One-or, preferably, two-year visiting scientist appointments might provide quick access to needed personnel and allow CDC management greater flexibility in meeting changing staff needs. The committee recommends the use of PHS fellowship programs and Intergovernmental Personnel Appointments (IPAs) as an interim means for rapidly enlarging the cadre of senior behavioral and social scientists working on AIDS programs at CDC and other PHS agencies.

Collaborative Research

Much of the best behavioral and statistical research on AIDS has occurred through collaborations among scientists from universities, the staffs of government agencies (at all levels), and organizations rooted in the communities that have borne the brunt of the AIDS epidemic. Collaborations of this kind are seldom without conflict; differences of social origin, ethnicity, economic status, or sexual orientation may sometimes lead to misunderstandings. Yet such misunderstandings should not deter collaboration; they should be seen as part of an indispensable process of accommodation of varying viewpoints. Efforts to design and implement effective AIDS education without taking into account the idioms and milieu of the target population are doomed to failure. The active and equitable collaboration of persons in the target populations with "outside" scientists and researchers can provide an important safeguard against such failures.

Talented, well-trained, and dedicated workers will be needed for research and intervention efforts at all levels of involvement, from the coordination and funding centers of the federal government to local outreach and education programs. To have credibility in the communities suffering the highest rates of HIV infection and to maximize the likelihood of successfully preventing the further spread of infection, intervention programs at all levels must increase the involvement of minority researchers and minority health care workers in the black, Hispanic, and gay communities. In addition, the committee recommends that special support be provided to foster what are often weak linkages among practitioners (those best positioned to deliver services) and researchers and to remove or reduce organizational impediments to the establishment of those relationships.

One creative mechanism that has been developed to foster collaboration is the multidisciplinary AIDS research center. Much of the needed behavioral and social research on AIDS prevention requires large, multidisciplinary teams of scientists with close working relationships with many of the different communities in which interventions must be conducted. Recent initiatives, particularly those of the National Institute of Mental Health (NIMH), have been designed to stimulate the formation of multidisciplinary AIDS research centers in those cities that are the current foci of the AIDS epidemic. The committee believes that these initiatives are an appropriate component of rational strategies for the support of behavioral research on AIDS. The NIMH centers have shown evidence of involving scientists who have valuable links to the communities in which prevention research is needed. The committee recommends that support of multidisciplinary centers for research on AIDS prevention be viewed as a long-term commitment to allow sustained collaborative efforts, including valuable prospective studies.

Social Barriers To Intervention

Because AIDS and HIV infection are mainly transmitted by sexual activity and IV drug use, controlling the epidemic requires both a scientific understanding of these behaviors and a social commitment to behavioral interventions that are sufficient to reduce the transmission of HIV infection to a level that cannot sustain epidemic growth. As noted at the beginning of this summary, epidemic disease refers not so much to the number of people who are affected but rather to the sudden appearance and rapid spread of a disease in a community, a phenomenon that usually evokes strong political and social responses.

AIDS education efforts provide a number of examples in which potentially effective prevention activities have become entangled in social conflicts that caused delays in their implementation or a weakening of their message. Specific controversies have involved restrictions on the use of explicit language in educational materials, conflict between providing scientific information or promoting particular moral values in AIDS prevention messages, and prohibitions against condom advertising on network television.

Conflicts of this sort are not unique to this epidemic. Indeed, there are a number of similarities between the AIDS epidemic and epidemics of the past. For example, history suggests that cultural, political, and economic institutions faced with the need to respond quickly to catastrophe often cling to familiar practices, even in the face of an unusual threat. Certainly, instances of such institutional ''behavior'' can be noted in efforts to mobilize society's forces against AIDS and HIV infection.

A further similarity between this epidemic and most others is the disproportionate effect on the poor. Because education is critical to controlling the spread of HIV/AIDS, the ability to reach across class boundaries is vital. Yet those who must design and provide this education sometimes have little knowledge of the culture or conditions of poorer people. Differences of language, values, and lifestyle can make effective collaboration and communication difficult.

Complicating these factors is the additional element of stigmatization—the phenomenon of marking individuals or groups as warranting exclusion from human society. In its sociological meaning, stigma is the set of ideas, beliefs, and judgments the dominant group in a society holds about another group that it has selected as deserving of scorn or blame (in this case, those who are infected or who have the disease). These beliefs are not merely negative; often, members of the stigmatized group are characterized as dangerous or as deserving of punishment for some vague offense or moral improbity, a pattern of thought that has led throughout human history to the blaming and persecuting of minorities as the cause of plagues or scourges.

The HIV epidemic has led to stigmatization since its beginning. The fact that the disease has been largely confined to male homosexuals and IV drug users has made stigmatization almost inevitable, for these groups were already the objects to some degree of the deprecating judgments that constitute this phenomenon. Fortunately, even though stigmatization has occurred, the public thus far has repudiated the worst forms of stigmatizing punishment. Calls for quarantining those infected with HIV have been rejected, and some protections for ensuring confidentiality have been erected in the areas of antibody testing and serostatus disclosure. Nevertheless, more remains to be done. Health professionals have a particular responsibility to counter stigmatization, especially in light of their past success in destigmatizing other conditions: leprosy, epilepsy, and, to some extent, mental retardation. The media also bear a particular responsibility in what they present and how they present it. Similarly, churches and educators have important roles to play.

Finally, politicians and the American legal system can affect the extent to which any group in society is subject to stigmatization. A politician who becomes an advocate for the stigmatized obviously takes on an unpopular task. Laws, however, can retard the social process of stigmatization by prohibiting some of the behaviors that are inspired by it. Research has shown, for example, that the possibility of legal prosecution can alter discriminatory behaviors in various settings even in the presence of discriminatory attitudes. The law can also protect those who are infected with HIV from discrimination, and the educational message conveyed by such protection can help to reduce the underlying current of stigmatization that pushes those infected with HIV and AIDS to the outskirts of society.

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In closing, we return to the theme with which we began: the HIV/AIDS epidemic is partly a social phenomenon, and the major weapons that are currently available to contain it seek to change the behaviors that spread the disease. Even if fully effective therapies or vaccines were to be found, it is likely that there will be a continuing role for behavioral intervention. It is more than 40 years since effective drugs against syphilis and gonorrhea became widely available, but those diseases have not yet been eradicated in the United States. Similarly, the struggle to retard the spread of HIV is likely to persist well into the next century. Improved understanding and prevention of the behaviors that spread HIV/AIDS will be needed—not only in the short run, however many years that may be, but in the decades that follow any medical breakthrough as well.

This committee's review of the behavioral, social, and statistical issues related to HIV/AIDS builds on the work of the Institute of Medicine/National Academy of Sciences, which has produced two reports that focused on public health, biological research, and medical care issues: Confronting AIDS: Directions for Public Health, Health Care, and Research (1986) and Confronting AIDS: Update 1988 (both published by the National Academy Press, Washington, D.C.). The committee also wishes to acknowledge the related activities being carried out or planned by the Academy complex. Some of the efforts under consideration—including the future activities of our own committee and of the Institute of Medicine—address topics that will be of concern to readers of this report, including drug and vaccine development, AIDS research policy, and the social impact of the AIDS epidemic.

Including anthropology, economics, political science, psychology, sociology, and statistics, and their subdisciplines (e.g., demography, social psychology, biostatistics, etc.).

Specifically, the committee was charged to (1) describe what is known about the spread of HIV infection and AIDS in the United States; (2) identify critical groups at risk of infection and how to reach them; (3) describe research findings from the social and behavioral sciences that should be helpful in planning and choosing among ways to intervene successfully to control the spread of HIV infection; (4) describe ways to evaluate the effectiveness of such interventions; and (5) recommend new research that can expand our understanding of the spread of HIV infection and improve the nation's ability to control this spread in the future.

Two technical terms axe frequently used in discussions of epidemic diseases: incidence and prevalence. Incidence denotes the rate of occurrence of new infections per unit of time (e.g., per year). Thus, an incidence of 03 per year in some group means that new infections occurred in 3 percent of the group during the year in question. Prevalence denotes that proportion of a group that is currently infected. A prevalence of .10 means that 10 percent of the group is currently infected.

In a "convenience" sample, respondents are selected in a manner that precludes generalization of the statistical findings (e.g., prevalence of infection) with known margins of sampling error to any population beyond the particular individuals included in that sample.

As discussed in the following section, "National Seroprevalence Survey," the execution of such surveys requires that survey designers grapple with the potential problem of sample bias owing to selective nonresponse in the survey.

Chapter 1 of the main report discusses problems that affect the use of data from special populations (e.g., military recruits, blood donors, etc.) to infer HIV prevalence or changes in prevalence in the population at large.

Newborns of HIV-seropositive women carry the maternal antibody to HIV, even though the infants themselves may not be infected. After some time, the maternal antibodies disappear from the infant's blood if the baby is not infected. The Institute of Medicine/National Academy of Sciences 1988 report estimated that there is a 30-50 percent risk of perinatal HIV transmission from an infected mother to her child (p. 35).

Blind testing has been widely employed in studies using blood specimens that have been collected for other purposes. It is, however, feasible to use analogous methods in studies that collect blood specimens for the specific purpose of testing for HIV. In this case, all identifying information would have to be destroyed prior to the HIV test to ensure anonymity.

This practice includes the sharing of needles, syringes, and various other paraphernalia used for dissolving drugs and straining impurities.

For example, some AIDS intervention programs use mobile vans and cadres of "outreach workers"—who can go into "shooting galleries" and other places in which drug use occurs—which have proven helpful in serving people who have not been reached by other services or agencies.

NOTE: Reference documentation for the material in this Summary is presented in the respective chapters of the full report.

• Cite this Page National Research Council (US) Committee on AIDS Research and the Behavioral, Social, and Statistical Sciences; Turner CF, Miller HG, Moses LE, editors. AIDS: Sexual Behavior and Intravenous Drug Use. Washington (DC): National Academies Press (US); 1989. SUMMARY.
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Essay on HIV AIDs Awareness

Students are often asked to write an essay on HIV AIDs Awareness in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

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100 Words Essay on HIV AIDs Awareness

Understanding hiv and aids.

HIV stands for Human Immunodeficiency Virus. It attacks our body’s defense system. AIDS, or Acquired Immunodeficiency Syndrome, is the condition caused by HIV. It makes people very sick because their bodies can’t fight off illnesses well.

How HIV Spreads

HIV is passed from one person to another through blood, sharing needles, and from mother to baby during birth or breastfeeding. It’s also spread through sex without protection, like condoms.

Preventing HIV

Using new needles and safe sex practices, like condoms, can prevent HIV. Also, medicines can help mothers with HIV not pass the virus to their babies.

Living with HIV

People with HIV can live long, healthy lives with proper medicine. It’s important to get tested and start treatment early.

Spreading Awareness

Talking openly and learning more about HIV can help stop false beliefs and stop the virus from spreading. Schools and communities play a big role in this.

250 Words Essay on HIV AIDs Awareness

HIV stands for Human Immunodeficiency Virus. It attacks our body’s defense system, making it hard to fight off sickness. AIDS, which is Acquired Immune Deficiency Syndrome, happens when HIV has damaged the immune system a lot. People with AIDS can get very sick from infections that don’t usually make healthy people ill.

The Importance of Awareness

Knowing about HIV and AIDS is very important. It helps people learn how to protect themselves and others from getting the virus. Awareness also means understanding that people with HIV need support and should not be treated badly.

HIV can be passed from one person to another through blood, during sex, or from a mother to her baby during pregnancy, birth, or breastfeeding. It is not spread by touching, hugging, or sharing food.

Prevention is Key

Preventing HIV is better than trying to treat it. This means not sharing needles, using protection during sex, and getting tested if you think you might have been exposed to HIV. There are also medicines that can lower the risk of getting HIV.

Getting Tested

Getting tested for HIV is simple and can be private. If a test shows someone has HIV, it’s not the end of the world. With today’s medicines, people with HIV can live long and healthy lives.

Support and Respect

People with HIV deserve to be treated with kindness and respect. Being aware of HIV and AIDS means also fighting against wrong ideas and standing by those who have the virus. This way, we can all help stop HIV from spreading and support those living with it.

500 Words Essay on HIV AIDs Awareness

Understanding hiv/aids.

AIDS, which stands for Acquired Immune Deficiency Syndrome, is a serious health issue caused by the virus called HIV, or Human Immunodeficiency Virus. This virus attacks our body’s defense system, making it hard for the body to fight off diseases. People can get HIV from infected blood, sharing needles, or through unsafe sex. It’s also possible for a mother to pass it to her baby during pregnancy, birth, or breastfeeding.

Why Awareness is Important

Knowing about HIV/AIDS is very important because it helps prevent the spread of the disease. People who are aware are more careful and can protect themselves and others. They know the importance of safe practices, like using new needles for medicines and not sharing them. They also understand why it’s important to have safe sex, using protection to stop the virus from spreading.

One of the key parts of awareness is getting tested for HIV. Tests are the only way to know for sure if someone has the virus. Early testing means that if a person does have HIV, they can start treatment sooner. This helps them live a longer, healthier life and reduces the chance of passing the virus to someone else.

Treatments for HIV/AIDS

There is no cure for HIV/AIDS, but there are medicines called antiretroviral therapy (ART) that help control the virus. These medicines help people with HIV live longer, healthier lives and lower the chance of spreading the virus. Knowing about these treatments is a big part of awareness because it encourages people with HIV to get the help they need.

Support and Acceptance

People with HIV/AIDS often face tough times because others might not understand the disease. They can be treated unfairly or feel alone. HIV/AIDS awareness includes teaching people to be kind and supportive. When everyone understands the disease better, they can help those affected by HIV/AIDS feel accepted and not alone.

Education and Prevention

Teaching kids and adults about HIV/AIDS is a powerful way to stop the disease from spreading. Schools and community groups can give out information on how to stay safe and healthy. They can also explain that HIV is not spread by touching, hugging, or being friends with someone who has the virus.

Global Efforts

Countries around the world are working together to stop HIV/AIDS. They share information, support research for better treatments, and help people get the care they need. It’s a global fight, and awareness is a tool that everyone can use to join in.

HIV/AIDS awareness is about understanding the disease, knowing how to prevent it, and supporting those who have it. It’s about getting tested and starting treatment if needed. Most of all, it’s about kindness and working together to stop the spread of HIV/AIDS. When everyone knows more, they can do more to help themselves and others.

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Essay About HIV/AIDS

Introduction.

Human Immunodeficiency Virus, abbreviated as HIV, attacks the body’s immune system, and if left untreated, it can cause AIDS (Acquired Immune Deficiency Syndrome). HIV is a retroviral disease transmitted through unprotected sexual activity, from mother to child, blood transfusion, contact with infected body fluids, or hypodermic needles (Melhuish & Lewthwaite, 2018). The disease originated from a zoonotic animal, a chimpanzee in Central Africa. The virus version in chimpanzees, Simian Immunodeficiency Virus, is thought to have been passed to humans during their hunting activities way back in 1800. The disease has further been spread across Africa over the decades and eventually into other parts of the world. Its existence in the United States occurred between the mid to late 1970s.

Disease Manifestation

HIV weakens the immune system through infection and destruction of the CD4+ T cells, leading to immunodeficiency at the later stages of the disease. The virus adheres to the CD4+ protein on its surface and other cells to gain entry into the body  ( Melhuish & Lewthwaite, 2018 ).  Other coreceptors such as CCR5 and CXCR4 are essential in enabling the virus to gain complete access and cause infection to the body cells. HIV infection undergoes three stages: acute illness, chronic infection, and acquired immunodeficiency syndrome (AIDS) (Velloza et al., 2020). The first stage usually develops between 2 to 4 weeks after initial exposure. The stage often goes unrecognized because of the occasionally mild and nonspecific symptoms. Some of the clinical manifestations observed in the first stage include typical rushes distributed on the face and trunk, although they may also appear in the palms and soles. Oral and genital mucocutaneous ulceration is also another clinical manifestation that can be experienced during the first stage. In this stage, gastrointestinal manifestation, facial nerve palsy, acute encephalopathy, and many other clinical symptoms may participate.

In the second stage of infection, the virus continues to multiply but at low levels. Infected individuals who are in this stage may not have any alarming symptoms. The stage can last for up to 10 to 15 years, although it may move so fast in some individuals c. AIDs infection occurs in the third stage. The infection may be manifested by symptoms such as rapid loss of weight, recurring fever, extreme tiredness, prolonged swelling of the lymph glands in the groin, armpits, or neck, sores in the mouth, diarrhea that lasts for more than a week, or memory loss and other neurologic disorder (Nasuuna et al., 2018). When infected individuals are not treated, they may develop severe diseases such as serious bacterial infections, cryptococcal meningitis, tuberculosis, and cancers like Kaposi’s sarcoma and lymphomas.

Diagnosis and Treatment

HIV diagnosis can be made by a rapid diagnostic test that provides results on the same day. Individuals may also test themselves using an HIV self-test kit, although a confirmatory test has to be done later on by a qualified health professional (Mayo Clinic, 2020). The diagnostic test works by detecting antibodies produced by a person as part of their immune response to fight the virus. When the results turn out positive, immediate treatment should be done to manage the virus (Mayo Clinic, 2020). A combination of three or more antiretroviral drugs (ARVs) or antiretroviral therapy (ART) may suppress the symptoms and viral replication within an individual hence allowing recovery of the immune system and regain the ability to protect the body from opportunistic infections.

The public health measures of HIV prevention can be divided into three categories; primary, secondary, and tertiary prevention. Primary prevention measures protect an individual from acquiring HIV infection. It involves strategies such as abstaining from sex, not sharing needles and sharp objects and using condoms when engaging in sexual activities. Prevention medicines such as PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) may also be used to protect yourself from the infection (Mayo Clinic, 2020). Secondary HIV prevention involves measures that should be directed to infected individuals to prevent transmission to negative people (Mayo Clinic, 2020). Strategies used in secondary prevention entails giving health education to those who are infected, supporting ART adherence efforts, providing ongoing risk assessment regarding substance use and sexual behavior, encouraging infected individuals to disclose their HIV status to their sexual and drug use partners, prescribing condoms for positive individuals and providing counseling to them (Mayo Clinic, 2020). Tertiary prevention measures ensure the improved treatment to reduce the impact of HIV/AIDS disease and promote recovery. A tertiary prevention strategy aims at reducing complications that may be caused by HIV infection.

Surveillance measures

Local surveillance of HIV may be carried out using various reporting tools to fill HIV infection cases and later submitted to the local health departments for further analysis. The Centre for Disease Control and Prevention (CDC) plays a big role in collecting, analyzing, and disseminating data for national surveillance on HIV/AIDS. The CDC’s National surveillance system monitors HIV trends in the U.S (CDC, 2020). Moreover, the World Health organization can conduct international surveillance of HIV/AIDS, which surveys on HIV sentinel, STDs, and behavior.

Prevalence and Incidence

According to WHO (2020), the global prevalence of HIV is estimated to be over 37.7 million people, including 1.7 million children. The percentage prevalence in adults is 0.7%. Additionally, the incidence of HIV infection was 1.5 million (WHO, 2020). Most people living with HIV live in low and middle-income countries, with East and Southern Africa being the most affected region globally. In 2020, there were 670,000 new cases which amounted to 20.6 million infected individuals in East and Southern Africa.

Interesting facts

According to the WHO, some of the current interesting facts about HIV/AIDS is that it has claimed over 36.3 million people since its emergence; hence, it is still a major public health concern (WHO, 2021). Additionally, over 37.7 million were HIV positive in 2020, whereby 25.4 million were in the WHO African region. WHO also reports that over 680 thousand individuals succumbed to HIV-related infections, and over 1.5 million people acquired HIV/AIDS.

CDC. (2020, June 19).  Tracking AIDS Trends . Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/statistics/surveillance/index.html

Eisinger, R. W., & Fauci, A. S. (2018). Ending the HIV/AIDS pandemic.  Emerging infectious diseases ,  24 (3), 413.

Mayo Clinic. (2020, February 13).  HIV/AIDS – Symptoms and causes . https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

Melhuish, A., & Lewthwaite, P. (2018). Natural history of HIV and AIDS.  Medicine ,  46 (6), 356-361.

Nasuuna, E., Kigozi, J., Babirye, L., Muganzi, A., Sewankambo, N. K., & Nakanjako, D. (2018). Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda.  BMC Public Health ,  18 (1), 1-9.

Velloza, J., Kemp, C. G., Aunon, F. M., Ramaiya, M. K., Creegan, E., & Simoni, J. M. (2020). Alcohol use and antiretroviral therapy non-adherence among adults living with HIV/AIDS in Sub-Saharan Africa: a systematic review and meta-analysis.  AIDS and Behavior ,  24 (6), 1727-1742.

WHO. (2021, June 9).  HIV/AIDS . WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hiv-aids

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Essay on HIV AIDS

One of the deadliest and most destructive ailments that has gripped human society is the pandemic known as AIDS. The disease itself is a retro-viral disease with its pathogen known as HIV or Human Immunodeficiency Virus.

In this, the pathogen is able to utilize the patient’s body for its own survival (parasite) and reproduction resulting in the patient’s own body and immunity starts to falters (especially the white blood cells known as T-Cells).

However, HIV does not mean AIDS always as many HIV patients can take the help of medicines and stay HIV positive.

The biggest reason for the massive spread of the disease is due to its ease of transmission. Among its various modes of transmission, the most pertinent is through body fluids like blood.

Many a time unscreened or not properly screened blood is transfused into patients which results in HIV transmission. Multiple uses of syringes etc is another such mode.

Another mode is through a pregnant mother into her unborn child. It becomes especially dangerous in second and later terms (for the fetus/child). The spread can also materialize post-birth through breast milk.

The third and probably the easiest one to avoid is through unprotected sexual activity. The threat of this disease can be traced by its difficult to identify symptoms.

Most of the early symptoms are that of the common flu with joint pains, fever, a period of chills and profuse sweating, glandular infection, tiredness, and sudden weight loss, etc.

After the disease has progressed, there are more severe symptoms like diarrhea, etc. However, the most lethal is Tuberculosis which causes the most HIV related deaths. India, unfortunately, is the site for the worst number and cases of such fatalities which are showing no signs of abatement.

The sad reality is that there exists no cure for AIDS. The progression can be slowed or stopped by anti-retro-viral drugs and therapy. This can significantly enhance the quality and longevity of the patient. However, there is no absolute remedy for the disease.

Even more difficult than physical destruction is the psychological blow that is dealt with by anyone who is diagnosed with such a condition. This is down to the misunderstanding and social stigma attached to HIV/AIDS.

Herein lies the biggest threat of HIV and must be addressed and corrected to help give the people with the disease a fighting a chance.

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Talking with Your Children about HIV: HIV Awareness for Children

Para leer esta hoja informativa en español, haga clic aquí .

Table of Contents

The facts about hiv, starting the discussion, talking to children of different ages, taking care of yourself.

Note: This fact sheet talks about discussing HIV in general. If you or your child are living with the virus, you may want to read our fact sheet "Talking with Your Children About Your HIV Status or Your Children's Status."

HIV can be a tough subject for parents, guardians, and caregivers to discuss with their children. However, it is important that all families teach their children about HIV. There are many reasons you may want to discuss HIV and AIDS with your children: you or a family member is living with HIV, your child is living with HIV, or you simply want to help your child understand HIV so that he or she does not acquire the virus.

There can be times when it is not appropriate or safe for women to tell their children or families that they are living with HIV. For more information about telling others that you or your child is living with HIV, see our fact sheet on Disclosure and HIV .

Important: if you are feeling threatened right now, call 911 or the National Domestic Violence hotline in the US at 800-799-SAFE [1-800-799-7233; or 1-800-787-3224 (TTY)]. You can also search for a safe space online at Domestic Shelters . If you live outside the US, please go to the Hot Peach Pages to find help near you.

HIV can be a tough subject for parents, guardians, and caregivers to discuss with their children. However, it is important that all families teach their children about HIV.

Globally, around 1.7 million people living with HIV are between 10 and 19 years old. In 2020, 150,000 adolescents acquired HIV, UNICEF reports. Young women and girls accounted for 80 percent of these new HIV cases.

In the US, the Centers for Disease Control and Prevention (CDC) reports that young people, ages 13 to 24, accounted for one in five of all people newly living with HIV in 2020. Yet nearly half of young people who are living with HIV don't know it. These statistics serve as a serious reminder to parents that they cannot afford to avoid talking with their children about HIV. For more information, see our fact sheet on  HIV Risk and Teens .

Children and teenagers find out about HIV from all sorts of places: school, TV, radio, friends, newspapers, magazines, and the Internet. Talking with your children about HIV lets you give them facts and correct any myths or incorrect information they may have picked up outside the home. It is also a chance to develop an open and honest relationship with your children.

Many parents are uncomfortable talking with their children about HIV because they do not have the correct information themselves. Before you talk to your children about HIV, it is important for you to know the facts.

What is HIV?

• HIV stands for "Human Immunodeficiency Virus"
• Without treatment, HIV will eventually wear down the immune system in most people to the point where they develop serious infections, which can lead to an AIDS diagnosis
• Many people take powerful and effective medications to fight the virus and live full lives; however, there is no cure for HIV

What is AIDS?

• AIDS stands for "Acquired Immunodeficiency Syndrome"
• AIDS is the most advanced stage of HIV infection
• Many people take powerful and effective combinations of medications to fight the virus; however, there is no cure for AIDS

What is the difference between HIV and AIDS?

• Someone can be infected with HIV for many years with no signs of disease, or only mild-to-moderate symptoms
• At least one AIDS-defining opportunistic infection (see a list of opportunistic infections in our fact sheet on  AIDS Defining Conditions )
• A CD4 cell count of 200 cells/mm 3 or less (a normal CD4 count is about 600 to 1,500 cells/mm 3 )
• When people are diagnosed with HIV, they will always live with HIV. Regardless of how low their viral load may be – even if it becomes "undetectable" – they will never go back to being HIV-negative.

For more information, see our fact sheet "What Are HIV & AIDS?"

How is HIV transmitted (spread)?

HIV is transmitted through:

• Blood (including menstrual blood)
• Semen ("cum") and other male sexual fluids ("pre-cum")
• Vaginal fluids
• Breast milk

HIV is not transmitted through:

• Saliva (spit)
• Urine (pee)
• Feces (poop)

A person living with HIV who is taking HIV drugs daily and has an undetectable viral load will not transmit the virus through sex. This is one way that HIV treatment can also be HIV prevention. For more information on this exciting development, please see our fact sheet on Undetectable Equals Untransmittable .

The most common ways in which HIV is passed from one person to another are:

• Re-using and sharing needles and other drug equipment ("works") for injecting drugs (including steroids or hormones)
• Unprotected/unsafe anal or vaginal sex (no condoms or other barriers, or treatment-as-prevention methods). There is little risk of acquiring HIV during oral sex.
• Mother-to-child (during pregnancy , birth, or breastfeeding )

For more information on how HIV is spread, see our fact sheet on HIV Transmission .

How can HIV be prevented?

One of the most important messages you can share with your children is that HIV can be prevented. HIV cannot be transmitted, except when certain body fluids are exchanged (see above). For more information, see our fact sheets on  HIV Prevention and Transmission .

Teach your children that they can greatly reduce the risk of acquiring HIV by:

• Always practicing safer sex (using condoms or other barriers, or treatment-as-prevention methods)
• Not having sex, if that is appropriate for them
• Having types of sex that present no risk of HIV , including masturbation
• Once they are sexually active, getting tested regularly for HIV and other sexually transmitted infections (STIs) and getting any treatment they need
• Taking pre-exposure prophylaxis (PrEP) , if that is appropriate for them.
• Talking with their partners about sexual histories and HIV/STI status, and when they were each last tested
• Limiting their number of sexual partners
• Not injecting drugs , or if they do, always using new, clean needles and drug equipment

It is also important to tell children that HIV is not transmitted by casual contact such as:

• Being a friend to someone who is living with HIV
• Sharing food or drinks
• Using a shower, bath, or bed used by a person living with HIV
• Kissing (between people with no significant dental problems, such as bleeding gums or open sores)
• Sharing exercise equipment or a swimming pool

Talking to Teens about HIV and HIV Prevention: For the 24th episode of A Girl Like Me LIVE , host Ciarra "Ci Ci" Covin was joined by Kimberly Canady and Ieshia Scott, two long-time The Well Project community advisory board members. Don’t miss the chance to learn from these advocates about how they have initiated the conversation about HIV prevention and awareness with youth in their communities, tips for when to begin talking with children, and what you can do to create a supportive and loving environment in which adolescents and teens will feel comfortable asking questions and empowered to make healthy life choices.     View other episodes in the A Girl Like Me LIVE series

For more information, see our fact sheet on  HIV Transmission .

Every parent has his or her own style when talking about important subjects. Some parents choose to have a specific time when the family will sit down and discuss sexual activities and sexually transmitted infections, including HIV. They may give out printed information (e.g., books, info sheets) or other resources to help children understand the facts.

Other parents take hints from their children and from what is going on around them to talk about HIV. For example, they may try to bring up the topic when their children see or hear something about HIV on TV. Ask what the children have heard and what they know about HIV. This will help you figure out what they already know and what you need to explain.

Note: When talking with your children about HIV, questions about death may come up. Explain death in simple terms. It is important not to explain that death is like sleep. Such an explanation may make your children worry that if they fall asleep, they will never wake up. It is also important to explain that while HIV is serious, it can be prevented and treated.

It is never too early to talk to your children about HIV. In fact, by age eight (third grade in the US), many children have already heard about it. Talking to children about HIV is not a one-time-only conversation. Children will be ready to hear different levels of information at different ages. Often their questions will let you know that they are ready to hear more about it. The more open you are to questions about HIV or sex in general, the more likely your children will be to ask them, and the greater your opportunity to give them correct information and help them make healthy choices. Talk early and talk often to make sure that your children have the right information for their age throughout their childhood.

Toddlers/Preschoolers:

Children will be ready to hear different levels of information at different ages.

Children up to age four are learning the basics about their bodies. They do not understand the concepts of disease, death, or sex. However, you can set the stage for future conversations: introduce them to the idea of sexuality by telling them the correct names for body parts. You may also want to tell them that certain body parts are private, and that they should let you know if anyone touches them in a way that makes them uncomfortable. Most importantly, however, you want to give young children the message that you are open to their questions. When they feel they can ask you anything, they will be more likely to talk to you as they get older.

School-age Children:

Children five to eight years old are just learning about health, sickness, death, and sex. They can understand that HIV is a serious health problem which is caused by a virus, and that their chances of acquiring HIV are very low. You do not have to discuss sex at this age; however, you can teach children that some body fluids carry infection and should not be shared.

Preteens/Tweens:

Children nine to 12 years old think a lot about their bodies. Many of them are entering or going through puberty. At this age, children also feel a lot of peer pressure – pressure from other children their age – to try new (and possibly dangerous) things. Now is the time to tell them how HIV is transmitted. Since HIV is often transmitted by sexual contact, now is the time to give your children correct information about sex. Tell them about the importance of sexual health and safer sex . Let them know that sharing needles or syringes for injection drug use , steroid injection, and informal tattooing or body piercing can put them at risk for acquiring HIV. Teach preteens that they have choices in life and that the decisions they make today could affect them for the rest of their lives. You may also want to tell your children that it is okay for them to talk to an adult they trust (parent, teacher, older relative) if they feel unhappy, pressured, or bullied.

Thirteen- to 19-year-olds are often more concerned with their self-image and friendships than with what their parents have to say. Many teenagers take risks and feel that "it can't happen to me." During these formative years, it is important to continue to provide your child with correct information about HIV and safer sex. You may wish to provide resources such as books and videos that they can view on their own. This is also an important age to talk about treatment as prevention , including pre-exposure prophylaxis ( PrEP ) and post-exposure prophylaxis (PEP). For more information, see our fact sheet on  What Parents and Providers Need to Know about HIV Risk and Teens .

Talking with children about HIV can make parents anxious. Educate yourself and have resources on hand. You will feel more comfortable if you know the facts. Try to relax and let the conversation flow naturally. It is important to begin talking with your children at an early age, so that you all become comfortable with the subject and the words used to talk about it. You can use this opportunity to create a supportive and loving environment in which your children will feel comfortable asking questions and empowered to make healthy life choices.

Related articles by The Well Project

Talking with Your Children About Your HIV Status or Your Children's Status

Disclosure and HIV

What Parents and Providers Need to Know about HIV Risk and Teens

• Teens and HIV: The Transition into Adulthood

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• Talking with Your Children about Your HIV Status or Your Children's Status
• Teens and HIV Prevention: What Parents and Providers Need to Know

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How to Write Striking Essays on HIV/AIDS

Definitely, the problem of HIV/AIDS is of great concern for many people. Since effective treatment is not found yet, we are all a bit endangered.

However, this topic has been discussed so many times that some students may find it a bit boring to cover it once again. “Fine, I have to write an essay on HIV/AIDS. Do I really have something exclusive to say?”

Well, we can understand you if this is what you are thinking about. Most likely, you will not highlight some brand new issues in your essay on HIV/AIDS. Still, you have a chance to make the HIV/AIDS essay striking.

These are several ways to do it.

Give statistical data in HIV/AIDS essays

It is the best way to demonstrate the scope of the problem. For instance, do you know that:

• There are several the worst-affected countries where 2 out of 5 pregnant women are infected?
• In the year 2000, 5 million people became infected with the virus. It means that approximately 7 women and men were infected every minute.

So, this and other statistics can be used in HIV/AIDS essays.

Give vivid examples in your essay on HIV/AIDS

Depending on the topic of your essay on HIV/AIDS, you can choose several illustrative examples to sound more impressive and convincing.

Think over the key idea of the essay on HIV/AIDS thoroughly

Whether you like it or not, but you have to consider significant and burning problems about the virus. In order to pick such issues for discussion in your essay on HIV/AIDS, you need to look through scientific journals related to the problem, watch Discovery, etc.

So, even the most frequently discussed topics can be covered in a captivating manner.

This weblog will be useful if you need articles on dental hygiene or a health promotion essay.

Expository Essay on HIV AIDS

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Here you have Expository essay on HIV AIDS, Learn how to write an Essay by this example.

Introduction

One of the most feared diseases of the twentieth century is HIV. The Human Immunodeficiency Virus (HIV) causes AIDS by destroying the human immune system. It has claimed the lives of more than 29% of the world’s population. AIDS has spread like wildfire over the world since its discovery. The maximum population knows about this dangerous disease, AIDS, thanks to the efforts of the government and non-governmental organizations.

AIDS – Causes and Spread

The Human Immunodeficiency Virus, also known as HIV, is the primary cause of AIDS. This virus replicates itself in the human body by injecting a copy of its DNA into the human host cells. The virus is also known as a retrovirus because of its property and capabilities. WBCs (White Blood Cells), which are part of the human immune system, are the host cells in which HIV lives.

HIV destroys WBCs, and the human immune system is weakened as a result. The immune system’s deterioration impacts a person’s ability to combat diseases quickly. A cut or a wound, for example, takes much longer to heal or the blood to clot. The injury may never recover in rare circumstances.

The direct transmission of HIV is through one of three routes: blood, prenatal, or sexual transmission. During the early stages of HIV transmission, blood transfusions were extremely popular. However, in today’s world, all developed and developing countries have vital processes in place to ensure that blood is clear of the virus before it is transfused. Sharing needles can also transmit HIV from one infected person to another.

HIV can transmit through body fluids during sexual activity as part of sexual transmission. HIV can quickly spread from an infected person to a healthy person through oral, genital, or rectal areas if they engage in unprotective sexual intercourse.

Prenatal transmission means that an HIV-positive woman can easily transmit the virus to her kid during pregnancy, breastfeeding, or even childbirth.

AIDS – Symptoms

HIV reduces the general immune system of the human body by attacking and infecting the WBCs, leaving the infected individual exposed to any other sickness or minor infection. In comparison to other diseases, AIDS has a substantially longer incubation time. The symptoms occur gradually over 0-12 years.

Fever, exhaustion, and weight loss are frequent AIDS symptoms, including diarrhea, enlarged nodes, yeast infection, and herpes zoster. Because of their decreased immunity, the infectious individual is susceptible to various unusual diseases, including persistent fever, nocturnal sweating, skin rashes, oral sores, and more.

AIDS – Treatment and Prevention

There is currently no treatment or cure for AIDS, making it a life-threatening condition. According to medical professionals, antiretroviral therapy, or ART, is the best approach to stop it from spreading. It is a drug therapy that prevents HIV from replicating and thus slows the progression of the disease. To minimize immune system damage, it is always best to begin treatment as soon as possible. However, it is only a precaution and does not guarantee that it will prevent you from AIDS.

The process of halting the spread of AIDS is AIDS prevention. Before engaging in any sexual activity, an individual should be aware of his or her own HIV status and that of his or her partner. It is imperative to practice safe sex at all times. Males should always use condoms during sexual encounters, and they should limit the number of individuals with whom they have sex.

It is not advisable to become addicted to illegal substances or narcotics. Multiple public awareness campaigns led by the United Nations, local governments, and nonprofit organizations have reduced the danger of AIDS spreading by raising a general understanding of the disease’s spread and prevention.

AIDS prevention is the method of preventing the spread of AIDS. It is mandatory to perform a regular check of AIDS. An individual should be aware of his or her own HIV status and that of his or her partner before engaging in any sexual activity. Males should always wear condoms during sexual interactions and keep the number of people they have intercourse with to a minimum.

Addiction to illegal substances or narcotics is not a good idea. Needles and razors that haven’t been sterilized should be avoided at all costs. Multiple public awareness efforts conducted by the UN, local governments, and nonprofit organizations have helped minimize the risk of AIDS spreading by increasing public awareness of the disease’s spread and prevention.

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Essay on the HIV/Aids Health Issue in South Africa

The Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is one of the major health challenges affecting public health in South Africa. Despite South Africa’s efforts to avail medications for controlling and reducing viral transmission, HIV/AIDS still poses a significant health challenge to the public. The disease has already devastated thousands of families across the country. Deaths resulting from HIV/AIDS have orphaned millions of children and disrupted the normal structure of the community. HIV/AIDS has affected almost every sector of life. The pandemic has largely contributed to the increase in health expenditures in South Africa. The critical level of care required by the patients is forcing the government to divert resources that would otherwise be used to finance other development projects. Apart from overburdening the overall health and social support expenditures in the country, the virus is claiming the lives of hundreds of health practitioners in South Africa. The HIV/AIDS pandemic in South Africa is a complicated public health issue that requires a strategic approach from the national governmental organizations, non-governmental organizations, and international organizations.

Historical Context of HIV/AIDS in South Africa

South Africa reported its first HIV case in 1982, a time when the country was fighting to end the apartheid system (Hodes, 2018). The government ignored the HIV/AIDS problem as the country was facing other serious challenges such as political unrest. The media outlets did not react to the pandemic immediately (Hodes, 2018). Politics dominated major headlines at the time and the public was not immediately made aware of the pandemic. HIV silently began to take hold mostly among the gay population of South Africa and the black population.

Three years after the first case was reported, the department of health initiated a public awareness campaign. The campaign included the use of coffins and skeletons to convey messages about HIV/AIDS in the country (Hodes, 2018). The campaign however did not convey messages on the mode of transmission. In 1987, the apartheid government sought to restrict the civil liberties of infected persons (Hodes, 2018). South Africans diagnosed with HIV were quarantined while immigrants who had the disease or were suspected to have been infected were deported back to their countries.

By 1990, HIV/AIDS prevalence in South Africa had reached an all-time high. The country was at this time transitioning from apartheid to democracy and the government was facing a myriad of challenges which included corruption and abuse of power (Hodes, 2018). There was no elaborate plan by the government to handle the HIV/AIDS issue. The department of health was unable to take the appropriate measures to curb the spread of the disease. Infected people could not access the life-saving antiretroviral treatment (Hodes, 2018). These factors led to the rise of public health activist movements in the country. Members of these movements sought to compel the government to enable public access to testing and treatment of the virus. The movements further sought to force the government to undertake the necessary steps to curb the spread of the virus.

The efforts of the activists saw the formation of The National Aids Convention of South Africa (NACOSA) in 1991 (Geffen and Welte, 2018). This organization sought to strengthen partnerships among civil groups, health workers, and development agencies in a bid to curb the spread of HIV on the. In 1993, the South Africa government published its first plan to intervene HIV/AIDS pandemic issue (Hodes, 2018). Despite all these activities, the response to the pandemic remained inadequate and ineffective. Cultural challenges impeded the government’s efforts in addressing the HIV/AIDS issue. For instance, it was a taboo among some South African communities to talk openly about sex.

Current Developments of HIV/AIDS Pandemic Issue

Currently, South Africa has the highest HIV prevalence rate in the world. Out of the 58 million people in the country, 7.7 million are estimated to have contracted the virus (Avert, 2020). In the Southern Africa region, South Africa alone accounts for 30% of all new HIV infections. Of the 240,000 new infections in 2018, 71,000 were from South Arica (Avert, 2020). The burden of the pandemic has profound implications on the development of South Africa. The high rates of HIV-related infections and deaths have compromised household stability and investments in children.

The government of South Africa has made commendable efforts to address the HIV/AIDS issue. Steps undertaken by the government include enhanced clinical testing and financing the anti-retroviral program (ART) (Avert, 2020). Today, South Africa has the largest antiretroviral treatment in the world (Avert, 2020). This program is largely financed from domestic resources. As a result of the ART program, the national life expectancy in the country has increased from 56 to 63 years.

There has been notable progress in the testing and suppression of the virus. A report by the world health organization indicates that 90% of the people living with HIV have so far been tested and 87% of them have enrolled in the treatment program (Avert, 2020). The prevalence, however, remains high especially in the Western Cape and in KwaZulu-Natal areas.

HIV/AIDS Health and Social Policies in South Africa and a Comparative Analysis with the United States

Access to Testing

The government of South Africa has launched a number of HIV testing and care programs. The two recent nationwide testing initiatives are the National HIV testing and the National HIV/AIDS counseling campaign (Avert, 2020). These initiatives were part of the government’s policy to have people working in the private sector and the higher education sector get tested for the virus. As a result of this policy, more than 10 million people have since been tested (Avert, 2020). There have however been discrepancies in the number of women when compared to that of men who present themselves for testing. More women are tested as compared to men. Men are reportedly worried about queuing outside the testing facilities.

Access to HIV testing is a priority in many other countries. In the United States, for instance, the government has undertaken measures to include annual HIV testing for people aged between 15-65 years (Avert, 2019). Such measures include the expansion of the national health insurance program. The rate of people who turn in for HIV testing in the United States of America is however low as compared to that of South Africa. In the United States, people have a low disease risk perception while others are afraid of being stigmatized after diagnosis.

Access to Care and Treatment

The United Nations program introduced the 90-90-90 targets to mitigate the adverse effects of HIV/AIDS (UNAIDS, 2017). In line with the UN’s program, South Africa guarantees free and reliable access to anti-retroviral treatment (ART) (Avert, 2020). At least 4.8 million people in the country are receiving HIV/AIDS treatment as a result of the free access to care and treatment policy (Masquillier et al., 2020). Studies reveal that more women than men are more likely to enroll for ART in South Africa and as a result, the mortality rate of men is twice that of women.

Just like in South Africa, there is free access to care and treatment policy for the people living with HIV/AIDS in the United States (Avert, 2020). Testing for HIV/AIDS in the United States has become widespread over time. However, more than half of the adult population are were yet to turn out for testing as at 2012 (Rizza et al., 2012). The number of people who turn in for these services in the United States is, however, lower when compared with that of South Africa. This can be attributed to lack of awareness and misconceptions related to the HIV/AIDS virus in the United States.

Education and Awareness

The government of South Africa has made numerous efforts to educate the masses and create awareness of the HIV/AIDS pandemic (Avert 2020). The government is determined to use the education policy to provide comprehensive sexuality education in both public and private schools. By the end of the year 2016, only 5% of the schools were offering sexuality education in South Africa (Avert 2020). The government is planning to introduce a system of education that will assist learners to prevent and report incidents of sexual violence.

In the United States, the status of sexual health education is insufficient in most areas. There are claims that sexual education is not taken seriously and in some cases, it does not start early enough for the learners. The number of schools where students are supposed to get advice on HIV prevention keeps decreasing in the United States. Offering HIV/AIDS education and creating awareness has not been taken seriously in the United States. According to the Centers for Diseases Control and Prevention (2016), many Americans have become complacent about HIV/AIDS and at least a quarter of the patients are not aware of their statuses.

Legislation

Through legislation, the government of South Africa has managed to minimize cases of discrimination on an HIV status basis. Section 6(1) of the constitution requires the public especially those at the workplace to desist from any form of unfair discrimination based on a person’s HIV status (Mubangizi, 2009). The constitution bars employees from dismissing employees who turn out to be HIV positive. These laws aim to promote a non-discriminatory work environment and curb the stigmatization of HIV patients.

HIV/AIDS Pandemic issue in the Context of Social Divisions in South Africa

Apart from HIV/AIDS being a medical problem in South Africa, it is a social problem. This is demonstrated by the virus’s widespread, ineffectiveness and the inability of the medical department to control HIV expansion in the country. South Africa is one of the world’s countries that have experienced gross social inequalities (Gordon, Booysen and Mbonigaba, 2020). Such inequalities are mostly based on racial, class, and gender factors. Apartheid for instance has for a long time shaped the social profile and as a result, derailed the efforts to deal with the HIV/AIDS pandemic.

Social divisions and issues related to it have been the major setback in the fight against the virus. Whereas anyone regardless of their social status can get infected with HIV/AIDS, certain groups of people are at a higher risk of getting the infection (Avert, 2020). These groups of people engage in high-risk behaviors while others experience stigma and discrimination. Stigma and discrimination are among the major hindrances for people to seek HIV testing and treatment. If the social issues are well understood and dealt with, the government and international organizations could effectively roll out prevention programs to the people at high risks.

Women in South African society have an unequal cultural, social, and economic status. This is largely a result of inequitable laws and harmful cultural practices that empower men and disempower women. Women are at a higher risk of contracting the virus as compared to men. By 2017, the percentage of women infected stood at 26% while that of men stood at 15% (Avert, 2020). Gender-based violence, poverty, and the low status of women in South Africa are largely to blame for the high disease prevalence among women. A third of women in the country have at one time experienced intimate partner violence.

A report by the world health organization indicated that the HIV prevalence among young women was much higher than that of young men in the year 2018. Intergeneration relationships between older men and young women were understood to be the major force behind this disparity. Discriminative social attitude towards women makes it harder for them to access testing and treatment services.

South Africa is among the countries with the highest unequal distribution of resources (Gordon, Booysen and Mbonigaba, 2020). The HIV/AIDS epidemic in the country has brought about huge demands for medical care in the public health sector. As a result, the disease is more prevalent among the middle class and lower class population.

Preventing early deaths arising from HIV-related infections requires a household member to first identify the infection through testing, and enroll in the treatment program. Though testing is free in South Africa, there are other related expenses such as transport fees. People of the lower class may have problems in financing such expenses. People of the lower social class report lower rates of HIV testing as compared to those of high social class.

Being of a lower social class in South Africa is associated with reduced or no food security, lack of food diversity, and increased chances of skipping meals. Poor women are forced to adopt behaviors that increase their risk of getting infected. These behaviors include commercial sex and early marriages. HIV patients require a balanced diet to boost their immune response to opportunistic infections. In addition, Low-class people may have difficulties accessing protection equipment such as condoms due to their reduced financial capability.

Globally, racial inequalities play a significant role in escalating the HIV/AIDS pandemic. Some ethnic groups are at a higher risk of acquiring and transmitting HIV when compared to other ethnic groups. This is because, in some places such as South Africa, some population groups have higher rates of HIV/AIDS prevalence. The risk of acquiring the infection in these groups is high.

In South Africa, Black African males have high HIV/AIDS prevalence as compared to their counterparts from other races (Avert, 2020). The high prevalence among blacks is created by historical social injustices and unequal social and economic status. The apartheid particularly has contributed significantly to the HIV prevalence among the black community in South Africa (Hodes, 2018). In a country where blacks are the majority, apartheid perpetuated HIV through denial of health services and access to quality education to the black community. Apartheid policies mostly addressed the social and economic advances for the minority white communities at the expense of the black race. Up to date, the black community is yet to recover from the burden of high HIV prevalence which would otherwise not be there had it not for the apartheid system.

Cultural Issues

The high prevalence of HIV/AIDS in South Africa has prompted speculations regarding risk factors that may be unique to the country. Some cultural practices increase the risk of HIV/AIDS in the region. These factors include polygamy, early marriages, and virginity testing. All these vices characterize most South African societies.

Polygamy is not primarily a harmful practice that can directly lead to the spreading of HIV/AIDS. However, how people in polygamous marriages conduct themselves ends up facilitating the spread of the virus. Wives in a polygamous marriage have little or no control over the sexual behaviors of their husbands or co-wives. Infidelity for instance could be a catalyst for the spread if the cheating partner gets infected. In the KwaZulu-Natal community of South Africa, there has been a resurgence of virginity testing (Ngubane, 2020). The public identification of a young girl as a virgin increases her risk of sexual abuse.

Age and Family Status

By 2018, the number of HIV-infected children in South Africa stood at 260,000 and 63% of them were on treatment. These were children of age 0-14 (Avert, 2020). The rate of infection among young children is lower as compared to that of people aged 15 years and above. The decline in new infections among children is attributed to the government’s efforts in preventing mother-to-child HIV transmission. Children are however mostly affected by the HIV pandemic through the loss of their parents and guardians. HIV/AIDS pandemic has orphaned At least 1.2 million children in South Africa (Avert, 2020). This creates another problem as these children lose their providers. They become insecure and vulnerable to HIV due to economic and social insecurities. Such children become targets of sexual predators who force them to have sex in exchange for support.

The Role of International Organizations and Aid Agencies in Addressing the HIV/AIDS Issue

There are many international organizations involved in the fight against the spread of the HIV/AIDS pandemic. These organizations engage in a coordinated effort to stop new HIV infections and ensure that everyone living with the virus has unrestricted access to testing and quality treatment. International Organizations such as the Joint United Program on HIV/AIDS (UNAIDS) are responsible for promoting human rights for the patients and producing data for decision making. Some of the prominent international organizations involved in this fight include The Global Fund, The World Health Organization (WHO), and UNAIDS. These organizations undertake the international role of policy formulation and legislation in matters concerning the HIV/AIDS pandemic.

Formulation of Policies

One of the policies adopted by international organizations is the creation of awareness about HIV/AIDS. Kaiser Family Foundation for instance focuses on the provision of the latest data and information about the virus (Kaiser Family Foundation, 2016). The organization conducts research and data analysis on regular basis. In addition, Kaiser Family Foundation works with major news organizations across the world to enable easy access to information. Its information is provided free of charge.

International health organizations aim to build a better and healthier future for people living with HIV/AIDS across the world. These organizations advocate for equality and preservation of human rights regardless of their health status. The World Health Organization particularly provides evidence-based technical support to countries across the world. The organization supports its members in the quest to scale up the treatment of the virus and slow down its spread. The mission of such organizations is to lead collective action on the global HIV response.

The United Nations General Assembly fully recognizes human rights and freedoms. The organization has formulated a number of international regulations and guidelines meant to protect HIV patients across the world. Following a global outcry against the high cost of HIV treatment, the ministerial council in 2001 made a regulation prompting its members to take measures to protect public health (Patterson and London, 2002). The United Nations members were required to allow easier access to medications for people living with the virus.

International organizations have made numerous efforts to form and support national organizations. These national organizations comprise professionals and HIV/AIDS victims who are united in advocating for the rights of patients. With the support of the United Nations Development Programme, many countries have been able to form law associations meant to oversee the implementation of the rights of patients. Organizations such as legal clinics promote laws and policies on human rights and freedom.

Global Issues in the Fight against HIV/AIDS

The global economic crisis is a major hindrance to the international fight against HIV/AIDS. The UNAIDS faces a greater challenge in ensuring that UN agencies heed their call of supporting developing countries that are severely affected by the pandemic. Financing a sustainable response to the disease is a hard task especially for developing nations. With the emergence of other pandemics that require huge financing, international organizations face a challenge in financing the HIV/AIDS control measures.

The emergence of other infections has derailed the international fight against HIV/AIDS. Currently, the world is battling a new virus. The COVID-19 pandemic has a serious impact on the most vulnerable communities and impedes the progress of the fight against HIV/AIDS. World resources are now redirected to the new virus. At the moment, there is no single country that is immune to the increasing economic cost of the new pandemic.

The HIV/AIDS pandemic poses a significant health threat to South Africa. The complex nature of the disease makes it even harder for the government and other international organizations to develop a comprehensive approach to addressing it. The government and other organizations, however, have made numerous efforts to intensify testing, treatment, and provision of care to HIV patients. All these efforts have been derailed by other social factors such as class differences, gender inequalities, ethnicity, and cultural issues. In its efforts to slow the spread of the disease and mitigate its adverse effects, the government has enacted a number of policies. The policies include free access to HIV testing, education, and the creation of public awareness. International organizations have made numerous efforts to help South Africa and other developing nations in fighting the virus. These include financing the war against the disease and developing policies meant to address the HIV/AIDS issue.

 Avert. 2019. HIV and AIDS in the United States of America (USA). [Online] Available at: <https://www.avert.org/professionals/hiv-around-world/western-central-europe-north-america/usa> [Accessed 17 April 2021].

Avert. 2020. HIV and AIDS in South Africa. [Online] Available at: <https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa> [Accessed 17 April 2021].

Centers for Disease Control and Prevention. 2016.  Challenges in HIV Prevention . [Online] Available at: <https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/challenges-508.pdf> [Accessed 6 May 2021].

UNAIDS. 2017. Ending Aids; Progress towards the 90-90-90 targets. [Online] Available at: <https://www.unaids.org/sites/default/files/media_asset/Global_AIDS_update_2017_en.pdf> [Accessed 17 April 2021].

Geffen, N. and Welte, A., 2018. Modeling the human immunodeficiency virus (HIV) epidemic: A review of the substance and role of models in South Africa.  Southern African Journal of HIV Medicine , 19(1).

Gordon, T., Booysen, F. and Mbonigaba, J., 2020. Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa. BMC Public Health, 20(1).

Hodes, R, 2018. ‘HIV/AIDS in South Africa’,  Oxford Research Encyclopedia of African History .

Kaiser Family Foundation. 2016. HIV Awareness and Testing. [Online] Available at: <https://www.kff.org/slideshow/hiv-awareness-and-testing/> [Accessed 17 April 2021

Masquillier, C., Knight, L., Campbell, L., Sematlane, N., Delport, A., Dube, T., and Wouters, E., 2020. Sinako, a study on HIV competent households in South Africa: a cluster-randomized controlled trial protocol. Trials, 21(1).

Mubangizi, J., 2009. HIV/AIDS and the South African Bill of Rights, with specific reference to the approach and role of the courts.  African Journal of AIDS Research , 3(2), pp.113-119.

Ngubane, L., 2020. Traditional Practices and Human Rights: An Insight on a Traditional Practice in Inchanga Village of Kwazulu-Natal, South Africa. The Oriental Anthropologist:  A Bi-annual International Journal of the Science of Man , 20(2), pp.315-331.

Patterson, D. and London, L., 2002. International law, human rights, and HIV/AIDS. [Online] Global Public Health and International Law. Available at: <https://www.who.int/bulletin/archives/80(12)964.pdf> [Accessed 17 April 2021].

Rizza, S., MacGowan, R., Purcell, D., Branson, B. and Temesgen, Z., 2012. HIV Screening in the Health Care Setting: Status, Barriers, and Potential Solutions.  Mayo Clinic Proceedings , 87(9), pp.915-924.

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