HIV/AIDS Determinants and Control of the Epidemic

1. Use the BIG GEMS framework to examine the factors in addition to infection that

have affected the spread of HIV and the control or failure to control the HIV/AIDS

epidemic.

Behavior: Actions such as taking part in unprotected intercourse is a high risk factor for

contracting HIV. However, becoming educated and taking precautions necessary for intercourse

(such as the use of condoms) could control the HIV/AIDS epidemic. This behavior can protect

individuals who are at risk for HIV/AIDS. Other behavioral actions that people can take are

monogamous sexual relationships.

Infection: HIV stands for human immunodeficiency virus. It is a retrovirus that attacks CD4

cells in the immune system, and as a result it prevents the body from fighting infectious diseases.

The fast spreading quality of HIV/AIDS makes its emergence even more significant in the lives

of people. It can be spread through sexual intercourse, sharing of needles, or exposure to body

fluids (such as semen, vaginal fluids, rectal fluids, pre-seminal fluids, and breast milk).

Genetics: In the case of HIV/AIDS, genetics is a very rare determinant, as only a “small

number of people have well documented protection on a genetic basis.” There is also mother to

child transmission, but is preventable if there are treatments during pregnancy.

Geography: According to the Center for Disease Control (CDC), the states with the most

commons diagnoses of HIV/AIDS is Florida, California, and Texas. These states are also the

states with the highest populations, according to the World Population Review. The emergence

of HIV/AIDS will be more common in states in which there is a large population, this makes it

very difficult to control the HIV/AIDS epidemic. In developed countries, the rates of HIV/AIDS

is much lower than in developing countries. This can be correlated with the availability to health
care centers or treatments. The highest rates of HIV/ADS are in East and Southern Africa. The

lowest rates are in Middle East and Northern Africa. The countries in East and Southern Africa

are poorer than the countries in the Middle East and Africa.

Medical Care: In a social environment where there is no use of protection during sexual

intercourse, the spread of HIV/AIDS will be more drastic. On the other hand, in an environment

where there are safe practices of sexual intercourse, the spread of HIV/AIDS will be limited.

Though there is no cure for HIV/AIDS, there are therapies such as Antiretroviral Therapy (ART)

in which a combination of HIV medications are taken. There are also HIV/AIDS programs that

work with cities and states and can provide essential services to those who are at risk for

HIV/AIDS.

SES: Factors such as education and income can have an effect on the control of HIV/AIDS.

Those who are exposed to lower level of education are not well educated on the symptoms of

HIV, the treatments of HIV, or how to prevent it. It is contrary for those who are exposed to a

higher level of education as they are well aware about protection techniques. This is correlated to

those with lower income and higher income.

2. What roles has health care played in controlling or failing to control the HIV/AIDS

epidemic.

Health care provides people, who are at risk for HIV/AIDS, with security and protection. Having

organizations like the Center for Disease Control (CDC) is very helpful in the control of

HIV/AIDS and awareness of HIV/AIDS. Accessibility to medication controls the epidemic,

which is why there are lower number of cases in developed countries. However, access to

medication in developing countries is hard and is the reason that HIV/AIDS is not controlled as

much. There are additional resources such AIDS Healthcare Foundation and UNAIDS. The AHF
has a goal to advocate AIDS and brings medication to at-risk communities. UNAIDS consists of

a group of countries (where HIV is prevalent) and they work together to stop the spreading of the

disease.

3. What roles has traditional public health played in controlling or failing to control

the HIV/AIDS epidemic?

Public health has been essential for the control of HIV/AIDS as the study of public health

identified the status of HIV/AIDS, the transmission of it, and how to prevent cases from

occurring- whether it means using condoms, using new needles (rather than reusing them), or

encouraging monogamous sexual relationships. The study of public health encompasses studying

the rate of infections, the origin of the infections, and the process of moving forward. The act of

moving forward includes removing the social stigma that comes with HIV/AIDS, and this comes

through HIV/AIDS awareness campaigns and accessible treatment options. As an example, the

population in South Africa makes up “70% of HIV- positive patients in the world.” As a way to

move forward, the leaders in this region and the Sub-Saharan region are finally making changes.

The study of population health, which is an approach for health departments/societies to directly

change policies to transform local communities, is also important as local government programs

can make explicit changes immediately.

4. What roles have social factors (beyond the sphere of health care of public health)

played in controlling or failing to control the HIV/AIDS epidemic?

As previously stated in question 1, education and income are factors that can affect HIV/AIDS in

certain populations. Social status is an important facet of social factors, as those with higher

status and income are easily able to get treatment, and are in a better environment where

prevention of HIV/AIDS is supported. Some other social factors could be support groups; in
these groups, community support between family and friends can be associated to better health.

Another social factor is social stigma. The negative social stigma about men and treatment can

discourage men to reach out and get treatment or help for this disease. The rates of HIV/AIDS

among women in the United States is highest among black women in the United States. In an

article on Infections Disease News, it was stated that sexual network patterns along with

economic/racial disparities have an effect on the spreading of HIV. Dr. Adimora of UNC Chapel

Hill stated that “The interrelatedness of these factors underscores the fact that social and

contextual factors are not ‘distal’ determinants in the way that we usually use the word distal, but

instead they directly impact behavior and the risk for infection.” This shows the effect of “social

and contextual” factors on the emergence of HIV/AIDS.