The Effects OF Stratification On Class, Gender, Race, And/Or Age On The Research Paper Samples
Social Problem of HIV/AIDS
One of the most common problems in societies worldwide is the increasing prevalence of HIV/AIDS. The lack of a definite cure for HIV/AIDS subsequently contributes to its increasing prevalence and such prevalence bears with it different consequences—one of which is the inevitable stratification applied to individuals affected by the disease. Stratification among HIV/AIDS-positive individuals is usually the result of extensive studies that aimed to link different aspects, such as gender, class, race and/or age, to the prevalence of the disease. While the intention of developing stratification is to fully understand the disease, its effect to manage and prevent the spread of HIV/AIDS has been suggested and somewhat proven to be detrimental.
Among the stratifications used to classify individuals affected with HIV/AIDS is the socioeconomic status. Socioeconomic status pertains to the condition of an individual’s lifestyle based on his/her income which also determines his/her place or importance in the society. Socioeconomic status plays an important role in determining the success or failure of a health-related intervention aimed at reducing or completely stopping the spread of a disease such as in the case of HIV/AIDS (Hajizadeh, Sia, Heymann, and Nandi, 2014). However, such stratification that solely involves socioeconomic status usually brings more challenge to public health than good (Hajizadeh et al., 2014). Focusing on sub-Saharan African (SSA) countries, a large body of literature written during the early years of HIV epidemic has supported the finding that there is a higher risk of HIV/AIDS related to higher socioeconomic status (SES) (Wabiri and Taffa, 2013). As exemplified by one study, individuals and households belonging to groups with higher incomes are more likely to be engaged in risky sexual behaviors such as having multiple sexual partners with the absence of sufficient information regarding HIV/AIDS status (Wabiri and Taffa, 2013). However, still concentrating on SSA countries, people from the lower income brackets are also becoming equally exposed to HIV/AIDS as people on higher income groups (Wabiri and Taffa, 2013). Such prevalence of HIV/AIDS among individuals in sub-Saharan African countries, both from low- and high-income groups, is attributed to the rapid expansion of sexual networks and increasing popularity of transactional sex (Wabiri and Taffa, 2013). In Uganda, this issue of transactional sex is remarkably noted among fishermen in fishing communities such as Lake Victoria (Kiwanuka, Ssetaala, Nalutaaya, Mpendo, Wambuzi, Nanvubya, Sigirenda, Kitandwe, Nielsen, Balyegisawa, Kaleebu, Nalusiba, and Sewankambo, 2014). Higher incidences of HIV-1 infection are seen to affect more individuals belonging to fisher folk communities (FFC) than those belonging to the general population (Kiwanuka et al., 2014). Such prevalence of HIV among fishermen in Uganda, based on numerous literatures, is caused by the itinerary or migratory nature of work involved in fishing (Kiwanuka et al., 2014). The mobile lifestyle of fishermen in Uganda often keeps them away from their spouses and other social structures which consequently lead them to the services of sex workers, resulting to increased risk of acquiring HIV/AIDS (Kiwanuka et al., 2014). Aside from individuals in fishing industry in Uganda, commercial sex workers, truck drivers and individuals belonging to uniformed services are also some of the common victims of HIV/AIDS (Kiwanuka et al., 2014). Generally, HIV/AIDS prevalence in sub-Saharan African countries in relation to socioeconomic status does not seem to post substantial difference among individuals belonging to either high- or low-income groups (Wabiri and Taffa, 2013). However, HIV/AIDS-positive individuals in high-income bracket have better chance of survival since they can avail of the treatment and other interventions offered and sold to promote survival and alleviate symptoms of the diseases (Wabiri and Taffa, 2013). On the other hand, people from the low-income bracket are less likely to avail of interventions that are currently offered for HIV/AIDS-positive individuals (Wabiri and Taffa, 2013). This unfortunate fact worsens the campaign against HIV/AIDS in African countries, where cases of its occurrence are most prevalent (Wabiri and Taffa, 2013). In a 2005 study, it was drawn that socioeconomic inequality and vulnerability are the primary deterrents of HIV/AIDS intervention rather than poverty alone in sub-Saharan African countries (Wabiri and Taffa, 2013). In a separate study, prevalence of HIV/AIDS in relation to socioeconomic status is measured by Gini Coefficient Index and the countries that showed the greatest results are found to be among the Southern African region, therefore supporting the initial finding that socioeconomic inequality and vulnerability are the deterrents of HIV/AIDS intervention rather than poverty alone (Piot, Greener, and Russell, 2007, Temah, 2008 as cited in Wabiri and Taffa, 2013). While using socioeconomic inequality and vulnerability as a means to measure the epidemiological extent of HIV/AIDS can be useful and helpful in deriving substantial results, its methodologies still remain widely disputed (Wabiri and Taffa, 2013). The method of filtering correspondents for socioeconomic surveys in relation to HIV/AIDS prevalence is considered faulty with the consideration of having the usual amenities such as water, electricity and toilets as the sole determinants of people belonging to high-income groups—the lack thereof considers a household to automatically belong to the low-income groups (Wabiri and Taffa, 2013). This is considered faulty as the original measure of wealth and social status in African countries is through the possession of land, cattle, and agricultural properties—a measure that remains effective despite the Africans’ shift from rural to a more urbanized lifestyle (Wabiri and Taffa, 2013). Aside from the socioeconomic status, HIV/AIDS prevalence is also commonly stratified according to gender.
Being a sexually-related disease, HIV/AIDS is universally associated with gender. The involvement of gender in cases of HIV/AIDS is almost ultimately impossible to eliminate and this is often what gives rise to numerous false myths that stigmatize a certain group of individuals which in return, impedes the application of certain interventions that could have controlled the problem. But, like in the case of socioeconomic status, extensive studies pertaining to the possible causes of HIV/AIDS prevalence have led to the marginalization of women in Africa as the most vulnerable gender in relation to HIV/AIDS incidence (Wabiri and Taffa, 2013). Focusing on African countries, women are considered more vulnerable when it comes to the issue of HIV/AIDS risks (Wabiri and Taffa, 2013). The large involvement of female individuals in transactional sex in African countries is one of the main reasons for the marginalization of women as the gender most affected by HIV/AIDS in African countries (Kiwanuka et al., 2014). In terms of the effectiveness of interventions applied, currently it is known that women have shorter survival time compared to men in USA (Jarrin, Geskus, Bhaskaran, Prins, Perez-Hoyos, Muga, Hernández-Aguado, Meyer, Porter, del Amo, and the CASCADE Collaboration, 2008). Furthermore, women affected with HIV/AIDS were found to have increased risk of developing toxoplasmosis and herpes simplex virus ulcerations compared to men who are also affected by the same disease (Jarrin et al., 2008). In addition to the abovementioned diseases to which women with HIV/AIDS are more susceptible than men, risk for bacterial pneumonia is also increased in HIV/AIDS-positive women while the risk for Kaposi’s sarcoma is reduced (Jarrin et al., 2008). Generally, women are considered to be the most affected of HIV/AIDS and its subsequent complications when taking into consideration gender stratification in relation to HIV/AIDS. Using sex or gender as a means to stratify HIV/AIDS patients is actually helpful as it helps in determining improvements with medications to make them more effective. But this also has negative effects as will be tackled later.
Race is another factor for stratifying HIV/AIDS patients. The prevalence of HIV/AIDS is significantly higher among individuals belonging to black African race (Wabiri and Taffa, 2013). Taking into consideration other races, the question often revolves around the rate of progression between men and women. In USA, HIV-infected women were reported to experience worse complications and shorter survival time after being diagnosed as having the disease compared to men (Jarrin et al., 2008). In European countries, women compared to men showed slower HIV progression to AIDS and death after being exposed to the intervention called highly active antiretroviral therapy or HAART (Jarrin et al., 2008). In a French cohort study, The Spanish Multicenter Study Group of Seroconverters have reported that women who received shots of HAART showed slower HIV progression rates and better outcomes (Jarrin et al., 2008). Clearly, race has played a substantial role in stratifying patients with HIV/AIDS. But, with the evidence presented by the literature reviewed in this section, race has little association with the rate of progression and prevalence of HIV among women and men. Rather, the introduction of the intervention HAART to affected patients is the very factor that contributed more to the issue. The marginalization of black Africans as the race more commonly affected by HIV/AIDS may be brought by the unavailability of intervention for the African population as well as the prevalence of poverty which also limits HIV/AIDS-positive individuals from availing proper treatment and management for their diseases.
Low educational attainment among the African population is also considered as one of the major factors that predispose a population to risks of acquiring HIV/AIDS (Wabiri and Taffa, 2013). Low educational attainment may be linked to the high possibility of unemployment later in life. Such unemployment, which is rather prevalent among the African regions, may cause an individual to settle for occupations which may greatly expose him/her to increased risks of acquiring HIV/AIDS. Also, dropping out of school at an early age or not being able to attend a formal educational setting often predispose youth to increased risks of exposure to HIV/AIDS.
Locating stratifications applied among patients of HIV/AIDS may be helpful in improving existing research as well as debunking false conclusions that often result in large marginalization of a certain group of the society. While formulating stratification among HIV/AIDS patients may help in targeting the specific causes of the disease, it also has its negative impact: The stigma. As mentioned earlier, HIV/AIDS is universally associated with risky sexual behaviors that often include unconventional and deviant sexual practices and approaches. With the absence of a cure or definite course of intervention that eventually clears all traces of the disease, HIV/AIDS is one of the most feared and dreaded diseases and its association to uncanny sexual practices that are deemed immoral by most cultures, stigma becomes one of its inseparable results. HIV/AIDS related stigma often causes negative impacts on familial, social and economic aspects of an individual’s life (Mahajan, Sayles, Patel, Remien, Ortiz, Szekeres, and Coates, 2008). The discrimination associated with social stigma caused by HIV/AIDS is the main culprit that makes the lives of affected individuals so much harder. But aside from the familial, social and economic aspects negatively affected by HIV/AIDS, the stigma that comes with the diagnosis of the disease also gives rise to the barriers that keep patients from seeking professional help and intervention to prolong their survival (Mahajan et al., 2008). As explained by the UNAIDS Executive Director, Peter Piot, the stigma related to HIV/AIDS is one of the main factors that impedes the success of interventions directed at improving the survival rate of HIV/AIDS victims (Mahajan et al., 2008). Effective prevention and treatment program for HIV/AIDS is considered to be hampered by the stigma that is inevitably associated with the patients diagnosed as having the disease (Mahajan et al., 2008). HIV/AIDS stigma affects the attempts at prevention and treatment by reducing the uptake and adherence of patients to treatment and prevention services available and offered to them (Mahajan et al., 2008). Patients with HIV/AIDS, in fear of being rejected or excluded from the society, resorts to keeping their real situation in secrecy, rejecting any attempts at prevention or cure to avoid having to disclose their identity as well as their HIV/AIDS status (Mahajan et al., 2008). Furthermore, HIV/AIDS stigma also hampers the development of an effective vaccine as possible pioneer human subjects reject getting injected with HIV/AIDS vaccine in fear of the experiment backfiring which could result to their acquisition of the disease instead of developing resistance which would then result to stigma (Mahajan et al., 2008). In South Africa, PLHA or persons living with HIV/AIDS who experienced being stigmatized and discriminated for their condition refuse to disclose or reveal their status to their partners which subsequently leads to further transmission of the disease (Mahajan et al., 2008). The same finding was observed among a population of different race. In France, a sample that includes 2000 sexually-active PLHA has reported an inclination to engage in unsafe sex after experiencing stigma and discrimination pertaining to their HIV/AIDS status (Mahajan et al., 2008).
Stigma is included in this study as the stratification formulated to narrow the patients diagnosed with HIV/AIDS often gives birth to discrimination and biased marginalization. The best thing that can be applied to resolve this case is to entirely clarify the findings of a result of a study especially if it inevitably marginalizes one group of the society. Also, results shall be transparent and directive to prevention and/or treatment plan, not in avoiding the marginalized group. Sufficient information and knowledge regarding the issue is also required among policymakers. Like in the case of Uganda, where in 1990s, the president, Mr. Musevemi, exerted needed efforts to address the problem enough to raise it as a nationally important issue—a move which successfully gave birth to several interventions and treatment programs to manage and control HIV/AIDS in Uganda. In contrast to the success story of Uganda, lack of knowledge of the South African president, Mbeki, stating that HIV does not actually cause AIDS, led to the massive problem the country is facing now with regards to the issue of HIV/AIDS—a significant proof that shows how important it is to keep the policymakers not just active in campaign against HIV/AIDS but also sufficiently informed about the issue being discussed or resolved.
Hajizadeh, M., Sia, D., Heymann, S.J., and Nandi, A. (2014). Socioeconomic inequalities in HIV/AIDS prevalence in sub-Saharan African countries: evidence from the Demographic Health Surveys. International Journal for Equity in Health, 13(18), 1-22. DOI: 10.1186/1475-9276-13-18
Jarrin, I., Geskus, R., Bhaskaran, K., Prins, M., Perez-Hoyos, S., Muga, R., Hernández-Aguado, I., Meyer, L., Porter, K., del Amo, J., and the CASCADE Collaboration. (2008). Gender Differences in HIV Progression to AIDS and Death in Industrialized Countries: Slower Disease Progression Following HIV Seroconversion in Women. American Journal of Epidemiology, 168(5), 532-540. DOI: 10.1093/aje/kwn179
Kiwanuka, N., Ssetaala, A., Nalutaaya, A., Mpendo, J., Wambuzi, M., Nanvubya, A., Sigirenda, S., Kitandwe, P.K., Nielsen, L.E., Balyegisawa, A., Kaleebu, P., Nalusiba, J., Sewankambo, N.K. (2014). High Incidence of HIV-1 Infection in a General Population of Fishing Communities around Lake Victoria, Uganda. PLoS ONE, 9(5), 1-9. DOI: 10.1371/journal.pone.0094932
Mahajan, A.P., Sayles, J.N., Patel, V.A., Remien, R.H., Ortiz, D., Szekeres, G., and Coates, T.J. (2008 August). Stigma in the HIV/AIDS epidemic: A review of literature and recommendations for the way forward. NIH AIDS, 22(2), 1-20. DOI: 10.1097/01.aids.0000327438.13291.62.
Wabiri, N., and Taffa, N. (2013). Socio-economic inequality and HIV in South Africa. BMC Public Health, 13(1307), 1-10. DOI: 10.1186/1471-2458-13-1037
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