HIV: Public Health Challenges, Stigma, and Global Socioeconomic Impact

This essay provides a comprehensive overview of HIV, addressing its introduction, transmission mechanisms, and the impact on global public health. It explores the virus's effect on the immune system, the role of biomedical and lay perspectives in treatment and prevention, and the influence of social stigma. The essay highlights the importance of collaborative approaches between healthcare structures and affected communities to overcome barriers to treatment and promote effective public health interventions. It also examines the socioeconomic consequences of HIV, including its impact on individuals, families, and economies, as well as the environmental and host factors that contribute to its spread. The essay emphasizes the need for education, vaccine development, and the importance of addressing environmental and social determinants to combat the HIV epidemic effectively.

HIV (Human Immunodeficiency virus)
Introduction
HIV is considered as one of the challenges to the life of human and dignity. It gives direct impact on the
levels of society and also gives impact on the global economic and social development. It is a virus that
directly attacks the immune system. The virus gives negative impact on the white blood cell in the immune
system named as T helper cell and makes many copies of it inside the cells. The biomedical concept is
taken into consideration and it remains as a dominant concept related with health. It states that the body is a
machine that comprises of various parts working together. If one part is not functioning properly, then
proper diagnosis takes place and it is healed by taking medicines prescribed by a doctor. Pharmacology is
considered as a treatment that is beneficial in the treatment of HIV.
It is assessed that to promote biomedical, the alternatives approaches are taken into consideration to
heal the problem of an individual. The biomedical approach can be unsuitable for some communities and
also it generates the feeling of helplessness and gives impact on the success of the interventions. The
concept that is related to health and illness are diverse and also complex as compared to the medical model.
It gives the main emphasis on the health of an individual and also it is related to the complete life
experiences that are concerned with local and cultural structures. But the biomedical approach heals the
whole person by connecting the illness of an individual with the person's social and economic background.
The critics are evaluated of this model that the concept is very difficult to analyze and also it remains
marginalized and also less recognized. On the contrary, Taylor (2003) states that lay perspective is
considered as an important knowledge for the health of the public as it searches the root of illness for giving
treatment to a large population if the comparison is made with the individual focused interventions. The
medical model creates hindrance in enhancing and creating prevention of the diseases like HIV (Wouters et
al. (2016).
In the theory of Goffman (1990), it assists to understand that how the stigma is built and how it
influences the lives of the people that create the boundaries between those in power and those do not have
the power (Attell,2013). By the power the social inequality is created that lead to creation of social norms.
The stigma is formulated that helps to interact with people and also power structure that helps to maintain
control of the powerless. Both the theories are taken into consideration in HIV and are concerned to
1

showcase that how negative attitude, abuse are directed towards PLWHA have given direct impact on the
progress of treatment and prevention (Ngo et al., 2013).
The investigation has highlighted that stigma in health care settings are taken from social power
imbalances that give contribution to keep the people away from the treatment of HIV. Also, the patients feel
sad and disappointed when they analyzed that the health workers are feeling uncomfortable and also giving
treatment in an inferior manner (Rodger et al., 2014). In Tanzania, there are many discriminatory practices
like talking about the HIV status, neglect and also discloses the information without the consent of the
patients. Also, it is evaluated that in many countries the health workers disclose the status of HIV patients to
their families without giving information to the patients. In most of the studies, harassment and also
avoiding the patients who are suffering from HIV positive are the common features that are analyzed. There
are many health workers who used protective clothing even when there is no physical interaction at the time
of interactions (Matheson et al., 2013).
The literature on HIV and also to access the health services is negative as the evidence is evaluated
and also the HIV services were de stigmatizing in various parts of the globe. Brazil has also taken into
consideration the model by PLWHA. For them, it is the supportive structural system that enhances healthy
environments and promotes the participation of various groups in the society and also in the government. In
South Africa, many people rely on traditional healing. In the prevention of HIV, Aids Activism plays a
great role by converting the biomedical approach in the framework of ideologies (Earnshaw et al., 2013).
The literature states that for effective control of HIV it is important to have collaboration between
lay perspectives and biomedical approach. It is also evaluated that there is no cure for AIDS but it can
enhance the life by reducing the level of HIV in the body, it delays the process between the HIV and AIDS.
According to the World Bank, There are 60 million people who are living with HIV globally. Also, the
treatment has enhanced but as it is analyzed that for every 100 people on treatment, 250 people get infected.
The people are only trusting biomedical approach for treatment and care of HIV (Katz et al., 2013).
By analyzing the UNAIDS Report on the Global AIDS Epidemic 2010, it is seen that in total 7
countries the HIV has enhanced by 25 percent between 2001 and 2009. Sub Saharan Africa, is considered
as the area that is highly affected by the epidemic and also it shows the signs in reducing the positive
behavior due to the enhancement of the services that are related to the local culture (Joint United Nations
2

Programme on HIV/AIDS & UNICEF, 2010).The challenges that are given by HIV to the global public
health are, the Baum says collective participation fight can be conducted against the disease. She stated that
the community level mobilization is when there is an effective partnership between the structure and the lay
people (Campbell & Foulis, 2004). This is then supported by the farmer who does not consider the dominance
of biomedical in health and healing (Norris et al., 2014).
He considers that the lay people have an important role in the health improvements and also gives
focus on the significance of understanding the experience of lay people for conducting successful
interventions. He showed that the health care services should be easily visible to PLWHA .Also; the
professional of healthcare should give knowledge about the impact of stigma on patients and policies that
enhances inclusion of PLWHA in decisions that gives direct impact on the lives (Wu & Li, 2013). Parker
and Aggleton, (2003) also stated that collective participation between the lay people and health structures
plays as a successful anti-stigma services (Parker & Aggleton, 2003).
It is evaluated that the health structure and PLWHA can be enhanced by involving lay people
through advocacy. If the involvement is high of PLWHA, then the focus is given on the principle of PLWA
because the situation can be analyzed in an effective manner (Li et al., 2015). Also, the voices can listen if
the needs are showcased by people in the same situation. In the study of Zambia, it is seen that the
professionals who are living with HIV are in the position to sponsor for the people who access the services.
Baum states that the advocacy consists of public health a practitioner who gives direct influence on the
barriers in the health of the public. Literature also states that the concept of health and healing helps to
access the services that give treatment and prevention from AIDS (Herek et al., 2013).The biomedical
approach is related to the concept of health and illness through science and expertise by giving emphasis on
the individual. The lay concept considers health and healing as surrounded by the local, social and cultural
structures and also it considers the public health for a wide population. The literature also advises the
approach is effective in the prevention of HIV. The arguments give significance on collaborating the
models. So there is the need of the intervention programmers so that holistic approach can be developed and
also proper understanding should be taken into consideration (World Health Organization, 2016).
Role of Agent
Before the identification of HIV as the causative agent of AIDS, the principal mode that is
considered in the transmission was through the contaminated blood. There are 13,000 cases of AIDS that
3

have occurred among hemophiliacs in the United States. There are two reasons due to which the risk
categories are reduced, screening of blood and also to prevent the individual from donating the blood. It is
also analyzed that HIV is transmitted through the maternal blood that enters by the circulation of fetal
circulation virus at the time of labor and delivery. The postnatal HIV infection can take place via
breastfeeding and also include 14 percent of the HIV infections at the time of delivery. The virus can easily
enter the body through infected cells. The transmission mode considers the initial cells that encounter virus.
Indication suggests that in the sexual transmission 1 variant of HIV Can reduce the frequency in order to
pass to the recipient (Brown et al., 2016).
Host and Environmental factor
HIV is enhancing in context with the socioeconomic problem. There are many factors that cause
poverty, cultural aspects and also it is essential for the rapid and global development of AIDS epidemic. It
is a virus that is caused due to the deficiency in the human. It is important to have a proper scientific
knowledge that is essential to prevent AIDS. The progress is made in which micro bides are developed and
also there is anti-infective medication that is formulated to prevent HIV. It is also important that the
development should be supported by the education campaigns that geared women perspective to safeguard
themselves and their children from the transmission of HIV (Yusuf et al., 2015). It is significant that the
vaccine development should take place in a proper manner. In the recent scenario, the environmental
awareness has attained the attention of the public.
The influence is also put on the environmental factors like weather, personal attitudes and also on
policies that have infected the life of the persons. In the idea of a vaccine, the edible tissue of transgenic
crop plants has also achieved a great success (Emlet et al., 2015).It has a negative impact on the economies
of many countries. The magnitude of the demographic and economic impact is reducing the health gains
that are made in the last few decades. People with HIV create a burden on the public finance and the major
impact was on the health sector. The impact of HIV is on the individuals and also on their families. There
are many cases that have resulted in the loss of the income and also enhanced expenditure. The families that
are affected by HIV reduce the savings and assets so that the expenditure and income shocks can be attained
(Siegel et al., 2015). It has also reduced the profits and labor productivity due to the enhancement in the
AIDS expenditure. ILO evaluates that thirty-seven million people globally are involved in the productive
economic activities are HIV positive. It has also given impact on employment, relationships and also on the
social reactions of the community members. HIV has also given impact on the parenthood. It is stated that
4

70 percent of the parents who are HIV infected taken into consideration that their family planning is over,
as it is not possible to bear any more child (Masur et al., 2014).
The children suffering from HIV have a high risk of death and also the direct impact is given on the
psychology of the children. The study states that genetic measurements should be straightforward and
should also measure the environmental exposure. There are various challenges to overcome the
environmental factors. The multivariate models require validation both internally and externally. The
research also investigated that the social and health factor that is related to the HIV infection. If there is a
higher rate of prevalence and also the availability is easy of the physicians then the prevention can be made
easily by the HIV. If there is a high rate of an adolescent fertility rate that can easily enhance the epidemic.
It is also evaluated that HIV gives impact on the family, community, and country (Bennett et al., 2014).
Potential Policy Responses
It is analyzed that in the countries of central Asia the HIV is enhancing globally, and also it has been driven
by injecting drug use. There are various approaches that give support to children who are affected by HIV.
It gives direct and indirect impact on the rights of children and also the consequences of the impact can be
minimized if the qualities of health and education services are accessed. There are four major principles
related to the rights of children: The right to survive and also to protect from the neglection and from abuse,
the right to listen and to raise the voice and also the right related to freedom from discrimination. Right
based programming is also related to prevention, care, protection and impact mitigation. It focuses on
promoting the participation of the children in implementing the HIV programmes (Okoror et al., 2014).
The global strategy is taken into consideration so that the guidance can be attained for the orphans and also
for the infected children by HIV. The strategies that are analyzed have the aim to: Enhance the capacity of
the families so that the protection and care can be given to orphans and to the infected children. It also
ensures that the essential services should be given to the orphan and infected children that consist of
education and health. It is also analyzed that awareness is essential for creating a supportive environment
for the children and also for families who are directly affected by HIV. The strategies are considered as an
important aspect that is required for effective care and support (Insight Start Study Group, 2015).
5

There are various policies and practices that have given significant improvement in the lives of the affected
children. It consists of policies and laws that hold the property rights of the orphan. The school education is
given for free with the subsidiary and the good governance is supported and promoted. Government
programs play a significant role in assisting care for people with HIV but it is evaluated that there are some
limitations. The limitations are: Some people do not consider the early therapy because of some rules
related to eligibility. The goals and the standards of HIV are related to the primary care so that the disease
can be monitored and also effective therapy that is based on the clinical indicator for the progression of
disease (Cohen et al., 2016).
The majority of funds are provided in context with the Care act that is distributed with the community
input. The care Act gives emphasis on the role of planning and also in decision making with the
involvement of the community and also it meets the needs of HIV. Congress also considered the unmet
needs of the communities. In 1999, Congress has given funds to assist a minority HIV people. The main
aim of the member of the community is to give a response to the HIV Epidemic (Oni & Unwin, 2015). The
congressional Black caucus also played a significant role in creating the initiatives and also to consider the
priority of funding. Medicaid is one of the public programs that give drug coverage. Under this, the drug is
considered as an optional service that should be provided by the state. There are very important variations
to cover the policies from state to state and also to limit the number of prescriptions that are given and filled
each month (Breet et al., 2014).
In many states, an individual who is disabled and eligible for the income-related with supplemental income
qualifies for Medicaid. The SSI is an income support program that is conducted by the social security
administration for low-income group. The program that is related to social security disability gives income
support payments to the workers who are considered as disabled. The state gives an offer of providing full
Medicaid benefit to the individuals that consist of disabilities and also the income that is more than the
income level. The state also considers a certain amount to disregard and also gives focus on determining the
eligibility criteria of Medicaid (Deeks et al., 2013).
The high ability of the policy refers to collect, analyze and also to use the data and the result of health
policy that helps to implement in an effective manner. HPP give strength to the governments, individuals
and also to the society to frame the policy to develop and implement to give a boost to the national efforts
related to HIV. The biological, behavioral and also structural plays a great role and also there is a higher
risk for HIV transmission rather than for other individuals (Hanson et al., 2014).
6

Conclusion
So, it is analyzed that there are many individuals who are affected by the virus. The direct impact is on
contracting and also living with the virus is a great challenge for the individual. The direct impact is
considered by analyzing the effectiveness of the management program and also it is related to the
prevention of new infections. The main challenge is to encourage HIV testing by considering the risk
groups and the care should be given who are living with HIV. It is essential to take corrective steps and also
to consider prevention methods so that it cannot be spread easily. At the time of prevention, it is essential
that physical and psychosocial impact should be taken into consideration of the virus. The policies and
procedures should consider the wants of the individuals, families and of the community so that the impact
on the various sectors can be addressed properly. Also, it is evaluated that the biomedical and lay
perspective approach helps to prevent HIV and also enhances the benefits. The holistic approach should be
considered that collaborates the model of HIV. It gives impact on lot of the lives of an individual and also
through the collective action of the society and also by the national support it can be controlled.
7

References
Attell,B.K.(2013). Social contact theory: A framework for understanding Aids related stigma. The journal
of public and professional Sociology.
Bennett, J. E., Dolin, R., &Blaser, M. J. (2014). Principles and practice of infectious diseases (8th ed.).
Elsevier Health Sciences.
Breet, E., Kagee, A., &Seedat, S. (2014). HIV-related stigma and symptoms of post-traumatic stress
disorder and depression in HIV-infected individuals: does social support play a mediating or
moderating role?. AIDS care, 26(8), 947-951. doi:10.1080/09540121.2014.901486
Brown, M. J., Serovich, J. M., Kimberly, J. A., & Hu, J. (2016).Psychological reactance and HIV-related
stigma among women living with HIV. AIDS care, 28(6), 745-749.
Doi:10.1080/09540121.2016.1147015
Campbell, C., & Foulis, C. (2004). Creating contexts for effective home-based care of people living with
HIV/AIDS. Curationis, 27(3), 5-14.
Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy,
N., ...&Godbole, S. V. (2016). Antiretroviral therapy for the prevention of HIV-1 transmission. New
England Journal of Medicine, 375(9), 830-839. doi:10.1056/NEJMoa1600693
Deeks, S. G., Lewin, S. R., &Havlir, D. V. (2013). The end of AIDS: HIV infection as a chronic
disease. The Lancet, 382(9903), 1525-1533. doi:10.1016/S0140-6736(13)61809-7
Earnshaw, V. A., Smith, L. R., Chaudoir, S. R., Amico, K. R., &Copenhaver, M. M. (2013). HIV stigma
mechanisms and well-being among PLWH: a test of the HIV stigma framework. AIDS and
Behavior, 17(5), 1785-1795. doi:10.1007/s10461-013-0437-9
8

Emlet, C. A., Brennan, D. J., Brennenstuhl, S., Rueda, S., Hart, T. A., &Rourke, S. B. (2015). The impact
of HIV-related stigma on older and younger adults living with HIV disease: does age matter?. AIDS
care, 27(4), 520-528. doi:10.1080/09540121.2014.978734
Hanson, M. A., Gluckman, P. D., & Godfrey, K. M. (2014).Developmental epigenetics and risks of later
non-communicable disease.In Hormones, Intrauterine Health and Programming (pp. 175-
183).Springer International Publishing. doi:10.1007/978-3-319-02591-9_12
Herek, G. M., Saha, S., &Burack, J. (2013). Stigma and psychological distress in people with
HIV/AIDS. Basic and Applied Social Psychology, 35(1), 41-54. doi: 10.1080/01973533.2012.746606
Insight Start Study Group. (2015). Initiation of antiretroviral therapy in early asymptomatic HIV
infection. N Engl J Med, 2015(373), 795-807. doi: 10.1056/NEJMoa1506816
Joint United Nations Programme on HIV/AIDS., & UNICEF. (2010). Children and AIDS: Fifth Stocktaking
Report, 2010. UNICEF.
Katz, I. T., Ryu, A. E., Onuegbu, A. G., Psaros, C., Weiser, S. D., Bangsberg, D. R., & Tsai, A. C. (2013).
Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. Journal
of the International AIDS Society, 16(3Suppl 2). doi: 10.7448/IAS.16.3.18640
Li, L., Liang, L. J., Lin, C., & Wu, Z. (2015).Addressing HIV stigma in protected medical settings. AIDS
care, 27(12), 1439-1442. doi: 10.1080/09540121.2015.1114990
Masur, H., Brooks, J. T., Benson, C. A., Holmes, K. K., Pau, A. K., & Kaplan, J. E. (2014). Prevention and
treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from
the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine
Association of the Infectious Diseases Society of America. Clinical infectious diseases, 58(9), 1308-
1311. doi: 10.1093/cid/ciu094
Matheson, G. O., Klügl, M., Engebretsen, L., Bendiksen, F., Blair, S. N., Börjesson, M., ...& Khan, K. M.
(2013). Prevention and management of non-communicable disease: the IOC consensus statement,
Lausanne 2013. Br J Sports Med, 47(16), 1003-1011. doi: 10.1136/bjsports-2013-093034
Ngo, V. K., Rubinstein, A., Ganju, V., Kanellis, P., Loza, N., Rabadan-Diehl, C., &Daar, A. S. (2013).
Grand challenges: integrating mental health care into the non-communicable disease agenda. PLoS
medicine, 10(5), e1001443. doi: 10.1371/journal.pmed.1001443
Norris, S. A., Anuar, H., Matzen, P., Cheah, J. C. H., Jensen, B. B., & Hanson, M. (2014). The life and
health challenges of young Malaysian couples: results from a stakeholder consensus and engagement
9

study to support non-communicable disease prevention. BMC public health, 14(2), S6.
doi:10.1186/1471-2458-14-S2-S6
O’Neil, A., Jacka, F. N., Quirk, S. E., Cocker, F., Taylor, C. B., Oldenburg, B., &Berk, M. (2015). A shared
framework for the common mental disorders and non-communicable disease: key considerations for
disease prevention and control. BMC psychiatry, 15(1), 15. doi:10.1186/s12888-015-0394-0
Okoror, T. A., BeLue, R., Zungu, N., Adam, A. M., &Airhihenbuwa, C. O. (2014). HIV positive women's
perceptions of stigma in health care settings in Western Cape, South Africa. Health care for women
international, 35(1), 27-49. doi: 10.1080/07399332.2012.736566
Oni, T., &Unwin, N. (2015). Why the communicable/non-communicable disease dichotomy is problematic
for public health control strategies: implications of multimorbidity for health systems in an era of
health transition. International health, 7(6), 390-399. doi: 10.1093/inthealth/ihv040
Parker, R., & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination: a conceptual
framework and implications for action. Social science & medicine, 57(1), 13-24.
Rodger, A., Bruun, T., Cambiano, V., Vernazza, P., Strada, V., & Van Lunzen, J. (2014, March). 153LB:
HIV transmission risk through condomless sex if HIV+ partner on suppressive ART: PARTNER
Study. In 21st Conference on Retroviruses and Oppotunistic Infections (pp. 3-6). Retrieved from
http://www.croiconference.org/sites/default/files/abstracts/153LB.pdf
Siegel, J., Yassi, A., Rau, A., Buxton, J. A., Wouters, E., Engelbrecht, M. C., ...&Nophale, L. E. (2015).
Workplace interventions to reduce HIV and TB stigma among health care workers–Where do we go
from here?. Global public health, 10(8), 995-1007. doi:10.1080/17441692.2015.1021365
World Health Organization. (2016). Consolidated guidelines on the use of antiretroviral drugs for treating
and preventing HIV infection: recommendations for a public health approach. World Health
Organization. Retrieved from
http://apps.who.int/iris/bitstream/10665/208825/1/9789241549684_eng.pdf
Wouters, E., Rau, A., Engelbrecht, M., Uebel, K., Siegel, J., Masquillier, C., ...&Yassi, A. (2016). The
development and piloting of parallel scales measuring external and internal HIV and tuberculosis
stigma among healthcare workers in the Free State Province, South Africa. Clinical Infectious
Diseases, 62(suppl_3), S244-S254. doi:10.1093/cid/civ1185
Wu, L., & Li, X. (2013). Community-based HIV/AIDS interventions to promote psychosocial well-being
among people living with HIV/AIDS: a literature review. Health Psychology and Behavioral
Medicine: An Open Access Journal, 1(1), 31-46.
10