HIV/AIDS and Adolescents

South Pacific and Caribbean

Prem Misir

• Publisher: Palgrave Macmillan
• Year: 2019
• Print ISBN: 9789811359880
• eBook ISBN: 9789811359897
• Topic: Business
• Subtopic: Management
• Index: Business

This book addresses the relationship between high school students' HIV and AIDS knowledge and their stigma-related attitudes/perceptions of people living with HIV (PLHIV) in the Caribbean and South Pacific, with a view to designing effective stigma-reduction combined intervention programs.

Presenting an international cross-sectional study using a purposive sample of high school students from Fiji (South Pacific), Vanuatu (South Pacific), Guyana, and Antigua & Barbuda (Caribbean) to assess HIV and AIDS knowledge and stigma-related attitudes by gender, age, religion, race/ethnicity, and socioeconomic status, the book shows how stigmatizing attitudes and beliefs negatively impact interventions to prevent and treat HIV and AIDS.

© The Author(s) 2019

Prem MisirHIV/AIDS and Adolescentshttps://doi.org/10.1007/978-981-13-5989-7_1

Begin Abstract

1. Introduction

Prem Misir¹

(1)

The University of the South Pacific (USP), Solomon Islands Campus, Honiara, Solomon Islands

Prem Misir

End Abstract

Three and half decades ago, a major public health phenomenon, more dreadful than the Black Death, descended upon humankind. This phenomenon which continues to plague the global population is Acquired Immunodeficiency Syndrome (AIDS), the end-stage of the Human Immunodeficiency Virus (HIV). HIV is the virus that produces AIDS, and AIDS emerges at the later stages of the HIV infection. Even though there are precautionary measures that people can take to avoid or limit their chances of contracting this fatal virus, HIV/AIDS remains a serious threat to human existence because at this time, the virus is transmittable as well as incurable. In the search for a cure, technical clinical skills remain a potent necessity. At the same time, in the absence of a cure, behavioral skills and knowledge, possible preconditions for behavioral changes, persist as an absolute necessity to stem the flow of HIV transmission.

There is a view out there that presents AIDS not as an epidemic, but a plague (Roell 2018). This view suggested that the term ‘epidemic’ does not depict the full gamut of human suffering. This interpretation probably implies that this is the first disease that impacts each person in a family, and the communities where they live and work, and, indeed, the disease is global. Undeniably, many developing countries are at the mercy of this epidemic. These factors place developing countries at high risk for transmitting HIV: illiteracy, low per capita income, gender discrimination, inadequate HIV transmission knowledge, and social stigma (Othman 2014). Population growth, urban migration, sociocultural barriers, and deficient prevention activities also could contribute to HIV/AIDS transmission (UNAIDS 2012).

UNAIDS (2018) presented the following global statistics:

• 36.9 million PLHIV in 2017.
• 21.7 million people had access to antiretroviral therapy in 2017.
• 1.8 million people were newly infected with HIV in 2017.
• 940,000 people succumbed to AIDS-related illnesses in 2017.
• 77.3 million people were HIV-infected since the commencement of the epidemic in 1981.
• 35.4 million people died from AIDS-related illnesses since the commencement of the epidemic in 1981.

PLHIV

• In 2017, PLHIV numbered 36.9 million, of which 35.1 million were adults and 1.8 million were children < 15 years.
• 75% of PLHIV were aware of their HIV status in 2017, but circa 9.4 million people were unaware that they contracted HIV.

PLHIV with Access to Antiretroviral Treatment

• In 2017, 21.7 million PLHIV had access to antiretroviral therapy, a rise of 2.3 million since 2016 and an increase from 8 million in 2010.
• In 2017, 59% of all PLHIV had access to antiretroviral treatment.
• In 2017, 80% of HIV-infected pregnant women had access to antiretroviral treatment.

New Infections

• In 2017, new HIV infections showed a 47% reduction, since its highest number in 1996.

90–90–90

• In 2017, 3 out of 4 PLHIV (75%) were aware of their HIV status.
• Among PLHIV who were aware of their status, 4 out of 5 of them (79%) had access to antiretroviral treatment.
• Of those accessing treatment, 4 out of 5 (81%) experienced viral suppression.
• 47% of all PLHIV were virally suppressed.

Women

• Each week, some 7000 young women aged 15–24 contract HIV.
• In excess of one-third (35%) of women globally experience physical and/or sexual violence; in some regions, women who are victims of violence are one and a half times more probable to contract HIV.

HIV/Tuberculosis (TB)

• TB is the leading cause of death among PLHIV, generating 1 in 3 AIDS-related deaths.
• In 2016, 10.4 million people contracted TB, of which 1.2 million were PLHIV. PLHIV with no TB symptoms should have TB preventative therapy, which may reduce the risk of contracting TB and could cut TB/HIV death rates by about 40%.

Unquestionably, there have been considerable gains in the fight against HIV and AIDS. UNAIDS (2018) provided some regional statistics for 2017, thus:

• Eastern and Southern Africa which is the world’s most HIV and AIDS-ravaged region had about 12.9 million people with access to treatment; there were 19.6 million PLHIV; in addition, there were 380,000 AIDS-related deaths.
• In the Asia and Pacific region, there were 5.2 million PLHIV; 2.7 million persons with access to treatment; 280,000 new infections; and 170,000 AIDS-related deaths.
• In Latin America, there were 1.8 million PLHIV; 100,000 new infections; 37,000 AIDS-related deaths; and 1.1 million people with access to treatment.
• In the Caribbean, there were 310,000 PLHIV; 15,000 new infections; 10,000 AIDS-related deaths; and 181,000 persons with access to treatment.

Figure 1.1 provides a sense of the current HIV/AIDS scenario: there were 36.7 million PLHIV in 2016 (36.9 million PLHIV in 2017); only 70% knew that they were HIV positive; about 50% of PLHIV had access to treatment; and about 44% had untraceable levels of HIV. And so, there was the need for a new strategy to combat HIV and AIDS, thus, the current pursuit of the 90–90–90 treatment target: by 2020, 90% of PLHIV will know their HIV status; by 2020, 90% who will know their HIV status will receive treatment; and by 2020, 90% receiving treatment will have a repressed viral load (UNAIDS 2016). UNAIDS favors this strategy because it is not possible to end the AIDS epidemic without antiretroviral treatment.

Fig. 1.1

90–90–90 treatment for all (

Source [UNAIDS 2016])

Significance of Study

The evidence is clear that significant advances continue to penetrate almost every dimension of the fight against HIV and AIDS. But advancements for adolescents are still way behind. The WHO defines adolescents as persons within the 10–19 age group (WHO 2018). In this multi-country study, the high school students were adolescents, who constituted on average about 20% or one-fifth of the total population in each of the four countries (Fiji, Vanuatu, Antigua and Barbuda, and Guyana).

The United Nations Children’s Fund (UNICEF) (2018) n...

Table of contents

• Cover
• Front Matter
• 1. Introduction
• 2. A Systematic Review of the Literature
• 3. Methodology
• 4. HIV/AIDS Knowledge
• 5. HIV/AIDS Stigma
• 6. Predictors of HIV/AIDS Knowledge and HIV-Related Stigma
• 7. Discussion and Implications
• Back Matter