Education is recognized as a social determinant of health. [1] [2] Education has also been identified as a social vaccine against contracting HIV. [3] Research suggests a negative linear relationship between educational attainment (years of education) and HIV infection rate, especially the educational attainment of women and girls. [4] [5] [6]
The United Nations Educational, Scientific, and Cultural Organization (UNESCO) aims to ensure all individuals, in and out of formal education, have access to comprehensive HIV education. [7] UNESCO is a founding cosponsor of UNAIDS, and in conjunction with partner agencies UNESCO published the International Technical Guidance on Sexuality Education in 2018. [8] [9] This report provides evidence-based guidelines for developing and implementing comprehensive sexuality education curriculum for young people.
Education is a strong factor in improving population health by building in individuals the capacity to process and understand risks related to the HIV/AIDS pandemic. Poor information hinders individuals from analyzing their behavioural choices by masking potential health risks.[ citation needed ]
Inadequate information becomes a risk factor for the spread of sexually transmitted diseases. The mischaracterization of HIV/AIDS as a homosexual disease has led higher status heterosexuals that participate in risky sexual behaviour to continue without considering the risk of infection. [5]
Data analysis collected in Sydney, Australia in 2007 found that within 236 adults, age 20 to 65, respondents were concerned about risks of HIV/AIDS transmitted through casual contact, leading to disapproval of homosexuality and drug use. In contrast, highly educated respondents were shown to be less likely to overestimate the possibility of HIV transmission through casual contact compared to respondents with a lower level education. [10]
In a 2011 study, 1 in 4 students aged 16 and above in England stated they had learned nothing about HIV/AIDS in school, even though learning about sexually transmitted diseases is compulsory for secondary school students in England and Wales. [11]
Stigma associated with those who have HIV/AIDS in Sub-Saharan Africa prevents many from getting tested. As formal education continues to change attitudes towards those living with HIV/AIDS, the reduction of stigma enhances prevention techniques. [12]
A 2016 study in primarily African-American faith-based organizations in South Carolina, United States found that education level was associated with lower levels of stigmatizing attitudes about HIV/AIDS. [13]
A 2020 systematic review showed that financial education increased self-efficacy and lowered vulnerability to HIV in young people in low and middle income countries. In many of the studies in the review, financial education was combined with sexual health education and/or counselling. [14]
In the late 1980s and early 1990s, the introduction of partially accurate information in Sub-Saharan Africa led to a decline in HIV rates among more educated, suggesting they may have the greater cognitive skill required to sift through the various levels of accuracy and mount a more effective response. [12] Increased motivation needed to analyze personal risks and behavioural choices were increased by cognitive abilities enhanced by formal education, suggesting a direct correlation. [12]
A 2018 analysis of data from over 500,000 people in sub-Saharan Africa showed that secondary school completion for women was correlated with a lower likelihood of being HIV positive. [15] However, primary school completion alone, without subsequent secondary school completion, is associated with a higher risk of being HIV positive than not completing primary school. This finding applies to both men and women.[ citation needed ]
A 2018 review of studies on sub-Saharan Africa found evidence that support for girls' and young women's schooling is associated with lower rates of HIV infection. [16] Types of support include cash transfers to families, educational support (such as school fees paid on student's behalf), savings accounts and microcredit, and vocational training.
In Zambia, a 2018 study of over 15,000 women of childbearing age found a strong correlation between educational attainment and uptake of HIV testing. [17] Similar findings were reported in a 2020 study of 2660 women in Ghana. [18]
A study of nearly 25,000 European patients who started combined antiretroviral treatment (cART) between 1996-2013 found that patients with fewer years of education had poorer responses to cART and lower survival. [19]
Studies of the effectiveness of HIV education programs often rely on self-reported information about knowledge and behavior, leading to a possible social desirability bias if subjects report what they think the interviewer wants to think. [20] Encouraging Kenyan students to write essays on way of protecting oneself against HIV/AIDS led to increased self-reported use of condoms without an increase in self-reported sexual activity. There is no evidence to determine whether an increase in condom use by students corresponds to actual reduction in HIV/AIDS. [20]
Early research in Sub-Saharan Africa identified formal education as a risk factor, with more educated individuals being most likely to be infected. [3] By the mid-1990s, education began to shift from risk factor to social vaccine.[ citation needed ]
Some studies have found that educational attainment decreases girls' and women's vulnerability to HIV/AIDS, but does not affect or even worsens boys' and men's risk. [21] [15]
HIV/AIDS originated in Africa during early 20th century and is a major public health concern and cause of death in many African countries. AIDS rates varies significantly between countries, though the majority of cases are concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total population infected worldwide – some 35 million people – were Africans, of whom 15 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 70 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, AIDS has raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, the life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic with life-expectancy in some countries reaching as low as thirty-nine years.
Male circumcision reduces the risk of human immunodeficiency virus (HIV) transmission from HIV positive women to men in high risk populations.
HIV/AIDS has been a public health concern for Latin America due to a remaining prevalence of the disease. In 2018 an estimated 2.2 million people had HIV in Latin America and the Caribbean, making the HIV prevalence rate approximately 0.4% in Latin America.
Sexual and reproductive health (SRH) is a field of research, health care, and social activism that explores the health of an individual's reproductive system and sexual well-being during all stages of their life.
The global epidemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), as of 2021, HIV/AIDS has killed approximately 40.1 million people, and approximately 38.4 million people are infected with HIV globally. Of these 38.4 million people, 75% are receiving antiretroviral treatment. There were about 770,000 deaths from HIV/AIDS in 2018, and 650,000 deaths in 2021. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.
Diseases of poverty are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.
The Caribbean is the second-most affected region in the world in terms of HIV prevalence rates. Based on 2009 data, about 1.0 percent of the adult population is living with the disease, which is higher than any other region except Sub-Saharan Africa. Several factors influence this epidemic, including poverty, gender, sex tourism, and stigma. HIV incidence in the Caribbean declined 49% between 2001 and 2012. Different countries have employed a variety of responses to the disease, with a range of challenges and successes.
Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. Comprehensive sex education, by contrast, covers the use of birth control and sexual abstinence.
Comprehensive sexuality education (CSE) is a sex education instruction method based on a curriculum that aims to give students the knowledge, attitudes, skills, and values to make appropriate and healthy choices in their sexual lives. The intention is that this understanding will prevent students from contracting sexually transmitted infections, such as HIV and HPV. CSE is also designed with the intention of reducing unplanned and unwanted pregnancies, as well as lowering rates of domestic and sexual violence, thus contributing to a healthier society, both physically and mentally.
Abstinence, be faithful, use a condom, also known as the ABC strategy or abstinence-plus sex education, also known as abstinence-based sex education, is a sex education policy based on a combination of "risk avoidance" and harm reduction which modifies the approach of abstinence-only sex education by including education about the value of partner reduction safe sex and birth control methods. Abstinence-only sex education is strictly to promote the sexual abstinence until marriage, and does not teach about safe sex or contraceptives. The abstinence-based sex education program is meant to stress abstinence and include information on safe sex practices. In general terms, this strategy of sex education is a compromise between abstinence-only education and comprehensive sex education. The ABC approach was developed in response to the growing epidemic of HIV/AIDS in Africa, and to prevent the spread of other sexually transmitted diseases. This approach has been credited by some with the falling numbers of those infected with AIDS in Uganda, Kenya and Zimbabwe, among others. From 1990 to 2001 the percentage of Ugandans living with AIDS fell from 15% to between 5 and 6%. This fall is believed to result from the employment of the ABC approach, especially reduction in the number of sex partners, called "Zero-Grazing" in Uganda.
HIV/AIDS in Lesotho constitutes a very serious threat to Basotho and to Lesotho's economic development. Since its initial detection in 1986, HIV/AIDS has spread at alarming rates in Lesotho. In 2000, King Letsie III declared HIV/AIDS a natural disaster. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2016, Lesotho's adult prevalence rate of 25% is the second highest in the world, following Eswatini.
HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).
Mozambique is a country particularly hard-hit by the HIV/AIDS epidemic. According to 2008 UNAIDS estimates, this southeast African nation has the 8th highest HIV rate in the world. With 1,600,000 Mozambicans living with HIV, 990,000 of which are women and children, Mozambique's government realizes that much work must be done to eradicate this infectious disease. To reduce HIV/AIDS within the country, Mozambique has partnered with numerous global organizations to provide its citizens with augmented access to antiretroviral therapy and prevention techniques, such as condom use. A surge toward the treatment and prevention of HIV/AIDS in women and children has additionally aided in Mozambique's aim to fulfill its Millennium Development Goals (MDGs). Nevertheless, HIV/AIDS has made a drastic impact on Mozambique; individual risk behaviors are still greatly influenced by social norms, and much still needs to be done to address the epidemic and provide care and treatment to those in need.
HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.
Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.
Initial events and trends in the discussion of HIV and AIDS in mass media contributed to the stigma and discrimination against those affected with the disease. Later discussion, sometimes led by HIV+ individuals themselves, moved toward advocacy and education on disease prevention and management. The UNESCO report on Journalism Education says, "Well researched television content can create public awareness about HIV prevention, treatment, care and support can potentially influence the development and implementation of relevant policies."
Life expectancy in Nicaragua at birth was 72 years for men and 78 for women in 2016. While communicable diseases such as dengue, chikungunya, and Zika continue to persist as national health concerns, there is a rising public health threat of non-communicable diseases such as diabetes, cardiovascular disease, and cancer, which were diseases previously thought to be more relevant and problematic for more developed nations. Additionally, in the women's health sector, high rates of adolescent pregnancy and cervical cancer continue to persist as national concerns.
Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981 and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.
Nyovani Janet Madise is the current director of research and sustainable development policies and head of the Malawi office of the African Institute for Development Policy. She is an advisor to the World Health Organization and a former professor at the University of Southampton in demography and social statistics. Nyovani has over 100 peer-reviewed research publications that focus on global health issues to highlight the influence of social and economic factors on health in low-income countries.
Human sexual promiscuity is the practice of having many different sexual partners. In the case of men, this behavior of sexual nondiscrimination and hypersexuality is referred to as satyriasis, while in the case of women, this behavior is conventionally known as nymphomania. Both conditions are regarded as possibly compulsive and pathological qualities, closely related to hyper-sexuality. The results of, or costs associated with, these behaviors are the effects of human sexual promiscuity.
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