HIV/AIDS AND ITS EFFECTS ON SOCIETY CONT. 3

HIV/AIDS and Socio-economic impact on society:

Human development is the end, economic growth the means. The purpose of wealth should be to enrich people's lives, to broaden people's choices and to enable every citizen, every child, every woman and every man to reach his or her full potential. But HIV has found a wealth of opportunities to thrive among tragic human conditions fueled by poverty, abuse, violence, prejudice and ignorance.

Social and economic circumstances contribute to vulnerability to HIV infection and intensify its impact, while HIV/AIDS generates and amplifies the very conditions that enable the epidemic to thrive. Just as the virus depletes the human body of its natural defenses, it can also deplete families and communities of the assets and social structures necessary for successful prevention and provision of care and treatment for persons living with HIV/AIDS. This is demonstrated by the estimated millions of people living with HIV/AIDS world wide, mostly in developing countries the reports suggest. And a sizable number of those infected die from HIV/AIDS and related illnesses yearly suggesting that the epidemic is not slowing down fast enough. The impact of HIV/AIDS extends beyond those living with the virus, as each infection produces consequences which affect the lives of the family, friends and communities surrounding an infected person.

The overall impact of the epidemic encompasses effects on the lives of multiples of the millions of people living with HIV/AIDS or of those who have died. Those most affected by HIV/AIDS are children. Children are affected by HIV/AIDS in ways that can diminish their childhoods and as a result limit choices and opportunities for successful survival throughout their lives.

The circumstances of an individual's life and their social context in family and community during childhood can increase the probability they will one day be exposed to, and infected by, HIV. In order to develop appropriate means of enabling and protecting people, either as children or as adults, against infection and the effects of HIV/AIDS, adequate and judicious attention needs to be given to the rights and realities of childhood.

Children living in poverty because of being orphaned due to HIV/AIDS or other related cases are especially prone to victimization and in most cases become an easy pray for traffickers- as commodities for sale in local and global sexual prostitution and pornography industries.

The roles that children fill as poor, hungry, exploited and abused human beings increase their vulnerability to HIV infection. This can occur directly through those activities known to be associated with transmission, or indirectly as when the earlier harm turns children into vulnerable adults. For example those with a history of childhood physical or sexual abuse have also been found in adolescence or adulthood to be more likely than non-abused peers to engage in behaviors that place them at high risk of HIV infection.

Poverty as among the Leading Promoters of HIV and AIDS:

Poverty is clearly a factor in the spread and impact of HIV/AIDS. The struggle to survive everyday overshadows attention and concern about a virus that does not demonstrate any immediate harm. HIV/AIDS is a distant threat until it has a visible presence manifested by illness and death. Poverty, in depriving people of access to health facilities, schools and media also limits their access to information and education on HIV/AIDS.

Poverty pushes families, often unaware of the risks, to send children into the work force or to hand them over to recruiters promising jobs in a distant place where, unprotected, they might be forced into a childhood of harsh labor or sexual abuse. When HIV/AIDS appears in an already impoverished household- there are limited means for response. The mortality rate is high, the impact is severe and the pressures and pain of poverty increases. As increasing numbers of infected young adults are unable to contribute to their communities through their work as parents, teachers, laborers, drivers, farmers, etc., entire economic and social structures of communities suffers and demands for services increase with fewer able people to provide them. And there comes the big danger of the whole society being wiped out. Although life-saving drug regimens have dramatically decreased mother-to-child transmission of HIV and have kept mothers well and alive longer in the industrialized countries, poverty and the lack of necessary medical infrastructure and services make them inaccessible in those places where they are most needed.

Many women who know that they have tested positive for HIV may have no choice but to breast feed their babies when clean water and formula are unobtainable, even though they risk transmitting infection to their babies. Without access to health care or a nutritious diet, infected infants often die before they are two or three years old. For those who survive longer, or the uninfected ones whose parents or guardians are incapacitated by HIV/AIDS, or those orphaned- childhood can be dramatically shortened in other ways.

The illness or death of parents or guardians because of HIV/AIDS can rob a child of the emotional and physical support that defines and sustains childhood. It leaves a void where parents and guardians once provided love, protection, care and support. Since HIV is often (but by no means always) transmitted to sexual partners, children are more likely to lose both parents to HIV/AIDS. Someone is needed to step into parental roles so that children can survive and develop into healthy and productive adults. Grandparents, aunts, uncles or other caring adults frequently assume responsibilities that enable children to remain in their homes or take them into their own families and households. However, where the infection rate is high or harsh social or economic conditions exist, adults may be unable to assume the additional responsibilities of these families and children affected by HIV/AIDS. Other barriers grow out of ignorance and social attitudes. Fear of discrimination leads to families keeping secret the knowledge of HIV infection and AIDS within the household rather than seeking help. Others seek help but are rejected or abandoned, even by family members, when they reveal the nature of the illness. Fear, discrimination, ignorance, and social stigma associated with HIV/AIDS, in addition to overwhelming demands on caring adults, leave children isolated with their grief and suffering while they watch parents and other loved ones die as the families languish.

In many families and communities the environment for healthy growth and well-being has been devastated by HIV/AIDS. Instead of receiving special care and assistance, childhood is spent providing care and assistance. Children become decision-makers, responsible for the social and economic future of the family, and fill these roles without the physical and emotional protection, guidance and support that, as children, they deserve. They may act like adults, but it cannot be forgotten that these are still children acting (heads of households) and are children whose childhoods have been impoverished by HIV/AIDS. In such households, all children are affected. The care that older siblings can provide for younger children is likely to be inadequate because of the increased poverty of the household and the lack of maturity and experience of the caretaker, leading to poor health, hygiene and nutrition; absence from school, and developmental delays. The loss of material, emotional and developmental support from an adult exposes children to the distress which results from lack of affection, insecurity, fear, loneliness, grief or despair. It limits the possibility of a successful childhood which, in turn, affects the future as adults.

Solutions that Address Reality:

Protecting Well-being

The problems the children are facing are monumental but so is the HIV epidemic which weaves through us all. The social context cannot be ignored or neglected in efforts to contain the virus. If success in prevention, treatment and cure is ever going to reach the majority of the population of the world affected by HIV/AIDS, then the elimination of conditions which nurture and strengthen its hold on individuals and communities and which provide obstacles to prevention and care must be zealously sought.

Prevention is usually easier than cure and recovery not only in matters of physical health but in all ways that affect the total well being of persons. Opportunities that foster the well being of a person begin in the uterus and depend on long term support from others. This dependency and support must exist throughout childhood only diminishing as the child approaches adulthood equipped with the strength and skills for independence and self sufficiency. The lifelong well being of a person depends on opportunities for the development of strengths and skills during childhood.

Aiding and Protecting Development:

Sustainable development, simply stated as the continued ability to develop and provide for one's needs, is a concept that can be applied to individuals or societies. The process towards the sustainable development of a human being, childhood, takes place at the center of many interdependent layers of social structures. The first tier is most often the basic social unit of the family. Outside the boundaries of the family the child is enveloped in broader social components of the community - extended family, peer groups, school, social and religious organizations, work places, etc. The development of children is determined by the willingness and ability of family and community members to contribute to their successful survival and growth. In the most concrete ways this includes the provision of food, shelter, clothing, health care, schools and recreational opportunities. It also includes emotional needs such as love, security, guidance, and encouragement.

In much the same way the family or community which has not achieved sustainability is dependent on the willingness and ability of other social entities (the state, international) to provide support and assistance. At all levels the ability of each social entity to sustain itself and provide support for others is dependent on the ability of its individual members to contribute to the existing demands within the social group. Just as a family benefits from the contributions and achievements of individual members, so does the community or nation.

The provision of a full and productive childhood for the potential future contributors of any society is necessary for the continuation of that society's sustainable development.

Building on Existing Strength and Human Assets:

The provision of sustainable conditions which will decrease the vulnerability of all people to HIV infection requires cooperative efforts on all levels of society to provide for the healthy growth and development of children. Children, by necessity, require continued support, but they also possess enormous potential for growth and sustainability. Successful approaches have been developed which focus on increasing the ability of families and communities to care for their children. The following are examples of such approaches.

Community support groups:

For children and family members who are living with HIV and for uninfected family members and affected others, this can provide:
•emotional support
•a forum where family members, including children, can discuss concerns and ask questions
•opportunities for sharing information about available services
•a platform for speakers to discuss prevention, care and treatment
•a focus for educational activities
•a focus for mutual support and income generating projects
•a platform for community advocacy and activism.

Services and assistance:

To support families affected by HIV/AIDS in ways that enable them to stay together and maintain their home. Such services can be offered by a combination of formal and informal service providers, including government or privately supported agencies, and might include:
•health and nutritional support
•home health care providers
•Income generating projects or direct financial support.

Training for those in the community who interact with HIV/AIDS affected families, can allow more people to contribute to prevention and the provision of quality care, and to offer support to dying parents and their children in planning for the future. Such training can also reduce the fear and discrimination which result from misunderstanding and misinformation.

**TO BE CONTINUED**