Why HIV/AIDS is more prevalent in Africa

A friend of mine recently asked me why HIV/AIDS is so much more prevalent in Africa than anywhere else in the world. Seeing that this topic is something I am somewhat knowledgeable about, I thought the question would be relatively easy to answer. However, after several minutes of roundabout answers and ‘maybes’ and ‘I thinks’, I realized that I really did not have a concrete response to her question. There are, however, several factors that account for Africa’s high infection rate, so I decided to summarize a few of them briefly.

The first, and most common reason, is the high rate of poverty and economic disparity. Sub-Saharan Africa is currently home to over ¾ of the world’s ‘ultra poor’ people (just over 121 million individuals), and is seeing very little progress in terms of reducing the proportion of those suffering from severe destitute circumstances. Although HIV/AIDS affects both the poor and rich, it is a known reality that those affected by poverty, are more readily affected by the epidemic. There are several reasons for this, the first and most significant, being that poverty offers fewer defenses against the disease. By defenses, I am referring to medical defenses, educational defenses and financial defenses. As the lack of these defenses increases, the HIV/AIDS infection increases, in turn forcing more of the population towards poverty. The result is a perpetuating cycle of the epidemic leading to poverty, and vice versa.

This leads me to another bi-causal relationship; the one between education and HIV. I will not spend too much time on this one, because the correlation between a lack of education and an increased HIV/AIDS rate, is an obvious one. The epidemic, unfortunately, has a crippling effect on Africa’s infrastructure, particularly the education system. Education plays a vital role on both HIV/AIDS awareness as well as support for those affected by the illness. As th
e endemic worsens, a toll is taken on education systems as they lose teachers, faculty, staff and students. In terms of general HIV awareness and education, there has been a significant effort to spread the knowledge of the illness throughout the continent, however, due to a lack of infrastructure, funding and poor communication paths, there are still countless communities and individuals who do not fully understand the illness, how it is spread, prevention methods and treatment.
Also concerning education and awareness, Africa also struggles with the added challenge of overcoming traditional and cultural beliefs regarding HIV/AIDS (as I explore this cause, keep in mind that this is something that affects primarily rural parts of the continent, much more than urban and developed communities). Traditional beliefs have long impeded not only the process of eradicating the epidemic, but also the process of enlightening educationally unwilling parties. There have been several psychological studies and surveys that have recently explored the relationship between people’s cultural views and prevention efforts. One study published by the University of Connecticut and the Human Sciences Research Council in South Africa, was particularly informative. It found that about 34% of residents in Cape Town, South Africa (a country with the most HIV/AIDS deaths in the world), either firmly believed, or believed there was a possibility, that the disease is caused by spirits or some form of supernatural forces.

These misunderstandings are not only about the causes of HIV/AIDS. Many communities and individuals are misinformed as to how the disease is spread, and are also plagued with falsities in regards to people living with HIV/AIDS; beliefs that are spurred by deep-seated traditional and cultural understandings. There are several stigmatizing beliefs concerning HIV/AIDS sufferers, for example, that such individuals are the victims of witchcraft, voodoo, curses etc., or that they are involved in culturally unacceptable homosexual activities. With such negative stigmas, people are deterred from getting themselves tested, fearing the stigmas that are attached to the disease, much more than the illness itself. In fact, 44% of surveyed individuals expressed that these stigmas influence their decisions to seek HIV antibody testing. This, of course, increases infection rates, as people who are unaware of their status, are engaging in unprotected sex and are unknowingly spreading the virus at disturbing rates. However, as widespread and popular as these traditional beliefs may be, I firmly believe that it is not a specific issue about traditional and cultural convictions, however, it is a general issue regarding the misinformation of HIV/AIDS and its facts and details as a whole. It is an issue of broad-spectrum education and the spread of accurate HIV awareness throughout all levels of society and geographic localities.

These issues are certainly not all-encompassing, in terms of why Africa suffers from a far greater infection rate than any other continent, however they provide a basic explanation of some of the root causes. The high rate of prostitution, polygamy and promiscuity, sexual violence and rapid urbanization and mobilization also play a major role on high infection rates and the spread of the epidemic. I am well aware that each of these examples can be further broken down and dissected into hundreds of detailed, separate entities, however, I do not have the knowledge, expertise or time to do so. This is merely a basic exploration into a few possibilities and patterns. For more details, click on the hyperlinks throughout this blog entry for links to detailed studies and reports.

As always, feel free to comment or provide me with feedback, because TALK AIDS!