The Victories and Vexations of HIV and AIDS: An African Critical Public Health Perspective

Abstract

Background: In sub-Saharan Africa, AIDS has resulted in many deaths, economic loss, sufferings and cultural changes. This paper focuses on the health, cultural, social and economic impact of HIV and AIDS on African communities. Objective: The study was conducted to analyse the problems ushered in by HIV and AIDS and developmental benefits that have resulted from the pandemic from an African perspective. Methods: This was not a systematic review because the medical and health literature related to the topic was searched unsystematically. We conducted a structured literature search using the following keywords: HIV/AIDS, victories, vexations, public health and African. The major literature data bases used were PubMed, EMBASE, google scholar and African Journals online. We also scanned reference lists for relevant citations including books, conferences and workshop reports. All articles selected were in English. We used most publications from 1983 to 2012. In-depth interviews were also held with some elderly persons. Observations on some African cultures were also conducted. Results: With rapid diagnostic tests and antiretroviral drugs, many lives have been saved from AIDS-related deaths. Victories in the fight against HIV/AIDS include a good diagnostic test, anti-retrovirals, risky behaviour changes that predispose people to HIV and vexations like lack of a vaccine, deaths, economic loss, hardship, social stigma and continuous HIV transmission. The changes in repugnant cultural habits have reduced the burden of HIV/AIDS in some communities. AIDS orphans need food, shelter, education, clothing, emotional and psychological well-being, health care and subsistence. Behaviour change and stigma have been difficult to measure and quantify but a validation scale has been developed. The new vision of three zeros (zero new infections, zero discrimination and zero AIDS-related deaths), lack of financial commitment from African governments, the concentration of new HIV infections among youths and the enactment of laws on human rights forHIV/AIDS patients canmitigate the impact of HIV/AIDS. Conclusions: Even though substantial progress has been made in the areas of treatment, health education, diagnosis, family planning, stigma reduction, home-based care and identification of high risk groups, there are still a number of barriers to HIV and AIDS service provision that need to be addressed. Community coping mechanisms should be sustained for the care of AIDS orphans.