Issue: World AIDS Day

Today, December 1, is World AIDS Day. In fact, it's the 20th anniversary of World AIDS Day. So I thought it fitting to do a post about the global HIV/AIDS pandemic. (A pandemic is an epidemic that affects various geographical areas at the same time.)

If you take a look at this map, you'll see that AIDS truly is a global issue. Nearly 40 million people are infected, including over 2 million children. The countries with the highest rates of AIDS are the southernmost countries in Africa; in some areas, 35 percent of all people are infected with AIDS. Listen to this: 25 million people have died of AIDS since 1981. These mind-boggling death rate has left an estimated 15 million children orphaned in Africa alone.



In the United States, the AIDS issue sometimes gets marginalized and treated as a "gay issue," since about 50 percent of Americans with AIDS are gay men. But Americans tend to drastically underestimate the global impact of the disease, as well as the fact that AIDS really isn't an issue that we can bundle up and put on the doorstep of any particular group. For example, the demography of AIDS is significantly different in Africa. There, AIDS is typically transmitted through heterosexual sex (in some cases from unfaithful husbands to their wives). In fact, in sub-Saharan Africa, nearly 60 percent of the people infected with AIDS are women. This is partially due to the fact that women's anatomy renders them more vulnerable to contracting AIDS. There are other reasons, too, like the fact that women typically have less control over their sexual choices than men, and the rampant rates of sexual violence in many parts of the world. (Sadly, forced sex is even more likely to result in HIV infection for a woman because of the increased risk of tissue tearing and blood-to-blood contact.)

HIV/AIDS is also transmitted from mothers to their babies (either in utero or sometimes through breastfeeding), through blood transfusions, and through contaminated needles. (In the U.S., "dirty needles" typically refers to needles used for intravenous drug injections, but in less-developed countries where health care facilities have considerably fewer resources at their disposal, it often refers to unsanitized needles used in hospitals and health clinics.) There is evidence that the role of contaminated needles has been underplayed in the AIDS discussion. There is plenty of controversy around questions of prevalent transmission in Africa, and also plenty of controversy around the best way to stop the spread of the disease (or at least which kinds of programs are most effective).

I personally saw evidence of the needle issue at a focus group in Mozambique. At the orphanage where we volunteered, I attended a meeting with orphan heads of household. Most of the attendees were teenagers whose parents were dead, and they came to discuss the realities of their lives. It was sobering; perhaps another day I'll write more about this experience. For today, I'll just mention that their economic situations were as grave as you might expect in a country where the average yearly income is $250. (Total. Per year. And don't buy the "cost of living is so small" argument either; Joe and I found it more expensive to buy groceries there than in Utah.) The children at this meeting talked about the economic challenges of trying to keep their siblings in school, trying to keep food on the table. But one thing that really stood out to me was their accounting of their experiences with health care. The teenagers reported that at local health clinics, if they needed a vaccination or injection, they were required to bring their own needles. None of them could afford to buy new, sterile needles--they could hardly afford food--and so they borrowed used needles from their neighbors and took them to the clinics.

This focus group helped me understand why an estimated 16 percent of Mozambicans are infected with AIDS. It also helped me understand the staggering implications of the AIDS orphan situation for these 15 million African AIDS orphans. (The number might be much higher; it's hard to get good numbers.) The situation of AIDS orphans deserves a post in and of itself, so I will come back to it later, but for now please check out this website and this article for a good overview. Also, a few years ago I wrote an essay about my experiences at the orphanage in Mozambique that you can read here.

A couple of other good websites for learning more about the global AIDS pandemic are The Global Fund and (RED).