Global Challenges and Responses in Managing HIV or AIDS

Introduction

In the current condition, Human Immunodeficiency Virus (HIV) is one of the viruses which causes major health issues among wide number of people globally that disrupts their health and well-being. HIV mainly causes AIDS and it attacks the immune system of the body to be degraded which causes the person vulnerable to fight infections and diseases (Algarin et al., 2020). In this essay, the factors influencing global emergence of HIV is to be explained. Thereafter, the global institution working for managing HIV and the challenges faced by them are to be examined and identified.

Global emergence and prevalence of HIV

The global prevalence of HIV is caused due to one of the key factors that is any form of unprotected sexual intercourse (Shannon et al., 2018). According to Queiroz et al., (2021), unprotected anal sexual intercourse is the predominant means of transmission of HIV to individual with vaginal sexual intercourse regarded as the second most predominant form of HIV transmission in people. Anal sexual intercourse is considered 18 times greater efficient in supporting HIV transmission compared to sexual intercourse. This is because during anal sexual intercourse little microtears occur on the rectal tissues which are more vulnerable and fragile than the vaginal tissues. It leads to allow more viruses to enter inside the body and causes exposure of the receptive partner’s blood infective by HIV to the insertive partner supporting transmission to the partner too (German et al, 2015). Moreover, before anal sex people are considered to douche leading to strip aware the mucus layer on the site which is considered to impede HIV transmission (Wang et al., 2018). The fact is evident as in the UK, 53% of the HIV diagnosis is made among them gay and bisexual men with 18% and 24% diagnosis made among heterosexual men and women in 2017 (avert.org, 2021). In addition, globally 23% of the diagnosed HIV is made among gay men and 8% among sex workers and 38% among rest of the population (avert.org, 2021a). Thus, the people with the capability to involve in anal sexual intercourse is seen to be more vulnerable to the condition and indicates unprotected anal sex to be potential factor for causing HIV.

The other factors responsible for increased prevalence of HIV in the global context is sharing of contaminated needles, inappropriate blood transfusion and pregnancy (Can, 2021). In the study by Peters et al., (2016), it is mentioned that injected drug use or sharing of contaminated needles is the third major cause of HIV transmission in the US and the primary mode of transmission among the people in Asia and Russia due to high flow of illegal drugs in the areas. For instance, in the US, the developing opioid crisis has increased HIV infection as in 2015 nearly 75 of the infections are reported to cause HIV transmission in Austin, Indiana where people used shared needles for using recreation oxymorphone (Peters et al., 2016). In the UK, it is mentioned that 1 in every 100 individuals who inject drugs are living with HIV due to sharing of needles during the act. In 2016, in the UK, 1 in 6 people was reported to be using shared needles in injecting drugs (avert.org, 2021a). It indicates that injecting drugs by sharing needles leads to the transmission of HIV globally. This is because during sharing of needles, the virus is present on the surface of the needle from the partner which gets directly transmitted to the blood during it insertion in the body by the shared person (Williams et al., 2014).

In the initial days of HIV epidemic in the 1980s and 1990s, increased number of individuals were reported to be infected during blood transfusion due to use of tainted needles or infected blood for transfusion. This is because at the time there were no screening available for determining the blood to be HIV virus-free or not (Scott and Wu, 2019). Thus, blood transfusion acted as key factor in the initial stage for increased transmission of the disease. However, it is still a major factor contributing to HIV transmission in few countries such as in South Africa where it is reported that 1 in 76,000 blood transfusion is considered to be risky for HIV transmission (UNAIDS, 2021). According to the report by UNAIDS, it is mentioned that every year nearly 4 million blood donations occur for transfusion worldwide that are not tested for HIV presence (UNAIDS, 2021). This indicates that the blood transfusion still remains an existing factor responsible for causing HIV globally thought in small but steady way.

The risk of HIV transmission to child from the mother occurs during pregnancy and is still a major factor contributing to the increased prevalence of HIV globally in children (Iyun et al., 2018). It is evident as in UK and France, the transmission of HIV from diagnosed mother during pregnancy is 0.7% and 0.3% respectively with 2-2.5% rate of infection chances reported in the sub-Sharan area (Pintye et al., 2017). During pregnancy and childbirth, the rupturing of the membrane in the mother exposes the bay to the HIV tainted blood of the mother and vaginal fluids. The HIV present in the mother’s blood is unable to cross the placenta unless there is any abruption on the placenta or other (Pintye et al., 2017). In the current condition, the use of antiretrovirals are used in pregnant person for reducing the risk of vertical transmission of HIV from mother to child in 95% cases as it supports suppression of the virus to undetectable levels in the body (Adeniyi et al., 2018).

Global health institutions related to HIV management

In combating and preventing HIV, one of the global organisations working in the aspect is the World Health Organisation (WHO) which is the United Nations Agency with the role of connecting partners, nations and people together in promoting their health, resolving vulnerable situation and keeping the world safe. WHO through the Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programme plays the role of leading the development as well as implementation of global strategies in eliminating HIV along with the other diseases. They play the role of offering evidence-based guidelines for the common people and health professionals to follow in addressing the gaps and challenges leading to the prevalence of HIV globally (WHO, 2021). The UNAIDS (Joint United Nations Programme on HIV/AIDS) is another international agency that plays the role of delivering strategic direction, coordination, advocacy and technical support in the leading global effort to end AIDS/HIV by 2030 (UNAIDS, 2021).

The International AIDS Society is regarded as one of the largest organisations consisting of professional working to manage HIV with members from 170 countries. Its role is to promote establishment of evidence-based information and human rights-based strategic actions for enhancing the lives of the people who are affected by HIV. It acts as through various programs and campaigns over the world targeting the vulnerable communities affected by HIV to support advocacy of the individuals suffering from the disease (IAS, 2021). The Kaiser Family Foundation is one of the non-profit organisations that is based in the US to promote national health issues and improve the global health policy landscape regarding HIV by focussing on the response required in the management and control of the disease. It plays the role of executing research and collection of evidence to act in favour of the US government to resolve the HIV epidemic in the world as well as in the country (KFF, 2021).

Challenges faced by global institutions regarding HIV management

In preventing and combating HIV, one of the key challenges faced by WHO is availability of adequate finances. This is because of the ever-expanding development agenda along with change in the priorities of the donors and existing threats to the global economy which has create financial challenges for investing in the WHO to support the end to HIV/AIDS (WHO, 2016). The other reason for the financial challenge faced by WHO in managing HIV is the lack of belief of many countries towards its efficiency in using the funds effectively to develop strategies in combating the condition. It is evident as countries like Norway is seen to have contributed to new players like the Global Fund to Fight AIDS and others to support HIV control and prevention leading to avoid funding to WHO for control of the health condition globally (WHO, 2016). Another challenge faced by WHO in controlling HIV globally is the lack of effective participation of the people in holistic manner to get awareness and treatment regarding the health issue. This has led WHO unable to reach many localities and communities over the world to educate them regarding HIV and provide treatment of HIV in lowering the prevalence of the disease (WHO, 2016).

In combating HIV, UNAIDS experiences the challenge of the global economic crisis that has increased lack of availability of adequate finances for the UN agencies in delivering global support for HIV (UNAIDS, 2021). Thus, like the WHO, UNAIDS also experienced funding issues in the current condition that is limiting their power to act globally in effectively managing and preventing prevalence of HIV among people. In the current condition of the COVID-19 epidemic, the UNAIDS has experienced a setback due to more investment been made in controlling COVID-19 as it is dreadful disease that affected many and causing increased mortality. In this condition, the UNAIDS experience problem with collective support from global partners to work for managing HIV prevention across the globe (UNAIDS, 2021b). Moreover, the insufficient presence of funds, staffs and lack of time during the COVID-19 pandemic has led UNAIDS HHIV programmes to be compromised leading to hindered management of the disease (UNAIDS, 2021a). The conservative legal environment in different countries regarding IDUs use as a result of opioid substitution therapy ban is creating challenges for the UNIADS is reaching effective treatment to the people for the HIV (UNAIDS, 2021b). Thus, the legal policies in certain countries are acting as barrier for UNAIDS to freely perform their role of lowering prevalence of AIDS.

One of the challenges faced by International AIDS Society in executing their role of limiting HIV prevalence globally is lack of effective participation of the people to availing their services and support. This is because HIV affected people in most countries are found to be still highly stigmatised in society which makes the individuals feel fear of being isolated and harmed on revelation of their condition. It makes the individuals irrespective of the efforts from the International AIDS Society in supporting them avoid services from them and contribute to hindered HIV management (IAS, 2021). In addition, staffing issues in many countries act as key challenge in supporting smooth execution of their role of taking actions in lowering HIV prevalence. This is because without adequate availability of health professionals and healthcare staffs, the International AIDS Society is unable to perform enhanced research and gather effective evidence to be strategically managed in determining way to tackle HIV (IAS, 2021).

The Kaiser Family Foundation which has the role to reach testing, treatment and prevention of HIV to people is facing challenge of lack of adequate participation of people in abiding by the treatment protocols and support provided by them. This is evident as the foundation provides support to diverse population globally as well as in the US affected by HIV, but it is found that due to travelling issues, personal financial context, family matters and others, many of the individual affected by HIV show hindered continuation of the treatment. It has led to negative control of HIV by the organisation and experience challenge in reaching to end HIV from the world (KFF, 2021). The complacent condition regarding HIV has made many people globally to effectively participate and work with global agencies such as Kaiser Family Foundation in receiving treatment to manage and end HIV (KFF, 2021). Thus, the behavioural condition of the people is acting as challenge for the Kaiser Family Foundation in managing and combating HIV. In many communities, less number people are aware of the HIV condition and show forwardness in seeking assistance and reaching global health organisation for support. Thus, the hindered interest of the people globally to identify and receive treatment for HIV has created challenges for Kaiser Family Foundation in executing their role as they cannot identify such people to reach them (KFF, 2021).

Conclusion

The above discussion informs that unprotected sexual intercourse, sharing of infected needle for drug transfusion, blood transfusion and pregnancy are the key factors that are responsible in globally increasing prevalence of HIV. The global organisations such as Kaiser Family Foundation, WHO, International AIDS Society UNAIDS are working manage and combat HIV. They also paly role in promoting research and development of strategies in controlling HIV in the world so that the disease can be ended. The common challenges faced by them in executing their role is staffing issues, financial crisis, lack of effective participation of common people in accessing their services and others.

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