Research conducted 20 years ago indicated that the pandemic of HIV spreads through the faults evident in society. For instance, feminization of the disease clearly explains its spread due to societal faults of denying women equality. Women in most regions have been denied the opportunity to enjoy basic social freedoms, a factor that has been fuelling the spread of the disease. In the US, the disease was initially associated with gays only but in the recent past, it is has been claiming many lives in the country and other parts of the world (CDC, n.d). Lack of good employment opportunities, sound education, favorable neighborhoods, and overall societal inequalities create differences among various groups in the society. These inequalities cause health disparities including the HIV pandemic. This is a fact that has been confirmed by a study on HIV among communities living in the US. Since these are challenges that have been facing society on a daily basis, they have been referred to as social determinants of HIV. This paper will look at the social determinants of HIV and how they influence the spread of HIV.
The first social determinant that contributes to the spread of HIV is segregation. It is associated with disparities among different groups in the society which constitute social determinants contributing towards the spread of HIV. Societal disparities are defined as differences that exist in a society at a community level. Multiple conditions such as physical closeness or common purposes and interests maybe some of the features that define most communities. However, societal disparities are identifiable through ethnicity or race and this is what defines society. This implies that social segregation caused by racism is basically an important social determinant of HIV. By extension, most of the social determinants of HIV that lead to racial disparities are caused by social segregation.
In 1965, a civil rights act that was passed in the United States disbanded segregation based on race. This act discouraged racial segregation by invalidating the laws passed by the state that made it possible for the continuation of racial segregation. The act stipulated that segregation was an inherent way of encouraging inequality. However, it was not adequate to deal with disparities that came with legal segregation (Blas & WHO, 2010).
Ethnic or racial segregation is defined as the social or physical separation of people into distinct groups based on their ethnicity or race. Many studies and reviews highlighting some of the environmental factors that contribute towards segregation have been conducted. There are different measures used to determine the extent of social construction in society including doing it at an individual level. The different measures and factors used in studying segregation have revealed that it is more likely for individuals to associate themselves with others with whom they share similarities as opposed to individuals and groups with whom they do not share similarities. The census conducted in 2000 in the US indicated that approximately 60% of the households exhibited racial homogeneity (Stone & Ojikutu, 2009). This implied that the ethnic minorities and the percentage of the US population that surrounded them were less than 20 %. Analyzing group segregation based on past health disparities, a situation that has historically remained in the US, research has proved that segregation contributes towards the spread of HIV.
The second social determinant of HIV which is closely related to segregation is migration. Under certain circumstances, migration creates bridging and clustering of people based on segregation. Bridging is described as the process through which individuals from one community contract a disease from individuals of another community and then transmit it among members of their community. Migration is a key social determinant of HIV since every year, migrants move into the US due to economic hardships in their home countries. For example, approximately 7 % of the US population in 2004 was comprised of people who had migrated from other countries (Marmot & Wlkinson, 2006).
The majority of the migrants do not have access to medical facilities and although they have the freedom of moving from one place to another, they are segregated from other communities living in the US. They settle in groups that vary in their extent of segregation. The rates of HIV infections for the migrants are between 2-4 times those of the US population. In instances where the migrants are not accompanied by their sex partners, they look for new sex partners in the communities they join. These sexual relationships increase the risks of transmission and acquisition of HIV. Those infected turn into bridges of spreading the disease in their communities (Institute of Medicine, 1997).
The third social determinant of HIV is the social-economic status of the societal members. The social-economic status of the members of a society is a key factor in determining sexual health. Unemployment and poverty contribute towards segregation, instability, and migration. Segregation and racism cause minority groups to live in poverty and lack access to educational services. Discrimination and segregation which are perpetuated by some institutions in the US deny minority groups economic resources. This instability caused by poverty is a major factor that contributes towards increased cases of HIV transmission in society. Organizations that deal with HIV-related issues have suggested that there is a need to address such issues to counter the spread of the disease.
Inequality and the fact that some people cannot access basic resources lead to dangerous sexual behaviors which increase the prevalence and severity of HIV. For instance, HIV infections are prevalent in countries characterized by income inequalities among the members of the society. In the United States, income inequality has been a social determinant of HIV. In addition, lack of employment opportunities and low levels of education contribute to the severity of HIV infections. Unemployment and poverty can also increase the rates of migration and risky sexual behaviors. For instance, it has been found that skilled men in the US who move in search of employment opportunities increase the rates of HIV transmission by creating sex ratios that are disproportionate (Institute of Medicine, 1997).
To deal with the problem of HIV and its spread in the US, the government should come up with policies aimed at combating the disease. The first policy that the government should adopt is focusing on the youths who remain the most vulnerable group with regard to HIV infections. The government should come up with programs at a national that educate the youths on ways of reducing HIV infections. The second policy that the government should adopt is conducting educational campaigns to equip minority groups with knowledge regarding the dangers of segregation. Research has shown that segregation is one of the factors that contribute towards increased cases of HIV infection. The population should be educated on the importance of accepting people who migrate into the US from other countries. The third policy that should be adopted by the government to reduce HIV infection is increasing access to education. Lack of education makes it difficult for the citizens to get good jobs. As a result, unemployment compels most people to engage in risky sexual behaviors that increase HIV prevalence.
References
Blas, E., & WHO. (2010). Equity, social determinants and public health programmes. Washngton: World Health Organization.
CDC. (n.d). Social Determinants of Health. Web.
Institute of Medicine. (1997). The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washngton: National Academic Press.
Marmot, M., & Wlkinson, r. (2006). Social determinants of health. New York: Oxford University Press.
Stone, V., & Ojikutu, B. (2009). HIV/AIDS in U.S. Communities of Color. New York: Springer.