Despite the fact that the human immunodeficiency virus (HIV) is a global problem, HIV prevalence rates vary dramatically from one country to another. The discrepancies are mainly the result of such factors as country income level and the efficacy of its health care system, which depends on both human and financial resources.
HIV is a type of human virus that attacks the immune system and causes acquired immune deficiency syndrome (AIDS). The virus was first clinically observed in the US in the 1980s when large numbers of homosexual men and drug users showed symptoms of diseases that typically affected people with severely impaired immune systems (Holland, 2013, par. 2). It is generally accepted that the virus originated in West-central Africa in the 1920s and spread to other countries through migration (Origin of HIV & AIDS, 2016).
Due to the fact that the virus was undiscovered for 60 years, by the time, it was clinically observed, the virus had gone out of control. Since the 1980s, HIV caused tens of millions of deaths worldwide (Holland, 2013). In different countries, the number of people infected with HIV varies greatly. The majority of HIV-infections happen in lower-income developing countries in Sub-Saharan Africa. For example, a small African country of Swaziland is struggling with a severe HIV epidemic, with at least 26 percent of the adult population diagnosed as HIV-positive (Swaziland, 2014, p. 1). The situation is drastically different in high-income developed countries.
For example, in the United States, there were at least 1.2 million HIV-positive people living by the end of 2012, which accounts for less than 1 percent of the population (Hall et al., 2015). The prevalence rate is estimated at around 400 per 100,000 people (Annual Surveillance Report, 2014, p. 12). The situation is similar or better in other high-income developed countries. For example, in New Zealand, the HIV prevalence rate is four times lower than in the US and is estimated at around 100 per 100,000 people (Annual Surveillance Report, 2014, p. 12).
It is generally accepted that high HIV prevalence rates are associated with low-income countries. In low-income African countries, such as Swaziland, the availability of health care facilities and personnel is very low. Low-income African countries have the greatest number of HIV-positive people and the lowest number of health care personnel: 24% of the world’s population lives in low-income African countries; however, only 3% of the world’s health care workers offer their services in Sub-Saharan Africa (Health & Education in Africa, n.d., para. 3).
In Swaziland, “the ratio of doctors and nurses to the population was 1: 5 953 and 1: 356, respectively (National Health Policy, n.d., p. 5). There are 0.1 physicians per 1000 people in Swaziland in comparison to 2.5 physicians per 1000 people in the US and 1.9 in New Zealand (Physicians (per 1,000 people), n.d.). Because of the lack of financial resources and the HIV/AIDS epidemic, the number of beds in hospitals is also inadequate.
The availability of health services is low, and the majority of the population lives eight kilometers away from a health facility (National Health Policy, n.d., p. 5). Less than 20% of the population live less than 8 kilometers away from a hospital (National Health Policy, n.d., p. 5). As such, HIV prevention and treatment are a challenge in low-income African countries due to the need for substantial financial resources in order to build and sustain the necessary infrastructure.
Such resources are available to both the US and New Zealand, however, despite having fewer health care personnel, New Zealand has a significantly lower HIV prevalence rate. This fact is in part due to a very strict immigration policy. HIV is listed under “Medical conditions deemed to impose significant costs and/or demands on New Zealand’s health and/or education services” and make an individual ineligible for a residence class visa (A4.10 Acceptable standard of health (applicants for residence), 2014).
In New Zealand, HIV testing is compulsory for anyone seeking a visa. In comparison, the US has removed HIV infection screening from its immigration requirements in 2010. The ethics of New Zealand’s decision to make HIV-positive people ineligible for a permanent visa is questionable, however, there is no denying that strict screening and immigration procedures have affected the country’s HIV prevalence rate in a positive way. In fact, the incidence of AIDS is on a decline in New Zealand (Gibney, DiClemente, & Vermund, 2006, p. 36).
As such, the US could change its immigration policies to at least make HIV screening a necessity in order to have better HIV rates. In addition, the accessibility of high-quality treatment has been quite high, and discrimination against HIV-positive people has been on a decline (Gibney, DiClemente, & Vermund, 2006, p. 37). Improving accessibility of health care services, especially among minority populations, is necessary to improve HIV statistics.
HIV prevention and treatment is a major global challenge. Total elimination of this virus might require strict immigration policies, and treatment is largely dependent on an efficient health care system, which is impossible without substantial financial and human resources.
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Gibney, L., DiClemente, R., & Vermund, S. (2006). Preventing HIV in Developing Countries: Biomedical and Behavioral Approaches. Berlin: Springer Science & Business Media.
Hall, I.m An, Q., Tang, T., Song, R., Chen, M., Green, T.,…Kang, J. (2015). Prevalence of Diagnosed and Undiagnosed HIV Infection — United States, 2008–2012. Weekly, 64(24), 657-662.
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