- June 18, 2020
HIV/AIDS Policy Paper
HIVinfection has been spreading for over three decades, in spite of thefact that the local stakeholders and the international community havedevelopment numerous prevention strategies. It is estimated that theU.S. government invested about $ 24 billion and $ 27 billion in HIVprevention strategies in 2015 and 2016, respectively (U.S. Departmentof Health and Human Services 1). The fact that over 12.2 million newinfections are reported annually at the global level raises doubtabout the effectiveness of the initiatives taken by the governmentand other stakeholders (HSS 1). This paper will address the policyinterventions that should be taken to prevent HIV infection. Thecurrent interventions are effective, but they should be evaluated andupdated in order to address emerging challenges.
HIVPrevention Strategies that Should be Included in the Policy
Civiceducation for sexually active citizens
Thereare several factors that should be taught to citizens who aresexually active. First, teaching of sexually active people about thesignificance of using condoms minimize the risk of being infectedwith HIV. Data shows that a proper use of condoms reduces the chancesof infection by 63 % during anal sex, 72 % when engaging in receptiveanal sex and 80 % in heterosexual intercourse with infected partners(U.S. Department of Health and Human Services 1). The main focus of acivic education program is to save the lives of those who are not yetinfected. This program can be supported and funded by the governmentin collaboration with the non-governmental agencies because itrequires a lot of human as well as the financial resources. However,this strategy could encourage sexual intercourse between uninfectedand infected partners. Pressuring people to use condoms willinterfere with their privacy.
Secondly,serosorting is an effective strategy that guarantees sexually activepeople that they will not be infected when they engage in sexualintercourse with their partners. A study shows that the effectivenessof the serosorting strategy is 54 % during anal sex as well asheterosexual intercourse (HSS 1). Serosorting is the HIV preventionstrategy that encourages people to engage in sexual activities withuninfected partners, especially when they do not want to use condoms.The inclusion of the serosorting in the civic education program canincrease awareness among the target populations. The health of theuninfected citizens is important. Theoretically, having sex withuninfected partners is supposed to lower the risk of infection by 100% (HSS 1). However, it is difficult to determine the status of thepartners with certainty every time that people want to have sex.
Passinglaws that will require or encourage men to undergo circumcision willgo a long way in reducing the rate at which new infections have beenincreasing. Research shows that male circumcision has the capacity tominimize the risk of being infected with the virus by about 50 % (HSS1). Male circumcision leads to the removal of the piece of skin thatcreates an environment for the HIV virus to develop and reproduce.The process of circumcision reduces the surface on which the viruscan attach and multiply. It is only the house of representative thatcan pass this law since people might claim that such a moveinterferes with their private life. This law may not apply tocommunities whose traditions prohibit circumcision. The law will gotoo far since it will limit the autonomy of the affected people tomake choices regarding what happens in their bodies.
Reformthe legal forms
Thefederal as well as well as the state governments can lower the rateof HIV transmission by reforming the laws that prohibit the exchangeand access to syringes without prescription. Most of the states havedeveloped laws that prohibit the sale of syringes to the citizenswithout prescription, with the objective of reducing substance abuse(Lurie 5). However, these laws are more harmful than useful sincethey limit the ability of the people who use drugs to accesssyringes. This forces them to share syringes, which subject them tothe risk of contracting HIV from their infected colleagues. The lawsthat are developed with the objective of reducing the supply ofsyringes to drug addicts are counterproductive since they increasethe prevalence of the HIV infection. The legislators at the statelevel have the capacity to remove these laws because such an actionwill help drug addicts to access new syringes, instead of sharingthem. However, the removal of these laws will encourage substanceabuse. In addition, the strategy may not assist the vulnerable groupsthat have no money to access new syringes, even after the removal ofthe laws.
Thegovernment can make it mandatory for HIV-positive persons to takeantiretroviral therapy (ART) that is specifically designed to reducethe viral load and minimize the risk of infection. The level ofeffectiveness of ART in minimizing the risk of transmitting the HIVvirus to negative partners has been shown to be 96 % (HSS 1). Thelevel of effectiveness of prevention initiatives is determined by theextent to which the viral suppression occurs. The HIV infectedpersons need to understand the significance of protecting theirpartners. Taking an initiative to use ART or complying withgovernment requirements will go a long way in helping theserodiscordant couples lead a fulfilling life. The house ofrepresentative has the capacity to pass a law that will eitherrequire the HIV infected persons to take ART or facilitate thedevelopment of policies that will encourage the affected people to gofor the drugs. However, the enforcement of a law that requiresindividual citizens to take drugs may be a major challenge. Inaddition, the law or a policy that forces people to take drugs cannotwork in a free society where citizens have the right to make choicesand take actions affecting their lives without government’sinterference.
Increasingthe availability and accessibility of daily pre-exposure prophylaxis
Thegovernment can minimize the rate at which the spread of the HIV takesplace by enhancing the accessibility of pre-exposure prophylaxis(PrEP) to all vulnerable citizens. Studies have shown that the use ofPrEP lowers the risk of infection by 92 % among the gay couples and90 % among the heterosexual partners (HSS 1). The data also show thatPrEP reduce the chances of being infected by 70 % among the drugaddicts who use the injection equipment, such as needles. Theobjective of using the PrEP is to help the HIV negative citizensprotect themselves whenever they feel that they are exposed to thevirus. For example, citizens living with partners or relatives whoare infected can use these drugs to minimize the risk of contractingthe pathogen as they interacted with the patients in the domesticsettings. However, requiring healthy people to live on drugs as a wayof protecting themselves is an indication of fear and it may notappeal to all vulnerable individuals. The fear of side effects ofconsuming drugs among the healthy people implies that this strategywill not work.
Developmentof laws and policies that limit mother-to-child infection
Statesgovernments have the ability to limit the prevalence ofmother-to-child infection by developing laws that require expectantmothers to undergo the test for HIV infection. Those who are foundill should be required to undergo mandatory treatment in order toprotect the unborn children from infection. Data shows that treatmentprograms that target the HIV infected and expectant mothers reducethe risk of new infection by about 92 % – 99 % (Lurie 4). Thistherapy involves the application of the combination of strategies,such as the use of ARVs prior to delivery and bottle feeding of thebabies once they are born. The laws and policies that make itmandatory for the infected pregnant mothers to under the treatmentwill protect the life as well as the overall wellbeing of the unbornchildren. The Congress can pass laws because the infected mothers canforget, ignore, or refuse to protect their unborn children once theylearn that they are suffering from the HIV. However, these laws andpolicies will interfere with the privacy of the HIV infected mothers.In addition, the laws will be objected by civil rights activistswince they violate the right of the patients to enjoy the autonomy.
Anincrease in investment in social marketing programs
Theuse of social marketing strategies can help the stakeholders reducestigma, increase the sale of condoms, and access to health careservices for HIV related problems. A research conducted to assess theimpact of the social marketing on the sale of condoms in Zaireindicated that this new strategy resulted in an increase in thedistribution of protective targets from 10,000 to more than 18million between 1987 and 1991 (The National Academy of Science 1). Anincrease the accessibility of condoms is vital because it helps thesexually active citizens to stop fearing the criticism from thesociety and protect themselves from unsafe sex. The social marketingstrategy targets the youths, who form the largest percentage of themost vulnerable population. Therefore, it has the capacity to make asignificant impact in terms of a decline in the number of newinfections that affect the young people. However, the fact thatsocial marketing targets the youths indicates that the vulnerableolder adults may not benefit. In addition, the social marketingstrategy that seeks to increase the distribution of condoms may notwork among the religious groups (such as Catholic) that oppose theuse of protective devices since they propagate immorality.
Theanalysis performed in this paper indicates that the mainresponsibility of preventing the spread of HIV lies with thegovernment. However, it has been argued that government interventionshave failed to prevent new infections. A study conducted to assessthe effectiveness of government initiatives in several countries(such as Botswana and U.S.) indicated that these measures have failedto prevent new infections (Mellin 1). The study showed that the newcases of infection range from 17 % to 33 %, in spite of the largeamount of money and time invested by the government agencies tosupport the HIV prevention campaigns. Some of these governmentinitiatives have failed because they do not take account of thecultural practices (such as community’s belief on the issue of malecircumcision) help by the target or the vulnerable groups. Similarstudies have indicated that the current programs have failed tofacilitate an effective change of behavior among the citizens whoengage in risky sexual practices (Dennin 596). These facts lead to anargument that the government involvement in the campaigns that seekto minimize the rate of new infections is a waste of resources andtime.
Anargument that the money and time invested in campaigns against thespread of the HIV infection is a waste of time is inconclusive. Thefact that new infections are reported every year is not an indicationof a complete failure of the current programs. There are no perfectprograms that can lead to a complete elimination of the HIVinfections. The government plays a critical role of developingpolicies and supplying resources that are required to disseminateinformation and help the vulnerable groups access facilities (such ascondoms) that can help them minimize the level of risk and exposureto viral infection (Dennin 600). The continuous evaluation of theexisting programs can enhance their effectiveness and increase thecapacity of the stakeholders to address emerging challenges.
Newcases of HIV infection are reported each year, in spite of the moneyand time invested by the government and other stakeholders in orderto protect the vulnerable groups. However, the current programs canbe evaluated and adjusted in order to ensure that they can addressthe emerging challenges. For example, an increase in investment incivic education about the importance of using condoms can minimizethe level of vulnerability, especially among the youths. Similarly,the development of laws and policies that encourage men to undergocircumcision and expectant women to be tested for HIV can go a longway in reducing the rate of new infections. In addition, the ongoingcampaigns should be boosted by including the civic education aboutthe pharmaceutical products (such as pre-exposure prophylaxis) thathave been shown to reduce the viral load or destroy the pathogen atlower concentration levels, thus helping the healthy and sexuallyactive citizens to avoid the infection.
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