PHE101: Social Determinants of Health

Introduction

HIV (human immunodeficiency virus) is a virus, which weakens and constantly attacks immunity cells, leading to compromised body immunity mechanisms and making the body more vulnerable to infections and diseases. It is transmitted from bodily fluids, such as during unprotected sex or from the infected injection drug. If it is left uncured and untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome). AIDS is the last stage of HIV infection which causes the body’s immune system to be badly damaged by the virus. The report, the main aim is to discuss the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) in South Africa and Australia, identifying the impacts on the gender and living environment especially on women when it comes to two countries.

In South Africa, Young women are more vulnerable in comparison to men with the infected HIV. In 2005, infection was widespread mainly in the 15-24 years of 16.9% women age group as compared to 4.4% in men (Ginsburg, et al.,2021). The high rise in HIV cases has been mainly due to growing poverty, violence against women, implications of cultural limitations and causing more intergenerational sex, unsafe and unprotected sex practices, high cases of drug use and a history of rising sexually transmitted infections (STI) (Celum, et al.,2019)

While in Australia, HIV has been growing among the Indigenous community with a rate of 1.3 times in 2016–2018, as compared to the Other Australians (4.9 per 100,000) (Australian Government, 2020). Mainly Indigenous women are more vulnerable due to the rise in poverty, financial problems, and illiteracy problems and the Indigenous community has high cases of drugs, alcohol and abuse as compared to the non-Indigenous community (Azzopardi, et al.,2018).

HIV/AIDS and the Vulnerable Group – the Situation

South Africa's vulnerable group has been the tribal young women who do not have any literacy, are educated or are poor. There has been a rising spike in the cases of 90% in the HIV status from 2018. South Africa still lacks HIV treatment; does not have strict policies and regulations programs, lacks the infrastructure to educate the masses and even adopt strong measures to curb unprotected sex practices (Ginsburg , et al., 2021).

Male Versus Female HIV increased rate in between 2019-2021 (Ginsburg, et al.,2021).

HIV/AIDS population in South Africa (Ginsburg, et al.,2021).

While in Australia, a total of 4,289 HIV people were diagnosed in 2015 and 2019, with a growing rate of 173 total people being detected at 3.3 per 100,000 Indigenous people. Indigenous people in Australia experience more sexually transmissible infections (STIs), with a higher prevalence of HIV transmission. But Australian government are very particular in curbing the STI and HIV prevention and management practices in controlling the HIV/AIDS growing problems (Ford, 2013).

Indigenous HIV status (Australian Government,2020)

Indigenous HIV stagnant growth Australian (Government, 2020)

Read more: HIV AIDS Analysis Assignment Sample

Social determinant (Education)

In the two different groups of the South African Young Women and the Australian Indigenous group, there has been a series of devotion when it comes to the Social determinants such as:

Barriers to Diagnosis Due to the Lack of Education

In the South African and Australian groups, both the women groups face barriers to the diagnosis of HIV infection in ATSI people, which may explain the higher rates of HIV infection spread in the population. But male diagnosis is better as compared to the female groups, due to less stereotyping and stigma (Azzopardi, et al., 2018). In the Indigenous male group, still, a point of barrier is in the diagnosis as their culture does not allow touching their body parts or looking into their eyes when examining them. There has been a growing lack of medical literacy, the facing the social and structural late diagnosis, which has caused the lack of optimal testing, intervention procedures like TasP and PEP and discrimination stigma which does not lead to a proper treatment and diagnosis. The other factors like lack of determinants are poorer physical, financial and cultural aspects that can lead to crowded housing, limited transport and lower education and employment levels, which can cause personal health problems (Ford, 2013).

Opportunities for Early Diagnosis

In the Women both in South Africa and Indigenous Group Australia, diagnosis is the main challenge, as the cultural aspects do not allow touching women or examining their body parts. Often the screening or discussion about sex practices is a point of hindrance as compared to the male counterparts. Opportunities and missing out on screening for HIV infection have led to growing challenges in medical examination (Fogarty, 2018).

Social Determinant (Cultural practices)

The second social determinant problem is the lack of equitable cultural practices between South Africa and Indigenous Group Australia.

Management – Cultural Differences

Growing evidence shows similar outcomes, like lack of management of ATSI people having HIV infection. Critical examination of the Indigenous group’s men and women lacks the equitable status, Due to the social stigma and stereotyping there has been an unequal status and growing implications when it comes to checking for the greater disparity factors. In South Africa women face a challenge in the local health barriers, such as the nurses diagnosing facing hindrances when it comes to the examination, continuity of care and making the workforce more achievable.

Cultural Differences During Treatment Adherence

In the South African and Australian Indigenous groups, both groups face the lack of continuity of care, due to the lack of stigma, stereotyping and lack of maintaining a strong relationship between patient and health care provider. With the growing long-standing adherence to the treatment, having a lack of good therapeutic outcomes, and holistic services, there is a lack of medical care and a social support system. While Australia has been actively involved when it comes to improvising the equitable infrastructure of health facilities, South Africa lacks a proper financial support system (Fogarty, 2018).

Recommendations

Having uniformed cultural practices for both men and women, when it comes to the diagnosis, treatment and educating about the unprotected sex should be an important policy and program. South Africa lacks in the equitable cultural competency and lack of acceptance due to the less knowledge and awareness (Filiatreau et al., 2021). Australian Indigenous community face hindrance in the healthcare settings and lacks cultural ideas, values and practices (Collins, et al., 2017). Through adopting efficient interaction, collaboration in the healthcare practitioners and introducing cultural training programs when approaching the South Africa and Australian Indigenous groups would help to approach well and provide them required treatment.

Specifically introducing educational programs, like funding and introducing higher education levels would help to approach the health care and consider the decision making skills when educating bot the South Africa and Indigenous Australian groups. By establishing the learning and delivering excellent education, can overcome structural impediments, proving achievements and emphasising on the reduction of the socioeconomic gaps (Ginsburg , et al., 2021).

Conclusion

Towards the end, both the Indigenous Australian groups and South African young women can be provided the continuity of care, treatment and even diagnosis, provided their social determinant of cultural and educational elements are supported by the historical and structural issues. Through achieving the fair cultural seniti and educational equity can be introduced in the top priority. Health disparities and overcoming education hindrances, providing values to healthcare and outcomes can help to support health outcomes and life expectancy parity.

References

Australian Government. (2020). Aboriginal and Torres Strait Islander health performance framework. Retrieved from https://www.indigenoushpf.gov.au/publications/hpf-summary-2020

Azzopardi, P. S., Sawyer, S. M., Carlin, J. B., Degenhardt, L., Brown, N., Brown, A. D., & Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782. DOI: https://doi.org/10.1016/S0140-6736(17)32141-4 

Celum, C. L., Delany‐Moretlwe, S., Baeten, J. M., van der Straten, A., Hosek, S., Bukusi, E. A., ... & Bekker, L. G. (2019). HIV pre‐exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery. Journal of the International AIDS Society, 22, e25298.

Collins, J., Morrison, M., Basu, P. K., & Krivokapic-Skoko, B. (2017). Indigenous culture and entrepreneurship in small businesses in Australia. Small Enterprise Research, 24(1), 36-48. DOI- https://doi.org/10.1080/13215906.2017.1289855

Filiatreau, L. M., Pettifor, A., Edwards, J. K., Masilela, N., Twine, R., Xavier Gómez-Olivé, F., ... & Kahn, K. (2021). Associations between key psychosocial stressors and viral suppression and retention in care among youth with HIV in rural South Africa. AIDS and Behavior, 25, 2358-2368.

Fogarty, W., Riddle, S., Lovell, M., & Wilson, B. (2018). Indigenous education and literacy policy in Australia: Bringing learning back to the debate. The Australian Journal of Indigenous Education, 47(2), 185-197. DOI- https://doi.org/10.1017/jie.2017.18

Ford, M. (2013). Achievement gaps in Australia: What NAPLAN reveals about education inequality in Australia. Race Ethnicity and Education, 16(1), 80-102. DOI- https://doi.org/10.1080/13613324.2011.645570

Ginsburg, C., Collinson, M. A., Gómez-Olivé, F. X., Gross, M., Harawa, S., Lurie, M. N., ... & White, M. J. (2021). Internal migration and health in South Africa: determinants of healthcare utilisation in a young adult cohort. BMC Public Health, 21(1), 1-15.

Guerra, O., & Kurtz, D. (2017). Building collaboration: a scoping review of cultural competency and safety education and training for healthcare students and professionals in Canada. Teaching and learning in medicine, 29(2), 129-142. DOI- https://doi.org/10.1080/10401334.2016.1234960

Read more: HIV Strategy Evaluation Assignment Sample

Contemporary Indigenous Health & WellBeing Assignment Answer