Re-Evaluating Socioeconomic Conditions and the Continuing Spread of HIV/AIDS in Sub-Saharan Africa

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The ravages of the HIV/AIDS pandemic in sub-Saharan Africa are widely acknowledged (UNAIDS, 2003; Whitehouse Fact Sheet, 2003, Taylor et al., 2003; Pratt, et al., 2000). The unique challenges in combating the spread of the disease in the region have also been widely discussed (Gallant and Maticka-Tyndale, 2004; Eaton et al., 2003; UNAIDS/UNICEF/WHO, 2002; Plot, 2000). While a number of well meaning individuals and organizations continue to find ways to reduce the morbidity and mortality rates of the disease in the region, socioeconomic (as well as political) factors remain major constraints in this effort. For example, many governments in the region are yet to fully acknowledge HIV/AIDS as a major cause of morbidity and mortality in their vital statistics for fear of the stigma associated with the disease including economic consequences (Ahmad, 2001; Baleta, 2000; Serwadda and Katongole-Mbidde, 1990). Those that do are disappointed with the limited support provided by the rich nations of the world for combating the disease in the region. Many African leaders are suspicious of the real intentions of individuals and organizations from affluent countries on the premise that they focus more on behavior and morality rather than socioeconomic factors (Wax, 2003; Wise, 2003).

The behavioral and biological risk factors in the etiology of HIV/AIDS in Africa have been widely discussed with most researchers focusing on the behavioral aspects of the disease (Taylor, et al., 2003; Volk and Koopman, 2001; Cohall, 2001; Adih and Alexander, 1999). Conspicuously limited in these discussions is the role of socioeconomic factors. Packard and Epstein (1991) have criticized the association of Africans with sexual promiscuity and the tendency of Western thought to link sexuality with high incidence of HIV/AIDS in Africa (p. 773). The focus on micro-social factors such as African sexuality and culture in communicable disease etiology dates back in Western thought. "Is the attitude of medical researchers towards AIDS in Africa not based on deeply embedded image or trope which continues to shape western and popular thought about African sexuality?" the above authors question (Packard and Epstein, 1991). The emphasis on behavioral factors in the spread of HIV/AIDS in sub-Saharan Africa would appear to mask the socioeconomic conditions that fuel the pandemic in the first place. Failure to emphasize macro-social factors such as economic impoverishment, access to education especially educational empowerment of women, access to health care, man-made and natural disasters among others, remains a major barrier in the war against HIV/AIDS. The need to understand the political and socioeconomic context within which these behavioral factors occur is of particular significance in the region and would avert victim blaming. Schoepf has noted "issues of apparent scientific validity which blame the victim, resulting in fatalism and self-fulfilling prophecy." This is true of research on Africa that explains communicable disease etiology in terms of micro-social factors. Schoepf emphasizes the need to focus on the dynamic relationship of diseases, environment and socioeconomic status (p. 749).

This paper aims at reexamining those macro-social factors influencing the continuing spread of HIV/ AIDS, such as economic impoverishment, limited educational opportunities (especially among women), limited access to health care, politics, and other socioeconomic conditions that are often beyond the control of sub-Saharan Africans.

It is the view of this author that Africans especially south of the Sahara should be seen as victims of HIV/ AIDS in light of the prevailing socioeconomic constraints that predispose them to this modern plague. Also, the paper will discuss ways that the low status of women in the region continues to disenfranchise them from accessing those measures that would limit them from falling victims to HIV/AIDS. …