Transmition:
- Sexual contact - unprotected vaginal or anal sex. Only condoms provide 'all-in-one' protection from pregnancy and sexually transmitted infections including HIV.
- Direct innoculation of the virus - for example infection through contaminated needles
- Contaminated blood products / transplanted organs.
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An infected mother may sometimes pass the virus to her developing fetus during the birth or breast milk.
How HIV damages the immune system (pag 420, Biology principles and processes ROBerts 574)
Socio-Economic impacts
Economic impacts
Economic Impact in Africa
One way in which HIV and AIDS affect the economy is by reducing the labour supply through increased mortality and illness. Amongst those who are able to work, productivity is likely to decline as a result of HIV-related illness. Government income also declines, as tax revenues fall and governments are pressured to increase their spending to deal with the expanding HIV epidemic.
By making labour more expensive and reducing profits, AIDS limits the ability of African countries to attract industries that depend on low-cost labour and makes investments in African businesses less desirable. HIV and AIDS therefore threaten the foundations of economic development in Africa.40
The impact that AIDS has had on the economies of African countries is difficult to measure. The economies of the worst affected countries were already struggling with development challenges, debt and declining trade before the epidemic started to affect the continent. AIDS has combined with these factors to further aggravate the situation. It is thought that the yearly impact of AIDS on sub-Saharan Africa’s gross domestic product (GDP) is a loss of 1%. While this is a relatively modest effect, it will build in significance over time, especially in countries where HIV prevalence is rising.
One way in which this impact can be reduced is through the provision of antiretroviral drugs to people living with HIV. A recent study in South Africa suggested that if ARV coverage expanded to reach 50% of those in need of the drugs then the effect of the epidemic on economic growth would be reduced by 17%.
The Impact on Enterprises and Workplaces
HIV and AIDS dramatically affect labour, setting back economic and social progress. The vast majority of people living with HIV in Africa are between the ages of 15 and 49 - in the prime of their working lives.
AIDS damages businesses by squeezing productivity, adding costs, diverting productive resources, and depleting skills. Company costs for health-care, funeral benefits and pension fund commitments are likely to rise as the number of people taking early retirement or dying increases. Also, as the impact of the epidemic on households grows more severe, market demand for products and services can fall. The epidemic hits productivity through increased absenteeism. Comparative studies of East African businesses have shown that absenteeism can account for as much as 25-54% of company costs.30
A study in several southern African countries has estimated that the combined impact of AIDS-related absenteeism, productivity declines, health-care expenditures, and recruitment and training expenses could cut profits by at least 6-8%.31 Another recent study of a thousand companies in Southern Africa found that 9% had suffered a significant negative impact due to AIDS. In areas that have been hit hardest by the epidemic, it found that up to 40% of companies reported that HIV and AIDS were having a negative effect on profits. Despite this, only 13% of the companies surveyed with fewer than 100 workers had a company policy in place to deal with HIV and AIDS.
Example: Some companies, though, have implemented successful programs to deal with the epidemic. An example is the gold-mining industry in South Africa. The gold mines attract thousands of workers, often from poor and remote regions. Most live in hostels, separated from their families; as a result a thriving sex industry operates around many mines and HIV is common. In recent years, mining companies have been working with a number of organisations to implement prevention programmes for the miners. These have included mass distribution of condoms, medical care and treatment for sexually transmitted diseases, and awareness campaigns. Some mining companies have started to replace all-male hostels with accommodation for families, in order to reduce the transmission of HIV and other sexually transmitted diseases.32
Example: In Swaziland, an employers' anti-AIDS coalition has been set up to promote voluntary counselling and testing. The coalition not only includes larger companies but also small and medium sized enterprises.33
Example: In Botswana, the Debswana diamond company offers all employees HIV testing, and provides antiretroviral drugs to HIV positive workers and their spouses.34 This policy was introduced in 1999 when the company found that many of their workforce were HIV positive. With a skilled workforce, it is financially worth their while to protect the health and therefore the productivity of their workers.
Social Impacts
The Impact on Households
The toll of HIV and AIDS on households can be very severe. Although no part of the population is unaffected by HIV, it is often the poorest sectors of society that are most vulnerable to the epidemic and for whom the consequences are most severe. In many cases, the presence of AIDS causes the household to dissolve, as parents die and children are sent to relatives for care and upbringing. A study in rural South Africa suggested that households in which an adult had died from AIDS were four times more likely to dissolve than those in which no deaths had occurred.8 Much happens before this dissolution takes place: AIDS strips families of their assets and income earners, further impoverishing the poor.
The Impact on the Education Sector
The relationship between AIDS and the education sector is circular – as the epidemic worsens, the education sector is damaged, which in turn is likely to increase the incidence of HIV transmission. There are numerous ways in which AIDS can affect education, but equally there are many ways in which education can help the fight against AIDS. The extent to which schools and other education institutions are able to continue functioning will influence how well societies eventually recover from the epidemic.
The Impact on Teachers
HIV/AIDS does not only affect pupils but teachers as well. In the early stages of the African epidemic it was reported that teachers were at a higher risk of becoming infected with HIV than the general population, because of their relatively high socio-economic status and a lack of understanding about how the virus is transmitted. This trend appears to have changed, as evidence increasingly shows that the more educated an individual is, the more likely they are to change their behaviour.25 But HIV and AIDS are still having a devastating affect on the already inadequate supply of teachers in African countries; for example, a study in South Africa found that 21% of teachers aged 25-34 are living with HIV.26
Teachers who are affected by HIV and AIDS are likely to take increasing periods of time off work. Those with sick families may also take time off to attend funerals or to care for sick or dying relatives, and further absenteeism may result from the psychological effects of the epidemic.27
When a teacher falls ill, the class may be taken on by another teacher, may be combined with another class, or may be left untaught. Even when there is a sufficient supply of teachers to replace losses, there can be a significant impact on the students. This is particularly concerning given the important role that teachers can play in the fight against AIDS.
The Impact on Life Expectancy
In many countries of sub-Saharan Africa, AIDS is erasing decades of progress in extending life expectancy. A recent study found that the average life expectancy of individuals living in sub-Saharan Africa has fallen by five years since the early 1990s, mainly because of AIDS.35 In Swaziland it has been estimated that life expectancy at birth, which is currently just 33, would be 66 without AIDS.36 37
The impact that AIDS has had on average life expectancy is partly attributed to child mortality, as increasing numbers of babies are born with HIV infections acquired from their mothers. The biggest increase in deaths, however, has been among adults aged between 20 and 49 years. This group now accounts for 60% of all deaths in sub-Saharan Africa, compared to 20% between 1985 and 1990, when the epidemic was in its early stages.38 By affecting this age group so heavily, AIDS is hitting adults in their most economically productive years and removing the very people who could be responding to the crisis.