Excerpt
The HIV infectious has become one of the most serious epidemics worldwide, with significant impact on mortality, morbidity, overall quality of life, and the use of health care services. The HIV epidemic remains unstable and the latest statistics of the global HIV and AIDS were published by UNAIDS in November 2009, and refer to the end of 2008. It is estimated that 33.4 million people are living with HIV/AIDS and the epidemic has been changing. The most notable change observed is the increase in the proportion of women infected. The proportion of women diagnosed with HIV has dramatically increased in recent years and accounted for 50% of all adults living with HIV worldwide (
www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive). While mortality from AIDS has been largely controlled through the availability of antiretroviral therapy (ART), several physical and psychosocial complications remain serious concerns. A diagnosis of HIV can carry with it tremendous social stigma. Women living with HIV face not only a chronic illness and complex medical demands but also extensive social challenges, including access to health care, financial assistance, emotional and social support, assistance with daily activities, housing, and family services (Bing et al.
2001). Many people with HIV struggle with social and economic stresses that have a negative effect on their health. In a survey conducted for the Canadian AIDS Society, almost 60% of people with HIV reported annual incomes of less than $20,000 (De Bruyn
1998). According to the Ontario HIV/AIDS Strategy (Network CAA
2004), as well as the Federal Initiative to Address HIV/AIDS in Canada, poverty, lack of affordable housing, homelessness, racism, stigma, and discrimination all contribute to HIV infection, disease progression, and a person’s ability to manage and live with the disease (PHAo
2002). Gender inequities also drive the epidemic. A survey of 110 women infected with HIV found that 53% of women had been sexually assaulted as an adult, 43% had been sexually abused as a child, and 27% had been sexually abused or assaulted as both a child and as an adult. Women who were abused were almost seven times more likely than those who were not to engage in injection drug use (Network CAA
2004). Abused women are four times more likely than others to engage in high-risk sex (Kirkham and Lobb
1998). The biggest barrier that women face in disclosing their HIV status to their partners is fear of violence. Risk factors for experiencing abuse after disclosure of HIV status include prior history of abuse, drug use, and having a low income (El-Bassel
1998). …
