27/10/2016

Perspectives of HIV-AIDS,
Drug and Substance Abuse
Assignment 1
Raj G Gami
AD102069
Diploma in Computer Science
Question 1:

1) Describe four behavioural factors that influence the transmission of HIV/AIDS

(20marks)

Behavioural factors refers to any specific behaviour pattern which adversely affects the health.
There are several behavioural factors that increase the chance of developing HIV/AIDS. Below
are four factors explained that influence the transmission of HIV/AIDS.

Firstly, some cultures have legally sanctioned a cultural practice which allows husbands to
have more than one wife. This practice creates simultaneous sexual networks within marriage
between several wives and their husband. This scenario may worsen if the spouse has any extra
martial sexual contacts. A direct transmission of HIV can take place in this sexual network of
several marriages through the spouse’s extra martial affair which spreads out to his wives.
Another possibility is a new wife who is already HIV positive who spreads the infection to the
husband, which is followed by infection spreading to his other wives. This practice allows
spread of HIV infection at a tremendous rate as some cultures do not allow HIV testing and
condom use.

Secondly, early marriage of young girls makes them severely exposed to HIV as they will be
forced to have sexual intercourse with their much older spouse. Young girls tend to have fragile
vaginal membrane which is easily damaged, making them surrender to HIV and other sexually
transmitted diseases. Their spouse tend to be more sexually experienced therefore possibly
infected with HIV. Increase in young girls’ contact to unprotected sex is caused by pressure to
have children and their inability to discuss for safe sex. There is also power differential between
husband and wife due to the large age gap, which further affects the effective and open
communication about uptake of voluntary counselling and HIV testing, sharing the test results
and development for safe sexual relations during the marriage.

Moreover, unfaithfulness in marriages creates a gap between the couples allowing extra-marital
affairs to flow in. These refers to the husband and wife having other sexual partners outside the
marriage. This creates a sexual network whereby transmission of HIV becomes much easier.
Some cultural practices also believe that men should take primary responsibility and dominate
the household. This gender inequality also encourages men to have multiple sexual partners
outside the marriage, whereas the wife is expected to be faithful. Such norms make men and
their partners vulnerable to HIV infection.
Finally, certain cultural and traditional practices are harmful and directly expose one to
infection to HIV. Practices such as widowhood-related rituals, sexual cleansing and female
genital cutting intensify the risk of HIV transmission. These practices are often justified in the
name of cultural values, traditions and morals. Sexual intercourse is one of the major channel
for transmission of HIV, and some communities often believe in having sexual intercourse after
every function such as a new house construction. There are also some other communities which
believe in “cleansing” of widows by forcing them to have sexual intercourse with a male
relative of the deceased, before she can remarry. Such practices are void and do not have any
religious meaning. They increase chances of transmission of HIV at a greater margin, causing
an outspread of HIV infection.
2) You are a human resource manager in a large multinational corporation. The health
records available show that 30 employees are HIV positive. Discuss how you would
handle their health ensuring that they are not stigmatized and discriminated. (20
marks)

The workplace is an effective point to enable access to HIV prevention, treatment, care and
support services as well as a significant spot to enforce human rights obligations by ensuring
that HIV stigma is minimised and discrimination is prevented. There should be no
discrimination or stigmatisation of workers, including job applicants and job seekers in either
access to employment, terms and conditions of work or right to remain in employment. Various
policies should be put in action in workplace, which contributes to the realization of human
rights, fundamental freedom and gender equality. This policies include:

1) Retaining in work and recruitment of the persons living with HIV needs to be promoted.
2) NOT compelling an employee to submit to a test for evidence of HIV. The employee
should not be subjected to pressure to disclose their HIV status.
3) No penalty should be enforced consequently if evidence later emerges of an HIV
positive.
4) Staff management policies should provide HIV positive employees with the same rights
and benefits offered to employees with other predispositions, diseases and disabilities.
5) Employees with any illness or disabilities, including HIV infection should be treated
equally and with appreciation and should be permitted to continue working as long as
they are able to.
6) Programmes of care and support should include measures of reasonable
accommodation in workplace.
7) Real or perceived HIV status should not be a base of discrimination for employment
purposes, including in access to employment and occupation.
8) Persons living with HIV should enjoy the possibility of continuing to carry out their
work and their recruitment should be promoted.
9) Provision of HIV education in workplace which would spread awareness among the
work force which would reduce the gap between HIV positive and negative as well as
reduce discrimination and stigmatisation.
Occupational healthcare staff plays a major role in managing the work environment and
preventing stigma and discrimination towards any type of illness, including HIV infection.
They have to follow a set of rules and regulations as they carry out their day to day duties.

10) Occupational health care staff should not carry out HIV screening on employees,
regardless the pressure from the employer.
11) If an employee informs occupational health care staff about a possible HIV infection,
the case should be treated with rules of confidentiality and use the information only in
the well-being of the patient’s health.
12) Occupational health care staff should NOT reassess his ability in the light of such
information (unless the employee might risk exposure to factors in the workplace
potentially detrimental to his health),
13) They should not inform the employer of the condition of any worker who is HIV
infected;
14) Employers should have a duty to protect the confidentiality of medical information
relating to their employees, particularly as concerns HIV infection; therefore health data
should only be handled and stored by authorised personnel who are bound by rules on
medical confidentiality.
3) Discuss how drug and substance abuse can predispose one to HIV/AIDS infection

Alcohol and other drugs use have an adverse effect on the spread of HIV infection. There are
several types of drugs, each with a risk of HIV infection in its own unique manner. Below are
some of the major channels of transmission of HIV via use of drugs and substance abuse.

Firstly, HIV transmission from sharing drug injecting equipment. This type of transmission
takes place when the drug in discussion is taken through injecting tools such as a syringe.
Sharing this tools with a person who is HIV positive can cause transmission of HIV as blood
from the HIV infected can be found on the needle of the syringe which is then transmitted into
the blood of non-infected person as he/she shares the syringe. This causes transmission of HIV
into the blood of non-infected person, thus spreading the infection

Secondly, inebriated state of mind due to consumption of alcohol or other drugs can increase
the risk of transmission of HIV as well as other sexually transmitted diseases. Being drunk
affects the person’s mind to be able to make logical and safe choices, leading to risks of
unprotected sex or sex with multiple partners. Such decisions or actions are less likely to occur
when a person is sober and in control of his senses.

Finally, usage of drugs by HIV infected people can worsen their medical condition as drugs
and alcohol affect the immune system. This speeds up the progression of the HIV infection
causing it to become uncontrollable.

Below are some of the drugs that are associated with increase in risk of HIV infection. This list
includes: injected drugs, methamphetamine, alcohol, crack cocaine among others.

Firstly, Injected drugs, as the name suggests, are drugs that are directly administered into the
person’s bloodstream using a needle and syringe. The transmission of HIV is primarily due to
sharing of the drug injecting equipment. If a non-infected person shares his/her equipment with
someone who is HIV positive, infected blood would remain on the needle or could also spread
into the drug solution. Injection of this drug solution or needle into the non-infected person
would easily transmit the HIV.
Secondly, methamphetamine, also known as “meth”, is one of the major addictive intoxicant
which is snorted, smoked or injected. Apart from meth, it is also known by many names:
crystal, tina, black beauties etc. Meth can affect a person’s self-consciousness and interfere
with victim’s judgement, regarding his/her behaviour. This may cause victim to become
vulnerable against others. This increases the risk of HIV transmission through unprotected sex
and shared injection use. Meth usage has proved to be a risk factor of HIV transmission for
anyone who uses it however it has proved to be fatal in homosexual sex (sexual encounter
involving men having sex with men), as it increases the HIV transmission probability margin
beyond expectation. It has been studied that homosexual men who are users of meth increase
their sexual and drug risk factors due to using condoms less often, having multiple sex partners,
having unprotected anal sex, injecting meth instead of smoking or snorting it.

Furthermore, drinking alcohol can increase the risk of transmission of HIV. This occurs,
majorly, in binge drinking, which refers to drinking a large amount of alcohol in a short period
of time. Inebriated state affects the victim’s ability to make logical and safe decisions as well
as reduces self-consciousness, which may lead the victim to take severe risky decisions such
as unprotected sex, however this may not be the case if victim is sober and in control. Alcohol
use can also have adverse effects on those who are HIV positive. One of the major effects
include adherence to the HIV treatment plan (failure to take ARV medicines on time) due to
lack of self-control, causing deterioration of victim’s HIV infection beyond control. In addition
to that, alcohol use causes other health issues such as liver disease that leads to advancement
of HIV infection.

Crack cocaine is another potent addictive stimulant drug. This drug is normally found in
powdered which can be inhaled through the nose, or it could be dissolved in water and injected
straight into the bloodstream. The term “crack” refers to the form of cocaine that has been
processed to form rock crystals that victims can easily smoke. Use of crack cocaine can put the
victim at risk of getting HIV infection because it adversely affects the proper judgement
causing him/her to have risky sexual behaviour. Moreover, the effect of drug is short lived
therefore the addictiveness can create a compulsive cycle which would lead to exhaustion of
money. This will lead to victim indulging into other methods of getting the drug such as trading
sex for drugs and money which boosts the infection risk to an extreme extent. Use of this drug
has several adverse effects such as: high numbers of sexual partners, less frequent use of
condom, using more than one drug, and less responsive to ARV treatments.
Among the list, there are other drugs that are less powerful, nevertheless, they are associated
with increased risk for HIV infection. Drugs like Ecstasy, ketamine, GHB, and amyl nitrite can
alter the judgement of the users and affect the ability to make logical decision about sex and
other drug use. These drugs increase the chances of the victim to have unprotected sex or even
use other powerful drugs such as mentioned above. These behaviours can increase the risk of
exposure to HIV at a great extent. If the victim is already HIV positive then, he/she may become
a potential threat of spreading the infection to others.

The use of amyl nitrite, also known as “poppers”, which is inhaled, is known to be associated
with HIV infection. Amyl nitrite is specially used when victims want to indulge in anal sex as
the drug is known to relax the anal sphincter muscles. This is majorly linked to the risky sexual
behaviours, illegal drug use and sexually transmitted diseases among homosexual and bisexual
men.