Comparing Social Determinant and Prevalence of HIV/AID in Southern States (USA) and South Africa

Comparing Social Determinant and Prevalence of HIV/AIDS in the Southern States (USA) and South Africa HIV prevalence is an issue of concern, World Health Organization lists HIV among the most risk health problem across the globe. Like some killer diseases, the high rate of spread associated with HIV concern critical health determinants that vary across the globe.

Notably, HIV infection varies along vulnerability and health determinants. Commonly noted vulnerable groups experience the problem with respect to gender, sex, age, economic status and mode of drug intake among other factors. In addition, some health determinant with regard to HIV prevalence is of a social nature, according to the WHO (2015) definition of the social determinants of health, this is the conditions under which given community must live and work. The determinant of health can be of social, economic or political proportions.

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A common effect of the social determinants of health is that it leads to inequality in the provision of health care thus affecting the health of individuals disproportionately. Previous research that the lowest ranked member of the society is more likely to suffer from diseases leading to premature death, among then HIV/AIDS. This paper will compare and contrast social determinants of health along one vulnerable group in two distinct geographical locations. It will also explore how the society changed in the countries since the onset of HIV-AIDS epidemic, the communities under study will be African Americans in the Southern States of the USA and Black women in South Africa.

The case of African Americans in the Southern States and Black Women in South Africa HIV impact on the Southern States is disproportionate with reference to race and sex, one of the defining characteristics of the region is the presence of policies that impede early detection and prevention of the HIV prevalence among African Americans, hereafter referred to as Blacks. Historically, Blacks in the region have been a center of discussion during the years of civil rights movements, today, while there might be equality in terms of civil rights, the social relation in the region places black women at higher of HIV epidemic. Southern United States account for 44% of people living with HIV, as of 2015, the HIV diagnosis of the population revealed a prevalence rate of 73.7 per 100000 black community compared to the 24.8 per 100000 registered by the Hispanic population (Rosenberg, Grey, Sanchez & Sullivan, 2016).

The figures suggest that black women are at risk of infection given the poor social structure. Arguably, Black women in the Southern States double oppression, one from the feminist setting and the other imposed by the socio-political culture that adopted since the beginning. A similar situation is evidenced in South Africa, one of the defining features of South Africa is apartheid, although it does represent the typical elements of slavery, it does expose women to similar health deterrents experienced by women in the US.

A prominent social determinant in both settings is social norms and exclusions directed towards women. However, while the Southern States does not have a particular culture direct towards women, but the only familial relation with close relation to cultural norms, South African Black women face a culturally mediated deterrence to access to healthcare. An examination of the prevalence of HIV with regard to set reveal that only 9.5 of men are positive as compared to 13% for women (Kalichman, 2005). The role of men and women in social relations, access to health and familial duty is so deep that both men and women see male dominance as an acceptable norm.

The subordination of women that sometimes lead to sexual coercion, violence, and rape is a practice that places women at risk of infection (Kalichman, 2005). In a similar manner, men and women do not typically rank the same in typical setting of the Southern States, they tend to go through subordination and its potential risks in a similar manner as women in the South Africa. In 2005, 40% of women in South Africa reported sexual coercion and 1.6 million women reported rape in the same year (Bruyn, 2004).The figures are important since the high rates mean that victims have a 30-40% chance of contracting the virus.

The United States is not different from South Africa, a significant percentage of women report similar cases, In 2011, the New York Times reported that 1 in 5 women reported a history of sexual coercion, with a national HIV prevalence of 49%, women are at risk of new infections as long as the social structure allows for male dominance and associated effects (Rosenberg, Grey, Sanchez & Sullivan, 2016). CDC revealed that there are higher rates of HIV prevalence in an area with higher urbanity, fewer owner-occupied units and more females per household, the findings suggest that these social and structural determinants of health affect HIV prevalence. The findings suggest a similar pattern developed by previous research that indicates a correlation between poverty, urbanization and disease prevalence (Rosenberg, Grey, Sanchez & Sullivan, 2016).

Poor women in South Africa are worst affected by the epidemics that high-income women, the pattern appears in the Southern States. Since access to health care varies along income levels, people with higher income can access quality care and thus show a lower rate of new infection than those in a lower income bracket. In previous studies.Race is among the oldest determinants of health in modern societies, researchers content that race relates to a social class which in turn translates to economic status. A similarity between South African and American societies is the existence of racial divide, in both cases, the Black race makes the lower income group. The suffering of Black women in the Southern States emerged year of slavery, the trend continued to modern times. Generally, they have limited access to quality healthcare as well as health support systems.

In a similar manner, women in Black women in South Africa went through the years of apartheid. A unifying factor is that in both societies, access to better healthcare was limited to people of a particular race, the black hospitals were limited in terms of resources, the same trend continues to manifest itself in modern societies. Since race has a close relationship to ones ability to climb up the social ladder of income, many women in both settings continue to live a life of economic disadvantage, this applied in their access to HIV management services. In both cases, the high rate of HIV prevalence has deep roots associated with complex political history, interconnected social and structural deterrence. A major unifying factor in the cause of disparities in diagnosis, mediation, and care related to the modern social setting.

The US is a high-income country, however, Black women face such limitations due to factors connected to racism and discriminatory policies, poverty, low health insurance coverage, unequal education, high rates of unemployment and rate of other sexually transmitted infections. While Women in South African and women in the Southern States in the US face similar health deterrents, they face this challenges in different levels. A major difference is the level of poverty, health care quality and access to health care.

While the USA is a developed country, South Africa is a middle-income country, the quality of healthcare available to women are thus less developed compared to that available to Black women. In addition, while health in the Southern States is affected by the rate of incarceration of male partners, women in South Africa face more problems resulting from extreme poverty in comparison to women in the Southern States. The societies have changed in various ways in response to the HIV epidemic. For instance, USA has increased access to health services for women, aided by insurance schemes that target the HIV epidemic.

The government has developed policies that allow women to acquire health coverage that was not accessible to them in past at a lower cost (Outwater, Abrahams & Campbell, 2005). In a similar manner, the South African government is taking interest in the affairs of women. One of the risk factors that the government is combating in health inequality, it notes that it is essential to provide women with an intervention that prevent their exclusion and subordination, there are legislations to protect them and provide them with adequate healthcare and health education (WHO, 2005).

While such initiative will give women a chance to take control over their health, it is essential to achieve a higher level of awareness in both cases to ensure a reduction in the spread of HIV (Marmot, 2005). In a society where there is better access to health and education, women can play a role in reducing the spread of the virus. Once women in South Africa and the Southern States are educated and empowered, they will be in a position to lead the way in taking initiatives to protect and support themselves in the in a face of HIV epidemic.


World Health Organization.? (2005). Social Determinants of Health: The Solid Facts.? 2nd? ed. Richard Wilkinson and Michael Marmot. Denmark: World Health Organization, 2003. Web. 10 August 2015.

Marmot, M. (2005). Social determinants of health inequalities.? The Lancet? 365: 1099-1104.

Kalichman, S. (2005). Gender Attitudes, Sexual Violence, and HIV/AIDS Risks among Men and Women in Cape Town, South Africa.? The Journal of Sex Research? 42.4 (2005): 299-305. Web. 27 July 2015.

Outwater, A., Abrahams, N & Campbell, J.C. (2005). Women in South Africa: Intentional Violence and HIV/AIDS: Intersections and Prevention.? Journal of Black Studies? 35(4): 135-154.

Rosenberg ES, Grey JA, Sanchez TH & Sullivan PS.? (2016). Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in US States, metropolitan statistical areas, and counties, 2012-2013. Stall R, ed.? JMIR Public Health Surveillance. 2(1):e22 doi:? 10.2196/publichealth.5684

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