The influence or effects of HIV / AIDS differs significantly in the countries present in the region, relying upon the duration and the magnitude of the epidemic. Many of the countries go through epidemics that are generalized. The occurrence rate in adults have gone to a percentage that is greater than twenty in some of the countries that include Swaziland (26%), Lesotho (24%) and Botswana (25%), as per the Joint United Nations Program carried out on HIV / AIDS (UNAIDS) (USAID, 2011b).

The rest of the countries undergo concentrated epidemics with Burundi being an example of the disease hotspot. Here the occurrence rate of the disease is as high as almost forty percent and this rate is around sixteen times higher for sex workers when they are compared with the overall adult population as a whole. In the region of West Africa, an overall occurrence rate is considerably less than what is prevalent in Southern and East Arica (Gilks et al., 2006).

However, in areas for MARPs or where most-at-risk populations are present, epidemics are not a rarity. Because of the differences, the strategic methodologies to counter the ailment ought to be developed to appropriately address the epidemiology of the respective disease in each country and area where it is present (The Sydney Declaration, 2007).


A heterogeneous epidemic scenario exists in the area of Sub-Saharan Africa that revolves around varying trends and prevalent in the stated three areas. When it comes to the region of Southern Africa, occurrence rate has come to a stable point that is very high in many of the countries. However, in the area of East Africa, the prevalence rate has gone down since the year 2000 and has settled at a level that is lower than what is existent in Southern Africa (The Sydney Declaration, 2007).

When the area of West Africa is considered, the occurrence rate is significantly less when compared with the overall rates of the rest of the region with an average of less than two percent prevalence rate existing. However, some exceptions are Cote d'Ivoire where there is an average of 3.4%, Gabon had an average of 5.2%, Nigeria had an average of 3.6%, Cameroon had an average of 5.3%. Inside the countries mentioned, the influence of HIV differs considerably (Sarna et al., 2008).

It is reported that it is the urban centers that are affected the most. Among the three areas, the main type of transmission is offered by heterosexual sex, although in areas that have concentrated epidemics, other types of transmission can serve an important function, not excluding migration, mother to child transmission, men having sex with men and sex work (Burgoyne and Tan, 2008).

Southern Africa.

Southern Africa had around eleven million people with PLWHA in the year 2009 and is still one of the areas that are most severely affected. Given this, it's not a surprise that almost fifty percent of all the PLWHA come from Southern Africa. According to UNAID, around forty percent of the women that are tested HIV-positive globally reside in the respective sub-region (Bunnell et al., 2006).

Of all the PLWHA in the world, out of five at least one resides in Zimbabwe, South Africa and Botswana. Around 6 million of them reside in South Africa. One of the countries that have the greatest occurrence rate all over the world is Swaziland. It is estimated that of its entire population, one in every four is tested HIV positive (Zachariaha et al., 1007). The occurrence rates in majority of the countries in the area have settled down, though in the country of Zimbabwe the rate has undergone an increase in light of newer infections potentially associated to its continuing political and civil destabilization (Watt et al., 2009).

Moreover, reducing the amount of HIV infections in the area of Southern Africa is increasingly becoming a growing problem and difficulty. When compared with other areas in the sub-region, Angola consists of a considerably low HIV occurrence rate that is settled at two percent (Bekker et al., 2006). This is partly because of the restricted travel that is allowed between countries at the time it was undergoing the civil war in the years between 1975 and 2002 that slowed the growth of the disease in the country (Feradinni et al., 2006).

In the respective area, the epidemic influences people in most of the levels of income, education, migration and society sub-groups. Increase of programs that are designed to prevent is essential to develop ongoing decreases in the occurrence rate of HIV (Ivers et al., 2005).

East Africa

In the countries present in East Africa the occurrence rate of HIV has gone down or settled at a stable rate in the years that have gone by recently. In the respective area, the severity of national epidemics differs with each country. Also, the main type of transmission is still given by heterosexual sex. Various and simultaneous linkages are especially difficult as they associate a reasonably low risk for people, the ones that are in committed relationships or are married at a higher threat (Stringer et al., 2006).

The occurrence rate of Uganda, Tanzania and Kenya is greater than 5% standing at 5.4%, 6.2% and 6.3% respectively. The presence of hotspots in these countries is not a rarity and the occurrence differs with region to region. The area of Rwanda has undergone considerable success in decreasing the prevalence in adults that now stands at a mere 2.8%, even though the occurrence rate is still significantly high in pregnant women that are of nineteen years of age and below (Nachega, 2006).

Because of the continuous controversies and disagreements occurring in a military coup present in Madagascar and the DRC or Democratic Republic of the Congo, it is uncertain what the future will hold for the HIV / AIDS epidemic. In the region of East Africa, Madagascar has had the lowest occurrence rate with only 0.1 prevalence rate existent in its adult population (Bristol-Myers, 2007).

West Africa

The information that is provided by the UNAIDS depict that the West Africa countries have one of the lowest HIV occurrence rate in the whole of Sub-Saharan region of Africa. The occurrence rate in adults is greater than two percent only in the regions of Nigeria, Cote d'Ivoire, Gabon and Cameroon as mentioned above. A decrease is reported by the UNAIDS in the occurrence of HIV in Mali, Burkina Faso, Togo, Cote d'Ivoire and Niger especially with respect to pregnant women. In most of the other countries, the epidemic has also reached a stable level, even though concentrated epidemics continue to exist in MARPs, for instance men who are having sex with men (MSM) and in females working as sex workers (Weidle, 2006).

For instance, in the region of Senegal the occurrence stands at less than one percent, even though, among the sex workers living in Ziguinchor, the occurrence rate almost touches the thirty percent mark. Few of the countries have experienced decreases in the growth of occurrence, particularly with respect to young people. In the area of Ghana, the occurrence with respect to young adults, the ones who are of less than twenty four years of age, has gone down considerably from being 3.2% in the year 2002 to being 1.3% in the year 2009 (Posse and Baltussen, 2009).

In order to prevent PMTCT, the provision of ARVs or antiretroviral drugs has been enhanced. However, the provision level continues to be low in the area of Central Africa and West when compared with Southern and East Africa (Mshana et al., 2006). Because of its hugely growing population, Nigeria carries the second greatest HIV burden globally, with around 3.3 million people being afflicted from it. However, the occurrence rate has settled down at 4% (Hardon et al., 2007).


Social determinants of disease

Violence, gender bias and physiological vulnerability to HIV make women a more susceptible target to acquiring HIV when compared to men. Also, further legal, economic and social imbalances also add to the overall level of risk. The occurrence rate within women is almost four times higher when compared to the prevalence in men who are of the same age and in the same region. Restricted power while making decisions about sex, for instance the decisions about the usage of condoms also contributes to the overall level of risk (Ncama et al., 2008).

After analyzing the situation of HIV in Africa, the following hypothesis can be formed which either will be proven or refuted:

H1: the sex industry in Africa feeds the growth of HIV / AIDS in the region

H2: social instability i.e. violence and gender bias in Africa feeds the growth of HIV / AIDS in the region

H3: instable government input in Africa feeds the growth of HIV / AIDS in the region


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