HIV, which is an acronym standing for Human Immuno Deficiency syndrome refers to the virus that causes Aids as a result of the weakening of the immune system by the virus. It is not just a serious threat to social and economic development, but also to our very existence. Millions of people are already infected and others affected by the pandemic, living children as orphans, wives and husbands widowed and a major blow on socio-economic development of any nation due to low economic productivity leading to low standards of living or stagnation. According to Justice Michael Kirby 1992, the reaction of the society to the disease as an epidemic has been characterized by panic, alarm, banishment, public stigmatization and legal provisions reinforcing them.
However, the focus will be more on HIV in prison, which is an area believed to have a high prevalence rate of HIV infection due to the conditions, policies governing the inmates and the character orientation of those in prison. This will be guided by a brief literature review on the topic to explore the problems of HIV, the impact of the problem to the society, the future implications and the recommendations or solutions to the problem.
HIV in prisons poses a very serious public health concern not only to the government but also to the society at large. This is because people in prison are more likely to increase the transmission of the disease due to the fact that most of them are already infected and more often than not they will find themselves in and out of the prison, thus infecting the outside population and those already in prison. In addition, people in prison are at risk of contracting HIV through injecting drug use, unprotected sex and tattooing, rape and sexual harassment due to deviant behavior of the prisoners. However, in spite of this fact, many countries have greatly neglected HIV intervention, prevention and care in prisons (Larneys, 2009).
According to a source by Dolan and Larneys, a review on HIV in prisons in Nepal, and another source on program of international research and national drug and alcohol research centre, university of new south Wales of Australia, the poor conditions in prisons and information asymmetry regarding HIV prevalence or risky behaviors among prisoners has led to increased transmission of the disease. Nepal’s national prisons HIV strategy acknowledges the importance of prisons in broader HIV prevention and intervention efforts. However, HIV prevention and intervention measures have largely been limited to organized small committees and training workshops. In addition, antiretroviral treatment is not available to the infected prisoners (Larneys, 2009).
The study concludes by pointing out that the government has put some efforts in the litigation of the problem as it points out that there is recognition in government policy documents that prisons must be involved in efforts to stem the HIV epidemic. However, HIV prevention and care remains largely non-existence in Nepal’s prison. Also the study points out that in order to reduce the problem of HIV prevalence in prisons, there is needed more efforts to obtain external funding and maintain programs such as drug dependency treatment and condom distribution. Also more attention should be given to introducing alternative punishments for less serious offenders and drug dependant offenders instead of putting them behind bars hence perpetuating the transmission of HIV in prison. Other related sources to the study include; sex health by Hellad ME, Altken C, 2004, which touches on HIV in prison, risks and what can be done on the same problem, Jurgen R, Ball A, Vester A, 2009, on interventions to reduce HIV transmission related to injecting drug use in prison, Larney S. 2010, who focuses on the question whether opioid substitution treatment in prisons reduce injecting-related HIV risky behaviors.
From the above sources, one can draw up a conclusion that governments and the society at large is putting more efforts and consideration to the problem and challenges posed by HIV epidemic specifically in prison and by coming up with preventive and intervention measures so as to reduce the prevalence.
More over, HIV epidemic is associated with a number of problems that it poses to the society including those living in prison. For those living in prison, the problem of HIV is fueled by a number of factors such as poor prison conditions, high rates of HIV prevalence in prison and high risky behavior among prisoners. For instance, most prisons of the world are associated with overcrowding which increases chances of deviant behavior due to a large number of people with different personality and character. In addition, prisons commonly operate in atmosphere of violence and fear and therefore prisoners may be oriented to this kind of maladjustment therefore engaging in crimes deviant behavior such as sexual harassment of their colleagues, rape, homosexuality and lesbianism, which are one of the contributors to HIV transmission. There is also tension that is associated with the prisoners such as sexual tension and boredom and to release themselves from these tensions, they indulge in consumption of drugs and risky sexual activities such as unprotected sex.
The risky behavior that contribute to the problem of HIV in prison include behaviors such as use of contaminated needles to inject drugs, sharing of tools used in tattooing and engaging in unprotected sex. The other problems associated with HIV health problems such as aids which is an infection or infections that happen only when a person has a weak immune system and opportunistic infections that are common to all people but are worse to those who are HIV positive. Other health problems associated with HIV infection include neurological problems such as memory loss, heart disease and diabetes. Research also has shown that those that are HIV positive tend to age faster than their counter parts who are HIV negative.
The other problem is that there is a lot of stigmatization of those infected and affected by HIV in the society leading to discrimination when it comes to enjoying favors in different aspects of life. This leads to low self esteem of these individuals and self pity, others succumb to death due to stress and pressure from the community and giving up in life. The impact of HIV to the society is far and reaching. It is seen to have a lot of impact, negative impact in this case to the various sectors such as; impact on the health sector, households, enterprises and work places and finally impact on the economy. This leads one to look at the whole problem in terms of the socio-economic impact.
Looking at the health sector, there has been a rise in demand for care of those living with HIV which the health practitioners may not be in a position to provide sometimes due to the limited resources. In addition, there has been a toll on health workers who get infected in their course of duty who eventually may die or fail to continue with their work thus leading to a shortage of the health personnel who are supposed to provide health care and advice. Due to the same problem, there has been an increased medical cost on HIV for example costs spent on drugs, preventive and intervention measures and trainings and workshops for the health personnel. Also, provision of antiretroviral therapy puts pressure on professionals as it requires more time and training than is available for them.
The impact on the households is seen in the sense that many families have succumbed to poverty due to the problems of HIV and aids. This is because it deprives families of their assets and resources that are supposed to be used for developments and for economic purposes. It has also led to increased cases of divorce as spouses start blaming one another, leaving one spouse to take care of the children which lead to over burdening of one individual. Their is also increased dependence on one bread winner, sometimes forcing children to abandon their education and women forced to turn to prostitution which in turn fuels further and a higher risk of infection.
To the enterprises and workplaces, the impact is of equal weight. It greatly affects the workforce hence creating a set back in socio-economic progress. The company costs are likely to be diverted to from the main objectives and diverted to activities such as health care of those infected by HIV, funeral benefits, and pension fund commitments are likely to increase hence increasing the company’s cost. The problem also leads to a fall in demand for products and services of a company due to a decrease in population. Finally, there is reduced productivity due to absenteeism of the workers either because of weakness or taking care of their loved ones back at home.
The impact on the economy is that the supply of labor is reduced due to increased mortality and illness of the workforce. To the government, there is increased pressure to increase its public spending on prevention and intervention measures against a declining income as tax revenue falls. The income tax falls as a result of its workforce succumbing to the illness. Also the fact that the age group that is supposed to be productive in the economy of any country is the one that is largely affected by the disease indicates the adverse effect that HIV can have on the economy.
The future implications of HIV, either to the society or in prisons are inevitable. These implications can be on the issues of land, the livelihood of people, on education, the economy, to the government and to the business and industry. If no litigation measures are going to be put in place, for instance, the education sector is going to be greatly affected registering low rates of enrollments in school, high rates of drop outs and repetition. This due to the fact that many children are left orphaned with nobody to take care of their educational needs and those that succeed to enroll in school face a lot of stigmatization and discrimination from their peers and teachers. Also investments in education are reduced as the parents and the government lacks motivation (Jurgen, et al, 2009).
Also if no preventive measures are going to be taken, food security may be threatened leaving the nations in food crisis with lack of a nutritious diet. This is because the productive people are greatly affected by HIV and most of them end up dyeing or becoming too weak to engage in any productive activities. Finally, governments and political systems, including effects of on levels of civic participation, policy and law and availability of qualified personnel for civil services and political positions are the areas that are the areas that are likely to be affected in future if the problem is not taken care of before it gets out of hand. This is because if candidates who are qualified for the positions in government and policy development are dying of the disease, then the country is left with weakened political systems and low levels of civic participation.
My personal recommendation is that there is need for the health sector to provide guidelines on health and safety of the staff when taking care of those infected. It is also of great importance to provide adequate education and information to the inmates on how HIV is transmitted and how they can effectively protect themselves from the scourge. Also a lot of care should be taken when it comes to handling HIV positive inmates and the normal, those infected in the normal population as some of them tend to be aggressive and jealous and can easily scheme ways of infecting someone.
In the case of drug abuse by the prisoners, they can be sensitized on the role that these drugs play in the transmission of HIV and then be discouraged from taking them. They can also be forewarned on the dangers of sharing sharp objects such as needles and tattooing instruments and also engaging in unprotected sex. In addition prison reforms can be one of the litigation measures to reducing HIV prevalence in prisons. These reforms can either be through reducing overcrowding and providing resource facilities for those prisoners infected and may not be eligible for release. Finally on stigmatization, the society can be enlightened on how the one can and cannot be infected by HIV and showing them that those infected are also normal human beings.
Also considerably, the future of any nation depends upon a healthy population and thus the government or those in administration should take relative measures to ensure a healthy future population by giving public education to the masses, make available and accessible anti retroviral drugs and therapy to people living with HIV and Aids at subsidized rates, make Antiretroviral available for free to HIV positive expectant mothers and also encourage donations and support from Non-Governmental organizations. More over, HIV/Aids should be treated like any other incurable diseases like hypertension, diabetes, cancer and arthritis. To this end, insurance companies should be made to consider the disease in the same way and start proving an insurance cover to those infected. There can be no justification for refusing to honor the contract on principles of disclosure. By so doing, it will save the public as well as the insurance companies the burden of proof (Jurgen, et al, 2009).
Also bills to HIV prevention and control should be passed as a matter of urgency. This can go a long way in solving the problems of people living with HIV/aids with respect to discrimination. The government should also encourage continued medical research, it can do so by enhancing and financing and recognizing herbal therapy. However, there should be measures to govern the research. Penalties on alarming reports should be encouraged whether by individual media or any other sector. This will check on illegal practices by unqualified people. All employers and institutions should as a mandatory requirement introduce HIV/Aids program and safety guidelines and other measures in the work place. This will go a long way in reducing illiteracy, unethical justification and also check on rampant spread of HIV/Aids. Finally, the prison conditions including prisoners’ rights must be addressed. For instance married person should have access to their spouses while serving sentences. To solve the problem of congestion, the court can also mete out non custodial sentences which include community service orders which may help curb the spread of the disease amongst the inmates (Jurgen, et al, 2009).
In conclusion, HIV is manageable whether in prison or outside. However, it all depends on the seriousness of the involved parties in its prevention and interventions. Prisons were hit by HIV early and hard. The rate of HIV infection among prisoners is significantly higher that those in the general population in many countries. While most of the prisoners with HIV in prisons contracted the infection before imprisonment, the risk of getting the infection particularly through sharing of contaminated equipments and having unprotected sex is high. Various studies have shown that most prisoners have a history of difficult drug use and the use of the drugs, that comprises injecting drug use, takes place in prison. HIV outbreaks takes place in various prison systems. This shows how rapidly it can spread if no effective measures are put in place to avert the transmission.
The significance of executing HIV interventions, which comprises of drug treatment programs in prisons, was acknowledged earlier in the epidemic. The universal HIV environment is substantially aiming at massively scaling up of prevention, treatment, and care interventions. To enhance this, extra resources have been put in place to finance an enhanced response including via the worldwide Fund to Fight AIDS, TB and Malaria. Various governments have been faced by various challenges in translating their commitments into practical programs, which would encompass implementation of a all-inclusive range of interventions to deal with HIV transmission that may be as a result of injecting drug use, as well as in their prison systems.