AIDS, Early pregnancy and Artificial conception are just some of the main issues commonly interrelated with fertility or reproduction, both of which are sensitive topics, that ironically must be given more attention academically.
This paper is divided in two parts. The first part tackles In-Vitro Fertilization and other kinds of artificial conception, and the correlation of AIDS, early pregnancy and prostitution, while the latter part focuses the socio-economic and health impacts of AIDS and prostitution with more emphasis on developing countries.
Emergence of Artificial Conception
Artificial insemination and In-Vitro Fertilization are just two ways of replicating pregnancy through the normal process of fertilization wherein a single sperm cell from a male organism combines with a female from the same specie’s egg, without having to engage in coitus or what is more commonly known as sexual intercourse. Artificial insemination is a fertility treatment for humans, and is frequently practiced in breeding dairy cattle and pigs; it may make use of assisted reproductive technologies such as donated sperms and/or animal husbandry techniques. On the other hand, In-Vitro Fertilization refers to the process of joining a woman’s egg and a man’s sperm in a laboratory dish. The term “In Vitro” means ‘outside the body.’ while fertilization refers to the process wherein a sperm has attached or entered the egg (Alvarez, Garrido, Taronger, & Merlo, 2013).
Amidst impotence and infertility problems among men and women, fertility rate in some countries are still high resulting to uneven distribution of population. In Niger for example, the average number of child that a women would probably give birth to is 7.3, the highest among 224 countries. Singapore in comparison got the lowest fertility rate with only 0.79 per women followed by Macau with only 0,93, which is literally a far cry from the fertiliy rate that Niger, and other densely populous cities got in various international census done by agencies such as the Central Intelligence Agency and the World Bank (Strassburger, Goldstein, Friedler, Raziel, Kasterstein, & Mashevich, 2010).
Psychological Impacts of Infertility
The failure to conceive children is often perceived as a traumatic experience by individuals and couples, regardless of the family or cultural background (Cha & Chian, 2008). The consequences of infertility are multiple and can consist of societal repercussions and personal agony. Developments in assisted reproductive technologies, such as Intro-Vitro Fertilization, can offer optimism to many couples where treatment is available, even though barriers exist in terms of medical coverage and affordability (Huang, Chang, Tsai, Lin, Kung, & Wu, 2009).
Female infertility experience can be both intricate and agonizing. It is generally characterized by periods of intense feelings of loneliness- triggered by her spouse, her social sphere and society. As more than one female client has reflected, it can be considered as if they are not conforming to the normal human ways of the world, which is to procreate (Smitz & Cortvrindt, 2009).
Females can feel more insecure and misunderstood all throughout the experience, which adds to their likelihood of suffering from depression and loneliness. Pregnancy and maternity is inextricably wrapped up in perceptions of feminity, and infertility can bring to mind a persistent sense of failure as a woman. A woman may also have the tendency to feel that her body has failed her (De Vos, Van de Velde, Joris, & Van Steirteghem, 2009).
All of which can have a distressing effect on self-confidence. For those who desire a child, this desire can actually worsen the situation, and for some it can become overwhelming, which creates disturbance within the family. This may result in a condition wherein the male, the female, or the couple themselves becomes in pursuit of a treatment without taking time to think about the impact of such decisions on their body, their partner and their relationship. The treatments and their corresponding results can be unpredictable. Ultimately the experience for females can lead to major psychiatric conditions such as anxiety, depression, and other anxiety and depression related disorders (Schoevers, Bevers, Roelen, & Colenbrander, 2005).
On the other hand, the experience for males can be an apprehension filled one that poses a major impact on their masculinity. Conversely, it is not necessarily a painful experience. All that males usually problemize is their possible contribution with their female partner who according to sutides, suffer more than their male counterparts (Nagy, Cecile, Liu, Loccufier, Devroey, & Van, 2006). Unluckily, this can lead people around them to make the supposition that they are fine. Another characteristic of the usual experience for males in situatons wherein they are accidentally paired with an unknowingly infertile partner is that they worry about the pressure on their partner and their partner’s increasing desire for a child, and they also usually become preoccupied by the idea of what might happen in the future if they faile to achieve their goal. To summarize, it can be a time or instance of great insecurity for males (Adesiyun, 2012).
The medicalization of infertility has unknowingly led to a disregard of the mental, physical, social, and emotional responses that couples experience, which include distress, loss of control, stigmatization, and disturbance in the developmental course of adulthood. Substantiation refers to the merging of or association between anxiety of fertility treatment and patient pregnancy and drop-out rates. Auspiciously, psychological interventions, especially those emphasizing stress administration and coping skills exercise, have been shown to have useful effects among infertility patients. Further study is needed to comprehend the connection between anxiety and fertility outcome, as well as successful psychosocial interventions however (Popkin, 2008).
AIDS, Prostitution and its effects in Fertility
Reproduction is a dual obligation, but so frequently in much of the world, it is seen wholly as the woman's liability. Women bear the burden not only of pregnancy and childbirth but also the threats from too much child bearing; some more responsibilities brought about by contraception, infertility investigation and often undiagnosed sexually transmitted diseases (STDs) including AIDS. Failure to target men in reproductive health interventions has weakened the impact of reproductive health care programs (Bakari, Sani, Aliyu, & Hassan, 2008).
In Botswana, people consider that male infertility in their country is caused by the use of contraceptives which is secondary to another issue which according to reviews turns out to be the rapid increase in HIV/AIDS prevalence rates in the region. Male infertility in particular is understood as a result of female contraceptive use and is highly stigmatized. In an area with such high HIV rates, these perceptions directly contribute to the lack of effective family planning and HIV prevention agenda in the country (Crosignni, Ragni, Parazzini, Wyssling, Lombrosso, & Perotti, 2004).
There are countless theories about the origin of Human Immunodeficiency Virus (HIV). The first known case was discovered in a blood sample collected from a man in Kinshasa, Democratic Republic of Congo in 1959. Genetic analysis of his blood suggests that the origin of HIV came from a single strain of HIV-1 in the 1940s or 1950s . In United States, the virus is known to have existed since the mid 1970s. Symptoms of rare types of what is now known as opportunistic infections began manifesting themselves between 1979-1981. HIV was first isolated by scientists in 1983 (CDC, 2012).
The emergence of AIDS in the global panorama has been a major source of distress world-wide. Since the mid-1980s, HIV has reached almost every country in the world. The international Labor Organization and Lisk describe HIV/AIDS as constituting a crisis for gender and development, as women are particularly vulnerable to infection comparative to men. The reasons are varied, which may include but are not certainly limited to psychological, socio-cultural and economic reasons. The latest HIV sero-prevalance survey shows that women aged 15 – 49 years old, comprise 56 percent of the 4.74 million infected. Women also tends to be younger at age of infection (15 – 35 years), compared to men (20 – 45); The combination of advanced infection rates among women, and their current economic and social vulnerabilities resulting in a deficit of income for therapeutic care and treatment, may translate in women dying sooner than men (Garg, Mohl, & Joshi, 2012).
Almost 10% or 3.1 million people out of the total number infected with AIDS die every year while another five million new cases are documented yearly. There are about 2.4 % AIDS transmission probability in every male to female sexual intercourse making commercial sex workers the most vulnerable of the disease.
. There are 34 million people living with Human Immunodefficiency Virus (HIV) worldwide and 72% of the children in need of HIV treatment are not receiving it. The highest numberr of HIV victims is in the continent of Africa with a concentration in the south, study shows that an estimated 69 % of all people living with HIV is inhabiting in the continent, also, 70% of all HIV related death are reported to happen in the same area.
In South Africa, the leading cause of death is still complications brought by HIV/AIDS as of year 2000. Around 132,990 out of 521,082 or roughly 25.5% of death was brought by complications related to HIV/AIDS. This is at least five times greater than the next single cause of death-stroke and heart disease, followed by tuberculosis and interpersonal violence each ranging for about 5.5 percent of deaths.
Meanwhile, the correlation of sexually transmitted diseases, prostitution and teenage pregnancy is inevitable, it will usually point in one cause which is miseducation as a result to lack of economic stability and government support. In United States alone, 82% of pregnancies in those between 15 and 19 are unplanned (Marnach, Long, & Casey, 2013)
Various studies about causes and effects of prostitution or the act or practice of engaging in promiscuous sexual relations for economic gain has been established, especially as threat of incurable diseases such as Acquired Immunodeficiency Virus (AIDS) spread in Africa, South-East Asia and other parts of the Globe, not to mention the increasing number of children who suffer from sexually transmitted diseases and teenage pregnancy due to early and permanent exposure in prostitution and other related activities, manifesting misconceptions about AIDS makes the increasing number of victims soar year by year .
This part of the paper aims to provide a comprehensive research and analysis of the current situation and probability of AIDS transmission to commercial sex workers as well as the risk of infertility and teenage pregnancy. Aiming to cite the effects and provide concrete recommendation on how to strengthen the campaign against these three acute diseases of humanity, the researcher maximizes latest studies about the subject matter and applied it in the current socio-economic condition of certain areas that could find the missing links on why these diseases continue to spread.
Poverty, Prostitution and its health effects
In developing countries, it has also been projected that "70 percent of female infertility is caused by sexually transmitted diseases that can be traced back to their husbands or partners. Among women in rural Africa, female infertility is widespread from husbands or partners who migrate to urban areas, buy commercial sex, and bring home infection and sexually transmitted diseases . Women in commercial sex industries have been blamed for the almost uncontrollable spread of STDs when, in reality, studies prove that it is men who buy sex in the course of migration and are also the ones who transmit the disease from one prostituted woman to one more and ultimately back to their wives and partners. This scenario perfectly describes a cruel vicious cycle which often leads to infertility and then to divorce and, in a few cases, the ex-wife who has been cast aside turns to prostitution to go on (McGovern, 2002).
Unquestionably, poverty is the root cause of prostitution resulting to higher probability of HIV/AIDS spread in developing countries. For centuries, it became a modern form of slavery wherein foreigners travel in third world countries to look for affordable and young commercial sex workers. In Thailand, prostituting children for economic gain was among the most despicable act. They characterize a sad story of human humiliation. Girls as young as 10-12 years old are recruited to work as sex slaves in the sex industry. Commercial sex workers in Thailand typically have sex with 10 to 15 different men every day and sometimes as many as 20 or even 30.
Every commercial sex worker is in danger of having AIDS with 2.4 percent probability in every act, summing all the service made by commercial sex workers in Thailand, they are 48-60 persent probable to be infected with HIV everyday, this statistics is very alarming especially that reported cases of AIDS in the said country already reached 1,115,415 in just a span of 24 years from 1984 to 2008.
Public health report in Thailand also shows that teenage mother aged 15-18 increased by 43% between 2000-2011. Lack of discussion and guidance leading to misinformation traced as one of the causes of teenage pregnancy, but going through an in-depth analysis, ‘lack of discussion’ has been just a result of time allotted focused on eradicating poverty or economic difficulties. Also, study shows that children living in rural areas migrate to look for a descent job but unfortunately falling in the hands of human traffickers in Urban areas.
The HIV incidence rate in the South and South-East Asia (mostly in developing countries) is reaching 0.35 percent with a total of 4.2-4.7 million adults and child victims. More AIDS caused deaths reaching 480,000 occur in this region than in any other place except Africa. The Geographical size and population diversity of the South and South-East Asia have resulted in the HIV epidemics varying in different regions. The AIDS epidemic in South Asia is being led by the epidemic in India. In South and South-East Asia, HIV remains principally concentrated in men having sexual intercourse with the same sex and commercial sex workers, clients of sex workers and their immediate partners.
Meanwhile 14,500-17,500 girls from other countries (usually from developing countries in Africa and SoutEast Asia) are smuggled into United States each year to serve as commercial sex worker while as many as 2.8 million children live on streets, a third are recruited as sex workers within 48 hours of leaving home. Average age of children entering into prostitution in United States is in between 12-14 years old, alarming fact that people getting involve in sex trafficking is getting younger and younger.
Discrimination among victims of teenage pregnancy and STDs
The troubles that face HIV/AIDS victims are now well familiar. These incorporate experiences of anger, guilt, fear of abandonment, grief, and potential economic destitution and marginalization due to others’ fear of contagion and associated stigma. However, limited attention has been paid to the effects of AIDS and AIDS-related disorders on the access to, and the provision of, health services. Considering how the stigma of AIDS affects the processes and experiences of identification, treatment, deterrence, and care is critical to efficient public health guidelines and the delivery of health care programs and health care services.
Discrimination of HIV infected person occurs in different ways including ostracism or exclusion, rejection and avoidance; compulsory HIV testing without prior consent or protection of confidentiality; violence, quarantine and in some cases, the lost of property rights when a spouse dies . Stigma related violence like these causes trauma and prevents people from seeking examination, returning for their results or securing treatment, making what could be a controllable chronic infection into death sentence that perpetuates the spread of disease.
Hardships of dealing with the social stigmas of unplanned pregnancy is also as serious as dealing with AIDS. If the common point of these problems is prostitution, then another dilemma would arise in which a child infected with HIV would be born. An estimated 14 million children in Africa have been made an orphan as a result of HIV/AIDS.
Expensive Cost of Treatment
Currently, the lifetime treatment cost of an HIV infection is estimated to be at S379, 668 (in 2010 dollar). This cost is equivalent to a $2,000-$5,000 cost of monthly treatment regimens.
According to the Centers for Disease Control and Prevention, roughly half of the people diagnosed with HIV in United States do not receive standard health care. Of those who do 42% receive Medicaid and 24% are not insured. People who are not insured can still qualify for health services through the federally financed and state run centers which pays for medication through the AIDS Drug Assistance Program.
Increasing awareness as a solution
Despite the effort of the World Health organization and other international health organizations concerned with various issues about HIV/AIDS, prostitution and teenage pregnancy, the number of new cases reported continuously increase day by day. It just shows that these institutions should not shoulder the full responsibility of controlling the spread of diseases such as AIDS. State governments should take the initiative to strategize a comprehensive plan of action against this incurable disease (as of the moment).
Education campaign in order to increase awareness and little by little eradicate the probability of spreading the virus is also a key factor to win the battle against HIV/AIDS and teenage pregnancy. This requires a higher budget allocation to education or or simply follow the recommendation of United Nation and World Health Organization to allocate each 6% of Gross Domestic Product in health and education sector.
A special committee that will focus on this kind of disease should also be established or strengthened (in case there is already one) through sufficient funding in each country to equip the people with a better understanding of the disease, appropriate medical assistance and attention to those who are already infected. In this way, each country would be capable of monitoring and controlling the spread of virus. Latest reports say that there is already a significant development in the research for HIV treatment regimens and strategies, this news reinvigorated the confidence of infected patients that finding a cure in AIDS is coming soon.
Latest Developments in Search of HIV/AIDS cure
Just this year, Deborah Persaud, M.D. a virologist from John Hopkins Children’s Center and colluagues Hanna Gay, M.D., from the University of Mississippi Medical Center, and Katherine Luzuriaga, M.D., an immunologist from the University of Massachusetts Medical School, announced the first possible real and functional cure of HIV in an infant.
A functional cure occurs when a person is able to keep the virus at clinically untraceable levels over the long term even after stopping treatment. While the group of scientists remind that the infants’ unusual case still need to undergo several studies, this could be considered as one of the greatest developments in the journey towards the search of HIV/AIDS cure. Dr. Deborah Persaud received the 2013 prominent Elizabeth Glazer Scientist award, the award is presented to her by the Pediatric AIDS foundation for her breakthrough research in pediatric HIV/AIDS. Reports say that Persaud will use the $700,000 prize money to better comprehend her work in drug-resistant HIV in pediatric patients in the United States and around the world.
Other higher education institution, private individuals and the government should support these talented people for future developments of their studies. For decades of research and experiments, it is the first time that a group of scientist made it to save an infant from a fatal virus such as HIV. It is now the perfect opportunity to further develop medicines or even vaccines against the incurable AIDS and save millions of lives now suffering from this disease.
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