| Chapter 1: | Introduction |
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illnesses, vulnerable population groups, such as those at the bottom of the social stratification system—the poor, women, and children—have been disproportionately affected by HIV/AIDS. Statistics reveal that since the epidemic outbreak, the poor (especially those living in low-income nations, specifically in sub-Saharan Africa) have carried the biggest burden of AIDS. This may be because, unlike in developed nations where the infection rate was easily contained in the first few years after the initial outbreak, the disease spread like fire in developing countries that lacked well-established surveillance, monitoring, and prevention systems. Of the 33 million individuals living with the virus in 2009, about 23 million lived in sub-Saharan Africa (71%) (UNAIDS, 2009). Only about 1.5 million lived in the United States and Canada combined. During the same year, sub-Saharan Africa reported about 1.8 million new HIV infections as opposed to the 70,000 reported in North America (UNAIDS, 2009). Likewise, of the 1.8 million individuals who died of HIV/AIDS worldwide in 2009, 1.3 million are said to have been living in sub-Saharan Africa as opposed to the 26,000 in North America (WHO, 2011b). The advent of antibiotics in the 1940s had steadily increased life expectancy globally by 1980 to above 60. However, AIDS has tremendously reduced life expectancy, specifically in countries most affected by the pandemic as compared to the least affected. For example, the average life expectancy of individuals who live in sub-Saharan Africa is about 54 years. In contrast, life expectancy in developed countries remains high—with that of Japan being 86, Australia, 84, and the United States, 79 (UNAIDS, 2010a).
Females, especially those of childbearing age (15–45), have also been disproportionately infected with the disease. According to the World Health Organization and the Joint United Nations Program on HIV/AIDS estimates, in 2009 some 50% of those living with HIV/AIDS globally were females (Laing & Hodgkin, 2006; UNAIDS, 2006c). In sub-Saharan Africa, females carried 60% of the HIV/AIDS burden in 2009 (WHO, 2011b). In a study of nine countries in sub-Saharan Africa, Gouws (2008) reported an HIV prevalence rate of about three times higher for females as opposed to males ages 15–24. The most affected