Key Drivers of HIV/AIDS in Sub Saharan Africa and in San Francisco


HIV/AIDS continues to be a leading cause of alarm globally. New infections and deaths due to HIV/AIDS related complications are major issues that need to be dealt with urgently. It is particularly alarming in the sub-Saharan Africa where an average of 10% HIV prevalence in adults has been recorded. This is very high compared to the global average of 1%. The Southern Africa region accounts for about 40% of the global population living with HIV.

However, the female gender is more affected by the pandemic with women and girls accounting for about 60% of this population. Although the records indicate optimistic results, there is still need to enhance the campaign. In San Francisco, the new infections and death tolls may be on a down slope but the marginalized groups are still at a risk and this needs to be addressed. In this paper the key drivers of HIV/AIDS in Southern Africa and San Francisco will be discussed.

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HIV/AIDS in Sub Saharan Africa

The extent of the HIV/AIDS pandemic in the region can be attributed to such things as; Sexual behavior-many men and women in the region have different sex partners concurrently; these may be in cases of polygamy, small houses (side partners apart from spouse) and prostitution.

Many of them do not use condoms consistently meaning that safe sex practice has not been cultivated in them (Jana et al, 13-16). Secondly, male circumcision is practiced in very low levels and as we know, male circumcision is a major boost in the prevention efforts so lack of it is on the contrary. A third driver is the stigma associated with infection. This lack of acceptance by the individual and the community forces an infected person to keep their status secret which leads to further spread of the virus.

In some cases some people do not want to know their status for fear of stigmatization and this brings down the efforts of treating the infected persons. Also many sexually transmitted infections go untreated mainly due to this fear and they are a factor that encourages HIV infection. Male attitudes towards gender related issues such as reproductive health is also another contributing factor.

Men do not involve themselves in such issues and therefore many of them lack the knowledge to curb the pandemic. They involve themselves in intergenerational sex, gender based violence and sexual violence. This means that the women and girls are the major victims of the men’s ignorance hence the high number of infections in females (Expert Think Tank Meeting on HIV Prevention in High-Prevalence Countries in Southern Africa 5-7).

HIV/AIDS in San Francisco

In San Francisco, the efforts of prevention and treatment have born fruits since the number of new infections and HIV/AIDs related deaths is on a downward trend. The reduction in these numbers can be highly attributed to the change of sexual behavior in heterosexual men and women and non-injecting drug users.

Cases of new infections in these groups of people are very rare. However, there are still other driving forces in the spread of the disease and these include; Homosexual behavior; men who have sexual relationships with other men are at a major risk of infection. Transfemales are also another group of people who are on the higher side of the risk and hence their behavior is a key driver for the epidemic.

Injection drug use is another major driving force. HIV transmission among this group of people is very likely and so the risk of new infections is unacceptably high. Disparities and unequal treatment for different groups of people may have been a major drawback on the efforts but it is now on the downward slope. This is as a result of the efforts by different care groups to involve representation of all the communities; including the marginalized groups, in the decision making process (San Francisco HIV Prevention Plan 1).

Comparison between the key Drivers in the two regions

The driving forces in these two regions are very different since they are driven by the people’s lifestyles which in these cases are worlds apart. As a comparison of the key drivers in these regions, we look at the drivers the way they affect the efforts made to eradicate the disease.

As we have seen in the discussion earlier, the major driving forces in the sub Saharan Africa can be attributed to the regions position in terms of development. Most countries in the region are developing countries; and factors such as gender and sexual violence, poverty which leads to intergenerational sex and prostitution especially in women are inherent in these countries.

This makes the prevention and treatment processes very hard since some people are driven to the wall by circumstances; meaning that they may be willing to change their ways but the situations they are in cannot allow that.

In San Francisco however, the major driving force is the sexual orientation of individuals as well as drug and substance abuse. These can not be attributed to under development, therefore, the efforts to curb the epidemic can only be strengthened by the people’s willingness to change their ways.

If the high risk groups of people are willing, they can put in their efforts; for instance, the gay community can accept to learn and use preventive measures, the drug users can accept rehabilitation plans or in extreme cases they should take precautions in their sharing.

The Response of the Church to the Key Drivers of HIV/AIDS

The church has made a lot of efforts in the fight against HIV/AIDs; However, this has not prevented the spread of the disease. This continued deterioration can be attributed to the churches’ ethical, liturgical and ministerial practices. These have encouraged the spread of the disease both passively and actively. These factors include the lack of an open, realistic way of involvement due to the shyness in addressing sex education and sexuality issues which are involved in prevention of HIV spread.

Exclusion, theological interpretation of scriptures and definition of sin have contributed to increase stigmatization and suffering. A plan has been put forward to add an ecumenical dimension to the church’s effort and if implemented, it is bound to yield better results (Global consultation on the ecumenical response to the challenge of HIV/AIDS in Africa 9)

In the US, the church’s involvement is mainly through faith based organizations. These have continually offered support to the infected and affected in terms of medical care, food supplies, cancelling and the general support needed morally and spiritually. They have also offered care to the care givers and education to the communities on the risk factors and prevention services.

The government has since supported these organizations through federal funding. Laws have also been put down to prevent discrimination against such organization, the beneficiary or volunteer on the basis of religion. Also, it ensures that nobody should be forced to get involved in any religious activity involuntarily. These partnerships ensure that the church’s efforts are delivered painlessly and the beneficiaries are satisfied.


From these findings, we can conclude that the spread of HIV is highly dependent on a people’s lifestyle. This covers the level of development, the cultural beliefs and religious beliefs. The Church and the various arms of government can play a major role in the effort to curb the pandemic especially when they work together.

Works Cited

“Expert Think Tank Meeting on HIV Prevention in High-Prevalence Countries in Southern Africa.” SADC 2006: 5-10. Web. 04 Oct. 2011.

“Global consultation on the ecumenical response to the challenge of HIV/AIDS in Africa.” The Ecumenical Response to HIV/AIDS in Africa 2001: Web. 04 Oct.

Jana Mere, Nkambule Paul and Tumbo D; One Love: Multiple and concurrent Sexual Partnerships in Southern Africa: A Ten Country Research Report. 2008:13-36 Web. 04 Oct. 2011.

“San Francisco HIV Prevention Plan.” San Francisco HIV Prevention Planning Council 2010: 1-3. Web. 04 Oct. 2011.


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