Introduction
Background of the Study
According to UNAIDS (2023), despite significant advancements in combating HIV/AIDS in 2022, numerous challenges persist, particularly for the youth residing in urban areas such as Rio de Janeiro. Five nations met the 95-95-95 objectives of the United Nations; however, approximately 2.1 million people were on treatment but were not virally suppressed, and 9.2 million people worldwide were not receiving antiretroviral therapy. In 2022, one person succumbed to an AIDS-related cause of death every minute, primarily in sub-Saharan Africa, demonstrating that this disease remains a significant public health concern.
Sub-Saharan Africa has experienced the most significant declines in new HIV infections as a result of an accumulation of effective preventative measures. Nevertheless, endeavours to mitigate the transmission of illnesses have lagged behind in regions beyond this one. A notable achievement of the 1980s was the reduction in the global incidence of newly diagnosed HIV infections among minors (UNAIDS, 2023). Most of this decline, in fact, is due to successful programs aimed at reducing or preventing HIV transmission during pregnancy, childbirth, and breastfeeding.
Rationale of the Study
Although progress has been made, adolescent females and young women are still at a greater risk. A total of 210,000 new HIV infections occurred in 15-24 year olds in 2022 (Marty et al., 2022). This in turn emphasizes the need to focus on strategic interventions in the areas most heavily affected by HIV/AIDS, such as the state of Rio de Janeiro, where the rate of infection is still very high among youths. Due to the impact a disease like HIV/AIDS has on society and the fact that it tends to aggravate existing injustices or sources of stigma, tackling youth HIV/AIDS is not just a public health issue, it is also related to sustainable development.
Signposting
This case study investigates Rio de Janeiro’s escalating teen HIV/AIDS rate in light of Sustainable Development Goal 3. History, UNAIDS data, population health requirements, and socio-political and environmental factors are covered. Key stakeholders, effective initiatives, and lessons learnt are analysed to provide future suggestions. The study emphasises socio-economic aspects and community-based activities for HIV/AIDS management health outcomes.
Population Health Needs
Many studies of the rate of HIV infection among adolescents in various circumstances have found that the infection rate varies greatly between regions and demographic groups. For example, in 2004-2005, the prevalence among those under the age of 25 in Rio de Janeiro was estimated at around 2.6 % (Duarte et al., 2022). Moreover, from 2007 to 2013, the incidence rate among blood donors aged 16-24 in Santa Catarina was 1.22 % (Madeira et al., 2021). Accordingly, an awareness raising and intervention program must be developed to deal with the special problems that this age group must confront.
HIV/AIDS and other sexually transmitted infections (STIs) are frequently transmitted through sexual contact in low and medium income countries (Khumalo et al., 2023). Approximately 10% of transmissions are the result of contaminated blood being used in transfusions (McCullough, 2021). The variability in susceptibility to the virus and the clinical course of HIV can both be influenced by hereditary factors.
In low- and middle-income countries, the accessibility of antiretroviral therapy (ART) and high-quality healthcare facilities is a critical component of HIV management. Nonetheless, obtaining the second and third lines of ART remains difficult. Pre-exposure prophylaxis (PrEP), an anti-HIV medication, has demonstrated encouraging outcomes, specifically among men who have sex with men (Grov et al., 2021). However, its accessibility remains limited in low- and middle-income countries (LMICs). Diverse economic conditions give rise to unique challenges, and these differences are most conspicuously manifested in the disparities between high-income, middle-income, and low-income nations regarding the management of HIV/AIDS, treatment accessibility, and the most prevalent modes of transmission.
Socio-political and Environmental Determinants
Socio-physical vulnerability has a substantial effect on the prevalence of HIV/AIDS in Rio de Janeiro (Lua et al., 2023). Certain demographic groups exhibit an increased vulnerability as a result of factors such as socioeconomic disadvantages, insufficient access to education, obstacles in healthcare access, and cultural conventions.
The socio-environmental vulnerability of Rio de Janeiro is exacerbated by various factors, including the dense population concentration in shanty areas, where marginalised communities contend with environmental degradation and urban isolation (Malta and Costa, 2021). A number of sociodemographic and economic variables are correlated with health status, adding to the complexity of the situation. Overall, low-income and black neighbourhoods with a disproportionate population have the lowest health index scores. These regions exhibit a greater incidence of socio-environmental diseases, including tuberculosis and HIV.
In conjunction with medical interventions, an integrated approach that addresses the socioeconomic dimensions of health disparities is imperative when addressing HIV/AIDS in these particular settings. To solve these problems and reduce the prevalence of HIV/AIDS, the government must make effective policies and ensure fair resource allocations. Despite Brazil having implemented numerous medical and social programmes, including the Family Health Programme, addressing the underlying socio-environmental causes remains extremely difficult (Sanmartino et al., 2022). It is evident that only healthcare cannot better the health of the population. Collaborations between education, social assistance, and urban development are also necessary. In order for HIV/AIDS prevention and control initiatives in Rio de Janeiro to be successful, these systemic causes must be addressed.
Key Stakeholders
Contributing significantly to Brazil’s response to the HIV/AIDS pandemic have been the efforts of indigenous non-governmental organisations such as the Brazilian Interdisciplinary AIDS Association (Cueto and Lopes, 2022). These organisations are key to improving community health through activities aimed at raising awareness and educating the public as well as providing greater access to medical care. They are just two among many effective policies and initiatives already carried out by Brazilian government agencies, of which the HIV/AIDS Programme clearly deserves special mention. The government must be able to negotiate reduced medicine prices with pharmaceutical companies so that more individuals can afford treatment in order for these initiatives to be successful.
International organisations contribute financially and through research to aid local initiatives and provide a global outlook on effective HIV/AIDS solutions. As an illustration, advancements in HIV prevention and treatment have been made possible through collaborations with scholarly establishments including Columbia University and the University of California, Los Angeles. In addition to other healthcare professionals, clinics and hospitals are essential in the provision of treatment for HIV/AIDS (Guilamo-Ramos et al., 2021). Providing testing, treatment, and ongoing support, they aid those who are afflicted with HIV/AIDS. Their role is significant in measuring the performance of ART and in ensuring that patients stay on their treatment. In situations where resources are scarce, community mobilisation is significantly dependent on the leadership exhibited by members of the local community. They play vital roles in disseminating information, encouraging individuals to undergo testing and treatment, and reducing stigma.
Effective Interventions
In spite of recent advances in global efforts to prevent and treat AIDS, many obstacles remain. According to the UNAIDS Global AIDS Update 2023, in 2022, five countries had reached the 95-95-95 targets. A further sixteen were close to the finish line (UNAIDS, 2023). Despite these developments, an estimated 9.2 million people with HIV are not taking antiretroviral medication, and another 2.1 million are taking medication but not able to achieve viral suppression (UNAIDS, 2023). The report notes that as a result of measures to reduce transmission of HIV during pregnancy, delivery, and breastfeeding, the incidence of new infections among children worldwide has reached its lowest level since the 1980s (UNAIDS, 2023) . The lack of success in containing the transmission of HIV to populations outside sub-Saharan Africa only highlights the need for strategies tailored to the individual regions.
Only in so far as they take the city’s special cultural, economic, and political conditions into account can local initiatives in Rio de Janeiro be effective (Comelli et al., 2022). Local interventions could provide synergy with established community networks and influential constituents to promote testing and treatment, break down stigma, and raise awareness. In this way global initiatives could be further strengthened. Improving the accessibility, non-discrimination and culturally sensitive character of health care to really respond to the special needs of the important Rio populations, such as youngers, sex workers and the LGBTQ+ community. Examples of social factors in health include employment, housing and education, all of which may be reduced through the supply of minimum social services. The will of political leaders must be resolved.
Conclusion
The importance of community engagement has been underlined by achievements in intervention in this case study report. Community-based therapeutic programmes and campaigns to raise public awareness have shown outstanding results, especially in socioeconomically impoverished areas (Comelli et al., 2022). Thus, by taking account of cultural factors, this approach ensures that interventions are accepted well by the people they are intended to benefit. These results show that healthcare services tailored to meet the needs of specific populations, such as sex workers, adolescents, and the LGBTQ+, are more effective than blanket approaches.
Recommendations
In order to achieve better health outcomes for people with HIV/Aids, it is necessary to address socioeconomic factors such as housing, work, and social participation (Papageorgiou et al., 2022). Social and economic support services may improve the effectiveness of medical interventions, meeting as they do the more deeply rooted needs of people with HIV/AIDS.
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All efforts must be made to further strengthen community-based initiatives suited to local conditions. These are preventative and therapeutic programmes in which it is essential to make an effort to reduce stigma. There is nothing more important than prioritizing adolescent education and participation. HIV prevention and treatment campaigns which involve young people, and comprehensive sexual education programmes in schools and community centres, all have a long-term impact (Duby et al., 2023). If HIV/AIDS programmes are to continue operating, they must keep their financial and political support. Policy makers must emphasize reliable financing mechanisms and long-term planning. HIV/AIDS interventions can be disseminated widely and effectively.
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References
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