Family and other social factors contributing to differences in human immunodeficiency virus infection between South Africa and Bangladesh

Abstract

The objective of this study is to draw attention to the importance of social, cultural, economic and political factors as causes of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in South Africa by comparing the current situation in this country with Bangladesh, where there is no HIV/AIDS epidemic. Special attention is also paid to the interrelatedness of the various factors, and for this reason these are classified into three groups: proximate, intermediate and distal or underlying factors. Evidence is provided showing substantial differences, at the level of proximate factors, in high-risk sexual and other behaviour between South Africa and Bangladesh. This difference in high-risk behaviour between the two countries is – at the intermediate level – due partly to the characteristics and functioning of the formal (family) and informal sexual union systems (premarital and extramarital sex). These differences are, at the underlying or distal level, influenced by economic and political developments in the past two centuries in both countries. Conclusions are drawn on the implications of the findings for development of HIV/AIDS strategies and policies in both countries.

Keywords:

• HIV/AIDS
• South Africa
• Bangladesh
• social determinants
• family