AIDS and the social side of health.

The presence of AIDS in epidemic proportions in the African context can directly and indirectly affect the health of the majority of people. AIDS highlights the social side of health, those factors of a social nature that enhances or potentially weakens the health status of individuals and whole communities. Attention solely on a limited range of social behaviors or health activities may obscure this fact with the consequence that the spread of HIV/AIDS is not controlled. Focus is turned in this paper to the stress in AIDS policies and programs on terminal illness more than on terminal life. This approach, if not altered, can increase the vulnerability of persons who live with AIDS. The influence that the subordination of women exerts on the spread of HIV infection calls into question the traditions of male sexuality. The adverse effects of HIV on the health of men as well as women suggest the urgent need for re-assessment of the concepts of maleness held in the region. Change in male attitudes and behavior may require change in legislation and a resocialization to a new orientation in male/female relationship. The health of family members may be endangered because of the demands of the care-giving role. Traditional community mechanisms for coping with illnesses may be inadequate in the face of an epidemic. Rather than the pursuit of strategies to assist categories of selected persons, such as widows or orphans, whole affected communities will need to be approached as weakened families. It is questioned whether the health care system can adequately respond to the health requirements of the many when resources are drained, health care providers are overburdened, and primary health care is fragmented because of AIDS. The social dimension of health makes it imperative that policy and program measures to stop AIDS be a collective, balanced social and biomedical scientific effort.