This paper was produced by professional caregivers trying to explore the intensity of institutional, cultural and socio-economic factors against HIV and AIDS. “The HIV/AIDS epidemic has been unprecedented in Africa, especially sub- Saharan Africa, where over 80% of HIV/AIDS deaths have occurred.” (Caldwell 2000) Due to political, cultural and economic practices in the disease these three factors exclude the individuals from effective prevention and treatment programmes.
This study explored deeply into these factors. The study claimed that there are certain practices within institutional, cultural and socio-economic that put the Togolese people at high risk of contracting HIV also the complications the individual has to face that are already suffering from the disease. Also the importance of educating people about this disease is very vital. People with HIV/AIDS, the public, traditional healers and family caregivers should be educated in this particular subject as these are the main targets to contain and hopefully prevent the disease from spreading.
Awareness of how to intervene within the prevention and care should be carefully analysed due to the structural factors having a big part to play in the individual’s cultural day to day life. Due to the lack of education and understanding of this chronic illness official reports stated that Togo has risen from 0.1% in 1987 to 4% in 2000. “A commonly cited cultural factor used in explaining the rapid growth in AIDS prevalence in the world (UNAIDS, 2000), and specifically in Africa, is the common practice of men having multiple sexual partners.” (Caldwell et al, 1989)
In Togo the practice of pdygyny within marriage men is a nom for their culture, also having mistresses outside of marriage. This dominating power held by the male species is due to lack of recognition of women. Women have very small power when it is regarding sexual practices with the male species. This makes it hard for the women to negotiate with their husbands about safe sex or even questions them about there sexual references with other partners. Also they are very unlikely to discuss protected sex without having consent from their husbands. “Women tend to be blamed for the spread of sexually transmitted diseases in the first place, thus women can only hope that their husbands do not HIV.” (Amunyunzu – Nyamongo et al, 1999)
Another culture factor that is included is that most of the women are married to older men especially in polygynous unions, (Lesthaeghe, 1989) this again is domination of power from the males. They decide about any sexual preferences made due to them being older and wiser (Schoepf, 1992; Varga, 1997; Wood & Jewkes, 1998), a woman questioning a male about safe sex is seen to be very disrespectful. Even if the woman is educated and has knowledge about HIV/AIDS she will feel very uneasy to talk about it due to male dominance.
Three researchers Kalipeni, Parker and Oppong stated that people who have lack of socio-economic means are most likely to be infected with sexually transmitted diseases. Women having lack of education, which is also coherent with poverty, this is the reason why women are dependent on men to survive socio-economically. Women play a social rule due to economic exigencies they have older boyfriends that provide for them financially but also date men of there age. The woman will not impose safe sex on her boyfriends without their consent due to her being afraid of not having resources for herself and loosing out on her finances.
“Ugandan government is actively working with its people, HIV-positive as well as HIV-negative citizens, to openly talk about HIV/AIDS and how it can be prevented. Education on HIV/AIDS is pervasive and taught in schools. This HIV/AIDS awareness has led to major behavioural changes among the people in Uganda. Because of the success of the Ugandan campaign against HIV/AIDS, the president was given international recognition for his leadership in the fight against the disease” (A.R Moore & D.A.Williamson) The spread of the disease can be controlled if the government feeds the public with general information about HIV/AIDS. The knowledge they receive will hopefully change attitudes and behaviours which will combat the spread of HIV/AIDS.
Professional caregivers produced this paper to analyse the different approaches Togolese people have to go through for the survival against HIV/AIDS. Professional caregivers are interacting with patients who suffer from HIV/AIDS that the reason why they have a valuable perspective which helps to asses the problems associated with this disease. In this paper structured interviews were used. In a structured interview a questionnaire is prepared for the individual, which they respond to by answering the questions.
The structure of the questions is in a systematic order also from the prepared script it will have no deviation. Within the structured interview the role of the respondent will be to answer the question but the information given will be kept to a minimum as for the interviewers role will be to ask the questions. The interviewer will have a set of questions preplanned for the respondent but may not present them in order.
Also the recording of information in a structural interview may be done by an answer sheet that will be collected by the interviewer at the end of the session, the information can also be collected via audio taped rather than open ended questions being used, in structured interviews the questions are more closed with preplanned valid answers. This however can effect the data as closed questions are answered by the choice of the interviewers response via there choice of answers whereas in a open ended questions it’s the respondents choice of their answer and how to answer it describing and making te interviewer understand on their behalf in there vocabulary.
The control of the interviewer in structured interviews is that they take responsibility of guiding and directing the flow of conversation rather than the respondent setting the agenda. The advantages with strucutured interviews is that the data collected from the respondents will very similar, which when presenting the data will precise. Also structured interviews are less time consuming. Disadvantagesfor structural interviews are that the respondents answer may not be recorded in the words of the respondent, also if there is a language barrier between the interviewer and the respondent the results will not be accurate.
For this study alternative methods (semi-structured interviews) should have been used. This is because it uses open questions which are not prepared in order but a framework is prescribed. The conversation between the interviewee and respondent will be co-ordinated in a natural manner, although the intense education of the interviewee and experience will be a barrier in the conversation, as the respondent will have a lack of education. This is why the interviewee has to permit a unique perspective which will be as clear as possible for the respondent to understand.
The advantages for semi-structured interviews are that they are genuine, full of information and authentic. The interviews and the process are flexible to adapt to the respondants. The relaxed atmosphere between the interviewee and respondants drives the respondent to be more open and so more information is retrieved. The disadvantages for semi-structured interviews are the effects from interpersonal differences between the interviewee and respondent.
Audio taping was used to collect the data for the study. The advantages for audio taping are that researchers are provided with a full transcript of the interview, which is very important as the researchers can analyse the interview fully and pick up vital information. Audio recording lets the interviewee access themselves to independent analysis. The disadvantage with audio taping is that the respondent may feel intrusive not as much as video recording. There is a reduced disclosure with audio taping. The lost of audio taping is also a disadvantage. Potentially there is a greater rate of refusal to participate with audio taping. Sampling is a selection of the population that take part in the research. In this certain study the population were thirty professional caregivers who had been workin with HIV/AIDS patients.