Introduction

Human immune deficiency virus(HIV), tiny particles that attaches themselves to
cell which belongs to another creature and uses it to multiply. HIV enters the body either
through mucus membrane or blood. Its thought to have originated in U.S.A around late
70’s and early 80’s and started among the homosexual population of united states of
America in the state of San Francisco.once the virus enters the body of a human and attaches to his/her her cell(s) it suppresses the immune system of the person and he/she contracts Aids. i.e the CD4 count decreases and viral lord(the infecting component of the virus-attacks the CD4) shoots up. Once the CD4-which plays the defensive role-shoots down to below 300, the person is said/likely/suspected to have contracted HIV. He/she is normally said to be at full blown infection and requires diagnosis.
However, the society has come up with different ways of controlling HIV /aids by first of all identifying the factors that fuels it in both rural and urban population, youth population, working population e.t.c.

There are several factors that fuels the spread of HIV/Aids. Including are
Ignorance
Social economic factors
Cultural factors
Poverty,
conflicts and social strife
political factors
fear and stigma
physiological and societal effects
myths, mysteries and beliefs surrounding HIV/Aids e.t.c.

IGNORANCE
Ignorance could either be real or informed
1.1. Real ignorance; it refers to the lack of information on some or all aspects of the HIV/AIDS infection which may include
information on the transmission,
spread and preventative measures.  e.t.c.
1.2. Informed partial/Ignorance; it refers to those that are fully aware of the infection including its transmission and control but somehow for some reasons either:
1.2.1. Refuse to believe on some aspect of the infection (like causative agent) or
1.2.2. Believe that the condition can be cured either through local herbs or some other methods.
1.2.3. Or chooses to develop a carefree/less attitude on matters concerning HIV/Aids
Overcoming ignorance is the essential first step towards achieving behavioural change which for now, remains the most important strategic option for control of the epidemic.
N/B: ignorance is still high many parts of Africa especially the rural areas.  Studies in Nigeria in 1999 (UNICEF 2001) found that about 90 per cent of men and 74 per cent of women knew of AIDS with variations within age groups.  In some parts of the country, the study showed only 47 per cent and 50 per cent of women and men respectively knew about HIV/AIDS.  Significant percentages of people were reported to be unaware of any way of preventing HIV infection (in some places as high as 30 per cent).  Similar picture may prevail in other parts of sub-Saharan Africa especially West Africa.

FEAR AND STIGMA/ASSOCIATED PSYCHOLOGICAL EFFECTS
Fear and Stigma associated with HIV/AIDS is normally at two levels; individual and institutional.
Individual level; stigma associated with the disease at both family and community results in fear, withdrawal or even suicidal tendencies.  This has been shown to contribute greatly to the reluctance of individuals to go for voluntary testing or in some cases concealing the true status from family and friends.  The consequence of this is the “business as usual” approach by such people and the limitation to access to treatment options, care and support.  It also has the potential of spreading the infection to many other people.
In most cases reactions from people who are HIV negative (-) greatly determine welfare/social being of HIV positive(+) people. Most of the HIV negative (-) people regards the HIV positive(+) as a bother, neglect them and equates HIV/Aids to
“Institutional” fear of stigmatization is manifested through under-reporting by some states or regions within a country or even a whole country.  This is to avoid their perceived stigmatization as “HIV endemic” region or country.

CULTURAL FACTORS
Some cultural values, beliefs and attitudes further compound the problem of ignorance and reinforce each other to promote the spread of HIV infection.  One such cultural value is shyness which prevents open discussion and education on sexuality and reproduction thus leaving adolescents to acquire such information from their uninformed peers or by experimentation, and trial and error!  Similarly, the culture of polygamy and frequent divorce in Sub-Sahara Africa greatly promote and aid the spread of HIV.  Other equally negative practices include female genital mutilation, mass circumcision for boys especially in rural areas, traditional face markings and culturally – based gender discrimination in access to education.
POVERTY
Poverty drives the HIV/AIDS phenomenon in two Broadways; by increasing the population of people at risk and secondly by limiting the management of those already infected.  Poor people are more prone to engage in high risk behaviour such as commercial sex work and drug use.  They are also more likely to become migrant workers, (being un-or semi-skilled), a group that has been identified as being among those at the greatest risk of acquiring and spreading the infection.
Poor people with Sexually Transmitted Infections (STIs) are similarly more likely to resort to self medication and the use of traditional herbs being unable to afford full hospital diagnosis and management thus creating another pool of people at great risk of acquiring HIV/AIDS.  Tuberculosis,  a disease closely associated with HIV/AIDS in Africa is basically a disease of poverty.
Poverty further limits the education of children and adolescents, especially girls thus making them more ignorant.  AIDS, by its very nature impoverishes the affected individuals, families and communities as indicated in .  The synergistic relationship and vicious cycle of poverty, ignorance and disease is thus clearly manifested in HIV/AIDS.

CONFLICTS AND SOCIAL STRIFE
Sub-Saharan Africa has been going through various conflicts and social strife for decades either within or between nations.  These conflicts have created a large population of refugees and caused damaging social vices within the continent.  Child soldiers, social violence, drugs and prostitution have become the norm in many of the countries involved.  This is aside the total breakdown in social services and infrastructure like health and education.  The net result of all these is the total absence of any meaningful HIV/AIDS control programmes in such countries and the phenomenal increase in the people at risk and promotion of high risk behaviour.

For Africa to fight HIV/AIDS effectively, the implementation of the various control programmes must go in tandem with measures that address the driving forces of the infection in the continent especially poverty alleviation, conflict resolution and improved access to social services like health and education.

This Work was an assignment of Wilson Manyuira Wanja of Kenyatta University.