Abstracts

85 sources during Zuma’s term as president. The country has high hopes that Cyril Ramaphosa, president since 2018, will reduce corruption, thereby creating an environment in which equality can flourish, funding for the epidemic can continue to increase, and the underlying causes of the epidemic can dissolve (Cohen, 2019). Segregation and a highly patriarchal society set up the epidemic and created some of the proximate barriers to health care and education that allowed the epidemic to flourish in a subset of the population. Directly treating only HIV and AIDS will not break down these sociocultural barriers; thus, a different strategy must be used to achieve this broader goal. Poverty, substance abuse, lack of access to health care and education, and sexual abuse all are barriers to achieving proper HIV protection and treatment. All these areas are sources of inequalities in South African society; they vary along the same lines as the racial and sexual hierarchies that thrive in South Africa. These fundamental societal issues directly increase the prevalence of sexually transmitted diseases like HIV (“Factors That Contribute…,”1997). Such an inequitable society is ripe for epidemics in the poorer parts of the population. A new tactic that can break down these barriers should be used to begin to close the inequalities, end the HIV/AIDS epidemic, and help South Africans protect their society from future threats. Status of Current Efforts Many countries have poured money into ending the HIV/AIDS epidemic in Africa. However, the United States and South Africa itself have done the most in fighting the country’s ongoing epidemic. Although the country denied the connection between HIV and AIDS and procrastinated during the early years of the epidemic, South Africa now contributes over half of the funding going toward the epidemic (Avert…, 2019). The United States created the President’s Emergency Plan for Aids Relief (PEPFAR) in 2003, which benefits many countries in Africa. The funding from these two sources and other international sources goes toward expenses for the epidemic, including setting up medical facilities, buying and distributing medication, and educating the public about the disease. PEPFAR has made significant progress in educating South Africans while adapting to the local norms and taboos surrounding health and sexual education (Henry J. Kaiser Family Foundation, 2019). These interventions have resulted in a 10-year increase in the average life span of South Africans (Cohen, 2019), which comes from 90% of those living with HIV knowing their status, 62% of those living with HIV receiving ART, and over 50% of those living with HIV being virally suppressed (UNAIDS, 2019). Ultimately, the combined efforts of PEPFAR, international aid programs, and South Africa itself, further supported by aid from other countries, have made great strides toward controlling this epidemic. However, these strategies have run their course, and new methods must be utilized to bring an end to the epidemic. The successful deployment of foreign aid in education has been instrumental in beginning to quell the epidemic, but schooling will not be able to end it because current programs primarily use the same limited behavioral change theory. Existing educational programs all use the Health Belief Model, which posits that individuals act rationally based on the information that is available to them; thus, educating individuals who are at risk theoretically will change their risky behaviors. This theory is based on perceptions of the susceptibility and severity of the potential negative outcomes, the benefits, barriers to making behavioral changes to avoid the negative outcome, and a person’s own self-efficacy. When education of the risks and benefits does not change a person’s behavior, the failure is blamed on a lack of self- efficacy, which is, in turn, blamed on socially embedded factors such as empowerment and socioeconomic status. Multiple surveys have confirmed that most people in sub-Saharan Africa understand how HIV is transmitted. Consequently, the educational programs likely have run their course because the people who have not changed their behavior either see too many barriers or lack the self-efficacy to make the necessary changes (Trinitapoli & Weinreb, 2012). The education strategy, therefore, should be changed to address those barriers