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Leslie Jermyn

of 5
Lecture 8
Guest Lecturer: Paul
Question: What causes AIDS?
HIV is a retro virus (
First you get infected and once you get infected it goes into cells and
starts replicating
Consequence of cells- replication, they burst and it kills immune cells (T
helper cells)
Infection -> cell death
So what is having an immune system destroyed is a bad idea? – because
of opportunist infections
End up with a CD4 cell count that is very low
Less than 200 cells /mm – CD4 cell count in AIDS
Acquired immune deficiency diseases
Syndrome- entire class of infections that you can get
Epithelial skin cancer – your immune system does surveylence of cancer
Infection -> cell death -> CD4 -> AIDS -> your death
In sub Saharan Africa- co-morbidity factors contributing to this huge
Anti retroviral drugs – prevents the virus from replicating
Look at graph to compare US and sub-Saharan Africa
US – 10,000 AIDS deaths per year
Sub Saharan Africa - 2.5 million per year
Having the virus does shorten your lifespan
What is the difference between the both other than co-morbidities? - Sub-
Saharan Africa does not have anti retroviral drugs
Do you think it is possible to make enough Retroviral drugs for everyone?
Pharmaceutical industries in Sub-Saharan Africa- non existent
Bill Clinton in 1994-1995- destroyed a pharmaceutical plant in Sudan –
destroyed the place where Africa got their drugs
What is a consequence? – increase in mortality in the course of 1 or 2
The differences in the death rates have to do with the access to anti
retroviral drugs
AIDS- immune system is attacks
In the US you prevent the virus from attacking the immune system with the
use of the drugs
What causes AIDS? – you can avoid having attack on the immune system
with the use of drugs.
From having AIDS down to the place where you are very sick = the
primary determinant of this transition is poverty
HIV- inevitable or not inevitable?
Ways to avoid it
Whole spectrum of things that makes people susceptibile to getting
infected in the first place
Vulnerability, disempowerments, lack of education, social/economic
constructs – these conditions are vulnerable to POVERTY
These constructs are the one that generate the situation in which people
are vulnerable to getting the HIV infection in the first place
Some of these constructs come out of the fact that you are infected in the
first place
Infection causes you to becomes more vulnerable to becoming
disempowered and becoming low in social/economic constructs and why?
As soon as you admit that you are infected in some places – you can get
fired from your job
If you are the breadwinner of your family you put them into that vulnerable
AIDS – you tend to get a variety of diseases
Untreated it is about 7.5 years for HIV to progress to AIDS
Takes 6-8 weeks for you to be able to detect that there is a virus in your
You are most infectious at the time that you cannot detect it
Small group of people who can carry the virus and there appears to be no
effect on their immune system – Very small amount
The structural constructs that make people vulnerable in the first place can
also be a results of getting the disease
Class circumstances, age, gender, race/ethnicity, collectives, living
conditions -> Socialization experience -> life choices (agency)
Simultaneously, the first situations leads to -> life chances (structure)
Enormous number of students involved in sex trade and prostitution in
order to pay for rents and to pay their fees and this makes it easier for
them to be exposed to the virus
There is an interplay between life choices (agency) and life chances
Longevity of people on this planet continues to increase globally
Poverty causes ill health
When you situations in which people live in poverty the tend to have
shorter lives
Increase in longevity based on having more money
The United States
Longevity of males vs females – females generally appear to be living
longer than males
What accounts for the unequal distribution of longevity in the US? – more
African Americans in the southern states and it is a poor part of the
country which fits in with our notion of poverty
The richest regions- California and New York city
The part with the highest longevity is certainly not the richest part
How does this work? – lifestyle!
This lifestyle could be- less stress with their lifestyle choices, agricultural
practices, isolation health, could have something to do with population
densities in this area, less inequality
Longevity of poor black men in a region in DC- 57 years compared to the
longevity of rich white men in a certain area is 76.7 years
Under 5 mortality rate = 123/1000 (in Canada it is 5.8-6/1000)
Maternal mortality rate = 520/ 100,000
<50% have access to improved sanitation
28% to improved water resources
undernourished people – 50%
mean life expectancy <50%
75-80% live below the poverty line
GDP 1,860 per capitae
Dominican Republic:
Under 5 : 47/1000
Maternal – 230/100,000
67% improved sanitation
86% improved water resources
mean – 66.7 years
25% live below poverty line
GDP – 7,020 per capita
9/1000 : Under 5 mortality Rate
33/100,000 : maternal mortality rate
98% : access to improved sanitation
91% :access to improved water resources
13%: undernourished
76.7 years : mean life expectancy