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  1. The tuberculosis challenge in a rural South African HIV programme

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    Cooke Graham S

    2010-02-01

    Full Text Available Abstract Background South Africa remains the country with the greatest burden of HIV-infected individuals and the second highest estimated TB incidence per capita worldwide. Within South Africa, KwaZulu-Natal has one of the highest rates of TB incidence and an emerging epidemic of drug-resistant tuberculosis. Methods Review of records of consecutive HIV-infected people initiated onto ART between 1st January 2005 and 31st March 2006. Patients were screened for TB at initiation and incident episodes recorded. CD4 counts, viral loads and follow-up status were recorded; data was censored on 5th August 2008. Geographic cluster analysis was performed using spatial scanning. Results 801 patients were initiated. TB prevalence was 25.3%, associated with lower CD4 (AHR 2.61 p = 0.01 for CD4 25 copies/ml (OR 1.75 p = 0.11. A low-risk cluster for incident TB was identified for patients living near the local hospital in the geospatial analysis. Conclusion There is a large burden of TB in this population. Rate of incident TB stabilises at a rate higher than that of the overall population. These data highlight the need for greater research on strategies for active case finding in rural settings and the need to focus on strengthening primary health care.

  2. Can local communities 'sustain' HIV/AIDS programmes? A South African example

    OpenAIRE

    Gibbs, Andrew; Campbell, Catherine; Maimane, Sbongile

    2015-01-01

    Globally, there is a renewed interest in building the local sustainability of HIV/AIDS programmes to ensure that once funders withdraw, local communities can sustain programmes. While the ‘local sustainability assumption’ is widespread, little research has assessed this. In this article, we assess the sustainability of the Entabeni Project, a community-based intervention that sought to build women's local leadership and capacity to respond to HIV/AIDS through a group of volunteer carers, 3 ye...

  3. Promoting critical consciousness and social mobilization in HIV/AIDS programmes: lessons and curricular tools from a South African intervention.

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    Hatcher, Abigail; de Wet, Jacques; Bonell, Christopher Philip; Strange, Vicki; Phetla, Godfrey; Proynk, Paul M; Kim, Julia C; Morison, Linda; Porter, John D H; Busza, Joanna; Watts, Charlotte; Hargreaves, James R

    2011-06-01

    The development of critical consciousness is seen as a key stage in communities increasing levels of dialogue about priority problems and effecting structural change for health. However, relatively little research identifies concrete methods for programmes to build critical consciousness. We examined how a South African structural intervention used critical consciousness as a tool for prevention of intimate partner violence and HIV infection. We collected qualitative data in the form of in-depth interviews with managers, trainers, and participants of the Intervention with Microfinance for AIDS and Gender Equity intervention (IMAGE) in rural South Africa. The data were analysed through a coding structure developed in QSR NVivo. We draw practical lessons from IMAGE to guide other HIV programmes aiming to promoting critical consciousness and social mobilization. This research suggests that specific curricular tools can work towards critical consciousness and that mobilization efforts in future programmes can be strengthened by including individual and collective efforts by participants. PMID:20965911

  4. Contrasting predictors of poor antiretroviral therapy outcomes in two South African HIV programmes: a cohort study

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    Hamilton Robin

    2010-07-01

    Full Text Available Abstract Background Many national antiretroviral therapy (ART programmes encourage providers to identify and address baseline factors associated with poor treatment outcomes, including modifiable adherence-related behaviours, before initiating ART. However, evidence on such predictors is scarce, and providers judgement may often be inaccurate. To help address this evidence gap, this observational cohort study examined baseline factors potentially predictive of poor treatment outcomes in two ART programmes in South Africa, with a particular focus on determinants of adherence. Methods Treatment-naïve patients starting ART were enrolled from a community and a workplace ART programme. Potential baseline predictors associated with poor treatment outcomes (defined as viral load > 400 copies/ml or having discontinued treatment by six months were assessed using logistic regression. Exposure variables were organised for regression analysis using a hierarchical framework. Results 38/227 (17% of participants in the community had poor treatment outcomes compared to 47/117 (40% in the workplace. In the community, predictors of worse outcomes included: drinking more than 20 units of alcohol per week, having no prior experience of chronic medications, and consulting a traditional healer in the past year (adjusted odds ratio [aOR] 15.36, 95% CI 3.22-73.27; aOR 2.30, 95%CI 1.00-5.30; aOR 2.27, 95% CI 1.00-5.19 respectively. Being male and knowing someone on ART were associated with better outcomes (aOR 0.25, 95%CI 0.09-0.74; aOR 0.44, 95%CI 0.19-1.01 respectively. In the workplace, predictors of poor treatment outcomes included being uncertain about the health effects of ART and a traditional healer's ability to treat HIV (aOR 7.53, 95%CI 2.02-27.98; aOR 4.40, 95%CI 1.41-13.75 respectively. Longer pre-ART waiting time (2-12 weeks compared to Conclusion Baseline predictors of poor treatment outcomes were largely unique to each programme, likely reflecting

  5. Measurement of the effectiveness of an HIV/AIDS intervention programme on knowledge, attitudes, and behaviour of the South African Polise Service employees

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    L. Cherian

    2009-09-01

    Full Text Available This study investigated if there was any change in the HIV/AIDS knowledge, attitudes, and behaviour of the South African Police Service’s (SAPS employees of Limpopo province after attending the HIV/AIDS intervention programme. From a population of (N=108 employees, those who attended the HIV/AIDS awareness workshop participated as experimental group (n=51 while those who attended the suicide prevention and disability workshop as control group (n=57. Random sampling method was used to select the above sample. Both workshops were conducted at various places in Limpopo Province. Pre-tests were administered before the workshops while the post-tests were administered after the workshops. The results were analysed using 2 (Group: Experimental versus Control Group x 2 (Time: Pre-test versus Post-test, a repeated measure Analyses of Variances (ANOVA. The findings showed that there was a significant change in HIV/AIDS knowledge after employees have attended the HIV/AIDS awareness workshop. There was however no significant change in attitude and behaviour after the HIV/AIDS awareness programme. The study recommends that a one day workshop is not enough to change attitude and behaviour. It also recommends that a follow up in the form of delayed post-test is required to investigate if the behaviour of the members who promised to change positively had actually changed as behaviour changes cannot manifest in a one day workshop. This can also serve as a suggestion for further research.

  6. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

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    Kielmann Karina

    2008-02-01

    Full Text Available Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs and one human resources manager. Results The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Conclusion Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  7. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

    OpenAIRE

    Kielmann Karina; Fielding Katherine; Hamilton Robin; Charalambous Salome; Dahab Mison; Churchyard Gavin J; Grant Alison D

    2008-01-01

    Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs) and one human resources manager. Results The main reported barriers were denial of existen...

  8. Should HIV and AIDS workplace programmes still be advocated in the automotive industry?

    OpenAIRE

    Liana Steenkamp; Jill von der Marwitz; Friederike Baasner-Weihs; Jacques Pietersen

    2015-01-01

    Orientation: In light of the human immunodeficiency virus (HIV) pandemic, and in order to improve competitiveness in the South African private sector, many structures have implemented subsidised workplace programmes.Research purpose: The aim of this study was to collect baseline data regarding the knowledge, attitudes, practices and belief (KAPB) of employees in the automotive industry in relation to HIV and AIDS, in order to assess the need for HIV and AIDS workplace programmes.Motivation fo...

  9. South African History Online's Education Programme.

    OpenAIRE

    Jardine, Varushka

    2011-01-01

    This paper outlines South African History Online as a NGO that focuses on the enhancement of history especially at school level. The advent of digital and social media platforms has changed the way scholars learn and the way they perceive their world. The book, paper and journals should no longer provide the exclusive model for historical knowledge to be passed on. With this in mind, SAHO has developed a comprehensive online programme that focuses on the current curriculum a...

  10. Understandings of gender and HIV in the South African media.

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    Gibbs, Andrew

    2010-01-01

    It is widely agreed empowering women to take control of their lives and sexual health is a key strategy for tackling gender inequalities and HIV/AIDS, but to date this has been exceedingly difficult to achieve. This paper explores how a sample of South African media represent the relationship between gender and HIV/AIDS in the interests of understanding the symbolic context in which HIV/AIDS programmers conduct their work. The starting assumption is that representations of gender and HIV in the symbolic sphere provide the context within which people charged with designing and implementing women's empowerment interventions--government officials and NGO programme managers--construct understandings of this relationship and how best to tackle it. Content analysis was conducted on four South African newspapers between 1 January 2007 and 31 December 2008. Newspapers selected are widely read by "opinion leaders"; government officials and NGO programme managers. It is accepted that women's empowerment needs to involve top-down and bottom-up approaches. Dominant media representations portray women's empowerment as almost entirely a top-down process in which powerful actors are responsible for identifying and implementing women-focused interventions. Newspapers pay little attention to the need for the mobilisation of women via bottom-up programmes. Furthermore, while the media focuses on structural- and individual-level interventions, there is limited discussion of the importance of community-development interventions. Community-development interventions emphasise the need to build and support community-led responses to HIV. For women's empowerment to be successful interventions need to be at all levels. Currently, much emphasis is placed on the need for "socially responsible" media reporting in South Africa that supports positive social development and social justice. Against this background, we conclude media representations of appropriate ways to tackle gender and HIV

  11. HIV among African American Gay and Bisexual Men

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    ... VIH En Español Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Email Updates on HIV Syndicated Content Website Feedback HIV Among African American Gay and Bisexual Men Format: ...

  12. The communication approach of the loveLife HIV/AIDS prevention programme / S. Bosch

    OpenAIRE

    Bosch, Steven

    2009-01-01

    loveLife, the South African national HIV/AIDS prevention programme for youth, is known for its brand-oriented billboards and mass media campaign that ranges over various print-, broadcast- and alternative media. However, the organisation also implements a national grass-roots peer motivation programme where various activities are co-ordinated by youths (GroundBREAKERS and Mpintshis) from the community. The organisation has been criticised for its communication approach, with many rese...

  13. Amsterdam's STI/HIV Programme: An Innovative Strategy to Achieve and Enhance the Participation of Migrant Community-Based Organisations

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    Wagemakers, Annemarie; van Husen, Gwen; Barrett, Jennifer B.; Koelen, Maria A.

    2015-01-01

    Objective: The STI/HIV prevention programme in Amsterdam aims to improve the sexual health of Amsterdam residents of African, Antillean, Aruban and Surinamese origins. The programme strategy is to achieve and enhance the participation of migrant community-based organisations (CBOs) in sexual health promotion through a grant scheme and by providing…

  14. HIV Stigma and Social Support among African Americans

    OpenAIRE

    Galvan, Frank H.; Davis, E. Maxwell; Banks, Denedria; Bing, Eric G.

    2008-01-01

    HIV-related stigma and discrimination negatively impact African Americans living with HIV. Social support theory hypothesizes that social support can serve to protect individuals against the negative effects of stressors, such as discrimination, by leading them to interpret stressful occasions less negatively. This study sought to examine the relationship between perceived social support and perceived HIV stigma among HIV-positive African Americans. A cross-sectional convenience sample of 283...

  15. Should HIV and AIDS workplace programmes still be advocated in the automotive industry?

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    Liana Steenkamp

    2015-03-01

    Full Text Available Orientation: In light of the human immunodeficiency virus (HIV pandemic, and in order to improve competitiveness in the South African private sector, many structures have implemented subsidised workplace programmes.Research purpose: The aim of this study was to collect baseline data regarding the knowledge, attitudes, practices and belief (KAPB of employees in the automotive industry in relation to HIV and AIDS, in order to assess the need for HIV and AIDS workplace programmes.Motivation for the study: Given the abundance of HIV and AIDS information, the question is whether these workplace programmes’ efforts are still relevant.Research design, approach and method: A quantitative descriptive study design was used using a self-administered questionnaire covering questions about KAPB with regard to HIV and AIDS. The data collection took place in seven automotive supplier companies in South Africa (n = 733 who were going to implement HIV and AIDS workplace programmes with the support of the Automotive Industry Development Centre in the Eastern Cape.Main findings: High-risk behaviour, as indicated by sexual relations with more than one partner in the last 12 months, occurred in between 12% (management and 42% (cleaners of employees. All risk behaviour indicators showed significant differences (p < 0.05 between management and administrative staff on the one hand and technicians, operators and cleaners on the other. Despite being aware of an HIV policy, more than 50% of employees indicated that they would not be willing to disclose their status.Practical/managerial implications: As HIV and AIDS risk behaviour and stigma remain a problem, HIV infection with associated health problems may threaten productivity in the automotive industry if no measures are taken to address the impact on employees and the company.Contribution: This study strongly supports the conclusion that KAPB studies can still provide important information to tailor HIV workplace

  16. An investigation into newly diagnosed HIV infection among Africans living in London

    OpenAIRE

    Burns, F. M.

    2009-01-01

    In the UK substantial numbers of new HIV diagnoses are within migrant African communities. A continuing feature of HIV in this population is the late presentation to HIV services. This dissertation sets out to explore HIV testing among Africans in the UK, the factors associated with late presentation to HIV services, and the extent of HIV acquisition within the UK in African communities. The main focus of the thesis is the ‘study of newly diagnosed HIV among Africans in London’...

  17. Why do some South African ethnic groups have very high HIV rates and others not?

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    Kenyon, Chris; Zondo, Sizwe

    2011-04-01

    The differences in HIV prevalence between South Africa's racial/ethnic groups (19.9%, 3.2%, and 0.5% among 15-49-year-old blacks, coloureds and whites, respectively) are as big as those between the countries with the highest and lowest levels of HIV prevalence worldwide. These large racial/ethnic differences are largely determined by different sexual network structures. In networks among black South Africans, sexual partnerships are more likely to be arranged concurrently - a configuration that leads to exponential increases in the spread of HIV. An examination of the historical origins of polygamy (where it is normative for partnerships to be arranged concurrently) and monogamy (serial or lifetime) reveals that it is the practice of universal monogamy in stratified societies which is the outlier. The ideology and practice of universal monogamy originated in Europe as the result of several factors, most prominently conflicts between the Christian Church and the nobility. After its imposition in Europe, the European colonial project would see this ideology disseminated around the world. Under the influence of liberalism it would mutate into a secular and unacknowledged value-programme of monogamy as a universal norm. This value-programme and practice of monogamy (mostly serial) is still the norm for white South Africans; thus, this sexual behaviour 'spandrel' (by-product of other historical processes) is a large contributor to the lower levels of HIV prevalence among whites. In pre-colonial African societies, polygyny was normative, and the Christian value-programme of monogamy never achieved the hegemonic status it did in Europe and other areas of conquest. Married black African men who converted to Christianity were no less likely to have additional sexual partners, but only more likely to conceal them. The ongoing secrecy about having concurrent partners has contributed to the connectedness of sexual networks among black Africans at large and in this manner has

  18. Integrating eHealth in HIV/AIDS intervention programmes in South Africa

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    Babasile D. Osunyomi

    2015-02-01

    Full Text Available Background: With an estimated 12.2% of its population infected in 2012, South Africa has the highest percentage of people living with the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS in the world. Although the mortality rate of the epidemic is decreasing, it has adverse impacts on the socio-economic development status and human capital of South Africa.Objective: The key aim of this article is to explore the status quo of the implementation of information and communication technologies (ICTs in selected intervention programmes in the South African HIV/AIDS care delivery value chain. The contribution of this article is the mapping of key intervention activities along an HIV care value chain and to suggest a roadmap towards the integration of ICTs in service delivery programmes.Method: 20 managers of HIV/AIDS intervention programmes were surveyed, followed by semi-structured in-depth interviews with these respondents. A further five in-depth interviews were conducted with experts in the ICT area for exploring the uses of and barriers to integrating ICTs in the HIV/AIDS care delivery value chain.Results: The researchers mapped the barriers to implementation and ICT tools utilised within the HIV/AIDS care delivery value chain, which proves to be a useful tool to explore the status quo of technology in such service delivery programmes. The researchers then considered the wider policy environment and provided a roadmap based on the analysis and the South Africa eHealth strategy for driving development in this sector.Conclusion: The authors found that South Africa’s eHealth environment is still nascent and that the South African eHealth strategy does not place enough emphasis on systems integration and stakeholder engagement or the planning and process of uptake of ICTs by target audiences.

  19. The Global Fund's resource allocation decisions for HIV programmes

    DEFF Research Database (Denmark)

    Avdeeva, Olga; Lazarus, Jeff; Aziz, Mohamed Abdel;

    2011-01-01

    Between 2002 and 2010, the Global Fund to Fight AIDS, Tuberculosis and Malaria's investment in HIV increased substantially to reach US$12 billion. We assessed how the Global Fund's investments in HIV programmes were targeted to key populations in relation to disease burden and national income....

  20. Behavioural Precursors and HIV Testing Behaviour among African American Women

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    Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami

    2012-01-01

    Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment…

  1. Coping with HIV/AIDS Stigma in Five African Countries

    OpenAIRE

    Makoae, Lucia N; Greeff, Minrie; Phetlhu, René D.; Uys, Leana R; Naidoo, Joanne R.; Kohi, Thecla W.; Dlamini, Priscilla S.; Chirwa, Maureen L.; Holzemer, William L

    2008-01-01

    People living with HIV (PLWH) and their families are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. This paper examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive, qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. Forty-three focus groups were conducted with 251 participants (114 n...

  2. The South African National Accelerator Centre and its research programme

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Y. [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    An overview of the South African National Accelerator Centre and its research activities is given with emphasis on medium energy nuclear physics and nuclear data measurements for medical use. Also presented is a preliminary result of {sup 40}Ca(p,p`x) spectrum measurement for 392 MeV which has been carried out at RCNP, Osaka University, under the South Africa-Japan collaborative programme. (author)

  3. The impact of alcohol on HIV prevention and treatment for South Africans in primary healthcare

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    Michelle Schneider

    2014-02-01

    Full Text Available Background: Antiretroviral treatment (ART has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.Method: This study comprised a narrative review of relevant literature.Results: Alcohol acts through both behavioural and physiological pathways to impact on the acquisition, further transmission and then progression of HIV disease. Besides links to risky sex, alcohol undermines the immune system, raising susceptibility to contracting and then countering HIV and other infections. There are important drug interactions between alcohol and ART, or therapies for opportunistic infections and other co-morbidities. Moreover, alcohol undermines adherence to the medication which is essential for effective ART.Conclusion: Primary healthcare clinic attendees need evidence-based information on the detrimental effects of alcohol consumption on HIV infection, which ensue throughout the clinical course of HIV. This spans the role of alcohol consumption as a risk factor for HIV infection, HIV replication in infected individuals, a person’s response to HIV infection and HIV treatment. Primary healthcare workers, especially nurses and HIV counsellors, require training in order to screen for and provide appropriate interventions for HIV-positive patients, those on treatment and treatment-naïve patients, who will benefit from reduced alcohol consumption or the cessation thereof.

  4. False positive HIV diagnoses in resource limited settings: operational lessons learned for HIV programmes.

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    Leslie Shanks

    Full Text Available BACKGROUND: Access to HIV diagnosis is life-saving; however the use of rapid diagnostic tests in combination is vulnerable to wrongly diagnosing HIV infection when both screening tests give a false positive result. Misclassification of HIV patients can also occur due to poor quality control, administrative errors and lack of supervision and training of staff. Médecins Sans Frontières discovered in 2004 that HIV negative individuals were enrolled in some HIV programmes. This paper describes the result of an audit of three sites to review testing practices, implement improved testing algorithms and offer re-testing to clients enrolled in the HIV clinic. FINDINGS: In the Democratic Republic of Congo (DRC, Burundi and Ethiopia patients were identified for HIV retesting. In total, 44 false-positive patients were identified in HIV programmes in DRC, two in Burundi and seven in Ethiopia. Some of those identified had been abandoned by partners or started on anti-retroviral therapy or prophylaxis. Despite potential damage to programme reputations, no impact in terms of testing uptake occurred with mean monthly testing volumes stable after introduction of re-testing. In order to prevent the problem, training, supervision and quality control of testing procedures were strengthened. A simple and feasible confirmation test was added to the test algorithm. Prevalence of false positives after introducing the changes varied from zero percent (95% CI 0%-8.2% to 10.3 percent (95% CI: 7.2%-14.1% in Burundi and DRC respectively. CONCLUSION: False HIV diagnoses were found in a variety of programme settings and had devastating individual consequences. We re-tested individuals in our programmes while instituting improved testing procedures without a negative impact on test uptake. Considering the importance of correct diagnosis to the individual, as well as the resources needed to care for someone with HIV, it is critical to ensure that all patients registered in

  5. An implementation evaluation of a voluntary counselling and testing programme for the human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS

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    Tarryn N. Anderson

    2012-07-01

    Full Text Available Orientation: Employee wellness programmes have become standard interventions in mostorganisations. In South Africa, these programmes invariably contain an element to addressthe problem of the human immunodeficiency virus (HIV and acquired immunodeficiencysyndrome (AIDS in the workplace.Research purpose: The purpose of this evaluation was to assess whether or not a VoluntaryCounselling and Testing (VCT programme for HIV and AIDS, at a South African university,was implemented as intended.Motivation for the study: The evaluators were motivated to explore indications in the existingliterature about these programmes that participants in VCT programmes are often not theintended target population who live a high risk lifestyle.Research design, approach and method: A descriptive design was used to evaluate serviceutlisation, service delivery and organisational support. Questionnaire data from 285respondents who participated in the programme and programme records supplied by theprogramme staff were consulted to answer the evaluation questions.Main findings: The evaluation showed that the highest uptake for the programme occurredamongst female students. The low uptake amongst men was a concern. It was found that theprogramme was delivered as intended and that there were enough resources to implement itaccording to standards set.Practical/managerial implications: The systematic report on the programme process providedthe programme managers with practical suggestions for programme improvement.Contribution/value-add: This was the first implementation evaluation of a VCT programme ina South African university context. As such it aimed to educate programme managers to thinkevaluatively about introducing new or continuing existing programmes.

  6. Rethinking HIV prevention to prepare for oral PrEP implementation for young African women

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    Connie L Celum

    2015-07-01

    for delivering oral PrEP, a first-generation biomedical HIV prevention product, will inform development of new and less user-dependent PrEP formulations and delivery of an expanding choice of prevention options in HIV prevention programmes for young African women.

  7. HIV Stigma and Nurse Job Satisfaction in Five African Countries

    OpenAIRE

    Greeff, Minrie; Chirwa, Maureen L.; Kohi, Thecla W.; Naidoo, Joanne R.; Makoae, Lucy N.; Dlamini, Priscilla S.; Kaszubski, Christopher; Cuca, Yvette P.; Uys, Leana R; Holzermer, William L

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sa...

  8. HIV Stigma and Nurse Job Satisfaction in Five African Counties

    OpenAIRE

    Chirwa, Maureen L.; Greeff, Minrie; Kohi, Thecla W.; Naidoo, Joanne R.; Makoae, Lucy N.; Dlamini, Priscilla S.; Kaszubski, Christopher; Cuca, Yvette P.; Uys, Leana R; Holzemer, William L

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The subscale, Personal Satisfaction, was the highest in this ...

  9. Reviewing gender and cultural factors associated with HIV/AIDS among university students in the South African context

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    A. van Staden

    2009-09-01

    Full Text Available South Africa is in the midst of a catastrophic AIDS epidemic. HIV prevalence statistics in most countries indicate that up to 60% of all new infections occur among 15 to 24 year olds, whilst this group also boasts the highest incidence of sexually transmitted infections (STIs. Statistical findings among South African students predict a 10% increase in the HIV infection rate, highlighting the inability of universities to cope with societies’ demands for academically trained workers which, in the near future, will have a detrimental effect on the economy of South Africa. From the literature it is evident that HIV/AIDS is more than a health issue, it is an inter-sectoral challenge to any society. This paper explored the interplay of gender and cultural factors on South African students’ sexual behaviour by inter alia discussing the following factors that might put students at risk for HIV infection: male dominance vs. female submissiveness; age of first sexual encounter; gender-based violence; contraception; circumcision; financial status; myths and ‘othering’; demonstrating the need for effective strategies, policies and programmes to protect young people, especially females from sexual abuse/rape and its consequences, including HIV. The literature review revealed that South African students, despite adequate HIV/AIDS knowledge, demonstrated high rates of sexual practices that place them at risk for HIV infection, i.e. unprotected sex, multiple partners and ‘sugar-daddy practices’. The paper concludes with a discussion on recommendations for future HIV prevention/ intervention programmes, highlighting the fact that it acquires an inclusive approach. Such interventions should move beyond the individual level to be effective and target gender-based inequalities, human rights violations, including sexual violence and rape, as well as stigma and poverty reduction, both at community and tertiary educational level.

  10. A Mid-South Perspective: African American Faith-based Organizations, HIV, and Stigma.

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    Otey, Tamara D; Miller, Wendy Renee

    2016-01-01

    Shelby County, Tennessee has the fastest growing rate of HIV infection in the state, and the majority of new infections are in African Americans. In 2011, a Centers for Disease Control and Prevention report stated that Memphis (the largest city in Shelby County) ranked seventh highest in new HIV infections. Little research has addressed HIV-related themes in African American culture that could hinder HIV prevention measures. Our qualitative study engaged African American, faith-based leaders in areas with high rates of HIV in meaningful conversations regarding their attitudes toward HIV and those who are infected. Although faith-based leaders felt they had a role in HIV prevention, only 4% in our study had participated in HIV prevention activities, but they were open to HIV prevention programs. We found that faith-based leaders had limited knowledge of health disparities and ongoing stigma concerning HIV, which served as a major barrier to HIV prevention. PMID:27209431

  11. Renal impairment in a rural African antiretroviral programme

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    Lessells Richard J

    2009-08-01

    Full Text Available Abstract Background There is little knowledge regarding the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment, nor evidence to inform the most cost effective methods of screening for renal impairment. With the increasing availability of the potentially nephrotixic drug, tenofovir, such information is important for the planning of antiretroviral programmes Methods (i Retrospective review of the prevalence and risk factors for impaired renal function in 2189 individuals initiating antiretroviral treatment in a rural African setting between 2004 and 2007 (ii A prospective study of 149 consecutive patients initiating antiretrovirals to assess the utility of urine analysis for the detection of impaired renal function. Severe renal and moderately impaired renal function were defined as an estimated GFR of ≤ 30 mls/min/1.73 m2 and 30–60 mls/min/1.73 m2 respectively. Logistic regression was used to determine odds ratio (OR of significantly impaired renal function (combining severe and moderate impairment. Co-variates for analysis were age, sex and CD4 count at initiation. Results (i There was a low prevalence of severe renal impairment (29/2189, 1.3% 95% C.I. 0.8–1.8 whereas moderate renal impairment was more frequent (287/2189, 13.1% 95% C.I. 11.6–14.5 with many patients having advanced immunosuppression at treatment initiation (median CD4 120 cells/μl. In multivariable logistic regression age over 40 (aOR 4.65, 95% C.I. 3.54–6.1, male gender (aOR 1.89, 95% C.I. 1.39–2.56 and CD4 Conclusion In this rural African setting, significant renal impairment is uncommon in patients initiating antiretrovirals. Urine analysis alone may be inadequate for identification of those with impaired renal function where resources for biochemistry are limited.

  12. HIV Stigma and Nurse Job Satisfaction in Five African Counties

    Science.gov (United States)

    Chirwa, Maureen L.; Greeff, Minrie; Kohi, Thecla W.; Naidoo, Joanne R.; Makoae, Lucy N.; Dlamini, Priscilla S.; Kaszubski, Christopher; Cuca, Yvette P.; Uys, Leana R.; Holzemer, William L.

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The subscale, Personal Satisfaction, was the highest in this sample as in the other 2. Job Satisfaction scores differed significantly among the 5 countries and these differences were consistent across all subscales. A hierarchical regression demonstrated that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influences on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These findings provide new areas for intervention strategies that might enhance the work environment for nurses in these countries. PMID:19118767

  13. HIV stigma and nurse job satisfaction in five African countries.

    Science.gov (United States)

    Chirwa, Maureen L; Greeff, Minrie; Kohi, Thecla W; Naidoo, Joanne R; Makoae, Lucy N; Dlamini, Priscilla S; Kaszubski, Christopher; Cuca, Yvette P; Uys, Leana R; Holzemer, William L

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sample, as in the other 2. Job satisfaction scores differed significantly among the 5 countries, and these differences were consistent across all subscales. A hierarchical regression showed that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influence on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These results provide new areas for intervention strategies that might enhance the work environment for nurses in these countries. PMID:19118767

  14. Political will, traditional leaders and the fight against HIV/AIDS: a South African case study.

    Science.gov (United States)

    Campbell, Catherine

    2010-01-01

    "Political will" and leadership are increasingly considered key contextual influences on the outcomes of HIV/AIDS programmes in sub-Saharan Africa. Such debates tend to focus on the role of national leadership in shaping responses to the epidemic, with little attention to local leaders. Yet many of the settings in which HIV/AIDS flourishes are geographically distant from the reach of national leadership and policies. Furthermore, local leaders often play a key role in shaping how national policies and decisions are interpreted and implemented in local areas. Against this background, we present a case study of the impact of the leadership style of a traditional Chief on a community-based AIDS programme in a South African rural community, which sought to build community-level "AIDS competence", using the "empowerment via participation" approach. The case study involved 134 interviews and 57 focus groups conducted over three years. Thematic content analysis revealed a number of direct and indirect ways in which his leadership style impacted on project outcomes. Despite his strong support for the programme, the Chief's "traditional" attitudes towards women and youth, his celebration of polygamy, and his authoritarian governance style undermined the project's "empowerment via participation" agenda - especially the programme's attempts to reduce AIDS stigma, to build female and youth capacity to control their sexual health, and to encourage men to take responsibility for their role in tackling AIDS. PMID:21161769

  15. Human-resources strategies for managing HIV/AIDS: the case of the South African forestry industry.

    Science.gov (United States)

    Gow, Jeff; Grant, Bligh

    2010-09-01

    Previous work has focused on HIV prevalence among forestry workers and the impact of HIV/AIDS on the sustainability of forest resources. Following a review of work examining the impacts of HIV/AIDS on the South African economy, this article presents original qualitative research examining the responses of company management to the HIV epidemic across a range of enterprises in the South African forestry industry, including large companies, contractors and cooperatives. At the level of the enterprise, management occupies a critical nexus, at which the intersecting requirements of complex government legislation, the wellbeing of workers and the demands of the business must be met. The research demonstrates that large forestry companies tend to provide only a small fraction of their workforces with HIV/AIDS education, prevention or treatment services, as they have essentially outsourced the requirement through the use of labour-supply contractors who, by and large, provide workers with scant HIV/AIDS-related programmes or benefits. Moreover, the extent to which the different types of forestry enterprises incorporate the management of HIV/AIDS in the workforce with the management of the business is highly variable, and in most instances falls short of legislative requirements that have been in place for over a decade. The implications of this for the forestry industry in South Africa are acute. PMID:25860632

  16. The Four Cs of HIV Prevention with African Americans: Crisis, Condoms, Culture, and Community

    OpenAIRE

    Williams, JK; Wyatt, GE; Wingood, G

    2010-01-01

    HIV/AIDS continues to be a devastating epidemic with African American communities carrying the brunt of the impact. Despite extensive biobehavioral research, current strategies have not resulted in significantly decreasing HIV/AIDS cases among African Americans. The next generation of HIV prevention and risk reduction interventions must move beyond basic sex education and condom use and availability. Successful interventions targeting African Americans must optimize strategies that integrate ...

  17. The role of HIV/AIDS committees in effective workplace governance of HIV/AIDS in South African small and medium-sized enterprises (SMEs).

    Science.gov (United States)

    Vaas, Jocelyn R

    2008-04-01

    The primary purpose of this study was to assess the role, status and scope of workplace HIV/AIDS committees as a means of effective workplace governance of the HIV/AIDS impact, and their role in extending social protective HIV/AIDS-related rights to employees. In-depth qualitative case studies were conducted in five South African small and medium-sized enterprises (SMEs) that were actively implementing HIV/AIDS policies and programmes. Companies commonly implemented HIV/AIDS policies and programmes through a workplace committee dedicated to HIV/AIDS or a generic committee dealing with issues other than HIV/ AIDS. Management, through the human resources department and the occupational health practitioner often drove initial policy formulation, and had virtually sole control of the HIV/AIDS budget. Employee members of committees were mostly volunteers, and were often production or blue collar employees, while there was a notable lack of participation by white-collar employees, line management and trade unions. While the powers of workplace committees were largely consultative, employee committee members often managed in an indirect manner to secure and extend social protective rights on HIV/AIDS to employees, and monitor their effective implementation in practice. In the interim, workplace committees represented one of the best means to facilitate more effective workplace HIV/AIDS governance. However, the increased demands on collective bargaining as a result of an anticipated rises in AIDS-related morbidity and mortality might prove to be beyond the scope of such voluntary committees in the longer term. PMID:18496614

  18. Challenges and opportunities for HIV prevention and care: insights from focus groups of HIV-infected African American men.

    Science.gov (United States)

    Buseh, Aaron G; Stevens, Patricia E; McManus, Patricia; Addison, Reverend Jim; Morgan, Sarah; Millon-Underwood, Sandra

    2006-01-01

    Given the inordinate burden of HIV illness borne by African American men, investigations of HIV prevention and care in this population are urgently needed. In this qualitative study, a sample of 20 HIV-infected African American men participated in two focus groups in which they exchanged experiences and ideas about living with HIV. They shared details about how they were personally impacted by HIV, and together they constructed a perspective on the larger societal context in which the HIV infection rate among African American men continues unabated. The men focused on growing complacency about HIV/AIDS in the United States, underfunding of supports and services, stigmas operative in African American communities, and differential care based on race, gender, and diagnosis. They saw opportunity in personal strategies that help individual men infected with HIV to take a more empowered stance to deal with the disease and improve their health but looked for changes undertaken by African Americans at the community level to make a real difference in the epidemic. Their vision included enhanced support for HIV prevention and care from influential community institutions like Black churches, more open dialogue about drugs and sexual behavior, and capacity-building for families whose members are HIV-infected or at risk for HIV. PMID:16849084

  19. HIV Risk Behaviors among African American Women with at-Risk Male Partners

    OpenAIRE

    Paxton, KC; Williams, JK; Bolden, S; Guzman, Y; Harawa, NT

    2013-01-01

    Background: HIV continues to impact African American women at alarming rates. Yet, few researchers have examined the relationship factors promoting unprotected sex within African American communities, especially instances in which women are aware that their male partners are engaging in high risk behaviors. This qualitative study explored the sexual behaviors, relationship characteristics, and HIV prevention strategies utilized by African American women in relationships with African American ...

  20. The FAO programme for the control of African animal trypanosomiasis and related development

    International Nuclear Information System (INIS)

    The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980

  1. Coping with HIV-related stigma in five African countries.

    Science.gov (United States)

    Makoae, Lucia N; Greeff, Minrie; Phetlhu, René D; Uys, Leana R; Naidoo, Joanne R; Kohi, Thecla W; Dlamini, Priscilla S; Chirwa, Maureen L; Holzemer, William L

    2008-01-01

    People living with HIV (PLWH) and their families are subjected to prejudice, discrimination, and hostility related to the stigmatization of AIDS. This report examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. A total of 43 focus groups were conducted with 251 participants (114 nurses, 111 PLWH, and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents. Nurse reports of coping strategies that they used as well as observed in HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. A total of 17 different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one's HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma. PMID:18328964

  2. Coping with HIV/AIDS Stigma in Five African Countries

    Science.gov (United States)

    Makoae, Lucia N.; Greeff, Minrie; Phetlhu, René D.; Uys, Leana R.; Naidoo, Joanne R.; Kohi, Thecla W.; Dlamini, Priscilla S.; Chirwa, Maureen L.; Holzemer, William L.

    2008-01-01

    People living with HIV (PLWH) and their families are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. This paper examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive, qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. Forty-three focus groups were conducted with 251 participants (114 nurses, 111 PLWHs and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents of stigma. Nurse reports of coping strategies that they used as well as coping strategies they observed as used by HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. Seventeen different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one’s HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma. PMID:18328964

  3. Is Knowledge Enough? Considering HIV/AIDS Risk Behaviors and HIV/AIDS Knowledge with African American Women

    OpenAIRE

    Perkins, Emory L; Stennis, Kesslyn Brade; Taylor Spriggs, Velva; Kwegyir-Afful, Emma Aya; Prather, Aaron

    2014-01-01

    Background: This quantitative explanatory study was designed to explain the relationship between HIV/AIDS risk-taking behaviors among African American women and their knowledge surrounding HIV/AIDS. More specifically, the research considers whether knowledge alone was sufficient to alter African-American women’s risk-taking behaviors regarding HIV/AIDS. Objectives: This study was designed to investigate knowledge surrounding sexual risk-taking behaviors including 1) heterosexual transmission;...

  4. Four African Nations Agree to Water Management Programme

    International Nuclear Information System (INIS)

    Full text: Seeking to improve their management of water resources, four northeast African nations today agreed at the International Atomic Energy Agency (IAEA) to establish a long-term framework for utlizing a key underground water system. Chad, Egypt, Libya and Sudan signed a Strategic Action Programme (SAP) that aims to optimize the equitable use of the Nubian Sandstone Aquifer System, a huge water resource that lies beneath the four nations. The SAP also commits the countries to strengthen and build upon a previously existing regional coordination mechanism, in part by establishing a new Joint Authority for the Nubian Aquifer System. The Programme lays the groundwork for improving cooperation among the four arid nations and for strengthening their capacity to monitor and manage the aquifer effectively. With growing populations and decreasing water availability from other sources in the region, the aquifer is under mounting pressure. Removing water without a clear understanding of transboundary and other implications threatens water quality and has the potential to harm biodiversity and accelerate land degradation. The agreement resulted from a joint Technical Cooperation project of the United Nations Development Programme (UNDP) and the Global Environment Facility (GEF), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the IAEA. ''I congratulate all involved on this significant achievement,'' said IAEA Director General Yukiya Amano. ''Water is a key resource, and effective management and use of such water resources is essential for the future. The agreement of the Strategic Action Programme is the result of real cooperation between the four States, the Agency and UNDP-GEF. I am confident that this Programme will be a success and will benefit the people of the region. This positive project experience benefits strengthened and expanded cooperation between the IAEA and the UNDP-GEF.'' ''UNDP would like to congratulate the

  5. HIV-positive African women’s engagement with HIV care in the UK during and after pregnancy

    OpenAIRE

    Tariq, S.

    2013-01-01

    Approximately 1400 HIV-positive women are known to become pregnant in the UK each year, the overwhelming majority being from Sub-Saharan Africa. The overall question I pose in this thesis is: how do African women living with HIV in the UK engage with HIV services and interventions during and after pregnancy? The question is addressed through a mixed methods approach. Drawing upon epidemiological data from the UK and Ireland's National Study of HIV in Pregnancy and Childhood, and primary ethno...

  6. HIV testing and conspiracy beliefs regarding the origins of HIV among African Americans.

    Science.gov (United States)

    Bohnert, Amy S B; Latkin, Carl A

    2009-09-01

    Conspiracy beliefs regarding the origins of HIV are common among African Americans, and have been associated with engaging in HIV risk behaviors but also with earlier diagnosis among HIV patients. The objective of the present study was to test the association of HIV serostatus testing with conspiracy beliefs. A total of 1430 African Americans from low-income neighborhoods with high rates of drug use were surveyed in 1997-1999 in face-to-face interviews. Two 4-point items assessed if participants agreed that "AIDS was started by an experiment that went wrong" and "AIDS was created to kill blacks and poor folks." A binary variable indicated if the respondent agreed with the statements, on average. 22.5% of the sample endorsed conspiracy beliefs, 4.0% of whom reported not having had an HIV test, compared to 7.7% of those who did not endorse conspiracy beliefs. In multivariable logistic regression modeling, never having had an HIV test was significantly associated with conspiracy beliefs (adjusted odds ratio [AOR] = 0.43, 95% confidence interval [CI] = 1.3-4.3), having a high school education (AOR = 0.55, CI = 0.35-0.84), having depression (AOR = 1.61, CI = 1.02-2.52), female gender (AOR = 0.54, CI = 0.34-0.86), younger age, and a history of injection drug use (AOR = 0.36, CI = 0.23-0.56), but not sex risk behaviors (multiple partners, irregular condom use). The finding that individuals who have conspiracy beliefs are more likely to have been tested for HIV may partially explain why HIV-positive individuals who endorse conspiracy beliefs are more likely to obtain an earlier diagnosis. PMID:19663716

  7. Genital infections and syndromic diagnosis among HIV-infected women in HIV care programmes in Kenya.

    Science.gov (United States)

    Djomand, Gaston; Gao, Hongjiang; Singa, Benson; Hornston, Sureyya; Bennett, Eddas; Odek, James; McClelland, R Scott; John-Stewart, Grace; Bock, Naomi

    2016-01-01

    Control of genital infections remains challenging in most regions. Despite advocacy by the World Health Organization for syndromic case management, there are limited data on the syndromic approach, especially in HIV care settings. This study compared the syndromic approach with laboratory diagnosis among women in HIV care in Kenya. A mobile team visited 39 large HIV care programmes in Kenya and enrolled participants using population-proportionate sampling. Participants provided behavioural and clinical data with genital and blood specimens for lab testing. Among 1063 women, 68.4% had been on antiretroviral therapy >1 year; 58.9% were using cotrimoxazole prophylaxis; 51 % had CD4+T-lymphocytes symptom. Clinical signs were found in 63% of women; and 30.8% had an aetiological diagnosis. Bacterial vaginosis (17.4%), vaginal candidiasis (10.6%) and trichomoniasis (10.5%) were the most common diagnoses. Using laboratory diagnoses as gold standard, sensitivity and positive predictive value of the syndromic diagnosis for vaginal discharge were 47.6% and 52.7%, respectively, indicating a substantial amount of overtreatment. A systematic physical examination increased by 9.3% the positive predictive value for genital ulcer disease. Women attending HIV care programmes in Kenya have high rates of vaginal infections. Syndromic diagnosis was a poor predictor of those infections. PMID:25614522

  8. Teaching journalism or teaching African journalism? Experiences from foreign involvement in a journalism programme in Ethiopia

    OpenAIRE

    Skjerdal, Terje S

    2011-01-01

    Journalism programmes across the African continent have different attitudes to the issue of universal vs.
    local values in journalism. This article discusses the issue in light of a post-graduate journalism
    programme that opened at Addis Ababa University in 2004. In its 5-year implementation phase, the
    programme engaged educators from Europe and North America in addition to local instructors. Thus, one
    could expect a potential conflict between Wester...

  9. The role of public schools in HIV prevention: perspectives from African Americans in the rural south

    OpenAIRE

    Lloyd, Stacey W.; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J.; Youmans, Selena; Muhammad, Melvin R; Wynn, Mysha; Adimora, Adaora; Akers, Aletha

    2012-01-01

    Though African American youth in the south are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and ...

  10. Correlates of HIV Testing among Rural African American Cocaine Users

    Science.gov (United States)

    Wright, Patricia B.; Booth, Brenda M.; Curran, Geoffrey M.; Borders, Tyrone F.; Ounpraseuth, Songthip T.; Stewart, Katharine E.

    2014-01-01

    Andersen's Revised Behavioral Model of Health Services Use (RBM) was used as a framework in this correlational cross-sectional study to examine factors associated with HIV testing among a sample of 251 rural African American cocaine users. All participants reported using cocaine and being sexually active within the past 30 days. Independent variables were categorized according to the RBM as predisposing, enabling, need, or health behavior factors. Number of times tested for HIV (never, one time, two to four times, five or more times) was the outcome of interest. In ordered logistic regression analyses, HIV testing was strongly associated with being female, of younger age (predisposing factors); having been tested for sexually transmitted diseases or hepatitis, ever having been incarcerated in jail or prison (enabling factors); and having had one sex partner the past 30 days (health behavior factor). Other sexual risk behaviors, drug use, health status, and perception of risk were not associated with HIV testing. Our findings confirm the importance of routine testing in all healthcare settings rather than risk-based testing. PMID:25346379

  11. Contact with HIV prevention programmes & willingness for new interventions among truckers in India

    OpenAIRE

    Prem Kumar, S.G.; Kumar, G Anil; Poluru, Ramesh; Schneider, John A.; Dandona, Lalit; Vemu, Lakshmi; Sudha, T; Mayer, Kenneth H.; Dandona, Rakhi

    2013-01-01

    Background & objectives: Systematic data on existing coverage and willingness for HIV prevention strategies among truckers are not readily available in India. The present study aimed to further the understanding on contact of truckers with existing HIV prevention services and to assess willingness for new HIV prevention strategies. Methods: A total of 1,800 truck drivers and helpers aged 16-65 yr passing through Hyderabad were approached to assess contact made with HIV prevention programmes, ...

  12. Till Death Do Us Part: Lived Experiences of HIV-Positive Married African American Women

    Science.gov (United States)

    Edwards, Lorece V.; Irving, Shalon M.; Hawkins, Anita S.

    2011-01-01

    HIV/AIDS disease continues to be an escalating health problem, particularly among women. However, African American women are among the leading demographic groups for HIV prevalence in the United States. The typical woman with HIV/AIDS is young, in her late twenties, economically challenged, and of childbearing age. Participants were recruited from…

  13. Teaching journalism or teaching African journalism? Experiences from foreign involvement in a journalism programme in Ethiopia

    Directory of Open Access Journals (Sweden)

    Terje S. Skjerdal

    2011-11-01

    Full Text Available Journalism programmes across the African continent have different attitudes to the issue of universal vs.
    local values in journalism. This article discusses the issue in light of a post-graduate journalism
    programme that opened at Addis Ababa University in 2004. In its 5-year implementation phase, the
    programme engaged educators from Europe and North America in addition to local instructors. Thus, one
    could expect a potential conflict between Western and Ethiopian approaches to journalism. However, on
    the basis of experiences with the Addis Ababa programme, the present study questions the assumed
    dichotomy between Western and Ethiopian (or African journalism discourses. Tensions did indeed come
    to the fore when the programme was planned and implemented, but they were defined by determinants
    such as professional background and personal preferences of the instructors involved rather than by
    geographical and cultural origin.

  14. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    OpenAIRE

    Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; Macdonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D

    2013-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV tr...

  15. Examining Church Capacity to Develop and Disseminate a Religiously Appropriate HIV Tool Kit with African American Churches

    OpenAIRE

    Berkley-Patton, Jannette; Thompson, Carole Bowe; Martinez, David Alfonso; Hawes, Starlyn Montez; Moore, Erin; Williams, Eric; Wainright, Cassandra

    2012-01-01

    Increasingly, African American churches have been called upon to assist in efforts to address HIV/AIDS in underserved communities. African Americans churches may be well-positioned to provide HIV education, screening, and support services, particularly if they are equipped with church-appropriate, easy-to-deliver HIV tools that can be implemented through the naturalistic church environment. To inform the development of a church-based HIV tool kit, we examined church capacity with African Amer...

  16. What African American Male Adolescents Are Telling Us about HIV Infection among Their Peers: Cultural Approaches for HIV Prevention

    Science.gov (United States)

    Voisin, Dexter R.; Bird, Jason D. P.

    2009-01-01

    This study explored the beliefs of African American male adolescents concerning the high rates of HIV infection among their peers and their reasons for those beliefs. In-depth interviews were conducted with a sample of 16 male African Americans, and a thematic analysis of the data was conducted. Half of the participants believed that peers were…

  17. Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dandona Rakhi

    2009-05-01

    Full Text Available Abstract Background HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources. Methods Detailed cost and output data were collected from written records and interviews for 2005–2006 fiscal year using standardized methods at six sampled HIV prevention programmes for truck drivers in the Indian state of Andhra Pradesh. The total economic cost for these programmes was computed and the relation of unit cost of services per truck driver with programme scale was assessed using regression analysis. Results A total of 120,436 truck drivers were provided services by the six programmes of which 55.9% were long distance truck drivers. The annual economic cost of providing services to a truck driver varied between programmes from US$ 1.52 to 4.56 (mean US$ 2.49. There was an inverse relation between unit economic cost of serving a truck driver and scale of the programme (R2 = 0.63; p = 0.061. The variation between programmes in the average number of contacts made by the programme staff with truck drivers was 1.3 times versus 5.8 times for contacts by peer educators. Only 1.7% of the truck drivers were referred by the programmes for counseling and HIV testing. Conclusion These data provide information for further planning of HIV prevention programmes for truck drivers and estimating the resources needed for such programmes. The findings suggest the need to strengthen the role of peer educators and increase referral of truck drivers for HIV testing.

  18. Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa

    Directory of Open Access Journals (Sweden)

    Mirkuzie Alemnesh H

    2012-12-01

    Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources

  19. Correlates of posttraumatic growth among African Americans living with HIV/AIDS in Mississippi1

    OpenAIRE

    Evans, Shenell D.; Williams, Bryman E.; Leu, Cheng-Shiun

    2013-01-01

    Individuals diagnosed with HIV face a host of challenges post-diagnosis. At risk for negative psychological outcomes, persons living with HIV/AIDS may also experience posttraumatic growth (i.e., positive cognitive and emotional changes that may occur following HIV diagnosis). African Americans, in particular, experience poorer psychosocial and behavioral outcomes and greater HIV-related health disparities, and also tend to report more posttraumatic growth than European Americans. This explora...

  20. The Experience of Sexual Risk Communication in African American Families Living With HIV

    OpenAIRE

    Cederbaum, Julie A.

    2011-01-01

    Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV risk behaviors. Data were collected from 12 African American women and 10 of their adolescent daughters through focus groups. Both mothers and daught...

  1. Evaluating the Measurement Structure of the Abbreviated HIV Stigma Scale in a Sample of African Americans Living with HIV/AIDS

    Science.gov (United States)

    Johnson, Eboneé T.; Yaghmaian, Rana A.; Best, Andrew; Chan, Fong; Burrell, Reginald, Jr.

    2016-01-01

    Purpose: The purpose of this study was to validate the 10-item version of the HIV Stigma Scale (HSS-10) in a sample of African Americans with HIV/AIDS. Method: One hundred and ten African Americans living with HIV/AIDS were recruited from 3 case management agencies in Baton Rouge, Louisiana. Measurement structure of the HSS-10 was evaluated using…

  2. Planning the Social Studies Programme for the Contemporary African Society.

    Science.gov (United States)

    Enaohwo, J. Okpako

    1989-01-01

    Identifies characteristics of a viable social studies program for African nations, urging multidisciplinary and integrated approaches. Offers a cyclical framework for planning a curriculum which includes defining the problem, setting objectives, identifying methods of implementation, evaluation, and regeneration. (LS)

  3. Spatial clustering of all-cause and HIV-related mortality in a rural South African population (2000-2006.

    Directory of Open Access Journals (Sweden)

    Elias Namosha

    Full Text Available BACKGROUND: Sub-Saharan Africa bears a disproportionate burden of HIV infection. Knowledge of the spatial distribution of HIV outcomes is vital so that appropriate public health interventions can be directed at locations most in need. In this regard, spatial clustering analysis of HIV-related mortality events has not been performed in a rural sub-Saharan African setting. METHODOLOGY AND RESULTS: Kulldorff's spatial scan statistic was used to identify HIV-related and all-cause mortality clusters (p<0.05 in a population-based demographic surveillance survey in rural KwaZulu Natal, South Africa (2000-2006. The analysis was split pre (2000-2003 and post (2004-2006 rollout of antiretroviral therapy, respectively. Between 2000-2006 a total of 86,175 resident individuals ≥15 years of age were under surveillance and 5,875 deaths were recorded (of which 2,938 were HIV-related over 343,060 person-years of observation (crude all-cause mortality rate 17.1/1000. During both time periods a cluster of high HIV-related (RR = 1.46/1.51, p = 0.001 and high all-cause mortality (RR = 1.35/1.38, p = 0.001 was identified in peri-urban communities near the National Road. A consistent low-risk cluster was detected in the urban township in both time periods (RR = 0.60/0.39, p = 0.003/0.005 and in the first time period (2000-2003 a large cluster of low HIV-related and all-cause mortality in a remote rural area was identified. CONCLUSIONS: HIV-related and all-cause mortality exhibit strong spatial clustering tendencies in this population. Highest HIV-related mortality and all-cause mortality occurred in the peri-urban communities along the National Road and was lowest in the urban township and remote rural communities. The geography of HIV-related mortality corresponded closely to the geography of HIV prevalence, with the notable exception of the urban township where high HIV-related mortality would have been expected on the basis of the high HIV

  4. Strategies to prevent HIV transmission among heterosexual African-American men

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    Peters Ronald J

    2005-01-01

    Full Text Available Abstract Background As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs. Methods The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors. Conclusions The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while

  5. Eclecticism Beyond Orthodoxies: African Social Science Research in the Fight Against HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Ambe-Uva T. Nom

    2005-01-01

    Full Text Available This study examines the importance of social science research on HIV/AIDS in Africa. There is a dearth of social science research on HIV/AIDS epidemic in Africa as available literature focus essentially on biomedical and epidemiological aspect of HIV/AIDS research and behavioral changes. In Africa however, efforts at preventing and mitigating the impact of HIV/AIDS epidemic will have to consider the social dimension of the epidemic. This study argues for a distinct social science research on HIV/AIDS which will, first, enhance ownership of Africans in participation in HIV/AIDS research; second, developed within a specific African orientation in mind and third, relevant/ essential to Africa. Such research must equally be multi/interdisciplinary involving stakeholders and responsive to the methodological challenges posed by HIV/AIDS research.

  6. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    Science.gov (United States)

    Cluver, Lucie Dale; Orkin, Frederick Mark; Meinck, Franziska; Boyes, Mark Edward; Sherr, Lorraine

    2016-01-01

    Introduction Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. Methods This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention). Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1) potential structural drivers of HIV infection such as poverty and community violence; 2) HIV risk behaviours; 3) hypothesized psychosocial mediating factors; and 4) types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Results Structural drivers were associated with increased onset of adolescent HIV risk behaviour (p<0.001, B=0.06, SE=0.01), fully mediated by increased psychosocial problems. Both cash and care aspects of social protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=−0.08, p<0.002 between structural deprivation and psychosocial problems, and B=−0.07, p<0.001 between psychosocial problems and HIV risk behaviour). Conclusions Adolescents with the greatest structural

  7. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    Directory of Open Access Journals (Sweden)

    Lucie Dale Cluver

    2016-04-01

    Full Text Available Introduction: Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. Methods: This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention. Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1 potential structural drivers of HIV infection such as poverty and community violence; 2 HIV risk behaviours; 3 hypothesized psychosocial mediating factors; and 4 types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Results: Structural drivers were associated with increased onset of adolescent HIV risk behaviour (p<0.001, B=0.06, SE=0.01, fully mediated by increased psychosocial problems. Both cash and care aspects of social protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=−0.08, p<0.002 between structural deprivation and psychosocial problems, and B=−0.07, p<0.001 between psychosocial problems and HIV risk behaviour. Conclusions: Adolescents with the greatest

  8. Straight talk: HIV prevention for African-American heterosexual men: theoretical bases and intervention design.

    Science.gov (United States)

    Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A

    2012-10-01

    In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. PMID:23016501

  9. Prevalence of common vitamin D receptor gene polymorphisms in HIV-infected and uninfected South Africans

    Science.gov (United States)

    McNamara, Lynne; Takuva, Simbarashe; Chirwa, Tobias; MacPhail, Patrick

    2016-01-01

    Background: Host genetic factors may a play role in susceptibility to infection. Vitamin-D is an immunomodulator that may play a role in HIV infection. Vitamin-D action is mediated by the vitamin-D receptor. We establish prevalence of ApaI, BsmI, FokI and TaqI polymorphisms (VDRPs) amongst a black southern African HIV+ve population and investigate polymorphic differences between HIV+ve and -ve people. Methods: Seventy-nine sex and age-group matched HIV+ve patients of African origin initiating antiretroviral therapy (ART) and 79 HIV-ve participants, also of African origin, were recruited from a public sector HIV testing and treatment clinic and investigated for the 4 polymorphisms. The genotype frequencies were compared, odds ratios and 95% confidence intervals of the association of HIV status and each genotype were calculated. Both dominant, co-dominant, recessive and allele models were tested. Results: We found no evidence of difference in distribution and association between HIV infection and the genotypes of the BsmI, FokI and TaqI VDR polymorphisms. The genotype distributions were consistent with Hardy-Weinberg equilibrium for these genotypes. The ApaI genotype showed differences in distribution by HIV status in the dominant and co-dominant models. However this finding is cautiously stated as the ApaI genotype violated the Hardy-Weinberg equilibrium and frequency of the minor variant was unexpectedly low in this population. Conclusion: We do not show convincing differences in distribution of the VDR genotypes among HIV+ve and HIV-ve black southern African persons. Future studies need to be replicated in larger study populations as understanding polymorphic differences and similarities may offer insights into the different susceptibility and progression of HIV in southern African populations. PMID:27186331

  10. Risk and protection for HIV/AIDS in African-American, Hispanic, and White adolescents.

    Science.gov (United States)

    Bartlett, Robin; Buck, Raymond; Shattell, Mona M

    2008-07-01

    African-Americans and Hispanics are disproportionately affected by HIV/AIDS in the United States. HIV infection is often acquired during adolescence, a time when risky sexual behaviors are at their peak. This study explored relationships among selected risk factors, protective factors, and risky sexual behaviors among African-American, Hispanic, and White adolescents, from a sample of adolescents from the National Longitudinal Study of Adolescent Health. African-Americans and Hispanics were more likely to have sexual intercourse without the use of birth control than were Whites. African-Americans were more likely to have sexual behavior with multiple sexual partners than either Hispanics or Whites were, and African-Americans had higher self-esteem than did Hispanics and Whites. In order to develop culturally sensitive, effective interventions to prevent HIV/AIDS in adolescents, racial differences in risk and protective factors must be examined. PMID:18807775

  11. The impact of HIV/AIDS on human development in African countries

    OpenAIRE

    Boutayeb, Abdesslam

    2009-01-01

    Background In the present paper, we consider the impact of HIV/AIDS on human development in African countries, showing that, beyond health issues, this disease should and must be seen as a global development concern, affecting all components of human development. Consequently, we stress the necessity of multidisciplinary approaches that model, estimate and predict the real impact of HIV/AIDS on human development of African countries in order to optimise the strategies proposed by national cou...

  12. When HIV is ordinary and diabetes new: Remaking suffering in a South African Township

    OpenAIRE

    Mendenhall, Emily; Norris, Shane A.

    2015-01-01

    Escalation of non-communicable diseases (NCDs) among urban South African populations disproportionately afflicted by HIV/AIDS presents not only medical challenges but also new ways in which people understand and experience sickness. In Soweto, the psychological imprints of political violence of the Apartheid era and structural violence of HIV/AIDS have shaped social and health discourses. Yet, as NCDs increasingly become part of social and biomedical discussions in South African townships, ne...

  13. Replicating Impact of a Primary School HIV Prevention Programme: Primary School Action for Better Health, Kenya

    Science.gov (United States)

    Maticka-Tyndale, E.; Mungwete, R.; Jayeoba, O.

    2014-01-01

    School-based programmes to combat the spread of HIV have been demonstrated to be effective over the short-term when delivered on a small scale. The question addressed here is whether results obtained with small-scale delivery are replicable in large-scale roll-out. Primary School Action for Better Health (PSABH), a programme to train teachers to…

  14. "Views from the Nano Edge": Women on Doctoral Preparation Programmes in Selected African Contexts

    Science.gov (United States)

    Williamson, Charmaine

    2016-01-01

    The study explored the conceptual views of "critical mass", alongside micro experiences, of women, at a practice level, on a doctoral preparation programme which was implemented within the South African Development Community (SADC) and Ethiopian contexts. At the strategising level of policies, insufficient attention has been paid to the…

  15. Developing a Cancer Prevention Programme for African-American Daughters and Mothers

    Science.gov (United States)

    Annang, Lucy; Spencer, S. Melinda; Jackson, Dawnyéa; Rosemond, Tiara N.; Best, Alicia L.; Williams, Leah R.; Carlos, Bethany

    2015-01-01

    Objective: To describe how nominal group technique was used to inform the development of a breast and cervical cancer awareness programme for African-American adult daughters and mothers. Design: A qualitative approach using nominal group technique. Setting: A mid-sized city in the Southern USA. Method: Nominal group technique was used with 30…

  16. The Refuge: An After-School Care Programme for African-American Children in Poverty

    Science.gov (United States)

    Tuason, Ma. Teresa; Marcetic, Andjela; Roberts, Shavaun; Stuart, Karly; Rearick, Jessica

    2009-01-01

    The Refuge is an after-school care programme in the southeastern USA that caters to the academic and psychological needs of impoverished African-American children. This study evaluated the Refuge through interviews with staff, small group discussions with children and persistent observation. By evaluating the after-school care services they…

  17. Conceptualizing community mobilization for HIV prevention: implications for HIV prevention programming in the African context.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation.We aimed to identify the key domains of community mobilization (CM essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting.We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge.CM DOMAINS INCLUDE: 1 shared concerns, 2 critical consciousness, 3 organizational structures/networks, 4 leadership (individual and/or institutional, 5 collective activities/actions, and 6 social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks.To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of

  18. Risk Reduction for HIV-Positive African American and Latino Men with Histories of Childhood Sexual Abuse

    OpenAIRE

    Williams, John K.; Wyatt, Gail E.; Rivkin, Inna; Ramamurthi, Hema Codathi; Li, Xiaomin; Liu, Honghu

    2008-01-01

    While the HIV epidemic has disproportionately affected African American and Latino men who have sex with men (MSM), few HIV prevention interventions have focused on African American and Latino men who have sex with both men and women (MSMW). Even fewer interventions target HIV-positive African American and Latino MSM and MSMW with histories of childhood sexual abuse (CSA), a population that may be vulnerable to high-risk sexual behaviors, having multiple sexual partners, and depression. The M...

  19. Predictors of HIV-related stigmas among African American and Latino religious congregants

    Science.gov (United States)

    Derose, Kathryn Pitkin; Kanouse, David E.; Bogart, Laura M.; Griffin, Beth Ann; Haas, Ann; Stucky, Brian D.; Williams, Malcolm V.; Flórez, Karen R.

    2015-01-01

    Objectives Inform church-based stigma interventions by exploring dimensions of HIV stigma among African American and Latino religious congregants and how these are related to drug addiction and homosexuality stigmas and knowing someone HIV-positive. Methods In-person, self-administered surveys of congregants 18+ years old across two African American and three Latino churches (n=1235, response rate 73%) in a western US city with high HIV prevalence. Measures included 12 items that captured dimensions of HIV stigma, a 5-item scale that assessed attitudes towards people who are addicted to drugs, a 7-item scale assessing attitudes towards homosexuality, and questions regarding socio-demographics and previous communication about HIV. Results 63.8% of survey participants were women, mean age was 40.2 years, and 34.4% were African American, 16.8% were U.S.-born Latinos, 16.0% were foreign-born, English-speaking Latinos, and 32.9% were foreign-born, Spanish-speaking Latinos. Exploratory and confirmatory factor analyses identified four dimensions of HIV stigma – discomfort interacting with people with HIV (4 items, α=0.86), feelings of shame “if you had HIV” (3 items, α=0.78), fears of rejection “if you had HIV” (3 items, α=0.71) and feelings of blame towards people with HIV (2 items, α=0.65). Across all dimensions, after controlling for socio-demographic characteristics and previous communication about HIV, knowing someone with HIV was associated with lower HIV stigma, and greater stigma concerning drug addiction and homosexuality were associated with higher HIV stigma. Conclusions Congregation-based HIV stigma reduction interventions should consider incorporating contact with HIV-affected people. It may also be helpful to address attitudes toward drug addiction and sexual orientation. PMID:26213890

  20. Factors Contributing to the Development of an HIV Ministry within an African American Church

    OpenAIRE

    Stewart, Jennifer M.; Dancy, Barbara L.

    2011-01-01

    Having an HIV ministry within a church depends on the religious culture of that church. However, little is known about how a church’s religious culture influences an HIV ministry. This study’s purpose was to examine how an African American church’s religious culture supported the development, implementation, and maintenance of an HIV ministry within the church. An ethnographic case study research design was used. Data were collected through interviews, non-participant and participant observat...

  1. HIV testing practices of South African township MSM in the era of expanded access to ART

    OpenAIRE

    Sandfort, Theo G. M.; Knox, Justin; Collier, Kate L.; Lane, Tim; Reddy, Vasu

    2015-01-01

    While men who have sex with men (MSM) in Africa are at high risk for HIV infection, few of those already infected know their status. Effectively promoting frequent HIV testing—of increasing importance with the expanding accessibility of antiretroviral treatment—requires an understanding of the testing practices in this population. To understand men’s HIV testing practices, including their behavior, experiences, and perceptions, we conducted in-depth interviews with 81 black South African MSM ...

  2. Community Influences on Married Men's Uptake of HIV Testing in Eight African Countries

    OpenAIRE

    Stephenson, Rob; Elfstrom, K. Miriam; Winter, Amy

    2013-01-01

    Despite efforts to increase HIV testing in the African region, the proportion of men who report ever having been tested for HIV remains low. Research has focused on individual level determinants of women's testing however little is known about factors associated with men's testing behavior. This analysis investigates community influences on HIV testing among men ages 15–54, using Demographic and Health Survey (DHS) data from Chad, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia, and Zimbabwe...

  3. African American church-based HIV testing and linkage to care: assets, challenges and needs.

    Science.gov (United States)

    Stewart, Jennifer M; Thompson, Keitra; Rogers, Christopher

    2016-06-01

    The US National HIV AIDS strategy promotes the use of faith communities to lessen the burden of HIV in African American communities. One specific strategy presented is the use of these non-traditional venues for HIV testing and co-location of services. African American churches can be at the forefront of this endeavour through the provision of HIV testing and linkage to care. However, there are few interventions to promote the churches' involvement in both HIV testing and linkage to care. We conducted 4 focus groups (n = 39 participants), 4 interviews and 116 surveys in a mixed-methods study to examine the feasibility of a church-based HIV testing and linkage to care intervention in Philadelphia, PA, USA. Our objectives were to examine: (1) available assets, (2) challenges and barriers and (3) needs associated with church-based HIV testing and linkage to care. Analyses revealed several factors of importance, including the role of the church as an access point for testing in low-income neighbourhoods, challenges in openly discussing the relationship between sexuality and HIV, and buy-in among church leadership. These findings can support intervention development and necessitate situating African American church-based HIV testing and linkage to care interventions within a multi-level framework. PMID:26652165

  4. African-American sexuality and HIV/AIDS: recommendations for future research.

    Science.gov (United States)

    Wyatt, Gail E; Williams, John K; Myers, Hector F

    2008-01-01

    HIV/AIDS continues to create a significant health crisis in African-American communities and health disparities within the United States. Understanding African-American sexuality within a culturally congruent and ethnocentric approach is critical to decreasing the HIV infection and transmission rates for African Americans. This brief discusses two major factors: 1) confusion about race-based stereotypes; and 2) historical health disparities and mistrust, which have influenced our understanding of African-American sexuality despite that fact that very little research has been conducted in this area. This paper discusses the limitations of what is known and makes recommendations for research surrounding sexuality and HIV/AIDS. Research trainings for new and established investigators and collaborations among health, community, religious, political organizations, and historically black colleges and universities are needed to disseminate relevant HIV prevention messages. Conducting research to better understand African-American sexuality will facilitate the development of behavioral interventions that address health, HIV and mental health risk reduction within the context of African-American life. PMID:18277807

  5. Medical mistrust is related to lower longitudinal medication adherence among African-American males with HIV.

    Science.gov (United States)

    Dale, Sannisha K; Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J

    2016-07-01

    African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.g. viral suppression) than do their White counterparts. In a 6-month longitudinal study, we investigated whether medical mistrust among African-American males with HIV (214 enrolled, 140 with longitudinal data) predicted lower electronically monitored antiretroviral medication adherence. General medical mistrust (e.g. suspicion toward providers), but not racism-related mistrust (e.g. belief that providers treat African-Americans poorly due to race), predicted lower continuous medication adherence over time (b = -.08, standard error = .04, p = .03). Medical mistrust may contribute to poor health outcomes. Intervention efforts that address mistrust may improve adherence among African-Americans with HIV. PMID:25293970

  6. Increasing HIV/AIDS awareness among African-American women: an exploratory study.

    Science.gov (United States)

    Brown, Ludella; Tabi, Marian M

    2013-07-01

    This exploratory study was conducted to assess the effect of an HIV/AIDS prevention program on producing positive changing attitudes among African-American women in Southeast Georgia. This study used a faith-based approach. Data were collected from 23 respondents recruited from a local African-American church. HIV training was conducted over four 1-hour sessions using web-based interactive videos and lectures on HIV/AIDS. Constructs from the Social Cognitive Theory comprised the framework upon which the women received HIV/AIDS prevention training. Participants completed a 25-item pre- and post-intervention questionnaire to measure any changes that occurred in their attitudes regarding HIV/AIDS. Results showed a statistically significant difference in mean scores of individual knowledge and attitudes about HIV. The difference in mean scores for the remaining items was found to be statistically insignificant. The overall change in attitudes was also statistically significant, t = 2.27, df = 22, p < 0.05, which provided further evidence that when peers educate their communities on HIV/AIDS, it makes a significant difference in changing their attitudes about this disease. Although findings were positive, further data is needed to substantiate and validate the use of community peers to increase knowledge and awareness about HIV/AIDS among the African-American population. PMID:24218873

  7. A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women.

    Science.gov (United States)

    Stewart, Jennifer M; Rogers, Christopher K; Bellinger, Dawn; Thompson, Keitra

    2016-07-01

    HIV/AIDS has a devastating impact on African Americans, particularly women and young adults. We sought to characterize risks, barriers, and content and delivery needs for a faith-based intervention to reduce HIV risk among African American women ages 18 to 25. In a convergent parallel mixed methods study, we conducted four focus groups (n = 38) and surveyed 71 young adult women. Data were collected across four African American churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting, and financial burdens into faith-based HIV risk-reduction interventions. Incorporating additional social context-related factors into HIV risk-reduction interventions for young African American women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings. PMID:26879828

  8. Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

    Science.gov (United States)

    Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

    2011-01-01

    A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…

  9. An empowerment programme for social work students regarding HIV and AIDS : adapted REds programme / H. Malan

    OpenAIRE

    Malan, Hanelie

    2009-01-01

    According to Lerole (1994:9), practitioners in the health care and social services find themselves in the frontline regarding their attempt to prevent the spread of HIV as well as deal with its consequences. Having well-trained, knowledgeable and highly motivated professionals working in service delivery at all levels is crucial for effective management of the HIV epidemic. HIV and Aids present a significant problem at both societal and professional levels for social workers. Individuals who ...

  10. Modelling the impact and cost-effectiveness of the HIV intervention programme amongst commercial sex workers in Ahmedabad, Gujarat, India.

    OpenAIRE

    Foss Anna M; Vadhvana Jagdish; Vannela Gangadhar; Watts Charlotte; Vickerman Peter; Guinness Lorna; Fung Isaac; Malodia Laxman; Gandhi Meena; Jani Gaurang

    2007-01-01

    Abstract Background Ahmedabad is an industrial city in Gujarat, India. In 2003, the HIV prevalence among commercial sex workers (CSWs) in Ahmedabad reached 13.0%. In response, the Jyoti Sangh HIV prevention programme for CSWs was initiated, which involves outreach, peer education, condom distribution, and free STD clinics. Two surveys were performed among CSWs in 1999 and 2003. This study estimates the cost-effectiveness of the Jyoti Sangh HIV prevention programme. Methods A dynamic mathemati...

  11. Evaluating the potential impact of enhancing HIV treatment and tuberculosis control programmes on the burden of tuberculosis

    OpenAIRE

    Chindelevitch, Leonid; Menzies, Nicolas A.; Pretorius, Carel; Stover, John; Salomon, Joshua A.; Cohen, Ted

    2015-01-01

    HIV has fuelled increasing tuberculosis (TB) incidence in sub-Saharan Africa. Better control of TB in this region may be achieved directly through TB programme improvements and indirectly through expanded use of antiretroviral therapy (ART) among those with HIV. We used a mathematical model of TB and HIV in South Africa to examine the potential epidemiological impact in scenarios involving improvements in three dimensions of TB programmes: coverage, diagnosis and treatment effectiveness, as w...

  12. Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora.

    Science.gov (United States)

    Millett, Gregorio A; Jeffries, William L; Peterson, John L; Malebranche, David J; Lane, Tim; Flores, Stephen A; Fenton, Kevin A; Wilson, Patrick A; Steiner, Riley; Heilig, Charles M

    2012-07-28

    Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources. PMID:22819654

  13. Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Hader Shannon L

    2009-08-01

    Full Text Available Abstract Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes.

  14. HIV-related stigma among African, Caribbean, and Black youth in Windsor, Ontario.

    Science.gov (United States)

    Mihan, Robert; Kerr, Jelani; Maticka-Tyndale, Eleanor

    2016-01-01

    HIV-related stigma has been shown to undermine prevention, care, treatment, and the well-being of people living with HIV. A disproportion burden of HIV infection, as well as elevated levels of HIV-related stigma, is evidenced in sub-Saharan African (SSA) and African-diasporic populations. This study explores factors that influence HIV-related stigma among 16- to 25-year-old youth residing in a Canadian city who identify as African, Caribbean, or Black. Stigma, as rooted in cultural norms and beliefs and related social institutions, combined with insights from research on stigma in SSA and African-diasporic populations, guided the development of a path analytic structural equation model predicting levels of HIV-related stigmatizing attitudes. The model was tested using survey responses of 510 youth to estimate the direct and indirect influences of ethno-religious identity, religious service attendance, time in Canada, HIV/AIDS knowledge, HIV-testing history, sexual health service contact, and gender on HIV-related stigma. Statistically significant negative associations were found between levels of stigma and knowledge and HIV-testing history. Ethno-religious identity and gender had both direct and indirect effects on stigma. African-Muslim participants had higher levels of stigma, lower knowledge, and were less likely to have been tested for HIV infection than other ethno-religious groups. Male participants had higher levels of stigma and lower knowledge than women. Time in Canada had only indirect effects on stigma, with participants in Canada for longer periods having higher knowledge and less likely to have been tested than more recent arrivals. While the strength of the effect of knowledge on stigmatizing attitudes in this research is consistent with other research on stigma and evaluations of stigma-reduction programs, the path analytic results provide additional information about how knowledge and HIV-testing function as mediators of non

  15. Optimizing HIV/AIDS resources in Armenia: increasing ART investment and examining HIV programmes for seasonal migrant labourers

    Science.gov (United States)

    Kelly, Sherrie L; Shattock, Andrew J; Kerr, Cliff C; Stuart, Robyn M; Papoyan, Arshak; Grigoryan, Trdat; Hovhannisyan, Ruben; Grigoryan, Samvel; Benedikt, Clemens; Wilson, David P

    2016-01-01

    Introduction HIV prevalence is declining in key populations in Armenia including in people who inject drugs (PWID), men who have sex with men, prison inmates, and female sex workers (FSWs); however, prevalence is increasing among Armenians who seasonally migrate to work in countries with higher HIV prevalence, primarily to the Russian Federation. Methods We conducted a modelling study using the Optima model to assess the optimal resource allocation to meet targets from the 2013 to 2016 national strategic plan to minimize HIV incidence and AIDS-related deaths by 2020. Demographic, epidemiological, behavioural, and programme cost data from 2000 through 2014 were used to inform the model. The levels of coverage that could be attained among targeted populations with different investments, as well as their expected outcomes, were determined. In the absence of evidence of the efficacy of HIV programmes targeted at seasonal labour migrants, we conducted a sensitivity analysis to determine the cost-effective funding threshold for the seasonal labour migrant programme. Results The optimization analysis revealed that shifts in funding allocations could further minimize incidence and deaths by 2020 within the available resource envelope. The largest emphasis should be on antiretroviral therapy (ART), with the optimal investment to increase treatment coverage by 40%. Optimal investments also involve increases in opiate substitution therapy and FSW programmes, as well as maintenance of other prevention programmes for PWID and prevention of mother-to-child transmission. Additional funding for these increases should come from budgets for general population programmes. This is projected to avert 17% of new infections and 29% of AIDS-related deaths by 2020 compared to a baseline scenario of maintaining 2013 spending. Our sensitivity analysis demonstrated that, at current spending, coverage of annual testing among migrants of at least 43% should be achieved to warrant continuation

  16. Skills-Based, Interactive Computer Interventions to Prevent HIV Infection Among African-American and Hispanic Adolescents

    OpenAIRE

    Schinke, Steven P.; Orlandi, Mario A.

    1990-01-01

    The spread of the acquired immunodeficiency virus (AIDS) virus, human immunodeficiency virus (HIV) infection, is increasingly evident. Despite the attention that HIV infection has received, few effective prevention strategies have been developed. The present paper reviews the epidemiology of AIDS among African-American and Hispanic adolescents. From epidemiological data, the authors argue for preventive approaches to reduce the risks of HIV transmission among African-American and Hispanic ado...

  17. Patterns of resistance: African American mothers and adult children with HIV illness.

    Science.gov (United States)

    Boyle, J S; Hodnicki, D R; Ferrell, J A

    1999-01-01

    Although the research on caregiving and caregivers has been extensive, there have been few studies on the cultural context and meaning of African American caregiving in relation to HIV illness. Many Black feminists have argued that African American women experience a world different from those who are not Black and that failure to take account of race, class, and gender is paramount in an attempt to authentically portray the lives of African American women. This study argues that rural African American culture and experiences of racism and discrimination in the rural South shaped the responses of mothers when their adult children developed HIV illness. The study employed the ethnographic techniques of participant observation and in-depth interviews with 14 rural, poor, African American mothers who cared for adult children with HIV illness. Analysis of the data identified patterns of resistance that mothers employed throughout the caregiving experience. Mothers resisted labels and other controlling images that they believed marginalized them and negated what was happening to their children. Mothers used culturally patterned behaviors to protect their families and resist the stigma of HIV/AIDS. PMID:10530083

  18. Shared Illness and Social Support Within Two HIV-Affected African American Communities.

    Science.gov (United States)

    Mosack, Katie E; Stevens, Patricia E; Brouwer, Amanda M; Wendorf, Angela R

    2016-09-01

    A key source of resiliency within HIV-affected African American communities is informal social support. Data from dyadic conversations and focus groups were used to address the following research question: What are HIV-positive African Americans' social support experiences within their informal social networks in response to HIV-related problems? Circumstances that exacerbated HIV-related problems included others' fear of contagion, reticence to be involved, judgment and rejection, and disregard for privacy Support from HIV-negative others buffered the impact of problems when others communicate interest, take the initiative to help, or make a long-term investment in their success. Support from other HIV-positive persons was helpful given the shared connection because of HIV, the opportunity to commiserate about what is mutually understood, and the fight for mutual survival Based on these findings, we offer suggestions for future research and social network interventions aimed at bolstering connections between HIV-positive peers, reducing stigma, and improving family support. PMID:26515921

  19. Researching South African Youth, Gender and Sexuality Within the Context of HIV/AIDS

    OpenAIRE

    Deevia Bhana; Rob Pattman

    2009-01-01

    In the context of HIV/AIDS, youth have become central to contemporary South African social thought and educational policy concerns regarding changing behaviour, addressing gender inequalities, safe sex and preventing the spread of the disease. Yet we know very little about how youth in specific social contexts give meaning to gender and sexuality. Greater understanding of these processes would appear vital to successful educational strategies in the protection against HIV/AIDS in South Africa...

  20. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  1. The Impact of Perceived Group Support on the Effectiveness of an HIV Prevention Intervention for African American Women

    Science.gov (United States)

    Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela

    2010-01-01

    The enormous HIV/AIDS disparity among African American women and women in other ethnic groups dictates the need to implement the most effective HIV prevention interventions. This study examined the impact of perceived group support on HIV protective behaviors (i.e., attitudes and behaviors related to condom use, alcohol, and drugs) of African…

  2. Strategies to prevent HIV transmission among heterosexual African-American women

    Directory of Open Access Journals (Sweden)

    Peters Ronald J

    2005-03-01

    Full Text Available Abstract Background African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. Methods Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and

  3. Strategies to prevent HIV transmission among heterosexual African-American women.

    Science.gov (United States)

    Essien, E James; Meshack, Angela F; Peters, Ronald J; Ogungbade, Go; Osemene, Nora I

    2005-03-17

    BACKGROUND: African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. METHODS: Twenty five low income African American women, ages 18-29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. RESULTS: The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and personal experience with

  4. Preventing HIV among Latino and African American Gay and Bisexual Men in a Context of HIV-Related Stigma, Discrimination, and Homophobia: Perspectives of Providers

    OpenAIRE

    Brooks, Ronald A.; Etzel, Mark A.; Hinojos, Ernesto; Henry, Charles L.; Perez, Mario

    2005-01-01

    HIV-related stigma, discrimination, and homophobia impede community based efforts to combat HIV disease among Latino and African American gay and bisexual men. This commentary highlights ways to address these social biases in communities of color in Los Angeles from the perspectives of staff from HIV prevention programs. Information was collected from HIV prevention program staff participating in a two-day symposium. The outcomes from the symposium offer strategies for developing and implemen...

  5. Correlates of posttraumatic growth among African Americans living with HIV/AIDS in Mississippi1

    Science.gov (United States)

    Evans, Shenell D.; Williams, Bryman E.; Leu, Cheng-Shiun

    2015-01-01

    Individuals diagnosed with HIV face a host of challenges post-diagnosis. At risk for negative psychological outcomes, persons living with HIV/AIDS may also experience posttraumatic growth (i.e., positive cognitive and emotional changes that may occur following HIV diagnosis). African Americans, in particular, experience poorer psychosocial and behavioral outcomes and greater HIV-related health disparities, and also tend to report more posttraumatic growth than European Americans. This exploratory study examined demographic, psychosocial, and behavioral correlates of posttraumatic growth among 45 African American adults living with HIV in Mississippi. Statistical methods included correlational analyses and independent sample t-tests. As measured by the Posttraumatic Growth Inventory, posttraumatic growth was associated with several demographic (i.e., age, education, employment, income), psychosocial (i.e., social support, coping self-efficacy, psychological distress [negative]), and behavioral variables (i.e., church attendance, abstinence from drugs, alcohol, and cigarettes). Findings indicate that African Americans living with HIV in underserved, under-resourced areas are capable of perceiving posttraumatic growth post-diagnosis. Moreover, research has shown that perceived positive growth is associated with important sociocultural, psychosocial, and behavioral factors that directly and/or indirectly influence health and treatment outcomes. Implications of findings are discussed. PMID:26523161

  6. Keeping the faith: African American faith leaders' perspectives and recommendations for reducing racial disparities in HIV/AIDS infection.

    Directory of Open Access Journals (Sweden)

    Amy Nunn

    Full Text Available In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia's most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia's racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations' existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after

  7. Keeping the faith: African American faith leaders' perspectives and recommendations for reducing racial disparities in HIV/AIDS infection.

    Science.gov (United States)

    Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy

    2012-01-01

    In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia's most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia's racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations' existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after worship services and in

  8. Measuring HIV stigma for PLHAs and nurses over time in five African countries.

    Science.gov (United States)

    Holzemer, William L; Makoae, Lucy N; Greeff, Minrie; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Durrheim, Kevin; Cuca, Yvette; Uys, Yvette R

    2009-09-01

    The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association. PMID:19936409

  9. Mitochondrial DNA variation and virologic and immunological HIV outcomes in African Americans

    Science.gov (United States)

    Aissani, Brahim; Shrestha, Sadeep; Wiener, Howard W.; Tang, Jianming; Kaslow, Richard A.; Wilson, Craig M.

    2016-01-01

    Objective To evaluate the impact of mitochondrial DNA (mtDNA) haplogroups on virologic and immunological outcomes of HIV infection. Design HAART-naive African American adolescent participants to the Reaching for Excellence in Adolescent Care and Health study. Methods The mtDNA haplogroups were inferred from sequenced mtDNA hypervariable regions HV1 and HV2 and their predictive value on HIV outcomes were evaluated in linear mixed models, controlled for human leukocyte antigen (HLA)-B27, HLA-B57 and HLA-B35-Px alleles and other covariates. Results We report data showing that the mtDNA L2 lineage, a group composed of L2a, L2b and L2e mtDNA haplogroups in the studied population, is significantly associated (beta=−0.08; Bonferroni-adjusted P=0.004) with decline of CD4+ T cells (median loss of 8 ± 1 cells per month) in HAART-naive HIV-infected individuals of African American descent (n=133). No significant association (PHIV infection, its phylogenetic divergence from J and U5a, two lineages associated with accelerated HIV progression in European Americans, raises the possibility that interactions with common nucleus-encoded variants drive HIV progression. Disentangling the effects of mitochondrial and nuclear gene variants on the outcomes of HIV infection is an important step to be taken toward a better understanding of HIV/AIDS pathogenesis and pharmacogenomics. PMID:24932613

  10. Intervention Mapping as a Participatory Approach to Developing an HIV prevention Intervention in Rural African American Communities

    OpenAIRE

    Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

    2010-01-01

    Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few multilevel HIV interventions that have been developed, tailored or tested in rural communities for African Americans. We describe how Project GRACE int...

  11. Political will, traditional leaders and the fight against HIV/AIDS: a South African case study

    OpenAIRE

    Campbell, Catherine

    2010-01-01

    Political will and leadership are increasingly considered key contextual influences on the outcomes of HIV/AIDS programmes in sub-Saharan Africa. Such debates tend to focus on the role of national leadership in shaping responses to the epidemic, with little attention to local leaders. Yet many of the settings in which HIV/AIDS flourishes are geographically distant from the reach of national leadership and policies. Furthermore, local leaders often play a key role in shaping how national polic...

  12. Premarital screening programmes for haemoglobinopathies, HIV and hepatitis viruses: review and factors affecting their success.

    Science.gov (United States)

    Alswaidi, Fahad M; O'Brien, Sarah J

    2009-01-01

    This literature review is a comprehensive summary of premarital (prenuptial) screening programmes for the most prevalent hereditary haemoglobinopathies, namely thalassaemia and sickle cell disease, and the important infections HIV (human immunodeficiency virus) and hepatitis viruses B and C (HBV and HCV). It describes the background to premarital screening programmes and their value in countries where these diseases are endemic. The use of premarital screening worldwide is critically evaluated, including recent experiences in Saudi Arabia, followed by discussion of the outcomes of such programmes. Despite its many benefits, premarital testing is not acceptable in some communities for various legal and religious reasons, and other educational and cultural factors may prevent some married couples following the advice given by counsellors. The success of these programmes therefore depends on adequate religious support, government policy, education and counselling. In contrast to premarital screening for haemoglobinopathies, premarital screening for HIV and the hepatitis viruses is still highly controversial, both in terms of ethics and cost-effectiveness. In wealthy countries, premarital hepatitis and HIV testing could become mandatory if at-risk, high-prevalence populations are clearly identified and all ethical issues are adequately addressed. PMID:19349527

  13. Monitoring HIV Prevention Programme Outcomes among Key Populations in Kenya: Findings from a National Survey.

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    Parinita Bhattacharjee

    Full Text Available In preparation for the implementation of the Kenya AIDS Strategic Framework 2014/15-2018/19, the Kenya National AIDS and STI Control Programme facilitated a national polling booth survey as part of a baseline assessment of HIV-related risk behaviours among FSWs, MSM, and PWID, and their utilization of existing preventive interventions, as well as structural factors that may influence KPs' vulnerability to HIV. The survey was conducted among "key populations" (female sex workers, men who have sex with men, and people who inject drugs to understand current HIV risk and prevention behaviours, utilization of existing programmes and services, and experiences of violence. In total, 3,448 female sex workers, 1,308 men who have sex with men, and 690 people who inject drugs were randomly selected to participate in polling booth survey sessions from seven priority sites. Survey responses were aggregated and descriptive statistics derived. In general, reported condom use among all key populations was quite high with paying clients, and lower with regular, non-paying partners. Many participants reported unavailability of condoms or clean injecting equipment within the past month. Exposure to, and utilization of, existing HIV prevention services varied significantly among the groups, and was reported least commonly by female sex workers. Encouragingly, approximately three-quarters of all key population members reported receiving an HIV test in the past three months. All key population groups reported experiencing high levels of physical and sexual violence from partners/clients, and/or arrest and violence by law enforcement officials. Although some of the findings are encouraging, there is room for improvement in HIV prevention programmes and services for key populations across Kenya.

  14. Social support, psychological vulnerability, and HIV risk among African American men who have sex with men.

    Science.gov (United States)

    Saleh, Lena D; van den Berg, Jacob J; Chambers, Christopher S; Operario, Don

    2016-05-01

    Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM. PMID:26588945

  15. HIV Risk Behaviors among African American Male Violent Youth Offenders

    Science.gov (United States)

    Richardson, Joseph B., Jr.; Brown, Jerry; Van Brakle, Mischelle; Godette, Dionne C.

    2010-01-01

    Bay City (pseudonym) is one of the nation's urban epicenters of the HIV epidemic. Although researchers have examined HIV risk behaviors among juvenile offenders detained in juvenile facilities, no study has examined these risk behaviors among youth offenders who have been waived to adult criminal court and detained in U.S. jails. In the present…

  16. Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries

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    Mitchell Steven

    2010-09-01

    Full Text Available Abstract Background HIV testing with counseling is an integral component of most national HIV and AIDS prevention strategies in southern Africa. Equity in testing implies that people at higher risk for HIV such as women; those who do not use condoms consistently; those with multiple partners; those who have suffered gender based violence; and those who are unable to implement prevention choices (the choice-disabled are tested and can have access to treatment. Methods We conducted a household survey of 24,069 people in nationally stratified random samples of communities in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe. We asked about testing for HIV in the last 12 months, intention to test, and about HIV risk behaviour, socioeconomic indicators, access to information, and attitudes related to stigma. Results Across the ten countries, seven out of every ten people said they planned to have an HIV test but the actual proportion tested in the last 12 months varied from 24% in Mozambique to 64% in Botswana. Generally, people at higher risk of HIV were not more likely to have been tested in the last year than those at lower risk, although women were more likely than men to have been tested in six of the ten countries. In Swaziland, those who experienced partner violence were more likely to test, but in Botswana those who were choice-disabled for condom use were less likely to be tested. The two most consistent factors associated with HIV testing across the countries were having heard about HIV/AIDS from a clinic or health centre, and having talked to someone about HIV and AIDS. Conclusions HIV testing programmes need to encourage people at higher risk of HIV to get tested, particularly those who do not interact regularly with the health system. Service providers need to recognise that some people are not able to implement HIV preventive actions and may not feel empowered to get themselves

  17. Impact of comorbidities and drug therapy on development of renal impairment in a predominantly African American and Hispanic HIV clinic population

    OpenAIRE

    Rawlings, M Keith; Klein, Jennifer; Klingler, Edna P Toubes; Queen, Ejeanée; Rogers, Lauren; Yau, Linda H; Pappa, Keith A; Gary E. Pakes

    2011-01-01

    Purpose Renal impairment in human immunodeficiency virus (HIV)-infected patients could potentially be caused by many factors. HIV-related renal impairment risks have been little studied in African Americans and Hispanics. We investigated the impact of HIV itself, highly active antiretroviral therapy (HAART), comorbidities, and non-HIV-related drug treatment on glomerular filtration rate in a predominantly African American/Hispanic HIV-infected population who had received HAART for at least on...

  18. Nutritional status and HIV in rural South African children

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    Klipstein-Grobusch Kerstin

    2011-03-01

    Full Text Available Abstract Background Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status. Methods The study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritonal status. Results Prevalence of malnutrition, particularly stunting (18%, was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97. HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence. Conclusions This study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival.

  19. African American Gay Family Networks: An Entry Point for HIV Prevention.

    Science.gov (United States)

    Horne, Sharon G; Levitt, Heidi M; Sweeney, Kristin Kay; Puckett, Julia A; Hampton, Martavius L

    2015-01-01

    Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered. PMID:24992185

  20. Association of pol diversity with antiretroviral treatment outcomes among HIV-infected African children.

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    Iris Chen

    Full Text Available In HIV-infected children, viral diversity tends to increase with age in the absence of antiretroviral treatment (ART. We measured HIV diversity in African children (ages 6-36 months enrolled in a randomized clinical trial comparing two ART regimens (Cohort I of the P1060 trial. Children in this cohort were exposed to single dose nevirapine (sdNVP at birth.HIV diversity was measured retrospectively using a high resolution melting (HRM diversity assay. Samples were obtained from 139 children at the enrollment visit prior to ART initiation. Six regions of the HIV genome were analyzed: two in gag, one in pol, and three in env. A single numeric HRM score that reflects HIV diversity was generated for each region; composite HRM scores were also calculated (mean and median for all six regions.In multivariable median regression models using backwards selection that started with demographic and clinical variables, older age was associated with higher HRM scores (higher HIV diversity in pol (P = 0.005 and with higher mean (P = 0.014 and median (P<0.001 HRM scores. In multivariable models adjusted for age, pre-treatment HIV viral load, pre-treatment CD4%, and randomized treatment regimen, higher HRM scores in pol were associated with shorter time to virologic suppression (P = 0.016 and longer time to study endpoints (virologic failure [VF], VF/death, and VF/off study treatment; P<0.001 for all measures.In this cohort of sdNVP-exposed, ART-naïve African children, higher levels of HIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes.

  1. HLA disease association and protection in HIV infection among African Americans and Caucasians.

    Science.gov (United States)

    Cruse, J M; Brackin, M N; Lewis, R E; Meeks, W; Nolan, R; Brackin, B

    1991-01-01

    In a previous investigation, we demonstrated an increased progression of overt AIDS in the African American population compared to the Caucasian population as reflected by the significantly lower absolute number of CD4+ lymphocytes detected in the African American population in an earlier study. The present study elucidates some of the possible genetic factors which may contribute to disease association or protection against HIV infection. The HLA phenotypes expressed as A, B, C, DR and DQw antigens were revealed by the Amos-modified typing procedure. NIH scoring was utilized to designate positive cells taking up trypan blue. A test of proportion equivalent to the chi 2 approximation was used to compare the disease population (n = 62; 38 African Americans, 24 Caucasians) to race-matched normal heterosexual local controls (323 African Americans, 412 Caucasians). Significant p values were corrected for the number of HLA antigens tested. HLA markers associated with possible protection from infection for African Americans were Cw4 and DRw6, whereas Caucasians expressed none. Disease association markers present in the African American population were A31, B35, Cw6, Cw7, DR5, DR6, DRw11, DRw12, DQw6 and DQw7, whereas in the Caucasian population A28, Aw66, Aw48, Bw65, Bw70, Cw7, DRw10, DRw12, DQw6 and DQw7 were demonstrated. The highest phenotypic frequency for a disease association marker in the study was for HLA-DR5 (62.9%) in the HIV-infected African American population without Kaposi's sarcoma compared to a frequency of 28.9% for the regional control group (p = 0.0012). We conclude that genetic factors do have a role in HIV infection since only 50-60% of those exposed to the AIDS virus will become infected. PMID:1910527

  2. Sexuality, Sexual Practices, and HIV Risk among Incarcerated African-American Women in North Carolina

    Science.gov (United States)

    Farel, Claire E.; Parker, Sharon D.; Muessig, Kathryn E.; Grodensky, Catherine A.; Jones, Chaunetta; Golin, Carol E.; Fogel, Catherine I.; Wohl, David A.

    2013-01-01

    Background Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. Methods We conducted digitally recorded qualitative interviews with 29 AA women (15 HIV-positive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. Results Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. Conclusions Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration. PMID:24183410

  3. AIDS in Black and White: The Influence of Newspaper Coverage of HIV/AIDS on HIV/AIDS Testing Among African Americans and White Americans, 1993–2007

    Science.gov (United States)

    STEVENS, ROBIN; HORNIK, ROBERT C.

    2014-01-01

    This study examined the impact of newspaper coverage of HIV/AIDS on HIV testing behavior in the US population. HIV testing data were taken from the CDC’s National Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2007 (n=265,557). News stories from 24 daily newspapers and one wire service during the same time period were content analyzed. Distributed lagged regression models were employed to estimate how well HIV/AIDS newspaper coverage predicted later HIV testing behavior. Increases in HIV/AIDS newspaper coverage were associated with declines in population level HIV testing. Each additional 100 HIV/AIDS related newspaper stories published each month was associated with a 1.7% decline in HIV testing levels in the subsequent month. This effect differed by race, with African Americans exhibiting greater declines in HIV testing subsequent to increased news coverage than did Whites. These results suggest that mainstream newspaper coverage of HIV/AIDS may have a particularly deleterious effect on African Americans, one of the groups most impacted by the disease. The mechanisms driving the negative effect deserve further investigation to improve reporting on HIV/AIDS in the media. PMID:24597895

  4. Contraceptive Use and Uptake of HIV-Testing among Sub-Saharan African Women.

    Directory of Open Access Journals (Sweden)

    Katherine E Center

    Full Text Available Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA. Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom or traditional (e.g., periodic abstinence, withdrawal forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment

  5. Factors influencing retention in care after starting antiretroviral therapy in a rural South African programme.

    Directory of Open Access Journals (Sweden)

    Tom H Boyles

    Full Text Available INTRODUCTION: The prognosis of patients with HIV in Africa has improved with the widespread use of antiretroviral therapy (ART but these successes are threatened by low rates of long-term retention in care. There are limited data on predictors of retention in care, particularly from rural sites. METHODS: Prospective cohort analysis of outcome measures in adults from a rural HIV care programme in Madwaleni, Eastern Cape, South Africa. The ART programme operates from Madwaleni hospital and seven primary care feeder clinics with full integration between inpatient and outpatient services. Outreach workers conducted home visits for defaulters. RESULTS: 1803 adults initiated ART from June 2005 to May 2009. At the end of the study period 82.4% were in active care or had transferred elsewhere, 11.1% had died and 6.5% were lost to follow-up (LTFU. Independent predictors associated with an increased risk of LTFU were CD4 nadir >200, initiating ART as an inpatient or while pregnant, and younger age, while being in care for >6 months before initiating ART was associated with a reduced risk. Independent factors associated with an increased risk of mortality were baseline CD4 count 6 months before initiating ART and initiating ART while pregnant were associated with a reduced risk. CONCLUSIONS: Serving a socioeconomically deprived rural population is not a barrier to successful ART delivery. Patients initiating ART while pregnant and inpatients may require additional counselling and support to reduce LTFU. Providing HIV care for patients not yet eligible for ART may be protective against being LTFU and dying after ART initiation.

  6. Analysis of quality assurance programmes for HIV screening in blood transfusion centres in Delhi.

    OpenAIRE

    Dhingra-Kumar, N.; Sharma, A.K.; N Madan

    1997-01-01

    The safety of blood transfusion has attained tremendous importance because of the problems posed by acquired immunodeficiency syndrome (AIDS) and other transfusion-transmissible diseases. While performing screening tests for human immunodeficiency virus (HIV) antibodies in donated blood is indispensable, it is also essential to introduce an effective quality assurance programme covering inspection of specimens, review of record-keeping, maintenance of equipment, and verification of results. W...

  7. Infected Lives: Lived Experiences of Young African American HIV-Positive Women.

    Science.gov (United States)

    Peltzer, Jill N; Domian, Elaine W; Teel, Cynthia S

    2016-02-01

    This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes--Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal--emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma. PMID:25239137

  8. South African Politics, Inequalities, and HIV/AIDS

    OpenAIRE

    Margaret Cunha

    2007-01-01

    The bulk of the response to the HIV/AIDS crisis in South Africa has been in the form of interventions that address risk behaviors, but not the context in which such behaviors occur. Literature reviews have identified poverty, mobility, and gender inequality as the three major social determinants shaping the AIDS epidemic in developing nations and, specifically, in South Africa. This article first aims to describe how HIV/AIDS risk behavior is linked to social determinants and how social and p...

  9. A CLUSTER ANALYSIS OF DRUG USE AND SEXUAL HIV RISKS AND THEIR CORRELATES IN A SAMPLE OF AFRICAN-AMERICAN CRACK COCAINE SMOKERS WITH HIV INFECTION

    OpenAIRE

    Schönnesson, Lena Nilsson; Atkinson, John; Williams, Mark L.; Bowen, Anne; Michael W. Ross; Timpson, Sandra C.

    2008-01-01

    The purpose of this cross-sectional study was to classify a sample of HIV seropositive African American crack cocaine smokers into homogenous HIV drug use and sexual risk groups using a two step multivariate cluster analysis. Two hundred and fifty eight crack cocaine smokers participated in the study. Cluster analysis revealed three distinct HIV risk groups. The highest risk group, the largest one, was characterized by frequent, daily crack use, multiple sex partners, trading sex, and inconsi...

  10. HIV and gender-based violence: welcome policies and programmes, but is the research keeping up?

    Science.gov (United States)

    Gruskin, Sofia; Safreed-Harmon, Kelly; Moore, Chelsea L; Steiner, Riley J; Dworkin, Shari L

    2014-11-01

    The global HIV policy arena has seen a surge of interest in gender-related dimensions of vulnerability to HIV and violence. UNAIDS and other prominent actors have named gender-based violence a key priority, and there seems to be genuine understanding and commitment to addressing gender inequalities as they impact key populations in the AIDS response. In the quest for evidence-informed interventions, there is usually a strong connection between the research conducted and the policies and programmes that follow. Regarding gender, HIV and violence, is this the case? This discussion paper asks whether the relevant peer-reviewed literature is suitably representative of all affected populations--including heterosexual men, transgender men and women, women who have sex with women, and men who have sex with men--as well as whether the literature sufficiently considers gender norms and dynamics in how research is framed. Conclusions about violence in the context of heterosexual relationships, and with specific attention to heterosexual women, should not be presented as insights about gender-based violence more generally, with little attention to gender dynamics. Research framed by a more comprehensive understanding of what is meant by gender-based violence as it relates to all of the diverse populations affected by HIV would potentially guide policies and programmes more effectively. PMID:25555774

  11. Promoting HIV Vaccine Research in African American Communities: Does the Theory of Reasoned Action Explain Potential Outcomes of Involvement?

    OpenAIRE

    Frew, Paula M; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J.

    2007-01-01

    The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms. The Theory of Reasoned Action (TRA) may be a useful framework for exploration o...

  12. Perspectives on Efforts to Address HIV/AIDS of Religious Clergy Serving African American and Hispanic Communities in Utah

    OpenAIRE

    Alder, Stephen C.; Simonsen, Sara Ellis; Duncan, Megan; Shaver, John; DeWitt, Jan; Crookston, Benjamin

    2007-01-01

    Introduction The HIV/AIDS epidemic in America is rapidly progressing in certain subpopulations, including African-American and Hispanic communities. Churches may provide a means for reaching high-risk minority populations with effective HIV/AIDS prevention. We report on a series of focus group interviews conducted with Utah clergy who primarily serve African American and Hispanic congregations. Methods A total of three focus groups (two with Catholic clergy serving Hispanic congregations and ...

  13. 'It's my inner strength': spirituality, religion and HIV in the lives of young African American men who have sex with men.

    Science.gov (United States)

    Foster, Michael L; Arnold, Emily; Rebchook, Gregory; Kegeles, Susan M

    2011-10-01

    Young black men who have sex with men account for 48% of 13-29-year-old HIV-positive men who have sex with men in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men's lives. Towards this goal, we conducted 31 interviews with 18-30-year-old men who have sex with men in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in men who have sex with men's lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions, (2) the continued importance of spirituality among men who have sex with men, (3) homophobia and stigmatisation in traditional black churches, (4) tension between being a man who has sex with men and being a Christian, (5) religion and spirituality's impact on men's sense of personal empowerment and coping abilities and (6) treatment of others and building compassion. Findings suggest that integrating spiritual practice into HIV prevention may help programmes be more culturally grounded, thereby attracting more men and resonating with their experiences and values. In addition, faith-based HIV/AIDS ministries that support HIV-positive men who have sex with men may be particularly helpful. Finally, targeting pastors and other church leaders through anti-stigma curricula is crucial. PMID:21824017

  14. HIV/AIDS in the workplace and the impact on firm efficiency and firm competitiveness: The South African manufacturing industry as a case study

    Directory of Open Access Journals (Sweden)

    Gerhardus van Zyl

    2009-04-01

    Full Text Available The aim of the article was to determine the extent of the negative impact of HIV/AIDS in the workplace on firm efficiency and firm competitiveness. The South African manufacturing sector was used as a case study. The above-mentioned research was deemed necessary, as very limited research has been published specifically on the technical measuring of the extent of the impact of HIV/AIDS on firm efficiency and firm competitiveness in South Africa. A survey questionnaire was designed for use in the research in order to capture the extent of the impact of HIV/AIDS on all levels of firm efficiency and firm competitiveness. A detailed statistical analysis of the results of the survey questionnaire and the parameter estimates of impact log-linear econometric power functions indicated that the negative impact of HIV/AIDS on firm efficiency and firm competitiveness was becoming more prevalent and serious, as it is underpinned by the statistical significance of the results and the high elasticity coefficients of the estimated log-linear power functions. It is recommended that human resource managers implement and manage HIV/AIDS programmes more effectively in order to counter the extent of the negative impact on firm efficiency and firm competitiveness.

  15. Access to employment among African migrant women living with HIV in France: opportunities and constraints.

    Science.gov (United States)

    Gerbier-Aublanc, Marjorie; Gosselin, Anne

    2016-08-01

    HIV in France particularly affects sub-Saharan migrants as they accounted for 31% of the new diagnoses in 2013. The objective of this study is to investigate the access to and the experience of employment among migrant women living with HIV in France. We use a mixed-method approach. The quantitative data come from the ANRS Parcours study, a life-event survey conducted in 2012-2013 in 70 health centres which collected year-by-year detailed information on living conditions about 755 sub-Saharan women migrants in the greater Paris region (470 with HIV and 285 without HIV). The qualitative data have been collected independently in the same region through socio-ethnographic observations and interviews conducted in 8 HIV-positive migrant organisations and among 35 women-members from 2011 to 2013. Two main results are noteworthy. First, being HIV-positive unexpectedly gives sub-Saharan migrant women a quicker access to employment thanks to the social support they find in migrant organisations: in the third year in France in median (versus 5th year among HIV-negative group). This effect of being HIV-positive on the access to employment remains all things being equal in a discrete-time logistic regression (aOR [95% CI] HIV+: 1.4[1.1;1.8]). Second, their employment situation remains strongly shaped by the racial division of work existing in France and they develop individual strategies to negotiate this constraint: for example, temporary jobs and working as health mediators. The type of jobs they find, mainly in the care sector, force them to carefully hide their HIV status because they fear discrimination at work. Not only migrant women endure structural discrimination in a segmented labour market, but they also anticipate HIV-related discrimination related to caring activities. Thus, the design and implementation of programmes that address stigma should consider structural discrimination to improve PLWHA's working experiences. PMID:27098378

  16. Cost Effective Ways of Implementing Nuclear Power Programme in African Countries

    International Nuclear Information System (INIS)

    still growing fast and hence are characterized by a foreseeable increase in electricity demand to drive the factors of production. 1.3 Objective of this Paper The purpose of this paper is to explore the efficient means of building nuclear power plants and associated infra structure in African countries. The concept adopted in this paper to achieve efficient allocation of resources is sharing of infrastructural items. The paper lists examples of sharing arrangement on the African continent for other purposes other than nuclear power programme. This is an attempt to justify the workability of the concept for nuclear power programme. Mention has also been made of similar sharing arrangement in other countries for the purpose of nuclear power programme. The factors that will enhance the success of sharing concept in African countries have also been highlighted

  17. Prediction of HIV Sexual Risk Behaviors Among Disadvantaged African American Adults Using a Syndemic Conceptual Framework.

    Science.gov (United States)

    Nehl, Eric J; Klein, Hugh; Sterk, Claire E; Elifson, Kirk W

    2016-02-01

    The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographic, and psychological functioning factors help explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems. PMID:26188618

  18. Association of pol Diversity with Antiretroviral Treatment Outcomes among HIV-Infected African Children

    Science.gov (United States)

    Chen, Iris; Khaki, Leila; Lindsey, Jane C.; Fry, Carrie; Cousins, Matthew M.; Siliciano, Robert F.; Violari, Avy; Palumbo, Paul; Eshleman, Susan H.

    2013-01-01

    Background In HIV-infected children, viral diversity tends to increase with age in the absence of antiretroviral treatment (ART). We measured HIV diversity in African children (ages 6–36 months) enrolled in a randomized clinical trial comparing two ART regimens (Cohort I of the P1060 trial). Children in this cohort were exposed to single dose nevirapine (sdNVP) at birth. Methods HIV diversity was measured retrospectively using a high resolution melting (HRM) diversity assay. Samples were obtained from 139 children at the enrollment visit prior to ART initiation. Six regions of the HIV genome were analyzed: two in gag, one in pol, and three in env. A single numeric HRM score that reflects HIV diversity was generated for each region; composite HRM scores were also calculated (mean and median for all six regions). Results In multivariable median regression models using backwards selection that started with demographic and clinical variables, older age was associated with higher HRM scores (higher HIV diversity) in pol (P = 0.005) and with higher mean (P = 0.014) and median (PHIV viral load, pre-treatment CD4%, and randomized treatment regimen, higher HRM scores in pol were associated with shorter time to virologic suppression (P = 0.016) and longer time to study endpoints (virologic failure [VF], VF/death, and VF/off study treatment; PHIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes. PMID:24312277

  19. Sexual Risk Behavior among African American College Women: Understanding Socio-Cultural Factors in the Context of HIV/AIDS

    Science.gov (United States)

    Gibbons, Maya A.

    2010-01-01

    African American women are at the center of the discussion on health disparities, specifically disparities regarding HIV/AIDS and Sexually Transmitted Infections (STIs). Though there has been substantial research examining sexual risk behavior among low income African American women, little has been done to understand sexual behavior…

  20. An HIV/AIDS intervention programme with Buddhist aid in Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    WU Feng; ZHANG Kong-lai; SHAN Guang-liang

    2010-01-01

    Background The prevalence of HIV/AIDS in Chinese ethnic minorities is an important component of China's AIDS issues. In this study, we launched an intervention programme in Yunnan Province of China, where the Dai people live, to carry out the community-based HIV/AIDS health education and behavioral interventions on ordinary Dai farmers. The Dai people believe in Theravada Buddhism.Methods Four rural communities were randomly divided into two groups. In one group (Buddhist group), HIV/AIDS health education and behavioral intervention were carried out by monks. The other group (women group) was instructed by women volunteers. The intervention continued for one year and the data were collected before and after the intervention project.Results In the Buddhist group, the villagers' AIDS related knowledge score was boosted from 3.11 to 3.65 (P<0.001),and some indices of the villagers' behavior using condoms improved after the intervention. But this improvement was poorer than that in the women group. In the Buddhist group, the villager's attitude score towards the people living with HIV and AIDS (PLWHA) also increased significantly from 1.51 to 2.16 (P<0.001).Conclusion The results suggested that the Buddhist organization has limited success in promoting the use of condoms,but plays an important role in eliminating HIV/AIDS related discrimination.

  1. Perceptions of Sexual Risks and Injection for HIV among African American Women Who Use Crack Cocaine in Nashville, Tennessee

    Science.gov (United States)

    MacMaster, Samuel A.; Rasch, Randolph F. R.; Kinzly, Mark L.; Cooper, R. Lyle; Adams, Susan M.

    2009-01-01

    Significant health disparities in the rates of HIV infection primarily affect African American women. Although research has demonstrated that for some individuals HIV is connected to preventable high-risk behaviors related to substance use, a further examination of how these risks are perceived by the individuals involved in these activities is…

  2. "I Don't Know Who to Blame": HIV-Positive South African Women Navigating Heterosexual Infection

    Science.gov (United States)

    Long, Carol

    2009-01-01

    Women who become HIV infected through heterosexual transmission are faced with the task of making sense of how they became infected. This paper presents a qualitative analysis based on interviews with 35 HIV-positive South African Black women. A specific theme, that blame of a male partner was avoided or disavowed in interviews, is explored in…

  3. Transportation-related barriers to care among African American women living with HIV/AIDS: “What you getting out of the cab for?”

    OpenAIRE

    Evans, Shenell D.; Williams, Bryman E.

    2013-01-01

    Transportation-related problems have been consistently reported as barriers to accessing and remaining in HIV medical care, particularly among African American women living in under-resourced areas. With emphasis on the Southern region of the United States, this commentary presents a brief overview of the HIV/AIDS epidemic among African Americans, barriers to remaining in HIV care, and pilot data from a study conducted among African American women living in Mississippi. A small focus group st...

  4. Service Quality and Students' Satisfaction with the Professional Teacher Development Programmes by Distance Mode in a South African University

    Science.gov (United States)

    Oduaran, A. B.

    2011-01-01

    This article reports on the relationship between seven factors that described dimensions of education service quality and overall service quality on one hand, and students' satisfaction with the professional teacher development programmes by distance mode in a South African University on the other. We sought to find out whether students enrolled…

  5. The Factor Structure of The HIV Antibody Testing Attitude Scale in Four African Countries

    OpenAIRE

    K. Peltzer; Mpofu, E

    2013-01-01

    Objective: To determine the facture structure of the HIVAntibody Testing Attitude Scale (HTAS) in an Africanpopulation.Method: 760 first-year African university students fromNigeria, South Africa, Uganda and Zimbabwe weresurveyed using the HIV Antibody Testing Attitude Scale.Factor structure was determined by using the principalcomponent analysis with varimax rotation.Results: Five components accounting for 51% of thetotal variance were identified. The first factor(eigenvalue: 5.11) accounted...

  6. Mycobacterium sherrisii visceral disseminated infection in an African HIV-infected adolescent

    Directory of Open Access Journals (Sweden)

    Francesco Santoro

    2016-04-01

    Full Text Available A case of visceral disseminated infection by Mycobacterium sherrisii in an African HIV-infected adolescent with multiple abdominal abscesses is reported. Despite multiple drug resistance to first-line antibiotics in vitro, long-term treatment with clarithromycin, moxifloxacin, and clindamycin, together with appropriate antiretroviral treatment, resulted in clinical and radiological cure after 19 months of therapy and follow-up.

  7. Relational Factors and Family Treatment Engagement among Low-Income, HIV-Positive African American Mothers

    OpenAIRE

    Mitrani, Victoria B.; Prado, Guillermo; Feaster, Daniel J.; Robinson-Batista, Carleen; Szapocznik, Josê

    2003-01-01

    Clinically derived hypotheses regarding treatment engagement of families of low-income, HIV-positive, African American mothers are tested using univariate and multivariate logistic regression models. Predictors are baseline family relational factors (family support, mother’s desire for involvement with family, and family hassles) and mother’s history of substance dependence. The study examines a subsample of 49 mothers enrolled in a clinical trial testing the efficacy of Structural Ecosystems...

  8. Applying Social Psychological Models to Predicting HIV-Related Sexual Risk Behaviors Among African Americans

    OpenAIRE

    Cochran, Susan D.; MAYS, VICKIE M.

    1993-01-01

    Existing models of attitude-behavior relationships, including the Health Belief Model, the Theory of Reasoned Action, and the Self-Efficacy Theory, are increasingly being used by psychologists to predict human immunodeficiency virus (HIV)-related risk behaviors. The authors briefly highlight some of the difficulties that might arise in applying these models to predicting the risk behaviors of African Americans. These social psychological models tend to emphasize the importance of individualis...

  9. Observational cohort study of HIV-infected African children.

    NARCIS (Netherlands)

    Laufer, M.K.; Oosterhout, J.J. van; Perez, M.A.; Kanyanganlika, J.; Taylor, T.E.; Plowe, C.V.; Graham, S.M.

    2006-01-01

    BACKGROUND: Most information about children living with HIV is based on follow up from children identified through mother-to-child transmission studies. Children identified through voluntary counseling and testing (VCT) represent a unique cohort that has not been previously described in the literatu

  10. South African HIV/AIDS programming overlooks migration, urban livelihoods, and informal workplaces.

    Science.gov (United States)

    Vearey, Jo; Richter, Marlise; Núñez, Lorena; Moyo, Khangelani

    2011-01-01

    South Africa has the largest population of people living with HIV globally and is associated with high population mobility. The majority of migrants move in search of improved livelihood opportunities, and many who migrate (both internally and across borders) move into urban areas, often through peripheral informal settlements where HIV prevalence is shown to be double that of urban formal areas. While the relationship between migration and the spread of HIV is acknowledged as complex, the context of migration may place individuals at increased risk for acquiring HIV. Studies have demonstrated the long-wave impact of HIV and AIDS on livelihood activities and, more recently, on patterns of migration. Many migrants engage in livelihood strategies situated within the urban 'informal economy'; these informal workplaces are often overlooked in global and national legislation governing workplace responses to health and HIV and AIDS. This study draws on existing research and limited primary data to explore the implications of HIV/AIDS programming for diverse migrant groups labouring in informal workplaces in Johannesburg, South Africa. We describe three case studies: waste-pickers at a dumpsite in a peripheral urban informal settlement; barmen and cleaners working in inner-city hotels where sex is also sold; and, migrants engaged in informal livelihood activities who are also members of burial societies. Given the importance of varied informal livelihood activities for diverse migrant groups, particularly in urban areas of South Africa, we propose that the national HIV/AIDS response can and should engage with internal and cross-border migrants in informal workplaces - which is in line with the principle of universal access and will strengthen the national response. Especially, we point out the potential for burial societies to provide an entry point for HIV/AIDS programming that targets migrant groups involved in the informal economy of South African cities. PMID:25865514

  11. An Extended Model of Reasoned Action to Understand the Influence of Individual- and Network-Level Factors on African Americans’ Participation in HIV Vaccine Research

    OpenAIRE

    Frew, Paula M.; Archibald, Matthew; Diallo, Dazon Dixon; Hou, Su-I; Horton, Takeia; Chan, Kayshin; Mulligan, Mark J.; Del Rio, Carlos

    2010-01-01

    In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS...

  12. Lived experiences of HIV community workers participating in a community empowerment programme

    Directory of Open Access Journals (Sweden)

    Juliana Horn

    2014-02-01

    Full Text Available Background: Both non-governmental organisations and governmental organisations are very involved in the development and implementation of community empowerment programmes (CEPs. Because of various health issues within the community, 10 CEPs were launched in Ladysmith with a focus on addressing the particular needs of HIV-affected and -infected members. Of the 10 programmes, however, only four were deemed sustainable after five years.Objectives: The researcher explored the lived experiences of HIV community workers participating in two CEPs in Ladysmith, KwaZulu-Natal in order to develop recommendations for CEPs.Method: Data were explored using a qualitative hermeneutic phenomenological approach. Ten participants who had been involved in HIV CEPs for more than six months were identified and individual interviews were held.Results: Three themes emerged, namely, giving of yourself, maintaining sustainability and assisting the CEPs and community workers. Each of these themes also contained a number of subthemes. Exploring the lived experience of the community workers revealed that there are a number of ways in which to promote the sustainability of CEPs.Conclusion: The community should be involved in all aspects of the CEP and community workers must respect the community and their knowledge, experience and value systems.

  13. Does perceived HIV stigma contribute to nurses' intent to migrate in five African countries?

    Science.gov (United States)

    Kohi, Thecla W; Portillo, Carmen J; Durrheim, Kevin; Dlamini, Priscilla S; Makoae, Lucy N; Greeff, Minrie; Chirwa, Maureen; Naidoo, Joanne; Uys, Leana R; Holzemer, William L

    2010-01-01

    Nurse migration out of low-resource countries has occurred for many years, resulting in workforce shortages, particularly in countries with a high prevalence of HIV. A cross-sectional survey of 1,374 nurses from five African countries (Lesotho, Malawi, South Africa, Swaziland, and Tanzania) was conducted. A logistic regression analysis resulted in a profile of odds ratios predicting increased odds of intent to migrate for nurses who were more experienced and working in urban hospitals. These data provide the first support that HIV stigma experienced by nurses through their association as providers for people living with HIV may also be contributing to their intent to migrate. The study contributes to a greater understanding of the complexity of nurse migration in Africa. PMID:20116298

  14. nef gene sequence variation among HIV-1-infected African children

    Czech Academy of Sciences Publication Activity Database

    Chakraborty, R.; Reiniš, Milan; Rostron, T.; Philpott, S.; Dong, T.; D'Agostino, A.; Musoke, R.; de Silva, E.; Stumpf, M.; Weiser, B.; Burger, H.; Rowland-Jones, S.L.

    2006-01-01

    Roč. 7, č. 2 (2006), s. 75-84. ISSN 1464-2662 Grant ostatní: Fogarty International Center, NIH(US) 3D43TW00915; NIH(US) RO1 AI 42555 Institutional research plan: CEZ:AV0Z50520514 Keywords : HIV-1 nef gene * non-clade B * Kenya Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.674, year: 2006

  15. The impact of social environments on the effectiveness of youth HIV prevention: a South African case study

    OpenAIRE

    Campbell, Cathy; Foulis, C.; Maimane, S.; Sibiya, Z.

    2005-01-01

    Few would disagree that ‘social context’ shapes the effectiveness of HIV-prevention programmes. However much work remains to be done in developing systematic conceptualisations of HIV/AIDS-relevant aspects of social environments in vulnerable communities. This paper contributes to this challenge through a case study (44 interviews, 11 focus groups with 55 people and fieldworker diaries) of the impact of social context on a participatory peer education programme involving young people in a per...

  16. The role of South African traditional health practitioners in the treatment of HIV/AIDS; A study of their practices and use of herbal medicines

    Directory of Open Access Journals (Sweden)

    David R Walwyn

    2010-11-01

    Full Text Available Background A large proportion of HIV positive South Africans regularly consult Traditional Health Practitioners (THPs for their healthcare needs, despite some evidence of negative interactions with antiretrovirals (ARVs and no published peer-reviewed clinical evidence for the efficacy of traditional medicines in the treatment of HIV. In this study, we investigated the dominant practices of THPs towards HIV positive patients and whether these practices have changed following widespread public awareness campaigns covering HIV and its treatment. Method The study used a semi-structured interviewer-administered questionnaire in the home language of the interviewee. A total of 52 THPs from four provinces (Gauteng, Limpopo, Kwazulu Natal and Eastern Cape were interviewed. 38% of the respondents were based in the rural areas, and 69% classified themselves as inyangas, with the remainder being sangomas. Findings All of the THPs in the survey offered treatment for HIV, although only 20% claimed to be able to cure the disease. 88% prepared their own medication, mostly from plant material, and sold their products as aqueous extracts in labelled bottles. None of these products had been systematically evaluated, and there was mostly no record keeping, either of the patient, or of the medicine itself. Quality control practices such as expiry dates, controlled storage conditions and batch records were totally unknown in our sample. Only 38% of the THPs had received training on HIV/AIDS although 75% believed that they were well informed about the disease. Our own assessment was that only 50% had a working knowledge of HIV; more disturbingly 37% believe that only traditional medicines should be used for the treatment of HIV and a further 50% believe that both traditional medicines and ARVs can be taken simultaneously. Interpretation Despite ongoing public educational campaigns on HIV, some of which have specifically targeted THPs, the care of HIV positive

  17. Taking it one day at a time: African American women aging with HIV and co-morbidities.

    Science.gov (United States)

    Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

    2014-07-01

    Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies. PMID:24933093

  18. ACCESS TO TREATMENT IN HIV PREVENTION TRIALS: PERSPECTIVES FROM A SOUTH AFRICAN COMMUNITY

    OpenAIRE

    BARSDORF, NICOLA; Maman, Suzanne; Kass, Nancy; Slack, Catherine

    2009-01-01

    Access to treatment, in HIV vaccine trials (HVTs), remains ethically controversial. In most prevention trials, including in South Africa, participants who seroconvert are referred to publicly funded programmes for treatment. This strategy is problematic when there is inadequate and uneven access to public sector antiretroviral therapy (ART) and support resources. The responsibilities, if any, of researchers, sponsors and public health authorities involved in HVTs has been hotly debated among ...

  19. Suicidal ideation among attendees of a West African HIV clinic.

    Science.gov (United States)

    Ogundipe, Olasimbo A; Olagunju, Andrew T; Adeyemi, Joseph D

    2015-01-01

    The paucity of information on suicide and its related issues among people living with HIV/AIDS (PLWHA) can impair evidence guided intervention. This study was set to determine the prevalence of suicidal ideation and the associated risk factors among PLWHA. A total of 295 participants made up of HIV positive individuals were subjected to a sociodemographic/clinical profile questionnaire. This was followed by the 28-item General Health Questionnaire (GHQ-28), suicidal intention item from the Beck Depression Inventory (BDI) and World Health Organisation Quality of Life (WHOQOL)--Bref scale to assess emotional distress, suicidal ideation, and quality of life respectively. The prevalence of suicidal ideation among PLWHA was 13.6%; and being unmarried, poor medication adherence, and poorer quality of life were significantly associated (p unemployment (odds ratio [OR] = 0.200; 95% Confidence Interval [CI] = 0.084-0.476; P emotional distress (OR = 5.734; 95% CI = 2.119-15.519; P--0.001), religion (OR = 4.829; 95% CI = 1.639-14.231; P--0.004), HIV status non-disclosure (OR = 2.630; 95% CI = 1.015-6.809; P--0.046) and previous suicidal attempt (OR = 0.172, 95% CI = 0.042-0.705; P--0.014) were not only associated but predictive of suicidal ideation in PLWHA. These findings indicate a significant burden of suicidal ideation, and psychosocial with clinical factors constitute identifiable risk factors among PLWHA. The development of evidence guided preventive and treatment measures against suicide among PLWHA are implied. PMID:25058473

  20. Who are the peer educators? HIV prevention in South African schools.

    Science.gov (United States)

    Mason-Jones, Amanda J; Flisher, Alan J; Mathews, Catherine

    2011-06-01

    Characteristics of learners who become peer educators are rarely explored despite the potential relevance to the success of peer education programmes. Fifteen high schools selected to implement peer education HIV prevention programmes in South Africa were recruited. A total of 2339 Grade 10 learners were surveyed and comparisons were made between socio-demographic characteristics, key skills, school experience and sexual behaviour of those students who had volunteered or been chosen by teachers to be peer educators (n = 295) and their fellow students (n = 2044), the potential recipients of the programme. On most of the socio-demographic variables, school experiences, aspirations, sexual debut and use of condoms at last sex or whether they had been tested for HIV status, there were no significant differences between the two groups. Volunteers and teacher-chosen peer educators tended to be younger than their classmates (16.19 versus 16.52, P electricity (97.9% versus 94.0%, P = 0.006), a bicycle (41.9% versus 32.7%, P = 0.004) or car (50.2% versus 41.0%, P = 0.005)]. Further research is needed to explore specific peer educator characteristics and recruitment and selection approaches that are associated with effective HIV prevention interventions. PMID:21081483

  1. Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Graeme Meintjes

    2015-04-01

    Full Text Available The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults. The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.

  2. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    OpenAIRE

    Lucie Dale Cluver; Frederick Mark Orkin; Franziska Meinck; Mark Edward Boyes; Lorraine Sherr

    2016-01-01

    Introduction: Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of ...

  3. HIV Stigma and Missed Medications in HIV-Positive People in Five African Countries

    OpenAIRE

    Greeff, Minrie; Dlamini, Priscilla S.; Wantland, Dean; Makoae, Lucy N.; Chirwa, Maureen; Kohi, Thecla W.; Naidoo, Joanne; Mullan, Joseph; Uys, Leana R; Holzemer, William L

    2009-01-01

    The availability of antiretroviral medications has transformed living with HIV infection into a manageable chronic illness, and high levels of adherence are necessary. Stigma has been identified as one reason for missing medication doses. The objective of this study was to explore the relationship between perceived HIV stigma and self-reported missed doses of antiretroviral medications in a 12-month, repeated measures cohort study conducted in Lesotho, Malawi, South Africa, Swaziland, and Tan...

  4. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    OpenAIRE

    Lucie Dale Cluver; Frederick Mark Orkin; Franziska Meinck; Mark Edward Boyes; Lorraine Sherr

    2016-01-01

    Background Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. But questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can ‘cash plus care’ social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV-risks, and then examining potential main and moderating effects of soci...

  5. HIV/AIDS messages as a spur for conversation among young South Africans?

    Science.gov (United States)

    Lubinga, Elizabeth; Schulze, Margrit; Jansen, Carel; Maes, Alfons

    2010-06-01

    HIV/AIDS messages are often deliberately puzzling so as to increase the chance for them to be used as food for conversation. The South African health organisation 'loveLife,' for instance, uses messages that include complicated rhetorical expressions in their media campaigns, reasoning that those who find the messages puzzling and wonder about their meaning will be inclined to discuss the messages with their peers. In order to test the assumption that puzzlement about health messages is related to keenness to talk about these messages, structured interviews were held with 30 black learners, ages 15 to 19, from Limpopo Province, South Africa, about the messages of six HIV/ AIDS posters and six HIV/AIDS radio advertisements from 'loveLife' or another South African health organisation. No support was found for the assumption that presenting a puzzling health message will contribute to engaging the recipients in discussion. The participants indicated that they were willing to discuss the themes addressed in either a poster or radio advertisement because they appreciated the message and felt that its content was relevant to them, rather than because the message was puzzling or difficult to understand. The participants' overall actual comprehension of the messages, however, proved to be strikingly low. PMID:25860526

  6. Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas

    DEFF Research Database (Denmark)

    Duda, Stephany N; Farr, Amanda M; Lindegren, Mary Lou;

    2014-01-01

    and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS: Staff from 128 sites in 41 countries...

  7. Modelling the impact and cost-effectiveness of the HIV intervention programme amongst commercial sex workers in Ahmedabad, Gujarat, India

    Directory of Open Access Journals (Sweden)

    Foss Anna M

    2007-08-01

    Full Text Available Abstract Background Ahmedabad is an industrial city in Gujarat, India. In 2003, the HIV prevalence among commercial sex workers (CSWs in Ahmedabad reached 13.0%. In response, the Jyoti Sangh HIV prevention programme for CSWs was initiated, which involves outreach, peer education, condom distribution, and free STD clinics. Two surveys were performed among CSWs in 1999 and 2003. This study estimates the cost-effectiveness of the Jyoti Sangh HIV prevention programme. Methods A dynamic mathematical model was used with survey and intervention-specific data from Ahmedabad to estimate the HIV impact of the Jyoti Sangh project for the 51 months between the two CSW surveys. Uncertainty analysis was used to obtain different model fits to the HIV/STI epidemiological data, producing a range for the HIV impact of the project. Financial and economic costs of the intervention were estimated from the provider's perspective for the same time period. The cost per HIV-infection averted was estimated. Results Over 51 months, projections suggest that the intervention averted 624 and 5,131 HIV cases among the CSWs and their clients, respectively. This equates to a 54% and 51% decrease in the HIV infections that would have occurred among the CSWs and clients without the intervention. In the absence of intervention, the model predicts that the HIV prevalence amongst the CSWs in 2003 would have been 26%, almost twice that with the intervention. Cost per HIV infection averted, excluding and including peer educator economic costs, was USD 59 and USD 98 respectively. Conclusion This study demonstrated that targeted CSW interventions in India can be cost-effective, and highlights the importance of replicating this effort in other similar settings.

  8. Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

    Science.gov (United States)

    Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

    2016-08-01

    We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions. PMID:26718361

  9. HIV stigma and missed medications in HIV-positive people in five African countries.

    Science.gov (United States)

    Dlamini, Priscilla S; Wantland, Dean; Makoae, Lucy N; Chirwa, Maureen; Kohi, Thecla W; Greeff, Minrie; Naidoo, Joanne; Mullan, Joseph; Uys, Leana R; Holzemer, William L

    2009-05-01

    The availability of antiretroviral medications has transformed living with HIV infection into a manageable chronic illness, and high levels of adherence are necessary. Stigma has been identified as one reason for missing medication doses. The objective of this study was to explore the relationship between perceived HIV stigma and self-reported missed doses of antiretroviral medications in a 12-month, repeated measures cohort study conducted in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Data were collected from 1457 HIV-positive individuals at three times between January 2006 and March 2007. Participants completed a series of questionnaires. Of the 1457 participants, 698 were taking ARVs during the study and are included in this analysis. There was a significant relationship between perceived HIV stigma and self-report of missed medications over time (t = 6.04, p HIV stigma. Individuals reporting fewer medication worries reported decreased stigma over the one year period (t = -4.79, p HIV stigma and self-reported reasons for missed medications over time. These findings suggest that part of the reason for poor adherence to ARV medications is linked to the stigma experienced by people living with HIV. PMID:19327098

  10. Inculcating safe sex attitudes in South African adolescents: a directive for the government's anti-HIV/AIDS policy.

    Science.gov (United States)

    D'Souza, Jayesh

    2010-01-01

    South Africa has one of the highest rates of HIV/AIDS in the world. Much blame for this has been laid on the apathy of the South African government and the cultural traits of South Africans. AIDS prevention research calls for early childhood education to raise awareness of the causes, dangers, and prevention of HIV/AIDS. This study involved surveys among a select sample of South African adolescents to determine their sexual attitudes before and after a cognitive-behavioral intervention. Overall, the results did not make a significant difference in their attitudes, suggesting pre-adolescent sex education might prove to be a more useful tool in anti-HIV/AIDS education. Risky sexual behavior, under the influence of alcohol, also serves as a warning to educate young consumers of alcohol. PMID:22192941

  11. "Out of All of this Mess, I Got a Blessing": Perceptions and Experiences of Reproduction and Motherhood in African American Women Living With HIV.

    Science.gov (United States)

    Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Richter, Donna L; Sowell, Richard

    2016-01-01

    HIV disproportionately impacts African American women of childbearing age residing in the southern United States. Antiretroviral therapy has increased the quantity and quality of life for people living with HIV and produced viable and safe reproduction possibilities for women living with HIV. However, little is known about reproductive decision-making processes for African American women living with HIV. The overall goal of our study was to qualitatively explore perspectives related to reproduction and motherhood in HIV-infected African American women of childbearing capacity. HIV-infected African American women of childbearing capacity in South Carolina (N = 42) participated in in-depth interviews. Our respondents held positive views about pregnancy and motherhood, despite nonsupportive pregnancy messages from interpersonal influences, including health care providers. Study findings uncovered the need for programs and interventions to support women's reproductive autonomy and focus on reducing conception- and pregnancy-related transmission risks to infants and uninfected sexual partners. PMID:26781931

  12. A sport management programme for educator training in accordance with the diverse needs of South African schools / Johannes Jacques Vosloo

    OpenAIRE

    Vosloo, Johannes Jacques

    2014-01-01

    In school sport the professionalisation of sport has reached the domain of school sport as a grassroots incubator for sporting talent and for providing positive experiences that might lead to lifelong engagement in physical activity. This has inevitably led to the development of specialised human resources required to manage school sport. In the South African context, despite the existence of a variety of sport management programmes, there is a need for continuously updated and adapted progra...

  13. A Qualitative Study of Barriers to the Utilization of HIV Testing Services Among Rural African American Cocaine Users

    Science.gov (United States)

    Wright, Patricia B.; Stewart, Katharine E.; Curran, Geoffrey M.; Booth, Brenda M.

    2013-01-01

    This qualitative study is about barriers to the utilization of HIV testing as perceived by African Americans who have recently used cocaine and who live in the rural Delta region of Arkansas. Affordability, physical accessibility, and geographic availability were not perceived as barriers to HIV testing in this sample, yet acceptability was still perceived as poor. Acceptability due to social mores and norms was a major barrier. Many said testing was unacceptable because of fear of social costs. Many were confident of being HIV-negative based on risky assumptions about testing and the notification process. Small-town social and sexual networks added to concerns about reputation and risk. System approaches may fail if they focus solely on improving access to HIV services but do not take into consideration deeply internalized experiences of rural African Americans as well as involvement of the community in developing programs and services. PMID:24039279

  14. Blood Group Antigens C, Lub and P1 May Have a Role in HIV Infection in Africans.

    Directory of Open Access Journals (Sweden)

    Modisa Sekhamo Motswaledi

    Full Text Available Botswana is among the world's countries with the highest rates of HIV infection. It is not known whether or not this susceptibility to infection is due to genetic factors in the population. Accumulating evidence, however, points to the role of erythrocytes as potential mediators of infection. We therefore sought to establish the role, if any, of some erythrocyte antigens in HIV infection in a cross-section of the population.348 (346 HIV-negative and 2 HIV-positive samples were obtained from the National Blood Transfusion Service as residual samples, while 194 HIV-positive samples were obtained from the Botswana-Harvard HIV Reference Laboratory. Samples were grouped for twenty three antigens. Chi-square or Fischer Exact analyses were used to compare the frequencies of the antigens in the two groups. A stepwise, binary logistic regression was used to study the interaction of the various antigens in the light of HIV-status.The Rh antigens C and E were associated with HIV-negative status, while blood group Jka, P1 and Lub were associated with HIV-positive status. A stepwise binary logistic regression analysis yielded group C as the most significant protective blood group while Lub and P1 were associated with significantly higher odds ratio in favor of HIV-infection. The lower-risk-associated group C was significantly lower in Africans compared to published data for Caucasians and might partially explain the difference in susceptibility to HIV-1.The most influential antigen C, which also appears to be protective, is significantly lower in Africans than published data for Caucasians or Asians. On the other hand, there appear to be multiple antigens associated with increased risk that may override the protective role of C. A study of the distribution of these antigens in other populations may shed light on their roles in the HIV pandemic.

  15. Reviewing gender and cultural factors associated with HIV/AIDS among university students in the South African context

    OpenAIRE

    A. van Staden; G Badenhorst

    2009-01-01

    South Africa is in the midst of a catastrophic AIDS epidemic. HIV prevalence statistics in most countries indicate that up to 60% of all new infections occur among 15 to 24 year olds, whilst this group also boasts the highest incidence of sexually transmitted infections (STIs). Statistical findings among South African students predict a 10% increase in the HIV infection rate, highlighting the inability of universities to cope with societies’ demands for academically trained workers which, in ...

  16. African HIV/AIDS trials are more likely to report adequate allocation concealment and random generation than North American trials.

    OpenAIRE

    Nandi Siegfried; Michael Clarke; Jimmy Volmink; Lize Van der Merwe

    2008-01-01

    BACKGROUND: Adherence to good methodological quality is necessary to minimise bias in randomised conrolled trials (RCTs). Specific trial characteristics are associated with better trial quality, but no studies to date are specific to HIV/AIDS or African trials. We postulated that location may negatively impact on trial quality in regions where resources are scarce. METHODS: 1) To compare the methodological quality of all HIV/AIDS RCTs conducted in Africa with a random sample of similar trials...

  17. `I count myself as being in a different world?: African gay and bisexual men living with HIV in London. An Exploratory study. AIDS IMPACT

    OpenAIRE

    Paparini, Sara; Doyal, L; Anderson, Jane

    2008-01-01

    Abstract The experiences of men from African backgrounds living with HIV who are gay/bisexual have so far been overlooked in the research on HIV in the UK. Little is known about the ways that HIV impacts on this population.. We report on an exploratory qualitative study with 8 gay/bisexual men from 7 different African countries living with HIV in London, based on in depth semi structured interviews and a thematic analysis. HIV testing and diagnosis, disclosure to others, social an...

  18. Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey.

    Science.gov (United States)

    Shisana, Olive; Risher, Kathryn; Celentano, David D; Zungu, Nompumelelo; Rehle, Thomas; Ngcaweni, Busani; Evans, Meredith G B

    2016-01-01

    South Africa has experienced declining marriage rates and the increasing practice of cohabitation without marriage. This study aims to improve the understanding of the relationship between marital status and HIV in South Africa, an HIV hyperendemic country, through an analysis of findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The nationally representative population-based cross-sectional survey collected data on HIV and socio-demographic and behavioural determinants in South Africa. This analysis considered respondents aged 16 years and older who consented to participate in the survey and provided dried blood spot specimens for HIV testing (N = 17,356). After controlling for age, race, having multiple sexual partners, condom use at last sex, urban/rural dwelling and level of household income, those who were married living with their spouse had significantly reduced odds of being HIV-positive compared to all other marital spouses groups. HIV incidence was 0.27% among respondents who were married living with their spouses; the highest HIV incidence was found in the cohabiting group (2.91%). Later marriage (after age 24) was associated with increased odds of HIV prevalence. Our analysis suggests an association between marital status and HIV prevalence and incidence in contemporary South Africa, where odds of being HIV-positive were found to be lower among married individuals who lived with their spouses compared to all other marital status groups. HIV prevention messages therefore need to be targeted to unmarried populations, especially cohabitating populations. As low socio-economic status, low social cohesion and the resulting destabilization of sexual relationships may explain the increased risk of HIV among unmarried populations, it is necessary to address structural issues including poverty that create an environment unfavourable to stable sexual relationships. PMID:26551532

  19. A cluster analysis of drug use and sexual HIV risks and their correlates in a sample of African-American crack cocaine smokers with HIV infection.

    Science.gov (United States)

    Schönnesson, Lena Nilsson; Atkinson, John; Williams, Mark L; Bowen, Anne; Ross, Michael W; Timpson, Sandra C

    2008-09-01

    The purpose of this cross-sectional study was to classify a sample of HIV-seropositive African-American crack cocaine smokers into homogenous HIV drug use and sexual risk groups using a two step multivariate cluster analysis. Two hundred and fifty-eight crack cocaine smokers participated in the study. Cluster analysis revealed three distinct HIV risk groups. The highest risk group, the largest one, was characterized by frequent, daily crack use, multiple sex partners, trading sex, and inconsistent condom use. The consistent condom use group, the smallest group, was characterized by consistent condom use. The inconsistent condom use group, the second largest group, was distinguished by inconsistent condom use. Comparisons of the three HIV risk groups revealed that the highest risk group had a higher proportion of illegal sources of income, higher proportion of binged crack use, frequent, daily, alcohol use, same gender sex partners, and scored higher on depressive symptoms. Members of the consistent condom use group were more likely to have been HIV diagnosed for a shorter time, to have HIV serodiscordant casual sex partners, higher psychological motivation for condom use, and a lower frequency of vaginal sex. Members of the inconsistent condom use group were more likely to have a main sex partner, to be married, to be on public assistance, to know the HIV serostatus of their casual partner, and less likely to conceal their HIV serostatus. An alarming finding was that a large number of participants inconsistently used condoms with HIV serodiscordant sex partners. Interventions aiming to prevent the secondary spread of HIV infection in African-American crack cocaine smokers should take this variability in account and focus on the differences. PMID:18495380

  20. HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey

    OpenAIRE

    Ruton Hinda; Mugwaneza Placidie; Shema Nadine; Lyambabaje Alexandre; Bizimana Jean de Dieu; Tsague Landry; Nyankesha Elevanie; Wagner Claire M; Mutabazi Vincent; Nyemazi Jean Pierre; Nsanzimana Sabin; Karema Corine; Binagwaho Agnes

    2012-01-01

    Abstract Background Operational effectiveness of large-scale national programmes for the prevention of mother to child transmission (PMTCT) of HIV in sub-Saharan Africa remains limited. We report on HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the national PMTCT programme in Rwanda. Methods We conducted a national representative household survey between February and May 2009. Participants were mothers who had attended antenatal care at least once duri...

  1. Problem posing and cultural tailoring: developing an HIV/AIDS health literacy toolkit with the African American community.

    Science.gov (United States)

    Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa

    2012-09-01

    The rate of HIV infection among African Americans is disproportionately higher than for other racial groups in the United States. Previous research suggests that low level of health literacy (HL) is an underlying factor to explain racial disparities in the prevalence and incidence of HIV/AIDS. The present research describes a community and university project to develop a culturally tailored HIV/AIDS HL toolkit in the African American community. Paulo Freire's pedagogical philosophy and problem-posing methodology served as the guiding framework throughout the development process. Developing the HIV/AIDS HL toolkit occurred in a two-stage process. In Stage 1, a nonprofit organization and research team established a collaborative partnership to develop a culturally tailored HIV/AIDS HL toolkit. In Stage 2, African American community members participated in focus groups conducted as Freirian cultural circles to further refine the HIV/AIDS HL toolkit. In both stages, problem posing engaged participants' knowledge, experiences, and concerns to evaluate a working draft toolkit. The discussion and implications highlight how Freire's pedagogical philosophy and methodology enhances the development of culturally tailored health information. PMID:22102601

  2. Outcomes of a Behavioral Intervention to Increase Condom Use and Reduce HIV Risk Among Urban African American Young Adults.

    Science.gov (United States)

    Henry Akintobi, Tabia; Trotter, Jennie; Zellner, Tiffany; Lenoir, Shelia; Evans, Donoria; Rollins, Latrice; Miller, Assia

    2016-09-01

    African Americans comprise nearly half of people in the United States living with the human immunodeficiency virus (HIV) but compose one tenth of the population. Infection rate among young African American adults is 11 times that of Whites. The Color It Real Program was a seven-session, weekly administered, age-specific, and culturally tailored intervention designed to provide HIV education and address behavioral motivations (risk awareness, decisional balance exercises, partner negotiation, and attitudes) associated with HIV risk among African Americans ages 18 to 24 years in Atlanta, Georgia. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 88) and control (n = 52) groups completing a 45-item survey. When controlling for gender and education, repeated measures analysis of variance revealed that the intervention group had significant increases in HIV transmission knowledge (F = 4.84, p = .0305), condom use, and intentions to use condoms (F = 4.38, p = .0385). Risky sexual behavior means did not significantly differ between groups (F = 1.44, p = .2331). Results indicate the value of culturally tailored educational strategies toward improved HIV knowledge and adoption of risk reduction strategies. Future studies investigating the differential impact of programs by gender and sexual orientation are also critical. Continued innovation and tailoring of risk reduction strategies for minority young adults will contribute to reducing HIV incidence and prevalence over the life course. PMID:27216874

  3. HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.

    Directory of Open Access Journals (Sweden)

    Wim Delva

    Full Text Available Until now, decisions about how to allocate ART have largely been based on maximising the therapeutic benefit of ART for patients. Since the results of the HPTN 052 study showed efficacy of antiretroviral therapy (ART in preventing HIV transmission, there has been increased interest in the benefits of ART not only as treatment, but also in prevention. Resources for expanding ART in the short term may be limited, so the question is how to generate the most prevention benefit from realistic potential increases in the availability of ART. Although not a formal systematic review, here we review different ways in which access to ART could be expanded by prioritising access to particular groups based on clinical or behavioural factors. For each group we consider (i the clinical and epidemiological benefits, (ii the potential feasibility, acceptability, and equity, and (iii the affordability and cost-effectiveness of prioritising ART access for that group. In re-evaluating the allocation of ART in light of the new data about ART preventing transmission, the goal should be to create policies that maximise epidemiological and clinical benefit while still being feasible, affordable, acceptable, and equitable.

  4. Constructing Hope: a Multi-Agency Programme model for Young Sex Offenders living with HIV/AIDS in South Africa

    Directory of Open Access Journals (Sweden)

    Douglas P. Boer

    2007-12-01

    Full Text Available Many young sex offenders in South Africa have HIV/AIDS. This fact both complicates and underlines the importance of delivering effective multi-agency sex offender programmes to these individuals. Reducing reoffending rates is of obvious importance, as stopping these young offenders from offending also means limiting the spread of HIV to new victims. We are proposing an integrative programme that incorporates proven models of sex offender treatment in combination with medical, educational and family support systems to facilitate community reintegration of young sex offenders living with HIV/AIDS. It is our hope to work in partnership with the Department of Correctional Services in South Africa to facilitate such programming in the near future.

  5. African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

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    Luc E Coffeng

    Full Text Available BACKGROUND: Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. METHODS AND FINDINGS: With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. CONCLUSIONS: Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

  6. Associations between Childhood Adversity and Depression, Substance Abuse and HIV and HSV2 Incident Infections in Rural South African Youth

    Science.gov (United States)

    Jewkes, Rachel K.; Dunkle, Kristin; Nduna, Mzikazi; Jama, P. Nwabisa; Puren, Adrian

    2010-01-01

    Objectives: To describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes. Methods: We analyzed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of a behavioral intervention, and also tested blood HIV and herpes…

  7. Structural Ecosystems Therapy for HIV-Seropositive African American Women: Effects on Psychological Distress, Family Hassles, and Family Support

    Science.gov (United States)

    Szapocznik, Jose; Feaster, Daniel J.; Mitrani, Victoria B.; Prado, Guillermo; Smith, Lila; Robinson-Batista, Carleen; Schwartz, Seth J.; Mauer, Magaly H.; Robbins, Michael S.

    2004-01-01

    This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of…

  8. "The need for circumcised men" : the quest for transformed masculinities in African Christianity in the context of the HIV epidemic

    NARCIS (Netherlands)

    van Klinken, A.S.

    2011-01-01

    In sub-Saharan Africa, among others as a result of the HIV epidemic hegemonic forms of masculinity are contested and the need to change men and to transform masculinities is widely acknowledged. This thesis investigates this development in the context of African Christianity, making use of theologic

  9. Effect of HIV status on fertility intention and contraceptive use among women in nine sub-Saharan African countries: evidence from Demographic and Health Surveys

    OpenAIRE

    Mumah, Joyce N.; Ziraba, Abdhalah K.; Sidze, Estelle M.

    2014-01-01

    Background: Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals.Design: Using multiple rounds of biomarker data from Demographic and Health Surveys (2004–2012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context ...

  10. Associations between mode of HIV testing and consent, confidentiality, and referral: a comparative analysis in four African countries

    OpenAIRE

    Obermeyer, CM; Neuman, M.; Desclaux, A.; Wanyenze, R.; Ky-Zerbo, O.; Cherutich, P; Namakhoma, I; Hardon, A.

    2012-01-01

    Editors' Summary Background In 2007, World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) issued a joint guidance document on “provider-initiated” HIV testing and counseling. They noted that previous testing strategies that relied on “client-initiated” testing (also referred to as VCT, for voluntary counseling and testing) had failed to reach enough people, both in high-income and resource-constrained countries—in Africa, for example, at that time, just ...

  11. The occurrence of anti-retroviral compounds used for HIV treatment in South African surface water

    International Nuclear Information System (INIS)

    The study and quantification of personal care products, such as pharmaceuticals, in surface water has become popular in recent years; yet very little description of these compounds’ presence in South African surface water exists in the literature. Antiretrovirals (ARVs), used to treat human immunodeficiency virus (HIV) are rarely considered within this field. A new method for the simultaneous quantification of 12 antiretroviral compounds in surface water using the standard addition method is described. Water samples were concentrated by a generic automated solid phase extraction method and analysed by ultra-high pressure liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). Substantial matrix effect was encountered in the samples with an average method detection limit of 90.4 ng/L. This is the first reported countrywide survey of South African surface water for the quantification of these compounds with average concentrations ranging between 26.5 and 430 ng/L. - Highlights: • An LC-MS/MS method for the detection of 12 antiretroviral drugs was developed. • The compounds were detected in South African surface water for the first time. • Targets occurred in the low to mid ng/L range. • Nevirapine occurred ubiquitously across all the samples tested. • Matrix effect was corrected for using a modified standard addition method. - This work represents the first quantitative description of anti-retrovirals, as a group, in surface water using a modified standard addition method and UHPLC-MS/MS

  12. Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS

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    Lorna A Renner

    2013-09-01

    Full Text Available Introduction: There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART containing zidovudine (ZDV recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database. Methods: Standardized collection of data from HIV-infected children (positive PCR<18 months or positive serology ≥18 months followed up in HIV programmes was included in the regional IeDEA West Africa collaboration. Ten clinical centres from seven countries contributed (Benin, Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal to this collection. Inclusion criteria were age <16 years and starting ART. We explored the data quality of haemoglobin documentation over time and the incidence and predictors of severe anaemia (Hb<7g/dL per 100 child-years of follow-up over the duration of first-line antiretroviral therapy. Results: As of December 2009, among the 2933 children included in the collaboration, 45% were girls, median age was five years; median CD4 cell percentage was 13%; median weight-for-age z-score was−2.7; and 1772 (60.4% had a first-line ZDV-containing regimen. At baseline, 70% of the children with a first-line ZDV-containing regimen had a haemoglobin measure available versus 76% in those not on ZDV (p≤0.01: the prevalence of severe anaemia was 3.0% (n=38 in the ZDV group versus 10.2% (n=89 in those without (p<0. 01. Over the first-line follow-up, 58.9% of the children had ≥1 measure of haemoglobin available in those exposed to ZDV versus 60.4% of those not (p=0.45. Severe anaemia occurred in 92 children with an incidence of 2.47 per 100 child-years of follow-up in those on a ZDV-containing regimen versus 4.25 in those not (p≤0.01. Adjusted for age at ART initiation and first-line regimen, a weight-for-age z-score ≤−3 was a strong predictor associated with a 5.59 times risk of

  13. The application of Intervention Mapping in developing and implementing school-based sexuality and HIV/AIDS education in a developing country context: the case of Tanzania

    NARCIS (Netherlands)

    Mkumbo, K.; Schaalma, H.P.; Kaaya, S.; Leerlooijer, J.N.; Mbwambo, J.; Kilonzo, G.

    2009-01-01

    Aims: Effective sexuality and HIV/AIDS education programmes are needed to protect young people against HIV/AIDS and teenage pregnancy in Tanzania and other Sub-Saharan African countries. Using a theory- and evidence-based approach and adapting the programmes to local contexts, increases the effectiv

  14. Early and Late Direct Costs in a Southern African Antiretroviral Treatment Programme: A Retrospective Cohort Analysis

    OpenAIRE

    Leisegang, Rory; Cleary, Susan; Hislop, Michael; Davidse, Alistair; Regensberg, Leon; Little, Francesca; Maartens, Gary

    2009-01-01

    Editors' Summary Background About 30 million people (22 million people in sub-Saharan Africa alone) are infected with the human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS). HIV destroys immune system cells (including CD4 cells, a type of lymphocyte), leaving infected individuals susceptible to other infections. Early in the AIDS epidemic, on average HIV-positive people died within 10 years of infection. Then, in 1996, highly active antiretroviral thera...

  15. Research gaps in neonatal HIV-related care

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    Mary-Ann Davies

    2015-04-01

    Full Text Available The South African prevention of mother to child transmission programme has made excellentprogress in reducing vertical HIV transmission, and paediatric antiretroviral therapyprogrammes have demonstrated good outcomes with increasing treatment initiation inyounger children and infants. However, both in South Africa and across sub-Saharan African,lack of boosted peri-partum prophylaxis for high-risk vertical transmission, loss to followup,and failure to initiate HIV-infected infants on antiretroviral therapy (ART before diseaseprogression are key remaining gaps in neonatal HIV-related care. In this issue of the Southern African Journal of HIV Medicine, experts provide valuable recommendations for addressingthese gaps. The present article highlights a number of areas where evidence is lacking toinform guidelines and programme development for optimal neonatal HIV-related care.

  16. HIV-inhibitory michellamine-type dimeric naphthylisoquinoline alkaloids from the Central African liana Ancistrocladus congolensis.

    Science.gov (United States)

    Bringmann, Gerhard; Steinert, Claudia; Feineis, Doris; Mudogo, Virima; Betzin, Julia; Scheller, Carsten

    2016-08-01

    Five michellamine-type dimeric naphthylisoquinoline alkaloids (NIQs), named michellamines A2, A3, A4, B2, and B3, have been isolated from the root bark of the Central African liana Ancistrocladus congolensisJ. Léonard (Ancistrocladaceae), along with their two known parent compounds, the michellamines A and B, which had so far only been detected in the Cameroonian species Ancistrocladus korupensis. Five monomeric representatives, viz., korupensamine D, ancistrobrevine B, hamatine, 5'-O-demethylhamatine, and 6-O-methylhamatine, already known from related Ancistrocladus species, have likewise been identified. The structure elucidation was achieved by spectroscopic analysis including HRESIMS, 1D and 2D NMR, and by chemical and chiroptical methods. The michellamines A2, A3, B3, and A4 were evaluated for their cytotoxic and anti-HIV activities at a concentration range of 0-100 μM against the HIV reference strain IIIB/LAI in A3.01 T lymphoblast cell cultures, and their effects were compared to the ones displayed by the known michellamines A and B. Inhibitory activities for HIV replication were monitored for the michellamines A2 (IC50 = 29.6 μM), A3 (IC50 = 15.2 μM), A4 (IC50 = 35.9 μM), and B (IC50 = 20.4 μM). The michellamines A and B3, by contrast, did not inhibit HIV replication. No cytotoxicity was observed. Furthermore, the chemotaxonomic significance of the previously undescribed michellamines is discussed. PMID:27137461

  17. Predictors and Profiles of Antiretroviral Therapy Adherence Among African American Adolescents and Young Adult Males Living with HIV.

    Science.gov (United States)

    Gross, Israel Moses; Hosek, Sybil; Richards, Maryse Heather; Fernandez, M Isabel

    2016-07-01

    Adherence to antiretroviral therapy (ART) is crucial for thwarting HIV disease progression and reducing secondary HIV transmission, yet youth living with HIV (YLH) struggle with adherence. The highest rates of new HIV infections in the United States occur in young African American men. A sample of 387 HIV-positive young African American males on ART was selected from a cross-sectional assessment of (YLH) receiving medical care within the Adolescent Trials Network for HIV/AIDS Interventions (ATN) from 2010 to 2012 (12-24 years old, median 22.00, SD 2.08). Participants completed self-reported adherence, demographic, health, and psychosocial measures. Sixty-two percent self-reported 100% ART adherence. Optimal data analysis identified frequency of cannabis use during the past 3 months as the strongest independent predictor of adherence, yielding moderate effect strength sensitivity (ESS) = 27.1, p cannabis use, 72% reported full adherence; in contrast, only 45% of participants who used cannabis frequently reported full adherence. Classification tree analysis (CTA) was utilized to improve classification accuracy and to identify the pathways of ART adherence and nonadherence. The CTA model evidenced a 38% improvement above chance for correctly classifying participants as ART adherent or nonadherent. Participants most likely to be adherent were those with low psychological distress and minimal alcohol use (82% were adherent). Participants least likely to be adherent were those with higher psychological distress and engaged in weekly cannabis use (69% were nonadherent). Findings suggest multiple profiles of ART adherence for young African American males living with HIV and argue for targeted psychosocial interventions. PMID:27410496

  18. Implementing good participatory practice guidelines in the FEM-PrEP Preexposure Prophylaxis Trial for HIV Prevention among African Women: a focus on local stakeholder involvement

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    Mack N

    2013-10-01

    Full Text Available Natasha Mack,1 Stella Kirkendale,1 Paul Omullo,2 Jacob Odhiambo,2 Malebo Ratlhagana,3 Martha Masaki,4 Phumzile Siguntu,5 Kawango Agot,2 Khatija Ahmed,3 Saidi Kapiga,4 Johan Lombaard,5 Lut Van Damme,1 Amy Corneli1 1FHI 360, Durham, NC, USA; 2Impact Research and Development Organization, Bondo, Kenya; 3Setshaba Research Centre, Soshanguve, South Africa; 4Kilimanjaro Christian Medical Center, Moshi, Tanzania; 5Josha Research, Bloemfontein, South Africa Abstract: Biomedical HIV-prevention research is most likely to succeed when researchers actively engage with community stakeholders. To this effect, the Joint United Nations Programme on HIV/AIDS and the AIDS Vaccine Advocacy Coalition developed good participatory practice guidelines for biomedical HIV-prevention trials in 2007 and updated them in 2011. The Preexposure Prophylaxis Trial for HIV Prevention among African Women (FEM-PrEP clinical trial, testing once-daily Truvada as preexposure prophylaxis among women at higher risk of HIV in Kenya, South Africa, and Tanzania, included a community program to engage with local stakeholders. Following the trial, we revisited the community program to situate activities in the context of the 2011 guidelines. In the paper, we describe implementation of the six guidelines relevant to local stakeholder engagement – stakeholder advisory mechanisms, stakeholder engagement plan, stakeholder education plan, communications plan, issues management plan, trial closure, and results dissemination – in light of on-the-ground realities of the trial. We then identify two cross-cutting themes from our considerations: (1 stakeholder education beyond the good participatory practice recommendation to increase research literacy about the specific trial is needed; education efforts should also communicate a base of information on HIV transmission and prevention; and (2 anticipatory preparation is useful in communications planning, issues management, and trial closure and

  19. Differences in Clinical Manifestations of Acute and Early HIV-1 Infection between HIV-1 Subtypes in African Women

    OpenAIRE

    Lemonovich, Tracy L.; Watkins, Richard R.; Morrison, Charles S.; Kwok, Cynthia; Chipato, Tsungai; Musoke, Robert; Arts, Eric J; Nankya, Immaculate; Salata, Robert A.

    2015-01-01

    Little is known about the differences in clinical manifestations between women with various HIV-1 subtypes during acute (AI) and early (EI) HIV infection. In a longitudinal cohort study, clinical signs and symptoms among Uganda and Zimbabwe women with AI and EI were compared with HIV-negative controls; symptoms were assessed quarterly for 15 to 24 months. Early HIV infection was defined as the first visit during which a woman tested HIV antibody positive. Women who were HIV negative serologic...

  20. “Keep it simple”: older African Americans’ preferences for a health literacy intervention in HIV management

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    Gakumo CA

    2015-01-01

    Full Text Available Carrie Ann Gakumo,1 Comfort C Enah,1 David E Vance,1,2 Efe Sahinoglu,3 Jim L Raper1,3,4 1School of Nursing, 2Center for Nursing Research, 3School of Medicine, 41917 HIV/AIDS Outpatient Clinic, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: Health literacy is lower in minorities and older adults, and has been associated with nonadherence to medications, treatment, and care in people living with human immunodeficiency virus (HIV. Likewise, African Americans with HIV are more likely to be nonadherent to their HIV medications, less likely to keep their clinic appointments related to HIV treatment and care, and more likely to die during hospitalizations than their ethnic counterparts. The present study explored the preferences of older African Americans with HIV for a health literacy intervention to promote HIV management.Patients and methods: In this qualitative study, 20 older adult African Americans living with HIV were recruited from an HIV/acquired immunodeficiency syndrome outpatient clinic in the southeastern region of the US. Using patient-centered participatory design methods, semi-structured individual interviews were conducted to determine patient preferences for intervention development and design. Health literacy was also measured using the Rapid Estimate of Adult Literacy in Medicine – Revised (REALM-R.Results: Four major themes emerged related to intervention development and design: keep health information simple; use a team-based approach for health education; tailor teaching strategies to patients’ individual needs; and account for patients’ low experience, but high interest, in technology. Forty-five percent of the study population had low health literacy based on the revised Rapid Estimate of Adult Literacy in Medicine.Conclusion: Future interventions that target minorities and older adults living with HIV should consider patients’ learning needs, sex-specific and mental health needs, and delivery

  1. African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology

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    Seely Dugald

    2005-05-01

    Full Text Available Abstract In Africa, herbal medicines are often used as primary treatment for HIV/AIDS and for HIV-related problems. In general, traditional medicines are not well researched, and are poorly regulated. We review the evidence and safety concerns related to the use of two specific African herbals, which are currently recommended by the Ministry of Health in South Africa and member states for use in HIV: African Potato and Sutherlandia. We review the pharmacology, toxicology and pharmacokinetics of these herbal medicines. Despite the popularity of their use and the support of Ministries of Health and NGOs in some African countries, no clinical trials of efficacy exist, and low-level evidence of harm identifies the potential for drug interactions with antiretroviral drugs. Efforts should be made by mainstream health professionals to provide validated information to traditional healers and patients on the judicious use of herbal remedies. This may reduce harm through failed expectations, pharmacologic adverse events including possible drug/herb interactions and unnecessary added therapeutic costs. Efforts should also be directed at evaluating the possible benefits of natural products in HIV/AIDS treatment.

  2. Adapting an evidence-based HIV prevention intervention for pregnant African-American women in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Winona Poulton

    2011-02-01

    Full Text Available Wendee M Wechsberg1, Felicia A Browne1, Winona Poulton1, Rachel Middlesteadt Ellerson1, Ashley Simons-Rudolph1, Deborah Haller2,  1RTI International,* Research Triangle Park, NC, USA; 2Columbia University College of Physicians and Surgeons, New York, NY, USA,  *RTI International is a trade name of Research Triangle InstituteAbstract: An adaptation of an evidence-based, woman-focused intervention designed to reduce HIV risk behaviors was conducted for pregnant, African-American women in substance abuse treatment in North Carolina. The intervention adaptation process included focus groups, expert panels, and the filming of women who spoke about their experiences with pregnancy, drug use, sex risk behaviors, HIV testing and treatment, need for substance abuse treatment, violence, and victimization. The assessment instrument was adapted for pregnant women and the intervention was organized into a 4-session PowerPoint presentation, with an additional session if a woman tested positive for HIV. All sessions and assessment instrument were installed on laptop computers for portability in treatment programs. We pilot tested our adaptation with 59 pregnant African-American women who had used an illicit drug within the past year and were enrolled in substance abuse treatment. At baseline, 41% were currently homeless, 76% were unemployed, 90% had not planned their current pregnancy, and approximately 70% reported drug use since finding out about the pregnancy. This sample of participants rated the intervention sessions and were highly satisfied with their experience, resulting in a mean satisfaction score of 6.5 out of 7. Pregnant African-American women who use drugs need substance abuse treatment that they do not currently access. Woman-focused HIV interventions help to address intersecting risk behaviors and need for treatment prevalent among this vulnerable group.Keywords: African-American woman, HIV prevention pregnancy, drug use, violence, sexual

  3. Evaluation of a targeted HIV prevention programme among female commercial sex workers in the south of Thailand

    OpenAIRE

    van Griensven, G J; Limanonda, B.; Ngaokeow, S.; Ayuthaya, S. I.; Poshyachinda, V.

    1998-01-01

    OBJECTIVE: To evaluate a targeted HIV prevention programme among female commercial sex workers (CSWs) in the south of Thailand. SUBJECTS AND METHODS: A pretest-post-test comparison group study was carried out in Sungai Kolok and Betong between June and December 1994. In June 408 CSWs were entered in Sungai Kolok (the intervention area) and 343 CSWs were enrolled in Betong (the comparison area). In December 1994, 416 women were enrolled in Sungai Kolok and 342 in Betong. Of these women 3...

  4. Localisation strategy for the South African nuclear power programme / Alden Willem Johan van Wyk

    OpenAIRE

    Van Wyk, Alden Willem Johan

    2012-01-01

    Through this study, a strategy for the localisation and development of the South African nuclear industry was developed. As background, the Korean localisation experience was investigated, along with international recommendations regarding nuclear localisation, and South African governmental policies. This research was used as foundation for the formulation of a localisation strategy. The possibility of using localisation and nuclear industry development as a means to address governmental soc...

  5. The Social Context of Prevention of Mother to Child Transmission of HIV (PMTCT) in Uganda: Mothers’ and health care providers’ experiences and lessons for programme improvement

    OpenAIRE

    Rujumba, Joseph

    2012-01-01

    Introduction: The prevention of mother-to-child transmission of HIV (PMTCT) programme has been operational in Uganda since the year 2000, but its performance remains sub-optimal. The objective of this thesis is to increase understanding of the role of the social context in the delivery and utilization of PMTCT services, focusing on how pregnant women experience routine HIV counselling and testing as part of antenatal care, HIV status disclosure to partners and lessons leant by ...

  6. HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey

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    Ruton Hinda

    2012-01-01

    Full Text Available Abstract Background Operational effectiveness of large-scale national programmes for the prevention of mother to child transmission (PMTCT of HIV in sub-Saharan Africa remains limited. We report on HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the national PMTCT programme in Rwanda. Methods We conducted a national representative household survey between February and May 2009. Participants were mothers who had attended antenatal care at least once during their most recent pregnancy, and whose children were aged nine to 24 months. A two-stage stratified (geographic location of PMTCT site, maternal HIV status during pregnancy cluster sampling was used to select mother-infant pairs to be interviewed during household visits. Alive children born from HIV-positive mothers (HIV-exposed children were tested for HIV according to routine HIV testing protocol. We calculated HIV-free survival at nine to 24 months. We subsequently determined factors associated with mother to child transmission of HIV, child death and HIV-free survival using logistic regression. Results Out of 1448 HIV-exposed children surveyed, 44 (3.0% were reported dead by nine months of age. Of the 1340 children alive, 53 (4.0% tested HIV positive. HIV-free survival was estimated at 91.9% (95% confidence interval: 90.4-93.3% at nine to 24 months. Adjusting for maternal, child and health system factors, being a member of an association of people living with HIV (adjusted odds ratio: 0.7, 95% CI: 0.1-0.995 improved by 30% HIV-free survival among children, whereas the maternal use of a highly active antiretroviral therapy (HAART regimen for PMTCT (aOR: 0.6, 95% CI: 0.3-1.07 had a borderline effect. Conclusions HIV-free survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% in Rwanda. The national PMTCT programme could achieve greater impact on child survival by ensuring access to HAART for all HIV-positive pregnant women in

  7. Programme Review Guidelines for Quality Assurance in Higher Education: A South African Perspective

    Science.gov (United States)

    Bornman, Gertruida M.

    2004-01-01

    All educators should reflect on and assess the quality of their teaching and their learning programmes. Such reflection is the subject of this article. The focus is on higher education (HE) with particular emphasis on distance learning institutions. A particular educational programme is considered, namely a course-work Master's degree in…

  8. Health and economic impact of HIV/AIDS on South African households: a cohort study

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    Booysen Frederick LR

    2003-04-01

    Full Text Available Abstract Background South African households are severely affected by human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS but health and economic impacts have not been quantified in controlled cohort studies. Methods We compared households with an HIV-infected member, and unaffected neighbouring households, in one rural and one urban area in Free State province, South Africa. Interviews were conducted with one key informant in each household, at baseline and six months later. We studied 1913 members of 404 households, with 94% and 96% follow up, respectively. Household and individual level analyses were done. Results Members of affected households, compared to members of unaffected households, were independently more likely to be continuously ill (adjusted odds ratio (OR 2.1, 95% CI 1.3–3.4 at follow up, and to die (adjusted OR 3.4, 95% CI 1.0–11, mainly due to infectious diseases. Government clinics and hospitals were the main sources of health care. Affected households were poorer than unaffected households at baseline (relative income per person 0.61, 95% CI 0.49–0.76. Over six months expenditure and income decreased more rapidly in affected than in unaffected households (baseline-adjusted relative expenditure 0.86, 95% CI 0.75–0.99 and income 0.89, 95% CI 0.75–1.05. Baseline morbidity was independently associated with lower income and expenditure at baseline but not with changes over six months. Conclusions HIV/AIDS affects the health and wealth of households as well as infected individuals, aggravating pre-existing poverty.

  9. The West African monsoon: Contribution of the AMMA multidisciplinary programme to the study of a regional climate system.

    Science.gov (United States)

    Lebel, T.; Janicot, S.; Redelsperger, J. L.; Parker, D. J.; Thorncroft, C. D.

    2015-12-01

    The AMMA international project aims at improving our knowledge and understanding of the West African monsoon and its variability with an emphasis on daily-to-interannual timescales. AMMA is motivated by an interest in fundamental scientific issues and by the societal need for improved prediction of the WAM and its impacts on water resources, health and food security for West African nations. The West African monsoon (WAM) has a distinctive annual cycle in rainfall that remains a challenge to understand and predict. The location of peak rainfall, which resides in the Northern Hemisphere throughout the year, moves from the ocean to the land in boreal spring. Around the end of June there is a rapid shift in the location of peak rainfall between the coast and around 10°N where it remains until about the end of August. In September the peak rainfall returns equatorward at a relatively steady pace and is located over the ocean again by November. The fact that the peak rainfall migrates irregularly compared to the peak solar heating is due to the interactions that occur between the land, the atmosphere and the ocean. To gain a better understanding of this complex climate system, a large international research programme was launched in 2002, the biggest of its kind into environment and climate ever attempted in Africa. AMMA has involved a comprehensive field experiment bringing together ocean, land and atmospheric measurements, on timescales ranging from hourly and daily variability up to the changes in seasonal activity over a number of years. This presentation will focus on the description of the field programme and its accomplishments, and address some key questions that have been recently identified to form the core of AMMA-Phase 2.

  10. Insights from an individual-level model of HIV programmes in southern Africa: HIV testing, ART and resistance

    OpenAIRE

    Cambiano, V.

    2014-01-01

    Antiretroviral therapy (ART) has transformed HIV infection from a death sentence into a chronic condition. In sub-Saharan Africa, the area most affected by this disease, availability of ART has increased dramatically over the last few years. Nevertheless, many people are still not receiving ART either because they are not aware of being HIV-positive or because they struggle to access ART or to engage in HIV care. It is fundamental to take decisions which maximise the health benefits with the ...

  11. Prevalence and correlates of knowledge of male partner HIV testing and serostatus among African-American women living in high poverty, high HIV prevalence communities (HPTN 064)

    Science.gov (United States)

    Jennings, Larissa; Rompalo, Anne M.; Wang, Jing; Hughes, James; Adimora, Adaora A.; Hodder, Sally; Soto-Torres, Lydia E.; Frew, Paula M.; Haley, Danielle F.

    2014-01-01

    Knowledge of sexual partners' HIV infection can reduce risky sexual behaviors. Yet, there are no published studies to-date examining prevalence and characteristics associated with knowledge among African-American women living in high poverty communities disproportionately affected by HIV. Using the HIV Prevention Trial Network's (HPTN) 064 Study data, multivariable logistic regression was used to examine individual, partner, and partnership-level determinants of women's knowledge (n=1,768 women). Results showed that women's demographic characteristics alone did not account for the variation in serostatus awareness. Rather, lower knowledge of partner serostatus was associated with having two or more sex partners (OR=0.49, 95%CI: 0.37-0.65), food insecurity (OR=0.68, 95%CI: 0.49-0.94), partner age>35 (OR=0.68, 95%CI: 0.49-0.94), and partner concurrency (OR=0.63, 95%CI: 0.49-0.83). Access to financial support (OR=1.42, 95%CI: 1.05-1.92) and coresidence (OR=1.43, 95%CI: 1.05-1.95) were associated with higher knowledge of partner serostatus. HIV prevention efforts addressing African-American women's vulnerabilities should employ integrated behavioral, economic, and empowerment approaches. PMID:25160901

  12. Re-testing and misclassification of HIV-2 and HIV-1&2 dually reactive patients among the HIV-2 cohort of The West African Database to evaluate AIDS collaboration

    Directory of Open Access Journals (Sweden)

    Boris K Tchounga

    2014-08-01

    Full Text Available Introduction: West Africa is characterized by the circulation of HIV-1 and HIV-2. The laboratory diagnosis of these two infections as well as the choice of a first-line antiretroviral therapy (ART is challenging, considering the limited access to second-line regimens. This study aimed at confirming the classification of HIV-2 and HIV-1&2 dually reactive patients followed up in the HIV-2 cohort of the West African Database to evaluate AIDS collaboration. Method: A cross-sectional survey was conducted from March to December 2012 in Burkina Faso, Côte d’Ivoire and Mali among patients classified as HIV-2 or HIV-1&2 dually reactive according to the national HIV testing algorithms. A 5-ml blood sample was collected from each patient and tested in a single reference laboratory in Côte d’Ivoire (CeDReS, Abidjan with two immuno-enzymatic tests: ImmunoCombII® (HIV-1&2 ImmunoComb BiSpot – Alere and an in-house ELISA test, approved by the French National AIDS and hepatitis Research Agency (ANRS. Results: A total of 547 patients were included; 57% of them were initially classified as HIV-2 and 43% as HIV-1&2 dually reactive. Half of the patients had CD4≥500 cells/mm3 and 68.6% were on ART. Of the 312 patients initially classified as HIV-2, 267 (85.7% were confirmed as HIV-2 with ImmunoCombII® and in-house ELISA while 16 (5.1% and 9 (2.9% were reclassified as HIV-1 and HIV-1&2, respectively (Kappa=0.69; p<0.001. Among the 235 patients initially classified as HIV-1&2 dually reactive, only 54 (23.0% were confirmed as dually reactive with ImmunoCombII® and in-house ELISA, while 103 (43.8% and 33 (14.0% were reclassified as HIV-1 and HIV-2 mono-infected, respectively (kappa= 0.70; p<0.001. Overall, 300 samples (54.8% were concordantly classified as HIV-2, 63 (11.5% as HIV-1&2 dually reactive and 119 (21.8% as HIV-1 (kappa=0.79; p<0.001. The two tests gave discordant results for 65 samples (11.9%. Conclusions: Patients with HIV-2 mono-infection are

  13. Assessing behavioural intention of small and medium enterprises in implementing an HIV/AIDS policy and programme

    Directory of Open Access Journals (Sweden)

    A. Parsadh

    2005-10-01

    Full Text Available Small and Medium Enterprises (SMEs are likely to feel the impact of an HIV/AIDS epidemic through reduced productivity and an increased percentage of absenteeism; staff turnover; recruitment and training costs; cost of employee benefits; and poor staff morale. One of the interventions is to implement an HIV/AIDS policy and programme, yet a literature search showed that psychological studies of SMEs in implementing an HIV/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1988, 1991, which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. The intention to implement an HIV/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to have limited use in assessing behavioural intention of SMEs in implementing an HIV/AIDS policy and programme. Opsomming Die uitwerking van die MIV/VIGS pandemie op Klein en Medium Sake-ondernemings sal tot gevolg hê ’n afname in produktiwiteit; ’n toename in personeelafwesigheid, personeelomset, personeelwerwing en –opleidingskoste, personeelvoordele; en swak personeel moraal tot gevolg hê. Een manier om die probleem aan te spreek is om ’n MIV/VIGS beleid en program te implimenteer. Navorsing toon dat psigologiese studies van klein en medium sakeondernemings om ’n HIV/VIGS beleid en program te implimenteer, beperk is. Hierdie navorsing steun op die teorie van planmatige gedrag (Ajzen, 1988; 1991, wat ’n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. Die oogmerk met die implimentering van ’n MIV/VIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in houding, subjektiewe norme en waargenome gedragskontrole. Die resultate toon dat die teorie van planmagtige gedrag

  14. High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of acting.

    OpenAIRE

    Manzi, M; Zachariah, R.; Teck, R; Buhendwa, L.; Kazima, J.; Bakali, E; Firmenich, Peter; Humblet, P

    2005-01-01

    SETTING: Thyolo District Hospital, rural Malawi. OBJECTIVES: In a prevention of mother-to-child HIV transmission (PMTCT) programme, to determine: the acceptability of offering 'opt-out' voluntary counselling and HIV-testing (VCT); the progressive loss to follow up of HIV-positive mothers during the antenatal period, at delivery and to the 6-month postnatal visit; and the proportion of missed deliveries in the district. DESIGN: Cohort study. METHODS: Review of routine antenatal, VCT and PMTCT ...

  15. Association between age at antiretroviral therapy initiation and 24-month immune response in West-African HIV-infected children

    DEFF Research Database (Denmark)

    Desmonde, Sophie; Dicko, Fatoumata; Koueta, Fla;

    2014-01-01

    OBJECTIVE: We describe the association between age at antiretroviral therapy (ART) initiation and 24-month CD4 cell response in West African HIV-infected children. METHODS: All HIV-infected children from the IeDEA paediatric West African cohort, initiating ART, with at least two CD4 cell count...... measurements, including one at ART initiation (baseline) were included. CD4 cell gain on ART was estimated using a multivariable linear mixed model adjusted for baseline variables: age, CD4 cell count, sex, first-line ART regimen. Kaplan-Meier survival curves and a Cox proportional hazards regression model...... compared immune recovery for age within 24 months post-ART. RESULTS: Of the 4808 children initiated on ART, 3014 were enrolled at a median age of 5.6 years; 61.2% were immunodeficient. After 12 months, children at least 4 years at baseline had significantly lower CD4 cell gains compared with children less...

  16. "Knowledge, attitude, behavior and practice (KABP) regarding HIV/AIDS among pregnant women attending PPTCT programme in New Delhi".

    Science.gov (United States)

    Rahbar, T; Garg, S; Tripathi, R; Gupta, V K; Singh, M M

    2007-09-01

    In India, several thousand HIV-infected babies are expected to be born every year. Despite effective intervention, the identification of HIV infected pregnant women prior to delivery is a major problem. KABP and acceptance of rapid screening of women for HIV among pregnant women attending ANC clinic and availing Voluntary Counselling and Confidential Testing services was assessed. The study was done among 90 pregnant women. There was no significant difference between one's husbands's job and income with respect to pregnant women's awareness of risk factors except that of tattooing. Education level had significant bearing on awareness level. Attitude about PLWHA indicates that 29% of the participants believed individuals with HIV shouldn't be allowed to get married, while 31% saying that they should not be allowed to have children. Participants supported compulsory HIV testing for pregnant women (39%) and couples before marriage. Almost 96% of participants had unprotected sex, though 41% casually used condom. All denied herself or her husband indulging in extramarital sex. The country is about to embark on its prevention of mother to child transmission (PMTCT) programme. This study throws some light on the level of knowledge acceptability and adoption of VCT and other PMTCT strategies among potential beneficiaries. PMID:18697582

  17. "The need for circumcised men" : the quest for transformed masculinities in African Christianity in the context of the HIV epidemic

    OpenAIRE

    van Klinken, A.S.

    2011-01-01

    In sub-Saharan Africa, among others as a result of the HIV epidemic hegemonic forms of masculinity are contested and the need to change men and to transform masculinities is widely acknowledged. This thesis investigates this development in the context of African Christianity, making use of theological and gender critical tools of analysis derived from subdisciplines in religious studies such as the study of World Christianity and the study of religion and gender. The thesis specifically exami...

  18. An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

    Directory of Open Access Journals (Sweden)

    Sibanda Euphemia L

    2012-05-01

    Full Text Available Abstract Background Provider-initiated HIV testing and counselling (PITC is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1 assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2 in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3 Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics. All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.

  19. Determinants of HIV sero-conversion among male injection drug users enrolled in a needle exchange programme at Karachi, Pakistan

    International Nuclear Information System (INIS)

    Objective: To assess the determinants of HIV sero-conversion among male injection drug users enrolled in needle exchange programme at Karachi. Methods: An unmatched retrospective case control study was conducted among male injection drug users receiving needle exchange services in Karachi. The cases and controls were identified from one drop in center providing needle exchange services. The data for the study participants was collected retrospectively from the programme. Descriptive statistics, univariate analysis, and multivariate regression analysis for determinants of HIV sero-conversion and Hosmer and Lameshow goodness of fit test for model adequacy were performed. Results: Mean age of the study participants was 34.17 +- 10.74 years. Average monthly income of the participants was US$ 125.15+-76.32. In unconditional multivariate regression analysis being unmarried (AOR: 3.0 95% CI 1.14-7.9, p=0.02), not living with family (AOR: 2.8 95% CI 1.18-6.79 p=0.02), family history of addiction (AOR: 2.5, 95% CI 1.01-6.49, p=0.04), injecting drugs in groups (AOR: 2.8, 95% CI 1.12 7.02 p=0.02), not obtaining syringes from the programme (AOR: 26.45, 95% CI 2.47-282.8 p=0.007), and history of blood transfusion (AOR: 52.9, 95% CI 1.32-2118.41 p=0.03) were significantly associated with HIV positive sero-status. Model adequacy was assessed by Hosmer and Lameshow goodness of (J: 4.95, p=0.7) indicating that the model was accurate. Conclusion: Social and drug related risky behaviours are important determinants of HIV among male IDUs in Karachi. The situation calls for programmatic initiatives for addressing the risky behaviours among IDUs for effective control of epidemic in the country. (author)

  20. How is the epidemiology of heterosexually-acquired HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?

    OpenAIRE

    Rice, Brian

    2016-01-01

    In the United Kingdom (UK), an estimated 107,800 people were living with HIV in 2013, of whom 55% were heterosexual men and women. Black African men and women accounted for the majority of heterosexuals living with HIV in the UK in 2013. In this PhD by prospective publication my research question is “How is the epidemiology of heterosexually-acquired HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?”. I conducted a quantitative analysis of nati...

  1. History and origin of the HIV-1 subtype C epidemic in South Africa and the greater southern African region

    Science.gov (United States)

    Wilkinson, Eduan; Engelbrecht, Susan; de Oliveira, Tulio

    2015-01-01

    HIV has spread at an alarming rate in South Africa, making it the country with the highest number of HIV infections. Several studies have investigated the histories of HIV-1 subtype C epidemics but none have done so in the context of social and political transformation in southern Africa. There is a need to understand how these processes affects epidemics, as socio-political transformation is a common and on-going process in Africa. Here, we genotyped strains from the start of the epidemic and applied phylodynamic techniques to determine the history of the southern Africa and South African epidemic from longitudinal sampled data. The southern African epidemic’s estimated dates of origin was placed around 1960 (95% HPD 1956–64), while dynamic reconstruction revealed strong growth during the 1970s and 80s. The South African epidemic has a similar origin, caused by multiple introductions from neighbouring countries, and grew exponentially during the 1980s and 90s, coinciding with socio-political changes in South Africa. These findings provide an indication as to when the epidemic started and how it has grown, while the inclusion of sequence data from the start of the epidemic provided better estimates. The epidemic have stabilized in recent years with the expansion of antiretroviral therapy. PMID:26574165

  2. Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities

    Science.gov (United States)

    Chan, Philip A; Mena, Leandro; Patel, Rupa; Oldenburg, Catherine E; Beauchamps, Laura; Perez-Brumer, Amaya G; Parker, Sharon; Mayer, Kenneth H; Mimiaga, Matthew J; Nunn, Amy

    2016-01-01

    Introduction Despite the efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV transmission, few studies have evaluated PrEP use and retention in care outcomes in real-world settings outside of clinical trials. Methods Data were collected from PrEP clinical care programmes in three mid-size US cities: Providence, Rhode Island (RI); Jackson, Mississippi (MS); and St. Louis, Missouri (MO). We assessed the demographic and social characteristics of patients prescribed PrEP and documented their insurance and copayment experiences. We assessed retention in PrEP care at three and six months. Multivariate analyses were used to predict retention in care among men who have sex with men (MSM). HIV acquisition among the cohort was also assessed. Results A total of 267 (RI: 117; MS: 88; MO: 62) patients were prescribed PrEP; 81% filled prescriptions (RI: 73%; MS: 82%; MO: 94%; p<0.001). Patients in MS and MO were more commonly African American than in RI (72% and 26% vs. 7%, respectively), but less frequently Latino (2% and 3% vs. 24%, respectively). More patients reported living below the federal poverty line in MS (52%) compared to MO (23%) and RI (26%). Most patients were MSM (RI: 92%; MS: 88%; MO: 84%). The majority of MSM reported recent condomless anal sex (RI: 70%; MS: 65%; MO: 75%). Among 171 patients prescribed PrEP at least six months beforehand, 72% were retained in care at three months (RI: 68%; MS: 70%; MO: 87%; p=0.12) and 57% were retained in PrEP care at six months (RI: 53%: MS: 61%; MO: 63%; p=0.51). Insurance status and medication costs were not found to be significant barriers for obtaining PrEP. Three patients became infected with HIV during the six-month period after being prescribed PrEP (1.1%; 3/267), including one in RI (suspected acute HIV infection), one in MO (confirmed poor adherence) and one in MS (seroconverted just prior to initiation). Conclusions PrEP initiation and retention in care differed across these distinct settings. In contrast

  3. The Impact of HIV/AIDS Regarding Informal Social Security: Issues and Perspectives from a South African Context

    Directory of Open Access Journals (Sweden)

    C Tshoose

    2010-12-01

    Full Text Available The purpose of the article is to examine the right to social assistance for households living with HIV/AIDS in South Africa. In particular, the article focuses on the impact of this pandemic on households' access to social assistance benefits in the wake of the HIV/AIDS pandemic, which has wrought untold sorrow and suffering to the overwhelming majority of households in South Africa. The article analyses the consequences of HIV/AIDS in relation to households' support systems, care and dependency burdens, and the extent to which the household members either acknowledge the illness (enabling them to better engage with treatment options or alternatively, deny its existence. The article commences by reviewing the literature concerning the effects and social impact of HIV/AIDS on the livelihoods of households and their families. The social reciprocity that underpins households' livelihoods is briefly recapitulated. The article concludes that, while recent policy developments are to be welcomed, the current South African legal system of social security does not provide adequate cover for both people living with HIV/AIDS and their families. More remains to be done in order to provide a more comprehensive social security system for the excluded and marginalised people who are living with HIV/AIDS and their families.

  4. Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

    Science.gov (United States)

    El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Richard Landis, J; Remien, Robert H

    2016-06-01

    Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions. PMID:26577402

  5. Added benefits: reduced depressive symptom levels among African-American female adolescents participating in an HIV prevention intervention.

    Science.gov (United States)

    Brown, Jennifer L; Sales, Jessica M; Swartzendruber, Andrea L; Eriksen, Michael D; DiClemente, Ralph J; Rose, Eve S

    2014-10-01

    Adolescents experience elevated depressive symptoms which health promotion interventions may reduce. This study investigated whether HIV prevention trial participation decreased depressive symptoms among African-American female adolescents. Adolescents (N = 701; M age = 17.6) first received a group-delivered HIV prevention intervention and then either 12 sexual health (intervention condition) or 12 general health (comparison condition) phone counseling contacts over 24 months. ACASI assessments were conducted at baseline, and at 6-, 12-, 18-, and 24-months post-baseline. Linear generalized estimating equations were used to detect percent relative change in depressive symptoms. Participants reported a 2.7% decrease in depressive symptoms (p = 0.001) at each assessment. Intervention participants endorsed an additional 3.6% decrease in depressive symptoms (p = 0.058). Trial participation was associated with reduced depressive symptomatology, particularly among those receiving personalized sexual health counseling. HIV prevention interventions may benefit from incorporating additional content to address adolescents' mental health needs. PMID:24366521

  6. Traditional Healing, Biomedicine and the Treatment of HIV/AIDS: Contrasting South African and Native American Experiences

    Directory of Open Access Journals (Sweden)

    Adrian Flint

    2015-04-01

    Full Text Available Traditional healing remains an important aspect of many people’s engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different. However, given the gravity of the global HIV/AIDS pandemic, there has been much debate as to the value of traditional healing in this respect. Accordingly, this paper explores the extent to which meaningful accommodation between the biomedical and traditional sectors is possible (and/or even desirable. It does this through a consideration of Native American and South African experiences, looking at how the respective groups, in which medical pluralism is common, have addressed the issue of HIV/AIDS. The paper points to the importance of developing “culturally appropriate” forms of treatment that emphasise complementary rather than adversarial engagement between the traditional and biomedical systems and how policymakers can best facilitate this.

  7. Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe

    Directory of Open Access Journals (Sweden)

    Muchedzi Auxilia

    2010-10-01

    Full Text Available Abstract Background This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART among HIV-positive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results Of the 147 HIV-positive women interviewed, 95 (65% had registered with the ART programme. However, documentation of the referral was noted in only 23 (16% of cases. Of the 95 registered women, 35 (37% were receiving ART; 17 (18% had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89-11.65 and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13-4.88. Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16-0.99. Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%, unreliable access to laboratory testing (35% and high transport costs (12%. Of the 147 clients surveyed, 52 (35% women did not access HIV care and treatment. Barriers included perceived long queues (50%, competing life priorities, such as seeking food or shelter (33% and inadequate referral information (15%. Conclusions Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral

  8. ‘I woke up after I joined Stepping Stones’: meanings of an HIV behavioural intervention in rural South African young people's lives

    OpenAIRE

    Jewkes, Rachel; Wood, Katharine; Duvvury, Nata

    2010-01-01

    Evaluation of the Stepping Stones human immunodeficiency virus (HIV) prevention programme in South Africa showed sustained reduction in men and women's herpes simplex type 2 virus incidence and male violence, but no impact on HIV in women. Companion qualitative research was undertaken to explore how participants made meaning from the programme and how it influenced their lives. In-depth interviews were conducted with 10 men and 11 women before the intervention (one to three interviews per per...

  9. Concurrent partnerships and HIV: an inconvenient truth

    OpenAIRE

    Epstein Helen; Morris Martina

    2011-01-01

    Abstract The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers ...

  10. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES.

    Science.gov (United States)

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D

    2008-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further. PMID:20052299

  11. Uptake of HIV testing and outcomes within a Community-based Therapeutic Care (CTC programme to treat Severe Acute Malnutrition in Malawi: a descriptive study

    Directory of Open Access Journals (Sweden)

    Bahwere Paluku

    2008-07-01

    Full Text Available Abstract Background In Malawi and other high HIV prevalence countries, studies suggest that more than 30% of all severely malnourished children admitted to inpatient nutrition rehabilitation units are HIV-infected. However, clinical algorithms designed to diagnose paediatric HIV are neither sensitive nor specific in severely malnourished children. The present study was conducted to assess : i whether HIV testing can be integrated into Community-based Therapeutic Care (CTC; ii to determine if CTC can improve the identification of HIV infected children; and iii to assess the impact of CTC programmes on the rehabilitation of HIV-infected children with Severe Acute Malnutrition (SAM. Methods This community-based cohort study was conducted in Dowa District, Central Malawi, a rural area 50 km from the capital, Lilongwe. Caregivers and children admitted in the Dowa CTC programme were prospectively (Prospective Cohort = PC and retrospectively (Retrospective Cohort = RC admitted into the study and offered HIV testing and counseling. Basic medical care and community nutrition rehabilitation was provided for children with SAM. The outcomes of interest were uptake of HIV testing, and recovery, relapse, and growth rates of HIV-positive and uninfected children in the CTC programme. Student's t-test and analysis of variance were used to compare means and Kruskall Wallis tests were used to compare medians. Dichotomous variables were compared using Chi2 analyses and Fisher's exact test. Stepwise logistic regression with backward elimination was used to identify predictors of HIV infection (α = 0.05. Results 1273 and 735 children were enrolled in the RC and PC. For the RC, the average age (SD at CTC admission was 30.0 (17.2 months. For the PC, the average age at admission was 26.5 (13.7 months. Overall uptake of HIV testing was 60.7% for parents and 94% for children. HIV prevalence in severely malnourished children was 3%, much lower than anticipated. 59% of HIV

  12. The Primate Habituation Programme, Dzanga Sangha Protected Areas, Central African Republic: An overview

    OpenAIRE

    Fuh Neba, Terence; Feistner, Anna; Todd, Angélique

    2014-01-01

    Dzanga Sangha Protected Areas (DSPA), including Dzanga-Ndoki National Park (DNNP), are located in SW Central African Republic (CAR) and are managed by the government and WWF. DSPA is CAR’s largest remaining nearly intact forest block and known for its outstanding biodiversity, including most of CAR's gorillas (G. g. gorilla). In 2012, DNNP, and its neighbouring NPs, were designated a World Heritage Site, the Sangha Tri-National complex (TNS) – classified as an exceptional priority area for we...

  13. Productivity assessments in small ruminants improvement programmes. A case study of the West African Dwarf Goat.

    NARCIS (Netherlands)

    Bosman, H.

    1995-01-01

    Livestock production in the tropics is characterised by a high degree of variability in terms of composition, setting and aims. A good understanding of these characteristics is a prerequisite for the planning of a successful improvement programme. A frequently used criterion to assess the suitabilit

  14. Reflecting on a Leadership Development Programme: A Case Study in South African Higher Education

    Science.gov (United States)

    Louw, Ina; Zuber-Skeritt, Ortrun

    2009-01-01

    Leadership development in higher education is of vital importance to South Africa's future. We present a case study that focuses on a leadership development programme (LDP) through action learning and action research (ALAR) for women academics in South Africa during 2000 and 2001. It identifies the effects of the LDP on participants five years…

  15. A pilot sterile insect release programme to suppress codling moth in South African apple and pear orchards

    International Nuclear Information System (INIS)

    distribution of laboratory-reared moths, in conventional and pheromone treated orchards has been assessed over a period of 20 weeks. Results indicate that locally produced moths are competitive. The determination of the costs and benefits associated with the integrated use of SIT is central to the pilot programme. Initial estimates of production costs indicate that the treatment of an orchard with sterile moths is comparable to the cost of codling moth pheromone disruption. The benefits accrued by the use of SIT over a number of seasons will be determined. The programme is financially supported by the South African Apple and Pear Producers Association, the IAEA and the participating farms. The total costs for the first year of operation are approximately USD 100,000. The local fruit industry has insisted on the rapid commercialization of the programme if it proves to be financially viable. (author)

  16. Scale-up of HIV Viral Load Monitoring--Seven Sub-Saharan African Countries.

    Science.gov (United States)

    Lecher, Shirley; Ellenberger, Dennis; Kim, Andrea A; Fonjungo, Peter N; Agolory, Simon; Borget, Marie Yolande; Broyles, Laura; Carmona, Sergio; Chipungu, Geoffrey; De Cock, Kevin M; Deyde, Varough; Downer, Marie; Gupta, Sundeep; Kaplan, Jonathan E; Kiyaga, Charles; Knight, Nancy; MacLeod, William; Makumbi, Boniface; Muttai, Hellen; Mwangi, Christina; Mwangi, Jane W; Mwasekaga, Michael; Ng'Ang'A, Lucy W; Pillay, Yogan; Sarr, Abdoulaye; Sawadogo, Souleymane; Singer, Daniel; Stevens, Wendy; Toure, Christiane Adje; Nkengasong, John

    2015-11-27

    To achieve global targets for universal treatment set forth by the Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (UNAIDS), viral load monitoring for HIV-infected persons receiving antiretroviral therapy (ART) must become the standard of care in low- and middle-income countries (LMIC) (1). CDC and other U.S. government agencies, as part of the President's Emergency Plan for AIDS Relief, are supporting multiple countries in sub-Saharan Africa to change from the use of CD4 cell counts for monitoring of clinical response to ART to the use of viral load monitoring, which is the standard of care in developed countries. Viral load monitoring is the preferred method for immunologic monitoring because it enables earlier and more accurate detection of treatment failure before immunologic decline. This report highlights the initial successes and challenges of viral load monitoring in seven countries that have chosen to scale up viral load testing as a national monitoring strategy for patients on ART in response to World Health Organization (WHO) recommendations. Countries initiating viral load scale-up in 2014 observed increases in coverage after scale-up, and countries initiating in 2015 are anticipating similar trends. However, in six of the seven countries, viral load testing coverage in 2015 remained below target levels. Inefficient specimen transport, need for training, delays in procurement and distribution, and limited financial resources to support scale-up hindered progress. Country commitment and effective partnerships are essential to address the financial, operational, technical, and policy challenges of the rising demand for viral load monitoring. PMID:26605986

  17. Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition.

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

    Full Text Available BACKGROUND: Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa. METHODOLOGY/PRINCIPAL FINDINGS: All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline. CONCLUSIONS/SIGNIFICANCE: System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement

  18. Lost opportunities in HIV prevention: programmes miss places where exposures are highest

    OpenAIRE

    Siziya Seter; Sandøy Ingvild F; Fylkesnes Knut

    2008-01-01

    Abstract Background Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence. Methods The PLACE method was used to collect data. Inhabitants of selected communities in Lusaka and Li...

  19. Infrastructure and other considerations to launch nuclear power programme: The case of sub-sahara African developing countries like Ethiopia

    International Nuclear Information System (INIS)

    The Sub-Saharan countries are new to launch a nuclear power (NP) programme. If they are interested to consider this technology, they should be highly committed to develop the required basic infrastructure in stages; and should conduct important activities that need to be completed in phases. This include longer than 100 years of maintaining a sustainable national infrastructure throughout its operation, decommissioning and waste disposal. The major challenges to launch a NP programme in these countries are; lack of funding, inadequate technical know-how, lack of information on the available resources, low grid capacity of nations, lack of required organizations and physical component of the infrastructure. However, there are also encouraging aspects such as commitment to expand electric supply to rural areas, strategic shift to diversify energy sources, availability of uranium (thorium) reserves, availability of basic regulatory infrastructure in radiation protection and nuclear safety, and enhanced regional and international economic cooperation. In conclusion, the high level of poverty in Sub-Saharan countries mainly is due to lack of adequate energy and its poor coverage. It is vital to assert here that provision of sustainable and sufficient amount of energy in the region can greatly advance development, alleviate poverty and ensure stability. Besides, to come out of this cyclic challenge; countries based on regional economic cooperation and ideals of African Union, should interconnect their electricity grid like EAPP and commonly invest to launch NP programmes in relatively stable countries. Candid support of the international community is crucial, and IAEA should support and encourage such arrangements

  20. An assessment of a large-scale HIV prevention programme for high-risk men who have sex with men and transgenders in Andhra Pradesh, India: using data from routine programme monitoring and repeated cross-sectional surveys

    OpenAIRE

    Goswami, Prabuddhagopal; Rachakulla, Hari Kumar; Ramakrishnan, Lakshmi; Mathew, Shajan; Ramanathan, Shreena; George, Bitra; Adhikary, Rajatashuvra; Kodavalla, Venkaiah; Rajkumar, Hemalatha; Paranjape, Ramesh S.; G N V Brahmam

    2013-01-01

    Objectives To assess a large-scale intervention, the Avahan intervention, using an evaluation framework that included programme coverage, condom use and changes in sexually transmitted infection (STI) and HIV prevalence among high-risk men who have sex with men/transgender (HR-MSM/TG) in the state of Andhra Pradesh, India. Design Programme monitoring data and results from two rounds of cross-sectional integrated biological and behavioural assessment (IBBA) in 2006 (Round 1) and 2009 (Round 2)...

  1. Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial.

    Science.gov (United States)

    Mathews, Catherine; Eggers, Sander M; Townsend, Loraine; Aarø, Leif E; de Vries, Petrus J; Mason-Jones, Amanda J; De Koker, Petra; McClinton Appollis, Tracy; Mtshizana, Yolisa; Koech, Joy; Wubs, Annegreet; De Vries, Hein

    2016-09-01

    Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61-0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV. PMID:27142057

  2. How can the quality of South African environmental management programmes be determined? / Ebenhaezer van Schalkwyk.

    OpenAIRE

    Van Schalkwyk, Ebenhaezer

    2013-01-01

    At the heart of Environmental Impact Assessment (EIA) lies the focus of identification and assessment of predicted impacts, with the management actions (i.e. Environmental Management Programmes) (EMPr) often being described only in illustrative terms. In order to promote effective Environmental Management (EM) it is important that the management actions arising from EIAs are clearly defined and translated into a good quality EMPr. The thesis had three aims, (1) to determine what is regard...

  3. South African CSP projects under the REIPPP programme - Requirements, challenges and opportunities

    Science.gov (United States)

    Relancio, Javier; Cuellar, Alberto; Walker, Gregg; Ettmayr, Chris

    2016-05-01

    Thus far seven Concentrated Solar Power (CSP) projects have been awarded under the Renewable Energy Independent Power Producer Procurement Programme (REIPPPP), totalling 600MW: one project is in operation, four under construction and two on their way to financial close. This provides an excellent opportunity for analysis of key features of the projects that have contributed to or detracted from the programme's success. The paper draws from Mott MacDonald's involvement as Technical Advisor on the seven CSP projects that have been successful under the REIPPPP to date as well as other global CSP developments. It presents how various programme requirements have affected the implementation of projects, such as the technical requirements, time of day tariff structure, economic development requirements and the renewable energy grid code. The increasingly competitive tariffs offered have encouraged developers to investigate efficiency maximising project configurations and cost saving mechanisms, as well as featuring state of the art technology in their proposals. The paper assesses the role of the project participants (developers, lenders and government) with regards to these innovative technologies and solutions. In our paper we discuss the status of projects and the SA market, analysing the main challenges and opportunities that in turn have influenced various aspects such as technology choice, operational regimes and supply chain arrangements.

  4. Lessons Learned From Delivering Imara, an HIV/STI Risk Reduction Intervention for African American Girls in Juvenile Detention.

    Science.gov (United States)

    Davis, Teaniese L; Boyce, Lorin S; Rose, Eve; Swartzendruber, Andrea; DiClemente, Ralph; Gelaude, Deborah; Fasula, Amy M; Carry, Monique

    2016-01-01

    A critical need exists for efficacious interventions to reduce sexual risk and sexually transmitted infections (STIs) among African American girls in juvenile detention. Adapting evidence-based interventions is one strategy for developing interventions that might protect detained African American girls from adverse sexual health outcomes. To support development and implementation of evidence-based HIV/STI prevention interventions for this population, this qualitative study describes lessons learned from delivering Imara, an adapted HIV/STI prevention intervention for detained African American girls. Program implementation includes one-on-one sessions in the detention facility that offer logistical advantages; provide intervention contact inside the facility, soon after release, and frequently thereafter; address STI treatment for girls and their sexual partners; tailor intervention content based on individual risk and learning needs; and identify and acknowledge girls' competing priorities. These lessons are discussed in the context of challenges encountered and solutions for addressing the challenges, and in terms of the structure and content of the intervention. The lessons learned from delivering Imara exemplify the continuous process of adapting an existing intervention for a new population and setting. PMID:26452768

  5. Improving medication adherence in African-American women living with HIV/AIDS: Leveraging the provider role and peer involvement.

    Science.gov (United States)

    Okoro, Olihe; Odedina, Folakemi T

    2016-01-01

    African-American women continue to be disproportionately affected by HIV-related morbidity and mortality. To address the burden of HIV/AIDS among this at-risk population, there is need to gain a better understanding of the factors that influence and affect their care-seeking behavior and specifically adherence to antiretroviral treatment. A preliminary qualitative study was conducted with a sample of the target population (n = 10) using grounded theory as the methodological approach. Similarly, 21 healthcare providers - physicians, pharmacists, nurses, and case managers - were then interviewed. A thematic analysis of the transcripts compared care-provider perceptions and narrated experiences with those from the patient participants. Themes related to patient care perceived to enhance medication adherence included (1) provider-patient relationship; (2) holistic and patient-centered care; (3) adequacy of patient education and counseling; (4) modeling adherence behavior; and (5) motivation. Two intervention strategies are proposed - Peer educators as an integral part of the care team and Patient Advisory Groups as a feedback mechanism to enhance effective delivery of patient care in the target population. This exploratory research lays a foundation for the design of targeted interventions to improve linkage to care and enhance medication adherence in African-American women living with HIV/AIDS. PMID:26278429

  6. Differential effects of sex in a West African cohort of HIV-1, HIV-2 and HIV-1/2 dually infected patients

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Hønge, Bo Langhoff; Esbjörnsson, Joakim;

    2016-01-01

    OBJECTIVES: Several studies have reported conflicting effects of sex on HIV-1 infection. We describe differences in baseline characteristics and assess the impact of sex on HIV progression among patients at a clinic with many HIV-2 and HIV-1/2 dually infected patients. METHODS: This study utilised...... visit until initiation of ART, death or loss to follow-up using Cox proportional hazard models. RESULTS: A total of 5694 patients were included in the study, 3702 women (65%) and 1992 men (35%). Women were more likely than men to be infected with HIV-2 (19% vs. 15%, P < 0.01) or dually infected with HIV...

  7. HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

    Science.gov (United States)

    Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

    2016-06-01

    The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention. PMID:26873022

  8. Effectiveness of HIV/AIDS School-based Programme Delivery on Behaviour Change for Sustainable Development among Zimbabwean ‘O’ Level Secondary School Students

    Directory of Open Access Journals (Sweden)

    Muguwe Emely

    2012-10-01

    Full Text Available This study was carried out to find out the effectiveness of HIV/AIDS School-based programme delivery on behavior change for sustainable development among Zimbabwean ‘O’ secondary school students. The sample consisted of one hundred and twenty students, twenty-four teachers and twelve school heads, drawn from the twelve secondary schools in GweruUrban District of Zimbabwe. Simple random sampling technique was used to come up with a sample of students while teachers and heads were purposively sampled. Questionnaires were administered to students and teachers while school heads were interviewed. The study found out that the school based programme is effective to a reasonable extent. The majority of the respondents rated the programme as important since it helped to bring awareness to students that AIDS is a reality. Heads revealed that HIV/AIDS should be examinable for it to get the attention that it deserves. Results indicated that students were aware of the objectives of the programme. Students revealed that areas mostly emphasized in delivery were, peer pressure resistance and decision making, communication and attitudes and facts about HIV/AIDS. Students revealed that they had managed to maintain and or change their behaviour as a result of programme delivery. However teachers indicated that peer pressure remained a serious problem among the youth and rendered some aspects of the programme ineffective. Some heads indicated that behaviour change was a long term process which required a close follow-up. One of the heads indicated that students benefitted from the programme. Peer education was rated an effective strategy in programme delivery. Teachers and heads cited time constraints, some students’ negative attitudes, shortage of resources and large enrolments as some of the major challenges in programme delivery. Students cited problems of peer pressure and unavailability of literature and unruly behaviours. Students revealed that

  9. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

    Directory of Open Access Journals (Sweden)

    Maher Dermot

    2010-07-01

    Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

  10. Failure of a novel, rapid antigen and antibody combination test to detect antigen-positive HIV infection in African adults with early HIV infection.

    Directory of Open Access Journals (Sweden)

    William Kilembe

    Full Text Available BACKGROUND: Acute HIV infection (prior to antibody seroconversion represents a high-risk window for HIV transmission. Development of a test to detect acute infection at the point-of-care is urgent. METHODS: Volunteers enrolled in a prospective study of HIV incidence in four African cities, Kigali in Rwanda and Ndola, Kitwe and Lusaka in Zambia, were tested regularly for HIV by rapid antibody test and p24 antigen ELISA. Five subgroups of samples were also tested by the Determine Ag/Ab Combo test 1 Antigen positive, antibody negative (acute infection; 2 Antigen positive, antibody positive; 3 Antigen negative, antibody positive; 4 Antigen negative, antibody negative; and 5 Antigen false positive, antibody negative (HIV uninfected. A sixth group included serial dilutions from a p24 antigen-positive control sample. Combo test results were reported as antigen positive, antibody positive, or both. RESULTS: Of 34 group 1 samples with VL between 5x105 and >1.5x107 copies/mL (median 3.5x106, 1 (2.9% was detected by the Combo antigen component, 7 (20.6% others were positive by the Combo antibody component. No group 2 samples were antigen positive by the Combo test (0/18. Sensitivity of the Combo antigen test was therefore 1.9% (1/52, 95% CI 0.0, 9.9. One false positive Combo antibody result (1/30, 3.3% was observed in group 4. No false-positive Combo antigen results were observed. The Combo antigen test was positive in group 6 at concentrations of 80 pg/mL, faintly positive at 40 and 20 pg/mL, and negative thereafter. The p24 ELISA antigen test remained positive at 5 pg/mL. CONCLUSIONS: Although the antibody component of the Combo test detected antibodies to HIV earlier than the comparison antibody tests used, less than 2% of the cases of antigen-positive HIV infection were detected by the Combo antigen component. The development of a rapid point-of-care test to diagnose acute HIV infection remains an urgent goal.

  11. A decade of an HIV workplace programme in armed conflict zones; a social responsibility response of the International Committee of the Red Cross.

    Science.gov (United States)

    Du Mortier, Stéphane; Mukangu, Silas; Sagna, Charles; Nyffenegger, Laurent; Aebischer Perone, Sigiriya

    2016-01-01

    The International Committee of the Red Cross (ICRC) works in fragile States and in armed conflict zones. Some of them are affected by the HIV pandemic. Within the framework of its social responsibility programme concerning HIV affecting its staff members, the organization has implemented an HIV workplace programme since 2004. We carried out a retrospective analysis over 10 years. Data collected were initially essentially qualitative and process-oriented, but were complemented over the years by data on annual voluntary counselling and testing (VCT) uptake and on direct annual costs covering awareness, testing and antiretroviral therapy. The number of people covered by the programme grew from none in 2003 to 4,438 in 2015, with an increase in annual VCT uptake over the years increasing from 376 persons (14 %) in 2007 to 2,663 in 2015 (60 %). Over the years, the services were expanded from awareness raising to bringing VCT to the workplace, as well as offering testing and health coverage of other conditions and innovative approaches to facing challenges linked to situations of violence. Within its social responsibility framework, the ICRC has shown the importance and feasibility of a workplace HIV programme in conflict zones. A sustainable workplace programme in these conflict settings requires constant adaptation, with regular follow-up given the relatively high turnover of staff, and ensuring sustainable stocks of condoms and antiretroviral drugs. PMID:27247611

  12. Nurse educators’ experiences of case-based education in a South African nursing programme

    Directory of Open Access Journals (Sweden)

    Felicity M. Daniels

    2015-07-01

    Full Text Available Background: A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE approach was adopted for the delivery of the Bachelor of Nursing programme in 2005.Aim: The aim of the study was to explore nurse educators’ experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape.Methods: A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data.Results: Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening.Conclusion: It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.

  13. Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial.

    Directory of Open Access Journals (Sweden)

    Prudence Ive

    Full Text Available BACKGROUND: Hepatitis B virus (HBV infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA 'Safeguard the household study' in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART initiation. METHODS: 812 participants from two South African townships Soweto and Masiphumelele were enrolled in a randomized trial of ART (CIPRA-SA. Participants were tested for hepatitis B surface antigen (HBsAg, hepatitis B e antigen (HBeAg, and HBV DNA. FIB-4 scores were calculated at baseline. RESULTS: Forty-eight (5.9% were HBsAg positive, of whom 28 (58.3% were HBeAg positive. Of those with HBV, 29.8% had an HBV DNA<2000 IU/ml and ALT<40 IU/ml ; 83.0% had a FIB-4 score <1.45, consistent with absent or minimal liver disease. HBV prevalence was 8.5% in Masiphumelele compared to 3.8% in Soweto (relative risk 2.3; 95% CI: 1.3-4.0. More participants in Masiphumelele had HBeAg-negative disease (58% vs. 12%, p = 0.002 and HBV DNA levels ≤2000 IU/ml, (43% vs. 6% p<0.007. CONCLUSION: One third of HIV/HBV co-infected subjects had low HBV DNA levels and ALT while the majority had indicators of only mild liver disease. There were substantial regional differences in HBsAg and HbeAg prevalence in HIV/HBV co-infection between two regions in South Africa. This study highlights the absence of severe liver disease and the marked regional differences in HIV/HBV co-infection in South Africa and will inform treatment decisions in these populations.

  14. Discrimination and Hate Crimes in the Context of Neighborhood Poverty and Stressors Among HIV-Positive African-American Men Who Have Sex with Men.

    Science.gov (United States)

    Dale, Sannisha K; Bogart, Laura M; Galvan, Frank H; Wagner, Glenn J; Pantalone, David W; Klein, David J

    2016-06-01

    In a sample of HIV-positive African-American men who have sex with men (MSM), we examined neighborhood factors that may contextualize perceived discrimination from three intersecting stigmatized characteristics: race, HIV status, and sexual orientation. HIV-positive African-American MSM (N = 162, mean age = 44, SD = 8) provided information on neighborhood-related stressors and discrimination experiences related to being Black, HIV-positive, or perceived as gay. Residential ZIP codes and US Census data were used to determine neighborhood poverty rates. Regressions, controlling for socio-demographics, indicated that (1) higher neighborhood poverty was significantly related to more frequent experiences with hate crimes (Gay-related: b = 1.15, SE = .43, p poverty and related stressors are associated with experiencing more discrimination and hate crimes. Interventions for this group should promote individual- and neighborhood-level socioeconomic empowerment and stigma reduction. PMID:26696119

  15. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Roger J. Chin, MA, MPA

    2015-04-01

    Full Text Available Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President’s Emergency Plan for AIDS Relief (PEPFAR with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country’s HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

  16. Microbicides Development Programme: design of a phase III trial to measure the efficacy of the vaginal microbicide PRO 2000/5 for HIV prevention

    OpenAIRE

    Pool Robert; Crook Angela M; McCormack Sheena; Nunn Andrew; Rutterford Clare; Hayes Richard

    2009-01-01

    Abstract Background With 2.5 million new HIV infections per year, effective preventive methods against HIV are urgently needed, especially in sub-Saharan Africa. MDP301 is an ongoing trial of the vaginal microbicide PRO 2000/5 being conducted by the Microbicides Development Programme. The main objective of the trial is to determine the efficacy and safety of 0.5% and 2% concentrations of PRO 2000/5 gel compared to placebo in preventing vaginally acquired HIV infection. Methods/Design MDP301 i...

  17. Functional analysis of 'a' determinant mutations associated with occult HBV in HIV-positive South Africans.

    Science.gov (United States)

    Powell, Eleanor A; Boyce, Ceejay L; Gededzha, Maemu P; Selabe, Selokela G; Mphahlele, M Jeffrey; Blackard, Jason T

    2016-07-01

    Occult hepatitis B is defined by the presence of hepatitis B virus (HBV) DNA in the absence of hepatitis B surface antigen (HBsAg). Occult HBV is associated with the development of hepatocellular carcinoma, reactivation during immune suppression, and virus transmission. Viral mutations contribute significantly to the occult HBV phenotype. Mutations in the 'a' determinant of HBsAg are of particular interest, as these mutations are associated with immune escape, vaccine escape and diagnostic failure. We examined the effects of selected occult HBV-associated mutations identified in a population of HIV-positive South Africans on HBsAg production in vitro. Mutations were inserted into two different chronic HBV backbones and transfected into a hepatocyte-derived cell line. HBsAg levels were quantified by enzyme-linked immunosorbent assay (ELISA), while the detectability of mutant HBsAg was determined using an HA-tagged HBsAg expression system. Of the seven mutations analysed, four (S132P, C138Y, N146D and C147Y) resulted in decreased HBsAg expression in one viral background but not in the second viral background. One mutation (N146D) led to a decrease in HBsAg detected as compared to HA-tag, indicating that this mutation compromises the ability of the ELISA to detect HBsAg. The contribution of occult-associated mutations to the HBsAg-negative phenotype of occult HBV cannot be determined adequately by testing the effect of the mutation in a single viral background, and rigorous analysis of these mutations is required. PMID:27031988

  18. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    OpenAIRE

    Imrie John; Newell Marie-Louise; Harrison Abigail; Hoddinott Graeme

    2010-01-01

    Abstract Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, ...

  19. Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol

    OpenAIRE

    Watkins, David A.; Tulloch, Nathaniel L.; Anderson, Molly E.; Barnhart, Scott; Steyn, Krisela; Levitt, Naomi S.

    2016-01-01

    Background People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the curr...

  20. African HIV/AIDS trials are more likely to report adequate allocation concealment and random generation than North American trials.

    Directory of Open Access Journals (Sweden)

    Nandi Siegfried

    Full Text Available BACKGROUND: Adherence to good methodological quality is necessary to minimise bias in randomised conrolled trials (RCTs. Specific trial characteristics are associated with better trial quality, but no studies to date are specific to HIV/AIDS or African trials. We postulated that location may negatively impact on trial quality in regions where resources are scarce. METHODS: 1 To compare the methodological quality of all HIV/AIDS RCTs conducted in Africa with a random sample of similar trials conducted in North America; 2 To assess whether location is predictive of trial quality. We searched MEDLINE, EMBASE, CENTRAL and LILACS. Eligible trials were 1 randomized, 2 evaluations of preventive or treatment interventions for HIV/AIDS, 3 reported before 2004, and 4 conducted wholly or partly (if multi-centred in Africa or North America. We assessed adequacy of random generation, allocation concealment and masking of assessors. Using univariate and multivariate logistic regression analyses we evaluated the association between location (Africa versus North America and these domains. FINDINGS: The African search yielded 12,815 records, from which 80 trials were identified. The North American search yielded 13,158 records from which 785 trials were identified and a random sample of 114 selected for analysis. African trials were three times more likely than North American trials to report adequate allocation concealment (OR = 3.24; 95%CI: 1.59 to 6.59; p<0.01 and twice as likely to report adequate generation of the sequence (OR = 2.36; 95%CI: 1.20 to 4.67; p = 0.01, after adjusting for other confounding factors. Additional significant factors positively associated with quality were an a priori sample size power calculation, restricted randomization and inclusion of a flow diagram detailing attrition. We did not detect an association between location and outcome assessor masking. CONCLUSIONS: The higher quality of reporting of methodology in African trials is

  1. The Experience of Sexual Risk Communication in African American Families Living with HIV

    Science.gov (United States)

    Cederbaum, Julie A.

    2012-01-01

    Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV…

  2. Measures needed to strengthen strategic HIV/AIDS prevention programmes in China.

    Science.gov (United States)

    Chen, P

    2007-01-01

    This paper traces the commonly believed three phases of the HIV/AIDs epidemic in China from the early 1980s to the present time and reviews how the Chinese Government and NGOs are dealing with the crisis. Transmission routes for HIV infection in China are thought to be via IDUs, blood plasma donors, sexual contacts and from mother-to-child transmissions. The author examined interventions for HIV/ AIDS prevention tried in other countries that could provide useful lessons learned and discussed how they could be adapted or replicated in China. While recognising the need for the treatment of HIV positive persons and AIDS patients, this paper is limited to suggesting a number of proven strategic interventions to prevent new HIV infections in China among the "general population", adolescents in schools, sex workers and their clients, injecting drug users, and, prevention of mother to child transmission of HIV/AIDS to stem the epidemic. An extensive literature search of articles in published academic journals, published and unpublished documents of international agencies and development NGOs and media reports was conducted for data source to this paper. Internet search engines such as ProQuest, PubMed, Google and Yahoo search engines were used as well as hard copies of reports and internal documents available at the UNFPA Country Technical Services Team's Office in Bangkok tapped for information. PMID:17784652

  3. Integration of health systems and priority health interventions: a case study of the integration of HIV and TB control programmes into the general health system in Vietnam.

    Science.gov (United States)

    Conseil, Alexandra; Mounier-Jack, Sandra; Coker, Richard

    2010-11-01

    This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integration was ultimately classified as being 'fully/predominantly integrated', 'partially integrated', 'not or predominantly not integrated'. The results showed that none of the six programme functions was fully integrated into the general health care system as a whole. They were established either in parallel, notably at higher administrative levels, or were partially integrated. The study findings also revealed that little integration across all functional levels has occurred between the two programmes. Generally international agencies and sub-national domestic stakeholders supported more integration between vertical programmes (HIV and TB) and the general health systems, while national bodies responsible for HIV and TB favoured reinforcing a more vertical and thus less integrated approach. In the absence of shared assumptions and goals, this polarization of views may result in sub-optimal effectiveness and efficiency of each of the disease programmes as well as of HIV/TB interventions. PMID:20966106

  4. Feasibility of provider-initiated HIV testing and counselling of tuberculosis patients under the TB control programme in two districts of South India.

    Directory of Open Access Journals (Sweden)

    Sophia Vijay

    Full Text Available BACKGROUND: Provider-initiated HIV testing and counselling (PITC is internationally recommended for tuberculosis (TB patients, but the feasibility, effectiveness, and impact of this policy on the TB programme in India are unknown. We evaluated PITC of TB patients across two districts in India considered to have generalized HIV epidemics, Tiruchirappalli (population 2.5 million and Mysore (population 2.8 million. METHODOLOGY/PRINCIPAL FINDINGS: Starting June 2007, healthcare providers in both districts were instructed to ascertain HIV status for all TB patients, and refer those with unknown HIV status to the nearest Integrated Counselling and Testing Centre (ICTC--often in the same facility--for counselling and voluntary HIV testing. All TB patients registered from June 2007 to March 2008 were followed prospectively. Field investigators assessed PITC practices and abstracted data from routine TB programme records and HIV counselling registers to determine the proportion of TB patients appropriately evaluated for HIV infection. Patient records were traced to determine the efficiency of referral links to HIV care and antiretroviral treatment (ART. Between July 2007 and March 2008, 5299 TB patients were registered in both study districts. Of the 4701 with unknown HIV status at the time of TB treatment initiation, 3368 (72% were referred to an ICTC, and 3111 (66% were newly tested for HIV. PITC implementation resulted in the ascertainment of HIV status for 3709/5299 (70% of TB patients, and detected 200 cases with previously undiagnosed HIV infection. Overall, 468 (8.8% of all registered TB patients were HIV-infected; 177 (37% were documented to have also received any ART. CONCLUSIONS: With implementation of PITC in India, HIV status was successfully ascertained for 70% of TB patients. Previously undiagnosed HIV-infection was detected in 6.4% of those TB patients newly tested, enabling referral for life-saving anti-retroviral treatment. ART uptake

  5. Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection

    Directory of Open Access Journals (Sweden)

    Lai S

    2013-08-01

    Full Text Available Shenghan Lai,1–4 Elliot K Fishman,2 Gary Gerstenblith,3 Jeffrey Brinker,3 Hong Tai,1 Shaoguang Chen,1 Ji Li,4 Wenjing Tong,1 Barbara Detrick,1 Hong Lai2 1Department of Pathology, 2Department of Radiology, 3Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA; 4Department of Epidemiology, John Hopkins University, Johns Hopkins Bloomberg School of Public Heath, Baltimore, MD, USA Objective: Patients with HIV infection are at increased risk for coronary artery disease (CAD, and growing evidence suggests a possible link between vitamin D deficiency and clinical/subclinical CAD. However, the relationship between vitamin D deficiency and coronary artery calcification (CAC, a sensitive marker for subclinical CAD, in those with HIV infection is not well investigated. Methods: CAC was quantified using a Siemens Cardiac 64 scanner, and vitamin D levels and the presence of traditional and novel risk factors for CAD were obtained in 846 HIV-infected African American (AA participants aged 25 years or older in Baltimore, MD, USA without symptoms or clinical evidence of CAD. Results: The prevalence of vitamin D deficiency (25-hydroxy vitamin D <10 ng/mL was 18.7%. CAC was present in 238 (28.1% of the 846 participants. Logistic regression analysis revealed that the following factors were independently associated with CAC: age (adjusted odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.08–1.14; male sex (adjusted OR: 1.71; 95% CI: 1.18–2.49; family history of CAD (adjusted OR: 1.53; 95% CI: 1.05–2.23; total cholesterol (adjusted OR: 1.006; 95% CI: 1.002–1.010; high-density lipoprotein cholesterol (adjusted OR: 0.989; 95% CI: 0.979–0.999; years of cocaine use (adjusted OR: 1.02; 95% CI: 1.001–1.04; duration of exposure to protease inhibitors (adjusted OR: 1.004; 95% CI: 1.001–1.007; and vitamin D deficiency (adjusted OR: 1.98; 95% CI: 1.31–3.00. Conclusion: Both vitamin D deficiency and CAC are prevalent in AAs with

  6. PCR-based identification of eight Lactobacillus species and 18 hr-HPV genotypes in fixed cervical samples of South African women at risk of HIV and BV.

    Science.gov (United States)

    Dols, Joke A M; Reid, Gregor; Kort, Remco; Schuren, Frank H J; Tempelman, Hugo; Bontekoe, Tj Romke; Korporaal, Hans; Van der Veer, E M; Smit, Pieter W; Boon, Mathilde E

    2012-06-01

    Vaginal lactobacilli assessed by PCR-based microarray and PCR-based genotyping of HPV in South African women at risk for HIV and BV. Vaginal lactobacilli can be defined by microarray techniques in fixed cervical samples of South African women. Cervical brush samples suspended in the coagulant fixative BoonFix of one hundred women attending a health centre for HIV testing in South Africa were available for this study. In the Ndlovu Medical Centre in Elandsdoorn, South Africa, identification of 18 hr-HPV genotypes was done using the INNO-LiPA method. An inventory of lactobacilli organisms was performed using microarray technology. On the basis of the Lactobacillus and Lactobacillus biofilm scoring, the cases were identified as Leiden bacterial vaginosis (BV) negative (BV-; n = 41), Leiden BV intermediate (BV±; n = 25), and Leiden BV positive (BV+; n = 34). Fifty-one women were HIV positive and 49 HIV negative. Out of the 51 HIV positive women, 35 were HPV infected. These 51 HIV positive women were frequently infected with HPV16 and HPV18. In addition, HPV35, HPV52, HPV33, and HPV66 were often detected in these samples. Lactobacillus salivarius and Lactobacillus iners were the most prevalent lactobacilli as established by the microarray technique. In women with HPV infection, the prevalence of Lactobacillus crispatus was significantly reduced. In both HIV and HPV infection, a similar (but not identical) shift in the composition of the lactobacillus flora was observed. We conclude that there is a shift in the composition of vaginal lactobacilli in HIV-infected women. Because of the prominence of HPV35, HPV52, HPV33, and HPV66, vaccination for exclusively HPV16 and HPV18 might be insufficient in South African HIV+ women. PMID:22021225

  7. Lost opportunities in HIV prevention: programmes miss places where exposures are highest

    Directory of Open Access Journals (Sweden)

    Siziya Seter

    2008-01-01

    Full Text Available Abstract Background Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence. Methods The PLACE method was used to collect data. Inhabitants of selected communities in Lusaka and Livingstone were interviewed about where people met new sexual partners. Signs of HIV preventive activities in these places were recorded. At selected venues, people were interviewed about their sexual behaviour. Peer educators and staff of NGOs were also interviewed. Results The places identified were mostly bars, restaurants or sherbeens, and fewer than 20% reported any HIV preventive activity such as meetings, pamphlets or posters. In 43% of places in Livingstone and 26% in Lusaka, condoms were never available. There were few active peer educators. Among the 432 persons in Lusaka and 676 in Livingstone who were invited for interview about sexual behaviour, consistent condom use was relatively high in Lusaka (77% but low in Livingstone (44% of men and 34% of women. Having no condom available was the most common reason for not using one. Condom use in Livingstone was higher among individuals socializing in places where condoms always were available. Conclusion In the places studied we found a high prevalence of behaviours with a high potential for HIV transmission but few signs of HIV preventive interventions. Covering the gaps in prevention in these high exposure places should be given the highest priority.

  8. A conceptual and analytical approach to comparative analysis of country case studies: HIV and TB control programmes and health systems integration

    DEFF Research Database (Denmark)

    Coker, Richard; Balen, Julie; Mounier-Jack, Sandra;

    2010-01-01

    make systematic comparisons to offer novel insights, to test new theories and to offer new hypotheses. We illustrate through a preliminary analysis how this framework can be applied to compare the impact of health systems integration and HIV and TB programmes in four countries in South-East Asia that...

  9. Cabergoline for suppression of puerperal lactation in a prevention of mother-to-child HIV-transmission programme in rural Malawi.

    OpenAIRE

    Buhendwa, L.; Zachariah, R.; Teck, R; Massaquoi, M; Kazima, J.; Firmenich, Peter; Harries, A. D.

    2008-01-01

    This study shows that cabergoline (single oral-dose) is an acceptable, safe and effective drug for suppressing puerperal lactation. It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings.

  10. Relationship between Housing Status and Retention Rates among HIV-Positive African Americans Enrolled in a Comprehensive Care Program.

    Science.gov (United States)

    Xiao, Hong; Mains, William

    2016-01-01

    Service provision using "one-stop shopping" of medical, psychiatric, and case management services at the same location has been associated with superior client retention. The Yadumu project tested this premise, with attention to HIV-infected African Americans. Each client was assigned a case manager, who arranged meetings with mental health, substance abuse, and medical care professionals. The Center for Mental Health Services, National Outcome Measures (CMHS NOMs) questionnaire was used to evaluate client progress. Data were collected longitudinally and the program evaluation was performed by an outside center. Among 129 clients, 47% were male, 30% were female, and 22% were transgender. The majority (72%) were African American. Clients who lived in detox/drug treatment programs had higher completion rates (48%) than those who were homeless or otherwise housed (28%) (p = 0.04). Logistic regression was used to assess associations between independent factors and retention. Clients satisfied with their housing situation were less likely to retain in the program than those who were not satisfied with their housing situation (OR = 0.15, 95% CI: 0.03-0.78). High discharge rates among HIV-infected people were observed and may reflect the unstable circumstances of the population studied, but structured residential programs could be advantageous for improving retention. PMID:26960017

  11. A preliminary evaluation of a community-based campaign to increase awareness of concurrency and HIV transmission in African American and African-Born communities.

    Science.gov (United States)

    Andrasik, Michele Peake; Clad, Rachel; Bove, Joanna; Tsegaselassie, Solomon; Morris, Martina

    2015-10-01

    We evaluate an innovative grassroots community-based campaign in Seattle, WA focused on educating African American and African-born communities about concurrent partnerships and HIV transmission. Respondents completed a short self-administered questionnaire on a handheld personal digital assistant to evaluate the reach, acceptability and preliminary efficacy of the campaign. Of those who remembered seeing the campaign materials (82 %), social networks were the most common source of exposure (80 %). Respondents rated campaign materials very visually attractive (86 %), very interesting (91 %), and very important for themselves (90 %) and their community (93 %). Respondents reported that the campaign increased their knowledge about concurrency (84 %), changed their attitudes about it (77 %), and 65 % said it was likely or very likely that they would change their behavior as a result. This inexpensive grassroots campaign demonstrated extensive reach in the local black community and was able to move beyond individual exposure and into social networks. PMID:25711296

  12. HIV/AIDS through the lens of Christianity: perspectives from a South African urban support group.

    Science.gov (United States)

    Hlongwana, K; Mkhize, S

    2007-05-01

    HIV is one of the most obscure viruses that humankind has had to face in recent times. Compounding this obscurity are often contesting perspectives on what it means to be HIV infected, and these perspectives are largely constituted by people's rationalisation of complex situations or experiences. Using qualitative research methods and ethnography in particular, this paper reflects on a broad understanding of what it means to live with HIV in the context of Christianity, using research participants' perspectives in an urban support group setting. Two fundamental patterns are evident in this paper: (1) as support group members rationalise their HIV infection, they continuously construct and reconstruct their identities; and (2) support group members rationalise their HIV infection to enhance their coping abilities, using Christianity and the Bible in particular, as a reference. Whilst rationalising HIV infection, three viewpoints emerge. The first viewpoint perceives HIV infection as an affliction by Satan; the second viewpoint sees it as originating from God; while the last viewpoint interprets HIV infection as a negotiated settlement between God and Satan. The paper is intended to trigger debate, and hopefully also to seek and provide answers from various sectors of society, and religious communities in particular, in order to help other HIV positive people in similar situations better manage their HIV condition. PMID:18040534

  13. Perceptions of HIV risks and prevention strategies by rural and small city African Americans who use cocaine: views from the inside.

    Science.gov (United States)

    Brown, Emma J; Hill, Mary Angelique

    2005-05-01

    HIV/AIDS disproportionately affects African Americans, yet knowledge gaps exist regarding their views of risks and effective prevention strategies. This focus group study of rural and small city African Americans who use drugs sought to assess these perceptions. Common views of HIV risks included drug use, physical appearance as an indicator of HIV status, intentional transmission, having multiple partners, unprotected sex, bisexuality, and unfounded trust. Trading sex for drugs and unprotected sex when high were seen as drug use/HIV risk links, while HIV education and condom use were identified as ways to decrease risk. Perceptions of effective strategies included community-based programs, gender specific groups, providing food or other incentives, and making the program fun. Healthcare professionals and parents were viewed as the best people to promote HIV prevention. Based on the findings, effective intervention for this target group should encompass ethnocentric community-based strategies that focus on HIV education, condom use skills, and drug risk reduction. PMID:16020054

  14. Maternal HIV/AIDS and depressive symptoms among inner-city African American youth: the role of maternal depressive symptoms, mother-child relationship quality, and child coping.

    Science.gov (United States)

    McKee, Laura; Jones, Deborah J; Roland, Erin; Coffelt, Nicole; Rakow, Aaron; Forehand, Rex

    2007-04-01

    This study was designed to examine interactions between psychosocial risk (i.e., maternal depressive symptoms) and protective (i.e., child coping skills and mother-child relationship quality) correlates of depressive symptoms among inner-city African American children of mothers with and without HIV/AIDS. Two primary hypotheses were tested: (a) whether these correlates interact differently in HIV-infected and noninfected samples and (b) whether child coping skills and a positive mother-child relationship interact to protect children from developing depressive symptoms in the context of maternal HIV infection. Results indicated that (a) a positive mother-child relationship, but not child coping skills, was protective in the HIV-infected sample when maternal depressive symptoms were high and (b) the combination of a positive mother-child relationship and child coping skills was associated with the lowest level of child depressive symptoms in the HIV-infected sample. These findings highlight the differential importance of various risk and protective mechanisms for HIV-infected and noninfected African American samples and, as such, have preventative implications for children of HIV-infected women. PMID:17535124

  15. Acceptability and Feasibility of Cash Transfers for HIV Prevention among Adolescent South African Women

    OpenAIRE

    MacPhail, Catherine; Adato, Michelle; Kahn, Kathleen; Selin, Amanda; Twine, Rhian; Khoza, Samson; Rosenberg, Molly; Nguyen, Nadia; Becker, Elizabeth; Pettifor, Audrey

    2013-01-01

    Women are at increased risk of HIV infection in much of sub-Saharan Africa. Longitudinal and cross-sectional studies have found an association between school attendance and reduced HIV risk. We report feasibility and acceptability results from a pilot of a cash transfer intervention conditional on school attendance paid to young women and their families in rural Mpumalanga, South Africa for the prevention of HIV infection. Twenty-nine young women were randomised to intervention or control and...

  16. InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2013-10-01

    Full Text Available Background: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world’s AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7–91.4%. Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1–31.0, after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions

  17. Soluble Urokinase Plasminogen Activator Receptor (suPAR) is Associated with Metabolic Changes in HIV-1-Infected Africans: A Prospective Study

    DEFF Research Database (Denmark)

    Fourie, Carla M T; Van Rooyen, Johannes M; Olsen, Michael H;

    2011-01-01

    -infected black South Africans had significantly higher suPAR levels than uninfected controls at baseline and at follow-up 3 years later. However, only the treated HIV-1-infected participants showed an increase in suPAR levels at follow-up. The treated group also showed signs of lipodystrophy and their...

  18. Influences on HIV Testing among Young African-American Men Who Have Sex with Men and the Moderating Effect of the Geographic Setting

    Science.gov (United States)

    Mashburn, Andrew J.; Peterson, John L.; Bakeman, Roger; Miller, Robin L.; Clark, Leslie F.

    2004-01-01

    This study examined the influence of demographic characteristics, risk behaviors, knowledge, and psychosocial variables on HIV testing among a sample (n = 551) of young African-American men who have sex with men (MSM) from three cities--Atlanta (n = 241), Birmingham (n = 174), and Chicago (n = 136). Among the entire sample of young men, age,…

  19. The Process of Adaptation of a Community-Level, Evidence-Based Intervention for HIV-Positive African American Men Who Have Sex with Men in Two Cities

    Science.gov (United States)

    Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.

    2012-01-01

    We describe the process of adapting a community-level, evidence-based behavioral intervention (EBI), Community PROMISE, for HIV-positive African American men who have sex with men (AAMSM). The Centers for Disease Control and Prevention (CDC) Map of the Adaptation Process (MAP) guided the adaptation process for this new target population by two…

  20. Challenges of Diagnosing Acute HIV-1 Subtype C Infection in African Women: Performance of a Clinical Algorithm and the Need for Point-of-Care Nucleic-Acid Based Testing

    OpenAIRE

    Mlisana, Koleka; Sobieszczyk, Magdalena; Werner, Lise; Feinstein, Addi; van Loggerenberg, Francois; NAICKER, Nivashnee; Williamson, Carolyn; Garrett, Nigel

    2013-01-01

    Background Prompt diagnosis of acute HIV infection (AHI) benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. Methods 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symp...

  1. Attitudes Toward HIV Voluntary Counseling and Testing (VCT) Among African American Men Who Have Sex With Men: Concerns Underlying Reluctance to Test.

    Science.gov (United States)

    St Lawrence, Janet S; Kelly, Jeffrey A; Dickson-Gomez, Julia; Owczarzak, Jill; Amirkhanian, Yuri A; Sitzler, Cheryl

    2015-06-01

    Contemporary antiretroviral therapy (ART) can produce viral suppression of HIV, maintain health, and prevent onward HIV transmission from infected persons to their sexual partners, giving rise to the concept of treatment as prevention. Successful implementation of test-and-treat strategies rests on the early detection of HIV infection through voluntary counseling and testing (VCT) followed by entry and retention in care, ART initiation and adherence, and subsequent viral suppression. In the United States, African American men who have sex with men (MSM) bear a disproportionate burden of HIV and have high rates of undetected and untreated HIV infection. However, little research has examined racial minority MSM's views about HIV testing. In this study, in-depth interviews were conducted with 96 key informants knowledgeable about racial minority MSM as well as 100 African American MSM community members in Milwaukee, Cleveland, and Miami. Most men in the sample were aware of the availability of testing and knew testing locations, but many voiced great personal ambivalence about being tested, feared knowing their HIV status, expressed concern about stigma and loss of confidentiality, and held beliefs indicative of medical mistrust. Participants did not spontaneously cite benefits of being tested, risk reduction behavior changes made as a consequence of testing, nor the benefits of testing to get early medical care for HIV infection. There is a gap between the public health field's perception of testing benefits and the beliefs about testing held by racial minority MSM in this sample. To increase the desired outcomes from VCT for minority MSM, VCT promotion should address the concerns of African American MSM and underscore the benefits of early entry into medical care. PMID:26010312

  2. Natural convection solar crop dryers in Kenya: Theory and practical application. African Energy Programme research report series no. 3

    International Nuclear Information System (INIS)

    The African Energy Programme (AEP) was established by the Commonwealth Science Council (CSC) to strengthen Africa's scientific and technical capabilities to develop and utilise the continent's enormous renewable energy resources to assist its socio-economic development. The AEP was conceived at a regional workshop held at Arusha, Tanzania in 1979, at which African researchers met to share their experiences of and explored the feasibility of establishing a collaborative regional R and D programme to develop and adapt technologies appropriate to the specific needs of the participating countries. The AEP researchers accorded the highest priority to seeking solutions to the energy problems of Africa's predominantly rural populations and identified eight project areas as the nodes for regional collaborative research and development: 1. Biogas for rural development; 2. Wood/Charcoal production and utilisation; 3. Solar crop drying; 4. Solar thermal heating and cooling; 5. Wind electricity generation; 6. Wind water pumping; 7. Resources Assessments; 8. Energy policy and planning. The primary goal of the AEP activities were to develop indigenous national capabilities to enable the examination and application of technological solutions appropriate to the unique problems and socio-cultural environments of each country. However, the severe limitations on expertise and the broad similarity of many of the critical problems favoured regional R and D cooperation around common techniques and methodologies in each project area. This work has made a significant contribution to Science and Technology. Prior to this work there was no detailed information in natural convection solar dryers. This work has exposed a number of critical design factors which must be considered in order to design an efficient dryer. Buoyancy-induced pressure inside the dryer, problems of multiple radiative heat exchange in the heater and cooling effects of wind have been studied in detail. The final dryer

  3. Readiness to Implement HIV Testing in African-American Church Settings.

    Science.gov (United States)

    Stewart, Jennifer M; Thompson, Keitra

    2016-04-01

    HIV and AIDS continue to impact Black Americans at disproportionately high rates. Promotion of HIV testing and linkage to care is a national health imperative for this population. As a pillar in the Black community, the Black Church could have a significant impact on the promotion of HIV testing within their churches and surrounding communities. Churches, however, have varied levels of involvement in testing. Furthermore, little is known about how to assess a church's readiness to integrate HIV testing strategies into its mission, much less how to promote this practice among churches. This qualitative study used interviews and focus groups with pastors and church leaders from four churches with varying levels of involvement in HIV testing to identify key stages in the progression of toward church-based HIV testing and linkage to care. Findings showed that churches progressed through levels of readiness, from refusal of the possibility of HIV interventions to full integration of HIV testing and linkage to care within the church. PMID:26019024

  4. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    Directory of Open Access Journals (Sweden)

    Imrie John

    2010-02-01

    Full Text Available Abstract Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1 study design and outcomes, 2 intervention design (content, curriculum, theory, adaptation process, 3 thematic focus and HIV causal pathways, 4 intervention delivery (duration, intensity, who, how, where. Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5 or group-based (3, involving in- and out-of-school youth. Primary outcomes included HIV incidence (2, reported sexual risk behavior alone (4, or with alcohol use (2. Interventions led to reductions in STI incidence (1, and reported sexual or alcohol risk behaviours (5, although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3, alcohol/substance use (2, or economic factors (2. Delivery methods and formats varied, and included teachers (5, peer educators (5, and older mentors (1. School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning.

  5. Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

    Science.gov (United States)

    Boyes, Mark E; Cluver, Lucie D

    2015-04-01

    South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention. PMID:24996836

  6. HIV Infection and the Epidemiology of Invasive Pneumococcal Disease (IPD in South African Adults and Older Children Prior to the Introduction of a Pneumococcal Conjugate Vaccine (PCV.

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    Susan Meiring

    Full Text Available Streptococcus pneumoniae is the commonest cause of bacteremic pneumonia among HIV-infected persons. As more countries with high HIV prevalence are implementing infant pneumococcal conjugate vaccine (PCV programs, we aimed to describe the baseline clinical characteristics of adult invasive pneumococcal disease (IPD in the pre-PCV era in South Africa in order to interpret potential indirect effects following vaccine use.National, active, laboratory-based surveillance for IPD was conducted in South Africa from 1 January 2003 through 31 December 2008. At 25 enhanced surveillance (ES hospital sites, clinical data, including HIV serostatus, were collected from IPD patients ≥ 5 years of age. We compared the clinical characteristics of individuals with IPD in those HIV-infected and -uninfected using multivariable analysis. PCV was introduced into the routine South African Expanded Program on Immunization (EPI in 2009.In South Africa, from 2003-2008, 17 604 cases of IPD occurred amongst persons ≥ 5 years of age, with an average incidence of 7 cases per 100 000 person-years. Against a national HIV-prevalence of 18%, 89% (4190/4734 of IPD patients from ES sites were HIV-infected. IPD incidence in HIV-infected individuals is 43 times higher than in HIV-uninfected persons (52 per 100 000 vs. 1.2 per 100 000, with a peak in the HIV-infected elderly population of 237 per 100 000 persons. Most HIV-infected individuals presented with bacteremia (74%, 3 091/4 190. HIV-uninfected individuals were older; and had more chronic conditions (excluding HIV than HIV-infected persons (39% (210/544 vs. 19% (790/4190, p<0.001. During the pre-PCV immunization era in South Africa, 71% of serotypes amongst HIV-infected persons were covered by PCV13 vs. 73% amongst HIV-uninfected persons, p = 0.4, OR 0.9 (CI 0.7-1.1.Seventy to eighty-five percent of adult IPD in the pre-PCV era were vaccine serotypes and 93% of cases had recognized risk factors (including HIV-infection for

  7. Financial obligations and economic barriers to antiretroviral therapy experienced by HIV-positive women who participated in a job-creation programme in northern Uganda.

    Science.gov (United States)

    Dovel, Kathryn; Thomson, Kallie

    2016-06-01

    Economic costs are commonly cited as barriers to women's use of antiretroviral therapy (ART) in sub-Saharan Africa; however, little is known about how changes in women's income influence economic barriers to care. We analysed in-depth interviews with 17 HIV-positive women who participated in a job-creation programme in northern Uganda and two key informant interviews with programme staff to examine lingering economic barriers to care experienced after programme enrolment. We found that participants continued to experience economic barriers even after receiving a steady income and improving their economic status. Two themes emerged: first, limited resources in health facilities (e.g. drug and staff shortages) led participants to view ART utilisation as a primarily economic endeavour where clients made informal payments for prompter service or sought treatment in private facilities where ART was readily available; second, increased economic status among participants increased expectations of economic reciprocity among participants' social networks. Financial obligations often manifested themselves in the form of caring for additional dependents, limiting the resources women could allocate toward their HIV treatment. When paired with limited resources in health facilities, increased financial obligations perpetuated the economic barriers experienced by participants. Job-creation programmes should consider how health institutions interact with participants' financial obligations to influence women's access to HIV services. PMID:26652011

  8. HIV counselling and testing utilisation and attitudes of male inmates in a South African prison.

    Science.gov (United States)

    Motshabi, Lelaka C; Pengpid, Supa; Peltzer, Karl

    2011-01-01

    The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction, their experiences and expectations, and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre, South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200 male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34, 95%CI: 0.23 - 0.50) was inversely associated with HIV testing acceptance in prison, while age, educational level, population group, marital status, length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50%) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services, ranging from 79% (fair to very good) for 'the way he/she received you' to 62% 'clarified all your concerns'. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctional centres especially with regard to VCT services. PMID:23237725

  9. Understanding client satisfaction with HIV testing and counseling services: a mixed-methods study in four African countries.

    Science.gov (United States)

    Osborn, Michelle; Obermeyer, Carla Makhlouf

    2016-06-01

    This paper uses mixed methods to provide comparative evidence across four African countries and identify those aspects of the testing experience that are the most important components of clients' satisfaction with services. We analyze data from three sources: a survey of clients at health facilities that included closed-ended questions about specific services and interactions around testing; responses to open-ended questions about testing experiences that were part of the same survey; and semi-structured interviews with a subsample of respondents who described their experience of testing and being diagnosed with HIV. High levels of reported satisfaction are found in both the survey and interview. The critical factors contributing to client satisfaction included: the three C's of testing-counseling, consent, and confidentiality, client-provider interactions, convenience of location, "good services", and reliable test results. PMID:26872848

  10. The Efficacy of Structural Ecosystems Therapy for HIV Medication Adherence with African American Women

    OpenAIRE

    Feaster, Daniel J; Brincks, Ahnalee M.; Mitrani, Victoria B.; Prado, Guillermo; Schwartz, Seth J.; Szapocznik, Jose

    2010-01-01

    A systemic family therapy intervention, Structural Ecosystems Therapy (SET), has been shown to promote adaptation to living with HIV by reducing psychological distress and family hassles. This investigation examines the effect of SET on HIV medication adherence relative to a person-centered condition and a community control condition. Medication adherence was assessed on 156 trial participants. Results of a two-part model showed that SET was significantly more likely to move women to high lev...

  11. SiHLEWeb.com: Development and usability testing of an evidence-based HIV prevention website for female African-American adolescents.

    Science.gov (United States)

    Danielson, Carla Kmett; McCauley, Jenna L; Gros, Kirstin Stauffacher; Jones, Andrea M; Barr, Simone C; Borkman, April L; Bryant, Brittany G; Ruggiero, Kenneth J

    2016-06-01

    African-American adolescent girls are at disproportionate risk for HIV infection. Although numerous evidence-based risk-reduction interventions exist, dissemination and implementation resources remain limited, and prevention services remain notably inaccessible to the very populations at highest risk for HIV infection. Internet delivery of HIV risk-reduction programming has promise as a mechanism for extending the reach of existing prevention efforts and overcoming barriers associated with traditional service delivery. This article (1) details the development process for the creation of SiHLEWeb, a web-adapted version of an evidence-based, culturally informed HIV prevention program traditionally delivered to female African-American adolescents via an in-person group format, and (2) presents findings from quantitative and qualitative usability testing conducted among 18 African-American girls (13-18 years). Results suggest that users found the website improved knowledge and learning, was helpful, efficient to use, and generally attractive. Users reported some concerns about website navigation. Implications for Internet delivery of health prevention programming are discussed. PMID:25167865

  12. SiHLEWeb.com: Development and Usability Testing of an Evidence-Based HIV/STI Prevention Website for Female African-American Adolescents

    Science.gov (United States)

    Danielson, Carla Kmett; McCauley, Jenna L.; Gros, Kirstin Stauffacher; Jones, Andrea M.; Barr, Simone C.; Borkman, April L.; Bryant, Brittany G.; Ruggiero, Kenneth J.

    2014-01-01

    African-American adolescent girls are at disproportionate risk for HIV infection. Although numerous evidence-based risk-reduction interventions exist, dissemination and implementation resources remain limited, and prevention services remain notably inaccessible to the very populations at highest risk for HIV infection. Internet delivery of HIV risk-reduction programming has promise as a mechanism for extending the reach of existing prevention efforts and overcoming barriers associated with traditional service delivery. This article: (1) details the development process for the creation of SiHLEWeb, a web-adapted version of an evidence-based, culturally-informed HIV prevention program traditionally delivered to female African-American adolescents via an in-person group format; and (2) presents findings from quantitative and qualitative usability testing conducted among 18 African-American girls (13–18). Results suggest that users found the website improved knowledge and learning, was helpful, efficient to use, and generally attractive. Users reported some concerns about website navigation. Implications for internet delivery of health prevention programming are discussed. PMID:25167865

  13. Transportation-related barriers to care among African American women living with HIV/AIDS: “What you getting out of the cab for?”

    Science.gov (United States)

    Evans, Shenell D.; Williams, Bryman E.

    2015-01-01

    Transportation-related problems have been consistently reported as barriers to accessing and remaining in HIV medical care, particularly among African American women living in under-resourced areas. With emphasis on the Southern region of the United States, this commentary presents a brief overview of the HIV/AIDS epidemic among African Americans, barriers to remaining in HIV care, and pilot data from a study conducted among African American women living in Mississippi. A small focus group study was conducted to examine the relative influence of transportation-related barriers on attendance and motivation to attend HIV medical care appointments. Eight African American women (mean age of 43.50, SD = 10.82) who were engaged in medical care participated in one focus group session. Time since diagnosis ranged from 6 to 17 years. Participants reported transportation-related barriers that were generally consistent with previous research, including lack of personal transportation, limited financial resources to pay family and friends for transportation or gasoline, and inconveniences associated with sharing van services with other patients. Participants appeared to have learned how to successfully navigate these barriers in order to remain in care. Interestingly, participants reported significant fear of disclosure related to use of transportation services provided by insurance providers and community organizations. Specifically, many of the women indicated that family, friends, and neighbors questioned them about where they were going and why they used taxis. These types of encounters might influence whether individuals utilize available transportation services. Participants provided several recommendations for improving the transportation system. Additional research is warranted to obtain a more representative sampling of opinions among African American women living in under-resourced areas. PMID:26523160

  14. Correlates of HIV Risk Reduction Self-Efficacy among Youth in South Africa

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    Julia Louw

    2012-01-01

    Full Text Available Even though a decline in HIV prevalence has been reported among South African youth 15–24 from 10.3% in 2005 to 8.6% in 2008, the prevalence remains disproportionately high for females overall in comparison to males. This study examines factors associated by HIV risk reduction self-efficacy of South African youth as part of an evaluation of the impact of loveLife, a youth focused HIV prevention programme. A cross-sectional population-based household survey was conducted with persons of ages 18 to 24 years in four selected provinces in South Africa. Among female respondents (, factors associated with high self-efficacy in the adjusted model were having a low HIV risk perception, HIV/AIDS stigma, ever using drugs, and having life goals. Male respondents ( with high self-efficacy were more likely to have been tested for HIV, have concurrent sexual partners, have had a transactional sex partner in lifetime, a low HIV risk perception, difficulty in having condoms, agreed with coercive sex, high relationship control, and had loveLife face-to-face programme participation. The factors identified with high self-efficacy and HIV-sexual risk behaviour may be considered to strengthen youth HIV prevention programmes in South Africa.

  15. Measuring Men's Gender Norms and Gender Role Conflict/Stress in a High HIV-Prevalence South African Setting.

    Science.gov (United States)

    Gottert, Ann; Barrington, Clare; Pettifor, Audrey; McNaughton-Reyes, Heath Luz; Maman, Suzanne; MacPhail, Catherine; Kahn, Kathleen; Selin, Amanda; Twine, Rhian; Lippman, Sheri A

    2016-08-01

    Gender norms and gender role conflict/stress may influence HIV risk behaviors among men; however scales measuring these constructs need further development and evaluation in African settings. We conducted exploratory and confirmatory factor analyses to evaluate the Gender Equitable Men's Scale (GEMS) and the Gender Role Conflict/Stress (GRC/S) scale among 581 men in rural northeast South Africa. The final 17-item GEMS was unidimensional, with adequate model fit and reliability (alpha = 0.79). Factor loadings were low (0.2-0.3) for items related to violence and sexual relationships. The final 24-item GRC/S scale was multidimensional with four factors: Success, power, competition; Subordination to women; Restrictive emotionality; and Sexual prowess. The scale had adequate model fit and good reliability (alpha = 0.83). While GEMS is a good measure of inequitable gender norms, new or revised scale items may need to be explored in the South African context. Adding the GRC/S scale to capture men's strain related to gender roles could provide important insights into men's risk behaviors. PMID:27209467

  16. Vitamin D deficiency is associated with development of subclinical coronary artery disease in HIV-infected African American cocaine users with low Framingham-defined cardiovascular risk

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    Lai H

    2013-11-01

    Full Text Available Hong Lai,1 Elliot K Fishman,1 Gary Gerstenblith,2 Richard Moore,2 Jeffrey A Brinker,2 Jeanne C Keruly,2 Shaoguang Chen,3 Barbara Detrick,3 Shenghan Lai1–31Department of Radiology, 2Department of Medicine, 3Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USAAbstract: Chronic cocaine use may lead to premature atherosclerosis, but the prevalence of and risk factors for coronary artery disease (CAD in asymptomatic cocaine users have not been reported. The objective of this study was to examine whether vitamin D deficiency is associated with the development of CAD in human immunodeficiency virus (HIV-infected African American cocaine users with low CAD risk.Methods: In this prospective follow-up study, we investigated 169 HIV-infected African American cocaine users with low Framingham risk at baseline. The main outcome measures were incidence of subclinical CAD and development of subclinical CAD.Results: Fifty of the 169 African Americans had evidence of subclinical disease on the initial cardiac computed tomography. A second cardiac computed tomography was performed on the 119 African Americans without disease on the first scan. The total sum of person-years of follow-up was 289.6. Subclinical CAD was detected in 11 of these, yielding an overall incidence of 3.80/100 person-years (95% confidence interval 1.90–6.80. Among the factors investigated, only vitamin D deficiency was independently associated with development of subclinical CAD. The study did not find significant associations between CD4 count, HIV viral load, or antiretroviral treatment use and the incidence of subclinical CAD. This study appears to suggest that there is a threshold level of vitamin D (10 ng/mL above which the effect of vitamin D on subclinical CAD is diminished.Conclusion: The incidence of subclinical CAD in HIV-infected African American cocaine users with low CAD risk is high, especially in those with vitamin D deficiency. Well designed

  17. Multi-analyte profiling of ten cytokines in South African HIV-infected patients with Immune Reconstitution Inflammatory Syndrome (IRIS

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    Worsley Catherine M

    2010-10-01

    Full Text Available Abstract Background Immune reconstitution inflammatory syndrome (IRIS is an important complication of HAART in sub-Saharan Africa, where opportunistic infections (OIs including mycobacteria and cryptococcus are common. The immune system's role in HIV infected patients is complex with cytokine expression strongly influencing HIV infection and replication. Methods We determined the expression patterns of 10 cytokines by Luminex multi-analyte profiling in 17 IRIS nested case-control pairs participating in a prospective South African cohort initiating anti-retroviral therapy. Results Interferon-gamma (IFN-γ expression was significantly elevated in IRIS cases compared to controls (median 9.88 pg/ml versus 2.68 pg/ml, respectively, P = 0.0057, while other cytokines displayed non-significant differences in expression. Significant correlation was observed between IL-6, IL-10, and IFN-γ expression in the IRIS patients. Conclusions Significantly increased expression levels of IFN-γ suggest that this cytokine possibly plays a role in IRIS pathology and is a potential diagnostic marker.

  18. How peer conversations about HIV/AIDS media messages affect comprehension and beliefs of young South African women.

    Science.gov (United States)

    Lubinga, E; Maes, A A; Jansen, C J M

    2016-12-01

    Most existent research on the effects of interpersonal discussions about health campaign messages is based on surveys. In this study, we analysed actual conversations about an HIV/AIDS poster to find out possible effects. Young South African women in 59 dyads (n = 118) participated in conversations about a deliberately puzzling HIV and AIDS poster that cautioned the target group to be faithful to one sexual partner. We measured their comprehension of the poster and beliefs about the message, before and after the conversations. Overall, actual comprehension (AC) was low, and we observed a large discrepancy between actual and perceived comprehension. In general, conversations did not improve AC. It proved to be even more probable that a correct interpretation before a conversation turned into an incorrect interpretation than the other way around. However, having a well-informed conversation partner increased the chance of acquiring adequate subsequent comprehension. We found, in general, that conversations did not decrease undesirable beliefs. One important undesirable belief even became reinforced after the conversations. Conversations among peers might be valuable in health campaigns, but our study shows that intended positive effects do not automatically follow. PMID:27310424

  19. 'Let Us Protect Our Future' a culturally congruent evidenced-based HIV/STD risk-reduction intervention for young South African adolescents.

    Science.gov (United States)

    Jemmott, L S; Jemmott, J B; Ngwane, Z; Icard, L; O'Leary, A; Gueits, L; Brawner, B

    2014-02-01

    One of the worst HIV/AIDS epidemics in the world is occurring in South Africa, where heterosexual exposure is the main mode of HIV transmission. Young people 15-24 years of age, particularly women, account for a large share of new infections. Accordingly, there is an urgent need for behavior-change interventions to reduce the incidence of HIV among adolescents in South Africa. However, there are few such interventions with proven efficacy for South African adolescents, especially young adolescents. A recent cluster-randomized controlled trial of the 'Let Us Protect Our Future!' HIV/STD risk-reduction intervention for Grade 6 South African adolescents (mean age = 12.4 years) found significant decreases in self-reported sexual risk behaviors compared with a control intervention. This article describes the intervention, the use of the social cognitive theory and the reasoned action approach to develop the intervention, how formative research informed its development and the acceptability of the intervention. Challenges in designing and implementing HIV/STD risk-reduction interventions for young adolescents in sub-Saharan Africa are discussed. PMID:23962491

  20. Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

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    Linda-Gail Bekker

    2016-02-01

    Full Text Available The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP guidelines in June 2012 for men who have sex with men (MSM who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

  1. Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities

    OpenAIRE

    Philip A Chan; Leandro Mena; Rupa Patel; Oldenburg, Catherine E.; Laura Beauchamps; PEREZ-BRUMER, Amaya G.; Sharon Parker; Mayer, Kenneth H.; Mimiaga, Matthew J.; Amy Nunn

    2016-01-01

    Introduction: Despite the efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV transmission, few studies have evaluated PrEP use and retention in care outcomes in real-world settings outside of clinical trials. Methods: Data were collected from PrEP clinical care programmes in three mid-size US cities: Providence, Rhode Island (RI); Jackson, Mississippi (MS); and St. Louis, Missouri (MO). We assessed the demographic and social characteristics of patients prescribed PrEP and documente...

  2. HIV and the urban homeless in Johannesburg

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    G M Lohrmann

    2012-11-01

    Full Text Available Background. There are few data on HIV prevalence and risk factors among inner-city homeless and marginally housed individuals in South Africa. Methods. We recruited 136 adults from a Johannesburg inner-city homeless clinic; mean age was 32.4 years, 129 (95% were male, and 90 (66% were of South African nationality. Participants were tested for HIV and answered a short demographic survey. Descriptive statistics and uni- and multivariate regression analyses were used for data analysis. Results. The HIV prevalence in the cohort was 23.5%. Transactional sex, relationship status, number of concurrent sexual partners, condom usage and history of previously treated sexually transmitted infections (STIs, living on the street, the use of alcohol or drugs, and previous exposure to voluntary counselling and testing (VCT, were not significant risk factors for HIV-positivity. Statistically significant HIV risk factors on multivariate analysis included the presence of an STI (odds ratio (OR 5.6; p<0.01 and unemployment (OR 6.7; p<0.01. South African nationality was a significant risk factor on univariate analysis (OR 2.99; p<0.05, but not on multivariate analysis (OR 2.2; p=0.17. Conclusion. The HIV prevalence in the sample did not differ appreciably from HIV prevalence estimates in other at-risk populations in similar settings, suggesting that homelessness in a South African city alone may not be a significant risk factor for HIV infection. HIV prevention efforts cannot be restricted to behaviour change programmes, but must be more holistic, recognising the protective role that employment has on HIV incidence.

  3. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium

    Science.gov (United States)

    Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald

    2016-01-01

    Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking “why me?” A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration

  4. Recurrent Giant Molluscum Contagiosum Immune Reconstitution Inflammatory Syndrome (IRIS) after Initiation of Antiretroviral Therapy in an HIV-infected South African Male

    OpenAIRE

    Drain, Paul K.; Mosam, Anisa; Gounder, Lilishia; Gosnell, Bernadett; Manzini, Thandekile; Moosa, Mahomed-Yunus S.

    2013-01-01

    We describe an HIV-infected South African male who experienced two distinct episodes of disseminated giant molluscum contagiosum (MC) immune reconstitution inflammatory syndrome (IRIS) over a 6-year period. The first episode of MC-IRIS occurred with rapid virologic suppression following antiretroviral therapy (ART) initiation. The second episode occurred during a rapid increase in CD4 cells following stable viral suppression with second-line ART. His MC lesions then completely resolved during...

  5. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

    Science.gov (United States)

    Jaquet, Antoine; Garanet, Franck; Balestre, Eric; Ekouevi, Didier K.; Azani, Jean Claude; Bognounou, René; Dah, Elias; Kondombo, Jean Charlemagne; Dabis, François; Drabo, Joseph

    2013-01-01

    Introduction The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30–44] and their median CD4 count was 181 cells/mm3 (IQR 97–269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p<10−4) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (p<10−2). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10−4) and 45.3 (p<10−3), respectively. Discussion The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the

  6. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Antoine Jaquet

    2013-12-01

    Full Text Available Introduction: The scale-up of highly active antiretroviral therapy (HAART has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods: HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS and mental (MHS summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36 questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results: A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR 30–44] and their median CD4 count was 181 cells/mm3 (IQR 97–269. The mean [standard deviation (SD] PHS score increased from 45.4 (11.1 at baseline to 60.0 (3.1 at 12 months (p < 10−4 and the mean (SD MHS score from 42.2 (8.7 to 43.9 (3.4 (p<10−2. After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9 and MHS (43.8 scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10−4 and 45.3 (p<10−3, respectively. Discussion: The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during

  7. The Blame Game: Stigma and HIV/AIDS in an African Metropolis

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    WA Akande

    2011-03-01

    Full Text Available "nBackground: The purpose of the present study was to explore further the cross-cultural validity, consistency, and replicability of FAIDSS among students when assessing HIV/AIDS-related stigma and fear of people living with HIV/AIDS (PLWHA in Lagos metropolis."nMethods: Using a purposive method, participants in Lagos Metropolis were surveyed using a questionnaire and concep­tualization derived from the work of Ross and Hunter (1992 to measure a variety of HIV-related attitudinal and behavioural items. Quantitative data analyzed employing factor analysis using maximum-likelihood extraction followed by oblique rotation (direct oblimin, delta= 0."nResults: On the factor scale measuring having fear of sex with a particular person, younger respondents especially females significantly more likely to report greater fear than for any other groups. Our findings further suggest that levels of fear of outsiders are high among males and need urgent action and intervention at both individual and societal levels."nConclusion: It is argued that messages and interventions must be targeted to promote a positive social environment for those living with or affected by HIV/AIDS, and to be useful in understanding stigma, fear and prejudice more fully and in reducing them. A crosscurrent behavioral change that can transform AIDS from an inevitably fatal pandemic to a chronic and manageable disease is the answer. 

  8. Potential future impact of a partially effective HIV vaccine in a southern African setting

    DEFF Research Database (Denmark)

    Phillips, Andrew N; Cambiano, Valentina; Nakagawa, Fumiyo;

    2014-01-01

    of a realistic future implementation scenario in resource limited settings. METHODS: An individual level model of HIV transmission, progression and the effect of antiretroviral therapy was used to predict the outcome to 2060 of introduction in 2025 of a partially effective vaccine with various...... public health goal....

  9. Clinical versus Rapid Molecular HIV Diagnosis in Hospitalized African Infants: A Randomized Controlled Trial Simulating Point-of-Care Infant Testing

    Science.gov (United States)

    McCollum, Eric D.; Preidis, Geoffrey A.; Maliwichi, Madalitso; Olson, Dan; McCrary, L. Madeline; Kazembe, Peter N.; van der Horst, Charles; Hoffman, Irving; Hosseinipour, Mina C.

    2014-01-01

    Objective Many African infants fail to receive their diagnostic HIV molecular test results and subsequently, antiretroviral therapy (ART). To determine whether a point-of-care molecular HIV test increases ART access for hospitalized Malawian infants, we simulated a point-of-care test using rapid HIV RNA polymerase chain reaction (Rapid PCR) and compared patient outcomes to an optimized standard care that included assessment with the World Health Organization (WHO) clinical algorithm for HIV infection plus a DNA PCR with a turnaround time of several weeks (standard care). Design Randomized controlled trial. Methods Hospitalized HIV-exposed Malawian infants <12 months old were randomized into Rapid PCR or standard care. Rapid PCR infants obtained molecular test results within 48 hours to facilitate immediate ART, similar to a point-of-care test. Standard care infants meeting clinical criteria were also offered inpatient ART. The primary outcome was appropriate in-hospital ART for DNA or RNA PCR-confirmed HIV-infected infants. Results 300 infants were enrolled. A greater proportion of HIV-infected infants receiving Rapid PCR, versus standard care, started inpatient ART (72.3% vs 47.8%, p=0.016). Among molecular test-negative infants, 26.9% receiving standard care unnecessarily initiated inpatient ART, versus 0.0% receiving Rapid PCR (p<0.001). Rapid PCR modestly reduced the median days to ART (3.0 vs 6.5, p=0.001) but did not influence outpatient follow-up for HIV-infected infants (78.1% vs 82.4%, P = 0.418). Conclusions Rapid PCR, versus an optimized standard care, increased the proportion of hospitalized HIV-infected infants initiating ART and reduced ART exposure in molecular test-negative infants, without meaningfully impacting time to ART initiation or follow-up rates. PMID:24326604

  10. Rational medication use review: a quality assurance/improvement process for HIV/AIDS treatment programme

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    Henry Fomundam

    2015-02-01

    Methods: A comprehensive data collection tool was developed to systematically and retrospectively capture relevant data from randomly selected ART patient files in the four ART facilities. Results: ART data from 157 patients receiving ART services from four facilities was extracted and analysed. WHO stage 4 AIDS defining diseases were recorded in 125 (79.6% of the patients at the time of ART initiation. The most frequent opportunistic infections and/or co-morbidities were cryptosporidiosis (14.4%, HIV wasting (14.4%, tuberculosis (13% and candidiasis (17.4%. 97.8% of the patients were taking concomitant medicines. A large percentage of patients (72.4% had done a baseline CD4 test before initiation of therapy with a majority of the patients (85.8% getting their lab results within one week of the collection of the specimens. For some patients (9%, it took up to 8 weeks to get test results. About 21.8% of the patients were hospitalized at least once while on ART and 11.2% of the hospitalized patients died. Conclusion: RMUR is a simple and accurate strategy that can be appropriately modified to suite local settings. It offers a cost-effective and participatory method of identifying any factors that may negatively affect the quality and desired outcomes of ART enabling prompt correction and continuous improvement of treatment related outcomes. [Int J Res Med Sci 2015; 3(2.000: 383-390

  11. Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.

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    Sophia Vijay

    Full Text Available BACKGROUND: There is paucity of data from India on the impact of HIV related immunosuppression in response to TB treatment and mortality among HIV infected TB patients. We assessed the TB treatment outcome and mortality in a cohort of HIV infected TB patients treated with intermittent short course chemotherapy under TB control programme in a high HIV prevalent district of south India. METHODOLOGY/ FINDINGS: Among 3798 TB patients registered for treatment in Mysore district from July 2007 to June 2008, 281 HIV infected patients formed the study group. The socio-demographic and treatment related data of these patients was obtained from TB and HIV programme records and patient interviews 19 months after TB treatment initiation by field investigators. Treatment success rate of 281 patients was 75% while in smear positive pulmonary tuberculosis cases it was 62%, attributable to defaults (16% and deaths (19%. Only 2 patients had treatment failure. Overall, 83 (30% patients were reported dead; 26 while on treatment and 57 after TB treatment. Association of treatment related factors with treatment outcome and survival status was studied through logistic regression analysis. Factors significantly associated with 'unfavourable outcome' were disease classification as Pulmonary [aOR-1.96, CI (1.02-3.77], type of patient as retreatment [aOR-4.78, CI (2.12-10.76], and non initiation of ART [aOR-4.90, CI (1.85-12.96]. Factors associated with 'Death' were non initiation of ART [aOR-2.80, CI (1.15-6.81] and CPT [aOR-3.46, CI (1.47-8.14]. CONCLUSION: Despite the treatment success of 75% the high mortality (30% in the study group is a matter of concern and needs immediate intervention. Non initiation of ART has emerged as a high risk factor for unfavourable treatment outcome and mortality. These findings underscore the importance of expanding and improving delivery of ART services as a priority and reconsideration of the programme guidelines for ART initiation in

  12. Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial.

    Science.gov (United States)

    DiClemente, Ralph J; Davis, Teaniese L; Swartzendruber, Andrea; Fasula, Amy M; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M; Brown, Jennifer L; Staples-Horne, Michelle

    2014-01-01

    Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N = 188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment, and counseling. At the 6-month assessment (3-months post-intervention), Imara participants reported higher condom use self-efficacy (p < 0.001), HIV/STI knowledge (p < 0.001), and condom use skills (p < 0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains. PMID:25190056

  13. Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

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    Alioum Ahmadou

    2011-06-01

    Full Text Available Abstract Background Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children. Methods All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation. Results 405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8 at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71 versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1 at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42. Conclusions Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.

  14. The Distribution of Obesity Phenotypes in HIV-Infected African Population

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    Kim Anh Nguyen

    2016-06-01

    Full Text Available The distribution of body size phenotypes in people with human immunodeficiency virus (HIV infection has yet to be characterized. We assessed the distribution of body size phenotypes overall, and according to antiretroviral therapy (ART, diagnosed duration of the infection and CD4 count in a sample of HIV infected people recruited across primary care facilities in the Western Cape Province, South Africa. Adults aged ≥ 18 years were consecutively recruited using random sampling procedures, and their cardio-metabolic profile were assessed during March 2014 and February 2015. They were classified across body mass index (BMI categories as normal-weight (BMI < 25 kg/m2, overweight (25 ≤ BMI < 30 kg/m2, and obese (BMI ≥ 30 kg/m2, and further classified according to their metabolic status as “metabolically healthy” vs. “metabolically abnormal” if they had less than two vs. two or more of the following abnormalities: high blood glucose, raised blood pressure, raised triglycerides, and low HDL-cholesterol. Their cross-classification gave the following six phenotypes: normal-weight metabolically healthy (NWMH, normal-weight metabolically abnormal (NWMA, overweight metabolically healthy (OvMH, overweight metabolically abnormal (OvMA, obese metabolically healthy (OMH, and obese metabolically abnormal (OMA. Among the 748 participants included (median age 38 years (25th–75th percentiles: 32–44, 79% were women. The median diagnosed duration of HIV was five years; the median CD4 count was 392 cells/mm3 and most participants were on ART. The overall distribution of body size phenotypes was the following: 31.7% (NWMH, 11.7% (NWMA, 13.4% (OvMH, 9.5% (OvMA, 18.6% (OMH, and 15.1% (OMA. The distribution of metabolic phenotypes across BMI levels did not differ significantly in men vs. women (p = 0.062, in participants below vs. those at or above median diagnosed duration of HIV infection (p = 0.897, in participants below vs. those at or above median

  15. The Distribution of Obesity Phenotypes in HIV-Infected African Population.

    Science.gov (United States)

    Nguyen, Kim Anh; Peer, Nasheeta; de Villiers, Anniza; Mukasa, Barbara; Matsha, Tandi E; Mills, Edward J; Kengne, Andre Pascal

    2016-01-01

    The distribution of body size phenotypes in people with human immunodeficiency virus (HIV) infection has yet to be characterized. We assessed the distribution of body size phenotypes overall, and according to antiretroviral therapy (ART), diagnosed duration of the infection and CD4 count in a sample of HIV infected people recruited across primary care facilities in the Western Cape Province, South Africa. Adults aged ≥ 18 years were consecutively recruited using random sampling procedures, and their cardio-metabolic profile were assessed during March 2014 and February 2015. They were classified across body mass index (BMI) categories as normal-weight (BMI pressure, raised triglycerides, and low HDL-cholesterol. Their cross-classification gave the following six phenotypes: normal-weight metabolically healthy (NWMH), normal-weight metabolically abnormal (NWMA), overweight metabolically healthy (OvMH), overweight metabolically abnormal (OvMA), obese metabolically healthy (OMH), and obese metabolically abnormal (OMA). Among the 748 participants included (median age 38 years (25th-75th percentiles: 32-44)), 79% were women. The median diagnosed duration of HIV was five years; the median CD4 count was 392 cells/mm³ and most participants were on ART. The overall distribution of body size phenotypes was the following: 31.7% (NWMH), 11.7% (NWMA), 13.4% (OvMH), 9.5% (OvMA), 18.6% (OMH), and 15.1% (OMA). The distribution of metabolic phenotypes across BMI levels did not differ significantly in men vs. women (p = 0.062), in participants below vs. those at or above median diagnosed duration of HIV infection (p = 0.897), in participants below vs. those at or above median CD4 count (p = 0.447), and by ART regimens (p = 0.205). In this relatively young sample of HIV-infected individuals, metabolically abnormal phenotypes are frequent across BMI categories. This highlights the importance of general measures targeting an overall improvement in cardiometabolic risk profile across

  16. The Heart of the Matter: Methodological Challenges in Developing a Contemporary 257-269 Reading Programme for Monolingual Lexicography, from the Perspective of the Dictionary Unit for South African English

    OpenAIRE

    Leela Pienaar

    2011-01-01

    Abstract: This article argues the importance of the reading programme as the pivotal issue inthe lexicographic process. It is essentially a practical article which outlines strategies for developingand implementing a reading programme for monolingual lexicography. The arguments are informedby theory, together with an examination of the data-collection procedures followed by theDictionary Unit for South African English (DSAE) and a survey of current practice in major Englishdictionary...

  17. Cervical dysplasia and HIV type 1 infection in African pregnant women: a cross sectional study, Kigali, Rwanda. The Pregnancy and HIV Study Group (EGE)

    OpenAIRE

    Leroy, V.; Ladner, J.; A. De Clercq; Meheus, A.; Nyiraziraje, M.; Karita, E; Dabis, F

    1999-01-01

    OBJECTIVE: To study the prevalence of cervical squamous intraepithelial lesions (SILs) and their association with HIV-1 infection and immunodeficiency among pregnant women in Kigali, Rwanda. METHODS: As part of a cohort study on the impact of HIV-1 infection on pregnancy outcome, HIV-1 seropositive (HIV+) and seronegative (HIV-) pregnant women were enrolled during the last trimester of pregnancy at the maternity ward of the Centre Hospitalier de Kigali from July 1992 to August 1993. At ...

  18. The Health Intervention Project: HIV risk reduction among African American women drug users.

    OpenAIRE

    Sterk, Claire E.

    2002-01-01

    OBJECTIVE: This article describes the Health Intervention Project, an intervention for African American women in Atlanta, Georgia, who are crack cocaine users. METHODS:A formative phase involved ethnographic mapping of the physical and social infrastructure of the study communities and in-depth interviews with women crack cocaine users. Key findings that were incorporated into the intervention program included the exchange of sex for money or drugs, the women's experience with trauma and abus...

  19. Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities

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    Bekan Brigitte

    2007-12-01

    Full Text Available Abstract Background Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods Influence Network Agents (INAs from the health, religious, non-governmental, and private sectors were trained to invite couples for CVCT. Predictors of successful promotion were identified using a multi-level hierarchical analysis. Results In 4 months, 9,900 invitations were distributed by 61 INAs, with 1,411 (14.3% couples requesting CVCT. INAs in Rwanda distributed fewer invitations (2,680 vs. 7,220 and had higher response rates (26.9% vs. 9.6%, than INAs in Zambia. Context of the invitation event, including a discreet location such as the INA's home (OR 3.3–3.4, delivery of the invitation to both partners in the couple (OR 1.6–1.7 or to someone known to the INA (OR 1.7–1.8, and use of public endorsement (OR 1.7–1.8 were stronger predictors of success than INA or couple-level characteristics. Conclusion Predictors of successful CVCT promotion included strategies that can be easily implemented in Africa. As new resources become available for Africans with HIV, CVCT should be broadly implemented as a point of entry for prevention, care and support.

  20. HIV diversity and drug resistance from plasma and non-plasma analytes in a large treatment programme in western Kenya

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    Rami Kantor

    2014-11-01

    Full Text Available Introduction: Antiretroviral resistance leads to treatment failure and resistance transmission. Resistance data in western Kenya are limited. Collection of non-plasma analytes may provide additional resistance information. Methods: We assessed HIV diversity using the REGA tool, transmitted resistance by the WHO mutation list and acquired resistance upon first-line failure by the IAS–USA mutation list, at the Academic Model Providing Access to Healthcare (AMPATH, a major treatment programme in western Kenya. Plasma and four non-plasma analytes, dried blood-spots (DBS, dried plasma-spots (DPS, ViveSTTM-plasma (STP and ViveST-blood (STB, were compared to identify diversity and evaluate sequence concordance. Results: Among 122 patients, 62 were treatment-naïve and 60 treatment-experienced; 61% were female, median age 35 years, median CD4 182 cells/µL, median viral-load 4.6 log10 copies/mL. One hundred and ninety-six sequences were available for 107/122 (88% patients, 58/62 (94% treatment-naïve and 49/60 (82% treated; 100/122 (82% plasma, 37/78 (47% attempted DBS, 16/45 (36% attempted DPS, 14/44 (32% attempted STP from fresh plasma and 23/34 (68% from frozen plasma, and 5/42 (12% attempted STB. Plasma and DBS genotyping success increased at higher VL and shorter shipment-to-genotyping time. Main subtypes were A (62%, D (15% and C (6%. Transmitted resistance was found in 1.8% of plasma sequences, and 7% combining analytes. Plasma resistance mutations were identified in 91% of treated patients, 76% NRTI, 91% NNRTI; 76% dual-class; 60% with intermediate-high predicted resistance to future treatment options; with novel mutation co-occurrence patterns. Nearly 88% of plasma mutations were identified in DBS, 89% in DPS and 94% in STP. Of 23 discordant mutations, 92% in plasma and 60% in non-plasma analytes were mixtures. Mean whole-sequence discordance from frozen plasma reference was 1.1% for plasma-DBS, 1.2% plasma-DPS, 2.0% plasma-STP and 2

  1. Current status of medication adherence and infant follow up in the prevention of mother to child HIV transmission programme in Addis Ababa: a cohort study

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    Mirkuzie Alemnesh H

    2011-10-01

    Full Text Available Abstract Background Prevention of mother to child HIV transmission (PMTCT programmes have great potential to achieve virtual elimination of perinatal HIV transmission provided that PMTCT recommendations are properly followed. This study assessed mothers and infants adherence to medication regimen for PMTCT and the proportions of exposed infants who were followed up in the PMTCT programme. Methods A prospective cohort study was conducted among 282 HIV-positive mothers attending 15 health facilities in Addis Ababa, Ethiopia. Descriptive statistics, bivariate and mulitivariate logistic regression analyses were done. Results Of 282 mothers enrolled in the cohort, 232 (82%, 95% CI 77-86% initiated medication during pregnancy, 154 (64% initiated combined zidovudine (ZDV prophylaxis regimen while 78 (33% were initiated lifelong antiretroviral treatment (ART. In total, 171 (60%, 95% CI 55-66% mothers ingested medication during labour. Of the 221 live born infants (including two sets of twins, 191 (87%, 95% CI 81-90% ingested ZDV and single-dose nevirapine (sdNVP at birth. Of the 219 live births (twin births were counted once, 148 (68%, 95% CI 61-73% mother-infant pairs ingested their medication at birth. Medication ingested by mother-infant pairs at birth was significantly and independently associated with place of delivery. Mother-infant pairs attended in health facilities at birth were more likely (OR 6.7 95% CI 2.90-21.65 to ingest their medication than those who were attended at home. Overall, 189 (86%, 95% CI 80-90% infants were brought for first pentavalent vaccine and 115 (52%, 95% CI 45-58% for early infant diagnosis at six-weeks postpartum. Among the infants brought for early diagnosis, 71 (32%, 95% CI 26-39% had documented HIV test results and six (8.4% were HIV positive. Conclusions We found a progressive decline in medication adherence across the perinatal period. There is a big gap between mediation initiated during pregnancy and actually

  2. Violence, homelessness, and HIV risk among crack-using African-American women.

    Science.gov (United States)

    Wechsberg, Wendee M; Lam, Wendy K K; Zule, William; Hall, Grace; Middlesteadt, Rachel; Edwards, Jessica

    2003-01-01

    This study compares the characteristics of out-of-treatment, homeless, crack-using African-American women with those who are not homeless to determine what risks and protective factors differentiate the two groups. From 1999 to 2001, 683 out-of-treatment, African-American crack-using women (of whom 219 were categorized as homeless) were interviewed and serologically tested. Risk factors that were examined include adverse childhood experiences, psychological distress, physical health, violence and victimization, drug use, and risky sex behaviors. Protective factors that were examined include marital status, education, public assistance, and the responsibility of caring for children. Overall, both groups of women started crack use in their mid-twenties and started drug use with alcohol in their teenage years, though differed significantly on each risk factor examined. Logistic regression analysis found that variables associated with increased odds of being homeless are physical abuse before age 18, crack runs greater than 24 hours, income less than dollars 500 in the last 30 days, depression, and current cigarette smoking. Protective factors found are marital status, living with children under 18, having had a physical in the past year, and receiving money from welfare in the last 30 days. Being sexually assaulted in the past 90 days was marginally associated with homelessness in the model. These findings, specific to crack-using African-American women, suggest that not only do these women overall report painful histories and currently stressful lives, but homeless women are more likely than women who are not homeless to have experienced childhood abuse and are more involved with drug use. Interventions designed for these women need to consider gender, cultural, and contextual issues that not only incorporate aspects of risk reduction related to violence, alcohol use, and comorbid conditions, but also linkages that will address housing issues, education, and skills

  3. Minority drug-resistant HIV-1 variants in treatment naive East-African and Caucasian patients detected by allele-specific real-time PCR.

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    Halime Ekici

    Full Text Available To assess the presence of two major non-nucleoside reverse transcriptase inhibitors (NNRTI drug resistance mutations (DRMs, Y181C and K103N, in minor viral quasispecies of treatment naïve HIV-1 infected East-African and Swedish patients by allele-specific polymerase chain reaction (AS-PCR.Treatment naïve adults (n=191 with three epidemiological backgrounds were included: 92 Ethiopians living in Ethiopia; 55 East-Africans who had migrated to Sweden; and 44 Caucasians living in Sweden. The pol gene was analysed by standard population sequencing and by AS-PCR for the detection of Y181C and K103N.The Y181C was detected in the minority quasispecies of six Ethiopians (6.5%, in two Caucasians (4.5%, and in one East-African (1.8%. The K103N was detected in one East- African (1.8%, by both methods. The proportion of mutants ranged from 0.25% to 17.5%. Additional DRMs were found in all three treatment naïve patient groups by population sequencing.Major NNRTI mutations can be found by AS-PCR in minor quasispecies of treatment naïve HIV-1 infected Ethiopians living in Ethiopia, in East-African and Caucasian patients living in Sweden in whom population sequencing reveal wild-type virus only. Surveys with standard sequencing are likely to underestimate transmitted drug resistance and the presence of resistant minor quasispecies in treatment naïve patients should be topic for future large scale studies.

  4. Oral manifestations among people living with HIV/AIDS in Tanzania

    DEFF Research Database (Denmark)

    Fabian, F M; Kahabuka, F K; Petersen, P E;

    2009-01-01

    BACKGROUND: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. METHODS: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living with...... HIV/AIDS, 16.6% were males and females 83.4%. Information on weight and height, as well as extra oral and intra oral examinations for different manifestations were gathered. Treatment and referral for special care were offered. RESULTS: At least one oral lesion was present in 45% of the participants...... associated with low body mass index (BMI). CONCLUSION: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should...

  5. CD4:CD8 lymphocyte ratio as a quantitative measure of immunologic health in HIV-1 infection: findings from an African cohort with prospective data

    Science.gov (United States)

    Tang, Jianming; Li, Xuelin; Price, Matthew A.; Sanders, Eduard J.; Anzala, Omu; Karita, Etienne; Kamali, Anatoli; Lakhi, Shabir; Allen, Susan; Hunter, Eric; Kaslow, Richard A.; Gilmour, Jill

    2015-01-01

    In individuals with human immunodeficiency virus type 1 (HIV-1) infection, CD4:CD8 lymphocyte ratio is often recognized as a quantitative outcome that reflects the critical role of both CD4+ and CD8+ T-cells in HIV-1 pathogenesis or disease progression. Our work aimed to first establish the dynamics and clinical relevance of CD4:CD8 ratio in a cohort of native Africans and then to examine its association with viral and host factors, including: (i) length of infection, (ii) demographics, (iii) HIV-1 viral load (VL), (iv) change in CD4+ T-lymphocyte count (CD4 slope), (v) HIV-1 subtype, and (vi) host genetics, especially human leukocyte antigen (HLA) variants. Data from 499 HIV-1 seroconverters with frequent (monthly to quarterly) follow-up revealed that CD4:CD8 ratio was stable in the first 3 years of infection, with a modest correlation with VL and CD4 slope. A relatively normal CD4:CD8 ratio (>1.0) in early infection was associated with a substantial delay in disease progression to severe immunodeficiency (hazards ratio (HR) = 0.43, 95% confidence interval (CI) = 0.29-0.63, P 1.0, but HLA variants (e.g., HLA-B*57 and HLA-B*81) previously associated with VL and/or CD4 trajectories in eastern and southern Africans had no obvious impact on CD4:CD8 ratio. Collectively, these findings suggest that CD4:CD8 ratio is a robust measure of immunologic health with both clinical and epidemiological implications. PMID:26191056

  6. The African traditional religious landscape: An examination of the role of traditional leaders in the fight against HIV and AIDS in Chipinge, Zimbabwe

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    Joel Marashe

    2014-01-01

    Full Text Available This study examines the role of traditional leaders, as custodians of culture, in the fight against infection with the HI virus and the AIDS pandemic in the Chipinge District of Zimbabwe. The research aims to assess traditional leaders� knowledge of HIV and AIDS and its causes. It also examines some traditional practices to determine whether they expose people to HIV and AIDS, and it evaluates the traditional leaders� roles in curbing the pandemic. From a phenomenological standpoint � and grounded in the African traditional religious landscape � the study uses a survey research design. A convenient sample of 18 participants for the study consisted of 3 chiefs and 5 headmen who completed a questionnaire as well as 5 village heads and 5 elders who were interviewed and involved in four focus-group discussions (FGDs that provided a variety of insightful information. The study identifies promiscuity as a major cause of HIV infection in communities. The results show that traditional leaders discourage barika and kuputsa as being harmful traditional marriage practices. Furthermore, the study indicates that traditional leaders encourage behavioural change amongst the youth and adults alike to curb the spread of HIV and that the pandemic could possibly be contained if government fully empowered the traditional leaders. The research has value in attempting to minimise the spread of HIV if communities discontinue harmful cultural practices. Therefore, donor agencies involved in intervention projects concerning the HIV and AIDS pandemic and government should work closely with traditional leaders who wield considerable power in areas under their jurisdiction to arrest the spread of the HIV and AIDS pandemic in the Chipinge district in Zimbabwe.

  7. Correlates of requesting home HIV self-testing kits on online social networks among African-American and Latino men who have sex with men.

    Science.gov (United States)

    Chiu, ChingChe J; Young, Sean D

    2016-01-01

    High levels of HIV stigma are one of the main difficulties in engaging African-American and Latino men who have sex with men (MSM) in HIV testing. The availability of home HIV test and the possibility of self-testing in private may improve uptake and counteract stigma. This paper sought to determine the correlates of requesting home HIV test kits among a sample of MSM social media users. The odds of participants requesting a test kit were significantly associated with using social networks to seek sexual partners (aOR: 2.47, 95% CI: 1.07-6.06) and thinking it is easier to use social networks for seeking sexual partners (1.87, 1.2-3.12), uncertain HIV status (4.29, 1.37-14.4), and having sex under the influence of alcohol (2.46, 1.06-5.77). Participants who had not been tested for more than 6 months were more likely to request a test kit than those who were tested in the past 6 months (2.53, 1.02-6.37). Participants who frequently talked to others about having sex with men online were less likely to request a test kit (0.73, 0.56-0.92). By reaching people over social media and offering them access to test kits, we were able to reach at-risk individuals who were uncertain about their HIV status and had not been regularly tested. The findings of the study will help to inform future HIV testing interventions. PMID:26444956

  8. Persuading, protesting and exchanging favours: strategies used by Indian sex workers to win local support for their HIV prevention programmes

    OpenAIRE

    Cornish, Flora; Shukla, Anuprita; Banerji, Riddhi

    2010-01-01

    Given that the communities which are most vulnerable to HIV often have little control over their own lives and their health-related behaviour, HIV prevention policies increasingly recommend that HIV prevention projects work to build relationships with powerful external groups (i.e., build "bridging social capital"). To aid conceptualisation of how community organisations may build such social capital, this paper outlines a typology of strategies for influencing local stakeholders. We present ...

  9. Effectiveness of HIV/AIDS School-based Programme Delivery on Behaviour Change for Sustainable Development among Zimbabwean ‘O’ Level Secondary School Students

    OpenAIRE

    Muguwe Emely

    2012-01-01

    This study was carried out to find out the effectiveness of HIV/AIDS School-based programme delivery on behavior change for sustainable development among Zimbabwean ‘O’ secondary school students. The sample consisted of one hundred and twenty students, twenty-four teachers and twelve school heads, drawn from the twelve secondary schools in GweruUrban District of Zimbabwe. Simple random sampling technique was used to come up with a sample of students while teachers and heads were purposively s...

  10. Timing of antenatal care and ART initiation in HIV-infected pregnant women before and after introduction of NIMART

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    Coceka Nandipha Mnyani

    2014-05-01

    Full Text Available In this review of routinely collected data from five community health centres in the Johannesburg Health District, we assess timing of antenatal care and antiretroviral therapy (ART initiation in HIV-infected pregnant women before and after the introduction of nurse-initiated management of ART in antenatal clinics. There are important lessons to be learnt as we reflect on the South African prevention of mother-to-child transmission of HIV programme.

  11. Peer Review and the Dilemmas of Quality Control in Programme Accreditation in South African Higher Education: Challenges and Possibilities

    Science.gov (United States)

    Cross, Michael; Naidoo, Devika

    2011-01-01

    The paper scrutinises the dynamics and the nature of peer review in the programme evaluation and accreditation process within the context of diverse individual and institutional legacies in South Africa. It analyses the peer review process and highlights the contestation at political, policy and epistemological levels. The paper argues that,…

  12. Scale-up of a decentralized HIV treatment programme in rural KwaZulu-Natal, South Africa: does rapid expansion affect patient outcomes?

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    Portia C Mutevedzi

    2010-08-01

    Full Text Available OBJECTIVE: To describe the scale-up of a decentralized HIV treatment programme delivered through the primary health care system in rural KwaZulu-Natal, South Africa, and to assess trends in baseline characteristics and outcomes in the study population. METHODS: The programme started delivery of antiretroviral therapy (ART in October 2004. Information on all patients initiated on ART was captured in the programme database and follow-up status was updated monthly. All adult patients (> 16 years who initiated ART between October 2004 and September 2008 were included and stratified into 6-month groups. Clinical and sociodemographic characteristics were compared between the groups. Retention in care, mortality, loss to follow-up and virological outcomes were assessed at 12 months post-ART initiation. FINDINGS: A total of 5719 adults initiated on ART were included (67.9% female. Median baseline CD4+ lymphocyte count was 116 cells/μl (interquartile range, IQR: 53-173. There was an increase in the proportion of women who initiated ART while pregnant but no change in other baseline characteristics over time. Overall retention in care at 12 months was 84.0% (95% confidence interval, CI: 82.6-85.3; 10.9% died (95% CI: 9.8-12.0; 3.7% were lost to follow-up (95% CI: 3.0-4.4. Mortality was highest in the first 3 months after ART initiation: 30.1 deaths per 100 person-years (95% CI: 26.3-34.5. At 12 months 23.0% had a detectable viral load (> 25 copies/ml (95% CI: 19.5-25.5. CONCLUSION: Outcomes were not affected by rapid expansion of this decentralized HIV treatment programme. The relatively high rates of detectable viral load highlight the need for further efforts to improve the quality of services.

  13. Impact of comorbidities and drug therapy on development of renal impairment in a predominantly African American and Hispanic HIV clinic population

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    M Keith Rawlings

    2011-01-01

    Full Text Available M Keith Rawlings1, Jennifer Klein1, Edna P Toubes Klingler1, Ejeanée Queen1, Lauren Rogers1, Linda H Yau2, Keith A Pappa2, Gary E Pakes21AIDS Arms Peabody Health Clinic, Dallas, Texas; 2GlaxoSmithKline, Research Triangle Park, North Carolina, USAPurpose: Renal impairment in human immunodeficiency virus (HIV-infected patients could potentially be caused by many factors. HIV-related renal impairment risks have been little studied in African Americans and Hispanics. We investigated the impact of HIV itself, highly active antiretroviral therapy (HAART, comorbidities, and non-HIV-related drug treatment on glomerular filtration rate in a predominantly African American/Hispanic HIV-infected population who had received HAART for at least one year. This study was a retrospective electronic medical record database evaluation of renal impairment risks in a largely African American/Hispanic HIV population obtaining medical care at an HIV clinic in Dallas, Texas.Methods: Proportional hazards models were used to investigate an association between an estimated glomerular filtration rate decrease >25% from baseline (ie, renal impairment and demographics, antiretroviral/nonantiretroviral medications, comorbidities (hypertension, diabetes mellitus, hepatitis C virus [HCV] infection, hepatitis B virus [HBV] infection, CD4+ counts, viral load, and duration patients were monitored at the clinic (time on study.Results: In total, 323 patients were evaluated: 82% males; 61% African American/12% Hispanic/19% Caucasian; mean age 37.9 years (standard deviation [SD] 8.5; 6% HBV-positive; 34% HCV-positive; 29% hypertensive; 3% diabetic; 52% tenofovir-treated; mean weight 75.4 kg (SD, 15.4; mean estimated glomerular filtration 114.5 mL/min/1.73 m2 (SD, 36.7 using the Modification of Diet in Renal Disease (MDRD calculation method; mean creatinine clearance (from which estimated glomerular filtration was extrapolated by the Cockcroft-Gault calculation method 120.6 mL/min/1

  14. Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV

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    Christoforos Mallouris

    2012-07-01

    Full Text Available Introduction: In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global and the Global Network of People living with HIV (GNP +  were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. Discussion: The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries, an anonymous online e-survey (601 respondents from 58 countries, and focus-group discussions with people living with HIV in Jamaica (27 participants. The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers’ attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. Conclusions: The consultation provided some understanding and insight into the participants’ experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy

  15. WHEN RELEVANCE DECENTERS CRITICALITY: THE CASE OF THE SOUTH AFRICAN NATIONAL CRIME, VIOLENCE AND INJURY LEAD PROGRAMME

    OpenAIRE

    Mohamed Seedat

    2010-01-01

    Following the formal demise of political apartheid in SouthAfrica in 1994, critical and community-centred psychologistshave tended to obtain relevance through alignment with thetenets of social justice and the larger democratic project. Thisarticle draws on the experiences of the Crime, Violence andInjury Lead Programme (CVI) to illustrate how particularformulations of scientific and social relevance function tomarginalize criticality and critical scholarship. The authorsuggests that relevanc...

  16. Attitudes towards HIV-antibody testing and people with aids among university students in India, South Africa and United States

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    Peltzer Karl

    2004-03-01

    Full Text Available CONTEXT: Stigmatizing attitudes toward persons with AIDS (PWAs may reduce people′s willingness to have themselves tested for Human Immunodeficiency Virus (HIV - thereby increasing the risk of transmission. AIMS: To examine attitudes towards (HIV testing and determinants of attitudes towards PWAs. SETTINGS AND DESIGN: A cross-sectional. MATERIAL AND METHODS: 600 first-year university students from South India, South African and America filled in a self-administered questionnaire. Main outcome measures included an Attitudes towards HIV-Antibody Testing Scale and Readiness to engage in personal forms of contact with People With AIDS. RESULTS indicate that the majority of American and South African students and only 10 percent of the Indian students had been sexually active in the past 12 months. Almost one fifth of the American and South African participants but only 10% of the Indian students admitted to having had an HIV test. American students had a much more positive attitudes toward HIV testing than South African and Indian students. Regression analysis for the Indian student sample identified blaming, irritation and negative attitudes toward homosexuals as independent predictors of readiness to engage in personal contact with PWAs, while the regression analyses for both South African and American students identified pity and irritation as independent predictors of contact readiness with PWAs. Positive HIV testing attitudes were positively associated with contact readiness with PWAs. CONCLUSION: The findings are important for the role of HIV testing and counselling in campus AIDS programmes. The findings reveal important factors related to HIV testing and suggest strategies for developing effective HIV/AIDS counselling programmes in universities.

  17. Interaction between 5-HTTLPR polymorphism and abuse history on adolescent African-American females' condom use behavior following participation in an HIV prevention intervention.

    Science.gov (United States)

    Sales, Jessica M; DiClemente, Ralph J; Brody, Gene H; Philibert, Robert A; Rose, Eve

    2014-06-01

    Not everyone exposed to an efficacious human immunodeficiency virus (HIV) intervention will reduce sexual risk behaviors, yet little is known about factors associated with "failure to change" high-risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene (5-HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents' failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females (N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. Forty-four percent did not increase their condom use from baseline levels 6 months after participating in the sexually transmitted infection (STI)/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime. PMID:23479192

  18. Sex Differences in HIV Prevalence, Behavioral Risks and Prevention Needs Among Anglophone and Francophone Sub-Saharan African Migrants Living in Rabat, Morocco.

    Science.gov (United States)

    Johnston, Lisa; Oumzil, Hicham; El Rhilani, Houssine; Latifi, Amina; Bennani, Aziza; Alami, Kamal

    2016-04-01

    Morocco has experienced a dramatic increase of migration from sub-Sahara Africa during the past decade. Recently included among the most vulnerable populations cited in the Morocco National Strategic Plans on HIV/TB for 2012-2016, sub-Saharan Africa migrants living in an irregular administrative situation participated in a survey to provide baseline data about their socio-demographic, sexual and HIV testing behaviors and HIV and syphilis prevalence. Two surveys using respondent driven sampling were conducted in 2013 among males and females, ≥18 years, originating from sub-Saharan African countries and living and/or working in an irregular administrative situation in Rabat and residing at least 3 months in Morocco. Analysis was conducted to evaluate differences between the two samples and between females and males within each sample using the successive sampling estimator in RDS Analyst. Roughly 3 % of francophone and anglophone migrants were infected with HIV, whereas a statistically significantly higher percentage of francophone (2.8 %), compared to anglophone (0.3 %), migrants were infected with syphilis. Females were found to have HIV infection rates three times higher and past year sexually transmitted infection signs and symptoms more than two times higher than their male counterparts. Female migrants also had statistically significantly higher percentages of ever testing for HIV and HIV testing and receiving results in the past year compared to males. We found distinct and important differences between migrants depending on whether they come from francophone versus anglophone countries and whether they were male or female. Future research should continue to explore these differences, while policies and programs should note these differences to best allocate resources in providing social and health services to these populations. PMID:26122648

  19. [Simultaneous association of tubercular meningitis and cryptococcal meningitis in an African with human immunodeficiency virus HIV positive serology. University Hospital Center of Bujumbura,Burundi].

    Science.gov (United States)

    Niyongabo, T; Aubry, P

    1992-01-01

    The authors report a connection between a meningitis tuberculosis and a meningoencephalitis with cryptococcus in the case of an african VIH+. The diagnostic of a meningitis tuberculosis was retained on an indirect arguments, this of meningoencephalitis of direct arguments (antigen cryptococcus, cultivation on Sabouraud environment). The pulmonary tuberculosis and/or extrapulmonary tuberculosis is current in Central Africa during HIV infection, as well as the crytococcosis during AIDS. But, any observation on neuromeningitis strike of those two infections have been reported up to now. PMID:1406216

  20. “Why me and not my neighbour?” HIV/AIDS care and counselling in a traditional African context.

    OpenAIRE

    AC van Dyk

    2001-01-01

    HIV/AIDS in Africa places a tremendous burden on the nursing profession. Hospitals are inundated with very sick and dying AIDS patients and nurses often find that their role as healers has shifted to a great extent to that of caregivers, counsellors and educators. AIDS also calls for nurses to go beyond the strict Western-based bio-medical model to be able to help and understand patients who come from a traditional African background. This article discusses relevant aspects of the traditional...

  1. Persistent high burden of invasive pneumococcal disease in South African HIV-infected adults in the era of an antiretroviral treatment program.

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    Marta C Nunes

    Full Text Available BACKGROUND: Highly active antiretroviral treatment (HAART programs have been associated with declines in the burden of invasive pneumococcal disease (IPD in industrialized countries. The aim of this study was to evaluate trends in IPD hospitalizations in HIV-infected adults in Soweto, South Africa, associated with up-scaling of the HAART program from 2003 to 2008. METHODS: Laboratory-confirmed IPD cases were identified from 2003 through 2008 through an existing surveillance program. The period 2003-04 was designated as the early-HAART era, 2005-06 as the intermediate-HAART era and 2007-08 as the established-HAART era. The incidence of IPD was compared between the early-HAART and established-HAART eras in HIV-infected and-uninfected individuals. RESULTS: A total of 2,567 IPD cases among individuals older than 18 years were reported from 2003 through 2008. Overall incidence of IPD (per 100,000 did not change during the study period in HIV-infected adults (207.4 cases in the early-HAART and 214.0 cases in the established-HAART era; p = 0.55. IPD incidence, actually increased 1.16-fold (95% CI: 1.01; 1.62 in HIV-infected females between the early-and established-HAART eras (212.1 cases and 246.2 cases, respectively; p = 0.03. The incidence of IPD remained unchanged in HIV-uninfected adults across the three time periods. CONCLUSION: Despite a stable prevalence of HIV and the increased roll-out of HAART for treatment of AIDS patients in our setting, the burden of IPD has not decreased among HIV-infected adults. The study indicates a need for ongoing monitoring of disease and HAART program effectiveness to reduce opportunistic infections in African adults with HIV/AIDS, as well as the need to consider alternate strategies including pneumococcal conjugate vaccine immunization for the prevention of IPD in HIV-infected adults.

  2. South Africans with recent pregnancy rarely know partner’s HIV serostatus: implications for serodiscordant couples interventions

    OpenAIRE

    Matthews, Lynn T.; Moore, Lizzie; Crankshaw, Tamaryn L; Milford, Cecilia; Mosery, Fortunate N; Greener, Ross; Psaros, Christina; Safren, Steven A.; Bangsberg, David R.; Smit, Jennifer A.

    2014-01-01

    Background Implementation of safer conception strategies requires knowledge of partner HIV-serostatus. We recruited women and men in a high HIV-prevalence setting for a study to assess periconception risk behavior among individuals reporting HIV-serodiscordant partnerships. We report screening data from that study with the objective of estimating the proportion of individuals who are aware that they are in an HIV-serodiscordant relationship at the time of conception. Methods We screened women...

  3. An action agenda for HIV and sex workers.

    Science.gov (United States)

    Beyrer, Chris; Crago, Anna-Louise; Bekker, Linda-Gail; Butler, Jenny; Shannon, Kate; Kerrigan, Deanna; Decker, Michele R; Baral, Stefan D; Poteat, Tonia; Wirtz, Andrea L; Weir, Brian W; Barré-Sinoussi, Françoise; Kazatchkine, Michel; Sidibé, Michel; Dehne, Karl-Lorenz; Boily, Marie-Claude; Strathdee, Steffanie A

    2015-01-17

    The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. PMID:25059950

  4. Intervention Mapping as a Participatory Approach to Developing an HIV Prevention Intervention in Rural African American Communities

    Science.gov (United States)

    Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

    2010-01-01

    Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few…

  5. HIV and tuberculosis trends in the United States and select Sub-Saharan Africa countries.

    Science.gov (United States)

    Mahmud, Ousman; Dates, Centdrika; Akil, Luma; Ahmad, Hafiz A

    2011-06-01

    Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB) for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for HIV/AIDS (UNAIDS), US Census Bureau and World Health Organization (WHO) databases and analyzed using Statistical Analysis Software (SAS v 9.1). Analysis of Variance (ANOVA) was performed to compare the variables of interest between the countries and across time. Results showed that percent rates of TB cases, TB deaths, HIV cases and HIV deaths were significantly different (PUnited States, but were significantly lower when compared to South Africa (PUnited States and the Sub-Saharan African countries, as well as differences within the Sub-Saharan African countries from 1993 to 2006. More analysis needs to be carried out in order to determine the prevalence and incidence of HIV and TB among multiple variables like gender, race, sexual orientation and age to get a comprehensive picture of the trends of HIV and TB. PMID:21776244

  6. Mental health of carers of children affected by HIV attending community-based programmes in South Africa and Malawi

    OpenAIRE

    Skeen, Sarah; Tomlinson, Mark; Macedo, Ana; Croome, Natasha; Sherr, Lorraine

    2014-01-01

    There is strong evidence that both adults and children infected with and affected by HIV have high levels of mental health burden. Yet there have been few studies investigating carer mental health outcomes in the context of HIV in Malawi and South Africa. The objective of this study was to assess the mental health of carers of children affected by HIV as a part of the Child Community Care study, which aims to generate evidence on the effectiveness of community-based organisation (CBO) service...

  7. Microbicides Development Programme: design of a phase III trial to measure the efficacy of the vaginal microbicide PRO 2000/5 for HIV prevention

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    Pool Robert

    2009-10-01

    Full Text Available Abstract Background With 2.5 million new HIV infections per year, effective preventive methods against HIV are urgently needed, especially in sub-Saharan Africa. MDP301 is an ongoing trial of the vaginal microbicide PRO 2000/5 being conducted by the Microbicides Development Programme. The main objective of the trial is to determine the efficacy and safety of 0.5% and 2% concentrations of PRO 2000/5 gel compared to placebo in preventing vaginally acquired HIV infection. Methods/Design MDP301 is a multicentre randomised placebo-controlled Phase III trial. The design was informed by pre-trial feasibility and pilot studies. The choice of trial population, assessments and endpoints are discussed along with statistical and ethical considerations. Adaptations to the design were made during the conduct of the trial; these included closing a study arm and changing the timing of the primary endpoint. Discussion The development of effective microbicide products remains one of the strongest hopes for new biomedical prevention tools. MDP301 is the largest Phase III microbicide trial to date, with 9404 enrolments, and is scheduled for completion in September 2009. Results are expected towards the end of 2009. Trial registration Current controlled trials ISRCTN64716212.

  8. Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme

    OpenAIRE

    Ngabo, Fidele; Franceschi, Silvia; Baussano, Iacopo; Umulisa, M. Chantal; Snijders, Peter J F; Uyterlinde, Anne M.; Lazzarato, Fulvio; Tenet, Vanessa; Gatera, Maurice; Binagwaho, Agnes; Clifford, Gary M

    2016-01-01

    Background: Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). Methods: To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18–69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytolog...

  9. Falling through the gaps: how should HIV programmes respond to families that persistently deny treatment to children?

    Science.gov (United States)

    Busza, Joanna; Strode, Ann; Dauya, Ethel; Ferrand, Rashida A

    2016-01-01

    Introduction Children living with HIV rely on adult caregivers for access to HIV testing and care, including clinical monitoring and adherence to treatment. Yet, many caregivers confront barriers to ensuring children's care, including fear of disclosure of the child's or the parents’ HIV status, competing family demands, fluctuating care arrangements and broader structural factors such as entrenched poverty or alternative beliefs about HIV's aetiology and treatment. Thus, many children are “falling through the gaps” because their access to testing and care is mediated by guardians who appear unable or unwilling to facilitate it. These children are likely to suffer treatment failure or death due to their caregivers’ recalcitrance. Discussion This Commentary presents three cases from paediatric HIV services in Zimbabwe that highlight the complexities facing health care providers in providing HIV testing and care to children, and discusses the implications as a child's rights issue requiring both legal and programmatic responses. The cases provide examples of how disagreements between family members about appropriate care, conflicts between a child and caregiver and religious objections to medical treatment interrupt children's engagement with HIV services. In all three cases, no social or legal mechanisms were in place for health staff to intervene and prevent “loss to follow up.” Conclusions We suggest that conceptualizing this as a child's rights issue may be a useful way to raise the debate and move towards improved treatment access. Our cases reflect policy failure to facilitate access to children's HIV testing and treatment, and are likely to be similar across international settings. We propose sharing experiences and encouraging dialogue between health practitioners and global advocates for children's right to health to raise awareness that children are the bearers of rights even if they lack legal capacity, and that the failure of either the state

  10. Falling through the gaps: how should HIV programmes respond to families that persistently deny treatment to children?

    Directory of Open Access Journals (Sweden)

    Joanna Busza

    2016-05-01

    Full Text Available Introduction: Children living with HIV rely on adult caregivers for access to HIV testing and care, including clinical monitoring and adherence to treatment. Yet, many caregivers confront barriers to ensuring children's care, including fear of disclosure of the child's or the parents’ HIV status, competing family demands, fluctuating care arrangements and broader structural factors such as entrenched poverty or alternative beliefs about HIV's aetiology and treatment. Thus, many children are “falling through the gaps” because their access to testing and care is mediated by guardians who appear unable or unwilling to facilitate it. These children are likely to suffer treatment failure or death due to their caregivers’ recalcitrance. Discussion: This Commentary presents three cases from paediatric HIV services in Zimbabwe that highlight the complexities facing health care providers in providing HIV testing and care to children, and discusses the implications as a child's rights issue requiring both legal and programmatic responses. The cases provide examples of how disagreements between family members about appropriate care, conflicts between a child and caregiver and religious objections to medical treatment interrupt children's engagement with HIV services. In all three cases, no social or legal mechanisms were in place for health staff to intervene and prevent “loss to follow up.” Conclusions: We suggest that conceptualizing this as a child's rights issue may be a useful way to raise the debate and move towards improved treatment access. Our cases reflect policy failure to facilitate access to children's HIV testing and treatment, and are likely to be similar across international settings. We propose sharing experiences and encouraging dialogue between health practitioners and global advocates for children's right to health to raise awareness that children are the bearers of rights even if they lack legal capacity, and that the

  11. The impact of the global economic crisis on HIV and AIDS programmes directed at women and children in Zambia.

    Science.gov (United States)

    Serieux, John; Njelesani, Mwansa; Chompolola, Abson; Sepehri, Ardeshir; Guliani, Harminder

    2015-01-01

    This investigation sought to ascertain the extent to which the global economic crisis of 2008-2009 affected the delivery of HIV/AIDS-related services directed at pregnant and lactating mothers, children living with HIV and children orphaned through HIV in Zambia. Using a combined macroeconomic analysis and a multiple case study approach, the authors found that from mid-2008 to mid-2009 the Zambian economy was indeed buffeted by the global economic crisis. During that period the case study subjects experienced challenges with respect to the funding, delivery and effectiveness of services that were clearly attributable, directly or indirectly, to the global economic crisis. The source of funding most often compromised was external private flows. The services most often compromised were non-medical services (such as the delivery of assistance to orphans and counselling to HIV-positive mothers) while the more strictly medical services (such as antiretroviral therapy) were protected from funding cuts and service interruptions. Impairments to service effectiveness were experienced relatively equally by (HIV-positive) pregnant women and lactating mothers and children orphaned through HIV. Children living with AIDS were least affected because of the primacy of ARV therapy in their care. PMID:26223326

  12. Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study.

    OpenAIRE

    Cluver, L.; Boyes, M.; Orkin, M.; Pantelic, M; Molwena, T; Sherr, L.

    2013-01-01

    BACKGROUND: Effective and scalable HIV prevention for adolescents in sub-Saharan Africa is needed. Cash transfers can reduce HIV incidence through reducing risk behaviours. However, questions remain about their effectiveness within national poverty-alleviation programmes, and their effects on different behaviours in boys and girls. METHODS: In this case-control study, we interviewed South African adolescents (aged 10-18 years) between 2009 and 2012. We randomly selected census areas in two ur...

  13. Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study

    OpenAIRE

    Lucie Cluver, PhD; Mark Boyes, PhD; Mark Orkin, PhD; Marija Pantelic, MSc; Thembela Molwena; Lorraine Sherr, PhD

    2013-01-01

    Background: Effective and scalable HIV prevention for adolescents in sub-Saharan Africa is needed. Cash transfers can reduce HIV incidence through reducing risk behaviours. However, questions remain about their effectiveness within national poverty-alleviation programmes, and their effects on different behaviours in boys and girls. Methods: In this case-control study, we interviewed South African adolescents (aged 10–18 years) between 2009 and 2012. We randomly selected census areas in two...

  14. The Perceived Impact Of The PPTCT Programme On The Management Of Parent To Child HIV And AIDS Transmission A Case Study Of Chikuku Hospital

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    Mashamba Tarashika

    2015-08-01

    Full Text Available ABSTRACT The study was carried out to investigate the perceived impact of the PPTCT programme on the management of parent-to-child HIV and AIDS transmission in Chikuku rural hospital community in Bikita district. A case study was used. A sample of ten expecting couples on Chikuku PPTCT programme and ten expecting mothers who were not on Chikuku PPTCT but attending ANC there participated in the study. Five professional counsellors also participated. Questionnaires and the interviews were used as data collection instruments. The data collected was analysed and interpreted using descriptive statistics and narratives. Tables were used to present the data and each question was analysed. The general findings agree with the reviewed literature as reflected that awareness and knowledge of PPTCT services and knowledge of its benefits was common but there were certain hurdles that need to be overcome in implementing and utilising them effectively. The clarion call is to review and reorganise the existing polices and current approaches in increasing PPTCT service uptake in communities similar to the study area. Recommendations were also made for programme implementers and policy makers in respect of the research findings in order to plan for the future.

  15. Mortality and loss to programme before antiretroviral therapy among HIV-infected children eligible for treatment in The Gambia, West Africa

    Directory of Open Access Journals (Sweden)

    Okomo Uduak

    2012-10-01

    Full Text Available Abstract Background HIV infection among children, particularly those under 24 months of age, is often rapidly progressive; as a result guidelines recommend earlier access to combination antiretroviral therapy (cART for HIV infected children. Losses to follow-up (LTFU and death in the interval between diagnosis and initiation of ART profoundly limit this strategy. This study explores correlates of LTFU and death prior to ART initiation among children. Methods The study is based on 337 HIV-infected children enrolled into care at an urban centre in The Gambia, including those alive and in care when antiretroviral therapy became available and those who enrolled later. Children were followed until they started ART, died, transferred to another facility, or were LTFU. Cox proportional hazards regression models were used to determine the hazard of death or LTFU according to the baseline characteristics of the children. Results Overall, 223 children were assessed as eligible for ART based on their clinical and/or immunological status among whom 73 (32.7% started treatment, 15 (6.7% requested transfer to another health facility, 105 (47.1% and 30 (13.5% were lost to follow-up and died respectively without starting ART. The median survival following eligibility for children who died without starting treatment was 2.8 months (IQR: 0.9 - 5.8 with over half (60% of all deaths occurring at home. ART-eligible children less than 2 years of age and those in WHO stage 3 or 4 were significantly more likely to be LTFU when compared with their respective comparison groups. The overall pre-treatment mortality rate was 25.7 per 100 child-years of follow-up (95% CI 19.9 - 36.8 and the loss to programme rate was 115.7 per 100 child-years of follow-up (95% CI 98.8 - 137. In the multivariable Cox proportional hazard model, significant independent predictors of loss to programme were being less than 2 years of age and WHO stage 3 or 4. The Adjusted Hazard Ratio

  16. “It pains me because as a woman you have to breastfeed your baby”: decision-making about infant feeding among African women living with HIV in the UK

    Science.gov (United States)

    Tariq, Shema; Elford, Jonathan; Tookey, Pat; Anderson, Jane; de Ruiter, Annemiek; O'Connell, Rebecca; Pillen, Alexandra

    2016-01-01

    Objectives UK guidance advises HIV-positive women to abstain from breast feeding. Although this eliminates the risk of postnatal vertical transmission of HIV, the impact of replacement feeding on mothers is often overlooked. This qualitative study examines, for the first time in the UK, decision-making about infant feeding among African women living with HIV. Methods Between 2010 and 2011, we conducted semistructured interviews with 23 HIV-positive African women who were pregnant or had recently given birth. We recruited participants from three HIV antenatal clinics in London. Results Women highlighted the cultural importance of breast feeding in African communities and the social pressure to breast feed, also describing fears that replacement feeding would signify their HIV status. Participants had significant concerns about physical and psychological effects of replacement feeding on their child and felt their identity as good mothers was compromised by not breast feeding. However, almost all chose to refrain from breast feeding, driven by the desire to minimise vertical transmission risk. Participants’ resilience was strengthened by financial assistance with replacement feeding, examples of healthy formula-fed children and support from partners, family, peers and professionals. Conclusions The decision to avoid breast feeding came at considerable emotional cost to participants. Professionals should be aware of the difficulties encountered by HIV-positive women in refraining from breast feeding, especially those from migrant African communities where breast feeding is culturally normative. Appropriate financial and emotional support increases women's capacity to adhere to their infant-feeding decisions and may reduce the emotional impact. PMID:26757986

  17. Infrastructure and Other Considerations to Launch Nuclear Power Programme: The Case of Sub-Sahara African Developing Countries like Ethiopia

    International Nuclear Information System (INIS)

    Trends in the world's population and energy use during the past decades show dramatic increases; and the demand for electricity, mainly from developing countries, is expected to increase more rapidly than the demand for other forms of energy. Besides, concern of climate change led to the need for production of significant amount of 'safe and clean' energy which in turn favours to nuclear option. Other alternative renewable sources like solar and wind can assist but currently they are short of supplying the required high energy demand either economically or/and in substantial amount. Nuclear option therefore remains a possible (developed) technology to fill this energy gap; and many countries including developing one show interest to make use of this energy source. In this paper the economic situations and energy production of six East Africa Sub-Saharan developing countries, with total population of 240 million were assessed, and 6.8% and 2.9% average GDP and population growth respectively registered in the last four years; however, their energy production in 2008 (est.) was 17.662 billion kWh, which is the least in the world. The contribution of inadequate energy and its poor coverage in hampering development, increase poverty and unstability were also analyzed. To come out of this cyclic challenge; it is recommended that countries based on regional economic cooperation should interconnect their electricity grid like EAPP and cooperate to invest commonly or unilaterally to launch Nuclear Power Programmes in relatively stable countries. Candid support of the international community is crucial, and IAEA should support and encourage such arrangements. It is also noted that the best candidate to start NP programme in these countries would be the worldwide dominant water cooled reactors. However, for countries with low grid capacity and to carry out projects in remote areas which are far-away from national grid systems or to desalinate water, considerations for smaller

  18. Epidemiological trends of HIV/AIDS in Pakistan: a twelve year experience at the national AIDS Programme

    International Nuclear Information System (INIS)

    A total of 23,40,000 blood samples were screened for the presence of antibodies against Human Immunodeficiency Virus (HIV) at various officially designated surveillance and diagnostic centers throughout the country, during the period of 12 years extending from 1986 to 1999. The reported positive cases screened before blood transfusion under the initiative launched in public sector hospitals during 1995 are also included in the total figure. A total of 1395 as symptomatic persons have been diagnosed and reported as HIV positive whereas 178 persons with signs and symptoms of full blown AIDS have been diagnosed. The tests were performed on selected categories of persons and include; persons with risky behavior, patients with sexually transmitted disease, professional blood donors, blood and blood product recipients intravenous drug injectors, patients with tuberculosis, women attending antenatal clinics, long distance drivers, and seaman. Apart from these identified groups, referred patients from the public and private hospitals, laboratories, clinics, nursing homes and HIV positive. The male to female ratio for HIV positive and AIDS cases as 7:1 and 8:1 respectively. Most of the cases acquired the disease through sexual contact including hetro, Homo and bisexual modes of transmission. Maximum numbers of the HIV positive individuals are between the age's 20-29 years. The data gives an overall prevalence rate of 0.07% which, although looking low, still deserves serious attention in view of system anomalies relating and under reporting and very long incubation period of the disease. (author)

  19. What can volunteer co-providers contribute to health systems? The role of people living with HIV in the Thai paediatric HIV programme.

    Science.gov (United States)

    Tulloch, Olivia; Taegtmeyer, Miriam; Ananworanich, Jintanat; Chasombat, Sanchai; Kosalaraksa, Pope; Theobald, Sally

    2015-11-01

    In Thailand people living with HIV (PLHIV) have played a major role in shaping policy and practice. They have acted as volunteer co-providers, although their potential in terms of paediatric service provision has seldom been explored from a health systems perspective. We describe the Thai paediatric HIV care system and use both demand- and supply-side perspectives to explore the impact, opportunities and challenges of PLHIV acting as volunteer co-providers. We employed qualitative methods to assess experiences and perceptions and triangulate stakeholder perspectives. Data were collected in Khon Kaen province, in the poorest Northeastern region of Thailand: three focus group discussions and two workshops (total participants n = 31) with co-providers and hospital staff; interviews with ART service-users (n = 35). Nationally, key informant interviews were conducted with policy actors (n = 20). Volunteer co-providers were found to be ideally placed to broker the link between clinic and communities for HIV infected children and played an important part in the vital psychosocial support component of HIV care. As co-providers they were recognized as having multiple roles linking and delivering services in clinics and communities. Clear emerging needs include strengthened coordination and training as well as strategies to support funding. Using motivated volunteers with a shared HIV status as co-providers for specific clinical services can contribute to strengthening health systems in Asia; they are critical players in delivering care (supply side) and being responsive to service-users needs (demand side). Co-providers blur the boundaries between these two spheres. Sustaining and optimising co-providers' contribution to health systems strengthening requires a health systems approach. Our findings help to guide policy makers and service providers on how to balance clinical priorities with psycho-social responsiveness and on how best to integrate the views and

  20. Alterations in Natural Killer Cell Receptor Profiles During HIV Type 1 Disease Progression Among Chronically Infected South African Adults

    OpenAIRE

    Wong, Ambrose H.W.; Williams, Katie; Reddy, Sharon; Wilson, Douglas; Giddy, Janet; Alter, Galit; Ghebremichael, Musie; Carrington, Mary N; Ndung'u, Thumbi; Walker, Bruce D.; Altfeld, Marcus; Carr, William H.

    2010-01-01

    Recent studies suggest that innate immune responses by natural killer (NK) cells play a significant role in restricting human immunodeficiency virus type-1 (HIV-1) pathogenesis. Our aim was to characterize changes in NK cells associated with HIV-1 clade C disease progression. Here we used multiparametric flow cytometry (LSRII) to quantify phenotype and function of NK cells in a cross-sectional analysis of cryopreserved blood samples from a cohort of 41 chronically HIV-1-infected, treatment-na...

  1. Shorter telomere length - A potential susceptibility factor for HIV-associated neurocognitive impairments in South African women [corrected].

    Directory of Open Access Journals (Sweden)

    Stefanie Malan-Müller

    Full Text Available The neuropathogenesis of the human immunodeficiency virus (HIV may manifest as various neurocognitive impairments (NCI. HIV-positive individuals also have significantly shorter telomere length (TL in peripheral blood mononuclear cells (PBMCs and CD8+ T cells compared to HIV-negative individuals. Additionally, reduced TL has been found to be associated with chronic psychological stress. This study focused on the effects of HIV-infection and chronic stress associated with childhood trauma on telomere length, and investigated whether leukocyte TL (LTL, in particular, represents a risk factor for NCI. Eighty-three HIV-positive and 45 HIV-negative women were assessed for childhood trauma and were subjected to detailed neurocognitive testing. Blood from each participant was used to extract Deoxyribonucleic acid (DNA. Relative LTL were determined by performing real time quantitative PCR reactions as described by Cawthon et al. (2002. As expected, relative LTL in the HIV-positive individuals was significantly shorter than that of HIV-negative individuals (F = 51.56, p = <0.01. Notably, a significant positive correlation was evident between relative LTL and learning performance in the HIV-positive group. In addition, a significant negative correlation was observed between relative LTL and verbal fluency, but this association was only evident in HIV-positive individuals who had experienced trauma. Our results suggest that reduced LTL is associated with worse learning performance in HIV-positive individuals, indicating that TL could act as a susceptibility factor in increasing neurocognitive decline in HIV-infected individuals.

  2. Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA Collaboration

    Directory of Open Access Journals (Sweden)

    Stephany N Duda

    2014-12-01

    Full Text Available Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20, Latin America and the Caribbean (n=7, North America (n=7, Central Africa (n=12, East Africa (n=51, Southern Africa (n=16 and West Africa (n=15. We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61%; region range (rr: 33–100% and both adult and paediatric populations (77%; rr: 29–96%. Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services – nutritional support (82%, combination antiretroviral therapy adherence support (88%, prevention of mother-to-child transmission (PMTCT (94% and other prevention and clinical management services (97% – were uniformly available. Approximately half (46% of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI, especially those in the President's Emergency

  3. HPV infection and EGFR activation/alteration in HIV-infected East African patients with conjunctival carcinoma.

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    Jing Jie Yu

    Full Text Available BACKGROUND: There has been substantial growth in the numbers of patients with conjunctival squamous cell carcinoma infected with HIV in East Africa. The natural history of the conjunctival squamous cell carcinoma appears to be unique in this region of the world, but the etiologic mechanism unclear and therapeutic options limited. This research was carried out to determine if conjunctival squamous cell carcinoma harbors human papillomavirus DNA and is associated with activation of the EGFR signaling pathway. Positive findings would identify etiologic causes and provide clinical guidance to improve treatment. METHODS/FINDINGS: Expression of p-MAPK/MAPK, p-Akt/Akt and p-EGFR/EGFR in cell nuclei and cytoplasm of 38 FFPE specimens were assessed by immunohistochemistry; HPV genotype was detected by qPCR assay; EGFR mutation was assessed by DNA sequencing analysis; and EGFR mRNA expression was measured using relative qPCR. Statistical analyses included two-sided Fisher exact test or chi-square test, Spearman correlation coefficient and ANOVA. HPV 18 was found in 61% of samples, with HPV 16 double-genotype in 6 patients (16%. Immunohistochemistry and qPCR data suggest that activation and expression of the EGFR signaling pathway is related to disease progression of conjunctival cancer. The associations between cytoplasmic p-MAPK, cytoplasmic p-Akt and tumor invasiveness were significant (p = 0.05 or 0.028. Nuclear p-EGFR appeared only in invasive tumors. A significant positive association between EGFR expression and disease invasiveness was observed (p = 0.01. A SNP in 10 patients and one missense mutation were found within EGFR tyrosine kinase domain. Statistical analysis indicates that patients with measurable EGFR expression more likely harbor EGFR mutations, compared to those with negative EGFR expression (35.3% vs. 0%. CONCLUSIONS/SIGNIFICANCE: We conclude that HPV types 16/18 infection is frequent in East African patients with AIDS

  4. Effect of Age at Antiretroviral Therapy Initiation on Catch-up Growth Within the First 24 Months Among HIV-infected Children in the IeDEA West African Pediatric Cohort

    DEFF Research Database (Denmark)

    Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R;

    2015-01-01

    BACKGROUND: We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the International epidemiologic Databases to Evaluate Aids West African paediatric cohort. METHODS: Malnutrition was def...

  5. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children.

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    Marta C Nunes

    Full Text Available BACKGROUND: Advances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV, human rhinovirus (hRV, polyomavirus-WU (WUPyV and -KI (KIPyV and human coronaviruses (CoV-OC43, -NL63, -HKU1 and -229E among children hospitalized with lower respiratory tract infections (LRTI. METHODS: Multiplex real-time reverse-transcriptase polymerase chain reaction was undertaken on archived nasopharyngeal aspirates from HIV-infected and -uninfected children (<2 years age hospitalized for LRTI, who had been previously investigated for respiratory syncytial virus, human metapneumovirus, parainfluenza I-III, adenovirus and influenza A/B. RESULTS: At least one of these viruses were identified in 274 (53.0% of 517 and in 509 (54.0% of 943 LRTI-episodes in HIV-infected and -uninfected children, respectively. Human rhinovirus was the most prevalent in HIV-infected (31.7% and -uninfected children (32.0%, followed by CoV-OC43 (12.2% and hBoV (9.5% in HIV-infected; and by hBoV (13.3% and WUPyV (11.9% in HIV-uninfected children. Polyomavirus-KI (8.9% vs. 4.8%; p = 0.002 and CoV-OC43 (12.2% vs. 3.6%; p<0.001 were more prevalent in HIV-infected than -uninfected children. Combined with previously-tested viruses, respiratory viruses were identified in 60.9% of HIV-infected and 78.3% of HIV-uninfected children. The newly tested viruses were detected at high frequency in association with other respiratory viruses, including previously-investigated viruses (22.8% in HIV-infected and 28.5% in HIV-uninfected children. CONCLUSIONS: We established that combined with previously-investigated viruses, at least one respiratory virus was identified in the majority of HIV-infected and HIV-uninfected children hospitalized for LRTI. The high frequency of viral co-infections illustrates the complexities in attributing causality to specific viruses

  6. "How can I tell?" Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV "test-and-treat" trial.

    Science.gov (United States)

    Maeri, Irene; El Ayadi, Alison; Getahun, Monica; Charlebois, Edwin; Akatukwasa, Cecilia; Tumwebaze, Dennis; Itiakorit, Harriet; Owino, Lawrence; Kwarisiima, Dalsone; Ssemmondo, Emmanuel; Sang, Norton; Kabami, Jane; Clark, Tamara D; Petersen, Maya; Cohen, Craig R; Bukusi, Elizabeth A; Kamya, Moses; Havlir, Diane; Camlin, Carol S

    2016-01-01

    People living with HIV/AIDS anticipate HIV-related stigma and fear disclosure to intimate partners. Yet, disclosure is critical to reducing HIV transmission and improving care engagement. This qualitative study characterized HIV disclosure experiences and normative beliefs among couples in communities participating in an HIV test-and-treat trial in Kenya and Uganda (Sustainable East Africa Research in Community Health, NCT#01864603). In-depth interviews were conducted with care providers (n = 50), leaders (n = 32) and members (n = 112) of eight communities. Data were analyzed using grounded theoretical approaches and Atlas.ti software. Findings confirmed gender differences in barriers to disclosure: while both men and women feared blame and accusation, women also feared violence and abandonment ("I did not tell my husband because [what if] I tell him and he abandons me at the last moment when I am in labor?"). Positive consequences included partner support for increased care-seeking and adherence ("My husband keeps on reminding me 'have you taken those drugs?'") Yet negative consequences included partnership dissolution, blame, and reports of violence ("some men beat their wives just because of that [bringing HIV medications home]"). Among HIV-infected individuals in discordant relationships, men more often reported supportive spouses ("we normally share [HIV-risk-reduction strategies] since I have been infected and she is HIV negative"), than did women ("my husband refused to use condoms and even threatened to marry another wife"). Care providers lent support for HIV-positive women who wanted to engage partners in testing but feared negative consequences: "They engaged the two of us in a session and asked him if we could all test." Findings demonstrate differing experiences and support needs of women and men living with HIV in eastern Africa, with HIV-positive women in discordant couples particularly vulnerable to negative consequences of disclosure

  7. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

    OpenAIRE

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S.; Kohi, Thecla W.; Chirwa, Maureen L.; Naidoo, Joanne R.; Phetlhu, Rene D.

    2008-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year proje...

  8. Research capacity building and collaboration between South African and American partners: the adaptation of an intervention model for HIV/AIDS prevention in corrections research.

    Science.gov (United States)

    Reddy, Priscilla; Taylor, Sandra E; Sifunda, Sibusiso

    2002-10-01

    This article examines a partnership between researchers from the United States who are involved in corrections health issues and scientists from South Africa who conduct prison health research, a previously underresearched area in South Africa. The article discusses some of the challenges as well as opportunities for knowledge and skills exchange via capacity building and collaboration strategies. Through historical and contemporary perspectives, it also discusses barriers and benefits of collaboration when forging links between researchers from developed and less developed nations. A focus on conducting public health research in South Africa, and on HIV/AIDS studies in particular, is placed within the context of the 2001 document of the Council on Health Research for Development. The South African prison health study represents a collaborative between the South African National Health Promotion Research and Development Group of the Medical Research Council, the South African Department of Correctional Services, and Emory University in Atlanta, Georgia. The article illuminates the process of adapting a model for a postapartheid prison study from one designed for use in the American correctional system. PMID:12413197

  9. Stress and Coping with Racism and Their Role on Sexual Risk for HIV among African American, Asian/Pacific Islander, and Latino Men Who Have Sex With Men

    Science.gov (United States)

    Han, Chong-suk; Ayala, George; Paul, Jay; Boylan, Ross; Gregorich, Steven E.; Choi, Kyung-Hee

    2014-01-01

    The deleterious effects of racism on a wide range of health outcomes, including HIV risk, is well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (n = 403), Asian/Pacific Islander (n = 393), and Latino (n = 400) MSM recruited in Los Angeles County, CA during 2008–2009. Almost two-thirds (65%) of the sample reported being stressed as a consequence of racism experienced within the gay community. Overall, 51% of the sample reported having UAI in the prior six months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI. PMID:25060122

  10. Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France

    Science.gov (United States)

    Desgrees-du-Lou, Annabel; Pannetier, Julie; Ravalihasy, Andrainolo; Le Guen, Mireille; Gosselin, Anne; Panjo, Henri; Bajos, Nathalie; Lydie, Nathalie; Lert, France; Dray-Spira, Rosemary

    2016-01-01

    Objectives: In Europe, sub-Saharan African migrants are a key population for HIV infection. We analyse how social hardships during settlement in France shape sexual partnerships and HIV risk. Design: PARCOURS is a life-event survey conducted in 2012–2013 in 74 health-care facilities in the Paris region, among three groups of sub-Saharan migrants: 926 receiving HIV care (296 acquired HIV in France), 779 with chronic hepatitis B, and 763 with neither HIV nor hepatitis B (reference group). Methods: Hardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in France. For each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models. Results: Hardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. Most of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired HIV in France compared with reference group, as were casual partnerships among men (76.7 vs. 54.2%; P = 0.004) and women (52.4 vs. 30.5%; P = 0.02), concurrent partnerships among men (69.9 vs. 45.8%; P = 0.02), and transactional partnerships among women (8.6 vs. 2.3%; P = 0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR) = 2.01(1.48–2.72) and OR = 6.27(2.25–17.44)]. Same trends were observed for lacking stable housing [OR = 3.71(2.75–5.00) and OR = 10.58 (4.68–23.93)]. Conclusion: Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable. PMID:26558722

  11. Attracting, equipping and retaining young medical doctors in HIV vaccine science in South Africa

    Directory of Open Access Journals (Sweden)

    Danna Flood

    2015-04-01

    Full Text Available Background: HIV remains a significant health problem in South Africa (SA. The development of a preventive vaccine offers promise as a means of addressing the epidemic, yet development of the human resource capacity to facilitate such research in SA is not being sustained. The HIV Vaccine Trials Network (HVTN has responded by establishing South African/HVTN AIDS Early Stage Investigator Programme (SHAPe, a programme to identify, train and retain clinician scientists in HIV vaccine research in SA.Objectives: The present study sought to identify factors influencing the attraction and retention of South African medical doctors in HIV vaccine research; to understand the support needed to ensure their success; and to inform further development of clinician research programmes, including SHAPe.Methods: Individual interviews and focus groups were held and audio-recorded with 18 senior and junior research investigators, and medical doctors not involved in research. Recordings were transcribed, and data were coded and analysed.Results: Findings highlighted the need for: (1 medical training programmes to include a greater focus on fostering interest and developing research skills, (2 a more clearly defined career pathway for individuals interested in clinical research, (3 an increase in programmes that coordinate and fund research, training and mentorship opportunities and (4 access to academic resources such as courses and libraries. Unstable funding sources and inadequate local funding support were identified as barriers to promoting HIV research careers.Conclusion: Expanding programmes that provide young investigators with funded research opportunities, mentoring, targeted training and professional development may help to build and sustain SA’s next generation of HIV vaccine and prevention scientists.

  12. The Effectiveness of HIV/AIDS School-Based Sexual Health Education Programmes in Nigeria: A Systematic Review

    Science.gov (United States)

    Amaugo, Lucky Gospel; Papadopoulos, Chris; Ochieng, Bertha M. N.; Ali, Nasreen

    2014-01-01

    HIV/AIDS is one of the most important public health challenges facing Nigeria today. Recent evidence has revealed that the adolescent population make up a large proportion of the 3.7% reported prevalence rate among Nigerians aged 15-49 years. School-based sexual health education has therefore become an important tool towards fighting this problem.…

  13. Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV prevention programme

    Directory of Open Access Journals (Sweden)

    Tara S Beattie

    2015-10-01

    Full Text Available Introduction: Female sex workers (FSWs frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact. Methods: As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA surveys (four districts (2005 to 2011 and anonymous polling booth surveys (PBS (16 districts (2007 to 2011 were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1 changes in reported violence and arrests over time and 2 associations between violence by non-partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. Results: 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS (30.0% in 2007, 10.0% in 2011, p<0.001, being arrested in the past year [adjusted odds ratio (AOR 0.57 (0.35, 0.93, p=0.025] and being beaten in the past six months by a non-partner (clients, police, pimps, strangers, rowdies [AOR 0.69 (0.49, 0.95, p=0.024] (IBBA. The proportion drinking alcohol (during the past week also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001. Violence by non-partners (being raped in the past year and/or beaten in the past six months and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15, p=0.002; AOR 1.91 (1.17, 3.12, p=0.01, respectively]. They were also associated with drinking alcohol (during the past week [AOR 1.98 (1.54, 2.53, p<0.001; AOR 2.79 (1.93, 4.04, p<0.001, respectively], reduced condom self-efficacy with clients [AOR 0.36 (0.27, 0.47, p<0.001; AOR 0.62 (0.39, 0.98, p=0.039, respectively], symptomatic STI (during the past year

  14. HIV Prevention Counseling Intervention Delivered During Routine Clinical Care Reduces HIV Risk Behavior in HIV-Infected South Africans Receiving Antiretroviral Therapy: The Izindlela Zokuphila/Options for Health Randomized Trial

    Science.gov (United States)

    Fisher, Jeffrey D.; Cornman, Deborah H.; Shuper, Paul A.; Christie, Sarah; Pillay, Sandy; Macdonald, Susan; Ngcobo, Ntombenhle; Amico, K. Rivet; Lalloo, Umesh; Friedland, Gerald; Fisher, William A.

    2014-01-01

    Context Sustainable interventions are needed to minimize HIV risk behavior among people living with HIV (PLWH) in South Africa on antiretroviral therapy (ART), a significant proportion of whom do not achieve viral suppression. Objective To determine whether a brief lay counselor delivered intervention implemented during routine care can reduce risky sex among PLWH on ART. Design Cluster randomized 16 HIV clinical care sites in KwaZulu Natal, South Africa, to intervention or standard-of-care. Setting Publicly funded HIV clinical care sites. Patients 1891 PLWH on ART received the HIV prevention counseling intervention (n = 967) or standard-of-care counseling (n = 924). Intervention Lay counselors delivered a brief intervention using motivational interviewing strategies based on the Information—Motivation—Behavioral Skills (IMB) model during routine clinical care. Main Outcome Measures Number of sexual events without a condom in the past four weeks with partners of any HIV status, and with partners perceived to be HIV-negative or HIV-status unknown, assessed at baseline, 6, 12, and 18 months. Results Intervention participants reported significantly greater reductions in HIV risk behavior on both primary outcomes, compared to standard-of-care participants. Differences in STI incidence between arms were not observed. Conclusion Effective behavioral interventions, delivered by lay counselors within the clinical care setting, are consistent with the strategy of linking HIV care and HIV prevention and integrating biomedical and behavioral approaches to stemming the HIV epidemic. PMID:25230288

  15. A partnership approach to providing on-site HIV services for probationers and parolees: a pilot study from Alabama, USA

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    Bronwen Lichtenstein

    2016-07-01

    Full Text Available Introduction: HIV in the United States is concentrated in the South, an impoverished region with marked health disparities and high rates of incarceration, particularly among African Americans. In the Deep South state of Alabama, a policy directive to reduce prison overcrowding has diverted large numbers of convicted felons to community supervision. Probation and parole offices have yet to provide the HIV education and testing services that are offered in state prisons. This study sought to implement on-site HIV services for probationers and parolees through an intersectoral programme involving law enforcement, university and HIV agency employees. The three main objectives were to (1 involve probation/parole officers in planning, execution and assessment of the programme, (2 provide HIV education to the officers and (3 offer voluntary pretest HIV counselling and testing to probationers and parolees. Methods: The partnered programme was conducted between October and December 2015. Offenders who were recently sentenced to probation (“new offenders”, received HIV education during orientation. Offenders already under supervision prior to the programme (“current offenders” learned about the on-site services during scheduled office visits. Outcomes were measured through officer assessments, informal feedback and uptake of HIV services among offenders. Results: A total of 86 new and 249 current offenders reported during the programme (N=335. Almost one-third (31.4% of new offenders sought HIV testing, while only 3.2% of current offenders were screened for HIV. Refusals among current offenders invoked monogamy, time pressures, being tested in prison, fear of positive test results and concerns about being labelled as gay or unfaithful to women partners. Officers rated the programme as worthwhile and feasible to implement at other offices. Conclusions: The partnership approach ensured support from law enforcement and intersectoral cooperation

  16. A partnership approach to providing on-site HIV services for probationers and parolees: a pilot study from Alabama, USA

    Science.gov (United States)

    Lichtenstein, Bronwen; Barber, Brad Wayne

    2016-01-01

    Introduction HIV in the United States is concentrated in the South, an impoverished region with marked health disparities and high rates of incarceration, particularly among African Americans. In the Deep South state of Alabama, a policy directive to reduce prison overcrowding has diverted large numbers of convicted felons to community supervision. Probation and parole offices have yet to provide the HIV education and testing services that are offered in state prisons. This study sought to implement on-site HIV services for probationers and parolees through an intersectoral programme involving law enforcement, university and HIV agency employees. The three main objectives were to (1) involve probation/parole officers in planning, execution and assessment of the programme, (2) provide HIV education to the officers and (3) offer voluntary pretest HIV counselling and testing to probationers and parolees. Methods The partnered programme was conducted between October and December 2015. Offenders who were recently sentenced to probation (“new offenders”), received HIV education during orientation. Offenders already under supervision prior to the programme (“current offenders”) learned about the on-site services during scheduled office visits. Outcomes were measured through officer assessments, informal feedback and uptake of HIV services among offenders. Results A total of 86 new and 249 current offenders reported during the programme (N=335). Almost one-third (31.4%) of new offenders sought HIV testing, while only 3.2% of current offenders were screened for HIV. Refusals among current offenders invoked monogamy, time pressures, being tested in prison, fear of positive test results and concerns about being labelled as gay or unfaithful to women partners. Officers rated the programme as worthwhile and feasible to implement at other offices. Conclusions The partnership approach ensured support from law enforcement and intersectoral cooperation throughout the

  17. HIV and Tuberculosis Trends in the United States and Select Sub-Saharan Africa Countries

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    Ousman Mahmud

    2011-06-01

    Full Text Available Tuberculosis (TB and Human Immunodeficiency Virus (HIV are two catastrophic diseases affecting millions of people worldwide every year; and are considered to be pandemic by the World Health Organization. This study aims to compare the recent trends in TB and HIV in the United States and Sub-Saharan African Countries. Data (incidence, prevalence and death rates of HIV and TB for the United States, Cameroon, Nigeria, and South Africa were collected from The Joint United Nations Programme for HIV/AIDS (UNAIDS, US Census Bureau and World Health Organization (WHO databases and analyzed using Statistical Analysis Software (SAS v 9.1. Analysis of Variance (ANOVA was performed to compare the variables of interest between the countries and across time. Results showed that percent rates of TB cases, TB deaths, HIV cases and HIV deaths were significantly different (P < 0.001 among these countries from 1993 to 2006. South Africa had the highest rates of HIV and TB; while US had the lowest rates of both diseases. Tuberculosis and HIV rates for Cameroon and Nigeria were significantly higher when compared to the United States, but were significantly lower when compared to South Africa (P < 0.001. There were significant differences (P < 0.001 in the prevalence of TB and HIV between the United States and the Sub-Saharan African countries, as well as differences within the Sub-Saharan African countries from 1993 to 2006. More analysis needs to be carried out in order to determine the prevalence and incidence of HIV and TB among multiple variables like gender, race, sexual orientation and age to get a comprehensive picture of the trends of HIV and TB.

  18. The Gentlemen’s Club: An innovation to improve HIV counselling and testing uptake at a South African university campus

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    Sogo F. Matlala

    2013-01-01

    Full Text Available Background: Many university students were found to be engaging in high HIV risk practiceson campuses which then necessitated discovering their HIV status by participating in HIVcounselling and testing (HCT campaigns. HCT is an entry point into a comprehensivecontinuum of prevention, treatment, care and support services for HIV infection and AIDS.However, it was also found that many students, mostly males, did not take regular HIV teststo discover their HIV status and receive the necessary counselling and support.Objectives: The innovative Gentlemen’s Club was therefore implemented at a universitycampus to increase HCT uptake.The club was formed to motivate male students on behaviourand lifestyle changes so that they could become responsible men.Method: To join the club, a student was required to take a confidential HIV test and as amember he was expected to follow rules of good and responsible behaviour as prescribed bythe club.Results: Club membership and attendance for meetings showed an increase after the launchof the club in 2010 because of its appeal, and there was also a notable increase in the numberof male students attending HCT campaigns. Women have formed a similar club to motivateother women to take regular HIV tests as well.Conclusion: The Gentlemen’s Club was an innovative idea that increased HCT uptake by malestudents and served as vehicle to address health and social issues facing university students.

  19. Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men

    OpenAIRE

    van den Hoek Caty; Wolfers Mireille EG; Brug Johannes; de Zwart Onno

    2007-01-01

    Abstract Background There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence base...

  20. Development of Nevirapine Resistance in Children Exposed to the Prevention of Mother-to-Child HIV-1 Transmission Programme in Maputo, Mozambique.

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    Francisco Antunes

    Full Text Available Single-dose nevirapine (sd-NVP has been the main option for prevention of mother-to-child transmission (PMTCT of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM in the context of PMTCT.To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique.One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012 at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq. Sequencing was performed with ABI 3100 (Applied Biosystems. Logistic regression modelling was undertaken to identify the factors associated with NVP RAM.Seventy-nine children had their samples genotyped. Their median age was 7.0 (3-12 months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs for PMTCT. ARV RAM were detected in 43 (54.4% of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16 and Y181C (n = 15. NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93-186.34 and with mother's CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02-9.32. In the multivariable analysis the mother's exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33-253.66.We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers' exposure to PMTCT significantly increased the risk of NVP RAM.

  1. Recall of intestinal helminthiasis by HIV-infected South Africans and avoidance of possible misinterpretation of egg excretion in worm/HIV co-infection analyses

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    van der Merwe Lize

    2006-05-01

    Full Text Available Abstract Background Ascariasis and HIV/AIDS are often co-endemic under conditions of poverty in South Africa; and discordant immune responses to the respective infections could theoretically be affecting the epidemic of HIV/AIDS in various ways. It is well-known that sensitisation to helminthic antigens can aggravate or ameliorate several non-helminthic diseases and impair immunisation against cholera, tetanus and tuberculosis. The human genotype can influence immune responses to Ascaris strongly. With these factors in mind, we have started to document the extent of long-term exposure to Ascaris and other helminths in a community where HIV/AIDS is highly prevalent. In more advanced studies, objectives are to analyse relevant immunological variables (e.g. cytokine activity and immunoglobulin levels. We postulate that when Ascaris is hyperendemic, analysis of possible consequences of co-infection by HIV cannot be based primarily on excretion vs non-excretion of eggs. Methods Recall of worms seen in faeces was documented in relation to the age of adult volunteers who were either seropositive (n = 170 or seronegative (n = 65 for HIV. Reasons for HIV testing, deworming treatments used or not used, date and place of birth, and duration of residence in Cape Town, were recorded. Confidence intervals were calculated both for group percentages and the inter-group differences, and were used to make statistical comparisons. Results In both groups, more than 70% of participants were aware of having passed worms, often both when a child and as an adult. Most of the descriptions fitted Ascaris. Evidence for significantly prolonged exposure to helminthic infection in HIV-positives was supported by more recall of deworming treatment in this group (p Conclusion There was a long-term history of ascariasis (and probably other helminthic infections in both of the groups that were studied. In women in the same community, and in children living where housing and

  2. Measuring coverage in MNCH: population HIV-free survival among children under two years of age in four African countries.

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    Jeffrey S A Stringer

    Full Text Available BACKGROUND: Population-based evaluations of programs for prevention of mother-to-child HIV transmission (PMTCT are scarce. We measured PMTCT service coverage, regimen use, and HIV-free survival among children ≤24 mo of age in Cameroon, Côte D'Ivoire, South Africa, and Zambia. METHODS AND FINDINGS: We randomly sampled households in 26 communities and offered participation if a child had been born to a woman living there during the prior 24 mo. We tested consenting mothers with rapid HIV antibody tests and tested the children of seropositive mothers with HIV DNA PCR or rapid antibody tests. Our primary outcome was 24-mo HIV-free survival, estimated with survival analysis. In an individual-level analysis, we evaluated the effectiveness of various PMTCT regimens. In a community-level analysis, we evaluated the relationship between HIV-free survival and community PMTCT coverage (the proportion of HIV-exposed infants in each community that received any PMTCT intervention during gestation or breastfeeding. We also compared our community coverage results to those of a contemporaneous study conducted in the facilities serving each sampled community. Of 7,985 surveyed children under 2 y of age, 1,014 (12.7% were HIV-exposed. Of these, 110 (10.9% were HIV-infected, 851 (83.9% were HIV-uninfected, and 53 (5.2% were dead. HIV-free survival at 24 mo of age among all HIV-exposed children was 79.7% (95% CI: 76.4, 82.6 overall, with the following country-level estimates: Cameroon (72.6%; 95% CI: 62.3, 80.5, South Africa (77.7%; 95% CI: 72.5, 82.1, Zambia (83.1%; 95% CI: 78.4, 86.8, and Côte D'Ivoire (84.4%; 95% CI: 70.0, 92.2. In adjusted analyses, the risk of death or HIV infection was non-significantly lower in children whose mothers received a more complex regimen of either two or three antiretroviral drugs compared to those receiving no prophylaxis (adjusted hazard ratio: 0.60; 95% CI: 0.34, 1.06. Risk of death was not different for children whose

  3. Potential use and performance studies of solar crop driers in Mauritius. African Energy Programme research report series no. 2

    International Nuclear Information System (INIS)

    Monoculture has in the past, been the norm in agriculture in Mauritius. However under a recent policy of self reliance, there has been a move to multi-crop culture. Under this policy it has been decided to release, in the first instance, 800 hectares of the best arable land for the production of food crops. This decision, coupled with further increase in intense cultivation of crops in the interrow space of the 80,000 hectares of sugar cane fields, will make the need for crop drying more and more indispensable. As the present oil bill of MuR 25 million in precious foreign exchange, for crop drying only is already too much the country could afford, the need for solar drying remains the only other alternative. The Government's Plan of Action calls for immediate action on at least 10 major crops, among which maize is the single most important. The major land holders who will participate in the programme of agricultural diversification will normally use the established artificial drying process. However the 1200 small scale farmers who will also be called upon to contribute their share will obviously not be able to afford such an expensive process and open air or sun drying remains the only resort for them. However sun drying methods have several major constraints not least of which is the inability to dry down to the safe moisture content for subsequent storage. For example, sun-dried maize will only reach a minimum of 15 to 16% moisture and must be further dried artificially at a cost of about MuR 200 per tonne to attain the 12% moisture for storage. It is apparent that the use of solar driers would generate a higher income, through a reduction in post-harvest losses and a saving in drying cost, to these small scale farmers. This, in turn, would act as an impetus to grow more food for self-reliance, if not for export. This research work was, therefore, undertaken with the aim of fulfilling the needs of small-scale farmers. The objectives of the project were to

  4. Multi-analyte profiling of ten cytokines in South African HIV-infected patients with Immune Reconstitution Inflammatory Syndrome (IRIS)

    OpenAIRE

    Worsley Catherine M; Suchard Melinda S; Stevens Wendy S; Van Rie Annelies; Murdoch David M

    2010-01-01

    Abstract Background Immune reconstitution inflammatory syndrome (IRIS) is an important complication of HAART in sub-Saharan Africa, where opportunistic infections (OIs) including mycobacteria and cryptococcus are common. The immune system's role in HIV infected patients is complex with cytokine expression strongly influencing HIV infection and replication. Methods We determined the expression patterns of 10 cytokines by Luminex multi-analyte profiling in 17 IRIS nested case-control pairs part...

  5. Local Residents Trained As ‘Influence Agents’ Most Effective In Persuading African Couples On HIV Counseling and Testing

    OpenAIRE

    Lambdin, Barrot; Kanweka, William; Inambao, Mubiana; Mwananyanda, Lawrence; Shah, Heena; Linton, Sabriya; Wong, Frank; Luisi, Nicole; Tichacek, Amanda; Kalowa, James; Chomba, Elwyn; Allen, Susan

    2011-01-01

    Couples in sub-Saharan Africa are the largest group in the world at risk for HIV infection. Couples counseling and testing programs have been shown to reduce HIV transmission, but such programs remain rare in Africa. Before couples counseling and testing can become the norm, it is essential to increase demand for the services. We evaluated the effectiveness of several promotional strategies during a two -year program in Kitwe and Ndola, Zambia. The program attracted more than 7,600 couples th...

  6. To tell or not to tell: South African women’s disclosure of HIV status during pregnancy

    OpenAIRE

    Visser, Maretha J.; Neufeld, Sharon; de Villiers, Annelize; Makin, Jennifer D.; Forsyth, Brian W.C.

    2008-01-01

    HIV-positive pregnant women often do not disclose their serostatus to their partners, family and friends, creating potential barriers to preventing sexual transmission to partners and mother-to-child transmission through breastfeeding. This research explores recently diagnosed HIV-positive pregnant women’s reasons for disclosure and non-disclosure of serostatus to various members of their social networks, as well as the consequences of their disclosure. Data were collected through open-ended ...

  7. Access to medicines under India’s National Disease Control Programmes: local study of TB, HIV and malaria medicines

    OpenAIRE

    Chinai, R; Kadam, Abhay; Pollock, Allyson M; Jeffery, Roger; Weiss, Mitchell; Mistry, Nerges

    2013-01-01

    Medicines for treating three of India’s key public health threats – malaria, tuberculosis and AIDS – are differently available within the national disease control programmes. Progress in controlling these diseases is heavily constrained by poor coverage in the case of AIDS and treatment for P. Falciparum malaria. There is a need to consider innovative solutions to reduce travel costs and improve drug availability.

  8. Girls want money, boys want virgins: the materiality of love amongst South African township youth in the context of HIV and AIDS.

    Science.gov (United States)

    Bhana, Deevia; Pattman, Rob

    2011-09-01

    How do young South Africans give meaning to love? In this paper we draw on findings from an interview study to examine the ways in which young Africans, aged 16 to 17 years in a poor township in KwaZulu-Natal province, express ideals of love and romance. Their claims to love we show are strategic advantages as they negotiate poverty and economic marginalisation. Girls' ideals of love are tied to their aspirations towards middle-class consumerism. Love becomes inseparable from the idealisation of men who provide. Upholding provider masculinity is a strategic means to claim money, fashionable clothes and prestige. Unlike girls, the boys' love investments were focused on farm girls from rural areas in South Africa. Farm girls were constructed as virgins with little investment in commodification. Farm girls are a strategic option through which boys' economic marginalisation experienced in the township girls is reconciled through an exalted masculinity. Love is produced by particular sets of economic and social circumstances through which gender inequalities are reproduced, and should be taken more seriously in working with young people to address gendered social environments and HIV risk. PMID:21656409

  9. Chlamydia trachomatis, human immunodeficiency virus (HIV distribution and sexual behaviors across gender and age group in an African setting.

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    Joel Fleury Djoba Siawaya

    Full Text Available OBJECTIVE: The purpose of this study was to (1 describe the distribution of Chlamydia trachomatis (CT and Human Immunodeficiency Virus (HIV cases across gender and age groups in Libreville (Gabon; (2 examine Gabonese Sexually Transmitted Infections (STIs-related risk behaviour. METHODS: The sampled population was people attending the "Laboratoire National de Santé Plublique". Between 2007 and 2011, 14 667 and 9 542 people respectively, were tested for CT and HIV infections. 1 854 of them were tested for both infections. We calculated CT and HIV rates across gender and age groups. Also analysed was the groups' contribution to the general CT and HIV epidemiology. STIs-related risk behaviours were assessed in 224 men and 795 women (between July 2011 and March 2013 who agreed and answered a questionnaire including questions on their marital status, number of sex partners, sexual practices, history of STIs, sex frequency and condom use. RESULTS: Data showed a 24% dropped in the CT infection rate between 2007 and 2010, followed by a 14% increase in 2011. The HIV infection rates for the same period were between 15% and 16%. The risk of a CT-positive subject getting HIV is about 0.71 times the risk of a CT-negative subject. Young adult aged between 18 and 35 years old represented 65.2% of people who had STIs. 80% of women and 66% of men confessed to an inconsistent use of condoms. 11.6% of women and 48% of men declared having multiple sex partners. 61% of questioned women and 67% of men declared knowing their HIV status. CONCLUSIONS: In this Gabonese setting, the population-aged from 18 to 35 years is the most affected by STIs. Other matters of concern are the inconsistent use of protection and sex with non-spousal or non-life partners.

  10. Baseline morbidity in 2,990 adult African volunteers recruited to characterize laboratory reference intervals for future HIV vaccine clinical trials.

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    Wendy Stevens

    Full Text Available BACKGROUND: An understanding of the health of potential volunteers in Africa is essential for the safe and efficient conduct of clinical trials, particularly for trials of preventive technologies such as vaccines that enroll healthy individuals. Clinical safety laboratory values used for screening, enrolment and follow-up of African clinical trial volunteers have largely been based on values derived from industrialized countries in Europe and North America. This report describes baseline morbidity during recruitment for a multi-center, African laboratory reference intervals study. METHODS: Asymptomatic persons, aged 18-60 years, were invited to participate in a cross-sectional study at seven sites (Kigali, Rwanda; Masaka and Entebbe, Uganda; Kangemi, Kenyatta National Hospital and Kilifi, Kenya; and Lusaka, Zambia. Gender equivalency was by design. Individuals who were acutely ill, pregnant, menstruating, or had significant clinical findings were not enrolled. Each volunteer provided blood for hematology, immunology, and biochemistry parameters and urine for urinalysis. Enrolled volunteers were excluded if found to be positive for HIV, syphilis or Hepatitis B and C. Laboratory assays were conducted under Good Clinical Laboratory Practices (GCLP. RESULTS AND CONCLUSIONS: Of the 2990 volunteers who were screened, 2387 (80% were enrolled, and 2107 (71% were included in the analysis (52% men, 48% women. Major reasons for screening out volunteers included abnormal findings on physical examination (228/603, 38%, significant medical history (76, 13% and inability to complete the informed consent process (73, 13%. Once enrolled, principle reasons for exclusion from analysis included detection of Hepatitis B surface antigen (106/280, 38% and antibodies against Hepatitis C (95, 34%. This is the first large scale, multi-site study conducted to the standards of GCLP to describe African laboratory reference intervals applicable to potential volunteers in

  11. Stress and coping with racism and their role in sexual risk for HIV among African American, Asian/Pacific Islander, and Latino men who have sex with men.

    Science.gov (United States)

    Han, Chong-suk; Ayala, George; Paul, Jay P; Boylan, Ross; Gregorich, Steven E; Choi, Kyung-Hee

    2015-02-01

    The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008-2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI. PMID:25060122

  12. Concurrent partnerships and HIV: an inconvenient truth.

    Science.gov (United States)

    Epstein, Helen; Morris, Martina

    2011-01-01

    The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency.Practical prevention-oriented research on concurrency is only just beginning. Most interventions to raise awareness about the risks of concurrency are less than two years old; few evaluations and no randomized-controlled trials of these programmes have been conducted. Determining whether these interventions can help people better assess their own risks and take steps to reduce them remains an important task for research. This kind of research is indeed the only way to obtain conclusive evidence on the role of concurrency, the programmes needed for effective prevention, the willingness of people to change behaviour, and the obstacles to change. PMID:21406080

  13. Concurrent partnerships and HIV: an inconvenient truth

    Directory of Open Access Journals (Sweden)

    Epstein Helen

    2011-03-01

    Full Text Available Abstract The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency. Practical prevention-oriented research on concurrency is only just beginning. Most interventions to raise awareness about the risks of concurrency are less than two years old; few evaluations and no randomized-controlled trials of these programmes have been conducted. Determining whether these interventions can help people better assess their own risks and take steps to reduce them remains an important task for research. This kind of research is indeed the only way to obtain conclusive evidence on the role of concurrency, the programmes needed for effective prevention, the willingness of people to change behaviour, and the obstacles to change.

  14. HIV prevention interventions to reduce sexual risk for African Americans: the influence of community-level stigma and psychological processes.

    Science.gov (United States)

    Reid, Allecia E; Dovidio, John F; Ballester, Estrellita; Johnson, Blair T

    2014-02-01

    Interventions to improve public health may benefit from consideration of how environmental contexts can facilitate or hinder their success. We examined the extent to which efficacy of interventions to improve African Americans' condom use practices was moderated by two indicators of structural stigma-Whites' attitudes toward African Americans and residential segregation in the communities where interventions occurred. A previously published meta-analytic database was re-analyzed to examine the interplay of community-level stigma with the psychological processes implied by intervention content in influencing intervention efficacy. All studies were conducted in the United States and included samples that were at least 50% African American. Whites' attitudes were drawn from the American National Election Studies, which collects data from nationally representative samples. Residential segregation was drawn from published reports. Results showed independent effects of Whites' attitudes and residential segregation on condom use effect sizes. Interventions were most successful when Whites' attitudes were more positive or when residential segregation was low. These two structural factors interacted: Interventions improved condom use only when communities had both relatively positive attitudes toward African Americans and lower levels of segregation. The effect of Whites' attitudes was more pronounced at longer follow-up intervals and for younger samples and those samples with more African Americans. Tailoring content to participants' values and needs, which may reduce African Americans' mistrust of intervention providers, buffered against the negative influence of Whites' attitudes on condom use. The structural factors uniquely accounted for variance in condom use effect sizes over and above intervention-level features and community-level education and poverty. Results highlight the interplay of social identity and environment in perpetuating intergroup disparities

  15. Purification and characterization of naturally occurring HIV-1 (South African subtype C) protease mutants from inclusion bodies.

    Science.gov (United States)

    Maseko, Sibusiso B; Natarajan, Satheesh; Sharma, Vikas; Bhattacharyya, Neelakshi; Govender, Thavendran; Sayed, Yasien; Maguire, Glenn E M; Lin, Johnson; Kruger, Hendrik G

    2016-06-01

    Human immunodeficiency virus (HIV) infections in sub-Saharan Africa represent about 56% of global infections. Many studies have targeted HIV-1 protease for the development of drugs against AIDS. Recombinant HIV-1 protease is used to screen new drugs from synthetic compounds or natural substances. Along with the wild type (C-SA) we also over-expressed and characterized two mutant forms from patients that had shown resistance to protease inhibitors. Using recombinant DNA technology, we constructed three recombinant plasmids in pGEX-6P-1 and expressed them containing a sequence encoding wild type HIV protease and two mutants (I36T↑T contains 100 amino acids and L38L↑N↑L contains 101 amino acids). These recombinant proteins were isolated from inclusion bodies by using QFF anion exchange and GST trap columns. In SDS-PAGE, we obtained these HIV proteases as single bands of approximately 11.5, 11.6 and 11.7 kDa for the wild type, I36T↑Tand L38L↑N↑L mutants, respectively. The enzyme was recovered efficiently (0.25 mg protein/L of Escherichia coli culture) and had high specific activity of 2.02, 2.20 and 1.33 μmol min(-1) mg(-1) at an optimal pH of 5 and temperature of 37 °C for the wild type, I36T↑T and L38L↑N↑L, respectively. The method employed here provides an easy and rapid purification of the HIV-1(C-SA) protease from the inclusion bodies, with high yield and high specific activities. PMID:26917227

  16. Seroepidemiology of HIV, syphilis and hepatitis B and C viruses among blood donors in Bangui, Central African Republic.

    Science.gov (United States)

    Nambei, W S; Rawago-Mandjiza, D; Gbangbangai, E

    2016-05-01

    The aim of this study was to determine the seroprevalence of HIV, the hepatitis B and C viruses, and syphilis as well the risk factors for these diseases among blood donors in Bangui, Central Africa Republic. This cross-sectional study examined samples from donors giving blood in August and September, 2013. HIV1/2 antibodies was screened with the Determine and Unigold HIV tests. Hepatitis B surface antigens were detected by sandwich immunochromatographic methods (DIAspot HBsAg test), and antibodies to HCV by the DIAspot test strip. Syphilis was diagnosed with the VDRL and TPHA methods (Omega Diagnostic, UK). The Chi(2) test was used for statistical analysis. The study included samples from 551 individuals, 350 (63.52%) of whom were frequent volunteer donors. In all, 132 (23.95%) were infected with at least one pathogen. The overall seroprevalence rate was 8.89% for HBV, 4.72% for HCV, 4.36% for syphilis, and 5.98% for HIV. Eight patients had two concomitant infections, with HIV-HBV the most common combination. Compared to long-term volunteers, first-time donors were more often infected by at least one of the pathogens we screened for, most especially HVB (OR = 5.06; 95% CI = 4.22-7.11) and syphilis (OR = 2.05; 95% CI = 2.02-7.44). Our findings indicate the high seroprevalence of transfusion-transmitted infections in blood donated in Bangui. The most common combined infections were HIV-HBV. The most common risk factor was a family history of HBV infection, and especially, mother-child transmission. PMID:27412978

  17. Four years of natural history of HIV-1 infection in African women : a prospective cohort study in Kigali (Rwanda), 1988-1993

    OpenAIRE

    Leroy, V.; Msellati, Philippe; Lepage, P; Batungwanayo, J.; Hitimana, D.G.; Taelman, H.; Bogaerts, J.; Boineau, F.; Van De Perre, P.; Simonon, A; Salamon, R.; Dabis, F

    1995-01-01

    Clinical features and mortality due to human immunodeficiency virus type-1 (HIV-1) infection in women are described as part of a prospective 4-year cohort study on perinatal transmission of HIV in Kigali, Rwanda. Two hundred fifteen HIV-positive (HIV+) and 216 HIV-negative (HIV-) pregnant women were enrolled at delivery between November 1988 and June 1989. Clinical information collected during systematic quarterly examinations was compared. HIV antibody tests were performed at delivery and CD...

  18. Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Paul Mee

    2014-11-01

    Full Text Available Background: Antiretroviral treatment (ART has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities. Design: This study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality. Results: Among the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007–2008 and 2009–2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes. Conclusions: In this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained.

  19. A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African community

    Directory of Open Access Journals (Sweden)

    Eucebious Lekalakala- Mokgele

    2011-02-01

    Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV and acquired immune deficiency syndrome (AIDS pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (www.ebsco.co, which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.

    Opsomming

    Die status van ouer volwassenes in Afrika beklee’n klein, maar vinnig groeiende deel van die globale verouderings literatuur. Die menslike immuniteitsgebreksvirus (MIV en verworwe immuniteitsgebreksindroom (VIGS pandemie het ‘n nuwe fokus op die veranderende rol van bejaardes in die gemeenskap wat deur VIGS beïnvloed word, gegenereer. In sub-Sahara Afrika waar na beraming miljoene geïnfekteer word met MIV, met sowat twee miljoen sterftes jaarliks gerekordeer

  20. Sex drugs, peer connections, and HIV: Use and risk among African American, Latino, and Multiracial young men who have sex with men (YMSM) in Los Angeles and New York

    OpenAIRE

    Mutchler, Matt G.; McKay, Tara; Candelario, Norman; Liu, Honghu; Stackhouse, Bill; Bingham, Trista; Ayala, George

    2011-01-01

    African American and Latino young men who have sex with men are at high risk for HIV infection. We administered brief intercept surveys (N=416) at 18 Black and Latino gay pride events in Los Angeles and New York in 2006 and 2007. Ordinal logistic regressions were used to model the effects of substance use during sex, peer connectedness, relationship status, and homelessness on condom use. Alcohol use, crystal use, homelessness, and having a primary relationship partner were negatively associa...

  1. Reported physical and sexual abuse in childhood and adult HIV risk behaviour in three African countries: findings from Project Accept (HPTN-043).

    Science.gov (United States)

    Richter, Linda; Komárek, Arnošt; Desmond, Chris; Celentano, David; Morin, Steve; Sweat, Michael; Chariyalertsak, Suwat; Chingono, Alfred; Gray, Glenda; Mbwambo, Jessie; Coates, Tom

    2014-02-01

    Childhood sexual and physical abuse have been linked to adolescent and adult risky sexual behaviors, including early sexual debut, an increased number of sexual partners, unprotected sex, alcohol and drug use during sex and sexual violence. This paper explores these relationships among both men and women who report histories of childhood abuse from representative samples of communities in three countries in southern and eastern Africa (South Africa, Zimbabwe and Tanzania). Data were collected as part of a 3-year randomized community trial to rapidly increase knowledge of HIV status and to promote community responses through mobilisation, mobile testing, provision of same-day HIV test results and post-test support for HIV. The results indicate that reported childhood sexual and physical abuse is high in all three settings, also among men, and shows strong relationships with a range of sexual risk behaviors, including age at first sex (OR -0.6 (CI: -0.9, -0.4, p < 0.003)-among men, OR -0.7 (CI: -0.9, -0.5, p < 0.001)-among women), alcohol (OR 1.43 (CI: 1.22, 1.68, p < 0.001)-men, OR 1.83 (CI: 1.50, 2.24, p < 0.001)-women) and drug use (OR 1.65 (CI: 1.38, 1.97, p < 0.001)-men, OR 3.14 (CI: 1.95, 5.05, p < 0.001)-women) and two forms of partner violence-recent forced sex (OR 2.22 (CI: 1.66, 2.95, p < 0.001)-men, OR 2.76 (CI: 2.09, 3.64, p < 0.001)-women) and ever being hurt by a partner (OR 3.88 (CI: 2.84, 5.29, p < 0.001)-men, OR 3.06 (CI: 2.48, 3.76, p < 0.001)-women). Individuals abused in childhood comprise between 6 and 29 % of young adult men and women living in these African settings and constitute a population at high risk of HIV infection. PMID:23474641

  2. From rhetoric to reality? Putting HIV and AIDS rights talk into practice in a South African rural community.

    Science.gov (United States)

    Campbell, Catherine; Nair, Yugi

    2014-01-01

    Whilst international rhetoric on HIV and AIDS frequently invokes discourses of human rights to inspire and guide action, translating universal rights talk into practice in specific settings remains a challenge. Community mobilisation is often strategy of choice. We present a case study of the Entabeni Project in South Africa--in which a foreign-funded NGO sought to work with female health volunteers in a deep rural community to increase their access to two HIV-relevant rights: women's rights (especially gender equality) and rights to health (especially access to HIV- and AIDS-related services). Whilst the project had short-term health-related successes, it was less successful in implementing a gender empowerment agenda. The concept of women's rights had no purchase with women who had little interest in directly challenging male power, foregrounding the fight against poverty as their main preoccupation. The area's traditional chief and gatekeeper insisted the project should remain 'apolitical'. Project funders prioritised 'numbers reached' over a gender empowerment orientation. In the absence of (1) a marginalised group who are willing to assert their rights; and (2) a context where powerful people are willing to support these claims, 'rights' may be a blunt tool for HIV-related work with women in deeply oppressive and remote rural communities beyond the reach of international treaties and urban-based activist movements. PMID:25005486

  3. The pharmacokinetics and acceptability of lopinavir/ritonavir minitab sprinkles, tablets, and syrups in african HIV-infected children

    NARCIS (Netherlands)

    Musiime, V.; Fillekes, Q.; Kekitiinwa, A.; Kendall, L.; Keishanyu, R.; Namuddu, R.; Young, N.; Opilo, W.; Lallemant, M.; Walker, A.S.; Burger, D.M.; Gibb, D.M.

    2014-01-01

    BACKGROUND: Guidelines recommend lopinavir/ritonavir (LPV/r) as first- and second-line therapy for young and older HIV-infected children, respectively. Available formulations have limitations making their widespread use complex. METHODS: An open-label comparative bioavailability (randomized crossove

  4. Applying the Dynamic Social Systems Model to HIV Prevention in a Rural African Context: The Maasai and the "Esoto" Dance

    Science.gov (United States)

    Siegler, Aaron J.; Mbwambo, Jessie K.; DiClemente, Ralph J.

    2013-01-01

    This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate…

  5. 'They can't report abuse, they can't move out. They are at the mercy of these men': exploring connections between intimate partner violence, gender and HIV in South African clinical settings.

    Science.gov (United States)

    Sprague, Courtenay; Hatcher, Abigail M; Woollett, Nataly; Sommers, Theresa; Black, Vivian

    2016-05-01

    This qualitative study captured South African female health provider perspectives of intimate partner violence in female patients, gender norms and consequences for patients' health. Findings indicated female patients' health behaviours were predicated on sociocultural norms of submission to men's authority and economic dependence on their partners. Respondents described how men's preferences and health decision-making in clinics affected their patients' health. Adverse gender norms and gender inequalities affected women's opportunities to be healthy, contributing to HIV risk and undermining effective HIV management in this context. Some providers, seeking to deliver a standard of quality healthcare to their female patients, demonstrated a willingness to challenge patriarchal gender relations. Findings enhance understanding of how socially-sanctioned gender norms, intimate partner violence and HIV are synergistic, also reaffirming the need for integrated HIV-intimate partner violence responses in multi-sector national strategic plans. Health providers' intimate knowledge of the lived experiences of female patients with intimate partner violence and/or HIV deepens understanding of how adverse gender norms generate health risks for women in ways that may inform policy and clinical practice in South Africa and other high-HIV prevalence settings. PMID:26505136

  6. Mental Health and African Americans

    Science.gov (United States)

    ... Program Grants Other Grants Planning and Evaluation Grantee Best Practices Black/African American Asthma Cancer Chronic Liver Disease Diabetes Heart Disease Hepatitis HIV/AIDS Immunizations Infant Heath & Mortality Mental Health Obesity Organ and Tissue Donation Stroke Stay Connected ...

  7. Relationship power, communication, and violence among couples: results of a cluster-randomized HIV prevention study in a South African township

    Directory of Open Access Journals (Sweden)

    Minnis AM

    2015-05-01

    Full Text Available Alexandra M Minnis,1,2 Irene A Doherty,1,3 Tracy L Kline,1 William A Zule,1 Bronwyn Myers,4,5 Tara Carney,4 Wendee M Wechsberg1,3,6,7 1RTI International, Research Triangle Park, NC, 2School of Public Health, University of California, Berkeley, CA, 3University of North Carolina, Chapel Hill, NC, USA; 4Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, 5Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; 6North Carolina State University, Raleigh, 7Duke University School of Medicine, Durham, NC, USA Background: Inequitable gender-based power in relationships and intimate partner violence contribute to persistently high rates of HIV infection among South African women. We examined the effects of two group-based HIV prevention interventions that engaged men and their female partners together in a couples intervention (Couples Health CoOp [CHC] and a gender-separate intervention (Men’s Health CoOp/Women’s Health CoOp [MHC/WHC] on women’s reports of power, communication, and conflict in relationships. Methods: The cluster-randomized field experiment included heterosexual couples from a high-density South African township in which neighborhoods were randomized to one of the intervention arms or a control arm that received the WHC only. Participants completed in-person study visits at baseline and 6-month follow-up. We examined group differences using one-way analysis of variance and multivariable regression models.Results: Of the 290 couples enrolled, 255 women remained in the same partnership over 6 months. Following the intervention, women in the CHC arm compared with those in the WHC arm were more likely to report an increase in relationship control (ß=0.92, 95% confidence interval [CI]: 0.02, 1.83, P=0.045 and gender norms supporting female autonomy in relationships (ß=0.99, 95% CI: 0.07, 1.91, P=0.035. Women in the MHC/WHC arm were more likely to report increases

  8. Human papillomavirus infection and disease in men: Impact of HIV

    Directory of Open Access Journals (Sweden)

    Sinead Delany-Moretlwe

    2013-12-01

    Full Text Available There is growing evidence of a significant burden of human papillomavirus (HPV infection and associated disease in men. High rates of HPV infection have been observed in men from sub-Saharan Africa where HIV prevalence is high. HIV infection increases HPV prevalence, incidence and persistence and is strongly associated with the development of anogenital warts and anal, penile and head and neck cancers in men. Despite increasing access to antiretroviral therapy, there appears to be little benefit in preventing the development of these cancers in HIV-positive men, making prevention of infection a priority. New prevention options that are being introduced in many African countries include male circumcision and HPV vaccination. However, more data are needed on the burden of HPV disease in men before boys are included in HPV vaccination programmes.

  9. Health Facility Characteristics and Their Relationship to Coverage of PMTCT of HIV Services across Four African Countries: The PEARL Study

    OpenAIRE

    Ekouevi, Didier K; Stringer, Elizabeth; Coetzee, David; Tih, Pius; Creek, Tracy,; Stinson, Kathryn; Westfall, Andrew O.; Welty, Thomas; Chintu, Namwinga; Chi, Benjamin H.; Wilfert, Cathy; Shaffer, Nathan; Stringer, Jeff; Dabis, Francois

    2012-01-01

    Background Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT) coverage in sub-Saharan are poorly understood. Methodology/Principal Findings We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenat...

  10. Sexual behaviour in a rural high HIV prevalence South African community: time trends in the antiretroviral treatment era

    OpenAIRE

    McGrath, N.; Eaton, J W; Barnighausen, T.; Tanser, F.

    2013-01-01

    Objectives: Data from generalized epidemic settings have consistently found that patients on antiretroviral therapy (ART) reduce sexual risk behaviours, but how sexual behaviour changes in the general population in response to ART availability, including amongst HIV-uninfected and undiagnosed adults, has not been characterized in these settings. Design: General population open cohort. Methods: We report trends in sexual behaviour indicators for men aged 17–54 years and women aged 17–4...

  11. Sexuality and the limits of agency among South African teenage women: theorising femininities and their connections to HIV risk practices

    OpenAIRE

    Jewkes, R; Morrell, R.

    2011-01-01

    In South Africa, both HIV and gender-based violence are highly prevalent. Gender inequalities give men considerable relational power over young women, particularly in circumstances of poverty and where sex is materially rewarded. Young women are often described as victims of men, but this inadequately explains women’s observed sexual agency. This paper takes a different approach. We use qualitative interviews and ethnographic observation among 16 young women from the rural Eastern Cape to exp...

  12. The relational dynamics of hegemonic masculinity among South African men and women in the context of HIV.

    Science.gov (United States)

    Stern, Erin; Buikema, Rosemarie

    2013-01-01

    In South Africa, the frequent positioning of men's sexual behaviours as a prime driver of the HIV epidemic has generated much interest in men's sexuality. However, the relational nature of dominant male norms that exacerbate the risk of HIV transmission is inadequately understood. This study used sexual biographies to explore how men and women negotiate gendered norms and how this affects their sexual and reproductive health (SRH). A total of 50 sexual-history interviews and 10 focus group discussions were conducted with men, and 25 sexual-history interviews with women, with participants sampled from three age categories (ages 18-24, 25-55 and 55+years), a range of cultural and racial backgrounds and urban and rural sites across five provinces in South Africa. The narratives illustrate that men and women's SRH is largely dependent on the type and quality of their relationships. Men's sexuality was regularly depicted as being detached from intimacy and uncontrollable, which was premised as being opposite from and/or superior to women's sexuality and could justify men's high-risk sexual behaviours. Yet many participants also supported gender equitable relationships and endorsed accountable and healthy SRH behaviours. The narratives reveal that HIV-risky dominant male norms should be addressed relationally for the sake of better SRH outcomes. PMID:23805918

  13. The Heart of the Matter: Methodological Challenges in Developing a Contemporary 257-269 Reading Programme for Monolingual Lexicography, from the Perspective of the Dictionary Unit for South African English

    Directory of Open Access Journals (Sweden)

    Leela Pienaar

    2011-10-01

    Full Text Available

    Abstract: This article argues the importance of the reading programme as the pivotal issue inthe lexicographic process. It is essentially a practical article which outlines strategies for developingand implementing a reading programme for monolingual lexicography. The arguments are informedby theory, together with an examination of the data-collection procedures followed by theDictionary Unit for South African English (DSAE and a survey of current practice in major Englishdictionary units around the world, namely the Oxford English Dictionary, the Canadian OxfordDictionary, the Australian National Dictionary Centre and the New Zealand Dictionary Centre.The reading programme for the DSAE is first defined and contextualized within its mission statement.The article then explores the challenges inherent in sampling contemporary written and spokenEnglish in the South African multilingual context. It is intended to inform the DSAE's intakepolicy, in terms of the following critical issues:

    — the definition of South African English,

    — the monitoring and selection of print, oral and electronic sources,

    — the excerpting of citations and relevant bibliographic information, and

    — the recruiting and training of readers.

    These interlinked aspects of the reading programme have crucial implications for the quality andauthority of the monolingual dictionary on historical principles.

    Keywords: READING PROGRAMME, MONOLINGUAL DICTIONARY, HISTORICAL PRINCIPLES, CONTEMPORARY, INTAKE, CITATIONS, STRATEGIES

    Opsomming: Die kern van die saak: Metodologiese uitdagings by die ontwikkelingvan 'n eietydse leesprogram vir eentalige leksikografie, uit dieperspektief van die Dictionary Unit for South African English. Hierdie artikelbepleit die belangrikheid van die leesprogram as die kernsaak in die leksikografiese proses. Dit ishoofsaaklik 'n praktiese artikel wat stategieë vir die ontwikkeling en implementering van 'n

  14. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

    Science.gov (United States)

    Nachega, Jean B; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F; Altice, Frederick L; Burke, Jessica G; Lester, Richard T; Uthman, Olalekan A; Knowlton, Amy R; Cotton, Mark F; Anderson, Jean R; Theron, Gerhard B

    2016-01-01

    Objective To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting A community primary care clinic in Cape Town, South Africa. Participants HIV-infected pregnant women. Main outcomes Acceptability and feasibility of mHealth and cDOT interventions. Results Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. PMID

  15. On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial.

    Science.gov (United States)

    Jemmott, John B; Jemmott, Loretta Sweet; O'Leary, Ann; Icard, Larry D; Rutledge, Scott E; Stevens, Robin; Hsu, Janet; Stephens, Alisa J

    2015-07-01

    We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk-reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV-diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk-reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention, immediately post-intervention, and 6 and 12 months post-intervention surveys. Of 595 participants, 503 (85 %) completed the 12-month follow-up. Generalized-estimating-equations analysis indicated that, compared with the attention-matched control intervention, the BRO intervention did not increase consistent condom use averaged over the 6- and 12-month follow-ups, which was the primary outcome. Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection. Mediation analysis using the product-of-coefficients approach revealed that although BRO increased seven of nine theoretical constructs it was designed to affect, it increased only one of three theoretical constructs that predicted consistent condom use: condom-use impulse-control self-efficacy. Thus, BRO indirectly increased consistent condom use through condom-use impulse-control self-efficacy. In conclusion, although BRO increased several theoretical constructs, most of those constructs did not predict consistent condom use; hence, the intervention did not increase it. Theoretical constructs that interventions should target to increase African American MSM

  16. Sexuality and the limits of agency among South African teenage women: theorising femininities and their connections to HIV risk practices.

    Science.gov (United States)

    Jewkes, R; Morrell, R

    2012-06-01

    In South Africa, both HIV and gender-based violence are highly prevalent. Gender inequalities give men considerable relational power over young women, particularly in circumstances of poverty and where sex is materially rewarded. Young women are often described as victims of men, but this inadequately explains women's observed sexual agency. This paper takes a different approach. We use qualitative interviews and ethnographic observation among 16 young women from the rural Eastern Cape to explore ways young women construct their femininities and exercise agency. The data were collected as part of an evaluation of Stepping Stones, which is a participatory behavioural intervention for HIV prevention that seeks to be gender transformative. Agency was most notable in particular stages of the dating 'game', especially relationship initiation. Constructions of desirable men differed but generally reflected a wish to avoid violence, and a search for mutual respect, sexual pleasure, romance, modernity, status and money. Agency was constrained once relationships were consented to, as men expected to control their partners, using violent and non-violent methods. Women knew this and many accepted this treatment, although often expressing ambivalence. Many of the women expressed highly acquiescent femininities, with power surrendered to men, as a 'choice' that made their lives in cultural terms more meaningful. In marked contrast to this was a 'modern' femininity, centred around a desire to be 'free'. A visible third position, notably emerging after the Stepping Stones intervention, rested not on a feminist challenge to patriarchy, but on an accommodation with men's power whilst seeking to negotiate greater respect and non-violence within relations with men. These multiple and dynamic femininities open up possibilities for change. They demonstrate the need to engage with women, both as victims of patriarchy and active supporters of the gender order. The multiplicity of women

  17. HIV infection in India: Epidemiology, molecular epidemiology and pathogenesis.

    Indian Academy of Sciences (India)

    Samir Lakhashe; Madhuri Thakar; Sheela Godbole; Srikanth Tripathy; Ramesh Paranjape

    2008-11-01

    The year 1986 saw first case of HIV infection as well as first report of AIDS case in India. Since then the epidemic has spread throughout the country. In the recent years there is evidence of epidemic being stabilized with decrease in new infections reported from some parts of the country. The absolute number of HIV infections in the country is expected to be close to 2.5 million and National AIDS Control Programme, phase III is geared to contain the epidemic. HIV viruses circulating in India predominantly belong to HIV-1 subtype C. However, there have been occasional reports of HIV-1 subtype A and B. Matter of concern is reports of A/C and B/C mosaic viruses that are being reported from different parts of the country. The data on HIV drug resistance from India is rather limited. Most of the studies have shown that the virus strains from drug naïve patients do not show significant level of drug resistance mutations. The few immunological studies in Indian patients show that the Indian HIV infected patients show both HIV-specific CTL responses as well as neutralizing antibody response. Mapping of CTL epitopes showed that while Indian patients identify same regions of Gag antigen as recognized by South African subtype C infected patients, some regions are uniquely recognized by Indian patients. There are very few studies on host genetic factors in India in context with HIV infection. However there are evidences reported of association of host genetic factors such as HLA types and haplotypes and HIV disease.

  18. GEOTHERM programme supports geothermal energy world-wide. Geothermal energy, a chance for East African countries; GEOTHERM: BGR foerdert weltweit Nutzung geothermischer Energie. Geothermie - eine Chance fuer ostafrikanische Laender

    Energy Technology Data Exchange (ETDEWEB)

    Kraml, M.; Kessels, K.; Kalberkamp, U.; Ochmann, N.; Stadtler, C. [Bundesanstalt fuer Geowissenschaften und Rohstoffe (BGR), Hannover (Germany)

    2007-02-15

    The high geothermal potential of East Africa, especially of the Eastern Rift, is known for a long time. Since these pioneer studies, geothermal plants have been constructed at three sites in East Africa. Nevertheless, up to now geothermal has been a success story only in Kenya. The steam power plant Olkaria I in Kenya is running reliability since 25 years. Today, the country produces more than 12% of its electricity from geothermal. Now, Eritrea, Djibouti, Uganda, Tanzania and Ethiopia which are also situated along the East African Rift, are planning similar projects. The countries need to develop new energy sources because oil prices have reached a critical level. In the past, hydro power was regarded to be a reliable source of energy, but increased droughts changed the situation. Thus, the african states are searching for alternatives to be able to stabilise their energy supply and to cover the growing energy demand. There is much hope that the success of the Kenyan geothermal power plants will be repeated in the neighbouring countries. The East African countries have joined their forces to give impetus to the use of the regional geothermal resources. On behalf of the Federal Ministry for Economic Cooperation and Development, the Federal Institute for Geosciences and Natural Resources supports the countries in realising their plans as part of the GEOTHERM Programme. Together with further donors (Iceland, France, USA, Global Environment Facility) the path will be paved for geothermal power plants in the above mentioned six East African countries. The following main steps are necessary: - Awareness raising of political decision makers about the advantages of including geothermal into the national power plans - Improvement of knowledge about potentials geothermal sites - Development of a regional equipment pool including the necessary geophysical equipment, laboratories, etc. - Training in geothermal exploration and plant maintenance, to minimise risks of site

  19. Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Ekouevi, Didier K; Coffie, Patrick A; Messou, Eugene;

    2013-01-01

    HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework o...

  20. Subtype C gp140 Vaccine Boosts Immune Responses Primed by the South African AIDS Vaccine Initiative DNA-C2 and MVA-C HIV Vaccines after More than a 2-Year Gap.

    Science.gov (United States)

    Gray, Glenda E; Mayer, Kenneth H; Elizaga, Marnie L; Bekker, Linda-Gail; Allen, Mary; Morris, Lynn; Montefiori, David; De Rosa, Stephen C; Sato, Alicia; Gu, Niya; Tomaras, Georgia D; Tucker, Timothy; Barnett, Susan W; Mkhize, Nonhlanhla N; Shen, Xiaoying; Downing, Katrina; Williamson, Carolyn; Pensiero, Michael; Corey, Lawrence; Williamson, Anna-Lise

    2016-06-01

    A phase I safety and immunogenicity study investigated South African AIDS Vaccine Initiative (SAAVI) HIV-1 subtype C (HIV-1C) DNA vaccine encoding Gag-RT-Tat-Nef and gp150, boosted with modified vaccinia Ankara (MVA) expressing matched antigens. Following the finding of partial protective efficacy in the RV144 HIV vaccine efficacy trial, a protein boost with HIV-1 subtype C V2-deleted gp140 with MF59 was added to the regimen. A total of 48 participants (12 U.S. participants and 36 Republic of South Africa [RSA] participants) were randomized to receive 3 intramuscular (i.m.) doses of SAAVI DNA-C2 of 4 mg (months 0, 1, and 2) and 2 i.m. doses of SAAVI MVA-C of 1.45 × 10(9) PFU (months 4 and 5) (n = 40) or of a placebo (n = 8). Approximately 2 years after vaccination, 27 participants were rerandomized to receive gp140/MF59 at 100 μg or placebo, as 2 i.m. injections, 3 months apart. The vaccine regimen was safe and well tolerated. After the DNA-MVA regimen, CD4(+) T-cell and CD8(+) T-cell responses occurred in 74% and 32% of the participants, respectively. The protein boost increased CD4(+) T-cell responses to 87% of the subjects. All participants developed tier 1 HIV-1C neutralizing antibody responses as well as durable Env binding antibodies that recognized linear V3 and C5 peptides. The HIV-1 subtype C DNA-MVA vaccine regimen showed promising cellular immunogenicity. Boosting with gp140/MF59 enhanced levels of binding and neutralizing antibodies as well as CD4(+) T-cell responses to HIV-1 envelope. (This study has been registered at ClinicalTrials.gov under registration no. NCT00574600 and NCT01423825.). PMID:27098021

  1. CD4 trajectory adjusting for dropout among HIV-positive patients receiving combination antiretroviral therapy in an East African HIV care centre

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    Agnes N Kiragga

    2014-08-01

    Full Text Available Objective: Estimates of CD4 response to antiretroviral therapy (ART obtained by averaging data from patients in care, overestimate population CD4 response and treatment program effectiveness because they do not consider data from patients who are deceased or not in care. We use mathematical methods to assess and adjust for this bias based on patient characteristics. Design: We examined data from 25,261 HIV-positive patients from the East Africa IeDEA Consortium. Methods: We used inverse probability of censoring weighting (IPCW to represent patients not in care by patients in care with similar characteristics. We address two questions: What would the median CD4 be “had everyone starting ART remained on observation?” and “were everyone starting ART maintained on treatment?” Results: Routine CD4 count estimates were higher than adjusted estimates even under the best-case scenario of maintaining all patients on treatment. Two years after starting ART, differences between estimates diverged from 30 cells/µL, assuming similar mortality and treatment access among dropouts as patients in care, to over 100 cells/µL assuming 20% lower survival and 50% lower treatment access among dropouts. When considering only patients in care, the proportion of patients with CD4 above 350 cells/µL was 50% adjusted to below 30% when accounting for patients not in care. One-year mortality diverged 6–14% from the naïve estimates depending on assumptions about access to care among lost patients. Conclusions: Ignoring mortality and loss to care results in over-estimation of ART response for patients starting treatment and exaggerates the efficacy of treatment programs administering it.

  2. High-levels of acquired drug resistance in adult patients failing first-line antiretroviral therapy in a rural HIV treatment programme in KwaZulu-Natal, South Africa.

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    Justen Manasa

    Full Text Available OBJECTIVE: To determine the frequency and patterns of acquired antiretroviral drug resistance in a rural primary health care programme in South Africa. DESIGN: Cross-sectional study nested within HIV treatment programme. METHODS: Adult (≥ 18 years HIV-infected individuals initially treated with a first-line stavudine- or zidovudine-based antiretroviral therapy (ART regimen and with evidence of virological failure (one viral load >1000 copies/ml were enrolled from 17 rural primary health care clinics. Genotypic resistance testing was performed using the in-house SATuRN/Life Technologies system. Sequences were analysed and genotypic susceptibility scores (GSS for standard second-line regimens were calculated using the Stanford HIVDB 6.0.5 algorithms. RESULTS: A total of 222 adults were successfully genotyped for HIV drug resistance between December 2010 and March 2012. The most common regimens at time of genotype were stavudine, lamivudine and efavirenz (51%; and stavudine, lamivudine and nevirapine (24%. Median duration of ART was 42 months (interquartile range (IQR 32-53 and median duration of antiretroviral failure was 27 months (IQR 17-40. One hundred and ninety one (86% had at least one drug resistance mutation. For 34 individuals (15%, the GSS for the standard second-line regimen was <2, suggesting a significantly compromised regimen. In univariate analysis, individuals with a prior nucleoside reverse-transcriptase inhibitor (NRTI substitution were more likely to have a GSS <2 than those on the same NRTIs throughout (odds ratio (OR 5.70, 95% confidence interval (CI 2.60-12.49. CONCLUSIONS: There are high levels of drug resistance in adults with failure of first-line antiretroviral therapy in this rural primary health care programme. Standard second-line regimens could potentially have had reduced efficacy in about one in seven adults involved.

  3. Childbearing in a Time of ART: Birth Rates, Childbearing Desires and Family Planning in a Rural HIV Treatment and Care Programme in South Africa

    OpenAIRE

    Benton, L. M.

    2015-01-01

    Mixed methods investigate the association between HIV, ART and fertility following scale-up of HIV treatment and care in South Africa. Two longitudinal analyses of surveillance data from the Africa Centre for Health and Population Studies compare factors associated with live birth by HIV and ART exposure. Semi-structured interviews with women enrolled on ART and healthcare providers explore perceptions of childbearing and contraceptive use. A quantitative study reports on one open cohort anal...

  4. Prevention of mother-to-child HIV transmission in resource-limited settings: assessment of 99 Viramune Donation Programmes in 34 countries, 2000–2011

    OpenAIRE

    Ladner, Joël; Besson, Marie-Hélène; Rodrigues, Mariana; Sams, Kelley; Audureau, Etienne; Saba, Joseph

    2013-01-01

    Background Transmission of HIV from mother-to-child during pregnancy, labor, or breastfeeding is the primary cause of pediatric HIV infection in sub-Saharan Africa. A regimen of single-dose nevirapine administered to both HIV-positive pregnant women and their infants has been shown to lower the risk of mother-to-child transmission (MTCT) of HIV. In an effort to facilitate scale-up of PMTCT programs in low-income countries, Boehringer Ingelheim, the manufacturer of Viramune (branded nevirapine...

  5. Bacterial vaginosis associated with increased risk of female-to-male HIV-1 transmission: a prospective cohort analysis among African couples.

    OpenAIRE

    Craig R Cohen; Lingappa, Jairam R.; Baeten, Jared M.; Ngayo, Musa O.; Spiegel, Carol A.; Ting Hong; Deborah Donnell; Connie Celum; Saidi Kapiga; Sinead Delany; Bukusi, Elizabeth A.

    2012-01-01

    Editors' Summary Background Since the first reported case of AIDS in 1981, the number of people infected with HIV, the virus that causes AIDS, has risen steadily. By the end of 2010, 34 million people were living with HIV/AIDS. At the beginning of the epidemic more men than women were infected with HIV. Now, however, 50% of all adults infected with HIV are women and in sub-Saharan Africa, where two-thirds of HIV-positive people live, women account for 59% of people living with HIV. Moreover, ...

  6. Feasibility and acceptability of point of care HIV testing in community outreach and GUM drop-in services in the North West of England: A programmatic evaluation

    OpenAIRE

    Jelliman Pauline; Harrison Ian; Spaine Vida; Coffey Emer; Jones Kathy; Chawla Anu; MacPherson Peter; Phillips-Howard Penelope; Beynon Caryl; Taegtmeyer Miriam

    2011-01-01

    Abstract Background In Liverpool, injecting drug users (IDUs), men-who-have-sex-with-men (MSM) and UK Africans experience a disproportionate burden of HIV, yet services do not reach out to these groups and late presentations continue. We set out to: increase testing uptake in targeted marginalized groups through a community and genitourinary medicine (GUM)-based point of care testing (POCT) programme; and conduct a process evaluation to examine service provider inputs and document service use...

  7. Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe's National Antiretroviral Therapy Programme, 2007-2010.

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    Tsitsi Mutasa-Apollo

    Full Text Available BACKGROUND: Since establishment of Zimbabwe's National Antiretroviral Therapy (ART Programme in 2004, ART provision has expanded from <5,000 to 369,431 adults by 2011. However, patient outcomes are unexplored. OBJECTIVE: To determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART. METHODS: A retrospective review of abstracted patient records of adults ≥ 15 years who initiated ART from 2007 to 2009 was done. Frequencies and medians were calculated for rates of retention in care and changes in key health status outcomes at 6, 12, 24 and 36 months respectively. Cox proportional hazards models were used to determine factors associated with attrition. RESULTS: Of the 3,919 patients, 64% were female, 86% were either WHO clinical stage III or IV. Rates of patient retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. After ART initiation, median weight gains at 6, 12, and 24 months were 3, 4.5, and 5.0 kgs whilst median CD4+ cell count gains at 6, 12 and 24 months were 122, 157 and 279 cells/µL respectively. Factors associated with an increased risk of attrition included male gender (AHR 1.2; 95% CI, 1.1-1.4, baseline WHO stage IV (AHR 1.7; 95% CI, 1.1-2.6, lower baseline body weight (AHR 2.0; 95% CI, 1.4-2. 8 and accessing care from higher level healthcare facilities (AHR 3.5; 95% 1.1-11.2. CONCLUSIONS: Our findings with regard to retention as well as clinical and immunological improvements following uptake of ART, are similar to what has been found in other settings. Factors influencing attrition also mirror those found in other parts of sub-Saharan Africa. These findings suggest the need to strengthen earlier diagnosis and treatment to further improve treatment outcomes. Whilst decentralisation improves ART coverage it should be coupled with strategies aimed at improving patient retention.

  8. Land use and land cover change as a consequence of the South African land reform programme : A remote sensing approach / Zwidofhelangani Lidzhegu

    OpenAIRE

    Lidzhegu, Zwidofhelangani

    2012-01-01

    Over 18 years after the democratic government took power in South Africa, environmental changes relevant to the land reform policies are taking place because of unintended consequences of land reform policy. This study aimed at investigating the effects of the South African land reform policy on land use and land cover change on a land restitution project in Makotopong, Limpopo province, South Africa. The study used remote sensing techniques through the analysis of Landsat TM i...

  9. Experiences and conceptualizations of sexual debut from the narratives of South African men and women in the context of HIV/AIDS.

    Science.gov (United States)

    Stern, Erin; Cooper, Diane

    2014-01-01

    Given the pivotal role of first sex in the development of sexual and reproductive health (SRH) practices, there is a need for more contextualised and nuanced understandings of young people's early sexual debut experiences. This study used sexual history narratives to investigate how South African men and women experience and attribute meaning to their sexual debut, and their SRH practices. In light of the gendered disparities among young people's SRH awareness and risk, differences between men and women's narratives of sexual debut were assessed. Fifty sexual history interviews were conducted with men and 25 sexual history interviews with women, with participants purposively sampled from three age categories, a range of cultural and racial backgrounds and urban and rural sites across five provinces. Narrative interviews were designed to elicit stories around participants' early knowledge of sex and sexual experimentation, their range of sexual relationships and SRH practices. The data were analysed using a thematic approach. Participants generally reflected on their early sexual experiences with feelings of inadequacy and disappointment. While men appeared to hold greater decision-making power than women at sexual debut, descriptions of men's early sexual experiences were often characterised by respect, intimacy and vulnerability. Many men attributed the timing of their sexual debut to peer pressure, which typically generated higher social status and rarely included consideration of the need to practice safer sex. Several women felt pressured by their partner to sexually debut, which could have informed their perceptions of men being sexually controlling and aggressive. The study demonstrates the value of a narrative approach for generating insights on young people's sexual debut experiences and SRH practices, and the underlying gendered norms and expectations that shape these. The findings indicate the need for gender transformative HIV interventions to take into

  10. Applying the Dynamic Social Systems Model to HIV prevention in a rural African context: the Maasai and the esoto dance.

    Science.gov (United States)

    Siegler, Aaron J; Mbwambo, Jessie K; DiClemente, Ralph J

    2013-12-01

    This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate with sexual partnership, including "wife sharing", fertility rituals, and various traditional dances. One dance, esoto, accounted for more than two thirds of participants' lifetime sexual partners (n = 10.5). The DSSM, combining structural and systems theories, was applied to systematize complex multilevel factors regarding esoto practice. Participants reported multifaceted beliefs regarding esoto; a majority viewed the dance as exciting and essential, yet most men feared social stigma and three quarters of women had experienced physical punishment for nonattendance. In multivariate logistic regression, esoto attendance was predicted by female gender (adjusted odds ratio [AOR] = 4.67, 95% confidence interval [CI] = 1.6-13.2), higher positive beliefs regarding esoto (AOR = 2.84, 95% CI = 1.9-4.2), and Maasai life cycle events (AOR = 0.06, 95% CI = 0.01-0.47). The DSSM proved useful for characterizing esoto and for revealing feedback loops that maintain esoto, thus indicating avenues for future interventions. PMID:23372030

  11. Challenges of diagnosing acute HIV-1 subtype C infection in African women: performance of a clinical algorithm and the need for point-of-care nucleic-acid based testing.

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    Koleka Mlisana

    Full Text Available BACKGROUND: Prompt diagnosis of acute HIV infection (AHI benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. METHODS: 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symptoms at first HIV-positive visit were compared to HIV-negative visits. Logistic regression identified clinical predictors of AHI. A model-based score was assigned to each predictor to create a risk score for every woman. RESULTS: Twenty-eight women seroconverted after a total of 390 person-years of follow-up with an HIV incidence of 7.2/100 person-years (95%CI 4.5-9.8. Fifty-seven percent reported ≥1 sign or symptom at the AHI visit. Factors predictive of AHI included age <25 years (OR = 3.2; 1.4-7.1, rash (OR = 6.1; 2.4-15.4, sore throat (OR = 2.7; 1.0-7.6, weight loss (OR = 4.4; 1.5-13.4, genital ulcers (OR = 8.0; 1.6-39.5 and vaginal discharge (OR = 5.4; 1.6-18.4. A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p<0.001. CONCLUSIONS: Accurate recognition of signs and symptoms of AHI is critical for early diagnosis of HIV infection. Our algorithm may assist in risk-stratifying individuals for AHI, especially in resource-limited settings where there is no routine testing for AHI. Independent validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care antigen or viral load technology is required, however, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission.

  12. Comparing eLearning and Classroom Instruction on HIV/AIDS Knowledge Uptake and Internalizing among South African and Irish Pupils

    Science.gov (United States)

    van Zyl, Hendra; Visser, Pieter; van Wyk, Elmarie; Laubscher, Ria

    2014-01-01

    Objective: Innovative public health approaches are required to improve human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and prevention among adolescents, one of the most vulnerable groups to HIV/AIDS. Consequently, elearning and classroom instruction was assessed for HIV/AIDS knowledge uptake and internalizing…

  13. The Tingathe programme: a pilot intervention using community health workers to create a continuum of care in the prevention of mother to child transmission of HIV (PMTCT cascade of services in Malawi

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    Gordon E Schutze

    2012-07-01

    Full Text Available Introduction: Loss to follow-up is a major challenge in the prevention of mother to child transmission of HIV (PMTCT programme in Malawi with reported loss to follow-up of greater than 70%. Tingathe-PMTCT is a pilot intervention that utilizes dedicated community health workers (CHWs to create a complete continuum of care within the PMTCT cascade, improving service utilization and retention of mothers and infants. We describe the impact of the intervention on longitudinal care starting with diagnosis of the mother at antenatal care (ANC through final diagnosis of the infant. Methods: PMTCT service utilization, programme retention and outcomes were evaluated for pregnant women living with HIV and their exposed infants enrolled in the Tingathe-PMTCT programme between March 2009 and March 2011. Multivariate logistic regression was done to evaluate maternal factors associated with failure to complete the cascade. Results: Over 24 months, 1688 pregnant women living with HIV were enrolled. Median maternal age was 27 years (IQR, 23.8 to 30.8; 333 (19.7% were already on ART. Among the remaining women, 1328/1355 (98% received a CD4 test, with 1243/1328 (93.6% receiving results. Of the 499 eligible for ART, 363 (72.8% were successfully initiated. Prior to, delivery there were 93 (5.7% maternal/foetal deaths, 137 (8.1% women transferred/moved, 51 (3.0% were lost and 58 (3.4% refused ongoing PMTCT services. Of the 1318 live births to date, 1264 (95.9% of the mothers and 1285 (97.5% of the infants received ARV prophylaxis; 1064 (80.7% infants were tested for HIV by PCR and started on cotrimoxazole. Median age at PCR was 1.7 months (IQR, 1.5 to 2.5. Overall transmission at first PCR was 43/1047 (4.1%. Of the 43 infants with positive PCR results, 36 (83.7% were enrolled in ART clinic and 33 (76.7% were initiated on ART. Conclusions: Case management and support by dedicated CHWs can create a continuum of longitudinal care in the PMTCT cascade and result in

  14. Health challenges in South African automotive companies: Wellness in the workplace

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    Anna Meyer-Weitz

    2015-03-01

    Full Text Available Orientation: In South Africa, workplace programmes in the automotive industry focus predominantly on occupational health and safety and HIV and AIDS. The implementation of focused workplace interventions might be hampered when companies are not convinced that the condition (i.e. HIV and AIDS is the main negative health influencing factor responsible for increased production costs.Research purpose: The study investigated the health influencing conditions perceived to negatively impact company production costs and related interventions.Motivation for the study: Apart from HIV and AIDS, little information is available about the health challenges in the South African workplace and focused HIV and AIDS programmes might only partly respond to the key health challenges of workplaces. The inter-relatedness of various risky lifestyle factors linked to health conditions necessitates a comprehensive health promotion approach.Research approach, design and method: A cross-sectional survey was conducted amongst 74 companies selected through stratified random sampling. Non-parametric tests were conducted to investigate the health influencing factors perceived to impact production costs, the monitoring thereof, extent of containment and the implementation of interventions in terms of company size and ownership.Main findings: The health factors perceived to have a moderate to large impact were HIV and AIDS, smoking, alcohol use, stress, back and neck ache and tuberculosis, also reported to be better monitored and managed by medium and large organisations. Small organisations reported a smaller impact, fewer efforts and less success. HIV and AIDS programmes were more evident in large companies and those with wellness programmes (52%. Workplace programmes enabled better monitoring and managing of impacting health conditions. Smaller organisations were not convinced of the benefits of interventions in addressing health challenges.Practical/managerial implications

  15. New Patterns of Disclosure: How HIV-Positive Support Group Members from KwaZulu-Natal Speak of their Status in Oral Narratives

    OpenAIRE

    Denis, Philippe

    2014-01-01

    This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African government’s ARV roll-out programme on the basis of in-depth oral history interviews of HIV-positive support group members. It argues that the wider availability of ARV treatment, the ensuing reduced fatality rate and the increased number of people, including men, who receive counselling and testing, may mean that HIV/A...

  16. Healthcare Programmes for Truck Drivers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

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    Samanta Tresha Lalla-Edward

    Full Text Available Truck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population's health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes.We searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio and model to summarise results (fixed vs. random effects.Thirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most

  17. ‘We have beaten HIV a bit’: a qualitative study of experiences of peer support during pregnancy with an HIV Mentor Mother project in England

    Science.gov (United States)

    McLeish, Jenny; Redshaw, Maggie

    2016-01-01

    Objectives To explore the experiences of women living with HIV in England who received or gave Mentor Mother (trained mother-to-mother) volunteer peer support during pregnancy and early motherhood. Design Qualitative descriptive study, using semistructured, in-depth interviews and inductive thematic analysis, theoretically informed by phenomenological social psychology. Setting A London-based third sector peer support organisation for people living with HIV. Participants 12 women living with HIV who had given or received Mentor Mother volunteer peer support (6 had given support and 6 had received support). 11 were black African. Results The key themes in participants' descriptions of their lives as pregnant women and mothers living with HIV were ‘fear and distress’, ‘stigma and isolation’ and ‘the gap in maternity care’. The key themes related to Mentor Mother peer support during and after pregnancy were ‘support to avoid mother-to-child transmission’ (with subthemes ‘reinforcing medical advice’, ‘reframing faith issues’, ‘prioritisation and problem-solving’ and ‘practical strategies for managing HIV and motherhood’), and ‘emotional support’ (with subthemes ‘role modelling and inspiring hope’, ‘openness and non-judgemental acceptance’, ‘a caring relationship’, ‘recreating the lost family network’, ‘being understood from the inside’ and ‘self-confidence’). The Mentor Mothers' support appeared to be a successful hybrid between the peer education Mentor Mothers programmes in southern Africa and the more general pregnancy volunteer peer support models operating in England. Conclusions A Mentor Mother peer support programme is acceptable to, and valued by, black African mothers with HIV in England. Peer support from trained volunteers during and after pregnancy can complement and reinforce medical advice on avoiding mother-to-child transmission of HIV, and can have a multidimensional positive impact on

  18. Family-based HIV prevention and intervention services for youth living in poverty-affected contexts: the CHAMP model of collaborative, evidence-informed programme development

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    Bhana Arvin

    2010-06-01

    Full Text Available Abstract Family-based interventions with children who are affected by HIV and AIDS are not well established. The Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP represents one of the few evidence-based interventions tested in low-income contexts in the US, Caribbean and South Africa. This paper provides a description of the theoretical and empirical bases of the development and implementation of CHAMP in two of these countries, the US and South Africa. In addition, with the advent of increasing numbers of children infected with HIV surviving into adolescence and young adulthood, a CHAMP+ family-based intervention, using the founding principles of CHAMP, has been developed to mitigate the risk influences associated with being HIV positive.

  19. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

    OpenAIRE

    Nomafrench Mbombo; Million Bimerew

    2012-01-01

    South Africa (SA) has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT). However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to...

  20. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes.

    OpenAIRE

    Medley, Amy; Garcia-Moreno, Claudia; McGill, Scott; Maman, Suzanne

    2004-01-01

    This paper synthesizes the rates, barriers, and outcomes of HIV serostatus disclosure among women in developing countries. We identified 17 studies from peer-reviewed journals and international conference abstracts--15 from sub-Saharan Africa and 2 from south-east Asia--that included information on either the rates, barriers or outcomes of HIV serostatus disclosure among women in developing countries. The rates of disclosure reported in these studies ranged from 16.7% to 86%, with women atten...

  1. Do Unsafe Tetanus Toxoid Injections Play a Significant Role in the Transmission of HIV/AIDS? Evidence from Seven African Countries

    OpenAIRE

    de Walque, D.

    2008-01-01

    OBJECTIVES: Although sexual transmission is generally considered to be the main factor driving the HIV/AIDS epidemic in Africa, recent studies have claimed that iatrogenic transmission should be considered as an important source of HIV infection. In particular, receipt of tetanus toxoid injections during pregnancy has been reported to be associated with HIV infection in Kenya. The objective of this paper is to assess the robustness of this association among women in nationally representative ...

  2. The Accelerating Access Initiative: experience with a multinational workplace programme in Africa

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    S Van der Borght

    2009-10-01

    Full Text Available PROBLEM: A multinational company with operations in several African countries was committed to offer antiretroviral treatment to its employees and their dependants. APPROACH: The Accelerating Access Initiative (AAI, an initiative of six pharmaceutical companies and five United Nations' agencies, offered the possibility of obtaining brand antiretroviral drugs (ARVs at 10% of the commercial price. PharmAccess, a foundation aimed at removing barriers to AIDS treatment in Africa, helped to establish an HIV policy and treatment guidelines, and a workplace programme was rolled out from September 2001. LOCAL SETTING: Private sector employers in Africa are keen to take more responsibility in HIV prevention and AIDS care. An important hurdle for African employers remains the price and availability of ARVs. RELEVANT CHANGES: The programme encountered various hurdles, among them the need for multiple contracts with multiple companies, complex importation procedures, taxes levied on ARVs, lack of support from pharmaceutical companies in importation and transportation, slow delivery of the drugs, lack of institutional memory in pharmaceutical companies and government policies excluding the company from access to ARVs under the AAI. LESSONS LEARNED: The launch of the AAI enabled this multinational company to offer access to ARVs to its employees and dependants. The private sector should have access to these discounted drugs under the AAI. A network of local AAI offices should be created to assist in logistics of drugs ordering, purchase and clearance. No taxes should be levied on ARVs.

  3. An expanded analysis of pharmacogenetics determinants of efavirenz response that includes 3'-UTR single nucleotide polymorphisms among Black South African HIV/AIDS patients

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    Marelize eSwart

    2016-01-01

    Full Text Available Introduction: Efavirenz (EFV is a non-nucleoside reverse transcriptase inhibitor prescribed as part of first-line highly active antiretroviral therapy in South Africa. Despite administration of fixed doses of EFV, inter-individual variability in EFV plasma concentrations has been reported. Poor treatment outcomes such as the development of adverse drug reactions or treatment failure have been linked to EFV concentrations outside the therapeutic range (1 - 4 µg/mL. The drug metabolising enzyme (DME, CYP2B6, is primarily responsible for EFV metabolism with minor contributions by CYP2A6, CYP3A4, CYP3A5, UGT2B7 and CYP1A2. Genes coding for DMEs have been shown to be regulated by microRNAs through targeting the 3'-untranslated region. Genetic variation in the 3'-UTR, in addition to genetic variation in the coding regions, could potentially be used to explain a larger proportion of the inter-individual variability observed in drug response. Methods: SNPs in CYP1A2, CYP2B6, UGT2B7 and NR1I2 (PXR were selected for genotyping among 222 Bantu-speaking South African HIV-infected patients receiving EFV-containing HAART. This study is a continuation of earlier pharmacogenetics studies emphasizing specifically the role of genetic variation in the 3'-UTR of genes which products are either pharmacokinetic or pharmacodynamic targets of EFV.Results: In addition to CYP2B6 c.516G>T and c.983T>C SNPs, the CYP2B6 c.1355A>G SNP was identified as pharmacogenetics determinant of EFV concentration among CYP2B6 intermediate and extensive metabolisers (carriers of either c.516G/G+c.983T/T or c.516G/G+c.983T/C or c.516G/T+c.983T/T genotypes. NR1I2 c.522C>T and NR1I3 c.239-1089T>C SNPs were predictors of EFV concentration among CYP2B6 poor metabolisers (carriers of either c.516T/T or c.983C/C or both c.516G/T and c.983T/C genotypes.Conclusion: Genotyping results provide support for comprehensive studies of genetic variation in the 3'-UTR of genes coding for DMEs and their

  4. Differences in body circumferences, skin-fold thicknesses and lipid profiles among HIV-infected African children on and not on stavudine

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    V Musiime

    2012-11-01

    Full Text Available Purpose of the study To compare body circumferences, skin-fold thickness (SFT and lipid levels (LL, as measures of lipodystrophy, among antiretroviral therapy (ART-naïve and experienced children at enrolment into the CHAPAS-3 trial. Methods HIV-infected children in Uganda and Zambia, either ART-naïve or on stavudine (d4T for ≥2 years without clinical lipodystrophy, were randomised to receive d4T, abacavir (ABC or zidovudine (ZDV with lamivudine and efavirenz (EFV or nevirapine. At enrolment, mid-upper arm (MUAC and calf (CC circumferences, SFT (biceps, triceps, sub-scapular, supra-iliac and fasting lipids (total cholesterol (TC, low density lipo-protein (LDL, high density lipoprotein (HDL, triglycerides (TRIG were measured. Age/sex adjusted z-scores of MUAC, CC, SFT and the sum of SFT (SSF used Dutch reference data. ART-naïve and ART-experienced children were compared with t-tests using Stata v11.0. Summary of results Among 444 children, 224 (51% were male and 331 (74.5% ART-naïve. Mean (sd CD4% was 19.7% (10.2 versus (vs 34.2% (7.7 in ART-naïve vs ART-experienced children. The ART-naïve were younger than the ART-experienced children (median [IQR] age 2.5 [1.5, 4.0] vs 6.0 [5.5, 7.0] years, p<0.0001. Among the ART-experienced, 4/108 (3.7% were on EFV and median (IQR d4T use was 3.5 (2.7, 4.2 years. As expected, MUAC, CC, weight-for-age (WAZ and height-for-age (HAZ z-scores were lower in the ART-naïve; the ART-experienced had lower SFT z-scores and higher TC and HDL, but lower TRIG (Table 1. Conclusions Failure-to-thrive likely contributed to lower circumference values in ART-naïve children. Among the ART-experienced, thinner SFT and higher TC values could be ART (particularly d4T-related. Normal values, currently unavailable for African children, are being collected. During trial follow-up, we will evaluate the effect of ABC, ZDV and d4T on development of lipodystrophy in naïve children and its reversibility in d4T-treated children

  5. Seroincidence of HIV-1 infection in african women of reproductive age: a prospective cohort study in Kigali, Rwanda, 1988-1992

    OpenAIRE

    Leroy, V.; Van De Perre, P.; Lepage, P; Sab, J.; Nsengumuremyi, F.; Simonon, A; Karita, E; Msellati, Philippe; Salamon, R.; Dabis, F

    1994-01-01

    To estimate the seroincidence of HIV-1 infection among women of reproductive age in Kingali, Rwanda. A total of 216 HIV-seronegative women were enrolled at delivery between November 1988 and June 1989. A blood sample was obtained at delivery to test for HIV antibodies (by enzyme-linked immunoassay and Western blot). Serum was tested every 3 months during follow-up. Incidence density rates of HIV seroconversion were estimated. The follow-up rate after 3 years was 89%, assessed by the maximum p...

  6. THE EMBEDDEDNESS OF ENTREPRENEURSHIP EDUCATION IN THE CURRICULA OF NON-BUSINESS UNIVERSITY PROGRAMMES: PRELIMINARY EVIDENCE FROM SOUTH AFRICAN UNIVERSITIES OF TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    Robertson K. Tengeh

    2015-06-01

    Full Text Available The total early stage entrepreneurial activity (TEA in South Africa is said to be extremely low compared to those of other sub-Saharan countries. This is despite the concerted efforts of the government to establish, develop and nurture entrepreneurship at all levels, especially among the youths. This calls for concern given the current state of the economy and the challenges faced by South Africa’s future generation. This paper is anchored on two theoretical frameworks to substantiate our argument for the inclusion of entrepreneurship education in the curricula of non-business programmes at universities of technology. The theoretical frameworks are the contingency organizational theory and the magnet versus radiant model. The study adopted an exploratory cross sectional research design which allowed us to collect data from a cross-section of a population: the universities of technology in South Africa. The findings suggest that only fifteen (out of the 46 of the programmes showed visible evidence of entrepreneurship/business studies in their content. Such finding implies that there is a need for entrepreneurship to be integrated into the curricula of all non-business departments if not for the sake of its perceived employment generation attributes, but for its other attributes such as innovation, and more importantly employability.

  7. Update on HIV in Western Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-01-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people l...

  8. Factors Influencing the Nutritional Health and Food Choices of African American HIV-Positive Marginally Housed and Homeless Female Substance Abusers

    Science.gov (United States)

    Mahadevan, Meena; Fisher, Celia B.

    2010-01-01

    The toll of HIV/AIDS and drug abuse on economically disadvantaged women of color in the United States is a public health problem of epidemic proportions. Malnutrition, believed to be pervasive in this population, exacerbates the devastating health effects of addiction and HIV. This study documented dietary deficiencies in this population and…

  9. Assessment of HIV-1 patient recruitability in the Republic of Guinea-Bissau using African versus North American hematology and biochemistry reference intervals

    DEFF Research Database (Denmark)

    Gómez Román, Victor Raúl; Jensen, Sanne Skov; Leo-Hansen, Christian;

    2012-01-01

    Hematology and biochemistry reference intervals have been derived from healthy, HIV-negative populations to guide clinical trials worldwide. However, it is less clear how such values may be applied to clinical trials involving HIV-infected individuals. We show that contradictory interpretations...

  10. Evolution of HIV/AIDS in Southern Africa

    NARCIS (Netherlands)

    Lauwers, L.; Pruyt, E.; Hens, L.; Brans, J.p.

    2008-01-01

    This paper presents a system dynamics model to study the spread of HIV/AIDS in Southern Africa. The HIV/AIDS model includes important feedback mechanisms of the spread of HIV/AIDS, and partly explains the dynamics of the epidemic in a representative Southern African country. The HIV/AIDS model indic

  11. The use of immunoassay method to improve the diagnosis of African trypanosomosis and its application to monitor disease control programmes: A summary

    International Nuclear Information System (INIS)

    The traditional diagnostic techniques for detecting trypanosomes in animals have been the microscopic examination of wet blood films or of thin and thick bloodsmears following fixation and Giemsa staining. The development of concentration methods such as the microhaematocrit centrifuge technique (MHCT) or the buffy coat technique (BCT) using a phase contrast/darkground microscope has improved diagnosis considerably. All these parasitological techniques are very specific (a positive result indicates the true presence of a trypanosome and few false positives are encountered), but generally lack sensitivity. However, in chronically infected animals low parasitaemias often occur, which could not be detected by the most sensitive technique, the BCT method. In 1971 the enzyme-linked immunosorbent assay (ELISA) was developed and various applications of the technique soon proved to be highly sensitive and specific as well as reliable and flexible methods for screening large number of samples. The technique was modified for the detection of trypanosomal antigens and applied for the diagnosis of T. vivax, T. congolense and T. brucei infections in cattle. In experimental infections the test proved to be a sensitive technique for the diagnosis of animal trypanosomosis. Moreover, indications were that the test was well suited for application in developing countries. Consequently, the ELISA was transferred to the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture for distribution to various African research institutes for extensive validation under tropical conditions. 17 refs, 2 tabs

  12. The role of partners’ educational attainment in the association between HIV and education amongst women in seven sub-Saharan African countries

    Directory of Open Access Journals (Sweden)

    Guy Harling

    2016-02-01

    Full Text Available Introduction: Individuals’ educational attainment has long been considered as a risk factor for HIV. However, little attention has been paid to the association between partner educational attainment and HIV infection. Methods: We conducted cross-sectional analysis of young women (aged 15–34 in 14 Demographic and Health Surveys from seven sub-Saharan Africa (SSA countries with generalized HIV epidemics. We measured the degree of similarity in educational attainment (partner homophily in 75,373 partnerships and evaluated the correlation between homophily and female HIV prevalence at the survey cluster level. We then used logistic regression to assess whether own and partner educational attainment was associated with HIV serostatus amongst 38,791 women. Results: Educational attainment was positively correlated within partnerships in both urban and rural areas of every survey (Newman assortativity coefficients between 0.09 and 0.44, but this correlation was not ecologically associated with HIV prevalence. At the individual level, larger absolute differences between own and partner educational attainment were associated with significantly higher HIV prevalence amongst women. This association was heterogeneous across countries, but not between survey waves. In contrast to other women, for those aged 25–34 who had secondary or higher education, a more-educated partner was associated with lower HIV prevalence. Conclusions: HIV prevalence amongst women in SSA is associated not only with one's own education but also with that of one's partner. These findings highlight the importance of understanding how partners place individuals at risk of infection and suggest that HIV prevention efforts may benefit from considering partner characteristics.

  13. Differences in antiretroviral scale up in three South African provinces: the role of implementation management

    Directory of Open Access Journals (Sweden)

    Van Rensburg Dingie

    2010-07-01

    Full Text Available Abstract Background South Africa’s antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country’s quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. Methods The paper is a comparative case study of the early management of ART scale up in three South African provincial governments – Western Cape, Gauteng and Free State – focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high achieved in the three provinces. Results While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. Conclusions This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.

  14. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

    OpenAIRE

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to ...

  15. HIV: Social and Environmental Factors

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses how social and environmental factors may put African Americans at greater risk for HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  16. CIHR canadian HIV trials network HIV workshop: ethical research through community participation and strengthening scientific validity

    OpenAIRE

    Mbuagbaw, Lawrence; Slogrove, Amy; Sas, Jacqueline; Kunda, John; Morfaw, Frederick; Mukonzo, Jackson; Thabane, Lehana

    2014-01-01

    The CIHR canadian HIV trials network mandate includes strengthening capacity to conduct and apply clinical research through training and mentoring initiatives of HIV researchers by building strong networks and partnerships on the African continent. At the17th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), the CTN facilitated a two-day workshop to address ethical issues in the conduct of HIV research, and career enhancing strategies for young African HI...

  17. Characteristics, Immunological Response & Treatment Outcomes of HIV-2 Compared with HIV-1 & Dual Infections (HIV 1/2) in Mumbai

    OpenAIRE

    Chiara, Montaldo; Rony, Zachariah; Homa, Mansoor; Bhanumati, Varghese; Ladomirska, Joanna; Manzi, M.; Wilson, N; Alaka, Deshpande; Harries, A. D.

    2010-01-01

    Background & objectives: Information available on HIV-2 and dual infection (HIV-1/2) is limited. This study was carried out among HIV positive individuals in an urban referral clinic in Khar, Mumbai, India, to report on relative proportions of HIV-1, HIV-2 and HIV-1/2 and baseline characteristics, response to and outcomes on antiretroviral treatment (ART). Methods: Retrospective analysis of programme data (May 2006-May 2009) at Khar HIV/AIDS clinic at Mumbai, India was done. Three test algori...

  18. Do employees participate in workplace HIV testing just to win a lottery prize? A quantitative study

    Directory of Open Access Journals (Sweden)

    Martin Weihs

    2016-02-01

    Full Text Available Orientation: To encourage workers to participate in workplace HIV testing, some SouthAfrican automotive companies use lotteries. However, there is a lack of empirical evidence on how lottery incentives may influence employees’ workplace HIV counselling and testing behaviour.Research purpose: Determine whether workers intend to test for HIV only to win a lottery prize.Motivation for the study: The positive and also negative influences of lotteries on workers’ HIV testing behaviour need to be understood to avoid undue coercion in workplace HIV testing participation.Research design, approach and method: Post-test only quasi-experimental studies were conducted the day HIV testing and lotteries were announced to staff in four companies using a cross-sectional, self-administered survey that measured workers’ workplace HIV testing behaviour intentions. Intention to participate in workplace HIV counselling and testing was used as the main outcome of respondents’ behaviour and investigated via the statement: ‘If the company would organise its on-site Wellness Day tomorrow, I would go testing for HIV tomorrow’. In a first setting, two companies’ workers had to test for HIV to be entered in the lottery (n = 198. In the second setting, two other companies’ workers did not have to test to be entered in the lottery (n = 316. Chi-square tests were conducted to measure significant differences between the two conditions distinguishing between permanent and non-permanent staff.Main findings: No significant association was found between behaviour intention in the two settings for permanent workers’ workplace HIV testing intention ( χ2 = 1.145, p = 0.285, phi = -0.097. However, a significant association with a small effect size was found for non-permanent workers ( χ2 = 8.04, p = 0.005, phi = -0.279.Practical/managerial implications: Results show that lotteries to encourage workplace HIV testing are very likely to help workers ‘do the right

  19. Community response to intermittent preventive treatment of malaria in infants (IPTi delivered through the expanded programme of immunization in five African settings

    Directory of Open Access Journals (Sweden)

    Slutsker Lawrence

    2009-08-01

    Full Text Available Abstract Background IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20–59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also crucial to ensure that attitudes to IPTi do not negatively influence attitudes to and uptake of immunization, or that people do not misunderstand IPTi as immunization against malaria and neglect other preventive measures or delay treatment seeking. Methods These issues were studied in five African countries in the context of clinical trials and implementation studies of IPTi. Mixed methods were used, including structured questionnaires (1,296, semi-structured interviews (168, in-depth interviews (748 and focus group discussions (95 with mothers, fathers, health workers, community members, opinion leaders, and traditional healers. Participant observation was also carried out in the clinics. Results IPTi was widely acceptable because it resonated with existing traditional preventive practices and a general concern about infant health and good motherhood. It also fit neatly within already widely accepted routine vaccination. Acceptance and adherence were further facilitated by the hierarchical relationship between health staff and mothers and by the fact that clinic attendance had a social function for women beyond acquiring health care. Type of drug and regimen were important, with newer drugs being seen as more effective, but potentially also more dangerous. Single dose infant formulations delivered in the clinic seem to be the most likely to be both acceptable and adhered to. There was little evidence that IPTi per se had a negative impact on attitudes to EPI or that it had any affect on EPI adherence. There was also little evidence of IPTi having a negative impact on health seeking for infants with febrile illness or existing preventive practices. Conclusion IPTi is generally acceptable across a wide range of

  20. The impact of exposure to mass media campaigns and social support on levels and trends of HIV-related stigma and discrimination in Nigeria: tools for enhancing effective HIV prevention programmes.

    Science.gov (United States)

    Fakolade, R; Adebayo, S B; Anyanti, J; Ankomah, A

    2010-05-01

    People living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (psocial support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001). PMID:20018118

  1. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

    Directory of Open Access Journals (Sweden)

    Nachega JB

    2016-04-01

    University, Cape Town, South Africa Objective: To examine the acceptability and feasibility of mobile health (mHealth/short message service (SMS and community-based directly observed antiretroviral therapy (cDOT as interventions to improve antiretroviral therapy (ART adherence for preventing mother-to-child human immunodeficiency virus (HIV transmission (PMTCT. Design and methods: A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20 examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1 SMS text messaging and 2 patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+” were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting: A community primary care clinic in Cape Town, South Africa. Participants: HIV-infected pregnant women. Main outcomes: Acceptability and feasibility of mHealth and cDOT interventions. Results: Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%, and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95% identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion: mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were

  2. Update on HIV in Western Europe

    OpenAIRE

    Nakagawa, F.; Phillips, A N; Lundgren, J. D.

    2014-01-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. Th...

  3. Infant feeding practices at routine PMTCT sites, South Africa: results of a prospective observational study amongst HIV exposed and unexposed infants - birth to 9 months

    Directory of Open Access Journals (Sweden)

    Goga Ameena E

    2012-04-01

    Full Text Available Abstract Background We sought to investigate infant feeding practices amongst HIV-positive and -negative mothers (0-9 months postpartum and describe the association between infant feeding practices and HIV-free survival. Methods Infant feeding data from a prospective observational cohort study conducted at three (of 18 purposively-selected routine South African PMTCT sites, 2002-2003, were analysed. Infant feeding data (previous 4 days were gathered during home visits at 3, 5, 7, 9, 12, 16, 20, 24, 28, 32 and 36 weeks postpartum. Four feeding groups were of interest, namely exclusive breastfeeding, mixed breastfeeding, exclusive formula feeding and mixed formula feeding. Cox proportional hazards models were fitted to investigate associations between feeding practices (0-12 weeks and infant HIV-free survival. Results Six hundred and sixty five HIV-positive and 218 HIV-negative women were recruited antenatally and followed-up until 36 weeks postpartum. Amongst mothers who breastfed between 3 weeks and 6 months postpartum, significantly more HIV-positive mothers practiced exclusive breastfeeding compared with HIV-negative: at 3 weeks 130 (42% versus 33 (17% (p Conclusions Although feeding practices were poor amongst HIV-positive and -negative mothers, HIV-positive mothers undertake safer infant feeding practices, possibly due to counseling provided through the routine PMTCT programme. The data on differences in infant outcome by feeding practice and site validate the WHO 2009 recommendations that site differences should guide feeding practices amongst HIV-positive mothers. Strong interventions are needed to promote exclusive breastfeeding (to 6 months with continued breastfeeding thereafter amongst HIV-negative motherswho are still the majority of mothers even in high HIV prevalence setting like South Africa.

  4. Abacavir, zidovudine, or stavudine as paediatric tablets for African HIV-infected children (CHAPAS-3): an open-label, parallel-group, randomised controlled trial

    OpenAIRE

    V Mulenga; Musiime, V.; Kekitiinwa, A.; Cook, AD; G Abongomera; Kenny, J.; Chabala, C; Mirembe, G.; Asiimwe, A; Owen-Powell, E.; Burger, D.; McIlleron, H.; N. Klein; Chintu, C; Thomason, MJ

    2015-01-01

    Summary Background WHO 2013 guidelines recommend universal treatment for HIV-infected children younger than 5 years. No paediatric trials have compared nucleoside reverse-transcriptase inhibitors (NRTIs) in first-line antiretroviral therapy (ART) in Africa, where most HIV-infected children live. We aimed to compare stavudine, zidovudine, or abacavir as dual or triple fixed-dose-combination paediatric tablets with lamivudine and nevirapine or efavirenz. Methods In this open-label, parallel-gro...

  5. Leadership in the African context

    Directory of Open Access Journals (Sweden)

    M. Masango

    2002-08-01

    Full Text Available The Western world has always viewed the African continent as plagued by corruption; dictatorship; military coups; rebellious leaders; greediness; misuse of power; and incompetent, politically unstable leaders - in effect, suspicious leaders who undermine their own democracies. This paper analyzes African leadership and its impact by concentrating on three historical eras, namely; the African Religious era; the Christian era, and the era of Globalization. These affected African leadership. In addition, many brilliant minds left the continent in search of greener pastures. A review of these three eras will help us understand how leadership shifted from African values into Western concepts. The role of missionaries lead African people to live with both an African and a Western concept of life. In spite of the above problems, our past leaders did their best in addressing the difficulties they faced during the three eras. African concepts of leadership were often regarded as barbaric and uncultured. Structures were evaluated by Western standards. Due to globalisation, African leaders, through programmes like NEPAD, are going back to basics, drawing on African concepts of unity among its leadership. Effectiveness or life-giving leadership is emerging and empowering villagers/communities in the continent. This type of leadership is innovative and has brought new hope for the continent.

  6. AIDS in Africans living in London.

    OpenAIRE

    O'Farrell, N.; Lau, R.; Yoganathan, K; Bradbeer, C S; Griffin, G E; Pozniak, A L

    1995-01-01

    OBJECTIVES--To investigate the presentation of HIV infection and AIDS amongst Africans diagnosed with AIDS living in London. METHODS--Identification of all AIDS cases of African origin attending four HIV specialist centres in South London--Guy's, King's, St George's and St Thomas' Hospitals--up to March 1994, by retrospective review of case notes of all HIV positive patients. RESULTS--Of 86 patients (53 women, 33 men) studied, 59 (69%) were from Uganda. The most frequent AIDS-defining diagnos...

  7. Keep It Up: development of a community-based health screening and HIV prevention strategy for reaching young African American men.

    Science.gov (United States)

    O'Donnell, Lydia; Bonaparte, Beverly; Joseph, Heather; Agronick, Gail; Leow, Deborah McLean; Myint-U, Athi; Stueve, Ann

    2009-08-01

    This article addresses the challenge of developing HIV prevention interventions that not only prove to be efficacious but also are designed from the outset to overcome obstacles to reaching priority populations. We describe how community input has informed development of Keep It Up (KIU), a community health screening and behavioral prevention program for young Black men. KIU embeds HIV prevention in a broader health promotion campaign, with the goal of reducing stigma and reaching a population that bears a disproportionate burden of HIV/AIDS and other health problems-hypertension, high cholesterol, diabetes, asthma, and obesity. Information from community partners, expert advisers, and focus groups was collected at key junctures and incorporated into four core components: social marketing, a computerized behavioral learning module, biological testing for HIV and other conditions, and a personalized health profile and risk reduction plan. A pilot with 116 participants provided evidence that the KIU model of integrating HIV prevention with other health screening is acceptable and has the potential to reach Black men at risk for HIV as well as other chronic health conditions. PMID:19670966

  8. The emotional wellbeing of lay HIV counselling and testing counsellors.

    Science.gov (United States)

    Visser, Maretha; Mabota, Princess

    2015-01-01

    The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions. PMID:26223334

  9. From population to HIV: the organizational and structural determinants of HIV outcomes in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Robinson Rachel

    2011-09-01

    Full Text Available Abstract Background There exists no consistent explanation for why some countries are successful in combating HIV/AIDS and others are not, and we need such an explanation in order to design effective policies and programmes. Research evaluating HIV interventions from a biomedical or public health perspective does not always take full account of the historical and organizational characteristics of countries likely to influence HIV outcomes. The analysis in this paper addresses this shortcoming by testing the impact of organizational and structural factors, particularly those resulting from population interventions, on HIV outcomes at the country level in sub-Saharan Africa. Methods The primary independent variables are factors that originated from efforts to slow population growth: whether a country has a long-time affiliate of the International Planned Parenthood Federation and whether a country has a population policy. Additional structural factors likely to impact HIV outcomes include the level of wealth, the level of cultural fractionalization, and the former colonial power. The present study uses multivariate regression techniques with countries in sub-Saharan Africa as the unit of analysis, and four measures of success in addressing HIV: the change in prevalence between 2001 and 2009; the change in incidence between 2001 and 2009; the level of overall antiretroviral coverage in 2009; and the level of antiretroviral coverage for prevention of vertical transmission in 2009. Results Countries with the greatest declines in HIV prevalence and incidence had older International Planned Parenthood Federation affiliates and had adopted population policies, even after controlling for age of epidemic, level of antiretroviral coverage, and funding for HIV. Population policies are also important predictors of levels of overall antiretroviral coverage and of coverage of HIV-positive pregnant women to prevent vertical transmission. Structural factors with

  10. HIV and incarceration: prisons and detention

    Directory of Open Access Journals (Sweden)

    Jürgens Ralf

    2011-05-01

    Full Text Available Abstract The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners. The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.

  11. Evaluation of selected aspects of the Nutrition Therapeutic Programme offered to HIV-positive women of child-bearing age in Western Cape Province, South Africa

    Directory of Open Access Journals (Sweden)

    Tine T. Hansen

    2015-04-01

    Full Text Available Background: The Nutrition Therapeutic Programme (NTP involves the provision of food supplements at primary health clinics (PHCs to correct nutritional deficiencies in vulnerable groups. Although previous studies have identified problems with implementing the programme at PHCs, assessments of its efficiency have been scarce.Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy.Methods: A cross-sectional, descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data.Results: Only 2 women (10% lived in food-secure households; the rest were either at risk of hunger (29% or classified as hungry (61%. Most of the women knew they had to take the supplements to improve their nutritional status, but the majority only recalled receiving basic nutritional advice, and the information was mainly given verbally. Ten of the women had shared their supplements with others, mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs, causing confusion amongst the staff. Although many staff members expressed problems with the NTP, only 38% of them reported having routine evaluations regarding the programme.Conclusion: Several aspects compromised the effectiveness of the NTP, including socio- economic factors leading to clients’ non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy, and staff experienced difficulties with the logistics of the programme.

  12. Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

    Directory of Open Access Journals (Sweden)

    Southern African HIV Clinicians Society Consensus Committee

    2012-06-01

    Full Text Available Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i explain what pre-exposure prophylaxis (PrEP is; (ii outline current indications for its use; (iii outline steps for appropriate client selection; and (iv provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI management and risk reduction counselling. Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral

  13. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

    Directory of Open Access Journals (Sweden)

    Nomafrench Mbombo

    2012-05-01

    Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  14. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

    Directory of Open Access Journals (Sweden)

    Nomafrench Mbombo

    2012-11-01

    Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we describedteaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  15. Novel engineered HIV-1 East African Clade-A gp160 plasmid construct induces strong humoral and cell-mediated immune responses in vivo

    International Nuclear Information System (INIS)

    HIV-1 sequences are highly diverse due to the inaccuracy of the viral reverse transcriptase. This diversity has been studied and used to categorize HIV isolates into subtypes or clades, which are geographically distinct. To develop effective vaccines against HIV-1, immunogens representing different subtypes may be important for induction of cross-protective immunity, but little data exist describing and comparing the immunogenicity induced by different subtype-based vaccines. This issue is further complicated by poor expression of HIV structural antigens due to rev dependence. One costly approach is to codon optimize each subtype construct to be examined. Interestingly, cis-acting transcriptional elements (CTE) can also by pass rev restriction by a rev independent export pathway. We reasoned that rev+CTE constructs might have advantages for such expression studies. A subtype A envelope sequence from a viral isolate from east Africa was cloned into a eukaryotic expression vector under the control of the CMV-IE promoter. The utility of inclusion of the Mason-Pfizer monkey virus (MPV)-CTE with/without rev for driving envelope expression and immunogenicity was examined. Expression of envelope (gp120) was confirmed by immunoblot analysis and by pseudotype virus infectivity assays. The presence of rev and the CTE together increased envelope expression and viral infection. Furthermore the CTE+rev construct was significantly more immunogenic then CTE alone vector. Isotype analysis and cytokine profiles showed strong Th1 response in plasmid-immunized mice, which also demonstrated the superior nature of the rev+CTE construct. These responses were of similar or greater magnitude to a codon-optimized construct. The resulting cellular immune responses were highly cross-reactive with a HIV-1 envelope subtype B antigen. This study suggests a simple strategy for improving the expression and immunogenicity of HIV subtype-specific envelope antigens as plasmid or vector

  16. Stress and Coping with Racism and Their Role on Sexual Risk for HIV among African American, Asian/Pacific Islander, and Latino Men Who Have Sex With Men

    OpenAIRE

    Han, Chong-suk; Ayala, George; Paul, Jay; Boylan, Ross; Gregorich, Steven E.; Choi, Kyung-Hee

    2014-01-01

    The deleterious effects of racism on a wide range of health outcomes, including HIV risk, is well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sam...

  17. South African AIDS plan criticised.

    Science.gov (United States)

    Sidley, P

    1998-10-17

    In a television broadcast, Deputy President Mbeki of South Africa announced a campaign against HIV/AIDS that would involve coordination between various government departments and nongovernmental organizations. Mbeki, who is associated with Virodene (a drug treatment for AIDS that is considered a scam), replaced President Mandela at the last minute in the broadcast. Two days after the broadcast, the government refused to support treatment of pregnant women infected with HIV with zidovudine to prevent transmission of the virus to the baby. The treatment is considered cost-effective by AIDS workers and public health officials. According to Mark Heywood of the AIDS law project at Witwatersrand University, 16% of pregnant women attending antenatal clinics were HIV-positive in 1997; this means that about 3 million South Africans (8% of the population) were living with HIV. Heywood said that the government believes there are 1500 new cases daily. By the end of 1998, 3.5 million South Africans will be living with HIV. Although the government is asking other sectors to join in the campaign, what the government is doing is unclear. Mother-to-child transmission of HIV is second only to transmission of the virus through heterosexual sex in South Africa. PMID:9841037

  18. Sustaining the future of HIV counselling to reach 90-90-90: a regional country analysis

    Science.gov (United States)

    Bemelmans, Marielle; Baert, Saar; Negussie, Eyerusalem; Bygrave, Helen; Biot, Marc; Jamet, Christine; Ellman, Tom; Banda, Amanda; van den Akker, Thomas; Ford, Nathan

    2016-01-01

    Introduction Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. Methods We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Results and discussion Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. Conclusions The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery. PMID:27189531

  19. Sustaining the future of HIV counselling to reach 90-90-90: a regional country analysis

    Directory of Open Access Journals (Sweden)

    Marielle Bemelmans

    2016-05-01

    Full Text Available Introduction: Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. Methods: We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Results and discussion: Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. Conclusions: The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.

  20. Knowledge and awareness of HIV/AIDS among high school girls in Ghana

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    Appiah-Agyekum NN

    2013-07-01

    Full Text Available Nana Nimo Appiah-Agyekum,1,3 Robert Henry Suapim2,3 1Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana; 2Department of General Administration, Achimota Government Hospital, Ghana Health Service, Achimota, Ghana; 3Faculty of Health and Social Sciences, Institute for Health and Wellbeing, Leeds Metropolitan University, Leeds, UK Abstract: HIV/AIDS is recognized as a national priority health issue in Ghana. Consequently, the Ghana AIDS Commission and the National AIDS Control Programme were established, among other things, to enhance the knowledge and awareness on the nature, causes, effects and means of managing the spread of HIV/AIDS among populations at risk in Ghana. Through the efforts of these bodies and other stakeholders in health, several awareness creation and sensitization efforts have been targeted at teenage girls, a high risk group in Ghana. This study therefore assesses the knowledge and awareness of HIV/AIDS among senior high school girls in their teens in Ghana using a sample of 260 female students of West African Senior High School. The data collected were analyzed and discussed under relevant themes and within the context of the literature. The study revealed that generally, senior high school girls were knowledgeable on the nature, modes of transmission, and prevention of HIV/AIDS. There were however some students who exhibited limited knowledge on some issues including the spiritual causes and treatment of HIV/AIDS, contacts and associations with infected persons, as well as determination of HIV infection from appearances rather than testing. The study also raised important concerns about the reluctance of senior high school girls to use condoms as a preventive measure and the need to reorient HIV/AIDS awareness interventions in Ghana. Keywords: adolescent school girls, HIV/AIDS, Ghana, awareness, knowledge

  1. Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

    Directory of Open Access Journals (Sweden)

    Naeemah Abrahams

    2012-08-01

    Full Text Available Background: Living with HIV is of daily concern for many South Africans and poses challenges including adapting to a chronic illness and continuing to achieve and meet social expectations. This study explored experiences of being HIV-positive and how people manage stigma in their daily social interactions. Methods: Using qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews. Results: HIV was ubiquitous in our informants’ lives, and almost all participants reported fear of stigma (perceived stigma, but this fear did not disrupt them completely. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality. Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance. Conclusions: The study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes.

  2. Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

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    Donald J. Hamel

    2015-05-01

    Full Text Available Introduction: From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations.Methods: Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings.Results: Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories.Conclusions: Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and

  3. HIV Transmission

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... on HIV Syndicated Content Website Feedback HIV/AIDS HIV Transmission Language: English Español (Spanish) Recommend on Facebook ...

  4. HIV/AIDS, Population and Sustainable Development

    OpenAIRE

    Angelo, Victor

    2014-01-01

    The wide-ranging impact of HIV/ AIDS on demographic trends and socio-economic development of African countries deserves renewed attention and additional research. HIV/ AIDS severely undermines the development prospects of many African countries, most of which have recorded shockingly high prevalence rates of the epidemic. In the years to come, Sub-Saharan Africa is far more certain to experience further demographic changes that would continue to impact negatively on developm...

  5. Benefiting Africans

    Institute of Scientific and Technical Information of China (English)

    ZHANG ZHIPING

    2011-01-01

    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September.This activity was launched by Hengyuanxiang,a leading Chinese wool manufacturer.

  6. Benefiting Africans

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September. This activity was launched by Hengyuanxiang,aleading Chinese wool manufacturer.

  7. Anti-staphylococcal, anti-HIV and cytotoxicity studies of four South African medicinal plants and isolation of bioactive compounds from Cassine transvaalensis (Burtt. Davy) codd

    OpenAIRE

    Mthethwa, Ningy S; Oyedeji, Bola AO; Obi, Larry C.; Aiyegoro, Olayinka A.

    2014-01-01

    Background Medicinal plants represent an important opportunity to rural communities in Africa, as a source of affordable medicine and as a source of income. Increased patient awareness about safe usage is important as well as more training with regards to traditional medicine. The aim of this study was to evaluate the ethnomedicinal prowess of some indigenous South African plants commonly used in Eastern Cape Province of South Africa for the treatment of skin and respiratory tract infections,...

  8. "I don't know if this is right … but this is what I'm offering": healthcare provider knowledge, practice, and attitudes towards safer conception for HIV-affected couples in the context of Southern African guidelines.

    Science.gov (United States)

    West, Nora; Schwartz, Sheree; Phofa, Rebecca; Yende, Nompumelelo; Bassett, Jean; Sanne, Ian; Van Rie, Annelies

    2016-03-01

    The 2011 guidelines for safer conception for HIV-affected individuals and couples were adopted by the South African Department of Health in December 2012. We assessed implementation gaps and facilitators and barriers to delivering safer conception services through examining patient and healthcare provider (HCP) experiences. At Witkoppen Health and Welfare Centre, a primary care clinic in Johannesburg, we conducted in-depth interviews (IDIs) with nine HCPs (doctors, nurses, and counselors) and IDIs and focus group discussions with 42 HIV-affected men and women interested in having a child. Data were analyzed using a grounded theory approach. HCPs were supportive of fertility intentions of HIV-affected couples and demonstrated some knowledge of safer conception methods, especially ART initiation to suppress viral load in infected partners. Unfortunately, HCPs did not follow the key recommendation that HCPs initiate conversations on fertility intentions with HIV-affected men and women. Providers and clients reported that conversations about conception only occur when client-initiated, placing the onus on HIV-affected individuals. Important barriers underlying this were the misconception held by some HCPs that uninfected partners in serodiscordant partnerships are "latently" infected and the desire by most HCPs to protect or control knowledge around fertility and safer conception methods out of concern over what clients will do with this knowledge before they are virally suppressed or ready to conceive. Almost all participants who had conceived or attempted conception did so without safer conception methods knowledge. HCP concern over conception readiness, perception of what clients will do with safer conception knowledge, and gaps in safer conception knowledge prevent HCPs from initiating conversations with HIV-affected patients on the issue of childbearing. Examining these findings in the context of existing South African guidelines illuminates areas that need to be

  9. A cluster randomized controlled trial evaluating the efficacy of peer mentors to support South African women living with HIV and their infants.

    Directory of Open Access Journals (Sweden)

    Mary Jane Rotheram-Borus

    Full Text Available OBJECTIVE: We evaluate the effect of clinic-based support by HIV-positive Peer Mentors, in addition to standard clinic care, on maternal and infant well-being among Women Living with HIV (WLH from pregnancy through the infant's first year of life. METHODS: In a cluster randomized controlled trial in KwaZulu-Natal, South Africa, eight clinics were randomized for pregnant WLH to receive either: a Standard Care condition (SC; 4 clinics; n = 656 WLH; or an Enhanced Intervention (EI; 4 clinics; n = 544 WLH. WLH in the EI were invited to attend four antenatal and four postnatal meetings led by HIV-positive Peer Mentors, in addition to SC. WLH were recruited during pregnancy, and at least two post-birth assessment interviews were completed by 57% of WLH at 1.5, 6 or 12 months. EI's effect was ascertained on 19 measures of maternal and infant well-being using random effects regressions to control for clinic clustering. A binomial test for correlated outcomes evaluated EI's overall efficacy. FINDINGS: WLH attended an average of 4.1 sessions (SD = 2.0; 13% did not attend any sessions. Significant overall benefits were found in EI compared to SC using the binomial test. Secondarily, over time, WLH in the EI reported significantly fewer depressive symptoms and fewer underweight infants than WLH in the SC condition. EI WLH were significantly more likely to use one feeding method for six months and exclusively breastfeed their infants for at least 6 months. CONCLUSIONS: WLH benefit by support from HIV-positive Peer Mentors, even though EI participation was partial, with incomplete follow-up rates from 6-12 months. TRIAL REGISTRATION: ClinicalTrials.gov NCT00972699.

  10. Are WHO/UNAIDS/UNICEF-recommended replacement milks for infants of HIV-infected mothers appropriate in the South African context?

    OpenAIRE

    2004-01-01

    OBJECTIVE: Little is known about the nutritional adequacy and feasibility of breastmilk replacement options recommended by WHO/UNAIDS/UNICEF. The study aim was to explore suitability of the 2001 feeding recommendations for infants of HIV-infected mothers for a rural region in KwaZulu Natal, South Africa specifically with respect to adequacy of micronutrients and essential fatty acids, cost, and preparation times of replacement milks. METHODS: Nutritional adequacy, cost, and preparation time o...

  11. Pre-ART levels of inflammation and coagulation markers are strong predictors of death in a South African cohort with advanced HIV disease.

    Directory of Open Access Journals (Sweden)

    Lotty Ledwaba

    Full Text Available BACKGROUND: Levels of high-sensitivity C-reactive protein (hsCRP, interleukin-6 (IL-6, and D-dimer predict mortality in HIV patients on antiretroviral therapy (ART with relatively preserved CD4+ T cell counts. We hypothesized that elevated pre-ART levels of these markers among patients with advanced HIV would be associated with an increased risk of death following the initiation of ART. METHODS: Pre-ART plasma from patients with advanced HIV in South Africa was used to measure hsCRP, IL-6 and D-dimer. Using a nested case-control study design, the biomarkers were measured for 187 deaths and two controls matched on age, sex, clinical site, follow-up time and CD4+ cell counts. Odds ratios were estimated using conditional logistic regression. In addition, for a random sample of 100 patients, biomarkers were measured at baseline and 6 months following randomization to determine whether ART altered their levels. RESULTS: Median baseline biomarkers levels for cases and controls, respectively, were 11.25 vs. 3.6 mg/L for hsCRP, 1.41 vs. 0.98 mg/L for D-dimer, and 9.02 vs. 4.20 pg/mL for IL-6 (all p<0.0001. Adjusted odds ratios for the highest versus lowest quartile of baseline biomarker levels were 3.5 (95% CI: 1.9-6.7 for hsCRP, 2.6 (95%CI 1.4-4.9 for D-dimer, and 3.8 (95% CI: 1.8-7.8 for IL-6. These associations were stronger for deaths that occurred more proximal to the biomarker measurements. Levels of D-dimer and IL-6, but not hsCRP, were significantly lower at month 6 after commencing ART compared to baseline (p<0.0001. CONCLUSIONS: Among patients with advanced HIV disease, elevated pre-ART levels of hsCRP, IL-6 and D-dimer are strongly associated with early mortality after commencing ART. Elevated levels of inflammatory and coagulation biomarkers may identify patients who may benefit from aggressive clinical monitoring after commencing ART. Further investigation of strategies to reduce biomarkers of inflammation and coagulation in patients with

  12. HIV, poverty and women.

    Science.gov (United States)

    Rodrigo, Chaturaka; Rajapakse, Senaka

    2010-03-01

    This review examines the interactions of financial status and HIV and its implications for women. MEDLINE and Google scholar were searched using the keywords 'women', 'poverty' and 'HIV' in any field of the article. The search was limited to articles published in English over the last 10 years. The first section of the article tries to establish whether poverty or wealth is a risk factor for HIV. There is credible evidence for both arguments. While wealth shows an increased risk for both sexes, poverty places women at a special disadvantage. The second section explains how the financial status interacts with other 'non biological' factors to put women at increased risk. While discrimination based on these factors disadvantage women, there are some paradoxical observations that do not fit with the traditional line of explanation (e.g. paradoxical impact of wealth and education on HIV). The final section assesses the impact of HIV in driving poverty and the role of women in interventional programmes. The specific impact of poverty on females in families living with HIV is less explored. Though microfinance initiatives to empower women are a good idea in theory, the actual outcome of such a programme is less convincing. PMID:24037044

  13. Opportunities for HIV Combination Prevention to Reduce Racial and Ethnic Health Disparities

    Science.gov (United States)

    Grossman, Cynthia I.; Purcell, David W.; Rotheram-Borus, Mary Jane; Veniegas, Rosemary

    2013-01-01

    Despite advances in HIV prevention and care, African Americans and Latino Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, and are less likely to have suppressed viral load than are Whites. The first National HIV/AIDS Strategy…

  14. Minority Women's Health: HIV/AIDS

    Science.gov (United States)

    ... Women's Health > African-Americans Minority Women's Health HIV/AIDS Find HIV/AIDS Prevention & Service Providers GO Enter your location, such ... For more information on this widget, please visit AIDS.gov . Please contact contact@aids.gov with any ...