Sahara J-Journal of Social Aspects of Hiv-Aids最新文献

This article reflects on an internal evaluation undertaken to estimate the potentials of a community-university pilot project to be developed into a bonafide innovation that can be applied at scale. The focus of the community-university partnership has been to reduce the unintended consequences of medical pluralism on the HIV and AIDS epidemic in Waterberg district, Limpopo Province, South Africa. Despite promising outputs from the partnership - including an increase in adherence to antiretroviral therapy and a reduction in stigma among traditionalists living with HIV - the partnership wished to establish whether further funding should be applied for to take the pilot from its current prototype status to a more established innovation. In order to evaluate the innovative potentials of the pilot, the opportunity vacuum model of innovation was adapted and applied. The findings indicate that (1) the application of the opportunity vacuum model of innovation to evaluate the potentials of the pilot to be developed into a bonafide innovation was fit for purpose and (2) the pilot contains the key ingredients that are associated with innovations in the making. The discussion reflects on the social potentials of the pilot to contribute to 90-90-90 from a global, national and local perspective. The reflection concludes by suggesting that the opportunity vacuum model of innovation is a versatile heuristic that could be applied in other contexts and the community-university pilot represents a nascent innovation which has sufficient potential to justify further development.

Few researchers have investigated how female caregivers of institutionalised children, especially those affected by HIV and AIDS, experience stress. The role played by caregivers cannot be overemphasised; yet caregivers who work in institutions caring for orphaned and/or abandoned children affected by HIV and AIDS, are often marginalised and on the periphery of the HIV and AIDS pandemic. The implication is that insufficient attention or consideration is given to the importance of the role they play in these children's lives. The objective of the study was to explore how female caregivers of institutionalised children affected by HIV and AIDS experience stress. A qualitative research project with a case study design was conducted. The purposively selected participants from a previously identified care facility were seven females in the age ranges of 35-59. Data was gathered during individual interviews and focus group discussions. Thematic content analysis of the data yielded the following themes: (1) contextualising caregiving as 'work'; (2) stresses linked to caregiving; and (3) coping with stress. Findings from this study indicated that participants experienced caregiving in an institution as stressful, demotivating, and emotionally burdensome. Moreover, caregivers working in an environment of HIV and AIDS experienced additional stress related to organisational and management impediments, lack of emotional and practical support, inadequate training, discipline difficulties, and lack of respect and appreciation from the children in their care. It is recommended that training and management support as well as personal support and counselling for caregivers in the institutional context could help them to cope better, feel empowered and to potentially elevate their status as valued members of society.

Background: HIV/AIDS has led to increased mortality and morbidity, negatively impacting adult labour especially in HIV/AIDS burdened Sub-Saharan Africa. There has been some exploration of the effects of HIV/AIDS on paid child labour, but little empirical work on children's non-paid child work. This paper provides quantitative evidence of how child and household-level factors affect children's involvement in both domestic and family farm work for households with a person living with HIV/AIDS (PLWHA) compared to non-PLWHA households using the 2010/2011 Centre for Health Economics Uganda HIV questionnaire Survey.

Method: Descriptive analysis and multivariate logistic modelling is used to explore child and household-level factors that affect children's work participation.

Results: This research reveals greater demands on the labour of children in PLWHA households in terms of family farm work especially for boys. Results highlight the expected gendered social responsibilities within the household space, with girls and boys engaged more in domestic and family farm work, respectively. Girls shared a greater proportion of household financial burden by working more hours in paid work outside the household than boys. Lastly, the study revealed that a household head's occupation increases children's participation in farm work but had a partial compensatory effect on their involvement in domestic work. Wealth and socio-economic standing is no guarantee to reducing child work.

Conclusion: Children from PLWHA households are more vulnerable to child work in family farm work especially boys; and girls are burdened beyond the household space through paid work. Differing perspectives and solutions need to consider the contextual nature of child work.

Background: Globally, individuals' self-assessment of vulnerability to HIV infection is important to maintain safer sexual behaviour and reduce risky behaviours. However, determinants of self-perceived risk of HIV infection are not well documented and differ. We assessed the level of self-perceived vulnerability to HIV infection in Nigeria and also identified its risk factors.

Methods: We explored a recent nationally representative data with self-reported vulnerability ('high', 'low' and 'no risk at all') to HIV infection as the outcome of interest. Data were weighted and association between the outcomes and the risk factors determined. We used simple ordered logit regression to model relationship between the outcome variable and risk factors, and controlled for the significant variables in multiple ordered logistic regression at 5% significance level.

Results: About 74% had good knowledge of HIV transmission and 6% had experienced STI recently. The likelihood of assessing oneself as having 'no risk at all' was 50% and for 'high chances' was 1.6%. Self-perceived high risk of HIV was higher among those who recently experienced STI (5.6%) than those who did not (1.7%), and also higher among those who recently engaged in transactional sex and had multiple sexual partners. The odds of good knowledge of HIV transmission on high self-perceived vulnerability to HIV was 19% higher than poor knowledge (OR = 1.19, 95% CI: 1.12-1.27). Also, respondents who recently had multiple sexual partners were 72% (OR = 1.72, 95% CI: 1.60-1.86) more likely to report self as having high risk. Younger respondents aged 14-19 years had higher odds of 41% (OR = 1.41, 95% CI: 1.29-1.55) to perceive self as having high vulnerability to HIV than older respondents.

Conclusion: High vulnerability to HIV infection was reported among younger respondents, those with history of STIS and those who engage in multiple sexual relations. Despite high level of risky sexual behaviour and good knowledge of HIV transmission and prevention found in this study, self-perceived vulnerability to HIV generally is low. For the low perception found in this study to translate to low chance of HIV infection, there is need for all stakeholders to embark on risk reduction initiatives through sexual education that would minimise risky sexual practices and ensuring availability and affordability of HIV prevention methods.

When human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are framed within an intersectional approach, they have the potential to transform understandings of social justice within the curriculum and education policy and practice in general. Yet, this transformative potential is often hampered by official narratives that fail to position HIV and AIDS as an integral component of overlapping systems of oppression, domination and discrimination. This article explores how official HIV and AIDS narratives tend to promote systemic injustice and inequality within education policy and practice in both Scotland and Zimbabwe, despite their good intents. We frame our argument within a transformative education discourse which seeks to create participatory and emancipatory HIV-related messages at school, tertiary and community levels. Using a narrative enquiry design, a Foucauldian theoretical lens was used to analyse the narratives derived from key informant responses, supplemented by analysis of key documents that deal with HIV and AIDS in both Scotland and Zimbabwe. Four broad narratives emerged: the 'Gay' Narrative; the Migration Narrative; the Conspiracy Narrative; and the Religious Narrative. We discuss how each of these narratives entrench stigma across both developed and developing world contexts, and propose how a more intersectional interpretation would contribute to a deeper and less stigmatizing understanding of HIV, thus offering more useful insights into related policy and educational practices. This article will thus contribute to the growing body of intersectional HIV and AIDS knowledge that is relevant for schools, teacher education, public health and community settings, not only in the countries studied, but the world over.

There are number of Non-Governmental Organisations (NGOs) in South Africa that use sport as a tool to respond to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. A qualitative method study was carried out with seven employees of five selected NGOs that integrate sport to deliver HIV/AIDS programmes in South Africa. The study further involved six specialists/experts involved in the field of HIV/AIDS and an official from Sport Recreation South Africa (SRSA). Multiple data collection instruments including desktop review, narrative systematic review, document analysis, one-on-one interviews and focus group interview were used to collect information on outcomes and indicators for sport-based HIV/AIDS awareness programmes. The information was classified according to the determinants of HIV/AIDS. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. However, monitoring and evaluating outcomes of sport-based HIV/AIDS programmes of the selected NGOs remains a challenge. A need exists for the improvement of the outcome statements and indicators for their sport-based HIV/AIDS awareness programmes. This study proposed a total of 51 generic outcome indicators focusing on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measure predictors of HIV risk behaviour. The selected NGOs can adapt the proposed generic outcomes and indicators based on the settings of their programmes. A collaborative approach by all stakeholders is required, from international organisations, funders, governments, NGOs and communities to strengthening monitoring and evaluation of sport-based HIV/AIDS awareness programmes including other development programmes. This will assist the NGOs that use sport for development to be able to reflect accurately the information about their HIV/AIDS activities and also be able to contribute to on-going monitoring activities at a national and global level as well as to the Sustainable Development Goals.

Higher socioeconomic status impacts profoundly on quality of life. Life-event stressors, such as loss of employment, marital separation/divorce, death of a spouse and food insecurity, have been found to accelerate disease progression among people with human immunodeficiency virus (HIV). The objective of this study was to determine significant independent sociodemographic and food security factors associated with HIV status in people from rural and urban communities in the Assuring Health for All study, which was undertaken in rural Trompsburg, Philippolis and Springfontein and urban Mangaung, in the Free State Province of South Africa. Sociodemographic and food security factors associated with HIV status were determined in 886 households. Logistic regression with forward selection (p < 0.05) was used to select significant independent factors associated with HIV status. Variables with a p-value of <0.15 were considered for inclusion in the model. Adults 25-64 years of age were eligible to participate. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. A relatively high percentage of respondents had never attended school, while very few participants in all areas had a tertiary education. The unemployment rate of HIV-infected adults was higher than that of HIV-uninfected adults. A high percentage of respondents in all areas reported running out of money to buy food, with this tendency occurring significantly more among urban HIV-infected than HIV-uninfected respondents. In all areas, a high percentage of HIV-infected respondents relied on a limited number of foods to feed their children, with significantly more HIV-infected urban respondents compared to their uninfected counterparts reporting this. Most participants in all areas had to cut the size of meals, or ate less because there was not enough food in the house or not enough money to buy food. During periods of food shortage, more than 50% of respondents in all areas asked family, relatives or neighbours for assistance with money and/or food, which occurred at a higher percentage of HIV-infected rural participants compared to HIV-uninfected rural participants. More than half of all participants reported feeling sad, blue or depressed for two weeks or more in a row. HIV infection was negatively associated with being married (odds ratio 0.20 in rural areas and 0.54 in urban areas), while church membership decreased the likelihood of HIV (odds ratio 0.22 in rural areas and 0.46 in urban areas). Indicators of higher socioeconomic status (having a microwave oven and access to vegetables from local farmers or shops) decreased the likelihood of HIV in rural areas (odds ratios 0.15 and 0.43, respectively). Indicators of lower socioeconomic status such as spending less money on food in the rural sample (odds ratio 3.29) and experiencing periods of food shortages in the urban sample (odds ratio 2.14), increased the likelihood of being HIV-inf

Since the advent of HIV/AIDS, sexuality studies in sub-Saharan Africa (SSA) have focused mainly on the sexual behaviour of the younger generation (15-49 years) and little has been done to understand the sexual behaviour of those a 50 years and above. The objective of this study is therefore to examine the covariates of high-risk sexual behaviour among men aged 50 years plus within the SSA region. Data from Demographic and Health Surveys of 10 SSA countries were pooled together and a sample of 5394 men aged 50 years plus who have ever had sex was analysed. Findings show that in SSA, a large proportion of men aged 50 years plus (74%) were sexually active and a substantial proportion of these men engaged in unsafe sexual behaviours, such as having multiple sexual partners and unprotected sex. The multivariate logistic regression analysis showed that involvement with multiple sexual partners was significantly associated with older age, urban residence, religion, having primary or secondary education, and ever taken an HIV test. Condom use at last sex was significantly associated with age at first sex, multiple sexual partners, level of education and ever been tested for HIV. These results suggest that HIV prevention and intervention programmes should also target older men as they are also sexually active and at risk of being infected because of unsafe sexual practices.