Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1636708
Humphrey Brydon, Rénette Blignaut, Joachim Jacobs
The latest population estimates released by Statistics South Africa indicate that 25.03% of all deaths in 2017 in South Africa were AIDS-related. Along with these results, it is also reported that 7.06% of the population were living with HIV, with the HIV-prevalence among youth (aged 15-24) at 4.64% for 2017 (STATSSA. (2018). Retrieved from Statistics South Africa: http://www.statssa.gov.za/publications/P0302/P03022017.pdf ). The data used in the study contained information related to the risk-taking behaviours associated with the sexual activity of entering first-year students at the University of the Western Cape. In this study, a logistic regression modelling procedure was carried out on those students that were determined to be sexually active, therefore, in the modelling procedure significant risk behaviours of sexually active first-year students could be identified. Of the 14 variables included in the modelling procedure, six were found to be significantly associated with sexually active students. The significant variables included; the age and race of the student, whether the student had ever taken an HIV test, the importance of religion in influencing the sexual behaviour of the student, whether the student consumed alcohol and lastly whether the student smoked. This study further investigated the impact of introducing sample weighting, bootstrap sampling as well as variable selection methods into the logistic regression modelling procedure. It is shown that incorporating these techniques into the modelling procedure produces logistic regression models that are more accurate and have an increased predictive capability. The bootstrapping procedure is shown to produce logistic regression models that are more accurate than those produced without a bootstrap procedure. A comparison between 200, 500 and 1000 bootstrap samples is also incorporated into the modelling procedure with the models produced from 200 bootstrap samples shown to be just as accurate those produced from 500 or 1000 bootstrap samples. Of the five variable selection methods used, it is shown that the Newton-Raphson and Fisher methods are unreliable in producing logistic regression models. The forward, backward and stepwise variable selection methods are shown to produce very similar results.
{"title":"A weighted bootstrap approach to logistic regression modelling in identifying risk behaviours associated with sexual activity.","authors":"Humphrey Brydon, Rénette Blignaut, Joachim Jacobs","doi":"10.1080/17290376.2019.1636708","DOIUrl":"https://doi.org/10.1080/17290376.2019.1636708","url":null,"abstract":"<p><p>The latest population estimates released by Statistics South Africa indicate that 25.03% of all deaths in 2017 in South Africa were AIDS-related. Along with these results, it is also reported that 7.06% of the population were living with HIV, with the HIV-prevalence among youth (aged 15-24) at 4.64% for 2017 (STATSSA. (2018). Retrieved from Statistics South Africa: http://www.statssa.gov.za/publications/P0302/P03022017.pdf ). The data used in the study contained information related to the risk-taking behaviours associated with the sexual activity of entering first-year students at the University of the Western Cape. In this study, a logistic regression modelling procedure was carried out on those students that were determined to be sexually active, therefore, in the modelling procedure significant risk behaviours of sexually active first-year students could be identified. Of the 14 variables included in the modelling procedure, six were found to be significantly associated with sexually active students. The significant variables included; the age and race of the student, whether the student had ever taken an HIV test, the importance of religion in influencing the sexual behaviour of the student, whether the student consumed alcohol and lastly whether the student smoked. This study further investigated the impact of introducing sample weighting, bootstrap sampling as well as variable selection methods into the logistic regression modelling procedure. It is shown that incorporating these techniques into the modelling procedure produces logistic regression models that are more accurate and have an increased predictive capability. The bootstrapping procedure is shown to produce logistic regression models that are more accurate than those produced without a bootstrap procedure. A comparison between 200, 500 and 1000 bootstrap samples is also incorporated into the modelling procedure with the models produced from 200 bootstrap samples shown to be just as accurate those produced from 500 or 1000 bootstrap samples. Of the five variable selection methods used, it is shown that the Newton-Raphson and Fisher methods are unreliable in producing logistic regression models. The forward, backward and stepwise variable selection methods are shown to produce very similar results.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2019.1636708","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37123964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1572533
Katelyn M Sileo, Laura M Bogart, Glenn J Wagner, William Musoke, Rose Naigino, Barbara Mukasa, Rhoda K Wanyenze
HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02-9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting.
艾滋病毒宿命论,即认为艾滋病毒的感染和死亡不受自己控制的信念,被认为是东非捕鱼人口感染艾滋病毒风险的原因之一。这项横断面研究旨在调查宿命论与性风险行为(无保护性行为、参与性交易)之间的关联,而不考虑其他已知的 HIV 风险因素(如粮食不安全、流动性)的影响,并确定 HIV 宿命论的人口、社会心理和结构相关因素。在 2015 年 5 月至 7 月期间,居住在乌干达维多利亚湖两个岛屿渔村的 91 名男性和女性在家庭或社区 HIV 检测中检测出 HIV 阳性后,填写了一份由访谈者主持的问卷。多变量逻辑回归用于检验艾滋病毒宿命论与性交易之间的关联,多变量线性回归用于识别艾滋病毒宿命论的人口、社会心理和结构相关因素。HIV宿命论与发生性交易的可能性明显相关(AOR = 3.07,95% CI = 1.02-9.23,p = 0.04),HIV关怀的结构性障碍(如到诊所的距离)与HIV宿命论明显相关(β = 0.26,SE = 0.12,p = 0.04)。我们的研究结果表明,HIV宿命论是导致乌干达渔业社区发生性交易的一个因素,也是更广泛的社会和环境因素的产物,这表明在这种环境下可能需要对 HIV 进行结构性干预。
{"title":"HIV fatalism and engagement in transactional sex among Ugandan fisherfolk living with HIV.","authors":"Katelyn M Sileo, Laura M Bogart, Glenn J Wagner, William Musoke, Rose Naigino, Barbara Mukasa, Rhoda K Wanyenze","doi":"10.1080/17290376.2019.1572533","DOIUrl":"10.1080/17290376.2019.1572533","url":null,"abstract":"<p><p>HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02-9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36925773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1626760
Emmanuel Kimera, Sofie Vindevogel, John Rubaihayo, Didier Reynaert, Jessica De Maeyer, Anne-Mie Engelen, Johan Bilsen
As Youth Living With HIV/AIDS (YLWHA) continue to survive and live with HIV chronically due to effective Antiretroviral Therapy (ART), it is paramount to work toward maximising their psychosocial wellbeing. The school where these YLWHA are expected to spend most of their time is an excellent environment to investigate this. In this study, we explore perspectives of Peer Educators (PEs) in secondary schools of one district in Western Uganda on how YLWHA are perceived in school, on their daily stressors and their way of coping with their HIV-positive serostatus given the support of the schools. We conducted eight focus groups with a total of 59 students who were members of Peer Educators Clubs (PECs) as well as 8 in-depth interviews with patron teachers of PECs in eight secondary schools of Kabarole district, selected through a stratified random sampling method. Focus groups and interviews were tape-recorded, transcribed and analysed thematically both inductively and deductively. Stressors and support in schools, as identified by the PEs were categorised into three interrelated thematic domains; psychological wellbeing of YLWHA, disclosure of HIV status by YLWHA, and health and treatment adherence. Stigma was found to be a key stressor and an intermediary in all the three thematic domains Stressors affecting psychological wellbeing were fear of death and uncertainty of the future compounded by financial and academic challenges. Stressors affecting disclosure centred around lack of privacy, confidentiality and fear of loss of friends. Stressors affecting treatment adherence included lack of privacy while taking drugs, unintended disclosure while obtaining drugs or seeking permission to attend clinic appointments and fear of drug adverse effects due to poor nutrition. A supportive school environment involved the availability of a school nurse, counselling services and PECs. We conclude that the school environment brings more stressors than supports for YLWHA. The daily stressors related to HIV stigma, uncertainty, disclosure, privacy and confidentiality render schooling a hassle for YLWHA. Interventions that promote resilient school communities are necessary to foster disclosure in a non-discriminatory and stigma-free environment. This calls for concerted efforts from all school stakeholders.
{"title":"Youth living with HIV/AIDS in secondary schools: perspectives of peer educators and patron teachers in Western Uganda on stressors and supports.","authors":"Emmanuel Kimera, Sofie Vindevogel, John Rubaihayo, Didier Reynaert, Jessica De Maeyer, Anne-Mie Engelen, Johan Bilsen","doi":"10.1080/17290376.2019.1626760","DOIUrl":"https://doi.org/10.1080/17290376.2019.1626760","url":null,"abstract":"<p><p>As Youth Living With HIV/AIDS (YLWHA) continue to survive and live with HIV chronically due to effective Antiretroviral Therapy (ART), it is paramount to work toward maximising their psychosocial wellbeing. The school where these YLWHA are expected to spend most of their time is an excellent environment to investigate this. In this study, we explore perspectives of Peer Educators (PEs) in secondary schools of one district in Western Uganda on how YLWHA are perceived in school, on their daily stressors and their way of coping with their HIV-positive serostatus given the support of the schools. We conducted eight focus groups with a total of 59 students who were members of Peer Educators Clubs (PECs) as well as 8 in-depth interviews with patron teachers of PECs in eight secondary schools of Kabarole district, selected through a stratified random sampling method. Focus groups and interviews were tape-recorded, transcribed and analysed thematically both inductively and deductively. Stressors and support in schools, as identified by the PEs were categorised into three interrelated thematic domains; psychological wellbeing of YLWHA, disclosure of HIV status by YLWHA, and health and treatment adherence. Stigma was found to be a key stressor and an intermediary in all the three thematic domains Stressors affecting psychological wellbeing were fear of death and uncertainty of the future compounded by financial and academic challenges. Stressors affecting disclosure centred around lack of privacy, confidentiality and fear of loss of friends. Stressors affecting treatment adherence included lack of privacy while taking drugs, unintended disclosure while obtaining drugs or seeking permission to attend clinic appointments and fear of drug adverse effects due to poor nutrition. A supportive school environment involved the availability of a school nurse, counselling services and PECs. We conclude that the school environment brings more stressors than supports for YLWHA. The daily stressors related to HIV stigma, uncertainty, disclosure, privacy and confidentiality render schooling a hassle for YLWHA. Interventions that promote resilient school communities are necessary to foster disclosure in a non-discriminatory and stigma-free environment. This calls for concerted efforts from all school stakeholders.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2019.1626760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1610485
Ephias Gudyanga, Naydene de Lange, Mathabo Khau
In spite of the importance of sexuality education and HIV and AIDS education in preventing HIV infections, Zimbabwean secondary school Guidance and Counseling teachers are not engaging optimally with the current Guidance and Counseling, HIV and AIDS & Life Skills education curriculum, and hence, they are not serving the needs of the learners in the context of the HIV and AIDS pandemic. The aim of the study, therefore, was to explore how Guidance and Counseling teachers could be enabled to teach the necessary critical content in sexuality education in the HIV and AIDS education curriculum. A qualitative research design, informed by a critical paradigm, using participatory visual methodology and methods such as drawing and focus group discussion, was used with eight purposively selected Guidance and Counseling teachers from Gweru district, Zimbabwe. The study was theoretically framed by Cultural Historical Activity Theory. Guidance and Counseling teachers found themselves in a community with diverse cultural practices and beliefs of which some seemed to contradict what was supposed to be taught in the curriculum. The participatory visual methodology, however, enabled a process in which the Guidance and Counseling teachers could reflect on themselves, the context in which they taught, their sexuality education work and learn how to navigate the contradictions and tensions, and to use such contradictions as sources of learning and sources for change. The results have several implications for policy in terms of the Guidance and Counseling curriculum and engaging with cultural issues; and for practice in terms of teacher professional development, teacher training, and for stakeholder contribution.
{"title":"Zimbabwean secondary school Guidance and Counseling teachers teaching sexuality education in the HIV and AIDS education curriculum<sup>.</sup>","authors":"Ephias Gudyanga, Naydene de Lange, Mathabo Khau","doi":"10.1080/17290376.2019.1610485","DOIUrl":"10.1080/17290376.2019.1610485","url":null,"abstract":"<p><p>In spite of the importance of sexuality education and HIV and AIDS education in preventing HIV infections, Zimbabwean secondary school Guidance and Counseling teachers are not engaging optimally with the current Guidance and Counseling, HIV and AIDS & Life Skills education curriculum, and hence, they are not serving the needs of the learners in the context of the HIV and AIDS pandemic. The aim of the study, therefore, was to explore how Guidance and Counseling teachers could be enabled to teach the necessary critical content in sexuality education in the HIV and AIDS education curriculum. A qualitative research design, informed by a critical paradigm, using participatory visual methodology and methods such as drawing and focus group discussion, was used with eight purposively selected Guidance and Counseling teachers from Gweru district, Zimbabwe. The study was theoretically framed by Cultural Historical Activity Theory. Guidance and Counseling teachers found themselves in a community with diverse cultural practices and beliefs of which some seemed to contradict what was supposed to be taught in the curriculum. The participatory visual methodology, however, enabled a process in which the Guidance and Counseling teachers could reflect on themselves, the context in which they taught, their sexuality education work and learn how to navigate the contradictions and tensions, and to use such contradictions as sources of learning and sources for change. The results have several implications for policy in terms of the Guidance and Counseling curriculum and engaging with cultural issues; and for practice in terms of teacher professional development, teacher training, and for stakeholder contribution.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37374083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1605537
Christina Tafadzwa Dzimiri, Patrick Dzimiri, Kezia Batisai
Since reports of the first incidence of the HIV virus in Zimbabwe in 1985, the epidemic has negatively impacted on every facet of human security. Rural areas, by virtue of being the periphery and constrained in terms of resources and health care provision, bear the brunt of the epidemic. In light of the above background, this paper examined how the establishment of Ruvheneko Programme by the people of Chirumhanzu helped in mitigating on the impact of HIV and AIDS in the rural sphere. The paper analyses how the community of Chirumhanzu successfully engaged each other to the extent of coming up with such a vibrant programme. This is raised against the backdrop of failure usually associated with HIV and AIDS engagement projects. The study made use of field interviews and focus group discussions as data collection instruments. Participants were purposively selected on the basis of their knowledge and participation in the establishment and activities of Ruvheneko Programme. Selected were 5 St Theresa's Hospital Staff, 10 Roman Catholic Church members of which, 5 were from the St Anna's woman prayer group and 5 men from St Joseph's men prayer group, 1 village head and 2 elders from the same nearby village constituted key informants. Complementing the use of interviews and focus group discussions was the analysis of secondary data sources on HIV and AIDS in Zimbabwe as well as the Ruvheneko Programme. To understand the collective role of various sectors of the community in establishing Ruvheneko Programme, the paper derives insights from the perspective of social capital theory and its notion of commonality to strengthen communities. Findings from the study show that, unlike other HIV and AIDS programmes that are exported from the urban to the rural areas, Ruvheneko Programme demonstrates a grassroots-level response to HIV and AIDS. Again, social cohesion fostered by aspects such as religiosity, cultural ethos of Ubuntu, and a consultative approach played a key role in unifying people towards fighting HIV and AIDS in Rural Chirumhanzu.
{"title":"Fighting against HIV and AIDS within a resource constrained rural setting: a case study of the Ruvheneko Programme in Chirumhanzu, Zimbabwe.","authors":"Christina Tafadzwa Dzimiri, Patrick Dzimiri, Kezia Batisai","doi":"10.1080/17290376.2019.1605537","DOIUrl":"https://doi.org/10.1080/17290376.2019.1605537","url":null,"abstract":"<p><p>Since reports of the first incidence of the HIV virus in Zimbabwe in 1985, the epidemic has negatively impacted on every facet of human security. Rural areas, by virtue of being the periphery and constrained in terms of resources and health care provision, bear the brunt of the epidemic. In light of the above background, this paper examined how the establishment of Ruvheneko Programme by the people of Chirumhanzu helped in mitigating on the impact of HIV and AIDS in the rural sphere. The paper analyses how the community of Chirumhanzu successfully engaged each other to the extent of coming up with such a vibrant programme. This is raised against the backdrop of failure usually associated with HIV and AIDS engagement projects. The study made use of field interviews and focus group discussions as data collection instruments. Participants were purposively selected on the basis of their knowledge and participation in the establishment and activities of Ruvheneko Programme. Selected were 5 St Theresa's Hospital Staff, 10 Roman Catholic Church members of which, 5 were from the St Anna's woman prayer group and 5 men from St Joseph's men prayer group, 1 village head and 2 elders from the same nearby village constituted key informants. Complementing the use of interviews and focus group discussions was the analysis of secondary data sources on HIV and AIDS in Zimbabwe as well as the Ruvheneko Programme. To understand the collective role of various sectors of the community in establishing Ruvheneko Programme, the paper derives insights from the perspective of social capital theory and its notion of commonality to strengthen communities. Findings from the study show that, unlike other HIV and AIDS programmes that are exported from the urban to the rural areas, Ruvheneko Programme demonstrates a grassroots-level response to HIV and AIDS. Again, social cohesion fostered by aspects such as religiosity, cultural ethos of Ubuntu, and a consultative approach played a key role in unifying people towards fighting HIV and AIDS in Rural Chirumhanzu.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2019.1605537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37160610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1080/17290376.2019.1604254
Allison Ruark, Edward C Green, Amy Nunn, Caitlin Kennedy, Alfred Adams, Thandeka Dlamini-Simelane, Pamela Surkan
Couple relationship functioning impacts individual health and well-being, including HIV risk, but scant research has focused on emic understandings of relationship quality in African populations. We explored relationship quality and satisfaction in Eswatini (formerly Swaziland) using data from 148 in-depth interviews (117 life-course interviews with 28 adults and 31 interviews with 29 marriage counselors and their clients) and 4 focus group discussions. Love, respect, honesty, trust, communication, sexual satisfaction, and sexual faithfulness emerged as the most salient characteristics of good relationships, with both men and women emphasising love and respect as being most important. Participants desired relationships characterised by such qualities but reported relationship threats in the areas of trust, honesty, and sexual faithfulness. The dimensions of relationship quality identified by this study are consistent with research from other contexts, suggesting cross-cultural similarities in conceptions of a good relationship. Some relationship constructs, particularly respect, may be more salient in a Swazi context.
{"title":"Navigating intimate sexual partnerships in an era of HIV: dimensions of couple relationship quality and satisfaction among adults in Eswatini and linkages to HIV risk.","authors":"Allison Ruark, Edward C Green, Amy Nunn, Caitlin Kennedy, Alfred Adams, Thandeka Dlamini-Simelane, Pamela Surkan","doi":"10.1080/17290376.2019.1604254","DOIUrl":"10.1080/17290376.2019.1604254","url":null,"abstract":"<p><p>Couple relationship functioning impacts individual health and well-being, including HIV risk, but scant research has focused on emic understandings of relationship quality in African populations. We explored relationship quality and satisfaction in Eswatini (formerly Swaziland) using data from 148 in-depth interviews (117 life-course interviews with 28 adults and 31 interviews with 29 marriage counselors and their clients) and 4 focus group discussions. Love, respect, honesty, trust, communication, sexual satisfaction, and sexual faithfulness emerged as the most salient characteristics of good relationships, with both men and women emphasising love and respect as being most important. Participants desired relationships characterised by such qualities but reported relationship threats in the areas of trust, honesty, and sexual faithfulness. The dimensions of relationship quality identified by this study are consistent with research from other contexts, suggesting cross-cultural similarities in conceptions of a good relationship. Some relationship constructs, particularly respect, may be more salient in a Swazi context.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2019.1604254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37154560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1080/17290376.2018.1527245
Salome C Erekaha, Llewellyn J Cornelius, Melissa L Bessaha, Abdulmumin Ibrahim, Gabriel D Adeyemo, Mofoluwake Fadare, Manhattan Charurat, Echezona E Ezeanolue, Nadia A Sam-Agudu
The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART -before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria. Qualitative data were manually analyzed via Grounded Theory. PMTCT users had mixed views about lifelong ART, strongly influenced by motivation to prevent infant HIV and by presence or absence of maternal illness. Newly-diagnosed women were most enthusiastic about lifelong ART, however postpartum and LTFU women expressed conditionalities for acceptance and adherence, including minimal ART side effects and potentially serious maternal illness. Providers corroborated user findings, identifying the postpartum period as problematic for lifelong ART acceptability/adherence. Option B plus scale-up in Nigeria will require proactively addressing PMTCT user fears about ART side effects, and continuous education on long-term maternal and infant benefits. Structural barriers such as the availability of trained providers, long clinic wait times and patient access to ART should also be addressed.
{"title":"Exploring the acceptability of Option B plus among HIV-positive Nigerian women engaged and not engaged in the prevention of mother-to-child transmission of HIV cascade: a qualitative study.","authors":"Salome C Erekaha, Llewellyn J Cornelius, Melissa L Bessaha, Abdulmumin Ibrahim, Gabriel D Adeyemo, Mofoluwake Fadare, Manhattan Charurat, Echezona E Ezeanolue, Nadia A Sam-Agudu","doi":"10.1080/17290376.2018.1527245","DOIUrl":"https://doi.org/10.1080/17290376.2018.1527245","url":null,"abstract":"<p><p>The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART -before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria. Qualitative data were manually analyzed via Grounded Theory. PMTCT users had mixed views about lifelong ART, strongly influenced by motivation to prevent infant HIV and by presence or absence of maternal illness. Newly-diagnosed women were most enthusiastic about lifelong ART, however postpartum and LTFU women expressed conditionalities for acceptance and adherence, including minimal ART side effects and potentially serious maternal illness. Providers corroborated user findings, identifying the postpartum period as problematic for lifelong ART acceptability/adherence. Option B plus scale-up in Nigeria will require proactively addressing PMTCT user fears about ART side effects, and continuous education on long-term maternal and infant benefits. Structural barriers such as the availability of trained providers, long clinic wait times and patient access to ART should also be addressed.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1527245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36524264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1080/17290376.2018.1492960
Dominic Targema Abaver, Elphina Nomabandla Cishe
The Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) South Africans continue to face considerable challenges, including societal stigma, homophobic violence (particularly corrective rape), and high rates of sexually transmitted diseases and infections (particularly Human Immunodeficiency Virus (HIV)/AIDS) even when discrimination based on sexual orientation was outlawed by South African's post-apartheid constitution. This study was conducted to ascertain violence, abuse and discrimination against the LGBTI sector as key factors that hinder the smooth implementation of HIV/AIDS programme among sexually minority (LGBTI) group in Walter Sisulu University, South Africa. The self-structured questionnaire was used to collect data. The study involved 3048 purposively selected participants (1285 male and 1763 female) aged 17-38 years. About 70.5% of the participants witnessed physical attack as a form of violence against people in same-gender relationship; 47.7% disagreed that violent targeted at this sexually minority group is justified. The LGBTI face challenges which include verbal insults (937, 32.4%), bullying (532, 18.4%) and name-calling (1389, 48%). Discrimination against members of the LGBTI sector was witnessed in various forms: non-acceptance (981, 33.9%), disapproval of act of homosexuals (1308, 45.2) and denial of rights (327, 11.3). Violence, abuse and discrimination which constitute stigmatisation among the LGBTI sector are received with mix feeling. Some respondents justified the use of one or more of these key elements of stigmatisation against the LGBTI (6.6%, supports violence), others condemned these acts of stigmatisation (28.8%), against discrimination). Social stigma which resulted from violence, abuse and discrimination exist in this institution and is responsible for the unwillingness of disclosure of sexual orientation among the LGBTI members. An enabling environment should be created where the LGBTI members could come out freely to access programmes targeted at the prevention and control of HIV/AIDS.
{"title":"Violence, abuse and discrimination: key factors militating against control of HIV/AIDS among the LGBTI sector.","authors":"Dominic Targema Abaver, Elphina Nomabandla Cishe","doi":"10.1080/17290376.2018.1492960","DOIUrl":"https://doi.org/10.1080/17290376.2018.1492960","url":null,"abstract":"<p><p>The Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) South Africans continue to face considerable challenges, including societal stigma, homophobic violence (particularly corrective rape), and high rates of sexually transmitted diseases and infections (particularly Human Immunodeficiency Virus (HIV)/AIDS) even when discrimination based on sexual orientation was outlawed by South African's post-apartheid constitution. This study was conducted to ascertain violence, abuse and discrimination against the LGBTI sector as key factors that hinder the smooth implementation of HIV/AIDS programme among sexually minority (LGBTI) group in Walter Sisulu University, South Africa. The self-structured questionnaire was used to collect data. The study involved 3048 purposively selected participants (1285 male and 1763 female) aged 17-38 years. About 70.5% of the participants witnessed physical attack as a form of violence against people in same-gender relationship; 47.7% disagreed that violent targeted at this sexually minority group is justified. The LGBTI face challenges which include verbal insults (937, 32.4%), bullying (532, 18.4%) and name-calling (1389, 48%). Discrimination against members of the LGBTI sector was witnessed in various forms: non-acceptance (981, 33.9%), disapproval of act of homosexuals (1308, 45.2) and denial of rights (327, 11.3). Violence, abuse and discrimination which constitute stigmatisation among the LGBTI sector are received with mix feeling. Some respondents justified the use of one or more of these key elements of stigmatisation against the LGBTI (6.6%, supports violence), others condemned these acts of stigmatisation (28.8%), against discrimination). Social stigma which resulted from violence, abuse and discrimination exist in this institution and is responsible for the unwillingness of disclosure of sexual orientation among the LGBTI members. An enabling environment should be created where the LGBTI members could come out freely to access programmes targeted at the prevention and control of HIV/AIDS.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1492960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36327390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV self-testing strategy could increase the uptake of HIV testing among the people. The aim of the study was to assess outpatients' health care user's knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users' knowledge of HIVST, assess health care users' attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of health care users towards HIVST. A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three purposefully selected Addington, R. K. Khan and Prince Mshiyeni Memorial Hospital Gateway clinics at eThekwini Health District. A convenience sampling of 442 respondents were sampled from the three study sites. Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they could use it if it can be made freely available to the public and be properly regulated. Generally, health care users indicated positive attitudes towards HIV self-testing. Nevertheless, issues of lack of pre and post-test counselling, false negative results and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated in South Africa.
{"title":"Health care users' knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa.","authors":"Sibongiseni Daphney Gumede, Maureen Nokuthula Sibiya","doi":"10.1080/17290376.2018.1517607","DOIUrl":"10.1080/17290376.2018.1517607","url":null,"abstract":"<p><p>Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV self-testing strategy could increase the uptake of HIV testing among the people. The aim of the study was to assess outpatients' health care user's knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users' knowledge of HIVST, assess health care users' attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of health care users towards HIVST. A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three purposefully selected Addington, R. K. Khan and Prince Mshiyeni Memorial Hospital Gateway clinics at eThekwini Health District. A convenience sampling of 442 respondents were sampled from the three study sites. Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they could use it if it can be made freely available to the public and be properly regulated. Generally, health care users indicated positive attitudes towards HIV self-testing. Nevertheless, issues of lack of pre and post-test counselling, false negative results and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated in South Africa.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36454443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1080/17290376.2018.1433057
Karl Peltzer
The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09-3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37-0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34-0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25-0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68-6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73-5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36-0.99), being on ART (OR = 0.48, 95% CI = 0.25-0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18-0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15-0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19-3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82-10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16-0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24-0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41-0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.
本研究的目的是在南非的一项纵向研究设计中确定结核病(TB)患者的各种艾滋病毒风险行为。在3省3个区的42个公共初级卫生保健机构中,在开始抗结核治疗1个月内对成年新发结核病患者和危险或有害饮酒的结核病再治疗患者进行了访谈,并在6个月时进行了随访。完成6个月随访评估的总样本为853例。在随访评估中,从基线到随访期间,若干艾滋病毒风险行为显著减少。在多元广义估计方程logistic回归分析中,高度贫困(优势比(OR): 2.68, 95%可信区间(CI): 1.56-4.62)、创伤后应激障碍(PTSD)症状(OR = 1.55, 95% CI = 1.03-2.36)和性伴侣接受抗逆转录病毒治疗(ART) (OR = 1.84, 95% CI = 1.09-3.10)与较高的几率相关,以及良好/非常好的感知健康状况(OR: 0.61, 95% CI:0.37-0.98)、严重的心理压力(OR = 0.51, 95% CI = 0.34-0.77)和未向最近的性伴侣透露艾滋病毒(OR = 0.40, 95% CI = 0.25-0.65)与不一致使用避孕套的几率较低相关。HIV阳性(或= 4.18,95% CI = 2.68 - -6.53)和优秀的/非常主观的健康状态(或= 2.98,95% CI = 1.73 - -5.13)被关联到一个更高的可能性,和创伤后应激障碍症状(或= 0.60,95% CI = 0.36 - -0.99),在艺术(或= 0.48,95% CI -0.95 = 0.25),对艺术产生了性伴侣(或= 0.41,95% CI = 0.18 - -0.96),和艾滋病毒状况保密(或= 0.25,95% CI = 0.15 - -0.41)有关做爱的几率较低的艾滋病毒阳性或艾滋病毒状况未知的人。高贫困指数(OR = 1.97, 95% CI = 1.19-3.25)和性伴侣接受抗逆转录病毒治疗(OR = 4.37, 95% CI = 1.82-10.48)与较高的几率相关,而性伴侣呈HIV阴性(OR = 0.29, 95% CI = 0.16-0.51)和不一致使用安全套(OR = 0.39, 95% CI = 0.24-0.64)与最后性行为中HIV状态不披露的几率较低相关。该研究发现,在6个月的结核病治疗期间有饮酒问题的结核病患者中,一些艾滋病毒风险行为(不一致使用安全套)的频率下降了(OR = 0.64, 95% CI = 0.41-0.98),但也坚持要求加强艾滋病毒预防并将其纳入结核病管理。
{"title":"Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa.","authors":"Karl Peltzer","doi":"10.1080/17290376.2018.1433057","DOIUrl":"https://doi.org/10.1080/17290376.2018.1433057","url":null,"abstract":"<p><p>The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09-3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37-0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34-0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25-0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68-6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73-5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36-0.99), being on ART (OR = 0.48, 95% CI = 0.25-0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18-0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15-0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19-3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82-10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16-0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24-0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41-0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1433057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35795561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}