Sexual health exchange最新文献

AIDS is steeped in moral judgments about who becomes infected with HIV. Consequently, an AIDS diagnosis inevitably brings with it feelings of shame, guilt, loss, depression, fear of disclosure and some form of self-imposed isolation. Because of the stigma of an HIV-positive diagnosis, people are often reluctant to come forward and be tested, which makes it difficult for them to make informed decisions about their own future and that of their family. Nevertheless, since early in the epidemic, people living with HIV/AIDS have spoken out to present their personal perspectives on living with HIV and to challenge perceptions about who can and cannot become infected. However, there has been little research to explore their role in the global response to AIDS and the impact of public HIV disclosure on the HIV-positive persons themselves.

On 21 April, 1999, the Namibian press reported that the government was going to declare AIDS a notifiable disease. This announcement sparked much debate about the role of confidentiality in a sound public health approach to the prevention and control of HIV/AIDS. It also became apparent that in Namibia people's understanding of the principle of confidentiality varies widely. Many seem to confuse the concepts of secrecy and confidentiality. They see preserving confidentiality about HIV/AIDS information as strengthening the "veil of secrecy" that surrounds HIV, reinforcing stigma and undermining efforts to control the spread of HIV. A consultative process, initiated by Joint UN Program on HIV/AIDS, led to the formulation of a much needed policy framework for reporting and notification of HIV/AIDS. A task force was established to identify, discuss and report on national issues, policies and experiences that could inform the discussion on HIV reporting and confidentiality.

The prevalence of HIV infection in Indonesia is generally held to be low. Since the first case was officially identified in 1987, only 1146 people have been diagnosed with HIV, 293 of them reported as having AIDS. The latest estimate from WHO (June 1999) is that 250,000 Indonesians are infected, giving a prevalence among this 200+ million population of around 120/100,000 population. This figure is generally agreed to be in the correct range--for sexual transmission of the virus. It is probable, however, that the total figure may be several times higher as a result of the sudden explosion of injecting drug use, with no surveillance and little outreach yet having been undertaken among this group.

Since 1992, the National Community of Women Living with HIV/AIDS in Uganda has been working to improve the quality of life of Ugandan women living with HIV/AIDS. HIV-positive mothers who were finding it difficult to tell their children about their HIV status started the so-called Memory Project, which tries to help HIV-positive parents give their children the support they need to survive with as little trauma as possible after the deaths of their parents.

Kara Counselling and Training Trust (Kara) began offering voluntary counseling and testing (VCT) for HIV to the Zambian public in 1992. In the first years, clients came for testing because they were sick. These days however, more and more healthy young people are requesting tests for other reasons: they may be planning to get married, to have children or to engage in unprotected sex after being in an intimate relationship for some time. More than 20% of the clients now come for marriage-related reasons--as individuals or as couples. People want to know their HIV status so they can share it with their current or future spouse in order to make informed choices and protect each other's sexual and reproductive health.