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Comprehensive sexuality education is seen as a key intervention to address the high HIV-incidence rate and low knowledge among young people in South Africa, yet this lacks inclusion of learners with disabilities. At the same time, educators of learners with disabilities experience cultural barriers and lack skills and knowledge on how to deliver sexuality education in accessible formats. In response, the Breaking the Silence approach, a curriculum implementation and disability-accommodating approach, was developed and tested. This paper presents findings from a formative evaluation using in-depth interviews with educators from eight “schools for learners with special educational needs”. The paper focuses on their experience with implementing the approach. The analysis used conventional content analysis and NVIVO software. Educators conceptualized sexuality education within a risk-protection discourse. They revealed that the training and tools enabled them to provide sexuality education in accessible formats, tackle difficult topics such as sexual orientation and masturbation, and improved awareness and assertiveness within their learners. Educators identified the need for further development including a whole school approach, adjustments to differentiating developmental stages and addressing gender-specific topics. Through its application within the South African mainstream Life Orientation curriculum, this approach lends itself for further development and testing through implementing the approach within a whole school setting and ongoing support that will not only drive change in educators’ skills and knowledge but also drive the needed shift in cultural norms and values. [ABSTRACT FROM AUTHOR]

In rural South Africa, pregnant HIV-infected women report high rates of psychological (55%) and physical (20%) intimate partner violence (IPV). IPV increases the risk of infant developmental delays. Such delays may have negative socioemotional and cognitive outcomes throughout the lifespan. This paper assesses the relationship between IPV and infant development in rural South Africa. The present investigation was a cross-sectional add-on follow-up designed retrospectively. A randomly selected sub-sample of mothers from the main randomized controlled trial (n = 72) were asked to participate with their infants at 12 months of age; all women invited agreed to participate. Women were 18.35 ± 5.47 weeks pregnant; demographics, HIV disclosure status, and pre- and postnatal IPV measured via the Conflict Tactics Scale during pregnancy at baseline and 12 months post-partum were assessed. Infant HIV serostatus and developmental functioning at 12 months of age were assessed. Women were a mean age of 29 ± 2 years. One third had completed at least 12 years of education and had a monthly income of ~ US$76. At 12 months post-partum, 6% of infants tested HIV seropositive. Postnatal physical IPV was associated with delays in cognitive and receptive language development p < 0.05, but only in unadjusted analyses. This study identified an association between early IPV exposure and infant cognitive and receptive communication delays. Given the small sample size, findings support replication. Longitudinal studies are needed to confirm temporal order and identify appropriate timing for interventions in HIV-exposed infants. [ABSTRACT FROM AUTHOR]

Using a triangulation design combining participant observation, survey results, and interviews, this paper studies the current form of the response to HIV in the local Anglican Church in the Western Cape, South Africa. The results show that people are generally aware of HIV. The 'buzz' around HIV has, however, subsided. The local church does not directly engage HIV anymore, and HIV is more mentioned than talked about. HIV stigma continues to pose a challenge. To work towards the prevention of HIV, the local church needs to put HIV back on the agenda and continue to speak about the virus. [ABSTRACT FROM AUTHOR]

Cities in the South are faced with the double challenges of underdevelopment and poverty on the one hand and urbanisation on the other. As the developing regions of the South continue to urbanise at an incredible rate, it is clear that many cities do not have the necessary capacity to respond to the increasing needs and demands by urban residents. As a result, many new city residents have no other option but to settle in informal areas. These areas have long been associated with poor and unhealthy living conditions and, more recently, the links between these living conditions and HIV/AIDS have become increasingly clear. Research suggests that developmental factors like poverty, unemployment, gender inequality and inadequate shelter, water and sanitation all play a role in increasing vulnerability to HIV/AIDS. These conditions further affect the ability of HIV-positive individuals, households and communities to cope with the consequences of the epidemic. This in turn leads to further impoverishment and reduces the likelihood that people living in informal settlements will be able to improve their livelihoods. Yet, little attention has been paid by policy makers and planners to the relationship between HIV/AIDS and informality despite the challenge it provides for cities and the implications of the epidemic for government institutions and local government in particular. This paper argues that informality is complex and that its heterogeneous nature is not effectively understood and thus not given appropriate recognition and support. It looks at the effects of the HIV/AIDS epidemic within this context of informality and the inevitable wave of urbanisation. The paper suggests that the only way to deal effectively with HIV/AIDS (and informality) is through planning and building integrated and sustainable urban settlements that respond to the complexities of informality in cities of the developing world. [ABSTRACT FROM AUTHOR]

Livelihood insecurity, HIV and AIDS, and environmental change, including high climate variability, have negatively impacted the southern African region for the last decade. It is increasingly evident that there is a complex interplay of factors shaping rural livelihoods at various scales. Recognition of the varied impacts of HIV and AIDS has led to development of a conceptual framework that utilises the ‘AIDS Timeline’ or ‘Programming Matrix’, which enables differential intervention strategies to be adopted depending on the dominant impacts and trends on livelihoods. This paper presents this approach and links it to case study material from two districts in Malawi and South Africa. The evidence suggests that although there are some areas where HIV and AIDS are mainstreamed into livelihood security interventions, this is not sufficient, as holistic environmental and social approaches are not adopted. This paper reflects on the fieldwork findings to link to the AIDS Timeline in support of appropriate interventions. At the same time, we highlight the urgency in addressing the meso-scale and adopting a holistic framework that addresses livelihood security from a range of angles, including the implications for the chronically ill, interactions with environment and the capacity to implement change. [ABSTRACT FROM AUTHOR]

In KwaZulu-Natal disability and gender are associated with myths and stereotypes that exacerbate the vulnerability of people with disability (PWD) to HIV/AIDS. The present analysis results from a three year qualitative study of 25 people with disabilities and their caregivers. It outlines the interweaving patterns of stereotyping gender and disability and how this may increase the vulnerability of PWD to HIV/AIDS. The paper emphasizes that access to prevention and treatment is still an unfulfilled goal and that an enormous gap in service delivery persists. Sexual abuse and exploitation have become a major threat to fighting HIV/AIDS within the group of PWD. PWD are particularly vulnerable to HIV/AIDS through the threat of sexual abuse. Potential contributors to this are sexual purification rituals, sexual exploitation and the process of the judicial system. The notion that PWD are asexual, virgins, sexually overactive, cursed, dirty or clean increases their exposure to abuse and subsequently HIV/AIDS. Additionally, misconceptions regarding sexuality, gender and HIV/AIDS have exposed women and girls with disabilities, in particular, to abuse and HIV. Yet, effective responses are still scarce and people with disabilities are often denied access to sexual education as well as prevention and treatment of HIV/AIDS. [ABSTRACT FROM AUTHOR]

A recent randomized controlled trial shows a significant reduction in women-to-men transmission of HIV due to male circumcision. Such development calls for a rigorous mathematical study to ascertain the full impact of male circumcision in reducing HIV burden, especially in resource-poor nations where access to anti-retroviral drugs is limited. First of all, this paper presents a compartmental model for the transmission dynamics of HIV in a community where male circumcision is practiced. In addition to having a disease-free equilibrium, which is locally-asymptotically stable whenever a certain epidemiological threshold is less than unity, the model exhibits the phenomenon of backward bifurcation, where the disease-free equilibrium coexists with a stable endemic equilibrium when the threshold is less than unity. The implication of this result is that HIV may persist in the population even when the reproduction threshold is less than unity. Using partial data from South Africa, the study shows that male circumcision at 60% efficacy level can prevent up to 220,000 cases and 8,200 deaths in the country within a year. Further, it is shown that male circumcision can significantly reduce, but not eliminate, HIV burden in a community. However, disease elimination is feasible if male circumcision is combined with other interventions such as ARVs and condom use. It is shown that the combined use of male circumcision and ARVs is more effective in reducing disease burden than the combined use of male circumcision and condoms for a moderate condom compliance rate. [ABSTRACT FROM AUTHOR]

Presents a paper to explore the nature and impacts of HIV/AIDS in urban areas in South Africa and to identify core determinants facilitating the spread of the epidemic in South African cities and towns. Impact of social and geopolitical factors in the manifestation of HIV/AIDS; Capacity of HIV/AIDS to frustrate efforts to improve the quality of life; Effect of HIV/AIDS on urban development planning.