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In this paper problems associated with the modeling of HIV/AIDS in Southern Africa are presented. A mathematical model is presented to highlight the three major challenges of modeling HIV/AIDS, i.e condom use, vertical transmission and treatment. The model analysis for the case, where the treatment parameter ρ = 0, is presented in terms of the model reproduction number R and threshold parameters RT and RA that show the contribution of vertical transmission. It is shown that if R, RT , RA < 1, then the disease free equilibrium point is both locally asymptotically and globally stable. Numerical simulations for the model are presented to determine the role of some key epidemiological parameters of the model. [ABSTRACT FROM AUTHOR]

This paper reports on a study with rural young people (aged 10-24 years) in Malawi and Lesotho, focusing on their opportunities to learn skills and access capital and assets to engage in income-generating activities (IGAs). Participatory group exercises and individual interviews provide many examples of how young people learn skills and start small businesses, as well as an insight into their strategic thinking about engaging in these livelihood options. Various factors, including the effects of AIDS, are shown to affect young people's prospects of succeeding in their ventures. Young people are very keen on starting IGAs, and are supported by adult members of their communities in asking for interventions to help them. We argue that expanded vocational and business training, focusing on locally appropriate types and scale of businesses, coupled with help to raise start-up capital has the potential to improve the chances of young people who are poor and/or AIDS-affected securing sustainable rural livelihoods in their futures. Since AIDS is intertwined with many other issues affecting young people's livelihoods, it is problematic to single out and target only AIDS-affected young people with interventions on skills building and IGAs. Policymakers' attitudes to vocational skills training and support for IGAs in Malawi and Lesotho are also explored, and policy recommendations made to support vulnerable rural young people in their attempts to build sustainable livelihoods. [ABSTRACT FROM AUTHOR]

Abstract: This paper addresses the interactions between the AIDS epidemic and climate change in southern Africa, particularly as they impact on food security. An assessment was undertaken through a comprehensive literature review. Understanding the underlying causes of regional food insecurity inevitably means understanding the role of the AIDS epidemic and increasingly climate change amongst other stressors. AIDS cuts through household and community level capacity, as well as the capacity of key facilitators of the adaptation process including state extension services and civil society organisations. The main argument of the paper is that adaptation to climate change must explicitly factor in the existing and long-term effects of the epidemic. While calls for embracing adaptation abound, little is being done to assess and strengthen the organisational capacity of institutions, which should play leading roles in any attempt to help prepare for a changing climate. In particular the capacity of key agencies has been undermined by the AIDS epidemic. This reiterates the need for a multisectoral approach and building bridges between agriculture and health sectors to ensure longer term support to livelihoods where HIV and hunger coexist, often overlaid by climate change. [ABSTRACT FROM AUTHOR]

Research is commonly evaluated through an analysis of research outputs (i.e. theses and dissertations, papers in scholarly journals and conference proceedings, etc.) and research outcomes (i.e. new discoveries, Nobel prize winners, graduating students, new developments of drugs. etc.) using research units (e.g. persons or bodies responsible, sources in which the findings are published, medium of communication, nature of information conveyed, timing and frequency with which information is conveyed, amount of information conveyed, etc). Some of the methods of research evaluation that have been proposed and are commonly used include peer-review and informetric approaches. This paper reports findings of an informetric study of HIV/AIDS literature published by and on Eastern and Southern Africa in order to find out the number of countries engaged in the publication of HIV/AIDS literature: the most productive authors, institutions and countries; and the countries in which the literature is published. A comparison is made between regional (i.e. African) and foreign (or international) productivity. Results indicate that foreign authorship dominates the scene and that majority of the publications are published in foreign countries. The implications of this pattern of publication for researchers based in Africa are discussed. Finally, recommendations based on the findings are provided. [ABSTRACT FROM AUTHOR]

Over a million children are infected by the human immunodeficiency virus (HIV); most of whom live in the developing world. Bacterial meningitis is a serious infection of childhood that is 10 times more common in resource-constrained settings than well-resourced countries, and the outcome is worse. This paper reviews the relationship of bacterial meningitis to HIV infection and also the effect of HIV status on antibiotic sensitivity to common causes of childhood meningitis. The combined effects on outcome and long-term sequelae of meningitis are discussed and illustrated with results from Malawi and Southern Africa. [ABSTRACT FROM AUTHOR]

Background Migrant populations such as mine workers contributed to the spread of HIV in sub-Saharan Africa. We used a mathematical model to estimate the community-wide impact of targeting treatment and prevention to male migrants. Methods We augmented an individual-based network model, EMOD-HIV v0.8, to include an age-dependent propensity for males to migrate. Migrants were exposed to HIV outside their home community, but continued to participate in HIV transmission in the community during periodic visits. Results Migrant-targeted interventions would have been transformative in the 1980s to 1990s, but post-2015 impacts were more modest. When targetable migrants comprised 2% of adult males, workplace HIV prevention averted 3.5% of community-wide infections over 20 years. Targeted treatment averted 8.5% of all-cause deaths among migrants. When migrants comprised 10% of males, workplace prevention averted 16.2% of infections in the community, one-quarter of which were among migrants. Workplace prevention and treatment acted synergistically, averting 17.1% of community infections and 11.6% of deaths among migrants. These estimates do not include prevention of secondary spread of HIV or tuberculosis at the workplace. Conclusions Though cost-effective, targeting migrants cannot collapse generalized epidemics in their home communities. Such a strategy would only have been possible prior to the early 1990s. However, migrant-targeted interventions synergize with general-population expansion of HIV services. [ABSTRACT FROM PUBLISHER]

Regional differences in neurovirulence have been documented among subtype/clade-C HIV-1 isolates in India and Southern Africa. We previously demonstrated that a C31S substitution in Clade-C Tat dicysteine motif reduces monocyte recruitment, cytokine induction and direct neurotoxicity. Therefore, this polymorphism is considered to be a causative factor for these differences in neurovirulence. We previously reported on the genotypic differences in Tat protein between clade-C and rest of the clades showing that approximately 90% of clade-C HIV-1 Tat sequences worldwide contained this C31S polymorphism, while 99% of non-clade C isolates lacked this Tat polymorphism at C31 residue (Ranga et al. (2004) J Virol 78∶2586–2590). Subsequently, we documented intra-clade-C differences in the frequency of Tat dicysteine variants between India and Southern Africa, as the basis for differential disease severity and showed the importance of the Tat dicysteine motif for neuropathogenesis using small animal models. We have now examined if determinants of neurovirulence besides Tat are different between the clade-C HIV-1 isolates from Southern Africa and India. Envelope glycoprotein gp120 is a well-documented contributor to neurotoxicity. We found that gp120 sequences of HIV-1 isolates from these two regions are genetically distinct. In order to delineate the contribution of gp120 to neurovirulence, we compared direct in vitro neurotoxicity of HIV-infected supernatants of a representative neurovirulent US clade-B isolate with two isolates each from Southern Africa and India using primary human neurons and SH-SY5Y neuroblastoma cells. Immunodepletion of gp120 of both US clade B and the Southern African clade C isolates revealed robust decreases in neurotoxicity, while that of the Indian isolates showed minimal effect on neurotoxicity. The gp120 as a cause of differential neurotoxicity was further confirmed using purified recombinant gp120 from HIV isolates from these regions. We conclude that gp120 is one of the key factors responsible for the decreased neurovirulence of Indian clade C HIV-1 isolates when compared to South African clade C HIV-1. [ABSTRACT FROM AUTHOR]

Introduction: Shifting HIV treatment tasks from physicians to nurses and midwives is essential to scaling-up HIV services in sub-Saharan Africa. Updating nursing and midwifery regulations to include task shifting and pre-service education reform can help facilitate reaching new HIV targets. Donor-supported initiatives to update nursing and midwifery regulations are increasing. However, there are gaps in our knowledge of current practice and education regulations and a lack of information to target and implement regulation strengthening efforts. We conducted a survey of national nursing and midwifery councils to describe current nursing and midwifery regulations in 13 African countries. Methods: A 30-item survey was administered to a convenience sample of 13 national nursing and midwifery regulatory body leaders in attendance at the PEPFAR-supported African Health Profession Regulatory Collaborative meeting in Nairobi, Kenya on 28 February, 2011. The survey contained questions on task shifting and regulations such as registration, licensure, scope of practice, pre-service education accreditation, continuing professional development and use of international guidelines. Survey data were analyzed to present country-level, comparative and regional findings. Results: Task shifting to nurses and midwives was reported in 11 of the 13 countries. Eight countries updated their scope of practice within the last five years; only one reported their regulations to reflect task shifting. Countries vary with regard to licensure, pre-service accreditation and continuing professional development regulations in place. There was no consistency in terms of what standards were used to design national practice and education regulations. Discussion: Many opportunities exist to assist countries to modernise regulations to incorporate important advancements from task shifting and pre-service reform. Appropriate, revised regulations can help sustain successful health workforce strategies and contribute to further scale-up HIV services and other global health priorities. Conclusions: This study provides fundamental information from which to articulate goals and to measure the impact of regulation strengthening efforts [ABSTRACT FROM AUTHOR]

This article considers the impact of AIDS on women's roles and responsibilities within the household ‘care economy’. In particular, it emphasizes that all interventions aimed at reversing the AIDS epidemic need to take into account the excessive work-load that members of the household, usually women, shoulder in responding to the needs of sick family members. Most notably, gender equality and care economy issues need to be identified by development programmes. There is also a need to implement policies that focus on issues such as treatment, prevention, education, economic empowerment and violence against women. The article argues that unless the care economy and the relations of gender inequality within the household are included in the design, implementation, monitoring and evaluation of such interventions, results will be compromised. [ABSTRACT FROM AUTHOR]

Objective: To investigate trends in child malnutrition in six countries in southern Africa, in relation to the HIV epidemic and drought in crop years 2001/2 and 2002/3.Design: Epidemiological analysis of sub-national and national surveys with related data.Setting: Data from Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, compiled and analysed under UNICEF auspices.Subjects: Secondary data: children 0–5 years for weight-for-age; HIV prevalence data from various sources especially antenatal clinic surveillance.Results: Child nutritional status as measured by prevalence of underweight deteriorated from 2001 onwards in all countries except Lesotho, with very substantial increases in some provinces/districts (e.g. from 5 to 20% in Maputo (Mozambique, 1997–2002), 17 to 32% in Copperbelt (Zambia, 1999–2001/2) and 11 to 26% in Midlands province (Zimbabwe, 1999–2002)). Greater deterioration in underweight occurred in better-off areas. Areas with higher HIV/AIDS prevalences had (so far) lower malnutrition rates (and infant mortality rates), presumably because more modern areas – with greater reliance on trade and wage employment – have more HIV/AIDS. Areas with higher HIV/AIDS showed more deterioration in child nutrition. A significant area-level interaction was found of HIV/AIDS with the drought period, associated with particularly rapid deterioration in nutritional status.Conclusions: First, the most vulnerable may be households in more modern areas, nearer towns, to whom resources need to be directed. Second, the causes of this vulnerability need to be investigated. Third, HIV/AIDS amplifies the effect of drought on nutrition, so rapid and effective response will be crucial if drought strikes again. Fourth, expanded nutritional surveillance is now needed to monitor and respond to deteriorating trends. Finally, with or without drought, new means are needed of bringing help, comfort and assistance to the child population. [ABSTRACT FROM AUTHOR]

Background: The gap between what is known and what is done about public health (the evidence-practice gap) needs addressing. One solution may be through mixed and participatory training in accessing and appraising research. Approach: Residential workshops trained policy-makers, practitioners and researchers from seven southern-African countries in evidence-based decision-making for HIV prevention. They included training in accessing, critiquing and summarizing research, whilst remaining responsive to the priorities of the participants. Reflections: Drawing on the participants' feedback and our observations, we reflected on how these workshops may have addressed the evidence-practice gap. We identified three areas: access to research, understanding of research and the relevance of research. The workshops enabled a small group of people to access relevant research in a timely manner. However, more needs to be done to disseminate research findings appropriately as any long-term impact will be affected by the political and economic context in which participants work. We are confident that the participants went away with increased understanding of the purposes and processes of research, but for research to make a difference, the research community needs to emphasise more the publication of research findings written for potential users. The workshops were most successful in influencing researchers to consider bridging the evidence-practice gap by producing more relevant research , applicable to policy-makers and practitioners. Conclusion: This intensive intervention has the potential to reduce the evidence-practice gap for HIV prevention in southern Africa by training non-researchers to engage with research, whilst providing an opportunity for researchers to engage with policy-makers and practitioners. [ABSTRACT FROM AUTHOR]

This study, informed by historical and socio-cultural studies into HIV/AIDS, examines the political and commercial appropriation of female music by males specifically in Malawi and, in general, Southern Africa.1 Once appropriated, this music is often used, via the oral public sphere, in ways that, politically and economically, impact negatively on women. It is here argued that while recognized factors perpetuating gender inequalities are responsible for this appropriation, factors within the power dynamics of female culture itself may be contributory. It is further suggested that this public sphere use of appropriated female music may significantly negate or subvert some formal, especially written, positive gender equality messages. [ABSTRACT FROM AUTHOR]

The article focuses on the raging Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome pandemic among the armed forces in southern Africa. The high infection rates in the armed forces is a security threat that threatens the very institutions that define and defend the character of society. The pandemic has added to the political instability and slowed down democratic development. The article also discusses the testing policy, the human rights policy implications, human resource challenges, and health care and prevention efforts employed by the South African National Defence Force.