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In this paper, a compartmental model on the co-infection of pneumonia and HIV/AIDS with optimal control strategies was formulated using the system of ordinary differential equations. Using qualitative methods, we have analysed the mono-infection and HIV/AIDS and pneumonia co-infection models. We have computed effective reproduction numbers by applying the next-generation matrix method, applying Castillo Chavez criteria the models disease-free equilibrium points global stabilities were shown, while we have used the Centre manifold criteria to determine that the pneumonia infection and pneumonia and HIV/AIDS co-infection exhibit the phenomenon of backward bifurcation whenever the corresponding effective reproduction number is less than unity. We carried out the numerical simulations to investigate the behaviour of the co-infection model solutions. Furthermore,wehave investigated various optimal control strategies to predict the best control strategy to minimize and possibly to eradicate the HIV/AIDS and pneumonia co-infection from the community. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

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Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

What could be more logical than a gay–feminist alliance to respond to the AIDS epidemic in Latin America? However, drawing on published articles and the author''s experience in HIV/AIDS work in Chile, this paper argues that such an alliance is more rhetorical than real. Instead, both groups tend to stick to their respective niches and view the epidemic through the prism of the particular needs and concerns of their target constituencies, rather than learn from and support each other. Feminist rhetoric sometimes suggests that AIDS is a problem only because it affects women. The African paradigm of vulnerable women is inexactly applied, given the predominantly male and homosexual nature of the epidemic in most Latin American countries. Both women and homosexually active men are highly vulnerable to HIV infection, and little is gained by competing for the top slot on the “tragedy honour roll”. Latin American gay men''s groups, torn between AIDS and gay rights activism, often resist both protagonism by women and women''s issues. Although the fight for access to antiretroviral treatment has obscured this conflict, it resurfaces in associations of HIV-positive people and may increase along with heterosexual transmission in the region. Discussion and exchanges should be encouraged to overcome these largely hidden divisions. [Copyright &y& Elsevier]

A multi-patch HIV/AIDS model with heterosexual transmission is formulated to investigate the impact of population migration on the spread of HIV/AIDS. We derive the basic reproduction number $ R_{0} $ R 0 and prove that if $ R_{0} \lt 1 $ R 0 < 1 , the disease-free equilibrium is globally asymptotically stable. If $ R_{0} \gt 1 $ R 0 > 1 and certain conditions are satisfied, the endemic equilibrium is globally asymptotically stable. We apply the model to two patches and conduct numerical simulations. If HIV/AIDS becomes extinct in each patch when two patches are isolated, the disease remains extinct in two patches when the population migration occurs; if HIV/AIDS spreads in each patch when two patches are isolated, the disease remains persistent in two patches when the population migration occurs; if the disease disappears in one patch and spreads in the other patch when they are isolated, the disease can spread or disappear in two patches if migration rates of individuals are suitably chosen. [ABSTRACT FROM AUTHOR]

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Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper reports on a study of the relationship of homophobia to HIV/AIDS-related stigma in Jamaica. Ethnography, key informant interviews and focus groups were used to gather data from a sample of 33 male and female adults during the summer of 2003. The sample included health and social service providers, HIV positive men and women, and men and women with same sex partners in urban and rural Jamaica. A strong and consistent relationship between homophobia and HIV/AIDS-related stigma was reported, but the relationship varied according to geographic location, social class, gender, and skin colour (complexion)—to the extent that this coincided with class. Stigma against people living with HIV/AIDS and homosexuality was implicated in low levels of use of HIV testing, treatment and care services and the reluctance of HIV positive people to reveal their serostatus to their sexual partners. Data reveal a pressing need for anti-stigma measures for both homophobia and HIV/AIDS, and for training for health and human service professionals. [ABSTRACT FROM AUTHOR]

This article reports on ethnographic and demographic findings on AIDS and HIV infection in China. Also, it elaborates those cultural, social and political factors involved in China's attempt to manage its growing HIV epidemic. Data from the First Sino-American Management of HIV Diseases Symposium are also blended with the ethnographic material to further clarify the cultural and epidemiologic status of HIV/AIDS in China. Since HIV predominates among drug users, this fact aroused great attention from the Chinese government early on. Laws introduced in 1988 aimed at strengthening existing statutes to insure that drug dealers, traffickers, and users were prosecuted. Not only is drug-dealing illegal in China, but so is drug-taking. Also, it is argued that providing sexuality education as a means of preventing HIV infection offers no guarantee of reduced behavioral risks. It is concluded that HIV/AIDS and its management pose a transforming challenge to: (1) realistically appraise sexual expression, (2) change traditional sexual language symbols, and (3) revamp the avenues by which China presently addresses "sex."

All over the world HIV has been stigmatised, making it difficult for people living with HIV to access testing, treatment, care and counselling or even to act on a diagnosis or get advice and treatment, for fear of being judged. Prejudice in society has also often been reflected and reproduced by health care providers. A human rights approach, which positively incorporates sexual and reproductive rights, rather than a restricted medical view, is therefore essential for the achievement of true partnerships between health care providers and service users. This paper is about the experiences of HIV positive women and men in sexual and reproductive health services and HIV testing. It provides guidance not only on how things could and should be done but also on how they should not be done. It outlines the sexual and reproductive rights positive people consider crucial and gives examples of how these are being violated. It presents perceptions and implications of HIV testing and how health services can support people after a positive diagnosis. It analyses the importance of confidentiality, continuity of care, knowledge and information, and the role of support groups and home-based care. It calls on sexual and reproductive health services to address issues of stigma and discrimination when offering and carrying out HIV testing and counselling, and in providing treatment, care and support. Partout dans le monde, les personnes vivant avec le VIH souffrent de stigmatisation, ce qui entrave leur accès au dépistage, au traitement et aux soins, les empêche d'agir après le diagnostic et d'obtenir des conseils ou un traitement, par crainte d'être jugées. Le personnel sanitaire a souvent reproduit les préjugés de la société. Une approche des droits de l'homme, qui inclut positivement les droits génésiques, de préférence à une perspective médicale restreinte, est donc essentielle pour établir de véritables partenariats entre le personnel sanitaire et les patients. Cet article porte sur les expériences d'hommes et de femmes séropositifs dans les services de santé génésique et de dépistage du VIH. Il conseille non seulement sur la manière dont les choses peuvent et doivent être faites, mais aussi sur la manière dont il ne faut pas les faire. Il répertorie les droits génésiques jugés fondamentaux par les personnes séropositives et donne des exemples de violations. Il présente des conceptions et des conséquences du dépistage du VIH et montre comment les services de santé peuvent soutenir les patients après un diagnostic positif. Il analyse l'importance de la confidentialité, de la continuité des soins, de la connaissance et de l'information, et du rôle des groupes de soutien et des soins à domicile. Il demande aux services de santé génésique d'aborder les questions de stigmatisation et de discrimination quand ils proposent et assurent des programmes de conseil et dépistage du VIH, et dispensent un traitement, des soins et un soutien. Por todo el mundo el VIH ha sido estigmatizado, lo cual dificulta que las personas que viven con VIH tengan acceso a pruebas, tratamiento, atención y consejería, o incluso que tomen medidas respecto al diagnóstico u obtengan consejos y tratamiento, por temor a ser juzgados. El prejuicio de la sociedad con frecuencia también ha sido reflejado y reproducido por los prestadores de servicios de salud. Por tanto, un enfoque de derechos humanos, que incorpore de manera positiva los derechos sexuales y reproductivos, en vez de una visión médica restringida, es esencial para lograr verdaderas alianzas entre los prestadores de servicios de salud y los usuarios. Este artículo trata sobre las experiencias de mujeres y hombres VIH-positivos con servicios de salud sexual y reproductiva y pruebas de VIH. Proporciona orientación no sólo respecto a cómo pueden y deben hacerse las cosas, sino también respecto a cómo no deben hacerse. Esboza los derechos sexuales y reproductivos que las personas seropositivas consideran cruciales y da ejemplos de cómo estos están siendo violados. Expone percepciones e implicaciones de las pruebas de VIH y cómo los servicios de salud pueden apoyar a las personas después de un diagnóstico positivo. Analiza la importancia de la confidencialidad, continuidad de la atención, conocimiento e información, y la función de los grupos de apoyo y la atención en el hogar. Hace un llamado a los servicios de salud sexual y reproductiva para que traten los problemas de estigma y discriminación al ofrecer y realizar pruebas y consejería de VIH, y al brindar tratamiento, atención y apoyo. [ABSTRACT FROM AUTHOR]

Most sexual health education programmes use fear and risk of disease to try to motivate people to practise safer sex. This gives the impression that safer sex and pleasurable sex are mutually exclusive. Yet there is growing evidence that promoting pleasure alongside safer sex messaging can increase the consistent use of condoms and other forms of safer sex. To this end, the Pleasure Project created The Global Mapping of Pleasure, a document that identifies projects and organisations worldwide that put pleasure first in HIV prevention and sexual health promotion, and sexually provocative media that include safer sex. This article summarises some of the findings of this mapping exercise and what we learned about incorporating pleasure from it. We found that there are a variety of organisations, including religious and youth groups, and HIV/AIDS organisations and NGOs, promoting pleasurable safer sex. The techniques they use include promoting sexual techniques and dialogue about sex, teaching married couples how to have better sex and putting images of desire in sexual education materials. This paper focuses on ways of eroticising female and male condoms as examples of effective ways of using pleasure in HIV prevention and sexual health promotion. La plupart des programmes d'éducation en matière de santé génésique tablent sur la peur et le risque d'infection pour inciter les couples à se protéger lors des relations sexuelles, donnant l'impression que la protection et le plaisir s'excluent mutuellement. Pourtant, on comprend de mieux en mieux que promouvoir le plaisir avec des messages sur les relations sexuelles protégées, peut accroître l'utilisation régulière de préservatifs et d'autres formes de relations protégées. À cette fin, le Projet Plaisir a dressé la carte mondiale du plaisir qui recense les projets et les organisations qui donnent la priorité au plaisir dans la prévention du VIH et la promotion de la santé génésique, et les films érotiques avec relations sexuelles protégées. Cet article résume certaines des conclusions et des enseignements de cette initiative. Nous avons constaté que des organisations diverses, notamment des groupes religieux et de jeunes, des organisations sur le VIH/SIDA et des ONG prônent les relations sexuelles sûres et agréables. Pour cela, elles encouragent les techniques sexuelles et le dialogue sur les rapports sexuels, elles apprennent aux couples mariés à améliorer leur sexualité et introduisent des images du désir dans le matériel d'éducation sexuelle. Cet article décrit en particulier les moyens d'érotiser les préservatifs masculins et féminins, afin d'illustrer l'utilisation du plaisir dans la prévention du VIH et la promotion de la santé génésique. La mayoría de los programas de educación sexual utilizan el temor y el riesgo de enfermedades para motivar a las personas a tener sexo más seguro. Esto da la impresión de que el sexo más seguro y el sexo por placer son mutuamente exclusivos. No obstante, cada vez existen más pruebas de que la promoción del placer con los mensajes de sexo más seguro pueden aumentar el uso sistemático de los condones y otras formas de sexo más seguro. Con este fin, el Proyecto Placer creó el Mapa Mundial del Placer, un documento que identifica proyectos y organizaciones internacionales que anteponen el placer en la prevención del VIH y la promoción de la salud sexual, y medios de comunicación sexualmente provocativos que tratan sobre el sexo más seguro. En este artículo se resumen algunos hallazgos de este ejercicio y lo que se aprendió respecto a la incorporación del placer. Encontramos que una variedad de organizaciones, incluidos los grupos religiosos y de jóvenes, y ONG y organismos dedicados a la lucha contra el VIH/SIDA, promueven el sexo más seguro placentero. Algunas tácticas empleadas son promover diálogo y técnicas sexuales, enseñar a las parejas casadas cómo mejorar sus relaciones sexuales e incluir imágenes del deseo en los materiales de educación sexual. Este artículo se centra en las formas de erotizar los condones masculino y femenino como ejemplos de medios eficaces de utilizar el placer en la prevención del VIH y la promoción de la salud sexual. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

After years of passionate advocacy informed by solid policy work on the ground, the global response to HIV/AIDS is better resourced. Poor countries can absorb considerably higher levels of aid than they currently receive, but recent increases in funding have generated a number of concerns. This paper analyses the capacity of NGOs, community-based organisations and governments to ensure that the influx of funds has a significant effect on the HIV epidemic and people's lives. Limited absorptive capacity may be an obstacle to the uptake of funding. To avoid community-based organisations being over-stretched by AIDS and to ensure capacity is maintained, HIV-positive staff must be enabled to continue their work through access to antiretroviral therapy and related services. Equally challenging, given that donors are increasingly using governments as intermediaries to fund civil society organisations, is increasing the capacity of developing country governments to disburse funds effectively. If donors do not accept that governments and civil society organisations need technical support in order to accept, distribute and account for increases in funding, there is a danger that home-grown responses will be replaced with imported solutions. The community sector is the glue that holds responses to HIV/AIDS together; now it needs to adapt to new partnerships with government and other emerging HIV/AIDS service providers. Après des années de plaidoyer passionné fondé sur un solide travail politique sur le terrain, la lutte mondiale contre le VIH/SIDA dispose de meilleures ressources. Les pays pauvres peuvent absorber des niveaux nettement plus élevés d'assistance, mais les accroissements récents du financement ont suscité certaines préoccupations. L'article analyse la capacité des ONG, des organisations à assise communautaire et des gouvernements de s'assurer que l'afflux de fonds améliore sensiblement la lutte contre l'épidémie et la vie de la population. Une capacité d'absorption limitée peut s'opposer à l'accroissement du financement. Pour éviter que les organisations communautaires ne soient mises à rude épreuve par le SIDA, et pour garantir le maintien de la capacité, le personnel séropositif doit continuer à travailler grâce à l'accès à la thérapie antirétrovirale et aux services liés. Tout aussi difficile, étant donné que les donateurs utilisent de plus en plus les gouvernements comme intermédiaires pour financer les organisations de la société civile, il convient d'accroı̂tre la capacité des gouvernements des pays en développement d'allouer efficacement les fonds. Si les donateurs ne reconnaissent pas que les gouvernements et les organisations de la société civile requièrent un appui technique pour accepter, distribuer et comptabiliser les hausses de financement, les solutions nationales risquent d'être remplacées par des approches importées. Le secteur communautaire assure la cohésion des réponses au VIH/SIDA ; il doit s'adapter aux nouveaux partenariats avec les pouvoirs publics et d'autres prestataires de services émergents en matière de VIH/SIDA. Después de años de realizar vehementes esfuerzos de gestorı́a y defensa informados por medio de un trabajo sólido de formulación de polı́ticas en este tema, la respuesta mundial al VIH/SIDA cuenta con mejores recursos. Los paı́ses pobres pueden asimilar niveles de ayuda financiera considerablemente más altos de los que reciben actualmente, pero los recientes aumentos en el financiamiento han generado varias inquietudes. En este artı́culo se analiza la capacidad de las ONG, las organizaciones comunitarias y los gobiernos de garantizar que el flujo de fondos tenga un efecto significativo sobre la epidemia del VIH y la vida de las personas. Una capacidad limitada de asimilación puede ser un obstáculo a la captación de financiamiento. Para evitar que las organizaciones comunitarias se extralimiten por el SIDA y para garantizar que se mantenga la capacidad, se debe facultar al personal VIH-positivo para que continúe su trabajo mediante el acceso a la terapia antirretroviral y a los servicios complementarios. Igual de desafiante, dado que los donantes emplean cada vez más a los gobiernos como intermediarios para financiar a las organizaciones de la sociedad civil, es aumentar la capacidad de crear gobiernos en cada paı́s con el fin de desembolsar los fondos de manera eficaz. Si los donantes no aceptan el hecho de que los gobiernos y las organizaciones de la sociedad civil necesitan apoyo técnico para poder aceptar, distribuir y explicar los aumentos en el financiamiento, existe el peligro que las respuestas formuladas a nivel local se sustituyan con soluciones importadas. El sector comunitario es el elemento que mantiene unidas las respuestas al VIH/SIDA; y ahora necesita adaptarse a las nuevas alianzas con el gobierno y a otros prestadores de servicios de VIH/SIDA emergentes. [ABSTRACT FROM AUTHOR]

Sex workers in Kerala, India, live in a coercive environment and face violence from the police and criminals, lack of shelter, lack of childcare support and have many physical and mental health problems. This paper documents the environment in which women have been selling sex in Kerala since 1995, and their efforts to claim their rights. It is based on sex workers'' own reports and experiences, a situation analysis and a needs assessment study by the Foundation for Integrated Research in Mental Health. Involvement in HIV/AIDS prevention projects first gave sex workers in Kerala an opportunity to come together. Some have become peer educators and distribute condoms but they continue to be harassed by police. Most anti-trafficking interventions, including rescue and rehabilitation, either criminalise or victimise sex workers, and sex workers reject them as a solution to sex work. They understand that the lack of sexual fulfillment in other relationships and their own lack of access to other work and resources are the reasons why commercial sex flourishes. Sex workers are not mere victims without agency. They have a right to bodily integrity, pleasure, livelihood, self-determination and a safe working environment. Sex workers are organising themselves for these objectives and demand decriminalisation of sex work. [Copyright &y& Elsevier]

As a clarion call by Higher Education HIV/AIDS programme (HEAIDS) to South African universities, entrenching, integration and infusing the teaching and learning of HIV/AIDS in the curriculum of universities prove to be a sustainable solution to changing risky behaviour and attitudes of university students towards HIV/AIDS. The majority of students in South African universities lack general awareness and education in HIV/AIDS. This raises the need to produce graduates who are knowledgeable and have a positive attitude regarding HIV/AIDS. A pilot study on HIV/AIDS curriculum integration at the University of Fort Hare involved academic staff was done. A qualitative case study approach was used to describe the process and effectiveness of the curriculum integration process. The data collection was through evaluation forms, reports and a focus group interview. Data were analysed using content analysis. Guskey's model for professional development was followed to understand the process and effect of curriculum integration. Initially, the academic staff anticipated that the HIV/AIDS curriculum integration process would result in credit overload for students, time constraints and increased workload. Later, most academic staff affirmed the benefits of being involved in the project such as improving teaching and facilitation styles and research. [ABSTRACT FROM AUTHOR]

The barbing industry poses particular public health risks if it is not conducted in a safe and hygienic manner. These risks can lead to the transmission of infectious diseases like the Human Immunodeficiency Virus (HIV) to the barbers or their clients. This study investigated the knowledge, attitudes and prevention practices regarding HIV transmission among barbers in the Ho Municipality. A descriptive cross-sectional design was employed. A pretested structured questionnaire was administered to a consented sample of barbers sampled using a multistage random sample design. Descriptive and inferential statistics were performed using Stata version 14.0 software programme where 0.05 level was used as a measure of significance. The knowledge level of the barbers regarding HIV/AIDS was inadequate (63.6%). Knowledge was significantly associated with work experience [AOR = 13.56 (95% CI: 2.73–67.25); p = 0.001], with attitude [AOR = 4.07 (95% CI: 1.27–13.08); p = 0.018], with level of education [AOR = 10.22 (95% CI: 2.24–46.64); p = 0.003], with marital status [AOR = 0.07 (95% CI: 0.01–0.50); p = 0.008] and with number of clients per day [AOR = 0.13 (95% CI: 0.03–0.52); p = 0.004]. The attitude of barbers was also inadequate (58.7%). Attitude was significantly associated with the mode of learning the barbing profession [AOR = 0.32 (95% CI: 0.11–0.89); p = 0.029], and with level of knowledge [AOR = 5.48 (95% CI: 2.01–14.93); p = 0.001]. Majority of the participants exhibited poor prevention practices regarding HIV/AIDS (87.6%). Prevention practice was significantly associated with work experience [AOR = 24.92 (95% CI: 2.08–297.86); p = 0.011] and with level of knowledge [AOR = 12.57 (95% CI: 1.35–116.86); p = 0.026]. The barbers in Ho exhibited inadequate knowledge and attitude regarding HIV/AIDS, and also manifested poor prevention practices regarding HIV/AIDS. Programmes aimed at improving the knowledge, attitudes and prevention practices should be implemented among barbers, with focus on those without any formal education, those with less than five years work experience and those with more than ten clients a day. [ABSTRACT FROM AUTHOR]

The conventional survival analysis model on HIV/AIDS prognosis is the Cox proportional hazard model, which deals with only one event type, death, regardless of the cause. Few studies have used a competing risk model to evaluate the predictors of AIDS-related mortality. To estimate the influence of antiretroviral therapy (ART) initiation time and baseline CD4+ cell counts on acquired immunodeficiency syndrome (AIDS)-related death among former plasma donors. A retrospective cohort study was conducted involving 11,905 human immunodeficiency virus (HIV) or AIDS patients in a high-risk area of Henan province in China between 1995 and 2016. Demographic and clinical data were collected. Sub-distribution hazard ratios (sHRs) for AIDS-related mortality with baseline CD4+ cell counts and ART initiation time were determined using a competing risk model. Patients who initiated ART within 90 days of HIV/AIDS diagnosis (sHR: 0.24, 95% CI: 0.22–0.27) or had baseline CD4+ counts of >500 cells/μL (sHR: 0.23, 95% CI: 0.19–0.28) were associated with lower AIDS-related mortality risk. Patients with ART initiation time >1 year but CD4+ counts >350 cells/μL (sHR: 4.42, 95% CI: 3.30–5.91) had a higher AIDS-related mortality risk than those with ART initiation time >90 days but CD4+ counts ≤350 cells/μL (sHR: 4.33, 95% CI: 3.58–5.23). Our results demonstrate that patients with high CD4+ cell counts and late ART had a 9% higher risk of AIDS-related death than those with low CD4+ cell counts and early ART. This study confirms the great significance of immediate ART initiation among former plasma donor HIV patients in China. [ABSTRACT FROM AUTHOR]

Sub-Saharan Africa faces and is severely affected by many conflicts. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) threaten both the physical and financial well-being of individuals in these struggling countries. This research aims to investigate the immigrants' attitudes and beliefs regarding HIV/AIDS in the Mopani district, Limpopo Province. Qualitative and quantitative designs were used, and 200 immigrants were sampled. Data was collected using a questionnaire with closed and open-ended questions. Ethical standards were maintained. The study revealed that many respondents expressed discriminatory practices towards individuals infected by HIV. Many viewed promiscuity and the disease called Makhume (meaning illness caused by the omission of purification rites following the death of a family member) as causes of HIV/AIDS. These attitudes could hinder the achievement of healthy lives and the promotion of well-being at all ages if not addressed appropriately. The collaboration of various departments in the Mopani district is required to change these negative attitudes and beliefs that influence immigrants' behaviours. Also, the use of audio-visuals and peer teaching is most successful in changing attitudes and beliefs. [ABSTRACT FROM AUTHOR]

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Background: South Africa, as an emerging middle-income country, is becoming increasingly influential in global health diplomacy (GHD). However, little empirical research has been conducted to inform arguments for the integration of domestic health into foreign policy by state and non-state actors. This study seeks to address this knowledge gap. It takes the form of an empirical case study which analyses how South Africa integrates domestic health into its foreign policy, using the lens of access to antiretroviral (ARV) medicines. Objective: To explore state and non-state actors’ perceptions regarding how domestic health policy is integrated into foreign policy. The ultimate goal of this study was to achieve better insights into the health and foreign policy processes at the national level. Methods: Employing qualitative approaches, we examined changes in the South African and global AIDS policy environment. Purposive sampling was used to select key informants, a sample of state and non-state actors who participated in in-depth interviews. Secondary data were collected through a systematic literature review of documents retrieved from five electronic databases, including review of key policy documents. Qualitative data were analysed for content. This content was coded, and the codes were collated into tentative categories and sub-categories using Atlas.ti v.7 software. Results: The findings of this work illustrate the interplay among social, political, economic and institutional conditions in determining the success of this integration process. Our study shows that a series of national and external developments, stakeholders, and advocacy efforts and collaboration created these integrative processes. South Africa’s domestic HIV/AIDS constituencies, in partnership with the global advocacy movement, catalysed the mobilization of support for universal access to ARV treatment nationally and globally, and the promotion of access to healthcare as a human right. Conclusions: Transnational networks may influence government’s decision making by providing information and moving issues up the agenda. [ABSTRACT FROM PUBLISHER]

Background: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7-91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1-31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions: These results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality. [ABSTRACT FROM AUTHOR]

Estimating the prevalence of sexual behaviors is difficult because of self-report biases. This is particularly relevant in assessing high-risk sexual behaviors for the purpose of reducing the transmission and acquisition of sexually transmitted infections (STIs) and HIV/AIDS. The present study employed the unmatched count technique (UCT), which provides estimates of the prevalence of risky sexual behaviors without requiring participants to confess to socially undesirable or stigmatized behaviors. Compared to a standard, anonymous self-report questionnaire, the UCT protocol revealed that people were less likely to notify their partners about STIs or discuss their history of sexual experiences. Effects were particularly large in women suggesting that women may be more likely to misrepresent their sexual behaviors. The findings suggest that conventional, anonymous self-report questionnaire data of base rates of risky sexual behavior and sexual communication are consistently inaccurate. These discrepant base rates suggest that the UCT might provide a better estimate of the frequency of these behaviors. Results suggest that inconsistent sexual behavior is more rampant than anonymous questionnaires suggest. They also underscore the need for improvements in the anonymity of assessment of sexual behaviors, which could in turn improve the targeting of prevention efforts. Results have important public health implications because accurate assessment of sexual behaviors is crucial for developing effective STI prevention interventions among target populations. [ABSTRACT FROM AUTHOR]

Background: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7-91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1-31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions: These results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality. [ABSTRACT FROM AUTHOR]

The current overriding thought in HIV/AIDS communication in developing countries is the need for a shift from the cognitive model, which emphasises the decision-making of the individual, to the activity model, which emphasises the context of the individual. In spite of the acknowledged media shift from the cognitive to the activity model in some developing countries, some HIV/AIDS communication scholars have felt otherwise. It was against this background that this study examined the content of some selected Nigerian newspapers to ascertain the attention paid to HIV/AIDS cognitive and activity information. Generally, the study found that Nigerian newspapers had shifted from the cognitive to the activity model of communication in their coverage of HIV/AIDS issues. The findings of the study seem inconsistent with the theoretical argument of some scholars that insufficient attention has been paid by mass media in developing countries to the activity model of HIV/AIDS communication. It is suggested that future research replicate the study for Nigerian and other developing countries' mass media. [ABSTRACT FROM AUTHOR]

With data from a surveillance system that uses verbal autopsies to identify cause of death in rural South Africa, we investigated whether mortality from HIV/AIDS differs from other causes of death in its effect on household dependency ratio, and to what extent the effect is mediated by the baseline dependency ratio. Findings: (i) the impact of death from HIV/AIDS on the dependency ratio in 2005 is marginally positive compared with other causes of death, but (ii) the impact is overpowered by the effect of death at working age, and (iii) the baseline dependency ratio mediates the effects on the 2005 ratio of cause of death and of the individual's sex and age at death. Migration into and out of the household—anticipating or responding to a death—seems to be a key source of change in the household dependency ratio. [ABSTRACT FROM AUTHOR]

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One of the more striking features of international responses to HIV/AIDS has been the framing of the pandemic in terms of security. But while a growing literature attempts to establish and explain putative linkages between HIV/AIDS and security, little work has addressed HIV/AIDS-security discourse with critical reflexivity or applied such an approach to particular cases. This article makes contributions in both these areas, locating discussion in the context of post-Cold War and post-9/11 shifts in geopolitics and biopolitics. It argues that while analyses employing securitization theory and biopolitics have advanced critical understanding of HIV/AIDS and security, a more historicized approach and greater attention to geopolitics and gender are required. The article then reviews increasing US strategic interest in Africa and considers the emergence of particular formations of geopolitics and biopolitics around HIV/AIDS and security in the relationship between the US and Nigeria, drawing particular attention to the role of US-based think tanks. It shows how US strategic discourse has targeted the Nigerian state not just as a partner in energy security and counter-terrorism, but also as a key locale in the 'next wave' of HIV/AIDS. The article describes HIV/AIDS interventions that the US is supporting in Nigeria, identifies connections between HIV/AIDS relief and questions of security and gender, and considers some implications of the convergence of multiple security logics on Nigeria. The article concludes with reference to the political sociology of HIV/AIDS relief and the era of formal colonialism. [ABSTRACT FROM AUTHOR]

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The study presented here is an investigation of the importance of social interactions to perceptions of the risk of AIDS, and explores spousal communication about the AIDS epidemic in rural Malawi. A fixed-effects analysis based on longitudinal data collected in 1998 and 2001 shows that social interactions on the subject of HIV/AIDS have significant and substantial effects on respondents’ perceptions of the risk of HIV/AIDS, even after controlling for unobserved factors that affect the selection of social networks. These effects are more complex than previously thought. The dominant mechanisms—social learning and social influence—are found to vary by sex and by region, because of regional variations in the marriage pattern and the resulting implications for the formation of local social networks. The conclusion of the study is that rather than fostering denial and inaction, social interactions are an important vector of change in the face of the HIV/AIDS epidemic. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Drawing from ethnographic, archival and secondary research, this article examines multiple-sexual partners in historical perspective in KwaZulu-Natal, a South Africa province where one in three people are thought to be HIV positive. Research on masculinities, multiple-partners, and AIDS has been predominantly directed towards the present day. This article stresses the importance of unraveling the antecedents of contemporary masculinities particularly the gendered cultural politics through which they have been produced. Arguing against dominant conceptions of African masculinity as being innate or static, it charts the rise and fall of the isoka, the Zulu man with multiple-sexual partners, over the last century. Showing how the isoka developed through changing conditions occasioned by capitalism, migrant labor and Christianity, it contends that an important turning point took place from the 1970s when high unemployment threatened previous expressions of manliness, notably marriage, setting up an independent household and becoming umnumzana (a household head). The high value placed on men seeking multiple-partners increasingly filled the void left by men's inability to become men through previous means. Turning to the contemporary period, the article argues that, shaken by the huge AIDS deaths, men are betraying increasing doubts about the isoka masculinity. [ABSTRACT FROM AUTHOR]

This study explores how urban youth in Mozambique perceive their sexual behaviour and identifies the factors that hinder them from having safer sex in the context of HIV/AIDS, with special emphasis on the condom use. Data was collected form high school students in Maputo, Mozambique. Using a combination of focus group discussions, interviews and informal conversations, it was possible to identify that one major obstacle to the use of condoms was young people's belief that they did not have to use condoms in steady relationships built on love and trust. Trust and love provide a sense of immunity to infection. Such a perception is reinforced, it is argued, by previous HIV/AIDS campaigns in Mozambique that have advocated the use of condoms only with ‘occasional sexual partners'. Students' understandings of pleasure, lack of accurate information, lack of sex education at home and at school, and gender inequalities further contribute to making condom use a difficult issue. There should be a change in focus in condom campaigns. Efforts should also be made to encourage young people to ‘emotionally invest’ in their health by using condoms. [ABSTRACT FROM AUTHOR]

Background: Traditional health practitioners (THPs) have been identified as a key local resource in the fight against human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in South Africa. However, their approaches to the treatment of people living with HIV (PLHIV) have been met with scepticism by some biomedical practitioners amid increasing access to antiretroviral therapy (ART). Objective: In light of this ambivalence, this study aims to document and identify treatment approaches of THPs to the management of illness among PLHIV in the current era of widespread access to ART. Methods: The study was conducted as part of a larger trial of Treatment as Prevention (TasP) in rural northern Kwa-Zulu Natal, intended to treat PLHIV regardless of CD4 count. Nine THPs were enrolled using purposive and snowballing techniques. Repeat group discussions, triangulated with community walks and photovoice techniques, were conducted. A thematic analysis approach was used to analyse the data. Results: Eight of the nine THPs had received training in biomedical aspects of HIV. THPs showed a multilayered decision-making process in managing illness among PLHIV, influenced by the attributes and choices of the THPs. THPs assessed and managed illness among PLHIV based on THP training in HIV/AIDS, THP type, as well as knowledge and experience in the traditional healing practice. Management of illness depended on the patients’ report of their HIV status or willingness to test for HIV. Conclusions: THPs’ approaches to illness in PLHIV appear to be shifting in light of increasing exposure to HIV/AIDS-related information. Importantly, disclosure of HIV status plays a major role in THPs’ management of illness among PLHIV, as well as linkage to HIV testing and care for their patients. Therefore, THPs can potentially enhance the success of ART for PLHIV when HIV status is known. [ABSTRACT FROM PUBLISHER]

HIV/AIDS stigmatizing behaviors are a huge barrier to early detection and treatment of individuals with the AIDS virus. HIV/AIDS stigma and related consequences are debilitating, especially for vulnerable populations. This study sought to assess whether young women’s HIV/AIDS knowledge levels and exposure to mass media (television and radio) have an influence on their stigmatizing behaviors and role as agents of stigma towards individuals living with HIV and AIDS. The data used for this study originated from the Ghana Multiple Indicator Cluster Survey 2011. Binary and multiple (stepwise) logistic regression analyses were used to examine the associations between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors among young women aged 15–24 years in Ghana. Of the 3573 young women, 80% of 15–19-year-olds and 76% of 20–24-year-olds had at least one stigmatizing behavior towards persons living with HIV/AIDS (PLHA). Young women with increased knowledge regarding HIV/AIDS and frequent exposure to mass media (television and radio) had lesser tendency to stigmatize or act as agents of stigma towards PLHA (proportion with at least one stigmatizing behavior per subgroup – HIV/AIDS knowledge: those with highest knowledge score 579 [70.1%], those with lowest knowledge score 28 [90.3%]; mass media: those with daily exposure 562 [73.4%], those not exposed at all 249 [89.2%]). There was a graded negative ‘exposure–response’ association between the ranked variables: HIV/AIDS knowledge, mass media, and HIV/AIDS stigmatizing behaviors. The significant inverse association between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors persisted even after adjusting for all other covariates in the multiple logistic regression models. It is extremely important to increase HIV/AIDS-related knowledge and reduce stigma among young women in Ghana through targeted HIV/AIDS factual knowledge transfer. The use of mass media for communication of issues regarding HIV/AIDS, its mode of transmission, and associated stigma should be emphasized among women in Ghana. [ABSTRACT FROM PUBLISHER]

Background: The HIV/AIDS epidemic has become a point of important political concern for governments especially in Sub-Saharan Africa. Clinical and public health interventions to curb the epidemic can be greatly enhanced with the strategic support of political leaders. Objective: We analyzed the role of national political leadership in large-scale HIV/AIDS communications campaigns in 14 countries in Sub-Saharan Africa. Methods: We primarily reviewed grey and white literature published from 2005–2014. We further triangulated data from in-person and phone interviews with key public health figures. Results: A number of themes emerged supporting political leaders’ efforts toward HIV/AIDS program improvement, including direct involvement of public officials in campaign spearheading, the acknowledgment of personal relationship to the HIV epidemic, and public testing and disclosure of HIV status. Areas for future improvement were also identified, including the need for more directed messaging, increased transparency both nationally and internationally and the reduction of stigmatizing messaging from leaders. Conclusions: The political system has a large role to play within the healthcare system, particularly for HIV/AIDS. This partnership between politics and the health must continue to strengthen and be leveraged to effect major change in behaviors and attitudes across Sub-Saharan Africa. [ABSTRACT FROM PUBLISHER]