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Integrated Access to Care and Treatment (I ACT) for adolescents is an educational support group initiative conducted monthly by trained healthcare providers (counsellors/health promoters). It follows a defined educational curriculum of six topics including, HIV/AIDS, disclosure, sexual and reproductive and mental health. Qualitative assessments, conducted midway of I ACT implementation at four primary healthcare facilities in North West province, South Africa, aimed to explore the perceptions of healthcare providers and the experiences of adolescents living with HIV (ALHIV). Face-to-face interviews were conducted with healthcare providers (n = 4), Facility Managers (n = 4) and ALHIV 15-19 years (n = 15). Interviews were recorded, transcribed, translated, verified and a content analysis performed. ALHIV reported the benefit and educational value of I ACT support groups. Healthcare providers shared their experience with initiating the groups and Facility Managers highlighted implementation challenges. In this study I ACT for adolescents supported ALHIV needs and promoted engagement with healthcare providers and peers. Sustaining I ACT for adolescents will require additional health system strengthening like provision of human and material resources. [ABSTRACT FROM AUTHOR]

Rural South African men who have sex with men (MSM) are likely to be underserved in terms of access to relevant healthcare and HIV prevention services. While research in urban and peri-urban MSM populations has identified a range of factors affecting HIV risk in South African MSM, very little research is available that examines HIV risk and prevention in rural MSM populations. This exploratory study begins to address this lack by assessing perceptions of HIV risk among MSM in rural Limpopo province. Using thematic analysis of interview and discussion data, two overarching global themes that encapsulated participants’ understandings of HIV risk and the HIV risk environment in their communities were developed. In the first theme, “community experience and the rural social environment”, factors affecting HIV risk within the broad risk environment were discussed. These included perceptions of traditional value systems and communities as homophobic; jealousy and competition between MSM; and the role of social media as a means of meeting other MSM. The second global theme, “HIV/AIDS knowledge, risk and experience”, focused on factors more immediately affecting HIV transmission risk. These included: high levels of knowledge of heterosexual HIV risk, but limited knowledge of MSM-specific risk; inconsistent condom and lubricant use; difficulties in negotiating condom and lubricant use due to uneven power dynamics in relationships; competition for sexual partners; multiple concurrent sexual partnerships; and transactional sex. These exploratory results suggest that rural South African MSM, like their urban and peri-urban counterparts, are at high risk of contracting HIV, and that there is a need for more in-depth research into the interactions between the rural context and the specific HIV risk knowledge and behaviours that affect HIV risk in this population. [ABSTRACT FROM AUTHOR]

In the context of the ANRS 12249 Treatment as Prevention (TasP) trial, we investigated perceptions of regular and repeat HIV-testing in rural KwaZulu-Natal (South Africa), an area of very high HIV prevalence and incidence. We conducted two qualitative studies, before (2010) and during the early implementation stages of the trial (2013–2014), to appreciate the evolution in community perceptions of repeat HIV-testing over this period of rapid changes in HIV-testing and treatment approaches. Repeated focus group discussions were organized with young adults, older adults and mixed groups. Repeat and regular HIV-testing was overall well perceived before, and well received during, trial implementation. Yet community members were not able to articulate reasons why people might want to test regularly or repeatedly, apart from individual sexual risk-taking. Repeat home-based HIV-testing was considered as feasible and convenient, and described as more acceptable than clinic-based HIV-testing, mostly because of privacy and confidentiality. However, socially regulated discourses around appropriate sexual behaviour and perceptions of stigma and prejudice regarding HIV and sexual risk-taking were consistently reported. This study suggests several avenues to improve HIV-testing acceptability, including implementing diverse and personalised approaches to HIV-testing and care, and providing opportunities for antiretroviral therapy initiation and care at home. [ABSTRACT FROM AUTHOR]

Years of state denial in South Africa resulted in poor national understandings of HIV and the urgent need to increase public engagement with health research, and encourage behaviour that reduces transmission and supports the uptake of relevant health interventions. Behaviour change is, however, a lengthy, complex process and there is always space for entertaining non-didactic mechanisms to engage audiences and engender social change.Jiving with Scienceinvolved developing, distributing and evaluating three edutainment CDs over two years. The CDs, which were distributed free-of-charge to community stakeholders – in particular to mini-bus taxi drivers, for the entertainment of commuters – were endorsed by local celebrities and contain a narrative informed by local scientific data on HIV/AIDS, interspersed with popular music tracks. A critical examination of the project concept, production and distribution processes reveals that this is an example of how small media methodologies can empower health researchers to create low-cost, targeted products to engender positive social change. However, the strength of the product lies in its connection to a complex, well-established research programme and the authors suggest that researchers keep this in mind when developing similar material, and also that they consider incorporating a greater degree of participatory techniques, because these can only add value to the quality and relevance of the edutainment product. [ABSTRACT FROM AUTHOR]

Concern internationally that young gay men are at increased risk of HIV infection has not been reflected in earlier findings in Australia where younger men have not been found to be at increased likelihood to engage in unprotected anal intercourse with casual partners (UAIC). There has, however, been little attention paid to the issue of age in relation to HIV risk behaviour in Australia in recent years. In 2007, among men who completed Gay Community Periodic Survey questionnaires in Sydney, Melbourne and Brisbane, Australia, younger men were more likely to report being in relatively short-term monogamous relationships than were their older counterparts. They were also less likely to know their own or their partners' HIV serostatus. Men aged less than 25 years reported fewer recent partners and were less likely to report sex with casual male partners in the previous six months (p<0.001). Younger men were also less likely to engage in group sex. Approximately, one-quarter of the sample reported engaging in any UAIC in the previous six months during each year of the survey. Younger men were no less likely to report UAIC overall, but they were somewhat more likely to report taking the receptive position during UAIC. While age is a consideration in the assessment of risk of HIV transmission among gay men, this risk is dependent upon the context in which it occurs: Age mixing may be an important consideration in understanding HIV risk among young gay men. [ABSTRACT FROM AUTHOR]

We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner's seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner's status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner's status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men. [ABSTRACT FROM AUTHOR]

Individual in-depth, semi-structured interviews with 30 HIV positive Black Africans were conducted in London, UK. The interviews focused upon experiential accounts of living with HIV. The interviews were transcribed and analysed for recurrent themes using interpretative phenomenological analysis. The social context of being a Black African living in the UK emerged as an important framework within which the experience of being HIV positive was positioned. In terms of people's accounts of their own experiences of living with HIV, diagnosis figured as an important moment in people's lives. The majority of participants were surprised and upset upon receiving their positive antibody test results. Many reported a period of depression and social isolation. Stigma and prejudice associated with HIV also emerged as a major force shaping the daily lives of the participants. We discuss the role of identity and social context in disrupting the medical meaning of diagnostic tests. [ABSTRACT FROM AUTHOR]

This paper identifies some aspects of the risk management practices of HIV positive gay men in relation to HIV treatments and sexual practice. The paper uses qualitative methods to examine sexual practice and HIV transmission in relation to HIV blood test viral load information. Questions of reinfection with HIV are also examined. Open-ended interviews were conducted with 25 gay and other homosexually active men and analysed for relevant themes. Interviewees spoke of different approaches to risk assessment in relation to viral load and reinfection, drawing on their experiences and advice. This diversity is connected with various risk management 'styles' that reflected positions about HIV transmission risk, the characteristics of the partner and the sexual situation. Some implications for HIV prevention are identified, including the need to address the links between prevention and treatment. HIV prevention strategies will need to address development of education in relation to evolving knowledge about treatment technologies and connections with HIV transmission. [ABSTRACT FROM AUTHOR]

Presents news briefs related to the Society of Archivist recent as of April 1974. Highlights of the society's 1973 annual general meeting in London, England; Obituaries for society members who died in 1973.