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This paper explores ethical considerations for active studies of circumcision, i.e., the amputation of the foreskin, in the form of a case study of three major trials performed in African countries in the early 2000s. The paper outlines the function of the foreskin and method and history of its amputation as well as its current use in attempting to combat the global AIDS crisis. These trials are then interrogated in accordance with the Declaration of Helsinki. In particular, the irreversible nature of amputation is given great consideration. The case studies are found to have serious failures in terms of the modern iteration of the Declaration of Helsinki. This paper calls for extreme scrutiny in accordance with international norms relating to the ethical treatment of human subjects in a research context of studies of circumcision if and when they are proposed again. [ABSTRACT FROM AUTHOR]

HIV/AIDS and child malnutrition are pervasive in eastern and southern Africa. This paper employs cross‐country panel data on 20 countries from 1991 to 2017 to explore the macro‐level relationship between HIV/AIDS and child malnutrition. Using instrumental variables (IV) regression, we find that HIV/AIDS is a robust predictor of long‐term and chronic malnutrition. Conditional on various controls, the results demonstrate a positive empirical association between HIV/AIDS and stunting. Moreover, increased access to improved water, female education, and food availability are critical for reducing stunting. These findings underscore the need for an integrated national policy on nutrition and HIV/AIDS and intersectoral collaboration between government agencies responsible for managing nutrition and HIV/AIDS programs. [ABSTRACT FROM AUTHOR]

Although the world has experienced remarkable progress in health care since the last half of the 20th century, global health inequalities still persist. In some poor countries life expectancy is between 37-40 years lower than in rich countries; furthermore, maternal and infant mortality is high and there is lack of access to basic preventive and life-saving medicines, as well a high prevalence of neglected diseases, HIV/AIDS, tuberculosis, and malaria. Moreover, globalization has made the world more connected than before such that health challenges today are no longer limited within national or regional boundaries, making all persons equally vulnerable. Because of this, diseases in the most affluent countries are closely connected with diseases in the poorest countries. In this paper, we argue that, because of global health inequalities, in a situation of equal vulnerability, there is need for global solidarity not only as a means of reducing health inequalities, but also as a way of putting up a united force against global health challenges. We argue for an African approach to solidarity in which the humanity of a person is not determined by his/her being human or rational capacity, but by his/her capacity to live a virtuous life. According to this view of solidarity, because no one is self-sufficient, no individual can survive alone. If we are to collectively flourish in a world where no individual, nation or region has all the health resources or protection needed for survival, we must engage in solidarity where we remain compassionate and available to one another at all times. [ABSTRACT FROM AUTHOR]

BACKGROUND: The increase in human immunodeficiency virus infection among women of childbearing age increases the potential risk for vertical transmission of infection to their newborns. AIM: This paper discusses literature reviewed on human immunodeficiency virus infection of women in Africa with reference to Ghana, West Africa. The paper provides an epidemiological overview of human immunodeficiency virus infection of women in Ghana and Africa and the potential risk for vertical transmission and associated contributing factors. Literature reviewed was retrieved from the Cumulative Index of Nursing and Allied Health Literature and United States National Library of Medicine databases. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Findings from the review of literature suggest that human immunodeficiency virus infection of African women is a major public health problem which must be addressed and considered a priority in the next decade. Leadership in African countries including nurses and policy-makers will have to do more to make a difference to the epidemic. Measures to reduce transmission of human immunodeficiency virus are discussed. [ABSTRACT FROM AUTHOR]

Background: The increasing numbers of adolescents living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are a compelling public health issue, and interventions are more likely to be effective if developed from the perspective of those adolescents. Despite the prevalence of HIV in Botswana, stigmatization is a common occurrence. Aim: The purpose of this paper is to report on the findings of a study undertaken to describe adolescents' perceptions in Botswana on the behaviours that HIV-positive adolescents use in dealing with stigmatization. Method: Four focus group discussions were held with 18 adolescents. Findings: Adhering to AIDS therapies, seeking early treatment for common conditions and keeping silent about their diagnosis were the major findings of the study. Conclusion: The findings have implications for both policy makers and health care practitioners. [ABSTRACT FROM AUTHOR]

Building on theory and past research, in early 2000 scientists in the Division of Reproductive Health developed a prevention innovation for CDC’s Global AIDS Program for use in countries severely affected by the HIV/AIDS epidemic. This innovative program model is called MARCH: Modeling and Reinforcement to Combat HIV/AIDS (Galavotti et al. Am J Public Health 91:1602–1607, ). MARCH promotes behavioral changes that reduce the risk of HIV infection and creates normative environments that sustain these changes through two key program components: entertainment-education using mass media, particularly long-running radio serial dramas, and reinforcement activities at the community level. Using the framework developed by Wandersman et al. (Am J Commun Psychol, 41(3–4), 2008), we describe the key elements of the MARCH prevention innovation and outline how we support its adaptation and implementation. We focus on the following questions: How do we get from an innovative model to effective program implementation in the field? How do we support implementation with fidelity when adaptation is required? And, once implemented, can we demonstrate fidelity of the adaptation to the original program model? Because our program model requires local adaptation for every instance of implementation, we suggest a potential enhancement to the Interactive Systems Framework—support for adaptation of the innovation—as part of the Prevention Support System. In this paper we describe how we supported adaptation of the radio serial drama component for unique contexts in several African countries. We focus attention on the tools and trainings we developed to build innovation specific capacity for implementation, including capacities for adaptation. We then present results of a qualitative analysis of scripts from the MARCH radio serial drama in Zimbabwe to assess the adapted program’s fidelity to the original design of the innovation. Finally, we discuss lessons learned and explore implications for the field. [ABSTRACT FROM AUTHOR]

HIV/AIDS continues to constitute a serious threat to the social and physical wellbeing of African mothers and their babies. In the hardest hit countries of sub-Saharan Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Mother-to-child transmission (MTCT) constitutes 90% of new HIV infections among infants and young children. Most of these infections can be prevented. However, the social stigma of HIV/AIDS insidiously continues to undermine the success of prevention programs. Ironically, some attributes or characteristics of prevention of mother-to-child transmission (PMTCT) programs may in fact serve as catalysts to the stigmatization process. This paper identifies and discusses six potential initiators: (1) Routine HIV testing, (2) Six months exclusive breastfeeding, (3) Incentives, (4) Home visits, (5) Location of PMTCT program, and (6) PMTCT terminology. In all these areas, there are practical strategies that may be applied to reduce the chances of being stigmatized. These strategies are introduced and discussed. [ABSTRACT FROM AUTHOR]

This paper observes that a substantially large moral duty of dealing with the AIDS situation in Africa has been placed on the drug companies and argues that this approach is inequitable. Using the poverty-AIDS relationship and the human rights framework it argues for a more balanced AIDS activism, which puts equal pressure on all potential stakeholders in the war against AIDS. It argues that this redistribution of the HIV/AIDS moral burden is perhaps the only hope for curbing the African AIDS epidemic that continues to ravage communities on that continent. [ABSTRACT FROM AUTHOR]