465 results
Search Results
2. A Landmark Paper in HIV Research?
- Author
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Peter Cleaton-Jones
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,Urology ,Decision Making ,Health Behavior ,education ,Alternative medicine ,Human immunodeficiency virus (HIV) ,lcsh:Medicine ,HIV Infections ,medicine.disease_cause ,Condoms ,South Africa ,medicine ,HIV Infection/AIDS ,Humans ,Ethics, Medical ,Randomized Controlled Trials as Topic ,Gynecology ,Ethics ,Research ethics ,Medicine in Developing Countries ,Ethical issues ,business.industry ,Health Policy ,lcsh:R ,Ethics committee ,General Medicine ,Correspondence and Other Communications ,Bioethics ,Sexually transmitted infections - other than HIV/AIDS ,Infectious Diseases ,Sexual behavior ,Circumcision, Male ,Male circumcision ,Epidemiology/Public Health ,Family medicine ,Personal Autonomy ,HIV/AIDS ,Health behavior ,Sexual Health ,business ,Ethics Committees, Research ,Perspectives - Abstract
Cleaton-Jones, chair of the ethics committee that approved the trial of circumcision for preventing HIV, shares with us the discussions that the committee had ahead of granting approval.
- Published
- 2005
3. Implementation of South Africa’s Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation
- Author
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Laura M. Bogart, Zinhle Shazi, Sarah MacCarthy, Alexandra Mendoza-Graf, Nafisa J. Wara, Dani Zionts, Nduduzo Dube, Sabina Govere, and Ingrid V. Bassett
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Original Paper ,Social Psychology ,Social Stigma ,Public Health, Environmental and Occupational Health ,HIV Infections ,Focus Groups ,Ambulatory Care Facilities ,Antiretroviral therapy ,South Africa ,Infectious Diseases ,Differentiated service delivery ,HIV/AIDS ,Implementation science ,Humans ,Qualitative ,Qualitative Research - Abstract
We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa's Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretroviral therapy refills at clinic- or community-based pick-up points. Across ten clinics, we conducted 109 semi-structured interviews with stakeholders (pick-up point staff, CCMDD service providers and administrators) and 16 focus groups with 138 patients. Participants had highly favorable attitudes and said CCMDD decreased stigma concerns. Patient-level barriers included inadequate education about CCMDD and inability to get refills on designated dates. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid CCMDD rules, and inadequate infrastructure. Recommendations included: (1) provide patient education and improve communication around refills (at the patient level); (2) provide dedicated space and staff, and ongoing training (at the organizational/clinic level); and (3) allow for prescription renewal at pick-up points and less frequent refills, and provide feedback to clinics (at the CCMDD program level).
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- 2022
4. Homelessness and Hiv/Aids in Johannesburg
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OlusolaOlufemi
- Published
- 2008
- Full Text
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5. 'I had Made the Decision, and No One was Going to Stop Me' —Facilitators of PrEP Adherence During Pregnancy and Postpartum in Cape Town, South Africa
- Author
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Yolanda Gomba, Dvora Joseph Davey, Jackie Markt-Maloney, Nokwazi Tsawe, Pamina M. Gorbach, Linda-Gail Bekker, Kathryn Dovel, Thomas J. Coates, Landon Myer, Nyiko Mashele, and Lucia Knight
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Pediatric AIDS ,Social Work ,medicine.medical_specialty ,Social Psychology ,Anti-HIV Agents ,Family support ,HIV prevention ,HIV Infections ,Reproductive health and childbirth ,Medication Adherence ,Pre-exposure prophylaxis ,South Africa ,Clinical Research ,Pregnancy ,Postpartum ,Behavioral and Social Science ,medicine ,Humans ,Medical prescription ,Pediatric ,Original Paper ,Prevention ,Public health ,Postpartum Period ,Public Health, Environmental and Occupational Health ,medicine.disease ,PrEP ,Health psychology ,Mental Health ,Infectious Diseases ,Family medicine ,Public Health and Health Services ,HIV/AIDS ,Female ,Public Health ,Serostatus ,Psychology ,Postpartum period - Abstract
PrEP is safe and effective but requires adherence during potential HIV exposure, yet the facilitators of long-term maternal adherence are not well understood. We conducted semi-structured interviews with 25 postpartum women who reported high adherence (PrEP use ≥ 25 days in last 30-days and never missed a PrEP prescription in pregnancy/postpartum period) within a PrEP service for pregnant and postpartum women. A thematic approach guided an iterative process of coding and analysis. Themes identified as drivers of optimal PrEP use were HIV risk perception, mainly because of partner's behaviors and unknown serostatus, and a strong desire to have a baby free of HIV. Reported disclosure of PrEP use facilitated PrEP adherence. Women discussed having partner and family support, which included reminders to take PrEP daily. Primary barriers were anticipated or experienced stigma, overcome through education of partners and family about PrEP. Pregnant women experienced transient side-effects, but found ways to continue, including taking PrEP at night. PrEP programs for pregnant and postpartum women should integrate strategies to assist women with realistic appraisals of risk and teach skills for disclosure and securing support from significant others.La profilaxis Pre-exposición (PrEP, siglas en inglés) es segura y eficaz, pero requiere adherencia durante una posible exposición al VIH; sin embargo, no se conocen bien los factores que facilitan la adherencia materna a largo plazo. Realizamos entrevistas semiestructuradas con 25 mujeres en posparto que informaron un alto cumplimiento (uso de PrEP25 días en los últimos 30 días y nunca omitieron una receta de PrEP en el embarazo y período posparto) dentro de un servicio de PrEP para mujeres embarazadas y posparto. Un enfoque temático guio un proceso iterativo de codificación y análisis. Los temas identificados como impulsores del uso óptimo de la PrEP fueron la percepción del riesgo de VIH, principalmente debido a los comportamientos de la pareja y el estado serológico desconocido, y un fuerte deseo de tener un bebé libre de VIH. La divulgación informada del uso de PrEP facilitó la adherencia a la PrEP. Las mujeres hablaron sobre el apoyo de su pareja y familia, incluidos recordatorios para tomar la PrEP cada dia. Las barreras primarias fueron el estigma anticipado o experimentado, superado a través de la educación de los socios y familiares sobre la PrEP. Las mujeres embarazadas experimentaron efectos secundarios transitorios, pero encontraron formas de continuar, incluida la toma de PrEP por la noche. Los programas de PrEP para mujeres embarazadas y posparto deben integrar estrategias para ayudar a las mujeres con evaluaciones realistas del riesgo y enseñar habilidades para la divulgación y obtener el apoyo de otras personas importantes.
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- 2021
6. Women's Economic Contribution, Relationship Status and Risky Sexual Behaviours: A Cross-Sectional Analysis from a Microfinance-Plus Programme in Rural South Africa
- Author
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Janke Tolmay, Louise Knight, Lufuno Muvhango, Tara Polzer-Ngwato, Heidi Stöckl, and Meghna Ranganathan
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Acquired Immunodeficiency Syndrome ,Original Paper ,Women’s empowerment ,Social Psychology ,Risky sexual behaviour ,Sexual Behavior ,Microfinance-plus ,Public Health, Environmental and Occupational Health ,HIV Infections ,South Africa ,Infectious Diseases ,Cross-Sectional Studies ,Sexual Partners ,Humans ,HIV/AIDS ,Female ,Aged - Abstract
In sub-Saharan Africa, women bear a disproportionate burden of HIV/AIDS while also facing economic and gender inequalities. To explore the association of women’s economic contribution and relationship status with risky sexual behaviour, this study analysed cross-sectional data from 626 women aged 22 to 84 in rural South Africa. All women were enrolled in a microfinance plus gender training programme (Intervention with Microfinance for AIDS and Gender Equity (IMAGE)). We used univariable and multivariable logistic regression to explore the associations of relationship status and women’s household income contribution with inconsistent condom use, multiple sexual partners and transactional sex, respectively. We found that married, older women had the highest odds of inconsistent condom use, while those contributing all the household income had higher odds of multiple sexual partnerships, but lower odds of transactional sex compared to those with no contribution. Income contribution and relationship status have a nuanced relationship with sexual risk behaviours. Thus, economic strengthening interventions should target relevant vulnerable women while also addressing the broader social and economic drivers of risky sexual behaviour.
- Published
- 2021
7. Outcomes of patients lost to follow‐up after antiretroviral therapy initiation in rural north‐eastern South Africa
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David Etoori, Francesc Xavier Gómez-Olivé, Kathryn Risher, Georges Reniers, Julie Ambia, Brian Rice, and Chodziwadziwa W. Kabudula
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Adult ,Male ,Rural Population ,Databases, Factual ,Anti-HIV Agents ,030231 tropical medicine ,Breastfeeding ,HIV Infections ,analyse des risques concurrents ,Asymptomatic ,couplage des données ,South Africa ,Young Adult ,système de surveillance démographique ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Humans ,HIV/AIDs ,Medicine ,Cumulative incidence ,demographic surveillance system ,Lost to follow-up ,re‐engagement ,Proportional Hazards Models ,VIH/SIDA ,business.industry ,Incidence ,competing risk analysis ,Medical record ,Public Health, Environmental and Occupational Health ,perte au suivi ,Middle Aged ,Antiretroviral therapy ,réengagement ,Infectious Diseases ,Increased risk ,loss to follow‐up ,record linkage ,Female ,Lost to Follow-Up ,Original Article ,Parasitology ,medicine.symptom ,Rural area ,business ,Original Research Papers ,Demography - Abstract
The vital status of patients lost to follow-up often remains unknown in antiretroviral therapy (ART) programmes in sub-Saharan Africa because medical records are no longer updated once the patient disengages from care. Thus, we aimed to assess the outcomes of patients lost to follow-up after ART initiation in north-eastern South Africa.Using data from a rural area in north-eastern South Africa, we estimated the cumulative incidence of patient outcomes (i) after treatment initiation using clinical records, and (ii) after loss to follow-up (LTFU) using data from clients that have been individually linked to Agincourt Health and Demographic Surveillance System (AHDSS) database. Aside from LTFU, we considered mortality, re-engagement and migration out of the study site. Cox proportional hazards regression was used to identify covariates of these patient outcomes.Between April 2014 and July 2017, 3700 patients initiated ART and contributed a total of 6818 person-years of follow-up time. Three years after ART initiation, clinical record-based estimates of LTFU, mortality and documented transfers were 41.0% (95% CI: 38.5-43.4%), 1.9% (95% CI 1.0-3.2%) and 0.1% (95% CI 0.0-0.9%), respectively. Among those who were LTFU, the cumulative incidence of re-engagement, out-migration and mortality at 3 years were 38.1% (95% CI 33.1-43.0%), 49.4% (95% CI 43.1-55.3%) and 4.7% (95% CI 3.5-6.2%), respectively. Pregnant or breastfeeding women, foreigners and those who initiated ART most recently were at an increased risk of LTFU.LTFU among patients starting ART in north-eastern South Africa is relatively high and has increased in recent years as more asymptomatic patients have initiated treatment. Even though this tendency is of concern in light of the prevention of onwards transmission, we also found that re-engagement in care is common and mortality among persons LTFU relatively low.Le statut vital des patients perdus au suivi reste souvent inconnu dans les programmes de traitement antirétroviral (ART) en Afrique subsaharienne parce que les dossiers médicaux ne sont plus mis à jour une fois que le patient se désengage des soins. Notre objectif était d’évaluer les résultats des patients dans le nord-est de l'Afrique du Sud. MÉTHODES: A l'aide de données provenant d'une zone rurale du nord-est de l'Afrique du Sud, nous avons estimé l'incidence cumulée des résultats pour les patients (i) après le début du traitement à l'aide des dossiers cliniques et (ii) après la perte au suivi (PS) à l'aide des données des patients qui ont été reliées individuellement à la base de données du système de surveillance démographique et de santé (AHDSS) d'Agincourt. Outre les PS, nous avons pris en compte la mortalité, le réengagement et la migration hors du site de l’étude. La régression des risques proportionnels de Cox a été utilisée pour identifier les covariables de ces résultats pour le patient. RÉSULTATS: Entre avril 2014 et juillet 2017, 3.700 patients ont commencé l’ART constituant un suivi total de 6.818 années-personnes. Trois ans après le début de l’ART, les estimations des PS, de la mortalité et des transferts documentés selon les registres cliniques étaient de 41,0% (IC95%: 38,5% à 43,4%), 1,9% (IC95%: 1,0% à 3,2%) et 0,1% (IC95%: 0,0% -0,9%), respectivement. Parmi ceux qui étaient PS, l'incidence cumulative de réengagement, d’émigration et de mortalité à trois ans était de 38,1% (IC95%: 33,1% à 43,0%), 49,4% (IC95%: 43,1% à 55,3%) et 4,7% (IC95%: 3,5% -6,2%), respectivement. Les femmes enceintes ou allaitantes, les étrangers et les personnes qui ont commencé l’ART le plus récemment couraient un risque accru de PS.La PS chez les patients commençant une ART dans le nord-est de l'Afrique du Sud est relativement élevée et a augmenté ces dernières années à mesure que davantage de patients asymptomatiques ont commencé le traitement. Même si cette tendance est préoccupante à la lumière de la prévention de la transmission, nous avons également constaté que le réengagement dans les soins était courant et que la mortalité parmi les PS était relativement faible.
- Published
- 2019
8. Staff Perceptions of Preimplementation Barriers and Facilitators to a Mobile Health Antiretroviral Therapy Adherence Counseling Intervention in South Africa: Qualitative Study
- Author
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Claude A. Mellins, John A. Joska, John Torline, Neshaan Peton, Jessica C. Rowe, Stephan Rabie, Siobhan McCreesh-Toselli, Reuben N. Robbins, Hetta Gouse, and Robert H. Remien
- Subjects
Counseling ,antiretroviral treatment ,low-resource settings ,HIV Infections ,Health Informatics ,Information technology ,Consolidated Framework for Implementation Research ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Nursing ,implementation research ,Intervention (counseling) ,Computer literacy ,medicine ,Humans ,030212 general & internal medicine ,Curriculum ,mHealth ,Original Paper ,mobile phone ,030505 public health ,lay antiretroviral therapy adherence counselors ,medicine.disease ,T58.5-58.64 ,Focus group ,Telemedicine ,Masivukeni ,HIV/AIDS ,Perception ,Implementation research ,Public aspects of medicine ,RA1-1270 ,0305 other medical science ,Psychology ,Qualitative research - Abstract
Background South Africa adopted a universal test and treatment program for HIV infection in 2015. The standard of care that people living with HIV receive consists of 3 sessions of readiness counseling delivered by lay counselors (LCs). In the largest antiretroviral therapy (ART) program worldwide, effective and early HIV and ART education and support are key for ensuring ART adoption, adherence, and retention in care. Having LCs to deliver readiness counseling allows for the wide task-sharing of this critical activity but carries the risks of loss of standardization, incomplete content delivery, and inadequate monitoring and supervision. Systems for ensuring that a minimum standard of readiness counseling is delivered to the growing number of people living with HIV are essential in the care cascade. In resource-constrained, high-burden settings, mobile health (mHealth) apps may potentially offer solutions to these treatment gaps by providing content structure and delivery records. Objective This study aims to explore, at a large Cape Town–based nonprofit HIV care organization, the staff’s perceived preimplementation barriers and facilitators of an mHealth intervention (Masivukeni) developed as a structured app for ART readiness counseling. Methods Masivukeni is a laptop-based app that incorporates written content, graphics, short video materials, and participant activities. In total, 20 participants were included in this study. To explore how an mHealth intervention might be adopted across different staff levels within the organization, we conducted 7 semistructured interviews (participants: 7/20, 35%) and 3 focus groups (participants in 2 focus groups: 4/20, 20%; participants in 1 focus group: 3/20, 15%) among LCs, supervisors, and their managers. In total, 20 participants were included in this study. Interviews lasted approximately 60 minutes, and focus groups ranged from 90 to 120 minutes. The Consolidated Framework for Implementation Research was used to explore the perceived implementation barriers and facilitators of the Masivukeni mHealth intervention. Results Several potential facilitators of Masivukeni were identified. Multimedia and visual elements were generally regarded as aids in content delivery. The interactive learning components were notably helpful, whereas facilitated updates to the adherence curriculum were important to facilitators and managers. The potential to capture administrative information regarding LC delivery and client logging was regarded as an attractive feature. Barriers to implementation included security risks and equipment costs, the high volume of clients to be counseled, and variable computer literacy among LCs. There was uncertainty about the app’s appeal to older clients. Conclusions mHealth apps, such as Masivukeni, were perceived as being well placed to address some of the needs of those who deliver ART adherence counseling in South Africa. However, the successful implementation of mHealth apps appeared to be dependent on overcoming certain barriers in this setting.
- Published
- 2021
9. Modeling Cash Plus Other Psychosocial and Structural Interventions to Prevent HIV Among Adolescent Girls and Young Women in South Africa (HPTN 068)
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Jessie K. Edwards, Marie C D Stoner, Jennifer Ahern, Kelly Kilburn, Daniel Westreich, Kathleen Kahn, Audrey Pettifor, F. Xavier Gómez-Olivé, and Sheri A. Lippman
- Subjects
Social Work ,medicine.medical_specialty ,Social Psychology ,Adolescent ,HIV prevention ,Psychological intervention ,HIV Infections ,No Poverty ,Cohort Studies ,South Africa ,Clinical Research ,Behavioral and Social Science ,medicine ,Humans ,Social determinants of health ,Social determinants ,Child ,Poverty ,Pediatric ,Original Paper ,Depression ,business.industry ,Prevention ,Public health ,Incidence ,Public Health, Environmental and Occupational Health ,Correction ,Public Health, Global Health, Social Medicine and Epidemiology ,Health psychology ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Mental Health ,Infectious Diseases ,Cohort ,Public Health and Health Services ,HIV/AIDS ,Observational study ,Female ,Public Health ,Young women ,Infection ,business ,Psychosocial ,Adolescent girls ,Cash transfer ,Demography ,Causal inference - Abstract
Poverty alleviation programs can reduce HIV incidence but may have greater impacts when combined with other psychosocial interventions. We modeled the change in HIV incidence among South African adolescent girls and young women (AGYW) associated with combining a cash transfer (the South African Child Support Grant (CSG)) with other structural and behavioral interventions. We modeled observational data from the HPTN 068 study where 2328 HIV negative AGYW (13-20 years) were followed for 4 years. In a Monte Carlo simulation based on this cohort (N = 10,000), CSG receipt was not independently associated with HIV incidence. Providing the CSG combined with increasing caregiver care and reducing adolescent depression had the largest reduction in HIV incidence with the fewest number of combined interventions (RD - 3.0%; (95% CI - 5.1%, - 0.9%). Combining a monthly grant with interventions to increase caregiver care and reduce adolescent depression could substantially reduce HIV incidence above the provision of cash alone. Correction: Modeling Cash Plus Other Psychosocial and Structural Interventions to Prevent HIV Among Adolescent Girls and Young Women in South Africa (HPTN 068). AIDS and Behavior, (2021), 25, 144, DOI:10.1007/s10461-021-03261-5
- Published
- 2021
10. HIV self-testing among young women in rural South Africa: A randomized controlled trial comparing clinic-based HIV testing to the choice of either clinic testing or HIV self-testing with secondary distribution to peers and partners
- Author
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Ryan G. Wagner, Audrey Pettifor, Linda Kimaru, Hailey J. Gilmore, Amanda Selin, Sheri A. Lippman, Rhian Twine, Xavier Gómez-Olivé, Brian Mdaka, Zola Mayakayaka, Noah Haber, Daniel Westreich, Kathleen Kahn, and Stephen Tollman
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Pediatric AIDS ,medicine.medical_specialty ,Research paper ,Standard of care ,HIV prevention ,Clinical Trials and Supportive Activities ,Human immunodeficiency virus (HIV) ,Hiv testing ,medicine.disease_cause ,01 natural sciences ,law.invention ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Clinical Research ,law ,Behavioral and Social Science ,Medicine ,030212 general & internal medicine ,Significant risk ,0101 mathematics ,Pediatric ,lcsh:R5-920 ,business.industry ,Prevention ,010102 general mathematics ,Self testing ,Absolute risk reduction ,General Medicine ,HIV counseling ,HIV testing ,Test (assessment) ,Infectious Diseases ,Family medicine ,HIV/AIDS ,Young people ,business ,lcsh:Medicine (General) - Abstract
Background: HIV testing rates in many hyper-endemic areas are lower than needed to curtail the HIV epidemic. New HIV testing strategies are needed to overcome barriers to traditional clinic based testing; HIV self-testing is one modality that offers promise in reaching individuals who experience barriers to clinic-based testing. Methods: We conducted a randomized control trial among young women ages 18-26 living in rural Mpumalanga, South Africa where they were randomized in a 1:1 allocation to either the: (1) HIV Counseling and Testing (HCT) arm: an invitation to test at one of the 9 local government clinics where free HCT is provided and is standard of care (SOC), or (2) choice arm: choice of either a clinic-based HCT invitation or oral HIV Self-Testing (HIVST) kits. Depending on the arm, participants were also provided either: (1) 4 HCT invitations to provide to peers/partners for HIV testing at one of the 9 local clinics, or (2) 4 HIV self-test kits to provide to peers/partners (thus 5 total HIVST kits or HCT invitations). Young women were asked to return 3 months and 9 months after enrollment to assess testing uptake and invitation or kit distribution to peers and partners and experiences with testing. Peers and partners who were reported by index participants to have received kits/invitations during follow-up visits were also invited to attend a study visit to assess their testing experiences. The trial is registered at clinical trials.gov NCT03162965. Findings: 287 young women were enrolled and randomized, with 146 randomized to the HCT arm and 141 to the choice (HCT or HIVST) arm. Of those randomized to the choice arm, over 95% (n=135) chose the HIV self-testing kit and only 6 individuals chose HCT. At the 3-month follow-up visit, 92% of index participants in the choice arm reported having tested for HIV compared to 43% of participants in the HCT arm, resulting in a significant risk difference of 49% (95% CI 40%, 58%). By 9 months, this difference decreased to a risk difference of 25% (95% CI 17%, 33%) between arms (96% in the choice arm and 72% in the HCT arm). Participants in the choice arm were also more likely to invite peers and partners to test compared to the HCT arm (94% vs. 76% or an average of 4.97 vs 2.79 tests). Few male partners were invited to test by index participants; however, index participants in the choice arm were more likely to have their male partners test than index participants in the HCT arm (RR 2.99, 95% CI 1.45, 6.16). Interpretation: When given a choice between clinic-based HIV testing and HIV oral self-testing, the overwhelming majority of young women chose HIVST. In addition, those offered a choice of HIV testing modality were much more likely to test, distribute test kits to peers and partners, and to have peers and partners who reported testing compared to the HCT arm. Self-testing offers an important opportunity to significantly increase testing rates among young women and their peers and partners compared to clinic-based HCT. Other strategies to reach men with testing are needed. Funding: US National Institutes of Health Keywords: HIV testing, Self testing, South Africa, HIV prevention, Young people
- Published
- 2020
11. Do HIV treatment eligibility expansions crowd out the sickest? Evidence from rural South Africa
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Matthew P. Fox, Sheryl A. Kluberg, Till Bärnighausen, Jacob Bor, Michael P. LaValley, and Deenan Pillay
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Adult ,Male ,Rural Population ,0301 basic medicine ,medicine.medical_specialty ,Anti-HIV Agents ,Art initiation ,antiretroviral therapy ,HIV diagnosis ,Eligibility Determination ,HIV Infections ,Cohort Studies ,South Africa ,directives ,03 medical and health sciences ,continuity of care ,thérapie antirétrovirale ,0302 clinical medicine ,adults ,medicine ,Humans ,guidelines ,030212 general & internal medicine ,Quality of care ,Hiv treatment ,Afrique du Sud ,business.industry ,Public Health, Environmental and Occupational Health ,Interrupted time series ,adultes ,continuité des soins ,030112 virology ,Antiretroviral therapy ,3. Good health ,Infectious Diseases ,Emergency medicine ,Hiv patients ,HIV/AIDS ,Female ,Original Article ,Parasitology ,business ,Original Research Papers ,Program Evaluation ,Healthcare system - Abstract
Objective The 2015 WHO recommendation to initiate all HIV patients on antiretroviral therapy (ART) at diagnosis could potentially overextend health systems and crowd out sicker patients, mitigating the policy's impact. We evaluate whether South Africa's prior eligibility expansion from CD4 ≤ 200 to CD4 ≤ 350 cells/μl reduced ART uptake in the sickest patients. Methods Using data on all patients presenting to the Hlabisa HIV Treatment and Care Programme in KwaZulu‐Natal from April 2010 to June 2012 (n = 13 809), we assessed the impact of the August 2011 eligibility expansion on the number of patients seeking care, number initiating ART and time from HIV diagnosis to ART initiation among patients always eligible (CD4 0–200), newly eligible (CD4 201–350) and not yet eligible by CD4 count (>350). We used interrupted time series methods to control for long‐run trends and isolate the effect of the policy. Results Expanding ART eligibility led to an increased number of patients initiating ART per month [+95.5; 95% CI (−1.3; 192.3)]. Newly eligible patients (CD4 201–350) initiated treatment 47% faster than before (95% CI 19%; 82%), while the sickest patients (CD4 ≤ 200) saw no decline in the monthly number of patients initiating treatment or the rate of treatment uptake. Conclusion The Hlabisa programme successfully extended ART to patients with CD4 ≤ 350 cells/μl, while ensuring that the sickest patients did not experience delays in ART initiation. Treatment programmes must be vigilant to maintain quality of care for the sickest as countries move to treat all patients irrespective of CD4 count.
- Published
- 2018
12. A 10-year cohort analysis of routine paediatric ART data in a rural South African setting
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Remco P. H. Peters, James McIntyre, Jean Railton, B. Mutasa, R.P. Lilian, W. Mongwe, and Helen Struthers
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Male ,Rural Population ,0301 basic medicine ,Pediatrics ,Databases, Factual ,Sustained Virologic Response ,Epidemiology ,HIV Infections ,Cohort Studies ,South Africa ,0302 clinical medicine ,Antiretroviral Therapy, Highly Active ,Agency (sociology) ,Medicine ,030212 general & internal medicine ,Child ,education.field_of_study ,public health ,Viral Load ,Original Papers ,Stavudine ,Infectious Diseases ,Anti-Retroviral Agents ,Child, Preschool ,HIV/AIDS ,Female ,International development ,Cohort study ,medicine.medical_specialty ,Adolescent ,Population ,Developing country ,paediatrics ,03 medical and health sciences ,Acquired immunodeficiency syndrome (AIDS) ,Humans ,education ,Electronic Data Processing ,business.industry ,Public health ,Infant, Newborn ,HIV ,Infant ,medicine.disease ,030112 virology ,Dideoxynucleosides ,Family medicine ,Analysis of data ,Lost to Follow-Up ,Rural area ,business - Abstract
SUMMARYSouth Africa's paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged P< 0·0001) and in children aged ≤1 year at treatment initiation (P< 0·0001). For children aged P< 0·001). Viral load was suppressed in 48–52% of the cohort, with no significant change over the years (P= 0·398). Analysis of TIER.Net data over time provides enhanced insights into the performance of the paediatric ART programme and highlights interventions to improve programme performance.
- Published
- 2016
13. Situating Expertise: Lessons from the HIV/AIDS Epidemic
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Lauren Paremoer
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Sociology of scientific knowledge ,Full Paper ,business.industry ,media_common.quotation_subject ,Public policy ,Public relations ,Full Papers ,scientific advisory committees ,Deliberation ,Collective action ,Politics ,South Africa ,social movements ,Political science ,social determinants of health ,Agency (sociology) ,General Earth and Planetary Sciences ,HIV/AIDS ,business ,General Environmental Science ,media_common ,Social movement ,Social theory - Abstract
How do Scientific Advisory Committees (SACs) frame the relationship between political agency and expertise in their work? What are the political implications of the ways in which SACs legitimate or obscure specific forms of political agency? Using a South African case study, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) activists' participation in clinical trials designed to demonstrate the efficacy of highly active antiretroviral treatment (HAART) in resource‐poor settings, and the process of translating scientific knowledge about HIV/AIDS into public policy under the leadership of a SAC, the South African National AIDS Council (SANAC), is analyzed. The case study suggests that 1) political agency plays a significant role in generating and disseminating scientific data that allow activists to fulfill their political goals; 2) SACs primarily value political agency as a resource for implementing their prescriptions and legitimating their work; 3) processes of political conscientization, movement building, democratic collective action, and deliberation can contribute to the reliability and validity of the technical knowledge SACs rely on, and under some circumstances, contribute to the political resonance their recommendations have with impacted constituencies; and 4) social theory can serve as a resource for negotiating conflicts between technical experts and activists that cannot be settled by appealing to clinical facts.
- Published
- 2018
14. What Influences Linkage to Care After Home-Based HIV Counseling and Testing?
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Tanya Doherty, Wanga Zembe, Debra Jackson, Frank G. Feeley, Elizabeth F. Jackson, Reshma Naik, Fatima Adigun, and Hanani Tabana
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Adult ,Counseling ,Male ,0301 basic medicine ,Coping (psychology) ,medicine.medical_specialty ,Social Psychology ,Anti-HIV Agents ,Psychological intervention ,HIV Infections ,Health Services Accessibility ,Home-based ,Interviews as Topic ,South Africa ,03 medical and health sciences ,Social support ,Linkage to care ,0302 clinical medicine ,Nursing ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Test and treat ,Referral and Consultation ,Qualitative Research ,HIV counseling & testing ,Original Paper ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,Continuity of Patient Care ,Patient Acceptance of Health Care ,medicine.disease ,030112 virology ,HIV care cascade ,3. Good health ,Health psychology ,Infectious Diseases ,Content analysis ,HIV/AIDS ,Female ,business ,Qualitative research - Abstract
To maximize the benefits of test and treat strategies that utilize community-based HIV testing, clients who test positive must link to care in a timely manner. However, linkage rates across the HIV treatment cascade are typically low and little is known about what might facilitate or hinder care-seeking behavior. This qualitative study was conducted within a home-based HIV counseling and testing (HBHCT) intervention in South Africa. In-depth interviews were conducted with 30 HBHCT clients who tested HIV positive to explore what influenced their care-seeking behavior. A set of field notes for 196 additional HBHCT clients who tested HIV positive at home were also reviewed and analyzed. Content analysis showed that linkage to care is influenced by a myriad of factors at the individual, relationship, community, and health system levels. These factors subtly interact and at times reinforce each other. While some factors such as belief in test results, coping ability, social support, and prior experiences with the health system affect clients’ desire and motivation to seek care, others such as limited time and resources affect their agency to do so. To ensure that the benefits of community-based testing models are realized through timely linkage to care, programs and interventions must take into account and address clients’ emotions, motivation levels, living situations, relationship dynamics, responsibilities, and personal resources.
- Published
- 2017
15. An information system to manage the rollout of the antiretroviral treatment programme in the Free State
- Author
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J.E. Kotzé and Theo McDonald
- Subjects
Program evaluation ,medicine.medical_specialty ,Data Warehouse ,Palm Computer System ,Developing country ,South Africa ,Acquired immunodeficiency syndrome (AIDS) ,Information system ,Antiretroviral Treatment Programme ,Medicine ,Humans ,Operations management ,lcsh:RT1-120 ,Acquired Immunodeficiency Syndrome ,lcsh:Nursing ,business.industry ,Public health ,Public sector ,General Medicine ,Monitoring and evaluation ,Paper-based Information System ,medicine.disease ,Hospital Information System ,Management information systems ,Anti-Retroviral Agents ,Computers, Handheld ,Models, Organizational ,Hospital Information Systems ,HIV/AIDS ,Medical emergency ,Public Health ,business - Abstract
The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity’s greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.
- Published
- 2010
16. Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept
- Author
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Linda Richter, G. Szekeres, Michael D. Sweat, Michal Kulich, Kriengkrai Srithanaviboonchai, Alfred Chingono, Glenda Gray, N. Salazar-Austin, H. Van Rooyen, David D. Celentano, Thomas J. Coates, Jessie Mbwambo, Stephen F. Morin, and Suwat Chariyalertsak
- Subjects
0301 basic medicine ,Counseling ,Male ,Pediatric AIDS ,Project accept ,Youth ,Socio demographics ,Social Sciences ,HIV Infections ,Tanzania ,law.invention ,South Africa ,Determinants HTC ,0302 clinical medicine ,Randomized controlled trial ,law ,ADOLESCENTS ,Medicine ,Mass Screening ,030212 general & internal medicine ,SUB-SAHARAN AFRICA ,Mobile HIV testing and counseling ,Public, Environmental & Occupational Health ,RISK ,Pediatric ,education.field_of_study ,biology ,Age Factors ,Thailand ,3. Good health ,Health psychology ,Mental Health ,Infectious Diseases ,Sexual Partners ,1117 Public Health And Health Services ,Public Health and Health Services ,HIV/AIDS ,Female ,Public Health ,Infection ,Life Sciences & Biomedicine ,Adult ,Zimbabwe ,medicine.medical_specialty ,Social Work ,STRATEGIES ,Social Psychology ,Adolescent ,Population ,Hiv testing ,03 medical and health sciences ,Young Adult ,Clinical Research ,Behavioral and Social Science ,Humans ,Operations management ,SOUTH-AFRICAN YOUTH ,ATTITUDES ,education ,Original Paper ,Science & Technology ,High-risk sexual behavior ,business.industry ,Prevention ,Public health ,Public Health, Environmental and Occupational Health ,NIMH Project Accept (HPTN 043) Study Team ,COMMUNITY-BASED INTERVENTION ,Patient Acceptance of Health Care ,biology.organism_classification ,030112 virology ,Biomedical Social Sciences ,RANDOMIZED-TRIAL ,Social Sciences, Biomedical ,Cross-Sectional Studies ,Community mobilization ,Socioeconomic Factors ,KENYA ,business ,Demography - Abstract
Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18–24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61–0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05–1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85–2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08–1.36), and marriage (aOR 1.55; 95% CI 1.37–1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18–24 vs. 25–32 years). Electronic supplementary material The online version of this article (doi:10.1007/s10461-017-1807-5) contains supplementary material, which is available to authorized users.
- Published
- 2018
17. Analysing behavioural outcome effectiveness in a musical theatre-based HIV/AIDS intervention among South African farm workers.
- Author
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Walker, Gavin Robert
- Subjects
AIDS prevention ,HIV prevention ,EVALUATION of medical care ,HEALTH Belief Model ,CLINICAL trials ,INFORMATION services ,SOCIAL stigma ,COMMUNITY health services ,MEDICAL screening ,AIDS serodiagnosis ,HEALTH behavior ,MUSIC ,CONDOMS ,SOCIAL skills ,PERFORMING arts ,HEALTH promotion ,AGRICULTURAL laborers - Abstract
In 2005, an applied theatre community outreach programme was launched to address low levels of HIV/AIDS awareness among farm workers in the Cape Winelands of South Africa. In cooperation with HIV testing organizations, the Lucky , the Hero mini-musical promoted regular HIV testing, condom use and acceptance of people living with HIV until being retired in 2017. Applying principles of the health belief model to interview data collected in 2015 from former Lucky, the Hero participants, this paper examines the effectiveness of the theatre production to achieve the behavioural outcomes of (i) encouraging regular HIV testing and ongoing awareness of HIV serostatus, and (ii) reducing AIDS-related social stigma. The findings suggest that the interventions were successful in persuading participants to know their HIV status immediately following the shows, as well as potentially contributing to a reduction of community-based external social stigma. However, the interventions were unable to maintain engagement with these behavioural outcomes in the years following the performances, resulting in low adherence to regular HIV testing and inconsistent condom use. Additionally, ongoing social and structural barriers to regular HIV testing and the potential for self-imposed HIV-related stigma were highlighted during the discussions. While applied theatre can be an effective avenue for HIV awareness and prevention, the paper demonstrates the importance of creating and maintaining strong community networks to support continued engagement with health-related behavioural outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
18. Pulsing bodies and embodying pulse: musical effervescence in a South African HIV/AIDS community outreach program.
- Author
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Robert Walker, Gavin
- Subjects
AIDS treatment ,HIV infections ,BUSINESS management of health facilities ,MATHEMATICAL models ,MUSIC therapy ,ETHNOLOGY research ,COMMUNITY-based social services ,THEORY - Abstract
Early in South Africa's HIV/AIDS crisis, entertainment education emerged as a powerful vehicle for communicating health and social messaging to combat the epidemic. Applied theatre now accounts for the majority of arts-based HIV interventions in sub-Saharan Africa, and continues a history of theatre for social change in South Africa in particular. While much has been written about the dramaturgical and communication theories that support such interventions, the role of music, a formidable tool in the applied theatre intervention arsenal, has received considerably less attention within applied arts intervention scholarship. This paper draws from Durkheim's collective effervescence to propose a theoretical approach to music within the creation and maintenance of effervescent assemblies that is being employed by HIV/AIDS interventions to encourage participation in HIV testing. The theoretical model of musical effervescence is situated within ethnographic fieldwork conducted while accompanying an applied HIV/AIDS theatre company on a national tour of South Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
19. South African community health workers' pursuit of occupational security.
- Author
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van de Ruit, Catherine and Breckenridge, Alexandra
- Subjects
- *
COMMUNITY health workers , *AFRICANS , *AIDS prevention , *AIDS treatment , *OCCUPATIONAL roles - Abstract
Community health workers (CHWs) are central to the global health response to crises like the AIDS epidemic. Yet community health work remains undervalued and undercompensated worldwide owing in large part to the gendered and racialized contexts of care work. This paper investigates the possibility of occupational security for CHWs by comparing two cases from South Africa's response to AIDS. The first draws on ethnographic research (2007–2009) in rural KwaZulu‐Natal province and documents the fraught formation of a union representing CHWs. The second examines legal action in the Free State province for a group of CHWs known as the Bophelo House 94, who were arrested and criminally charged in June 2014 after protesting their sudden dismissal by the government. This case comparison finds that collective action has thus far had limited effects on CHWs' position as a nascent occupation. The South African Ministry of Health has obstructed CHW professionalization, and non‐state actors' involvement has been a mixture of benefit and impediment: some social justice agencies have facilitated CHW advocacy, while many AIDS service organizations have cooperated with the state and exacerbated the precarity of CHWs' working conditions. However, the consolidation of CHW work roles—owing to advances in AIDS prevention and treatment—holds promise for future CHW collective organization. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
20. Migration Status, Work Conditions and Health Utilization of Female Sex Workers in Three South African Cities
- Author
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Matthew Chersich, Jo Vearey, Stanley Luchters, Benn Sartorius, Marlise Richter, and Marleen Temmerman
- Subjects
Adult ,Zimbabwe ,medicine.medical_specialty ,Geographic mobility ,Epidemiology ,JOHANNESBURG ,Health care utilization ,Health Behavior ,condoms ,Context (language use) ,Vulnerable Populations ,law.invention ,Condoms ,CUP ,South Africa ,Condom ,Acquired immunodeficiency syndrome (AIDS) ,law ,Risk Factors ,Environmental health ,Health care ,medicine ,Medicine and Health Sciences ,Humans ,Sex work ,Demography ,RISK ,Transients and Migrants ,CONDOM USE ,Original Paper ,Sex Workers ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,HIV PREVENTION ,virus diseases ,Health Services ,medicine.disease ,TIME ,COMMUNITY ,Migration status ,CONTEXT ,Cross-Sectional Studies ,HIV/AIDS ,Health education ,Female ,business - Abstract
Intersections between migration and sex work are underexplored in southern Africa, a region with high internal and cross-border population mobility, and HIV prevalence. Sex work often constitutes an important livelihood activity for migrant women. In 2010, sex workers trained as interviewers conducted cross-sectional surveys with 1,653 female sex workers in Johannesburg (Hillbrow and Sandton), Rustenburg and Cape Town. Most (85.3 %) sex workers were migrants (1396/1636): 39.0 % (638/1636) internal and 46.3 % (758/1636) cross-border. Cross-border migrants had higher education levels, predominately worked part-time, mainly at indoor venues, and earned more per client than other groups. They, however, had 41 % lower health service contact (adjusted odds ratio = 0.59; 95 % confidence interval = 0.40–0.86) and less frequent condom use than non-migrants. Police interaction was similar. Cross-border migrants appear more tenacious in certain aspects of sex work, but require increased health service contact. Migrant-sensitive, sex work-specific health care and health education are needed.
- Published
- 2012
21. Preventing human immunodeficiency virus infection among sexual assault survivors in Cape Town, South Africa: an observational study
- Author
-
Lynette Denny, Michelle E. Roland, Thomas J. Coates, Landon Myer, Priya Batra, Lorna J. Martin, Anastasia Maw, and Elizabeth D. Arend
- Subjects
Counseling ,Male ,Pediatric AIDS ,Time Factors ,medicine.medical_treatment ,Psychological intervention ,Poison control ,HIV Infections ,Sexual assault ,South Africa ,0302 clinical medicine ,Unsafe Sex ,Risk Factors ,030212 general & internal medicine ,Survivors ,Young adult ,Pediatric ,education.field_of_study ,Human immunodeficiency virus ,Risk behavior ,Rehabilitation ,3. Good health ,Mental Health ,Infectious Diseases ,Public Health and Health Services ,HIV/AIDS ,Female ,Public Health ,0305 other medical science ,Infection ,medicine.medical_specialty ,Social Work ,Social Psychology ,Adolescent ,Anti-HIV Agents ,Population ,Guidelines as Topic ,Post-exposure prophylaxis ,Medication Adherence ,03 medical and health sciences ,Young Adult ,Clinical Research ,Internal medicine ,Behavioral and Social Science ,medicine ,Humans ,Seroconversion ,education ,Psychiatry ,Original Paper ,030505 public health ,business.industry ,Public health ,Prevention ,Public Health, Environmental and Occupational Health ,Good Health and Well Being ,Adherence ,Rape ,Injury (total) Accidents/Adverse Effects ,business ,Follow-Up Studies - Abstract
We describe 131 South African sexual assault survivors offered HIV post-exposure prophylaxis (PEP). While the median days completed was 27 (IQR 27, 28), 34% stopped PEP or missed doses. Controlling for baseline symptoms, PEP was not associated with symptoms (OR = 1.30, 95% CI = 0.66, 2.64). Factors associated with unprotected sex included prior unprotected sex (OR = 6.46, 95% CI = 3.04, 13.74), time since the assault (OR = 1.33, 95% CI = 1.12, 1.57) and age (OR = 1.30, 95% CI = 1.08, 1.57). Trauma counseling was protective (OR = 0.18, 95% CI = 0.05, 0.58). Four instances of seroconversion were observed by 6 months (risk = 3.7%, 95% CI = 1.0, 9.1). Proactive follow-up is necessary to increase the likelihood of PEP completion and address the mental health and HIV risk needs of survivors. Adherence interventions and targeted risk reduction counseling should be provided to minimize HIV acquisition.
- Published
- 2012
22. Aging, (un)certainty and HIV management in South Africa.
- Author
-
Rishworth, Andrea and King, Brian
- Subjects
OLDER people ,HIV ,OLDER women ,AGING ,CERTAINTY - Abstract
Research within geography and cognate disciplines demonstrates how (un)certainty informs relational, emergent and open‐ended processes of healthy aging. Although (un)certainty shapes aging health inequities and possibilities for reconfiguration, research often centres on challenges for aging individuals, eliding more dynamic, complex and contradictory factors shaping the health and wellbeing of aging individuals and societies. This paper uses qualitative research with older women in South Africa to engage contradictions in (un)certainty. We argue that while advances in HIV/AIDS testing and treatment allow individuals to grow older with greater certainty, longer lives managing HIV rework new forms of ill‐health through contested disease etiology, indeterminant multitemporal processes, and dubious livelihood prospects. (Un)certain HIV landscapes can create new forms of disadvantage and subjection, while in other instances encourage opportunities for healthier lives and pragmatic social change. The findings highlight the importance of considering (un)certain aging, health and disease realities and the structures that assuage them. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
23. Seven 'deadly' assumptions: unravelling the implications of HIV/AIDS among grandmothers in South Africa and beyond.
- Author
-
CHAZAN, MAY
- Subjects
GRANDMOTHERS ,AIDS ,DISEASES in older women ,SOCIAL networks ,HIV - Abstract
Over the past few years, the pivotal roles older women play in responding to the unprecedented HIV/AIDS epidemic in southern Africa has received increasing recognition by academics, governments, funding agencies, non-governmental organisations, and citizens around the world. Yet, discourses surrounding AIDS and 'grandmotherhood' are laden with a number of ungrounded assumptions that have important implications for researchers, advocates and decision-makers. Drawing on ethnographic and survey data predominantly from South Africa, this paper challenges seven such assumptions. The paper illustrates how certain prevailing 'wisdoms' about grandmothers and AIDS in southern Africa are not entirely accurate and may mask many women's struggles and vulnerabiities, perpetuate stereotypes and misguide well-meaning policies. It also suggests that the societal impacts of AIDS in the region are, at present, not as dramatic as often portrayed, largely because the strength and resilience of many older women have cushioned some of the negative consequences. The paper thus calls for more nuanced and forward-looking analyses and interventions - ones that recognise grandmothers as central to the society's thin safety net and that grapple with older women's complex and diverse vulnerabilities. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
24. GETTING IN STEP WITH THE SPIRIT: APPLYING PENTECOSTAL COMMITMENTS TO HIV/AIDS IN SOUTH AFRICA.
- Author
-
Attanasi, Katy
- Subjects
AIDS ,PENTECOSTALISM ,CHURCH work with AIDS patients ,CHRISTIANITY - Abstract
Pentecostalism is the fastest growing form of Christianity in developing countries. Paralleling Pentecostalism's growth has been the HIV/AIDS pandemic. This paper examines how post-apartheid South Africans are responding to the conflicts born of the HIV/AIDS crisis. Fieldwork conducted in 2005 shows that Pentecostals who were not involved in efforts to address HIV/AIDS saw the church's mission as almost exclusively spiritual in nature. Pentecostals who were engaged in HIV/AIDS-related work were more likely to have an integrated worldview and to see the church's mission as relevant to the physical world. Beliefs about removing racism from the church and sin as structural as well as individual were also associated with this integrated worldview. These insights lay the foundation for constructing a Pentecostal social ethic for addressing HIV/AIDS. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
25. Mitigating South Africa's HIV Epidemic: The Interplay of Social Entrepreneurship and the Innovation System.
- Author
-
Kahn, Michael
- Subjects
THERAPEUTICS ,HIV infections ,SOCIAL entrepreneurship ,HIV ,INNOVATIONS in business ,LIFE expectancy ,MARKET failure - Abstract
With the struggle against apartheid achieved, South Africa faced the new struggle of overcoming the HIV/AIDS pandemic. This paper examines the response of government, the innovation system and civil society in rising to the challenge. The response included a fatal denialism concerning the etiology of AIDS, a fatalism that constitutes political market failure. This political market failure was counteracted through the emergence of social entrepreneurship in the form of the Treatment Action Campaign (TAC) that mobilized civil society and like-minded health practitioners and researchers within the innovation system. Dependency Theory coupled with a Quadruple Helix model of the innovation system offer possible explanations of this complex human tragedy and the way that government was compelled to embark on a massive program of providing anti-retroviral therapy that has now significantly improved life expectancy. The paper provides socio-economic context, appraisal of the innovation system, and a sketch of how the Quadruple Helix took form. Of special importance is the independence of South Africa's 'Republic of Science.' Independent courts were critical in allowing TAC to obtain remedy against government, Big Pharma, and AIDS dissident scientists. It is argued that its Republic of Science met its obligation of objectivity by shifting emphasis to the cause of AIDS research in the face of official denialism. In effect, the system of innovation and social entrepreneurs are shown to have acted in concert in constituting a Quadruple Helix. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
26. Everyday mobilisations among grandmothers in South Africa: survival, support and social change in the era of HIV/AIDS.
- Author
-
CHAZAN, MAY
- Subjects
CAREGIVERS ,FOCUS groups ,GRANDPARENTS ,HIV infections ,INTERVIEWING ,PARTICIPANT observation ,POVERTY ,QUESTIONNAIRES ,RESEARCH funding ,STEREOTYPES ,SOCIAL stigma ,VIOLENCE ,PSYCHOLOGY - Abstract
In many sub-Saharan African communities, caring for vulnerable children in the era of HIV/AIDS appears to be creating deep financial, physical and psychological strains for care-givers, the great majority of whom are ageing women or ‘grandmothers’. Yet, limited primary research has been carried out with older women in specific communities, and therefore grandmothers' collective responses, sources of support, complex lived experiences, and diverse family situations are not well understood. This paper presents the findings of research undertaken in four communities in KwaZulu-Natal, South Africa, between 2006 and 2010. The purpose was to understand the daily stresses, collective responses and mobilisations of older women in these communities. The research involved repeated focus groups, interviews and participant observation involving approximately 100 older women. In the analysis, attention is given to the diversities among participants, the ways in which HIV/AIDS intermingles with other stresses in their lives to drive their mobilisations, and their collective responses, even amidst highly constrained conditions. Through these lenses, the paper illuminates how older women in these communities are organising in response to the combined, devastating and diverse effects of HIV/AIDS, poverty, violence and illness. It also suggests that, counter to some stereotyping of ‘African grandmothers’ as frail or passive, these women are forming associations in order to generate incomes, resist stigma, connect with broader support networks and provide care to hundreds in their communities. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
- Full Text
- View/download PDF
27. The HIV/AIDS epidemic revisited in times of COVID-19: advocating for responsibility and rights in South African writing.
- Author
-
Englund, Lena
- Subjects
AIDS ,EPIDEMICS ,HIV ,COVID-19 ,ANTIRETROVIRAL agents ,ATTITUDE (Psychology) ,SKEPTICISM - Abstract
This paper examines two autobiographical responses to the HIV/AIDS epidemic in South Africa from the perspective of responsibility and rights. The analysis draws on interdisciplinary studies of the epidemic and its effects on South African communities. Memoirs by Edwin Cameron and Sister Abegail Ntleko address challenges in South Africa with regard to attitudes toward and treatment of HIV-infected people. Both writers use their texts to advocate for social and political responsibility and for the rights of those infected. Rian Malan's essays function as a counterpoint, bringing into focus controversial questions about the role of funding and reliable statistics for the epidemic. The topic is relevant in a South African context where antiretroviral treatment was met with skepticism in official political discourse. Representations of responsibilities and rights as well as official responses to the HIV/AIDS epidemic have been additionally reexamined in relation to the COVID-19 pandemic, giving the epidemic renewed relevance. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
28. Emotions and HIV/AIDS in South Africa : a multilingual perspective
- Author
-
Oostendorp, Marcelyn and Bylund, Emanuel
- Subjects
emotions ,hiv/aids ,south africa ,multilingualism ,Philology. Linguistics ,P1-1091 ,African languages and literature ,PL8000-8844 - Abstract
This paper argues that in order to gain a more informed perspective on emotions and HIV/AIDS, crosslinguistic differences in emotion language need to be taken into account, particularly in a multilingual context. The paper reviews four published academic articles with the aim of illustrating how more consideration of the crosslinguistic and multilingual aspects of emotion language could have contributed to better theoretical understanding of HIV/AIDS and emotions as well as aiding the development of practical interventions in HIV/AIDS counselling and care. Finally, this paper argues that a lack of engagement with language and multilingualism around HIV/AIDS and emotions will stifle the development of a theoretical account of emotions as multi-semiotic and embodied, as well as the development of locally based, community-driven practical interventions.
- Published
- 2012
- Full Text
- View/download PDF
29. Rationale and procedures for nesting semi-structured interviews in surveys or censuses.
- Author
-
Schatz, Enid
- Subjects
DEMOGRAPHIC research ,DEMOGRAPHIC surveys ,CENSUS ,SURVEYS ,QUALITATIVE research ,MIXED methods research - Abstract
Demographers who use survey data and census data from health and demographic surveillance areas can gain substantially from expanding their repertoire of methods to make use of qualitative methods. Similarly, those who conduct and analyse data primarily from semi-structured interviews or focus groups can benefit from information provided by survey research. This paper presents a systematic mixed-methods model—data-linked nested studies—for sampling respondents for semi-structured interviews from survey or census lists. The paper outlines how to conduct these types of study, and their technical and analytical advantages. It highlights the benefits of building on a strong foundation, the ability to compare samples, and the expansion of the range of evidence for, or against, the validity of the substantive findings. Case studies from two data-linked nested projects—in Malawi and South Africa—are used to describe in detail the nested-study approach. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
- Full Text
- View/download PDF
30. Traditional healers use of personal protective equipment: a qualitative study in rural South Africa.
- Author
-
Audet, Carolyn M., Gobbo, Elisa, Sack, Daniel E., Clemens, Elise M., Ngobeni, Sizzy, Mkansi, Mevian, Aliyu, Muktar H., and Wagner, Ryan G.
- Subjects
PERSONAL protective equipment ,HEALERS ,LATEX gloves ,HIV infections ,HEPATITIS C virus - Abstract
Background: Traditional healers are frequently exposed to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) through the widespread practice of traditional "injections", in which the healer performs dozens of subcutaneous incisions using a razor blade to rub herbs directly into bloodied tissue. An average healer in Agincourt, a rural northeastern sub-district in Mpumalanga province, South Africa, experiences approximately 1500 occupational blood exposures over the course of their lifetime. Healers in Agincourt have an HIV prevalence of 30% compared to 19% in the general population, and healers who report exposure to patient blood have an adjusted 2.4-fold higher odds of being HIV-positive than those with no exposure. Although research on appropriate PPE use has been well documented for allopathic care providers, little is known about the practices of traditional healers.Methods: This qualitative study was conducted with 30 traditional healers who practice in the rural Bushbuckridge sub-district of Mpumalanga province, northeastern South Africa. We elicited traditional healer attitudes towards glove use during traditional treatments - including patient baths, injections, or other treatments that exposed healers to patient blood or open sores.Results: While 90% of healers reported using latex gloves during some treatments, the majority do not use them regularly. Most employ a combination of gloves, plastic shopping bags, bread bags, paper, and sticks to prevent blood exposure. Healers reported plastic bags slipping or breaking during procedures, exposing them to patient blood. Only three healers consistently used gloves, regardless of the cost.Conclusions: Inadequate PPE use and high HIV prevalence make traditional healers particularly susceptible to contracting HIV in rural South Africa. Despite positive attitudes, consistent glove use remains low due to financial constraints and glove availability. Addressing issues of accessibility and cost of gloves for traditional healers could have a significant impact on the adherence to PPE and, in turn, reduce new HIV infections among this high-risk group. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
31. Migration, access to ART, and survivalist livelihood strategies in Johannesburg.
- Author
-
Vearey, Joanna
- Subjects
EMIGRATION & immigration ,HIV ,MEDICAL care - Abstract
Since the end of apartheid, patterns of migration into South Africa have shifted, and South Africa has become a destination for people from across the African continent and beyond - a small but important number of whom are refugees and asylum seekers. While South Africa has a protective, integrative, urban refugee policy, many of these individuals struggle to access the rights to which they are entitled, including healthcare. In addition, many lower-skilled international migrants are unable to legalise their stay in South Africa. As a result, international migrants often become part of the group of 'urban poor,' falling within the periphery of health and social welfare provision and relying on a survivalist livelihood within the informal economy. The health and wellbeing of an individual impact greatly on their ability to maintain a secure livelihood, and this becomes more difficult in the context of an HIV epidemic. This paper presents findings from a case study situated in the City of Johannesburg. The research made use of 1) 2006 survey data on migrant livelihood strategies in Johannesburg, 2) a study investigating non-citizens' access to antiretroviral treatment (ART) in the inner city, which included 3) a set of interviews conducted with migrant ART clients who were working in the city's informal economy. The findings indicate (a) the importance of the informal economy for migrants to Johannesburg; (b) the challenges that non-citizens face in accessing ART in the public sector in South Africa; and (c) the linkages between urban migrants' access to ART and their ability to maintain a survivalist livelihood. The paper argues that upholding people's right to ART for all who need it within South Africa will enable international migrants (including refugees and asylum seekers) to maintain an otherwise fragile survivalist livelihood, and this in turn will assist their self-reliance and integration into urban life. Recommendations are made to ensure that the right to healthcare is upheld for all in South Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
32. Beyond stigma? Young children's responses to HIV and AIDS.
- Author
-
Bhana, Deevia
- Subjects
SOCIAL stigma ,SOCIAL psychology ,CHILD care ,AIDS ,HIV infections ,ETHNOLOGY ,LECTURES & lecturing ,IMPLICIT learning - Abstract
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.)
- Published
- 2008
- Full Text
- View/download PDF
33. A (des)proteção social aos soropositivos na África do Sul Pós-apartheid: da segregação racial ao minimalismo neoliberal.
- Author
-
Barbosa Filho, Evandro Alves and de Souza Vieira, Ana Cristina
- Abstract
Copyright of O Social em Questão is the property of Faculdades Catolicas - Pontificia Universidade Catolica do Rio de Janeiro 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.)
- Published
- 2019
34. Policy change and micro-politics in global health aid: HIV in South Africa.
- Author
-
Kavanagh, Matthew M and Dubula-Majola, Vuyiseka
- Subjects
GOVERNMENT policy ,INTERNATIONAL relief ,HIV prevention ,HEALTH policy ,AIDS & politics ,HEALTH planning - Abstract
Efforts to improve the effectiveness of global health aid rarely take full account of the micro-politics of policy change and implementation. South Africa's HIV/AIDS epidemic is a case in point, where the US President's Emergency Plan for AIDS Relief (PEPFAR) has provided essential support to the national AIDS response. With changing political context, PEPFAR has shifted focus several times-most recently reversing the policy of 'transition' out of direct aid to a policy of re-investing in front-line services in priority districts to improve aid effectiveness. However, this policy shift has not led to the expected impact on health services. This paper reports the findings of a study on the implementation of the recent policy through interviews at randomly selected sites in high HIV-burden districts of South Africa that capture the experiences of public-sector health leaders. We find little evidence to support the explanation that the new aid policy displaced government staff and resources. Instead, our findings suggest that legacies of the previous policy remained as local aid managers did not shift funding and practice at sufficient scale to drive the planned service delivery expansion. Human resource support, the main PEPFAR contribution to service delivery at front-line facilities, was not adequate or distributed based on the size of the HIV programme, leaving notable gaps in outreach, defaulter tracing, and community service delivery. Instead, services that better fit the previous policy paradigm, like training and data-sharing, are common at site-level but provide diminishing returns. Together, our findings suggest opportunities for PEPFAR South Africa to revisit its model and increase service delivery intensity, in particular through community-based services. More broadly, this case illustrates the need for greater attention to the multiple actors with discretion in the policy system of health aid and the mechanisms through which political priority is translated into programming as policy shifts are made. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
35. The pull of soccer and the push of Xhosa boys in an HIV and drug abuse intervention in the Western Cape, South Africa.
- Author
-
Medich, Melissa, Mindry, Deborah, Tomlinson, Mark, Rotheram-Borus, Mary Jane, Bantjes, Jason, and Swendeman, Dallas
- Subjects
XHOSA (African people) ,HIV ,DRUG abuse ,CONCEPTUALISM ,MASCULINITY - Abstract
There is growing interest in engaging men and boys in health and development programmes targeting the intersection of HIV risk, substance abuse, and violence. Understanding the conceptualisations of masculinities or masculine identities that shape both behaviours and opportunities for intervention is central to advancing the global agenda to engage men in health and development interventions. This paper examines an intervention using soccer and job training to engage and deliver activities for HIV prevention, substance abuse, and gender-based violence in a South African township. A literature review provides theoretical, historical and social context for the intersection of gender, masculinity, soccer, violence, and sexual relationships. Qualitative data from in-depth interviews and focus groups is analysed using theoretical and contextual frames to elucidate the negotiation of shifting, contradictory, and conflicting masculine roles. Results highlight how changing risky, normative behaviours among young men is a negotiated process entailing men's relationships with women and with other men. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
36. ‘Our songs were our stones’: song and struggle in the treatment action campaign.
- Author
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Walker, Gavin Robert
- Subjects
SONGS -- Social aspects ,AIDS ,ANTIRETROVIRAL agents ,AIDS & society ,SEXUAL assault ,ACTIVISM - Abstract
With 3 million people receiving anti-retroviral therapies (ARV) in South Africa, it has the largest public ARV programme in the world. The implementation of this programme was made possible by the efforts of AIDS advocacy groups that lobbied the government to make ARV available. Chief among these was the Treatment Action Campaign (TAC). The group mobilised South Africans across socio-economic and racial lines against the AIDS denial of key members of the African National Congress (ANC). Through interviews with TAC members and ethnographic accounts of ©current activism, this paper examines song as a method of mobilisation against HIV/AIDS-related injustices. As instrumental components of the liberation struggle, songs have become ubiqioutus within protest action, as demonstrated by the recent hashtag student movements. By utilising similar forms of rights-based activism found in the country's liberation struggle, TAC is able to tap into reservoirs of emotional potential rooted in political struggle. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
37. Mutual HIV status disclosure is associated with consistent condom use in public sector ART clients in Free State province, South Africa: a short report.
- Author
-
Booysen, Frederik le Roux, Wouters, Edwin, de Walque, Damien, and Over, Mead
- Subjects
ANTIVIRAL agents ,CONDOMS ,CONFIDENCE intervals ,HIV-positive persons ,RESEARCH methodology ,LOGISTIC regression analysis ,DISCLOSURE ,PUBLIC sector ,SECONDARY analysis ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Risky sexual behaviour in PLWHA on antiretroviral therapy threatens both prevention and treatment efforts, but disclosure promises to support safer sexual practices. This paper investigates the association between HIV self-disclosure and consistent condom use in a cohort of public sector patients on antiretroviral (ARV) treatment. Using data from the FEATS cohort study, logistic regression analysis shows that knowledge of your partner's HIV status is positively associated with consistent condom use (OR 2.73, 95% CI 1.37-5.43, p = 0.004) and so too mutual HIV disclosure (OR 3.38, 95% CI 1.60-7.18, p = 0.001). Prevention and treatment programmes, through couple HIV counselling and testing (CHCT) and other assistance programmes, should focus on supporting the mutual disclosure of HIV status among PLWHA on ARV treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
38. Managing the costs of HIV/AIDS: A case study of a South African contract cleaning company.
- Author
-
Gow, Jeff, George, Gavin, and Grant, Bligh
- Subjects
HIV ,AIDS ,MEDICAL care costs ,CASE studies ,PANDEMICS ,BUSINESS enterprises - Abstract
This paper, based on a case study of a South African contract cleaning company in Durban, KwaZulu-Natal, adds to the recent literature on the management of the financial impact of the HIV/AIDS pandemic. After situating the research alongside recent contributions that have examined large enterprises, and small, medium and micro enterprises, the paper provides a profile of the company and its predominantly female workforce. The company's management of costs incurred due to HIV/AIDS is critically assessed from the perspective of financial sustainability, using an AIDS Projection Model developed by Matthews (2007). It was found that while continued employment of this workforce is economically sustainable, both from the perspective of the business and the associated provident fund, the costs to employees are far from equitable. The paper therefore recommends the implementation of a holistic HIV/AIDS management programme, including treatment and prevention activities. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
- Full Text
- View/download PDF
39. “An Unchanging God in a Changing World”: Sexual Practice and Decision-Making among Christian Women in South Africa
- Author
-
Perera, Shehani and Swartz, Alison
- Published
- 2021
- Full Text
- View/download PDF
40. Narratives of transactional sex on a university campus.
- Author
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Shefer, Tamara, Clowes, Lindsay, and Vergnani, Tania
- Subjects
TRANSACTIONAL sex ,HUMAN sexuality ,SEX workers ,WOMEN'S rights - Abstract
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.)
- Published
- 2012
- Full Text
- View/download PDF
41. Older Female Caregivers and HIV/AIDS-Related Secondary Stigma in Rural South Africa.
- Author
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Ogunmefun, Catherine, Gilbert, Leah, and Schatz, Enid
- Subjects
CAREGIVERS ,PSYCHOLOGY of women ,SOCIAL stigma ,HIV infections ,AIDS - Abstract
South Africa's HIV/AIDS epidemic poses a major public health threat with multi-faceted harmful impacts and 'socially complex' outcomes. While some outcomes relate to structural issues, others stem from society's attitudinal milieu. Due to negative attitudes toward People Living with HIV/AIDS, stigmatisation mars their own experience and often extends to those close to them, in particular their caregivers. Many of the caregivers in South Africa are older women; thus, older women are the focus of this paper, which aims to examine HIV/AIDS-related stigma from their perspective. This paper explores secondary stigma as a socio-cultural impact of HIV/AIDS through repeated semistructured interviews with 60 women aged 50-75 in the MRC/Wits Rural Public Health and Health Transitions Unit research site (Agincourt), many of whom had cared for a family member with HIV/AIDS. Respondents' narratives reveal that many older persons attribute high rates of death in their community to young persons' lack of respect for societal norms and traditions. The findings illustrate the forms and expressions of HIV/AIDS-related secondary stigma and their impacts on older female caregivers. The types of secondary stigma experienced by the respondents include physical stigma in the form of isolation and separation from family members; social stigma in the form of voyeurism and social isolation; and verbal stigma in the form of being gossiped about, finger-pointing and jeering at them. Despite mixed reports about community responses toward infected and affected people, HIV/AIDS-related stigma remains a cause for concern, as evidenced by the reports of older women in this study. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
42. Cell Phone Short Messaging Service (SMS) for HIV/AIDS in South Africa: A literature review.
- Author
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Safran, C., Reti, S., Marin, H.F., Mukund Bahadur, Khatry-Chhetry, and Murrayb, Peter J.
- Abstract
The HIV/AIDS pandemic is one of the most serious threats to global health. HIV/AIDS is a chronic illness, requiring patient empowerment to enhance adherence to treatment regimes if it is to be managed effectively. While healthcare costs are rising, people still have expectations of high-quality care. This literature review-based study explored the use of cell phone (mobile phone) short messaging services (SMS) in health care, in particular for HIV/AIDS in South Africa. From an initial corpus of 212 papers, 28 were reviewed. The main findings include that SMS can improve service delivery through appointment reminders and improve communication between healthcare workers. It improves diagnosis, prevention, treatment and rehabilitation by supporting adherence to medication, and monitoring illness and medical interventions. SMS is useful in public health programmes, such as contact tracing and partner notification, therefore playing an important role in control of HIV/AIDS. As South Africa has one of the highest uptakes and demographic distributions of cellular technology in the world, SMS is feasible as a tool to deliver quality health care with low cost. [ABSTRACT FROM AUTHOR]
- Published
- 2010
43. Broadening Psychology’s Contribution to Addressing Issues of HIV/AIDS, Poverty and Nutrition.
- Author
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Tomlinson, Mark, Rohleder, Poul, Swartz, Leslie, Drimie, Scott, and Kagee, Ashraf
- Subjects
AGRICULTURE ,AIDS ,HEALTH behavior ,HEALTH promotion ,HIV ,INCOME ,NUTRITION ,PEOPLE with disabilities ,POVERTY ,PSYCHOLOGY - Abstract
HIV/AIDS, more than any other public health problem, challenges dominant models of the role of psychology in health promotion and prevention. This paper focuses on poverty and resulting food insecurity as a structural risk factor for HIV infection. The paper considers the role of health psychology in global health concerns and argues that, while individual-based interventions are important, health psychology needs to shift to playing a proper role in broader level initiatives. Health psychology, in thinking about global health concerns such as HIV, needs to view an understanding of health, education and nutrition delivery programmes in low resourced contexts as at the core of the discipline. [ABSTRACT FROM PUBLISHER]
- Published
- 2010
- Full Text
- View/download PDF
44. How much do young children know about HIV/AIDS?
- Author
-
Bhana, Deevia
- Subjects
HIV infections ,AIDS ,SCHOOL children ,PRIMARY education ,HIV - Abstract
This paper explores the ways in which young South African school children (aged between seven and eight) in a predominantly white primary school give meanings to HIV/AIDS. Using ethnographic methods and interview data, the analysis of young children's responses shows that their accounts of HIV/AIDS draw from their knowledge of disease more generally and associate it with allergies, fungus, moss as well as contagion. Their knowledge is also intricately connected with their understandings of sex and gender. Within the same age group young children's knowledge of the disease vacillates from inaccurate information to graphic accounts of sex as a transmission route and gendered vulnerability to the disease. The findings of this study suggest that children are active makers of meanings about the disease. They relate HIV/AIDS to disease, to contagion and dirt, and in doing so harness social processes including race, class, sex and gender. Efforts to scale up young children's understanding of the disease in the early years of primary schooling are significant in the light of this study. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
45. Changing masculinities: land-use, family communication and prospects for working with older men towards gender equality in a livelihoods intervention.
- Author
-
Jobson, Geoffrey
- Subjects
MASCULINITY ,LAND use ,SEX discrimination ,HIV - Abstract
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.)
- Published
- 2010
- Full Text
- View/download PDF
46. HIV/AIDS and disability organisations in South Africa.
- Author
-
Rohleder, Poul, Swartz, Leslie, Schneider, Marguerite, Groce, Nora, and Eide, ArneHenning
- Subjects
HEALTH ,AIDS ,HIV prevention ,PREVENTION of epidemics ,HEALTH education ,SOCIETIES - Abstract
Despite the seriousness of the HIV epidemic globally, and in South Africa in particular, little is known about how HIV/AIDS affects disabled people. One important and little explored area is the role that organisations that represent disabled people or that work on behalf of disabled people, are playing in addressing the HIV/AIDS epidemic among the disabled people they represent or serve. This paper presents the findings of a nationwide survey of disability organisations in South Africa. The purpose of this study was to explore the role of disability organisations in addressing the HIV epidemic among disabled people in South Africa. The findings suggest that while organisations recognise the importance of providing HIV education, and many have taken steps to do so, disabled people are largely excluded from general HIV prevention messages. Disabled people also have significant difficulties in accessing general health care, relevant for HIV testing and treatment. In a country trying to manage serious social problems with limited resources, this paper highlights the need for increased cooperation and collaboration between relevant parties in order to facilitate the changes necessary for disabled people to access needed health information and care. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
47. Political ecologies of health.
- Author
-
King, Brian
- Subjects
POLITICAL ecology ,GREEN movement ,PUBLIC health ,ECONOMICS - Abstract
Emerging research within health geography and related fields is attending to the social dimensions of human health. Notwithstanding these contributions, health geography has provided less rigorous attention to the role of political economy in producing disease and shaping health decision-making. Additionally, the reciprocal relationships between health and environment have been underexplored. This paper asserts that political ecology would contribute by examining the political economy of disease, interrogating health discourses, and understanding the interactions between social and environmental systems. The benefits of a political ecology of health are demonstrated through an examination of the HIV/AIDS epidemic in South Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
48. 'Boys will be boys': traditional Xhosa male circumcision, HIV and sexual socialisation in contemporary South Africa.
- Author
-
Vincent, Louise
- Subjects
CIRCUMCISION ,INITIATION rites ,RITES & ceremonies ,XHOSA (African people) ,ETHNOLOGY ,HIV infections ,HIV-positive persons ,HUMAN sexuality - Abstract
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.)
- Published
- 2008
- Full Text
- View/download PDF
49. Building contexts that support effective community responses to HIV/AIDS: a South African case study.
- Author
-
Campbell, Catherine, Nair, Yugi, and Maimane, Sbongile
- Subjects
AIDS ,HIV infections ,HEALTH care reform ,MEDICAL partnership ,PREGNANT women - Abstract
In this paper we discuss our conceptualisation of a ‘health-enabling social environment’, and some of the strategies we are currently using to build social contexts most likely to support effective HIV/AIDS management in southern Africa. In developing these ideas, we draw on our on-going collaboration with residents of Entabeni, a remote rural community in South Africa where 43% of pregnant women are HIV positive. The aim of this collaboration is to facilitate contextual changes that will enable more effective community-led HIV/AIDS management in an isolated area where people have little or no access to formal health or welfare support, and where HIV/AIDS is heavily stigmatised. We give an account of the three phases of collaboration to date. These include research; the dissemination of findings and community consultation about the way forward; preliminary project activities (skills training for volunteer health workers; partnership building and a youth rally) as a way of illustrating what we believe are six key strategies for facilitating the development of ‘AIDS-competent’ communities: building knowledge and basic skills; creating social spaces for dialogue and critical thinking; promoting a sense of local ownership of the problem and incentives for action; emphasising community strengths and resources; mobilising existing formal and informal local networks; and building partnerships between marginalized communities and more powerful outside actors and agencies, locally, nationally and internationally. We discuss some of the triumphs and trials of this work, concluding with a discussion of the need to set realistic goals when working at the community level in highly conservative patriarchal communities to tackle problems which may be shaped by economic and political processes over which local people have little control. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
50. Childhood sexuality and rights in the context of HIV/AIDS.
- Author
-
Bhana, Deevia
- Subjects
CHILDREN & sex ,CHILDREN'S rights ,AIDS ,HIV infections - Abstract
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.)
- Published
- 2007
- Full Text
- View/download PDF
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