SAHARA-J : Journal of Social Aspects of HIV/AIDS, published by Taylor and Francis Group on behalf of SAHARA, disseminates vital open access research on social factors relating to HIV/AIDS. Areas covered include care, support, behaviour change, behavioural surveillance, counselling, impact, mitigation, stigma, discrimination, prevention, treatment, adherence, culture, faith-based approaches, evidence-based intervention, health communication, structural and environmental intervention, financing, policy, media and more.

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The Globethics.net library contains articles of Sahara-J as of vol. 1(2004) to current.

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  • Transgender in Africa: Invisible, inaccessible, or ignored?

    Jobson, GA; Theron, LB; Kaggwa, JK; Kim, H-J (Taylor & Francis, 2012-12-06)
    Transgender people are an important key population for HIV risk globally, and several studies have found HIV prevalence rates in transgender populations that are significantly higher than those among other key populations such as men who have sex with men (MSM). There is a lack of research on transgender populations in Africa, and at present, there is almost no data available on HIV prevalence and risk among transgender people on the continent. It is possible that the invisibility of transgender people in epidemiological data from Africa is related to the criminalisation of same-sex behaviour in many countries and the subsequent fear of negative repercussions from participation in research. Alternatively, transgender people may be being overlooked in research due to confusion among researchers about how to ask questions about gender identity. It is also possible that transgender populations have simply been ignored in research to date. Without research on transgender-specific HIV prevalenceand risk, it is very difficult to know what interventions and services are needed for this risk population. Therefore, it is important that researchers, governments, Non Governmental Organisations (NGOs) and donor organisations begin to pay explicit attention to transgender people in their HIV-related research and programmes in Africa.
  • Conflicting discourses of church youths on masculinity and sexuality in the context of HIV in Kinshasa, Democratic Republic of Congo

    San Sebastian, M; Lusey, H; Edin, KE; Christianson, M; Dahlgren, L (Taylor & Francis, 2014-10-08)
    Masculinity studies are fairly new and young churchgoers are an under-researched group in the current Congolese church context. In response to this knowledge gap, this paper attempts to explore discourses of young  churchgoers from deprived areas of Kinshasa regarding masculinity and sexuality in the era of HIV. A series of 16 semi-structured interviews were conducted with unmarried young churchgoers from the Salvation Army, Protestant and Revival churches. The interviews were tape-recorded, transcribed verbatim and analysed using discourse analysis. Five main discourses emerged: ‘we are aware of the church message on sex’, ‘young men need sex’, ‘young women need money’, ‘to use or not to use condoms’ and ‘we trust in the church message’. Although all informants knew and heard church messages against premarital sex, many of them were sexually active. The perception was that young men were engaged in sexual activities with multiple partners as a result of sexual motivations surrounding masculinity and sexual potency, while young women sought multiple partners through transactional and intergenerational sex for economic reasons. These sexual practices of young people conflicted with church messages on sexual abstinence and faithfulness. However, a small number of participants challenged current gender norms and suggested alternative ways of being a man or a woman. To elucidate these  alternatives, we suggest that church youths and church leaders might take concrete actions to deconstruct misconceptions about being men. In this way, they can possibly enhance a frank and fruitful dialogue on sex, sexuality and gender to promote positive masculinities and constructive partnerships to prevent HIV.Keywords: masculinity, sexuality, young churchgoers, HIV prevention, gender equality, DR CongoDans le contexte actuel des e´glises Congolaises, les e´tudes relatives a` la masculinite´ sont presque re´centes et les jeunes chre´tiens constituent un groupe d’individus qui ne font pas l’objet des recherches scientifiques  approfondies. En re´ponse a` cette insuffisance de connaissances dans le contexte a` VIH, le pre´sent article tente d’explorer les discours relatifs a` la masculinite´ et a` la sexualite´ des jeunes chre´tiens issus des  quartiers de´favorise´s de Kinshasa. Une se´rie de 16 interviews semi-structure´es ont e´te´ mene´s aupre`s des jeunes chre´tiens ce´libataires appartenant a` l’Arme´e du Salut, aux e´glises Protestantes et a` celles du Re´veil du Congo. Les interviews ont e´te´ enregistre´es et analyse´es en utilisant la me´thode du discours. Cinq discours ont e´merge´ notamment: « Nous connaissons le message des e´glises au sujet du sexe », « les garc¸ons ont besoin des rapports sexuels », « les filles ont besoin d’argent », « faudrait-il utiliser ou ne pas utiliser les condoms » et « nous croyons dans le message des e´glises ». Alors que tous les participants  connaissaient le message des e´glises qui interdisent les rapports sexuels pre´maritaux, beaucoup d’entre eux e´taient de´ja` sexuellement actifs. Les garc¸ons ont e´te´ perc¸us comme des personnes qui ont des rapports sexuels avec plusieurs partenaires concomitants pour prouver leur masculinite´ et leur puissance sexuelle. Les filles chercheraient a` avoir des rapports sexuels mercantiles et interge´ne´rationnels avec des partenaires  multiples a` des fins e´conomiques. Ces pratiques sexuelles des jeunes s’opposent aux discours des e´glises  qui promeuvent l’abstinence sexuelle et la fide´lite´. Cependant, quelques participants ont remis en cause les normes courantes du genre et ont sugge´re´ des alternatives en ce qui concerne l’identite´ des hommes et des femmes. Pour les e´lucider, nous proposons que les jeunes chre´tiens et les leaders des e´glises puissent mener des actions concre`tes dans le but de de´construire les conceptions errone´es de ce que veut dire eˆtre homme. Ce faisant, ils peuvent probablement maximiser les chances d’un dialogue franc et productif en ce qui concerne le sexe, la sexualite´ et le genre afin de promouvoir la masculinite´ positive et le partenariat  constructif, susceptibles de pre´venir l’infection a` VIH.Mots cle´s: masculinite´, sexualite´, jeunes chre´tiens, pre´vention du VIH, e´galite´ du genre, RD Congo
  • Alcohol abuse, gender-based violence and HIV/AIDS in Botswana: establishing the link based on empirical evidence

    D Ntseane; Department of Social Work at the University of Botswana.; K Nthomang; Department of Social Work, University of Botswanamage/pj; OD Phorano; Department of Social Work at the University of Botswana (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-26)
    The existence of gender-based violence has been a source of concern within the public and private sectors as well as civil society organisations in Botswana. The present study investigated the link between alcohol abuse, gender-based violence and HIV/AIDS. Further, it attempted to unravel the often unquestioned assumption that gender-based violence is perpetuated by cultural practices. Case study qualitative methodology was used to gather data for the study.A sample of 20 cases was selected purposively from five women\'s non-governmental organisations. In addition, in-depth interviews were conducted with agency coordinators, social workers, police commanders and police officers. The findings of the study revealed a relationship between alcohol abuse and gender-based violence, which makes victims vulnerable to HIV infection. From the findings, it is recommended that gender-based programmes be established to sensitise people about the link between alcohol abuse, gender based violence and HIV/AIDS. Key words: gender-based violence, alcohol abuse, HIV/AIDS, Botswana, poverty, NGOs. RÉSUMÉ L\'existence de la violence sexiste fut une source d\'inquiétude dans les secteurs publics et privés ainsi que dans des organisations de la société civile au Botswana. Cette étude a mené une enquête sur le lien entre l\'abus d\'alcool, la violence sexiste et le VIH/SIDA. De plus, elle a tenté de démêler la supposition que la violence sexiste est perpétuée par des pratiques culturelles. Cette étude a utilisé la méthodologie quanlitative de cas d\'étude afin de recueillir les données. Un échantillon de 20 cas a été intentionnellement sélectionné à partir de cinq organisations non-gouvernementales de femmes. En outre, des entretiens profonds ont été menés auprès de coordinateurs des agences, des assistants sociaux et des chefs de la police. Les résultats de cette étude ont tout dit du lien entre l\'abus d\'alcool et la violence sexiste qui rendent les victimes encore plus vulnérables à la contamination du VIH.A partir de résultats, il est recommandé que des programmes sexistes soient mis en place afin de sensibiliser les gens du lien entre l\'abus d\'alcool, la violence sexiste et le VIH/SIDA. Mots clés: la violence sexiste, l\'abus d\'alcool, le VIH/SIDA, le Botswana, la pauvreté, les ONGs. Sahara J Vol.2(1) 2005: 188-202
  • HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia

    YK Teh (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
    This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; hormone-taking behaviour; safe sex; health care; substance abuse; harassment from authorities; and HIV prevention. The HIV problem among the mak nyah, mak nyah sex workers and their clients is critical. Many do not have in-depth HIV/AIDS knowledge and do not practise safe sex. The problem gets worse when most mak nyah do not consider HIV/AIDS as a primary concern because of other pressing problems like employment and discrimination. There are also no HIV prevention activities in many parts of Malaysia. Mak nyah also face constant harassment from enforcement authorities for prostitution. This hampers HIV prevention work. Keywords: Transsexuals, transgender, sex workers, HIV prevention. SAHARA-J Vol. 5 (4) 2008: pp. 178-185
  • The Farmer Life School: experience from an innovative approach to HIV education

    M Salomon; M Mudhara; JF Bunders; K Swaans; M Mweli; JE Broerse (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-08-14)
    The Farmer Life School (FLS) is an innovative approach to integrating HIV education into life skills and technical training for farmers. This study aims to gain insight into the strengths and weaknesses of this relatively new approach, through the implementation of an adapted version in South Africa. The results are presented of a pilot with three groups of community gardeners, predominantly women, attending weekly sessions. Impact was assessed in terms of three key elements: participation, learning, and empowerment. Data were collected through extensive session reports, follow-up interviews, and reflection exercises with facilitators and participating groups and individuals. The results suggest that a group-based discovery learning approach such as the FLS has great potential to improve food security and wellbeing, while allowing participants to explore issues around HIV/AIDS. However, the analysis also shows that HIV/AIDS-related illness and death, and the factors that drive the epidemic and its impact, undermine farmers\' ability to participate, the safety and trust required for learning, and the empowerment process. Participatory approaches such as the FLS require a thorough understanding of and adaptation to the context. Keywords: Farmer Life School, HIV/AIDS, participation, learning, empowerment.SAHARA J Vol. 5 (2) 2008: pp. 56-64
  • Book ReviewHIV/AIDS and Democratic Governance in South Africa: Illustrating the Impact on Electoral ProcessesBy Per Strand, Khabele Matlosa, Ann Strode & Kondwani Chirambo (2005)

    Pugh, Sarah; Dalhousie University, Canada (Taylor & Francis, 2006-04-26)
    Institute for Democracy in South Africa (IDASA), Pretoria, South AfricaISBN 1-919798-80-3 SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 354-355
  • Book ReviewHIV/AIDS and Democratic Governance in South Africa: Illustrating the Impact on Electoral ProcessesBy Per Strand, Khabele Matlosa, Ann Strode & Kondwani Chirambo (2005)

    Sarah Pugh; Dalhousie University, Canada (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2006-04-26)
    Institute for Democracy in South Africa (IDASA), Pretoria, South AfricaISBN 1-919798-80-3 SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 354-355
  • Book ReviewHIV/AIDS and Democratic Governance in South Africa: Illustrating the Impact on Electoral ProcessesBy Per Strand, Khabele Matlosa, Ann Strode & Kondwani Chirambo (2005)

    Pugh, Sarah; Dalhousie University, Canada (Taylor & Francis, 2006-04-26)
    Institute for Democracy in South Africa (IDASA), Pretoria, South AfricaISBN 1-919798-80-3 SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 354-355
  • Stigma, discrimination and its implications for people living with HIV/AIDS in South Africa

    S Mfecane; Social Aspects of HIV/AIDS and Health research programme of the HSRC; D Skinner; Social Aspects of HIV/AIDS and Health research programme at the HSRC (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-06)
    Stigma and discrimination play significant roles in the development and maintenance of the HIV epidemic. It is well documented that people living with HIV and AIDS experience stigma and discrimination on an ongoing basis. This impact goes beyond individuals infected with HIV to reach broadly into society, both disrupting the functioning of communities and complicating prevention and treatment of HIV.This paper reviews the available scientific literature on HIV/AIDS and stigma in South Africa, as well as press reports on the same subject over a period of 3 years. Analysis of this material indicates that stigma drives HIV out of the public sight, so reducing the pressure for behaviour change. Stigma also introduces a desire not to know one\'s own status, thus delaying testing and accessing treatment. At an individual level stigma undermines the person\'s identity and capacity to cope with the disease. Fear of discrimination limits the possibility of disclosure even to potential important sources of support such as family and friends. Finally, stigma impacts on behaviour change as it limits the possibility of using certain safer sexual practices. Behaviour such as wanting to use condoms could be seen as a marker of HIV, leading to rejection and stigma. All interventions need to address stigma as part of their focus. However, the difficulty of the task should not be underestimated, as has been shown by the persistence of discrimination based on factors such as race, gender and sexual orientation. Key words: HIV,AIDS, stigma, Africa, discrimination. La stigmatisation, la discrimination et ses implications pour les gens vivant avec le VIH/SIDA en Afrique du Sud RÉSUMÉ La stigmatisation et la discrimination jouent des rôles importants dans le développement et le maintien de l\'épidémie de VIH. Il existe beaucoup de travaux écrits sur la stigmatisation et la discrimination que subissent, de manière continue, les personnes vivant avec le VIH/SIDA. Cet impact va au-delà des individus contaminés du VIH et atteint la société en gros. Cet impact, à la fois bouleverse le fonctionnement de communautés et complique la prévention et le traitement du VIH. La présente communication a pour but de passer en revue la littérature scientifique existante sur le VIH/SIDA et la stigmatisation en Afrique du Sud ainsi que les rapports de presse sur le même sujet au cours d'une période de 3 ans. Une analyse de ce matériel indique que la stigmatisation cache le VIH du public, de sorte, la pression de changement du comportement est réduite. La stigmatisation suscite un désir de ne pas vouloir savoir son statut sérologique. De ce fait, le dépistage et l'accès au traitement sont retardés. Au niveau individuel, la stigmatisation sape l'identité de la personne et sa capacité de faire face à la maladie. La peur d'être discriminé réduit la possibilité de dévoiler son état sérologique même auprès des sources de soin importantes comme la famille et des amis. Enfin, la stigmatisation a un impact sur le changement comportemental étant donné qu'elle réduit la possibilité d'avoir des rapports sexuels sans risque. Vouloir utiliser un préservatif peut être considéré comme signe de VIH suivi par le rejet et la stigmatisation. Toutes les interventions doivent mettre l'accent sur la stigmatisation.Toutefois, la difficulté de cette tache ne doit pas être sous-estimée. Cette difficulté apparaît dans la persistance de discrimination basée sur des facteurs comme la race, le sexe et l'orientation sexuelle. Mots clés: VIH, SIDA, stigmatisation, Afrique, discrimination. Sahara J Vol.1(3) 2004: 157-164
  • ‘Public enemy no. 1’: Tobacco industry funding for the AIDS response

    Smith, Julia; Thompson, Sheryl; Lee, Kelley (Taylor & Francis, 2016-03-31)
    This article analyzes the history of tobacco industry funding for the AIDS response – a largely ignored aspect of private donor involvement. Primary documents from the Legacy Tobacco Documents Library and AIDS organizations are analyzed, alongside existing literature on the tobacco control and AIDS responses. Research on the tactics of transnational tobacco companies has documented how they have used various charitable causes to subvert tobacco control efforts and influence public health policy. This raises questions, which this paper seeks to answer, about if donations by tobacco companies to AIDS organizations have been used for similar means, and if so how AIDS organizations have responded to tobacco industry overtures. Two examples illustrate how tobacco companies initially tried to use the AIDS response to counter tobacco control measures: (1) During the 1990s, Philip Morris, one of the largest corporate donors of the AIDS response in the USA, used its connections with AIDS organizations to create competition for health resources, improve its reputation, and market tobacco products to the LGBT community; (2) In both Latin America and sub-Saharan Africa, Philip Morris and British American Tobacco championed the AIDS response in order to delegitimize efforts to develop the World Health Organization’s Framework Convention on Tobacco Control. However, from the late 1990s onwards, AIDS organizations began to refuse tobacco funding and partnerships – though these policies have been not comprehensive, as many tobacco companies still fund programs in sub-Saharan Africa. The article concludes that tobacco companies aimed to exploit competition between health issues, and use the high-profile AIDS response to improve their reputation and market access. However, AIDS organizations, adhering to broader health goals and drawing on extensive resources and networks, were able to shut the tobacco industry out of much of the response, though pockets of influence still exist. This demonstrates the importance of co-operation and policy convergence across health sectors and suggests that tobacco control advocates, and other charitable sectors that receive funding from the tobacco industry, may be able to draw lessons from the experiences of AIDS organizations.Keywords: HIV, AIDS, donors, corporations, WHO, tobacco industry
  • Compassion or condemnation? South African Muslim students' attitudes to people with HIV&AIDS

    University of KwaZulu-Natal; Paruk, Zubeda; School of Psychology at the University of KwaZulu-Natal; Mohamed, Sitti Djamela; University of KwaZulu-Natal (Taylor & Francis, 2007-02-28)
    Given the dearth of literature on the influence of religiosity on attitudes toward people with HIV/AIDS, the present study surveyed these variables in a sample of South African Muslim university students using the Religious Orientation Scale (ROS) and an attitude to people with HIV scale. Gender differences in attitudes towards people with HIV were also examined. The sample comprised 90 male and female undergraduate and postgraduate Muslim students. While both males and females displayed high religiosity scores, male students were found to be significantly more religious than female students. No gender differences were found on the attitude to people with HIV scale, with students indicating positive attitudes to people with HIV. Higher religiosity was significantly correlated with a more positive attitude to people with HIV. The implications of the findings are discussed. Keywords: HIV/AIDS, attitudes, religiosity, Muslim, students. RÉSUMÉ Etant donné le manque de littérature sur l'influence de la bigoterie sur les attitudes envers des gens séropositifs, cette étude a examiné ces variables auprès d'un échantillon d'étudiants universitaires musulmans sud-africains en utilisant le barème d'orientation religieuse (ROS) et le barème de l'attitude envers les gens séropositifs. Les différences de sexes aux attitudes envers des gens séropositifs étaient également étudiées. L'échantillon consistait de 90 étudiants musulmans hommes et femmes de deuxième et troisième cycles. Pendant que tous les étudiants, hommes et femmes, montraient des résultats de la bigoterie élevés, les hommes étaient plus religieux que les femmes. Il n'y a pas eu de différences de sexes sur le barème des attitudes envers les gens séropositifs chez les étudiants qui montraient des attitudes positives envers les séropositifs. Une bigoterie plus élevée était sensiblement en corrélation avec une attitude plus positive envers des séropositifs. Les implications des résultats sont exposés. Mots clés:VIH/SIDA, attitudes, bigoterie,Musulman, étudiants.
  • Social support seeking and self-efficacy-building strategies in enhancing the emotional well-being of informal HIV/AIDS caregivers in Ibadan, Oyo state, Nigeria

    Okeke, Bernedette Okwuchukwu (Taylor & Francis, 2016-03-31)
    This study examined the relative efficacy of social support seeking (SSS) and self-efficacy building (SEB) in the management of emotional well-being of caregivers of people suffering from HIV/AIDS. It was based at the United States President’s Emergency Plan for AIDS Relief (PEPFAR) center in the University College Hospital, Ibadan, Oyo state, being the first and the largest teaching hospital in Nigeria. A 3 × 2 factorial design consisting of treatment and a control group was used. The columns have two levels of gender being male and female caregivers. One-hundred and sixty-five (165) caregivers who were taking care of people that are suffering from HIV/AIDS were purposively selected and randomly assigned to the treatment groups and control. The treatment was carried out for a period of eight weeks. Two null hypotheses were tested, both at .05 levels of significance. Data were collected with the use of standardized intruments rating scale; social support scale, general self-efficacy scale and emotional well-being scale. ANCOVA was used to establish significant treatment effects with the pretest as covariate. Even though SSS and SEB were both found to be effective in enhancing the emotional well-being of informal caregivers in this study when compared to the controls, SSS was significantly more effective than SEB in achieving this goal. Since the HIV/AIDS patients cannot be adequately cared for in the hospital settings due to severe shortages of material, personnel and time, serious efforts should be made by the three levels of the health care system viz: the primary, secondary and tertiary health care systems, to encourage the employment of the psychological management of caregivers of people suffering from HIV/AIDS. Also, the psychologists, clinical psychologists and the significant others should be encouraged to employ this psychological management in the care of HIV/AIDS informal caregivers.Keywords: HIV/AIDS, informal caregivers, enhancing emotional well being
  • Self-care among caregivers of people living with HIV and AIDS in Kakola location, Nyando District, Kisumu County, Kenya

    Geteri, LM; Angogo, EM (Taylor & Francis, 2014-02-21)
    This study was carried out in Kakola Location of Nyando District in Kenya. The aim of study was to determine the factors influencing the practice of self-care among caregivers for person living with HIV/AIDS (PLWHAs) as well as their practice of self-care. A study by World Health Organization approximated that in developing countries, the need for long-term care will increase by as much as 40% in the coming years. HIV/AIDS has been cited as one of the challenges in long-term care. As demand for long-term care increases, the assumption that extended family networks can meet all the needs of their members deteriorates. The community-based survey employed descriptive cross-sectional design, involving primary caregivers of PLWHAs in Kakola location who had practiced care giving for more than 3 months. A household survey was conducted with 150 respondents. Quantitative data were analyzed using the Statistical Package for Social Sciences (SPSS) program version 11.0. Simple frequencies and cross tabulations to compare variables were produced. Microsoft Excel was used to produce tables and graphs. Majority of the respondents 124 (82.7%) were female, while 26 (17.3%) were male. Self-care elements most  practiced by the respondents in all the age categories were infection prevention and nutritional care. Female respondents had the highest proportions in all the practices of self-care. The results also showed that gender, relationship of patient to caregiver and marital status were the main demographic factors that significantly influenced the practice of self-care among caregivers. There was a significant relationship between main sources of income of caregivers with the practice of self-care. The study also revealed that respondents with no education had the lowest number of respondents practicing all the six practices of self-care and  belonging to a support group. Recommendations for the study included, forging partnerships among stakeholders, training of caregivers and review of the home-based care policy.Keywords: self-care, primary caregivers, Kenya, PLWHAs, HIV and AIDS
  • Awareness and practices of contraceptive use among university students in Botswana

    Hoque, ME; Ntsipe, T; Mokgatle-Nthabu, M (Taylor & Francis, 2014-02-21)
    In Botswana, unplanned pregnancies, especially among the youth constitutes a growing health and social problem. Research in the field of contraceptive practices, and the causes of sexual practices in Botswana, remains scarce and relatively limited. The objectives of this study was to investigate the awareness and utilization of various contraceptive methods, among university students in Botswana. A descriptive, cross-sectional, research study was conducted among 346 randomly selected students, who completed confidential, self-administered questionnaires. The average age of the respondents was 21 years (SD ¼ 2.8 years). The level of awareness among students regarding contraception was good (score ≥9). Both the male and the female students had almost similar awareness level of contraceptive use, as their mean scores were 8.79 and 8.72, respectively (p ¼ .733). All the female students (100%) were ‘aware’ that the effectiveness of the contraceptives used, as compared to male students, being 93.7%. A greater proportion of the female students (90.6%) knew that using contraceptives irregularly would result in pregnancy, in contrast to 76.4% males. More than half (59.0%) of the students indicated that they had engaged in sexual acts. Significantly, more male students (68.5%) had sexual experiences prior to the study, compared to 54.5% of their female counterparts (p ¼ .038).The majority of the students (76%) reported that they had always used contraceptive methods. The most  commonly used contraceptive method was the condom (95.6%), followed by oral contraceptive pill (86.7%). There was no significant association found between the level of awareness and the use of contraceptives. Results suggested that many students still engaged in risky, contraceptive practices by engaging in unprotected sexual acts. Therefore, there is a need to educate the students about sexually transmitted infections, the different contraceptive methods and the regular use of the available contraceptives.Keywords: awareness, utilization, contraception, university students, Botswana
  • A review of the response to HIV/AIDS in Trinidad and Tobago: 1983–2010

    Laptistea, C; Beharry, V; Edwards-Wescottc, P (Taylor & Francis, 2014-02-21)
    This paper examines the character of the response to HIV/AIDS in Trinidad and Tobago and assesses the impact of the response on reducing the spread of the epidemic. The launch of the National HIV/AIDS Strategic Plan in 2004 signalled the intent of the government to take the response to HIV/AIDS to a different level. This is seen by the sheer increase in the volume of resources allocated to the response from the levels of the 1980s and 1990s. The expectation was that there would be increased cohesiveness, which would allow for targeted interventions to be more effective. Though in 2009, there was a slight increase in the HIV prevalence rate to 1.5%, this was due mainly to improvements in access to antiretrovirals and same-day testing as well as improvements in data collection and analysis. The annual number of new infections fell from a high of 1709 in 2003 to 1154 in 2010. Additionally, great strides have been made in the prevention of mother-to-child transmission programme with some regions reporting 100% coverage of antenatal attendees. The study indicates that the country has responded relatively well in the areas of Strategic Planning, Care and Support, and Prevention and there has been involvement by both the public and private sector (NGOs in particular), in the response. However, there are gaps in the provision of social services and the implementing legislation to protect the rights of persons living with HIV/AIDS. Of note is the fact that a successful response to the HIV/AIDS epidemic is one that embraces all social groups, all spheres of activity and all areas of the country.Keywords: HIV/AIDS, response, health sector, treatment and care, prevention
  • A comparison of quality of life between HIV positive and negative diamond miners in South Africa

    Gow, J; George, G; Govender, K (Taylor & Francis, 2014-02-21)
    Objective: To analyse the health-related quality of life (HR-QOL) in two groups of diamondminers (HIVnegative and positive) in South Africa using three instruments. Two hypotheses were to be tested. One, was that the HR-QOL of HIV positive miners would be lower than that of HIV negative miners; and two, the selected instruments would behave consistently and thus all would confirm hypothesis one. Methods: In our study, workers were recruited during a voluntary counselling and testing programme for HIV. HR-QOL were estimated using the Assessment of Quality of Life (AQOL) Mark 2, EQ-5D (EuroQOL), and Health Utilities Index 3 (HUI3) instruments. The data were analysed for utility values and for correlations between variables of interest (in particular HIV status). Goodness of fit, Pearson’s r coefficient and t-tests were the statistical tests applied to the data. Results: Just over 1100 respondents were included in the analysis. HIV positive workers scored significantly lower on quality of life on the HUI3 as compared to HIV negative workers but this relationship did not (surprisingly) hold for the AQOL or EQ-5D. There was a significant positive correlation between all three instruments. Conclusion: There was inconsistency among the instruments in measuring quality of life differences according to HIV status. The HUI3 confirmed the a priori expectation that the HR-QOL of HIV positive miners would be lower than HIV negativeminers. There was no statistical difference for theAQOL and a confounding result was found for the EQ5D.Keywords: health-related quality of life, South Africa, miners
  • Accessibility of antiretroviral therapy in Ghana: Convenience of access

    Addo-Atuah, J; Gourley, D; Gourley, G; White-Means, SI; Womeodu, RJ; Faris, RJ; Addo, NA (Taylor & Francis, 2012-08-28)
    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants’ perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, orotherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin’s case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. . Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA.. Waiting time to receive care was from 4 to 9 h. . While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. . The PLWHA corroborated the providers’ description of the procedure for initiating and monitoring ART in Ghana. . PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider–patient communication, which might explain the PLWHA’sunderstanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.
  • Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria

    Johnson, OE (Taylor & Francis, 2012-08-28)
    People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive studycarried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25–44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apartfrom spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reportedfrom the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society.
  • Contraceptive practices in the era of HIV/AIDS among university students in KwaZulu-Natal, South Africa

    Hoque, M; Ghuman, S (Taylor & Francis, 2012-08-27)
    University students as a population of young adults are reportedly at a higher risk of acquiring sexually transmitted infections and HIV infection than the general public due to their higher levels of sexual  experimentation and unsafe sexual practices. The objective of thiscross-sectional study was to find the patterns of contraceptive use among university students at Mangosuthu University of Technology (MUT), KwaZulu-Natal, South Africa. A total of 752 students were selected by stratified random sampling techniques. A self-administered questionnaire probing contraceptive usage and reasons for non-usage was used to collect data. The results were summarized using means (SD) for continuous variables and percentages for categorical variables. Chi-square test was used to find the association between gender and contraceptive use. The mean age of the participants was 21.25 years (SD ¼ 2.99). Fifty-ninepercent (n ¼ 442) were sexually active. Of the sexually active students, 90.7% (n ¼ 401) used contraceptives. Among contraceptive users, 90.5% (n ¼ 363) used condoms. Gender was not significantly associated (p ¼ 0.327) with contraceptive use, but there was a significant association between gender and condom use as males used condom more than females (p , 0.001). Eighty-one percent (n ¼ 323) of the sexually active students reported that they had used a contraceptive the last time they had sex. Regarding frequency of contraceptive use, 38.7% (n ¼ 155) reported that they use contraceptives sometimes or rarely. The frequency of contraceptive use was not significantly related to gender (p ¼ 0.305). Among 60 participants those who disapproved of using contraception, 68.3% (n ¼ 41) were afraid that contraception would cause sterility and 6 students reported that contraception would make their partner promiscuous. In conclusion, a large proportion of university students at MUT in South Africa are sexually active and use contraception, but the use may be inconsistent. Thus, more research is needed to create  interventions on contraception uptake.
  • Social and cultural aspects of HIV and AIDS in West Africa: A narrative review of qualitative research

    Samuelsen, H; Norgaard, O; Ostergaard, LR (Taylor & Francis, 2012-08-28)
    With the increasing focus on the role of social aspects of the HIV epidemic in sub-Saharan Africa, the need for an overview of existing research dealing with such issues has become more urgent. The objective of this article is to provide a thematic overview of existing qualitative research on HIV and AIDS in the West African region and to analyze the main researchfindings in order to identify possible gaps and recommend new research themes to inform future research-based interventions. The analysis is based on a total of 58 articles published from 2001 to 2009 in English or French identified through a literature search in seven scientific, bibliographical databases. Searches included terms related to qualitative studies combined with various terms related to HIV/AIDS. The results of this narrative review show that there was a geographical concentration on Nigeria, Ghana, Burkina Faso and Coˆte d’Ivoire and a strong urban bias, with most studies taking place in the capital cities of these countries. The majority of the studies focused on women or women and men; only four articles dealt exclusively with men, of which only two were on men who have sex with men. The main study groups were people living with HIV, young people or female sex workers. Sexual risk-taking and  stigmatization were the themes that were most prominently explored in the articles we reviewed. We conclude that research needs to be strengthened in relation to the analysis of experiences with antiretroviraltherapy and the non-optimal access to treatment in West Africa. Also, more research is needed on men and their exposure to HIV/AIDS, as well as on the role of concurrent partnership in the spread of HIV.

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