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.


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

Recent Submissions

  • Provision of HIV testing services and its impact on the HIV positivity rate in the public health sector in KwaZulu-Natal: a ten-year review

    Rizwana Desai; Stanley Onwubu; Elizabeth Lutge; Nondumiso Patience Buthelezi; Nirvasha Moodley; Firoza Haffejee; Bontle Segobe; Suresh Babu Naidu Krishna; Maureen Nokuthula Sibiya; Champaklal Chhaganlal Jinabhai (Taylor & Francis Group, 2024-12-01)
    ABSTRACTSouth Africa has been rated as having the most severe HIV epidemic in the world since it has one of the largest populations of people living with HIV (PLHIV). KwaZulu-Natal (KZN) is the epicentre of the HIV epidemic. The HIV test and treat services in the public health sector are critical to managing the epidemic and responding to the increase in HIV infections. The KwaZulu-Natal Department of Health (DOH) commissioned a review of the provision of HIV testing services in the province and aimed to investigate its impact on the HIV positivity rate over a ten-year period. The study was an ecological study design using data extracted from the Department’s District Health Information System (DHIS). Descriptive analysis was conducted in addition to ANOVA and multiple regression analysis. The results of this study have shown that the total number of HIV tests conducted over the ten-year period in the province has increased with the highest number of HIV tests being conducted in the 2018/2019 MTEF year. ANOVA analysis indicates that there was a statistically significant difference in the total number of HIV tests conducted and the number of HIV tests per 100 000 population across the province’s 11 districts (p < 0.001). Statistically significant differences were observed in the HIV testing rate and in the HIV positivity rate over the period (p < 0.001). Results from multiple regression analysis showed that the HIV testing rate per 100 000 population was the strongest predictor of the HIV positivity rate. HIV positivity among clients correlated negatively with the number of HIV tests conducted per 100 000 population (r = −0.823; p < 0.001) and the HIV testing rate (r = −0.324; p < 0.01). This study has found that HIV testing could have an impact on reducing the positivity rate of HIV in the province and is therefore an effective strategy in curbing the HIV epidemic. The KwaZulu-Natal Department of Health should ensure that strategies for implementing and maintaining HIV testing and treating services should continue at an accelerated rate in order to achieve the first 95 of the UNAIDS 2025 SDG target.
  • Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data

    Victor Mudhune; Kate Winskell; Robert A. Bednarczyk; Ken Ondenge; Calvin Mbeda; Emily Kerubo; Richard Ndivo; Judith Arego; Marissa Morales; Brianna Halliburton (Taylor &amp; Francis Group, 2024-12-01)
    ABSTRACTSexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices.Trial registration: identifier: NCT04437667.
  • Spatial variations in STIs among women enrolled in HIV prevention clinical trials in Durban, KwaZulu-Natal, South Africa

    Reshmi Dassaye; Handan Wand; Tarylee Reddy; Frank Tanser; Benn Sartorius; Natashia Morris; Gita Ramjee (Taylor &amp; Francis Group, 2023-12-01)
    ABSTRACTSouth Africa is faced with a high HIV and STI prevalence and incidence, respectively, with pockets of high burden areas driving these diseases. Localised monitoring of the HIV epidemic and STI endemic would enable more effective targeted prevention strategies. We assessed spatial variations in curable STI incidence among a cohort of women enrolled in HIV prevention clinical trials between 2002 and 2012. STI incidence rates from 7557 South African women enrolled in five HIV prevention trials were geo-mapped using participant household GPS coordinates. Age and period standardised incidence rates were calculated for 43 recruitment areas and Bayesian conditional autoregressive areal spatial regression (CAR) was used to identify significant patterns and spatial patterns of STI infections in recruitment communities. Overall age and period standardised STI incidence rate were estimated as 15 per 100 PY and ranged from 6 to 24 per 100 PY. We identified five significant STI high risk areas with higher-than-expected incidence of STIs located centrally (three-locations) and southern neighbouring areas of Durban (two-locations). Younger age (<25), not married/cohabitating, parity <3 and poor education were all significant correlates of high STI communities. Findings demonstrate sustained STI incidence rates across the greater Durban area. The role of STI incidence in HIV acquisition in high HIV endemic areas need to be revisited as current highly effective PrEP interventions do not protect from STI acquisition. In these settings there is an urgent need for integrative HIV and STI prevention and treatment services.
  • “ …  [I]f I can [be] infected now that means I am going to die … ”: an explorative study focusing on vulnerable, immunocompromised groups and caregivers experiences and perceptions of the Covid-19 pandemic in South Africa

    Alicia North; Allanise Cloete; Shandir Ramlagan; Thabang Manyaapelo; Amukelani Ngobeni; Noloyiso Vondo; Derrick Sekgala (Taylor &amp; Francis Group, 2023-12-01)
    ABSTRACTIn this paper, we explored how vulnerable, immunocompromised groups and caregivers of the elderly experienced and perceived the onset of the Covid-19 pandemic in South Africa. Semi-structured interviews were conducted remotely between the 5th andthe 18th of April 2020 in the three South African provinces hardest hit by Covid-19, namely Gauteng, KwaZulu-Natal and the Western Cape. In total, 60 qualitative key informant interviews and one focus group discussion were conducted. Study participants expressed concerns for elderly people and people with underlying health conditions because of their increased vulnerability to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). People living with HIV expressed an increased fear of infection following the advent of the Covid-19 pandemic in South Africa. The sidelining of healthcare services and stock-outs of medication proved to be an added concern in particular for vulnerable and immunocompromised groups. Overall, the data suggest that the fear of infection is ubiquitous for people who live in unstable environments such as overcrowded townships and informal settlements. Given the increased fears of infection brought on by the Covid-19 pandemic, the mental health of vulnerable communities and those caring for them becomes an added burden for people living in unstable environments.
  • Factors influencing the adoption of HIV prevention measures in low socio-economic communities of inner-city Durban, South Africa

    Firoza Haffejee; Jennifer Ducray; Jyotika Basdav; Colette Kell (Taylor &amp; Francis Group, 2023-12-01)
    ABSTRACTSouth Africa is the epicentre of the HIV pandemic. Although there have been health promotion education campaigns to reduce HIV incidence, these have not achieved the desired outcomes. When exploring the effectiveness of these campaigns, it is useful not only to examine HIV knowledge, but also to explore the relationship between that knowledge and health-related behaviour. This study aimed to determine the (1) level of knowledge of HIV prevention, (2) relationship between the level of knowledge and the adoption of these behaviours and (3) barriers to sexual behaviour change of vulnerable women in Durban’s city centre, KwaZulu-Natal, South Africa. A mixed methods approach was used to collect information from a marginalised population of women (n = 109) attending a non-governmental organisation, which provides for the needs of people from low socio-economic strata. Data were collected during September 2018 at a wellness day programme at the centre. A total of 109 women, over the age of 18 years answered the questionnaire. Knowledge of HIV transmission was high, with majority of participants correctly identifying modes of transmission. Almost all the participants (91.2%) had been tested for HIV, with 68.8% tested a minimum of three times. Despite this, sexual risk behaviour was high. Despite the high level of knowledge of HIV transmission, there was no relationship between HIV knowledge and adoption of behaviours for the prevention of HIV transmission (p = .457). However, bivariate analysis showed an association between transactional sex and living in informal housing (OR = 31.94, 95% CI: 5.65–180.63, p < .001). Living in informal housing was also associated with having multiple current sexual partners (OR = 6.30, 95% CI: 1.39–28.42, p = .02). Multivariate analysis, after adjusting for all other factors, indicated that the odds of having transactional sex was increased by 23 times in those who did not have formal housing (OR = 23.306, 95% CI: 3.97–144.59, p = .001). Qualitative responses showed that women perceived poverty as the overarching factor determining the lifestyle choices which impacted their health. They indicated a need for employment opportunities and provision of housing to alleviate both poverty as well as transactional sex. Although, participants from this study understood the benefits of the protective behaviours to prevent HIV transmission, economic and social factors do not afford this vulnerable group the opportunity nor the motivation to adopt such behaviours. In the current climate of increasing unemployment and escalating GBV, urgent interventions are needed in terms of employment opportunities and empowerment drives to prevent an increase in HIV transmission.
  • Challenges with couples HIV counselling and testing among black MSM students: perspectives of university students in Durban, South Africa

    Geogina Charity Gumindega; Pranitha Maharaj (Taylor &amp; Francis Group, 2022-01-01)
    Research suggests that HIV infections among men who have sex with men (MSM) are acquired from primary partners, yet MSM continually fail to take part in couples HIV counselling and testing (CHCT). To identify factors that inhibit MSM in universities from regularly testing for HIV with their sexual partners, this study considered the perspectives and experiences of 15 MSM students in Durban, South Africa. The findings show that despite appreciating the value of couple testing it is relatively uncommon. MSM resist doing so with their casual partners as this would presumably signal an intention to advance the relationship beyond the short-term. Other barriers included; experienced and perceived homophobia at public testing centres, trust-based assumptions that primary partners need not test for HIV and fear of discord. They also employed alternative strategies to purportedly determine their casual and primary partners’ status in the absence of CHCT. Alternative strategies include; initiating sexual relationships with casual partners whose sexual history is known and making use of home-based testing kits to avoid CHCT at public testing centres. These findings emphasise the need for LGBTIQ-friendly couple-based approaches as a necessary component of HIV prevention interventions among MSM in universities.
  • Social and economic consequences of HIV and AIDS on children: case study of a high-density community in Harare, Zimbabwe

    Joshua Kembo (Taylor &amp; Francis Group, 2010-12-01)
    We present results from a household-based survey that was conducted in Mabvuku, a high-density community in Zimbabwe. The objective of the study was to improve understanding of social and economic consequences of HIV and AIDS on children. Children affected by HIV and AIDS (CABA) formed the treatment group while those not affected by HIV and AIDS (non-CABA) were the control group. We found that many of the differences in the socio-economic indicators that we studied between CABA and non-CABA were not significant. Therefore our results indicate a gloomy scenario for all the children. These results are consistent with existing literature which indicates that the impact of HIV and AIDS is exacerbated by poverty. Based on evidence from this paper, we conclude that programmes and interventions targeted at children should encompass both CABA and non-CABA within a framework of sustained commitment to improving the lives of these children. We hope that our findings will be used in the formulation of interventions and strategies to improve the situation of children affected by HIV and AIDS and/or living in impoverished communities.
  • Report and policy brief from the 4th Africa Conference on Social Aspects of HIV/AIDS Research: Innovations in access to prevention, treatment and care in HIV/AIDS, Kisumu, Kenya, 29 April–3 May 2007

    G. Setswe; K. Peltzer; M. Banyini; D. Skinner; J. Seager; S. Maile; S. Sedumedi; D. Gomis; I. van der Linde (Taylor &amp; Francis Group, 2007-08-01)
    About 520 delegates from all over Africa and 21 countries attended the conference. This report and policy brief summarises the key findings and suggested policy options that emerged from rapporteur reports of conference proceedings including the following themes: (1) Orphans and vulnerable children, (2) Treatment, (3) Prevention, (4) Gender and male involvement, (5) Male circumcision, (6) People living with HIV/AIDS, (7) Food and nutrition, (8) Socioeconomics, and (9) Politics/policy. Two (11.8%) of the 17 OVC projects from the three countries were classified as best practice interventions. Of the 83 abstracts that were accepted at the conference, only 7 (8.4%) were dealing with antiretroviral therapy (ART). There has been tremendous effort by various organisations to provide information about prevention of HIV/AIDS. Information received by adolescents has been effective in increasing their knowledge, but without positive sexual behaviour change.The conference noted the contribution of gender discrimination and violence to the HIV epidemic and the different risks that men and women face in relation to the epidemic. Social scientists need to study the deep cultural meanings attached to male circumcision among different ethnic groups to be able to guide the debate on the latest biomedical findings on the protective effect of circumcision against HIV. Palliative care and support is crucial for coping among people living with HIV/AIDS (PLWHA) in order to deal with medical and psychological issues. Results from several countries have helped researchers to explore alternative ways of examining poverty in the context of HIV and AIDS. Policy frameworks which are likely to succeed in combating HIV/AIDS need to be updated to cover issues of access, testing, disclosure and stigma. In general, the conference was successful in identifying innovations in access to prevention, treatment and care in HIV/AIDS.
  • Correlates of condom use among sexually experienced secondary school male students in Nairobi, Kenya

    Marcel Yotebieng; Carolyn Tucker Halpern; Ellen MH Mitchell; Ada Adimora (Taylor &amp; Francis Group, 2009-03-01)
    This study aimed to examine perceptual factors associated with condom use, and the relationship between condom use and the timing of sexual debut among male secondary school students in Nairobi, Kenya. Data are from the TeenWeb study, a school-based project that used the World Wide Web to assess the health needs of secondary school students, and tested the web's utility as a teaching and research modality. Analyses are based on 214 sexually experienced males aged 14 – 20 years who completed webbased questionnaires about their sexual attitudes and behaviour. Results indicate that students did not see themselves as susceptible to HIV/AIDS and believed condom effectiveness in preventing HIV to be low. Consequently, only a marginal association was found between agreeing that buying condoms is embarrassing and condom use at first sexual intercourse. However, contrary to expectation, agreeing that condoms often break (almost half of participants) was associated with a higher likelihood of condom use at first sex. Each year of delay in sexual debut increased the likelihood of using a condom at first sex by 1.44 times. In turn, having used a condom at first sex increased the likelihood of using one at the most recent sex by 4.81 times, and elevated general condom use (‘most or all the time’) by 8.76 times. Interventions to increase awareness about the role of condoms in preventing HIV, delay sexual initiation, and teach proper condom use among secondary-school students in Nairobi are needed.
  • Innovations dans les approches, activités et résultats des conférences internationales sur le VIH/SIDA en Afrique — Le cas de la 3ème conférence africaine sur les aspects sociaux du VIH/SIDA, Dakar, 10 – 14 octobre 2005

    Cheikh Ibrahima Niang; O. Shisana; G. Andrews; D. Kaseje; L. Simbayi; K. Peltzer; Y. Toefy (Taylor &amp; Francis Group, 2006-08-01)
    La situation du VIH/SIDA en Afrique demeure très préoccupante. L'impact du VIH est considérable et menace la survie et le développement des sociétés africaines. Bien qu'il y ait beaucoup d'efforts, les réponses ne sont pas encore à la hauteur des défis. Le SIDA apparaît comme étant une épidémie par rapport à laquelle il est nécessaire d'avoir beaucoup de créativité dans les initiatives. C'est dans ce cadre que la 3ème conférence africaine pour la recherche sur les aspects sociaux du VIH/SIDA a apporté des innovations dans la manière de concevoir les conférences internationales, dans les activités mises en oeuvre et dans les résultats obtenus.Les innovations portent sur la manière de penser les conférences internationales et tiennent compte de la reconceptualisation du VIH/SIDA qui privilégient des approches holistiques et une plus grande visibilité des groupes vulnérables. Les activités de la conférence avaient été organisées de sorte que les PVVIH, les communautés de base et les groupes marginalisés y jouent un rôle central. La conférence a été l'occasion de développer des activités culturelles qui traduisent les concepts culturels africains qui ont été considérés comme importants dans l'analyse de la situation et des réponses concernant le VIH. Les espaces interactifs créés par la conférence ont permis de parvenir à des analyses qui abordent différentes dimensions des déterminants politiques, culturels, économiques.La conférence a suscité une réflexion autour de la construction des réponses en mettant en exergue les thèmes de l'urgence et de l'accélération des réponses, de la construction de synergie, de coordination et de la conception de réponses politiques.
  • Knowledge of HIV/AIDS and attitudes towards people living with HIV among the general staff of a public university in Malaysia

    Yvonne Tee; Mary Huang (Taylor &amp; Francis Group, 2009-12-01)
    Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57±1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65±10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.
  • Resources and infrastructure for the delivery of antiretroviral therapy at primary health care facilities in the Free State Province, South Africa

    Ega Janse van Rensburg-Bonthuyzen; Michelle Engelbrecht; Francois Steyn; Nandi Jacobs; Helen Schneider; Dingie van Rensburg (Taylor &amp; Francis Group, 2008-09-01)
    There are concerns as to whether South Africa's public health system has sufficient resources, human and otherwise, to ensure universal access to antiretroviral treatment (ART). We report on public sector implementation of the Comprehensive Care Management and Treatment (CCMT) programme in the Free State Province, South Africa, in particular whether the primary health care (PHC) infrastructure was able to mobilise the necessary inputs to effectively provide ART, without undermining other services within facilities.A longitudinal study was conducted of the first 16 PHC facilities accredited to provide ART in the province. The facilities were visited on three occasions over 2 years, involving both structured and open-ended interviews with professional and lay staff, and observations of available resources. The resources assessed were staffing, space, essential equipment, drug supplies and laboratory systems.Approximately one-fifth (20%) of professional nurses were allocated to the CCMT programme in the facilities, although the overall number of professional nurses increased by only 14%. This process resulted in some displacement of professional nurses towards the CCMT Programme away from other services in the facilities. However, this could have been partially compensated for by task shifting towards community health workers and the appointment of additional support staff. Staff were largely positive about the programme. Drug supplies, availability of equipment and laboratory systems, although good at the baseline, improved further over the period of observation. The lack of adequate space to accommodate the new programme was a frequently reported problem.Overall, our assessment is that the PHC infrastructure in the Free State's public health system is capable of implementing and benefiting from the CCMT programme. Nevertheless, constraints in the availability of professional staff threaten future implementation of both the CCMT and other PHC programmes.
  • Effect of exposure to clinic-based health education interventions on behavioural intention to prevent mother-to-child transmission of HIV infection

    Jude Igumbor; Supa Pengpid; Larry Obi (Taylor &amp; Francis Group, 2006-05-01)
    HIV and AIDS incidence among infants in South Africa is on the increase. The uptake of prevention of mother-to-child transmission (PMTCT) interventions is often said to be dependent on the beliefs and educational needs of those requiring PMTCT services. This study therefore sought to examine the effect of clinic-based health education interventions (HEI) on behavioural intention of PMTCT among 300 pregnant women from 4 primary health care clinics in Tshilidzini Hospital catchments area, South Africa. An interview schedule was used to obtain information regarding participants' demographic characteristics, level of exposure to clinic-based HEI, salient beliefs and behavioural intention on PMTCT. The major findings included that approximately 85% of the participants had heard of PMTCT. There was very little association between frequency of antenatal clinic (ANC) visits and level of exposure to PMTCT information. Condom use had the lowest set of salient belief scores. Control belief was the most common belief contributing to behavioural intention. Generally, the association between PMTCT salient beliefs and behavioural intention was weak. Clinic-based HEI had an impact on behavioural intention of HIV testing, normative belief of regular ANC visit and nevirapine use. The vital contribution of alternative PMTCT information sources such as the radio and television was observed. Enhancing initiatives that empower women, and a better coordination of the existing HEI through better implementation of health education strategy may strengthen the prevailing moderate PMTCT intention in the area investigated.
  • Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

    Kebede Deribe; Kifle Woldemichael; Bernard Joseph Njau; Bereket Yakob; Sibhatu Biadgilign; Alemayehu Amberbir (Taylor &amp; Francis Group, 2010-07-01)
    There are inconsistent findings about the relation between gender and HIV status disclosure. We conducted a facility-based cross-sectional study, using qualitative and quantitative data collection methods, to explore gender differences in HIV-positive status disclosure among service users in south-west Ethiopia. Among 705 participants, an equal number of men and women (94.6% men v. 94.3%, women) indicated that they had disclosed their result to someone, and the majority (90.9% men v. 90.7% women) to their current main partner. ‘It is customary to tell my partner everything’ was the most frequently cited reason for disclosing (62.5% men v. 68.5% women). Reasons for non-disclosure varied by gender: men were concerned about their partner's worry and exposure of their own unfaithfulness. Women feared physical violence, and social and economic pressure in raising their children. Factors that influenced disclosure also indicated gender variation. For men, disclosure of HIV results to a sexual partner was positively associated with knowing the partner's HIV status and discussion about HIV testing prior to seeking services, while for women it was associated with knowing the partner's HIV status, advanced disease stage, having no more than primary education, being married, and perceiving the current relationship as long-lasting.There was no significant difference in the proportion of HIV status disclosure among men and women. However, the contextual barriers and motivators of disclosure varied by gender. Therefore it is important that clinicians, counsellors, and health educators underscore the importance of gender-specific interventions in efforts to dispel barriers to HIV status disclosure.
  • Editorial Board

    Taylor &amp; Francis Group, 2009-12-01
  • Assessment of utilisation of PMTCT services at Nyanza Provincial Hospital, Kenya

    Iscah Akoth Moth; A.B.C.O. Ayayo; Dan Kaseje (Taylor &amp; Francis Group, 2005-07-01)
    The main objective of the study was to assess the utilisation of prevention of mother-to-child transmission (PMTCT) services among mothers registered for services at Nyanza Provincial Hospital in Kenya. A cross-sectional exploratory study was conducted, using both quantitative and qualitative approaches to collect primary and secondary data. The study population was 133 clients registered for PMTCT services. The study revealed that 52.4% of clients received PMTCT information at the health facility without prior knowledge about intervention, 96% waited for more than 90 minutes, and 89% took less than 10 minutes for post-test counselling. Knowledge of MTCT and PMTCT was inadequate even after counselling, as participants could not recall the information divulged during counselling. In addition, 80% of clients did not present for follow-up counselling irrespective of HIV status, and 95% did not disclose positive HIV status to spouses/relatives for fear of stigma, discrimination and violence. Inadequate counselling services delivered to clients affected service utilisation, in that significant dropout occurred at the stages of HIV result (31.5%), enrollment (53.6%), and delivery (80.7%). Reasons for dropout included fear of positive HIV result, chronic illness, stigma and discrimination, unsupportive spouse and inability to pay for the services.
  • Impact of AIDS on rural livelihoods in Benue State, Nigeria

    Thea Hilhorst; Marti van Liere; Adiya V Ode; Korrie de Koning (Taylor &amp; Francis Group, 2006-05-01)
    This study addresses the socio-economic impact of AIDS on rural livelihoods in Benue State, Nigeria, where HIV prevalence is 9.3% but the number of AIDS cases is still relatively low. About 6% of the study households had experienced illness and death classified as AIDS, and reported high costs in terms of expenditures and time spent on care, funerals and mourning. These demands on time affected income and productivity, while the diversion of resources had implications for investments and savings. Coping strategies varied between households, mainly as a reflection of asset levels, which were often related to the gender of the household head. Reported coping strategies also differed between ethnic groups. First-line relatives were the most important source of support for households under pressure. Erosive coping strategies that undermined the sustainability of livelihoods were used by more vulnerable households following multiple cases of illness and death. Mourning practices, rules of inheritance and stigma tended to increase a household's vulnerability. Currently, Benue State is facing growing adult morbidity and mortality because of HIV infections. A context-specific study of its possible impact in a setting with a still relatively low number of AIDS cases is therefore important for informing local policy development and for building advocacy.
  • Editorial Board

    Taylor &amp; Francis Group, 2005-04-01
  • The quality of material care provided by grandparents for their orphaned grandchildren in the context of HIV/AIDS and poverty: a study of Kopanong municipality, Free State

    Tsiliso Tamasane; Judith Head (Taylor &amp; Francis Group, 2010-08-01)
    A pervasive argument in the literature on AIDS orphans in South Africa is that grandparents, who often care for their orphaned grandchildren, lack the material means to provide adequate care. This study investigated that claim in an area of ubiquitous poverty and very high unemployment. It is based on the analysis of data obtained from two surveys carried out by the HSRC in the semi-rural municipality of Kopanong in the Free State. The first study was a census which targeted the whole population. The second, smaller survey sampled households which accommodated orphaned and vulnerable children. Based on four proxy indicators for material care: possession of birth certificates, uptake of welfare grants, levels of school attendance, and the number of meals consumed daily, the study revealed that there was very little difference in the quality of care provided by grandparents and other carers, including biological parents. Indeed, since the old age pension is much higher than the child support grant and the foster care grant it may be that grandparents who are pensioners generally have higher incomes than most other adults. In line with the findings of other research, the study found that poverty is a major problem confronting all carers in the area. It concludes that interventions that primarily target orphans overlook the material needs of all poor children. It therefore joins the calls of other researchers for greater state support for all poor children, irrespective of whether they are orphans and who their carers are.

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