• A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males

      Sherry Azar; Betsy L Fife; Lorna Kendrick; Kwabena A Poku; J Gary Linn (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2006-04-26)
      The purpose of this paper was to address two questions: (i) Do Ghanaian and African American males with HIV/AIDS experience different types and degrees of stigma? and (ii) Is the impact of stigma associated with HIV/AIDS on the self different for Ghanaian and African American males? A quantitative method was used, and the four dimensions of stigma (social rejection, financial insecurity, internalised shame, and social interaction) were identified and measured using combination Likert-type questionnaires. Data regarding positive feelings of selfworth and self-deprecation, stress related to body image, and personal control were also collected in Ghana and the southeastern USA.The sample consisted of 55 men from Ghana and 55 men from the southeastern USA. Results indicate that values for the scales measuring stigma and self-perception were significantly higher for the Ghanaian sample than for the African American sample.Thus we conclude that the Ghanaian sample living with HIV/AIDS experienced a greater amount of negative self-perception and stigma-related strife than the African American sample.Keywords: stigma, HIV/AIDS, social rejection, financial insecurity, internalised shame, cultureRésuméLe but de cette communication est d'aborder deux questions, à savoir: (i) Est-ce que les hommes Ghanéens et Afro-Américains vivant avec le VIH/SIDA éprouvent de types et de degrés différents de stigmatisation? et (ii) Estce que l'impact de stigmatisation liée au VIH/SIDA sur le moi est différent chez les Ghanéens en comparaison aux Afro-Américains? Une méthode quantitative a été employée et les quatre dimensions de stigmatisation (le rejet social, l'insécurité financière, la honte intériorisée et l'interaction sociale) ont été identifiés et mesurés grâce à une combinaison des questionnaires Likert-type. Des données concernant des sentiments positifs de la valeur personnelle et d'auto-dénigrement, le stresse lié à l'image corporel et le contrôle de soi-même ont été recueilles au Ghana et au sud-est des États Unis. L'échantillon consistait de 55 hommes du Ghana et 55 hommes du sud-est des États Unis. Les chiffres des barèmes utilisées pour mesurer la stigmatisation et la perception de soi-même étaient sensiblement élevés pour l'échantillon ghanéen par rapport à l'échantillon afro-américain. L'échantillon ghanéen vivant avec le VIH/SIDA a davantage de perception négative de soi-même ainsi que la lutte liée à la stigmatisation par rapport à l'échantillon afro-américain.Mots clés: stigmatisation,VIH, SIDA, rejet social, insécurité financière, honte intériorisée, culture SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 344-351
    • A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat

      Vyas, KJ; Patel, GR; Shukla, D; Mathews, WC (Taylor & Francis, 2011-07-08)
      The present study measures levels of stigma within health care settings in urban and rural Gujarat, in an attempt to understand how this may have contributed to the state’s increasing HIV incidence. Two sites were studied: a rural hospital in Bardoli and an urban hospital in Surat. HIV-associated stigma among healthcare workers (N=170) was assessed using a Stigma Index. Overall, analyses suggest an increase in medical education was found to be associated with higher stigmatisation (p
    • 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
    • A comprehensive programme addressing HIV/AIDS and gender based violence

      M S Janse van Rensburg (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-01-22)
      A survey was administered to 304 respondents participating from three areas near Welkom, South Africa. Face-toface interviews were conducted with women from randomly selected households to evaluate the impact of a service provision programme targeting women living with HIV/AIDS and gender based violence. Gender based violence (GBV) awareness and knowledge was high. Respondents had high perceived levels of risk.They reported making various behavioural changes to avoid GBV.The respondents were aware of their legal rights pertaining to GBV. HIV/AIDS knowledge levels and attitudes were acceptable. Behavioural changes included condom use, abstinence and being faithful to one partner. Disclosure of HIV was lower than disclosure of GBV.Awareness and knowledge of female condoms were high, yet usage low. Participants reported that they would be able to introduce condoms to a relationship and negotiate usage with relative ease. Perceived levels of GBV and HIV were high, and stigma levels towards the affected women were also relatively high.The awareness and knowledge levels of GBV and HIV of older respondents were lower than younger respondents.The key findings of this study support the notion of using a holistic approach, targeting more than one issue.There is lower stigma levels associated with combined conditions, which might allow easier access to vulnerable groups. Coordination and collaboration of services are however needed to enable this benefit. Une étude a été faite auprès de 304 participantes venant de trois quartiers près de Welkom, en Afrique du Sud. Des chercheurs de terrain, bien formés, ont mené des entretiens en tête-à-tête avec des femmes de foyers sélectionnés au hasard avec le but d'évaluer l'impact du programme de service visant des femmes qui vivent avec le VIH/SIDA et la violence contre les femmes. La prise de conscience et la connaissance de la violence contre les femmes étaient élevées. Les participantes montraient des niveaux élevés du risque perçu. Elles avouent avoir changé leur comportement afin d'éviter la violence contre les femmes, ainsi que dénoncer le malfaiteur. Elles connaissaient leurs droits par rapport à la violence contre les femmes. Les niveaux de connaissance du VIH/SIDA et des attitudes étaient satisfaisants. Le changement de comportement inclut entre autres, l'utilisation du préservatif (même si cela n'était pas fait régulièrement), l'abstinence et être fidèle à un seul partenaire. La divulgation de sa séropositivité était plus basse que celle de la violence. La prise de conscience et la connaissance du préservatif féminin était élevé. Cependant, son usage était très bas car il n'est pas facilement disponible. Les participantes ont signalé qu'elles pourraient proposer un préservatif et négocier son usage sans beaucoup de difficulté. Les niveaux perçus de la violence contre les femmes et le VIH étaient élevés. Le niveau de stigmatisation envers des femmes infectées était relativement élevé. Le niveau de conscience et de connaissance de la violence contre les femmes et du SIDA chez les participantes plus âgées était plus bas par rapport à celui de participantes plus jeunes.Tandis que tous les trois quartiers ont montré une évidence de valeur des activités de “LifeLine”, la valeur des interventions à Odendaalsrus était moins importante. Il y a un besoin de réorganiser des activités prioritaires par le biais de “LifeLine”. Les résultats de cette étude soutien la notion de l'utilisation d'une approche holistique visant plus d'un sujet. Le niveau de stigmatisation liée aux conditions complexes est moins élevé. Cela peut permettre l'accès plus facile aux groupes vulnérables. La coordination et la collaboration des services sont toutefois nécessaires afin de permettre la rentabilité. Les résultats des interventions de GBV et de VIH confirment d'autres études. Le manque des documents et davantage d'études sur la rentabilité des interventions compréhensives est abordé dans cette description d'une approche qui a pour but d'aborder la violence contre les femmes et le VIH en se servant d'une approche holistique. Keywords: HIV/AIDS and GBV, holistic, comprehensive programme.SAHARA J Vol. 4 (3) 2007: pp. 695-706
    • A decade of research involving men who have sex with men in sub-Saharan Africa: Current knowledge and future directions

      Muraguri, N; Temmerman, M; Geibel, S (Taylor & Francis, 2012-12-06)
      It has been just over 10 years since the first large behavioral survey of men who have sex with men (MSM) was implemented in Senegal in 2001. Since then, behavioral and/or HIV prevalence surveys have been conducted in over 14 other countries in sub- Saharan Africa. Current available evidence and review have established that HIV prevalence among MSM in these countries are significantly higher than corresponding general populations, that MSM engage in sexual risk behaviors that place them and sexual partners at higher risk, and that issues of discrimination and stigmatization inhibit HIV interventions for MSM. This paper summarizes the existing knowledge, describes limitations of this evidence, and proposes new and enhanced research approaches to fulfill needed gaps to inform national HIV responses for MSM populations.
    • A Generation at Risk: The Global Impact of HIV/AIDS on Orphans and Vulnerable Children

      G Setswe (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
      Edited by: G Foster, C Levi and J Williamson. Cambridge University Press, 2005. ISBN 978-0-521-65264-3This publication helps us to understand the impacts of HIV/AIDS on OVC in the family and community-based care, households and communities; needs of OVC and responses in the educational system; psychosocial impact on children and youth; human rights of children affected by HIV/AIDS; and religion and responses to OVC. It does this with the help of many contributors with expert knowledge on issues affecting children, particularly those who are orphaned and made vulnerable by HIV/AIDS.SAHARA-J Vol. 5 (3) 2008: pp. 158-158
    • A livelihood intervention to improve economic and psychosocial well-being in rural Uganda: Longitudinal pilot study

      Kakuhikire, Bernard; Suquillo, Diego; Atuhumuza, Elly; Mushavi, Rumbidzai; Perkins, Jessica M.; Venkataramani, Atheendar S.; Weiser, Sheri D.; Bangsberg, David R.; Tsai, Alexander C. (Taylor & Francis, 2016-09-14)
      HIV and poverty are inextricably intertwined in sub-Saharan Africa. Economic and livelihood intervention strategies have been suggested to help mitigate the adverse economic effects of HIV, but few intervention studies have focused specifically on HIVpositive persons. We conducted three pilot studies to assess a livelihood intervention consisting of an initial orientation and loan package of chickens and associated implements to create poultry microenterprises. We enrolled 15 HIV-positive and 22 HIV-negative participants and followed them for up to 18 months. Over the course of follow-up, participants achieved high chicken survival and loan repayment rates. Median monthly income increased, and severe food insecurity declined, although these changes were not statistically significant (P-values ranged from 0.11 to 0.68). In-depth interviews with a purposive sample of three HIV-positive participants identified a constellation of economic and psychosocial benefits, including improved social integration and reduced stigma.Keywords: HIV, poverty, social stigma, Uganda
    • A lottery incentive system to facilitate dialogue and social support for workplace HIV counselling and testing: A qualitative inquiry

      Weihs, M; Meyer-Weitz, A (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2014-10-08)
      Despite South African mid-sized companies’ efforts to offer HIV counselling and testing (HCT) in the workplace, companies report relatively poor uptake rates. An urgent need for a range of different interventions aimed at increasing participation in workplace HCT has been identified. The aim of this study was to explore qualitatively the influence of a lottery incentive system (LIS) as an intervention to influence shop-floor workers’ workplace HIV testing behaviour. A qualitative study was conducted among 17 shop-floor workers via convenience sampling in two mid-sized South African automotive manufacturing companies in which an LIS for HCT was implemented. The in-depth interviews employed a semi-structured interview schedule and thematic analysis was used to analyse the data. The interviews revealed that the LIS created excitement in the companies and renewed employees’ personal interest in HCT. The excitement facilitated social interactions that resulted in a strong group cohesion pertaining to HCT that mitigated the burden of HIV stigma in the workplace. Open discussions allowed for the development of supportive social group pressure to seek HCT as a collective in anticipation of a reward. Lotteries were perceived as a supportive and innovative company approach to workplace HCT. The study identified important aspects for consideration by companies when using an LIS to enhance workplace HIV testing. The significance of inter- and intra-player dialogue in activating supportive social norms for HIV testing in collectivist African contexts was highlighted.Keywords: HCT, company, collectivist, group pressure, norm, South AfricaMalgre´ les efforts que font les petites et moyennes entreprises sud-africaines pour offrir le conseil et de´pistage volontaire du VIH (CDV) en milieu de travail, les entreprises font e´tat de taux de participation relativement bas. Un besoin urgent pour une gamme de diffe´rentes interventions visant a` accroıˆtre la participation au CDV en milieu de travail a e´te´ identifie´e. Le but de cette e´tude e´tait d’e´tudier qualitativement l’influence d’un syste`me d’incitation a` la loterie comme intervention pour influencer le comportement CDV des ouvriers en milieu de travail. Une e´tude qualitative a e´te´ mene´e aupre`s de 17 ouvriers choisis par e´chantillonnage de commodite´ dans 2 entreprises de fabrication automobile en Afrique du Sud. Dans ces 2 entreprises de taille moyenne, un syste`me d’incitation a` la loterie a e´te´ mis en oeuvre pour encourager le CDV en milieu de travail. Un guide d’interviews semistructure ´es a e´te´ employe´ pour mener des entretiens approfondis. L’analyse the´matique a e´te´ utilise´e pour analyser les donne´es. Les entrevues ont re´ve´le´ que les syste`mes d’incitation ont cre´e´ de l’excitation dans les entreprises et ont renouvele´ l’inte´reˆt personnel des employe´s pour le CDV. L’excitation a facilite´ des interactions sociales qui ont abouti a` une forte cohe´sion du groupe d’ouvriers concernant le CDV et atte´nuant ainsi la stigmatisation lie´e au VIH en milieu de travail. Des discussions ouvertes ont permis l’e´laboration de pression sociale de groupe en support a` la participation collective au CDV en pre´vision d’une re´compense. Les loteries ont e´te´ perc¸ues comme une approche soutenante et innovante de la part des entreprises pour le CDV en milieu de travail. L’e´tude a identifie´ des aspects importants a` prendre en compte par les entreprises lors de l’utilisation d’un syste`me d’incitation a` la loterie pour augmenter le taux de de´pistage VIH en milieu de travail. L’importance du dialogue inter- et intra-joueur dans l’activation de normes sociales favorables pour le de´pistage VIH dans les contextes collectivistesafricains a e´te´ souligne´e.Mots cle´s: CDV, entreprise, collectiviste, pression de groupe, norme, Afrique du Sud
    • A mobile school-based HCT service – is it youth friendly?

      Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert (Taylor & Francis, 2016-09-14)
      Background: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly.Methods: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions.Key Results: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and nonjudgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care.Conclusion: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.Keywords: HIV/AIDS, HIV Counselling and Testing, youth, students, school, youth friendly
    • A new measurement of an indirect measure of condom use and its relationships with barriers

      Levy, Einav; Gidron, Yori; Olley, Benjamin O. (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2017-09-15)
      One of the challenges facing researchers in the domain of human immunodeficiency virus prevention is the assessment of condom use in an unbiased self-reported manner. The current study presents the development and preliminary validation of an indirect condom use test (I-CUTE), designed to assess condom use tendencies and to overcome self-report biases. Two samples were included using correlational designs. In sample 1, 88 students from European university completed the I-CUTE with questionnaires of condom use barriers, social desirability, and condom use negotiation self-efficacy. In sample 2, 212 students from sub-Saharan universities completed the I-CUTE with questionnaires of condom use barriers and knowledge. The I-CUTE included 17 pictures of human figures in relation to condom use, where participants had to choose one of the four a-priori given sentences reflecting the figures’ thoughts. This represented a semi-projective, yet standardized test. In sample 1, I-CUTE scores were inversely related to barriers, positively correlated with condom use negotiation self-efficacy and unrelated to social desirability. In sample 2, I-CUTE scores were inversely related to barriers and unrelated to knowledge scores. In a multiple regression, condom use barriers had a unique contribution to explaining variance in I-CUTE scores, beyond the contribution of background variables and knowledge. These results support the preliminary reliability and validity of the I-CUTE tool in a variety of cultures, and reveal its lack of bias by social desirability and the importance of condom use barriers in condom use tendencies.Keywords: condom use, barriers, social desirability, assessment, measure
    • A new measurement of an indirect measure of condom use and its relationships with barriers

      Einav Levy; Yori Gidron; Benjamin O. Olley (Taylor & Francis Group, 2017-01-01)
      One of the challenges facing researchers in the domain of human immunodeficiency virus prevention is the assessment of condom use in an unbiased self-reported manner. The current study presents the development and preliminary validation of an indirect condom use test (I-CUTE), designed to assess condom use tendencies and to overcome self-report biases. Two samples were included using correlational designs. In sample 1, 88 students from European university completed the I-CUTE with questionnaires of condom use barriers, social desirability, and condom use negotiation self-efficacy. In sample 2, 212 students from sub-Saharan universities completed the I-CUTE with questionnaires of condom use barriers and knowledge. The I-CUTE included 17 pictures of human figures in relation to condom use, where participants had to choose one of the four a-priori given sentences reflecting the figures’ thoughts. This represented a semi-projective, yet standardized test. In sample 1, I-CUTE scores were inversely related to barriers, positively correlated with condom use negotiation self-efficacy and unrelated to social desirability. In sample 2, I-CUTE scores were inversely related to barriers and unrelated to knowledge scores. In a multiple regression, condom use barriers had a unique contribution to explaining variance in I-CUTE scores, beyond the contribution of background variables and knowledge. These results support the preliminary reliability and validity of the I-CUTE tool in a variety of cultures, and reveal its lack of bias by social desirability and the importance of condom use barriers in condom use tendencies.
    • A qualitative evaluation of a stress management programme for HIV and AIDS home-based care workers in Tshwane, South Africa

      P. M. Kupa; L. S. Geyer (Taylor & Francis Group, 2020-01-01)
      The HIV and AIDS pandemic resulted in increased demands on the South African healthcare system and contributed to elevated stress levels among healthcare workers, including home-based care workers. The goal of the study was to evaluate a stress management programme for HIV and AIDS home-based care workers in Tshwane, South Africa. Social constructionism was adopted as the theoretical framework of the study. The study implemented intervention research and adopted a qualitative research approach, specifically the instrumental case study. Non-probability sampling, specifically volunteer sampling was utilised to recruit a group of twelve HIV and AIDS home-based care workers (n = 12). The data were collected through semi-structured interviews and administered before and after exposure to the stress management programme. The research findings, based on thematic analysis, revealed that the programme was effective in mitigating the impact of stress experienced by the HIV and AIDS home-based care workers in Tshwane. Recommendations are proffered for the refinement of the newly developed stress management programme for implementation among HIV and AIDS home-based care workers in similar field settings.
    • A qualitative exploration of HIV-positive pregnant women’s decision-making regarding abortion in Cape Town, South Africa

      Orner, P; de Bruyn, M; Harries, J; Cooper, D (Taylor & Francis, 2011-07-08)
      HIV-positive women’s abortion decisions were explored by: (i) investigating influencing factors; (ii) determining knowledge of abortion policy and public health services; and (iii) exploring abortion experiences. In-depth interviews were held with 24 HIVpositive women (15 had an abortion; 9 did not), recruited at public health facilities in Cape Town, South Africa. Negative perceptions towards HIV-positive pregnant women were reported. Women wanted abortions due to socio-economic hardship in conjunctionwith HIV-positive status. Respondents were generally aware that women in South Africa had a right to free abortions in public health facilities. Both positive and negative abortion experiences were described. Respondents reported no discrimination by providers due to their HIV-positive status. Most respondents reported not using contraceptives, while describing their pregnancies as ‘unexpected’. The majority of women who had abortions wanted to avoid another one, and would encourage other HIV-positive women to try to avoid abortion. However, most felt abortions were acceptable for HIV-positive women in some circumstances. Data suggestedthat stigma and discrimination affect connections between abortion, pregnancy and HIV/AIDS, and that abortion may be more stigmatised than HIV/AIDS. Study results provide important insights, and   any revision of reproductive health policy, services, counselling for abortion and HIV/AIDS care should address these issues.
    • A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility

      Pienaar, A; Swanepoel, Z; van Rensburg, H; Heunis, C (Taylor & Francis, 2012-08-27)
      This article presents the findings of a study among a small group of South African AIDS orphans living in a residential care facility, Lebone Land. The research was conducted between June and September 2006. A qualitative, exploratory study consisting of in-depth, semistructured interviews with eight children and seven key informants aimed to identify and investigate developmental assets operating in the children’s lives to help them cope amid exposure to adversities. The findings indicate that the  developmental assets that facilitate coping and foster resilience in these children relate to four main components: external stressors and challenges, external supports, inner strengths and interpersonal and problem-solving skills. Emerging key themes relate to the experience of illness, death, poverty and violence, as well as the important roles of morality, social values, resistance skills, religion and faith in assisting these children in defining their purpose in life. To this end, constructive use of time, commitment to learning, goal-setting, problem-solving ability and self-efficacy are fundamental in the children’s attainment of their future projections. Therefore, qualities such as optimism, perseverance and hope seem to permeate the children’s process of recovery. Strong networks of support, particularly friendships with other children, also seemto contribute to developing and sustaining resilience.
    • 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 study of local government HIV/AIDS projects in South Africa

      N Roux; Chief Directorate: Population and Development, Department of Social Development, Private Bag X901, Pretoria 0001, South Africa; L Swartz; Chief Directorate: Population and Development, Department of Social Development, Private Bag X901, Pretoria 0001, South Africa (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2004-10-01)
      The primary goal of this study was to survey local government HIV/AIDS projects in South Africa.A total of 240 questionnaires were sent to local municipalities nationally between May and July 2002.A total of 44 municipalities returned their questionnaires, covering 53 projects. Most projects focused on prevention and awareness and the majority had awareness/prevention/information as part of their objectives as well as their activities. Home/community-based care was also prominent. It seems that in the future the focus of programme development will shift in this direction. Major constraints were a lack of funds, transport and trained personnel. Future emphasis must thus be put on these components. In addition government needs to put more resources into local government HIV/AIDS programmes since this tier will be the nodal point for national combatting of the HIV/AIDS epidemic. SAHARA-J (2004) 1(2): 99-106 Keywords: local government, HIV/AIDS, home/community-based care, Department of Social Development. RÉSUMÉ Le but principal de cette étude fut de sonder des projets du VIH/SIDA dans le gouvernement local en Afrique du Sud. Deux cents quarante questionnaires ont été envoyés aux municipalités locales du pays à partir du mois de mai jusqu'au mois de juillet 2002. Au total, 44 municipalités ont renvoyé leurs questionnaires. Ce derniers couvrent 53 projets. La plupart de projets se sont concentrés sur la prévention et la prise de conscience alors que la majorité de projets incluent la prise de conscience, la prévention et l'information parmi leurs objectif et leurs activités. Les soins à domicile ou dans la communauté étaient également saillants. Il semble que dans l'avenir le développement de programme se focalisera vers cette direction. Les contraintes majeures furent le manque de fonds, du transport et du personnel qualifié. De ce fait, dans l'avenir l'accent doit être mis sur ces facteurs. De plus, le gouvernement doit procurer davantage des ressources pour les programmes du VIH/SIDA au gouvernement local vu que cette étape sera le centre d'intérêt vis-à-vis le combat national contre l'épidémie du VIH/SIDA. SAHARA-J (2004) 1(2): 99-106 Mots clés: le gouvernement local, le VIH/SIDA, les soins à domicile ou dans la communauté, le Département de Développement Social.
    • A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

      Bharat, S (Taylor & Francis, 2012-08-27)
      HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement, conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as,  transgender people. Context-specific (health care, community)  interventions are needed to address various forms of stigma – enacted, perceived, internalised and layered – including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall, the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government’s goal of stigma reduction.
    • A weighted bootstrap approach to logistic regression modelling in identifying risk behaviours associated with sexual activity

      Humphrey Brydon; Rénette Blignaut; Joachim Jacobs (Taylor & Francis Group, 2019-01-01)
      The latest population estimates released by Statistics South Africa indicate that 25.03% of all deaths in 2017 in South Africa were AIDS-related. Along with these results, it is also reported that 7.06% of the population were living with HIV, with the HIV-prevalence among youth (aged 15–24) at 4.64% for 2017 (STATSSA. (2018). Retrieved from Statistics South Africa: http://www.statssa.gov.za/publications/P0302/P03022017.pdf). The data used in the study contained information related to the risk-taking behaviours associated with the sexual activity of entering first-year students at the University of the Western Cape. In this study, a logistic regression modelling procedure was carried out on those students that were determined to be sexually active, therefore, in the modelling procedure significant risk behaviours of sexually active first-year students could be identified. Of the 14 variables included in the modelling procedure, six were found to be significantly associated with sexually active students. The significant variables included; the age and race of the student, whether the student had ever taken an HIV test, the importance of religion in influencing the sexual behaviour of the student, whether the student consumed alcohol and lastly whether the student smoked. This study further investigated the impact of introducing sample weighting, bootstrap sampling as well as variable selection methods into the logistic regression modelling procedure. It is shown that incorporating these techniques into the modelling procedure produces logistic regression models that are more accurate and have an increased predictive capability. The bootstrapping procedure is shown to produce logistic regression models that are more accurate than those produced without a bootstrap procedure. A comparison between 200, 500 and 1000 bootstrap samples is also incorporated into the modelling procedure with the models produced from 200 bootstrap samples shown to be just as accurate those produced from 500 or 1000 bootstrap samples. Of the five variable selection methods used, it is shown that the Newton–Raphson and Fisher methods are unreliable in producing logistic regression models. The forward, backward and stepwise variable selection methods are shown to produce very similar results.
    • A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand

      Aphichat Chamratrithirong; Kathleen Ford; Sureeporn Punpuing; Pramote Prasartkul (Taylor & Francis Group, 2017-01-01)
      Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18–24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.
    • Acceptabilite´ du test VIH propose´ aux nourrissons dans les services pe´ diatriques, en Coˆ te d’Ivoire, Significations pour la couverture du diagnostic pe´diatrique

      Oga, M; Brou, H; Dago-Akribi, H; Coffie, P; Amani-Bosse´, C; E´ koue´vi, D; Yapo, V; Menan, H; Ndondoki, C; Timite-Konan, M (Taylor & Francis, 2014-10-08)
      Proble`me: Le de´pistage VIH chez les enfants a rarement e´te´ au centre des pre´occupations des chercheurs. Quand le de´pistage pe´diatrique a retenu l’attention, cela a e´te´ pour e´clairer seulement sur les performances diagnostiques en ignorant meˆme que le test pe´diatrique comme bien d’autres peut s’accepter ou se refuser. Cet article met au coeur de son analyse les raisons qui peuvent expliquer qu’on accepte ou qu’on refuse de faire de´pister son enfant.Objectif: Etudier chez les parents, les me`res, les facteurs explicatifs de l’acceptabilite´ du test VIH des  nourrissons de moins de six mois.Me´thodes: Entretien semi-directif a` passages re´pe´te´s avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pese´e/vaccination et les consultations pe´diatriques avec proposition syste´matique d’un test VIH pour leur nourrisson.Re´sultats: Nous retenons que la re´alisation effective du test pe´diatrique du VIH chez le nourrisson repose sur trois e´le´ments. Primo, le personnel de sante´ par son discours (qui de´note de ses connaissances et  perceptions meˆme sur l’infection) oriente´ vers les me`res influence leur acceptation ou non du test. Secundo, la me`re qui par ses connaissances et perceptions meˆme sur le VIH, dont le statut particulier, l’impression de bien-eˆtre chez elle et son enfant influence toute re´alisation du test pe´diatrique VIH. Tertio, l’environnement conjugal de la me`re, particulie`rement caracte´rise´ par les rapports au sein du couple, sur la facilite´ de parler du test VIH et sa re´alisation chez les deux parents ou chez la me`re seulement sont autant de facteurs qui influencent la re´alisation effective du de´pistage du VIH chez l’enfant. Le principe pre´ventif du VIH, et le de´sir de faire tester l’enfant ne suffisent pas a` eux seuls pour aboutir a` sa re´alisation effective, selon certaines me`res confronte´es au refus du conjoint. A l’oppose´, les autres me`res refusant la re´alisation du test  pe´diatrique disent s’y opposer ; bien entendu, meˆme dans le cas ou` le conjoint l’accepterait.Discussion: Les me`res sont les principales mises en cause et craignent les re´primandes et la stigmatisation. Le pe`re, le conjoint peut eˆtre un obstacle, quand il s’oppose au test VIH du nourrisson, ou devenir le facilitateur de sa re´alisation s’il est convaincu. Le positionnement du pe`re demeure donc essentiel dans la question de l’acceptabilite´ du VIH pe´diatrique. Les me`res en ont conscience et pre´sagent des difficulte´s a` faire  de´pister ou non les enfants sans avis pre´alable du conjoint a` la fois pe`re, et chef de famille.Conclusion: La question du de´pistage pe´diatrique du VIH, au terme de notre analyse, met en face trois e´le´ments qui exigent une gestion globale pour assurer une couverture effective. Ces trois e´le´ments n’existeraient pas sans s’influencer, donc ils sont constamment en interaction et empeˆchent ou favorisent la re´alisation ou non du test pe´diatrique. Aussi, dans une intention d’aboutir a` une couverture effective du de´pistage VIH des nourrissons, faut-il tenir compte d’une gestion harmonieuse de ces trois e´le´ments: La premie`re, la me`re seule (avec ses connaissances, ses perceptions), son environnement conjugal (de  proposition du test inte´grant 1- l’e´poux et / ou pe`re de l’enfant avec ses perceptions et connaissances sur l’infection 2- la facilite´ de parler du test et sa re´alisation chez les deux ou un des parents, la me`re) et les connaissances, attitudes et pratiques du personnel de l’e´tablissement sanitaire sur l’infection du VIH.Recommandations: Nos recommandations proposent une rede´finition de l’approche du VIH/sida vers des familles expose´es au VIH et une inte´gration plus accentue´e du pe`re facilitant leur propre acceptation du test VIH et celle de leur enfant.Mots cle´s: Acceptabilite´, Test VIH, Enfants, Nourrissons Problem: HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parent’s reasons which explain why pediatric HIV test is accepted or refused.Objective: To study among parents, the explanatory factors of the acceptability of pediatric HIV testing among infant less than six months.Methods: Semi-structured interview with repeated passages in the parents of infants less than six months attending in health care facilities for the pediatric weighing/vaccination and consultations.Results: We highlight that the parent’s acceptance of the pediatric HIV screening is based on three elements.Firstly, the health care workers by his speech (which indicates its own knowledge and perceptions on the infection) directed towards mothers’ influences their acceptance or not of the HIV test. Secondly, the mother who by her knowledge and perceptions on HIV, whose particular status, give an impression of her own wellbeing for her and her child influences any acceptance of the pediatric HIV test. Thirdly, the marital environment of the mother, particularly characterized by the ease of communication within the couple, to speak about the HIV test and its realization for the parents or the mother only are many factors which influence the effective realization of the pediatric HIV testing. The preventive principle of HIV transmission and the desire to realize the test in the  newborn are not enough alone to lead to its effective realization, according to certain mothers confronted with the father’s refusal. On the other hand, the other mothers refusing the realization of the pediatric test told to be opposed to it; of course, even if their partner would accept it.Discussion: The mothers are the principal facing the pediatric HIV question and fear the reprimands and stigma. The father, the partner could be an obstacle, when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family.Conclusion: The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution.Recommendations: Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.Keywords: acceptability, HIV testing, children, infantsArticle in French.