• Challenges impacting on the quality of care to persons living with HIV/AIDS and other terminal illnesses with reference to Kanye community home-based care programme

      S Kang’ethe (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-01-20)
      HIV/AIDS has been found to be a challenging disease to humanity, its challenge spin-offs falling especially on to the caregivers of those infected and affected by the virus. This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care (CHBC) programme in Botswana. The study was qualitative in design and explorative in nature, involving 82 primary caregivers in focus group discussions, and 5 CHBC nurses in individual interviews. Caregivers were found challenged by lack of community networks support, inadequate sanitary and care packages, poor shelter compromising privacy, inadequate income and food for their clients, inadequate care motivation as their volunteerism does not attract any payment, inadequate health personnel to offer psychosocial support like counselling, and an unconducive caring environment generally. Putting in place policies to redress caregivers’ poverty, helping caregivers start income-generating projects, increasing community assistance and caregiving facilities are recommended as factors to address caregiver challenges.
    • Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

      Kembo, J (Taylor & Francis, 2014-11-21)
      HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p = .000) and 5.9% (p = .001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p = .029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p = .000) and 1.4% (p = .000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (24.5%), premarital sex (22.6%), sex before age 18 (22.4%) and proportion reporting multiple partnerships (21.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries.Keywords: sexual behaviour and practice, young people, Demographic and Health Survey, HIV and AIDS, Zambia
    • Changing trends and the impact of alcohol on the HIV/AIDS epidemic in South Africa: Review

      Setshedi, M; de la Monte, SM (Taylor & Francis, 2011-06-28)
      The association between increased HIV infection and alcohol use has been extensively studied and is established. South Africa is among one of the sub-Saharan African countries with the highest prevalence and number of people living with HIV/AIDS in the world. Although recent evidence suggests that the epidemic has stabilised, infection rates remain unacceptably high. Alcohol use is on the increase, particularly in the groups most susceptible to HIV infection, namely women and young adults, and informs poor choices with respect to safer sexual practices. This paper reviews the association between alcohol and HIV. More specifically, however, it aims to explore the potential socio-politico-biological and cultural explanations as to the factors that intersect to drive these two epidemic diseases: alcoholism and HIV/AIDS in South Africa. Understanding some of the underlying factors will provide a framework to implement public health measures to curb HIV.Keywords: HIV, AIDS, South Africa, alcohol, politics of South Africa.L’association entre l’augmentation du VIH et la consommation d’alcool fait l’objet d’une étude. L’Afrique du Sud reste l’un des pays Sub-Saharien les plus touché par un taux de prévalence élevé et par le nombre de personnes vivant avec le VIH/SIDA dans le monde. Bien que les dernières objectives fussent de stabiliser l’épidémie, néanmoins le taux d’infection reste inacceptable. L’utilisation de l’alcool, particulièrement chez les femmes et les jeunes, est susceptible d’augmenter l’infection du VIH, et le peu d’information qu’ils ont sur le respect des pratiques sexuels sûr. L’article examine le lien entre l’association de l’alcool et le VIH, plus spécifiquement, cependant elle vise à explorer des explications potentielles socio-politico-culturelles et biologiques sur les facteurs de ces maladies épidémiques alcoolisme et le VIH/SIDA en Afrique du Sud. Il faut comprendre que les facteurs sous-jacents fourniront un cadre pour mettre en oeuvre des mesures de santé publique pour lutter contre le VIH.
    • ‘Checkmating HIV&AIDS’: Using chess to break the silence in the classroom

      Esau, O (Taylor & Francis, 2012-12-13)
      In this article, I give an account of my ‘Checkmating HIV&AIDS’ action research project, which was an attempt to break the ‘culture of silence’ concerning HIV&AIDS and sex and sexuality in my classroom. In this project, I focused specifically on one code of sport, namely chess, and I point out and discuss the potential of using chess as an educational tool in addressing HIV&AIDS. It was found that learners enjoy playing chess and that it can be used in the Life Orientation classroom to promote HIV&AIDS awareness. This type of alternative awareness is relevant as learners in most schools were becoming fatigued by HIV&AIDS information overload. The project portrays the role of the teacher as a researcher and critical change agent in an HIV&AIDS-challenged society.Keywords: HIV&AIDS, action research, chess, checkmating, culture of silence, prevention, awareness
    • ‘Checkmating HIV&AIDS’: Using chess to break the silence in the classroom

      Esau, O (Taylor & Francis, 2012-12-13)
      In this article, I give an account of my ‘Checkmating HIV&AIDS’ action research project, which was an attempt to break the ‘culture of silence’ concerning HIV&AIDS and sex and sexuality in my classroom. In this project, I focused specifically on one code of sport, namely chess, and I point out and discuss the potential of using chess as an educational tool in addressing HIV&AIDS. It was found that learners enjoy playing chess and that it can be used in the Life Orientation classroom to promote HIV&AIDS awareness. This type of alternative awareness is relevant as learners in most schools were becoming fatigued by HIV&AIDS information overload. The project portrays the role of the teacher as a researcher and critical change agent in an HIV&AIDS-challenged society.Keywords: HIV&AIDS, action research, chess, checkmating, culture of silence, prevention, awareness
    • Ciliated hepatic foregut cyst: a rare cystic liver lesion

      JM Shaw; SJ Beninfield; JEJ Krige (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-07-14)
      No Abstract.
    • ‘Clinics aren’t meant for men’: Sexual health care access and seeking behaviours among men in Gauteng province, South Africa

      Leichliter, JS; Paz-Bailey, G; Friedman, AL; Habel, MA; Vezi, A; Sello, M; Farirai, T; Lewis, DA (Taylor & Francis, 2011-06-28)
      Men may be key players in the transmission of sexually transmitted infections (STI), and it is important that STI/HIV health services reach men. The objective of this study was to explore sexual health care access and seeking behaviours in men. This study used focus groups to examine sexual health care access and seeking behaviours in men 5 years after implementation of free antiretroviral therapy (ART) in the South African public sector. Six focus groups (N=58) were conducted with men ≥18 years in an urban area of Gauteng province. Men were recruited from various locations throughout the community. Men reported several barriers and facilitators to the use of public and private clinics for sexual health services including HIV testing, and many men reported seeking care from traditional healers. Men often viewed public clinics as a place for women and reported experiences with some female nurses who were rude or judgmental of the men. Additionally, some men reported that they sought sexual health care services at public clinics; however, they were not given physical examinations by health care providers to diagnose their STI syndrome. Most men lacked knowledge about ART and avoided HIV testing because of fear of death or being abandoned by their families or friends. Study findings suggest that men still require better access to high-quality, non-judgmental sexual health care services. Future research is needed to determine the most effective method to increase men’s access to sexual health care services.Keywords: sexual health care access, men.Les hommes peuvent être des responsables dans la transmission des infections sexuellement transmissibles (IST), et il est important que les services de santé des IST/VIH les sensibilisent (les hommes). Les objectifs de cette étude étaient d’examiner l’accès aux soins de santé et les comportements sexuels des hommes pendant 5 ans après la mise en oeuvre de la thérapie antirétrovirale (ART) gratuite dans le secteur public Sud-Africain. Six groups d’hommes âgés ≥18 ans (N=58) ont menés des discussions dans la zone urbaine de la province de Gauteng. Ces hommes sont recrutés dans divers endroits dans toute la communauté. Ils ont déclarés rencontrés des obstacles et facilitateurs à l’accès des cliniques publiques et privées des services de santé sexuelle, y compris le test du VIH, et beaucoup d’hommes déclarent être à la recherche de soins vers des guérisseurs traditionnels. Les hommes ont souvent vu les cliniques publiques comme des endroits pour les femmes et se sont souvent plaint des expériences qu’ils ont eues par rapport aux infirmières qui ont un mauvais jugement sur eux. Certains d’entre eux ont déclaré qu’ils cherchaient des soins de santé dans les cliniques publiques, mais qu’ils n’étaient pas soumis à des examens physiques pour diagnostiquer leurs syndrome d’IST. La plupart d’entre eux n’avaient pas de connaissances de l’ART et évitent le test du VIH parce qu’ils ont peur de la mort ou d’être abandonné par leurs familles ou leurs amis. Cette étude suggère que les hommes doivent exiger de meilleures qualités de soins, un non-jugement des services de santé sexuelle. Les recherches futures sont nécessaires pour déterminer la méthode la plus efficace d’accroitre l’accès des hommes aux services de santé sexuelle.
    • Comparison of the health-related quality of life, CD4 count and viral load of AIDS patients and people with HIV who have been on treatment for 12 months in rural South Africa

      Igumbor, J; Stewart, A; Holzemer, W (Taylor & Francis, 2013-10-10)
      This study compared the level of CD4 count, viral load and health-related quality of life (HRQOL) between treatment-naı¨ve AIDS patients and a cohort of people living with HIV who have been on treatment for 12 months. This study is based on a secondary data analysis of the records of 642 people with HIV consisting of 311 treatment-naı¨ve AIDS patients and 331 people with HIV who have been on treatment for 12 months. The study findings are mostly presented in tables and analysed using the t-test to compare HRQOL scores, CD4 count and viral load in the two groups. The study generally noted poor financial capacity and low activity tolerance among the participants. Significant changes were noted in all the domains of HRQOL compared between the treatment-naı¨ve patients and the 12 months treatment cohort. In the same manner, the median CD4 cell count and viral load differed significantly between both groups. The treatment-naı¨ve and the 12 months treatment cohorts consistently reported much lower quality of life scores in the level of dependence domain which includes the measures of mobility, activity of daily living, dependence on medication and work capacity. There were little or no associations between the biomedical markers (CD4 count and viral load) and HRQOL indicators. However, the quality of life tended to increase with increase in the CD4 cell count. The poor to no association between the biomedical markers and HRQOL indicators show that these cannot be direct proxies of each other and that the CD4 cell count and viral load alone may be inadequate eligibility criteria for social support.Keywords: AIDS/HIV, CD4 cell count, health-related quality of life, viral load, WHOQOL-HIV
    • Compassion or condemnation? South African Muslim students' attitudes to people with HIV&AIDS

      University of KwaZulu-Natal; Zubeda Paruk; School of Psychology at the University of KwaZulu-Natal; Sitti Djamela Mohamed; University of KwaZulu-Natal (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 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.
    • 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.
    • 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.
    • 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.
    • Concurrent sexual and substance-use risk behaviours among female sex workers in Kenya’s Coast Province: Findings from a behavioural monitoring survey

      Tegang, SP; Abdallah, S; Emukule, G; Luchters, S; Kingola, N; Barasa, M; Mucheke, S; Mwarogo, P (Taylor & Francis, 2011-07-08)
      While many studies confirm the association between HIV, alcohol and injecting drug use by female sex workers (FSWs), little is known about their use of marijuana, khat and other substances and the association of these substances with HIV, risky sexual behaviour, and sexual violence. To better understand this association, data were analysed from a cross-sectional, behavioural survey of 297 FSWs in Mombasa, a well-known tourist destination and the second largest port in Africa and capital city of the Coast Province in Kenya. Among the FSWs, lifetime use of different substances was reported by 91% for alcohol, 71% for khat, 34% for marijuana, and 6% for heroin, cocaine, glue or petrol. The majority (79%) used more than one substance, and multiple-substance use was reported by all respondents who ever used marijuana, heroin, cocaine, glue and petrol. The risk of HIV acquisition was perceived as medium to highby 41% of respondents, 75% of whom attributed this risk to multiple partners. Sexual violence was reported by 48% of respondents,and 30% indicated that this happened several times. Despite HIV prevention programmes targeting FSWs in Mombasa, most of them continue to engage in risky sexual behaviours. This suggests that harm reduction strategies for substance use should be coupled with efforts to promote consistent condom use and partner reduction.
    • Condom use as part of the wider HIV prevention strategy: Experiences from communities in the North West Province, South Africa

      M Murray; M Versteeg (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-08-14)
      Correct and consistent condom usage remains a pivotal strategy in reaching the target set by the South African government to reduce new HIV infections by 50% in the next 5 years. Studies have found that there has been an increase in condom usage by some categories of the population, but usage has not yet reached the desired levels in order to meet the target. This article reports on the findings of a study on condom usage in eight communities in the North West Province, which was part of a wider HIV and AIDS programme evaluation commissioned by the North West Provincial Department of Health. The main aim was to assess accessibility to condoms, and knowledge, attitudes and practices around condom use by four sampled communities in the North West Province. Eight focus group discussions were held and 50 households were interviewed. The study found positive results regarding accessibility and awareness of condoms. However, this often did not lead to the desired behavioural change of using condoms in risky sexual interactions. The majority of respondents still resisted condom usage, used condoms inconsistently, or were not in a position to negotiate protected sexual intercourse. The main reasons reported for this were: reduced pleasure, perceived and real physical side-effects, myths, lack of information, status, financial reasons, distrust in the efficacy of condoms, family planning, cultural reasons, gender-related reasons and trust. Many of the barriers to consistent condom use cannot be overcome by strategies that target the individual. Interventions need to address underlying developmental factors such as the non-biological factors that increase the susceptibility of women to HIV infection. As this falls outside of the scope of the mandate of the Department of Health, various partnerships with other key role players need to be established and/or strengthened, such as with local government, non-governmental organisations and faith-based organisations. Keywords: HIV and AIDS, condoms, behavioural change, South Africa, development.SAHARA J Vol. 5 (2) 2008: pp. 83-93
    • Confidentiality or continuity? Family caregivers\' experiences with care for HIV/AIDS patients in homebased care in Lesotho

      K Jubber; M Makoae (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-07-14)
      In the context of poor access to antiretroviral therapies in sub-Saharan Africa, the minimum treatment package intended to treat opportunistic infections common with HIV infection is inadequate but appealing, since it presumes universal coverage of medical care for patients living with HIV and AIDS. The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. A qualitative study using in-depth interviews with a sample of 21 family caregivers –16 females and 5 males aged between 23 and 85 years was conducted with the assistance of health personnel in two hospitals in Lesotho. Using the concept of continuity of care, this article discusses the experiences of family caregivers about home care, including their experiences of adherence to confidentiality by health care professionals and non-disclosure of AIDS as the context of illness, the circumstances under which the caregivers initiated caregiving and sought medical care, and how these factors could be stressors in caregiving. There was continuity of care where the caregivers obtained hospital support. However, when confidentiality was adhered to the caregivers were frustrated by lack of information, disrupted treatment, exclusion of their perspectives in medical care, failure to secure hospitalisation, ambiguous goals and non-responsiveness, so that continuity of care was jeopardised. Thus it can be concluded that professional-assisted disclosure benefited the patients because it facilitated continuity of care through the caregivers. Dans un contexte africain sous-Saharien où l'accès aux thérapies antirétrovirales est très limité, le paquet minimum de traitement destiné au traitement des infections opportunistes liées à la séropositivité est inadéquat mais attirant puisqu'il suppose une couverture universelle de soins médicaux pour des malades vivant avec le VIH/SIDA. L'objectif global de cette communication est d'analyser les défis auxquels les soignants familiaux font face en soins à domicile lorsqu'ils essayent d'avoir accès au traitement médical pour les malades du SIDA dans un contexte de confidentialité et des soins médicaux limités. Une étude qualitative employant des entretiens détaillés auprès d'un échantillon de 21 soignants familiaux (16 femmes et 5 hommes âgés de 23 à 85 ans) a été menée grâce à l'aide du personnel de santé dans deux hôpitaux au Lesotho. En utilisant le concept de continuité de soins, cette communication met en relief des expériences des soignants sur les soins à domicile. Cette communication examine des expériences des soignants familiaux sur les éléments suivants : l'adhésion par les professionnels de santé et de soins à la confidentialité et à la non-divulgation de séropositivité comme étant le contexte de maladie, les circonstances sous lesquelles les soignants ont initié les soins, les soins médicaux suscités, surtout le diagnostic et le traitement, ainsi que l'hospitalisation et la manière dans laquelle ces facteurs pourraient être à l'origine du stresse chez les soignants. On a constaté que la continuité des soins dans le cas où les soignants recevaient du soutien hospitalier – l'information, un traitement gratuit des multiples symptômes et l'hospitalisation de manière prévue et consistante. Cependant, lorsqu'il y avait adhésion à la confidentialité, les soignants étaient frustrés par le manque d'information, un traitement perturbé, l'exclusion de leurs opinions vis-à-vis les soins médicaux, ne pas pouvoir assurer l'hospitalisation des malades et les objectifs ambigües, la non-réceptivité et la continuité a été compromise. En conclusion, on constate que en divulguant sa séropositivité avec l'aide professionnelle a énormément aidé les malades car cela a facilité la continuité de soins assurés par les soignants. Keywords: Lesotho, HIV/AIDS, confidentiality, caregiving, continuity of care, ethic of care. SAHARA J Vol. 5 (1) 2008: pp. 36-46
    • 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
    • Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambe´ zia Province, Mozambique

      Mukolo, A; Torres, I; Bechtel, RM; Sidat, M; Vergara, AE (Taylor & Francis, 2014-11-21)
      Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives. We describe action research to generate consensus on critical characteristics of HIV stigma and anti-stigma interventions in Zambe´zia Province, Mozambique. Qualitative data gathering methods, including indepth key-informant interviews, community interviews and consensus group sessions, were utilized. Delphi methods and the strategic options development analysis technique were used to synthesize qualitative data. Key findings are that stigma enacted by the general public might be declining in tandem with the HIV/AIDS epidemic in Mozambique, but there is likely excessive residual fear of HIV disease and  community attitudes that sustain high levels of perceived stigma. HIV-positive women accessing maternal and child health services appear to shoulder a disproportionate burden of stigma. Unintentional biases among healthcare providers are currently the critical frontier of stigmatization, but there are few interventions designed to address them. Culturally sensitive psychotherapies are needed to address psychological distress associated with internalized stigma and these interventions should complement current supports for voluntary counseling and testing. While advantageous for defining stakeholder priorities for stigma reduction efforts, confirmatory quantitative studies of these consensus positions are needed before the launch of specific interventions.Keywords: stigma reduction, consensus, HIV/AIDS, Mozambique
    • Considering childbearing in the age of highly active antiretroviral therapy (HAART): Views of HIV-positive couples

      V Ndlovu (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-01-20)
      Objectives: Based on a qualitative study conducted in Bulawayo, Zimbabwe, this article examines how the availability of HAARTsince April 2004 may impact the views and choices of HIV-positive couples on childbearing.Methods: In-depth interviews were conducted with 15 couples where at least one partner was HIV positive. All respondents were ofreproductive age and had or were confronting reproductive and sexual decision-making.Results: HAART seems to have had a profound impact on the subject of childbearing among those who still desire to have children.Where hitherto individuals had only a desire for a child many are now, as a result of the availability of HAART, actively planningto have one. HAART has not only transformed their physical state but it has also transformed mostly what had been desire intointention. The impact, however, has not been uniform. Some respondents still desired to have a child but were not yet convincedabout the efficacy of HAART in preventing vertical transmission. Some respondents felt that HAART may have a negative impact onthe foetus and as such were against childbearing by HIV-positive people. No respondent indicated that their desire or intention tohave a child had been extinguished by the advent of HAART.Conclusion: Based on the findings of the study, HAART seems to have had a differential but nonetheless significant role in thereproductive plans of HIV-positive couples. The study also notes that there is a need to make available complete and unbiasedinformation on HAART, mother-to-child transmission risk (MTCT) and pregnancy to HIV-positive couples so as to enable them tomake informed decisions.
    • Contemporary HIV/AIDS research: Insights from knowledge management theory

      Callaghan, Chris William (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2017-09-19)
      Knowledge management as a field is concerned with the management of knowledge, including the management of knowledge in research processes. Knowledge management theory has the potential to support research into problems such as HIV, antibiotic resistance and others, particularly in terms of aspects of scientific research related to the contribution of social science. To date, however, these challenges remain with us, and theoretical contributions that can complement natural science efforts to eradicate these problems are needed. This paper seeks to offer a theoretical contribution grounded in Kuhn’s paradigm theory of innovation, and in the argument by Lakatos that scientific research can be fundamentally non-innovative, which suggests that social science aspects of knowledge creation may hold the key to more effective biomedical innovation. Given the consequences of ongoing and emerging global crises, and the failure of knowledge systems of scientific research to solve such problems outright, this paper provides a review of theory and literature arguing for a new paradigm in scientific research, based on the development of global systems to maximise research collaborations. A global systems approach effectively includes social science theory development as an important complement to the natural sciences research process. Arguably, information technology and social media technology have developed to the point at which solutions to knowledge aggregation challenges can enable solutions to knowledge problems on a scale hitherto unimaginable. Expert and non-expert crowdsourced inputs can enable problem-solving through exponentially increasing problem-solving inputs, using the ‘crowd,’ thereby increasing collaborations dramatically. It is argued that these developments herald a new era of participatory research, or a democratisation of research, which offers new hope for solving global social problems. This paper seeks to contribute to this end, and to the recognition of the important role of social theory in the scientific research process.Keywords: HIV/AIDS research, methodology, collaborative research problem solving, real time research, theory development
    • Contemporary HIV/AIDS research: Insights from knowledge management theory

      Chris William Callaghan (Taylor & Francis Group, 2017-01-01)
      Knowledge management as a field is concerned with the management of knowledge, including the management of knowledge in research processes. Knowledge management theory has the potential to support research into problems such as HIV, antibiotic resistance and others, particularly in terms of aspects of scientific research related to the contribution of social science. To date, however, these challenges remain with us, and theoretical contributions that can complement natural science efforts to eradicate these problems are needed. This paper seeks to offer a theoretical contribution grounded in Kuhn’s paradigm theory of innovation, and in the argument by Lakatos that scientific research can be fundamentally non-innovative, which suggests that social science aspects of knowledge creation may hold the key to more effective biomedical innovation. Given the consequences of ongoing and emerging global crises, and the failure of knowledge systems of scientific research to solve such problems outright, this paper provides a review of theory and literature arguing for a new paradigm in scientific research, based on the development of global systems to maximise research collaborations. A global systems approach effectively includes social science theory development as an important complement to the natural sciences research process. Arguably, information technology and social media technology have developed to the point at which solutions to knowledge aggregation challenges can enable solutions to knowledge problems on a scale hitherto unimaginable. Expert and non-expert crowdsourced inputs can enable problem-solving through exponentially increasing problem-solving inputs, using the ‘crowd,’ thereby increasing collaborations dramatically. It is argued that these developments herald a new era of participatory research, or a democratisation of research, which offers new hope for solving global social problems. This paper seeks to contribute to this end, and to the recognition of the important role of social theory in the scientific research process.