• Factors associated with consistent condom use by employees in the brewery industry in Nigeria

      AM Sunmola; Department of Psychology, University of Ibadan (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2004-07-14)
      Many employees of large organisations in Nigeria face significant risks for HIV infection, especially due to occasional or regular job transfers, involvement in casual sexual encounters and lack of consistent condom use. The current study analysed the determinants of consistent condom use in 710 sexually active men (N = 617) and women (N = 93) recruited from the country's brewery industry. Results showed that only 12% of the employees consistently used a condom. Men who used condoms for all sexual encounters were more likely to be single, had 12 - 18 years of schooling, worked as intermediate level staff, thought a condom was useful to prevent HIV infection, and perceived that condoms hinder sexual satisfaction.Women who consistently used condoms were more likely to have 7 - 12 years of schooling. It is appropriate that brewery authorities develop work place programmes to enhance condom use among employees in order to prevent the spread of HIV infection. Keywords: condom use, HIV/AIDS, Nigeria. RÉSUMÉ Beaucoup d'employés des grandes entreprises du Nigéria courent un grand risque de contamination par le VIH surtout à cause des déplacements réguliers ou qui se font de temps en temps dûs au travail, des relations sexuelles non suivies et de ne pas utiliser des préservatifs à chaquefois. Cette étude a fait une analyse des déterminants de l'utilisation des préservatifs de manière systèmatique chez 710 hommes (N = 617) et femmes (N = 93) qui sont sexuellement actifs et qui travaillent dans la brasserie du pays. Les résultats ont montré que 12% des employés utilisent des préservatifs systèmatiquement. Les hommes qui se servent des préservatifs à chaquefois qu'ils ont des rapports sexuels étaient plus souvent célibataires, ont subit 12 - 18 ans de scolarisation, étaient dans des postes moyennement placés sur l'échelon, ils considéraient des préservatifs comme un moyen de prévention contre la contamination par le VIH et ils pensaient que les préservatifs diminuent le plaisir sexuel. Les femmes qui utilisaient des préservatifs ont subit 7-12 ans de scolarisation. Il est nécessaire que les autorités de la brasserie puissent mettre en place des programmes/projets de sensibilisation à l'utilisation des préservatifs parmi les employés avec le but d'éviter la dissémination de l'infection par le VIH. Mots clés : l'utilisation des préservatifs,VIH/SIDA, le Nigéria. SAHARA J Vol.1(1) 2004: 27-34
    • Factors associated with discriminatory attitudes towards people living with HIV among adult population in Ethiopia: analysis on Ethiopian demographic and health survey

      Gedefaw Alen Diress; Mohammed Ahmed; Melese Linger (Taylor & Francis Group, 2020-01-01)
      Extensive discriminatory attitudes in a population can affect people’s willingness to be tested for Human Immunodeficiency Virus (HIV), their initiation of antiretroviral therapy, social support as well as the quality of life of people infected with HIV. This study aimed to assess factors associated with discriminatory attitudes towards people living with HIV/AIDS (PLWHA). Secondary data analysis was conducted using data from the 2016 Ethiopia Demographic Health Survey. A total of 26,623 adult populations were included. Multivariable logistic regression analysis was conducted to identify factors associated with discriminatory attitudes. The proportion of participants having discriminatory attitudes towards PLWHA was 93.8% among men and 64.5% among women. This study revealed that rural residence, no formal education, lack of media access, not previously tested for HIV and lack of comprehensive HIV knowledge increase the odds of having discriminatory attitudes. In conclusion, there is a high-level discriminatory attitude towards PLWHA. Improvement in HIV-related knowledge and dealing with wrong perceptions and myths are extremely vital to reduce discriminatory attitudes towards HIV-infected people. Information, education and communication programmes need to intensify its educational campaigns to dispel these misconceptions.
    • Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey

      Haque, Md. Ashiqul; Hossain, Md. Sha Newaj; Chowdhury, Muhammad Abdul Baker; Uddin, Md. Jamal (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-09-27)
      Women in Bangladesh share a greater risk of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about11 basic questions related to individual’s awareness. A score of the respondent’s knowledge and awareness was determined based on these questions. We used logistic regression models for analysing the data. We found about 62% of the respondents had an adequate knowledge and consciousness about the HIV/AIDS. Respondents’ education status, massmedia access, place of living, and working status played significant role on the awareness. As expected, respondents with higher education were more aware than those with no education (odds ratio (OR) = 3.56, 95% confidence interval (CI): 2.99–4.23). Moreover, respondents who had access to the mass media were more likely to be aware compared to those who did not have the access (OR = 1.14, 95% CI: 1.04–1.26). Although a sizeable proportion of women had an adequate knowledge and awareness regarding the HIV/AIDS, we recommend implementing educational programmes related to HIV/AIDS in the curriculum to ensure a standard level of awareness throughout the nation. Since the respondents from rural areas scored significantly lower than the urban areas, awareness through mass media, particularly in rural areas, is of prime concern for raising awareness.Keywords: Risk; HIV/AIDS infection; knowledge score; mass media; education;demographic and health survey
    • Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey

      Md. Ashiqul Haque; Md. Sha Newaj Hossain; Muhammad Abdul Baker Chowdhury; Md. Jamal Uddin (Taylor & Francis Group, 2018-01-01)
      Women in Bangladesh share a greater risk of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about 11 basic questions related to individual’s awareness. A score of the respondent’s knowledge and awareness was determined based on these questions. We used logistic regression models for analysing the data. We found about 62% of the respondents had an adequate knowledge and consciousness about the HIV/AIDS. Respondents’ education status, mass-media access, place of living, and working status played significant role on the awareness. As expected, respondents with higher education were more aware than those with no education (odds ratio (OR) = 3.56, 95% confidence interval (CI): 2.99–4.23). Moreover, respondents who had access to the mass media were more likely to be aware compared to those who did not have the access (OR = 1.14, 95% CI: 1.04–1.26). Although a sizeable proportion of women had an adequate knowledge and awareness regarding the HIV/AIDS, we recommend implementing educational programmes related to HIV/AIDS in the curriculum to ensure a standard level of awareness throughout the nation. Since the respondents from rural areas scored significantly lower than the urban areas, awareness through mass media, particularly in rural areas, is of prime concern for raising awareness.
    • Factors underlying taking a child to HIV care: implications for reducing loss to follow-up among HIV-infected and -exposed children

      Wachira, J; Middlestadt, SE; Vreeman, R; Braitstein, P (Taylor & Francis, 2012-08-27)
      Objective: With the aim of reducing pediatric loss to follow-up (LTFU) from HIV clinical care programs in sub-Saharan Africa, we sought to understand the personal and socio-cultural factors associated with the behavior of caregivers taking HIV-infected and -exposed children for care in western Kenya.Methods: Between Mayand August, 2010, in-depth interviews were conducted with 26 purposively sampled caregivers caring for HIVinfected(7), HIV-exposed (17) and HIV-unknown status (2) children, documented as LTFU from an urban and rural HIV care clinic. All were women with a majority (77%) being biological parents. Interviews were audio-recorded, transcribed and content analyzed.Results: Thematic content analysis of the women’s perceptions revealed that their decision about routinely taking their children to HIV care involved multiple levels of factors including: (1) intrapersonal: transport costs, food availability, time constraints due to work commitment, disclosure of HIV status for both mother and child, perception that child is healthy and religious beliefs; (2) interpersonal: unsupportive male partner, stigma by the family and family conflicts; (3) community: cultural norms, changingcommunity dynamics and perceived stigma; (4) health care system: clinic location, lack of patient-centered care, delays at the clinic and different appointment schedules (mother and child). Furthermore, the factors across these different levels interacted with each other in a complex way, illustrating the challenges women face in taking their children to HIV care.Conclusion: The complexity and interconnectedness of the factors underlying retention of children in HIV care perceived by these women caregivers suggests that interventions to reduce pediatric LTFU need to be holistic and address multiple socio-ecological levels. Patient-centered care that integrates a family-centered approach to HIV pediatric care is recommended.
    • Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa

      Morojele, NK; Kitleli, N; Ngako, K; Kekwaletswe, CT; Nkosi, S; Fritz, K; Parry, CDH (Taylor & Francis, 2014-10-07)
      Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes  experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief  intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV  and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors  received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and  referrals to the patrons of the bars. A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the  counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the  community at large) was an important contributor to the feasibility and acceptability of the intervention.Keywords: HIV prevention, bar-based intervention, server intervention, peer intervention, brief intervention, motivationalinterviewingLa consommation d’alcool est un facteur a` risque reconnu de transmission de l’infection du VIH. Les e´tablissements servant de l’alcool ont e´te´ identifie´s comme des lieux approprie´s pour effectuer des  interventions de pre´vention contre le VIH. Cet article de´crit les expe´riences et les lec¸ons tire´es de  l’imple´mentation d’une intervention combine´e de pre´vention contre le VIH dans un bar de la ville et un bar du township de Tshwane en Afrique du Sud. L’intervention consistait en de brefs sous-composants de conseils donne´s par des pairs. Trente neuf clients de bars ont e´te´ recrute´s et forme´s et ont rec¸us des activite´s lie´es a` la re´duction de l’alcool et du risque de VIH pour les transmettre a` leurs pairs en tant  qu’interventionnistes. En meˆme temps, neuf conseillers ont e´te´ forme´s et sont alle´s dans ces bars toutes les semaines pour donner de brefs conseils, avis et recommandations concernant les entretiens de motivation (EM) aux clients de bars. Un sous-composant de serveurs responsables qui avait e´galement e´te´ programme´ n’a pas e´te´ transmis e´tant donne´ qu’il n’e´tait pas possible de former le personnel de deux bars participants. Au cours des huit mois, les conseillers ont e´te´ aborde´s et ont donne´ des conseils et des avis  concernant les proble`mes lie´s aux risques sexuels et a` la consommation d’alcool a` 111 clients de bars. Les interventionnistes ont signale´ 1 323 interventions de re´duction des risques aupre`s de leurs clients de bars durant la meˆme pe´riode. L’intervention a globalement e´te´ bien rec¸ue et sugge`re que les clients de bars et serveurs peuvent accepter bon nombre d’activite´s d’intervention afin de re´duire les comportements sexuels a` risque dans les e´tablissements de consommation d’alcool. Cependant, dans certains cas, la stigmatisation lie´e au VIH et au SIDA a entrave´ la participation de certaines activite´s d’interventions. Le be´ne´fice que nous avons rec¸u des intervenants concerne´s (a` savoir proprie´taires de bars et clients, et la communaute´ dans son ensemble) e´tait un facteur important de la faisabilite´ et de l’acceptation de l’intervention.Mots cle´s: pre´vention VIH, intervention dans des bars, intervention des serveurs, intervention des pairs, bre`ve  intervention, entretien de motivationArticle in English.
    • Fighting against HIV and AIDS within a resource constrained rural setting: a case study of the Ruvheneko Programme in Chirumhanzu, Zimbabwe

      Christina Tafadzwa Dzimiri; Patrick Dzimiri; Kezia Batisai (Taylor & Francis Group, 2019-01-01)
      Since reports of the first incidence of the HIV virus in Zimbabwe in 1985, the epidemic has negatively impacted on every facet of human security. Rural areas, by virtue of being the periphery and constrained in terms of resources and health care provision, bear the brunt of the epidemic. In light of the above background, this paper examined how the establishment of Ruvheneko Programme by the people of Chirumhanzu helped in mitigating on the impact of HIV and AIDS in the rural sphere. The paper analyses how the community of Chirumhanzu successfully engaged each other to the extent of coming up with such a vibrant programme. This is raised against the backdrop of failure usually associated with HIV and AIDS engagement projects. The study made use of field interviews and focus group discussions as data collection instruments. Participants were purposively selected on the basis of their knowledge and participation in the establishment and activities of Ruvheneko Programme. Selected were 5 St Theresa’s Hospital Staff, 10 Roman Catholic Church members of which, 5 were from the St Anna’s woman prayer group and 5 men from St Joseph’s men prayer group, 1 village head and 2 elders from the same nearby village constituted key informants. Complementing the use of interviews and focus group discussions was the analysis of secondary data sources on HIV and AIDS in Zimbabwe as well as the Ruvheneko Programme. To understand the collective role of various sectors of the community in establishing Ruvheneko Programme, the paper derives insights from the perspective of social capital theory and its notion of commonality to strengthen communities. Findings from the study show that, unlike other HIV and AIDS programmes that are exported from the urban to the rural areas, Ruvheneko Programme demonstrates a grassroots-level response to HIV and AIDS. Again, social cohesion fostered by aspects such as religiosity, cultural ethos of Ubuntu, and a consultative approach played a key role in unifying people towards fighting HIV and AIDS in Rural Chirumhanzu.
    • Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa

      Steenkamp, L; Goosen, A; Venter, D; Beeforth, M (Taylor & Francis, 2016-08-22)
      The HIV prevalence in South Africa among students at higher education institutions (HEIs) in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socioeconomic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. The purpose of this paper is to describe food insecurity and the nutritional status among HIV-infected students on the Nelson Mandela Metropolitan University campuses in South Africa, as well as current initiatives to strengthen the safety nets for food-insecure students. This descriptive, cross-sectional survey was conducted among a convenience sample of known HIV-infected, registered students (n ¼ 63), older than 18 years of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme. Ethical approval for the study was obtained from the Research Ethics Committee (NMMU) and participants were included in the sample after providing written, informed consent. Findings indicate that food insecurity was common with more than 60% of the sample reporting food insecurity at the household level during the previous month. Of the sample, 51% were classified as being either overweight or obese. Although food insecurity did not contribute to weight loss in our sample, food-insecure students were more likely to consume inadequate amounts of vitamins and minerals, especially antioxidants that are important in supporting the immune system. Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent the development of chronic diseases of lifestyle, thus allowing for a healthier more productive life. Current intervention strategies to strengthen food security have made inroads to improve access to healthier food options.Keywords: food insecurity, nutrition, hunger, HIV, higher education institutions, safety nets
    • Food insecurity, HIV/AIDS pandemic and sexual behaviour of female commercial sex workers in Lagos metropolis, Nigeria

      J L Oyefara (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2007-11-19)
      This study examined the role of hunger and food insecurity in the sexual behaviour of female commercial sex workers in Lagos metropolis, Nigeria within the context of HIV/AIDS. In addition, the study investigated the prevalence of sexually transmitted infections (STIs) and induced abortion among the respondents. Cross-sectional survey and in-depth interview research methods were adopted to generate both quantitative and qualitative data from the respondents. Findings of the study showed that 35.0% of the respondents joined the sex industry because of poverty and lack of other means of getting daily food. While all the respondents had knowledge about the existence of HIV/AIDS, 82.0% of them identified sexual intercourse as a major route of HIV transmission. There was a significant relationship between poverty, food insecurity and consistent use of condoms by female sex workers at P
    • Food security in HIV/AIDS response: Insights from Homa Bay, Kenya

      D Datta; J Njuguna (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-02-05)
      This paper examines the viability and effectiveness of a pilot farming initiative in reversing impacts of HIV/AIDS on the most affected households in Homa Bay, Kenya. The paper argues that once patients are stable, they can effectively be engaged in farming with minimal financial and technical support, resulting in enhanced food security of the affected households. More importantly, it helps to reduce HIV/AIDS-related stigma and improve the individual’s self-esteem. Some of the key challenges of the pilot initiative were the limited number of agricultural extension workers and absence of facilities to enable them to deliver services to the farmers, the high cost of farm inputs, the unavailability of farm inputs when they were needed, poorly developed agricultural markets, and the absence of irrigation facilities. The paper recommends the sensitive scaling-up of this approach. However, farming initiatives by HIV/AIDS service NGOs should be linked to at least three key aspects: (a) treatment, care and support to HIV/AIDS affected households; (b) micro grant schemes or subsidies to enable farmers to purchase farming tools and farm inputs; and (c) comprehensive on-farm training support. To ensure effectiveness and wider reach, government needs to view agriculture through an HIV lens and promote a multisectoral approach thatrecognises the relationship between HIV/AIDS and food security. A number of immediate actions are required to strengthen this relationship, such as increased public investment to augment extension services, subsidise farm inputs, and develop infrastructure including agricultural markets.Keywords: HIV and AIDS, food security, agriculture, Kenya.
    • For the common good: Measuring residents\' efforts to protect their community from drug- and sex-related harm

      M Sandoval; PL Flom; M Bolyard; P Mateu-Gelabert; SR Friedman; C Maslow (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
      People in high-risk neighbourhoods try to protect their friends, neighbours, relatives and others from the social and physical risks associated with sex and drug use. This paper develops and validates a community-grounded questionnaire to measure such ‘intravention\' (health-directed efforts to protect others). An initial ethnography, including life-history interviews and focus groups, explored the forms of intravention activities engaged in by residents of Bushwick (a high-risk New York City neighbourhood). Grassroots categories of intraventions were derived and questions developed to ask about such behaviours. Face validity and adequacy of the questions were assessed by independent experts. Pre-testing was conducted, and reliability and validity were assessed. An instrument including 110 intravention items was administered to 57 community-recruited residents. Analysis focused on 57 items in 11 domain-specific subscale. All subscales had good to very good reliability; Cronbach\'s alpha ranged from .81 to .95. The subscales evidenced both convergent and discriminant validity. Although further testing of this instrument on additional populations is clearly warranted, this intravention instrument seems valid and reliable. It can be used by researchers in comparative and longitudinal studies of the causes, prevalence and affects of different intravention activities in communities. It can benefit public health practitioners by helping them understand the environments in which they are intervening and by helping them find ways to cooperate with local neighbourhood-level health activists. Keywords: Intravention, drug prevention, harm reduction, community actions, protecting others.SAHARA-J Vol. 5 (3) 2008: pp. 144-157
    • Gender and HIV/AIDS impact mitigation in sub-Saharan Africa - recognising the constraints

      T Barnett; Development Studies Institute, London School of Economics and Political Science; R Grellier; Options Consultancy Services, London; J Seeley; Gender and Development at the School of Development Studies, University of East Anglia, Norwich (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2004-10-01)
      In discussions of gender and HIV/AIDS, attention has focused on prevention. This is a vital area. However, we argue that there is also a need to focus more attention on the resulting impact of the epidemic, because inequalities that promote the spread of infection are also hampering containment and impact mitigation. We propose a framework highlighting the gendered constraints exacerbated by the epidemic. These constraints are reviewed under the following headings: Gender-specific constraints: stemming from the specific nature of gender relations themselves, such as the availability of labour in agriculture, business and for household tasks, as well as access to services and markets, and the incidence of gendered violence. Gender-intensified disadvantages: stemming from the uneven and often inequitable distribution of resources between men and women, including cultural/religious conventions, and the social rules and norms that regulate property rights, inheritance practices and resource endowments. Gender-imposed constraints: resulting from biases and partialities of those individuals who have the authority and power to allocate resources. These include provision of credit, information, agricultural extension and health care. The differential involvement of men and women in development programmes affects access to resources, as does political participation, including involvement in the formulation of policies aimed at poverty reduction. These constraints take us beyond gender relations and sexual behaviour. But women's lives will not change in the short term. The challenges they face in mitigating the impact of HIV/AIDS will not be addressed by focusing only on their specific vulnerability to HIV/AIDS infection. Unequal gender relations and the nature of development' need to be changed too. SAHARA-J (2004) 1(2): 87-98 Keywords: gender, HIV/AIDS, impact mitigation,sub-Saharan Africa RÉSUMÉ Pendant les discussions de sexes et du VIH/SIDA, la prévention fut le centre d'intérêt. Ce dernier est un domaine primordial. Cependant, nous débattons qu'il est aussi nécessaire de se focaliser sur l'impact de l'épidémie car les inégalités qui favorisent la dissémination de l'infection ont tendance à entraver l'enraiement de l'épidémie et l'atténuation de l'impact. Nous proposons un cadre qui met en relief les contraintes de sexes aggravées par l'épidémie. Ces contraintes sont re-examinées sous les titres suivants: Des contraintes particulières aux genres: découlant de la nature particulière des relations de genres, comme la disponibilité du travail en agriculture, dans les affaires et à domicile ainsi que l'accès aux services et aux marchés et la fréquence de la violence de sexes. Les inconvénients intensifiés par le genre: découlant de la distribution irrégulière et souvent inéquitable des ressources entre les hommes et les femmes. Ceci inclue des conventions culturelles/religieuses ainsi que les règlements sociaux et des normes qui réglementent les droits aux propriétés, les pratiques de l'héritage et les dotations de ressources. Les contraintes imposées par le genre: résultant des préjudices et des partialités de ceux qui ont le droit et le pouvoir d'assigner les ressources. Ceci inclue l'approvisionnement du crédit, l'information, l'extension dans l'agriculture et les soins sanitaires. L'écart de participation des hommes et des femmes dans le développement des programmes a une incidence à l'accès aux ressources, comme c'est le cas dans la participation politique ainsi que la participation dans la mise en place d'une politique visant la réduction de la pauvreté. Ces contraintes nous amènent au delà des relations de genres et le comportement sexuel. Cependant, la vie des femmes ne changera pas du jour au lendemain. Les défis auxquels elles font face en atténuant l'effet du VIH/SIDA ne seront pas prise en charge uniquement en se focalisant sur leurs vulnérabilité particulière vis-à-vis l'infection par le VIH/SIDA. Les relations inégales de genre et la nature du développement doivent être changés également. SAHARA-J (2004) 1(2): 87-98 Mots clés : le genre, le VIH/SIDA, atténuer l'impact, le Sous-Sahara.
    • Gender differences in university students\' HIV/AIDS-related knowledge and sexual behaviours in Malawi: a pilot study

      EE Kayambazinthu; AS Muula; PRT Ntata; S Siziya (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
      A cross-sectional study was conducted among first-year university students in Malawi to determine distributions of HIV/AIDSrelated knowledge, and sexual behaviours. A total of 314 (199 male and 115 female) students were eligible to participate, and of these 221 (70.4%) participated in the survey. Generally, levels of HIV/AIDS-related knowledge were similar between sexes. Overall, 68.9% of students of both sexes felt that they knew enough about HIV/AIDS. Altogether, 83.3% of students reported that they knew where to access HIV testing on campus, but only 19.0% reported that they knew their HIV status. Some 60.3% of students who had never been tested intended to have an HIV test. A history of having ever been tested was not associated with sex. Most (68.4%) students felt that they were not at risk of acquiring HIV infection. Overall, 66.8% of students knew where to get a condom on campus, and 38.7% stated that they knew exactly how to use it. About half (52.6%) of the students used a condom at last vaginal sexual intercourse. Having multiple sex partners in the last 12 months was reported by 40.4% of students. Keywords: University students, HIV/AIDS-related knowledge, sexual behaviours, Malawi.SAHARA-J Vol. 5 (4) 2008: pp. 201-205
    • Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

      Deribe, K; Woldemichael, K; Njau, BJ; Yakob, B; Biadgilign, S; Amberbir, A (Taylor & Francis, 2011-07-07)
      There are inconsistent findings about the relation between gender and HIV status disclosure. We conducted a facility-based crosssectional 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% menv. 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.
    • Health care users’ knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa

      Gumede, Sibongiseni Daphney; Sibiya, Maureen Nokuthula (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-09-27)
      Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV selftesting strategy could increase the uptake of HIV testing among the people. The aim of the study was to assess outpatients’ health care user’s knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users’ knowledge of HIVST, assess health care users’ attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of healthcare users towards HIVST. A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three purposefully selected Addington, R. K. Khan and Prince Mshiyeni Memorial Hospital Gateway clinics at eThekwini Health District. A convenience sampling of 442 respondents were sampled from the three study sites. Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they could use it if it can be made freely available to the public and be properly regulated. Generally, health care users indicated positive attitudes towards HIV self-testing. Nevertheless, issues of lack of pre and post-test counselling, false negative results and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated in South Africa.Keywords: HIV self-testing; oral HIV testing; South Africa
    • Health care users’ knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa

      Sibongiseni Daphney Gumede; Maureen Nokuthula Sibiya (Taylor & Francis Group, 2018-01-01)
      Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV self-testing strategy could increase the uptake of HIV testing among the people. The aim of the study was to assess outpatients’ health care user’s knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users’ knowledge of HIVST, assess health care users’ attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of health care users towards HIVST. A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three purposefully selected Addington, R. K. Khan and Prince Mshiyeni Memorial Hospital Gateway clinics at eThekwini Health District. A convenience sampling of 442 respondents were sampled from the three study sites. Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they could use it if it can be made freely available to the public and be properly regulated. Generally, health care users indicated positive attitudes towards HIV self-testing. Nevertheless, issues of lack of pre and post-test counselling, false negative results and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated in South Africa.
    • Health-related quality of life and associated factors in adults living with HIV in Rwanda

      Biraguma, Juvenal; Mutimura, Eugene; Frantz, José M. (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-09-27)
      In Rwanda, as in other sub-Saharan African (SSA) countries, life expectancy of people living with HIV (PLWH) has increased dramatically as a result of combined antiretroviral therapy (cART). People living with HIV can now live longer but with increasing rates of non-communicable diseases (NCDs). Thus, prevention of NCD comorbidities in PWLHI is crucial to maintain and gain health-related benefits and to maximise the health-related quality of life (HRQOL) in the long-term management of PLWH. This study determines the association between physical and mental health-related dimensions of quality of life (QOL) with behavioural and biological risk factors, after controlling socio-demographic and HIV-related factors in adults living with HIV in Rwanda. A cross-sectional study using the WHO STEPwise approach and Kinyarwanda version of the MOS-HIV Health Survey, risk factors for NCDs and HRQOL were analysed for 794 PLWH, both HIV+ on ART and ART-naïve. Multiple regression analysis was used to examine the relationship between CMD risk factors and physical health and mental health summary scores. A total of 794 participants were interviewed. The mean age of the sample was 37.9 (±10.8) years and the majority of the participants were women (n = 513; 64.6%). About 16.2% reported daily smoking, 31.4% reported harmful alcohol use and 95% reported insufficient consumption of vegetables and fruits while 26.1% reported being physically inactive. 18.4% were overweight 43.4% had abdominal obesity, i.e. waist-hip-ratio (WHR) ≥0.95 in males and 0.85 in females. High blood pressure (HBP), i.e. systolic blood pressure (SBP) of ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg was 24.4%. The results reveal that mean physical health summary and mental health summary score values were 63.96 ± 11.68 and 53.43 ± 10.89, respectively. While participants indicated that tobacco users and those who had abdominal obesity reported poor mental HRQOL, physical inactivity and hypertension have a negative impact on physical HRQOL. In addition, certain sociodemographic and HIV-related variables – specifically being unmarried, lack of HIV disclosure and low CD4 count (less 350 cell counts /mm3) – were associated with significantly lower mental and physical dimensions of quality of life. The results of this study reveal that behavioural and biological risk factors for NCDs were significantly associated with a lower HRQOL. These research findings also suggest that the assessment of the association between behavioural and biological risk factors for NCDs and a HRQOL provides opportunities for targeted counselling and secondary prevention efforts, so that health care providers can implement strategies that have a significant impact on the HRQOL.Keywords: Non-communicable diseases; risk factors; HIV; healthrelated quality of life; physical health; Rwanda
    • Health-related quality of life and associated factors in adults living with HIV in Rwanda

      Juvenal Biraguma; Eugene Mutimura; José M Frantz (Taylor & Francis Group, 2018-01-01)
      In Rwanda, as in other sub-Saharan African (SSA) countries, life expectancy of people living with HIV (PLWH) has increased dramatically as a result of combined antiretroviral therapy (cART). People living with HIV can now live longer but with increasing rates of non-communicable diseases (NCDs). Thus, prevention of NCD comorbidities in PWLHI is crucial to maintain and gain health-related benefits and to maximise the health-related quality of life (HRQOL) in the long-term management of PLWH. This study determines the association between physical and mental health-related dimensions of quality of life (QOL) with behavioural and biological risk factors, after controlling socio-demographic and HIV-related factors in adults living with HIV in Rwanda. A cross-sectional study using the WHO STEPwise approach and Kinyarwanda version of the MOS-HIV Health Survey, risk factors for NCDs and HRQOL were analysed for 794 PLWH, both HIV+ on ART and ART-naïve. Multiple regression analysis was used to examine the relationship between CMD risk factors and physical health and mental health summary scores. A total of 794 participants were interviewed. The mean age of the sample was 37.9 (±10.8) years and the majority of the participants were women (n = 513; 64.6%). About 16.2% reported daily smoking, 31.4% reported harmful alcohol use and 95% reported insufficient consumption of vegetables and fruits while 26.1% reported being physically inactive. 18.4% were overweight 43.4% had abdominal obesity, i.e. waist-hip-ratio (WHR) ≥0.95 in males and 0.85 in females. High blood pressure (HBP), i.e. systolic blood pressure (SBP) of ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg was 24.4%. The results reveal that mean physical health summary and mental health summary score values were 63.96 ± 11.68 and 53.43 ± 10.89, respectively. While participants indicated that tobacco users and those who had abdominal obesity reported poor mental HRQOL, physical inactivity and hypertension have a negative impact on physical HRQOL. In addition, certain socio-demographic and HIV-related variables – specifically being unmarried, lack of HIV disclosure and low CD4 count (less 350 cell counts /mm3) – were associated with significantly lower mental and physical dimensions of quality of life. The results of this study reveal that behavioural and biological risk factors for NCDs were significantly associated with a lower HRQOL. These research findings also suggest that the assessment of the association between behavioural and biological risk factors for NCDs and a HRQOL provides opportunities for targeted counselling and secondary prevention efforts, so that health care providers can implement strategies that have a significant impact on the HRQOL.
    • Hearing community voices: grassroots perceptions of an intervention to support health volunteers in South Africa

      C Campbell; S Maimane; Y Nair; A Gibbs (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
      With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS – as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. Given the growing emphasis on involving community voices in project research, we conducted 17 discussions with 34 community members, including those involved and uninvolved in project activities – at the end of this 3-year period. These discussions aimed to elicit local people's perceptions of the project, its strengths and its weaknesses. Community members perceived the project to have made various forms of positive progress in empowering volunteers to run a more effective home nursing service. However, discussions suggested that it was unlikely that these efforts would be sustainable in the long term, due to lack of support for volunteers both within and outside of the community. We conclude that those seeking to increase the role and capacity of community volunteers in AIDS care need to make substantial efforts to ensure that appropriate support structures are in place. Chief among these are: sustainable stipends for volunteers; commitment from community leaders and volunteer team leaders to democratic ideals of project management; and substantial support from external agencies in the health, welfare and NGO sectors. Keywords: Evaluation, home-based care, volunteers, task shifting, participation, stipends, leadership.SAHARA-J Vol. 5 (4) 2008: pp. 162-177
    • High levels of psychosocial readiness for ART in an African population at the onset of treatment

      B Wolff; M Mbonye; S Jaffar; B Amuron; A Coutinho; R Nkabala; H Grosskurth (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-02-05)
      Adherence at the earliest stages of treatment is likely to be influenced by prior illness trajectories and future expectations, best captured (and addressed) before treatment begins. We examined the influence of illness trajectories and treatment expectations on psychosocial readiness to start antiretroviral therapy (ART) in Jinja, Uganda. In-depth interviews were conducted between October 2005 and April 2006 with 41 members of an AIDS support organisation on their first day of treatment. Transcribed texts were translated, coded and analysed thematically using NVIVO-7 software. Results indicated that acute fear of death and progressive withdrawal from social, economic and sexual roles narrowed focus on survival, while efficacy-enhancing experiences with septrin prophylaxis and trust in counsellors reinforced belief in HIV diagnosis and importance of adherence. Most enjoyed supportive home environments after disclosing their serostatus. Lack of money for food and transport was anticipated as the main barriers to future adherence, particularly among women. Integrating strong counselling support with ART provision helped channel the power of shared illness experience into positive motivation to adhere at the onset of treatment.Keywords: HIV, antiretroviral therapy, adherence, qualitative, Africa.