• 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.
    • HIV counselling and testing utilisation and attitudes of male inmates in a South African prison

      Motshabi, LC; Pengpid, S; Peltzer, K (Taylor & Francis, 2012-08-27)
      The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction, their experiences and expectations, and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre, South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34, 95%CI:0.23 - 0.50) was inversely associated with HIV testing acceptance in prison, while age, educational level, population group, marital status, length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50%) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services, ranging from 79% (fair to very good) for ‘the way he/she received you’ to 62% ‘clarified all your concerns’. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctionalcentres especially with regard to VCT services.
    • HIV fatalism and engagement in transactional sex among Ugandan fisherfolk living with HIV

      Katelyn M. Sileo; Laura M. Bogart; Glenn J. Wagner; William Musoke; Rose Naigino; Barbara Mukasa; Rhoda K. Wanyenze (Taylor & Francis Group, 2019-01-01)
      HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02–9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting.
    • HIV in (and out of) the clinic: Biomedicine, traditional medicine and spiritual healing in Harare

      O'Brien, S; Broom, A (Taylor & Francis, 2014-10-08)
      Contemporary lived experiences of the human immunodeficiency virus (HIV) are shaped by clinical and cultural encounters with illness. In sub-Saharan countries such as Zimbabwe, HIV is treated in very different ways in  various therapeutic contexts including by biomedical experts, traditional medicine and faith healers. The  co-existence of such expertise raises important questions around the potencies and limits of medicalisation and alternative healing practices in promoting HIV recovery. First, in this study, drawing on in-depth qualitative  interviews with 60 people from poor urban areas in Harare, we explore the experiences of people living with and affected by HIV. Specifically, we sought to document, interrogate and reflect on their perceptions and experiences of biomedicine in relation to traditional medicine and spiritual healing. Their accounts indicate that traditional medicine and spiritual beliefs continue to significantly influence the way in which HIV is understood, and the forms of help and care people seek. Second, we observe the dramatic and overwhelmingly beneficial impact of  Antiretroviral Therapy and conclude through Zimbabwean’s own stories that limitations around delivery and wider structural inequalities impede its potential. Lastly, we explore some practical implications of the biomedical clinic (and alternative healing practices) being understood as sites of ideological and expert  contestation. This paper aimed to add to our knowledge of the relationships between traditional medicine and spiritual healing in  connection with biomedicine and how this may influence HIV treatment and prevention.Keywords: antiretroviral therapy, HIV/AIDS, qualitative sociology, spiritual healing, traditional medicine, ZimbabweLes experiences contemporaines du virus humain de deficience immunologique VIH sont determinees par des rencontres cliniques et culturelles avec la maladie. Dans les pays sub-Sahariens comme le Zimbabwe, le VIH est soigne´ de manie`re tre`s diffe´rente selon des contextes the´rapeutiques varie´s y compris les experts en me´decine biome´dicale, les gue´risseurs traditionnels et les gue´risseurs par la foi. L’existence coˆte a` coˆte de ces pratiques soule`ve des questions importantes concernant l’efficacite´ et les limites de la me´dicalisation et des pratiques de gue´rison alternatives afin de promouvoir la gue´rison du VIH. Dans cette e´tude faisant appel a` des interviews qualitatives en profondeur avec 60 personnes provenant de secteurs urbains appauvris a` Harare, nous explorons les expe´riences des personnes qui vivent avec et qui sont affecte´es par le VIH. Surtout nous avons essaye´ de documenter d’interroger et de reflechir sur leurs perceptions et expe´riences de la biome´dicine par rapport a la medicine traditionnelle et des gue´risseurs par la foi. Leurs comptes rendus indiquent que les pratiques traditionnelles et les croyances spirituelles continuent a` influencer de fac¸on significative la fac¸on dans laquelle le VIH est compris et les types d’aide et de soins que les gens recherchent. Deuxiemement, nous observons l’impacte drammatique et be´ne´fique de la The´rapie Antire´troviale (TAR) et concluons selons les rapports du Zimbabwe que les limites de livraison et que des ine´galite´s de structure  re´pandues empeˆchent l’accomplissement de leur potentiel. En dernier lieu, nous explorons certaines  implications pratiques de la Clinique biome´dicale (et autres pratiques ‘alternatives’ de gue´rison) comme etant  comprises en tant que champs ide´ologiques et experts en contestation. Le but de cet article est de renforcer  notre connaissance de la relation entre la gue´rison traditionnelle et la gue´rison par la foi en rapport avec la  biome´dicine et comment cela peut influencer le traitement et la pre´vention du VIH.Mots cle´s: the´rapie antire´troviale, gue´risseurs par la foi, gue´rison traditionnelle, sociologie qualitative, VIH/SIDA, Zimbabwe
    • HIV knowledge and health-seeking behavior in Zambe´ zia Province, Mozambique

      Audet, CM; Sidat, M; Blevins, M; Moon, TD; Vergara, A; Vermund, SH (Taylor & Francis, 2012-08-27)
      HIV prevalence rates in Zambe´zia Province were estimated to be 12.6% in 2009. A number of educational campaigns have been aimed at improving HIV transmission and prevention knowledge among community members in an effort to reduce infection rates. These campaigns have also encouraged people to seek health care at clinical sites, instead of employing traditional healers to cure serious illness. The impact of these programs on the rural population has not been well documented. To assess the level of knowledge about HIV transmission and prevention and health-seeking behavior, we interviewed 349 people in 2009 using free response and multiple choice questionnaires. Over half reported first seeking treatment at a government health clinic; however, the majority of participants had visited a traditional healer in the past. Knowledge regarding prevention and transmission of HIV was primarily limited to the sexual origins of infection and the protective advantages of condom use.Increased educational level and having learned about HIV from a community health worker were associated with higher HIV prevention and transmission knowledge. Traditional healers and community health-care workers were both conduits of health information to our study participants. HIV education and use of clinical services may be facilitated by partnering more closely with these groups.
    • HIV prevention among female sex workers in Africa

      Scheibe, A; Drame, FM; Shannon, K (Taylor & Francis, 2012-12-06)
      Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. The criminalisation of sex work; community and service provider stigma; violence; substance use and limited access to health services and prevention commodities contribute to the high HIV burden evident among female sex workers in Africa. Following UNAIDS’ three pillar approach to HIV prevention and sex work we present an overview of current opportunities, barriers and suggestions to improve HIV prevention policy and programming for sex work in Africa. Universal access to a comprehensive package of HIV services is the first pillar. Reproductive health commodities; voluntary and anonymous HIV counselling andtesting; treatment of sexually transmitted infections, HIV and opportunistic infections; harm reduction for substance use and psychosocial support services make up the recommended package of services. The second pillar is a sex worker-supportive environment. The inclusion of sex worker programmes within national HIV strategic planning; sex worker-led community mobilisation and the establishment of sex work community networks (comprised of sex workers, health service providers, law enforcers and other stakeholders) enable effective programme implementation and are recommended. The reduction of sex worker vulnerability and addressing structural issues form the final pillar. The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the inclusiveness of the HIV response.
    • HIV protective strategies among college students in Durban, South Africa

      Maharaj, P; Cleland, J (Taylor & Francis, 2012-08-27)
      There is growing concern about the high level of HIV infection among young people in South Africa. The aim of the study is to examine the HIV protective strategies used by college students with specific emphasis on variations by race group. The data for the study come from a self-administrated survey that was conducted with 3 000 college students in Durban in order to understand the strategies they use to protect themselves against the risk of HIV infection. Overall, students perceived a far greater risk of pregnancy than HIV infection. The results show that abstinence is the most common protective factor among Indian and White students. Among African students, there is great concern about HIV but abstinence is less common. Among sexually active men and women, the majority report having more than one sexual partner (with the exception of Indian females). Female students among all groups were more likely than male students to report that they were faithful to their partners. In Africans the contrast is stark: 25% for women versus 6% for men. Condoms are the most commonly used method by students but are not used in every sexual encounter. Consistent condom use was highest among Indian males (46%) and lowest among White females (13.7%). More effort needs to be directed at promoting correct and consistent condom use in order to avoid the negative consequences associated with unprotected sexual intercourse including unwanted pregnancy and HIV/AIDS.
    • HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria

      Ubesie, A.C.; Iloh, K.K.; Emodi, I.J.; Ibeziako, N.S.; Obumneme-Anyim, I.N.; Iloh, O.N.; Ayuk, A.C.; Anikene, C.J.; Enemuo, J.E. (Taylor & Francis, 2016-09-14)
      Aims: To determine the rate of HIV status disclosure, caregivers’ reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria.Methods: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software.Results: Caregivers of 107 children (age 5–16 years; mean 10.1 + 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure.Conclusions: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.Keywords: HIV, children, disclosure, caregivers, pediatric, rate, AIDS, Enugu, Southeast Nigeria
    • HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia

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

      A E Oluwagbemiga (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-01-22)
      Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family.The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families.The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state, while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey, among people living with HIV/AIDS, 66% of females and males were in the age group 21-40 years, while 10% were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents, grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children.They are often forced to work more than they would have, or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus, while their children have had to drop out of school, since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment, in order to reduce the impact of the disease on the family. Keywords:Family, orpharns, HIV/AIDS, NigeriaSAHARA J Vol. 4 (3) 2007: pp. 668-677
    • HIV/AIDS and Indian youth – a review of the literature (1980 - 2008)

      A Nath (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-01-20)
      The main objective of this article is to provide a comprehensive overview of the situation regarding HIV/AIDS among youth in India, and explore the possible strategies that could be effective in combating the spread of this disease. India is in the grip of the HIV/AIDS epidemic, with an increasing number of infections being reported among youth, who comprise a quarter of the population but account for almost one-third of the HIV/AIDS burden. The prevalence in young women appears to be on the rise. Although the majority of youth are aware of the disease, a number of myths and misconceptions still prevail. Furthermore, or as a consequence, a higher percentage of young males report engaging in premarital sexual activity compared with females. Even though condom awareness is fairly high, condom usage is low. Of late, sex tourism and its implications for the HIV/AIDS epidemic present an increasing concern. Indian youth appear to hold negative attitudes towards HIV testing and people living with HIV/AIDS. Although a number of preventive and control programmes and policies exist, these need further strengthening and evaluation.
    • HIV/AIDS and older adults in Cameroon: Emerging issues and implications for caregiving and policy-making

      Tanyi, Perpetua Lum; Pelser, André; Okeibunor, Joseph (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-02-08)
      The burden of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of HIV infection and AIDS on the older adults in the Northwest Region of Cameroon. Using in-depth interviews (IDIs) and focus group discussions (FGDs), data were collected from 36 participants who were purposively selected from the three divisions which had been chosen randomly. 6 FGD sessions were held with 30 women aged 60 years and above and who were affected by HIV infection and AIDS, while IDIs sessions were held with 6 male community leaders. The results revealed that HIV infection and AIDS has added another dimension to the role of older persons. HIV infection and AIDS affects older people in diverse ways, as they have to look after themselves, their sick children and are often also left to look after their grandchildren orphaned by HIV infection and AIDS. These emerging issues in their lives make them vulnerable to health, social, economic and psychological challenges, and place a burden on them as caregivers instead of being cared for in their old age. Apart from increased direct expenditures, taking care of victims of HIV infection and AIDS requires older people to stay away from social, religious and community activities. The results showed that the loss of a child to HIV infection and AIDS affects the economic/financial well-being, participation in social/religious interactions as well as the community activities of older people participants. The implications of these findings for caregiving and social policy are discussed.Keywords: HIV/AIDS, older adults, African family, caregiving, Cameroon
    • HIV/AIDS and older adults in Cameroon: Emerging issues and implications for caregiving and policy-making

      Perpetua Lum Tanyi; André Pelser; Joseph Okeibunor (Taylor & Francis Group, 2018-01-01)
      The burden of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of HIV infection and AIDS on the older adults in the Northwest Region of Cameroon. Using in-depth interviews (IDIs) and focus group discussions (FGDs), data were collected from 36 participants who were purposively selected from the three divisions which had been chosen randomly. 6 FGD sessions were held with 30 women aged 60 years and above and who were affected by HIV infection and AIDS, while IDIs sessions were held with 6 male community leaders. The results revealed that HIV infection and AIDS has added another dimension to the role of older persons. HIV infection and AIDS affects older people in diverse ways, as they have to look after themselves, their sick children and are often also left to look after their grandchildren orphaned by HIV infection and AIDS. These emerging issues in their lives make them vulnerable to health, social, economic and psychological challenges, and place a burden on them as caregivers instead of being cared for in their old age. Apart from increased direct expenditures, taking care of victims of HIV infection and AIDS requires older people to stay away from social, religious and community activities. The results showed that the loss of a child to HIV infection and AIDS affects the economic/financial well-being, participation in social/religious interactions as well as the community activities of older people participants. The implications of these findings for caregiving and social policy are discussed.
    • HIV/AIDS knowledge, behaviour and beliefs among South African university students

      Reddy, P; Frantz, J (Taylor & Francis, 2012-08-27)
      Globally, South Africa has the highest prevalence of HIV/AIDS. In the absence of cure, prevention is the only available method to reduce HIV prevalence rates. This can only be obtained through behavioural change, which is associated with a good knowledge about HIV. The study aims to determine the knowledge, beliefs, behaviours and sources of HIV and AIDS information among university students at two tertiary institutions in South Africa. The study was a quantitative, cross-sectional, descriptive and comparative survey. Students from the Western Cape Province and the KwaZulu-Natal Province participated in the study. The main findings of the study were that althoughstudents had an adequate general knowledge on HIV/AIDS, both groups scored the lowest in the transmission modes of HIV. The media was the main source of HIV/AIDS information for students and university health care facilities need to be more proactive in informing students about the transmission of HIV/AIDS.
    • HIV/AIDS prevention through peer education and support in secondary schools in South Africa

      M J Visser (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-01-22)
      The implementation and evaluation of a peer education and support programme in secondary schools to prevent and reduce high-risk sexual behaviour amongst adolescents is discussed.The aims of the programme were to provide accurate information about HIV/AIDS, discuss and reconsider peer group norms, and establish support for learners. In the programme that was implemented in 13 secondary schools in Tshwane, South Africa, peer educators were identified, trained and supported to implement the programme in their schools with the assistance of a teacher and postgraduate students as facilitators. Peer educators organised HIV awareness activities, facilitated class discussions on risk behaviour and gender relationships, and supported learners in solving personal problems. Process evaluation included weekly reports and focus group discussions with peer educators and teachers. A quasiexperimental design involving an experimental and control group, as well as pre- and post-assessments, was used to evaluate the impact of the programme on psychological well-being, personal control, school climate and reported high-risk behaviour of learners aged between 13 and 20 years.The results showed that the percentage of learners in the experimental group who were sexually experienced remained unchanged over the time period of 18 months. In contrast, a significantly increased percentage of learners in the control group were sexually experienced after the same time period.The control group also perceived more of their friends to be sexually experienced. No differences were reported in condom use in either of the groups.The findings of this study suggest that peer education can contribute to a delayed onset of sexual activity, and can therefore contribute to the prevention of HIV/AIDS amongst adolescents. Cette communication expose une mise en application et une évaluation de l'éducation par les pairs et le programme de soutien dans des lycées afin d'éviter et de réduire le comportement sexuel à risque élevé parmi des adolescents. Les objectifs de ce programme étaient les suivants : la mise à disposition de l'information précise portant sur le VIH/SIDA, débattre et revoir les normes de groupes de pairs, et établir un service de soutien pour des apprenants. Pendant l'exécution du programme dans 13 lycées à Tshwane, Afrique du Sud, les pairs éducateurs ont été identifiés, formés et soutenus afin d'exécuter ce programme dans leurs lycées avec l'aide d'un enseignant et des étudiants postuniversitaires comme animateurs. Les pairs éducateurs ont organisé des activités de prise de conscience du VIH. Ils ont animé des discussions, en classe, sur le comportement à risque et les relations entre garçons et filles, et ils ont enfin soutenu et aidé des apprenants à résoudre leurs problèmes personnels. L'évaluation de ce processus a aussi inclus des rapports hebdomadaires et des discussions de groupes de foyer avec les pairs éducateurs et les enseignants. Un plan quasi expérimental, incluant deux groupes : un groupe expérimental et un groupe de contrôle et l'évaluation antérieure et postérieure, a été utilisé afin d'évaluer l'impact du programme sur le bien-être psychologique, le contrôle de soi-même, l'atmosphère au lycée et le comportement à risque élevé des apprenants âgés de 13 à 20 ans. Les résultats ont montré que, d'une part, le pourcentage des apprenants sexuellement expérimentés du groupe expérimental est resté pareil durant la période de 18 mois. D'autre part, le pourcentage des apprenants sexuellement expérimentés du groupe de contrôle était plus élevé. Le groupe de contrôle estime que bien plus de leurs amis ont déjà eu des rapports sexuels. Aucune différence n'a été constatée concernant l'utilisation des préservatifs dans les deux groupes. Les résultats de cette étude suggèrent que l'éducation par les pairs peut contribuer à tarder le tout premier rapport sexuel et peut aussi contribuer à la prévention du VIH/SIDA parmi les adolescents. Keywords: Peer education and support, HIV prevention, school-based HIV education, high-risk behaviour, adolescents.SAHARA J Vol. 4 (3) 2007: pp. 678-694