• L'ascenseur et l'escalier — la lutte contre le SIDA au Cameroun

      Jacques-Philippe Tsala Tsala; Department of Psychology, University of Yaoundé I and Catholic University of Central Africa (Cameroon). (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-06)
      The lift and the stairs - the fight against AIDS in Cameroon HIV/AIDS infection has spread like wildfire in the countries of sub-Saharan Africa. In order to fight that pandemic, Cameroon has organised itself by setting up, with the assistance of bilateral and multilateral partners, a national structure with the aim to reduce the spread of the disease. Two years after the launch of the National Plan for the Fight Against HIV/AIDS, an advocacy campaign targetting social leaders made it possible to assess the difficulties encountered by such an entity in a social and cultural environment as complex as that of Cameroon. The paper presents the initiatives taken by the government and analyses the major specific obstacles which are met on the ground. They include beliefs, social structures, gender issues, the status of women and the social representations of sexuality. If consensus and compromise are the usual ways of solving the problems raised at the national level, the analysis stresses the need for a more courageous political will adapted to the urgency of the prevailing situation. Key words: HIV/AIDS, Cameroon, National AIDS Control Committee, National Plan for Fight against HIV/AIDS, resistance to change, public health policy. RÉSUMÉ L\'infection au VIH/SIDA s\'est répandue comme une traînée de poudre dans les pays d\'Afrique subsaharienne. Pour lutter contre cette pandémie, le Cameroun s\'est organisé en mettant en place, avec l\'aide de ses partenaires bilatéraux et multilatéraux, une structure nationale ayant pour objectif de réduire la progression de la maladie. Deux ans après le lancement du Plan National de Lutte contre le VIH/SIDA, une campagne de plaidoyer visant les leaders sociaux a permis de mesurer les difficultés auxquelles une telle entreprise est confrontée dans un environnement socioculturel aussi complexe que celui du Cameroun. L\'article présente les initiatives gouvernementales et analyse les principaux obstacles spécifiques qui surviennent sur le terrain. Ils vont des croyances aux structures sociales en passant par la problématique du genre, le statut de la femme, les représentations sociales de la sexualité. Si le consensus et le compromis sont les modes de résolution habituels des problèmes nationaux, l\'analyse aboutit à la nécessité d\'une volonté politique plus courageuse, adaptée à l\'urgence de la situation. Mots clés: VIH/SIDA, Cameroun, Comité National de Lutte contre le SIDA, Plan National de Lutte contre le SIDA, résistance au changement, politique de santé publique. Sahara J Vol.1(3) 2004: 139-156
    • L'ascenseur et l'escalier — la lutte contre le SIDA au Cameroun

      Jacques-Philippe Tsala Tsala (Taylor & Francis Group, 2004-11-01)
      HIV/AIDS infection has spread like wildfire in the countries of sub-saharan Africa. In order to fight that pandemic, Cameroon has organised itself by setting up, with the assistance of bilateral and multilateral partners, a national structure with the aim to reduce the spread of the disease. Two years after the launch of the National Plan for the Fight Against HIV/AIDS, an advocacy campaign targetting social leaders made it possible to assess the difficulties encountered by such an entity in a social and cultural environment as complex as that of Cameroon. The paper presents the initiatives taken by the government and analyses the major specific obstacles which are met on the ground. They include beliefs, social structures, gender issues, the status of women and the social representations of sexuality. If consensus and compromise are the usual ways of solving the problems raised at the national level, the analysis stresses the need for a more courageous political will adapted to the urgency of the prevailing situation.
    • Laughter therapy as an intervention to promote psychological well-being of volunteer community care workers working with HIV-affected families

      Irene Hatzipapas; Maretha J. Visser; Estie Janse van Rensburg (Taylor & Francis Group, 2017-01-01)
      The study explores the experiences of volunteer community care workers working with HIV-affected families, participating in laughter therapy. Laughter therapy is being used as an intervention to positively influence individuals experiencing various forms of emotional distress. Community care workers play a vital role in the support of the HIV/AIDS-infected and -affected members in communities. The nature of this type of work and their limited training contributes to high levels of secondary trauma and emotional exhaustion. The purpose of the study was firstly, to explore the effects of working with orphans and vulnerable children (OVC) on the community care workers and secondly, to establish the impact that laughter therapy has to positively combat stresses of working within the care workers’ environment. All the community care workers from a community-based organisation that provides care for HIV/AIDS-infected and -affected OVC and their families in the greater region of Soweto, South Africa, took part in daily laughter therapy sessions for one month. To assess the experiences of participants of laughter therapy, seven community care workers agreed to participate in a mixed method assessment. Interviews were conducted before and after the intervention using the Interpretative Phenomenological Analysis as framework. As supportive data, a stress and anxiety and depression scale were added in the interview. Participants reported more positive emotions, positive coping, improved interpersonal relationships and improvement in their care work after exposure to laughter therapy. Quantitative results on stress, anxiety and depression for each participant confirmed observed changes. Laughter therapy as a self-care technique has potential as a low-cost intervention strategy to reduce stress and counteract negative emotions among people working in highly emotional environments.
    • Le conseil post-test encourage-t-il les PVVIH &#224 partager leur statut s&#233rologique? Pratiques et suggestions des conseillers au Burkina Faso

      Ky-Zerbo, O; Some, JF; Simaga, F (Taylor & Francis, 2013-10-11)
      Full Title:Le conseil post-test encourage-t-il les PVVIH à partager leur statut sérologique? Pratiques et suggestions des conseillers au Burkina Faso (Does post-test counseling support PLHIV in disclosing their HIV status? Practices and propositions by counselors in Burkina Faso)Le partage du rèsultat du test VIH est, selon les normes, abordé lors du counseling post-test. Cependant, alors que les obstacles au partage d’un résultat VIH positif sont attestés, la littérature reste peu abondante sur la maniére dont les directives sont appliquées sur le terrain. L’objectif de cet article est d’examiner les pratiques de conseil concernant le partage du résultat avec l’entourage rapportées par les clients et les prestataires du conseil et test VIH (CTV) au Burkina Faso. Une enquête transversale a été conduite en milieu urbain et en milieu rural en 2008. Un questionnaire intégrant des questions semi-ouvertes a été utilisé. Un nombre total de 542 personnes qui ont réalisé le test depuis 2007 et 111 prestataires de services de conseil et test VIH ont été interviewés. Les données ont été analysées sur SPSS 12. Seulement 29 % des personnes testées déclarent que le théme du partage du résultat avec l’entourage a été discuté avec elles lors du counseling post-test. Ce résultat s’explique par les incertitudes et les inquiétudes des prestataires sur la maniére de partager et sur les risques de conséquences défavorables du partage. Des stratégies sont développées par les prestataires pour soutenir les personnes dont la séropositivité a été dépistée à partager cette information avec l’entourage mais ils reconnaissent que ces actions sont insuffisantes. Les suggestions des prestataires pour améliorer la situation incluent la lutte contre la stigmatisation vis-à-vis des personnes vivant avec le VIH, le renforcement des compétences des prestataires et l’adoption de textes juridiques pour rendre obligatoire le partage du résultat avec le partenaire. En conclusion, l’étude a identifié plusieurs pistes pour améliorer les pratiques de conseil concernant le partage des résultats au Burkina Faso. Ces observations pourraient avoir une portée globale pour la région Afrique.Mots cle´: partage résultat VIH, rôle des prestataires, conseil post-test, MATCH, Burkina Faso
    • Le conseil post-test encourage-t-il les PVVIH &#224 partager leur statut s&#233rologique? Pratiques et suggestions des conseillers au Burkina Faso

      Ky-Zerbo, O; Some, JF; Simaga, F (Taylor & Francis, 2013-10-11)
      Full Title:Le conseil post-test encourage-t-il les PVVIH à partager leur statut sérologique? Pratiques et suggestions des conseillers au Burkina Faso (Does post-test counseling support PLHIV in disclosing their HIV status? Practices and propositions by counselors in Burkina Faso)Le partage du rèsultat du test VIH est, selon les normes, abordé lors du counseling post-test. Cependant, alors que les obstacles au partage d’un résultat VIH positif sont attestés, la littérature reste peu abondante sur la maniére dont les directives sont appliquées sur le terrain. L’objectif de cet article est d’examiner les pratiques de conseil concernant le partage du résultat avec l’entourage rapportées par les clients et les prestataires du conseil et test VIH (CTV) au Burkina Faso. Une enquête transversale a été conduite en milieu urbain et en milieu rural en 2008. Un questionnaire intégrant des questions semi-ouvertes a été utilisé. Un nombre total de 542 personnes qui ont réalisé le test depuis 2007 et 111 prestataires de services de conseil et test VIH ont été interviewés. Les données ont été analysées sur SPSS 12. Seulement 29 % des personnes testées déclarent que le théme du partage du résultat avec l’entourage a été discuté avec elles lors du counseling post-test. Ce résultat s’explique par les incertitudes et les inquiétudes des prestataires sur la maniére de partager et sur les risques de conséquences défavorables du partage. Des stratégies sont développées par les prestataires pour soutenir les personnes dont la séropositivité a été dépistée à partager cette information avec l’entourage mais ils reconnaissent que ces actions sont insuffisantes. Les suggestions des prestataires pour améliorer la situation incluent la lutte contre la stigmatisation vis-à-vis des personnes vivant avec le VIH, le renforcement des compétences des prestataires et l’adoption de textes juridiques pour rendre obligatoire le partage du résultat avec le partenaire. En conclusion, l’étude a identifié plusieurs pistes pour améliorer les pratiques de conseil concernant le partage des résultats au Burkina Faso. Ces observations pourraient avoir une portée globale pour la région Afrique.Mots cle´: partage résultat VIH, rôle des prestataires, conseil post-test, MATCH, Burkina Faso
    • Life skills as a behaviour change strategy in the prevention of HIV and AIDS: Perceptions of students in an open and distance learning institution

      Mohapi, B.J.; Pitsoane, E.M. (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2017-09-22)
      The prevention of HIV and AIDS, especially amongst young people, is very important, as they are the future leaders. South Africa carries a high burden of the HIV and AIDS disease, and efforts at the prevention of the disease need to be intensified. University students are also at risk, and prevention efforts need to be intensified to ensure that students graduate and enter the world of work to become productive citizens. Failure to pay attention to preventative behaviour amongst university students may have negative socioeconomic consequences for the country. The paper presents a quantitative study undertaken amongst students at the University of South Africa, an Open and Distance Learning Institution in South Africa. The aim of the study was to explore the perceptions of students regarding life skills as a behaviour change strategy at Unisa. The study was conducted in the three regions of the University: Midlands region, Gauteng region and Limpopo region. Data were collected by means of self-administered questionnaires and were analysed by using the Statistical Programme for Social Sciences. The findings revealed that students have a need to attend life skills workshops, which are facilitated by trained student counsellors since they believe that the life skills training will assist them to be assertive and practise behaviours which will not make them vulnerable to the HIV and AIDS infection.Keywords: life skills, HIV/AIDS, students, youth, HIV prevention
    • Life skills as a behaviour change strategy in the prevention of HIV and AIDS: Perceptions of students in an open and distance learning institution

      B.J. Mohapi; E.M. Pitsoane (Taylor & Francis Group, 2017-01-01)
      The prevention of HIV and AIDS, especially amongst young people, is very important, as they are the future leaders. South Africa carries a high burden of the HIV and AIDS disease, and efforts at the prevention of the disease need to be intensified. University students are also at risk, and prevention efforts need to be intensified to ensure that students graduate and enter the world of work to become productive citizens. Failure to pay attention to preventative behaviour amongst university students may have negative socio-economic consequences for the country. The paper presents a quantitative study undertaken amongst students at the University of South Africa, an Open and Distance Learning Institution in South Africa. The aim of the study was to explore the perceptions of students regarding life skills as a behaviour change strategy at Unisa. The study was conducted in the three regions of the University: Midlands region, Gautengregion and Limpopo region. Data were collected by means of self-administered questionnaires and were analysed by using the Statistical Programme for Social Sciences. The findings revealed that students have a need to attend life skills workshops, which are facilitated by trained student counsellors since they believe that the life skills training will assist them to be assertive and practise behaviours which will not make them vulnerable to the HIV and AIDS infection.
    • Life skills training as HIV/AIDS preventive strategy in secondary schools: evaluation of a large-scale implementation process

      MJ Visser; Department of Psychology at the University of Pretoria. (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-26)
      A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training and HIV/AIDS education in schools as part of the school curriculum. The implementation of the intervention was evaluated in 24 schools in two educational districts in Gauteng province using an action research approach. Data about the implementation were gathered through interviews and focus group discussions with school principals, teachers and learners. A repeated measurement research design was used to assess the impact of the intervention in terms of knowledge, attitudes and reported risk behaviour in a sample of 667 learners representing learners from grades 8 to 12 from different population groups. Results showed that the programme was not implemented as planned in schools due to organisational problems in the schools, lack of commitment of the teachers and the principal, non-trusting relationships between teachers and learners, lack of resources and conflicting goals in the educational system. In an outcome evaluation over the period of a year it was found that learners' knowledge of HIV/AIDS increased and their attitudes were more positive although the changes may not be attributed to the programme alone. In the post-test more learners were sexually active, although preventive behaviour did not increase. The programme as implemented in the area did not succeed in changing high-risk behaviour patterns among school-going young people. From the evaluation of the intervention a few valuable lessons were learned about the content and implementation of HIV/AIDS preventive interventions, which could be useful in the implementation of various other HIV/AIDS preventive interventions in the community. Key words: Life skills training, HIV/AIDS prevention, large-scale intervention, secondary schools, action research, programme evaluation. RÉSUMÉ Un programme de l'enseignement des compétences (life skills) et du VIH/SIDA a été mis en oeuvre dans des lycées à titre de stratégie contre la dissémination du VIH/SIDA parmi les jeunes écoliers en Afrique du Sud. Faisant partie d'un effort commun des Ministère de la Santé et de l'Éducation, deux enseignants de chacune des écoles ont subit une formation avec le but d'intégrer l'éducation sur le VIH/SIDA et les compétences (life skills) dans le cursus scolaire. La mise en oeuvre de l'intervention a été évaluée dans 24 écoles situées dans deux régions éducatives de Gauteng où on a utilisé l'approche de la recherche active. Les données sur la mise en oeuvre ont été recueillies par le biais des entretiens et des discussions de groupes de foyer avec les proviseurs, les enseignants et les élèves. Le modèle de recherche-à-mesure répétée a été utilisé pour évaluer l'impact de l'intervention par rapport à la connaissance, les attitudes et le comportement-à-risque signalé, auprès de l'échantillon de 667 élèves qui représentent des élèves de grade 8 à 12 originaires de différents groupes de la population. Le résultats ont montré que le programme n'a pas été mis en oeuvre dans les écoles comme cela était prévu. Ceci à cause des problèmes d'organisation dans les écoles mêmes, les relations de non-confiance entre les enseignants et les élèves, le manque de ressources et les buts contradictoires du système éducatif.A l'occasion de l'évaluation de résultats, qui a eu lieu tout au long d'une année, on a constaté que la connaissance du VIH/SIDA chez les élèves avait augmenté et que les attitudes étaient devenues plutôt positives malgré que le comportement préventif ne s'est pas amélioré. La mise en oeuvre de ce programme dans ces régions n'a pas réussi à changer le comportement à haut-risque des jeunes écoliers. Pendant l'évaluation de cette intervention, on a tiré quelques le¡ons importantes en ce qui concerne le contenu et la mise en oeuvre des interventions préventives du VIH/SIDA. Ceci peut être utile dans la mise en oeuvre d'autres interventions préventives du VIH/SIDA dans la communauté. Mots clés : Formation sur les life skills, prévention du VIH/SIDA, intervention à grande échelle, lycées, recherche active, évaluation du programme. Sahara J Vol.2(1) 2005: 203-216
    • Life skills training as HIV/AIDS preventive strategy in secondary schools: evaluation of a large-scale implementation process

      Maretha J. Visser (Taylor & Francis Group, 2005-04-01)
      A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training and HIV/AIDS education in schools as part of the school curriculum. The implementation of the intervention was evaluated in 24 schools in two educational districts in Gauteng province using an action research approach. Data about the implementation were gathered through interviews and focus group discussions with school principals, teachers and learners. A repeated measurement research design was used to assess the impact of the intervention in terms of knowledge, attitudes and reported risk behaviour in a sample of 667 learners representing learners from grades 8 to 12 from different population groups. Results showed that the programme was not implemented as planned in schools due to organisational problems in the schools, lack of commitment of the teachers and the principal, non-trusting relationships between teachers and learners, lack of resources and conflicting goals in the educational system. In an outcome evaluation over the period of a year it was found that learners' knowledge of HIV/AIDS increased and their attitudes were more positive although the changes may not be attributed to the programme alone. In the post-test more learners were sexually active, although preventive behaviour did not increase. The programme as implemented in the area did not succeed in changing high-risk behaviour patterns among school-going young people. From the evaluation of the intervention a few valuable lessons were learned about the content and implementation of HIV/AIDS preventive interventions, which could be useful in the implementation of various other HIV/AIDS preventive interventions in the community.
    • Linking anthropological analysis and epidemiological evidence: Formulating a narrative of HIV transmission in Acholiland of northern Uganda

      M Westerhaus (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2007-11-19)
      For twenty years, a region of northern Uganda known as Acholiland has been heavily affected by war, leading to the formation of internally displaced people's camps, rape, transactional sex and child abductions. While it is clear that the war has had onerous consequences for the health of the Acholi people, the specific impact of the war on HIV transmission remains unclear, as the epidemiological evidence presents an ambiguous picture of HIV prevalence patterns. Other than a few non-governmental organization reports, very little qualitative data exists about the impact of HIV on the Acholi population. Attempting to formulate a clearer narrative of HIV transmission in Acholiland, this paper jointly analyses the historical and political context of the Acholi people and the war, the epidemiologic evidence of HIV prevalence patterns, and the ethnographic perspectives of Acholi healthcare workers and patients living with HIV/AIDS. Juxtaposing these sources of information allows for the emergence of a rich understanding of HIV in Acholiland. It is argued that three specific forms of violence – physical, symbolic and structural – create vulnerability to HIV infection in Acholiland, although to variable degrees dependent on location. The ethnographic evidence presented regarding HIV's impact on Acholiland suggests that an incorporation of historical, political, cultural and social factors must form the backbone. SAHARA J Vol. 4 (2) 2007: pp. 590-605
    • Linking anthropological analysis and epidemiological evidence: Formulating a narrative of HIV transmission in Acholiland of northern Uganda

      Michael Westerhaus (Taylor & Francis Group, 2007-08-01)
      For twenty years, a region of northern Uganda known as Acholiland has been heavily affected by war, leading to the formation of internally displaced people's camps, rape, transactional sex and child abductions. While it is clear that the war has had onerous consequences for the health of the Acholi people, the specific impact of the war on HIV transmission remains unclear, as the epidemiological evidence presents an ambiguous picture of HIV prevalence patterns. Other than a few non-governmental organization reports, very little qualitative data exists about the impact of HIV on the Acholi population. Attempting to formulate a clearer narrative of HIV transmission in Acholiland, this paper jointly analyses the historical and political context of the Acholi people and the war, the epidemiologic evidence of HIV prevalence patterns, and the ethnographic perspectives of Acholi healthcare workers and patients living with HIV/AIDS. Juxtaposing these sources of information allows for the emergence of a rich understanding of HIV in Acholiland. It is argued that three specific forms of violence – physical, symbolic and structural – create vulnerability to HIV infection in Acholiland, although to variable degrees dependent on location. The ethnographic evidence presented regarding HIV's impact on Acholiland suggests that an incorporation of historical, political, cultural and social factors must form the backbone of efforts both to understand HIV transmission and design strategies for curbing the epidemic in war settings.
    • Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa

      Peltzer, Karl (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-02-08)
      The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56–4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03–2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09–3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37–0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34–0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25–0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68–6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73–5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36–0.99), being on ART (OR = 0.48, 95% CI = 0.25–0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18–0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15–0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19–3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82–10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16–0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24–0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41–0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.Keywords: sexual risk behaviour, TB patients, health status, mental health, longitudinal study, South Africa
    • Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa

      Karl Peltzer (Taylor & Francis Group, 2018-01-01)
      The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56–4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03–2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09–3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37–0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34–0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25–0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68–6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73–5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36–0.99), being on ART (OR = 0.48, 95% CI = 0.25–0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18–0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15–0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19–3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82–10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16–0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24–0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41–0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.
    • L’annonce du statut VIH de l’enfant : exp&#233riences des m&@232 res et interpr&#233 tations des soignants au Burkina Faso

      Desclaux, A; Alfieri, C (Taylor & Francis, 2013-10-11)
      Full Title: L’annonce du statut VIH de l’enfant : expé riences des mè res et interpré tations des soignants au Burkina Faso(Disclosure of infant HIV status: mothers’ experiences and health workers’interpretations in Burkina Faso)L’annonce du statut sérologique d’un enfant constitue une situation particulière qui ne peut pas obéir aux recommandations générales pour le counseling définies pour des adultes; elle est très peu normée. Alors que les programmes de Prévention de la Transmission Mère-Enfant (PTME) devraient induire environ 700 000 annonces du statut d’enfants nés de mères séropositives chaque année en Afrique, les effectifs des enfants qui ont été testés sont beaucoup plus faibles et les conditions de réalisation de cette annonce et ses aspects sociaux sur le terrain sont très peu connus. L’article a pour objectifs de décrire et d’analyser l’expérience de l’annonce du statut sérologique des nourrissons et enfants à partir d’entretiens réalisés avec des mères et des équipes de services de PTME au Burkina Faso. La méthode a reposé sur des entretiens répétés auprés de 37 mères et auprès de professionnels de santé. Leurs propos révèlent toute la complexité de l’annonce dans un contexte marqué par l’incertitude. Ils montrent d’abord les retards liés aux difficultés des prélèvements veineux et aux écueils des méthodes de diagnostic et de gestion de l’information dans les services de soins. Les acteurs de l’annonce ne se limitent pas au médecin du programme PTME, mais relèvent également d’autres fonctions professionnelles ou institutions. La mère joue un rôle clé, y compris pour solliciter l’annonce; le père n’est généralement informé que secondairement, malgré sa responsabilité légale concernant l’enfant. L’analyse des interactions révèle certaines ambiguïtés de l’annonce, à propos des informations que les médecins gardent secrétes, des attentes réciproques entre médecins et femmes en matiére de communication, des interprétations que font les mères d’indices concernant la santé de leur enfant, et des situations de transmission d’informations incertaines. Le sens de l’information transmise est souvent chargé d’une dimension culpabilisante pour les mères; l’évocation du suivi ultérieur ne tempére pas cet effet. Ces observations conduisent à solliciter l’élaboration d’un modèle de conseil (counseling) spécifique, qui permette d’apporter aux mères les éléments d’information générale, d’interaction personnalisée et de soutien dont elles ont besoin pour gérer l’annonce du statut VIH de leur enfant.Mots clés: partage, enfant, Afrique, femmes, conseil, test, VIH
    • L’annonce du statut VIH de l’enfant : exp&#233riences des m&@232 res et interpr&#233 tations des soignants au Burkina Faso

      Desclaux, A; Alfieri, C (Taylor & Francis, 2013-10-11)
      Full Title: L’annonce du statut VIH de l’enfant : expé riences des mè res et interpré tations des soignants au Burkina Faso(Disclosure of infant HIV status: mothers’ experiences and health workers’interpretations in Burkina Faso)L’annonce du statut sérologique d’un enfant constitue une situation particulière qui ne peut pas obéir aux recommandations générales pour le counseling définies pour des adultes; elle est très peu normée. Alors que les programmes de Prévention de la Transmission Mère-Enfant (PTME) devraient induire environ 700 000 annonces du statut d’enfants nés de mères séropositives chaque année en Afrique, les effectifs des enfants qui ont été testés sont beaucoup plus faibles et les conditions de réalisation de cette annonce et ses aspects sociaux sur le terrain sont très peu connus. L’article a pour objectifs de décrire et d’analyser l’expérience de l’annonce du statut sérologique des nourrissons et enfants à partir d’entretiens réalisés avec des mères et des équipes de services de PTME au Burkina Faso. La méthode a reposé sur des entretiens répétés auprés de 37 mères et auprès de professionnels de santé. Leurs propos révèlent toute la complexité de l’annonce dans un contexte marqué par l’incertitude. Ils montrent d’abord les retards liés aux difficultés des prélèvements veineux et aux écueils des méthodes de diagnostic et de gestion de l’information dans les services de soins. Les acteurs de l’annonce ne se limitent pas au médecin du programme PTME, mais relèvent également d’autres fonctions professionnelles ou institutions. La mère joue un rôle clé, y compris pour solliciter l’annonce; le père n’est généralement informé que secondairement, malgré sa responsabilité légale concernant l’enfant. L’analyse des interactions révèle certaines ambiguïtés de l’annonce, à propos des informations que les médecins gardent secrétes, des attentes réciproques entre médecins et femmes en matiére de communication, des interprétations que font les mères d’indices concernant la santé de leur enfant, et des situations de transmission d’informations incertaines. Le sens de l’information transmise est souvent chargé d’une dimension culpabilisante pour les mères; l’évocation du suivi ultérieur ne tempére pas cet effet. Ces observations conduisent à solliciter l’élaboration d’un modèle de conseil (counseling) spécifique, qui permette d’apporter aux mères les éléments d’information générale, d’interaction personnalisée et de soutien dont elles ont besoin pour gérer l’annonce du statut VIH de leur enfant.Mots clés: partage, enfant, Afrique, femmes, conseil, test, VIH
    • Making sense of fidelity: young Africans’ cross-national and longitudinal representations of fidelity and infidelity in their HIV-related creative narratives, 1997–2014

      Robyn Singleton; Manon Billaud; Haley McLeod; Georges Tiendrebeogo; Fatim Dia; Chris Obong’o; Siphiwe Nkambule-Vilakati; Benjamin Mbakwem; Gaelle Sabben; Kate Winskell (Taylor & Francis Group, 2021-01-01)
      Mutual fidelity and partner reduction have been identified as key behavioural strategies to prevent HIV transmission in sub-Saharan Africa, particularly following recognition of the role that multiple concurrent sexual partnerships play in driving generalised HIV epidemics. We analysed social representations of fidelity and infidelity in a sample of 1,343 narratives about HIV written by young Africans between 1997 and 2014. The narratives were written at four different time points (1997, 2005, 2008, 2014) by authors aged 10–24 in urban and rural areas of Senegal, Burkina Faso, South-east Nigeria, Kenya and Eswatini. We combined three analytical approaches: descriptive statistics of quantifiable characteristics of the narratives, thematic data analysis and a narrative-based approach. In the sample, fidelity is often promoted as the ideal by narrators, peers and romantic partners, in line with broader discourses around HIV prevention, romantic relationships, familial obligations, and religious and moral imperatives. However, mutual fidelity is rarely modelled in the narratives and representations of combining methods to prevent HIV from entering relationships via infidelity are uncommon. Representations of fidelity reflect loss-framed fear arousal techniques that perpetuate HIV-related stigma. Narrative-based approaches that facilitate skills-building, critical reflection and address stigma can better address fidelity and partner reduction.
    • Male circumcision and its association with HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa

      Samson Gebremedhin (Taylor & Francis Group, 2011-04-01)
      The study aimed to assess the association between male circumcision and HIV infection and STDs. The issue is controversial as various studies reported conflicting findings. A cross-sectional comparative study based on the secondary data of 18 Demographic Health Surveys (DHS), carried out in Sub-Saharan Africa starting from 2003, was conducted. From all surveys, information on 70 554 males aged 15 – 59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic socio-demographic variables. The weighted prevalence of HIV among men 15 – 59 years was 3.1%. In the bivariate analysis uncircumcised status was significantly associated with risk of HIV, with odds ratio (OR) of 4.12 (95% CI: 3.85 – 4.42). The association was even more significant (4.95 (95% CI: 4.57–5.36)) after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcised status is significantly lower among younger men aged 15 – 29 years than those in 30 – 59-year age category. About 5.5% of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision status was not significantly associated with either of the symptoms, with adjusted OR of 1.07 (95% CI: 0.99 – 1.15). The study concludes that there is a strong association between uncircumcised status and HIV infection. Hence, male circumcision can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types of STDs is recommended.
    • Managing AIDS stigma

      WL Holzemer; University of California, San Francisco; LR Uys; College of Health Sciences at the University of KwaZulu-Natal (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-06)
      ccording to anecdotal reports, AIDS stigma and discrimination continue to influence people living with and affected by HIV disease as well as their health care providers, particularly in southern Africa where the burden of AIDS is so significant. Stigma is perceived as a major limiting factor in primary and secondary HIV/AIDS prevention and care. It reportedly interferes with voluntary testing and counselling, and with accessing care and treatments, thereby increasing suffering and shortening lives. Many health care workers in southern Africa have come to the conclusion that unless stigma is conquered, the illness will not be defeated. While there is substantial anecdotal evidence of the impact of stigma on AIDS care, very little rigorous research has been conducted. This article explores three questions: What is AIDS stigma? What is the impact of AIDS stigma? How can health care providers help to manage AIDS stigma? Key words: HIV/AIDS stigma, management, measurement. La gestion de la stigmatisation liée au SIDA RÉSUMÉ D'après des rapports anecdotiques, la stigmatisation et la discrimination liées au SIDA continuent à influencer les personnes vivant avec la maladie du VIH, ceux qui en sont affectés ainsi que leurs fournisseurs de soins particulièrement en Afrique Australe où le fardeau du SIDA est très prononcé. La stigmatisation est perçue comme un facteur majeur qui restreint la prévention et les soins primaires et secondaires du VIH/SIDA. Il est dit que la stigmatisation entrave la Consultation et le Dépistage Volontaires (VCT) et l'accès au soin et au traitement. Pour cette raison, la stigmatisation augmente la souffrance et raccourcit la vie. Beaucoup de personnel de soin, en Afrique Australe, ont tiré la conclusion qu'à moins que la stigmatisation soit conquise, la maladie ne sera jamais vaincue. Pendant qu'il y a une évidence anecdotique importante de l'impact de la stigmatisation sur le soin du SIDA, très peu de recherche rigoureuse a été faite. Cette présente communication étudie trois questions: Qu'est-ce que la stigmatisation? Quel est l'impact de la stigmatisation liée au SIDA? Comment est-ce que les fournisseurs de soin peuvent aider dans la gestion de la stigmatisation associée au SIDA? Mots clés: VIH/SIDA, soigner, stigmatisation. Sahara J Vol.1(3) 2004: 165-174
    • Managing AIDS stigma

      William L. Holzemer; Leana R. Uys (Taylor & Francis Group, 2004-11-01)
      According to anecdotal reports, AIDS stigma and discrimination continue to influence people living with and affected by HIV disease as well as their health care providers, particularly in southern Africa where the burden of AIDS is so significant. Stigma is perceived as a major limiting factor in primary and secondary HIV/AIDS prevention and care. It reportedly interferes with voluntary testing and counselling, and with accessing care and treatments, thereby increasing suffering and shortening lives. Many health care workers in southern Africa have come to the conclusion that unless stigma is conquered, the illness will not be defeated. While there is substantial anecdotal evidence of the impact of stigma on AIDS care, very little rigorous research has been conducted. This article explores three questions: What is AIDS stigma? What is the impact of AIDS stigma? How can health care providers help to manage AIDS stigma?