• Parental HIV disclosure in Burkina Faso: Experiences and challenges in the era of HAART

      Tiendrebeogo, G; Hejoaka, F; Belem, EM; Compaore, PLG; Wolmarans, L; Soubeiga, A; Ouangraoua, N (Taylor & Francis, 2013-10-11)
      Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However, limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children’s role in their parents’ treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex, parent’s older age, parent’s marital history and number of children. After adjustment, it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases, children suspected, and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However, parents who disclosed to their children did not experience blame nor was their secret revealed. Rather, children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However, whether aware or not of their parents’ HIV-positive status, children contribute positively to the care of parents living with HIV. Perceptions about children’s vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally, without institutional counselling support, disclosure to children remains a challenge for both parents and children, which suggests a need for rethinking of current counselling practices.Keywords: : HIV, parental disclosure, children, care and support, counselling, Burkina Faso
    • Parenting experiences of couples living with human immunodeficiency virus: A qualitative study from rural Southern Malawi

      Gombachika, BC; Sundby, J; Chirwa, E; Malata, A (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2014-10-07)
      The advent of antiretroviral therapy (ART) has allowed couples living with human immunodeficiency virus (HIV) to live longer and healthier lives. The reduction in the mother-to-child transmission of HIV has encouraged some people living with HIV (PLWH) to have children. However, little is known about the parenting experiences of couples living with HIV (CLWH). The aim of this qualitative study was to explore and describe parenting  experiences of seroconcordant couples who have a child while living with HIV in Malawi. Data were collected using in-depth interviews with 14 couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa  communities from July to December 2010. The research findings shows that irrespective of kinship organization, economic hardships, food insecurity, gender-specific role expectations and conflicting information from health institutions and media about sources of support underpin their parenting roles. In addition, male spouses are directly involved in household activities, childcare and child feeding decisions, challenging the existing  stereotyped gender norms. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband relatives. Finally, the study has shown that CLWH are able to find solutions for the challenges they encounter. Contrary to existing belief that such who have children depend solely on public aid. Such claims without proper knowledge of local social cultural contexts, may contribute to stigmatizing CLWH who continue to have children. The study is also relevant to PLWH who, although not parents themselves, are confronted with a situation where they have to accept responsibility for raising children from their kin. We suggest the longer-term vision for ART wide access in Malawi to be broadened beyond provision of ART to incorporate social and economic interventions that support the rebuilding of CLWH social and economic lives. The interventions must be designed using a holistic multi-sector approach.Keywords: Malawi, couples, experiences, HIV and AIDS, parentingL’ave`nement de la the´rapie antire´trovirale a permis couples vivant avec le VIH de vivre plus longtemps et en meilleure sante´. La re´duction de la transmission du VIH de la me`re a` l’enfant a encourage´ certaines personnes vivant avec le VIH ont deux enfants. Cependant, on sait peu sur les expe´riences parentales des  couples vivant avec le VIH. Le but de cette e´tude qualitative e´tait d’explorer et de´crire des expe´riences  parentales des couples se´roconcordants qui ont un enfant tout en vivant avec le VIH au Malawi. Les donne´es  ont e´te´ collecte´es abuser des entrevues en profondeur avec des quatorze couples dessein e´chantillonne´s dans les communaute´s matriline´aires et patriline´aires Chiradzulu, Chikhwawa de Juillet jeu. De´cembre 2010.  Les re´sultats de recherche montrent que, inde´pendamment de l’organisation de la parente´, les difficulte´s  e´conomiques, l’inse´curite´ alimentaire, le roˆle des attentes spe´cifiques de genre et des informations  contradictoires des institutions de sante´ et les me´dias au sujet des sources de soutien angoisse leur roˆle  parental En outre, les conjoints de sexe masculin sont directement implique´s dans les activite´s de me´nage,  garde d’enfants et les de´cisions de l’alimentation des enfants, contestant la norme de genre ste´re´otype´s existant. En l’absence de l’he´ritage des veuves, veuves des communaute´s patriline´aires ne rec¸oivent pas le  soutien attendu de la famille du mari de´funt. Enfin, l’e´tude a montre´ que les couples vivant avec le VIH sont  a` l’aise pour trouver des solutions aux de´fis qu’ils rencontrent. Contrairement deux croyance existante que ce  qui ont des enfants de´pendent uniquement sur l’aide publique. Ces revendications sans la connaissance de  contextes socioculturels locaux, peut contribuer a` stigmatiser les couples vivant avec le VIH qui continuent deux  ont des enfants. L’e´tude est e´galement pertinent pour les personnes vivant avec le VIH qui, bien que non les  parents themelves, sont confronte´s a` une situation ou` ils doivent accepter la responsabilite´ d’e´lever les enfants de leurs parents. Nous sugge´rons la vision a` long terme de la the´rapie antire´trovirale large acce`s au Malawi a` eˆtre e´largi au-dela` de la fourniture d’un traitement antire´troviral deux interventions sociales et e´conomiques Incorporer qui soutiennent la reconstruction des couples vivant avec le VIH vie sociale et  e´conomique. Les interventions doivent eˆtre conc¸ues utilisation excessive d’une approche multi-sectorielle  globale.Mots cle´s: Malawi, les couples, les expe´riences, le VIH et le SIDA, la parentalite´
    • Partager l’information sur son statut s&#233rologique VIH dans un contexte de polygamie au S&#233n&#233gal (HIV disclosure in polygamous settings in Senegal)

      Sow, K (Taylor & Francis, 2013-10-11)
      Au Sénégal, où la prévalence du VIH est inférieure à 1 % et la stigmatisation reste importante, 40 % des unions sont polygamiques. L’objet de cet article est de décrire et analyser les motivations, les avantages et les contraintes liés au partage de l’information à propos du statut VIH + , en explorant les particularités relatives aux situations de polygamie. Il repose sur les données d’une recherche qualitative par entretiens approfondis et répétés sur l’expérience du traitement antirétroviral et ses effets sociaux, menée sur une période de 10 ans auprès de personnes sous traitement et de leurs soignants. Les professionnels de santé encouragent les personnes à partager leur statut, surtout dans certaines circonstances telles que la prévention de la transmission mère-enfant; néanmoins ils sont bien conscients des risques sociaux que courent certains patients, notamment des femmes. Certains insistent, d’autres n’interviennent pas auprès de celles qui ne partagent pas avec leur conjoint, tout en soulignant leur dilemme éthique. Les entretiens retracent l’évolution des attitudes des soignants à cet égard. La majorité des femmes mariées commencent par partager leur statut VIH+ avec leur mère, attendant d’elle qu’elle atteste que la contamination n’est pas due à des comportements amoraux et qu’elle participe à la mise en place d’une stratégie. Dans les foyers polygames, les femmes tentent de partager l’information avec leur conjoint, en maintenant le secret au-delà du couple. Certaines craignent la divulgation par leur conjoint auprès des coépouses, dont les attitudes peuvent être très diverses: des récits rapportent le rejet collectif hors du foyer dont certaines femmes ont été victimes; l’annonce est parfois faite de manière progressive en suivant la hiérarchie des positions de chaque interlocuteur dans le foyer; une autre personne rapporte la solidarité montrée par ses coépouses qui lui a permis de maintenir le secret hors du foyer. L’article montre la diversité des situations et leur caractère évolutif tant en matiére de partage du statut qu’à propos des effets sociaux de ce partage.Mots clé: partage de l’information, polygamie, femme, VIH, PTME
    • Partager l’information sur son statut s&#233rologique VIH dans un contexte de polygamie au S&#233n&#233gal (HIV disclosure in polygamous settings in Senegal)

      Sow, K (Taylor & Francis, 2013-10-11)
      Au Sénégal, où la prévalence du VIH est inférieure à 1 % et la stigmatisation reste importante, 40 % des unions sont polygamiques. L’objet de cet article est de décrire et analyser les motivations, les avantages et les contraintes liés au partage de l’information à propos du statut VIH + , en explorant les particularités relatives aux situations de polygamie. Il repose sur les données d’une recherche qualitative par entretiens approfondis et répétés sur l’expérience du traitement antirétroviral et ses effets sociaux, menée sur une période de 10 ans auprès de personnes sous traitement et de leurs soignants. Les professionnels de santé encouragent les personnes à partager leur statut, surtout dans certaines circonstances telles que la prévention de la transmission mère-enfant; néanmoins ils sont bien conscients des risques sociaux que courent certains patients, notamment des femmes. Certains insistent, d’autres n’interviennent pas auprès de celles qui ne partagent pas avec leur conjoint, tout en soulignant leur dilemme éthique. Les entretiens retracent l’évolution des attitudes des soignants à cet égard. La majorité des femmes mariées commencent par partager leur statut VIH+ avec leur mère, attendant d’elle qu’elle atteste que la contamination n’est pas due à des comportements amoraux et qu’elle participe à la mise en place d’une stratégie. Dans les foyers polygames, les femmes tentent de partager l’information avec leur conjoint, en maintenant le secret au-delà du couple. Certaines craignent la divulgation par leur conjoint auprès des coépouses, dont les attitudes peuvent être très diverses: des récits rapportent le rejet collectif hors du foyer dont certaines femmes ont été victimes; l’annonce est parfois faite de manière progressive en suivant la hiérarchie des positions de chaque interlocuteur dans le foyer; une autre personne rapporte la solidarité montrée par ses coépouses qui lui a permis de maintenir le secret hors du foyer. L’article montre la diversité des situations et leur caractère évolutif tant en matiére de partage du statut qu’à propos des effets sociaux de ce partage.Mots clé: partage de l’information, polygamie, femme, VIH, PTME
    • Partager l’information sur son statut s&#233rologique VIH dans un contexte de polygamie au S&#233n&#233gal (HIV disclosure in polygamous settings in Senegal)

      Sow, K (Taylor & Francis, 2013-10-11)
      Au Sénégal, où la prévalence du VIH est inférieure à 1 % et la stigmatisation reste importante, 40 % des unions sont polygamiques. L’objet de cet article est de décrire et analyser les motivations, les avantages et les contraintes liés au partage de l’information à propos du statut VIH + , en explorant les particularités relatives aux situations de polygamie. Il repose sur les données d’une recherche qualitative par entretiens approfondis et répétés sur l’expérience du traitement antirétroviral et ses effets sociaux, menée sur une période de 10 ans auprès de personnes sous traitement et de leurs soignants. Les professionnels de santé encouragent les personnes à partager leur statut, surtout dans certaines circonstances telles que la prévention de la transmission mère-enfant; néanmoins ils sont bien conscients des risques sociaux que courent certains patients, notamment des femmes. Certains insistent, d’autres n’interviennent pas auprès de celles qui ne partagent pas avec leur conjoint, tout en soulignant leur dilemme éthique. Les entretiens retracent l’évolution des attitudes des soignants à cet égard. La majorité des femmes mariées commencent par partager leur statut VIH+ avec leur mère, attendant d’elle qu’elle atteste que la contamination n’est pas due à des comportements amoraux et qu’elle participe à la mise en place d’une stratégie. Dans les foyers polygames, les femmes tentent de partager l’information avec leur conjoint, en maintenant le secret au-delà du couple. Certaines craignent la divulgation par leur conjoint auprès des coépouses, dont les attitudes peuvent être très diverses: des récits rapportent le rejet collectif hors du foyer dont certaines femmes ont été victimes; l’annonce est parfois faite de manière progressive en suivant la hiérarchie des positions de chaque interlocuteur dans le foyer; une autre personne rapporte la solidarité montrée par ses coépouses qui lui a permis de maintenir le secret hors du foyer. L’article montre la diversité des situations et leur caractère évolutif tant en matiére de partage du statut qu’à propos des effets sociaux de ce partage.Mots clé: partage de l’information, polygamie, femme, VIH, PTME
    • Patients-to-healthcare workers HIV transmission risk from sharp injuries, Southern Ethiopia

      Desalegn, B; Beyene, H; Yamada, R (Taylor & Francis, 2012-08-27)
      Background: Accidental needlestick injury rate among healthcare workers in Hawassa is extremely high. Epidemiological findings proved the infectious potential of this injury contaminated with a Human  Immunodeficiency Virus (HIV)-infected patient’s blood.Objective: This study aimed at estimating the risk of HIV transmission from patients to healthcare workers in Hawassa City, Ethiopia.Method: A probabilistic risk model was employed. Scenario-based assumptions were made for the values of parameters following areview of published reports between 2007 and 2010.Parameters: HIV prevalence, needlestick injury rate, exposure rate, sero-conversion rate, risk of HIV transmission and cumulative risk of HIV transmission.Finding: Generally, healthcare workers in Hawassa are considered to be at a relatively low (0.0035%) occupational risk of contracting HIV – less than 4 in 100,000 of healthcare workers in the town (1 in 28,751 workers a year). The 30 years’ maximum cumulative risk estimate is approximately five healthcare workers per 1000 workers in the study area. Still, this small number should be considered a serious matter requiring post-exposure prophylaxis following exposure to unsafe medical practice leading to HIV infection.
    • People living with HIV and AIDS in everyday conditions of township life in South Africa: between structural constraint and individual tactics

      R Ebrahim-Vally; Department of Anthropology, University of the Witwatersrandge/pj; F Le Marcis; Department of Social Anthropology, University of Victor Segalen – Bordeaux 2 (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-26)
      The HIV/AIDS pandemic in South Africa has negatively transformed the lives of many in townships and rural areas. People living with AIDS (PWAs) are the socially weakened, whose means of survival include migrating, enduring gender violence, and they are thus confined to living in the margins of society. Using the concept of tactic as defined by de Certeau, this paper shows how anthropology can use the narratives of everyday life to make sense of the different ways the socially weakened create networks of support, find a cure, and generate forms of income or use running away as a means to avoid gender violence. This paper argues that if the State hopes to successfully introduce antiretroviral therapy and so turn everyday logics of survival into long-term strategies, it needs to commit itself firmly to reducing inherited forms of inequalities. Similarly, the State\'s commitment to eradicate poverty also requires it to take cognisance of the different borderline activities the socially weakened regard as avenues of survival. Rather than morally condemn such activity as a wrongdoing, the State should enhance its knowledge of the socio-economic conditions that almost coerce the socially weakened to ‘do wrong\'. The data were collected during intensive fieldworlk carried out in Alexandra township and Diepkloof (Gauteng) in 2001 - 2002, using participant observation and repeated in-depth interviews. Key words: HIV/AIDS, social anthropology, conditions of life, tactics, life narratives, structural constraint. RÉSUMÉ La pandémie du VIH/SIDA en Afrique du Sud a négativement transformé la vie de nombreux individus aussi bien dans les townships que dans les zones rurales. Les séropositifs, souffrant de discriminations, développent des moyens de survie impliquant notamment la migration ou le fait d\'accepter des violences inscrites dans des relations de genre, á l\'instar de ceux qui, nombreux, vivent aux marges de la société sud africaine.A partir du concept de tactique, défini par de Certeau, cet article montre comment l\'anthropologie peut faire usage de récits du quotidien afin de rendre compte de l\'existence de réseaux de soutiens, afin de comprendre comment ceux vivant dans les marges trouvent des soins et génèrent des formes de revenus ou bien utilisent la fuite comme moyen d\'échapper aux violences de genre. Subtiliser, braconner, ‘voler à la tire\', ou vendre des substances illicites sont certaines des tactiques de survie que ceux qui vivent aux marges utilisent pour rester en vie. L\'argument de cet article est que si l\'objectif de l\'État sud africain est d\'introduire avec succès les médicaments antirétroviraux et ainsi de favoriser pour les individus le passage de logiques quotidiennes de survie à des stratégies à long terme, il doit simultanément s\'atteler fermement à la réduction des inégalités socio-économiques héritées du passé. Parallèlement, l\'engagement de l\'État pour l\'éradication de la pauvreté nécessite également de reconnaître que certaines activités illicites ou simplement blâmables constituent des moyens de survie. Plutôt que de condamner moralement de telles activités, l\'État doit améliorer ses connaissances de la matrice socio-économique qui les génère. Les données présentées dans cet article furent collectées lors d\'enquêtes de terrain menées de 2001 à 2002 dans le township d\'Alexandra et à Diepkloof (Gauteng) et reposant à la fois sur une observation participante et des entretiens ouverts répétés. Mots clefs: VIH/SIDA, anthropologie sociale, conditions de vie, tactiques, récits de vie, contraintes structurelles. Sahara J Vol.2(1) 2005: 217-235
    • People’s perceptions of HIV/AIDS as portrayed by their labels of the disease: the case of Botswana

      Mathangwane, JT (Taylor & Francis, 2012-08-27)
      It is typical of societies to come up with their own labels or names to any phenomenon that may befall them in the course of their life time. Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been no exception to this practice. In Botswana most of these labels are either in Setswana or English whereby an Eglish expression is simply adopted and used to refer to HIV/AIDS. This study looks at the different labels or names that have been used to refer to HIV/AIDS in Botswana. It is an attempt to provide insights into perceptions of HIV/AIDS by the local communities portrayed through the naming of this disease. The study demonstrates how, through the different labels, the local communities started in denial distancing themselves from this disease and in some cases associating AIDS with ailments already known to them, cultural practices and taboos. Some of these labels further demonstrate thenegative attitudes that may have fuelled HIV-related stigma in the country. Based on the informants’ responses, the paper further attempts a categorisation of these labels influenced by different attitudes to HIV/AIDS, some of which are self-perpetuating and may continue to be a hindrance to the fight against the disease.
    • Perceived HIV/AIDS impact among staff in tertiary institutions in the Eastern Cape, South Africa

      K Peltzer; Chief Research Specialist at the Social Aspects of HIV/AIDS and Health of the Human Sciences Research Council, Pretoria; N Phaswana-Mafuya; Chief Research Manager at the Social Aspects of HIV/AIDS and Health of the Human Sciences Research Council in Cape Town (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-10-13)
      A descriptive questionnaire-based study was undertaken among staff in tertiary institutions in the Eastern Cape Province.The objective of the study was to explore perceived HIV/AIDS impact on duties at work, staff morale, job satisfaction and workload among a proportionate sample of 872 employees in eight randomly selected tertiary institutions.The results of the study showed that HIV/AIDS impacts negatively on duties at work, lowers staff morale and increases staff workload. Keywords: HIV,AIDS, impact, tertiary institutions, South Africa.R&#201SUM&#201Une &#233tude bas&#233e sur un questionnaire descriptif a &#233t&#233 faite parmi le personnel des &#233tablissements d&#39enseignement sup&#233rieur de la province du Cap de l&#39Est. Le but de cette &#233tude fut d&#39&#233tudier l&#39impact du VIH/SIDA perçu sur les fonctions &#224 remplir dans le lieu de travail, le moral du personnel, la satisfaction professionnelle et la charge de travail parmi un &#233chantillon proportionnel de 872 employ&#233s de huit &#233tablissements s&#233lectionn&#233s au hasard. Les r&#233sultats de cette &#233tude ont montr&#233 que le VIH/SIDA a un impact n&#233gatif sur les fonctions &#224 remplir dans le lieu de travail, qu'il r&#233duit le moral du personnel et qu&#39il augmente la charge de travail. Mots cl&#233s: VIH, SIDA, impact, &#233tablissements d&#39enseignement sup&#233rieur, l&#39Afrique du Sud. Journal of Social Aspects of HIV/AIDS, Vol 2(2) 2005: 277-285
    • Perceived influence of value systems on the uptake of voluntary medical male circumcision among men in Kweneng East, Botswana

      Thandisizwe R. Mavundla; Fungai Mbengo; Khanyenda Bruce Ngomi (Taylor & Francis Group, 2020-01-01)
      Botswana is one of the countries in Eastern and Southern Africa significantly impacted by the Human Immunodeficiency Virus (HIV). To control the spread of HIV, the government in 2009 rolled out the voluntary medical male circumcision (VMMC) programme as an additional HIV prevention strategy with the goal of circumcising 80% of HIV negative men by 2016. However, the country failed to achieve this goal as less than 30% of the targeted men were circumcised by 2016. A study was therefore conducted to explore and describe the factors that are perceived by men in Botswana to influence the uptake of VMMC in order to inform future policymaking and programming on VMMC. An exploratory descriptive, qualitative design was utilised to investigate perceived factors influencing the uptake of VMMC among men. Data were collected from 38 men, aged 18–49 years in Kweneng East, Botswana using semi-structured individual interviews and focus group discussions (FGDs). Tesch's method of qualitative data analysis was used to code and categorise transcribed data into meaningful themes. Upon analysis, three themes emerged as influencing the uptake of VMMC: (a) the influence of value systems associated with stakeholder consultation in the community; (b) the influence of value systems associated with cultural beliefs and (c) the influence of value systems associated with religious beliefs. The influence of value systems associated with stakeholder consultation in the community was found to manifest in the form of the lack of consultation with men at the inception of the VMMC; the lack of involvement of village elders during the service delivery process and the lack of involvement of women in VMMC. In addition, the influence of value systems associated with cultural beliefs was found to manifest in the form of the lack of openness between parents and children on sexual matters and the lack of traditional leadership support in VMMC. Lastly, the influence of value systems associated with religious beliefs was found to manifest in the form of religious views not in support of the VMMC and religious views in support of the VMMC. It is concluded that value systems associated with stakeholder consultation, cultural beliefs and religious beliefs were the factors influencing the uptake of VMMC among men in Kweneng East, Botswana, and these factors to a larger extent deterred men from using VMMC services. Based on these findings, it is therefore concluded that government and other providers of VMMC should consider the influence of value systems on the uptake of VMMC in order to provide culturally congruent VMMC services and boost of the uptake of VMMC among men in Kweneng East, Botswana.
    • Perception of risk of HIV infections and sexual behaviour of the sexually active university students in Zimbabwe

      Nkomazana, N; Maharaj, P (Taylor & Francis, 2014-10-08)
      The study sought to establish university students’ perceptions of risk of HIV infections. A cross-sectional survey was conducted on 345 sexually active students at two universities in Zimbabwe (one state and one private).  Results revealed that above a quarter of the respondents felt at risk of getting HIV due to their regular partners’ sexual behaviours and more than half felt at risk of getting HIV due to their casual partners’ sexual behaviours. In addition, a third of the respondents acknowledged the HIV risk due to their own sexual behaviours. More state university respondents felt exposed to HIV infections due to own sexual behaviours than their private university counterparts. Despite these revelations, only 66.56% had earlier thought of their chances of getting infected with HIV. Personal HIV risk perceptions were low, reported by 27.76% of the sexually active respondents. Almost all respondents described their fellows’ sexual behaviours as either risky or very risky.Keywords: university students, HIV risk perceptions, sexual behaviour, ZimbabweL’e´tude visait a` e´valuer la perception du risque d’infection a` VIH des e´tudiants de l’universite´. Une ’e´tude transversale a e´te´ mene´e sur 345 e´tudiants sexuellement actifs dans deux universite´s du Zimbabwe (une e´tatique et une prive´e). Les re´sultats ont re´ve´le´ que plus d’un quart des re´pondants s’estimaient eˆtre expose´s au risque de contracter le VIH a` cause du comportement sexuel de leurs partenaires re´guliers et plus de la moitie´ se sentait exposer au risque de contracter le VIH a` cause du comportement sexuel de leurs partenaires occasionnels. En outre, un tiers des re´pondants ont reconnu qu’ils e´taient expose´s au risque de contracter le VIH a` cause de leur propre comportement sexuel. Il y a eu plus des re´pondants de l’universite´ de l’E´tat qui ont estime´ qu’ils e´taient expose´s au risque d’infection a` VIH a` cause de leur comportement sexuel que leurs homologues de l’universite´ prive´e. Malgre´ ces affirmations, seulement 66,56% s’e´taient de´ja` imagine´ qu’ils e´taient expose´s au risque d’eˆtre infecte´ par le VIH. La perception de contracter le VIH au niveau individuel e´tait faible, c’e´tait reconnu par 27,76% des re´pondants sexuellement actifs. Presque tous les re´pondants de´crivent le comportement sexuel de leurs semblables comme e´tant a` risque ou tre`s a` risque.Mots-cle´s: e´tudiants de l’universite´, risque d’infection a` VIH, comportement sexuel, Zimbabwe
    • Perceptions about the acceptability and prevalence of HIV testing and factors influencing them in different communities in South Africa

      Ntsepe, Y; Simbayi, LC; Shisana, O; Rehle, T; Mabaso, M; Ncitakalo, N; Davids, A; Naidoo, YD (Taylor & Francis, 2014-10-08)
      HIV counselling and testing (HCT) is considered important because it is an entry point to a comprehensive continuum of care for HIV/AIDS. The South African Department of Health launched an HCT campaign in April 2010, and this reached 13,269,746 people by June 2011, of which 16% tested HIV positive and 400,000 of those were initiated into antiretroviral treatment. The overall objective of this project was to gain insight into the general perceptions about HIV testing in the different South African communities. Factors influencing testing in these communities were also explored. Discussions with twelve focus groups (FG) of 8–12 participants each were  conducted with male and female participants recruited from both urban formal and informal communities in Cape Town and Durban. Participants included four racial groups represented by different age groups as follows: adolescents (12–17 years), youth (18–24 years) and adults (25 years and older). Data were analyzed using thematic coding. Among the key themes that emerged from the findings were the inaccurate perception of risk, fear of testing HIV positive, stigma and discrimination. Participants from both African and Indian FGs reported being less likely to do self-initiated HIV testing and counselling, while those from the FG consisting of young whites were more likely to learn about their HIV status through blood donations and campus HIV testing campaigns. Most FGs said they were likely to test if they understood the testing process better and also if the results are kept confidential. The present findings reiterate the importance of spreading positive messages and ensuring confidentiality for HIV testing in a society where there is still some stigma associated with people living with HIV/AIDS. This can partly be accomplished by the continuation of the national HCT campaign, which has been a considerable success in the fight against HIV/AIDS in South Africa during the past two years.Keywords: HIV Counselling and Testing, perceptions, stigma, discrimination and confidentiality, South AfricaLe conseil et le de´pistage (CDV) du VIH sont conside´re´s importants pour les programmes de soins du VIH/SIDA. Le ministe`re sudafricain de la Sante´ a lance´ une campagne de CDV en avril 2010, et a atteint 13 269 746 personnes en juin 2011, dont 16% ont e´te´ identifie´s se´ropositifs, et dont 400,000 ont commence´ le traitement antire´troviral. L’objectif global de ce projet e´tait de mieux comprendre les perceptions ge´ne´rales sur le de´pistage du VIH dans les diffe´rentes communaute´s sud-africaines. Les facteurs influenc¸ant la participation au de´pistage du VIH ont e´te´ aussi e´tudie´s. Douze groupes de discussion (GDD), consistant de huit a` douze hommes et femmes, ont e´te´ forme´s. Les participants e´taient recrute´s dans les localite´s urbaines formelles et informelles a` Cape-Town et a` Durban. Les groupes e´taient repartie en quatre sur base d’ethnicite´, repre´sentant diffe´rents groupes d’aˆge: les adolescents (12–17 ans), les jeunes (18–24 ans) et les adultes (25 ans et plus). Les donne´es ont e´te´ analyse´es en utilisant un codage the´matique. La  perception errone´e du risque, la peur du de´pistage du VIH, la stigmatisation et la discrimination e´taient parmi les principaux the`mes qui ont e´merge´. Les participants africains et indiens ont de´clare´ d’eˆtre moins dispose´s a` se faire tester pour le VIH a` propre initiative, tandis que les jeunes blancs e´taient dispose´s a` connaıˆtre leur statut VIH graˆce aux dons de sang et aux campagnes universitaires de de´pistage du VIH. La plupart des participants des DDG ont dit qu’ils e´taient dispose´s a` se laisser tester s’ils avaient une meilleure compre´hension du processus de de´pistage, et s’ils e´taient convaincus de sa confidentialite´. Les re´sultats de cette recherche ont re´ite´re´ l’importance de la diffusion de messages positifs et de la confidentialite´ des re´sultats le de´pistage du VIH dans une socie´te´ ou` il y a encore un stigmate associe´ au VIH. Cela peut eˆtre accompli en partie par la poursuite de la campagne nationale de CDV, qui a e´te´ un succe`s conside´rable dans la lutte contre le VIH/SIDA en Afrique du Sud au cours des deux dernie`res anne´es.Mots cle´s: Le conseil et le depistage du VIH, Perceptions, stigmate, discrimination, confidentialite, Afrique du Sud
    • Perceptions of acceptability and utility of microbicides in Ghana, West Africa: A qualitative, exploratory study

      AE Tanner (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2008-07-14)
      Vaginal microbicides, substances that may substantially decrease transmission of sexually transmitted infections (STI) including human immunodeficiency virus (HIV), are currently in clinical trials. They are being presented as woman-initiated prevention methods that have the potential to be used without partners\' knowledge. However, it is recognised that covert use may be challenging, due to the accompanying increase in vaginal lubrication. This study explored factors that may influence acceptability and utilisation of vaginal microbicides in Ghana, a sub-Saharan West African country with relatively low rates of HIV. Qualitative research methods were employed in Accra, Ghana in 2005. Individual interviews were conducted with 10 staff working in reproductive health settings, and two focus groups were conducted with young women aged 24-28. Three main topics emerged during the interviews and focus groups, including issues related to available contraceptive and prevention methods, perceptions of microbicide interest and acceptability, and cultural influences on microbicide acceptability and use. Participants discussed issues associated with available contraceptive options that may influence microbicide uptake. All respondents suggested that Ghanaian women would have a high level of interest in microbicides, with varying interest in formulas with different contraceptive and disease prevention properties. Cultural factors that may impact on microbicide use, often related to gender and power issues, were also discussed. Thus, as microbicides are being developed, cultural issues and behavioral correlates will need to be assessed to help ensure acceptability and use. In addition, gendered negotiation power and the implications of covert use need to be addressed in microbicide education and social marketing. Les microbicides vaginaux, une substance qui pourrait largement réduire les infections sexuellement transmises (IST) et le VIH inclus, font actuellement parti des essais cliniques. On prétend que les microbicides sont une méthode de prévention initiée par les femmes elles-mêmes qu\'on peut utiliser sans la connaissance du partenaire sexuel. Cependant, on reconnait que l\'utilisation secrète de cette substance peut être un défis diffi cile à surmonter étant donné la lubrification vaginale exagérée (Global Campaign for Microbicides GCM, 2007). Cette étude examine les facteurs qui peuvent influencer l\'admissibilité et l\'usage des microbicides vaginaux au Ghana, un pays sous-Saharien de l\'Afrique de l\'Ouest ayant un taux assez bas de VIH. (UNAIDS, 2005). Des méthodes de recherche qualitative ont été utilisées à Accra, Ghana pendant le mois de mai jusqu\'en juillet 2005. Des entretiens individuels ont été menés auprès de 10 personnes qui travaillent en milieu de santé de la reproduction qui par la suite pourraient devenir de partenaires importants de la promotion des microbicides. En plus de cela, deux groupes de foyer ont été menés auprès des jeunes femmes âgées de 24 à 28 ans. Trois sujets principaux ont émergé pendant les entretiens et les groupes de foyer - les sujets liés aux méthodes de contraception et de prévention disponibles, les perceptions de l\'intérêt aux microbicides et leur admissibilité et des influences culturelles sur l\'admissibilité et l\'usage de microbicides. Toutes les participantes ont suggéré que les femmes ghanéennes seront plus intéressées aux microbicides avec un intérêt varié vis-à-vis les formules ayant des propriétés différentes de contraception et de prévention de maladies. Des facteurs culturels, souvent associés aux sexes et au pouvoir, qui pourraient avoir l\'impact sur l\'usage des microbicides ont été discutés. Bien qu\'il y ait eu un grand intérêt aux microbicides qui font la une, il y a de nombreux facteurs qui pourraient avoir l\'impact sur l\'usage. De ce fait, pendant que les microbicides sont aménagés, les questions culturelles et les corrélats comportementaux doivent être évalués afin d\'assurer l\'admissibilité et l\'usage. De plus, on doit aborder le pouvoir de négociation entre les sexes et les implications de l\'usage secret lors de l\'éducation portant sur les microbicides et le marketing social. Keywords: Microbicides, STI/HIV prevention, reproductive health professionals, Ghana, West Africa, gender. SAHARA J Vol. 5 (1) 2008: pp. 11-18
    • Perceptions of door-to-door HIV counselling and testing in Botswana

      Kroeger, K; Taylor, A; Marlow, H; Fleming, DT; Beyleveld, V; Alwano, MG; Kejelepula, MT; Chilume, KB; Smith, DK; Roels, TH; et al. (Taylor & Francis, 2012-08-27)
      Prevalence of HIV infection in Botswana is among the highest in the world, at 23.9% of 15 - 49-year-olds. Most HIV testing is conducted in voluntary counselling and testing centres or medical settings. Improved access to testing is urgently needed. This qualitative study assessed and documented community perceptions about the concept of door-to-door HIV counselling and rapid testing in two of the highest-prevalence districts of Botswana. Community members associated many positive benefits with home-based, door-to-door HIV testing, including convenience, confidentiality, capacity to increase the number of people tested, and opportunities to increase knowledge of HIV transmission, prevention and care through provision of correct information to households. Community members also saw the intervention as increasing opportunities to engage and influence family members and to role model positive behaviours. Participants also perceived social risks and dangers associated with home-based testing including the potential for conflict, coercion, stigma, and psychological distress within households. Community members emphasised the need for individual and community preparation, including procedures to protect confidentiality, provisions for psychological and social support, and links to appropriate services for HIV-positive persons.
    • Perceptions of the availability and effectiveness of HIV/AIDS awareness and intervention programmes by people with disabilities in Uganda

      Chireshe, R; Rutondoki, EN; Ojwang, P (Taylor & Francis, 2011-07-08)
      The study investigated perceptions of the availability and effectiveness of HIV/AIDS awareness and intervention programmes by people with disabilities in Uganda. Participants (N=95) were made up of 15 leaders of disabled people’s organisations (DPOs) and 80 people with disabilities (PWDs). A survey design which used both quantitative and qualitative research methods was adopted. A questionnaire was used for leaders of DPOs while focus group discussions (FGDs) were held with the rest of the participants. Descriptive statistics were used to analyse the quantitative data. The qualitative data were analysed by means of a content analysis. The study found that although PWDs were aware of the HIV/AIDS pandemic, they felt discriminated against on HIV/AIDS issues. The PWDs had difficulties in accessing HIV/AIDS services because of mainly communication problems. Results further revealedthat the HIV/AIDS policy on disability was not very clear. The PWDs requested for full involvement in HIV/AIDS advocacy and training programmes. Recommendations were made.
    • Peripheral neuropathy and quality of life of adults living with HIV/AIDS in the Rulindo district of Rwanda

      Biraguma, J; Rhoda, A (Taylor & Francis, 2012-08-28)
      Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital in the Rulindo district of Rwanda. Another aim was to determine these patients’ QoL. A cross-sectional descriptive quantitative research design was used. A time-constrained method was used to sample 185 adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital. The subjective PN screen and the World Health Organization Quality of Life Scale Brief Version were used to collect the data. Data were analysed using the Statistical Package for the Social Sciences. Student’s t-test and one-way analysis of variance were performed to determine ifsignificant differences existed between QoL scores in participants with and without PN symptoms. The results indicated that 40.5% of respondents experienced PN. QoL in participants with PN showed significantly lower scores in the physical (p ¼ 0.013) and psychological (p ¼ 0.020) domains when compared with those who did not have PN. These results indicate a high prevalence of neuropathy among PLWH attending the outpatients’ clinic at Rutongo Hospital. In addition, patients with neuropathy had lowerQoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them.
    • Phase III microbicide trial methodology: opinions of experienced expanded safety trial participants in South Africa

      Annalie Pistorius; Mohlatlego Sebola; Janneke van de Wijgert; IATEC Foundation, Pietersbergweg 9, 1105 BM Amsterdam, The Netherlands; Anwar Hoosen; Alana de Kock; Nicol Coetzee; Heidi Jones (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2006-04-26)
      In preparation for effectiveness trials of candidate vaginal microbicides, scientists are debating trial design and implementation challenges, including choice of control arm(s), product-sharing across arms, and visit schedules. This study involved a survey of South African women participating in an expanded safety trial of the candidate microbicide Carraguard gel.The first 100 consenting women who attended the study clinics in Ga-Rankuwa and Gugulethu (total N = 200) were interviewed; all women had been using a study gel for at least 6 months at the time of the interview.The study found that many participants thought that including a condoms-only arm would result in increased product-sharing, male partner resistance to trial participation and decreased enrollment; no clear patterns emerged regarding the potential effect on condom use and cohort retention.The majority of women preferred a monthly visit schedule, would be willing to use a product for 2 years, and thought that their product use would not decrease over time.Thus flexibility in trial design and implementation strategies is needed until evidence-based decisions can be made.When including a condoms-only arm, extra efforts should be made to explain the importance of all study arms to potential participants and to measure adherence and product-sharing. Keywords: microbicides, HIV prevention interventions, randomised controlled trialsRésuméAu cours des préparatifs des épreuves d'efficacité de candidat des microbicides vaginaux, les scientifiques discutent les défis de la conception et l'exécution d'une épreuve, entre autres, le choix de bras commandé, un bras de partage de produit et les visites prévues. Cette étude a nécessité une enquête auprès des femmes sud-africaines participant à l'épreuve de sûreté augmentée du gel candidat microbicide Carraguard. La première centaine de femmes consentantes qui assistaient à l'étude clinique de Garankuwa et de Gugulethu (N = 200 au total) ont subit des entretiens: toutes les femmes utilisaient le gel d'étude pendant une période de 6 mois au moment de l'entretien. L'étude a démontré que beaucoup de participants étaient de l'avis que l'ajout d'un bras seulementcondoms aurait pour conséquence une hausse de partage de produit, la résistance à la participation des partenaires masculins et la baisse des inscriptions; il n'y a pas eu d'émergence de tendances claires concernant l'effet potentiel sur l'utilisation du préservatif et la rétention de cohorte. La majorité de femmes ont préféré une visite mensuelle, elles seraient prêtes à utiliser le produit au cours d'une période de 2 ans et elles estimaient que leur utilisation du produit ne va pas diminuer entre-temps. De ce fait, il faut une flexibilité de stratégies de la conception et l'exécution de l'épreuve jusqu'à ce que des décisions basées sur preuves soient prises. Lorsqu'on ajoute le bras seulement-condoms, on doit faire davantage d'efforts pour expliquer l'importance de tous les bras d'étude aux participants potentiels et de mesurer l'adhésion et le partage de produit.Mots clés: microbicides, interventions de prévention au VIH, épreuves commandées randomisées SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 311-319
    • Policy-maker attitudes to the ageing of the HIV cohort in Botswana

      Matlho, Kabo; Lebelonyane, Refelwetswe; Driscoll, Tim; Negin, Joel (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2017-09-19)
      Background: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana.Methods: We conducted qualitative face-to-face interviews with 15 consenting personnel from the Ministry of Health, medical practitioners and non-governmental organizations involved in the administration of medical services, planning, strategies and policies that govern social, physical and medical intervention aimed at people living with HIV and health in general. The Shiffman and Smith Framework of how health issues become a priority was used as a guide for our analysis.Results: Amidst an HIV prevalence of 25% among those aged 50–64 years, the respondents passively recognized the predicament posed by a population aging with HIV but exhibited a lack of comprehension and acknowledgement of the extent of the issue. An underlying persistent ageist stigma regarding sexual behaviour existed among a number of interviewees. Respondents also noted the lack of defined geriatric care within the provision of the national health care system. There seemed, however, to be a debate among the policy strategists and care providers as to whether the appropriate response should be specifically towards older adults living with HIV or rather to improve health services for older adults more generally. Respondents acknowledged that health systems in Botswana are still configured for individual diseases rather than coexisting chronic diseases even though it has become increasingly common for patients, particularly the aged, to have two or more medical conditions at the same time.Conclusions: HIV among older adults remains a low priority among policy-makers in Botswana but is at least now on the agenda. Action will require more concerted efforts to recognize HIV as a lifelong infection and putting greater emphasis on targeted care for older adults, focussing on multimorbidity.Keywords: ageing population, older adults, PLWH, HIV policy
    • Policy-maker attitudes to the ageing of the HIV cohort in Botswana

      Kabo Matlho; Refelwetswe Lebelonyane; Tim Driscoll; Joel Negin (Taylor & Francis Group, 2017-01-01)
      Background: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana. Methods: We conducted qualitative face-to-face interviews with 15 consenting personnel from the Ministry of Health, medical practitioners and non-governmental organizations involved in the administration of medical services, planning, strategies and policies that govern social, physical and medical intervention aimed at people living with HIV and health in general. The Shiffman and Smith Framework of how health issues become a priority was used as a guide for our analysis. Results: Amidst an HIV prevalence of 25% among those aged 50–64 years, the respondents passively recognized the predicament posed by a population aging with HIV but exhibited a lack of comprehension and acknowledgement of the extent of the issue. An underlying persistent ageist stigma regarding sexual behaviour existed among a number of interviewees. Respondents also noted the lack of defined geriatric care within the provision of the national health care system. There seemed, however, to be a debate among the policy strategists and care providers as to whether the appropriate response should be specifically towards older adults living with HIV or rather to improve health services for older adults more generally. Respondents acknowledged that health systems in Botswana are still configured for individual diseases rather than coexisting chronic diseases even though it has become increasingly common for patients, particularly the aged, to have two or more medical conditions at the same time. Conclusions: HIV among older adults remains a low priority among policy-makers in Botswana but is at least now on the agenda. Action will require more concerted efforts to recognize HIV as a lifelong infection and putting greater emphasis on targeted care for older adults, focussing on multimorbidity.
    • Poverty and HIV/AIDS in South Africa: an empirical contribution

      HSRC; Lerato Sonia Tladi; HSRC (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2007-02-08)
      This study sets out to establish and explain the empirical link between HIV/AIDS and poverty using data collected by the 1998 South African Demographic and Health Survey (SADHS).Analysis is restricted to women of reproductive age (15 - 49 years).The results indicate an increased risk of HIV infection among the poor, due to poverty-related characteristics of low education and low knowledge of the means of avoiding HIV infection, as opposed to the non-poor. Moreover, the poor and the less educated were found to be more likely not to use condoms than the non-poor. The results do not, however, provide the reasons for these relations and as such further research is required. One possible explanation was financial dependence on their partners, as it was found that women who received money from their partners, as well as those who came from households where hunger was a common phenomenon, were more likely not to use condoms because their partners disliked condoms, than those who did not receive money from their partners. The results also hinted at the intricacy of the poverty- HIV/AIDS relationship, so that it was not only low socio-economic status that increased susceptibility to HIV infection but also high socio-economic status. Keywords: HIV/AIDS, poverty, HIV knowledge, condom use. Résumé Cette étude a pour but d'établir et d'expliquer un lien empirique entre le VIH/SIDA et la pauvreté en utilisant des données recueillies par l'Enquête Démographique et de Santé sud-africaine (SADHS) de 1998. L'analyse se limite aux femmes d'un âge de reproduction (15 - 49 ans). Les résultats indiquent un risque plus élevé d'infection de VIH parmi les pauvres. Ceci à cause des traits particuliers d'une éducation très basse liée à la pauvreté et la connaissance très réduite des moyens d'éviter l'infection par le VIH chez les pauvres en comparaison aux personnes aisées. D'autant plus qu'on a constaté que les pauvres et moins éduquées étaient plus disposés à ne pas utiliser les préservatifs par rapport aux personnes aisées. De ce fait, il est nécessaire de prendre la recherche plus loin. Une explication possible fut la dépendance financière de femmes sur leurs partenaires, puisqu'on a constaté que les femmes qui reçoivent l'argent de leurs partenaires ainsi que celles qui vivent dans des foyers sans nourriture étaient plus disposées à ne pas utiliser les préservatifs parce que leurs partenaires n'en veulent pas, que pour les femmes qui ne reçoivent pas d'argent de leurs partenaires. Les résultats ont aussi fait allusion à la complexité de la relation pauvreté-VIH/SIDA en montrant que le statut socio-économique assez bas n'est pas le seul responsable de la susceptibilité à l'infection du VIH élevée mais que le contraire et aussi vrai. Mots clés:VIH/SIDA, pauvreté, connaissance du VIH et l'utilisation des préservatifs.