• Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

      Jaiantilal, P; Gutin, SA; Cummings, B; Mbofana, F; Rose, CD (Taylor & Francis, 2015-05-05)
      Despite the Mozambique government’s efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as gender inequalities, stigma and discrimination which hinder the full impact of PP interventions in this context.Keywords: positive prevention, feasibility and acceptability, healthcare provider, HIV/AIDS
    • Accessibility of antiretroviral therapy in Ghana: Convenience of access

      Addo-Atuah, J; Gourley, D; Gourley, G; White-Means, SI; Womeodu, RJ; Faris, RJ; Addo, NA (Taylor & Francis, 2012-08-28)
      The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants’ perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, orotherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin’s case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. . Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA.. Waiting time to receive care was from 4 to 9 h. . While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. . The PLWHA corroborated the providers’ description of the procedure for initiating and monitoring ART in Ghana. . PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider–patient communication, which might explain the PLWHA’sunderstanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.
    • Accounting for youth audiences’ resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa

      Makwambeni, Blessing; Salawu, Abiodun (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-03-09)
      Theoretical debates and literature on E-E efforts in Africa have largely focussed on understanding how and why interventions on HIV and AIDS are effective in influencing behaviour change among target communities. Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study investigated and accounted for the oppositional readings that subaltern black South African youths negotiate from Tsha Tsha, an E-E television drama on HIV and AIDS in South Africa. Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do not only hold several implications for E-E practice and research, they further reflect the utility of articulating cultural studies and reception analysis into a more nuanced theoretical and methodological framework for evaluating the ‘impact’ of E-E interventions on HIV and AIDS.Keywords: audience reception, cultural studies, entertainment-education, HIV and AIDS
    • Accounting for youth audiences’ resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa

      Blessing Makwambeni; Abiodun Salawu (Taylor & Francis Group, 2018-01-01)
      Theoretical debates and literature on E-E efforts in Africa have largely focussed on understanding how and why interventions on HIV and AIDS are effective in influencing behaviour change among target communities. Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study investigated and accounted for the oppositional readings that subaltern black South African youths negotiate from Tsha Tsha, an E-E television drama on HIV and AIDS in South Africa. Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do not only hold several implications for E-E practice and research, they further reflect the utility of articulating cultural studies and reception analysis into a more nuanced theoretical and methodological framework for evaluating the ‘impact’ of E-E interventions on HIV and AIDS.
    • Achievement of interventions on HIV infection prevention among migrants in China: A meta-analysis

      Zhang, Rui; Chen, Ling; Cui, Ya deng; Li, Ge (SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2018-04-11)
      In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for human immunodeficiency virus (HIV) infection prevention for migrants in China and to identify factors associated with intervention efficacy. A computerized literature search of the Chinese National Knowledge Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was health education were included. Rev Manager 5.3 software was used to analyze the intervention effects in terms of knowledge, attitude, and behavior indexes. Relative to pre-intervention, the HIV interventions showed statistically significant efficacy in terms of sexual transmission of HIV, condom use for HIV prevention, change in attitude towards HIV/AIDS patients, incidence of commercial sex behavior, and recent condoms use during sex (P < .01). Moreover, the baseline rate of migrants, intervention time, peer education, region, and education background were factors influencing the efficacy of the intervention. Significant improvement in terms of knowledge of sexual transmission of HIV and attitudes and behaviors among migrants was observed; however, based on the findings of previous studies, the interventions should be customized for different people from different districts in China. Further research is needed to evaluate subgroups of migrants in China according to their baseline characteristics.Keywords: migrants, AIDS/HIV, intervention, meta-analysis, precision intervention
    • Achievement of interventions on HIV infection prevention among migrants in China: A meta-analysis

      Rui Zhang; Ling Chen; Ya deng Cui; Ge Li (Taylor & Francis Group, 2018-01-01)
      In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for human immunodeficiency virus (HIV) infection prevention for migrants in China and to identify factors associated with intervention efficacy. A computerized literature search of the Chinese National Knowledge Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was health education were included. Rev Manager 5.3 software was used to analyze the intervention effects in terms of knowledge, attitude, and behavior indexes. Relative to pre-intervention, the HIV interventions showed statistically significant efficacy in terms of sexual transmission of HIV, condom use for HIV prevention, change in attitude towards HIV/AIDS patients, incidence of commercial sex behavior, and recent condoms use during sex (P < .01). Moreover, the baseline rate of migrants, intervention time, peer education, region, and education background were factors influencing the efficacy of the intervention. Significant improvement in terms of knowledge of sexual transmission of HIV and attitudes and behaviors among migrants was observed; however, based on the findings of previous studies, the interventions should be customized for different people from different districts in China. Further research is needed to evaluate subgroups of migrants in China according to their baseline characteristics.
    • Addressing HIV/AIDS challenges in Uganda: does social capital generation by NGOs matter?

      Muriisa, RK; Jamil, I (Taylor & Francis, 2011-06-28)
      HIV/AIDS has had devastating impacts in many countries, Uganda in particular. However, Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others, Uganda’s success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition, the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard, HIV/AIDS NGOs play a central role in the way individuals, groups and communities interact, and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs’ success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels, and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda.Keywords: HIV/AIDS, social capital, NGOs, Uganda.Le VIH/SIDA a eu des effets dévastateurs dans de nombreux pays et en Ouganda en particulier. L’Ouganda, cependant, est dépeint comme l’un des pays les plus performants en matière de lutte contre le VIH/SIDA. L’une des raisons de ce succès est attribuée à l’environnement ouvert dans le pays qui a permis des discussions avec un esprit ouvert sur la question du VIH/SIDA. Dans d’autres pays comme en Afrique du Sud et au Kenya, l’existence de cette maladie était au contraire niée. En outre, ce succès est attribué à la politique qui a favorisé la participation de plusieurs acteurs à la lutte contre la maladie. L’objectif principal de cet article est d’établir le processus de production de capital social par les ONG, et de montrer comment les bénéfices du capital social favorisent l’atténuation des problèmes liés au VIH/SIDA en Ouganda. La clé du capital social réside dans l’entretien des relations sociales. À cet égard, les ONG s’occupant de la question du VIH/SIDA jouent un rôle central dans la façon dont les individus, les groupes et les communautés interagissent, et dans la manière par laquelle les différents types de relations sociales se nouent pour les personnes qui côtoient le VIH/SIDA, et surtout pour celles quisont infectées par le VIH. La réussite des ONG dans la réduction du nombre de cas de VIH/SIDA en Ouganda est basée sur leur capacité à générer du capital social. Cela implique l’inclusion et le renforcement des réseaux sociaux, l’autonomisation aux niveaux individuel et communautaire, et la diffusion de l’information pour réduire la stigmatisation sociale ainsi que la discrimination. Pour cette étude, nousavons utilisé comme stratégie une méthode mixte de collecte de données. Nous avons utilisé un questionnaire structuré ayant des séries de questions quantitatives et qualitatives qui ont été axés sur différents indicateurs de mesure du capital social. Nous avons utilisé des observations et des entretiens poussés en face-à-face. Une des principales conclusions de l’étude est que la façon dont les individus et lesgroupes sont liés et interagissent les uns avec les autres sont d’importants mécanismes pour atténuer les défis liés à la question du VIH/SIDA en Ouganda.
    • Adolescent experiences of HIV and sexual health communication with parents and caregivers in Soweto, South Africa

      CN, Soon; Kaida, A; Nkala, B; Dietrich, J; Cescon, A; Gray, G; Miller, CL (Taylor & Francis, 2014-11-21)
      Communication about sexual health between parents and adolescents has been shown to have a protective influence on behaviours that reduce the risk of HIV transmission. This study explored experiences of HIV and sexual health (HSH) communication between parents and/or caregivers and adolescents in an urban HIV-endemic community in Southern Africa. Adolescents (aged 14–19 years) were recruited from the Kganya Motsha Adolescent Centre and the Kliptown community between June and August 2009. Qualitative data were collected through focus group discussions (n = 10 adolescents) and semi-structured interviews (n = 31 adolescents). In total, 41 adolescents (56% female, 44% male, mean age = 17.2) participated in the study. Adolescent participants identified emotional, physical and sociocultural barriers to initiating HSH communication with parents and caregivers including fear of verbal warnings, threats and physical assault. Adolescents also expressed a desire for mentorship around HSH communication beyond abstinence and peer-based information. Public health interventions need to support adolescents’ access to bi-directional HSH information from adult mentors that address the lived realities of adolescents beyond expectations of abstinence.Keywords: adolescent, parent–adolescent communication, qualitative, sexual health, HIV prevention, South Africa
    • Adolescent religiosity and attitudes to HIV and AIDS in Ghana

      Amoako-Agyeman, KN (Taylor & Francis, 2013-01-08)
      This study investigated the relationships between adolescent religiosity and attitudes to HIV/AIDS based on two major techniques of analysis, factor and regression analysis towards informing preventive school education strategies. Using cross-sectional data of 448 adolescents in junior high school, the study incorporated survey in a self-administered questionnaire and sought to identify underlying factors that affect pupils’ responses, delineate the pattern of relationships between variables and select models which best explain and predict relationships among variables. A seven-factor solution described the ‘attitude’ construct including abstinence and protection, and six for ‘religiosity’. The results showed relatively high levels of religiosity and a preference for private religiosity as opposed to organisational religiosity. The regression analysis produced significant relationships between factors of attitudes to HIV/AIDS and of religiosity. Adolescent with very high private religiosity are more likely to abstain from sex but less likely to use condoms once they initiate: protection is inversely related to religiosity. The findings suggest that religious-based adolescent interventions should focus on intrinsic religiosity. Additionally, increasing HIV prevention information and incorporating culturally relevant and socially acceptable values might lend support to improved adolescent school-based HIV/AIDS prevention programmes.
    • Adoption of formal HIV and AIDS workplace policies: An analysis of industry/ sector variations

      Bakuwa, R (Taylor & Francis, 2011-07-08)
      Addressing HIV and AIDS is the responsibility of many stakeholders including private sector companies. However, increasing evidence reveals that the majority of companies around the world are yet to acknowledge and respond to HIV and AIDS as a workplace issue. One factor that has been identified in the literature as playing a role in determining whether a company responds to HIV and AIDS, or not, is the industry/sector in which a company operates. This study therefore sought to empirically examinewhether in the context of Malawi there were significant variations in the adoption of formal HIV and AIDS workplace policies based on the industry/sector in which a company was operating, as well as analyse the dynamics underlying such variations. Using survey data collected from 152 randomly selected private sector companies in Malawi, the results of this study revealed significant variations in the adoption of HIV and AIDS workplace policies among companies operating in various sectors. Companies in the service sector were leading the adoption compared to companies in other sectors such as the trading sector. Furthermore, the evidence from this study showed that differences in staff participation in the activities of HIV and AIDS institutions may explain the industry/sector variations. These results provide an important avenue to scale up company responses to HIV and AIDS by intensifying staff participation in the activities of HIV and AIDS institutions. Such institutions appear to play a vital role of providing up to date HIV and AIDS-related information upon which companies are able to develop a business case for responding to the epidemic.
    • AIDS-related knowledge and sexual behaviour among married and previously married persons in rural central Mozambique

      A Gomes; BH Noden; A Ferreira (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2010-01-20)
      HIV prevalence in central Mozambique is the highest in the country with high urban rates impacting on the rural areas. To identify potential factors influencing the spread of HIV in three sparsely populated districts in southern Sofala province, 847 married and previously married persons were surveyed for their knowledge, practices and beliefs regarding HIV/AIDS and STIs. 21.9% and 6.5% of males and females, respectively, were engaged in casual sexual partnerships in the past year. Being male, married, educated, and having genital discharge and ulcers in the last year were significantly associated with risky sexual activity. Risky behaviour wassignificantly associated with being Catholic or Protestant when compared  with those from Zionist churches. Knowledge of ABC prevention strategies and condom usage was significantly associated with being male, married, having an STI in the past year, and being educated, particularly at the secondary level (Grade 8+). Attitudes and behaviour were influenced by cultural and religious involvement, as well as sex and marital status. It is imperative that prevention strategies take into account the cultural, economic and religious conditions present in rural African settings to create HIV prevention programmes that are culturally relevant and acceptable to the participants.
    • Alcohol abuse, gender-based violence and HIV/AIDS in Botswana: establishing the link based on empirical evidence

      D Ntseane; Department of Social Work at the University of Botswana.; K Nthomang; Department of Social Work, University of Botswanamage/pj; OD Phorano; Department of Social Work at the University of Botswana (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2005-05-26)
      The existence of gender-based violence has been a source of concern within the public and private sectors as well as civil society organisations in Botswana. The present study investigated the link between alcohol abuse, gender-based violence and HIV/AIDS. Further, it attempted to unravel the often unquestioned assumption that gender-based violence is perpetuated by cultural practices. Case study qualitative methodology was used to gather data for the study.A sample of 20 cases was selected purposively from five women\'s non-governmental organisations. In addition, in-depth interviews were conducted with agency coordinators, social workers, police commanders and police officers. The findings of the study revealed a relationship between alcohol abuse and gender-based violence, which makes victims vulnerable to HIV infection. From the findings, it is recommended that gender-based programmes be established to sensitise people about the link between alcohol abuse, gender based violence and HIV/AIDS. Key words: gender-based violence, alcohol abuse, HIV/AIDS, Botswana, poverty, NGOs. RÉSUMÉ L\'existence de la violence sexiste fut une source d\'inquiétude dans les secteurs publics et privés ainsi que dans des organisations de la société civile au Botswana. Cette étude a mené une enquête sur le lien entre l\'abus d\'alcool, la violence sexiste et le VIH/SIDA. De plus, elle a tenté de démêler la supposition que la violence sexiste est perpétuée par des pratiques culturelles. Cette étude a utilisé la méthodologie quanlitative de cas d\'étude afin de recueillir les données. Un échantillon de 20 cas a été intentionnellement sélectionné à partir de cinq organisations non-gouvernementales de femmes. En outre, des entretiens profonds ont été menés auprès de coordinateurs des agences, des assistants sociaux et des chefs de la police. Les résultats de cette étude ont tout dit du lien entre l\'abus d\'alcool et la violence sexiste qui rendent les victimes encore plus vulnérables à la contamination du VIH.A partir de résultats, il est recommandé que des programmes sexistes soient mis en place afin de sensibiliser les gens du lien entre l\'abus d\'alcool, la violence sexiste et le VIH/SIDA. Mots clés: la violence sexiste, l\'abus d\'alcool, le VIH/SIDA, le Botswana, la pauvreté, les ONGs. Sahara J Vol.2(1) 2005: 188-202
    • Ambiguous diagnosis, futile treatments and temporary recovery: Meanings of medical treatment among HIV/AIDS family caregivers providing care without ARVs

      Makoae, MG (Taylor & Francis, 2012-08-27)
      The capacity of countries with high HIV and AIDS prevalence to provide antiretroviral treatment and care for all people who need support remains a public health challenge. In Lesotho, there are improvements in this area but the high proportion of people who need ART yet they do not receive treatment suggests that many HIV-infected people continue to depend on medicines that treat opportunistic infections. The objective of the article is to explore caregivers’ experiences with diagnostic procedures and outcomes, prescriptions and treatment outcomes when ARVs were unavailable. A phenomenological design using in-depth face-to-face interviews was used to obtain the experiences of 21 family caregivers about caregiving, including access to and use of medical treatments. Caregivers’ experiences indicate that most of the consulted health professionals provided vague and inconsistent diagnoses while the medication they prescribed failed to treat most of the symptoms. Unavailability of medicines that control pain and symptoms effectively continues to be a prominent feature of HIV and AIDS home-based caregiving in Lesotho. It is recommended that health professionals should facilitate disclosure of HIV diagnosis to family caregivers to assist them to understand unstable treatment outcomes; and policy makers should strengthen home-based care by developing policies that integrate palliative care into HIV and AIDS care.
    • An assessment of government policy response to HIV/AIDS in Ghana

      JN Fobil; School of Public Health, College of Health Sciences, PO Box LG 13, University of Ghana, Legon, Acra; IN Soyiri; Deaprtment of Population, Family and Reproductive HEalth, School of Public Health, University of Ghana (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2007-01-18)
      The HIV/AIDS epidemic in Africa has assumed a dimension raising heartbreaking anxiety among national governments and civil society groups. In Ghana for example, the pandemic is well-documented and has gone beyond a health problem, and now encompasses all socio-economic aspects of life.The estimated rate of infection from the mid-1980s to 2000 has more than doubled, and in spite of the control efforts by various groups and organisations, prevalence of the disease has not declined notably.This paper assesses government policy, programmes and strategies to combat the disease, using analysis of time trend sentinel data and weighting these against control efforts.The assessment revealed that 380 000 adults and 36 000 children are currently infected. There are wide spatial variations in prevalence across the country and the overall national prevalence has fluctuated over time, standing at 2.6% in 2000, 3.6% in 2002 and 3.1% in 2004.This appears relatively lower than in adjacent countries, where prevalence is around 5% and over 25% in East and Southern African countries. Although the review found a robust multipronged government intervention approach to containing the disease, we are hesitant to claim that the fairly stable or low national prevalence in Ghana compared with its immediate neighbours may have been the consequence of the effectiveness of national AIDS control programmes and impact of government interventions. Keywords: assessment response, sentinel surveillance system, prevalence, vulnerability, generalised epidemic Journal of Social Aspects of HIV/AIDS Vol. 3 (2) August 2006: 457-465
    • An enumeration of orphans and analysis of the problems and wishes of orphans: the case of Kariba, Zimbabwe

      E Dhlomo; J Mangoma; C Chimbari (SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance), 2009-01-07)
      In southern Africa, HIV and AIDS accounts for the largest proportion of orphans. Very often the orphaned children become destitute, and young girls in particular become more vulnerable to HIV and AIDS as they try to fend for the rest of the family. This paper reports on the number of orphans in Kariba, Zimbabwe, describing their problems, coping strategies and wishes. The study was carried out in Nyamhunga and Mahombekombe high-density residential areas of Kariba, Zimbabwe. All households in the study area were visited, and a semi-structured questionnaire aimed at enumerating orphans and obtaining information regarding general problems of orphans was administered to heads of households present. In additio n, information on the plight, coping strategies and survival wishes of orphans were collected through 15 focus group discussions held with orphans, care givers, community leaders and stakeholders. The prevalence of orphans in Kariba, based on a sample of 3 976 households, was found to be very high (56%) with most of the orphans in the age group 6 - 12 years. The majority of the orphans were paternal and under maternal care. Over 30% of the orphans of schoolgoing age were not in school, and some young girl orphans became involved in commercial sex work. The survival wish list of the orphans included school fees, accommodation, health care provision, adequate food and income-generating projects. However, suggestions on orphan care and needs given by community members were somewhat divergent from the orphans\' wish list, indicating that community interventions may not be sensitive to the wishes of those affected. Although the study did not categorise orphans according to cause of death of parents, there are indications that most of the orphans are accounted for by HIV and AIDS. Keywords: Orphans, care givers, problems, needs and coping strategies.SAHARA-J Vol. 5 (3) 2008: pp. 120-128
    • An evaluation of a refresher training intervention for HIV lay counsellors in Chongwe District, Zambia

      Msisuka, C; Nozaki, I; Kakimoto, K; Seko, M; Ulaya, MMS; Syakantu, G (Taylor & Francis, 2012-08-27)
      To address a severe shortage of human resources for health, the Zambian Ministry of Health has begun to make use of lay counsellors for HIV counselling and testing. However, their skills and knowledge rarely have been reviewed or refreshed. We conducted a two-day refresher workshop for lay counsellors to review their performance and refresh their skills and knowledge. The objective of this study was to evaluate the refresher training intervention for HIV lay counsellors in the rural district of Chongwe in Zambia. The two-day refreshertraining workshop was held in November 2009. Twenty-five lay counsellors were selected by District Health Office and participated in the workshop. The workshop included: the opening, a pre-training exercise, lectures on quality assurance with regard to testing and safety precautions, lectures on counselling, filling the gap/Q&A session, and a post-training exercise. In both the pre- and post-trainingexercise, participants answered 25 true/false questions and tested 10 blood panel samples to demonstrate their knowledge and skill on HIV counselling and testing. The average overall knowledge test score  increased from 79% to 95% (p<0.001). At the baseline, knowledgetest scores in topic of standard precaution and post-exposure prophylaxis were relatively low (58%) but rose to 95% after the training (p<0.001). The per cent agreement of HIV testing by lay counsellors with reference laboratory was 99.2%. Participants’ knowledge was improved during the workshop and skill at HIV testing was found to remain at a high level of accuracy. Relatively weak knowledge of standard precautions and post-exposure prophylaxis suggests that lay counsellors are at risk of nosocomial infections, particularly in the absence of refresher training interventions. We conclude that the refresher training was effective for improving the knowledge and skills of lay counsellors and provided an opportunity to monitor their performance.
    • An evaluation of the innovative potentials of a HIV pilot exploring medical pluralism in rural South Africa

      Christopher J. Burman (Taylor & Francis Group, 2018-01-01)
      This article reflects on an internal evaluation undertaken to estimate the potentials of a community-university pilot project to be developed into a bonafide innovation that can be applied at scale. The focus of the community-university partnership has been to reduce the unintended consequences of medical pluralism on the HIV and AIDS epidemic in Waterberg district, Limpopo Province, South Africa. Despite promising outputs from the partnership – including an increase in adherence to antiretroviral therapy and a reduction in stigma among traditionalists living with HIV – the partnership wished to establish whether further funding should be applied for to take the pilot from its current prototype status to a more established innovation. In order to evaluate the innovative potentials of the pilot, the opportunity vacuum model of innovation was adapted and applied. The findings indicate that (1) the application of the opportunity vacuum model of innovation to evaluate the potentials of the pilot to be developed into a bonafide innovation was fit for purpose and (2) the pilot contains the key ingredients that are associated with innovations in the making. The discussion reflects on the social potentials of the pilot to contribute to 90-90-90 from a global, national and local perspective. The reflection concludes by suggesting that the opportunity vacuum model of innovation is a versatile heuristic that could be applied in other contexts and the community-university pilot represents a nascent innovation which has sufficient potential to justify further development.
    • Application of the information, motivation and behavioural skills model for targeting HIV risk behaviour amongst adolescent learners in South Africa

      Ndebele, M; Kasese-Hara, M; Greyling, M (Taylor & Francis, 2012-12-13)
      This paper discusses the application of an information, motivation and behavioural skills (IMB) model in a school-based programme for the reduction of HIV risk behaviour among 259 Grade 11 learners in two high schools in Alexandra township, Johannesburg. School 1 was the Experimental group, while School 2 was the Control group. After a baseline study (Time 1) at both schools, a 3-week intervention programme was conducted at School 1. A post-test (Time 2) was conducted at both schools. The intervention was repeated at School 2, followed by another post-test (Time 3) at both schools. A final test (Time 4) was conducted at both schools. While there were positive changes in the levels of HIV&AIDS IMB in learner participants, these changes may not be entirely attributed to the intervention. If an IMB model-based intervention is to be maximally effective in reducing HIV-risk behaviour among adolescents, it must focus on the behavioural, structural and socio-cultural contexts in which adolescents live.Keywords: IMB model, vulnerability, adolescents, risk behaviour, structural, socio-cultural
    • Appraisal of the inherent socio-demographic dynamics of HIV/AIDS epidemic in four districts of South-Western Uganda

      Agwu, E; Ihongbe, JC; Pazos, V; Ssengendo, J (Taylor & Francis, 2012-08-27)
      Although HIV prevalence in Uganda is much lower than it once was, AIDS is still claiming many lives each year with clear signs of escalating rural epidemics. The objective of this study was to appraise the socio-economic and demographic dynamics of HIV/AIDS epidemic in South-Western Uganda. Data were collected with standard closed ended semi-structured questionnaires self-administered to consenting, 605 HIV/AIDS patients, selected using the multistage random sampling technique, logistic linear regression, randomized block design and Pearson’s Chi square test (á=0.01) were used to analyse the data obtained. The duration of carriage was inversely proportional (r=-0.94) to population of HIV/AIDS patients surveyed. There were 98.2% Bantu (55.5% Banyankole and 22.6% Baganda); 77.5% females and 22.5% males; more widows (38.0%) than married (35.5%). HIV/AIDS prevalence generally decreased with increasinglevel of education. The highest (66.7%) HIV/AIDS prevalence was recorded in Bushenyi, followed by 58.4% in Masaka, 57.9% in Mbarara and 53.3% in Rukungiri. Rukungiri patients above 60 years of age harboured 57.1% HIV/AIDS followed by 45.5% among Masaka patients aged 11 - 20 years and 40% among Mbarara patients less than 10 years of age. HIV/AIDS prevalence was significantly (p<0.05) dependent on socio-economic and demographic factors of surveyed population. Therefore socio-economic and demographic factors underlie HIV/AIDS prevalence in this region. Observed differences in prevalence of HIV/AIDS between the surveyed districts wereremarkable and warrant regular surveillance for updated disease  epidemiology. Education can debunk the generally misconstrued rolesof social, economic and demographic factors in the spread of HIV/AIDS.
    • Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services

      Semugoma, P; Beyrer, C; Baral, S (Taylor & Francis, 2012-12-06)
      Uganda’s response to the HIV epidemic has been lauded for its robustness and achievements. However, a key component of HIV prevention programming has been missing, for men who have sex with men (MSM). The main reason cited has been criminalization of male homosexual behavior. In 2009, the Anti-Homosexuality Bill (AHB) was introduced in the parliament to enhance existing anti-homosexuality law. A multi-disciplinary team made a Health Impact Assessment of the proposed AHB. The bill as tabled would severely increase punishments, increased closeting. Social capital of MSM would be eroded by clauses mandating reporting byfriends, relatives, and acquaintances. Health-care professionals would have to inform on homosexuals. Mandatory HIV testing would be a blow to programming. Probable disclosure of HIV status in a public space (court) would also be a deterrent. Heftier punishments for those testing positive increases stigma and hobbles subsequent care. The AHB argues for exclusion, and more discrimination targeting persons living with HIV and sexual minorities. It will exacerbate the negative public healthconsequences of the existing legislation. The government of Uganda should review guidance documents published by authoritative bodies including the World Bank, World Health Organization to develop and bring to scale Human rightsaffirming HIV prevention, treatment, and care responses.