Sahara J-Journal of Social Aspects of Hiv-Aids最新文献

{"title":"'Why would you promote something that is less percent safer than a condom?': Perspectives on partially effective HIV prevention technologies among key populations in South Africa.","authors":"Clara Rubincam, Peter A Newman, Millicent Atujuna, Linda-Gail Bekker","doi":"10.1080/17290376.2018.1536561","DOIUrl":"10.1080/17290376.2018.1536561","url":null,"abstract":"<p><p>New biomedical prevention technologies (NPTs) for HIV, including oral Pre-Exposure Prophylaxis, and vaginal and rectal microbicides and HIV vaccines in development, may contribute substantially to controlling the HIV epidemic. However, their effectiveness is contingent on product acceptability and adherence. We explored perceptions and understanding of partially effective NPTs with key populations in South African townships. From October 2013 to February 2014, we conducted six focus groups and 18 individual interviews with Xhosa-speaking adolescents (n = 14), adult men who have sex with men (MSM) (n = 15), and adult heterosexual men (n = 9) and women (n = 10), and eight key informant (KI) interviews with healthcare workers. Interviews/focus groups were transcribed and reviewed using a thematic approach and framework analysis. Overall, participants and KIs indicated scepticism about NPTs that were not 100% efficacious. Some participants equated not being 100% effective with not being completely safe, and thus not appropriate for dissemination. KIs expressed concerns that promoting partially effective NPTs would encourage substitution of a more effective with a less effective method or encourage risk compensation. Educational and social marketing interventions that address the benefits and appropriate use of partially effective NPTs, including education and support tailored for frontline service providers, are needed to prepare for successful NPT implementation in South Africa.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"179-186"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36606755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a multicomponent behavioural PMTCT cluster randomised controlled trial on HIV stigma reduction among perinatal HIV positive women in Mpumalanga province, South Africa.","authors":"Karl Peltzer, Suat Babayigit, Violeta J Rodriguez, Jenny Jean, Sibusiso Sifunda, Deborah L Jones","doi":"10.1080/17290376.2018.1510787","DOIUrl":"10.1080/17290376.2018.1510787","url":null,"abstract":"<p><strong>Background: </strong>We evaluate the impact a multicomponent, behavioural, prevention of mother to child transmission (PMTCT), cluster randomised controlled trial on HIV stigma reduction among perinatal HIV infected women in rural South Africa.</p><p><strong>Methods: </strong>In a cluster randomised controlled trial, twelve community health centres (CHCs) in Mpumalanga Province, South Africa, were randomised; pregnant women living with HIV enrolled received either: A Standard Care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n =357), or an Enhanced Intervention (EI) condition of SC PMTCT plus the 'Protect Your Family' intervention (EI; 6 CHCs; n =342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions; those in the EI, four antenatal and two postnatal group PMTCT sessions, including stigma reduction, led by trained lay health workers. Maternal PMTCT, HIV knowledge and HIV related stigma were assessed. The impact of the EI was ascertained on stigma reduction (baseline, 12 months postnatally). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention.</p><p><strong>Results: </strong>In all, 699 women living with HIV were recruited during pregnancy (8-24 weeks), and assessments were completed prenatally at baseline and at 12 months (59.5%) postnatally. Baseline scores of overall HIV related stigma and the four scale factors (personalised stigma, disclosure concerns, negative self-image, and concern public attitudes) decreased at follow-up in the intervention group, while baseline scores of overall stigma and three scale factors (personalised stigma, negative self-image, and concern public attitudes) increased at follow-up in the control group. Using longitudinal analyses, Model 1, which included time-invariant predictors of stigma assessed over the two time periods of baseline and 12 months, increases in stigma from baseline to 12 months were associated with being unemployed, having been diagnosed with HIV before the current pregnancy, and alcohol use. In Model 2, which included time-varying predictors, lower stigma scores were associated with participation in the intervention, greater male partner involvement, and consistent condom use.</p><p><strong>Conclusion: </strong>The enhanced PMTCT intervention, including stigma reduction, administered by trained lay health workers had a significant effect on the reduction of HIV related stigma.</p><p><strong>Trial registration: </strong>clinicaltrials.gov: number NCT02085356.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"80-88"},"PeriodicalIF":1.8,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36420982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability and health outcomes - from a cohort of people on long-term anti-retroviral therapy.","authors":"Hellen Myezwa,&nbsp;Jill Hanass-Hancock,&nbsp;Adedayo Tunde Ajidahun,&nbsp;Bradley Carpenter","doi":"10.1080/17290376.2018.1459813","DOIUrl":"https://doi.org/10.1080/17290376.2018.1459813","url":null,"abstract":"<p><p>Human-immunodeficiency virus (HIV)/Acquired immunodeficiency Syndrome (AIDS) remains a major health problem in South Africa - even after two decades since the introduction of antiretroviral therapy (ART). Long-term survival with HIV is associated with new health-related issues and a risk of functional limitation/disability. The aim of this study was to assess functional limitation associated with HIV/AIDS among people living with HIV (PLHIV) in South Africa. This study is a cross-sectional survey using a cohort in an urban area in Gauteng province, South Africa. Data were collected using questionnaires through an interview process. The information collected included aspects such as demographics, livelihood, the state of mental and physical health, adherence and disability. A total of 1044 participants with an average age of 42 ± 12 years were included in the study, with 51.9% of the participants reporting functional limitations (WHODAS ≥ 2). These were reported mainly in the domains of participation (40.2%) and mobility (38.7%). In addition, adherence to ART, symptoms of poor physical health and depression were strongly associated with their functional limitations/disability. HIV as a chronic disease is associated with functional limitations that are not adequately addressed and pose a risk of long-term disability and negative adherence outcomes. Therefore, wellness for PLHIV/AIDS needs to include interventions that can prevent and manage disability.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"50-59"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1459813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35993117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'It's not good to eat a candy in a wrapper': male students' perspectives on condom use and concurrent sexual partnerships in the eastern Democratic Republic of Congo.","authors":"Maroyi Mulumeoderhwa","doi":"10.1080/17290376.2018.1516160","DOIUrl":"10.1080/17290376.2018.1516160","url":null,"abstract":"<p><p>This paper reports on fieldwork carried out in 2011 with aim to investigate young men's perspectives about condoms use, concurrent sexual partnerships and sex in the context of HIV/AIDS. This study employed a qualitative approach to collect data from 28 boys aged 16-20 from two urban and two rural high schools in South Kivu province. Four focus group discussions and 20 individual interviews were conducted among them. The findings showed that most students identified condoms as unsafe and untrustworthy. Reasons given for the mistrust of condoms were related to the belief that condoms do not give enough protection from Sexually Transmitted Infections, HIV and pregnancies. Most participants believe that condoms have a 'small hole' or are unreliable and are therefore not effective in prevention. They also mentioned that condoms encourage inappropriate sexual activity. They prefer flesh-to-flesh sex rather than protected sex using a condom. However, a few participants acknowledged the importance of condom use. Despite the risk of HIV transmission, boys believe that it is appropriate for them to have concurrent sexual partnerships. They justified the concurrent sexual partnerships as a way of ensuring that they cannot miss a girl to satisfy their sexual desire. Given the boys' failure to use condoms and their strong inclination to concurrent sexual partnerships, there is a need for heath groups and stakeholders within the area to increase awareness about condoms' effectiveness and improve knowledge dissemination on Sexually Transmitted Diseases and how they are prevented.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"89-102"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36434010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a community-based ART programme after tapering home visits in rural Sierra Leone: a 24-month retrospective study.","authors":"J Daniel Kelly,&nbsp;Raphael Frankfurter,&nbsp;Gregoire Lurton,&nbsp;Sulaiman Conteh,&nbsp;Susannah F Empson,&nbsp;Fodei Daboh,&nbsp;Brima Kargbo,&nbsp;Thomas Giordano,&nbsp;Joia Mukherjee,&nbsp;M Bailor Barrie","doi":"10.1080/17290376.2018.1527244","DOIUrl":"https://doi.org/10.1080/17290376.2018.1527244","url":null,"abstract":"<p><p>Evaluations of community-based antiretroviral therapy (ART) programmes have demonstrated positive outcomes, but little is known about the impact of tapering community-based ART. The objective of this study was to assess 24-month HIV retention outcomes of a community-based ART programme and its tapered visit frequency in Koidu City, Sierra Leone. This retrospective, quasi-experimental study compared outcomes of 52 HIV-infected persons initiated on community-based ART against 91 HIV-infected persons receiving the standard of care from November 2009 to February 2013. The community-based ART pilot programme was designed to strengthen the standard of care through a comprehensive, patient-centred case management strategy. The strategy included medical, educational, psychological, social, and economic support. Starting in October 2011, the frequency of home visits was tapered from twice daily every day per week to once daily three days per week. Outcomes were retention in care at 12 and 24 months and adherence to ART over a three-month time period. Participants who received community-based ART had significantly higher retention than those receiving standard of care. At 12 months, retention rates for community-based ART and standard of care were 61.5% and 31.9%, respectively (p < .01). At 24 months, retention rates for community-based ART and standard of care were 73.1% and 44.0%, respectively (p < .01). Significant differences in levels of adherence were observed when comparing community-based ART against persons receiving standard of care (p < .05). No differences in adherence levels were observed between groups of people receiving various frequencies of home visits. Our pilot programme in Koidu City provides new evidence that community-based ART has the potential to improve retention and adherence outcomes for HIV-infected persons, regardless of the frequency of home visits. Overcoming the barriers to HIV care requires a comprehensive, patient-centred approach that may include clinic-based and community-based interventions.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"138-145"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1527244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36525213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accounting for youth audiences' resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa.","authors":"Blessing Makwambeni,&nbsp;Abiodun Salawu","doi":"10.1080/17290376.2018.1444506","DOIUrl":"https://doi.org/10.1080/17290376.2018.1444506","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"20-30"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1444506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35886738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey.","authors":"Md Ashiqul Haque,&nbsp;Md Sha Newaj Hossain,&nbsp;Muhammad Abdul Baker Chowdhury,&nbsp;Md Jamal Uddin","doi":"10.1080/17290376.2018.1523022","DOIUrl":"https://doi.org/10.1080/17290376.2018.1523022","url":null,"abstract":"<p><p>Women in Bangladesh share a greater risk of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about 11 basic questions related to individual's awareness. A score of the respondent's knowledge and awareness was determined based on these questions. We used logistic regression models for analysing the data. We found about 62% of the respondents had an adequate knowledge and consciousness about the HIV/AIDS. Respondents' education status, mass-media access, place of living, and working status played significant role on the awareness. As expected, respondents with higher education were more aware than those with no education (odds ratio (OR) = 3.56, 95% confidence interval (CI): 2.99-4.23). Moreover, respondents who had access to the mass media were more likely to be aware compared to those who did not have the access (OR = 1.14, 95% CI: 1.04-1.26). Although a sizeable proportion of women had an adequate knowledge and awareness regarding the HIV/AIDS, we recommend implementing educational programmes related to HIV/AIDS in the curriculum to ensure a standard level of awareness throughout the nation. Since the respondents from rural areas scored significantly lower than the urban areas, awareness through mass media, particularly in rural areas, is of prime concern for raising awareness.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"121-127"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17290376.2018.1523022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36520415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the innovative potentials of a HIV pilot exploring medical pluralism in rural South Africa.","authors":"Christopher J Burman","doi":"10.1080/17290376.2018.1536560","DOIUrl":"10.1080/17290376.2018.1536560","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"15 1","pages":"164-178"},"PeriodicalIF":1.1,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36645292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special thanks to reviewers 2018","authors":"","doi":"10.1080/17290376.2018.1546160","DOIUrl":"https://doi.org/10.1080/17290376.2018.1546160","url":null,"abstract":"","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"10 1","pages":"200 - 200"},"PeriodicalIF":1.1,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88431013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the periphery of HIV and AIDS: Reflections on stress as experienced by caregivers in a child residential care facility in South Africa.","authors":"Kesh Mohangi, Chereen Pretorius","doi":"10.1080/17290376.2017.1389300","DOIUrl":"10.1080/17290376.2017.1389300","url":null,"abstract":"<p><p>Few researchers have investigated how female caregivers of institutionalised children, especially those affected by HIV and AIDS, experience stress. The role played by caregivers cannot be overemphasised; yet caregivers who work in institutions caring for orphaned and/or abandoned children affected by HIV and AIDS, are often marginalised and on the periphery of the HIV and AIDS pandemic. The implication is that insufficient attention or consideration is given to the importance of the role they play in these children's lives. The objective of the study was to explore how female caregivers of institutionalised children affected by HIV and AIDS experience stress. A qualitative research project with a case study design was conducted. The purposively selected participants from a previously identified care facility were seven females in the age ranges of 35-59. Data was gathered during individual interviews and focus group discussions. Thematic content analysis of the data yielded the following themes: (1) contextualising caregiving as 'work'; (2) stresses linked to caregiving; and (3) coping with stress. Findings from this study indicated that participants experienced caregiving in an institution as stressful, demotivating, and emotionally burdensome. Moreover, caregivers working in an environment of HIV and AIDS experienced additional stress related to organisational and management impediments, lack of emotional and practical support, inadequate training, discipline difficulties, and lack of respect and appreciation from the children in their care. It is recommended that training and management support as well as personal support and counselling for caregivers in the institutional context could help them to cope better, feel empowered and to potentially elevate their status as valued members of society.</p>","PeriodicalId":45939,"journal":{"name":"Sahara J-Journal of Social Aspects of Hiv-Aids","volume":"14 1","pages":"153-161"},"PeriodicalIF":1.1,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35539490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}