Ajar-African Journal of Aids Research最新文献

{"title":"\"<i>We mostly focus on preventing pregnancy, we don't really focus on preventing HIV</i> … \": Young people's perceptions and priorities when preventing unplanned pregnancy and HIV.","authors":"Jewelle Js Methazia, Tshegofatso P Bessenaar, Sarah E Baum","doi":"10.2989/16085906.2023.2279646","DOIUrl":"10.2989/16085906.2023.2279646","url":null,"abstract":"<p><p>In South Africa, the high rate of human immunodeficiency virus (HIV) infection among young people and unplanned pregnancies remains a concern. Using a qualitative approach, this study aimed to explore how young people between 18 and 24 years old perceive the risk of unplanned pregnancy and HIV, and how they give priority to and act to prevent both concerns. Fifty-four young people were recruited from three provinces in South Africa: KwaZulu-Natal, Eastern Cape, and Gauteng. Data collection took place between May and June in 2016. All data collection was carried out in person using a standardised discussion guide and a semi-structured interview guide in English. We conducted eight focus group discussions with young people and three in-depth interviews with young people who had become parents in their teens. We utilised thematic analysis grounded in a social constructionist framework to assess patterns and associations in the data. Respondents reported unplanned pregnancy and HIV as prevalent among their peers, but prioritised both concerns differently. Preventing pregnancy was a greater priority and threat than HIV. Respondents were less concerned about being infected with HIV which was perceived as invisible and not a death sentence because of the efficacy and ease of use of treatment. HIV was considered comparatively more manageable and less burdensome than other chronic illnesses and unplanned pregnancy. Our study suggests unplanned pregnancy and HIV prevention interventions should prioritise responding to young people's primary desire to control their fertility, but also encourage them to have holistic sexual and reproductive health goals that include HIV prevention. Our findings suggest a pressing need for biomedical therapies that offer combined HIV and pregnancy prevention for young people. Future programmes need to be agile and innovative in addressing young people's tendency to prioritise HIV and pregnancy differently, and they need to revive the sense of urgency to prevent HIV.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998224","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":"Experiences of participants in an agricultural livelihood support initiative for people living with HIV in central Uganda.","authors":"Christopher Tumwine, Isaac Yeboah Addo, Henry Zakumumpa, Janet Seeley, Lazarus Oucul","doi":"10.2989/16085906.2024.2341750","DOIUrl":"10.2989/16085906.2024.2341750","url":null,"abstract":"<p><p>This study aimed at assessing the experiences of people living with HIV who participated in an agricultural livelihood support initiative in selected districts of Uganda. The initiative, implemented from 2017 to 2018, involved the provision of agricultural inputs such as beans, cassava cuttings, goats, chickens, and pigs to participants. In-depth interviews were conducted with 37 people (28 women and 9 men) from the districts of Kampala, Masaka and Wakiso (specifically Entebbe) in central Uganda, who had participated in the project. Data were analysed thematically focusing on facilitators, challenges and outcomes from the project. The following themes emerged as facilitators: access to land and animal feed, prior farming experience and supportive family and friends. Some participants experienced challenges including animal/poultry diseases, livestock theft, \"low quality\" agricultural inputs, unfavourable weather conditions, limited finance and land to support livelihood activities and difficulties working in groups. Several participants reported positive livelihood outcomes including improved food security, better nutrition, increased income and improved mental health. However, some participants reported negative outcomes which took the form of a loss of money and time invested when their livestock died from disease. Although participants in the agricultural livelihood initiative faced challenges which reduced the profitability of their projects, the initiative was regarded as beneficial and worthwhile. These findings have relevance to the broader field of livelihoods programming. Future interventions can draw from the experiences of our participants while also taking seriously into consideration the different circumstances of individuals in a targeted population so as to increase the chances of producing more positive outcomes.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"30-40"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401874","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":"Assessing the pertinence and usefulness of HIV and AIDS indicators for evaluating clinical care quality: Perspectives of health care professionals.","authors":"Tambwe Willy Muzumbukilwa, Manimani Riziki Ghislain, Aganze Glory-Aime Mushebenge, Rajesh Vikram Vagiri, Manimbulu Nlooto","doi":"10.2989/16085906.2024.2358758","DOIUrl":"10.2989/16085906.2024.2358758","url":null,"abstract":"<p><p>Following a systematic review of quality indicators employed in the evaluation of clinical care for individuals with HIV and AIDS, we performed \"an exploratory study\" that aims to assess the clinical significance and practical applicability of these indicators from the perspective of health care professionals (HCPs) specialising in HIV and AIDS care. Twenty-five HCPs filled out two questionnaires. From the initial list of 88 quality indicators, 50 were identified as the most relevant and useful in HIV and AIDS clinical care. Analysis was conducted on the individual indicators, and the outcomes were categorised into seven domains for clinical relevance and practical usefulness. Health care professionals deemed the functional organisational structure and the therapy domain to have the most pertinent and useful indicators among the seven different clinical domains, followed by the prevention domain.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"60-72"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401873","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":"Experiences and challenges of nurses in initiating antiretroviral drugs among adolescents living with HIV and AIDS in Thaba-Tseka, Lesotho.","authors":"Palesa Grace Likoti, Nelisiwe Khuzwayo","doi":"10.2989/16085906.2024.2336261","DOIUrl":"10.2989/16085906.2024.2336261","url":null,"abstract":"<p><strong>Background: </strong>Lesotho has the second-highest HIV and AIDS prevalence globally and is the country's second leading cause of death. Despite increasing ART coverage, adolescents remain left behind and face high mortality because of delayed ART initiation. This study aimed to explore the experiences and challenges of nurses when initiating adolescents living with HIV on ART in Thaba-Tseka, Lesotho.</p><p><strong>Methods: </strong>A qualitative descriptive research design and twelve in-depth interviews were conducted among nurses from a hospital in the Thaba-Tseka district. Participants were selected purposively until data saturation was reached. Data were transcribed verbatim and analysed manually using the thematic analysis approach. The findings were presented in themes and sub-themes. Individual face-to-face interviews were conducted in English and Sesotho from May to August 2021.</p><p><strong>Results: </strong>The key findings in this study involved adolescents' attendance at the health care facility, ART initiation process, HIV stigma influencing the uptake of ART, poor ART follow-up and socio-economic factors affecting adherence to ART.</p><p><strong>Conclusion: </strong>The themes uncovered in this study provide valuable insights into the gaps in ART initiation, and highlight the challenges encountered by nurses during this process among adolescents in Lesotho. The experiences and obstacles shared by nurses during ART initiation cover a range of issues, collectively demonstrating their engagement in HIV and ART care. These findings emphasise the critical role of policymakers and health care providers in devising customised ART initiation interventions for adolescents. Addressing these challenges will be crucial for enhancing ART uptake and adherence among adolescents living with HIV in Lesotho.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"12-20"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479992","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":"Relationship between social capital and post-partum antiretroviral therapy adherence among women living with HIV in the Eastern Cape, South Africa.","authors":"Khadijat K Adeleye, Eyitayo O Owolabi, Oladele V Adeniyi, David Aduragbemi Okunlola, Anthony I Ajayi","doi":"10.2989/16085906.2024.2337763","DOIUrl":"10.2989/16085906.2024.2337763","url":null,"abstract":"<p><strong>Background: </strong>Adherence to antiretroviral therapy (ART) is crucial for preventing vertical transmission of HIV and maternal deaths. While the literature is replete with studies on ART adherence, the role of social capital in adherence to ART is less studied. Drawing from the social cognitive theory, this study examines the relationship between social capital and post-partum adherence to ART.</p><p><strong>Methods: </strong>We analysed data from 481 post-partum women with HIV in the Eastern Cape, South Africa. Adherence to ART was measured using a validated scale, capturing self-reported medication-taking behaviours. Social capital was assessed using a pre-validated tool, encompassing indicators of social engagement, support networks and community connectedness. We used logistic regression models to examine social capital and ART adherence associations, while controlling for relevant covariates.</p><p><strong>Results: </strong>Participants mean age was 32.9 (SD ± 5.76) years. After adjusting for age, education level, alcohol use, status disclosure to partner, marital status, desire for more children, employment status and living arrangements, social capital was significantly associated with higher odds of ART adherence (p = 0.004, AOR 1.09; 95% CI 1.03-1.16).</p><p><strong>Conclusion: </strong>We found evidence in support of the role of social capital in ART adherence. Strengthening social support networks and addressing psychosocial factors could improve adherence to ART. As such, policymakers and programme managers should consider the role of social capital in designing interventions to improve ART adherence. Future research should explore the mechanisms through which social capital impacts ART adherence.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"21-29"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479993","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":"Prevalence and neighbourhood determinants of early sexual debut and multiple sexual partnerships among young people in Rwanda, Ghana and South Africa.","authors":"Nebechukwu H Ugwu, Clifford O Odimegwu","doi":"10.2989/16085906.2024.2343395","DOIUrl":"10.2989/16085906.2024.2343395","url":null,"abstract":"<p><strong>Background: </strong>The consequences of engaging in risky sexual behaviours (RSB) can lead to HIV infection, sexually transmitted diseases and unintended pregnancy. The relationship between neighbourhood characteristics and youth involvement in RSB such as early sexual debut and multiple sexual partnerships has been of great concern to government, researchers and policymakers. However, there are very few empirical studies using demographic and health surveys to unpack the nature of this relationship in Rwanda, Ghana and South Africa. The objective of this study was to estimate the prevalence and determinants of early sexual debut and condom use, and to explore the neighbourhood factors associated with early sexual debut and condom use in Rwanda, Ghana and South Africa.</p><p><strong>Methods: </strong>This was a cross-sectional study using the most recent Demographic and Health Survey Data (DHS 2014-2016) from Ghana, Rwanda and South Africa to investigate the relationship between neighbourhood characteristics and risky sexual behaviour among the youth.</p><p><strong>Results: </strong>The prevalence of risky sexual behaviour in the three countries ranges from 56% (South Africa), 30% (Ghana) and 12% (Rwanda). Male youth in the 20-to-24-year-old category had increased odds of engaging in multiple sexual partnerships for the three countries (AOR 4.58; 95% CI 3.40-6.16), Rwanda (AOR 2.72; 95% CI 2.04-3.68) and South Africa (AOR 4.56; 95% CI 3.33-6.24). Meanwhile, at the community level, community education significantly increased the odds of age sexual debut among female adolescents by 50% (South Africa), and 46% (Ghana), while in Rwanda, this factor had decreased odds with higher community education.</p><p><strong>Conclusion: </strong>To lower the incidence of risky sexual behaviour in the community, programmes aimed at appropriate policy options must be intensified. The implications of these findings is helpful for a developmental approach aimed at reaching Africa's long-term development goal of eliminating STIs among young people.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"41-59"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401875","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":"Biopolitics from the Global South: a new generation takes on customary nationalism in eSwatini.","authors":"Casey Golomski, Vito Laterza","doi":"10.2989/16085906.2023.2270963","DOIUrl":"https://doi.org/10.2989/16085906.2023.2270963","url":null,"abstract":"","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 4","pages":"257-260"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832771","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":"Influences on decision-making about disclosure of HIV status by adolescents and young adults living with HIV in KwaZulu-Natal, South Africa.","authors":"Thandeka Smith, Janet Seeley, Maryam Shahmanesh, Christina Psaros, Chiedza Munikwa, Nothando Ngwenya","doi":"10.2989/16085906.2023.2277358","DOIUrl":"https://doi.org/10.2989/16085906.2023.2277358","url":null,"abstract":"<p><p><i>Background:</i> Adolescents and young adults living with HIV (AYA) are faced with the challenge of living with a life-long chronic condition. We investigated the influences on the decisions by AYA to disclose their HIV status to family, intimate partners and friends.<i>Methods:</i> Twenty AYA aged between 15 and 24 years were purposely selected through local community-based organisations in eThekwini municipality and uMkhanyakude district in KwaZulu-Natal Province, South Africa. Virtual in-depth interviews were conducted between September 2020 to October 2021 using a topic guide focusing on HIV-status disclosure and the impact of stigma on decision-making capacity. An iterative thematic process was used for analysis.<i>Results:</i> Findings revealed the challenges that AYA experience for disclosure because of stigma and how this impacts their decision-making capacity. Family and friends influenced AYA in processing their discovery of their HIV status offering support needed to manage living with HIV. However, for some AYA disclosing to relatives, friends and intimate partners was difficult because of fears of rejection and recrimination. The act of disclosure was influenced by both internalised and external stigma and the type of relationships and interactions that AYA had with relatives, friends and caregivers.<i>Conclusions:</i> The decision to disclose is challenging for AYA because of the fear of rejection, along with internal and external stigma. The provision of support, whether from family or peers, is important. Enhancing the decision-making capacity of AYA is essential for developing their self-esteem as well as supporting future healthcare choices.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 4","pages":"306-315"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832772","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":"The role of the social sciences and humanities in pandemic preparedness responses: insights gained from COVID-19, HIV and AIDS and related epidemics.","authors":"Kaymarlin Govender, Judith King, Patrick Nyamaruze, Tim Quinlan","doi":"10.2989/16085906.2023.2262977","DOIUrl":"https://doi.org/10.2989/16085906.2023.2262977","url":null,"abstract":"<p><p>The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations (e.g. adolescent girls and young women) who are the focus of these programmes and - as importantly but less well-documented - the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during \"lockdowns\"). The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic (e.g. wide-spread surveillance coupled with rapid updates on the epidemiology of infections, rapid development of vaccines and revisions of treatment). However, drawing upon the widespread criticisms of state responses to the socio-economic effects of the COVID-19 pandemic and of \"lockdowns\" themselves, this article elaborates a core argument within those criticisms, namely that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. Our critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses. At root, we re-assert a key value of 'integrated' interventions, namely the accommodation of context-sensitive considerations in the formulation of strategies, policies, plans and programme designs.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 4","pages":"269-275"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832773","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":"Identifying HIV-exposed uninfected children and adolescents in resource-limited settings: the HOPE study experience.","authors":"Hellen Moraa, Maureen Kinge, Alvin Onyango, Daniel Matemo, Grace John-Stewart, Dalton Wamalwa, Irene Njuguna","doi":"10.2989/16085906.2023.2276376","DOIUrl":"10.2989/16085906.2023.2276376","url":null,"abstract":"<p><p>HIV-exposed uninfected (HEU) children and adolescents are at higher risk of poor outcomes compared to HIV-unexposed children (HUU). In program settings, it is critical to understand how to identify HEU for screening services. We describe our experience identifying HEU for a neurodevelopment and mental health screening study. We recruited mothers living with HIV (MLHIV) and mothers not living with HIV (MNHIV) and enrolled their HEU or HUU children. We summarise the reasons for ineligibility and recruitment challenges. Among MLHIV, their child's ineligibility increased with age: 12%, 27%, 50% and 80% in age groups 3-6, 7-10, 11-14, and 15-18, respectively (<i>p</i> < 0.001). Reasons for ineligibility were unknown maternal HIV status during pregnancy or breastfeeding (30%), and maternal disinterest due to fear of inadvertent disclosure of their HIV status to older youth. Recruiting older HEU youth is challenging. Maternal concerns of self-disclosing their HIV status impedes identification of older HEU.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 3","pages":"244-246"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453009","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}