African journal of AIDS research : AJAR最新文献

{"title":"Disclosure of HIV status to children on antiretroviral therapy: Perspectives and experiences of healthcare providers in the Masaka region, Uganda.","authors":"Robert Kairania, Washington Onyango-Ouma, Tom Gesora Ondicho","doi":"10.2989/16085906.2026.2701067","DOIUrl":"https://doi.org/10.2989/16085906.2026.2701067","url":null,"abstract":"<p><strong>Background: </strong>This study explored healthcare providers' perspectives and experiences regarding HIV status disclosure to children receiving antiretroviral therapy (ART) in the Masaka region of Uganda. Despite national and World Health Organization (WHO) recommendations to disclose HIV status by age 12 years, disclosure rates remain low in Uganda. Understanding providers' views is critical, given their central role in supporting caregivers and children throughout the process.</p><p><strong>Methods: </strong>The study employed a qualitative design, drawing on key informant interviews (KIIs) with 18 purposively selected healthcare providers that included, medical officers, clinical officers, nurses, and counsellors. Data were analysed thematically following Braun and Clarke's approach.</p><p><strong>Results: </strong>Two overarching themes emerged: HIV disclosure enablers and impediments. HIV disclosure enablers included the availability of national disclosure guidelines, integration of disclosure activities into routine ART clinic practice, provision of safe psychosocial spaces for children and caregivers, and the presence of structured peer support networks led by young people with HIV. These elements facilitated developmentally appropriate, emotionally supportive, and systematic disclosure. Conversely, HIV disclosure impediments included unstable or unsupportive home environments, domestic violence, child schooling and extended stays with relatives, prioritisation of disclosure only for children with high viral loads, lack of standardised facility-level disclosure protocols, and role ambiguity between caregivers and providers. Such barriers often delayed or undermined the process, leaving many adolescents unaware of their HIV status despite being on lifelong treatment.</p><p><strong>Discussion: </strong>The findings underscore that paediatric HIV disclosure is a complex, multilevel process shaped by structural, psychosocial, and contextual factors. Strengthening health system structures through standardised guidelines, continuous provider training, and clear role delineation, combined with psychosocial interventions such as providing social and psychological spaces for clients to vent their issues and strong child peer support, can enhance disclosure practices. Tailored approaches for children in schools and extended family settings are also essential for improving adherence, retention, and long-term well-being among children with HIV.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"1-10"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding the future: The urgent need to sustain HIV services for children and adolescents in sub-Saharan Africa in the wake of foreign aid cuts.","authors":"Olivier Mukuku, Kaymarlin Govender","doi":"10.2989/16085906.2026.2696580","DOIUrl":"10.2989/16085906.2026.2696580","url":null,"abstract":"<p><p>Amidst severe aid cuts, sustaining paediatric HIV care in Africa is urgent. Children and adolescents face disproportionate risks from treatment disruptions. A youth-centred, multisectoral approach-integrating mental health, long-acting therapies, and community-based support-is essential to prevent catastrophic setbacks and protect vulnerable populations from rising infections, neurocognitive decline, and systemic exclusion.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"75-77"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criminalisation, stigma, and survival: A qualitative study of men who have sex with men and HIV prevention in Lagos, Nigeria.","authors":"Roberta E Emetu, Cecilia E Dagher","doi":"10.2989/16085906.2026.2671928","DOIUrl":"10.2989/16085906.2026.2671928","url":null,"abstract":"<p><strong>Background: </strong>In Nigeria, HIV prevalence among men who have sex with men (MSM) continues to rise due to sociocultural barriers hindering prevention efforts.</p><p><strong>Aim: </strong>This study investigated the barriers MSM face in HIV prevention.</p><p><strong>Methods: </strong>Informed by the social ecological model (SEM), a qualitative study was conducted with 12 participants via online semi-structured interviews. Participants were men over the age of 18 years who were HIV negative and recruited from a non-governmental organisation (NGO) in Lagos, Nigeria.</p><p><strong>Results: </strong>Using a thematic analysis approach, six themes appeared as common barriers to HIV prevention, including (i) adult violence and extortion, (ii) perceptions of HIV biomedical approaches, (iii) condom attitudes, (iv) access to HIV and sexually transmitted infection services and education, (v) internalised stigma, and (vi) externalised stigma. These themes reflected the systemic and multipart sociocultural environment that inhibits MSM from seeking HIV prevention resources.</p><p><strong>Conclusion: </strong>There is a need to improve access to community-based NGOs and trauma-informed mental health resources. Furthermore, until policy reforms are implemented and homophobia is significantly reduced, the development of intersectional, community-informed interventions is particularly important for addressing inadequacies in healthcare for MSM.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"56-66"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in condom use and its socioeconomic inequalities among men in Sierra Leone for HIV prevention, 2008-2019: A longitudinal analysis.","authors":"Alpha Umaru Bai-Sesay, Daniel Karim Dauda Sesay, Alieu Tommy, Jusu Musa, Fasineh Shekuba Samura, Augustus Osborne","doi":"10.2989/16085906.2026.2667733","DOIUrl":"10.2989/16085906.2026.2667733","url":null,"abstract":"<p><strong>Introduction: </strong>Health equity is a central objective of global health, requiring the removal of barriers to ensure equitable access and use of services for all. Monitoring inequalities in health service use is critical to evaluate progress toward this goal. This study analyses longitudinal trends in condom use, a key HIV prevention service and the associated socioeconomic inequalities among men in Sierra Leone to assess whether access and use are becoming more equitable.</p><p><strong>Methods: </strong>We conducted a secondary analysis of data from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys. The sample included 9 375 men aged 15 to 59 years who reported sex with a non-marital, non-cohabiting partner in the past 12 months. Using the World Health Organization's Health Equity Assessment Toolkit (HEAT), we calculated absolute (Difference, Slope Index of Inequality) and relative (Ratio, Relative Index of Inequality) measures to quantify inequalities across economic status, education, age, marital status, residence, and region.</p><p><strong>Results: </strong>National condom use at last higher-risk sex remained stable at 23.0% in 2008, 21.4% in 2013, and 22.5% in 2019. However, disaggregated analysis revealed persistent absolute inequalities. In 2019, the absolute gap (D) by economic status was 12.4 percentage points and by education was 18.0 percentage points. A notable finding was the decline in condom use among the richest (40.4% to 31.7%) and most educated (53.6% to 34.2%) men, even as use increased among the poorest (4.7% to 19.3%) and least educated (10.2% to 16.2%).</p><p><strong>Conclusion: </strong>While improvements among the most disadvantaged men are encouraging, persistent absolute inequalities and declining use among more privileged groups highlight a complex landscape for HIV prevention. Achieving health equity requires targeted interventions that address the specific barriers faced by disadvantaged groups while countering risk compensation in higher socioeconomic strata. Longitudinal inequality monitoring is vital for guiding these efforts.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"67-74"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can health taxes help sustain Africa's HIV response and research agenda? Potential fiscal space, implementation risks, and equity considerations.","authors":"Charles Birungi, Melissa Sobers, Lazarus Muchabaiwa, Jaime Atienza Azcona","doi":"10.2989/16085906.2026.2704802","DOIUrl":"10.2989/16085906.2026.2704802","url":null,"abstract":"<p><p>Sub-Saharan Africa's HIV response is under acute financing stress as external assistance becomes less predictable, debt service costs displace public expenditure, and governments face growing demands on health and community systems. Health taxes on tobacco, alcohol, and sugar-sweetened beverages are increasingly proposed as one instrument of domestic resource mobilisation, but their contribution to HIV sustainability is contested, and their design space in African contexts is imperfectly characterised. The present paper asks under what conditions health taxes can contribute to sustaining HIV services and African-led research without worsening inequity or fragmenting public finance. It combines a critical narrative review, a descriptive analysis of African excise tax indicators, an interpretation of country-level revenue-potential indicators drawn from stochastic frontier benchmark estimates, and four purposive policy cases, including South Africa, Botswana, Kenya, and Zimbabwe. Across 49 sub-Saharan African economies, the median tax-revenue-minus-social-contributions ratio is approximately 11.7% of gross domestic product, with most low-income countries below the 15% state capacity threshold. Among African countries with data, median excise taxes represented 25.2% of the retail price of the most-sold cigarette brand, 14.5% for beer and 5.0% for a comparable carbonated sugary drink. The median overall cigarette tax score was 1.38 on a 0-5 scale. Benchmark effort gaps are heterogeneous across products and countries, indicating that binding constraints differ by product and jurisdiction. The four cases show that outcomes depend jointly on tax structure, administration, enforcement, market response, and revenue governance. Health taxes may contribute to HIV sustainability through additional domestic revenue, reduced exposure to selected HIV-related comorbidities, and HIV-sensitive investment in services, community systems, and African-led research. Their contribution is conditional on accountable public finance, monitoring of unintended effects, and progressive benefit incidence. They cannot substitute for wider tax reform or continued international solidarity.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":"25 2","pages":"98-113"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities of foreign aid cuts and HIV/AIDS response in Nigeria: A focus on orphans, vulnerable children, and the Families Matter! Program.","authors":"Ginika Rita Ugwuanyi, Justin Ingwu","doi":"10.2989/16085906.2026.2668667","DOIUrl":"10.2989/16085906.2026.2668667","url":null,"abstract":"<p><p>For more than two decades, United States foreign assistance, particularly through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), has been central to Nigeria's HIV response, supporting antiretroviral therapy (ART), laboratory systems, and community-based prevention initiatives. Among these are programs for orphans and vulnerable children (OVC) and the Families Matter! Program (FMP), which equips parents and caregivers to guide adolescents away from behaviours that increase HIV risk and help reduce HIV-related stigma within families and communities.The temporary freeze on U.S. foreign aid announced in January 2025 disrupted these interventions and raised concerns about the sustainability of Nigeria's HIV response. While much attention has focused on the risk of treatment interruptions and ART stock-outs, less attention has been given to the suspension of OVC and FMP programs despite their role in prevention, psychosocial support, and household stability.This paper examines the short-and long-term implications of the aid freeze for Nigeria's HIV response, with particular focus on adolescents, vulnerable children, and family-centred prevention initiatives. It argues that disruptions to these programs may undermine prevention gains and weaken social protection systems, while also highlighting the need for stronger domestic resource mobilisation and institutionalisation of community-based HIV interventions to ensure a more sustainable and resilient response.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"78-85"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors shaping understanding and interpretation of sexual practice survey questions in south-central Uganda: A qualitative analysis of cognitive interviews.","authors":"William Ddaaki, Fred Nalugoda, Holly Nishimura, Ping Teresa Yeh, Rosette Nakubulwa, Dauda Isabirye, Gertrude Nakigozi, Godfrey Kigozi, Caitlin E Kennedy, Neema Nakyanjo","doi":"10.2989/16085906.2026.2671922","DOIUrl":"10.2989/16085906.2026.2671922","url":null,"abstract":"<p><strong>Background: </strong>Accurate interpretation of survey questions about sensitive matters such as sexual practices is crucial for obtaining reliable data to inform effective public health interventions. Describing sexual practices involves reflecting on acts and contextually attributing meanings. However, participants in sexual behaviour studies may struggle to understand questions, affecting the validity of the data.</p><p><strong>Aim: </strong>We investigated factors that shape the understanding of survey questions on sexual practices in South Central Uganda using a survey instrument and a semi-structured cognitive interview guide.</p><p><strong>Methodology: </strong>Participants (<i>n</i> = 24), stratified by age, sex, and community type, and including persons with disabilities, were recruited. Interviews were conducted in person, and data were analysed using thematic analysis and an analytic matrix.</p><p><strong>Results: </strong>A complex interaction between awareness or knowledge of the practice, memory retrieval, denial, sexual involvement, and cultural beliefs influenced participants' understanding of survey questions on sexual activities. Specifically, awareness and knowledge of the practice facilitated spontaneous and accurate responses, while a lack of familiarity led to hesitation and confusion. Memory retrieval was easier for recent experiences, and denial slowed down the process.</p><p><strong>Conclusion: </strong>This study highlights the importance of considering individual, interpersonal, and community-level factors to improve the accuracy and reliability of survey research on sexual practices for effective public health interventions.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"47-55"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lenacapavir effect: Triumphalist rhetoric and the displacement of social and structural responses to HIV prevention.","authors":"Warren Parker","doi":"10.2989/16085906.2026.2686719","DOIUrl":"10.2989/16085906.2026.2686719","url":null,"abstract":"<p><p>Lenacapavir, a long-acting injectable pre-exposure prophylaxis (PrEP) medication for HIV prevention with proven high efficacy in randomised controlled trials, has been widely positioned as a \"game-changing\" technology capable of ending the AIDS epidemic. Despite the withdrawal of major donor funding that necessitates a critical reappraisal of HIV prevention priorities, lenacapavir has been rapidly embedded within global policy discourse through claims of exceptional efficacy, anticipated cost-efficiency, and potential epidemiological impact. These narratives reflect a long-standing pattern of biomedical triumphalism, the rhetorical apparatus through which a political economy of biomedical HIV prevention reproduces itself. This rhetoric emanates collectively from a network of institutions, including pharmaceutical companies, research institutions, multilateral agencies, donors, and advocacy coalitions. This article traces how the rhetorical construction of lenacapavir promotes technological salvation while diverting attention from the structural and social conditions that shape HIV vulnerability. Drawing on critical social science frameworks to show the social construction of biomedical prevention, the synthesis demonstrates how triumphalist rhetoric directs resources toward biomedical approaches and products in the absence of implementation science or a robust prioritisation rationale, while marginalising other approaches of known impact, including community- centred approaches that moderate the drivers of HIV vulnerability. Billions of dollars in public funding have been directed toward biomedical HIV prevention research and development over the previous decades on microbicides and PrEP products. These investments mainly benefited research institutions in the North and select Southern partners, without contributing to epidemiological gains against HIV in eastern and Southern Africa. At a moment of constrained resources and fragile health systems, the rhetorical urgency surrounding lenacapavir limits substantive debate and is unwarranted, given that prioritisation and sustainability analyses are vital for country HIV responses in the region. Ethical, accountable discourse and the remobilisation of critical social science are needed to guide the next phase of the global HIV response.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"86-97"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confronting the cuts in foreign HIV/AIDS funding: African perspectives.","authors":"Tim Quinlan","doi":"10.2989/16085906.2026.2704310","DOIUrl":"https://doi.org/10.2989/16085906.2026.2704310","url":null,"abstract":"","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":"25 2","pages":"iv"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators influencing the use of HIV self-testing amongst adolescent girls and young women in South Africa.","authors":"Mimi Eve Teffo, Mbongeleni Thembalihle Mgwaba","doi":"10.2989/16085906.2025.2596606","DOIUrl":"10.2989/16085906.2025.2596606","url":null,"abstract":"<p><strong>Introduction: </strong>Despite global strides in HIV testing strategies in recent years, such as home testing and non-medical testing sites, HIV testing uptake and access to treatment, care, and support remain at very low access levels amongst key and priority populations, such as adolescent girls and young women (AGYW). The study assessed the barriers and facilitators influencing the use of HIV self-testing (HIVST) among AGYW in Sekhukhune Technical Vocational Education and Training college, South Africa.</p><p><strong>Methods: </strong>An institution-based descriptive exploratory qualitative study was employed in which 22 AGYW were purposively sampled. Data were collected through four focus group discussions with an average of six participants between February and April 2024. The data were analysed thematically.</p><p><strong>Results: </strong>The participants were enrolled on levels 2 to 6 of training (age range = 19 to 24 years). Fear, doubt, and anxiety regarding HIVST results, mental health concerns after self-testing, and concerns over the accuracy and the interpretation of results were barriers linked to HIVST use. Convenience, privacy, and ease of use made HIVST appealing to AGYW.</p><p><strong>Conclusion: </strong>To ensure the successful implementation of HIVST interventions, there is a need to implement a tailored modality that is appealing to AGYW. This should focus on addressing current HIVST barriers and leveraging facilitators to enhance HIVST uptake among AGYW.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"14-21"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146152134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}