- A-Z Publications
- SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance
- Previous Issues
- Volume 1, Issue 2, 2004
SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance - Volume 1, Issue 2, 2004
Volume 1, Issue 2, 2004
Report and policy brief : 2nd Annual Conference on Social Aspects of HIV / AIDS Research, Cape Town, 9 - 12 May 2004 : conference reportSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 62 –77 (2004)More Less
This report and policy brief summarises the overarching principles, key findings and suggested policy options that emerged from rapporteur reports of conference proceedings. Detailed presentations may be viewed at www.sahara.org.za. A total of 25 million of the 38 million people infected with HIV globally at the end of 2003 were Africans. There appears to be a stabilisation in HIV prevalence, but this is mainly due to a rise in AIDS deaths and a continued increase in new infections. Prevalence is still rising in some countries such as Madagascar and Swaziland, and is declining nationwide in Uganda.
Microbicide trials for preventing HIV / AIDS in South Africa : phase II trial participants' experiences and psychological needs : original articleSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 78 –86 (2004)More Less
The Microbicide Division of the Department of Medical Microbiology at MEDUNSA, South Africa, recently completed a phase II expanded safety trial of the candidate microbicide Carraguard. A microbicide is a vaginal product that women might use, if proven safe and effective, to protect themselves from HIV and possibly other sexually transmitted infections (STIs). The study participants were from Ga-Rankuwa and its neighbouring areas, an historically disadvantaged residential township near Pretoria. We conducted six focus group discussions with phase II trial participants to evaluate their experiences with trial participation and their psychological needs. Participants spontaneously talked about their experiences with the study gel and speculum examinations. They felt that they had received high quality medical care. They indicated that their personal hygiene and knowledge of the female reproductive system, HIV and other STIs had improved, which helped their families and empowered them as women. Participants valued being able to discuss their anxiety about HIV / AIDS with study staff. They felt that the study provided them with a supportive environment in which their personal problems (not necessarily restricted to HIV / AIDS) could be addressed. Some recommended that the study staff improve their professionalism and punctuality. They suggested the formation of participant support groups, and expressed a preference to remain involved in the trial. Some participants appeared to have become dependent on services provided during the trial. We have taken the results of these focus group discussions into account during planning for a phase III efficacy trial of Carraguard to be conducted in the same and other similar communities.
Gender and HIV / AIDS impact mitigation in sub-Saharan Africa - recognising the constraints : original articleSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 87 –98 (2004)More Less
In discussions of gender and HIV / AIDS, attention has focused on prevention. This is a vital area. However, we argue that there is also a need to focus more attention on the resulting impact of the epidemic, because inequalities that promote the spread of infection are also hampering containment and impact mitigation. We propose a framework highlighting the gendered constraints exacerbated by the epidemic. These constraints are reviewed under the following headings : Gender-specific constraints: stemming from the specific nature of gender relations themselves, such as the availability of labour in agriculture, business and for household tasks, as well as access to services and markets, and the incidence of gendered violence. Gender-intensified disadvantages: stemming from the uneven and often inequitable distribution of resources between men and women, including cultural/religious conventions, and the social rules and norms that regulate property rights, inheritance practices and resource endowments. Gender-imposed constraints: resulting from biases and partialities of those individuals who have the authority and power to allocate resources. These include provision of credit, information, agricultural extension and health care. The differential involvement of men and women in development programmes affects access to resources, as does political participation, including involvement in the formulation of policies aimed at poverty reduction. These constraints take us beyond gender relations and sexual behaviour. But women's lives will not change in the short term. The challenges they face in mitigating the impact of HIV / AIDS will not be addressed by focusing only on their specific vulnerability to HIV / AIDS infection. Unequal gender relations and the nature of 'development' need to be changed too.
Source: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 99 –106 (2004)More Less
The primary goal of this study was to survey local government HIV / AIDS projects in South Africa. A total of 240 questionnaires were sent to local municipalities nationally between May and July 2002. A total of 44 municipalities returned their questionnaires, covering 53 projects. Most projects focused on prevention and awareness and the majority had awareness/prevention/information as part of their objectives as well as their activities. Home/community-based care was also prominent. It seems that in the future the focus of programme development will shift in this direction. Major constraints were a lack of funds, transport and trained personnel. Future emphasis must thus be put on these components. In addition government needs to put more resources into local government HIV / AIDS programmes since this tier will be the nodal point for national combatting of the HIV / AIDS epidemic.
Willingness to pay for treatment with highly active antiretroviral (HAART) drugs : a rural case study in Cameroon : original articleSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 107 –113 (2004)More Less
This paper reports on the willingness of HIV / AIDS patients to pay for the most affordable triple therapy combination of antiretrovirals in a local setting in Cameroon. Questionnaires were used to evaluate willingness to pay, and patients who could still afford their medication 6 months after the survey were also investigated, to give an indication of actual ability to pay. In addition, oral interviews were carried out for clarification. In all, 84 patients out of a total of 186 were involved in the study. Results indicated that more men (39%) were willing to pay than women (22%), although more women (56%) were afflicted than men. Willingness to pay was directly dependent on cost with 69%, 22% and 9% of respondents indicating willingness to pay $1, $2 and $3 a day respectively. After 6 months of treatment, 22% of patients were still on therapy. A majority of patients stopped taking the drugs after 6 months due to financial constraints. Apart from cost, stigma, disbelief and side-effects of medication were found to be the main factors militating against willingness to pay. Improved counselling and provision of information, reduced cost of drugs including laboratory tests, and destigmatisation programmes are recommended to improve patients' ability to pay for antiretrovirals.
Impact of long-term civil disorders and wars on the trajectory of HIV epidemics in sub-Saharan Africa : original articleAuthor David GisselquistSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 114 –127 (2004)More Less
From the mid-1970s, seven countries in sub-Saharan Africa have experienced civil disorders and wars lasting for at least 10 years. In two - Sierra Leone during 1991-2002, and Somalia from 1988 and continuing - adult HIV prevalence remained below 1%. In the Democratic Republic of the Congo, HIV prevalence appears to have stabilised during post-1991 civil disorder and war. Limited information from Angola (civil war 1975 -2002) and Liberia (civil disorder and war from 1989 and continuing) suggests low HIV prevalence. Mozambique's HIV prevalence was near 1% after its 1975 - 1992 civil war, but increased dramatically in the first post-war decade. Across African countries with long-term wars, HIV seems to have spread more slowly than in most neighbouring countries at peace. This evidence contributes to the ongoing debate about the factors that explain differential epidemic trajectories, a debate which is crucial to the design of HIV prevention programmes. One possible explanation for slow epidemic growth in wartime is that unsterile health care accounts for an important proportion of HIV transmission during peacetime, but much less when wars disrupt health services. However, other explanations are also possible. The roles of sex and blood exposures in HIV epidemics in war and peace await empirical determination.