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- Volume 10, Issue 2, 2009
Southern African Journal of HIV Medicine - Volume 10, Issue 2, 2009
Volumes & issues
Volume 10, Issue 2, 2009
Author Francois VenterSource: Southern African Journal of HIV Medicine 10 (2009)More Less
South Africa has lost a passionate humanitarian and a superb doctor. The Society owes him a huge debt - he has been part of a small and committed group that has overseen the little HIV interest group grow to one of the largest and most influential medical special interest organisations in the world. His dedication and hard work on the Exco, his leadership in terms of ethics, guidelines and policy, and his moral clarity on so many things we deal with will be sorely missed.
Author Linda-Gail BekkerSource: Southern African Journal of HIV Medicine 10 (2009)More Less
This issue is the first after the gratifyingly successful 4th South African AIDS Conference. To remind those of you who attended and give those who didn't a taste of some of the subjects covered, we asked the track chairs of each of the six tracks and their respective rapporteurs for a concise report. We also publish reports on two excellent satellite symposia.
Author Gary MaartensSource: Southern African Journal of HIV Medicine 10 (2009)More Less
Steve's strong sense of justice resulted in his becoming a treatment activist who worked closely with the Treatment Action Campaign. He provided cheap generic fluconazole in defiance of patent regulations prior to the Pfizer fluconazole donation, and was an active participant in various campaigns to lower the price of antiretrovirals.
Source: Southern African Journal of HIV Medicine 10, pp 8 –10 (2009)More Less
Children (persons under 18) are a vulnerable group and require legal protection because of their youth and inexperience. As a result, various provisions in the law ensure the care and protection of children through mechanisms such as mandatory reporting obligations, which generally require persons in positions of authority, in special relationships with children or even strangers to report to the authorities when a child is in need of care and protection. Within this context, a recent change in the law has placed an obligation on any person who is aware of a sexual offence having been committed against a child to report this to the police in terms of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, hereafter referred to as the 'Sexual Offences Act'. Given that it is an offence in terms of this Act to have sex below the age of 16, researchers involved in research with teenage participants in the course of which they may become aware that participants are engaging in sex or sexual activity but are under the age of 16 will be obliged to inform the police of this fact.
This article describes the changes introduced by the Sexual Offences Act and the implications it poses for the research relationship. It proposes non-compliance with certain provisions in this Act when specific conditions are met, and concludes with recommendations for advocacy against inappropriate and senseless reporting of consensual under-age sex or sexual activity.
Conserving (not preserving) culture : avoiding the damage to culture of veiled moralism in HIV education : opinionAuthor Leigh PriceSource: Southern African Journal of HIV Medicine 10, pp 12 –15 (2009)More Less
Language mechanisms in much HIV discourse insist that a Western-based moralism dominates. These mechanisms include the use of strategic absences of information about the moral grounding of texts, and slippages of meaning where one word is used to refer to many meanings. A common slippage of meaning is use of the word 'polygamy' to refer to a range of behaviours, thus hiding low-HIV-risk sexual practices (polyfidelity) under the same umbrella as high-risk practices (promiscuity) and advocating their general removal. Another dubious method of achieving a moral position is to take a true premise and use it to advance a false conclusion. For example, the true premise that wife inheritance in its historical form is an HIV risk factor does not automatically lead to the conclusion that wife inheritance 'must' be eradicated. This is only one possible conclusion. Another more culturally sensitive conclusion could be that wife inheritance should be embarked upon, as should all sexual relationships, in a context of HIV tests and safer sexual practice. I argue that moralism (such as 'wife inheritance is morally wrong') cloaked as science (the claim that science 'proves' the moral position that wife inheritance is wrong) is a threat to traditional culture and discriminates against upholders of traditional lifestyles.
Drawing primarily from my experience of HIV education in a development setting in southern Africa, I offer a weak (realist) moral relativism as an alternative to on the one hand the positivist-based, absolutist morality that threatens to destroy traditional cultures in the name of HIV education, and on the other hand extreme cultural relativism in which 'anything goes'. Possibly HIV educators have not done enough to include some traditional safer sex practices in their professional inventory of acceptable behaviours, such as hlobonga (thigh sex) and polygamy interpreted as polyfidelity. My hope is that by being more respectful of traditional culture, while encouraging cultural change where necessary, HIV education will register greater success in achieving safer sexual practice. This article will be particularly useful for writers and researchers tasked with achieving behavioural change and / or writing educational materials on HIV in the southern African context.
Author Claire Von MollendorfSource: Southern African Journal of HIV Medicine 10, pp 17 –21 (2009)More Less
Health care providers are faced with a number of challenges with regard to acute HIV infection. The first of these is recognition, because the acute retroviral symptoms mimic a number of other viral infections. The second challenge is treatment, as treating early HIV has a number of benefits and risks both on an individual and a public health level. This review hopes to address some of these questions.
Author Pam MichelowSource: Southern African Journal of HIV Medicine 10, pp 23 –27 (2009)More Less
Globally cervical cancer is one of the commonest cancers in women. It comprises approximately 12% of all cancers and is the commonest cancer in women in developing countries. The most recent compilation of global data indicates that an estimated 490 000 new cases of cervical cancer occur annually worldwide and nearly 80% of these are in developing countries, where screening programmes are not well established and are poorly organised. Cervical cancer is the leading cause of cancer death among women. It is estimated that 270 000 women die annually from cervical cancer, 85% of them in low-resource nations. In Africa, cervical cancer comprises 23.3% of all cancers in women. According to the South African National Cancer Registry (NCR) data, the lifetime risk for the development of cervical cancer in 1998 was 1 in 26 for South African women and 1 in 21 for black South African women. These are believed to be minimal rates, as the registry publishes only data collected from the pathology laboratories and is not a population-based cancer registry.
HIV / AIDS poses a severe threat to global health. In addition, the HIV epidemic has hit hardest in regions of high prevalence of cervical dysplasia and cancer. The HIV epidemic in South Africa is one of the worst in the world. The prevalence of HIV among South African women attending antenatal clinics in 2006 was 29.1%. With improved access to antiretroviral therapy, women are expected to live longer as the risk of death from opportunistic infections decreases. It is assumed that the incidence of cervical cancer and the prevalence of precursor lesions will increase, especially in countries that lack well-organised cervical screening. However, this remains to be seen.
'Scaling up for success' : the 4th Southern African AIDS Conference, 31 March - 3 April 2009, Durban : conference reportsSource: Southern African Journal of HIV Medicine 10, pp 30 –36 (2009)More Less
The 4th South African HIV Conference held at the International Convention Centre, Durban, on 31 March - 3 April 2009 attempted to address some of the operational gaps and prioritise our efforts to get the 'best bang for our bucks' before 2011. With the theme 'Scaling up for success', overwhelming attendance, participation and feedback indicated that many of the goals set by the scientific and organising committee were met. Perhaps most significant to many of us was the tangible and positive spirit of determination and co-operation between researchers, practitioners, activists, civil society and government at the conference, which bodes well for the busy time ahead.
The 3I's Satellite Symposium : reducing the risk of tuberculosis in HIV-infected individuals : 4th Southern African AIDS Conference, 31 March 2009, Durban : conference reportsSource: Southern African Journal of HIV Medicine 10, pp 38 –47 (2009)More Less
HIV-infected individuals, especially those requiring antiretroviral therapy (ART), are at a greatly increased risk of developing active tuberculosis - and one consequence of this has been the resurgent TB epidemic in sub-Saharan Africa and other settings with a high burden of HIV.
SA AIDS 2009 MSM Satellite Conference, Research and Advocacy : sharing the strength, bridging the gap : 30 - 31 March 2009, Durban : conference reportsAuthor E. BurrellSource: Southern African Journal of HIV Medicine 10, pp 48 –49 (2009)More Less
Over 35 participants from four African nations, the USA, the UK and the European Union - 21 of whom gave oral presentations - were brought together for this satellite conference, the first such to accompany the South African AIDS Conference. This executive summary reviews the conference proceedings in each of the following categories: New MSM Research and Challenges, Current LGBT Programmes Overview and Needs Assessment, and Developing Advocacy and Funding Strategies.
The role of the multidisciplinary team meeting in an antiretroviral treatment programme : original articleSource: Southern African Journal of HIV Medicine 10, pp 50 –52 (2009)More Less
The importance of adherence in the management of patients on combination antiretroviral therapy has been well documented. However, for sustainability of the overall programme adequate patient 'tracking' is required in order to understand where the programme may be failing.
HIV / AIDS-related knowledge, sexual practices and predictors of condom use among long-distance truck drivers in Nigeria : original articleSource: Southern African Journal of HIV Medicine 10, pp 54 –56 (2009)More Less
Background. Long-distance truck drivers (LDTDs) are exposed to high-risk sexual behaviour because of the nature of their work and are at high risk for HIV acquisition. Assessing their sexual practices and condom use is an important step in HIV / AIDS prevention in this target group.
Objective. To determine HIV / AIDS-related knowledge, sexual practices and predictors of condom use among Nigerian LDTDs. Design, setting, subjects. A cross-sectional survey of 116 LDTDs in Enugu, Nigeria, was carried out using pre-tested structured questionnaires.
Results. The 116 respondents ranged in age from 21 to 69 years with a mean of 40.5 years; 95.7% were aware of HIV / AIDS, 88.8% identified unprotected sexual intercourse as a mode of transmission, and 78.4% knew that use of a condom during sexual intercourse protects against HIV / AIDS transmission. Ninety-eight drivers (84.5%) engaged in extramarital sexual relationships and 42.9% had multiple sexual partners. Of the drivers 43.1% had used condoms at some stage and 28.6% used them consistently. Reasons for non-use were mainly unavailability, sexual dissatisfaction and religious convictions. Age, marital status and educational status were significant predictors of condom use among sexually active LDTDs.
Conclusion. Condom use among LDTDs is low despite their high-risk sexual behaviour. Promotion campaigns to improve the general acceptability of condoms are recommended. Improved distribution of condoms at the stations where the drivers stop would improve accessibility and use.