- A-Z Publications
- SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance
- Previous Issues
- Volume 1, Issue 1, 2004
SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance - Volume 1, Issue 1, 2004
Volume 1, Issue 1, 2004
Source: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 2 –3 (2004)More Less
Social and behavioural patterns contribute more to the spread (or to the prevention) of an epidemic than the availability of medical treatment. Currently no cure or vaccine for HIV / AIDS is available and access to affordable antiretrovirals is still not available to the wider public.Thus, social and behavioural interventions become a key option to prevent and control the further spread of HIV / AIDS. By understanding the role that various psychosocial, cultural and religious factors play in the transmission of HIV infection in communities, possible strategies and options for prevention programmes can be developed.
Source: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 4 –13 (2004)More Less
Culture plays a vital role in determining the level of health of the individual, the family and the community. This is particularly relevant in the context of Africa, where the values of extended family and community significantly influence the behaviour of the individual. The behaviour of the individual in relation to family and community is one major cultural factor that has implications for sexual behaviour and HIV / AIDS prevention and control efforts. As the impact of HIV / AIDS in Africa remains unabated, a culture-centered approach to prevention, care and support is increasingly recognised as a critical strategy. In this article PEN-3, a model developed to centralise culture in health promotion interventions, is presented as a framework to be used in HIV / AIDS prevention, care and support in Africa. The three domains of the PEN-3 model incorporate specific constructs: relationships and expectations, cultural empowerment, and cultural identity. The cultural empowerment and relationships and expectations domains are 'assessment / appraisal' domains used for cultural assessment. Community identity is the 'application / transformation' domain that helps the public health practitioner assist the community to identify the point of entry of the intervention. In this paper the authors describe PEN-3 and then present examples of how the assessment / appraisal domains can be utilised to frame HIV / AIDS-related concerns in the context of Africa.
Source: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 14 –26 (2004)More Less
The price of antiretroviral (ARV) medicines in Uganda has fallen dramatically in recent years and more people are under treatment. By mid-2003 it was estimated that 10 000 people were taking ARVs. Drawing on participant observation, qualitative interviews, work with key informants and document reviews, we seek to map out the channels through which ARVs are being made available to people and to describe and assess the social implications of the present system of distribution. Four channels of access to ARV medicines were common in mid-2003: (i) Medicines were provided free in structured research and treatment programmes funded by donors, but only to those who lived in a defined catchment area and met inclusion criteria. (ii) Gazetted treatment centres provided drugs on a fee-for-service basis; these urban-based institutions account for the largest number of drugs dispensed. (iii) Private practitioners, mainly based in Kampala, provided discrete treatment for those who could afford it. (iv) Finally, medicines were 'facilitated' along informal networks, supplying friends and relatives on a less regular basis, sometimes for free, sometimes for cash. However, access to ARVs remains highly uneven. We argue that cheaper drugs make possible different kinds of access, different qualities of care, and a growing awareness of inequity. Because the price of drugs has fallen drastically, middle-class families now have the possibility of buying them. But this requires tough prioritising and many cannot follow the regimen regularly. Health workers must consider whether patients will be able to purchase the drugs or not. In a kind of popular social pharmacy, people assess who can and should and does get access to ARVs. Further research should examine the whole range of ARV access channels in different countries and the associated patterns of social differentiation and exclusions.
Factors associated with consistent condom use by employees in the brewery industry in Nigeria : original articleAuthor A.M. SunmolaSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 27 –34 (2004)More Less
Many employees of large organisations in Nigeria face significant risks for HIV infection, especially due to occasional or regular job transfers, involvement in casual sexual encounters and lack of consistent condom use. The current study analysed the determinants of consistent condom use in 710 sexually active men (N = 617) and women (N = 93) recruited from the country's brewery industry. Results showed that only 12% of the employees consistently used a condom. Men who used condoms for all sexual encounters were more likely to be single, had 12 - 18 years of schooling, worked as intermediate level staff, thought a condom was useful to prevent HIV infection, and perceived that condoms hinder sexual satisfaction. Women who consistently used condoms were more likely to have 7 - 12 years of schooling. It is appropriate that brewery authorities develop work place programmes to enhance condom use among employees in order to prevent the spread of HIV infection.
The evaluation of immediate behavioural outcomes of the syndromic case management approach for the treatment of patients with sexually transmitted infections at PHC centres in South Africa : knowledge, attitudes, beliefs and sexual behaviour : original articleSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 35 –44 (2004)More Less
This study aimed to determine the immediate behavioural outcomes of the WHO syndromic case management model for STIs in the public health sector in South Africa, on the levels of knowledge, attitudes and beliefs, and behavioural practices (KABPs) concerning STIs. An outcomes evaluation was conducted using KABP methodology. Exit interviews were conducted with 126 STI and non-STI patients at 24 primary health care (PHC) centres in four provinces. Both groups were found to have equally high levels of knowledge about STIs and their attitudes towards and beliefs about STIs were mostly practical and slightly negative, with only promiscuity both stereotyped and stigmatised. However, both groups were found to engage in risky sexual behavioural practices although they also indicated very strong intentions to use condoms in future. Overall, no significant differences were found between the two groups on any of the variables investigated. The implications of these findings for the control and prevention of both classic STIs and HIV / AIDS in South Africa are discussed.
Author F. BooysenSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 45 –56 (2004)More Less
South Africa has a well-developed system of social security and the reach of the social grant safety net has expanded rapidly over the past five years. Social grants are likely to play an important role in mitigating the impact of HIV / AIDS, given that eligibility for these grants is driven largely by the increasing burden of chronic illness, the mounting orphan crisis and the impoverishment of households associated with the epidemic. This paper investigates the role of social grants in mitigating the socio-economic impact of HIV / AIDS in South Africa, using data from a panel designed to investigate the household impact of the epidemic. Data were collected from a total of 351 purposively sampled households interviewed four times over a period of two and a half years. Affected households were more dependent on income from social grants compared with households that had never experienced morbidity or mortality. A significantly larger proportion of affected households qualified for social assistance. Access to the old age pension remained relatively stable, highlighting the high take-up rate of this grant, while access to the child support and disability grant increased over time. Yet, take-up of these grants remains low and there is still much scope to improve take-up rates. Social grants also play an important role in poverty alleviation. The rate of poverty reduction continued to increase over time in affected households, but remained relatively stable in the case of households that had not experienced morbidity or mortality. This saw the gap in the incidence, depth and severity of poverty between affected households and households that had not experienced morbidity decline. Social grants also translated into a significant reduction in the severity of poverty in affected households.
Health social science support will enhance the effectiveness of WHO / UNAIDS' 3by5 Initiative : letter to the editorAuthor P.H. StreeflandSource: SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance 1, pp 57 –58 (2004)More Less
In sub-Saharan Africa and Asia treatment with highly active antiretroviral therapy (HAART) of many people living with AIDS (PLWA) is planned to be the reality in the coming years, as part of the WHO/UNAIDS' '3by5' Initiative (WHO/UNAIDS, 2003). Tailoring 3by5 strategy to local social and cultural conditions is important, in order to enhance its effectiveness and sustainability. Insights from health social science - medical anthropology and medical sociology - will be particularly useful in this respect. Moreover, at an early stage the 3by5 strategy can show unrealistic assumptions that may thwart the implementation process.