SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance
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HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. ⋯ HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02-9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting.
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Randomized Controlled Trial Multicenter Study
Effect of a multicomponent behavioural PMTCT cluster randomised controlled trial on HIV stigma reduction among perinatal HIV positive women in Mpumalanga province, South Africa.
We evaluate the impact a multicomponent, behavioural, prevention of mother to child transmission (PMTCT), cluster randomised controlled trial on HIV stigma reduction among perinatal HIV infected women in rural South Africa. ⋯ The enhanced PMTCT intervention, including stigma reduction, administered by trained lay health workers had a significant effect on the reduction of HIV related stigma.
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The HIV prevalence in South Africa among students at higher education institutions (HEIs) in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socio-economic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. ⋯ Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent the development of chronic diseases of lifestyle, thus allowing for a healthier more productive life. Current intervention strategies to strengthen food security have made inroads to improve access to healthier food options.
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Multicenter Study
Taxi 'sugar daddies' and taxi queens: male taxi driver attitudes regarding transactional relationships in the Western Cape, South Africa.
Media reports are emerging on the phenomenon of young girls who travel with older mini-bus taxi drivers, and who are thought to have sex with the drivers in exchange for gifts and money. The extent to which such relationships might facilitate unsafe sexual practices and increased risks for both the men and the young women, often referred to as taxi queens, remains an important question in the light of the current challenges of HIV/AIDS in sub-Saharan Africa. However, very little research has been undertaken on this issue, especially regarding the perceptions and experiences of taxi drivers. ⋯ Drivers had knowledge and awareness of the risks of unsafe sex and supported condom use, although there appeared to be some uncertainty and confusion about the likelihood of HIV infection between drivers and girls. While taxi drivers recognised the role of alcohol in relationships with young girls, they seemed to deny that the abuse of drugs was common. The study highlights a number of key areas that need to be explored with men in the taxi industry, in order to address risk behaviours for both taxi drivers and the girls who ride with them.
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Multicenter Study
'We are left in the cold': nurses' perceptions and responses to antiretroviral treatment roll-out in the Free State, South Africa.
The unprecedented roll-out of antiretroviral therapy (ART) in South Africa is a complex process where no previous endeavour exists that can measure, predict, or direct an intervention of this scale. In the Free State province, unique characteristics and problems distinguish its ART programme, although countrywide problems also occur within the province. The Free State province faces high vacancy rates among its health-care workers, the programme has lower patient enrolment rates because of an obsession with quality to the detriment of quantity, and various incidents of ART shortages have also shook the province. ⋯ The objective of this article is to present a typology of contradictory contextual factors in the antiretroviral programme as identified through group interviews that were conducted with PNs at public health-care clinics in the five districts of the Free State province during 2005 and 2006. We intend to show that transformations often have contradictory and problematic outcomes as expressed and perceived by the nurses themselves. This unprecedented endeavour of ART roll-out inevitably has to treasure and support its most valued implementers, i.e. the front-line providers who are not only professionals in the health-care setting, but also social agents in a wider contextual framework.