SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance
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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.
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Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients' clinic at Rutongo Hospital in the Rulindo district of Rwanda. ⋯ These results indicate a high prevalence of neuropathy among PLWH attending the outpatients' clinic at Rutongo Hospital. In addition, patients with neuropathy had lower QoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them.
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Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. ⋯ The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the inclusiveness of the HIV response.
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The HIV/AIDS pandemic put significant strain on healthcare services in the country. Hospitals were no longer coping with the escalating number of AIDS patients. This resulted in the early discharge of patients, with some patients, too ill to be nursed at home, being sent to hospices for continued care. ⋯ However, they also observed the high quality of care provided by the hospice and understood its benefits for AIDS patients. The study concluded that hospice care relieved families of terminally ill AIDS patients of the burden of care and enabled them to keep on working and earning a living. Recommendations to policy-makers included enhancing hospice care and ensuring the provisioning of culturally safe hospice care.