The implementation and evaluation of a peer education and support programme in secondary schools to prevent and reduce high-risk sexual behaviour amongst adolescents is discussed. The aims of the programme were to provide accurate information about HIV, discuss and reconsider peer group norms, and establish support for learners. In the programme that was implemented in 13 secondary schools in Tshwane, South Africa, peer educators were identified, trained and supported to implement the programme in their schools with the assistance of a teacher and postgraduate students as facilitators. The results showed that the percentage of learners in the experimental group who were sexually experienced remained unchanged over the time period of 18 months. In contrast, a significantly increased percentage of learners in the control group were sexually experienced after the same time period. The control group also perceived more of their friends to be sexually experienced. No differences were reported in condom use in either of the groups. The findings of this study suggest that peer education can contribute to a delayed onset of sexual activity, and can therefore contribute to the prevention of HIV amongst adolescents.
Equity and HIV/AIDS
Tuberculosis infection rates in Uganda have increased due to the AIDS epidemic in the country, but the scarcity of health centres and over-crowding in camps for the displaced are also to blame, officials said. "The rise in the infection rate is mainly because of HIV. In many countries with a high prevalence of HIV/AIDS, TB cases have gone up because HIV has attacked and weakened the body’s defence systems, which would keep at bay widespread TB infections,” Joseph Imoko, the World Health Organisation (WHO) national professional officer for TB in Uganda said.
South African AIDS activists have called on doctors and nurses to act in the best interests of HIV-positive pregnant women and their unborn children by not waiting any longer for an official directive to switch from single antiretroviral (ARV) treatment to more effective dual treatment for the prevention of mother-to-child HIV transmission (PMTCT). At a meeting of the South African National AIDS Council in November 2007 South Africa’s Deputy President and the Director-General of Health announced that public health facilities would abandon the regimen of administering nevirapine only in favour of a short course of two antiretroviral (ARV) drugs for pregnant HIV-positive women. Nearly two months later, the new PMTCT guidelines have yet to be published and disseminated to health workers at state facilities.
This paper demonstrates the importance of utilising official statistics from the voluntary counselling and testing centres (VCT) to determine the association between gender and HIV infection rates in Kenya.The study design adopted was a record based survey of data collected from VCT sites in Kenya between the second quarter of 2001 and the second quarter of 2004. Of those who were tested, significantly more females tested positive (P<0.0001) and had twice as high a chance of being infected by HIV (Odds ratio 2.27 with CI 2.23 to 2.31) than males.We conclude that VCT statistics may lead to better planning of services and gender sensitive interventions if utilised well.
This report from the World Health Organization (WHO) and UNAIDS contains revised estimates of the number of people with HIV globally. Estimates of the total number of people infected with HIV fell from 39.5m in 2006 to 33.2m in 2007, a reduction of 16 percent. This reduction was mainly due to a change in the method used to measure the size of the epidemic, rather than trends in prevalence or incidence. The biggest drop came from a reassessment of India’s epidemic, with other important revisions being made in Angola, Mozambique, Nigeria, Kenya and Zimbabwe.
This article expresses concern about whether a reauthorised PEPFAR would ramp up prevention efforts. President Bush's target of preventing 12 million new HIV infections means lowered sights in the second five years, as PEPFAR's original goal had been to prevent 7 million new infections in five years. Advocates are now campaigning for the increase to $55 to $60 billion.
This paper is a response to a growing vision of schools as sites of care and support for vulnerable children in the context of HIV and AIDS. The paper is based on a desk review of projects working in schools on HIV and AIDS and document review of a project in a province of South Africa. The authors outline education policies in South Africa related to the care and support of vulnerable children in the context of HIV and AIDS. The misalignment between the policies around schools and vulnerable children, the resourcing of these policies, and their contexts of implementation is brought into relief, as well as the implications for thinking about expanded roles for schools and teachers. The paper offers possible ways forward in considering the role of schools in the context of HIV and AIDS. These include new ways of thinking about resourcing, proper monitoring and evaluation of projects, and a focus on quality teaching and learning.
Children contract HIV infection largely through vertical transmission and are vulnerable to AIDS illness due to an immature immune system. In South Africa, hospitals are often overburdened and thus children with HIV may be directed to the community for care. As a result, non-professional caregivers are a predominant source of care for children living with HIV. Various authors, including the Department of Health, have stipulated the importance of establishing the knowledge and needs of non-professional caregivers of children with HIV. Our research has investigated the extent of non-professional caregivers' knowledge and needs, specifically those within the Potchefstroom district of the North-West Province. The objectives included formulating guidelines for a training programme that can enhance relevant knowledge and skills among these caregivers. Quantitative data were gathered using a questionnaire, which was developed following a literature study. The 109 non-professional caregivers who responded to the questionnaire displayed some knowledge and skills concerning specifically the care of children with HIV or AIDS, although gaps existed concerning their knowledge of community-based referral, caring needs specific to children, and precautionary measures to prevent HIV transmission. Recommendations are made with specific reference to a training programme. We surmise that non-professional caregivers play a pivotal role in the care of children with HIV in the Potchefstroom district — a service that is sometimes rendered in perilous conditions. This study improves our understanding of the support and training needed for non-professional caregivers in their pursuit to care for children with HIV in resource-limited communities, and thus it contributes to the field of nursing science. The findings may generate ideas for future research on this important topic.
This study explores the social representations of HIV and AIDS that circulate among white women teachers in South Africa, a group whose personal risk of the disease is low but who have a major role to play in shaping attitudes to HIV/AIDS among children and young people. The study examines how white women talk about the origin and causes of the spread of HIV in South Africa and their personal and community risk. This was explored through 25 semi-structured interviews and two focus groups with white female teachers in Johannesburg. A thematic analysis of the in-depth interviews revealed a shared private understanding of the disease, wherein the women distanced themselves by anchoring it in the context of racist cultural stereotypes of black sexuality and vulnerability. In contrast, the focus group discussions revealed a type of public talk in which HIV/AIDS is anchored in the contemporary cultural images of the new South Africa and the spirit of ubuntu or togetherness. These contradictory views reflect the racial tensions and social contexts of South Africa and which shape HIV/AIDS discourses. The findings suggest that more needs to be done to create a genuine understanding of HIV and AIDS within contemporary South African contexts.
This paper explores the nature of HIV/AIDS education and information networks in Malawi, with a focus on Dedza district. We consider the role of institutional and personal actors involved in Malawi's recently instated and decentralised behaviour-change intervention strategy, as well as the form and function of interpersonal social networks that mediate this information. The research reveals that the organisational capacity of actors and the conflicting messages regarding promotion of condom use may prevent Malawi from achieving a coordinated and effective decentralised response to the HIV epidemic. The research shows that individuals draw on complex interpersonal social networks, often processing mixed messages regarding HIV prevention strategies and receiving negative messages regarding condom use. The paper discusses the implications of such inconsistencies and conflicts with actors, interpersonal social networks and the nature of the messages themselves for HIV/AIDS education in Malawi.