Prevention of mother-to-child transmission of HIV (PMTCT) is a major public health challenge in Zimbabwe. Using trained peer counselors, a nevirapine (NVP)-based PMTCT programme was implemented as part of routine care in urban antenatal clinics. This paper documents the successes and challenges of the programme and concludes that peer counselors were a definite advantage in PMTCT.
Equity and HIV/AIDS
The feasibility of preventing mother-to-child transmission of HIV using peer counselors in Zimbabwe
Shetty A, Marangwanda C, Stranix-Chibanda L, Chandisarewa W, Chirapa E, Mahomva A, Miller A, Simoyi M and Maldonado Y: AIDS Research and Therapy 5(17), 1 August 2008
Understanding diversity in impact and responses among HIV and AIDS-affected households: The case of Msinga, South Africa
Swaans K, Broerse J, van Diepen I, Salomon M and Bunders J: African Journal of AIDS Research 7(2): 167–178, 2008
To gain a more comprehensive understanding of the impact of HIV and AIDS on rural households in Msinga, South Africa, this paper adapted the sustainable livelihoods framework. An ethnographic perspective was employed to examine the impact of HIV/AIDS-related illnesses on people's mind and spirit (the internal environment) and the influence of institutional structures and processes (the external environment) to better understand the actions taken by individuals and households in response to HIV and AIDS. Members of three support groups at a local drop-in centre were consulted about the impact of HIV and AIDS on their lives through focus groups, a questionnaire and in-depth interviews. The study shows that the psychosocial impact and associated coping strategies, as well as prevailing gender-based power relations and exclusion from social-exchange networks (which are not readily available factors in the sustainable livelihoods framework), affect people's lives in different ways and depend on the specific situation of the individual or household concerned. The study confirms the need to restore a household's resource base and to address psychosocial issues. However, the variation in impact on different households requires a diversified and holistic programme of development interventions.
AIDS spending breaks records, but needs more focus
PlusNews, 8 July 2008
HIV/AIDS funding to low- and middle-income countries reached a record level in 2007, according to a new report by UNAIDS. AIDS spending by the G8 group of wealthy nations, the European Commission and other donors hit US$ 6.6 billion last year, up from US$ 5.6 billion in 2006. However, despite the largesse, UNAIDS said a US$8.1 billion gap in funding for essential HIV/AIDS programmes remained.
HIV/AIDS and home-based health care
Opiyo PA, Yamano T; Jayne TS: International Journal for Equity in Health, 2008
Public health services are becoming increasingly important in Kenya, where more than 2.5 million people are living with HIV/AIDS. This paper in the International Journal for Equity in Health highlights the socio-economic impacts of HIV/AIDS on women. Two separate data sets from Western Kenya, one being quantitative and another qualitative data have been used. The authors argue that the socio-cultural beliefs that value the male and female lives differently lead to differential access to health care services. The position of women is exacerbated by their low financial base especially in the rural community where their main source of livelihood, agricultural production does not pay much. But even their active involvement in agricultural production or any other income ventures is hindered when they have to give care to the sick and bedridden friends and relatives. This in itself is a threat to household food security.
HIV: Cheaper to treat
Sanne I: Mail & Guardian, 3 July, 2008
Failure to properly manage HIV strategies for employees has led to some workplace programmes being closed down, as audits have revealed unacceptable costs. Individual companies, communities and the South African economy are under threat if companies do not initiate expertly managed, independent and outsourced HIV programmes for their employees. Failure to expertly manage programmes effectively means money spent on them is wasted, with consequent negative impacts on the individuals concerned, and workplace productivity and morale. Companies that try to cut corners are reported to be undermining themselves, as well as the entire local treatment initiative.
Homophobia fuelling the spread of HIV
Integrated Regional Information Network, 23 July 2008
The persistent and increasing outbreaks of violence against members of the gay community in Africa are jeopardising efforts undertaken to combat HIV, both within this group and across the population as a whole, AIDS activists warned at a recent meeting in Limbé, Cameroon. The extreme vulnerability of members of the gay community to HIV on the continent was highlighted during a meeting initiated by the French non-governmental organisation, AIDES, and its partners, which took place at the beginning of July in the south west of Cameroon. The meeting brought together many AIDS activists from Francophone African countries. On average it is estimated that HIV infection rates amongst MSM (men who have sex with men) are four to five times higher than the population overall.
Improving the education response to HIV and AIDS: Lessons of partner efforts in coordination, harmonisation, alignment, information sharing and monitoring in Jamaica, Kenya, Thailand and Zambia
UNAIDS Inter-Agency Task Team on Education, 2008
Education contributes toward the knowledge and personal skills essential for the prevention of HIV, and the mitigation of the impacts caused by AIDS. Produced by the Joint United Nations Programme on HIV/AIDS (UNAIDS)'s Inter-Agency Task Team (IATT) on Education, this report synthesises case study exercises undertaken to examine the quality, effectiveness, and coordination of the education sector's response to the HIV epidemic in 4 countries - Jamaica, Kenya, Thailand, and Zambia. In each country, stakeholders assessed: critical achievements and gaps in the education sector response to HIV and AIDS; the evolution and effectiveness of coordination mechanisms and structures; progress toward harmonisation and alignment; information-sharing on HIV & AIDS and education; key resources for the response; and monitoring and evaluation. This report presents the overall findings from the study and makes recommendations for the IATT on Education and its partners to improve coordination in support of country level and to facilitate global actions.
Prevalence and pattern of HIV-related malnutrition among women in sub-Saharan Africa: A meta-analysis of demographic health surveys
Uthman OA: BMC Public Health 2008, 8:226
The world's highest HIV infection rates are found in Sub-Saharan Africa (SSA), where adult prevalence in most countries exceeds 25%. Food shortages and malnutrition have combined with HIV/AIDS to bring some countries to the brink of crisis. The aim of this study was to describe prevalence of malnutrition among HIV-infected women and variations across socioeconomic status using data from 11 countries in SSA. Prevalence of HIV-related malnutrition among women varies by wealth status, education attainment, occupation, and type of residence (rural/urban). The observed socioeconomic disparities can help provide more information about population subgroups in particular need and high risk groups, which may in turn lead to the development and implementation of more effective intervention programmes.
Public-Health and Individual Approaches to Antiretroviral Therapy: Township South Africa and Switzerland Compared
Keiser O, Orrell C, Egger M, Wood R, Brinkhof MWG, Furrer H, van Cutsem G, Ledergerber B, Boulle A: PLoS Med 5(7), 8 July 2008
The provision of highly active antiretroviral therapy (HAART) in resource-limited settings follows a public health approach, which is characterised by a limited number of regimens and the standardisation of clinical and laboratory monitoring. In industrialised countries doctors prescribe from the full range of available antiretroviral drugs, supported by resistance testing and frequent laboratory monitoring. This study compared virologic response, changes to first-line regimens, and mortality in HIV-infected patients starting HAART in South Africa and Switzerland. The study team analysed data from the Swiss HIV Cohort Study and two HAART programmes in townships of Cape Town, South Africa. Compared to the highly individualised approach in Switzerland, programmatic HAART in South Africa resulted in similar virologic outcomes, with relatively few changes to initial regimens. Further innovation and resources are required in South Africa to both achieve more timely access to HAART and improve the prognosis of patients who start HAART with advanced disease.
Saving lives now: female condoms and the role of US foreign aid
Saving Lives Now!: Center for Health and Gender Equity, 2008
This report from the Centre for Health and Gender Equity outlines the importance of the female condom in preventing the spread of HIV. Female condoms are not readily accessible in most countries and significant investment is needed to overcome barriers to their use such as cost and difficulty of use, however the report finds that in the countries where they are accessible, there is a growing demand for them. The report concludes that high quality female condom programming is critical to increasing female condom demand and uptake. The role of the US government in these programmes is highlighted. The authors recommend policy changes that will promote the integration of female condoms into HIV prevention and family planning programmes within US funded development programs, including PEPFAR.