This article refers to that by John Cleland and Mohamed Ali in the same issue of the Lancet. The authors offer interesting results on behaviours about HIV sexual transmission in women from different African countries. Cleland and Ali use information from all countries in sub-Saharan Africa that have had two or more Demographic and Health Surveys since 1990 to estimate behaviour trends.Their study is valuable for epidemiologists and public-health practitioners, and has important strengths.
Equity and HIV/AIDS
Changes in sexual behaviours to prevent HIV
de Irala J, Alonso A: Lancet 368 (9549), 1749-1750, 18-24 November 2006
Dealing with HIV and AIDS: Solutions in ordinary people's actions
id21 insights 64, November 2006
Twenty-five years of knowingly living with HIV, the global community is still falling behind the virus in its alarming, complex and often hidden progress. Despite many diverse and creative successes in committed peoples' responses and many lessons drawn along the way, few have been widely adopted. Civil society groups have often led the way. A passionate - sometimes desperate - drive to respond to HIV and AIDS, and their own diversity unites them. This issue of id21 insights features examples of such real-life responses and asks: how can we move forward to catch up with the virus?
Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: A cluster randomised trial
Pronyk PM, Hargreaves JR, Kim JC: The Lancet 368:1973-1983, 2 Decemer 2006
A research article highlights how the combination of a microfinance initiative and an educational programme can empower women and reduce the incidence of intimate partner violence in rural South African communities. The study showed no effect, however, in reducing HIV.
Effect of the HIV epidemic on infant feeding in South Africa
Doherty T, Chopra M, Nkonki L: Bulletin of the World Health Organization 84 (2), 2006
This article, published in the Bulletin of the World Health Organization, explores how the HIV epidemic has affected the infant feeding experiences of HIV-positive mothers in South Africa. The paper finds that the HIV epidemic has changed the context in which infant-feeding choices are made and implemented. HIV positive mothers are struggling to protect their decision-making autonomy; uncertainty about the safety of breastfeeding has increased the power and influence of health workers who act as gatekeepers to knowledge and resources such as formula milk. Women who chose to exclusively formula feed experience difficulties accessing formula milk because of inflexible policies and a lack of supplies at clinics. Limited support for mothers with newborn babies can result in social isolation and mothers doubting their ability to care for their children.
Global Fund round 6 grants to the Alliance of up to $83m will enable much needed work with those most vulnerable to HIV
International HIV/AIDS Alliance, 27 November 2006
Organisations in the International HIV/AIDS Alliance have been awarded up to $83 million in the sixth round of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Proposals have been successful in Alliance countries including India, Morocco, Senegal and Ukraine, with Global Fund grants for these countries totalling $480 million.
HIV incidence among women of reproductive age in Malawi and Zimbabwe
Kumwenda N, Hoffman I , Chirenje M, et al: Sexually Transmitted Diseases 33 (11), 646-651, 2006
The article examines the incidence of HIV infection among women of reproductive age in Malawi and Zimbabwe. Of the 2,016 women who participated in the study, 1,679 were tested for HIV during follow up and 113 seroconverted resulting in an overall HIV incidence rate of 4.7 per 100 women. HIV incidence continues to be high among women in both countries despite counselling and condom promotion.
Microfinance and HIV prevention: Emerging lessons from rural South Africa
Pronyk PM, Kim JC, Hargreaves JR, Makhubele MB, Morison LA, Watts C, PorterJDH: Rural AIDS and Development Action Research Programme (RADAR), School of Public Health, University of the Witwatersrand
Do the gains in confidence and economic well being that can come from participation in a microfinance programme reduce clients’ vulnerability to HIV infection? Until now practical experience and an evidence base relating to such activities have been limited. This article reviews the evidence supporting an enhanced role for microfinance in HIV prevention activities. It describes the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) – a South African case study that has been specifically designed to explore these relationships. The paper discusses the operational integration of microfinance and HIV prevention – highlighting challenges, emerging lessons and limitations in the light of international best practice and several years of field experience.
Promoting self-testing for HIV in developing countries: Potential benefits and pitfalls
Kachroo S: Bulletin of the World Health Organisation 84 (12), 999-1000, December 2006
This article preventive measures for reducing the prevalence and incidence of HIV by weighing the potential benefits of promoting self testing for HIV in developing countries and the concerns that need to be raised.
SADC failing in AIDS fight says Cameron
iafrica, 5 December 2006
Good governance in the Southern African Development Community (SADC) was the key to dealing with HIV/AIDS, Judge Edwin Cameron said. "Where there are human rights abuse, we cannot deal properly with Aids," Cameron said in Johannesburg at the launch of the AIDS Rights Alliance for Southern Africa's (Arasa's) report on HIV/AIDS and human rights in the SADC region. The report is an evaluation of the steps taken by countries in the SADC region to implement international guidelines on HIV/AIDS and human rights.
Sexual abstinence, contraception, and condom use by young African women: A secondary analysis of survey data
Cleland J, Ali MM: Lancet 368(9549), 1788-93, 2006
Drug therapy for people with AIDS is a humanitarian priority but prevention of HIV infection remains essential. Focusing on young single African women, the authors aimed to assess trends in a set of behaviours sexual abstinence, contraceptive use, and condom use-that are known to affect the rates of HIV transmission. Methods involved secondary analysis of public-access data sets in 18 African countries (132800 women), calculating changes in a set of behavioural indicators over time. Condom promotion campaigns in sub-Saharan Africa were found to have affected the behaviour of young single women; the pace of change having matched the rise in contraceptive use by married couples in developing countries over recent decades.