Under the Global Coalition on Women and AIDS (GCWA), the International Planned Parenthood Federation (IPPF), together with the United Nations Populations Fund (UNFPA) and Young Positives are developing 23 country Report Cards with the aim to strengthen HIV Prevention strategies for girls and young women. Each Report Card provides a country profile, information on HIV prevention from the legal, policy, service availability and accessibility, rights and participation perspectives and includes quotes and issues raised by young women and girls of the country. They also discuss key social and cultural issues, including the role of men and boys in HIV prevention. These form the basis for a series of recommendations aimed at increasing and improving the programmatic, policy and funding actions taken on HIV prevention for young women and girls, targeting national, regional and international decision makers. Follow- up work from these report cards has also shown that facilitating dialogue between young women and girls and national stakeholders in an open forum, can have a direct and positive influence on both policy and programmes. It also helps to develop the leadership skills of the young women so that they can take their future into their own hands.
Equity and HIV/AIDS
Rural women living with HIV in circumstances of poverty in South Africa face discrimination in relationships and in communities because of their gender, HIV status and economic marginalisation. A new Amnesty International report based on interviews with rural women, the majority of them living with HIV, exposes the overwhelming challenges they face in the midst of the severe HIV epidemic affecting the country. Despite gradual improvements in the government's response to the HIV epidemic and the adoption of a widely-welcomed five-year plan, five and a half million South Africans are HIV-infected – one of the highest numbers in any country in the world. Fifty-five percent of them are women. South African women under 25 are between three and four times more likely to be HIV-infected than men in the same age group.
Limited research has been conducted outside Western settings on how HIV-positive parents decide to test and disclose their own HIV status to children. This qualitative study was conducted in 2001 and 2005 to assess parent attitudes and current counselling policy and practice regarding child testing and parental disclosure in Uganda prior to the roll-out of antiretroviral therapy. Concerns over disclosure to children of parent's HIV status and testing children for HIV represent a major psychological burden for HIV-positive parents. Further research is reported to be needed, but current counselling practice could be improved now by adapting lessons learned from existing research.
The research in this book was carried out among banana-farming households in the districts of Masaka and Kabarole in Uganda. A gendered livelihood approach was used. The research focused on the identification of critical factors that need to be taken into consideration in the development of relevant policies for HIV/AIDS-affected agriculture-based households or those that are at risk. The book shows that HIV/AIDS causes significant negative effects on the lives of those affected. Their resources are affected due to HIV/AIDS-related labour loss and asset-eroding effects and disinvestment in production and child education. While in the overwhelming majority of the affected cases the effects of AIDS are negative and lead to increased impoverishment and vulnerability, for some households HIV/AIDS-related effects are manageable. It is concluded that a household's socio-economic status and demographic characteristics influence the magnitude of HIV/AIDS-related impacts experienced and capacity to cope. The book also highlights some historically specific social practices, policies, and ideologies that continue to maintain or reproduce distinct forms of inequality, with certain social groups being marginalized and others being privileged. Unless these are redressed, they will continue to aggravate people's vulnerability regardless of the type of shock that they are exposed to or experience.
The failure to remove barriers that determine whether a person can access and use a condom is one of the biggest impediments to preventing millions more HIV infections. This advocacy briefing from International Council of AIDS Service Organisations (ICASO) examines some of these barriers and addresses what can be done to overcome them. Information was sourced from a community-led monitoring project in 14 countries undertaken in 2005 and 2006 which collected and analysed data and information on the broad response to HIV and AIDS. The report states that to overcome prominent barriers, governments and donors around the world need to commit new resources and enact and reform legislation, policy and programming that will ensure condom access and availability. It argues that a mobilised community sector that can forcefully advocate for condom access is needed now more than ever.
This paper based on findings from the KwaZulu-Natal Income Dynamics Study (KIDS) describes caregivers’ perspectives on providing care for HIV positive family members. The paper focuses on understanding what care provision means to family caregivers and in turn why they provide care. More centrally it highlights various aspects of the experience of providing care and the effects of care on caregivers’ lives. Caregiver’s reported that caring is stressful and physically, emotionally and socially taxing. Moreover, in households in which care takes place there is in most cases a lack of resources to provide appropriate care. Almost all caregivers indicate that they do not always know what to do to provide care. The report recommends increased support for caregivers, namely training in how to provide the highest quality care possible such as delivering palliative care. This should be provided by home-based care organisations and health workers such as community health workers and nurses through home visits.
This research was undertaken to investigate what level of HIV knowledge medical staff have in a state hospital in South Africa. In particular it looks at their knowledge about and practical use of current HIV policy and counselling programmes within their hospital. The conclusions are applicable to other hospitals in South Africa. The report highlights several areas of poor knowledge. Education of medical staff may be insufficient due to several factors including lack of access to information, lack of training and counselling, and lack of knowledge about HIV policy. The authors recommend the effectiveness of current counseling services is evaluated and that hospital HIV policy and counselling programmes are developed in co- operation with community based organisations and all disciplines in the hospital, especially nurses.
The long wait is over. South Africa's HIV-positive pregnant women will now have access to medication that could further reduce the risk of passing the virus to their babies after the health department released guidelines for administering more effective dual therapy instead of single antiretroviral (ARV) treatment. The challenge now is to make sure that healthcare workers at public health facilities receive the guidelines and the medicines so that new mothers and babies will benefit as soon as possible.
The achievement of the Millennium Development Goals (MDGs) depends on sufficient supply of health workforce in each country. Although country-level data support this contention, it has been difficult to evaluate health workforce supply and MDG outcomes at the country level. The purpose of the study was to examine the association between the health workforce, particularly the nursing workforce, and the achievement of the MDGs, taking into account other factors known to influence health status, such as socioeconomic indicators. The main factors in understanding HIV prevalence rates are physician density followed by female literacy rates and nursing density in the country. Using general linear model approaches, increased physician and nurse density (number of physicians or nurses per population) was associated with lower adult HIV prevalence rate, even when controlling for socioeconomic indicators. Increased nurse and physician density are associated with improved health outcomes, suggesting that countries aiming to attain the MDGs related to HIV would do well to invest in their health workforce. Implications for international and country level policy are discussed.
A survey was administered to 304 respondents participating from three areas near Welkom, South Africa. Face-to-face interviews were conducted with women from randomly selected households to evaluate the impact of a service provision programme targeting women living with HIV/AIDS and gender based violence. Gender based violence (GBV) awareness and knowledge was high. Respondents had high perceived levels of risk. The key findings of this study support the notion of using a holistic approach, targeting more than one issue. There is lower stigma levels associated with combined conditions, which might allow easier access to vulnerable groups. Coordination and collaboration of services are however needed to enable this benefit.