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.
Equity and HIV/AIDS
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.
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.
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.