Children's Vulnerability to HIV/AIDS; Poverty and Malnutrition in Buhaya:Advancement through Women's Empowerment

Children form a vulnerable segment in society in general; given their dependence on adults for their immediate needs. HIV/AIDS has resulted in increasing children's vulnerability to HIV/AIDS; poverty and hunger. This epidemic has also resulted in many children being orphaned and raised by grandparents and members of their extended family. This paper focuses on children's particular vulnerability to the vicious cycle of poverty; hunger and HIV/AIDS in Buhaya in northwestern Tanzania; a region that has been impacted by HIV/AIDS for nearly three decades. The region has also experienced a decline in access to land and agricultural productivity; which has escalated household poverty. I highlight the plight of children living with single mothers who are often viewed as `illegitimate' and not recognized by patriarchal Bahaya clans. This results in deprivation of their rights to land inheritance; as well as to basic needs such as food security; health and education. Given that children's and women's health; nutrition; and poverty generally work in synergy; I argue that empowering women and upholding their human rights is crucial to advancing the lives and future of children

Evolution of HIV/AIDS Discourse among the Haya on Ten Landing Sites on the Western Shores of Lake Victoria; Tanzania: Need for a Shift from a Biomedical to a Meaningful Life Discourse

"Kagera is one of the areas considered to be an epicentre of the HIV/AIDS epidemic in Tanzania. This has been due to linking HIV/AIDS and the cross-border trade between Uganda and Tanzania; an activity that was due to lack of essential commodities after the Uganda-Tanzania War of 1978-1981. In a survey in the landing sites of Lake Victoria; where one of the elements is to know the state of HIV/AIDS; it is found out that people are giving up in their struggle against HIV/AIDS; a situation that leads to the perception of contracting HIV/AIDS being an ""occupational hazard"". As the African sexual permissiveness theory has been at the back of the bio-medical discourse and the eventual behavioural change paradigms in guiding HIV/AIDS interventions; this article proposes change of discourse by having the meaningful life discourse in HIV/AIDS interventions."

SISTA South Africa: The Adaptation of an Efficacious HIV Prevention Trial Conducted with African-American Women for isiXhosa-speaking South African Women

Although new HIV treatments continue to offer hope for individuals living with HIV; behavioural interventions shown to reduce HIV risk behaviour remain one of the most powerful tools in curbing the HIV epidemic. Unfortu- nately; the development of evidencebased HIV interventions is a resource-intensive process that has not progressed as quickly as the epidemiology of the disease. As the epidemic continues to evolve; there is a need to expedite the development of evidence-based HIV interventions for populations that are often disproportionately impacted by HIV/AIDS. One mechanism of accelerating the development process is to adapt evidence-based HIV interventions for vulnerable populations. The aim of this paper was to describe the adaptation process of a HIV intervention for African-American women for black South African Xhosa women. For African-American women the intervention was effective in increasing consistent condom use; sexual self-control; sexual communication; sexual assertiveness and partner adoption of norms supporting consistent condom use

Poverty; Sexual Practices and Vulnerability of Female Sex Workers to HIV/AIDS Pandemic in Lagos Metropolis; Nigeria

"The objectives of this study were to know those factors that made women to join sex industry and effects of these factors on the practice of safe sex by female sex workers in Lagos metropolis within the context of HIV/AIDS pandemic. To achieve these objectives; quantitative and qualitative research methods were adopted. In the quantitative method; 320 female sex workers were sampled in a cross-sectional survey; while 20 in-depth interviews were conducted among the respondents in the qualitative method. Findings of the study showed that female sex workers in the metropolis were young ladies in their early twenties because the mean age of respondents was 23.8 years. Data on family socio-economic background revealed that 74.4of the respondents were from poor family; while 85.6of them grew up from one or two-room apartment. 35.0of the respondents stated that poverty made them to join sex industry. It is instructive to know that all the respondents had knowledge about the existence of HIV/AIDS and 81.9of them identified sexual intercourse as major route of HIV transmission. There is significant relationship between poverty; educational level; ever contraction of STIs; charging of higher price for ""flesh to flesh"" sexual contact and consistent use of condom by sex workers at P0.01. Specifically; only 24.7of the respondents were using condom regularly in each of the sexual acts. Poverty is a major factor that pushed young women into prostitution and this same factor hindered them from practising safe sex. Thus; programmes that will reduce poverty level should be developed in order to reduce rapid transmission of HIV infection in the country."

Barriers to HIV Care and Treatment by Doctors : a Review of the Literature

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion; fear of losing patients; unwillingness to care; and inadequate knowledge /training about treating HIV patients. Barriers to treating HIV infected patients is frequently reported in many countries and it is important for developing countries such as South Africa to learn from these experiences by identifying local problems so that constructive interventions and strategies can be developed to address these barriers; thereby improving the quality of patient care. Further research in respect of the local situation is requiredIntroduction: Over the last two decades acquired immunodeficiency syndrome (AIDS) has emerged as one of the most serious public health problems in the world; and by the end of 2003 it was estimated that 5.3 million South Africans were human immunodeficiency virus (HIV) positive; which corresponds to 21.5of the population. In the early phase of the HIV epidemic few doctors saw infected patients and treatment options were limited. As a result many doctors were reluctant to provide care to HIV infected patients and homophobia amongst doctors; fear of contact with patients and unwillingness to care were frequently reported. However; there has been an exponential increase in the number of HIV and AIDS related cases and more doctors are encountering infected individuals. This review summarizes our current knowledge of barriers to treatment of HIV infected patients by doctors.Method: A comprehensive literature review was undertaken by searching the MEDLINE database; Psychlit; ISI Web; EBSCOHost; and Sabinet on line; for eng language literature published between 1985 and 2004. The database search terms included keywords such as fear/s; barrier/s; concern; HIV; AIDS; attitudes; physician/s (doctor/s); practice; treatment; care and knowledge. A variety of combinations of these words were entered. All duplicate articles were removed and only studies that used doctors as the sample population were considered. Titles expressing comment; news items; opinion pieces or letters were rejected.Results: Thirty two relevant studies were identified from the literature search. The four most commonly reported barriers were: fear of contagion; fear of losing patients; unwillingness to care; and inadequate knowledge /training about treating HIV patients

Acceptance of counseling, voluntary HIV testing and use of prophylactic nevirapine in labour and immediate puerperium at Muhimbili national hospital, Tanzania

Background: Mother to child transmission contributes significantly to the incidence of HIV in our country. A PMTCT program exists in Muhimbili National Hospital (MNH) and some surrounding public hospitals since 2000. Inspite of this it has been observed that a substantial number of women delivering at MNH have not had VCT and therefore cannot benefit from the PMTCT intervention.Objective: To determine the acceptance of counseling; voluntary HIV testing and prophylactic use of Nevirapine among pregnant women during labour / immediate postpartum at Muhimbili National Hospital.Methodology: This descriptive Cross-sectional study was done in the labour ward of MNH.Data collection: Trained counselors invited all women who met inclusion criteria as they were admitted. Patients who had obstetric complications were excluded. Women who accepted counseling were taken to private rooms for discussion and those who consented were screened for HIV using rapid tests. Direct observed therapy with Nevirapine was done. Data was filled in a structured questionnaire and analysed by EPI Info 6 and SPSS software.Results: We recruited 885 women with unknown sero-status through convenient sampling. The overall acceptance of pre-test counseling in labour among women with unknown sero-status was 71.7while acceptance of counseling and voluntary HIV testing was 56.6. Among those who accepted pre-test counseling in labour; 78.9accepted HIV testing and 8.6of these were found to be HIV infected. Eighty-three percent of women diagnosed to be HIV infected accepted Nevirapine. Counselor's experience of more than 3 years had a significant impact on acceptance of counseling and testing of HIV in labour.Conclusion and recommendation: The results of this study show that HIV testing during labour and use of prophylactic ARV is acceptable in our setting. Women with unknown serostatus in labour should be offered counseling and testing in order to prevent MTCT of HIV

Effect of Exposure to Clinic-Based Health Education Interventions on Behavioural Intention to Prevent Mother-to-Child Transmission of HIV infection

HIV and AIDS incidence among infants in South Africa is on the increase. The uptake of prevention of motherto-child transmission (PMTCT) interventions is often said to be dependent on the beliefs and educational needs of those requiring PMTCT services. This study therefore sought to examine the effect of clinic-based health education interventions (HEI) on behavioural intention of PMTCT among 300 pregnant women from 4 primary health care clinics in Tshilidzini Hospital catchments area; South Africa. An interview schedule was used to obtain information regarding participants' demographic characteristics; level of exposure to clinic-based HEI; salient beliefs and behavioural intention on PMTCT. The major findings included that approximately 85 of the participants had heard of PMTCT. There was very little association between frequency of antenatal clinic (ANC) visits and level of exposure to PMTCT information. Condom use had the lowest set of salient belief scores. Control belief was the most common belief contributing to behavioural intention. Generally; the association between PMTCT salient beliefs and behavioural intention was weak. Clinic-based HEI had an impact on behavioural intention of HIV testing; normative belief of regular ANC visit and nevirapine use. The vital contribution of alternative PMTCT information sources such as the radio and television was observed. Enhancing initiatives that empower women; and a better coordination of the existing HEI through better implementation of health education strategy may strengthen the prevailing moderate PMTCT intention in the area investigated

Evaluation des facteurs determinant l'utilisation des services de prevention de la transmission mere-enfant du VIH/SIDA dans le district de Bamako

Nous avons mene une etude transversale sur une periode de quatre pour evaluer les facteurs determinants de l'utilisation des services de prevention de transmission mere-enfant du VIH/SIDA dans cinq centres PTME du district de Bamako. Une interview des femmes en CPN et des parturientes a ete recueillie sur un questionnaire dans le but : 1] d'etudier leur connaissance et attitude vis-a-vis du VIH /SIDA ainsi que l'utilisation du programme PTME ; 2] d'evaluer l'application des procedures du CTV par les prestataires. Une etude CAP de la connaissance sur le VIH/SIDA chez 68 femmes en CPN et 90 parturientes a montre que : 44;1p.100 en CPN et 48;9p.100 des parturientes ont une bonne connaissance sur le VIH/SIDA; pres de 26;7p.100 des parturientes connaissent l'existence du programme PTME. L'etude evaluative du counseling nous a revele que seulement 32;3p.100 des prestations sont correctement execute en pre-test et 17;3p.100 en post-test . Ces resultats ont montre que les femmes n'ont pas une bonne connaissance de la transmission du VIH/SIDA. Seulement un O des femmes connaissait l'existence du programme. L'etude a egalement trouve que les conseillers n'ont pas une maitrise des procedures du CTV telles que recommande par ONUSIDA et adopte par le PNLS du Mali. Une meilleure approche de diffusion des informations sur le programme de PTME s'avere necessaire

Migration et Sida en Afrique de l'Ouest

L'article etudie la question des inter-relations entre le Sida et les phenomenes migratoires en Afrique de l'ouest

SIDA : la prevention en milieu de soins

Le risque de contamination par le VIH existe en milieu de soins. Ce risque est cependant tres faible. L'adhesion du personnel medical et paramedical aux regles d'hygiene permet la prevention des contaminations susceptibles de se produire a l'occasion des soins. Leur connaissance et leur application rationnelle representent le meilleur moyen d'accomplir le devoir de soins dans le calme necessaire au bien-etre des malades et du personnel soignant

SIDA et chirurgie. [Resume]

Le Congo est dans la zone ou le SIDA sevit da facon endemique. La Chirurgie dans cette zone est peut-etre a l'origine de plusieurs contaminations accidentelles (transfusions; blessures). Quelle attitude adopter vis-a-vis des malades sero-positifs qui presentent des affections chirurgicales ou des malades immuno-deprimes pour lesquels les confreres medecins nous demandent de faire des biopsies ganglionnaires. Pour nous; le SIDA ne constitue pas une contre-indication operatoire du moins pour la chirurgie d'urgence. Il faudrait bien sur redoubler de vigilance; travailler avec des gants corrects; du materiel bien sterilise; et des locaux desinfectes regulierement. Les blocs operatoires ne doivent souffrir d'aucune rupture de detergents; ni d'antiseptiques

La surveillance sanitaire des prostituées et la lutte contre la transmission sexuelle du SIDA

Pendant une periode de 8 mois; 80 prostituees de la ville de Cotonou (Benin) ont fait l'objet d'une surveillance sanitaire et d'une enquete qui evaluait leur niveau d'information sur le SIDA et les autres maladies sexuellement transmissibles (MST). La moitie de la population etudiee etait atteinte d'une ou plusieurs MST dont l'infection par le VIH (37;5 pour cent des cas); la syphilis (21 pour cent des cas) et l'hepatite virale B (10 pour cent des cas). Si toutes les prostituees avaient entendu parler du SIDA; elles ne se sentaient pas concernees par cette maladie dont elles ignoraient les regles de prevention. La plupart d'entre elles ne savaient rien des autres MST. Les campagnes d'information et d'education pour la sante en direction de ce groupe a risque sont utiles; cependant elles ne peuvent atteindre pleinement leurs objectifs que si les memes actions sont menees en direction de la population generale ou se recrutent les partenaires sexuels des prostituees

Transmission materno-foetale du virus de l'immunodeficience humaine : cause majeure de SIDA congenital en Afrique Sub-Saharienne

En Afrique Sub-Saharienne; le nombre de femmes en age de procreer et infectees par le VIH est dans certains grands centres urbains extrement important; avec en corrolaire une prevalence en augmentation croissante d'enfants contamines a la naissance qui developperont un SIDA congenital; en moyenne dans les deux premieres annees de vie. Le taux de transmission materno-foetale de l'infection par le VIH 1 est d'environ 30-40 pour cent; alors qu'il n'est que de 15-20 pour cent dans les pays industrialises; celui de l'infection par le VIH de type 2 (Afrique de l'Ouest) serait inferieur a celui du VIH 1. La transmission du VIH a lieu preferentiellement durant la periode perinatale; notamment lors de l'accouchement; probablement via les secretions vaginales contaminees. Cependant; la contamination durant la gestation; par voie trans-placentaire et/ou trans-annexielle; est possible. En Afrique Noire; les consequences sociales de l'infection par le VIH chez les femmes en age de procreer seront a terme desastreuses; avec une augmentation de la mortalite infantile (transmission materno-foetale du VIH) et l'emergence d'enfants orphelins (deces premature des parents sideens)

Some aspects of sexual behaviour and the potential demographic impact of AIDS in developing countries

This review examines recent research on the influence of heterogeneity in sexual behaviour on the transmission dynamics of the human immunodeficiency virus (HIV); the aetiological agent of AIDS. Attention is focused on the potential demographic impact of AIDS in developing countries and how this is influenced by the structure of networks of sexual contacts (who mixes with whom); age-dependency in rates of sexual partner change and differences in the ages of female and male sexual partners. Analyses based on the construction of simple and complex mathematical models of the spread of HIV via heterosexual contact serve as a template for the interpretation of observed pattern and as a guide to the major aspects of sexual behaviour that govern the transmission dynamics of the virus. It is argued that much greater attention must be addressed to the quantification of patterns of sexual behaviour in defined communities; despite the many practical problems that surround data collection and interpretation

Sida et mobilite en Afrique de l'ouest : dynamiques sur les trajets et autour des grands carrefours au Senegal; au Mali et en Guinee : synthese

Ce rapport est la synthese d'une mission menee au Senegal; au Mali et en Guinee sur les grands axes et autour des grands carrefours ou passent et sejournent les migrants pour ce qui est de la transmission du Sida dans le cadre d'une mission organisee par Enda

Mother to Child HIV Transmission

Mother-to-Child Human Immunodeficiency Virus (HIV) Transmission is the largest source of HIV infection among children below 15 years of age. On a global scale; children are being infected at the rate of one child every minute of everyday. World Health Organisation estimated that 600;000 children World Wide were born with HIV infection in 1999 of whom 90were born to mothers from Sub-Saharan Africa. Babies acquire the virus during pregnancy; in labour (the vast majority of cases) and during breastfeeding. The possibility of a baby born to HIV infected mother acquiring HIV infecvtion is 15-25in developed countries and 25-45in developing countries. This difference is accounted for by a number of factors including breastfeeding and nutrition. HIV infection is a fatal disease with no apparent cure. If left unchecked; it is bound to abolish all the gains in child survival registered through the Expanded Programme on Immunization (EPI) in Africa. Up to recent years; Primary HIV prevention and use of contraceptives to stop infected women becoming pregnant have been the only means for prevention of Mother to Child HIV transmission (MTCT). With better understanding of the mechanism and methods of Mother to Child HIV transmission; more and better scientific methods of prevention of Mother to Child HIV Transmission have been developed. The future generation of children could be protected from HIV infection with rapid implementation of effective; economical and simple strategies for prevention of MTCT

Precautions to Prevent HIV Transmission in Hospitals and other Health Institutions

Introduction: HIV transmission can take place in hospital settings through contact with blood and other body fluids of patients infected with HIV. Safety measures have been revised in Mulago National Referral Hospital; which is also the Teaching Hospital for Makerere University Medical School. AIM(S): This is done in order to minimise the risks of the staff and students being exposed to the dangerous virus in the course of their work on the words; in thatres and laboratories