Can Metabolic Factors be Used Prognostically for Short-term Mortality in HIV-infected Patients?

Metabolic abnormalities are common throughout the course of human immunodeficiency virus (HIV) infection and may occur either due to HIV infection or as a result of side effects of antiretroviral therapy. It has been established that dyslipidemia and dysglycemia associated with HIV disease reduce the long-term survival of the patients; but their role for predicting prognosis of short-term mortality in HIV patients is unknown. Aim: To study dyslipidemia and dysglycemia as a prognostic indicator for short-term mortality (3 months) in HIV patients. Subjects and Methods: An observational; prospective study was conducted at a tertiary care center over a period of 6 months. Consecutive HIV-positive patients hospitalized (both; HIV status known prior to hospitalization and the diagnosis made for the first time at admission) in medical wards from March to May 2010 were studied. All patients had their random blood sugars; fasting blood sugars (if possible); fasting lipid profile; and cluster of differentiation 4 (CD4) counts tested at the time of enrollment. The patients were followed for a period of 3 months; at the end of which they were categorized as survivors and non-survivors; and the demographic; clinical; and investigational parameters were compared between the above groups. Data was analyzed by applying Mann-Whitney U test; two sample t-test; Fisher-Exact test; and stepwise logistic regression analysis of significance; using the computer-based program; Stata; version 11.1. Results: A total of 82 patients were enrolled for the study of which 64 (78.05) were males and 18 (21.95) were females; with a mean (SD) age of 34.00 (7.0) years. The mean CD4 count was 206.23 (129.5) cells/mm 3 . The overall mortality within 3 months was 20.7(17/82). Mycobacterium tuberculosis as opportunistic infection was found in 42 patients; out of which 13 expired (P

The Effect of Maternal HIV Status on Perinatal Outcome at Mowbray Maternity Hospital and Referring Midwife Obstetric Units; Cape Town

Objectives. To study the effect of maternal HIV status on perinatal outcome at Mowbray Maternity Hospital (a secondary-level hospital in Cape Town) and its satellite community midwife obstetric units. Design. A retrospective descriptive and comparative study.Setting. Public sector maternity facilities serving historically disadvantaged populations. Subjects. All deliveries at Mowbray Maternity Hospital and its referral midwife obstetric units from January to December 2008. Outcome measures. Stillbirth; early neonatal death; perinatal mortality and neonatal encephalopathy rates in HIV-positive and HIVnegative subjects. Results. There was a total of 18 870 deliveries at the units studied; 3 259 (17.2) of them to HIV-positive mothers. The stillbirth rate in the HIV-positive population was 17.1/1 000 births; compared with 8.3/1 000 in the HIV-negative population (odds ratio (OR); 2.07; 95 confidence interval (CI) 1.5 - 2.8). The early neonatal death rate in the HIV-positive population was 4.6/1 000 live births; compared with 3.1/1 000 in the HIV-negative population (OR 1.46; 95 CI 0.8 - 2.6). The perinatal mortality rate in the HIV-positive population was 21.7/1 000 births; compared with 11.7 in the HIV-negative population (OR 1.91; 95 CI 1.4 - 2.5). A comparison of the pattern of primary obstetric causes of perinatal mortality showed that infection; intra-uterine growth restriction (IUGR) and antepartum haemorrhage (APH) were significantly more common as causes for perinatal death in the HIV-positive population. The risk of neonatal encephalopathy in the HIV-exposed population was 4.9/1 000 live births compared with 2.07 in the HIV-negative group (OR 2.36; 95 CI 1.28 - 4.35). The 1 643 women (8.7 of total deliveries) who were not tested for HIV were at particularly high risk of adverse perinatal outcome. This group included women who had either declined testing or not attended for antenatal care. Conclusion. The perinatal mortality rate in the group of HIV-exposed mothers was significantly higher than that in the HIV-negative group due to a higher stillbirth rate. Infection; IUGR and APH were significantly more common obstetric causes for mortality in the HIV-infected population. The risk of neonatal encephalopathy was also significantly higher in the HIV-positive population

Social Grants for People Living with HIV and on Antiretroviral Therapy in KwaZulu-Natal; South Africa: a Longitudinal Study

The aim of this studywas to assess the predictorsof thereceipt of a disability grant (DG) status and the impact of theDGon health outcomes of HIV patients and on antiretroviral therapy (ART) in a longitudinal study over 20 months in KwaZulu-Natal; South Africa. Consecutive patients; 735 (29.8 males and 70.2 females); who attended three HIV clinics completed the assessments (with a structured questionnaire and medical file review) prior to antiretroviral initiation; 519 after 6 months; 557 after 12months and 499 after 20 months on ART. The results indicate that a large number ofHIV or ART patients were found to be in receipt of a DG;which declined significantly over the time of being on ART (from 52.3 at 6months onART to 9.8 at 20months on ART). At various stages; being in receipt of aDGwas found to be associated with not being employed; higher quality of life (QoL); older age; higher alcohol use score; noformal salary as householdincome and higher subjective health status in multivariable analyses. A significant number of patients lost their DG status over the assessment period; which was not found to be associated with major health outcomes (CD4 cell counts; adherence to ART and HIV symptoms). In a multiple regression generalized estimating equation model; not being in receipt of a DG; health-related QoL; lower HIV symptoms and lower depression scores were associated with CD4 counts. HIV patients who no longer qualify for the DG and yet do not haveadequate financial means to meet basic necessities should be put on a nutritional support programme

Peripheral neuropathy and quality of life of adults living with HIV/AIDS in the Rulindo district of Rwanda

Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients' clinic at Rutongo Hospital in the Rulindo district of Rwanda. Another aim was to determine these patients' QoL. A cross-sectional descriptive quantitative research design was used. A time-constrained method was used to sample 185 adults living with HIV/AIDS and attending the outpatients' clinic at Rutongo Hospital. The subjective PN screen and the World Health Organization Quality of Life Scale Brief Version were used to collect the data. Data were analysed using the Statistical Package for the Social Sciences. Student's t-test and one-way analysis of variance were performed to determine if significant differences existed between QoL scores in participants with and without PN symptoms. The results indicated that 40.5% of respondents experienced PN. QoL in participants with PN showed significantly lower scores in the physical (p ¼ 0.013) and psychological (p ¼ 0.020) domains when compared with those who did not have PN. These results indicate a high prevalence of neuropathy among PLWH attending the outpatients' clinic at Rutongo Hospital. In addition, patients with neuropathy had lower QoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them

The Experiences of Batswana Families Regarding Hospice Care of AIDS Patients in the Bophirima district; North West province; South Africa

The HIV/AIDS pandemic put significant strain on healthcare services in the country. Hospitals were no longer coping with the escalating number of AIDS patients. This resulted in the early discharge of patients; with some patients; too ill to be nursed at home; being sent to hospices for continued care. The Batswana had mixed feelings about hospice care; because their beliefs on patient care are based on the ubuntu philosophy; which emphasises the principle of caring for one another. The purpose of this study was to explore and describe the experiences of Batswana families regarding hospice care for patients in the Thlabane township in the province of the North West as well as to make recommendations to policy-makers to ensure that hospices are accepted by community members and utilised effectively. A qualitative; explorative; descriptive research design was applied. Purposive sampling was applied to select study participants with whom in-depth unstructured interviews were conducted. A qualitative data analysis was done by categorising; ordering; and summarising the data; and describing the findings. The findings indicated that families of patients in hospice care experienced such care as foreign to their culture. These families also experienced stigmatisation; firstly owing to the stigma associated with AIDS and secondly because they opted for hospice care. However; they also observed the high quality of care provided by the hospice and understood its benefits for AIDS patients. The study concluded that hospice care relieved families of terminally ill AIDS patients of the burden of care and enabled them to keep on working and earning a living. Recommendations to policy-makers included enhancing hospice care and ensuring the provisioning of culturally safe hospice care

Efficacy of a Lay Health Worker Led Group Antiretroviral Medication Adherence Training Among Non-Adherent HIV-Positive Patients in KwaZulu-Natal; South Africa: Results from a Randomized Trial

There is a lack of theory-based randomized controlled trials to examine the effect of antiretroviral adherence in sub-Saharan Africa. We assessed the effectiveness of a lay health worker lead structured group intervention to improve adherence to antiretroviral therapy (ART) in a cohort of HIV-infected adults. This two-arm randomized controlled trial was undertaken at an HIV clinic in a district hospital in South Africa. A total of 152 adult patients on ART and with adherence problems were randomized 1:1 to one of two conditions; a standard adherence intervention package plus a structured three session group intervention or to a standard adherence intervention package alone. Self-reported adherence was measured using the Adult AIDS Clinical Trials Group adherence instrument prior to; post intervention and at follow-up. Baseline characteristics were similar for both conditions. At post-intervention; adherence information knowledge increased significantly in the intervention condition in comparison to the standard of care; while adherence motivation and skills did not significantly change among the conditions over time. There was a significant improvement in ART adherence and CD4 count and a significant reduction of depression scores over time in both conditions; however; no significant intervention effect between conditions was found. Lay health workers may be a useful adjunct to treatment to enhance the adherence information component of the medication adherence intervention; but knowledge may be necessary but not sufficient to increase adherence in this sample. Psychosocial informational interventions may require more advanced skill training in lay health workers to achieve superior adherence outcomes in comparison standard care in this resource-constrained setting

Adequacy of Pain Management in HIV-Positive Patients

"Background: A growing body of literature supports the view that people infected with HIV suffer significant pain and that pain is not well recognised or managed by health care professionals. This study investigated the prevalence; severity; recognition and management of pain in adult patients with HIV infection in a South African hospital setting. Methods: The Brief Pain Inventory (BPI) (short form) questionnaire was administered to 100 consecutive; consenting HIV positive patients admitted to an urban district-level hospital in KwaZulu-Natal. Convenience sampling was employed with participants recruited on consecutive days. Data sources comprised patient interviews and review of hospital records. A Pain Management Index derived from the BPI was calculated to establish the adequacy of pain management. Descriptive statistics were tabulated for the recognition of pain; pain severity and appropriateness of analgesia. Correlation analyses were used to assess the association between pain and daily life. Results: Ninety-one per cent of participants reported pain with 83 experiencing significant pain; in other words a ""worst pain"" rating of five or above on the BPI (short form) questionnaire. The correlation analysis between the severity of pain and its interference with daily life suggests that moderate and severe pain interferes with the patients' daily functioning. Pain was documented on 71 of the patients' medical charts that were reviewed; however; only 34 were considered to be adequately managed for their pain. Conclusion: Pain prevalence is high in the sample. While pain was recognised and noted in the majority of patients' medical records; the management of pain was considered to be inadequate in a third of those experiencing pain."

Focus Group Discussion with Private Sector Doctors in the eThekwini Metro of KwaZulu-Natal on the Management of HIV/AIDS Patients

Background: Highly active antiretroviral treatment (HAART) is essential in the treatment of HIV/AIDS; however; a holistic approach to HIV/AIDS management is important. This study was done to confirm the findings of two studies done previously in the eThekwini Metro of KwaZulu-Natal on private sector doctors' management of HIV-infected patients and to obtain morein in depth information about their nonpharmacological management of HIV-infected patients. Methods: Two focus group discussions were conducted amongst private sector doctors in the eThekwini Metro; after obtaining their consent. The focus group sessions were scripted; audio-taped and transcribed verbatim. Prevalent themes were identified and reported. Results: Eight doctors participated. Of the total patient population seen annually by the majority of the doctors; an average of 43.8 was HIV infected. Doctors in this study managed their patients both pharmacologically and nonpharmacologically. Seventy-five per cent of doctors indicated that the taste of medicine played an important role in nonadherence to treatment; but all agreed that cultural beliefs also influenced the patient's adherence to medication. Theft of medicines and the outof-stock situation prevented antiretroviral drug access; which impacted negatively on adherence. Five doctors mentioned that depressed patients abused alcohol; resulting in nonadherence. One doctor reported that he used the biopsychosocial approach to improve adherence in his patients. Doctors indicated that the disability grant given by the South African Government caused patients not to adhere to treatment in order to maintain a CD4 count of 200 or less so as to qualify for the grant. Conclusions: The study confirmed the previous study findings in that it showed that private sector doctors manage their HIV-infected patients both pharmacologically and nonpharmacologically. It further provided new and interesting information with regard to the nonpharmacological methods employed in HIV/AIDS management; that is the incorporation of cultural beliefs in the management of HIV-infected patients to improve adherence to treatment; and the role of the disability grant and pharmaceutical formulations in contributing to nonadherence by HIV-infected patients

Addressing HIV/AIDS Challenges in Uganda: does Social Capital Generation by NGOs Matter?

HIV/AIDS has had devastating impacts in many countries; Uganda in particular. However; Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others; Uganda's success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition; the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard; HIV/AIDS NGOs play a central role in the way individuals; groups and communities interact; and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs' success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels; and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda

The Effects of Psychological Inoculation on Cognitive Barriers Against Condom Use in Women with HIV: A Controlled Pilot Study

Past studies have shown that in attempts to prevent HIV; health education yields little change in condom use. The reason may be that education fails to target barriers for changing behaviour. The present controlled pilot study tested whether psychological inoculation (PI) reduces such barriers for using male condoms. Twenty-two Nigerian women with HIV were randomly assigned to receive PI or health education (control). In the PI condition; women learned to refute sentences reflecting barriers against condom use; while controls learned how to use condoms and the consequences of their non-use. Barriers for condom use; self-efficacy to negotiate condom use with partners and actual condom use were self-reported before and one week after interventions. Results revealed that only in the PI group were there statistically significant increases in condom use negotiating self-efficacy and reductions in barriers concerning motivation; sexual satisfaction and partners. Controls reported no statistically significant changes. However; actual reported condom use was unchanged in both groups. Thus; it is feasible to conduct PI interventions in an African sample of HIV patients. Furthermore; PI can reduce cognitive barriers for condom use; while health education yields little changes in such outcomes over time. If replicated in larger samples with longer follow-ups; these findings could eventually have implications for HIV prevention in several world regions

Provision of Psychosocial Support for Young people Living with HIV: Voices from the Field

This review provides a synthesis of the experiences of organisations providing psychosocial support for young people living with HIV (YPLHIV) from throughout the world. Little research exists on psychosocial support for YPLHIV; with many providers uncertain about how to address their complex needs. Eighty-six organisations were sent a survey containing 15 semi-structured; open-ended questions. Sixty-eight organisations from the United States; Europe; Africa; Asia; Latin America and the Middle East responded. The survey asked what challenges the organisation's patient group face; what the organisational aims are; how; where and by whom psychosocial support is delivered; what types of psychosocial support have been effective and which have not; and what recommendations the organisation has for service provision and policy.Data were stratified by age of population; region of the world and whether youth were infected at birth or in adolescence. The problems and needs across groups were more consistent than disparate. Adherence to medication; disclosure of HIV status; issues relating to sex and lack of support networks are problems faced by all YPLHIV. Most organisations use a multi-disciplinary team of individuals to meet these needs; with particular emphasis on individual and group therapy; educational support; and skills-building programmes. The review stresses the importance of youth-centered and youth-led approaches that engage young people in the planning; implementation and evaluation of programmes. Organisations underlined the need for increased funding; capacity building and trained staff. They suggest that policy makers put more effort into understanding the distinctiveness of adolescence; particularly in the context of HIV; andchallenge them to make longer-term commitments to funding and programme support. In order for organisations to provide better services; they need further evidence of effective solutions; programme guidance and support tools; and increased collaboration and communication with one another; and with policy-makers and donors

ASystematic Review of HIV/AIDS-Related Stigma and Discrimination in India: Current Understanding and Future Needs

HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research; highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement; conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition; more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as; transgender people. Context-specific (health care; community) interventions are needed to address various forms of stigma - enacted; perceived; internalised and layered - including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall; the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction

HIV/AIDS Stigma at the Workplace: Exploratory Findings from Pakistan

People living with HIV/AIDS (PLHA) are stigmatised socially. They are devalued and considered like outcasts by having lesser opportunities for education; treatment and housing; and in an organisational context they get reduced opportunities of selection; promotion and income. The phenomena have been extensively researched in developed countries but limited literature addresses the situation in underdeveloped countries like Pakistan; which is also facing spread of the HIV/AIDS epidemic. There are a number of groups who are carrying the disease but the problems being faced by PLHA employed in different organisations have rarely been analysed. Stigma at the workplace can generate a number of negative outcomes. The present study considers two such outcomes among stigmatised PLHA. These outcomes are organisational cynicism and breach of psychological contract. A questionnaire was used to collect data froma sample of 174 PLHA; having a work experience after identification of the epidemic; working in different organisations across Pakistan. These PLHA were identified and recruited through a scattered record available with some government/non-government organisations operating in Pakistan to control HIV/AIDS. Findings of the study extend the knowledge about HIV/AIDS stigma indicating that PLHA are subjected to stigma; which is significantly associated with a breach of psychological contract and organisational cynicism. There is a need at governmental and organisational level as well to increase awareness about the disease and formulate policies to reduce stigma against PLHA working in different organisations

Parental HIV Disclosure in Burkina Faso: Experiences and Challenges in the Era of HAART

Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However; limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex; parent's older age; parent's marital history and number of children. After adjustment; it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases; children suspected; and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However; parents who disclosed to their children did not experience blame nor was their secret revealed. Rather; children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However; whether aware or not of their parents' HIV-positive status; children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally; without institutional counselling support; disclosure to children remains a challenge for both parents and children; which suggests a need for rethinking of current counselling practices

Experience of stigma and discrimination and the implications for healthcare seeking behavior among people living with HIV/AIDS in resource-limited setting

Background: Stigma and discrimination can limit access to care and treatment services. Stigma hides HIV from the public; resulting in reduced pressure for behavioral change. For effective behavior change; empirically grounded and theory-based behavioral change approaches are fundamental as a prevention interventions directed on decreasing stigma and discrimination. The objective of the study was to assess the experience of stigma and discrimination on the psychosocial and health care seeking behavior of people living with HIV/AIDS (PLHIV) in Arba Minch; Ethiopia. Methods: This study uses qualitative methods involving focus-group discussions and in-depth interviews conducted in Arba Minch town and nearby Kebeles. Our sample consisted of PLHIV and other key informants who were purposively selected. Data were analyzed manually using thematic content analysis framework. Results: It appears that the magnitude of stigma and discrimination in the area has decreased to a considerably lower level; however; the problem's severity is still being influenced by various factors including: current residence; disclosure status and level of community's awareness about HIV/AIDS. Care and support services provided to PLHIV were well accepted by the respondents and the majority of them were willing to make use of any service available. Health information messages that have been disseminated to the public through mass media since the start of the epidemic in 1984 and AIDS cases in 1986 have played a significant role regarding the current prevailing problem of stigma and discrimination of PLHIV. Conclusion: Stigma and discrimination have come to a level that can be tolerated by most PLHIV that live in this region; especially those who have disclosed their HIV status and were living in urban areas. This calls for a strategy that improves the rates of serostatus disclosure after HIV counseling and testing and strengthens and integrates activities in the task of expanding care and support activities

Perception of HIV/AIDS Among the Igbo of Anambra State; Nigeria

Perception is fundamental in the fight against stigmatization of people living with HIV/AIDS (PLHIV). Perception generally influences discriminatory attitudes towards PLHIV which exacerbates their problems and quickens the degeneration of the disease from HIV to AIDS. This study examined the Anambra people's perception and knowledge of HIV/AIDS with the goal of creating knowledge on these issues in order to design effective intervention programmes towards the reduction of social stigmatization associated with the pandemic. The study was carried out in Idemmili North and Oyi local government areas of Anambra State. Qualitative and quantitative methodologies were used to elicit information from respondents who were adult males and females of 18 years and above. The research instruments were questionnaires and in-depth interview schedule. Questionnaires were administered on 1000 respondents while 13 people were interviewed in-depth. Analysis of quantitative data were conducted by using the Statistical package for Social Sciences. Univariate analysis in the form of frequencies were conducted which generated the distribution of respondents across the research variables. Furthermore; multivariate analysis were conducted to test the hypotheses and sought for relationships among variables. The qualitative data were reported in themes based on the research objectives and were analysed jointly with the quantitative data. The findings were that majority of the respondents viewed HIV/AIDS as a disease that afflict immoral people and as a punishment from God. Only a handful of them saw the disease as a disease that could afflict anybody. Also; many of the respondents said that AIDS is real but showed a low level of knowledge. It was further indicated that there were significant relationships between educational level; sex; occupation; income influence perception and peoples' reactions to HIV positive status of a relative while there were no significant relationships between these variables and knowledge of HIV/AIDS. It was concluded that these negative perceptions were as a result of the people's low level of knowledge and cultural belief systems; which see a strange illness as punishment from God for disobedience. Furthermore; the fact that most of the socio-economic characteristics of the respondents had significant relationship with perception and reaction to HIV was an indication that most people in the study area had a uniform perception. It was also an indication that government HIV/AIDS awareness programmes were not effective. It was recommended that strategies for effective HIV educational programme should be sought and carried out in the study area. Effective intervention programme have the power to change behaviours and would likely change the people's negative perception and low level of knowledge of HIV/AIDS; thereby reducing stigmatization of people living with HIV/AIDS

Social and Economic Consequences of HIV and AIDS on Children: Case Study of a High-Density Community in Harare; Zimbabwe

We present results from a household-based survey that was conducted in Mabvuku; a high-density community in Zimbabwe. The objective of the study was to improve understanding of social and economic consequences of HIV and AIDS on children. Children affected by HIV and AIDS (CABA) formed the treatment group while those not affected by HIV and AIDS (non-CABA) were the control group. We found that many of the differences in the socio-economic indicators that we studied between CABA and non-CABA were not significant. Therefore our results indicate a gloomy scenario for all the children. These results are consistent with existing literature which indicates that the impact of HIV and AIDS is exacerbated by poverty. Based on evidence from this paper; we conclude that programmes and interventions targeted at children should encompass both CABA and non-CABA within a framework of sustained commitment to improving the lives of these children. We hope that our findings will be used in the formulation of interventions and strategies to improve the situation of children affected by HIV and AIDS and/or living in impoverished communities