Austin Journal of HIV/AIDS Research is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of research in HIV/AIDS. The aim of the journal is to provide a forum for researchers and other health professionals to find most recent advances in the areas of HIV/AIDS research and treatment.
Austin Journal of HIV/AIDS Research covers special areas of virology such as HIV/AIDS diagnosis, early detection, prognosis, epidemiology, transmission, palliative care and large multicentre studies of new therapies.
Austin Journal of HIV/AIDS Research accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of diagnosis and treatments of HIV/AIDS.
Psychological Challenges Facing Women Living With HIV/AIDS: A Case of Nakuru ...paperpublications3
Abstract: HIV/AIDS is a critical concern in Kenya, ever since the HIV/AIDS virus was identified, many campaigns have been put in place, and people have been made aware of the various effects of the virus. However, much emphasis has been on the physiological effects, but little concern has been given to the major psychological effects the virus can have on individuals who contract the HIV virus. There is strong evidence that people who have been diagnosed with HIV are more likely to develop a mental health or psychological problem such as anxiety or depression. The purpose of this study was to explore and describe the psychological challenges faced by people who are living with HIV/AIDS in Nakuru municipality and how they cope with those challenges. A sample of 248 out of a target population of 700 was used. The instruments used to collect data were questionnaires and interviews schedules. The data was analyzed using descriptive statistics. The findings of the study revealed that most of the women living with HIV/AIDS suffer stigma, anger, trauma, denial and fear of disclosure. The disparities that existed among the singles and the married revealed that one’s marital status determined the extent to which one was stigmatized, angered, traumatized, and experienced denial or fear of disclosure. These findings have implications for developing interventions to support the psychological needs of people living with HIV, to accurately reflect the views and needs of the target users.
Knowledge, Attitude and Practice of Migrant Workers’ Wives on HIVAIDS in Bang...Md. Tarek Hossain
In Bangladesh, the targets under MDG-6 are to halt the spread of HIV/AIDS, malaria and other diseases by 2015 and reverse the spread of the diseases. The increasing trend of HIV/AIDS positively indicates that country is on the brink of a nationwide crisis. Mobility is a key structural factor that has been linked to increased HIV incidence and vulnerability globally. Bangladeshi migrant workers suffer problems found among other internal and international migrant groups including socioeconomic and power inequalities, limited social capital, loneliness, and coping with different cultural norms relating to sex. HIV transmission from international migrant workers who have returned and are HIV positive has been mostly restricted to their spouses, although the degree of spousal transmission and couples in which one person is HIV positive and putting the other at high risk has not been evaluated methodically in Bangladesh. Given the large numbers of people on the move, ensuring the rights and access to HIV prevention, treatment and care and support services for the wives of these migrant workers is a crucial component of an effective regional response to HIV. Therefore, it is important to analyze the knowledge, attitude and practice level of these groups of women. Therefore, the present study aims to analyze the knowledge, attitude and practice of wives of the emigrant workers of Bangladesh and factors that may influence their health decisions. Seven
(7) districts from seven (7) administrative divisions of the country were selected purposively as the study area. The study areas include Tangail (Dhaka division), Comilla (Chittagong division), Moulovibazar (Sylhet division), Meherpur (Khulna division), Dinajpur (Rangpur division), Barisal (Barisal division) and Serajganj (Rajshahi division). Women at their reproductive age from selected households of these seven districts, whose heads are/used to be a migrant worker, was the study subject. Respondents also include health service professionals from the study areas. The general knowledge/ perception, attitudes, and practices were assessed through qualitative study method while a quantitative socio economic survey was also done to attain information related to respondents’ age, education, income and expenditure. The tools include in-depth interview (II), focus group discussion (FGD) and key informant interview (KII). In total,
70 KIIs and 7 FGDs with 63 women participants were done while a short survey of the socioeconomic status of all 133 women was conducted through structured questionnaire.
Teenage pregnancy is pregnancy in human females under the age of 20. A pregnancy can take place after the start of puberty before the first menstrual period but usually occurs after the onset. In well-nourished girls, menarche usually takes place around the age of 12 or 13.
Pregnant teenagers face many of the same obstetrics issues as other women. There are, however, additional medical concerns for mothers aged below 15 years of age. For mothers aged 15–19, risks are associated more with socioeconomic factors than with the biological effects of age. Risks of low birth weight, premature labor, anemia, and pre-eclampsia are connected to the biological age itself, as it was observed in teen births even after controlling for other risk factors (such as utilization of antenatal care etc.).
In developed countries, teenage pregnancies are often associated with social issues, including lower educational levels, higher rates of poverty, and other poorer life outcomes in children of teenage mothers. Teenage pregnancy in developed countries is usually outside of marriage, and carries a social stigma in many communities and cultures. By contrast, teenage parents in developing countries are often married, and their pregnancies welcomed by family and society. However, in these societies, early pregnancy may combine with malnutrition and poor health care to cause medical problems.
Teenage pregnancies appear to be preventable by comprehensive sex education and access to birth control. Abstinence-only sex education does not appear to be effective.
Through generations teenage pregnancy has converted into one of the Philippines' most challenging social issues. Becoming pregnant at such an early age brings multiple obstacles such as, lower expectations of finishing high school, not attending college, and less success in the job industry. Not only do these obstacles regard the teenage parents but harm their unborn child in academic and health issues, for instance tending to score less optimally on assessments of cognitive development and academic achievement, and also tend to exhibit more problem behaviors than other children. Other than social dilemmas there are certain health issues that are more likely to appear in a teenage pregnancy for example the baby is more likely to have a low birth weight, to be born before term, and have developmental delay.
The issue we focus on is premarital sex among teenager that results to teenage pregnancy. Further explanation will be discussed in the parts to follow.
Psychological Challenges Facing Women Living With HIV/AIDS: A Case of Nakuru ...paperpublications3
Abstract: HIV/AIDS is a critical concern in Kenya, ever since the HIV/AIDS virus was identified, many campaigns have been put in place, and people have been made aware of the various effects of the virus. However, much emphasis has been on the physiological effects, but little concern has been given to the major psychological effects the virus can have on individuals who contract the HIV virus. There is strong evidence that people who have been diagnosed with HIV are more likely to develop a mental health or psychological problem such as anxiety or depression. The purpose of this study was to explore and describe the psychological challenges faced by people who are living with HIV/AIDS in Nakuru municipality and how they cope with those challenges. A sample of 248 out of a target population of 700 was used. The instruments used to collect data were questionnaires and interviews schedules. The data was analyzed using descriptive statistics. The findings of the study revealed that most of the women living with HIV/AIDS suffer stigma, anger, trauma, denial and fear of disclosure. The disparities that existed among the singles and the married revealed that one’s marital status determined the extent to which one was stigmatized, angered, traumatized, and experienced denial or fear of disclosure. These findings have implications for developing interventions to support the psychological needs of people living with HIV, to accurately reflect the views and needs of the target users.
Knowledge, Attitude and Practice of Migrant Workers’ Wives on HIVAIDS in Bang...Md. Tarek Hossain
In Bangladesh, the targets under MDG-6 are to halt the spread of HIV/AIDS, malaria and other diseases by 2015 and reverse the spread of the diseases. The increasing trend of HIV/AIDS positively indicates that country is on the brink of a nationwide crisis. Mobility is a key structural factor that has been linked to increased HIV incidence and vulnerability globally. Bangladeshi migrant workers suffer problems found among other internal and international migrant groups including socioeconomic and power inequalities, limited social capital, loneliness, and coping with different cultural norms relating to sex. HIV transmission from international migrant workers who have returned and are HIV positive has been mostly restricted to their spouses, although the degree of spousal transmission and couples in which one person is HIV positive and putting the other at high risk has not been evaluated methodically in Bangladesh. Given the large numbers of people on the move, ensuring the rights and access to HIV prevention, treatment and care and support services for the wives of these migrant workers is a crucial component of an effective regional response to HIV. Therefore, it is important to analyze the knowledge, attitude and practice level of these groups of women. Therefore, the present study aims to analyze the knowledge, attitude and practice of wives of the emigrant workers of Bangladesh and factors that may influence their health decisions. Seven
(7) districts from seven (7) administrative divisions of the country were selected purposively as the study area. The study areas include Tangail (Dhaka division), Comilla (Chittagong division), Moulovibazar (Sylhet division), Meherpur (Khulna division), Dinajpur (Rangpur division), Barisal (Barisal division) and Serajganj (Rajshahi division). Women at their reproductive age from selected households of these seven districts, whose heads are/used to be a migrant worker, was the study subject. Respondents also include health service professionals from the study areas. The general knowledge/ perception, attitudes, and practices were assessed through qualitative study method while a quantitative socio economic survey was also done to attain information related to respondents’ age, education, income and expenditure. The tools include in-depth interview (II), focus group discussion (FGD) and key informant interview (KII). In total,
70 KIIs and 7 FGDs with 63 women participants were done while a short survey of the socioeconomic status of all 133 women was conducted through structured questionnaire.
Teenage pregnancy is pregnancy in human females under the age of 20. A pregnancy can take place after the start of puberty before the first menstrual period but usually occurs after the onset. In well-nourished girls, menarche usually takes place around the age of 12 or 13.
Pregnant teenagers face many of the same obstetrics issues as other women. There are, however, additional medical concerns for mothers aged below 15 years of age. For mothers aged 15–19, risks are associated more with socioeconomic factors than with the biological effects of age. Risks of low birth weight, premature labor, anemia, and pre-eclampsia are connected to the biological age itself, as it was observed in teen births even after controlling for other risk factors (such as utilization of antenatal care etc.).
In developed countries, teenage pregnancies are often associated with social issues, including lower educational levels, higher rates of poverty, and other poorer life outcomes in children of teenage mothers. Teenage pregnancy in developed countries is usually outside of marriage, and carries a social stigma in many communities and cultures. By contrast, teenage parents in developing countries are often married, and their pregnancies welcomed by family and society. However, in these societies, early pregnancy may combine with malnutrition and poor health care to cause medical problems.
Teenage pregnancies appear to be preventable by comprehensive sex education and access to birth control. Abstinence-only sex education does not appear to be effective.
Through generations teenage pregnancy has converted into one of the Philippines' most challenging social issues. Becoming pregnant at such an early age brings multiple obstacles such as, lower expectations of finishing high school, not attending college, and less success in the job industry. Not only do these obstacles regard the teenage parents but harm their unborn child in academic and health issues, for instance tending to score less optimally on assessments of cognitive development and academic achievement, and also tend to exhibit more problem behaviors than other children. Other than social dilemmas there are certain health issues that are more likely to appear in a teenage pregnancy for example the baby is more likely to have a low birth weight, to be born before term, and have developmental delay.
The issue we focus on is premarital sex among teenager that results to teenage pregnancy. Further explanation will be discussed in the parts to follow.
Madridge Journal of AIDS (ISSN: 2638-1958); Nigeria is a heavily populated country in West Africa and highly enriched with natural resources, a country that is very much encoded with high cultural values and appears to severely constrain women to attain their potentials.
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
For an appropriate health intervention to be implemented in a community, it is required to define the health needs of the community.
Communities vary by way of their geographic location, occupation, ethnicity, housing conditions, beliefs, festivals, oracle or religious beliefs, topography, etc. that in one way or another influences their health. These communal traits may also in turn influence their attitude towards traditional or modern health care. Meaning, every community provides its own unique/ special health challenges to the health authority and one cannot be used completely for the other. To obtain this important data, a community diagnosis is done to comprehensively assess the health state of the community in relation to the social, physical and biological environment. This qualitative and quantitative description of the health of the citizens of the community is important to ascertain the characteristics that put members at higher risk or lower risk or may actually be protective.
Ankyease community was coined from the local name of the Guava tree. That is “Atia” = guava tree and “ase” = under (Twi language). Put together, we have under the Guava tree.
Community diagnosis of Ankyease was done and the observation summarized in this presentation. A descriptive/ cross-sectional study was done within the period of July and August 2017. A structured questionnaire was used but a visit to each of the 50 household (sample size), involved an informal focus-group/ qualitative interview to buttress some of the responses given by the respondents. A visual observation of the community was also done to obtain the housing profile and other structures of interest.
Most of the inhabitants of the community were of Ewe background and mostly below the age of 18 years. On the average, most of the members of each household or occupants were below the 5 in number.
The usual high prevalence of malaria was observed with an increase in the incidence of teenage pregnancy. There were no toilet facilities, schools, health centres as well as any established local or traditional industries within the community. They however produce most of their staple foods themselves since most of them are farmers. Others were also involved in the trading of firewood with the nearby communities for money, fish or any other good that may be mutually acceptable to both parties.
Assessing the Quality of Life of HIV/AIDS Patients attending Anti-Retroviral ...RosyPurakayastha
The study was an observational, cross-sectional study, which was conducted from May to July 2013, in the outpatient department of the Anti-Retroviral Therapy (ART) Clinic at MGM Medical College and Hospital, Kamothe, which is a tertiary care Hospital in Navi Mumbai. The study aimed to assess the Quality of Life (QOL) of patients living with HIV and AIDS using WHOQOL-HIV BREF Scale.
Lady health workers' perceptions towards tuberculosis and its determinants at...Zubia Qureshi
Background: Lady Health Workers (LHWs), performing in Tuberculosis control programs have direct access in the communities. This study was designed to improve the TB status in Sindh province by improving the knowledge and practices of LHWs. Objective: To assess the TB related knowledge, attitude and practices among LHWs at tehsil Latifabad, district Hyderabad, Sindh. Method: A mixed method Cross-sectional study was done on universally selected 384 LHWs from Latifabad. Three focus group discussions were conducted with eight participants for each group. A pre-tested structured questionnaire and eld guidelines were used for data collection. Analysis was done on SPSS software by calculating frequencies, percentages, mean and median. While for inferential analysis chi square, t-test and Mann Whitney U tests were used. For FGDs, content analysis method was used. Results: Sufcient knowledge was found in about half 193(50.3%) of the participants. The overall attitude and practices of most of the LHWs 214(55.7%) and 205 (53.4%) respectively was not good. A signicant difference was found between LHWs knowledge score of those who had insufcient (28.08 ± 3.0) and sufcient knowledge (28.08 ± 3.1) with p-value <0.001. Also good attitude (47.74±2.8) and practices (51.45±3.8) of LHWs differed signicantly from those who did not have good attitude (36.09±4.8), and practices (40.44±3.3) with p-value <0.001. The insufcient knowledge was associated with unsafe practices. Tuberculosis related stigma was found in the community, people do not want to disclose their disease. Conclusion: Overall knowledge, attitude and practices about TB were not satisfactory among LHWs of Latifabad. An educational intervention is recommended for LHWs. Key words: Community health workers, infectious disease, knowledge, attitude, practices, developing country
Madridge Journal of AIDS (ISSN: 2638-1958); Nigeria is a heavily populated country in West Africa and highly enriched with natural resources, a country that is very much encoded with high cultural values and appears to severely constrain women to attain their potentials.
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
For an appropriate health intervention to be implemented in a community, it is required to define the health needs of the community.
Communities vary by way of their geographic location, occupation, ethnicity, housing conditions, beliefs, festivals, oracle or religious beliefs, topography, etc. that in one way or another influences their health. These communal traits may also in turn influence their attitude towards traditional or modern health care. Meaning, every community provides its own unique/ special health challenges to the health authority and one cannot be used completely for the other. To obtain this important data, a community diagnosis is done to comprehensively assess the health state of the community in relation to the social, physical and biological environment. This qualitative and quantitative description of the health of the citizens of the community is important to ascertain the characteristics that put members at higher risk or lower risk or may actually be protective.
Ankyease community was coined from the local name of the Guava tree. That is “Atia” = guava tree and “ase” = under (Twi language). Put together, we have under the Guava tree.
Community diagnosis of Ankyease was done and the observation summarized in this presentation. A descriptive/ cross-sectional study was done within the period of July and August 2017. A structured questionnaire was used but a visit to each of the 50 household (sample size), involved an informal focus-group/ qualitative interview to buttress some of the responses given by the respondents. A visual observation of the community was also done to obtain the housing profile and other structures of interest.
Most of the inhabitants of the community were of Ewe background and mostly below the age of 18 years. On the average, most of the members of each household or occupants were below the 5 in number.
The usual high prevalence of malaria was observed with an increase in the incidence of teenage pregnancy. There were no toilet facilities, schools, health centres as well as any established local or traditional industries within the community. They however produce most of their staple foods themselves since most of them are farmers. Others were also involved in the trading of firewood with the nearby communities for money, fish or any other good that may be mutually acceptable to both parties.
Assessing the Quality of Life of HIV/AIDS Patients attending Anti-Retroviral ...RosyPurakayastha
The study was an observational, cross-sectional study, which was conducted from May to July 2013, in the outpatient department of the Anti-Retroviral Therapy (ART) Clinic at MGM Medical College and Hospital, Kamothe, which is a tertiary care Hospital in Navi Mumbai. The study aimed to assess the Quality of Life (QOL) of patients living with HIV and AIDS using WHOQOL-HIV BREF Scale.
Lady health workers' perceptions towards tuberculosis and its determinants at...Zubia Qureshi
Background: Lady Health Workers (LHWs), performing in Tuberculosis control programs have direct access in the communities. This study was designed to improve the TB status in Sindh province by improving the knowledge and practices of LHWs. Objective: To assess the TB related knowledge, attitude and practices among LHWs at tehsil Latifabad, district Hyderabad, Sindh. Method: A mixed method Cross-sectional study was done on universally selected 384 LHWs from Latifabad. Three focus group discussions were conducted with eight participants for each group. A pre-tested structured questionnaire and eld guidelines were used for data collection. Analysis was done on SPSS software by calculating frequencies, percentages, mean and median. While for inferential analysis chi square, t-test and Mann Whitney U tests were used. For FGDs, content analysis method was used. Results: Sufcient knowledge was found in about half 193(50.3%) of the participants. The overall attitude and practices of most of the LHWs 214(55.7%) and 205 (53.4%) respectively was not good. A signicant difference was found between LHWs knowledge score of those who had insufcient (28.08 ± 3.0) and sufcient knowledge (28.08 ± 3.1) with p-value <0.001. Also good attitude (47.74±2.8) and practices (51.45±3.8) of LHWs differed signicantly from those who did not have good attitude (36.09±4.8), and practices (40.44±3.3) with p-value <0.001. The insufcient knowledge was associated with unsafe practices. Tuberculosis related stigma was found in the community, people do not want to disclose their disease. Conclusion: Overall knowledge, attitude and practices about TB were not satisfactory among LHWs of Latifabad. An educational intervention is recommended for LHWs. Key words: Community health workers, infectious disease, knowledge, attitude, practices, developing country
Gender,HIV/AIDs Transmission: Socio Economic And Socio Cultural Impact in Tan...Sandeep Singh
The research was done in Tanzania and presented at Banaras Hindu University International Conference who also published Complete article in "EDUCATION FOR THE NEW MILLENNIUM" by Nutan Publication Chapter 6 ISBN: 978 81 927002 1 2
Socio-Economic Effect of HIV/AIDS on Orphans and Vulnerable Children in Nyami...paperpublications3
Since the first case of HIV/AIDS was reported in Kenya in 1984 the numbers of those infected have risen and many people have since died or are living with the HIV/AIDS since the epidemic started in 1980s in the drug injecting people and the homosexuals. These deaths have resulted in Orphans and Vulnerable Children (OVC). This was a descriptive cross-sectional study, with one of the objective of finding out the socio-economic effect of HIV/AIDS on Orphans and Vulnerable Children in Nyamira district. A sample of 384 people participated in the study. The people were through simple random selected from Bonyegwe sublocation of Nyamusi division. Semi-structured interview schedules were used in data collection from the households. To remove ambiguity, the research tools were pre-tested to both HIV/AIDS organizations and householders not in the sample population but with similar characteristics. The research tools were refined and used on the actual sample population. Text, graphs, figures and tables were used in data presentation. The study indicates that those people who had not attained any level of formal education were (17%). The study revealed that householders (40%) had higher proportion of secondary education as compared with members of HIV/AIDS organizations (37%). Most of the members of HIV/AIDS organizations (89%) indicated that farming is their main source of income and a cushion for food security as compared with householders (63%). The ministry of health should strengthen provision of PMTCT services at the ANC clinic so that we prevent more cases of orphans and vulnerable children. The study suggests that in future all mothers who test positive for HIV virus should be put on treatment in order to reduce defaulters at the same time reach sustainable coverage in the provision of HIV/AIDS services to the orphans and vulnerable children in the society.
Achievements and Implications of HIV Prevention Programme among Female Sex wo...QUESTJOURNAL
Background: Plateau State, Nigeria with HIV prevalence rate of 7.7% as at 2010 had among the highest HIV and syphilis levels in Nigeria, earning itself a reputation of being one of the 12 + 1 states contributing the highest HIV prevalence in Nigeria and described as “hot zone” of HIV infections. Factors responsible for this were not unrelated to the high-risk activities of Female Sex Workers (FSWs). This paper therefore presents achievements and implications HIV prevention among FSWs in Plateau State, Nigeria Methods: This project was an intervention effort focused on delivering evidence-based HIV prevention activities among FSWs in 3 local government areas within the State. The estimated target population for the study was 460 and this project used the minimum prevention package intervention (MPPI). Peer educators were selected and trained among the FSWs to reach out to their peers using cohort session. Data were documented using various monitoring and evaluation tools, entered on the District Health Information Software version 2 and analyzed using Microsoft Excel. Results: A total of 68 community dialogues were held with 1,466 influencers participating in the process. In addition, 601 peers were registered, while 18 persons benefitted from 27 income generation activities aimed at capacity building for FSWs. A total of 642 persons were counseled, tested and shown their results, with 15 persons tested positive resulting in HIV prevalence of 2.3%. Although 10,560 condoms were distributed however, these numbers was below the number of condoms required during the intervention. Conclusion: This intervention was a success. However, more needs to be done with regards to condom distribution and supply among FSWs since there is a crucial role for FSWs to play in the plot of taking the HIV prevalence of Plateau State even further down
NATIONAL AIDS CONTROL PROGRAM
1992- - NACP 1 launched to show down the spread of HIV infection
- national AIDS control board constituted
- NACO setup
1999- - NACP 2 begins focusing on behaviour change , increased decentralization and NGO involvement.
- state AIDS control societies developed .
2002- - national AIDS control policy adopted.
- national blood policy adopted.
2004- - antiretroviral treatment initiated .
2006- - national council on AIDS constituted under chairmanship of prime minister.
- national policy on paediatric ART formulated.
2007- - NACP 3 launched for years (2007-2012)
2012- - NACP 4 launched for next 5 years
Achievements and Implications of HIV Prevention Programme among Men who have ...inventionjournals
Background: Targeted interventions among men who have sex with men (MSM) could have a considerable effect in slowing the spread of HIV epidemic. This paper therefore presents the achievements and implications of HIV prevention programme among MSM in Bayelsa State, Nigeria Methods: The project was an intervention study carried out among MSM in Bayelsa State, Nigeria. The calculated sample size for this project was 155 MSM and snowball sampling technique was used for their selection. The project adopted the minimum prevention package intervention (MPPI) and data collected with output indicators were entered into the District Health Information Software (DHIS) 2, exported into Microsoft Excel and analysed using same. Results: The overall target population reached during this intervention was 381 MSM given a target reached of 245.8%. A total of 35 community dialogues were held within the duration of the intervention and 49 influencers participated. The number of peers registered during the intervention were 203 and out of the total number of condom (20582) required for this intervention, only 15235 (74.0%) were distributed. A total of 185 (91.1%) of the registered peers were reached with all the three stages of MPPI and 381 (245.8%) were reached with HCT. Among these, 17 (4.5%) were tested positive to HIV. Conclusion: This study showed an HIV prevalence of 4.5% among men who have sex with men in Bayelsa state at the time of the intervention. Given this high HIV prevalence, it is vital to enact more targeted and evidencebased prevention programs for these men.
RESEARCH ARTICLEWill Combined Prevention Eliminate Racia.docxronak56
RESEARCH ARTICLE
Will "Combined Prevention" Eliminate Racial/
Ethnic Disparities in HIV Infection among
Persons Who Inject Drugs in New York City?
Don Des Jarlais1*, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1,
Holly Hagan2, Hannah Cooper3, Aimee Campbell4, Susan Tross4, David Perlman1
1 The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York,
New York, United States of America, 2 College of Nursing, New York University, New York, New York,
United States of America, 3 Rollins School of Public Health at Emory University, Atlanta, Georgia, United
States of America, 4 Department of Psychiatry, Columbia University, New York, New York, United States of
America
* [email protected]
Abstract
It has not been determined whether implementation of combined prevention programming
for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine
racial/ethnic disparities in New York City among persons who inject drugs after implementa-
tion of the New York City Condom Social Marketing Program in 2007. Quantitative inter-
views and HIV testing were conducted among persons who inject drugs entering Mount
Sinai Beth Israel drug treatment (2007–2014). 703 persons who inject drugs who began in-
jecting after implementation of large-scale syringe exchange were included in the analyses.
Factors independently associated with being HIV seropositive were identified and a pub-
lished model was used to estimate HIV infections due to sexual transmission. Overall HIV
prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted
odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI
1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced
HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6–
0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Ra-
cial/ethnic disparities among persons who inject drugs were not significantly different from
previous disparities. Reducing these persistent disparities may require new interventions
(treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Introduction
Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID)
have been observed in many countries, with ethnic minority group members [1] and females
[2] typically having higher HIV prevalence. There are effective interventions to reduce HIV
transmission among PWID, and the logic of “combined” prevention programming is that
PLOS ONE | DOI:10.1371/journal.pone.0126180 May 12, 2015 1 / 11
OPEN ACCESS
Citation: Des Jarlais D, Arasteh K, McKnight C,
Feelemyer J, Hagan H, Cooper H, et al. (2015) Will
"Combined Prevention" Eliminate Racial/Ethnic
Disparities in HIV Infection among Persons Who
Inject Drugs in New York City? PLoS ONE 10(5):
e0126180. doi:10.1371/journal.pone.0126 ...
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Mangi JE Austin Publishing Group
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criminalize HIV transmission and exposure with the exception of
intentional transmission. In response to public outcry over the need
to devise ways to manage the epidemic, the Tanzanian government
passed a law to prevent and control the spread of HIV and AIDS [18].
Among other things, the law sets up criminal penalties for different
actions by individuals and institutions that if violated would amount
to deliberate spread of HIV [18].
Previous studies conducted in Tanzania and elsewhere have
documented concerns about the potential risks of HIV spread due
to increased availability of ART [19-21]. There has also been some
evidence of the legal sanctions to curb the spread of the epidemic
[18,15]. Despite the existence of a law describing intentional spread
of HIV in Tanzania, there has been no attempt to systematically
investigate the social definitions of deliberate spread of HIV
through empirical studies. Thus, little is known about different
conceptualizations of deliberate spread of HIV at the community
level in Tanzania, and this study sought to feel this knowledge gap.
Methods
Setting
We conducted the study between January and March 2008 in
Kahe ward, Kilimanjaro region of Tanzania, located about 30 km
south of Moshi town. This is a rural area inhabited by several ethnic
groups including the Kahe, Pare, Chagga, Sambaa, Maasai and
many other ethnic groups from within and beyond the country. The
nearest HIV/AIDS care and treatment clinic is located at the regional
headquarters in Moshi town. The study area has been described in
detail elsewhere [22].
Study design
This was a cross sectional explorative qualitative study based on
In-Depth Interviews (IDIs) with persons living with HIV and AIDS
who were already on ART, and with local community-based health
workers.
Recruitment of participants and data collection
Participants were recruited with the assistance of local staff
working with a local Non- Governmental Organization (NGO)
providing care and support to people living with HIV and AIDS. The
first author and local project staff approached all individuals receiving
ART to describe the study and extend an invitation to participate.
We also interviewed three female health workers from the NGO
responsible for providing care and support to persons with HIV and
AIDS in the study area. All IDIs were conducted in Kiswahili mainly
at participants’ homes or other locations of their own choice. IDIs
used interview guide and questions covered topics related to personal
experiences with illness and drug use, reproductive intentions, access
to drugs, prevention of infection and opinion about ways to control
deliberate spread of HIV/AIDS. IDIs took between 70-100 minutes
and were audio recorded. Full transcripts were translated into English
and cross checked by the first author.
The research project was approved by the Tanzania‘s Ministry of
Health and Social Welfare and the Norwegian Committee for Medical
Research Ethics. Participation in the study was preceded by a written
consent from each participant.
Analysis
Our study employed an inductive approach to allow for data
collection and analysis to proceed concurrently [23]. This allowed
us to continuously describe, compare, contrast and interpret
participants’ experiences as data collection progressed. We read the
interviews several times to obtain an overall understanding and gain
insights into the meaning of text. All expressions and descriptions
related to intentional spread of HIV that emerged throughout
the data collection were condensed into categories. We organized
categories of text into themes that focused on: perception about their
health and the body, reproductive intentions, status disclosure and
formal control of deliberate transmission of HIV.
Findings
Study participants
The study involved 22 (Female=16, Male=6) people on ART and
3 community based health workers. More than half (11) of persons
on ART were single (never married), 5 were married or living with
partner, and 6 were either widowed or deserted by their sexual
partners. All participants had received treatment for a considerable
period-ranging from 7 months to 3 years. The participants’ age
ranged from 26 to 53 years. Some (n=3) of the participants who
initially agreed to participate declined to take part in the study.
The body, reproductive intentions and deliberate HIV
transmission
Participants described several scenarios and stories about
people accused of deliberately spreading the HIV through trickery,
transactional sex and re-marrying after losing their partners to HIV/
AIDS. One of the male interviewees said that people living with HIV
may need someone to live with in order to get support in doing some
works such as assist in doing household activities due to recurrent
illness.
Generally, health workers appeared to be opposed to the idea of
People Living with HIV (PLHIV) getting married or re-married as
this was thought to constitute deliberate attempts to get other sexual
partner infected.
You will find that somebody knows that they are already (HIV)
infected, yet s/he is busy looking for someone to marry. Now how
would you describe this person? Is it not looking for someone he/she
should die with? (Health worker).
Health workers considered marriage or any other form of sexual
relationship among HIV positive persons as endangering the lives
of both partners and a child. However many said they were too
preoccupied with managing their illness to be able to care for the
children. When asked about the possibility of infected persons having
children and establishing family while preventing further infection,
one health worker responded;
Yes, we know that there are possibilities of preventing passing
the virus to the child or sexual partner, but given the life difficulties
already facing persons with HIV, raising a child is like adding a
new problem to infected persons. You saw the conditions they live
in… most of them are struggling to get their daily meal…Yet we are
already having a good number of children orphaned by HIV/AIDS…
attempting to have children could be as good as spreading the disease
(Health worker).
3. Austin J HIV/AIDS Res 4(1): id1033 (2017) - Page - 03
Mangi JE Austin Publishing Group
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A common theme emerging from several interviews related
to the existence of some form of transactional sexual practices.
Economically powerful persons on ART were singled out as the main
perpetrators of this form of deliberate spread of HIV. Although many
cited examples of people from nearby urban centres who frequently
visited the area for business or farming, they also insisted that some
HIV positive men in the study area were known to spend money to
buy sex. Some still emphasized the role of urban dwellers in spreading
HIV in rural areas. The least mentioned behaviour described to
constitute deliberate transmission of HIV like piercing a hole in a
condom either during or before sexual intercourse to allow the virus
to pass to the sexual partner.
Status disclosure
Both health workers and people on ART seemed to agree that
HIV/AIDS was a growing problem in the village. Participants reported
that there were many HIV infected people in the study area. They
described those who came out and disclosed their status to partners
or relatives as a small fraction of all infected people. Most participants
cited failure to disclose HIV status to sexual partners as a major driver
of transmission of HIV and leads to engaging in unprotected sexual
relationships with uninfected individuals. Furthermore, people on
ART acknowledged that more people were disclosing HIV status,
but also pointed out a number of difficulties. Fear of negative family
response to disclosure, marital conflict, men’s reluctance to disclose,
women’s fear of negative consequences from spouses and elements of
stigma were the main problems mentioned by participants.
If it were not for these drugs, I would be a dead man by now, if
you saw me a year ago, I did not look as I do now …was weak, very
sick and bedridden. But now I can say that am doing fine because the
frequency of sickness is much less now. I am stronger and my body is
almost back to what I can call normal (male participant).
Controlling deliberate transmission of HIV and AIDS
Although few were aware of the new HIV prevention law, they
suggested some form of government intervention to address the
problem. Many proposed that the law should punish culprits because
it is morally unacceptable to spread the disease. Some said that since
there is evidence of people in the area allegedly known to deliberately
infect others, some kind of action needed to be taken. Despite some
reservations, there seemed to be a general consensus that the law to
control HIV/AIDS might be good, but should have come earlier when
HIV/AIDS was not as widespread as it had become.
Discussion
Results from this study have demonstrated that a number of sexual
behaviours may be perceived as potential deliberate transmission of
HIV/AIDS by local people on ART and health workers. The findings
indicate that most participants support the establishment of some
form of legal or other mechanisms to control intentional spread of
HIV/AIDS. However, there are serious concerns about the practical
applicability of legal sanctions to control sexual behaviours. Although
there is a national law (passed in 2008) that defines various offences
and remedies for persons and institutions proven to intentionally
spread HIV, few participants were aware of it.
The results from our study suggest that expressing sexuality is
one of the many routine activities that persons on HIV treatment
wish to engage in. However, this choice is constrained by realities
surrounding risks of HIV transmission. Deliberate spread of HIV
could be understood as an attempt by HIV positive persons to resist
the sick role that is embodied in this chronic illness. The embodiment
of ART consequently forms a category of identity that is reflexively
associated with deliberate spread of the disease in the community. In
rural communities where ART is not fully integrated into the local
discourse on treatment and healing, associating some behaviours
of ARV users with deliberate spread of HIV may pave the way for
misinformation and create new forms of stigma [20,22,24].
An understanding of deliberate spread of HIV must also take into
account the gender dynamics and HIV status disclosure. Our findings
suggest that some HIV positive persons had experienced negative
consequences following status disclosure. Due to biological and social
cultural reasons, women have tended to bear a significant share of the
AIDS burden and they are usually the first to be diagnosed with HIV
and therefore be accused of bringing the virus into the family [25,26].
Therefore, it is highly likely that accusations of deliberate spread of
HIV will disproportionately affect women. However, this stands in
contrast to the evidence showing that women are often excused from
blame/accusations due to their poverty and powerlessness [20].
While women in particular have been portrayed as victims of
harmful male sexual behaviours [20], the current study suggests that
women constituted both perpetrators and victims. This appears to be
a break from the long established beliefs that often have portrayed
men as the main perpetrators of risk sexual behaviours and women
as the victims. Findings also indicate that almost every participant
was blaming someone else for deliberate spread of HIV. This suggests
that the underlying conditions and structures might account for
vulnerability to and/or motivation for deliberate spread of HIV/
AIDS. Vulnerability described by some participants is similar to what
Farmer [27] has described as structural violence which tends to place
blame on disease sufferers while neglecting the underlying causes.
Application of formal sanctions proposed to control HIV spread may
be targeting individual shortcomings instead of addressing conditions
that structure people’s (risk) behaviours [27].
Depiction of some ART users as transmitters of HIV may
consequently affect community perspectives about care and support
of HIV infected persons. As a result, HIV positive persons may
lose legitimate claim to sick role and put them in ambivalent illness
position before other members of community. Evidence shows that
any ambivalence or deviations in socially appropriate presentation of
sick role may expose persons on ART to accusations about deliberate
spread of HIV and other risk sexual behaviours and assigning
stigmatizing bodily identities as described in local illness discourse
[22,19]. It has also been documented that accusations by other
members of community can make ill persons be seen as faking their
illness and thus be denied ‘permission to get ill’ [28]. Contrary to [28]
findings, despite existing medical knowledge about the therapeutic
benefits of ART, persons on HIV treatment in the current study
appeared to have been denied ‘permission to return to normalcy and
express their sexuality’.
Previous evidence shows that laws criminalizing deliberate
spread of HIV may increase stigma and violate the rights of persons
living with HIV to life, health services and treatment [16]. The HIV
4. Austin J HIV/AIDS Res 4(1): id1033 (2017) - Page - 04
Mangi JE Austin Publishing Group
Submit your Manuscript | www.austinpublishinggroup.com
prevention and Control Act recognizes government responsibility to
ensure persons living with HIV and AIDS are accorded with basic
health services. It also places responsibility on “persons who have
knowledge of being infected to inform their spouse/sexual partner
and to take reasonable measures and precautions to prevent the
transmission of HIV to others” [18]. This also raises legal issues of
whether HIV positive persons have a legal duty to disclose their HIV
status before engaging in sexual activities that can lead to transmission
of the virus [16].
However, the views presented here should be limited to persons
on HIV treatment in the study setting. Interviews with health workers
acted as a triangulation strategy to enhance reliability of findings. The
fact that the HIV and AIDS prevention and control Act had not been
operational when the study was carried out might have affected ability
of participants to relate and reflect fully on the contents therein, thus
a potential for interpretive bias. However since our study did not aim
to perform a critical legal analysis of the Act, we managed to gather
reflections on social definitions and suggestions on ways to control
deliberate transmission of HIV.
Conclusion
The fact that issues related to deliberate transmission of HIV
gain prominence in the context of increased ART availability could
be a mark of new illness trajectory among HIV positive persons.
There is little doubt that ARVs have made a significant impact
on the lives of people living with HIV/AIDS. However, there are
many issues concerning their effectiveness and impact that are still
unresolved. People on ART face personal and structural challenges
that affect their bodies, sexual active lives and social wellbeing. While
some may wish to exercise their right to enjoy sexual lives, there is
constant recognition of the risks involved in transmitting the virus
to uninfected people. What constitutes deliberate HIV transmission
is a function of local processes of labeling and may vary depending
on persons and contexts. Likewise, ways of dealing with deliberate
spread of HIV appear to reflect the socio-economic difficulties and
specific individual situations of people living with HIV.
In the quest to address deliberate transmission of HIV health
education efforts, need to avoid blaming the victims and invoking
fear of criminal penalties. Instead, efforts should emphasize positive
prevention, care, status disclosure and increased access to treatment
and support services.
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