Helen Epstein
Author of the new book The Invisible Cure: Africa, the West and the Fight against AIDS (Farrar, Straus & Giroux May 2007.) She is also a frequent contributor to The New York Review of Books, The New York Times Magazine and other publications. June 6, 2007
This document provides an overview of the HIV/AIDS situation among men who have sex with men (MSM) in the Middle East and North Africa region. It finds that HIV prevalence among MSM ranges from 3-9% in studies from several countries. However, data is still limited overall in the region. Key challenges include criminalization of homosexuality, social stigma, insufficient funding, and lack of targeted prevention programs for at-risk groups like MSM. Some successes highlighted are increased treatment access in some countries and advocacy efforts by civil society organizations. The 2011 UN Political Declaration on HIV/AIDS set goals to reduce new infections among key populations by 50% by 2015.
Gender inequality poses significant barriers to women's ability to prevent and manage HIV infection. Women face higher biological and social vulnerability to HIV due to unequal power dynamics and lack of control over sexual decision making. Violence against women and girls is widespread in many parts of the world, increasing vulnerability. Fear of violence also prevents women from accessing HIV testing, treatment and support services. Addressing gender inequality is critical to effectively respond to the HIV/AIDS epidemic.
Dr. Henry Mosley of the Bloomberg School of Public Health at Johns Hopkins University discusses the global unmet need for contraception, the reasons behind the unmet need, and ways the problem can be addressed.
The Big Picture: Trends In Protective Behaviour Among Young WomenIDS
1) The document analyzes trends in protective sexual behavior among young women in Africa based on Demographic and Health Survey data from 18 countries.
2) It finds that condom use among single, sexually active young women has increased substantially over time, with the median rising from 18.5% in 1997 to 31.2% in 2003.
3) Dual use of condoms for pregnancy and HIV prevention is around 58.5% on average, while consistent use among those using condoms is 81.3%, with some differences between urban/rural and education levels.
HIV Self-Testing in the context of South AfricaCarmen Figueroa
This document discusses HIV self-testing in South Africa. It notes that while South Africa's HIV/AIDS program is doing well overall, movement towards improving testing rates, particularly among men and youth, has been slow. HIV self-testing has the potential to help increase testing among these groups but its introduction in South Africa has also been slow due to various ethical, regulatory, and policy issues. Now that guidelines have been developed, self-testing can be considered as a way to augment South Africa's HIV response by improving testing rates among populations that have been under-tested so far.
Understanding the Cancer burden and risk factors.MAK1stABMSC2019
Leocardia Kwagonza. Epidemiologist. Uganda Cancer Society
Presented by Kayiwa Robert.
Makerere University's 1st African Biomedical Scientists' Conference 2nd March 2019 (MAK 1st ABMSC 2019) at Kampala Kolping Hotel
The document discusses three main points:
1) Achieving the Millennium Development Goals requires universal access to reproductive healthcare for women in Africa in order to effectively roll back HIV in the region.
2) The African Women's Protocol commits to achieving this universal access and reproductive rights, including access to information, services, and decision making.
3) For these goals to be realized, all African governments must ratify, domesticate, and report on their implementation of the African Women's Protocol.
This document provides an overview of the HIV/AIDS situation among men who have sex with men (MSM) in the Middle East and North Africa region. It finds that HIV prevalence among MSM ranges from 3-9% in studies from several countries. However, data is still limited overall in the region. Key challenges include criminalization of homosexuality, social stigma, insufficient funding, and lack of targeted prevention programs for at-risk groups like MSM. Some successes highlighted are increased treatment access in some countries and advocacy efforts by civil society organizations. The 2011 UN Political Declaration on HIV/AIDS set goals to reduce new infections among key populations by 50% by 2015.
Gender inequality poses significant barriers to women's ability to prevent and manage HIV infection. Women face higher biological and social vulnerability to HIV due to unequal power dynamics and lack of control over sexual decision making. Violence against women and girls is widespread in many parts of the world, increasing vulnerability. Fear of violence also prevents women from accessing HIV testing, treatment and support services. Addressing gender inequality is critical to effectively respond to the HIV/AIDS epidemic.
Dr. Henry Mosley of the Bloomberg School of Public Health at Johns Hopkins University discusses the global unmet need for contraception, the reasons behind the unmet need, and ways the problem can be addressed.
The Big Picture: Trends In Protective Behaviour Among Young WomenIDS
1) The document analyzes trends in protective sexual behavior among young women in Africa based on Demographic and Health Survey data from 18 countries.
2) It finds that condom use among single, sexually active young women has increased substantially over time, with the median rising from 18.5% in 1997 to 31.2% in 2003.
3) Dual use of condoms for pregnancy and HIV prevention is around 58.5% on average, while consistent use among those using condoms is 81.3%, with some differences between urban/rural and education levels.
HIV Self-Testing in the context of South AfricaCarmen Figueroa
This document discusses HIV self-testing in South Africa. It notes that while South Africa's HIV/AIDS program is doing well overall, movement towards improving testing rates, particularly among men and youth, has been slow. HIV self-testing has the potential to help increase testing among these groups but its introduction in South Africa has also been slow due to various ethical, regulatory, and policy issues. Now that guidelines have been developed, self-testing can be considered as a way to augment South Africa's HIV response by improving testing rates among populations that have been under-tested so far.
Understanding the Cancer burden and risk factors.MAK1stABMSC2019
Leocardia Kwagonza. Epidemiologist. Uganda Cancer Society
Presented by Kayiwa Robert.
Makerere University's 1st African Biomedical Scientists' Conference 2nd March 2019 (MAK 1st ABMSC 2019) at Kampala Kolping Hotel
The document discusses three main points:
1) Achieving the Millennium Development Goals requires universal access to reproductive healthcare for women in Africa in order to effectively roll back HIV in the region.
2) The African Women's Protocol commits to achieving this universal access and reproductive rights, including access to information, services, and decision making.
3) For these goals to be realized, all African governments must ratify, domesticate, and report on their implementation of the African Women's Protocol.
The African Women's Protocol is the continent's commitment to achieving universal access to reproductive health care for women, thereby rolling back HIV in Africa. A requirement to realizing the vision of the African Women's Protocol is that all African governments ratify, domesticate, and transparently report on it. Achieving universal access to reproductive health rights would be a major step towards rolling back HIV in Africa. Parliaments and parliamentarians have a unique role to play in ensuring the success of the African Women's Protocol.
HIV & Education in Young South African WomenRENEWAL-IFPRI
This document summarizes research on HIV prevalence, risk behaviors, and the relationship between education and HIV risk among young South African women. It finds:
1) HIV prevalence is very high among young South African women, reaching over 30% among those aged 20-24.
2) Despite this, young women do not report many "high risk" behaviors like early sexual debut or multiple partners.
3) Higher education is associated with lower HIV rates and riskier behaviors. Women who complete high school are less likely to be infected than those without.
4) Barriers to education for girls include costs, pregnancy, and family responsibilities. Programs providing cash transfers have increased school attendance, especially for girls.
HIV disproportionately affects women, who make up nearly half of those infected globally. Women are more vulnerable to HIV infection due to physical differences and complications during childbirth. In the US, most new HIV cases among women occur in 10 states, with nearly half in New York, Florida, Texas, California, and New Jersey. The largest age group of infected women is 25-34 years old. While HIV cannot be cured, treatment involves combinations of antiretroviral drugs that suppress the virus and stop disease progression.
This document discusses the importance of access to safe water for people living with HIV/AIDS, especially in developing countries. It notes that people with HIV have higher risks of opportunistic infections transmitted through contaminated water, including diarrhea. Lack of access to clean water negatively impacts HIV treatment and outcomes. Interventions to provide clean water can reduce diarrhea and improve health for those with HIV. Overall, the document emphasizes that access to safe water is critical for HIV care, treatment, and management of opportunistic infections in developing countries.
Sub-Saharan Africa remains the region most heavily affected by HIV/AIDS, accounting for two-thirds of people living with HIV and three-quarters of AIDS deaths worldwide in 2007. Heterosexual sex is the main driver of the epidemic, though sex work, injection drug use, and sex between men are also significant factors in some countries. While many epidemics appear stable, HIV prevalence continues to grow in southern Africa and Mozambique's central and southern provinces in particular. Some countries like Zimbabwe, South Africa, and Botswana are seeing declines in HIV prevalence among youth.
This document discusses female genital mutilation/cutting (FGM/C), including terminology, global prevalence, types of procedures, complications, and social dynamics. It defines four main types of FGM/C and lists potential early and late complications. Socio-cultural factors that perpetuate the practice include ensuring marriageability, cleanliness, and controlling women's sexuality. Religious, social, and cultural misperceptions also contribute to the continuation of FGM/C in some communities.
Female Genital Mutilation for Healthcare Professionalsmeducationdotnet
1. My first response would be to ensure the 6-year-old's immediate medical needs are addressed, contact child protective services, and seek guidance on next steps from social work and police regarding her safety and potential legal issues.
2. I would need to examine the child to assess for medical complications of FGM, contact on-call pediatrician for consult, and consider notifying authorities if FGM is identified given its illegality.
3. The child is at risk for infections, bleeding, pain, and long-term sexual and psychological issues from undergoing this traumatic procedure. Her well-being and protection from further harm is
The document provides statistics comparing human development indicators for three countries: the United States (a highly developed country), Tunisia (a medium developed country), and Russia (a BRIC country). It includes data on population, GDP, literacy rates, life expectancy, gender equality indices, poverty levels, and wealth distribution for each country.
Female Genital Mutilation/Cutting: A statistical overview and exploration of ...UNICEF Publications
Over the last two decades, reliable data on FGM/C have been generated through two major sources: the Demographic and Health Surveys (DHS), supported by the United States Agency for International Development (USAID), and the Multiple Indicator Cluster Surveys (MICS), supported by UNICEF. The new UNICEF report reviews all available DHS and MICS data and presents the most comprehensive compilation to date of statistics and analyses on FGM/C. It covers all 29 countries in Africa and the Middle East where FGM/C is concentrated and includes, for the first time, statistics from countries where representative survey data were lacking. The report highlights trends across countries, and it examines differentials in prevalence according to social, economic, demographic and other variables. The findings add crucial evidence that sheds further light on how abandonment of harmful social norms can be accelerated.
This document is an interagency statement from 10 United Nations organizations calling for the elimination of female genital mutilation. It provides an overview of female genital mutilation, including that it is practiced in around 28 countries in Africa and Asia, affecting over 100 million girls and women. It discusses the four types of female genital mutilation and why the practice continues due to social and cultural reasons, despite having no health benefits and causing harm. The statement calls on states, organizations and communities to strengthen efforts to end the practice through advocacy, education and legislation.
Violence against women is widespread in Western Africa, where 67% of women experience some form of violence. Common forms of violence include domestic abuse, marital rape, child marriage, and sexual violence during conflicts. Child marriage is particularly common, with 42% of African girls married before age 18, which forces them to drop out of school and leaves them vulnerable to domestic violence and HIV. While laws have been implemented to address this issue, enforcement remains a challenge at the rural level due to lack of training and social stigma. Educating communities, empowering women, and changing social norms are necessary to fully eliminate violence against women in Western Africa.
Fewer COVID-19 cases among women in Africa: WHO analysisSABC News
Women account for a slightly smaller proportion of COVID-19 infections and deaths compared with men, a preliminary analysis by the World Health Organization (WHO) in 28 African countries shows.
Sub-Saharan Africa faces immense challenges from AIDS including providing healthcare and treatment to those infected, reducing new infections through prevention, and coping with the impact of over 20 million AIDS deaths on communities and development. An estimated 900 babies in developing countries are infected with HIV daily due to lack of services to prevent mother-to-child transmission. Three southern African countries have adult HIV prevalence rates over 20%, with Botswana at 23.9%, Lesotho at 23.2%, and Swaziland at 26.1%. AIDS has orphaned over 11 million African children due to parental deaths.
The document summarizes HIV epidemiology among men who have sex with men (MSM) globally and in Asia Pacific. Some key points:
- HIV prevalence among MSM ranges from under 1% to over 25% depending on the country/region, with most of Asia and Africa over 5%.
- HIV is increasing among MSM in many countries as prevalence declines elsewhere, with urban areas often having much higher rates.
- Condom use and HIV testing is low among MSM in most areas. Criminalization and stigma also limit data collection and access to services.
- MSM population size estimates vary widely but are often in the hundreds of thousands to millions in Asia Pacific countries.
This document discusses how culture affects the spread of HIV/AIDS in sub-Saharan Africa. It provides global and continental HIV/AIDS statistics. The research question examines if culture impacts the epidemic in sub-Saharan Africa and what cultural aspects most influence transmission. Literature reviews cultural practices that may increase risk like polygamy, mobility, and gender inequality. The methodology analyzes secondary data from the WHO and CIA on countries to determine correlations between prevalence and cultural variables. Results found industrialization and poverty increased figures while literacy decreased transmission due to influencing gender norms.
Tendayi Westerhof is a model from Zimbabwe who is now an educator working to combat HIV/AIDS and gender inequality. As a child, her father did not support her dreams of furthering her education or career. After becoming pregnant in her youth, she struggled as a single mother but was determined to support her children. Now as a public figure, she speaks candidly about being HIV positive to help reduce stigma and encourage prevention, treatment, and women's empowerment.
The document discusses how HIV/AIDS disproportionately affects women and girls globally. It outlines that nearly half of all HIV cases worldwide are among women, and young women ages 15-24 are most at risk. Factors like gender inequality, lack of education, poverty, and violence against women increase women's vulnerability to infection. Effective prevention requires empowering women through education, access to healthcare and protection methods, and eliminating discrimination.
Female genital mutilation/cutting (FGM/C) is concentrated in 29 countries, primarily in Africa and the Middle East. The report provides an overview of FGM/C using data from over 200 surveys in these countries:
- Approximately 125 million girls and women have undergone FGM/C, with the practice being most common in Somalia, Guinea, Djibouti, Egypt and Eritrea, where over 80% of women have been cut.
- While FGM/C rates vary significantly both between and within countries, the majority of girls undergoing FGM/C are cut before age 15, often between ages 5-14.
- Traditional practitioners perform most procedures, though in
This document provides a situational analysis of the gender dimensions of the HIV/AIDS epidemic in Zimbabwe. It notes that women are disproportionately affected, accounting for nearly 60% of those living with HIV in Sub-Saharan Africa. Socially, women have less power to negotiate safer sex, greater economic vulnerability pushing some into transactional relationships, and take on most of the unpaid care burden. This is exacerbated by high poverty levels, limited access to information and services in rural areas, and increased risk of gender-based violence. The epidemic thus intensifies pre-existing gender inequalities and vulnerabilities.
The document is a research proposal that aims to study the factors related to sexual risk behavior among men who have sex with men (MSM) living in Thailand. It outlines several research objectives and hypotheses, which aim to determine the association between knowledge/attitudes, socio-demographic factors, socioeconomic factors, and social support with sexual risk behaviors in this population. The proposal provides definitions for key terms and variables that will be studied, which include age, education level, income, knowledge of HIV/AIDS, peer support, number and type of sexual partners, alcohol use, and role during sex.
The African Women's Protocol is the continent's commitment to achieving universal access to reproductive health care for women, thereby rolling back HIV in Africa. A requirement to realizing the vision of the African Women's Protocol is that all African governments ratify, domesticate, and transparently report on it. Achieving universal access to reproductive health rights would be a major step towards rolling back HIV in Africa. Parliaments and parliamentarians have a unique role to play in ensuring the success of the African Women's Protocol.
HIV & Education in Young South African WomenRENEWAL-IFPRI
This document summarizes research on HIV prevalence, risk behaviors, and the relationship between education and HIV risk among young South African women. It finds:
1) HIV prevalence is very high among young South African women, reaching over 30% among those aged 20-24.
2) Despite this, young women do not report many "high risk" behaviors like early sexual debut or multiple partners.
3) Higher education is associated with lower HIV rates and riskier behaviors. Women who complete high school are less likely to be infected than those without.
4) Barriers to education for girls include costs, pregnancy, and family responsibilities. Programs providing cash transfers have increased school attendance, especially for girls.
HIV disproportionately affects women, who make up nearly half of those infected globally. Women are more vulnerable to HIV infection due to physical differences and complications during childbirth. In the US, most new HIV cases among women occur in 10 states, with nearly half in New York, Florida, Texas, California, and New Jersey. The largest age group of infected women is 25-34 years old. While HIV cannot be cured, treatment involves combinations of antiretroviral drugs that suppress the virus and stop disease progression.
This document discusses the importance of access to safe water for people living with HIV/AIDS, especially in developing countries. It notes that people with HIV have higher risks of opportunistic infections transmitted through contaminated water, including diarrhea. Lack of access to clean water negatively impacts HIV treatment and outcomes. Interventions to provide clean water can reduce diarrhea and improve health for those with HIV. Overall, the document emphasizes that access to safe water is critical for HIV care, treatment, and management of opportunistic infections in developing countries.
Sub-Saharan Africa remains the region most heavily affected by HIV/AIDS, accounting for two-thirds of people living with HIV and three-quarters of AIDS deaths worldwide in 2007. Heterosexual sex is the main driver of the epidemic, though sex work, injection drug use, and sex between men are also significant factors in some countries. While many epidemics appear stable, HIV prevalence continues to grow in southern Africa and Mozambique's central and southern provinces in particular. Some countries like Zimbabwe, South Africa, and Botswana are seeing declines in HIV prevalence among youth.
This document discusses female genital mutilation/cutting (FGM/C), including terminology, global prevalence, types of procedures, complications, and social dynamics. It defines four main types of FGM/C and lists potential early and late complications. Socio-cultural factors that perpetuate the practice include ensuring marriageability, cleanliness, and controlling women's sexuality. Religious, social, and cultural misperceptions also contribute to the continuation of FGM/C in some communities.
Female Genital Mutilation for Healthcare Professionalsmeducationdotnet
1. My first response would be to ensure the 6-year-old's immediate medical needs are addressed, contact child protective services, and seek guidance on next steps from social work and police regarding her safety and potential legal issues.
2. I would need to examine the child to assess for medical complications of FGM, contact on-call pediatrician for consult, and consider notifying authorities if FGM is identified given its illegality.
3. The child is at risk for infections, bleeding, pain, and long-term sexual and psychological issues from undergoing this traumatic procedure. Her well-being and protection from further harm is
The document provides statistics comparing human development indicators for three countries: the United States (a highly developed country), Tunisia (a medium developed country), and Russia (a BRIC country). It includes data on population, GDP, literacy rates, life expectancy, gender equality indices, poverty levels, and wealth distribution for each country.
Female Genital Mutilation/Cutting: A statistical overview and exploration of ...UNICEF Publications
Over the last two decades, reliable data on FGM/C have been generated through two major sources: the Demographic and Health Surveys (DHS), supported by the United States Agency for International Development (USAID), and the Multiple Indicator Cluster Surveys (MICS), supported by UNICEF. The new UNICEF report reviews all available DHS and MICS data and presents the most comprehensive compilation to date of statistics and analyses on FGM/C. It covers all 29 countries in Africa and the Middle East where FGM/C is concentrated and includes, for the first time, statistics from countries where representative survey data were lacking. The report highlights trends across countries, and it examines differentials in prevalence according to social, economic, demographic and other variables. The findings add crucial evidence that sheds further light on how abandonment of harmful social norms can be accelerated.
This document is an interagency statement from 10 United Nations organizations calling for the elimination of female genital mutilation. It provides an overview of female genital mutilation, including that it is practiced in around 28 countries in Africa and Asia, affecting over 100 million girls and women. It discusses the four types of female genital mutilation and why the practice continues due to social and cultural reasons, despite having no health benefits and causing harm. The statement calls on states, organizations and communities to strengthen efforts to end the practice through advocacy, education and legislation.
Violence against women is widespread in Western Africa, where 67% of women experience some form of violence. Common forms of violence include domestic abuse, marital rape, child marriage, and sexual violence during conflicts. Child marriage is particularly common, with 42% of African girls married before age 18, which forces them to drop out of school and leaves them vulnerable to domestic violence and HIV. While laws have been implemented to address this issue, enforcement remains a challenge at the rural level due to lack of training and social stigma. Educating communities, empowering women, and changing social norms are necessary to fully eliminate violence against women in Western Africa.
Fewer COVID-19 cases among women in Africa: WHO analysisSABC News
Women account for a slightly smaller proportion of COVID-19 infections and deaths compared with men, a preliminary analysis by the World Health Organization (WHO) in 28 African countries shows.
Sub-Saharan Africa faces immense challenges from AIDS including providing healthcare and treatment to those infected, reducing new infections through prevention, and coping with the impact of over 20 million AIDS deaths on communities and development. An estimated 900 babies in developing countries are infected with HIV daily due to lack of services to prevent mother-to-child transmission. Three southern African countries have adult HIV prevalence rates over 20%, with Botswana at 23.9%, Lesotho at 23.2%, and Swaziland at 26.1%. AIDS has orphaned over 11 million African children due to parental deaths.
The document summarizes HIV epidemiology among men who have sex with men (MSM) globally and in Asia Pacific. Some key points:
- HIV prevalence among MSM ranges from under 1% to over 25% depending on the country/region, with most of Asia and Africa over 5%.
- HIV is increasing among MSM in many countries as prevalence declines elsewhere, with urban areas often having much higher rates.
- Condom use and HIV testing is low among MSM in most areas. Criminalization and stigma also limit data collection and access to services.
- MSM population size estimates vary widely but are often in the hundreds of thousands to millions in Asia Pacific countries.
This document discusses how culture affects the spread of HIV/AIDS in sub-Saharan Africa. It provides global and continental HIV/AIDS statistics. The research question examines if culture impacts the epidemic in sub-Saharan Africa and what cultural aspects most influence transmission. Literature reviews cultural practices that may increase risk like polygamy, mobility, and gender inequality. The methodology analyzes secondary data from the WHO and CIA on countries to determine correlations between prevalence and cultural variables. Results found industrialization and poverty increased figures while literacy decreased transmission due to influencing gender norms.
Tendayi Westerhof is a model from Zimbabwe who is now an educator working to combat HIV/AIDS and gender inequality. As a child, her father did not support her dreams of furthering her education or career. After becoming pregnant in her youth, she struggled as a single mother but was determined to support her children. Now as a public figure, she speaks candidly about being HIV positive to help reduce stigma and encourage prevention, treatment, and women's empowerment.
The document discusses how HIV/AIDS disproportionately affects women and girls globally. It outlines that nearly half of all HIV cases worldwide are among women, and young women ages 15-24 are most at risk. Factors like gender inequality, lack of education, poverty, and violence against women increase women's vulnerability to infection. Effective prevention requires empowering women through education, access to healthcare and protection methods, and eliminating discrimination.
Female genital mutilation/cutting (FGM/C) is concentrated in 29 countries, primarily in Africa and the Middle East. The report provides an overview of FGM/C using data from over 200 surveys in these countries:
- Approximately 125 million girls and women have undergone FGM/C, with the practice being most common in Somalia, Guinea, Djibouti, Egypt and Eritrea, where over 80% of women have been cut.
- While FGM/C rates vary significantly both between and within countries, the majority of girls undergoing FGM/C are cut before age 15, often between ages 5-14.
- Traditional practitioners perform most procedures, though in
This document provides a situational analysis of the gender dimensions of the HIV/AIDS epidemic in Zimbabwe. It notes that women are disproportionately affected, accounting for nearly 60% of those living with HIV in Sub-Saharan Africa. Socially, women have less power to negotiate safer sex, greater economic vulnerability pushing some into transactional relationships, and take on most of the unpaid care burden. This is exacerbated by high poverty levels, limited access to information and services in rural areas, and increased risk of gender-based violence. The epidemic thus intensifies pre-existing gender inequalities and vulnerabilities.
The document is a research proposal that aims to study the factors related to sexual risk behavior among men who have sex with men (MSM) living in Thailand. It outlines several research objectives and hypotheses, which aim to determine the association between knowledge/attitudes, socio-demographic factors, socioeconomic factors, and social support with sexual risk behaviors in this population. The proposal provides definitions for key terms and variables that will be studied, which include age, education level, income, knowledge of HIV/AIDS, peer support, number and type of sexual partners, alcohol use, and role during sex.
The document provides background information on AIDS in South Africa, including statistics on prevalence and the country's slow government response. It then summarizes the plot of the film "Yesterday", which portrays the struggles of a rural family affected by AIDS, and analyzes the film techniques used to convey their hardship and maintain a sympathetic portrayal. The conclusion is that the film aims to educate and reduce stigma, showing the power of love, hope and dignity.
A Bold Endgame_Ending Preventable Maternal Deaths Worldwide by 2035_Mary Elle...CORE Group
This document discusses strategies for ending preventable maternal deaths worldwide by 2035. It notes that over half of all maternal deaths occur in just eight countries, with India and Nigeria accounting for over 30%. Reducing maternal mortality will require focusing on high-burden populations and implementing high-impact practices like family planning, skilled birth attendance, and treatment for conditions that increase mortality risk such as HIV/AIDS, malaria, and malnutrition. Achieving the target will also depend on strengthening health systems, promoting respectful care, and addressing contextual challenges in different regions. With targeted strategies and increased accountability, it may be possible to accelerate progress and end preventable maternal deaths globally by 2035.
This document summarizes the global impact of AIDS, noting that it has killed over 60 million people since the beginning and is still infecting over 5 million new people each year. Africa has been disproportionately affected, with over 25 million people living with HIV/AIDS in 2005 alone. Some of the hardest hit countries include South Africa, Botswana, Zimbabwe and Kenya, where AIDS has become a major cause of death and has left millions of children orphaned. The epidemic continues to grow rapidly in many parts of the world without effective prevention and treatment efforts.
The document discusses how AIDS is spreading, its effects in Africa, and prevention efforts. It spreads through unprotected sex, contaminated needles and blood transfusions. Two-thirds of people with HIV live in Africa, where AIDS has killed over 15 million people since the epidemic began. Countries have promoted abstinence and condom use to curb transmission rates, with Uganda and Zimbabwe seeing reductions after prevention programs. Over 20 million people globally are currently living with HIV/AIDS.
The document discusses how AIDS is spreading, its effects in Africa, and prevention efforts. It spreads through unprotected sex, contaminated needles and blood transfusions. Two-thirds of people with HIV live in Africa, where AIDS has killed over 15 million people since the epidemic began. Countries are promoting abstinence and condom use to curb transmission rates. Uganda saw infection rates drop from 15% to 5% through prevention programs. Over 22 million people have HIV/AIDS globally and 1.5 million died from it in 2007.
The document discusses HIV and AIDS, providing information on:
1. What HIV and AIDS are and how they are transmitted between people.
2. The global and local impact of the HIV/AIDS pandemic, including statistics on infection rates and numbers of deaths.
3. The effects of HIV/AIDS on communities, including impacts on healthcare systems, education, orphaned children and food security.
4. Strategies for preventing the spread of HIV, caring for infected individuals, and supporting children and families affected by the disease.
Cervical cancer is a major public health problem in Malawi, with the highest rates in Africa. It is caused by certain strains of HPV, which is sexually transmitted. Over 3,000 women are diagnosed with cervical cancer annually in Malawi and over 2,000 die from the disease each year. However, cervical cancer is highly preventable through regular screening which can detect pre-cancerous lesions, and treatable if caught early. The document outlines cervical cancer prevention efforts in Malawi including screening programs and centers, and the work of KUHEM Trust in raising awareness, screening women, and supporting patients.
Contextualising demographic transition in subSaharan AfricaSeamus Grimes
This document discusses trends in population and development in sub-Saharan Africa. It provides data on maternal mortality rates, infant mortality rates, life expectancy, total fertility rates, and HIV prevalence across various African countries. Some key points made are that maternal mortality in SSA has declined significantly from 1980 to 2008, though rates still vary widely by country; infant and child mortality have also declined rapidly in some countries like Kenya, Rwanda, and Senegal in recent years; and total fertility rates have fallen in many countries but still remain high in others like Niger and Uganda. The document argues for considering the complex contextual factors that influence demographic trends in Africa.
The document discusses the global HIV/AIDS epidemic and its impact. It notes that as of 2008, there were an estimated 33.4 million people living with HIV/AIDS globally. Women accounted for half of new infections that year. The epidemic disproportionately impacts those in sub-Saharan Africa, where 22.4 million people were estimated to be living with HIV/AIDS in 2008. The epidemic has had vast social and economic impacts, including orphaning millions of children and slowing economic growth.
How does a gender lens contribute to a healthy environment and healthy people...Jo Vearey
1) The document discusses how gender influences health and the environment in the context of migration, HIV/AIDS, and food security in South Africa.
2) It presents results from a household survey of 500 households in Johannesburg that show female-headed households are larger and women are more likely to feel at risk of HIV than men.
3) The study finds a need to consider women's multiple roles and vulnerabilities to design more effective health interventions for migrants, given trends toward more female migration and the burden of sickness.
This document summarizes the work of mothers2mothers (m2m) in preventing mother-to-child transmission of HIV. It describes how m2m uses mentor mothers to educate and support HIV-positive pregnant women and new mothers, with the goals of preventing HIV transmission to babies, keeping mothers and infants healthy, and empowering mothers. The model employs and trains local HIV-positive women to mentor others in health facilities and communities. An evaluation found that m2m significantly increases utilization of PMTCT services and improves psychosocial outcomes for participants. m2m has expanded from South Africa to 11 countries in sub-Saharan Africa.
The fertility transition in Sub-Sahara Africa: Quo Vadis ?Ron Lesthaeghe
This document discusses fertility transitions in sub-Saharan Africa based on data from Demographic and Health Surveys conducted between 1986-2011. It finds that while total fertility rates have declined in many countries, the pace of decline varies significantly between urban and rural areas as well as between different countries. The relationship between contraceptive use and fertility is complex, with some countries seeing their fertility decline offset by decreasing duration of postpartum abstinence, while others have had net fertility declines driven by increased contraceptive use. High levels of unmet need for contraception persist throughout sub-Saharan Africa.
On 4 March 2022, International Human Papilloma Virus (HPV) Day, the Cancer Association of South Africa (CANSA) supports the International Papillomavirus Society’s (IPVS) #OneLessWorry campaign, that aims to raise awareness of the virus, and the tools to overcome it, such as screening and vaccination programmes. HPV can cause cancer and is responsible for almost half a million deaths globally each year.
#OneLessWorry #HPV #EliminateCervicalCancer #CANSACervicalCancerAwareness
Find out more:
https://cansa.org.za/cervical-cancer/
Similar to Africa, the West and the Fight Against AIDS (20)
This document summarizes self-care initiatives for sexual and reproductive health. It discusses the WHO definition of self-care, and examples like the Caya diaphragm introduced in Niger through the EECO project. Over 600 diaphragm kits were sold or distributed there from 2019-2020. The DOT app was marketed in India to help women track their periods and fertility. Looking ahead, more evidence is still needed on specific self-care interventions and how to evaluate them, while building advocacy and addressing regulatory questions. COVID-19 also impacts future self-care work.
- The SASS Project aimed to assess how well California high schools complied with the California Healthy Youth Act (CHYA) standards for comprehensive sex education, from the perspective of students.
- Students at 13 LAUSD high schools completed an anonymous online survey assessing their sex ed classes' coverage of CHYA standards and classroom environment.
- Results showed a range of compliance across schools, with strongest coverage of HIV topics and weakest coverage of gender/sexuality and contraception. Classroom environment also varied, with teachers generally comfortable but time limited.
- The findings could help identify areas of improvement, but LAUSD had not yet decided to formally incorporate the student surveys or provide feedback to schools.
This document discusses the persistence of electronic fetal monitoring (EFM) despite evidence that it does not improve neonatal outcomes for low-risk pregnancies compared to intermittent auscultation. While EFM was introduced to screen for fetal distress and reduce cerebral palsy rates, multiple studies have found it does not achieve these goals. However, EFM continues to be used in 85% of deliveries and has led to increased cesarean rates and costs without clear benefits. The document examines possible explanations for EFM's persistence, including the influence of law and economics, and calls for more randomized trials before new medical technologies are widely adopted.
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This document provides an overview of challenges in implementing sexual and reproductive health rights in Southern Africa, using examples from Botswana, South Africa, and Eswatini. It discusses how international law establishes these rights but they still face challenges in practice. Key issues include lack of legal protections, socio-cultural norms that discriminate against women, and lack of resources. While countries have laws incorporating international standards, discrimination and harmful practices still undermine equal access to healthcare and decision making. Ensuring sexual and reproductive rights requires addressing both legal frameworks and social attitudes.
Justice Oagile Key Dingake, who has had a distinguished career as a judge in Botswana and is now a judge in Papua New Guinea and Sierra Leone, will be giving a lecture at UCLA on gender discrimination in sexual and reproductive health rights. Justice Dingake received his LLB from the University of Botswana and LLM and PhD from universities in the UK and South Africa. He is recognized as a leading scholar in sexual and reproductive rights and has held prominent roles in judicial organizations in Africa focused on health, HIV/AIDS, and social justice. The introduction praised Justice Dingake for his progressive opinions on gender equality that have made him equivalent to U.S. Supreme Court Justice Ruth Bader
UCLA, Bixby Center Lecture
"From horror to humor: Abortion on American television"
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Advancing New Standards in Reproductive Health (ANSIRH)
UCSF Bixby Center for Global Reproductive Health
Bixby Center Lecture
"Homeless and Vulnerable Youth in Los Angeles: Sexual and Reproductive Helth Challenges"
November 29, 2017
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This document summarizes the Creating Space lactation accommodation project at UCLA. The project aims to improve support for breastfeeding mothers on campus by investing in lactation rooms, education, and support services. A needs assessment found few appropriate lactation spaces and a lack of support services. The project works to map and improve existing rooms, train lactation educators, and provide counseling services on campus.
KIHEFO is a local non-profit organization in Kabale District, Uganda dedicated to community development. It operates a medical clinic, HIV/AIDS clinic, nutrition center, and other projects focused on healthcare services and community development. Adolescent reproductive health is a major issue in Uganda, as 25% of the population is between 10-19 years old. Issues include lack of awareness, peer pressure, poverty, and cultural norms. Sexual activity begins early, and coercion, unwanted pregnancies, and STIs are problems. KIHEFO aims to address the integrated problems of disease, poverty, and lack of education through an integrated approach of healthcare services and community development projects.
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3. Adult HIV Prevalence
Worldwide
Source: UNAIDS 2004: 2004 Report on the Global AIDS Epidemic
This map does not reflect a position by the UN on the legal status of
any country or territory or the delimitations of any frontiers.
6. “HIGH RISK GROUP” MODEL
• ACCORDING TO “HRG” MODEL, THE
EXTENT OF SPREAD OF HIV IN A
POPULATION WILL DEPEND ON:
• FRACTION OF PEOPLE IN “HRG”s
(CSWs, MIGRANT LABORERS, ETC)
AND
• THE DEGREE OF “MIXING” BETWEEN
HIGH AND LOWER RISK GROUPS.
9. Frequency of concurrent and suspected concurrent relationships.
Redrawn from Carael M. “Sexual Behavior” Chapter 4 in
Cleland and Ferry 1995
n/a
n/a
36
n/a
13
n/a
55
39
18
9
22
11
3
3
2
0.2
2
1
3
0.2
7
0.4
0 10 20 30 40 50 60
CAR
Cote d'Ivoire
Kenya
Lesotho
Tanzania
Lusaka
Manila
Singapore
Sri Lanka
Thailand
Rio de Janeiro
F do
M do
4
20
n/a
48
n/a
20
15
35
4
25
4
23
1
2
n/a
n/a
n/a
n/a
0.3
4
1
4
0 10 20 30 40 50 60
CAR
Cote d'Ivoire
Kenya
Lesotho
Tanzania
Lusaka
Manila
Singapore
Sri Lanka
Thailand
Rio de Janeiro
F think
M think
11. Effects of Concurrency
HIV Negative Male
HIV Positive Viremic Male
HIV Positive Non-Viremic Male
HIV Negative Female
HIV Positive Viremic Female
HIV Positive Non-Viremic
Female
34. Premarital sex: % of never married women 15-
24 years old who had sex in the past year
48
33
18
52
35
39
13
3534
22
15
32
2627
0
10
20
30
40
50
60
70
Uganda Zambia Cameroon Kenya Zimbabwe
early-1990s
mid-1990s
late 1990s
ORC Macro
Early 90s/late 80s
Mid 90s
Late 90s/early 2000s
Uganda Zambia Cameroon Kenya Zimbabwe
35 22 27 39 34 26
48 52
33 35 32
18 13 15
35. Teenage pregnancy in Uganda
Percentage who have had children or who are currently pregnant
From USAID funded Demographic and Health Surveys
23.2
43.3
44.1
17year olds
12.9
22.1
20.8
16 year olds
54.0
64.7
58.3
18 year olds
61.23.32000/1
70.87.71995
59.48.71988
19 year olds15 year olds
36. Condoms?
Since the beginning of the HIV/AIDS epidemic, a considerable amount of
programmatic effort has focused on condom promotion…
Reported condom use last higher-risk sex for ages 15-24 (UNAIDS, 2001 & BAIS 2001)
Given that Botswana has for some time featured some of the highest
rates of (self-reported) condom use in the world, why isn’t Botswana
hailed alongside of Uganda as a major success story?
0
10
20
30
40
50
60
70
80
90
Botswana Uganda Zimbabwe Rwanda Senegal Kenya Malawi
Male
Female
Percent
37. The condom quandary
HIV Prevalence in Pregnant Women VS PSI Condom Sales
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
50.00%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Year
Prevalence
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
4,500,000
5,000,000
CondomSales
Urban Rural PSI
Condom sales
HIV
Prevalence
38. C is for condomize
1
Shelton, et al (2004)
“Ever” use of condoms
among adults increased
from 15 to 30 percent in
men, and from 7 to 20
percent for women, from
1989 to 19951
Botswana may have the
highest levels of
reported condom use in
Sub-Saharan Africa
0
20
40
60
80
100
Women
Men
Women 37.8
Men 58.9
Condom Use Last Higher-Risk Sex
(UNAIDS 2000, ages 15-24)
Uganda:
0
20
40
60
80
100
Women
Men
Women 75.3
Men 88.3
Condom Use Last Higher-Risk Sex (BAIS
2001, ages 15-24)
Botswana:
39. “CONSISTENT” CONDOM USE PROTECTS, BUT NOT TOTALLY….
(PROBABLY BECAUSE THE USE IS NOT AS CONSISTENT AS IT SHOULD
BE.)
40. Consistent condom use by type
of partner, Zambia 2003
0
10
20
30
40
50
60
70
80
90
With Sex
Workers
With
Regular
Partner
With wives
Truck drivers
Uniformed Personnel
Minibus Drivers
41.
42. B is for be faithful
Uganda coined (from
agricultural tradition) the “zero-
grazing” approach to
prevention
1
Shelton, et al (in press) 3
BAIS
(2001)
2
Reported higher risk sex in the past 12-months2
0
10
20
30
40
50
60
70
80
90
100
15-49 year olds
15-49 year olds 28.4 14.1
Men Women
Uganda:
Reported higher risk sex in the past 12-months3
0
10
20
30
40
50
60
70
80
90
100
15-49 year olds
15-49 year olds 64.5 53.6
Men Women
Botswana:
0
10
20
30
40
1989
1995
1989 35 16 15
1995 15 6 3
Men with one or more
"casual" partners in past
year
Women with one of more
"casual" partners in past
year
Men with three or more
"non-regular" partners in
the past year
Uganda1
:
43. Types of Reported Behavior Change in
Uganda: DHS 1995
Never-Married People’s Behavior Change to Avoid AIDS
Delayed First
Sex or
Stopped Sex
Restricted
Sex to One
Partner
Began Using
Condoms
Did Not
Change
Behavior
Percent of
Men:
29 27 17 15
Percent of
Women:
38 29 3 27
44. Types of Reported Behavior Change in
Uganda: DHS 1995
Married People’s Behavior Change to Avoid AIDS
Restricted Sex to
One Partner
Began Using
Condoms
Did Not Change
Behavior
Percent of Men: 66 5 11
Percent of
Women:
58 1 38
46. From Warren Winkelstein Jr et al, “The San Francisco Men’s Health Study: Continued Decline in HIV
Seroconversion Rates among Homosexual/Bisexual Men.” AJPH November 1988 vol 78, pp. 1472-4
48. The HIV rate is beginning to
decline in several African
countries, including Kenya,
Zimbabwe and I think maybe
Malawi and Zambia.
But—why did it take so long?
And why is the HIV rate still so
high in southern Africa?
49. The importance of evidence-based practice
How does what is being done…
•Mass-mediated
advertising targeting
young men
•“Miss Lovers Plus”
beauty pageant
•Youth-oriented jam
sessions
•Etc…
50.
51.
52. IMPLICATIONS FOR PREVENTION?
• AFRICAN PEOPLE NEED TO KNOW WHERE THEIR RISKS ARE COMING FROM
—IE NOT JUST FROM “PROMISCUOUS PEOPLE.”
• MY HYPOTHESIS IN INVISIBLE CURE IS THAT AN UNDERSTANDING OF
CONCURRENCY NETWORKS COULD HELP REDUCE THE STIGMA AND DENIAL
SURROUNDING THE EPIDEMIC IN MUCH OF SOUTHERN AFRICA, AS IT DID IN
UGANDA, AND THIS COULD FOSTER A MORE PRAGMATIC RESPONSE TO THE
EPIDEMIC..
• UGANDANS DID KNOW EARLY ON THAT HIV WAS SPREADING THROUGH
CONCURRENT LONG TERM RELATIONSHIPS ALTHOUGH THEY DIDN’T USE
THE WORLD “CONCURRENCY.” UGANDAN GOVERNMENT CAMPAIGNS MADE
IT CLEAR THAT EVERYONE WAS AT RISK, NOT JUST SEX WORKERS AND
PROMISCUOUS, ‘IMMORAL’ PEOPLE. THIS HELPED ROUSE A MORE
COMPASSIONATE, OPEN REPONSE TO THE AFFLICTED, AND A GENERAL
RECOGNITION THAT AIDS WAS NEITHER AN ACT OF GOD OR A PUNISHMENT
FOR SIN, BUT A TERRIBLE DISEASE THAT NO ONE DESERVES.
• TOO MANY HIV PREVENTION PROGRAMS HAVE DIVIDED PEOPLE: HIV POS
FROM HIV NEG, MORAL FROM IMMORAL, YOUNGER PEOPLE FROM ELDERS,
MEN FROM WOMEN. WHAT WE NEED ARE MORE PROGRAMS THAT BRING
PEOPLE TOGETHER: WOMEN’S RIGHTS PROGRAMS, MICROFINANCE
PROGRAMS, ORPHAN CARE PROGRAMS, HOME BASED CARE PROGRAMS,
ETC.
Editor's Notes
Pretty good model for what’s happening in the rest of the world, but not adequate for what’s happening in E and S Africa.
Shown here are HIV prevalence rates over an approximately 15 year period from about a dozen sub-Saharan African cities. Despite many previous (and current) predictions to the contrary, for the most part HIV has remained relatively low and relatively flat in most of west Africa, with the exception of Ivory Coast (and Cameroon’s prevalence increased significantly during the 1990s). Although certainly a prevalence rate of 5-7%, as in Lagos for example, is a major problem, we still have not seen prevalence in west Africa reach anywhere near the levels observed in parts of southern and east Africa, even though most scientists believe that HIV probably emerged in west Africa, at least 70 years ago (probably in the Cameroon/Gabon rain forest region). A number of factors may be involved (such as, at least in some African countries, a certain degree of non-sexual transmission stemming from contaminated blood, reuse of syringes, etc.), yet many epidemiologists increasingly believe that male circumcision is particularly key to explaining many of the regional disparities in SSA (and in south and southeast Asia as well). In the extensive UNAIDS 4-site study, for example, there were no significant differences in sexual behavior -- or even prevalence of most STDs – between the high-HIV-prevalence sites in east and southern Africa, compared to the much lower prevalence west African sites. If anything (as we shall similarly see for our ABC Study), reported sexual behavior was markedly riskier in Yaonde, Cameroon than in Kisumu, Kenya or in Ndola, Zambia, yet even so HIV prevalence was much higher in the latter two sites. Few men were circumcised in those sites, whereas nearly all men were circumcised in Cameroon and Benin (the other lower-prevalence site in the study). In most of west Africa, male circumcision is the rule (with some parts of Ivory Coast and Burkina Faso being the main exceptions). In the east and southern African sites, we see that, in contrast, HIV prevalence rose dramatically during the late 1980s and throughout most of the 1990s, with the now famous exception of Uganda (Kampala pictured here in red), where prevalence evidently began plateauing after 1987 and then began to decline sharply after 1993. Various modelers and other researchers believe that, for various epidemiological reasons, HIV incidence (the rate of new infections) would have had to begin declining, perhaps rather sharply, sometime in the late 1980s.
Most of the Phase 1 Report focuses on a comparative analysis of behavior and behavior change (or lack of change) across the five African countries in the ABC Study. (Thailand was the other country studied.) As shown here, in the two countries for which there is evidence of HIV prevalence decline in key populations (i.e., among many populations in Uganda, and probably among young women in Lusaka, Zambia during the 1990s), there was also a significant decline in premarital sex, whereas there was little change in levels of premarital sexual behavior in the three countries where HIV prevalence had not declined during the 1990s (Cameroon, Kenya, Zimbabwe). In Uganda, levels fell between the 1989 and 1995 surveys; however, the level of premarital sex in young women actually rose somewhat between the 1995 and 2000 surveys. Note: the ABC Study Director, Doug Kirby, suggested at a July 2003 Youth Research Meeting in DC that, based on recent study data from focus groups, key informant interviews, etc., this may have been due in part to the possible “substitution” or “disinhibitory” effect of the greater impact of condom promotion in recent years in Uganda. This does not mean that condom promotion has necessarily been unbeneficial in Uganda overall, but perhaps raises the question, as some other recent data from places such as Rakai has similarly done so, about how best to promote condoms, especially so as not to inadvertently negate “A” and “B” outcomes (and vice-versa), as Kirby emphasized in his talk.
Also, Zero grazing in the Diocese of Kampala. Also, a very compassionate response, like that seen in gay community in 80s. Lots of talking about AIDS, in very personal ways, a huge number of spontaneous “care” groups, that weren’t necessarily formal, also women’s rights groups, etc etc. Co-wives and concubines…It was like this national obsession for a few years…
These data are from a question which used to be a standard one included in the DHS AIDS module.
How do you get people to do this? Everyone says behavior change is impossible…sneers at this. But I don’t know, I think we need to ask Africans what they think. Obviously, the Ugandans DID think it would work….
In Uganda’s generalized epidemic , Efforts to encourage people to limit their sexual partners played a central role in Uganda’s early approach to HIV prevention, and appear to have contributed to significant declines in HIV infection rates in the last 1980s and early 1990s. Interestingly , there seemed to be little change in teenage pregnancy rates from 1989-1995, the period in which incidence seemed to decline most dramatically. A recent paper presented at the 2005 retrovirus conference concluded that deaths contributed significantly to declines in HIV prevalence in Rakai, in the study period of 1994-2002 -- following the period in which Uganda experienced its dramatic declines in HIV incidence According to this new paper, the rates of new infections remained fairly stable in Rakai after the dramatic declines of the late ’80s and early ’90s. This later period was characterized by increases in reported condom use , but also by increases in the proportion of people reporting more than one sexual partner . There also may have been slight decreases in the median age of sexual initiation among males . Some argue that the programmatic emphasis migrated away from “B” and towards “C” during this later period, and that consistent emphasis on all three of the “ABCs” of prevention might have resulted in continued declines in HIV incidence. The most recent DHS, which included a linked HIV biomarker, found that adult prevalence in Uganda is now 7% (the UNAIDS estimate is 4.1%), and that 39% of sexually active men and 18% of sexually active women reported sex with a non-marital, non-cohabitating partner in the past year. 41% of women and 50% of men reported condom use at last sex with a non-marital, non-cohabitiating partner.
By promoting the correct and consistent use of condoms in brothel settings, and by emphasizing the risks associated with casual sexual partnerships, Thailand was able to reverse a rising tide of new infections occurring via prostitution.
I personally think these bilboards sent the wrong message. They basically say, just go ahead and screw around, just use condoms. But by associating disease with “disreputable” behavior, womanizing, even violence and rape, reinforced the stigma and denial that have made the response to AIDS so desultory, so steeped in shame throughout much of southern Africa. Not Soddom and Gomorrha. Sex holds an important place in cosmology, and silence around it reinforced by centuries of racist stereotypes about black sexuality. Those stereo types were used to justify colonialism, idea being that black were less evolved, more subject to basic “drives” and therefore couldn’t govern these selves. So ads like this only emphasized the point. You are seeing a more compassionate response now, but it took a long time, and lot of people suffered in the meatime.
Here’s another one. I have nothing against condoms, and nothing against teen sex, if a young girl wants to go around wth an older man, that’s her business. But if your business is preventing HIV in southern Africa, I just think the risks are too great to be fooling around like this. I know it sounds puritanical and preachy, but would YOU really want your kid running around with condoms, thinking she’s safe, in a 30% HIV epidemic? Obviously everyone needs access to condom and information about how to use them. And that should be, I think, taught in schools, and health clinics and such, in a sober neutral manner. But when it comes to mass advertising, I really think you’d want to have another type of message out there that doesn’t glamorixze what is in fact insanely dangerous behavior. It reminds me of those cigarette ads from the sixties-Come to marlboro country, you’ve come a long way baby, etc. That tried to make what is an incredibly dangerous habit, seems sexy and fun.Or even worse, they gave people a false sense of security.. ”for a milder flavor smoke burpos….” It also seems to me a little racist, but African-Americans can tel me if they agree. I mean would this be an apprpriate poster to put up in a black neighborhood in the US? Would that be considered a little offensive? The corresponding Ugandan message during the early 90s was different, it was a poster, unfortunately I don’t have it, but it depicted a big fat man standing next to a car counting a handful of banknotes, and three teenage girls in school uniform and one of whom is making for the man, but the others are holding her back. And the slogan is: protect your friends! Don’t let them go with sugar daddys! And the norms around that did change. Not that there aren’t still sugar daddys in uganda, but its less common and more frowned upon than it used to be.
TOO MANY HIV PREVENTION PROGRAMS HAVE DIVIDED PEOPLE: HIV POS FROM HIV NEG, MORAL FROM IMMORAL, YOUNGER PEOPLE FROM ELDERS, MEN FROM WOMEN. WHAT WE NEED ARE MORE PROGRAMS THAT BRING PEOPLE TOGETHER: WOMEN’S RIGHTS, MICROFINANCE, ORPHAN CARE, HOME BASED CARE, ETC.