An initiative by African governments to step up the pace of HIV prevention was launched at four simultaneous events across the continent. African health ministers designated 2006 as the Year for Accelerating Access to HIV Prevention at a meeting in Maputo last August. The purpose of the campaign is to ensure that prevention reassumes its rightful position as the mainstay of the global response to HIV and AIDS.
Equity and HIV/AIDS
Southern African leaders commit to stepping up HIV/AIDS prevention
World Health Organisation Mozambique E-News
Southern African Treatment programmes skewed in favour of urban males
The shortfall in extending antiretroviral therapy (ART) to HIV positive people in Southern Africa is "enormous", with mostly educated, urban males benefiting from existing programmes, says a new report. The report was compiled by the Regional Network for Equity in Health in Southern Africa (Equinet) and Oxfam GB, and focuses on equity in health sector responses to HIV/AIDS.
Steady progress as ARV rollout gathers momentum in Mozambique
When Maria (last name withheld), 35 years old and HIV-positive, reflects on the past year she gives an answer that a growing number of Mozambicans living with HIV/AIDS would probably echo. "The year 2005 has been good for my health. It has got so much better because this year I started taking ARVs (antiretroviral drugs)," she told PlusNews. Maria is one of 17,000 people now accessing ARVs of a national target to treat 20,000 people by the end of 2005.
Steep HIV prevalence declines among young people in selected Zambian communities: population-based observations (1995–2003)
Michelo C, Sandøy IF, Dzekedzeke K, Siziya S, Fylkesnes K: BMC Public Health 6:279, 10 November 2006
Understanding the epidemiological HIV context is critical in building effective setting-specific preventive strategies. We examined HIV prevalence patterns in selected communities of men and women aged 15–59 years in Zambia.
Stories of innovation and impact: The Global Fund 2010
The Global Fund to Fight AIDS, Tuberculosis and Malaria: 2010
This review of Global Fund projects in 2010 includes some chapters on projects they have funded in the east, central and southern African region. A chapter on HIV prevention in South Africa focuses on peer education in townships, while prevention of mother-to-child transmission of HIV in Namibia is also covered in terms of breaking the stigma surrounding the disease. Malaria prevention in Zambia is presented as a success story, as clinics are reported to be 'empty of patients', and a chapter on malaria prevention in Swaziland outlines the country's ambitious plan to eliminate malaria by 2015.
Strange bedfellows: bridging the worlds of academia, public health and the sex industry to improve sexual health outcomes
Knerr W and Philpott A: Health Research Policy and Systems 9(Suppl 1): S13, 16 June 2011
The public health response to sexually transmitted infections, particularly HIV, has been and continues to be overwhelmingly focused on risk, disease and negative outcomes of sex, while avoiding discussion of positive motivations for sex like pleasure, desire and love. Recent advocacy efforts have challenged this approach and organisations have promoted the eroticisation of safer sex, especially in the context of HIV prevention.
This paper is a case study of one of these organisations – the Pleasure Project. The authors give a brief background on the public-health approach to sex and sexual health, and recommend an alternative approach that incorporates constructs of pleasure and desire into sexual health interventions. The Pleasure Project’s aims and unorthodox communications strategies are described, as are the response to and impact of its work, lessons learned and ongoing challenges to its approach. Despite the backdrop of sex-negative public health practice, there is anecdotal evidence that safer sex, including condom use, can be eroticised and made pleasurable, based on qualitative research by the Pleasure Project and other like-minded organisations. Yet there is a need for more research on the effectiveness of pleasure components in sexual health interventions, particularly in high-risk contexts, the authors argue. This need has become urgent as practitioners look for new ways to promote sexual health and as new prevention technologies (including female condoms and microbicides) are introduced or disseminated.
Streamlining ARV provision for refugees
Science in Africa, February 2007
The United Nations refugee agency, UNHCR, has launched a new policy to ensure that HIV-positive refugees and other displaced people around the world have access to life-prolonging antiretroviral (ARV) medication. The policy, designed to offer guidance to UNHCR and its partners as well as host governments, aims to integrate ARV provision as part of a comprehensive HIV/AIDS programme for refugees that includes prevention, care and support.
Streamlining tasks and roles to expand treatment and care for HIV: Randomised controlled trial protocol
Fairall LR, Bachmann MO, Zwarenstein MF, et al: Trials 9: 21, 23 April 2008
This is a protocol for a pragmatic cluster randomised trial to evaluate the effectiveness of a complex intervention based on and supporting nurse led antiretroviral treatment (ART) for South African patients with HIV/AIDS, compared to current practice in which doctors are responsible for initiating ART and continuing prescribing. The trial will randomly allocate 31 primary care clinics in the Free State province to nurse-led or doctor-led ART. Two groups of patients aged 16 years and over will be included: a) 7400 registering with the programme with CD4 counts of 350 cells/mL or less (mainly to evaluate treatment initiation) and b) 4900 already receiving ART (to evaluate ongoing treatment and monitoring). The primary outcomes will be time to death (in the first group) and viral suppression (in the second group). Patients' survival, viral load and health status will be measured at least 6-monthly for at least one year and up to 2 years, using an existing province-wide clinical database linked to the national death register.
Street children’s vulnerability to HIV and sexually transmitted infections in Malawian cities
Mandalazi P, Banda C and Umar E: Malawi Medical Journal 25(1): 1-4, 2013
The objective for this study was to explore street children’s vulnerability to HIV and STIs infection. Researchers employed In-depth interviews with street children in the two main cities of Malawi, Blantyre and Lilongwe. A total of 23 street children were interviewed. Results of the study strongly suggest that street children could be vulnerable to HIV and other sexually transmitted infections (STIs). This is due to various factors which include low knowledge levels of STIs and HIV, high risk sexual practices, lack of safer place to spend their nights for both boys and girls rendering them vulnerable to sexual abuses and the use of sex as a tool to secure protection and to be accepted especially for the newcomers on the street. This study highlights street children’s vulnerability to sexual exploitation which predisposes them to risk of HIV and AIDS as well as STIs. Furthermore, the street environment offers no protection against such vulnerability. There is need to explore potential and context sensitive strategies that could be used to protect street children from sexual exploitation and HIV and STIs.
Strengthening health systems for treatment access
This summary document presents: The principles for ensuring universal treatment access through sustainable public health systems; The major findings and issues from the work carried out in southern Africa on equity in health sector responses to HIV and AIDS, particularly in terms of access to antiretroviral treatment; The key challenges for follow up work identified at the southern African regional meeting on 'Strengthening Health systems for treatment access and equitable responses to HIV/AIDS' in Harare, Zimbabwe, February 2004.