This study examined the utilisation of the prevention of mother to child transmission (PMTCT) services in five reproductive and child health clinics in 2007 and 2008 in Moshi, northern Tanzania, after the implementation of routine counselling and testing and explored the level of knowledge the postnatal mothers had about PMTCT. Researchers interviewed 446 mothers when they brought their four-week-old infants to five reproductive and child health clinics for immunization and conducted thirteen in-depth interviews with mothers and nurses, four focus group discussions with mothers, and four observations of mothers receiving counselling. The study found that nearly all mothers (98%) were offered HIV testing, and all who were offered accepted. However, the counselling was hasty with little time for clarifications. Mothers attending urban antenatal clinics tended to be more knowledgeable about PMTCT than the rural attendees. Compared with previous studies in the area, this study found that PMTCT knowledge had increased and the counsellors had greater confidence in their counselling. The study concludes that when the PMTCT programme has had time to get established, both its acceptance and the understanding of the topics dealt with during the counselling increases.
Equity and HIV/AIDS
The war against HIV/AIDS, which has too often been fought in plush offices and conference centres, needs to be reclaimed by people in developing countries, who are most affected, or it will continue to be a losing battle. This was the message from the Global Citizens Summit in Nairobi, Kenya from 27-29 May 2009, organised by international anti-poverty agency ActionAid, and attended by a broad range of organisations in the field of HIV and AIDS to discuss using social mobilisation to ‘repackage’ the HIV response. ‘The fight against HIV did not originate in boardrooms’, said ActionAid. ‘It was citizens rising up to make their voices heard and to put AIDS on the agenda. We need to go back there.’ Participants pointed out that although community-based organisations did the lion's share of HIV-care work, they received only a fraction of global AIDS funding.
In Mozambique's Machava Central Prison, the largest jail in the country, sex between prisoners is an unavoidable reality, but little is being done to prevent it, according to inmates and medical staff. Overcrowding, violence and high-risk behaviour, such as sharing drug-use equipment and unprotected sex increase risk of HIV transmission in prisons. Lack of information on HIV and AIDS and inadequate health facilities also contribute to the spread of the disease. This article explores the limits to prevention activities such as condom distribution given the taboo on homosexuality in Mozambique.
If President Museveni assents to the new HIV/Aids Prevention and Control Bill, 2010, passed by Parliament in May, it will be criminal for a person to ‘willfully’ or ‘intentionally’ infect another with the HIV/Aids virus.
Under Clause 41(1), a person who knowingly transmits HIV/Aids to another shall, on conviction, be liable to a fine of not more that Shs4.8 million or imprisonment for a term not exceeding 10 years or both. Additionally, Clause 14 of the BIll makes it mandatory for men to test alongside their pregnant partners with a view of placing an obligation on both parents to be responsible and protect the unborn child from acquiring the disease. The Bill also establishes a fund, the HIV Trust Fund, which will help boost the fight against the pandemic. The proposed fund imposes an obligation on the government to make quarterly contributions to ministry of Health. Government will contribute 2 per cent to the fund off levies from beer, bottled water and soft drinks.
This report evaluates the work that Medicins sans Frontiers (MSF) has done in HIV and AIDS in Mozambique over the past ten years. MSF’s HIV and AIDS programmes offer HIV testing and counseling, treatment and prevention of opportunistic infections, paediatric diagnosis and treatment, prevention of mother-to-child transmission, and the provision of anti-retroviral therapy. At the end of August 2010, more than 33,000 people in Mozambique were being treated for HIV and AIDS through MSF’s projects. However, the report cautions that MSF’s model of care is not a prescriptive cure, and significant challenges remain. More than 350,000 people in Mozambique are in need of ARV treatment but do not have access to it, which equates to two-thirds of all HIV-positive Mozambicans. After years of political willingness and financial commitment to combat HIV and AIDS, external funders are now either flatlining, reducing or withdrawing their funding for HIV, thus abandoning those who are still in dire need of lifesaving treatment. HIV-infected people continue to face major barriers in their access to services, even in a context of free treatment. A shortage of qualified health workers is also considered a major barrier to access in Mozambique, with only 3 doctors and 143 nurses per 100,000 people, one of the lowest workforce per population ratios in the world.
This report evaluates the work that Medicins sans Frontiers (MSF) has done in HIV and AIDS in Mozambique over the past ten years. MSF’s HIV and AIDS programmes offer HIV testing and counseling, treatment and prevention of opportunistic infections, paediatric diagnosis and treatment, prevention of mother-to-child transmission, and the provision of anti-retroviral therapy. At the end of August 2010, more than 33,000 people in Mozambique were being treated for HIV and AIDS through MSF’s projects. However, the report cautions that MSF’s model of care is not a prescriptive cure, and significant challenges remain. More than 350,000 people in Mozambique are in need of ARV treatment but do not have access to it, which equates to two-thirds of all HIV-positive Mozambicans. After years of political willingness and financial commitment to combat HIV and AIDS, external funders are now either flatlining, reducing or withdrawing their funding for HIV, thus abandoning those who are still in dire need of lifesaving treatment. HIV-infected people continue to face major barriers in their access to services, even in a context of free treatment. A shortage of qualified health workers is also considered a major barrier to access in Mozambique, with only 3 doctors and 143 nurses per 100,000 people, one of the lowest workforce per population ratios in the world.
Men who have sex with men (MSM) do not make headlines in South African media and HIV experts have warned that a lack of accurate coverage prevents targeted HIV prevention and care for these men. Human rights activists have spoken up about the South African media's tendency to divide men into two groups - heterosexual or homosexual - and caution against reinforcing stereotypes that deter them from accessing target HIV services for fear of being labelled. About 6% of lesbian, bisexual, transgender or intersex people and MSM surveyed have reported being turned away from government clinics, the government estimates. According to the national strategic plan (NSP), at least 70% of MSM should have been reached with a comprehensive, customised HIV prevention package by 2011. But the country is unlikely to meet this target. According to a recently released government review of NSP progress, nobody is systematically collecting data on HIV prevention among MSM.
The Health4Men Clinic at Baragwanath Hospital, South Africa, is an HIV and Aids advocacy network specifically devoted to the needs of men who have sex with men (MSM). Nthato Ramushu from the Clinic says that the term MSM is quite new for many people. Because same-sex sexuality is easily misunderstood, this group is often neglected in HIV prevention and treatment campaigns. He states that almost half of those men living in Soweto, Gauteng who are gay or are MSM are too afraid to identify themselves as gay or MSM, despite their needs for health services and higher risk of HIV infection and transmission. Ramushu noted that many MSM are married men who are not open about their sexuality, fearing rejection by their families and communities.
A new World Bank report on HIV/AIDS launched in June says the mobilisation of empowered 'grassroots' communities, along with delivering condoms and life-saving treatments, are beginning to slow the pace of the continent's epidemic. According to the new report ultimate success in defeating HIV/AIDS will depend on marshalling effective prevention, care, and treatment, measures to boost 'social immune systems' in African countries - changing beliefs, perceptions, and social and individual behaviors around the disease to reverse the advance of HIV and stop the damage done by AIDS.
Multiple partnerships may not be as common in South Africa as previously thought, according to a study presented at the recent AIDS Research Symposium at the University the Witwatersrand, in Johannesburg. Saul Johnson, managing director of Health & Development Africa (HDA), a health consultancy which conducted the research, said findings from four sites across the country showed about 26% of men and 5% of women reported having had more than one partner in the past year. ‘The perception out there is that [having multiple partners] is more common than it really is,’ he said. The reason may be that men tend to inflate their partner counts. Johnson and his team found that when men were asked to write down a figure for the number of partners they had had in the last twelve months they exaggerated, but when asked to plot their sexual encounters in more detail, using a sexual partner calendar, they often revised the number down slightly. Women's responses were more likely to be consistent.