For businesses, the daily cost of managing HIV/Aids can be a bitter pill to swallow. Statistics reveal an alarming situation: the pressure on business is considerable and costs ballooning. If no action is taken to manage the epidemic, profitability will be affected adversely. This article discusses this impact of HIV/Aids on the workplace.
Equity and HIV/AIDS
Kenya: Workplace AIDS cover in the offing
Ng\\\'aru I, The Nation (Nairobi), 21 March 2006
Kenya: World Bank approves US$80 million HIV/AIDS program
Warutere P, Auma A: The World Bank, 26 June 2007
The World Bank approved a credit of US$80 million for Kenya to expand the coverage of targeted HIV and AIDS interventions to prevent and mitigate the impact of the disease. The Total War Against HIV and AIDS (TOWA) Project will assist Kenya to further reduce the prevalence of HIV/AIDS, which dropped from over 13 percent in 2001 to about 6 percent in 2005, by further strengthening the governance of the National AIDS Control Council (NACC)— the lead agency for designing strategies and overseeing the implementation of programmes to control the pandemic. The programmes include use of grant funds by non-governmental organisations (NGOs) which will be subjected to rigorous and transparent processes of selection, implementation monitoring and performance. This approach includes greater community oversight and blacklisting of NGOs that do not perform.
Kenyan National Guidelines on Nutrition and HIV and AIDS
Republic of Kenya, Ministry of Health, April 2006
Successful nutritional care and support of PLWHA requires an inferred partnership between those affected and different levels of care providers. A coordinated effort is required from people in many disciplines. The wide dissemination and use of these Guidelines, as well as supportive policies and services to implement the recommendations herein, will help all stakeholders to improve the quality of life of people living with HIV and AIDS.
Key determinants of AIDS impact in Southern sub-Saharan Africa
Shandera WX: African Journal of AIDS Research 6(3): 271–286
This narrative review evaluates: 1) viral factors, in particular the aggregation of subtype-C HIV infections in Southern sub-Saharan Africa; 2) host factors, including unique behaviour patterns, concomitant high prevalence of sexually transmitted diseases, circumcision patterns, average age at first marriage and immunogenetic determinants; and, 3) transmission and societal factors, including levels of poverty, degrees of literacy, migrations of people, extent of political corruption, and the usage of contaminated injecting needles in community settings. HIV prevalence data and published indices on wealth, fertility, and governmental corruption were correlated using statistical software. The high prevalence of HIV in Southern sub-Saharan Africa is not explained by the unusual prevalence of subtype-C HIV infection. Many host factors contribute to HIV prevalence, including frequency of genital ulcerating sexually transmitted infections, absence of circumcision and immunogenetic loci, but no factor alone explains the high prevalence of HIV in the region. Among transmission and societal factors, the wealthiest, most literate and most educated, but also the most income-disparate, nations of sub-Saharan Africa show the highest HIV prevalence. HIV prevalence is also highest within societies experiencing significant migration and conflict as well as in those with government systems experiencing a high degree of corruption. The interactions between poverty and HIV transmission are complex. Epidemiologic studies currently do not suggest a strong role for the community usage of contaminated injecting needles. Areas meriting additional study include clade type, host immunogenetic determinants, the complex interrelationship of HIV with poverty, and the community usage of contaminated injecting needles.
Knowledge about HIV/AIDS and policy in a South African state hospital
Dijkstra A, Kangawaza E, Martens C: Social Aspects of HIV/AIDS Research Alliance , 2007
This research was undertaken to investigate what level of HIV knowledge medical staff have in a state hospital in South Africa. In particular it looks at their knowledge about and practical use of current HIV policy and counselling programmes within their hospital. The conclusions are applicable to other hospitals in South Africa. The report highlights several areas of poor knowledge. Education of medical staff may be insufficient due to several factors including lack of access to information, lack of training and counselling, and lack of knowledge about HIV policy. The authors recommend the effectiveness of current counseling services is evaluated and that hospital HIV policy and counselling programmes are developed in co- operation with community based organisations and all disciplines in the hospital, especially nurses.
Knowledge about safe motherhood and HIV/AIDS among school pupils in a rural area in Tanzania
Mushi DL, Mpembeni RM, Jahn A: BMC Pregnancy and Childbirth 7:5, 24 April 2007
The majority of adolescents in Africa experience pregnancy, childbirth and enter motherhood without adequate information about maternal health issues. Information about these issues could help them reduce their pregnancy related health risks. Existing studies have concentrated on adolescents' knowledge of other areas of reproductive health, but little is known about their awareness and knowledge of safe motherhood issues. We sought to bridge this gap by assessing the knowledge of school pupils regarding safe motherhood in Mtwara Region, Tanzania.
Knowledge, attitudes and practices of women regarding the prevention of mother-to-child transmission programme at the Vanguard Community Health Centre, Western Cape: A pilot study
Petrie KE, Schmidt SD, Schwarz CE, Koornhof HE and Marais D: South African Journal of Clinical Nutrition 20(2)71–75
The aim of this study was to determine the knowledge, attitudes and practices of women regarding the prevention of mother-to-child transmission (PMTCT) programme at a community health centre. Thirty-six educated women aged 18 - 39 years and attending the clinic took part, from informal settlements and mostly unemployed, receiving government grants. Most scored 80% or more with regard to general HIV knowledge. Attitudes were found to be positive with regard to both breastfeeding and formula feeding, but HIV status influenced it significantly. In conclusion, the women were knowledgeable about HIV transmission and mother-to-child transmission (MTCT), but an informed decision-making process was not followed, the sustainability of formula feeding after six months is a problem and health workers need to be trained about feeding options.
Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in sub-Saharan Africa
Kigozi IM, Dobkin LM, Martin JN, Geng EH, Muyindike W, Emenyonu N, Bangsberg DR and Hahn JA: Journal of Acquired Immune Deficiency Syndromes, (published ahead-of-print) 10 June 2009
Little is known about the stage at which those infected with HIV present for treatment in sub-Saharan Africa. This study conducted a cross-sectional analysis of initial visits to the Immune Suppression Syndrome Clinic of the Mbarara University Teaching Hospital, Uganda, totalling 2,311 patients with an initial visit between February 2007 and February 2008. The median age of the patients was 33 years and 64% were female. More than one third (40%) were categorised as late presenters (stage three or four, according to the World Health Organization disease levels). Late presentation was associated with a lower education level, unemployment, living in a household with others or being unmarried, whereas being pregnant, having young children and consuming alcohol in the prior year were associated with early presentation. Targeted public health interventions to facilitate earlier entry into HIV care are needed, as well as additional study to determine whether late presentation is due to delays in testing vs. delays in accessing care.
Learning from diverse contexts: Equity and inclusion in the responses to AIDS
Loewenson R: AIDS Care 19 (S1): 83-90, 2007
This paper situates the findings of the diverse studies reported in this journal supplement in a global context that both fuels the epidemic through inequality and poverty and also provides new opportunities for global commitments, solidarity and resources. The studies in this issue signal that, while information and awareness about HIV and AIDS is now high, there is still poor access to services for people to know their own risk and a deeper need to address the asymmetries of power and access to resources that influence the control people have over their sexual relationships and lives.
Letter to Partners 2011, from the UNAIDS Executive Director
Sidibé M: UNAIDS, 18 February 2011
This Letter to Partners coincides with the 10th anniversary of the 2001 Declaration of Commitment on HIV/AIDS and five years since the world committed to achieve universal access to HIV prevention, treatment, care and support. In the letter, Michel Sidibé outlines a set of six new frontiers to move the global AIDS response forward. He calls for the democratisation of the response: political promises must be realised in the form of improved resources and services, and the communities that are served must be included in decision-making. Also, he notes that the law must work for not against AIDS: for example, national laws must stop discrimination against people living with HIV, men who have sex with men, lesbians, people who inject drugs, sex workers and transgender people. Sidibé calls on stakeholders to reduce the upward trajectory of programme costs, and make funding for AIDS a shared responsibility, as well as help build the AIDS movement as a bridge to development and foster scientific innovation for HIV prevention and treatment. According to Sidibé, each of the six new frontiers supports the other, and he cautions that a singular advancement in only one will not be sufficient to move the entire global AIDS response forward.