It is generally assumed that caring is a substantial burden upon households afflicted by HIV/AIDS. However, as a ‘private’ household responsibility, little is known about the experiences of either those who provide the care, or those receiving care, despite the fact that the process may extend over several years and may have a greater impact upon the livelihood security and well-being of the household than the actual death of the ill person. Drawing upon data collected through solicited diaries, this paper explores how illness and the daily and long-term duties of caring amongst a sample of households in the Caprivi Region of Namibia impacts upon the physical and psychological well-being of ill people and their carers.
Equity and HIV/AIDS
Exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia
Thomas, F: Social Science & Medicine, 63(12), 3174-3187, 2006
Funeral associations - for the living as well as the dead
IRIN News, 22 November 2006
Support for Ethiopian families affected by the AIDS pandemic has come from an unexpected source - local funeral associations, known as edirs. An edir is a traditional 'burial society' to which members make monthly contributions and receive a payment to help cover funeral expenses in return. Nearly every modern Ethiopian is thought to be a member of at least one edir, either a neighbourhood association, one based at work, or operating along age or gender lines. Now one edir changed its constitution to allow members to draw a quarter of their 2,000 birr (US$238) funeral payout before death, and permit a small extra fee to be levied to pay for additional social support from Tesfa, an organisation providing help, particularly in the area of HIV, to 26 affiliated edirs.
Invitation for public comment on draft WHO/UNAIDS guidance on provider-initiated HIV testing and counselling
WHO, 28 November 2006
Since June of this year, the World Health Organization and the UNAIDS Secretariat have been coordinating a consultative process to develop guidance on provider-initiated HIV testing and counselling in health care settings. The latest draft of the guidance document in English is now available. An Executive Summary of the document is available in French, and will soon be available in Spanish. The full text of the document in these languages should be available on the same website by December 18. WHO are now seeking broad public comment on this document. If you wish to provide comments, please follow the instructions that appear on the website and send in your comments according to the following schedule:
o English comments by 5 January, 2007; and
o French and Spanish comments by 19 January, 2007.
Malawi: Limping PMTCT programme failing infants
IRIN News, 21 November 2006
Despite being largely preventable, mother-to-child transmission of HIV accounts for 30% of all new infections in Malawi and is the second major mode of transmission after unprotected sex. Every year, an estimated 30,000 babies are born HIV positive. Relatively simple interventions to lower the risk of infection are available to only a small number of women and lag far behind the country's antiretroviral (ARV) treatment programme, which now reaches 70,000 HIV-infected people, or about 40 percent of those who need them.
The impact of conflict on HIV/AIDS in sub-Saharan Africa
Mills EJ, Singh S, Nelson BD, Nachega JB: International Journal of STD and AIDS 17 (11) 713-717, 2006
Sub-Saharan Africa disproportionately represents the largest incidence of both HIV/AIDS and internal conflicts. The impact of conflict on HIV incidence is largely unknown. Current epidemiological evidence paradoxically suggests that in most populations affected by conflict, HIV prevalence is lower than surrounding communities. Together, these dimensions of conflict create a complex and challenging situation for prevention of HIV/AIDS and delivery of care to conflict-affected populations. The authors examine the complexity of monitoring HIV/AIDS in conflict settings, and argue that increased efforts are needed to protect vulnerable populations and design health-delivery systems that are sustainable in settings of conflict.
The potential impact of ART on fertility in sub-Saharan Africa
Kaida A, Andia I, Maier M et al: Current HIV/AIDS Reports 3 (4) 187-194, 2006
Women with HIV infection have between 25% and 40% lower fertility than non-infected women. As antiretroviral therapy (ART) becomes increasingly accessible in sub-Saharan Africa, it is important to understand whether and how the associated clinical improvements correspond with changes in the incidence of pregnancy and fertility. Accordingly, this paper reviews the literature on the potential impact of ART on the fertility of women with HIV infection in sub-Saharan Africa. The authors use Bongaarts' proximate determinants of fertility framework (adapted for conditions of a generalised HIV epidemic) to examine the underlying mechanisms through which use of ART may impact the fertility of women with HIV infection.
The role of health care in the spread of HIV/AIDS in Africa: Evidence from Kenya
Deuchert E, Brody S: International Journal of STD & AIDS 17 (11) 749-752, 2006
It is commonly asserted that the sub-Saharan African HIV/AIDS epidemic is predominantly due to heterosexual transmission. However, recent re examination of the available evidence strongly suggests that unsafe health care is the more likely vector. The present report adds to the evidence for health-care transmission by showing that Kenyan women who received prophylactic tetanus toxoid injections during pregnancy are 1.89 times (95% confidence interval [CI]:1.03-3.47) more likely to be HIV-1 seropositive than women who did not receive this vaccination. In contrast, recent sexual behaviour (condom use, number of partners) was not related to HIV status. The results are consistent with health care being a very important vector for HIV in sub-Saharan Africa.
What breakthrough is needed to combat HIV/AIDS?
Maoulidi S, Phambuzuka News 280
For an HIV/AIDS breakthrough to happen in Tanzania, a radical approach to tackling HIV/AIDS and its impact is needed, writes Salma Maoulidi, who asks “How can any progress be made in the HIV/AIDS battle if current strategies are superficial and isolated?"
Zambia: More than 10 girls raped every week
IRIN News, 27 November 2006
A Zambian nongovernmental organisation (NGO) revealed this week that it records eight cases of rape of young girls every week at its centre in the capital, Lusaka. The statistics were released by the Young Women's Christian Association (YWCA) of Zambia to mark the start of the global campaign, '16 Days of Activism Against Gender Violence', which runs from 25 November - International Day for the Elimination of Violence Against Women - until International Human Rights Day on 10 December.
Achieving and sustaining universal ART access in rural areas: The PHC approach to HIV services in Lusikisiki, Eastern Cape
Medecins Sans Frontiers, October 2006
The chronic shortage of health care workers is recognised as a major bottleneck to scaling up antiretroviral therapy (ART) , and this has the biggest impact in rural areas where the human resource crisis is most acute. There is a need to develop innovative, effective delivery models, particularly for rural areas with weak health systems. This document reports how the HIV/AIDS programme in Lusikisiki, a partnership between Médecins sans Frontières (MSF) and the Department of Health of the Eastern Cape, has managed to achieve universal ART access in one of the most under-resourced and disadvantaged areas of South Africa without compromising on quality.