This paper presents information on the association between socio-demographic variables and AIDS prevalence in some African and the Organization for Economic Cooperation and Development (OECD) countries. Insignificant difference in the means of AIDS-rates between the OECD countries and the African group was found, but the difference was significant when the USA was excluded from the analysis. As initially expected, life expectancy in the OECD countries was significantly higher than that of the African group while the average rates of infant mortality, population growth, fertility, and death were significantly higher within the African group. Significant association between AIDS-rate and life expectancy was only found for African males, while association with fertility, infant mortality, population density, and calorie intakes was statistically insignificant. No clear difference between urban and rural areas with respect to AIDS-rates was discerned. Communities of Muslims were less subject to the AIDS problem. In conclusion, future studies should devote more attention toward impacts on HIV/AIDS prevalence of other equally important variables such as access to social and health care services, cultural norms, ethnic diversity, and educational facilities.
Equity and HIV/AIDS
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.
As part of quarterly national reports on the scale up of antiretroviral therapy (ART), demographic and clinical characteristics are recorded including data on occupation. The largest occupational category is that of “other”. As there is no information on the composition of the different occupations of patients placed in this category, a formal study was therefore conducted in six representative public sector facilities in the Southeastern Region of Malawi. Between January to June 2006, there were 126 adult patients recorded as “other” in the occupation column. A great variety of different occupations was recorded including no employment 30%, administration jobs 24%, general labourers 11%, builders 10%, tailors 9% and drivers 7%. A wide range of people with different jobs are accessing ART, and this should help in improving the economy of the patients as well as the country at large.
At the 2006 United Nations High Level Meeting on HIV/AIDS, world leaders reaffirmed that “the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV/AIDS pandemic.” Yet, 25 years into the AIDS epidemic, this “essential element” remains the missing piece in the fight against AIDS. Now more than ever, law and human rights should occupy the center of the global HIV/AIDS struggle. This booklet, published by OSI's Law and Health Initiative, presents 10 reasons why.
This paper highlights the socio-economic impacts of HIV on women. It argues that the socio-cultural beliefs that value the male and female lives differently lead to differential access to health care services. The position of women is exacerbated by their low financial base especially in the rural community where their main source of livelihood, agricultural production does not pay much. But even their active involvement in agricultural production or any other income ventures is hindered when they have to give care to the sick and bedridden friends and relatives. This in itself is a threat to household food security. The paper proposes that gender sensitive policies and programming of intervention at community level would lessen the burden on women who bear the brunt of AIDS as caregivers and livelihood generators at household level. Improvement of medical facilities and quality of services at local dispensaries is seen as feasible since they are in the rural areas. Other interventions should target freeing women's and girls' time for education and involvement in income generating ventures. Two separate data sets from Western Kenya, one being quantitative and another qualitative data have been used.
Active tuberculosis (TB) is common among HIV-infected persons living in tuberculosis endemic countries, and screening for tuberculosis (TB) is recommended routinely. The study sought to determine the role of chest x-ray and sputum culture in the decision to treat for presumptive TB using active case finding in a large cohort of HIV-infected patients. Many ambulatory HIV-infected patients with CD4 counts >200/mm3 are treated for presumptive TB. Data suggests that optimal detection requires comprehensive evaluation, including CXR and sputum culture on both symptomatic and asymptomatic subjects.
PRESIDENT Yoweri Museveni of Uganda has called for death penalty for people who knowingly spread HIV. He also called for the outlawing of primitive methods used by the Bagishu and Sebei in eastern Uganda of using knives for circumcision that are likely to spread the virus. Speaking at the commemoration of 25 years since the first case was identified at Kasensero landing site in Rakai District on Friday, the President lauded the parliamentary committee on HIV/AIDS for coming up with the draft Bill.
The first global consultation led by people living with HIV to address their sexual and reproductive health (SRH) and rights took place in Amsterdam, The Netherlands, 5-7 December 2007. The international group of 65 HIV-positive women, men, young people, and transgender people articulated a vision statement to guide advocacy, policy, legal, programmatic and funding priorities that respect SRH and rights, and that underscores the need for health systems to do the same.
Researchers conducted a retrospective cohort study analysing data on patients who presented to McCord Hospital, Durban, and started ART between 1 January 1999 and 29 February 2004. Univariate and multivariate analysis were performed and Kaplan-Meier curves were created to assess predictors. Simple clinical and laboratory data independently predict mortality and allow for risk stratification in patients initiating ART in South Africa. Interventions enabling patients to be identified before they develop these clinical markers and earlier initiation of ART will help to ensure maximum benefits of therapy.
There are the four pillars that will ensure that Africa and Asia are both able to respond to the challenges of HIV and also apply the painful lessons learned from this epidemic in cultures and societies that may – at first glance – seem so different. These are: Visionary leadership; people-centred policies; innovative evidence-informed programmes and passionate participation.