Failure to properly manage HIV strategies for employees has led to some workplace programmes being closed down, as audits have revealed unacceptable costs. Individual companies, communities and the South African economy are under threat if companies do not initiate expertly managed, independent and outsourced HIV programmes for their employees. Failure to expertly manage programmes effectively means money spent on them is wasted, with consequent negative impacts on the individuals concerned, and workplace productivity and morale. Companies that try to cut corners are reported to be undermining themselves, as well as the entire local treatment initiative.
Equity and HIV/AIDS
Homophobia fuelling the spread of HIV
Integrated Regional Information Network, 23 July 2008
The persistent and increasing outbreaks of violence against members of the gay community in Africa are jeopardising efforts undertaken to combat HIV, both within this group and across the population as a whole, AIDS activists warned at a recent meeting in Limbé, Cameroon. The extreme vulnerability of members of the gay community to HIV on the continent was highlighted during a meeting initiated by the French non-governmental organisation, AIDES, and its partners, which took place at the beginning of July in the south west of Cameroon. The meeting brought together many AIDS activists from Francophone African countries. On average it is estimated that HIV infection rates amongst MSM (men who have sex with men) are four to five times higher than the population overall.
Improving the education response to HIV and AIDS: Lessons of partner efforts in coordination, harmonisation, alignment, information sharing and monitoring in Jamaica, Kenya, Thailand and Zambia
UNAIDS Inter-Agency Task Team on Education, 2008
Education contributes toward the knowledge and personal skills essential for the prevention of HIV, and the mitigation of the impacts caused by AIDS. Produced by the Joint United Nations Programme on HIV/AIDS (UNAIDS)'s Inter-Agency Task Team (IATT) on Education, this report synthesises case study exercises undertaken to examine the quality, effectiveness, and coordination of the education sector's response to the HIV epidemic in 4 countries - Jamaica, Kenya, Thailand, and Zambia. In each country, stakeholders assessed: critical achievements and gaps in the education sector response to HIV and AIDS; the evolution and effectiveness of coordination mechanisms and structures; progress toward harmonisation and alignment; information-sharing on HIV & AIDS and education; key resources for the response; and monitoring and evaluation. This report presents the overall findings from the study and makes recommendations for the IATT on Education and its partners to improve coordination in support of country level and to facilitate global actions.
Prevalence and pattern of HIV-related malnutrition among women in sub-Saharan Africa: A meta-analysis of demographic health surveys
Uthman OA: BMC Public Health 2008, 8:226
The world's highest HIV infection rates are found in Sub-Saharan Africa (SSA), where adult prevalence in most countries exceeds 25%. Food shortages and malnutrition have combined with HIV/AIDS to bring some countries to the brink of crisis. The aim of this study was to describe prevalence of malnutrition among HIV-infected women and variations across socioeconomic status using data from 11 countries in SSA. Prevalence of HIV-related malnutrition among women varies by wealth status, education attainment, occupation, and type of residence (rural/urban). The observed socioeconomic disparities can help provide more information about population subgroups in particular need and high risk groups, which may in turn lead to the development and implementation of more effective intervention programmes.
Public-Health and Individual Approaches to Antiretroviral Therapy: Township South Africa and Switzerland Compared
Keiser O, Orrell C, Egger M, Wood R, Brinkhof MWG, Furrer H, van Cutsem G, Ledergerber B, Boulle A: PLoS Med 5(7), 8 July 2008
The provision of highly active antiretroviral therapy (HAART) in resource-limited settings follows a public health approach, which is characterised by a limited number of regimens and the standardisation of clinical and laboratory monitoring. In industrialised countries doctors prescribe from the full range of available antiretroviral drugs, supported by resistance testing and frequent laboratory monitoring. This study compared virologic response, changes to first-line regimens, and mortality in HIV-infected patients starting HAART in South Africa and Switzerland. The study team analysed data from the Swiss HIV Cohort Study and two HAART programmes in townships of Cape Town, South Africa. Compared to the highly individualised approach in Switzerland, programmatic HAART in South Africa resulted in similar virologic outcomes, with relatively few changes to initial regimens. Further innovation and resources are required in South Africa to both achieve more timely access to HAART and improve the prognosis of patients who start HAART with advanced disease.
Saving lives now: female condoms and the role of US foreign aid
Saving Lives Now!: Center for Health and Gender Equity, 2008
This report from the Centre for Health and Gender Equity outlines the importance of the female condom in preventing the spread of HIV. Female condoms are not readily accessible in most countries and significant investment is needed to overcome barriers to their use such as cost and difficulty of use, however the report finds that in the countries where they are accessible, there is a growing demand for them. The report concludes that high quality female condom programming is critical to increasing female condom demand and uptake. The role of the US government in these programmes is highlighted. The authors recommend policy changes that will promote the integration of female condoms into HIV prevention and family planning programmes within US funded development programs, including PEPFAR.
South Africa: New improved PMTCT brings challenges
PlusNews, 11 July 2008
Prince Mshiyeni Memorial Hospital, just outside the port city of Durban, in KwaZulu-Natal Province, has one of South Africa's busiest maternity wards. About 1,200 women a month give birth there, of which about 40% are HIV-positive, according to figures from the antenatal clinic. For staff working in the hospital's antenatal clinic and maternity ward, implementing the government's new guidelines for the prevention of mother-to-child HIV transmission (PMTCT) has not been easy. HIV-positive mothers with CD4 counts over 200 should now receive zidovudine, also known as AZT, from their 28th week of pregnancy until labour, as well as a single dose of nevirapine during labour. Their infants should get a single dose of nevirapine, and then AZT for seven days (or four weeks if AZT was started late). The new drug regimen means extra work for the hospital staff, while the number of doctors, nurses and counsellors providing PMTCT services at the hospital has not increased. This article reports on the workload and facility issues that arise inimplementing the guidelines.
The role of HIV/AIDS committees in effective workplace governance of HIV/AIDS in South African small and medium-sized enterprises (SMEs)
Vass JR: SAHARA Journal 5(1): 2-10
The primary purpose of this study was to assess the role, status and scope of workplace HIV/AIDS committees as a means of effective workplace governance of the HIV/AIDS impact, and their role in extending social protective HIV/AIDS-related rights to employees. In-depth qualitative case studies were conducted in five South African small and medium-sized enterprises (SMEs) that were actively implementing HIV/AIDS policies and programmes. Companies commonly implemented HIV/AIDS policies and programmes through a workplace committee dedicated to HIV/AIDS or a generic committee dealing with issues other than HIV/ AIDS. Management, through the human resources department and the occupational health practitioner often drove initial policy formulation, and had virtually sole control of the HIV/AIDS budget. Employee members of committees were mostly volunteers, and were often production or blue collar employees, while there was a notable lack of participation by white-collar employees, line management and trade unions. While the powers of workplace committees were largely consultative, employee committee members often managed in an indirect manner to secure and extend social protective rights on HIV/AIDS to employees, and monitor their effective implementation in practice. In the interim, workplace committees represented one of the best means to facilitate more effective workplace HIV/AIDS governance. However, the increased demands on collective bargaining as a result of an anticipated rises in AIDS-related morbidity and mortality might prove to be beyond the scope of such voluntary committees in the longer term.
Training of HIV/AIDS committees at local government authorities
Tanzania Commission for AIDS
Tanzania is one of the countries hardest hit by the HIV/AIDS epidemic. The Tanzania Commission for AIDS was established as part of the government response to the HIV epidemic. This manual is part of the Tanzania Commission for AIDS strategic plan to coordinate and strengthen the efforts of stakeholders involved in the fight against HIV/AIDS. It is intended as a training manual for local government authorities.
World Disasters Report 2008: Focus on HIV and AIDS
HealthLink Bulletin
The AIDS epidemic is a disaster on many levels. In the most affected countries in sub-Saharan Africa, where prevalence rates reach 20%, development gains are reversed and life expectancy may be halved. For specific groups of marginalized people injecting drug users, sex workers and men who have sex with men across the world, HIV rates are on the increase. Yet they often face stigma, criminalization and little, if any, access to HIV prevention and treatment services. As this report explains, HIV is a challenge to the humanitarian world whose task is to improve the lives of vulnerable people and to support them in strengthening their capacities and resilience. Disasters, man-made and ‘natural’, exacerbate other drivers of the epidemic and can also increase people’s vulnerability to infection.