Greater involvement of people living with HIV/AIDS in South Africa

This study reports on a pilot project, the greater involvement of people living with HIV/AIDS Workplace Model, which places trained fieldworkers living openly with HIV/AIDS in selected partner organisations sectors, where they set up, review or enrich workplace policies and programmes. The project adds credibility to partners' HIV/AIDS programmes and creates a supportive environment for people living with HIV/AIDS (PLWHA) and others to speak about HIV/AIDS. Eleven men and women living with HIV, aged between 30 and 45, and with varied life experiences and education levels, shared a willingness to speak about their HIV status in their workplace. They worked in very different environments but their collective experiences showed that PLWHA can add value to workplace HIV/AIDS programmes in a way that is relevant, effective, efficient, sustainable and ethical. They made companies and communities more aware of the intense need for HIV/AIDS policies and encouraged care and support for infected and affected people.     

Who Can Help People with HIV/AIDS in Africa? Governance of HIV/AIDS and Civil Society

This paper locates NGOs dealing with HIV/AIDS problems in sub-Saharan Africa into the larger governance context within which they function. This aims at a theoretical shift to assess the aspirational characteristics for the agency of NGOs that are used to legitimate contracting out implementation of internationally designed HIV/AIDS policies to these organizations. The paper interrogates the nature and impact of the governance structure on NGOs and then looks at the implications of this for HIV/AIDS. The questioning is based on a juxtaposition of the perspective of international policy fora in relation to civil society organizations with the way NGO work is perceived by the people at the receiving end of the policies. The paper suggests that as part of the international governance structure, NGOs are limited within the policy frameworks created by this structure. Furthermore, due to their organizational characteristics, NGOs lack capacity to establish sustainable long-term interventions relevant for sociocultural change as perceived by people themselves.     

阿拉伯国家艾滋病问题现状综述

本文概述了阿拉伯国家艾滋病问题的现状，分析了阿拉伯国家自身的文化、社会结构特点与艾滋病传播的关系，指出艾滋病已成为当今阿拉伯各国不可忽视的重要问题，同时也对阿拉伯国家防治艾滋病的前景做出了较乐观的估计。     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).     

Righteous Dopefiend and AIDS,Sex, and Culture: Global Politics and Survival in Southern Africa

This essay offers a comparative reading of two ethnographies, Ida Susser's AIDS, Sex, and Culture: Global Politics and Survival in Southern Africa (2009 Susser, I. 2009. AIDS, Sex, and Culture: Global Politics and Survival in Southern Africa, Oxford: Wiley-Blackwell. [Crossref] , [Google Scholar]), a multisited text focused on community responses to dynamics of HIV/AIDS prevention and treatment in Southern Africa, and Philippe Bourgois and Jeff Schonberg's Righteous Dopefiend (2009 Bourgois, P. and Schonberg, J. 2009. Righteous Dopefiends, Berkeley: University of California Press.  [Google Scholar]), a photo-ethnographic exploration of lumpen subjectivity within an encampment of homeless drug addicts in San Francisco. Pointing out these texts' common focus on circumstances of the precarious and marginal poor under conditions of neoliberalization, social conditions shaping dynamics of HIV prevention, and poor people's negotiations of affliction and structural violence, this essay highlights the theoretical and practical effects of these books' divergent methodologies, scopes of analysis, and differing degrees of emphasis on subjective experience as well as women's experiences. It also considers a key commonality across these texts: their attention to the role of historical experience and political-economic context in shaping responses to affliction and structural violence.     

College Students and HIV/AIDS: A Comparison of Nontraditional and Traditional Student Perspectives

Objective and Participants The authors compared nontraditional college students' knowledge and perceptions of HIV/AIDS and sexual practices with previously reported results about traditional students. Methods Nontraditional students completed an online survey with questions based on national HIV/AIDS surveys. Traditional students completed the same survey with paper and pencil. Results Overall, the authors found more similarities than differences between the 2 groups. The findings support previous research that suggests that although college students are knowledgeable about HIV and its risks, they express little personal concern about becoming infected. The authors also discuss how apparent differences between nontraditional and traditional students regarding personal concern about becoming infected, relationship status, and information sources may influence the development of effective prevention strategies geared toward nontraditional college students. Conclusions Institutional leaders need to adapt to these differences, and researchers should undertake additional studies to clarify these differences so that college students may be more effectively educated about HIV/AIDS and encouraged to get tested.     

Donor withdrawal and local civil society organizations: An analysis of the HIV/AIDS sector in Vietnam

The impact of international donor arrival on local civil society organizations (CSOs) is well researched. Less well understood is how local CSOs react and adapt to donor withdrawal. This article explores this phenomenon in the context of the HIV/AIDS sector in Vietnam. Using data from government, donor and CSO sources in Vietnam, it examines how current and planned cuts in donor funding, including donor exit, impact local CSO agency and effectiveness. It finds that while donor withdrawal may reduce CSO capacity and independence, it can also prompt local innovations that—if successful—may improve CSOs’ responsiveness to local stakeholders.     

An ethnography of HIV/AIDS and sexuality in the People's Republic of China

China's HIV epidemic is now a growing reality, yet there is virtually no evidence of it in the HIV/AIDS literature. This report documents ethnographic and epidemiologic findings from field visits conducted in Beijing, Chengdu, and Kunming; the latter in Yunnan province, site of China's most severe nidus of HIV infection. This report also elaborates those cultural, social, and political factors involved in China's attempt to manage its growing HIV epidemic. Contemporary attitudes toward sexuality in China which impinge upon such management, as revealed through ethnographic interviews, are reviewed. Data from the First Sino‐American Management of HIV Disease Symposium (to which the author was a delegate) are also blended with the ethnographic material to further clarify the cultural and epidemiologic status of HIV/AIDS in China. It is the conclusion of this report that HIV/AIDS and its management pose a transforming, ineluctable challenge to China's traditional attitudes toward sexuality.     

HIV/AIDS and Home Based Care in Botswana

SUMMARY

The extent of the AIDS pandemic in Africa (and specifically in Botswana), and the lack of institutional frameworks to address concomitant issues, have necessitated the adoption of home based care for sufferers as national policy. The practice is beset by problems, given the severe symptomatic nature of the disease and the general lack of human and material resources to address the needs of patients and care-givers.

A study of one such programme in the Kweneng District of Botswana highlighted gender imbalances, poverty, lack of appropriate skills, over-involvement of the elderly, deficient specialised facilities, need for volunteer capacity building, inadequate income generating activities, insufficient counseling services, and culturally determined cognitive processes as areas requiring urgent attention. It is apparent that the programme needs strengthening through appropriate support mechanisms and that alternative strategies should be devised for those whose circumstances demand them.

The international hospice movement, represented in Botswana, exemplifies a philosophical and service model for multisectoral consideration and implementation on a nationwide scale. The article discusses, inter alia, day care centres and residential units for the terminally ill; a system of highly trained volunteers to work with patients and their families; consistent, skilled nursing services in home based care situations; and halfway houses for training of care-givers as possible solutions to the problem.

The contextualization of such measures will undoubtedly assist in bolstering Botswana's unchallenged record of high standards in governance and social development.     

Fallout from Communism: The Role of Feminism in Fighting HIV/AIDS among Women in Russia

ABSTRACT

I have no political platforms. I don't like the system of rules the word ‘feminist’ implies.

—Roza Khatskelevich, New York Times, 2003     

The Socio‐Economic Determinants of HIV/AIDS Infection Rates in Lesotho,Malawi, Swaziland and Zimbabwe

Using data from the Demographic and Health Survey, this article analyses the relationship between HIV status and the socio‐economic and demographic characteristics of adults in Lesotho, Malawi, Swaziland and Zimbabwe. It constructs the risk profile of the average adult, computes the values of age, education and wealth where the estimated probability of infection assumes its highest value, and determines the percentage of adults for whom these three factors are positively correlated with that probability. It finds that in all four countries: (i) the probability of being HIV‐positive is higher for women than for men; (ii) the likelihood of infection is higher for urban than for rural residents; and (iii) there is an inverted‐U relationship between age and HIV status. Also that, unlike gender, rural/urban residence and age, the relationship between the probability of infection and wealth, education and marital status varies by country. The results provide support for country‐specific and more targeted HIV policies and programmes.     

Qualitative evaluation of HIV/AIDS IEC activities in Madagascar

UNICEF commissioned a qualitative evaluation of a program in which two partners conducted prevention activities concerning HIV/AIDS and STIs amongst youth in Madagascar. The evaluation assessed project activities and conducted a practical exercise in focus group methodology, following a workshop on evaluation techniques. Information was collected from a wide range of people, including 441 participants in 46 focus groups in nine sites. Six sites were areas of project activities and three sites were targeted for future activities. Clubs that integrated HIV/AIDS and STI information into their regular activities were most successful in their information, education and communication activities. A more participatory approach is recommended, to achieve a better match between target groups and messages delivered, and to foster trust and support. Another challenge remaining is to address fears and stigma through advocacy for the care and support of affected people.     

Women,Economic Development,and HIV/AIDS: Transforming Systems of Care for Sustainable Change

ABSTRACT

In this concept article, the authors utilize Maslow's Hierarchy to define and discuss a proposed conceptual treatment framework that includes economic development efforts with examples of successes that have been demonstrated in the literature. The authors posit that HIV/AIDS treatment practitioners should not overlook the interconnectedness and interdependency of economic equilibrium and public health and suggest that the creation of treatment plans based on multi-dimensional interdisciplinary approaches are necessary to achieve maximum benefit for care and resource dollars.     

Rethinking international and domestic financing for HIV in low‐ and middle‐income countries

The scaling up of treatment for HIV across the world has been one of the most significant recent achievements in international health. But the commitment on antiretroviral treatment also creates a financial liability which is large and insufficiently recognized. In this article, we explore how this financial liability could be met by domestic and international sources. We argue that (1) governments and donors should recognize the magnitude of the problem and develop tools to manage the liability, (2) allocation of aid should be more rational, transparent and sustainable, (3) more fiscal space should be created domestically, (4) borrowing offers some limited potential for prevention interventions characterized by high returns on investment, and (5) efficiency gains, while not in themselves likely to bridge the resourcing gap, should be energetically pursued.     

Potential Roles of Black Churches in HIV/AIDS Prevention

Abstract

This study examines the role of Black churches in AIDS/HIV prevention. This is a pilot survey study design administered to 11 churches represented by 11 ministers and one church member. The analysis is both qualitative and quantitative. The results showed that most of the ministers had spoken with their congregation on HIV/AIDS. A few ministers had previously sponsored or taken part in HIV/AIDS workshops and disseminated HIV/AIDS educational material in the African American community. None of the churches had an established HIV/AIDS prevention program. Most of the ministers were receptive to implementing an HIV/AIDS prevention program, provided that it did not violate the church doctrines. The findings in this study suggest that Black churches represent an important potential resource for HIV/AIDS prevention. For success, the initial strategy should involve the minister in the early planning stage. Future research should focus on expanding the scope of this study and improving communication between the church, community-based organizations, and health professionals.     

Strengthening the Capacity of Grandparents in Providing Care to Young Children Affected by HIV/AIDS

Abstract

Action for Children (AFC) is a non-governmental organization founded and registered with the government of Uganda in 1998 to rescue children from immediate danger and to advocate for their rights. AFC is working on a three-year pilot project entitled the Grandparents Action Support Project (GAS), designed and implemented to strengthen the capacity of grandparents providing care to HIV/AIDS orphans and vulnerable children under the age of eight, and to improve the overall welfare of the families taking care of these children. After only seven months, an interim program evaluation revealed that several effective innovative and pragmatic community-based strategies have been developed and implemented by participants. The Project has had a multiplier effect in participating communities in that ‘non-Project’ families are copying and learning from GAS Project homes. Challenges and future expansion of the Project are described.     

Analyzing HIV/AIDS and Alcohol and Other Drug Use as a Social Problem

Most prevention and intervention activities directed toward HIV/AIDS and alcohol and other drug use separately as well as the combining of the two (e.g., those who are both HIV/AIDS and using alcohol and other drugs) comes in the form of specific, individualized therapies without consideration of social influences that may have a greater impact on this population. Approaching this social problem from the narrowed view of individualized, micro solutions disregards the larger social conditions that affect or perhaps even are at the root of the problem. This paper analyzes the social problem of HIV/AIDS and alcohol and other drug abuse using three sociological perspectives—social construction theory, ethnomethodology, and conflict theory—informing the reader of the broader influences accompanying this problem.     

Enhancing community-based organizations’ capacity for HIV/AIDS education and prevention

The catalytic potential of community-based organizations to promote health, prevent disease, and address racial, ethnic, and socio-economic disparities in local communities is well recognized. However, many CBOs, particularly, small- to medium-size organizations, lack the capacity to plan, implement, and evaluate their successes. Moreover, little assistance has been provided to enhance their capacity and the effectiveness of technical assistance to enhance capacity is likewise limited. A unique private–academic partnership is described that simultaneously conducted program evaluation and addressed the capacity needs of 24 CBOs funded by the Pfizer Foundation Southern HIV/AIDS Prevention Initiative. Assessments of key program staff members at 12 and 18 months after the initial cross-site program assessment survey indicated a significant improvement in the CBOs’ knowledge, skills, and abilities and a substantial reduction in their technical assistance needs for HIV/AIDS prevention. Full participation of CBOs in technical assistance and a concurrent empowerment evaluation framework were necessary to enhance prevention capacity.     

Lived Experience and Interpretation in Narrative Theory: Experiences of Living with HIV/AIDS

Narrative analysis builds on the strengths of qualitative research by examining the construction of meaning and symbolic systems in a framework that is explicitly temporal and that links research in the humanities with that in the social sciences. Qualitative methodologies often assume reported data accurately reflects the realities of lived experience. On the other hand some research drawing on cultural studies argues that the facts of a person's life are irrelevant. This paper argues for a middle way based on narrative theory that explores the interaction of objective events and their subjective interpretation. Further, narrative analysis enables exploration of the temporal structure of people's experiences focusing on both how a person's memories of the past and anticipations of the future influence their understanding and actions in the present. These points are developed drawing on the theory and methodology of both Symbolic Interactionism and Paul Ricoeur's Hermeneutics. The experiences of people living with HIV/AIDS are used to illustrate and explicate the usefulness of narrative analysis.     

Challenges and Opportunities in HIV/AIDS Counseling: A Case of Jharkhand

The study highlights the challenges and opportunities in HIV/AIDS counseling. The major challenges are recruiting the right individuals and their capacity building and retention. The finding shows that most of the counselors are not befitting in terms of qualification and experience besides motivation, remuneration, and other issues. The study suggests that to ensure the effective counseling to reverse the epidemic, it is important to focus on such issues through appropriate policy interventions.