Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia

This report evaluates the extent of perceived and enacted HIV/AIDS-related stigma in a rural setting in Zambia. Stigmatisation is abundant, ranging from subtle actions to the most extreme degradation, rejection and abandonment. Women with HIV and pregnant women assumed to be HIV positive are repeatedly subjected to extensive forms of stigma, particularly once they become sick or if their child dies. Despite increasing access to prevention of mother to child transmission initiatives, including anti-retroviral drugs, the perceived disincentives of HIV testing, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status. Unless efforts to reduce stigma are, as one peer educator put it, “written in large letters in any HIV/AIDS campaign rather than small”, stigma will remain a major barrier to curbing the HIV/AIDS pandemic.     

The African Evaluation Guidelines: 2002. A checklist to assist in planning evaluations, negotiating clear contracts, reviewing progress and ensuring adequate completion of an evaluation

A review of the US ‘program evaluation standards’ (PES), undertaken in a series of workshops and meetings of networks of evaluators in Africa, resulted in modifications to those standards. The result was presented to a plenary session of the Inaugural Conference of the African Evaluation Association in September 1999, attended by over 300 evaluators from 35 countries. The AfrEA Conference decided that a systematic effort should be made to produce a list of African evaluation guidelines, similar to the PES, and that this checklist should be reviewed by national evaluation associations and networks in Africa and field tested in several countries. Ten national and regional networks and associations suggested modifications to the text and endorsed the final version of the guidelines.     

Backfitting Random Varying-Coefficient Models with Time-Dependent Smoothing Covariates

Abstract.  In this paper, we propose a random varying-coefficient model for longitudinal data. This model is different from the standard varying-coefficient model in the sense that the time-varying coefficients are assumed to be subject-specific, and can be considered as realizations of stochastic processes. This modelling strategy allows us to employ powerful mixed-effects modelling techniques to efficiently incorporate the within-subject and between-subject variations in the estimators of time-varying coefficients. Thus, the subject-specific feature of longitudinal data is effectively considered in the proposed model. A backfitting algorithm is proposed to estimate the coefficient functions. Simulation studies show that the proposed estimation methods are more efficient in finite-sample performance compared with the standard local least squares method. An application to an AIDS clinical study is presented to illustrate the proposed methodologies.     

Monitoring and evaluation of loveLife's AIDS prevention and advocacy activities in South Africa, 1999–2001

loveLife is the largest effort ever launched in South Africa to change adolescent sexual behaviour with the aim of reducing the rate of HIV infection among 15–20 year olds by 50%, reducing other STIs, and reducing the incidence of teenage pregnancy. loveLife combines high-powered media awareness and education, development of adolescent-friendly reproductive health services, and outreach and support programmes. The 5-year research and evaluation plan includes a multi-year comprehensive observational study, tracking change in a range of behavioural indicators and in sexual health outcomes. In its first 2 years, loveLife reached more than 4 million youth. Sixty-two percent of youth and 59% of their parents/guardians recognize the brand, while the vast majority of parents (97%) and youth (89%) exposed to loveLife, identified loveLife as being positive. Challenges in the next years are the continued roll out of the programme, and the development of institutional support and behaviour change.     

Zimbabwe's AIDS action programme for schools

AIDS education started very early in Zimbabwe and is now compulsory in all schools. This evaluation documents the development of the primary and secondary school AIDS Action Programme from 1991 to 1998. Six programme aspects were evaluated: programme start-up, planning and management, development of syllabi and materials, teacher training, research, monitoring and evaluation, and co-ordination. The Programme drew on resources from within the existing educational system. Due to broad-based consultation and participation, it was supported by Government and partners. Flexible management ensured implementation of mid-course corrections. It was concluded that school AIDS programmes should stress participatory teaching and learning methods and life-skills training. Curriculum writers and teachers needed training and supervision in participatory techniques. Cluster workshops between district and school levels were needed to strengthen the cascade model of teacher training that had been adopted. Systematic research, monitoring and evaluation were essential, including follow-ups to baseline surveys. The Zimbabwean programme was well-designed, relatively inexpensive and replicable.     

Evaluation of HIV/AIDS peer education projects in Zambia

This 1998 evaluation assessed the peer education programmes of HIV/AIDS projects run by four non-governmental organisations. A mini-case study approach was used and analysis was based on cross-case itemistic variables. The projects were assessed only in terms of immediate developmental outcomes to target groups rather than on long-term impact. The study concluded the following: (1) The projects had raised community awareness of HIV/AIDS; (2) Basic knowledge of HIV/AIDS was for the most part accurate; (3) There was anecdotal evidence of behavioural changes in terms of partner-reduction as reported by the projects, though the evidence was sometimes conflicting; and (4) There was evidence that certain traditional practices, which contributed to the spread of the virus (e.g. sexual cleansing and scarification), were becoming modified over time. The programmes were also instrumental in protecting human rights and enabling people living with HIV/AIDS to maintain human dignity.     

全民预防艾滋病教育体系整体构建的初步研究

艾滋病教育是全球各国用来预防艾滋病最有效的公器,它能传播健康的生活知识。现有的艾滋病教育研究虽已取得了巨大的成就,但研究仍缺乏系统性的思考。本文针对现有研究的不足,提出了整体构建全民预防艾滋病教育体系的构思,并详述了整体构建全民预防艾滋病教育体系的思路、方法、步骤以及全民预防艾滋病教育体系的结构框架。     

动机与第二语言习得

动机是学习第二语言成就大小的重要因素之一。很多研究实验已经证明动机在人类认知过程中起非常关键性的作用。本文打算对动机，融合性动机和功用性动机及其与第二语言习得的关系做一些探讨     

Drug resistance in an age-of-infection model

ABSTRACT

In the case of a disease spreading over a time-scale comparable to the average lifetime in a host population, when the infectiousness of individuals depends on the tine since the onset of infection and when infections involve both drug-sensitive and drug-resistant strains of a pathogen, resistance may develop during the treatment of drug-sensitive strains. If increasing the treatment rate reduces the reproduction number of the drug-sensitive strain to a value below the reproduction number of the drug-resistant strain, then the disease may persist at a boundary equilibrium where only drug-resistant infection is present.     

A growth mixture Tobit model: application to AIDS studies

This paper presents an alternative analysis approach to modeling data where a lower detection limit (LOD) and unobserved population heterogeneity exist in a longitudinal data set. Longitudinal data on viral loads in HIV/AIDS studies, for instance, show strong positive skewness and left-censoring. Normalizing such data using a logarithmic transformation seems to be unsuccessful. An alternative to such a transformation is to use a finite mixture model which is suitable for analyzing data which have skewed or multi-modal distributions. There is little work done to simultaneously take into account these features of longitudinal data. This paper develops a growth mixture Tobit model that deals with a LOD and heterogeneity among growth trajectories. The proposed methods are illustrated using simulated and real data from an AIDS clinical study.