The demographic and socioeconomic consequences of HIV/AIDS

Using a sample of HIV-positive women (n=353) and men (n=299) from Nigeria and Zambia as well as their health care providers (n=179), we examine attitudes towards childbearing and abortion among HIV-positive women on individual measures as well as an index. Support for HIV-positive women to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already has an HIV-positive child. Support for childbearing among the HIV-positive was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than support from providers. Support for abortion varied more depending on the measure. Half of all respondents indicated no/low support for abortion on the index measure while between 2 to 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion for HIV-positive women indicate that HIV does not seem to qualify for most respondents as a medical condition which justifies abortion. While integrating HIV and family planning services remains challenging, increased medical and social education about childbearing while managing HIV may have the potential to reduce stigma and help HIV-positive individuals meet their reproductive goals.

We aim to analyse relationships and trends between socio-economic status and HIV infection rates while accounting for demographic and behavioural factors using data over several rounds of a large population-based cohort study in Manicaland, Zimbabwe, over the period 1998 to 2011.
Socio-economic status will be estimated from summed asset ownership scores for sellable, non-sellable and all assets. Multilevel random-effects models will be used to analyse associations between wealth and HIV. Sexual behaviour data will be incorporated in the models to assess for a potential mediating role. Results will be compared over several study rounds to assess for trends and dynamics.
Preliminary results showed that mean asset scores decreased between rounds, reflecting a shift from moderate to poorer absolute wealth. Whilst ownership of sellable assets declined, there was an increase in non-sellable assets over time. Asset scores varied by location and were highest (and rising) in towns and lowest (and falling) in subsistence farming areas. Concurrently, adult HIV prevalence dropped significantly from 22.4% to 16.2%. In men, we found no significant associations between household wealth and HIV prevalence across all rounds. In women, multivariate analyses showed associations between greater poverty and higher HIV prevalence up to 2003-2005.

This paper uses data from the 2008 Botswana AIDS Impact Survey (BAISIII) to investigate the impact of knowledge of HIV status on sexual and HIV risk behaviors in Botswana. The logistic regression net effects model shows that knowing that one is HIV positive was associated reduction in the odds of having had sex with two or more people during the year leading to the survey; reporting two or more current partners and inconsistent condom use. Being HIV positive and not knowing it, was associated with increased likelihood of having had sex with two or more people during the year leading to the survey and having two or more current sexual partners, compared to respondents who were HIV negative and did know it.
Knowing one’s HIV negative status was associated with marginally increased likelihood of having had sex with two or more people during the year leading to the survey; having two or more current sexual partners, and a decline in likelihood of inconsistent condom use, compared to respondents who were HIV negative and didn’t know it. While promotion of HIV VCT has the potential to reduce sexual and HIV risk behaviours in Botswana, there is also a need to investigate the potential for sexual dis-inhibition associated with knowledge of an HIV negative status.

Background
The use of home-based peer counselling has widely
resulted in significant increase in the rate of EBF in both developed and developing countries. Unfortunately barriers to implementation of interventions rarely prioritized the needs of HIV positive women
during the design and conduct of the interventions even in countries with high rates of HIV among pregnant women.

Method
We conducted qualitative in-depth interviews between January to August 2012 targeting HIV positive women, peer counsellors and health professionals who were directly involved in the community based intervention conducted by MaiMwana Project in the rural Malawi between 2005 to 2010. A total of 39 respondents were purposively selected and interviewed once using a pre-designed interview guide.

Results
Lack of time because of household chores and farming, poverty, transportation and non-disclosure of HIV status were seen as main barriers to effectively visit and counsel women in their homes. In fact the presence of other family members during the visit and fear of stigma made many HIV positive women not to disclose their HIV status to the counsellors which made it difficult for the counsellors to effectively counsel the woman. The needs of HIV positive women need to be considered when developing these community based interventions.

The Aids orphans crisis constitutes one of the greatest human challenges of the global community; for Brazil the estimate is 200.000 orphans in 2010. In Santos, city known by the Aids high prevalence, researchers worried about orphanhood carried out the first national study for estimate total paternal and maternal Aids orphans, aged less than 15 years, in the period 1995-2001. The present work improves the Aids orphans estimation methodology, validated in the previous study, updating the informations and incorporating the knowledge of the international and national epidemic trends. Applying demographic techniques, Aids orphans estimate was updated to 2012 and the age increased up to 18 years, following international recommendations about the Aids orphans vulnerability, not barely to 15 years. The new epidemic tendencies, maternal transmission decline, survival increase by the use of antirretroviral therapy and the growing exercise of the reproductive right to maternity of seropositive women were also incorporated.

Objective: To appraise the contribution of intensive programme among Long Distance Truck Drivers in terms of safe sex practices with paid female partners.Methods: The key variable -exposure to HIV prevention interventions was divided into three categories - less exposure, moderate exposure and intensive exposure. IBBA Truckers data were analyzed using multiple logistic regression methods to understand the relationship between program exposure and consistent condom use practices. Significant factors were further analyzed using decomposition method to examine the contribution of different components of that factor towards the total increase in consistent condom use over time.Results: There was significant increase in consistent condom use with paid female partners among long distance truck drivers from round1 to round2.Truckers, exposed to intensive intervention programmes were two times more likely to use condom consistently with paid partners (OR 2.1; 95% CI 1.4-3.1;p-value <0.0001). Out of total increase in consistent condom use practices with paid partners, truckers who were exposed to Avahan programme contributed 58%. Conclusions: This study results highlight the ability of intensive program to reach truckers who have sex outside marriage with HIV prevention interventions and promote safe sex behaviour among them.

In the era of accessibility to HAART, one challenge is growing-up of children born from HIV-positive mother in earlier of HIV epidemic since HIV can positively and negatively effect on their current and future living.

The cross-sectional survey was done by using questionnaire of socio-demography and life events and the PedsQL™4.0 to explore life experiences and well-being among children aged 5-18 years who born from HIV-positive mothers in 2 selected provinces of Thailand. There were 115 HIV-positive children and their caregivers voluntarily participated and completed questionnaires.

Preliminary results showed that two-third of children lose father and/or mother. Stigma & discrimination were occurred outside more than inside of home. Around 60% knew their HIV-status. About 70% had severely illness and nearly 100% received ARV. Besides, children had problems on physical and intellectual developments higher than emotional development. Mean of total score of PedsQL4.0 was 78%. Score of physical health were higher a bit than psychosocial health. The lowest score of psychosocial health was schooling functioning.

The results suggest that to support these HIV-positive children living with well-being, it needs intervention to support them coping with problems concerning school functioning and its related problem.

Undernutrition is common among children living with HIV/AIDS. The vexing challenge is inadequate sustainability components of caretakers to meet the nutritional needs of such children. Supporting the needs of mothers/caretakers and CLHA can reduce the risk of MTCT and improve the nutritional status of the infected/affected child for proper early childhood growth. The present study examines the impact of supplementary feeding on the nutritional status of CLHA under five years of age. A cross-sectional implementation data was collected by HAU (2010/2011) on 883 CLHA under five years provided by their mothers/caretakers in Amuru and Gulu districts. ANOVA/MCA was used to compare mean anthropometric indicators recorded before and after introducing the child to supplementary feeding and other health integrated programmes. Overall, mean discharge weights and MUAC of the child increased significantly. Cure rate was as high as 83% above the standard 75%. Although length of stay was slightly above the standard (97.7 days), the average weight gained for children was 2.8g/Kg per day within the recommended IMAM guideline 90 days and <5g/kg per day. Introducing supplementary feeding to CLHA together with an integrated health programs such as vaccination/immunization, family planning and VCT would boost the survival status of CLHA.

This paper examines the impact of HIV/AIDS on household income and productivity in Nigeria using North Centre Region (NCR). The HIV/AIDS prevalence rate in the region is the highest among the six regions in the Country and is estimated to be 7.2 percent which is above the National prevalence rate of 4.1 (National Bureau of Statistics, 2010). The focus states in NCZ include: Benue, Niger, Nasarawa and the Federal Capital Territory (FCT). These four states have the highest HIV/AIDS prevalence rate in NCZ as revealed by National Bureau of Statistics (2009).The theory of production was utilized as the theoretical framework for the study and the empirical analysis will be carried out using primary data of 1000 households that have a member(s) suffering from the illness. Both the logistic regressions and Pseudo regression was adopted for the analysis. The preliminary result (pivot study) has shown that HIV/AIDS has adverse impact on household income and productivity in each states and the region as a well. It is recommended that, the government should assist household experiencing the illness through provision of cheap antiretroviral drugs, financial aims and provide jobs to infected economic active persons.

Studies have examined the AIDS/TB Mortality Consequence of Migration but ignored other causes. We recognise that migrants could die of causes that can preclude AIDS/TB. Therefore, this paper employs a competing risk technique developed by Gray and Fine to investigate how the relationship between migration and AIDS/TB has evolved between 1994 and 2009 in South Africa in the context of other diseases and how the relationship compares with that of migration and other causes of death

The results indicate a changing relationship between migration and AIDS/TB mortality at each period of analysis . Migrants have greater odds of dying of AIDS/TB compared to their non-migrants counterparts. However, the gap became narrow at the later period. It is shown also that migration affects all causes of death

While we expect migration to influence AIDS/TB epidemic the way it did (increasing then decreasing contribution due to the availability of ART at the population level) but what is probably much less expected was its role on "silent" NCDs and other causes.