Nuanced approaches to HIV/AIDS research

HIV testing is an integral component to HIV prevention strategies and a gateway to treatment and care. Over the past decade, the MEASURE DHS project has noted a substantial increase in HIV testing uptake across sub-Saharan African countries, sometimes by more than ten-fold. Drawing from repeated cross-sectional DHS/AIS data in Cameroon, Congo-Brazzaville, Ethiopia, Ghana, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Nigeria, Rwanda, Senegal, Tanzania, Uganda, and Zimbabwe, this paper analyzes demographic divergence in HIV testing uptake within and across countries, with special attention to HIV positive adults. While testing uptake has increased in all 15 countries with repeated DHS/AIS surveys, gains have been uneven. Using logistic decomposition on pooled cross-national data we differentiate factors associated with being tested that relate to time period of survey and to country-level endowments related to access and outreach from individual socio-demographic characteristics associated with having ever been tested for HIV. Despite dramatic increases in testing uptake, the majority of HIV-positive adults in six countries have no way of knowing their HIV serostatus. Continued expansion of outreach and access to HIV testing will help determine future demand for medical treatment and support for persons living with HIV/AIDS.

In light of the increasing ‘feminisation’ of the HIV epidemic, this paper aims to increase understanding with regard to the factors which help shape the context of vulnerability in sub-Saharan Africa. Relatively few studies have examined the relationship between gender-related variables and HIV prevalence at the population level and existing studies have reported conflicting results, focus on relatively few issues, and are usually limited to one setting. The sex ratio in HIV prevalence has received even less attention despite substantial variation between countries. This paper focuses mainly on gender disparity in the 15-24 age group as this is not only the age group in which women are argued to be particularly vulnerable, but also in which gender disparity is most pronounced. The influence of several gender-related variables is explored using partial correlation coefficients and linear regression. The analysis controls for a number of variables which may influence the ratio of female to male HIV prevalence including the maturity of the epidemic, prevalence of other STIs and gender differences in accessing ART as well as other social and institutional differences.

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.

The 2011 HIV sentinel report for Ghana reveals that HIV prevalence rates in five out of ten regions in Ghana recorded an increase over the 2010 figures. Also, prevalence among young persons aged between 15- 24 years (was used as a proxy for new infections) increased from 1.5 percent in 2010 to 1.7 per cent in 2011. This clearly suggests that the HIV/AIDS situation in Ghana is unstable and therefore has the tendency to increase if measures towards prevention are not intensified. Reducing number of sexual partners, regular use of condom, avoiding sharing needles during intravenous drug use, and HIV voluntary counseling and testing (VCT) are seen as key in fighting the epidemic.
It has been strongly argued that that young people’s inability to reduce risky behaviour can be attributed to the poor knowledge about the HIV/AIDS. Against this background, the University of Cape Coast for the past four years, offers a compulsory HIV/AIDS course for all first year undergraduates students.
Using cross sectional primary data from 600 students randomly selected from the University, the study finds out whether or not the course has influenced students’ behaviour.

Clinic-based studies routinely report a higher prevalence of domestic violence among HIV-positive women compared to HIV-negative women. This same association is not consistently found in population-based cross-sectional studies. The usual interpretation, if an association is detected, is that domestic violence leads to an increased risk of HIV. Yet a direct effect is unlikely. If domestic violence increases the odds of a woman having HIV, it must do so indirectly through her own risk behaviors, those of her partner, or her partner’s HIV status. Population-based studies seldom explicitly articulate and model the intervening paths through which domestic violence may influence HIV status; Variation in their findings may well depend on variations in the conceptualization of violence, analytic methodologies, and included covariates. Additionally, most studies are based on women’s data with limited information on partners’ HIV status and risk behaviors. This paper clarifies the ways in which domestic violence contribute to women’s HIV status, using recent DHS surveys from five Sub-Saharan countries with data on domestic violence, HIV test results and risk factors for both partners of married/in-union matched couples and guided by a conceptual framework depicting possible pathways by which violence could indirectly effect HIV status.

This study examined the illness or diseases affecting people living in South Africa. In this study we focus on the dependent variables of health status and whether subjects suffered from illness/sickness. The study focused on respondent’s age 15-49 years, corresponding to a total of 55,384 people composed of 25,859 males and 29,525 females. Among this population, 5,935 people suffered from illness/injury, including 2,469 (41.6%) males and 3,466 (58.4%) females. This article provides weighted multivariate estimates of illness by province, in association with background characteristics of the target population, and selected socioeconomic and demographic variables. Tuberculosis (TB) is the second most common cause of illness/injury only in the provinces of Kwazulu Natal (9.1%), North West (5.4%) and Limpopo (4.2%). People who are not married have 1.2 times greater chance than those currently married to suffer from illnesses/injuries. Those with non-living spouses are 1.09 times more likely than the others to suffer from illness/injury. This study concluded that rapid action is needed to fight illness/diseases to produce a healthy population. Therefore, follow-up care and special consideration is urgently needed for the weaker provinces like KwaZulu Natal.

The majority of women in Uganda are sexually active, yet many do not take appropriate precautions to prevent the spread of sexually transmitted infections. This paper discusses the factors associated with having had an STI during the past year for women of reproductive ages 15-49 years. Women may be prone to contracting STIs because of the behavior of their partners; however they too may be engaging in risky sexual behavior which could lead to this vice. Contracting STIs and worse still HIV could ultimately lead to both immediate and long-term negative consequences. Using data from the most recent Uganda Demographic and health Survey, a binary logistic regression is fitted to the data to examine the association between a number of sex partners and risk of contracting an STI in the year preceding the survey. In the model we also control for a number socioeconomic factors and age of the respondent. The findings show that the risk of contracting STIs were least in Northern region of Uganda compared to Kampala and other regions of the country. The findings sow that the odds of contracting STIs varied significantly with age and income. As expected, married and formerly married exhibited higher odds of contracting STIs compared to the unmarried. Having more than one partner significantly increased the odds of contracting an STI.

The SSA HIV epidemic presents patterns that challenge conventional understandings of the relationships between SES and health. It has often been assumed that Africa’s status as the continent with the highest HIV infection rates is linked to endemic high poverty and a corresponding lack of access to adequate health care resources. Somewhat surprisingly, a growing number of studies show that wealthier individuals (irrespective of gender), wealthier regions (urban areas), and wealthier countries within SSA often display the highest levels of HIV infection.Despite evidence of a positive SES-HIV gradient, researchers and policy-makers frequently assume that range of protective interventions – increasing awareness of mechanisms of HIV transmission, techniques for prevention, greater access to health care facilities, and greater availability of condoms – will reduce the likelihood of contracting HIV, even among higher SES populations. We explore the relationships between SES and a range of intervening risk factors to illuminate the complex causal processes that link SES and HIV in Cameroon.Results show at least through 2004 any benefit that may have accrued from high SES appears to be offset by higher riskier sexual practices – including more premarital sexual activity, higher numbers of sexual partners, and higher rates of infidelity

With the outbreak of the HIV scourge in Uganda in the early 80s, AIDS has had its turn on numerous individuals in Uganda. While so many studies have examined the effect of HIV/AIDS on the population, very few studies have analyzed the major factors heightening the HIV prevalence rate in Uganda, which among others include complacency and poverty. Basing on the primary data collected, the results revealed that, respondent (who were mainly youths) were more afraid of pregnancy other than contracting HIV/AIDS (73%). Results also showed that, 59% of the respondents were highly prone to contracting HIV/AIDS due to poverty. The results also go ahead to show that more females engage in risky sexual behaviour compared to males. Results therefore emphasize need for heightening the campaign on Behavioural change communication especially among the youths, and by so doing, this will help to eventually halt the mother to Child Transmission of HIV/AIDS.

Intimate partner relationship provides emotional support and social security to FSWs despite sometimes putting safe sexual practices at stake. This paper analyzes prevalence of STIs among FSWs having intimate partner relationships in the last 12 months prior to survey in Nepal. Information pertains to 1401 respondents selected following a modified time-location cluster sampling. Findings reveal that protective sex with intimate partner is reported by less than half of FSWs and is even lower among married FSWs. STI prevalence is higher among this group with 1/3rd reporting the symptoms in last 12 months, which can be attributed to the unprotected sex. Age above 30, illiteracy and currently married status have significant affect on the STI prevalence among this group. Further, marital status and coital frequency seems to have a significant effect on the condom use behaviour of the FSW. It is seen that those who are unmarried are 0.3 times (p<0.01) less likely to use condom as compared to their counterparts. Literacy and migratory status are significantly affecting the prevalence of STI. Understanding the worth of intimate partners in an FSW’s life, strategies should be devised to promote protective sex in intimate partner relationships in order to combat its serious bearings on STIs among the group.