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Full-Text Articles in Medicine and Health Sciences
Paving The Path: Preparing For Microbicide Introduction—Report Of A Qualitative Study In South Africa, Julie Becker, Rasha Dabash, C. Elizabeth Mcgrory, Diane Cooper, Jane Harries, Margaret Hoffman, Jennifer Moodley, Phyllis Orner, Hillary J. Bracken
Paving The Path: Preparing For Microbicide Introduction—Report Of A Qualitative Study In South Africa, Julie Becker, Rasha Dabash, C. Elizabeth Mcgrory, Diane Cooper, Jane Harries, Margaret Hoffman, Jennifer Moodley, Phyllis Orner, Hillary J. Bracken
HIV and AIDS
With recently accelerated support for the development of microbicides to prevent HIV transmission and the urgency of the global AIDS epidemic, it is important to begin to identify strategies for introducing a microbicide once it is proven safe and effective and is approved for use. This report presents results from a qualitative study that explored a range of issues likely to influence microbicide introduction—positively or negatively—at three levels: community, health service, and policy. The study, which identified critical issues to be addressed in building support for microbicides and facilitating a smooth introduction, was conducted between September 2002 and September 2003 …
Challenges Faced By Households In Caring For Orphans And Vulnerable Children, Population Council
Challenges Faced By Households In Caring For Orphans And Vulnerable Children, Population Council
HIV and AIDS
South Africa has seen a rapid increase in HIV prevalence among the general population over the past ten years, from less than 1 percent in 1990 to 20 percent in 2001. As the HIV/AIDS epidemic increases, so do the number of orphans and vulnerable children (OVC). In 2002, an estimated five million people were living with HIV/AIDS. Because of the average 10-year period between infection and death, even if HIV prevalence declined rapidly, South Africa would still experience an increasing orphan burden for many years to come. By 2010, 16 percent of all children in South Africa will be orphans …
Adherence To Antiretroviral Therapy In Adults: A Guide For Trainers, Horizons Program, International Centre For Reproductive Health, Mombasa Coast Province General Hospital
Adherence To Antiretroviral Therapy In Adults: A Guide For Trainers, Horizons Program, International Centre For Reproductive Health, Mombasa Coast Province General Hospital
HIV and AIDS
Over the last five years, there has been a rapid change in treatment strategies for HIV infection. With the advent of newer antiretrovirals, treatment has moved from mono-therapy and bi-therapy to triple drug therapy or Highly Active Antiretroviral Therapy. One of the foremost concerns of ARV programs is the ability of people living with HIV/AIDS to maintain near perfect adherence over the long term. To achieve the goal of antiretroviral therapy (ART), undetectable levels of the virus in the blood, patients are required to maintain more than 90–95% adherence. Adherence is defined as a patient’s ability to follow a treatment …
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
Poverty, Gender, and Youth
The detrimental consequences of the AIDS epidemic for older adults in sub-Saharan Africa suggest the need to investigate their characteristics, living situations, and well-being. In this study, we examine the living arrangements of persons aged 60 and older in 16 countries. Data come from the household roster component of recent Demographic and Health Surveys. The focus is on the tendency of the elderly to live with children and grandchildren, and we examine distributions and determinants. Results show that older adults in sub-Saharan Africa live in a variety of household arrangements. Men are more likely to be living in a nuclear …
Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health
Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health
Reproductive Health
In September 1999, the Zimbabwe National Family Planning Council (ZNFPC) and the Population Council initiated a one-year study to assess the performance of ZNFPC’s community-based distribution (CBD) program. A continual decline in the program’s productivity, combined with the expanding HIV/AIDS epidemic, indicated a need to reconsider ZNFPC’s objectives and revise the roles and responsibilities of its full-time, salaried CBD agents. The study examined the productivity, costs, and potential sustainability of the CBD program. Researchers gathered information by reviewing program documents through 1999. They also interviewed program managers, district and community nurses, and community leaders and CBD agents from eight regions. …
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
Poverty, Gender, and Youth
Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Poverty, Gender, and Youth
In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Poverty, Gender, and Youth
To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …
Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta
Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta
HIV and AIDS
While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
Poverty, Gender, and Youth
The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …
Zimbabwe: Los Métodos De Detección De Itr En Mujeres No Son Cost-Efectivos, Population Council
Zimbabwe: Los Métodos De Detección De Itr En Mujeres No Son Cost-Efectivos, Population Council
Reproductive Health
Las infecciones del tracto reproductivo (ITR) son frecuentes en Zimbabwe. Muchas de estas infecciones aumentan el riesgo de contraer el virus de inmunodeficiencia humana (VIH). En 1998, el Consejo Nacional de Planificación Familiar de Zimbabwe (en inglés, ZNFPC) realizó un estudio de IO para evaluar la viabilidad de integrar el diagnóstico y tratamiento de ITR en su oferta de servicios. La población estudiada estaba constituida por 1,634 clientas de tres clínicas de ZNFPC. Se preguntó a las usuarias si presentaban dolor en la región abdominal inferior, flujo vaginal y otros síntomas de ITR; asimismo, se les examinó para detectar la …
Zimbabwe: Les Méthodes De Dépistage Des Iar Chez Les Femmes Sont Chères Et Inefficaces, Population Council
Zimbabwe: Les Méthodes De Dépistage Des Iar Chez Les Femmes Sont Chères Et Inefficaces, Population Council
Reproductive Health
Les Infections de l’Appareil Reproductif (IAR) sont courantes au Zimbabwe. Beaucoup d’IAR augmentent le risque d’infection au Virus de l’Immunodéficience Humaine. En 1998, le Conseil National de Planification Familiale du Zimbabwe (ZNFPC) a entrepris une recherche opérationnelle afin d’évaluer la faisabilité de l’intégration du diagnostic des IAR et des services de traitement dans son menu de services. La population étudiée consistait en 1634 clientes de trois cliniques du ZNFPC. Chaque cliente a été interrogée sur les douleurs au bas ventre, les pertes vaginales et autres symptômes d’IAR. Elles ont ensuite été examinées pour des signes cliniques d’IAR, et ont subi …
Zimbabwe: Rti Screening Methods For Women Are Not Cost-Effective, Population Council
Zimbabwe: Rti Screening Methods For Women Are Not Cost-Effective, Population Council
Reproductive Health
Reproductive tract infections (RTIs) are common in Zimbabwe. Many RTIs increase the risk of human immunodeficiency virus (HIV) infection. In 1998, the Zimbabwe National Family Planning Council (ZNFPC) conducted an operations research study to assess the feasibility of adding RTI diagnosis and treatment to its menu of services. The study population consisted of 1,634 clients at three ZNFPC clinics. Each client was asked about lower abdominal pain, vaginal discharge, and other RTI symptoms; examined for clinical signs of RTIs; and given laboratory tests to confirm the accuracy of diagnosis based upon symptoms and signs. Findings detailed in this brief were …
Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias
Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias
Reproductive Health
As the world grapples with the HIV pandemic, the implementation of the agenda determined by the International Conference on Population and Development (1994) at Cairo, and the matter of providing health services of adequate quality in an ethical, gender-sensitive manner, new questions are arising about how to attend to reproductive tract infections, including sexually transmitted infections (STIs), among women. This paper reviews the results of validation studies of syndromic algorithms, other nonlaboratory clinically based tools, and risk scoring for finding women infected with chlamydia and gonorrhea, particularly among those attending family planning and antenatal clinics in developing countries. The results …
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Reproductive Health
The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Poverty, Gender, and Youth
The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …
Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh
Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh
Reproductive Health
The sexual and reproductive health of adolescents has become a major public concern, particularly with the advent of HIV/AIDS. Many organizations have tried to find strategies to reach youth with reproductive health (RH) information and services through various service delivery models. One such model has been the multipurpose youth center approach. Multipurpose youth centers typically include recreational or vocational services as entry points for RH and family planning (FP) information and services. There is some evidence in a variety of African settings (notably Kenya and Zimbabwe) suggesting that these centers are underutilized and not cost-effective. As a result, the Planned …
Community-Based Aids Prevention And Care In Africa: Results Of Four Action-Research Interventions In East And Southern Africa, Ann Leonard, Esther Muia
Community-Based Aids Prevention And Care In Africa: Results Of Four Action-Research Interventions In East And Southern Africa, Ann Leonard, Esther Muia
HIV and AIDS
The Community Counseling Aides (CCA) project operating with support from the National AIDS Control Programme (NACP) in Uganda, is a government initiative being carried out in collaboration with local communities. As the Ministry of Health seeks to develop local capacity to support and operate these efforts at the community level, it has identified the need to improve the skills of local project staff so that they may begin to assume the responsibility for monitoring and evaluating their own program performance. This is part of an overall strategy on the part of the Ugandan Government to decentralize control and allocation of …
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa
Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa
Reproductive Health
The Family Life Education Project (FLEP) was started in 1986 by the Busoga Diocese of the Anglican Church of Uganda with assistance from Pathfinder International. The project provides integrated MCH, FP, STD, and HIV/AIDS services to more than 500,000 individuals through 48 clinics and 162 trained village health workers (VHWs). Each clinic serves an estimated 11,000 people living in a sub-Parish. Each sub-Parish has a health subcommittee selected by the community that is responsible for hiring clinic staff, identifying VHWs, and mobilizing resources for clinic staff salaries. Data suggest that the program is reaching a large number of clients through …
Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal
Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal
Reproductive Health
Until recently the study of sexual behavior, despite being a very important area of human behavior, has remained an untouchable subject. The sensitivity of the subject and difficulties collecting required information discouraged social scientists from venturing into this area of human behavior. However, the advent of AIDS and its rapid spread in India has changed the scenario. Today the study of sexual behavior is an important subject and both national and international agencies, as part of the AIDS control program, are encouraging research on the subject. This paper addresses a totally neglected area, which is sexual coercion within marriage. The …
Reproductive Health Approach To Family Planning, Population Council
Reproductive Health Approach To Family Planning, Population Council
Reproductive Health
This report collects presentations from a panel held on Professional Development Day at the USAID Cooperating Agencies meeting in November 1994. The panel was designed to review key reproductive health elements that relate to family planning, including: reproductive tract and sexually transmitted infections, including AIDS; the prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. While there is increasing international consensus that family planning should be broadened to include reproductive health care, it is far from clear as to how this should be done, and which elements should be incorporated. This panel explored some of …