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Understanding the Scourge of HIV/AIDS in Sub-Saharan Africa
Inungu Joseph,Karl Sarah
Journal of the International AIDS Society , 2006, DOI: 10.1186/1758-2652-8-4-30
Abstract: Sub-Saharan Africa is the part of the world that has been hit hardest by the HIV epidemic. To fight the spread of HIV in the continent, it is necessary to know and effectively address the factors that drive the spread of HIV. The purpose of this article is to review the factors associated with the spread of the HIV epidemic in sub-Saharan Africa and to propose 6 essential activities, which we refer to by the acronym "ESCAPER," to help curb the spread of HIV/AIDS in Africa.
Stigma of People with HIV/AIDS in Sub-Saharan Africa: A Literature Review  [PDF]
Ngozi C. Mbonu,Bart van den Borne,Nanne K. De Vries
Journal of Tropical Medicine , 2009, DOI: 10.1155/2009/145891
Abstract: The aim of this literature review is to elucidate what is known about HIV/AIDS and stigma in Sub-Saharan Africa. Literature about HIV/AIDS and stigma in Sub-Saharan Africa was systematically searched in Pubmed, Medscape, and Psycinfo up to March 31, 2009. No starting date limit was specified. The material was analyzed using Gilmore and Somerville's (1994) four processes of stigmatizing responses: the definition of the problem HIV/AIDS, identification of people living with HIV/AIDS (PLWHA), linking HIV/AIDS to immorality and other negative characteristics, and finally behavioural consequences of stigma (distancing, isolation, discrimination in care). It was found that the cultural construction of HIV/AIDS, based on beliefs about contamination, sexuality, and religion, plays a crucial role and contributes to the strength of distancing reactions and discrimination in society. Stigma prevents the delivery of effective social and medical care (including taking antiretroviral therapy) and also enhances the number of HIV infections. More qualitative studies on HIV/AIDS stigma including stigma in health care institutions in Sub-Saharan Africa are recommended.
Social class and HIV/AIDS prevalence in Sub-Saharan Africa
D Buor
Journal of Science and Technology (Ghana) , 2005,
Abstract: The main objective of the paper is to test hypotheses on social class variables as determinants of the prevalence of HIV/AIDS in Sub-Saharan Africa, and to structure a schematic model for the relationship on the impact of social class on HIV/AIDS prevalence. World Bank data, 2002 World Development Indicators, are used for the analyses. Interactive graphs, with a combination of regression lines, are used as the main instruments of analysis. The indicators of social class used for the analysis are education, women's education, Gross National Income (GNI) per capita, level of poverty, urbanisation and contraceptive usage. Inbound tourist movement is included in the analysis, though not directly linked with social class, due to it being an emerging factor in the spread of the pandemic. Education has turned out to be the main determinant of HIV/AIDS prevalence in Sub-Saharan Africa. Inbound tourism movement has emerged as an important factor in the prevalence of the disease, after education. Defects of quality of data would not be far fetched, given the lack of logistics and financial resources of most governments for the exercise, possible political manipulations and ideological biases. It is recommended that primary research at individual country levels be carried out on the effectiveness of the use of condoms, and the social class and tourist movement factors on HIV/AIDS prevalence to confirm the sub-regional findings. Journal of Science and Technology Vol. 25(2) 2005: 66- 79
Political and socio-economic instability: does it have a role in the HIV/AIDS epidemic in sub-Saharan Africa?
A Tebandeke, R Premkumar
SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) , 2011,
Abstract: (Case studies from selected countries) Many sub-Saharan African countries are confronted by the HIV/AIDS epidemic. This article reviews academic literature in the social sciences and health to discover why HIV/AIDS has become an epidemic in sub-Saharan Africa and not in other parts of the world. This was studied by examining the social determinants of diminishment of tradition and social cohesion in terms of political, social and economic problems. Four countries in this region were selected for this case study, namely South Africa, Botswana, Uganda and Zimbabwe. The findings showed that instability in socio-economic and political aspects in these nations was responsible for creating a suitable environment for the spread of HIV/AIDS infection. This paper concludes by using the theories of collective action/responsibility and social cohesion to hypothesise that the breakdown of social ties due to various kinds of conflicts and unrest is one of the main contributors to the HIV/AIDS epidemic.
The Environmental and Social Influences of HIV/AIDS in Sub-Saharan Africa: A Focus on Rural Communities  [PDF]
Christine U. Oramasionwu,Kelly R. Daniels,Matthew J. Labreche,Christopher R. Frei
International Journal of Environmental Research and Public Health , 2011, DOI: 10.3390/ijerph8072967
Abstract: The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
An evaluation of the prevalence of HIV/AIDS on selected economies of sub-Saharan Africa  [cached]
Raji Abdulghafar Bello,Gafar Tunde Ijaiya
Journal of Public Health in Africa , 2012, DOI: 10.4081/jphia.2012.e27
Abstract: Human immunodeficiency syndrome (HIV) whose full-blown period is called acquired immunity deficiency syndrome (AIDS) is today a terminal disease. While one weakens the body hormones, the other comes to claim the life with its accompanying opportunistic diseases. Several factors have been reviewed to be causing the infection and its prevalence as well as its socio-economic, scientific and cultural dimensions. The cost implication of this ailment is enormous when considered from individual, national or global perspective, especially when the cost of treatment and the cost of the disability adjusted life years (DALYs) lost to incapacitation from HIV/AIDS is considered. This study has investigated the financial implications of treatment and the DALYs lost to HIV/AIDS from the perspective of sub-Saharan Africa covering thirty-five countries. Infected population of age 15-49 years were considered, being the active life year age group. Applying Morrow’s DALYs measurement, and Ainsworth’s per capita general rule method of costing HIV/AIDS, it was found that the cost of treatment of HIV/AIDS in any country depends on her economic strength on the one hand and the size of the infected population on the other, to the extent that no country spends or loses less than 3 percent of her national income on treatment and to DALYs. To any country, the financial cost of the DALYs lost to HIV/AIDS is much more than the cost of treatment per episode, mostly huge enough to develop a sector of the country’s economy. However, a single recommendation could be difficult as individual countries experience different effect, but different countries must pursue long-run anti-prevalence policies individually and as economic region or bloc.
HIV/AIDS mitigation strategies and the State in sub-Saharan Africa – the missing link?
Abdu Mohiddin, Deborah Johnston
Globalization and Health , 2006, DOI: 10.1186/1744-8603-2-1
Abstract: Donor and International Institutions' strategies to mitigate HIV/AIDS in sub-Saharan Africa are premised on a single optimal model of the State, one which focuses on the decentralised delivery of public goods alone (such as healthcare) – the service delivery state. The empirical evidence, though sparse, of "successful" and "unsuccessful" sub-Saharan Africa states' performance in mitigating HIV/AIDS does not support this model. Rather, the evidence suggests an alternative model that takes a country context specific approach – encompassing political power, institutional structures and the level of health technology needed. This model draws on the historical experience of East Asian countries' rapid development.For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.The HIV/AIDS epidemic in sub-Saharan Africa (SSA) is a human and development disaster [1]. Now significant donor resources are available to fund mitigation strategies [2-4]. However, the approach to HIV/AIDS in SSA has been criticised as being based on health policies from industrialised countries which treat HIV/AIDS differently from other sexually transmitted infections – HIV exceptionalism. Some have called for a new strategy based on a public health model that rejects uniform approaches to the epidemic, emphasises social justice and public health, rather than only individual human rights [5]. We ask, are there limitations too, in the model of the State that current mitigation policies assume and insist are optimal for SSA? Though the evidence-base is sparse, our findings suggest that persisting with the current model risks possible failure of the donor mitigation strategies – there is an imperative to consider countries' diversity and context in designing mitigation stra
AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach  [PDF]
Peter M. Mwamba,Walter O. Mwanda,Naftali W. Busakhala,R. Matthew Strother,Patrick J. Loehrer,Scot C. Remick
Lymphoma , 2012, DOI: 10.1155/2012/904367
Abstract: Today AIDS-related non-Hodgkin's lymphoma (AR-NHL) is a significant cause of morbidity and mortality in HIV-infected patients the world over, and especially in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence of combination antiretroviral therapy (cART) era has declined, the occurrence of this disease appears to have stabilized. In regions where access to cART is challenging, the impact on disease incidence is less clear. In the resource-rich environment it is clinically recognized that it is no longer appropriate to consider AR-NHL as a single disease entity and rather treatment of AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive therapeutic strategies in the resource-rich world are clearly improving outcome, in AIDS epicenters of the world and especially in sub-Saharan Africa there is a paucity of data on treatment and outcomes. In fact, only one prospective study of dose-modified oral chemotherapy and limited retrospective studies with sufficient details provide a window into the natural history and clinical management of this disease. The scarcities and challenges of treatment in this setting provide a backdrop to review the current status and realities of the therapeutic approach to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic approaches are needed. 1. Introduction While the advent of combination antiretroviral therapy (cART) has had a dramatic effect on the clinical manifestations and progression of HIV disease, reduced the incidence of opportunistic infection(s) and AIDS-related malignancies, and improved overall survival in the resource-rich world, the impact of cART scale-up afforded through World Health Organization (WHO) global initiatives and the President’s Emergency Plan for AIDS Relief (PEPFAR) in improving access and patient monitoring is less apparent in resource challenged AIDS epicenters of the world and especially Africa [1–6]. The fact remains that the overwhelming majority of HIV-infected individuals in these resource challenged regions are either unaware of their underlying infection and/or go untreated. Thus, the burden of HIV infection and AIDS is greatest in the developing world (95%) with sub-Saharan Africa harboring essentially two-thirds of the world’s population of persons living with HIV/AIDS [7]. Cancer is now a leading cause of morbidity and mortality among individuals living with HIV and AIDS [2, 3, 8–12]. The risk of developing United States (US) Centers for Disease Control AIDS-defining malignancy in HIV-infected subjects is associated
Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics
Salomon,Joshua A.; Murray,Christopher J.L.;
Bulletin of the World Health Organization , 2001, DOI: 10.1590/S0042-96862001000700004
Abstract: objective: to improve the methodological basis for modelling the hiv/aids epidemics in adults in sub-saharan africa, with examples from botswana, central african republic, ethiopia, and zimbabwe. understanding the magnitude and trajectory of the hiv/aids epidemic is essential for planning and evaluating control strategies. methods: previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. in this project, we have extended these models in order to take full advantage of the available data. we developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. findings: in the four countries analysed, there were an estimated half a million new adult hiv infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from aids (range: 266 to 492 thousand). conclusion: while this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of hiv and aids in the general population.
Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics  [cached]
Salomon Joshua A.,Murray Christopher J.L.
Bulletin of the World Health Organization , 2001,
Abstract: OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand). CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population.
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