Predictors of survival among HIV-positive children on ART in Swaziland.
The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively. The results ...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Love matters: exploring conceptions of love in Rwanda and Swaziland and relationship to HIV and intimate partner violence.
This study explores how women and men in Rwanda and Swaziland understand and represent love in their intimate sexual partnerships. In Rwanda, 58 in-depth interviews with 15 couples, 12 interviews with activists, and 24 focus group discussions were carried out during formative and evaluative research of the Indashyikirwa programme, which aims to reduce IPV and support healthy couple relationships. In Swaziland, 117 in-depth, life-course interviews with 14 women and 14 men focused on understanding intimate sexual partnerships. We analysed these qualitative data thematically using a Grounded Theory approach. Participants desc...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Empowering caregivers of orphans and vulnerable children in Swaziland.
Authors: Makufa SC, Kisyombe D, Miller N, Barkey N
Abstract
This paper reports on the health and psychosocial impacts of a programme designed to economically empower female caregivers of orphans and vulnerable children (OVC). The results presented are from a cohort of 492 female caregivers who participated in savings groups and were responsible for 887 OVC. The data showed that the caregivers had increased earnings, borrowed more, repaid their loans, and expanded their businesses. Important health impacts were found for both the caregivers and the OVC. Access to health care increased and the proportion of ...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland.
This study was designed to collect qualitative data from mothers and caregivers of HIV-positive children to identify the barriers to ART initiation. Focus group discussion (FGD) sessions were conducted in siSwati between July and September 2014 among caregivers of aged children 2-18 months in Swaziland who did or did not initiate ART between January 2011 and December 2012 after HIV DNA PCR-positive diagnosis of the infants. Denial, guilt, lack of knowledge, tuberculosis (TB)/HIV co-infection, HIV-related stigma, lack of money, and distance to clinics were reported by the participants as barriers to ART initiation. The find...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
History of the HIV epidemic and response in Swaziland.
Authors: Mabuza K, Dlamini T
PMID: 29132290 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
HIV prevention needs for men who have sex with men in Swaziland.
This study aimed to explore the HIV prevention needs of MSM in Swaziland, including factors elevating their risks and vulnerabilities to HIV infection; to find out what HIV prevention strategies exist; and to determine how best to meet the prevention needs of MSM. A total of 50 men who reported anal sex with other men in the past 12 months were recruited through simple respondent driven sampling. They completed either a structured quantitative survey (n = 35) or participated in a semi-structured qualitative interview (n = 15). Both quantitative and qualitative findings indicated perceived and experienced stigma among MSM. ...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
The gendered experiences of children in child-headed households in Swaziland.
This study investigated the gender dynamics of living in child-headed households (CHHs) in a rural area in Swaziland that experiences high levels of drought, poverty and HIV and AIDS. Using a qualitative research methodology, the study examined ways in which children in CHHs meet their daily family needs and address their vulnerabilities according to their gender, focusing on the experiences of the children. The study sample consisted of 10 households, with 5 boy and 5 girl-headed households from the chiefdoms within the area. A semi-structured interview guide was used to conduct interviews in the respondents' own homes. T...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Constrained relationship agency as the risk factor for intimate partner violence in different models of transactional sex.
Authors: Fielding-Miller R, Dunkle K
Abstract
Women who engage in transactional sex are more likely to experience intimate partner violence (IPV) and are at higher risk of HIV. However, women engage in transactional sex for a variety of reasons and the precise mechanism linking transactional sex and IPV is not fully understood. We conducted a behavioural survey with a cross-sectional sample of 401 women attending 1 rural and 1 urban public antenatal clinic in Swaziland between February and June 2014. We used structural equation modelling to identify and measure constrained relationship agency (CRA) as a la...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Mixed results: the protective role of schooling in the HIV epidemic in Swaziland.
This study carried out a detailed analysis using the Annual Education Census Reports from 2012 to 2014 produced by the Ministry of Education. In addition, this topic was explored, during fieldwork with key informants in the country. While HIV prevalence rises rapidly among young women in Swaziland, as is the case across most of Southern Africa, the data showed there were few dropouts. This was the case at all levels of education - primary, junior secondary and senior secondary. The major reason for dropping out of primary school was family reasons; and in junior and senior secondary, pregnancy was the leading cause. Swazil...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
"I will take ARVs once my body deteriorates": an analysis of Swazi men's perceptions and acceptability of Test and Start.
This study presents findings regarding the perceptions of this promising HIV-prevention intervention among men aged 17-69 years. A combination of qualitative methods including focus group discussions (12), in-depth interviews (17), informal conversations and participant observation (21) were used to collect data in two peri-urban communities in 2013-2014. Findings illustrate that men still fear taking an HIV test because of a relatively high probability of a positive test which some still interpret as a death sentence. Other potential barriers to the effectiveness of Test and Start programmes include lack of hospitality in...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Gendered childcare norms - evidence from rural Swaziland to inform innovative structural HIV prevention approaches for young women.
Authors: Shabangu PN, Brear MR
Abstract
Addressing discriminatory gender norms is a prerequisite for preventing HIV in women, including young women. However, the gendered expectation that women will perform unpaid childcare-related labour is rarely conceptualised as influencing their HIV risk. Our aim was to learn from members of a rural Swazi community about how gendered childcare norms. We performed sequential, interpretive analysis of focus group discussion and demographic survey data, generated through participatory action research. The results showed that gendered childcare norms were firmly entrenche...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
Legal responses to HIV and AIDS: lessons from Swaziland.
The objective is to assess whether and to what extent Swazi law addresses human rights issues related to HIV and AIDS. Through the application of a human rights based theory, the paper analyses the domestication of Swaziland's treaty commitments, and the constitutional and the statutory frameworks. The paper advances the importance of "law" as a tool that can create an enabling environment for a national response to HIV and AIDS. It analyses how the government has successfully crafted the normative framework so as to make it responsive to the fight against HIV and AIDS, and the shortcomings of the Swaziland legal system in...
Source: African Journal of AIDS Research - November 16, 2017 Category: African Health Tags: Afr J AIDS Res Source Type: research
HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis
by Tonia Poteat, Benjamin Ackerman, Daouda Diouf, Nuha Ceesay, Tampose Mothopeng, Ky-Zerbo Odette, Seni Kouanda, Henri Gautier Ouedraogo, Anato Simplice, Abo Kouame, Zandile Mnisi, Gift Trapence, L. Leigh Ann van der Merwe, Vicente Jumbe, Stefan Baral
IntroductionSub-Saharan Africa bears more than two-thirds of the worldwide burden of HIV; however, data among transgender women from the region are sparse. Transgender women across the world face significant vulnerability to HIV. This analysis aimed to assess HIV prevalence as well as psychosocial and behavioral drivers of HIV infection among transgender women compared with c...
Source: PLoS Medicine - November 7, 2017 Category: Internal Medicine Authors: Tonia Poteat Source Type: research
Effectiveness of a combination strategy for linkage and retention in adult HIV care in Swaziland: The Link4Health cluster randomized trial
by Margaret L. McNairy, Matthew R. Lamb, Averie B. Gachuhi, Harriet Nuwagaba-Biribonwoha, Sean Burke, Sikhathele Mazibuko, Velephi Okello, Peter Ehrenkranz, Ruben Sahabo, Wafaa M. El-Sadr
BackgroundGaps in the HIV care continuum contribute to poor health outcomes and increase HIV transmission. A combination of interventions targeting multiple steps in the continuum is needed to achieve the full beneficial impact of HIV treatment. Methods and findingsLink4Health, a cluster-randomized controlled trial, evaluated the effectiveness of a combination intervention strategy (CIS) versus the standard of care (SOC) on the primary ou...
Source: PLoS Medicine - November 7, 2017 Category: Internal Medicine Authors: Margaret L. McNairy Source Type: research
Global Health Education for Medical Students: When Learning Objectives Include Research
The Luke Commission, a provider of comprehensive mobile health outreach in rural Swaziland, focuses on human immunodeficiency virus testing and prevention, including the performance of over 100 circumcisions weekly. Educational objectives for medical student global health electives are essential. Learning research methodology while engaging in clinical activities reinforces curriculum goals. Medical care databases can produce clinically significant findings affecting international health policy. (Source: Journal of Surgical Education)
Source: Journal of Surgical Education - October 6, 2017 Category: Surgery Authors: Alison M. Bales, Anthony R. Oddo, David J. Dennis, Robert C. Siska, Echo VanderWal, Harry VanderWal, Nompumelelo Dlamini, Ronald J. Markert, Mary C. McCarthy Tags: Original Reports Source Type: research
