Availability of human immunodeficiency virus prevention services in secondary schools in Kabarole District, Uganda

This study was to assess the level of availability of HIV prevention strategies in secondary schools in Kabarole district, Uganda in order to inform the design of interventions to strengthen HIV Prevention and psychosocial support.The aim of this study was to assess the level of availability of HIV prevention strategies in secondary schools in Kabarole district, Uganda in order to inform the design of interventions to strengthen HIV Prevention and psychosocial support. Quantitative and qualitative research methods were used in eight secondary schools in Kabarole district to establish available HIV prevention and psychosocial support services. Questionnaires were administered to 355 students 12-24 years old. In addition, 20 Key Informant interviews were held with education service providers. Quantitative data was analyzed using Epi-data and qualitative data were analyzed by thematic content analysis. Seven of the eight schools had at least one HIV prevention strategy. Two teachers in each of the five schools had been trained in HIV prevention. No school had a nurse trained in HIV prevention, care and support. Education service providers had limited knowledge of HIV prevention support and care of students living with HIV. We found out that students had knowledge on how one can acquire HIV. HIV prevention services reported by students in schools included: talks from teachers and guests (19%), drama with HIV prevention related messages (16%), peer education clubs (15%), workshops and seminars on HIV (8%), sensitization about HIV/AIDS (7%), guidance and counseling (6%), talking compounds- (5%), abstinence talks (6%), keeping students busy in sports (4%), straight talk (4%). Sixty three percent reported receiving HIV reading materials from various sources. Preventing HIV infection among students in schools is still demanding with limited interventions for students. Efforts to support school interventions should focus on including HIV Prevention in the school curriculum, working with peer educators as well as education service providers who spend much of the time with the students while at school

Environmental Security in Transnational Contexts: What Relevance for Regional Human Security Regimes?

AbstractThe year 2015 was meant to be a seminal year in global geopolitics due to the transition from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). This transition was significant because the MDGs, even though they raised global consciousness around the need to combat poverty, remained indicator-based, and thus, they did not adequately address socio-economic inequalities and power imbalances in global affairs. For this reason, much of the discussion surrounding the definition of the SDGs and the post-2015 global development agenda contextualized sustainable development within the framework of ‘transformation’, specifically prioritizing concepts such as equity, security, justice, and rights. While these debates correctly discussed power imbalances and relational obstacles to human development they remained abstract because they focused only on the international level. In this regard, discussions did not adequately examine mechanisms that facilitate or block the emergence of sustainable development as a political priority, nor did they address specific policy proposals to link environmental justice to human development strategies. Thus, this special issue introduction argues that human and environmental security should be framed in terms of transnational discussions rather than being limited to international debates. The special issue undertakes an examination of the interactions between human and environmental security, border studies, and comparative regional integration; and interactions between competing globalizations. The articles in the special issue address the relationships between international norms, transnational human and environmental security issues, and the regionalization of governance

"Every drug goes to treat its own disease…" - a qualitative study of perceptions and experiences of taking anti-retrovirals concomitantly with anti-malarials among those affected by HIV and malaria in Tanzania.

BACKGROUND: Little is known about how people living with human immunodeficiency virus (HIV) experience malaria and the concomitant use of anti-malarial treatments with anti-retrovirals (ARVs). An understanding of how patients make sense of these experiences is important to consider in planning and supporting the clinical management and treatment for co-infected individuals. METHODS: A qualitative study was conducted in Tanzania alongside a clinical trial of concomitant treatment for HIV and malaria co-infection. Focus group discussions were held with people receiving treatment for HIV and/or malaria, and in-depth interviews with health workers responsible for HIV care and members of the clinical trial team. Data were analysed inductively to identify themes and develop theoretical narratives. RESULTS: Results suggest that people living with HIV perceived malaria to be more harmful to them due to their compromised immune status but saw the disease as unavoidable. For those enrolled in the clinical controlled study, taking anti-malarials together with ARVs was largely seen as unproblematic, with health workers' advice and endorsement of concomitant drug taking influential in reported adherence. However, perceptions of drug strength appeared to compel some people not enrolled in the clinical study to take the drugs at separate times to avoid anticipated harm to the body. CONCLUSIONS: Management of HIV and malaria concurrently often requires individuals to cross the domains of different disease programmes. In the context of a trial concerned with both diseases, patients experienced the support of clinicians in guiding and reassuring them about when and how to take drugs concomitantly. This points towards the need to continue to strive for integrated care for patients with HIV