Condom Use and Culture of Life: The Roman Catholic Church Dilemma in the Wake of New HIV Infections

The World has devotedly committed to ending HIV and AIDS epidemic by 2030. However, the latest global data demonstrate among other challenges an increase in new HIV infections. In 2015 there was an increase of new HIV infections from 1.8 million to 2.4 million, an average of 2.1 million. In light of this challenge of increasing new HIV infections, a scrutiny on the effectiveness of HIV prevention strategies and measures is important. Abstinence, fidelity and condom use are among the strategies that have been lauded to prevent further transmission of HIV infections. However, the Roman Catholic Church (RCC) stance and repression of condom use by her adherents bars the positive strides of preventing the spread of HIV. This paper addresses the possible grounds for review of the RCC negative stance on condom use. This is premised on the famous Pope John Paul II’s culture of life theology that upholds not only the sanctity of human life but also the intrinsic value and dignity of the human person. A phenomenological approach was employed in guiding this discourse. The following concepts illuminate this worth course. They include the primacy of subjective interiority in sexual choices, valued inter-relational sociability of human persons and pursuance of eschatological hope. In this era of HIV and AIDS, we argue for a relational eschatology rather than a punitive eschaton. This is believed to cushion a time that is permeated with relational challenges that are meant to steer the values of love and trust. Keywords: Condom use, culture of life, HIV and AIDS, new infections, church teaching on sexualit

An Ethical Claim for Administration of Pre-Exposure Prophylaxis (PREP) in HIV and AIDS Burdened Africa

It is morally justifiable for every person of good will to venture into HIV and AIDs prevention among the populace. Pre-exposure Prophylaxis (PrEP) administration promises to help meet the promise of this moral claim, which is founded on two ethical principles of ensuring wellbeing and justice for all. In spite of the efforts, challenges abound, especially in Africa. Some African tenets of sexuality, unavailability of contextualized and harmonized African sexuality theory as well as Africa’s poor economic standing are major threats to the administration of PrEP. This paper highlighted the major challenges and calls for their resolution if PrEP administration is to be of help to the poor and HIV burdened Africans.Key Words: HIV prevention, Preexposure Prophylaxis (PrEP), well-being, justic

Female Genital Mutilation: A Religio-Cultural Sensitive Issue Determining Maternal Health Care Choices among Somali Women in Dadaab Refugee Camp, Kenya

The paper addresses Kenya’s development challenges in maternal health care with a specific focus on the impact of traditional birth attendants (TBAs) and female genital mutilation (FGM) among the refugees. It purposes to achieve four objectives: to discuss the persistence of FGM among Somali women in Ifo Refugee Camp, to establish the hospital process of providing maternal health care to mothers who have gone through FGM; find out the level of preparedness of the midwives to handle mothers with religio- cultural concerns such as prayer, non-involvement of male nurses and how the practice of FGM contributes to the preference of TBA by mothers. The study assumes that midwives’ training may not have effectively addressed FGM, a social-cultural sensitive issue affecting childbirth and care. Secondly, the specific support of midwives in refugee camps contexts remains limited. A qualitative research approach was used in the study, involving Snowballing sampling method, in-depth interviews, and focus group discussions (FGDs). These methods brought out pertinent issues that make TBAs the preferential option for some mothers in spite of the presence of level 4 category hospitals in the refugee camps. In case of birth complications, the mother’s choice for TBA delays the family’s decision to take her to the hospital and for health care workers to save mother and child. The shortage of midwives and the presence of male midwives in hospitals make some Somali mothers seek assistance from TBAs. There is a need to contextualize midwifery training by enhancing the curriculum with evidence-based /mother-centered skills

Female Genital Mutilation: A Religio-Cultural Sensitive Issue Determining Maternal Health Care Choices among Somali Women in Dadaab Refugee Camp, Kenya

The paper addresses Kenya’s development challenges in maternal health care with a specific focus on the impact of traditional birth attendants (TBAs) and female genital mutilation (FGM) among the refugees. It purposes to achieve four objectives: to discuss the persistence of FGM among Somali women in Ifo Refugee Camp, to establish the hospital process of providing maternal health care to mothers who have gone through FGM; find out the level of preparedness of the midwives to handle mothers with religio- cultural concerns such as prayer, non-involvement of male nurses and how the practice of FGM contributes to the preference of TBA by mothers. The study assumes that midwives’ training may not have effectively addressed FGM, a social-cultural sensitive issue affecting childbirth and care. Secondly, the specific support of midwives in refugee camps contexts remains limited. A qualitative research approach was used in the study, involving Snowballing sampling method, in-depth interviews, and focus group discussions (FGDs). These methods brought out pertinent issues that make TBAs the preferential option for some mothers in spite of the presence of level 4 category hospitals in the refugee camps. In case of birth complications, the mother’s choice for TBA delays the family’s decision to take her to the hospital and for health care workers to save mother and child. The shortage of midwives and the presence of male midwives in hospitals make some Somali mothers seek assistance from TBAs. There is a need to contextualize midwifery training by enhancing the curriculum with evidence-based /mother-centered skills

We chose PrEP because I wanted to be sure that this child my wife was going to conceive was indeed mine. Factors influencing the choice of safer conception methods and experiences with its use: a qualitative study among HIV sero-discordant couples in Zimbabwe.

BACKGROUND: Safer conception services are needed to minimize HIV transmission among HIV sero-discordant couples desiring pregnancy. Few studies have evaluated the choices couples make when they are offered multiple safer conception methods or real-world method acceptability. This paper addresses an important knowledge gap regarding factors that influence the choice of safer conception methods, couples actual experiences using safer conception methods, and why some couples switch safer conception methods. METHODS: Between February and June 2019, we conducted semi-structured in-depth interviews among 14 men and 17 women, representing 17 couples who exited the SAFER study-a pilot safer conception study for HIV sero-discordant couples in Zimbabwe that offered couples a choice of ART with monthly viral load monitoring (ART/VL), oral PrEP, vaginal insemination, and semen washing. All couples in SAFER had used at least two safer conception methods. RESULTS: We found that safer conception method choice often centered around a desire for intimacy, condomless sex, and certainty in the conception process, particularly for men. Method-related attributes such as familiarity, perceived ease of use, side effects, and perceived level of effectiveness in preventing HIV and achieving pregnancy influenced method choice, switching, and satisfaction. Concerns were expressed about each safer conception method and couples were willing to try different methods until they found method(s) that worked for them. The majority of participants reported having positive experiences using safer conception, especially those using ART/VL + PrEP, citing that they were able to attempt pregnancy for the first time with peace of mind and experienced joy and satisfaction from being able to achieve pregnancy safely. CONCLUSIONS: The differences in method preferences and experiences voiced by participants in this study and in other studies from the region point to the importance of having a variety of safer conception options in the service delivery package and addressing concerns about paternity, intimacy, and method-related attributes to enable HIV sero-discordant couples to safely achieve their reproductive goals

Ethical and scientific considerations on the establishment of a controlled human infection model for schistosomiasis in Uganda: report of a stakeholders' meeting held in Entebbe, Uganda.

Controlled human infection (CHI) models are gaining recognition as an approach to accelerating vaccine development, for use in both non-endemic and endemic populations: they can facilitate identification of the most promising candidate vaccines for further trials and advance understanding of protective immunity. Helminths present a continuing health burden in sub-Saharan Africa. Vaccine development for these complex organisms is particularly challenging, partly because protective responses are akin to mechanisms of allergy. A CHI model for Schistosoma mansoni (CHI-S) has been developed at Leiden University Medical Centre, the Netherlands. However, responses to schistosome infections, and candidate vaccines, are likely to be different among people from endemic settings compared to schistosome-naïve Dutch volunteers. Furthermore, among volunteers from endemic regions who have acquired immune responses through prior exposure, schistosome challenge can be used to define responses associated with clinical protection, and thus to guide vaccine development.  To explore the possibility of establishing the CHI-S in Uganda, a Stakeholders' Meeting was held in Entebbe in 2017. Regulators, community members, researchers and policy-makers discussed implementation challenges and recommended preparatory steps: risk assessment; development of infrastructure and technical capacity to produce the infectious challenge material in Uganda; community engagement from Parliamentary to grass-roots level; pilot studies to establish approaches to assuring fully informed consent and true voluntariness, and strategies for selection of volunteers who can avoid natural infection during the 12-week CHI-S; the building of regulatory capacity; and the development of study protocols and a product dossier in close consultation with ethical and regulatory partners. It was recommended that, on completion, the protocol and product dossier be reviewed for approval in a joint meeting combining ethical, regulatory and environment management authorities. Most importantly, representatives of schistosomiasis-affected communities emphasised the urgent need for an effective vaccine and urged the research community not to delay in the development process

Ethical and scientific considerations on the establishment of a controlled human infection model for schistosomiasis in Uganda: report of a stakeholders’ meeting held in Entebbe, Uganda.

Controlled human infection (CHI) models are gaining recognition as an approach to accelerating vaccine development, for use in both non-endemic and endemic populations: they can facilitate identification of the most promising candidate vaccines for further trials and advance understanding of protective immunity. Helminths present a continuing health burden in sub-Saharan Africa. Vaccine development for these complex organisms is particularly challenging, partly because protective responses are akin to mechanisms of allergy. A CHI model for Schistosoma mansoni (CHI-S) has been developed at Leiden University Medical Centre, the Netherlands. However, responses to schistosome infections, and candidate vaccines, are likely to be different among people from endemic settings compared to schistosome-naïve Dutch volunteers. Furthermore, among volunteers from endemic regions who have acquired immune responses through prior exposure, schistosome challenge can be used to define responses associated with clinical protection, and thus to guide vaccine development.  To explore the possibility of establishing the CHI-S in Uganda, a Stakeholders’ Meeting was held in Entebbe in 2017. Regulators, community members, researchers and policy-makers discussed implementation challenges and recommended preparatory steps: risk assessment; development of infrastructure and technical capacity to produce the infectious challenge material in Uganda; community engagement from Parliamentary to grass-roots level; pilot studies to establish approaches to assuring fully informed consent and true voluntariness, and strategies for selection of volunteers who can avoid natural infection during the 12-week CHI-S; the building of regulatory capacity; and the development of study protocols and a product dossier in close consultation with ethical and regulatory partners. It was recommended that, on completion, the protocol and product dossier be reviewed for approval in a joint meeting combining ethical, regulatory and environment management authorities. Most importantly, representatives of schistosomiasis-affected communities emphasised the urgent need for an effective vaccine and urged the research community not to delay in the development process.</ns4:p