Marriage, Intimacy and Risk of HIV Infection in South West Uganda

Long-term, monogamous, relationships are often portrayed as protective in HIV prevention campaigns. Focusing on marriage in a community in south west Uganda, we examine why and how people enter long term relationships, what their expectations are and what factors sustain those relationships. Qualitative data were collected using in-depth interviews with 50 men and women randomly selected from a General Population Cohort. The results showed that managing expectations to sustain marriage is challenging; however the socio-economic and cultural benefits of marriage: having children, property acquisition as well as securing societal status tend to overshadow the costs associated with risks from infidelity such as sexually transmitted infections (including HIV). Recognising the compromises that couples may make to sustain their marriage is an important step towards acknowledging that `being faithful’ may be about staying together and showing commitment, not sexual exclusivity. Keywords: marriage; long-term relationship; HIV epidemic; UgandaLes relations monogames à long terme, sont souvent dépeintes comme une protection dans les campagnes de prévention du VIH. En mettant l'accent sur le mariage dans une communauté dans le sud ouest de l'Ouganda, nous examinons pourquoi et comment les gens entrent dans des relations à long terme, quelles sont leurs attentes et quels facteurs soutiennent ces relations. Les données qualitatives ont été recueillies au moyen d'entrevues en profondeur avec 50 hommes et femmes choisis au hasard à partir d'une population générale cohorte. Les résultats ont montré que la gestion des attentes pour soutenir le mariage est difficile, mais les avantages socio-économiques et culturels du mariage: avoir des enfants, acquis de la propriété ainsi que l’obtention d’un bon état-civil dans la société, ont tendance à éclipser les coûts associés aux risques de l'infidélité telles que les infections sexuellement transmissibles (y compris le VIH). La reconnaissance des compromis que les couples peuvent faire pour soutenir leur mariage, est une étape importante vers la reconnaissance du fait que « être fidèle» peut signifier rester ensemble et de faire preuve de l'engagement, pas l'exclusivité sexuelle. Mots clés: mariage; relation à long terme; Épidémie de VIH; Ougand

Therapists

This study aimed at establishing the impact of past traumatic experiences on the performance of professional therapists drawn from a group of professional therapists (N=84) working in Eldoret, Kenya. A simple random sampling procedure was used to select a sample of 61 professional therapists. The study adopted a cross-sectional descriptive survey design. The proQOL scale was the primary instrument used to collect data. Analysis of data involved descriptive and inferential statistics using STATA version 12 SE. The findings of the study indicated that 70% of the professional therapists presented with compassion fatigue. The study found that 31% of those who had experienced traumatic events had their performance affected while 69% did not have their performance affected

Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management

Atrioventricular block is classified as congeni- tal if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental pas- sage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive car- diac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe perma- nent cardiac pacing in almost all patients, including those with structural heart abnormalities

A Latent Class Analysis of Agricultural Technology Use Behavior in Uganda and Implications for Optimal Targeting

Agricultural productivity is still very low in Africa largely due to low use of improved agricultural technologies. Existing adoption studies are marred by univariate analyses, often focusing on single technologies over a limited scope while assuming uniform effects of the explanatory variables across farm households. In this study, we use a large dataset that covers a wide geographical and agricultural scope to describe use-patterns of improved agro-technology in Uganda. Using latent class analysis, and over 12,500 households collected across the four regions of Uganda, we classify farmers based on the package of improved agro-technologies used. We find that the majority of farmers (61%) do not use any improved agricultural practices ( non-users ) while only 5% of the farmers belong to the class of intensified diversifiers , using most of the commonly available agro-technologies across crop and livestock enterprises. Using multinomial regression analysis, we show that education of the household head, access to extension messages and affiliation to social groups, are the key factors that drive switching from the non-user reference class to the other three preferred classes that use improved agro-technologies to varying levels. Results reveal that different farmer categories with different agro-technology needs, which may have implications for optimal targeting. Acknowledgement : The authors would like to thank the International Institute for Impact Evaluation (3ie) for financial support. This work was undertaken as part of the CGIAR Research Program on Policies, Institutions, and Markets (PIM) led by the International Food Policy Research Institute (IFPRI)

Personal barriers to antiretroviral therapy adherence: case studies from a rural Uganda prospective clinical cohort.

BACKGROUND: Although good adherence to antiretroviral therapy (ART) is essential for successful treatment outcomes, some patients may have specific personal barriers to ART adherence. OBJECTIVES: To study specific personal barriers to ART adherence. METHODS: Quantitative data on patients' health status, ART adherence, CD4 cell counts and viral loads were collected, and qualitative data on life experiences of five patients with poor ART outcomes and adherence were also collected. RESULTS: Out of 35 patients with poor immunological and virological ART outcomes, 17 (49%) also had poor ART adherence. Patient 1 had no living child and did not disclose her HIV serostatus to her spouse because she wanted to have a child. Patient 2 was an orphan with neither social nor family support. Patient 3 stopped ART when she conceived, returned to the study clinic when pregnant again and was sickly. She was switched to second-line ART with satisfactory outcomes. Patient 4, a 14 year old orphan had missed ART for 2 months when his treatment supporter was away. Patient 5 aged 66 years stopped ART which he blamed for his erectile dysfunction. CONCLUSION: ART adherence counselling should target specific personal barriers to ART adherence like: lack of family support, health and sexual life concerns, desire to have children and family instability