Vivre et penser le sida en Afrique = Experiencing and understanding AIDS in Africa

Dans un contraste de plus en plus accusé entre le Nord et le Sud, qui met en relief deux sortes de sida - l'un traitable et en voie de stabilisation, l'autre incurable et en voie d'expansion -, des chercheurs francophones et anglophones en sciences sociales tentent de répondre ici à une double exigence. Travaillant en Afrique subsaharienne sur une épidémie qui représente 70% des cas mondiaux, ils entendent contribuer à rendre intelligible les programmes d'information et de prévention. Se démarquant nettement des stéréotypes par trop répandus d'un continent où les cultures immémoriables et une certaine "promiscuité sexuelle" seraient le terreau de l'épidémie, leurs diverses approches mettent l'accent sur les contextes de vulnérabilité économique, sociale et politique des populations africaines et sur la façon dont celles-ci interprètent l'épidémie au regard de leurs conditions concrètes d'existence et des multiples difficultés et tensions auxquelles elles sont confrontées. Non réductible à un problème sanitaire, le "phénomène sida" appelle des politiques publiques qui ne se contentent pas de délivrer des messages de prévention sur le préservatif ou la fidélité, mais qui diversifient leurs interventions en fonction des situations sociales et des significations auxquelles le sida a déjà donné lieu. Mais cette démarche analytique des chercheurs en sciences sociales est prolongée d'un point de vue plus critique : parler de politiques publiques, c'est d'abord, pour eux, refuser que perdure en Afrique l'image d'un sida incurable et que ne soient pas transférés les progrès thérapeutiques qui ont considérablement modifié cette image au Nord. C'est par conséquent au prix d'une mobilisation de la communauté internationale que les Etats africains seront amenés eux-mêmes à manifester une plus grande volonté politique et à faire en sorte que le sida devienne un sujet central du débat public. (Résumé d'auteur

From Mexico to Beijing: "Women in Development" Twenty Five Years On

During the past twenty five years the Women in Development (WID)approach has become an increasingly important issue in the literature on Third World development. WID issues and related activities have now been incorporated into the aid practice of most development agencies. This paper critically analyses the diverse and conflicting ideologies that have emerged in the WID literature since the early seventies

Evaluation of a Peer Network-Based Sexual Risk Reduction Intervention for Men in Beer Halls in Zimbabwe: Results from a Randomized Controlled Trial

While much emphasis has been placed on involving men in AIDS prevention in sub-Saharan Africa, there remain few rigorously evaluated interventions in this area. A particularly appealing point of intervention is the sexual risk behavior associated with men’s alcohol consumption. This article reports the outcomes of The Sahwira HIV Prevention Program, a male-focused, peer-based intervention promoting the idea that men can assist their friends in avoiding high-risk sexual encounters associated with alcohol drinking. The intervention was evaluated in a randomized, controlled trial (RCT) implemented in 24 beer halls in Harare, Zimbabwe. A cadre of 413 male beer hall patrons (~20% of the patronage) was trained to assist their male peers within their friendship networks. Activities included one-on-one interactions, small group discussions, and educational events centering on the theme of men helping their male friends avoid risk. Venues were randomized into 12 control versus 12 intervention beer halls with little cross-contamination between study arms. The penetration and impact of the intervention were assessed by pre- and post-intervention cross-sectional surveys of the beer hall patronage. The intervention was implemented with a high degree of fidelity to the protocol, with exposure to the intervention activities significantly higher among intervention patrons compared to control. While we found generally declining levels of risk behavior in both study arms from baseline to post-intervention, we found no evidence of an impact of the intervention on our primary outcome measure: episodes of unprotected sex with non-wife partners in the preceding 6 months (median 5.4 episodes for men at intervention beer halls vs. 5.1 among controls, P = 0.98). There was also no evidence that the intervention reduced other risks for HIV. It remains an imperative to find ways to productively engage men in AIDS prevention, especially in those venues where male bonding, alcohol consumption, and sexual risk behavior are intertwined

Antiprotozoal activity of Khaya anthotheca, (Welv.) C.D.C. A plant used by chimpanzees for self medication

ETHNOPHARMACOLOGICAL RELEVANCE: Khaya species, endemic to Africa and Madagascar, continues to be valuable in indigenous traditional medicine. Their bitter tasting barks are decocted to treat fevers, several febrile conditions, microbial infections and worm infestations. In the Budongo rain forest of Western Uganda, non-human primates, especially chimpanzees and baboons, have been observed to eat the bitter non-nutritious bark and occasionally the seed. MATERIALS AND METHODS: Extracts were prepared by sequential fractionation with solvents of increasing polarities and assayed using standard procedures. Bioassay guided purification of the petroleum ether extract by column chromatography yielded three pure limonoids, Grandifolione (1), 7-deacetylkhivorin (2) and 1,3-deacetyldeoxyhavenensin (3). The antitrypanosomal, antileishmanial and antiplasmodial activities of pure compounds (1) and (2) were evaluated in vitro against Plasmodium falciparum K1, Trypanosoma brucei rhodesiense STIB 900, Trypanosoma cruzi trypomastigotes (Tulahuen C4), and axenic Leishmania donovani MHOMET-67/L82 and for cytotoxicity against L6 rat skeletal myoblast cells, in parallel with standard drugs. RESULTS: Of the four extracts tested, the petroleum ether extract showed activity against Plasmodium falciparum (IC50 0.955?g/ml) and Trypanosoma brucei rhodesiense (IC50 5.72?g/ml). The pure compounds (1) and (2) demonstrated activity against Plasmodium falciparum (KI strain) and marginal activities against Trypanosoma brucei brucei, Trypanosoma brucei rhodesiense, Trypanosoma cruzi and Leishmania donovani. CONCLUSION: The present study provides evidence justifying the use of Khaya preparations in traditional medicine to treat fevers and microbial infections. The observed antiprotozoal activity of grandifolione and 7-deacetylkhivorin from the seed of Khaya anthotheca further confirms the ethnomedicinal potential of this plant and supports the hypothesis that non-human hominids (chimpanzees and baboons) too, eat the bitter bark and seeds for self-medication and in general, the use of Khaya plant material for medication by humans in disease endemic tropical areas. The antiprotozoal activity of gradifolione, and, the antitrypanosomal and antileishmanial activities of 7-deacetylkhivorin are reported here for the first time

Money, men and markets: economic and sexual empowerment of market women in southwestern Uganda.

Market trading requires access to cash, independent decision-making, mobility and social interaction. This study sought to explore whether market work empowers women with respect to spending decisions and negotiation over sex and condom-use. A semi-structured questionnaire was administered to 212 market women; and 12 focus group discussions and 52 in-depths interviews were conducted among market women in southwestern Uganda. Market women reported high levels of independence, mobility, assertiveness and social interaction. Access to cash was not synonymous with control over it, however. Spending decisions were limited by men's ability to selectively withdraw finances for expenditures central to women's concerns including household and children's needs. Trading in markets earns women masculine labels such as kiwagi, characterized variously as independent, rebellious and insubordinate. Earning money does not change expectations of correct behaviour for wives, making it difficult for women to initiate, deny sex or ask for condoms. Independence and income from market work may make it easier for women to enter and exit new sexual relationships. However, unable to protect themselves within partnerships, HIV risk may increase as a result

Looking from the South, Speaking from Home: African women confronting development

Jessica Horn interrogates the discourse and practice of development in the post-independence, globalized world. She argues that development, defined in Euro-American forums, has been unresponsive to the varied needs of African women. She shows that it is African women themselves who are now confronting the Euro-centric presumptions of development, and are working to better the lives of women on the continent through place-based coalitions and culturally sensitive activism. Development (2007) 50, 109–116. doi:10.1057/palgrave.development.1100352