Determinants of Self-Perceived HIV Risk in Young South Africans Engaged in Concurrent Sexual Relationships

Concurrent sexual partnerships are increasingly believed to be a key factor explaining the size of the HIV pandemic in Southern and Eastern Africa. Little, however, is known about what determines if persons in concurrent relationships develop a perception of being at risk for HIV infection. Data from a representative sample of 2245 young sexually active inhabitants of Cape Town, South Africa, were analysed using multivariate logistic regression to examine what the correlates of HIV risk were in both those involved in concurrent relations (termed the high risk group) and in those not (the low risk group). A considerable difference was noted between males and females. In the high risk group, amongst the males, secondary level education (as compared with primary or post-secondary level), and believing in monogamy (as a means of HIV risk reduction) were correlated with a decreased-perception-of-HIV-risk. The usage of drugs was associated with an increased-perception-of-HIV-risk. Amongst the females, a longer time since sexual debut, having experienced sexual coercion, a greater number of sex partners in the past year and knowing someone who died of AIDS were correlated with an increased-HIV-risk-perception (Afr. J. Reprod. Health 2010; 14[3]: 171-181).Key words: HIV risk perception, sexual partner concurrency, health belief model, illness representation theory, social identity theory, cognitive dissonance theory

(Ad)dressing sexual reproductive health issues and its determinants in KwaZulu-Natal and Eastern Cape provinces of South Africa: evidence from a situational analysis of millennium development goals indicators

This chapter presents a synthesis of the progress on key health-related MDGs in two South African provinces of KwaZulu-Natal (KZN) and the Eastern Cape (EC) focusing on sexual reproductive health and rights (SRHR) indicators. Utilizing a mixed method approach that included a desk review of policy directives on SRHR, secondary quantitative analysis of key epidemiological indicators, and a qualitative component that included focus groups discussions at both urban and rural contexts; we offer evidence about how demographic and socioeconomic conditions explain trends in SRHR and show the complexity, interaction, and intersection of SRHR and all its determinants. The chapter concludes by discussing challenges [including (infra)structural, service delivery, access] in addressing specific SRHR goals and offers evidence of progress and prospects for a post 2015 agenda in addressing health-related MDGs in South Africa.

Health information exchange policy and standards for digital health systems in africa: A systematic review.

Lack of interoperability and integration between heterogeneous health systems is a big challenge to realize the potential benefits of eHealth. To best move from siloed applications to interoperable eHealth solutions, health information exchange (HIE) policy and standards are necessary to be established. However, there is no comprehensive evidence on the current status of HIE policy and standards on the African continent. Therefore, this paper aimed to systematically review the status of HIE policy and standards which are currently in practice in Africa. A systematic search of the literature was conducted from Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, Web of Science, and Excerpta Medica Database (EMBASE), and a total of 32 papers (21 strategic documents and 11 peer-reviewed papers) were selected based on predefined criteria for synthesis. Results revealed that African countries have paid attention to the development, improvement, adoption, and implementation of HIE architecture for interoperability and standards. Synthetic and semantic interoperability standards were identified for the implementation of HIE in Africa. Based on this comprehensive review, we recommend that comprehensive interoperable technical standards should be set at each national level and should be guided by appropriate governance and legal frameworks, data ownership and use agreements, and health data privacy and security guidelines. On top of the policy issues, there is a need to identify a set of standards (health system standards, communication, messaging standards, terminology/vocabulary standards, patient profile standards, privacy and security, and risk assessment) and implement them throughout all levels of the health system. On top of this, we recommend that the Africa Union (AU) and regional bodies provide the necessary human resource and high-level technical support to African countries to implement HIE policy and standards. To realize the full potential of eHealth in the continent, it is recommended that African countries need to have a common HIE policy, interoperable technical standards, and health data privacy and security guidelines. Currently, there is an ongoing effort by the Africa Centres for Disease Control and Prevention (Africa CDC) towards promoting HIE on the continent. A task force has been established from Africa CDC, Health Information Service Provider (HISP) partners, and African and global HIE subject matter experts to provide expertise and guidance in the development of AU policy and standards for HIE. Although the work is still ongoing, the African Union shall continue to support the implementation of HIE policy and standards in the continent. The authors of this review are currently working under the umbrella of the African Union to develop the HIE policy and standard to be endorsed by the head of states of the Africa Union. As a follow-up publication to this, the result will be published in mid-2022