Marital status and risk of HIV infection in South Africa

Objective. Available evidence on the relationship between marital status and HIV is contradictory. The objective of this study was to determine HIV prevalence among married people and to identify potential risk factors for HIV infection related to marital status in South Africa. Methods. A multistage probability sample involving 6 090 male and female respondents, aged 15 years or older was selected. The sample was representative of the South African population by age, race, province and type of living area, e.g. urban formal, urban informal, etc. Oral fluid specimens were collected to determine HIV status. A detailed questionnaire eliciting information on socio-demographic, sex behaviour and biomedical factors was administered through face-to-face interviews from May to September 2002. Results. HIV prevalence among married people was 10.5% compared with 15.7% among unmarried people (p-value < 0.001). The risk of HIV infection did not differ significantly between married and unmarried people (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.71 - 1.02) when age, sex, socio-economic status, race, type of locality, and diagnosis of a sexually transmitted infection (STI) were included in the logistical regression model. However, the risk of HIV infection remained significantly high among unmarried compared with married people when only sex behaviour factors were controlled for in the model (OR 0.55; 95% CI: 0.47 - 0.66). Conclusions. The relationship between marital status and HIV is complex. The risk depends on various demographic factors and sex behaviour practices. Increased prevention strategies that take socio-cultural context into account are needed for married people. S Afr Med J 2004; 94: 537-543

Government's changing reponses to HIV/AIDS

In this chapter we review the changing responses of the governments of South Africa, during and after apartheid. The focus is on the post-apartheid government, and particularly the debates and disputes which have shaped the management of the epidemic of this country.

AIDS: A threat to human security

In this chapter it is argued that a health issue constituted a security threat. The authors argue that that AIDS like other epidemics such as bubonic plague, smallpox and influenza, has the potential to annihilate human populations, destroy communities, and stifle economic growth, especially in heavily affected countries. Thus, it constitutes a clear threat not only to national security or the security of states, but more importantly to human security, security of individuals and communities. The authors discuss the cumulative impact of AIDS on social, economic, political, and military sectors and suggest specific policy options aimed at reducing this threat to human security

HIV/AIDS in South Africa: entitlement and rights to health-implications of the 2002 household survey

Paper presented at the "Remaking law in Africa: transnationalism, persons and rights": annual international conference, Centre for African Studies, University of Edinburgh, 21-22 Ma

Projects funded by the WK Kellogg Foundation on HIV/AIDS in southern Africa: report of the colloquium 26-27 November 2003

In November of 2003, the Human Sciences Research Council (HSRC) and the WK Kellogg Foundation (WKKF) hosted a colloquium to present and review the research that the HSRC has conducted with the support of the Foundation in projects across six southern African countries namely, Botswana, Lesotho, Mozambique, South Africa, Swaziland, and Zimbabwe. The two-day event was designed to cover the two focal areas of the work; thus the first day focused on the policy research that has been done across the six countries in southern Africa, and the second day looked at the work that has been done with orphaned and vulnerable children (OVC) in Botswana, South Africa and Zimbabwe. The colloquium was seen as an opportunity to report back to the WKKF and to local stakeholders, including representatives from government, service providers in health and social development, state policy and regulatory bodies, academics and researchers, intervention workers from both NGOs and state services, policy makers and interested advocates around policy and children.Work at the colloquium was directed at using the forum to facilitate as much discussion and debate as possible. The event was also designed to serve as a space for networking and social connection between all the organisations involved

Examining the impact of HIV & AIDS on South African educators

Our aim in this study was to examine the impact of HIV&AIDS; on South African educators. A cross-sectional survey was conducted in public schools combining HIV testing and a face-to-face interview with participants from a nationally representative sample of public educators. The results show that HIV is highly prevalent among South African public educators (12.7%) and the educators who are absent from school for longer periods (20 days or more) compared with those who are absent for less than four days have higher HIV prevalence (16.8% vs 11.95%). Educators also spend time away from teaching while they attend funerals for colleagues who have died (6.7%), for family members (13.4%) and for members of their communities (47.6%). This makes them feel depressed (71%). These results suggest that HIV&AIDS; has an impact on the quality of education. There is a need to prevent new HIV infections and reduce morbidity through the implementation of comprehensive integrated prevention and treatment programmes targeted at educators. There is also a need to support educators in coping with the problem of HIV&AIDS; at work and in the community.

Social determinants for HIV prevalence among South African educators

HIV prevalence among women in South Africa continues to be high despite the availability of a comprehensive plan for the control of HIV/AIDS and a plethora of prevention programmes. Any explanation for the ongoing high HIV prevalence continues to be elusive. The objective of this study was to understand the relationship between HIV, gender, race and socioeconomic status among South African public sector educators in order to inform prevention programmes. A cross-sectional survey involving a probability sample of 1,766 schools out of 26,713 in the Department of Education Register of School Needs was selected. A sample of 24,200 respondents out of 356,749 public sector educators participated in the study. Nurses registered with the South African Nursing Council were recruited, trained to conduct interviews and to collect specimens for HIV testing. The study found an association between HIV, gender, race and socioeconomic status among educators. African educators showed a higher HIV prevalence than other race groups. Among females, the highest HIV prevalence was among educators aged 25-35 years and in males aged 36-49 years. Further, educators with a high income and educational qualifications had a lower HIV prevalence compared to educators with low income and low educational qualifications, regardless of sex. Migration and marital factors were also found to play a role in HIV infection. The results suggest that HIV prevention needs to take into account critical issues around empowerment of vulnerable groups such as women and certain race groups to be able to implement safe sexual practices and therefore reduce HIV infections.

Selective serotonin reuptake inhibitors in the treatment of post-traumatic stress disorder: A meta-analysis of randomized controlled trials

Advances in the neurobiology of post-traumatic stress disorder (PTSD) and the availability of modern psychotropics have led to renewed interest in the pharmacotherapy of this disorder. In this paper we focus on trials of the selective serotonin reuptake inhibitors (SSRIs) in PTSD. Studies of the pharmacotherapy of PTSD were identified using methods developed by the Cochrane collaboration. Although a range of open trials of different SSRIs in PTSD show promise, there are few controlled pharmacotherapy studies in this disorder. Nevertheless, pharmacotherapy for PTSD appears to have reasonably robust effects, with odds ratios for responder status, defined as 'much improved' or 'very much improved' on the Clinical Global Impression Scale (CGI), on drug versus placebo varying from 2.2 to 5.6 in randomized controlled trials of different agents. The SSRIs appear both safe and effective for this indication. Additional research with these agents is necessary to clarify many questions, including predictors of response, duration of treatment, comparison with other agents, and integration with psychotherapy. In the interim, however, the SSRIs can be recommended as a first-line medication for the treatment of PTSD. (C) 2000 Lippincott Williams and Wilkins.Conference Pape