Community-based AIDS prevention and care in Africa

With the support of the Welcome Foundation Limited's "Positive Action" Program, the Population Council has undertaken a 3 year project entitled "Community-Based AIDS Prevention and Care in Africa: Building on Local Initiatives." This project is underway in 5 countries: Kenya, Tanzania, Uganda, Zambia, and Zimbabwe. The ultimate goal of the project is to understand the essential components of effective community-based efforts for AIDS prevention and the care of persons living with HIV infection. For more information, please contact: Dr. Colette Dehlot, Project Director, The Population Council, P.O. Box 17643, Nairobi, Kenya.     

The state of immunology in Africa: HIV/AIDS and malaria.

HIV and malaria are two major infections that are responsible for the greatest burden of diseases, morbidity and mortality in the African population. Successful research has been undertaken in Africa into novel means of monitoring HIV disease progression and in identifying vaccine candidates. The role of IgG isotypes in malaria has been investigated, as have parasite adhesion molecules important for pathogenesis. It is hoped that vaccines for malaria will soon prove successful. However, many problems still face immunology research in Africa.     

Predictors of condom use in the prevention of HIV/AIDS in South Africa

The HIV epidemic is well established in South Africa. Approximately 2.4 million people are already infected, and more than 700 new infections occur every day. To date the application of economics to the problem of HIV/AIDS in South Africa has tended to focus on the economic impact of the consequences of the condition, costing and cost effectiveness analysis of clinical and community-based strategies for care. There has been no attempt to model individual sexual behaviour and hence understand the factors which influence individual behavior. The objectives of this study are threefold. First, to identify the factors that are important in individuals' decisions to use condoms during sexual intercourse in order to prevent HIV/AIDS infection. Second, to estimate the effects of respondents' personal characteristics and service specific attributes on individuals' decisions to use condoms. Lastly, to explore the policy implications of the analysis. A logistic regression model is used to analyse empirically the determinants of the choice to use condoms using micro-level data from the 1994 South African National Household Survey of Health Inequalities. The respondents' race, gender, marital status, smoking status, beer drinking status, income, price at the facility normally visited, travel time to the source of condoms, self-assessed health status and knowledge that condoms offer contraception benefits were found to be highly significant predictors of demand for condoms. There is a need for developmental programmes aimed at raising incomes and access to modern health care services for the South Africans who were discriminated against during the apartheid era.     

Community collaborative youth-focused HIV/AIDS prevention in South Africa and Trinidad: preliminary findings

BACKGROUND: South Africa and Trinidad and Tobago are disproportionately impacted by high rates of HIV/AIDS among adolescents. OBJECTIVE: The article describes the HIV crises in these countries; outlines a community participatory research framework to adapt and deliver family-based prevention; and presents preliminary data from intervention pilots in each setting. METHODS: Adapted interventions were piloted with N = 140 families in South Africa and N=16 families in Trinidad and Tobago to refine recruitment and retention efforts and to assess the adapted interventions' impact on family and risk-related constructs. RESULTS: Both settings reported promising results including high recruitment and retention and favourable pre to post changes in parent/youth frequency and comfort in talking about sensitive subjects, HIV transmission knowledge and attitudes about persons with HIV/AIDS. CONCLUSION: International HIV-prevention alliances are increasing. Such alliances are challenged by trust issues, power-differentials and ideological differences. Recommendations are provided on how some challenges can be overcome.     

艾滋病手术患者的心理护理

目的探讨艾滋痛手术患者的心理特点。对23例艾滋病手术患者进行心理分析。结果艾滋病手术患者存在着严重的心理障碍。运用专业知识、语言能力、表达方式、有效的心理疏导,缓解了患者的压力,改善了心理状态。结论对艾滋病患者采取以心理护理为重点的全方位个体化护理．减轻艾滋病心理障碍、效果满意。     

PVO / NGO initiatives,Africa. Society for Women and AIDS in Africa (SWAA), Mauritania

Society for Women and AIDS in Africa (SWAA), Mauritania, uses a multi-sectoral approach to raise awareness of the HIV/AIDS pandemic and provide assistance when needed. SWAA believes that in order to have an impact on women and development in their country they must address issues of health, education, and society. To these ends they have created a special center to provide health care and counseling to HIV-positive women and their children; they conduct health and general education sessions geared towards women; and they have formed local chapters of SWAA throughout Mauritania to provide support and information to women within their own communities. SWAA has also taken on a mass education campaign which includes the production of flyers, educational materials, and public service announcements for radio and television. For more information, please contact Mme. Sana Mint Abass, President, SWAA/Mauritanie, BP 118, Nouakchott, Mauritanie; tel: +222 564 69 (office), +222 524 04 (home); fax: +222 599 26.     

The role of academic medicine in improving health care quality.

Academic medicine, often entrenched in biomedical and clinical research, has largely ignored the development and application of quality metrics to ensure the delivery of high-quality health care. Nevertheless, academic medicine has substantial opportunities to lead the charge in building a quality infrastructure with the goal of delivering high-quality and cost-efficient health care to all Americans. The American College of Cardiology (ACC) and American Heart Association (AHA) have worked jointly to measure and improve the quality of cardiovascular care. This effort has led to the development of clinical practice guidelines, performance measures, data standards, national registries, and appropriateness criteria for cardiovascular care. Academic medicine should actively embrace and promote the type of quality metrics and criteria developed by ACC and AHA and apply this model across the entire academic medicine community. Academic medicine, with its many resources, could lead the way in the expanding field of quality science by supporting fundamental research in quality improvement, supporting academicians to improve quality at their own institutions, developing educational models for quality assessment and improvement, creating and implementing data registries, and serving as a conduit for developing the emerging science of quality assessment. In this and many other ways, academic medicine must offer the health care community leadership for improving our nation's health care quality with the same fervor presently exhibited for the advancement of basic science, the development of specialized and experimental therapy, and as centers for tertiary and quaternary patient care.     

Surveys on AIDS in Africa

The interest of inquiries on SIDA is analysed through this article to test the disease extent among the population and to analyse knowledge and behaviour in front of this disease either, in order to organise better prevention campaigns. Thus this is the point to lead inquiries on one hand of epidemiological type and in the other hand of socio-demographic and anthropological type to study behaviours in front of disease and its prevention.     

Society for Women and AIDS in Africa (SWAA)

In 1988, a group of African women founded the Society for Women and AIDS in Africa (SWAA) during the Fourth International Conference on AIDS in Stockholm. SWAA founders were concerned that national AIDS programs, professional associations, and donor agencies were not paying enough attention to how HIV/AIDS touches the lives of women in Africa. SWAA provides opportunities for women to be leaders in bringing about positive change. It asserts that if women have appropriate education and problem-solving opportunities, they will use their knowledge to make decisions and to take action, minimizing their risk of HIV infection and the risk behaviors of their partners and family members. SWAA helps women to provide AIDS education appropriate for women and safe, effective home and community-based HIV/AIDS health care and to address the cultural beliefs that foster misinformation about AIDS and the stigmatization of women. SWAA also assists women in changing traditional norms, in reducing prostitution, and in being advocates for persons living with HIV/AIDS, including AIDS orphans, grandparents, and street children. SWAA targets male policy and decision makers at both the national and international level. It cooperates with governmental and nongovernmental organizations to stem the AIDS epidemic in Africa. SWAA News is a permanent link between the SWAA branches in 25 countries and members. It features meetings, conferences, and SWAA activities. SWAA has increased solidarity among African women. It provides a forum for examining the sexual, social, and economic factors affecting the lives of women. It is expanding to include women's support centers and networks, counseling and help for women and HIV/AIDS, and training of media professionals on women and AIDS issues.