Exposure to Workplace Violence and Quality of Life among Drivers and Conductors in Maputo City,Mozambique

Abstract

This cross-sectional study examined exposure to workplace violence and its consequences on quality of life (QOL) among workers in the road passenger transport sector in Maputo city, Mozambique. A random sample of 504 drivers and conductors were interviewed using structured questionnaires. Many participants reported experiencing psychological or physical violence at work. Sequelae of violence included sick leave following abuse (20%), physical injuries (32%), financial loss (28%), and various emotional reactions (28–56%). Exposure to workplace violence was a significant predictor of QOL even after adjusting for confounding. Mechanisms to detect and deal with both immediate and long term consequences of work-related violence on QOL are recommended.     

The power of AIDS: kinship,mobility and the valuing of social and ritual relationships in Tanzania

The HIV/AIDS epidemic in Africa has become a test case of the effects of globalisation, in that it demonstrates how international processes may affect regional life situations and how 'the local' can simultaneously develop in its own way, through the processes of appropriating, modifying, and resisting global influences. Drawing on fieldwork in Tanzania, I show how the Luo in the Mara region define HIV/AIDS as an outcome of modernity and globalisation, which to them have become embodied in processes of migration, the collapse of generational and gender hierarchies, and an increased immorality in contemporary society. While social and moral ruptures in Mara become further condensed in tensions between lineages and AIDS-sick relatives, mourning and burial rituals (including widow cleansing), disputes over inheritance rights, and the attribution of illness to the breaking of a taboo (chira) have become essential for negotiating and maintaining social and cultural relationships in an era of AIDS. In conclusion I argue that the concepts of vitality and moral practice may assist an understanding of how different social actors in sub-Saharan Africa have responded to the breakdowns associated with increased suffering and death, and to describe some social and moral developments observable in the context of internationally driven public health campaigns in the region.     

Reconceptualising vulnerable children by acknowledging their assets

We report on a study that sought to find alternative pathways to conceptualising vulnerable children. We have extracted a section from a longitudinal study that focuses on the ways in which vulnerable children in a rural community in South Africa cope with the impact of HIV and AIDS. We relied on the concepts of assets, resources and capacities to guide our understanding of 'vulnerable children', in an attempt to open up conceptualisations of the term, which have previously almost exclusively focused on deficits and needs. The study used a case study design with a small group of children who were engaged in making memory boxes. The study shows that numerous resources and capacities for coping and well-being are evident within and around the children. Most prominent among the capacities of the participants in this study are a positive identity and essential social competencies.     

Preliminary investigation of adherence to antiretroviral therapy among children in Aminu Kano Teaching Hospital,Nigeria

Treatment of HIV with highly active antiretroviral therapy (HAART) has resulted in declining morbidity and mortality rates from HIV-associated diseases, but concerns regarding access and adherence are growing. To determine the adherence level and the reasons for non-adhering to antiretroviral therapy (ART) among children attending the clinic for infectious diseases at Aminu Kano Teaching Hospital in Nigeria, a cross-sectional study using the selfreport tool was carried out among 40 children with HIV infection who had been on ART for at least six months. Thirty-two patients (80%) were 95% or more adherent to their medications. The most common reasons for nonadherence were running out of medicines and the inability to purchase more due to financial constraints; other barriers were non-availability and inaccessibility to medications. Eighty-five percent of the paediatric patients took their medications at the same time everyday, and scheduled appointments were kept by 87.5%. The social class of the patients did not significantly affect adherence level. The level of adherence to ART was comparable to levels reported from other developing and developed countries. The cost of ART, and availability and accessibility to medications were the most significant barriers to adherence. Expanded access to subsidised antiretroviral drugs should improve adherence — and consequently treatment outcomes — for patients receiving this treatment in resource-poor settings.     

Fertility desire and family-planning demand among HIV-positive women and men undergoing antiretroviral treatment in Addis Ababa,Ethiopia

Little information exists about desire to have children and family-planning use among HIV-positive individuals and how this may vary according to individual, social, health and demographic characteristics, especially in developing countries. To assess these topics in Ethiopia, a facility-based cross-sectional study was undertaken among 460 HIV-positive individuals receiving follow-up care at antiretroviral treatment (ART) centres in six public hospitals in Addis Ababa in 2006. One hundred and nine of the women (44.7%), 76 of the men (35.2%), and 40.2% overall of the HIV-positive individuals receiving care desired to have children. In comparison to those who said they did not desire to have children, those who did desire children tended to be younger (18–29 years) (adjusted odds ratio [OR]: 3.05, 95% CI: 1.5–6.4), married or in a relationship (adjusted OR: 3.4, 95% CI: 2.1–5.6), without a child (adjusted OR: 11.5, 95% CI: 5.3–24.9), and with a partner who also desired to have children (adjusted OR: 38.7, 95% CI: 16.7–89.1). Two hundred and forty-six individuals (53.5%) were using family planning (e.g. condoms, abstinence, injectables) and 85 wanted to use family planning in the future. The fertility desire and family-planning needs of these ART clients have implications for preventing vertical and heterosexual transmission of HIV, and the need for appropriate counselling and delivery of services.     

Neurological manifestations of HIV infection in Nigerians

Nervous system complications commonly accompany HIV infection and are associated with significant morbidity and mortality. HIV incidence has been progressively increasing in Nigeria, yet the neurological manifestations of the disease have not been systematically studied in Nigerians. This study aimed to describe the nature and frequency of neurological manifestations associated with HIV infection in a sample of 202 Nigerians. This was a prospective study of patients with documented HIV infection who attended a referral centre clinic in Abuja in 2003. A personal history, general and neurological examinations, and other relevant medical investigations were carried out for all subjects. A mini mental-state exam was carried out with those willing to cooperate. In all, 89 patients (44%) were diagnosed with at least one neurological disorder. Herpes zoster and cognitive impairment were the most frequent, each present in 12.3% of the study group. Peripheral neuropathy and facial palsy were also present, in 10.4% and 3.9% of subjects, respectively. Brain mass lesions, seizure disorder, cryptococcal meningitis, cord compression syndrome, and trigeminal neuralgia were also documented. There was no significant difference demographically between subjects with or without neurological impairment. Future studies in this area should utilise nerve conduction studies and more detailed testing of cognitive function to further characterise the neurological manifestations of HIV infection.     

HIV/AIDS,childhood and governance: sundering the bonds of human society

There is a disharmonious resonance between the length of HIV infection in the individual human host and the length of a human generation. In brief, an infected person may have children, these may be orphaned and grow up to become infected, and afterwards they themselves may have children, who can be orphaned in turn. Hence, a basic unit of social structure in most human societies, the three-generation bond between grandparents, parents and the current generation — and on into the future — is repeatedly torn apart in the absence of treatment, a vaccine or behaviour change. This situation should be read against the threat of growing viral resistance. Certain implications of these processes for the future are outlined and discussed. The paper notes the uncertain future confronting societies that already have a relatively high number of orphans, and considers some otherwise unexpected possibilities, as well as the dangers of assuming that large-scale orphaning necessarily leads to social unrest and disorder.     

Muted voices: HIV/AIDS and the young people of Burkina Faso and Senegal

This article explores the discrepancies between the vocal public discourse on HIV/AIDS and sexuality as generally encouraged by policy-makers and donor communities in Africa, and the often hushed voices of their target groups: young people in African communities. Based on fieldwork among urban youth in Senegal and Burkina Faso, we describe the silence of young people with regard to HIV/AIDS and sexuality as a social phenomenon, with focus given to family relations, peer relations and gender aspects in partnerships. Drawing on Foucault and Morrell, an inability and unwillingness to speak about HIV/AIDS and sexuality are analysed as a response to an everyday life characterised by uncertainty. This response represents a certain degree of resistance, while it constitutes a major barrier to any HIV/AIDS prevention effort. Finally, we stress that despite great constraints in their everyday lives, young people have some room to manoeuvre and are able to apply some negotiating strategies to reduce sexually-related health risks.     

Using an undertaker's data to assess changing patterns of mortality and their consequences in Swaziland

This paper measures AIDS mortality using routinely collected data from one of two nationally operating undertakers in Swaziland. The business recorded a marked increase in the number of deaths it handled between 1998 and 2002, most obvious in the 0–4 and 20–49 age categories. Cost data reflects this increase in mortality. Prices for funerals and coffins have declined in real terms. Recorded causes of death were of little use in determining the extent of AIDS mortality. This was due to stigma and denial, the relatively small number of people dying in hospitals and lack of accurate reporting of medical diagnoses. Key informant interviews were done to support the undertaker's data and determine how families bear the burden of burying deceased relatives. Despite a disproportionate increase in deaths in certain age categories and evidence of worsening poverty, funerals remain large and elaborate affairs.     

Perception of risk of HIV infection in marital and cohabiting partnerships

The purpose of this paper is to understand how married and cohabiting men and women define risk and to identify the factors that influence risk perceptions in a setting with a high prevalence of HIV infection. A combination of qualitative and quantitative methods was used during a cross-sectional survey conducted among 248 men and 289 women in KwaZulu-Natal, South Africa. Forty in-depth interviews were conducted with sexually-active men and women in the same population. The majority of men and women perceived themselves at risk of HIV infection. Women were more likely than men to report a higher risk of HIV infection. Nearly 46% of women and 28% of men perceived themselves at medium or high risk of HIV infection. The qualitative and quantitative data show that perception of risk of HIV infection was influenced both by a person's own sexual behaviour and a partner's sexual behaviour. Men were significantly more likely to perceive themselves at risk because of their own risky sexual behaviour (P < 0.01). In general, few women reported engaging in risky sexual behaviour. However, women were more likely to report that their partners had other sexual partners. Thus, women were significantly more likely to perceive themselves at risk because of their partner's sexual behaviour (P < 0.05). Also, rural women were significantly more likely than urban women to perceive a high risk of HIV infection (P < 0.05). Prevention programmes have an important role to play in creating awareness of the risk of HIV, especially among men. The belief that they are not at risk of HIV infection may result in their failure to adopt self-protective behaviour.