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  1. 1
    372962

    HIV/AIDS in the Western Balkans: priorities for early prevention in a high-risk environment.

    Godinho J; Jaganjac N; Eckertz D; Renton A; Novotny T; Garbus L

    Washington, D.C., World Bank, 2005. [217] p. (World Bank Working Paper No. 68)

    In recent years, Europe and Central Asia has experienced the world’s fastest growing HIV/AIDS epidemic. Yet, in the Western Balkan countries the HIV prevalence rate is under 0.1 percent, which ranks among the lowest. This may be due to a low level of infection among the population—or partly due to inadequate surveillance systems. All major contributing factors for the breakout of an HIV/AIDS epidemic are present in the Western Balkans. HIV/AIDS disproportionably affects youth (80 percent of HIV-infected people are 30 years old or younger). Most of the Western Balkan countries have very young populations, which have been affected by the process of social transition, wars, unemployment and other factors. Among youth, there is generalized use of drugs and sexual risk behavior. Therefore, the number of cases of HIV has been increasing, especially in Serbia, and the incidence of Hepatitis C has clearly increased, which suggests that sharing of infected needles is practiced by injecting drug users. Apart from human suffering, an HIV/AIDS epidemic can have a significant impact on costs of care for individuals, households, health services and society as a whole. This study has found weak public health systems and gaps in financing and institutional capacity necessary to implement evidence-based and cost-effective HIV/AIDS Strategies. Political commitment must increase for action to occur promptly. Prevention interventions are cost effective and, in the short term, affordable with own-country resources. Medium- and long-term interventions would require donor assistance. Longer-term interventions would aim at preventing poverty, exclusion and unemployment, for example, by empowering young people to participate in the regional and global labor market.
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  2. 2
    297795

    HIV and AIDS in Armenia: a socio-cultural approach.

    Papoyan A; Arakelyan A; Bakshinyan E

    Paris, France, UNESCO, Division of Cultural Policies and Intercultural Dialogue, Culture and Development Section, 2005. 83 p. (CLT/CPD/CAD-05/4B)

    Evaluating and effectively responding to the global challenge of the HIV epidemic requires an indepth understanding of the strong correlation between health and social, cultural and economic conditions, and how these shape behaviour at both individual and societal levels. While the number of people living with HIV (PLHIV) in Armenia is comparatively low, the rate is growing rapidly. Current prevalence among officially registered cases is 0.02%. The actual rate of prevalence is estimated to be approximately ten times higher, with a greater prevalence among distinct key population groups. Among the factors driving the HIV epidemic in the country - which faces profound socio-economic, political and cultural changes - are: a particular negative and fearful attitude towards the disease; discrimination against people living with HIV; low level of HIV and AIDS awareness among the population; and an increase in injecting drug use and commercial sex work. In Armenia, HIV-positive people are primarily associated with three key populations that are socially marginalized: commercial sex workers (CSWs), injecting drug users (IDUs) and men who have sex with men (MSM). For many years an individual's positive HIV status has been equated with immoral behaviour. As a result, PLHIV face aggression. Moreover, it is taboo to openly discuss HIV and AIDS, resulting in the further isolation of PLHIV. Currently many programmes have been implemented in Armenia to surmount stigmatization. However, this process demands numerous long-term activities and commitments from the state. (excerpt)
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  3. 3
    287823
    Peer Reviewed

    Good governance and good health: the role of societal structures in the human immunodeficiency virus pandemic.

    Menon-Johansson AS

    BMC International Health and Human Rights. 2005 Apr 25; 5:[10] p..

    Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. Based on Professor Amartya Sen's analysis of the link between famine and democracy, the following null hypothesis was tested: "Human Immunodeficiency Virus (HIV) prevalence is not associated with governance". Governance has been divided by a recent World Bank paper into six dimensions. These include Voice and Accountability, Political Stability and Absence of Violence, Government Effectiveness, Regulatory Quality, Rule of Law and the Control of Corruption. The 2002 adult HIV prevalence estimates were obtained from UNAIDS. Additional health and economic variables were collected from multiple sources to illustrate the development needs of countries. The null hypothesis was rejected for each dimension of governance for all 149 countries with UNAIDS HIV prevalence estimates. When these nations were divided into three groups, the median (range) HIV prevalence estimates remained constant at 0.7% (0.05 – 33.7%) and 0.75% (0.05% – 33.4%) for the lower and middle mean governance groups respectively despite improvements in other health and economic indices. The median HIV prevalence estimates in the higher mean governance group was 0.2% (0.05 – 38.8%). HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented. (author's)
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