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Migration as a Risk Factor for HIV Infection among Youths in Sub-Saharan Africa: Evidence from the DHS.
Annals of the American Academy of Political and Social Science. 2013 Jul; 648(1):136-158.Of the estimated 10 million youths living with HIV worldwide, 63 percent live in sub-Saharan Africa. This article focuses on migration as a risk factor of HIV infection among the youths in sub-Saharan Africa. The study is based on multilevel modeling, applied to the youth sample of the Demographic and Health Surveys (DHS), conducted from 2003 to 2008 in nineteen countries. The analysis takes into account country-level and regional-level variations. The results suggest that across countries in sub-Saharan Africa, migrants have on average about 50 percent higher odds of HIV infection than nonmigrants. The higher risk among migrants is to a large extent explained by differences in demographic and socioeconomic factors. In particular, migrants are more likely to be older, to have been married, or to live in urban areas, all of which are associated with higher risks of HIV infection. The higher risk among youths who have been married is particularly pronounced among young female migrants.
Turning gender and HIV commitments into action for results: an update on United Nations interagency activities on women, girls, gender equality and HIV.
[Geneva, Switzerland], UNAIDS, 2009 Dec. 4 p.In September 2000, 189 UN Member States committed to achieving the Millennium Development Goals (MDGs) by 2015. Among these goals is a commitment to promoting gender equality and empowering women and combating HIV, malaria, and other diseases. Today, almost 10 years on, addressing gender inequality and AIDS remains the most significant challenge to achieving the MDGs, as well as broader health, human rights, and development goals. This update highlights key 2009 interagency initiatives, all of which operate at the intersection of gender equality, women's empowerment, and HIV.
New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2008 Mar.  p. (ST/ESA/SER.A/270)The AIDS epidemic remains one of the greatest challenges confronting the international community. In countries with a large number of people living with HIV, all population and development indicators are affected by the epidemic. Governments often cite HIV/AIDS as their most significant demographic concern. For more than two decades, the rapidly expanding HIV/AIDS epidemic has triggered a wide array of responses at the national, regional and global levels. The goals established by the United Nations General Assembly in the 2000 Millennium Declaration and through the adoption of the 2001 Declaration of Commitment on HIV/AIDS reflect widely-held concerns about the impact of the epidemic on development and human well-being. More recently, at the 2006 High Level Meeting on AIDS, Member States adopted a Political Declaration focusing on how to attain universal access to comprehensive HIV/AIDS prevention programs, treatment, care and support by 2010. (excerpt)
Integration of the human rights of women and the gender perspective: Violence against women. Towards an effective implementation of international norms to end violence against women. Report of the Special Rapporteur on violence against women, its causes and consequences, Yakin Ertürk.
[New York, New York], Economic and Social Council, 2003 Dec 26. 24 p. (E/CN.4/2004/66)In section I, the report defines the mandate and methods of work of the Special Rapporteur. Section II describes the activities of the Special Rapporteur since she took over the mandate in August 2003. Reference is also made to the activities of the former Special Rapporteur from 2003, until the end of her tenure in July. Section III starts with an assessment of the developments of the past decade in the area of women's human rights and violence against women, and continues with a focus on violence against women, as it manifests within a broad spectrum from the domicile to the transnational arena, in order to capture the persistence of the old as well as the emergence of new sites and forms of violence. Within this context, emphasis is placed on the universality of violence against women, the multiplicity of its forms and the intersectionality of diverse kinds of discrimination against women and its linkage to a system of domination that is based on subordination and inequality. HIV/AIDS is highlighted as the single most devastating epidemic experienced in modern history and that embodies the intersectionality of diverse forms of discrimination. Owing to the magnitude of health, security, development and human rights problems associated with HIV/AIDS and its intricate interplay with violence against women, the Special Rapporteur intends to carry out extensive research on the issue for her annual report for 2005. Finally, section III of the present report elaborates on guidelines for developing strategies for the effective implementation of international standards to end violence against women at the national level and proposes an intervention strategy with three interrelated levels, consisting of the State, the community, and the individual woman. While the State is bound by international human rights law, it is suggested that the human rights discourse at the level of the community and individual women needs to be complemented by a culture and an empowerment discourse, respectively. Section IV contains the conclusions of the report, highlighting the issues raised throughout the report that require further research and analysis. (excerpt)
Supporting and sustaining national responses to children orphaned and made vulnerable by HIV and AIDS: Experience from the RAAAP exercise in sub-Saharan Africa.
Vulnerable Children and Youth Studies. 2006 Aug; 1(2):170-179.The growing number of children orphaned and made vulnerable by HIV and AIDS in sub-Saharan Africa presents an enormous socioeconomic and public policy challenge. Despite international commitments to increase resource allocation and scale up services and support for AIDS-affected children, families and communities, the national- and sub-national-level state responses have been inadequate. The rapid assessment, analysis and action planning (RAAAP) process for orphans and vulnerable children, conceived in late 2003, was intended as a multicountry incentive to identify and resource immediate actions that can be taken to scale in 16 heavily affected countries. This review of experiences to date with the RAAAP process highlights some key areas of learning, including: (a) fund mobilization has been slow and has reached approximately only one-third of what is required; (b) ownership and integration into development planning of the issue of orphans and vulnerable children at country level has been undermined by the perception that the response is an 'emergency' and externally (donor) driven exercise; (c) centralized planning has failed to appreciate the complexity of context and responses at the meso- and micro-levels within countries, entailing the need to support a comprehensive decentralization process of planning and implementation; (d) comprehensive multisectoral and interagency collaboration, involving civil society, is an important but overlooked element of the planning process; and (e) definitional variation between countries has led to large variations in budgets and coverage targets. While the RAAAP process has undoubtedly raised awareness at state level of the nature and extent of the 'orphan crisis' and raised vital resources, only full integration of the new planning process for orphans and vulnerable children within the range of macro and national development tools will allow the response to be sustainable in the longer term. (author's)
Lancet. 2007 Dec 1; 370(9602):1821.One Sunday morning last year, an elderly Zambian woman, four grandchildren in tow, showed up at Elizabeth Mataka's door. "I'm looking for Mrs Mataka-people said she will help me. She's the one who helps grandmothers", the woman said. She had found exactly the right person. Mataka, herself a grandmother of three, heads the Zambia National AIDS Network (ZNAN) and helps coordinate funds fl owing in from donors. And earlier this year she was elevated to the highest levels of the global response to the pandemic. In April, 61-year-old Mataka was elected Vice Chair of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The next month, she got a surprise midnight call from New York with the news that she had been chosen to replace the outgoing United Nations Special Envoy for HIV/AIDS in Africa, Canadian diplomat Stephen Lewis. (excerpt)
New York, New York, OSAGI, .  p.Her name is Joyce Puta, a 48-year-old Zambian army colonel on secondment to the United Nations. An unabashed fighter, her enemy for the last ten years has been HIV/AIDS. Her latest battleground is Liberia, and by all accounts she has been waging a successful campaign. Working with the United Nations Mission in Liberia (UNMIL), Colonel Puta points out that any environment requiring peacekeepers is also a risky one for the spread of HIV/AIDS. In post-conflict situations, social structures crumble and economies are unstable. In order to survive, desperate young women may turn to commercial sex work, often around military bases. So how did a career Zambian army officer find herself on the frontlines in the fight against HIV/AIDS? Joyce Puta joined the army at eighteen. Six years later she became a registered nurse and midwife, and then nursing services manager for Zambia's main military hospital. (excerpt)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:80-87.The paper critically analyzes, from the gender standpoint, official results presented in the Brazilian government report to the Joint United Nations Programme on HIV/ AIDS (UNAIDS). Specifically, the fulfillment of 2003 targets set forth in the United Nations Declaration of Commitment on HIV/AIDS, under the category of Human Rights and Reduction of the Economic and Social Impact of AIDS, are evaluated. Key concepts are highlighted, including indicators and strategies that may help civilian society better monitor these targets until 2010. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:94-100.The objective of this study was to analyze, on the national level, the process of monitoring the proposed UNGASS indicators through the use of the Brazilian National Program for STD/AIDS's indicators. Two groups of proposed indicators were analyzed in 2002 and 2005 respectively, as part of the monitoring of the progress of the UNGASS Declaration of Commitment. The availability of information and limitations in calculating the proposed indicators in Brazil were analyzed and the appropriateness of the indicators for monitoring the epidemic in Brazil was discussed. Of the 13 quantitative indicators originally proposed by UNGASS, five were not included in the National Program. One was not included due to its qualitative nature. Two of the indicators were considered to be of little use and two were not included due to the lack of available data needed for their calculation. As the epidemic in Brazil is characterized as being concentrated, within the second group of proposed UNGASS indicators those that refer to the accompaniment of epidemic among high-risk population groups were prioritized. The study highlights that the National Program concentrates its efforts in the development, adaptation, and sharing of sampling methodologies for hard to reach populations. Such activities are geared towards estimating the size of vulnerable population groups, as well as obtaining more information regarding their knowledge, attitudes, and practices. The study concludes that by creating the possibility of international comparisons between advances achieved, the proposal of supranational indicators stimulates countries to discuss and make their construction viable. In a complementary way, the national monitoring systems should focus on program improvement by covering areas that permit the evaluation of specific control and intervention actions. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:42-51.Items from the UNGASS Draft Declaration of Commitment on HIV/AIDS (2001) are analyzed. The Brazilian experience of new methods for testing and counseling among vulnerable populations, preventive methods controlled by women, prevention, psychosocial support for people living with HIV/AIDS, and mother-child transmission, is discussed. These items were put into operation in the form of keywords, in systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The Brazilian experience relating to testing and counseling strategies has been consolidated through the utilization of algorithms aimed at estimating incidence rates and identifying recently infected individuals, testing and counseling for pregnant women, and application of quick tests. The introduction of alternative methods and new technologies for collecting data from vulnerable populations has been allowing speedy monitoring of the epidemic. Psychosocial support assessments for people living with HIV/AIDS have gained impetus in Brazil, probably as a result of increased survival and quality of life among these individuals. Substantial advances in controlling mother-child transmission have been observed. This is one of the most important victories within the field of HIV/ AIDS in Brazil, but deficiencies in prenatal care still constitute a challenge. With regard to prevention methods for women, Brazil has only shown a shy response. Widespread implementation of new technologies for data gathering and management depends on investments in infrastructure and professional skills acquisition. (author's)
Orphans and vulnerable children affected by HIV / AIDS in Brazil: where do we stand and where are we heading?
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:23-30.This study aimed at identifying human rights' status and situation, as expressed in the United Nations General Assembly Special Session on HIV/AIDS, of children and adolescents living with HIV/AIDS, non-orphans and orphans affected by AIDS, based on local and international literature review. The main study findings did not allow to accurately estimating those children and adolescents living with HIV and non-orphans affected by HIV/AIDS but data was available on those living with AIDS and orphans. The limitations and possibilities of these estimates obtained from surveillance systems, mathematical models and surveys are discussed. Though studies in literature are still quite scarce, there is indication of compromise of several rights such as health, education, housing, nutrition, nondiscrimination, and physical and mental integrity. Brazil still needs to advance to meet further needs of those orphaned and vulnerable children. Its response so far has been limited to providing health care to those children and adolescents living with HIV/AIDS, preventing mother-to-child HIV transmission and financing the implementation and maintenance of support homes (shelters according to Child and Adolescent Bill of Rights) for those infected and affected by HIV/AIDS, either orphans or not. These actions are not enough to ensure a supportive environment for children and adolescents orphaned, infected or affected by HIV/AIDS. It is proposed ways for Brazil to develop and improve databases to respond to these challenges. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:31-41.The focus of the present study is the Brazilian response within science, technology and innovation to the targets formulated in the UNGASS document. An analysis was made of items 70-73 of the UNGASS Draft Declaration of Commitment on HIV/ AIDS (2001), which defined science, technology and innovation targets relating to HIV/AIDS. The main topics listed in these items were put into operation in the form of keywords, in order to guide systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The success of Brazilian research within the field of characterization and isolation of HIV-1 is undeniable. Phase II/III vaccine studies have been developed in Rio de Janeiro, Belo Horizonte and São Paulo. Empirical studies on the monitoring of primary resistance have been developed in specific populations, through the Brazilian HIV Resistance Monitoring Network. Within the field of monitoring secondary resistance, initiatives such as the National Genotyping Network have been highlighted. Two national systems - the Mortality Information System and the Notifiable Diseases Information System-AIDS - and some studies with wider coverage have given rise to work on trends within the epidemic. The production of high-quality generic medications and their free distribution to patients have been highlighted. Brazil has implemented a consistent and diversified response within the field of HIV/AIDS, with studies relating to the development of vaccines, new medications and monitoring of the epidemic. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:5-8.Recognizing the HIV/AIDS pandemic as an unprecedented worldwide emergency and one of the greatest challenges to life and the enjoyment of human rights, the United nations called on member states to reflect on this matter. In June 2001, around 20 years after the first AIDS cases were recorded, the United Nations General Assembly Special Session on HIV and AIDS (UNGASS HIV/AIDS) was held in New York. The Session culminated in the drafting of the Declaration of Commitment on HIV and AIDS: a document that reflected the consensus between 189 countries, including Brazil, and stated some essential principles for an effective response to the epidemic. The Declaration recognized that economic, racial, ethnic, generational and gender inequalities, among others, were factors that boosted vulnerability and, whether acting separately or in synergy, favored HIV infection and the onset and evolution of AIDS. The Declaration of Commitment on HIV and AIDS has become transformed into a tool for reaffirming the urgency and necessity of promoting the solidarity that the epidemic demands. It aims towards better management of the actions and resources destined for controlling HIV and AIDS and towards social control over public HIV/AIDS policies. (excerpt)
Fulfilling reproductive rights for women affected by HIV / AIDS. A tool for monitoring progress toward three Millennium Development Goals. Updated version.
Chapel Hill, North Carolina, Ipas, 2006 Aug. 20 p.In 2004, more than 25 national and international organizations presented a statement to the secretariat of the United Nations (UN) Commission on the Status of Women that highlighted relatively neglected areas in the reproductive health of women affected by HIV/AIDS. In collaboration with the International Community of Women Living with HIV/AIDS (ICW), the Center for Health and Gender Equity (CHANGE) and the Pacific Institute for Women's Health, Ipas used that statement and a literature review to develop this practical tool to help nongovernmental organizations (NGOs) address those neglected areas of reproductive health. Since the Millennium Development Goals (MDGs) have become a common framework for assessing progress in development, the tool links those areas of reproductive health to three of the MDGs related to empowering women, improving maternal health and combating HIV/AIDS. This document is an updated version of the original resource published in 2004. Changes were made after the eight partner NGOs listed below piloted the benchmarks in 11 developing countries. (excerpt)
Choices. 2004; 4-5.This approach is underpinned by promoting leadership in government, in civil society, in the private sector and in communities. We promote leadership of people living with HIV/AIDS and women's leadership to ensure that they participate in planning and implementing HIV/AIDS responses. We also work with a broad range of partners, including from the media and in the arts, to generate society-wide responses that are gender-sensitive and respect the rights of people living with HIV/AIDS. We also work to strengthen community capacity for action and social change by helping communities to address the underlying causes of the epidemic. (excerpt)
Choices. 2001 Dec; 1.As UNDP's Goodwill Ambassador to combat poverty, I am deeply aware of the link between poverty and AIDS. Poor people suffer more from disease, and HIV/ AIDS creates more poverty. Being poor is hard enough, but poverty added to a deadly disease is nothing short of a disaster for families and whole communities. Since HIV/ AIDS is found especially among the youngest and most active, the more it spreads, the more people in the prime of life must stop working and support those who depend on them. The results are devastating for low-income families. HIV/AIDS is becoming a major development problem affecting all sectors of society and, even worse, it is wiping out the progress made thus far. While it has been possible to contain the spread of HIV/AIDS in rich countries through prevention campaigns and investment in research and treatment, things have been very different in many poor countries. In the poorest countries, many have no access to information that could prevent infection, and those who are infected do not have the drugs that could give them a few more precious years to live. (excerpt)
Choices. 2001 Dec; 4.We are facing the most devastating global epidemic in modern history. Over 60 million people have been infected. In the worst affected countries one in four adults are now living with HIV/AIDS, a disproportionate number of younger women and girls. More than 80 percent are in their twenties. The result is a devastating hollowing out of communities, leaving only the very young and the very old and thrusting millions of families deeper into poverty. Meeting this challenge means progress on three fronts: first, preventing new infections and reversing the spread of the epidemic; second, expanding equitable access to new HIV treatments; third, alleviating the disastrous impact of AIDS on human development. Effectively responding to HIV/AIDS requires a wide range of initiatives under strong national political leadership, including sex education in schools, public awareness campaigns, programmes in the workplace, mobilization of religious and community leaders, action to mitigate the impact on poverty and essential social services, support for orphans and tough policy decisions in ministries of finance to ensure optimal allocation of resources to cope with the crisis. (excerpt)
Choices. 2004; 6.HIV/AIDS has reached the proportion of a pandemic because human rights continue to be violated on a massive scale. During my term as UN High Commissioner for Human Rights, and in the years since, I have seen first-hand how these rights violations fuel the spread of HIV/AIDS. I have met with women in rural areas across Africa who feared losing their homes and being rejected by their families due to their actual or suspected HIV status. I will never forget the elderly man I met in Delhi who was refused hospital treatment for a broken hip because he was HIV positive, or the discrimination against the gay, lesbian and transsexual community recounted to me by a group in Argentina, every one of whom had a personal story of rejection and hardship. (excerpt)
Choices. 2001 Dec; 23.HIV/AIDS is the most serious epidemic confronting the world. Since its first appearance some 20 years ago, countries have struggled to come to grips with its immense impact on every aspect of life. To date an estimated 60 million people globally have been infected with HIV/AIDS. After years of denial and inadequate activity at all levels and regions, a coordinated international effort is now led by the United Nations, from the highest level onward: the UN Secretary-General has made the fight against HIV/AIDS his personal priority; it is a preoccupation of the UN Security Council; and at a special session in June the UN General Assembly issued a Declaration of Commitment outlining specific leadership and coordination targets to be met over the decade. (excerpt)
Choices. 2001 Dec; 18-19.I don't have any used syringes. Somebody has stolen all, Anka was almost begging. In a worn-out black T-shirt and torn jeans, she looked helpless and desperate, standing in the middle of a vacant square, squeezed between Warsaw's main railway station and a Holiday Inn hotel. "I really don't have any," she repeated. "You know it's an exchange. Go and find some," Grzegorz Kalata said, patiently but firmly. Kalata comes to the square -- a meeting point for local drug users -- almost every evening. He is a streetworker from Monar, Poland's leading chain of non-profit detoxification centres. Under a harm reduction programme, partly sponsored by the United Nations Development Programme (UNDP), Kalata gives disposable syringes and needles, bandages, condoms and antiseptics to drug addicts who meet at the square. In return, he collects used syringes and needles in a plastic container, usually full by the end of his visit. After scouring the grass at the site, Anka came back with four used needles. Kalata gave her seven new ones and a package of bandages. On average, Kalata gives out some 200 needles and 150 syringes during an evening. (excerpt)
Choices. 2001 Dec; 16-17.The Caribbean is regarded as one of the territories hardest hit by the HIV/AIDS pandemic, which has become a major cause of death among men and women in the 15 to 44 age group in several countries. There are an estimated 500,000 people living with HIV/AIDS in the region. The World Health Organization (WHO) reports that more than half the Caribbean's HIV/AIDS victims are under 25 and that as many as 60 percent of the newly infected are in the 15 to 24 age range. This infection rate is estimated to be second only to that of sub-Saharan Africa. Barbados and the Organization for Eastern Caribbean States (OECS) member states--former British Territories that gained independence between 1966 and 1984--are part of this Caribbean grouping. Together these islands have a population of approximately one million people. And based on the experience of sub-Saharan Africa, it is expected that the epidemic will deepen already high levels of poverty existing here. (excerpt)
Choices. 2001 Dec; 5.The HIV/AIDS epidemic is the world's most serious development crisis. Nearly 58 million people have been infected, and 22 million are already dead. The epidemic continues to spread, with over 15,000 new infections every day. The devastating scale and impact of this catastrophe is a call of the utmost urgency for each of us to act. On 27 June 2001, the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), adopted the "Declaration of Commitment on HIV/ AIDS." The Declaration recognized in clear and forthright terms the driving forces of the epidemic, including social, economic, and cultural aspects; and set specific measurable goals in four key areas: prevention of new infections; provision of improved care, support and treatment; reduction of vulnerability; and mitigation of the socio-economic impact of HIV/AIDS. The global community is challenged to respond to the epidemic in a new way, with strategic attention to its human rights and gender dimensions, greater accountability for results, and courageous and visionary leadership. (excerpt)
Choices. 2001 Dec; 17.Each passing day, one is more and more aware of the devastating scope of the HIV/AIDS epidemic and of the toll it will take on future generations in Haiti. This island nation has a population of eight million people, 70 percent of whom are poor, 50 percent illiterate and 70 percent unemployed. The combination of high rates of poverty, illiteracy and unemployment increases people's vulnerability to the AIDS virus. Haiti, the poorest country in the Americas, has the highest rate of infection of that region, and 67 percent of all the cases reported in the Caribbean. Since the advent of the epidemic in the 1980s, some 300,000 Haitians have died from it; more than 160,000 children have been orphaned, and about 260,000 currently live with the virus. (excerpt)
New York, New York, UNDP, . 16 p.The 22 country offices where the We Care programme has been rolled out are taking great strides in making their workplaces truly AIDS competent. We are beginning to understand that HIV/AIDS is not 'out there' but among us -- and that if we are to make a difference in the way the world responds to it, WE MUST BEGIN WITH OURSELVES. Today, the We Care initiative is a global programme aiming at creating HIV/AIDS competence in all country offices, regional offices and headquarters by end of 2005. We Care is promoted together with initiatives spearheaded by other UN agencies, including 'Caring for Us' by UNICEF, the joint Access to Treatment and Inter-Organisational Needs (ACTION) programme facilitated by the UN Secretariat and the 'HIV/AIDS in the Workplace' initiative by WFP and ILO. (excerpt)
New York, New York, UNDP, . 16 p.We often assume that as UN employees, especially at Headquarters, we are somehow immune. Immune to being infected or affected by HIV/AIDS, immune from stigma and discrimination, immune from needing care, counselling, testing or treatment. But the truth is, we are as vulnerable as everyone else in society, and just like everyone else, we need to make informed decisions when it comes to HIV and AIDS. We need to be educated, we need to know how we can protect ourselves and how we can have a better quality of life if we happen to be living with HIV. We need to know that we have access to care and treatment and the right to confidentiality and non-discrimination in the workplace. In addition, as UN employees we have a special role to play. Before we can share with the world how HIV/AIDS should be addressed, we need to look into ourselves. Are we really that well informed, that sensitive? Can we talk openly to our co-workers about HIV/AIDS? Are we really sure that we will not be stigmatized if we happen to be living with HIV? Are we afraid of working closely with someone living with HIV? Do we discuss our anxieties and concerns within our families, with our partners, friends and co-workers? The We Care initiative addresses these issues. It helps us recognize that HIV/AIDS is not only 'out there' but also among us. And that if we are to create an environment that is empowering and respectful of the rights and responsibilities of every individual, we must first begin with ourselves. (excerpt)