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Social Science and Medicine. 2012 Jan; 74(1):52-7.Based on data from Afrobarometer's 2008-2009 public opinion surveys in 20 sub-Saharan African states, this article examines the extent of support for government AIDS policies. While many international and nongovernmental organizations have criticized African governments for failing to implement comprehensive HIV/AIDS policies, survey data shows that citizens have generally positive assessments of their governments' responses. The findings demonstrate that support for a government's AIDS policies arises less from demographic characteristics and more from experiences with and perceptions of the government's capabilities. In particular, those in better economic circumstances and those who approve of the president's job performance show particularly strong support for their government's AIDS policies. This may suggest that leaders are exhibiting the political will necessary to implement holistic AIDS policies and receiving support for them, but it may also suggest respondents are not differentiating between support for the government as a whole and support for particular policy areas. Copyright (c) 2011 Elsevier Ltd. All rights reserved.
Sexually Transmitted Infections. 2009 Feb; 85(1):65-69.Objectives: To design and assess HIV and homosexuality related stigma scales in a developing world context. Methods: A respondent-driven sampling survey was conducted among 351 men who have sex with men (MSM) in Shenzhen, China. Exploratory and confirmatory factor analyses were used to examine and determine the latent factors of stigma subscales. Results: Factor analyses identified three subscales associated with homosexuality and HIV stigma: public homosexual stigma (10 items), self homosexual stigma (8 items) and public HIV stigma (7 items). There were no items with cross-loadings onto multiple factors, supporting the distinctness of the constructs that these scales were meant to measure. The fit indices in confirmatory factor analysis provide evidence for the hypothesised three-factor structure of associations (the x2/degree ratio=1.84, CFI=0.91, RMSEA=0.05 and SRMR=0.05). Reliability of the three scales was excellent (Cronbach's alpha: 0.78-0.85) and stable across split samples and for the data as a whole. Conclusions: The selection of three latent factors was supported by both psychometric properties and theories of stigmatisation. The scales are brief and suitable for use in developing countries where less time-consuming measurement is preferable.
Global Public Health. 2008; 3(S2):39-57.This study is aimed at examining how subsequent Peruvian governments, since 1990, have addressed reproductive rights, HIV/AIDS prevention and treatment, and sexual diversity rights, as well as the drastic policy shifts and its many contradictions. Abortion and contraception consistently generated the deepest public controversies and debates, which made progress in reproductive rights difficult. HIV/AIDS was often portrayed as having the potential to affect everyone, which allowed advocates and activists to achieve some success in advancing HIV/AIDS-related rights. Sexual diversity rights, perceived as a demand made by "others", were generally trivialised and disdained by politicians, officials, and the general population. Positive changes occurred as long as the issue was given a low political and institutional profile. The analysis of policy-making and programme implementation in these three areas reveals that: (1) Weaknesses in national institutional frameworks concerning reproductive health made it possible for governments to adopt two very different (even contradictory) approaches to the issue within the past 15 years; (2) Policies were presented as rights-based in order to garner political legitimacy when, in fact, they evidenced a clear disregard for the rights of individual citizens; and (3) By favouring low-profile "public health" discourses, and marginalising "the sexual" in official policies related to sexuality, advocacy groups sometimes created opportunities for legal changes but failed to challenge conservative powers opposing the recognition of sexual and reproductive rights and the full citizenship of women and sexual minorities. (author's)
Is it all in a word? The effect of issue framing on public support for U.S. spending on HIV / AIDS in developing countries.
Harvard International Journal of Press / Politics. 2007; 12(2):120-132.The frequency of government foreign aid decisions influenced by pubic opinion has risen dramatically in the past few years. This study looks at the effect of issue framing on support for U.S. spending on HIV/AIDS in developing countries-specifically, at how support changes when the phrase foreign aid is included or omitted from a survey question. Analyses reveal a significant effect of issue framing for women and Democrats. Omitting the phrase foreign aid is associated with increased support for U.S. spending among Democrats and decreased support among women. Regardless of issue framing, blacks, Hispanics, and more educated individuals support U.S. spending on HIV/AIDS in developing countries. However, when forced to decide between funds' going overseas for HIV/AIDS in developing countries or remaining in the United States, all respondents overwhelmingly support monies' being used in the United States. (author's)
‘But where are our moral heroes?’ An analysis of South African press reporting on children affected by HIV / AIDS.
Rondebosch, South Africa, University of Cape Town, Children's Institute, 2005 Sep. 34 p.Messages conveyed both explicitly and implicitly in the media play an important role in the shaping of public understanding of issues, as well as associated policy, programme and popular responses to these issues. This paper applies discourse analysis to a series of articles on children affected by HIV/AIDS published in 2002/ 2003 in the English-medium South African press. The analysis reveals layer upon layer of moral messaging present in the reporting, the cumulative effect of which is the communication of a series of moral judgements about who is and who is not performing appropriate roles in relation to children. Discourses of moral transgression specifically on the part of African parents and ‘families’ for failing in their moral responsibilities towards their children coalesce with discourses of anticipated moral decay amongst (previously innocent) children who lack their due care. The need for moral regeneration amongst South Africans generally (but implicitly black South Africans) is contrasted with an accolade of (usually white) middle class individuals who have gone beyond their moral duty to respond. The paper argues that in each instance, the particular moralism is questionable in the light of both empirical evidence and principles of human dignity underlying our constitution. Children – and particularly ‘AIDS orphans’ – are shown to be presented as either the quintessential innocent victims of the epidemic or as potential delinquents. While journalists intentions when representing children in these ways are likely to be positive, the paper argues that this approach is employed at a cost, both in the public’s knowledge and attitudes around the impact of AIDS, and more importantly, in the lives of children affected by the epidemic. (author's)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2001. 22 p.Latinos, who now comprise the largest and fastest growing ethnic minority in the United States, continue to be disproportionately affected by HIV/AIDS. Although they represent approximately 14% of the U.S. population, Latinos accounted for 19% of new AIDS cases reported in 2000. The AIDS case rate (per 100,000) among Latino adults (30.4) was almost four times that for whites (7.9), and AIDS is now the fourth leading cause of death for Latinos between the ages of 25 and 44. The epidemic’s effect on different subgroups of Latinos is also striking. For example, the AIDS case rate among adult Latinas is 13.8 per 100,000, more than six times the rate for white women (2.2). And although Latino youth represent approximately 14% of U.S. teenagers, they accounted for 20% of new AIDS cases reported among those ages 13–19 in 2000. In addition, in a recent study of young men who have sex with men (MSM), HIV prevalence (the proportion of people living with HIV in a population) for young Latinos was 6.9, compared to 3.3 for whites. Finally, there is growing evidence that the HIV/AIDS epidemic is increasingly concentrated in low-income communities in which people of color are often disproportionately represented. Such communities generally are faced with multiple other health and social issues and limited resources with which to respond to the epidemic. (excerpt)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2001. 60 p.On June 5, 1981, the U.S. Centers for Disease Control and Prevention (CDC) issued its first warning about a relatively rare form of pneumonia among a small group of young gay men in Los Angeles, which was later determined to be AIDS-related. Since that time, more than 750,000 cases of AIDS have been reported in the U.S. and almost half a million Americans have died of the disease. Of the more than 36 million individuals worldwide estimated to be living with HIV/AIDS, approximately 95% live in the developing world – a full 70% in sub-Saharan Africa alone. During this twenty-year period, there has been a great deal of progress in the fight against AIDS. New infections in the U.S. have declined dramatically, and there are signs that new infections in sub-Saharan Africa may be stabilizing. The more widespread use of antiretroviral drugs has also contributed to fewer new AIDS cases and AIDS-related deaths. Despite this progress, critical challenges remain. The AIDS epidemic is becoming increasingly complex. Proven prevention programs are not reaching everyone in need. More people are living with HIV/AIDS than ever before, and significant disparities exist across age and race. For example, while African Americans and Latinos represent 12% and 13% of the U.S. population, they represent 47% and 19% of reported cases, respectively. An estimated half of all new infections in the U.S. are among those under the age of 25. In addition, the high cost of HIV care presents significant barriers to access for people with HIV/AIDS in the United States, many of whom are not in regular care, and treatment is not available to the vast majority of those living with HIV/AIDS in the developing world. And though progress is steady, we are still years away from developing an effective vaccine. (excerpt)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2001. 18 p.African Americans have been disproportionately affected by HIV/AIDS since the epidemic’s beginning. In the year 2000, more African Americans were reported with AIDS, and estimated to be living with AIDS, than any other racial or ethnic group in the United States. Although African Americans represent approximately 12% of the U.S. population, they now account for an estimated 54% of new HIV infections and 47% of new AIDS cases. The AIDS case rate (per 100,000) among African Americans is more than eight times the rate among whites and more than twice the rate for Latinos. Moreover, AIDS is now the leading cause of death for African Americans between the ages of 25 and 44. The epidemic has also affected particular subgroups within the African American community. Although African American women represent only 13% of the U.S. female population, they account for almost two-thirds (63%) of AIDS cases reported among women in 2000. African American teens represent 15% of the teen population, yet comprise 64% of new AIDS cases reported among 13–19 year olds in 2000. In addition, in a recent multi-city study of young men who have sex with men (MSM), HIV prevalence (the proportion of people living with HIV in a population) for young African Americans was 14.1%, compared to 3.3% for whites. Finally, there is growing evidence that the HIV/AIDS epidemic is increasingly concentrated in low-income communities in which people of color are often disproportionately represented. Such communities generally are faced with multiple other health and social issues and limited resources with which to respond to the epidemic. (excerpt)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2003 Jun. 4 p. (Facts. Fact Sheet)Each year, there are approximately fifteen million new cases of sexually transmitted diseases (STDs) in the U.S., and this country has the highest rate of STD infection in the industrialized world. By age 24, at least one out of every four Americans is believed to have contracted an STD, and an estimated 65 million Americans are now living with an incurable STD. Research suggests that women are biologically more susceptible to STD exposure than men. While STDs, including HIV, affect every age group, people under 25 account for roughly two-thirds of all new STD infections: 42 percent occur among those aged 20-24 and 25 percent occur among 15-to-19-year-olds. CDC data also show higher reported rates of STDs among some racial and ethnic minority groups, compared with rates among whites – possibly reflecting overall health disparities as well as greater use of public health clinics by minority populations. (excerpt)
Columbia Journalism Review. 2004 Mar-Apr; (2 Suppl):1-8.HIV/AIDS took the U.S. by surprise in the 1980s, and it continues to be a health epidemic with unique characteristics. As a news topic, HIV/AIDS has not only been a health story, but also one about arts, culture, taboo, sexuality, religion, celebrity, business, and politics on the local, national, and global stage. Media coverage of the HIV/AIDS epidemic has, at times, helped shape the policy agenda, while also reflecting current policy discussions, debates and important events. In many cases, the news media have served as an important source of information about the epidemic for the public. In an October 2003 survey by the Kaiser Family Foundation, 72% of the U.S. public said that most of the information they get about HIV/AIDS comes from the media, including television, newspapers, and radio. (excerpt)
AIDS and Behavior. 2005 Jun; 9(2):135-143.Although there has been progress in AIDS stigma research, there are no multi-item AIDS stigma scales that have been shown reliable and valid in Africa. The current research reports the development of the nine-item AIDS-Related Stigma Scale. Research conducted in five South African communities (N = 2306) found the scale internally consistent, a = 0.75 and time stable over 3 months, r = 0.67. The scale was also reliable in three different languages (English, Xhosa, and Afrikaans). Correlations showed that the AIDS-Related Stigma Scale was moderately inversely correlated with years of education and AIDS knowledge. In addition, individuals who stated that HIV positive persons should conceal their HIV status had higher AIDS-Related Stigma Scale scores. Also supporting the scale’s construct validity, individuals who refused to report whether they had been tested for HIV scored higher on the AIDS-Related Stigma Scale. (author's)
International Journal of STD and AIDS. 2004 Jan; 15(1):56-60.One thousand individuals in the age group 18± 69 were selected for a multistage nationwide random sample. Of the interviewees 68.3% were of the opinion that the risk of AIDS, in Portugal, is considerably high and 37.1% stated that they had feared being infected by the HIV; 28.0% established a connection between being afraid and the fact that AIDS is a serious/incurable disease; 31.5% believed that there are risks inherent to the health services; only 7.8% expressed fear of AIDS because of an infected partner. Only 42.6% regarded extra-marital sexual relations as either partially or totally acceptable. Sexual relations between youths were seen as totally acceptable by 11.9% and partially acceptable by 51.1%. Homosexual relations between men were seen as either totally or partially acceptable by 38%. Of the interviewees, 7.8% thought that recent treatments can definitely cure AIDS and 6.5% believed that with recent treatments HIV transmission would no longer be possible. (author's)
Alliance News. 2001 Dec; (12): p..Increasing attention is being paid to the role of stigma as a major contributory factor in the global HIV/AIDS pandemic. Stigma associated with HIV/AIDS is especially powerful and pervasive because the disease is usually closely associated with such fundamental issues as life and death, sex and sexuality, and morality. (excerpt)
KAISER DAILY HIV / AIDS REPORT. 2000 Dec 1; 6 p..In honor of World AIDS Day, world leaders, organizations, columnists and others are filling the international media with commentary, editorials and statements. This paper presents a sample of what some members of the international media are saying. In terms of statements, the messages of US President Bill Clinton, UN Secretary General Kofi Annan, South African President Nelson Mandela, House Minority Leader Richard Gephardt, the World Federation of Public Health Associations, Chris Labonte of the Human Rights Campaign, and May Rihani of the Academy for Educational Development are included. In general, these statements called for improvements of efforts addressing the HIV/AIDS pandemic. Other articles incorporated in this paper are from the Boston Globe, Washington Post, South Florida Sun-Sentinel, Bakersfield Californian, Reuters, USA Today, Philadelphia Inquirer, Los Angeles Times, and the New York Times.
AIDS WEEKLY PLUS. 1999 Jul 12-19; 7.AIDS-related mortality has declined significantly since the mid-1990s, although the rate of new infections has remained steady. While recent data indicate that fewer teenagers are having sex and more are using condoms, 20% of AIDS cases in Massachusetts are young adults who were probably infected as teens. There is now a rebirth of denial and considerable complacency about the reality of the HIV/AIDS pandemic. Part of that complacency stems from the development and use of protease inhibitors since 1996, a class of drugs capable of extending the lives of people infected with HIV. The initial success rates of these drugs have led many people to believe that AIDS is no longer life-threatening, but rather manageable over the long term. However, these drugs are complex and there is much misinformation about their success rates. The effectiveness of protease inhibitors has been short-lived in many patients, and sometimes ineffective in people who could not adhere to the strict drug regimen. Thousands of people participated in AIDS Action Committee's 14th annual AIDS Walk to raise awareness and pay tribute to those who have been affected by the disease.
In: Sexuality, politics and AIDS in Brazil: in another world?, [by] Herbert Daniel and Richard Parker. London, England, Falmer Press, 1993. 33-47. (Social Aspects of AIDS)Physicians, scientists, journalists, and politicians announced the coming of AIDS to Brazil long before its arrival. Indeed, the Brazilian press carried important pieces on the subject since 1982. The press fueled most of the public debate on HIV/AIDS, playing up the more striking and enigmatic side of the epidemic. AIDS was depicted as a mystery, something beyond the technological capacity of the modern world, with death as its most distinguishing feature. Brazil had its first public case of AIDS in 1983, followed by a torrent of press on what was referred to as a gay cancer or gay plague. None of the media attention and related debate, however, resulted in the taking of preventive measures. The author argues that an inappropriate ideological model was adopted early in the epidemic which has guided Brazil's responses up to the present. The author discusses the features of that model. The main characteristic of the predominant model of AIDS generated in Brazil is that AIDS is a disease of gay men or the very poor, but definitely a disease of others.
Lancet. 1996 Jun 15; 347(9016):1688.Professor Arthur Obel, a Kenyan scientist who claims to have found the cure for acquired immunodeficiency syndrome (AIDS), through treatment with either of two drugs (Kemron and Pearl Omega) is being sued by patients upon whom Kemron was tested, and Pearl Omega has been banned by the Kenyan Ministry of Health. The backlog of cases in the Kenyan judicial system will allow Obel to avoid answering questions about Kemron, which was launched as an AIDS cure in 1993, while the case is coming to court. Obel then announced in a book, which was published in March, that Pearl Omega had converted the positive serostatus for human immunodeficiency virus (HIV) of seven patients. The Kenyan government had initially supported further clinical trials of Pearl Omega, which was announced to parliament by Assistant Health Minister Basil Criticos on April 24. A week later, Health Minister Joshua Angatia denounced Pearl Omega as an herbal concoction and stated that Obel had "bent the rules." Philip Mbithi, an old schoolfriend of Obel and former Chief Secretary in the Office of the President, is thought to have secured extensive research funds for Obel, who had compared himself to historical figures who had made important discoveries that were initially greeted with skepticism. Obel's reputation with the public is far from discredited. He was cheered during a lecture at Kenyatta University in Nairobi when he offered to donate Pearl Omega to the campus; in the same talk, he said that condoms imported from Europe were infected with HIV, a statement the government has yet to condemn.
AIDS ANALYSIS AFRICA. 1996 Jun; 6(3):15.In Uganda, before the acquired immunodeficiency syndrome (AIDS) epidemic, rape or sexual abuse of children was not considered a serious offense by the public, although the maximum criminal offense for rape was death. Because so many young girls are testing positive for human immunodeficiency virus (HIV), and due to the efforts of women's groups, public opinion is changing. According to the United Nations International Children's Fund (UNICEF), girls aged 9-15 years are five times more likely to be infected with HIV than boys of the same age. Adults, who fear their peers may be infected with HIV, turn to children; some AIDS patients believe sleeping with a virgin girl will cure their illness. Uganda is targeting a $15 million project to protect children 5-15 years of age. A study commissioned by the Uganda National Council for Women and Children in 1994 found that in Kabale district 31% of girls and 15% of boys had been abused, many by teachers. In Masaka district, the Council found that 30% of women had been coerced into sex; bosses abuse their maids, and customers abuse alcohol sellers. According to police, rape is the second most common crime in Uganda. Victims are reluctant to come forward to testify; rape victims can be shunned in their communities and may be considered ineligible for marriage. Cases which make it to court rarely get a fair hearing, according to the Council of Women, because the men handling the cases often favor the culprits. FIDA, an association of women lawyers, Action for Development (ACFODE), and the National Association of Women's Organisations in Uganda (NAWOU) are lobbying for tougher laws on rape and closed courts. They are pressuring newspapers to not disclose the names of victims. Although many expect the Ministry of Women to take the lead in this area, it has been unable to do so, because of a lack of funds; it received two-thirds of its budget for 1994-95, an indication, perhaps, of the Ugandan government's intentions. Two figures are shown; one concerns the relation of abuser to child, while the other concerns the action taken on abuse cases.
[Unpublished] . , 25 p.The World Health Organization's Global Programme on AIDS has put together this inventory and review of AIDS-related knowledge, attitudes, beliefs, and risk behaviors (KABP) to provide updated information on research findings to researchers, IEC (information, education, and communication) planners, and national AIDS prevention and control staff. The studies in this inventory were all published between January 1, 1989 and March 1, 1989. Each of the inventory's six parts addresses a specific population group: adolescents and young people, the general public, health care workers, homosexual/bisexual population, intravenous drug users, and prostitutes (both male and female). In those cases where a published study has information on more than one of the groups, the inventory includes that study in each of the appropriate sections. In each section, the studies are in chronological order, according to the date the study was conducted. The first column lists the complete bibliographic reference to allow the reader to refer to the original publication. A code has been assigned to the first column for each study to designate what primary type of study it is. These codes denote a KABP study (or at least one of the elements), a study focusing on sexual practices, a methodological study, an epidemiological study, a counseling study, a health promotion study, and a qualitative study. The second column lists the date of the study. The third column provides the site of the study. Most of the sites are in the US. Other sites are in both developed and developing countries. The fourth and fifth columns list the population studied and the size of the sample, respectively. The method of data collection is revealed in the sixth column. The methods are interview, telephone interview, questionnaire, and medical (physical or laboratory examination). The last column provides a brief summary of the major findings.
AIDS BULLETIN. 1995 Jul; 4(1):22-3.People who are infected with HIV or have AIDS know that AIDS is not just a neutral label for a disease caused by a virus. They know through personal experience that people's perception and understanding of AIDS are built from many different images drawn from varying sources. People's understanding of AIDS is shaped by words and language and through visual images or representations. The author discusses the understanding that people have of AIDS, where it comes from, and how it impacts upon people with AIDS and informs their self-image. The media, the medical profession and health care setting, initial designation of AIDS as a gay plague, and inadequate, sanitized education have all shaped public knowledge, beliefs, and opinions about HIV, AIDS, and those who are infected. No real distinction has been made in the media between HIV and AIDS, and inflammatory phrases are common, with the apparent intention to frighten rather than educate. The fear generated about AIDS has been greatly disproportionate to the risk of contracting the disease. The blame around HIV has had extremely negative consequences such as the curtailment of personal freedoms, discrimination, and ostracism. The medical profession and health care setting through the use of full barrier procedures, refusing to treat people with AIDS, isolating AIDS patients, testing without consent or counseling, and breaching confidentiality have also done considerable harm to individuals with HIV and to society in general. The author stresses the need to depict people with AIDS positively. People live with HIV and AIDS, and must be empowered to work and function.
PUSAT MEDIA PELATIHAN AIDS NEWSLETTER. 1995 Jul; (1):6-7.Those who are responsible for the mass media coverage of the HIV/AIDS epidemic must make an extra effort to thoroughly understand the problems such reporting entails. In order to achieve this goal, a new type of emphatic journalism is developing in which a journalist or editor puts himself in the place of a person with HIV/AIDS, an information activist, or an "opposition fighter," depending upon which issues of the epidemic are addressed. HIV/AIDS requires serious journalism because the epidemic poses very broad social and cultural problems and because the disease has created conflicts by crossing age, sex, race, and political borders. The new emphatic journalism will direct attention to fighting against the disease in order to save humankind.
Reporting AIDS in Kenya: a personal report. Guidelines for journalists have been issued in the UK. What about Africa?
AIDS ANALYSIS AFRICA. 1993 Nov-Dec; 3(6):1.A Norwegian journalist reports on his experiences covering the acquired immunodeficiency syndrome (AIDS) epidemic in Kenya. Denial by the government has resulted in reduced figures. President Daniel Arap Moi refuses to admit that the epidemic has become national in scope. The public broadcasting services carry little information about the epidemic. A study indicating that 25/1700 prostitutes in Nairobi were positive for human immunodeficiency virus (HIV) has been met with skepticism by the public, who question the survey (what was the relationship between researchers and prostitutes, were the prostitutes paid to risk their lives, why was the study carried out in Africa). Some believe the 25 positive women are 'immune' because of a similar gene pattern. There are 750,000 HIV positive adults and 30,000 AIDS cases in Kenya, including a large number of cases among street urchins. Most AIDS cases are sent home to die because of the short supply of hospital beds (45,000). One of these was Ruth Kasuki, a 36-year-old mother of three and AIDS educator and counselor in Kenya, who is now deceased. In an interview conducted shortly before her death, she criticizes the government for its denial and predicts disastrous results. Ms. Kasuki also blamed the extramarital affairs of men for the spread of AIDS among Kenyan women. 8% of women receiving antenatal care are estimated to have HIV; in Nyanza Coast and Nairobi the estimate reaches 12%. Ms. Kasuki also cited the negative attitude of the clergy.
SOUTH AFRICAN MEDICAL JOURNAL. 1992 Jan 18; 81(2):55-6.Public attitudes toward AIDS in South Africa as the epidemic enters its 2nd decade have evolved from casual indifference to hysterical panic. In 1992 the projected number of HIV infections was 446,000, with no evidence of a plateau. The premises on which control is based are that HIV is not casually transmissible, and that entrenched behavior is amenable to modification. The goals of awareness and empowerment are elusive: even the university educated and the medical community lack enough knowledge; empowerment depends on addressing issues of poverty, economic dependence of women, and such institutions as migrant labor. Issues important in the 2nd decade of AIDS are fear of infection by casual contact, and in the workplace, especially by health care workers. New information confirms that HIV cannot penetrate intact skin and mucous membranes, even though CD4+ cells of the genitalia and so-called M cells of the rectal mucosa are portals of entry for HIV. While physicians are relatively unconcerned about much more contagious hepatitis B, which infects 12,000 per year in the U.S., compared to a total of 28 health care professionals of all types to date reported to have seroconverted HIV+, fear of HIV infection dominates medical forums. Non-scientific doomsday-like forecasts in the media have adverse economic implications in South Africa. There are some signs of behavior change (in parts of the U.S. and Uganda), and research on drug treatment of HIV infections is promising. Even more hopeful are initial results of several of 11 vaccine trials in progress.
Social Science and Medicine. 1992 Jan; 34(1):63-73.Data from eastern and central sub-Saharan Africa suggest that women in countries of the region are increasingly at risk for HIV infection. Poverty, malnutrition, uncontrolled fertility, complications of childbirth, and sex behavior associated with male/female rural-urban migration are contributory factors. While much may go into preventing the transmission of HIV, the cooperative participation of both sex partners is certainly required. Further, while campaigns may educate both men and women of the need to limit the number and choice of sex partners, and use condoms during intercourse, they may fail to recognize the highly unfeasible nature of these behavioral changes for the majority of sub-Saharan African women. Marginally included in the development process, and poorly empowered to make decisions regarding male or female sexuality, women are largely subject to the sexual demands and economic rewards of their male sex partners. Husbands and/or other sex partners may strongly resist or refuse to employ condoms during sexual intercourse. Social expectations and/or economic necessity, however, often dictate a woman's compliance with the man's choice despite her desire to use a condom. HIV transmission and the risk to women and children, national development and the status of women, accommodation to economic scarcity, altering high-risk behavior, symbolic approaches to behavior change, and methodological issues in the study of these issues are discussed. Research is then proposed on understanding the meaning of AIDS, the context and norms of decision making, the norms of sexual behavior, the gatekeepers of sexual behavior change, the economic determinants of sexual risk, womens perceptions of control, and gender-sensitive strategies for reducing the risk of AIDS. Such research will provide a better understanding of how women perceive and respond to AIDS prevention interventions, and will constitute a necessary 1st step toward increasing male participation in protecting themselves and their families.
AIDS and sexually transmitted diseases in Jamaica: highlights of a nationwide survey and focus group series assessing current knowledge, attitudes, and practices.
[Unpublished] 1989 Jan. ii, 19 p.A nationwide baseline survey of 1,200 men and women aged 15-60 years was conducted to find information on Jamaicans' knowledge, attitude, and practices (KAP) regarding AIDS, STDs, and family planning. 25 focus group session were also held to gain more indepth knowledge and understanding of KAP. Results on KAP regarding AIDS and STDs are summarized and presented in comparison with similar data from a 35-country Gallup International study. Virtually all respondents were highly aware of AIDS and other STDs, and realize both its deadly nature and sexual transmissibility. There is, however, only low unprompted awareness of how one may protect against infection and the spread of HIV. General objection to adopting safer sex and using condoms was voiced. Over 1/2 of survey respondents perceived themselves at risk of infection. Both studies, however, show approximately 5% of the population to feel at risk. Those felling at greatest risk are aged 20-49, and especially urban males aged 20-39. Behavioral change was reported among 48% of survey respondents, especially in men, person of lower socioeconomic status, and those who perceived themselves at greater risk of infection. More concern was voiced over AIDS than for all other diseases including cancer, herpes, diabetes, gonorrhea, malnutrition, high blood pressure, and diarrhea. Further, almost 90% believe at least one important myth about a mode of transmission, and 20% think that people with AIDS (PWA) are readily recognized at sight. 5% of the population knew a PWA. Fear followed by compassion dominates public opinion toward them. Specific recommendations for AIDS media communications are presented.