We conducted a cross sectional survey in Zimbabwe to describe urban-rural disparity in socio-demographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women (AGYW) and their male sexual partners. Between September and November 2016, we interviewed 360 sexually active HIV positive AGYW, aged 15--24 years attending ART and PMTCT clinics in urban and rural health facilities in Harare and Mazowe district respectively. HIV positive AGYW in rural areas as compared to those in urban areas were older, less educated, more frequently married or cohabiting, had lower number of male sexual partners in their lifetime and in the last 12 months preceding the survey.
View Article and Find Full Text PDFPersons with disabilities have often been overlooked in the context of HIV and AIDS risk prevention and service provision. This paper explores access to and use of HIV information and services among persons with disabilities. We conducted a multi-country qualitative research study at urban and rural sites in Uganda, Zambia, and Ghana: three countries selected to exemplify different stages of the HIV response to persons with disabilities.
View Article and Find Full Text PDFBackground: New HIV infections among sub-Saharan Africa's adolescent girls and young women (AGYW, ages 15-24) greatly exceed those of their male peers. In addition, AGYW tend to acquire HIV at a much earlier age. Understanding the factors associated with HIV infection in AGYW could inform effective prevention and treatment interventions for these populations and their male sexual partners.
View Article and Find Full Text PDFEfforts are currently underway by major orchestrators and funders of the global AIDS response to realise the vision of achieving an end to AIDS by 2030. Unlike previous efforts to provide policy guidance or to encourage 'best practice' approaches for combatting AIDS, the end of AIDS project involves the promotion of a clear set of targets, tools, and interventions for a final biomedical solution to the epidemic. In this paper, we examine the bureaucratic procedures of one major AIDS funder that helped to foster a common vision and mission amongst a global AIDS community with widely divergent views on how best to address the epidemic.
View Article and Find Full Text PDFThe rapid scale-up of effective HIV prevention strategies is a central theme of the post-2015 health and development agenda. All major global HIV and AIDS funders have aligned their policies and plans to achieve sharp reductions in new HIV infections and reach epidemic control by 2030. In these "fast-track" plans, increased antiretroviral treatment coverage and the attainment of viral suppression are pivotal, and there is firm recognition of the need for countries to mobilise more domestic resources and build stronger community clinic systems.
View Article and Find Full Text PDFAs the search for more effective HIV prevention strategies continues, increased attention is being paid to the potential role of cash transfers in prevention programming in sub-Saharan Africa. To date, studies testing the impact of both conditional and unconditional cash transfers on HIV-related behaviours and outcomes in sub-Saharan Africa have been relatively small-scale and their potential feasibility, costs and benefits at scale, among other things, remain largely unexplored. This article examines elements of a successful cash transfer program from Latin America and discusses challenges inherent in scaling-up such programs.
View Article and Find Full Text PDFBackground: Multiple and concurrent sexual partnerships have been identified as southern Africa's key behavioural driver of HIV, resulting in calls to make partner reduction programming central to an intensified HIV prevention focus. Various efforts are currently being made in the region in response to this call. Such efforts will likely have as limited success as past prevention efforts if the cultural milieu in which sexual partnering practices are located and reproduced remains poorly understood, unaccounted for, and unaddressed in prevention programming.
View Article and Find Full Text PDFThis paper reviews the current state of knowledge on age-disparate sexual relationships in the context of the southern African HIV/AIDS hyperepidemic. Disproportionately high HIV infection rates among young women aged 15-24 years have been attributed to their greater involvement in relationships with older-aged partners. Whereas early studies emphasized economic concerns in the context of poverty as driving girls to accept or seek the attentions of older employed men, close-grained studies reveal a complex interplay of meanings and motives that prompt both men and women across socioeconomic strata to engage in intergenerational sex.
View Article and Find Full Text PDFThe maturing HIV epidemic has led to a decline in the health status of many South Africans. One result is an increasing number of AIDS-affected poor who qualify for a government disability grant. Recent research has drawn attention to the unintended conflict that this may present for poor people who might be faced with choosing between maintaining health through antiretroviral treatment and obtaining money through the state grant.
View Article and Find Full Text PDFThe belief that HIV/AIDS can be cured as a result of having sex with a virgin has been identified as a possible factor in the rape of babies and children in South Africa. While the prevalence of this myth has been a matter of concern in local communities for some time, there have been recent attempts to discern the extent to which this belief is exacerbating perceived increases in child rape and the rate of new HIV infections nationwide. This article attempts to reveal the systematic logic upon which is based the idea of 'virgin cleansing' as a therapeutic response to HIV/AIDS amongst the Zulu.
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