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UNESCO HIV and Health Education Clearinghouse

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  1. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household surevy

    Objectives: To determine the prevalence of HIV infection, HIV risk factors, and exposure to national HIV prevention programs, and to identify factors associated with HIV infection among South African youth, aged 15–24 years. Design: A cross-sectional, nationally representative, household survey. Methods: From March to August 2003 we conducted a national survey of HIV prevalence and sexual behavior among 11 904 15–24 year olds. Multivariable models for HIV infection were restricted to sexually experienced youth. …

  2. Can we use young people’s knowledge to develop teachers and HIV-related education?

    Despite recent progress in meeting the goals of the Education for All agenda, certain groups of young people are particularly vulnerable to exclusion and underachievement, including children with HIV/AIDS, children living in poverty, and children with disabilities. HIV/AIDS has reduced many young people’s rights to access education, to live a full and healthy life, and to have a life as a child. …

  3. Eliminating mother-to-child HIV transmission in South Africa

    This article discusses the effect that the WHO guidelines for the prevention of mother-to-child transmission of HIV has had on South Africa. South Africa initiated its PMTCT programme in 2002, however political support for it has increased since 2008. Since then the proportion of HIV-exposed infants who underwent PCR tests to detected early HIV transmission has increased, and the estimated HIV transmission rate has decreased. …

  4. Access to safe abortion: building choices for women living with HIV and AIDS

    In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. …

  5. HIV infection and sexual risk behaviour among youth who have experienced orphanhood: systematic review and meta-analysis

    Background: Previous research has suggested that orphaned children and adolescents might have elevated risk for HIV infection. We examined the state of evidence regarding the association between orphan status and HIV risk in studies of youth aged 24 years and younger. Methods: Using systematic review methodology, we identified 10 studies reporting data from 12 countries comparing orphaned and non-orphaned youth on HIV-related risk indicators, including HIV serostatus, other sexually transmitted infections, pregnancy and sexual behaviours. …

  6. I did it for him, not for me: an exploratory study of factors influencing sexual debut among female university students in Durban, South Africa

    The authors used qualitative interviews to explore influences on first sexual intercourse among 10 young women who had sexual debut within a year of enrolling in the university. University culture of sexual permissiveness and pressure from sexually experienced friends and male partners were the main factors influencing sexual debut. Ambivalence and a range of coercive behaviors characterized first sex. Participants were unprepared for sex and lacked power in deciding the timing and circumstances of first sex, which resulted in physical and emotional pain and regret. …

  7. Transactional sexual relationships, sexually transmitted infection risk, and condom use among young Black Women in peri-urban areas of the Western Cape Province of South Africa

    This study evaluated the relationship between having a history of transactional sexual relationships with condom use and STI risk. Participants completed a behavioral questionnaire and provided self-collected vaginal swabs which were tested for chlamydia trachomatis, neisseria gonorrhea, and trichomonas vaginalis. Multinomial logistic regression was used to compare condom use rates and STI risk among women with a history of transactional sexual relationships to women with a history of casual sexual relationships and those with no history of casual sexual relationships. …

  8. Sexuality and the limits of agency among South African teenage women: theorising femininities and their connections to HIV risk practices

    In South Africa, both HIV and gender-based violence are highly prevalent. Gender inequalities give men considerable relational power over young women, particularly in circumstances of poverty and where sex is materially rewarded. Young women are often described as victims of men, but this inadequately explains women's observed sexual agency. This paper takes a different approach. The authors use qualitative interviews and ethnographic observation among 16 young women from the rural Eastern Cape to explore ways young women construct their femininities and exercise agency. …

  9. Treatment outcomes in HIV-infected adolescents attending a community-based antiretroviral therapy clinic in South Africa

    As the HIV epidemic matures, survival of children with perinatally acquired HIV infection into adolescence is increasingly being documented in sub-Saharan African countries. In addition, the burden of HIV in the adolescent patient population in the region is also due to sexual transmission, with adolescents and young adults being particularly vulnerable to this mode of infection. HIV care and treatment services in the region need to adapt to adequately meet the specific needs of this expanding disease burden among adolescents. …

  10. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    South Africa's HIV prevalence among 15-24 year olds is one of the highest in the world. This systematic review looks at the evidence for youth HIV prevention in the country since 2000 and critically assesses interventions across four domains: study design and outcomes; intervention design; thematic focus and HIV causal pathways; and intervention delivery. Eight interventions were included in the review, all similar regarding content and objectives, but with variouis thematic foci, causal pathways, theoretical bases, delivery methods, intensity and duration. …

  11. The Social Conditions for Successful Peer Education: A Comparison of Two HIV Prevention Programs Run by Sex Workers in India and South Africa

    Peer education is increasingly being used to combat the spread of HIV and AIDS. However, results are inconsistent. This study systematically compares the context and implementation of two peer educational approaches among sex workers in India and South Africa, which had contrasting outcomes, to identify factors leading to success or failure. The Indian intervention's success was enabled by: a stable, supportive social, material and political context; and an ethos of community development which committed resources to sex worker empowerment, ownership and involvement. …

  12. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women

    This study aimed to identify risk factors for HIV infection among women aged 15-24 years who reported having one lifetime sexual partner in South Africa. A 2003 household survey of 11,904 15-24 year old women on sexual behavior and HIV testing was used. The analysis focuses on a sample of 1,708 women reporting one lifetime partner. Results show that 15% of the women reporting one lifetime partner were HIV positive. In multivariable analysis, completion of high school was associated withábeing HIV-negative (AOR 3.75; 95% CI 1.34-10.46). …

  13. They've Got All the Knowledge: HIV Education, Gender and Sexuality in South African Primary Schools

    Data from two primary schools in Durban, South Africa finds that discussions on gender and sexuality during life skills lessons are not sufficiently in-depth and comprehensive. Teachers find it difficult to provide comprehensive information on sex, sexuality and gender at the primary school level due to discourses on childhood innocence. The paper discusses implications for teacher training in the conclusion.

  14. Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes

    Prognostic models have been developed for patients infected with HIV-1 who start combination antiretroviral therapy (ART) in high-income countries, but not for patients in sub-Saharan Africa. The article shows the development of two prognostic models to estimate the probability of death in patients starting ART in sub-Saharan Africa. Data for adult patients who started ART in four scale-up programmes in Côte d'Ivoire, South Africa, and Malawi from 2004 to 2007 are analised. Patients lost to follow-up in the first year were excluded. …

  15. Pregnancy-related school dropout and prior school performance in KwaZulu-Natal, South Africa

    This study is an article extracted from "Studies in family planning", special issue on Adolescent Sexual and Reproductive health in sub-Saharan Africa, published in December 2008. This study uses data from KwaZulu-Natal in South Africa to examine the factors associated with schoolgirl pregnancy and subsequent educational pathways. …

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