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UNESCO HIV and Health Education Clearinghouse

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  1. Improving lives by accelerating progress towards the UN Sustainable Development Goals for adolescents living with HIV: a prospective cohort study

    Background: Low-income and middle-income countries (LMICs) face major challenges in achieving the UN's Sustainable Development Goals (SDGs) for vulnerable adolescents. We aimed to test the UN Development Programme's proposed approach of development accelerators—provisions that lead to progress across multiple SDGs—and synergies between accelerators on achieving SDG-aligned targets in a highly vulnerable group of adolescents in South Africa. …

  2. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa.

  3. Training for health services and systems research in Sub-Saharan Africa - a case study at four East and Southern African Universities

    Background: The need to develop capacity for health services and systems research (HSSR) in low and middle income countries has been highlighted in a number of international forums. However, little is known about the level of HSSR training in Sub-Saharan Africa (SSA). We conducted an assessment at four major East and Southern African universities to describe: a) the numbers of HSSR PhD trainees at these institutions, b) existing HSSR curricula and mode of delivery, and c) motivating and challenging factors for PhD training, from the trainees’ experience. …

  4. Cash plus care: social protection cumulatively mitigates HIV-risk behaviour among adolescents in South Africa

    Objectives: It is not known whether cumulative ‘cash plus care’ interventions can reduce adolescent HIV-infection risks in sub-Saharan Africa. This study investigated whether parental AIDS and other environmental adversities increase adolescent HIVrisk behaviour and whether social protection provision of ‘cash’ or integrated ‘cash plus care’ reduces HIV-risk behaviour. Design: A prospective observational study with random sampling (<2.5% baseline refusal, 1-year follow-up, 96.8% retention). …

  5. HIV/AIDS and the South African Bill of Rights, with specific reference to the approach and role of the courts

    An outstanding feature of the 1996 South African Constitution is the inclusion of a Bill of Rights, which contains all the categories of human rights that are ordinarily included in most international human rights instruments. Section 27 provides for, among other things, the right to health care services and the right to emergency medical treatment. Several other provisions in the Bill of Rights are quite relevant to the fight against HIV/AIDS and to protecting the rights of those who are infected. …

  6. Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study

    Background: Effective and scalable HIV prevention for adolescents in sub-Saharan Africa is needed. Cash transfers can reduce HIV incidence through reducing risk behaviours. However, questions remain about their effectiveness within national poverty-alleviation programmes, and their effects on different behaviours in boys and girls. Methods: In this case-control study, we interviewed South African adolescents (aged 10–18 years) between 2009 and 2012. …

  7. Saving lives for a lifetime: Supporting orphans and vulnerable children impacted by HIV/AIDS

    President's Emergency Plan for AIDS Relief (PEPFAR's) response to the millions of children impacted by HIV/AIDS was to designate 10% of its budget to securing their futures, making it the leading supporter of programs reaching orphan and vulnerable children (OVC) programs globally. This article describes the evolution of PEPFAR's OVC response based on programmatic lessons learned and an evergrowing understanding of the impacts of HIV/AIDS. …

  8. Masculinities and condom use patterns among young rural South Africa men: a cross-sectional baseline survey

    Notions of ideal manhood in South Africa are potentially prescriptive of male sexuality thus accounting for the behaviors which may lead to men being at greater HIV risk. We tested the hypothesis that gender and relationship constructs are associated with condom use among young men living in rural South Africa. 1219 men aged 15–26 years completed a cross-sectional baseline survey from an IsiXhosa questionnaire asking about sexual behaviour and relationships. …

  9. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention

    Research shows that gender power inequity in relationships and intimate partner violence places women at enhanced risk of HIV infection. Men who have been violent towards their partners are more likely to have HIV. Men's behaviours show a clustering of violent and risky sexual practices, suggesting important connections. This paper draws on Raewyn Connell's notion of hegemonic masculinity and reflections on emphasized femininities to argue that these sexual, and male violent, practices are rooted in and flow from cultural ideals of gender identities. …

  10. Adolescent HIV: cause for concern in Southern Africa

    There is a substantial burden of HIV infection in adolescents in southern Africa who acquired HIV perinatally. It is evident that they contribute substantially to hospital admissions and in-hospital deaths. There is an urgent need for services that will be able to provide accessible and appropriate HIV testing, counseling, and support, as well as facilitate access to ART and appropriate sexual risk-reduction interventions. …

  11. Correlates of intention to use condoms among Sub-Saharan African youth: the applicability of the theory of planned behaviour

    Aims: To test the applicability of an extended version of the theory of planned behaviour for the study of condom use intentions among large samples of young people in South Africa and Tanzania. Methods: Baseline data of a randomized controlled trial of school-based HIV/AIDS prevention programmes were used. The setting comprised secondary schools in the regions of Cape Town, Polokwane and Dar es Salaam. Participants were 15,782 secondary school students. …

  12. Dating violence among school students in Tanzania and South Africa: prevalence and socio-demographic variations

    Aims: To identify with whom in-school adolescents preferred to communicate about sexuality, and to study adolescents' communication on HIV/AIDS, abstinence and condoms with parents/guardians, other adult family members, and teachers. Data were obtained from a baseline questionnaire survey carried out in South Africa (Cape Town and Mankweng) and Tanzania (Dar es Salaam) in early 2004. We analysed data for 14,944 adolescents from 80 randomly selected schools. …

  13. 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. …

  14. PlusNews - Global HIV/AIDS News and Analysis

    This newsletter concerns South African countries. …

  15. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study

    Cross-sectional studies have shown that intimate partner violence and gender inequity in relationships are associated with increased prevalence of HIV in women. Yet temporal sequence and causality have been questioned, and few HIV prevention programmes address these issues. The article assessed whether intimate partner violence and relationship power inequity increase risk of incident HIV infection in South African women. …

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