5. HIV AND WOMEN: THE AFRICAN EXPERIENCE

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 286
Author(s):  
D. A. Lewis

Africa as a continent has been devastated by the acquired immunodeficiency syndrome epidemic caused by the human immunodeficiency virus (HIV). Women are more likely to acquire HIV/AIDS for a number of reasons and incidence studies show that younger women are particularly at risk of HIV acquisition. Biologically, they are more vulnerable and the acquisition of HIV can be influenced by hormonal contraceptives as well as sexually transmitted infections, which are often more asymptomatic than is the case for men. Women in Africa are also more vulnerable because of cultural issues; in some countries polygamy is accepted practice. Women are often economically disadvantaged and disempowered. It is often hard for them to insist on the use of condoms with husbands and regular partners. Physical and sexual abuse of women, including rape, remains a major problem on the continent, particularly in times of civil war. Many women are forced to work as sex workers or be involved in transactional sex in order to survive. Most countries rely on anonymous antenatal surveys to generate HIV seroprevalence data for women of reproductive age. These data is often used as surrogate markers for HIV prevalence rates in men of a similar age. The seroprevalence of HIV among pregnant women differs remarkably around the continent, with the highest rates being seen in Southern Africa, as high as 30%, and much lower rates being seen in West Africa. These reasons underlying these differences are complex and not completely understood. UNAIDS estimated in 2005 that 470�000 (87%) of the world's 540�000 newly infected children (<15 years old) reside in Sub-Saharan Africa. Prevention of mother to child transmission (PMTCT) of HIV is thus a national priority in many Sub-Saharan African countries. Despite policies, treatment is sometimes not given at the clinic level for several reasons, and when it is, most commonly it is with single dose Nevirapine. Data from South Africa has shown that both mothers and infected babies rapidly acquire nevirapine resistance. It is likely that this will lead to early failure of first line antiretroviral (ARV) therapy among these mothers once they start their ARVs. In South Africa, for example, either efavirenz or nevirapine form the backbone of the first-line ARV regimens. AIDS defining illnesses (ADIs) in women living in Africa are similar to those observed in men. Tuberculosis is the most common ADI but other life-threatening illnesses such as cryptococcal meningitis are relatively common compared to other parts of the world. Cervical cancer and cervical intra-epithelial neoplasia (CIN) lesions are more common in HIV-infected than in non-infected women. Most countries in Africa do not have cervical screening programmes and, even in richer countries such as South Africa, the national policy is to screen women three times in their life at 30, 40 and 50 years of age. Many HIV specialist centres, with additional donor funds, are now attempting to perform annual cervical screening, at least in South Africa.

2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Biniam E. Bedasso ◽  
Pascal Jaupart

AbstractLittle is known about the political consequences of immigration in Sub-Saharan Africa. In this paper, we estimate the effect of exposure to immigration on election outcomes in South Africa. Our analysis is based on municipality panel data and an instrumental variable (IV) strategy exploiting historical migrant settlement patterns. We find that local immigration concentration has a negative impact on the performance of the incumbent African National Congress, whereas support for the main opposition party, the Democratic Alliance, is found to increase in municipalities with a larger immigrant presence. These effects hold regardless of the skill levels of immigrants in a municipality. In terms of mechanisms, competition over jobs and local public services as well as ethnic diversity and cultural factors influence how immigration affects election outcomes. These findings are robust to a broad range of sensitivity checks. They provide evidence that immigration can be a politically salient issue in migrant-destination Sub-Saharan African countries. They also show that immigration can affect election results even in contexts where there is no single issue anti-migrant party.


2016 ◽  
Vol 9 (35) ◽  
pp. 233-242
Author(s):  
Boris Baumgartner

Abstract The Sub-Saharan Africa belongs to the most underdeveloped regions in the world economy. This region consists of forty nine countries but it’s world GDP share is only a small percentage. There are some very resource rich countries in this region. One of them is Angola. This former Portuguese colony has one of the largest inventories of oil among all African countries. Angola recorded one of the highest growth of GDP between 2004-2008 from all countries in the world economy and nowadays is the third biggest economy in Sub-Saharan Africa after Nigeria and South Africa. The essential problem of Angola is the one-way oriented economy on oil and general on natural resources. Angola will be forced to change their one-way oriented economy to be more diversified and competitive in the future.


Significance The split between Qatar and its neighbours has pushed a few small African countries to side with Saudi Arabia, but leaves the continent’s leading powers and several conflict-afflicted nations eager to stay neutral -- for now. In sub-Saharan Africa (SSA) -- where Gulf countries have strong diplomatic ties and major economic investments -- the crisis has had significant political effects. Impacts The withdrawal of Qatari peacekeepers from the Djibouti-Eritrea border will become a pressing concern for the African Union. Ongoing expulsions of African migrants from Saudi Arabia will complicate Saudi and Emirati efforts to find African partners against Qatar. Countries such as South Africa and Nigeria may begin to act more assertively in calling for neutrality.


2018 ◽  
Vol 45 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Samson Gebremedhin ◽  
Anteneh Asefa

BackgroundLittle is known whether contraceptive methods differentially modify women’s risk of anaemia or not. We compared the haemoglobin status of women currently using different fertility regulation methods in sub-Saharan Africa (SSA) where anaemia is a major concern.MethodsWe conducted the study based on the secondary data of 24 nationally representative demographic and health surveys carried out recently in SSA. The data of 105 532 women were included in the analysis. In the original surveys, respondents were selected using multistage sampling techniques and haemoglobin was determined using the HemoCue analyser. The association between method of contraception and anaemia status was determined via a mixed-effects logistic regression model adjusted for potential confounders. The outputs are presented using adjusted odds ratio (AOR) with 95% CI.ResultsThe mean (±SD deviation) haemoglobin was 12.3 (±1.7) g/dl and 36.7% of the women had anaemia. Current use of modern contraceptives, as compared with non-use, was associated with a 25% reduction (AOR=0.75 (95% CI: 0.73 to 0.78)) in the odds of anaemia. Comparison among individual modern methods showed, as compared with current barrier methods users, use of injectables (AOR=0.62 (95% CI: 0.57 to 0.67)), oral contraceptive pills (OCP) (AOR=0.62 (95% CI: 0.57 to 0.66)) and implants (AOR=0.63 (95% CI: 0.58 to 0.70)) were significantly associated with reduced odds of anaemia. With reference to women with less than 12 months of use, the odds were significantly reduced by about a quarter among women with more than 12 months of OCP or injectables use.ConclusionThe use of hormonal contraceptives is associated with lower odds of anaemia.


2022 ◽  
pp. 1-13
Author(s):  
Collins Adu ◽  
James Boadu Frimpong ◽  
Aliu Mohammed ◽  
Justice Kanor Tetteh ◽  
Eugene Budu ◽  
...  

Abstract Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.


2021 ◽  
Author(s):  
Filippa Ek ◽  
Rasmus Kløcker Larsen

This brief provides insights about the impacts of the COVID-19 pandemic on those who are deaf, blind, and deafblind living in four sub-Saharan African countries: Cameroon, Rwanda, South Africa, and Zimbabwe.


2021 ◽  
Author(s):  
Peter Cunliffe-Jones ◽  
Assane Diagne ◽  
Alan Finlay ◽  
Sahite Gaye ◽  
Wallace Gichunge ◽  
...  

Misinformation Policy in Sub-Saharan Africa is a single volume containing two research reports by eight authors examining policy towards misinformation in Sub-Saharan Africa. The volume first examines the teaching of ‘media literacy’ in state-run schools in seven Sub-Saharan African countries as of mid-2020, as relates to misinformation. It explains the limited elements of media and information literacy (MIL) that are included in the curricula in the seven countries studied and the elements of media literacy related to misinformation taught in schools in one province of South Africa since January 2020. The authors propose six fields of knowledge and skills specific to misinformation that are required in order to reduce students’ susceptibility to false and misleading claims. Identifying obstacles to the introduction and effective teaching of misinformation literacy, the authors make five recommendations for the promotion of misinformation literacy in schools, to reduce the harm misinformation causes. The second report in the volume examines changes made to laws and regulations related to ‘false information’ in eleven countries across Sub-Saharan Africa 2016-2020 from Ethiopia to South Africa. By examining the terms of such laws against what is known of misinformation types, drivers and effects, it assesses the likely effects of punitive policies and those of more positive approaches that provide accountability in political debate by promoting access to accurate information and corrective speech. In contrast to the effects described for most recent regulations relating to misinformation, the report identifies ways in which legal and regulatory frameworks can be used to promote a healthier information environment.


Author(s):  
HADSON SITEMBO

Sustainable development goals (SDGs) are a global agenda consisting of 17 goals which are to be achieved in 2030 by all member states. SDGs are more holistic goals i.e. these goals are closely interrelated and they affect the progress of one another. Sub-Saharan Africa countries are, once more lagging behind in the implementations of SDGs despite the efforts by governments, non-government organisations and international agencies. Rwanda, South Africa and Zambia where the three Sub-Saharan Africa countries on which the study focused. The three countries in this study were chosen on the basis that they cater to the general overview of African countries performance on SDGs. To conduct this study, a desk research method was adopted and secondary data was utilised. An in-depth analysis was done on the on three subs Saharan African countries i.e. Rwanda, South Africa, Zambia. Those goals where serious attention is needed are goals 1-9, 16 and 17. Most Sub-Saharan African countries performed better on goals 11, 12 and 15. It was concluded that the achievement of Sustainable development goals remains a mere dream for Sub Saharan Africa unless serious interventions are made.


2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001489 ◽  
Author(s):  
Bob Mash ◽  
Sunanda Ray ◽  
Akye Essuman ◽  
Edu Burgueño

IntroductionCommunity-orientated primary care (COPC) is an approach to primary healthcare (PHC) that originated in South Africa and contributed to the formulation of the Declaration of Alma-Ata 40 years ago. Despite this, PHC remains poorly developed in sub-Saharan African countries. There has been a resurgence of interest in strengthening PHC systems in the last few years and identifying key knowledge gaps. COPC has been an effective strategy elsewhere, most notably Brazil. This scoping review investigated COPC in the sub-Saharan African context and looked for evidence of different models, effectiveness and feasibility.MethodsDatabases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Studies were grouped into five categories: historical analysis, models, implementation, educational studies and effectiveness.ResultsA total of 1997 publications were identified and 39 included in the review. Most publications were from the last 5 years (n = 32), research (n = 27), from South Africa (n = 27), focused on implementation (n = 25) and involving case studies (n = 9), programme evaluation (n = 6) or qualitative methods (n = 10). Nine principles of COPC were identified from different models. Factors related to the implementation of COPC were identified in terms of governance, finances, community health workers, primary care facilities, community participation, health information and training. There was very little evidence of effectiveness of COPC.ConclusionsThere is a need for further research to describe models of COPC in Africa, investigate the appropriate skills mix to integrate public health and primary care in these models, evaluate the effectiveness of COPC and whether it is included in training of healthcare workers and government policy.


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