Children's care and living arrangements in a high HIV prevalence area in rural South Africa

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

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Traditional Healers use of Personal Protective Equipment: a qualitative study in rural South Africa

10.21203/rs.2.21299/v1 ◽

2020 ◽

Author(s):

Carolyn Audet ◽

Elisa Gobbo ◽

Daniel E Sack ◽

Elise M Clemens ◽

Sizzy Ngobeni ◽

...

Keyword(s):

South Africa ◽

Qualitative Study ◽

Traditional Healers ◽

Hiv Prevalence ◽

High Risk Group ◽

Care Providers ◽

Razor Blade ◽

Rural South ◽

Mpumalanga Province ◽

Rural South Africa

Abstract Background: Traditional healers are frequently exposed to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) through the widespread practice of traditional “injections”, in which the healer performs dozens of subcutaneous incisions using a razor blade to rub herbs directly into bloodied tissue. An average healer in Agincourt, a rural northeastern sub-district in Mpumalanga province, South Africa, experiences approximately 1,500 occupational blood exposures over the course of their lifetime. Healers in Agincourt have an HIV prevalence of 30% compared to 19% in the general population, and healers who report exposure to patient blood have an adjusted 2.4-fold higher odds of being HIV-positive than those with no exposure. Although research on appropriate PPE use has been well documented for allopathic care providers, little is known about the practices of traditional healers. Methods: This qualitative study was conducted with 30 traditional healers who practice in the rural Bushbuckridge sub-district of Mpumalanga province, northeastern South Africa. We elicited traditional healer attitudes towards glove use during traditional treatments – including patient baths, injections, or other treatments that exposed healers to patient blood or open sores. Results: While 90% of healers reported using latex gloves during some treatments, the majority do not use them regularly. Most employ a combination of gloves, plastic shopping bags, bread bags, paper, and sticks to prevent blood exposure. Healers reported plastic bags slipping or breaking during procedures, exposing them to patient blood. Only three healers consistently used gloves, regardless of the cost. Conclusions: Inadequate PPE use and high HIV prevalence make traditional healers particularly susceptible to contracting HIV in rural South Africa. Despite positive attitudes, consistent glove use remains low due to financial constraints and glove availability. Addressing issues of accessibility and cost of gloves for traditional healers could have a significant impact on the adherence to PPE and, in turn, reduce new HIV infections among this high-risk group.

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Continued explosive rise in HIV prevalence among pregnant women in rural South Africa

AIDS ◽

10.1097/00002030-199904160-00023 ◽

1999 ◽

Vol 13 (6) ◽

pp. 740 ◽

Cited By ~ 22

Author(s):

D. Wilkinson ◽

C. Connolly ◽

K. Rotchford

Keyword(s):

South Africa ◽

Pregnant Women ◽

Hiv Prevalence ◽

Rural South ◽

Rural South Africa

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Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa

BMC Public Health ◽

10.1186/1471-2458-7-160 ◽

2007 ◽

Vol 7 (1) ◽

Cited By ~ 36

Author(s):

Brian D Rice ◽

Jörg Bätzing-Feigenbaum ◽

Victoria Hosegood ◽

Frank Tanser ◽

Caterina Hill ◽

...

Keyword(s):

South Africa ◽

Hiv Prevalence ◽

Rural South ◽

Female Population ◽

Prevalence Estimates ◽

Rural South Africa

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‘Testing Together Challenges the Relationship’: Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa

PLoS ONE ◽

10.1371/journal.pone.0066390 ◽

2013 ◽

Vol 8 (6) ◽

pp. e66390 ◽

Cited By ~ 19

Author(s):

Hanani Tabana ◽

Tanya Doherty ◽

Birgitta Rubenson ◽

Debra Jackson ◽

Anna Mia Ekström ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Hiv Prevalence ◽

Rural South ◽

The Relationship ◽

Rural South Africa

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Trends in HIV Prevalence in Pregnant Women in Rural South Africa

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000000761 ◽

2015 ◽

Vol 70 (3) ◽

pp. 289-295 ◽

Cited By ~ 30

Author(s):

Ayesha B. M. Kharsany ◽

Janet A. Frohlich ◽

Nonhlanhla Yende-Zuma ◽

Gethwana Mahlase ◽

Natasha Samsunder ◽

...

Keyword(s):

South Africa ◽

Pregnant Women ◽

Hiv Prevalence ◽

Rural South ◽

Rural South Africa

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Living Arrangements, Disability and Gender of Older Adults Among Rural South Africa

The Journals of Gerontology Series B ◽

10.1093/geronb/gbx081 ◽

2017 ◽

Vol 73 (6) ◽

pp. 1112-1122 ◽

Cited By ~ 3

Author(s):

Enid Schatz ◽

Margaret Ralston ◽

Sangeetha Madhavan ◽

Mark A Collinson ◽

F Xavier Gómez-Olivé

Keyword(s):

South Africa ◽

Living Arrangements ◽

Older Persons ◽

Living Arrangement ◽

Policy Implications ◽

Adult Health ◽

Older Individuals ◽

Rural South ◽

And Gender ◽

Rural South Africa

Abstract Objective A limited understanding exists of the relationship between disability and older persons’ living arrangements in low and middle-income countries (LMICs). We examine the associations between living arrangements, disability, and gender for individuals older than 50 years in rural South Africa. Method Using the Study on global AGEing and adult health (SAGE) survey and Agincourt Health and socio-Demographic Surveillance System (HDSS) data, we explore older persons’ self-reported disability by living arrangements and gender, paying particular attention to various multigenerational arrangements. Results Controlling for past disability status, a significant relationship between living arrangements and current disability remains, but is moderated by gender. Older persons in households where they may be more “productive” report higher levels of disability; there are fewer differences in women’s than men’s reported disability levels across living arrangement categories. Discussion This study underscores the need to examine living arrangements and disability through a gendered lens, with particular attention to heterogeneity among multigenerational living arrangements. Some living arrangements may take a greater toll on older persons than others. Important policy implications for South Africa and other LMICs emerge among vibrant debates about the role of social welfare programs in improving the health of older individuals.

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Household transitions in rural South Africa, 1996—2003

Scandinavian Journal of Public Health ◽

10.1080/14034950701355429 ◽

2007 ◽

Vol 35 (69_suppl) ◽

pp. 130-137 ◽

Cited By ~ 17

Author(s):

Martin Wittenberg ◽

Mark A. Collinson

Keyword(s):

South Africa ◽

Living Arrangements ◽

Surveillance System ◽

Transition Probabilities ◽

Rural South ◽

Single Person ◽

The Social ◽

System Data ◽

Rural South Africa ◽

Hiv Aids

Aims: To investigate changes in household structure in rural South Africa over the period 1996—2003, a period marked by politico-structural change and an escalating HIV/AIDS epidemic. In particular, the authors examine whether there is dissolution of extended family living arrangements. Methods: Data from the Agincourt demographic surveillance system, in rural north-eastern South Africa, and the rural sub-samples of selected nationally representative data sets were used to compare changes in the cross-sectional distribution of household types. Surveillance system data were further analysed to estimate the transition probabilities between household types. The latent pressures for change within the Agincourt area were analysed by projecting the household transition probabilities forward and comparing the projected steady-state distributions to the current distributions. Results: The national surveys show dramatic changes in the social structure in rural areas, particularly an increase in the importance of single person households. These trends are not confirmed in the surveillance system data. The national ``changes'' can possibly be ascribed to changes in sampling frames or household definitions. The transition probabilities within the Agincourt area show considerable changes between household types, despite a slower change in the aggregate distributions. The most important projected long-run changes are an increase in the proportion of three-generation linear households. ``Simpler'' household types such as single person households and nuclear households will become relatively less common. Conclusions: The structure of households is evolving under the pressure of social change and increased mortality due to HIV/AIDS. There is no evidence, however, that the social fabric is unravelling or that individuals are becoming increasingly isolated residentially.

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