scholarly journals Fear of stigma, beliefs, and knowledge about HIV are barriers to early access to HIV testing and disclosure for perinatally infected children and adolescents in rural communities in South Africa

2017 ◽  
Vol 59 (3) ◽  
pp. 37
Author(s):  
Sphiwe Madiba ◽  
Mathildah Mokgatle
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Hiv Testing ◽  
Health Care Facilities ◽  
Hiv Status ◽  
Hiv Diagnosis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mpumalanga Province ◽  
Perinatally Infected

Background: The majority of HIV-infected children in resource-limited countries are not aware of their HIV status because of the various reasons responsible for the delay in seeking HIV testing for children. The aim of the study was to determine the prevalence and barriers to testing and disclosing the HIV status of children aged between 5 and 18 years. Methods: This was a cross-sectional survey involving 405 caregivers of HIV perinatally infected children receiving anti-retroviral treatment (ART) in primary health care facilities in a rural district of Mpumalanga province in South Africa. Results: The prevalence of disclosure was 27%, and disclosure was done to promote adherence (26%) or because it was the child’s right to know his/her status (43%). Children’s age was significantly associated with disclosure (AOR = 2.81, p < 0.000, CI 1.64–4.81). Concerns that children were too young and would not understand the implications of HIV diagnosis (74.5%) or would not keep the diagnosis secret (7%) were reasons for non-disclosure. Over half of the caregivers intended to disclose status when the child was aged between 12 and 15 years. In response to children’s questions about medication, caregivers substituted HIV with other less stigmatising conditions (32%). Conclusion: The prevalence of disclosure was low and delayed till the child was above 10 years of age. The main barrier to disclosure was fear of stigma, or fears of the child telling others about their HIV status with consequences of stigma. The need for guidelines to provide caregivers with disclosure skills, to overcome the barriers that prevent disclosure, is crucial. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1329489

scholarly journals Factors Associated with PMTCT Cascade Completion in Four African Countries

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jodie Dionne-Odom ◽  
Thomas K. Welty ◽  
Andrew O. Westfall ◽  
Benjamin H. Chi ◽  
Didier Koumavi Ekouevi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Antenatal Visit ◽  
Hiv Status ◽  
Hiv Diagnosis ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mother To Child ◽  
Pmtct Cascade

Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A cross-sectional survey was performed across 26 communities in Cameroon, Cote d’Ivoire, South Africa, and Zambia. Women who reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with all of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received, initiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified using multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT cascade. Although most women (69.2%) did not know their partner’s HIV status; awareness of partner HIV status was associated with cascade completion (aOR 1.4, 95% CI 1.01–2.0). Completion was also associated with receiving an HIV diagnosis prior to pregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2–38.6). Conclusions. Pregnant women with HIV infection in Africa who were aware of their partner’s HIV status and who were diagnosed with HIV before pregnancy were more likely to complete the PMTCT cascade.

Proposal for Improving Records Management Practices of Traditional Institutions in Ga Molepo, South Africa

Mousaion ◽  
10.25159/2054 ◽  
2017 ◽  
Vol 35 (1) ◽  
pp. 46-67
Author(s):  
Mahlaga Johannes Molepo ◽  
Linda M. Cloete
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Management Practices ◽  
Records Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Record Keeping ◽  
Local Municipalities ◽  
Management Procedures ◽  
Traditional Institutions

The way in which an institution treats its records is crucial for its survival in a rapidly changing society. The purpose of the study was to investigate the records management practices and challenges faced by traditional institutions of leadership and governance in Ga Molepo, Limpopo, South Africa. The researcher employed a cross-sectional survey in order to quantitatively examine the challenges faced by members of traditional councils. A researcher administered questionnaire was used as a data collection tool to study a stratified sample of 35 members from an estimated population of 350. The findings revealed patterns and trends of non-compliance with records management standards and guidelines. Although there were sporadic cases of record keeping, a greater number of respondents revealed that traditional institutions lack the facilities, equipment, education and trained/skilled personnel to apply correct records management procedures in their daily administration of their traditional communities. The main value of the study is to create awareness of records management as one of the neglected areas in traditional institutions – which are by current legislative arrangement, the closest form of leadership and governance for rural communities in light of their relationship with local municipalities and the Department of Cooperative Governance and Traditional Affairs.

scholarly journals Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 253 ◽  
Author(s):  
Khensane Mengwai ◽  
Sphiwe Madiba ◽  
Perpetua Modjadji
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Partner Violence ◽  
Hiv Transmission ◽  
Sexual Partners ◽  
Hiv Treatment ◽  
Hiv Diagnosis ◽  
Cross Sectional Survey ◽  
Access To Treatment ◽  
Cross Sectional

The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.

Determinants of Gender Disparities in Scaling Up the First 90 Towards the UNAIDS 90-90-90 Targets in South Africa: Findings From the 2017 Household-based National Cross-sectional Survey

2020 ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Tertiary Education ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Cascade

Abstract Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa.Methods: The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender.Results: Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p<0.001). Both females aged 25 to 49 years [aOR=3.20 (95% CI: 1.35–7.57), p=0.008], and 50 years and older [aOR=3.19 (95% CI: 1.04–9.76), p=0.042] and males aged 25 to 49 years [aOR=3.00 (95% CI: 1.13–7.97), p=0.028], and 50 years and older [aOR=7.25 (95% CI: 2.07–25.36), p=0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR=75.24 (95% CI: 9.07–624.26), p<0.001] compared to those with no education or with primary level education. Females with secondary [aOR=3.28 (95% CI: 1.20–8.99), p=0.021] and matric [aOR=4.35 (95% CI: 1.54–12.37), p=0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education.Conclusion: Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.

scholarly journals Census and vaccination coverage of owned dog populations in four resource-limited rural communities, Mpumalanga province, South Africa

2017 ◽  
Vol 88 ◽  
Author(s):  
Anne Conan ◽  
Joy A.C. Geerdes ◽  
Oluyemisi A. Akerele ◽  
Bjorn Reininghaus ◽  
Gregory J.G. Simpson ◽  
...  
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Vaccination Coverage ◽  
Herd Immunity ◽  
Public Health Issue ◽  
Human Rabies ◽  
African Countries ◽  
Cross Sectional ◽  
Mpumalanga Province ◽  
Sub Saharan

Dogs (Canis familiaris) are often free-roaming in sub-Saharan African countries. Rabies virus circulates in many of these populations and presents a public health issue. Mass vaccination of dog populations is the recommended method to decrease the number of dog and human rabies cases. We describe and compare four populations of dogs and their vaccination coverage in four different villages (Hluvukani, Athol, Utah and Dixie) in Bushbuckridge Municipality, Mpumalanga province, South Africa. Cross-sectional surveys were conducted in the villages of Athol, Utah and Dixie, while data from a Health and Demographic Surveillance System were used to describe the dog population in Hluvukani village. All households of the villages were visited to obtain information on the number, sex, age and rabies vaccination status of dogs. From May to October 2013, 2969 households were visited in the four villages and 942 owned dogs were reported. The populations were all young and skewed towards males. No differences were observed in the sex and age distributions (puppies 0–3 months excluded) among the villages. Athol had a higher proportion of dog-owning households than Hluvukani and Utah. Vaccination coverages were all above the 20% – 40% threshold required for herd immunity to rabies (38% in Hluvukani, 51% in Athol, 65% in Dixie and 74% in Utah). For the preparation of vaccination campaigns, we recommend the use of the relatively stable dog:human ratio (between 1:12 and 1:16) to estimate the number of dogs per village in Bushbuckridge Municipality.

scholarly journals Factors associated with HIV in younger and older adult men in South Africa: findings from a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031667 ◽  
Author(s):  
Kaymarlin Govender ◽  
Sean Edward Beckett ◽  
Gavin George ◽  
Lara Lewis ◽  
Cherie Cawood ◽  
...  
Keyword(s):  
South Africa ◽  
Older Men ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Community Based Interventions ◽  
Cross Sectional ◽  
Factors Associated ◽  
Younger Men

ObjectiveThis study investigated the behavioural, psychosocial and biological factors associated with HIV in a younger group of men (15 to 24 years) compared with an older group of men (25 to 35 years).DesignA household-based, cross-sectional study was conducted.SettingMen were randomly selected using a two-stage random sampling method in KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsOverall, we interviewed 1472 younger men and 1138 older men. Only participants who could speak English or Zulu, were able to provide informed consent and who were expected to be living in the study area for the next 12 months were enrolled into the study.Primary and secondary outcomesHIV status was the primary outcome for the study. Men’s HIV status was derived from blood samples collected in the study which were tested for HIV antibodies.ResultsHIV prevalence was higher among older men (35.4%, 95% CI: 31.7 to 39.1) than younger men (7.6%, 95% CI: 6.2 to 9.4, p<0.01). Older men, who completed secondary school had a lower likelihood of being HIV positive (adjusted OR (AOR): 0.41, 95% CI: 0.27 to 0.63, p<0.001) and those with greater food insecurity had a higher likelihood of being HIV positive (AOR: 1.57, 95% CI: 1.05 to 2.34, p=0.04). Younger men with a higher number of lifetime sexual partners had a higher likelihood of being HIV positive (AOR: 1.04, 95% CI: 0.99 to 1.09, p=0.09).ConclusionGiven that the HIV prevalence is higher in the older men, community based interventions need to target older men for medical circumcision and support HIV positive men to improve their material conditions early. For younger men intervening to reduce HIV risk behaviours at a young age before these behaviours become entrenched should be central to HIV prevention programmes.

scholarly journals Clients’ perceptions and satisfaction with HIV counselling and testing: A cross-sectional study in 56 HCT sites in South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Gladys Matseke ◽  
Karl Peltzer ◽  
Neo Mohlabane
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Client Satisfaction ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Staff Attitude ◽  
Hiv Test ◽  
Hiv Counselling And Testing ◽  
Study Participants

Background: Client satisfaction serves as a predictor for acceptance of HIV counselling and testing (HCT) services. Therefore, the study of clients’ perception and satisfaction may offer insights on how to improve HCT programmes. Aim and setting: The aim of this study was to assess clients’ satisfaction with HCT as well as describe perceived barriers to and facilitators of HIV testing by HCT clients in South Africa.Methods: A cross-sectional survey was conducted through interviews with 498 clients purposefully selected at the end of an HCT visit at 56 HCT sites throughout the country. Results: All the 498 study participants had tested for HIV with 98.8% receiving their results. Most (88.2%) reported testing for HIV before. The vast majority (75.5%) of clients reported that they had decided to be tested for HIV by themselves. High levels of satisfaction with HCT service (89.8%), low levels (27.7%) of difficulty in making the decision to have an HIV test and high levels of perceived confidentiality (94.6%) of the HIV test results were reported in this study. The most cited perceived barrier to HIV testing was lack of awareness about the HCT service (98%), while staff attitudes (37%), confidentiality (29.6%) and privacy (23.6%) were perceived facilitators. In multivariate logistic regression, staff attitude was significantly associated with client satisfaction (p < 0.05).Conclusion: High levels of client satisfaction with HCT services were observed. Various barriers to and facilitators of – including staff attitude – HCT were identified which can help guide the improvement of HCT services in South Africa.

scholarly journals Determinants of gender disparities in scaling up the first 90 towards the UNAIDS 90–90–90 targets in South Africa: findings from the 2017 household-based national cross-sectional survey

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
S. Jooste ◽  
M. Mabaso ◽  
M. Taylor ◽  
A. North ◽  
Y. L. Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Tertiary Education ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Cascade

Abstract Background The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa. Methods The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender. Results Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p < 0.001). Both females aged 25 to 49 years [aOR = 3.20 (95% CI 1.35–7.57), p = 0.008], and 50 years and older [aOR = 3.19 (95% CI 1.04–9.76), p = 0.042] and males aged 25 to 49 years [aOR = 3.00 (95% CI 1.13–7.97), p = 0.028], and 50 years and older [aOR = 7.25 (95% CI 2.07–25.36), p = 0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR = 75.24 (95% CI 9.07–624.26), p < 0.001] compared to those with no education or with primary level education. Females with secondary [aOR = 3.28 (95% CI 1.20–8.99), p = 0.021] and matric [aOR = 4.35 (95% CI 1.54–12.37), p = 0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education. Conclusion Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.

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