Uganda is one of the highest consumer of alcohol in the world. However, HIV care and treatment programs have limited evidence based strategies for alcohol use among persons living with HIV. Instead HIV care and treatment programs have adopted a no alcohol position when on ART policy to deal with poor adherence among patients in care programs. In our findings, a half of the patients interviewed (50%, 95% CI 45-55) consumed alcohol. Men were more likely to consume alcohol compared to women (OR= 2.39, 95% CI 1.53-3.72) and lack of information on adverse effects of alcohol was associated with alcohol use. (OR= 0.54, 95% CI 0.33-0.86). HIV prevention and control programs need to consider alcohol use in reducing the rate of HIV transmission and re-infection among PLH in resource limited settings.
Sub-Saharan Africa (SSA) is home for 67% of HIV- infected individuals, 68% of new HIV infections and 72% of AIDS-related deaths. Up to 80% of infected adults remain undiagnosed and lack access to adequate prevention, treatment, care and support services. Although the availability of antiretroviral therapy (ART) has increased rapidly to reach over three million people in low- and middle-income countries, coverage remains at about 44% of people in need of it. Furthermore, high attrition rates (20-30% loss to follow up) are reported within HIV/AIDS care programs. It is therefore critical to study, analyse and implement strategies to improve efficiency of HIV/AIDS care and treatment programs in the region. This book addresses challenges in HIV diagnosis, linkage and retention in comprehensive HIV/AIDS care and treatment programs, and clinical-biomedical research to maximise clinical and immunological outcomes of HIV treatment. We target local and international clinicians, scientists, investors and donors that are interested in combating HIV/AIDS within the unique socio-cultural, economic and health care delivery context in SSA.
Maternal mortality in Ethiopia is the highest in the world. A study was carried out in 2006 among Family Planning, Antenatal Care, and Delivery Care Service attendees in the health facilities, Ethiopia. A quantitative and qualitative methodologies were applied. The study indicated that integration of programs is critically important to increase utilization of services and minimize missed opportunities in maternal care and HIV/AIDS services in health facilities of Ethiopia.
HCPs' Knowledge, Attitudes and Practices HIV and AIDS contribute to nearly one-fifth of disease burden in sub-Saharan Africa. The challenge of HIV and AIDS disease is further compounded by the health care providers' struggle to acquire necessary knowledge and skills to deliver effective HIV and AIDS prevention, care and treatment services. Many countries have therefore initiated human capacity development programs focusing on training of the health care providers to support HIV and AIDS prevention, care and treatment services as part of the effort to scale up HIV and AIDS services. In order to describe their characteristics and to determine the physicians' knowledge, attitudes and practices on HIV and AIDS a group of physicians attending a Training of Trainers (TOT) course in HIV and AIDS held in Nairobi were surveyed. Individual physician data characterizing their knowledge, attitudes, beliefs and practices was collected using an anonymous group-administered questionnaire. This study indicated that the more the number of years a physician was in health care practices the better his/her knowledge, attitudes and practices in provision of HIV and AIDS treatment and care services.
Globally, an estimated 35.3 million people were living with HIV in 2012. In Kenya, HIV and AIDS is a national disaster affecting mainly people in the productive and reproductive age group of 15 to 49 years. Home and Community Based Care (HBC) is a critical component in the care, support and mitigation of the effects of HIV and AIDS but whose utilization is still low in Kenya. The aim of this book is to document the factors associated with HBC uptake among rural PLWHAs in Kenya. A population based survey was conducted in rural Kenya among adult PLHIV. Respondents were randomly from among PLHIV registered and receiving HIV care and treatment in Government of Kenya comprehensive care centres. The overall utilization of HBC uptake among rural PLWHAs is low in Kenya. The study recommends scaling up of HBC programs to comprehensively cover all sub-counties that have established the services and to reach those PLHIV who have not accessed HBC, strengthening referral systems between HBC and other services including strengthening of linkage between health facilities and community so as to ensure the continuum of care, and strengthening Districts to support monitor and supervise HBC programs.
Millions of people in East Africa are suffering from overlapped public health challenges of humanitarian crisis (natural and human-made) and HIV/AIDS pandemic. Public Health Programs on both challenges lack integration that is a missed opportunity. Thus,humanitarian and HIV/AIDS programs based on countries context in East Africa need to be integrated so as to be efficient and effective to address the challenges.
Alcohol consumption during pregnancy is a threat to the wellbeing of the unborn child. Whilst there is evidence of the benefits of screening and alcohol brief interventions (ABIs) in reducing hazardous and harmful drinking among primary care populations, evidence of their effectiveness with antenatal care populations is limited. In an effort to protect the health and safety of the unborn child, the Scottish Government recently implemented screening and ABIs in antenatal care settings. This book examines concepts important for understanding and improving effectiveness of screening and ABIs in practice in these settings. It also offers detailed and applied use of the realistic evaluation approach. The book is an important addition to a sensitive prenatal alcohol exposure subject area which is of immense relevance to policy, health professionals and public health researchers.
Adolescence, as a developmental stage, is characterized by the initiation of risky health behaviors. Alcohol use behaviors are often initiated in early-to-middle adolescence and reach peak levels in young adulthood, after which they decline. This book was to identify trajectories of alcohol use and to investigate the significant predictors of alcohol use from early adolescence to young adulthood. The specific contents were: first, the investigation of predictors of different ages of onset of alcohol use; second, determinants of the impact of acculturation and psychosocial factors on alcohol use trajectories; and third, identification of the influence of parent, peer, school, and neighborhood factors on alcohol use trajectories at the individual-level, and the school and neighborhood-level. This book should be a valuable source of prevention and education programs against alcohol use and health policies for health promotion for Asian American adolescents. Interventions to delay the onset of alcohol use and decrease alcohol use should focus on peer and parental influences and positive school outcomes.
This comparative study on factors affecting young people in utilizing HIV/AIDS services used data obtained from Africa Youth Alliance (AYA) project of UNFPA. This study investigated HIV service utilization, variations in HIV service utilization, reasons for non-use of HIV/AIDS services (condom use, counseling & testing) and attitude towards use of condoms. The results indicate that condom use among was low (24%). The reasons for this low were trust from their partners, refusal by sexual partners to use condoms and lack of condoms. The attitude towards condoms had changed and many adolescents looked at people who use condoms to be protective (60%) and 43% had used condoms for HIV prevention. Education level was influential in affecting condom use. The counseling service utilization is still very low due to inconvenient locations and cost. The HIV testing service was still low because young people considered themselves to HIV negative (no need to be tested), fear of test results and also not being sexually active. All in all, age, education level, occupation and residence were very influential in affecting HIV testing and condom use as shown by logistic regression models
The study analyzed the relationship between fertility intention and contraceptive use among women in Nigeria’s Federal Capital territory, Abuja. It also examined the relationship between HIV status and fertility intention and compared patterns of contraceptive use and fertility intentions between HIV positive and HIV negative women. This was with a view to identifying the dynamics of fertility decision making and contraceptive use among women living with HIV in the study area. The study concluded that being HIV positive had no dampening effect on childbearing desires. Hence, programmes and policies aimed at strengthening mother-to-child transmission should encourage contraceptive use among HIV positive women.
In two decades since HIV was first diagnosed, AIDS has claimed 20 million lives and currently 40 million people are infected with HIV/AIDS. HIV/AIDS is inextricably linked to poverty and erodes hard-won livelihoods of the world poorest communities. The research study conducted under this thesis investigates HIV Risk Behavior Practice and helps to fight HIV/AIDS by changing people behavior. The sample involved in the study consists of 200 individuals living in Addis Ababa: Ethiopia. The behavior that has been taken into consideration is HIV Risk Behavior and it includes: number of sexual partners, sexual practice with casual and high risk partners, condom use, sexual trading, using alcohol and drug for sexual initiation, and deviant sexual practice like anal sex. The data has been collected by questionnaire. The findings of the study suggested that a significant portion of the research participants had multiple sexual partners, sexual practices with casual and high-risk partners, sex without condom, involved in anal sex, used alcohol and drug for sexual initiation and engaged in sexual trading which are some of the major factors that contribute to the wide spread of HIV.
There is a wide availability of HIV/AIDS care services in Uganda, including counseling, testing, and treatment. These services are provided by both the public and the private sectors. In 2008, the country had approximately 121,218 people with HIV/AIDS receiving antiretroviral therapy, and the target for the year 2011/12 was to increase this figure. This involves ambitious expansion. Nonetheless, there are few assessments of how the process of scale-up of HIV/AIDS care affects quality, efficiency and cost effectiveness. Quality of care has an important bearing on client satisfaction, a key aspect of health care delivery. Client satisfaction can determine if a client seeks medical advice and care and adheres to prescribed treatment. Dissatisfaction can have terrible consequences, like patients not following treatment regimens. Little information is available on satisfaction among clients who receive HIV/AIDS care in Uganda, comparing public and private health facilities. It was necessary to find out the situation in each, and the perceived quality of care. This study measured client satisfaction in Kabale district where HIV/AIDS prevalence is about 10%.
In Pakistan, there is a pressing need for a suitable algorithm(s) that meet the demand for the expand access to HIV screening, diagnosis, treatment and care in line with the National AIDS Control Programme’s, Strategic Framework and National HIV and AIDS Policy through its multi-donor financed Social Action Programme. This book, therefore outlines the adapted diagnostic procedures for the detection of HIV, evaluates the performance and diagnostic effectiveness of three different HIV antibody assays and formulates an alternative cost-effective confirmatory approach for HIV diagnosis that is suitable for use in Pakistan. This book would be useful for HIV diagnostic laboratories, researchers and also decision makers at the National AIDS Control Programme to implement and then regularly validate the national testing strategy.