Putting prevention at the forefront of HIV/AIDS

The Lancet (Impact Factor: 45.22). 09/2008; 372(9637):421-2. DOI: 10.1016/S0140-6736(08)60882-X
Source: PubMed
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    • "The proficient and competent planning of effective customized HIV prevention programs and monitoring their impact relies on strong health information systems as well as good local and national surveillance. The exact mix of HIV prevention, treatment, care, support strategies, and structural interventions is determined by this data (Horton & Das, 2008). While several HIV prevention interventions appear promising with mathematical modelling providing further optism for the intervention, no single intervention is likely to be sufficient to prevent transmission of HIV on a global scale. "
    HIV-infection - Impact, Awareness and Social Implications of living with HIV/AIDS, 10/2011; , ISBN: 978-953-307-343-9
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    • "In the absence of stronger and more effective PMTCT services, it is expected that the number of children with HIV will continue to increase and pose additional challenges to health systems. One of the reasons suggested to explain the low coverage of PMTCT services is the dominance of treatment and care over prevention in HIV control efforts (Horton & Das, 2008). Other reasons include limited financial and human resources (Paintsil & Andiman, 2009); fragile maternal, newborn, and child health (MNCH) services; low acceptance of HIV testing due to the poor quality of services; limited information; lack of access to ART (Dahl, Mellhammar, Bajunirwe, & Bjorkman, 2008); and problems related to the involvement of male partners (Kakimoto et al., 2007). "
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    ABSTRACT: Recent achievements in scaling up paediatric antiretroviral therapy (ART) have changed the life of children living with HIV, who now stay healthy and live longer lives. However, as it becomes more of a chronic infection, a range of new problems have begun to arise. These include the disclosure of HIV serostatus to children, adherence to ART, long-term toxicities of antiretroviral drugs and their sexual and reproductive health, which are posing significant challenges to the existing health systems caring for children with HIV with limited resources, experiences and capacities. While intensified efforts and actions to improve care and treatment for these children are needed, it is crucial to accelerate the prevention of mother-to-child transmission (PMTCT) of HIV, which is the main cause of paediatric HIV in the ASEAN region so as to eliminate the fundamental cause of the problem. This report argues that given over 70% of women have access to at least one antenatal care visit in the region and acceptance of HIV testing after receiving counselling on PMTCT could be as high as 90%, there is an opportunity to strengthen PMTCT services and eventually eliminate new paediatric HIV infections in the ASEAN countries.
    AIDS Care 04/2011; 23(4):413-6. DOI:10.1080/09540121.2010.516338 · 1.60 Impact Factor
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    • "Despite several legislative and policy changes that have been undertaken in the area of reproductive health since 1994, the outcomes of HIV behavioural interventions have largely been inadequate and ineffective and HIV incidence remains unacceptably high (5, 6). In the last 25 years, HIV prevention efforts have predominantly sought to influence the individual; targeting knowledge, attitude and practices of people, whereas structural factors, e.g. "
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    ABSTRACT: The perspectives of heterosexual males who have large sexual networks comprising concurrent sexual partners and who engage in high-risk sexual behaviours are scarcely documented. Yet these perspectives are crucial to understanding the high HIV prevalence in South Africa where domestic violence, sexual assault and rape are alarmingly high, suggesting problematic gender dynamics. To explore the construction of masculinities and men's perceptions of women and their sexual relationships, among men with large sexual networks and concurrent partners. This qualitative study was conducted in conjunction with a larger quantitative survey among men at high risk of HIV, using respondent-driven sampling to recruit participants, where long referral chains allowed us to reach far into social networks. Twenty in-depth, open-ended interviews with South African men who had multiple and concurrent sexual partners were conducted. A latent content analysis was used to explore the characteristics and dynamics of social and sexual relationships. We found dominant masculine ideals characterised by overt economic power and multiple sexual partners. Reasons for large concurrent sexual networks were the perception that women were too empowered, could not be trusted, and lack of control over women. Existing masculine norms encourage concurrent sexual networks, ignoring the high risk of HIV transmission. Biological explanations and determinism further reinforced strong and negative perceptions of women and female sexuality, which helped polarise men's interpretation of gender constructions. Our results highlight the need to address sexuality and gender dynamics among men in growing, informal urban areas where HIV prevalence is strikingly high. Traditional structures that could work as focal entry points should be explored for effective HIV prevention aimed at normative change among hard-to-reach men in high-risk urban and largely informal contexts.
    Global Health Action 07/2010; 3. DOI:10.3402/gha.v3i0.5092 · 1.93 Impact Factor
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