AIDS In Africa Research Articles

Africa's AIDS crisis in context: 'how the poor are dying'

The 13th International Conference on AIDS held in Durban, South Africa, highlighted the social catastrophe unfolding on the African continent. The meeting took place in the country with the largest number of people infected by HIV - the virus that causes AIDS - on the continent that is home to 70% of the world's HIV-infected population. The cruel irony of the unfolding human tragedy is that Africa is also the least equipped region in the world to deal with the multiplicity of challenges posed by the HIV virus. Drawn from ongoing research in southern Africa, this article charts the relationship between poverty, HIV prevalence and the politics of global response.

Sources of Financial Assistance for Households Suffering an Adult Death in Kagera, Tanzania

The AIDS crisis in Africa and elsewhere compels us to design appropriate assistance policies for households experience a death. Policies should take into account and strengthen existing household coping strategies, rather than duplicate or undermine them. The authors investigate the nature of coping mechanisms among a sample of households in Kagera, Tanzania in 1991-1994. They estimate the magnitude and timing of receipts of private transfers, credits, and public assistance by households with different characteristics. Their empirical strategy addresses three common methodological difficulties in estimating the impact of adult death: selection bias, endogeneity, and unobserved heterogeneity. The authors find that less-poor households (those with more physical and human capital) benefit from larger receipts of private assistance than poor households. Resource-abundant households are wealthy in social assets as well as physical assets. Poor households, on the other hand, rely relatively more on loans than private transfers, for up to a year after a death. This suggests that credit acts as insurance for households where informal interhousehold assistance contracts are not enforceable. A donor in Kagera can be sure that assistance to a wealthy household may not be able to return the favor. Assistance to the poor is more likely to come with more formal arrangements for repayment. Formal-sector assistance is targeted toward the poor immediately following the death. The impact of adult deaths on households may be mitigated either ex ante, through programs that minimize poverty and vulnerability, or ex post, by assistance targeted to the poorest and most vulnerable households. In addition, to the extent to which micro-credit programs improve access and lower the total costs of borrowing, they may not only stimulate growth and investment but also help resource-poor households overcome the impact of an adult death in the areas hard-hit by the AIDS epidemic.

Sexual Health Exchange Southern Africa AIDS information dissimination service (SAfAIDS) and the royal tropical institute (KIT), 2000/1

Sexual Health Exchange Southern Africa AIDS information dissimination service (SAfAIDS) and the royal tropical institute (KIT), 2000/1

Extent to which low-level use of antiretroviral treatment could curb the AIDS epidemic in sub-Saharan Africa

Despite growing international pressure to provide HIV-1 treatment to less-developed countries, potential demographic and epidemiological impacts have yet to be characterised. We modelled the future impact of antiretroviral use in South Africa from 2000 to 2005. We produced a population projection model that assumed zero antiretroviral use to estimate the future demographic impacts of the HIV-1 epidemic. We also constructed four antiretroviral-adjusted scenarios to estimate the potential effect of antiretroviral use. We modelled total drug cost, cost per life-year gained, and the proportion of per-person health-care expenditure required to finance antiretroviral treatment in each scenario. With no antiretroviral use between 2000 and 2005, there will be about 276,000 cumulative HIV-1-positive births, 2,302,000 cumulative new AIDS cases, and the life expectancy at birth will be 46.6 years by 2005. By contrast, 110,000 HIV-1-positive births could be prevented by short-course antiretroviral prophylaxis, as well as a decline of up to 1 year of life expectancy. The direct drug costs of universal coverage for this intervention would be US$54 million--less than 0.001% of the per-person health-care expenditure. In comparison, triple-combination treatment for 25% of the HIV-1-positive population could prevent a 3.1-year decline in life expectancy and more than 430,000 incident AIDS cases. The drug costs of this intervention would, however, be more than $19 billion at present prices, and would require 12.5% of the country's per-person health-care expenditure. Although there are barriers to widespread HIV-1 treatment, limited use of antiretrovirals could have an immediate and substantial impact on South Africa's AIDS epidemic.

South Africa's AIDS play provokes controversy

The European Union (EU) has earmarked a total of 40 million rand (US$12 million) to foster AIDS awareness in South Africa. 14.27 million rand, approximately US$3.45 million, has been allocated by the Department of Health to fund "Sarafina 2," a controversial musical show about AIDS awareness written by Mbongeni Ngema. The allocation of such a large portion of EU funding to this one play has been strongly criticized. The funds could have instead been used to provide essential services. In response, the Department of Health claims that the money had not been subjected to the usual checking processes because the amount had been specifically dedicated to the production of the play. The EU ambassador, however, has reportedly stated that the play was never discussed and was not part of their program. The director of the AIDS directorate was out of the country when Ngema's tender for the play was accepted last August, and it was not until November that she learned about her department's sponsoring of the play. The health department has now forbade its employees from discussing the matter with the media. Minister of Health Nkosazana Zuma should expect a tough time when she goes before Manto Tshabalala's parliamentary portfolio committee on health which has been charged with investigating the matter. The committee will also review some of the accounting related to this issue.

Managing the AIDS crisis in Africa: in support of pluralism.

Although substantial evidence is now accumulating that some African peoples readily accept advice and help about health from both modern medical and traditional sources, this has not yet happened with--what is arguably the major health problem in many part of Africa--AIDS. We asked 175 of Malawi's undergraduates what sources they judged to be credible with regard to information on preventing and clinically managing AIDS. While traditional healers were seen on average to be less credible than modern health professionals (doctors and nurses), there was no correspondence between credibility of traditional healers and modern health professionals. Thus a strong belief in the credibility of modern health professionals was not associated with low credibility ratings for traditional healers. Our findings provide further support for "tropical tolerance", especially as regards a pluralistic (modern and traditional together) approach to the prevention of AIDS. Given the over-stretched health services in Malawi and many other African countries, a pluralistic approach to AIDS prevention could be a credible and economic use of indigenous human resources.

HIV in South Africa

More than 1 in 40 young adults in South Africa were estimated to be infected with HIV through the end of 1992. The rate of infection has slowed so that the current doubling time is 16 months; 400 people are nonetheless newly infected daily. HIV and AIDS were first noted among gay White Men in the Cape of South Africa. Education and support from within the gay community, however, prompted the rapid and substantial decrease in the incidence of infection. The 1st evidence of infection among Black heterosexuals was then noted in 1987. It is mainly young adults who are infected, with women affected earlier than and at least as often as men. The arrival of HIV to South Africa and its expected pattern of transmission should have been no surprise to country health policymakers and administrators. Sexually transmitted diseases (STD) facilitate the spread of HIV infection and tuberculosis (TB) fosters the development of AIDS once people are infected with HIV. An estimated 3 million cases of STD present annually in South Africa and almost half of the adult population is infected with quiescent TB. The failure to learn from experiences with HIV in some central and eastern Africa countries simply highlights the extent of poor public health in South Africa. South Africa has the infrastructure and health funding needed to check AIDS, but failed to take action. The central health ministry did not respond to the epidemic until 1990 with the establishment of an AIDS unit, secondary school AIDS prevention programs and packages in 8 languages, a neutral national information campaign, workshops to increase awareness, and funding to organizations targeting hard-to-reach groups. The AIDS unit was soon merged into a health promotion section and the unit's head fired, with all the prevention initiatives terminated except the continued availability of pamphlets in only English and Afrikaans. An official complaint has been made to no avail against the health department official who closed the AIDS campaign. Meanwhile, the government contends that it holds no responsibility for educating its population in the prevention of AIDS. These recent actions suggest that the government is committing genocide by allowing excess mortality from AIDS to decimate Black heterosexuals during the impending period of interim rule and political transition. These observations and conclusions are based in part on the author's experience as medical advisor to South Africa's AIDS unit in 1991/92.

Blacks and AIDS: causes and origins

Introduction The Health Status of Black Americans History and Epidemiology of AIDS Transmission of HIV and Pathogenesis of AIDS AIDS in Africa AIDS and HIV Infection Genetics versus the Environment AIDS in Perspective The Control of the AIDS Epidemic A Comprehensive Approach The Control of AIDS in Black Populations The Comprehensive Approach Financing AIDS Control It Can Be Done

SOVIET ECONOMIC AID TO AFRICA

Journal Article SOVIET ECONOMIC AID TO AFRICA Get access COLIN W. LAWSON COLIN W. LAWSON Senior Lecturer in Economics Cohn W. Lawson is Senior Lecturer in Economics at the University of Bath. He is currently undertaking an investigation of parastatal organizations in central and southern Africa. He is grateful to Anthony Kirk-Greene and Alice Leonard for helpful suggestions. Search for other works by this author on: Oxford Academic Google Scholar African Affairs, Volume 87, Issue 349, October 1988, Pages 501–518, https://doi.org/10.1093/oxfordjournals.afraf.a098087 Published: 01 October 1988

Epidemiological and sociological aspects of HIV-infection in developing countries.

The epidemiologic and social aspects of AIDS are different in developed and developing countries. In Africa, where there are several tens of thousands of cases, the ratio of female to male cases is 1:1. The highest incidence in men is at age 37.4 and in women 30 years. In Haiti the female to male ratio is 1:1.8. In Rwanda and Zambia the incidence is higher among educated people. In most of Africa AIDS is predominantly urban. Also, in Africa the time between diagnosis and death is shorter. Seroprevalence rates in Africa and the Caribbean are between .5 and 18% for the population at large. In Zaire seroprevalence peaks between ages 16-20 and at under 1 year. Both in the US and in Africa the epidemic appears to have begun around 1980. In West Africa a related virus, HIV-2, has been identified. Progression rates from seropositivity to AIDS or AIDS-related complex in Africa are similar to those in the US. However, in Africa, and recently in Haiti, transmission has been heterosexual. In Africa female prostitutes have the highest incidence of HIV seropositivity, and there is much female to male transmission via this route. Genital ulcers, especially chancroid, increase the risk of AIDS, and condom use may protect women from infection. The 2nd most important route of AIDS transmission in Africa and Haiti is blood transfusion. Blood transfusion are common in treatment of children with anemia from malaria and with sickle cell anemia, and many children have been infected via this route in Africa. Medical injections, scarification and circumcision also account for HIV transmission. Perinatal transmission from seropositive mothers is also common in Africa. Among patrilineal African societies premarital or extramarital sex is rare among girls, but young men and husbands of nursing mothers often visit prostitutes. In the cities there are varying degrees of promiscuity. In couples where the husband is seropositive, he usually has a history of sex with prostitutes, but in couples where the wife is seropositive, she usually has a history of blood transfusion.

Some epidemiological and clinical characteristics of African AIDS.

The virological pattern of AIDS in Africa is quite different from that found in Western countries. For example viral isolates (LAV-II) related by their glycoprotein to the simian T lymphotropic virus type III (STLV-III) and by their core proteins to LAV-I have been isolated in AIDS patients from West Africa. Further antibodies against STLV-III and HTLV-IV have been identified in residents of Senegal who previously had no history of AIDS or AIDS-related illness until now. Additionally scientists have found that HTLV-III/LAV is linked to visna virus and to bovine leukemia virus. Therefore it is possible that the HTLVs are related to a continuum of genomic evolution from a common animal ancestor present for a long time in Africa. This hypothesis is supported by the fact that the Aids virus or a related virus has been present in Africa since the early 1960s and its prevalence was a low .2%. There are also differences between the epidemiology of AIDS in African and that in the US and Europe. In Africa AIDS is primarily transmitted heterosexually rather than homosexually and via intravenous (IV) drug use as is the case in the US and Europe. In a study of 36 African AIDS patients in a Belgian hospital the most frequent opportunistic infections included digestive candidiasis cerebral toxoplasmosis and cryptococcal meningitis. This study confirmed the remarkable differences in the type of opportunistic infections between african heterosexual patients and US homosexuals or IV drug users. For example 58-63% of US AIDS patients acquired Pneumocystis carinii pneumonia while only 25% of the African patients had it. On the other hand 7% US patients had cryptococcal meningitis and 4% had Toxoplasma gondii encephalitis and 13% and 21% of the African patients acquired them respectively.