AIDS Prevention Efforts Research Articles

Factors associated with casual sexual behavior among college students in Zhejiang Province, China: A cross-sectional survey.

This study aimed to analyze the characteristics and risk factors associated with casual sexual behavior among sexually active college students and to contribute to AIDS prevention and control efforts among this demographic. A cross-sectional survey was conducted using a stratified cluster sampling technique. Self-reported sexually active college students were selected as respondents from 11 cities in Zhejiang Province from October 8 to November 30, 2018. A questionnaire was used to collect variables such as demographic information, sexual attitudes, intervention acceptance, and self-efficacy of condom use. Univariate and multivariate analyses were performed. Among 3,771 college students who reported engaging in sexual activity, 675 (17.90%) reported engaging in casual sexual encounters. The multivariate analysis revealed multiple factors associated with casual sexual behavior among students: being male, originating from a city/town, having pursued HIV testing education in the last year, seeking HIV risk self-assessment within the last year, accepting to engage in one-night stand behavior, accepting to partake in commercial sexual activity, having conducted HIV antibody tests within the last year, homosexual partner or homosexual/heterosexual partner, demonstrating self-efficacy in condom usage, and monthly living expenses falling within the range of 1001-1500 yuan. Additionally, students with knowledge that appearance does not determine HIV infection, a proclivity for seeking HIV counseling and testing following high-risk sexual behavior and awareness that the centers for disease control provides HIV diagnosis were found to have significant associations with casual sexual activity. Casual sex is significantly prevalent among college students, with male, students from urban areas, those who accepted to engage in one-night stand behavior and partook in commercial sexual activity demonstrating a higher propensity for such behavior. This tendency can be attributed to several factors including a more liberal sexual attitude, a rudimentary understanding of HIV risk, and a low adoption rate of HIV testing. Therefore, it is imperative to enhance HIV prevention and education among college students.

Reconstruction of HIV and AIDS Prevention in Palu City

BACKGROUND: The resolution of the problem of HIV and AIDS seems to be deadlocked both at the national and local government levels, actors related to the issue of HIV and AIDS prevention seem powerless to dispel the trend of increasing HIV and AIDS infections. The purpose of this research is to become a reference in various HIV and AIDS prevention efforts
 METHOD: This type of research is qualitative research. The informants in this study were 25 people who were selected based on the criteria in accordance with the initial design of the study. These informants are key actors representing members of the City Health Office, Palu City Rutan Class II, Palu City AIDS Commission (KPA Palu City), Central Sulawesi Provincial AIDS Commission (KPA Prov. Central Sulawesi), Risk Groups (Housewives), Prisoners, Youth, Health Cadres). The sampling technique uses grounded research techniques that seek to explore in depth the phenomenon of the discourse on HIV and AIDS prevention. 
 RESULTS: The result of the research is that the construction of discourse on HIV and AIDS prevention operates in the form of production and organization of discourse controlled by the media through the dissemination of knowledge that has been legitimized by the power elite. Knowledge of HIV and AIDS originating from actors is produced and reproduced in the form of discourse by the media so that it is transformed into a dominant discourse. Conflictual discourses on HIV and AIDS tend to be parallel to the discourses held by actors because the configuration of conflict discourse is built on the basis of public morality. 
 CONCLUSION: The local government, especially the City of Palu, makes a basic scheme and roadmap in preventing HIV and AIDS transmission by building wider synergy and collaboration. Public health degree.

The Distribution of HIV and AIDS Cases in Luzhou, China, From 2011 to 2020: Bayesian Spatiotemporal Analysis.

BackgroundThe vastly increasing number of reported HIV and AIDS cases in Luzhou, China, in recent years, coupled with the city’s unique geographical location at the intersection of 4 provinces, makes it particularly important to conduct a spatiotemporal analysis of HIV and AIDS cases.ObjectiveThe aim of this study is to understand the spatiotemporal distribution of HIV and the factors influencing this distribution in Luzhou, China, from 2011 to 2020.MethodsData on the incidence of HIV and AIDS in Luzhou from 2011 to 2020 were obtained from the AIDS Information Management System of the Luzhou Center for Disease Control and Prevention. ArcGIS was used to visualize the spatiotemporal distribution of HIV and AIDS cases. The Bayesian spatiotemporal model was used to investigate factors affecting the spatiotemporal distribution of HIV and AIDS, including the gross domestic product (GDP) per capita, urbanization rate, number of hospital beds, population density, and road mileage.ResultsThe reported incidence of HIV and AIDS rose from 8.50 cases per 100,000 population in 2011 to 49.25 cases per 100,000 population in 2020—an increase of 578.87%. In the first 5 years, hotspots were concentrated in Jiangyang district, Longmatan district, and Luxian county. After 2016, Luzhou’s high HIV incidence areas gradually shifted eastward, with Hejiang county having the highest average prevalence rate (41.68 cases per 100,000 population) from 2011 to 2020, being 2.28 times higher than that in Gulin county (18.30 cases per 100,000), where cold spots were concentrated. The risk for the incidence of HIV and AIDS was associated with the urbanization rate, population density, and GDP per capita. For every 1% increase in the urbanization rate, the relative risk (RR) increases by 1.3%, while an increase of 100 people per square kilometer would increase the RR by 8.7%; for every 1000 Yuan (US $148.12) increase in GDP per capita, the RR decreases by 1.5%.ConclusionsIn Luzhou, current HIV and AIDS prevention and control efforts must be focused on the location of each district or county government; we suggest the region balance urban development and HIV and AIDS prevention. Moreover, more attention should be paid to economically disadvantaged areas.

Prevention of Sexually Transmitted Infectious Diseases (STI), HIV AIDS Based Onottawa Charter Health Promotion Strategy in Wakatobi District, Southeast Sulawesi

Targeting to end the AIDS Epidemic by 2030, the government of Wakatobi Regency, Southeast Sulawesi undertakes HIV prevention efforts with Health promotion strategies based on the Ottawa Charter so that individuals and communities can adopt healthy behaviors by not behaving at risk. This study aimed to examine the prevention of STIs and HIV AIDS based on the Ottawa Charter in Wakatobi in 2022. Using Quasi qualitative data collection techniques using observation, in-depth interviews, and documentation. Informants, namely 1 key informant: Head of the Wakatobi District Health Office, 1 Supporting Informant is the Wakatobi KPAD, and 3 regular informants, namely the Head of Division and Head of the Prevention and Control of Infectious Diseases and Public Health Center officers in Wakatobi Regency. Based on the study results, shows that prevention efforts based on the Ottawa strategy have been implemented but have not been maximized. There are several dimensions: health-oriented policies, a supportive environment, Reorientation of Health Services, individual skills strategies, and Community Movements. Although not many activities have been carried out related to independent programs in HIV prevention and control, the Health Office and KPAD have included plans to approach existing risk groups so that they can realize positive behaviors for health. Based on the results of the study, HIV AIDS Prevention Efforts in Wakatobi Regency based on the Ottawa Charter still need to be improved and strengthened by the local government, especially the Health Service and KPAD. Several programs are still in the planning stages within the dimensions of the Ottawa Charter.

Intersectional Stigma Among People Transitioning From Incarceration to Community-Based HIV Care in Gauteng Province, South Africa.

People transitioning from incarceration to community-based HIV care experience HIV stigma, incarceration stigma, and the convergence of these stigmas with social inequities. The objective of this study is to understand intersectional stigma among people returning from incarceration with HIV in Gauteng Province, South Africa. Qualitative interviews were conducted with 42 study participants. We analyzed transcript segments and memos from these interviews. Our results showed that anticipated HIV stigma increased participants' difficulty with disclosure and treatment collection. Incarceration stigma, particularly the mark of a criminal record, decreased socioeconomic stability in ways that negatively affected medication adherence. These stigmas converged with stereotypes that individuals were inherently criminal "bandits." Male participants expressed concerns that disclosing their HIV status would lead others to assume they had engaged in sexual activity with men while incarcerated. AIDS education and prevention efforts will require multilevel stigma interventions to improve HIV care outcomes.

HUBUNGAN PENGETAHUAN IBU HAMIL TENTANG HIV/AIDS SERTA DUKUNGAN SUAMI DENGAN KESEDIAAN IBU DALAM MELAKUKAN VCT DI PUSKESMAS BALOI PERMAI KOTA BATAM.

A normal and healthy pregnancy is what every woman desires. Diseases experienced during pregnancy will be at risk for the baby. One of the most feared diseases is the Human Immunodeficiency Virus (HIV). The VCT strategy is at the core of all HIV / AIDS prevention and control efforts. Therefore, preventive service of HIV transmission from a mother to a child is one of the efforts to combat HIV and AIDS integrated with health services. The purpose of this study was to determine whether the Relationship between Knowledge of Pregnant Women and HIV / AIDS and the Support of Husbands in Their Willingness to Perform VCT. The research design used in this study was an Analytical Survey using the Cross Sectional approach. The study was conducted in April to August at the Public Health Center Baloi Permai in Batam. The population in this study was 273 respondents with a sample of 73 respondents, using a point time approach technique. Data collection using questionnaire instruments filled out by respondents. Data in tabular and textual form was analyzed using Chi-Square. The statistical test results obtained 66 respondents with good knowledge, husband less-support was 40 respondents and the willingness of pregnant women 73 respondents There is a significant relationship between Knowledge (p = 0,000) and husband support (p = 0.007) with the willingness of mothers to conduct VCT. It is expected to improve socialization about HIV / AIDS and VCT services at the Public Health Center and motivate health workers to play a role in increasing public knowledge about VCT testing through counseling in more creative ways. Hence, the community is interested in participating in these activities, and providing educative information so as to increase the knowledge of pregnant women related to VCT.

UPAYA PENCEGAHAN HIV/AIDS PADA WANITA PEKERJA SEKSUAL (WPS) DI KLINIK INFEKSI MENULAR SEKSUAL (IMS)

The problem that has developed in connection with HIV / AIDS infection is the high incidence and mortality. HIV / AIDS is a virus that causes disease by destroying the body's defense system so that sufferers do not have the ability to defend themselves from disease attacks. The aim of the study was to determine the HIV / AIDS prevention efforts of FSW at the IMS Clinic at the Gurah Health Center, Kediri Regency in 2019.Quantitative descriptive research design. The total population of all FSW who have not been exposed to HIV / AIDS who visited the STI Clinic at the Gurah Health Center, Kediri Regency in 2019. With a sample size of 39 and the sampling technique used accidental sampling. The instrument used was a questionnaire.Efforts to prevent HIV / AIDS among FSW include the use of male condoms where as many as 20 respondents (66.7%) sometimes use condoms, 24 respondents (80%) use condoms either, based on the use of female condoms as many as 21 FSW (70 %) never used, the way to use female condoms was 22 respondents (73.3%) good.It is hoped that health workers will increase the provision of information to the public regarding HIV / AIDS prevention efforts by using condoms so that the HIV / AIDS rate in Kediri Regency can be reduced.Â

Pengetahuan Dan Sikap Tentang HIV/AIDS Dan Upaya Pencegahan HIV/AIDS

ABSTRACT HIV / AIDS in adolescents is an important matter to consider, given the many behavioral problems adolescents are increasingly vulnerable to HIV / AIDS. The number of cases among adolescents against HIV / AIDS is caused by ignorance and indifference of adolescents. In Indonesia in 2018 HIV / AIDS was reported as many as 433 (84.2%). To determine the relationship between the level of knowledge about HIV / AIDS with HIV / AIDS prevention efforts in adolescents. The research is a type of quantitative research using a descriptive correlation design, a time approach using cross sectional, sampling techniques using simple random sampling. The sample in this study were 133 respondents. Data analysis used univariate analysis and bivariate analysis. Bivariate analysis using Chi Square test. Based on the Chi Square test there is a relationship between the level of knowledge about HIV / AIDS with HIV / AIDS prevention efforts in adolescents (P-value 0.004 <0.05) and there is a relationship between attitudes about HIV / AIDS with HIV / AIDS prevention efforts in adolescents (P -value 0.001 <0.05). Most respondents are well-informed, have a positive attitude, and take preventative measures. Students are expected to increase their knowledge by reading health books or accessing them through other information media so as to increase understanding of HIV / AIDS. Schools are expected to conduct health education programs or provide health information, one of which is about HIV / AIDS in order to increase knowledge and knowledge for students and facilitate library with more resources related to HIV / AIDS.

Integrasi Program Pencegahan HIV/AIDS melalui Transmisi Seksual ke dalam Sistim Kesehatan di Kota Kupang

Background: HIV and AIDS prevention efforts in Indonesia could not be denied that it is still influenced by global health initiatives. As global initiatives continue to decline, efforts to integrate HIV and AIDS programs into the framework of the national health system are both challenges and hopes for achieving program effectiveness and sustainability. This study aims to explore how far the integration of HIV transmission program through sexual transmission into the health system contributes to the effectiveness of programs at the Kupang City level. Method: The method used in this research is qualitative analysis with case study design as an effort to understand more deeply the relationship between the integration and effectiveness of AIDS prevention program. In this study the 'case' chosen was HIV prevention programs through sexual transmission for Female Sex Workers. Results: The results of the study showed that in the prevention of HIV transmission programs through sexual transmission as many as five sub-systems of health were partially integrated, including sub-systems of management and regulation, health financing, human resource management, provision of pharmaceuticals and medical devices and sub-systems for community participation management, while the strategic information sub sub-system is not integrated in the health system. The integration of some sub-systems into the health system does not contribute to the effectiveness of the program. Therefore, it was necessary to strengthen each sub-systim, especially in regions ranging from regulation, planning and budget including human resources to increase regional independence and not rely on foreign funds for the implementation of HIV prevention programs through sexual transmission, besides that it also increases collaboration with stakeholders.

Care and Support Programmes for Orphans and Vulnerable Children: Achievements and Implications of HIV/AIDS Funded Project in Osun State, Nigeria

Orphans and Vulnerable Children (OVC) and their families face many challenges but there are opportunities to provide care and support programmes for them in their communities. This paper presents the achievements and implications of HIV Programme Development Project (HPDP) funded by World Bank on care and support services for OVC in Osun State, Nigeria. Eight Civil Society Organisations (CSOs) were engaged by Osun State Agency for the Control of AIDS (OSACA) as part of HPDP to provide care and support services for OVC between year 2013 and 2015. Using reporting tools, data collected by the CSOs were entered into District Health Information System 2 (DHIS2) platform and analysed using Microsoft Excel. In addition, Key Informant Interviews (KII) were conducted among the selected CSOs, OVC and the caregivers who were beneficiaries of HPDP in Osun State, Nigeria. A total of 12,353 OVC were reached and about half of them were female. There was an increase in the trends of number of OVC seen and the support services provided from the year 2013 to 2015. Of the 12,353 OVC that benefitted from this programme, 1905 (15.4%) received health care services, 5383 (43.6%) received nutritional services, 5317 (43.0%) received educational services and 9861 (79.8%) were provided with psychosocial support services. About 503 (4.1%) of the OVC received economic strengthening services while 270 (2.2%) of household heads were provided with economic support. However, 3 OVC were lost to follow-up, 14 OVC voluntarily withdrew from the project and 6 OVC died. The FGD and KII revealed that the project was very impactful in transforming the lives of the OVC. Programmes for children orphaned and made vulnerable by HIV/AIDS will contribute to the achievement of HIV/ AIDS prevention and control efforts. The HIV/AIDS free generation can be built by responding to the physical, social and mental needs of these children and their families in their communities. There is a need to scale-up this programme.

IMPLEMENTASI KEBIJAKAN PERATURAN DAERAH NOMOR 2 TAHUN 2013 TERHADAP PENANGGULANGAN HIV DAN AIDS DI KABUPATEN SIDENRENG RAPPANG PROVINSI SULAWESI SELATAN

Kebijakan HIV and AIDS in Sidenreng Rappang the government's efforts to address HIV and AIDS, but the implementation of the policy can not suppress the spread of the disease. Efforts are being made consisting of prevention, treatment, and rehabilitation. This study aimed to describe the process of implementation of the HIV and AIDS policy that has been done by the government Sidenreng Rappang and to illustrate the effect of policy implementation against HIV and AIDS. This research uses descriptive quantitative method. The sampling technique is purposive sampling. Data collection methods used through observation, questionnaires (questionnaire) and technical literature. The data analysis technique that collected data is simple regression analysis with SPSS 21 for windows. The results of the analysis in the form of descriptive statistics, test data quality, classic assumption test, simple regression analysis and hypothesis testing. The results showed that, on a variable policy implementation in each indicator to get a percentage, ie, indicator policy provisions of 31.2%, an indicator of the implementing provisions are in percentages of 29.8%, an indicator of the target provisions that are in a percentage of 35.8 % and an indicator environment provisions that are in percentages of 31.5%, an indicator of the provisions in the category once or percentage of 38.2%. In the variable response to HIV and AIDS prevention efforts in the category ever with a percentage of 39%, the handling in the category ever with a percentage of 28.4% and rehabilitation efforts in the category ever with a percentage of 25.6%. Implementation of Government policy affects the response to HIV and AIDS in Sidenreng Rappang, 50.2% to be in good enough category.

(Re)politicising and (re)positioning prevention: community mobilisations and AIDS prevention in the new AIDS era

An increasing focus on the relationship between AIDS prevalence and socio-economic inequality signals the need for a revaluation of the role of “politics” and “power” in AIDS prevention. This revaluation bears great significance when considering the future trajectories of the AIDS prevention efforts that target highly marginalised populations with high prevalence rates. An emphasis on intersecting forms of inequality has direct implications for the future of AIDS prevention practice. This study explores the experiences of participants, facilitators and local stakeholders applying the United Nations Development Programme (UNDP) Community Capacity Enhancement-Community Conversations (CCE-CC) approach to AIDS prevention in the Eastern Cape province of South Africa. It uses the political narrative analysis of life histories and semi-structured interviews as a means to interrogate the lived experiences of local actors participating in or influenced by this popularised form of community mobilisation used throughout sub-Saharan Africa. Findings suggest the need for a more explicit and intentional valuation for the intersection between the social and political determinants of health in programmes that use community mobilisation as prevention. They also signal a need to critically re-evaluate “community mobilisation” as an AIDS prevention tradition. Intersecting social and political power dynamics play a significant role in both opening up and constraining community mobilisation efforts. This paper proposes the need for a pedagogical turn to “deep organising” and “participatory forms of democracy”, as a necessary frontier for programmes working with highly marginalised populations with high prevalence rates. Programmes need to more explicitly support, protect, and advocate for the ability of affected communities to engage in political processes, discourse and long-term organising.

Reaching the girls left behind

HIV and AIDS prevention efforts have relied heavily on providing information, and have sometimes provided a weak link to services, without perceiving or addressing the factors which make adolescent girls particularly vulnerable. Social factors, such as friendship networks, and economic factors, such as financial literacy and financial goals, independently but synergistically decrease girls’ risk of coerced sex or exchanges of sex for money, and increase their ability to cope in HIV-affected households. Current work focusing on HIV and youth is failing to reach many of the most vulnerable girls. This article discusses innovative interventions in four African countries, which explicitly address the distinctive social, economic, and cultural factors that shape girls’ vulnerability, and build up their health, social, and economic assets.

RESPONSE TO AMUNDSEN

Evidence of the effectiveness of AIDS prevention efforts has been constrained by the use of poor study designs, small sample sizes, short evaluation periods and a lack of control groups [1]. However, ‘These same flaws are common to a surprisingly high percentage of research in all areas of medicine, and are not necessarily more problematic in the AIDS area’[1]. These flaws are evident and have been acknowledged widely in the literature on the effectiveness of needle and syringe programmes (NSPs) [2,3]. In a recent editorial, Amundsen [4] relies on these limitations to question the status of NSPs as a ‘superior tool’ for HIV prevention and suggests that more emphasis be placed on testing and counselling to reduce risk behaviour in injecting drug users (IDUs). However, the evidence base for voluntary testing and counselling (VTC) is relatively weak compared to that supporting NSPs. VTC is most effective in reducing risk behaviours among serodiscordant heterosexual couples and those testing HIV positive [5]. While some studies show reductions in risk behaviour following a positive diagnosis [6], many indicate ongoing risk behaviour [7,8]. At best the effects of VTC are variable, with some [8–10], but not all [11], randomized controlled trials reporting a dose–response relationship, with greater reductions in risk associated with more intensive counselling. Evidence of beneficial effects in particular populations is especially weak [12], and many IDUs continue to engage in risk behaviours despite knowledge of their positive serostatus [13,14]. While some studies indicate that HIV-positive IDUs report less risk behaviour than those not tested or infected [15], a randomized trial [16] and a prospective study [17] found that VTC was not associated with a reduction in injection risk behaviour. To date, no trials have evaluated the impact of testing and counselling on HIV transmission, compared with no testing and counselling. However, prevention research is increasingly shifting its focus towards group and structural interventions that address the social and environmental contexts of risk [18] and the role of social networks and group dynamics [19]. The evidence to date suggests that VTC is clearly necessary, but not sufficient, in preventing the transmission of HIV and other blood-borne pathogens. As in other areas of medicine, evidence of the effectiveness of public health interventions is rarely clear-cut and policy makers have traditionally rejected putting all the eggs into a particular basket in favour of a range of interventions which, in turn, have different costs and varying levels of effectiveness. A recent study which examined the allocation of resources to NSP, methadone maintenance and condom distribution programmes targeting different population groups found that best allocations varied by epidemic scenario. In a setting characterized by 40% HIV seroprevalence among IDUs, allocating approximately 75% of the budget to NSP and 25% to a condom availability programme maximized the number of HIV infections averted. In a lower prevalence setting (5%), the best allocation expended almost all funds on methadone maintenance for HIV-positive IDUs [20]. NSPs are clearly a critical component of an effective harm reduction response. Unfortunately, questioning the efficacy of this vital public health tool on the basis of a lack of gold standard evidence may serve to undermine current attempts to scale up NSPs in settings where they are needed most.

UNAIDS Report: AIDS Epidemic Slowing, But Huge Challenges Remain

AIDS PREVENTION AND TREATment efforts are helping to slow the spread of HIV in some countries. But millions of new infections still occur each year and only a tiny fraction of the millions who are infected are receiving treatment, according to a report by the Joint United Nations Programme on HIV/AIDS (UNAIDS). An estimated 38.6 million individuals are currently living with HIV. Comprehensive data from the report show some progress in dealing with the pandemic has been made since 2001, when 189 countries signed the Declaration of Commitment, which outlined HIV prevention and treatment goals aimed at stopping and beginning to reverse the AIDS epidemic by 2015. But many countries are falling short and the epidemic continues to grow, particularly in Asia. The report (http://www.unaids.org /en/HIV_data/2006GlobalReport/default .asp) was released on May 30, the day before world leaders gathered in New York City for 3 days to review progress and discuss new goals at the United Nations General Assembly High Level Meeting on AIDS.

Sexual risks among southern thai drug injectors.

Sexual risks for HIV transmission among injection drug users (IDUs) in Thailand are not well characterized. We surveyed 272 male IDUs about their background, sexual behaviors, and drug use at drug treatment clinics in southern Thailand. HIV seroprevalence was determined using enzyme immunoassay. Fifty-six percent of participants were sexually active, of whom 88% had sex mostly with a noninjecting regular partner (wife or steady girlfriend), reporting low rates (34%) of condom use. Among sexually active IDUs, 43% were HIV infected and only a few were aware of their HIV serostatus. Condom use was associated with history of HIV voluntary counseling and testing (VCT) and poor perceived health status in multivariate analysis. Unprotected sex with regular sexual partners is frequent among IDUs in southern Thailand, where most IDUs have not sought VCT services. AIDS prevention efforts should address access to VCT and condom promotion to sexually active couples to prevent sexual transmission of HIV.

The San Francisco Bathhouse Battles of 1984

Summary In the mid-1980s, controversy emerged in a number of American cities over the roles gay bathhouses and sex clubs might play in the spread of AIDS, and in raising safe-sex awareness. In 1984, San Francisco became the first city where political debates broke out over AIDS-related policies for bathhouses and sex clubs. These debates were dominated by questions of public health and gay civil liberties. A variety of proposals were put forward during 1984 to try to reconcile these two concerns, or to give one a higher priority than the other. Certain officials in San Francisco's government, and members of its gay/lesbian/bisexual community, strongly disagreed over whether the businesses should be closed, should make their own AIDS-prevention efforts, or should continue operating under new regulations. Policies implemented for the city's baths were disconnected from the known AIDS risk of different sexual behaviors, and from research findings on AIDS and the local baths. Political and judicial decisions concerning San Francisco's bathhouses and sex clubs that were made in 1984 had continuing influences on these businesses through the later 1980s and the 1990s.

Needle sharing among southern Thai drug injectors.

To examine factors associated with needle sharing among injecting drug users (IDU) in southern Thailand. Using a cross-sectional survey, 272 active IDU were interviewed about their socio-economic background, needle sharing and drug use patterns at six drug-treatment clinics in southern Thailand. Ninety-one per cent of IDU gave a past history of ever sharing injecting equipment: of these, 23% currently injected but did not share and 68% still shared. Only 5% of participants knew that bleaching needles could reduce HIV transmission risks. Recent needle sharing was correlated with number of IDU friends (OR 12.23; CI, 5.24-28.51), engaging in illegal jobs (OR 2.74; CI, 1.13-6.67), being unable to use new needles at all times (OR 2.89; CI, 1.17-7.14) and believing that cleaning contaminated shared needles with at least plain water could reduce HIV transmission (OR 3.32; CI, 1.16-6.68). Our data suggest that AIDS prevention efforts should focus on approaches to reduce needle sharing. Needle exchange programs, HIV counseling and testing and bleach distribution may reduce levels of needle-sharing risks.

Risk factors for HIV infection among drug injectors in southern Thailand

Background: To determine HIV sero-prevalence and risk factors for HIV infection among injecting drug users (IDU) in southern Thailand. Methods: Using a cross-sectional HIV sero-prevalence and behavioral survey, 272 active IDU were interviewed about background, life-style, drug use patterns, and sexual behaviors at six drug-treatment clinics in southern Thailand. Results: Ninety-one percent reported lifetime needle sharing; 96% had tried HIV risk-reduction by either stopping/decreasing visits to sex workers and/or stopping/decreasing needle sharing. Only 5% knew that bleaching needles could reduce transmission risks. Overall, 51% tested HIV-positive (43% ethnic Thai vs. 64% ethnic Malay). HIV seropositivity among ethnic Thai was independently correlated with past history of needle sharing (OR 6.95; 1.89–25.58), injecting immediately at drug onset (OR 2.53; 1.25–5.13), and starting first injection at younger age (OR 2.61; 1.31–5.22). Injecting immediately at drug onset (OR 4.32; 1.23–15.14) and not carrying new needles (OR 4.47; 1.27–15.69) were risk factors among minority ethnic Malay. Conclusion: A high rate of HIV infection persists among southern-Thai IDU. HIV-infected individuals may act as a bridge of HIV transmission to their sex partners. AIDS prevention efforts should more intensely focus on minority ethnic Malays, discouraging needle sharing and increasing protected sex with regular sexual partners.

The Impact of AIDS on Intergenerational Relationships in Africa

This paper describes die impact of AIDS on intergenerational relationships in Africa (especially Sub-Saharan Africa). The AIDS infection in Sub-Saharan Africa has expanded astronomically with up to 18.5 million living with the disease. Young adults between the ages of 14 and 49 are most likely to be infected. In the countries of Sub-Saharan Africa, three levels of HIV/AIDS infection among adults can be identified-hardest hit, high, and moderate. This ranges from 3.6% for moderate level to 35.8% for the hardest hit. The situation has changed the youth population profile and has numerous quality of life implications for young people, older adults, and a multi-dimensional impact on community life. With the adverse socioeconomic and psychological effect of AIDS, interactions between members of the different generations are made difficult-relationships are becoming more of a burden than a mutual source of satisfaction. Children and young adults are losing their parents and mentors, and sometimes have to take care of their infected and dying parents at a very early stage in life. The older population is now losing its social and economic support, which hitherto, they have drawn from their adult children, and at the same time, they are assuming a new caregiving role to either their infected and affected children or grandchildren, or both. Hope exists if the trend is checked by AIDS prevention efforts with examples drawn from countries like Uganda, Senegal, and Nigeria. But since there are some victims already, efforts should be made to help them cope with the stress and adverse effects of the disease. Governmental policies should also aim at assisting victims and volunteers financially. As part of the strategy, intergenerational relationships at family, organizational and community levels should be strengthened. Reinforcing the value of being one's “brother's keeper” both as individuals and groups/organizations is crucial at this time of crisis.