Academic literature on the topic 'AIDS (Disease) – Economic aspects – Uganda'

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment. Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2. Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 – 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not. Discussion: Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge.

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment. Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2. Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 – 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not. Discussion: Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS based on Bloom’s cut-off point. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge.

SummaryThough HIV/AIDS poses serious risks to economic security, there is very little economics literature quantifying awareness and knowledge of this disease and their principal socioeconomic determinants. This is what the present study attempts to do in the context of India, which faces a significant threat from HIV/AIDS. The study is based on India's National Family Health Surveys covering the period of economic reforms and beyond. The contribution is both methodological and empirical. The study shows that the recent multi-dimensional deprivation approach to poverty can also be used to measure and analyse awareness and lack of knowledge of HIV/AIDS. The use of decomposable multi-dimensional measures helps in identifying regions, socioeconomic groups and aspects of HIV knowledge that should be targeted in policy interventions. The study identifies the importance of safe sex practices as an area that needs to be targeted in future information campaigns. The study also explores the impact of increased female autonomy in health and economic decision-making on their and their partners' knowledge of the disease, along with a host of other economic and demographic determinants.

OBJECTIVE: To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS: This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS: The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS: HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

Background: Malnutrition is an important clinical outcome amongst HIV patients in developing countries and in Uganda, there is scarcity of information on its prevalence and risk factors amongst HIV adult patients. Methods: A cross-sectional study amongst 253 HIV patients in Bushenyi district assessed their nutritional status using the body mass index (BMI) and mid-upper arm circumference (MUAC), and a questionnaire was used to identify major risk factors. Results: The mean age of the study participants was 38.74 ± 0.80 yrs, while females and males were 52.2% and 47.8% respectively. Prevalence of malnutrition was 10.28% (95% CI: 6.82 – 14.69) in the study. Major socio-economic factors associated with malnutrition were being female, unemployed, dependent and with many family members. Patients with op- portunistic infections, low adherence to HAART, and stage of HIV/AIDS had a higher risk of malnutrition. Discussion: In rural communities, a majority of malnourished patients are elderly and these were identified as priority groups for HIV outreach campaigns. The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communities. Conclusion: Malnutrition is a threat in HIV adult patients in rural communities of Uganda. Keywords: Malnutrition; HIV adult patients; Bushenyi district; Uganda.

There is a nationwide resurgence of tuberculosis (TB) in the country’s urban centers; New York City stands at the forefront of this resurgence. The root causes are increased homelessness, drug addiction and poverty, all symbols of deteriorating social and economic conditions in the city. The inadequate level of public health resources devoted to TB has also contributed to its spread. Still, even with these factors, it is questionable whether the escalating number of TB cases in this country would have occurred without the reservoir of immunosuppressed persons, who are less resistant to the disease, created by the AIDS epidemic. The fear and urgency of this public health crisis, which has been emerging since the beginning of the last decade, are fueled by the rise of TB strains resistant to the first-line drugs and by the disease’s contagiousness.

Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were conducted with 17 persons living with HIV who completed/interrupted depression treatment but had not been interviewed. Only data collected from persons living with HIV and lay health workers were analysed for the purpose of this paper. A narrative thematic approach was used in data analysis. Findings. There were several pathways through which lack of family social support reportedly led to depression: worries about disclosure in discordant relationships, false perceptions of social support, stigmatisation and discrimination, and domestic violence. Economic/poverty and other causes were identified, but their role was less significant or moderated by family social support. Conclusion. Family social support plays a dominant role—both directly and indirectly—in influencing depression risk. We propose the mainstreaming of formal psychosocial support and a shift from individual to family-focused counselling that targets both persons living with HIV and their family.

In March 2003, the world discovered, again, that I humanity's battle with infectious diseases continues. The twenty-first century began with infectious diseases, especially HIV/AIDS, being discussed as threats to human rights, economic development, and national security. Bioterrorism in the United States in October 2001 increased concerns about pathogenic microbes. The global outbreak of severe acute respiratory syndrome (SARS) in the spring of 2003 kept the global infectious disease challenge at the forefront of world news for weeks. At its May 2003 annual meeting, the World Health organization (WHO) asserted that SARS is “the first severe infectious disease to emerge in the twenty-first century” and “poses a serious threat to global health security, the livelihood of populations, the functioning of health systems, and the stability and growth of economies.”

In the United States, health disparities have been framed by categories of race. Racial health disparities have been documented for cardiovascular disease, cancer, diabetes, HIV/AIDS, and numerous other diseases and measures of health status. Although such disparities can be read as symptoms of disparities in healthcare access, pervasive social and economic inequities, and discrimination, some have suggested that the disparities might be due, at least in part, to biological differences based on race. Or, to be more precise, if race itself has no determined biological meaning, race may nonetheless be a proxy that collects a group of individuals who share certain physiological or genotypic features that affect health.

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The purpose of this study was to investigate how rural Ugandan women engage with discussions of HIV and AIDS on community radio. It explored how this audience may relate such broadcast discussions to their own lived experience of HIV and AIDS. It is explained in the study that, while the Uganda government has an official policy of openly discussing matters of HIV and AIDS, health communication strategies still operate within a context where there is an underlying "culture of silence" that discourages openness about sexual matters. It is also pointed out that there are widespread gender disparities among rural communities, which severely limit women's ability to make use of health communication initiatives aimed at educating them. Against this backdrop, the study sets out to explore audience responses to a particular example of Speak Out and Listen, a weekly programme broadcast on Mama FM, a Kampala-based radio station managed by the Uganda Media Women's Association (UMWA). The study maps out responses to the programme by a particular group of rural women. It is argued that these research participants' comments confirm the importance, noted in literature dealing with health education, of drawing for content on what members of an audience have to say about their own lived context. It is proposed that, despite the existence of a 'culture of silence', the women's comments demonstrate an ability to speak with confidence about their experience of living with HIV and AIDS. Thcy are able, more particularly to discuss the constraints placed by gendered power relations on women's ability to draw on the educational content of programming that targets people living with HIV and AIDS. As such, the comments that such women offer represent a valuable resource for HIV and AIDS related programming. The principal conclusion of the study is that health communication initiatives such as Speak Out and Listen would benefit from facilitating conversations with their target audience about their lived experience of HIV and AIDS, and incorporating such discussion into their programmes

This study is a qualitative ethnographic investigation of how teenagers in Kampala, Uganda, who read the HIV/AIDS publication aimed at adolescents, Straight Talk, negotiate HIV/AIDS messages. It seeks to establish to what extent these secondary school teenagers accept the key messages (known as ABC; Abstain, Be faithful or use a Condom) and understand the factual aspects of the messages about HIV/AIDS, its process of transmission and prevention. It also seeks to probe how the lived realities of the teenagers affect their particular negotiations of the HIV/AIDS messages. It includes a focus on how proximity to HIV/AIDS, gender and family economic disposition might affect teenagers, negotiation of the HIV/AIDS meanings. To investigate the respondents’ reception of HIV/AIDS messages, the study employed focus groups that consisted of two stages, namely the ‘news game’ and group discussions. In the ‘news game’ stage (Philo, 1990; Kitzinger, 1993) the teenage participants were required to produce a version of a one-page copy of an HIV/AIDS newspaper targeting teenagers. In the second stage of the focus group a structured discussion probed the teenagers’ negotiation of the HIV/AIDS media messages. In the news game, the teenagers on the whole reproduced the key Straight Talk HIV/AIDS messages ‘Abstain, Be faithful or use a Condom’ and also images showing the effects of HIV/AIDS but featured fewer images depicting the factual aspects of HIV/AIDS process of transmission and risky behaviour. In the structured discussion that followed the news game, it was evident that not all the teenagers necessarily believed the messages they produced. In spite of producing the ABC Straight Talk messages, some of them were uncertain and confused about the absolute safety of the condom because of fears that they were either porous, expired or would interfere with sexual pleasure. Secondly, though many of the teenagers in the study reproduced images that showed that they consider marriage as desirable and talked about their desire to abstain from sex till marriage, a considerable number think abstinence is not achievable due to competing values. Thirdly, the participant teenagers could differentiate between HIV and AIDS but many did not realise that with the advent of anti-retroviral drugs even people who have AIDS can look normal. In spite of repeating the Straight Talk message that “no one was safe” and being aware of the risky behaviour that their fellow teenagers get involved in, the teenagers seemed to think that their age cohort is safe from HIV and it is the adults who are likely to infect them. The study findings further indicate that the teenagers’ lived experience at times influence their negotiation of HIV/AIDS media messages. This was probed in terms of economic standing, gender and proximity to HIV/AIDS. In relation to gender one surprising discovery was that certain girls in the study feared getting pregnant more than getting HIV/AIDS. The study finally suggests that these findings are of significance for designing future media initiatives in relation to HIV/AIDS.

The way gender relations influence access to care and treatment particularly access to antiretroviral medicines is a challenge to HIV/AIDS programmes and to the individuals and families with HIV. Gender norms that push women and men to adhere to dominant ideals of femininity and masculinity may restrict women's access to economic resources, health care and fuel the spread of HIV. The aim of this study was to determine the role of gender relations in influencing decision-making for access to antiretroviral medicines between partners and in the family.

Thesis (MComm)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: South Africa faces one of the world's most severe HIV/AIDS epidemics. Whereas the disease was initially only regarded as a serious health crisis, it is now clear that the epidemic will also have economic repercussions. The objective of this study is to project the extent of the macro-economic impact of HIV/AIDS in South Africa over the next 10 to 15 years. The study commences with a discussion of the key characteristics of HIV/AIDS and the current status of the epidemic in South Africa. The demographic inputs used are based on projections produced by the HIV/AIDS model of Metropolitan Life (the Doyle model). The methodology and key assumptions behind the Doyle model are described briefly, after which the demographic projections are presented and discussed. The paper contains a summary of previous approaches to modelling the economic impact of HIV/AIDS, as well as a presentation and discussion of their simulation results. In reviewing the available literature on the economic impact of HIV/AIDS, it becomes apparent that researchers have not yet reached consensus on the economic impact of HIV/AIDS in South Africa - estimates of the impact on GDP growth range anywhere between a reduction of 0.3 and 2.0 percentage points over the next 10 to 15 years. The approach that is used in modelling the economic impact of HIV/AIDS in this study comprises the following: Firstly, a no-AIDS forecast of the South African economy is generated using the annual macro-econometric forecasting model of the Bureau for Economic Research. Secondly, the channels through which the epidemic would likely impact on the economy are identified and modelled. These include slower growth in the population and the labour force; higher employee benefit contributions by employers and employees; indirect costs to the private and public sectors (e.g. lower productivity and higher recruitment and training costs); and higher health and welfare expenditure by the government, as well as an increase in tax rates. The economic effects of each impact channel are analysed independently, after which the different impact channels are combined in the model for the aggregated AIDS inclusive simulation. The results are presented in the form of comparisons between "no-AIDS" and "AIDS" projections for key economic variables for the period 2001 to 2015. The paper also contains results from a macro-economic sensitivity analysis, in which seven of the key assumptions are altered in order to test the sensitivity of the model to these changes. Simulation results indicate that the epidemic will have a negative impact on economic growth in South Africa - real GDP growth could fall from a projected average of 3.7% over the period 2002-2015 without HIV/AIDS to between 3.4% and 3.1 % per year with HIV/AIDS. In contrast, real per capita GDP growth is projected to be 0.7 to 1.0 percentage points higher compared to a no-AIDS scenario, as the adverse impact of the epidemic on the population will outweigh the negative impact on real GDP.
AFRIKAANSE OPSOMMING: Suid-Afrika staar een van die wêreld se ernstigste MIV/VIGS epidemies in die gesig. Aanvanklik is die siekte slegs as 'n erge gesondheidskrisis beskou, maar vandag is dit duidelik dat die epidemie ook ekonomiese gevolge sal hê. Die oogmerk van hierdie studie is om die omvang van die makro-ekonomiese impak van MIV/VIGS oor die volgende 10 tot 15 jaar in Suid-Afrika te beraam. Die proefskrif begin met 'n bespreking van die belangrikste eienskappe van MIV/VIGS en die huidige stand van die epidemie in Suid-Afrika. Die demografiese insette wat gebruik word, is gebaseer op projeksies van Metropolitan se MIV/VIGS model (die Doyle model). Die metodiek en die sleutel aannames van die Doyle model word kortliks bespreek, waarna die demografiese projeksies aangebied en bespreek word. Die studie bevat 'n opsomming van benaderings wat van te vore gebruik is om die ekonomiese impak van MIV/VIGS te modelleer, asook 'n voorlegging en 'n bespreking van hul resultate. 'n Oorsig van beskikbare literatuur oor die ekonomiese impak van MIV/VIGS bring aan die lig dat daar in werkilikheid nog geen konsensus oor die omvang van die impak op die Suid-Afrikaanse ekonomie bereik is nie. Beramings van die impak op BBP groei oor die volgende 10 tot 15 jaar wissel van 'n vermindering met 0.3 tot 2.0 persentasie punte. Die benadering wat in hierdie studie gevolg word om die ekonomiese impak van HIV/VIGS te modelleer behels die volgende: Eerstens word 'n vooruitskatting van die Suid- Afrikaanse ekonomie sonder MIV/VIGS gegenereer met die hulp van die makroekonometriese vooruitskattings model van die Buro vir Ekonomiese Ondersoek. Die tweede stap behels die identifisering en die modellering van die verskillende kanale waardeur die epidemie moontlik die ekonomie kan affekteer. Dit sluit onder andere die volgende in: stadiger groei in die populasie en die arbeidsmag; hoër bydraes deur werkgewers en werknemers aan werknemer-bystandfondse; indirekte onkostes vir die privaat en openbare sektore (bv. laer produktiviteit en hoër werwings- en opleidings koste); 'n toename in staatsbesteding op gesondheids en welsyns dienste; asook 'n styging in belastingkoerse. Die ekonomiese implikasies van elkeen van die kanale word individueelontleed, waarna die verskillende kanale saamgevoeg word vir die oorkoepelende simulasie. Die resultate word aangebied in die vorm van vergelykings tussen "geen-VIGS" en "VIGS" projeksies vir sleutel ekonomiese veranderlikes oor die periode 2001-2015. Die proefskrif bevat ook 'n voorlegging van die resultate van 'n makro-ekonomiese sensitiviteits ontleding, waarin sewe van die sleutel aannames verander is met die doelom die gevoeligheid van die model vir hierdie veranderinge te bepaal. Die resultate toon dat die epidemie 'n negatiewe uitwerking op ekonomiese groei in Suid-Afrika sal hê - die gemiddelde groeikoers in die reële BBP oor die periode 2001-2015 mag daal van 'n geprojekteerde 3.7% sonder MIV/VIGS tot tussen 3.4% en 3.1 % met MIV/VIGS. In teenstelling toon die resultate dat die gemiddelde groeikoers in per capita reële BBP tussen 0.7 en 1.0 persentasie punte hoër mag wees vergeleke met die "geen-VIGS" scenario. Die toename in per capita BBP groei kan toegeskryf word aan die skerp daling in die groei van die populasie as gevolg van MIV/VIGS.

This study proposed a modification of the traditional cost-of-illness approach. It considered additional indirect cost parameters that yield a comprehensive cost structure for human capital at a micro level. Although HIV/AIDS is an epidemiological problem, it has enormous direct and indirect economic costs. Arguably, the most important cost associated with HIV/AIDS results from the high rates of morbidity and mortality among working age adults, the vast majority of those infected. These are essentially losses in an economy's existing stock and potential accumulation of human capital, implying lower levels of labor productivity and eventually loss of labor. These impacts are accounted for in existing macroeconomic and microeconomic impact studies. Indirect costs, such as forgone earnings due to illness, are included whereas forgone earnings of caregivers in the household are unaccounted for.

The aim of this study was to capture the intensity and incidence of catastrophic health care expenditures in order to describe the degree to which catastrophic health care payments occur among households. Simultaneously, the study set out to assess the extent to which people are made poor or poorer by health spending, i.e. the impoverishing effects of healthcare spending.

Thesis (MBA)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: HIV/AIDS is one of the biggest challenges faced by many countries in this century. The rate of infection is rapidly increasing and more and more people are getting ill and dying from AIDS. Of all the people living with AIDS in the world, seven out of ten live in Sub-Saharan Africa. Namibia is one of the top five most HIV/AIDS affected countries in the world. There is therefore no question about the urgent need to accelerate actions to reduce prevalence, expand care and support and extend access to treatment. AIDS is eroding decades of progress made in extending life expectancy; thus hundreds of adults are dying young or in early middle age. The national strategic plan (2004) on HIV/AIDS indicated that the average life expectancy in Namibia is now 42 years, when it could have been 60 without AIDS. A 2003 study on the impact of HIV/AIDS on Windhoek indicated that the antenatal HIV/AIDS prevalence rate in Windhoek for 2002 was 27%, while the national prevalence rate was estimated at 22.3%. The prevalence rate for Windhoek is expected to reach its peak at 38% during 2005. Even though HIV/AIDS will have a diminishing effect on population growth, Windhoek's population is expected to continue growing, particular as a result of inward migration, but at a slower pace. Similarly, HIV/AIDS will have an abating effect on GDP growth as the virus will mainly affect the economic active and available labour force of the population and result in increased labour costs and skilled labour shortages. The impact on the informal sector is potentially more damaging than on the formal economic sector, as the majority of micro- enterprises and informal businesses are build around one individual. As the breadwinner dies, household income and expenditures levels deteriorate and increase poverty levels, because households within the city are very dependent on family structures to support their income levels. Informal settlements are also more volatile to HIV transmission and the majority of HIV infected individuals are likely to be found within these areas as the populations is poorer, crowded, has fewer social services facilities and is more likely migratory compared to those in affluent formal settlements. Considering that the incubation period of HIV/AIDS from infection to death takes about ten years, the real impact of current HIV infections in Windhoek will only be experienced during 2010. Health services will have to attend to a greater demand for curative services as well as to social care and support programs. Social welfare programmes will need to find ways of caring for a large population of HIV/AIDS orphans. Municipalities can playa critically important role in addressing HIV/AIDS at a local level as they are at the interface of community and government. They are ideally placed to playa coordinating and facilitating role that is needed to make sure that partnerships are built to bring prevention and care programmes to every community affected by AIDS. Therefore, in order to succeed in confronting HIV/AIDS, it is important to work closely with all levels of government as well as working with local partners in civil society that are fighting HIV/AIDS at the community level. By taking action against HIV/AIDS, municipalities are securing the future of their towns and communities.
AFRIKAANSE OPSOMMING: MIV/VIGS is een van die grootste uitdagings wat baie lande hierdie eeu in die gesig staar. Die koers van infeksie is vinnig aan die toeneem en al hoe meer mense word siek en sterf as gevolg van VIGS. Van al die mense wat met VIGS lewe in die wêreld, bly sewe uit tien in sub-Sahara Afrika. Namibië is een van die vyf mees MIV/VIGS geaffekteerde lande in die wêreld. Derhalwe is daar geen twyfel rakende die noodsaaklikheid om daadwerklike aksies te bewerkstellig om die voorkoms te verminder, sorg en ondersteuning te verhoog en toegang na behandeling uit te brei. VIGS vernietig dekades van groei behaal in die verlenging van lewensverwagting; dus sterf honderde volwassenes vroeg of gedurende hul middeljare. Die nasionale strategiese plan (2004) rakende MIV/VIGS toon dat die gemiddelde lewensverwagting in Namibië huidiglik 42 jaar is instede van 60 sonder VIGS. 'n Studie onderneem gedurende 2003, rakende die effek van MIV/VIGS in Windhoek, dui aan dat die voorgeboorte MIV/VIGS voorkoms koers 27% vir 2002 was, terwyl die nasionale voorkoms koers slegs 22.3% was. Daar word verwag dat die voorkoms koers vir Windhoek sy maksimum van 38% sal bereik gedurende 2005. Alhoewel MIV/VIGS 'n negatiewe effek op bevolkingsgroei groei gaan het, sal Windhoek se inwoners getalle steeds groei, alhoewel teen 'n stadiger koers, as gevolg van inwaartse migrasie. Terselfdertyd, gaan MIV/VIGS 'n verminderde effek het op die groei van die Bruto Binnelandse Produk (BBP), omdat die virus hoofsaaklik die ekonomiese aktiewe en beskikbare arbeidsmag van die bevolking affekteer wat as gevolg hiervan 'n verhoging in arbeidskoste en tekort aan geskoolde arbeid het. Die effek op die informele sektore is potensieel meer skadelik as op die formele ekonomiese faktore, aangesien die meeste klein en informele besighede rondom een persoon gebou is. lndien die broodwinner sterf, versleg die vlakke van huishoudelike inkomste en uitgawes wat lei tot verhoogde armoede, omdat huishoudings in die stad baie afhanklik is op familie strukture om hulle inkomste te ondersteun. Informele vestigings is meer kwesbaar in die oordrag van MIV en die meerderheid van die MIV geïnfekteerde individue word gewoonlik in hierdie areas aangetref omdat die bevolking armer is, meer persone huisves, minder welsyn dienste fasiliteite het en meer swerwend is in vergelyking met die meer welgestelde formele vestigings. As in ag geneem word dat die ontkiemings periode van MIV/VIGS vanaf infeksie tot en met sterfte omtrent tien jaar neem, sal die werklike effek van die huidige VIGS besmettings in Windhoek slegs ervaar word gedurende 2010. Gesondheidsdienste sal moet aandag skenk aan 'n groter aanvraag vir geneeslike dienste sowel as sosiale sorg en ondersteunings programme. Gemeenskaplike welsyn programme sal maniere moet vind om vir 'n groot populasie van MIV/VIGS weeskinders te sorg. Munisipaliteite kan 'n belangrike rol speel in die aanspreek van die MIV/VIGS epidemie op 'n plaaslike vlak omdat hulle die skakel is tussen die gemeenskap en die regering. Hulle is ideaal geplaas om 'n koordineerende en fasiliterende rol te speel wat nodig is om seker te maak dat vennootskappe gebou word om voorkomings en versorgings programme te lewer aan elke gemeenskap wat deur MIV/VIGS geraak word. Dus, om sukses te behaal in die bekamping van MIV/VIGS , is dit belangrik om nou saam te werk met alle vlakke van die regering sowel as met plaaslike vennote in die gemeenskap wat MIV/VIGS bekamp op gemeenskapsvlak. Deur aksie te neem teen MIV/VIGS , kan munisipaliteite die toekoms van hulle dorpe en gemeenskappe verseker.

The aim of this research was to provide a preliminary investigation of how the HIV and AIDS epidemic will impact on management of municipalities, specifically George Municipality. Municipalities provide a large proportion of essential basic services and also represent one of the primary opportunities for public participation and decision-making at a community level. This paper takes George Municipality in the Western Cape as a case study of the current and potential impact of HIV and AIDS on public demand for services and on the municipality's capacity to govern and provide services. It also reviews the responses of the municipality to HIV and AIDS.The research was conducted using a questionnaire which was distributed to municipal officials in the different departments but also included a review of relevant literature and analysis of quantitative data. The study focused on a single case: An investigation into the impact of HIV and AIDS on municipal management of George Municipality. The study identified strategies utilised by the municipality to reduce the impact of HIV and AIDS. The study drew on people's experiences, perceptions and interpretations of the impact of HIV and AIDS on municipal management, responses and any other related factors that may have impeded the realisation of the reduction of the impact of HIV and AIDS on municipal management in the George Municipality.Fifty questionnaires were distributed, 40 copies by hand delivery and ten copies via e-mail to employees ranging from general worker to senior management. Employees participated in the study through interviews and answering of the questionnaires. An internet search was also conducted using Wed Crawler and by visiting the official website of the George Municipality for all policies, minutes, reports and all other relevant documents regarding HIV and AIDS. The researcher also drew on personal observations because she has been in George for almost six years and is also employed by George Municipality. Participants who were selected by the researcher for interviews purposes were five councillors and five ward committee members because councillors are decision makers in the municipality. The rest were given questionnaires to complete. Data was analysed by using interpretation analysis, namely codes to explain data collected. Results were presented in the form of tables and conclusions warranted by the data are presented. Statistical analysis was done to check correlation between the different aspects in the questionnaire. According to the research findings it can be confirmed that more of the budget needs to be allocated for employment of suitably qualified persons like occupational nurses, who will drive HIV and AIDS education and awareness campaigns. HIV and AIDS mainstreaming should be regarded as a priority in order make people aware about the realities of HIV and AIDS in communities. Leadership and management buy-in should be obtained to win the fight against the epidemic. A comprehensive strategy should be compiled and implemented to reduce the spread and stigma of HIV and AIDS. Proper planning should be done for compiling the strategy. This strategy should specify the budget for HIV and AIDS and how HIV and AIDS is going to be integrated into an IDP. Prevention and management strategies used by the organisation should be explained.

Thesis (MBA)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: HIV infection has increased sharply in SA over the past decade, from almost zero to a level where between 4-6 million citizens are estimated to be HIV positive (i.e. around Il percent of the total population). Given the considerable lag and link between the HIV and AIDS epidemic, the mortality consequences of this exponential increase in HIV infection over the 1990s are more or less matter-of-fact over the coming decade; even drastic interventions can do little to avoid this reality, albeit possibly impactingfurther beyond. The health care industry, and more specifically the pharmaceutical industry, is the only industry that can have a direct impact on the outcome of the epidemic in terms of provision of antiretroviral drugs. More importantly, the decision by multinational companies to provide voluntary licensing to local SA pharmaceutical manufacturers for the manufacturing of generic ARVs has gone a long way into achieving the World Health Organisations' objective of providing an ARV cocktail for less than $1,00 per day. The mam aim of the study is to establish and study the micro-economic effect of HIV/AIDS on a South African pharmaceutical manufacturer and to evaluate their HIV/AIDS Policy with the framework of the mV/AIDS & SID Strategie Plan for South Africa 2000-2005. Both qualitative and quantitative methods were used to obtain data from various key informants, manufacturers and market survey companies. The analysis of quantitative data was done using Excel software and a descriptive analysis method was used to interpret the data. The key findings from the study are that Aspen Pharmacare will experience a 20,8 % HIV prevalence rate in 2005, which will progressively increase to a 25,6 % level in 2015. This prevalence level will be severely experienced in the skilled, semi-skilled and unskilled employment of the company during the 2010 period and will start to stabilise in the latter part of 2015. The AIDS prevalence in the company will increase from a 2,0 % level in 2005 to a 4,4 % level in 2015. This increase is largely due to the increase in the prevalence rates in the semi-skilled and unskilled employees. At a senior management level the forecasted number of employees that will have clinical AIDS after 2010 is between 6 and 8. This clearly indicates that mv/AIDS prevalence at this level is independent of race and is lifestyle dependent. If the company were to have the full responsibility for the provision of benefits, based on the current expected employee benefit structures, the direct cost to company would add 10 % to salary and wages by 2005 and around 20 % by 2010. Indirect costs to company, such as recruitment and training, increased labour turnover, lost skills and intellectual property, etc. are estimated to be 2,5 % by 2005 and 5 % by 2010. With the high HIV/AIDS prevalence rates, especially amongst the unemployed, companies will have to carry the costs of their mv/AIDS patients for longer and register then with Aid for AIDS when it becomes too costly. More importantly employers will have to investigate the cost implication of assisting employee dependents, as this will have a direct impact on the morale of the employees. Aspen Pharmacares' mv/AIDS Policy goes beyond the requirements of the mv/AIDS Strategic Plan for SA in terms of the legal and social requirements. The company also has a Corporate Social Investment division that assists many NGOs, clinics, hospitals and communities. Based on the intellectual property, the pharmaceutical competencies and the continuous dialogue that exists between the pharmaceutical industry and the department of health, the researcher concludes, that pharmaceutical companies have an advantage over nonpharmaceutical companies in dealing with the mv/AIDS issues. The paper concludes by suggesting recommendations that companies can adopt to ensure that their mv/AIDS policy can form a significant component of their skills retention strategy.
AFRIKAANSE OPSOMMING: MIV infeksie het skerp gestyg in SA oor die laaste dekade, vanaf amper geen tot 'n vlak waar tussen 4-6 miljoen inwoners beraam word om MIV positiefte wees (minstens 11% van die totale bevolking). Gegee die aansienlike vertraging en skakel tussen die MIV en VIGS epidemie, word die eksponensiële toename in die sterfte syfer as gevolg van MIV infeksies gedurende die jare negentig as vanselfsprekend aanvaar in die komende dekade. Selfs ingrypende veranderinge kan min doen om hierdie katastrofe te keer. Die gesondheidsorg industrie, en meer spesifiek die farmaseutiese industrie is die enigste industrie wat 'n direkte slag kan slaan om die uitkoms van die epidemie te beinvloed, in terme van voorsiening van antiretrovirale medisyne. Die besluit van die multinasionale maatskappye om vrywillige lisensiëring aan plaaslike farmaseutiese maatskappye te bied, vir die vervaardiging van generiese antiretrovirale medisyne, is een stap vorentoe om by die doelwit van die Wereld Gesondheidsorg Organisasie se doelwit van die voorsiening van 'n daaglikse toediening van antiretrovirale medisyne van minder as $1.00 per dag. Die primêre doelwit van hierdie projek is om te bepaal wat die mikro-ekonomiese effek van MIV/VIGS op 'n Suid Afriakaanse farmaseutiese vervaardiger is en hul MIV/VIGS beleid te evalueer binne die raamwerk van die MIV/VIGS en SOS Strategiese Plan vir SA 2000-2005. Beide kwalitatiewe en kwantitatiewe metodes is gebruik om data te verkry vanaf verskeie bronne, vervaardigers en marknavorsings maatskappye. Die kwantitatiewe inligting was geanaliseer deur gebruik te maak van "Excel" sagteware en 'n beskrywende analitiese metode was gebruik om die data te interpreteer. Die hoof bevindinge van die studie is dat Aspen Pharmacare 'n MIV infeksie vlak van 20.8 % in 2005 sal ondervind, wat progressief sal toeneem tot 25,6 % in 2015. Hierdie infeksie vlak sal in die geskoolde, semi-geskoolde en ongeskoolde arbeid die ergste voorkom gedurende die 2010 periode en sal dan stabiliseer in die latere gedeelte van 2015. Die VIGS infeksie vlak in die maatskappy sal toeneem vanaf 2,0 % in 2005 tot 'n 4,4 % in 2015. Hierdie toename kan toegeskryf word aan die toename in die infeksie vlakke van die semi-geskoolde and ongeskoolde arbeid. Op die senior bestuurs vlak word beraam dat tussen 6 en 8 werknemers VIGS onder lede sal hê na 2010. Hierdie beraming toon duidelik aan dat MIV/VIGS op hierdie vlak onafhankilik van kleurgroup is en direk leefstyl verwant is. Gebaseer op die huidige verwagte werknemer voordele struktuur, en die feit dat die maatskappy volle verantwoordelikheid sou aanvaar vir die voorsiening van voordele, word beraam dat die direkte koste as gevolg van MIV/VIGS 'n toename van 10 % in 2005 en 20 % in 2010 by salarisse en lone sal voeg. 'n Toename van 2,5 % in 2005 en 5 % in 2010 word beraam vir indirekte koste (werwing van personeel, opleiding, ens.)as gevolg van MIV/VIGS. Met die hoë MIV/VIGS infeksievlakke, veral onder werkloses, sal maatskappye die kostes vebonde aan hul MIV/VIGS werknemers vir langer moet verduur en dan later sulke werknemers registreer by "Aid for AIDS" indien dit onbekostigbaar word. Belangriker is die feit dat werknemers die koste implikasie bepaal in die verband, omdat dit 'n direkte invloed sal hê op werknemer selfvertroue. Aspen Pharmacare se MIV/VIGS beleid bied meer as die wettige en sosiale vereistes soos uiteengesit in die MIV/VIGS en SOS Strategiese Plan vir SA 2000-2005. Die maatskappy het ook 'n Korporatiewe Maatskaplike Beleggings afdeling wat 'n bydra lewer by NGOs, klinieke,hospitale en gemeenskappe. Gebaseer op die intelligensie eiendom, die farmaseutiese bekwaamheid en die aanhoudende gesprekvoering wat bestaan tussen die farmaseutiese bedryf en die department van gesondheid, oortuig die navorser dat farmaseutiese maatskappye 'n voordeel het bo nie-farmaseutiese maatskappye in die hantering van die MIV/VIGS strydvraag. Hierdie studie sluit af met aanbevelings wat maatskappye kan toepas om te verseker dat hul MIV/VIGS beleid 'n betekenisvolle komponent van hul bekwaanheids retensie strategie is.

AbstractA key component of current global HIV prevention efforts is widespread HIV testing. This strategy in part reflects the focus on the broader global targets to eliminate AIDS by achieving high rates of viral suppression. In this chapter we look at young people’s engagement with HIV prevention options in South-West Uganda. Taking a qualitative approach, using repeat in-depth interviews and participatory workshops with 50 young people aged 16–24 years old, we reflect on their accounts of how they navigate risks and opportunities within their daily lives. These risks include HIV-acquisition, but also the harms of economic precarity. Within a context in which using HIV prevention methods, such as condoms or abstinence, were for various reasons severely compromised by their contextual realities, some young people reported relying on irregular HIV testing as their singular method. The young people’s accounts demonstrate that an unintended consequence of the ‘push’ for HIV testing may be the justification of its replacement of other behavioural prevention strategies. This case study illustrates what impact such biomedical interventions may have if implemented as a priority and in isolation from the structural drivers of vulnerability: the social context of young people’s lives.

This Chapter reviews and discusses the experiences of Uganda and the lessons learnt during the successful implementation of its HIV/AIDS Control Program. The major mode of transmission was by the heterosexual route. Control measures thus emphasized behavior change and sexual discipline that promoted faithfulness and monogamous sexual relationships. This chapter examines the factors responsible for the positive outcomes in the implementation of the national AIDS control strategy. The review is based on literature, reports and personal experience. The Uganda Program AIDS in the Ministry of Health (MOH) was one of the earliest AIDS Control Programs in the world. A cumulative total of nearly 2 million people have been infected since the onset of the outbreak in 1982. Some one million HIV related deaths also occurred. When the National AIDS Control Program was initially rolled out in the country there was no cure and the disease was like a death sentence. The available evidence then demonstrated heterosexual transmission as the major mode of spread. Interventions based on the promotion of Abstinence, Being faithful, and Condom use (ABC strategy) were the main components of the strategy in the public campaigns. This complex disease also impacted society and the social fabric deeply. The activities were expanded to include the socio and economic dimensions of HIV/AIDS. Later on the combination strategy integrating biomedical and social behavior change strategies offered new and more encompassing opportunities. The introduction of the antiretroviral therapy (ART) and availability of simplified tests for detection of the viral load status improved treatment and restored hope. Social support and programs for reduction of stigma opened up participation by people living with HIV/AIDS. A community based intersectoral and decentralized strategy reached every village and assured community engagement and involvement. Drastic and steady declines in prevalence and incidence followed. Cases have been declining steadily and prevalence and incidence rates continue to drop and reverse the HIV status in the country. Community Engagement strategy to promote monogamous sexual behavior and the introduction of the highly active retroviral treatment significantly consolidated to the successful outcomes.

Palliative care of persons with HIV and AIDS has changed over the course of the first three decades of the pandemic. The most radical shifts occurred in the second decade with the introduction of combination antiretroviral therapy and other advances in HIV care. In the United States and throughout the world, progress in prevention of HIV transmission has not kept pace with progress in treatment, thus the population of persons living with AIDS continues to grow. Furthermore, economic, psychiatric, social, and political barriers leave many persons without access to adequate HIV care. As a result, persons who lack access to care may need palliative care for late-stage AIDS while persons with access to AIDS treatments are more likely to need palliative care for multimorbid medical illnesses such as cardiovascular disease, cancer, pulmonary disease, and renal disease. Palliative care of persons with HIV and AIDS cannot be confined to the end of life. We present palliative care on a continuum as part of an effort to alleviate suffering and attend to pain, emotional distress, and existential anxiety during the course of the illness. We will provide guidelines for psychiatric and palliative care and pain management to help persons with AIDS cope better with their illnesses and live their lives to the fullest extent, and minimize pain and suffering for them and their loved ones. This chapter reviews basic concepts and definitions of palliative and spiritual care, as well as the distinct challenges facing clinicians involved in HIV palliative care. Finally, issues such as bereavement, cultural sensitivity, communication, and psychiatric contributions to common physical symptom control are reviewed. The terms palliative care and palliative medicine are often used interchangeably. Modern palliative care has evolved from the hospice movement into a more expansive network of clinical care delivery systems with components of home care and hospital-based services (Butler et al., 1996; Stjernsward and Papallona, 1998). Palliative care must meet the needs of the “whole person,” including the physical, psychological, social, and spiritual aspects of suffering (World Health Organization, 1990).

In the previous ten years in the EU, the youth have become one of the priority groups that is being strengthened for more intensive involvement in the life and development of society. Research has shown that the youth are quite uninterested in getting involved in political and social activities that contribute to the development of the community and society. The still current pandemic caused by Coronavirus Disease (COVID-19) has further “pushed” the youth into the virtual world because they are now forced to conduct their daily activities (for example, schooling, additional education) in an online environment. The youth, otherwise avid fans of technological achievements, are now trapped in their homes with computers, smartphones and other technological aids, thus losing direct contact with their peers and adults, remaining deprived of some of the socializing effects of the teaching process and are at risk of complete alienation. EU Youth Strategy 2019-2027 addresses youth organizations, as one of the key actors that strengthen the competencies of the youth and promote their social inclusion. Youth associations and associations for the youth, in addition to providing various services and programs for the youth, strengthen empathy among the youth, raise awareness of the youth on the needs of society and, through the development of additional competencies, empower them to actively participate in community life. This paper presents the results of the part of the research created within the Youth Activation Network project. The research was conducted using the focus group method, where the respondents were representatives of youth associations and associations for the youth from entire Croatia. Research questions were focused on trying to identify and differentiate youth associations and associations for the youth from other associations, ways to activate and involve the youth in the work of associations, and assess the current legal framework of associations. The results obtained from the implementation of focus groups were transcribed, processed in Dedoose computer program and presented in the paper according to main research issues. For results analysis, content analysis method was used, as well as comparison method and contrast method. The results of the research show that it is necessary to legally define work with the youth so that it can be used as one of the distinguishing criteria of youth associations and associations for the youth. Associations involve the youth as volunteers, users and service providers, and empower and motivate them to further engage in social activities. The biggest problems pointed out by the representatives of associations are related to the ways of financing the work of the associations. Although some respondents pointed out certain shortcomings, research results indicate that the existing legal framework for the work of the associations is satisfactory, while its amendments could further complicate the work of youth associations. The revocation of the complex consequences of the pandemic requires the active involvement of all factors in society, where active and engaged, socially responsible and empathetic youth can be the bearers of change and improvement.

This brief summarises key considerations concerning cross-border dynamics between Uganda and Kenya in the context of the outbreak of Ebola (Sudan Virus Disease, SVD) in Uganda. It is part of a series focusing on at-risk border areas between Uganda and four high priority neighbouring countries: Kenya; Rwanda; Tanzania, and South Sudan. The outbreak began in Mubende District, Uganda on 19 September 2022, approximately 340km from the Kenyan border. At the time of writing (December 2022), the outbreak had spread to eight Ugandan districts, including two in the Kampala metropolitan area. Kampala is a transport hub, with a population over 3.6 million. While the global risk from SVD remains low according to the World Health Organization (WHO), its presence in the Ugandan capital has significantly heightened the risk to regional neighbours. Kenya is categorised as a priority level 1 country, following a case in Jinja on the road between Kampala and the Kenyan border, on 13 November 2022. A total of 23 suspected cases were tested in Kenya up to 1 December 2022, all with negative results. To date, no case of SVD has been imported into the country from Uganda. This brief provides details about cross-border relations between the two states, the political and economic dynamics likely to influence these, and the specific areas and actors most at risk. The brief is based on a rapid review of existing published and grey literature, news reports, previous ethnographic research in Kenya and Uganda, and informal discussions with colleagues from the International Organisation for Migration, UNICEF, UNDP, Save the Children, the Kenyan Red Cross Society, the Kenyan Ministry of Health (MoH) and Ministry of Livestock, Agriculture and Fisheries in Kenya, and the Safe Water and AIDS project in Kisumu. It was requested by the Collective Service, written by Hugh Lamarque (University of Edinburgh) and Hannah Brown (Durham University) and supported by Olivia Tulloch (Anthrologica). It was further reviewed by colleagues from Anthrologica, the Institute of Development Studies, and the Collective Service. This brief is the responsibility of SSHAP.