Academic literature on the topic 'HIV infections – Economic aspects – Uganda'

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 The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communities.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.

Introduction Women engaged in sex work (WESW) have an elevated risk of the human immunodeficiency virus (HIV) and sexually transmitted infections (STI). Estimates are three times higher than the general population. Understanding the predictors of HIV and STI among WESW is crucial in developing more focused HIV and STI prevention interventions among this population. The study examined the prevalence and predictors of HIV and STI among WESW in the Southern part of Uganda. Methodology Baseline data from the Kyaterekera study involving 542 WESW (ages 18–55) recruited from 19 HIV hotspots in the greater Masaka region in Uganda was utilized. HIV and STI prevalence was estimated using blood and vaginal fluid samples bioassay. Hierarchical regression models were used to determine the predictors of HIV and STI among WESW. Results Of the total sample, 41% (n = 220) were found to be HIV positive; and 10.5% (n = 57) tested positive for at least one of the three STI (Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis) regardless of their HIV status. Older age (b = 0.09, 95%CI = 0.06, 0.13, p≤0.001), lower levels of education (b = -0.79, 95%CI = -1.46, -0.11, p≤0.05), fewer numbers of children in the household (b = -0.18, 95%CI = -0.36, -0.01), p≤0.05), location (i.e., fishing village (b = 0.51, 95%CI = 0.16, 0.85, p≤0.01) or small town (b = -0.60, 95%CI = -0.92, -0.28, p≤0.001)), drug use (b = 0.58, 95%CI = 0.076, 1.08, p≤0.05) and financial self-efficacy (b = 0.05, 95%CI = -0.10, 0.00, p≤0.05), were associated with the risk of HIV infections among WESW. Domestic violence attitudes (b = -0.24, 95%CI = -0.42, -0.07, p≤0.01) and financial distress (b = -0.07, 95%CI = -0.14, -0.004, p≤0.05) were associated with the risk of STI infection among WESW. Conclusion Study findings show a high prevalence of HIV among WESW compared to the general women population. Individual and family level, behavioural and economic factors were associated with increased HIV and STI infection among WESW. Therefore, there is a need for WESW focused HIV and STI risk reduction and economic empowerment interventions to reduce these burdens.

ObjectiveTo identify economic evaluations of interventions to control STIs and HIV targeting young people, and to assess how costs and outcomes are measured in these studies.DesignSystematic review.Data sourcesSeven databases were searched (Medline (Ovid), EMBASE (Ovid), Web of Science, PsycINFO, NHS Economic Evaluation Database, NHS Health Technology Assessment and Database of Abstracts of Reviews of Effects) from January 1999 to April 2019. Key search terms were STIs (chlamydia, gonorrhoea, syphilis) and HIV, cost benefit, cost utility, economic evaluation, public health, screening, testing and control.Review methodsStudies were included that measured costs and outcomes to inform an economic evaluation of any programme to control STIs and HIV targeting individuals predominantly below 30 years of age at risk of, or affected by, one or multiple STIs and/or HIV in Organisation for Economic Co-operation and Development countries. Data were extracted and tabulated and included study results and characteristics of economic evaluations. Study quality was assessed using the Philips and BMJ checklists. Results were synthesised narratively.Results9530 records were screened and categorised. Of these, 31 were included for data extraction and critical appraisal. The majority of studies assessed the cost-effectiveness or cost-utility of screening interventions for chlamydia from a provider perspective. The main outcome measures were major outcomes averted and quality-adjusted life years. Studies evaluated direct medical costs, for example, programme costs and 11 included indirect costs, such as productivity losses. The study designs were predominantly model-based with significant heterogeneity between the models.Discussion/ConclusionNone of the economic evaluations encompassed aspects of equity or context, which are highly relevant to sexual health decision-makers. The review demonstrated heterogeneity in approaches to evaluate costs and outcomes for STI/HIV control programmes. The low quality of available studies along with the limited focus, that is, almost all studies relate to chlamydia, highlight the need for high-quality economic evaluations to inform the commissioning of sexual health services.

Viral infection is a globally leading health issue, causing significantly unfavourable mortality with an adversely decreasing socio-economic growth. To solve those infections of global pandemic HIV specifically, the current utilization of highly active antiretroviral therapy (HAART) in human deficiency virus (HIV) theranostics has remarkably improved the life’s duration of patients infected by human immunodeficiency virus (HIV); however, the unfortunate drawbacks in combination with prolonged HAART therapy need to be used continuously along patient’s lifetime. Additionally, RNA virus of COVID-19 is also associated with viral pneumonia and acute respiratory distress syndrome causing significant morbidity and mortality. Meanwhile, many scientific researchers have explored the successive novelty of carbon quantum dots (CQDs) as alternative to HIV or other related viruses theranostics in the field of antiviral drugs research, but the attempt has been still challenging to introduce perfect antiviral CQDs with excellent biocompatibility, drug resistance, and safety at several areas in the virus’s life cycle. On the contrary, CQDs-based nano-therapy is currently promising because those carbon quantum dots had multiple favourable properties, including significant antiviral response effects, water-soluble activity, color-tunable fluorescence, high yield, low cytotoxic behaviour, and promising biocompatibility. In this review, some effectively recent progress of promising CQDs forviral inhibition and theranostics explored by many studies are systematically summarized.

Viral infection is a globally leading health issue, causing significantly unfavourable mortality with an adversely decreasing socio-economic growth. To solve those infections of global pandemic HIV specifically, the current utilization of highly active antiretroviral therapy (HAART) in human deficiency virus (HIV) theranostics has remarkably improved the life’s duration of patients infected by human immunodeficiency virus (HIV); however, the unfortunate drawbacks in combination with prolonged HAART therapy need to be used continuously along patient’s lifetime. Additionally, RNA virus of COVID-19 is also associated with viral pneumonia and acute respiratory distress syndrome causing significant morbidity and mortality. Meanwhile, many scientific researchers have explored the successive novelty of carbon quantum dots (CQDs) as alternative to HIV or other related viruses theranostics in the field of antiviral drugs research, but the attempt has been still challenging to introduce perfect antiviral CQDs with excellent biocompatibility, drug resistance, and safety at several areas in the virus’s life cycle. On the contrary, CQDs-based nano-therapy is currently promising because those carbon quantum dots had multiple favourable properties, including significant antiviral response effects, water-soluble activity, color-tunable fluorescence, high yield, low cytotoxic behaviour, and promising biocompatibility. In this review, some effectively recent progress of promising CQDs forviral inhibition and theranostics explored by many studies are systematically summarized.

The HIV epidemic has dramatically changed over the past 30 years; there are now fewer newly infected people (especially children), fewer AIDS-related deaths, and more people with HIV (PWH) receiving treatment. However, the HIV epidemic is far from over. Despite the tremendous advances in anti-retroviral therapies (ART) and the implementation of ART regimens, HIV incidence (number of new infections over a defined period of time) and prevalence (the burden of HIV infection) in certain regions of the world and socio-economic groups are still on the rise. HIV continues to disproportionally affect highly marginalized populations that constitute higher-risk and stigmatized groups, underserved and/or neglected populations. In addition, it is not uncommon for PWH to suffer enhanced debilitating conditions resulting from the synergistic interactions of both communicable diseases (CDs) and non-communicable diseases (NCDs). While research utilizing only a comorbidities framework has advanced our understanding of the biological settings of the co-occurring conditions from a molecular and mechanistic view, harmful interactions between comorbidities are often overlooked, particularly under adverse socio-economical and behavioral circumstances, likely prompting disease clustering in PWH. Synergistic epidemics (syndemics) research aims to capture these understudied interactions: the mainly non-biological aspects that are central to interpret disease clustering in the comorbidities/multi-morbidities only framework. Connecting population-level clustering of social and health problems through syndemic interventions has proved to be a critical knowledge gap that will need to be addressed in order to improve prevention and care strategies and bring us a step closer to ending the HIV epidemic.

IntroductionThe research literature addressing pre-exposure prophylaxis (PrEP) has increased considerably over the last decade. To better understand the research areas and explore research gaps, we will conduct a scoping review to map study topics and describe study characteristics and populations in publications focused on PrEP. The purpose of this protocol is to describe planned methods for the scoping review.Methods and analysisWe will implement a comprehensive systematic literature search to identify PrEP citations in the United States Centres for Disease Control and Prevention HIV/AIDS Prevention Research Synthesis Project database that is unique and extensively focuses on HIV/sexually transmitted infections/hepatitis. We will screen and include studies that are (1) focused on HIV PrEP, (2) primary research with human participants and (3) published in English. Two reviewers will independently abstract data on authors’ names, study years, countries, population characteristics and design. To describe and summarise study topics, we will use 19 codes and five categories that were developed from a preliminary study. The five categories arecategory 1: potential PrEP user/prescriber(behaviours/issues for potential PrEP takers/healthcare professionals),category 2: considerations while on PrEP(experiences of and problems related to staying on or prescribing PrEP),category 3: PrEP efficacy and safety(biomedical aspects and medication efficacy),category 4: methods of and experiences with PrEP clinical trials(possesses/experiences of clinical trials) andcategory 5: cost-effectiveness or economic evaluation(cost studies). Data will be analysed with descriptive statistics.Ethics and disseminationThe findings will be presented at HIV-related conferences and published in peer-review journals.

OBJECTIVE: To review the risk of HIV infection following occupational exposure, the theoretical basis for chemoprophylaxis, investigative experience with chemoprophylaxis in animals and humans, and the economic aspects of postexposure chemoprophylaxis. DATA SOURCES: English-language articles and conference proceedings pertaining to the risk of occupational HIV infection and to postexposure chemoprophylaxis. STUDY SELECTION: Studies evaluating chemoprophylaxis of HIV infection following occupational exposure were selected for review. Abstracts reporting ongoing clinical trials were also included. DATA EXTRACTION: In vitro studies are discussed to provide the immunologic rationale for chemoprophylaxis. Animal studies examining the efficacy of chemoprophylaxis in preventing non-HIV retroviral infection are reviewed, and their applicability to human HIV infection is critically evaluated. Human studies and case reports describing attempts at chemoprophylaxis of HIV infection following occupational exposure are discussed. DATA SYNTHESIS: Chemoprophylaxis of HIV infection following occupational exposure has focused on the use of zidovudine (ZDV) because it was previously the only antiretroviral agent approved for treating HIV infection. Animal models of retroviral infection provide conflicting data regarding the efficacy of ZDV chemoprophylaxis, and there are important questions about the applicability of animal data to human HIV infection because of differences in natural histories of non-HIV retroviral infections, inoculum size, dosing of ZDV, and routes of infection. Human surveillance studies are thus far inadequate to determine the efficacy of ZDV prophylaxis because of the very low HIV seroconversion rates following occupational exposure. ZDV is well tolerated during short-term administration in people without HIV infection, but long-term safety is unknown. In addition, the true cost-benefit ratio of ZDV chemoprophylaxis is uncertain. CONCLUSIONS: Current data from in vitro, animal, and human studies are inadequate to define the appropriate role of ZDV in preventing HIV infection following occupational exposure. Limited toxicity data and the high cost of treatment must be weighed against the theoretical benefits of ZDV use in this setting. The decision to employ ZDV for postexposure prophylaxis must ultimately be based on existing institutional policies, the attitude of the responsible physician regarding such practice, and/or the desires of the exposed healthcare worker after being properly informed of potential risks and benefits.

Background: India faces a high burden of HIV. An understanding of the determinants of this disease is of vital importance in curtailing this epidemic. The objective was to study the clinico-demographic profile of the study subject.Methods: This is a cross sectional study done on 142 patients which includes all newly diagnosed (diagnosed on or after 1st January 2012), sero positive, adult patients, enrolled at ART centre, Nalgonda and started on treatment during the months of December 2012, January 2013, February 2013. A pre designed, pre tested questionnaire was used. Data regarding their demographic characteristics and various clinical aspects was obtained. Results: Out of a total of 142 study subjects, majority (78.88%) belonged to economically productive age group (16-45 years). Married individuals constituted a majority (79.57%). A majority of the subjects were skilled laborers, belonged to lower middle class of BG Prasad classification, hailed from rural areas and belonged to nuclear families. Very few had high educational attainment. A majority (95.78%) reported not using condoms during their last sexual act and 9.16% subjects reported being previously diagnosed with an STD. Most common presenting complaint was fever and most common opportunistic infections were candidiasis and tuberculosis. Majority were found to belong to stage 1 HIV. Participants were mostly underweight and had severe anaemia. Majority had CD4 count between 201- 350 cells/mm3. Conclusions: Interventions targeting improvement in socio economic status, education levels, nutritional status as well as awareness about condom use must be built into the national HIV programme.

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.

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 item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf
Bachelors
Arts and Sciences
Political Science

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.

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.

The present study was conducted to determine the readiness of management at selected manufacturing organisation in the Buffalo City area to manage the HIV/AIDS epidemic. The study was conducted in the Buffalo City area on manufacturing organisations with a workforce greater than 250. The main aims of the present study were: · To provide an overview of relevant literature concerning theoretical key issues related to the management of HIV/AIDS in the workplace. · To assess the readiness of Buffalo City organisations in managing HIV/AIDS in the workplace, and to identify areas of improvement. · In the light of the findings, make further recommendations to manufacturing organisations to further improve their workplace policy, education and awareness programmes; and the accommodation of HIV-infected employees in the workplace. Another objective of the study was to provide additional research as a tool to assist organisations in managing HIV/AIDS in the workplace and to assist in fighting the HIV/AIDS epidemic in the Buffalo City area. The research process entailed: the selection of a test sample of manufacturing organisations in the Buffalo City area, and selecting an appropriate Human Resource manager or representative from these organisations to complete a structured questionnaire. The research tool used in the study was a questionnaire, which was used to extract relevant information on the demographics, policies, education and the accommodation of HIV/AIDS affected and infected employees in the workplace. The results revealed the following: · 73 percent of the selected manufacturing organisations in the Buffalo City have an HIV/AIDS policy in place; · 87 percent of the organisation indicated that their management are committed to the development and implementation of a HIV/AIDS policy; · management and supervisors in these organisations have not been adequately trained to manage the impact of HIV/AIDS in the workplace; · organisations in the Buffalo City area need to collaborate and share information; and · that very few organisations benchmark against best practices. Future research on HIV/AIDS policy can explore the effective implementation of HIV/AIDS policies in these organisations as well as the effective management of HIV/AIDS in the workplace.

Thesis (MBA)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: Why should the Lewis Group be concerned about HIV/AlDS? The answer is quite simple. HIV/AIDS poses a clear and present danger to the twin rationales on which businesses like the Lewis Group are based. The rationales are low-cost labour for own and supply chain purposes, and fast-growing markets. This research focuses more towards the latter and presents a review of the current literature and attempts to estimate the impact of HIV/AIDS on the group's market. Literature on the subject is surprisingly limited (Bloom & Mahal, 200 I: 10) and often dated seen in the light of the fact that it is one of the most oppressing issues in the Southern African business arena today. Amidst a rather slow awakening in the private sector to the effects of HIV/AlDS on markets a lot of resources and time are being spent on research in this area. Although the scope of this research does not encompass the full impact of the epidemic on the company, it provides insight into an area on which very little is known yet. Companies have a high level of control over, and information, about their employees but significantly less about their customers} hence the reason for the use of hypothesising and adopting a tailor-made methodology to quantify prevalence rates and vulnerability. This paper is therefore not a complete assessment of impact of the disease on the group as a whole. AlDS is a bottom line issue for most companies as it impacts on production costs and consumer markets (Ellis & Terwin, 2003: 55). A number of "doom-and-gloom" merchants have come forward with doomsday estimates about the impact of the epidemic on business. As a result, the extent of the problem might have been overstated by some. This sparked a lot of the debates that resulted in many different opinions which have caused a lot of uncertainty. This research will attempt to clarify these issues and fonnulate an unbiased opinion as of the impact of the company. The HIV/AIDS problem is sti ll gathering momentum and prevalence rates are still on the rise. There is currently no cure for HIV / AIDS and chances look diminutive that there will be one within the next decade. If prevention programmes had been successful, this report would never have been written. The problem is aggravated by the fact that the core modes of HN transmission are deeply rooted in social behavioural patterns, value systems and traditional and cultural beliefs. This makes it hard to imagine that the spread of the epidemic will decrease and eventually stop soon (Goldstein, Pretorius, Stuart, 2003). As we are entering a phase where the number of AIDS-related deaths is starting to rise rapidly, it is important to gain sufficient insight into the effect of the disease, especially now that infonnation is becoming more available in the public domain (McClintock & Truen, 2003: 3). AIDS primarily kills young and middle-aged adults during their most productive years. This section of the population is the major source of demand for goods and services. The macro-economic impact of this is expected to influence demand for goods, especially durables, and services. This is aggravated by slower population growth rates that will further slow down the demand for certain goods and services (McClintock & Truen, 2003: 3). HIV/AIDS must be managed proactively. In order to assess and manage this risk, management must have a clear understanding of nature and extent of the risk (Ellis & Terwin, 2003: 1). The Bureau for Economic Research did a survey in 2003 on the impact of HIV/AIDS on business in South Africa. It found that only 8 percent of retail companies surveyed have assessed the impact of the disease on their consumer base (Ellis & Terwin, 2003: 30). A possible reason might be because companies want to see proven input and exit strategies for HIV/AIDS contributions. These are not yet possible for HN/AIDS (Barrett & Ruggie, 2004: 5). The HlV/AIDS prevalence rates estimate for the Lewis Group revealed significantly lower prevalence rates than the national averages. Nevertheless, HlV and AIDS prevalence rates for 2004 are estimated 16.5 percent and 2.5 percent respectively. HIV-prevalence is expected to increase to 17.1 percent and AIDS to 4.7 percent by 2009. There are a number of interventions and strategic responses the company can consider to mitigate the risks entrenched in these estimates. Recommended strategic responses include diversification of profit generators into the higher income group market, focus on areas of growth and building the Lewis Group's brands. It is generally believed that good and responsible corporate citizenship will benefit from involvement in community and charitable projects. The belief is that customers can become predisposed towards the company and that the group can gain goodwill from new and existing customers. It is therefore clear that there are remedies the company can consider to manage and mitigate its risks. It is, however, possible for the company to emerge stronger, more efficient and more competitive if the right responses are implemented.

Thesis (MPhil--Stellenbosch University, 2013.
ENGLISH ABSTRACT: The incidence of HIV/AIDS in Botswana is one of the largest in the world taking its toll on many lives and posing developmental challenges to the nation. Nearly 25% of the population is living with HIV and 14% are newly infected; AIDS is acknowledged as the major cause of death. Most HIV and AIDS studies have been dominated by surveillance, biomedical and ethical methodologies. These approaches failed to stem the tide of HIV infection because they did not follow-up with the tracking of risky behaviours and the underlying causes of the behaviours. This research scrutinized socio-economic factors in relation to the spread of the epidemic. Available literature showed that little or no attention has been paid to the socio-economic backgrounds in which individuals exist in connection with understanding HIV and AIDS. This study used an economic model of risky sexual behaviour to explore the link between socio-economic status and the practice of HIV self-protective/preventive behaviours in Maruapula, Gaborone, Botswana. The research is vital as it goes beyond surveillance in an effort to establish why the community of the study is susceptible to HIV infection. This research l used both collected data and that from BAIS II.
AFRIKAANSE OPSOMMING: Die navorsing is oor die verhouding tussen sosio-ekonomiese status en die praktyk van MIV self-protective/preventive gedrag binne Maruapula distrik. Die doel van die studie is om vas te stel of daar 'n verband tussen sosio-ekonomiese status en die praktyk van MIV-voorkomende gedrag onder die inwoners, van Maruapula, Gaborone, Botswana. Data is ingesamel deur die gebruik van vraelyste en die ontleding van die statistiek het getoon dat die is geen verwantskap tussen sosio-ekonomiese status en die praktyk van MIV self-protective/preventive gedrag onder die inwoners. Aanbevelings gebaseer op die bevindinge is gemaak met betrekking tot MIV-voorkoming in die woongebied in die besonder en in die land in die algemeen.

Thesis (MPhil)--Stellenbosch University, 2005.
ENGLISH ABSTRACT: Despite the seriousness of HIV and AIDS affecting productivity at workplaces, little attention is being paid to the special needs of the infected people in the world of work and the ultimate reality this will have on the companies’ financial health. HIV/AIDS retards economic development and business growth. The epidemic influences the workforce and markets in which business operates. Business must play a leading part in the internal response to HIV/AIDS pandemic. This is both an ethical imperative and the key to business success. Most research conducted on the subject mainly concentrated on the effects of HIV and AIDS on productivity, emphasizing absenteeism as the direct cause of low productivity. The costs of HIV and AIDS will be felt beyond the direct effect of the disease. The indirect costs include the following: The increased costs of recruiting and training, given the extra deaths and disabilities expected. The negative effect on staff morale Loss of time as a result of management and labor meetings to discuss the AIDS crisis as it develops, this resulting in loss of turnover and profits. With the rising prevalence of HIV/AIDS, businesses should be increasingly concerned about the impact of the disease on their organizations-concerns that should be well founded. At the broadest level, businesses are dependent on the strength and vitality of the economies in which they operate. HIV/AIDS raises the costs of doing business, reduces productivity and lowers overall demand for goods and services. The research process in this article focused particularly on workplace issues, which are a key dimension of the relationship between corporations and HIV/AIDS. Data collection was by both structured questionnaires and unstructured interviews, interviews with both management and workers’ representatives and structured questionnaires with the general workforce. The questions asked were open-ended: “Is HIV/AIDS a problem for your company now or in the future?” and “If HIV/AIDS impacted on your company’ financial performance would you act and why?” The research group consisted of four companies in different areas of operations: retail, service and manufacturing and the participants were chosen on the basis of certain inclusive criteria: The number of employees employed. Length of service operation. Willingness to share certain financial information. A qualitative method of data analysis was used in the study and is described in detail. The qualitative research method looks at the subjective meanings attached, descriptions, metaphors, symbols and descriptions of specific cases. It was found that despite the differences from one company to the other, the potential impact of HIV/AIDS on companies’ financials went beyond the direct costs of productivity. As the debate over the availability of cheaper generic anti-retroviral drugs rages in the background, business is faced with the dilemma of significant investment to keep their labour force healthy and alive. This has to be weighed up against the high costs involved in rehiring, retraining and re-incentivising their replacements.
AFRIKAANSE OPSOMMING: Ten spyte van tekens dat MIV en VIGS produktiwiteit in die werkplek affekteer, word daar nog baie min te doen aan die behoeftes van die werkers wat deur die epidemie getref word. Verder, word min aandag geskenk aan die potensiële uitwerking van die epidemie op die finansiële gesondheid van maatskappye. MIV/VIGS vertraag ekonomiese ontwikkeling en besigheidsgroei. Die epidemie het ‘n negatiewe impak op die arbeidsmag en die market waarin besigheid plaasvind. Besigheid moet dus die leiding neem in die interne respons op die MIV/VIGS pandemie. Dit is eties belangrik en die sleutel tot die sukses van besigheid. Die meeste navorsing oor die onderwerp het tot dusver gekonsentreer op die effek van MIV en VIGS op produktiwiteit met die klem op afwesigheid as ‘n direkte oorsaak van lae produktiwiteit. Die koste van MIV en VIGS behels egter veel meer as net die direkte gevolge van die siekte. Die indirekte koste sluit die volgende in: Die koste verbonde aan opleiding en die soeke na nuwe personeel weens sterftes en siekte van personeel. Die negatiewe effek op die moraal van personeel. Verlore tyd as gevolg van bestuurs- en arbeidsvergaderings om die VIGS-krisis te bespreek namate dit ontwikkel en winste negatief beïnvloed. Besigheid behoort meer bekommerd te wees oor die toename in MIV/VIGS gevalle en die impak wat dit op organisasies sal hê. MIV/VIGS verhoog die kostes van besigheid doen, verminder produktiwiteit en verlaag die algemene vraag na goedere en dienste. Die navorsingsbenadering in die artikel fokus op daardie werkplek-aangeleenthede wat ‘n sleuteldimensie is van die verhouding tussen organisasies en MIV/VIGS. Data is ingewin deur middel van gestruktureerde vraelyste en ongestruktureerde onderhoude. Onderhoude is met beide bestuurslui en verteenwoordigers van werkers gevoer, en gestruktureerde vrae met die werkers. Die vrae gestel was oop vrae soos “Is MIV/VIGS `n problem vir u onderneming huidiglik of in die toekoms? En “Indien MIV/VIGS ‘n negatiewe impak het op die onderming se prestasie sal jy optree en waarom?” Die navorsingsgroep het bestaan uit vier ondernemings in die kleinhandels-, dienslewerings-, en vervaardigingssektor. Die deelnemers is gekies op die basis van inklusiwiteit met die volgende criteria: Die getal werkers in diens. Hoe lank is onderneming in besigheid? Die bereidwilligheid om inligting te deel. `n Kwalitatiewe metode van data analise is gebruik wat breedvoerig verduidelik en beskryf word. Die navorsingsmetode kyk veral na subjektiewe betekenisse, omskrywings, metafore, simbole en omskrywings van spesifieke gevalle. Navorsing het getoon dat MIV/VIGS ‘n impak het op ondernemings se finansiële omstandighede en produktiwiteit. Terwyl die debat oor goedkoper generiese anti-retrovirale middele aan die gang is, word ondernemings of besighede konfronteer met die keuse tussen beduidende investering om die arbeidsmag gesond en lewendig te hou of die hoë koste van herindiensneming, heropleiding en insentiewe.

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.