Managing and controlling HIV/AIDS talk among Ghanaians living with HIV/AIDS

Abstract

This study explored the meanings people attribute to talking about living with HIV/AIDS. Framed by interpersonal and health communication scholarship based on disclosure and the meanings of talk about illness, people living with HIV/AIDS are asked to describe how and why they discussed their health condition with others. Interviews (focus group and one-on-one) were conducted with 120 people living with HIV/AIDS. A grounded theory analysis of the interviews revealed how communication about HIV/AIDS may be particularly meaningful because it is something people feel they can control during what is already a highly stressful and turbulent time. However, attempts to manage communication are challenged by constraints imposed by others, such as unfavourable and unpredictable reactions to disclosure, which ultimately place limits on how people living with HIV/AIDS control information about them.     

A participatory approach to community-based HIV / AIDS awareness

This paper examines a participatory approach to community-based HIV/AIDS awareness campaigns in South Africa. The SARAR methodology, developed by Lyra Srinivasan, Ron Sawyer, and Jake Pfohl, was adapted specifically to the water supply and environmental sanitation sector through the PROWWESS and Participatory Hygiene and Sanitation Transformation (PHAST) initiative. The SARAR methodology of participatory learning is based on the innate ability of the people to address and resolve their own problems. The application of this methodology in HIV/AIDS awareness was explored through a training session held in KwaZulu/Natal, South Africa. The course seeks to demonstrate how participatory methods could intensify mass media campaigns. A summary of this approach, together with the outcome of the workshop, was presented. This paper concludes that participatory methodologies, such as modified versions of SARAR and PHAST, could open up discussions on HIV/AIDS. It could also assist in developing and strengthening existing household-coping strategies, and emphasize alternative ways for health care professionals to play a supportive, proactive, and constructive role at the community level.     

The persuasive effect of Tsotsitaal in HIV/AIDS material

ABSTRACT

According to Statistics South Africa (2002) HIV infections were the leading cause of death for females between 15 and 39 years of age for the period 1997 to 2001. The South African Department of Health (2003) estimates that 3.1 million women (15–49 years) in South Africa are HIV-infected. The Human Sciences Research Council (HSRC) (2002) claimed that in the 15- to 24-year age group, 12 per cent of the women and 6.1 per cent of the males are HIV-infected. The high incidence of HIV/AIDS has resulted in a number of campaigns that seek to promote safe sex. According to the results that have been published, young people are seen as a high-risk group. However, of the campaigns that seek to address the issue of HIV/AIDS, the loveLife project is the only campaign aimed exclusively at young people. loveLife makes extensive use of the printed media in their campaigns. They claim to speak in a language with which young people will identify. Very little research into the effectiveness of the language use in these campaigns has been undertaken. Saal (2003) examined the effect of teenager slang as used by loveLife among learners in the Western Cape. This research is an extension of the research conducted by Saal (2003), looking in particular at the effect of Tsotsitaal among learners in the Eersterust area. Tsotsitaal is widely used in Eersterust, Gauteng Province, and its persuasive effect in HIV/AIDS material will be examined. Two brochures (written in Standard Afrikaans and Tsotsitaal) were tested in terms of their effect on source–receiver–similarity, source attraction and credibility (source expertise and trustworthiness) as well as persuasiveness. The findings of the study suggested, somewhat surprisingly, that speakers of Standard Afrikaans are rated more favourably than Tsotsitaal speakers in terms of source–receiver–similarity and credibility. The participants also viewed the brochure in Standard Afrikaans as significantly more persuasive than the Tsotsitaal brochure.     

Evaluating HIV/AIDS education programmes in Ugandan secondary schools

Although not part of the national curriculum until 2004, HIV/AIDS education has been taught for some time in Ugandan secondary schools through a variety of extracurricular means, including the media, youth groups, drama, music, and Parent–Teacher Associations. This article identifies and evaluates the integration of HIV/AIDS information into the national curriculum in Ugandan secondary schools between 2002 and 2004, based on the viewpoints of administrators, teachers, and students from 76 schools. While most schools did not include HIV/AIDS as part of the formal national curriculum at this time, the information was disseminated through a range of alternative means. The authors identify the most effective of these, discuss the perceived reactions of various stakeholders regarding HIV/AIDS being taught in secondary schools, and make recommendations for curricular reform.     

Global Society's Response to HIV/AIDS: Botswana's Experience

Approximately 37% of Botswana's population was HIV-positive in 2005. This study examines Botswana's experience of the HIV/AIDS threat in order to assess the strengths and weaknesses of the response by global society. Botswana is particularly useful in evaluating the pandemic threat and national and global responses since it is considered a sub-Saharan leader in establishing a national infrastructure of HIV/AIDS governance—one closely coordinated with global society's infrastructure and culture of HIV/AIDS governance. This paper argues that a polyarchic notion of governance and authority has relevance to the sphere of HIV/AIDS governance and this is evident in Botswana's experience. This study analyses the key features of the global response to the pandemic. It then explains and evaluates Botswana's administrative, financial and operational responses to the pandemic. The paper concludes by identifying critical policy challenges for the further development of effective global–national HIV/AIDS governance.     

全球艾滋病现状综述

艾滋病的完整名称为“获得性免疫功能丧失综合症”(AIDS:Acquired Immure Deficiency Syndrome),其病毒的完整名称为“人体免疫缺损病毒”(HIV:HumanImmunodeficiency Virus)。它作为一种非传统安全威胁,在冷战结束而“9·11”事件尚未发生的整个20世纪90年代,一直被视为是人类安全的头号威胁。“9·11”事件以来,艾滋病对人类威胁的严重程度仍可与国际恐怖主义相提并论。因此,诺贝尔奖委员会2001年10月宣布将诺贝尔和平奖同时授予联合国与安南秘书长时,特意夸赞其对两种威胁的应对,一个是恐怖主义,另外一个就是艾滋病。     

Measuring the success of HIV/AIDS NGOs among Nairobi's youth

NGOs receive praise and criticism for their international development efforts, but more work is needed to measure their contributions. This article lays out the contributions of local NGOs to HIV-prevention efforts. It draws on data from a survey of young people's experiences with NGOs to demonstrate the reach of several local HIV-prevention NGOs in Nairobi, Kenya. It argues that even small NGOs are capable of making measurable contributions to development in their fields. It also shows how factors such as education levels, religiosity, and discussions about HIV/AIDS can support NGO efforts by encouraging youth to participate in HIV-prevention programming.     

Using art and everyday objects to fight HIV/AIDS in Uganda

This paper argues for the importance of enabling dialogue between women and men about taboo subjects of sex and sexuality in HIV/AIDS prevention. It reports the findings of a project that sought to use art (specifically sculpture) for creating dialogue between women and men in rural Uganda. It then provides suggestions for HIV/AIDS practitioners on how to use everyday objects to stimulate similar discussion about sex and disease prevention between women and men. We argue for the utility of art and everyday objects where literacy rates are low, or where modes of communication and information-sharing are predominantly orate.     

HIV/AIDS and governance along the corridors of conflict in West Africa

West Africa demonstrates a sub-regional pattern of violence and political instability that has engulfed Côte d'Ivoire, Liberia, Sierra Leone and Guinea, and now extends out from these states through corridors of violent conflict throughout the region; both physical and figurative. This article makes two arguments. That HIV/AIDS has developed a complex inter-relationship with violent conflict in the West African sub-region; and that the presence of HIV/AIDS in West Africa in zones of violent conflict is not given the recognition needed by the international policy community. The neglect of West Africa in the Pan-African response to HIV/AIDS, and the intractability of the region's Complex Political Emergencies, is creating an emerging phenomenon of Complex Human Emergency in the region. An acknowledged gap exists in social analyses of HIV/AIDS between policy speculations and the actual evidence base that these are built upon. Instead of speculative theorizing, this article presents seven key questions that need to be asked about HIV/AIDS and conflict in West Africa, in order to begin the process of serious policy research on the issue.     

Bureaucratic façade and political realities of disarmament and demobilisation in Afghanistan

Internationally sponsored disarmament and demobilisation in Afghanistan was characterised by a marked divergence between the bureaucratic process designed by the UN and the political reality of disarmament. The bureaucratic process had several flaws of its own, which were particularly obvious in the case of DIAG, but the main reason for the substantial failure of disarmament was the absence of political will among key Afghan partners. International players in the process choose to compromise on ratherunfavourable terms, saving the façade of demobilisation thanks to the formal disbandment of the militias incorporated under the Ministry of Defence, but in fact allowing thousands of militias to continue operating throughout the country. The article shows how the very limited impact of DDR and even more so DIAG was already obvious in the early stages of the process and was deliberately ignored. The article concludes that the compromise could at least have achieved some limited aims, such as delegitimising the militias, had not many of their leaders been allowed to compete successfully for parliamentary seats shortly afterwards.     

Meeting the challenges to scaling up HIV/AIDS treatment in Africa

AIDS-related morbidity and mortality not only affects individuals and their families, but is rapidly undermining African states' capacity to develop. Stemming the impacts of the pandemic has therefore become a major concern. This calls for meeting the needs for care and support of those affected, and increasing the access of persons living with HIV/AIDS to effective treatment. Provision of such complex medication in resource-limited settings is a fairly recent phenomenon. In this context, the article builds on emerging experiences from the field in identifying issues and challenges that need to be addressed in order to facilitate the scaling-up of HIV/AIDS treatment in Africa.     

Covering HIV/AIDS: Towards a heuristic comparison between communitarian and utilitarian ethics

Abstract

This article considers two approaches to ethical decision-making on the issue of reporting on human immunodeficiency virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)-related deaths in the popular media. The conflict between cultural values and the public interest is explored via the ethical approaches of communitarianism and utilitarianism. The death of a former South African presidential spokesperson, is taken as an illustration of how these approaches might lead to different ethical decisions.     

Achieving behaviour change: Three generations of HIV/AIDS programming and jargon in Thailand

NGOs have played an important role worldwide in the fight to prevent the spread of HIV/AIDS through achieving behaviour change. NGOs have often been at the forefront of innovative changes, influencing government and international programming activities. This paper identifies and analyses the evolution of the HIV/AIDS programmes of one NGO in Thailand over a period of ten years. Three generations of programming are identified both through distinct approaches to this area of work and through the changing jargon used to describe the people the programmes are aimed at.     

Conflict and gender: the implications of the Burundian conflict on HIV/AIDS risks

Sexual and gender-based violence in many conflict and post-conflict contexts are creating vulnerabilities to HIV. The paper is based on research conducted in Burundi in 2007–2008.The country experienced long-term civil war from the early 1990s until recently and has been the locus of post-conflict disarmament, demobilisation and reintegration programmes, providing a coherent and focused study. The research finds that the relationship between conflict and HIV/AIDS is a function of pre-existing gender relations that also regulate sexual life and determine critical female vulnerabilities. When put under stress by armed conflict, these vulnerabilities become amplified, creating conditions for the increased spread of HIV. Analysis of how gender relations and vulnerabilities change according to the specific social and economic circumstances generated by military mobilisation, organisation and deployment, in relation to civilian displacement and insecurity, in a range of distinct circumstances, provides a framework for understanding HIV vulnerabilities during and after the conflict.     

HIV/AIDS prevention: building on community strengths in Ajegunle,Lagos

This paper builds upon field research in Ajegunle, Nigeria, which suggests that effective HIV/AIDS prevention requires a much higher degree of independent community participation. In exploring ways to achieve this, we suggest that assessing community strengths provides positive scope for understanding and utilising a much wider variety of HIV/AIDS responses which have not been previously used in the context of community development. Community-based approaches also encourage a deeper understanding of locally-specific vulnerability issues that surround HIV and AIDS. Such initiatives can be linked to trends that value the knowledge and capacities of neglected local people and build on their resources, including their networks, relationships and trust. However, the connection to, and use of, the resources of international NGOs (INGOs) remain central to success. If an interactive community-based agenda of working with local level resources receives enough acceptance at the higher levels of the INGOs, the results could be very significant. Such international/local agreements, where INGOs seek to work more closely with local community groups and their people on shared agendas, could begin to tackle some of the key structural issues, especially conflict and poverty, that exacerbate HIV/AIDS at the grassroots and are not responsive to purely medical solutions.

Prévention du VIH/sida: développer les points forts des communautés à Ajegunle, Lagos

Ce document se base sur des recherches menées sur le terrain à Ajegunle, au Nigeria, qui suggèrent que, pour être efficace, la prévention du VIH et du sida requiert un degré beaucoup plus élevé de participation communautaire indépendante. Dans le cadre d'une étude des manières d'arriver à ce résultat, nous suggérons qu'une évaluation des points forts de la communauté donne des perspectives positives pour la compréhension et l'utilisation d'une variété beaucoup plus importante d'interventions en matière de VIH/sida qui n'ont pas été précédemment lancées dans le contexte du développement communautaire. Les approches fondées sur les communautés encouragent par ailleurs une compréhension plus profonde des questions de vulnérabilité propres au niveau local autour du VIH et du sida. Les initiatives de ce type peuvent être reliées à des tendances qui accordent une importance aux connaissances et aux capacités des populations locales délaissées et qui se basent sur leurs ressources, y compris leurs réseaux, leurs relations et leur confiance. Cependant, la connexion avec les ressources des ONG internationales (ONGI) et leur utilisation restent essentielles pour le succès. Si un ordre du jour interactif fondé sur les communautés du travail avec les ressources locales reçoit une acceptation suffisante aux échelons plus élevés des ONGI, les résultats pourraient être très considérables. Les accords internationaux/locaux de ce type, dans le cadre desquels les ONGI cherchent à travailler en plus étroite collaboration avec les groupes communautaires locaux et leurs membres sur des ordres du jour partagés, pourraient commencer à remédier à des problèmes structurels clés, en particulier les conflits et la pauvreté, qui ont pour effet d'exacerber le VIH/le sida au niveau de la base populaire et ne peuvent pas être résolus par des moyens purement médicaux.

Prevenção do HIV/AIDS: aproveitando os pontos fortes da comunidade em Ajegunie, Lagos

Este artigo baseia-se em uma pesquisa de campo em Ajegunle, Nigéria, que sugere que a prevenção efetiva do HIV/AIDS exige um grau muito maior de participação da comunidade independente. Ao explorar maneiras para se alcançar isto, sugerimos que avaliar os pontos fortes da comunidade oferece um escopo positivo para se compreender e utilizar uma variedade muito mais ampla de respostas ao HIV/AIDS que não foram utilizadas anteriormente no contexto de desenvolvimento da comunidade. Abordagens baseadas na comunidade também incentivam uma compreensão mais profunda de questões de vulnerabilidade localmente específica que cercam o HIV e AIDS. Tais iniciativas podem ser conectadas a tendências que valorizam o conhecimento e a capacidade de pessoas locais negligenciadas e aproveitar seus recursos, inclusive suas redes de trabalho, relacionamentos e confiança. Porém, a conexão com recursos de ONGs Internacionais (ONGIs) e o uso deles permanecem centrais para o sucesso. Se uma agenda de trabalho interativa baseada na comunidade com recursos no âmbito local obtém aceitação suficiente nos níveis mais altos das ONGIs, os resultados podem ser muito significativos. Tais acordos internacionais/locais, em que ONGIs buscam trabalhar de maneira mais próxima com grupos da comunidade local e suas pessoas em agendas compartilhadas, poderiam começar a lidar com algumas das questões estruturais centrais, especialmente conflito e pobreza, que agravam o HIV/AIDS na base e não são suscetíveis a soluções puramente médicas.

La prevención del VIH/SIDA: confiando en las fortalezas de la comunidad. Una experiencia en Ajegunie, Lagos

Este ensayo se centra en una investigación de campo realizada en Ajegunle, Nigeria, la cual demostró que para conseguir una prevención efectiva del VIH/SIDA se requiere de una profunda e independiente participación comunitaria. En su investigación sobre cómo lograr este objetivo, los autores sugieren que valorar las fortalezas comunitarias puede ser una base sólida para concebir y utilizar una gama de respuestas ante el VIH/SIDA más amplia de la que hasta ahora se aplica en el contexto del desarrollo comunitario. Los métodos basados en la comunidad también contribuyen a que se entiendan mejor las vulnerabilidades específicas y locales ante el VIH/SIDA. Estas iniciativas pueden contribuir a valorar más los hasta ahora ignorados conocimientos y capacidades de las personas locales, los cuales se basan en sus recursos propios como sus redes, sus relaciones sociales y su confianza. Sin embargo, el acceso a, y el uso de, los recursos de las ONG internacionales (ONGI) siguen siendo factores importantes para lograr el éxito. Si las directivas de las ONGI consideraran una agenda de trabajo interactiva con las comunidades utilizando los recursos locales, los resultados podrían ser muy significativos. Con este tipo de acuerdos internacionales/locales en los que las ONGI intentan trabajar más estrechamente con los grupos comunitarios y las personas a nivel local compartiendo estrategias, podrían comenzar a atajarse algunos de los principales problemas estructurales, en especial en situaciones de conflicto y pobreza, que agravan el VIH/SIDA entre personas de la base y que no pueden resolverse únicamente con soluciones médicas.