Preventing and mitigating AIDS in Sub-Saharan Africa : research and data priorities for the social and behavioral sciences / Barney Cohen and James Trussell, editors ; Panel on Data and Research Priorities for Arresting AIDS in Sub-Saharan Africa, Committee on Population, Commission on Behavioral and Social Sciences and Education, National Research Council.

Format:

Book

Author/Creator:

National Research Council (U.S.). Panel on Data and Research Priorities for Arresting AIDS in Sub-Saharan Africa.

Contributor:

Cohen, Barney, 1959-

Trussell, James.

Language:

English

Subjects (All):

AIDS (Disease)--Africa, Sub-Saharan.

AIDS (Disease).

Physical Description:

xi, 356 p. : ill., maps.

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1996.

Language Note:

English

Summary:

The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.

Contents:

Preventing and Mitigating AIDS in Sub-Saharan Africa

Copyright

Acknowledgments

Contents

Summary

NEED FOR IMMEDIATE ACTION

SOCIETAL CONTEXT OF HIV/AIDS IN AFRICA

EPIDEMIOLOGY OF THE HIV/AIDS EPIDEMIC

SEXUAL BEHAVIOR AND HIV/AIDS

PRIMARY HIV-PREVENTION STRATEGIES

MITIGATING THE IMPACT OF THE EPIDEMIC

BUILDING CAPACITY FOR AIDS-RELATED RESEARCH

CONCLUSION: THE NEED FOR BETTER BEHAVIORAL AND SOCIAL SCIENCE RESEARCH

Resume

IL FAUT AGIR SANS TARDER

CONTEXTE SOCIETAL DU VIH/SIDA EN AFRIQUE

EPIDEMIOLOGIE DU VIH/SIDA

COMPORTEMENT SEXUEL ET VIH/SIDA

STRATEGIES PREVENTIVES DE BASE CONTRE LE VIH

L'ALLEGEMENT DE L'IMPACT DE L'EPIDEMIE

MISE SUR PIED D'UNE CAPACITE DE RECHERCHE SUR LE SIDA

CONCLUSION: BESOIN DE MEILLEURES RECHERCHES EN SCIENCES SOCIALES ET COMPORTEMENTALES

1 Introduction

PURPOSE OF THE REPORT

BACKGROUND

Extent of the Epidemic

Need for Immediate Action

The Need for Better Behavioral and Social Science Research

THE PANEL'S TASK

ORGANIZATION OF THE REPORT

2 Societal Context

SOCIAL STRUCTURE AND FAMILY ORGANIZATION

MOBILITY

Rural-Urban Migration

Diffusion via Major Roads

Civil Unrest and Wars

MEDICAL AND PROGRAM FACTORS

ECONOMIC FACTORS

3 Epidemiology of the HIV/AIDS Epidemic

STATUS OF THE EPIDEMIC

HIV/AIDS Statistics

Demographics of HIV Infection

HIV-2 Infection

MODES OF TRANSMISSION

Sexual Transmission

Risk Factors in Sexual Transmission

HIV and STDs

Perinatal Transmission

Parenteral Transmission

REMAINING GAPS IN KNOWLEDGE

Limitations of Existing African Behavioral Data

The Need to Combine Epidemiological and Social/Behavioral Research

Ethical Issues in STD/HIV Research

RECOMMENDATIONS

4 Sexual Behavior and HIV/AIDS

SOURCES OF INFORMATION.

QUESTIONS OF METHODOLOGY

The Issue of Validity

PATTERNS OF SEXUAL ACTIVITY

Sexual Initiation and Premarital Intercourse

Sex Within Marriage or a Stable Union

Extramarital and Casual Sex

Commercial Sex

SEX-RELATED RISK FACTORS

High Number of Partners/Commercial Sex

Perceived Risk

Age

Education

Marital Status

Residence

Migration

Sexually Transmitted Diseases

Circumcision and Traditional Medical Practices

Alcohol

SEXUAL PRACTICES AND BELIEFS

The Notion That Men Need Sex

Coercive Sex

Health Beliefs

Dry Sex

Oral/Anal Sex

Homosexuality

Postpartum and Other Abstinence

Levirate Marriage

AIDS AWARENESS

Modes of Transmission

Asymptomatic Transmission

Severity and Perceived Threat

Attitudes Toward Sufferers

Testing

THE ROLE OF CONDOMS

Condom Use

Condoms and STD and HIV Prevention

Attitudes Toward Condoms

BEHAVIOR CHANGE

CONCLUSIONS

5 Primary HIV-Prevention Strategies

BEHAVIOR-CHANGE INTERVENTION PROGRAM DESIGN AND EVALUATION

Guiding Principles for Behavior-Change Interventions

INTERVENTION EVALUATION

A TYPOLOGY OF INTERVENTION PROGRAMS

Institution-based Programs

Community-based Programs

Population-based Programs

INTERVENTIONS TARGETING SEXUALLY ACTIVE MEN

Issues

Target Population

Types of Strategies and Programs

Case Study

Lessons Learned

INTERVENTIONS TARGETING SEXUALLY ACTIVE WOMEN

Case Study: An Intervention Targeted to Commercial Sex Workers

Case Study: A Community-based Intervention

INTERVENTIONS TARGETING YOUTH

PERINATAL TRANSMISSION

RECOMMENDATIONS.

ANNEX 5-1 SELECTED AIDS INTERVENTION PROGRAMS IN AFRICA

6 Mitigating the Impact of the Epidemic

INTRODUCTION

IMPACT ON PERSONS WITH HIV

Stigmatization of the Seropositive

Economic Hardship Due to HIV

Care for People with AIDS

IMPACT ON EXTENDED FAMILY MEMBERS AND FRIENDS

Caring for Survivors: Children and the Elderly

INDIRECT IMPACT OF AIDS ON THE REST OF SOCIETY

Demographic Impact

Morbidity and Mortality

Anticipated Future Impact

Relationship Between Seroprevalence and Mortality Rates

Economic Impact

HIV/AIDS and Per Capita Income Growth

Effect of the Epidemic on Sectors of Economic Activity

Impact of the Epidemic on Firms

ATTEMPTS TO MITIGATE THE IMPACT OF HIV/AIDS

Intended Beneficiary

Providers of Mitigation Assistance

Types of Mitigation Help Being Provided

ANNEX 6-1: A BRIEF SURVEY OF NONGOVERNMENTAL ORGANIZATIONS IMPLEMENTING MITIGATION PROGRAMS IN SUB-S ...

7 Building Capacity for AIDS-Related Research

Problem Statement

Data Sources

CONSTRAINTS ON RESEARCH IN SUB-SAHARAN AFRICA

Insufficient/Poorly Allocated Funds

Inadequate Manpower

Unintended Negative Consequences of Donor Policies

Inadequate Coordination

Lack of Information on Previous and Ongoing Research Efforts

Lack of Research-Needs Assessment and Difficulty of Coordinating Funding from Multiple Sources

Lack of Cooperation Among Donor Agencies

Harsh Environment for Social and Behavioral Research

Unfavorable Political Climate

Decline of Higher-Education Systems in Sub-Saharan Africa

Inadequate Infrastructure

Economic Weakness

Weak Policy Support for the Health Sector

Low Value Placed on Social and Behavioral Research

References.

APPENDIX A Panel Visits to Three African Countries: January 20-February 12, 1995

ZAMBIA JANUARY 23-27, 1995

Overview of Current HIV/AIDS Situation

History of AIDS-Prevention Efforts

Ongoing Prevention and Mitigation Initiatives

Workplace Peer Education and Counseling

Traditional Healer Component

Programs for Orphans

The State of Social and Behavioral Research

TANZANIA JANUARY 30-FEBRUARY 3, 1995

Components of the Tanzania AIDS Project

The Nongovernmental Organization Strategy

Social and Economic Mitigation of AIDS

CAMEROON

Ongoing Prevention and Mitigation Efforts

Overview

AIDSCAP

IRESCO

FOCAP

OVERALL THEMES

REFERENCES

PEOPLE CONTACTED

Zambia

Tanzania

Cameroon

APPENDIX B Biographical Sketches

Index.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references (p. 271-314) and index.

ISBN:

9786610192366

9781280192364

1280192364

9780309589055

0309589053

9780585023649

0585023646

OCLC:

811258876