African Journal of AIDS Research <p><a href="" target="_blank" rel="noopener"><em>African Journal of AIDS Research (AJAR)</em></a> is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. <em>AJAR</em> includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.</p> <p class="MsoNormal">Subscriber information for this journal is available online <a href="" target="_blank" rel="noopener">here</a>.</p> en-US Copyright for articles published in this journal is retained by the publisher. (Publishing Manager) (Editorial Office) Mon, 08 Nov 2021 06:42:52 +0000 OJS 60 Reflecting on pandemic publishing, now and then: COVID-19 and HIV <p>No Abstract.</p> Alan Whiteside Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Barriers to condom use in casual sexual relationships known as ukujola in KwaZulu-Natal, South Africa <p>South Africa has the largest number of people living with HIV in the world. Of the nine provinces in South Africa, KwaZulu-Natal is the worst affected. HIV is largely transmitted through unprotected penetrative sexual intercourse. Male latex condoms are central to HIV prevention because of their effectiveness in preventing HIV transmission in almost all sexual encounters if used consistently and correctly. There are, however, various barriers to condom use. This study sought to unpack barriers to condom use in the context of ukujola (casual or informal sexual relationships) in a South African, isiZulu-speaking community. A generic qualitative approach was used, drawing on a range of methods — four focus groups and twenty in-depth interviews. The study was conducted exclusively with isiZulu speaking African participants, aged 21–34 years, from the uMgungundlovu district in KwaZulu-Natal, South Africa. Ukujola relationships encompass all casual relationships, i.e. those in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a prerequisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. The interviews suggest the existence of various barriers to condom use, including lack of trust, sexual pleasure and alcohol. There is a need for increased HIV prevention campaigns with particular emphasis on consistent condom use.</p> Mbongeleni Thembalihle Mgwaba, Pranitha Maharaj Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Living with HIV in Ghana: Disclosure of status and experiences of persons receiving antiretroviral therapy <p><span dir="ltr" style="left: 76.1142px; top: 336.76px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.10535);" role="presentation">Barriers to treatment faced by people living with HIV (PLWH) have been well explored in the literature. Despite </span><span dir="ltr" style="left: 76.1142px; top: 346.705px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.11003);" role="presentation">the importance of antiretroviral therapy (ART) in the treatment of HIV and prevention of AIDS, in the Ghanaian&nbsp; </span><span dir="ltr" style="left: 76.1142px; top: 356.65px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.18981);" role="presentation">context only about 32% of infected persons have access to treatment. This underscores a need to understand the </span><span dir="ltr" style="left: 76.1142px; top: 366.595px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.09921);" role="presentation">experiences of PLWH receiving ART to provide baseline information for policymakers’ efforts to increase access </span><span dir="ltr" style="left: 76.1142px; top: 376.54px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.17695);" role="presentation">to treatment. This study captures the voices of PLWH who were receiving ART in Ghana. A total of 35 participants </span><span dir="ltr" style="left: 76.1142px; top: 386.485px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.13935);" role="presentation">receiving treatment in a hospital setting (11 males, 24 females; mean age 38 years, age range 21–60 years) took part </span><span dir="ltr" style="left: 76.1142px; top: 396.43px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.09372);" role="presentation">in semi-structured face-to-face interviews to discuss their opinions about the cause of their HIV infection and its </span><span dir="ltr" style="left: 76.1142px; top: 406.375px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.17951);" role="presentation">impact on their lives. The study found that the participants were susceptible to discrimination in their communities </span><span dir="ltr" style="left: 76.1142px; top: 416.32px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.17073);" role="presentation">and at health care facilities. Some participants experienced marriage breakdowns, unemployment, social isolation, </span><span dir="ltr" style="left: 76.1142px; top: 426.265px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.12405);" role="presentation">and were unable to perform everyday chores and responsibilities. Concerted efforts to address the barriers to </span><span dir="ltr" style="left: 76.1142px; top: 436.21px; font-size: 7.95597px; font-family: sans-serif; transform: scaleX(1.15163);" role="presentation">treatment faced by PLWH are needed.</span></p> Maxwell Peprah Opoku, Eric Lawer Torgbenu, J-F, William Nketsia, Wisdom Kwadwo Mprah, Anthony Kweku Edusei Copyright (c) Mon, 08 Nov 2021 00:00:00 +0000 Experiences of intimate relationships, stigma, social support and treatment adherence among HIV-positive adolescents in Chiredzi district, Zimbabwe <p>This study explored experiences of intimate relationships, stigma, social support and treatment adherence among HIV-positive adolescents in Chiredzi district, Zimbabwe. The study adopted an interpretive qualitative methodology to explore the intricacies of living with HIV as an adolescent. Thirty (N = 30) adolescents aged between 13 and 19 years participated in this study. They were recruited while attending social support or during their routine visits to collect antiretrovirals. In-depth interviews were conducted to generate data. Adolescents were asked about their romantic lives and the difficulties they faced while living with HIV. Findings revealed that adolescents living with HIV (ALHIV) are confronted with stigma and discrimination. They also grapple with emotional issues such as dealing with disclosure. However, social support minimises the risk of harbouring suicidal thoughts. To the various challenges ALHIV face, most of them (particularly males) adopt several coping mechanisms. These include (but are not limited to) non-disclosure of their seropositive status to sexual partners, thereby risking reinfection and exposing their partners to HIV. Non-disclosure of seropositive status contributed to either poor antiretroviral therapy (ART) adherence or defaulting on HIV medication. A life-cycle approach to HIV prevention and management is crucial to mitigating the challenges faced by ALHIV because risks of HIV infection, challenges of access to HIV services and solutions to these challenges change at different stages of someone’s life. This scenario justifies the necessity of a holistic bio-psychosocial approach to managing HIV among adolescents, not only limited to the client, but also involving appropriate education programmes for the broader community.</p> Christopher Jimu, Kaymarlin Govender, Roselyn Kanyemba, Marie-Jeanne Offosse Ngbesso Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Catch them young: Knowledge and awareness levels of HIV and AIDS transmission among high school students in Harare, Zimbabwe <p>HIV and AIDS has developed as one of the urgent problems affecting many youths in Africa. Yet many of the knowledge and awareness programmes aimed at young people do not target high schools where the majority of young people are found. As a result, many youths do not have accurate information on HIV and AIDS that they can use to protect themselves from the disease. The objectives of this study were to determine the knowledge and awareness of Sixth Form students regarding the spread of HIV and AIDS among young people. A study was carried out among Sixth Form students in three schools in Harare from October 2017 to November 2017. A total of 156 students participated in the survey. Results showed that most students (74%) obtained their&nbsp; information on HIV and AIDS from television and radio programmes. Most students (92%) were able to identify unprotected sexual intercourse as the major mode of HIV transmission, while 89% said that HIV could be transmitted through sharing injections. Some students had misconceptions about HIV and AIDS which might negatively influence their behaviour and attitude towards HIV and AIDS, for example, 11% of students said HIV and AIDS could be cured. The study concludes that programmes on awareness and knowledge application in schools are limited, and efforts should be increased to help students effectively apply the knowledge they have about HIV and AIDS in everyday life situations, and protect themselves from the disease.</p> Dennis Junior Choruma, Simbarashe Dexter Choruma, Rutendo Moyra Pasirayi Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Barriers to ART adherence among school students living with HIV in Kenya <p>HIV has transformed from a serious acute illness with high rates of morbidity and mortality to a fairly easily managed chronic disease. However, children and adolescents living with HIV are yet to achieve similar improvement in their HIV care outcomes compared to adults. There have been a number of studies assessing the reasons for slower improvement in these age categories, mainly focusing on health systems, drug- and familyrelated barriers to ART adherence in children. We sought to explore school-related barriers to adherence through in-depth interviews with students living with HIV (SLHIV) aged 13–17 years who had fully disclosed their HIV status in western Kenya. Data was analysed using NVivo 8™. The study found that stigmatisation in the form of negative discussions and alienation, fear of unintended disclosure (due to the drug packaging and lack of privacy while taking their pills) were barriers to ART adherence among these SLHIV. Other barriers included challenges with drug storage while in school and the complexity of coordinating school and clinic-related activities and a lack of structured support systems in schools. In addition to hindering their adherence to ART, these barriers resulted in negative emotions (anger, sadness, frustration) and affected school performance. This study found fairly serious barriers to ART adherence among SLHIV, which calls for structured communication and coordinated support between government ministries of health and education in Kenya.</p> Edith Apondi, Juddy Wachira, Rose Ayikukwei, Catherine Kafu, Jael Onyango, Mark Omollo, Becky Genberg, Winstone Nyandiko, Paula Braitstein Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Internalised HIV-related stigma associated with physical inactivity in people with HIV and AIDS: A cross-sectional study from Uganda <p><strong>Aim</strong>: The aim of the current study was to explore correlations between continuous physical activity (PA) levels and HIV-related stigma and differences in HIV-related stigma between those who meet versus those who do not meet the international PA recommendation of 150 min of PA per week at moderate intensity.<br><strong>Methods</strong>: 295 people living with HIV (PLHIV) (median [interquartile range] age = 37.0 [16.0]; 67.8% [n = 200] female) from central Uganda completed the Internalised AIDS-Related Stigma Scale (IA-RSS), Generalised Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Alcohol Use Disorders Identification Test (AUDIT) and the Physical Activity Vital Sign (PAVS).<br><strong>Results</strong>: There was a significant correlation between the PAVS and IA-RSS scores correcting for GAD-7, PHQ-9 and AUDIT scores (r = −0.15, p = 0.009). The IA-RSS score was also significantly different between those meeting versus not meeting PA guidelines.<br><strong>Conclusions</strong>: Our data demonstrate that higher internalised HIV-related stigma is associated with lower levels of physical activity. The current evidence demonstrates the need to explore whether HIV stigma-reduction interventions could improve physical activity participation and consequently physical and mental health outcomes in PLHIV.</p> Davy Vancampfort, Peter Byansi, Eugene Kinyanda, Richard Serunkuma Bbosa, James Mugisha Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000 Factors influencing HIV-risk perception among MSM students at a university in Durban, South Africa <p>Risk perception is embedded in attitudes and beliefs that determine how one ultimately behaves. In relation to HIV-risk behaviours, risk perception is a key dimension in most health behaviour models used to construct health promotion campaigns. This study aimed to understand HIV-risk perception and associated factors among men who have sex with men (MSM). The qualitative data used in this study came from 15 in-depth interviews with MSM studying at the University of KwaZulu-Natal in Durban, South Africa. The findings show that MSM perceive themselves to be at risk for HIV due to their awareness of the main routes of infection. This perception exists because HIV has affected them through the loss of close family members. With each sexual encounter, risk perception changed based on factors such as the sexual role being assumed (insertive versus receptive), the socio-economic status of the partner, perceived level of discriminatory dating patterns, and the use of preventive measures. High levels of risk perception among the men did not translate into positive attitudes towards condoms as many of them preferred to have unprotected sex with trusted partners. Despite perceiving their risk of HIV infection to be high, MSM continue to engage in multiple sexual partnerships and high partner turnover. However, the men in this study were keen to protect their health; with time, they have developed more positive attitudes towards HIV and they understand that it is possible to protect oneself before and after infection.</p> Geogina Charity Gumindega, Pranitha Maharaj Copyright (c) Fri, 05 Nov 2021 00:00:00 +0000