艾滋病、非洲与国际援助

艾滋病的流行不仅严重地影响了人类的健康,而且对社会经济等诸多方面都产生了不利的影响.从艾滋病在全球流行的基本状况入手,指出艾滋病对流行地区,尤其是撒哈拉以南非洲社会经济等方面的影响程度,并结合该地区多数国家经济发展水平落后和发达国家对外援助的现实状况,提出加大国际援助非洲控制艾滋病的紧迫性.     

艾滋病的流行及对我国社会、经济的影响

本文对艾滋病在中国流行的总体情况和今后的感染数量进行了估计 ,对艾滋病影响的社会经济过程进行了分析。目前 ,艾滋病对我国个人和家庭的影响已经出现。感染者及患者的家庭和个人均遭受经济和精神的巨大压力。由于未来必须增加更多的投入用于艾滋病治疗和开展干预活动 ,对卫生部门和局部地区已构成为明显的经济负担。尽管目前艾滋病对宏观经济和整个社会的影响虽然还不十分明显 ,但国外高流行地区的严酷现实告诉我们 ,如不重视艾滋病的预防控制 ,非洲某些高流行国家的悲剧可能在我国重演     

羞辱与歧视对艾滋病传播机制的影响及对策

艾滋病的流行已成为一个严重影响全球卫生和社会经济发展的重要问题,而中国也已经面临艾滋病流行的高峰期。在艾滋病流行过程中,羞辱和歧视是一个非常重要的社会影响因素。从传染病流行病学方面进行剖析,讨论了羞辱与歧视对艾滋病传播机制的影响及对策。     

羞辱与歧视对艾滋病传播机制的影响及对策

艾滋病的流行已成为一个严重影响全球卫生和社会经济发展的重要问题,而中国也已经面临艾滋病流行的高峰期.在艾滋病流行过程中,羞辱和歧视是一个非常重要的社会影响因素.从传染病流行病学方面进行剖析,讨论了羞辱与歧视对艾滋病传播机制的影响及对策.     

非洲防控艾滋病的本土模式

防控艾滋病的全球模式主要基于危机减少和治疗干预,在可接受性、可支付性等方面存在制约.非洲控制艾滋病流行的本土解决办法内容十分丰富,与现代方法相比,同样甚至更加有效.非洲典型的本土艾滋病防控模式有:危机避免模式、本土药物开发模式和传统护理、支持模式,值得研究和借鉴.     

对安徽阜阳地区艾滋儿童社会心理支持问题的思考

艾滋病的快速传播不但直接威胁到人类的健康,而且对艾滋病家庭中儿童的心理产生了较大的伤害。开展对艾滋孤儿的社会心理支持,不仅需要心理咨询的介入,而且是一项社会救助的综合工程。针对安徽阜阳地区艾滋病流行的特点,以及艾滋病对儿童身心的影响,提出了为艾滋儿童提供社会心理支持的内容与措施。     

非洲防控艾滋病的本土模式

防控艾滋病的全球模式主要基于危机减少和治疗干预，在可接受性、可支付性等方面存在制约。非洲控制艾滋痛流行的本土解决办法内容十分丰富，与现代方法相比，同样甚至更加有效。非洲典型的本土艾滋病防控模式有：危机避免模式、本土药物开发模式和传统护理、支持模式，值得研究和借鉴。     

浅析影响艾滋病流行的社会因素

影响艾滋病流行的社会因素从宏观层面看有经济发展水平、法律政治和宗教文化等,从微观层面看有贫困、社会资本、教育、就业和人口流动、歧视等.研究社会影响因素不仅有助于揭示艾滋病流行根源,制定科学干预策略,也有助于反思当前的社会治理,促进社会公平与和谐发展.     

宗教资本的再生产与宗教组织角色创新——基于清真寺参与艾滋病宣传预防行动实践的田野调查

近年来艾滋病在少数民族聚居地区呈快速流行趋势,对少数民族聚居地区的经济、社会发展和人口安全构成了潜在威胁.自2005年甘肃省参与了一系列国际卫生防艾合作项目以来,卫生疾控部门联合宗教组织针对少数民族聚居社区的宣传预防艾滋病工作进行了有益的探索并取得显著成效.本文基于甘肃省兰州市的宗教组织——清真寺在参与宣传预防艾滋病工作中的田野调查个案为分析中心,讨论宗教组织及其宗教文化资本如何在基层公共卫生治理中发挥作用并参与社会建设的实践个案以及对现实的启示.     

论我国艾滋病防治工作中的政府职能

艾滋病是世界性的重大公共卫生问题和社会问题。近年来,我国艾滋病的流行呈现快速上升趋势,流行范围广,局部地区疫情相当严重,疫情正在从高危人群向一般人群传播。政府的组织领导是做好我国艾滋病防治工作的根本保证,各级政府要强化政府的公共卫生职责,发挥政府的主导作用,动员足够的防治资源和力量,引导社会各方面力量的广泛参与,打一场防治艾滋病的“人民战争”,我们一定能够控制艾滋病的流行。     

HIV and AIDS in Africa: social,political, and economic realities

Sub-Saharan Africa bears the brunt of the HIV epidemic, which is fueled by the many ethical, social, and political complexities that make up Africa. In turn, the pandemic has also caused many ethical, social, and political complexities that Africa now grapples with. Being infected with HIV is highly complex and challenging. Regrettably, gender inequality is still pervasive in Africa. The response by African leaders to the pandemic has been, on the whole, shamefully lethargic. For Africa to win its war against HIV/AIDS, a paradigm shift is required from the perspective of its socio-political context. What is called for is positive political will that will address all aspects of the social determinants of AIDS. What is also required is that Ubuntu is embraced meaningfully.     

特殊人群艾滋病行为干预的思考

艾滋病直接危害人类的健康,也对社会、政治、经济及人文伦理道德产生重大的负面影响。对艾滋病病人犯罪的监管问题,公安干警的职业暴露问题,都是目前司法实践中遇到的新课题。加强艾滋病患者违法监管,对特殊群体进行行为干预,是司法结构急待解决问题。     

Syndrome d’apnée hypopnée obstructif du sommeil en Afrique Sub-saharienne : une revue de la littérature

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is common, under diagnosed and severe. It increases cardiovascular morbidity and mortality, reduces life expectancy and alters the quality of life.The objective of this work was to review the scientific literature on OSAHS in Sub-Saharan Africa from 2009 to September 2019.A search on PubMed, Science Direct, African Index Medicus, African Journals on line and Google scholar found a total of 43 references relevant to the theme.OSAHS publications are scarce in sub-Saharan Africa with no data for 36 countries. Practitioners’ level of knowledge about the disease was low. Polygraphy and / or polysomnography were not available in the majority of Sub-Saharan African countries. The prevalences obtained remained higher than those found in Europe and USA. OSAHS predominated in men, with a peak around 55 years old. The most consistent risk factor was obesity. The association OSAHS chronic pathology remained frequent. The excessive cost of continuous positive pressure, surgery and the lack of health insurance in these countries limited access to treatment.We need to improve the knowledge, in sub-Saharan Africa, of practitioners in the field of sleep medicine, to make polysomnography available in public health structures, to create sleep units in teaching hospitals to strengthen practical training and finally to make accessible treatment.     

Routine third party disclosure of HIV results to identifiable sexual partners in Sub-Saharan Africa

The challenges of dealing with disclosure of HIV status cause frustration to health care providers and counselors. This frustration follows from the already known high risk to the third party on one hand and our ethical obligation to “respect persons” in terms of privacy and confidentiality on the other side. Given the stubbornly low rates of voluntary disclosure (partner notification) among couples, however, it is quite tempting to suggest a paradigm of routine third party disclosure to identifiable sexual partners by health care providers. This might be the lesser of the two evils and might give better public health outcomes in the fight against HIV/AIDS in Sub-Saharan Africa.     

Reviewing policies on satellite broadcasts in east asia: New technology,political economy,and civil society

As an instrument of national integration, domestic television in many post-colonial countries has long neglected cultural minorities. Transnational television via newer satellite and cable technologies has been able to target cross-border ethnic groups which then constituted viable audience markets. Governments in Asia sought initially to control access to transnational broadcasts out of paternalistic nationalism, but audiences and entrepreneurs have circumvented such policies. Thus over the last decade the political economy of television in countries such as Malaysia, Philippines and Thailand have been transformed, though in differing ways. Belated media deregulation has often led to alliances between business and political elites. This paper argues that most policy developments in Asian television have been driven by business and government imperatives rather than by civil society involvement. Australia where he teaches marketing and international business. His eclectic research interests include the political economy of international communications, globalization/transnationalization strategies, cross-cultural dimensions in marketing and management, and ethical issues in post-industrial society. Prior to a 15-year academic career across four universities in the Asia-Pacific region, Amos worked for twelve years in multinational corporations, NGOs, and government.     

The Making of a Sexual Being in Ghana: The State,Religion and the Influence of Society as Agents of Sexual Socialization

With the aim of generating in-depth information on society’s expectations and views on sexual expression in Ghana, we present findings on what was expected of the state, religion, and the influence of society on sexual socialization in Ghana. As a society, our need to break the culture of silence about sex cannot be overemphasized. Our study is important against a background that in Sub-Saharan African, HIV and AIDS is mostly spread through sexual intercourse, and that the region bears a disproportionate large percentage of the world’s HIV and AIDS burden. Although Ghana has a 2009 adult (15+ years) prevalence rate of 1.6% and a prevalence rate of 1.9% for persons 15–49 years old, some regions and sentinel sites show rather high rates, making HIV and AIDS issues of high concern nationally. Respondents from the general public, key informants and special groups across all three ecological zones of Ghana were purposively selected. All the interviewees agreed that in Ghana fidelity in all sexual relationships is highly valued and expected. However, there is gender discrimination in the application of such social norms of fidelity, in favor of males. Amongst the three agents of socialization studied, religion seemed to exert the most influence. Modernity interwoven with Christianity seem to have taken a great toll on such norms of sexual socialization.     

Emotional and Behavioral Problems Among Impoverished Kenyan Youth: Factor Structure and Sex-Differences

Data on youth emotional and behavioral problems from societies in Sub-Saharan Africa are lacking. This may be due to the fact that few youth mental health assessments have been tested for construct validity of syndrome structure across multicultural societies that include developing countries, and almost none have been tested in Sub-Saharan Africa. The Youth Self-Report (YSR), for example, has shown great consistency of its syndrome structure across many cultures, yet data from only one developing country in Sub-Saharan Africa have been included. In this study, we test the factor structure of YSR syndromes among Kenyan youth ages 11–18 years from an informal settlement in Nairobi, Kenya and examine sex-differences in levels of emotional and behavioral problems. We find the eight syndrome structure of the YSR to fit these data well (Root Mean Square Error of Approximation = 0.049). While Kenyan girls have significantly higher internalizing (Anxious/Depressed, Withdrawn/Depressed, Somatic) problem scores than boys, these differences are of similar magnitude to published multicultural findings. The results support the generalizability of the YSR syndrome structure to Kenyan youth and are in line with multicultural findings supporting the YSR as an assessment of emotional and behavioral problems in diverse societies.     

Pain Control in the African Context: the Ugandan introduction of affordable morphine to relieve suffering at the end of life

Dr Anne Merriman is the founder of Hospice Africa and Hospice Africa Uganda. She is presently Director of Policy and International Programmes. Here she tells the story of how HAU was founded. Dr Richard Harding is an academic researcher working on palliative care in Sub-Saharan Africa. This paper described Dr Merriman's experience in pioneering palliative care provision. In particular it examines the steps to achieving wider availability of opioids for pain management for those with far advanced disease. Hospice Africa Uganda has been a model facility in achieving high quality clinical care embedded in a strategy of advocacy and education, using a multifaceted approach that has addressed logistical, policy and legislative barriers. Until 1990 control of severe pain in Sub-Saharan Africa was non-existent except in Zimbabwe and S Africa. Oral affordable morphine was brought to Kenya through Nairobi Hospice that year, and to Uganda through Hospice Africa Uganda in 1993. This paper offers an example of a highly effective and cost efficient model of care that has transformed the ability to humanely manage the problems of those with terminal illness, and to offer a culturally appropriate "good death". Thus it is now possible to complete the ethical circle of care in resource poor circumstances.     

Changes in contraceptive method mix in developing countries

CONTEXT: Understanding shifts in contraceptive method mix is key to helping policymakers, program managers and donor agencies meet current contraceptive demand and estimate future needs in developing countries. METHODS: Data from Demographic and Health Surveys, Reproductive Health Surveys and other nationally representative surveys were analyzed to describe trends and shifts in method mix among married women of reproductive age from 1980 to 2005. The analysis included 310 surveys from 104 developing countries. RESULTS: Contraceptive use among married women of reproductive age increased in all regions of the developing world, reaching 66% in Asia and 73% in Latin America and the Caribbean in 2000-2005, though only 22% in Sub- Saharan Africa. The proportion of married contraceptive users relying on the IUD declined from 24% to 20%, and the proportion using the pill fell from 16% to 12%. The share of method mix for injectables rose from 2% to 8%, and climbed from 8% to 26% in Sub-Saharan Africa, while the share for condoms was 5-7%. The overall proportion of users relying on female sterilization ranged from 29% to 39%, reaching 42-43% in Asia and in Latin America and the Caribbean in 2000-2005; on average, the share of all method use accounted for by male sterilization remained below 3% for all periods. Use of traditional methods declined in all regions; the sharpest drop-from 56% to 31% of users-occurred in Sub-Saharan Africa. CONCLUSIONS: To meet the rising demand for modern methods, it is critical that future programmatic efforts provide methods that are both accessible and acceptable to users.     

In the high court of South Africa,case no. 4138/98: the global politics of access to low-cost AIDS drugs in poor countries

In 1998, 39 pharmaceutical manufacturers sued the government of South Africa to prevent the implementation of a law designed to facilitate access to AIDS drugs at low cost. The companies accused South Africa, the country with the largest population of individuals living with HIV/AIDS in the world, of circumventing patent protections guaranteed by the intellectual property rules that were included in the latest round of world trade agreements. The pharmaceutical companies dropped their lawsuit in the spring of 2001 after an avalanche of negative publicity. Yet, despite the government's victory, AIDS drugs remain very expensive in South Africa, and the government still refuses to provide antiretroviral therapy to adults. These events have shone a spotlight, not only on the possibilities for coordinated political activism in the era of instant global communications, but also on the tangled social, economic, and political dimensions of AIDS treatment in poor countries.