Browsing Faculty of Health Sciences by Author "Phaladze, N."
Now showing items 1-5 of 5
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Weiser, S.D.; Leiter, K.; Bangsberg, D.R.; Butler, L.M.; Percy-de Korte, F.; Hlanze, Z.; Phaladze, N.; Iacopino, V.; Heisler, M. (Plos Medicine. www.plosmedicine.org, NaN, 2007)[more][less]
Abstract: Background: Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. Methods and Findings: We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27–2.36), sex exchange (AOR 1.84, 95% CI 1.74–1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03–2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24–2.28). Associations between food insufficiency and risky sex were much attenuated among men. Conclusions: Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women’s leg URI: http://hdl.handle.net/10311/556 Files in this item: 1
Food insufficiency.pdf (2.245Mb) -
Phaladze, N.; Tlou, S. (Oxfam. http://www.ingentaconnect.com/content/routledg/cgde, January 1, 2006)[more][less]
Abstract: This article discusses the response of Botswana to the HIV/AIDS epidemic. In recognition of the fact that HIV/AIDS is more than just a health issue, Botswana has instigated a multi-sectoral response to the epidemic, which sets Botswana apart as an example of a country following ‘best practice’ in HIV/AIDS prevention and control. Yet the battle is not over. AIDS is the leading cause of death in Botswana for young adult women aged between 15 and 19 years old. This article makes suggestions for future improvement, to respond to the challenges facing Batswana women living with, and affected by, HIV/AIDS. URI: http://hdl.handle.net/10311/567 Files in this item: 1
Gender and HIV.pdf (1.167Mb) -
Nthomang, K.; Phaladze, N.; Oagile, N.; Ngwenya, B.; Seboni, N.; Gobotswang, K.; Kubanji, R. (Taylor & Francis, http://www.informaworld.com/smpp/title~db=all~content=t713723020, NaN, 2009)[more][less]
Abstract: HIV-related stigma is a life-altering phenomenon. The consequence of the stigmatization process sets apart stigmatized person(s) as a distinct category, leading to various forms of disapproval, rejection, exclusion, labeling, stereotyping, and discrimination. Stigma of HIV-positive people in Botswana is a complex social phenomenon associated with the disease itself and the behaviors that lead to infection. This is a synthesis paper based on the literature review on HIV- and AIDS-related stigmatization of HIV-positive people in Botswana and in-depth interviews with people living with HIV and AIDS (PLWHAs). I examine the literature on HIV- and AIDS-related stigmatization and subsequent discrimination and the implications for intervention programs for people living with HIV and AIDS. The findings from the literature and in-depth interviews show that HIV-AIDS-related stigma is deeply embedded in societal structures and culture which promote nonacceptance of those branded HIV positive. This often is reinforced at a practical level by pervasive negative attitudes toward PLWHAs. Recommendations argue for the adoption of Healthy Relationship. This intervention seeks to promote and strengthen decision-making skills among PLWHAs and programs that promote destigmatization of, and tolerant attitudes toward, PLWHAs. URI: http://hdl.handle.net/10311/857 Files in this item: 1
Nthomang_HCWI_2009.pdf (103.4Kb) -
Weiser, S. D.; Leiter, K.; Heisler, M.; McFarland, W.; Percy-de Korte, F.; DeMonner, S. M.; Tlou, S.; Phaladze, N.; Iacopino, V.; Bangsberg, D. R. (Public Library of Science, http://www.plos.org/, January 1, 2006)[more][less]
Abstract: Background In Botswana, an estimated 24% of adults ages 15–49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors. Methods and Findings We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age ≥gap 10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers. Conclusions Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere. URI: http://hdl.handle.net/10311/591 Files in this item: 1
Populaton based study.pdf (2.223Mb) -
Weiser, S.D.; Heisler, M.; Leiter, K.; Percy-de Korte, F.; Tlou, S.; DeMonner, S.; Phaladze, N.; Bangsberg, D.R.; Iacopino, V. (PLoS Medicine. www.plosmedicine.org, NaN, 2006)[more][less]
Abstract: Background The Botswana government recently implemented a policy of routine or "opt-out" HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults. Methods and Findings We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81%) reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%), HIV-related stigma (60%), and violence toward women (55%), and would increase access to antiretroviral treatment (93%). At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR ¼ 1.5, 95% CI ¼ 1.1–1.9), higher education (AOR¼2.0, 95% CI¼1.5–2.7), more frequent healthcare visits (AOR¼ 1.9, 95% CI ¼ 1.3–2.7), perceived access to HIV testing (AOR ¼ 1.6, 95% CI ¼ 1.1–2.5), and inconsistent condom use (AOR ¼ 1.6, 95% CI ¼ 1.2–2.1). Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR ¼ 0.7, 95% CI ¼ 0.5–0.9) or to have heard of routine testing (AOR ¼ 0.59, 95% CI ¼ 0.45–0.76). While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one’s status (49%), lack of perceived HIV risk (43%), and fear of having to change sexual practices with a positive HIV test (33%). Conclusions Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is adopted elsewhere, measures should be implemented to assure true informed consent and human rights safeguards, including protection from HIV-related discrimination and protection of women against partner violence related to testing. URI: http://hdl.handle.net/10311/554 Files in this item: 1
Routine HIV testing.pdf (1.339Mb)
Now showing items 1-5 of 5