Browsing Faculty of Health Sciences by Author "Tlou, S."
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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) -
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)
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