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Randomized controlled trial evaluating the effect of an interactive group counseling intervention for HIV-positive women on prenatal depression and disclosure of HIV status
- Authors:
- KAAYA Sylvia F., et al
- Journal article citation:
- AIDS Care, 25(7), 2013, pp.854-862.
- Publisher:
- Taylor and Francis
To assess the effectiveness of group counseling on reducing depressive symptoms and increasing prenatal disclosure rates of HIV status among HIV-positive pregnant women living in Tanzania, a randomized controlled trial was performed comparing a six-week structured nurse-midwife facilitated psychosocial support group with the standard of care. Sixty percent of women in the intervention group were depressed post-intervention, versus 73% in the control group. HIV disclosure rates did not differ across the two study arms. However, among those women who disclosed, there was a significantly higher level of overall personal satisfaction with the response to disclosure from family and friends among women in the treatment (88%) compared to the control group (62%). The results indicate reductions in the level of depressive symptoms comparable with major depressive disorder (MDD) for HIV-positive pregnant women participating in a group counseling intervention. Although the psychosocial group counseling did not significantly increase disclosure rates, an improvement in the level of personal satisfaction resulting from disclosure was associated with the intervention. This suggests that the counseling sessions have likely reduced the burden of depression and helped clients better manage partner reactions to disclosure. (Edited publisher abstract)
Reflections on study abroad education: guidelines on study abroad preparation and process
- Authors:
- JACKSON Delma S., NYONI Frowin P.
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 22(2), February 2012, pp.201-212.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Cultural competence provides an education and training perspective with which to develop professional skills in working with culturally diverse clients. In view of constant changes in today's world, it is imperative that social work education embrace a global perspective. Therefore, educators must continue to pay attention to, and adopt methods of, social interventions needed to address changing world circumstances. This article presents a rationale for the study abroad experience and for the use of social networking to enhance the experience, and considers the preparation and education of social work students for a global perspective in social work practice.
Predictors of welfare and child outcomes in female-headed households in sub-Saharan Africa
- Authors:
- LOMBE Margaret, SAFADI Najwa, NEWRANSKY Chrisann
- Journal article citation:
- Journal of Comparative Social Welfare, 27(1), February 2011, pp.75-89.
- Publisher:
- Taylor and Francis
This study examines correlates of household welfare in female-headed households in three countries of sub-Saharan Africa – Tanzania, Zambia, and Zimbabwe – using data from the 2004 wave of the Afrobarometer survey (n = 3525). More specifically, the authors assess the role government interventions and informal assistance might play in predicting household welfare. The association between female headship of a household and aspirations for child future outcomes is also examined. Study findings suggest country variations in experiences of welfare and perception of child outcomes. The authors also note that certain individual and household characteristics are linked to both household welfare and perception of child outcomes. Practice and policy implications are suggested.
Exploring moderating effects of violent conflict on household welfare in a resource-constrained environment: the case of sub-Saharan Africa
- Authors:
- LOMBE Margaret, et al
- Journal article citation:
- Journal of Social Service Research, 36(4), July 2010, pp.289-302.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Correlates of household welfare in three countries of sub-Saharan Africa, Tanzania, Zambia, and Zimbabwe are examined using data from the 2004 wave of the Afrobarometer survey. It also assesses the role that violent conflict might play in influencing this relationship. This subject has become especially relevant today in sub-Saharan Africa, given the growing disfranchisement of vulnerable individuals and households and increased incidents of violent conflict. Insight into the relationship between violent conflict and household welfare may be an important step in understanding why many sub-Saharan African countries have difficulties in stimulating economic growth and welfare. The Afrobarameter survey makes up a series of national public attitude surveys from 16 African countries; the study sample for the three selected countries included 3,525 respondents. The study findings provided partial support for the hypothesised relationship. Specifically, poverty reduction initiatives and informal assistance are associated with reduced hardship, while violent conflict is related to an increase in hardship. The article also notes that certain individual and household characteristics are linked to hardship. Practice and policy implications are suggested.
Attainment of basic needs as a predictor of civic engagement in sub-Saharan Africa: some implications
- Authors:
- LOMBE Margaret, OCHUMBO Alex Juma, NORSTRAND Julie
- Journal article citation:
- Journal of Comparative Social Welfare, 24(2), October 2008, pp.103-117.
- Publisher:
- Taylor and Francis
Building on previous research on basic needs and civic engagement, this study attempts to understand whether or not attainment of basic needs will predict civic engagement in a resource-constrained environment. It also assess the moderating effects of perceived trust in governmental institutions on this relationship. Data from the Afrobarometer survey is used to examine these relationships in three sub-Saharan Africa countries: Tanzania, Zambia and Zimbabwe. Findings provide support for the hypothesized relationship that attainment of basic needs predicts civic engagement. Furthermore, civic engagement appears to be higher at higher levels of perceived trust in government. These findings provide a preliminary base for exploring factors that may be important in understanding civic behaviour in the context of sub-Saharan Africa.
Couple counselling and testing for HIV at antenatal clinics: views from men, women and counsellors
- Authors:
- MLAY R., LUGINA H., BECKER S.
- Journal article citation:
- AIDS Care, 20(3), March 2008, pp.356-360.
- Publisher:
- Taylor and Francis
The purpose of this study was to gain insight from views of Tanzanian men and women on couple voluntary counselling and testing (CVCT) for HIV at antenatal clinics (ANC) in Tanzania. Data collection was through focus group discussions with women aged 25-48 years (n=8), women 18-24 years (n=10), HIV counsellors (n=11), men aged 20-34 (n=8) and men aged 35-75 years (n=8) and in-depth interviews (IDI) with five men and eight women. Participants were asked their views concerning men volunteering for CVCT for HIV, motivation of couples to receive results together and effective ways of counselling sero-discordant couples. Many participants agreed on the importance of incorporating CVCT at ANC, while others expressed reservations due to the cultural belief that ANC is for women. The importance of love, care and respect between sero-discordant couples was stressed; nonetheless, many anticipated that disclosure of HIV-positive status to an HIV-negative spouse could result in abandonment, divorce or violence against the woman whether she was sero-negative or -positive. Couple counselling and testing at ANC incorporating the suggestions made by study participants could become an important intervention for the prevention of HIV transmission and maintenance of good relations between sero-discordant partners.
Community perspectives on care options for HIV prevention trial participants
- Authors:
- McQUEEN K. M., et al
- Journal article citation:
- AIDS Care, 19(4), April 2007, pp.554-560.
- Publisher:
- Taylor and Francis
There is on-going global debate and policy-setting concerning researchers' obligations to meet the health needs of people participating in HIV prevention trials in resource-poor settings. The perspectives of local community stakeholders on this issue are poorly understood as most of what is presented on behalf of communities where research takes place is anecdotal commentary. Using qualitative methods (130 in-depth interviews and 20 focus groups) the authors assessed perceived fairness of different strategies to meet the health needs of women who become HIV-infected during a hypothetical vaginal microbicide trial. Respondents included HIV prevention research participants, community stakeholders and health-care service providers in ten sites in seven countries (South Africa, Malawi, Tanzania, Zimbabwe, Zambia, India, US). Many respondents perceived referrals to be a potentially fair way to address care and treatment needs but concerns were also voiced about the adequacy of local health-care options and the ability of trial participants to access options. Most respondents viewed the provision of antiretroviral treatment by researchers to HIV-infected trial participants as unfair if treatment was not sustained beyond the end of the trial. The results underscore the importance of effectively linking trial participants to sustainable, community-based treatment and care.
Responsibility as a dimension of HIV prevention normative beliefs: measurement in three drug-using samples
- Authors:
- ROSS M.W., et al
- Journal article citation:
- AIDS Care, 19(3), March 2007, pp.403-409.
- Publisher:
- Taylor and Francis
The concept of responsibility was derived originally from principles of morality, as part of a network of rights, duties and obligations. HIV risk-related studies have suggested that a sense of responsibility for condom use to protect a partner is a potentially important predictor of condom use in drug-using populations. The authors created a four-item scale measuring Self responsibility to use condoms and Partner's responsibility to use condoms. Data were collected from three drug-using samples: crack smokers, HIV seropositive crack smokers in an intervention study in Houston, Texas, and Tanzanian heroin users in Dar es Salaam. Data indicated that the four responsibility items had high alpha coefficients in each sample, and that there were moderate to high intercorrelations between equivalent self and partner responsibility items. There were significant differences in scale scores between the crack smokers and the HIV positive crack smokers and the Tanzanian samples, but no significant differences between the HIV positive and Tanzanian samples. Comparing within the first crack-smoker sample those who were HIV positive and negative showed significant differences in the direction of higher beliefs in responsibility to use condoms in the HIV positive group. These data suggest that responsibility is measurable, holds similar psychometric properties across three samples differing in culture and HIV serostatus, and that condom use responsibility is conceptualized as a measure of general responsibility rather than as a reciprocal self/partner responsibility.
`The man who believed he had AIDS was cured': AIDS and sexually-transmitted infection treatment-seeking behaviour in rural Mwanza, Tanzania
- Authors:
- PLUMMER Mary L., et al
- Journal article citation:
- AIDS Care, 18(5), July 2006, pp.460-466.
- Publisher:
- Taylor and Francis
Most people living with AIDS in sub-Saharan Africa have had neither a biomedical diagnosis nor antiretroviral medication, leading to the question of how individuals understand and treat AIDS. This study examined general illness, sexually-transmitted infection (STI) and AIDS treatment-seeking behaviour in rural Mwanza, Tanzania. From 1999-2002, participant observation was carried out in nine villages for a total of 158 person-weeks. Treatments were pluralistic and opportunistic, usually beginning with home remedies (western or traditional), followed by visits to traditional healers (THs) and/or health facilities (HFs). THs were sometimes preferred over HFs because of familiarity, trust, accessibility, expense, payment plans, and the perceived cause, nature and severity of the illness, e.g. only THs were believed to successfully treat bewitchment. Some people, particularly young girls, delayed or avoided seeking treatment for STIs for fear of stigma. Most STIs were attributed to natural causes, but AIDS was sometimes attributed to witchcraft. Locally available biomedical care of people with AIDS-like symptoms consisted of basic treatment of opportunistic infections. Most such individuals repeatedly visited THs and HFs, but many stopped attending HFs because they came to believe they could not be cured there. Some THs claimed to cure witchcraft-induced, AIDS-like illnesses. There is an urgent need for improved biomedical services, and TH interventions could be important in future HIV/AIDS education and care.
The epidemiology of HIV-1 infection in northern Tanzania: results from a community-based study
- Authors:
- KAPIGA S. H., et al
- Journal article citation:
- AIDS Care, 18(4), May 2006, pp.379-387.
- Publisher:
- Taylor and Francis
The authors conducted a community-based study to determine the predictors of HIV-1 among women aged 20–44 years (N=1,418) and their regular male partners (N=566) from randomly selected households in Moshi, Tanzania. The weighted prevalence of HIV-1 was 10.3% in women and 7% in men. The highest risk of HIV-1 was in subjects whose partners were HIV-1 seropositive in both women and men. Herpes simplex virus type 2 (HSV-2) and Mycoplasma genitalium were also significantly associated with HIV-1. Women with male partners 12 or more years older than themselves had increased risk of HIV-1. Other predictors of HIV-1 were history of infertility and the number of sex partners in the last three years in women and the age at time of circumcision and history of past sexually transmitted diseases (STDs) in male partners. These findings show that HIV-1/STDs were major public health problems among women and their long-term partners in this population. HIV-1 prevention efforts should include promotion of couple's HIV-1 counseling and testing services, control of HSV-2, promotion of safer sexual practices and strategies to reduce the age difference between women and their partners.