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The study investigates the risk exposure to HIV infection among South African children aged 2-9 years served by public health services. Together with their biological mothers, 3471 children and were recruited from inpatient and outpatient children in the Free State Province. Blood samples were taken by professional nurses and a history taken of exposure factors associated with HIV transmission. DNA testing was used to confirm biological maternity where the child was HIV-positive and the mother HIV-negative. Mother-child pairs were stratified by mother's HIV status. Exposure factors related to the child's HIV status were examined in each stratum using a chi-square test. Independent factors were then included in a multiple logistic regression model. Having an HIV-positive mother was strongly related to HIV infection in children (OR: 310; 95%CI: 148-781). However, seven HIV-positive children had HIV-negative mothers. Transmission in this group was significantly associated with breastfeeding by a non-biological mother (OR: 437; 95%CI: 53-5020), being fed with expressed breast milk from a milk room (OR: 37.6; 95%CI: 6.2-259.0), dental injection history (OR: 31.5; 95%CI: 4.5-189.4) and visits to a dentist (OR: 26.9; 95%CI: 4.4-283.5). Although mother-to-child-transmission is shown to be the primary mode of HIV transmission in South African children, the few HIV-positive children infected by other modes of transmission suggest a potential risk of non-vertical HIV infections. These infections can be prevented through education and improved infection-control procedures. [ABSTRACT FROM AUTHOR]

HIV prevalence among women in South Africa continues to be high despite the availability of a comprehensive plan for the control of HIV/AIDS and a plethora of prevention programmes. Any explanation for the ongoing high HIV prevalence continues to be elusive. The objective of this study was to understand the relationship between HIV, gender, race and socioeconomic status among South African public sector educators in order to inform prevention programmes. A cross-sectional survey involving a probability sample of 1,766 schools out of 26,713 in the Department of Education Register of School Needs was selected. A sample of 24,200 respondents out of 356,749 public sector educators participated in the study. Nurses registered with the South African Nursing Council were recruited, trained to conduct interviews and to collect specimens for HIV testing. The study found an association between HIV, gender, race and socioeconomic status among educators. African educators showed a higher HIV prevalence than other race groups. Among females, the highest HIV prevalence was among educators aged 25-35 years and in males aged 36-49 years. Further, educators with a high income and educational qualifications had a lower HIV prevalence compared to educators with low income and low educational qualifications, regardless of sex. Migration and marital factors were also found to play a role in HIV infection. The results suggest that HIV prevention needs to take into account critical issues around empowerment of vulnerable groups such as women and certain race groups to be able to implement safe sexual practices and therefore reduce HIV infections. [ABSTRACT FROM AUTHOR]

There is a growing need for applied social sciences research to provide scientific evidence for use in both policy and programme development in the health sector to match the strides made in clinical medicine over the past few decades. This article presents an account of the development, implementation and progress as well as lessons learnt to date from a 5-year programme for the care of orphans and vulnerable children (OVC) in Botswana, South Africa and Zimbabwe that began in 2002. The project is being conducted by the Social Aspects of HIV/AIDS Research Alliance (SAHARA) under the auspices of the Human Sciences Research Council (HSRC) of South Africa. The main objective of the project is to provide empirical evidence of the effectiveness of various OVC interventions with a view to identifying best practices for scaling-up in the Southern African region, which is most heavily burdened by the HIV/AIDS epidemic. The initiative, which is funded by the WK Kellogg Foundation, brought together six organizations in Botswana, South Africa and Zimbabwe, with the blessing of their respective governments – one national implementation grant maker to coordinate the delivery of various child, family and community-centred OVC interventions and one research organization in each country. The project is currently being implemented in various sites in each of the three countries. Some previously existing OVC interventions are being supported in a number of sites in each country, which are receiving process evaluations, while both qualitative and quantitative baseline studies have been completed in two new sites in each country. Newly developed interventions developed or described by the project that are felt to reflect a best practice approach will be implemented in these new sites and will be evaluated, using a summative evaluation approach in the next phase of the project, which is expected to last another 3–5 years. Although there have been many challenges experienced in the project, some excellent progress has also been accomplished, especially in terms of various research outputs that have been completed to date which lay a strong foundation for the next phase of the project beginning in 2006. These lessons, together with the implications for the use of implementation research networks to conduct multi-country and multi-site projects, and on OVC policy in particular, are discussed. [ABSTRACT FROM AUTHOR]

South Africa is reported to have the largest number of people living with HIV/AIDS in the world. The present study investigated the behavioural responses of South African youth to the HIV/AIDS epidemic. A multi-stage stratified cluster sample of 2,430 youths aged 15-24 was selected, 46.9% of them males and 53.1% females. Nurses administered questionnaires to consenting youths, measuring behavioural risks and also took an oral fluid specimen for HIV antibody testing. It was found that the median age of sexual debut for both sexes was 16.5 years; most of the youths were sexually experienced with no variation by sex; sexual experience was highest among Africans living in informal urban areas; partner turnover was low and multiple partners were more common among African males living in urban informal settings; sexual frequency among sexually active youth was relatively low; secondary abstinence during the past 12 months was 24%; condom use at last sexual intercourse was high, at 52.8% for males and 47.6% for females, especially among Africans living in urban informal settings; and the majority of youths (74%) indicated that they had discussed HIV prevention with their partners during the past 12 months. These results suggest that South African youth are heeding the message to abstain, be faithful and use a condom; messages that are at the core of South Africa's HIV/AIDS prevention programme. [ABSTRACT FROM AUTHOR]