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The aim of this study was to examine the relationships among changes in self-reported HIV and sexually transmitted infection (STI) and exposure to the loveLife youth HIV prevention programmes. A cross-sectional population-based household survey was conducted using a multistage stratified cluster sampling approach. The total sample included 3123 participants, aged 18-24, 54.6% men and 45.4% women, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). Results indicate a self-reported STI past-year prevalence of 2.6%, experienced genital sores or ulcers in the past year prevalence of 3.9% and an HIV self-reported prevalence of 7.4%. In multivariable analyses it was found that knowing a person living with HIV and a person who has died from AIDS, lower education, having had two or more sexual partners in the past year, not having talked with a partner about condom use, difficulty of getting condoms and not having been male circumcised were associated with having been diagnosed with an STI in the past 12 months and/or HIV. Face-to-face and multimedia youth HIV prevention programmes had limited effect. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of obesity, overweight, central obesity and their associated factors in older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. In a national population-based survey, height, weight, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of central obesity. Participants included 2202 women and 1638 men (total n=3840) with respective mean ages of 63.1 ± 10.0 and 62.2± 9.3 years aged 50 years or older in South Africa. Among men 66.7% were overweight or obese (> or =25 kg/m2) and 56.0% had abdominal obesity (WHR >0.90), whereas 76.7% of women were overweight or obese and 70.4% had abdominal obesity (WHR >0.85). Underweight (BMI <18.5 kg/m2) was found in 4.2% of men and 2.6% of women. The overall prevalence rates of overweight and obesity were 27.2% and 45.1%, respectively. The overall prevalence rate of abdominal obesity was 64.1%. In multivariable regression analysis, female gender (0R0.58, 0.47-0.72), low physical activity (OR=I.96, 1.39-2.76), arthritis (OR=l.73, 1.24-2.43) and hypertension (ORl.41, 1.04-1.92) were associated with obesity based on BMI. Overnutrition is prevalent among older South Africans, particularly women. Determinants of overnutrition include female gender, low physical activity and chronic conditions. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore drug prescription habits using WHO standard indicators in 15 public hospitals and 36 private surgeries in 2 provinces in South Africa. A high mean number of drugs were prescribed per patient (3.2 versus 2.8) in public hospitals and by general practitioners (GPs) respectively and generic prescribing rates were low (45.2% versus 24.5%). The rates of prescribing in public hospitals and by GPs were 8.3% versus 23.3% for injections, 68.1% versus 31.9% for antibiotics and 92.6% versus 68.5% for drugs from the essential drugs list. Drug prescribing in both sectors needs to be regulated, especially the use of antibiotics, essential drugs and generic prescribing. [ABSTRACT FROM AUTHOR]

PURPOSE: The paper's aim is to determine the role of non-profit organizations (NPOs) in filling possible gaps in primary health care (PHC) service provision. DESIGN/METHODOLOGY/APPROACH: District (n = 10) and sub-district needs (n = 14) analyses were conducted in five South African provinces. In each case, the district/sub-district manager was interviewed using a semi-structured interview guide. FINDINGS: The service gaps identified were understaffing/lack of capacity, difficulty in retaining and recruiting staff, service disparities, inaccessibility of services/low-service utilisation and limited funding. It was believed that NPOs could fill these gaps. About 83 per cent perceived the relationship between government and NPOs as good. Contract monitoring, quality of service, communication and quality control were said to be unsatisfactory. The majority of sub-districts (11) indicated that they provided supplies to NPOs; 50 per cent perceived the relationship between the sub-districts and NPOs as good or very good. NPOs have critical role to play in PHC service delivery. ORIGINALITY/VALUE: The study provides critical information required to make informed effective strategic decisions that support district/sub-district performance and sustainability in a decentralized health system. [ABSTRACT FROM AUTHOR]

In order to explore the relevance of social concepts such as stigma and denial to the transmission of HIV, this qualitative study sought to examine cultural and racial contexts of behaviour relevant to the risk of HIV infection among South Africans. A cultural model was used to analyse transcripts from 39 focus group discussions and 28 key informant interviews. Results reveal how cultural and racial positionings mediate perceptions of the groups considered to be responsible and thus vulnerable to HIV infection and AIDS. An othering of blame for HIV and AIDS is central to these positionings, with blame being refracted through the multiple prisms of race, culture, homophobia and xenophobia. The study's findings raise important questions concerning social life in South Africa and the limitation of approaches that do not take into account critical contextual factors in the prevention of HIV and care for persons living with AIDS. [ABSTRACT FROM AUTHOR]

Abstract Background Successful antiretroviral treatment is dependent on sustaining high rates of adherence. In the southern African context, only a handful of studies (both quantitative and qualitative) have looked at the determinants including a health behaviour theory of adherence to antiretroviral therapy. The aim of this study is to assess factors including the information, motivation and behavioural skills model (IMB) contributing to antiretroviral (ARV) adherence six months after commencing ARVs at three public hospitals in KwaZulu-Natal, South Africa. Methods Using systematic sampling, 735 HIV-positive patients were selected prior to commencing on ART from outpatient departments from three hospitals and followed-up at six months and interviewed with a questionnaire. Results A good proportion of patients were found to be adherent using both adherence instruments (visual analog scale = VAS 82.9%; Adult AIDS Clinical Trials Group = AATCG 70.8%). After adjusting for significant socio-economic variables, both the VAS and the dose, schedule and food adherence indicator found levels of adherence amongst urban residents to be almost 3 times greater than that of rural residents. After adjusting for health-related variables, for both indicators better adherence was associated with low depression and poorer adherence was associated with poor environmental factors. Adjusted odds ratios for adherence when taking into account different behavioural variables were for both adherence indicators, discrimination experiences were associated with lower adherence, and higher scores in adherence information and behavioural skills were associated with higher adherence. For the VAS adherence indicator, higher social support scores were associated with higher adherence. For the dose, schedule and food adherence indicator, using herbal medicines for HIV was associated with lower adherence. Conclusion For the patients in this study, particularly those not living in urban areas, additional support may be needed to ensure patients are able to attend appointments or obtain their medications more easily. Adherence information and behavioural skills as part of the IMB model should be strengthened to improve adherence. Further psychological support is also required and patients' perceived need for ARTs should be routinely assessed.

Abstract Background Traditional medicine use has been reported is common among individuals with moderate and advanced HIV disease. The aim of this cross-sectional study was to assess the use of Traditional Complementary and Alternative Medicine (TCAM) for HIV patients prior to initiating antiretroviral therapy in three public hospitals in KwaZulu-Natal, South Africa. Methods Using systematic sampling, 618 HIV-positive patients were selected from outpatient departments from three hospitals and interviewed with a questionnaire. Results TCAM was commonly used for HIV in the past six months by study participants (317, 51.3%) and herbal therapies alone (183, 29.6%). The use of micronutrients (42.9%) was excluded from TCAM since mostly vitamins were provided by the health facility. Herbal therapies were the most expensive, costing on average 128 Rand (US$16) per patient per month. Most participants (90%) indicated that their health care provider was not aware that they were taking herbal therapies for HIV (90%). Herbal therapies were mainly used for pain relief (87.1%) and spiritual practices or prayer for stress relief (77.6%). Multivariate logistic regression with use of herbs for HIV as the dependent variable identified being on a disability grant and fewer clinic visits to be associated with use of herbs, and TCAM use for HIV identified being on a disability grant, number of HIV symptoms and family members not contributing to main source of household income to be associated with TCAM use. Conclusion Traditional herbal therapies and TCAM are commonly used by HIV treatment naïve outpatients of public health facilities in South Africa. Health care providers should routinely screen patients on TCAM use when initiating ART and also during follow-up and monitoring keeping in mind that these patients may not fully disclose other therapies.