The political environment of HIV: lessons from a comparison of Uganda and South Africa

Parkhurst, Justin; Lush, Louisiana

doi:10.1016/j.socscimed.2004.02.026

Cited by 108 publications

(45 citation statements)

References 12 publications

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“…Although health department employees were consulted in designing the intervention, it may be beneficial to extend the macrolevel structural approach by including greater direct involvement by community agencies as well as other sectors of local government to promote condom use in such establishments (Parkhurst & Lush, 2004). Before bar managers and owners will commit fully to a macrolevel structural approach encouraging condom use among their FCSWs and clients, both the message and the behavior of a variety of governmental agencies must be nonambiguous.…”

Section: Suggestions For Future Researchmentioning

confidence: 99%

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Morisky¹,

Stein²,

Chiao³

et al. 2006

Health Psychology

103

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The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager-peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences. Keywordsfemale commercial sex workers; HIV/AIDS risk; social influence intervention; STIs; condom use Female commercial sex workers (FCSWs) are at high risk of transmitting HIV and sexually transmitted infections (STIs). This is particularly true in Asian countries, such as the Philippines. For instance, a recent large survey showed an exceptionally high prevalence rate of chlamydiosis among Filipino FCSWs ranging from 27% to 36% (World Health Organization, 2002). According to the survey, the principal mode of transmission was heterosexual contact (World Health Organization, 2002 HIV prevention has traditionally focused on using cognitive-behavioral individually oriented approaches to induce beneficial changes in the individual's attitudes, knowledge, and behaviors regarding HIV, with little attention to important structural-environmental factors that also account for individual behaviors (O'Leary, Holtgrave, Wright-DeAguero, & Malow, 2003). However, individualized prevention strategies may be less than optimal in changing risky behaviors in such situations as those of commercial sex workers (Bandura, 1982(Bandura, , 1987Ford et al., 1996;O'Leary & Martins, 2000;Pleck, Sonenstein, & Ku, 1990). Social-structural factors, such as extreme poverty, which characterizes Filipino FCSWs, and a lack of support by employers as well as customers may impede safe sex practices; satisfying the customer's desire for sex without a condom may have become almost mandatory in maintaining one's livelihood and reducing conflicts with employers, despite the FCSW's personal perception of risk. Peers may also exert an influence on safe sex behaviors when FCSWs are based within establishments. Therefore, economic factors, peer influences, and employment-or employerrelated factors may have become a major barrier against consistent condom use ( Morisky et al., 1998;Outwater et al., 2000).In contrast, a perception of a supportive attitude by one's employer toward cond...

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Section: Suggestions For Future Researchmentioning

confidence: 99%

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Morisky¹,

Stein²,

Chiao³

et al. 2006

Health Psychology

103

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“…25 Another candidate for criminalization of transmission facilitation might be deliberate activities to discourage people on a wide scale from getting effective treatment. For example, Thabo Mbeki, president of South Africa from 1999 to 2008, denied the reality of HIV during his term in office (Parkhurst and Lush 2004). His denials persisted despite repeated pleas from scientists and South Africa's own HIV plan.…”

Section: Criminal Law and Transmission Facilitationmentioning

confidence: 99%

Criminalizing Health-Related Behaviors Dangerous to Others? Disease Transmission, Transmission-Facilitation, and the Importance of Trust

Francis

2011

Criminal Law, Philosophy

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“…It has traditionally been heralded as a model sub-Saharan Africa county for curbing the HIV epidemic-from 35% prevalence in 1992 [3][4][5], to a national HIV prevalence of 6.4% by 2005 [4]. The early success of Uganda in reducing HIV prevalence has been engendered impassioned debates, and has been attributed in-part to an early national policy of open discussion about AIDS and messages that emphasized the risks and reality of AIDS and communications that focused on partner reduction outside of long-term marital and cohabiting partnerships (referred to as "zero grazing") [4,6]. It is hypothesized that these in turn triggered risk avoidance and changes in sexual behavior [5].…”

Section: Introductionmentioning

confidence: 99%

Re-focusing HIV Prevention Messages: A Qualitative Study in Rural Uganda

Mathur

Romo

Rasmussen

et al. 2016

Journal of Adolescent Health

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The political environment of HIV: lessons from a comparison of Uganda and South Africa

Cited by 108 publications

References 12 publications

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

Criminalizing Health-Related Behaviors Dangerous to Others? Disease Transmission, Transmission-Facilitation, and the Importance of Trust

Re-focusing HIV Prevention Messages: A Qualitative Study in Rural Uganda

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