Publications
In this section ,AHRF NEWS aims to give you a comprehensive review of research related to the UK African HIV epidemic, published in the preceding quarter.This issue covers publications between January and June 2003.
February 2003 saw the welcome addition of two social research reports to the evidence base relating to issues surrounding the sexual health of Africans in the UK. The launch of Project Nasah and The Padare Study has opened the way for more research and provided practical information for use in the field.
Weatherburn, P et al. Project
Nasah: An Investigation into the HIV treatment information and other
needs of African people with HIV resident in England. Sigma Research,
2003 (ISBN 1 872956 66 1).
This community-based study used an action research methodology to determine
the anti-HIV treatments information intervention needs of African people
with diagnosed HIV. Questionnaires were used to gather data on issues
around health promotion needs, treatment intervention, and living with
HIV. The authors concluded that the UK government should address these
needs by: developing HIV policy that responds to these needs both within
and beyond public health; providing human rights protections to all people
with HIV in the UK; and re-focussing the national HIV social research
agenda to answer some of the many questions raised by the survey.
Chinouya, M. and Davidson, O. The
Padare Project: Assessing health-related knowledge, attitudes and
behaviours of HIV-positive Africans accessing services in north central
London.
The aims of this project were to develop the methodology and collect preliminary
data regarding HIV related knowledge, attitudes and practices (KAP) amongst
HIV positive Africans accessing services in Camden and Islington. The
data showed that religious beliefs played an important part in adhering
to HIV-related medication and that elders and peers were believed to be
credible sources of information about HIV. The data also revealed some
confusion around technical notions such as “undetectable viral load”.
The Padare project has shown that it is feasible to engage HIV positive
Africans in the collection of data regarding their sexual attitudes, practices
and access to HIV related services.
AIDS And Other Manifestations Of HIV Infection
Edited by: Dr. Gary Wormser
Publishers Blurb (Abridged): AIDS and Other Manifestations of HIV Infection is a comprehensive overview of the biologic properties of the etiologic viral agent, its clinico-pathological manifestations, the epidemiology of its infection, and present and future therapeutic and preventive options.
Academic Press, August 2003 • 1000 Pages •ISBN: 0127640517
The Handbook of Social Studies in Health and Medicine
Edited By: Gary L Albrecht, Ray Fitzpatrick and Susan C Scrimshaw
Publishers Blurb (Abridged): Five years in the making, and building on the insights and advice of an international editorial board, this book brings together world-class figures to provide an indispensable, comprehensive resource book on social science, health and medicine. The book will be of interest to nurses, students in physical therapy, occupational therapy, epidemology, primary care and public health.
Sage Publications, March 2003 (Paperback) • 546 Pages • ISBN: 0761942726.
The following papers were published in peer-reviewed journals between 1st January 2003 and 1st June 2003.
Bachmann MO,.Booysen FL. Health and economic
impact of HIV/AIDS on South African households: a cohort study. BMC Public
Health 2003;3:14.
This study compared households with and without an HIV-infected
member to determine the health and economic impacts of living with HIV.
The study showed HIV/AIDS affects the health and wealth of households
as well as infected individuals, aggravating pre-existing poverty
Castle S. Doubting the existence of AIDS:
a barrier to voluntary HIV testing and counselling in urban Mali. Health
Policy Planning. 2003;18:146-55.
Qualitative research was carried out in two Malian cities with a view
to setting up HIV voluntary testing and counselling (VCT) services. A
large number of respondents said they did not believe in the existence
of AIDS. Reasons for disbelief were related to the perceived lack of AIDS
cases in China, the inability of the virus to be transmitted by mosquitoes
and confusion about mother-to-child transmission. Widespread awareness-raising
campaigns and participatory education programmes are required to address
HIV in the context of other health risks.
Corbett EL, Watt CJ, Walker N, Maher D, Williams
BG, Raviglione MC et al.
The growing burden of tuberculosis: global trends and interactions with
the HIV epidemic. Archives of internal medicine.. 2003;163:1009-21.
Researchers reviewed data from notifications of TB cases, cohort
treatment outcomes, surveys of Mycobacterium tuberculosis infection, and
HIV prevalence in patients with TB and other subgroups. The authors conclude
prevention of HIV and TB and a focused effort to control HIV-related TB
in areas of high HIV prevalence are matters of great urgency.
Das S,.Miller RF. Lymphocytic interstitial
pneumonitis in HIV infected adults. Sexually Transmitted Infection 2003;79:88-93.
The authors describe the current knowledge on the aetiology, pathology,
presentation, diagnosis, and treatment of lymphocytic interstitial pneumonitis
in HIV infected adults. Lymphocytic interstitial pneumonitis is described
most commonly among black African and Afro-Caribbean patients. This condition
should be considered in HIV infected patients presenting with respiratory
symptoms as they may gain considerable benefit from antiretroviral therapy.
Eaton L, Flisher AJ, Aaro LE. Unsafe sexual
behaviour in South African youth. Social Science Medicine. 2003;56:149-65.
This paper presents the findings of a review of research on the factors
promoting and perpetuating unsafe sexual behaviour in South African youth.
The findings illustrate the powerful impact of the proximal and distal
contexts, and in particular , the pervasive effect of poverty and social
norms that perpetuate women’s subordination within sexual relationships.
Ghani AC, Donnelly CA, Anderson RM. Patterns of antiretroviral
use in the United States of America: analysis of three observational databases.
HIV Medicine. 2003;4:24-32.
The authors characterize patterns of antiretroviral use in HIV-infected
patients and explore variation by patient characteristics and disease
stage. Over 2000 different combinations of antiretroviral agents are recorded.
Those of African American race (odds ratio 0.59) and funded by Medicaid
(odds ratio 0.72) were significantly less likely to begin antiretroviral
therapy on HAART.
Godfrey-Faussett P,.Ayles H. Can we control
tuberculosis in high HIV prevalence settings? Tuberculosis.(Edinb.) 2003;83:68-76.
To control tuberculosis in high HIV prevalence settings, we must strengthen
health systems to include full-blooded implementation of voluntary counselling
and testing, enhanced and active tuberculosis case-finding, preventive
therapy and better care for people living with HIV including antiretroviral
therapy. The approach needed to control tuberculosis needs also to be
integrated into broader development and poverty reduction goals.
Lush L, Walt G, Ogden J. Transferring policies
for treating sexually transmitted infections: what’s wrong with
global guidelines? Health Policy Planning 2003;18:18-30.
The paper uses a case study of the development of syndromic management
for treating sexually transmitted infections (STIs) and subsequent policies
recommending worldwide use of syndromic management guidelines.
Ogundele MO,.Coulter JB. HIV transmission through breastfeeding: problems
and prevention. Annals of tropical paediatrics. 2003;23:91-106.Maternal
and infant factors contributing to the risk of MTCT through breastfeeding
are still poorly understood and not well researched. Factors identified
in this paper include: advanced clinical stages of infection in the mother;
high maternal plasma HIV-1 load; presence of mastitis; and infant oral
thrush.
Piyadigamage A,.Monteiro EF. Associations of newly diagnosed HIV-1 infections and ethnicity at a provincial UK genitourinary medicine clinic: 1998-2001 International journal of STD & AIDS. 2003;14:66-8.
Singh A, Georgalas C, Patel N, Papesch M.
ENT presentations in children with HIV infection. Clinical otolaryngology
and allied sciences.2003;28:240-3
Illnesses of the ear, nose and throat (ENT) are common in children
with HIV infection. The authors reviewed the case files of 107 HIV seropositive
children in the paediatric HIV unit at St Mary’s Hospital. The commonest
ENT diseases were cervical lymphadenopathy (70%), otitis media (46%),
oral candidiasis (35%) and adenotonsillar disease (31%). HIV transmission
was vertical in 90%. Maternal country of origin was Africa in 70% and
the UK in 13%.
Smith PR, Sarner L, Murphy M, James B, Thomas JM, Skinner CJ et al. Ethnicity
and discordance in plasma HIV-1 RNA viral load and CD4+ lymphocyte count
in a cohort of HIV-1-infected individuals. J.Clin.Virol. 2003;26:101-7.
The results suggest that plasma HIV-1 viral load is discordantly low in
Black compared with Caucasian groups stratified for CD4+ count, in this
cohort of individuals living in London. This finding has considerable
clinical relevance for the management of Black HIV-1-infected patients
within UK, with significant implications for the decision about when to
commence antiretroviral or immune-based therapies
Stephenson JM,.Cowan FM. Evaluating interventions for HIV prevention in Africa. Lancet 2003;361:633-4.
Walker PR, Worobey M, Rambaut A, Holmes EC, Pybus OG. Epidemiology: Sexual transmission of HIV in Africa. Nature 2003;422:679.
Willumsen JF, Filteau SM, Coutsoudis
A, Newell ML, Rollins NC, Coovadia HM et al. Breastmilk RNA viral load
in HIV-infected South African women: effects of subclinical mastitis and
infant feeding. AIDS 2003;17:407-14.