Publications

This section aims to provide a comprehensive review of research related to the UK African HIV epidemic published in the last quarter. This issue covers publications between October and December 2003.

Reports | Papers | Books

Books

Health and Social Justice: Politics, Ideology, and Inequity in the Distribution of Disease
Edited by Richard Hofrichter
Publisher’s Blurb: This important book examines the political implications of various perspectives used to explain health inequities and explores alternative strategies for eliminating them.
Jossey-Bass • Oct. 2003 • 688 pages • ISBN: 0787967335

Lipodystrophhy Syndrome in HIV
Edited by Christine A. Wanke and Sherwood L. Gorbach
Publisher’s Blurb: This volume allows the reader to develop a relatively complete snapshot of HIV-associated Lypodystrophy syndrome and confront the emerging literature with a critical eye.
Kluwer Academic Publishers • Oct. 2003 • 248 pages ISBN 1402076223

Learning from HIV and AIDS
Edited by George Ellison, Melissa Parker and Catherine Campbell
Publisher’s Blurb: Written for students and researchers, and taking an interdisciplinary perspective, this book provides a complete picture of HIV/AIDS - from the biological and social factors which facilitate HIV transmission - to the powerful cultural and political forces which fuel the pandemic.
Cambridge University Press • Oct. 2003 • 318 pages ISBN: 0521004705

Papers

The following papers were published in peer-reviewed journals between 1st September 2003 and 31st December 2003.

Kesby, M. et al. (2003). An agenda for future research on HIV and sexual behaviour among African migrant communities in the UK. Soc.Sci.Med., 57, 1573-1592.
The epidemiology of the recent rise in HIV cases in Britain highlights the need for more research among the heterosexual African migrant population. The authors advocate that a broad range of qualitative techniques be deployed both to uncover the empirical details of specifically African sexual behaviours and to highlight and explore the ‘relational’ nature of sexual decision-making. Researchers need to utilise the parallel literature on the social embeddedness of HIV in Africa to inform analysis of the British context. It would then be possible to address the crucial question of whether the social conditions known to cause high-risk behaviours and facilitate transmission in Africa persist, or are transformed, after migration to the UK. Finally the authors propose that researchers seek ways to work with, not on, African communities in order to facilitate their own informed management of sexual health.

Gibb, D. M. et al. (2003). Decline in mortality, AIDS, and hospital admissions in perinatally HIV-1 infected children in the United Kingdom and Ireland. BMJ, 327, 1019.
The authors describe changes in demographic factors, disease progression, hospital admissions, and use of antiretroviral therapy in children with HIV. 944 children with perinatally acquired HIV were reported in the United Kingdom and Ireland by October 2002; 628 (67%) were black African, 205 (22%) were aged > or = 10 years at last follow up, 193 (20%) are known to have died. The proportion of children presenting who were born abroad increased from 20% in 1994-5 to 60% during 2000-2. In children with HIV infection, mortality, AIDS, and hospital admission rates have declined substantially since the introduction of three or four drug antiretroviral therapy in 1997. As infected children in the United Kingdom and Ireland are living longer, there is an increasing need to address their medical, social, and psychological needs as they enter adolescence and adult life.

Day, J. H. et al. (2003). Attitudes to HIV voluntary counselling and testing among mineworkers in South Africa: will availability of antiretroviral therapy encourage testing? AIDS Care, 15, 665-672.
This study was conducted to identify attitudes that influence uptake of HIV voluntary counselling and testing (VCT) amongst gold mine workers in South Africa; 105 healthy men were interviewed. The level of basic knowledge of HIV was high, but reported awareness of the extent of HIV infection in the workforce and perceived personal risk of HIV infection was low; one-third of the men had been tested. Fear of testing positive for HIV and the consequences, such as stigmatization, disease and death, were the major identified barriers to VCT. A vigorous community education programme is essential if the introduction of ART is to be effective in promoting uptake of VCT

McGinnis, K. A. et al. (2003). Understanding racial disparities in HIV using data from the veterans aging cohort 3-site study and VA administrative data. Am.J.Public Health, 93, 1728-1733.
The authors identified race-associated differences in survival among HIV-positive US veterans to examine possible etiologies for these differences. Nationally, minority veterans had higher mortality rates than did white veterans with HIV. Minority veterans had poorer health than white veterans with HIV. No significant differences were found in clinical management or adherence. HIV-positive minority veterans experience poorer survival than white veterans. This difference may derive from differences in comorbidities and in the severity of illness of HIV-related disease

Taha, T. E. et al. (2003). Short post exposure prophylaxis in newborn babies to reduce mother-to-child transmission of HIV-1: NVAZ randomised clinical trial. Lancet, 362, 1171-1177.
The authors aimed to determine whether post-exposure prophylaxis of nevirapine plus zidovudine given to babies only reduced transmission of HIV more than did a regimen of nevirapine alone. The overall rate of mother-to-child transmission at 6-8 weeks was 15.3% in 484 babies who received nevirapine and zidovudine and 20.9% in 468 babies who received nevirapine only (p=0.03). At 6-8 weeks, in babies who were HIV negative at birth, 34 (7.7%) babies who had nevirapine and zidovudine and 51 (12.1%) who received nevirapine only were infected (p=0.03)-a protective efficacy of 36%. Post exposure prophylaxis can offer protection against HIV infection to babies of women who missed opportunities to be counselled and tested before or during pregnancy. The nevirapine and zidovudine regimen is safe and easy to implement

Bradshaw, D. et al. (2003). Initial burden of disease estimates for South Africa, 2000. S.Afr.Med.J., 93, 682-688.
This paper describes the first national burden of disease study for South Africa. The top single cause of mortality burden was HIV/AIDS followed by homicide, tuberculosis, road traffic accidents and diarrhoea. HIV/AIDS accounted for 38% of total Years of life lost (YLLs), which is proportionately higher for females (47%) than for males (33%). Pre-transitional diseases, usually associated with poverty and underdevelopment, accounted for 25%, non-communicable diseases 21% and injuries 16% of YLLs.

Boerma, J. T. et al. (2003). Understanding the uneven spread of HIV within Africa: comparative study of biologic, behavioral, and contextual factors in rural populations in Tanzania and Zimbabwe. Sex Transm.Dis., 30, 779-787.
Large differences in the spread of HIV have been observed within sub-Saharan Africa. Substantial differences exist between the contemporary sociodemographic profiles of rural Manicaland and Kisesa. However, these differences did not translate into measurable differences in the biologic or behavioral factors for which data were available and did not explain the much higher HIV prevalence found in Manicaland. These findings might reflect more extensive AIDS-selective mortality and behavior change or greater bias in reporting of sexual behavior in Zimbabwe.