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Archive for September 8th, 2012

DESIRE TO HAVE CHILDREN CONTRIBUTES TO HIV INFECTIONS

Posted by African Press International on September 8, 2012

www.africanpress.me/ Maurice Alal.API reporter Kisumu.Kenya

http://www.africanpress.me/ Maurice Alal.API reporter Kisumu.Kenya

BY MAURICE ALAL, reporting from Kisumu Kenya

The desire to have children among the discordant couples is reportedly fueling the rate of HIV infection in Nyanza Province of Kenya, this is according to the health experts.

They noted that the persistent cultural perception held by many
communities in Kenya especially Nyanza who see children as the epitome of a successful and fulfilling factor to spread of the deadly virus among couples who could otherwise have been discordant.

Medically speaking, discordant couples are those living together as husband and wife or sexual partners who whereas one is free from HIV, the other party in the relationship is infected with the lot who
are more prone to infection if having children is their biggest desire.

Medics are of the view that whereas there was nothing wrong in couples wanting children, it became a health concern when the desire pushes them including those who would otherwise have been discordant to engage in unprotected sexual activities.

As such, they say, the possibility of the negative partner getting infected at some point is high. The Nyanza Provincial Aids and STIs Control Coordinator Dr Charles Okal says providing services for the discordant couples is curtailed by the fact that testing is the only sure way to find them, yet couples rarely turn up for testing together.

“We are constantly passing the message forward that couples should get tested together so that those who are discordant can be singled out and ways to stop the infection of the negative partner put in place,” he says.

Dr Okal observes that many marriages continue to be at risks because people do not know their partner’s status, added to the fact that it is in such institutions where the use of condoms as a HIV preventive measure is at its lowest.

“Even those partners who already know their status would rather resort to keeping mum about it because they do not know how the other partner will react on knowing their zero-positive status,” he says.

An estimated 6% of couples in the country that is about 344,000 are HIV discordant while a further 22% of couples know their sexual partners HIV status.
According to the Kenya AIDS indicator survey of 2007, 45% of all new HIV infections occur in marriages.

The survey shows that the fear of disclosure of the status remained a major problem in the war against the disease.The recent study shows that more couples in sexual relationships across Nyanza are turning out discordant to HIV tests.

The research which has been conducted by the Kenya Medical Research Institute and the America’s Centre for Disease and Control (KEMRI/CDC) in Kisumu since November 2009 has shown that over the last three years, there has been an increase in such cases in the region.

This is the group the study has concentrated on in Nyanza for the purposes of research trials.The findings show that among these discordant couples who have already been infected but have their CD4 count at 350 and above if put to ARVs at the initial stage can greatly help reduce chances of their spouses contracting the virus by the said percentage.

KEMRI/CDC study Coordinator for the Project Arthur Ogendo says the study findings are indeed a breakthrough in the fight against HIV and AIDS in Nyanza region.

“These study findings are exciting because they prove that HIV infections can be managed by prevention. We now know that this is true for the discordant couple. Our next step should be on how to explore this within the local communities across Nyanza,”Ogendo says.

The medics say the study findings will be shared with the World Health Organization (WHO) so as to make a policy on HIV that can be shared by a number of nations worldwide.

However, Dr Victor Akelo, medical Officer for the study notes that whereas findings were impressive, its important that the couples exercised care so as not to infect the other even if they are not on treatment.

“The best preventions is to use all the available prevention tools and I recommend that all get tested, if found to be negative then get linked to care and treatment services,” Dr Akelo says.

The results of the trials which was also conducted in other 12 countries is the first one from a randomized clinical trial to show that testing HIV infected persons can greatly help in reducing the risks of sexual transmission of the virus to their uninfected partners.

The study known as HIV prevention Trials study began in Botswana, India, South Africa,Brazil, Thailand and United States in 2005.
In Kenya it started in 2009 with some 1,763 discordant couples. The Kenya AIDS strategic plan of 2009 to 2013 shows that the higher

levels of HIV testing among women are 43% as compared to men which is only 25%. This attribute to testing of the pregnant women who visits clinics for the Ante Natal services where HIV testing is crucial for the prevention of mother to child transmission.

The up take of the prevention of the mother to child transmission programs at the hospitals for expectant women is also said to have contributed to high rate of HIV testing among women in marriage.
END

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The (re)making of men

Posted by African Press International on September 8, 2012

Photo: USAID
Brothers for Life

JOHANNESBURG,  – Manhood might be hard to define but South African media make it even harder, according to editors of a new book, who argue that negative coverage of men is doing more harm than good, especially when it comes to HIV. Now they are looking to rewrite masculinity in a country that ranks among the most gender inequitable in the world.

(Un)covering Men: Rewriting Masculinity and Health in South Africa is a compilation of works by journalism fellows through Anova Health Institute’s HIV and Media Project, originally the brainchild of noted South African journalist Anton Harber and HIV researcher and programme implementer Helen Struthers, who co-edited the book.

The book’s other co-editor, Melissa Meyers, characterized the 211-page book as a bid to combat stereotypes of men perpetuated by the media and to create a more nuanced portrayal of men by telling stories around issues such as fatherhood, men-who-have-sex-with-men
(MSM) and traditional male circumcision.

“Writing about different kinds of men involves looking at all these different stereotypes or men – men as Lotharios, as risk-seekers, as domineering,” she told IRIN/PlusNews. “By contrasting these stories, we were able to show that the current media engagement with men and notions of masculinities is disturbingly shallow.”

“We’ve looked at how that might affect health-seeking behaviours,” said Meyers, who also coordinates the HIV and AIDS Media Project for Anova. “So we’ve taken that conversation and put it in the context of the most pressing health concern in this country and one that’s most linked to ideas of masculinity – HIV.”

South Africa continues to battle high levels of gender inequality, ranking in the bottom half of all countries surveyed in the 2011 United Nations Development Programmes’ Gender Inequality Index. In 2009, a study by South Africa’s Medical Research Council (MRC) made international headlines after it found that one in four South African men surveyed admitted to having raped a woman in their lives.

Using the same data set, researchers also revealed last year that about 10 percent of South African men had experienced sexual violence at the hands of another man. The overwhelming majority of men who reported sexually abusing another man also reported being violent towards their female partners – an HIV risk factor for women in a country where HIV prevalence is about 12 percent.

Looking at the man in the mirror

Statistics like this may contribute to men’s bad rap, but stereotypes portrayed in the media are hurting those working to change men’s bad behaviour, according to Mandla Ndlovu, who works for Johns Hopkins Health and Education in South Africa.

To combat high levels of gender-based violence, John Hopkins launched its Brothers for Life programme in 2009. Designed to re-enforce positive gender norms, the programme set about trying to promote positive male role models, but Ndlovu admits it was hard in the beginning,

“It was difficult to find materials to use at the start of Brothers for Life,” Ndlovu told IRIN/PlusNews. “You were always finding resources that pointed a finger at men instead of telling us what made them tick.”

''A father is seen as a provider. He leads the family. He’s ‘the man’ … When your father is HIV-positive and dying, when he cannot provide for the family, it destroys (some) families completely''

“I’ll be the first to admit a lot of our social ills can really be [tied to] how masculinities have been framed – a man is the boss, what a man should be,” he added. “But it’s important if we want to solve the same social ills that we talk to the very same men and walk with them in their journey.”

Thabisile Dlamini, a journalist, actor and author, wrote about HIV and fatherhood – a topic close to her heart after the loss of her own father to AIDS-related illnesses in 2008. At 20 years old, Dlamini was left to care for her younger siblings.

“A father is seen as a provider. He leads the family. He’s ‘the man,’” she said. “When your father is HIV-positive and dying, when he cannot provide for the family, it destroys (some) families completely.”

“I remember interviewing one family where the father was HIV-positive and had had a stoke so he was disabled. He couldn’t work anymore,” she said. “There were issues of resentment there. I remember sitting down with a father and daughter, and we actually had to postpone the meeting because tensions were so high.”

But Dlamini said she also saw some men’s HIV-positive diagnosis bring families together as they rallied to support fathers or as fathers looked back on their lives as absentee dads and were moved to rekindle bonds with their children.

What’s left unsaid 

Pieter van Zyl, a senior writer for South African media house Media24’s family magazines, used the opportunity to write about gay men and MSM. He spent three weeks in Cape Town’s Guglethu township interviewing MSM and gay men in 2009.

He produced five stories about issues faced by MSM such as discordance, disclosure, and balancing marriages to women with desires to be with men.

The book provides an outlet for some of the stories South African outlets would not run. More than a year after the stories were written, four of the six stories remain unpublished, even by van Zyl’s own Media24 Afrikaans-language magazine, which van Zyl said has a large gay readership.

According to van Zyl, while he found resistance to the stories’ same-sex subject matter among mainstream media houses, outlets within the gay community were also reluctant to run HIV-related copy they saw as ‘depressing.’

Finally for some contributors, such as clinical psychologist Mthetho Tshemese, the work he explored regarding sexuality, masculinity and traditional male circumcision within his Xhosa culture has cemented his interested in working with young men.

He’s started a programme at his former high school in South Africa’s Eastern Cape Province to talk to young men about sex, sexuality and HIV prevention.

“I want them to have the space to reflect on the kind of masculinities they want to embrace,” he told IRIN/PlusNews. “There comes a time, even though we embrace rituals about who we are, [when] we have to start thinking about that that means for us as individuals because all the things we do as men, we do mostly in our individual spaces.”

llg/kn/rz  source http://www.irinnews.org

 

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Cash payments reduce risky behaviour

Posted by African Press International on September 8, 2012

Without economic support, orphans and vulnerable children can be exploited

NAIROBI,  – Cash transfer programmes not only improve nutrition, education and health benefits for orphans and vulnerable children, but new research now suggest that these programmes can also significantly reduce risky sexual behaviour and HIV infection.

While the use of cash to improve health outcomes has long been established, not much has been known about its potential impact on HIV prevention.

study carried out in Kenya examined cash transfers, part of the government’s social protection scheme, benefiting an estimated 102,000 households and 375,000 orphans and vulnerable children in 60 districts. The study revealed that children enrolled in the programme were 30 percent more likely to delay their sexual debut than those who were not enrolled. Among programme participants, the number of female adolescents who’d had two or more sexual partners in the last 12 months declined by 7.2 percent.

But the study also found that the cash grant did not affect condom use and that recipients were no more likely to use protection the first time they had sex.

“Our study is based on the Government of Kenya’s Cash Transfer for OVC [orphans and vulnerable children]. We find that those aged 11 to 16 at baseline were 7 percentage points less likely to engage in sexual activity 4 years later. Other studies have also shown a link between sexual activity and HIV-related behavioural risk and receipt of cash transfers, but those have been from small-scale experiments. Ours is the first study from an actual, scaled-up national programme,” Handa Sudhanshu, a lecturer at the University of North Carolina and one of the study’s researchers, told IRIN/PlusNews.

Under the cash transfer scheme, each of the targeted households receives a monthly stipend of US$25. There are, according to the government, an estimated 2.4 million orphans in Kenya – 48 percent of orphaned by HIV.

“A large-scale, national cash transfer programme may prevent HIV among adolescents by postponing sexual debut, reducing the number of partners and reducing the number of unprotected sex acts,” the authors concluded.

Reducing exploitation

Trephine*, a 15-year-old orphan who cares for her three siblings, says they have been able to stay in school because of the cash vouchers.

“I used to skip school to wash clothes for rich people so that they could pay me. My performance at school was bad because I wasn’t getting time to read. Now I perform better… Now when I am at school, I don’t worry about where food will come from. Some of my friends have boyfriends who give them money, and I almost did it but now I [don’t have to],” she added.

Without economic support, orphans and vulnerable children are exposed to exploitation. “This situation exposes the orphan and vulnerable children to different forms of abuse and exploitation; physical abuse, defilement, sexual exploitation, child labour and early marriages. This condition [reduces] their capacity to participate in matters that impact on their lives,” James Nyikal, permanent secretary in the Ministry of Gender and Children Services in Kenya, told IRIN/PlusNews

A similar study in Malawi showed that schoolgirls whose families received monthly cash transfers had a significantly lower rate of HIV infection than those who didn’t receive anything. Beneficiaries of the cash transfer project were also less likely to drop out of school, and teen pregnancies declined by 30 percent.

In Kenya, school enrolment among children benefiting from the cash transfer scheme increased by 8 percent, according to the study.

“We are…trying to understand how cash transfer affects risky behaviour, whether it is by keeping young people in school and making them more economically independent, by changing their peer group and social networks, or self-esteem,” Sudhanshu told IRIN/PlusNews.

*Name changed

ko/kn/rz source http://www.irinnews.org

 

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Increasing hostility towards Chinese traders

Posted by African Press International on September 8, 2012

The streets of Maseru are lined with Chinese-run shops and restaurants (file photo)

JOHANNESBURG/BLANTYRE/MASERU/LUSAKA,  – In the last decade, Asian migrants have fanned out through southern Africa, opening shops in small towns and rural backwaters. While consumers in countries facing increasing economic hardships have come to depend on their low prices, local shop owners complain they are being forced out of business, pressuring governments to introduce restrictions on foreign traders.

In Malawi, Chinese-owned shops and restaurants have proliferated since the country established diplomatic ties with China in 2007. But the government was recently prompted by bitter complaints from local business owners to introduce legislation preventing foreign traders from operating outside of major cities.

The new law has mainly targeted Chinese traders, many of whom are now being forced to shutter their businesses in rural areas and to apply to the Ministry of Industry and Trade for business licenses to operate in Lilongwe, Blantyre, Mzuzu or Zomba – the country’s four major cities.

“They can operate in rural areas when they are in production and big business, not doing petty trading,” Malawi Minister of Industry and Trade John Bande told IRIN, adding that the government would continue passing legislation that encouraged serious foreign investment “to the benefit of Malawians”.

But human rights groups have described the legislation as xenophobic, and consumers like Arnold Mwenefumbo, from Karonga District in northern Malawi, complain that forcing out the Chinese traders will mean paying much higher prices for products sold by Malawians and other African nations.

“[The Chinese] were also employing our son and daughters,” said Mwenefumbo.

Lesotho

In Lesotho, a tiny land-locked country facing high rates of poverty and unemployment, the relatively recent appearance of thousands of foreign, mostly Chinese-owned, businesses has generated similar resentment from local business owners, but little government intervention.

Before the mid-1990s, Makhabane Theko ran a successful retail business in the capital, Maseru, but now leases his building to the same Chinese traders who he says pushed him out of business. “It’s difficult to compete against the foreign investors, especially the Chinese. You sell 500g of sugar for 8.00 maloti (US$1.4) and they will sell it for a price that is almost half that,” he told IRIN.

Stories like Theko’s are common. Although the exact number of Chinese in Lesotho is unknown, estimates range between 10,000 and 20,000, or up to 1 percent of Lesotho’s population of 1.9 million, according to a recent report released by the Brenthurst Foundation. “Business is good here,” said one Chinese trader.

Unlike neighbouring South Africa, which has a long history of Chinese migration and Chinese-run businesses, Lesotho has traditionally been a country of out-migration and has little experience with immigrants. National legislation limits ownership of small businesses to Basotho citizens, but the government has largely turned a blind eye to corrupt practices allowing Chinese migrants to purchase trading licenses or even national identity documents.

“Chinese are now selling makoenya [fat cakes], loose cigarettes, even beer at retail prices, but their business category forbids them from doing so,” said a street vendor who sells cigarettes in Maseru.

Yoon Jung Park, coordinator of the Chinese in Africa/Africans in China (CA/AC) International Research Working Group, has conducted research on perceptions of Chinese in southern Africa. She noted that small countries with struggling economies like Lesotho are seeing funding from Western donors dwindling; many may view Chinese investment as their next best hope. This is reflected in the lack of government action to regulate the proliferation of small Chinese-run businesses.

“I think there’s a link between official ties [with China] and the messages that get filtered down to people, especially in these small countries that are desperate for foreign aid, that the Chinese are the great hope and we need to be nice to them,” she told IRIN.

Many complain that the Chinese add little to the local economy because they send all of their money home, but according to Park, few Chinese migrants in Lesotho send remittances home. Instead, they spend their first two or three years in the country repaying loans, and then they tend to reinvest in their businesses. Most also employ at least one local to interact with customers.

They keep their prices as low as possible by buying from other Chinese (often at a slight discount), forming cooperatives to make bulk purchases and focusing on rapid turnover rather than high profit margins. Rumours that the more unscrupulous also engage in under-handed practices like re-packaging expired food and removing a few ounces from bags of flour and sugar before resealing them may also be true in some cases, said Park.

“Profit margins are so narrow, that they probably do resort to some of those things. And government in Lesotho isn’t doing enough to prevent them,” she commented.

In the run-up to Lesotho’s general elections in June, several political parties indicated their intention to expel foreign traders from the country, but apart from several raids on Chinese supermarkets said to be selling expired meat, no action has been taken to prevent them from operating.

Zambia

Zambia’s open-door investment policy has seen hundreds of Asian migrants setting up businesses in the country in recent years, but locals employed by them complain about low wages.

“Yes, they are giving us jobs, but these are not jobs to help us [improve our lives]. They are jobs to help them make more money. I am paid 350,000 kwacha [US$70] every month, and what can you do with that amount? It is like my salary just goes for transport to come here and go home,” said Melinda Daka, a shop worker in a Chinese-owned business in Kamwala, Lusaka’s upmarket trading area.

“Zambian employers pay much better, but they are very few, and they only employ very few people… So, there is nothing we can do but work for these same people [foreigners].”

In July, the Zambian government increased the monthly minimum wage for shop workers and other general workers, from $80 to $220, but employers are reluctant to pay the new salaries, saying they could make the cost of business unsustainable.

Positive relations

But negative attitudes toward Chinese traders are not uniform throughout the region. In countries such as South Africa and Swaziland, where Chinese migrants arrived several generations ago and now run businesses that fill gaps in the market without competing with locals, relations have remained fairly good.

Park’s research in Zimbabwe found that during that country’s severe economic crisis, consumers were grateful to Chinese traders for getting goods into the country when no one else could. “They said that if it hadn’t been for them, they wouldn’t have been able to send their kids to school with basic supplies. They helped them survive the crisis,” she told IRIN.

However, in countries with struggling economies, the arrival of large numbers of entrepreneurial Chinese migrants combined with a lack of enforcement of laws and regulations have fuelled tense relations with locals.

“Oftentimes, they know it’s not the fault of the Chinese. They respect them for their work ethic, but they’re angry that the government is allowing them to do some of the things they do,” said Park.

ks/ms/rc/nm/rz source http://www.irinnews.org

 

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