LEADER 09290nam 2200673 a 450 001 9910965703903321 005 20251017110055.0 010 $a9786610192366 010 $a9781280192364 010 $a1280192364 010 $a9780309589055 010 $a0309589053 010 $a9780585023649 010 $a0585023646 035 $a(CKB)110986584753434 035 $a(SSID)ssj0000226782 035 $a(PQKBManifestationID)11199674 035 $a(PQKBTitleCode)TC0000226782 035 $a(PQKBWorkID)10263416 035 $a(PQKB)11696350 035 $a(MiAaPQ)EBC3375990 035 $a(Au-PeEL)EBL3375990 035 $a(CaPaEBR)ebr10054981 035 $a(OCoLC)811258876 035 $a(Perlego)4738797 035 $a(DNLM)813967 035 $a(BIP)47128933 035 $a(EXLCZ)99110986584753434 100 $a19960215d1996 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt 182 $cc 183 $acr 200 10$aPreventing and mitigating AIDS in Sub-Saharan Africa $eresearch and data priorities for the social and behavioral sciences /$fBarney Cohen and James Trussell, editors ; Panel on Data and Research Priorities for Arresting AIDS in Sub-Saharan Africa, Committee on Population, Commission on Behavioral and Social Sciences and Education, National Research Council 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1996 215 $axi, 356 p. $cill., maps 300 $aBibliographic Level Mode of Issuance: Monograph 311 08$a9780309054805 311 08$a030905480X 320 $aIncludes bibliographical references (p. 271-314) and index. 327 $aPreventing and Mitigating AIDS in Sub-Saharan Africa -- Copyright -- Acknowledgments -- Contents -- Summary -- NEED FOR IMMEDIATE ACTION -- SOCIETAL CONTEXT OF HIV/AIDS IN AFRICA -- EPIDEMIOLOGY OF THE HIV/AIDS EPIDEMIC -- SEXUAL BEHAVIOR AND HIV/AIDS -- PRIMARY HIV-PREVENTION STRATEGIES -- MITIGATING THE IMPACT OF THE EPIDEMIC -- BUILDING CAPACITY FOR AIDS-RELATED RESEARCH -- CONCLUSION: THE NEED FOR BETTER BEHAVIORAL AND SOCIAL SCIENCE RESEARCH -- Resume -- IL FAUT AGIR SANS TARDER -- CONTEXTE SOCIETAL DU VIH/SIDA EN AFRIQUE -- EPIDEMIOLOGIE DU VIH/SIDA -- COMPORTEMENT SEXUEL ET VIH/SIDA -- STRATEGIES PREVENTIVES DE BASE CONTRE LE VIH -- L'ALLEGEMENT DE L'IMPACT DE L'EPIDEMIE -- MISE SUR PIED D'UNE CAPACITE DE RECHERCHE SUR LE SIDA -- CONCLUSION: BESOIN DE MEILLEURES RECHERCHES EN SCIENCES SOCIALES ET COMPORTEMENTALES -- 1 Introduction -- PURPOSE OF THE REPORT -- BACKGROUND -- Extent of the Epidemic -- Need for Immediate Action -- The Need for Better Behavioral and Social Science Research -- THE PANEL'S TASK -- ORGANIZATION OF THE REPORT -- 2 Societal Context -- SOCIAL STRUCTURE AND FAMILY ORGANIZATION -- SEXUAL BEHAVIOR AND HIV/AIDS -- MOBILITY -- Rural-Urban Migration -- Diffusion via Major Roads -- Civil Unrest and Wars -- MEDICAL AND PROGRAM FACTORS -- ECONOMIC FACTORS -- 3 Epidemiology of the HIV/AIDS Epidemic -- STATUS OF THE EPIDEMIC -- HIV/AIDS Statistics -- Demographics of HIV Infection -- HIV-2 Infection -- MODES OF TRANSMISSION -- Sexual Transmission -- Risk Factors in Sexual Transmission -- HIV and STDs -- Perinatal Transmission -- Parenteral Transmission -- REMAINING GAPS IN KNOWLEDGE -- Limitations of Existing African Behavioral Data -- The Need to Combine Epidemiological and Social/Behavioral Research -- Ethical Issues in STD/HIV Research -- RECOMMENDATIONS -- 4 Sexual Behavior and HIV/AIDS -- SOURCES OF INFORMATION. 327 $aQUESTIONS OF METHODOLOGY -- The Issue of Validity -- PATTERNS OF SEXUAL ACTIVITY -- Sexual Initiation and Premarital Intercourse -- Sex Within Marriage or a Stable Union -- Extramarital and Casual Sex -- Commercial Sex -- SEX-RELATED RISK FACTORS -- High Number of Partners/Commercial Sex -- Perceived Risk -- Age -- Education -- Marital Status -- Residence -- Migration -- Sexually Transmitted Diseases -- Circumcision and Traditional Medical Practices -- Alcohol -- SEXUAL PRACTICES AND BELIEFS -- The Notion That Men Need Sex -- Coercive Sex -- Health Beliefs -- Dry Sex -- Oral/Anal Sex -- Homosexuality -- Postpartum and Other Abstinence -- Levirate Marriage -- AIDS AWARENESS -- Modes of Transmission -- Asymptomatic Transmission -- Severity and Perceived Threat -- Attitudes Toward Sufferers -- Testing -- THE ROLE OF CONDOMS -- Condom Use -- Condoms and STD and HIV Prevention -- Attitudes Toward Condoms -- BEHAVIOR CHANGE -- CONCLUSIONS -- RECOMMENDATIONS -- 5 Primary HIV-Prevention Strategies -- BEHAVIOR-CHANGE INTERVENTION PROGRAM DESIGN AND EVALUATION -- Guiding Principles for Behavior-Change Interventions -- INTERVENTION EVALUATION -- A TYPOLOGY OF INTERVENTION PROGRAMS -- Institution-based Programs -- Community-based Programs -- Population-based Programs -- INTERVENTIONS TARGETING SEXUALLY ACTIVE MEN -- Issues -- Target Population -- Types of Strategies and Programs -- Case Study -- Lessons Learned -- INTERVENTIONS TARGETING SEXUALLY ACTIVE WOMEN -- Issues -- Target Population -- Types of Strategies and Programs -- Case Study: An Intervention Targeted to Commercial Sex Workers -- Case Study: A Community-based Intervention -- Lessons Learned -- INTERVENTIONS TARGETING YOUTH -- Issues -- Target Population -- Types of Strategies and Programs -- Case Study -- Lessons Learned -- PERINATAL TRANSMISSION -- RECOMMENDATIONS. 327 $aANNEX 5-1 SELECTED AIDS INTERVENTION PROGRAMS IN AFRICA -- 6 Mitigating the Impact of the Epidemic -- INTRODUCTION -- IMPACT ON PERSONS WITH HIV -- Stigmatization of the Seropositive -- Economic Hardship Due to HIV -- Care for People with AIDS -- IMPACT ON EXTENDED FAMILY MEMBERS AND FRIENDS -- Caring for Survivors: Children and the Elderly -- INDIRECT IMPACT OF AIDS ON THE REST OF SOCIETY -- Demographic Impact -- Morbidity and Mortality -- Anticipated Future Impact -- Relationship Between Seroprevalence and Mortality Rates -- Economic Impact -- HIV/AIDS and Per Capita Income Growth -- Effect of the Epidemic on Sectors of Economic Activity -- Impact of the Epidemic on Firms -- Summary -- ATTEMPTS TO MITIGATE THE IMPACT OF HIV/AIDS -- Intended Beneficiary -- Providers of Mitigation Assistance -- Types of Mitigation Help Being Provided -- RECOMMENDATIONS -- ANNEX 6-1: A BRIEF SURVEY OF NONGOVERNMENTAL ORGANIZATIONS IMPLEMENTING MITIGATION PROGRAMS IN SUB-S ... -- 7 Building Capacity for AIDS-Related Research -- INTRODUCTION -- Problem Statement -- Data Sources -- CONSTRAINTS ON RESEARCH IN SUB-SAHARAN AFRICA -- Insufficient/Poorly Allocated Funds -- Inadequate Manpower -- Unintended Negative Consequences of Donor Policies -- Inadequate Coordination -- Lack of Information on Previous and Ongoing Research Efforts -- Lack of Research-Needs Assessment and Difficulty of Coordinating Funding from Multiple Sources -- Lack of Cooperation Among Donor Agencies -- Harsh Environment for Social and Behavioral Research -- Unfavorable Political Climate -- Decline of Higher-Education Systems in Sub-Saharan Africa -- Inadequate Infrastructure -- Economic Weakness -- Weak Policy Support for the Health Sector -- Low Value Placed on Social and Behavioral Research -- RECOMMENDATIONS -- References. 327 $aAPPENDIX A Panel Visits to Three African Countries: January 20-February 12, 1995 -- INTRODUCTION -- ZAMBIA JANUARY 23-27, 1995 -- Overview of Current HIV/AIDS Situation -- History of AIDS-Prevention Efforts -- Ongoing Prevention and Mitigation Initiatives -- Workplace Peer Education and Counseling -- Traditional Healer Component -- Programs for Orphans -- The State of Social and Behavioral Research -- TANZANIA JANUARY 30-FEBRUARY 3, 1995 -- Overview of Current HIV/AIDS Situation -- History of AIDS-Prevention Efforts -- Ongoing Prevention and Mitigation Initiatives -- Components of the Tanzania AIDS Project -- The Nongovernmental Organization Strategy -- Social and Economic Mitigation of AIDS -- The State of Social and Behavioral Research -- CAMEROON -- Overview of Current HIV/AIDS Situation -- History of AIDS-Prevention Efforts -- Ongoing Prevention and Mitigation Efforts -- Overview -- AIDSCAP -- The State of Social and Behavioral Research -- IRESCO -- FOCAP -- OVERALL THEMES -- REFERENCES -- PEOPLE CONTACTED -- Zambia -- Tanzania -- Cameroon -- APPENDIX B Biographical Sketches -- Index. 330 $aThe AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs. 606 $aAIDS (Disease)$zAfrica, Sub-Saharan 615 0$aAIDS (Disease) 676 $a614.5/993 701 $aCohen$b Barney$f1959-$01791277 701 $aTrussell$b James$01803596 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910965703903321 996 $aPreventing and mitigating AIDS in Sub-Saharan Africa$94351216 997 $aUNINA