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Housing for people living with HIV/AIDS around the world
More than a Just a Roof Over My Head: Housing for people living with HIV/AIDS, 2010.
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Sponsored by the Ford Foundation and compiled by the National AIDS Housing Coalition (NAHC), this document examines the relationship between HIV/AIDS and housing instability in various communities, cities, and nations across the globe. The majority of the text was provided by advocates working on the ground in their communities and affiliated with the National AIDS Housing Coalition through the International AIDS Housing Roundtable; their organizations are cited and their testimonies were supplemented by data and information from UNAIDS, UN-Habitat, as well as other institutions and peer-reviewed articles. Names are withheld from personal testimony to protect confidentiality.
The purpose of this document is to examine the relationship between HIV/AIDS and housing instability. Adequate housing is a human right and a necessary foundation to fulfill other rights and to enjoy a decent quality of life. While poverty is linked to poorer health outcomes and creates an environment of risk across the globe, HIV infection is prevalent among all socioeconomic classes, and HIV/AIDS exacerbates poverty and inequalities across the board.
HIV prevalence in urban areas is 1.7 times the prevalence in rural areas, while HIV is most prevalent in the poorest region of the world: sub-Saharan Africa, where HIV/AIDS is most experienced in rural areas and where access to information and health services is limited.
Approximately 3.49 billion people (50.6% of the world’s population) live in urban areas; one third of these residents are poor, while almost a quarter (827.6 million people) live in slums. In sub-Saharan Africa, 61.7% of the urban population lives in slums, followed by South-Eastern Asia (31%), Latin America and the Caribbean (23.5%), and North Africa (13.3%). Slums are characterized by poor sanitation and hygiene, unsafe water supply, malnutrition, insecure land tenure, and lack of access to basic health, transportation, and other public services. These conditions increase the risk of HIV infection and poor health outcomes related to AIDS-related
complications and mortality.
CRS – Water, Sanitation and Hygiene Considerations in Home-Based Care For People Living with HIV
Water, Sanitation and Hygiene Considerations in Home-Based Care For People Living with HIV, May 2010.
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Christopher Seremet, Catholic Relief Services.
This guidance document offers water supply and sanitation facility and hygiene promotion design considerations and recommendations intended to increase access to these facilities by people living with HIV. People living with HIV often require modifications to their water supply and sanitation facilities and hygiene practices due to their debilitating illness. This guidance document is intended for Home-Based Care (HBC) practitioners serving people living with this disease as well as water and sanitation engineers and technicians tasked with providing community water supply and household sanitation systems.
South Africa: Urban Women Bear Brunt of Aids in KZN
The face of HIV/AIDS in KwaZulu-Natal is a woman in her thirties living in eThekwini, according to a study released this week.
Urban women in the province are far more likely to be HIV positive than their rural sisters, while over half (54%) of all pregnant women in their thirties were HIV positive.
Some 47% of pregnant women living in eThekwini who attended government clinics between May 2008 and April 2009 were HIV positive. This was followed closely by 45% in Umgungundlovu.
In contrast, women from the more rural districts of Amajuba (38%), Zululand (37%) and Umkhanyakude (35%) recorded significantly lower rates of HIV than their urban sisters.
The study, conducted by Dr Christiane Horwood from the University of KwaZulu-Natal’s Centre for Rural Health, was aimed at finding out the HIV prevalence of mothers and babies as well as the HIV transmission rate.
Despite levels of poverty being higher in the rural districts, social scientists believe that there is more social cohesion in rural communities that protects against women against HIV.
The large HSRC-Nelson Mandela Household surveys conducted among the general South African population since 2002 have consistently found that people living in informal settlements have the highest HIV prevalence.
“The mobility and transient nature of life in informal settlements, rather socio-economic status, makes those living in these areas most vulnerable to HIV,” explained the HSRC CEO Dr Shisana.
Men living in informal settlements were much more likely to have more than one sexual partner in a year than those living in tribal areas, while urban youth were significantly more sexually experienced, according to the household studies.
Horwood’s study found that KwaZulu-Natal has managed to slash HIV transmission from mothers to their newborn babies by almost two thirds — to seven percent – since it started giving pregnant women and their babies two antiretroviral drugs.
However, the transmission rate was highest in eThekwini with one in 10 pregnant women passing HIV onto their babies. Amajuba had the lowest transmission rate with just 4.3 percent of babies from HIV positive moms getting infected.
Interestingly, the study showed that nevirapine alone was relatively ineffective at preventing mothers from infecting their babies.
Since 2002, pregnant HIV positive women have been given the ARV nevirapine to prevent her from passing HIV on to her baby. This followed research in Uganda and South Africa that showed nevirapine could cut HIV transmission by about 30 percent.
But a 2004 study in the province found that about 20 percent of pregnant HIV positive women who got nevirapine were still passing the virus on to their babies.
In Horwood’s study, 13.5 percent of women who only got nevirapine passed HIV on to their babies, which is only marginally better than the 15 percent transmission rate from moms who got no ARVs at all to their babies.
But the transmission rate for those on dual therapy was dramatically reduced to only 5.6 percent, while only 5 percent of mothers on triple therapy passed HIV to their babies.
“It’s hard to say why nevirapine was so ineffective in comparison to the earlier research, but perhaps it was the difference between a research setting and operational setting,” said Horwood.
Horwood’s study also measured the infant mortality rate in the districts, and found that babies fared worst in eThekwini followed closely by Amajuba. In eThekwini, 85 babies per 1000 died before their first birthday.
“The infant mortality rate has tripled in the province over the past 10 years because of HIV/AIDS, so it is very exciting to see the impact of dual therapy, which will make massive strides to prevent the deaths of babies and children,” said Horwood.
Health MEC Sibongiseni Dhlomo welcomed the results of the study, but appealed to all pregnant women to report to their local clinics as soon as they knew they were pregnant.
“HIV positive women who are pregnant need to get dual therapy from 14 weeks of pregnancy but most of them only go to the clinic when they are in their last trimester of pregnancy,” said Dhlomo.
“We call on all community leaders to encourage pregnant women to go to their clinics early so they can be tested for HIV,” he added.
Ethiopia – USAID donates to Urban HIV/AIDS program
Addis Ababa, December 2 (WIC) – The United States Agency for International Development (USAID) has today donated 22 million USD to support the WFP’s Urban HIV/AIDS program over the next three years.
The contribution would help provide essential food and nutritional support targeting high-priority groups in urban and peri-urban areas who are severely or moderately malnourished.
Receiving the donation WFP Representative and Country Director, Mohammed Diab said the contribution will allow WFP to continue the important work of providing nutritional support to individuals living with, and affected by HIV/AIDS. It would help WFP expand coverage and meet the needs of those who are affected, he added.
USAID Ethiopia Mission Director Glenn Andres said this historic event would further strengthen the collaboration between the United Nations World Food Program and USAID and most importantly, will improve the lives of many people in need of help.
In Ethiopia, USAID and WFP have been partners since 2003 to support the Urban HIV/AIDS Project, reaching and improving the nutritional status and quality of life of food insecure people living with HIV.
Support for the contribution is from the US President’s Emergency Plan for AIDS Relief (PEPFAR), it was learnt.
Mexico – Behavioral Intervention Works To Reduce Risky Behavior
ScienceDaily (Sep. 24, 2008) — In an effort to curb the rising rates of HIV and sexually transmitted infections (STIs) along the Mexico-US border, a binational team of researchers led by the University of California, San Diego School of Medicine have shown that brief but personalized behavioral counseling significantly reduced rates and improved condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico.
The researchers observed a 40 percent decline in the combined rate of new STIs (including HIV, syphilis, gonorrhea and Chlamydia) in the group of female sex workers who received the 30-minute one-on-one counseling intervention, compared to an encounter that was based on educational information only. The study, headed by Thomas L. Patterson, Ph.D., professor of psychiatry at UC San Diego School of Medicine, in collaboration with researchers from across Mexico, at UC Davis and Northeastern University, will be published on line September 17 in advance of the November edition of the American Journal of Public Health.
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