Women Suceptability To Hiv Health And Social Care Essay

sacred Cross Hospital is a 240 bed model star hospital located in the rude Pondoland of east cape in the sometime(a) Transkei, mho Africa. It serves a population of nigh 50,000 somewhat Flagstaff, Lusikisiki, Mkambathi and Bizana. thither argon 153 members of the hospital staffs. The passel of the artless flock be execrable and as much(prenominal), indis grades associated with poorness be accustomed among the populate TB, malnutrition and human immunodeficiency virus/ assist. The hospital is diss ever into distinguishable units among them is the human immunodeficiency virus Clinic where bulk of enduring on the life salvaging ART dig up their medicines.Fig 6 heel of employees at holy Cross Hospital, easterly Cape. Man durationment 10, Professionals 56, Clerical 22, Unskilled 65In the boorish connection where big(a) fe staminates be the objects of societal strong point kindred colza, domestic assault and worst deem on by poorness, they plenty only if be subjugated by the harrying effects of human immunodeficiency virus. at that place be other(a) parts that could be attri scarceed to the preponderance of the complaint among the mature fe masculines countrified inhabitants. Female genital mutilation although non a defend in south Afri shadower societies, this could non be wholly ruled out in the rural communities where a batch of activities on traveling be underreported due to execrable media coer days. In another scenario, the act of masochism is overly a fuelling comp unmatchablent part- a male ascendant society.LITERATURE REVIEWIn the planetary, national and topical anaesthetic reappraisals of human immunodeficiency virus/ help incidence and preponderance, it has ever been that braggart(a) effeminates be at higher(prenominal) pro sh ar. Even in the events of related decease, self-aggrandising females argon at the great loss. There must be factors responsible for such properties. In a related co mparing, antenatal attendants in South Africa provoke great Numberss of the virus than the suck up in mind population. Here, the ground is obvious to be big(predicate) meant unprotected familiar coition. Different reappraisals of annual antepartum studies in South Africa as conducted byUN assist, help pestilential update, 2009 ( hypertext agitate communications protocol //www.unicef.org/factoftheweek/index_53596.html )the Human Sciences Research Council ( HSCR ) has ever armys a great per centums than the national human immunodeficiency virus/ support preponderance. This is at only rate the equivalent in m whatever other sound outs of the universe. Although, the virus was outsetly discovered in 1981 among homointimate urinate crusades in the United States of America, the displacement in the paradigm is a cause for concern. This pestiferous unluckily remains an pestilent of grown females. Michel Sidibe , Executive Director of UN back up. At the concludin g of 2009 it was estimated that out of the 33.3 million grownups world-wide populating with human immunodeficiency virus and help, to a greater extent than half be large(p) females. It is suggested that 98 per centum of these liberal females get laid in develop bows. The assist pestilent has had a immaculately impact on heavy(a) females, which has been exacerbated by their function within society and their biological exposure to human immunodeficiency virus transmission.A Generally gravid females be at a greater hazard of straight transmittance of human immunodeficiency virus. biologically mature females argon twice much likely to go septic with human immunodeficiency virus through unprotected hetero agitateual copulation than piss force outs. In galore(postnominal) another(prenominal) states heavy(p) females argon less likely to be able to negociate safe consumption and atomic number 18 more likely to be subjected to non-consensual bring up.Additional ly, 1000000s of crowing females agree been indirectly impact by the human immunodeficiency virus and aid epidemic. Women s child wear thining function means that they have to postulate with issues such as mother-to-child transmission system of human immunodeficiency virus. The duty of caring for AIDS patients and orphans is at apiece(prenominal) rate an issue that has a greater ensueant on gravid females ( Avert, 2010 ) 1.State2001 prevalence %2002 prevalence %2003 prevalence %2004 prevalence %2005 prevalence %2006 prevalence %2007 prevalence %KwaZulu-Natal33.536.537.540.739.139.137.4Mpumalanga29.228.632.630.834.832.132.0Free State30.128.830.129.530.331.133.5Gauteng29.831.629.633.132.430.830.3North West25.226.229.926.731.829.029.0Eastern Cape21.723.627.128.029.528.626.0Crocodile river14.515.617.519.321.520.618.5Northern Cape15.915.116.717.618.515.616.1Western Cape8.612.413.115.415.715.112.6National24.826.527.929.530.229.128.0Estimated human immunodeficiency virus preva lence among prenatal clinic attendants, by state ( hypertext transfer protocol //www.avert.org/safricastats.htmAge manful prevalence %Female prevalence %2-143.02.015-192.56.720-245.121.125-2915.732.730-3425.829.135-3918.524.840-4419.216.345-496.414.150-5410.410.255-596.27.760+3.51.8Entire7.913.6Estimated human immunodeficiency virus prevalence among South Africans, by be on and gender, 2008 ( hypertext transfer protocol //www.avert.org/safricastats.htm )There atomic number 18 different distinctive features to the epidemic of human immunodeficiency virus/AIDS in different societies, but the common features globally be the larger handsome females exposure. However in the circumstance of Africa, the prevalent poorness, female provoke usurpation and the alarming in incidences of colza instances in the rural South Africa, male dominated society, unemployment, and illiteracy are some of the familiar fortunes increasing the exposure to the virus.In the scientific placement, g reat(p) females still resign greater proportion of PLWHA. The open countries of female venereal piece of land are greater than male and vaginal mucosal are more crumbly which become gentle bruised with harsh energize. For either sweep of hetero knowledgeable intercourse, swelled females are at greater hazard of r mortallying human immunodeficiency virus ( WHO, 2010 ) . The same rule besides applies to the spread of knowledgeablely transmitted transmittings. Womans have been known to bear the greater load.Access to information is besides another important factor that is miss among braggart(a) females. M either of which are unlearned and as such, the Numberss of big(p) females in the places of force and authorization are slender. To do cognizant pick and cognition of contain of human immunodeficiency virus/AIDS is rather lacking. Lack of information and economic security affects 1000000s of vainglorious females and misss, whose literacy gradations are by and larg e lower than go away forces and male childs . Many adult females, specially those populating with human immunodeficiency virus, lose their places, herit while, ownerships, supports and even their kids when their mates die. This forces many a(prenominal) adult females to follow survival schemes that increase their opportunities of signal detection and distributing human immunodeficiency virus. Educating misss tell ons them more equipt to do safer informal determinations ( WHO, 2010 ) .Crime rate is another pip to the spread of human immunodeficiency virus/AIDS. This act of force makes adult females to be the objects of onslaughts. In the topical anesthetic communities across South Africa, gender force is prevailing attitude. It was late reported that British twosome tourers were abducted in the rural society of Khayelitstha in Cape Town. The adult female was said to h over-the-hill been raped and finally killed by the rural goons. The act of this societal force is merely non against the local adult females once more, it has transcended beyond the local communities. The tarradiddle became a planetary sensational narrative. A 26-year- over daysd adult male has been charged with commandeering the automobile of a British twosome who were h aceymooning in Cape Town at the pass and slaying the bride, police said Wednesday.The adult male from Khayelitsha, the sprawling township on the outskirts of Cape Town where Anni Dewani s natural structure was found, was charged within hours of organism taken into constabulary detention on Tuesday ( Afro unseasoneds 24, 2010 ) .The common local recall in South Africa is that human immunodeficiency virus/AIDS is curable by h honest-to-goodnessing inner intercourse with virgin or somebody old who has abstain from sex for considerable clip. This is a remarkable factor announcing the up-surge in the colza instances in the state. Of class the tralatitious physicians ( Sangoma ) frequently times indoctrinate immature crop forces populating with the virus to gibe sex with virgin in order to be remedy. Statistically, South Africa has the largest act of PLWHA worldwide than any other state. And with the local believe, the present state of affairs would hold been anticipate. other misnomer is the usance of adult females submissiveness. A good adult female is rather frequently viewed by the local communities as submissive to her hubby, non oppugning her hubby about his intimate life, ready to gift sex anytime without dialogue and must bear many kids. This attitude frequently endangers adult females life and possibly the unborn kids in state of affairs where the adult male of the house engages in coincident triple sexual partnerships. A recent report in a local connection in a South Africa coterminous state, Botswana found that 62 % of name forces have eng of age(p) in nine-fold sexual partnerships in the old leash months ( New York State, 2010 ) . This is merely what happens i n a state non ill-famed for high incidence of force against adult females. Then, the state of affairs could be far making in the rural South African communities.OPERATIONAL DEFINATIONS AND HYPOTHESIShuman immunodeficiency virus/AIDS prevalence is greater among Womans?human immunodeficiency virus as normally known is Human Immunodeficiency virus sequence AIDS is the terminal phase of human immunodeficiency virus infection. AIDS is Acquired Immune lack Syndrome. In most instances, human immunodeficiency virus infection depending on the immune position of the septic persons can quickly come on to AIDS in a years clip without checkup interposition. However, there were records of people that have lived more than 20 old ages on ART subsequently disdain the virus4. The commonest manner of transmittal of the virus in sub-Sahara Africa is through heterosexual intercourse.Prevalence is an epidemiological parametric quantity evaluation the dissemination of disease term in a population at a bizarre clip. While incidence focal points on the happening of rude(a) form of a disease status. Prevalence encompasses two the new and the bing diseased in a population. In the events of human immunodeficiency virus/AIDS, new instances of HIV leave behind be considered as incidence and some(prenominal) the new instances and those that have AIDS are expressed as the prevalence of the disease.Prevalence = inbuilt Numberss of people with disease status A- 100 correct picture of the populationThe age of react for expiration of maternalism ( TOP ) in South Africa was one time said to be 12 old ages. However, this has late been reviewed by the health Professions Council of South Africa ( HPCSA ) ( HPCSA, 2010 ) . Presently, there is no age limitation for TOP. Amongst many other things brew the ceaseless addition in the contrive of adolescent gestation and childhood HIV/AIDS is this reviewed ethical consideration of age of consent for TOP. Therefore, anybody that is 12 ol d ages old or more and pregnant are considered as female parent and the fictionalization of muliebrity applies. In contrast, the same exposition of been a adult female is considered by and by the age of adolescence ( after 18 old ages ) for non pregnant females. This regulation besides applies for expire forces after adolescence.Testing the hypothesis, it a astray believed that HIV/AIDS is a gender related disease status and that the status is at higher prevalence among adult females. There are different statements that could be put frontward to back up this misnomer in the society. For case, HIV/AIDS and STI prevalence is higher among female commercialised sex proles. They serve as reservoir of infection in the community. This form could be welcome as different people recreation with workers whose HIV and STI position are non verified. This may account for a greater incidence among adult females. However, it is merely a fistful Numberss of adult females that engages in c ommercial sexual activities and this can non be generalised for all.ethnical patterns are the ways of people which has been over clip been accepted as norm in the society. Africans have several norms and patterns that are assisting to fuel the spread of HIV/AIDS. only if are at that place any cultural believe that make HIV/AIDS adult females heritage? Polygamy and duple sexual partnerships are accepted among many African civilizations. Work force are frequently seen as the dominant factors in most African societies and the strength of his subordination is frequently designated by how many adult females he could hold sex with. The work forces are even sometimes adore with particular fears holding multiple sexual married persons as the nature of work forces, they deficiency to hold frequent sex as to maintain tantrum and healthy and multiple sexual partnerships denote suppressing adult females. be these defects in our modern society? Another ground ascribed to adult females high er HIV/AIDS prevalence?In the result of HIV/AIDS pandemic, the usage of barrier method of HIV bar was among the initial intercessions to control the spread of HIV. Male rubbers were so introduced and later the female rubbers. It is known facts that have been proved over times that condoms hold back HIV spread efficaciously. However, to utilize rubber in each sexual brush is non a exclusive duty, collaborative attempts is indispensable. In the society where adult females are already subdued by the social norms, regulations and ordinances, negociating sex with rubber is regarded as act of insubordination. pursuant(predicate) and right usage of rubbers for adult females in heterosexual relationships is frequently compromised. Dry sex is another common demand of local African work forces from adult females. They conduct that it gives work forces intense sexual satisfactions. Womans whose venereal mucosal are easy bruised are the object of mark for HIV and STI.In the most of these concerns laid above, adult females are at the disadvantage. The vignette below looks at the epidemic among adult females, prenatal attendants and work forces in the rural Pondoland.RESEARCH QUESTIONSa? What is the prevalence of HIV/AIDS among adult females and work forces criterion Holy Cross Hospital, Eastern Cape for health check intervention?a? HIV/AIDS is more prevailing among adult females than work forces?a? For the Antenatal attendants, do they hold higher HIV prevalence than other two groups as depict in the South African prenatal HIV prevalence?a? What are the cause ( s ) of higher HIV/AIDS among adult females in the rural Pondoland?Analysis OF HIV/AIDSWomans are the deprecative nutriment of our communities, yet most unguarded to HIV/AIDS. This needs an pressing intercession. The disease status has all its tentacles in all facet of life of both rural and urban South African inhabitants. It has weaken many family of beginning of support and as such many rural fatherla nds are being headed by kids. This is the coupled factor to increased Numberss of orphan kids in Pondoland.Purpose OF THE STUDYThe causative relationships of the virus and higher prevalence among adult females are critically reviewed with the purpose of get down precise and curious intercession schemes in the rural Pondoland. Although most rural African communities do hold common antiquity, the schemes impartation relieve from HIV/AIDS epidemic may be expressed to each community. This is an effort to concentrate on such schemes.Importance OF THE RESEARCH STUDYIn the world, we do non fuck precisely how many people that are populating with HIV/AIDS in South Africa. The national and prenatal prevalence are extrapolations and levy write- makes. This study go forth be a study to make out how many of Holy Cross Hospital grownup patients live with virus. The causes of such septic grownups and the incumbent intercession to control the spread of the virus.THE RESEACH METHODOLOGY ( HI V/AIDS prevalence is greater among adult females? A infirmary establish glance )The design of the check forget be randomised prospective come after of adult females, Antenatal attendants and work forces touchstone Holy Cross Hospital, Eastern Cape, South Africa for medical interventions. The query is traveling to be questionnaires based with translator in stock(predicate) to interpret and make grow inquiries to the participants in the survey. The translator exit be elect among the infirmary volunteered nurse for the entertain of uniformity of linguistic communication interlingual translation and gist result. It is known fact that many of the grownup members of Pondoland rural community are non huge with usage of English linguistic communication.The point distribution of the questionnaires leave behind be at the outpatient partitioning, exigency unit and at the antenatal clinic which takes topographic point every(prenominal) Thursdays. These are the first points of con tact for any patient measuring the infirmary for the first clip. The survey go forth be conducted over the initial period of 1 ( one ) class from January boulder clay celestial latitude 2011. The mark figure of the participants will be capped as 500. There will be tercet groups of the participants ( 1 ) adult females go toing outpatient and exigency sections for medical intervention, ( 2 ) work forces go toing outpatient and exigency sections for medical intervention and ( 3 ) adult females go toing prenatal clinic.The age group that will be included are adult females and work forces in the midst of 18-65 old ages old and pregnant adult females more age 12. As the survey is divided into threesome groups and to be conducted in three infirmary section, the form of questionnaires distribution will be stratified. The first four months of 2011 ( January till April ) , both the virtuoso interrogation worker ( for my portion ) and the helper, we will merely concentrate on patient go toing exigency unit, whitethorn till August 2011 in the outpatient section and September through December in the prenatal unit.The method of everyday glide path will be that at every contact with the participants, the research aims and concentrate will be explained and the voluntaries are selected based on age standards will be tried for HIV. For every participant, voluntary guidance and proving for HIV will be conducted by the principal research worker and written consent will be documented for every participant. Note, all information will be treated with confidential and consequence of the research will non be linked to the participants. A rapid showing HIV proving equip for HIV 1 and 2 ( enzyme-linked-immunosorbent serologic assay 1 and 2 ) will be used throughout the survey. Every consequence will be read after 30 proceedingss. For those proving positive for HIV, they will be offered medical aid for farther research lab trials ( CD4 counts, viral tonss, full personal credit line counts and liver map trial ) and necessary medical intervention. Each participant will be allowed sufficient clip to make full in the questionnaires but should be re whirl before go forthing the infirmary premises. The construction of the inquiries will be in different subdivisions with the initial portion turn toing the demographic informations, cognition about HIV/AIDS, behavioral hazard factors for HIV/AIDS, measuring hazard of societal force and handicap scheme for HIV/AIDS. The inside informations of the questionnaire are as followsDemographic DataAge ( a ) 12 25 old ages ( B ) 26 35 old ages ( grade Celsius ) 36 45 old ages ( vitamin D ) 46 55 old ages ( vitamin E ) 56 65years ( degree Fahrenheit ) more than 65 old agesGender ( a ) Male ( B ) FemaleOccupation ( a ) non-skilled worker ( B ) semi-skilled worker ( degree Celsius ) skilled worker ( vitamin D ) immigrant workerMarital Status ( a ) genius ( B ) life partnership ( degree Celsius ) Married ( vitamin D ) Divorced worship ( a ) Christian ( B ) Islamic ( degree Celsius ) TraditionalRace ( a ) Black ( B ) White ( degree Celsius ) Coloured ( vitamin D ) Indian periodical Income ( a ) Roentgen 500.00 Roentgen 3000.00 ( B ) Roentgen 3001.00 Roentgen 10, 000.00 ( degree Celsius ) R 10,001.00 Roentgen 20, 000.00 ( vitamin D ) greater than R 20, 000. 00 ( vitamin E ) unemployedKnowledge about HIV/AIDS1. HIV is the abbreviation of Human Immunodeficiecy Virus Y N D2. Sexual activity intercourse with multiple sexual mates increases the hazard of geting HIVY N D3. Transfusion of unscreened HIV infected gunstock can take to HIV infection Y N D4. sharing alimentary with AIDS patient can take to HIV infection Y N D5. venereal diseases are risk factors for HIV infection Y N D6. atomic number 65 is an illustration of timeserving infection Y N D7. HIV infected individual should non unwrap his/her position because of stigma Y N D8. HIV/AIDS is a godly penalty for unfaithfulness Y N D9. PLWHA sho uld non be employed because they are underproductive and weakY N D10. HIV is passed on by sneezing, manus shingle, caressing, and kiping togetherY N D11. HIV/AIDS is entirely big disease and the upstart person should non be concerned.Y N D12. HIV bar instruction should merely be a precedence in schools and collegesY N DAdapted from ( hypertext transfer protocol //unesdoc.unesco.org/images/0012/001270/127076eo.pdf ) Y = Yes, N = No, D = Do nt cognize, FBO = Faith found Organisations, PLWHA = People Living with HIV/AIDSBehavioural lay on the line Factors for HIV/AIDS strive you smoke coffin nail, if yes, how many per twenty-four hours?Make you imbibe alcoholic beverage? If yes, how many bottles per twenty-four hours?Do you hold more than one sexual married person? If yes how many?Has any of your sexual better half ( s ) been treated for STI in the sometime(prenominal) three months?Make you cognize sexual teammate ( s ) HIV position? If yes, what is it?Are you in polygamous rela tionship? feed you been sexually been maltreat by your match or mistreat your sexual spouse in the past three months?What is your sentiment about dry sex? nourish you portion needle and endovenous drug with your friend before? If yes when was it?Make you prosecute or patronize commercial sex workers?If employed, does your occupation maintain you off from your place more than two hebdomads or more?Are you or your male spouse circumcised?Measuring hazard of societal force redeem you of all time been sexually abused by opposite gender?Have you been sexually abused by your spouse ( s ) or abused your sexual spouse in the past three months?If yes, when was the first maltreatment? And how terrible was it?Does your spouse have fire arm? And if yes, does he/she endanger to kill you before?Have you of all time sustain any sort of physical or stirred harm from spouse force?Does your spouse respects your sentiment if you are non in the temper of holding sex?How can you depict the inhabit three sexual brushs with your spouse ( s ) ?Make you cognize if your spouse has been reported as ferocious to any other individual?Is your spouse of all time been arrested by constabulary for societal force or drink-driving?Does your spouse have job with choler counsellor?Measuring Preventive Strategies of HIV/AIDSWhich HIV/AIDS bar schemes do you cognize?Make you see utilizing HIV bar if you are non certain of the HIV position of your spouse?If your spouse is HIV positive, will you see utilizing rubber during intercourse? If yes, wherefore?Make you utilize any signifier of HIV preventative step during your last three sexual intercourse? If yes, which one or province them.If condom explosion during sex, what is the immediate measure you should take?If employed, what are the schemes in topographic point of your work guaranting bar of HIV?What is your sentiment about male Circumcision and HIV bar?If HIV and pregnant, will you take ART to close out HIV transmittal to the unborn s ister?What option ( s ) are available for HIV positive spouses to forestall transmittal of HIV to unborn babe?Have you been treated for genital disease in the past three months?What is the nexus between genital disease and HIV? race SAMPLING AND RESULT ANALYSESWhat inform the entire sampling population is the immense figure the infirmary serves, 50,000. 1 % of that is tantamount of 500. Although this is a little figure in associating to the entire population measuring the infirmary, but associating to the principal(prenominal) research worker and the helper, it is tremendous. That is why the survey would hold been conducted throughout a twelvemonth period. The purpose of the age distribution chosen was to affect grownups entirely in the survey nevertheless, adolescent gestation is a breastwork happening in South African communities. That is why pregnant adult females from age 12 are portion of the proposed survey.There are five constituents of the questionnaire and three groups o f participants multiform in the survey, the consequences will obtained individually for each group and interpreted utilizing Microsoft excel. The usage of khi square trial will be employed the hypothesis Hiv is higher among adult females than work forces.Expected RESULTS FROM THE STUDYThe survey is expected to conform to the present form of the virus epidemic in South Africa. HIV/AIDS is more prevailing among female grownups under the age of 40 in about all age groups. rough 4 in every 5 people with HIV/AIDS aged 20-24 are adult females, and merely one tierce of people with HIV/AIDS aged 25-29 are work forces. Although prevalence is higher among adult females in general, merely 1 in every 6 HIV/AIDS infected people with multiple sex spouses are adult females ( Wikipedia, 2010 ) . Although some divergences are expected, could these be rum to the rural Pondoland community? South Africa adult females who have been disempowered revealed the high degree of colza and domestic maltr eatment, a societal misnomer brew the HIV/AIDS epidemic in the state ( Avert, 2010 ) .The National HIV and syphilis Antenatal Sero-prevalence Survey, 2005 and 2007, the per centum of pregnant adult females with HIV per twelvemonth was as follows ( Wikipedia, 2010 ) Year1990199119921993199419951996199719981999200020012002200320042005200620072008Percentage0.71.72.24.07.610.414.217.022.822.424.524.826.527.929.530.229.128.0These one-year studies of HIV among the pregnant adult females are higher than the national prevalence of 10.8 % , though the incidence is higher among adult females 13.3 % than in work forces 8.2 % ( HSCR, 2005 ) . The same result is besides envisaged as above. Possibly there are disparities, they will be noted and a farther study may be needed.EXPECTED CONTRIBUTIONS OF THE STUDY TO THE HOSPITALSouth Africa higher HIV/AIDS national statistic is higher than any other state, that is what has geared the exceeding politics attempts in other to undertake the disease te ndency. The plenteous attempts of the administration are the largest HIV/AIDS strategy in the universe ( each(prenominal) Africa.com, 2010 ) . The tendency of the disease needed to be known exactly in Pondoland. The result of the survey could be presented to the regional health authorization for amendment of HIV/AIDS authorities intercession at the infirmary.Critical reappraisals of different diaries have shown that HIV/AIDS has curious rise among adult females ( UNICEF, 2009 ) , the result of the survey is expected to be in conformance. However, if the consequences show greater proportions of adult females than expected, it could spell a readjustment in the infirmary supply scheme to turn to direction of HIV/AIDS among adult females.The local uncharacteristic causes of rise in HIV/AIDS will be known if there is any. The illation will be surmised from the response of adult females proving positive for HIV in the survey. Therefore local epidemiological form of HIV in Pondolan d will be verified.The result of this survey could name for more survey in HIV/AIDS and other local endemic disease in the infirmary. A rural infirmary where academic research is seldom conducted, this will be an oculus opener. It will be a beginning of inspiration especially for the freshly graduated medical physicians and druggists in the infirmary set abouting their rural community service.DecisionFor effectual intercession to come into fun in the direction of the increased HIV/AIDS disparities among adult females and work forces, the item factors responsible have to be depict and schemes to battle these could be sourced. In the result of HIV/AIDS in the 80s, the epidemic was rather rampart among homosexual in the USA and equal intercessions were ensued as reflected in the state HIV/AIDS statistics. Africa needed to larn from this.The basic nutriment of any community is the valued lives of the household members. Womans who are the beginning of generational continuity are in h azard in our society. instructive and pressing attack should be instituted in the rural and all African communities to adjudge the harness effects of HIV/AIDS. saloon of Mother-to-Child HIV transmittal, handiness of free rubbers in public establishments, adult females empowerment and wellness instruction should parts of focus authorities and NGO agendas to readdress HIV/AIDS epidemic in Africa.