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School-going young people in South Africa engage in HIV risk behaviour despite high levels of HIV knowledge and a variety of interventions focusing on HIV prevention. The lack of empirical evidence on the effectiveness of current interventions leaves programme implementers with little consensus about how best to prevent HIV infection among young people. This research was done to explore factors underlying HIV risk of young people with the aim of developing HIV prevention in the third decade of the epidemic. Focus group discussions were conducted with young people, educators and parents in eight schools in four provinces of the country. A thematic analysis revealed risk factors especially on the interpersonal and community level. Peer pressure, gender norms and culture, poverty and financial gain and a culture of alcohol use were prominent themes. Negative family relationships, lack of role models and lack of sexual education from home contributed to risk behaviour. Community processes such as exposure to media, lack of recreational facilities, and an erosion of supportive culture and community structures created an environment which did not support healthy behaviour. Factors that prevented risk behaviour were identified as self-respect, open communication with parents, implementation of school programmes, positive peer pressure and a focus on young people's future. Prevention programmes should therefore not only focus on individual factors but should be multi-layered interventions involving various community structures aimed at changing the social ecology in communities to support an alternative lifestyle for young people.

Purpose – To examine and critique the research on HIV/AIDS health disparities among Black Americans.

Methodology – A selective investigation of quantitative research on HIV/AIDS health disparities from the 1980s to the present. Prevalence and incidence of HIV/AIDS in Black American communities and research targeting individual-level behaviors and their outcomes are presented. The impact of racialized discourses related to Black sexuality and its impact on research are discussed. Future policy and practice directions are offered.

Findings – This chapter notes the preponderance of studies at the individual level even in the face of null findings.

Research limitations/implications – This work is not an exhaustive examination of all the studies on HIV racial health disparity.

Practical implications – This chapter contributes to the literature that redirects HIV/AIDS research from focus on individual behaviors in the face of a population-level epidemic.

Social implications – This chapter demonstrates how research goals may be diverted by unacknowledged racialized assumptions.

Originality/value of chapter – This study is one of the few critiques of HIV/AIDS research on Black Americans.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

Women with HIV have increased longevity and the potential for decreasing mother to child transmission with the use of antiretroviral therapy. Since the beginning of the AIDS epidemic in 1980, the disease has evolved from an acute condition to a chronic one. How have women long-term survivors transitioned from a “death sentence” to living with HIV/AIDS as a chronic illness? In this study, we investigate the reproductive, mothering, and living experiences of HIV positive women 10 years after their participation in a study of their reproductive decisions. The sample was taken from two groups of women living with HIV (n = 60), one in Oakland, California (n = 30) and one in Rochester, New York (n = 30). Both groups participated in the initial study (1995–2001). The inclusion criteria for this study are women with HIV who are living and well enough to participate in a face-to-face interview. Of the original 60 women, 52 women are living. Two and one half years into this 4-year study, the author has completed interviews with 25 women from Oakland (n = 10) and Rochester (n = 15). An unexpected life with HIV challenges participants to live a viable life different from their pre-diagnosed life. It involves a life of defining normalcy in everyday experiences and building a legacy of a life worth living. Participants’ issues and concerns of living with HIV/AIDS identify what kinds of cultural notions, and medical and social interventions support or undermine women's reproductive, mothering, and long-term living with HIV/AIDS.

Impact mitigation strategies in sub-Saharan Africa on HIV/AIDS in the education sector involved initially the development of education sector policies. This study traces the policy development initiatives, level of implementation, progress made and existing challenges. The study is based on a close (textual) reading of authoritative literature from United Nations Programme on HIV/AIDS (UNAIDS), World Bank, UNESCO and UNICEF for the last decade on global monitoring of HIV/AIDS and statistical data. Studies on the impact of HIV/AIDS on the education sector in sub-Saharan Africa have been brought into focus and themes have been extracted and synthesised from a comparative perspective to guide the development of this chapter. Across the countries, the education sector HIV/AIDS policies had concurrence with the countries’ national HIV and AIDS policy or guidelines, and conformed to international conventions, national laws, policies, guidelines and regulations. Most of the countries in Sub-Saharan Africa showed a significant decline in HIV prevalence among young women or men and opportunities to improve HIV-prevention knowledge and behaviour still abound. Antiretroviral therapy and other types of treatment have expanded since the early 2000s, but the number of AIDS-related deaths remains high. This chapter fulfils an identified information/resources need and amplifies the progress achieved in the mitigation of the impact of HIV/AIDS on the education sector specifically and humanity in general.

By bringing together aspects of sustainable forest management, population health, and local livelihoods, the purpose of this study was to characterize how household dependence on forest resources changes through three phases: the period before HIV became a problem in the household, the period during HIV-related morbidity, and after AIDS-related mortality.

Sixty semi-structured interviews were conducted with members of unaffected and HIV/AIDS-affected households in four case study districts in Malawi.

This study demonstrates that the relationship between HIV/AIDS and dependence on specific forest resources appears to correspond closely with the stage of the disease. Firewood and water were consistently ranked as being one of the three most important resources, regardless of HIV-affectedness. During the morbidity phase, respondents reported their need for medicinal plants increased substantially, along with other resources. The importance of timber increased significantly after HIV-related mortality.

Interview respondents themselves suggested key interventions that would assist households in the HIV/AIDS-mortality phase, in particular, to obtain the forest resources they require. These interventions could address the impacts of HIV/AIDS on the sustainability of important resources, compensate for a decreased availability of household labor, and foster greater access to these resources for vulnerable households in the four study sites.

In spite of the fact that forest resources can play a crucial role in enabling a household to control and adapt to the disease, research on the environmental dimensions of HIV/AIDS remains limited. This chapter helps to address this knowledge gap, suggests practical, innovative interventions that could alleviate some of the disease burden on rural Malawian households, and offers insight into potential areas of further inquiry in this research domain.

The purpose of the study was to analyse approaches to HIV/AIDS education adopted by the Zambian Ministry of Education (MoE), using a holistic approach and focusing on the Zambian culture. This chapter reports on an explorative qualitative study involving focus group discussions and in-depth interviews with Ministry of Education and Health officials, pupils, students, and members of the community. Qualitative analysis was applied and themes from ecological theory were used to organise and discuss data. At the macro level, there was inadequate implementation of HIV/AIDS education in schools, very few handbooks, textbooks and learners’ reading materials, and no discussion of the Zambian cultural (sexual) practices in relation to HIV/AIDS education. Inadequate laws and policies on HIV/AIDS prevention, poverty, unemployment, lack of job creation, and lack of social security were blamed for the lack of positive sexual behaviour changes. Communities had strong theological and metaphysical beliefs including witchcraft and sex with a widow, a menstruating woman or a woman who had an abortion as possible causes of HIV and incurable diseases being a curse from God. At the individual level, the knowledge of HIV/AIDS was high with radio and television being sources of information. Respondents viewed sexual cultures in communities not to have significantly changed. A majority of respondents did not use condoms; most adults continued having multiple sexual partners and women were submissive in marriages. This chapter is useful to policy makers, teachers, pupils/students, and the community, and in understanding interactions and influences of cultures on HIV/AIDS education and government's role in creating an enabling environment to sustain desirable changes.

The HIV epidemic in South Africa affects young people in their teenage years, the majority of whom are young women located in schools. Sexual violence and gender inequalities create vulnerabilities for young women increasing their risk of HIV. Promoting their sexual health as well as preventing the disease amongst young people remains a substantial educational and health priority. South African education has well-developed policies related to HIV and AIDS education in schools. Despite this the disproportionate burden that young women bear in relation to HIV remains acute. What remains missing is the development of an integrated HIV and AIDS education approach that takes children, gender and sexuality seriously. Given the urgency of the disease in the country, there is need for renewed efforts to integrate gender and sexuality within HIV and AIDS education. This is the central focus of this chapter.

This chapter is an exploratory piece to comprehend how national policies react to regional policy solutions designed to cope with the HIV/AIDS epidemic. It uses data from the national strategic plans for HIV/AIDS from 13 of 15 Caribbean Community (CARICOM) members to illustrate how they interpret the regional response to the pandemic. In drawing upon the existing literature on transfer, it focuses on what I term cooperative policy transfer – explore how policy concepts flow back and forth between the national and regional levels through cohesive harmonization – to understand how new policy trends emerge. A cross-sectional analysis based on a content analysis reveals the emergence of three new policy trends distinct to the region that guide HIV/AIDS education: (i) creating a multisectoral approach; (ii) setting international targets; and (iii) establishing regional benchmarks. These new trends are identified as what I call the rise of new mutualism in education. The chapter concludes that the national and regional policy responses to HIV/AIDS in CARICOM countries, centered on new mutualism, became a rallying cry based on the belief that the Caribbean Single Market and Economy (CSME) can only function if CARICOM countries combine their resources to reverse the effect of HIV/AIDS on national educational systems.