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I am revising the Wikipedia article currently named “Health in Eswatini."
To be added under the HIV/AIDS heading:
HIV/AIDS
editHealthcare workers
editThe HIV pandemic in Eswatini does not spare healthcare workers, among which utilization of HIV/AIDS services is low.[1][2] Fears of HIV-related stigma are prevalent among members of the healthcare workforce.[1] Such stigma serves as a significant barrier for healthcare workers to accessing and utilizing HIV/AIDS care and prevention services, at their own workplace as well as at other facilities. In particular, workers have cited a fear of stigmatization by both their patients and colleagues, and a fear of breach of confidentiality, as reasons for deciding not to access HIV testing or care.[1] Self-stigmatization is exacerbated among healthcare workers.[1] They view themselves as separate from and more knowledgeable than the HIV-vulnerable general population, which enforces a professional need to be HIV free.[1] Many HIV-positive healthcare workers feel a sense of failure and professional embarrassment, as they have contracted an infection that they have been trained to avoid and prevent.[1]
The public health sector in Eswatini faces a shortage of healthcare workers, with many health workers overwhelmed by the demand for care.[2] This depletion of the healthcare workforce has been attributed partly to HIV/AIDS.[1][2] In fact, the prevalence of HIV among healthcare workers is estimated to be equal to that among the general Swazi population.[1] The self-stigmatization of HIV/AIDS care among healthcare workers prevents healthcare workers from accessing needed care,[2] which can contribute to HIV-related death and absenteeism of healthcare providers.[1]
Men who have sex with men
editHIV prevalence among men who have sex with men (MSM) aged 16 to 44 years is 17.7% in Eswatini, with the prevalence increasing in this group with age.[3] MSM represent a neglected population: HIV/AIDS data for MSM are less robust than for the general Swazi population (AMFAR), and the government of Eswatini has only just recently directed public funding towards programs aimed at addressing the epidemic among MSM.[4] MSM face criminalization, stigma, and discrimination when accessing HIV/AIDS services.[4] Although no laws in Eswatini specifically prohibit homosexuality, same-sex practices can be charged as indecent acts under common law, and these practices are widely regarded as illegal under the Sodomy Act.[5] More than a third of MSM in Eswatini reported having been tortured due to their sexual orientation, as found in a study published by the U.S. Agency for International Development (USAID) Research to Prevention program.[6] One fifth of respondents in this study also believed they had received lower quality medical care due to their orientation.[6] MSM also reported having experienced other rights violations related to sexual practices, such as denial of care, police-mediated violence, as well as verbal and/or physical harassment.[7] Such barriers to access are linked to lower levels of HIV/AIDS-related information, education, and communication services uptake among MSM, as compared with other reproductive-age adults, thus resulting in limited knowledge of HIV/AIDS-related risks associated with same-sex practices.[7][8] For instance, in a study of 324 Swazi MSM, participants were significantly more likely to have received information about HIV transmission via sex with women, rather than during sex with other men.[7] This lack of information could perpetuate ignorance regarding same-sex transmission of HIV. Among this study’s sample, there were lower rates of condom use with male sexual partners as compared to female sexual partners, emphasizing the need for specific information about same-sex HIV acquisition and transmission.[7] About half of the study’s respondents expressed concern about HIV. Furthermore, only a quarter of men living with HIV who participated in the study were aware of their seropositive status.[7] Although the HIV/AIDS situation has been reported to improve for MSM in urban regions of Eswatini, the situation has worsened in rural regions, where strong stigma associated with same-sex practices persists.[5] The provision of healthcare services for MSM and research into HIV/AIDS among MSM are largely concentrated in urban regions.[9][5]
- ^ a b c d e f g h i Vries, Daniel H. de; Galvin, Shannon; Mhlanga, Masitsela; Cindzi, Brian; Dlamini, Thabsile (2011). ""Othering" the health worker: self-stigmatization of HIV/AIDS care among health workers in Swaziland". Journal of the International AIDS Society. 14 (1): 60–60. doi:10.1186/1758-2652-14-60. ISSN 1758-2652. PMC 3287109. PMID 22192455.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ a b c d Kober, Katharina; Van Damme, Wim (2006-05-31). "Public sector nurses in Swaziland: can the downturn be reversed?". Human Resources for Health. 4: 13. doi:10.1186/1478-4491-4-13. ISSN 1478-4491. PMC 1513248. PMID 16737544.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ U.S. President’s Emergency Plan for AIDS Relief. (2018). Swaziland Country Operational Plan (COP) 2018 Strategic Direction Summary. Retrieved from https://www.pepfar.gov/documents/organization/285864.pdf
- ^ a b Sithole, Bhekie (2017-10-02). "HIV prevention needs for men who have sex with men in Swaziland". African Journal of AIDS Research. 16 (4): 315–320. doi:10.2989/16085906.2017.1379420. ISSN 1608-5906. PMID 29132291.
- ^ a b c The Foundation for AIDS Research. (2013). Country Profile: Swaziland (Achieving an AIDS-Free Generation for Gay Men and Other MSM in Southern Africa). Retrieved from https://www.amfar.org/uploadedFiles/_amfarorg/Articles/Around_The_World/GMT/2013/MSM%20Country%20Profiles%20Swaziland%20092613.pdf
- ^ a b U.S. Agency for International Development. (2013). HIV among Female Sex Workers and Men Who Have Sex with Men in Swaziland: A combined report of quantitative and qualitative studies. Retrieved from https://www.jhsph.edu/research/centers-and-institutes/research-to-prevention/publications/Swazi-integrated-report-final.pdf
- ^ a b c d e Baral, Stefan D.; Ketende, Sosthenes; Mnisi, Zandile; Mabuza, Xolile; Grosso, Ashley; Sithole, Bhekie; Maziya, Sibusiso; Kerrigan, Deanna L.; Green, Jessica L. (2013). "A cross-sectional assessment of the burden of HIV and associated individual- and structural-level characteristics among men who have sex with men in Swaziland". Journal of the International AIDS Society. 16 (4S3): 18768. doi:10.7448/IAS.16.4.18768. ISSN 1758-2652. PMC 3852353. PMID 24321117.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Sithole, Bhekie (2017-12). "HIV prevention needs for men who have sex with men in Swaziland". African journal of AIDS research: AJAR. 16 (4): 315–320. doi:10.2989/16085906.2017.1379420. ISSN 1727-9445. PMID 29132291.
{{cite journal}}: Check date values in:|date=(help) - ^ Imrie, John; Hoddinott, Graeme; Fuller, Sebastian; Oliver, Stephen; Newell, Marie-Louise (2013-5). "Why MSM in rural South African communities should be an HIV prevention research priority". AIDS and behavior. 17 Suppl 1: S70–76. doi:10.1007/s10461-012-0356-1. ISSN 1573-3254. PMC 3627851. PMID 23196857.
{{cite journal}}: Check date values in:|date=(help)CS1 maint: PMC format (link)