The article explores the relationship between social support and health behaviour of rural and urban women who are living with HIV in South Africa. Our study was a descriptive survey of a group of pregnant and non-pregnant women living with HIV. The sample size was 262 women, 165 from urban area and 97 from rural area. Data were collected using 3 instruments, namely a demographic questionnaire, the health behaviour schedule and the Medical Outcomes Study (MOS) Social Support Survey. Significant findings indicate that in the urban area 71% of women had disclosed their HIV status to someone, while in the rural area 49% had done so. A total of 77% of the women indicated that they were sexually active--21% had 2 partners and 20% indicated that they had at least one episode of a sexually transmitted disease since finding out their HIV status. A total of 16% said that they currently received counselling, which was significantly more frequent in the rural sample (27%) than the urban (11%). The membership of support groups is at 12% among the participating women, and social support as well as membership of a support group was higher in the rural group than the urban group. Good social support showed an association with condom use, support group attendance and taking vitamins. However, receiving counselling as well as membership of a support group showed stronger association with positive health behaviour than social support on its own. The higher social support was not associated with increased disclosure.
RESEARCHBackground. Although emergency contraception (EC) is widely available, its use is surrounded by many controversies. Overall, it seems to be underutilised worldwide. Objectives. To determine healthcare professionals᾽ knowledge, attitudes and perceptions regarding EC, and how frequently they encounter, educate and issue it to patients. Methods. A questionnaire-based survey of doctors and nurses (volunteers) working in obstetrics and gynaecology was conducted in 3 public hospitals and 17 clinics in Pietermaritzburg, KwaZulu-Natal Province, South Africa. Data were analysed using SPSS. Results. Sixty-seven (25%) doctors and 201 (75%) nurses participated in the survey. Awareness of the three ECs available in the public sector overall was 56.4%, and 62.7% of participants could prescribe one EC correctly. Only 39.6% knew that EC pills prevent ovulation. Seventy-six percent thought that the use of EC could lead to high-risk sexual behaviour, high risk of transmission of HIV and non-use of other forms of contraception. Only 7.8% saw patients seeking EC often, 5.6% issued it often and 23.5% educated patients about it often. Conclusion. Participants were familiar with EC, but lacked accurate and detailed knowledge about its mechanism of action and had misperceptions on its social impact. They seldom prescribed it. It is estimated that about 41.0% of the 208 million pregnancies that occurred worldwide in 2008 were unintended.[1] East and Central Africa have the highest rates of unintended pregnancies and about 14 million unintended pregnancies are estimated to occur in subSaharan Africa annually. [1,2] Unintended pregnancies are resolved differently by women. Globally, there were an estimated 42 million induced abortions in 2003, of which 48% were unsafe and 97% of the unsafe abortions were performed in developing countries.[3] The World Health Organization (WHO) estimated that 21.6 million unsafe abortions occurred worldwide in 2008, an increase from 19.7 million in 2003, [4] with Eastern and Central Africa having the highest rates.[5] Unsafe abortions have a negative impact on maternal morbidity and mortality. A reduction in unintended pregnancies may result in a reduction of unsafe abortions, hence lowering maternal mortality.In situations where there is unprotected sexual intercourse or contraceptive method failure, emergency contraception (EC) may be used to prevent unintended pregnancies. Although EC is widely available in many countries, its use has been marred with controversies and misperceptions, especially concerning its mode of action, impact on behaviour and safety. EC pills prevent pregnancy by inhibiting or delaying ovulation, but they cannot disrupt an established pregnancy. However, an analysis of 1 077 articles in 113 newspapers between 1992 and 2002 showed that 44.5% of them included at least one instance of confusion between EC and medical abortion, with 31.0% of the articles inaccurately portraying the mode of action of EC as medical abortion.[6] The use of EC varies in different countries, and o...
Women living with HIV/AIDS not only bear the burden of this pandemic in under-resourced countries, but are faced with the human rights issues concerning the management of their condition, not only for their own health, but also for prevention of mother-to-child transmission of the virus and infertility investigation. This article tackles the issues of reproductive health rights pertaining to prevention of HIV, and rights regarding HIV testing including the ethical dilemmas associated with "opt in," "opt out," and mandatory testing. Accountability, rights to treatment and travel, and employment issues are also discussed.
We present a case of spontaneous antepartum uterine rupture through a previous lower segment Caesarean section (LSCS) scar with clinical features mimicking an advanced extrauterine pregnancy (AEUP) in a twin pregnancy at 28 weeks gestation. This report illustrates the need to consider a diagnosis of a ruptured uterus in any patient with a previous abdominal delivery who presents with mild abdominal tenderness and an ultrasonographic image suggestive of demised fetus in the intra-peritoneal cavity.
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