The political environment of HIV: lessons from a comparison of Uganda and South Africa
The political environment of HIV: lessons from a comparison of Uganda and South Africa
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DOI：
10.1016/j.socscimed.2004.02.026
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发表时间：
2004-11-01
影响因子：
5.4
通讯作者：
Lush, L
中科院分区：
文献类型：
--
作者：
Parkhurst, JO;Lush, L
治理或政治承诺在决定撒哈拉以南非洲艾滋病毒/艾滋病政策成败方面的作用引起了相当大的兴趣。在1990年代，乌干达和南非都面临着戏剧性的艾滋病毒/艾滋病流行，也都经历了向新政治制度的转变。然而，他们对这种疾病的反应在许多方面都不同。本文比较和对比了政策环境，特别是政府结构，可以阻碍或加快有效预防艾滋病毒的实施的方式。讨论了这些环境的四个要素--政治领导的作用、现有的官僚制度、卫生保健基础设施以及分配给非国家行为者的角色。1990年代中后期，乌干达和南非审查了两种常见的预防艾滋病毒的国际战略--性传播感染综合症管理和性行为改变干预措施。在此期间，乌干达的政治制度成功地促进了行为改变干预，而南非在综合症状管理方面的努力更为成功。政策环境的四个要素之间的相互作用被认为有利于取得这样的成果。这些因素是社会政治环境的相对静态特征，因此可以从这两个国家的现行艾滋病毒/艾滋病政策以及更广泛的防治这一流行病的受众中吸取教训。(C)2004爱思唯尔有限公司。保留所有权利。
Considerable interest has arisen in the role of governance or political commitment in determining the success or failure of HIV/AIDS policies in sub-Saharan Africa. During the 1990s, Uganda and South Africa both faced dramatic HIV/AIDS epidemics and also saw transformations to new political systems. However, their responses to the disease differed in many ways. This paper compares and contrasts the ways in which policy environments, particularly government structures, can impede or expedite implementation of effective HIV prevention. Four elements of these environments are discussed-the role of political leadership, the existing bureaucratic system, the health care infrastructure, and the roles assigned to non-state actors. Two common international strategies for HIV prevention, syndromic management of sexually transmitted infections and sexual behaviour change interventions, are examined in relation to these elements in Uganda and South Africa during the mid-to-late 1990s. During this period, Uganda's political system succeeded in promoting behaviour change interventions, while South Africa was more successful in syndromic management efforts. Interactions between the four elements of the policy environment were found to be conducive to such results. These elements are relatively static features of the socio-political environments, so lessons can be drawn for current HIV/AIDS policy, both in these two countries and for a wider audience addressing the epidemic. (C) 2004 Elsevier Ltd. All rights reserved.