Design: A 12 month, prospective study of 210 female sex workers. Methods

We interviewed participants about their sexual behaviour every 2 months for a total of seven times and introduced female condoms after the third interview. We also collected cost data and calculated the cost and cost effectiveness of adding the female condom component to the existing programme.

Introduction of the female condom in an HIV/AIDS prevention project targeting sex workers led to small, but significant, increases in consistent condom use with all sexual partners. However, there was a high degree of substitution of the female condom for male condoms. The cost per additional consistent condom user at a programme level is estimated to be 2160 dollars (1169 pounds sterling, 1711 euros) (95% CI: 1338 to 11 179).

The female condom has some potential for reducing unprotected sex among sex workers. However, given its high cost, and the marginal improvements seen here, governments should limit promotion of the female condom in populations that are already successfully using the male condom. More research is needed to identify effective methods of encouraging sex workers to practise safer sex with their boyfriends

HIV/AIDS is the single major threat to human life and to economic development in Africa; the medical and economic impacts of HIV/AIDS are immense and complex. The response to stop and control HIV/AIDS has yielded many useful strategies and yet many mistakes and missed opportunities. Among

the later is the continued association of HIV/AIDS with medical departments than with all departments.

Of specific concern to the proposed study is the continued reluctance to associate HIV/AIDS control with factors of religion and spirituality. While positive living has been identified and prescribed for PLWHAs little research has been done to explain this in the context of religion and spirituality. Moreover no research has been done to empirically investigate the actual impact of religion and spirituality on healing and health for PLWHAs and consequently, on economics. This paper is part of a bigger project towards addressing this knowledge gap.

The goal of the proposed paper is to illustrate the need to integrate religion and spirituality into HIV/AIDS prevention and treatment for reduced health expenditure. The specific objectives include:

• 
  To develop a Religio-Spiritual Health and Healing Measure for People Living with HIV/AIDS (Reshem+) to empirically investigate the impact of religion and spirituality on healing and health for PLWHAs.
  
• 
  To explain positive living with HIV/AIDS in the context of religion and spirituality.
  
• 
  To indicate the relationship between religio-spiritual healing and health and economic development in Africa.
  

Basically, qualitative and quantitative methods of data collection and analysis will be used to collect data necessary for the development of a Reshem+. After an empirical measure is produced the relationship between spiritual healing and health and economic development will theoretically be propounded.

The expected findings of the research are:

Religion and spirituality is empirically related to Sexual healing and health for people living HIV/AIDS Religio-spiritual health and Sexual healing is positively related to economic development
Conclusion/lesson:

These findings will indicate one basic conclusion/lesson: the need to develop religio ­spiritual therapy for reduced health expenditure.

To compare HIV seroprevalence estimates obtained from antenatal care (ANC) sentinel surveillance surveys in Ethiopia, Kenya, Malawi, Tanzania and Uganda with those from population-based demographic and health surveys (DHS) and AIDS indicator surveys (AIS).

Geographical information system methods were used to map ANC surveillance sites and DHS/AIS survey clusters within a 15-km radius of the ANC sites. National DHS/AIS HIV prevalence estimates for women and men were compared with national prevalence estimates from ANC surveillance. DHS/AIS HIV prevalence estimates for women and men residing within 15 km of ANC sites were compared with those from ANC surveillance. For women, these comparisons were also stratified by current pregnancy status, experience of recent childbirth and receiving ANC for the last birth.

In four of the five countries, national DHS/AIS estimates of HIV prevalence were lower than the ANC surveillance estimates. Comparing women and men in the catchment areas of the ANC sites, the DHS/AIS estimates were similar to ANC surveillance estimates. DHS/AIS estimates for men residing in the catchment areas of ANC sites were much lower than ANC surveillance estimates for women in all cases. ANC estimates were higher for younger women than DHS/AIS estimates for women in ANC catchment areas, but lower at older ages. In all cases, urban prevalence was higher than rural prevalence but there were no consistent patterns by education.

ANC surveillance surveys tend to overestimate HIV prevalence compared to prevalence among women in the general population in DHS/AIS surveys. However, the ANC and DHS/AIS estimates are similar when restricted to women and men, or to women only, residing in catchment areas of ANC sites. Patterns by age and urban/rural residence suggest possible bias in the ANC estimates.