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134 results

1. Delivering PrEP to Young Women in a Low-Income Setting in South Africa: Lessons for Providing Both Convenience and Support

Author

Sarah Jane Steele, Nikiwe Malabi, Nelisiwe Ntuli, Laura Trivino Duran, Charllen Kilani, Tom Ellman, Aurelie Nelson, C. Pfaff, Rebecca O’Connell, Tali Cassidy, Tabitha Mutseyekwa, Bulelwa Rorwana, Virginia De Azevedo, and Zee Ndlovu

Subjects
Adult, Low income, medicine.medical_specialty, Adolescent, Social Psychology, Anti-HIV Agents, HIV prevention, HIV Infections, 030204 cardiovascular system & hematology, Medication Adherence, law.invention, South Africa, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, Social support, 0302 clinical medicine, Condom, law, medicine, Humans, 030212 general & internal medicine, Original Paper, business.industry, Public health, Public Health, Environmental and Occupational Health, Correction, Health psychology, Infectious Diseases, Adherence, Pill, Facilitator, Family medicine, Africa, Female, Young women, business
Abstract

Daily oral pre-exposure prophylaxis (PrEP) is a key tool in addressing high HIV incidence among young women, and breaking the cycle of transmission. From 2017 to 2020, Médecins Sans Frontières (MSF) offered PrEP, in conjunction with contraception and risk-reduction counselling, to women aged 18–25, in a government-run clinic in Khayelitsha, a low income high HIV prevalence area in South Africa. Drawing on clinical, quantitative, and qualitative interview data, we describe participants’ experiences and engagement with the PrEP program, participant adherence (measured by TFV-DP levels in dried blood spots) over time, and the indirect benefits of the PrEP program. Of 224 screened and eligible participants, 164 (73.2%) initiated PrEP, with no large differences between those who initiated and those who did not. Overall, 47 (29%) completed 18 months follow-up, with 15 (9.1%) attending all visits. 76 (46.9%) participants were lost to follow-up, 15 (9.1%) exited when leaving the area, and 28.7% of exits happened in the first month of the study. We identified two different trajectories of PrEP adherence: 67% of participants had, on average, consistently low TFV-DP levels, with the remaining 33% having sustained high adherence. Few baseline characteristics predicted good adherence. The main reported barrier to taking PrEP was forgetting to take or travel with the pills. Encouragement from others declined as a reported facilitator from month 6 to 18 (family: 93.1% vs 77.6%, p = 0.016, friends: 77.6% vs 41.4%, p ≤ 0.001, partners: 62.1% vs 46.6%, p = 0.096, other PrEP users: 89.7% vs 74.1%, p = 0.020). Disclosure to friends and family in some cases opened dialogue around sex, and helped to educate others about PrEP. Self-reported sex with more than one partner, and sex without a condom, decreased significantly after enrolment (p

Published
2021

2. Intravaginal and Menstrual Practices among Women Working in Food and Recreational Facilities in Mwanza, Tanzania: Implications for Microbicide Trials

Author

B. Chiduo, David Ross, Lemmy Medard, Andrew Vallely, Nicola Desmond, Richard J. Hayes, Suzanna C. Francis, Shelley Lees, and C. Allen

Subjects
Male, HIV Infections, Tanzania, Menstruation, Anti-Infective Agents, Hygiene, Workplace, Qualitative Research, media_common, education.field_of_study, biology, Sexually Transmitted Diseases, Viral, Focus Groups, Infectious Diseases, medicine.anatomical_structure, Vagina, Female, Adult, Employment, medicine.medical_specialty, Social Psychology, media_common.quotation_subject, Population, Vaginal microbicides, Young Adult, Environmental health, Microbicide, medicine, Humans, Women, Vaginal practices, education, Gynecology, Original Paper, Vaginal microbicide, business.industry, Public Health, Environmental and Occupational Health, HIV, biology.organism_classification, Microbicides for sexually transmitted diseases, Administration, Intravaginal, Clinical Trials, Phase III as Topic, Food, Africa, Prevention of sexual transmission, Recreation, business
Abstract

Intravaginal and menstrual practices may potentially influence results of trials of microbicides for HIV prevention through effects on the vaginal environment and on adherence to microbicide and placebo products. As part of the feasibility study for the Microbicides Development Programme Phase 3 trial of a vaginal microbicide in Mwanza, a variety of quantitative and qualitative methods were used to describe these practices, associations with behaviour and underlying social norms among women working in food and recreational facilities. Intravaginal cleansing by inserting fingers and either water alone or soap and water was thought necessary to remove "uchafu" (dirt), referring to vaginal secretions, including menstrual blood and post-coital discharge. Vaginal cleansing was carried out within 2 hours after 45% of sex acts. Sexual enhancement practices were less common. Intravaginal and menstrual practices and associated behaviours and demographic factors should be measured and monitored throughout microbicide trials to enable analyses of their impacts on microbicide effectiveness.

Published
2010

4. How Treatment Partners Help: Social Analysis of an African Adherence Support Intervention

Author

Monique A. Wyatt, David R. Bangsberg, Sylvia Kaaya, Norma C. Ware, and Kelli N O'Laughlin

Subjects
Adult, Male, medicine.medical_specialty, Social stigma, Social Psychology, Anti-HIV Agents, Social Stigma, Tanzania, Medication Adherence, Interviews as Topic, 03 medical and health sciences, Social support, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Outcome Assessment, Health Care, Humans, Medicine, Community Health Services, 030212 general & internal medicine, Social determinants of health, Psychiatry, Original Paper, Acquired Immunodeficiency Syndrome, 030505 public health, biology, business.industry, Public health, Treatment partner, treatment assistant, Public Health, Environmental and Occupational Health, HIV, Social Support, Helping Behavior, medicine.disease, biology.organism_classification, 3. Good health, Health psychology, Infectious Diseases, Caregivers, Socioeconomic Factors, Adherence, Family medicine, Africa, Structured interview, HIV/AIDS, Female, 0305 other medical science, business, Follow-Up Studies
Abstract

The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Treatment partnering is an adherence inter- vention developed in sub-Saharan Africa. This paper describes the additional social functions that treatment partners serve and shows how these functions contribute to health and survival for patients with HIV/AIDS. Ninety- eight minimally structured interviews were conducted with twenty pairs of adult HIV/AIDS patients (N = 20) and treatment partners (N = 20) treated at a public HIV-care setting in Tanzania. Four social functions were identified using inductive, category construction and interpretive methods of analysis: (1) encouraging disclosure; (2) com- bating stigma; (3) restoring hope; and (4) reducing social difference. These functions work to restore social con- nections and reverse the isolating effects of HIV/AIDS, strengthening access to essential community safety nets. Besides encouraging ARV adherence, treatment partners contribute to the social health of patients. Social health as well as HIV treatment success is essential to survival for persons living with HIV/AIDS in sub-Saharan Africa.

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6. Correlates of Adherence to Oral and Vaginal Pre-exposure Prophylaxis (PrEP) Among Adolescent Girls and Young Women (AGYW) Participating in the MTN-034/REACH Trial

Author

Ngure, Kenneth, Browne, Erica N., Reddy, Krishnaveni, Friedland, Barbara A., van der Straten, Ariane, Palanee-Phillips, Thesla, Nakalega, Rita, Gati, Brenda, Kalule, Hadijah N., Siziba, Bekezela, Soto-Torres, Lydia, Nair, Gonasagrie, Garcia, Morgan, Celum, Connie, and Roberts, Sarah T.

Published
2024
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7. High HIV Prevalence Among Men Who have Sex with Men in Soweto, South Africa: Results from the Soweto Men’s Study

Author

Tim Lane, Joseph Rasethe, H. Fisher Raymond, Sibongile Dladla, Willi McFarland, Helen Struthers, and James McIntyre

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Alcohol Drinking, Social Psychology, Substance-Related Disorders, Population, HIV Infections, Men who have sex with men, South Africa, Young Adult, Age Distribution, Risk-Taking, HIV Seroprevalence, Risk Factors, Surveys and Questionnaires, Prevalence, Humans, Medicine, Homosexuality, Male, Young adult, education, Socioeconomic status, Original Paper, education.field_of_study, business.industry, Public health, Gay men, Public Health, Environmental and Occupational Health, Odds ratio, Middle Aged, Hiv prevalence, Confidence interval, HIV prevalence, Sexual Partners, Infectious Diseases, Circumcision, Male, Socioeconomic Factors, Africa, Bisexuality, Female, business, Demography
Abstract

The Soweto Men's Study assessed HIV prevalence and associated risk factors among MSM in Soweto, South Africa. Using respondent driven sampling (RDS) recruitment methods, we recruited 378 MSM (including 15 seeds) over 30 weeks in 2008. All results were adjusted for RDS sampling design. Overall HIV prevalence was estimated at 13.2% (95% confidence interval 12.4-13.9%), with 33.9% among gay-identified men, 6.4% among bisexual-identified men, and 10.1% among straight-identified MSM. In multivariable analysis, HIV infection was associated with being older than 25 (adjusted odds ratio (AOR) 3.8, 95% CI 3.2-4.6), gay self-identification (AOR 2.3, 95% CI 1.8-3.0), monthly income less than ZAR500 (AOR 1.4, 95% CI 1.2-1.7), purchasing alcohol or drugs in exchange for sex with another man (AOR 3.9, 95% CI 3.2-4.7), reporting any URAI (AOR 4.4, 95% CI 3.5-5.7), reporting between six and nine partners in the prior 6 months (AOR 5.7, 95% CI 4.0-8.2), circumcision, (AOR 0.2, 95% CI 0.1-0.2), a regular female partner (AOR 0.2, 95% CI 0.2-0.3), smoking marijuana in the last 6 months (AOR 0.6, 95% CI 0.5-0.8), unprotected vaginal intercourse in the last 6 months (AOR 0.5, 95% CI 0.4-0.6), and STI symptoms in the last year (AOR 0.7, 95% CI 0.5-0.8). The results of the Soweto Men's Study confirm that MSM are at high risk for HIV infection, with gay men at highest risk. HIV prevention and treatment for MSM are urgently needed.

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8. Non-consensual Sex and Association with Incident HIV Infection Among Women: A Cohort Study in Rural Uganda, 1990–2008

Author

Helen A. Weiss, Janet Seeley, Billy N. Mayanja, Dermot Maher, Isolde Birdthistle, and Sian Floyd

Subjects
Adult, Rural Population, medicine.medical_specialty, Adolescent, Social Psychology, Cross-sectional study, Coercion, Population, HIV Infections, Cohort Studies, Young Adult, Non-consensual sex, HIV Seropositivity, medicine, Humans, Women, Uganda, Prospective Studies, Young adult, education, Prospective cohort study, Psychiatry, Developing Countries, Aged, Aged, 80 and over, education.field_of_study, Original Paper, business.industry, Public health, Incidence, Case-control study, Public Health, Environmental and Occupational Health, virus diseases, HIV, Middle Aged, Intimate partner violence, Cross-Sectional Studies, Infectious Diseases, Sexual abuse, Case-Control Studies, Rape, Africa, Spouse Abuse, Female, business, Cohort study, Demography
Abstract

Non-consensual sex is associated with HIV infection in Africa, but there is little longitudinal data on this association. We describe reported non-consensual sex among women over two decades in southwest Uganda, including associations with incident HIV infection. Between 1990 and 2008, individuals in a population cohort who recently seroconverted to HIV were enrolled into a clinical cohort, along with randomly selected HIV-negative controls. Participants were invited to the study clinic every 3 months, and females asked about recent experiences of sex against their will. Associations of non-consensual sex with HIV status were analyzed prospectively using conditional logistic regression, adjusting for age and year of interview, allowing for within-woman correlation. 476 women aged 14–81 enrolled and attended 10,475 visits over 19 years. The results show high levels of repeated non-consensual sex, often long after HIV infection. There was more reporting among women living with HIV compared to HIV-negative women (22 vs 9 %; OR = 2.29, 95 %CI 1.03–5.09), with the strongest associations among married participants. HIV programmes should address repeated sexual coercion before and subsequent to HIV infection.

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9. Framing Male Circumcision to Promote its Adoption in Different Settings

Author

Lee E. Klosinski, Greg Szekeres, Arleen Leibowitz, Ronald A. Brooks, Thomas J. Coates, Franklin D. Gilliam, Sharif Sawires, and Mark Weston

Subjects
Male, medicine.medical_specialty, Social Psychology, media_common.quotation_subject, Culture, HIV prevention, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, The Caribbean, Perception, medicine, Disease Transmission, Infectious, Medicine & Public Health, Humans, 030212 general & internal medicine, media_common, Original Paper, Health Psychology, business.industry, Public health, Communication, Health Policy, Communication tools, Health Plan Implementation, Public Health, Environmental and Occupational Health, Public relations, 3. Good health, Health psychology, Frames, Framing (social sciences), Latin America, Infectious Diseases, Circumcision, Male, Male circumcision, 030220 oncology & carcinogenesis, Medicine public health, Implementation, Africa, Female, Public Health, business, Attitude to Health, Public Health/Gesundheitswesen
Abstract

The effectiveness of male circumcision in preventing transmission of HIV from females to males has been established. Those who are now advocating its widespread use face many challenges in convincing policy-makers and the public of circumcision’s value. We suggest that frames are a useful lens for communicating public health messages that may help promote adoption of circumcision. Frames relate to how individuals and societies perceive and understand the world. Existing frames are often hard to shift, and should be borne in mind by advocates and program implementers as they attempt to promote male circumcision by invoking new frames. Frames differ across and within societies, and advocates must find ways of delivering resonant messages that take into account prior perceptions and use the most appropriate means of communicating the benefits and value of male circumcision to different audiences.

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19. Assessing Engagement of Adolescents and Young Adults (AYA) in HIV Research: A Multi-method Analysis of a Crowdsourcing Open Call and Typology of AYA Engagement in Sub-Saharan Africa

Author

Tahlil, Kadija M., Rachal, Laura, Gbajabiamila, Titi, Nwaozuru, Ucheoma, Obiezu-Umeh, Chisom, Hlatshwako, Takhona, Tembo, Mandikudza, Willis, Nicola, Nyagog, Carine Oum, Vorkoper, Susan, Sturke, Rachel, Rosenberg, Nora E., Ojo, Victor, Moses, Isaac, Ahmed, Nadia, Beima-Sofie, Kristin, Roberts, Sarah T., Kateera, Brenda, Namisoke-Magongo, Eleanor, Mbizvo, Michael T., Iwelunmor, Juliet, Ezechi, Oliver, and Tucker, Joseph D.

Published
2023
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20. Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania

Author

Concepcion, Tessa, Velloza, Jennifer, Kemp, Christopher G., Bhat, Amritha, Bennett, Ian M., Rao, Deepa, Polyak, Christina S., Ake, Julie A., Esber, Allahna, Dear, Nicole, Maswai, Jonah, Owuoth, John, Sing’oei, Valentine, Bahemana, Emmanuel, Iroezindu, Michael, Kibuuka, Hannah, and Collins, Pamela Y.

Published
2023
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