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Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper examines the atmosphere of mistrust that permeated the response to the tenth Ebola epidemic in Eastern DRC (2018–2020). The concept of an 'atmosphere of mistrust' that we develop in this article directs attention to the elusive-yet-pervasive presence of mistrust in interactions between responders and communities during the Ebola epidemic. This analysis focuses on the popular notion that 'Ebola is a business'. Our interviewees frequently used this saying during our research on the Ebola response to explain why mistrust had emerged, how it materialized, and against whom it was directed. Based on these interviews, we examine 'Ebola is a business' as a slogan that enabled people to voice mistrust. This slogan, as we aim to show, resonated with a wider atmosphere of mistrust that governed the emergency situation in Eastern DRC. In using it, people responded to their perceptions of mistrust whilst simultaneously perpetuating and extending this atmosphere of mistrust. Our analysis of the atmosphere of mistrust highlights the power of atmospheres in governing situations, mobilizing people, and disrupting structures of discrimination. It aims to contribute to a better understanding of the barriers inhibiting the collaborations between affected communities and responders, which are required to deliver effective epidemic responses. Moreover, we argue that voice and the atmosphere are important analytics for exploring the histories of mistrust that Ebola epidemics ask for. [ABSTRACT FROM AUTHOR]

Background: The integration of mental health into primary care—i.e., the process by which a range of essential mental health care and services are made available in existing multipurpose health care settings that did not previously provide them—can be facilitated or hindered by several health system factors that are still poorly understood. This study aimed to identify health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo (DRC) to improve the success rate of integration programs. Methods: We conducted a multimethod, cross-sectional exploratory study. Stakeholders (managers, health service providers, service users, etc.) from sixteen of the twenty-six provinces of the DRC participated. We collected qualitative data through 31 individual, semistructured, face-to-face key informant interviews. We then collected quantitative data through a population-based survey of 413 respondents. We analyzed the interviews via thematic analysis, assigning verbatims to predefined themes and subthemes. For the survey responses, we performed descriptive analysis followed by binomial logistic regression to explore the associations between the variables of interest. Results: Strong leadership commitment, positive attitudes toward mental health care, the availability of care protocols, mental health task sharing (p < 0.001), and sufficient numbers of primary care providers (PCPs) (p < 0.001) were identified as key health system facilitators of successful integration. However, barriers to integration are mainly related to a poor understanding of what integration is and what it is not, as well as to the poor functionality and performance of health facilities. In addition, stigma, low prioritization of mental health, lack of mental health referents, low retention rate of trained health professionals, lack of reporting tools, lack of standardized national guidelines for integration (p < 0.001), lack of funding (p < 0.001), shortage of mental health specialists to coach PCPs (p < 0.001), and lack of psychotropic medications (p < 0.001) were identified as health system barriers to integration. Conclusion: Improving the functionality of primary care settings before integrating mental health care would be beneficial for greater success. In addition, addressing identified barriers, such as lack of funding and mental health-related stigma, requires multistakeholder action across all building blocks of the health system. [ABSTRACT FROM AUTHOR]

More than a decade of fighting in the Democratic Republic of the Congo (DRC) has resulted in extensive human rights abuses, of which sexual and gender-based violence (SGBV) is one of the most salient and disturbing features. This paper uses qualitative data, based on 10 focus groups with 86 women and men to better understand gendered community perspectives on SGBV and its consequences in South Kivu. We conclude that for many survivors, rape has consequences far beyond the physiological and psychological trauma associated with the attack. Respondents say sexual violence has become a societal phenomenon, in which the community isolation and shame experienced as a result of the attack become as important as concerns about the attack itself. Male focus group participants explain their own feelings of shame and anger associated with knowing their female relatives were raped. These findings highlight the complexity of community reintegration for survivors and identify a number of programmatic and policy implications, such as the need for counselling for survivors of sexual violence with their families as well as individually; the importance of income-generating training; and the need for improved justice mechanisms to bring perpetrators to justice. [ABSTRACT FROM AUTHOR]

This study explores the relevance of integrating mental health and psychosocial support (MHPSS) into physical rehabilitation services in conflict settings. Symptoms of psychological distress and daily functioning of 132 physical rehabilitation service users in Eastern Democratic Republic of Congo were assessed before and after MHPSS. Logistical regression models were used to identify factors associated with these symptoms. Prior to receiving MHPSS, "extreme" symptoms of depression were reported by 64% of the service users. Amputation predicted high levels of depression (aOR 5.12, p = 0.021), anxiety (aOR 7.09, p = 0.004) and stress (aOR 3.37, p = 0.035), while having witnessed violence predicted high symptoms of stress (aOR 3.65, p = 0.014). Lack of social support was associated with high symptoms of stress prior to MHPSS (aOR 3.17, p = 0.046) as well as a large reduction in symptoms of depression following MHPSS (aOR 3.91, p = 0.019). Most physical rehabilitation service users reported a reduction in symptoms of depression (100.00%), anxiety (98.03%) and stress (100.00%) along with improved functioning (81.13%) after MHPSS. MHPSS needs of physical rehabilitation service users in conflict settings stem from the combined impact of disability and exposure to violence. MHPSS care, particularly the mobilization of peer support, appears necessary and relevant. In conflict settings, mental health and psychosocial support (MHPSS) needs of physical rehabilitation service users must address the combined impact of physical disability and exposure to violence. Physical rehabilitation service users who lacked social support prior to receiving MHPSS were more likely to report a large reduction in symptoms of depression following MHPSS. The study underlines the importance of social support, particularly peer support, in addressing MHPSS needs. [ABSTRACT FROM AUTHOR]

Introduction: Education and disease management have resulted in global decline of new HIV infections, from 2.8 million a year in 2000 to about 1.5 million in 2020 (46% reduction) as well as number of deaths, from 1.4 million in 2000 to 690,000 a year in 2020 (51% reduction). The purpose of this study was to examine factors associated with viral load (VL) suppression (< 1,000 copies/ml), including age, sex, and geographic and clinical characteristics of patients on antiretroviral therapy (ART) in outpatient clinics in Kinshasa and Haut-Katanga Provinces, Democratic Republic of Congo (DRC). Material and methods: Using a retrospective cohort study design, we analyzed data of 5,338 people living with HIV (PLHIV) on ART from 116 HIV/AIDS clinics located in the Haut-Katanga and Kinshasa Provinces in DRC. c2 and multivariable logistic regression analyses were applied. Results: Age and urban health zones were significantly associated with VL suppression. Eighty-six percent of adult patients (15 years or older) had achieved a VL suppression, compared to 73.5% of patients younger than 15 years. Average time on ART was less than three years, and majority of participants were 15 years of age or older, females, and mostly living in urban areas. Conclusions: Our findings indicated that younger patients on ART and patients living in semi-rural areas (vs. urban) had a significantly lower probability of risk of VL suppression, underscoring the need for enhanced efforts targeting these populations. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a period of psychological and somatic growth and development. Pregnancy and childbirth during this period expose women to medical and cognitive risks. The aim of this study was to determine the prevalence, indications, evolution and factors associated with the risk of caesarean section among adolescent and adult women. Methods: This was a cross-sectional, analytical study conducted at Lubao General Referral Hospital. Data covered the period from 2018 to 2022. Epi Info 7.2.4 and Jamovi 2.3.21 software were used for data analysis. The p-value and Odd ratio were used to determine the association between the variables. Results: Caesarean sections accounted for 15.3% of deliveries (375 out of 2444). The prevalence of caesarean sections was 78.0% (64 out of 82 deliveries) among adolescent women and 13.2% (311 out of 2362 deliveries) among adult women. The risk of caesarean section was 23.44 times higher among adolescents (OR 23.44; [IC95% 13.71-40.09]; p-0.0000). Fetal macrosomia and acute fetal distress were the main indications in both groups. Bone dystocia was found only among adolescents. Occupation (OR 39.04 [CI95% 5.34-285.27]; p=0.0000), being single (OR 43.26 [CI95% 9.54-196.10]; p=0.0000), mechanical dystocia (OR 2.08 [CI95% 1.11-3.87]; p=0.0190) and parity = three (p=0.0000) were associated with the indication for caesarean section among the adolescents studied. Maternal and early neonatal outcome were not associated with maternal age. Conclusion: Adolescents present a very high risk of caesarean section. Raising parents' awareness of the risks of early marriage, educating girls in favour of sex education in schools, churches and youth clubs, and combating sexual exploitation and abuse and even sexual violence are all solutions that should be considered. [ABSTRACT FROM AUTHOR]

This cross-sectional study sought to broaden the limited evidence on violence against young adolescent girls in non-conflict zones within the Democratic Republic of the Congo (DRC). Our goal was to estimate the prevalence of and the predictors of physical and/or sexual abuse among girls aged 11–18 years in Kinshasa. A total of 3,100 girls from five randomly selected schools were recruited by our team and given the questionnaires; among them, 3,011 (97.1%) participants completed the questionnaires and were included in the study for further analysis. After collecting all valid responses, the overall prevalence of physical and/or sexual abuse was sorted into the following categories: experienced physical abuse without a weapon (recorded by 70.1% of respondents), experienced physical abuse with a weapon (66.3% of respondents), attempted rape without penetration (76.5% of respondents), experienced attempted rape with penetration (73.9% of respondents), and experienced verbal sexual harassment (93.0%). Our logistic regression analysis indicated that specific kinds of living arrangements (such as only living with the father, mother, or a caregiver; odds ratio ranged 1.8 to 6.9) and places of residence (such as living in lower-class or middle-class districts; odds ratio ranged 1.7 to 6.2) had the strongest associations with higher risk pertaining to whether the respondent had experienced physical and/or sexual abuse in the past. Meanwhile, factors such as the students' level of education (both middle grade and upper grade) and occupation of the father (specifically whether holding a part-time job or retired) were deemed to be more protective. However, physical and/or sexual abuse prevalence was found to be high among middle school girls in Kinshasa. Therefore, we recommend that drastic policies and strategies aimed at socioeconomic issue and living condition ameliorations among families should be implemented to curtail physical and sexual abuse in the nonconflict zones of the DRC. [ABSTRACT FROM AUTHOR]

Evidence of sexual violence against men and boys in many conflict-affected settings is increasingly recognized. Yet relatively little is currently known about the varied forms, sites, and impacts of this violence. Further, scant research on sexual violence against men and boys in displacement contexts has been undertaken to date. To begin to address these knowledge gaps, we undertook a multicountry, qualitative, exploratory study to gain insights into these issues. Study settings and populations were Rohingya refugees in Bangladesh; refugees and migrants who had traveled through Libya residing in Italy; and refugees from eastern Democratic Republic of the Congo (DRC), Somalia, and South Sudan residing in Nairobi and Mombasa, Kenya. Methods included 55 semi-structured focus group discussions with 310 refugees and semi-structured key informant interviews with 148 aid workers and human rights experts. Data were thematically analyzed using NVivo 12. Findings suggest that sexual violence against men and boys may not be rare in Myanmar (northern Rakhine state), Libya, eastern DRC, and South Sudan. Frequently reported forms of violence in these settings were genital violence, forced witnessing of sexual violence, and rape. Sites where violence was often reported included border crossings, along the roadside, and during imprisonment. In host countries, forms of sexual violence included sexual abuse of boys, sexual exploitation particularly of adolescents and persons with diverse sexual orientation and gender identity, and rape. Impacts on survivors involved short- and long-term physical, mental, economic, and familial dimensions. These findings aim to inform sexual violence-related prevention, mitigation, and response efforts in humanitarian settings. More research is warranted, including on sexual violence against men and boys in Somalia, sexual violence by family and community members in conflict and displacement settings, sexual exploitation of adolescent boys, and sexual violence including sexual exploitation of persons with diverse sexual orientation and gender identity. [ABSTRACT FROM AUTHOR]

Numerous quality-improvement projects including healthcare professional training are conducted globally every year, but there is a gap between the knowledge obtained in the training and its implementation in practice and policy. A quality-improvement programme was conducted in eastern Democratic Republic of Congo (DRC) to reduce maternal and neonatal mortality and morbidity. This study explores the implementation process, mechanisms of impact, and outcomes of a training intervention addressing labour and birth management and involving healthcare providers in an urban health zone in eastern part of DRC. In 2019, master trainers were educated and in turn trained facilitators from seven participating healthcare facilities, which received the necessary equipment. Data comprised statistics on maternal and neonatal birth outcomes for the years before and after the training intervention, and focus group discussions (n = 18); and interviews (n = 2) with healthcare professionals, at the end of (n = 52) and after the training intervention (n = 59), respectively. The analysis was guided by a process evaluation framework, using descriptive statistics and content analysis. The three-pillar training intervention using a low-dose, high-frequency approach was successfully implemented in terms of fidelity, dose, adaptation, and reach. Several improved care routines were established, including improved planning, teamwork, and self-reflection skills, as well as improved awareness of the influence of the care environment, of having a respectful encounter, and of allowing a companion to be present with the birthing woman. The proportions of emergency caesareans decreased and of vaginal births increased without an increase in maternal and neonatal complications. The findings of this study are encouraging and provide learnings for other healthcare facilities in DRC as well as other low-income countries. When designing similar training interventions, it is crucial to consider contextual factors such as incentives and to measure more salutogenic outcomes. [ABSTRACT FROM AUTHOR]

Refugee-specific nutrition and cooking curricula addressing dietary acculturation barriers to food security are limited. A cooking curriculum was culturally adapted for Burundian and Congolese refugees to address their unique dietary acculturation experiences. A four-phase curriculum adaptation process (information gathering [literature review, researcher informed, and formative interviews; n = 18], preliminary adaptation design [data incorporation and steering committee; n = 5], pilot testing [ n = 10 youth/adult dyads], and refinement) was applied to the existing evidence-based iCook 4-H curriculum using a five-strategy (peripheral, evidential, linguistic, constituent-involving, and sociocultural) cultural adaptation framework. A multiphase, two-cycle coding analytic process was completed within NVivo 12, followed by direct content analysis. Seventeen adaptations were made to the iCook curriculum, derived from varying combinations of four data sources (literature review, researcher informed, priority population, and steering committee), applying all five cultural adaptation strategies. A majority of the curriculum adaptations were derived from two or more data sources (71%) and were categorized within multiple adaptation strategies (88%). This study provided a community-based cultural adaptation process that could be used with various populations to address unique barriers and facilitators to food security. This innovative model addresses cultural needs while simultaneously aiming to improve health habits of refugee communities. [ABSTRACT FROM AUTHOR]

Few studies have investigated how women's disability status may influence violence against women within conflict settings. A mixed-methods analysis of formative qualitative research and cross-sectional baseline pilot data from a violence prevention program in North Kivu, eastern Democratic Republic of Congo (DRC), was used to examine violence against disabled adult women within the home. Logistic regression models were constructed to examine the relationship between past-month physical/sexual intimate partner violence, disability status, and older age (N = 98 women). Deductive thematic analysis of focus groups and individual interviews (N = 57 men, 59 women) was used to identify community norms and perceptions of violence against women with disabilities in the home. Women who reported mild disability reported higher experiences of past-month physical and/or sexual IPV (85.0%) compared to those who reported severe or no disability (76.5% vs. 70.8%, respectively). Older women with mild disability were more likely to report physical IPV compared to their younger counterparts as well (OR = 1.23, 95%CI: 1.01, 1.49, p < 0.039). Qualitative findings suggested family members may be deterred from perpetrating abuse against older women. These findings highlight a complex relationship between women's disability status and violence perpetration, underscoring the importance of having inclusive, contextual violence against women prevention and response programming in conflict settings. [ABSTRACT FROM AUTHOR]

Purpose: Statelessness is the worst possible form of violation of fundamental human rights which can lead to improper health systems management and serious adverse health outcomes in children. To address this, the Thai Cabinet introduced the Health Insurance for People with Citizenship Problem (HIPCP) in 2010. The purpose of this study is to examine the association between insurance affiliations and the health status of stateless children insured with the HIPCP. The presence of pneumonia was selected as a proxy for health status. The comparison groups were Thai children insured with the Universal Coverage Scheme (UCS) which was launched in 2002 and the uninsured children of low-skilled migrants in Thailand. Design/methodology/approach: A retrospective study was conducted at four selected district hospitals: Mae Ramat Hospital, Phop Phra Hospital, Tha Song Yang Hospital and Umphang Hospital in Tak Province, located in northwestern Thailand. The study used the medical records of children aged 0-15 years who were admitted to the aforementioned hospitals between January 1, 2013 and December 31, 2017. Multivariate logistic regression model was applied with a binary response variable (ever diagnosed with pneumonia: yes/no). Exposure was three types of insurance status (uninsured, HIPCP and UCS) while covariates were age, sex, domicile and year of hospitalization of children. Findings: Of 7,098 hospitalized children between 2013 and 2017, 1,313 were identified with pneumonia. After controlling for key covariates, multivariate results depicted that the odds of pneumonia was 4 per cent higher in stateless children insured with the HIPCP as compared with uninsured children but non-significant (adjusted odds ratio [AOR] = 1.040, 95 per cent confidence interval [CI] = [0.526, 2.160], p = 0.916). Similarly, the odds of pneumonia was 10 per cent higher in Thai children insured with the UCS as compared with uninsured children but non-significant (AOR = 1.100, 95 per cent CI = [0.594, 2.180], p = 0.767). The children who were hospitalized in 2017 were 26 per cent more likely to have pneumonia as compared with those who were hospitalized in 2013 with statistical significance (AOR = 1.260, 95 per cent CI = [1.000, 1.580], p = 0.050). Results remained robust after performing sensitivity analyses. Social implications: This study suggests that health insurance is not associated with the health status of vulnerable children especially in the presence of multiple health interventions for uninsured and/or undocumented children living along the Thai–Myanmar border area. Further experimental studies are warranted to understand the causal relationship between insurance and health outcomes and to overcome the limitations of this observational study. Originality/value: This study has discovered that age and domicile of children are independently associated with pneumonia. In comparison with the youngest age group (0-1 year), the older age groups presented a significantly lower odds for pneumonia. The children living in Phop Phra, Tha Song Yang and Umphang districts revealed a reduced risk for pneumonia as compared with children living in Mae Ramat district. [ABSTRACT FROM AUTHOR]

Five years after a hunger strike of undocumented migrant workers, participants were interviewed to find out about the long term consequences and what the post-factum evaluation of their participation was. A longitudinal observational study was set up, interviewing 46 of the 100 ex-hunger strikers and combining quantitative and qualitative research. This grassroots study shows that one out of six did not derive any benefit from their participation. Half regretted their participation, especially the ones who lost again their legal permit, mentioning health consequences and the fact that their situation hadn't improved. Given the growing number of asylum seekers around the world who are being refused legal permits, hunger strikes will remain a pressing topic. Health professionals, confronted with this possible health and life threatening action, should be informed about the long term impact of voluntary fasting on body and mind of ex-participants. [ABSTRACT FROM AUTHOR]

With the exception of the last three fiscal years, there has been a consistent influx of refugees being resettled to the U.S. during the last 20 years from Somalia, the Democratic Republic of Congo, and Bhutan. Although there is existing literature examining the obstacles that recently resettled refugee families face, the ways in which these obstacles influence parenting has not been widely studied. For organizations to best serve these populations, a solid understanding of newly resettled refugee parents' experiences and opportunities for support is crucial. The purpose of this current study was to determine the needs of newly resettled refugee parents, specifically from Somalia, the Democratic Republic of Congo, and Bhutan, and the obstacles that influence their parenting in a Mid-Atlantic region of the U.S. [ABSTRACT FROM AUTHOR]

We examined associations between individual and community socioeconomic status (SES) and childbirth in a health facility in West and Central Africa using data from the 2009–2011 United Nations Children's Fund (UNICEF) Multiple Indicator Cluster Survey for women in seven countries (n = 34,487). Individual SES measures were education and wealth; community SES was low or high poverty index. In adjusted results, women residing in communities with high poverty had significantly lower odds of facility delivery than those who lived in more affluent communities in five countries (all p < 0.001). Reducing out-of-pocket healthcare costs may improve women's access to delivery in health facilities. [ABSTRACT FROM AUTHOR]

Sexual violence survivors who decide to report their assault interact with health care, law enforcement, and legal and judicial professionals. Professionals’ attitudes about sexual violence and survivors play an important role in caring for survivors and in the pursuit of justice. Despite evidence showing the relationship between service provider beliefs and survivor outcomes, relatively little is known about professionals’ beliefs about sexual violence or their attitudes toward sexual violence survivors. Between June 2012 and December 2014, our study examined the beliefs and attitudes of 181 professionals from the health care, legal, and law enforcement sectors in the Eastern Democratic Republic of the Congo (DRC) and the Rift Valley region of Kenya, areas with a high prevalence of sexual violence. To determine correlates of beliefs and attitudes about sexual violence and sexual violence survivors, multiple logistic regression models were adjusted for demographic and occupational characteristics. Respondents who agreed that survivors got what they deserved (7%) or that survivors should feel ashamed (9%) were the minority, while those who would be willing to care for a family member with a history of sexual violence (94%) were the majority. Profession was significantly associated with beliefs and attitudes about sexual violence and survivors. Law enforcement professionals were more likely than health professionals and lawyers to indicate that survivors should feel ashamed. Our findings suggest a need for interventions that adequately address potentially harmful beliefs and attitudes of some professionals serving sexual violence survivors. [ABSTRACT FROM AUTHOR]

Aims: The Democratic Republic of Congo (DRC) is a country with a high endemicity of hepatitis B virus (HBV) even if no national survey of prevalence has been performed. Data are based on extrapolations or limited studies. This review aimed to summarize all information about HBV infection in DRC during the period 2000-2016 to provide refined estimates and contribute to a better knowledge of its epidemiology.Subject and methods: We conducted a systematic search in electronic databases of all prevalence studies published between January 1st, 2000 and September 30th, 2016. Additional data from manual search or gray literature were also considered. We included only moderate or high quality studies using the JBI’ tools for qualitative evaluation of researches. HBsAg prevalence was estimated at 95% confidence interval (CI) as result of simple pooling analysis.Results: Twenty-eight studies were included with data providing from 154,926 subjects: in the majority of these studies (18 out of 28), results were obtained from blood donors. The estimated HBsAg prevalence was 4.9% (95% CI 4.2-5.0). The prevalence was estimated at 5.0% (95% CI 4.9-5.1) in blood donors and at 5.0% (95% CI 3.0-5.9) in pregnant women.Conclusion: This review suggests that DRC is a country characterized by an intermediate level of HBV infection endemicity rate. It remains however an important public health problem and efforts should continue in prevention and in policy to control this viral disease. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives The Democratic Republic of Congo (DR Congo) is one of the ten countries, which accounts for 60% of unvaccinated children worldwide. The aim of this study was to assess predictors of incomplete and untimely immunization among a cohort of infants recruited at birth and followed up through 24 weeks in Kinshasa. Methods Complete immunization for each vaccine was defined as receiving all the recommended doses. Untimely immunization was defined as receiving the given dose before (early) or after (delayed) the recommended time window. Infants not immunized by the end of the follow-up time were considered missing. Multivariate hierarchical model and generalized logistic model were used to assess the independent contribution of each socio-economic and demographic factors considered to complete immunization and timeliness, respectively. Results Overall, of 975 infants from six selected clinics included in the analysis 84.7% were fully immunized the three doses of DTP or four doses of Polio by 24 weeks of age. Independently of the vaccine considered, the strongest predictor of incomplete and untimely immunization was the clinic in which the infant was enrolled. This association was strengthened after adjustment for socio-economic and demographic characteristics. Education and the socio-economic status also were predictive of completion and timeliness of immunization in our cohort. Discussion In conclusion, the strongest predictor for incomplete and untimely immunization among infants in Kinshasa was the clinics in which they were enrolled. The association was likely due to the user fee for well-baby clinic visits and its varying structure by clinic. [ABSTRACT FROM AUTHOR]

Background: To determine the prevalence of microalbuminuria and associated factors among Congolese human immunodeficiency virus (HIV)-infected children. Methods: This was a cross-sectional study in which 77 HIV-infected antiretroviral therapy-naive children and 89 uninfected controls were enrolled. Microalbuminuria was assessed using the immune-turbidimetry method, and associated factors were studied by logistic regression. Results/Conclusion: The prevalence of microalbuminuria was 18% in the HIV-infected children and 2% in the HIV-uninfected children. No common determinants of proteinuria were significantly associated with microalbuminuria. [ABSTRACT FROM AUTHOR]

This study examined regret following HIV serostatus disclosure and associated factors in under-investigated contexts (Mali, Morocco, Democratic Republic of the Congo, Ecuador and Romania). A community-based cross-sectional study was implemented by a mixed consortium [researchers/community-based organizations (CBO)]. Trained CBO members interviewed 1,500 PLHIV in contact with CBOs using a 125-item questionnaire. A weighted multivariate logistic regression was performed. Among the 1,212 participants included in the analysis, 290 (23.9 %) declared that disclosure was a mistake. Female gender, percentage of PLHIV's network knowing about one's seropositivity from a third party, having suffered rejection after disclosure, having suffered HIV-based discrimination at work, perceived seriousness of infection score, daily loneliness, property index and self-esteem score were independently associated with regret. Discrimination, as well as individual characteristics and skills may affect the disclosure experience. Interventions aiming at improving PLHIV skills and reducing their social isolation may facilitate the disclosure process and avoid negative consequences. [ABSTRACT FROM AUTHOR]

In this study, the authors aimed to understand providers' role in delivering HIV transmission prevention counseling to youth living with HIV (YLWH). Fourteen in-depth interviews were conducted with providers in Kinshasa, DRC. Providers' lack of knowledge and comfort in talking to youth about sex because of cultural and religious beliefs about sexuality, coupled with confusion about legal issues related to youth and contraception, made it difficult for them to effectively counsel youth. For providers to deliver effective prevention counseling to YLWH, clinics should follow adolescent-friendly clinic standards, provide counseling in an adolescent-friendly style, and institute an effective referral system for additional prevention services. HIV prevention services can be improved through the creation of an adolescent-friendly environment and by providing “values clarification” and skill-based trainings so that providers are able to assess the role of their own beliefs and learn new skills. [ABSTRACT FROM PUBLISHER]