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Introduction: Although significant progress has been made in the fight against HIV/AIDS, structural factors continue to undermine this progress, especially among racialized populations in many countries. For instance, African, Caribbean and Black (ACB) men in Canada face barriers - such as unemployment, stigma, and racism - that increase their vulnerability to health-related events including HIV/AIDS. However, there is a paucity of culturally appropriate responses to address these factors within the ACB population in Canada. Hence, this paper sought to identify the structural barriers that increase the vulnerability of ACB heterosexual men to HIV, and the strategies for building resilience in response to HIV. Material and methods: This paper is based on the qualitative findings from the weSpeak project, which was a mixed-methods study informed by community-based participatory research (CBPR). Qualitative data were collected from 63 participants in Ottawa, Canada through focus group discussions (FGD) and in-depth interviews (IDI). The participants included ACB heterosexual men, service providers, and policy/decision-makers. All interviews were recorded, transcribed verbatim and analysed using NVivo Version 11. Results: The themes were: 1) systemic barriers to employment and income, 2) healthcare access and uptake, 3) stigma, discrimination and racism, 4) strategies for responding to HIV vulnerabilities. The participants highlighted the difficulties that new immigrants faced with recognition of their academic credentials, which then limits their income and job opportunities. Healthcare services were underutilized because of privacy issues, insufficient physicians and long waiting periods. Also, HIV-related stigma, anti-Black racism and stereotypes were factors that limited health and economic options for the participants. However, the participants acknowledged that health education, collaboration and engagement with faith-based leaders can reduce HIV vulnerabilities. Conclusions: The study highlights the role of structural factors in increasing HIV vulnerability among ACB heterosexual men, and the need for multilevel interventions to foster better a HIV response within the ACB community. [ABSTRACT FROM AUTHOR]

This paper discusses the sexual experiences of people involved in polyamorous relationships to determine the relation between polyamory and HIV/AIDS. The study was guided by social cognitive theory, constructivism, the meaning-making model and interpretative phenomenological analysis. Four emerging themes are discussed: sex practices in polyamorous relationships; the construction of sexual rules and agreements; the value of trust and honesty; and psychosocial support and services for polyamorists. The study concludes that polyamory does not pose risk to HIV. The paper suggests a reconceptualization of the partner reduction policy which was influenced by Morris and Kretzchmar's (1997) mathematical model Further, the findings are crucial to social work practice in the area of HIV/AIDS and social work education, particularly in regards to anti-discrimination. Therefore, social work is called upon to be aware and sensitive to polyamorous relationships. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is very dangerous. HIV targets the resistant system and weakens people's denial against many contaminations and some kinds of cancer. As the virus breaks up and impairs the function of immunity, infected people gradually become immunodeficient. Both deep learning and machine learning models play a great role in the prediction of diseases. The function of immunity is CD4 cell count. In this study both the machine learning and deep learning algorithms were applied. Material and methods: In this paper the data were collected from data world. Support vector machine, random forest, naïve Bayes, gated recurrent unit, and long short-term memory were used to fit the incidence data. The performance of the model was evaluated by accuracy, precision, sensitivity, and F-score with respective errors. Results: Based on the evaluation, deep learning models achieve better results in the metrics of accuracy, precision, and F-score than machine learning models. But in sensitivity metrics machine learning models achieve better result than deep learning. Machine learning algorithms SVM, RF, and NB provide accuracy of 89.00%, 87.00%, and 86.94%; precision of 75.89%, 74.97%, and 75.78%; sensitivity of 87.96%, 84.00%, and 84.12%; F-score of 82.87%, 80.03%, and 79.05%, respectively. LSTM, GRU provides accuracy of 97.65%, 96.00%, precision of 77.35%, 84.00%, sensitivity of 87.93%, 82.98%, and F-score of 82.03%, 83.20%, respectively. Conclusions: The possibility survival of the illness is less than no illness. The existence of TB negative is higher than TB positive. In the machine learning model SVM provides better sensitivity with 87.96%, long short-term memory provides accuracy of 97.65%, precision of 77.35%, sensitivity of 87.93%, and F-score of 82.03%. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV), HIV, and substance use are serious intersecting public health issues. This paper aims to describe the Social Intervention Group (SIG)'s syndemic-focused interventions for women that address the co-occurrence of IPV, HIV, and substance use, referred to as the SAVA syndemic. We reviewed SIG intervention studies from 2000 to 2020 that evaluated the effectiveness of syndemic-focused interventions which addressed two or more outcomes related to reducing IPV, HIV, and substance use among different populations of women who use drugs. This review identified five interventions that co-targeted SAVA outcomes. Of the five interventions, four showed a significant reduction in risks for two or more outcomes related to IPV, substance use, and HIV. The significant effects of SIG's interventions on IPV, substance use, and HIV outcomes among different populations of women demonstrate the potential of using syndemic theory and methods in guiding effective SAVA-focused interventions. [ABSTRACT FROM AUTHOR]

Introduction: Since the introduction of anti-retroviral therapy (ART) for managing human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Nigeria, adherence to treatment has been a critical issue due to its importance in improving the quality of life of people living with HIV/AIDS (PLWHA). The aim of this paper is to determine level of adherence to ART, examine reasons for non-adherence and the association between socio-demographic characteristics, and adherence to ART among PLWHA who were attending the State Hospital, Osogbo, Nigeria. These are with the view to establishing factors influencing adherence to ART among PLWHA in Nigeria. Material and methods: The health belief model and political economy perspectives framed the paper. Purposive/systematic sampling techniques were used to select 200 PLWHA (men and women) attending clinic in the State Hospital, Osogbo, South Western Nigeria. Results: Findings indicated adherence level of 69%. Furthermore, the reasons for non-adherence were forgetfulness (21.5%), work/travel (16.0%), fasting and spiritual interruption (8.5%), inadequate meal (7.0%), stigma (7.0%), and side effect of the drug (7.0%). It was revealed that the size of the ART was too big for some of the respondents, which militated against adherence. Moreover, the socio-demographic characteristics that influenced adherence were sex, age, marital status, marriage type, education, number of children, and occupation. However, most of these influences were not statistically significant. Finally, respondents' suggestions on how to improve adherence were PLWHA should be encouraged to take their drugs (33.5%), improve the size because it is too big (10.0%), educate PLWHA (24.0%), make ART more private (9.0%), and legislation on stigma (9.5%). Conclusions: The paper concluded that health behavior of PLWHA, socio-economic, and demographic factors influenced PLWHA's adherence to ART in the study area. [ABSTRACT FROM AUTHOR]

This paper explores how poor health outcomes in the HIV/AIDS and opioid epidemics in the United States are undergirded by iatrogenesis. Data are drawn from two projects in Southern California: one among men who have sex with men (MSM) engaging with pre-exposure prophylaxis to HIV (PrEP) and the other in a public hospital system encountering patients with chronic pain and opioid use disorder (OUD). Ethnographic evidence demonstrates how efforts to minimize risk via PrEP and opioid prescription regulation paradoxically generate new forms of risk. Biomedical risk management paradigms engaged across the paper's two ethnographic field sites hinge on the production and governance of deserving patienthood, which is defined by providers and experienced by patients through moral judgments about risk underlying both increased surveillance and abandonment. This paper argues that the logic of deservingness disconnects clinical evaluations of risk from patients' lived, intersectional experiences of race, class, gender, and sexuality. This paper's analysis thus re-locates patients in the context of broader historical and sociopolitical trajectories to highlight how notions of clinical risk designed to protect patients can in fact imperil them. Misalignment between official, clinical constructions of risk and the embodied experience of risk borne by patients produces iatrogenesis. [ABSTRACT FROM AUTHOR]

Africa is responsible for two‐thirds of the global total of new HIV infections. South Africa, Nigeria, Mozambique, Uganda, Tanzania, Zambia, Zimbabwe, Kenya, Malawi, and Ethiopia were responsible for 80% of HIV cases in Africa in 2014 according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). This study assesses antiretroviral coverage strategies implemented by these countries after the initiation of the "Fast‐Track strategy to end the AIDS epidemic by 2030." Data reported in this review were obtained from different e‐bibliographic including PubMed, Google Scholar, and Research Gate. Key terms were "Antiretroviral therapy," "Antiretroviral treatment," "HIV treatment," "HIV medication," "HIV/AIDS therapy," "HIV/AIDS treatment" + each of the countries listed earlier. We also extracted data on antiretroviral therapy (ART) coverage from the UNAIDS database. About 50 papers published from 2015 to 2021 met the inclusion criteria. All 10 countries have experienced an increase in ART coverage from 2015 to 2020 with an average of 47.6% increment. Nigeria recorded the highest increase in the rate of ART coverage (72% increase) while Ethiopia had the least (30%). New strategies adopted to increase ART coverage and retention in most countries were community‐based models and the use of mobile health technology rather than clinic‐based. These strategies focus on promoting task shifting, door‐to‐door access to HIV services, and a long‐term supply of antiretroviral medications. Most of these strategies are still in the piloting stage. However, some new strategies and frameworks have been adopted nationwide in countries like Mozambique, Tanzania, Zambia, Zimbabwe, Kenya, and Malawi. Identified challenges include lack of funding, inadequate testing and surveillance services, poor digital penetration, and cultural/religious beliefs. The adoption of community‐based and digital health strategies could have contributed to increased ART coverage and retention. African countries should facilitate nationwide scaling of ART coverage strategies to attain the 95–95–95 goal by 2030. [ABSTRACT FROM AUTHOR]

Taking into account the effects of the heterogeneity of the population and media coverage on disease transmission, in this paper, a hybrid HIV/AIDS model with age-structure, self-protection awareness and media coverage is formulated, which is made up of five partial differential equations (PDEs) and one ordinary differential equation (ODE). We establish the existence of the solution associated with the hybrid system and prove that the solution is unique, bounded and positive utilizing the semigroup approach. Based on the basic reproduction number R 0 , the threshold dynamics of this model are rigorously investigated, that is, there always is a unique disease-free steady state E 0 and it is globally stable when R 0 < 1 , that is, the disease dies out. Further, there exists a unique endemic steady state E * and it is locally stable when R 0 > 1 and some additional technical conditions are met. In addition, the uniform persistence of this hybrid system is demonstrated for R 0 > 1 , which means that the disease remains at the endemic level for a long time, which is not discussed in other age-structured infectious disease articles. Numerical simulations are also given to explain the main theoretical results, which suggest that age variability is a non-negligible factor in HIV/AIDS transmission, that is, the moment and scale of HIV/AIDS outbreaks are diverse for people of different ages, and media coverage can encourage people to take steps to avoid potential infection and control the spread of the disease. [ABSTRACT FROM AUTHOR]

Arunachal Pradesh has been placed amongst the highest ranking states in terms of drug and substance use in the National Survey of 2019. Risky sexual behaviours are considered to be associated with an increasing use of drugs. The main objective of the study is to examine the intersection between injecting drug use and sexual behaviour and to assess the level of knowledge of HIV/AIDS among the injecting drug-using youths of Arunachal Pradesh. The data for the present study was collected on a structured questionnaire from a sample of 1000 youth from four study areas purposively selected. A significant number of them (14%) have reported or perceived to be injecting drug users. The cross-tabulation and Pearson Chi-square test is performed to test significant association between the variables. The results show that there is a high prevalence of risky sexual and injecting behaviours and poor level of knowledge on HIV/AIDS. A statistically significant association is established between the variables of drug use and risky sexual behaviours. However, delineating the direct causal relationship between drug use and sexual behaviour is considered to be a complex one, because a wide variety of socio-cultural and psychological factors influenced it. The paper concludes with the suggestion that future social research needs to focus on examining the social interaction and social relations of drug use and sexual activity. [ABSTRACT FROM AUTHOR]

Introduction: A person‐centred model of care, developed in the early days of the HIV epidemic when there were no effective treatments for HIV, led to relatively close relationships between carers and people living with HIV (PLWH). Our study examines the experiences of carers using a relational framework, exploring the traumas and challenges involved, coping practices instigated by carers and the emergence of 'relational traumatic growth' opportunities. Methods: Twenty‐two UK healthcare workers and charity volunteers working with PLWH from the early years of the epidemic were recruited. Semistructured interviews were used to elicit participants' own stories of working with PLWH, from their initial involvement to the present time, and their reflections on the personal impact of working in the field of HIV. Data were analysed using a thematic approach employing relational categories. Results: The impact of care was related to the formation of close relationships, identification with PLWH, high numbers of deaths and the difficulties and challenges encountered relationally. Participants described attempts to cope through informal and formal support, as well as endeavours to manage professional boundaries. Various ways of making sense of experiences were described, ranging from denial to abandoning the HIV field, to intense commitment. For some, traumatic experiences lead to validation, a search for personal meaning and managing the sense of loss with an exploration of further ventures, contributing to the achievement of relational traumatic growth. Conclusion: The intensity of relationships in HIV work, developed through the emotional and practical work of caring for PLWH, led healthcare workers and volunteers to experience a range of psychological consequences, both negative (including distress and emotional exhaustion) and also positive (such as acquiring a sense of purpose). Patient or Public Contribution: People living with HIV and those working with them were involved in the initial study conceptualization and design. The second and fourth authors of this paper were professionals working in HIV throughout the pandemic and have led on all aspects of the study. People living with HIV and those working with them additionally guided participant selection by suggesting participants and supporting recruitment. Narrative transcripts were checked and amended (if necessary) by participants. Initial findings were presented at the AIDS impact conference, where PLWH and those working with them attended and feedback on important ideas that helped to prioritize and shape the study findings. [ABSTRACT FROM AUTHOR]

Research recruitment, eligibility, and who chooses to participate shape the resulting data and knowledge, which together inform interventions, treatment, and programming. Patterns of research participation are particularly salient at this moment given emerging biomedical prevention paradigms. This paper explores the perspectives of Black and Latino young men who have sex with men (BL-YMSM) regarding research recruitment and eligibility criteria, how their experiences influence willingness to enroll in a given study, and implications for the veracity and representativeness of resulting data. We examine inclusion and recruitment as a complex assemblage, which should not be reduced to its parts. From April to July 2018, we conducted in-depth interviews with 30 BL-YMSM, ages 18–29, in New York City. Interviews were recorded, transcribed, and analyzed using the constant comparative method. Black and Latino YMSM's responses unveiled tensions between researchers', recruiters', and participants' expectations, particularly regarding eligibility criteria (e.g. age, sex frequency), assumptions about 'risky behaviors,' and the 'target' community. Men preferred peer-to-peer recruitment, noting that most approaches miss key population segments. Findings highlight the need to critically examine the selected 'target' community, who sees themselves as participants, and implications for data comprehensiveness and veracity. Study eligibility criteria and recruitment approaches are methodological issues that shape knowledge production and the policies and programs deployed into communities. These findings can inform how future research studies frame recruitment and eligibility in order to better meet the needs of participants and ensure future research engagement. [ABSTRACT FROM AUTHOR]

In this paper, to investigate the synthetic effect of PrEP (pre‐exposure prophylaxis) and ART (antiretrovial therapy) on HIV transmission among MSM (men who have sex with men) in heterogenous environment, a realistic HIV epidemic model with spatial diffusion is established. Here, HIV infectious people are divided into three immunity based compartments, that is, CD4+ T cell count less than 350, between 350 and 500, and more than 500, respectively. The basic reproduction number R0 is established and proved as a threshold parameter: The global asymptotic stability of the disease‐free steady state holds for R0<1, and the disease will be present if R0>1. Considering the substantial advantages of PrEP and ART in controlling HIV transmissions among MSM, the optimal control problem is presented for the case of positive constant diffusion coefficients, which minimize the total population of susceptible individual and HIV infected individual, the cost of PrEP and ART therapy. As an illustration of our theoretical results, we conduct numerical simulations. We also conduct an optimal control case study where model parameters are estimated from the demographic and epidemiological data from China. This work suggests the following: (1) Spatial factors cannot be ignored during the HIV intervention; (2)taking the PrEP intervention measure for HIV transmissions among MSM as early as possible will help to improve the control efficiency and reduces its cost; (3) reducing the PrEP drug costs will promote the efficiency of PrEP treatment in preventing the spread of HIV among MSM. [ABSTRACT FROM AUTHOR]

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross‐sectional study on the validation of two stigma scales with a 1‐month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5‐month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish‐speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies. [ABSTRACT FROM AUTHOR]

Purpose – HIV prevention campaigns have focused on condom distribution and the dissemination of HIV-related knowledge, with the goal to reduce risky sexual behavior. However, very little empirical work has been done to reveal any possible association between HIV-related knowledge and risky sexual behavior. Hence, the purpose of this paper is to estimate such associations, using demographic health survey data for India. Design/methodology/approach – The authors estimate multiple binary response models and calculate average partial effects of every treatment (HIV-related knowledge) on the outcome variable (risky sexual behavior) controlling for socioeconomic characteristics, location of residence, and state specific effects. Findings – Using data from the third wave of the national demographic survey, it is found that better HIV-related knowledge does not always promote safer sexual practices. While, better HIV knowledge increases the likelihood of condom use, it also increases the likelihood of pre-marital sex, and reduces the likelihood of abstinence. These effects are much stronger for males when compared to females. These results also suggest, albeit indirectly, that informational and condom distribution campaigns are not necessarily promoting safer sexual practices in India. Research limitations/implications – One possible limitation of this study is the possibility of endogeneity bias due to omitted variables or reverse causality. The authors follow the literature in the use of controls and interpreted results with caution. Originality/value – The paper is believed to be the first to derive empirical results relating HIV knowledge and risky sexual behaviour, using a population-based survey for India. [ABSTRACT FROM AUTHOR]

The papers in this issue detail state-of-the science knowledge regarding the role of alcohol use in HIV/AIDS risk, as well as offer suggestions for ways forward for behavioral HIV prevention for at-risk alcohol-using populations. In light of recent evidence suggesting that the anticipated uptake of the newer biomedical HIV prevention approaches, prominently including pre-exposure prophylaxis, has been stalled owing to a host of barriers, it has become ever more clear that behavioral prevention avenues must continue to receive due consideration as a viable HIV/AIDS prevention approach. The papers collected here make a valuable contribution to 'combination prevention' efforts to curb HIV spread. [ABSTRACT FROM AUTHOR]

This paper explores the lived experiences of former NBA player Magic Johnson, and the late 'Godfather of Gangsta Rap' Eazy E to examine how their everyday realities as Black men with different socio-economic opportunities around the Civil Rights era affected their fight against HIV. Johnson contracted HIV nearly 30 years ago, and continues to live a healthy, productive life. Eazy E on the other hand, contracted the virus around the same time and later succumbed to AIDS. The differences in the lived experiences of the two men warrant scholarly attention, particularly now amidst the Covid-19 pandemic. Their differences in social position, stemming from the uneven inequities of the culture and racialization of poverty, much like the wider global epidemic of HIV/AIDS itself, are crucial in the spread and survival rate of those that contract HIV. Overall, then, this paper aims to address the following research question: how do social issues of space and racialized poverty affect the lived experiences of African Americans with HIV? This paper will examine the production of social space and spatial structural violence, as well as racialized poverty, and their effects on likelihood of infection and survival of HIV and infectious disease more broadly. [ABSTRACT FROM AUTHOR]

Some researchers continue to engage in "helicopter" or "parachute" research and do not ethically engage or collaborate with communities from which data are collected. This paper uses a case study to discuss the ethical issues arising from these research practices and the importance of increasing meaningful community involvement in research. Set in the context of research among older people living with HIV, the case study is followed by the perspectives of four research stakeholders. Through these perspectives, this paper demonstrates the ethical perils and harms that stem from research practices exemplified in the case. We argue instead for researchers to practice participatory research methods in line with community-based participatory research approaches (CBPR), good participatory practices (GPP), the Denver Principles, and CIOMS guidelines. Towards this end, we describe tools developed in collaboration with stakeholders in the research process to help researchers incorporate community participation and reduce unethical research conduct. [ABSTRACT FROM AUTHOR]

The health needs and relationships of Black women partnered with behaviorally bisexual Black men are under addressed in the public health literature. This paper explores the relationship dynamics of Black women’s sexual relationships with behaviorally bisexual Black men. We conducted thirty qualitative interviews with a group of HIV negative and HIV positive women partnered with behaviorally bisexual Black men in the San Francisco Bay Area. Women took part in a one-time qualitative interview that addressed relationships, bisexual partners, sexuality, HIV risk behaviors, and disclosure. Women described experiences of their own and their partner’s experiences of disclosure and sexual stigma, along with structural racism and masculine cultural norms that contribute to men’s non-disclosure of sex with men. The paper identifies the ways in which disclosure and stigma are experienced by a sample of women in relationships with behaviorally bisexual Black male partners, pointing to the ways in which these women demonstrate sexual agency in these relationships. These sexual narratives emphasize the ways in which Black women are at once agentic and also navigate gendered vulnerability in their relationships with bisexual men. These findings of Black women’s sexual agency present a call to develop health interventions resonant with Black women’s relationship experiences and structures of bisexual relationships. [ABSTRACT FROM AUTHOR]

Background: HIV stigma remains a formidable barrier to HIV treatment adherence among school-attending adolescents living with HIV, owing to high levels of HIV stigma within schools, rigid school structures and routines, lack of adherence support, and food insecurity. Thus, this protocol paper presents an evidence-informed multilevel intervention that will simultaneously address family- and school-related barriers to HIV treatment adherence and care engagement among adolescents living with HIV attending boarding schools in Uganda. Objective: The proposed intervention--Multilevel Suubi (MSuubi)--has the following objectives: examine the impact of M-Suubi on HIV viral suppression (primary outcome) and adherence to HIV treatment, including keeping appointments, pharmacy refills, pill counts, and retention in care; examine the effect of M-Suubi on HIV stigma (internalized, anticipated, and enacted), with secondary analyses to explore hypothesized mechanisms of change (eg, depression) and intervention mediation; assess the cost and cost-effectiveness of each intervention condition; and qualitatively examine participants' experiences with HIV stigma, HIV treatment adherence, and intervention and educators' attitudes toward adolescents living with HIV and experiences with group-based HIV stigma reduction for educators, and program or policy implementation after training. Methods: MSuubi is a 5-year multilevel mixed methods randomized controlled trial targeting adolescents living with HIV aged 10 to 17 years enrolled in a primary or secondary school with a boarding section. This longitudinal study will use a 3-arm cluster randomized design across 42 HIV clinics in southwestern Uganda. Participants will be randomized at the clinic level to 1 of the 3 study conditions (n=14 schools; n=280 students per study arm). These include the bolstered usual care (consisting of the literature on antiretroviral therapy adherence promotion and stigma reduction), multiple family groups for HIV stigma reduction plus family economic empowerment (MFG-HIVSR plus FEE), and Group-based HIV stigma reduction for educators (GED-HIVSR). Adolescents randomized to the GED-HIVSR treatment arm will also receive the MFG-HIVSR plus FEE treatment. MSuubi will be provided for 20 months, with assessments at baseline and 12, 24, and 36 months. Results: This study was funded in September 2021. Participant screening and recruitment began in April 2022, with 158 dyads enrolled as of May 2022. Dissemination of the main study findings is anticipated in 2025. Conclusions: MSuubi will assess the effects of a combined intervention (family-based economic empowerment, financial literacy education, and school-based HIV stigma) on HIV stigma among adolescents living with HIV in Uganda. The results will expand our understanding of effective intervention strategies for reducing stigma among HIV-infected and noninfected populations in Uganda and improving HIV treatment outcomes among adolescents living with HIV in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection. [ABSTRACT FROM AUTHOR]

Copyright of Social & Cultural Geography 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.)

Background: The role of global initiatives in catalyzing change within national contexts is complex and less understood. Addressing adolescent sexual and reproductive health in Kenya requires concerted efforts of both state and non-state actors and more importantly, a supportive environment. This paper deconstructs the moral and social narratives of adolescents' and young people's sexual and reproductive health (AYSRH) in Kenya as driven by the powerful discourse and ideologies pre- and within the Millennium Development Goal (MDG) era. Methods: Literature was systematically searched in PubMed and Medline with policy documents obtained from government agencies from the pre-MDG period (2000 and earlier) and within the MDG period (2001–2015). Literature with a substantial focus on SRH were eligible if they captured the different facets of ASRH in Kenya and sub-Saharan Africa (SSA). The results were reviewed and synthesized to disentangle the moral and social narratives of AYSRH in Kenya with an MDG lens. Results: The evolution of AYSRH policies and programmes in Kenya was gradual and largely shaped by prevailing development threats and moral and social narratives. Pre-MDG period was dominated by issue-based policies of population growth and high fertility rates, with a focus on married population with strong cultural and religious barriers to AYSRH; early to mid-MDG was mainly influenced by the threat of HIV/AIDS, culminating in the first Adolescent Reproductive Health and Development Policy in 2003. However, the policies and subsequent programmes focused on abstinence only and medical narratives, with persistent religious and cultural opposition to AYSRH. Late-MDG saw more progressive policies (these are policies that refer to those that tends towards acceptance of liberal social reforms and which sometimes are contrary to entrenched social norms, beliefs and practices), high government commitment and a refocus on SRH issues due to sustained early childbearing, culminating in the revised Adolescent Sexual and Reproductive Health Policy of 2015. Conclusion: Debates in the translation of global goals and commitments to policy and practice at country level need to account for national level realities in AYSRH reforms. The findings contribute to critical evidence for strategic policy and programming approaches for AYSRH in Kenya and in SSA and for the realization of their rights within the context of sustainable development goals. [ABSTRACT FROM AUTHOR]

Background: A gender gap exists in knowledge regarding persons living with HIV/AIDS in Ghana. Women living with HIV/AIDS (WLHIV) greatly outnumber males living with HIV/AIDS (MLHIV) in Ghana and Sub-Saharan Africa generally. This necessitates more gender-nuanced evidence-based information on HIV/AIDS to guide individuals, healthcare workers, and other stakeholders in Ghana particularly. This paper undertook a gender-focused analysis of the experiences of WLHIV and MLHIV in a municipal area in Ghana which has been most impacted by HIV/AIDS.Methods: In-depth interviews of 38 HIV-positive persons recruited using combined purposive and random sampling for one month, were tape recorded and analyzed using thematic content analysis. Participants were out-patients who were receiving routine care for co-morbidities at two specially equipped HIV/AIDS Voluntary Counseling and Testing Centers in the Lower Manya Krobo Municipality (LMKM), Eastern Region, Ghana.Results: Our data yielded three major themes: characteristics of participants, health status and health seeking behavior, and challenges encountered living with HIV/AIDS. Except for feeling of sadness due to their HIV/AIDS-positive status, there were significant differences in the experiences of MLHIV, compared to WLHIV. WLHIV were more likely to be housing insecure, unemployed due mostly to stigmatization/self-stigmatization, less likely to have revealed their HIV-positive status to multiple family members, and had more profound challenges regarding their healthcare. Most MLHIV expected, demanded, and had support from their wives; WLHIV were mostly single-never married, divorced or widowed (mostly due to HIV/AIDS). The vast majority of WLHIV complained of near-abject poverty, including for most of them, lack of food for taking their anti-retroviral medicines and/or taking it on time.Conclusions: The experiences of the MLHIV and WLHIV with living and coping with the virus mostly differed. These experiences were unequivocally shaped by differential socio-cultural tenets and gendered nuances; WLHIV had more negative experiences. Public education on the extra burden of HIV/AIDS on WLHIV, more social support, and affirmative action in policy decisions in favor of WLHIV in the study district are needed to seek public sympathy and improve health outcomes and livelihoods of WLHIV particularly. Further studies using multiple sites to explore these differences are warranted. [ABSTRACT FROM AUTHOR]

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Since reports of the first incidence of the HIV virus in Zimbabwe in 1985, the epidemic has negatively impacted on every facet of human security. Rural areas, by virtue of being the periphery and constrained in terms of resources and health care provision, bear the brunt of the epidemic. In light of the above background, this paper examined how the establishment of Ruvheneko Programme by the people of Chirumhanzu helped in mitigating on the impact of HIV and AIDS in the rural sphere. The paper analyses how the community of Chirumhanzu successfully engaged each other to the extent of coming up with such a vibrant programme. This is raised against the backdrop of failure usually associated with HIV and AIDS engagement projects. The study made use of field interviews and focus group discussions as data collection instruments. Participants were purposively selected on the basis of their knowledge and participation in the establishment and activities of Ruvheneko Programme. Selected were 5 St Theresa's Hospital Staff, 10 Roman Catholic Church members of which, 5 were from the St Anna's woman prayer group and 5 men from St Joseph's men prayer group, 1 village head and 2 elders from the same nearby village constituted key informants. Complementing the use of interviews and focus group discussions was the analysis of secondary data sources on HIV and AIDS in Zimbabwe as well as the Ruvheneko Programme. To understand the collective role of various sectors of the community in establishing Ruvheneko Programme, the paper derives insights from the perspective of social capital theory and its notion of commonality to strengthen communities. Findings from the study show that, unlike other HIV and AIDS programmes that are exported from the urban to the rural areas, Ruvheneko Programme demonstrates a grassroots-level response to HIV and AIDS. Again, social cohesion fostered by aspects such as religiosity, cultural ethos of Ubuntu, and a consultative approach played a key role in unifying people towards fighting HIV and AIDS in Rural Chirumhanzu. [ABSTRACT FROM AUTHOR]

High human immunodeficiency virus (HIV)–prevalence countries in Southern and Eastern Africa continue to receive substantial external assistance (EA) for HIV programming, yet countries are at risk of transitioning out of HIV aid without achieving epidemic control. We sought to address two questions: (1) to what extent has HIV EA in the region been programmed and delivered in a way that supports long-term sustainability and (2) how should development agencies change operational approaches to support long-term, sustainable HIV control? We conducted 20 semi-structured key informant interviews with global and country-level respondents coupled with an analysis of Global Fund budget data for Malawi, Uganda, and Zambia (from 2017 until the present). We assessed EA practice along six dimensions of sustainability, namely financial, epidemiological, programmatic, rights-based, structural and political sustainability. Our respondents described HIV systems' vulnerability to donor departure, as well as how development partner priorities and practices have created challenges to promoting long-term HIV control. The challenges exacerbated by EA patterns include an emphasis on treatment over prevention, limiting effects on new infection rates; resistance to service integration driven in part by 'winners' under current EA patterns and challenges in ensuring coverage for marginalized populations; persistent structural barriers to effectively serving key populations and limited capacity among organizations best positioned to respond to community needs; and the need for advocacy given the erosion of political commitment by the long-term and substantive nature of HIV EA. Our recommendations include developing a robust investment case for primary prevention, providing operational support for integration processes, investing in local organizations and addressing issues of political will. While strategies must be locally crafted, our paper provides initial suggestions for how EA partners could change operational approaches to support long-term HIV control and the achievement of universal health coverage. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

Objectives Our paper highlights areas of interest to psychologists studying aging in Africa and what has already been learned about aspects of psychological aging from studies done in the African context. We also considered whether there are issues that are unique about aging in the African context that might challenge how aging is typically considered in psychology research. Methods We reviewed articles recently published in major gerontology journals focusing on African older adults, with the goal of identifying key themes of current geropsychology in Africa. Results We identified a number of dominant themes including: subjective aging, psychosocial impact of widowhood at old age, aging in place, stress and caregiving, cognitive aging, interrelations between HIV and aging, and successful aging. Discussion The themes of psychological aging research identified as especially relevant in Africa provide a starting point for psychological aging researchers in general to engage with the African context. Many African countries may be facing common challenges, but the existing studies are not fully representative of the aging population in the continent. Creating a framework for organizing and coordinating funding will help to address the limited research on geropsychology in Africa. Collaborative research projects/programs, joint classrooms, and fellowships that support African geropsychology scholars will be helpful. Geropsychology will benefit from more engagement with the African context by applying innovative approaches such as the adoption of longitudinal designs, mixed-method research, Experience Sampling Methods, translation of measures into indigenous languages, involvement of rural samples, and implementation science and community-engaged research. [ABSTRACT FROM AUTHOR]

HIV/AIDS still imposes a high epidemiological and societal burden. Together with antiretroviral therapy, pre-exposure prophylaxis (PrEP) represents a fundamental tool in the fight against HIV/AIDS. PrEP is considered effective and safe, even though it may affect organs like the kidney, bone, and liver, as shown by randomized clinical trials (RCTs). These side effects may be mediated by alterations of the gut microbiome. Whilst the impact of the human rectal and vaginal microbiome on HIV prevention has been highly investigated among women, less is known about its effect among men having sex with men (MSM), a vulnerable population at high risk for HIV and disproportionately affected by HIV/AIDS. In the present paper, we will overview the effects of PrEP on the gut microbiota in MSM. Mining PubMed/MEDLINE, we identified three studies that have found significant changes affecting the gut microbiota. However, these shifts in the gut microbiome composition are variable, probably due to methodological differences, even though all studies reviewed in the present overview consistently report aberrations at the level of the gut microbiota. More data are needed, especially concerning the long-term side effects of PrEP: despite the studies included being a high-quality RCT, and two well-designed cross-sectional studies, evidence related to the impact of HIV PrEP on the gut microbiome in MSM is scarce and based on small populations. A better understanding of the interactions between the gut microbiota, sexual orientation/identity, and HIV prevention is expected to improve PrEP adherence and devise strategies to counteract PrEP-related side effects. [ABSTRACT FROM AUTHOR]

This paper analyses the lived experiences of people living with HIV in South Africa through the use of body mapping as a visual research method, by focusing on the physical and symbolic use of the body within the broader context of anthropology and medical anthropology. The study consists of an empirical analysis of the body maps themselves and the accompanied narratives of seven participants, six female and one male participant living with HIV in South Africa. Drawing upon theories and literature on theorising the body in medical anthropology and visual research, this study explores the significance of this practice as a visual research method in understanding the nuanced lived experiences of people living with HIV by highlighting the individuality of the body and emotions; embodied experiences: a bio-cultural approach; and the body politic: social injustice. The results of this study illustrate that body mapping is a unique visual research method, that explores the body as the vehicle in which we exist within the world, while containing a vast amount of layered interpretive and cultural meanings, which are key to understanding the lived experience of people from marginalised groups. [ABSTRACT FROM AUTHOR]