9 results
Search Results
2. "Emotional stress is more detrimental than the virus itself": A qualitative study to understand HIV testing and pre‐exposure prophylaxis (PrEP) use among internal migrant men in South Africa.
- Author
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Nardell, Maria Francesca, Govathson‐Mandimika, Caroline, Garnier, Salomé, Watts, Ashley, Babalola, Dolapo, Ngcobo, Nkosinathi, Long, Lawrence, Lurie, Mark N., Miot, Jacqui, Pascoe, Sophie, and Katz, Ingrid T.
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DIAGNOSIS of HIV infections ,PRE-exposure prophylaxis ,INTERNAL migrants ,PSYCHOLOGICAL stress ,STRAINS & stresses (Mechanics) ,EMOTIONAL experience - Abstract
Introduction: South Africa has one of the highest rates of internal migration on the continent, largely comprised of men seeking labour in urban centres. South African men who move within the country (internal migrants) are at higher risk than non‐migrant men of acquiring HIV yet are less likely to test or use pre‐exposure prophylaxis (PrEP). However, little is known about the mechanisms that link internal migration and challenges engaging in HIV services. Methods: We recruited 30 internal migrant men (born outside Gauteng Province) during August 2022 for in‐depth qualitative interviews at two sites in Johannesburg (Gauteng) where migrants may gather, a factories workplace and a homeless shelter. Interviewers used open‐ended questions, based in the Theory of Triadic Influence, to explore experiences and challenges with HIV testing and/or PrEP. A mixed deductive inductive content analytic approach was used to review data and explain why participants may or may not use these services. Results: Migrant men come to Johannesburg to find work, but unreliable income, daily stress and time constraints limit their availability to seek health services. While awareness of HIV testing is high, the fear of a positive diagnosis often overshadows the benefits. In addition, many men lack knowledge about the opportunity for PrEP should they test negative, though they express interest in the medication after learning about it. Additionally, these men struggle with adjusting to urban life, lack of social support and fear of potential stigma. Finally, the necessity to prioritize work combined with long wait times at clinics further restricts their access to HIV services. Despite these challenges, Johannesburg also presents opportunities for HIV services for migrant men, such as greater anonymity and availability of HIV information and services in the city as compared to their rural homes of origin. Conclusions: Bringing HIV services to migrant men at community sites may ease the burden of accessing these services. Including PrEP counselling and services alongside HIV testing may further encourage men to test, particularly if integrated into counselling for livelihood and coping strategies, as well as support for navigating health services in Johannesburg. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. Diagnostic radiographers' perceptions of professional identity in Johannesburg, Gauteng, South Africa.
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Mtombeni, Keleabetswe, Hazell, Lynne, and Mokoena, Louisa
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PROFESSIONAL identity ,RADIOLOGIC technologists ,THEMATIC analysis ,SEMI-structured interviews - Abstract
Introduction: The study explored and described the professional identity of diagnostic radiographers in Johannesburg, Gauteng, South Africa. Methods: The methodology employed for the study was qualitative, exploratory and descriptive design. Face‐to‐face interviews were conducted with thirteen diagnostic radiographers from private, public practices and individually owned practices. Semi‐structured interviews were conducted, and the responses underwent thematic analysis and used Braun and Clarke's six steps for analysing qualitative data. Results: The thematic analysis revealed three themes and six categories. The three themes identified were: perceptions of identity, environment influences and organisational institutions. Conclusion: This study provided an insight into the current perspectives of the professional identity of diagnostic radiographers in Johannesburg, South Africa, which reflected a positive professional identity. The three themes identified could inform guidelines for education in diagnostic radiographers' professional identity in the future. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Biochemical progression free and overall survival among Black men with stage IV prostate cancer in South Africa: Results from a prospective cohort study.
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Pumpalova, Yoanna S., Ramakrishnan, Adarsh, May, Michael, Pentz, Audrey, Minkowitz, Shauli, Doherty, Sean, Singh, Elvira, Chen, Wenlong Carl, Rebbeck, Timothy R., Neugut, Alfred I., and Joffe, Maureen
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PROSTATE cancer ,BLACK South Africans ,PROGRESSION-free survival ,BLACK men ,SOUTH Africans ,ANDROGEN deprivation therapy - Abstract
Background: Men of African descent are disproportionately affected by prostate cancer (PCa), and many have metastatic disease at presentation. In South Africa (SA), androgen deprivation therapy (ADT) is the first-line treatment for stage IV PCa. Objective: To identify predictors of overall survival (OS) in Black South African men with stage IV PCa treated with ADT. Design, Setting, and Participants: Men diagnosed with prostate cancer (3/22/2016–10/30/2020) at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, were recruited for the Men of African Descent with Cancer of the Prostate study. We included men with newly diagnosed stage IV PCa treated with ADT who had a prostate-specific antigen (PSA) level drawn prior to initiation of ADT and had ≥1 PSA drawn ≥12weeks after ADT start. Outcomes Measures and Statistical Analysis: We used Kaplan–Meier statistics to estimate OS and Cox regression models to identify predictors of OS. Results and Limitations: Of the 1097 men diagnosed with prostate cancer, we included 153 men with stage IV PCa who received ADT and met PSA requirements. The median age was 68.0 years (interquartile range 64–73 years). Median OS from time of ADT initiation was 3.39 years (95% confidence interval (CI): 3.14%–noncalculable), while biochemical progression-free survival was 2.36 years (95% CI: 2.03%–3.73%). Biochemical progression (HR 3.52, 95% CI: 1.85%–6.70%), PSA nadir level >4ng/mL (HR 3.77, 95% CI: 1.86%–7.62%), alkaline phosphatase level at diagnosis >150 IU/dL (HR 3.09, 95% CI: 1.64%– 5.83%), and hemoglobin at diagnosis <13.5 g/dL (HR 2.90, 95% CI: 1.28%–6.56%) were associated with worse OS. Conclusions: In this study, we identified factors associated with poor OS among Black South African men with stage IV PCa treated with ADT. These factors may be useful in identifying patients for upfront treatment escalation, including the use of docetaxel chemotherapy or escalation of therapy at the time of biochemical progression. Patient Summary: In this study, we found that high alkaline phosphatase level, anemia at diagnosis, and high PSA nadir after initiation of androgen deprivation therapy are associated with worse overall survival among Black South African men treated with androgen deprivation therapy for metastatic prostate cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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5. The South African Pollen Monitoring Network: Insights from 2 years of national aerospora sampling (2019–2021).
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Esterhuizen, Nanike, Berman, Dilys M., Neumann, Frank H., Ajikah, Linus, Quick, Lynne J., Hilmer, Erin, Van Aardt, Andri, John, Juanette, Garland, Rebecca, Hill, Trevor, Finch, Jemma, Hoek, Werner, Bamford, Marion, Seedat, Riaz Y., Manjra, Ahmed I., and Peter, Jonny
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POLLEN ,EFFECT of human beings on climate change ,RAINFALL ,CITIES & towns ,MORACEAE - Abstract
Background: Pollen monitoring has been discontinuously undertaken in South Africa, a country with high biodiversity, a seasonal rainfall gradient, and nine biomes from arid to subtropical. The South African Pollen Monitoring Network was set up in 2019 to conduct the first long‐term national aerospora monitoring across multiple biomes, providing weekly reports to allergy sufferers and healthcare providers. Methods: Daily airborne pollen concentrations were measured from August 2019 to August 2021 in seven cities across South Africa. Updated pollen calendars were created for the major pollen types (>3%), the average Annual Pollen Index over 12 months was calculated, and the results were compared to available historical data. Results: The main pollen types were from exotic vegetation. The most abundant taxa were Poaceae, Cupressaceae, Moraceae and Buddleja. The pollen season start, peak and end varied widely according to the biome and suite of pollen taxa. The main tree season started in the last week of August, peaked in September and ended in early December. Grass seasons followed rainfall patterns: September–January and January–April for summer and winter rainfall areas, respectively. Major urban centres, for example, Johannesburg and Pretoria in the same biome with similar rainfall, showed substantive differences in pollen taxa and abundance. Some major differences in pollen spectra were detected compared with historical data. However, we are cognisant that we are describing only 2 years of data that may be skewed by short‐term weather patterns. Conclusions: Differences in pollen spectra and concentrations were noted across biomes and between geographically close urban centres. Comparison with historical data suggests pollen spectra and seasons may be changing due to anthropogenic climate change and landscaping. These data stress the importance of regional and continuous pollen monitoring for informed care of pollinosis. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Community participation in a low‐income neighborhood: The salience of sociodemographic characteristics, perceptions and experience of violence, and neighborhood attachment.
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Swart, Lu‐Anne, Ismail, Ghouwa, and Seedat, Mohamed
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COMMUNITY involvement ,POOR communities ,NEIGHBORHOODS ,FEAR of crime ,VIOLENT crimes - Abstract
While community participation may serve as a vehicle to improve health and socioeconomic outcomes for residents in poor communities, little research exists on the individual factors that influence community participation, particularly in contexts where violence is exceptionally high. This study examined the relationship between sociodemographic characteristics, perceptions, and experiences of violence, neighborhood attachment, and community participation in a low‐income, under‐resourced neighborhood in Johannesburg South Africa. The study used baseline data from 300 randomly selected households and multiple linear regression to assess the relationship between individual factors and community participation. The results suggest a high level of community participation, with religious organizational membership the most common. Being female, employed, and fear of violent crime were positively associated with community participation. Future research should include mixed methods and transdisciplinary research approaches for building our understandings of social justice and transformation‐oriented community participation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. Comparative Assessment of Microplastics in Surface Waters and Sediments of the Vaal River, South Africa: Abundance, Composition, and Sources.
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Ramaremisa, Gibbon, Ndlovu, Michelle, and Saad, Dalia
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PLASTIC marine debris ,MICROPLASTICS ,RIVER sediments ,HIGH density polyethylene ,LOW density polyethylene ,SEDIMENT sampling ,PLASTICS ,VINYL acetate - Abstract
We extracted microplastics from surface water and sediment samples from the Vaal River in Johannesburg, South Africa. Average abundances of 0.61 ± 0.57 particles/m3and 4.6 × 102 ± 2.8 × 102 particles/kg dry weight were recorded for water and sediment samples, respectively. In both sediment and water samples, more than 80% of microplastics were fragments and fibers of smaller than 2 mm. High‐density polyethylene, low‐density polyethylene, and polypropylene were the dominant polymers identified in both sample types. In addition, polyethylene co‐vinyl acetate, polyester, polyurethane, and polyethylene/hexene‐1‐copolymer were also detected in sediment samples. Colored microplastics were the most commonly observed in both sample types; pigment yellow 83 was detected in surface water, and carbon black was detected in both sediment and water samples during Raman analysis. Taking into consideration the physical and chemical characteristics of the detected microplastics, their potential sources include inflow from tributaries, surface run‐off from urban city centers, recreational activities, and wastewater effluent from industries and households. Environ Toxicol Chem 2022;41:3029–3040. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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8. Processes of Peripheralisation: Toehold and Aspirational Urbanisation in the GCR.
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URBANIZATION ,MIDDLE class ,URBAN geography ,URBAN studies ,SOCIAL facts - Abstract
This article interrogates the term "periphery" by examining the forms of urbanisation unfolding in the Gauteng City‐Region (GCR) of South Africa. Among the urbanisation processes identified, it focuses on two, situating them among debates on informality and defining new vocabularies of urbanisation. Aligned with discussions of peripherality as a social phenomenon, the article first depicts how some marginalised groups of people using transversal means carve out "toeholds" near urban centralities and opportunities. Second, it conveys how peripherality is also a geographical phenomenon, describing "aspirational" mass housing for the lower‐middle class on urban peripheries that can generate unexpected forms of precarity. The article concludes that toehold urbanisation and aspirational urbanisation drive peripheralisation in the GCR, and considers the implications of these concepts for critical geography and urban studies. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Retention in care and viral suppression after same‐day ART initiation: One‐year outcomes of the SLATE I and II individually randomized clinical trials in South Africa.
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Maskew, Mhairi, Brennan, Alana T., Venter, Willem D. F., Fox, Matthew P., Vezi, Lungisile, and Rosen, Sydney
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CLINICAL trials ,ANTIRETROVIRAL agents ,ALGORITHMS ,CONFIDENCE intervals ,DRUGS - Abstract
Introduction: Same‐day initiation (SDI) of antiretroviral therapy (ART) for HIV consistently increases ART uptake, but concerns remain about higher attrition from care after initiation. We analysed 12‐month retention in the SLATE SDI trials. Methods: SLATE I (Simplified Algorithms for Treatment Eligibility I, enrolment 06 March–28 July 2017) and SLATE II (enrolment 14 March–18 September 2018) were individually randomized trials at public outpatient clinics in Johannesburg that enrolled patients not yet on ART and administered the SLATE I or II algorithm. This included a symptom self‐report, medical history, brief physical examination and readiness questionnaire to assess the eligibility for SDI. The studies compared the offer of SDI using the SLATE algorithms to standard of care initiation procedures. ART uptake and early retention were previously reported. Using routine clinic records, we conducted a pooled analysis of retention in care and HIV viral suppression 14 months after study enrolment, a time point equivalent to 12 months potential on ART, with an additional month allowed on either end to initiate ART and to return for the 12‐month visit. Results and discussion: We enrolled 1193 study participants (standard arms, n = 599, 50%; intervention arms, n = 594, 50%) and analysed by originally assigned groups. By 14 months after enrolment, 50% of intervention arm patients and 46% of standard arm patients remained in care at the initiating site (crude risk difference 4% (95% confidence interval −1%‐10%); crude relative risk 1.10 (0.97–1.23), with similar viral suppression between arms. Observed attrition from care at site by 14 months was high in both study arms, but we found no evidence that the offer of SDI led to greater overall attrition or lower rates of viral suppression 1 year after starting ART and may have generated small improvements. SDI may have shifted some attrition from before to after dispensing of the first dose of medication. Conclusions: An offer of SDI of ART, following a carefully designed protocol to identify patients who are eligible and ready to start treatment, is not inherently associated with an overall increase in patient attrition from care and leads to similar rates of viral suppression. Trial registration: Clinicaltrials.gov NCT02891135, registered 01 September 2016. First participant enrolled 06 March 2017 in South Africa. Clinicaltrials.gov NCT03315013, registered 19 October 2017. First participant enrolled 14 March 2018. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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