527 results on '"Kharsany A"'
Search Results
102. Evaluating the Effect of Schooling and Comprehensive Sexuality Education on HIV Prevalence, Pregnancy and Risky Sexual Behaviour Amongst Adolescents in South Africa
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George, Gavin, primary, Beckett, Sean, additional, Reddy, Tarylee, additional, Govender, Kaymarlin, additional, Cawood, Cherie, additional, Khanyile, David, additional, and Kharsany, Ayesha, additional
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- 2021
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103. DREAMS Intervention Uptake and Its Association with HIV Related Outcomes Among Adolescent Girls and Young Women in South Africa: Findings from a Cross Sectional Household Study
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Govender, Kaymarlin, primary, Beckett, Sean, additional, Reddy, Tarylee, additional, Cowden, Richard, additional, Cawood, Cherie, additional, Khanyile, David, additional, Kharsany, Ayesha, additional, George, Gavin, additional, and Puren, Adrian, additional
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- 2021
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104. Depression symptoms, HIV testing, linkage to ART, and viral suppression among women in a high HIV burden district in KwaZulu-Natal, South Africa: A cross-sectional household study
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Govender, Kaymarlin, primary, Durevall, Dick, additional, Cowden, Richard G, additional, Beckett, Sean, additional, Kharsany, Ayesha BM, additional, Lewis, Lara, additional, George, Gavin, additional, Cawood, Cherie, additional, and Khanyile, David, additional
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- 2020
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105. Depression symptoms, HIV testing, linkage to ART, and viral suppression among women in a high HIV burden district in KwaZulu-Natal, South Africa: A cross-sectional household study.
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Govender, Kaymarlin, Durevall, Dick, Cowden, Richard G, Beckett, Sean, Kharsany, Ayesha BM, Lewis, Lara, George, Gavin, Cawood, Cherie, and Khanyile, David
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HIV infections ,CONFIDENCE intervals ,VIRAL load ,CROSS-sectional method ,MEDICAL screening ,WOMEN ,HIGHLY active antiretroviral therapy ,SURVEYS ,MENTAL depression ,DESCRIPTIVE statistics ,MASS spectrometry ,DATA analysis software ,SECONDARY analysis - Abstract
Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental health challenges that may affect HIV testing and treatment-related behaviors. This study is based on survey data from KwaZulu-Natal, South Africa (2014–2015). HIV positive women who reported higher depression scores had a lower odds of having tested previously for HIV (15–25years: AOR=0.90, 95% CI [0.83, 0.98]; 26–49years: AOR=0.90, 95% CI [0.84, 0.96]). Because HIV testing behavior represents a gateway to treatment, the findings suggest mental health may be one challenge to attaining the UNAIDS 90-90-90 targets. [ABSTRACT FROM AUTHOR]
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- 2022
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106. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa
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Karim, Quarraisha Abdool, Kharsany, Ayesha BM, Frohlich, Janet A, Werner, Lise, Mashego, May, Mlotshwa, Mukelisiwe, Madlala, Bernadette T, Ntombela, Fanelesibonge, and Abdool Karim, Salim S
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- 2011
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107. Poor rates of linkage to HIV care and uptake of treatment after home-based HIV testing among newly diagnosed 15-to-49 year-old men and women in a high HIV prevalence setting in South Africa
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Maughan-Brown, Brendan, primary, Beckett, Sean, additional, Kharsany, Ayesha B. M., additional, Cawood, Cherie, additional, Khanyile, David, additional, Lewis, Lara, additional, Venkataramani, Atheendar, additional, and George, Gavin, additional
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- 2020
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108. Screening for ‘window-period’ acute HIV infection among pregnant women in rural South Africa
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Kharsany, A BM, Hancock, N, Frohlich, J A, Humphries, H R, Abdool Karim, S S, and Abdool Karim, Q
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- 2010
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109. Factors associated with HIV in younger and older adult men in South Africa: findings from a cross-sectional survey
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Govender, Kaymarlin, primary, Beckett, Sean Edward, additional, George, Gavin, additional, Lewis, Lara, additional, Cawood, Cherie, additional, Khanyile, David, additional, Tanser, Frank, additional, and Kharsany, Ayesha BM, additional
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- 2019
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110. HIV Risks in Sexual Networks of Heterosexual Men in South Africa
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Ntombela, Nonzwakazi P, primary, Mashamba-Thompson, Tivani P, additional, Mtshali, Andile N, additional, Kuupiel, Desmond, additional, and Kharsany, Ayesha BM, additional
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- 2019
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111. Trends in HIV Prevention, Treatment, and Incidence in a Hyperendemic Area of KwaZulu-Natal, South Africa
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Kharsany, Ayesha B. M., primary, Cawood, Cherie, additional, Lewis, Lara, additional, Yende-Zuma, Nonhlanhla, additional, Khanyile, David, additional, Puren, Adrian, additional, Madurai, Savathree, additional, Baxter, Cheryl, additional, George, Gavin, additional, Govender, Kaymarlin, additional, Beckett, Sean, additional, Samsunder, Natasha, additional, Toledo, Carlos, additional, Ayalew, Kassahun Abere, additional, Diallo, Karidia, additional, Glenshaw, Mary, additional, Herman-Roloff, Amy, additional, Wilkinson, Eduan, additional, de Oliveira, Tulio, additional, Abdool Karim, Salim S., additional, and Abdool Karim, Quarraisha, additional
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- 2019
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112. Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: a community-wide phylogenetic study
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Cherie Cawood, Ayesha B. M. Kharsany, Cheryl Baxter, Adrian Puren, Savathree Madurai, Tiago Gräf, Tulio de Oliveira, Salim S. Abdool Karim, Quarraisha Abdool Karim, Anna Christina. Grobler, and David Khanyile
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Adult ,0301 basic medicine ,Gerontology ,medicine.medical_specialty ,Adolescent ,Genotype ,Epidemiology ,Cross-sectional study ,Sexual Behavior ,Immunology ,HIV Infections ,Rural Health ,HIV Antibodies ,South Africa ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Surveys and Questionnaires ,Virology ,Prevalence ,Humans ,Medicine ,030212 general & internal medicine ,Young adult ,Phylogeny ,Family Characteristics ,business.industry ,Transmission (medicine) ,Incidence (epidemiology) ,Rural health ,Public health ,HIV ,Middle Aged ,Viral Load ,medicine.disease ,Cross-Sectional Studies ,Sexual Partners ,030104 developmental biology ,Infectious Diseases ,Female ,business ,Viral load ,Demography - Abstract
The incidence of HIV infection in young women in Africa is very high. We did a large-scale community-wide phylogenetic study to examine the underlying HIV transmission dynamics and the source and consequences of high rates of HIV infection in young women in South Africa.We did a cross-sectional household survey of randomly selected individuals aged 15-49 years in two neighbouring subdistricts (one urban and one rural) with a high burden of HIV infection in KwaZulu-Natal, South Africa. Participants completed structured questionnaires that captured general demographic, socioeconomic, psychosocial, and behavioural data. Peripheral blood samples were obtained for HIV antibody testing. Samples with HIV RNA viral load greater than 1000 copies per mL were selected for genotyping. We constructed a phylogenetic tree to identify clusters of linked infections (defined as two or more sequences with bootstrap or posterior support ≥90% and genetic distance ≤4·5%).From June 11, 2014, to June 22, 2015, we enrolled 9812 participants, 3969 of whom tested HIV positive. HIV prevalence (weighted) was 59·8% in 2835 women aged 25-40 years, 40·3% in 1548 men aged 25-40 years, 22·3% in 2224 women younger than 25 years, and 7·6% in 1472 men younger than 25 years. HIV genotyping was done in 1589 individuals with a viral load of more than 1000 copies per mL. In 90 transmission clusters, 123 women were linked to 103 men. Of 60 possible phylogenetically linked pairings with the 43 women younger than 25 years, 18 (30·0%) probable male partners were younger than 25 years, 37 (61·7%) were aged 25-40 years, and five (8·3%) were aged 41-49 years: mean age difference 8·7 years (95% CI 6·8-10·6; p0·0001). For the 92 possible phylogenetically linked pairings with the 56 women aged 25-40 years, the age difference dropped to 1·1 years (95% CI -0·6 to 2·8; p=0·111). 16 (39·0%) of 41 probable male partners linked to women younger than 25 years were also linked to women aged 25-40 years. Of 79 men (mean age 31·5 years) linked to women younger than 40 years, 62 (78·5%) were unaware of their HIV-positive status, 76 (96·2%) were not on antiretroviral therapy, and 29 (36·7%) had viral loads of more than 50 000 copies per mL.Sexual partnering between young women and older men, who might have acquired HIV from women of similar age, is a key feature of the sexual networks driving transmission. Expansion of treatment and combination prevention strategies that include interventions to address age-disparate sexual partnering is crucial to reducing HIV incidence and enabling Africa to reach the goal of ending AIDS as a public health threat.President's Emergency Program for AIDS Relief, US Centers for Disease Control and Prevention, South African Medical Research Council, and MAC AIDS Fund.
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- 2017
113. Impact of HIV testing and treatment services on risky sexual behaviour in the uMgungundlovu District, KwaZulu-Natal, South Africa: a cross-sectional study
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Cherie Cawood, Ayesha B. M. Kharsany, Sean Beckett, Kaymarlin Govender, David Khanyile, and Gavin George
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Counseling ,Male ,0301 basic medicine ,Cross-sectional study ,HIV Infections ,Human sexuality ,South Africa ,Health personnel ,0302 clinical medicine ,Surveys and Questionnaires ,SAFER ,Pharmacology (medical) ,030212 general & internal medicine ,Family Characteristics ,Health Services ,Middle Aged ,Viral Load ,3. Good health ,Sexual Partners ,Anti-Retroviral Agents ,Epidemiological Monitoring ,Molecular Medicine ,Female ,ART ,Kwazulu natal ,Adult ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,HIV prevention ,030106 microbiology ,Behaviour change communication ,Hiv testing ,HIV testing services ,Young Adult ,03 medical and health sciences ,Risk-Taking ,Virology ,Environmental health ,medicine ,Humans ,Risky sexual behaviour ,business.industry ,Research ,Public health ,Cross-Sectional Studies ,lcsh:RC581-607 ,business - Abstract
Introduction The South African public health system plays an important role in the delivery of HIV testing and treatment services. The health system is also an important conduit for targeted behaviour change communication with the expectation that clients who undergo counselling from health personnel, adopt safer sexual practices. Literature remains mixed on the impact these HIV services have on risky sexual behaviour. This analysis examines the sexual behaviour of clients following the utilisation of HIV testing and treatment services in Kwazulu-Natal, South Africa. Methods Data were used from two consecutive cross-sectional household surveys undertaken from June 2014 to June 2015 (2014/2015 survey) and from July 2015 to June 2016 (2015/2016 survey) in the uMgungundlovu District of KwaZulu-Natal, South Africa. Collectively, 20,048 randomly selected individuals aged 15 to 49 years old were interviewed across the two surveys. Utilisation of HIV testing and treatment services were used as independent variables and three sexual risk behaviours were used as dependent variables. Multiple regression models assessed the impact HIV testing and treatment services had on sexual risk behaviour while controlling for socio-demographic characteristics. Results Having tested for HIV had no association with any of the three sexual risk behaviours. However, receiving an HIV positive diagnosis reduced the likelihood of using condoms inconsistently with the respondents’ most recent partner (AOR: 0.64; 95% CI 0.54–0.77). Antiretroviral use was negatively associated with inconsistent condom use (AOR: 0.45; 95% CI 0.35–0.58) and number of sexual partners in the previous year (AOR: 0.61; 95% CI 0.46–0.81). Conclusions Results indicate that HIV testing and treatment services and the assumed exposure of clients to behaviour change communication, had a limited effect in reducing risky sexual behaviour. Data suggests that the engagement between health personnel and individuals accessing HIV testing and treatment services does not necessarily translate into the adoption of safer sexual practices, with the exception of individuals testing positive for HIV and those on ARV treatment, who had adopted safer sexual practices. Electronic supplementary material The online version of this article (10.1186/s12981-019-0237-z) contains supplementary material, which is available to authorized users.
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- 2019
114. The new buzz: Investigating the antimicrobial interactions between bioactive compounds found in South African propolis
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K. Kharsany, C.M. Leonard, S.F. Van Vuuren, and Alvaro M. Viljoen
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medicine.drug_class ,Microbial Sensitivity Tests ,Gram-Positive Bacteria ,Propolis ,03 medical and health sciences ,chemistry.chemical_compound ,Minimum inhibitory concentration ,South Africa ,0302 clinical medicine ,Antiseptic ,Anti-Infective Agents ,Drug Discovery ,Candida albicans ,Gram-Negative Bacteria ,medicine ,Animals ,Chrysin ,030304 developmental biology ,Pharmacology ,Flavonoids ,0303 health sciences ,Pinocembrin ,Traditional medicine ,Biofilm ,Quorum Sensing ,Antimicrobial ,Galangin ,chemistry ,030220 oncology & carcinogenesis ,Biofilms ,Flavanones ,Artemia - Abstract
Ethnopharmacological relevance Propolis, a resinous substance produced by the Apis mellifera bee, contains a number of flavonoids sourced from plants found in the surrounding region. Whilst bees use this substance to seal off and protect the beehive, humans have used propolis therapeutically for centuries, making use of its antibacterial, antiseptic, antipyretic and wound healing properties, among others. South African propolis is rich in the flavonoids pinocembrin, galangin, and chrysin and very little previous research has been conducted on the antimicrobial effects of these compounds. Aim of the study To obtain an understanding of the antimicrobial activity of the compounds pinocembrin, galangin, and chrysin, both independently and in combination. Materials and methods The compounds pinocembrin, galangin and chrysin were investigated for interactive antimicrobial activity by determining the minimum inhibitory concentrations (MIC), minimum bactericidal concentrations (MBC), anti-quorum sensing activity, biofilm studies, and toxicity studies (brine shrimp lethality assay). Results Minimum inhibitory concentration results demonstrated that combinations of compounds showed better inhibitory activity than single compounds. When the flavonoids were tested in combination using the MIC assay, synergy was noted for 22% of the 1:1 ratio combinations and for 66% of the triple 1:1:1 ratio combinations. Similarly, MBC results showed bactericidal activity from selected combinations, while the compounds on their own demonstrated no cidal activity. Quorum sensing studies showed that compound combinations are more effective at inhibiting bacterial communication than the individual compounds. Biofilm assays showed that the highest percentage inhibition was observed for the triple combination against E. coli at 24 h. Finally, brine shrimp lethality studies revealed that combinations of the three compounds had reduced cytotoxicity when compared to the individual compounds. Conclusion The results obtained in this study demonstrate that the compounds found in South African propolis work synergistically to achieve an optimal antimicrobial effect, whilst simultaneously minimizing cytotoxicity.
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- 2019
115. The impact of home-based HIV testing services on progress towards the UNAIDS 90-90-90 targets in a hyperendemic area of South Africa
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David Khanyile, Anneke Grobler, Mary Glenshaw, Cherie Cawood, Brendan Maughan-Brown, Ayesha B. M. Kharsany, and Lara Lewis
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Program evaluation ,Adult ,Male ,Adolescent ,United Nations ,Cross-sectional study ,Anti-HIV Agents ,Human immunodeficiency virus (HIV) ,HIV Infections ,Hiv testing ,medicine.disease_cause ,Article ,South Africa ,Young Adult ,medicine ,Prevalence ,Humans ,Mass Screening ,Pharmacology (medical) ,Young adult ,Epidemics ,Mass screening ,business.industry ,Middle Aged ,Patient Acceptance of Health Care ,Hiv prevalence ,Home based ,Self Care ,Infectious Diseases ,Cross-Sectional Studies ,Female ,Reagent Kits, Diagnostic ,business ,Delivery of Health Care ,Demography ,Program Evaluation - Abstract
Background In several subgroups of South Africa, the percentage of HIV-positive individuals aware of their status falls well below the UNAIDS 90% target. This study examined the impact that home-based HIV testing services (HBHTS) had on knowledge of status in a hyperendemic area of South Africa. Methods We analysed data from the second cross-sectional HIV Incidence Provincial Surveillance System survey (2015/2016), a representative sample (n = 10,236) of individuals aged 15-49 years. Participants completed a questionnaire, provided blood samples for laboratory testing (used to estimate HIV prevalence), and were offered HBHTS. The proportion of people living with HIV (n = 3870) made aware of their status through HBHTS was measured, and factors associated with HBHTS uptake were identified. Results Knowledge of HIV-positive status at the time of the survey was 62.9% among men and 73.4% among women. Through HBHTS, the percentage of HIV-positive men and women who knew their status rose to 74.2% and 80.5%, respectively. The largest impact was observed among youth (15-24 years). Knowledge of status increased from 36.6% to 59.3% and from 50.8% to 64.8% among young men and women, respectively. In addition, 51.4% of those who had previously never tested received their first test. Key reasons for declining HBHTS among undiagnosed HIV-positive individuals included fear and self-report of an HIV-negative status. Conclusions HBHTS was effective in increasing awareness of HIV-positive status, particularly among youth, men, and those who had never tested. HBHTS could have a marked impact on progress toward the UNAIDS 90-90-90 targets within these subgroups.
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- 2019
116. Moderate-to-High Levels of Pretreatment HIV Drug Resistance in KwaZulu-Natal Province, South Africa
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Ayesha B. M. Kharsany, Justen Manasa, Salim S. Abdool Karim, Benjamin Chimukangara, Deenan Pillay, Cherie Cawood, Tulio de Oliveira, Richard J Lessells, Kassahun Ayalew, David Khanyile, Gillian Hunt, Kogieleum Naidoo, Lara Lewis, Robert W. Shafer, Soo-Yon Rhee, Karidia Diallo, and Tiago Gräf
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0301 basic medicine ,Adult ,Male ,Adolescent ,Genotype ,Epidemiology ,Immunology ,Human immunodeficiency virus (HIV) ,Large population ,HIV Infections ,medicine.disease_cause ,03 medical and health sciences ,South Africa ,Young Adult ,0302 clinical medicine ,HIV Protease ,Virology ,Environmental health ,Drug Resistance, Viral ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,Hiv surveillance ,Molecular epidemiology ,business.industry ,virus diseases ,Middle Aged ,Antiretroviral therapy ,HIV Reverse Transcriptase ,030104 developmental biology ,Infectious Diseases ,Epidemiological Monitoring ,Mutation ,HIV-1 ,RNA, Viral ,Female ,business ,HIV drug resistance ,Kwazulu natal - Abstract
There is evidence of increasing levels of pretreatment HIV drug resistance (PDR) in Southern Africa. We used data from two large population-based HIV surveillance studies to estimate prevalence of PDR in KwaZulu-Natal, the province with the highest HIV prevalence in South Africa. Sanger sequencing was performed on samples obtained from a longitudinal HIV surveillance program (study A, 2013–2014) and the HIV Incidence Provincial Surveillance System (study B, 2014–2015). Sequences were included for adult HIV positive participants (age ≥15 years for study A, age 15–49 years for study B) with no documented prior exposure to antiretroviral therapy (ART). Overall and drug class-specific PDR was estimated using the World Health Organization 2009 surveillance drug resistance mutation (SDRM) list, and phylogenetic analysis was performed to establish evidence of drug resistance transmission linkage. A total of 1,845 sequences were analyzed (611 study A; 1,234 study B). An overall PDR prevalence of 9.2% [95% confidence interval (CI) 7.0–11.7] was observed for study A and 11.0% (95% CI 8.9–13.2) for study B. In study B, the prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) PDR exceeded 10% for sequences collected in 2014 (10.2%, 95% CI 7.5–12.9). The most prevalent SDRMs were K103NS (7.5%), M184VI (2.4%), and V106AM (1.4%). There was no evidence of large transmission chains of drug-resistant virus. High level NNRTI PDR (>10%) suggests a need to modify the standard first-line ART regimen and to focus attention on improving the quality of HIV prevention, treatment, and care.
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- 2019
117. Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000?2016: A Pooled Sequence Analysis
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Jennifer Giandhari, Reshmi Samuel, Cherie Cawood, Photini Kiepiela, Monalisa Kalimashe, Gita Ramjee, Benjamin Chimukangara, Johanna Ledwaba, David Khanyile, Richard J Lessells, John W. Mellors, Urvi M. Parikh, Alain Vandormael, Babill Stray-Pedersen, Ayesha B. M. Kharsany, Gillian Hunt, Robert W. Shafer, Salim S. Abdool Karim, Ravindra K. Gupta, Michelle Gordon, Tariro Makadzange, Deenan Pillay, Soo-Yon Rhee, Karidia Diallo, David Katzenstein, Lynn Morris, Lara Lewis, Kogieleum Naidoo, Tulio de Oliveira, Pravi Moodley, and Kassahun Ayalew
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medicine.medical_specialty ,Sequence analysis ,Drug resistance ,01 natural sciences ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Pre-treatment drug resistance ,030212 general & internal medicine ,0101 mathematics ,Surveillance ,Transmission (medicine) ,business.industry ,Public health ,010102 general mathematics ,HIV ,General Medicine ,Random effects model ,medicine.disease ,Confidence interval ,Antiretroviral therapy ,Regimen ,Pooled sequence analysis ,Molecular epidemiology ,business ,Research Paper ,Demography - Abstract
Background South Africa has the largest public antiretroviral therapy (ART) programme in the world. We assessed temporal trends in pretreatment HIV-1 drug resistance (PDR) in ART-naïve adults from South Africa. Methods We included datasets from studies conducted between 2000 and 2016, with HIV-1 pol sequences from more than ten ART-naïve adults. We analysed sequences for the presence of 101 drug resistance mutations. We pooled sequences by sampling year and performed a sequence-level analysis using a generalized linear mixed model, including the dataset as a random effect. Findings We identified 38 datasets, and retrieved 6880 HIV-1 pol sequences for analysis. The pooled annual prevalence of PDR remained below 5% until 2009, then increased to a peak of 11·9% (95% confidence interval (CI) 9·2-15·0) in 2015. The pooled annual prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) PDR remained below 5% until 2011, then increased to 10.0% (95% CI 8.4–11.8) by 2014. Between 2000 and 2016, there was a 1.18-fold (95% CI 1.13–1.23) annual increase in NNRTI PDR (p
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- 2019
118. MOESM1 of Impact of HIV testing and treatment services on risky sexual behaviour in the uMgungundlovu District, KwaZulu-Natal, South Africa: a cross-sectional study
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George, Gavin, Beckett, Sean, Cawood, Cherie, Khanyile, David, Kaymarlin Govender, and Kharsany, Ayesha
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Data_FILES - Abstract
Additional file 1. Additional tables.
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- 2019
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119. Burden of Sexually Transmitted Infections (STI) in Rural and Peri-Urban KwaZulu-Natal, South Africa: Findings from a Population-Based Household Survey
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Kaymarlin Govender, Gavin George, Lyle R. McKinnon, Sean Beckett, Cherie Cawood, Domiciled Venessa Maseko, Kassahun Ayalew, Carlos Toledo, Ayesha B. M. Kharsany, David Khanyile, Lara Lewis, and Tawni C. Goodman
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medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Public health ,Population ,medicine.disease ,medicine.disease_cause ,Rapid plasma reagin ,Syndemic ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Syphilis ,Chlamydia trachomatis ,business ,education ,Reproductive health ,Demography - Abstract
Background: Sexually transmitted infections (STI) contribute to enhancing HIV transmission and acquisition; however, population level prevalence of STI from high HIV burden settings are limited Methods: A population-based household survey undertaken between June 2014 and June 2015 enrolled 15–49 year old males and females in the Vulindlela and Greater Edendale areas of KwaZulu-Natal, South Africa. Data collected includedself-reported sociodemographic, behavioral, and clinical variables. For curable STIs, first-pass urine (males) or self-collected vulvo-vaginal swabs (females) were tested for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium using multiplex real-time polymerase chain reaction (PCR) and for syphilis serum sample was tested using a non-treponemal rapid plasma reagin (RPR) assay. Herpes simplex virus type 2 (HSV-2) and HIV antibodies were assessed by enzyme-linked immunosorbent assays. Prevalence of all STIs was measured and the association between participant characteristics and curable STIs was estimated using Poisson regression. Findings: Among the 9812 enrolled participants, 38·9% were under the age of 25 years and 63·9% were females. Among males and females, the prevalence of HIV was 28·0% and 44·1%, p
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- 2019
120. Utilizing nucleic acid amplification to identify acute HIV infection
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Karim, Salim S Abdool, Mlisana, Koleka, Kharsany, Ayesha BM, Williamson, Carolyn, Baxter, Cheryl, and Karim, Quarraisha Abdool
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- 2007
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121. Medical male circumcision and HIV prevention among men in Kwazulu-Natal, South Africa: A propensity score analysis
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Lara Lewis, Lateef O. Amusa, Temesgen Zewotir, Ayesha B. M. Kharsany, and Delia North
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medicine.medical_specialty ,Matching (statistics) ,Multidisciplinary ,Propensity score ,business.industry ,Confounding ,Human immunodeficiency virus (HIV) ,HIV ,Odds ratio ,medicine.disease_cause ,Medical male circumcision ,Kwazulu-Natal ,South Africa ,Male circumcision ,Epidemiology ,Propensity score matching ,medicine ,lcsh:Q ,lcsh:Science ,business ,Kwazulu natal ,Demography - Abstract
Introduction Epidemiological theory and many empirical studies support the hypothesis that there is a protective effect of medical male circumcision (MMC) against HIV infection. We aim to test this claim with evidence from a high endemic community in South Africa. Methodology We analysed a cross-sectional dataset, including HIV test outcome and MMC status of males aged 15–49, who participated in the HIV Incidence Provincial Surveillance System study between June 2014 and June 2015. We applied two propensity score methods, inverse probability of treatment weighting (IPTW) and full matching, to approximate a randomised trial investigating the hypothesis that MMC protects against HIV infection. We benchmarked our results using the conventional regression adjustment. Models were adjusted for identified confounders. Results The adjusted odds ratios (OR) provided evidence of a protective effect of MMC against HIV acquisition: IPTW (OR = 0.623, 95% CI: 0.467 – 0.830); Full matching (OR = 0.607, 95% CI: 0.440 – 0.837); Regression (OR = 0.579, 95% CI: 0.426 – 0.789). Conclusion There is a need to create more programmes that emphasise MMC as an important HIV preventive intervention.
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- 2021
122. A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting
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Rustomjee, Roxana, Kharsany, A. B. M., Connolly, C. A., and Karim, S. S. Abdool
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- 2002
123. Evolution in the trends of antimicrobial resistance in Neisseria gonorrhoeae isolated in Durban over a 5 year period: impact of the introduction of syndromic management
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Moodley, Prashini, Pillay, Chinsamy, Goga, Rabia, Kharsany, Ayesha B. M., and Sturm, A. Willem
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- 2001
124. Disappearing association between genital herpes and HIV infection
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Kharsany, A BM, Sturm, P DJ, Moodley, P, Mahabeer, Y, Connolly, C, and Sturm, A W
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- 2001
125. Sudden Death Caused by Myocardial Tuberculosis: Case Report and Review of the Literature
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Dada, Mahomed A., Lazarus, Nerissa G., Kharsany, A. B. M., and Sturm, A. W.
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- 2000
126. Transepithelial elimination of cutaneous vulval granuloma inguinale
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Ramdial, Pratistadevi K., Kharsany, Ayesha B. M., Reddy, Roshilla, and Chetty, Runjan
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- 2000
127. HIV Risks in Sexual Networks of Heterosexual Men in South Africa
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Tivani P. Mashamba-Thompson, Ayesha Bm Kharsany, Andile Mtshali, Desmond Kuupiel, and Nonzwakazi P Ntombela
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education.field_of_study ,030505 public health ,biology ,Transmission (medicine) ,business.industry ,Population ,Psychological intervention ,Human immunodeficiency virus (HIV) ,General Medicine ,biology.organism_classification ,Hiv risk ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Tanzania ,Medicine ,030212 general & internal medicine ,Thematic analysis ,0305 other medical science ,education ,business ,Inclusion (education) ,Demography - Abstract
BACKGROUND: The interaction of HIV risks in sexual networks remains unclear in South Africa. We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review. METHODS & ANALYSIS: Literature searches were conducted on seven online databases. Two reviewers independently screened articles against the inclusion criteria and performed a Kappa coefficient test to evaluate the degree of agreement on article selection. Thematic content analysis and a Mixed Method Appraisal Tool version 2018 were used to present the narrative account of the outcomes and to assess the risk of bias on included studies. RESULTS: Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks. All studies that were included were published between 2006 and 2016. The participants were aged 13 years and above and comprised of sero-discordant couples, HIV patients, and male and female in the general population. These studies were conducted in multiple diverse regions including South Africa, Senegal, Uganda, Malawi, Kenya, Tanzania, Botswana and Zambia. Evidence showed that age and sexual partnerships were most commonly identified attributes to either HIV infection and/or transmission risks in men. While other biological and behavioral data were reported, the results were not specific to men. DISCUSSION: The impact of age and sexual partnerships are poorly understood and the data available limit inferences to South African men. Limited empiric evidence of HIV risk among men impacts on the design, development and tailoring of HIV prevention interventions to alter the trajectory.
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- 2019
128. Trends in HIV Prevention, Treatment, and Incidence in a Hyperendemic Area of KwaZulu-Natal, South Africa
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Ayesha B. M. Kharsany, Lara Lewis, Kaymarlin Govender, Adrian Puren, Amy Herman-Roloff, Salim S. Abdool Karim, Gavin George, Cherie Cawood, Natasha Samsunder, Carlos Toledo, Karidia Diallo, Eduan Wilkinson, Quarraisha Abdool Karim, Nonhlanhla Yende-Zuma, Cheryl Baxter, David Khanyile, Tulio de Oliveira, Sean Beckett, Savathree Madurai, Kassahun Ayalew, and Mary Glenshaw
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Adult ,Male ,Adolescent ,Endemic Diseases ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,law.invention ,Cohort Studies ,Condoms ,Young Adult ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Condom ,Risk Factors ,law ,Interquartile range ,HIV Seropositivity ,parasitic diseases ,medicine ,Humans ,030212 general & internal medicine ,Viral suppression ,Original Investigation ,030304 developmental biology ,0303 health sciences ,business.industry ,Research ,Incidence ,Incidence (epidemiology) ,1. No poverty ,virus diseases ,General Medicine ,Middle Aged ,Viral Load ,Retention rate ,Health Surveys ,3. Good health ,Online Only ,Infectious Diseases ,Anti-Retroviral Agents ,Circumcision, Male ,Cohort ,Female ,business ,Follow-Up Studies ,Demography ,Cohort study - Abstract
This community-based cohort study examines trends in coverage of HIV prevention and treatment programs and HIV incidence among adults in the hyperendemic area of KwaZulu-Natal, South Africa., Key Points Question What are the trends in the coverage of HIV prevention and treatment programs and HIV incidence in a hyperendemic area of KwaZulu-Natal, South Africa? Findings This community-based cohort study of 2 sequential surveys in 9812 and 10 236 respondents showed that HIV incidence in young women (aged 15-19 years) declined significantly from 4.63 to 2.74 per 100 person-years, but declines were marginal or remained unchanged among men and women in other age groups. In parallel, the uptake of medical male circumcision, knowledge of HIV-positive status, antiretroviral therapy, and viral suppression increased. Meaning These findings suggest that, to further reduce HIV incidence, prevention and treatment program coverage must be intensified and scaled up., Importance In Africa, the persistently high HIV incidence rate among young women is the major obstacle to achieving the goal of epidemic control. Objective To determine trends in coverage of HIV prevention and treatment programs and HIV incidence. Design, Setting, and Participants This cohort study consisted of 2 sequential, community-based longitudinal studies performed in the Vulindlela and Greater Edendale area in KwaZulu-Natal, South Africa. Participants enrolled from June 11, 2014, to June 22, 2015 (2014 survey), with a single follow-up visit from June 24, 2016, to April 3, 2017 (2016 cohort), or enrolled from July 8, 2015, to June 7, 2016 (2015 survey), with a single follow-up visit from November 7, 2016, to August 30, 2017 (2017 cohort). Men and women aged 15 to 49 years were enrolled in the 2014 and 2015 surveys, and HIV-seronegative participants aged 15 to 35 years were followed up in the 2016 and 2017 cohorts. Analysis was conducted from January 1 through December 31, 2018. Exposures HIV prevention and treatment programs in a real-world, nontrial setting. Main Outcomes and Measures Trends in sex- and age-specific HIV incidence rates, condom use, voluntary medical male circumcision, knowledge of HIV-seropositive status, uptake of antiretroviral therapy, and viral suppression. Results A total of 9812 participants (6265 women [63.9%]; median age, 27 years [interquartile range, 20-36 years]) from 11 289 households were enrolled in the 2014 survey, and 10 236 participants (6341 women [61.9%]; median age, 27 years [interquartile range, 20-36 years]) from 12 247 households were enrolled in the 2015 survey. Of these, 3536 of 4539 (annual retention rate of 86.7%) completed follow-up in the 2016 cohort, and 3907 of 5307 (annual retention rate of 81.4%) completed follow-up in the 2017 cohort. From 2014 to 2015, condom use with last sex partner decreased by 10% from 24.0% (n = 644 of 3547) to 21.6% (n = 728 of 3895; P = .12) in men and by 17% from 19.6% (n = 1039 of 6265) to 16.2% (n = 871 of 6341; P = .002) in women. Voluntary medical male circumcision increased by 13% from 31.9% (1102 of 3547) to 36.1% (n = 1472 of 3895); P = .007) in men, and the proportion of women reporting that their partner was circumcised increased by 35% from 35.7% (n = 1695 of 4766) to 48.2% (n = 2519 of 5207; P
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- 2019
129. Perceived HIV-related stigma among university students in South Africa: implications for HIV testing
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Ayesha B. M. Kharsany, Thulasizwe John. Buthelezi, Firoza Haffejee, and Brendan Maughan-Brown
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,Adolescent ,Universities ,Social Stigma ,Human immunodeficiency virus (HIV) ,Stigma (botany) ,HIV Infections ,Hiv testing ,barriers, community, discrimination, HIV/AIDS, perceptions, perceived stigma, stigmatising attitudes, young people ,Social Environment ,medicine.disease_cause ,Ambulatory Care Facilities ,South Africa ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Surveys and Questionnaires ,Virology ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Students ,Perceived stigma ,Stereotyping ,030505 public health ,Public Health, Environmental and Occupational Health ,HIV ,virus diseases ,General Medicine ,medicine.disease ,Care Continuum ,Infectious Diseases ,Female ,Perception ,0305 other medical science ,Psychology ,Hiv related stigma ,Clinical psychology - Abstract
HIV-related stigma, and particularly perceived stigma, has a negative impact across the HIV care continuum. This study adds to our understanding of stigma by assessing how perceived stigma varies from one context to another and how such differences are associated with the location where individuals would prefer an HIV test. We used self-administered questionnaire data (n = 378) obtained from a convenience sample of students (18 years and older) attending a tertiary education institution in Durban, South Africa. Perceived stigma in the university environment was compared to perceived stigma in the home community environment. Multiple logistic regression analysis tested whether a higher level of perceived stigma in one setting was associated with a preference for HIV testing in the other setting. While levels of symbolic stigma and discrimination were low, a large proportion of the sample perceived that people living with HIV experience some form of stigmatisation in the home community and university environments (47% vs 41%, p = 0.09). A total of 31% reported less perceived stigma in the university environment. Students who perceived less stigma in the university environment were significantly more likely to report a preference for HIV testing at the university clinic rather than at a clinic in their community (aOR: 2.03; p < 0.01). Perceptions common across settings that people living with HIV experience stigmatisation are of great concern, especially for efforts to increase demand for HIV testing among young people. Results suggest that HIV-testing services in environments perceived to be less stigmatising than home communities could provide preferred alternatives for HIV testing.Keywords: barriers, community, discrimination, HIV/AIDS, perceptions, perceived stigma, stigmatising attitudes, young people
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- 2018
130. HIV Risk Among Adolescent Girls and Young Women in Age-Disparate Partnerships: Evidence From KwaZulu-Natal, South Africa
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Cherie Cawood, Meredith Evans, Sean Beckett, Gavin George, Ayesha B. M. Kharsany, David Khanyile, Lara Lewis, and Brendan Maughan-Brown
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,MEDLINE ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Hiv risk ,Article ,03 medical and health sciences ,South Africa ,Young Adult ,0302 clinical medicine ,Risk Factors ,Political science ,parasitic diseases ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Young adult ,Incidence (epidemiology) ,Incidence ,Hiv incidence ,Age Factors ,Middle Aged ,Viral Load ,030112 virology ,Disease control ,Infectious Diseases ,Sexual Partners ,Family medicine ,Female ,Kwazulu natal - Abstract
Evidence on the role of age-disparate partnerships in high HIV-infection rates among young women in sub-Saharan Africa remains inconclusive. This study examined the HIV-infection risk associated with age-disparate partnerships among 15- to 24-year-old women in a hyperendemic setting in South Africa.Face-to-face questionnaire, and laboratory HIV and viral load data were collected during 2014-2015 among a representative sample (15-49 years old) in KwaZulu-Natal. The association between age-disparate partnerships (age difference ≥5 years) and HIV status among 15- to 24-year-old women (N = 1459) was assessed using multiple logistic regression analyses. Data from the male sample on all on-going partnerships (N = 1229) involving 15- to 24-year-old women were used to assess whether young women's age-disparate male partners were more likely to have a viral load ≥1000 copies per milliliter, a marker of HIV-infection risk.Women reporting an age disparity in any of their 3 most recent partnerships were more likely to test HIV positive compared to women with only age-similar partners [adjusted odds ratio (aOR): 1.58, 95% confidence interval (CI): 1.20 to 2.09, P0.01]. Among partnerships men reported with 15- to 24-year-old women, the age-disparate male partners were more likely to be HIV positive and have a viral load ≥1000 copies per milliliter (aOR: 2.05, 95% CI: 1.30 to 3.24, P0.01) compared with age-similar partners. Results were similar for each category of age disparity: partners 5-9 years older (aOR: 2.01, 95% CI: 1.18 to 3.43, P = 0.010) and those ≥10 years older (aOR: 2.17, 95% CI: 1.01-4.66, P = 0.048).Results indicate that age-disparate partnerships increase young women's HIV risk, although conclusive evidence was not ascertained. Interventions addressing risk from age-disparate sexual partnering, including expanding antiretroviral treatment among older partners, may help to reduce HIV incidence among young women.
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- 2018
131. Age-disparate partnerships and HSV-2 among adolescent girls and young women in South Africa: implications for HIV infection risk
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Sean Beckett, Ayesha B. M. Kharsany, David Khanyile, Lara Lewis, Brendan Maughan-Brown, Meredith Evans, Gavin George, and Cherie Cawood
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Adult ,Male ,Infection risk ,Adolescent ,Herpesvirus 2, Human ,Sexual Behavior ,Human immunodeficiency virus (HIV) ,HIV Infections ,Dermatology ,030312 virology ,HIV Antibodies ,medicine.disease_cause ,Antibodies, Viral ,Article ,03 medical and health sciences ,symbols.namesake ,Household survey ,South Africa ,Young Adult ,0302 clinical medicine ,Risk Factors ,parasitic diseases ,medicine ,Humans ,030212 general & internal medicine ,Poisson regression ,Prevalence ratio ,0303 health sciences ,Herpes Genitalis ,business.industry ,Hiv incidence ,Age Factors ,Questionnaire data ,Infectious Diseases ,Cross-Sectional Studies ,Sexual Partners ,symbols ,Female ,business ,Demography - Abstract
ObjectiveThere is an urgent need to understand high HIV-infection rates among young women in sub-Saharan Africa. While age-disparate partnerships have been characterised with high-risk sexual behaviours, the mechanisms through which these partnerships may increase HIV-risk are not fully understood. This study assessed the association between age-disparate partnerships and herpes simplex virus type-2 (HSV-2) infection, a factor known to increase HIV-infection risk.MethodsCross-sectional face-to-face questionnaire data, and laboratory HSV-2 and HIV antibody data were collected among a representative sample in the 2014/2015 household survey of the HIV Incidence Provincial Surveillance System in KwaZulu-Natal, South Africa. Among 15–24-year-old women who reported having ever had sex (n=1550), the association between age-disparate partnerships (ie, male partner ≥5 years older) and HSV-2 antibody status was assessed using multivariable Poisson regression models with robust variance. Analyses were repeated among HIV-negative women.ResultsHSV-2 prevalence was 55% among 15–24-year-old women. Women who reported an age-disparate partnership with their most recent partner were more likely to test HSV-2 positive compared with women with age-similar partners (64% vs 51%; adjusted prevalence ratio (aPR):1.19 (95% CI 1.07 to 1.32, pConclusionsResults indicate that age-disparate partnerships are associated with a greater risk of HSV-2 among young women. These findings point towards an additional mechanism through which age-disparate partnerships could increase HIV-infection risk. Importantly, by increasing the HSV-2 risk, age-disparate partnerships have the potential to increase the HIV-infection risk within subsequent partnerships, regardless of the partner age-difference in those relationships.
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- 2018
132. Beyond syndromic management: Opportunities for diagnosis-based treatment of sexually transmitted infections in low- and middle-income countries
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Ayesha B. M. Kharsany, Bhavna. Maharaj, Natasha Samsunder, Nireshni Mitchev, Andrew Gibbs, Salim S. Abdool Karim, Farzana Osman, Emily. Norman, Koleka Mlisana, Ravesh Singh, Hope Ngobese, Nigel Garrett, Anne Rompalo, Adrian Mindel, and Nivashnee Naicker
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RNA viruses ,0301 basic medicine ,Epidemiology ,lcsh:Medicine ,Pilot Projects ,Pathology and Laboratory Medicine ,medicine.disease_cause ,Geographical locations ,South Africa ,Gonorrhea ,0302 clinical medicine ,Immunodeficiency Viruses ,Surveys and Questionnaires ,Prevalence ,Prospective Studies ,030212 general & internal medicine ,Chlamydia ,Young adult ,Prospective cohort study ,lcsh:Science ,Reproductive health ,Trichomonas Vaginalis ,Multidisciplinary ,Obstetrics ,Eukaryota ,HIV diagnosis and management ,Protists ,Bacterial Pathogens ,3. Good health ,Infectious Diseases ,Sexual Partners ,Treatment Outcome ,Chlamydia Trachomatis ,HIV epidemiology ,Medical Microbiology ,Point-of-Care Testing ,Viral Pathogens ,Viruses ,Cohort ,Trichomonas ,Female ,Pathogens ,Bacterial vaginosis ,Trichomonas Vaginitis ,Research Article ,Adult ,medicine.medical_specialty ,Urology ,030106 microbiology ,Sexually Transmitted Diseases ,Microbiology ,Young Adult ,03 medical and health sciences ,Bacterial Vaginosis ,Retroviruses ,medicine ,Humans ,Microbial Pathogens ,Poverty ,Medicine and health sciences ,Bacteria ,Genitourinary Infections ,business.industry ,Lentivirus ,lcsh:R ,Organisms ,Biology and Life Sciences ,HIV ,Chlamydia Infections ,medicine.disease ,Diagnostic medicine ,Africa ,Trichomonas vaginalis ,lcsh:Q ,People and places ,business ,Chlamydia trachomatis - Abstract
Introduction In light of the limited impact the syndromic management approach has had on the global sexually transmitted infection (STI) epidemic, we assessed a care model comprising point-of-care (POC) STI testing, immediate treatment, and expedited partner therapy (EPT) among a cohort of young women at high HIV risk in South Africa. Methods and findings HIV negative women presenting for STI care underwent POC testing for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), and swabs were sent for NG culture and susceptibility testing. Results were available within 2 hours and women with STIs were immediately treated and offered EPT packs, including medication, condoms, and information for sexual partners. An EPT questionnaire was administered after one week, and women retested for STIs after 6 and 12 weeks. 267 women, median age 23 (IQR 21–26), were recruited and 88.4% (236/267) reported genital symptoms. STI prevalence was CT 18.4% (95%CI 13.7–23.0), NG 5.2% (95%CI 2.6–7.9) and TV 3.0% (95%CI 1.0–5.0). After 12 weeks, all but one NG and two CT infections were cleared. No cephalosporin-resistant NG was detected. Of 63/267 women (23.6%) diagnosed with STIs, 98.4% (62/63) were offered and 87.1% (54/62) accepted EPT. At one week 88.9% (48/54) stated that their partner had taken the medication. No allergic reactions or social harms were reported. Of 51 women completing 6-week follow up, detection rates were lower amongst women receiving EPT (2.2%, 1/46) compared to those who did not (40.0%, 2/5), p = 0.023. During focus group discussions women supported the care model, because they received a rapid, specific diagnosis, and could facilitate their partners’ treatment. Conclusions POC STI testing and EPT were acceptable to young South African women and their partners, and could play an important role in reducing STI reinfection rates and HIV risk. Larger studies should evaluate the feasibility and cost-effectiveness of implementing this strategy at population level.
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- 2018
133. The new buzz: Investigating the antimicrobial interactions between bioactive compounds found in South African propolis
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Kharsany, K., primary, Viljoen, A., additional, Leonard, C., additional, and van Vuuren, S., additional
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- 2019
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134. Does voluntary medical male circumcision protect against sexually transmitted infections among men and women in real-world scale-up settings? Findings of a household survey in KwaZulu-Natal, South Africa
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Davis, Stephanie, primary, Toledo, Carlos, additional, Lewis, Lara, additional, Maughan-Brown, Brendan, additional, Ayalew, Kassahun, additional, and Kharsany, Ayesha B M, additional
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- 2019
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135. Coital frequency and condom use in age-disparate partnerships involving women aged 15 to 24: evidence from a cross-sectional study in KwaZulu-Natal, South Africa
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George, Gavin, primary, Maughan-Brown, Brendan, additional, Beckett, Sean, additional, Evans, Meredith, additional, Cawood, Cherie, additional, Khanyile, David, additional, Govender, Kaymarlin, additional, and Kharsany, Ayesha BM, additional
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- 2019
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136. Age-disparate partnerships and HSV-2 among adolescent girls and young women in South Africa: implications for HIV infection risk
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Maughan-Brown, Brendan, primary, George, Gavin, additional, Beckett, Sean, additional, Evans, Meredith, additional, Lewis, Lara, additional, Cawood, Cherie, additional, Khanyile, David, additional, and Kharsany, Ayesha B M, additional
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- 2019
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137. Moderate-to-High Levels of Pretreatment HIV Drug Resistance in KwaZulu-Natal Province, South Africa
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Chimukangara, Benjamin, primary, Kharsany, Ayesha B.M., additional, Lessells, Richard J., additional, Naidoo, Kogieleum, additional, Rhee, Soo-Yon, additional, Manasa, Justen, additional, Gräf, Tiago, additional, Lewis, Lara, additional, Cawood, Cherie, additional, Khanyile, David, additional, Diallo, Karidia, additional, Ayalew, Kassahun A., additional, Shafer, Robert W., additional, Hunt, Gillian, additional, Pillay, Deenan, additional, Abdool, Salim Karim, additional, and de Oliveira, Tulio, additional
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- 2019
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138. Burden of Sexually Transmitted Infections (STI) in Rural and Peri-Urban KwaZulu-Natal, South Africa: Findings from a Population-Based Household Survey
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Kharsany, Ayesha, primary, McKinnon, Lyle R., additional, Lewis, Lara, additional, Cawood, Cherie, additional, Khanyile, David, additional, Maseko, Domiciled Venessa, additional, Goodman, Tawni C., additional, Beckett, Sean, additional, Govender, Kaymarlin, additional, George, Gavin, additional, Ayalew, Kassahun Abere, additional, and Toledo, Carlos, additional
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- 2019
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139. Poor rates of linkage to HIV care and uptake of treatment after home-based HIV testing among newly diagnosed 15-to-49 year-old men and women in a high HIV prevalence setting in South Africa.
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Maughan-Brown, Brendan, Beckett, Sean, Kharsany, Ayesha B. M., Cawood, Cherie, Khanyile, David, Lewis, Lara, Venkataramani, Atheendar, and George, Gavin
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DIAGNOSIS of HIV infections ,HIV infections & psychology ,HIV infection epidemiology ,ATTITUDE (Psychology) ,COMMUNITY health services ,CONFIDENCE intervals ,CONTINUUM of care ,DIAGNOSTIC services ,FEAR ,HEALTH services accessibility ,HIV infections ,PSYCHOLOGY of HIV-positive persons ,LONGITUDINAL method ,MEDICAL appointments ,MEN'S health ,THERAPEUTICS ,TIME ,WOMEN'S health ,ANTIRETROVIRAL agents ,EARLY medical intervention ,PATIENTS' attitudes ,HOME diagnostic tests ,DESCRIPTIVE statistics ,ODDS ratio ,ATTITUDES toward illness - Abstract
Early antiretroviral therapy (ART) initiation is essential, but linkage to care following community-based services is often poor, and inadequately understood. This study examined factors influencing linkage to care following home-based HIV-testing services (HBHTS) in a hyper-endemic setting in South Africa. HBHTS was offered to participants (N = 10,236) enrolled in the second HIV Incidence Provincial Surveillance System survey (2015–2016), KwaZulu-Natal. Follow-up telephone surveys with 196 of the 313 individuals diagnosed HIV-positive through HBHTS were used to measure linkage to care (i.e., a clinic visit within 12 weeks) and ART-initiation. Among newly diagnosed individuals (N = 183), 55% linked to care, and 21% of those who were ART-eligible started treatment within 12 weeks. Linkage to care was less likely among participants who had doubted their HIV-diagnosis (aOR:0.46, 95%CI: 0.23–0.93) and more likely among participants who had disclosed their HIV-status (aOR:2.31, 95%CI: 1.07–4.97). Reasons for not linking to care included no time (61%), only wanting to start treatment when sick (48%), fear of side-effects (33%), and not believing the HIV-diagnosis (16%). Results indicate that HBHTS needs to be paired with targeted interventions to facilitate early linkage to care. Interventions are required to counter denial of HIV status and facilitate early linkage to care among healthier individuals. [ABSTRACT FROM AUTHOR]
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- 2021
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140. Misdiagnosis of HIV infection during a South African community-based survey: implications for rapid HIV testing
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Cherie Cawood, Lara Lewis, Zawadi. Chipeta, Tendesayi Kufa, Alfred Bere, Mary Glenshaw, Anna Christina. Grobler, David Khanyile, Adrian Puren, and Ayesha B. M. Kharsany
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,HIV Positivity ,030106 microbiology ,False positives and false negatives ,Population ,specificity ,Context (language use) ,HIV Infections ,Sensitivity and Specificity ,antibody testing ,03 medical and health sciences ,South Africa ,Young Adult ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Surveys and Questionnaires ,parasitic diseases ,False positive paradox ,Medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,misdiagnosis ,Diagnostic Errors ,education ,Mass screening ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,AIDS Serodiagnosis ,HIV ,medicine.disease ,sensitivity ,Confidence interval ,3. Good health ,Infectious Diseases ,Cross-Sectional Studies ,Immunology ,HIV-1 ,Female ,Other ,business ,Algorithms ,Research Article - Abstract
Introduction : We describe the overall accuracy and performance of a serial rapid HIV testing algorithm used in community-based HIV testing in the context of a population-based household survey conducted in two sub-districts of uMgungundlovu district, KwaZulu-Natal, South Africa, against reference fourth-generation HIV-1/2 antibody and p24 antigen combination immunoassays. We discuss implications of the findings on rapid HIV testing programmes. Methods : Cross-sectional design: Following enrolment into the survey, questionnaires were administered to eligible and consenting participants in order to obtain demographic and HIV-related data. Peripheral blood samples were collected for HIV-related testing. Participants were offered community-based HIV testing in the home by trained field workers using a serial algorithm with two rapid diagnostic tests (RDTs) in series. In the laboratory, reference HIV testing was conducted using two fourth-generation immunoassays with all positives in the confirmatory test considered true positives. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value and false-positive and false-negative rates were determined. Results : Of 10,236 individuals enrolled in the survey, 3740 were tested in the home (median age 24 years (interquartile range 19–31 years), 42.1% males and HIV positivity on RDT algorithm 8.0%). From those tested, 3729 (99.7%) had a definitive RDT result as well as a laboratory immunoassay result. The overall accuracy of the RDT when compared to the fourth-generation immunoassays was 98.8% (95% confidence interval (CI) 98.5–99.2). The sensitivity, specificity, positive predictive value and negative predictive value were 91.1% (95% CI 87.5–93.7), 99.9% (95% CI 99.8–100), 99.3% (95% CI 97.4–99.8) and 99.1% (95% CI 98.8–99.4) respectively. The false-positive and false-negative rates were 0.06% (95% CI 0.01–0.24) and 8.9% (95% CI 6.3–12.53). Compared to true positives, false negatives were more likely to be recently infected on limited antigen avidity assay and to report antiretroviral therapy (ART) use. Conclusions : The overall accuracy of the RDT algorithm was high. However, there were few false positives, and the sensitivity was lower than expected with high false negatives, despite implementation of quality assurance measures. False negatives were associated with recent (early) infection and ART exposure. The RDT algorithm was able to correctly identify the majority of HIV infections in community-based HIV testing. Messaging on the potential for false positives and false negatives should be included in these programmes. Keywords HIV; antibody testing; sensitivity; specificity; misdiagnosis (Published: 29 August 2017) Kufa T et al. Journal of the International AIDS Society 2017, 20 :21753 http://www.jiasociety.org/index.php/jias/article/view/21753 | http://dx.doi.org/10.7448/IAS.20.7.21753
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- 2017
141. P4.115 High uptake of effective expedited partner therapy among young women with sti and their partners in south africa
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Ayesha B. M. Kharsany, Hlengiwe Shozi, Nigel Garrett, Hope Ngobese, Bhavna. Maharaj, Nontobeko Ngubane, Noluthando Ngomane, Andrew Gibbs, Farzana Osman, Adrian Mindel, and Anne Rompalo
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Gynecology ,medicine.medical_specialty ,Chlamydia ,business.industry ,Hiv incidence ,Pharmacy ,Partner notification ,medicine.disease ,Hiv risk ,High uptake ,Family medicine ,medicine ,Drug side effects ,business ,Index case - Abstract
Introduction Expedited Partner Therapy (EPT) for STIs delivered by the index case or through pharmacies has been implemented in some settings in the US. In South Africa, partner notification through the provision of a contact card to the patient reminding the partner to seek treatment has been unsuccessful (partner treatment rates of 17%). Here, we explored the feasibility and acceptability of index case delivered EPT among young women in a high HIV incidence setting. Methods HIV negative women, aged 18–40 years were screened for chlamydia, gonorrhoea (Xpert CT/NG) and trichomonas (OSOM) at an urban primary health care clinic. Women with STIs were treated with stat doses of antibiotics and were offered EPT packs, which included medication, condoms and an information leaflet for the current partner(s). An EPT questionnaire was administered telephonically one week later, and women were reviewed in clinic after 6 and 12 weeks. Results: A total of 267 women, median age 23 (IQR 21–27), were screened and 63 (23.6%) were diagnosed with a STI. Of these, 62/63 (98.4%) were offered and 54/62 (87.1%) accepted EPT for their regular partner. Two women chose EPT for one additional casual partner. At telephonic follow-up 47/54 (87.0%) stated that they had successfully delivered EPT, i.e. the partner ingested the medication either observed 41/54 (75.9%) or unobserved 6/54 (11.1%). Only five women (9.2%) still had to deliver EPT and one partner refused. Some women reported that they (17.5%) or their partners (4.8%) experienced minor drug side effects consistent with antibiotic profiles, but no allergic reactions or social harms were reported. Of the first 53 women completing follow up reinfection rates were lower amongst women receiving EPT (1/47, 2.1%) compared to those not receiving EPT (2/6, 33.3%), p=0.031. Conclusion EPT uptake among young South African women and their partners was high and could play an important role in reducing reinfection rates and HIV risk. Larger studies should evaluate the feasibility of implementing this strategy at population level. Support: This work was co-funded by the South African Medical Research Council and the NIH (AI116759)
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- 2017
142. P3.166 High chlamydia and bacterial vaginosis burden in hiv epicentre in south africa
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Anne Rompalo, Koleka Mlisana, Nivashnee Naicker, N Ngubane, Farzana Osman, Adrian Mindel, Ayesha B. M. Kharsany, Nireshni Mitchev, Nigel Garrett, Jessica Naidoo, Natasha Samsunder, H Ngobese, N Dlamini, and N Ngomane
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Vaginal discharge ,medicine.medical_specialty ,GeneXpert MTB/RIF ,Chlamydia ,biology ,Obstetrics ,Vaginal flora ,business.industry ,Trichomonas ,030204 cardiovascular system & hematology ,biology.organism_classification ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,medicine.symptom ,Bacterial vaginosis ,business ,Cohort study ,Sex work - Abstract
Introduction As long as syndromic management of sexually transmitted infections (STI) remains the main model of care in low and middle income countries, diagnostic surveillance is essential for STI control, especially in high HIV incidence settings. Here, we present the baseline data from the CAPRISA 083 cohort study that was conducted in a large urban primary health care clinic in KwaZulu-Natal, South Africa. Methods Women aged 18–40 presenting for syndromic STI care at the facility were assessed for participation. HIV positive women (prevalence 39.1%), pregnant women (9.1%) or those engaging in sex work were excluded due to pre-determined eligibility criteria. Women consenting to the study completed a sexual risk questionnaire, were examined by a nurse, and underwent point-of-care testing for chlamydia and gonorrhoea (Xpert CT/NG), trichomonas (OSOM rapid test), and microscopy to assess for bacterial vaginosis (BV) and candida. Gonorrhoea cases were further investigated for antibiotic resistance. Results A total of 267 women, median age 23 (IQR 21–27), were enrolled and 88.4% reported to be symptomatic. All were sexually active and 75.7% stated that they used condoms with their partners, although only 3.7% used them consistently. 125 (46.8%) had abnormal pelvic examinations, including 106 (39.7%) women with vaginal discharge. STI testing revealed an 18.5% prevalence of chlamydia (20.5% in Conclusion In this high HIV incidence setting, the burden of chlamydia infection and abnormal vaginal flora was concernedly high, warranting enhanced STI management strategies at population level. Support: This work was NIH-funded (AI116759). Cepheid loaned two 4-module Genexpert machines to the study team free-of-charge, but did not contribute to the preparation of this abstract
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- 2017
143. Additional file 4: Table S2. of The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol
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Nonzwakazi Ntombela, Tivani Mashamba-Thompson, Andile Mtshali, Voce, Anna, and Kharsany, Ayesha
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Charting summary table. (DOCX 11Â kb)
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- 2017
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144. Additional file 2: Table S1. of The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol
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Nonzwakazi Ntombela, Tivani Mashamba-Thompson, Andile Mtshali, Voce, Anna, and Kharsany, Ayesha
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Framework for determining eligibility of research questions. (DOCX 13Â kb)
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- 2017
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145. Additional file 1: of The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol
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Nonzwakazi Ntombela, Tivani Mashamba-Thompson, Andile Mtshali, Voce, Anna, and Kharsany, Ayesha
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PRISMA-P checklist. (DOCX 29Â kb)
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- 2017
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146. Additional file 3: Figure S1. of The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol
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Nonzwakazi Ntombela, Tivani Mashamba-Thompson, Andile Mtshali, Voce, Anna, and Kharsany, Ayesha
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PRISMA chart of data extraction. PRISMA chart allows for transparent reporting of systematic reviews and meta-analysis. Data will be extracted at various stages of the chart through screening titles, abstracts, and full text. Articles failing to meet the inclusion criteria will be excluded at any stage of screening. (PDF 272Â kb)
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- 2017
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147. The Impact of Conditional Cash Transfers in Reducing HIV in Adolescent Girls and Boys (RHIVA): The CAPRISA 007 Matched Pair, Cluster Randomised Controlled Trial
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Quarraisha Abdool Karim, Kerry L Leask, Ayesha B. M. Kharsany, Fanelesibonge Ntombela, and Hilton Humphries
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Cash transfers ,medicine.medical_specialty ,030505 public health ,High prevalence ,business.industry ,education ,Human immunodeficiency virus (HIV) ,Behavioural intervention ,medicine.disease_cause ,Disease cluster ,Matched pair ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,medicine ,Physical therapy ,030212 general & internal medicine ,Cluster randomised controlled trial ,Hiv status ,0305 other medical science ,business - Abstract
The CAPRISA 007 trial, was a pilot, proof of concept, matched pair cluster randomised control trial evaluating the impact of conditional cash transfers to reduce HIV and HSV-2 acquisition in adolescent high-school students. The trial enrolled Grades 9 and 10 learners regardless of age, gender or HIV status from 14 randomly selected secondary schools in rural KwaZulu-Natal. The baseline bio-behavioural assessments highlight the overall high prevalence of HIV and Herpes simplex-2 (HSV-2) infections with notable age–sex differences in both infections in adolescent girls compared to their male peers. This chapter describes the rationale, study design and experiences of conducting the CAPRISA 007 trial that assessed the impact of a cash-incentivised multi-component structural and behavioural intervention for HIV and HSV-2 prevention in high-school learners in rural KwaZulu-Natal.
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- 2017
148. HIV Infection in High School Students in Rural South Africa: Role of Transmissions Among Students
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Gethwana Mahlase, Salim S. Abdool Karim, Simon A. Travers, Natasha Samsunder, Carolyn Williamson, Thulasizwe John. Buthelezi, Janet A. Frohlich, Ayesha B. M. Kharsany, Rachael C. Dellar, Quarraisha Abdool Karim, Nonhlanhla Yende-Zuma, and Jinny C. Marais
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Male ,Rural Population ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Epidemiology ,Cross-sectional study ,Immunology ,Population ,Developing country ,HIV Infections ,Polymerase Chain Reaction ,South Africa ,Risk Factors ,Virology ,medicine ,Humans ,Child ,Students ,education ,Phylogeny ,DNA Primers ,education.field_of_study ,Pregnancy ,Base Sequence ,Transmission (medicine) ,business.industry ,Odds ratio ,medicine.disease ,Confidence interval ,Infectious Diseases ,HIV-1 ,Female ,Rural area ,business ,Demography - Abstract
In South Africa, adolescents constitute a key population at high risk of HIV acquisition. However, little is known about HIV transmission among students within schools. This study was undertaken to assess the risk factors for HIV infection and the extent of transmission among rural high school students. Between February and May 2012, consenting students from five randomly selected public sector high schools in rural KwaZulu-Natal participated in an anonymous cross-sectional survey. Dried blood spot samples were collected and tested for HIV. β-Human chorionic gonadotropin (βHCG) levels were measured in females for pregnancy. Family circumstances as well as sociodemographic and behavioral factors were assessed as potential risk factors. A subset (106/148, 72%) of HIV-positive samples underwent gag p17p24 sequencing for phylogenetic analysis. A total of 3,242 students (81.7% of enrolled students) participated. HIV prevalence was 6.8% [95% confidence interval (CI) 3.9–9.8%] in girls and 2.7% (CI 1.6–3.8%) in boys [adjusted odds ratio (aOR)=3.0, CI 2.4–3.8; p
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- 2014
149. Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: a community-wide phylogenetic study
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de Oliveira,Tulio, Kharsany, Ayesha B M, Gräf, Tiago, Cawood, Cherie, Khanyile, David, Grobler, Anneke, Puren, Adrian, Madurai, Savathree, Baxter, Cheryl, Abdool Karim, Quarraisha, and Abdool Karim, Salim S
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Summary Background The incidence of HIV infection in young women in Africa is very high. We did a large-scale community-wide phylogenetic study to examine the underlying HIV transmission dynamics and the source and consequences of high rates of HIV infection in young women in South Africa. Methods We did a cross-sectional household survey of randomly selected individuals aged 15–49 years in two neighbouring subdistricts (one urban and one rural) with a high burden of HIV infection in KwaZulu-Natal, South Africa. Participants completed structured questionnaires that captured general demographic, socioeconomic, psychosocial, and behavioural data. Peripheral blood samples were obtained for HIV antibody testing. Samples with HIV RNA viral load greater than 1000 copies per mL were selected for genotyping. We constructed a phylogenetic tree to identify clusters of linked infections (defi ned as two or more sequences with bootstrap or posterior support ≥90% and genetic distance ≤4·5%). Findings From June 11, 2014, to June 22, 2015, we enrolled 9812 participants, 3969 of whom tested HIV positive. HIV prevalence (weighted) was 59·8% in 2835 women aged 25–40 years, 40·3% in 1548 men aged 25–40 years, 22·3% in 2224 women younger than 25 years, and 7·6% in 1472 men younger than 25 years. HIV genotyping was done in 1589 individuals with a viral load of more than 1000 copies per mL. In 90 transmission clusters, 123 women were linked to 103 men. Of 60 possible phylogenetically linked pairings with the 43 women younger than 25 years, 18 (30·0%) probable male partners were younger than 25 years, 37 (61·7%) were aged 25–40 years, and fi ve (8·3%) were aged 41–49 years: mean age diff erence 8·7 years (95% CI 6·8–10·6; p linked pairings with the 56 women aged 25–40 years, the age diff erence dropped to 1·1 years (95% CI –0·6 to 2·8; p=0·111). 16 (39·0%) of 41 probable male partners linked to women younger than 25 years were also linked to women aged 25–40 years. Of 79 men (mean age 31·5 years) linked to women younger than 40 years, 62 (78·5%) were unaware of their HIV-positive status, 76 (96·2%) were not on antiretroviral therapy, and 29 (36·7%) had viral loads of more than 50 000 copies per mL. Interpretation Sexual partnering between young women and older men, who might have acquired HIV from women of similar age, is a key feature of the sexual networks driving transmission. Expansion of treatment and combination prevention strategies that include interventions to address age-disparate sexual partnering is crucial to reducing HIV incidence and enabling Africa to reach the goal of ending AIDS as a public health threat. Funding President’s Emergency Program for AIDS Relief, US Centers for Disease Control and Prevention, South African Medical Research Council, and MAC AIDS Fund.
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- 2016
150. Does voluntary medical male circumcision protect against sexually transmitted infections among men and women in real-world scale-up settings? Findings of a household survey in KwaZulu-Natal, South Africa
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Lara Lewis, Kassahun Ayalew, Stephanie M. Davis, Brendan Maughan-Brown, Carlos Toledo, and Ayesha B. M. Kharsany
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medicine.medical_specialty ,Cross-sectional study ,prevention strategies ,030231 tropical medicine ,Prevalence ,cross-sectional survey ,Men who have sex with men ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,030212 general & internal medicine ,Reproductive health ,Transmission (medicine) ,business.industry ,Research ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,medicine.disease ,3. Good health ,community-based survey ,Syphilis ,business ,Demography - Abstract
IntroductionMale circumcision (MC) confers partial protection to men against HIV and, in research settings, some sexually transmitted infections (STIs). It is also associated with protection from some STIs among female partners. However, real-world data on changes in STI transmission associated with large-scale public African medical male circumcision (MMC) conducted for HIV prevention are lacking and would improve estimates of the health impact of MMC.MethodsThe HIV Incidence Provincial Surveillance System is a community-based surveillance platform for HIV prevalence, incidence and intervention coverage trends in KwaZulu-Natal province, South Africa. HIPPS collected cross-sectional self-reported data on circumcision status (from men), partner circumcision status for past three partners (from women) and demographic characteristics and behavioural risk factors; and tested participants for HIV, herpes simplex virus type 2 (HSV-2), syphilis, hepatitis B, Neisseriagonorrhoeae, Chlamydiatrachomatis, Trichomonasvaginalis and Mycoplasmagenitalium. Bivariable and multivariable analyses were performed on associations between own (men) or partner’s (women) circumcision status and each STI. Multivariable analyses adjusted for age, demographic characteristics and behavioural risk factors, and incorporated false discovery rate (FDR) correction.ResultsAmong men, MMC had a protective association with HSV-2 (OR 0.66, 95% CI 0.50 to 0.86), hepatitis B (OR 0.53, 95% CI 0.30 to 0.95), HIV (OR 0.50, 95% CI 0.38 to 0.65) and M.genitalium (OR 0.53, 95% CI 0.32 to 0.88). Among women, partner circumcision had a protective association with HSV-2 (OR 0.71, 95% CI 0.53 to 0.95) and HIV (OR 0.66, 95% CI 0.49 to 0.90). Associations with HIV and HSV-2 remained significant for men and all women after FDR correction.ConclusionThese real-world data, supporting protective associations between MMC conducted for HIV prevention and STIs in men and women, can help clarify the full impact of MMC and support a role in broader sexual health programming.
- Published
- 2019
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