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Background: Social network-based interventions can improve uptake of health interventions. However, limited evidence exists on their feasibility and acceptability in fishing community settings. We assessed the feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing (HIVST) intervention among men in Uganda. Methods: The PEer-led HIVST intervention for MEN (PEST4MEN) is a pilot intervention conducted among men in Kalangala and Buvuma districts. Baseline data were collected in July 2022 and follow-up data in September 2022. The intervention was implemented through 22 trained lay men ("peer-leaders") who received training in HIVST use and distribution processes and requested to refer at least 20 male members from their social networks for study eligibility screening. To be eligible, men had to be aged 15 years or older with unknown or HIV-negative status. After the baseline interview, men were requested to pick two oral fluid-based HIVST kits from their peer-leaders. The intervention was deemed feasible if peer-leaders gave-out > 80% of the kits and acceptable if > 80% of the kits' recipients used them to self-test for HIV. At the follow-up interview, newly diagnosed HIV-positive men were asked if they had linked to HIV care. Data were descriptively analyzed using STATA version 16.0. Results: Of 475 screened men, 400 (84.2%) met the eligibility criteria and completed the baseline interview. Of these, 56.7% (n = 227) were engaged in fishing or fishing-related activities. At follow-up, 361 men (90.2%) were interviewed; 98.3% (n = 355) received at least one kit from their peer-leaders. Nearly all (99.1%, n = 352) kits' recipients used them to self-test for HIV. Of the 352 HIV self-testers, 51 men (14.5%) had reactive (positive) HIV self-test results. Nearly one-third of the HIV self-tested men (31.4%, n = 16) were first-time HIV-positive testers. Of these, 87.5% (n = 14) went for confirmatory HIV testing, 50.0% (n = 7) were confirmed as HIV-positive and 71.4% (n = 5) were linked to HIV care. Conclusion: Our peer-led HIVST intervention was feasible and acceptable and identified newly diagnosed HIV-positive men who were linked to HIV care. However, while these results are promising, we recommend additional research in a randomized controlled trial prior to the eventual roll-out of this intervention. Trial registration: ClinicalTrials.Gov: NCT05685498 (retrospectively registered on January 17, 2023). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had far-reaching effects on various sectors globally, including fisheries in Africa. This review examines the effect of the pandemic on fisheries and the livelihoods of fishermen in Africa, analyzing the specific challenges faced by fishermen in Africa due to COVID-19 and exploring the implications for their livelihoods. It seeks to identify potential solutions and recommendations for policymakers and stakeholders in the fisheries sector. A review of existing literature involved academic databases: PubMed, Google Scholar, Scopus, and Web of Science. Institutional reports: FAO (Food and Agriculture Organization), the World Bank, and the African Development Bank; reports from national fisheries departments; and NGOs reports such as WWF (World Wildlife Fund) and Greenpeace. Findings indicate that supply chain disruptions caused delays in transportation and increased spoilage, while market closures and reduced demand led to income losses and increased operational costs for fishermen. Small-scale fishermen were particularly facing severe economic hardships, food insecurity, and a decline in fish production. Innovative policy responses, such as government support programs and community resilience-building initiatives, have been critical in mitigating these impacts. Government interventions included financial aid, subsidies, and the provision of fishing gear, while community resilience strategies focused on livelihood diversification and strengthening local governance. Policy measures should enhance market access, provide financial assistance, promote alternative livelihood strategies, develop targeted support programs for fishermen to address the specific challenges faced by fishermen during the pandemic, and prioritize livelihood safeguarding and sustainable fisheries management. [ABSTRACT FROM AUTHOR]

Abstract Background Social network-based interventions can improve uptake of health interventions. However, limited evidence exists on their feasibility and acceptability in fishing community settings. We assessed the feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing (HIVST) intervention among men in Uganda. Methods The PEer-led HIVST intervention for MEN (PEST4MEN) is a pilot intervention conducted among men in Kalangala and Buvuma districts. Baseline data were collected in July 2022 and follow-up data in September 2022. The intervention was implemented through 22 trained lay men (“peer-leaders”) who received training in HIVST use and distribution processes and requested to refer at least 20 male members from their social networks for study eligibility screening. To be eligible, men had to be aged 15 years or older with unknown or HIV-negative status. After the baseline interview, men were requested to pick two oral fluid-based HIVST kits from their peer-leaders. The intervention was deemed feasible if peer-leaders gave-out > 80% of the kits and acceptable if > 80% of the kits’ recipients used them to self-test for HIV. At the follow-up interview, newly diagnosed HIV-positive men were asked if they had linked to HIV care. Data were descriptively analyzed using STATA version 16.0. Results Of 475 screened men, 400 (84.2%) met the eligibility criteria and completed the baseline interview. Of these, 56.7% (n = 227) were engaged in fishing or fishing-related activities. At follow-up, 361 men (90.2%) were interviewed; 98.3% (n = 355) received at least one kit from their peer-leaders. Nearly all (99.1%, n = 352) kits’ recipients used them to self-test for HIV. Of the 352 HIV self-testers, 51 men (14.5%) had reactive (positive) HIV self-test results. Nearly one-third of the HIV self-tested men (31.4%, n = 16) were first-time HIV-positive testers. Of these, 87.5% (n = 14) went for confirmatory HIV testing, 50.0% (n = 7) were confirmed as HIV-positive and 71.4% (n = 5) were linked to HIV care. Conclusion Our peer-led HIVST intervention was feasible and acceptable and identified newly diagnosed HIV-positive men who were linked to HIV care. However, while these results are promising, we recommend additional research in a randomized controlled trial prior to the eventual roll-out of this intervention. Trial registration ClinicalTrials.Gov: NCT05685498 (retrospectively registered on January 17, 2023).

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

This article provides perspectives on the graying of the fleet and research efforts to understand it in Alaska fisheries, discusses recent abrupt multifaceted challenges faced by Alaskan fishermen, and compares divergent public perceptions and support programs for farmers and fishermen in the United States. Equity concerns have seen a resurgence in academic and policy realms and the graying of the fleet is now a common example of distributional inequity, yet despite in-depth research attention on the issue, few substantive programmatic modifications have been made to address it in Alaska. Aging trends in United States fisheries have typically been framed as one of changing aspirational preferences. Research suggests coastal youth do desire and highly value fishing careers, but structural and financial barriers limit opportunities for new generations. The precarity of the fishing industry was highlighted in 2023 with sudden global seafood market instability, rising interest rates and operating costs, destabilized geopolitical tensions, and hastening climate change impacts. This recent industry turmoil disproportionately impacts those on the margins and adds an additional layer of complexity to addressing graying of the fleet trends. Unlike in fisheries, there are numerous federal programs to support young farmers and the agricultural industry. This paper calls for proactive and comprehensive measures to stabilize and support fishing communities and the viability of next generation pathways amidst recent fishing industry market turmoil and longer term inequities in fishery governance. [ABSTRACT FROM AUTHOR]

Transdisciplinary approaches combining technical perspectives with qualitative insights from the social sciences and non-academic stakeholders have emerged as a promising way to address the complexity of current socioenvironmental crises. However, transdisciplinary incorporation of diverse interests, knowledge, and worldviews requires acknowledging and addressing inherent inequities. Our case study combines two complementary transdisciplinary studies, the first conducted by a biologist/ecologist being trained in inter- and transdisciplinary methods at the time of the study, applying a quick participatory diagnosis in a fishing community, while the second is conducted by a social scientist studying the research group itself. Our results allow an exploration of the challenges and possibilities of navigating from transdisciplinary ideals to practical implementation. Our findings highlight the importance of nurturing relationships built on care, reciprocity, and openness to address the power imbalances inherent in university-community participatory practices. We suggest that the community's autonomy and agency can be preserved while actively engaging its members in the transdisciplinary process, alleviating power differences and fostering a collaborative and equitable transdisciplinary framework. Overall, we emphasize the significance of integrating participatory methods, critical reflexivity, and attention to power dynamics in realizing the potential of transdisciplinary approaches for addressing complex conservation challenges and fostering meaningful community engagement. [ABSTRACT FROM AUTHOR]

Copyright of O Social em Questão is the property of Faculdades Catolicas - Pontificia Universidade Catolica do Rio de Janeiro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The fragility of coastal fishing localities in southern Mexico faces a series of threats that threaten the sustainability of this practice. The objective was to characterize socio-environmental problems and critical points for coastal fishing in the lagoon of Tres Palos, Guerrero, Mexico. The methodology was used with a qualitative approach through grounded theory and participatory cartography, using the techniques of mapping key actors, participatory workshops and expert opinion, the data were analyzed through semantic networks and a collective social map. The results indicated: contamination of water resources, lack of fisheries management and lack of participation and confidence of fishermen, which has caused the uncertainty and vulnerability of coastal communities, overexploitation of fishery resources and degradation of the ecosystem and habitat. It was concluded that socio-ecosystem development for coastal communities requires areas of opportunity that contemplate their participation in decision-making, in order to implement effective public policies to ensure the medium and long-term sustainability of aquatic, terrestrial and coastal zone resources as a whole. [ABSTRACT FROM AUTHOR]

Through commercial fishing, harvesters face elevated physical and financial occupational risk. We examine harvesters' utilization of health insurance to mitigate risk, drawing data from over 2,800 survey responses from US West Coast commercial fishing vessel owners from 2017 and 2020. Respondent health insurance coverage is compared with census county-level Small Area Health Insurance Estimates. We also explore drivers of obtaining health insurance using logistic regression, categorizing drivers as corresponding to either costs or benefits of insurance. Despite elevated occupational risk, we find empirical evidence that health insurance coverage for West Coast commercial vessel owners is lower than the general population of their county-level communities. Respondent health insurance uptake is also found to be primarily driven by variables associated with costs rather than benefits of health insurance, providing evidence against strong adverse selection. These insights provide potential mechanisms for management regimes that could benefit well-being in fishing communities. [ABSTRACT FROM AUTHOR]

Studying fishers and fishing communities' social‐cultural structures is vital in policy‐making concerning local marine ecosystem sustainability. Previous studies on marine communities seldom neglected the role of culture in marine biodiversity conservation, especially a marine protected area (MPA) establishment.This study first explores the cultural practices in coastal communities in Ghana that have the potential for the conservation of the marine ecosystem (MPA); second, it examines the willingness of coastal communities to welcome an MPA establishment.Primary data were collected using focus group discussions with 9 fishermen, key informant interviews with 20 chief fishermen, and self‐administered questionnaires to 491 fishermen across 9 semi‐urban, 2 urban, and 16 villages along the coast of Ghana.Adopting the convergent parallel mixed‐methods research design (quantitative method includes descriptive analysis using tables, charts, diagrams, and χ2 bivariate analysis; and qualitative method involves a narrative format), the study underscored that the socioeconomic characteristics of fishermen are diverse and mixed. Most of the fishermen do not know what an MPA is but are willing to accept an MPA initiative. Certain cultural practices such as the prohibition of gathering certain species, traditional close season, and fishing holidays are found to be conducive to an MPA initiative.These cultural practices should be integrated into an MPA policy. Fisheries practitioners should consider an ecosystem‐based approach (including cultural values) to fisheries management and fishermen should endeavour to learn new skills outside the industry. [ABSTRACT FROM AUTHOR]

Mud crab fishing (Scylla serrata) is an important activity contributing to the livelihood of coastal communities in Mozambique. The abundance of this crab and the increase in international companies in the region that exclusively buy crabs and export to the Asian market have caused fisheries to gain local importance in recent years. The present study evaluates the socioeconomic importance of mud crab fishing and the contribution of this activity to the quality of life (QoL) of the local communities along the Bons Sinais Estuary (BSE)—Mozambique. The study was conducted in three fishing villages of the BSE (Mucupia, Carungo, and Inhangulue) to collect information on the economic and sociocultural structure conditions of the local crab families. Field data collection focuses on direct observation and a semi-structured questionnaire divided into four categories/dimensions: fishing activity (FA), family structure (FS), typology of household expenditure (HE), and other activities (OTA). The socioeconomic conditions of fishers' families were analyzed based on the fishery contribution index (FCI), which comprises different indicators related to FA, HE, and OTA. The monthly fishing revenue ranged from MZN 2.500 (EUR ≈ 35) to MZN 30.000 (EUR ≈ 417), with an average of around MZN 10.796 (EUR ≈ 150) per fisher, slightly exceeding the minimum wage set for public service in Mozambique, which is around MZN 8000 (EUR ≈ 112). The contribution of mud crab fishing is low and is not directly related to enhancement of QoL, meaning that the fishing revenue of mud crabs is barely enough to cover the basic needs of fishers' families, such as basic services and basic goods. Investments are mainly for transport, including bicycles. The FCI was also low, standing at the alert level (FCI = 0.26–0.50) in all three communities. As the crab market is still growing in the country, it is important that the government, through competent authorities, creates public policies to ensure sustainable exploitation, regulates the selling price of mud crabs according to size, as happens in other countries, and promotes basic services that facilitate the self-development of the fishing communities. [ABSTRACT FROM AUTHOR]

This article provides perspectives on the graying of the fleet and research efforts to understand it in Alaska fisheries, discusses recent abrupt multifaceted challenges faced by Alaskan fishermen, and compares divergent public perceptions and support programs for farmers and fishermen in the United States. Equity concerns have seen a resurgence in academic and policy realms and the graying of the fleet is now a common example of distributional inequity, yet despite in-depth research attention on the issue, few substantive programmatic modifications have been made to address it in Alaska. Aging trends in United States fisheries have typically been framed as one of changing aspirational preferences. Research suggests coastal youth do desire and highly value fishing careers, but structural and financial barriers limit opportunities for new generations. The precarity of the fishing industry was highlighted in 2023 with sudden global seafood market instability, rising interest rates and operating costs, destabilized geopolitical tensions, and hastening climate change impacts. This recent industry turmoil disproportionately impacts those on the margins and adds an additional layer of complexity to addressing graying of the fleet trends. Unlike in fisheries, there are numerous federal programs to support young farmers and the agricultural industry. This paper calls for proactive and comprehensive measures to stabilize and support fishing communities and the viability of next generation pathways amidst recent fishing industry market turmoil and longer term inequities in fishery governance.

The problem of low performance of fishing communities in producing capture fisheries is generally related to the low quality of the capital ships used. This research aims to reveal the factors that caused the emergence of innovation in the business of assembling fiberglass fishing ships, the level of business development, and its impact on improving the socio-economic performance of fishing communities in rural areas. The research sample included small fishing communities and a group of fishermen who had built a business assembling fiberglass fishing ships in Bengkulu Selatan Regency. Because the data collected is mostly in the form of qualitative data, the analysis method used is a descriptive-qualitative method supported by statistical analysis methods. The results indicate that the emergence of innovation in assembling fiberglass fishing ships is driven by evidence highlighting the superior quality of fiberglass over wood in ship construction. The growth of the fiberglass ship assembly business is evident through its expanding market reach and increased sales turnover. Qualitatively, the study demonstrates that the innovation in assembling fiberglass ships has a positive impact on the socio-economic performance of fishermen, manifested through improved workability, heightened work motivation, and increased capture fisheries production. Three key recommendations emerge from the findings: (1) Stakeholders should consistently support the sustainability of fiberglass ship assembly businesses; (2) Relevant agencies are encouraged to actively contribute to the substantial development of the fiberglass ship assembly sector; and (3) Fishing communities greatly benefit from socialization, empowerment, literacy, and education programs.

We investigate the impact of health insurance subsidies on a US commercial fishing fleet. Prior to the passage of the Affordable Care Act, members of North Carolina's fleet showed different preferences for the private purchase of health insurance, with higher-income and offshore-active commercial fishermen disproportionately likely to have health insurance and pay private insurance premiums. We find that the act has largely eliminated that disparity. Lower-income and inshore commercial fishermen are now largely caught up to the rest of the fleet in terms of insurance coverage. We propose that the act's subsidies for insurance premiums are the cause of these changes. [ABSTRACT FROM AUTHOR]

In Southeastern Brazil, artisanal fishing communities reside, operate and suffer from interference originating from various economic branches. Thus, this study is aimed at identifying the critical points concerning the practice of artisanal fishing from the traditional knowledge of artisanal fishers in the coastal mesoregion of ES. 102 ethnographic interviews were conducted in 2022 with artisanal fishers through a semistructured questionnaire containing both open and closed questions. The critical points of fishing were identified through a SWOT analysis (strengths, weaknesses, opportunities, and threats). All the participants were men (n=102; 100%), and they reported that negative critical points (weaknesses and threats) exert the greatest influence on fishing. From the perspective of these fishers, the main problems that interfere with artisanal fishing are the lack of adequate fish storage, the precariousness of the vessels, the reduction in fish stocks, the high perishability of fish, the devaluation of traditional knowledge, and the presence of middlemen that prevent the commercialization of fish production from moving directly from the fisher to the final consumer. The identification of these critical points enables the recognition of flaws in the production chain and the realization that they can be minimized through public policies and comanagement strategies related to the economic, ecological, and social development of the sector. [ABSTRACT FROM AUTHOR]

Understanding and anticipating the effects of climate change on fisheries social-ecological systems (FSESs) is central to proactive fisheries management in a changing global climate. With fisheries management increasingly striving to consider interactions and feedbacks among people, targeted species, and the broader ecological and human communities, fisheries managers and participants need tools to help them assess these complex systems. We developed a new climate vulnerability assessment framework for analyzing the impacts of a climate-induced trend or event on a FSES. The framework divides the FSES into four interrelated and interacting domains: Ecological Community, Fished Species, Fishery, and Human Community. The framework provides a systematic approach to account for indirect as well as direct effects, links among subsystems, and multiple climate change-induced stressors. We demonstrate the framework’s utility by applying it to three case studies: the effects of a marine heatwave on the Dungeness crab FSES, the effects of a marine heatwave on the red sea urchin FSES, and the effects of long-term climate trends on North Pacific albacore. We found that the effects of a climatic trend or event on a FSES are often indirect and can trigger diverse and important feedbacks. These examples also showed that the climatic trend or event may cause changes in the temporal and spatial distribution of fishing effort and fished species that have a more significant impact on the FSES than changes to species abundance per se. Unlike other climate vulnerability assessment frameworks and applications, ours is designed to enable consideration of the range of feedbacks within and among both the ecological and human communities. As such, it is a valuable tool to guide the holistic examination and assessment of potential impacts to FSESs.

Commercial, recreational, and indigenous fisheries are critical to coastal economies and communities in the United States. For over three decades, the federal government has formally recognized the impact of fishery disasters via federal declarations. Despite these impacts, national syntheses of the dynamics, impacts, and causes of fishery disasters are lacking. We developed a nationwide Federal Fishery Disaster database using National Oceanic and Atmospheric Administration (NOAA) fishery disaster declarations and fishery revenue data. From 1989-2020, there were 71 federally approved fishery disasters (eleven are pending), which spanned every federal fisheries management region and coastal state in the country. To date, we estimate fishery disasters resulted in $2B (2019 USD) in Congressional allocations, and an additional, conservative estimate of $3.2B (2019 USD) in direct revenue loss. Despite this scale of impact, the disaster assistance process is largely ad hoc and lacks sufficient detail to properly assess allocation fairness and benefit. Nonetheless, fishery disasters increased in frequency over time, and the causes of disasters included a broad range of anthropogenic and environmental factors, with a recent shift to disasters now almost exclusively caused by extreme environmental events (e.g., marine heatwaves, hurricanes, and harmful algal blooms). Nationwide, 84.5% of fishery disasters were either partially or entirely attributed to extreme environmental events. As climate change drives higher rates of such extreme events, and as natural disaster assistance requests reach an all-time high, the federal system for fisheries disaster declaration and mitigation must evolve in order to effectively protect both fisheries sustainability and societal benefit.

Small-scale fisheries are globally important to food security, nutrition, culture, ecosystem health, and livelihoods for millions of people. They also face considerable ecological, and economic pressures, including climate change, privatization, and top-down decision-making. Historically, processes of exclusion (e.g. industrialization, market forces, and settler colonialism) have persisted in the global food system. To mitigate against such processes and protect the livelihoods and human rights of small-scale fishers, the socially responsible seafood movement has emerged. This paper examines the local relationships in a seafood value chain in Indonesia, which extends from village fishers to international export markets. We present a case study from Sumbawa Indonesia, where a foreign direct seafood exporter is focused on sourcing socially responsible seafood from waters worked by small-scale fishers. Applying a systems lens, we analyse how a system driven by market forces and underpinned by western values can integrate with a system driven by traditional customs, social ties, and trust. The findings demonstrate that social connections and feedbacks within the value chain play a key role. Systems thinking reveals pathways to help synergize the two systems. This research shows that to deliver on the promise of socially responsible seafood, better understanding is needed of the interconnected social, cultural, and economic ties of small-scale fishers. [ABSTRACT FROM AUTHOR]

Fish is readily available to fishing communities. Given the high nutritional value of fish, these communities are expected to have better nutritional status, compared to non-fishing communities. However, this assumption is not well studied across coastal fishing communities in Ghana. Hence, this cross-sectional study was conducted to investigate the nutritional status, dietary patterns, and fish consumption of children living in coastal fishing communities in Ghana. Nutritional status of 384 randomly selected children was assessed using the mid-upper arm circumference (MUAC) measurement. MUAC less than 12.5 cm was used as the cutoff to identify malnourished children. Food and fish consumption patterns were assessed using an adopted and pretested food frequency questionnaire. The findings showed a prevalence of 0.5% wasting among surveyed children. The mean dietary diversity score (DDS) of the study participants was 4.3 ± 1.2. The mean DDS of the children of fisher mothers was less than that of the children of the female caregivers who are involved in other occupations. However, no significant difference was observed in the DDS across the coastal regions. Seventy eight percent of the children who participated in the study consumed an adequately diversified diet, and more than 40 different small fish species were consumed across the four coastal regions. The average median weekly fish intake among the children in the study sample was 213 (64–468) g. Considering that one-third of the employed respondents were fisherfolk, coupled with the availability of a great diversity of small fish in the communities, the findings of our study suggest that there is great potential to incorporate small fish into strategic interventions aimed at improving nutrition, food security, and achieving economic sustainability in these communities. [ABSTRACT FROM AUTHOR]

Alcohol use, intimate partner violence (IPV) and HIV infection are associated, but few programmes and interventions have addressed their synergistic relationship or been evaluated for effectiveness and acceptability. This is a critical gap in populations with high rates of alcohol use, HIV and IPV, such as Uganda's fishing communities. This study examined drinking norms, barriers and facilitators to engagement in a risk reduction programme, and ideas for tailoring. Results showed that alcohol use is common in fishing villages. While men and women drink, gendered notions of femininity deem alcohol largely unacceptable for women. Plastic sachets of liquor were the most common alcoholic drink. Participants did not understand the definition of 'hazardous drinking', but recognised connections between drinking, violence and sexual risk-taking. The idea of an alcohol, IPV and HIV risk reduction intervention was supported, but barriers need to be addressed, including how best to help those uninterested in reducing their drinking, addressing normalisation of drinking and how best to inform those who truly need intervention. Intervention to people living with HIV around the time of diagnosis and treatment may be warranted. Study findings highlight the potential to integrate alcohol and IPV reduction programmes into an HIV service provision.

Abstract Background In countries with mature generalized HIV epidemics such as Uganda, there are still groups of individuals that are disproportionately affected. Among the key populations in Uganda are fishing communities, which make up about 10% of the population. Compared to the general population, HIV prevalence and incidence among individuals living in these communities is high. This high HIV burden has been attributed to several factors including limited access to prevention and treatment services as well as ongoing high-risk sexual behaviour. Methods We investigated the impact of combined HIV prevention interventions on HIV transmission dynamics in high-risk fishing communities in Uganda using a deterministic compartmental model. The model was calibrated to seroprevalence data from a census performed in 2014. To account for remaining uncertainty in the calibrated model parameters, 50 000 simulated scenarios were modelled to investigate the impact of combined prevention interventions. Results The projected HIV incidence decreased from 1.87 per 100 PY without intervention scale-up to 0.25 per 100 PY after 15 years (2014–2029) of intervention scale-up. A potential combination achieving this 87% reduction in incidence over 15 years in Ugandan FCs included condom use in about 60% of sexual acts, 23% of susceptible men circumcised, 87% of people living with HIV aware of their status, 75% of those on ART, and about 3% of susceptible individuals on oral PrEP. Uncertainty analysis revealed relative reductions in incidence ranging from 30.9 to 86.8%. Sensitivity analyses suggested that condom use and early ART were the most important interventions. Conclusion Reducing HIV incidence, as well as prevalence and AIDS-related mortality, in these high-risk fishing communities in Uganda is attainable over 15 years with a combination prevention package. Our projected intervention coverage levels are well within the national targets set by the Uganda government and enable coming close to reaching the UNAIDS 95-95-95 targets to end AIDS as a public health threat by 2030.

Abstract Background Population mobility is a demonstrated barrier to reducing HIV incidence. A clear understanding of social networks and their influence on mobility among women in the fishing communities of Lake Victoria may contribute to tailoring effective interventions that suit the needs of these mobile women. Methods A cross-sectional qualitative methods study was conducted to understand mobility patterns among women resident and or working in fishing communities of Lake Victoria in Kenya, Tanzania, and Uganda. The study was conducted in six fishing communities from March 2018 to June 2019. The communities were purposively selected, based on population size (1000 people or more) and HIV prevalence of > 15% among women aged 18 years or older who had lived in the fishing community for at least six months. In-depth interviews were conducted with 24 key informants and 72 women from the sites in the three countries. Questions focused on women’s social networks and other factors that fuelled or facilitated women’s mobility as well as challenges they faced due to mobility. Data analysis followed a thematic framework approach. Results Different social groupings/networks existed among women in the fishing communities of Lake Victoria. These included female sex workers, women fish processors/traders, women bar workers/owners, restaurant workers, and family networks. Networks encouraged mobility, supporting finding work opportunities, but also increased sexual risks through partner changes. The benefits of networks included information sharing, financial support, and group protection, especially against violence. Conclusion Social networks and groupings among women in the fishing communities of Lake Victoria could be useful in tailoring HIV prevention and HIV care interventions to suit the needs of these highly mobile populations.

Adolescent girls and young women (AGYW) in sub-Saharan Africa experience delayed linkage to and poor retention in HIV care. Identifying and addressing specific barriers in HIV care programming is important to achieving the upgraded UNAIDS 95-95-95 targets and epidemic control. We examined these challenges among 103 HIV-positive AGYW in and out of HIV care in communities around Lake Victoria in western Kenya as part of a larger qualitative study to identify drivers of HIV testing and HIV care utilisation in key populations. We used the social-ecological model to guide development of interview guides. Individual-level barriers included denial and forgetfulness and gendered household responsibilities, medication side effects, especially if taken without food, pills being too big and difficult to swallow and the burden of a daily medication-taking regimen. Interpersonal barriers included troubled family relationships and pervasive fears of stigma and discrimination by friends and family. Communitylevel barriers were stigmatising attitudes toward people living with HIV. Health-system barriers included negative provider attitudes and confidentiality breaches. At the structural level, participants noted high costs due to long travel times to facilities, long clinic waiting times, household food insecurity and school and work commitments. AGYW's limited decision-making autonomy due to age and gender norms, including their reliance on the authority of older adults, makes these barriers especially troubling. Innovative treatment approaches that take into account the unique vulnerabilities of AGYW are urgently needed. [ABSTRACT FROM AUTHOR]

Conservative Japanese politicians, academics, and journalists regularly state that whaling is an essential part of their national heritage, expressed in material culture, folk songs, ritual practices, and festivals. Japan has several whale festivals (kujira matsuri): playful events at which participants re-enact Edo-period (1600–1868) coastal whaling practices and perform whaling-related songs and dances. This article compares the festivals of Taiji (Wakayama), Kayoi (Yamaguchi), Shinkami-gotō (Nagasaki), and Ayukawa (Miyagi). It argues that these festivals not only have economic and social significance for the communities in question; they also support the notion of Japan as a traditional whaling nation. By organising and participating in these festivals, local priests, volunteers, and audiences enact this imagined whaling heritage, thus supporting the agenda of the present-day whaling industry. However, local actors have their own motivations and interests, and in fact the celebration of whaling heritage is not contingent upon the continuation of whaling today. [ABSTRACT FROM AUTHOR]

Fishing communities in Uganda have high rates of excessive alcohol consumption and negative health outcomes related to alcohol consumption, such as HIV acquisition and transmission and intimate partner violence victimization and perpetration. Research lacks understanding of alcohol use in Ugandan fishing communities, underlying reasons for excessive drinking among fishermen or how their community perceives negative health outcomes linked to excessive alcohol consumption. This qualitative study was conducted among Ugandan fisherfolk to determine why excessive alcohol consumption has overtaken their communities. Through analyzing in-depth interviews and focus group discussions, reasons for drinking and community perceptions of drinking were explored using the Socio Ecological Model and the Time Perspective Theory. Interviews were coded into two content themes: social influences on drinking and using alcohol to cope with stress. Participants acknowledged links between excessive alcohol consumption and negative health outcomes within their families and communities. These findings highlight the need for alcohol-related reduction interventions that are sensitive to contextual factors and self-identified contributors to problematic alcohol use within individuals and their communities. Such interventions must consider the social, ecological and economic conditions within fishing sites, focusing not only on individual-level behavioral change but also challenging the underlying structures that foster excessive alcohol consumption.

Appropriate governance structures are extremely important for fishery-dependent communities in developing integrated territorial development strategies and an adaptive capacity for change, including a climate one. This paper assesses to what extent fishery co-management schemes (e.g., fishery LAGs, being regional/local governance instruments in fishing communities) are strengthening sustainability. The latter includes improving energy efficiency, promoting renewable energy sources (RES), coping with the climate crisis, minimizing environmental impacts, and promoting a sustainable blue economy. For detecting the policy aspects of aligning climate neutrality and a sustainable blue economy, the research lens focuses on the Greek Fisheries Local Action Groups (FLAGs), given that these are mostly located in coastal/marine and insular territories with significant blue growth potential. To map and assess their capacity and efficiency in pursuing Green Deal objectives, a co-development process with FLAG managers was put in place. The results and findings of this process reveal the scarcity of sustainability and blue-economy-related strategies. The key conclusion is that a transition to a post-carbon blue economy on a local level requires an understanding of the evolutionary dynamics of fishery co-management schemes. The latter, being multi-sectoral structures, may boost dialogue and cooperation to harmonize local development strategies and EU policies. Maritime spatial planning (MSP), as an evolutionary governance process itself, can be a driver for making FLAGs evolve and strengthen commonization, blue justice, and equity for fishers. [ABSTRACT FROM AUTHOR]

Background: In countries with mature generalized HIV epidemics such as Uganda, there are still groups of individuals that are disproportionately affected. Among the key populations in Uganda are fishing communities, which make up about 10% of the population. Compared to the general population, HIV prevalence and incidence among individuals living in these communities is high. This high HIV burden has been attributed to several factors including limited access to prevention and treatment services as well as ongoing high-risk sexual behaviour. Methods: We investigated the impact of combined HIV prevention interventions on HIV transmission dynamics in high-risk fishing communities in Uganda using a deterministic compartmental model. The model was calibrated to seroprevalence data from a census performed in 2014. To account for remaining uncertainty in the calibrated model parameters, 50 000 simulated scenarios were modelled to investigate the impact of combined prevention interventions. Results: The projected HIV incidence decreased from 1.87 per 100 PY without intervention scale-up to 0.25 per 100 PY after 15 years (2014–2029) of intervention scale-up. A potential combination achieving this 87% reduction in incidence over 15 years in Ugandan FCs included condom use in about 60% of sexual acts, 23% of susceptible men circumcised, 87% of people living with HIV aware of their status, 75% of those on ART, and about 3% of susceptible individuals on oral PrEP. Uncertainty analysis revealed relative reductions in incidence ranging from 30.9 to 86.8%. Sensitivity analyses suggested that condom use and early ART were the most important interventions. Conclusion: Reducing HIV incidence, as well as prevalence and AIDS-related mortality, in these high-risk fishing communities in Uganda is attainable over 15 years with a combination prevention package. Our projected intervention coverage levels are well within the national targets set by the Uganda government and enable coming close to reaching the UNAIDS 95-95-95 targets to end AIDS as a public health threat by 2030. [ABSTRACT FROM AUTHOR]

Mobility is linked to negative HIV care continuum outcomes. We sought to understand factors associated with short and long term mobility among women in fishing communities in Kenya, Tanzania, and Uganda. From 2018 through 2019 we conducted a cross-sectional survey of women aged 15 years and above, randomly selected from a census of six fishing villages, around Lake Victoria. Data collected included: demographics, risky sexual behaviour on the most recent trip, and travel behaviour in the previous 4 months. Mobility was recorded as any overnight trip outside the participant's village. A two-level multinomial logistic regression model was used to determine the associated factors. A total of 901 participants were enrolled, of whom 645 (71.6%) reported travelling (53.4%; short and 18.2% long term trips). Five factors were associated with long term travel: age, travel purpose, frequency of travel, sexual behaviour while travelling, and destination. Trips made by women aged 46–75 years were less likely to be long term. Long term trips were more common if the trip was to visit, rather than to trade, and more common for women who reported one or two trips rather than three or more trips. Women who made long term trips were more likely to engage in unprotected sex while on a trip. Women who travelled to a regional town/district or another town/district were more likely to take long term trips. The factors associated with travel duration among women living in fishing communities could inform planning of future health care interventions in these communities. [ABSTRACT FROM AUTHOR]

Abstract Background Women’s support can improve uptake of voluntary medical male circumcision (VMMC). We assessed the level of women’s support for VMMC and associated factors in fishing settlements on the shores of Lake Victoria in Uganda, to inform interventions aimed at increasing the uptake of safe male circumcision services in such high-risk populations. Methods We conducted a cross-sectional study, employing mixed methods of data collection, at Kasenyi and Kigungu landing sites in April 2018. We included women aged 18–49 years, who had stayed at the landing sites for ≥3 months. We obtained qualitative data using focus group discussions (FGDs), and interviewer-administered semi-structured questionnaires for quantitative data. The tool captured demographic characteristics, community factors including cultural norms and beliefs, women’s experiences, and health facility-related factors. The dependent variable was derived from the response to the question: "Would you encourage your partner/husband to go for VMMC?", and used as a proxy for support of VMMC. We used modified Poisson regression to identify factors associated with women’s support for VMMC. Qualitative data were analysed using thematic content analysis. Results We enrolled 313 women with a mean age of 28 (SD±6.8) years. Of the 313 women, 230 (73.5%) supported VMMC. Belief that VMMC increases penile hygiene (Adjusted prevalence ratio [aPR]=1.9; CI: 1.8–3.2), performing VMMC for religious reasons (aPR=1.9; CI: 1.8–2.9), preference for a circumcised man (aPR=1.3; CI: 1.2–1.5), belief that vaginal fluids facilitate wound healing (aPR=1.9; CI: 1.3–2.7), and knowledge about when a man can resume sex (4 weeks) after circumcision (aPR=2.1; CI: 1.8–3.3) were associated with women’s support for VMMC. FGDs revealed that women were not adequately involved in VMMC activities for decision making. Conclusion The support for VMMC was high among women in the fishing communities. However, women perceived they were not involved in decision-making for VMMC and had several misconceptions, including a belief that vaginal fluids facilitate wound healing. The Ministry of Health and VMMC implementing partners should devise strategies to increase sensitization and involvement of women in VMMC decision-making without slowing service uptake.

Abstract Introduction Family planning knowledge is poor and use is low in Ugandan fishing communities. We compared the effectiveness of enhanced family planning (FP) education with routine counselling on FP knowledge and use. Methods Individuals aged 15–49 years were randomly assigned to intervention or control arm. The intervention constituted enhanced FP education based on a simplified handout extracted from the WHO FP guidance tool called, “Family planning: A global handbook for FP providers” which participants took home for additional reading. The control arm constituted FP counselling following Uganda Ministry of Health guidelines. FP knowledge score and contraceptive prevalence rate (CPR) were compared between trial arms at baseline and at 12 months. Negative binomial regression models were used to estimate the effect of the intervention on FP knowledge and use. Results Overall, 1410 participants were screened to enrol 1004 (502 per study arm, 48.5% women). Subsequently, 384 (76.5%) and 383 (76.3%) completed the 12 months’ follow-up in the intervention and control arms respectively. At baseline, a median FP knowledge score of 8 and a

Background The chances of developing cervical cancer in Uganda continue to rise especially in the fishing communities due to the relatively higher prevalence of inter-related personal risk factors. This study aimed to examine the Intrapersonal Factors Associated with Cervical Cancer Screening Among Women in Fishing Communities of Entebbe Municipality, Wakiso District. Methodology A descriptive cross-sectional survey study was conducted among women in the fishing communities of Entebbe-Municipality Wakiso district in Central Uganda and utilized quantitative methods of data collection. Data were collected using a structured questionnaire with multiple-response questions. Data were analyzed using SPSS version 25, univariate, bivariate, and multivariate analysis were performed at 5% level significance. Results Of the 293 respondents that were interviewed, only 23.2% of women had ever been screened for cervical cancer. More than three-quarters of them knew that cervical cancer is not curable 234(79.9%). 150(51.2%) women mentioned that the age at the start of screening for cervical cancer in Uganda is 18 years and had 46% less prevalence of cervical cancer screening (cPR = 0.54 [0.33 - 0.90], p = 0.020). Among the perception attributes Cervical cancer screening prevalence was twice as high among women who agreed that cervical cancer is a curse from God (cPR = 2.43 [CI = 1.49 - 3.97], P = 0.000) compared to those who disagreed. Conclusion The intrapersonal factors associated with cervical cancer screening among women in the fishing communities of Entebbe municipality were mainly; marital status, employment status, knowledge of age at the start of the screening, and perceptions of the relevance of screening. Recommendation Communication and education should focus on awareness creation about the fact that even in a marriage where not much risky sexual behavior may be present, the risk of HPV infection remains apparent, for instance from sexually transmitted infections within the couple.

Background: Population mobility is a demonstrated barrier to reducing HIV incidence. A clear understanding of social networks and their influence on mobility among women in the fishing communities of Lake Victoria may contribute to tailoring effective interventions that suit the needs of these mobile women. Methods: A cross-sectional qualitative methods study was conducted to understand mobility patterns among women resident and or working in fishing communities of Lake Victoria in Kenya, Tanzania, and Uganda. The study was conducted in six fishing communities from March 2018 to June 2019. The communities were purposively selected, based on population size (1000 people or more) and HIV prevalence of > 15% among women aged 18 years or older who had lived in the fishing community for at least six months. In-depth interviews were conducted with 24 key informants and 72 women from the sites in the three countries. Questions focused on women’s social networks and other factors that fuelled or facilitated women’s mobility as well as challenges they faced due to mobility. Data analysis followed a thematic framework approach. Results: Different social groupings/networks existed among women in the fishing communities of Lake Victoria. These included female sex workers, women fish processors/traders, women bar workers/owners, restaurant workers, and family networks. Networks encouraged mobility, supporting finding work opportunities, but also increased sexual risks through partner changes. The benefits of networks included information sharing, financial support, and group protection, especially against violence. Conclusion: Social networks and groupings among women in the fishing communities of Lake Victoria could be useful in tailoring HIV prevention and HIV care interventions to suit the needs of these highly mobile populations. [ABSTRACT FROM AUTHOR]

Small-scale fishers and fishing communities have long suffered marginalisation and discrimination in South Africa. New laws and policies promulgated as the result of a court case brought by small-scale fishers, NGOs and academics attempt to rectify this problem. Drawing on the poverty-vulnerability-marginalisation framework, the paper considers whether this regulatory regime reduces vulnerability and marginalisation within the sector as an important precursor to poverty reduction initiatives, such as improved rights allocation. While the new regulatory regime is a step in the right direction, the paper ultimately finds that there are shortcomings in these laws, many of which have been thrown into sharp relief by the rights implementation process and COVID-19 lockdowns. These include narrow eligibility criteria for fishing rights, a lack of substantive solutions when it comes to vulnerable groups, processes insufficient to prevent elite capture, and impediments to the practice of alternative livelihoods. These shortcomings must be addressed through the appropriate expansion of access rights, consultation with fishers and more inclusive drafting, if the contribution of small-scale fisheries to development and poverty reduction in South Africa is to be realised. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer disease in Uganda remains the leading causes of deaths among cancer patients, responsible for about 4,607 deaths annually. Despite the numerous modern treatment options and prevention strategies, cervical cancer screening prevalence remains undefined especially in the fishing communities and yet women living in fishing communities are core interest groups for cervical cancer due to their relatively higher risk of HIV and HPV infections. Methodology: A cross-sectional study employing a quantitative approach was performed, purposive sampling following a household survey was conducted. Structured interviews and questionnaires were administered to collect data from June 2021 to August 2021. Data were analyzed in SPSS version 25 using the log-binomial model. Results: prevalence of cervical cancer screening among women in fishing communities of Entebbe municipality, Wakiso district remains as low as 23.2%, mainly unsatisfactory among the married women (aPR = 0.232 [0.13 - 0.43], p < 0.001) and, Catholics (aPR = 0.050 [0.01 - 0.18], p < 0.001). At the same time, higher cervical cancer screening prevalence was observed among employed women (aPR= 2.81 [1.48 - 5.33], p = 0.002), those who had prior recommendation from healthcare workers (aPR = 1.25 [0.09 - 0.65], p = 0.004), and those who perceived that cervical cancer is a curse from God (cPR = 2.800 [CI = 1.798 - 4.36], P = 0.000). Conclusion: Cervical cancer screening is low among women in fishing communities of Entebbe municipality; only 2 in every 10 women have ever been screened for cervical cancer in their lifetime, while less than 1 in 10 had to follow-up of screening. Recommendation: Behavior change communication preferably using the intrapersonal channel on issues related to cervical cancer screening should be adopted in the fishing communities urgently if we are to elevate the uptake of this secondary prevention measure for cervical cancer.

Poor marital satisfaction is associated with high-risk sexual behavior and HIV transmission. We tested whether a counselor-led couple education and counseling intervention dubbed Waya (paternal aunt) would improve marital satisfaction and reduce HIV risk behavior among married couples in Kisumu County, western Kenya. In a pre–post design, we enrolled 60 heterosexual married couples at high risk for HIV to undergo five 1-h couple education and counseling sessions over 56 days. We collected self-reported data on marital satisfaction, the number of sex partners, and condom use with extramarital partners at pre- and post-intervention visits. We used Wilcoxon and McNemar tests to examine the association of our intervention with marital relationship satisfaction and reduction in HIV risk sexual behavior. The intervention was associated with marital relationship satisfaction score improvement from a median of 5 (interquartile range [IQR], 4–5) to 6 (IQR, 6–7) among men and 4 (IQR, 3–5) to 6 (IQR, 5–6) among women (p <.01). The intervention was also associated with reducing HIV risk sexual behaviors depicted by a reduction in the number of sex partners in the past one month and an increase in consistent extramarital condom use. The number of sex partners reduced from a median of 2 (IQR, 1–2) to 1 (IQR, 1–2) and consistent extramarital condom use increased from 4% at baseline to 56% among men. Our intervention was associated with improvements in marital relationship satisfaction and reductions in HIV high-risk behaviors necessary for achieving epidemic control in HIV hotspots such as fishing communities in western Kenya. [ABSTRACT FROM AUTHOR]

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The Mid-Barataria Sediment Diversion (MBSD) project, located in Barataria Bay, Southeast Louisiana, is one of the most ambitious coastal restoration projects in U.S. history. The MBSD project is designed to convey sediment-rich water from the Mississippi River through the levee system and into the coastal marshes of the Barataria basin. The MBSD project is intended to slow, and perhaps even reverse, coastal erosion through alluvial sedimentation and the augmentation of freshwater wetland vegetation communities. In spite of the importance of the MBSD project for the U.S. Army Corps of Engineers and Coastal Protection and Restoration Authority of Louisiana, it is extremely unpopular among coastal communities along the Barataria Bay coast and beyond. Based on our ethnographic research in Lower Plaquemines Parish, we provide some insights concerning why this level of opposition exists. Above all, the MBSD project is perceived as highly threatening to key marine fish species targeted by small-scale commercial fishers, especially shrimp (Farfantepenaeus aztecus and Litopenaeus setiferus) and oysters (Crassostrea virginica). Small-scale fishing is crucially important to the social and economic systems involved in risk buffering and community resilience, as well as a key feature of social identity and source of profound place attachment. While planning for the MBSD project has considered impacts to coastal communities in strictly financial and environmental terms, it has failed to adequately consider its potential social and social-psychological consequences among coastal communities. [ABSTRACT FROM AUTHOR]

As a member of the “High Level Panel for a Sustainable Ocean Economy”, Mexico has committed to expand community-based marine conservation. We draw from more than two decades of experience to outline how existing resources may be leveraged to help inform the country’s ambitious conservation plans. A total of 514.12 km2 have already been protected under community-based marine reserves. 14 years of ecological survey data, more than 130 community surveyors, more than one hundred publications, and an entire digital infrastructure provide a solid platform on which to continue building the community-based marine conservation movement. Parallel and complimentary efforts have advanced regulation, action, data access and transparency, and coordination. Future interventions should innovate, but leverage existing resources and continue to involve communities.

In 2000 Ecuador created the “Agreements of Sustainable Use and Custody of Mangroves” management for the local communities, helping to stop deforestation of mangroves caused by shrimp farming. With this program, the Ecuadorian government offers economic incentives to support community–based management without taking into consideration the essential role of ecosystem services. This policy fails to encourage the capacity of the communities to grow through monitoring of ecosystem services. This project seeks to understand which aspects of ecosystem services should be integrated into the sustainable management of mangroves in order to ensure that current policies lead to a desirable level of exploitation of resources and support mangrove conservation. A total of 96 surveys of stakeholders were conducted in three mangrove concessions in the Gulf of Guayaquil located in Cerrito de los Morrenos, Balao, and 6 de Julio. 96% of the stakeholders agreed that mangroves could deliver services or benefits, such as fisheries, nursery grounds for fishers, and climate regulation, which are the services that stakeholders wanted to maintain most. Additionally, 48% of the stakeholders believed that fishery services have declined in recent years. Stakeholders from 6 de Julio expressed significantly more value for a sense of place than those from the other two concessions. However, fishers in all three locations strongly valued maintaining mangroves for future generations. This study found that these two cultural services were most valued by fishing associations that have a strong leadership, motivated members, and a high level of involvement. This may happen because members of fishing associations which have a high participation level have internalized lessons from these activities. Thus, there is a strong case to include ecosystem services approaches in mangrove concession management. This is especially critical as resources continue to decline. Environmental policies should incorporate investment in participatory monitoring in order to strengthen social capital of mangrove concessions and create a strong platform for an adaptive approach to ecosystem management.

Introduction: In Uganda, people living in fishing communities tend to engage in high-risk sexual activity which leads to unintended pregnancies that may end in abortions. Abortion has negative social, psychological, and medical impacts. We determined the frequency of abortion and its correlates among female fisher-folk along Lake Victoria in Uganda. Methods: A cross-sectional survey was conducted among women aged 15– 49 years from Kigungu and Nsazi fishing communities. Data were collected on socio-demographic characteristics, abortion, and family planning use. Associations between abortion and participant characteristics were assessed using logistic regression models. Results: Of the 713 women interviewed, 36, 5% were pregnant and 247, 34.6 % were using contraception. Majority (600, 84.2%) of those interviewed reported ever being pregnant. Approximately 45% of the pregnancies were un-intended while a third of those who had ever been pregnant (195, 32.5%) reported having aborted before. Slightly over a third (247, 34.6%) reported currently using or ever using family planning. Women aged 30+ years were more likely to abort compared to those aged 15-29 years (aOR: 2.7; 95% CI: 1.23-5.91). Women who had living children were less likely to abort compared to those who didn't have any living child (aOR: 0.06; 95% CI: 0.01 – 0.17). Conclusion: The rate of abortion among female fisher-folk in Uganda is substantial. Family planning use is still low and unintended pregnancies are common. Abortion risk increased with the age of the mother. Continuous behavioral change communication and optimization of family planning use are recommended to reduce abortions.

Introduction: Family planning knowledge is poor and use is low in Ugandan fishing communities. We compared the effectiveness of enhanced family planning (FP) education with routine counselling on FP knowledge and use.Methods: Individuals aged 15-49 years were randomly assigned to intervention or control arm. The intervention constituted enhanced FP education based on a simplified handout extracted from the WHO FP guidance tool called, "Family planning: A global handbook for FP providers" which participants took home for additional reading. The control arm constituted FP counselling following Uganda Ministry of Health guidelines. FP knowledge score and contraceptive prevalence rate (CPR) were compared between trial arms at baseline and at 12 months. Negative binomial regression models were used to estimate the effect of the intervention on FP knowledge and use.Results: Overall, 1410 participants were screened to enrol 1004 (502 per study arm, 48.5% women). Subsequently, 384 (76.5%) and 383 (76.3%) completed the 12 months' follow-up in the intervention and control arms respectively. At baseline, a median FP knowledge score of 8 and a < 70% FP knowledge score was observed for all participants with a CPR of 36.8%. At month-12, the median FP knowledge score improved in both arms, higher in the intervention arm than the control arm (46 vs 30; p < 0.001). In the intervention arm, 304 (79.2%) had a score of ≥70 compared with 21 (5.5%) in the control arm (p < 0.001). In the negative binomial regression model, the change in FP knowledge score was 47% higher in the intervention arm than in the control arm (score ratio: 1.47, 95%CI: 1. 43-1.51, p < 0.001). The change in CPR was 16% higher in the intervention arm than in the control arm (Prevalence ratio: 1.16, 95%CI: 1.01-1.34, p < 0.040).Interpretation: Enhanced FP education using a simplified FP education handout was more effective in increasing FP knowledge and use compared to routine FP counselling for people living in fishing communities. Innovative FP education interventions are recommended for improving FP knowledge and optimizing uptake in remote-rural settings where literacy levels are low.Trial Registration: The study was registered by the Pan African Clinical Trial Registry on 03 July 2021 with a Trial Registration Number PACTR202107891858045 . "Retrospectively registered". [ABSTRACT FROM AUTHOR]

Background: Women's support can improve uptake of voluntary medical male circumcision (VMMC). We assessed the level of women's support for VMMC and associated factors in fishing settlements on the shores of Lake Victoria in Uganda, to inform interventions aimed at increasing the uptake of safe male circumcision services in such high-risk populations.Methods: We conducted a cross-sectional study, employing mixed methods of data collection, at Kasenyi and Kigungu landing sites in April 2018. We included women aged 18-49 years, who had stayed at the landing sites for ≥3 months. We obtained qualitative data using focus group discussions (FGDs), and interviewer-administered semi-structured questionnaires for quantitative data. The tool captured demographic characteristics, community factors including cultural norms and beliefs, women's experiences, and health facility-related factors. The dependent variable was derived from the response to the question: "Would you encourage your partner/husband to go for VMMC?", and used as a proxy for support of VMMC. We used modified Poisson regression to identify factors associated with women's support for VMMC. Qualitative data were analysed using thematic content analysis.Results: We enrolled 313 women with a mean age of 28 (SD±6.8) years. Of the 313 women, 230 (73.5%) supported VMMC. Belief that VMMC increases penile hygiene (Adjusted prevalence ratio [aPR]=1.9; CI: 1.8-3.2), performing VMMC for religious reasons (aPR=1.9; CI: 1.8-2.9), preference for a circumcised man (aPR=1.3; CI: 1.2-1.5), belief that vaginal fluids facilitate wound healing (aPR=1.9; CI: 1.3-2.7), and knowledge about when a man can resume sex (4 weeks) after circumcision (aPR=2.1; CI: 1.8-3.3) were associated with women's support for VMMC. FGDs revealed that women were not adequately involved in VMMC activities for decision making.Conclusion: The support for VMMC was high among women in the fishing communities. However, women perceived they were not involved in decision-making for VMMC and had several misconceptions, including a belief that vaginal fluids facilitate wound healing. The Ministry of Health and VMMC implementing partners should devise strategies to increase sensitization and involvement of women in VMMC decision-making without slowing service uptake. [ABSTRACT FROM AUTHOR]

Abstract Background Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs. Methods We conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Results Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. Conclusion FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

Abstract Background HIV-prevalence and incidence is high in many fishing communities around Lake Victoria in East Africa. In these settings, mobility among women is high and may contribute to increased risk of HIV infection and poor access to effective prevention and treatment services. Understanding the nature and patterns of this mobility is important for the design of interventions. We conducted an exploratory study to understand the nature and patterns of women’s mobility to inform the design of HIV intervention trials in fishing communities of Lake Victoria. Methods This was a cross-sectional formative qualitative study conducted in six purposively selected fishing communities in Kenya, Tanzania and Uganda. Potential participants were screened for eligibility on age (18+ years) and having stayed in the fishing community for more than 6 months. We collected data using introductory and focus group discussions, and in-depth interviews with key informants. Data focused on: history and patterns of mobility, migration in and out of fishing communities and the relationship between mobility and HIV infection. Since the interviews and discussions were not audio-recorded, detailed notes were taken and written up into full scripts for analysis. We conducted a thematic analysis using constant comparison analysis. Results Participants reported that women in fishing communities were highly mobile for work-related activities. Overall, we categorized mobility as travels over long and short distances or periods depending on the kind of livelihood activity women were involved in. Participants reported that women often travelled to new places, away from familiar contacts and far from healthcare access. Some women were reported to engage in high risk sexual behaviour and disengaging from HIV care. However, participants reported that women often returned to the fishing communities they considered home, or followed a seasonal pattern of work, which would facilitate contact with service providers. Conclusion Women exhibited circular and seasonal mobility patterns over varying distances and duration away from their home communities. These mobility patterns may limit women’s access to trial/health services and put them at risk of HIV-infection. Interventions should be tailored to take into account mobility patterns of seasonal work observed in this study.