Search

The article focuses on the impact of the COVID-19 pandemic on HIV-related prevention and treatment services, particularly among the Latina/o/x population. It mentions the pandemic disrupted HIV testing, treatment, and prevention efforts, with declines in testing, PrEP prescriptions, and new HIV diagnoses. It highlights despite policy interventions that improved access to services through telehealth and home delivery.

There is growing evidence of the association between gender-based violence and HIV from the perspective and experiences of women. The purpose of this study is to examine these associations from the perspective of young men living in Dar es Salaam, Tanzania. A community-based sample of 951 men were interviewed, of whom 360 had sex in the past 6 months and were included in these analyses. Almost a third of the men (29.2%) reported that they had been physically violent at least once with an intimate partner. Men who reported more lifetime sexual partners (OR = 8.75; 95% CI = 2.65, 28.92), experienced physical violence as a child at home (OR = 1.73; 95% CI = 1.09, 2.76), and were more educated (OR = 1.91; 95% CI = 1.18, 3.11) were significantly more likely to report perpetrating violence. These associations persisted after adjusting for other variables. These data from the perspective of young men reinforce earlier findings from women that HIV risk and violence are occurring together in relationships of young adults. Interventions are needed to identify men at high risk for HIV and engage them in interventions that are designed to change norms and behaviors related to power and control with their sexual partners. (Contains 2 tables.)

There is growing evidence of the association between gender-based violence and HIV from the perspective and experiences of women. The purpose of this study is to examine these associations from the perspective of young men living in Dar es Salaam, Tanzania. A community-based sample of 951 men were interviewed, of whom 360 had sex in the past 6 months and were included in these analyses. Almost a third of the men (29.2%) reported that they had been physically violent at least once with an intimate partner. Men who reported more lifetime sexual partners (OR = 8.75; 95% CI = 2.65, 28.92), experienced physical violence as a child at home (OR = 1.73; 95% CI = 1.09, 2.76), and were more educated (OR = 1.91; 95% CI = 1.18, 3.11) were significantly more likely to report perpetrating violence. These associations persisted after adjusting for other variables. These data from the perspective of young men reinforce earlier findings from women that HIV risk and violence are occurring together in relationships of young adults. Interventions are needed to identify men at high risk for HIV and engage them in interventions that are designed to change norms and behaviors related to power and control with their sexual partners.

Poverty is associated with numerous poor health outcomes. Youth unemployment in Tanzania is approximately 13.7%, and concentrates in urban areas. These youth lack relevant job skills and access to financial capital. Microfinance continues to be implemented globally to address poverty, and increasingly has been linked to health interventions. Men less frequently are recipients of microfinance loans. We offered microcredit to young men in an area of Dar es Salaam with high poverty as part of a randomised controlled-trial to assess the efficacy of a microfinance and health leadership intervention in preventing STI acquisition. We used mixed methods to understand predictors of successful loan repayment. Our qualitative sub-study showed that leader influence, prior business experience, personal motivation, and planning facilitated repayment. Using a modified Poisson approach, our quantitative analysis showed that successful repayment was associated with business experience, education, increasing number of children, community of residence, percentage of network members trained in business, and repayment success of peer leaders. Our results suggest that enforcing group accountability and repayment rules, offering ongoing training, and using successful entrepreneurs as role models could increase repayment success in similar populations. These strategies could provide financial opportunity for men while minimising risk for microfinance institutions. [ABSTRACT FROM AUTHOR]

We describe and compare the baseline rates of victimization and perpetration of three forms of intimate partner violence (IPV)—psychological, physical, and sexual—among sexually active men (n = 1,113) and women (n = 226) enrolled in an ongoing cluster-randomized HIV and gender-based violence prevention trial in Dar es Salaam, Tanzania. IPV was measured using a modified version of the World Health Organization Violence Against Women instrument. We assess the degree to which men and women report overlapping forms of IPV victimization and perpetration. Sociodemographic and other factors associated with increased risk of victimization and perpetration of IPV are examined. Within the last 12 months, 34.8% of men and 35.8% of women reported any form of IPV victimization. Men were more likely than women to report perpetrating IPV (27.6% vs. 14.6%, respectively). We also found high rates of co-occurrence of IPV victimization and perpetration with 69.7% of male perpetrators and 81.8% of female perpetrators also reporting victimization during the last year. Among men, having ever consumed alcohol and experiencing childhood violence were associated with increased risk of most forms of IPV. Younger women were more likely to report perpetrating IPV than older women. We found evidence of gender symmetry with regard to most forms of IPV victimization, but men reported higher rates of IPV perpetration than women. Given the substantial overlap between victimization and perpetration reported, our findings suggest that IPV may be bidirectional within relationships in this setting and warrant further investigation. Implications for interventions are discussed. [ABSTRACT FROM AUTHOR]

Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analysed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection, and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomised trial of the microfinance and peer health leadership intervention. [ABSTRACT FROM AUTHOR]