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Risk Perception Among Hiv Serodiscordant Couples In East Africa Taking Oral Prep For Hiv Prevention
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Book Synopsis Risk Perception Among HIV Serodiscordant Couples in East Africa Taking Oral PrEP for HIV Prevention by : Jennifer J. Carroll
Download or read book Risk Perception Among HIV Serodiscordant Couples in East Africa Taking Oral PrEP for HIV Prevention written by Jennifer J. Carroll and published by . This book was released on 2015 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: Levels of adherence varied across trials for pre-exposure prophylaxis (PrEP) for HIV prevention. One hypothesis for this inconsistency is that low perceived risk of HIV infection drove low adherence in trials where PrEP produced no reduction in risk. Using a mixed methods approach, we explored the level of perceived risk of incident HIV infection in the Partners PrEP Study, in which adherence was generally high. The Partners PrEP Study followed 4747 serodiscordant couples in Kenya and Uganda. A brief cross-sectional survey assessed perceived risk of HIV via questionnaire at 12 months after enrollment. Logistic regression was used to analyze the relationship between perceived risk and demographic variables, sexual behavior, and other objective measures of risk. 3226 couples from the Partners PrEP Study were included in this analysis. Perceived risk was low across the entire study cohort, with only 15.4% of participants reporting high or moderate perceived risk. Participants objectively assessed to be at higher risk for HIV were more likely to report high perceived risk (OR=1.60, 95%CI: 1.30-1.95, p
Book Synopsis Improving Pre-exposure Prophylaxis Delivery for Young Women in Kenya by : Valentine Adhiambo Wanga
Download or read book Improving Pre-exposure Prophylaxis Delivery for Young Women in Kenya written by Valentine Adhiambo Wanga and published by . This book was released on 2020 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt: The rollout of pre-exposure prophylaxis (PrEP) for HIV prevention to priority populations, including young women, is expanding in sub-Saharan Africa. However, existing barriers to PrEP rollout at the individual, community and policy levels could slow progress and impede the success of PrEP implementation programs. In order to achieve success in HIV prevention, it is crucial to address these barriers, particularly among young women, a population especially vulnerable to HIV. In this dissertation, we evaluated the links among risk perception, sexual behavior and PrEP adherence in serodiscordant couples, evaluated the impact of incorporating HIVST in PrEP delivery for young women and assessed the cost of delivering PrEP to young women. In Aim 1, we used data from HIV-negative adults enrolled in a study of PrEP and antiretroviral therapy for HIV-serodiscordant couples in Kenya and Uganda to examine associations between: 1) condom use and risk perception and 2) risk perception and PrEP adherence. In Aim 2, we offered HIV self-testing (HIVST) to young women enrolled in a PrEP implementation study in two family planning clinics and assessed satisfaction with HIV testing and clinic experience, and the impact of HIVST on PrEP delivery procedures. In Aim 3, using the same population as that in Aim 2, we used micro-costing methods to estimate the incremental cost of delivering PrEP to young women. We found that sexual behavior aligned with perceived HIV risk, which can facilitate an HIV-negative individual's decisions about PrEP use. Additionally, we found HIVST to be feasible and acceptable for young women using PrEP, highlighting the need to evaluate its utility to streamline PrEP delivery and provide more testing options for young women on PrEP. Lastly, using practical data from PrEP implementation, we estimated the cost of delivering PrEP to young women, providing valuable data to inform budget impact and cost-effectiveness analyses as well as local resource allocation for scale-up of PrEP delivery to young women. Collectively, these studies addressed some of the barriers to PrEP delivery, proposed solutions to these barriers and drew attention to priority research needs for PrEP delivery to young women.
Book Synopsis New Approaches to HIV Prevention in African HIV Serodiscordant Couples by : Kathryn G. Curran
Download or read book New Approaches to HIV Prevention in African HIV Serodiscordant Couples written by Kathryn G. Curran and published by . This book was released on 2013 with total page 118 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation informs the future implementation of HIV prevention for HIV serodiscordant couples in Africa. The research objectives include: 1) reviewing effective HIV prevention interventions, 2) evaluating the use of daily short message service (SMS, i.e. text message) surveys to measure sex and pre-exposure prophylaxis (PrEP) adherence, and 3) examining the acceptability of initiation of antiretroviral therapy (ART) at higher CD4 counts, a powerful HIV prevention tool. After the necessary first step of HIV testing and counseling, HIV serodiscordant couples may be offered appropriate HIV prevention interventions, including condoms, male circumcision, treatment of sexually transmitted infections, and two recent biomedical strategies: initiation of ART by the HIV-infected partner and PrEP by the HIV-uninfected partner. Importantly, the widespread implementation and effectiveness of HIV prevention interventions requires understanding and encouraging behaviors for acceptance, adherence, and correct use. We conducted a prospective study of HIV-related behaviors and qualitative research to answer key implementation questions regarding the feasibility of PrEP and acceptability of early ART among HIV serodiscordant couples. Within a clinical trial of PrEP, we evaluated the use of daily SMS surveys to examine patterns in sexual behavior and PrEP use. Daily SMS data collection was acceptable, obtained high response rates, and provided an assessment of temporal patterns of HIV risk behaviors and PrEP use over a 60-day period. Participants were more likely to adhere to daily PrEP doses when they were sexually-active, PrEP use was not associated with unprotected sex, and anticipating sex was difficult. In addition, HIV risk behaviors were reported on more days through daily SMS surveys compared to monthly interviewer-administered questionnaires, highlighting the potential of SMS to collect more accurate self-reported data. SMS may offer a new method for measuring and promoting behaviors related to HIV risk and adherence as well as enhancing communication between patients and providers. Qualitative research with HIV serodiscordant couples familiar with HIV prevention methodologies highlighted common perceived advantages and concerns related to early initiation of ART, and an important conceptualization of ART as the "final stage" before dying. This negative meaning of ART initiation poses a challenge to acceptance of early ART and indicates that new messages regarding ART initiation are needed. These new messages should emphasize the benefits of HIV prevention and maintaining good health; acknowledge concerns such as side effects and life-long adherence; and ultimately, portray a positive image of individuals on ART. Social and behavioral factors, in particular sustained adherence as well as individual and community acceptance, will be fundamental to successful implementation of early ART and PrEP and should remain a focus of HIV prevention and treatment
Book Synopsis Evaluating Measures of HIV Risk Perception with a Mixed Method Approach Among Adolescent Girls and Young Women Using PrEP in Kenya by : Murugi Micheni
Download or read book Evaluating Measures of HIV Risk Perception with a Mixed Method Approach Among Adolescent Girls and Young Women Using PrEP in Kenya written by Murugi Micheni and published by . This book was released on 2020 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pre-exposure prophylaxis (PrEP) for HIV prevention is a promising HIV prevention option for young African women. The evidence of effective PrEP use in this population group is mixed, and has been tied to poor adherence. Discordance between assessed HIV risk and the actual experience of risk may underlie the dissonance observed between epidemiologic risk, risk perception, uptake of and adherence to prevention measures. We examined the contribution of research methods used in characterising HIV risk to this dissonance by contrasting HIV risk awareness as assessed by standard structured questionnaires and qualitative in-depth interviews. Methods: We conducted secondary analysis of data from a trial of African women aged 18 to 24 years interested in taking PrEP. Enrollment took place at two sites in Thika and Kisumu, Kenya, and participants were followed up for a period of 24 months between 2017 and 2020. We conducted a multi-step mixed methods assessment of HIV risk awareness and related decision-making behaviour. First, a quantitative analysis of survey data with descriptive statistics to characterize the cohort, proportion testing for trend and generalised estimating equations to assess the association between predictors of risk and risk perception. Secondly, an inductive content analysis of interview data for narrative themes; and lastly, joint display methodology to summarise findings from the two analytical methods. We enrolled 350 young women with a median age of 21 years (IQR 19, 22). At baseline, 182 (52%) participants reported feeling at risk for HIV. In multivariable analysis, reporting a lot of HIV worry was significantly associated with higher odds of risk perception (OR 1.95 [CI 1.31, 2.91]), while significantly lower odds were associated with visits at month 12 (OR 0.30 [CI 0.18, 0.48]) and 24 (OR 0.21 [CI 0.09, 0.20]), living with other family or employer (OR 0.56 [CI 0.33, 0.95]) and being single with a steady partner (OR 0.48 [CI 0.33, 0.70]). Qualitative data from 75 serial interviews provided insight into the changes observed over time in report of both risk awareness and sexual behavioural choices. We identified three major themes from the combined qualitative and quantitative analysis: risk dynamism, behavioural risk patterns and the influence of the social environment. HIV risk awareness and decision making was both intentional and contextual; driven primarily by HIV literacy, PrEP use, assessment of a partner0́9s HIV risk profile and the self-agency to exercise held knowledge. Effective risk mitigation was contingent on intimate partner relationship dynamics and was hindered by the fear of intimate partner violence. Supportive social environments enabled disclosure and promoted the self-agency to effectively mitigate risk. Knowledge of partner status and PrEP use emerged as the primary determinants of risk awareness and related decision making, informing both risk perception and mitigation. We observed complementarity and contrast between the two quantitative and qualitative data in how HIV risk was defined and rationalised, and identified factors at the individual, partnership and societal levels that informed risk awareness and related decision-making. Interview data expounded on the quantitative findings and revealed a more dynamic and rationalised experience of risk than was observed in survey data. The experience of HIV risk by young African women was not haphazard, but rather was rationalised based on HIV and PrEP literacy, current knowledge of partner status and attitudes, and prevailing sexual and economic needs. HIV related decision making was dependent not just on having access to preventive measures, but also on the agency and wherewithal to actualize known mitigation measures. Further work on how knowledge of partner HIV status and PrEP use can be leveraged to support HIV prevention and other sexual reproductive health programs targeting young women is warranted.
Book Synopsis Antiretroviral Therapy Initiation for Treatment and Prevention in East Africa by : Andrew Mujugira
Download or read book Antiretroviral Therapy Initiation for Treatment and Prevention in East Africa written by Andrew Mujugira and published by . This book was released on 2013 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: In serodiscordant couples, provision of antiretroviral therapy (ART) to the HIV-infected partner significantly decreases risk of sexual HIV transmission of HIV. The World Health Organization has recently issued guidelines recommending ART initiation, regardless of CD4 count, for HIV-infected members of serodiscordant couples to prevent HIV transmission to the uninfected partner. We conducted a prospective cohort study among 1998 HIV-infected individuals with known HIV-uninfected partners who were enrolled in the Partners PrEP Study, an HIV prevention clinical trial in Kenya and Uganda. The primary objective was to assess ART initiation in those who became ART-eligible during study follow-up. The cumulative probabilities of initiating ART at 6, 12, and 24 months after referral were 60.8%, 78.8% and 91.5%, respectively. Approximately 40% of HIV-infected partners had not initiated ART six months after initial referrals. Higher CD4 (p0.001), asymptomatic HIV disease (p=0.04), and alcohol use (p=0.001) were significant predictors of ART initiation. To evaluate whether HIV-infected persons would be interested in earlier ART (CD4 350 cells/ [mu] L) for HIV prevention, as recommended by the WHO, we conducted a cross-sectional study among an additional 571 East African HIV-infected individuals in serodiscordant partnerships. The objective of the study was to determine whether fertility intentions were correlated with a greater likelihood to initiate early ART for prevention. We found that HIV-infected partners with fertility intentions were nearly twice as likely to express interest in early ART for HIV prevention (adjusted odds ratio [AHR] 1.83, p=0.02) than those without fertility intentions. Younger age (p
Book Synopsis Safer Conception Among HIV-1 Sero-discordant Couples in East Africa by : Kerry Nugent Hancuch
Download or read book Safer Conception Among HIV-1 Sero-discordant Couples in East Africa written by Kerry Nugent Hancuch and published by . This book was released on 2016 with total page 19 pages. Available in PDF, EPUB and Kindle. Book excerpt: Context: Supporting people affected by HIV-1 in achieving their reproductive goals while minimizing the risk of HIV-1 transmission is a public health imperative. Background: For HIV-1 serodiscordant couples, HIV-1 exposure and risk of transmission to the uninfected partner and unborn children is heightened during pregnancy attempts but safer conception strategies can mitigate risk. Understanding couples’ choices and experiences with safer conception can be useful for programmatic recommendations as safer conception programs are scaled up. Methods: 1013 high-risk, heterosexual HIV-1 serodiscordant couples from Kenya and Uganda were followed for two years in an open-label delivery study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), the Partners Demonstration Project. Annually, we assessed participant experience with safer conception strategies. Multivariate logistic regression was used to characterize women who reported ever having used a safer conception strategy during their first annual visit. Results: 859 couples were included in analysis. 66% of couples had HIV-infected women and 86% desired future children. The median age for women was 27 (interquartile range: 23-32). At the first annual visit, 32% of women reported use of a safer conception strategy ever in their life: 14% reported using ART, 16% PrEP, 3% self-insemination, and 2% STI treatment. Women who reported discussing their fertility desires with their male partners (adjusted odds ratio (aOR) = 1.91, 95% confidence interval (CI) 1.26-2.589), had no living children at the time of study enrollment (aOR = 1.71, 95% CI 1.14-2.57), and were HIV-uninfected (aOR = 1.56, 95% CI 1.11-2.20) were more likely to report having used at least one safer conception strategy. Conclusions: HIV-1 prevention counseling for serodiscordant couples should integrate opportunities for couples to share their fertility desires and discuss preferences for safer conception strategies.
Book Synopsis Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples by : Andrew Mujugira
Download or read book Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples written by Andrew Mujugira and published by . This book was released on 2016 with total page 78 pages. Available in PDF, EPUB and Kindle. Book excerpt: The studies described in this dissertation examine the relationship between use of antiretroviral therapy (ART) and biologic and behavioral factors related to HIV-1 transmission risk in stable heterosexual HIV-1 serodiscordant African couples. ART is recommended for all HIV-1 infected persons, regardless of CD4 count, to reduce HIV-1 related morbidity, mortality and risk of transmission to uninfected partners. ART is a cornerstone of combination HIV-1 prevention, and optimizing use of ART, both for treatment and prevention, is an urgent public health priority. The complementary prospective studies presented in this dissertation were secondary analyses of data from the Partners PrEP Study, a randomized clinical trial of daily oral pre-exposure prophylaxis (PrEP) to decrease HIV-1 acquisition among HIV-1 uninfected members of serodiscordant couples in Kenya and Uganda. This work includes prospective studies of: 1) correlates of failure to achieve plasma viral suppression and virologic rebound after initial suppression, 2) frequency, magnitude and correlates of seminal HIV-1 RNA shedding in men initiating ART, 3) residual HIV-1 transmission risk during the first 6 months of ART, and 4) sexual risk behavior before and after ART. Younger age was associated with delayed ART initiation, failure to achieve viral suppression, and increased risk of virologic rebound after initial suppression. Seminal HIV-1 RNA shedding was infrequent and present at low levels in HIV-1 infected African men with suppressed blood HIV-1 RNA. There were no HIV-1 transmission events on suppressive ART. We observed residual HIV-1 transmission risk during the first 6-months of ART, prior to complete viral suppression in blood and genital secretions. Importantly, substantial risk compensation did not occur following ART initiation among HIV-1 infected persons with known uninfected partners. Results from this dissertation contribute further evidence of the effectiveness of ART for HIV-1 prevention, and provide reassurance that HIV-1 transmission risk declines after starting ART. As treatment guidelines evolve from wait-and-treat to test-and-treat, scaling up access to HIV-1 testing, improving linkage and retention in care, and achieving high ART coverage and complete viral suppression at individual and population levels are essential to achieving zero new HIV-1 infections and zero AIDS-related deaths.
Book Synopsis Partner Violence and Self-reported Pre-exposure Prophylaxis (PrEP) Interruptions Among HIV Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda by : Alejandra Cabral
Download or read book Partner Violence and Self-reported Pre-exposure Prophylaxis (PrEP) Interruptions Among HIV Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda written by Alejandra Cabral and published by . This book was released on 2017 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Background: Pre-exposure prophylaxis (PrEP) is effective for HIV prevention among diverse populations and studies of PrEP delivery are investigating ways to deliver PrEP with high adherence. In many settings with high HIV burden, where PrEP is an important intervention, intimate partner violence (IPV) is reported often. We examined the role of IPV to influence interruptions in PrEP use. Methods: We analyzed data from 1,013 serodiscordant heterosexual couples enrolled in a large PrEP demonstration project in Kenya and Uganda, the Partners Demonstration Project. At quarterly study visits, HIV negative participants receiving PrEP self-reported interruptions in their PrEP use and experiences with IPV. The association of IPV and PrEP interruptions was analyzed using multivariate generalized estimating equations. Results: Of 1,013 HIV negative people who used PrEP during the study, 67% were male and the median age was 30 (interquartile range [IQR] 26-36). Interruptions in PrEP use were reported at 328 visits (7.1% of all visits). The median length of PrEP interruption was 28 days (interquartile range [IQR]: 7-45). At baseline and follow up there were 53 reports of abuse by HIV negative partners, including physical, economic, verbal, or other types of abuse. The frequency of PrEP interruption among people who experienced IPV was 23.8% and those without IPV was 6.9%. The crude odds ratio for PrEP interruption was 3.83 (95% CI 1.8-8.0) and remained significant after adjustment for age, and frequency of intercourse (aOR=2.64, 95% CI 1.17-6.00). Conclusion: IPV was more likely to be reported at visits when PrEP interruptions were also reported, which may have implications for successful adherence to PrEP. Within PrEP delivery, there may be opportunities to assess and intervene on IPV in order to bolster adherence.
Book Synopsis PrEP (pre-exposure Prophylaxis) Adherence Among East African Women by : Maria Pyra
Download or read book PrEP (pre-exposure Prophylaxis) Adherence Among East African Women written by Maria Pyra and published by . This book was released on 2018 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: HIV incidence remains disproportionately high for women, particularly young women, in Sub-Saharan Africa; women are also at heightened risk while pregnant, which may account for a substantial portion of their adult lives. Although HIV pre-exposure prophylaxis (PrEP) in pill form is known to be efficacious for women, there remain unanswered questions about adherence in open-label and real-world settings, as well as regarding the effectiveness of PrEP during pregnancy. In the work presented in this dissertation, we first examined how women used PrEP in an open-label demonstration project and particularly, how adherence was related to HIV risk behaviors. Second, to better assess adherence, we evaluated the sensitivity and specificity of a biomarker among East African men and women using PrEP. Finally, we examined the effect of pregnancy on PrEP concentrations. First, we found that women in known serodiscordant relationships were able to take PrEP effectively; more than half took PrEP during their entire risk period, with ≥6 doses for most weeks when on PrEP. HIV incidence was reduced 93% (95% CI 77%-98%) for all women and 91% (95% CI 29%-99%) among women under 25 years old. In further analysis, we found evidence of four adherence trajectories and two risk behavior trajectories over the first six months of PrEP use. Women with a declining risk behavior trajectory were more likely to have a declining adherence trajectory, while women with steady risk were more likely to have high steady adherence; this supports the idea of prevention-effective adherence, which optimizes PrEP use. In the second aim, we found low sensitivities for the adherence biomarker tenofovir-diphosphate, using thresholds established in U.S. populations. Adherence counseling based on biomarkers should carefully consider the trade-offs between sensitivity and specificity. Finally, we found that concentrations of PrEP are significantly lower in pregnant women compared to non-pregnant women, as well as during pregnancy compared to pre-pregnancy, after adjusting for adherence. Additional pharmacology and epidemiology studies are needed to determine if PrEP dosing should be altered to sustain systemic levels of tenofovir during pregnancy.
Book Synopsis Evaluation of Oral Pre-exposure Prophylaxis (prep) Implementation in Public HIV Care Clinics in Kenya by : Elizabeth M. Irungu
Download or read book Evaluation of Oral Pre-exposure Prophylaxis (prep) Implementation in Public HIV Care Clinics in Kenya written by Elizabeth M. Irungu and published by . This book was released on 2021 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly potent HIV prevention intervention with potential to reduce HIV incidence among populations at risk of HIV in Africa if delivered with sufficient coverage. There are extensive data from high-income countries describing diverse settings in which PrEP services are offered. However, data describing PrEP scale-up models in low- and middle-income countries are limited. Public HIV care and treatment programs in Africa have been very successful at scaling up antiretroviral therapy (ART) over the last 15 years and are an attractive choice for integration of PrEP delivery. The main objective of the work described in this dissertation was to evaluate the effectiveness of PrEP implementation and integration in public HIV care clinics. The specific aims include to 1) conduct a step wedge cluster randomized trial of PrEP integration in public health HIV care clinics (the Partners Scale-Up Project) and evaluate impact; 2) conduct a process evaluation of PrEP integration in public HIV care clinics in Kenya, focusing on adaptation; 3) develop and evaluate the effectiveness of an on-site modular training approach to amplify the number of health care providers trained to deliver PrEP in public HIV care clinics in Kenya; and 4) summarize early PrEP rollout in African settings, challenges encountered and opportunities to expand implementation. We found evidence that integration of PrEP in public HIV clinics was feasible. By improving the capacity of health providers in those care clinics to offer PrEP services through training and technical support, PrEP uptake increased more than 20-fold and was sustained. With existing personnel and infrastructure, the high-volume HIV care clinics efficiently reached partners of HIV infected persons and other populations at HIV risk. PrEP users had reasonable continuation rates and objective evidence of high adherence. Using qualitative methods, we found that clinics made pragmatic, effective adaptations to non-core components of PrEP delivery services and to their routine practice to address challenges in PrEP delivery. We established that clinics that instituted some of the adaptations had above average monthly PrEP initiation and continuation rates. To amplify PrEP delivery in public health facilities, we developed and evaluated an innovative on-site modular training approach. We found that this approach was acceptable and it enabled many health providers to receive PrEP training conveniently and at a relatively low cost. Finally, our summary of early PrEP roll out in Africa revealed that there was high interest in PrEP among all populations at risk of acquiring HIV, but individuals did not continue use as expected. We suggested strategies to make PrEP delivery efficient, including delivery within community pharmacies, use of peers, services availed in low tier facilities and exploration of one-stop services to make PrEP delivery less burdensome. The collective results presented in this dissertation illustrate that integration of PrEP services in public HIV care clinics in Kenya is a successful and sustainable model for PrEP implementation. We posit that this model can be scaled up in African countries planning to set up PrEP programs.
Book Synopsis Problem-solving Therapy by : Thomas J. D'Zurilla
Download or read book Problem-solving Therapy written by Thomas J. D'Zurilla and published by Springer Publishing Company. This book was released on 1999 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Disease Control Priorities, Third Edition (Volume 6) by : King K. Holmes
Download or read book Disease Control Priorities, Third Edition (Volume 6) written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 1027 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Book Synopsis Preventing HIV Among Young People in Southern and Eastern Africa by : Kaymarlin Govender
Download or read book Preventing HIV Among Young People in Southern and Eastern Africa written by Kaymarlin Govender and published by Routledge. This book was released on 2020-12-30 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides an overview of the current epidemiology of the HIV epidemic among young people in Eastern and Southern Africa (ESA) and examines the efforts to confront and reduce the high level of new HIV infections amongst young people. Taking a multi-dimensional approach to prevention, the contributors discuss the many challenges facing these efforts, in view of the slow progress in curbing the incidence of HIV amongst young people, focusing particularly on the structural and social drivers of HIV. Through an examination of these issues, chapters in this book provide valuable insights on how to mitigate HIV risk among young people and what can be regarded as the catalysts to mounting credible policy and programmatic responses required to achieve epidemic control in the region. The contributors draw on examples from a range of primary and secondary data sources to illustrate promising practices and challenges in HIV prevention, demonstrating links between conceptual approaches to prevention and lessons learnt from implementation projects in the region. Bringing together social scientists and public health experts who are actively engaged in finding effective solutions, the book discusses ‘which interventions works’, ‘why they work’, and the limitations and gaps in our knowledge to curb the pandemic amongst young people. As such it is an important read for researchers focusing on HIV/AIDS and public health. The Open Access version of this book, available at https://www.taylorfrancis.com/books/e/10.4324/9780429462818 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.
Book Synopsis Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection by : World Health Organization
Download or read book Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection written by World Health Organization and published by . This book was released on 2016 with total page 429 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.
Book Synopsis The Global HIV Epidemics among Sex Workers by : Deanna Kerrigan
Download or read book The Global HIV Epidemics among Sex Workers written by Deanna Kerrigan and published by World Bank Publications. This book was released on 2012-12-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: A global economic analysis of HIV infection amongst sex workers, finding that evidence based and rights affirming interventions are not implemented to the level that their efficacy warrants, and that doing so at scale would be cost effective and deliver significant returns on investment.
Book Synopsis Choosing Unsafe Sex by : Elisa Janine Sobo
Download or read book Choosing Unsafe Sex written by Elisa Janine Sobo and published by University of Pennsylvania Press. This book was released on 1995 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Choosing Unsafe Sex focuses on the ways in which condom refusal and beliefs regarding HIV testing reflect women's hopes for their relationships and their desires to preserve status and self-esteem. It also discusses the related issue of seropositivity concealment or non-disclosure. Many of the inner-city women who participated in Dr. Sobo's research were seriously involved with one man, and they had heavy emotional and social investments in believing or maintaining that their partners were faithful to them. Uninvolved women had similarly heavy investments in their abilities to identify or choose potential partners who were HIV-negative. In either case, women sought to present and to view themselves as wise and their men as monogamous. Women did not see themselves as being at risk for HIV infection, and so they saw no need for condoms. But they did recommend that other women use them; they saw other women as quite likely to be involved with sexually unfaithful men. Choosing Unsafe Sex includes recommendations for educational strategies that are sensitive to cultural expectations for relationships. Dr. Sobo's findings have significance not only for inner-city HIV/AIDS educators but for all who seek a deeper understanding of mainstream assumptions about heterosexual relationships.
Book Synopsis HIV/AIDS in South Africa 25 Years On by : Poul Rohleder
Download or read book HIV/AIDS in South Africa 25 Years On written by Poul Rohleder and published by Springer Science & Business Media. This book was released on 2009-09-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa’s history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.
