scholarly journals Social Influence and Uptake of Couples HIV Testing and Counselling in KwaZulu-Natal, South Africa

2021 ◽  
Author(s):  
Matthew J. Johnson ◽  
Lynae A. Darbes ◽  
Victoria Hosegood ◽  
Mallory O. Johnson ◽  
Katherine Fritz ◽  
...  

AbstractSocial influences may create a barrier to couples HIV testing and counselling (CHTC) uptake in sub-Saharan Africa. This secondary analysis of data collected in the ‘Uthando Lwethu’ randomised controlled trial used discrete-time survival models to evaluate the association between within-couple average ‘peer support’ score and uptake of CHTC by the end of nine months’ follow-up. Peer support was conceptualised by self-rated strength of agreement with two statements describing friendships outside of the primary partnership. Eighty-eight couples (26.9%) took up CHTC. Results tended towards a dichotomous trend in models adjusted only for trial arm, with uptake significantly less likely amongst couples in the higher of four peer support score categories (OR 0.34, 95% CI 0.18, 0.68 [7–10 points]; OR 0.53, 95% CI 0.28, 0.99 [≥ 11 points]). A similar trend remained in the final multivariable model, but was no longer significant (AOR 0.59, 95% CI 0.25, 1.42 [7–10 points]; AOR 0.88, 95% CI 0.36, 2.10 [≥ 11 points]). Accounting for social influences in the design of couples-focused interventions may increase their success.

2015 ◽  
Vol 2 (11) ◽  
pp. e483-e491 ◽  
Author(s):  
Nora E Rosenberg ◽  
Tiwonge K Mtande ◽  
Friday Saidi ◽  
Christopher Stanley ◽  
Edward Jere ◽  
...  

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Lionel Noah ◽  
Gisèle Pickering ◽  
Claude Dubray ◽  
Andre Mazur ◽  
Simon Hitier ◽  
...  

AbstractIntroductionEvidence from a recent randomised controlled trial1 suggests that in severely stressed subjects with low magnesemia, supplementation with magnesium (Mg) in combination with vitamin B6 (B6) provides greater benefits than Mg alone. B6 was reported to facilitate Mg absorption and its cellular uptake and to exert synergistic effect with Mg. The current secondary analysis explored the relationship between Mg-B6 combination and erythrocyte Mg concentration, used as a biomarker of body Mg status.Material and MethodsAn 8-week, Phase IV, controlled, single-blinded, parallel-group trial (EudraCT Number 2015-003749-24) stratified by sex was conducted in adults (n = 264) with a Depression Anxiety Stress Scales - stress subscale score (DASS-42SS) > 18 and serum Mg of 0.5–0.85mmol/L, randomised 1:1 to daily oral Mg-B6 (Magne B6®, Mg 300 mg; B6 30mg) or oral Mg alone (Magnespasmyl®, Mg 300mg). Outcomes were stress score, serum Mg (mmol/L), erythrocytes Mg (mmol/L), and serum B6 (nmol/L) from baseline to Week4 and Week8. Data are given as mean(SD) values.Results & DiscussionBaseline characteristics. Baseline magnesemia was 0.80(0.04) for both groups. Erythrocyte Mg concentration for the lower quintile of the studied population (n = 53) was 0.73–1.62, below the normal range of 1.65–2.65 in general population. The mean stress score in this subgroup was higher [29.5(6.3)], but not significantly different from that in other quintiles [lowest value: 26.1(7.6)]. Baseline B6 serum level for the lower B6 quintile (5–23), below the normal range for general population, was suggestive of possible B6 deficiency.Treatment effects. Both treatments increased slightly but not significantly erythrocyte Mg level from baseline to Week8 [1.84(0.03) to 1.86(0.03), and 1.86(0.03) to 188(0.03), respectively for Mg + B6 and Mg groups]. Significant changes were observed in subjects with low erythrocyte Mg level at baseline (< 1.6), namely an increase of + 0.13(0.04–0.22) for Mg + B6 and + 0.17(0.08–0.25) for Mg groups, but with no difference between treatments. Moreover, Mg + B6 supplementation led to a significant change (p < 0.0001) in serum B6 level between baseline and Wk8 [55.9(4.8) to 370.9(11.3)], as compared to Mg alone [51.9(4.8) to 51.5(11.3)].In conclusion, both treatments significantly increased erythrocyte Mg in subjects with low Mg status. B6 supplementation did not lead to further increase in erythrocyte Mg level. We have previously shown that severely stressed population benefits from B6 supplementation in combination with Mg, however, the mechanism of the interaction between Mg and B6 remains to be elucidated.1Sponsored by Sanofi


2017 ◽  
Vol 42 ◽  
pp. 103-110 ◽  
Author(s):  
C.I. Mahlke ◽  
S. Priebe ◽  
K. Heumann ◽  
A. Daubmann ◽  
K. Wegscheider ◽  
...  

AbstractBackgroundOne-to-one peer support is a resource-oriented approach for patients with severe mental illness. Existing trials provided inconsistent results and commonly have methodological shortcomings, such as poor training and role definition of peer supporters, small sample sizes, and lack of blinded outcome assessments.MethodsThis is a randomised controlled trial comparing one-to-one peer support with treatment as usual. Eligible were patients with severe mental illnesses: psychosis, major depression, bipolar disorder or borderline personality disorder of more than two years’ duration. A total of 216 patients were recruited through in- and out-patient services from four hospitals in Hamburg, Germany, with 114 allocated to the intervention group and 102 to the control group. The intervention was one-to-one peer support, delivered by trained peers and according to a defined role specification, in addition to treatment as usual over the course of six months, as compared to treatment as usual alone. Primary outcome was self-efficacy measured on the General Self-Efficacy Scale at six-month follow-up. Secondary outcomes included quality of life, social functioning, and hospitalisations.ResultsPatients in the intervention group had significantly higher scores of self-efficacy at the six-month follow-up. There were no statistically significant differences on secondary outcomes in the intention to treat analyses.ConclusionsThe findings suggest that one-to-one peer support delivered by trained peer supporters can improve self-efficacy of patients with severe mental disorders over a one-year period. One-to-one peer support may be regarded as an effective intervention. Future research should explore the impact of improved self-efficacy on clinical and social outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045481
Author(s):  
Ruth Verhey ◽  
Charmaine Chitiyo ◽  
Sandra Ngonidzashe Mboweni ◽  
Ephraim Chiriseri ◽  
Dixon Chibanda ◽  
...  

IntroductionCommon mental disorders (CMDs) are a leading cause of disability globally. CMDs are highly prevalent in Zimbabwe and have been addressed by an evidence-based, task-shifting psychological intervention called the Friendship Bench (FB). The task-shifted FB programme guides clients through problem-solving therapy. It was scaled up across 36 implementation sites in Zimbabwe in 2016.Methods and analysisThis study will employ a mixed-method framework. It aims to: (1) use quantitative survey methodologies organised around the Reach, Effectiveness, Adoption and Implementation and Maintenance evaluation framework to assess the current scaleup of the FB intervention and classify 36 clinics according to levels of performance; (2) use qualitative focus group discussions and semistructured interviews organised around the Consolidated Framework for Implementation Research to analyse determinants of implementation success, as well as elucidate heterogeneity in implementation strategies through comparing high-performing and low-performing clinics; and (3) use the results from aims 1 and 2 to develop strategies to optimise the Friendship Bench intervention and apply this model in a cluster randomised controlled trial to evaluate potential improvements among low-performing clinics. The trial will be registered with the Pan African Clinical Trial Registry (www.pactr.org). The planned randomised controlled trial for the third research aim will be registered after completing aims one and two because the intervention is dependent on knowledge generated during these phases.Ethics and disseminationThe research protocol received full authorisation from the Medical Research Council of Zimbabwe (MRCZ A/242). It is anticipated that changes in data collection tools and consent forms will take place at all three phases of the study and approval from MRCZ will be sought. All interview partners will be asked for informed consent. The research team will prioritise open-access publications to disseminate research results.


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