scholarly journals Understanding the Impact of a Community-led HIV Prevention Program in South Africa: Context, Conceptual Framework and Methodology

1999 ◽  
Vol 5 (4) ◽  
pp. 9 ◽  
Author(s):  
Catherine Campbell ◽  
Brian Williams
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Hiv Transmission ◽  
Evaluation Research ◽  
Evaluation Study ◽  
Social Contexts ◽  
Outcome Evaluation ◽  
Evaluation Methodology ◽  
Sexually Transmitted ◽  
The Impact

In this paper we provide an account of our multi-dimensional evaluation of a community led HIV-prevention program in the southern African mining community of Carletonville. The Mothusimpilo Project has three pillars: peer education and condom distribution, syndromic management of sexually transmitted diseases (STDs), and stakeholder mobilisation. Substantial efforts are being made to evaluate the impact of the intervention and in this paper we outline the theoretical rationale, research design and some preliminary results of the evaluation. The first section provides the setting for the evaluation work, viz an intervention which seeks to contextualise traditional biomedical and behavioural approaches to HIV-transmission within their broader community and social contexts. In the second section we outline the theoretical assumptions underlying the evaluation (which has both 'outcome evaluation' and 'process evaluation' components). In particular, we discuss the way in which the concepts of identity, empowerment and social capital are used to understand the processes involved in health-enhancing behaviour change. In the third section we describe our multi-disciplinary evaluation methodology and present some preliminary findings from our on-going evaluation study. One important goal of our evaluation research is to demonstrate the extent to which community level factors serve to assist or hinder the project in achieving its goals. In this way we hope to contribute to understandings of the role of community participation in influencing the outcomes of community-based health promotional projects.

scholarly journals Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India

2013 ◽  
Vol 7 (06) ◽  
pp. 484-488 ◽  
Author(s):  
Mugundu Ramien Parthasarathy ◽  
Prakash Narayanan ◽  
Anjana Das ◽  
Anup Gurung ◽  
Parimi Prabhakar ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Large Scale ◽  
Point Of Care ◽  
Key Populations ◽  
Immunochromatographic Strip ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Syphilis Screening ◽  
Strip Test

Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for “key populations at higher risk’ (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively. Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10. Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009). Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

scholarly journals The Intersection between Sex Work and Reproductive Health in Northern Karnataka, India: Identifying Gaps and Opportunities in the Context of HIV Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Marissa Becker ◽  
Satyanarayana Ramanaik ◽  
Shiva Halli ◽  
James F. Blanchard ◽  
T. Raghavendra ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Reproductive Health ◽  
Hiv Testing ◽  
Sex Work ◽  
Sex Workers ◽  
Prevention Program ◽  
Hiv Transmission ◽  
Health Indicators ◽  
Hiv Interventions ◽  
To Receive

Objective. To examine the reproductive health practices of female sex workers (FSWs) in the context of an HIV prevention program in Karnataka, India.Methods. Data obtained from a survey of 1,011 FSWs registered with an HIV prevention program. We examined reproductive health indicators, and performed multivariate logistic regression among primiparous FSWs to assess sex work during pregnancy and antenatal HIV testing.Results. Among primiparous FSWs (N=251), 92.0% continued sex work during pregnancy, and 55.4% received antenatal HIV testing. A longer duration in sex work (AOR 2.7, 95% CI: 1.0–7.5), rural residence (AOR 3.3, 95% CI: 1.2–8.9), and antenatal HIV testing (AOR 6.3, 95% CI: 2.0–20.1) were associated with continued sex work during pregnancy. Older FSWs (age >25 years, AOR 0.12, 95% CI: 0.05–0.33), who delivered at home (AOR 0.14, 95% CI: 0.09–0.34), were least likely to receive antenatal HIV testing. Antenatal HIV testing was associated with awareness of methods to prevent vertical HIV transmission (AOR 3.9, 95% CI: 1.9–14.1).Conclusions. Antenatal HIV testing remains low in the context of ongoing sex work during pregnancy. Existing HIV prevention programs are well positioned to immediately integrate reproductive health care with HIV interventions targeted to FSWs.

A New Era of HIV Risk: It's Not What You Know, It's Who You Know (and How Infectious)

2019 ◽  
Vol 70 (1) ◽  
pp. 673-701 ◽  
Author(s):  
Andrew C. Cortopassi ◽  
Redd Driver ◽  
Lisa A. Eaton ◽  
Seth C. Kalichman
Keyword(s):  
Hiv Prevention ◽  
Hiv Risk ◽  
Hiv Transmission ◽  
Belief Systems ◽  
Hiv Treatment ◽  
Sexual Relationships ◽  
Treatment As Prevention ◽  
New Era ◽  
Sexually Transmitted ◽  
Hiv Treatment As Prevention

HIV is transmitted in social and sexual relationships, and HIV transmission risks, as well as protective actions, are evolving as HIV epidemics unfold. The current focus of HIV prevention is centered on antiretroviral medications used to reduce HIV infectiousness in persons already infected with HIV [treatment as prevention (TasP)]. The same medications used to treat infected persons can also be used by uninfected persons as pre-exposure prophylaxis (PrEP) to reduce the infectivity of HIV. Both PrEP and TasP are effective when adherence is high and individuals do not have co-occurring sexually transmitted infections. HIV prevention is most effective and efficient when delivered within sexual networks with high HIV prevalence. Specific network characteristics are recognized as important facilitators of HIV transmission; these characteristics include the degree of similarity among network members (homophily), gender role norms, and belief systems. Since 2011, HIV risk has been redefined based on infectiousness and infectivity, ushering in a new era of HIV prevention with the potential to end HIV epidemics.

scholarly journals Successful integration of HIV pre-exposure prophylaxis into a community-based HIV prevention program for female sex workers in Kolkata, India

2021 ◽  
Vol 32 (7) ◽  
pp. 638-647
Author(s):  
Smarajit Jana ◽  
Protim Ray ◽  
Soma Roy ◽  
Abhijit Kadam ◽  
Raman R Gangakhedkar ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Sex Workers ◽  
Prevention Program ◽  
Female Sex Workers ◽  
Community Support ◽  
Final Visit ◽  
Community Based ◽  
Female Sex ◽  
Exposure Prophylaxis ◽  
The Impact

We assessed the impact of pre-exposure prophylaxis (PrEP) in the context of a community-based HIV program among female sex workers (FSWs) in Kolkata, India. This was an open-label, uncontrolled demonstration trial. HIV seronegative FSWs over 18 years were eligible. Participants were administered daily tenofovir/emtricitabine (TDF-FTC) with follow-up visits at months 1, 3, 6, 9, 12, and 15. Drug adherence was monitored by self-report, and a random subset of participants underwent plasma TDF testing. 843 women were screened and 678 enrolled and started on PrEP. Seventy-nine women (11%) did not complete all scheduled visits: four women died of reasons unrelated to PrEP and 75 withdrew, for a 15-month retention rate of 89%. Self-reported daily adherence was over 70%. Among those tested for TDF, the percentage of women whose level reached ≥40 ng/mL was 65% by their final visit. There were no HIV seroconversions, and no evidence of significant changes in sexual behavior. This study demonstrated the feasibility and effectiveness of PrEP for FSWs in Kolkata, with very high levels of adherence to PrEP and no HIV seroconversions. The integration of PrEP into an existing community-based HIV prevention program ensured community support and facilitated adherence.

scholarly journals The Impact of Human Mobility on Regional and Global Efforts to Control HIV Transmission

Viruses ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 67 ◽  
Author(s):  
Emily A. Eshraghian ◽  
Sepideh N. Ferdos ◽  
Sanjay R. Mehta
Keyword(s):  
Public Health ◽  
Hiv Prevention ◽  
Incidence Rate ◽  
Prevention And Control ◽  
Hiv Transmission ◽  
Human Mobility ◽  
Control Methods ◽  
And Migration ◽  
And Control ◽  
The Impact

HIV prevention and control methods are implemented on different scales to reduce the spread of the virus amongst populations. However, despite such efforts, HIV continues to persist in populations with a global incidence rate of 1.8 million in 2017 alone. The introduction of new infections into susceptible regional populations promotes the spread of HIV, indicating a crucial need to study the impact of migration and mobility on regional and global efforts to prevent HIV transmission. Here we reviewed studies that assess the impact of human mobility on HIV transmission and spread. We found an important role for both travel and migration in driving the spread of HIV across regional and national borders. Combined, our results indicate that even in the presence of control and preventive efforts, if migration and travel are occurring, public health efforts will need to remain persistent to ensure that new infections do not grow into outbreaks.

Outcome Evaluation of a Statewide Child Inpatient Mental Health Unit

2003 ◽  
Vol 37 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Susana Gavidia-Payne ◽  
Lyn Littlefield ◽  
Mats Hallgren ◽  
Peter Jenkins ◽  
Neil Coventry
Keyword(s):  
Mental Health ◽  
Family Functioning ◽  
Parenting Practices ◽  
Univariate Analysis ◽  
Evaluation Research ◽  
Outcome Evaluation ◽  
Health Unit ◽  
Family Variables ◽  
The Impact ◽  
Mental Health Unit

Objective: To assess the impact of inpatient intervention, provided by a child mental health unit in Victoria, Australia, on a number of key child and family variables. Method: Pre-post test design with a four-month follow up was applied to assess changes across time. Twenty-nine parents, 42 teachers, and 37 referrers provided reports on a series of child, parent, and family functioning measures. Results: Significant improvements in child behaviour and functioning, parenting competency and efficacy, parenting practices, and reduced parental depression were observed over time. Changes in family functioning scores were not significant; however, univariate analysis indicated improvements in two individual subscales. Conclusions: There is a lack of studies of the outcome of inpatient interventions of children in psychiatric settings. However, as shown in the present study, improvements in functioning can be detected and obtained with short-term interventions that focus on both children and families. Methodological shortcomings (i.e. absence of comparison groups) and lack of specificity in intervention variables, however, are difficulties yet to be overcome in evaluation research of inpatient treatment.

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