scholarly journals Rolling out new biomedical HIV prevention tools: what can be learned from Avahan, the India AIDS initiative?

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 207 ◽  
Author(s):  
Gina Dallabetta ◽  
Padma Chandrasekaran ◽  
Tisha Wheeler ◽  
Anjana Das ◽  
Lakshmi Ramakrishnan ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Routine Data ◽  
Population Level ◽  
Great Promise ◽  
Data Systems ◽  
African Countries ◽  
Hiv Prevention Intervention ◽  
Frontline Workers ◽  
Biomedical Hiv Prevention

More than 30 years after HIV was first identified as a disease, with disastrous consequences for many subpopulations in most countries and for entire populations in some African countries, it continues to occupy centre stage among the world’s many global health challenges. Prevention still remains the primary long-term focus. New biomedical tools such as pre-exposure propyhlaxis (PrEP) and treatment hold great promise for select groups such as key populations (KPs) who are critical to transmission dynamics, and serodiscordant couples. Programs delivering these new tools will need to layer them over existing services, with potential modifications for increased and sustained engagement between health services and beneficiaries owing to the nature of the interventions. Avahan, an HIV prevention intervention for KPs in six states in India, achieved population-level impact with conventional prevention programming, which, however, required high program–beneficiary engagement. Avahan’s implementation strategy included articulating clear service definitions and denominator-based targets; establishing routine data systems with regular, multilevel supervision that allowed for cross-learning across the program; and developing a cadre of frontline workers through KP peer outreach workers who addressed structural issues and provided viable and sustainable mechanisms for sustained interaction between health services and KPs. This basic prevention implementation infrastructure was used to expand clinical services over time. Many of the lessons from programs such as Avahan can be applied to KP programs that are expanding service scope, including PrEP and treatment.

'Getting to zero' in Asia and the Pacific through more strategic use of antiretrovirals for HIV prevention

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 107 ◽  
Author(s):  
Michael M. Cassell ◽  
Timothy H. Holtz ◽  
Mitchell I. Wolfe ◽  
Michael Hahn ◽  
Dimitri Prybylski
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Sex Workers ◽  
Population Level ◽  
Hiv Infections ◽  
Asia Pacific ◽  
Key Populations ◽  
Data Systems ◽  
Treatment Access ◽  
Sex With Men

Encouraged by experimental trials demonstrating the efficacy of antiretrovirals (ARVs) in preventing HIV infection, countries across the Asia-Pacific region have committed to the achievement of ambitious targets tantamount to ending AIDS. The available data suggest that some countries still can make progress through targeted condom promotion and the expansion of harm-reduction interventions, but that none may realise its vision of ‘zero new HIV infections’ without more strategic use of ARVs as part of a combination of HIV prevention efforts targeting key populations. Low rates of HIV testing among men who have sex with men, people who inject drugs, sex workers and other key populations evidence low treatment coverage where treatment could have the greatest impact on curbing local epidemics. Studies have demonstrated the promise of adding ARV treatment and pre-exposure prophylaxis to the existing HIV prevention toolkit, but achieving population-level impact will require service-delivery approaches that overcome traditional prevention, care and treatment program distinctions. Priorities include: (1) innovative strategies to reach, test, treat and retain in services the individuals most likely to acquire or transmit HIV; (2) task shifting and enhanced partnerships between the public sector and civil society; (3) improved ‘cascade’ data systems to assess and promote service uptake and retention; and (4) policy and financing reform to enhance HIV testing and treatment access among key populations.

scholarly journals Phylodynamics Helps to Evaluate the Impact of an HIV Prevention Intervention

Viruses ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 469 ◽  
Author(s):  
Tetyana I. Vasylyeva ◽  
Alexander Zarebski ◽  
Pavlo Smyrnov ◽  
Leslie D. Williams ◽  
Ania Korobchuk ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Hiv Transmission ◽  
Assessment Tool ◽  
Population Level ◽  
Reproductive Number ◽  
Post Intervention ◽  
Hiv Prevention Intervention ◽  
Transmission Parameters ◽  
Transmission Reduction ◽  
The Impact

Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013–2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied the birth-death skyline model to the sequences from Odessa (n = 275) and Kyiv (n = 92) in order to estimate changes in the epidemic’s effective reproductive number (Re) and rate of becoming uninfectious (δ). We identified 12 transmission clusters in Odessa; phylogenetic clustering was correlated with younger age and higher average viral load at the time of sampling. Estimated Re were similar in Odessa and Kyiv before the initiation of TRIP; Re started to decline in 2013 and is now below Re = 1 in Odessa (Re = 0.4, 95%HPD 0.06–0.75), but not in Kyiv (Re = 2.3, 95%HPD 0.2–5.4). Similarly, estimates of δ increased in Odessa after the initiation of TRIP. Given that both cities shared the same HIV prevention programs in 2013–2019, apart from TRIP, the observed changes in transmission parameters are likely attributable to the TRIP intervention. We propose that molecular epidemiology analysis can be used as a post-intervention effectiveness assessment tool.

Novel HIV-prevention intervention addressing minority stress among gay and bisexual men

2013 ◽  
Author(s):  
Cherie Moody ◽  
Amy C. Willis ◽  
Natalie Stratton ◽  
Nathan G. Smith ◽  
Trevor A. Hart ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Minority Stress ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Prevention Intervention ◽  
Hiv Prevention Intervention ◽  
And Bisexual

scholarly journals Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Data ◽  
Well Being ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Sub Saharan ◽  
Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

scholarly journals An evidence-based approach to routine outcome assessment

2012 ◽  
Vol 18 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Mike Slade
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Decision Making ◽  
Academic Discipline ◽  
Community Mental Health Services ◽  
Clinical Decision ◽  
Successful Implementation ◽  
Frontline Workers ◽  
Routine Outcome Assessment

SummaryRoutine use of Health of the Nation Outcome Scales (HoNOS) has not produced the anticipated benefits for people using mental health services. Four HoNOS-specific reasons for this are: low relevance to clinical decision-making; not reflecting service user priorities; being staff-rated; and having a focus on deficits. More generally, the imposition of a centrally chosen measure on the mental health system leads to a clash of cultures, since frontline workers do not need a standardised measure to treat individuals. A better approach might be to use research from the emerging academic discipline of implementation science to inform the routine use of a standardised measure that is chosen by the people who will use it and hence is more concordant with existing clinical processes. This is illustrated using a case study of successful implementation of the Camberwell Assessment of Need (CAN) in community mental health services across Ontario, Canada.

Sign in / Sign up

Export Citation Format

Share Document