scholarly journals 1657. Notes From the Field: A Survey of Mobile Device Usage Among Individuals in KwaZulu-Natal, South Africa

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S606-S606
Author(s):  
Breanna R Campbell ◽  
Koeun Choi ◽  
Megan Gray ◽  
Chelsea Canan ◽  
Anthony Moll ◽  
...  
Keyword(s):  
South Africa ◽  
Health Information ◽  
Cell Phone ◽  
Data Access ◽  
People Living With Hiv ◽  
Medical Male Circumcision ◽  
Condomless Sex ◽  
Private Data ◽  
Kwazulu Natal ◽  
To Receive

Abstract Background mHealth (mobile health) is a promising tool to deliver healthcare interventions to underserved populations. Across low- and middle-income countries (LMIC), the prevalence of smartphones has risen to 42%. Effective mHealth deployment in LMIC requires an understanding of how LMIC populations use mobile technology. We characterized the use of mobile devices in rural KwaZulu-Natal, South Africa to tailor mHealth interventions for people living with HIV and at risk for acquiring HIV. Methods We surveyed participants in community settings and offered free HIV counseling and testing. Participants self-reported their gender, age, relationship status, living distance from preferred clinic, receipt of monthly grant, condomless sex frequency, and circumcision status (if male). Outcomes included cell phone and smartphone ownership, private data access, health information seeking, and willingness to receive healthcare messages. We performed multivariable logistic regression to assess the relationship between demographic factors and outcomes. Results Among 788 individuals surveyed, the median age was 28 (IQR 22–40) years, 75% were male, and 86% owned personal cell phones, of which 43% were smartphones. The majority (59%) reported having condomless sex and most (59%) males reported being circumcised. Although only 10% used the phone to seek health information, 93% of cell phone owners were willing to receive healthcare messages. Being young, female, and in a relationship were associated with cell phone ownership. Smartphone owners were more likely to be young and female, less likely to live 10–30 minutes from preferred clinic, and less likely to receive a monthly grant. Those reporting condomless sex or lack of circumcision were significantly less likely to have private data access. Conclusion Most participants were willing to receive healthcare messages via phone, indicating that mHealth interventions may be feasible in rural KwaZulu-Natal. Smartphone-based mHealth interventions specifically geared to prevent or support the care of HIV in young women in KwaZulu-Natal may be feasible. mHealth interventions encouraging condom use and medical male circumcision should consider the use of non-smartphone SMS and be attuned to mobile data limitations. Disclosures All authors: No reported disclosures.

scholarly journals Implementation of Adolescent-Friendly Voluntary Medical Male Circumcision Using a School Based Recruitment Program in Rural KwaZulu-Natal, South Africa

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e96468 ◽  
Author(s):  
Carl Montague ◽  
Nelisiwe Ngcobo ◽  
Gethwana Mahlase ◽  
Janet Frohlich ◽  
Cheryl Pillay ◽  
...  
Keyword(s):  
South Africa ◽  
Male Circumcision ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
School Based ◽  
Kwazulu Natal

scholarly journals The role and effectiveness of School-based Extra-Curricular Interventions on children’s health and HIV related behaviour: the case study of Soul Buddyz Clubs Programme in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lebohang Letsela ◽  
Michael Jana ◽  
Rebecca Pursell-Gotz ◽  
Phinah Kodisang ◽  
Renay Weiner
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Survey Data ◽  
Secondary Data ◽  
People Living With Hiv ◽  
Hiv Education ◽  
Hiv Knowledge ◽  
Medical Male Circumcision ◽  
School Based ◽  
Curricular Interventions

Abstract Background HIV education targeting children and adolescents is a key component of HIV prevention. This is especially important in the context of increasing HIV prevalence rates among adolescents and young people. The authors sought to examine the role and effectiveness of an extra-curricular school based programme, Soul Buddyz Clubs (SBC) on HIV knowledge, attitudes, behaviours and biomedical outcomes. Methods This paper employs a mixed methods approach drawing on data from independent qualitative and quantitative sources. Secondary data analysis was performed using survey data from a nationally representative sample that was restricted to 10-14 year-old males and females living in South Africa. Ten focus group discussions and ten in-depth interviews conducted with SBC members and facilitators from 5 provinces, as part of a process evaluation are used to triangulate the effectiveness of SBC intervention. Results The analysis of survey data from 2 198 children indicated that 12% of respondents were exposed to SBC with 4% reporting that they had ever belonged to a club. Children exposed to SBC were more likely to be medically circumcised (AOR 2.38; 95%CI 1.29 -4.40, p=0.006), had correct HIV knowledge (AOR 2.21; 95%CI 1.36 – 3.57, p<0.001) and had less HIV stigmatising attitudes (AOR 0.54; 95%CI 0.31-0.93, p=0.025), adjusting for age, sex, province and exposure to other media – in comparison to those not exposed. Propensity Score Matching findings were consistent with the regression findings. Qualitative findings also supported some of the quantitative results. SBC members reported having learnt about HIV prevention life skills, including condom use, positive attitudes towards people living with HIV, and alcohol abuse. Conclusions Participation in SBC is associated with accessing biomedical HIV prevention services, specifically MMC, correct HIV prevention knowledge and less HIV stigmatizing attitudes. This paper demonstrates the effectiveness of a school-based extracurricular intervention using a club approach targeting boys and girls ages 10-14 years on some of the key HIV prevention biomarkers as well as knowledge and attitudes. The article suggests that extra-curricular interventions can form an effective component of school-based comprehensive sexuality education in preventing HIV and promoting medical male circumcision.

scholarly journals Prevalence and correlates of prescription drug diversion and misuse among people living with HIV in the eThekwini district, KwaZulu-Natal, South Africa

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243718
Author(s):  
Buyisile Chibi ◽  
Nonhlanhla Yende-Zuma ◽  
Tivani P. Mashamba-Thompson
Keyword(s):  
South Africa ◽  
Prescription Drug ◽  
Prescription Medication ◽  
Drug Misuse ◽  
People Living With Hiv ◽  
Prescription Drug Misuse ◽  
The Past ◽  
Drug Diversion ◽  
Kwazulu Natal ◽  
Living With Hiv

Background Prescription drug diversion, and misuse has increased over the past decade and is notably in high-income-countries and significantly contributes to the opioid epidemic. People living with HIV (PLWH) are particularly vulnerable to prescription drug diversion, and misuse as most experience chronic pain, mental health problems and HIV-related illnesses. The researchers investigated the prevalence and correlates of prescription drug diversion, and misuse among PLWH in the eThekwini district, KwaZulu-Natal. Methods A cross-sectional study was conducted among 392 PLWH, conveniently recruited from the public healthcare facilities located in rural, semi-urban and urban areas of the eThekwini district. Participants answered questions about their background, prescription medications, substance use, and prescription drug diversion, and misuse. Descriptive analysis was performed to estimate the prevalence of prescription drug diversion, and misuse. Multivariable logistic regression was used to identify predictors of prescription drug diversion, and misuse. Findings Overall, 13% of the participants reported lifetime prescription drug diversion. The most common type of diversion was using prescription medication not prescribed by a healthcare provider (11%), followed by sharing of prescription medication (9%) and buying prescription medication without a medical script (5%). Twenty-three per cent of the participants reported prescription drug misuse in the past 90 days, with using prescription medication without a healthcare providers’ guidance (9%) and not following the scheduled time periods (8%) being the most common reported types of misuse. Self-medicating was identified as a risk factor for prescription drug misuse. There was no association between ART adherence and prescription drug diversion, and misuse. Conclusion The study findings contribute to improving the limited data available on prescription drug diversion, and misuse among PLWH in South Africa. The prevalence underscores a need for urgent interventions when prescribing medications with potential risks. Addressing the risk of self-medicating is imperative for HIV care outcomes and to avert death.

scholarly journals The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Celenkosini T. Nxumalo ◽  
Gugu G. Mchunu
Keyword(s):  
South Africa ◽  
Male Circumcision ◽  
Primary Healthcare ◽  
Explanatory Model ◽  
Outcome Variable ◽  
Care Practice ◽  
Model Description ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
Kwazulu Natal

Background: KwaZulu-Natal (KZN) remains the epicentre of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in South Africa. The incidence of HIV infection in KZN necessitates cost-effective strategies to curb the spread of infection. Voluntary medical male circumcision (VMMC) has been adopted as an additional biomedical preventive strategy since 2010 in line with recommendations from the World Health Organization. Despite several attempts to scale-up VMMC to reach age specific targets to achieve immediate aversion of infections, the uptake of VMMC remains sub-optimal, particularly in KZN. The purpose of this study is to describe the processes that were followed in developing, describing and evaluating an explanatory model for VMMC in KZN, South Africa.Methods: A qualitative theory-generative phenomenographic study design was used to analyse the qualitative differences in primary healthcare stakeholders’ experiences, understanding and conceptions of VMMC in KZN, South Africa. The emerging results informed the development of the VMMC explanatory model for KZN, South Africa. The model development process followed four steps, namely (1) concept analysis, (2) construction of relational statements, (3) model description and (4) model evaluation. The criteria of relevance for the target audience – applicability, clarity, user friendliness and originality of work – were used to evaluate the model.Results: The model’s central premise is that the decision to undergo VMMC is shaped by a complex interplay of factors in the context or external environment of males (the extrinsic variable), which influences specific experiences, conceptions and understanding regarding VMMC (the influential/intrinsic variables). These collectively determine men’s responses to VMMC (the outcome variable).Conclusion: The model describes the process by which contextual, extrinsic and intrinsic variables interact to determine an individual male’s response to VMMC, thus providing a guide to primary healthcare providers on care, practice and policy interventions to support the uptake of VMMC in the rural primary healthcare context of KZN, South Africa.

scholarly journals Healthcare providers’ perceptions and understanding of voluntary medical male circumcision in KwaZulu-Natal, South Africa: A qualitative study

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Celenkosini T. Nxumalo ◽  
Gugu G. Mchunu
Keyword(s):  
South Africa ◽  
Male Circumcision ◽  
Healthcare Workers ◽  
Scale Up ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Heterosexual Transmission ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
Kwazulu Natal

Background: There is compelling evidence that voluntary medical male circumcision (VMMC) reduces the chances of heterosexual transmission of HIV infection. Healthcare workers are among the key influencers in terms of the scale-up of VMMC as they are often involved in mobilisation for uptake. There is a paucity of qualitative research on healthcare workers’ experiences, understanding and perceptions of VMMC; particularly in the South African rural primary healthcare context. This study was conducted to examine healthcare workers perceptions and understanding of VMMC in KwaZulu-Natal, South Africa.Methods: The study employed a qualitative approach using a phenomenographic design. A purposive sample of 15 doctors, nurses and clinical associates working in 6 different rural clinics in KwaZulu-Natal, South Africa, were interviewed in English in-depth using a semi-structured interview schedule. The interviews were audio-recorded, and transcribed. The results were analysed thematically using phenomenographic data analysis procedures.Results: Categories of description in participants’ perceptions and understanding of VMMC emerged. The findings of this study revealed that healthcare workers perceptions and understanding of VMMC were predominantly influenced by the hegemonic religious and cultural norms associated with male circumcision in KwaZulu-Natal, South Africa.Conclusion: The findings of this study suggest that tailored training to address healthcare workers misperceptions and poor understanding of VMMC is necessary to ensure that they become effective custodians for VMMC implementation.

scholarly journals An HIV-free generation: review of prevention strategies

2019 ◽  
Vol 61 (6) ◽  
Author(s):  
I. Moodley
Keyword(s):  
South Africa ◽  
Behavioural Change ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Voluntary Medical Male Circumcision ◽  
Eastern Cape ◽  
Prevention Strategies ◽  
Medical Male Circumcision ◽  
Key Population ◽  
Exposure Prophylaxis

Globally South Africa has the largest HIV epidemic, with an estimated 7.7 million people living with HIV (PLHIV). The burden of HIV in South Africa varies by age, gender and key population groups. Prevalence is highest among adults between the ages of 15 and 49 years and is higher among females than males. The prevalence rate also varies by province with the highest rates observed in KwaZulu-Natal, Free State, Eastern Cape, Mpumalanga and Northwest.While greater access to anti-retroviral treatment (ART) has significantly reduced the number of deaths and new infections, the number of new infections is still relatively high, highlighting the need for prevention.Initial prevention strategies focus on behavioural change through increased education and awareness to ensure safer sex, mainly through peer education, condom distribution and voluntary medical male circumcision (VMMC), all of which are in place with varying degrees of success. More recently newer approaches are being considered such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP). The major challenge is still behavioural change.This review sets out to critically evaluate the current and newer approaches. Studies suggest that to achieve greater impact, rather than targeting the general population, prevention strategies should focus on vulnerable populations and in provinces with the highest HIV burden.

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