scholarly journals Diverse experts’ perspectives on ethical issues of using machine learning to predict HIV/AIDS risk in sub-Saharan Africa: a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e052287
Author(s):  
Ariadne A Nichol ◽  
Eran Bendavid ◽  
Farirai Mutenherwa ◽  
Chirag Patel ◽  
Mildred K Cho
Keyword(s):  
Public Health ◽  
Machine Learning ◽  
Ethical Issues ◽  
Expert Panel ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modified Delphi ◽  
Aids Risk ◽  
Sub Saharan ◽  
Hiv Aids

ObjectiveTo better understand diverse experts’ views about the ethical implications of ongoing research funded by the National Institutes of Health that uses machine learning to predict HIV/AIDS risk in sub-Saharan Africa (SSA) based on publicly available Demographic and Health Surveys data.DesignThree rounds of semi-structured surveys in an online expert panel using a modified Delphi approach.ParticipantsExperts in informatics, African public health and HIV/AIDS and bioethics were invited to participate.MeasuresPerceived importance of or agreement about relevance of ethical issues on 5-point unipolar Likert scales. Qualitative data analysis identified emergent themes related to ethical issues and development of an ethical framework and recommendations for open-ended questions.ResultsOf the 35 invited experts, 22 participated in the online expert panel (63%). Emergent themes were the inclusion of African researchers in all aspects of study design, analysis and dissemination to identify and address local contextual issues, as well as engagement of communities. Experts focused on engagement with health and science professionals to address risks, benefits and communication of findings. Respondents prioritised the mitigation of stigma to research participants but recognised trade-offs between privacy and the need to disseminate findings to realise public health benefits. Strategies for responsible communication of results were suggested, including careful word choice in presentation of results and limited dissemination to need-to-know stakeholders such as public health planners.ConclusionExperts identified ethical issues specific to the African context and to research on sensitive, publicly available data and strategies for addressing these issues. These findings can be used to inform an ethical implementation framework with research stage-specific recommendations on how to use publicly available data for machine learning-based predictive analytics to predict HIV/AIDS risk in SSA.

scholarly journals Willingness to Pay for Condoms among Men in Sub-Saharan Africa

2018 ◽  
Vol 16 (1) ◽  
pp. 34 ◽  
Author(s):  
William Evans ◽  
Kuyosh Kadirov ◽  
Ibou Thior ◽  
Ramakrishnan Ganesan ◽  
Alec Ulasevich ◽  
...  
Keyword(s):  
Public Health ◽  
Willingness To Pay ◽  
Condom Use ◽  
Sub Saharan Africa ◽  
Linear Regression Models ◽  
African Countries ◽  
Donor Funding ◽  
Sub Saharan ◽  
Tool Building ◽  
Hiv Aids

HIV/AIDS and other sexually transmitted infections (STIs) continue to be among the greatest public health threats worldwide, especially in sub-Saharan Africa (SSA). Condom use remains an essential intervention to eradicate AIDS, and condom use is now higher than ever. However, free and subsidized condom funding is declining. Research on how to create healthy markets based on willingness to pay for condoms is critically important. This research has three primary aims: (1) willingness of free condom users in five African countries to pay for socially marketed condoms; (2) the relationship between specific population variables and condom brand marketing efforts and willingness to pay; and (3) potential opportunities to improve condom uptake. Nationally representative samples of at least 1200 respondents were collected in Kenya, Nigeria, South Africa, Zambia, and Zimbabwe. We collected data on a range of demographic factors, including condom use, sexual behavior, awareness of condom brands, and willingness to pay. We estimated multivariate linear regression models and found that free condom users are overwhelmingly willing to pay for condoms overall (over 90% in Nigeria) with variability by country. Free users were consistently less willing to pay for condoms if they had a positive identification with their free brand in Kenya and Zimbabwe, suggesting that condom branding is a critical strategy. Ability to pay was negatively correlated with willingness, but users who could not obtain free condoms were willing to pay for them in Kenya and Zimbabwe. In a landscape of declining donor funding, this research suggests opportunities to use scarce funds for important efforts such as campaigns to increase demand, branding of condoms, and coordination with commercial condom manufacturers to build a healthy total market approach for the product. Free condoms remain an important HIV/AIDS prevention tool. Building a robust market for paid condoms in SSA is a public health priority.

scholarly journals ONSET OF SEXUAL ACTIVITY AMONG ADOLESCENTS IN HIV/AIDS-AFFECTED HOUSEHOLDS IN SUB-SAHARAN AFRICA

2014 ◽  
Vol 47 (2) ◽  
pp. 238-257 ◽  
Author(s):  
MONICA A. MAGADI ◽  
JOSEPH UCHUDI
Keyword(s):  
Sexual Activity ◽  
Individual Characteristics ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Demographic And Health Surveys ◽  
Adolescent Boys ◽  
Hiv Test ◽  
Sub Saharan ◽  
Hiv Aids

SummaryThis paper examines the effect of orphanhood and HIV status of adults in a household on onset of sexual activity among adolescent girls and boys aged 15–17 years in sub-Saharan Africa. Multilevel logistic regression models were applied to pooled Demographic and Health Surveys data from nineteen countries of sub-Saharan Africa where HIV test data were collected during 2003–2008 from nationally representative samples of men and women of reproductive age. The results highlight increased vulnerability among adolescent boys and girls living in households where an adult is infected with HIV, and adolescent boys who are paternal orphans. On average, adolescent boys and girls living in households where at least one adult is HIV-positive have about 25% higher odds of having initiated sexual activity compared with their counterparts of similar characteristics in households where no adult is HIV-positive. Furthermore, adolescent boys who are paternal orphans have about 25% higher odds of having initiated sexual activity than their non-orphan counterparts of similar individual characteristics. Further analysis reveals that household circumstances relating to living arrangements and poverty are important pathways through which household HIV/AIDS status is linked to adolescent sexual debut. The findings underscore the importance of international efforts in the sub-Saharan Africa region to address the plight of other children in HIV/AIDS-affected households, beyond orphans.

scholarly journals COVID-19 in Uganda: Predicting the impact of the disease and public health response on disease burden

2020 ◽  
Author(s):  
David Bell ◽  
Kristian Schultz Hansen ◽  
Agnes N. Kiragga ◽  
Andrew Kambugu ◽  
John Kissa ◽  
...  
Keyword(s):  
Public Health ◽  
Population Structure ◽  
Maternal Mortality ◽  
Disease Burden ◽  
Sub Saharan Africa ◽  
Lead Author ◽  
Mortality Data ◽  
Sub Saharan ◽  
The Impact ◽  
Hiv Aids

AbstractObjectiveCOVID-19 transmission and the public health ‘lock-down’ response are now established in sub-Saharan Africa, including Uganda. Population structure and prior morbidities differ markedly between these countries from those where outbreaks were previously established. We predicted the relative impact of COVID-19 and the response in Uganda to understand whether the benefits could be outweighed by the costs.Design and settingAge-based COVID-19 mortality data from China were applied to the population structures of Uganda and countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. Based on recent Ugandan data and theoretical scenarios of programme deterioration, we predicted potential additional disease burden for HIV/AIDS, malaria and maternal mortality.Main outcome measuresDALYs lost and mortality.ResultsBased on population age structure alone Uganda is predicted to have a relatively low COVID-19 burden compared to equivalent transmission in China and Western countries, with mortality and DALYs lost predicted to be 12% and 19% that of Italy. Scenarios of ‘lockdown’ impact predict HIV/AIDS and malaria equivalent to or higher than that of an extensive COVID-19 outbreak. Emerging HIV/AIDS and maternal mortality data indicate that such deterioration could be occurring.ConclusionsThe results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. The results are likely to reflect the situation in other sub-Saharan populations, underlining the importance of tailoring COVID-19 responses to population structure and potential disease vulnerabilities.Transparency statementThe lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there are no discrepancies from the study as originally planned.

HIV/AIDS and Fertility

2009 ◽  
Vol 1 (3) ◽  
pp. 170-194 ◽  
Author(s):  
Jane G Fortson
Keyword(s):  
Cross Sections ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Fertility Rates ◽  
Difference In Differences ◽  
Aids Epidemic ◽  
Sub Saharan ◽  
Hiv Negative ◽  
Hiv Aids

This paper studies the response of fertility to the HIV/AIDS epidemic in sub-Saharan Africa. I use repeated cross sections of the Demographic and Health Surveys for 12 countries in sub-Saharan Africa to examine this question empirically. Using individual birth histories from these data, I construct estimates of the regional total fertility rate over time. In a difference-in-differences approach, I compare regional HIV prevalence to changes in total fertility rates from the 1980s to the present. My results suggest that HIV/AIDS had very little impact on fertility, both overall and in a sample of HIV-negative women. (JEL I12, J13, O12)

scholarly journals Relative burdens of the COVID-19, malaria, tuberculosis and HIV/AIDS epidemics in sub-Saharan Africa in 2020

2021 ◽  
Author(s):  
DAVID BELL ◽  
Kristian Schultz Hansen
Keyword(s):  
Public Health ◽  
South Africa ◽  
Sub Saharan Africa ◽  
Public Health Response ◽  
Health Response ◽  
Life Years ◽  
African Populations ◽  
Life Years Lost ◽  
Sub Saharan ◽  
Hiv Aids

Objectives: While the COVID-19 pandemic has had considerable global impact, recorded mortality in sub-Saharan Africa has been relatively low. Ensuring the public health response creates overall benefit is therefore critical. However, the highly age-dependent nature of COVID-19 mortality makes comparisons of disease burden challenging unless considered in terms of metrics that incorporate life years lost and time lived in adverse health. We therefore assessed the relative disease burdens of COVID-19 and the three major epidemic-causing pathogens; malaria, tuberculosis and HIV/AIDS, in sub-Saharan Africa. Design: We compared estimates of 2020 disease burdens in sub-Saharan African populations in terms of mortality and Disability-Adjusted Life Years lost (DALYs) for COVID-19, malaria, tuberculosis and HIV/AIDS, applying known age-related mortality to UN estimates of sub-Saharan population age structure. We further compared exacerbations of these diseases predicted to occur through the COVID-19 public health response. Data was derived from public sources, predicted disease exacerbations from those published by international agencies. Main outcome measures: Mortality and DALYs lost Results: For sub-Saharan African populations north of South Africa, recorded COVID-19 DALYs lost in 2020 was 2.0%, 1.2% and 1.3% of those estimated for tuberculosis, HIV/AIDS and malaria respectively. The predicted exacerbations alone of each of these comparator diseases were greater than the estimated COVID-19 burden. Including South Africa and Lesotho, COVID-19 DALYs lost were ≤6% of each of these predicted disease burdens and dominated by them in all age groups below 70 years. Conclusions: The analysis here suggests a relatively low impact from COVID-19. While all four epidemics continue, concentration on COVID-19 runs a high risk of increasing the overall health burden, further increasing global inequities in health and life expectancy, and needs to be guided by clear economic evaluation.

scholarly journals Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa: Evidence from 33 countries recent Demographic and Health Surveys

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253164
Author(s):  
Achamyeleh Birhanu Teshale ◽  
Zemenu Tadesse Tessema ◽  
Adugnaw Zeleke Alem ◽  
Yigizie Yeshaw ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Associated Factors ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Reproductive Age Women ◽  
Sub Saharan ◽  
Mother To Child ◽  
Hiv Aids

Background In sub-Saharan Africa (SSA) 90 percent of babies acquired HIV/AIDS from infected mothers. Maternal knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention is a cornerstone for elimination of MTCT of HIV/AIDS. Despite this, there is limited evidence about knowledge about MTCT of HIV/AIDS and its prevention and associated factors in SSA. Therefore, this study aimed to assess knowledge of MTCT of HIV/AIDS, its prevention (PMTCT) and, associated factors among reproductive-age women in sub-Saharan Africa. Objective To assess Knowledge about mother to child transmission of HIV/AIDS and its prevention and associated factors among reproductive-age women in Sub-Saharan Africa. Methods The recent SSA countries’ Demographic and Health Surveys (DHS), which were conducted from 2008/09 to 2018/19, was our data source. We appended 33 countries’ DHS data for our analysis. For our study, a total weighted sample of 350,888 reproductive-age women was used. Due to the hierarchical nature of the DHS data, we conducted a multilevel analysis. Finally, the adjusted odds ratio with its 95% confidence interval was reported, and variables with p-value≤0.05 were considered as significant predictors of knowledge of MTCT of HIV/AIDS and its prevention. Results In this study, 56.21% (95% CI: 56.05–56.38) of respondents had correct knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA. In the multilevel logistic regression analysis: being in the older age group, better education level, being from a rich household, having mass media exposure, having parity of one and above were associated with higher odds of knowledge about MTCT of HIV/AIDS and its prevention. However, being perceiving distance from the health facility as a big problem was associated with lower odds of knowledge about MTCT of HIV/AIDS and its prevention. Conclusion Knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.

scholarly journals What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Drissa Sia ◽  
Yentéma Onadja ◽  
Mohammad Hajizadeh ◽  
S. Jody Heymann ◽  
Timothy F. Brewer ◽  
...  
Keyword(s):  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Gender Inequalities ◽  
Sub Saharan ◽  
Hiv Aids
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