scholarly journals When and why? Timing of post-migration HIV acquisition among sub-Saharan migrants in France

2019 ◽  
Vol 96 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Anne Gosselin ◽  
Andrainolo Ravalihasy ◽  
Julie Pannetier ◽  
France Lert ◽  
Annabel Desgrées du Loû
Keyword(s):  
At Risk ◽  
Reference Group ◽  
Sub Saharan Africa ◽  
Event Data ◽  
Life Event ◽  
Settlement Period ◽  
Concurrent Partnerships ◽  
Prevention Programmes ◽  
Sub Saharan ◽  
Hiv Acquisition

ObjectiveRecent studies highlighted that many HIV-positive migrants in Europe acquired their infections post-migration. However, the timing of these infections is not always known. This study aims to estimate the timing of post-migration HIV acquisition among sub-Saharan migrants in France and to understand the correlates of post-migration infection.MethodsWithin the PARCOURS retrospective survey conducted in 2012–2013 in 74 healthcare facilities in the Paris region, life-event data were collected among a random sample of 926 patients living with HIV in HIV services and 763 patients undiagnosed with HIV in primary care centres born in sub-Saharan Africa (reference group). Based on previous analysis, we considered the first 6 years in France after migration as a settlement period. Among the persons who acquired HIV after migration, we estimated the proportion of persons infected during settlement (0–6 years after migration) and after settlement (>6 years after migration) by using an algorithm that combines life-event data and a modelisation of CD4+ T-cell count decline. We then assessed the determinants of HIV acquisition during settlement and after settlement using bivariate logistic regression models.ResultsOverall, 58% of sub-Saharan migrants who acquired HIV after migration were infected during the first 6 years in France. HIV acquisition during settlement was found to be linked to short/transactional partnerships and lack of a resident permit. 42% of migrants had contracted HIV after settlement. After settlement, HIV acquisition was associated with short/transactional but also with concurrent partnerships and not with social hardship.ConclusionTwo profiles of HIV post-migration acquisition emerged. The majority of HIV post-migration acquisition occurs during the settlement period: comprehensive combination prevention programmes among recently arrived migrants are needed. However, long-term migrants are also at risk for HIV through multiple partnerships. Prevention programmes should address the different profiles of migrants at risk for post-migration HIV acquisition.

Introducing the UCDP Peacemakers at Risk dataset, sub-Saharan Africa, 1989–2009

2017 ◽  
Vol 55 (1) ◽  
pp. 122-131 ◽  
Author(s):  
Sara Lindberg Bromley
Keyword(s):  
At Risk ◽  
Data Collection ◽  
Use Of Force ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Peace Operations ◽  
Event Data ◽  
Potential Applications ◽  
Research Questions ◽  
Sub Saharan

This article introduces new event data on violence against peacekeepers deployed to conflict-affected countries in sub-Saharan Africa between 1989 and 2009. While the practice of peacekeeping is often described as fraught with risk, a shortage of data has left scholars poorly equipped to study this important phenomenon. The Peacemakers at Risk (PAR) dataset records reported incidences of violence resulting in direct peacekeeping personnel fatalities, injuries and kidnappings. Information on the timing, location, outcomes and actors implicated is provided for each recorded event, including information on the nationalities of violence-affected peacekeepers. The dataset also charts reports of fatal violence by peacekeepers. This enables the study of peacekeepers’ use of force and provides a new lens for examining wider questions related to peacekeeping effects and conflict dynamics. Peace operations deployed by the UN as well as other peacekeeping actors are included, allowing for a rich dataset that reflects today’s diverse peacekeeping landscape. The PAR dataset makes possible the evaluation of reigning assumptions regarding peacekeeping intervention and risk, and allows scholars to pose research questions regarding the causes, characteristics and consequences of peacekeeper violence, within and across interventions. This article introduces the criteria and procedures guiding the data collection and presents the data. The article also highlights key patterns emerging from the dataset and identifies a number of potential applications and avenues for future research.

scholarly journals Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya

2021 ◽  
pp. bmjsrh-2020-200944
Author(s):  
Celia Karp ◽  
Shannon N Wood ◽  
Georges Guiella ◽  
Peter Gichangi ◽  
Suzanne O Bell ◽  
...  
Keyword(s):  
At Risk ◽  
Burkina Faso ◽  
Unintended Pregnancy ◽  
Sexual And Reproductive Health ◽  
Universal Access ◽  
Sociodemographic Factors ◽  
Sub Saharan Africa ◽  
Contraceptive Services ◽  
Logistic Regressions ◽  
Sub Saharan

IntroductionEvidence from health emergencies suggests COVID-19 will disrupt women’s sexual and reproductive health (SRH). In sub-Saharan Africa, which experiences the highest rates of unintended pregnancy and unsafe abortion globally, COVID-19 is projected to slow recent progress toward universal access to contraceptive services.MethodsWe used longitudinal data collected from women at risk of unintended pregnancy in Burkina Faso (n=1186) and Kenya (n=2784) before (November 2019–February 2020) and during (May–July 2020) COVID-19 to quantify contraceptive dynamics during COVID-19; examine sociodemographic factors and COVID-19 experiences related to contraceptive dynamics; and assess COVID-19-related reasons for contraceptive non-use. Bivariate and multivariate logistic regressions were used to examine correlates of contraceptive dynamics amid COVID-19.ResultsMost women did not change their contraceptive status during COVID-19 (68.6% in Burkina Faso and 81.6% in Kenya) and those who did were more likely to adopt a method (25.4% and 13.1%, respectively) than to discontinue (6.0% and 5.3%, respectively). Most women who switched contraceptives were using methods as or more effective than their pre-pandemic contraception. Economic instability related to COVID-19 was associated with increased contraceptive protection in Burkina Faso but not in Kenya. Altogether, 14.4% of non-contraceptive users in Kenya and 3.8% in Burkina Faso identified COVID-19-related reasons for non-use.ConclusionsThe vast majority of women at risk of unintended pregnancy did not change their contraceptive status during COVID-19, and more women adopted than discontinued methods. A minority of women reported COVID-19-related reasons for non-use, underscoring the importance of expanding safe modes of service delivery during health crises.

scholarly journals Cohort profile: internal migration in sub-Saharan Africa—The Migration and Health in Malawi (MHM) study

BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e014799 ◽  
Author(s):  
Philip Anglewicz ◽  
Mark VanLandingham ◽  
Lucinda Manda-Taylor ◽  
Hans-Peter Kohler
Keyword(s):  
Health Outcomes ◽  
Reference Group ◽  
Sub Saharan Africa ◽  
Extensive Information ◽  
Sub Saharan ◽  
The Relationship ◽  
Mental And Physical Health ◽  
Use Of Health Services ◽  
Migration And Health ◽  
Selection Of

PurposeThe Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes.ParticipantsData are available for two waves. The MHM interviewed 398 of 715 migrants in 2007 (55.7%) and 722 of 1013 in 2013 (71.3%); as well as 604 of 751 (80.4%) for a non-migrant reference group in 2013. The total interviewed sample size for the MHM in both waves is 1809. These data include extensive information on lifetime migration, socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, social networks and social capital, HIV/AIDS biomarkers and other dimensions of health.Findings to dateOur result for the relationship between migration and health differs by health measure and analytic approach. Migrants in Malawi have a significantly higher HIV prevalence than non-migrants, which is primarily due to the selection of HIV-positive individuals into migration. We find evidence for health selection; physically healthier men and women are more likely to move, partly because migration selects younger individuals. However, we do not find differences in physical or mental health between migrants and non-migrants after moving.Future plansWe are preparing a third round of data collection for these (and any new) migrants, which will take place in 2018. This cohort will be used to examine the effect of migration on various health measures and behaviours, including general mental and physical health, smoking and alcohol use, access to and use of health services and use of antiretroviral therapy.

scholarly journals Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 126 ◽  
Author(s):  
Ying-Ru Lo ◽  
Masaya Kato ◽  
Nittaya Phanuphak ◽  
Masami Fujita ◽  
Duong Bui Duc ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Treatment As Prevention ◽  
The Pacific ◽  
Prep Implementation ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Operational Issues ◽  
Exposure Prophylaxis ◽  
Firm Evidence

Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of ‘real world’ effectiveness is still lacking.

Oral and injectable contraception use and risk of HIV acquisition among women in sub-Saharan Africa

AIDS ◽  
2013 ◽  
Vol 27 (6) ◽  
pp. 1001-1009 ◽  
Author(s):  
Sandra I. McCoy ◽  
Wenjing Zheng ◽  
Elizabeth T. Montgomery ◽  
Kelly Blanchard ◽  
Ariane van der Straten ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Contraception Use ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

scholarly journals “I wish to remain HIV negative”: Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244226
Author(s):  
Makobu Kimani ◽  
Elise M. van der Elst ◽  
Oscar Chirro ◽  
Elizabeth Wahome ◽  
Fauz Ibrahim ◽  
...  
Keyword(s):  
Risk Behaviour ◽  
Healthcare Services ◽  
Transgender Women ◽  
Situational Factors ◽  
Sub Saharan Africa ◽  
Sexual Risk Behaviour ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Background Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700–1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.

scholarly journals Schistosoma and Other Relevant Helminth Infections in HIV-Positive Individuals—an Overview

2019 ◽  
Vol 4 (2) ◽  
pp. 65 ◽  
Author(s):  
Amrei von Braun ◽  
Henning Trawinski ◽  
Sebastian Wendt ◽  
Christoph Lübbert
Keyword(s):  
Neglected Tropical Diseases ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Treatment And Prevention ◽  
Helminth Infections ◽  
Helminthic Infections ◽  
Sub Saharan ◽  
Health Organization ◽  
Hiv Acquisition

For many years, researchers have postulated that helminthic infections may increase susceptibility to HIV, and that immune activation may have contributed to the extensive spread of HIV in sub-Saharan Africa. In the meantime, immunological studies have provided some evidence in support of this hypothesis, while cross-sectional clinical studies were able to further support the assumed association between HIV infection and selected helminthic co-infections. However, as many of the helminthic infections relevant to HIV-infected patients belong to the group of “neglected tropical diseases”, as defined by the World Health Organization, a certain lack of attention has inhibited progress in fully scaling up treatment and prevention efforts. In addition, despite the fact that the challenges of co-infections have preoccupied clinicians for over two decades, relevant research questions remain unanswered. The following review aims to provide a concise overview of associations between HIV and selected helminthic co-infections concerning aspects of HIV acquisition and transmission, clinical and immunological findings in co-infected individuals, as well as treatment and prevention efforts.

scholarly journals Strongyloides stercoralis infection in San Marino Republic: first epidemiological data from an observational study

2019 ◽  
Vol 147 ◽  
Author(s):  
E. D. Cappella ◽  
A. C. Piscaglia ◽  
A. Cadioli ◽  
S. Manoni ◽  
R. Silva ◽  
...  
Keyword(s):  
At Risk ◽  
Epidemiological Data ◽  
Strongyloides Stercoralis ◽  
Northern Italy ◽  
Sub Saharan Africa ◽  
Routine Practice ◽  
Travel History ◽  
Imported Case ◽  
Serology Test ◽  
Sub Saharan

AbstractStrongyloides stercoralis is a neglected parasite that can cause death in immunocompromised individuals. There were no data on the epidemiology of S. stercoralis infection in San Marino Republic until two patients (one of whom died) were diagnosed with severe strongyloidiasis (hyperinfection) between September 2016 and March 2017. A serology test for Strongyloides spp. was introduced in routine practice in the laboratory of the State Hospital to test patients considered to be at risk for strongyloidiasis. Between August 2017 and August 2018, of 42 patients tested with serology, two (4.8%) were positive. An additional case was found by gastric biopsy. Two of the positive cases were presumably autochthonous infections (elderly people with no significant travel history), while the other was a probable imported case (young man born in Nigeria and settled in Europe since 2003). Epidemiology of strongyloidiasis in San Marino might be similar to Northern Italy, where a relevant proportion of cases was diagnosed in immigrants (mainly from sub-Saharan Africa) and in elderly Italians with eosinophilia. Screening for strongyloidiasis might be worthwhile in inhabitants of San Marino in the same categories of individuals, particularly those at risk of immune suppression.

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