Overcoming Barriers and Ensuring Access to HPV Vaccines in Low-Income Countries

2009 ◽  
Vol 35 (2-3) ◽  
pp. 401-413 ◽  
Author(s):  
Vivien Davis Tsu
Keyword(s):  
Adolescent Girls ◽  
Low Income ◽  
Low Income Countries ◽  
Political Commitment ◽  
Hpv Vaccines ◽  
Transmitted Infection ◽  
High Coverage ◽  
Sexually Transmitted ◽  
Potential Barriers ◽  
Screening Services

AbstractThe inequitable burden of cervical cancer falls on women in poorer countries, due primarily to a disparity in access to screening services. To ensure that access to the new human papillomavirus (“HPV”) vaccines is not similarly skewed toward higher-income populations, it is important to understand the appropriate priority group for receiving vaccines, the potential barriers to reaching that group, and the options for overcoming those barriers. Based on vaccine efficacy data, the likelihood of achieving high coverage with various groups, and the resultant cost-effectiveness ratios, it is widely agreed that young adolescent girls should be the primary recipients. Potential barriers include the fact that young adolescents are not currently reached by many health services; that there might be stigma attached to a vaccine for a sexually transmitted infection; that financing for the vaccine must be allocated; and that there is limited political commitment to women's health, to cancer prevention, or to this particular vaccine when so many other new vaccines are also becoming available. Despite these very real challenges, there is reason to be cautiously optimistic that those most in need of an HPV vaccine can receive it in programs that are affordable, effective, and acceptable to girls, their families, and their societies.

scholarly journals Global e-government development: besides the relative wealth of countries, do policies matter?

2020 ◽  
Vol 14 (3) ◽  
pp. 381-400 ◽  
Author(s):  
Gonçalo Paiva Dias
Keyword(s):  
Low Income ◽  
Public Policies ◽  
Low Income Countries ◽  
Political Commitment ◽  
Content Type ◽  
Secondary Sources ◽  
Relative Wealth ◽  
Innovative Thinking ◽  
High Level ◽  
Government Development

Purpose This study aims to investigate whether, discounting the effect of the relative wealth of countries, it is possible to observe the relevance of policies for e-government development. Design/methodology/approach The deviations of countries' results from what could be expected, considering their relative wealth is calculated by using the residuals of a linear regression using the Gross Domestic Product per capita as the independent variable and the UN E-Government Development Index as the dependent variable. The countries that achieve better and worse results than expected are then identified and their cases are analyzed by resorting to secondary sources, namely, published research referring to their cases. Those research documents were identified by successively searching the Scopus database, the Google Scholar database and the Web of Science. Findings The existence of formal e-government strategies and plans and the capacity to implement them can make a difference, allowing countries to achieve better results than expected or, in their absence, to perform worse than expected. Research limitations/implications The proposed methodology can be useful to e-government researchers, particularly as a basis for deeper and more detailed studies. Practical implications Countries should invest in well-developed and focused strategies and continuity of public policies and their capacity to deliver results. For that purpose, political commitment and high-level coordination are key factors. For low-income countries, long-lasting cooperation with external experienced partners is crucial. For high-income countries, innovative thinking is a key enabler. Originality/value This study uses an innovative method to look beyond the effect of the relative wealth of countries and investigate the relevance of public policies for e-government development.

scholarly journals Education, HIV, and Early Fertility: Experimental Evidence from Kenya

2015 ◽  
Vol 105 (9) ◽  
pp. 2757-2797 ◽  
Author(s):  
Esther Duflo ◽  
Pascaline Dupas ◽  
Michael Kremer
Keyword(s):  
Sexual Behavior ◽  
Experimental Evidence ◽  
Adolescent Girls ◽  
Sexually Transmitted Infection ◽  
Factor Model ◽  
Unprotected Sex ◽  
Education Subsidies ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Randomized Evaluation

A seven-year randomized evaluation suggests education subsidies reduce adolescent girls' dropout, pregnancy, and marriage but not sexually transmitted infection (STI). The government's HIV curriculum, which stresses abstinence until marriage, does not reduce pregnancy or STI. Both programs combined reduce STI more, but cut dropout and pregnancy less, than education subsidies alone. These results are inconsistent with a model of schooling and sexual behavior in which both pregnancy and STI are determined by one factor (unprotected sex), but consistent with a two-factor model in which choices between committed and casual relationships also affect these outcomes. (JEL I12, I18, I21, J13, J16, O15)

scholarly journals Transcriptomic Data Sets To Determine Gene Expression Changes Mediated by the Presence of PBT2 in Growth Medium of Multidrug-Resistant Neisseria gonorrhoeae WHO Z

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Freda E.-C. Jen ◽  
Ibrahim M. El-Deeb ◽  
John M. Atack ◽  
Mark von Itzstein ◽  
Michael P. Jennings
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Transcriptome Sequencing ◽  
Multidrug Resistant ◽  
Data Sets ◽  
Sequencing Data ◽  
Transmitted Infection ◽  
High Coverage ◽  
Content Type ◽  
Sexually Transmitted ◽  
Transcriptomic Data

ABSTRACT Neisseria gonorrhoeae causes the sexually transmitted infection gonorrhea. High-coverage (∼3,300-fold) transcriptome sequencing data have been collected from multidrug-resistant N. gonorrhoeae strain WHO Z grown in the presence and absence of PBT2.

scholarly journals Increasing adolescent girls’ ability to identify STI-risk characteristics of sexual partners: a pilot study within an alternative disciplinary school

2019 ◽  
Vol 95 (8) ◽  
pp. 580-583
Author(s):  
Eric Richardson ◽  
Kelli A Komro ◽  
Esaa Samarah ◽  
Stephanie A S Staras
Keyword(s):  
Pilot Study ◽  
Adolescent Girls ◽  
Preventive Intervention ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Risk Characteristics ◽  
Post Test ◽  
Partner Characteristics ◽  
Partner Risk

ObjectivesWe evaluated the feasibility of conducting a 9-week long sexually transmitted infection (STI) prevention intervention, Angels in Action, within an alternative disciplinary school for adolescent girls.MethodsAll girls who were 16–18 years old, enrolled in the school and did not have plans to transfer from the school were eligible to participate. We measured process feasibility with recruitment, retention and participant enjoyment. Using a pretest-post-test design with a double post-test, we used χ² tests to estimate the intervention effect on participants’ sexual partner risk knowledge, intentions to reduce partner risk and sexual activities in the past 60 days with three behavioural surveys: prior to, immediately following and 3 months after the intervention.ResultsAmong the 20 girls who were eligible, 95% (19/20) of parents consented and all girls (19/19) agreed to participate. Survey participation was 100% (19/19) prior to, 76% (13/17) immediately following and 53% (9/17) 3 months after the intervention. The intervention was administered twice and a total 17 girls participated. Session attendance was high (89%) and most participants (80%) reported enjoying the intervention. The intervention increased the percentage of girls who could identify partner characteristics associated with increased STI risk: 38% before, 92% immediately following and 100% 3 months after the intervention (p=0.01). Girls also increased their intentions to find out four of the most highly associated partner characteristics (partner’s age, recent sexual activity and STI or jail history): 32% before to 75% immediately following (p=0.02) and 67% 3 months after the intervention (p=0.09).ConclusionsThis pilot study suggests girls at alternative disciplinary schools participated in and enjoyed a 9-week STI preventive intervention. Within alternative disciplinary schools, it is potentially feasible to increase girls’ consideration of partner risk characteristics as a means to enhance their STI prevention skills.

scholarly journals To pool or not to pool samples for Sexually Transmitted Infections detection in Men who have Sex with Men? An evaluation of a new pooling method using the GeneXpert instrument in West-Africa

2020 ◽  
Author(s):  
Irith De Baetselier ◽  
Bea Vuylsteke ◽  
Issifou Yaya ◽  
Anoumou Dagnra ◽  
Souba Diandé ◽  
...  
Keyword(s):  
West Africa ◽  
Sexually Transmitted Infections ◽  
Low Income ◽  
Low Income Countries ◽  
African Countries ◽  
Sexually Transmitted ◽  
Sample Pooling ◽  
Pooling Strategies ◽  
Sex With Men ◽  
Positive Results

AbstractBackgroundMen who have sex with Men (MSM) using Pre-exposure prophylaxis (PrEP) are at risk for Sexually Transmitted Infections (STIs). Therefore, PrEP services should include regular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at urethra, anorectum and pharynx. However, financial and logistic challenges arise in low resource settings. We assessed a new STI sample pooling method using the GeneXpert instrument among MSM initiating PrEP in West-Africa.MethodsUrine, anorectal and pharyngeal samples were pooled per individual for analysis. Unpooled samples were analyzed in case of an invalid or positive result of the pool, to identify the infection’s biological location. The results of two different pooling strategies were compared against a gold standard.ResultsWe found a prevalence of 14.5% for chlamydia and 11.5% for gonorrhea, with a predominance of infections being extra-genital (77.6%). The majority of infections were asymptomatic (88.2%). The pooling strategy with unpooling of invalid results only, had a sensitivity, specificity and agreement for CT of 95.4%, 98.7% and 0.93, respectively; and 92.3%, 99.2% and 0.93 with additional unpooling of positive results. For NG, these figures were 88.9%, 97.7% and 0.85 for testing of invalid results, and 88.9%, 96.7% and 0.81 with unpooling of positive results.ConclusionWest-African MSM have a high prevalence of extra-genital and asymptomatic STIs. The GeneXpert method provides an opportunity to move from syndromic towards etiological STI diagnosis in low income countries, as the platform is available in all African countries for tuberculosis testing. Pooling will reduce costs of triple site testing.

scholarly journals Prevalence of open air defecation and awareness and practices of sanitary latrine usage in a rural village of Raipur district

2017 ◽  
Vol 4 (9) ◽  
pp. 3279 ◽  
Author(s):  
Prem S. Panda ◽  
Aditi Chandrakar ◽  
Gopal P. Soni
Keyword(s):  
Low Income ◽  
Administrative Support ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Low Income Countries ◽  
Political Commitment ◽  
Background Characteristics ◽  
Key Points ◽  
The Family ◽  
Study Participants

Background: The practice of open defecation is rampant in India and our country is home to the world’s largest population of people who defecate in the open. Insanitary disposal of human excreta, along with unsafe drinking water and poor hygiene conditions, is a leading cause of morbidity and mortality in low-income countries. The study was conducted with objective to find sanitary latrine usage, prevalence of open air defecation and awareness related to diseases caused by open air defecation in the rural population of a village in Raipur district.Methods: A total of 155 households were selected for the study using simple random sampling technique by lottery method. One member from each household, preferably the head of the family (if not available, any elder person in the family), was interviewed personally. A structured questionnaire was used to collect information regarding the background characteristics, awareness and practices about sanitary latrine usage. Results: Majority of the study participants 109 (70.3%) had sanitary latrines in their houses. The prevalence of open air defecation in the study area was found to be 23.2%. Around 2/3rd (65.2%) of study subjects were not aware about spread of disease due to open air defecation. Conclusions: Awareness regarding spread of diseases due to open air defecation is poor. Effective political commitment and administrative support will be the key points of success of the Swachha Bharat Abhiyaan program. 

scholarly journals Trichomonas vaginalis AND HIV INFECTION: RELATION AND PREVALENCE AMONG WOMEN IN SOUTHERN BRAZIL

2019 ◽  
Vol 48 (1) ◽  
pp. 15-24
Author(s):  
Mirian Pinheiro Bruni ◽  
Carolina Caetano dos Santos ◽  
Dulce Stauffert ◽  
Nilton Da Cunha Filho ◽  
Guilherme De Oliveira Bicca ◽  
...  
Keyword(s):  
Viral Load ◽  
Low Income ◽  
Trichomonas Vaginalis ◽  
Hiv Positive ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Cell Counts ◽  
Hiv Negative

Trichomoniasis is a curable sexually transmitted infection (STI) that has been reported to be linked to exposure to human immunodeficiency virus (HIV), although few studies have described this association. The purpose of this study was to focus on the incidence of trichomoniasis in low-income women, its relation to HIV status, viral load levels and TCD4+ cell counts, among other risk factors, using an in vitro culture as a diagnostic test. A crosssectional study among 267 women (103 HIV-positive and 164 HIV-negative) was conducted in 2015. The overall prevalence of Trichomonas vaginalis (TV) infection was 6.4%. Among HIVpositive and HIV-negative women, the prevalence was 3.9% and 7.9%, respectively, yet these results were not statistically different (p=0.1878). The factors associated with TV infection were cigarette smoking (OR= 3.52), vaginal itching (OR=4.43) and bacterial vaginosis (BV) (OR= 5.29). HIV status, TCD4+ cell count and viral load were not associated with TV infection in this group. The prevalence rates found, lower than those observed in other studies, may be due to the fact that the women evaluated in the present study are part of a low-risk populationas well as the limited sample size of HIV positive women.

Awareness and uptake of pre-exposure prophylaxis for HIV among low-income, HIV-negative heterosexuals in San Francisco

2021 ◽  
pp. 095646242098666
Author(s):  
Daphine Namara ◽  
Hui Xie ◽  
Desmond Miller ◽  
Danielle Veloso ◽  
Willi McFarland
Keyword(s):  
San Francisco ◽  
Low Income ◽  
Educational Materials ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Left Behind ◽  
Prep Implementation ◽  
Prep Awareness ◽  
Exposure Prophylaxis ◽  
Hiv Negative

We examined pre-exposure prophylaxis (PrEP) awareness and uptake among low-income heterosexual men and women in San Francisco in 2019. Of 294 HIV-negative survey participants, 42.5% were aware of PrEP. Few women (12.5%) and men (8.9%) had discussed PrEP with a healthcare provider; 3.8% of women and 0% of men had used PrEP in the last year. White participants (adjusted odds ratio (aOR) 5.39, 95% CI 1.02, 28.56), women (aOR 2.19, 95% CI 1.30, 3.70), and age 60 years or above (aOR 4.00, 95% CI 1.12, 14.34) had greater odds of being aware of PrEP. Testing for HIV or sexually transmitted infection in the past year was marginally associated with a greater PrEP awareness. Our findings reveal gaps in PrEP implementation associated with social disparities among low-income heterosexuals. Testing services and targeted promotional and educational materials are needed lest high-risk, low-income populations are left behind in San Francisco’s aggressive “Getting to Zero” efforts.

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