scholarly journals Built Environment and HIV Linkage to Care in Rural South Africa

2021 ◽  
pp. 0272684X2110065
Author(s):  
Nosipho Shangase ◽  
Brian Pence ◽  
Sheri A. Lippman ◽  
Mi-Suk Kang Dufour ◽  
Chodziwadziwa Whiteson Kabudula ◽  
...  
Keyword(s):  
South Africa ◽  
Land Use ◽  
Built Environment ◽  
Multilevel Models ◽  
Linkage To Care ◽  
Risk Difference ◽  
Residential Density ◽  
Universal Test And Treat ◽  
Effect Measure Modification ◽  
Hiv Linkage To Care

Background We assessed built environment (residential density, landuse mix and aesthetics) and HIV linkage to care (LTC) among 1,681 (18–49 years-old) residents of 15 Mpumalanga villages, South Africa. Methods Multilevel models (linear-binomial) were used for the association between built environment, measured using NEWS for Africa, and LTC from a clinical database of 9 facilities (2015–2018). Additionally, we assessed effect-measure modification by universal test-and-treat policy (UTT). Results We observed, a significant association in the adjusted 3-month probability of LTC for residential density (risk difference (RD)%: 5.6, 95%CI: 1.2–10.1), however, no association for land-use mix (RD%: 2.4, 95%CI: −0.4, 5.2) and aesthetics (RD%: −1.2, 95%CI: −4.5–2.2). Among those diagnosed after UTT, residents of high land-use villages were more likely to link-to-care than those of low land-use villages at 12 months (RD%: 4.6, 95%CI: 1.1–8.1, p < 0.04), however, not at 3 months (RD%: 3.0, 95%CI: −2.1–8.0, p > 0.10). Conclusion Findings suggest, better built environment conditions (adequate infrastructure, proximity to services etc.) help facilitate LTC. Moreover, UTT appears to have a protective effect on LTC.

scholarly journals Completion of the tuberculosis care cascade in a community-based HIV linkage-to-care study in South Africa and Uganda

2018 ◽  
Vol 21 (1) ◽  
pp. e25065 ◽  
Author(s):  
Adrienne E Shapiro ◽  
Alastair van Heerden ◽  
Torin T Schaafsma ◽  
James P Hughes ◽  
Jared M Baeten ◽  
...  
Keyword(s):  
South Africa ◽  
Linkage To Care ◽  
Community Based ◽  
Care Cascade ◽  
Hiv Linkage To Care ◽  
Tuberculosis Care ◽  
Care Study

scholarly journals The Moderating Effect of Distance on Features of the Built Environment and Active School Transport

2020 ◽  
Vol 17 (21) ◽  
pp. 7856
Author(s):  
Allison Ross ◽  
Josephine Godwyll ◽  
Marc Adams
Keyword(s):  
Land Use ◽  
Built Environment ◽  
Multilevel Models ◽  
Parent Survey ◽  
Environmental Features ◽  
Safe Routes To School ◽  
Intersection Density ◽  
Objectively Measured ◽  
The Impact ◽  
Walking And Biking

Despite growing research supporting the impact of the built environment on active school transport (AST), distance persists as the most powerful predictor of walking and biking to school. There is a need to better understand how environmental features interact with distance to affect AST, and whether the influence of environmental factors persist across different distance thresholds. Multilevel models using cluster-robust standard errors were used to examine for interactions between objectively measured macroscale environmental features and several reported distances from home to school (up to ¼, ¼ up to ½, ½ up to 1, 1+ miles) on the likelihood of parent reported AST for children grades 3–8 (n = 2751) at 35 schools who completed a Safe Routes to School Parent Survey about Walking and Biking to School (SRTS Parent Survey). An interaction between both intersection density and food-related land use with distance was observed. The likelihood of AST decreased as intersection density and distance increased (i.e., 31.0% reduced odds among those living within ¼ mile compared to 18.2% using ½–1-mile criterion). The likelihood of using AST were reduced as food-related land use and distance increased (i.e., 43.67% reduced odds among those living under ¼ mile compared to 19.83% reduced odds among those living ½–1 mile). Programs and infrastructure improvements focused on overcoming environmental barriers to promote AST may be most effective when targeting neighborhoods within ¼ mile of schools.

Can SPLUMA Play a Role in Transforming Spatial Injustice to Spatial Justice in Housing in South Africa?

2017 ◽  
Vol 30 (1) ◽  
pp. 26-41 ◽  
Author(s):  
Jeannie Van Wyk
Keyword(s):  
South Africa ◽  
Land Use ◽  
Land Reform ◽  
Spatial Planning ◽  
National Development ◽  
Well Being ◽  
Spatial Development ◽  
Land Use Management ◽  
Spatial Justice ◽  
Spatial Environment

Our spatial environment is one of the most important determinants of our well-being and life chances. It relates to schools, opportunities, businesses, recreation and access to public services. Spatial injustice results where discrimination determines that spatial environment. Since Apartheid in South Africa epitomised the notion of spatial injustice, tools and instruments are required to transform spatial injustice into spatial justice. One of these is the employment of principles of spatial justice. While the National Development Plan (NDP) recognised that all spatial development should conform to certain normative principles and should explicitly indicate how the requirements of these should be met, the Spatial Planning and Land Use Management Act 16 of 2013 (SPLUMA) contains a more concrete principle of spatial justice. It echoes aspects of both the South African land reform programme and global principles of spatial justice. Essentially section 7(a) of SPLUMA entails three components: (1) redressing past spatial imbalances and exclusions; (2) including people and areas previously excluded and (3) upgrading informal areas and settlements. SPLUMA directs municipalities to apply the principle in its spatial development frameworks, land use schemes and, most importantly, in decision-making on development applications. The aim of this article is to determine whether the application of this principle in practice can move beyond the confines of spatial planning and land use management to address the housing issue in South Africa. Central to housing is section 26 of the Constitution, that has received the extensive attention of the Constitutional Court. The court has not hesitated to criticize the continuing existence of spatial injustice, thus contributing to the transformation of spatial injustice to spatial justice. Since planning, housing and land reform are all intertwined not only the role of SPLUMA, but also the NDP and the myriad other policies, programmes and legislation that are attempting to address the situation are examined and tested against the components of the principle of spatial justice in SPLUMA.

The Impact of Zoning and Built Environment Characteristics on Transit, Biking, and Walking

2019 ◽  
Vol 11 (1) ◽  
pp. 108-129
Author(s):  
Andrew G. Mueller ◽  
Daniel J. Trujillo
Keyword(s):  
Land Use ◽  
Built Environment ◽  
Discrete Choice ◽  
Travel Behavior ◽  
Choice Model ◽  
Mode Choice ◽  
Land Use Regulation ◽  
Policy Action ◽  
Development Goals ◽  
The Impact

This study furthers existing research on the link between the built environment and travel behavior, particularly mode choice (auto, transit, biking, walking). While researchers have studied built environment characteristics and their impact on mode choice, none have attempted to measure the impact of zoning on travel behavior. By testing the impact of land use regulation in the form of zoning restrictions on travel behavior, this study expands the literature by incorporating an additional variable that can be changed through public policy action and may help cities promote sustainable real estate development goals. Using a unique, high-resolution travel survey dataset from Denver, Colorado, we develop a multinomial discrete choice model that addresses unobserved travel preferences by incorporating sociodemographic, built environment, and land use restriction variables. The results suggest that zoning can be tailored by cities to encourage reductions in auto usage, furthering sustainability goals in transportation.

scholarly journals Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa

2021 ◽  
Author(s):  
Dorina Onoya ◽  
Tembeka Sineke ◽  
Idah Mokhele ◽  
Jacob Bor ◽  
Matthew P. Fox ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Self Report ◽  
Hiv Diagnosis ◽  
Adjusted Risk ◽  
Art Initiation ◽  
Art Policy ◽  
Universal Test And Treat ◽  
Post Test ◽  
Treat All

AbstractWe aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for  > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.

Sign in / Sign up

Export Citation Format

Share Document