scholarly journals Developing Action Plans in Youth Photovoice to Address Community-Level HIV Risk in Rural Malawi

2020 ◽  
Vol 19 ◽  
pp. 160940692092013 ◽  
Author(s):  
Saria Lofton ◽  
Kathleen F. Norr ◽  
Diana Jere ◽  
Crystal Patil ◽  
Chimwemwe Banda
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
Sexual Behaviors ◽  
Planning Process ◽  
Action Planning ◽  
Sub Saharan Africa ◽  
Action Plans ◽  
Unsafe Sex ◽  
Community Issues

Youth-driven approaches to HIV prevention can engage youth and improve health outcomes. Photovoice has been used to engage youth in identifying the assets and challenges in their communities. In sub-Saharan Africa, youth remain vulnerable to HIV infection. This article describes a photovoice project, named Youth Photovoice, conducted in rural Malawi, which focused on community places and situations relating to risky sexual behaviors that place youth at risk of HIV infection. Twenty-four youth, ages 13–17 (12 males and 12 females), participated in Youth Photovoice. During the photovoice process, youth identified five community situations and places that put them at risk of unsafe sex and thus HIV infection: initiation ceremonies, isolated places, community celebrations, local businesses such as bars and rest houses, and church-sponsored activities. Youth used a systematic action planning process to develop action plans. They presented their action plans to local leaders and parents. Parents and leaders responded positively and agreed to help the youth carry out their plans. If their plans to address community situations that put them at risk of unsafe sex succeed, there will be a direct impact on reducing the risk of HIV infection among youth. Youth Photovoice provided the opportunity for youth to obtain new skills, build new partnerships, and present their ideas to community leaders. Integrating this action planning process into photovoice helped to guide the youth toward actualizing their HIV prevention plans in their community. This process can increase the effectiveness of photovoice initiatives to address other community issues in a wide variety of settings.

scholarly journals Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Southern African HIV Clinicians Society Consensus Committee
Keyword(s):  
At Risk ◽  
Renal Function ◽  
Hiv Prevention ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Fixed Dose ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

scholarly journals Preliminary Impacts of an HIV-Prevention Program Targeting Out-of-School Youth in Postconflict Liberia

2018 ◽  
Vol 5 ◽  
pp. 2333794X1875445
Author(s):  
Stephen B. Kennedy ◽  
Katherine Atwood ◽  
Albert O. Harris ◽  
Curtis H. Taylor ◽  
Steve Shamblen ◽  
...  
Keyword(s):  
At Risk ◽  
Sexual Behaviors ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Sub Saharan Africa ◽  
Sexual Risk Taking ◽  
Community Based ◽  
Transmitted Infection ◽  
Positive Effects ◽  
Condom Attitudes

Adolescents in Sub-Saharan Africa account for greater HIV/STI (human immuno defiency virus/sexually transmitted infection) burdens and difficult-to-reach populations. This study implemented a community-based HIV/STI program to reach at-risk youth aged 15 to 17 years in postconflict Liberia. Using a randomized controlled trial, community youths were assigned to an adapted version of an effective HIV/STI program, Making Proud Choices, or attention-matched comparison curriculum, General Health Program. Both programs were of similar doses, reach and coverage, and administered in classroom settings by trained health educators. The findings suggest that the adapted HIV/STI program had positive effects on knowledge, sexual refusal and condom use self-efficacy, condom negotiation self-efficacy, positive condom attitudes, parental communication about sex, and negative condom attitudes over time. Culturally adapted community-based, behavioral-driven programs can positively affect mediators of sexual behaviors in at-risk adolescents in postconflict settings. This is the first published report of an evidence-based HIV/STI program on sexual risk-taking behaviors of community youths in Liberia.

scholarly journals “The Drug Will Help Protect My Tomorrow”: Perceptions of Integrating PrEP into HIV Prevention Behaviors Among Female Sex Workers in Lilongwe, Malawi

2019 ◽  
Vol 31 (5) ◽  
pp. 421-432
Author(s):  
Jaclyn Shea ◽  
Agatha Bula ◽  
Wezzie Dunda ◽  
Mina C. Hosseinipour ◽  
Carol E. Golin ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Economic Effects ◽  
Sub Saharan Africa ◽  
Prevention Strategies ◽  
Female Sex ◽  
Hiv Prevention Strategies ◽  
Hiv Acquisition

Female sex workers (FSW) are disproportionately at risk for HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, yet approaches for incorporating PrEP within prevention strategies used by FSW are lacking. Semistructured focus group discussions were conducted with 44 HIV-negative FSW in Lilongwe, Malawi to explore perceptions of PrEP: acceptability, integration within HIV prevention behaviors, and barriers to use. Acceptability of PrEP was high. Motivation to use PrEP was rooted in love for one's life, anticipated negative economic effects associated with HIV acquisition. PrEP was viewed as complementary to existing norms for engaging in healthy sexual behaviors. Many felt PrEP may provide extra protection from HIV, along with condoms and frequent STI testing. Unpredictable daily lives, stigma, and side effects were barriers that could affect PrEP use. Leveraging existing HIV prevention strategies and social norms surrounding HIV prevention behaviors may positively impact PrEP uptake among FSW in Malawi and sub-Saharan Africa.

scholarly journals Differentiated Prevention And Care To Reduce The Risk of HIV Acquisition And Transmission Among Female Sex Workers In Zimbabwe: Study Protocol For The ‘AMETHIST’ Cluster Randomised Trial

2021 ◽  
Author(s):  
Frances Cowan ◽  
Fortunate Machingura ◽  
Sungai T Chabata ◽  
Sanni Ali ◽  
Joanna Busza ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sub Saharan Africa ◽  
Total N ◽  
Female Sex ◽  
Prevention And Treatment ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

Abstract Background: Female sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and are critical to engage in both HIV prevention and care. Here we describe our approach to evaluation of the AMETHIST intervention for FSW, adapted to the African context and set in Zimbabwe where there is a nationally-scaled programme for sex workers (Sisters). We hypothesise this intervention will raise uptake and adherence to prevention and treatment among FSW resulting in a reduction in their risk of HIV acquisition/transmission.Methods: The AMETHIST intervention (Adapted Microplanning to Eliminate Transmission of HIV in Sex Transactions) aims to provide risk differentiated prevention and care to FSW through microplanning and self help groups. Twenty two towns with the Sisters programme were randomised using restricted randomisation to either the Sisters programme or the Sister programme plus AMETHIST. The primary outcome is composite and is defined as the proportion of HIV positive FSW at risk of HIV transmission combined with the proportion of HIV negative FSW at risk of HIV acquisition. The outcome will be assessed after two years of intervention delivery in a respondent-driven sampling survey (total n=4400; n=200 FSW recruited at each site). Primary analysis will use the ‘RDS-2’ method to estimate cluster summaries and will adapt Hayes and Moulton’s ‘2-step’ method to adjust effect estimates for individual-level confounders and further adjust for cluster baseline prevalence. An in-depth process evaluation guided by our project trajectory will be undertaken.Discussion: Innovative pragmatic trials are needed to generate evidence on effectiveness of combination interventions in HIV prevention and treatment in different contexts. We describe the design and analysis of such a study.Trial Registration: The trial was registered at Pan African Clinical Trials Registry (PACTR202007818077777) on 2 July 2020.

scholarly journals Male circumcision and HIV prevention: Directions for future research

2000 ◽  
Author(s):  
Johannes van Dam ◽  
Marie Christine Anastasi
Keyword(s):  
Hiv Prevention ◽  
Hiv Infection ◽  
Male Circumcision ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Scientific Publications ◽  
Sexually Transmitted ◽  
Cultural Implications ◽  
The World ◽  
Sub Saharan

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and HIV infection have been done in Africa, and the discussion focuses largely on this continent. The conclusions and recommendations from the meeting, however, may be relevant for other parts of the world. Based on the discussion, participants determined that there is considerable evidence supporting a protective effect of male circumcision on HIV infection in men in sub-Saharan Africa. Participants also concluded that there are many unknowns.

Alcohol and drug use and sexual behaviors placing runaways at risk for HIV infection

1994 ◽  
Vol 19 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Cheryl Koopman ◽  
Margaret Rosario ◽  
Mary Jane Rotheram-Borus
Keyword(s):  
At Risk ◽  
Drug Use ◽  
Hiv Infection ◽  
Sexual Behaviors ◽  
Alcohol And Drug Use

scholarly journals An Examination of Twitter Data to Identify Risky Sexual Practices Among Youth and Young Adults in Botswana

2019 ◽  
Vol 16 (4) ◽  
pp. 656 ◽  
Author(s):  
Judith Cornelius ◽  
Anna Kennedy ◽  
Ryan Wesslen
Keyword(s):  
Young Adults ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
Sexual Behaviors ◽  
Sexual Practices ◽  
Twitter Data ◽  
Significant Difference ◽  
Youth And Young Adults ◽  
Social Media Platforms ◽  
Twitter Users

Botswana has the third highest rate of HIV infection, as well as one of the highest mobile phone density rates in the world. The rate of mobile cell phone adoption has increased three-fold over the past 10 years. Due to HIV infection rates, youth and young adults are the primary target for prevention efforts. One way to improve prevention efforts is to examine how risk reduction messages are disseminated on social media platforms such as Twitter. Thus, to identify key words related to safer sex practices and HIV prevention, we examined three months of Twitter data in Botswana. 1 December 2015, was our kick off date, and we ended data collection on 29 February 2016. To gather the tweets, we searched for HIV-related terms in English and in Setswana. From the 140,240 tweets collected from 251 unique users, 576 contained HIV-related terms. A representative sample of 25 active Twitter users comprised individuals, one government site and 2 organizations. Data revealed that tweets related to HIV prevention and AIDS did not occur more frequently during the month of December when compared to January and February (t = 3.62, p > 0.05). There was no significant difference between the numbers of HIV related tweets that occurred from 1 December 2015 to 29 February 2016 (F = 32.1, p > 0.05). The tweets occurred primarily during the morning and evening hours and on Tuesdays followed by Thursdays and Fridays. The least number of tweets occurred on Sunday. The highest number of followers was associated with the Botswana government Twitter site. Twitter analytics was found to be useful in providing insight into information being tweeted regarding risky sexual behaviors.

scholarly journals A Young Black MSM on PrEP Is Lost to Follow-Up and Acquires HIV Infection: A Case to Call for Improved Strategies to Support Youth Adherence and Engagement in HIV Prevention

2019 ◽  
Vol 18 ◽  
pp. 232595821985383 ◽  
Author(s):  
Ketzela Jacobowitz Marsh ◽  
Meghan Rothenberger
Keyword(s):  
Hiv Prevention ◽  
Hiv Infection ◽  
Sexual Behaviors ◽  
The United States ◽  
Black Msm ◽  
Sex With Men ◽  
Young Black Msm ◽  
Exposure Prophylaxis ◽  
Lost To Follow Up

Young men who have sex with men (YMSM) are disproportionately affected by HIV in the United States. High-risk sexual behaviors are difficult to modify; thus, HIV pre-exposure prophylaxis (PrEP) with a daily pill is a promising prevention tool for this vulnerable population. We present a case of a young black MSM who was able to successfully access PrEP with the help of a community program but was not able to adhere to the regimen or engage in care. He ultimately acquired HIV infection. We review the existing literature and advocate for increased services and research to support youth’s adherence to PrEP and engagement in HIV prevention programs, with a focus on YMSM of color.

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