Evaluating the effect of a community score card among pregnant and breastfeeding women living with HIV in two districts in Malawi

Malawi faces challenges with retaining women in prevention of mother-to-child HIV transmission (PMTCT) services. We evaluated Cooperative for Assistance and Relief Everywhere, Inc. (CARE’s) community score card (CSC) in 11 purposively selected health facilities, assessing the effect on: (1) retention in PMTCT services, (2) uptake of early infant diagnosis (EID), (3) collective efficacy among clients, and (4) self-efficacy among health care workers (HCWs) in delivering quality services. The CSC is a participatory community approach. In this study, HCWs and PMTCT clients identified issues impacting PMTCT service quality and uptake and implemented actions for improvement. A mixed-methods, pre- and post-intervention design was used to evaluate the intervention. We abstracted routine clinical data on retention in PMTCT services for HIV-positive clients attending their first antenatal care visit and EID uptake for their infants for 8-month periods before and after implementation. To assess collective efficacy and self-efficacy, we administered questionnaires and conducted focus group discussions (FGDs) pre- and post-intervention with PMTCT clients recruited from CSC participants, and HCWs providing HIV care from facilities. Retention of HIV-positive women in PMTCT services at three and six months and EID uptake was not significantly different pre- and post-implementation. For the clients, the collective efficacy scale average improved significantly post-intervention, (p = 0.003). HCW self-efficacy scale average did not improve. Results from the FGDs highlighted a strengthened relationship between HCWs and PMTCT clients, with clients reporting increased satisfaction with services. However, the data indicated continued challenges with stigma and fear of disclosure. While CSC may foster mutual trust and respect between HCWs and PMTCT clients, we did not find it improved PMTCT retention or EID uptake within the short duration of the study period. More research is needed on ways to improve service quality and decrease stigmatized behaviors, such as HIV testing and treatment services, as well as the longer-term impacts of interventions like the CSC on clinical outcomes.

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Women of Reproductive Age Living with HIV in Argentina: Unique Challenges for Reengagement in Care

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958219883250 ◽

2019 ◽

Vol 18 ◽

pp. 232595821988325

Author(s):

Diego Cecchini ◽

Maria Luisa Alcaide ◽

Violeta de Jesus Rodriguez ◽

Lissa Nicole Mandell ◽

John Michael Abbamonte ◽

...

Keyword(s):

Self Efficacy ◽

Latent Class ◽

Hiv Transmission ◽

Reproductive Age ◽

Hiv Care ◽

Women Of Reproductive Age ◽

Physician Visits ◽

Women Living With Hiv ◽

Living With Hiv ◽

Disproportionate Burden

This study evaluated the reasons for not taking antiretroviral treatment (ART) among women of reproductive age who are disengaged from HIV care (have missed pharmacy pickups and physician visits), with the goal of identifying strategies for reengagement in HIV care. Participants were cisgender women (n = 162), 18 to 49 years of age, and who completed sociodemographic, medical history, reasons why they were not taking ART, mental health, motivation, and self-efficacy assessments. Latent class analysis was used for analysis. Women who reported avoidance-based coping (avoid thinking about HIV) had higher depression ( U = 608.5, z = −2.7, P = .007), lower motivation ( U = 601, z = −2.8, P = .006), and lower self-efficacy ( U = 644.5, z = −2.4, P = .017) than those not using this maladaptive strategy. As women living with HIV experience a disproportionate burden of poor health outcomes, interventions focused on the management of depression may improve HIV outcomes and prevent HIV transmission.

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A Cohort Study: Evaluating Self-Efficacy in Adolescents Attending a Tailored Youth-Informed Breastfeeding Program

10.1101/2020.02.10.20021808 ◽

2020 ◽

Author(s):

Christina M. Cantin ◽

Wendy E. Peterson ◽

Amisha Agarwal ◽

Jemila S. Hamid ◽

Bianca Stortini ◽

...

Keyword(s):

Cohort Study ◽

Peer Support ◽

Adolescent Mothers ◽

Low Income ◽

Self Efficacy ◽

Short Form ◽

Post Intervention ◽

Non Profit ◽

Before And After ◽

Support Housing

ABSTRACTAdolescents (≤19 years of age) have lower rates of breastfeeding (BF) compared to older mothers. BF self-efficacy (SE), defined as a mother’s confidence in her ability to breastfeed her infant, has been identified as an important factor influencing BF outcomes. An innovative youth-informed BF program for young women was designed and implemented, which included staff training, a prenatal BF class and BF peer support. The objective of this cohort study was to evaluate the effectiveness of the program in improving young mother’s BF SE.Participants were pregnant adolescents recruited from a large urban non-profit social service outreach centre. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to participants before and after participating in the BF program. BSES-SF scores were summed to determine a composite score and compared descriptively using mean score. Un-aggregated, item-by-item, comparison of pre-vs post-BF program scores were also compared to examine improvements in SE. A total of 20 adolescent mothers (mean age = 16.6) attended the BF program. An increase in the total BSES-SF score was observed based on descriptively comparing the mean pre vs post intervention.Prenatal education and peer support adapted to the needs of adolescent mothers was associated with increased BSES-SF. These results are promising given that clients attending programs at this agency have low-income, low educational attainment, variable family support, housing instability, and are at-risk for not breastfeeding. Future studies with larger cohort are required to further validate and establish generalizability, as well as to determine the effect on BF duration rates.

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The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11967 ◽

2020 ◽

Vol 14 (11.1) ◽

pp. 122S-127S

Author(s):

Maryana Sluzhynska ◽

Olga Denisiuk ◽

Ruzanna Grigoryan ◽

Yulia Sereda ◽

Gennadiy Slabkiy ◽

...

Keyword(s):

Urban Areas ◽

Hiv Transmission ◽

Cross Sectional Study ◽

Medical Doctor ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional ◽

Aids Epidemic ◽

Mode Of Transmission ◽

Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

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Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2017-101825 ◽

2017 ◽

Vol 44 (1) ◽

pp. 1.2-12 ◽

Cited By ~ 2

Author(s):

Lisa B Haddad ◽

Jennifer H Tang ◽

Jamie Krashin ◽

Wingston Ng’ambi ◽

Hannock Tweya ◽

...

Keyword(s):

Condom Use ◽

Hiv Care ◽

Consistent Condom ◽

Hiv Positive ◽

Consistent Condom Use ◽

Cross Sectional ◽

Men And Women ◽

Factors Associated ◽

Women Living With Hiv ◽

Living With Hiv

BackgroundUnderstanding the influences on condom use among men and women living with HIV is critical to tailoring sexually transmitted infection/HIV prevention efforts.MethodsThis is a sub-analysis of a cross-sectional survey including 255 women and 220 men who were sexually active, HIV-positive, and attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (aPRs) to evaluate for factors associated with consistent condom use (always using condoms in the past month) and use at last coitus for men and women in separate models.ResultsAmong women: 38% and 55% reported consistent condom use and condom use at last coitus, respectively. For women, consistent use and use at last coitus were positively associated with the ability to refuse sex without condoms and shared decision-making compared with making the decision alone regarding condom use, and negatively associated with desire for children in the future. Consistent use also increased with longer antiretroviral therapy (ART) use (≥1 year compared with no ART use). Among men: 51% and 69% reported consistent condom use and condom use at last coitus, respectively. For men, the ability to refuse sex without condoms was associated with consistent use and use at last coitus, and believing that condoms should be used with other contraception was associated with consistent use.ConclusionsOur findings demonstrate ongoing low condom utilisation among HIV-positive individuals, and highlight that ART and contraceptive use do not deter condom use. Efforts to increase condom utilisation must recognise individual-level factors that influence use and should focus on relationship dynamics and promotion of empowerment and self-efficacy.

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Enhancing domestic violence advocates’ ability to discuss HIV pre-exposure prophylaxis (PrEP): Feasibility and acceptability of an educational intervention

Women s Health ◽

10.1177/17455065211070548 ◽

2022 ◽

Vol 18 ◽

pp. 174550652110705

Author(s):

Tiara C Willie ◽

Laurel Sharpless ◽

Mauda Monger ◽

Trace S Kershaw ◽

Wendy B Mahoney ◽

...

Keyword(s):

Domestic Violence ◽

Intimate Partner Violence ◽

Hiv Prevention ◽

Partner Violence ◽

Self Efficacy ◽

Intimate Partner ◽

Hiv Care ◽

Post Intervention ◽

Prevention Services ◽

Exposure Prophylaxis

Background: Survivors of intimate partner violence are at elevated risk for HIV acquisition, yet there is limited research on the best strategies to optimize biomedical HIV prevention, such as pre-exposure prophylaxis among this population. Domestic violence agencies are critical collaborating partners and function as potential entry points into HIV prevention services for survivors; however, limited knowledge regarding HIV prevention has been an important barrier to advocate-led discussions. This study aimed to develop, implement, and evaluate an HIV prevention intervention for domestic violence advocates. Setting: A nonrandomized, group-based intervention with pre-intervention, immediate post-intervention, and 3-month post-intervention periods were conducted with multiple domestic violence agencies in Mississippi. Methods: Overall, 25 domestic violence advocates participated in the two-session intervention. Surveys were administered to assess pre-exposure prophylaxis knowledge, self-efficacy, subjective norms, and willingness to provide HIV prevention services to intimate partner violence survivors. Generalized estimating equations were conducted to assess change in behavioral outcomes over time. Results: Compared to pre-intervention, there were significant increases at immediate and 3-month post-intervention in advocates’ intervention acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to provide HIV prevention information, discuss pre-exposure prophylaxis eligibility criteria, assist pre-exposure prophylaxis-engaged clients, and initiate pre-exposure prophylaxis counseling. Conclusion: This group-based intervention enhanced domestic violence advocates’ acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to offer HIV care information, discuss pre-exposure prophylaxis eligibility, assist pre-exposure prophylaxis-engaged survivors, and initiate pre-exposure prophylaxis counseling with intimate partner violence survivors. Efforts should focus on training domestic violence advocates in HIV prevention care for survivors and also include these agencies in collaborative strategies to reduce HIV incidence.

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Improving retention in care of HIV+ women through behavioural change interventions aimed at their male partners: A prospective, controlled before-and-after study protocol (WeMen) (Preprint)

10.2196/preprints.19384 ◽

2020 ◽

Author(s):

Stefano Orlando ◽

Ilaria Palla ◽

Fausto Ciccacci ◽

Isotta Triulzi ◽

Darlington Thole ◽

...

Keyword(s):

Adult Population ◽

Retention In Care ◽

Hiv Positive ◽

Male Partners ◽

Post Intervention ◽

Intervention Phase ◽

The World ◽

Before And After ◽

Living With Hiv ◽

Before And After Study

BACKGROUND According to the World Health Organization (WHO), in 2018, 37.9 million people were living with HIV (PLWHIV) worldwide. More than two-thirds of PLWHIV reside in Sub-Saharan Africa (SSA), where the HIV prevalence in the adult population (aged 15-49) is 3.9%. This includes 1.3 million pregnant women living with HIV, of whom 82% received Antiretroviral Therapy (ART) for Prevention of HIV Mother-To-Child Transmission (PMTCT). In these countries, one of the main challenges is an insufficient level of treatment adherence, particularly in HIV positive pregnant women. Among the causes, the lack of male partner involvement represents a significant contributor to the problem. This issue emerges strongly in Malawi, one of the countries with the highest HIV prevalence in the world: 9.2% of its adult population lived with HIV in 2018. OBJECTIVE The objective of the study is to assess three different interventions aimed at improving ART adherence and retention among HIV positive women through engagement with their male partners in four Malawian healthcare centres. METHODS The prospective, controlled before-and-after study is articulated in three phases (total duration of 24 months): pre-intervention, intervention and post-intervention analyses. The number of selected clusters (clinical centres) is limited to four, one for each intervention plus a cluster where no intervention will be performed (control arm). The interventions are 1) opening the facility on one Saturday per month, only for men, defined as a "special day"; 2) testing peer-to-peer counselling among men, "male champions"; 3) providing a non-economic incentive to all women who are accompanied by their partners to the facility, "nudge". The primary outcome of the study is to evaluate differences in retention in care and adherence among women to therapeutic protocols; the intermediate outcome is the assessment of differences in Male Involvement (MI). The level of MI in the health of their female partners (intermediate outcome) will be evaluated through a dedicated questionnaire administered at baseline and in the post-intervention phase. Data will be collected at the clinical centres and stored in two electronic databases managed through two different types of software. RESULTS Analysis of data collected in the four centres during the pre-intervention phase is ongoing as enrolment ceased on March 31, 2020. The total number of patients enrolled was 452 (Namandanje: 133, Kapeni: 78, Kapire: 75, Balaka: 166). Meanwhile several meetings have taken placeat the centres to organize the intervention phase. CONCLUSIONS The study will identify the best intervention which enhances involvement of male partners in womens health, using an approach that takes into consideration a broad spectrum of behaviours. An important aspect will the use of educational tools focused on messages initiating a reflective discussion of stereotypes and false beliefs related to the idea of masculinity present in Malawian culture. CLINICALTRIAL Clinicaltrials.gov NCT04356157 https://clinicaltrials.gov/show/NCT04356157

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Effects of experiential-based videos in multi-disciplinary learning

Australasian Journal of Educational Technology ◽

10.14742/ajet.208 ◽

2013 ◽

Vol 29 (4) ◽

Author(s):

Khalid Bin Abdul Jabbar ◽

Alex Ong ◽

Jeannette Choy ◽

Lisa Lim

Keyword(s):

Critical Thinking ◽

Self Efficacy ◽

Control Group ◽

Motivational Strategies ◽

Post Intervention ◽

Projectile Motion ◽

Before And After ◽

Quasi Experimental ◽

And Control ◽

Experimental Group

This study examined the use of authentic experiential-based videos in self-explanation activities on 32 polytechnic students' learning and motivation, using a mixed method quasi-experimental design. The control group analysed a set of six pre-recorded videos of a subject performing the standing broad jump (SBJ). The experimental group captured videos of two subjects performing six variations of the SBJ. They then proceeded to analyse those videos as with the control group. All students then attempted a worksheet designed to elicit various levels of principled understanding of the topic on "projectile motion". In addition, data on students' motivation to learn and learning outcomes were measured by using three subscales of the Motivational Strategies for Learning Questionnaire (MSLQ) ― task value, critical thinking, and self-efficacy ― both before and after the intervention. Data were also collected through online pre- and post-tests, classroom observations as well as reflection journals. No significant differences between the experimental and control groups in terms of the post-intervention results were found (p > 0.05). However, the results suggested that use of experiential-based videos and video-based tools may in fact be more beneficial for students who are weaker in critical thinking and self-efficacy, to gain a better understanding of their learning.

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Study of Depression and Its Associated Factors among Women Living with HIV/AIDS in Coastal South India

ISRN AIDS ◽

10.5402/2012/684972 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

B. Unnikrishnan ◽

Vinita Jagannath ◽

John T. Ramapuram ◽

B. Achappa ◽

D. Madi

Keyword(s):

Rural Women ◽

South India ◽

Hiv Care ◽

Hiv Positive ◽

Chi Square ◽

Cross Sectional ◽

Women Living With Hiv ◽

Hiv Positive Women ◽

Living With Hiv ◽

Hiv Aids

Background. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals. Women with HIV are about four times more likely to be depressed than those who are not infected. Aims. To assess the sociodemographic and clinical correlates of depression among women living with HIV/AIDS. Setting and Design. One public and one private hospital in Mangalore, Coastal South India, and cross-sectional design. Methods and Materials. Study constituted of 137 HIV-positive women, depression was assessed using BDI (Beck Depression Inventory), and social support was assessed using Lubben Social Network Scale. Statistical Analysis. All analysis was conducted using SPSS version 11.5. Chi-square test with value less than 0.05 was taken as statistically significant. Results. Among 137 HIV-positive women, 51.1% were depressed. Around 16% were having moderate to high risk for isolation. Depression was statistically significant in rural women, widowed women, and lower socioeconomic class women. Conclusion. Depression is highly prevalent among women living with HIV which is still underdiagnosed and undertreated, and there is a need to incorporate mental health services as an integral component of HIV care.

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The Comparative Change of Self-Efficacy in Nursing Students After Verbal De-Escalation Education

International Journal of Studies in Nursing ◽

10.20849/ijsn.v5i1.730 ◽

2020 ◽

Vol 5 (1) ◽

pp. 103

Author(s):

Tina Hostetler

Keyword(s):

Nursing Students ◽

Workplace Violence ◽

Self Efficacy ◽

Nursing Programs ◽

Post Intervention ◽

Eta Squared ◽

Before And After ◽

Health Course ◽

The Mean ◽

School Purpose

Background: The incidence of workplace violence has continued to occupy a significant place in healthcare at a rate nearly double that in other industries. Those providing direct bedside care are among the most vulnerable to violence, including nursing students. Many students report experiencing verbal or physical aggression prior to graduating from nursing school. Purpose: The purpose of this quantitative prospective experimental study was to measure the level of self-efficacy of nursing students’ verbal de-escalation skills before and after verbal de-escalation training, to see if the training made a measurable effect on the level of self-efficacy. Method: Seventeen nursing students in their psychiatric-mental health course rotation completed a pre- and post-intervention survey based on Thackrey’s Confidence in Coping with Patient Aggression scale (1987) to measure self-efficacy. The intervention included up to 90 minutes of interactive verbal de-escalation training. Result: A statistically significant increase in self-efficacy scores was noted from pre-intervention (M = 39, SD = 13.5) to post-intervention (M = 60.9, SD = 14.3), t (16) = 6.92, p < .001 (two-tailed). The mean increase in CCCPA scores was 21.8 with a 95% confidence interval ranging from 28.6 to 15.2. The eta squared statistic (0.46) indicated a large effect size. Conclusion: Verbal de-escalation training in all nursing programs is recommended.

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HIV/AIDS Stigma Reduction as a Risk Factor for New HIV Infections: A Lived Experience Study of HIV Positive Young Women in a Rural Setting of Northern Uganda

10.21203/rs.3.rs-101843/v1 ◽

2020 ◽

Author(s):

Amir Kabunga ◽

Maxson Anyolitho Kenneth

Keyword(s):

Young Women ◽

Hiv Transmission ◽

Unprotected Sex ◽

Rural Setting ◽

Hiv Positive ◽

Stigma Reduction ◽

Sexual Activities ◽

Women Living With Hiv ◽

Related Stigma ◽

Living With Hiv

Abstract BackgroundHIV/AIDS-related stigma is a global problem among HIV patients with far-reaching implications. However, stigma reduction among HIV positive young women may be a catalyst to new HIV infections. This study aimed at exploring the coping strategies used and influence of HIV-related stigma on new infections among HIV positive young women in a rural setting. MethodsA cross-sectional exploratory research design was used. HIV positive young women in the catchment area of Aboke Health Center IV were part of the study. In-depth interviews were used to collect data and analysis was done using thematic approach. ResultsThe results from the data showed that acceptance of counseling and social support are some of the ways HIV-positive young women coped up with stigma. The results also showed that While HIV-related reduction has influenced positively for some HIV positive young mothers, to others as HIV-related stigma reduces, young women living with HIV are likely to get involved in risky sexual activities like having unprotected sex thus increasing HIV transmission. ConclusionsHIV-related reduction has influenced positively for some HIV positive young mothers. However, to others as HIV-related stigma reduces, young women living with HIV are likely to get involved in risky sexual activities like having unprotected sex thus increasing HIV transmission. Based on the results, there is need to understand the negative effects HIV-related stigma reduction as this may have implications for further transmission and control of HIV pandemic. Also, further research is needed to understand whether lessening HIV-related stigma encourages risky sexual behaviors among young women.

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