Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

Compared with women and girls, proportionately fewer men and boys in sub-Saharan Africa receive HIV testing, treatment, and other services. This study determined factors associated with never testing for HIV and examined never testing as a predictor of sexual risk behavior among men in Zambia. The sample included 2,609 men aged 15 to 24 from the 2018 Zambia Demographic and Health Survey. Logistic regression results revealed that compared with men who ever tested for HIV, men who never tested were more likely to be younger, have less education, have no children, be unemployed, and belong to the low wealth bracket. They also had a higher likelihood of not using a condom at last sex but were less likely to have more than five lifetime sexual partners. HIV prevention programs can use sociodemographic characteristics to identify those who have a lower likelihood of testing for HIV. Prevention programs can use sociodemographic characteristics to develop profiles of those who may especially need to be targeted by initiatives to promote HIV testing. Awareness does not always engender behavior change; therefore, in addition to knowledge of HIV status, risk reduction should also be emphasized.

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Three integrated elements of empowerment: HIV prevention with sub-Saharan African adolescent females involved in transactional sex.

Clinical Practice in Pediatric Psychology ◽

10.1037/cpp0000251 ◽

2018 ◽

Vol 6 (4) ◽

pp. 355-363 ◽

Cited By ~ 2

Author(s):

Sarah W. Feldstein Ewing ◽

Angela D. Bryan ◽

Tutu Alicante ◽

P. Todd Korthuis ◽

Karen A. Hudson ◽

...

Keyword(s):

Hiv Prevention ◽

Adolescent Females ◽

Transactional Sex ◽

Sub Saharan

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Ten Core Principles of Effective HIV Prevention Programs for Adolescents

PsycEXTRA Dataset ◽

10.1037/e705492007-001 ◽

2007 ◽

Cited By ~ 1

Author(s):

Barbara L. Ingram ◽

Mary Jane Rotheram-Borus ◽

Amy Elkavich

Keyword(s):

Hiv Prevention ◽

Prevention Programs

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Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-047280 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047280

Author(s):

Gamji M’Rabiu Abubakari ◽

Debbie Dada ◽

Jemal Nur ◽

DeAnne Turner ◽

Amma Otchere ◽

...

Keyword(s):

Hiv Prevention ◽

Data Extraction ◽

Grey Literature ◽

Secondary Data ◽

Well Being ◽

Sub Saharan Africa ◽

African Countries ◽

Scoping Reviews ◽

Sub Saharan ◽

Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

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Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.879 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Galle ◽

H Cossa ◽

N Osman ◽

K Roelens ◽

S Griffin ◽

...

Keyword(s):

Health Care ◽

Maternal Health ◽

Hiv Prevention ◽

Health Care Providers ◽

Male Involvement ◽

Sub Saharan Africa ◽

Care Providers ◽

Pregnancy And Childbirth ◽

Policy Level ◽

Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

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