scholarly journals Challenges in modelling the proportion of undiagnosed HIV infections in Sweden

2019 ◽  
Vol 24 (14) ◽  
Author(s):  
Emmi Andersson ◽  
Fumiyo Nakagawa ◽  
Ard van Sighem ◽  
Maria Axelsson ◽  
Andrew N Phillips ◽  
...  
Keyword(s):  
Hiv Infections ◽  
Data Availability ◽  
Sub Saharan Africa ◽  
Estimation Methods ◽  
Migration Data ◽  
Persons Living With Hiv ◽  
Clinical Surveillance ◽  
Sub Saharan ◽  
Sex With Men ◽  
And Migration

Background Sweden has a low HIV prevalence. However, among new HIV diagnoses in 2016, the proportion of late presenters and migrants was high (59% and 81%, respectively). This poses challenges in estimating the proportion of undiagnosed persons living with HIV (PLHIV). Aim To estimate the proportion of undiagnosed PLHIV in Sweden comparing two models with different demands on data availability and modelling expertise. Methods An individual-based stochastic simulation model of HIV positive populations (SSOPHIE) and the incidence method of the European Centre for Disease Prevention and Control (ECDC) HIV Modelling Tool were applied to clinical, surveillance and migration data from Sweden 1980–2016. Results SSOPHIE estimated that the proportion of undiagnosed PLHIV in 2013 was 26% (n = 2,100; 90% plausibility range (PR): 900–5,000) for all PLHIV, 17% (n = 600; 90% PR: 100–2,000) for men who have sex with men (MSM), 35% in male (n = 300; 90% PR: 200–700) and 34% in female (n = 400; 90% PR: 200–800) migrants from sub-Saharan Africa (SSA). The estimates for the ECDC model in 2013 were 21% (n = 2,013; 95% confidence interval (CI): 1,831–2,189) for all PLHIV, 15% (n = 369; 95% CI: 299–434) for MSM and 21% (n = 530; 95% CI: 436–632) for migrants from SSA. Conclusions The proportion of undiagnosed PLHIV in Sweden is uncertain. SSOPHIE estimates had wide PR. The ECDC model estimates were unreliable because migration was not accounted for. Better migration data and estimation methods are required to obtain reliable estimates of proportions of undiagnosed PLHIV in similar settings.

Epidemiology and the Spread of HIV

2017 ◽  
Author(s):  
Philip Bolduc ◽  
Navix Order ◽  
Emily Colgate
Keyword(s):  
United States ◽  
The United States ◽  
Sub Saharan Africa ◽  
Heterosexual Transmission ◽  
Persons Living With Hiv ◽  
The Us ◽  
Sub Saharan ◽  
Sex With Men ◽  
Prevention Methods ◽  
Living With Hiv

Worldwide, approximately 36 million people are infected with HIV. The number of new infections has been declining in most geographic areas including sub-Saharan Africa due to a larger number of persons receiving antiretroviral therapy (ART) and the uptake of new prevention methods. Prevalence in many areas has either stabilized or gradually increased due to prolonged survival. The US epidemic has remained stable, with approximately 1.2 million persons living with HIV. There are fewer AIDS deaths and approximately 40,000–50,000 new infections yearly, leading to an overall increase in HIV prevalence in the United States. Globally, most new infections are via heterosexual transmission, with more than half of new infections occurring in women. In Europe and the United States, the largest number of new infections is occurring in men who have sex with men. Due to the progressive uptake of ART, mother-to-child transmission has declined significantly throughout the world.

Characteristics Associated With Migration Among Older Women and Men in Rural Malawi

2017 ◽  
Vol 25 (4) ◽  
pp. 283-308 ◽  
Author(s):  
Jacob Kendall ◽  
Philip Anglewicz
Keyword(s):  
Physical Health ◽  
Older Women ◽  
Religious Affiliation ◽  
Older Men ◽  
Household Size ◽  
Sub Saharan Africa ◽  
Older Individuals ◽  
Before And After ◽  
Sub Saharan ◽  
And Migration

The older population in sub-Saharan Africa is growing rapidly, but little is known about the migration patterns of older individuals in this setting. In this article, we identify the determinants of migration for older individuals in a rural African setting. To do so, we use rare longitudinal data with information for older individuals both before and after migration. We first identify premigration factors associated with moving in the future and then identify differences in characteristics between migrants and nonmigrants after migration. In addition to basic sociodemographic information, we examine differences between migrants and nonmigrants in land ownership, number of lifetime marriages, number of living offspring, previous migration experience, household size, social and religious participation, and religious affiliation. Results show that (a) migration in older age is related to marriage, health and HIV status, household size, and religion; (b) older women who are HIV-positive are more likely to move, and older men with better physical health are more likely to move; (c) older female migrants have worse postmigration physical health; and (d) the relationship between health and migration for older men disappears after migration.

scholarly journals Continuing high levels of HIV diagnoses in men who have sex with men in the United Kingdom

2008 ◽  
Vol 13 (14) ◽  
pp. 3-4
Author(s):  
B Rice ◽  
A Nardone ◽  
N Gill ◽  
V Delpech
Keyword(s):  
United Kingdom ◽  
Confidence Intervals ◽  
Sub Saharan Africa ◽  
Newly Diagnosed ◽  
The United Kingdom ◽  
Reporting Delays ◽  
Sub Saharan ◽  
Sex With Men ◽  
The Uk ◽  
Almost All

The latest HIV data for 2007 has recently been published for the United Kingdom (UK). During the year, an estimated 6,840 (95% confidence intervals 6,600-7,050) persons (adjusted for reporting delays) were newly diagnosed with HIV in the UK. This represents a 12% decline from a peak of new HIV diagnoses reported in 2005 (7,800). Almost all this decline in new HIV diagnoses was in HIV-infected heterosexuals from sub-Saharan Africa who were probably infected in their country of origin.

scholarly journals Understanding gender, sexuality and HIV risk in HEIs: narratives of international post-graduate students

2013 ◽  
Vol 9 (3) ◽  
Author(s):  
Mathabo Khau ◽  
Naydene De Lange ◽  
Logamurthie Athiemoolam
Keyword(s):  
University Students ◽  
Hiv Risk ◽  
Hiv Infections ◽  
Sexual Relationships ◽  
Sub Saharan Africa ◽  
Post Graduate ◽  
Sexual Identities ◽  
Hiv Intervention ◽  
Memory Work ◽  
And Migration

Thirty years into the HIV&AIDS pandemic, the world is still striving to reduce new HIV infections and halve AIDS related deaths by 2015. However, sub-Saharan Africa still faces the burden of HIV infections as governments and private institutions try out different prevention strategies (UNAIDS 2011). Several scholars have argued that multiple concurrent sexual partnerships (MCSP) pose the greatest risk for new HIV infections. Furthermore, research has also linked MCSPs to mobility and migration. This paper draws from the project ‘Sexual identities and HIV&AIDS: an exploration of international university students’ experiences” which employed memory work, photo-voice, drawings and focus group discussions with ten (5male and 5female) Post Graduate international students at a South African university. Focussing on the data produced through memory work, I present university students’ lived-experience narratives of mobility and migration in relation to how they perceive MCSPs and HIV risk. The findings show how students construct their gendered and sexual identities in a foreign context and how these constructions intersect with their choices of sexual relationships and HIV risk. I argue from the findings that Higher Education Institutions should be treated as high risk ‘spaces of vulnerability’ and hence health support services and HIV intervention programming policies should be geared towards addressing such vulnerabilities in order to create sustainable teaching and learning environments that allow for all students to explore their full capabilities.

scholarly journals HIV Status in Sero-Discordant Couples: Prevalence and Pattern among Pregnant Women in Plateau State, Nigeria

2018 ◽  
pp. 33-40
Author(s):  
Magaji FA ◽  
Ocheke AN ◽  
Ocheke AN ◽  
Pam VC ◽  
Pam VC ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Descriptive Analysis ◽  
Hiv Infections ◽  
Sub Saharan Africa ◽  
Hiv Status ◽  
Discordant Couples ◽  
Sub Saharan ◽  
Plateau State ◽  
Mother To Child ◽  
Made In

Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.

scholarly journals Health system challenges affecting falls prevention in persons living with HIV: perspectives from physiotherapists in four sub-Saharan regions

2021 ◽  
Vol 22 ◽  
Author(s):  
Maria Y. Charumbira ◽  
Karina Berner ◽  
Quinette A. Louw
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Fall Prevention ◽  
Falls Prevention ◽  
Sub Saharan Africa ◽  
Prevention Services ◽  
Persons Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv

Abstract Aim: The aim of this study was to explore the perspectives of physiotherapists in four selected regions of sub-Saharan Africa regarding health system challenges impacting the integration of physiotherapy-led falls prevention services in the primary care of persons living with HIV (PLWH). Background: Falls may pose a significant problem among younger PLWH in low- and middle-income countries. Physiotherapists’ role in optimising function and quality of life can do much in the prevention of falls in PLWH and reducing the harm that results. However, falls prevention strategies have not been implemented effectively especially in primary health care settings in sub-Saharan Africa. Physiotherapists’ account of the health system challenges they encounter may provide insights into potential strategies that may be considered in optimising fall prevention for PLWH in poorly resourced settings. Methods: A descriptive qualitative study was conducted in selected urban districts in the capital cities of four sub-Saharan African countries. In-depth interviews were conducted with 21 purposively selected physiotherapists involved in the primary care of PLWH. Audio recordings of interviews were transcribed verbatim and analysed using deductive thematic content analysis. Findings: The main results are presented in the theme ‘Health care system challenges’ and in nine categories informed by the WHO health system framework: lack of policies and clinical practice guidelines, shortage/Inaccessible falls prevention services, inadequate human resource, physiotherapists not adequately equipped in falls prevention, inaccessible/No facilities for BMD measurement, inefficient data capturing systems, lack of evidence regarding falls among PLWH, unclear physiotherapy role descriptions, inefficient referral system. Physiotherapists highlighted the need for more information and research regarding fall prevention for PLWH, promote their role in the primary care of PLWH and adopt a patient-centred approach to fall prevention.

Mental health needs of transgender women, gay men, and other men who have sex with men across sub-Saharan Africa.

2020 ◽  
pp. 153-166
Author(s):  
Carolyn Brown ◽  
Keletso Makofane ◽  
Kevin Rebe ◽  
L. Leigh Ann van der Merwe ◽  
Bhekie Sithole ◽  
...  
Keyword(s):  
Mental Health ◽  
Gay Men ◽  
Transgender Women ◽  
Health Needs ◽  
Sub Saharan Africa ◽  
Mental Health Needs ◽  
Sub Saharan ◽  
Sex With Men

scholarly journals How men who have sex with men experience HIV health services in Kampala, Uganda

2020 ◽  
Vol 5 (4) ◽  
pp. e001901
Author(s):  
Rachel King ◽  
Zubayiri Sebyala ◽  
Moses Ogwal ◽  
George Aluzimbi ◽  
Rose Apondi ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Health Staff ◽  
Structural Factors ◽  
Structural Barriers ◽  
Sub Saharan ◽  
Sex With Men

In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.

scholarly journals The state of business sustainability reporting in sub-Saharan Africa: an agenda for policy and practice

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Carol A. Tilt ◽  
Wei Qian ◽  
Sanjaya Kuruppu ◽  
Dinithi Dissanayake
Keyword(s):  
Sustainability Reporting ◽  
New Institutional Economics ◽  
The State ◽  
Data Availability ◽  
Policy Implications ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Content Type ◽  
Reporting Practices ◽  
Sub Saharan

Purpose Developing countries experience their own social, political and environmental issues, but surprisingly limited papers have examined sustainability reporting in these regions, notably in sub-Saharan Africa. To fill this gap and understand the state of sustainability reporting in sub-Saharan Africa, this paper aims to investigate the current state of reporting, identifies the major motivations and barriers for reporting and suggests an agenda of future issues that need to be considered by firms, policymakers and academics. Design/methodology/approach This paper includes analysis of reporting practices in 48 sub-Saharan African countries using the lens of New Institutional Economics. It comprises three phases of data collection and analysis: presentation of overall reporting data collected and provided by Global Reporting Initiative (GRI). analysis of stand-alone sustainability reports using qualitative data analysis and interviews with key report producers. Findings The analysis identifies key issues that companies in selected sub-Saharan African countries are grappling within their contexts. There are significant barriers to reporting but institutional mechanisms, such as voluntary reporting frameworks, provide an important bridge between embedding informal norms and changes to regulatory requirements. These are important for the development of better governance and accountability mechanisms. Research limitations/implications Findings have important implications for policymakers and institutions such as GRI in terms of regulation, outreach and localised training. More broadly, global bodies such as GRI and IIRC in a developing country context may require more local knowledge and support. Limitations include limited data availability, particularly for interviews, which means that these results are preliminary and provide a basis for further work. Practical implications The findings of this paper contribute to the knowledge of sustainability reporting in this region, and provide some policy implications for firms, governments and regulators. Originality/value This paper is one of only a handful looking at the emerging phenomenon of sustainability reporting in sub-Saharan African countries.

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