scholarly journals SARS-CoV-2 and HIV: Convergence of Two Pandemics in the Caribbean

2020 ◽  
Vol 3 ◽  
Author(s):  
Robert Paulino-Ramirez
Keyword(s):  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Caribbean Region ◽  
Community Based ◽  
Self Testing ◽  
The Social ◽  
Timely Access ◽  
The Caribbean ◽  
Sub Saharan

This article describes the social, biological, and programmatic interactions between HIV and SARS-CoV-2 co-infections in The Caribbean region. The country islands represent the second most affected region by HIV/AIDS after Sub-Saharan Africa. After the first confirmed COVID-19 cases in the region, it is necessary to reinvent the programmatic interventions designed to eliminate HIV transmission, and implement innovative interventions that are not yet currently available like PrEP, HIV self-testing, and multiple medication dispensing. COVID-19 pandemic offers an opportunity to governments, community-based organizations, and international partners to maintain the HIV care continuum, with particular efforts made to ensure timely access to, and to avoid disruption of routinely HIV services.

Passionate Leaders in Social Entrepreneurship: Exploring an African Context

2015 ◽  
Vol 57 (3) ◽  
pp. 481-524 ◽  
Author(s):  
Sara Thorgren ◽  
Adesuwa Omorede
Keyword(s):  
Social Enterprise ◽  
Social Needs ◽  
Social Enterprises ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Social Mission ◽  
The Social ◽  
Sub Saharan ◽  
Private Entrepreneurs ◽  
Enterprise Leader

Nonstate actors such as social enterprises are increasingly influential for addressing pressing social needs in sub-Saharan Africa. Moving responsibility from the state to private entrepreneurs calls for a greater understanding of how single individuals achieve their social mission in a context characterized by acute poverty and where informal institutions, such as trust and collective norms, are strong governance mechanisms. This study recognizes the role of leader passion as a key element for gaining people’s trust in the social enterprise leader and the social mission. Qualitative data were collected on 37 leaders of Nigerian social enterprises in arenas such as health, women’s rights, children’s rights, AIDS/HIV care and education, and sustainable development. Drawing on 100 semistructured interviews, the authors develop an inductive model illustrating how leader passion interrelates with the social enterprise organizing and outcomes.

scholarly journals The cultural politics of biomedicine in the Caribbean

1998 ◽  
Vol 72 (1-2) ◽  
pp. 101-109 ◽  
Author(s):  
Paul E. Brodwin
Keyword(s):  
Caribbean Region ◽  
Scientific Medicine ◽  
Community Based ◽  
Social Transformations ◽  
Health Politics ◽  
The Social ◽  
The Caribbean ◽  
Political Dimensions ◽  
The Masses ◽  
And Child Health

[First paragraph]Healing the Masses: Cuban Health Politics at Home and Abroad. JULIE M. FEINSILVER. Berkeley: University of California Press, 1993. xx + 307 pp. (Cloth US$ 45.00, Paper US$ 17.00)The Blessings of Motherhood: Health, Pregnancy and Child Care in Dominica. ANJA KRUMEICH. Amsterdam: Het Spinhuis, 1994. iii + 278 pp. (Paper NLG 47.50)Disability and Rehabilitation in Rural Jamaica: An EthnographicStudy. RONNIE LINDA LEAVITT. Rutherford NJ: Fairleigh Dickinson University Press; London: Associated University Presses, 1992. 249 pp. (Cloth US$ 39.50)Based on research in three Caribbean societies, these books explore the contours of biomedicine ("Western" or scientific medicine) as a cultural system and an instrument of state power. On a theoretical level, the authors take up the blurred boundaries between Western biomedicine and other forms of healing as well as the political meanings and contradictions hidden behind everyday clinical routines. Their particular research projects, however, ask what has happened to the dream of universally accessible medical care in the past twenty years in the Caribbean region. The books focus on a community-based pediatric disability program in Jamaica(Leavitt), maternal and child health care in Dominica (Krumeich), and Cuba's national project of medical modernization (Feinsilver). Specific diseases or clinical outcomes are less at issue than the cultural and political dimensions of planned health development and the social transformations it sets into motion on both local and national levels.

Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

Curationis ◽  
2014 ◽  
Vol 37 (1) ◽  
Author(s):  
Nokwanda E. Bam ◽  
Joanne R. Naidoo
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Interdisciplinary Teams ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Terminally Ill Patients ◽  
Hiv Management ◽  
The Social ◽  
Sub Saharan

Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent.Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered.Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data.Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes.Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.

scholarly journals Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246471
Author(s):  
Sylvia Kusemererwa ◽  
Dickens Akena ◽  
Damalie Nakanjako ◽  
Joanita Kigozi ◽  
Regina Nanyunja ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Hiv Care ◽  
Heterosexual Men ◽  
Inclusion Criteria ◽  
Community Based ◽  
Art Programs ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Retention In Hiv Care ◽  
Sub Saharan

Expansion of Antiretroviral Therapy (ART) programs in sub-Saharan Africa (SSA) has increased the number of people accessing treatment. However, the number of males accessing and being retained along the human immunodeficiency virus (HIV) care cascade is significantly below the UNAIDS target. Male gender has been associated with poor retention in HIV care programs, and little is known about strategies that reduce attrition of men in ART programs. This review aimed to summarize any studies on strategies to improve retention of heterosexual males in HIV care in SSA. An electronic search was conducted through Ovid® for three databases (MEDLINE®, Embase and Global Health). Studies reporting interventions aimed at improving retention among heterosexual men along the HIV care cascade were reviewed. The inclusion criteria included randomized-controlled trials (RCTs), prospective or retrospective cohort studies that studied adult males (≥15years of age), conducted in SSA and published between January 2005 and April 2019 with an update from 2019 to 2020. The search returned 1958 articles, and 14 studies from eight countries met the inclusion criteria were presented using the PRISMA guidelines. A narrative synthesis was conducted. Six studies explored community-based adherence support groups while three compared use of facility versus community-based delivery models. Three studies measured the effect of national identity cards, disclosure of HIV status, six-monthly clinic visits and distance from the health center. Four studies measured risk of attrition from care using hazard ratios ranging from 1.2–1.8, four studies documented attrition proportions at an average of 40.0% and two studies an average rate of attrition of 43.4/1000PYs. Most (62%) included studies were retrospective cohorts, subject to risk of allocation and outcome assessment bias. A pooled analysis was not performed because of heterogeneity of studies and outcome definitions. No studies have explored heterosexual male- centered interventions in HIV care. However, in included studies that explored retention in both males and females, there were high rates of attrition in males. More male-centered interventions need to be studied preferably in RCTs. Registry number: PROSPERO2020 CRD42020142923 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020142923.

scholarly journals Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men – Lessons From Ghana, West Africa

2021 ◽  
Vol 9 ◽  
Author(s):  
Gamji M'Rabiu Abubakari ◽  
DeAnne Turner ◽  
Zhao Ni ◽  
Donaldson F. Conserve ◽  
Debbie Dada ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Linkage To Care ◽  
Mobile App ◽  
Sub Saharan Africa ◽  
Security And Privacy ◽  
Hiv Care ◽  
Hiv Education ◽  
Community Based Interventions ◽  
Community Based ◽  
Self Testing

MSM in Ghana encounter challenges in accessing HIV services and may experience barriers to HIV self-testing due to multiple forms of stigma present in health care settings. We worked with community-based organization partners to implement three interventions that successfully engaged and retained MSM which provides an opportunity for linkage to self-testing and medical care. These interventions were (1) Many Men Many Voices (3MV) a locally-led culturally grounded group-level HIV prevention program, (2) Auntie's Corner: a mobile-app based connecting MSM to health monitoring by a registered nurse and (3) HIV Education, Empathy, & Empowerment (HIVE3): a mobile-app based peer support intervention for MSM living with HIV. The 3MV intervention may be effective in improving HIV self-testing due to its effectiveness in engaging MSM, increasing HIV testing, and improving MSM understanding of the need for HIV testing. The utilization of apps like Auntie's Corner could positively impact HIV self-testing among MSM because it increases contact with nurses and reporting of symptoms. In HIVE3, participants expressed appreciation of the security and privacy that protects their identities as MSM and the peer mentors' abilities to make referrals to the nurses in Auntie's Corners. The confidentiality component has proven key among MSM and connecting MSM to self-testing through apps to report their process and receive care could increase utilization. Together, we show the efficacy of using the community-engaged process in reaching and engaging highly stigmatized populations like Ghana and sub-Saharan Africa, and its potential in increasing HIV self-testing and linkage to HIV care.

scholarly journals Low levels of frailty in HIV-positive older adults on antiretroviral therapy in northern Tanzania

2021 ◽  
Author(s):  
Clare Bristow ◽  
Grace George ◽  
Grace Hillsmith ◽  
Emma Rainey ◽  
Sarah Urasa ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
High Standard ◽  
Female Gender ◽  
Screening Tools ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Diagnostic Tools ◽  
Clinical Frailty Scale ◽  
Frailty Phenotype ◽  
Sub Saharan

Abstract There are over 3 million people in sub-Saharan Africa (SSA) aged 50 and over living with HIV. HIV and combined antiretroviral therapy (cART) exposure may accelerate the ageing in this population, and thus increase the prevalence of premature frailty. There is a paucity of data on the prevalence of frailty in an older HIV + population in SSA and screening and diagnostic tools to identify frailty in SSA. Patients aged ≥ 50 were recruited from a free Government HIV clinic in Tanzania. Frailty assessments were completed, using 3 diagnostic and screening tools: the Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and Brief Frailty Instrument for Tanzania (B-FIT 2). The 145 patients recruited had a mean CD4 + of 494.84 cells/µL, 99.3% were receiving cART and 72.6% were virally suppressed. The prevalence of frailty by FFP was 2.758%. FFP frailty was significantly associated with female gender (p = 0.006), marital status (p = 0.007) and age (p = 0.038). Weight loss was the most common FFP domain failure. The prevalence of frailty using the B-FIT 2 and the CFS was 0.68%. The B-FIT 2 correlated with BMI (r = − 0.467, p = 0.0001) and CD4 count in females (r = − 0.244, p = 0.02). There is an absence of frailty in this population, as compared to other clinical studies. This may be due to the high standard of HIV care at this Government clinic. Undernutrition may be an important contributor to frailty. It is unclear which tool is most accurate for detecting the prevalence of frailty in this setting as levels of correlation are low.

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