scholarly journals Phylodynamics Helps to Evaluate the Impact of an HIV Prevention Intervention

Viruses ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 469 ◽  
Author(s):  
Tetyana I. Vasylyeva ◽  
Alexander Zarebski ◽  
Pavlo Smyrnov ◽  
Leslie D. Williams ◽  
Ania Korobchuk ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Hiv Transmission ◽  
Assessment Tool ◽  
Population Level ◽  
Reproductive Number ◽  
Post Intervention ◽  
Hiv Prevention Intervention ◽  
Transmission Parameters ◽  
Transmission Reduction ◽  
The Impact

Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013–2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied the birth-death skyline model to the sequences from Odessa (n = 275) and Kyiv (n = 92) in order to estimate changes in the epidemic’s effective reproductive number (Re) and rate of becoming uninfectious (δ). We identified 12 transmission clusters in Odessa; phylogenetic clustering was correlated with younger age and higher average viral load at the time of sampling. Estimated Re were similar in Odessa and Kyiv before the initiation of TRIP; Re started to decline in 2013 and is now below Re = 1 in Odessa (Re = 0.4, 95%HPD 0.06–0.75), but not in Kyiv (Re = 2.3, 95%HPD 0.2–5.4). Similarly, estimates of δ increased in Odessa after the initiation of TRIP. Given that both cities shared the same HIV prevention programs in 2013–2019, apart from TRIP, the observed changes in transmission parameters are likely attributable to the TRIP intervention. We propose that molecular epidemiology analysis can be used as a post-intervention effectiveness assessment tool.

scholarly journals Understanding the Impact of a Community-led HIV Prevention Program in South Africa: Context, Conceptual Framework and Methodology

1999 ◽  
Vol 5 (4) ◽  
pp. 9 ◽  
Author(s):  
Catherine Campbell ◽  
Brian Williams
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Hiv Transmission ◽  
Evaluation Research ◽  
Evaluation Study ◽  
Social Contexts ◽  
Outcome Evaluation ◽  
Evaluation Methodology ◽  
Sexually Transmitted ◽  
The Impact

In this paper we provide an account of our multi-dimensional evaluation of a community led HIV-prevention program in the southern African mining community of Carletonville. The Mothusimpilo Project has three pillars: peer education and condom distribution, syndromic management of sexually transmitted diseases (STDs), and stakeholder mobilisation. Substantial efforts are being made to evaluate the impact of the intervention and in this paper we outline the theoretical rationale, research design and some preliminary results of the evaluation. The first section provides the setting for the evaluation work, viz an intervention which seeks to contextualise traditional biomedical and behavioural approaches to HIV-transmission within their broader community and social contexts. In the second section we outline the theoretical assumptions underlying the evaluation (which has both 'outcome evaluation' and 'process evaluation' components). In particular, we discuss the way in which the concepts of identity, empowerment and social capital are used to understand the processes involved in health-enhancing behaviour change. In the third section we describe our multi-disciplinary evaluation methodology and present some preliminary findings from our on-going evaluation study. One important goal of our evaluation research is to demonstrate the extent to which community level factors serve to assist or hinder the project in achieving its goals. In this way we hope to contribute to understandings of the role of community participation in influencing the outcomes of community-based health promotional projects.

scholarly journals Deep–sequence phylogenetics to quantify patterns of HIV transmission in the context of a universal testing and treatment trial — BCPP/ Ya Tsie trial

2021 ◽  
Author(s):  
Lerato E Magosi ◽  
Yinfeng Zhang ◽  
Tanya Golubchick ◽  
Victor De Gruttola ◽  
Eric J Tchetgen Tchetgen ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Population Level ◽  
Treatment As Prevention ◽  
Population Mobility ◽  
Mobility Patterns ◽  
Test And Treat ◽  
Hiv Intervention ◽  
Universal Test ◽  
Universal Test And Treat ◽  
The Impact

Mathematical models predict that community–wide access to HIV testing–and–treatment can rapidly and substantially reduce new HIV infections. Yet several large universal test–and–treat HIV prevention trials in high–prevalence epidemics demonstrated variable reduction in population–level incidence. To elucidate patterns of HIV spread in universal test–and–treat trials we quantified the contribution of geographic–location, gender, age and randomized–HIV–intervention to HIV transmissions in the 30–community Ya Tsie trial in Botswana (estimated trial population: 175,664). Deep–sequence phylogenetic analysis revealed that most inferred HIV transmissions within the trial occurred within the same or between neighboring communities, and between similarly–aged partners. Transmissions into intervention communities from control communities were more common than the reverse post–baseline (30% [12.2 – 56.7] versus 3% [0.1 – 27.3]) than at baseline (7% [1.5 – 25.3] versus 5% [0.9 – 22.9]) compatible with a benefit from treatment–as–prevention. Our findings suggest that population mobility patterns are fundamental to HIV transmission dynamics and to the impact of HIV control strategies.

scholarly journals Evaluating the Impact of Zimbabwe’s Prevention of Mother-to-Child HIV Transmission Program: Population-Level Estimates of HIV-Free Infant Survival Pre-Option A

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0134571 ◽  
Author(s):  
Raluca Buzdugan ◽  
Sandra I. McCoy ◽  
Constancia Watadzaushe ◽  
Mi-Suk Kang Dufour ◽  
Maya Petersen ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Population Level ◽  
Infant Survival ◽  
The Impact ◽  
Mother To Child

The Impact of Perceived Group Support on the Effectiveness of an HIV Prevention Intervention for African American Women

2010 ◽  
Vol 36 (2) ◽  
pp. 127-143 ◽  
Author(s):  
Faye Z. Belgrave ◽  
Maya Corneille ◽  
Kristina Hood ◽  
Julia Foster-Woodson ◽  
Angela Fitzgerald
Keyword(s):  
African American ◽  
Hiv Prevention ◽  
African American Women ◽  
Group Support ◽  
Prevention Intervention ◽  
American Women ◽  
Hiv Prevention Intervention ◽  
The Impact

scholarly journals Sexual Behaviours among Oil and Gas Workers in the Niger-Delta Region of Nigeria: Assessing the Impact of Comprehensive HIV/AIDS Prevention Programs

2021 ◽  
Vol 11 (2) ◽  
pp. 80-88
Author(s):  
Ali Johnson Onoja ◽  
Felix Olaniyi Sanni ◽  
Paul Olaiya Abiodun ◽  
John Shaibu ◽  
Sheila Iye Onoja ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Hiv Prevention ◽  
Marital Status ◽  
Rural Community ◽  
Odds Ratio ◽  
Oil And Gas ◽  
Unprotected Sex ◽  
Post Intervention ◽  
Rivers State ◽  
The Impact

Introduction: The major means of transmitting sexual-related diseases including HIV is through unprotected sexual activities. This study aimed to assess the impact of comprehensive HIV prevention interventions on the sexual behavior of oil and gas workers in Bonny Island, a rural community of Rivers State, Nigeria. Methods: This is a cross-sectional-quantitative study that employed a structured questionnaire among oil and gas workers aged 15 – 49 years in Bonny Island. The information collected from February to April 2012 (after a three year HIV prevention and control intervention programs) includes the socio-demographics; age, gender, education, occupation, marital status and data related to sexual behaviors. Data were analyzed using IBM-SPSS version 25.0. Results: There were 419 respondents each in baseline and post-intervention surveys. The rate of unprotected sex among respondents at baseline was 82.1% as compared to 20.3% after the intervention, odds ratio-18.02 (95% CI-12.76-25.45; P<0.0001). Sixty-one (14.6%) exchanged sex for gifts in the baseline and 12.4% in the post-intervention. At the baseline, 5.0% used condoms in the last sexual intercourse as compared to 26.0% in the post-intervention; odds ratio - 6.66 (95% CI-4.08-10.88; P<0.0001). Factors associated with condoms use include sex, age, education, duration in the community, marital status, and living with spouses (p<0.01). Conclusion: There was a significant positive impact of a comprehensive intervention programme on the sexual behavior of the workers in the rural community of Rivers State, Nigeria. However, regular interventions in rural communities towards the prevention of spread of STIs and HIV are needed in Nigeria.

Crossover and Repeated Randomization in Event Driven Trials for HIV Prevention: Addressing the Impact of Heterogeneity in Risk in the Trial Design

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Clara P. Domínguez Islas ◽  
Elizabeth R. Brown
Keyword(s):  
Hiv Prevention ◽  
Study Finding ◽  
Population Level ◽  
Ethical Considerations ◽  
On Demand ◽  
Higher Power ◽  
Event Driven ◽  
Exposure Prophylaxis ◽  
Future Work ◽  
The Impact

Abstract The availability of effective Pre-Exposure Prophylaxis (PrEP) for HIV introduces new challenges for testing novel on-demand, user-controlled HIV prevention products, including lower placebo arm incidence and increased between-participant variability in HIV risk. In this paper, we discuss how low HIV incidence may result in longer trials in which the variability in participants' risk may impact the estimate of risk reduction. We introduce a measure of per-exposure efficacy that may be more relevant than the population level reduction in incidence for on demand products and explore alternatives to the parallel arm design that could target better this parameter of interest: the crossover and the re-randomization designs. We propose three different ways in which crossover and re-randomization of intervention assignments could be implemented in event-driven trials. We evaluate the performance of these designs through a simulation study, finding that they allow for better estimation and higher power than the traditional event-driven parallel arm design. We conclude by discussing future work, practical challenges and ethical considerations that need to be addressed to take these designs closer to implementation.

scholarly journals The Impact of Teachers’ Modifications of an Evidenced-Based HIV Prevention Intervention on Program Outcomes

2015 ◽  
Vol 17 (1) ◽  
pp. 122-133 ◽  
Author(s):  
Bo Wang ◽  
Bonita Stanton ◽  
Sonja Lunn ◽  
Glenda Rolle ◽  
Maxwell Poitier ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Program Outcomes ◽  
Prevention Intervention ◽  
Hiv Prevention Intervention ◽  
Evidenced Based ◽  
The Impact

scholarly journals Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacob Burns ◽  
Christoph Kurz ◽  
Michael Laxy
Keyword(s):  
Type 2 Diabetes ◽  
Disease Management ◽  
Time Lag ◽  
Population Level ◽  
Synthetic Control ◽  
Post Intervention ◽  
Disease Management Programs ◽  
All Cause Mortality ◽  
The Impact

Abstract Background In 2002–2003 disease management programs (DMPs) for type 2 diabetes and coronary heart disease were introduced in Germany to improve the management of these conditions. Today around 6 million Germans aged 56 and older are enrolled in one of the DMPs; however, their effect on health remains unclear. Methods We estimated the impact of German DMPs on circulatory and all-cause mortality using a synthetic control study. Specifically, using routinely available data, we compared pre and post-intervention trends in mortality of individuals aged 56 and older for 1998–2014 in Germany to trends in other European countries. Results Average circulatory and all-cause mortality in Germany and the synthetic control was 1.63 and 3.24 deaths per 100 persons. Independent of model choice, circulatory and all-cause mortality decreased non-significantly less in Germany than in the synthetic control; for the model with a 3 year time lag, for example, by 0.12 (95%-CI: − 0.20; 0.44) and 0.22 (95%-CI: − 0.40; 0.66) deaths per 100 persons, respectively. Further main analyses, as well as sensitivity and subgroup analyses supported these results. Conclusions We observed no effect on circulatory or all-cause mortality at the population-level. However, confidence intervals were wide, meaning we could not reject the possibility of a positive effect. Given the substantial costs for administration and operation of the programs, further comparative effectiveness research is needed to clarify the value of German DMPs for type 2 diabetes and CHD.

scholarly journals In Their Eyes: HIV prevention from an Islamic perspective in Lamu, Kenya.

2012 ◽  
Vol 2 (1) ◽  
pp. 89-102 ◽  
Author(s):  
A O Maulana ◽  
A Krumeich ◽  
B Van den Borne
Keyword(s):  
Hiv Prevention ◽  
Literature Review ◽  
Hiv Transmission ◽  
Premarital Sex ◽  
Symbiotic Relationship ◽  
Religious Leaders ◽  
Key Factors ◽  
Hiv Prevention Intervention ◽  
Factors Influencing ◽  
Hiv Aids

Despite efforts to curb the spread of HIV amongst the youth and its positive indication of success in Kenya, the epidemic continues to pose serious challenges to these efforts amongst all demographic groupings across Kenya. This article presents findings of a qualitative study involving 45 youth and 23 Islamic leaders from Lamu, Kenya. The study looked at participant’s perceptions of HIV/AIDS. It also explored participant’s perceptions on what they see as the factors influencing HIV transmission amongst the Lamu youth. Additionally a literature review was used together with the study findings to identify elements for an Islamic based HIV prevention intervention. Our findings indicated that both the youth and religious leaders’ perceptions of HIV/AIDS comprise a mixture of facts and misconceptions. The participants identified idleness, drug abuse and premarital sex as key factors contributing to the risk of HIV infection amongst the Lamu youth. The symbiotic relationship between religious leaders and youth on various aspects of daily practices was evident throughout the study thereby suggesting the importance of working with both in addressing HIV/AIDS in Lamu. 

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