Public Health Commons^™

Evidence To Support Hiv Prevention For Adolescent Girls And Young Women (Agyw) And Their Male Partners: Results From Malawi Dreams Studies With Agyw, Male Partners Of Agyw, Men Living With Hiv, And Program Implementing Partners, Nanlesta Pilgrim, Victor Mwapasa, Effie Chipeta, Wanangwa Chimwaza, Nrupa Jani, Tracy Mcclair, Lyson Tenthani, Sanyukta Mathur

HIV and AIDS

Project SOAR, led by the Population Council, in partnership with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted a research portfolio to generate evidence to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. The objectives of this implementation research were to generate evidence for describing HIV-related risk factors among AGYW; assess the extent to which the overall DREAMS project contributed toward the goal of reducing HIV risk among AGYW; and understand the characteristics of male partners and how to link them to HIV services, as well as retain …

Strengthening Capacity For Assessment Of Hiv-Related Data Needs Among Key Populations To Inform Evidence-Based Responses, Amrita Rao, Nikita Viswasam, Stefan Baral

HIV and AIDS

Defining the HIV prevention and treatment needs of key populations who have disproportionate HIV acquisition and transmission risks has been particularly difficult in the context of generalized HIV epidemics where less attention has historically been placed on the HIV prevention and treatment needs of these groups. There is a gap in our understanding of the specific needs of—and ultimately the investment case for the added value of supporting—disproportionately burdened key populations in these settings. In response to this gap, Johns Hopkins University under the United States Agency for International Development (USAID)-funded Project SOAR implemented a project in partnership with collaborators, …

Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council

HIV and AIDS

Over the last 20 years, the Population Council has carried out extensive work examining the intersection of stigma and gender and its impact on HIV-related outcomes. This brief summarizes key Population Council findings from a range of studies which elucidate the experiences of stigma among women and highlights avenues for addressing stigma to mitigate women’s risk and burden of HIV.

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Growing Up In Rural India: An Exploration Into The Lives Of Younger And Older Adolescents In Madhya Pradesh And Uttar Pradesh, K.G. Santhya, Shireen J. Jejeebhoy, Iram Saeed, Archana Sarkar

Poverty, Gender, and Youth

This technical report describes the situation of adolescents according to a baseline assessment conducted in selected villages in India. The objectives of the assessment were to explore the attitudes, practices, and behaviors of adolescent girls, their adolescent brothers and if married, their husbands, with regard to sexual and reproductive matters, including HIV; their perspectives on adolescent girls’ and boys’ vulnerability to HIV and ways in which it can be mitigated; and the perspectives of parents and other critical adults in the community on the vulnerability of adolescent girls and boys to HIV. Results will be used to: (1) enhance adolescent …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

The Community Mobilization For Preventive Action (Compact) Project In Zambia: A Midline Evaluation, Waimar Tun, Chabu Kangale, Scott Geibel, Meredith Sheehy, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council and its partner, Project Concern International, implemented the Community Mobilization for Preventive Action (COMPACT) HIV-prevention program in Zambia. The program works with communities to develop “compacts” through a participatory, community-led process, and assists them in working toward reaching HIV-related “benchmarks,” intended to result in a reduction in HIV-related risk behaviors and harmful norms and ultimately contribute over time to the reduction of HIV incidence. This mid-term evaluation in four of six COMPACT communities indicates that COMPACT is improving some HIV-related behaviors and attitudes, particularly those related to gender norms, multiple sex partnerships, and alcohol abuse. The report …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

Nonclinical Development Needs And Regulatory Requirements For Multipurpose Prevention Technologies: A Primer, Joseph W. Romano, Martha Brady, Judy Manning

HIV and AIDS

This summary outlines key development elements that will be necessary for various configurations of multipurpose prevention products for the simultaneous prevention of HIV, sexually transmitted infections, and/or pregnancy.

Assessing And Improving Self-Reporting Of Male Circumcision In Zambia And Swaziland, Paul C. Hewett, Nicole Haberland, Barbara Mensch, Louis Apicella

HIV and AIDS

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for …

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Hiv Integrated Biological And Behavioural Surveillance Survey (Ibbss) 2010, Federal Ministry Of Health

HIV and AIDS

This report by the Nigerian Federal Ministry of Health highlights the findings of an integrated biological and behavioral surveillance survey (IBBSS) in Nigeria among groups whose behaviors or occupations often place them at higher risk of contracting sexually transmitted infections, including HIV. The main objectives of the study were to assess the knowledge and beliefs of high-risk groups about STI and HIV, determine the prevalence of HIV infection among these groups, and obtain data that will permit identification of trends over time. Since the 2007 IBBSS survey report, a considerable number of interventions have commenced among the study groups.

Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel

HIV and AIDS

In the past, HIV prevention efforts have focused primarily on developing risk-reduction interventions for those presumed to be HIV-negative and therefore at risk of becoming infected with HIV. In recognition of the need for prevention among people living with HIV (PLHIV), programs have been initiated in Africa, but primarily in clinical settings for those who are on antiretroviral therapy (ART). There is little knowledge about how to reach those PLHIV not on ART, and therefore not in regular contact with the health system or with effective prevention messages. This diagnostic study aimed to address the gap in information on how …

Monitoring And Evaluation Of The Emergency Plan Progress (Meepp): End-Of-Project Evaluation, Sam Kalibala

HIV and AIDS

This report evaluates the scope of the Monitoring and Evaluation of the Emergency Plan Progress (MEEPP) and the lessons learned from the project in Uganda, which aims to improve availability and quality of PEPFAR data.

Future Orientation Of Adolescents In Foster Care: Relationship To Trauma, Mental Health, And Hiv Risk Behaviors, Peter Cabrera, Wendy Auslander, Michael Polgar

Elián P. Cabrera-Nguyen

Future orientation has been found to protect against risk behaviors in adolescents from diverse backgrounds. However, no studies have specifically examined future orientation as a potential protective factor against HIV risk behaviors in foster care adolescents. In this study, 343 foster care adolescents were interviewed about their future orientation, mental health, trauma histories, and cognitions related to HIV risk behaviors. Results indicated variability in future orientation, but there were no significant differences by race, gender, and age. Future orientation was significantly associated with mental health, trauma, HIV-related knowledge, attitudes, behavioral intentions, and number of sexual intercourse partners. Furthermore, externalizing behaviors …

Commercial Sex Workers In Five Ethiopian Cities: A Baseline Survey For Usaid Targeted Hiv Prevention Program For Most-At-Risk Populations, Woldemariam Girma, Annabel Erulkar

HIV and AIDS

This report presents findings from a baseline survey of commercial sex workers (CSWs) that was undertaken in five Ethiopian cities. 2,050 CSWs were interviewed for the survey. CSW were disproportionally young and came from extremely disadvantaged backgrounds. Most respondents also cited negative working standards from another profession, or family responsibilities as reasons leading to sex work. Condom use was very high but use may be inconsistent or over-reported and should be studied further. Findings also propose additional advocacy for positive peer support groups, more HIV testing for at-risk populations, and addressing violence among CSWs and other Ethiopian women.

Consentimiento Informado En Ensayos De Prevención Del Vih: Aspectos Destacados De Un Taller Internacional, Population Council

HIV and AIDS

Resumen adaptado del informe del taller organizado conjuntamente por el Population Council y Family Health International en mayo de 2005. El resumen se centra específicamente en las herramientas y estrategias presentadas en el taller que se están usando en ensayos de prevención del VIH para facilitar el consentimiento informado, explicar conceptos difíciles, y evaluar la comprensión entre los participantes del ensayo. Se destacan ejemplos ilustrativos de ensayos concluidos y en curso. Este resumen será útil para una audiencia de investigadores locales, defensores y personal de ensayos clínicos.

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Brief adapted from the report of the workshop co-hosted by the Population …

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

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Brief adapted from the report of the workshop co-hosted …

Consentimento Informado Nos Ensaios De Prevenção Do Hiv: Pontos Altos Dum Workshop Internacional, Population Council

HIV and AIDS

Resumo adaptado do relatório do workshop organizado pelo Population Council e Family Health International em maio de 2005. O resumo se concentra especificamente nas ferramentas e estratégias apresentadas no workshop que estão sendo usadas em testes de prevenção do HIV para facilitar o consentimento informado, explicar conceitos difíceis e avaliar a compreensão entre os participantes do estudo. Exemplos ilustrativos de ensaios concluídos e em andamento são destacados. Este resumo será útil para um público de investigadores locais, advogados e equipe de ensaios clínicos.

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Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health …

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Propiciando Cambio Personal Y Social Alrededor Del Género, Sexualidad Y Vih: Evaluación De Impacto De La Estrategia De Comunicación De Puntos De Encuentro En Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

School As A Workplace In Kenya: Evaluation Of The Teachers Matter Hiv/Aids Project, Karusa Kiragu, Caroline Mackenzie, Jennifer Weiss, Murungaru Kimani, Debbie Gachuhi

HIV and AIDS

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …

Catalyzing Personal And Social Change Around Gender, Sexuality, And Hiv: Impact Evaluation Of Puntos De Encuentro´S Communication Strategy In Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Assessment Of Risk Factors For Hiv Infection In Female Sex Workers And Men Who Have Sex With Men In Ciudad Del Este, Paraguay, Magda Chinaglia, Waimar Tun, Maeve Mello, Magdalena Insfran, Juan Diaz

HIV and AIDS

Research conducted by the Population Council/Brazil, supported by the USAID-funded Horizons Project, documents findings from a study in Paraguay among men who have sex with men and female sex workers to estimate HIV and syphilis prevalence; examine knowledge, attitudes, and risk behaviors related to HIV and STIs; and describe the contextual and behavioral factors influencing HIV and STI transmission. Findings provide guidance to the development of HIV and STI prevention and care interventions and further operations research to test strategies and interventions to reduce the spread of HIV and STIs in these groups.

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …