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Promoting Adherence Through A Directly Administered Antiretroviral Therapy Strategy In Mombasa, Kenya, Avina Sarna, Stanley Luchters, Scott Geibel, Matthew F. Chersich, Paul Munyao, Rick Homan, Susan Kaai, Kishorchandra N. Mandaliya, Marleen Temmerman, Naomi Rutenberg
Promoting Adherence Through A Directly Administered Antiretroviral Therapy Strategy In Mombasa, Kenya, Avina Sarna, Stanley Luchters, Scott Geibel, Matthew F. Chersich, Paul Munyao, Rick Homan, Susan Kaai, Kishorchandra N. Mandaliya, Marleen Temmerman, Naomi Rutenberg
HIV and AIDS
A principal concern of antiretroviral therapy (ART) programs is the ability of clients to maintain a high level of adherence to medication. Based on formative research conducted with HIV-infected clients and health workers in Mombasa, Kenya, and lessons learned from directly observed therapy strategies to encourage adherence to treatment for tuberculosis, a directly administered antiretroviral therapy (DAART) strategy to promote adherence to ART was developed. This study examines whether the intervention was more effective in fostering adherence to ART than standard follow-up among people living with HIV in Mombasa. Researchers from the Horizons Program and the International Centre for Reproductive …
Sexual Risk Behaviors Of Hiv-Positive Persons Receiving Art In Mombasa, Kenya: Longitudinal Study Findings, Stanley Luchters, Avina Sarna, Scott Geibel, Matthew F. Chersich, Paul Munyao, Susan Kaai, Kishorchandra N. Mandaliya, Naomi Rutenberg, Marleen Temmerman
Sexual Risk Behaviors Of Hiv-Positive Persons Receiving Art In Mombasa, Kenya: Longitudinal Study Findings, Stanley Luchters, Avina Sarna, Scott Geibel, Matthew F. Chersich, Paul Munyao, Susan Kaai, Kishorchandra N. Mandaliya, Naomi Rutenberg, Marleen Temmerman
HIV and AIDS
As a result of the success of antiretroviral therapy (ART) in dramatically decreasing morbidity and mortality due to HIV, many HIV-infected individuals are now living longer, healthier, and more sexually active lives. However, unprotected sex by people living with HIV is an area of concern because of the risk of transmission to sero-discordant partners and reinfection with new, drug-resistant viral strains. There is evidence to suggest that some sero-positive individuals continue to engage in unprotected sex that places others at risk for infection and places themselves at risk for contracting secondary infections. To learn more about the impact of ART …
Psychosocial Benefits Of A Mentoring Program For Youth-Headed Households In Rwanda, Lisanne Brown, Janet C. Rice, Neil W. Boris, Tonya R. Thurman, Leslie M. Snider, Joseph Ntaganira, Laetitia N. Nyirazinyoye, Edward Kalisa, Emmanuel Nshizirungu
Psychosocial Benefits Of A Mentoring Program For Youth-Headed Households In Rwanda, Lisanne Brown, Janet C. Rice, Neil W. Boris, Tonya R. Thurman, Leslie M. Snider, Joseph Ntaganira, Laetitia N. Nyirazinyoye, Edward Kalisa, Emmanuel Nshizirungu
HIV and AIDS
In Rwanda, the combined effects of the 1994 genocide and the AIDS pandemic have devastated the lives of children and families. More than 300,000 young people have been “left behind,” not only by parents and other caregivers who have died, but also by extended families and communities who stigmatize and fail to support them. The phenomenon of youth-headed households in the region is a relatively recent development. Despite the long history of fostering in sub-Saharan Africa, family and community safety nets are overstretched. Youth-headed households may be a legitimate coping strategy; however, children living in youth-headed households are less likely …
Supporting Volunteer Mentors: Insights From A Mentorship Program For Youth-Headed Households In Rwanda, Lisanne Brown, Tonya R. Thurman, Edward Kalisa, Janet C. Rice, Jean De Dieu Bizimana, Neil W. Boris, Leslie M. Snider, Joseph Ntaganira
Supporting Volunteer Mentors: Insights From A Mentorship Program For Youth-Headed Households In Rwanda, Lisanne Brown, Tonya R. Thurman, Edward Kalisa, Janet C. Rice, Jean De Dieu Bizimana, Neil W. Boris, Leslie M. Snider, Joseph Ntaganira
HIV and AIDS
In 2004, World Vision Rwanda (WVR), in collaboration with Tulane University and the Rwanda School of Public Health, implemented a program to provide support through regular visits by an adult mentor to youth living without adult care. After completion of baseline quantitative and qualitative research, WVR implemented the program in two areas of a province in southwestern Rwanda. Over an 18-month period, 156 trained adult mentors visited and supported 441 youth-headed households. The mentor training covered key aspects of child development and skills for addressing key psychosocial issues that were identified through the baseline research. Specifically, the training addressed how …
Implementing Sti/Hiv Prevention And Care Interventions For Men Who Have Sex With Men In Senegal, Amadou Moreau, Placide Tapsoba, Abdoulaye Ly, Cheikh Ibrahima Niang, Abdou Khoudia Diop
Implementing Sti/Hiv Prevention And Care Interventions For Men Who Have Sex With Men In Senegal, Amadou Moreau, Placide Tapsoba, Abdoulaye Ly, Cheikh Ibrahima Niang, Abdou Khoudia Diop
HIV and AIDS
Exploratory research conducted by the Horizons Program in 2002 revealed that men who have sex with men (MSM) in Dakar, Senegal, are particularly vulnerable to sexually transmitted infections (STIs) and HIV. Further, the stigma and discrimination suffered by many MSM result in the concealment of sexual behaviors from health-care providers, making it difficult to receive appropriate services. Finally, there is a lack of HIV-prevention campaigns geared to this group. Key stakeholders in Dakar developed and implemented an intervention to meet the STI/HIV prevention needs of MSM and address prevailing stigma that effectively serves as a barrier to care. The intervention …
Building The Capacity Of Faith-Based Organizations To Promote Mutual Monogamy In South Africa, Waimar Tun, Nathi Sohaba, Unathi Malinzi, Matthew Nqono, Osborne Mzilikazi, Bonisiwa Mgujulwa, Moses Madywabe, Mbulelo Fatyeni, Christine Fontecchio
Building The Capacity Of Faith-Based Organizations To Promote Mutual Monogamy In South Africa, Waimar Tun, Nathi Sohaba, Unathi Malinzi, Matthew Nqono, Osborne Mzilikazi, Bonisiwa Mgujulwa, Moses Madywabe, Mbulelo Fatyeni, Christine Fontecchio
HIV and AIDS
In South Africa, where sex partnerships outside primary relationships are common even among church members, HIV-prevention programs focusing on mutual monogamy (MM) are needed. Church leaders, highly regarded by the community, may be effective in reaching congregation members with HIV-prevention messages. However, implementing programs that promote faithfulness pose several challenges. In response to a lack of research on effective strategies to promote MM, the Horizons Program, in partnership with the Eastern Cape Provincial Council of Churches and the South African Council of Churches, piloted an intervention to promote MM. A curriculum was developed covering topics including HIV transmission, personal relationships, …
Intergenerational Communication On Sexuality And Hiv/Aids: Exploring Feasibility Of Building Effective Youth-Adult Partnerships To Reduce Young People's Hiv Vulnerabilities, Vaishali Sharma Mahendra, Sarat Chandra Pradhan, Saraswati Swain, Aradhana Nanda, Sanjit Patnayak, Sucheta Panda, Rajendra Prasad
Intergenerational Communication On Sexuality And Hiv/Aids: Exploring Feasibility Of Building Effective Youth-Adult Partnerships To Reduce Young People's Hiv Vulnerabilities, Vaishali Sharma Mahendra, Sarat Chandra Pradhan, Saraswati Swain, Aradhana Nanda, Sanjit Patnayak, Sucheta Panda, Rajendra Prasad
HIV and AIDS
In India, over one-third of all reported AIDS cases occur among people aged 15–24 years. Young people need competencies to navigate daily-life situations and engage in productive activities, and the relationships they form with adults and peers are the source of support and guidance critical to the development of their competencies. The peer-based approach is integral to sexual health and HIV-prevention programs for youth. However, in some settings, program and policy directions have been hampered by adult beliefs of what young people should be permitted to know. Recent projects show that working on changing the norms and beliefs of adults …
Exploring The Barriers To Accessing Care And Treatment For Hiv-Infected Children In India: A Diagnostic Study, Avina Sarna, Jaleel Ahmad, Glory Alexander, Vaishali Sharma Mahendra, Ashok Rau, Arjun Singh, Naomi Rutenberg
Exploring The Barriers To Accessing Care And Treatment For Hiv-Infected Children In India: A Diagnostic Study, Avina Sarna, Jaleel Ahmad, Glory Alexander, Vaishali Sharma Mahendra, Ashok Rau, Arjun Singh, Naomi Rutenberg
HIV and AIDS
Each year 27 million births take place in India. A conservative estimate of HIV prevalence of 1 percent among antenatal women translates to about 80,000 HIV-infected children being born annually. The latest figures from the National AIDS Control Organisation show that there are about 5,600 documented HIV-positive children (0–14 years), but a very small number are receiving antiretroviral therapy. The Population Council and partners conducted a qualitative study in three high-prevalence states of India to explore the facilitators and barriers to accessing care for HIV-positive children and assessed the current level of adherence to ART among children receiving treatment. A …
The Hiv/Aids Prevention Project For Vulnerable Youth In Northern Nigeria: Community Advocates Training Manual, Population Council, Adolescent Health And Information Projects, Federation Of Muslim Women's Associations In Nigeria, Islamic Education Trust
The Hiv/Aids Prevention Project For Vulnerable Youth In Northern Nigeria: Community Advocates Training Manual, Population Council, Adolescent Health And Information Projects, Federation Of Muslim Women's Associations In Nigeria, Islamic Education Trust
HIV and AIDS
This Community Advocates training manual contains a curriculum developed by the Population Council, Nigeria, under the HIV Prevention Project for Vulnerable Youth in Northern Nigeria funded by USAID/Nigeria. The curriculum was developed as a tool for training community advocates in conducting advocacy activities on the issues of early marriage, HIV/AIDS, and reproductive health. The curriculum aims to improve knowledge and strengthen the skills of community representatives from the northern region of Nigeria so they can openly discuss sensitive issues relating to HIV/AIDS, reproductive health, and marriage. Designed to be adapted or implemented as written, the curriculum is based on the …
Addressing Gupt Rog: Narrative Prevention Counselling For Sti/Hiv Prevention—A Guide To Ayush And Allopathic Practitioners, Bonnie K. Nastasi, Niranjan Saggurti, Stephen L. Schensul, Ravi K. Verma, Meena Gandhi
Addressing Gupt Rog: Narrative Prevention Counselling For Sti/Hiv Prevention—A Guide To Ayush And Allopathic Practitioners, Bonnie K. Nastasi, Niranjan Saggurti, Stephen L. Schensul, Ravi K. Verma, Meena Gandhi
HIV and AIDS
Although India has over 600,000 registered AYUSH practitioners who are engaged in homeopathic, Ayurvedic, and Unani systems of medicine, they have not been integrated into the country’s national health system. While practitioners of these systems of medicine treat all illnesses, they have a special niche in providing services to address men’s sexual health concerns (Gupt Rog). A project on Research and Intervention in Sexual Health: Theory to Action was undertaken by the International Institute for Population Sciences/Mumbai, the Population Council/New Delhi, and partners, in three slum communities in Mumbai, from 2001–07. The objective was to control the spread of sexually …
Engaging Advocates From Concept To Results: Summary Report Of The Advocates' Consultation On Hiv Prevention Trials: Carraguard And Voice Studies, Johannesburg, South Africa, 18-19 October 2007, Microbicide Trials Network, Population Council
Engaging Advocates From Concept To Results: Summary Report Of The Advocates' Consultation On Hiv Prevention Trials: Carraguard And Voice Studies, Johannesburg, South Africa, 18-19 October 2007, Microbicide Trials Network, Population Council
HIV and AIDS
Advocate consultations are increasingly becoming the rule, not the exception in the HIV-prevention research field. As an increasing number of Phase III trials enter the field, research groups are seeking new ways to collaborate with advocates and maximize civil society input and engagement. The Advocates’ Consultation for HIV Prevention Trials: Carraguard and VOICE Studies provided leaders from African NGOs a unique opportunity to learn about the clinical trial process from beginning to end, and to collectively identify ways to influence how scientific research is formulated. Participants represented a wide range of advocacy groups from Southern African countries, including those working …
Current Research And Good Practice In Hiv And Aids Treatment Education, Avina Sarna, Ellen Weiss
Current Research And Good Practice In Hiv And Aids Treatment Education, Avina Sarna, Ellen Weiss
HIV and AIDS
This report was prepared by UNESCO and WHO for presentation at the HIV and AIDS Treatment Education Technical Consultation in Paris, November 22–23, 2005. There is a growing realization among program managers and donors that merely providing antiretroviral therapy (ART) and training health providers is not sufficient and that unless efforts are made to engage communities and individuals to improve their knowledge and understanding of HIV, AIDS, and ART, programs will not meet the targets set by these initiatives and will fall short of contributing to the goal of attaining universal access to treatment. This report describes current research and …
Preparedness Of Kenyan Health Workers To Deliver Hiv/Aids Services, National Aids And Std Control Programme, Ministry Of Health Kenya, Centers For Disease Control And Prevention, Horizons Program
Preparedness Of Kenyan Health Workers To Deliver Hiv/Aids Services, National Aids And Std Control Programme, Ministry Of Health Kenya, Centers For Disease Control And Prevention, Horizons Program
HIV and AIDS
Most Kenyan adults do not know their HIV status. Patients who present to a health facility can learn their status as part of a diagnostic assessment, enabling health-care personnel to provide a more accurate clinical evaluation and accelerate access to comprehensive care. This is particularly relevant in Kenya because up to 60 percent of all medical ward hospital beds are occupied by HIV-infected patients. Therefore provider-initiated HIV testing and counseling, which includes diagnostic testing and counseling (DTC), provides an opportunity to interrupt the cycle of HIV transmission to patients’ partners and children. In 2004, the Kenya Ministry of Health launched …
Identifying Areas For Linkages Between Hiv And Srh For Vulnerable Populations: An Exploratory Study To Assess Female Sex Workers' Sexual And Reproductive Health Needs, Vaishali Sharma Mahendra, Sushma Mehrotra, B. Srikanthi, Sucheta Panda, Avina Sarna, A.K. Jayasree, Rajendra Prasad, Naomi Rutenberg
Identifying Areas For Linkages Between Hiv And Srh For Vulnerable Populations: An Exploratory Study To Assess Female Sex Workers' Sexual And Reproductive Health Needs, Vaishali Sharma Mahendra, Sushma Mehrotra, B. Srikanthi, Sucheta Panda, Avina Sarna, A.K. Jayasree, Rajendra Prasad, Naomi Rutenberg
HIV and AIDS
Sexual and reproductive ill-health and HIV/AIDS share root causes, including poverty, gender inequality, and social marginalization of the most vulnerable populations. This has prompted the international community to call for policy and program approaches to strengthen the linkages between SRH and HIV/AIDS programs. However, most integration efforts have given priority to family planning, maternal and child health, and STI treatment and to addressing the needs of married women from the general population. Female sex workers have been targeted for HIV prevention efforts but little attention has been given to SRH-related care. To bring sex workers into the focus for SRH-HIV …
Changes In Stigma Among A Cohort Of People On Antiretroviral Therapy: Findings From Mombasa, Kenya, Susan Kaai, Avina Sarna, Stanley Luchters, Scott Geibel, Paul Munyao, Kishorchandra N. Mandaliya, Khadija Shikely, Marleen Temmerman, Naomi Rutenberg
Changes In Stigma Among A Cohort Of People On Antiretroviral Therapy: Findings From Mombasa, Kenya, Susan Kaai, Avina Sarna, Stanley Luchters, Scott Geibel, Paul Munyao, Kishorchandra N. Mandaliya, Khadija Shikely, Marleen Temmerman, Naomi Rutenberg
HIV and AIDS
Stigma has been a reality in the lives of people living with HIV (PLHIV) since the inception of the AIDS epidemic, and it can have profound implications for health, psychosocial well-being, and utilization of health services. In the industrialized world, the availability of antiretroviral therapy (ART) and a subsequent change in perception of AIDS as a chronic manageable disease has coincided with a decrease in stigma and discrimination directed toward PLHIV. However, little is known in developing countries about whether perceptions and experiences of stigma among PLHIV have changed following increased access to ART. The Horizons Program and the International …
Ethical Approaches To Gathering Information From Children And Adolescents In International Settings: Guidelines And Resources, Katie D. Schenk, Jan Williamson
Ethical Approaches To Gathering Information From Children And Adolescents In International Settings: Guidelines And Resources, Katie D. Schenk, Jan Williamson
HIV and AIDS
This publication provides practical guidance to help program managers and researchers understand and uphold ethical standards when planning and implementing information-gathering activities among children and adolescents, and promotes discussion of ethical issues among people of different backgrounds and training who gather information for different purposes. The publication, which is divided into three parts, is intended to be helpful to anyone who plans, manages, implements, analyzes, or funds any program or research activity that requires gathering information from children and adolescents, including monitoring and evaluation. Part 1 presents key issues that must be considered from the earliest stages of planning and …
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
Poverty, Gender, and Youth
The detrimental consequences of the AIDS epidemic for older adults in sub-Saharan Africa suggest the need to investigate their characteristics, living situations, and well-being. In this study, we examine the living arrangements of persons aged 60 and older in 16 countries. Data come from the household roster component of recent Demographic and Health Surveys. The focus is on the tendency of the elderly to live with children and grandchildren, and we examine distributions and determinants. Results show that older adults in sub-Saharan Africa live in a variety of household arrangements. Men are more likely to be living in a nuclear …
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
Poverty, Gender, and Youth
Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Poverty, Gender, and Youth
In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Poverty, Gender, and Youth
To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …
Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta
Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta
HIV and AIDS
While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
Poverty, Gender, and Youth
The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …
Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias
Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias
Reproductive Health
As the world grapples with the HIV pandemic, the implementation of the agenda determined by the International Conference on Population and Development (1994) at Cairo, and the matter of providing health services of adequate quality in an ethical, gender-sensitive manner, new questions are arising about how to attend to reproductive tract infections, including sexually transmitted infections (STIs), among women. This paper reviews the results of validation studies of syndromic algorithms, other nonlaboratory clinically based tools, and risk scoring for finding women infected with chlamydia and gonorrhea, particularly among those attending family planning and antenatal clinics in developing countries. The results …
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom
Poverty, Gender, and Youth
The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …
Reproductive Health Approach To Family Planning, Population Council
Reproductive Health Approach To Family Planning, Population Council
Reproductive Health
This report collects presentations from a panel held on Professional Development Day at the USAID Cooperating Agencies meeting in November 1994. The panel was designed to review key reproductive health elements that relate to family planning, including: reproductive tract and sexually transmitted infections, including AIDS; the prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. While there is increasing international consensus that family planning should be broadened to include reproductive health care, it is far from clear as to how this should be done, and which elements should be incorporated. This panel explored some of …