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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 …

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 …

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 …

Support By Migrants To Their Elderly Parents In Rural Cambodia And Thailand: A Comparative Study, Zachary Zimmer, Kim Korinek, John Knodel, Napaporn Chayovan

Poverty, Gender, and Youth

Internal migration in Southeast Asia raises questions about strains upon traditional systems of support for older adults. While remittances to parents’ households play a role in rural household economies, uncertainty remains regarding whether and under what circumstances children interact with their elderly parents. This paper focuses on the adult children of older persons living in rural Cambodia and Thailand and examines the determinants of personal visits, monetary remittances, and more general forms of household support. Analyses consider ways in which geographically distant children support parents, the extent to which characteristics of parents, children, and households enhance or detract from these …

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 …

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

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 …

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 …

Patterns And Implications Of Male Migration For Hiv Prevention Strategies In Andhra Pradesh, Ravi K. Verma, Niranjan Saggurti, Madhumita Das, Saumya Ramarao, Anrudh K. Jain

HIV and AIDS

HIV is widespread in Andhra Pradesh, with high HIV prevalence among pregnant women receiving antenatal care and patients receiving treatment for sexually transmitted infections. High HIV prevalence among women indicates that the infection, rather than being restricted to groups at high risk, is present in the general population. Districts with high HIV prevalence are also destinations for large numbers of male migrants. Migration may be a major contributor to the spread of HIV in the state, however empirical evidence is limited. Furthermore, evidence is required to maximize the impact of programmatic inputs intended to contain the spread of the epidemic. …

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 …

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 …

A Theory And Definition Of Public Health Law, Lawrence O. Gostin

Journal of Health Care Law and Policy

No abstract provided.

Public Health And Constitutional Law: Recognizing The Relationship, Wendy E. Parmet

Journal of Health Care Law and Policy

No abstract provided.

Beyond Compensation: Using Torts To Promote Public Health, Elizabeth A. Weeks

Journal of Health Care Law and Policy

No abstract provided.

"Public-Private" Health Law: Multiple Directions In Public Health, Nan D. Hunter

Journal of Health Care Law and Policy

No abstract provided.

Medicine And Public Health: Crossing Legal Boundaries, Wendy K. Mariner

Journal of Health Care Law and Policy

No abstract provided.

R.J. Reynolds Tobacco Co. V. Shewry: Has The Tobacco Industry Met Its Match?, Lauren Rachel Bregman

Journal of Health Care Law and Policy

No abstract provided.

The Human Papillomavirus Vaccine: Should It Be Mandatory Or Voluntary?, Carrie A. Roll

Journal of Health Care Law and Policy

No abstract provided.

Guest Editorial, Greg Holzman

Michigan Journal of Public Health

No abstract provided.

Village Health Workers Improve Child Health: The Jamkhed, India Experience, A. Crandall, J. S. Job, P. N. Singh, S. R. Arole, R. S. R. Arole

International Journal of Global Health and Health Disparities

OBJECTIVE: To assess the effect of the three-decade old Comprehensive Rural Health Project (CRHP) on morbidity, mortality, immunization rates, and health care utilization among children under 5 years of age in Jamkhed, Central India. METHODS: We conducted a cross-sectional survey of a stratified, cluster sample of 879 children (under-fives) in 15 Jamkhed villages served by CRHP. CRHP has a three-tiered primary health care model that comprises a tertiary care facility, a mobile health program supporting 30 subcenters, and community-based health workers.

FINDINGS: We found a prevalence of diarrhea [6.4%, 95% CI: 4.0%-8.8%], measles [2.3%, 95% CI: 0%-5.6%], tuberculosis [0.3%, 95% …

Injecting Drug Users In India: Understanding Sexual Behaviours And Sexual Networks To Design Effective Behaviour Change Strategies, Avina Sarna, Waimar Tun, Aruna Bhattacharya, Vaishali Sharma Mahendra, Neville Selhore, Arjun Singh, Louis Apicella

HIV and AIDS

The practice of injecting drug use has been spreading to different parts of India since the early 1980s and is associated with an increase in HIV prevalence rates. Injecting drug users (IDUs) engage in both risky injection and sexual practices that increase the risk for HIV transmission. While risky injection practices are well understood, there is limited understanding of IDUs’ sexual behaviors and social networks. The Population Council conducted a cross-sectional study to explore patterns of risky sexual behaviors, sexual network characteristics, and drivers of high-risk behaviors of IDUs in Delhi and Imphal. The contrasting settings were selected to allow …

The Status Of Childhood Lead Poisoning And Prevention In Nevada, Usa, Anne Rothweiler, Elena E. Cabb, Shawn Gerstenberger

Environmental & Global Health Faculty Research

One of the first steps in addressing the problem of childhood lead poisoning is to identify the possible sources of exposure in specific communities and target high-risk populations with appropriate interventions. Due to several factors, such as lack of funding and lack of blood lead reporting, little information exists regarding the occurrence of childhood lead poisoning and the prevalence of potential exposure sources in the state of Nevada. Following the recent establishment of a Nevada-based Lead Poisoning Program, we compiled the most current information available on Nevadans, and use this knowledge to suggest future research objectives and outreach activities for …

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 …

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 …

Continuum Of Care For Hiv-Positive Women Accessing Programs To Prevent Parent-To-Child Transmission: Findings From India, Vaishali Sharma Mahendra, Rupa Mudoi, Archana Oinam, Venkat Pakkela, Avina Sarna, Sucheta Panda, Ashok Rau, L. Birendrajit Singh, Naomi Rutenberg

HIV and AIDS

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, …

Reducing Disparities Beginning In Early Childhood: Short Takes No. 4, Kay Johnson, Suzanne Theberge, Copyright © 2007 By The National Center For Children In Poverty; Columbia University Mailman School Of Public Health Ny

Mickey Leland Center Information Portal

Research shows that many disparities in health and well-being are rooted in early childhood. These disparities reflect gaps in access to services, unequal treatment, adverse congenital health conditions, and exposures in the early years linked to elevated community and family risks.1 Early health risks and conditions can have long-range implications for physical, emotional, and intellectual development as well as health. Their contribution to disparities in health status, disabilities, and educational achievement is well documented.2 But many risks can be addressed in the early years, starting with quality prenatal care and interventions in the earliest stages of life. Thus, literally, reducing …

Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi

Reproductive Health

The objective of this paper is to explore the perceptions and experiences of providers with regard to the process of informed consent in the provision of female sterilization services in Chennai, south India. It describes the quality of information provided to clients of sterilization, providers’ attitudes toward clients and the quality of decisionmaking, as well as the quality of the consent-taking process in this setting. In addition, providers’ perceptions of the importance of informed consent are discussed. Findings strongly suggest the need to train and sensitize providers in public as well as private facilities on their ethical responsibilities of ensuring …

Developing Regional Operations Research Training Capacity In South Asia, M.E. Khan, James R. Foreit, Sohini Roychowdhury, F. Ram, Chander Shekhar

Reproductive Health

This project’s overall objective was to create a self-sustaining regional operations research (OR) training and research center for South Asia at the International Institute of Population Sciences (IIPS), in Mumbai, India. The goal was to institutionalize operations research (OR) in IIPS by building the teaching and research capabilities of the faculty and research team. Capacity building was accomplished through a training of trainers that included an OR workshop in Nepal, two four-day OR workshops for program managers, one ten-day OR workshop for researchers, and a four-day scientific-writing course for researchers and program managers to provide guidelines for preparing research articles …

Situation Analysis Of The Sexual And Reproductive Health And Hiv Risks And Prevention Needs Of Older Orphaned And Vulnerable Children In Nyanza Province, Kenya, Milka Juma, Ian Askew, Alan Ferguson

Reproductive Health

The increasing number of children in Kenya who are orphaned or made vulnerable (OVC) from HIV/AIDS and other factors calls for a holistic understanding of their situation so that effective programs to address their needs can be designed. This is especially important for those areas hardest hit by the HIV/AIDS pandemic, such as Nyanza Province. Little is known about the vulnerabilities of older orphans to risky sexual behavior, and whether they are more vulnerable than nonorphans. The Department of Children’s Services has initiated a cash transfer program to households taking care of OVC. The main objective is to provide a …

Water Source Outbreaks, Policy, And The South Bass Island Investigation, David Brett-Major, Sherry M. Brett-Major

Journal Articles: Epidemiology

No abstract provided.