Medicine and Health Sciences Commons^™

Parallel Ngo Networks For Hiv Control: Risks And Opportunities For Ngo Contracting., Shehla Zaidi, Xaher Gul, Noureen Aleem Nishtar

Community Health Sciences

Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO …

Exposé Of Misleading Claims That Male Circumcision Will Increase Hiv Infections In Africa, Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner

Richard G. Wamai

Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We …

Comparison Of Need And Supply Of Syringes For Therapeutic Injections In Pakistan, Adnan Ahmad Khan, Momina Saleem, Huma Qureshi, Rashid Jooma, Ayesha Khan

Section of Neurosurgery

Objectives: To determine the extent of shortfall in syringes by measuring the need from nationally validated sources and comparing it with position on the supply side. This was done in order to contribute to the ongoing national discussions that have focused on increasing syringe supply to curtail syringe reuse.
Methods: Using 'Injections received' data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), the study estimated the number of injections received in Pakistan. We matched these against the local syringe production figures from the syringe manufacturers' association and import figures from the Federal …

Living With Uncertainty: Acting In The Best Interests Of Women, Erica Gollub, Zena Stein

HWCOM Faculty Publications

A recent multi-country study on hormonal contraceptives (HC) and HIV acquisition and transmission among African HIV-serodiscordant couples reported a statistically significant doubling of risk for HIV acquisition among women as well as transmission from women to men for injectable contraceptives. Together with a prior cohort study on African women seeking health services, these data are the strongest yet to appear on the HC-HIV risk. This paper will briefly review the Heffron study strengths and relevant biological and epidemiologic evidence; address the futility of further trials; and propose instead an alternative framework for next steps. The weight of the evidence calls …

Female Sex Work And International Sport Events - No Major Changes In Demand Or Supply Of Paid Sex During The 2010 Soccer World Cup: A Cross-Sectional Study, Marlise Richter, Stanley Luchters, Dudu Ndlovu, Marleen Temmerman, Matthew Francis Chersich

Population Health, East Africa

Background: Important unanswered questions remain on the impact of international sporting events on the sex industry. Speculation about increased demand and supply of sex work often generates significant attention, but also additional funding for HIV programmes. This study assessed whether changes occurred in the demand and supply of paid sex during the 2010 Soccer World Cup in South Africa.

Methods: Trained sex worker interviewers conducted face-to-face semi-structured interviews among consenting female sex workers during May-September 2010. Using bivariate analyses we compared supply, demand, sexual risk-taking, and police and health services contact pre-World Cup, to levels during the World …

A Pilot Self-Care Group Intervention For Low-Income Hiv-Positive Women, Maithe Enriquez, Margaret S. Miles, Jacki Witt, Paul Gore, Nancy Lackey

Journal of Health Disparities Research and Practice

This article describes the development of a self-care intervention and examines its efficacy with low-income HIV-positive women (n=34) in the Midwestern United States. Adapted from an individual nurse-led intervention, this effort focused on increasing self-care behaviors through enhancing self-esteem and social support. The investigators used a community-based participatory approach and partnered with three HIV-positive women to adapt and pilot test the new group intervention. A within-group, repeated-measures, pre-/post-test design, together with participant interviews, was used to evaluate the intervention. Mean scores on measures of self-care behaviors, self-esteem, social support and depressive symptoms all changed in the clinically desirable direction. Group …

Relationships And Context As A Means For Improving Disease Prevention And Sexual Health Messages, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

In many ways, the HIV epidemic changed the discourse about sex in the United States and worldwide (Ehrhardt, 1992; Everett, 1986) and continues to drive approaches to sex education. After a period of rapid growth in the late 1980s (approximately 150,000 new infections per year), by the late 1990s, HIV rates in the United States slowed to some 40,000 new infections annually (Centers for Disease Control and Prevention [CDC], 2001), and new HIV infections continue to hover around that number. The first successful examples of behavior change that resulted in decreased HIV transmission emerged from …

Beyond The It Magic Bullet: Hiv Prevention Education And Public Policy, Fay C. Payton

Journal of Health Disparities Research and Practice

Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

Independent Evolution Of Macrophage-Tropism And Increased Charge Between Hiv-1 R5 Envelopes Present In Brain And Immune Tissue, Maria Paz Gonzalez-Perez, Olivia O’Connell, Rongheng Lin, W Matthew Sullivan, Jeanne Bell, Peter Simmonds, Paul R. Clapham

Rongheng Lin

Background: Transmitted HIV-1 clade B or C R5 viruses have been reported to infect macrophages inefficiently, while other studies have described R5 viruses in late disease with either an enhanced macrophage-tropism or carrying envelopes with an increased positive charge and fitness. In contrast, our previous data suggested that viruses carrying non-macrophage-tropic R5 envelopes were still predominant in immune tissue of AIDS patients. To further investigate the tropism and charge of HIV-1 viruses in late disease, we evaluated the properties of HIV-1 envelopes amplified from immune and brain tissues of AIDS patients with neurological complications. Results: Almost all envelopes amplified were …

Mexico's Northern Border Conflict: Collateral Damage To Health And Human Rights Of Vulnerable Groups, Leo Beletsky, Gustavo Martinez, Tommi Gaines, Lucie Nguyen, Remedios Lozada, Gudelia Rangel, Alicia Vera, Heather L. Mccauley, Andrea Sorensen, Steffanie A. Strathdee

Leo Beletsky

Objectives: Given links between policing environment and infectious disease risk among vulnerable groups, we surveyed female sex workers who inject drugs in Tijuana and Ciudad (Cd.) Juarez. Data were used to 1. compare distributions of human rights violations and disease risk, 2. juxtapose these patterns against demographic and structural environment variables, and 3. formulate implications for structural interventions. Methods: Structured interviews and testing for sexually-transmitted infections (STIs) were conducted (October 2008-October 2009). Frequency of individual and environmental factors, including police abuse, HIV risk and protective behaviors were compared between sites using univariate logistic regression. Results: Of 624 women, almost half …

Hiv And Aids Education: The Tanzanian Case, Katherine Ellison

Social Sciences

This project takes a look at the cultural, religious, and socio-economic roles that affect the spread of education regarding HIV/AIDS in Tanzania. A personal experience in Zanzibar, Tanzania was the incentive to spark interest in teaching. HIV/AIDS is a powerful epidemic that has taken the lives away from millions. This article takes a deeper look at the transmission, stigmas, and pathways for change.

An Evaluation Of The Pre-Release Planning Program Of The Georgia Department Of Corrections And A Qualitative Assessment Of Reentry Experiences Of Program Participants, Alison N. Mccullough

Public Health Theses

Higher rates of HIV are seen within correctional systems across the United States. Georgia has one of the largest correctional populations in the country and HIV rates among prisoners are elevated when compared to the state as a whole. The purpose of this project was to evaluate the Pre-Release Planning Program of the Georgia Department of Corrections and to identify reentry needs unique to persons living with HIV. This evaluation was informed by the post-release experiences of participants who described their own reentry journeys through semi-structured qualitative interviews. A convenience sample of 45 program participants was recruited to complete a …

Epidemiology Of Contemporary Seroincident Hiv Infection In The Navy And Marine Corps, David Brett-Major, Shilpa Hakre, Neal A. Naito, Adam Armstrong, Eric A. Bower, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

Prognostic Implications Of Oral Health Status In Hiv-Positive Women In St. Petersburg, Russia, Anna Vinogradova

Legacy Theses & Dissertations (2009 - 2024)

Objective: To assess state of oral health in HIV-positive women in St. Petersburg, Russia and to study the association of oral health with pregnancy status and other factors in this sample.

Migrant Workers In Kazakhstan : Gender Differences In Hiv Knowledge And Sexual Risk Behaviors, Baurzhan Zhussupov

Legacy Theses & Dissertations (2009 - 2024)

Background:

Love And Risk: Intimate Relationships Among Female Sex Workers Who Inject Drugs And Their Non-Commercial Partners In Tijuana, Mexico, Jennifer L. Syvertsen

USF Tampa Graduate Theses and Dissertations

This dissertation examines the influence of love and other emotions on sexual and drug-related HIV risk among female sex workers who inject drugs and their intimate, non-commercial partners in Tijuana, Mexico. My work on a public health study along the Mexico-U.S. border and independent ethnographic research in Tijuana suggests the importance of emotions in shaping sex workers' relationships and health risks.

Love is a universal human emotional experience embodied within broader cultural, social, and economic contexts. A growing body of cross-cultural research suggests that modern relationships have transformed to emphasize love and emotional intimacy over moral or kinship obligations. Particularly …

A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba

Krishna C. Poudel

Background: The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods: We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related …

A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masaya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba

Krishna C. Poudel