Medicine and Health Sciences Commons^™

Improving The Coverage And Accuracy Of Syphilis Testing: The Development Of A Novel Rapid, Point-Of-Care Test For Confirmatory Testing Of Active Syphilis Infection And Its Early Evaluation In China And South Africa, Minh D. Pham, Amy Wise, Mary L. Garcia, Huy Van, Shuning Zheng, Yasmin Mohamed, Yan Han, Wan-Hui Wei, Yue-Ping Yin, Stanley Luchters

Population Health, East Africa

Background: Current point-of-care tests (POCT) for syphilis, based on the detection of Treponema pallidum (TP) total antibodies, have limited capacity in distinguishing between active and past/treated syphilis. We report the development and early evaluation of a new prototype POCT based on the detection of TP-IgA antibodies, a novel biomarker for active syphilis.

Methods: The TP-IgA POCT (index test) was developed in response to the World Health Organisation (WHO) target product profile (TPP) for a POCT for confirmatory syphilis testing. Two sub-studies were conducted consecutively using 458 pre-characterised stored plasma samples in China (sub-study one, addressing the criteria for the WHO …

Ethical Considerations For Conducting Sexual And Reproductive Health Research With Female Adolescents Engaged In High-Risk Behaviours In China, Xu-Dong Zhang, Sabrina Ching Yuen Luk, Yue-Hong Han, Gui-Rong Chen, Bao-Sheng Zhu, Stanley Luchters

Population Health, East Africa

Background: Chinese female adolescents engaged in sex trade and substance use are often criminalized and stigmatized. As a result of these cultural, legal and political constraints, ethical concerns can discourage investigators from engaging these adolescents in research. This paper aims to address the ethical tensions between protection and inclusion in conducting sexual and reproductive health (SRH) research with adolescents engaged in high-risk behaviours. Processes of moral reasoning, and examples and practical mechanisms in managing such ethical challenges were presented in the hope of advancing the research ethics policies and practice with adolescents.

Methods: We extracted ethical issues from three previously …

A Qualitative Exploration Of Perceptions And Experiences Of Contraceptive Use, Abortion And Post-Abortion Family Planning Services (Pafp) In Three Provinces In China, Yan Che, Esther Dusabe-Richards, Shangchun Wu, Yi Jiang, Xiaojing Dong, Jian Li, Wei-Hong Zhang, Marleen Temmerman, Rachel Tolhurst, Inpac Group

Obstetrics and Gynaecology, East Africa

Background: The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change.

Methods: Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities …

Safer Sex Practices Among Newly Diagnosed Hiv-Positive Men Who Have Sex With Men In China: Results From An Ethnographic Study, Haochu Li, Andrea Sankar, Eleanor Holroyd, Baofa Jiang

School of Nursing & Midwifery, East Africa

The study reported here sought to understand the rationales of safer sex practices adopted by newly diagnosed HIV-positive men who have sex with men (MSM). Guided by a socio-ecological framework, an ethnography was conducted among newly diagnosed HIV-positive MSM. In-depth interviews and participant observation were employed to produce an account of the social and cultural settings that was faithful to the perspectives of participants. A total of 31 participants with diverse backgrounds were recruited in a southern city of China. Participant observation was conducted in local healthcare settings, MSM venues, and NGO offices. Most participants (24/31) reported stopping unprotected anal …

Barriers And Facilitators Of Linkage To Hiv Care Among Hiv-Infected Young Chinese Men Who Have Sex With Men: A Qualitative Study, Haochu Li, Chongyi Wei, Joseph Tucker, Dianmin Kang, Meizhen Liao, Eleanor Holroyd, Jietao Zheng, Qian Qi, Wei Ma

School of Nursing & Midwifery, East Africa

Background: The Four Free and One Care Policy (HIV/AIDS-related free services) has been in place in China since 2004. However, linkage to human immunodeficiency virus (HIV) care is not yet achieved very well among people living with HIV. We conducted a qualitative study to explore individual and contextual factors that may influence a linkage to HIV care from the perspective of young HIV-infected men who have sex with men (MSM) in a highly centralized HIV care context of China.

Methods: Purposive sampling was used to recruit 21 HIV-infected MSM in Shandong Province, with in-depth interviews conducted between March and July …

Sexual And Reproductive Health Risks Amongst Female Adolescents Who Use Amphetamine-Type Stimulants And Sell Sex: A Qualitative Inquiry In Yunnan, China, Xu-Dong Zhang, Angela Kelly-Hanku, Jia-Jia Chai, Jian Luo, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background: China, as other Southeast Asian countries, has witnessed an increased use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst female adolescents who both sell sex and use ATS, risk behaviours are compounded resulting in even poorer health outcomes. However, limited knowledge exists on ATS use patterns and ATS-related risk behaviours, particularly in this context. This research aimed to improve the understanding of these issues amongst female adolescents who use ATS and sell sex, and to inform future programming.

Method: This study utilised monthly focus group discussions (four in total) with the same study participants in Yunnan, China. From within …

Sexual And Reproductive Health Knowledge, Contraception Uptake, And Factors Associated With Unmet Need For Modern Contraception Among Adolescent Female Sex Workers In China, Megan S. C. Lim, Xu-Dong Zhang, Elissa Kennedy, Yan Li, Yin Yang, Lin Li, Yun-Xia Li, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Objective: In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China.

Methods: A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire …

Exploring Unprotected Anal Intercourse Among Newly Diagnosed Hiv Positive Men Who Have Sex With Men In China: An Ethnographic Study, Haochu Li, Eleanor Holroyd, Joseph Lau

School of Nursing & Midwifery, East Africa

Background: Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.

Methods: We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.

Results: Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing …

Vulnerabilities, Health Needs And Predictors Of High-Risk Sexual Behaviour Among Female Adolescent Sex Workers In Kunming, China, Xu-Dong Zhang, Marleen Temmerman, Yan Li, Wei Luo, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Objectives: This study assessed social and behavioural predictors for sexual risk taking and sexually transmitted infections (STIs) including HIV among adolescent female sex workers (FSWs) from Kunming, China. Additionally, health services needs and use were assessed.

Methods: A cross-sectional survey was conducted in 2010. Using snowball and convenience sampling, self-identified FSWs were recruited from four urban areas in Kunming. Women consenting to participate were administered a semi-structured questionnaire by trained interviewers identified from local peer-support organisations. Following interview, a gynaecological examination and biological sampling to identify potential STIs were undertaken. Descriptive and multivariable logistic regression analyses were performed.

Results: Adolescent …

Adults' Perceived Prevalence Of Enteric Fever Predicts Laboratory-Validated Incidence Of Typhoid Fever In Children, Xinguang Chen, Bonita Stanton, Al Pach, Andrew Nyamete, R. Leon Ochiai, Linda Kaljee, Baiqing Dong, Dipika Sur, S.K. Bhattacharya, Siti Sapardiyah Santoso, Magdarina Agtini, Zahid Memon, Zulfiqar Ahmed Bhutta, Canh Gia Do, Lorenz Von Seidlein, John Clemens

Centre of Excellence in Women and Child Health

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults’ perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through …