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Full-Text Articles in Medicine and Health Sciences

Integrating Depression Management Into Hiv Care In Lilongwe, Malawi: Feasibility And Impact, Brian Wells Pence, Michael Udedi, Kazione Kulisewa, Mina C. Hosseinipour, Steven M. Mphonda, Melissa A. Stockton, Bradley N. Gaynes Feb 2021

Integrating Depression Management Into Hiv Care In Lilongwe, Malawi: Feasibility And Impact, Brian Wells Pence, Michael Udedi, Kazione Kulisewa, Mina C. Hosseinipour, Steven M. Mphonda, Melissa A. Stockton, Bradley N. Gaynes

HIV and AIDS

In Malawi, as in other sub-Saharan countries, mental health care infrastructure and resources are limited. Accordingly, there is a clear need to shift the provision of mental health treatment to the primary care level. The Malawi Ministry of Health, in partnership with UNC Project-Malawi, designed a program that would integrate depression screening and management into HIV care at two public HIV clinics in Lilongwe, Malawi. The purpose of this study, conducted under Project SOAR, was to evaluate the implementation of this program and its impact on HIV and mental health outcomes.


Impulsiveness, Depression, Sexual Behavior, And Sexually Transmitted Infections And Hiv-Related Outcomes Among Out-Of-School Adolescent Girls And Young Women In Rural Southern Malawi, Project Soar Jan 2021

Impulsiveness, Depression, Sexual Behavior, And Sexually Transmitted Infections And Hiv-Related Outcomes Among Out-Of-School Adolescent Girls And Young Women In Rural Southern Malawi, Project Soar

HIV and AIDS

Under Project SOAR, the Population Council in collaboration with the University of Malawi College of Medicine monitored key HIV prevention, care, and treatment outcomes among populations who are targeted by the One-C program. Under that study, the Population Council investigated associations between impulsiveness, depression, sexual behavior, sexually transmitted infections, and HIV among out-of-school adolescent girls and young women. Impulsivity is a personality trait that has been associated with risky sexual behavior among young people in different settings in the developed world.


Hiv Testing And Treatment Among Adults Working In The Fishing Sector, Agricultural Estates, And As Market Vendors In Rural Southern Malawi, Project Soar Jan 2021

Hiv Testing And Treatment Among Adults Working In The Fishing Sector, Agricultural Estates, And As Market Vendors In Rural Southern Malawi, Project Soar

HIV and AIDS

This brief focuses on the findings from Project SOAR’s monitoring of the One Community (One-C) project in areas where it is operating in Malawi. The brief describes the characteristics of male and female adults working in the fishing sector, in agricultural estates, and as market vendors. It also describes the prevalence of HIV testing and treatment among these populations and explores whether participation in One-C activities is associated with higher uptake of HIV services.


Characteristics And Relationship Dynamics Of Male Partners Of Adolescent Girls And Young Women In Malawi, Project Soar Jan 2021

Characteristics And Relationship Dynamics Of Male Partners Of Adolescent Girls And Young Women In Malawi, Project Soar

HIV and AIDS

Project SOAR, in collaboration with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted qualitative research in the Zomba and Machinga districts to understand how programs can better engage men living with HIV in care, treatment, and support services. This brief summarizes findings on men’s characteristics, the types and dynamics of their sexual relationships, and their vulnerabilities and environmental stressors.


Hiv Knowledge, Service Utilization, And Exposure To Dreams Among Male Partners Of Adolescent Girls And Young Women In Malawi, Project Soar Jan 2021

Hiv Knowledge, Service Utilization, And Exposure To Dreams Among Male Partners Of Adolescent Girls And Young Women In Malawi, Project Soar

HIV and AIDS

Project SOAR, in collaboration with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted qualitative research in the Zomba and Machinga districts to understand how programs can better engage men living with HIV in care, treatment, and support services. This brief summarizes findings on men’s knowledge of HIV, use of HIV services, stigma, and exposure to PEPFAR’s DREAMS (Determined Resilient Empowered AIDS-free Mentored and Safe) program which took a multi-sectoral approach to reduce HIV risk among adolescent girls and young women and their male partners.


Improving Pmtct Outcomes For Mother-Infant Pairs Through Community-Facility Linkage: Results From A Mixed Methods Study In Malawi, Michael Herce, Jess Edwards, Stephanie M. Topp, Michael Eliya, Nicole Carbone, Lauren Zalla, Jennifer Tseka, Maga Chagomerana, Mina C. Hosseinipour, Innocent Mofolo Jan 2021

Improving Pmtct Outcomes For Mother-Infant Pairs Through Community-Facility Linkage: Results From A Mixed Methods Study In Malawi, Michael Herce, Jess Edwards, Stephanie M. Topp, Michael Eliya, Nicole Carbone, Lauren Zalla, Jennifer Tseka, Maga Chagomerana, Mina C. Hosseinipour, Innocent Mofolo

HIV and AIDS

To improve MIP care retention in Malawi, several prevention of mother-to-child transmission of HIV (PMTCT) care delivery models have emerged to strengthen community-facility linkage (CFL), a concept defined as any “formalized connection between a health facility and the communities it serves to support improved health outcomes.” Similar to other settings in sub-Saharan Africa, three models have been widely implemented to complement Malawi’s National PMTCT Programme: 1) mentor mothers; 2) expert clients; and 3) community health workers. While the rationale underpinning these models has been substantiated by evidence generated from general antiretroviral therapy and PMTCT programs across SSA, a clear and …


Assessment Of Community-Based Art Service Model Linking Female Sex Workers To Hiv Care And Treatment In Blantyre And Mangochi, Malawi, Lung Vu, Brady Zieman, Adamson Muula, Vincent Samuel, Lyson Tenthani, David Chilongozi, Simon Sikwese, Grace Kumwenda, Scott Geibel Jan 2021

Assessment Of Community-Based Art Service Model Linking Female Sex Workers To Hiv Care And Treatment In Blantyre And Mangochi, Malawi, Lung Vu, Brady Zieman, Adamson Muula, Vincent Samuel, Lyson Tenthani, David Chilongozi, Simon Sikwese, Grace Kumwenda, Scott Geibel

HIV and AIDS

The Population Council and partners (through Project SOAR) conducted this study to assess whether acquiring antiretroviral treatment medication through community-based drop-in centers would appeal to female sex workers in this context, to describe any observed effects on treatment outcomes, and to identify opportunities for improvement should this model be selected for future scale-up.


Reducing Hiv Risk Among Young Women And Their Partners: Highlights From The Dreams Implementation Science Research Portfolio, Population Council Jun 2020

Reducing Hiv Risk Among Young Women And Their Partners: Highlights From The Dreams Implementation Science Research Portfolio, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the U.S. Agency for International Development through Project SOAR, led a set of implementation science studies to capture multiple perspectives that reflect the innovative aspects of DREAMS. These mixed-method studies conducted across seven countries (Eswatini, Kenya, Malawi, South Africa, Tanzania, Uganda, and Zambia) provide critical evidence that fill knowledge gaps on how to reduce HIV risk among AGYW and their male partners. This brief presents key findings grouped around four areas of inquiry: 1) HIV vulnerability and risk; 2) social drivers of HIV risk; 3) effects of …


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 Manda, Nrupa Jani, Tracy Mcclair, Lyson Tenthani, Sanyukta Mathur Feb 2020

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 Manda, 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 …


Can Depression Screening Be Integrated Into Busy Hiv Clinics In Malawi? Early Results Demonstrate Its Feasibility And Acceptability, Project Soar—Malawi Mental Health Jan 2018

Can Depression Screening Be Integrated Into Busy Hiv Clinics In Malawi? Early Results Demonstrate Its Feasibility And Acceptability, Project Soar—Malawi Mental Health

HIV and AIDS

Integration of depression screening and treatment into HIV care may prove critical to achievement of the 90–90–90 goals in Malawi and elsewhere in the region. Project SOAR has partnered with the Malawi Ministry of Health to implement and evaluate the integration of a depression management program into HIV care in Malawi. This brief focuses on initial results from the screening phase, which show that more than 90 percent of patients have been appropriately screened for depression. Based on a first round of qualitative interviews, the program has been well received by clinic staff and patients. The brief lists key lessons …


Engaging Male Partners Of Adolescent Girls And Young Women In Hiv Services In Malawi: Findings From Dreams Implementation Science Research, Project Soar Jan 2018

Engaging Male Partners Of Adolescent Girls And Young Women In Hiv Services In Malawi: Findings From Dreams Implementation Science Research, Project Soar

HIV and AIDS

Important contributors to adolescent girls' and young women's (AGYWs') vulnerability to HIV are the power differentials in their sexual relationships with male partners. Therefore, engaging male partners of AGYWs is important in reducing HIV incidence among these women. Project SOAR, in collaboration with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted qualitative research in the districts of Zomba and Machinga in Malawi to: 1) identify and locate the types of men who have sexual relationships with AGYW; 2) understand the challenges to and facilitators of accessing HIV services among AGYWs’ male partners; and 3) …


Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar Jan 2017

Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar

HIV and AIDS

In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …


Evaluation Of The “One Community” Program In Malawi, Project Soar Jan 2017

Evaluation Of The “One Community” Program In Malawi, Project Soar

HIV and AIDS

“One Community” is the United States Agency for International Development’s flagship community-based response to Malawi’s HIV epidemic. The primary objective of One Community is to support the government’s efforts to reduce new infections and to mitigate the impact of HIV among orphans and vulnerable children, out-of-school adolescent girls and young women, and other at-risk populations in eight districts in the southern region of Malawi. Project SOAR is conducting a rigorous evaluation of One Community in five of the eight program districts. The results from this evaluation will be used to inform Malawi’s support strategies for at-risk populations, improve the United …


Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek Jan 2017

Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

The DREAMS (Determined, Resilient, Empowered AIDS-free, Mentored, and Safe) partnership aims to significantly reduce new HIV infections in adolescent girls and young women (AGYW) in Malawi and other sub-Saharan African countries. To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study to identify the factors associated with the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the epidemiological and gendered context of the HIV epidemic in Malawi. This …


Evaluation A Depression Treatment Program On Hiv Care And Mental Health Outcomes In Malawi, Project Soar Jan 2017

Evaluation A Depression Treatment Program On Hiv Care And Mental Health Outcomes In Malawi, Project Soar

HIV and AIDS

This brief outlines a Project SOAR study which will provide critical evidence on the feasibility, effectiveness, and cost-effectiveness of an integrated depression treatment model for improving retention in and adherence to HIV care in Malawi. Among people initiating antiretroviral therapy (ART), those with depression are a large and especially vulnerable population. Depression affects 18–30 percent of patients receiving HIV care in Africa and is an important barrier to early ART retention. Evidence revealed by the study will have implications not only for the applicability of the model in Malawi but for other countries in sub-Saharan Africa as well.


Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek Jan 2017

Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study (MSAS) to identify the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the changing epidemiological and gendered context of the HIV epidemic in Machinga. The youth cohort data from the MSAS provide accurate estimates of HIV prevalence over time and HIV incidence, thereby filling important data gaps.


Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar Jan 2017

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …


A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman Jan 2015

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …