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Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar Apr 2021

Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar

HIV and AIDS

HIV testing is a critical entry point to life-saving antiretroviral therapy (ART) for those diagnosed with HIV and to prevention services for those at high risk of acquiring HIV. Despite advances in testing, there remain a variety of social and programmatic challenges that prevent access to HIV testing services, particularly for men and key populations. HIV program managers and policymakers are increasingly invested in understanding how best to deliver HIV testing services to different populations and to maximize health system resources at facility and community levels. Project SOAR has contributed to the evidence base and catalyzed research use by examining …


Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar Apr 2021

Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar

HIV and AIDS

Despite the availability of life-saving treatment for HIV, several barriers prevent patient access to high-quality services. HIV program managers and policymakers have shown increasing interest in understanding how best to deliver HIV treatment to different populations and maximize health-system resources at facility and community levels. Project SOAR recognizes the key role that treatment services play in achieving UNAIDS’ 90-90-90 goals for controlling the HIV epidemic through testing, treatment, and viral suppression by 2020. Project SOAR has contributed to the evidence base and catalyzed research use by assessing innovative strategies for antiretroviral treatment (ART) delivery that support different populations in remaining …


Advances In Conceptualizing And Measuring Stigma Among People Living With Hiv, Project Soar Apr 2021

Advances In Conceptualizing And Measuring Stigma Among People Living With Hiv, Project Soar

HIV and AIDS

Stigma, defined as the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination in a context in which power is exercised, has a negative impact on the health of people living with HIV (PLHIV), contributing to psychosocial stress, coercion and violence, job loss, and social exclusion. Widely recognized as a barrier to accessing HIV care, it is paramount that programs and policies are designed to mitigate HIV-related stigma to achieve the UNAIDS’ 90-90-90 goals. Project SOAR recognizes the importance of addressing stigma to control the HIV epidemic through testing, treatment, and viral suppression. Project SOAR has contributed to the evidence …


Project Yes! Youth Engaging For Success: A Randomized Controlled Trial Testing A Peer Mentoring Approach Among Hiv-Positive Adolescents And Young Adults In Ndola, Zambia, Julie Denison, Virginia M. Burke, Sam Miti, Bareng A.S. Nonyane, Christiana Frimpong, Katherine G. Merrill, Elizabeth A. Abrams, Jonathan Kaunda Mwansa Feb 2021

Project Yes! Youth Engaging For Success: A Randomized Controlled Trial Testing A Peer Mentoring Approach Among Hiv-Positive Adolescents And Young Adults In Ndola, Zambia, Julie Denison, Virginia M. Burke, Sam Miti, Bareng A.S. Nonyane, Christiana Frimpong, Katherine G. Merrill, Elizabeth A. Abrams, Jonathan Kaunda Mwansa

HIV and AIDS

This research addresses the gaps in knowledge about how to best support adolescents and young adults transitioning to HIV self-management in the context of both child-focused and adult-focused HIV care settings. Johns Hopkins University, in partnership with the Arthur Davison Children’s Hospital, implemented this study through the USAID-funded Project SOAR (led by the Population Council).


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 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.


Factors Influencing Hiv Care Outcomes Among Adolescents Living With Hiv In Rural South Africa, Lindsey M. Filiatreau, Audrey Pettifor, Jess Edwards, Nkosinathi Masilela, Rhian Twine, F. Xavier Gómez-Olivé, Nicole Haberland, Chodziwadziwa Whiteson Kabudula, Sheri A. Lippman, Kathleen Kahn Jan 2021

Factors Influencing Hiv Care Outcomes Among Adolescents Living With Hiv In Rural South Africa, Lindsey M. Filiatreau, Audrey Pettifor, Jess Edwards, Nkosinathi Masilela, Rhian Twine, F. Xavier Gómez-Olivé, Nicole Haberland, Chodziwadziwa Whiteson Kabudula, Sheri A. Lippman, Kathleen Kahn

HIV and AIDS

In the Agincourt Health and Socio-Demographic Surveillance System (HDSS) site in rural Mpumalanga Province, South Africa the Project SOAR team hypothesized that HIV status disclosure, individuals’ prior healthcare seeking experiences, history of depression and overall emotional well-being, experiences with domestic and intimate partner violence, and substance use could contribute to poor levels of treatment adherence among adolescents living with HIV. The overall objective of this study was to better understand HIV care outcomes among HIV-positive adolescents in the Agincourt HDSS in the era of universal test and treat so we can better inform HIV care programs targeting this vulnerable population.


The Power And Process Of Shifting Gender Norms: Insights From A Randomized Controlled Trial In South Africa, Nicole Haberland, Julie Pulerwitz, Ann Gottert, Audrey Pettifor, Sheri A. Lippman, Dean Peacock, Lumbwe Chola, Ryan Wagner, Anna M. Leddy, Rebecca West, Mi-Suk Kang Dufour, Jennifer Hove, Rhian Twine, Rhandzekile Mathebula, Dumisani Rebombo, Angelica Pino, F. Xavier Gómez-Olivé, Chodziwadziwa Whiteson Kabudula, Nkosinathi Masilela, Aimée Julien, Kathryn Spielman, Kathleen Kahn Jan 2021

The Power And Process Of Shifting Gender Norms: Insights From A Randomized Controlled Trial In South Africa, Nicole Haberland, Julie Pulerwitz, Ann Gottert, Audrey Pettifor, Sheri A. Lippman, Dean Peacock, Lumbwe Chola, Ryan Wagner, Anna M. Leddy, Rebecca West, Mi-Suk Kang Dufour, Jennifer Hove, Rhian Twine, Rhandzekile Mathebula, Dumisani Rebombo, Angelica Pino, F. Xavier Gómez-Olivé, Chodziwadziwa Whiteson Kabudula, Nkosinathi Masilela, Aimée Julien, Kathryn Spielman, Kathleen Kahn

HIV and AIDS

This Project SOAR report summarizes findings from a randomized controlled trial of Tsima ra rihanyu (“working together for health”), a three-year community mobilization program for treatment as prevention that aimed to address the social barriers to HIV testing and treatment in Mpumalanga Province, South Africa. In this report, the authors explore the types of gender norms that are salient for women and men, how these relate to HIV testing and treatment, and the pathways through which gender norms operate to affect women’s and men’s HIV service use and experience and perpetration of intimate partner violence.


Overview: Literature Review Of Linkage, Adherence, And Retention Interventions For Seropositive Children And Young People In Africa, Project Soar Jan 2021

Overview: Literature Review Of Linkage, Adherence, And Retention Interventions For Seropositive Children And Young People In Africa, Project Soar

HIV and AIDS

Various strategies have been implemented in countries around the world to reduce barriers to engagement in care and adherence to antiretroviral therapy among children and young people living with HIV. Despite these diverse programmatic strategies, a comprehensive understanding of what works best for children and adolescents in sub-Saharan Africa is lacking. To address this gap, Project SOAR conducted a systematic review of the peer-reviewed literature to: 1) document interventions that support engagement in care and ART adherence for infants, children, adolescents, and youth living with HIV in sub-Saharan Africa (SSA), including orphans and other vulnerable children; and 2) inform future …


Leveraging Adaptive Implementation Strategies To Achieve Universal Coverage Of Antiretroviral Therapy In Senegal, Gnilane Turpin, Carrie E. Lyons, Sidy Mokhtar Ndiaye, Nuria Gallego Marquez, Nika Elmi, Nguissali Turpin, Penda Dieng, Daouda Diouf, Stefan Baral Jan 2021

Leveraging Adaptive Implementation Strategies To Achieve Universal Coverage Of Antiretroviral Therapy In Senegal, Gnilane Turpin, Carrie E. Lyons, Sidy Mokhtar Ndiaye, Nuria Gallego Marquez, Nika Elmi, Nguissali Turpin, Penda Dieng, Daouda Diouf, Stefan Baral

HIV and AIDS

This report summarizes findings from a study Project SOAR conducted to develop and assess the feasibility, fidelity, and cost-effectiveness of a universal coverage of antiretroviral treatment intervention among people living with HIV who are not virally suppressed in Dakar and Ziguinchor, Senegal.


Optimizing Maternal, Newborn, And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho: Costing Component, Adebiyi Adesina, Rachael Linder, Lori Bollinger Jan 2021

Optimizing Maternal, Newborn, And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho: Costing Component, Adebiyi Adesina, Rachael Linder, Lori Bollinger

HIV and AIDS

This study builds on the USAID-funded prevention of mother-to-child transmission service delivery program (IMPROVE) already being implemented by Elizabeth Glaser Pediatric AIDS Foundation in Lesotho. Rather than designing a suite of entirely new services and delivery platforms, the intervention (conducted under Project SOAR) focused on improving existing services and strengthening the connection between facility- and community-based care. This brief describes the approach and key quantitative findings of the costing component of the IMPROVE intervention from the service provider perspective.


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.


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.


Optimizing Maternal And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho, Appolinaire Tiam, Vincent Tukei, Lauren Greenberg, Shannon Viana, Heather Hoffman, Laura Guay, Ramatlapeng Thabelo, Tsietso Mots'oane, Matsepeli Nchephe Jan 2021

Optimizing Maternal And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho, Appolinaire Tiam, Vincent Tukei, Lauren Greenberg, Shannon Viana, Heather Hoffman, Laura Guay, Ramatlapeng Thabelo, Tsietso Mots'oane, Matsepeli Nchephe

HIV and AIDS

The “Integrated Management Team to Improve Maternal-Child Outcomes” (IMPROVE) intervention is a comprehensive, evidence-based strategy to improve maternal and child health (MCH) outcomes through patient-centered, participatory service delivery and multidisciplinary management teams (MDT). The intervention includes three key approaches: (1) multidisciplinary, integrated management teams of facility- and community-based health care and lay workers; (2) Joint Positive Health Dignity, and Prevention (PHDP)-focused counseling for patients and skills-building training and job aids for health workers; and (3) increased early community-based counseling and support for patients. This report summarizes the key findings from the implementation of this intervention in Lesotho (under Project SOAR), …


Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council Oct 2020

Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council

Research Utilization and Impact Briefs

A recent Project SOAR study evaluated community-based delivery of antiretroviral treatment to female sex workers (FSWs) in Tanzania, demonstrating the value of this approach to improve HIV care. Informed by these findings, the Government of Tanzania changed national guidance to allow for community-based HIV treatment to better meet the needs of marginalized populations, including FSWs.


Piloting And Evaluating Family-Centered Hiv Care In Eswatini, Caspian Chouraya, Nobuble Mthethwa, Lynne Mofenson, Philisiwe Khumalo, Lydia Mpango, Munamato Mirira, Rhoderick Machekano, Leila Katirayi, Kim Ashburn Sep 2020

Piloting And Evaluating Family-Centered Hiv Care In Eswatini, Caspian Chouraya, Nobuble Mthethwa, Lynne Mofenson, Philisiwe Khumalo, Lydia Mpango, Munamato Mirira, Rhoderick Machekano, Leila Katirayi, Kim Ashburn

HIV and AIDS

There are substantial gaps in essential services and numerous missed opportunities to engage children in care and provide effective HIV treatment. Although not new, family-centered care models that provide HIV services comprehensively to families as a unit, rather than providing separate services to children and adults, have the potential to address family needs and break down social, physical, and emotional barriers to accessing care. The family-centered care study (FAM-CARE) aims to contribute to our understanding of the role of family-centered care models (FCCM) in improving pediatric HIV outcomes in a sub-Saharan African setting.


Evidence Around Engaging Men In Hiv Prevention And Treatment, Julie Pulerwitz, Ann Gottert, Jerry Okal, Sanyukta Mathur Apr 2020

Evidence Around Engaging Men In Hiv Prevention And Treatment, Julie Pulerwitz, Ann Gottert, Jerry Okal, Sanyukta Mathur

HIV and AIDS

No abstract provided.


Implementation Process Brief: Integrated Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Charlotte E. Warren, Aparna Jain, Melsa Lutomia, Jane Loech, Elizabeth Washika Mar 2020

Implementation Process Brief: Integrated Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Charlotte E. Warren, Aparna Jain, Melsa Lutomia, Jane Loech, Elizabeth Washika

Reproductive Health

Enabling women living with HIV to use contraception effectively can decrease unintended pregnancies and in turn reduce maternal mortality and vertical transmission of HIV. This brief describes the implementation process and intervention tested under the Evidence Project for delivering integrated FP and HIV services at the community level in Kenya. It outlines the implementation steps, best practices, and lessons learned of an intervention that was tested within the existing community health structure. Community health volunteers were trained to offer FP as part of their routine services to women living with HIV, and community health units were prepared to sustain those …


Youth Engaging For Success (Yes)—Youth Peer Mentor In-Service Training: Youth Peer Mentor Guide, Project Soar Jan 2019

Youth Engaging For Success (Yes)—Youth Peer Mentor In-Service Training: Youth Peer Mentor Guide, Project Soar

HIV and AIDS

No abstract provided.


Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council Jan 2019

Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council

HIV and AIDS

Over the last 20 years, the Population Council has carried out extensive work examining the intersection of stigma and gender and its impact on HIV-related outcomes. This brief summarizes key Population Council findings from a range of studies which elucidate the experiences of stigma among women and highlights avenues for addressing stigma to mitigate women’s risk and burden of HIV.


Youth Engaging For Success (Yes)—Youth Peer Mentor In-Service Training: Facilitator Guide, Project Soar Jan 2019

Youth Engaging For Success (Yes)—Youth Peer Mentor In-Service Training: Facilitator Guide, Project Soar

HIV and AIDS

No abstract provided.


Youth Engaging For Success (Yes)—Youth Peer Mentor Pre-Service Training: Youth Peer Mentor Guide, Project Soar Jan 2019

Youth Engaging For Success (Yes)—Youth Peer Mentor Pre-Service Training: Youth Peer Mentor Guide, Project Soar

HIV and AIDS

No abstract provided.


Youth Engaging For Success (Yes)—Youth Peer Mentor Pre-Service Training: Facilitator Guide, Project Soar Jan 2019

Youth Engaging For Success (Yes)—Youth Peer Mentor Pre-Service Training: Facilitator Guide, Project Soar

HIV and AIDS

No abstract provided.


Strengthening Capacity To Prevent Hiv Among Adolescent Girls And Young Women: Supporting Dreams Programming, Project Soar Jan 2019

Strengthening Capacity To Prevent Hiv Among Adolescent Girls And Young Women: Supporting Dreams Programming, Project Soar

HIV and AIDS

The Population Council, with funding from Girl Effect, worked in seven Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) Partnership countries to strengthen the capacity of implementing partners to develop new approaches to reach AGYWs at highest risk of HIV infection, link them with essential resources, and empower them with social and protective assets for a safe and healthy entry into adulthood. This technical assistance was informed by the Population Council’s decades of research and experience determining “what works”—and what doesn’t work—in girl-centered programming. Through Project SOAR, the Population Council provided technical assistance to implementing partners in five additional countries …


Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain Jan 2018

Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain

Reproductive Health

Study findings reveal that many Kenyan women living with HIV are comfortable receiving family planning (FP) services from community health volunteers and with proper training and support, community health volunteers have the potential to provide integrated FP/HIV services. Community-based integrated FP/HIV services could help connect women living with HIV who want to prevent or postpone a pregnancy to contraceptive services, which can reduce unintended pregnancies and in turn maternal mortality and vertical transmission of HIV. This implementation research study offers evidence of the feasibility, quality of care, and acceptability of using community health volunteers to integrate family planning into HIV/AIDS …


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 …


Implementing The Hiv “Treat All” Guidelines In Namibia: Patient And Health Provider Perspectives, Project Soar Jan 2018

Implementing The Hiv “Treat All” Guidelines In Namibia: Patient And Health Provider Perspectives, Project Soar

HIV and AIDS

In late 2015, the World Health Organization announced new treatment guidelines recommending that anyone who has tested positive for HIV should begin antiretroviral therapy (ART) as soon as possible. In light of this policy, the government of Namibia included “treat all” in the 2016 National Guidelines for ART, and began nationwide implementation in April 2017. Project SOAR is generating evidence on how the national rollout of the treat all guidelines and decentralization of ART services affect client-level treatment outcomes, quality of ART services, and treatment costs in Namibia. This brief summarizes the perspectives of clients and providers regarding ART service …


Optimizing Implementation Of Universal Hiv Treatment Coverage For People Living With Hiv In Senegal, Project Soar Jan 2018

Optimizing Implementation Of Universal Hiv Treatment Coverage For People Living With Hiv In Senegal, Project Soar

HIV and AIDS

Senegal plans a rapid scale up of HIV treatment for all people living with HIV (PLHIV), regardless of CD4 count or viral suppression. However, limited data exist on how to achieve sustained viral suppression among PLHIV in real world contexts where significant barriers to effective antiretroviral therapy (ART) delivery, uptake, and adherence persist. This brief describes a universal coverage ART intervention Project SOAR is conducting among PLHIV who are not virally suppressed. The findings from this study will inform the rollout of Senegal’s national test and treat strategy.