Public Health Commons^™

Partidarios De La Vida: Resiliencia En Los Afectados Directos De La Dictadura En Arica, Chile / Supporters Of Life: Resilience In The Direct Victims Of The Dictatorship In Arica, Chile, Danielle Levinson

Independent Study Project (ISP) Collection

The present study is a qualitative analysis of resilience mechanisms in inhabitants of the city of Arica, Chile who participated actively in the resistance against the Pinochet dictatorship. Through one-on-one interviews with members of this population and the coordinator/social assistant of the Arican branch of the Chilean government’s reparation program (PRAIS), this project was able to corroborate the existence of the following four categories of resilience mechanisms, which are identified in a technical standard published by the Chilean Under-Secretariat of Health: individual, family, social network, and values and ideology. However, it was revealed that this model should be adapted to …

Rural And Urban Injection Drug Use In Puerto Rico: Network Implications For Human Immunodeficiency Virus And Hepatitis C Virus Infection, Courtney Thrash, Melissa L. Welch-Lazoritz, G. Robin Gauthier, Bilal Khan, Roberto Abadie, Kirk Dombrowski, Sandra Miranda De Leon, Yadira Rolon Colon

Department of Sociology: Faculty Publications

Understanding the short- and long-term transmission dynamics of blood-borne illnesses in network contexts represents an important public health priority for people who inject drugs and the general population that surrounds them. The purpose of this article is to compare the risk networks of urban and rural people who inject drugs in Puerto Rico. In the current study, network characteristics are drawn from the sampling “trees” used to recruit participants to the study. We found that injection frequency is the only factor significantly related to clustering behavior among both urban and rural people who inject drugs.

“Arica Tiene Vih, ¿Y Tú?” El Rol Del Test Rápido De Vih En El Diagnóstico Oportuno Para Jóvenes De La Comuna De Arica, Chile / "Arica Has Hiv, And You?" The Role Of The Rapid Hiv Test In The Timely Diagnosis For Young People In The District Of Arica, Chile, Julia Zigman

Independent Study Project (ISP) Collection

Research question: How is the rapid HIV test useful in assuring access to timely diagnosis of HIV for young adults in the city of Arica, Chile?

Objectives: The primary objective of this study is to evaluate the rapid HIV test as a means of increasing access to timely diagnosis of HIV among those aged 18 – 29 in the community of Arica, which participated in a pilot of the rapid test in early 2018. The study sets out to evaluate the installation of this pilot to situate the role of the rapid test in Chile’s HIV landscape. Further objectives …

“Religion Is Religion; My Life Is My Life”: Religious Influences On Family Planning Decisions In Kapchorwa District, Uganda, Sarah Mathys

Independent Study Project (ISP) Collection

This report seeks to understand the influence that religion has on family planning decisions in Kapchorwa District, in eastern Uganda. Increased uptake of family planning has significant impliations for sustainability and development in Uganda as a whole. As a district with a high unmet need for faily planning, Kapchorwa serves as an important case study. Because over 99% of Uganda’s population reports a religious affiliation, and because literature on family planning claims conservative spirituality as a major cause of low uptake, religion is a natural lens through which to study family planning perceptions and utilization.

Through focus groups and key …

Families Communicating About Health: Conceptualization And Validation Of The Family Health Communication Quotient Scale, Erin E. Gafner

Communication & Theatre Arts Theses

Research on family health communication is based in part on the assumption that families actually communicate about a wide variety of topics pertaining to their health and wellness (or lack thereof). However, whether they do communicate about health and wellness, and exactly what they communicate about concerning health and wellness as well as how often, remains undocumented. To begin to address this problem of documenting the extent to which families talk about health and wellness, this study adapted Warren and Neer’s (1986) Family Sex Communication Quotient to create and report the preliminary validation of a new measurement instrument called the …

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) …

Graduate Admissions Recruitment Project, Kevin Anderson, Chiemela Dike, Yixin Du, Arvinder Kaur, Amanda Popp, Huizhong Yang

School of Professional Studies

In this project, several comparison schools were interviewed and disclosed to have used search lists to find candidates. The organizations that have valuable search lists which may be of good use for the School of Professional Studies include Educational Testing Service (ETS) and the Graduate Management Admission Council (GMAC). By choosing criteria such as demographics, location, academic performance, educational history provided by search lists, we believe there are many quality candidates for SPS programs. However, as we further investigated the functionality and cost-efficiency or return of investment of GRE search list, we spotted many uncertainties and few solid and successful …

Worcester Center For Crafts: A Transition To Online Sales, Monica Gow, Carly Branconnier, Srilatha Prodduturi, Ekaterina Shusharina, Alberta Yamoah

School of Professional Studies

The Clark University School of Professional Studies created a capstone team consisting of Monica Gow, Carly Branconnier, Iana Matkovskaia, Srilatha Prodduturi, Ekaterina Shusharina, and Alberta Yamoah to assist Worcester Center for Crafts (WCC) with the launch of their new online store. Worcester Center for Crafts wanted to showcase their beautiful American handmade crafts on an online platform, Shopify, in order to increase their sales and expand their market reach. The capstone team created a charter that outlined the scope of the project and what the team would deliver to WCC by the end of the project. The team agreed to …

A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life.

AIM: The purpose of this study was to develop a new measure to evaluate end of life planning.

DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine …

Audubon Data Project Final Report, Askhat Beygenov, Valinur Kutlambetov, Shrikant Patel, Phoebe Roberts, Ulfat Sayyed, Shriram Sivaraman

School of Professional Studies

The Audubon Data Project was initiated as a Clark University Capstone project. The project’s client, Mass Audubon’s Shaping the Future of Your Community program, had identified a need to improve their data management methods and make better use of their data. The Capstone team, composed of Clark University graduate students, met with the client regularly to review the current state of the data and potential improvements to be made. The process began with a data review. During the review we worked with the client to explicitly define the purposes and requirements of the data, the current process for updating and …

Addressing Stigma And Gender Inequities To Strengthen Hiv And Aids Programming: A Focus On Key Populations, Population Council

HIV and AIDS

Over the past 20 years, the Population Council has generated evidence around the types of stigma experienced by key populations at higher risk for HIV, and has designed and tested strategies aimed at reducing stigma and improving HIV programs and outcomes. Key populations (KPs), such as female sex workers, men who have sex with men, transgender individuals, and people who use drugs, often face multiple stigmas that reinforce one another. Evidence generated by the Population Council has shown that addressing and reducing stigma faced by KPs is a crucial step toward improving HIV prevention and treatment outcomes. This brief summarizes …

Are Services Meeting The Holistic Family Planning Needs Of Female Sex Workers Living With Hiv In Tanzania?, Project Soar

HIV and AIDS

Women of reproductive age living with HIV need access to comprehensive, voluntary family planning (FP) services to support their decisions about whether and when to have children. Contraceptive need is particularly acute among HIV-positive female sex workers who are often socially and economically disadvantaged. Furthermore, many HIV-positive female sex workers intend to have children some day, but may not be aware of strategies to minimize the risk of HIV transmission to infants and partners (i.e., “safer conception”). This activity brief describes a Project SOAR study in Tanzania that will contribute to the evidence base by conducting research that describes these …

Assessing The Feasibility, Acceptability, And Costs Of Diagnosing Hiv At Birth In Lesotho And Rwanda, Michelle M. Gill, Heather Hoffman, Majoalane Mokone, Lynne Mofenson, Michel Tchuenche, Steven Forsythe

HIV and AIDS

Infant HIV diagnosis as early as possible in a child’s life followed by immediate antiretroviral treatment (ART) could stem the progressive rise in infant mortality among HIV-positive infants, particularly as several studies have suggested that an increased proportion of perinatal infections may occur in utero when maternal ART is received during pregnancy. This Project SOAR study leveraged two existing cohort studies to address some critical questions related to very early infant diagnosis. The objective was to determine the feasibility, acceptability, and costs associated with the addition of birth HIV testing to the routine testing algorithm for infants born to HIV-positive …

Benchmark Assessment Of Orphaned And Vulnerable Children In Areas Of The Zambia Family (Zamfam) Project—Brief, Michael Mbizvo, Paul C. Hewett

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief (PEPFAR) are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS (OVC) in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. To inform that effort, Project SOAR conducted a benchmark survey among beneficiaries in the four provinces of the ZAMFAM program. The benchmark survey measured the status and conditions of OVC and their families. This brief provides a summary of the findings outlined in the final report on the needs …

Benchmark Assessment Of Orphaned And Vulnerable Children In Areas Of The Zambia Family (Zamfam) Project, Michael Mbizvo, Paul C. Hewett, Nkomba Kayeyi, Lyson Phiri, Saziso N. Mulenga, Bwalya Mushiki, Mwelwa Chibuye

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief (PEPFAR) are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS (OVC) in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. To inform that effort, Project SOAR conducted a benchmark survey among beneficiaries in the four provinces of the ZAMFAM program. The benchmark survey measured the status and conditions of OVC and their families. The findings provide a deeper understanding of the needs of OVC families and the gaps in …

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 …

Characterizing The Unmet Hiv Prevention Needs And Hiv Risk Vulnerabilities Of Adolescent Girls And Young Women In Ethiopia, Project Soar

HIV and AIDS

Adolescent girls and young women (AGYW) in Ethiopia, as well as across Eastern and Southern Africa, experience a disproportionate level of new HIV infections. AGYW who are out of school face a particular set of vulnerabilities, especially those living away from parents. Unfortunately, data characterizing unmet HIV prevention needs and risk vulnerabilities among AGYW, especially out-of-school AGYW, are lacking given the challenges in reaching and studying this population. To address this gap, Project SOAR is conducting an integrated HIV biobehavioral survey focused on out-of-school AGYW in three high HIV prevalence settings of Ethiopia. Study findings will inform HIV prevention and …

Does A Community-Based, Hiv Service Delivery Model Improve Female Sex Workers’ Care And Treatment Outcomes In Tanzania?, Project Soar

HIV and AIDS

Female sex workers living (FSWs) with HIV face significant challenges in accessing HIV care and, once started on antiretroviral therapy (ART), remaining in care and adhering to treatment. These challenges include attending regular medical appointments because of time and cost constraints, providers’ stigmatizing attitudes, and poor service quality due to crowded ART clinics, long waiting times, and a lack of clinicians. This brief describes a community-based model of ART delivery THAT Project SOAR, Sauti, the National AIDS Control Programme, and the National Institute of Medical Research are designing, implementing, and evaluating, in order to help mitigate the barriers HIV-positive FSWs …

Female Sex Workers Living With Hiv In Tanzania Have Both A Need For Contraception And A Desire To Have Children In The Future, Project Soar

HIV and AIDS

HIV-positive women often have critical family planning (FP) needs in addition to HIV-related care, treatment, and prevention concerns. In sub-Saharan Africa, unintended pregnancy is common among HIV-positive women. At the same time, many women living with HIV want to have children some day, and there are various “safer conception” strategies available to help HIV-affected individuals and couples get pregnant while minimizing the risk of HIV transmission to seronegative partners and the baby. This brief describes the fertility-related needs and desires of female sex workers living with HIV in Tanzania, highlighting results indicating that health services should help women meet both …

Health And Socioeconomic Well-Being Of Young People Living With Hiv In Zambia: Evaluating The Zamfam Project, Project Soar

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. Project SOAR is conducting a three-year prospective cohort study of young people living with (YPLHIV) and their primary caregivers/guardians in Central Province where the ZAMFAM project is being implemented, and in Eastern Province where there are no ongoing ZAMFAM activities for comparison. The information collected in the study focused on key …

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 …

Male Partners Of Adolescent Girls And Young Women: Relationship Characteristics And Hiv Risk—Findings From Dreams Implementation Science Research, Population Council

HIV and AIDS

Adolescent girls and young women (AGYW) in South Africa, as in many countries, are particularly vulnerable to HIV for a variety of reasons, including economic disadvantage and unequal power dynamics in sexual relationships with their male partners—many of whom are older and engage in high-risk behaviors. In an effort to learn more about men’s relationships with AGYW and how HIV services can better engage them, the Population Council is conducting implementation science research in KwaZulu-Natal Province. This brief reports findings from a 2017 baseline survey with nearly 1,000 men. An endline survey is planned for mid-late 2018, and will focus …

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.

Reducing Provider-Held Stigma And Improving Young Client Satisfaction In Strengthening Integrated Delivery Of And Access To Comprehensive Hiv And Sexual/Reproductive Health And Support Services For Msm In Lagos, Nigeria, Population Council

HIV and AIDS

Riding on the success of the one-stop shop community health center, in 2016 the Elton John AIDS Foundation engaged the Population Council to implement an integrated model providing comprehensive HIV and sexual and reproductive health and support services to men who have sex with men (MSM) in Lagos, Nigeria. The two-year project was designed to deploy a “hub and spoke” peer-led (or peer navigation) model to integrate comprehensive MSM-friendly HIV and sexual and reproductive health (SRH) services in public health facilities in Lagos state. This brief summarizes findings from the study which sought to reach 9,500 MSM with HIV testing …

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

HIV and AIDS

Many adolescent girls and young women (AGYW) lack opportunities and access to resources, and experience the harms of discriminatory gender norms. Despite decades of investment in HIV prevention, many AGYW remain invisible, underserved, and at disproportionate risk of HIV infection. The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) Partnership aims to significantly reduce HIV infections among AGYWs. DREAMS originally launched in 2014 focusing on 10 high-burden countries in sub-Saharan Africa. In 2017, five additional countries known as DREAMS-Like countries—Botswana, Cote d’Ivoire, Haiti, Namibia, and Rwanda—received support for DREAMS activities. This brief describes the technical assistance Project SOAR is providing …

Understanding The Dynamics Of Hiv Testing Services In South African Primary Care Facilities, Tonderai Mabuto, Bhakti Hansoti, Salome Charalambous, Christopher Hoffmann

HIV and AIDS

Facility-based HIV testing services remains underutilized in many settings, including South Africa—even in the context of opt-out testing. Additionally, linkages to care are often not made in a timely manner after an HIV diagnosis, limiting access to ART and the possibility of viral suppression. This brief summarizes findings from formative research conducted by Project SOAR and The Aurum Institute to understand the dynamics of HIV testing services and the key constraints to its optimal delivery.

What Do We Know About The Hiv Risk Characteristics Of Adolescent Girls And Young Women In Kenya? Findings From Dreams Implementation Science Research, Population Council

HIV and AIDS

The Population Council is conducting implementation science research in Kenya to build needed evidence to inform community-based, girl-centered interventions. DREAMS programs in Kenya are implementing a core package of interventions in the highest HIV-burden areas to address HIV risk among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. This brief summarizes key findings from a survey of 1,778 AGYW, more than half of whom are enrolled in DREAMS programming.

What Do We Know About The Hiv Risk Characteristics Of Adolescent Girls And Young Women In Zambia? Findings From Dreams Implementation Science Research, Population Council

HIV and AIDS

The Population Council is conducting implementation science research in Zambia and other countries across sub-Saharan Africa to build needed evidence to inform community-based, girl-centered HIV-prevention programming. Critical to this process is understanding adolescent girls’ and young women’s (AGYWs’) knowledge, attitudes, sexual behaviors, and characteristics of their sexual partnerships that may put them at risk of HIV acquisition. This results brief summarizes key findings from a cross-sectional survey of 1,915 AGYW, half of whom were 15–19 years old and the other half 20–24 years old, residing in urban districts of Lusaka and Ndola. The findings in this brief were shared at …

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

Early Results Demonstrate The Importance Of Early Treatment Of Hiv And The Feasibility And Acceptability Of Community-Based Antiretroviral Treatment Delivery For Female Sex Workers In Tanzania, Project Soar

HIV and AIDS

Project SOAR in collaboration with the National AIDS Control Program of the government of Tanzania, National Institute of Medical Research, and Jhpiego’s Sauti Program, is conducting implementation science research to investigate the delivery of community-based antiretroviral treatment (ART) services to female sex workers (FSWs) in Tanzania. This brief summarizes key findings from a baseline survey administered to a cohort of FSWs enrolled in the study, qualitative interviews with FSWs conducted three months after the start of the community-based ART services, and routine monitoring data. Early findings support the feasibility and acceptability of Sauti’s community-based antiretroviral treatment model—important first steps in …