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Full-Text Articles in International Public Health

Assessing Hiv-Related Outcomes Among Key Populations Accessing Community-Based Test And Start Services In Nigeria, Project Soar Jan 2017

Assessing Hiv-Related Outcomes Among Key Populations Accessing Community-Based Test And Start Services In Nigeria, Project Soar

HIV and AIDS

This activity brief describes a research study Project SOAR is conducting to better understand how to use existing key population community platforms in Nigeria to expand access to HIV treatment, the cost of such care provided outside of clinical health facilities, and the extent to which false positive misclassification may occur in outreach settings. Given the global “treat all” emphasis and the need to effectively scale up test and start services and minimize misclassification rates, these findings will be important in expanding timely antiretroviral treatment coverage in vulnerable communities in Nigeria and elsewhere.


Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Kenya, Population Council Jan 2017

Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Kenya, Population Council

HIV and AIDS

The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Kenya and similar ones in Zambia and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW’s vulnerability to HIV.


Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council Jan 2017

Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council

HIV and AIDS

The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Zambia and similar ones in Kenya and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW's vulnerability to HIV.


Assessment Of The Implementation Of The Treat-All Guidelines (Test And Start) In Namibia, Project Soar Jan 2017

Assessment Of The Implementation Of The Treat-All Guidelines (Test And Start) In Namibia, Project Soar

HIV and AIDS

The Government of Namibia has adopted “treat-all” guidelines, commonly referred to as test and start (TnS), as a national policy effective April 2017. These guidelines recommend that anyone who has tested positive for HIV should begin antiretroviral therapy (ART) as soon as possible. This brief describes the proposed research of a study team led by the Population Council to generate evidence on how the national rollout of the TnS guidelines and decentralization of ART services affect client-level treatment outcomes, quality of ART services, and treatment costs in Namibia. The results of this study will inform the implementation and scale-up of …


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 …


Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Hiv Services: Implementation Science Research In Swaziland, Population Council Jan 2017

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Hiv Services: Implementation Science Research In Swaziland, Population Council

HIV and AIDS

The Population Council is conducting implementation research in Swaziland, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Uganda, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Swaziland and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.


Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council Jan 2017

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council

HIV and AIDS

The Population Council is conducting implementation research in South Africa, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in Uganda, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in South Africa and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.


Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council Jan 2017

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council

HIV and AIDS

The Population Council is conducting implementation research in Uganda, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Uganda and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.


Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council Jan 2017

Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council in collaboration with Tanzania’s National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district and one rural district in the country, to provide needed evidence for informing decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW) in Tanzania. The aims of the research were to: assess the acceptability of PrEP among AGYW, their male partners, their parents/guardians, healthcare providers, and policymakers; determine the feasibility of and opportunities for providing PrEP to AGYW; and identify key facilitators and barriers to PrEP introduction …


Improving Uptake Of Hiv Testing Services And Linkage To Care After Diagnosis In Kenya, Project Soar Jan 2017

Improving Uptake Of Hiv Testing Services And Linkage To Care After Diagnosis In Kenya, Project Soar

HIV and AIDS

Project SOAR is conducting two complementary research activities in Kenya, to 1) understand the barriers to and facilitators of HIV testing among men seeking HIV testing services, and 2) to develop and pilot test an HIV post-test assessment tool to promote linkage to HIV care and treatment among newly diagnosed HIV-positive clients. This study will provide needed information to help Kenya and other countries that are scaling up test and start programs to develop effective strategies to increase uptake of HIV testing services among men and linkage to care and treatment among all newly diagnosed HIV-positive clients.


Optimizing Community Services For An Improved Continuum Of Hiv Care, Project Soar Jan 2017

Optimizing Community Services For An Improved Continuum Of Hiv Care, Project Soar

HIV and AIDS

Project SOAR, together with Aurum Institute, is conducting research in Ekurhuleni District and Bojanala District in South Africa to improve the availability of effective care continuum services to meet the communities’ HIV treatment needs. The two districts have a combined population of 3.6 million inhabitants and approximately 350 public clinics and hospitals. Through improved information on community HIV care services and their relationship to care continuum outcomes, the study will provide valuable new knowledge about service gaps and approaches to planning and delivering services that best achieve HIV treatment goals.


Preventing Pediatric Tuberculosis: A Randomized Trial Of Symptom-Based Screening Of South African Children Exposed To Tuberculosis, Population Council Jan 2017

Preventing Pediatric Tuberculosis: A Randomized Trial Of Symptom-Based Screening Of South African Children Exposed To Tuberculosis, Population Council

HIV and AIDS

In South Africa, a country with one of the highest levels of HIV prevalence, HIV-positive adults are the source case for a large proportion of pediatric tuberculosis (TB) cases. Unfortunately, TB index cases are not consistently asked about their child contacts, not all child contacts present to the clinic for TB screening, and it remains unknown what proportion of child contacts receive isoniazid preventive therapy (IPT)—a highly effective treatment for preventing TB in these children, long recommended by the World Health Organization. Project SOAR is assessing whether a symptom-based screening approach by TB nurses in community health clinics is more …


Men's Perceptions Of Prep Use By Their Adolescent And Young Adult Female Partners In Tanzania In Tanzania: Findings From Implementation Science Research, Population Council Jan 2017

Men's Perceptions Of Prep Use By Their Adolescent And Young Adult Female Partners In Tanzania In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

Prevailing gender norms about sexuality and relationship power dynamics have been shown to affect how women make decisions about the use of sexual and reproductive health products, including microbicides, condoms, and other contraceptives. It is therefore important to understand male partners’ views of oral pre-exposure prophylaxis (PrEP) to inform how to effectively introduce PrEP among adolescent girls and young women (AGYW) in Tanzania to ensure they use it correctly and consistently. The Population Council, in collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing PrEP …


Providers' Views On Prep For Adolescent Girls And Young Women In Tanzania: Findings From Implementation Science Research, Population Council Jan 2017

Providers' Views On Prep For Adolescent Girls And Young Women In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council conducted an implementation science research study to identify key considerations among healthcare providers for oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) in an urban and a rural setting in Dar Es Salaam and Mbeya districts, respectively. This brief presents results from a survey and in-depth interviews conducted with healthcare providers in each setting, assessing their knowledge, attitudes, and perceptions about PrEP; willingness to prescribe PrEP to AGYW; and perceived barriers and facilitators to providing PrEP to AGYW. The …


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.


Strengthening Capacity In Hiv Operations Research: Reflections On A Project Soar Workshop In Johannesburg, South Africa, Project Soar Jan 2017

Strengthening Capacity In Hiv Operations Research: Reflections On A Project Soar Workshop In Johannesburg, South Africa, Project Soar

HIV and AIDS

Capacity strengthening (CS) to support rigorous scientific research is a globally recognized need and central to Project SOAR. Over a four-day period, SOAR conducted a CS workshop to strengthen individual and institutional capacity in HIV operations research, with a particular emphasis on the research utilization process. This brief summarizes the CS activities conducted, insights from the workshop’s organization, and participants’ views of the workshop.


Updating The People Living With Hiv Stigma Index, Project Soar Jan 2017

Updating The People Living With Hiv Stigma Index, Project Soar

HIV and AIDS

In October 2015, supported by USAID/PEPFAR, Project SOAR established a small working group (SWG) with representatives from a variety of nongovernmental organizations, and several experts within and external to SOAR. The SWG outlined a process for evaluating and updating the Stigma Index, launched in 2008, that would be transparent and incorporate as many perspectives as possible in the process. The Stigma Index is both a data collection tool and an empowering intervention for the interviewers collecting data and the interviewees who are sharing their experiences of stigma. Since the Stigma Index was launched, there have been shifts in the HIV …


Considerations For Prep Introduction To Adolescent Girls And Young Women: Implementation Science Research In Tanzania, Population Council Jan 2017

Considerations For Prep Introduction To Adolescent Girls And Young Women: Implementation Science Research In Tanzania, Population Council

HIV and AIDS

In collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., a Tanzania-based research organization, the Population Council is conducting implementation science research in Tanzania to build needed evidence to inform decisionmaking around the introduction of oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW), ages 15–24. This research will actively engage key stakeholders throughout the study, including gaining their insights on key study questions, interpreting the findings, crafting initial programming recommendations based on findings, and supporting their adoption in Tanzania and beyond. Findings from this study and other observational studies and demonstration trials in progress …


Parents' And Guardians' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council Jan 2017

Parents' And Guardians' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council, in collaboration with the National AIDS Control Programme (NACP) and CSK Research Solutions Ltd., conducted implementation science research in two research sites in Tanzania to identify key considerations for introducing oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). The NACP and members of the study’s research utilization committee recognized the importance of learning about parents’ and guardians’ attitudes and perceptions of PrEP use by their adolescent and young adult daughters and peers to inform the PrEP implementation process in Tanzania. Moreover, existing research in Tanzania finds that parents communicate with their children about sexual …


A Systems Approach To Improving Delivery And Update Of Facility-Based Hiv Testing And Linkage To Care In South Africa, Project Soar Jan 2017

A Systems Approach To Improving Delivery And Update Of Facility-Based Hiv Testing And Linkage To Care In South Africa, Project Soar

HIV and AIDS

Project SOAR is examining the current delivery of HIV testing (HTS) and linkages to care (LTC) services—including barriers, facilitators, and infrastructure—in Ekurhuleni District, South Africa which has the second-highest district-level HIV prevalence in the country. Based on these formative findings, the project will develop and test tailored approaches to increase patients’ uptake of HTS and subsequent LTC, if positive. The project expects to find evidence of HTS coverage outside of antenatal care; document key systems-level barriers to HTS and LTC; assess potentially generalizable clinic-level strategies to increase HTS delivery and assess LTC needs; and identify the added value for implementation …


Effect Of A Family-Centered Model Of Hiv Care On Viral Suppression And Care Retention Among Hiv-Positive Children In Swaziland, Project Soar Jan 2017

Effect Of A Family-Centered Model Of Hiv Care On Viral Suppression And Care Retention Among Hiv-Positive Children In Swaziland, Project Soar

HIV and AIDS

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has been supporting the Kingdom of Swaziland since 2003 to prevent mother-to-child transmission and to provide care and treatment services to HIV-positive children and adults. Project SOAR and the Swaziland Ministry of Health are leveraging EGPAF’s establishment of a family-centered care service delivery program (FAM-CARE) and a national rollout of viral load monitoring to assess their implementation and effect on viral suppression and retention in care among children living with HIV. This implementation science study is important because it will provide critical data to national and global policymakers about the model’s feasibility, acceptability, …


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 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.


Project Yes! Youth Engaging For Success: A Peer Mentoring Program To Transition Youth To Hiv Self-Management In Zambia, Project Soar Jan 2017

Project Yes! Youth Engaging For Success: A Peer Mentoring Program To Transition Youth To Hiv Self-Management In Zambia, Project Soar

HIV and AIDS

This activity brief describes an operational study that responds to challenges and evidence gaps in Zambia about how to support adolescents and young adults living with HIV (YLHIV) in having a greater and more effective role in the management of their own care. The study aimed to refine and test a peer-mentoring strategy in Zambia to strengthen the capacity of health systems and families to support youth as they transition to, and engage in, self-management and adult HIV care and treatment. This approach builds on previous Ministry of Health–approved research at Arthur Davison Children’s Hospital with YLHIV and their families. …


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 Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Pakistan, Saleem Shaikh, Ali M. Mir Jan 2016

A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Pakistan, Saleem Shaikh, Ali M. Mir

Reproductive Health

Pakistan is one of the six countries that account for more than 50 percent of the world’s maternal deaths. According to Population Council estimates, each year nearly 8.6 million women become pregnant in the country. Of these, 1.2 million women are likely to face obstetric complications. Each year, there are nearly 14,000 pregnancy-related deaths. Information is lacking on context-specific health-system barriers that prevent optimal use of the lifesaving medicine magnesium sulfate (MgSO4) in Pakistan. Although efforts in Pakistan both at the national and subnational level are ongoing on the prevention and treatment of pre-eclampsia and eclampsia (PE/E), results are generally …


Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown Apr 2015

Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown

Independent Study Project (ISP) Collection

In recent decades, a double burden of disease has emerged that requires public health workers to fight both hunger and obesity. The obesity epidemic is unlike other epidemics in that it is largely man-made and dependent on social factors and industry influences, making it difficult to fight. The high global prevalence of obesity is partially a result of globalization, which has encouraged development and the liberalizing of economies all around the world, which in turn has increased the marketing and consumption of obesogenic products. Policy solutions have been proposed and implemented in some countries, but an international solution has yet …


The Impact Of Vaccine Hesitancy On The Polio Vaccine In South Asia, Leah Everist Apr 2015

The Impact Of Vaccine Hesitancy On The Polio Vaccine In South Asia, Leah Everist

Independent Study Project (ISP) Collection

A disease that paralyzes hundreds of children each year, polio is incurable but also entirely preventable through vaccination. Though part of the reason some children are not reached for immunization is that they are in areas too volatile for healthcare workers to access, vaccine hesitancy is increasingly being recognized as an important player. The objective of this study is to ascertain the degree to which vaccine hesitancy affects polio vaccine campaigns in Afghanistan and Pakistan, the countries in South Asia where polio continues to be endemic, to assess the drivers behind hesitancy in this region, and to present recommendations for …


Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council Jan 2015

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …


Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich Jan 2015

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …