International Public Health Commons^™

Helping Youth Prevent Hiv: An Evaluation Of The Straight Talk Program In Uganda, Susan E. Adamchak, Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey Nelson Sapiano, Ann Akia-Fiedler, Richard Kibombo, Milka Juma

HIV and AIDS

Mass media initiatives are being implemented globally to provide information and foster HIV preventive behavior, however there has been limited evaluation of these efforts in sub-Saharan Africa. The Straight Talk (ST) program in Uganda has targeted youth with HIV and reproductive health (RH) information for over a decade. Evaluation results show positive associations between exposure to ST media and a number of key outcomes among youth, including sexual behavior, knowledge, and attitudes. In 2005–06, the Horizons Program conducted the first impact evaluation of the ST program in Uganda to document its effects on young people. This brief focuses on the …

'Dare To Be Different': Enhancing Life Skills Education For Hiv Prevention In South African Schools, Tobey Nelson Sapiano, Nathi Sohaba, Eka Esu-Williams

HIV and AIDS

In South Africa, approximately 5.5 million people are living with HIV. One of the main strategies the South African Government has used to build HIV prevention awareness and promote behavior change among young people is school-based life skills education. Since 2000, the Horizons Program has conducted research exploring the impact of life skills education and other school-based HIV prevention activities on young South Africans. In contrast to the high HIV prevalence among youth ages 15–24, estimated to be over 10 percent, prevalence for youth ages 10–14 is estimated at just over 1 percent. People aged 10–14 are particularly receptive to …

Idhini Fahamishi Katika Majaribio Ya Kikliniki Ya Ukingaji Wa Virusi Vya Ukimwi, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Patterns And Implications Of Male Migration For Hiv Prevention Strategies In Maharashtra, India, Niranjan Saggurti, Ravi K. Verma, Anrudh K. Jain, Pranita Achyut, Saumya Ramarao

HIV and AIDS

Maharashtra was one of the first states to be affected by HIV in India. Results from the National Family Health Survey (NFHS-3) in 2005–06 indicate that 0.62 percent of men and women aged 15–49 years were infected with HIV, as compared to the national average of 0.28 percent. HIV sentinel surveillance data from sites across Maharashtra indicate that 1.3 percent of pregnant women receiving antenatal care (ANC) and 10.4 percent of patients receiving treatment for sexually transmitted infections in 2005 were infected with HIV. At the same time, Maharashtra ranks first nationally in the proportion of total migrants, and there …

Patterns And Implications Of Male Migration For Hiv Prevention Strategies In Karnataka, India, Niranjan Saggurti, Ravi K. Verma, Pranita Achyut, Saumya Ramarao, Anrudh K. Jain

HIV and AIDS

Karnataka is one of the high HIV prevalence states in India. Results from the National Family Health Survey indicate that 0.69 percent of adults aged 15–49 were infected with HIV in 2005–06. According to sentinel surveillance system data, HIV prevalence among pregnant women receiving antenatal care (ANC) in Karnataka was 1.3 percent. Further, 18 of the state's 27 districts have recorded HIV prevalence of more than 1 percent among pregnant women receiving ANC in sentinel sites. Strong male migration patterns are evident in some of the state’s high HIV prevalence districts. According to the 2001 census, Karnataka ranks fourth in …

Migration/Mobility And Vulnerability To Hiv Among Male Migrant Workers: Tamil Nadu 2007-08, Anjaneyalu Subbiah, S. Ramachandran, A.K. Ravi Shankar, Niranjan Saggurti, Ravi K. Verma, Anrudh K. Jain, Saumya Ramarao, Suvakanta N. Swain, Ajay Kumar Singh

HIV and AIDS

The present study was undertaken by the Population Council in partnership with Annamali University, Tamil Nadu, India to study the broad patterns and motivating forces driving migrant men’s mobility and the contexts that determine and influence their engaging in high-risk activities that increase their vulnerability to HIV. The results indicate large interdistrict movements of working men in Tamil Nadu with a little variation across districts and greater mobility among younger men. Research results suggest that further examination of the contract system under which many of the migratory laborers work is a potential focus for program intervention. Places of origin offer …

Consentimiento Informado En Ensayos De Prevención Del Vih: Aspectos Destacados De Un Taller Internacional, Population Council

HIV and AIDS

Resumen adaptado del informe del taller organizado conjuntamente por el Population Council y Family Health International en mayo de 2005. El resumen se centra específicamente en las herramientas y estrategias presentadas en el taller que se están usando en ensayos de prevención del VIH para facilitar el consentimiento informado, explicar conceptos difíciles, y evaluar la comprensión entre los participantes del ensayo. Se destacan ejemplos ilustrativos de ensayos concluidos y en curso. Este resumen será útil para una audiencia de investigadores locales, defensores y personal de ensayos clínicos.

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Brief adapted from the report of a workshop co-hosted by the Population …

Consentimento Informado Nos Ensaios De Prevenção Do Hiv: Pontos Altos Dum Workshop Internacional, Population Council

HIV and AIDS

Resumo adaptado do relatório do workshop organizado pelo Population Council e Family Health International em maio de 2005. O resumo se concentra especificamente nas ferramentas e estratégias apresentadas no workshop que estão sendo usadas em testes de prevenção do HIV para facilitar o consentimento informado, explicar conceitos difíceis e avaliar a compreensão entre os participantes do estudo. Exemplos ilustrativos de ensaios concluídos e em andamento são destacados. Este resumo será útil para um público de investigadores locais, advogados e equipe de ensaios clínicos.

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Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health …

Imvume Unolwazi Ocwaningweni Lokuvimbela Igciwane Lesandulela Ngculaza, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Patterns Of Migration/Mobility And Hiv Risk Among Female Sex Workers: Karnataka 2007-08, Shiva S. Halli, Raluca Buzdugan, Ravi K. Verma, Stephen Moses, James Blanchard, Anrudh K. Jain, Saumya Ramarao, Suvakanta N. Swain, Niranjan Saggurti

HIV and AIDS

In Karnataka, South India, HIV infection is spreading, with female sex workers (FSWs) a high-risk group. In an effort to gain control over the epidemic, the HIV/AIDS program has made substantial efforts in the last few years toward offering FSWs access to information about sexually transmitted infections/HIV/AIDS and to condoms, clinics, and other medical services. The present study was undertaken by the Karnataka Health Promotion Trust and the Population Council to determine the patterns and factors that drive mobility among FSWs and the association of mobility with HIV risk. The report’s findings—including mobility routes, sociodemographic profiles of FSWs, membership in …

Patterns Of Migration/Mobility And Hiv Risk Among Female Sex Workers: Tamil Nadu 2007-08, Niranjan Saggurti, Ravi K. Verma, Suvakanta N. Swain, Hanimi Reddy Modugu, Ajay Kumar Singh, Saumya Ramarao, Anrudh K. Jain

HIV and AIDS

In past years, considerable research has been undertaken on the role of female sex workers (FSWs) in the transmission of HIV infection. FSWs have been seen as a major “source” of infection, and consequently, have been extensively targeted to prevent its spread. There is, however, a gap in our understanding of the dynamics of sex work, sex workers' patterns of mobility, and the relationship of such mobility with risk of HIV infection and gender-based violence. The Population Council collaborated with its local partner, TNS, to carry out a study in Tamil Nadu to examine the patterns of mobility of FSWs …

Highlighting Marital Hiv Risk And Promoting Premarital Vct In Nyanza Province, Kenya, Ben Ochieng, Annabel Erulkar

Reproductive Health

This report describes a project undertaken in Kenya by the Population Council, in collaboration with PATH and Kendu Adventist Hospital, whose objectives were: 1) to design and implement educational strategies to raise awareness of the risks of HIV and early marriage; 2) to promote voluntary counseling and testing (VCT) for couples; and 3) to support and empower newly married girls through community-based clubs. The report notes that the strong technical support and leadership provided by the partners led to successful implementation of most project activities. The partnership enabled scarce resources to be shared, and has ensured that the comparative advantages …

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Feasibility, Acceptability, Effectiveness And Cost Of Models Of Integrating Hiv Prevention And Counseling And Testing For Hiv Within Family Planning Services In North West Province, South Africa, Saiqa Mullick, Mantshi Menziwa, Nzwakie Mosery, Doctor Khoza, Edwin Maroga

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program, in collaboration with the National Department of Health and the North West Provincial Department of Health and with support from PEPFAR, initiated a two-phased operations research study to test the acceptability, feasibility, and cost of two different models of integration of counseling and testing for HIV into family planning services in South Africa and to evaluate their effectiveness against standard practice. Based on the studies findings, the report concludes that the integration of HIV prevention activities, including education about prevention, dual protection, and counseling and testing within FP services in …

Exploring The Links Between Drug Use And Sexual Vulnerability Among Young Female Injecting Drug Users In Manipur, Archana Oinam

Reproductive Health

Given the high prevalence of HIV in Manipur, India and the critical role that female injecting drug users play in the transmission of HIV infection, it is becoming increasingly important to understand the sexual behaviors and drug use experiences of this group. This report describes the health status and patterns of treatment-seeking of female injecting drug users aged 15–34 in Manipur, and explores the factors underlying their vulnerability to HIV, including limited in-depth awareness of safe sexual behaviors and drug use practices, and limited self-perception of HIV risk. The report recommends development of IEC materials that address these information gaps …

Improving Reproductive Health And Hiv Prevention Among Married Adolescents In Amhara, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib

Reproductive Health

The objective of this project is to improve reproductive health (RH), prevent new HIV infections, and promote mutual faithfulness through addressing the HIV and reproductive risk among married adolescents, who are a large, vulnerable, and neglected category of Ethiopian youth. The Population Council partnered with Ethiopia Ministry of Education, the Ethiopian Orthodox Church, and the Ethiopian Muslim Development Agency to implement the project in Amhara region. The program used religious structures to spread messages about early marriage, HIV, and reproductive health. Local women leaders were trained as mentors of married adolescent girls, convening clubs through which HIV/RH information was conveyed, …

Promovendo Normas E Comportamentos Eqüitativos De Gênero Entre Homens Jovens Estratégia De Prevenção Do Hiv/Aids, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Horizons program and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …

The Straight Talk Campaign In Uganda: Impact Of Mass Media Initiatives—Summary Report, Susan E. Adamchak, Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey C. Nelson, Ann Akia-Fiedler, Richard Kibombo, Milka Juma

HIV and AIDS

This Horizons study in Uganda found that exposure by adolescents to Straight Talk, a mass media initiative focused on adolescent sexual and reproductive health (ASRH), was associated with greater ASRH knowledge, a greater likelihood of having been tested for HIV, and more communication with parents about ASRH issues.

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …

Beacon Of Hope: Evaluation Of The Kenya Girl Guides Association Hiv/Aids Program For School Children, Karusa Kiragu, George Odingo, Milka Juma, Jane Mbugua, Magdalen Waweru, Wamuyu Mahinda, Beatrice Mwaniki, Charity Muturi, Simon Ochieng, Tobey C. Nelson, Ann P. Mccauley

HIV and AIDS

This Horizons report presents findings from an evaluation of the Kenya Girl Guides Participatory Peer Education Program for HIV and AIDS Prevention. The objective of the program was to train Girl Guide patrol leaders as peer educators, who in turn would communicate key information and concepts about such topics as HIV prevention, relationships, and self-esteem to other Girl Guides, and ultimately to their school peers. The results demonstrate that peer education conducted by Girl Guides is a feasible strategy for imparting HIV and AIDS education to school-going youth; however, such a program would need to be branded, strengthened, and appropriately …

Implementing Sti/Hiv Prevention And Care Interventions For Men Who Have Sex With Men In Senegal, Amadou Moreau, Placide Tapsoba, Abdoulaye Ly, Cheikh Ibrahima Niang, Abdou Khoudia Diop

HIV and AIDS

Exploratory research conducted by the Horizons Program in 2002 revealed that men who have sex with men (MSM) in Dakar, Senegal, are particularly vulnerable to sexually transmitted infections (STIs) and HIV. Further, the stigma and discrimination suffered by many MSM result in the concealment of sexual behaviors from health-care providers, making it difficult to receive appropriate services. Finally, there is a lack of HIV-prevention campaigns geared to this group. Key stakeholders in Dakar developed and implemented an intervention to meet the STI/HIV prevention needs of MSM and address prevailing stigma that effectively serves as a barrier to care. The intervention …

Engaging Advocates From Concept To Results: Summary Report Of The Advocates' Consultation On Hiv Prevention Trials: Carraguard And Voice Studies, Johannesburg, South Africa, 18-19 October 2007, Microbicide Trials Network, Population Council

HIV and AIDS

Advocate consultations are increasingly becoming the rule, not the exception in the HIV-prevention research field. As an increasing number of Phase III trials enter the field, research groups are seeking new ways to collaborate with advocates and maximize civil society input and engagement. The Advocates’ Consultation for HIV Prevention Trials: Carraguard and VOICE Studies provided leaders from African NGOs a unique opportunity to learn about the clinical trial process from beginning to end, and to collectively identify ways to influence how scientific research is formulated. Participants represented a wide range of advocacy groups from Southern African countries, including those working …

Continuum Of Care For Hiv-Positive Women Accessing Programs To Prevent Parent-To-Child Transmission: Findings From India, Vaishali Sharma Mahendra, Rupa Mudoi, Archana Oinam, Venkat Pakkela, Avina Sarna, Sucheta Panda, Ashok Rau, L. Birendrajit Singh, Naomi Rutenberg

HIV and AIDS

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, …

The Hiv/Aids Prevention Project For Vulnerable Youth In Northern Nigeria: Community Advocates Training Manual, Population Council, Adolescent Health And Information Projects, Federation Of Muslim Women's Associations In Nigeria, Islamic Education Trust

HIV and AIDS

This Community Advocates training manual contains a curriculum developed by the Population Council, Nigeria, under the HIV Prevention Project for Vulnerable Youth in Northern Nigeria funded by USAID/Nigeria. The curriculum was developed as a tool for training community advocates in conducting advocacy activities on the issues of early marriage, HIV/AIDS, and reproductive health. The curriculum aims to improve knowledge and strengthen the skills of community representatives from the northern region of Nigeria so they can openly discuss sensitive issues relating to HIV/AIDS, reproductive health, and marriage. Designed to be adapted or implemented as written, the curriculum is based on the …

Key Findings From An Evaluation Of The Mothers2mothers Program In Kwazulu-Natal, South Africa, Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, Naomi Rutenberg

HIV and AIDS

The Horizons program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of mothers2mothers (m2m) as part of its introduction in KwaZulu-Natal Province, South Africa. It is the first external evaluation that provides quantitative evidence about the role of the well-known m2m program in complementing services to prevent mother-to-child transmission of HIV (PMTCT). m2m is a peer support program that aims to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care, and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. …

Sexuality And Hiv Education: Time For A Paradigm Shift, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

For decades, curriculum-based sexuality education has been a cornerstone of school- and community-based efforts to improve young people’s sexual and reproductive health, and more recently to prevent HIV infection. Unfortunately, public discourse about sex education has been mired in polarizing debates that distract attention from determining how sex and HIV education programs might best achieve the shared goals of many different constituencies. A recent comprehensive review of the impact of school-based sexuality and HIV education programs in developed and developing countries found that two-thirds of the programs reduced the risk associated with one or more reported sexual behaviors. This finding …

Éducation Sexuelle Et Vih : Il Est Temps De Changer De Méthodologie, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Pendant des décennies, l’éducation sexuelle basée sur un curriculum a été la pierre angulaire des efforts en fournis par les écoles et les communautés pour améliorer la santé sexuelle et génésique des jeunes, et plus récemment pour prévenir le VIH. Malheureusement, le discours public sur l'éducation sexuelle s’est égaré dans des débats polarisés qui ont détourné l'attention de la manière dont les programmes d'éducation sexuelle et VIH peuvent atteindre le mieux possible les objectifs partagés par différentes circonscriptions. Une étude exhaustive récente de l'impact des programmes d'éducation sexuelle et VIH dispensés par les écoles dans les pays développés et en …

Educación Sobre Sexualidad Y Vih: Tiempo Para Un Cambio De Paradigma, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Durante décadas, la educación sexual basada en un programa de estudio fue la piedra angular de los esfuerzos de la escuela y de la comunidad para mejorar la salud sexual y reproductiva de los jóvenes y, en forma más reciente, para prevenir la infección de VIH. Desafortunadamente, el discurso público sobre educación sexual ha estado envuelto en debates contradictorios que sirven para distraer la atención en lugar de determinar en que manera los programas de educación sobre sexualidad y VIH podrían alcanzar mejor los objetivos compartidos de las distintas partes. Una reseña exhaustiva que se realizó recientemente sobre el impacto …

Shifting Support For Inequitable Gender Norms Among Young Indian Men To Reduce Hiv Risk And Partner Violence, Ravi K. Verma, Vaishali Sharma Mahendra, Julie Pulerwitz, Sujata Khandekar, Gary Barker, P. Fulpagare, S.K. Singh

HIV and AIDS

India accounts for the second largest population of people living with HIV/AIDS (5.1 million), and almost half of new infections occur in young men below age 30. While there are multiple factors influencing young men’s HIV risk in India, one that is receiving increasing attention is early socialization about masculinity. Young men in India mature and develop in a male-dominated context, having little contact with female peers and virtually no sex education. In this context, most boys develop a sense of masculinity characterized by male dominance in the sexual arena and other areas. Although there is increasing awareness of the …

Promoting More Gender-Equitable Norms And Behaviors Among Young Men As An Hiv/Aids Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Population Council and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …