Demography, Population, and Ecology Commons^™

Prevalence Of Hiv, Hepatitis B And C, And Co-Infection In A Cohort Of Male Injection Drug Users In Delhi, Lopamudra Saraswati, Mary Philip Sebastian, Avina Sarna, Vartika Sharma, Ira Madan, Dean Lewis, Ibou Thior, Waimar Tun

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 …

High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …

Situation Analysis Of Programs To Meet The Hiv Prevention, Care, And Treatment Needs Of Persons With Disabilities In Ghana, Uganda, And Zambia, Waimar Tun, Jerry Okal, Katie D. Schenk, Meredith Sheehy, Emmanuel Kuffour, Selina F. Esantsi, Hilary Asiah, Grimond Moono, Felix Mutale, Rita Kyeremaa, Edson Ngirabakunzi, Atwijukire Justus

HIV and AIDS

National HIV strategic plans, HIV-related services, and HIV outreach efforts have tended to overlook persons with disabilities, and persons with disabilities are not reached by general HIV prevention, care, support, and treatment campaigns and services. To increase our understanding of how to make HIV programming more inclusive for persons with disabilities, HIVCore and partners conducted a three-country situation analysis (Uganda, Zambia, and Ghana). The study explored existing HIV services for persons with disabilities and determined the factors affecting their access to and use of HIV/sexual and reproductive health (SRH) services. Key findings: Persons with disabilities experience greater sexual vulnerability to …

A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland

HIV and AIDS

No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …

Hivcore Operations Research Workshop Summary Report, Nrupa Jani

HIV and AIDS

Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi

Poverty, Gender, and Youth

The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …

Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council

Poverty, Gender, and Youth

When a migrant girl is successful, she creates a ripple effect through generations: families and future children will be better off because of her ability to finish school, get a job, and stay healthy. Despite the positive potential of migration for adolescent girls, migrant girls are largely ignored in policy and programs designed to reach migrants and adolescents. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. If these girls arrive at their destination and settle in safely, their diligence can enable them to capitalize on new opportunities and become productive, contributing …

Designing, Implementing, And Evaluating A Targeted, Evidence-Based Intervention For A Vulnerable Subgroup Of Girls: A Case Study Of The Filles Éveillées ("Girls Awakened") Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen

Poverty, Gender, and Youth

Investing in adolescent girls is crucial in the developing world where a large and growing proportion of the population is under the age of 24. Research has demonstrated that adolescent girls face serious challenges around the time of puberty including withdrawal from (and lack of safety in) public spaces, loss of peers, leaving school, pressure for marriage or liaisons as livelihood strategies, and internalization of harmful gender norms. Investments need to be made at critical moments in early adolescence. While policymakers and development professionals have acknowledged the need to make investments in the poorest girls in the poorest communities early …

Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen

Poverty, Gender, and Youth

Circular migration (from rural to urban areas and back) among adolescents is common throughout West Africa, with the principle motivation being the search for economic opportunities, including domestic work. The evidence base on adolescent migration and domestic work is fairly thin. Evidence on programmatic effectiveness generally ends at program completion and does not follow adolescents over time. The current study follows a subsample of migrant adolescent girls in domestic service in urban Burkina Faso who participated in the first cohort of the Filles Éveillées (Girls Awakened) pilot program. Filles Éveillées was designed to provide migrant girls in domestic service with …

The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that compromise their healthy development into young women, and lack the social, health, and economic assets to mitigate these risks. The issues that girls are confronted with include high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, and lack of agency and participation. The Adolescent Girls Empowerment Program (AGEP) has three major components: safe spaces groups in which girls meet once a week over the course of two years for training …

Comprendre La Vie Des Adolescentes Avant Et Après La Migration: Enquête Réalisée Sur Les Sites D'Origine Auprès D'Anciennes Filles Migrantes Employées Comme Aide-Ménagères, Gisele Kaboré

Poverty, Gender, and Youth

Le Population Council met en œuvre un projet en direction des adolescentes migrantes travaillant comme employées de maison dans les zones urbaines au Burkina Faso (Ouagadougou et Bobo-Dioulasso). Ce programme, dénommé «Filles Éveillées», a pour objectif d’élargir les réseaux sociaux des filles et de développer leurs compétences en capacités financières, en santé et hygiène, santé de la reproduction et en compétences de la vie courante. Il offre également aux bénéficiaires l’opportunité d’accéder à l’alphabétisation. Dans un effort d’améliorer ce programme en ville, il s’est avéré opportun de mieux comprendre les circonstances de la vie des adolescentes dans le village avant …

Évaluation De Filles Éveillées : Programme Pilote Pour Adolescentes Migrantes Employées De Maison, Sarah Engebretsen

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu dans le but d’accroître les réseaux sociaux et de développer les compétences des adolescentes migrantes employées de maison au Burkina Faso urbain. Il a fait l’objet de deux cycles pilotes: en 2011-2012 à Bobo-Dioulasso, puis en 2012-2013 à Ouagadougou et Bobo-Dioulasso. Une évaluation de processus a été effectuée entre les deux cycles avant d’évaluer l’efficacité du programme et d’y proposer les améliorations de structure, mise en œuvre et contenu jugées utiles avant le lancement de la seconde cohorte. Cette évaluation a donné lieu aux changements suivants: simplification du contenu programmatique sur la santé …

Conception, Mise En Oeuvre Et Évaluation D'Une Intervention Factuelle Ciblée Au Profit D'Un Sous-Groupe De Filles Vulnérables : Étude De Cas Du Programme Pilote Filles Éveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain, Sarah Engebretsen

Poverty, Gender, and Youth

Il est crucial d’investir dans les adolescentes du monde en développement, où une proportion déjà importante et grandissante de la population tombe dans la catégorie des moins de 24 ans. La recherche a démontré que les défis posés aux filles sont particulièrement lourds aux alentours de la puberté, qu’il s’agisse de l’exclusion des espaces publics (et du manque de sécurité dans ceux accessibles), de la perte du réseau de pairs, de la déscolarisation, de la pression du mariage ou de liaisons comme stratégies de subsistance, ou encore de l’intériorisation de normes de genre préjudiciables. Les investissements consentis doivent l’être aux …

Evaluation Of Filles Eveillees ("Girls Awakened"): A Pilot Program For Migrant Adolescent Girls In Domestic Service, Sarah Engebretsen

Poverty, Gender, and Youth

The Filles Éveillées (Girls Awakened) program was designed to increase social networks and skill building among migrant adolescent girls in domestic service in urban Burkina Faso. The program was piloted over two cycles: 2011–2012 in Bobo Dioulasso, and 2012–2013 in Ouagadougou and Bobo Dioulasso. According to this evaluation report, process evaluation was conducted between the two cycles to assess program effectiveness and suggest improvements for program structure, implementation, and content before launching the second cohort. Changes resulting from this process evaluation included simplifying the sexual and reproductive health program content; reordering the modules and introducing financial capabilities earlier so that …

Girls On The Move: Adolescent Girls & Migration In The Developing World, Miriam Temin, Mark R. Montgomery, Sarah Engebretsen, Kathryn M. Barker

Poverty, Gender, and Youth

Adolescent girls in developing countries are migrating to urban areas in ever greater numbers. While migration can be risky, for the majority of girls, migration can increase opportunities and economic stability and provide them with the autonomy to make decisions about their lives. Preventing the worst outcomes and helping girls succeed are essential to unlocking the benefits of migration. When migrant girls can take advantage of the benefits, they can be a powerful force for change in the developing world—improving lives and reducing poverty in their communities and countries. This Girls Count report examines the social and economic determinants of …

The Adolescent Girls Vulnerability Index: Guiding Strategic Investment In Uganda, Sajeda Amin, Karen Austrian, Michelle Chau, Kimberly Glazer, Eric P. Green, David Stewart, Marie Stoner

Poverty, Gender, and Youth

Adolescence (from the ages of 10 to 19 years) is a critical stage of human development during which children experience rapid social, physical, psychological, and emotional changes on the path from childhood to adulthood. The decisions that are made during this period of life affect not only the individual well-being of young people, but also the well-being of the entire society. The Adolescent Girls Multilevel Vulnerability Index (AGI) was developed based on a growing recognition of the need to channel resources to vital—yet highly vulnerable and vastly underserved—populations of adolescent girls in Uganda specifically, and the East and Southern Africa …

Étude De Suivi Des Adolescentes Migrantes Employées De Maison Ayant Participé À La Première Cohorte Du Programme Filles Éveillées, Sarah Engebretsen

Poverty, Gender, and Youth

La migration circulaire (du milieu rural au milieu urbain et retour), est courante parmi les adolescents et adolescentes d'Afrique occidentale, la principale motivation étant la quête de débouchés économiques, y compris le travail domestique. Les données d’efficacité programmatique disponibles s’interrompent généralement au moment de la conclusion des programmes, sans suivi des adolescents à plus longue échéance. Cette étude suit un sous-échantillon d'adolescentes migrantes employées de maison au Burkina Faso après leur participation à la première cohorte du programme pilote Filles Éveillées. Ce programme a été conçu pour offrir aux filles migrantes employées de maison l’occasion de renforcer leurs réseaux sociaux …

Fp2020: A Research Roadmap, Population Council

Reproductive Health

The global community came together in July 2012 in pursuit of an ambitious yet essential goal: ensuring that 120 million additional women and girls have access to effective family planning information and services by 2020. National governments, civil society, and the private sector resolved to tackle the numerous supply and demand barriers that prevent many women from using contraceptives. Donors committed $2.6 billion in new funding to support these efforts, matched by pledges from many developing-country governments. To reap the benefits of family planning, clients must have easy access to a wide range of affordable contraceptive methods through multiple service …

Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

In late 2006, the Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The initiative included a core set of activities aimed at improving overall awareness of EC across the country and strengthening the quality of EC services in both the public and private sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa. The MOH drew lessons and experiences from the initiative …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

The Hiv/Aids Pandemic In African American Msm: Targets For Intervention, Kelly Neff

Journal of Health Disparities Research and Practice

The Centers for Disease Control and Prevention estimated in 2005 that 46% of African American men who have sex with men (MSM) are HIV positive. This review explores the unique factors that contribute to risky sexual behavior and the spread of HIV within this population, suggesting that the disparate prevalence of HIV among African American MSM is rooted in experiences of stigmatization from multiple sources and lack of social support from society at large as well as from within the African American community. Beliefs in HIV conspiracy myths are also thought to hinder HIV education, awareness and prevention for African …

Racial Differences In Preventive And Complementary Health Behaviors And Attitudes, Steven E. Shive, Grace X. Ma, Yin Tan, Jamil I. Toubbeh, Lalitha Parameswaran, Lalitha Parameswaran, Joe Halowich

Journal of Health Disparities Research and Practice

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

The Influence Of Patient-Centeredness On Minority And Socioeconomically-Disadvantaged Patients’ Trust In Their Physicians: An Evidence-Based Structural Equation Modeling Investigation, Stephen J. Aragon, Sylvia A. Flack, Cecil A. Holland, Racquel R. Ingram, Michael L. Clements

Journal of Health Disparities Research and Practice

The purpose of this investigation was to determine the effect of physician patient-centeredness on patient trust across randomly selected groups of patients from an inner city medical practice serving a preponderance of minority and socioeconomically-disadvantaged patients.

METHODS: A two-factor multigroup structural equation modeling design was employed, with randomly selected test (N = 300) and cross-validation (N = 300) samples of medical practice patients. Equality constraints were established to test the invariance of effects across groups. The model was compared to its unconstrained counterpart to further test its trustworthiness. An additional 5,000 nonparametric bootstrapped samples for each group were generated to …

Self-Rated Health Status Comparing Pacific Islanders To Asians, Maile Taualii

Journal of Health Disparities Research and Practice

Disease reporting for Asians/Pacific Islanders often conflicts and is, many cases, inaccurate because of the aggregation of Asians and Pacific Islanders. An analysis of 2005 Behavior Risk Factor Surveillance System data was performed to examine health status of Asians compared to Native Hawaiian or Other Pacific Islanders. Findings show a significant difference between Asians and Native Hawaiian or Other Pacific Islanders, with a greater likelihood for Native Hawaiians or Other Pacific Islanders to rate their health as poor. Conclusion: Asians and Native Hawaiians or Other Pacific Islanders do not have the same health status. By aggregating these two distinctly different …

Quality And Severity Of Lower Urinary Tract Symptoms Among African American Elders, Daniel L. Howard, Bennett G. Edwards, Kimberly Whitehead, M. A. Amamoo, Paul A. Godley

Journal of Health Disparities Research and Practice

Lack of population-based data on lower urinary tract symptoms (LUTS) among African American men represents a significant gap in understanding. This study examined LUTS among a racially over-sampled, mixed urban/rural, elderly cohort of African Americans and whites in the South to discern whether racial differences exist in the prevalence, severity, and associated risk factors of LUTS. Longitudinal analyses using generalized estimating equations (GEE) were conducted on the 1994–1998 EPESE dataset for 5 North Carolina counties. In 1994, the analytic cohort included 482 African Americans and 407 whites; by 1998, 249 and 222, respectively. In 1994, 49.4% of African Americans reported …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

Cumulative Risk And A Call For Action In Environmental Justice Communities, H. P. Hynes, Russ Lopez

Journal of Health Disparities Research and Practice

Health disparities, social inequalities, and environmental injustice cumulatively affect individual and community vulnerability and overall health; yet health researchers, social scientists and environmental scientists generally study them separately. Cumulative risk assessment in poor, racially segregated, economically isolated and medically underserved communities needs to account for their multiple layers of vulnerability, including greater susceptibility, greater exposure, less preparedness to cope, and less ability to recover in the face of exposure. Recommendations for evidence-based action in environmental justice communities include: reducing pollution in communities of highest burden; building on community resources; redressing inequality when doing community-based research; and creating a screening framework …

Consistency Of Minority And Socioeconomic Status As Predictors Of Health, Ari K. Mwachofi, Robert W. Broyles

Journal of Health Disparities Research and Practice

This paper examines the relative consistency of economic and racial status as predictors of the individual’s physical and emotional health. The focus of the study is the covariates of (1) limited activity resulting from poor physical and (2) limited activity resulting from poor emotional health. Using data from the 2003 Behavioral Risk Factor Surveillance System survey, the study was developed in two phases. In the first, logistic regression analysis was used to examine two binary variables that identified respondents who reported at least one day of limited activity that resulted from poor physical and then poor emotional or mental health. …

Seeking Cancer Information: An Appalachian Perspective, Robin C. Vanderpool, Bin Huang, Brent J. Shelton

Journal of Health Disparities Research and Practice

There are noted disparities by ethnicity, race, age, gender, and socioeconomic status in the reported use of and access to cancer information. Missing from this list of variables that predict these disparities are specific geographic locales, such as Appalachia, a region recognized as a medically underserved, “special population”. Through a secondary analysis of NCI’s 2003 HINTS dataset, we are able to describe the cancer information-seeking behaviors of Appalachians as compared to non-Appalachians with a focus on actual versus preferential information-seeking behaviors, information-seeking experiences, and demographics. In general, Appalachians and non-Appalachians do not significantly differ in their cancer information-seeking behaviors and …