Medicine and Health Commons^™

Being Transgender And Seeking Healthcare In The World’S Most Liberal City, Nicole Sharpe

Independent Study Project (ISP) Collection

The right to the highest form of healthcare is one of the most essential rights a person should have. It should be accessible to all human beings, and it appears this is not the case when it comes from the transgender population in the Netherlands and the U.S. In addition to transitional health care needs like hormonal treatment and surgery, transgender people require the same variety of general health care needs as many other groups of individuals. When obstacles create stigma within health care providing facilities, transgender individuals may be less inclined or discouraged to seek the care they need. …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

A Study Of Nature Versus Nurture While Diagnosing Anxiety Or Conduct Disorders In Adolescents, Austin Laura Schnur

Social Sciences

No abstract provided.

Comprehensive Neighborhood Portraits And Child Asthma Disparities Introduction, Ashley W. Kranjac, Rachel T. Kimbro, Justin T. Denney, Kristin M. Osiecki, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to …

Evaluation Of The Pepfar/Usaid Asibonisane Community Responses Program In Kwazulu-Natal, South Africa, Project Soar

HIV and AIDS

Few programs intended to improve HIV outcomes or modulate gender norms have been rigorously evaluated in South Africa’s informal settlements where nearly 400,000 people live in KwaZulu Natal province alone. There is limited evidence on how to implement large-scale HIV-prevention programming in these contexts. Project SOAR and partners are addressing these knowledge gaps by conducting an evaluation of the PEPFAR/USAID-funded Asibonisane Community Responses Program in South Africa. Specifically, the study will assess the effectiveness of this community-based HIV-prevention program in informal settlements throughout KwaZulu-Natal—one of four provinces where the program is being carried out. This study aims to influence the …

Private Sector Costing Of Voluntary Medical Male Circumcision In South Africa, Michel Tchuenche, Steven Forsythe

HIV and AIDS

In 2010, after voluntary medical male circumcision (VMMC) had been shown to be one of the most cost-effective strategies for preventing HIV infections, South Africa initiated a VMMC program with an ambitious target of performing 4.3 million circumcisions by 2016. However, because of a gap in knowledge concerning the overall cost of scaling up services, the South African National Department of Health requested that Project SOAR—Supporting Operational AIDS Research—conduct a private-sector costing of providing VMMC services in South Africa. The findings presented in this report provide a detailed investigation, through a comprehensive bottom-up approach, of the costs to private providers …

Stakeholder Considerations For Prep Introduction To Adolescent Girls And Young Women: Laying The Groundwork For Research Utilization In Tanzania, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council is conducting an implementation science research study in that country to build needed evidence to inform decisionmaking around oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) aged 15–24. The study uses quantitative and qualitative methods to gather data from AGYW, policymakers and other stakeholders, health providers, and AGYW’s parents and male partners to: assess their knowledge and attitudes toward oral PrEP; determine opportunities and approaches for providing PrEP; and identify potential facilitators and barriers to PrEP introduction and use. …

Reliability And Validity Of The Hd-Pro-Triadtm, A Health-Related Quality Of Life Measure Designed To Assess The Symptom Triad Of Huntington's Disease., Nicholas R Boileau, Julie C Stout, Janes S Paulsen, David Cella, Michael K Mccormack, Martha A Nance, Samuel Frank, Jin-Shei Lai, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington's disease (HD), is a neurodegenerative disorder that is associated with cognitive, behavioral, and motor impairments that diminish health related quality of life (HRQOL). The HD-PRO-TRIADTM is a quality of life measure that assesses health concerns specific to individuals with HD. Preliminary psychometric characterization was limited to a convenience sample of HD participants who completed measures at home so clinician-ratings were unavailable.

OBJECTIVES: The current study evaluates the reliability and validity of the HD-PRO-TRIADTM in a well-characterized sample of individuals with HD.

METHODS: Four-hundred and eighty-two individuals with HD (n = 192 prodromal, n = 193 early, and n …

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

HIV and AIDS

There is limited evidence from Tanzania to inform decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). To help fill this evidence gap, the Population Council in collaboration with the National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district (Dar es Salaam) and one rural district (Mbeya) in Tanzania to explore policymakers’ and key stakeholders’ perceptions and attitudes toward the introduction of PrEP to different groups, including AGYW, as well as to identify key issues that must be considered prior to its introduction. …

Adolescent Girls And Young Women’S 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 and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing pre-exposure prophylaxis (PrEP) antiretroviral medication to adolescent girls and young women (AGYW) at substantial risk of HIV infection. This brief presents results from qualitative in-depth interviews and focus group discussions with AGYWs. Based on the findings, the brief recommends including sensitization and education of communities, parents, and male partners of AGYWs in demand-creation activities; training providers to deliver adequate education about PrEP to avoid misperceptions about its intended use, side effects, and …

Are We Meeting The Hiv Service Needs Of People Living In Informal Settlements In Kwazulu-Natal, South Africa?, Project Soar

HIV and AIDS

This brief summarizes the characteristics and circumstances of approximately 1,500 men and women living in 18 informal settlements in KwaZulu-Natal, South Africa. The data come from a baseline survey conducted in mid-2017 as part of an evaluation of the PEPFAR/USAID-funded Asibonisane Community Responses program. Project SOAR/Population Council conducted the evaluation in partnership with the MatCH Research Unit at the University of Witwatersrand. The findings presented here highlight the need for HIV treatment services to be more responsive to residents living with HIV in informal settlements. Furthermore, continued efforts are needed to reduce HIV risk and intimate partner violence among young …

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 …