Medicine and Health Commons^™

Evaluating The Validity Of Restrictions On Blood Donation Eligibility For Men Who Have Sex With Men (Msm) In The United States, France, And Switzerland, Swathi Gorantla

Independent Study Project (ISP) Collection

For the first time in a decade, the number of new human immunodeficiency virus (HIV) diagnoses is higher for heterosexual people compared to gay and bisexual men (Florêncio, 2022). Additionally, in the United States, the American Red Cross has declared a national blood crisis due to the nationwide shortage of donated blood. During this crisis, charged with the new information on HIV diagnosis rates, many advocates for the Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) community question why discriminatory policy surrounding gay and bisexual men donating still exist around the world. These policies are changing worldwide – several European countries have …

Evidence To Support Hiv Prevention For Adolescent Girls And Young Women (Agyw) And Their Male Partners: Results From Malawi Dreams Studies With Agyw, Male Partners Of Agyw, Men Living With Hiv, And Program Implementing Partners, Nanlesta Pilgrim, Victor Mwapasa, Effie Chipeta, Wanangwa Chimwaza, Nrupa Jani, Tracy Mcclair, Lyson Tenthani, Sanyukta Mathur

HIV and AIDS

Project SOAR, led by the Population Council, in partnership with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted a research portfolio to generate evidence to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. The objectives of this implementation research were to generate evidence for describing HIV-related risk factors among AGYW; assess the extent to which the overall DREAMS project contributed toward the goal of reducing HIV risk among AGYW; and understand the characteristics of male partners and how to link them to HIV services, as well as retain …

Community-Based Hiv Treatment Service Delivery Model For Female Sex Workers In Tanzania: Evaluation Findings, Lung Vu, Waimar Tun, Louis Apicella, Jeremiah Kidola, Caterina Casalini, Gasper Mbita, Neema Makyao, Todd Koppenhaver, Erick Mlanga

HIV and AIDS

Project SOAR in collaboration with the National AIDS Control Program of the Government of Tanzania, National Institute of Medical Research, and Jhpiego’s Sauti Program, conducted an implementation science study to investigate the delivery of community-based antiretroviral treatment (ART) services to female sex workers (FSWs) in Tanzania. Studies from sub-Saharan Africa have shown improved HIV treatment outcomes, such as uptake of HIV services, retention in care, and increased dignity and quality of life, by using community-based delivery of HIV services. As detailed in this Project SOAR final report, the study assessed the effectiveness of the community-based ART delivery intervention in improving …

Strengthening Capacity For Assessment Of Hiv-Related Data Needs Among Key Populations To Inform Evidence-Based Responses, Amrita Rao, Nikita Viswasam, Stefan Baral

HIV and AIDS

Defining the HIV prevention and treatment needs of key populations who have disproportionate HIV acquisition and transmission risks has been particularly difficult in the context of generalized HIV epidemics where less attention has historically been placed on the HIV prevention and treatment needs of these groups. There is a gap in our understanding of the specific needs of—and ultimately the investment case for the added value of supporting—disproportionately burdened key populations in these settings. In response to this gap, Johns Hopkins University under the United States Agency for International Development (USAID)-funded Project SOAR implemented a project in partnership with collaborators, …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

From The American People: An Autoethnographic Exploration Of South African Ngos' Perceptions Of Pepfar, Antonia Asher

Independent Study Project (ISP) Collection

The aim of this research was to understand what the ideal partnership would be between United States (US) governmental aid agencies and South African non-governmental organizations (NGOs), specifically concerning HIV/AIDS programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), from the perspective of NGOs. PEPFAR is the largest relief fund for a single disease; thus, I additionally sought to deeply reflect upon myself as a US citizen in South Africa, a country that has received trillions of dollars from taxpayers such as myself.

To accomplish this, I interviewed NGO staff about the nature of current partnerships, outcomes …

“Hiv-Related Syndemic Pathways And Risk Subjectivities Among Gay And Bisexual Men: A Qualitative Investigation, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathways whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use, (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration, and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Gender Disparities In Access To Hiv Testing And Antiretroviral Treatment Services, Wyatt Lombard Smith

Independent Study Project (ISP) Collection

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this …

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Health Disparities Experienced By People With Disabilities In The Us: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Environmental & Occupational Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Study Guide For United In Anger: A History Of Act Up, Matt Brim

Open Educational Resources

The United in Anger Study Guide facilitates classroom and activist engagement with Jim Hubbard’s 2012 documentary, United in Anger: A History of ACT UP. The Study Guide contains discussion sections, projects and exercises, and resources for further research about the activism of the New York chapter of ACT UP (AIDS Coalition to Unleash Power). The Study Guide is a free, interactive, multimedia resource for understanding the legacy of ACT UP, the film’s role in preserving that legacy, and its meaning for viewers' lives.

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

Disease Prevalence And Behavioral Risk In Nevada, Shannon M. Monnat

Social Health of Nevada Reports

Throughout the last several years, people living in the United States have engaged in intense debates about health care reform, costs, and mandates. What is often missing from these debates is arguably the key issue in American health: What is making us sick in the first place?

Aging Trends And Challenges In Nevada, Jennifer Reid Keene, Kathryn Mcclain, Jacqueline Ragin

Social Health of Nevada Reports

Societal aging is one of the most important social trends of the 21st century. It affects our political, social, and economic institutions and also the nature of our interpersonal and family relationships (Quadagno 2011). In the coming decades, both as individuals and as a society, we will have to make important decisions regarding the consequences of our aging population. Policy makers, families, businesses, local, state, and federal governments, health care providers will have to meet the growing needs of the older population in the U.S. and in Nevada.

Assessing And Improving Self-Reporting Of Male Circumcision In Zambia And Swaziland, Paul C. Hewett, Nicole Haberland, Barbara Mensch, Louis Apicella

HIV and AIDS

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Nonclinical Development Needs And Regulatory Requirements For Multipurpose Prevention Technologies: A Primer, Joseph W. Romano, Martha Brady, Judy Manning

HIV and AIDS

This summary outlines key development elements that will be necessary for various configurations of multipurpose prevention products for the simultaneous prevention of HIV, sexually transmitted infections, and/or pregnancy.

Shaping The Operations Research Agenda For Antiretroviral-Based Prevention Products For Women: Gels And Rings, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

This report summarizes discussions from a two-day international experts consultation meeting in 2012 on preparing for the successful introduction of women-centered antiretroviral-based HIV prevention methods. It examines the limits and expectations of operations research in antiretroviral health technologies.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Swaziland, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Swaziland, led by Population Services International, in partnership with Jhpiego, Marie Stopes International, and the Population Council. The study assesses participants' comprehension of the circumcision process, the informed consent process, as well as the affect of male circumcision counseling on their experience.

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch

HIV and AIDS

Report of a study exploring the feasibility and acceptability of free HIV home self-testing among health workers in Kenya, within the range of other HIV testing options available.