Ajar-African Journal of Aids Research最新文献

{"title":"Factors influencing the transition from paediatric to adult HIV care in the Western Cape, South Africa: perspectives of health care providers.","authors":"Sylvie Mbebe, Stephan Rabie, Bronwyne J Coetzee","doi":"10.2989/16085906.2023.2246435","DOIUrl":"10.2989/16085906.2023.2246435","url":null,"abstract":"<p><p>Transitioning to adult care for HIV-infected adolescents is a critical process in determining long-term health outcomes. Poor transitioning to adult care can lead to several adverse HIV-related outcomes for adolescents living with HIV, including disruption of care, non-adherence to ART and virological failure. In this qualitative study, we explore the barriers to and facilitators of the transition to adult care among HIV-infected youth from the perspectives of health care workers and allied staff. We enrolled 24 health care workers and allied staff from two infectious diseases clinics in the Western Cape of South Africa. Participants took part in a once-off, semi-structured interview that was conducted face-to-face at the respective clinics. Interviews were audio-recorded and transcribed verbatim for thematic analysis using ATLAS.ti. Two superordinate themes and seven subthemes emerged from the data. We found that barriers to the transition process were related to a lack of preparedness and readiness to transition at both an institutional level and at the level of the caregiver and adolescent. At the institutional level, a lack of a transition policy and limited time and resources available for the transition process were salient barriers. At the caregiver-adolescent level, adolescents' desire for normality and caregivers' reluctance to devolve responsibility of care to their children were important barriers to the transition process. Facilitators prepare adolescents and caregivers for transition from an early age. Our findings highlight the importance of considering both adolescent, caregiver and institutional factors when preparing for the transition process. Our findings also show that pressure on the health care system precludes the time required for this process. However, counselling for transition from an early age might be an important way to negate these issues.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"175-184"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A spade was called a spade … \": Youth and intervention implementers' perceptions of a resilience-based HIV-prevention intervention for youth in South Africa.","authors":"Fungai Mbengo, Esther Adama, Amanda Towell-Barnard, Maggie Zgambo","doi":"10.2989/16085906.2023.2233496","DOIUrl":"10.2989/16085906.2023.2233496","url":null,"abstract":"<p><p>The youth (15-24 years old) in South Africa remain at high risk of HIV infection despite varied efforts to control the disease. An understanding of the perspectives of relevant stakeholders of HIV-prevention interventions targeting the youth is important to guide research, policy and practice aimed at improving these interventions. This study explores youth and intervention implementers' perceptions of a resilience-based HIV-prevention intervention (<i>You Only Live Once</i>) aimed at reducing risky sexual behaviours among the youth in South Africa. Semi-structured interviews were conducted with 10 young people who participated in the intervention, and four intervention implementers at a not-for-profit organisation in Maluti-a-Phofung Local Municipality, South Africa. Data were analysed using thematic analysis. Three main themes emerged from the data: (1) Acceptability and impact of the intervention; (2) Factors influencing intervention implementation; and (3) Recommendations to improve intervention implementation. These findings provide insights into the acceptability, impact, barriers and facilitators of resilience-based HIV-prevention interventions for the youth in South Africa and similar contexts, and how implementation of these interventions could be enhanced. The findings can help researchers, policy makers and health care practitioners in the field of HIV prevention to improve interventions targeting young people.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"145-156"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We will tell when we are ready\": perinatally HIV-infected adolescents and self-disclosure of their status in Eswatini.","authors":"Baliwe P Dlamini, Ntombifikile G Mtshali","doi":"10.2989/16085906.2023.2266406","DOIUrl":"10.2989/16085906.2023.2266406","url":null,"abstract":"<p><p>Access to antiretroviral therapy (ART) has promoted a significant decrease in mortality of vertically HIV-infected children. As a result, there has been an increasing growth of this population that reaches adolescence. These adolescents face problems such as self-disclosure and the stigma of the disease. This study aimed to determine the process followed by perinatally HIV-infected adolescents in self-disclosing their HIV status to significant others and the barriers and promoters of perinatally HIV-infected adolescents' disclosure of their HIV status to others. Data were collected from 15-19-year-old adolescents through 23 in-depth individual interviews and three focus groups. For adolescents, a clear barrier to disclosure was being told when they were younger by a parent to keep their status secret from other people. Lack of trust and fear of breaches of confidentiality which would lead to stigma and discrimination also hindered disclosure. For those adolescents who disclosed, they did so face to face and through short text messages. Adolescents expressed the need to be capacitated to self-disclose and also called for HIV and AIDS education to the general public as a way of fighting stigma and discrimination in their communities and in society. For adolescents to be able to disclose, they have to work through issues of acceptance of their own HIV status first. This study is the first-ever study to document difficulties faced by adolescents in the self-disclosure of their status in Eswatini.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"201-209"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the uptake of HIV testing among women in Liberia: the role of female genital mutilation/cutting.","authors":"Daniel Amoak, Nancy Osei-Kye, Florence W Anfaara, Yujiro Sano, Roger Antabe, Isaac Luginaah","doi":"10.2989/16085906.2023.2275695","DOIUrl":"10.2989/16085906.2023.2275695","url":null,"abstract":"<p><p>Past studies show that the processes of female genital mutilation/cutting (FGM/C) on women can increase their susceptibility to HIV infection. This is because genital tears or ruptures, scars and wounds from FGM/C may expose survivors to heightened risks of contracting sexually transmitted infections, including HIV, if they engage in unsafe sexual practices. Hence, there is the need to promote HIV screening and testing among this population. Yet, in Liberia, there is a dearth of studies exploring the uptake of HIV testing among women who have experienced FGM/C. To understand this relationship, we used the 2019-2020 Liberia Demographic and Health Survey (LDHS) and employed logistic regression analysis to answer the following questions: (1) Are FGM/C survivors less likely to have been tested for HIV compared to non-FGM/C women; and (2) How does this disparity in the uptake of HIV testing differ by women's marital status? We found that survivors of FGM/C were less likely to have been tested for HIV than non-FGM/C women, even after accounting for theoretically relevant variables (OR = 0.83, <i>p</i> < 0.01). In response to our second question, we found that survivors of FGM/C who were formerly married were less likely to have been tested for HIV compared to their non-FGM/C counterparts (OR = 0.48, <i>p</i> < 0.01). These findings highlight the importance of trauma-informed HIV prevention strategies in Liberia, and the need for policymakers to take a holistic approach to addressing the challenges that FGM/C survivors, especially formerly married women, may face in accessing HIV prevention and testing services, and to work towards creating a more inclusive and supportive environment for all at-risk groups.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 3","pages":"226-236"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices of health citizenship in South Africa: a case study of the Treatment Action Campaign (TAC) in Khayelitsha, Cape Town.","authors":"Ngwi Nnam Thecla Mulu","doi":"10.2989/16085906.2023.2274932","DOIUrl":"10.2989/16085906.2023.2274932","url":null,"abstract":"<p><p>This article examines the Treatment Action Campaign's (TAC) evolution and attrition as a social movement organisation to discern its implications for practices of health citizenship at the grassroots level. A qualitative approach to case study research was used to collect and analyse data. Practices of health citizenship were framed around the integration of biomedical knowledge and people's experiences of grassroots activism. By exploring how the TAC's brand of activism filtered down to the community level, the findings reveal the importance of diverse forms of activist-led collective action in promoting health-seeking behaviour. These comprise activist-led branch meetings, community workshops, health promotion talks at clinics and community radio stations, as well as protest action at community clinics. Findings indicate that participation in TAC-led activism in Khayelitsha is not a passive form of responsible HIV citizenship. Rather, it is an active process through which TAC members integrate their lived experiences with biomedical knowledge to construct meanings and articulate grievances to enhance the quality of health service delivery in their community. Also, although the TAC's practices of health citizenship have not changed significantly over time, its campaigns have evolved based on contextual factors. These practices have entrenched ways of being, doing and knowing that have become an important resource for activist-led health promotion. Key stakeholders in government and civil society can harness these practices to strengthen health systems.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"217-225"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I don't know if you have searched through the scriptures to find a reference on HIV/AIDS. I mean there isn't going to be one, right?\": HIV stigma solutions from dialogues between faith leaders and health care workers.","authors":"Germari Kruger, Eduardus Ajg van der Borght, Martha T Teijema, Marceline Tutu van Furth","doi":"10.2989/16085906.2023.2238687","DOIUrl":"10.2989/16085906.2023.2238687","url":null,"abstract":"<p><p>In South African communities, both faith leaders and health care workers play a vital role in supporting the health of community members and people living with HIV in particular. This study describes HIV stigma when faith leaders and health care workers engaged in discourse. The study used a descriptive qualitative inquiry design. Data were gathered between 2015 and 2016 in the areas of Masiphumelele and Gugulethu in Cape Town, South Africa. Three themes emerged: (1) participants identified influences that can increase HIV stigma; (2) participants shared the challenges that they face to reduce HIV stigma; and (3) participants suggested solutions to reduce HIV stigma. Themes discussed include ground-level problems and practical solutions to address HIV stigma in faith communities. Collaboration between faith leaders and health care workers are vital resources in the fight against HIV stigma. Future research and interventions should aim to promote organised collaboration between faith communities and health care structures.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"165-174"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-adherence to antiretroviral treatment among migrating fishermen in western Kenya's islands: a rapid qualitative study.","authors":"Stephen Okumu Ombere, Erick Otieno Nyambedha","doi":"10.2989/16085906.2023.2276375","DOIUrl":"10.2989/16085906.2023.2276375","url":null,"abstract":"<p><p>Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. The association of migration with HIV and AIDS in sub-Saharan Africa is well documented. Frequent mobility, high consumption of alcohol, multiple sexual partners, transactional and commercial sex, poor health infrastructure and limited access to health services are reported among the main factors shaping the HIV epidemic in fishing communities. Moreover, studies have been conducted in sub-Saharan Africa on adherence to antiretroviral treatment (ART) among fishers; however, non-adherence to ART remains poorly understood among migrating fishermen in the western Kenya islands. This qualitative study investigated factors contributing to non-adherence among fishermen in the western Kenya islands. This study utilised 51 in-depth interviews and six focus group discussions to highlight factors contributing to non-adherence to ART by mobile fishermen. Data were analysed using a contextualised thematic analysis. Results show that migration, alcohol consumption and ART sharing contributed to non-adherence. Adherence to ART is a powerful predictor of survival for individuals living with HIV and AIDS. The Kenyan government can use lessons from this study to target fishermen to achieve the UNAIDS 2025 recommendations on people-centred and context-specific service responses to AIDS as this would move Kenya closer to the 90% reduction in annual infections by 2030. This article contributes to a deeper understanding of how and why fishermen from the islands in western Kenya struggle to adhere to treatment even though they can access ARTs through the public health care system. Longitudinal studies should be conducted to explore how the factors associated with non-adherence correlate with other key health outcomes such as drug resistance.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 3","pages":"237-243"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Nigerian medical students in the HIV response: lessons from the COVID-19 pandemic.","authors":"Daniel Asogun, Mahmud A Mahmud, Akhaine Jesu-Oboh Precious, Ighodaro Osazuwa","doi":"10.2989/16085906.2023.2274343","DOIUrl":"10.2989/16085906.2023.2274343","url":null,"abstract":"<p><p><i>Background</i>: With the advent of the COVID-19 pandemic, this study seeks to understand how medical students' involvement in the HIV response during the COVID-19 pandemic - as well as before and after it - has influenced their decision to specialise in HIV care and their participation in HIV-related activities in the future.<i>Method</i>: Quantitative and qualitative approaches were utilised among medical students from Ambrose Alli University in their fourth, fifth and sixth years of study respectively. Data from this study was analysed using the SPSS version 21 module for descriptive statistics.<i>Results</i>: Medical students were more involved in community-based HIV awareness campaigns (48.6%) during the pre-COVID era, but then became more involved in online awareness campaigns (55%). Only 8.6% were involved in HIV research and evaluation activities. Over 31.2% of respondents were interested in specialising in HIV-related fields, with 23.6% attributing their decision to the COVID-19 pandemic. 92.3% of the respondents were of the opinion that medical students need to become more involved in HIV-related activities. There was statistical significance between the year of study of respondents and awareness of HIV-related activities (<i>p</i> < 0.007). Focused discussions revealed that all students felt that medical students should be more involved in HIV-related activities.<i>Conclusion</i>: Our results suggest that the COVID-19 pandemic marginally boosted the number of medical students involved in online awareness campaigns for HIV and AIDs, but there was decreased involvement in community campaigns and participation in community HIV testing. The impact of these findings on the lives of people living with HIV needs further investigation.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 3","pages":"210-216"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PrEP retention predictors among key populations in urban areas of Zimbabwe - a machine learning approach.","authors":"Bridgette Bero, Chipo Zidana, Sarudzai Portia Showa","doi":"10.2989/16085906.2023.2237002","DOIUrl":"10.2989/16085906.2023.2237002","url":null,"abstract":"<p><p>Pre-exposure prophylaxis (PrEP) success depends on adherence and hence retention in care. It is vital to find factors that affect PrEP retention to make this HIV-prevention method successful. The main objectives of this study were to identify the major determinants of PrEP retention at six months from day of initiation and to determine PrEP retention clusters. Data of people who were initiated on PrEP care at Population Services International sites between 2017 and 2019 in Zimbabwe were used. Determinants of PrEP retention were identified using multivariable logistic regression and partitioning around medoids (PAM) cluster analysis to determine the number and composition of PrEP retention clusters. Significant PrEP retention determinants were found to be population type, sex, marital status, employment type, age and education level. Female sex workers were most likely to stay on PrEP compared to other users. We found that PrEP users could be grouped into three risk clusters: cluster 1 consisted of married adult males who are high-risk individuals; cluster 2 consisted of the young single men who have sex with men (MSM); and cluster 3 consisted of adult women who are separated or divorced and employed as sex workers. The retention rates were 32%, 24% and 44% for clusters 1 to 3 respectively. We conclude that adults, female sex workers, high-risk individuals, women, people without or with little education and sex workers stay on PrEP better than youths, MSM, men and educated and employed individuals.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"157-164"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of type of sexual partnership on male condom use: empirical evidence from the South African construction industry.","authors":"Kamal Yakubu, Paul Bowen, Rajen Govender","doi":"10.2989/16085906.2023.2265902","DOIUrl":"10.2989/16085906.2023.2265902","url":null,"abstract":"<p><p>There are indications that gender has an effect on individual risk factors and pathways to HIV diagnoses and treatment. Furthermore, there is growing recognition that to improve HIV-related health outcomes for men, it is important to understand their experiences and perspectives. Perhaps because of the physical nature of construction work, the South African construction industry is dominated by men. Given that employed men are a hard-to-reach community population group, the construction workplace offers an ideal environment for data collection and delivery of non-health-facility-based HIV prevention and treatment interventions. Furthermore, workers in the construction industry have been identified as being at a heightened risk of acquiring HIV and AIDS because of work-related travel, the ubiquity of transactional sex around worker hostels and having an increased likelihood of multiple and concurrent sex partnerships. As a consequence, this study examines the association between condom use and sexual partnerships among men working in the construction industry. A purposive cross-sectional survey was used to collect data from 450 workers across 18 construction sites in the Western Cape province of South Africa. The types of sexual partnership had three categories: regular sex partnerships, casual sex partnerships and sex worker partnerships. Frequency of condom use was determined to be highest with casual sex partners (51.2%), followed by sex workers (40.6%) and regular sex partners (25.6%). Hierarchical multiple linear regression analysis was used to examine the demographic, experiential, behavioural and cognitive predictors of condom use across the three categories of sexual partnership. The results indicate that an individual's perception of control over condom use, and the perceived threat posed by HIV and AIDS are significantly associated with consistent condom use, even after accounting for differences in partner type. Implications of the findings are discussed, and directions for future research on the association between sexual partnerships and condom use are offered.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"185-200"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}