{"title":"Psychosocial support services to enhance well-being of orphaned and vulnerable learners in Eswatini early childhood centres and primary schools.","authors":"Patronella Bimha, Maureen Nokuthula Sibiya","doi":"10.2989/16085906.2023.2203128","DOIUrl":"https://doi.org/10.2989/16085906.2023.2203128","url":null,"abstract":"<p><p>In Eswatini (formerly Swaziland), the increasing number of orphans and vulnerable children due to HIV/AIDS has spurred demand for psychosocial support services. When the Ministry of Education and Training assumed responsibility for delivering psychosocial support, educators were burdened with the additional role of looking after orphans and vulnerable learners. This exploratory, sequential, mixed-methods study was employed to analyse factors that enhance the provision of psychosocial support services and the perceptions of educators towards psychosocial support delivery. The qualitative study phase entailed 16 in-depth interviews with multi-sectoral psychosocial support specialists and seven focus group discussions with orphans and vulnerable learners. In the quantitative study phase, 296 educators were surveyed. Thematic analysis was used for the qualitative data, and the quantitative data was analysed using Statistical Package for the Social Sciences version 25 software. The findings reveal problems associated with psychosocial support service delivery at strategy, policy and operational levels. The results indicate that orphans and vulnerable children are offered material support (e.g. food and sanitary pads) and spiritual support, but were rarely referred for social and psychological needs. There were no proper counselling facilities and not all teachers received relevant training in children's psychosocial needs. Training of educators in specific psychosocial support areas was considered significant to enhance service delivery and the psychosocial well-being of the learners. Overall, accountability was difficult to establish because the administration of psychosocial support is split among the Ministry of Education and Training, the Deputy Prime Minister's office and Tinkhundla administration. There is unequal distribution of qualified early childhood development teachers to cater for early childhood educational needs.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 2","pages":"102-112"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940775","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":"Factors associated with buying sex and the knowledge that condoms prevent HIV among long-distance truck drivers at Kazungula weighbridge terminal, Chobe District, Botswana.","authors":"Wada Gaolaolwe, Mathildah Mokgatle","doi":"10.2989/16085906.2023.2176331","DOIUrl":"https://doi.org/10.2989/16085906.2023.2176331","url":null,"abstract":"<p><p><i>Background</i>: Long-distance truck drivers (LDTDs) have a higher rate of HIV infection compared to the general population. This is due to their living and working conditions which predispose them to riskier sexual behaviours. Inadequate knowledge of HIV and AIDS, coupled with risky sexual behaviours such as unprotected sex with commercial sex workers (CSWs), predisposes LDTDs to contract and propagate HIV. This study aims to determine the factors associated with buying sex and the knowledge that condoms prevent HIV transmission among long-distance truck drivers at Kazungula weighbridge terminal in the Chobe District of Botswana.<i>Methods</i>: A cross-sectional descriptive survey was employed and 399 LDTDs participated. A questionnaire was used to collect sociodemographic data and information on knowledge of HIV and AIDS and the sexual behaviours of the LDTDs.<i>Results</i>: The results reveal that more than half of the LDTDs (56.9%; <i>n</i> = 227) had paid for sex with CSWs at some point in their travels, and 27.1% (<i>n</i> = 108) reported having had unprotected sex with CSWs. The LDTDs who preferred to have sex with CSWs without a condom had about five times the odds of buying sex with CSWs than those who preferred to use a condom (AOR 4.9; 95% CI 2.85-8.46). Disliking condom use was a factor contributing to less knowledge of condom use preventing HIV among the LDTDs (AOR 0.4; CI 0.17-0.97).<i>Conclusion</i>: It can be concluded from the results of this study that the LDTDs engage in considerable risky sexual behaviours, and associated factors were found to be multidimensional. This population remains of concern in HIV acquisition and transmission. Therefore, there is a need for a robust public health response to deal with the problem of both new infection and re-infection with HIV in this population.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"35-45"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360737","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}
Nkechinyere Harrison, Ismail Lawal, Kehinde Aribisala, Kenneth Oruka, Yakubu Adamu, Patricia Agaba, Elizabeth Lee, Laura Chittenden, Nathan Okeji
{"title":"Effect of multi-month antiretroviral dispensing on HIV clinic attendance at 68 Nigerian Army Reference Hospital, Yaba, Nigeria.","authors":"Nkechinyere Harrison, Ismail Lawal, Kehinde Aribisala, Kenneth Oruka, Yakubu Adamu, Patricia Agaba, Elizabeth Lee, Laura Chittenden, Nathan Okeji","doi":"10.2989/16085906.2023.2188232","DOIUrl":"https://doi.org/10.2989/16085906.2023.2188232","url":null,"abstract":"Background: Multi-month dispensing (MMD) of antiretroviral therapy has demonstrated benefits for HIV patients and health service delivery systems, including reduced frequency of hospital visits and improved retention. We evaluated the effect of 6-monthly dispensing (MMD6) on patient clinic attendance at a single military facility in the one-year pre- and post-policy change. Methods: This was a descriptive, retrospective, cross-sectional study, exploring the relationship between MMD6 and clinic attendance numbers. We reviewed aggregate clinic attendance records for clients on ART and documented monthly trends in clinic attendance numbers, number of clients current on ART, and amount of ART dispensed. Results: In the pre-MMD6 group, 4 150 patients were included, and 4 190 in the post-MMD6 group. Clinic attendance was 30 407 visits (16 111 pre-MMD6 and 14 296 post-MMD6). An overall mean increase of 326.58 ± 861.81 (95% CI = −874.15 ± 220.98) drugs were dispensed per month; t(11) = −1.31, p = 0.22; mean monthly clinic attendance declined from 1342.8 ± 220.10 visits pre-MMD6 to 1191.33 ± 309.10 post-MMD6 with t(11) = 1.601, p = 0.14, but was not statistically significant. Conclusion: Six-monthly dispensing can be an important tool to reduce HIV clinic volumes and improve antiretroviral access. It is particularly important for care continuity in military facilities where service members may be deployed or transferred to other bases along with their dependents.","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"63-68"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521596","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":"HIV infections averted at PEPFAR-APIN clinics in Nigeria: a ten-year retrospective evaluation of the clinical outcomes of post-exposure prophylaxis services.","authors":"Abdulmuminu Isah, Nneka Uchenna Igboeli, Obinna Felix Dim, Azubuike Amos Ekwuofu","doi":"10.2989/16085906.2023.2178317","DOIUrl":"https://doi.org/10.2989/16085906.2023.2178317","url":null,"abstract":"<p><p><i>Introduction:</i> Nigeria contributes a high fraction to the global burden of HIV infections. Post-exposure prophylaxis (PEP) is a proven strategy to prevent transmission of the virus. The aim of this study was to determine the clinical outcomes of PEP in Nigeria at four clinics funded by United States President's Emergency Plan for AIDS Relief and AIDS Prevention Initiative in Nigeria (PEPFAR-APIN): Ahmadu Bello University Teaching Hospital (ABUTH), Jos University Teaching Hospital (JUTH), University of Maiduguri Teaching Hospital (UMTH) and University College Hospital (UCH).<i>Methods:</i> This study adopted a multisite retrospective design using the site's databases (2006-2016). Retrieved data was exported into SPSS version 25 for statistical analysis. Outcomes were measured as a proportion of HIV infections averted after PEP. Frequencies and percentages were used to describe the findings, while binary logistic regression was used to determine the sociodemographic predictors of clinical outcomes.<i>Results:</i> The average age of the 575 PEP patients whose data were retrieved was 30.45 (SD ±9.50 years), with 344 (59.8%) being females. Out of 545 patients,157 (28.8%) indicated their job status as students. Out of 273 patients, 198 (72.5%) reported their exposure type was non-occupational. The HIV status of 129 (22.4%) patients was negative after completing PEP. Prescribed regimen (β = -0.048, 95% CI -0.095 to -0.001, <i>p</i> = 0.045) and type of exposure (β = 0.351, 95% CI 0.042-0.660, <i>p</i> = 0.027) were predictors of post-PEP HIV status in JUTH and ABUTH respectively.<i>Conclusion:</i> There was a high rate of lost-to-follow-up among the PEP patients, but the incidence of seroconversion was low in those who were tested after PEP. The right choice of regimen and presenting with non-occupational exposure affected the outcome of the service.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"46-53"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360738","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":"Correction.","authors":"","doi":"10.2989/16085906.2023.2202504","DOIUrl":"https://doi.org/10.2989/16085906.2023.2202504","url":null,"abstract":"","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"69"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9357631","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}
Merrian Brooks, Barbara Burmen, Anthony Olashore, Alemayehu Mekonnen Gezmu, Keneilwe Molebatsi, Ontibile Tshume, Onkemetse Phoi, Knashawn Morales, Mogomotsi Matshaba, Tami Benton, Elizabeth D Lowenthal
{"title":"Symptoms of depression, anxiety, and thoughts of suicide/self-injury in adolescents and young adults living with HIV in Botswana.","authors":"Merrian Brooks, Barbara Burmen, Anthony Olashore, Alemayehu Mekonnen Gezmu, Keneilwe Molebatsi, Ontibile Tshume, Onkemetse Phoi, Knashawn Morales, Mogomotsi Matshaba, Tami Benton, Elizabeth D Lowenthal","doi":"10.2989/16085906.2023.2186252","DOIUrl":"10.2989/16085906.2023.2186252","url":null,"abstract":"<p><p>Globally, mental health problems have been reported to be more common in youth living with HIV (YLWH) than in the general population, but routine mental health screening is rarely done in high-volume HIV clinics. In 2019, YLWH in a large HIV clinic in Botswana were screened using the Generalized Anxiety Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) in a pilot standard-of-care screening programme. Two-way ANOVA was used to describe the effects of age group (12-<16, 16-<20 and 20-25 years old) and sex on GAD-7 and PHQ-9 scores. Chi-square statistics were used to compare characteristics of YLWH with and without potential suicidality/self-harm symptoms based on question 9 in the PHQ-9. Among 1 469 YLWH, 33.1%, 44.3% and 15.0% had anxiety, depression and potential suicidality/self-harm symptoms respectively. YLWH of 20-25 years old and 16-<20 years old had higher GAD-7 scores compared to 12-<16-year-olds (<i>p</i> = 0.014 and <i>p</i> = <0.001 respectively). Female YLWH of 20-25 years old had higher PHQ-9 scores compared to 12-<16-year-olds (<i>p</i> = 0.002). There were no other sex-age dynamics that were statistically significant. Female YLWH endorsed more thoughts of suicidality/self-harm than males (17% versus 13%, <i>p</i> = 0.03 respectively). Given the proportion of YLWH with mental health symptoms, Botswana should enhance investments in mental health services for YLWH, especially for young female adults who bear a disproportionate burden.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"54-62"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10787227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charisse V Ahmed, Guy Weissinger, Anne M Teitelman, Ndumiso Sabelo Dlamini, Nontsikelelo Patience Dlamini, Thuthukile Cebsile Dlamini, Angel Nkambule, Siphesihle Nkambule, Bridgette M Rice, Marianne Calnan
{"title":"Roles and responsibilities of expert clients in adolescent HIV service delivery in Eswatini: a conventional content analysis.","authors":"Charisse V Ahmed, Guy Weissinger, Anne M Teitelman, Ndumiso Sabelo Dlamini, Nontsikelelo Patience Dlamini, Thuthukile Cebsile Dlamini, Angel Nkambule, Siphesihle Nkambule, Bridgette M Rice, Marianne Calnan","doi":"10.2989/16085906.2023.2169178","DOIUrl":"https://doi.org/10.2989/16085906.2023.2169178","url":null,"abstract":"<p><p>We aimed to elucidate the specific roles and responsibilities of expert clients in service delivery among adolescents living with HIV in Eswatini, and to provide recommendations for enhancing adolescent service provision among expert clients and similar lay health workers throughout low- and middle-income countries. An exploratory qualitative descriptive methodology using conventional content analysis was used to meet our study aims. We recruited 20 expert clients and 12 key informants (programme managers, programme coordinators and nurses) to participate in semi-structured interviews, and we arranged four focus group discussions among adolescents living with HIV with seven to ten participants per focus group. Adherence counselling in clinical and community settings was considered paramount to the roles and responsibilities of expert clients with regard to adolescent-specific HIV service delivery. The following recommendations were made to enhance expert client service delivery practices among adolescents: (1) training in adolescent developmental, sexual and reproductive needs; (2) training to enhance clinical knowledge and skills; (3) additional work equipment and compensation; and d) more parent and guardian engagement in their work. While expert clients meet the needs of adolescents living with HIV in several capacities, they require additional resources, skills and training to improve their work, especially in the realm of sexual and reproductive health. Future research is needed to evaluate the impact of expert client service delivery on adolescent health outcomes.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"27-34"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424858","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}
Ivana Beesham, Cecilia Milford, Dvora L Joseph Davey, Jenni Smit, Leila E Mansoor, Mags Beksinska
{"title":"Key stakeholders' perspectives on providing oral pre-exposure prophylaxis as HIV-prevention standard of care in clinical trials in South Africa.","authors":"Ivana Beesham, Cecilia Milford, Dvora L Joseph Davey, Jenni Smit, Leila E Mansoor, Mags Beksinska","doi":"10.2989/16085906.2023.2169177","DOIUrl":"https://doi.org/10.2989/16085906.2023.2169177","url":null,"abstract":"<p><p><i>Introduction</i>: HIV-prevention and endpoint-driven clinical trials enrol individuals at substantial risk of HIV. Recently, these trials have provided oral pre-exposure prophylaxis (PrEP) as HIV-prevention standard of care; however, data on PrEP uptake and use during the trial and post-trial access are lacking.<i>Methods</i>: We conducted once-off, telephonic, in-depth interviews from August 2020 to March 2021, with 15 key stakeholders (including site directors/leaders, principal investigators and clinicians), purposively recruited from research sites across South Africa that are known to conduct HIV-prevention and endpoint-driven clinical trials. The interview guide probed for facilitators and barriers to PrEP uptake and use during the trial, and post-trial PrEP access. Interviews were audio recorded and transcribed. Coding was facilitated using NVivo and emergent themes were identified.<i>Results</i>: Most stakeholders reported incorporating PrEP as part of the HIV-prevention package in HIV-prevention and endpoint-driven clinical trials. Stakeholders identified multiple barriers to PrEP uptake and use, including difficulties with daily pill taking, side effects, stigma, a lack of demand creation and limited knowledge and education about PrEP in communities. Facilitators of PrEP uptake and use included demand-creation campaigns and trial staff providing quality counselling and education. Post-trial PrEP access was frequently challenging as facilities were located a considerable distance from research sites, had long queues and inconvenient operating hours.<i>Conclusions</i>: Strategies to address barriers to PrEP uptake and use during trials and post-trial access, such as PrEP demand creation, education and counselling, addressing stigma, support for daily pill-taking and increased post-trial access, are urgently needed.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"18-26"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360739","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":"Evaluating HIV policy: a gender analysis of the representation of women and men in UNAIDS HIV-prevention guidelines.","authors":"Catherine Merriman, Kevin Deane","doi":"10.2989/16085906.2022.2154232","DOIUrl":"https://doi.org/10.2989/16085906.2022.2154232","url":null,"abstract":"<p><p>Gender inequalities have long been recognised as one of the most significant factors influencing the dynamics of the HIV epidemic in sub-Saharan Africa (SSA). However, it remains unclear how men and women are discussed in HIV-prevention initiatives and if certain representations of men and women impact prevention guidance. This research aimed to understand how men and women are portrayed in HIV-prevention guidelines produced by UNAIDS for the SSA region, and how these influence the different types of interventions targeted at women and men. Thirty-four UNAIDS prevention documents were included in the study. The policy documents were analysed to ascertain the frequency of different interventions suggested, the extent to which they were targeted at men and women, and a textual analysis of the way that men and women were represented. Due to a lack of information regarding other gender identities, the research was aimed at cis-gender men and women only. The analysis revealed that most policy documents focused on women, that there were differences in the types of interventions targeted at men and women, with few social interventions targeted at men, and that the language used to describe men and women repeats traditional gender stereotypes and cements simplistic dualisms. The lack of social interventions targeted at men suggests that behaviour change among men is not highly prioritised in current prevention initiatives. Instead, current UNAIDS policy focuses on women as the key site for intervention and empowerment. UNAIDS should therefore provide more details and examples about how best to engage men and boys in prevention efforts, as well as to include more nuanced conceptions of gender in policy guidance.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"9-17"},"PeriodicalIF":1.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9722053","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}
Rebecca L West, Rhandzekile Mathebula, Dumisani Rebombo, Rhian Twine, Aimée Julien, Nkosinathi Masilela, Mi-Suk Kang Dufour, Dean Peacock, Kathleen Kahn, Audrey Pettifor, Sheri A Lippman
{"title":"The use of monitoring data and community feedback mechanisms to increase HIV testing among men during a cluster-randomised community mobilisation trial in South Africa.","authors":"Rebecca L West, Rhandzekile Mathebula, Dumisani Rebombo, Rhian Twine, Aimée Julien, Nkosinathi Masilela, Mi-Suk Kang Dufour, Dean Peacock, Kathleen Kahn, Audrey Pettifor, Sheri A Lippman","doi":"10.2989/16085906.2023.2176330","DOIUrl":"10.2989/16085906.2023.2176330","url":null,"abstract":"<p><p>This short communication describes the development and implementation of a programme monitoring and feedback process during a cluster-randomised community mobilisation intervention conducted in rural Bushbuckridge, Mpumalanga, South Africa. Intervention activities took place from August 2015 to July 2018 with the aim of addressing social barriers to HIV counselling and testing and engagement in HIV care, with a specific focus on reaching men. Multiple monitoring systems were put in place to allow for early and continuous corrective actions to be taken if activity goals, including target participation numbers in events or workshops, were not reached. Clinic data, intervention monitoring data, team meetings and community feedback mechanisms allowed for triangulation of data and creative responses to issues arising in implementation. Monitoring data must be collected and analysed carefully as they allow researchers to better understand how the intervention is being delivered and to respond to challenges and make changes in the programme and target approaches. An iterative process of sharing these data to generate community feedback on intervention approaches was critical to the success of our programme, along with engaging men in the intervention. Community mobilisation interventions to target the structural and social barriers impeding men's uptake of services are feasible in this setting, but must incorporate a continuous review of monitoring data and community collaboration to ensure that the target population is reached, and may need to also be supplemented by changes in the structure of care provision.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":"22 1","pages":"1-8"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}