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Sample records for hiv-prevention nongovernmental organizations

  1. Low sustainability, poor governance, and other challenges encountered by grassroots non-governmental organizations targeting HIV prevention for men who have sex with men in China - a nation-wide study.

    Science.gov (United States)

    Lau, Joseph T F; Wang, Zixin; Kim, Yoona; Li, Jinghua; Gu, Jing; Mo, Phoenix K H; Wang, Xiaodong

    2017-12-01

    Grassroots non-governmental organizations (NGOs) played pivotal roles in HIV prevention among men who have sex with men (MSM) in China. Their governance and sustainability issues were under-studied. This nation-wide study surveyed leaders of 202 of the HIV related NGOs in China.58.4% of the leaders believed that their NGO would last for ≤5 years; which was negatively associated with perceived good relationship with CDC. 65.3% mentioned ≥3 non-sustainability issues; associated factors included perceived inadequacies in prevention skills, management skills, policy support, technical support, operational support, and CDC's support; a reverse association was found for frequent collaboration with organizations in China. 30.6% of the leaders mentioned ≥7 governance issues; a stepwise model found a positive association with having no office and negative associations with number of full-time staff and core volunteers. These problems would severely limit the effectiveness of HIV prevention among MSM. Related improvements and support are warranted.

  2. Financing of Romanian Non-governmental Organizations

    Directory of Open Access Journals (Sweden)

    Sebastian Ion CEPTUREANU

    2017-06-01

    Full Text Available Non-governmental organizations (NGOs have become increasingly important in the last decade for the Romanian society. They raise public awareness for human rights, promote development of democracy and seek to improve the well-being of communities by being increasingly engaging in various development, educational, social or health projects. Unfortunately, many NGOs has to cope with significant financing problems since competition for resources amplified and some of the traditional donors cut or reduced support. This paper analyze financing issues in NGOs, based on a quantitative analysis, using a structured questionnaire. Since it is one of the very few studies covering Romania, the scope of the paper was to provide for those involved or interested in NGO sector new data concerning, for instance, sources of revenue or destination of resources, enabling NGOs executives to build financial sustainable organizations.

  3. Role of Non-Governmental Organizations in Agriculture and ...

    African Journals Online (AJOL)

    Role of Non-Governmental Organizations in Agriculture and Development in Rivers State, Nigeria. ... International Journal of Agriculture and Rural Development ... The organizations are seen as essential mechanism by which the rural dwellers can participate, while mobilizing internal resources to improve their living ...

  4. Role Of Governmental And Non-Governmental Organizations In ...

    African Journals Online (AJOL)

    Objective: This study assessed the role of governmental and non-governmental organizations in mitigation of stigma and discrimination among people infected and affected by HIV/AIDS in informal settlements of Kibera. Methods: This was a descriptive cross-sectional study and used a multi stage stratified sampling method.

  5. Impact Of Non-Governmental Organizations\\' Activities In Creating ...

    African Journals Online (AJOL)

    The study examines the impact of Non-Governmental Organizations\\' (NGOs) intervention in creating awareness and changing the mindset of people in typical rural communities in Kaduna State towards victims of HIV/AIDS. Structured questionnaire were used to collect data from adult male and female as well as young ...

  6. Funding mobilization strategies of nongovernmental organizations in Cambodia

    NARCIS (Netherlands)

    Khieng, S.

    2014-01-01

    The objectives of this paper are to map strategies for resource mobilization of nongovernmental organizations (NGOs) in different sectors in heavily aid-dependent Cambodia and analyse the past and future trends of each of the evolving strategies. The data used is the product of a national survey

  7. The Role of Non-Governmental Organizations in Rural ...

    African Journals Online (AJOL)

    The main purpose of this study was to investigate the roles of non-governmental organizations in rural transformation in Odukpani Local Government Area of Cross River State, Nigeria. The activities they have engaged in and what result they achieved and how this impacted on rural livelihoods and development. A sample ...

  8. Team effectiveness in Non-Governmental Organizations (NGOs) projects.

    Science.gov (United States)

    Latif, Khawaja Fawad; Williams, Nigel

    2017-10-01

    The incorporation of team context into research and practice regarding team effectiveness in NGOs projects is a constant challenge. The research seeks to address the gap and identify the critical determinants of team effectiveness in projects undertaken by non-governmental organizations. Using a systematic process, the study involved both literature and focus group discussions to generate the required items. A total of 157 respondents (Team Members and Team Leaders) were part of the study that filled the questionnaires. Using exploratory factor analysis followed by confirmatory factor analysis, both convergent and discriminant validity was established. The present study found that team effectiveness in NGO social projects has a total of seven dimensions namely: Inter team coordination, community social linkage, team performance, knowledge, skills, and attitudes, leadership communication and engagement, decision making and information sharing, and team formation. There is a significant lack of research on team effectiveness in NGO projects. Where considerably large proportion of research on team effectiveness has focused on the corporate sector, the non-governmental teams have been neglected. This study clearly highlights the determinants that make up team effectiveness in NGOs. The determinants identified will help to specifically look at the effectiveness of teams in NGO projects. The study would help NGOs identify the dimensions in which they may be performing in a weaker manner and direct their energies in improving the factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. HIV Prevention

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Collapse All Is abstinence the only 100% effective HIV prevention option? Yes. Abstinence means not having oral, ...

  10. Effects of species' characteristics on nongovernmental organizations' attitudes toward species conservation policy

    NARCIS (Netherlands)

    Knegtering, E; Hendrickx, L.C W P; van der Windt, H.J.; Schoot Uiterkamp, A.J.M.

    The authors examined the willingness of nongovernmental organizations (NGOs) to support public species conservation measures as a function of species characteristics, NGOs' interests, and interests harmed by the measures. In an experiment, 39 policy makers from nature conservation, mobility and

  11. OVERWIEW ABOUT THE VISION, MISSION, GOALS AND VALUES OF NONGOVERNMENTAL ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Nicoleta Ciucescu

    2016-02-01

    Full Text Available The herein article aims to address several specific aspects regarding the definition of nongovernmental organizations, their vision and mission. Also the setting of goals and the presentation of the values of these types of organizations will be presented using a comparative study of literature as a research method. The fields in which nongovernmental organizations operate are very diverse, as are the needs of the community, respectively: education, science, research, culture, social protection, minorities, human rights, environmental protection, child protection, etc. The mission of the organization lies in the ample mentioning of the fundamental goals and of the view regarding the evolution and progress of the organization’s activities, from which the activity field, the market served, as well as the differentiation from other similar organizations, result. Nongovernmental organizations are characterized by a great mobility in the manner of action. Their operation is dependent on the correct identification of the needs of the community and on their ability to attract the funds required to cover them. A nongovernmental organization can play an essential role within the society by identifying certain courses of action, omitted by the public authorities. They can approach the identified niches by using their own organizational skills and human resources or they can offer assistance to the authorities.

  12. Promoting democracy in Ghana: exploring the democratic roles of donor-sponsored non-governmental organizations

    NARCIS (Netherlands)

    Kamstra, J.; Knippenberg, L.W.J.

    2014-01-01

    This article examines the democratic roles performed by Ghanaian non-governmental organizations (NGOs). Drawing on a comparative case study approach, it explores how the organizational characteristics of five donor-sponsored NGOs relate to their ability to perform different democratic roles. Our

  13. 20 CFR 410.470 - Determination by nongovernmental organization or other governmental agency.

    Science.gov (United States)

    2010-04-01

    ... ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.470 Determination by nongovernmental organization or other... death was or was not due to a particular cause, shall not be determinative of the question of whether or...

  14. Social media as a tool for positioning of youth non-governmental organizations activity

    OpenAIRE

    M. A. Shvab

    2014-01-01

    The article is devoted to the social media analysis, as an important tool of the mass media in the youth non-governmental organizations activity. The article is about special popularity of social media among youth because of the rapid information technologies development. The author emphasizes that social media is a main online channel of communication among young generation, that should be taken into the consideration during the external communication creation. Youth organizations often use ...

  15. The changing role of health-oriented international organizations and nongovernmental organizations.

    Science.gov (United States)

    Okma, Kieke G H; Kay, Adrian; Hockenberry, Shelby; Liu, Joanne; Watkins, Susan

    2016-10-01

    Apart from governments, there are many other actors active in the health policy arena, including a wide array of international organizations (IOs), public-private partnerships and non-governmental organizations (NGOs) that state as their main mission to improve the health of (low-income) populations of low-income countries. Despite the steady rise in numbers and prominence of NGOs, however, there is lack of empirical knowledge about their functioning in the international policy arena, and most studies focus on the larger organizations. This has also caused a somewhat narrow focus of theoretical studies. Some scholars applied the 'principal-agent' theory to study the origins of IOs, for example, other focus on changing power relations. Most of those studies implicitly assume that IOs, public-private partnerships and large NGOs act as unified and rational actors, ignoring internal fragmentation and external pressure to change directions. We assert that the classic analytical instruments for understanding the shaping and outcome of public policy: ideas, interests and institutions apply well to the study of IOs. As we will show, changing ideas about the proper role of state and non-state actors, changing positions and activities of major stakeholders in the (international) health policy arena, and shifts in political institutions that channel the voice of diverging interests resulted in (and reflected) the changing positions of the health-oriented organizations-and also affect their future outlook. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand.

    Science.gov (United States)

    Allman, Dan; Ditmore, Melissa Hope; Kaplan, Karyn

    2014-01-01

    This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) guided this work. Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs). Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical and participatory practice in other parts of the world where

  17. European experience of HIV prevention policy among men who have sex with men

    Directory of Open Access Journals (Sweden)

    Klymenko, Nadiia

    2012-07-01

    Full Text Available BACKGROUND: Men who have sex with men (MSM are a high-risk group for HIV. Implementation of effective preventive activities is an important way to combat HIV among MSM. However, in Ukraine there is no real HIV prevention policy among MSM and the need for its formulation is still open. MATERIAL AND METHODS: Analysis of legal acts, national reports and other official documents related to HIV prevention among MSM was carried out for Romania, Slovenia, the Netherlands, and Sweden.RESULTS: European countries use various approaches to HIV prevention among MSM: institutional, structural, and media approach.Countries under consideration have fully specified the minimum standard package for HIV prevention among MSM, who are defined as the highest priority group. Distinct strategies for MSM and ways to achieve them are outlined within the national plans and strategies for combating HIV/AIDS (Slovenia, Romania, the Netherlands. The National plan for HIV prevention among MSM will come into action in 2012 in Sweden. Countries, chosen for this study, use the principle of social contract by which the government provides subsidies and grants to nongovernmental organizations (NGOs working with MSM through its specialized health care units (Slovenia, Sweden, and sometimes only for one national NGO (the Netherlands. Outreach is the most common model of NGO’s activities.. In Sweden, MSM can get counseling and HIV testing in specialized HIV clinic for MSM. HIV prevention among MSM is run by representatives of NGOs through dating sites (Slovenia, Romania, through educating MSM and further promotion of healthy lifestyles among their friends. Along with the behavior modification activities, anti-discrimination strategies are used (Sweden, the Netherlands, Slovenia.CONCLUSIONS: Review of the regulatory frameworks, empowerment of NGOs, implementation of the social contract mechanisms, using interactive tools and providing education for MSM can be key points of HIV

  18. Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand.

    Directory of Open Access Journals (Sweden)

    Dan Allman

    Full Text Available BACKGROUND: This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. METHODS: In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP guided this work. RESULTS: Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs. Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. DISCUSSION: Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical

  19. Chapter 3: International non-governmental organizations in the emerging world society: the example of ISPRM.

    Science.gov (United States)

    Reinhardt, Jan D; von Groote, Per M; DeLisa, Joel A; Melvin, John L; Bickenbach, Jerome E; Li, Leonard S W; Stucki, Gerold

    2009-09-01

    Using the International Society of Physical and Rehabilitation Medicine (ISPRM) as a case in point, the paper describes the complex world societal situation within which non-governmental organizations that address health issues have to operate.This paper describes the complex world societal situation within which non-governmental organizations (NGOs), that are addressing health issues have to operate. In particular, as an international organization in official relation with the World Health Organization (WHO), ISPRM is confronted with a variety of responsibilities and a true world health political mandate. The accompanying rights need to be played out in relation to its own internal member organization and external allies. The theory of the world society and the current situation are briefly reviewed. The role of international NGOs within the world health polity, rehabilitation and Physical and Rehabilitation Medicine (PRM) is highlighted, whilst special emphasis is placed on NGOs in official relation with WHO. Functions, dysfunctions and challenges of international NGOs operating in the health sector are discussed. Against this background, key approaches to enhance ISPRM's political role are analysed. These include transparent and accountable development of the organization, the differentiation between internal and external policy relations, the harmonization of organizational structures and procedures, the consequential use of political structures available to influence WHO's agenda, and the identification of other policy players of major relevance to PRM in order to build strategic alliances with external partners and to enhance ISPRM's membership base.

  20. The role of non-governmental organizations in the social and the health system.

    Science.gov (United States)

    Piotrowicz, Maria; Cianciara, Dorota

    2013-01-01

    The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit.

  1. Structural vulnerability, disability, and access to nongovernmental organization services in rural Cambodia.

    Science.gov (United States)

    Gartrell, Alexandra; Hoban, Elizabeth

    2013-01-01

    Despite the recognition that people with disability are among the poorest and most marginalized, breaking the disability-poverty cycle has proven challenging. Although UN agencies, most donors, and nongovernmental organizations have disability and development policies, many programs perpetuate disability-based discrimination. Little research examines why such programs fail to achieve sustained livelihood improvement for people with disability. Findings from this study that explored the experience of disability in Cambodia suggest that programs must explicitly address social and cultural norms and power relations. Recommendations for inclusive practice are presented. Listening to the voices of people with disability is the crucial first step.

  2. Social media as a tool for positioning of youth non-governmental organizations activity

    Directory of Open Access Journals (Sweden)

    M. A. Shvab

    2014-09-01

    Full Text Available The article is devoted to the social media analysis, as an important tool of the mass media in the youth non-governmental organizations activity. The article is about special popularity of social media among youth because of the rapid information technologies development. The author emphasizes that social media is a main online channel of communication among young generation, that should be taken into the consideration during the external communication creation. Youth organizations often use social media for target audience involvement, information dissimilation and exchange, service promotion and online dialogue. The author analyses different social media tools, such as: blogs, microblogs (Twitter, social networking sites (Facebook, VKontakte, video-sharing websites (YouTube and others. All these tools are easy in use, do not need any special skills and resources, they are low-cost as well. The author considers that it would be useful to include the organization’s Internet addresses on all social media websites and in traditional media publications, to make it as easy as possible for customers to find the youth non-governmental organizations they are looking for among the broad range of social media communities and services.

  3. Mobilizing motherhood: case study of two women's organizations advocating HIV prevention programs in Indonesia

    NARCIS (Netherlands)

    Imelda, J.D.

    2011-01-01

    This PhD project examines the strategy of mobilizing motherhood through two Indonesian women’s organizations - the Pembinaan Kesejahteraan Keluarga (Family Welfare Movement, or PKK) and Tim ODHA Perempuan (Seropositive Women’s Team, or TOP Support) - in the attempt to make prevention of

  4. Non-governmental organizations assisting victims of crime in Belgrade: Survey results

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    Milivojević Sanja K.

    2003-01-01

    Full Text Available This paper presents the results of survey regarding non-governmental organizations assisting victims of crime in Belgrade. The survey was completed at the end of 2002 for purposes of establishing a Victim Support Service in Serbia. In introduction authors give a short review of victim support services development in the World and the region, explaining the need for such service in Serbia, the subject and the aim of the article as well as the purpose of the survey. Second part of the paper contains the sample, methodology and the aim of the interview with NGO representatives. In the third section authors present the analysis of the survey data. Finally, in conclusion authors summarize the data and observed problems, suggestions for possible solution and directions of future development of services and organizations assisting victims of crime in Serbia.

  5. THE ROLE OF NON-GOVERNMENTAL ORGANIZATIONS AS A CHANGE PROMOTER WITHIN EUROPEAN POLICIES

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    Carmen Claudia ARUSTEI

    2014-10-01

    Full Text Available The importance of the non-governmental organization (NGO in implementing specific activities and priorities of European policies increases continuously because of the new environment requirements. Through a qualitative research, our study aims to highlight the catalysts and the main constraints in operationalizing the European policies involving the civil sector. Our approach is integrative and nontheless sequential and it is based on a multi-player model with the identification of the role and types of actions specific to each party involved. A temporal comparative analysis is also made by highlighting the evolution in time of the strategic pillars, the constraints and problems specific to the NGOs. The conclusions of our study are going towards pro-active measures: a fair placement considering the role of NGOs within implementing European policies considering the fact that they can offer consistent support and can undertake innovative actions that generate benefits for the society, community and the organization itself.

  6. Non-governmental organizations and politics of interpretation of South-Slavic’s recent past

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    Radojičić Mirjana

    2005-01-01

    Full Text Available In the text the author considers politics of interpretation of South-Slavic peoples' recent past, which was demonstrated by the most prominent activists of Serbian non-governmental organizations. By summarizing the interpretation in a few points, the author attempts to identify its key features: arrogance and extremism as a style, counter factuality as a strategy and anti-Serbian nationalism and racism as an ideological strongpoint. In the final section of the text, what is pleaded is a precise legal regulation of that delicate area of civil activism, which in the last decade has presented a malignant protuberance on destroyed social tissue of Serbia and serious threat to the rest of its considerably lost national interests.

  7. Strengthening health systems in poor countries: a code of conduct for nongovernmental organizations.

    Science.gov (United States)

    Pfeiffer, James; Johnson, Wendy; Fort, Meredith; Shakow, Aaron; Hagopian, Amy; Gloyd, Steve; Gimbel-Sherr, Kenneth

    2008-12-01

    The challenges facing efforts in Africa to increase access to antiretroviral HIV treatment underscore the urgent need to strengthen national health systems across the continent. However, donor aid to developing countries continues to be disproportionately channeled to international nongovernmental organizations (NGOs) rather than to ministries of health. The rapid proliferation of NGOs has provoked "brain drain" from the public sector by luring workers away with higher salaries, fragmentation of services, and increased management burdens for local authorities in many countries. Projects by NGOs sometimes can undermine the strengthening of public primary health care systems. We argue for a return to a public focus for donor aid, and for NGOs to adopt a code of conduct that establishes standards and best practices for NGO relationships with public sector health systems.

  8. Obstacles to creating an environment conducive to HIV prevention ...

    African Journals Online (AJOL)

    ... who can affect their peers only to a narrow, albeit crucial extent. The external environment thus remains adverse to HIV prevention. Keywords: development management, HIV/AIDS, multiple-case study, non-governmental organisations, public sector, social change, South Africa, strategic planning, youth. African Journal of ...

  9. The role of space related non-governmental organizations (NGOs) in capacity building

    Science.gov (United States)

    Lukaszczyk, A.; Williamson, R.

    2010-02-01

    Non-governmental organizations (NGOs) play a unique role in international affairs, providing access to resources, expertise, and assistance to supplement State resources. Sometimes the diplomatic skills and unofficial access of NGOs to policymakers through Track Two diplomacy can move a previously stalled critical issue forward and assist policymakers from different countries to find common ground outside official channels. Because they work outside of official channels, they are not bound by State policy that may inhibit negotiations between States. Some also have a convening power that sometimes makes it possible for State representatives to meet discipline experts and each other for informal discussions on issues of mutual interest. Finally, NGOs can draw attention to issues that may be overlooked or avoided by State organizations. This paper examines the ways in which NGOs can assist in building scientific, technical, educational, and legal and policy expertise related to space and Earth science, technology and governance of space activities. In particular, it will explore and analyze the ways in which organizations such as the Space Generation Advisory Council, EURISY, the Planetary Society and Secure World Foundation contribute to building capacity in developing countries.

  10. The Role of Nongovernmental Organizations in Primary Education: A Study of Six NGOs in India. Working Paper.

    Science.gov (United States)

    Jagannathan, Shanti

    Nongovernmental organizations (NGOs) working in education in India are professional resource centers and innovators able to reach children who are educationally disadvantaged. The Indian government could improve the effectiveness of primary education by increasing its collaboration with NGOs. India has an arduous task ahead to provide good quality…

  11. A Conceptual Model for Supporting Para-Teacher Learning in an Indian Non-Governmental Organization (NGO)

    Science.gov (United States)

    Raval, Harini; McKenney, Susan; Pieters, Jules

    2010-01-01

    Non-governmental organizations (NGOs) are being recognized globally for their influential role in realizing the UN Millennium Development Goal of education for all in developing countries. NGOs mostly employ untrained para-educators for grassroots activities. The professional development of these teachers is critical for NGO effectiveness, yet…

  12. The role of nongovernmental organizations in fire education, fuels reduction, and forest restoration: a call for collaboration

    Science.gov (United States)

    Timothy Ingalsbee; Daniel Henry; Oshana Catranides; Todd. Schulke

    2008-01-01

    Successfully educating homeowners and communities about wildland fire ecology and management, reducing hazardous fuels, and restoring fire-adapted forest ecosystems will place enormous demands on the budgets, resources, and staff of federal agencies for several decades to come. This work can be aided by collaboration with non-governmental organizations (NGOs) that are...

  13. [Non-Governmental Organizations in the area of Child Healthcare - review of the literature].

    Science.gov (United States)

    Costa, Ana Maria Aranha Magalhães; Silva, Kátia Silveira da; Bonan, Cláudia

    2011-07-01

    The second half of the twentieth century saw the emergence of organizations that reflected the mobilization of civil society for more effective participation in questions in the public interest and of a social nature. These became known as non-governmental organizations (NGOs) and they assumed their place as partners with public and private sectors to develop actions in different areas, including healthcare. Based on a review of the literature, the scope of this paper was to assess the status of scientific knowledge on the participation of NGOs in child healthcare and, by identifying and classifying their activities, establish if they are in line with the agenda of the field. Analysis of the publications took into consideration where the authors were from, the journal in question, the origins and area of activity of the NGOs and the source of the funds applied to the projects implemented. The nature of activities varied with the degree of development of the region where the NGOs operated and the themes, partnership between government and private sector agencies, sustainability and impact of actions on the favored communities were the main topics highlighted by the authors. The conclusion reached was that the performance of NGOs in child health is in the early stages and is a knowledge field to be explored.

  14. Exploring fragility: industrial delocalization, occupational and environmental risks, and non-governmental organizations.

    Science.gov (United States)

    Rigotto, Raquel Maria

    2009-03-01

    What is the role of non-governmental organizations--NGOs--in the process of industrial delocalization and socio-spatial redistribution of occupational and environmental risks? In an attempt to contribute to this debate, this study approaches the issue in a very specific socio-historical context, marked by recent accelerated industrialization in a small town in Northeast Brazil. Based on semi-structured interviews with leaders of four local NGOs, the way they perceive and value the risks introduced into the area and relations between industrialization and local development are analyzed. Findings show a strong adherence to the industrial plan by workers' trade unions, whilst other NGOs are highly critical with regard thereto, but undertake no social or political activity regarding the issues they identify. This phenomenon is discussed in terms of the modus operandi of ideology and its strategies for symbolic construction, enabling a comprehensive reinterpretation of how capital also benefits, in its mobility, from local society's fragility in organizing and protecting quality of life and public health.

  15. The participation of non-governmental organizations in the Philippine population program.

    Science.gov (United States)

    1989-01-01

    In 1957 the National Council of Churches in the Philippines (NCCP) established the Family Welfare Center, offering an educational program in family planning; it was subsequently expanded and reorganized into the Planned Parenthood Movement of the Philippines. Since its creation in 1970 the Philippine Population Program has brought together government, private, and religious activities. Under the 1987-92 development plan nongovernmental organizations (NGOs) will be taking a more active role in the implementation of the population program by contributing to the maternal and child health/family planning and the information, education, and communication (IEC) components. There are more than 50 private organizations engaged in such population activities. These include national women's organizations and development NGOs with a mass base. The Family Planning Organization of the Philippines is carrying out a 3-year comparative study of the effectiveness of community volunteers in the acceptance of natural family planning. The Reproductive Health Philippines has completed a follow-up of Depo Provera defaulters in a previous clinical study of Depo Provera acceptors conducted in 1985-87. IEC support from various medical and social organizations also helped advance family planning and population awareness of the program. The Mary Johnston Hospital and Iglesia ni Kristo have been front-runners in sterilization through their mobile teams and regular clinics. On the negative side, funding constraints are threatening the very existence of some NGOs. Even those that do not face such constraints face problems related to cost effectiveness, priority setting, capability building, and staff development. A survey of the Population Center Foundation identified some urgent concerns: sharing experience in self-reliance, enhancement of the managerial skills of staff, and funding problems. NGOs complement the family planning services of the government as well as focus on the smooth flow of

  16. Research review of nongovernmental organizations' security policies for humanitarian programs in war, conflict, and postconflict environments.

    Science.gov (United States)

    Rowley, Elizabeth; Burns, Lauren; Burnham, Gilbert

    2013-06-01

    To identify the most and least commonly cited security management messages that nongovernmental organizations (NGOs) are communicating to their field staff, to determine the types of documentation that NGOs most often use to communicate key security messages, and to distinguish the points of commonality and divergence across organizations in the content of key security messages. The authors undertook a systematic review of available security policies, manuals, and training materials from 20 international humanitarian NGOs using the InterAction Minimum Operating Security Standards as the basis for a review framework. The most commonly cited standards include analytical security issues such as threat and risk assessment processes and guidance on acceptance, protection, and deterrence approaches. Among the least commonly cited standards were considering security threats to national staff during staffing decision processes, incorporating security awareness into job descriptions, and ensuring that national staff security issues are addressed in trainings. NGO staff receive security-related messages through multiple document types, but only 12 of the 20 organizations have a distinct security policy document. Points of convergence across organizations in the content of commonly cited standards were found in many areas, but differences in security risk and threat assessment guidance may undermine communication between aid workers about changes in local security environments. Although the humanitarian community has experienced significant progress in the development of practical staff security guidance during the past 10 years, gaps remain that can hinder efforts to garner needed resources, clarify security responsibilities, and ensure that the distinct needs of national staff are recognized and addressed.

  17. Harnessing a community for sustainable disaster response and recovery: an operational model for integrating nongovernmental organizations.

    Science.gov (United States)

    Acosta, Joie; Chandra, Anita

    2013-08-01

    Nongovernmental organizations (NGOs) are important to a community during times of disaster and routine operations. However, their effectiveness is reduced without an operational framework that integrates response and recovery efforts. Without integration, coordination among NGOs is challenging and use of government resources is inefficient. We developed an operational model to specify NGO roles and responsibilities before, during, and after a disaster. We conducted an analysis of peer-reviewed literature, relevant policy, and federal guidance to characterize the capabilities of NGOs, contextual factors that determine their involvement in disaster operations, and key services they provide during disaster response and recovery. We also identified research questions that should be prioritized to improve coordination and communication between NGOs and government. Our review showed that federal policy stresses the importance of partnerships between NGOs and government agencies and among other NGOs. Such partnerships can build deep local networks and broad systems that reach from local communities to the federal government. Understanding what capacities NGOs need and what factors influence their ability to perform during a disaster informs an operational model that could optimize NGO performance. Although the operational model needs to be applied and tested in community planning and disaster response, it holds promise as a unifying framework across new national preparedness and recovery policy, and provides structure to community planning, resource allocation, and metrics on which to evaluate NGO disaster involvement.

  18. Environmental non-governmental organizations and urban environmental governance: Evidence from China.

    Science.gov (United States)

    Li, Guangqin; He, Qiao; Shao, Shuai; Cao, Jianhua

    2018-01-15

    Environmental non-governmental organizations (ENGOs) play an increasingly important role in the process of urban environmental governance, especially in some developing countries such as China. However, existing studies pay little attention to such an issue in China. In this paper, we consider 113 cities in China from the pollution information transparency index (PITI) list released by ENGOs as the treatment group and some other cities as the control group, and use the difference-in-differences (DID) model and propensity score matching DID (PSM-DID) model to explore the role of ENGOs in China's urban environmental governance. The results show that ENGOs play a significantly positive and robust role in China's urban environmental governance. Furthermore, using regression analysis for eastern, central, and western China, we find that the influence of ENGOs exists in eastern and central China rather than in western China. In addition, the results of the Placebo test indicate that the effect of ENGOs shows an upward trend since 2008. We suggest that ENGOs' role should be strengthened in China, and governments at various levels should take into account environmental information released by ENGOs and consider appropriate measures to improve local environment quality using the obtained information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Conservation partnerships between Zoos and Aquariums, federal and state agencies, and nongovernmental organizations.

    Science.gov (United States)

    Smith, Kathleen N; Shaw, James H; Bettinger, Tammie; Caniglia, Beth; Carter, Tracy

    2007-11-01

    Partnerships are essential for the success of conservation organizations as they strive to achieve the ultimate goal of restoring and preserving biodiversity. Now is a particularly crucial time to develop partnerships owing to increasing financial constraints on all organizations and the urgent need for species recovery and habitat preservation. This study identified characteristics of successful conservation partnerships between Association of Zoos and Aquariums (AZA) accredited institutions and related facilities, US and international governmental agencies, and nongovernmental organizations. One hundred and five AZA accredited zoos and aquariums or related facilities participated in the preliminary survey. Staff at 75 of those zoos and aquariums were interviewed by telephone for a follow-up survey. Respondents were asked which characteristics most contributed to the success of their past and current conservation partnerships. Data were analyzed in two ways: descriptive statistics and principal component analysis. Descriptive statistics showed that effective leadership, clear and consistent communication, and trust between partners were the top three characteristics that led to partnership success. Ineffective leadership by those in charge, lack of clear, consistent communication between partners, and unreliable or insufficient sources of funding were the top three characteristics that inhibited partnership success. Using principal component analysis, the variables for each question on the questionnaire were reduced to a smaller subset of categories. Structure, personalities, process, and commitment were the four principal components of successful conservation partnerships. The three principal components that inhibited conservation partnerships were: communication, partnership personnel, and partner inequality. Results gained from this research are sure to increase the probability of success both for conservation partnerships that have already been established and

  20. FORUM OF POLITICAL PARTIES, THINK TANKS AND NON-GOVERNMENTAL ORGANIZATIONS OF THE BRICS GROUP

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    E. Gladun

    2017-01-01

    Full Text Available The Joint International Forum of Political Parties, Think Tanks and NonGovernmental Organizations of the BRICS took place in Fuzhou, China on 10–12 June 2017. The event was hosted jointly by the International Department of the Central Committee of the Communist Party of China, the China Council for BRICS Think Tank Cooperation and the China NGO Network for International Exchanges.For the first time in the story of BRICS cooperation the countries’ representatives witnessed the renewed format of the BRICS Academic Forum – two traditional tracks (academic conference and civil track were supplemented by the assembly of political parties. Taking its turn in chairing the multinational BRICS association in 2017, China proposed this new Forum format and joined together three dialogues that had grown out of the BRICS Academic Forum, which took place now for the ninth time.1 Another innovation on China’s part was the outreach format – representatives of 28 countries, including Indonesia, Malaysia, the Philippines, Cambodia, Egypt, Nigeria, Ethiopia, Kenya, Argentina, Chile and Mexico among others took part.The Joint International Forum was a truly large-scale international event – 37 political parties of 26 countries, 105 think tanks, and over 400 representatives of 79 civil society organizations were in attendance.2The Forum participants engaged in separate deliberations at the BRICS Academic Forum on “Pooling Wisdom and New Ideas for Cooperation,” the BRICS Civil Society Organizations Forum on “Stronger People-to-People Bond for Better Cooperation,” and the BRICS Political Parties Dialogue on the “Guiding Role of Political Parties in Promoting Cooperation.” The Forum was a complete success with broad consensus.

  1. An intervention to help community-based organizations implement an evidence-based HIV prevention intervention: the Mpowerment Project technology exchange system.

    Science.gov (United States)

    Kegeles, Susan M; Rebchook, Gregory; Pollack, Lance; Huebner, David; Tebbetts, Scott; Hamiga, John; Sweeney, David; Zovod, Benjamin

    2012-03-01

    Considerable resources have been spent developing and rigorously testing HIV prevention intervention models, but such models do not impact the AIDS pandemic unless they are implemented effectively by community-based organizations (CBOs) and health departments. The Mpowerment Project (MP) is being implemented by CBOs around the U.S. It is a multilevel, evidence-based HIV prevention program for young gay/bisexual men that targets individual, interpersonal, social, and structural issues by using empowerment and community mobilization methods. This paper discusses the development of an intervention to help CBOs implement the MP called the Mpowerment Project Technology Exchange System (MPTES); CBOs' uptake, utilization and perceptions of the MPTES components; and issues that arose during technical assistance. The seven-component MPTES was provided to 49 CBOs implementing the MP that were followed longitudinally for up to two years. Except for the widely used program manual, other program materials were used early in implementing the MP and then their use declined. In contrast, once technical assistance was proactively provided, its usage remained constant over time, as did requests for technical assistance. CBOs expressed substantial positive feedback about the MPTES, but felt that it needs more focus on diversity issues, describing real world implementation approaches, and providing guidance on how to adapt the MP to diverse populations.

  2. What Role Should Environmental and Conservation Nongovernmental Organizations Play in Science Communication?

    Science.gov (United States)

    Staudt, A. C.

    2008-12-01

    Communication of a scientific topic as complex and multifaceted as climate change requires multiple strategies that are effective for reaching different audiences. The scientific community plays a pivotal role in advancing public understanding of climate change, generally via statements issued by professional societies, synthesis assessments, and media coverage of research publications. These efforts can be especially influential in the national public policy arena, but are not always the best means for educating the general public. Indeed, polls of the American public's views on climate change present a contradictory picture: a large majority of Americans agree that climate change is taking place, but many have a fundamental lack of understanding as to what causes it or how it might impact them. This results in confusion about what are the best solutions for addressing climate change. In addition, large science organizations may be ill equipped to communicate about regional and local climate impacts and responses. Environmental and conservation nongovernmental organizations (NGOs) can help bridge these gaps in understanding by translating scientific information and making it relevant to targeted audiences. NGOs can be effective messengers because they often have extensive grassroots networks, staff focused on regional and local issues, and high credibility with their respective constituencies. Furthermore, NGOs typically devote considerable resources to communication, from developing print, web, and video materials for their outreach efforts to cultivating relationships with the media. However, NGOs that are involved in advocacy run the risk of being considered biased in their presentation of scientific information. For this reason, partnerships with scientists can be an effective way for NGOs to avoid the perception of bias and use their resources to greatly expand the understanding and relevancy of research results. Examples will be presented of the National

  3. Regional Environmental Non-Governmental Organizations: Between Resistance and Utopia, Some Reflections.

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    Jussara da Silva Tavares

    2015-01-01

    Full Text Available This paper has as its main objective the comprehension and analysis of the environmental action effectiveness of Non-Governmental Organizations (NGOs which are inserted in the region of the Hydrographic Basins of rivers "Turvo" and "Grande", and their relation with the others who act in this interactive field in order to understand what is being built in these regions considering the environmental issue. Material and Methodology: direct research in the selected NGOs and bibliographic review: NGOs, environmental legislation and participative democracy. Results: Participation in the survey data for the diagnosis of the current situation of hydric resource and the establishment of guidelines for the Plan of Hydrographic Basins of "Turvo" and "Grande" – Report Zero and in the Basins of "Turvo" and "Grande" Committee, actions in Environmental Education and reforestation/revegetation of part of the riparian forest and the protection of water sources. Conclusion: The environmental NGOs have played the protagonist role in the process of social transformation, with representativeness and competence to add people, institutions and resources to defend environment. Their acts show evidences that it's possible to overcome the environmental damages and they contribute to a reflection about the environment, means of organization and popular participation. The NGOs actions are often blocked by the game of interests that feeds the backstage of environmental matter. Business people pressure, lack of political will from the politicians to break the favor culture that was taken forward in relation to big interests; all these factors take part in the inhibition circuit that hinders the NGOs acts many times.

  4. Experiences about HIV-AIDS preventive-control activities. Discourses from non-governmental organizations professionals and users.

    Science.gov (United States)

    Berenguera, Anna; Pujol-Ribera, Enriqueta; Violan, Concepció; Romaguera, Amparo; Mansilla, Rosa; Giménez, Albert; Almeda, Jesús

    2011-01-01

    The main aim of this study was to identify the experiences of professionals in nongovernmental organizations (NGO) in Catalonia (Spain) working in HIV/AIDS prevention and control activities and potential areas of improvement of these activities and their evaluation. A further aim was to characterize the experiences, knowledge and practices of users of these organizations with regard to HIV infection and its prevention. A phenomenological qualitative study was conducted with the participation of both professionals and users of Catalan nongovernmental organizations (NGO) working in HIV/AIDS. Theoretical sampling (professional) and opportunistic sampling (users) were performed. To collect information, the following techniques were used: four focus groups and one triangular group (professionals), 22 semi-structured interviews, and two observations (users). A thematic interpretive content analysis was conducted by three analysts. The professionals of nongovernmental organizations working in HIV/AIDS adopted a holistic approach in their activities, maintained confidentiality, had cultural and professional competence and followed the principles of equality and empathy. The users of these organizations had knowledge of HIV/AIDS and understood the risk of infection. However, a gap was found between knowledge, attitudes and behavior. NGO offer distinct activities adapted to users' needs. Professionals emphasize the need for support and improvement of planning and implementation of current assessment. The preventive activities of these HIV/AIDS organizations are based on a participatory health education model adjusted to people's needs and focused on empowerment. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. The activities of non-governmental organizations for equal educational opportunities for children from the rural environment

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    KATARZYNA PALKA

    2017-10-01

    Full Text Available We live in a world where the access to knowledge has a decisive influence on our future. A large number of children in Poland have difficulties with this access, because they are raised in impoverished, excluded, poorly educated families of low social status. This phenomenon is mainly related to rural areas. Nonformal education should provide important support for formal education. Nonformal education should be organized with the cooperation of schools, kindergartens, and non-governmental organizations. The educational activities proposed for children and their parents by non-governmental organizations complement formal education. These activities are of crucial importance in the equalization of educational opportunities for children from rural areas. It is essential that these activities be planned, long-term, and a part of the entire educational program

  6. The Correspondence of Preventive Social Work of Non-governmental Organizations (NGO) the Actual Social Problems in Latvia

    OpenAIRE

    Bičkovska, Anna

    2012-01-01

    The subject of diploma work is „The Corespondance of Preventive Social Work of Non-governmental Organizations (NGO) the Actual Social Problems in Latvia”. An object of diploma paper is to research the corespondance of preventive social work of NGO the actual social problems in Latvia. Work is structured in five chapters with nine subchapters. Conclusion includes results and discussion which discloses results of empiric research. In the diploma work the authors theoretically analyse ...

  7. Unpacking Donor Retention: Individual Monetary Giving to U.S.-Based Christian Faith-Related, International Nongovernmental Organizations

    OpenAIRE

    Ramya Ramanath

    2016-01-01

    This article examines an important but relatively overlooked aspect in the field of international giving in the U.S.—individual monetary donations to Christian faith-related international nongovernmental organizations (INGOs)—and outlines the cognitive process influencing donors who choose to keep up their financial support to Christian faith-related INGOs. The propositions forwarded in this article draw on existing literature on Christian giving to international causes, INGO management, dono...

  8. The Role of Non-Governmental Non-Profit Organizations in the Provision of Social Services and the Palliation of Poverty

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    Mihaela Bronić

    2005-01-01

    Full Text Available After introductory considerations, arguments are put forward for non-governmental organisations as exclusive providers of social services. The negative characteristics of the non-governmental organization are subject of the third part of the paper. In the fourth part, the meaning of the social funds is explained (they are a kind of non-governmental organisations, and in Part 5, we explain the importance of the synergy between the government and society in the provision of social services. After the explanation of the situation in Croatia, in the Part 6 of the paper we give our final considerations. In Croatia non-governmental organizations that provide social services are slowly developing. In their further strengthening it is necessary to change the general viewpoints concerning the role and importance of the non-governmental sector in the alleviation of poverty, as well as to achieve better coordination between the state and the sector.

  9. Demographic and behavioral correlates of HIV risk among men and transgender women recruited from gay entertainment venues and community-based organizations in Thailand: implications for HIV prevention.

    Science.gov (United States)

    Newman, Peter A; Lee, Sung-Jae; Roungprakhon, Surachet; Tepjan, Suchon

    2012-10-01

    High HIV prevalence among men who have sex with men (MSM) and transgender women in Thailand suggest a vital need for targeted interventions. We conducted a cross-sectional survey to examine and compare sexual risk behaviors, and demographic and behavioral correlates of risk, among MSM and transgender women recruited from gay entertainment venue staff and community-based organization (CBO) participants. We used venue-based sampling across nine sites in Bangkok and Chiang Mai. Among 260 participants (57.3% gay-identified, 26.9% heterosexual/bisexual-identified, 15.8% transgender; mean age = 26.7 years), nearly one-fifth (18.5%) reported unprotected anal sex (UAS), half (50.4%) sex in exchange for money, and one-fifth (20.0%) STI diagnosis (past year). Nearly one-fourth (23.1%) reported oral erectile dysfunction medication use and nearly one-fifth (19.2%) illicit drug use (past 3 months). Overall, 43.1% indicated that healthcare providers exhibited hostility towards them. Gay entertainment venue staff were significantly more likely to self-identify as heterosexual/bisexual (versus gay or transgender female), and to have less than high school degree education, higher monthly income, to have engaged in sex in exchange for money, sex with women and unprotected vaginal sex, but were significantly less likely to have engaged in UAS than CBO participants. Targeted interventions for younger MSM and transgender women, for non gay-identified men, and strategies to address structural determinants of risk, including low education and discrimination from healthcare providers, may support HIV prevention among MSM and transgender women, and serve broader national HIV prevention efforts in Thailand.

  10. Non-Governmental Organization Leadership And Development. A Review Of The Literature

    OpenAIRE

    Dragos – Catalin Apostu

    2013-01-01

    Leaders of the Non-Governmental Organisations (NGOs) often face extraordinary challenges – both at a personal and organisational level. These challenges are demanding, and distinct from those faced by governments or the for-profit sector. NGO leaders are often isolated and unsupported. There is talk of a leadership deficit, because of the shortage of talented leaders and the growth of the non-profit sector generally. As a result there is some urgency in attempts to develop a new generation of...

  11. Significance of Non-Governmental Sport Organizations during the Integration Process of Russian-Speaking Immigrants in Finland

    OpenAIRE

    Gavrilova, Iuliia

    2016-01-01

    According to the annual report on immigration published by Statistics Finland in 2012, over a quarter of a million foreign-language speakers lived in Finland, and more than 60,000 of them were Russian speakers. By the end of 2012, foreign-language speakers accounted for 4.9% of the population. Those speaking Russian as their native language formed the largest group (62,554 people). The purpose of this thesis was to identify the role of SPINNISKOLA as a non-governmental sport organization ...

  12. Non-Governmental Organization Leadership And Development. A Review Of The Literature

    Directory of Open Access Journals (Sweden)

    Dragoș – Cătălin Apostu

    2013-05-01

    Full Text Available Leaders of the Non-Governmental Organisations (NGOs often face extraordinary challenges – both at a personal and organisational level. These challenges are demanding, and distinct from those faced by governments or the for-profit sector. NGO leaders are often isolated and unsupported. There is talk of a leadership deficit, because of the shortage of talented leaders and the growth of the non-profit sector generally. As a result there is some urgency in attempts to develop a new generation of leaders, and to provide relevant support to existing and future leaders. Leadership development programmes designed for NGO leaders must as a consequence incorporate best practice and current experience rather than rehashing tired, traditional approaches to leadership training. This paper examines the role of leaders and leadership in NGOs. It draws on the analysis of recent research into the characteristics of NGO leaders, and explores the challenges of designing leadership development programmes appropriate to the needs of NGOs. This paper identifies the elements of successful leadership development, and assesses the skills or competencies that need be developed.

  13. Female sex worker social networks and STI/HIV prevention in South China.

    Science.gov (United States)

    Tucker, Joseph D; Peng, Hua; Wang, Kaidi; Chang, Helena; Zhang, Sen-Miao; Yang, Li-Gang; Yang, Bin

    2011-01-01

    Reducing harm associated with selling and purchasing sex is an important public health priority in China, yet there are few examples of sustainable, successful programs to promote sexual health among female sex workers. The limited civil society and scope of nongovernmental organizations circumscribe the local capacity of female sex workers to collectively organize, advocate for their rights, and implement STI/HIV prevention programs. The purpose of this study was to examine social networks among low-income female sex workers in South China to determine their potential for sexual health promotion. Semi-structured interviews with 34 low-income female sex workers and 28 health outreach members were used to examine how social relationships affected condom use and negotiation, STI/HIV testing and health-seeking behaviors, and dealing with violent clients. These data suggested that sex worker's laoxiang (hometown social connections) were more powerful than relationships between women selling sex at the same venue in establishing the terms and risk of commercial sex. Female sex workers from the same hometown often migrated to the city with their laoxiang and these social connections fulfilled many of the functions of nongovernmental organizations, including collective mobilization, condom promotion, violence mitigation, and promotion of health-seeking behaviors. Outreach members observed that sex workers accompanied by their laoxiang were often more willing to accept STI/HIV testing and trust local sexual health services. Organizing STI/HIV prevention services around an explicitly defined laoxiang social network may provide a strong foundation for sex worker health programs. Further research on dyadic interpersonal relationships between female sex workers, group dynamics and norm establishment, and the social network characteristics are needed.

  14. An analysis of the implementation of PEPFAR's anti-prostitution pledge and its implications for successful HIV prevention among organizations working with sex workers.

    Science.gov (United States)

    Ditmore, Melissa Hope; Allman, Dan

    2013-03-28

    Since 2003, US government funding to address the HIV and AIDS pandemic has been subject to an anti-prostitution clause. Simultaneously, the efficacy of some HIV prevention efforts for sex work in areas receiving US government funding has diminished. This article seeks to explain why. This analysis utilizes a case story approach to build a narrative of defining features of organizations in receipt of funding from the President's Emergency Plan for AIDS Relief (PEPFAR) and other US funding sources. For this analysis, multiple cases were compiled within a single narrative. This helps show restrictions imposed by the anti-prostitution clause, any lack of clarity of guidelines for implementation and ways some agencies, decision-making personnel, and staff on the ground contend with these restrictions. Responses to PEPFAR's anti-prostitution clause vary widely and have varied over time. Organizational responses have included ending services for sex workers, gradual phase-out of services, cessation of seeking US government HIV funds and increasing isolation of sex workers. Guidance issued in 2010 did not clarify what was permitted. Implementation and enforcement has been dependent in part on the interpretations of this policy by individuals, including US government representatives and organizational staff. Different interpretations of the anti-prostitution clause have led to variations in programming, affecting the effectiveness of work with sex workers. The case story approach proved ideal for working with information like this that is highly sensitive and vulnerable to breach of anonymity because the method limits the potential to betray confidences and sources, and limits the potential to jeopardize funding and thereby jeopardize programming. This method enabled us to use specific examples without jeopardizing the organizations and individuals involved while demonstrating unintended consequences of PEPFAR's anti-prostitution pledge in its provision of services to sex

  15. An analysis of the implementation of PEPFAR's anti-prostitution pledge and its implications for successful HIV prevention among organizations working with sex workers

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    Melissa Hope Ditmore

    2013-03-01

    Full Text Available Introduction: Since 2003, US government funding to address the HIV and AIDS pandemic has been subject to an anti-prostitution clause. Simultaneously, the efficacy of some HIV prevention efforts for sex work in areas receiving US government funding has diminished. This article seeks to explain why. Methods: This analysis utilizes a case story approach to build a narrative of defining features of organizations in receipt of funding from the President's Emergency Plan for AIDS Relief (PEPFAR and other US funding sources. For this analysis, multiple cases were compiled within a single narrative. This helps show restrictions imposed by the anti-prostitution clause, any lack of clarity of guidelines for implementation and ways some agencies, decision-making personnel, and staff on the ground contend with these restrictions. Results: Responses to PEPFAR's anti-prostitution clause vary widely and have varied over time. Organizational responses have included ending services for sex workers, gradual phase-out of services, cessation of seeking US government HIV funds and increasing isolation of sex workers. Guidance issued in 2010 did not clarify what was permitted. Implementation and enforcement has been dependent in part on the interpretations of this policy by individuals, including US government representatives and organizational staff. Conclusions: Different interpretations of the anti-prostitution clause have led to variations in programming, affecting the effectiveness of work with sex workers. The case story approach proved ideal for working with information like this that is highly sensitive and vulnerable to breach of anonymity because the method limits the potential to betray confidences and sources, and limits the potential to jeopardize funding and thereby jeopardize programming. This method enabled us to use specific examples without jeopardizing the organizations and individuals involved while demonstrating unintended consequences of PEPFAR

  16. An analysis of the implementation of PEPFAR's anti-prostitution pledge and its implications for successful HIV prevention among organizations working with sex workers

    Science.gov (United States)

    Ditmore, Melissa Hope; Allman, Dan

    2013-01-01

    Introduction Since 2003, US government funding to address the HIV and AIDS pandemic has been subject to an anti-prostitution clause. Simultaneously, the efficacy of some HIV prevention efforts for sex work in areas receiving US government funding has diminished. This article seeks to explain why. Methods This analysis utilizes a case story approach to build a narrative of defining features of organizations in receipt of funding from the President's Emergency Plan for AIDS Relief (PEPFAR) and other US funding sources. For this analysis, multiple cases were compiled within a single narrative. This helps show restrictions imposed by the anti-prostitution clause, any lack of clarity of guidelines for implementation and ways some agencies, decision-making personnel, and staff on the ground contend with these restrictions. Results Responses to PEPFAR's anti-prostitution clause vary widely and have varied over time. Organizational responses have included ending services for sex workers, gradual phase-out of services, cessation of seeking US government HIV funds and increasing isolation of sex workers. Guidance issued in 2010 did not clarify what was permitted. Implementation and enforcement has been dependent in part on the interpretations of this policy by individuals, including US government representatives and organizational staff. Conclusions Different interpretations of the anti-prostitution clause have led to variations in programming, affecting the effectiveness of work with sex workers. The case story approach proved ideal for working with information like this that is highly sensitive and vulnerable to breach of anonymity because the method limits the potential to betray confidences and sources, and limits the potential to jeopardize funding and thereby jeopardize programming. This method enabled us to use specific examples without jeopardizing the organizations and individuals involved while demonstrating unintended consequences of PEPFAR's anti

  17. Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis

    Science.gov (United States)

    Holland, Claire E.; Papworth, Erin; Billong, Serge C.; Kassegne, Sethson; Petitbon, Fanny; Mondoleba, Valentin; Moukam, Laure Vartan; Macauley, Isaac; Eyene Ntsama, Simon Pierre; Yomb, Yves Roger; Eloundou, Jules; Mananga, Franz; Tamoufe, Ubald; Baral, Stefan D.

    2015-01-01

    Background Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM. Methods An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala. Results MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01). Conclusions With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV. PMID:25906046

  18. Bridging the gap: the role of pharmacists in managing the drug supply cycle within non-governmental organizations.

    Science.gov (United States)

    Villacorta-Linaza, Rocio

    2009-10-01

    Access to essential medicines remains one of the biggest problems that developing countries are facing in health care systems. Non-governmental organizations (NGOs) are implementing health programmes on the ground in areas affected by natural disasters or conflict. A vital component of these health programmes is the drug supply system. Based on a field research conducted in Pakistan 2007 and a field work experience in Afghanistan within an international NGO-Merlin-this paper analysed the four functions of the Drug Supply Cycle (Selection, Procurement, Distribution and Use) focusing attention on the importance in management support systems once the emergency phase is over. It shows the core role that the pharmacist plays within NGOs as a member of the health staff with the ability to improve the management of the Drug Supply Cycle. Copyright (c) 2009 John Wiley & Sons, Ltd.

  19. Unpacking Donor Retention: Individual Monetary Giving to U.S.-Based Christian Faith-Related, International Nongovernmental Organizations

    Directory of Open Access Journals (Sweden)

    Ramya Ramanath

    2016-11-01

    Full Text Available This article examines an important but relatively overlooked aspect in the field of international giving in the U.S.—individual monetary donations to Christian faith-related international nongovernmental organizations (INGOs—and outlines the cognitive process influencing donors who choose to keep up their financial support to Christian faith-related INGOs. The propositions forwarded in this article draw on existing literature on Christian giving to international causes, INGO management, donor retention and finally, the logic of self-perception to highlight how existing donors might evaluate their repeat giving decision. The more existing donors of Christian faith-related INGOs can identify themselves with the INGO’s identity—comprising its beliefs and values, its claims to legitimacy, and performance—the more likely it is for donors to be satisfied and decide to maintain a stable relationship with the specific INGO.

  20. Impact evaluation to communicate and improve conservation non-governmental organization performance: the case of Conservation International.

    Science.gov (United States)

    McKinnon, Madeleine C; Mascia, Michael B; Yang, Wu; Turner, Will R; Bonham, Curan

    2015-11-05

    The rising prominence of more rigorous approaches to measuring conservation outcomes has included greater adoption of impact evaluation by conservation non-governmental organizations (CNGOs). Within the scientific literature, however, little consideration has been given to the unique and specific roles of CNGOs in advancing impact evaluation. We explore these issues in the context of one CNGO-Conservation International (CI)-and its experiences producing, using and funding impact evaluations over the past decade. We examine the contributions of impact evaluation to CI's mission at three different stages of CI's strategy: innovation, demonstration and amplification. Furthermore, we review incentives and barriers encountered by CI in its 10+ years' experience in impact evaluation. More coordinated and strategic use of impact evaluation by CNGOs would facilitate learning and promote accountability across the conservation community. © 2015 The Author(s).

  1. The role of non-governmental organizations in global health diplomacy: negotiating the Framework Convention on Tobacco Control.

    Science.gov (United States)

    Lencucha, Raphael; Kothari, Anita; Labonté, Ronald

    2011-09-01

    The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions among state officials, has witnessed the dilution of its state-centric origins with the inclusion of non-governmental organizations (NGOs) in the diplomacy process. To engage in the discourse of global health diplomacy, NGO diplomats are immediately presented with two challenges: to convey the interests of larger publics and to contribute to inter-state negotiations in a predominantly state-centric system of governance that are often diluted by pressures from private interests or mercantilist self-interest on the part of the state itself. How do NGOs manage these challenges within the process of global health diplomacy itself? What roles do, and can, they play in achieving new forms of global health diplomacy? This paper addresses these questions through presentation of findings from a study of the roles assumed by one group of non-governmental actors (the Canadian NGOs) in the FCTC negotiations. The findings presented are drawn from a larger grounded theory study. Qualitative data were collected from 34 public documents and 18 in-depth interviews with participants from the Canadian government and Canadian NGOs. This analysis yielded five key activities or roles of the Canadian NGOs during the negotiation of the FCTC: monitoring, lobbying, brokering knowledge, offering technical expertise and fostering inclusion. This discussion begins to address one of the key goals of global health diplomacy, namely 'the challenges facing health diplomacy and how they have been addressed by different groups and at different levels of

  2. Male circumcision and HIV prevention.

    Science.gov (United States)

    Vardi, Yoram; Sadeghi-Nejad, Hossein; Pollack, Shimon; Aisuodionoe-Shadrach, Oseremen I; Sharlip, Ira D

    2007-07-01

    Growing evidence has linked circumcision with some protection against HIV infection. Should nations with a high HIV infection rate encourage male circumcision? Four people with expertise and/or interest in the area of circumcision and HIV were asked to contribute their opinions. To provide food for thought, discussion, and possible further research in a poorly discussed area of sexual medicine. Three clinical trials in Africa showed the benefit of circumcision in reducing HIV incidence in men. Sadeghi-Nejad cites these, but balances this with the pandemic in India, and the cultural implications of circumcision. Pollack cites these studies as well, but reinforces the World Health Organization and UNAIDS recommendations that male circumcision should not replace safe sex. As a Nigerian, Aisuodionoe-Shadrach discusses the indirect ways in which circumcision can reduce the spread of HIV, and advocates the surgery, although he proposes infant circumcision may be wiser. Ira Sharlip, President of the International Society for Sexual Medicine, explains some of the physiology involved while again citing the three recent African studies. He questions who would be circumcised and who would perform the procedure if pro-circumcision policies were adopted. While three clinical trials in Africa were halted after it became evident that circumcision was beneficial in protecting against HIV, further information on the health risks and benefits of male circumcision is needed. Ethical decisions need to be made and medical recommendations developed before circumcision can be considered for HIV prevention.

  3. 40 CFR 300.185 - Nongovernmental participation.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Nongovernmental participation. 300.185... PLAN Responsibility and Organization for Response § 300.185 Nongovernmental participation. (a) Industry... from on-scene operations. (d) Nongovernmental participation must be in compliance with the requirements...

  4. Everywhere in Japan: an international approach to working with commercial gay businesses in HIV prevention.

    Science.gov (United States)

    Sherriff, Nigel; Koerner, Jane; Kaneko, Noriyo; Shiono, Satoshi; Takaku, Michiko; Boseley, Ross; Ichikawa, Seiichi

    2017-06-01

    In the UK and Japan, there is concern regarding rising rates of annual new HIV infections among Men who have Sex with Men (MSM). Whilst in the UK and Europe, gay businesses are increasingly recognized as being important settings through which to deliver HIV prevention and health promotion interventions to target vulnerable populations; in Japan such settings-based approaches are relatively underdeveloped. This article draws on qualitative data from a recently completed study conducted to explore whether it is feasible, acceptable and desirable to build on the recent European Everywhere project for adaptation and implementation in Japan. A series of expert workshops were conducted in Tokyo, Nagoya and Osaka with intersectoral representatives from Japanese and UK non-governmental organizations (NGOs), gay businesses, universities and gay communities (n = 46). Further discussion groups and meetings were held with NGO members and researchers from the Japanese Ministry of Health, Labour and Welfare's Research Group on HIV Prevention Policy, Programme Implementation and Evaluation among MSM (n = 34). The results showed that it is desirable, feasible and acceptable to adapt and implement a Japanese version of Everywhere. Such a practical, policy-relevant, settings-based HIV prevention framework for gay businesses may help to facilitate the necessary scale up of prevention responses among MSM in Japan. Given the high degree of sexual mobility between countries in Asia, there is considerable potential for the Everywhere Project (or its Japanese variant) to be expanded and adapted to other countries within the Asia-Pacific region. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. RESTRICTION OF RIGHTS OF NON-GOVERNMENTAL ORGANIZATIONS IN RUSSIA AS A SUBJECT OF JUDICIAL CONTROL

    Directory of Open Access Journals (Sweden)

    P. Vinogradova

    2016-01-01

    Full Text Available This article examines the issue of the regulation of the Russian state’s control over the activities of non-governmental organizations and the limits to that control. Important changes made in 2014–2016 in the regulation of the organization and activity of judicial power show that the tasks of transformation of the judicial power structure, establishment of effective control mechanisms and strengthening of the requirements on substantiation of court judgments have become more topical. Addressing this issue and taking it as the subject of study are motivated by the small number of works dealing with this issue. The task of enhancing the effectiveness of the exercise of their powers by public authorities necessitates consideration of special features of judicial control over disputes related to restriction of rights. The adoption of the Administrative Procedure Code of the Russian Federation and the statutory formalization of special features of judicial control with respect to certain non-commercial organizations imply changes in judicial practice related to challenging the decisions made by public authorities. In addition to special procedural features such changes also facilitate the spread in law enforcement practice of legal arrangements like the ‘proportionality test’ and determining the balance between competing constitutional values and conditions of public order observance. The analysis carried out by the author reveals tendencies of improvement in legislative action and allows identification of future lines of improvement in judicial practice.

  6. The Rationalization of Educational Development: Scientific Activity among International Nongovernmental Organizations

    Science.gov (United States)

    Bromley, Patricia

    2010-01-01

    Educational development organizations and related global movements emerged and expanded during the twentieth century. Today, most activities in the educational development field are characterized by a scientific outlook that schooling can be transformed using measurable and generalizable knowledge, and most of its leaders believe that experts can…

  7. Women Empowerment through Access to Information: The Strategic Roles of Non-Governmental Organizations in Nigeria

    Science.gov (United States)

    Oyelude, Adetoun A.; Bamigbola, Alice A.

    2013-01-01

    In the last few decades, there has been steady increasing awareness of the need to empower women in order to improve their socioeconomic status to be able to cope and also contribute effectively in this period of economic crisis. ATI (access to information) provision is a vital factor in empowerment, thus, many organizations, such as library,…

  8. A Guide to NGO Directories: How To Find Over 20,000 Nongovernmental Organizations in Latin America and the Caribbean. Second Edition.

    Science.gov (United States)

    Anson, Christina N., Comp.; Barry, Maria E.

    This guide provides information on 42 directories that list over 20,000 nongovernmental organizations (NGOs) in Latin America and the Caribbean. Listings cover NGOs in Argentina, Bolivia, Brazil, Caribbean Region, Chile, Colombia, Costa Rica, Dominica, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jamaica, Mexico,…

  9. Frictions That Activate Change: Dynamics of Global to Local Non-Governmental Organizations for Female Education and Empowerment in China, India, and Pakistan

    Science.gov (United States)

    Seeberg, Vilma; Baily, Supriya; Khan, Asima; Ross, Heidi; Wang, Yimin; Shah, Payal; Wang, Lei

    2017-01-01

    This article examines how non-governmental organizations create resources and spaces for girls and women's education and empowerment in China, India and Pakistan--in the context of global expectations and local state relations as well as cultural norms. We examine the dynamics that foster female empowerment associated with educational attainment.…

  10. Travelling Policies and Global Buzzwords: How International Non-Governmental Organizations and Charities Spread the Word about Early Childhood in the Global South

    Science.gov (United States)

    Penn, Helen

    2011-01-01

    This article is based on a web-search commissioned by an international charity to review the work of international non-governmental organizations (INGOs) and charities which promote and support early childhood education and care (ECEC) in the global South. The article examines examples of such initiatives. It is suggested that there is…

  11. Cash grants in humanitarian assistance: a nongovernmental organization experience in Aceh, Indonesia, following the 2004 Indian Ocean Tsunami.

    Science.gov (United States)

    Doocy, Shannon; Johnson, Diane; Robinson, Courtland

    2008-06-01

    Historically, cash interventions, as opposed to material or in-kind aid, have been relatively uncommon in the humanitarian response to emergencies. The widespread implementation of cash-based programs following the 2004 Indian Ocean tsunami provided an opportunity to examine cash distributions following disasters. The Mercy Corps cash grant program in Aceh, Indonesia, was a short-term intervention intended to assist in recompensing losses from the December 2004 tsunami. An evaluation of the Mercy Corps cash grant program was conducted for the 12-month period following the tsunami using program monitoring data and a systematic survey of cash grant beneficiaries. in 2005, the cash grant program disbursed more than US$3.3 million to more than 53,000 beneficiaries; the average cash grant award was US$6390, which was shared by an average of 108 beneficiaries. In a beneficiary survey, more than 95% of respondents reported the grant allocation processes were fair and transparent and that grant funds were received. The Mercy Corps experience with cash programs suggests that cash interventions in the emergency context, when properly administered, can have an immediate impact and serve as an efficient mechanism for providing assistance. Organizations involved in humanitarian relief, particularly donors and nongovernmental organizations, should consider incorporating cash-based interventions as an element of their response in future emergencies.

  12. Role Of Non-Governmental Organizations Leadership In The Implementation Of Community Development Projects In Arumeru District Tanzania

    Directory of Open Access Journals (Sweden)

    Rajabu Ally Mtunge

    2015-08-01

    Full Text Available The purpose of this study was to examine the role of leadership in the implementation of community development projects by local non-governmental organizations in Arumeru District Tanzania. The study applied survey design which covered the sample of 46 respondents including District Executive Director District Social Workers Non-Governmental Organization leaders workers and volunteers and community members in Arumeru district Tanzania. The study employed simple random sampling technique in order to ensure equal chance of an individual being involved in this study as inferential statistics considered. Data collected from a sample of 46 NGOs employees using a semi-structured questionnaire with both closed and open-ended questions. The collected data analyzed using both descriptive and inferential statistics. The descriptive statistical tools used included frequencies mean and standard deviation while inferential statistical tool used was correlation. Statistical Package for the Social Sciences SPSS version 19 used for analyzing the data collected. The study achieved a response of 46 out of a sample of 47 representing a response rate of 97.87. The results show that a significant number of NGOs 34.8 had not completed their projects 21.7 stated that less than five projects were complete and 43.5 of the respondents confirmed that more than five projects not completed over the last one year. Regarding the influence of leadership on implementation of project spearmans rank correlation revealed a very strong positive correlation 0.910 between of leadership vision and implementation of community development projects a strong positive correlation between communication and implementation of community development projects rho 0.730 n 46 p .001 strong positive correlation between commitment and implementation of community developmental projects which was statistically significant rs .601 p .000 and a positive correlation between accountability and

  13. Ethical self-regulation systems for Non-Governmental Organizations (NGOs

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    Mario Aguiló

    2014-06-01

    Full Text Available The article presents the theoretical results of a study focusing on self-regulatory systems as the evaluative approach to the ethical performance of NGOs. Its aim is to analyse the current self-regulatory systems in NGOs in order to report their scope, identify the evaluative dimensions and variables used, and clarify their role in relation to other strategies and other apparently similar resources, such as quality control systems. From the literature survey and content analysis of the major databases and institutional documents of authors and managers of various self-regulatory systems, the current practices are described, compared and analysed. The results lead us to conclude that through self-regulation, primarily codes of conduct and certifications of good practices, a growing number of organizations are developing standards and shared rules of conduct to address and channel the emerging demand for transparency and accountability to their stakeholders. However, there is great disparity in the way they are used, along with their geographical distribution and content. Finally, we offer an integrative proposal of the different variables used to evaluate ethical management in the leading certification systems analysed.

  14. Uranium exploration, non-governmental organizations, and local communities. The origin, anatomy, and consequences of a new challenge in Finland

    Directory of Open Access Journals (Sweden)

    Eerola, Toni

    2008-06-01

    Full Text Available The advent of global warming has returned nuclear power to the agenda. Many countries, including Finland, have decided to construct more nuclear power plants. They will need uranium, and its price is rising in the international market. A new uranium exploration boom is going on. Finland is politically and economically stable, with good infrastructure and basic geodata, attracting foreign companies to explore the promising uranium showings of the country. However, this has triggered an extensive anti-uranium campaign in northern, eastern, and southern, but not in central Finland, which is related to anti-nuclear movement, green and leftist parties, and environmental non-governmental organizations (NGOs. The resistance, created mainly by lack of public awareness of geology and mining, surprised mining companies, the geological community, and the Ministry of Trade and Industry, who found themselves in a completely new situation. Here we will examine the origin, anatomy, and consequences of this challenge and how to deal with it. The picture presented herewithin is based on author’s active participation in uranium exploration in Finland, discussions with other geologists and activists, following the issue in newspapers, web-pages, reviews, and participating in NGO meetings.

  15. Chapter 5: Organizational structures suited to ISPRM's evolving role as an international non-governmental organization in official relation with the world health organization.

    Science.gov (United States)

    von Groote, Per M; Reinhardt, Jan D; Gutenbrunner, Christoph; DeLisa, Joel A; Melvin, John L; Bickenbach, Jerome E; Stucki, Gerold

    2009-09-01

    International non-governmental organizations (NGOs) in official relation with the World Health Organization (WHO) face organizational challenges against the background of legitimate representation of their membership and accountable procedures within the organization. Moreover, challenges arise in the light of such an international NGO's civil societal mandate to help reach the "health-for-all" goals as defined by WHO and to facilitate the implementation of the United Nations (UN) Convention on the Rights of Persons with Disabilities. The objective of this paper is to examine how such an international NGO using the International Society of Physical and Rehabilitation Medicine (ISPRM) as a case in point can address these challenges. The specific aims are to analyse ISPRM's structures and procedures of internal organs and external relations and to develop solutions. These possible solutions will be presented as internal organizational scenarios and a yearly schedule of meetings closely aligned to that of WHO to facilitate an efficient internal and external interaction.

  16. Collaboration between non-governmental organizations and public services in health – a qualitative case study from rural Ecuador

    Directory of Open Access Journals (Sweden)

    Olivia Biermann

    2016-11-01

    Full Text Available Background: Non-governmental organizations (NGOs have a key role in improving health in low- and middle-income countries. Their work needs to be synergistic, complementary to public services, and rooted in community mobilization and collective action. The study explores how an NGO and its health services are perceived by the population that it serves, and how it can contribute to reducing barriers to care. Design: A qualitative exploratory study was conducted in remote Ecuador, characterized by its widespread poverty and lack of official governance. An international NGO collaborated closely with the public services to deliver preventative and curative health services. Data were collected using focus group discussions and semistructured interviews with purposively sampled community members, healthcare personnel, and community health workers based on their links to the health services. Conventional qualitative content analysis was used, focusing on manifest content. Results: Emerging themes relate to the public private partnership (PPP, the NGO and its services, and community participation. The population perceives the NGO positively, linking it to healthcare improvements. Their priority is to get services, irrespective of the provider's structure. The presence of an NGO in the operation may contribute to unrealistic expectations of health services, affecting perceptions of the latter negatively. Conclusions: To avoid unrealistic expectations and dissatisfaction, and to increase and sustain the population's trust in the organization, an NGO should operate in a manner that is as integrated as possible within the existing structure. The NGO should work close to the population it serves, with services anchored in the community. PPP parties should develop a common platform with joint messages to the target population on the provider's structure, and regarding partners’ roles and responsibilities. Interaction between the population and the providers

  17. The role of non-governmental organizations in providing curative health services in North Darfur State, Sudan.

    Science.gov (United States)

    Yagub, Abdallah I A; Mtshali, Khondlo

    2015-09-01

    Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. To examine the role that Non-Governmental Organizations (NGOs) have played in providing curative health services, as well as to identify the difficulties and challenges that affect NGOs in delivering curative health services. Secondary data was collected from different sources, including government offices and medical organizations in Sudan and in North Darfur state. Primary data was obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) (2) health professionals and administrators working in health sector (N= 45) in the period from November 2010 to January 2011. The government in North Darfur state spent 70% of its financial budget on security, while it spent it less than 1% on providing health services. The international NGOs have been providing 70% of curative health services to the State's population by contributing 52.9% of the health budget and 1 390 health personnel. Since 2003 NGOs have provided technical assistance to the health staff. As a result, more than fifty nurses have been trained to provide care and treatment, more than twenty-three doctors have been trained in laboratory equipment operation, and approximately six senior doctors and hospital directors have received management training. NGOs have been managing and supporting 89 public health facilities, and established 24 health centres in IDP camps, and 20 health centres across all the districts in North Darfur state. The NGOs have played an important role in providing curative health services and in establishing good health facilities, but a future problem is how the government will run these health facilities after a peaceful settlement has been

  18. Maintaining health sector collaborations between United States non-governmental organizations and North Korea through innovation and planning.

    Science.gov (United States)

    Yim, Eugene S; Choi, Ricky Y; VanRooyen, Michael

    2009-01-01

    Humanitarian agencies in North Korea operate within a complex sociopolitical environment historically characterized by a baseline of mistrust. As a result of operating within such a heated environment, health sector collaborations between such agencies and the North Korean government have followed unpredictable courses. The factors that have contributed to successful programmatic collaborations, as perceived by United States non-governmental organizations (NGOs) and North Korean officials were investigated. A qualitative, multi-case, comparative, research design using semistructured interviews was used. Expert North Korean informants were interviewed to generate a list of factors contributing to programmatic success, defined as fulfilling mutually established objectives through collaboration. The North Korean informants were asked to identify US NGOs that fulfill these criteria ("mission-compatible NGOs"). Representatives from all of the mission compatible NGOs were interviewed. All informants provided their perspectives on the factors that contributed to successful programmatic collaborations. The interviews were recorded, transcribed, and analyzed for thematic content. North Korean informants identified six mission-compatible US NGOs. The North Korean and US NGO informants provided a number of factors that contributed to successful programs. These factors were grouped into the following themes: (1) responsiveness to North Korean requests; (2) resident status; (3) program monitoring; (4) sincerity (apolitical objectives); (5) information gathering; and (6) interagency collaboration. Some US NGOs have devised innovative measures to work within a unique set of parameters in North Korea. Both US NGOs and North Korean authorities have made significant concessions to maintain their programmatic partnerships. In this manner, seasoned collaborators have employed creative strategies and a form of health diplomacy to facilitate programmatic success in North Korea by

  19. Community-based public health interventions in North Korea: one non-governmental organization's experience with tuberculosis and hepatitis B.

    Science.gov (United States)

    Goe, L C; Linton, J A

    2005-05-01

    The Democratic People's Republic of Korea, also known as North Korea, is the most isolated country in the world, and has been a source of interest, politically and socially, since the 1953 ceasefire of the Korean War. While in the past year, interest has focused on the nuclear dispute with the USA, over the past decade, most interest has revolved around the economic plight of the country, the lack of funds and resources for health care, and the subsequent public health declines. North Korea's present economic and public health problems began in the early 1990s due to the gradual loss of economic support from its communist allies (i.e. after the fall of the Soviet Union and the capitalization of China), combined with an inordinate number of natural disasters (floods, famine and drought) all occurring within the same time span. These simultaneous events initiated a 'snowball effect' of severe economic depression and a rapid deterioration of the overall public health infrastructure in the country. North Korea's continued isolation and reluctance to release health statistics has left the international community uncertain of the precise extent of the public health devastation. The uncertainty of the situation has been further complicated by disparate accounts of the public health declines. For instance, the North Korean Government has estimated that approximately 220,000 people died due to famine in the 1990s, while the World Health Organization (WHO) claims that this figure is closer to 2 million. In the past few years, the willingness of the North Korean Government to engage the outside world has increased. This is reflected by the growing number of foreign aid organizations or non-governmental organizations (NGOs) that have been permitted entry into the country. NGOs have not only served to improve various aspects of the public health system but also serve as a source of 'on-the-ground' information for the outside world. This role has proven critical not only for

  20. HIV Prevention Messages Targeting Young Latino Immigrant MSM

    Directory of Open Access Journals (Sweden)

    Rosa Solorio

    2014-01-01

    Full Text Available Young Latino immigrant men who have sex with men (MSM are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a describe the development of HIV prevention messages through the integration of previously collected formative data; (b describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c describe testing the PSAs within the Latino MSM community; and (c determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.

  1. Collaboration between Government and Non-Governmental Organizations (NGOs) in Delivering Curative Health Services in North Darfur State, Sudan- a National Report.

    OpenAIRE

    Yagub, Abdallah I A

    2014-01-01

    Abstract Background North Darfur State has been affected by conflict since 2003 and the government has not been able to provide adequate curative health services to the people. The government has come to rely on Non-Governmental Organizations (NGOs) to provide curative health services. This study was conducted to examine the existing collaboration between government and NGOs in curative health service delivery in North Darfur State, and to identify the challenges that affect their collaborati...

  2. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study

    OpenAIRE

    Madelene Larsson; Camilla Pettersson; Therése Skoog; Charli Eriksson

    2016-01-01

    Abstract Background Mental health problems among young women aged 16–24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone...

  3. Capacity building of local governmental and non-governmental organizations on environmental hygiene through a community-based training workshop program.

    Science.gov (United States)

    Ohnishi, Mayumi; Nakamura, Keiko

    2009-01-01

    This study was performed to evaluate the feasibility of a joint community-based environmental hygiene program in partnership between local governmental and non-governmental organizations with participants from different professional backgrounds, including inspectors of environmental sanitation and community leaders in Lagos, Nigeria, because no suitable collaboration had been implemented in this area. Qualitative and quantitative evaluations were performed with regard to malaria prevention and community-based environmental hygiene training workshops in three local communities in Lagos, Nigeria. Qualitative evaluation revealed the importance of establishment of close partnerships between local governmental and non-governmental organizations, and possible community participation in the program for its success. A total of 36 participants completed pre- and follow-up assessment before and after the three-day training course. The mean pre-test score was 27.8 +/- 13.9 (mean +/- standard deviation), while that of the follow-up test was 57.1 +/- 17.8. This mean gain of 29.3 +/- 17.4 in the score represented a significant improvement (p environmental hygiene program, was successfully achieved. The training workshop also established good relations between governmental and non-governmental organizations with different professional backgrounds, and demonstrated the potential for sustained collaboration.

  4. Building the Capacity of the HIV Prevention Workforce

    Centers for Disease Control (CDC) Podcasts

    2010-07-29

    This podcast provides an overview of CDC's HIV prevention capacity building efforts with community-based organizations and health departments.  Created: 7/29/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 7/29/2010.

  5. Reputationally Strong HIV Prevention Programs: Lessons from the Front Line

    Science.gov (United States)

    Eke, Agatha N.; Mezoff, Jane S.; Duncan, Ted; Sogolow, Ellen D.

    2006-01-01

    Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite…

  6. Personalized Biobehavioral HIV Prevention for Women and Adolescent Girls

    Science.gov (United States)

    Teitelman, Anne M.; Bevilacqua, Amanda W.; Jemmott, Loretta Sweet

    2013-01-01

    Background: Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. Primary Study Objective: The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. Methods: We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. Results: The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk—reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk—reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Conclusions: Generalized programs and

  7. Personalized Biobehavioral HIV Prevention for Women and Adolescent Girls.

    Science.gov (United States)

    Brawner, Bridgette M; Teitelman, Anne M; Bevilacqua, Amanda W; Jemmott, Loretta Sweet

    2013-09-01

    Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk-reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk-reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Generalized programs and interventions may not have universal, transnational, and crosscultural

  8. eHealth interventions for HIV prevention.

    Science.gov (United States)

    Noar, Seth M; Willoughby, Jessica Fitts

    2012-01-01

    The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed.

  9. A Research Strategy Case Study of Alcohol and Drug Prevention by Non-Governmental Organizations in Sweden 2003-2009

    OpenAIRE

    Larsson Madelene; Geidne Susanna; Eriksson Charli; Pettersson Camilla

    2011-01-01

    Abstract Background Alcohol and drug prevention is high on the public health agenda in many countries. An increasing trend is the call for evidence-based practice. In Sweden in 2002 an innovative project portfolio including an integrated research and competence-building strategy for non-governmental organisations (NGOs) was designed by the National Board of Health and Welfare (NBHW). This research strategy case study is based on this initiative. Methods The embedded case study includes 135 pr...

  10. The impact of internalized homophobia on HIV preventive interventions.

    Science.gov (United States)

    Huebner, David M; Davis, Mary C; Nemeroff, Carol J; Aiken, Leona S

    2002-06-01

    A growing body of research implicates internalized homophobia--the internalization of society's antihomosexual sentiments by gay and lesbian people--as a factor contributing to HIV-related sexual risk behavior in gay and bisexual men. Although accumulating evidence links internalized homophobia and sexual risk behavior, no study has explored the impact of internalized homophobia on efforts to prevent these behaviors. This paper examines the effect of internalized homophobia on gay and bisexual men's awareness of participation in, and perceptions of programs offered by a community-based HIV prevention organization. In Study 1, 595 gay and bisexual men reported their levels of awareness of and participation in HIV prevention programming offered by one community organization. Internalized homophobia was negatively related to men's awareness of the services offered by the organization. However, among the men who were aware of at least one service, internalized homophobia did not further predict service utilization. Study 2 examined 89 gay and bisexual men who participated for a single session in a group-structured, community-based HIV preventive intervention. Pre- to immediate postintervention change in perceptions of condom use self-efficacy was inversely related to internalized homophobia. Internalized homophobia was also a significant negative predictor of the extent to which participants felt similar to and related well with other members of the group. Together, these findings suggest that internalized homophobia may pose multiple barriers to community-based HIV prevention efforts.

  11. Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era.

    Science.gov (United States)

    Mutchler, Matt G; McDavitt, Bryce; Ghani, Mansur A; Nogg, Kelsey; Winder, Terrell J A; Soto, Juliana K

    2015-09-01

    Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options.

  12. Conceptualizing community mobilization for HIV prevention: implications for HIV prevention programming in the African context.

    Science.gov (United States)

    Lippman, Sheri A; Maman, Suzanne; MacPhail, Catherine; Twine, Rhian; Peacock, Dean; Kahn, Kathleen; Pettifor, Audrey

    2013-01-01

    Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation. We aimed to identify the key domains of community mobilization (CM) essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting. We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge. CM DOMAINS INCLUDE: 1) shared concerns, 2) critical consciousness, 3) organizational structures/networks, 4) leadership (individual and/or institutional), 5) collective activities/actions, and 6) social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks. To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of specific

  13. Conceptualizing community mobilization for HIV prevention: implications for HIV prevention programming in the African context.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation.We aimed to identify the key domains of community mobilization (CM essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting.We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge.CM DOMAINS INCLUDE: 1 shared concerns, 2 critical consciousness, 3 organizational structures/networks, 4 leadership (individual and/or institutional, 5 collective activities/actions, and 6 social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks.To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of

  14. Standards and Guidelines for HIV Prevention Research ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Standards and Guidelines for HIV Prevention Research: Considerations for Local Context in the Interpretation of Global .... African women19,20. But then there is the question of which guidelines should be used to structure ..... sponsors prior to initiating HIV prevention studies. The lessons from this case study show that in.

  15. Chinese non-governmental organizations involved in HIV/AIDS prevention and control: Intra-organizational social capital as a new analytical perspective.

    Science.gov (United States)

    Wang, Danni; Mei, Guangliang; Xu, Xiaoru; Zhao, Ran; Ma, Ying; Chen, Ren; Qin, Xia; Hu, Zhi

    2016-11-15

    HIV/AIDS is a major public health and social problem worldwide, and non-governmental organizations (NGOs) have played an irreplaceable role in HIV/AIDS prevention and control. At the present time, however, NGOs have not fully participated in HIV/AIDS prevention and control in China. As an emerging focus on international academic inquiry, social capital can provide a new perspective from which to promote the growth of NGOs. The Joint United Nations Program on HIV/AIDS (UNAIDS) recommends creating regional policies tailored to multiple and varying epidemics of HIV/AIDS. In order to provide evidence to policymakers, this paper described the basic information on NGOs and their shortage of social capital. This paper also compared the actual NGOs to "government-organized non-governmental organizations" (GONGOs). Results indicated that i) Chinese NGOs working on HIV/AIDS are short of funding and core members. GONGOs received more funding, had more core members, and built more capacity building than actual NGOs; ii) Almost half of the NGOs had a low level of trust and lacked a shared vision, networks, and support. The staff of GONGOs received more support from their organization than the staff of actual NGOs. Existing intra-organizational social capital among the staff of NGOs should be increased. Capacity building and policymaking should differentiate between actual NGOs and GONGOs. The relationship between social capital and organizational performance is a topic for further study.

  16. The International Society of Hypertension and World Hypertension League call on governments, nongovernmental organizations and the food industry to work to reduce dietary sodium.

    Science.gov (United States)

    Campbell, Norman R C; Lackland, Daniel T; Chockalingam, Arun; Lisheng, Liu; Harrap, Stephen B; Touyz, Rhian M; Burrell, Louise M; Ramírez, Agustín J; Schmieder, Roland E; Schutte, Aletta E; Prabhakaran, Dorairaj; Schiffrin, Ernesto L

    2014-02-01

    The International Society of Hypertension and the World Hypertension League have developed a policy statement calling for reducing dietary salt. The policy supports the WHO and the United Nations recommendations, which are based on a comprehensive and up-to-date review of relevant research. The policy statement calls for broad societal action to reduce dietary salt, thus reducing blood pressure and preventing hypertension and its related burden of cardiovascular disease. The hypertension organizations and experts need to become more engaged in the efforts to prevent hypertension and to advocate strongly to have dietary salt reduction policies implemented. The statement is being circulated to national hypertension organizations and to international nongovernmental health organizations for consideration of endorsement. Member organizations of the International Society of Hypertension and the World Hypertension League are urged to support this effort.

  17. Perception Gaps on Food Additives among Various Groups in Korea: Food Experts, Teachers, Nutrition Teachers, Nongovernmental Organization Members, and General Consumers.

    Science.gov (United States)

    Kang, Hee-Jin; Kim, Suna; Lee, Gunyoung; Lim, Ho Soo; Yun, Sang Soon; Kim, Jeong-Weon

    2017-06-01

    The purpose of this study was to determine the perceptions and information needs of food experts, teachers, nutrition teachers, members of nongovernmental organizations, and general consumers concerning food additives. Questions in a survey format included perceptions, information needs, and preferred communication channels. The survey was conducted both off-line and on-line via e-mail and Google Drive in March 2015. The results indicated that most Korean consumers are concerned about the safety of using food additives in processed foods and do not recognize these additives as safe and useful materials as part of a modern diet. We also identified perception gaps among different groups regarding food additives. Nutrition teachers and members of nongovernmental organizations in Korea appeared to have a biased perception of food additives, which may cause general consumers to have a negative perception of food additives. The group of food experts did not have this bias. Governmental institutions must overcome the low confidence levels of various groups as an information provider about food additives. Based on the findings in this study, it will be possible to develop a strategy for risk communication about food additives for each group.

  18. Obstacles to creating an environment conducive to HIV prevention for young people.

    Science.gov (United States)

    Nm Kareithi, Roselyn; Lund, Crick

    2011-12-01

    The external environment of an organisation influences the desired goals and interventions of that organisation in many ways. However, strategies for influencing the external context to create a more enabling environment for the interventions of non-governmental organisations (NGOs) are often inadequately addressed. This article draws on an empirical multiple-case study conducted in 2007/08 of four NGOs providing HIV-prevention services to young people in several low-resource, high-HIV-prevalence communities in Cape Town, South Africa. In an earlier study, young people reported that the external environment hampered their ability to institutionalise HIV-prevention messages. The current study explored how the NGOs endeavoured to influence the external environment, and the challenges they faced. The findings show that the NGOs practised a combination of strategies, encompassing inter-organisational relationships, influencing policy, and championing by example. Key constraints to their influencing practices included fear of losing legitimacy as a service provider; inadequate knowledge, skills and opportunity; perceived deviation from their usual work; inadequate funding; conflicts over values and messages; and a habit of focusing more on young people's individual behaviours and less on context. The development management task of influencing the external environment to create an environment more conducive to HIV prevention seemed constrained mainly because: 1) donors focused on funding and monitoring the activities they were interested in and conceptualised as HIV-prevention services; 2) NGO efforts were restricted to programme implementation based on agreed deliverables, thus influencing was mainly confined to championing by example; consequently, 3) 'influencing efforts' to create an environment more conducive to HIV prevention were left mainly to young people themselves, who can affect their peers only to a narrow, albeit crucial extent. The external environment

  19. The Roles of Non-Governmental Organizations in Development of Schools of Public Health: An Example from Eastern Europe and Central Asia

    Directory of Open Access Journals (Sweden)

    Judith W. Overall

    2011-01-01

    Full Text Available The international non-governmental community has played a major role in developing schools of public health and continues to do so. Nearly a century ago, seminal investments of the Rockefeller Foundation played a pivotal role in developing schools of public health in North America and several abroad. Today, involvement of non-governmental organizations in continuing development of schools of public health is needed, as many countries throughout the world continue to battle the burden of disease with insufficient numbers and quality of trained public health workers. In this paper we discuss in particular the roles of the Open Society Institute working together with the Association of Schools of Public Health in the European Region to foster the development of schools of public health in formerly socialist countries. We describe the development process in three example countries (Ukraine, Lithuania, and Macedonia, along with the difficulties they have faced. Government support and accreditation processes are needed to sustain the efforts to launch new schools of public health and to ensure their quality. The lessons learned in these initiatives are relevant to future development of public health education to provide the workforce required to address needs of professional public health in the 21st century.

  20. Epidemiological pattern of leprosy in an endemic area of North-East Brazil, 1996-2005: the supporting role of a Nongovernmental Organization.

    Science.gov (United States)

    Mastrangelo, Giuseppe; Scoizzato, Luca; Fadda, Emanuela; Silva, Gilberto Valentim da; Santos, Luimar De Jesus; Cegolon, Luca

    2009-01-01

    In an endemic area of North-East Brazil (the town of Picos, State of Piauí), a nongovernmental organization (NGO) supported the activity against leprosy in connection with governmental health organizations and local agents. The indicators of leprosy elimination were compared over time (within Picos) and across space (Picos versus Piauí). The case detection rate, above 8 per 10,000 people in the last two years of observation, increased over time in Picos (p=0.010). This finding could be due to active detection activities rather than expanding endemicity, as suggested by the reduction in leprosy in children (p=0.053) and the decrease in the proportion of new cases with grade 2 disability (p<0.001). These indicators showed a more favorable time trend in the city than in the State, suggesting that NGO activity was supportive in the battle towards leprosy control.

  1. Collaborative community research consortium: a model for HIV prevention.

    Science.gov (United States)

    Sanstad, K H; Stall, R; Goldstein, E; Everett, W; Brousseau, R

    1999-04-01

    In 1991, the Center for AIDS Prevention Studies (CAPS) at the University of California, San Francisco, set out to develop a model of community collaborative research that would bring the skills of science to the service of HIV prevention and the knowledge of service providers into the domain of research. Essential elements of the model were training for community-based organizations (CBOs) in research protocol writing, partnership between CBOs and CAPS researchers, program research funding, support to implement studies and analyze results, and a program manager to oversee the effort and foster the relationships between CBOs and researchers. In this article, the authors describe the CAPS model of consortium-based community collaborative research. They also introduce a set of papers, written by researchers and service providers, that describes collaborative research projects conducted by research institutions and CBOs and illustrates how collaboration can change both HIV prevention research and service.

  2. Impact of climate change on the role of non-governmental organizations in environmental health delivery in south-eastern region of Nigeria

    Directory of Open Access Journals (Sweden)

    Jacinta A. Opara

    2016-04-01

    Full Text Available Climate change remains a serious problem to most rural settlement in Nigeria. Individuals are faced with a wide range of health problems. These problems include high risk of communicable and non-communicable diseases, an outbreak of epidemics, and scarcity of water. This study investigated the impact of climate change on health delivery services by Non-Governmental Organizations (NGOs to the different Local Government Areas (LGA of the five the States in the South -Eastern Region in Nigeria: Anambra, Imo, Abia, Ebonyi and Enugu were selected and three communities from each was sampled using stratified random sampling technique. The result revealed that most NGO health workers could not penetrate into most of the rural areas to deliver aids to the victims

  3. Chapter 4: A policy process and tools for international non-governmental organizations in the health sector using ISPRM as a case in point.

    Science.gov (United States)

    Reinhardt, Jan D; von Groote, Per M; DeLisa, Joel A; Melvin, John L; Bickenbach, Jerome E; Stucki, Gerold

    2009-09-01

    The politics of international non-governmental organizations (NGOs) such as the International Society of Physical and Rehabilitation Medicine (ISPRM) serve the function of selecting and attaining particular socially valued goals. The selection and attainment of goals as the primary function of political action can be structured along a policy process or cycle comprising the stages of strategic goal setting and planning of strategic pathways, agenda setting, resource mobilization, implementation, evaluation and innovation. At the various stages of this policy process different policy tools or instruments, which can be used to influence citizen and organizational behaviour in the light of defined goals, can be applied. The objective of this paper is to introduce and describe policy tools of potential relevance to ISPRM with regard to different policy functions and stages of the policy process.

  4. A research strategy case study of alcohol and drug prevention by non-governmental organizations in Sweden 2003-2009.

    Science.gov (United States)

    Eriksson, Charli; Geidne, Susanna; Larsson, Madelene; Pettersson, Camilla

    2011-04-14

    Alcohol and drug prevention is high on the public health agenda in many countries. An increasing trend is the call for evidence-based practice. In Sweden in 2002 an innovative project portfolio including an integrated research and competence-building strategy for non-governmental organisations (NGOs) was designed by the National Board of Health and Welfare (NBHW). This research strategy case study is based on this initiative. The embedded case study includes 135 projects in 69 organisations and 14 in-depth process or effect studies. The data in the case study has been compiled using multiple methods - administrative data; interviews and questionnaires to project leaders; focus group discussions and seminars; direct and participatory observations, interviews, and documentation of implementation; consultations with the NBHW and the NGOs; and a literature review. Annual reports have been submitted each year and three bi-national conferences Reflections on preventions have been held. A broad range of organisations have been included in the NBHW project portfolio. A minority of the project were run by Alcohol or drug organisations, while a majority has children or adolescents as target groups. In order to develop a trustful partnership between practitioners, national agencies and researchers a series of measures were developed and implemented: meeting with project leaders, project dialogues and consultations, competence strengthening, support to documentation, in-depth studies and national conferences. A common element was that the projects were program-driven and not research-driven interventions. The role of researchers-as-technical advisors was suitable for the fostering of a trustful partnership for research and development. The independence of the NGOs was regarded as important for the momentum in the project implementation. The research strategy also includes elements of participatory research. This research strategy case study shows that it is possible to

  5. Demographic and Behavioral Correlates of HIV Risk among Men and Transgender Women Recruited from Gay Entertainment Venues and Community-based Organizations in Thailand: Implications for HIV Prevention

    OpenAIRE

    Newman, PA; Lee, SJ; Roungprakhon, S; Tepjan, S

    2012-01-01

    High HIV prevalence among men who have sex with men (MSM) and transgender women in Thailand suggest a vital need for targeted interventions. We conducted a cross-sectional survey to examine and compare sexual risk behaviors, and demographic and behavioral correlates of risk, among MSM and transgender women recruited from gay entertainment venue staff and community-based organization (CBO) participants. We used venue-based sampling across nine sites in Bangkok and Chiang Mai. Among 260 partici...

  6. Payday, ponchos, and promotions: a qualitative analysis of perspectives from non-governmental organization programme managers on community health worker motivation and incentives.

    Science.gov (United States)

    B-Lajoie, Marie-Renée; Hulme, Jennifer; Johnson, Kirsten

    2014-12-05

    Community health workers (CHWs) have been central to broadening the access and coverage of preventative and curative health services worldwide. Much has been debated about how to best remunerate and incentivize this workforce, varying from volunteers to full time workers. Policy bodies, including the WHO and USAID, now advocate for regular stipends. This qualitative study examines the perspective of health programme managers from 16 international non-governmental organizations (NGOs) who directly oversee programmes in resource-limited settings. It aimed to explore institutional guidelines and approaches to designing CHW incentives, and inquire about how NGO managers are adapting their approaches to working with CHWs in this shifting political and funding climate. Second, it meant to understand the position of stakeholders who design and manage non-governmental organization-run CHW programmes on what they consider priorities to boost CHW motivation. Individuals were recruited using typical case sampling through chain referral at the semi-annual CORE Group meeting in the spring of 2012. Semi-structured interviews were guided by a peer reviewed tool. Two reviewers analyzed the transcripts for thematic saturation. Six key factors influenced programme manager decision-making: National-level government policy, donor practice, implicit organizational approaches, programmatic, cultural, and community contexts, experiences and values of managers, and the nature of the work asked of CHWs. Programme managers strongly relied on national government to provide clear guidance on CHW incentives schemes. Perspectives on remuneration varied greatly, from fears that it is unsustainable, to the view that it is a basic human right, and a mechanism to achieve greater gender equity. Programme managers were interested in exploring career paths and innovative financing schemes for CHWs, such as endowment funds or material sales, to heighten local ownership and sustainability of programmes

  7. Collaboration between Government and Non-Governmental Organizations (NGOs) in Delivering Curative Health Services in North Darfur State, Sudan- a National Report.

    Science.gov (United States)

    I A Yagub, Abdallah

    2014-05-01

    North Darfur State has been affected by conflict since 2003 and the government has not been able to provide adequate curative health services to the people. The government has come to rely on Non-Governmental Organizations (NGOs) to provide curative health services. This study was conducted to examine the existing collaboration between government and NGOs in curative health service delivery in North Darfur State, and to identify the challenges that affect their collaboration. Documentary data were collected from government offices and medical organizations. Primary data were obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) and (2), health professionals and administrators working in the health sector (N= 45). The collaboration between the government and NGOs has been very weak because of security issues and lack of trust. The NGOs collaborate by providing human and financial resources, material and equipment, and communication facilities. The NGOs supply 70% of curative health services, and contribute 52.9% of the health budget in North Darfur State. The NGOs have employed 1 390 health personnel, established 44 health centres and manage and support 83 health facilities across the State. The NGOs have played a positive role in collaborating with the government in North Darfur State in delivering curative health services, while government's role has been negative. The problem that faces the government in future is how health facilities will be run should a peaceful settlement be reached and NGOs leave the region.

  8. Non-Governmental Organization (NGO Libraries for The Visually Impaired in Nigeria: Alternative Format Use and Perception of Information Services

    Directory of Open Access Journals (Sweden)

    Adetoro, 'Niran

    2015-03-01

    Full Text Available Nigeria's non-government organization (NGO libraries for the visually impaired has over the years been at the forefront of information services provision to persons with visual impairment. This study adopted a survey research design to investigate use of alternative formats and perceptions of information services to the visually impaired, focusing on two purposively chosen NGO libraries for the visually impaired in Nigeria. Using a complete enumeration approach, data were gathered from 180 users of the libraries through the use of a structured questionnaire with a reliability score (${\\alpha}=0.74$. Data from 112 (62.2% of the 180 administered copies of a questionnaire that were retrieved were analysed. The study found that Braille materials had a high level of utilization ($\\bar{x}=4.46$ and were the most frequently utilized (90.9%. Perception of information services by the visually impaired was positive while use of alternative formats was significantly and positively related to users' perception of information services (r = .041; p < 0.05. The study recommends improved transcription and investment in alternative formats and in e-resources. It also recommends collaborations to widen access as well as constant evaluation of services.

  9. Contextual influences on safer sex negotiation among female sex workers (FSWs) in Hong Kong: the role of non-governmental organizations (NGOs), FSWs' managers, and clients.

    Science.gov (United States)

    Cheng, Shannon S Y; Mak, Winnie W S

    2010-05-01

    Despite social-cognitive interventions to increase safer sex awareness, condom use among female sex workers (FSWs) continued to be inconsistent. To account for the possible influences of contextual factors that may hinder or promote FSWs' safer sex negotiation and condom use, the present study examined the effects of non-governmental organizations (NGOs), FSWs' managers, and clients on FSWs' negotiation efficacy and condom-use efficacy, and the effects of efficacy on condom use. One hundred and nineteen FSWs in Hong Kong completed a questionnaire that focused on their perceived influences of NGOs, managers, and clients toward safer sex negotiation and condom use. Hierarchical regression results showed that whereas NGOs' influence and clients' support were positively related to negotiation self-efficacy, managers' pressure, and clients' pressure were negatively related to negotiation self-efficacy. Managers' pressure was negatively related to condom-use self-efficacy. Logistic regression results showed that FSWs with high condom-use self-efficacy was 24 times more likely to use condom in the previous six months than their counterparts. The present study indicated the importance of social contexts in affecting FSWs' safer sex negotiation and condom-use self-efficacy. Implications on preventive programs for FSWs, managers, and clients were discussed.

  10. Dengue Virus Infections among Haitian and Expatriate Non-governmental Organization Workers — Léogane and Port-au-Prince, Haiti, 2012

    Science.gov (United States)

    Salyer, Stephanie J.; Ellis, Esther M.; Salomon, Corvil; Bron, Christophe; Juin, Stanley; Hemme, Ryan R.; Hunsperger, Elizabeth; Jentes, Emily S.; Magloire, Roc; Tomashek, Kay M.; Desormeaux, Anne Marie; Muñoz-Jordán, Jorge L.; Etienne, Lesly; Beltran, Manuela; Sharp, Tyler M.; Moffett, Daphne; Tappero, Jordan; Margolis, Harold S.; Katz, Mark A.

    2014-01-01

    In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves. PMID:25356592

  11. INTERNATIONAL NON-GOVERNMENTAL ORGANIZATIONS (INGOs IN THE EVENTS OF THE «ARAB SPRING» IN EGYPT: ROLE, MECHANISMS OF INTERFERENCE AND RESULTS

    Directory of Open Access Journals (Sweden)

    А В Шитова

    2017-12-01

    Full Text Available “Arab spring” has launched a process of large-scale political transformation of the countries in the North Africa and the Middle East. There are many “points of tension” in the region of North Africa, in which converge the political and economic interests of external actors, including international non-governmental organizations (INGOs. The lobbying of democratic values as opposed to clan interests led to the strengthening of the role of the West in relation to the state and public institutions of the North Africa and the Middle East. Moreover, academic community recognizes that currently INGOs actively participate in modern international relations, in internal policy of the countries where they perform their activities. Their actions have even more significant impact during the times when the political regimes change. This article aims to analyze the activities of INGOs before, during and after the change of H. Mubarak’s government in Egypt, under the governments of M. Mursi and A.F. As-Sisi (2010-2016 gg.. The article deals with several active INGOs of the “Arab Spring”, such as National Democratic Institute, International Republican Institute, Carter Center and other. The analysis of the activities of the above-mentioned INGO allows us to draw conclusions about their strategies, methods, and instruments of modern technologies facilitating the change of the political regime. The most common mechanisms of INGOs influence on political transition were participation in or-ganization of the electoral process, organization of election campaigns, seminars, consultations for civil society that promote the emergence of new potential political leaders. Great attention in this article is paid to the socio-economic situation in Egypt after the mass unrest. The author shows how the external forces behind foreign NGOs contributed to the political transition, and relates to the ambiguous results for population it has brought. Methodological

  12. The role of non-governmental organizations in residential solid waste management: a case study of Puducherry, a coastal city of India.

    Science.gov (United States)

    Rajamanikam, Ramamoorthy; Poyyamoli, Gopalsamy; Kumar, Sunil; R, Lekshmi

    2014-09-01

    Poorly planned and uncontrolled urbanization in India has caused a variety of negative, often irreversible, environmental impacts. The impacts appear to be unavoidable and not easily mitigable due to the mounting public health problems caused by non-segregation of solid wastes at source and their subsequent improper management. Recently in India, non-governmental organizations (NGOs) and other civil society organizations have increasingly started to get involved in improving waste management services. Municipal solid waste management being a governmental function, the contribution of NGOs in this field has not been well documented. This study highlights the activities and services of Shuddham, an NGO functioning in the town of Puducherry within the Union Territory of Puducherry in South India. The NGO program promoted much needed awareness and education, encouraged source separation, enhanced door-to-door collection, utilized wastes as raw materials and generated more job opportunities. Even though source separation prior to door-to-door collection is a relatively new concept, a significant percentage of residents (39%) in the study area participated fully, while a further 48% participated in the collection service. The average amount of municipal solid waste generated by residential units in the Raj Bhavan ward was 8582 kg/month of which 47% was recovered through active recycling and composting practices. The study describes the features and performance of NGO-mediated solid waste management, and evaluates the strengths and weaknesses as well as the opportunities and threats of this system to see whether this model can sustainably replace the low-performance conventional solid waste management in practice in the town of Puducherry. The experiences from this case study are expected to provide broad guidelines to better understand the role of NGOs and their contributions towards sustainable waste management practices in urban areas. © The Author(s) 2014.

  13. Socially-integrated transdisciplinary HIV prevention.

    Science.gov (United States)

    Friedman, Samuel R; Downing, Martin J; Smyrnov, Pavlo; Nikolopoulos, Georgios; Schneider, John A; Livak, Britt; Magiorkinis, Gkikas; Slobodianyk, Liudmyla; Vasylyeva, Tetyana I; Paraskevis, Dimitrios; Psichogiou, Mina; Sypsa, Vana; Malliori, Melpomeni M; Hatzakis, Angelos

    2014-10-01

    Current ideas about HIV prevention include a mixture of primarily biomedical interventions, socio-mechanical interventions such as sterile syringe and condom distribution, and behavioral interventions. This article presents a framework for socially-integrated transdisciplinary HIV prevention that may improve current prevention efforts. It first describes one socially-integrated transdisciplinary intervention project, the Transmission Reduction Intervention Project. We focus on how social aspects of the intervention integrate its component parts across disciplines and processes at different levels of analysis. We then present socially-integrated perspectives about how to improve combination antiretroviral treatment (cART) processes at the population level in order to solve the problems of the treatment cascade and make "treatment as prevention" more effective. Finally, we discuss some remaining problems and issues in such a social transdisciplinary intervention in the hope that other researchers and public health agents will develop additional socially-integrated interventions for HIV and other diseases.

  14. Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

    Science.gov (United States)

    Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

    2014-01-01

    The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Different challenges, different approaches and related expenditures of community-based tuberculosis activities by international non-governmental organizations in Myanmar.

    Science.gov (United States)

    Han, Wai Wai; Saw, Saw; Isaakidis, Petros; Khogali, Mohammed; Reid, Anthony; Hoa, Nguyen; Zaw, Ko Ko; Aung, Si Thu

    2017-03-24

    International non-governmental organizations (INGOs) have been implementing community-based tuberculosis (TB) care (CBTBC) in Myanmar since 2011. Although the National TB Programme (NTP) ultimately plans to take over CBTBC, there have been no evaluations of the models of care or of the costs of providing CBTBC in Myanmar by INGOs. This was a descriptive study using routinely-collected programmatic and financial data from four INGOs during 2013 and 2014, adjusted for inflation. Data analysis was performed from the provider perspective. Costs for sputum examination were not included as it was provided free of charge by NTP. We calculated the average cost per year of each programme and cost per patient completing treatment. Four INGOs assisted the NTP by providing CBTBC in areas where access to TB services was challenging. Each INGO faced different issues in their contexts and responded with a diversity of strategies. The total costs ranged from US$ 140 754 to US$ 550 221 during the study period. The cost per patient completing treatment ranged from US$ 215 to US$ 1 076 for new cases and US$ 354 to US$ 1 215 for retreatment cases, depending on the targeted area and the package of services offered. One INGO appeared less costly, more sustainable and patient oriented than others. This study revealed a wide variety of models of care and associated costs for implementing CBTBC in diverse and challenging populations and contexts in Myanmar. Consequently, we recommend a more comprehensive evaluation, including development of a cost model, to estimate the costs of scaling up CBTBC country-wide, and cost-effectiveness studies, to best inform the NTP as it prepares to takeover CBTBC activities from INGOs. While awaiting evidence from these studies, model of CBTBC that have higher sustainability potential and allocate more resources to patient-centered care should be given priority support.

  16. International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

    Science.gov (United States)

    Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

    2017-03-24

    National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

  17. Shaped by asymmetrical interdependence: a qualitative case study of the external influences on international non-governmental organizations' implementation of equity principles in HIV/AIDS work.

    Science.gov (United States)

    Dyke, Elizabeth; Edwards, Nancy; McDowell, Ian; Muga, Richard; Brown, Stephen

    2014-10-08

    Addressing inequities is a key role for international non-governmental organizations (INGOs) working in health and development. Yet, putting equity principles into practice can prove challenging. In-depth empirical research examining what influences INGOs' implementation of equity principles is limited. This study examined the influences on one INGO's implementation of equity principles in its HIV/AIDS programs. This research employed a case study with nested components (an INGO operating in Kenya, with offices in North America). We used multiple data collection methods, including document reviews, interviews (with staff, partners and clients of the INGO in Kenya), and participant observation (with Kenyan INGO staff). Participant observation was conducted with 10 people over three months. Forty-one interviews were completed, and 127 documents analyzed. Data analysis followed Auerbach and Silverstein's analytic process (2003), with qualitative coding conducted in multiple stages, using descriptive matrices, visual displays and networks (Miles and Huberman, 1994). There was a gap between the INGO's intent to implement equity principles and actual practice due to multiple influences from various players, including donors and country governments. The INGO was reliant on donor funding and needed permission from the Kenyan government to work in-country. Major influences included donor agendas and funding, donor country policies, and Southern country government priorities and legislation. The INGO privileged particular vulnerable populations (based on its reputation, its history, and the priorities of the Kenyan government and the donors). To balance its equity commitment with the influences from other players, the INGO aligned with the system as well as pushed back incrementally on the donors and the Kenyan government to influence these organizations' equity agendas. By moving its equity agenda forward incrementally and using its reputational advantage, the INGO avoided

  18. STD patients’ preferences for HIV prevention strategies

    Directory of Open Access Journals (Sweden)

    Castro JG

    2014-12-01

    Full Text Available Jose G Castro,1 Deborah L Jones,2 Stephen M Weiss2 1Infectious Diseases, Department of Medicine, 2Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA Abstract: The objective of this pilot study was to explore the knowledge of and preferences regarding effective biomedical interventions among high risk individuals attending a sexually transmitted diseases clinic, and to examine the effect of a brief information intervention on preference. Participants completed a baseline assessment, attended a presentation on human immunodeficiency virus (HIV prevention methods, and completed a postintervention assessment. Outcome measures included: demographics and sexual risk factors, self-perceived HIV risk, and knowledge and attitudes regarding new biomedical methods of HIV prevention. After the baseline evaluation, participants were provided with information on new biomedical prevention strategies. Participants were given the option to review the information by reading a pamphlet or by viewing a brief video containing the same information. Participants (n=97 were female (n=51 and male (n=46. At baseline, only a small minority of participants were aware of the newer biomedical strategies to prevent HIV infection. Postintervention, 40% endorsed having heard about the use of HIV medications to prevent HIV infection; 72% had heard that male circumcision can decrease the risk of acquiring HIV infection in men; and 73% endorsed knowledge of the potential role of microbicides in decreasing the risk of acquiring HIV. Following the intervention, the most preferred prevention method was male condoms, followed by preexposure prophylaxis, and microbicides. The least preferred methods were male circumcision and female condoms. This study provides preliminary information on knowledge and attitudes regarding newer biomedical interventions to protect against HIV infection. Keywords: STD clinic, biomedical HIV prevention, PrEP, male

  19. Core indicators evaluation of effectiveness of HIV-AIDS preventive-control programmes carried out by nongovernmental organizations. A mixed method study

    Directory of Open Access Journals (Sweden)

    Mansilla Rosa

    2011-07-01

    Full Text Available Abstract Background The number of nongovernmental organizations working on AIDS has grown. There is great diversity in the type of activities and population groups that have been targeted. The purposes of this study are: to describe and analyze the objectives and HIV-AIDS preventive activities that are carried out by the AIDS-NGOs that work with AIDS in Catalonia and that receive subsidies from the Department of Health; and to develop a comprehensive proposal for measurable and agreed upon core quality evaluation indicators to monitor and assess those objectives and activities that can have an impact on the fight against inequalities and stigmatization, and incorporate the perspectives of the service providers and users. Methods A mixed method study has been carried out with professionals from the 36 NGOs that work with HIV/AIDS in Catalonia, as well as their users. This study achieved the completeness model using the following phases: 1. A systematic review of AIDS-NGOs annual reports and preparation of a catalogue of activities grouped by objectives, level of prevention and AIDS-NGOs target population; 2. A transversal study through an ad-hoc questionnaire administered to the AIDS-NGOs representatives; 3. A qualitative study with a phenomenological approach through focus groups, individual interviews and observations; 4. Consensus meetings between AIDS-NGOs professionals and the research team using Haddon matrices in order to establish a proposal of evaluation indicators. Results The information was classified according to level of prevention and level of intervention. A total of 248 objectives and 258 prevention activities were identified. 1564 evaluation indicators, addressed to 7 target population groups, were produced. Thirty core activities were selected. The evaluation indicators proposed for these activities were: 76 indicators for 15 primary prevention activities, 43 for 5 secondary prevention activities and 68 for 10 tertiary

  20. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study.

    Science.gov (United States)

    Larsson, Madelene; Pettersson, Camilla; Skoog, Therése; Eriksson, Charli

    2016-02-24

    Mental health problems among young women aged 16-24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés' own experiences of the relationship process based on a relational-cultural theory perspective. The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15-26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis. The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés' terms. The closure of relationships aroused feelings of both abandonment and developing strength. Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor training should focus on promoting skills such as active listening and respect

  1. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study

    Directory of Open Access Journals (Sweden)

    Madelene Larsson

    2016-02-01

    Full Text Available Abstract Background Mental health problems among young women aged 16–24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés’ own experiences of the relationship process based on a relational-cultural theory perspective. Methods The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15–26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis. Results The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés’ terms. The closure of relationships aroused feelings of both abandonment and developing strength. Conclusions Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor

  2. Evaluating the oil sands reclamation process: Assessing policy capacity and stakeholder access for government and non-governmental organizations operating in Alberta's oil sands

    Science.gov (United States)

    Patterson, Tyler

    By employing interpretive policy analysis this thesis aims to assess, measure, and explain policy capacity for government and non-government organizations involved in reclaiming Alberta's oil sands. Using this type of analysis to assess policy capacity is a novel approach for understanding reclamation policy; and therefore, this research will provide a unique contribution to the literature surrounding reclamation policy. The oil sands region in northeast Alberta, Canada is an area of interest for a few reasons; primarily because of the vast reserves of bitumen and the environmental cost associated with developing this resource. An increase in global oil demand has established incentive for industry to seek out and develop new reserves. Alberta's oil sands are one of the largest remaining reserves in the world, and there is significant interest in increasing production in this region. Furthermore, tensions in several oil exporting nations in the Middle East remain unresolved, and this has garnered additional support for a supply side solution to North American oil demands. This solution relies upon the development of reserves in both the United States and Canada. These compounding factors have contributed to the increased development in the oil sands of northeastern Alberta. Essentially, a rapid expansion of oil sands operations is ongoing, and is the source of significant disturbance across the region. This disturbance, and the promises of reclamation, is a source of contentious debates amongst stakeholders and continues to be highly visible in the media. If oil sands operations are to retain their social license to operate, it is critical that reclamation efforts be effective. One concern non-governmental organizations (NGOs) expressed criticizes the current monitoring and enforcement of regulatory programs in the oil sands. Alberta's NGOs have suggested the data made available to them originates from industrial sources, and is generally unchecked by government

  3. Research Program of Adolescent HIV Prevention Strategies | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In Africa, HIV is having a devastating impact on young people. Globally, youth aged 15 to 24 account for almost one third of all new infections. There are unique challenges to implementing adolescent-friendly policies and HIV prevention programs. More research is needed to inform HIV prevention strategies focusing on ...

  4. Influence of faith-based organisations on HIV prevention strategies ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... Keywords: Faith-based organisations, HIV prevention strategies, systematic review. DOI: https://dx.doi.org/10.4314/ahs.v17i3.18. Cite as: Ochillo MA, Teijlingen EV, Hind M. Influence of faith-based organisations on HIV prevention strategies in Africa: a systematic review. .... Business Source Complete. 3. 12.

  5. Research Program of Adolescent HIV Prevention Strategies | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In Africa, HIV is having a devastating impact on young people. Globally, youth aged 15 to 24 account for almost one third of all new infections. There are unique challenges to implementing adolescent-friendly policies and HIV prevention programs. More research is needed to inform HIV prevention strategies focusing on ...

  6. 75 FR 70270 - Submission for OMB Review; Comment Request; Pretesting of NIAID's Biomedical HIV Prevention...

    Science.gov (United States)

    2010-11-17

    ... NIAID's Biomedical HIV Prevention Research Communication Messages SUMMARY: In compliance with the... Collection: Title: Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages. Type of... biomedical HIV prevention research. The primary objectives of the pretests are to (1) Assess audience...

  7. A national, geographic database of CDC-funded HIV prevention services: development challenges and potential applications

    Directory of Open Access Journals (Sweden)

    Fogarty Kieran J

    2005-11-01

    Full Text Available Abstract Background From 2000–2002, the Centers for Disease Control and Prevention (CDC funded a study that was designed to improve the information available to program planners about the geographic distribution of CDC-funded HIV prevention services provided by community-based organizations (CBOs. Program managers at CDC recognized the potential of a geographic information system (GIS to organize and analyze information about HIV prevention services and they made GIS a critical component of the study design. The primary objective of this study was to construct a national, geographically-referenced database of HIV prevention services provided by CDC-funded CBOs. We designed a survey instrument to collect information about the geographic service areas where CBOs provided HIV prevention services, then collected data from CBOs that received CDC funding for these services during fiscal year 2000. We developed a GIS database to link questionnaire responses with GIS map layers in a manner that would incorporate overlapping geographies, risk populations and prevention services. We collected geographic service area data in two formats: 1 geopolitical boundaries and 2 geographic distance. Results The survey response rate was 70.3%, i.e. 1,020 of 1,450 community-based organizations responded. The number of HIV prevention programs administered by each CBO ranged from 1 to 23. The survey provided information about 3,028 prevention programs, including descriptions of intervention types, risk populations, race and ethnicity, CBO location and geographic service area. We incorporated this information into a large GIS database, the HIV Prevention Services Database. The use of geopolitical boundaries provided more accurate results than geographic distance. The use of a reference map with the questionnaire improved completeness, accuracy and precision of service area data. Conclusion The survey instrument design and database development procedures that we used

  8. The challenge of defining standards of prevention in HIV prevention trials.

    Science.gov (United States)

    Philpott, Sean; Heise, Lori; McGrory, Elizabeth; Paxton, Lynn; Hankins, Catherine

    2011-04-01

    As new HIV prevention tools are developed, researchers face a number of ethical and logistic questions about how and when to include novel HIV prevention strategies and tools in the standard prevention package of ongoing and future HIV prevention trials. Current Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) guidance recommends that participants in prevention trials receive 'access to all state of the art HIV risk reduction methods', and that decisions about adding new tools to the prevention package be made in consultation with 'all relevant stakeholders'. The guidance, however, leaves open questions of both process and implementation. In March 2009, the Global Campaign for Microbicides, UNAIDS and the Centers for Disease Control and Prevention convened a consultation to develop practical answers to these questions. Fifty-nine diverse participants, including researchers, ethicists, advocates and policymakers, worked to develop consensus criteria on when to include new HIV prevention tools in future trials. Participants developed a set of questions to guide decision-making, including: whether the method has been recommended by international bodies or adopted at a national level; the size of the effect and weight of the evidence; relevance to the trial population; whether the tool has been approved or introduced in the trial country; whether adding the tool might lead to trial futility; outstanding safety issues and status of the trial. Further work is needed to develop, implement and evaluate approaches to facilitate meaningful stakeholder participation in this deliberative process.

  9. Future of phylogeny in HIV prevention.

    Science.gov (United States)

    Brenner, Bluma G; Wainberg, Mark A

    2013-07-01

    The success of the HIV Prevention Trials Network 052 trial has led to revisions in HIV-1 treatment guidelines. Antiretroviral therapy may reduce the risk of HIV-1 transmissions at the population level. The design of successful treatment as prevention interventions will be predicated on a comprehensive understanding of the spatial, temporal, and biological dynamics of heterosexual men who have sex with men and intravenous drug user epidemics. Viral phylogenetics can capture the underlying structure of transmission networks based on the genetic interrelatedness of viral sequences and cluster networks that could not be otherwise identified. This article describes the phylogenetic expansion of the Montreal men who have sex with men epidemic over the last decade. High rates of coclustering of primary infections are associated with 1 infection leading to 13 onward transmissions. Phylogeny substantiates the role of primary and recent stage infection in transmission dynamics, underlying the importance of timely diagnosis and immediate antiretroviral therapy initiation to avert transmission cascades.

  10. Sex workers in HIV prevention: From Social Change Agents to Peer Educators.

    Science.gov (United States)

    George, Annie; Blankenship, Kim M; Biradavolu, Monica R; Dhungana, Nimesh; Tankasala, Nehanda

    2015-01-01

    We utilised a comparative ethnographic approach to study the implementation of a community mobilisation intervention addressing HIV risk among female sex workers (FSWs) in India, as implemented first by an non-governmental organisation and after oversight of the intervention was transitioned to the government. We demonstrate that the work of peer outreach workers changed from Social Change Agents within a community-led structural intervention (CLSI) to Peer Educators within a targeted intervention (TI). In the CLSI approach, built on the assumption that FSW risk for HIV is rooted in power inequality and structural vulnerability, peer outreach workers mobilised their peers through community-based organisations to address underlying conditions of inequality and vulnerability. In contrast, the TI approach, which views FSW risk as a function of limited knowledge and barriers to services, addressed peers' access to information and health services. Analysis of changes in the function of peer outreach workers reveals critical differences of which we discuss four: assumptions about conditions that produce HIV risk; degree of emphasis placed on collective mobilising and building collective power; extent to which community mobilisation and HIV prevention goals are linked; and the intervention's use of peer input. We discuss the implications of these findings for HIV prevention programming.

  11. Empowering peer group leaders for HIV prevention in Malawi.

    Science.gov (United States)

    McCreary, Linda L; Kaponda, Chrissie P N; Davis, Kristina; Kalengamaliro, Mary; Norr, Kathleen F

    2013-09-01

    Behavioral change interventions using peer group leaders are effective and widely used, but few studies have examined how being a peer group leader affects the leaders. This study describes how participants felt being a peer group leader affected their lives. This descriptive qualitative study interviewed 18 experienced peer group leaders who had conducted a multisession human immunodeficiency virus (HIV) prevention peer group intervention in rural Malawi. We used inductive content analysis and comparisons within and between cases. Three major themes were identified. All leaders said they experienced personal changes in their knowledge, attitudes, or HIV prevention behaviors. They described interacting with family, neighbors, and friends, and speaking at church or community meetings, to discuss HIV prevention issues. They increased their self-efficacy to engage others in sensitive HIV prevention issues, developed a self-identity as a change agent, and came to be recognized in their community as trustworthy advisors about HIV and acquired immunodeficiency syndrome. These three themes, taken together, form the meta-theme of psychological empowerment. Being a peer group leader empowered the leaders as change agents for HIV prevention and had impacts in the community after the intervention ended, potentially increasing the long-term effectiveness and cost effectiveness of peer group interventions. Healthcare workers and community volunteers who led HIV prevention sessions continued HIV prevention activities in the community and workplace after the program ended. Training health workers as volunteer HIV prevention leaders offers a strategy to bring HIV prevention to limited-resource settings, despite health worker shortages. © 2013 Sigma Theta Tau International.

  12. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.

    Science.gov (United States)

    Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin

    2016-11-01

    Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

  13. HIV prevention and education in state prison systems: an update.

    Science.gov (United States)

    Lyons, Thomas; Osunkoya, Emmanuel; Anguh, Ivonne; Adefuye, Adedeji; Balogun, Joseph

    2014-04-01

    The prevalence rate of HIV infection in jails and prisons is approximately 5 times the rate in the U.S. general population. The authors surveyed state prison officials to assess HIV testing and HIV prevention policies--specifically voluntary testing, group HIV prevention counseling, and peer education--in the 50 states and to determine whether those policies are associated with the characteristics of the state and its prison population.

  14. Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa

    National Research Council Canada - National Science Library

    Lippman, Sheri A; Treves-Kagan, Sarah; Gilvydis, Jennifer M; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

    2014-01-01

    ..., and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa...

  15. Recruitment of Underrepresented Minority Researchers into HIV Prevention Research: The HIV Prevention Trials Network Scholars Program

    Science.gov (United States)

    Hamilton, Erica L.; Griffith, Sam B.; Jennings, Larissa; Dyer, Typhanye V.; Mayer, Kenneth; Wheeler, Darrell

    2018-01-01

    Abstract Most U.S. investigators in the HIV Prevention Trials Network (HPTN) have been of majority race/ethnicity and sexual orientation. Research participants, in contrast, have been disproportionately from racial/ethnic minorities and men who have sex with men (MSM), reflecting the U.S. epidemic. We initiated and subsequently evaluated the HPTN Scholars Program that mentors early career investigators from underrepresented minority groups. Scholars were affiliated with the HPTN for 12–18 months, mentored by a senior researcher to analyze HPTN study data. Participation in scientific committees, trainings, protocol teams, and advisory groups was facilitated, followed by evaluative exit surveys. Twenty-six trainees have produced 17 peer-reviewed articles to date. Research topics typically explored health disparities and HIV prevention among black and Hispanic MSM and at-risk black women. Most scholars (81% in the first five cohorts) continued HIV research after program completion. Alumni reported program-related career benefits and subsequent funding successes. Their feedback also suggested that we must improve the scholars' abilities to engage new research protocols that are developed within the network. Mentored engagement can nurture the professional development of young researchers from racial/ethnic and sexual minority communities. Minority scientists can benefit from training and mentoring within research consortia, whereas the network research benefits from perspectives of underrepresented minority scientists. PMID:29145745

  16. Faith leaders' comfort implementing an HIV prevention curriculum in a faith setting.

    Science.gov (United States)

    Pichon, Latrice C; Griffith, Derek M; Campbell, Bettina; Allen, Julie Ober; Williams, Terrinieka T; Addo, Angela Y

    2012-08-01

    YOUR Blessed Health (YBH) is a faith-based HIV prevention pilot program designed to increase faith-based organizations' capacity to address HIV/AIDS among African American congregations. Faith leaders (e.g., pastors, pastors' spouses) were trained to deliver youth and adult HIV education sessions. Perceptions of comfort with discussing 11 sexual health topics were assessed after program implementation. Twenty-nine faith leaders self-reported their comfort discussing sexual behaviors, sexual communication, and sexual abuse. Overall, faith leaders were comfortable discussing these sexual health topics; however, denominational and leadership role differences were found. These findings suggest African American faith leaders are willing to lead faith-based HIV prevention efforts, but that consideration of denominational differences and organizational roles in faith-based health promotion programs is critical.

  17. Epistemic fault lines in biomedical and social approaches to HIV prevention

    Directory of Open Access Journals (Sweden)

    Adam Barry D

    2011-09-01

    Full Text Available Abstract This paper raises the question of how knowledge creation is organized in the area of HIV prevention and how this concatenation of expertise, resources, at-risk people and viruses shapes the knowledge used to impede the epidemic. It also seeks to trouble the discourses of biomedical pre-eminence in the field of HIV prevention by examining the claim for treatment as prevention, looking at evidence constructed through the biomedical frame and through the lens of the sociology of science. These questions lie within a larger socio-historical context of lagging worldwide attention and funding to prevention in the HIV area and, in particular, neglect of populations at greatest risk. Much contemporary HIV prevention research relies on a population science divided over an epistemic fault line from the communities and individuals who must make sense of the intrusion of a life-threatening disease into their pursuit of pleasure and intimacy. There are, nevertheless, lessons to be learned from prevention success stories among sex workers, injection drug users, and gay and bisexual men. The success stories point to a need for a robust social science agenda that examines: the ways that people are socially organized and networked; the popular strategies and folk wisdoms developed in the face of HIV risk; socio-historical movement of sexual and drug cultures; the dynamics of popular mobilization to advance health; the institutional sources of HIV discourses; and popular understandings of HIV technologies and messages.

  18. On the certification of forest concession: non-governmental organizations, enterprises, and the construction of a new institutional frame for the development of the lumber industry in the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Marcelo Sampaio Carneiro

    2011-12-01

    Full Text Available The article discusses the construction process of forest certification in the Brazilian Amazon, emphasizing its importance for the new frame of lumber industry on that region. We sustain that one of the main results of the promotion of forest certification by the Forest Stewardship Council (FSC in Amazon was the constitution of an alliance between the environmentalist Non-Governmental Organizations, representative segments of forest business and members of the state bureaucracy for the promotion of lumber exploration based on forest management. In this perspective, the results produced by certification must be understood as part of a process of promotion of forest resources access policies, such as the approval of the Public Forests Management Law, and the creation of state entities destined to the promotion of lumber extraction on Amazon.

  19. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen.

    Science.gov (United States)

    Salazar, Ximena; Núnez-Curto, Arón; Villayzán, Jana; Castillo, Regina; Benites, Carlos; Caballero, Patricia; Cáceres, Carlos F

    2016-01-01

    As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a "Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen." A policy dialogue between key stakeholders - Peru's Ministry of Health, academic scientists, civil society, transgender leaders and international agencies - created the conditions for a change in Peru's national HIV policy for transwomen. Supported by the effective engagement of all sectors, the Ministry of Health launched a plan to provide comprehensive HIV prevention and care for transwomen. The five-year plan includes new national guidelines for HIV prevention, care and support, and country-level investments in infrastructure and equipment. In addition to new biomedical strategies, the plan also incorporates several strategies to address structural factors that contribute to the vulnerability of transwomen. We identified three key factors that created the right conditions for this change in Peru's HIV policy. These factors include (1) the availability of solid evidence, based on scientific research; (2) ongoing efforts within the transwomen community to become better advocates of their own rights; and (3) a dialogue involving honest discussions between stakeholders about possibilities of changing the nation's HIV policy. The creation of Peru's national plan for HIV prevention and care for transwomen shows that long-term processes, focused on human rights for transwomen in Peru, can lead to organizational and public-policy change.

  20. Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. Methods A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY gained were also included. All studies were assessed against quality criteria. Results The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. Conclusion We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.

  1. The costs of HIV prevention for different target populations in Mumbai, Thane and Banglalore

    Directory of Open Access Journals (Sweden)

    Chandrashekar Sudha

    2011-12-01

    Full Text Available Abstract Background Avahan, the India AIDS Initiative, delivers HIV prevention services to high-risk populations at scale. Although the broad costs of such HIV interventions are known, to-date there has been little data available on the comparative costs of reaching different target groups, including female sex workers (FSWs, replace with ‘high risk men who have sex with men (HR-MSM and trans-genders. Methods Costs are estimated for the first three years of Avahan scale up differentiated by typology of female sex workers (brothel, street, home, lodge based, bar based, HR-MSM and transgenders in urban districts in India: Mumbai and Thane in Maharashtra and Bangalore in Karnataka. Financial and economic costs were collected prospectively from a provider perspective. Outputs were measured using data collected by the Avahan programme. Costs are presented in US$2008. Results Costs were found to vary substantially by target group. Non-governmental organisations (NGOs working with transgender populations had a higher mean cost (US $116 per person reached compared to those dealing primarily with FSWs (US $75-96 and MSWs (US $90 by the end of year three of the programme in Mumbai. The mean cost of delivering the intervention to HR-MSMs (US $42 was higher than delivering it to FSWs (US $37 in Bangalore. The package of services delivered to each target group was similar, and our results suggest that cost variation is related to the target population size, the intensity of the programme (in terms of number of contacts made per year and a number of specific issues related to each target group. Conclusions Based on our data policy makers and program managers need to consider the ease of accessing high risk population when planning and budgeting for HIV prevention services for these populations and avoid funding programmes on the basis of target population size alone.

  2. HIV prevention costs and their predictors: evidence from the ORPHEA Project in Kenya.

    Science.gov (United States)

    Galárraga, Omar; Wamai, Richard G; Sosa-Rubí, Sandra G; Mugo, Mercy G; Contreras-Loya, David; Bautista-Arredondo, Sergio; Nyakundi, Helen; Wang'ombe, Joseph K

    2017-12-01

    We estimate costs and their predictors for three HIV prevention interventions in Kenya: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT) and voluntary medical male circumcision (VMMC). As part of the 'Optimizing the Response of Prevention: HIV Efficiency in Africa' (ORPHEA) project, we collected retrospective data from government and non-governmental health facilities for 2011-12. We used multi-stage sampling to determine a sample of health facilities by type, ownership, size and interventions offered totalling 144 sites in 78 health facilities in 33 districts across Kenya. Data sources included key informants, registers and time-motion observation methods. Total costs of production were computed using both quantity and unit price of each input. Average cost was estimated by dividing total cost per intervention by number of clients accessing the intervention. Multivariate regression methods were used to analyse predictors of log-transformed average costs. Average costs were $7 and $79 per HTC and PMTCT client tested, respectively; and $66 per VMMC procedure. Results show evidence of economies of scale for PMTCT and VMMC: increasing the number of clients per year by 100% was associated with cost reductions of 50% for PMTCT, and 45% for VMMC. Task shifting was associated with reduced costs for both PMTCT (59%) and VMMC (54%). Costs in hospitals were higher for PMTCT (56%) in comparison to non-hospitals. Facilities that performed testing based on risk factors as opposed to universal screening had higher HTC average costs (79%). Lower VMMC costs were associated with availability of male reproductive health services (59%) and presence of community advisory board (52%). Aside from increasing production scale, HIV prevention costs may be contained by using task shifting, non-hospital sites, service integration and community supervision. © The Author 2017. Published by Oxford University Press in association with The London School of

  3. 'Culture' as HIV prevention: Indigenous youth speak up!

    OpenAIRE

    Ciann Wilson; Vanessa Oliver; Sarah Flicker; Native Youth Sexual Health Network; Tracey Prentice; Randy Jackson; June Larkin; Jean-Paul Restoule; Claudia Mitchell

    2016-01-01

    This article explores the ways in which (a) Indigenous youth involved in an HIV intervention took up and reclaimed their cultures as a project of defining ‘self’, and (b) how Indigenous ‘culture’ can be used as a tool for resistance, HIV prevention and health promotion. Data were drawn from the Taking Action Project: Using arts-based approaches to develop Aboriginal youth leadership in HIV prevention. ‘By youth, for youth’ HIV education and awareness workshops were facilitated in six Indigeno...

  4. Attitude of farmers towards Non-Governmental Extension ...

    African Journals Online (AJOL)

    ... to using NGOE services (r=0.428) had significant relationships with respondents' attitude towards NGEOs. Synergies and collaboration between governmental and NGEOs become imperative for efficient and effective delivery of extension services. Key words: Non-governmental extension organization, attitude of farmers ...

  5. Impact of Conservation Activities of Non-Governmental ...

    African Journals Online (AJOL)

    Impact of Conservation Activities of Non-Governmental Organizations on Sustainable Tourism and Economic Growth in Cross River State, Nigeria. ... Thus, different initiatives have been evolved by concerned agencies on how environmental resources can be preserved for continuous use and benefit - in perpetuity. Such a ...

  6. HIV prevention for Black women: structural barriers and opportunities.

    Science.gov (United States)

    Newman, Peter A; Williams, Charmaine C; Massaquoi, Notisha; Brown, Marsha; Logie, Carmen

    2008-08-01

    Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.

  7. Attitudes and Practices on HIV Prevention among students of Higher ...

    African Journals Online (AJOL)

    Attitudes and Practices on HIV Prevention among students of Higher Education Institutions in Ethiopia: The Case of Addis Ababa University. ... Data were collected using survey quantitative (questionnaire) and qualitative (FGDs), and subsequently, analysis of the data was made through the use of descriptive statistics ...

  8. Biomedical HIV Prevention Research and Development in Africa

    African Journals Online (AJOL)

    AJRH Managing Editor

    Chairman, Board of Trustees, New HIV Vaccine and Microbicide Advocacy Society (NHVMAS). The research and development process for new. HIV prevention technologies is a global enterprise and most parts of Africa, have been actively involved in the identification and development of effective methods. The new tools ...

  9. Placing contraception at the centre of the HIV prevention agenda ...

    African Journals Online (AJOL)

    However, the reach of these interventions is still very limited in adolescent girls and young women (15–24 years) and the full realisation of the intervention mandates has not yet been achieved. The HIV prevention field has been criticised for the tendency to adopt a narrow focus. The Fast-Track Strategy offers a unique ...

  10. Tapping local resources for HIV prevention among the Borana ...

    African Journals Online (AJOL)

    Key findings: In Borana, HIV prevention endeavors were found to be coordinated by the zonal health department. Health extension workers, local teachers and youth groups were important agents facilitating HIV awareness creation activities at community level. However, these facilitators were not recognized as credible ...

  11. HIV prevention awareness and practices among married couples in ...

    African Journals Online (AJOL)

    Abstract. In this study we explored the level of awareness and practice on HIV prevention among married couples from selected communities in. Malawi. Methods. We carried out the study from October to December, 2008 in four communities, two each from Chiradzulu and Chikhwawa districts of. Malawi. We conducted ...

  12. Tapping local resources for HIV prevention among the Borana ...

    African Journals Online (AJOL)

    admin

    members of the community were carried out. Data so collected were coded, categorized and summarized with an application of MAXQDA 10 qualitative data analysis software. Key findings: In Borana, HIV prevention endeavors were found to be coordinated by the zonal health department. Health extension workers, local ...

  13. Adolescent Use of Two Types of HIV Prevention Agencies

    Science.gov (United States)

    Hohman, Melinda; Shillington, Audrey M.; Min, Jong Won; Clapp, John D.; Mueller, Kristin; Hovell, Melbourne

    2008-01-01

    This study compared two groups of adolescents seeking help at HIV prevention drop-in agencies. The first group attended agencies in low-income Hispanic neighborhoods which recruited within the locale. The second group of youth attended agencies that recruited based upon a specific population--they targeted homeless and LGBQ youth. We explored the…

  14. Religiosity for HIV prevention in Uganda: A case study among ...

    African Journals Online (AJOL)

    Background: Utilization of religious institutions is one of the strategies for HIV prevention in Uganda. There is limited data on the association between religiosity and HIV infection rates. Objective: To determine the association between religiosity and HIV prevalence rates among Christians. Methods: An unmatched ...

  15. Resourcing resilience: social protection for HIV prevention amongst ...

    African Journals Online (AJOL)

    Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with ...

  16. Combination HIV prevention options for young women in Africa ...

    African Journals Online (AJOL)

    Combination HIV prevention options for young women in Africa. Cheryl Baxter, Salim Abdool Karim. Abstract. Although the number of new HIV infections has declined by over 30% in the past decade, the number of people who acquire HIV each year remains unacceptably high. In 2014 the Joint United Nations Programme ...

  17. Building Capacity for Conducting HIV Prevention Trials in the Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Healthcare workers are a priority group for HIV prevention trials because they constitute a large relatively healthy group at risk from blood-borne diseases ... to participate in designing, implementing and evaluating programs aimed at reducing the transmission of HIV and other infectious diseases in health personnel.

  18. Misconceptions about HIV prevention and transmission in Botswana ...

    African Journals Online (AJOL)

    Misconceptions about how HIV can be transmitted or prevented often prevent individuals from making informed choices and taking appropriate action. The purpose of the research was to explore the socio-demographic and behavioural factors in Botswana that are associated with misconceptions about HIV prevention and ...

  19. Technologies for HIV prevention and care: challenges for health services

    Directory of Open Access Journals (Sweden)

    Ivia Maksud

    2015-09-01

    Full Text Available ABSTRACTThis article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP and pre-exposure prophylaxis (PrEP, treatment as prevention (TASP and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  20. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  1. Non-governmental organizations and the sustainability of small and medium-sized enterprises in Peru : an analysis of networks and discourses

    OpenAIRE

    Castro Aponte, W.V.

    2013-01-01

      The importance of small and medium-sized enterprises (SMEs) in terms of employment and income generation has been recognized worldwide. In Peru, SMEs are responsible for 85% of the employment at the national level and they represent 98% of the total companies registered. Around 12% of SMEs, organized in associations, clusters, and cooperatives or as single companies, are dedicated to productive actives; the others are engaged in commercial and services activities. However, next to thei...

  2. [The impact of AIDS on the organizational development of nongovernmental organizations: a case study on Casa de Assistência Filadélfia].

    Science.gov (United States)

    Bochio, Ieda Maria Siebra; Fortes, Paulo Antonio de Carvalho

    2008-11-01

    AIDS has been a unique event due not only to its devastating effects, but also to the ways in which it has stimulated solidarity and mobilization of society in the defense of the rights of persons living with HIV/AIDS and their families, friends, and contacts. Beginning as initiatives to ensure dignity in death, AIDS NGOs have undergone structural changes to respond to the demands raised by the epidemic. The current study describes the history of the Brazilian AIDS NGO "Casa de Assistência Filadélfia" in relation to the evolution of the AIDS epidemic, highlighting the issue of organizational development. A qualitative case study methodology was used, and the data were collected from document analysis and semi-structured interviews with key informants identified by the organization. Data analysis was based on the theoretical premises of organizational development and shows how the organization made the transition from the pioneering phase marked by improvisation and expanded to a phase of regulation until reaching flexibility and innovation by diversifying its projects. The study highlights the importance of organizational development as an essential element in building healthy, agile organizations in the response to their demands.

  3. HIV prevention advice for people with serious mental illness.

    Science.gov (United States)

    Wright, Nicola; Akhtar, Athfah; Tosh, Graeme E; Clifton, Andrew V

    2014-12-08

    People with serious mental illness have rates of Human Immuno-deficiency Virus (HIV) infection higher than expected in the general population for the same demographic area. Despite this elevated prevalence, UK national strategies around sexual health and HIV prevention do not state that people with serious mental illness are a high risk group. However, a significant proportion in this group are sexually active and engage in HIV-risk behaviours including having multiple sexual partners, infrequent use of condoms and trading sex for money or drugs. Therefore we propose the provision of HIV prevention advice could enhance the physical and social well being of this population. To assess the effects of HIV prevention advice in reducing morbidity, mortality and preserving the quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (24 January, 2012), which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register. We planned to include all randomised controlled trials focusing on HIV prevention advice versus standard care or comparing HIV prevention advice with other more focused methods of delivering care or information for people with serious mental illness. Review authors (NW, AC, AA, GT) independently screened search results and did not identify any studies that fulfilled the review's criteria. We did not identify any randomised studies that evaluated advice regarding HIV for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to both people with serious mental illness and HIV risk are possible. Policy makers, clinicians, researchers and service users need to collaborate to produce guidance on how best to provide advice for people with serious mental illness in

  4. The challenge of defining standards of prevention in HIV prevention trials

    NARCIS (Netherlands)

    Philpott, Sean; Heise, Lori; McGrory, Elizabeth; Paxton, Lynn; Hankins, Catherine; Alexander, Lorraine; Apuuli, David Kihumuro; Baeten, Jared; Birx, Deborah; de Bruyn, Guy; Bukusi, Elizabeth; Burns, David; Calazans, Gabriela; Campbell, James; Caswell, Georgina; Coutinho, Alex; Dawson, Liza; Dhai, Amaboo; Dube, Samukeliso; Ecuru, Julius; Essack, Zaynab; Farley, Timothy; Gafos, Mitzy; Irungu, Pauline; Kaleebu, Pontiano; Kamali, Anatoli; Kestelyn, Evelyne; Kublin, James; Lohse, Nicolai; Lutalo, Tom; Macklin, Ruth; Mâsse, Benôıt; Mauney, Chris; McCormack, Sheena; Miller, Lori; Mfutso-Bengo, Joseph; Misra, Rajender; Muganwa, Margaret; Ndase, Patrick; Nel, Annalene; Nielsen, Leslie; Nkala, Busisiwe; O'Reilly, Kevin; Okware, Sam; Paicheler, Geneviève; Rees, Helen; Rerks-Ngarm, Supachai; Ridzon, Renee; Rosenberg, Zeda; Singh, Jerome; Sugarman, Jeremy; Taylor, Douglas; Tusubira, Evans; Ukpong, Morenike; Umulisa, Marie-Michèle; Warren, Mitchell; Slevin, Katherine West; van de Wijgert, Janneke

    2011-01-01

    As new HIV prevention tools are developed, researchers face a number of ethical and logistic questions about how and when to include novel HIV prevention strategies and tools in the standard prevention package of ongoing and future HIV prevention trials. Current Joint United Nations Programme on

  5. Sex, drugs and prisons: HIV prevention strategies for over 190 000 clients in Ukraine.

    Science.gov (United States)

    Denisiuk, O; Smyrnov, P; Kumar, A M V; Achanta, S; Boyko, K; Khogali, M; Naik, B; Zachariah, R

    2014-06-21

    One hundred and forty non-governmental organisations implementing human immunodeficiency virus (HIV) prevention programmes among clients, including people who inject drugs, prisoners, female sex workers, men who have sex with men and street children in Ukraine, 2010-2011. Among enrolled clients, to assess factors associated with HIV testing, HIV retesting within a year of initial testing and HIV seroconversion. Retrospective cohort study involving record reviews. Of 192 487 clients, 42 109 (22%) underwent an initial HIV test (22% were positive). Among HIV-negative clients at baseline, 10 858 (27%) were retested within a year: 317 (3%) of these were HIV-positive. HIV testing and retesting rates were lower among prisoners (0.3%) and others (street children and partners of those in risk groups, 6%), and those who did not receive counselling or services such as condom and needle distribution. Individuals who were not counselled were more likely to seroconvert. In this large cohort of high-risk groups from Eastern Europe, HIV testing was low and HIV sero-conversion was high. This is of public health concern, bringing into question the overall quality of counselling and how well it is tailored to the specific needs of various risk groups. Qualitative studies to understand the reasons for non-testing are urgently required for designing client-specific interventions.

  6. HIV prevention among transgender women in Latin America: implementation, gaps and challenges.

    Science.gov (United States)

    Silva-Santisteban, Alfonso; Eng, Shirley; de la Iglesia, Gabriela; Falistocco, Carlos; Mazin, Rafael

    2016-01-01

    Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate community and health workers in mixed teams; task

  7. HIV prevention among transgender women in Latin America: implementation, gaps and challenges

    Directory of Open Access Journals (Sweden)

    Alfonso Silva-Santisteban

    2016-07-01

    Full Text Available Introduction: Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. Methods: We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Results and discussion: Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina

  8. Fear appeals in HIV prevention: the role of anticipated regret.

    Science.gov (United States)

    Smerecnik, Chris M R; Ruiter, Robert A C

    2010-10-01

    The present study examined the role of a number of cognitive beliefs (i.e. attitude, subjective norm, anticipated regret, and self-efficacy) in explaining the effects of fear appeal information on behavioral motivation. A randomized experiment with a 2 (threat: low versus high) × 2 (coping: low versus high) between-subjects design was used in the study. Undergraduates were exposed to one of four scenario messages that presented high or low threat information about HIV/AIDS combined with high or low coping information with regard to condom use in HIV prevention. Explorative analyses revealed that only anticipated regret qualified as a mediator of the effect of the fear appeal message on intention. High coping information was observed to increase anticipated regret, which increased the intention to use condoms. Anticipated regret mediated the coping-intention relationship. This finding furthers our understanding of the working mechanisms of fear appeals in HIV prevention.

  9. Transgender HIV prevention: implementation and evaluation of a workshop.

    Science.gov (United States)

    Bockting, W O; Rosser, B R; Scheltema, K

    1999-04-01

    Virtually no HIV prevention education has specifically targeted the transgender community. To fill this void, a transgender HIV prevention workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evaluation using a pre-, post- and follow-up test design showed an increase in knowledge and an initial increase in positive attitudes that diminished over time. Due to the small sample size (N = 59) and limited frequency of risk behavior, a significant decrease in unsafe sexual or needle practices could not be demonstrated. However, findings suggested an increase in safer sexual behaviors such as (mutual) masturbation. Peer support improved significantly. Future prevention education should make special efforts to target the more difficult-to-reach, high-risk subgroups of the transgender population.

  10. Adapting HIV prevention evidence-based interventions in practice settings: an interview study

    Directory of Open Access Journals (Sweden)

    Kao Uyen H

    2009-11-01

    Full Text Available Abstract Background Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Methods Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73. Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Results Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Conclusion Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to

  11. Adapting HIV prevention evidence-based interventions in practice settings: an interview study.

    Science.gov (United States)

    Veniegas, Rosemary C; Kao, Uyen H; Rosales, Ricki

    2009-11-23

    Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73). Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to ensure that reinventions are evaluated and consistent with the

  12. Combination HIV Prevention and HIV Incidence in Uganda

    OpenAIRE

    Grabowski, Mary K; Serwadda, David M; Gray, Ronald H; Nakigozi, Gertrude; Kigozi, Godfrey; Kagaayi, Joseph; Ssekubugu, Robert; Nalugoda, Fred; Lessler, Justin; Lutalo, Thomas; Galiwango, Ronald; Makumbi, Fred; Kong, Xiangrong; Kabatesi, Donna; Alamo, Stella T

    2017-01-01

    BACKGROUND To assess the impact of combination HIV prevention (CHP) on HIV incidence, we analyzed the association between HIV incidence and scale-up of antiretroviral therapy (ART) and medical male circumcision in Rakai, Uganda. Changes in population-level viral load suppression and sexual behaviors were also examined. METHODS Between 1999 and 2016, data were collected through 12 surveys from 30 communities in the Rakai Community Cohort Study, an open population-based cohort of persons aged 1...

  13. 'Culture' as HIV prevention: Indigenous youth speak up!

    Directory of Open Access Journals (Sweden)

    Ciann Wilson

    2016-09-01

    Full Text Available This article explores the ways in which (a Indigenous youth involved in an HIV intervention took up and reclaimed their cultures as a project of defining ‘self’, and (b how Indigenous ‘culture’ can be used as a tool for resistance, HIV prevention and health promotion. Data were drawn from the Taking Action Project: Using arts-based approaches to develop Aboriginal youth leadership in HIV prevention. ‘By youth, for youth’ HIV education and awareness workshops were facilitated in six Indigenous communities across Canada, incorporating traditional and contemporary art forms to explore how youth perceived the links between structural inequality and HIV vulnerability. Over 100 youth participated, with 70 partaking in individual interviews to reflect on their experiences at the workshops. Interviews were audio-recorded, transcribed verbatim and analysed using NVivo software. Indigenous youth understood culture as a complex construct that included reconnecting to land, body, history, community and ceremony. For many youth, being Aboriginal and participating in cultural activities was seen as important for intergenerational healing, empowerment, health and combatting HIV. Youth spoke excitedly of their attempts to reclaim their languages and cultures despite barriers. They also understood art as a medium for self-expression and as an important site of cultural evolution. Our project demonstrates that the incorporation of culture within health strategies is important for effective HIV prevention amongst Indigenous youth. Reclaiming Indigenous cultures, languages and ceremonies may help to nurture future generations, diminish cycles of victimisation and combat hopelessness by reconnecting youth to stories of resistance and survival. Keywords: Indigenous youth, culture, HIV prevention, arts-based research

  14. Effective HIV prevention: the indispensable role of social science

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    Susan Kippax

    2012-04-01

    Full Text Available This paper examines the ways in which HIV prevention is understood including “biomedical”, “behavioural”, “structural”, and “combination” prevention. In it I argue that effective prevention entails developing community capacity and requires that public health addresses people not only as individuals but also as connected members of groups, networks and collectives who interact (talk, negotiate, have sex, use drugs, etc. together. I also examine the evaluation of prevention programmes or interventions and argue that the distinction between efficacy and effectiveness is often glossed and that, while efficacy can be evaluated by randomized controlled trials, the evaluation of effectiveness requires long-term descriptive strategies and/or modelling. Using examples from a number of countries, including a detailed account of the Australian HIV prevention response, effectiveness is shown to be dependent not only on the efficacy of the prevention technology or tool but also on the responses of people – individuals, communities and governments – to those technologies. Whether a particular HIV prevention technology is adopted and its use sustained depends on a range of social, cultural and political factors. The paper concludes by calling on biomedical and social scientists to work together and describes a “social public health”.

  15. HIV prevention research ethics: an introduction to the special issue.

    Science.gov (United States)

    Fisher, Celia B

    2014-02-01

    This special issue of the Journal of Empirical Research on Human Research Ethics represents a sampling of projects fostered through the NIDA-funded Fordham University HIV Prevention Research Ethics Institute. The first three articles employ processes of co-learning to give voice to the experiences of individuals recovering from substance abuse and engaged in sex work who have participated in HIV prevention studies in the United States, India, and the Philippines. The fourth article describes a unique community-based approach to the development of research ethics training modules designed to increase participation of American Indian and Alaskan Native (AI/AN) tribal members as partners in research on health disparities. The last two articles focus a critical scholarly lens on two underexamined areas confronting IRB review of HIV research: The emerging and continuously changing ethical challenges of using social media sites for recruitment into HIV prevention research, and the handling of research-related complaints from participants involving perceived research harms or research experiences that do not accord with their initial expectations. Together, the articles in this special issue identify key ethical crossroads and provide suggestions for best practices that respect the values and merit the trust of research participants.

  16. Persisting with prevention: The importance of adherence for HIV prevention

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    Hayes Richard J

    2008-07-01

    Full Text Available Abstract Background Only four out of 31 completed randomized controlled trials (RCTs of HIV prevention strategies against sexual transmission have shown significant efficacy. Poor adherence may have contributed to the lack of effect in some of these trials. In this paper we explore the impact of various levels of adherence on measured efficacy within an RCT. Analysis We used simple quantitative methods to illustrate the impact of various levels of adherence on measured efficacy by assuming a uniform population in terms of sexual behavior and the binomial model for the transmission probability per partnership. At 100% adherence the measured efficacy within an RCT is a reasonable approximation of the true biological efficacy. However, as adherence levels fall, the efficacy measured within a trial substantially under-estimates the true biological efficacy. For example, at 60% adherence, the measured efficacy can be less than half of the true biological efficacy. Conclusion Poor adherence during a trial can substantially reduce the power to detect an effect, and improved methods of achieving and maintaining high adherence within trials are needed. There are currently 12 ongoing HIV prevention trials, all but one of which require ongoing user-adherence. Attention must be given to methods of maximizing adherence when piloting and designing RCTs and HIV prevention programmes.

  17. Exploring Black College Females' Perceptions Regarding HIV Prevention Message Content.

    Science.gov (United States)

    Chandler-Coley, Rasheeta; Ross, Henry; Ozoya, Oluwatobi; Lescano, Celia; Flannigan, Timothy

    2017-02-01

    Media messages can facilitate the delivery of accurate information related to HIV and sexually transmitted infection. This study's purpose was to examine preexisting media campaigns from the iMPPACS study to assess age-, gender-, and culturally appropriate components identified by African American females who attend historically Black colleges/universities. In 3 separate focus group sessions, 31 Black female college students (M age = 20) viewed 4 vignettes and heard 3 audio-only clips, then ranked and commented on them based on perceived satisfaction with HIV prevention content and appropriateness of delivery. Conventional qualitative analysis using NVivo software was performed until saturation of content was achieved and themes derived. Six major themes emerged and were designated as (a) social media; (b) mirror image; (c) visually dynamic advertisements; (d) the real world; (e) people, place, things; and (f) HIV knowledge. Visually stimulating content (i.e., graphics) was found to be most appealing in marketing HIV prevention, with brief monologue/dialogue from scenarios that resemble daily life. Socially and culturally relevant HIV prevention messages are important to Black college female students. Participants recommended creating short audiovisual messages that encompass familiar contexts like dorm rooms and appealing graphics for HIV health promotion messages, such as emojis. Future audio-only prevention advertisements for this population should use recognizable voices (e.g., celebrities). Finally, messaging should be promoted on open and closed circuit social media platforms.

  18. A role for businesses in HIV prevention in Asia.

    Science.gov (United States)

    Kimball, A M; Thant, M

    1996-06-15

    The estimated number of HIV cases in Asia now exceeds the "worst case" scenario envisioned by the World Bank in 1993. While prevention efforts have failed to contain the epidemic in other parts of the world, Asia's private sector has the resources to contain the epidemic if it acts quickly. In parts of Asia, work place-based medical and health services already exist, but, to date, efforts to gain the cooperation of business and industry in HIV prevention programs have led to disappointment. Businesses in Thailand, on the other hand, have begun a vigorous prevention campaign led by the Thailand Business Coalition on AIDS. The countries where the epidemic has not yet made a big impact (Japan, Korea, Hong Kong, Indonesia, Viet Nam, and the Philippines) are those where intervention could be most effective. Unfortunately, little corporate cooperation is occurring in these areas. Asian companies seem to fear contamination from the disease if they engage in prevention activities. Businesses in Asia have not faced the reality of the costs of AIDS which will rob companies of highly skilled workers who are expensive to replace, drive away foreign capital, and shrink the home market as people dedicate their resources to health care. While the impact of AIDS on businesses follows a tiered approach, all enterprises will eventually be affected adversely. The interrelated nature of Asia economies will also mean that even nations which are not experiencing the epidemic will feel its economic impact (for example, Japan will see its gross national product decrease because of trade losses caused by the epidemic in Thailand). Prevention efforts by businesses must be supported and encouraged by governments with financial and other incentives. Multinational corporations can have an effect on national companies as well as organize programs for their own employees. Because they depend upon longterm strategic thinking, Asian financial institutions are beginning to understand the role that

  19. Prevention literacy: community-based advocacy for access and ownership of the HIV prevention toolkit.

    Science.gov (United States)

    Parker, Richard G; Perez-Brumer, Amaya; Garcia, Jonathan; Gavigan, Kelly; Ramirez, Ana; Milnor, Jack; Terto, Veriano

    2016-01-01

    Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings. Between January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention. The review included searches in electronic databases including MEDLINE, PsycINFO, PubMed, and Google Scholar. Permutations of the following search terms were used: "treatment literacy," "treatment education," "health literacy," and "prevention literacy." Through an iterative process of analyses and searches, titles and/or abstracts and reference lists of retrieved articles were reviewed for additional articles, and historical content analyses of grey literature and websites were additionally conducted. Treatment literacy was a well-established concept developed in the global South, which was later partially adopted by international agencies such as the World Health Organization. Treatment literacy emerged as more effective antiretroviral therapies became available. Developed from popular pedagogy and grassroots efforts during an intense struggle for treatment access, treatment literacy addressed the need to extend access to underserved communities and low-income settings that might otherwise be excluded from access. In contrast, prevention literacy is absent in the recent surge of new biomedical prevention strategies; prevention literacy was scarcely referenced and undertheorized in the available literature. Prevention efforts today include multimodal techniques, which jointly comprise a toolkit of biomedical, behavioural, and structural/environmental approaches. However, linkages to community advocacy and mobilization

  20. Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa.

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    Sheri A Lippman

    Full Text Available Building a successful combination prevention program requires understanding the community's local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa.The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO's Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews.We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV.Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four 'themes' identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis

  1. Effectiveness and impact of the cross-border healthcare model as implemented by non-governmental organizations: case study of the malaria control programs by health poverty action on the China-Myanmar border.

    Science.gov (United States)

    Zhang, Jun; Dong, Jia-Qiang; Li, Jia-Ying; Zhang, Yue; Tian, Yang-Hui; Sun, Xiao-Ying; Zhang, Guang-Yun; Li, Qing-Pu; Xu, Xiao-Yu; Cai, Tao

    2016-09-01

    In the Yunnan province of China, 18 counties in six prefectures border Myanmar. Due to its particular combination of geographic features, climate conditions, and cultural landscape, the area provides a suitable environment for the spread of insect-borne diseases such as malaria. In five identified Myanmar Special Regions along the China-Myanmar border, economic development is lagging, people live in extreme poverty, and the healthcare system is fragile. Coupled with political and other reasons, this precludes malaria control work to be effectively carried out in Myanmar, resulting in a heavy burden of the disease. Frequent population movements and favorable conditions for malaria transmission on the border fuel difficulties in controlling and eliminating the spread of the disease in the area. To reduce the prevalence of malaria in the China-Myanmar border area and improve healthcare services for local residents in this particular environment, Health Poverty Action (HPA) has provided malaria aid in the area since the beginning of 2006, as a sub-recipient of the China Global Fund Malaria Programs. In this case study, we examined HPA's activities as part of its malaria control programs in the area, analyzed and summarized the effectiveness and impact of the cross-border healthcare model as implemented by non-governmental organizations, and put forward suggestions for cross-border health aid models and for the prevention of malaria transmission in the Greater Mekong Subregion. HPA had carried out a great quantity of successful malaria control activities in border areas between China and Myanmar, strengthened the partnership and established the collaboration, coordination and cooperation channels among stakeholders. HPA has laid good groundwork and developed its valuable model that could be highlighted and referenced.

  2. Keeping gay and bisexual men safe: The arena of HIV prevention science and praxis.

    Science.gov (United States)

    Green, Adam Isaiah

    2016-04-01

    Abstract In this article, I draw from an ongoing ethnographic study of HIV prevention for gay, bisexual, and 'men who have sex with men' to develop an institutional analysis of HIV behavioral intervention science and praxis. I approach this analysis through the lens of the social worlds framework, focusing on the institutional arena in which HIV behavioral interventions are devised and executed. Toward this end, I focus on two fundamental points of contention that lie at the heart of the prevention enterprise and put its social organization in high relief: (1) conceptions of health and lifestyle practices and (2) attributions of expertise. These core contentions reveal less the steady advance of normal science than an arena of actors ensconced in boundary work and jurisdictional struggles over how to engineer behavior change and reduce the scale of the HIV epidemic. Their resolution, I argue, has occurred in a historically contingent process determined by the political economy of the US HIV prevention arena and the differential structural location of its social worlds.

  3. Clinical Trial Design for HIV Prevention Research: Determining Standards of Prevention.

    Science.gov (United States)

    Dawson, Liza; Zwerski, Sheryl

    2015-06-01

    This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  4. HIV prevention in action on the football field: the WhizzKids United program in South Africa.

    Science.gov (United States)

    Balfour, Louise; Farrar, Thomas; McGilvray, Marcus; Wilson, Douglas; Tasca, Giorgio A; Spaans, Johanna N; Mathews, Catherine; Maziya, Lungile; Khanyile, Siphosihle; Dalgleish, Tracy L; Cameron, William D

    2013-07-01

    The Africaid Trust is a grassroots South African non-profit organization that engages youth in HIV prevention by harnessing the popularity of football (i.e. soccer). WhizzKids United, the organization's primary program, operates a 12-week program in elementary schools in Pietermaritzburg, South Africa, which aims to impart knowledge and life skills critical to HIV prevention. The goal of this research was to compare elementary school youth who received the program to youth who only received traditional classroom-based HIV education on health behaviors and HIV-related knowledge and stigma. A secondary objective was to evaluate HIV knowledge, sexual behaviors, attitudes towards HIV and health care seeking behaviors among South African youth in grades 9-12. Elementary students who participated in the program reported greater HIV knowledge and lower HIV stigma (p < .001) than those who had not. The majority of youth in grades 9-12 report having sexual relations (55.6%), despite low levels of HIV testing (29.9%) in this high HIV prevalence region of South Africa. The results highlight the importance of supporting community-based HIV educational initiatives that engage high-risk youth in HIV prevention and the need for youth-friendly health services.

  5. New Resources on Youth Reproductive Health and HIV Prevention, 2002-2004. YouthLens on Reproductive Health and HIV/AIDS. Number 14

    Science.gov (United States)

    Finger, William, Comp.; Tipton, Margaret, Comp.

    2005-01-01

    As a sequel to YouthLens No. 1, New Resources Available on Youth Reproductive Health and HIV Prevention (July 2002), this YouthLens summarizes major reports and resources that have appeared since July 2002. The resources are organized by overview reports, reproductive health resources, and HIV/AIDS resources. [YouthLens is an activity of YouthNet,…

  6. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    OpenAIRE

    Imrie John; Newell Marie-Louise; Harrison Abigail; Hoddinott Graeme

    2010-01-01

    Abstract Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, ...

  7. HIV prevention among female sex workers in Africa.

    Science.gov (United States)

    Scheibe, A; Drame, F M; Shannon, K

    2012-01-01

    Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. The criminalisation of sex work; community and service provider stigma; violence; substance use and limited access to health services and prevention commodities contribute to the high HIV burden evident among female sex workers in Africa. Following UNAIDS' three pillar approach to HIV prevention and sex work we present an overview of current opportunities, barriers and suggestions to improve HIV prevention policy and programming for sex work in Africa. Universal access to a comprehensive package of HIV services is the first pillar. Reproductive health commodities; voluntary and anonymous HIV counselling and testing; treatment of sexually transmitted infections, HIV and opportunistic infections; harm reduction for substance use and psychosocial support services make up the recommended package of services. The second pillar is a sex worker-supportive environment. The inclusion of sex worker programmes within national HIV strategic planning; sex worker-led community mobilisation and the establishment of sex work community networks (comprised of sex workers, health service providers, law enforcers and other stakeholders) enable effective programme implementation and are recommended. The reduction of sex worker vulnerability and addressing structural issues form the final pillar. The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the

  8. AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research.

    Science.gov (United States)

    Fisher, William A; Kohut, Taylor; Fisher, Jeffrey D

    2009-12-01

    The current analysis considers the HIV prevention research record in the social sciences. We do so with special reference to what has been termed "AIDS Exceptionalism"- departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for "Prevention for Positives," supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to addresses effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior. At the first quarter century of the AIDS epidemic, it is important to weigh our accomplishments against our failures in the fight against AIDS…Future historians will conclude that we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven "prevention" that only served a particular political agenda.Editorial: A Quarter Century of AIDS . American Journal of Public Health. (Stall & Mills, 2006, p. 961).

  9. Development of an HIV Prevention Videogame: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Kimberly Hieftje

    2016-06-01

    Full Text Available The use of videogames interventions is becoming an increasingly popular and effective strategy in disease prevention and health promotion; however, few health videogame interventions have been scientifically rigorously evaluated for their efficacy. Moreover, few examples of the formative process used to develop and evaluate evidence-based health videogame interventions exist in the scientific literature. The following paper provides valuable insight into the lessons learned during the process of developing the risk reduction and HIV prevention videogame intervention for young adolescents, PlayForward: Elm City Stories. 

  10. ONGs/Aids, intervenções sociais e novos laços de solidariedade social Nongovernmental Organizations and AIDS, social intervention, and new ties in social solidarity

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    Cristina Luci Câmara da Silva

    1998-01-01

    Full Text Available A partir de uma breve contextualização do cenário social em que surge a epidemia da Aids no Brasil, o artigo situa a formação das primeiras Organizações Não Governamentais de luta contra a Aids no País. Atribuem-se peculiaridades às ONGs/Aids, na medida em que elas apresentam uma ambivalência entre o que caracteriza uma instituição profissionalizada e um grupo de pressão, além de lidar com questões como a sexualidade e a morte, rompendo as fronteiras entre as esferas pública e privada. Tendo como referência o Grupo Pela Vidda/RJ, procura-se apresentar a relação entre a valorização de um grupo de indivíduos e o princípio de universalidade presente na atuação do mesmo. Por fim, apresenta-se a hipótese de que as ONGs/Aids renovam os laços de solidariedade social a partir das relações que estabelecem com as esferas governamentais, os diversos pesquisadores envolvidos com a temática e as outras ONGs.Starting with a brief contextual analysis of the social scenario in which the AIDS epidemic is occurring in Brazil, the article focuses on the formation of the country's first Nongovernmental Organizations in the struggle against AIDS. There are peculiarities to AIDS NGOs to the extent that they display an ambivalence between the characteristics of a professional institution and a lobbying group, apart from the fact that dealing with sexuality and death breaks down the line between the public and the private spheres. The case in point is the Grupo Pela Vidda (For Life Group in Rio de Janeiro, which seeks to represent the enhancement of a group of individuals and the principle of universality. The study supports the hypothesis that AIDS NGOs renew ties of social solidarity through the relationships established between various researchers involved in this sector and other NGOs with governmental spheres.

  11. Drug treatment as HIV prevention: a research update.

    Science.gov (United States)

    Metzger, David S; Woody, George E; O'Brien, Charles P

    2010-12-01

    Drug use continues to be a major factor fueling the global epidemic of HIV infection. This article reviews the current literature on the ability of drug treatment programs to reduce HIV transmission among injection and noninjection drug users. Most data come from research on the treatment of opiate dependence and provide strong evidence on the effectiveness of medication-assisted treatment for reducing the frequency of drug use, risk behaviors, and HIV infections. This has been a consistent finding since the epidemic began among diverse populations and cultural settings. Use of medications other than methadone (such as buprenorphine/naloxone and naltrexone) has increased in recent years with promising data on their effectiveness as HIV prevention and as new treatment options for communities heavily affected by opiate use and HIV infection. However, few treatment interventions for stimulant abuse and dependence have shown efficacy in reducing HIV risk. The cumulative literature provides strong support of drug treatment programs for improving access and adherence to antiretroviral treatment. Drug users in substance abuse treatment are significantly more likely to achieve sustained viral suppression, making viral transmission less likely. Although there are challenges to implementing drug treatment programs for maximum impact, the scientific literature leaves no doubt about the effectiveness of drug treatment as an HIV prevention strategy.

  12. Mobile health applications for HIV prevention and care in Africa.

    Science.gov (United States)

    Forrest, Jamie I; Wiens, Matthew; Kanters, Steve; Nsanzimana, Sabin; Lester, Richard T; Mills, Edward J

    2015-11-01

    More people have mobile phones in Africa than at any point in history. Mobile health (m-health), the use of mobile phones to support the delivery of health services, has expanded in recent years. Several models have been proposed for conceptualizing m-health in the fields of maternal-child health and chronic diseases. We conducted a literature review of m-health interventions for HIV prevention and care in African countries and present the findings in the context of a simplified framework. Our review identified applications of m-health for HIV prevention and care categorized by the following three themes: patient-care focused applications, such as health behavior change, health system-focused applications, such as reporting and data collection, and population health-focused applications, including HIV awareness and testing campaigns. The potential for m-health in Africa is numerous and should not be limited only to direct patient-care focused applications. Although the use of smart phone technology is on the rise in Africa, text messaging remains the primary mode of delivering m-health interventions. The rate at which mobile phone technologies are being adopted may outpace the rate of evaluation. Other methods of evaluation should be considered beyond only randomized-controlled trials.

  13. The future of digital games for HIV prevention and care.

    Science.gov (United States)

    Hightow-Weidman, Lisa B; Muessig, Kathryn E; Bauermeister, José A; LeGrand, Sara; Fiellin, Lynn E

    2017-09-01

    Although there has been a significant increase in mHealth interventions addressing the HIV prevention and care continuum, interventions using game mechanics have been less explored. Digital games are rapidly becoming an important tool for improving health behaviors and supporting the delivery of care and education. The purpose of this review is to provide a historical context for the use of gamification and videogames (including those using virtual reality) used in technology-based HIV interventions and to review new research in the field. A review of recently published (1 January 2016-31 March 2017) or presented abstracts (2016) identified a paucity of technology-based interventions that included gamification elements or any terms associated with videogames or gameplay. A larger portfolio of digital gaming interventions is in the pipeline. Use of digital games that include elements of gamification or consist of standalone videogames or virtual-reality-based games, represent a promising intervention strategy to address the HIV prevention and care continuum, especially among youth. Our review demonstrates that there is significant room for growth in this area in designing, developing, testing and most importantly, implementation and dissemination these novel interventions.

  14. Ethical considerations regarding oral preexposure prophylaxis in HIV prevention trials.

    Science.gov (United States)

    Sugarman, Jeremy

    2016-01-01

    Although substantial evidence supports oral preexposure prophylaxis with tenofovir disoproxil fumarate and emtricitabine (OPTF) for the primary prevention of HIV infection in certain settings, assessing whether other promising HIV prevention interventions are safe and effective as well as determining optimal prevention strategies necessitates research. However, given the established safety and efficacy of OPTF, it is necessary to determine when and how is it ethically acceptable to conduct this research, which is the focus of this review. Although they are somewhat intertwined, questions regarding OPTF in research can be considered in two broad categories: use in a comparison arm and as a standard of prevention. Major statements addressing these issues are described and recent literature directed at the particular issue of OPTF in research is reviewed and critiqued. There is now arguably a rebuttable presumption for the use of OPTF as a comparator or as part of the standard of prevention in much future HIV prevention research. However, making such determinations necessitates taking into account scientific considerations, the modality being evaluated, acceptability, adherence, and the local context. Doing so should be optimized by robust stakeholder engagement.

  15. HIV prevention in prisons and jails: obstacles and opportunities.

    Science.gov (United States)

    Polonsky, S; Kerr, S; Harris, B; Gaiter, J; Fichtner, R R; Kennedy, M G

    1994-01-01

    High rates of human immunodeficiency virus (HIV) infection among jail and prison inmates suggest that HIV prevention efforts should focus on incarcerated populations. Overcrowding, the high prevalence of injection drug use, and other high-risk behaviors among inmates create a prime opportunity for public health officials to affect the course of the HIV epidemic if they can remedy these problems. Yet, along with the opportunity, there are certain obstacles that correctional institutions present to public health efforts. The various jurisdictions have differing approaches to HIV prevention and control. Whether testing should be mandatory or voluntary, whether housing should be integrated or segregated by HIV serostatus, and whether condoms, bleach, or clean needles should be made available to the prisoners, are questions hotly debated by public health and correctional officials. Even accurate assessment of risk-taking within the institutions leads to controversy, as asking questions could imply acceptance of the very behaviors correctional officials are trying to prevent. Education and risk-reduction counseling are the least controversial and most widely employed modes of prevention, but the effectiveness of current prevention efforts in reducing HIV transmission in this high-risk population is largely undetermined. PMID:7938381

  16. Cash transfers for HIV prevention: considering their potential

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    Lori Heise

    2013-08-01

    Full Text Available Introduction: Cash payments to vulnerable households and/or individuals have increasingly garnered attention as a means to reduce poverty, improve health and achieve other development-related outcomes. Recent evidence from Malawi and Tanzania suggests that cash transfers can impact HIV-related behaviours and outcomes and, therefore, could serve as an important addition to HIV prevention efforts. Discussion: This article reviews the current evidence on cash transfers for HIV prevention and suggests unresolved questions for further research. Gaps include (1 understanding more about the mechanisms and pathways through which cash transfers affect HIV-related outcomes; (2 addressing key operational questions, including the potential feasibility and the costs and benefits of different models of transfers and conditionality; and (3 evaluating and enhancing the wider impacts of cash transfers on health and development. Conclusions: Ongoing and future studies should build on current findings to unpack unresolved questions and to collect additional evidence on the multiple impacts of transfers in different settings. Furthermore, in order to address questions on sustainability, cash transfer programmes need to be integrated with other sectors and programmes that address structural factors such as education and programming to promote gender equality and address HIV.

  17. Adapting a Multifaceted U.S. HIV Prevention Education Program for Girls in Ghana

    Science.gov (United States)

    Fiscian, Vivian Sarpomaa; Obeng, E. Kwame; Goldstein, Karen; Shea, Judy A.; Turner, Barbara J.

    2009-01-01

    We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic…

  18. "It's Crazy Being a Black, Gay Youth." Getting Information about HIV Prevention: A Pilot Study

    Science.gov (United States)

    Voisin, Dexter R.; Bird, Jason D. P.; Shiu, Chen-Shi; Krieger, Cathy

    2013-01-01

    Background: Access and adoption of HIV prevention information are important criteria for reducing HIV infection rates among men who have sex with men. Methods: Using focus group data, researchers sought to identify sources of HIV prevention information and barriers to adopting protective behaviors among young African American men who have sex with…

  19. HIV Prevention Efforts and Incidence of HIV in Uganda.

    Science.gov (United States)

    Grabowski, M Kate; Serwadda, David M; Gray, Ronald H; Nakigozi, Gertrude; Kigozi, Godfrey; Kagaayi, Joseph; Ssekubugu, Robert; Nalugoda, Fred; Lessler, Justin; Lutalo, Thomas; Galiwango, Ronald M; Makumbi, Fred; Kong, Xiangrong; Kabatesi, Donna; Alamo, Stella T; Wiersma, Steven; Sewankambo, Nelson K; Tobian, Aaron A R; Laeyendecker, Oliver; Quinn, Thomas C; Reynolds, Steven J; Wawer, Maria J; Chang, Larry W

    2017-11-30

    To assess the effect of a combination strategy for prevention of human immunodeficiency virus (HIV) on the incidence of HIV infection, we analyzed the association between the incidence of HIV and the scale-up of antiretroviral therapy (ART) and medical male circumcision in Rakai, Uganda. Changes in population-level viral-load suppression and sexual behaviors were also examined. Between 1999 and 2016, data were collected from 30 communities with the use of 12 surveys in the Rakai Community Cohort Study, an open, population-based cohort of persons 15 to 49 years of age. We assessed trends in the incidence of HIV on the basis of observed seroconversion data, participant-reported use of ART, participant-reported male circumcision, viral-load suppression, and sexual behaviors. In total, 33,937 study participants contributed 103,011 person-visits. A total of 17,870 persons who were initially HIV-negative were followed for 94,427 person-years; among these persons, 931 seroconversions were observed. ART was introduced in 2004, and by 2016, ART coverage was 69% (72% among women vs. 61% among men, P<0.001). HIV viral-load suppression among all HIV-positive persons increased from 42% in 2009 to 75% by 2016 (P<0.001). Male circumcision coverage increased from 15% in 1999 to 59% by 2016 (P<0.001). The percentage of adolescents 15 to 19 years of age who reported never having initiated sex (i.e., delayed sexual debut) increased from 30% in 1999 to 55% in 2016 (P<0.001). By 2016, the mean incidence of HIV infection had declined by 42% relative to the period before 2006 (i.e., before the scale-up of the combination strategy for HIV prevention) - from 1.17 cases per 100 person-years to 0.66 cases per 100 person-years (adjusted incidence rate ratio, 0.58; 95% confidence interval [CI], 0.45 to 0.76); declines were greater among men (adjusted incidence rate ratio, 0.46; 95% CI, 0.29 to 0.73) than among women (adjusted incidence rate ratio, 0.68; 95% CI, 0.50 to 0.94). In this

  20. A leitura nas organizações não governamentais e inter-relações com a escola pública Reading in non-governmental organizations and interrelations with the public school

    Directory of Open Access Journals (Sweden)

    Ana Shitara Inglesi

    2011-08-01

    Full Text Available Considerando o baixo grau de letramento dos alunos do ensino fundamental e médio no Brasil e, concomitantemente, o crescimento espantoso do número de organizações não governamentais (ONGs trabalhando no campo da educação nas últimas décadas, o presente trabalho procura estabelecer uma ponte entre essas duas faces da educação no Brasil. Nesta investigação, pretendeu-se compreender a dinâmica e a influência das ONGs brasileiras, mais especificamente no campo da leitura, tendo em vista o desenvolvimento do letramento. Para tanto, foi realizado um estudo qualitativo, com características etnográficas, baseado, sobretudo, em observações feitas em campo das atividades de uma organização, as quais foram analisadas a partir das concepções de leitura propostas pelos teóricos da psicolinguística (SMITH, 1999, 2003 e da estética da recepção (JAUSS, 1994,2002. Com isso, procurou-se contribuir com os estudos sobre leitura e, principalmente, avançar nessas novas possibilidades educativas que hoje nos são apresentadas pela sociedade civil e que impulsionaram a busca por soluções alternativas para um problema que vem afligindo os educadores há décadas no Brasil. Assim, considera-se que, por meio da troca de ideias e experiências e da implementação de projetos envolvendo leitura, as instituições educacionais não governamentais podem contribuir para o desenvolvimento de uma escola pública de qualidade, sem, no entanto, substituí-la, deixando para o governo a responsabilidade que lhe cabe.Considering the low level of literacy of pupils in fundamental and secondary education in Brazil and, at the same time, the astounding growth in the number of non-governmental organizations (NGOs working in the field of education during the last decades, the present work attempts to throw a bridge across those two sides of Brazilian education. The investigation has tried to understand the dynamics and influence of Brazilian NGOs, more

  1. HIV prevention and low-income Chilean women

    Science.gov (United States)

    CIANELLI, ROSINA; FERRER, LILIAN; MCELMURRY, BEVERLY J.

    2008-01-01

    Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV. PMID:18432428

  2. Exploring HIV Prevention Strategies among Street-Based Female Sex Workers in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Huan Zeng

    2015-01-01

    Full Text Available Background: Commercial sex plays an increasingly important role in China’s growing HIV and sexually transmitted infection (STI epidemics. In China, street-based sex workers (SSWs are a subgroup of female sex workers with a particularly high risk of HIV/STI infections but are neglected in responses to HIV. This study assesses changes in HIV voluntary counseling and testing (VCT utilization and high-risk sexual behaviors following a three-month HIV preventive intervention among SSWs in Chongqing, China. Methods: A three-month intervention was conducted by a team of peer educators, outreach workers from community-based organizations and health professionals. It mainly included distribution of free pamphlets and condoms and delivery of onsite and clinic-based VCT. Cross-sectional surveys were conducted prior to (n = 100 and immediately following (n = 112 the intervention to assess its impact. In-depth interviews were conducted among 12 SSWs after the intervention to further explore potential barriers to HIV prevention. Results: The intervention significantly increased SSWs’ participation in VCT (from 2.0%–15.2%, P < 0.001. Despite participants’ improved HIV-related knowledge level (from 24.0%–73.2%, P < 0.001, there were minimal changes in the levels of condom use with clients. Qualitative research revealed that fear of police arrest and stigma were the main barriers to VCT utilization. Low condom use was associated with family financial constraints, inadequate power in condom negotiation, low awareness and misconceptions of HIV infection risks. Conclusion: HIV intervention improved VCT utilization and knowledge but we did not observe an increase in condom use after this short intervention. SSWs faced substantial economic, social and environmental barriers to VCT utilization and condom use.

  3. Web and Mobile Based HIV Prevention and Intervention Programs Pros and Cons - A Review.

    Science.gov (United States)

    Niakan, Sharareh; Mehraeen, Esmaeil; Noori, Tayebeh; Gozali, Elahe

    2017-01-01

    With the increasing growth of HIV positive people the use of information and communication technologies (ICT) can play an important role in controlling the spread of the AIDS. Web and Mobile are the new technologies that young people take advantage from them. In this study a review to investigate the web and mobile based HIV prevention and intervention programs was carried out. A scoping review was conducted including PubMed, Science direct, Web of Science and Proquest to find relevant sources that published in 2009 to 2016. To identify published, original research that reported the web and mobile-based HIV prevention and intervention programs, an organized search was conducted with the following search keywords in combination: HIV, AIDS, m-Health, Mobile phone, Cell phone, Smartphone, Mobile health, internet, and web. Using the employed strategies, 173 references retrieved. Searched articles were compared based on their titles and abstracts. To identify duplicated articles, the title and abstracts were considered and 101 duplicated references were excluded. By going through the full text of related papers, 35 articles were found to be more related to the questions of this paper from which 72 final included. The advantages of web and mobile-based interventions include the possibility to provide constancy in the delivery of an intervention, impending low cost, and the ability to spread the intervention to an extensive community. Online programs such as Chat room-based Education program, Web-based therapeutic education system, and Online seek information can use for HIV/AIDS prevention. To use of mobile for HIV/AIDS prevention and intervention, programs including in: Health system focused applications, Population health focused applications, and Health messaging can be used.

  4. Concurrent sexual partnerships among married Zimbabweans – implications for HIV prevention

    Directory of Open Access Journals (Sweden)

    Mugweni E

    2015-09-01

    Full Text Available Esther Mugweni,1 Stephen Pearson,2 Mayeh Omar2 1UCL Department of Infection and Population Health, University College London, London, 2The Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK Background: Concurrent sexual partnerships play a key role in sustaining the HIV epidemic in Zimbabwe. Married couples are at an increased risk of contracting HIV from sexual networks produced by concurrent sexual partnerships. Addressing these partnerships is an international HIV prevention priority. Methods: Our qualitative study presents the socioeconomic factors that contribute to the occurrence of concurrent sexual partnerships among married people in Zimbabwe. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008 to understand the organizations of concurrent sexual partnerships. Data were analyzed using framework analysis. Results: Our study indicates that relationship dissatisfaction played a key role in the engagement of concurrent sexual partnerships. Depending on the source of the dissatisfaction, there were four possible types of concurrent sexual relationships that were formed: sex worker, casual partner, regular girlfriend or informal polygyny which was referred to as “small house”. These relationships had different levels of intimacy, which had a bearing on practicing safer sex. Participants described three characteristics of hegemonic masculinity that contributed to the sources of dissatisfaction leading to concurrent sexual activity. Similarly, various aspects of emphasized femininity were described as creating opportunities for the occurrence of concurrent sexual relationships. Economic status was also listed as a factor that contributed to the occurrence of concurrent sexual partnerships. Conclusion: Marital dissatisfaction was indicated as a contributing factor to the occurrence of concurrent sexual relationships. There were several

  5. Divergent Preferences for HIV Prevention: A Discrete Choice Experiment for Multipurpose HIV Prevention Products in South Africa.

    Science.gov (United States)

    Quaife, Matthew; Eakle, Robyn; Cabrera Escobar, Maria A; Vickerman, Peter; Kilbourne-Brook, Maggie; Mvundura, Mercy; Delany-Moretlwe, Sinead; Terris-Prestholt, Fern

    2018-01-01

    The development of antiretroviral (ARV)-based prevention products has the potential to substantially change the HIV prevention landscape; yet, little is known about how appealing these products will be outside of clinical trials, as compared with the existing options. We conducted a discrete choice experiment (DCE) to measure preferences for 5 new products among 4 important populations in the HIV response: adult men and women in the general population (aged 18 to 49 y), adolescent girls (aged 16 to 17 y), and self-identifying female sex workers (aged 18 to 49 y). We interviewed 661 self-reported HIV-negative participants in peri-urban South Africa, who were asked to choose between 3 unique, hypothetical products over 10 choice sets. Data were analyzed using multinomial, latent class and mixed multinomial logit models. HIV protection was the most important attribute to respondents; however, results indicate significant demand among all groups for multipurpose prevention products that offer protection from HIV infection, other STIs, and unwanted pregnancy. All groups demonstrated a strong preference for long-lasting injectable products. There was substantial heterogeneity in preferences within and across population groups. Hypothetical DCE data may not mirror real-world choices, and products will have more attributes in reality than represented in choice tasks. Background data on participants, including sensitive areas of HIV status and condom use, was self-reported. These results suggest that stimulating demand for new HIV prevention products may require a more a nuanced approach than simply developing highly effective products. No single product is likely to be equally attractive or acceptable across different groups. This study strengthens the call for effective and attractive multipurpose prevention products to be deployed as part of a comprehensive combination prevention strategy.

  6. HIV prevention, structural change and social values: the need for an explicit normative approach.

    Science.gov (United States)

    Parkhurst, Justin O

    2012-06-14

    The fact that HIV prevention often deals with politicised sexual and drug taking behaviour is well known, but structural HIV prevention interventions in particular can involve alteration of social arrangements over which there may be further contested values at stake. As such, normative frameworks are required to inform HIV prevention decisions and avoid conflicts between social goals. This paper provides a conceptual review and discussion of the normative issues surrounding structural HIV prevention strategies. It applies political and ethical concepts to explore the contested nature of HIV planning and suggests conceptual frameworks to inform future structural HIV responses. HIV prevention is an activity that cannot be pursued without making value judgements; it is inherently political. Appeals to health outcomes alone are insufficient when intervention strategies have broader social impacts, or when incidence reduction can be achieved at the expense of other social values such as freedom, equality, or economic growth. This is illustrated by the widespread unacceptability of forced isolation which may be efficacious in preventing spread of infectious agents, but conflicts with other social values. While no universal value system exists, the capability approach provides one potential framework to help overcome seeming contradictions or value trade-offs in structural HIV prevention approaches. However, even within the capability approach, valuations must still be made. Making normative values explicit in decision making processes is required to ensure transparency, accountability, and representativeness of the public interest, while ensuring structural HIV prevention efforts align with broader social development goals as well.

  7. Partners or donors: The perceived roles of Global Fund Principal Recipient NGOs in HIV prevention programmes in Ukraine

    Directory of Open Access Journals (Sweden)

    Svetlana McGill

    2017-01-01

    Full Text Available Ukraine has one of Europe's fastest growing HIV rates and in 2003–2012 was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF. Doctoral research recently completed by the author investigates the conduct and practice of international and national nongovernmental organisations (NGOs as Principal Recipients (PRs of GF grants in Ukraine from 2003 to 2012. An ethnographic enquiry including 50 participant interviews was conducted in three oblasts in Ukraine, and in its capital, Kyiv. The paper presents some of the findings that emerged from the analysis. Discussing the PR NGOs roles and practices in delivering HIV prevention programmes funded by GF, the author argues that the anticipated benefits of NGO partnerships between PR NGOs and their Sub-Recipients (SRs have not been achieved. Rather, PRs acted as donors and ran highly discretionary policies in channelling GF funding to SRs that installed competition and vertical relations between NGO-grantors and NGO-grantees. The outcome was a servile civil society that is dependent on external funding and is unable to genuinely represent their communities. With an anticipated GF phasing out from Ukraine, there is a critical lack of advocacy potential of the civil society to articulate and defend the needs of PLHIV when transferring HIV services into state funding.

  8. The Development Trend of the Non-governmental Higher Education in China

    Directory of Open Access Journals (Sweden)

    Zhang Dewen

    2013-12-01

    Full Text Available In more than 30 years after China’s reform and opening to the outside world the non-governmental higher education has developed dramatically and enjoyed more and more favorable conditions, making great contributions to the popularization of higher education in China. According to the definition that “The non-governmental higher education is a major growth point for development of educational career and an important driving force in promoting educational reform”, quoting from The planning outline on the national medium and long-term educational reform and development (The Planning Outline for short issued in 2010 by China’s State Council, China has launched policies of greatly supporting the non-governmental higher education and designed the reform goals of the government as the main body of education, with the active participation of the whole society, and the mutual development of the governmental and non-governmental higher education. Soon afterwards, the nation has started the move of the non-governmental educational system, and positively explored the management of classification of profit and non-profit non-governmental educational institutions. Thus, the development of the Chinese non-governmental institutions of higher learning has been greatly influenced because of the policies and relevant practices. With the opening of the 18th national congress and the political direction mentioned in the report as “encouraging and guiding social organizations to initiate education”, the pace of development of the non-governmental institutions of higher learning will be accelerated and some new development trends will become clearer.

  9. The influence of a peer-based HIV prevention intervention on conversation about HIV prevention among people who inject drugs in Baltimore, Maryland.

    Science.gov (United States)

    Mihailovic, Aleksandra; Tobin, Karin; Latkin, Carl

    2015-10-01

    STEP into Action assessed the efficacy of a peer-based HIV prevention intervention in reducing HIV risk behaviors among people who inject drugs (PWIDs) in Baltimore. This analysis examined the effect of the intervention on the change in frequency of conversation about HIV prevention topics over time. 114 participants were randomized into an experimental and 113 into a control group. Data was collected prospectively at 6, 12, and 18 months. The experimental group talked more frequently about HIV prevention topics compared to the control group at 6-month visit. At 18 months relative risk ratios (RRR) remained statistically significant for conversation about the danger of needle sharing (RRR = 3.21) and condom use (RRR = 2.81). The intervention resulted in an increased conversation about HIV prevention among PWIDs, but the sustainability past 6 months remained a challenge; suggesting that interventions should be designed to constantly reinforce communication about HIV prevention among PWIDs.

  10. Of baby ducklings and clay pots: method and metaphor in HIV prevention.

    Science.gov (United States)

    Fletcher, Gillian

    2013-11-01

    In this article, I report on my decision to undertake a process of elicitation, development, and examination of metaphors for experiences of HIV prevention work in Burma/Myanmar. I cover the theoretical basis to that decision, my rationale for using metaphor elicitation as method when researching the rhetoric and practice of HIV prevention in Burma/Myanmar, the process I used, and some of the resultant metaphors. I also demonstrate that this process resulted in the opening up of a space for talking about HIV prevention that avoided recourse to standard prevention rhetoric, thereby enabling a new and deeper understanding of the gap between this rhetoric and people's actual practice or experience.

  11. Addressing the Unique Needs of African American Women in HIV Prevention

    Science.gov (United States)

    Caldeira, Nathilee A.; Ruglass, Lesia M.; Gilbert, Louisa

    2009-01-01

    African American women continue to be disproportionately affected by the HIV/AIDS epidemic, yet there are few effective HIV prevention interventions that are exclusively tailored to their lives and that address their risk factors. Using an ecological framework, we offer a comprehensive overview of the risk factors that are driving the HIV/AIDS epidemic among African American women and explicate the consequences of ignoring these factors in HIV prevention strategies. We also recommend ways to improve HIV prevention programs by taking into consideration the unique life experiences of adult African American women. PMID:19372518

  12. Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

    Directory of Open Access Journals (Sweden)

    Machado DM

    2017-11-01

    Full Text Available Daisy Maria Machado,1 Alexandre Machado de Sant’Anna Carvalho,2 Rachel Riera3 1Disciplina de Infectologia Pediátrica, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2Universidade Federal do Rio de Janeiro, Rio de Janeiro, 3Disciplina de Medicina Baseada em Evidências, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19 years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no

  13. Conflict transformation, stigma, and HIV-preventive structural change.

    Science.gov (United States)

    Miller, Robin Lin; Reed, Sarah J; Francisco, Vincent T; Ellen, Jonathan M

    2012-06-01

    Over the prior decade, structural change efforts have become an important component of community-based HIV prevention initiatives. However, these efforts may not succeed when structural change initiatives encounter political resistance or invoke conflicting values, which may be likely when changes are intended to benefit a stigmatized population. The current study sought to examine the impact of target population stigma on the ability of 13 community coalitions to achieve structural change objectives. Results indicated that coalitions working on behalf of highly stigmatized populations had to abandon objectives more often than did coalitions working for less stigmatized populations because of external opposition to coalition objectives and resultant internal conflict over goals. Those coalitions that were most successful in meeting external challenges used opposition and conflict as transformative occasions by targeting conflicts directly and attempting to neutralize oppositional groups or turn them into strategic allies; less successful coalitions working on behalf of stigmatized groups struggled to determine an appropriate response to opposition. The role of conflict transformation as a success strategy for working on behalf of stigmatized groups is discussed.

  14. Understanding Gay Community Subcultures: Implications for HIV Prevention.

    Science.gov (United States)

    Prestage, Garrett; Brown, Graham; De Wit, John; Bavinton, Benjamin; Fairley, Christopher; Maycock, Bruce; Batrouney, Colin; Keen, Phillip; Down, Ian; Hammoud, Mohamed; Zablotska, Iryna

    2015-12-01

    Gay and bisexual men (GBM) who participate in gay community subcultures have different profiles, including differing risk behaviors. We examined men's participation in gay community subcultures, and its association with risk behavior. In a cross-sectional survey, 849 GBM provided information about men in their personal networks. We devised measures of their participation in five subcultural groupings and explored their associations with sexual behavior. We identified five subcultural groupings: sexually adventurous; bear tribes; alternative queer; party scene; and sexually conservative. Higher scores on the sexually adventurous measure was associated with being older, having more gay friends, being HIV-positive, and being more sexually active. It was also independently associated with unprotected anal intercourse with casual partners (AOR 1.82; 95 % CI 1.20-2.76; p = 0.005). HIV prevention strategies need to account for the different subcultural groupings in which GBM participate. Measures of engagement with gay subcultures are useful indicators of differential rates of risk behavior and modes of participation in gay community life. Men in more sexually adventurous subcultures are more likely to engage in sexual risk behavior.

  15. Global HIV Prevention, Testing, and Counseling in Military Populations.

    Science.gov (United States)

    Grillo, Michael P; Sloan, Margo; Wankie, Che; Woodland, Kelly; Reader, Elizabeth; Porter, Bruce; Shaffer, Richard; Macera, Caroline A; Bulterys, Marc

    2017-01-01

    Compared with the general population in low- and middle-income countries, military members tend to be male, young, travel more frequently away from their main sexual partners, drink more alcohol and have a consistent source of income. All of these factors may lead to an increased risk of contracting HIV. In response, the Department of Defense HIV/AIDS Prevention Program advocates for the integration of HIV prevention "building blocks" into military health services to reduce the risk of acquiring HIV among foreign uniformed services. The building blocks include basic HIV education including outreach, condom promotion, enabling HIV policies, HIV testing services, screening for sexually transmitted infections, voluntary medical male circumcision where appropriate, prevention of mother-to-child transmission, and other supportive services. The Department of Defense HIV/AIDS Prevention Programs supports implementation of these building blocks though partnerships with foreign militaries. This comprehensive prevention package, when closely linked with HIV treatment services, is the cornerstone of creating an HIVfree generation in military and surrounding communities worldwide. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Male circumcision for HIV prevention: current research and programmatic issues.

    Science.gov (United States)

    Weiss, Helen A; Dickson, Kim E; Agot, Kawango; Hankins, Catherine A

    2010-10-01

    Randomized controlled trials in sub-Saharan Africa have shown that adult male circumcision reduces the risk of HIV acquisition in men by about 60%. In this article, we review recent data on the association of male circumcision and HIV/sexually transmitted infection in men and women. This includes a summary of data showing some evidence of an effect of male circumcision against genital ulcer disease, HSV-2 infection, human papillomavirus and Trichomonas vaginalis, but not Chlamydia trachomatis or Neisseria gonorrhoea in men. Longitudinal studies among HIV discordant couples suggest that male circumcision may provide some direct long-term benefit to women, which may start after complete wound healing. Circumcision may also protect against HIV acquisition in men who have sex with men (MSM) and those who practice unprotected anal intercourse (either exclusively or predominantly), although these data are not consistent. To date, there is little evidence from the few studies available of either unsafe practices or reported increases in risky behaviour, or adverse changes in sexual satisfaction and function. As countries in southern and eastern Africa scale up services, operational research will likely be useful to iteratively improve programme delivery and impact while identifying the best methods of integrating safe male circumcision services into HIV prevention strategies and strengthening health systems.

  17. An exploratory study of HIV-prevention advocacy by persons in HIV ...

    African Journals Online (AJOL)

    An exploratory study of HIV-prevention advocacy by persons in HIV care in Uganda. Christopher Tumwine, Annet Nannungi, Eric Ssegujja, Nicolate Nekesa, Sarah Ssali, Lynn Atuyambe, Gery Ryan, Glenn Wagner ...

  18. HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention

    National Research Council Canada - National Science Library

    Baggaley, Rebecca F; White, Richard G; Boily, Marie-Claude

    2010-01-01

    ...) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention...

  19. A Little Bit Pregnant: Modeling How the Accurate Detection of Pregnancy Can Improve HIV Prevention Trials

    OpenAIRE

    Schreiber, Courtney A.; Sammel, Mary; Hillier, Sharon L.; Barnhart, Kurt T.

    2008-01-01

    The prevalence of unplanned pregnancies contributes to the methodological challenges of human immunodeficiency virus (HIV) prevention trials. In this paper, the authors discuss the incidence of pregnancy, including chemical pregnancy, and how the different methods of pregnancy diagnosis could affect the statistical power and calculated outcomes of HIV prevention trials. Study sample size inflation factors are estimated to aid in the design of clinical trials.The authors used published data of...

  20. HIV prevention among transgender women in Latin America: implementation, gaps and challenges

    OpenAIRE

    Alfonso Silva-Santisteban; Shirley Eng; Gabriela de la Iglesia; Carlos Falistocco; Rafael Mazin

    2016-01-01

    Introduction: Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. Methods: We conducted a desk review of Global AIDS Response Progress Reports, national strate...

  1. Insights in Public Health: In What Ways are Hawaii's HIV Prevention Services Engaging Gay Male Couples and Using Technology?

    Science.gov (United States)

    Sophus, Amber I; Fujitani, Loren; Vallabhbhai, Samantha; Antonio, Jo Anna; Yang, Pua Lani; Elliott, Elyssa; Mitchell, Jason W

    2018-02-01

    Partner-oriented services and Health Information and Communication technology (HICT) in the forms of mHealth (eg, smartphone applications), eHealth (eg, interactive websites), telemedicine, and social media play an important and growing role in HIV prevention. Accordingly, the present study sought to describe: (1) the primary and secondary HIV prevention services available in Hawai'i, (2) the prevention services that are available for gay male couples and partners, and (3) the prevention services that use HICT. Information about prevention services and use of HICT were obtained from websites and phone calls made to 19 organizations in the state, including the Hawai'i Department of Health. Overall, partner-oriented services were limited and only 1 couples-based service was currently being offered. Technology, namely social media, was used by 14 organizations, primarily to increase HIV awareness and advertise events. These findings may inform how best to adapt and better leverage the use of innovative technological tools to help expand access to HIV testing and counseling, sexual health education, and case management services for gay male couples and other MSM populations in the state.

  2. Lessons learnt from implementing an empirically informed recruitment approach for FEM-PrEP, a large HIV prevention clinical trial

    Directory of Open Access Journals (Sweden)

    Parker C

    2014-12-01

    Full Text Available Caleb Parker,1 Amy Corneli,1 Kawango Agot,2 Jacob Odhiambo,2 Jesse Asewe,2 Khatija Ahmed,3 Joseph Skhosana,3 Malebo Ratlhagana,3 Michele Lanham,1 Christina Wong,1 Jennifer Deese,1 Rachel Manongi,4 Lut Van Damme,1On behalf of the FEM-PrEP recruitment group 1FHI 360, Global Health, Population and Nutrition, Durham, NC, USA; 2Impact Research and Development Organization, Kisumu, Kenya; 3Setshaba Research Centre, Soshanguve, Pretoria, South Africa; 4Kilimanjaro Christian Medical Centre, Moshi, Tanzania Abstract: We implemented an empirically informed, geographically based recruitment approach for FEM-PrEP, a human immunodeficiency virus (HIV prevention clinical trial of daily oral emtricitabine (FTC and tenofovir disoproxil fumarate (TDF for HIV prevention. During the formative research phase, we conducted a modification of the Priorities for Local AIDS Control Efforts (PLACE method and used those data and staff experiences to identify and prioritize for recruitment geographic areas where HIV incidence might be high. During the clinical trial, we implemented a routinely monitored and flexible recruitment plan in the geographical areas identified in the formative research. We describe three lessons learnt from implementing this approach: 1 the PLACE data were critical in identifying places presumed to be high risk; 2 staff experiences, in combination with PLACE data, were needed to inform a practical recruitment strategy; and 3 recruiting in establishments in priority areas identified by the PLACE data led to screening many HIV-positive women at the Bondo site (Kenya, placing additional burden on clinic staff. These lessons learnt highlight the critical importance of having a flexible and monitored recruitment strategy. Although we successfully recruited a study population at higher risk for HIV, FEM-PrEP was unable to determine the effectiveness of FTC/TDF for HIV prevention, due to low adherence to the study product among participants. We must

  3. Impact of Human Resources on Implementing an Evidence-Based HIV Prevention Intervention.

    Science.gov (United States)

    McKay, Virginia R; Dolcini, M Margaret; Catania, Joseph A

    2017-05-01

    Evidence-based interventions (EBIs) often require competent staff, or human resources (HR), for implementation. The empirical evidence characterizing the influence of HR fluctuations on EBI delivery is limited and conflicting. Using the Interactive Systems Framework, we explored staff fluctuation and the subsequent influence on RESPECT, an HIV prevention EBI. We conducted interviews with staff in two waves (n = 53, Wave I; n = 37, Wave II) in a national sample of organizations delivering RESPECT (N = 29). We analyzed interviews qualitatively to describe changes among RESPECT staff and explore the subsequent influences on RESPECT implementation. Organizations reported downsizing, turnover, and expansion of staff positions. Staff changes had multiple influences on RESPECT implementation including clients reached, fidelity to specific RESPECT protocols, and overall sustainability of RESPECT over time. HR fluctuations are common, and our analyses provide an initial characterization of the relationship between HR fluctuation and EBI implementation. Given the prominent influence of HR on EBI implementation, the Interactive Systems Framework is a useful guiding tool for future examinations.

  4. Coalition contract management as a systems change strategy for HIV prevention.

    Science.gov (United States)

    Darrow, William W; Montanea, Julie E; Sánchez-Braña, Elizabeth

    2010-11-01

    Racial and Ethnic Approaches to Community Health (REACH) 2010 provided a unique opportunity for minority community-based organizations (CBOs) to work together to eliminate disparities in HIV disease. A coalition was formed in Broward County to respond to the REACH 2010 program announcement, a university was chosen to coordinate efforts, and contracts were negotiated with CBO partners to develop, implement, and evaluate a community action plan. Contract management provided stability, focus, and a mechanism for coalition partners to measure progress toward achieving project objectives. By emphasizing documentation as well as the delivery of services, however, contract conditions also placed a heavy burden on educational outreach workers, restricted the reimbursable activities of member organizations, and created friction between minority agencies and university staff. Although the coalition met many of its objectives, the introduction and enforcement of a mutually agreed on set of rules and obligations as a way of promoting systems change in Broward County failed to make a lasting impact among community partners. CBOs continued to compete with one another for HIV prevention project funding and stopped collaborating as closely with another when federal support for our REACH 2010 community demonstration project ran out.

  5. Voluntary Medical Male Circumcision: An HIV Prevention Priority for PEPFAR

    Science.gov (United States)

    Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C.; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

    2013-01-01

    As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President’s Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya’s Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods—such as medical devices that remove the foreskin without injected anesthesia and/or sutures—are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all. PMID:22797745

  6. Where Are the Young Men in HIV Prevention Efforts? Comments on HIV Prevention Programs and Research from Young Men Who Sex with Men in Los Angeles County

    Science.gov (United States)

    Holloway, Ian W.; Cederbaum, Julie A.; Ajayi, Antonette; Shoptaw, Steven

    2012-01-01

    Despite increasing rates of HIV infection among young men who have sex with men (YMSM), only a minority participate in formal HIV prevention efforts. Semi-structured mixed-methods interviews were conducted with a diverse sample of YMSM (N = 100, M[subscript age] = 25.0 years) in Los Angeles, California, to identify facilitators and barriers to…

  7. The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

    2010-01-01

    In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

  8. Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services.

    Science.gov (United States)

    Semugoma, Paul; Beyrer, Chris; Baral, Stefan

    2012-01-01

    Uganda's response to the HIV epidemic has been lauded for its robustness and achievements. However, a key component of HIV prevention programming has been missing, for men who have sex with men (MSM). The main reason cited has been criminalization of male homosexual behavior. In 2009, the Anti-Homosexuality Bill (AHB) was introduced in the parliament to enhance existing anti-homosexuality law. A multi-disciplinary team made a Health Impact Assessment of the proposed AHB. The bill as tabled would severely increase punishments, increased closeting. Social capital of MSM would be eroded by clauses mandating reporting by friends, relatives, and acquaintances. Health-care professionals would have to inform on homosexuals. Mandatory HIV testing would be a blow to programming. Probable disclosure of HIV status in a public space (court) would also be a deterrent. Heftier punishments for those testing positive increases stigma and hobbles subsequent care. The AHB argues for exclusion, and more discrimination targeting persons living with HIV and sexual minorities. It will exacerbate the negative public health consequences of the existing legislation. The government of Uganda should review guidance documents published by authoritative bodies including the World Bank, World Health Organization to develop and bring to scale Human rights-affirming HIV prevention, treatment, and care responses.

  9. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nikola Fowler

    2014-11-01

    Full Text Available Introduction: Transmission in serodiscordant couples (SDCs accounts for approximately half of all new HIV infections, both in Kenya and the wider sub-Saharan region (1. With evidence to suggest inconsistent condom use within this population (2, the World Health Organization has recommended two new methods of HIV prevention for SDCs: Treatment as Prevention (TasP and Pre-Exposure Prophylaxis (PrEP. However, there has been little research about the attitudes of SDCs towards these strategies (3, 4; knowledge that is paramount for successfully predicting the acceptability and efficacy of each method, as well as for informing decisions regarding HIV policy changes in Kenya. Methods: An exploratory, qualitative study was conducted in the Muhoroni constituency of Nyando district, Kenya from January to March 2013. Purposive sampling was predominately used to recruit 21 HIV-positive and 17 HIV-negative individuals in a serodiscordant relationship from four hospitals and health centres. During face-to-face semi-structured interviews, topic guides were used to elicit information about participants’ attitudes and preferences towards TasP and PrEP. Collected data underwent framework analysis, allowing the development of overarching categories, sub-themes and inductive interpretation. Results: The majority of participants, irrespective of gender and HIV status, found TasP more acceptable than PrEP. A key factor influencing this decision was HIV-negative participants’ limited motivation to take and adhere to antiretrovirals (ARVs, primarily due to a predominantly external health locus of control, a lack of cultural acceptance of prophylactic medication and concerns about side effects. In addition to this, the likely health improvements TasP offers HIV-positive partners, as well as the attitude that the sick individual should be the first to receive HIV medication, also contributed to this conclusion. Issues of risk compensation were raised, with some HIV

  10. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Chattu

    2014-07-01

    Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

  11. To Depreciate or not to Depreciate Non-governmental Fixed Assets ...

    African Journals Online (AJOL)

    In the last two decades Africa and particularly Kenya has experienced an exponential growth of Non-Governmental Organizations (NGOs). This is attributed to the fact that they are established to solve immediate humanitarian problems that result from war, famine, poverty and bad governance in most countries in. Africa.

  12. Combination HIV Prevention and HIV Incidence in Uganda

    Science.gov (United States)

    Grabowski, Mary K; Serwadda, David M; Gray, Ronald H; Nakigozi, Gertrude; Kigozi, Godfrey; Kagaayi, Joseph; Ssekubugu, Robert; Nalugoda, Fred; Lessler, Justin; Lutalo, Thomas; Galiwango, Ronald; Makumbi, Fred; Kong, Xiangrong; Kabatesi, Donna; Alamo, Stella T; Wiersma, Steven; Sewankambo, Nelson K; Tobian, Aaron A R; Laeyendecker, Oliver; Quinn, Thomas C; Reynolds, Steven J

    2017-01-01

    BACKGROUND To assess the impact of combination HIV prevention (CHP) on HIV incidence, we analyzed the association between HIV incidence and scale-up of antiretroviral therapy (ART) and medical male circumcision in Rakai, Uganda. Changes in population-level viral load suppression and sexual behaviors were also examined. METHODS Between 1999 and 2016, data were collected through 12 surveys from 30 communities in the Rakai Community Cohort Study, an open population-based cohort of persons aged 15-49 years. We assessed HIV incidence trends based on observed seroconversion data, self-reported ART and male circumcision coverage, viral load suppression, and sexual behaviors. RESULTS In total, 33,937 study participants contributed 103,011 person-visits (HIV prevalence ~13%). Follow-up of 17,870 HIV-negative persons contributed 94,427 person-years with 931 seroconversions. ART was introduced in 2004; by 2016 coverage was 69% (72% in women vs. 61% in men, p<0.001). HIV viral load suppression among all HIV-positive persons increased from 42% in 2009 to 75% by 2016 (p<0.001). Male circumcision coverage increased from 15% in 1999 to 59% by 2016 (p<0.001). Persons 15-19 years reporting n 71 ever having sex increased from 30% to 55% (p<0.0001). HIV incidence declined by 42% in 2016 relative to the pre-CHP period prior to 2010 (1.17/100 py to 0.66/100 py; adjIRR:0.58: 95%CI: 0.45-0.76); declines were greater in men (adjIRR=0.46; 95%CI: 0.29-0.73) than women (adjIRR=0.68, 95%CI: 0.50-0.94). CONCLUSIONS In this longitudinal study, HIV incidence significantly declined with CHP scale-up, providing empiric evidence that HIV control interventions can have substantial population-level impact. However, additional efforts are needed to overcome gender disparities and achieve HIV elimination. PMID:29171817

  13. What Determines HIV Prevention Costs at Scale? Evidence from the Avahan Programme in India.

    Science.gov (United States)

    Lépine, Aurélia; Chandrashekar, Sudhashree; Shetty, Govindraj; Vickerman, Peter; Bradley, Janet; Alary, Michel; Moses, Stephen; Vassall, Anna

    2016-02-01

    Expanding essential health services through non-government organisations (NGOs) is a central strategy for achieving universal health coverage in many low-income and middle-income countries. Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs and have been demonstrated to be cost-effective and of substantial global public health importance. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs; and thus, policymakers have little guidance in how best to design programmes that are both effective and efficient. We collected economic costs from the Indian Avahan initiative, the largest HIV prevention project conducted globally, during the first 4 years of its implementation. We use a fixed-effect panel estimator and a random-intercept model to investigate the determinants of average cost. We find that programme design choices such as NGO scale, the extent of community involvement, the way in which support is offered to NGOs and how clinical services are organised substantially impact average cost in a grant-based payment setting. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

  14. MTV's "Staying Alive" global campaign promoted interpersonal communication about HIV and positive beliefs about HIV prevention.

    Science.gov (United States)

    Geary, Cynthia Waszak; Burke, Holly McClain; Castelnau, Laure; Neupane, Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

    2007-02-01

    In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household surveys. Using linear regression techniques, our evaluation examined the effects of campaign exposure on interpersonal communication about HIV and the effects of campaign exposure and interpersonal communication on beliefs about HIV prevention. We found a consistent positive effect of exposure on interpersonal communication across all sites, though there were differences among sites with regard to whom the respondent talked about HIV. We also found a consistent positive effect of exposure on HIV prevention beliefs across sites when interpersonal communication was simultaneously entered into the model. Finally, in two sites we found a relationship between interpersonal communication and HIV prevention beliefs, controlling for exposure, though again, the effects differed by the type of person the communication was with. These similar findings in three diverse sites provide ecological validity of the findings that "Staying Alive" promoted interpersonal communication and influenced young people's beliefs about HIV prevention in a positive way, evidence for the potential of a global media campaign to have an impact on social norms.

  15. Effectiveness of an HIV prevention intervention in prison among African Americans, Hispanics, and Caucasians.

    Science.gov (United States)

    Bryan, Angela; Robbins, Reuben N; Ruiz, Monica S; O'Neill, Dennis

    2006-04-01

    Prisons and prison inmates present important targets for HIV/AIDS prevention interventions. Inmates often have histories of high-risk behavior that place them in danger of contracting HIV/AIDS, and rates of HIV/AIDS tend to be much higher in this population. The goal of this study was to assess the effectiveness of a prison-based HIV/AIDS intervention to change attitudes toward HIV prevention, norms supporting HIV prevention, perceived behavioral control (i.e., self-efficacy) for HIV prevention behaviors, and intentions to engage in HIV prevention behaviors postrelease. The intervention also had the goal of encouraging inmates to become HIV/AIDS peer educators. The intervention appeared most successful at influencing beliefs and behaviors related to peer education and somewhat successful at influencing beliefs and intentions related to condom use. Analyses also showed some significant differences in effectiveness by race/ethnicity. Results are discussed from the perspectives of both research and practice with regard to prison-based HIV prevention efforts.

  16. Hearing our voices: assessing HIV prevention needs among Asian and Pacific Islander women.

    Science.gov (United States)

    Jemmott, L S; Maula, E C; Bush, E

    1999-04-01

    The purpose of this study was to (a) assess the impact of HIV/AIDS on the Asian-Pacific Islander (API) community and changes in their behavior due to AIDS, (b) identify perception of risk, HIV risk behaviors, factors contributing to those behaviors, barriers to HIV prevention, and the types of prevention programs that would benefit their community, and (c) describe culturally appropriate considerations when designing HIV prevention strategies for API women. Thirty API adults participated in three different groups. Focus group interviewing methods were used, guided by the Health Belief Model. The women had numerous concerns about HIV that placed them at risk for infection, such as their inability to talk with their sexual partners about condom use due to the cultural and taboo nature of sexual topics. All groups concluded that for HIV prevention interventions to be successful, they must be tailored to the cultural and specific needs of API women.

  17. Men who have sex with transgender women: challenges to category-based HIV prevention.

    Science.gov (United States)

    Operario, Don; Burton, Jennifer; Underhill, Kristen; Sevelius, Jae

    2008-01-01

    Although transgender women are acknowledged as a priority population for HIV prevention, there is little knowledge on men who have sex with transgender women (MSTGWs). MSTGWs challenge conventional sexual orientation categories in public health and HIV prevention research, and warrant increased attention from the public health community. This paper used qualitative techniques to analyze how MSTGWs describe their sexual orientation identities, and to explore the correspondence between men's identities and sexual behaviors with transgender women. We conducted in-depth semi-structured individual interviews with 46 MSTGWs in San Francisco. We observed a diversity in the ways participants identified and explained their sexual orientation, and found no consistent patterns between how men described their sexual orientation identity versus their sexual behavior and attraction to transgender women. Findings from this qualitative study question the utility of category-based approaches to HIV prevention with MSTGWs and offer insights into developing HIV interventions for these men.

  18. A dynamic social systems model for considering structural factors in HIV prevention and detection.

    Science.gov (United States)

    Latkin, Carl; Weeks, Margaret R; Glasman, Laura; Galletly, Carol; Albarracin, Dolores

    2010-12-01

    We present a model for HIV-related behaviors that emphasizes the dynamic and social nature of the structural factors that influence HIV prevention and detection. Key structural dimensions of the model include resources, science and technology, formal social control, informal social influences and control, social interconnectedness, and settings. These six dimensions can be conceptualized on macro, meso, and micro levels. Given the inherent complexity of structural factors and their interrelatedness, HIV prevention interventions may focus on different levels and dimensions. We employ a systems perspective to describe the interconnected and dynamic processes of change among social systems and their components. The topics of HIV testing and safer injection facilities (SIFs) are analyzed using this structural framework. Finally, we discuss methodological issues in the development and evaluation of structural interventions for HIV prevention and detection.

  19. Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa

    Science.gov (United States)

    Toska, Elona; Gittings, Lesley; Hodes, Rebecca; Cluver, Lucie D.; Govender, Kaymarlin; Chademana, KE; Gutiérrez, Vincent Evans

    2017-01-01

    Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child- and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with ‘care’ and ‘capability’ among children and adolescents. Social protection programmes should be dynamic and flexible, and take into account age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach, and uptake. Effective HIV prevention also requires integrated social protection policies, developed

  20. Ethical Issues to Consider in the Design of HIV Prevention Trials Involving Transgender People.

    Science.gov (United States)

    Singh, Jerome Amir

    2016-08-15

    Although transgender women have been included in HIV prevention pre-exposure prophylaxis studies, no pre-exposure prophylaxis study has focused exclusively on transgender persons. Drawing on the cardinal principles of ethics espoused in the Belmont Report, this work highlights, among other issues, that (1) the principle of Justice requires the HIV prevention field to focus exclusively on transgender persons, (2) the disclosure of potential study-related risks to study participants demonstrates Respect for Persons, and (3) devising risk mitigation plans, optimizing a proposed study's standard of care, and the provision of ancillary care satisfy the principle of Beneficence.

  1. Framing HIV prevention discourse to encompass the complexities of war in northern Uganda.

    Science.gov (United States)

    Westerhaus, Michael J; Finnegan, Amy C; Zabulon, Yoti; Mukherjee, Joia S

    2007-07-01

    In northern Uganda, physical and structural violence (political repression, economic inequality, and gender-based discrimination) increase vulnerability to HIV infection. In settings of war, traditional HIV prevention that solely promotes risk avoidance and risk reduction and assumes the existence of personal choice inadequately addresses the realities of HIV transmission. The design of HIV prevention strategies in northern Uganda must recognize how HIV transmission occurs and the factors that put people at risk for infection. A human rights approach provides a viable model for achieving this aim.

  2. PrEP Whores and HIV Prevention: The Queer Communication of HIV Pre-Exposure Prophylaxis (PrEP).

    Science.gov (United States)

    Spieldenner, Andrew

    2016-12-01

    HIV pre-exposure prophylaxis (PrEP) has been introduced as another biomedical tool in HIV prevention. Whereas other such tools-including post-exposure prophylaxis (PEP) and interruption of perinatal transmission-have been embraced by those impacted by HIV, PrEP has been met with more conflict, especially within the gay community and HIV organizations. The "PrEP whore" has come to designate the social value and personal practices of those taking PrEP. This study examines the "PrEP whore" discourse by using queer theory and quare theory. Within these theoretical vantage points, the study explicates four discursive areas: slut shaming, dirty/clean binaries, mourning the loss of condoms, and reclaiming the inner whore. The study illuminates possible discursive strategies that lie outside of the domains of public health and within the individual and community.

  3. Social marketing and diffusion-based strategies for communicating with unique populations: HIV prevention in San Francisco.

    Science.gov (United States)

    Dearing, J W; Rogers, E M; Meyer, G; Casey, M K; Rao, N; Campo, S; Henderson, G M

    1996-01-01

    We conducted a 2-year investigation of the extent to which strategies based on social marketing and diffusion of innovations concepts are used in preventive health communication with unique (highly ostracized) populations. Of the 49 organizations in San Francisco that operate HIV prevention programs (N = 100), programs that most highly targeted unique populations were surveyed. Personal interviews were then conducted with 38 staff leaders who operated the most and least effective programs. Audiotapes and transcripts were content analyzed to identify the strategies used by program staff. Strategies based on social marketing concepts were more prevalent than strategies based on the diffusion of innovations: More effective programs were characterized by emphasis on homophily, audience segmentation, compatibility-based strategies, and interorganizational collaboration.

  4. Experiences about HIV-AIDS preventive-control activities: Discourses from non-governmental organizations professionals and users Experiencias sobre la prevención y el control del VIH-sida: Discursos de los profesionales y usuarios de las organizaciones no gubernamentales

    Directory of Open Access Journals (Sweden)

    Anna Berenguera

    2011-06-01

    Full Text Available Objectives: The main aim of this study was to identify the experiences of professionals in nongovernmental organizations (NGO in Catalonia (Spain working in HIV/AIDS prevention and control activities and potential areas of improvement of these activities and their evaluation. A further aim was to characterize the experiences, knowledge and practices of users of these organizations with regard to HIV infection and its prevention. Methods: A phenomenological qualitative study was conducted with the participation of both professionals and users of Catalan nongovernmental organizations (NGO working in HIV/AIDS. Theoretical sampling (professional and opportunistic sampling (users were performed. To collect information, the following techniques were used: four focus groups and one triangular group (professionals, 22 semi-structured interviews, and two observations (users. A thematic interpretive content analysis was conducted by three analysts. Results: The professionals of nongovernmental organizations working in HIV/AIDS adopted a holistic approach in their activities, maintained confidentiality, had cultural and professional competence and followed the principles of equality and empathy. The users of these organizations had knowledge of HIV/AIDS and understood the risk of infection. However, a gap was found between knowledge, attitudes and behavior. Conclusions: NGO offer distinct activities adapted to users' needs. Professionals emphasize the need for support and improvement of planning and implementation of current assessment. The preventive activities of these HIV/AIDS organizations are based on a participatory health education model adjusted to people's needs and focused on empowerment.Objetivos: Identificar las experiencias y actividades de las organizaciones no gubernamentales (ONG que trabajan en la prevención y control del VIH/sida, las posibles áreas de mejora de las actividades y de su evaluación, e identificar las experiencias

  5. Personal Involvement of Young People in HIV Prevention Campaign Messages: The Role of Message Format, Culture, and Gender

    Science.gov (United States)

    Geary, Cynthia Waszak; Burke, Holly M.; Johnson, Laura; Liku, Jennifer; Castelnau, Laure; Neupane, Shailes; Niang, Cheikh

    2008-01-01

    To examine young people's reactions to and understanding of HIV prevention messages developed for MTV's global HIV prevention campaign Staying Alive, videotaped campaign materials were shown to focus group discussion (FGD) participants living in urban areas of Brazil, Kenya, Nepal, and Senegal. Responses related to "personal involvement"…

  6. Social marketing sexually transmitted disease and HIV prevention: a consumer-centered approach to achieving behaviour change.

    Science.gov (United States)

    Lamptey, P R; Price, J E

    1998-01-01

    This paper proposes that international sexually transmitted disease (STD)/HIV prevention efforts might be enhanced by the application of social marketing principles. It first outlines the conceptual basis of social marketing approaches to health behaviour change generally and then explores key issues and opportunities for using these principles to improve current STD/HIV prevention efforts.

  7. Knowledge Management in Non-Governmental Organisations: A Partnership for the Future

    OpenAIRE

    José Vasconcelos; Paulo Castro Seixas; Paulo Gens Lemos; Chris Kimble

    2005-01-01

    This paper explores Knowledge Management (KM) practices for use with portal technologies in Non-Governmental Organizations (NGOs). The aim is to help NGOs become true Civil Society Organizations (CSOs). In order to deal with more donors (at the top) and more beneficiaries (at the bottom), NGOs working in Humanitarian Aid and Social Development increasingly need systems to manage the creation, accessing and deployment information: within the NGOs themselves, between different NGOs that work to...

  8. Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics

    Science.gov (United States)

    Wirtz, Andrea L.; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R.; Sherman, Susan G.; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

    2014-01-01

    Introduction Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. Methods We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5–65% in Kenya and Ukraine; 10–70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012–2016 and, compared to status quo when all interventions are held constant. Results Optimistic but feasible coverage (65%–70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. Discussion A community empowerment approach to HIV prevention and

  9. Impact of HIV testing and counseling (HTC) knowledge on HIV prevention practices among traditional birth attendants in Nigeria.

    Science.gov (United States)

    Osuji, Alice; Pharr, Jennifer R; Nwokoro, Uche; Ike, Anulika; Ali, Christiana; Ejiro, Ogheneaga; Osuyali, John; Obiefune, Michael; Fiscella, Kevin; Ezeanolue, Echezona E

    2015-02-10

    Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p HTC training increases HIV prevention practices and can be a key to improve maternal and child health.

  10. Short-term effects of a peer group intervention for HIV prevention ...

    African Journals Online (AJOL)

    This report describes the implementation and short-term results of a peer group intervention for HIV prevention on the HIV-related attitudes, knowledge and behaviours of primary school teachers in Malawi. The intervention, based on the social-cognitive learning model, took place in 2000 at two teacher training colleges ...

  11. HIV prevention needs for men who have sex with men in Swaziland ...

    African Journals Online (AJOL)

    African Journal of AIDS Research ... There was limited knowledge of risk practices: When asked, 54% (19/35) of quantitative respondents reported that vaginal and anal sex carry an equal risk of HIV infection. ... Research is needed to increase knowledge on the HIV prevention needs for key populations, including MSM.

  12. Sexual Behavior and HIV Risk in Kenya: Epowering Youth in HIV Prevention

    NARCIS (Netherlands)

    C.W. Njue (Carolyne)

    2011-01-01

    textabstractThis thesis explores three topics concerning youth in Kenya: their knowledge and information needs regarding sexual and reproductive health including HIV/AIDS; their sexual risk behaviour; and HIV prevention efforts targeted at them. The data on which these studies are based were

  13. High School Health-Education Teachers' Perceptions and Practices Related to Teaching HIV Prevention

    Science.gov (United States)

    Herr, Scott W.; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Stone, Gregory E.

    2012-01-01

    Background: HIV/AIDS is one of the leading causes of illness and death in the United States with individuals between the ages of 13 and 19 years being especially vulnerable for infection. The purpose of this study was to examine the attitudes, perceptions, and instructional practices of high school health teachers toward teaching HIV prevention.…

  14. SOMOS: Evaluation of an HIV Prevention Intervention for Latino Gay Men

    Science.gov (United States)

    Vega, Miriam Y.; Spieldenner, Andrew R.; DeLeon, Dennis; Nieto, Bolivar X.; Stroman, Carolyn A.

    2011-01-01

    Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these…

  15. Perceptions of youth on the use of condoms for HIV prevention in ...

    African Journals Online (AJOL)

    The primary aim of this study was to determine the perceptions of youth on the use of condoms for HIV prevention in the Capricorn District of the Limpopo Province, South Africa. A qualitative, exploratory and descriptive design was used. The population included all youth from the ages of 15 to 19 years who attended two ...

  16. Public Health and Church-Based Constructions of HIV Prevention: Black Baptist Perspective

    Science.gov (United States)

    Roman Isler, Malika; Eng, Eugenia; Maman, Susanne; Adimora, Adaora; Weiner, Bryan

    2014-01-01

    The black church is influential in shaping health behaviors within African-American communities, yet few use evidence-based strategies for HIV prevention (abstinence, monogamy, condoms, voluntary counseling and testing, and prevention with positives). Using principles of grounded theory and interpretive description, we explored the social…

  17. Sexual Agreement Classifications for Gay and Bisexual Men and Implications for Harm Reduction HIV Prevention

    Science.gov (United States)

    Wilkerson, J. Michael; Smolenski, Derek J.; Morgan, Richard; Rosser, B. R. Simon

    2012-01-01

    HIV prevention educators frequently encourage gay and bisexual men (GBM) to negotiate condom use prior to sexual engagement. Identifying groups of GBM based on their presexual agreements can aid efforts to tailor interventions. Using cross-sectional data from 1,188 GBM who reported having sex with a nonprimary sex partner in the 90 days prior to…

  18. MTV's "Staying Alive" Global Campaign Promoted Interpersonal Communication about HIV and Positive Beliefs about HIV Prevention

    Science.gov (United States)

    Geary, Cynthia Waszak; Burke; Holly McClain; Castelnau, Laure; Neupane; Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

    2007-01-01

    In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; Sao Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based…

  19. Process Evaluation of HIV Prevention Peer Groups in Malawi: A Look inside the Black Box

    Science.gov (United States)

    McCreary, Linda L.; Kaponda, Chrissie P. N.; Kafulafula, Ursula K.; Ngalande, Rebecca C.; Kumbani, Lily C.; Jere, Diana L. N.; Norr, James L.; Norr, Kathleen F.

    2010-01-01

    This paper reports the process evaluation of a peer group intervention for human immunodeficiency virus (HIV) prevention which had positive outcomes for three target groups in Malawi: rural adults, adolescents and urban hospital workers. The six-session intervention was delivered to small groups of 10-12 participants by 85 trained volunteer peer…

  20. Peer outreach work as economic activity: implications for HIV prevention interventions among female sex workers.

    Directory of Open Access Journals (Sweden)

    Annie George

    Full Text Available Female sex workers (FSWs who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers' economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers' relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers.

  1. A little bit pregnant: modeling how the accurate detection of pregnancy can improve HIV prevention trials.

    Science.gov (United States)

    Schreiber, Courtney A; Sammel, Mary; Hillier, Sharon L; Barnhart, Kurt T

    2009-02-15

    The prevalence of unplanned pregnancies contributes to the methodological challenges of human immunodeficiency virus (HIV) prevention trials. In this paper, the authors discuss the incidence of pregnancy, including chemical pregnancy, and how the different methods of pregnancy diagnosis could affect the statistical power and calculated outcomes of HIV prevention trials. Study sample size inflation factors are estimated to aid in the design of clinical trials.The authors used published data of women attempting pregnancy as well as data from HPTN 055 (www.HPTN.org/research_studies/hptn055.asp) to estimate the percentage of early study discontinuation that would be associated with 3 diagnostic methods for pregnancy in a hypothetical clinical trial. They classified chemical pregnancies as false-positive pregnancy tests and showed the sample size adjustment that would be necessary in clinical trial design because of the early discontinuations associated with pregnancy. There is a greater than 3-fold difference in the number of falsely positive pregnancy tests that will be detected, depending upon the diagnostic method used. The number of incident pregnancies may render HIV prevention trial sample sizes inadequate by as much as 50%. Pregnancy prevention and precise pregnancy diagnosis are critical to the statistical power and integrity of HIV prevention trials.

  2. Vulnerable Youth as Prosumers in HIV Prevention: Studies Using Participatory Action Research.

    Science.gov (United States)

    Conn, Cath; Nayar, Shoba; Lubis, Dinar; Maibvisira, Carol; Modderman, Kristel

    2017-08-14

    Stigma, voicelessness, and legislative and rights barriers, coupled with top-down decision making, are the common experiences of vulnerable youth populations that limit their opportunities to participate in vital health promotion efforts such as HIV prevention. To consider new opportunities arising from a digital society for youth to creatively shape HIV prevention. Drawing on research with vulnerable youth in Busoga, Uganda; Bulawayo, Zimbabwe; Bangkok, Thailand; and Bali, Indonesia, we explore current youth participation, in theory and practice, while considering new opportunities arising from a digital society for youth to creatively shape HIV prevention. Collaborative commons and prosumer models are defined as people employing new technology to codesign toward a common goal. Within the context of a diminishing role of the traditional institution and the rise of digitized networks, such models offer exciting new directions for youth as electronic health promotion prosumers to participate in difficult challenges such as HIV prevention in the 21st century. It is time for institutions to embrace such opportunities, especially in areas where access to technology is widening, while continuing to champion youth and advocate for supportive social environments.

  3. Predictors of sexual-risk behaviour and HIV-preventive practices ...

    African Journals Online (AJOL)

    Predictors of sexual-risk behaviour and HIV-preventive practices among university students in Ethiopia. ... and higher income needs to be investigated. Keywords: condoms, East Africa, multiple sexual partners, prevention, sexual debut, sexually transmitted infections, young adults. African Journal of AIDS Research 2011, ...

  4. A Plan for the Next Generation of HIV Prevention Research: Seven Key Policy Investigative Challenges

    Science.gov (United States)

    Coates, Thomas J.; Szekeres,Gregory

    2004-01-01

    Although HIV prevention research has accomplished much over the last 2 decades, significant challenges remain. The accomplishments have included rapid progression through various stages of research--from descriptive to clinical trials--and the fielding of several Phase 3 trials with biological endpoints. The challenges include developing…

  5. A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions

    Science.gov (United States)

    Owczarzak, Jill; Phillips, Sarah D.; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

    2016-01-01

    The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to…

  6. HIV-prevention knowledge among illiterate and low-literate women ...

    African Journals Online (AJOL)

    HIV-prevention knowledge among illiterate and low-literate women in rural Amhara, Ethiopia. Gebeyehu W Bogale, Henk Boer, Erwin R Seydel. Abstract. More than 85% of Ethiopia's population lives in rural areas and literacy levels in the country are relatively low. Despite this, little is known about levels of knowledge in ...

  7. Capacity building among african american faith leaders to promote HIV prevention and vaccine research.

    Science.gov (United States)

    Alio, Amina P; Lewis, Cindi A; Bunce, Catherine A; Wakefield, Steven; Thomas, Weldon G; Sanders, Edwin; Keefer, Michael C

    2014-01-01

    In light of the increasing rates of HIV infection in African Americans, it is essential that black faith leaders become more proactive in the fight against the epidemic. The study aim was to engage faith leaders in a sustainable partnership to increase community participation in preventive HIV vaccine clinical research while improving their access to and utilization of HIV/AIDS prevention services. Leadership Development Seminars were adapted for faith leaders in Rochester, NY, with topics ranging from the importance of preventive HIV vaccine research to social issues surrounding HIV/AIDs within a theological framework. Seminars were taught by field-specific experts from the black community and included the development of action plans to institute HIV preventive ministries. To assess the outcome of the Seminars, baseline and post-training surveys were administered and analyzed through paired sample t Tests and informal interviews. 19 faith leaders completed the intervention. In general, the majority of clergy felt that their understanding of HIV vaccine research and its goals had increased postintervention. A critical outcome was the subsequent formation of the Rochester Faith Collaborative by participating clergy seeking to sustain the collaborative and address the implementation of community action plans. Providing scientific HIV/AIDS knowledge within the context of clergy members' belief structure was an effective method for engaging black Church leaders in Rochester, NY. Collaborative efforts with various local institutions and community-based organizations were essential in building trust with the faith leaders, thereby building bridges for better understanding of HIV/AIDS prevention efforts, including HIV vaccine research.

  8. A review of medical and substance use co-morbidities in Central Asian prisons: implications for HIV prevention and treatment.

    Science.gov (United States)

    Vagenas, Panagiotis; Azbel, Lyuba; Polonsky, Maxim; Kerimi, Nina; Mamyrov, Mirlan; Dvoryak, Sergey; Altice, Frederick L

    2013-11-01

    HIV incidence in Central Asia is rising rapidly. People who inject drugs (PWIDs) contribute greatest to the epidemic, with more than a quarter of all HIV cases being in the criminal justice system (CJS). This review assembled and aggregated recent data on drug-related health problems and respective healthcare services in the CJS of Central Asia and the Republic of Azerbaijan. Online databases and published literature (peer-reviewed and gray) were reviewed. Additionally, prison officials in the 6 countries were invited to participate in a survey and prison administrators from Kazakhstan, Kyrgyzstan and Tajikistan completed it. The data on conditions and healthcare in Central Asian prisons are inconsistent and lack unbiased details. Reporting is primarily based on "official" disease registries, which markedly underestimate prevalence. Even these limited data, however, indicate that HIV prevalence and drug-related health problems are high, concentrated and, in some countries, rising rapidly in CJS. Only some of the range of HIV prevention interventions recommended by international organizations have been implemented in the region with two of the crucial interventions, needle and syringe exchange programs (NSP) and opioid substitution therapy (OST), only available in prisons in Kyrgyzstan, with Tajikistan implementing a pilot NSP and contemplating introduction of prison-based OST. Despite deficiencies in routine health reporting and insufficient HIV sentinel surveillance undertaken in prisons, the data available on the concentration of HIV within at-risk populations in prisons indicate a necessity to broaden the range and increase the scale the scale of HIV prevention and treatment services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. HIV prevention for South African youth: which interventions work? A systematic review of current evidence.

    Science.gov (United States)

    Harrison, Abigail; Newell, Marie-Louise; Imrie, John; Hoddinott, Graeme

    2010-02-26

    In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning.

  10. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    Directory of Open Access Journals (Sweden)

    Imrie John

    2010-02-01

    Full Text Available Abstract Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1 study design and outcomes, 2 intervention design (content, curriculum, theory, adaptation process, 3 thematic focus and HIV causal pathways, 4 intervention delivery (duration, intensity, who, how, where. Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5 or group-based (3, involving in- and out-of-school youth. Primary outcomes included HIV incidence (2, reported sexual risk behavior alone (4, or with alcohol use (2. Interventions led to reductions in STI incidence (1, and reported sexual or alcohol risk behaviours (5, although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3, alcohol/substance use (2, or economic factors (2. Delivery methods and formats varied, and included teachers (5, peer educators (5, and older mentors (1. School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning.

  11. Estimating unbiased economies of scale of HIV prevention projects: a case study of Avahan.

    Science.gov (United States)

    Lépine, Aurélia; Vassall, Anna; Chandrashekar, Sudha; Blanc, Elodie; Le Nestour, Alexis

    2015-04-01

    Governments and donors are investing considerable resources on HIV prevention in order to scale up these services rapidly. Given the current economic climate, providers of HIV prevention services increasingly need to demonstrate that these investments offer good 'value for money'. One of the primary routes to achieve efficiency is to take advantage of economies of scale (a reduction in the average cost of a health service as provision scales-up), yet empirical evidence on economies of scale is scarce. Methodologically, the estimation of economies of scale is hampered by several statistical issues preventing causal inference and thus making the estimation of economies of scale complex. In order to estimate unbiased economies of scale when scaling up HIV prevention services, we apply our analysis to one of the few HIV prevention programmes globally delivered at a large scale: the Indian Avahan initiative. We costed the project by collecting data from the 138 Avahan NGOs and the supporting partners in the first four years of its scale-up, between 2004 and 2007. We develop a parsimonious empirical model and apply a system Generalized Method of Moments (GMM) and fixed-effects Instrumental Variable (IV) estimators to estimate unbiased economies of scale. At the programme level, we find that, after controlling for the endogeneity of scale, the scale-up of Avahan has generated high economies of scale. Our findings suggest that average cost reductions per person reached are achievable when scaling-up HIV prevention in low and middle income countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

    Directory of Open Access Journals (Sweden)

    Kumar G Anil

    2010-05-01

    Full Text Available Abstract Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India.

  13. Participatory Development and Non-Governmental Organisations in ...

    African Journals Online (AJOL)

    Participatory Development and Non-Governmental Organisations in Sudan: Expectations and Realities. ... links between government institutions local community organisations, private sectors and international organisations. Moreover, the article ... Information about NGOs is based on a field research conducted 2007.

  14. Sivil Toplum Örgütleri ve Kitle İletişim Araçlarının Çevre Okuryazarlığı Bilinci Oluşturmadaki Rolü / The Role of Nongovernmental Organizations and Mass Media on Creating Environmental Literacy Awareness

    Directory of Open Access Journals (Sweden)

    Özge Uluğ Yurttaş

    2012-12-01

    Full Text Available Tüketim toplumunun yükselişi ile birlikte tüketimin sınırları giderek genişlemekte, mal, ürün ve hatta hizmetin ötesinde; ormanların, doğal yaşamın, suyun, havanın tüketimine kadar uzanmaktadır. Böylece, tüketim ve tüketime yönelik üretim yaklaşımı, doğal kaynaklara büyük ölçüde zarar vermektedir. Bilinçsiz tüketim bir taraftan hammadde kaynaklarını olumsuz etkilerken öte yandan da çevreye zarar vermektedir. Bu geri döndürülmesi çoğu zaman imkânsız veya çok güç olan zararlı süreç, ancak bilinçli tüketimin yaygınlaşması ile önlenebilir. Bu çalışma, sivil toplum örgütlerinin toplumsal bilinç oluşturma ve toplumu bilinçsiz tüketime karşı harekete geçirme noktalarında neler yapabileceklerini ele almaktadır. The Role of Nongovernmental Organizations and Mass Media on Creating Environmental Literacy Awareness With the rise of consumer society, the limits of consumption has been expanding and it goes up further than goods, products and services to forests, wildlife habitat, water and air consumption. Consumption and production damage to a large extent on natural resources. Unconscious consumption damages the source of raw materials and environment. This generally not to be reversed and damaging process, could be prevented only with conscious consumption is widespread. This study, points at how the non-governmental organizations could play an important role to create social awareness and to prompt society against unconscious consumption.

  15. THE ROLE OF NON-GOVERNMENTAL ORGANISATIONS IN CREATING STANDARDS IN INTERNATIONAL ENVIRONMENTAL LAW

    Directory of Open Access Journals (Sweden)

    Oana Maria HANCIU

    2015-07-01

    Full Text Available The participation and influence of non-governmental actors in areas of international environmental governance has increased tremendously over the last decades. Some of these non-governmental organization (NGOs, like International Union for Conservation of Nature, World Wide Fund for Nature or Greenpeace, have a global character and an intense activity in promoting environmental protection. Of great importance is the fact that some NGOs have gained a consultative status in international and regional organizations influencing the process of drafting and adopting norms of international environmental law. The study analyses the contribution of NGOs in international environmental field and their essential role as ,,guardians of the environment” in promoting and respecting the provisions of international environmental agreements, in particular of Aarhus Convention.

  16. Preferences for a Mobile HIV Prevention App for Men Who Have Sex With Men.

    Science.gov (United States)

    Goldenberg, Tamar; McDougal, Sarah J; Sullivan, Patrick S; Stekler, Joanne D; Stephenson, Rob

    2014-10-29

    The Centers for Disease Control and Prevention recommends that sexually active men who have sex with men (MSM) in the United States test for human immunodeficiency virus (HIV) at least three times per year, but actual testing frequency is much less frequent. Though mHealth is a popular vehicle for delivering HIV interventions, there are currently no mobile phone apps that target MSM with the specific aim of building an HIV testing plan, and none that focuses on developing a comprehensive prevention plan and link MSM to additional HIV prevention and treatment resources. Previous research has suggested a need for more iterative feedback from the target population to ensure use of these interventions. The purpose of this study is to understand MSM's preferences for functionality, format, and design of a mobile phone-based HIV prevention app and to examine MSM's willingness to use an app for HIV prevention. We conducted focus group discussions with 38 gay and bisexual men, with two in-person groups in Atlanta, two in Seattle, and one online focus group discussion with gay and bisexual men in rural US regions. These discussions addressed MSM's general preferences for apps, HIV testing barriers and facilitators for MSM, and ways that an HIV prevention app could address these barriers and facilitators to increase the frequency of HIV testing and prevention among MSM. During focus group discussions, participants were shown screenshots and provided feedback on potential app functions. Participants provided preferences on functionality of the app, including the type and delivery of educational content, the value of interactive engagement, and the importance of social networking as an app component. Participants also discussed preferences on how the language should be framed for the delivery of information, identifying that an app needs to be simultaneously fun and professional. Privacy and altruistic motivation were considered to be important factors in men's willingness to

  17. Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach.

    Science.gov (United States)

    Seidman, Dominika L; Weber, Shannon; Cohan, Deborah

    2017-03-08

    HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women's vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV. We then describe a clinical approach to caring for women who both choose and decline pre-exposure prophylaxis during pregnancy and postpartum, highlighting areas for future research. Evidence suggests that pre-exposure prophylaxis with tenofovir/emtricitabine is safe in pregnancy and lactation. Identifying women vulnerable to HIV and eligible for pre-exposure prophylaxis is challenging in light of the myriad of individual, community, and structural forces impacting HIV acquisition. Validated risk calculators exist for specific populations but have not been used to screen and offer HIV prevention methods. Partner testing and engagement of men living with HIV are additional means of reaching at-risk women. However, women's vulnerabilities to HIV change over time. Combining screening for HIV vulnerability with HIV and/or STI testing at standard intervals during pregnancy is a practical way to prompt providers to incorporate HIV screening and prevention counselling. We suggest using shared decision-making to offer women pre-exposure prophylaxis as one of multiple HIV prevention strategies during pregnancy and postpartum, facilitating open conversations about HIV vulnerabilities, preferences about HIV prevention strategies, and choosing a method that best meets the needs of each woman. Growing evidence suggests that pre-exposure prophylaxis with tenofovir

  18. implementation of a school-based hiv prevention curriculum

    African Journals Online (AJOL)

    2014-05-05

    May 5, 2014 ... E. J. Matthews, BA, Robertson Scholars Programme, E. S. Puffer, PhD, Department of Psychology and Neuroscience and. Global Health Institute, C. S. Meade, PhD, Department of Psychiatry and ...... organization for this study. REFERENCES. 1. UNAIDS. Report on the global AIDS epidemic. 2008. 2.

  19. HIV Prevention for Adolescents: Where Do We Go from Here?

    Science.gov (United States)

    Lightfoot, Marguerita

    2012-01-01

    The World Health Organization estimates that 50% of the 30 million HIV infections worldwide occurred in young people between the ages of 15 and 24 years. In the United States, national statistics estimate that almost 40% of new HIV cases occur in youth ages 13-29 (Centers for Disease Control and Prevention, 2011). Therefore, a focus on preventing…

  20. Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles County.

    Science.gov (United States)

    Reynolds, Grace L; Fisher, Dennis G; Napper, Lucy E; Fremming, Brent W; Jansen, Michael A

    2010-01-01

    This study examined reported heterosexual receptive anal intercourse (HRAI) in a sample of women recruited from HIV prevention providers in Los Angeles County. The majority of women surveyed were Latina and the modal age was 19 years. Women reporting HRAI were more likely to use both injected and non injected drugs and to have sexual partners who injected drugs. Factors associated with HRAI in a multivariate regression model included use of methamphetamine; use of alcohol before, during, or after sex; and use of dental services at the interview agency. Factors inversely associated with heterosexual anal sex were being African American (compared with Latina) and endorsing the use of condoms for episodes of vaginal sex from start to finish. HIV prevention providers in Los Angeles County should be aware of the need for basic prevention messages concerning condom use and injection behavior in young Latina women. Copyright © 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  1. Affect management for HIV prevention with adolescents in therapeutic schools: the immediate impact of project balance.

    Science.gov (United States)

    Brown, Larry K; Houck, Christopher; Donenberg, Geri; Emerson, Erin; Donahue, Kelly; Misbin, Jesse

    2013-10-01

    Adolescents in therapeutic schools are at greater risk for HIV and other STIs than their peers due to earlier higher rates of sexual risk and difficulty managing strong emotions. HIV prevention programs that incorporate techniques for affect management (AM) during sexual situations may be beneficial. This paper determined the immediate impact of such an intervention, AM, compared to a standard, skills-based HIV prevention intervention and a general health promotion intervention (HP) for 377 youth, ages 13-19, in therapeutic schools in two cities. 1 month after the intervention, analyses that adjusted for the baseline scores found adolescents in AM were more likely to report condom use at last sex than those in HP (0.89 vs. 0.67, p = 0.02) and that their HIV knowledge was significantly greater. These data suggest that AM techniques might improve the impact of standard skills-based prevention programs for adolescents in therapeutic schools.

  2. Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template.

    Science.gov (United States)

    Beigi, Richard H; Noguchi, Lisa; Brown, Gina; Piper, Jeanna; Watts, D Heather

    2016-07-01

    Evidence-based guidance regarding use of nearly all pharmaceuticals by pregnant and lactating women is limited. Models for performing research may assist in filling these knowledge gaps. Internationally, reproductive age women are at high risk of human immunodeficiency virus (HIV) acquisition. Susceptibility to HIV infection may be increased during pregnancy, and risk of maternal-child transmission is increased with incident HIV infection during pregnancy and lactation. A multidisciplinary meeting of experts was convened at the United States National Institutes of Health to consider paradigms for drug research in pregnancy and lactation applicable to HIV prevention. This report summarizes the meeting proceedings and describes a framework for research on candidate HIV prevention agent use during pregnancy and lactation that may also have broader applications to other pharmaceutical products.

  3. Provider fatalism reduces the likelihood of HIV-prevention counseling in primary care settings.

    Science.gov (United States)

    Steward, Wayne T; Koester, Kimberly A; Myers, Janet J; Morin, Stephen F

    2006-01-01

    We examined the relationship between provider fatalism, a belief that behavior change among HIV-infected patients is unlikely, and HIV-prevention counseling in 16 publicly funded clinics. HIV-seropositive patients (N = 618) completed surveys assessing prevention counseling in the past 6 months. Additionally, 144 interviews were conducted with providers, administrators, and patients to examine beliefs about prevention counseling. We summed the number of fatalistic comments made by providers and administrators in each clinic, and assigned these counts as clinic-level fatalism scores to survey participants. Patients in high fatalism clinics were less likely to report prevention counseling than patients in low fatalism clinics. This difference remained significant even after controlling for clinic characteristics or patients' sexual risk and health status. However, clients in high fatalism clinics were more likely to be White, gay, educated, and older. Provider fatalism is a barrier that must be addressed when implementing HIV-prevention counseling in primary care settings.

  4. Exploring Social Networking Technologies as Tools for HIV Prevention for Men Who Have Sex With Men.

    Science.gov (United States)

    Ramallo, Jorge; Kidder, Thomas; Albritton, Tashuna; Blick, Gary; Pachankis, John; Grandelski, Valen; Grandeleski, Valen; Kershaw, Trace

    2015-08-01

    Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social etiquettes and rules that may increase HIV risk by discouraging HIV status disclosure. Overall, successful interventions for MSM using social networking technologies must consider aspects of privacy, stigma, and social norms in order to enact HIV reduction among MSM.

  5. A cost function for HIV prevention services: is there a 'u' – shape?

    Directory of Open Access Journals (Sweden)

    Hanson Kara

    2007-11-01

    Full Text Available Abstract Background Global resource needs estimation is a critical part of addressing the HIV/AIDS epidemic. To generate these estimates knowledge of costs and cost structures is required. The evidence base for costs of HIV prevention programmes is limited. Even less is known about the existence of economies scale and whether, as economic theory suggests, average costs form a 'u'-shaped curve as scale increases. Using an econometric analysis, this paper addresses this question by estimating marginal costs and economies of scale for HIV prevention programmes for vulnerable groups in Southern India with different levels of coverage. Methods Two hybrid translog-cost functions were estimated. First, expenditure data from 78 state-funded HIV prevention projects in Andhra Pradesh were used to explore the impact of scale, institutional history and price on costs; second, economic cost data from 16 commercial sex worker projects across Tamil Nadu and Andhra Pradesh were analysed to additionally assess the impact of the value of inputs not reported in expenditure data and location. Coefficient estimates were used to calculate marginal costs and economies of scale. Results The econometric model yielded a good fit (R2 = 0.46, p 2 = 0.79, p Conclusion Econometric analysis of these standardized datasets provides insights into how costs change with coverage, the impact of project location and nature of the project target group. The results demonstrate the importance of understanding the nature of the cost function when designing, budgeting and estimating resource requirements for scaling up coverage of HIV prevention projects.

  6. A journey to HIV prevention research: From social psychology to social health via multidisciplinarity.

    Science.gov (United States)

    Kippax, Susan

    2017-05-01

    This article is a personal account of my research in HIV prevention and how and why I navigated my way from social psychology to 'social health' via multidisciplinarity. My work in HIV prevention - from 1984 to the present day - developed my understandings of epistemology, building on and expanding the ways in which I undertook research. This article describes those whose writings and research influenced me and the input of colleagues and students. It also demonstrates my disquiet with the individualism of psychology as a way of thinking about what was needed to prevent HIV transmission. HIV prevention requires social transformation and such change is produced via changes in the social practices and social norms of communities and networks rather than by changes in the behaviours of individuals. While the input of social and biomedical scientists was and continues to be of central importance to the success of HIV prevention, so also is the input of the expertise of the members of the communities and networks most affected by HIV - collectivities of gay men, people who inject drugs and sex workers. It was the members of these communities and networks who collectively transformed their practices and made them safer. The article outlines the ways in which the research participants in research studies made me re-examine notions of knowledge and evidence. Over time, my colleagues and I developed a 'social health': a model of social transformation that involves enabling communities and their members to modify their social practices by building on emergent community responses, responses that were identified by the use of a reflexive research methodology.

  7. Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach

    Directory of Open Access Journals (Sweden)

    Dominika L Seidman

    2017-02-01

    Conclusion: Growing evidence suggests that pre-exposure prophylaxis with tenofovir/emtricitabine during pregnancy and lactation is safe and effective. Shared decision-making provides one approach to identify at-risk women and offers pre-exposure prophylaxis but requires implementation research in diverse clinical settings. Including pregnant and breastfeeding women in future HIV prevention research is critical for the creation of evidence-driven public health policies and clinical guidelines.

  8. Faith-based organisations and HIV prevention in Africa: A review

    Directory of Open Access Journals (Sweden)

    Rachel Mash

    2013-01-01

    Full Text Available Background: Faith-based organisations (FBOs are potentially an important role-player in HIV prevention, but there has been little systematic study of their potential strengths and weaknesses in this area.Objectives: To identify the strengths and weaknesses of FBOs in terms of HIV prevention. The questions posed were, (1 ‘What is the influence of religion on sexual behaviour in Africa?’,and (2 ‘What are the factors that enable religion to have an influence on sexual behaviour?’.Method: A literature search of Medline, SABINET, Africa Wide NIPAD and Google Scholar was conducted.Results: The potential for Faith-based organisations to be important role-players in HIV prevention is undermined by the church’s difficulties with discussing sexuality, avoiding stigma, gender issues and acceptance of condoms. It appears that, in contrast with high-income countries, religiosity does not have an overall positive impact on risky sexual behaviour in Africa. Churches may, however, have a positive impact on alcohol use and its associated risky behaviour, as well as self-efficacy. The influence of the church on sexual behaviour may also be associated with the degree of social engagement and control within the church culture.Conclusion: Faith-based organisations have the potential to be an important role player in terms of HIV prevention. However, in order to be more effective, the church needs to take up the challenge of empowering young women, recognising the need for their sexually-active youth to use protection, reducing judgemental attitudes and changing the didactical methods used.

  9. Human immunodeficiency virus (HIV) prevention education in Singapore: challenges for the future.

    Science.gov (United States)

    Wong, Mee Lian; Sen, Priya; Wong, Christina M; Tjahjadi, Sylvia; Govender, Mandy; Koh, Ting Ting; Yusof, Zarina; Chew, Ling; Tan, Avin; K, Vijaya

    2012-12-01

    We reviewed the current human immunodeficiency virus (HIV) prevention education programmes in Singapore, discussed the challenges faced and proposed prevention education interventions for the future. Education programmes on HIV prevention have shown some success as seen by reduced visits to sex workers among the general adult population and a marked increase in condom use among brothel-based sex workers. However, we still face many challenges such as low awareness of HIV preventive strategies and high prevalence of HIV stigma in the general population. Voluntary HIV testing and condom use remain low among the priority groups such as men who have sex with men (MSM) and heterosexual men who buy sex. Casual sex has increased markedly from 1.1% in 1989 to 17.4% in 2007 among heterosexuals in Singapore, with the majority (84%) practising unprotected sex. Sex workers have moved from brothels to entertainment venues where sex work is mostly hidden with lack of access to sexually transmitted infections (STIs)/ HIV prevention education and treatment programmes. Education programmes promoting early voluntary testing is hampered because of poor access, high cost and stigma towards people living with HIV. It remains a challenge to promote abstinence and consistent condom use in casual and steady sexual relationships among heterosexuals and MSM. New ways to promote condom use by using a positive appeal about its pleasure enhancing effects rather than the traditional disease-oriented approach should be explored. Education programmes promoting early voluntary testing and acceptance of HIV-infected persons should be scaled up and integrated into the general preventive health services.

  10. A New HIV Prevention Network Approach: Sociometric Peer Change Agent Selection

    OpenAIRE

    Schneider, John A; Zhou, A. Ning; Laumann, Edward O.

    2014-01-01

    Internationally, the Peer Change Agent (PCA) model is the most frequently used conceptual framework for HIV prevention. Change agents themselves can be more important than the messages they convey. PCA selection is operationalized via heterogeneous methods based upon individual-level attributes. A sociometric position selection strategy, however, could increase peer influence potency and halt transmission at key network locations. In this study, we selected candidate PCAs based upon relative ...

  11. Recruitment and retention of women in fishing communities in HIV prevention research

    OpenAIRE

    Ssetaala, Ali; Nakiyingi-Miiro, Jessica; Asiimwe, Stephen; Nanvubya, Annet; Mpendo, Juliet; Asiki, Gershim; Nielsen, Leslie; Kiwanuka, Noah; Seeley, Janet; Kamali, Anatoli; Kaleebu, Pontiano

    2015-01-01

    Introduction Women in fishing communities in Uganda are more at risk and have higher rates of HIV infection. Socio-cultural gender norms, limited access to health information and services, economic disempowerment, sexual abuse and their biological susceptibility make women more at risk of infection. There is need to design interventions that cater for women's vulnerability. We explore factors affecting recruitment and retention of women from fishing communities in HIV prevention research. Met...

  12. Fear appeals in HIV-prevention messages: young people's perceptions in northern Tanzania.

    Science.gov (United States)

    Bastien, Sheri

    2011-12-01

    The aims of the study were to elicit the perceptions of young people in Tanzania on the role of fear appeals in HIV-prevention messages and to identify important contextual factors that may influence young people's perceptions of HIV-prevention posters. A total of 10 focus groups were conducted to investigate the role of fear appeals using the extended parallel process model (EPPM) as a guide. Young people were shown a series of images (mostly posters) with alternating high and low-threat messages (fear appeals), and then asked questions about their overall beliefs about HIV and AIDS, as well as about their response in terms of perceived susceptibility to HIV infection, the severity of the message, and their perceptions of self-efficacy and response efficacy. The images and messages that specifically targeted young people were highest in inducing perceived susceptibility to HIV infection, while pictorial descriptions of the physical consequences of HIV infection and those messages related to the stigma and discrimination faced by HIV-infected or affected people induced greater perceptions of severity. The information-based posters rated high in inducing response efficacy, while none of the images seemed to convince young people that they had the self-efficacy to perform the recommended health behaviours. The young people expressed a preference for fear-based appeals and a belief that this could work well in HIV-prevention efforts, yet they also stated a desire for more information-based messages about how to protect themselves. Finally, the messages evoking the most emotional responses were those that had been locally conceived rather than ones developed by large-scale donor-funded campaigns. Finding the appropriate balance between fear and efficacy in HIV-prevention messages is imperative. Further research is needed to better understand how and when fear appeals work and do not work in African settings, especially among young people.

  13. A systematic review on cost effectiveness of HIV prevention interventions in the United States.

    Science.gov (United States)

    Huang, Ya-Lin A; Lasry, Arielle; Hutchinson, Angela B; Sansom, Stephanie L

    2015-04-01

    The Centers for Disease Control and Prevention (CDC) focus on funding HIV prevention interventions likely to have high impact on the HIV epidemic. In its most recent funding announcement to state and local health department grantees, CDC required that health departments allocate the majority of funds to four HIV prevention interventions: HIV testing, prevention with HIV-positives and their partners, condom distribution and policy initiatives. We conducted a systematic review of the published literature to determine the extent of the cost-effectiveness evidence for each of those interventions. We searched for US-based studies published through October 2012. The studies that qualified for inclusion contained original analyses that reported costs per quality-adjusted life-year saved, life-year saved, HIV infection averted, or new HIV diagnosis. For each study, paired reviewers performed a detailed review and data extraction. We reported the number of studies related to each intervention and summarized key cost-effectiveness findings according to intervention type. Costs were converted to 2011 US dollars. Of the 50 articles that met the inclusion criteria, 33 related to HIV testing, 15 assessed prevention with HIV-positives and partners, three reported on condom distribution, and one reported on policy initiatives. Methodologies and cost-effectiveness metrics varied across studies and interventions, making them difficult to compare. Our review provides an updated summary of the published evidence of cost effectiveness of four key HIV prevention interventions recommended by CDC. With the exception of testing-related interventions, including partner services, where economic evaluations suggest that testing often can be cost effective, more cost-effectiveness research is needed to help guide the most efficient use of HIV prevention funds.

  14. Young African women must have empowering and receptive social environments for HIV prevention.

    Science.gov (United States)

    Conn, Cath

    2013-01-01

    This paper describes a study which explored the lives of young Ugandan women through their voices, and related the findings to HIV prevention paradigms. The research was conducted in the context of the continuing vulnerability of young Ugandan women to HIV; reflected in disproportionately high prevalence compared to young men. The participants of the study were 15 young women aged 15-19 years, from Busoga Region in Eastern Uganda. Given the focus on young women's voices within norms of gender inequality, a narrative methodology was used as a safe space for participants to speak about their lives, expanding on research experiences with young people. The methods used included drawing; written stories and drama; aspirational writing and diary keeping. Forty-eight narratives, in image and word form, represented everyday experiences in young women's lives, as well as difficult experiences of inequality and resistance. Young women portrayed considerable social barriers to empowerment, and a challenging environment of poverty and educational limitations. Young women's representations were analysed using a gender empowerment and positive sexuality framework. The resulting analysis was then critically applied to HIV prevention paradigms. Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment. Alternative approaches need to build young African women's voices in the spaces of homes, schools and communities. It is vital, however, that such efforts are embedded in more radical change leading to social environments receptive to the needs of young women.

  15. Pre-exposure prophylaxis for HIV prevention: where have we been and where are we going?

    OpenAIRE

    Baeten, Jared M; Haberer, Jessica E.; Liu, Albert Y.; Sista, Nirupama

    2013-01-01

    Pre-exposure prophylaxis (PrEP), in which HIV-uninfected persons with ongoing HIV risk use antiretroviral medications to reduce their risk of acquiring HIV infection, is an efficacious and promising new HIV prevention strategy. The past two years have seen significant new advances in knowledge regarding PrEP, including definitive demonstration that PrEP reduces the risk of HIV acquisition, regulatory approval of combination oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) as the fir...

  16. "Let Me Help You Help Me": Church-Based HIV Prevention for Young Black Men Who Have Sex With Men.

    Science.gov (United States)

    Powell, Terrinieka W; Herbert, Ann; Ritchwood, Tiarney D; Latkin, Carl A

    2016-06-01

    The goal of this study was to identify strategies that could yield more inclusive church-based HIV prevention efforts. In-depth interviews were conducted with 30 young Black men who have sex with men (YBMSM) living in Baltimore, Maryland. The sample had an equal number of regular and infrequent church attendees. Nearly one-fourth of the sample was HIV-positive. Interviews were transcribed verbatim and analyzed inductively using a qualitative content analytic approach. Two main recommendations emerged for churches to offer more inclusive HIV prevention efforts: (1) reduce homosexuality stigma by increasing interpersonal and institutional acceptance, and (2) address the sexual health needs of all congregants by offering universal and targeted sexual health promotion. Thus, results support a tiered approached to providing more inclusive church-based HIV prevention efforts. We conclude that Black churches can be a critical access point for HIV prevention among YBMSM and represent an important setting to intervene.

  17. Can a pill prevent HIV? Negotiating the biomedicalisation of HIV prevention.

    Science.gov (United States)

    Young, Ingrid; Flowers, Paul; McDaid, Lisa

    2016-03-01

    This article examines how biomedicalisation is encountered, responded to and negotiated within and in relation to new biomedical forms of HIV prevention. We draw on exploratory focus group discussions on pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) to examine how the processes of biomedicalisation are affected by and affect the diverse experiences of communities who have been epidemiologically framed as 'vulnerable' to HIV and towards whom PrEP and TasP will most likely be targeted. We found that participants were largely critical of the perceived commodification of HIV prevention as seen through PrEP, although this was in tension with the construction of being medical consumers by potential PrEP candidates. We also found how deeply entrenched forms of HIV stigma and homophobia can shape and obfuscate the consumption and management of HIV-related knowledge. Finally, we found that rather than seeing TasP or PrEP as 'liberating' through reduced levels of infectiousness or risk of transmission, social and legal requirements of responsibility in relation to HIV risk reinforced unequal forms of biomedical self-governance. Overall, we found that the stratifying processes of biomedicalisation will have significant implications in how TasP, PrEP and HIV prevention more generally are negotiated. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  18. HIV prevention outreach in commercial gay venues in large cities: evaluation findings from London.

    Science.gov (United States)

    Bonell, Chris; Strange, V; Allen, E; Barnett-Page, E

    2006-08-01

    Human immunodeficiency virus (HIV) prevention delivered in gay venues in US cities has been found to be effective in reducing HIV transmission in the 1990s but effects might not be generalizable to different times and settings. Doubts have been raised about: outreach's ability to address skills and explore personal behaviour; big-city commercial gay venues being appropriate sites for outreach because of gossip and social surveillance; and acceptability of outreach by professionals rather than 'popular opinion formers'. We evaluated coverage, feasibility, acceptability and perceived impact of venue-based HIV prevention outreach by professionals in London, employing observation, surveys and interviews with venue-users, and focus groups/semi-structured interviews with workers. We found high coverage especially among target groups. Addressing negotiation skills and personal behaviour was feasible but required worker motivation and skill. Social surveillance rarely impeded work. Gay men generally found outreach acceptable and useful, and professionals were not regarded negatively. Impact on knowledge was commonly reported; impacts on negotiation skills and reflection on personal behaviour were more common among men experiencing longer contacts. In conclusion, professional HIV prevention outreach in gay venues in large cities is a feasible and acceptable intervention with significant potential impacts. Workers need to be well briefed and trained to maximize impact.

  19. Perspectives on biomedical HIV prevention options among women who inject drugs in Kenya.

    Science.gov (United States)

    Bazzi, Angela Robertson; Yotebieng, Kelly A; Agot, Kawango; Rota, Grace; Syvertsen, Jennifer L

    2017-08-05

    Due to heightened vulnerability to HIV from frequent engagement in sex work and overlapping drug-using and sexual networks, women who inject drugs should be a high priority population for pre-exposure prophylaxis (PrEP) and other biomedical HIV prevention tools. Kenya is one of the first African countries to approve oral PrEP for HIV prevention among "key populations," including people who inject drugs and sex workers. The objective of this study was to explore preferences and perceived challenges to PrEP adoption among women who inject drugs in Kisumu, Kenya. We conducted qualitative interviews with nine HIV-uninfected women who inject drugs to assess their perceptions of biomedical HIV interventions, including oral PrEP, microbicide gels, and intravaginal rings. Despite their high risk and multiple biomedical studies in the region, only two women had ever heard of any of these methods. All women were interested in trying at least one biomedical prevention method, primarily to protect themselves from partners who were believed to have multiple other sexual partners. Although women shared concerns about side effects and product efficacy, they did not perceive drug use as a significant deterrent to adopting or adhering to biomedical prevention methods. Beginning immediately and continuing throughout Kenya's planned PrEP rollout, efforts are urgently needed to include the perspectives of high risk women who use drugs in biomedical HIV prevention research and programing.

  20. Religious communities and HIV prevention: an intervention study using a human rights-based approach.

    Science.gov (United States)

    Paiva, V; Garcia, J; Rios, L F; Santos, A O; Terto, V; Munõz-Laboy, M

    2010-01-01

    Religious communities have been a challenge to HIV prevention globally. Focusing on the acceptability component of the right to health, this intervention study examined how local Catholic, Evangelical and Afro-Brazilian religious communities can collaborate to foster young people's sexual health and ensure their access to comprehensive HIV prevention in their communities in Brazil. This article describes the process of a three-stage sexual health promotion and HIV prevention initiative that used a multicultural human rights approach to intervention. Methods included 27 in-depth interviews with religious authorities on sexuality, AIDS prevention and human rights training of 18 young people as research-agents, who surveyed 177 youth on the same issues using self-administered questionnaires. The results, analysed using a rights-based perspective on health and the vulnerability framework, were discussed in daylong interfaith workshops. Emblematic of the collaborative process, workshops are the focus of the analysis. Our findings suggest that this human rights framework is effective in increasing inter-religious tolerance and in providing a collective understanding of the sexuality and prevention needs of youth from different religious communities, and also serves as a platform for the expansion of state AIDS programmes based on laical principles.

  1. Religious communities and HIV prevention: an intervention-study using a human rights-based approach

    Science.gov (United States)

    Paiva, V.; Garcia, J.; Rios, L.F.; Santos, A.O.; Terto, V.; Munõz-Laboy, M.

    2011-01-01

    Religious communities have been a challenge to HIV prevention globally. Focusing on the acceptability component of the right to health, this intervention study examined how local Catholic, Evangelical and Afro-Brazilian religious communities can collaborate to foster young people’s sexual health and ensure their access to comprehensive HIV prevention in their communities in Brazil. This article describes the process of a three-stage sexual health promotion and HIV prevention initiative that used a multicultural human rights approach to intervention. Methods included 27 in-depth interviews with religious authorities on sexuality, AIDS prevention and human rights, and training 18 young people as research-agents, who surveyed 177 youth on the same issues using self-administered questionnaires. The results, analysed using a rights-based perspective on health and the vulnerability framework, were discussed in daylong interfaith workshops. Emblematic of the collaborative process, workshops are the focus of the analysis. Our findings suggest that this human rights framework is effective in increasing inter-religious tolerance and in providing a collective understanding of the sexuality and prevention needs of youth from different religious communities, and also serves as a platform for the expansion of state AIDS programmes based on laical principles. PMID:20373192

  2. Brief report on ecological momentary assessment: everyday states predict HIV prevention behaviors.

    Science.gov (United States)

    Cook, Paul F; McElwain, Catherine J; Bradley-Springer, Lucy A

    2016-01-04

    Prevention behaviors help persons living with HIV (PLWH) to avoid transmitting HIV, and psychological variables have been found to predict HIV prevention behaviors. These variables have typically been measured using retrospective questionnaires about average psychological states over a period of time, which are likely to be biased by selective recall and interpretation. Measuring the same variables as momentary states, in the day-to-day context where they actually occur, may reveal different relationships to behavior. 21 PLWH completed daily surveys about momentary states and prevention behaviors. Brief, validated measures were used to assess control beliefs, mood, stress, coping, social support, stigma, knowledge, and motivation. We used multilevel models to predict prevention behaviors from momentary states the previous day, while controlling for the effect of multiple observations from the same person over time. Participants reported a moderate overall level of HIV prevention behaviors during the 6-month study. Although lapses in prevention were infrequent, there was room for improvement. Control beliefs, mood, and motivation had significant prospective effects on HIV prevention behaviors, rs = 0.07-0.21. Stress and coping had effects approaching significance. Some momentary states predicted prevention behaviors, providing partial support for the motivational model. This finding supports past research showing effects of momentary states on behavior, and advances the science by testing multiple predictors. High within-sample diversity strengthened generalizability, but the overall sample size was small and the findings require replication. Future research should continue to examine the everyday experiences of PLWH as influences on their behavior.

  3. Identifying Resilience Resources for HIV Prevention Among Sexual Minority Men: A Systematic Review.

    Science.gov (United States)

    Woodward, Eva N; Banks, Regina J; Marks, Amy K; Pantalone, David W

    2017-10-01

    Most HIV prevention for sexual minority men and men who have sex with men targets risk behaviors (e.g., condom use) and helps resilience might increase HIV prevention's effectiveness. This systematic review identified resilience resources (protective factors) in high-risk, HIV-negative, sexual minority men. We reviewed PsycINFO, PsycARTICLES, MEDLINE, references, and Listservs for studies including sexual minority men with 1+ HIV risk factor (syndemics): childhood sexual abuse, partner abuse, substance abuse, or mental health symptoms. From 1356 articles screened, 20 articles met inclusion criteria. Across the articles, we identified and codified 31 resilience resources: socioeconomic (e.g., employment), behavioral coping strategies (e.g., mental health treatment), cognitions/emotions (e.g., acceptance), and relationships. Resilience resources were generally associated with lower HIV risk; there were 18 low-risk associations, 4 high-risk associations, 8 non-significant associations). We generated a set of empirically based resilience variables and a hypothesis to be evaluated further to improve HIV prevention.

  4. PrEP as Peri-conception HIV Prevention for Women and Men.

    Science.gov (United States)

    Heffron, Renee; Pintye, Jillian; Matthews, Lynn T; Weber, Shannon; Mugo, Nelly

    2016-06-01

    Daily oral tenofovir (TDF)-based pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy and recommended for men and women with substantial risk of HIV acquisition. The peri-conception period, the stage prior to pregnancy when condom use is necessarily reduced, has elevated HIV risk that can be mitigated by PrEP use. Data from a randomized trial suggest that peri-conception PrEP use by HIV-seronegative women does not increase the risk of pregnancy loss, birth defects or congenital anomalies, preterm birth, or infant growth faltering. Women considering PrEP use throughout pregnancy must weigh the known increased risk of HIV acquisition with unknown risks of drug effects on infant growth. PrEP has been used safely by HIV-seronegative men with HIV-seropositive female partners who have become pregnant. As an effective user-controlled HIV prevention strategy, PrEP offers autonomy and empowerment for HIV prevention and can be recommended alongside antiretroviral therapy, fertility screening, vaginal self-insemination, intercourse timed to peak fertility, medically assisted reproduction, and other safer conception strategies to provide multiple options. The integration of PrEP into safer conception programs is warranted and will safely reduce HIV transmission to women, men, and children during the peri-conception period.

  5. The Fire is Coming: An HIV Prevention Intervention Contextualized to the Maasai People of Tanzania

    Directory of Open Access Journals (Sweden)

    Holly Freitas

    2014-01-01

    Full Text Available “The Fire is Coming” film is an innovative HIV-prevention intervention contextualized to the Maasai people of Tanzania through use of a traditional Maasai story. The intervention was developed and implemented in partnership with Maasai Pastoralists for Education and Development (MAPED. Although there have been numerous Knowledge-Attitude-Practice (KAP surveys conducted among the Maasai, this is the first control-group comparison study designed to measure the effectiveness of an HIV-prevention intervention contextualized specifically to the Maasai people of Tanzania. We will first discuss the background and context in which the intervention was developed and methods used to develop the intervention. We will then discuss the evaluation methods, results, and implications of a retrospective Knowledge, Attitudes, Practices (KAP two-village comparison survey (n=200 for “The Fire is Coming” HIV-prevention intervention among Maasai people. There was a significant effect for HIV-related attitudes, t(16 = 2.77, p 0.05. Implications: Belief in one’s ability to do something is often the pivotal point for behavior change. The results of the survey denote a highly effective intervention in changing HIV-related attitudes and behaviors. It is promising for replication among other Maasai communities and for adaptation with indigenous people groups in other regions.

  6. Adapting an Evidence-Based HIV-Prevention Intervention for Women in Domestic Violence Shelters.

    Science.gov (United States)

    Cavanaugh, Courtenay E; Campbell, Jacquelyn; Braxton, Nikia; Harvey, Jenna; Wingood, Gina

    2016-07-01

    Despite the documented intersection of intimate partner violence and HIV, there is a paucity of evidence-based HIV prevention interventions for female survivors of intimate partner violence in the United States. This paper describes the adaptation of an effective HIV prevention intervention, Sisters Informing Sisters about Topics on AIDS (SISTA), for women in domestic violence shelters and the steps taken to improve the adapted intervention's implementation. The adaptation process was guided by the ADAPT-ITT framework and data collected from directors, direct client service providers, and residents of two domestic violence shelters located in urban areas, as well as topical experts. Eleven of 12 shelter staff (92%) reported that HIV interventions had never been implemented at their shelter and 64% reported they had not provided residents with educational brochures about HIV prevention. Changes made to adapt SISTA for this population and enhance the implementation of the intervention included reducing the intervention's duration; adding education about the intersection of intimate partner violence, substance use, and HIV; and adding an HIV risk assessment and safety plan. Next steps will include implementing the adapted intervention and evaluating its perceived acceptability and efficacy, and assessing whether contextual factors influence the intervention's implementation.

  7. Child privacy rights: A ‘Cinderella’ issue in HIV-prevention research

    Directory of Open Access Journals (Sweden)

    Ann Elaine Strode

    2013-09-01

    Full Text Available Legal debates regarding child participation in HIV research have tended to focus on issues of informed consent. However, much less attention has been given to privacy; accordingly, we classify this as a ‘Cinderella issue’ that has been excluded from ‘the ball’ (academic debate. Here we argue that privacy issues are as important as consent issues in HIV-prevention research. We describe a child’s right to privacy regarding certain health interventions in South African law, and identify four key norms that flow from the law and that could be applied to HIV-prevention research: (i children cannot have an expectation of privacy regarding research participation if they have not given independent consent to the study; (ii children may have an expectation of privacy regarding certain components of the study, such as HIV testing, if they consent independently to such services; (iii children’s rights to privacy in health research are limited by mandatory reporting obligations; (iv children’s rights to privacy in HIV-prevention research may be justifiably limited by the concept of the best interests of the child. We conclude with guidelines for researchers on how to implement these principles in HIV-related research studies.

  8. Exploring the Masculine Identity in the Context of HIV Prevention in Chile.

    Science.gov (United States)

    Ferrer, Lilian; Cianelli, Rosina; Villegas, Natalia; Reed, Reiley; Bernales, Margarita; Repetto, Paula; Hufstader, Theodore; Lara, Loreto; Irarrázabal, Lisette; Peragallo-Montano, Nilda

    2016-03-01

    This study aims to describe human immunodeficiency virus (HIV)-related knowledge and beliefs, as well as understanding attitudes towards masculinity in the context of HIV prevention, held among Chilean men. This study reports the qualitative findings of a sequential qualitative-quantitative mixed methodology study: Bringing men into HIV Prevention in Chile, NIH R01 TW007674-03. Twenty in-depth interviews using a qualitative, descriptive approach to elicit information for the study were conducted among men residing in two communities of low socio-economic status in Santiago, Chile. Content analysis of interviews revealed three main themes regarding machismo and how it relates to HIV: sexuality and machismo, the changing nature of machismo, and violence against women. Addressing HIV and intimate partner violence through developing education programs tailored to meet the needs of Chilean men are needed to include men in HIV prevention efforts. Specifically, incorporating ideas of what men consider healthy masculinity and working to destigmatize men who have sex with men are important steps in addressing the negative aspects of machismo. © 2016 Sigma Theta Tau International.

  9. Impact of Mano a Mano Mujer, an HIV Prevention Intervention, on Depressive Symptoms among Chilean Women

    Science.gov (United States)

    Cianelli, Rosina; Lara, Loreto; Villegas, Natalia; Bernales, Margarita; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda

    2012-01-01

    Background Worldwide, an in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low income Chilean women. Depressed people are less willing to participate in behaviors that protect them against HIV. Objectives To analyze the impact of Mano a Mano-Mujer (MM-M) on depressive symptoms among Chilean women. Methods A quasi-experimental design was used to test the impact of MM-M, an HIV prevention intervention. The research was conducted in Santiago- Chile, a total of 400 women participated in the study (intervention group, n = 182; control group, n = 218). The intervention was guided by the social-cognitive model and the primary health model. The intervention consists of six two-hour sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face to face interviews were conducted at baseline and at 3 months follow-up Results At 3 months post-intervention, Chilean women who participated in MM-M significantly decreased their reported depressive symptoms. Conclusions MM-M provided significant benefits for women's depression symptoms. This study offers a model that address depression, a risk factor for HIV. It uses nurses as leaders for the screening of depressive symptoms and as facilitators of community interventions. PMID:22452388

  10. Social and structural HIV prevention in alcohol-serving establishments: review of international interventions across populations.

    Science.gov (United States)

    Kalichman, Seth C

    2010-01-01

    Alcohol use is associated with risks for sexually transmitted infections (STIs), including HIV/AIDS. People meet new sex partners at bars and other places where alcohol is served, and drinking venues facilitate STI transmission through sexual relationships within closely knit sexual networks. This paper reviews HIV prevention interventions conducted in bars, taverns, and informal drinking venues. Interventions designed to reduce HIV risk by altering the social interactions within drinking environments have demonstrated mixed results. Specifically, venue-based social influence models have reduced community-level risk in U.S. gay bars, but these effects have not generalized to gay bars elsewhere or to other populations. Few interventions have sought to alter the structural and physical environments of drinking places for HIV prevention. Uncontrolled program evaluations have reported promising approaches to bar-based structural interventions with gay men and female sex workers. Finally, a small number of studies have examined multilevel approaches that simultaneously intervene at both social and structural levels with encouraging results. Multilevel interventions that take environmental factors into account are needed to guide future HIV prevention efforts delivered within alcohol-serving establishments.

  11. AIDS Impact special issue 2009: HIV prevention through sport: the case of the Mathare Youth Sport Association in Kenya

    OpenAIRE

    Delva, Wim; Michielsen, Kristien; Meulders, Bert; Groeninck, Sandy; Wasonga, Edwin; Ajwang, Pauline; Temmerman, Marleen; Vanreusel, Bart

    2010-01-01

    Abstract Sport has become a popular tool for HIV prevention, based on claims that it can foster life skills that are necessary to translate knowledge, attitudes and behavioural intentions into actual behaviour. Empirical evidence of the effectiveness of sport-based HIV prevention programmes is, however, sorely lacking. We therefore conducted a cross-sectional survey assessing sexual behaviour and the determinants thereof among 454 youth of the Mathare Youth Sport Association (MYSA)...

  12. Implementing good participatory practice guidelines in the FEM-PrEP Preexposure Prophylaxis Trial for HIV Prevention among African Women: a focus on local stakeholder involvement

    Directory of Open Access Journals (Sweden)

    Mack N

    2013-10-01

    Full Text Available Natasha Mack,1 Stella Kirkendale,1 Paul Omullo,2 Jacob Odhiambo,2 Malebo Ratlhagana,3 Martha Masaki,4 Phumzile Siguntu,5 Kawango Agot,2 Khatija Ahmed,3 Saidi Kapiga,4 Johan Lombaard,5 Lut Van Damme,1 Amy Corneli1 1FHI 360, Durham, NC, USA; 2Impact Research and Development Organization, Bondo, Kenya; 3Setshaba Research Centre, Soshanguve, South Africa; 4Kilimanjaro Christian Medical Center, Moshi, Tanzania; 5Josha Research, Bloemfontein, South Africa Abstract: Biomedical HIV-prevention research is most likely to succeed when researchers actively engage with community stakeholders. To this effect, the Joint United Nations Programme on HIV/AIDS and the AIDS Vaccine Advocacy Coalition developed good participatory practice guidelines for biomedical HIV-prevention trials in 2007 and updated them in 2011. The Preexposure Prophylaxis Trial for HIV Prevention among African Women (FEM-PrEP clinical trial, testing once-daily Truvada as preexposure prophylaxis among women at higher risk of HIV in Kenya, South Africa, and Tanzania, included a community program to engage with local stakeholders. Following the trial, we revisited the community program to situate activities in the context of the 2011 guidelines. In the paper, we describe implementation of the six guidelines relevant to local stakeholder engagement – stakeholder advisory mechanisms, stakeholder engagement plan, stakeholder education plan, communications plan, issues management plan, trial closure, and results dissemination – in light of on-the-ground realities of the trial. We then identify two cross-cutting themes from our considerations: (1 stakeholder education beyond the good participatory practice recommendation to increase research literacy about the specific trial is needed; education efforts should also communicate a base of information on HIV transmission and prevention; and (2 anticipatory preparation is useful in communications planning, issues management, and trial closure and

  13. Targeting HIV prevention messaging to a new generation of gay, bisexual, and other young men who have sex with men.

    Science.gov (United States)

    Kingdon, Molly J; Storholm, Erik David; Halkitis, Perry N; Jones, Donovan C; Moeller, Robert W; Siconolfi, Daniel; Solomon, Todd M

    2013-01-01

    HIV prevention messaging has been shown to reduce or delay high-risk sexual behaviors in young men who have sex with men (YMSM). Since the onset of the HIV/AIDS epidemic, a new generation of YMSM has come of age during an evolution in communication modalities. Because both these communication technologies and this new generation remain understudied, the authors investigated the manner in which YMSM interact with HIV prevention messaging. In particular, the authors examined 6 venues in which YMSM are exposed to, pay attention to, and access HIV prevention information: the Internet, bars/dance clubs, print media, clinics/doctors' offices, community centers/agencies, and educational classes. Data were drawn from a community-based sample of 481 racially and ethnically diverse YMSM from New York City. Significant differences in exposure to HIV prevention messaging venues emerged with respect to age, race/ethnicity, and sexual orientation. Attention paid to HIV prevention messages in various venues differed by age and sexual orientation. Across all venues, multivariate modeling indicated YMSM were more likely to access HIV messaging from the same venues at which they paid attention, with some variability explained by person characteristics (age and perceived family socioeconomic status). This suggests that the one-size-fits-all approach does not hold true, and both the venue and person characteristics must be considered when generating and disseminating HIV prevention messaging.

  14. Impact of Non-governmental Organizations (NGOs) on Rural Poverty ...

    African Journals Online (AJOL)

    The incidence, depth and severity of poverty of rural people and influencing rural poverty were investigated in the Southwestern Nigeria. Multi-stage stratified random sampling procedure was used to collect data from 200 clients and 200 non-clients of NGOs in the study area. Linear multiple regression was used to ...

  15. Non-governmental organizations and agricultural development in ...

    African Journals Online (AJOL)

    This paper analyzes the potential collaboration between agricultural research and NGOs in the dissemination of agricultural technologies at the Kenyan coast. An inventory of NGOs working in the region was established, and 11 out of 25 were found to be active in agricultural development. These 11 NGOs were visited and ...

  16. The role of non-governmental organizations in providing curative ...

    African Journals Online (AJOL)

    Abstract. Background: Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. Objectives: To examine the role that ...

  17. Government and Nongovernmental Organizations Working Together in Gender Education

    Science.gov (United States)

    Su, Chien-Ling

    2014-01-01

    The promotion of sex/gender equity education in Taiwan was initiated by a women's movement group, the Awakening Foundation in the late 1980s. In 1997, it became a policy in education. The passage of the Gender Equity Education Act in 2004 was a major milestone. At present, although gender equity education has been essentially institutionalized,…

  18. Strengthening government management capacity to scale up HIV prevention programs through the use of Technical Support Units: lessons from Karnataka state, India

    Science.gov (United States)

    Sgaier, Sema K; Anthony, John; Bhattacharjee, Parinita; Baer, James; Malve, Vidyacharan; Bhalla, Aparajita; Hugar, Vijaykumar S

    2014-01-01

    ABSTRACT Scaling up HIV prevention programming among key populations (female sex workers and men who have sex with men) has been a central strategy of the Government of India. However, state governments have lacked the technical and managerial capacity to oversee and scale up interventions or to absorb donor-funded programs. In response, the national government contracted Technical Support Units (TSUs), teams with expertise from the private and nongovernmental sectors, to collaborate with and assist state governments. In 2008, a TSU was established in Karnataka, one of 6 Indian states with the highest HIV prevalence in the country and where monitoring showed that its prevention programs were reaching only 5% of key populations. The TSU provided support to the state in 5 key areas: assisting in strategic planning, rolling out a comprehensive monitoring and evaluation system, providing supportive supervision to intervention units, facilitating training, and assisting with information, education, and communication activities. This collaborative management model helped to increase capacity of the state, enabling it to take over funding and oversight of HIV prevention programs previously funded through donors. With the combined efforts of the TSU and the state government, the number of intervention units statewide increased from 40 to 126 between 2009 and 2013. Monthly contacts with female sex workers increased from 5% in 2008 to 88% in 2012, and with men who have sex with men, from 36% in 2009 to 81% in 2012. There were also increases in the proportion of both populations who visited HIV testing and counseling centers (from 3% to 47% among female sex workers and from 6% to 33% among men who have sex with men) and sexually transmitted infection clinics (from 4% to 75% among female sex workers and from 7% to 67% among men who have sex with men). Changes in sexual behaviors among key populations were also documented. For example, between 2008 and 2010, the proportion of

  19. Emotional Appeals in HIV Prevention Campaigns: Unintended Stigma Effects.

    Science.gov (United States)

    Thainiyom, Prawit; Elder, Katherine

    2017-07-01

    The purpose of this study was to determine whether HIV/AIDS public service announcements (PSAs) that use emotional appeals have unintended effects of creating stigmatizing attitudes in their viewers. We analyzed data for 240 respondents located in the United States who were recruited online. Respondents were randomly assigned to one of 3 conditions, where they viewed a PSA with hope appeals, fear appeals, or non-emotional appeals. Respondents then answered a series of questions about their attitudes about HIV/AIDS; testing behavior; engagement with HIV/AIDS-related people, organizations, and issues; and HIV/AIDS knowledge. We then performed MANOVA analyses and Pearson correlations. There were no significant differences in stigmatizing attitudes and behavior across the 3 conditions. However, once the data were split by sex, men exposed to the hope condition had significantly higher stigmatizing attitudes towards people living with HIV/AIDS than men in the other 2 conditions. This result was unexpected and suggests that further research needs to be conducted with a more robust sample size to account for any moderating influences that might explain why a hopeful message that communicates togetherness would have a negative attitudinal impact on male viewers.

  20. Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

    Directory of Open Access Journals (Sweden)

    Peter A Newman

    Full Text Available Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations.From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement.Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted.This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as

  1. Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

    Science.gov (United States)

    Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

    2015-01-01

    Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting

  2. The role of non-governmental organisations in empowering rural ...

    African Journals Online (AJOL)

    The key findings show that non-governmental organisations focused on imparting practical entrepreneurial skills and technical knowledge. However, participants encountered several challenges such as lack of access to capital for scaling up the projects, poor quality of finished products and limited access to markets. In turn ...

  3. Non-Governmental Organisations (NGOs) and global social change ...

    African Journals Online (AJOL)

    In the absence of fuller integration and representation within the sphere of law making in both domestic and international arrangement, the increasing influence, contribution and work of Non-Governmental Organisations (NGOs) for the purpose of social change, policy formulation and eventual rule making are undeniable.

  4. Timeliness of Nongovernmental versus Governmental Global Outbreak Communications

    Science.gov (United States)

    Mondor, Luke; Brownstein, John S.; Chan, Emily; Madoff, Lawrence C.; Pollack, Marjorie P.; Buckeridge, David L.

    2012-01-01

    To compare the timeliness of nongovernmental and governmental communications of infectious disease outbreaks and evaluate trends for each over time, we investigated the time elapsed from the beginning of an outbreak to public reporting of the event. We found that governmental sources improved the timeliness of public reporting of infectious disease outbreaks during the study period. PMID:22709741

  5. Venue-based recruitment of women at elevated risk for HIV: an HIV Prevention Trials Network study.

    Science.gov (United States)

    Haley, Danielle F; Golin, Carol; El-Sadr, Wafaa; Hughes, James P; Wang, Jing; Roman Isler, Malika; Mannheimer, Sharon; Kuo, Irene; Lucas, Jonathan; DiNenno, Elizabeth; Justman, Jessica; Frew, Paula M; Emel, Lynda; Rompalo, Anne; Polk, Sarah; Adimora, Adaora A; Rodriquez, Lorenna; Soto-Torres, Lydia; Hodder, Sally

    2014-06-01

    The challenge of identifying and recruiting U.S. women at elevated risk for HIV acquisition impedes prevention studies and services. HIV Prevention Trials Network (HPTN) 064 was a U.S. multisite, longitudinal cohort study designed to estimate HIV incidence among women living in communities with prevalent HIV and poverty. Venue-based sampling (VBS) methodologies and participant and venue characteristics are described. Eligible women were recruited from 10 U.S. communities with prevalent HIV and poverty using VBS. Participant eligibility criteria included age 18-44 years, residing in a designated census tract/zip code, and self-report of at least one high-risk personal and/or male sexual partner characteristic associated with HIV acquisition (e.g., incarceration history). Ethnography was conducted to finalize recruitment areas and venues. Eight thousand twenty-nine women were screened and 2,099 women were enrolled (88% black, median age 29 years) over 14 months. The majority of participants were recruited from outdoor venues (58%), retail spaces (18%), and social service organizations (13%). The proportion of women recruited per venue category varied by site. Most participants (73%) had both individual and partner characteristics that qualified them for the study; 14% were eligible based on partner risk only. VBS is a feasible and effective approach to rapidly recruit a population of women at enhanced risk for HIV in the United States. Such a recruitment approach is needed in order to engage women most at risk and requires strong community engagement.

  6. Adding to the HIV Prevention Portfolio – the Achievement of Structural Changes by 13 Connect to Protect® Coalitions

    Science.gov (United States)

    Chutuape, Kate S.; Muyeed, Adaline Z.; Willard, Nancy; Greenberg, Lauren; Ellen, Jonathan M.

    2015-01-01

    Opportunities to control risk factors that contribute to HIV transmission and acquisition extend far beyond individuals and include addressing social and structural determinants of HIV risk, such as inadequate housing, poor access to healthcare and economic insecurity. The infrastructure within communities, including the policies and practices that guide institutions and organizations, should be considered crucial targets for change. This paper examines the extent to which 13 community coalitions across the U.S. and Puerto Rico were able to achieve “structural change” objectives (i.e., new or modified practices or policies) as an intermediate step toward the long-term goal of reducing HIV risk among adolescents and young adults (12-24 years old). The study resulted in the completion of 245 objectives with 70% categorized as structural in nature. Coalitions targeted social services, education and government as primary community sectors to adopt structural changes. A median of 12 key actors and six new key actors contributed to accomplishing structural changes. Structural change objectives required a median of seven months to complete. The structural changes achieved offer new ideas for community health educators and practitioners seeking to bolster their HIV prevention agenda. PMID:25632407

  7. Community mobilization, empowerment and HIV prevention among female sex workers in south India.

    Science.gov (United States)

    Blanchard, Andrea K; Mohan, Haranahalli Lakkappa; Shahmanesh, Maryam; Prakash, Ravi; Isac, Shajy; Ramesh, Banadakoppa Manjappa; Bhattacharjee, Parinita; Gurnani, Vandana; Moses, Stephen; Blanchard, James F

    2013-03-16

    While community mobilization has been widely endorsed as an important component of HIV prevention among vulnerable populations such as female sex workers (FSWs), there is uncertainty as to the mechanism through which it impacts upon HIV risk. We explored the hypothesis that individual and collective empowerment of FSW is an outcome of community mobilization, and we examined the means through which HIV risk and vulnerability reduction as well as personal and social transformation are achieved. This study was conducted in five districts in south India, where community mobilization programs are implemented as part of the Avahan program (India AIDS Initiative) of the Bill & Melinda Gates Foundation. We used a theoretically derived "integrated empowerment framework" to conduct a secondary analysis of a representative behavioural tracking survey conducted among 1,750 FSWs. We explored the associations between involvement with community mobilization programs, self-reported empowerment (defined as three domains including power within to represent self-esteem and confidence, power with as a measure of collective identity and solidarity, and power over as access to social entitlements, which were created using Principal Components analysis), and outcomes of HIV risk reduction and social transformation. In multivariate analysis, we found that engagement with HIV programs and community mobilization activities was associated with the domains of empowerment. Power within and power with were positively associated with more program contact (p community mobilization has benefits for empowering FSWs both individually and collectively. HIV prevention is strengthened by improving their ability to address different psycho-social and community-level sources of their vulnerability. Future challenges include the need to develop social, political and legal contexts that support community mobilization of FSWs, and to prospectively measure the impact of combined community-level interventions

  8. Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India

    Science.gov (United States)

    Kumar, SG Prem; Dandona, Rakhi; Schneider, John A; Ramesh, YK; Dandona, Lalit

    2009-01-01

    Background HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources. Methods Detailed cost and output data were collected from written records and interviews for 2005–2006 fiscal year using standardized methods at six sampled HIV prevention programmes for truck drivers in the Indian state of Andhra Pradesh. The total economic cost for these programmes was computed and the relation of unit cost of services per truck driver with programme scale was assessed using regression analysis. Results A total of 120,436 truck drivers were provided services by the six programmes of which 55.9% were long distance truck drivers. The annual economic cost of providing services to a truck driver varied between programmes from US$ 1.52 to 4.56 (mean US$ 2.49). There was an inverse relation between unit economic cost of serving a truck driver and scale of the programme (R2 = 0.63; p = 0.061). The variation between programmes in the average number of contacts made by the programme staff with truck drivers was 1.3 times versus 5.8 times for contacts by peer educators. Only 1.7% of the truck drivers were referred by the programmes for counseling and HIV testing. Conclusion These data provide information for further planning of HIV prevention programmes for truck drivers and estimating the resources needed for such programmes. The findings suggest the need to strengthen the role of peer educators and increase referral of truck drivers for HIV testing. PMID:19457269

  9. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    Directory of Open Access Journals (Sweden)

    Sema K Sgaier

    2014-05-01

    Full Text Available Voluntary medical male circumcision (VMMC is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform.

  10. Within but without: human rights and access to HIV prevention and treatment for internal migrants

    Directory of Open Access Journals (Sweden)

    Amon Joseph J

    2009-11-01

    Full Text Available Abstract Worldwide, far more people migrate within than across borders, and although internal migrants do not risk a loss of citizenship, they frequently confront significant social, financial and health consequences, as well as a loss of rights. The recent global financial crisis has exacerbated the vulnerability internal migrants face in realizing their rights to health care generally and to antiretroviral therapy in particular. For example, in countries such as China and Russia, internal migrants who lack official residence status are often ineligible to receive public health services and may be increasingly unable to afford private care. In India, internal migrants face substantial logistical, cultural and linguistic barriers to HIV prevention and care, and have difficulty accessing treatment when returning to poorly served rural areas. Resulting interruptions in HIV services may lead to a wide range of negative consequences, including: individual vulnerability to infection and risk of death; an undermining of state efforts to curb the HIV epidemic and provide universal access to treatment; and the emergence of drug-resistant disease strains. International human rights law guarantees individuals lawfully within a territory the right to free movement within the borders of that state. This guarantee, combined with the right to the highest attainable standard of health set out in international human rights treaties, and the fundamental principle of non-discrimination, creates a duty on states to provide a core minimum of health care services to internal migrants on a non-discriminatory basis. Targeted HIV prevention programs and the elimination of restrictive residence-based eligibility criteria for access to health services are necessary to ensure that internal migrants are able to realize their equal rights to HIV prevention and treatment.

  11. Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dandona Rakhi

    2009-05-01

    Full Text Available Abstract Background HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources. Methods Detailed cost and output data were collected from written records and interviews for 2005–2006 fiscal year using standardized methods at six sampled HIV prevention programmes for truck drivers in the Indian state of Andhra Pradesh. The total economic cost for these programmes was computed and the relation of unit cost of services per truck driver with programme scale was assessed using regression analysis. Results A total of 120,436 truck drivers were provided services by the six programmes of which 55.9% were long distance truck drivers. The annual economic cost of providing services to a truck driver varied between programmes from US$ 1.52 to 4.56 (mean US$ 2.49. There was an inverse relation between unit economic cost of serving a truck driver and scale of the programme (R2 = 0.63; p = 0.061. The variation between programmes in the average number of contacts made by the programme staff with truck drivers was 1.3 times versus 5.8 times for contacts by peer educators. Only 1.7% of the truck drivers were referred by the programmes for counseling and HIV testing. Conclusion These data provide information for further planning of HIV prevention programmes for truck drivers and estimating the resources needed for such programmes. The findings suggest the need to strengthen the role of peer educators and increase referral of truck drivers for HIV testing.

  12. Access to HIV prevention services among gender based violence survivors in Tanzania

    Science.gov (United States)

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

  13. Rethinking HIV-prevention for school-going young people based on current behaviour patterns.

    Science.gov (United States)

    Visser, Maretha

    2017-12-01

    The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5-12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8-12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices.

  14. Framing the social in biomedical HIV prevention trials: a 20-year retrospective.

    Science.gov (United States)

    MacQueen, Kathleen M

    2011-09-27

    Biomedical research is critical to identifying effective and safe interventions, such as vaccines, microbicides, male circumcision and antiretrovirals, for prevention. Funding for clinical prevention trials is highly competitive and the benchmarks of success ultimately reduce to quickly enrolling a select group of people at risk, keeping them enrolled, and inducing them to be compliant with trial requirements - all at the lowest cost possible. Juxtaposed with this reality is the fact that HIV is situated with poverty, exploitation, assaults on human dignity, and human rights abuses. The result is a complex web of ethical challenges that are socially constructed along lines of wealth and power. While social science research methods are commonly employed to examine such topics, they have played a marginal role in biomedical HIV prevention research. Why? To answer this question, a core set of persistent interlocking social, behavioural and ethical challenges to biomedical HIV prevention research are described. A critique is offered on how the social has been framed relative to the behavioural, ethical and biomedical components. Examples of how this framing has devalued social knowledge are provided, including the conflation of qualitative research with anecdotal reporting, a bias toward brevity and accuracy over external validity, and difficulties in distinguishing between a moral understanding of social norms and achieving a moral outcome when confronted with ethical challenges in research. Lastly, opportunities are identified for enhancing the success of biomedical HIV prevention research through development of a coherent programme of social science research. Recommendations are offered for reframing the social as a valid domain of scientific inquiry in this highly applied and interdisciplinary context.

  15. Framing the social in biomedical HIV prevention trials: a 20-year retrospective

    Directory of Open Access Journals (Sweden)

    MacQueen Kathleen M

    2011-09-01

    Full Text Available Abstract Biomedical research is critical to identifying effective and safe interventions, such as vaccines, microbicides, male circumcision and antiretrovirals, for prevention. Funding for clinical prevention trials is highly competitive and the benchmarks of success ultimately reduce to quickly enrolling a select group of people at risk, keeping them enrolled, and inducing them to be compliant with trial requirements - all at the lowest cost possible. Juxtaposed with this reality is the fact that HIV is situated with poverty, exploitation, assaults on human dignity, and human rights abuses. The result is a complex web of ethical challenges that are socially constructed along lines of wealth and power. While social science research methods are commonly employed to examine such topics, they have played a marginal role in biomedical HIV prevention research. Why? To answer this question, a core set of persistent interlocking social, behavioural and ethical challenges to biomedical HIV prevention research are described. A critique is offered on how the social has been framed relative to the behavioural, ethical and biomedical components. Examples of how this framing has devalued social knowledge are provided, including the conflation of qualitative research with anecdotal reporting, a bias toward brevity and accuracy over external validity, and difficulties in distinguishing between a moral understanding of social norms and achieving a moral outcome when confronted with ethical challenges in research. Lastly, opportunities are identified for enhancing the success of biomedical HIV prevention research through development of a coherent programme of social science research. Recommendations are offered for reframing the social as a valid domain of scientific inquiry in this highly applied and interdisciplinary context.

  16. Within but without: human rights and access to HIV prevention and treatment for internal migrants.

    Science.gov (United States)

    Todrys, Katherine Wiltenburg; Amon, Joseph J

    2009-11-19

    Worldwide, far more people migrate within than across borders, and although internal migrants do not risk a loss of citizenship, they frequently confront significant social, financial and health consequences, as well as a loss of rights. The recent global financial crisis has exacerbated the vulnerability internal migrants face in realizing their rights to health care generally and to antiretroviral therapy in particular. For example, in countries such as China and Russia, internal migrants who lack official residence status are often ineligible to receive public health services and may be increasingly unable to afford private care. In India, internal migrants face substantial logistical, cultural and linguistic barriers to HIV prevention and care, and have difficulty accessing treatment when returning to poorly served rural areas. Resulting interruptions in HIV services may lead to a wide range of negative consequences, including: individual vulnerability to infection and risk of death; an undermining of state efforts to curb the HIV epidemic and provide universal access to treatment; and the emergence of drug-resistant disease strains. International human rights law guarantees individuals lawfully within a territory the right to free movement within the borders of that state. This guarantee, combined with the right to the highest attainable standard of health set out in international human rights treaties, and the fundamental principle of non-discrimination, creates a duty on states to provide a core minimum of health care services to internal migrants on a non-discriminatory basis. Targeted HIV prevention programs and the elimination of restrictive residence-based eligibility criteria for access to health services are necessary to ensure that internal migrants are able to realize their equal rights to HIV prevention and treatment.

  17. Combining biomedical preventions for HIV: Vaccines with pre-exposure prophylaxis, microbicides or other HIV preventions.

    Science.gov (United States)

    McNicholl, Janet M

    2016-12-01

    Biomedical preventions for HIV, such as vaccines, microbicides or pre-exposure prophylaxis (PrEP) with antiretroviral drugs, can each only partially prevent HIV-1 infection in most human trials. Oral PrEP is now FDA approved for HIV-prevention in high risk groups, but partial adherence reduces efficacy. If combined as biomedical preventions (CBP) an HIV vaccine could provide protection when PrEP adherence is low and PrEP could prevent vaccine breakthroughs. Other types of PrEP or microbicides may also be partially protective. When licensed, first generation HIV vaccines are likely to be partially effective. Individuals at risk for HIV may receive an HIV vaccine combined with other biomedical preventions, in series or in parallel, in clinical trials or as part of standard of care, with the goal of maximally increasing HIV prevention. In human studies, it is challenging to determine which preventions are best combined, how they interact and how effective they are. Animal models can determine CBP efficacy, whether additive or synergistic, the efficacy of different products and combinations, dose, timing and mechanisms. CBP studies in macaques have shown that partially or minimally effective candidate HIV vaccines combined with partially effective oral PrEP, vaginal PrEP or microbicide generally provided greater protection than either prevention alone against SIV or SHIV challenges. Since human CBP trials will be complex, animal models can guide their design, sample size, endpoints, correlates and surrogates of protection. This review focuses on animal studies and human models of CBP and discusses implications for HIV prevention.

  18. HIV Prevention

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about steps people can take to protect their health from HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  19. HIV, sex, and social change: applying ESID principles to HIV prevention research.

    Science.gov (United States)

    Fernández, M Isabel; Bowen, G Stephen; Gay, Caryl L; Mattson, Tiffany R; Bital, Evelyne; Kelly, Jeffrey A

    2003-12-01

    The HIV epidemic has been the most significant public health crisis of the last 2 decades. Although Experimental Social Innovation and Dissemination (ESID) principles have been used by many HIV prevention researchers, the clearest application is the series of model-building and replication experiments conducted by Kelly and colleagues. The model mobilized, trained, and engaged key opinion leaders to serve as behavior change and safe-sex endorsers in their social networks. This paper illustrates how ESID principles were used to develop, test, and disseminate an innovative social model and discusses the challenges of applying ESID methodology in the midst of a public health emergency.

  20. The Influence of Pastors' Ideologies of Homosexuality on HIV Prevention in the Black Church.

    Science.gov (United States)

    Quinn, Katherine; Dickson-Gomez, Julia; Young, Staci

    2016-10-01

    Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV, and Black Churches may be a source of stigma which can exacerbate HIV risk and contribute to negative health and psychosocial outcomes. Findings from this study are based on 21 semi-structured interviews with pastors and ethnographic observation in six Black Churches. Interview transcripts and field notes were analyzed in MAXQDA using thematic content analysis. Although pastors espoused messages of love and acceptance, they overwhelmingly believed homosexuality was a sin and had difficulty accepting YBMSM into their churches. The tension around homosexuality limited pastors' involvement in HIV prevention efforts, although there still may be opportunities for some churches.

  1. Mano a Mano-Mujer: an effective HIV prevention intervention for Chilean women.

    Science.gov (United States)

    Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L; McElmurry, Beverly

    2012-01-01

    The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries.

  2. Mano a Mano Mujer: An Effective HIV Prevention for Chilean Women

    Science.gov (United States)

    Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F.; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L.; McElmurry, Beverly

    2012-01-01

    The impact of a professionally-facilitated peer group intervention for HIV prevention among 400 low income Chilean women was examined using a quasi-experimental design. At three months post-intervention, the intervention group had higher HIV-related knowledge, more positive attitudes towards people living with HIV, fewer perceived condom use barriers, greater self-efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. However, they did not have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries. PMID:22420675

  3. A consultoria como oportunidade de aprendizagem para as Organizações Não Governamentais: um estudo na cidade de Recife/PE THE CONSULTING AS A LEARNING OPPORTUNITY FOR NONGOVERNMENTAL ORGANIZATIONS: A STUDY IN THE CITY OF RECIFE / PE

    Directory of Open Access Journals (Sweden)

    Naldeir dos Santos Vieira

    2010-08-01

    Full Text Available Non-governmental organizations (NGOs are active and growing institutions throughout the country, being from the 90s, to suit the environmental contingencies, are starting to professionalize, adopting administrative practices, such as management and evaluation of the impacts of their projects. Thus, part of NGOs started to hire professionals who act as consultants, which are organizational and specialists. In face of the above, the objective was to identify and analyze the learning, which are related to the practice of hiring consultants, obtained by NGOs. For both, there were semi-structured interviews with managers of NGOs that operate in the metropolitan area of Recife / EP and its contracted services of consultants. It appears that NGOs, with the hiring of consultants, learned that it is necessary that these professionals know and have experience of working in social organizations, who understand their specificities and to adopt a methodology which establishes a reflective learning, being regarded as ineffective those who only deploy “packages” managerial pre-prepared.As organizações não governamentais (ONGs são instituições atuantes e em crescimento por todo o país e, a partir dos anos 1990, para se adequarem às contingências ambientais, começaram a se profissionalizarem, adotando práticas administrativas, como a gestão e a avaliação dos impactos de seus projetos. Assim, parte das ONGs passou a contratar profissionais que atuam como consultores organizacionais ou especialistas. Diante do exposto, o objetivo deste trabalho foi identificar e analisar os aprendizados que estão relacionados à prática de contratação de consultoria, obtidos pelas ONGs. Para tanto, foram realizadas entrevistas semiestruturadas com gerentes de ONGs que atuam na Região Metropolitana de Recife, PE, e que contrataram serviços de consultorias. Conclui-se que as ONGs, com a contratação de consultores, aprenderam que é necessário que estes

  4. Concerns about partner infidelity are a barrier to adoption of HIV-prevention strategies among young South African couples.

    Science.gov (United States)

    Parker, Lisa; Pettifor, Audrey; Maman, Suzanne; Sibeko, Jabu; MacPhail, Catherine

    2014-01-01

    As part of a larger study to examine the feasibility and acceptability of a couples-based HIV-prevention intervention, we conducted formative in-depth interviews with 10 couples to explore topics such as challenges in practising safer sex, HIV-prevention strategies, gender power and violence, and issues of trust and infidelity. In this study, both men and women perceived infidelity as ubiquitous in their social context and were therefore unable to discuss HIV risk and prevention without suspicions of infidelity in their own relationship. This impacted couples' ability openly and effectively to discuss strategies to prevent HIV and thus may have contributed to the limited uptake of HIV-prevention strategies, such as condom use and HIV testing. The contentious nature of safe-sex discussions placed both members of the couple at a higher risk for HIV acquisition within the partnership. This study sheds light on how existing relationship norms in South Africa influence HIV-prevention communication within couples and suggests that new ways of approaching conflictual issues such as mistrust and infidelity are vital in order for HIV-prevention programmes to succeed.

  5. Effects of Internet-based instruction on HIV-prevention knowledge and practices among men who have sex with men.

    Science.gov (United States)

    Kasatpibal, Nongyao; Viseskul, Nongkran; Srikantha, Wimonsiri; Fongkaew, Warunee; Surapagdee, Natthakarn; Grimes, Richard M

    2014-12-01

    HIV infection is increasing among men who have sex with men. In this study, the effects of Internet-based instruction on HIV-prevention knowledge were evaluated. The sample consisted of 162 men-who-have-sex-with-men volunteers in Thailand. The research instruments included a demographic data questionnaire, a knowledge test, and an HIV preventive practice questionnaire. The participants completed these instruments upon entry to the study and four months later. After entry to the study, the participants were given access to a previously-developed Internet-based instruction on HIV risk behaviors. Data were analyzed using descriptive statistics and paired t-test. After accessing the Internet-based instruction, the average score of HIV-prevention knowledge among the sample increased significantly, from 11.17 to 15.09 (maximum score of 20 points). The average score of practicing HIV prevention among the sample increased significantly, from 62.94 to 76.51 (maximum score of 99 points). This study demonstrated that Internet-based instruction was effective in improving HIV-prevention knowledge and practices among men who have sex with men. This suggests that Internet-based instruction could be developed for use in other countries and evaluated in a similar way. © 2014 Wiley Publishing Asia Pty Ltd.

  6. Development of Combination HIV Prevention Programs for People Who Inject Drugs through Government and Civil Society Collaboration in the Russian Federation.

    Science.gov (United States)

    Volik, M V; Karmanova, G A; Berezina, E B; Kresina, T F; Sadykova, R G; Khalabuda, L N; Fattakhov, F Z

    2012-01-01

    Population Services International (PSI) has worked collaboratively with several government institutions of the Russian Federation to develop and implement a model program to access health services for individuals who are opioid dependent, including those with HIV infection. Through the development of partnership agreements between government organizations (GOs) and non-government organizations (NGOs), a model of the continuum of care has been developed that identifies a Recommended Package of HIV Prevention Services for Injecting Drug Users (RPS-IDU). The implementation of the RPS-IDU in the Russian Federation offers a model for other countries with HIV epidemics associated with injection drug use. This paper will describe the model program and its implementation in one of the pilot program regions.

  7. Development of Combination HIV Prevention Programs for People Who Inject Drugs through Government and Civil Society Collaboration in the Russian Federation

    Directory of Open Access Journals (Sweden)

    M. V. Volik

    2012-01-01

    Full Text Available Population Services International (PSI has worked collaboratively with several government institutions of the Russian Federation to develop and implement a model program to access health services for individuals who are opioid dependent, including those with HIV infection. Through the development of partnership agreements between government organizations (GOs and non-government organizations (NGOs, a model of the continuum of care has been developed that identifies a Recommended Package of HIV Prevention Services for Injecting Drug Users (RPS-IDU. The implementation of the RPS-IDU in the Russian Federation offers a model for other countries with HIV epidemics associated with injection drug use. This paper will describe the model program and its implementation in one of the pilot program regions.

  8. HIV prevention: Making male circumcision the 'right' tool for the job.

    Science.gov (United States)

    Bell, Kirsten

    2015-01-01

    In recent years, HIV/AIDS programming has been transformed by an ostensibly 'new' procedure: male circumcision. This article examines the rise of male circumcision as the 'right' HIV prevention tool. Treating this controversial topic as a 'matter of concern' rather than a 'matter of fact', I examine the reasons why male circumcision came to be seen as a partial solution to the problem of HIV transmission in the twenty-first century and to what effect. Grounded in a close reading of the primary literature, I suggest that the embrace of male circumcision in HIV prevention must be understood in relation to three factors: (1) the rise of evidence-based medicine as the dominant paradigm for conceptualising medical knowledge, (2) the fraught politics of HIV/AIDS research and funding, which made the possibility of a biomedical intervention attractive and (3) underlying assumptions about the nature of African 'culture' and 'sexuality'. I conclude by stressing the need to expand the parameters of the debate beyond the current polarised landscape, which presents us with a problematic either/or scenario regarding the efficacy of male circumcision.

  9. Safety-Related Moderators of a Parent-Based HIV Prevention Intervention in South Africa

    Science.gov (United States)

    Tarantino, Nicholas; Goodrum, Nada; Armistead, Lisa P.; Cook, Sarah L.; Skinner, Donald; Toefy, Yoesrie

    2017-01-01

    Our study examined factors influencing the effectiveness of a parent-based HIV prevention intervention implemented in Cape Town, South Africa. Caregiver-youth dyads (N = 99) were randomized into intervention or control conditions and assessed longitudinally. The intervention improved a parenting skill associated with youth sexual risk, parent–child communication about sex and HIV. Analyses revealed that over time, intervention participants (female caregivers) who experienced recent intimate partner violence (IPV) or unsafe neighborhoods discussed fewer sex topics with their adolescent children than caregivers in safer neighborhoods or who did not report IPV. Participants with low or moderate decision-making power in their intimate relationships discussed more topics over time only if they received the intervention. The effectiveness of our intervention was challenged by female caregivers’ experience with IPV and unsafe neighborhoods, highlighting the importance of safety-related contextual factors when implementing behavioral interventions for women and young people in high-risk environments. Moderation effects did not occur for youth-reported communication outcomes. Implications for cross-cultural adaptations of parent-based HIV prevention interventions are discussed. PMID:25286174

  10. Using Resource Allocation Modeling to Inform HIV Prevention Priority Setting for Baltimore-Towson, Maryland.

    Science.gov (United States)

    Holtgrave, David R; Maulsby, Cathy; Kim, J Janet; Cassidy-Stewart, Hope; Hauck, Heather

    2016-01-01

    In 2010, the Centers for Disease Control and Prevention (CDC) launched the "Enhanced Comprehensive HIV Prevention Planning" initiative, which targeted funding to the 12 U.S. metropolitan statistical areas (MSAs) with the most severe epidemics of human immunodeficiency virus infection to a) develop a plan to align each MSA's HIV prevention plan with the National HIV/AIDS Strategy (NHAS) and b) identify and implement the optimal combination of prevention services to reduce new infections. This paper describes how the Maryland Department of Health and Mental Hygiene (DHMH) partnered with the Johns Hopkins Bloomberg School of Public Health (JHSPH) to conduct mathematical modeling and economic analyses to inform local planning for resource allocation and intervention design for the Baltimore-Towson MSA. The paper outlines the steps of building and implementing that analytic partnership, illustrates how results were discussed with other key stakeholders, and shows how the findings informed local priority setting. The paper demonstrates how health departments, academia, and community partners can jointly use policy modeling to improve resource allocation and address urgent public health challenges.

  11. Preferred Physical Characteristics of Vaginal Film Microbicides for HIV Prevention in Pittsburgh Women.

    Science.gov (United States)

    Fan, Maria D; Kramzer, Lindsay F; Hillier, Sharon L; Chang, Judy C; Meyn, Leslie A; Rohan, Lisa C

    2017-05-01

    Unprotected heterosexual intercourse is the leading cause of HIV acquisition in women. Due to the complex nature of correct and consistent condom use by both men and women, developing alternative female-controlled HIV prevention options is a global health priority. Vaginal films containing antiretroviral drugs are a potential delivery system for the prevention of HIV acquisition through sexual contact. In this study, we explored women's preferences regarding physical characteristics of microbicide vaginal films through questionnaires and focus groups. Eighty-four sexually active, ethnically diverse women 18-30 years of age from Pittsburgh, Pennsylvania, participated in the study. Women visually and manually examined a variety of vaginal films, as well as three other vaginal products undergoing evaluation for HIV prevention: tablet, ring, and gel. Means and standard deviations or frequencies and 95 % confidence intervals were calculated for questionnaire data. Focus groups were audio-recorded, transcribed verbatim, and coded for content analysis. Women most frequently preferred vaginal films to be smooth and thin (63 %), translucent (48 %), and 2″ × 2″ square size (36 %). Driving these preferences were five major themes: ease and accuracy of use, desire for efficacy, discretion, intravaginal comfort and minimal impact, and minimizing disruption of sexual mood/activities. Women's preferences for various microbicide vaginal film physical attributes represented a balance of multiple values. In general, women desired a comfortable, efficacious, easy to use, and minimally intrusive product.

  12. Cost and threshold analysis of housing as an HIV prevention intervention.

    Science.gov (United States)

    Holtgrave, David R; Briddell, Kate; Little, Eugene; Bendixen, Arturo Valdivia; Hooper, Myrna; Kidder, Daniel P; Wolitski, Richard J; Harre, David; Royal, Scott; Aidala, Angela

    2007-11-01

    The Housing and Health study examines the effects of permanent supportive housing for homeless and unstably housed persons living with HIV. While promising as an HIV prevention intervention, providing housing may be more expensive to deliver than some other HIV prevention services. Economic evaluation is needed to determine if investment in permanent supportive housing would be cost-saving or cost-effective. Here we ask -- what is the per client cost of delivering the intervention, and how many HIV transmissions have to be averted in order to exceed the threshold needed to claim cost-savings or cost-effectiveness to society? Standard methods of cost and threshold analysis were employed. Payor perspective costs range from $9,256 to $11,651 per client per year; societal perspective costs range from $10,048 to $14,032 per client per year. Considering that averting a new case of HIV saves an estimated $221,365 in treatment costs, the average cost-saving threshold across the three study cities is 0.0555. Expressed another way, if just one out of every 19 Housing & Health intervention clients avoided HIV transmission to an HIV seronegative partner the intervention would be cost-saving. The intervention would be cost-effective if it prevented just one HIV transmission for every 64 clients served.

  13. Pharmaceutical HIV prevention technologies in the UK: six domains for social science research.

    Science.gov (United States)

    Keogh, Peter; Dodds, Catherine

    2015-01-01

    The development of pharmaceutical HIV prevention technologies (PPTs) over the last five years has generated intense interest from a range of stakeholders. There are concerns that these clinical and pharmaceutical interventions are proceeding with insufficient input of the social sciences. Hence key questions around implementation and evaluation remain unexplored whilst biomedical HIV prevention remains insufficiently critiqued or theorised from sociological as well as other social science perspectives. This paper presents the results of an expert symposium held in the UK to explore and build consensus on the role of the social sciences in researching and evaluating PPTs in this context. The symposium brought together UK social scientists from a variety of backgrounds. A position paper was produced and distributed in advance of the symposium and revised in the light this consultation phase. These exchanges and the emerging structure of this paper formed the basis for symposium panel presentations and break-out sessions. Recordings of all sessions were used to further refine the document which was also redrafted in light of ongoing comments from symposium participants. Six domains of enquiry for the social sciences were identified and discussed: self, identity and personal narrative; intimacy, risk and sex; communities, resistance and activism; systems, structures and institutions; economic considerations and analyses; and evaluation and outcomes. These are discussed in depth alongside overarching consensus points for social science research in this area as it moves forward.

  14. Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence.

    Science.gov (United States)

    Daniel-Ulloa, Jason; Ulibarri, M; Baquero, B; Sleeth, C; Harig, H; Rhodes, S D

    2016-12-01

    Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).

  15. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions

    Directory of Open Access Journals (Sweden)

    Amy M. Hernandez

    2012-01-01

    Full Text Available Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women’s risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication.

  16. Straight talk: HIV prevention for African-American heterosexual men: theoretical bases and intervention design.

    Science.gov (United States)

    Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A

    2012-10-01

    In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood.

  17. Influence of faith-based organisations on HIV prevention strategies in Africa: a systematic review.

    Science.gov (United States)

    Ochillo, Marylyn A; van Teijlingen, Edwin; Hind, Martin

    2017-09-01

    The HIV/AIDS epidemic remains of global significance and there is a need to target sub-Saharan Africa since it is the hardest hit region worldwide. Religion and more specifically faith-based organisations can have an effect on socio-cultural factors that increase or decrease the risk of infection; and offer preventative interventions to the wider community. To understand the influence of faith-based organisations on HIV prevention in Africa. The main search engine of a British university 'mysearch' was used as this incorporates all relevant databases. Studies were also retrieved by searches within Google scholar, PubMed and reference lists of included papers were hand searched. The authors assessed the relevance of each article separately against the inclusion criteria. The data extraction form was piloted by the first author and cross-checked by the other authors. Seven studies met all inclusion criteria and were reviewed. Seven individual themes were identified. However, for the purposes of focus within this paper only two themes were focused on. Given the accessibility of faith-based organisations (FBOs) and the coverage of religion among the population, FBOs are potentially important players in HIV prevention. Therefore, more resources and support should be given to support their health promotion strategies.

  18. A brief, peer-led HIV prevention program for college students in Bangkok, Thailand.

    Science.gov (United States)

    Thato, Ratsiri; Penrose, Joyce

    2013-02-01

    To test the effectiveness of a brief theory-based HIV prevention program led by peers among college students. A quasi-experimental research using a pretest-posttest nonequivalent control group design with 2-mo follow-up. A university in Bangkok. For peer leaders, 70 undergrad students taking health sexuality course were invited to participate in the study. Then, a convenience sample of undergraduate students was recruited through peer leaders, 226 for experimental group and 209 for control group. Information, motivation, behavioral skills, and AIDS/STIs preventive behaviors. The study revealed that a Brief, Peer-Led HIV Prevention Program significantly increased knowledge of preventive behaviors (β = 2.67, P motivated participants to have a better attitude toward preventive behaviors (β = -5.26, P  .05). Findings of this study provide initial evidence as to how theoretical variables were operated to effectively increase knowledge, change motivation, and behavioral skills of AIDS/STIs preventive behavior among Thai college students. More research is needed to further test the effectiveness of the program on AIDS/STIs preventive behaviors among college students. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. Preliminary evidence for the integration of music into HIV prevention for severely mentally ill Latinas.

    Science.gov (United States)

    Loue, Sana; Mendez, Nancy; Sajatovic, Martha

    2008-12-01

    Individuals with severe mental illness (SMI) may be at increased risk of HIV infection. Prevention programs designed specifically for SMI have relied primarily on principles of cognitive-behavior change theories delivered in a small group format and in venues and services utilized by SMI. Most intervention effects have not been shown to be sustainable over time. We report on our findings relating to the importance of music to Puerto Rican women with SMI and the implications for HIV prevention interventions with this population. We interviewed and shadowed over a 2-year period 53 women of Puerto Rican ethnicity between the ages of 18 and 50, residing in northeastern Ohio, who had been diagnosed with schizophrenia, bipolar disorder, or major depression. Nearly one-half of the participants listened to music regularly. Some reported that music was essential to their lives. Participants reported that music improved their mental and social well-being by facilitating expression and reflection of their emotions and increasing their energy levels. Music may affect the core negative symptoms and compensate for neuropsychological deficits in women with schizophrenia and related conditions by facilitating the articulation of emotion and allowing individuals to better attend to and potentially incorporate external activities into their lives. The use of music in HIV prevention efforts with SMI Latinas may facilitate their emotional expression and assist them in integrating the educative efforts into their life style choices.

  20. The village/commune safety policy and HIV prevention efforts among key affected populations in Cambodia: finding a balance

    Directory of Open Access Journals (Sweden)

    Thomson Nick

    2012-07-01

    Full Text Available Abstract The Village/Commune Safety Policy was launched by the Ministry of Interior of the Kingdom of Cambodia in 2010 and, due to a priority focus on “cleaning the streets”, has created difficulties for HIV prevention programs attempting to implement programs that work with key affected populations including female sex workers and people who inject drugs. The implementation of the policy has forced HIV program implementers, the UN and various government counterparts to explore and develop collaborative ways of delivering HIV prevention services within this difficult environment. The following case study explores some of these efforts and highlights the promising development of a Police Community Partnership Initiative that it is hoped will find a meaningful balance between the Village/Commune Safety Policy and HIV prevention efforts with key affected populations in Cambodia.

  1. Let's talk about sex: helping substance abuse counsellors address HIV prevention with men who have sex with men.

    Science.gov (United States)

    Spector, Anya Y; Pinto, Rogerio M

    2011-04-01

    Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors' work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse.

  2. "La Familia" HIV prevention program: a focus on disclosure and family acceptance for Latino immigrant MSM to the USA.

    Science.gov (United States)

    Melendez, Rita M; Zepeda, Jorge; Samaniego, Rafael; Chakravarty, Deepalika; Alaniz, Gabriela

    2013-01-01

    The objective of this study was to pilot test and evaluate a HIV prevention program that used a Freirean approach to engage Latino immigrant MSM (men who have sex with men) on issues of sexual orientation, family acceptance, stigma as well as HIV prevention and sexual risk behaviors. Participants were evaluated using a survey before and after participation in the program and compared to a control group. Focus groups where participants discussed their experiences in the program as well as perceptions of the program were held and analyzed. Survey results indicate that after their participation in the program, participants increased their safer sex behaviors, comfort disclosing their sexual orientation and support from friends. HIV prevention needs to incorporate cultural, social and structural factors.

  3. The promise of multimedia technology for STI/HIV prevention: frameworks for understanding improved facilitator delivery and participant learning.

    Science.gov (United States)

    Khan, Maria R; Epperson, Matthew W; Gilbert, Louisa; Goddard, Dawn; Hunt, Timothy; Sarfo, Bright; El-Bassel, Nabila

    2012-10-01

    There is increasing excitement about multimedia sexually transmitted infection (STI) and HIV prevention interventions, yet there has been limited discussion of how use of multimedia technology may improve STI/HIV prevention efforts. The purpose of this paper is to describe the mechanisms through which multimedia technology may work to improve the delivery and uptake of intervention material. We present conceptual frameworks describing how multimedia technology may improve intervention delivery by increasing standardization and fidelity to the intervention material and the participant's ability to learn by improving attention, cognition, emotional engagement, skills-building, and uptake of sensitive material about sexual and drug risks. In addition, we describe how the non-multimedia behavioral STI/HIV prevention intervention, Project WORTH, was adapted into a multimedia format for women involved in the criminal justice system and provide examples of how multimedia activities can more effectively target key mediators of behavioral change in this intervention.

  4. Assessing barriers and facilitators of implementing an integrated HIV prevention and property rights program in Western Kenya.

    Science.gov (United States)

    Lu, Tiffany; Zwicker, Lindsey; Kwena, Zachary; Bukusi, Elizabeth; Mwaura-Muiru, Esther; Dworkin, Shari L

    2013-04-01

    Despite the recognized need for structural HIV prevention interventions, few scientific programs have integrated women's property and inheritance rights with HIV prevention and treatment. The current study focused on a community-led land and property rights intervention that was implemented in two rural areas of Western Kenya with high HIV prevalence rates (24-30%). The program was designed to respond to women's property rights violations in order to reduce HIV risk at the local level. Through in-depth interviews with twenty program leaders, we identified several facilitators to program implementation, including the leadership of home-based HIV caregivers and involvement of traditional leaders in mediating property rights disputes. We also identified the voluntary basis of the intervention and its lack of integration with the formal justice system as implementation barriers. Our findings can guide future research and design of structural HIV prevention strategies that integrate women's economic empowerment through property and inheritance rights.

  5. Proposal for the development of a standardized protocol for assessing the economic costs of HIV prevention interventions.

    Science.gov (United States)

    Pinkerton, Steven D; Pearson, Cynthia R; Eachus, Susan R; Berg, Karina M; Grimes, Richard M

    2008-03-01

    Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and "buy-in" from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies.

  6. Contact with HIV prevention services highest in gay and bisexual men at greatest risk: cross-sectional survey in Scotland

    Directory of Open Access Journals (Sweden)

    Hart Graham J

    2010-12-01

    Full Text Available Abstract Background Men who have sex with men (MSM remain the group most at risk of acquiring HIV in the UK and new HIV prevention strategies are needed. In this paper, we examine what contact MSM currently have with HIV prevention activities and assess the extent to which these could be utilised further. Methods Anonymous, self-complete questionnaires and Orasure™ oral fluid collection kits were distributed to men visiting the commercial gay scenes in Glasgow and Edinburgh in April/May 2008. 1508 men completed questionnaires (70.5% response rate and 1277 provided oral fluid samples (59.7% response rate; 1318 men were eligible for inclusion in the analyses. Results 82.5% reported some contact with HIV prevention activities in the past 12 months, 73.1% obtained free condoms from a gay venue or the Internet, 51.1% reported accessing sexual health information (from either leaflets in gay venues or via the Internet, 13.5% reported talking to an outreach worker and 8.0% reported participating in counselling on sexual health or HIV prevention. Contact with HIV prevention activities was associated with frequency of gay scene use and either HIV or other STI testing in the past 12 months, but not with sexual risk behaviours. Utilising counselling was also more likely among men who reported having had an STI in the past 12 months and HIV-positive men. Conclusions Men at highest risk, and those likely to be in contact with sexual health services, are those who report most contact with a range of current HIV prevention activities. Offering combination prevention, including outreach by peer health workers, increased uptake of sexual health services delivering behavioural and biomedical interventions, and supported by social marketing to ensure continued community engagement and support, could be the way forward. Focused investment in the needs of those at highest risk, including those diagnosed HIV-positive, may generate a prevention dividend in the long

  7. Work environments and HIV prevention: a qualitative review and meta-synthesis of sex worker narratives.

    Science.gov (United States)

    Goldenberg, Shira M; Duff, Putu; Krusi, Andrea

    2015-12-16

    Sex workers (SWs) experience a disproportionately high burden of HIV, with evidence indicating that complex and dynamic factors within work environments play a critical role in mitigating or producing HIV risks in sex work. In light of sweeping policy efforts to further criminalize sex work globally, coupled with emerging calls for structural responses situated in labour and human-rights frameworks, this meta-synthesis of the qualitative and ethnographic literature sought to examine SWs' narratives to elucidate the ways in which physical, social and policy features of diverse work environments influence SWs' agency to engage in HIV prevention. We conducted a meta-synthesis of qualitative and ethnographic studies published from 2008 to 2014 to elucidate SWs' narratives and lived experiences of the complex and nuanced ways in which physical, social, and policy features of indoor and outdoor work environments shape HIV prevention in the sex industry. Twenty-four qualitative and/or ethnographic studies were included in this meta-synthesis. SWs' narratives revealed the nuanced ways that physical, social, and policy features of work environments shaped HIV risk and interacted with macrostructural constraints (e.g., criminalization, stigma) and community determinants (e.g., sex worker empowerment initiatives) to shape SWs' agency in negotiating condom use. SWs' narratives revealed the ways in which the existence of occupational health and safety standards in indoor establishments, as well as protective practices of third parties (e.g., condom promotion) and other SWs/peers were critical ways of enhancing safety and sexual risk negotiation within indoor work environments. Additionally, working in settings where negative interactions with law enforcement were minimized (e.g., working in decriminalized contexts or environments in which peers/managers successfully deterred unjust policing practices) was critical for supporting SWs' agency to negotiate HIV prevention. Policy

  8. The role of primary school teachers in HIV prevention in South Africa.

    Science.gov (United States)

    Ayo-Yusuf, I; Naidoo, S; Chikte, U M

    2001-12-01

    South Africa has the fastest growing HIV epidemic in the world. The need for an intensive campaign against its spread cannot be overemphasised. Such efforts may be particularly effective if introduced prior to the onset of risk behaviour. The purpose of this study was to investigate the knowledge of grade 3 and 4 schoolteachers on HIV/AIDS and their opinion on educating their pupils about HIV prevention. A self-administered questionnaire with knowledge, perception and sociodemographic variables was sent to all 120 grade 3 and 4 teachers in the Southern Bushveld district of Northern Province. Descriptive statistics and multiple regression analysis were used to analyse the data. The response rate was 67% (N = 81) and 87.7% were females. The mean age of the respondents was 37.7 (+/- 8.7 SD) years, 55% had a 3-year teacher's training qualification and 27% had a 4-year training qualification. The average teaching experience was 12 years. Most respondents (93.8%) had knowledge of what HIV/AIDS is, but only 85.2% indicated it could be prevented. 14.8% either did not know HIV/AIDS could be prevented or were not sure. Some teachers had an incomplete understanding of the transmission and prevention of HIV/AIDS. Furthermore only 9% mentioned education as a way to prevent HIV/AIDS and 16% abstinence. Of the respondents, 58% indicated teaching HIV prevention to their pupils. Of those who do not teach HIV prevention, 41.2% believed that the pupils were too young, and 20.6% claimed non-availability of guidelines and resources as reasons for not teaching. A significant negative correlation was found between level of qualification and teaching of HIV to pupils (p many primary school teachers were found to be wanting in their HIV/AIDS knowledge. This suggests that the schoolteachers would need to be adequately trained prior to their involvement in HIV/AIDS education to pupils. Grade 3 and 4 teachers may be considered suitable to provide HIV education to their pupils, but there is a

  9. The HOPE social media intervention for global HIV prevention in Peru: a cluster randomised controlled trial.

    Science.gov (United States)

    Young, Sean D; Cumberland, William G; Nianogo, Roch; Menacho, Luis A; Galea, Jerome T; Coates, Thomas

    2015-01-01

    Social media technologies offer new approaches to HIV prevention and promotion of testing. We examined the efficacy of the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. In this cluster randomised controlled trial, Peruvian MSM from Greater Lima (including Callao) who had sex with a man in the past 12 months, were 18 years of age or older, were HIV negative or serostatus unknown, and had a Facebook account or were willing to create one (N=556) were randomly assigned (1:1) by concealed allocation to join intervention or control groups on Facebook for 12 weeks. For the intervention, Peruvian MSM were trained and assigned to be HIV prevention mentors (peer-leaders) to participants in Facebook groups. The interventions period lasted 12 weeks. Participants in control groups received an enhanced standard of care, including standard offline HIV prevention available in Peru and participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants also completed questionnaires on HIV risk behaviours and social media use at baseline and 12 week follow-up. The primary outcome was the number of participants who received a free HIV test at a local community clinic. The facebook groups were analysed as clusters to account for intracluster correlations. This trial is registered with ClinicalTrials.gov, number NCT01701206. Of 49 peer-leaders recruited, 34 completed training and were assigned at random to the intervention Facebook groups. Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted

  10. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research.

    Science.gov (United States)

    Shrestha, Roman; Altice, Frederick; Karki, Pramila; Copenhaver, Michael

    2017-01-01

    To date, HIV prevention efforts have largely relied on singular strategies (e.g., behavioral or biomedical approaches alone) with modest HIV risk-reduction outcomes for people who use drugs (PWUD), many of whom experience a wide range of neurocognitive impairments (NCI). We report on the process and outcome of our formative research aimed at developing an integrated biobehavioral approach that incorporates innovative strategies to address the HIV prevention and cognitive needs of high-risk PWUD in drug treatment. Our formative work involved first adapting an evidence-based behavioral intervention-guided by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing model-and then combining the behavioral intervention with an evidence-based biomedical intervention for implementation among the target population. This process involved eliciting data through structured focus groups (FGs) with key stakeholders-members of the target population (n = 20) and treatment providers (n = 10). Analysis of FG data followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis and cross-case analysis. Based on all information, we integrated the adapted community-friendly health recovery program-a brief evidence-based HIV prevention behavioral intervention-with the evidence-based biomedical component [i.e., preexposure prophylaxis (PrEP)], an approach that incorporates innovative strategies to accommodate individuals with NCI. This combination approach-now called the biobehavioral community-friendly health recovery program-is designed to address HIV-related risk behaviors and PrEP uptake and adherence as experienced by many PWUD in treatment. This study provides a complete example of the process of selecting, adapting, and integrating the evidence-based interventions-taking into account both empirical evidence and input from target population members and target organization

  11. Considering treatment of male genital schistosomiasis as a tool for future HIV prevention

    DEFF Research Database (Denmark)

    Stecher, Chalotte Willemann; Kallestrup, Per; Kjetland, Eyrun Floerecke

    2015-01-01

    and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested. METHODS: Pub...... association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42015016252.......OBJECTIVES: Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission...

  12. Effectiveness of Nursing Student-led HIV Prevention Education for Minority College Students: The SALSA Project.

    Science.gov (United States)

    Jones, Sande Gracia; Chadwell, Katherine; Olafson, Elizabeth; Simon, Sharon; Fenkl, Eric; Framil, C Victoria

    2017-01-01

    To evaluate the effectiveness of the Student Awareness of the Link between Substance Abuse and AIDS (SALSA) Student Peer Educators (SPEs) in increasing freshman students' HIV knowledge/awareness, and to assess students' perceptions of the SPEs as teachers/HIV prevention educators. Junior nursing students served as SALSA SPEs and presented an updated 50-minute sexual health class to freshman students. An investigator-developed questionnaire and program evaluation form was completed by attendees at the end of class. A total of 66 classes were presented by 71 SALSA SPEs to 965 freshman students. Questionnaire results revealed that the freshman students increased their knowledge/awareness of HIV transmission/prevention, while decreasing their likelihood to engage in risky sex. Program evaluation resulted in ratings of excellent. The findings suggest that campus-based SPEs may be effective in educating freshman students about HIV and risky sexual behaviors.

  13. Opportunities for woman-initiated HIV prevention methods among female sex workers in southern China.

    Science.gov (United States)

    Weeks, Margaret R; Abbott, Maryann; Liao, Susu; Yu, Wang; He, Bin; Zhou, Yuejiang; Wei, Liu; Jiang, Jingmei

    2007-05-01

    Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women's knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China.

  14. The role of public schools in HIV prevention: perspectives from African Americans in the rural South.

    Science.gov (United States)

    Lloyd, Stacey W; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J; Youmans, Selena; Muhammad, Melvin R; Wynn, Mysha; Adimora, Adaora; Akers, Aletha

    2012-02-01

    Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and resources available to reduce transmission. Participants consistently identified the public schools' sex education policies and practices as major barriers toward preventing HIV infection among youth in their community. Ideas for decreasing youth's risk of HIV included public schools providing access to health services and sex education. Policymakers, school administrators, and other stakeholders should consider the public school setting as a place to provide HIV prevention education for youth in rural areas.

  15. The influence of pastors’ ideologies of homosexuality on HIV prevention in the Black Church

    Science.gov (United States)

    Quinn, Katherine; Dickson-Gomez, Julia; Young, Staci

    2016-01-01

    Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV and Black churches may be a source of stigma which can exacerbate HIV risk and contribute to negative health and psychosocial outcomes. Findings from this study are based on 21 semi-structured interviews with pastors and ethnographic observation in six Black Churches. Interview transcripts and field notes were analyzed in MAXQDA using thematic content analysis. Although pastors espoused messages of love and acceptance, they overwhelmingly believed homosexuality was a sin and had difficulty accepting YBMSM into their churches. The tension around homosexuality limited pastors’ involvement in HIV prevention efforts, although there still may be opportunities for some churches. PMID:27099095

  16. Altruism and Peer-Led HIV Prevention Targeting Heroin and Cocaine Users

    Science.gov (United States)

    Convey, Mark R.; Dickson-Gomez, Julia; Weeks, Margaret R.; Li, Jianghong

    2013-01-01

    Peer-delivered HIV prevention and intervention programs play an important role in halting the spread of HIV. Rigorous scientific analysis of the forementioned programs have focused on the immediate reduction of risk-related behaviors among the target populations. In our longitudinal study of the RAP Peer Intervention for HIV, we assessed the long-term behavioral effects of a peer-led HIV intervention project with active drug users. Initial analysis of the qualitative data highlights the role of altruism as a motivator in sustaining peer educators beyond the immediate goals of the project. We contend that altruism found in volunteers is an important factor in maintaining long-term participation in HIV intervention programs and initiatives using peer educators. PMID:20639354

  17. HIV prevention and low-income Chilean women: machismo, marianismo and HIV misconceptions.

    Science.gov (United States)

    Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J

    2008-04-01

    Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.

  18. An Assessment of Cost, Quality and Outcomes for Five HIV Prevention Youth Peer Education Programs in Zambia

    Science.gov (United States)

    Burke, H. M.; Pedersen, K. F.; Williamson, N. E.

    2012-01-01

    Youth peer education (YPE) programs are a popular strategy for HIV prevention in sub-Saharan Africa. However, research on the effectiveness of YPE programs is scarce and the wide variation in programs makes it difficult to generalize research findings. Measuring quality and comparing program effectiveness require the use of standardized…

  19. 'Every teacher is a researcher!': Creating indigenous epistemologies and practices for HIV prevention through values-based action research.

    Science.gov (United States)

    Wood, Lesley

    2012-12-01

    Since gender is an undisputed driver of HIV infection, teachers concerned with HIV prevention education should ideally encourage critical awareness of and culturally sensitive practices around gender inequalities. Many interventions and programmes have been developed for teachers to enable them to do this, however most have met with limited success. This article proceeds from the viewpoint that for HIV-prevention interventions to be sustainable and effective, teachers should be actively engaged in their design, implementation and evaluation. It outlines how teachers in an HIV prevention programme utilised an action research design to explore their own gender constructs as a necessary first step to the creation of more gender-sensitive school climates and teaching practices. This values-based self-enquiry moved the teachers to action on two levels: first, to adopt a more gender-sensitive approach in their own personal and professional lives and second, to take action to challenge gender inequalities within their particular educational contexts. Evidence is presented to justify the claim that action research of this genre helps teachers to generate indigenous epistemologies and practices that not only are effective in creating sustainable and empowering learning environments for HIV prevention education, but also for teaching and learning in general.

  20. Sexual Identity Disclosure and Awareness of HIV Prevention Methods Among Black Men Who Have Sex With Men.

    Science.gov (United States)

    Watson, Ryan J; Fish, Jessica N; Allen, Aerielle; Eaton, Lisa

    2017-10-12

    Black men who have sex with men (BMSM) are disproportionately affected by the human immunodeficiency virus (HIV) epidemic, yet we know little about how HIV-negative BMSM of different sexual orientations access HIV prevention strategies. Identity development, minority stress, and disclosure theories suggest that for people of different sexual orientations, disclosure of sexual identity may be related to health behaviors. We performed a latent class analysis on a sample of 650 BMSM (M age  = 33.78, SD = 11.44) from Atlanta, Georgia, to explore whether sexual orientation, disclosure of sexual identity, and relationship status were related to HIV prevention strategies, including awareness of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) and frequency of HIV testing. We found three distinct BMSM classes referred to as (1) closeted bisexuals, (2) sexual identity managers, and (3) gay, out, and open; all classes primarily engaged in casual sex. Classes differed in their awareness and access to HIV prevention strategies. The closeted bisexual class was least aware of and least likely to access HIV prevention. Findings have important implications for future research, namely the consideration of sexual identity and disclosure among BMSM. With this knowledge, we may be able to engage BMSM in HIV/sexually transmitted infection (STI) prevention services.

  1. Mobilizing Communities around HIV Prevention for Youth: How Three Coalitions Applied Key Strategies to Bring about Structural Changes

    Science.gov (United States)

    Chutuape, Kate S.; Willard, Nancy; Sanchez, Kenia; Straub, Diane M.; Ochoa, Tara N.; Howell, Kourtney; Rivera, Carmen; Ramos, Ibrahim; Ellen, Jonathan M.

    2010-01-01

    Increasingly, HIV prevention efforts must focus on altering features of the social and physical environment to reduce risks associated with HIV acquisition and transmission. Community coalitions provide a vehicle for bringing about sustainable structural changes. This article shares lessons and key strategies regarding how three community…

  2. Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

    Directory of Open Access Journals (Sweden)

    Mathew Nyashanu

    2016-12-01

    Full Text Available Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from fgm@dh.gsi.gov.uk.]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.

  3. Methodological Issues in Sampling the Local Immune System of the Female Genital Tract in the Context of HIV Prevention Trials

    NARCIS (Netherlands)

    Jespers, Vicky; Francis, Suzanna C.; van de Wijgert, Janneke; Crucitti, Tania

    2011-01-01

    The spread of HIV continues unabated in the most vulnerable populations of the world. HIV prevention methods, such as a vaginal microbicide, a mucosal vaccine, pre-exposure prophylaxis or a vaccine, are urgently needed in the fight against new infections. We must make a commitment to supporting

  4. Language Choice and Sexual Communication among Xhosa Speakers in Cape Town, South Africa: Implications for HIV Prevention Message Development

    Science.gov (United States)

    Cain, Demetria; Schensul, Stephen; Mlobeli, Regina

    2011-01-01

    Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social…

  5. HIV Prevention Service Utilization in the Los Angeles House and Ball Communities: Past Experiences and Recommendations for the Future

    Science.gov (United States)

    Holloway, Ian W.; Traube, Dorian E.; Kubicek, Katrina; Supan, Jocelyn; Weiss, George; Kipke, Michele D.

    2012-01-01

    African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however,…

  6. Mobilising indigenous resources for anthropologically designed HIV-prevention and behaviour-change interventions in southern Africa.

    Science.gov (United States)

    Green, Edward C; Dlamini, Cedza; D'Errico, Nicole C; Ruark, Allison; Duby, Zoe

    2009-12-01

    HIV prevention is often implemented as if African culture were either nonexistent or a series of obstacles to overcome in order to achieve an effective, gender-equitable, human rights-based set of interventions. Similarly, traditional or indigenous leaders, such as chiefs and members of royal families, have been largely excluded from HIV/AIDS responses in Africa. This qualitative study used focus group discussions and in-depth interviews with traditional leaders and 'ritual specialists' to better understand cultural patterns and ways of working with, rather than against, culture and traditional leaders in HIV-prevention efforts. The research was carried out in four southern African countries (Botswana, Lesotho, South Africa and Swaziland). The purpose was to discover what aspects of indigenous leadership and cultural resources might be accessed and developed to influence individual behaviour as well as the prevailing community norms, values, sanctions and social controls that are related to sexual behaviour. The indigenous leaders participating in the research largely felt bypassed and marginalised by organised efforts to prevent HIV infections and also believed that HIV-prevention programmes typically confronted, circumvented, criticised or condemned traditional culture. However, indigenous leaders may possess innovative ideas about ways to change individuals' sexual behaviour in general. The participants discussed ways to revive traditional social structures and cultural mechanisms as a means to incorporate HIV-prevention and gender-sensitivity training into existing cultural platforms, such as rites of passage, chiefs' councils and traditional courts.

  7. Encountering Gender: Resisting a Neo-Liberal Political Rationality for Sexuality Education as an HIV Prevention Strategy

    Science.gov (United States)

    Gacoin, Andrée E.

    2017-01-01

    Globally, sexuality education is framed as a key programmatic strategy for achieving HIV prevention among youth. In particular, sexuality education is positioned as a way to address gender inequalities and promote youth empowerment in relation to gendered identities. In this paper, I argue that the focus on what content should be taught and…

  8. Increasing support for contraception as HIV prevention: stakeholder mapping to identify influential individuals and their perceptions.

    Directory of Open Access Journals (Sweden)

    Tricia Petruney

    Full Text Available BACKGROUND: Voluntary contraceptive use by HIV-positive women currently prevents more HIV-positive births, at a lower cost, than anti-retroviral drug (ARV regimens. Despite this evidence, most prevention of mother-to-child transmission (PMTCT programs focus solely on providing ARV prophylaxis to pregnant women and rarely include the prevention of unintended pregnancies among HIV-positive women. METHODOLOGY/PRINCIPAL FINDINGS: To strengthen support for family planning as HIV prevention, we systematically identified key individuals in the field of international HIV/AIDS-those who could potentially influence the issue-and sought to determine their perceptions of barriers to and facilitators for implementing this PMTCT strategy. We used a criteria-based approach to determine which HIV/AIDS stakeholders have the most significant impact on HIV/AIDS research, programs, funding and policy and stratified purposive sampling to conduct interviews with a subset of these individuals. The interview findings pointed to obstacles to strengthening linkages between family planning and HIV/AIDS, including the need for: resources to integrate family planning and HIV services, infrastructure or capacity to provide integrated services at the facility level, national leadership and coordination, and targeted advocacy to key decision-makers. CONCLUSIONS/SIGNIFICANCE: The individuals we identified as having regional or international influence in the field of HIV/AIDS have the ability to leverage an increasingly conducive funding environment and a growing evidence base to address the policy, programmatic and operational challenges to integrating family planning with HIV/AIDS. Fostering greater support for implementing contraception for HIV prevention will require the dedication, collaboration and coordination of many such actors. Our findings can inform a targeted advocacy campaign.

  9. Increasing support for contraception as HIV prevention: stakeholder mapping to identify influential individuals and their perceptions.

    Science.gov (United States)

    Petruney, Tricia; Harlan, Sarah V; Lanham, Michele; Robinson, Elizabeth T

    2010-05-24

    Voluntary contraceptive use by HIV-positive women currently prevents more HIV-positive births, at a lower cost, than anti-retroviral drug (ARV) regimens. Despite this evidence, most prevention of mother-to-child transmission (PMTCT) programs focus solely on providing ARV prophylaxis to pregnant women and rarely include the prevention of unintended pregnancies among HIV-positive women. To strengthen support for family planning as HIV prevention, we systematically identified key individuals in the field of international HIV/AIDS-those who could potentially influence the issue-and sought to determine their perceptions of barriers to and facilitators for implementing this PMTCT strategy. We used a criteria-based approach to determine which HIV/AIDS stakeholders have the most significant impact on HIV/AIDS research, programs, funding and policy and stratified purposive sampling to conduct interviews with a subset of these individuals. The interview findings pointed to obstacles to strengthening linkages between family planning and HIV/AIDS, including the need for: resources to integrate family planning and HIV services, infrastructure or capacity to provide integrated services at the facility level, national leadership and coordination, and targeted advocacy to key decision-makers. The individuals we identified as having regional or international influence in the field of HIV/AIDS have the ability to leverage an increasingly conducive funding environment and a growing evidence base to address the policy, programmatic and operational challenges to integrating family planning with HIV/AIDS. Fostering greater support for implementing contraception for HIV prevention will require the dedication, collaboration and coordination of many such actors. Our findings can inform a targeted advocacy campaign.

  10. Examining the efficacy of a computer facilitated HIV prevention tool in drug court.

    Science.gov (United States)

    Festinger, David S; Dugosh, Karen L; Kurth, Ann E; Metzger, David S

    2016-05-01

    Although they have demonstrated efficacy in reducing substance use and criminal recidivism, competing priorities and limited resources may preclude drug court programs from formally addressing HIV risk. This study examined the efficacy of a brief, three-session, computer-facilitated HIV prevention intervention in reducing HIV risk among adult felony drug court participants. Two hundred participants were randomly assigned to an HIV intervention (n=101) or attention control (n=99) group. All clients attended judicial status hearings approximately every six weeks. At the first three status hearings following study entry, clients in the intervention group completed the computerized, interactive HIV risk reduction sessions while those in the control group viewed a series of educational life-skill videos of matched length. Outcomes included the rate of independently obtained HIV testing, engagement in high risk HIV-related behaviors, and rate of condom procurement from the research site at each session. Results indicated that participants who received the HIV intervention were significantly more likely to report having obtained HIV testing at some point during the study period than those in the control condition, although the effect was marginally significant when examined in a longitudinal model. In addition, they had higher rates of condom procurement. No group differences were found on rates of high-risk sexual behavior, and the low rate of injection drug reported precluded examination of high-risk drug-related behavior. The study provides support for the feasibility and utility of delivering HIV prevention services to drug court clients using an efficient computer-facilitated program. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. A new HIV prevention network approach: sociometric peer change agent selection.

    Science.gov (United States)

    Schneider, John A; Zhou, A Ning; Laumann, Edward O

    2015-01-01

    Internationally, the Peer Change Agent (PCA) model is the most frequently used conceptual framework for HIV prevention. Change agents themselves can be more important than the messages they convey. PCA selection is operationalized via heterogeneous methods based upon individual-level attributes. A sociometric position selection strategy, however, could increase peer influence potency and halt transmission at key network locations. In this study, we selected candidate PCAs based upon relative sociometric bridging and centrality scores and assessed their attributes in comparison to one another and to existing peer educators. We focused upon an emerging HIV epidemic among men who have sex with men in Southern India in 2011. PCAs selected based on their bridging score were more likely to be innovators when compared to other centrally-located PCAs, to PCAs located on the periphery, and to existing peer educators. We also found that sociodemographic attributes and risk behaviors were similar across all candidate PCAs, but risk behaviors of existing peer educators differed. Existing peer educators were more likely to engage in higher risk behavior such as receiving money for sex when compared to sociometrically selected peer changes agents. These existing peer educators were also more likely to exhibit leadership qualities within the overall network; they were, however, just as likely as other non-trained candidate peer change agents to report important HIV intravention behavior (encouraging condoms within their network). The importance of identifying bridges who may be able to diffuse innovation more effectively within high risk HIV networks is especially critical given recent efficacy data from novel HIV prevention interventions such as pre-exposure prophylaxis. Moreover, while existing peer educators were more likely to be leaders in our analysis, using peer educators with high risk behavior may have limited utility in enacting behavior change among sex worker peers or

  12. Recruitment and retention of women in fishing communities in HIV prevention research.

    Science.gov (United States)

    Ssetaala, Ali; Nakiyingi-Miiro, Jessica; Asiimwe, Stephen; Nanvubya, Annet; Mpendo, Juliet; Asiki, Gershim; Nielsen, Leslie; Kiwanuka, Noah; Seeley, Janet; Kamali, Anatoli; Kaleebu, Pontiano

    2015-01-01

    Women in fishing communities in Uganda are more at risk and have higher rates of HIV infection. Socio-cultural gender norms, limited access to health information and services, economic disempowerment, sexual abuse and their biological susceptibility make women more at risk of infection. There is need to design interventions that cater for women's vulnerability. We explore factors affecting recruitment and retention of women from fishing communities in HIV prevention research. An HIV incidence cohort screened 2074 volunteers (1057 men and 1017 women) aged 13-49 years from 5 fishing communities along Lake Victoria using demographic, medical history, risk behaviour assessment questionnaires.1000 HIV negative high risk volunteers were enrolled and followed every 6 months for 18 months. Factors associated with completion of study visits among women were analyzed using multivariable logistic regression. Women constituted 1,017(49%) of those screened, and 449(45%) of those enrolled with a median (IQR) age of 27 (22-33) years. Main reasons for non-enrolment were HIV infection (33.9%) and reported low risk behaviour (37.5%). A total of 382 (74%) women and 332 (69%) men completed all follow up visits. Older women (>24 yrs) and those unemployed, who had lived in the community for 5 years or more, were more likely to complete all study visits. Women had better retention rates than men at 18 months. Strategies for recruiting and retaining younger women and those who have stayed for less than 5 years need to be developed for improved retention of women in fishing communities in HIV prevention and research Programs.

  13. A New HIV Prevention Network Approach: Sociometric Peer Change Agent Selection

    Science.gov (United States)

    Schneider, John A.; Zhou, A. Ning; Laumann, Edward O.

    2014-01-01

    Internationally, the Peer Change Agent (PCA) model is the most frequently used conceptual framework for HIV prevention. Change agents themselves can be more important than the messages they convey. PCA selection is operationalized via heterogeneous methods based upon individual-level attributes. A sociometric position selection strategy, however, could increase peer influence potency and halt transmission at key network locations. In this study, we selected candidate PCAs based upon relative sociometric bridging and centrality scores and assessed their attributes in comparison to one another and to existing peer educators. We focused upon an emerging HIV epidemic among men who have sex with men in Southern India in 2011. PCAs selected based on their bridging score were more likely to be innovators when compared to other centrally-located PCAs, to PCAs located on the periphery, and to existing peer educators. We also found that sociodemographic attributes and risk behaviors were similar across all candidate PCAs, but risk behaviors of existing peer educators differed. Existing peer educators were more likely to engage in higher risk behavior such as receiving money for sex when compared to sociometrically selected peer changes agents. These existing peer educators were also more likely to exhibit leadership qualities within the overall network; they were, however, just as likely as other non-trained candidate peer change agents to report important HIV intravention behavior (encouraging condoms within their network). The importance of identifying bridges who may be able to diffuse innovation more effectively within high risk HIV networks is especially critical given recent efficacy data from novel HIV prevention interventions such as pre-exposure prophylaxis. Moreover, while existing peer educators were more likely to be leaders in our analysis, using peer educators with high risk behavior may have limited utility in enacting behavior change among sex worker peers or

  14. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    Science.gov (United States)

    Cluver, Lucie Dale; Orkin, Frederick Mark; Meinck, Franziska; Boyes, Mark Edward; Sherr, Lorraine

    2016-01-01

    Introduction Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. Methods This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention). Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1) potential structural drivers of HIV infection such as poverty and community violence; 2) HIV risk behaviours; 3) hypothesized psychosocial mediating factors; and 4) types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Results Structural drivers were associated with increased onset of adolescent HIV risk behaviour (psocial protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=−0.08, psocial protection has the greatest prevention effects for the most vulnerable. Social protection comprising unconditional cash plus care was associated with reduced risk pathways through moderation and main effects, respectively. Our findings suggest the importance of social protection within a combination

  15. Assessing HIV risk in workplaces for prioritizing HIV preventive interventions in Karnataka State, India.

    Science.gov (United States)

    Halli, Shiva S; Buzdugan, Raluca; Ramesh, B M; Gurnani, Vandana; Sharma, Vivek; Moses, Stephen; Blanchard, James F

    2009-09-01

    To develop a model for prioritizing economic sectors for HIV preventive intervention programs in the workplace. This study was undertaken in Karnataka state, India. A 3-stage survey process was undertaken. In the first stage, we reviewed secondary data available from various government departments, identified industries in the private sector with large workforces, and mapped their geographical distribution. In the second stage, an initial rapid risk assessment of industrial sectors was undertaken, using key-informant interviews conducted in relation to a number of enterprises, and in consultation with stakeholders. In the third stage, we used both quantitative (polling booth survey) and qualitative methods (key informant interviews, in-depth interviews, focus group discussions) to study high-risk sectors in-depth, and assessed the need and feasibility of HIV workplace intervention programs. The highest risk sectors were found to be mining, garment/textile, sugar, construction/infrastructure, and fishing industries. Workers in all sectors had at best partial knowledge about HIV/AIDS, coupled with common misconceptions about HIV transmission. There were intersector and intrasector variations in risk and vulnerability across different geographical locations and across different categories of workers. This has implications for the design and implementation of workplace intervention programs. There is tremendous scope for HIV preventive interventions in workplaces in India. Given the variation in HIV risk across economic sectors and limited available resources, there will be increased pressure to prioritize intervention efforts towards high-risk sectors. This study offers a model for rapidly assessing the risk level of economic sectors for HIV intervention programs.

  16. A European Seal of Approval for 'gay' businesses: findings from an HIV-prevention pilot project.

    Science.gov (United States)

    Sherriff, Nigel; Gugglberger, Lisa

    2014-05-01

    'Gay' businesses can be important settings through which to deliver health promotion interventions to vulnerable populations, such as men who have sex with men (MSM) regarding HIV prevention. This article draws on data from the European Everywhere project, which represents the first scheme to develop and pre-test a common framework for HIV/STI prevention in 'gay' businesses across eight European countries. The scientific basis of the Everywhere framework was developed using a comprehensive consensus-building process over 30 months. This process included: formative scoping research; interviews with 54 'gay' businesses; meetings/workshops with representatives from project partners, 'gay' businesses, public health administrations and external experts; 15 interviews and three focus groups with project partners; a five-month pilot action phase in eight countries, together with support from the project's Advisory Group; and all Everywhere project partners including the Scientific Steering Committee. A voluntary European code setting out differentiated HIV/STI-prevention standards for 'gay' businesses (including sex venues, 'gay' and 'gay' friendly social spaces, travel agencies, hotels, dating websites) was developed and piloted in eight European cities. During a five-month pilot action, 83 'gay' businesses were certified with the Everywhere Seal of Approval representing a considerable increase on the expected pilot target of 30. Everywhere offers a major contribution to the public health and/or health promotion field in the form of a practical, policy-relevant, settings-based HIV-prevention framework for 'gay' businesses that is common across eight European countries. Findings suggest that a European-wide model of prevention is acceptable and feasible to businesses.

  17. Emerging technologies for HIV prevention for MSM: what we have learned, and ways forward.

    Science.gov (United States)

    Sullivan, Patrick S; Grey, Jeremy A; Simon Rosser, Brian R

    2013-06-01

    Technology-enabled HIV research and prevention has emerged in the past 10 years as an exciting dynamic field that offers great potential to help bring HIV prevention efforts to scale in key risk communities. Evolutions in technologies and in HIV epidemics suggest mutual opportunities to reach most at risk populations in novel ways. New technologies cannot completely replace interventions and services currently delivered by the people. However, we suggest that emerging technologies hold promise to bring services to scale and produce efficiencies in reaching rural populations of men who have sex with men (MSM), connecting with populations who are not reached in current urban outreach efforts, and providing services or research surveys that can be described algorithmically. Furthermore, the types of technologies (eg, internet-based, smartphone-based, text messaging) should be matched with both the content to be delivered and the technology usage patterns of target populations. We suggest several key principles and lessons learned that comprise a framework in which to consider the opportunities of technologies and HIV prevention and research. Future directions include improvement of data quality in online surveying, better characterization of biases, developing improved sampling approaches, working with funders to ensure compatibility of funding mechanisms and online research proposals, and promoting consensus approaches to the duplication and presentation of research and program evaluation results from online research. Given the current calls for comprehensive packages of prevention services for MSM, effective prevention might require an intentional combination of technology-enabled prevention services to achieve scale and strategic use of personally delivered package components in cases where non-algorithmic services, such as individualized counseling, are needed.

  18. Undue inducement, or unfair exclusion: considering a case study of pregnancy in an HIV prevention trial.

    Science.gov (United States)

    Haire, Bridget G; Folayan, Morenike Oluwatoyin

    2017-12-01

    In their recent paper'Undue inducement: a case study in CAPRISA 008', Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not 'unduly induced' to participate by the offer of an experimental product. This paper argues that while the authors' conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy (regardless of whether those risks may be willingly assumed by pregnant women themselves). We suggest that the critical research ethics question raised by Mngadi et al's case study is not 'undue inducement', but the exclusion of pregnant women from research studies where the risks are acceptable to the potential participant, and benefits likely. We also suggest that current regulatory paradigms regarding pregnancy are both overly paternalistic and value the fetus over the mother. In order to ensure timely provision of new HIV prevention agents, we argue that there is a need for expeditious testing of proven effective agents in pregnancy, with due consideration given to situations where preliminary efficacy data exist but fall short of licensure standards. This requires a paradigm shift from researchers, funders, regulators and ethical review bodies towards practices that critically examine the legitimacy of the exclusion of pregnant women on a study-by-study basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Effectiveness of mass media interventions for HIV prevention, 1986-2013: a meta-analysis.

    Science.gov (United States)

    LaCroix, Jessica M; Snyder, Leslie B; Huedo-Medina, Tania B; Johnson, Blair T

    2014-08-15

    This meta-analysis was conducted to synthesize evaluations of mass media-delivered HIV prevention interventions, assess the effectiveness of interventions in improving condom use and HIV-related knowledge, and identify moderators of effectiveness. We systematically searched electronic databases, relevant Web sites, related journals, and reference lists of previous reviews and included studies. Studies that quantitatively evaluated the effectiveness of mass media-delivered HIV prevention using pre-/post-campaign assessments, targeted the general population, reported outcomes of interest, and were available as of September 30, 2013 were eligible for inclusion. Raters coded report, intervention, and sample characteristics. The standardized mean difference, d, comparing pretest and posttest assessments was calculated for each study sample. Effect sizes were analyzed incorporating random-effects assumptions. Of the 433 obtained and screened reports, 54 reports containing evaluations of 72 interventions using 93 samples (N = 142,196) met the selection criteria and were included. Campaigns were associated with increases in condom use [d+ = 0.25, 95% confidence interval (CI) = 0.18 to 0.21], transmission knowledge (d+ = 0.30, 95% CI = 0.18 to 0.41), and prevention knowledge (d+ = 0.39, 95% CI = 0.25 to 0.52). Increases in condom use were larger for longer campaigns and in nations that scored lower on the human development index. Increases in transmission knowledge were larger to the extent that respondents reported greater campaign exposure, for more recent campaigns, and for nations that scored lower on the human development index. Mass media interventions may be useful in reducing global HIV/AIDS disparities because of their reach and effectiveness.

  20. Harnessing Online Peer Education (HOPE): integrating C-POL and social media to train peer leaders in HIV prevention.

    Science.gov (United States)

    Jaganath, Devan; Gill, Harkiran K; Cohen, Adam Carl; Young, Sean D

    2012-01-01

    Novel methods, such as Internet-based interventions, are needed to combat the spread of HIV. While past initiatives have used the Internet to promote HIV prevention, the growing popularity, decreasing digital divide, and multi-functionality of social networking sites, such as Facebook, make this an ideal time to develop innovative ways to use online social networking sites to scale HIV prevention interventions among high-risk groups. The UCLA Harnessing Online Peer Education study is a longitudinal experimental study to evaluate the feasibility, acceptability, and preliminary effectiveness of using social media for peer-led HIV prevention, specifically among African American and Latino Men who have Sex with Men (MSM). No curriculum currently exists to train peer leaders in delivering culturally aware HIV prevention messages using social media. Training was created that adapted the Community Popular Opinion Leader (C-POL) model, for use on social networking sites. Peer leaders are recruited who represent the target population and have experience with both social media and community outreach. The curriculum contains the following elements: discussion and role playing exercises to integrate basic knowledge of HIV/AIDS, awareness of sociocultural HIV/AIDS issues in the age of technology, and communication methods for training peer leaders in effective, interactive social media-based HIV prevention. Ethical issues related to Facebook and health interventions are integrated throughout the sessions. Training outcomes have been developed for long-term assessment of retention and efficacy. This is the first C-POL curriculum that has been adapted for use on social networking websites. Although this curriculum has been used to target African-American and Latino MSM, it has been created to allow generalization to other high-risk groups.

  1. Costos y calidad de la prueba de detección oportuna del cáncer cervicouterino en una clínica pública y en una organización no gubernamental Comparison of cervical cancer screening program costs and quality of care between a public clinic and a Non-Governmental Organization

    Directory of Open Access Journals (Sweden)

    Jesica Gómez-Jauregui A.

    2001-08-01

    Full Text Available Objetivo. Comparar los costos y la calidad de la prueba de detección oportuna del cáncer cervicouterino, entre una clínica pública y una organización no gubernamental (ONG. Material y métodos. Se trata de un estudio de abordaje cuantitativo y cualitativo hecho en dos establecimientos asistenciales de la ciudad de Cuernavaca, Morelos, entre abril y julio de 1999. Mediante un estudio transversal se comparó el costo del proceso de producción de la prueba, desagregado en cuatro componentes, y para la evaluación de la calidad se utilizó el marco conceptual estructurado por Bruce, que incluye la percepción de las usuarias -acerca de la información recibida y el tiempo de espera- y de los proveedores -disponibilidad de espacio y de equipo-. Resultados. Los costos totales del proceso de producción completo de la clínica pública (144 pesos fueron 26% más altos que los costos de la ONG (114 pesos. Por lo que se refiere a la calidad, las usuarias de la ONG informaron una mayor satisfacción con los servicios recibidos. La inconformidad de las mujeres que se realizaron la prueba en la clínica pública se relacionó con el tiempo de espera para la toma de la muestra y para la entrega de los resultados. Conclusiones. Las diferencias en los costos y los indicadores de calidad de la atención entre ambos proveedores sugieren que las ONG deben contemplarse como una alternativa para ofrecer servicios de detección oportuna de cáncer cervicouterino. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To compare the costs and quality of cervical cancer screening between a non-governmental organization (NGO and a Ministry of Health clinic. Material and methods. A quantitative and qualitative cross-sectional study was conducted between April and July 1999, in two healthcare clinics in Cuernavaca, Morelos, Mexico. Cervical cancer screening production processes were compared along four

  2. Getting to zero the biomedical way in Africa: outcomes of deliberation at the 2013 Biomedical HIV Prevention Forum in Abuja, Nigeria.

    Science.gov (United States)

    Folayan, Morenike Oluwatoyin; Gottemoeller, Megan; Mburu, Rosemary; Brown, Brandon

    2014-01-01

    Over the last few decades, biomedical HIV prevention research had engaged multiple African stakeholders. There have however been few platforms to enable regional stakeholders to engage with one another. In partnership with the World AIDS Campaign International, the Institute of Public Health of Obafemi Awolowo University, and the National Agency for the Control of AIDS in Nigeria, the New HIV Vaccine and Microbicide Advocacy Society hosted a forum on biomedical HIV prevention research in Africa. Stakeholders' present explored evidences related to biomedical HIV prevention research and development in Africa, and made recommendations to inform policy, guidelines and future research agenda. The BHPF hosted 342 participants. Topics discussed included the use of antiretrovirals for HIV prevention, considerations for biomedical HIV prevention among key populations; HIV vaccine development; HIV cure; community and civil society engagement; and ethical considerations in implementation of biomedical HIV prevention research. Participants identified challenges for implementation of proven efficacious interventions and discovery of other new prevention options for Africa. Concerns raised included limited funding by African governments, lack of cohesive advocacy and policy agenda for biomedical HIV prevention research and development by Africa, varied ethical practices, and limited support to communities' capacity to actively engaged with clinical trial conducts. Participants recommended that the African Government implement the Abuja +12 declaration; the civil society build stronger partnerships with diverse stakeholders, and develop a coherent advocacy agenda that also enhances community research literacy; and researchers and sponsors of trials on the African continent establish a process for determining appropriate standards for trial conduct on the continent. By highlighting key considerations for biomedical HIV prevention research and development in Africa, the forum has

  3. Assessing cost and technical efficiency of HIV prevention interventions in sub-Saharan Africa: the ORPHEA study design and methods.

    Science.gov (United States)

    Bautista-Arredondo, Sergio; Sosa-Rubí, Sandra G; Opuni, Marjorie; Kwan, Ada; Chaumont, Claire; Coetzee, Jenny; Condo, Jeanine; Dzekedzeke, Kumbutso; Galárraga, Omar; Martinson, Neil; Masiye, Felix; Nsanzimana, Sabin; Wamai, Richard; Wang'ombe, Joseph

    2014-11-29

    Scaling up services to achieve HIV targets will require that countries optimize the use of available funding. Robust unit cost estimates are essential for the better use of resources, and information on the heterogeneity in the unit cost of delivering HIV services across facilities - both within and across countries - is critical to identifying and addressing inefficiencies. There is limited information on the unit cost of HIV prevention services in sub-Saharan Africa and information on the heterogeneity within and across countries and determinants of this variation is even more scarce. The "Optimizing the Response in Prevention: HIV Efficiency in Africa" (ORPHEA) study aims to add to the empirical body of knowledge on the cost and technical efficiency of HIV prevention services that decision makers can use to inform policy and planning. ORPHEA is a cross-sectional observational study conducted in 304 service delivery sites in Kenya, Rwanda, South Africa, and Zambia to assess the cost, cost structure, cost variability, and the determinants of efficiency for four HIV interventions: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT), voluntary medical male circumcision (VMMC), and HIV prevention for sex workers. ORPHEA collected information at three levels (district, facility, and individual) on inputs to HIV prevention service production and their prices, outputs produced along the cascade of services, facility-level characteristics and contextual factors, district-level factors likely to influence the performance of facilities as well as the demand for HIV prevention services, and information on process quality for HTC, PMTCT, and VMMC services. ORPHEA is one of the most comprehensive studies on the cost and technical efficiency of HIV prevention interventions to date. The study applied a robust methodological design to collect comparable information to estimate the cost of HTC, PMTCT, VMMC, and sex worker prevention services in

  4. Building a Mobile HIV Prevention App for Men Who Have Sex With Men: An Iterative and Community-Driven Process.

    Science.gov (United States)

    Goldenberg, Tamar; McDougal, Sarah J; Sullivan, Patrick S; Stekler, Joanne D; Stephenson, Rob

    2015-01-01

    Gay, bisexual, and other men who have sex with men (MSM) account for a disproportionate burden of new HIV infections in the United States. Mobile technology presents an opportunity for innovative interventions for HIV prevention. Some HIV prevention apps currently exist; however, it is challenging to encourage users to download these apps and use them regularly. An iterative research process that centers on the community's needs and preferences may increase the uptake, adherence, and ultimate effectiveness of mobile apps for HIV prevention. The aim of this paper is to provide a case study to illustrate how an iterative community approach to a mobile HIV prevention app can lead to changes in app content to appropriately address the needs and the desires of the target community. In this three-phase study, we conducted focus group discussions (FGDs) with MSM and HIV testing counselors in Atlanta, Seattle, and US rural regions to learn preferences for building a mobile HIV prevention app. We used data from these groups to build a beta version of the app and theater tested it in additional FGDs. A thematic data analysis examined how this approach addressed preferences and concerns expressed by the participants. There was an increased willingness to use the app during theater testing than during the first phase of FGDs. Many concerns that were identified in phase one (eg, disagreements about reminders for HIV testing, concerns about app privacy) were considered in building the beta version. Participants perceived these features as strengths during theater testing. However, some disagreements were still present, especially regarding the tone and language of the app. These findings highlight the benefits of using an interactive and community-driven process to collect data on app preferences when building a mobile HIV prevention app. Through this process, we learned how to be inclusive of the larger MSM population without marginalizing some app users. Though some issues in

  5. A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention.

    Science.gov (United States)

    Kennedy, Caitlin E; Fonner, Virginia A; O'Reilly, Kevin R; Sweat, Michael D

    2014-01-01

    Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. The authors conducted a systematic review by searching electronic databases from 1990 to 2012, examining secondary references, and hand-searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care, or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of the 5218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with six conducted in sub-Saharan Africa, three in South or Southeast Asia, and three in Latin America and the Caribbean. Target populations included adult women (N = 6), female sex workers/bar workers (N = 3), and youth/orphans (N = 3). All studies targeted females except two among youth/orphans. Study rigor was moderate, with two group-randomized trials and two individual-randomized trials. All interventions except three included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners, or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these

  6. Pre-exposure prophylaxis for HIV prevention in women: current perspectives

    Directory of Open Access Journals (Sweden)

    Flash CA

    2017-05-01

    Full Text Available Charlene A Flash,1 Sannisha K Dale,2–4 Douglas S Krakower3,5,6 1Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, 2Massachusetts General Hospital, 3Department of Psychiatry, Harvard Medical School, Boston, MA, 4Department of Psychology, University of Miami, Coral Gables, FL, 5Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 6The Fenway Institute, Boston, MA, USA Abstract: There are ~900,000 new HIV infections among women every year, representing nearly half of all new HIV infections globally. In the US, nearly one-fifth of all new HIV infections occur among women, and women from racial and ethnic minority communities experience disproportionately high rates of new HIV infections. Thus, there is a need to develop and implement effective HIV prevention strategies for women in the US and internationally, with a specific need to advance strategies in minority communities. Previous studies have demonstrated that oral HIV pre-exposure prophylaxis (PrEP, the use of antiretroviral medications by HIV-uninfected persons to prevent HIV acquisition, can reduce HIV incidence among women who are adherent to PrEP. However, to date, awareness and uptake of PrEP among women have been very limited, suggesting a need for innovative strategies to increase the knowledge of and access to PrEP among women in diverse settings. This narrative review summarizes the efficacy and safety data of PrEP in women, discusses considerations related to medication adherence for women who use PrEP, and highlights behavioral, social, and structural barriers to maximize the effectiveness of PrEP in women. It also reviews novel modalities for PrEP in women which are being developed and tested, including topical formulations and long-acting injectable agents that may offer advantages as compared to oral PrEP and proposes a community-oriented, social networking framework to increase awareness of PrEP among women. If

  7. Ethical Issues in HIV Prevention Research with People Who Inject Drugs

    Science.gov (United States)

    Sugarman, Jeremy; Rose, Scott M.; Metzger, David

    2013-01-01

    Background Injection drug use continues to significantly contribute to new infections with HIV. Moreover, conducting HIV prevention research with people who inject drugs (PWIDs) can be complicated for an array of practical, social, legal and ethical reasons. It is critical that these research efforts are sensitive to the particular vulnerabilities associated with injection drug use as well as those related to being at risk for acquiring HIV so as to minimize harm to participants in research. Purpose To describe how we addressed some of these ethical challenges during the course of a large-scale multinational randomized HIV prevention trial involving PWIDs, which was successfully completed. Methods The ethical issues encountered during the life-cycle of the trial were catalogued by the principal investigator, study coordinator and ethicist working on the trial. Relevant study documents were then reviewed to provide pertinent details. The ethical issues unique to the trial were then described. Results Before implementation, the trial faced particularly complex challenges related to the vulnerability of PWIDs where HIV seroincidence rates in the population were high and legal policies and stigma regarding injection drug use was severe. Accordingly, a rapid policy assessment was commissioned and a series of community engagement activities were conducted. During the trial, in addition to using careful standard operating procedures regarding all aspects of trial conduct and extensive staff training, the trial standardized informed consent procedures and assessed them. Further, social harms were monitored along with physical harms and adverse events. Following the decision to close the study, it was critical to develop an orderly and safe process for closing it. The issue of post-trial access to the study medication and a complex intervention also surfaced for consideration. Limitations The issues described in this paper are necessarily limited to how they manifested

  8. Ethical issues in HIV prevention research with people who inject drugs.

    Science.gov (United States)

    Sugarman, Jeremy; Rose, Scott M; Metzger, David

    2014-04-01

    Injection drug use continues to significantly contribute to new infections with HIV. Moreover, conducting HIV prevention research with people who inject drugs (PWIDs) can be complicated for an array of practical, social, legal, and ethical reasons. It is critical that these research efforts are sensitive to the particular vulnerabilities associated with injection drug use as well as those related to being at risk of acquiring HIV so as to minimize harm to participants in research. To describe how we addressed some of these ethical challenges during the course of a large-scale multinational randomized HIV prevention trial involving PWIDs, which was successfully completed. The ethical issues encountered during the life cycle of the trial were cataloged by the principal investigator, study coordinator, and ethicist working on the trial. Relevant study documents were then reviewed to provide pertinent details. The ethical issues unique to the trial were then described. Before implementation, the trial faced particularly complex challenges related to the vulnerability of PWIDs, where HIV seroincidence rates in the population were high and legal policies and stigma regarding injection drug use was severe. Accordingly, a rapid policy assessment was commissioned, and a series of community engagement activities were conducted. During the trial, in addition to using careful standard operating procedures regarding all aspects of trial conduct and extensive staff training, the trial standardized informed consent procedures and assessed them. Furthermore, social harms were monitored along with physical harms and adverse events. Following the decision to close the study, it was critical to develop an orderly and safe process for closing it. The issue of post-trial access to the study medication and a complex intervention also surfaced for consideration. The issues described in this article are necessarily limited to how they manifested themselves within the context of a

  9. Meeting the challenges of North-South collaboration: the case of HIV prevention for rural youth, Edo State, Nigeria.

    Science.gov (United States)

    Onokerhoraye, Andrew G; Maticka-Tyndale, Eleanor

    2012-06-01

    Despite the significant contributions of the various North-South research partnerships during the past five decades to enhancing research capacity in the South, they have faced a number of challenges associated with the various partnerships. There have been limited attempts to critically examine the successes and challenges associated with these partnerships. Based on the experiences of implementing the 'HIV Prevention for Rural Youth' programme by a Canadian-Nigerian partnership during a four year period, this paper outlines the successes achieved and the challenges faced. The paper reviews the context of contemporary North-South research collaboration which provided the framework for the implementation of the HIV Prevention for Rural Youth. It then examines the benefits which the implementation of the programme have stimulated as well as the various challenges which confronted the partnership and how they were handled. The implications of the project's implementation experiences for future North-South collaborative research programmes are highlighted.

  10. Combination HIV Prevention Strategy Implementation in El Salvador: Perceived Barriers and Adaptations Reported by Outreach Peer Educators and Supervisors

    Directory of Open Access Journals (Sweden)

    Meredith Buck

    2017-04-01

    Full Text Available El Salvador was one of three countries to receive funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria to conduct a combination HIV prevention intervention among transwomen (TW, men who have sex with men (MSM, and commercial sex workers (CSW. Program evaluation revealed that prevention activities reached only 50% of the target population. The purpose of this study is to examine the barriers that Salvadoran educators faced in implementing the peer education as designed and adaptations made as a result. Between March and June 2015, 18 in-depth interviews with educators were conducted. Violence was reported as the biggest barrier to intervention implementation. Other barriers differed by subpopulation. The level of violence and discrimination calls into question the feasibility and appropriateness of peer-led interventions in the Salvadoran context and demonstrates the importance of implementation research when translating HIV prevention interventions developed in high-income countries to low- and middle-income countries.

  11. Structure and agency in long-distance truck drivers' lived experiences of condom use for HIV prevention.

    Science.gov (United States)

    Sastry, Shaunak

    2016-01-01

    Condom promotion has emerged as a mainstay of targeted HIV prevention interventions in India, with its emphasis on individual behaviour change and personal responsibility. However, such approaches often do not account for marginalised populations' structural vulnerability to HIV, arising from social, economic and political factors in the lived environment. In this paper, I use a critical health communication framework to analyse how structure and agency interact in influencing condom use among long-distance truck drivers in India. Drawing on an abductive discourse analysis of condom-use discourses among truckers and peer educators in two Indian cities, findings reveal that while truckers understand the biomedical logic of condoms as barriers, they also express anxiety about condom breakage and experience structural barriers to condom use. The paper concludes by calling for greater attention to structural vulnerabilities in future HIV prevention efforts with truck drivers.

  12. Combination HIV prevention for female sex workers: what is the evidence?

    Science.gov (United States)

    Bekker, Linda-Gail; Johnson, Leigh; Cowan, Frances; Overs, Cheryl; Besada, Donela; Hillier, Sharon; Cates, Willard

    2015-01-03

    Sex work occurs in many forms and sex workers of all genders have been affected by HIV epidemics worldwide. The determinants of HIV risk associated with sex work occur at several levels, including individual biological and behavioural, dyadic and network, and community and social environmental levels. Evidence indicates that effective HIV prevention packages for sex workers should include combinations of biomedical, behavioural, and structural interventions tailored to local contexts, and be led and implemented by sex worker communities. A model simulation based on the South African heterosexual epidemic suggests that condom promotion and distribution programmes in South Africa have already reduced HIV incidence in sex workers and their clients by more than 70%. Under optimistic model assumptions, oral pre-exposure prophylaxis together with test and treat programmes could further reduce HIV incidence in South African sex workers and their clients by up to 40% over a 10-year period. Combining these biomedical approaches with a prevention package, including behavioural and structural components as part of a community-driven approach, will help to reduce HIV infection in sex workers in different settings worldwide. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Gendered Empowerment and HIV Prevention: Policy and Programmatic Pathways to Success in the MENA Region

    Science.gov (United States)

    Dworkin, Shari L.; Kambou, Sarah Degnan; Sutherland, Carla; Moalla, Khadija; Kapoor, Archana

    2011-01-01

    Although HIV in the Middle East and North Africa is currently characterized as a low seroprevalence epidemic, there are numerous factors that are present in the region that could prevent—or exacerbate—the epidemic. The time to invest substantially in prevention—and gender-specific prevention in particular—is now. Given that most policy makers do not make gender-specific plans as epidemics progress, our research team—which draws upon expertise from both within and outside the region—worked together to make programmatic and policy suggestions in the Middle East and North Africa region in 5 key areas: (1) gender-specific and gender transformative HIV prevention interventions; (2) access to quality education and improvements in life skills and sex education; (3) economic empowerment; (4) property rights; and (5) antiviolence. In short, this work builds upon many ongoing efforts in the region and elucidates some of the links between gendered empowerment and health outcomes around the world, particularly HIV and AIDS. PMID:19553778

  14. Strategic roles for health communication in combination HIV prevention and care programs.

    Science.gov (United States)

    Vermund, Sten H; Van Lith, Lynn M; Holtgrave, David

    2014-08-15

    This special issue of JAIDS: Journal of Acquired Immune Deficiency Syndromes is devoted to health communication and its role in and impact on HIV prevention and care. The authors in this special issue have tackled a wide swath of topics, seeking to introduce a wider biomedical audience to core health communication principles, strategies, and evidence of effectiveness. Better awareness of health communication strategies and concepts can enable the broader biomedical community to partner with health communication experts in reducing the risk of HIV, sexually transmitted infections, and tuberculosis and maximize linkage and adherence to care. Interventions can be strengthened when biomedical and health communication approaches are combined in strategic and evidence-based ways. Several of the articles in this special issue present the current evidence for health communication's impact. These articles show how far we have come and yet how much further we have to go to document impact convincingly. Examples of the biomedical approaches to HIV control include treatment as prevention, voluntary medical male circumcision, preexposure prophylaxis, sterile needle exchange, opiate substitution therapy, and prevention of mother-to-child transmission. None will succeed without behavior change, which can be facilitated by effective health communication.

  15. Superstition, witchcraft and HIV prevention in sub-Saharan Africa: the case of Ghana.

    Science.gov (United States)

    Tenkorang, Eric Y; Gyimah, Stephen O; Maticka-Tyndale, Eleanor; Adjei, Jones

    2011-10-01

    Belief in superstition and witchcraft is central to many African conceptions of illness, disease causation and etiology. While a number of anthropological studies have alluded to a theoretical link between such beliefs and HIV prevention in particular, there is limited empirical assessment of the association. Using data from the 2008 Ghana Demographic and Health Survey and applying random-effects logit models, we investigate whether the belief that AIDS can spread through witchcraft associates with the sexual decision making of never-married men and women. The results show that men who believed AIDS can spread through witchcraft and other supernatural means were less likely to have used condoms at last sexual intercourse, controlling for other socioeconomic and cultural variables. Women with similar beliefs were more likely to have experienced sexual intercourse but less likely to have used condoms at last sex. For women, however, the relationship between such superstitious beliefs and condom use was somewhat attenuated after controlling for ethnicity and region of residence. From a policy perspective, the findings suggest that local beliefs regarding AIDS causation must be considered in designing HIV/AIDS programmes and interventions.

  16. Engineering behaviour change in an epidemic: the epistemology of NIH-funded HIV prevention science.

    Science.gov (United States)

    Green, Adam; Kolar, Kat

    2015-05-01

    Social scientific and public health literature on National Institutes of Health-funded HIV behavioural prevention science often assumes that this body of work has a strong biomedical epistemological orientation. We explore this assumption by conducting a systematic content analysis of all NIH-funded HIV behavioural prevention grants for men who have sex with men between 1989 and 2012. We find that while intervention research strongly favours a biomedical orientation, research into the antecedents of HIV risk practices favours a sociological, interpretive and structural orientation. Thus, with respect to NIH-funded HIV prevention science, there exists a major disjunct in the guiding epistemological orientations of how scientists understand HIV risk, on the one hand, and how they engineer behaviour change in behavioural interventions, on the other. Building on the extant literature, we suggest that the cause of this disjunct is probably attributable not to an NIH-wide positivist orientation, but to the specific standards of evidence used to adjudicate HIV intervention grant awards, including randomised controlled trials and other quantitative measures of intervention efficacy. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  17. Evaluation of a school-based HIV prevention intervention among Yemeni adolescents

    Directory of Open Access Journals (Sweden)

    Crutzen Rik

    2011-05-01

    Full Text Available Abstract Background This article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen. The intervention was developed after a survey among the same population in 2005, which revealed a high level of stigma towards people living with HIV (PLWH and a low level of HIV knowledge. Methods In a quasi-experimental design students who received the peer education intervention (78.6% were compared with students who did not receive the intervention (21.4%. No systematic procedure was applied in selecting students for the intervention condition. Data were collected using a self-administered questionnaire from a sample of 2510 students from all 27 high-schools in Aden governorate. To increase internal validity, students were also compared with a cohort control sample surveyed in 2005, which was a random sample of 2274 students from the same schools. Results Sixty eight percent of students targeted by peer education had good knowledge scores, compared with 43.3% of students not targeted by peer education (χ2 = (df = 1 = 111.15, p Conclusion The school-based peer education intervention has succeeded in improving levels of knowledge on modes of transmission and prevention, and in decreasing levels of stigma and discrimination in a culturally conservative setting.

  18. Male circumcision for HIV prevention: Awareness, risk compensation, and risk perceptions among South African women.

    Science.gov (United States)

    Kalichman, Seth; Mathews, Catherine; Kalichman, Moira; Eaton, Lisa A; Nkoko, Koena

    2018-01-25

    Medical male circumcision (MMC) is a proven method of HIV risk reduction for men in southern Africa. MMC promotion campaigns and scale-up programmes are widely implemented throughout the Republic of South Africa. However, the impact of promoting MMC on women's awareness, beliefs, and behaviours has been understudied. We conducted a self-administered anonymous survey of 279 women receiving health services in an impoverished township located in Cape Town, South Africa. Results showed that two in three women were unaware that male circumcision partially protects men from contracting HIV. Women who were aware of MMC for HIV prevention also endorsed beliefs that male circumcision reduces the need for men to worry about HIV and reduces the need for men to use condoms. Male circumcision awareness was also related to reduced perceptions of HIV risk among women. Multivariable models showed that women's MMC awareness, circumcision risk compensation beliefs, and risk perceptions were associated with decreased condom use and higher HIV risk index scores defined as number of condomless vaginal intercourse X number of sex partners. These results suggest a need for MMC education efforts tailored for women living in communities with high-HIV prevalence where men are targeted for MMC.

  19. Facebook Advertising to Recruit Young, Urban Women into an HIV Prevention Clinical Trial.

    Science.gov (United States)

    Jones, Rachel; Lacroix, Lorraine J; Porcher, Eloni

    2017-11-01

    Advertising via Facebook to elicit involvement in clinical trials has demonstrated promise in expanding geographic reach while maintaining confidentiality. The purpose of this study is to evaluate Facebook advertising to reach at-risk, predominately African American or Black women in higher HIV prevalence communities for an HIV prevention clinical trial, and to compare baseline characteristics to those recruited on-the-ground. Maintaining confidentiality and the practical aspects of creating and posting ads on Facebook are described. The advertising strategy targeted multicultural affinities, gender, age, interest terms, and zip codes. We report on results during 205 days. A total of 516,498 Facebook users viewed the ads an average of four times, resulting in 37,133 clicks to the study website. Compared to 495 screened on-the-ground, 940 were screened via Facebook ads, of these, half (n = 477, 50.74%) were high risk, and of those at risk, 154 were randomized into the 6-month clinical trial. Black women comprised 71.60% (n = 673) of the total screened online. Roughly twice as many Black women screened via Facebook compared to on-the-ground, yet, the percentage at high risk was similar. Preliminary data suggest that the extent to which ad headlines and photos tap into authentic social experience, advertising on Facebook can extend geographic reach and provide a comparative sample to women recruited on-the-ground.

  20. HIV prevention and marriage: peer group effects on condom use acceptability in rural Kenya.

    Science.gov (United States)

    Cordero Coma, Julia

    2014-09-01

    The twofold function of condom use - contraception and sexually transmitted disease protection - should be taken into account when understanding attitudes towards this practice. Emphasis on the interpretation of condom use as a protective practice conflicts with the norms of fidelity and trust, which regulate marriage. The alternative interpretation of condom use as a contraceptive method may be less problematic. This paper analyzes the extent to which the attitude of married men and women towards condom use with their spouses, and their actual use of condoms within marriage, are affected by their expectations about the dominant attitudes and behaviors in their peer group. I expect that a social consensus on understanding condom use as an HIV-preventive behavior will not make this practice more acceptable within marriage, while social acceptance of modern contraception and, more specifically, of the use of condoms for contraceptive purposes will. Two waves of a longitudinal survey from 1996 to 1999 in rural Kenya are analyzed using fixed-effects regression. Social support for each function of condom use is measured with indicators of the proportion of individuals in the peer group that use condoms for a particular purpose or have a positive attitude towards each of the uses, according to the respondent. The results support the hypothesis for men, but are inconclusive for women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Barriers and facilitators of HIV prevention with heterosexual Latino couples: beliefs of four stakeholder groups.

    Science.gov (United States)

    Pérez-Jiménez, David; Seal, David W; Serrano-García, Irma

    2009-01-01

    Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men's involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed.

  2. Preliminary efficacy of a computer-delivered HIV prevention intervention for African American teenage females.

    Science.gov (United States)

    Klein, Charles H; Card, Josefina J

    2011-12-01

    This study translated SiHLE (Sisters Informing, Healing, Living, and Empowering), a 12-hour Centers for Disease Control and Prevention evidence-based group-level intervention for African American females 14-18 years of age, into a 2-hour computer-delivered individual-level intervention. A randomized controlled trial (n = 178) was conducted to examine the efficacy of the new Multimedia SiHLE intervention. Average condom-protected sex acts (proportion of vaginal sex acts with condoms, last 90 days) for sexually active participants receiving Multimedia SiHLE rose from M = 51% at baseline to M = 71% at 3-month follow-up (t = 2.06, p = .05); no statistically significant difference was found in the control group. Non-sexually active intervention group participants reported a significant increase in condom self-efficacy (t = 2.36, p = .02); no statistically significant difference was found in the control group. The study provides preliminary support for the efficacy of a computer-delivered adaptation of a proven HIV prevention program for African American teenage women. This is consistent with meta-analyses that have shown that computer-delivered interventions, which can often be disseminated at lower per-capita cost than human-delivered interventions, can influence HIV risk behaviors in positive fashion.

  3. Between hope and abandonment: black queer collectivity and the affective labour of biomedicalised HIV prevention.

    Science.gov (United States)

    van Doorn, Niels

    2012-01-01

    This paper investigates how current transformations in HIV prevention in the USA are intensifying a logic of viral containment rooted in biomedicine and behavioural science, in order to curb the recent rise in new HIV infections, predominantly among young African-American 'men who have sex with men'. Based on fieldwork in Baltimore, I examine how this paradigm shift is translated into concrete prevention activities that focus on HIV testing and treatment. By attending to the affective labour performed by members of Baltimore's Ballroom scene - a kinship system of black queer youth structured around competitive dance and performance - I show how the emergent 'Test & Treat' approach becomes a polyvalent object that attracts a host of optimistic investments in collective and individual prosperity, which nevertheless threaten to remain unrequited. Finally, I argue that the current move towards a biomedically mediated model of viral management depoliticises the struggle against HIV by suggesting that we can treat our way out of an epidemic that in fact remains intricately interwoven with racialised violence against the queer, the poor and the otherwise dispossessed.

  4. An evaluation of peer-led STD/HIV prevention work in a public sex environment.

    Science.gov (United States)

    French, R; Power, R; Mitchell, S

    2000-04-01

    This paper describes an independent evaluation of a peer-led STD/HIV prevention intervention conducted by Gay Men Fighting AIDS (GMFA) in a public sex environment (PSE). A variety of quantitative and qualitative research methods were employed to collect data on the intervention process as well as its outcomes. The main aim of the intervention was the distribution of condoms and safer sex literature to PSE users. During a five-month period, over 100,000 condoms and 2,200 safer sex information packs were distributed by GMFA volunteers to the PSE users. Condom provision was identified as the most needed health promotion activity in PSEs in a survey of gay and bisexual men (n = 688) conducted by the evaluators. Data collected showed that condoms provided by GMFA, as well as from other sources, were being used in the PSE. The peer-led focus of the intervention was acceptable to the PSE users. In addition, high levels of commitment and input from the volunteers contributed considerable added value to the intervention. The evaluation found that GMFA was successful in reaching the target population and addressing their needs and demands.

  5. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Men who have sex with men (MSM in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  6. Women's beliefs about male circumcision, HIV prevention, and sexual behaviors in Kisumu, Kenya.

    Directory of Open Access Journals (Sweden)

    Thomas H Riess

    Full Text Available It is important to understand how women's sexual practices may be influenced by male circumcision (MC as an HIV prevention effort. Women's beliefs about MC and sexual behaviour will likely influence the scale-up and uptake of medical MC. We conducted qualitative interviews with 30 sexually active women in Kisumu, Kenya. Women discussed MC related to perceived health benefits, condom use, sexual behaviour, knowledge of susceptibility to HIV and sexually transmitted infections (STIs, circumcision preference, and influence on circumcision uptake. Respondents had a good understanding of the partial protection of MC for acquisition of HIV for men. Women perceived circumcised men as cleaner, carrying fewer diseases, and taking more time to reach ejaculation. Male's circumcision status is a salient factor for women's sexual decision making, including partner choice, and condom use. It will be important that educational information affirms that MC provides only partial protection against female to male transmission of HIV and some STIs; that other HIV and STI prevention methods such as condoms need to be used in conjunction with MC; that MC does not preclude a man from having HIV; and that couples should develop plans for not having sex while the man is healing.

  7. Iteratively Developing an mHealth HIV Prevention Program for Sexual Minority Adolescent Men.

    Science.gov (United States)

    Ybarra, Michele L; Prescott, Tonya L; Philips, Gregory L; Bull, Sheana S; Parsons, Jeffrey T; Mustanski, Brian

    2016-06-01

    Five activities were implemented between November 2012 and June 2014 to develop an mHealth HIV prevention program for adolescent gay, bisexual, and queer men (AGBM): (1) focus groups to gather acceptability of the program components; (2) ongoing development of content; (3) Content Advisory Teams to confirm the tone, flow, and understandability of program content; (4) an internal team test to alpha test software functionality; and (5) a beta test to test the protocol and intervention messages. Findings suggest that AGBM preferred positive and friendly content that at the same time, did not try to sound like a peer. They deemed the number of daily text messages (i.e., 8-15 per day) to be acceptable. The Text Buddy component was well received but youth needed concrete direction about appropriate discussion topics. AGBM determined the self-safety assessment also was acceptable. Its feasible implementation in the beta test suggests that AGBM can actively self-determine their potential danger when participating in sexual health programs. Partnering with the target population in intervention development is critical to ensure that a salient final product and feasible protocol are created.

  8. Examining targets for HIV prevention: intravaginal practices in Urban Lusaka, Zambia.

    Science.gov (United States)

    Alcaide, Maria L; Chisembele, Maureen; Mumbi, Miriam; Malupande, Emeria; Jones, Deborah

    2014-03-01

    Intravaginal practices (IVP) are the introduction of products inside the vagina for hygienic, health, or sexuality reasons. The influence of men and Alengizis, traditional marriage counselors for girls, in promoting IVP has not been explored. We conducted gender-concordant focus groups and key informant interviews with Alengizis. The responses were conducted grouped into three themes: (1) cultural norms, (2) types and reasons for IVP, and (3) health consequences. We found that IVP were used by all participants in our sample and were taught from generation to generation by friends, relatives, or Alengizis. The reasons for women to engage in IVP were hygienic, though men expect women to engage in IVP to enhance sexual pleasure. Approximately 40% of women are aware that IVP can facilitate genital infections, but felt they would not feel clean discontinuing IVP. All men were unaware of the vaginal damage caused by IVP, and were concerned about the loss of sexual pleasure if women discontinued IVP. Despite the health risks of IVP, IVP continue to be widespread in Zambia and an integral component of hygiene and sexuality. The frequency of IVP mandates exploration into methods to decrease or ameliorate their use as an essential component of HIV prevention.

  9. In Their Eyes: HIV prevention from an Islamic perspective in Lamu, Kenya.

    Directory of Open Access Journals (Sweden)

    A O Maulana

    2012-04-01

    Full Text Available Despite efforts to curb the spread of HIV amongst the youth and its positive indication of success in Kenya, the epidemic continues to pose serious challenges to these efforts amongst all demographic groupings across Kenya. This article presents findings of a qualitative study involving 45 youth and 23 Islamic leaders from Lamu, Kenya. The study looked at participant’s perceptions of HIV/AIDS. It also explored participant’s perceptions on what they see as the factors influencing HIV transmission amongst the Lamu youth. Additionally a literature review was used together with the study findings to identify elements for an Islamic based HIV prevention intervention. Our findings indicated that both the youth and religious leaders’ perceptions of HIV/AIDS comprise a mixture of facts and misconceptions. The participants identified idleness, drug abuse and premarital sex as key factors contributing to the risk of HIV infection amongst the Lamu youth. The symbiotic relationship between religious leaders and youth on various aspects of daily practices was evident throughout the study thereby suggesting the importance of working with both in addressing HIV/AIDS in Lamu. 

  10. Assessing Adherence in the CAPRISA 004 Tenofovir Gel HIV Prevention Trial: Results of a Nested Case–Control Study

    OpenAIRE

    MacQueen, Kathleen M.; Weaver, Mark A.; van Loggerenberg, Francois; Succop, Stacey; Majola, Nelisle; Taylor, Doug; Karim, Quarraisha Abdool; Karim, Salim Abdool

    2014-01-01

    Adherence undeniably impacts product effectiveness in microbicide trials, but the connection has proven challenging to quantify using routinely collected behavioral data. We explored this relationship using a nested case–control study in the CAPRISA 004 Tenofovir (TFV) gel HIV prevention trial. Detailed 3-month recall data on sex events, condom and gel use were collected from 72 incident cases and 205 uninfected controls. We then assessed how the relationship between self-reported adherence a...

  11. MALE HOMOSEXUAL IDENTITIES, RELATIONSHIPS, AND PRACTICES AMONG YOUNG MEN WHO HAVE SEX WITH MEN IN VIETNAM: IMPLICATIONS FOR HIV PREVENTION

    OpenAIRE

    Ngo, Duc Anh; Ross, Michael W; Phan, Ha; Ratliff, Eric A.; Trinh, Thang; Sherburne, Lisa

    2009-01-01

    Rapid socioeconomic transformation in Vietnam in last 15 years has been followed by more liberation of sexual expression and representation of sexual identity among young people. There has been an increase in the visibility of homosexual men in major cities of Vietnam who were largely an unknown population until the emergence of the HIV epidemic. Men who have sex with men (MSM) are now considered as one of the target groups in many HIV prevention programs. This qualitative study examines loca...

  12. Mobilizing homeless youth for HIV prevention: a social network analysis of the acceptability of a face-to-face and online social networking intervention

    National Research Council Canada - National Science Library

    Rice, Eric; Tulbert, Eve; Cederbaum, Julie; Barman Adhikari, Anamika; Milburn, Norweeta G

    2012-01-01

    The objective of the study is to use social network analysis to examine the acceptability of a youth-led, hybrid face-to-face and online social networking HIV prevention program for homeless youth.Seven peer leaders (PLs...

  13. “Let Me Help You Help Me”: Church-based HIV Prevention for Young Black Men who have Sex with Men

    Science.gov (United States)

    Powell, Terrinieka W.; Herbert, Ann; Ritchwood, Tiarney D.; Latkin, Carl A.

    2016-01-01

    The goal of this study was to identify strategies that could yield more inclusive church-based HIV prevention efforts. In-depth interviews were conducted with 30 young Black men who have sex with men (YBMSM) living in Baltimore, Maryland. The sample had an equal number of regular and infrequent church attendees. Nearly one-fourth of the sample was HIV-positive. Interviews were transcribed verbatim and analyzed inductively using a qualitative content analytic approach. Two main recommendations emerged for churches to offer more inclusive HIV prevention efforts: (1) reduce homosexuality stigma by increasing interpersonal and institutional acceptance, and (2) address the sexual health needs of all congregants by offering universal and targeted sexual health promotion. Thus, results support a tiered approached to providing more inclusive church-based HIV prevention efforts. We conclude that Black churches can be a critical access point for HIV prevention among YBMSM and represent an important setting to intervene. PMID:27244189

  14. Pregnancy, contraceptive use, and HIV acquisition in HPTN 039: relevance for HIV prevention trials among African women.

    Science.gov (United States)

    Reid, Stewart E; Dai, James Y; Wang, Jing; Sichalwe, Bupe N; Akpomiemie, Godspower; Cowan, Frances M; Delany-Moretlwe, Sinead; Baeten, Jared M; Hughes, James P; Wald, Anna; Celum, Connie

    2010-04-01

    Biomedical HIV prevention trials enroll sexually active women at risk of HIV and often discontinue study product during pregnancy. We assessed risk factors for pregnancy and HIV acquisition, and the effect of pregnancy on time off study drug in HIV Prevention Trials Network 039. A total of 1358 HIV negative, herpes simplex virus type 2-seropositive women from South Africa, Zambia, and Zimbabwe were enrolled and followed for up to 18 months. A total of 228 pregnancies occurred; time off study drug due to pregnancy accounted for 4% of woman-years of follow-up among women. Being pregnant was not associated with increased HIV risk (hazard ratio 0.64, 95% confidence interval 0.23-1.80, P = 0.40). However, younger age was associated with increased risk for both pregnancy and HIV. There was no association between condom use as a sole contraceptive and reduced pregnancy incidence; hormonal contraception was not associated with increased HIV risk. Bacterial vaginosis at study entry was associated with increased HIV risk (hazard ratio 2.03, P = 0.02). Pregnancy resulted in only a small amount of woman-time off study drug. Young women are at high risk for HIV and are an appropriate population for HIV prevention trials but also have higher risk of pregnancy. Condom use was not associated with reduced incidence of pregnancy.

  15. Adding the female condom to HIV prevention interventions for women with severe mental illness: a pilot test.

    Science.gov (United States)

    Collins, Pamela Y; von Unger, Hella; Putnins, Susan; Crawford, Natalie; Dutt, Ragini; Hoffer, Marcela

    2011-04-01

    We evaluated the efficacy of a gender-specific intervention to reduce sexual risk behaviors by introducing female-initiated methods to urban women with severe mental illness. Seventy-nine women received 10 sessions of an HIV prevention intervention or a control intervention. The primary outcome was unprotected oral, anal, or vaginal intercourse, expressed using the Vaginal Episode Equivalent (VEE) score. Knowledge and use of the female condom were also assessed. Women in the HIV prevention intervention showed a three-fold reduction in the VEE score at the 3-month follow-up compared to the control group, but the difference was not significant. These women were significantly more likely to know about female condoms, have inserted one and used it with a sexual partner at the 3-month follow-up and to have inserted it at 6 months compared to controls. The female condom may be a useful addition, for a subset of women with SMI, to comprehensive HIV prevention programs.

  16. A situational analysis methodology to inform comprehensive HIV prevention and treatment programming, applied in rural South Africa.

    Science.gov (United States)

    Treves-Kagan, Sarah; Naidoo, Evasen; Gilvydis, Jennifer M; Raphela, Elsie; Barnhart, Scott; Lippman, Sheri A

    2017-09-01

    Successful HIV prevention programming requires engaging communities in the planning process and responding to the social environmental factors that shape health and behaviour in a specific local context. We conducted two community-based situational analyses to inform a large, comprehensive HIV prevention programme in two rural districts of North West Province South Africa in 2012. The methodology includes: initial partnership building, goal setting and background research; 1 week of field work; in-field and subsequent data analysis; and community dissemination and programmatic incorporation of results. We describe the methodology and a case study of the approach in rural South Africa; assess if the methodology generated data with sufficient saturation, breadth and utility for programming purposes; and evaluate if this process successfully engaged the community. Between the two sites, 87 men and 105 women consented to in-depth interviews; 17 focus groups were conducted; and 13 health facilities and 7 NGOs were assessed. The methodology succeeded in quickly collecting high-quality data relevant to tailoring a comprehensive HIV programme and created a strong foundation for community engagement and integration with local health services. This methodology can be an accessible tool in guiding community engagement and tailoring future combination HIV prevention and care programmes.

  17. Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

    Science.gov (United States)

    Cianelli, R; Lara, L; Villegas, N; Bernales, M; Ferrer, L; Kaelber, L; Peragallo, N

    2013-04-01

    Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions. © 2012 Blackwell Publishing.

  18. Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness.

    Science.gov (United States)

    Wainberg, Milton L; Alfredo González, M; McKinnon, Karen; Elkington, Katherine S; Pinto, Diana; Gruber Mann, Claudio; Mattos, Paulo E

    2007-07-01

    As in other countries worldwide, adults with severe mental illness (SMI) in Brazil are disproportionately infected with HIV relative to the general population. Brazilian psychiatric facilities lack tested HIV prevention interventions. To adapt existing interventions, developed only in the US, we conducted targeted ethnography with adults with SMI and staff from two psychiatric institutions in Brazil. We sought to characterize individual, institutional, and interpersonal factors that may affect HIV risk behavior in this population. We conducted 350 hours of ethnographic field observations in two mental health service settings in Rio de Janeiro, and 9 focus groups (n=72) and 16 key-informant interviews with patients and staff in these settings. Data comprised field notes and audiotapes of all exchanges, which were transcribed, coded, and systematically analyzed. The ethnography identified and/or characterized the institutional culture: (1) patients' risk behaviors; (2) the institutional setting; (3) intervention content; and (4) intervention format and delivery strategies. Targeted ethnography also illuminated broader contextual issues for development and implementation of HIV prevention interventions for adults with SMI in Brazil, including an institutional culture that did not systematically address patients' sexual behavior, sexual health, or HIV sexual risk, yet strongly impacted the structure of patients' sexual networks. Further, ethnography identified the Brazilian concept of "social responsibility" as important to prevention work with psychiatric patients. Targeted ethnography with adults with SMI and institutional staff provided information critical to the adaptation of tested US HIV prevention interventions for Brazilians with SMI.

  19. Short-term effects of a peer group intervention for HIV prevention among trainee teachers in Malawi.

    Science.gov (United States)

    Norr, Kathleen F; Norr, James L; Kaponda, Chrissie Pn; Kachingwe, Sitingawawo I; Mbweza, Ellen Md

    2007-11-01

    This report describes the implementation and short-term results of a peer group intervention for HIV prevention on the HIV-related attitudes, knowledge and behaviours of primary school teachers in Malawi. The intervention, based on the social-cognitive learning model, took place in 2000 at two teacher training colleges with a distance-learning programme. Primary school teachers attending a final six-week training session before certification volunteered to participate. Group leaders were teachers selected by each group, and after training they facilitated the peer group intervention. The teachers completed a pre-test and post-test questionnaire. The 286 trainee teachers whose pre- and post-test samples could be matched, largely reported positive changes in their HIV-prevention-related knowledge, attitudes, self-efficacy, behaviour change and condom-use intentions. However, at post-test immediately after the intervention they did not show a higher level of perceived-risk, a greater hope that people could change their high-risk sexual behaviour, or greater agreement that persons infected with HIV should be allowed in public places. This research demonstrates the feasibility of an HIV-prevention intervention for primary school teachers during their training. The Malawi Ministry of Education has since made the programme available to over 90 per cent of all trainee teachers through an NGO.

  20. India-US collaboration to prevent adolescent HIV infection: the feasibility of a family-based HIV-prevention intervention for rural Indian youth

    OpenAIRE

    Soletti Asha; Guilamo-Ramos Vincent; Burnette Denise; Sharma Shilpi; Bouris Alida

    2009-01-01

    Abstract Background Despite the centrality of family in Indian society, relatively little is known about family-based communication concerning sexual behaviour and HIV/AIDS in rural Indian families. To date, very few family-based adolescent HIV-prevention interventions have been developed for rural Indian youth. This study conducted formative research with youth aged 14 to18 years and their parents in order to assess the feasibility of conducting a family-based HIV-prevention intervention for...

  1. Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: initial data on an enrollment meta-intervention.

    Science.gov (United States)

    Wilson, Kristina; Durantini, Marta R; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

    2013-01-01

    Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N=41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention.

  2. Sexual behaviour of heterosexual men and women receiving antiretroviral pre-exposure prophylaxis for HIV prevention: a longitudinal analysis.

    Science.gov (United States)

    Mugwanya, Kenneth K; Donnell, Deborah; Celum, Connie; Thomas, Katherine K; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M

    2013-12-01

    Scarce data are available to assess sexual behaviour of individuals using antiretroviral pre-exposure prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like pre-exposure prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of pre-exposure prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex-unprotected by a condom-during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of pre-exposure prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. We analysed 56 132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Pre-exposure prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk

  3. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Science.gov (United States)

    2010-04-01

    ... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

  4. Defining Success: Insights From a Random Assignment, Multisite Study of Implementing HIV Prevention, Testing, and Linkage to Care in U.S. Jails and Prisons.

    Science.gov (United States)

    Mitchell, Shannon Gwin; Willett, Jennifer; Swan, Holly; Monico, Laura B; Yang, Yang; Patterson, Yvonne O; Belenko, Steven; Schwartz, Robert P; Visher, Christy A

    2015-10-01

    In the emerging field of implementation science, measuring the extent to which a new or modified healthcare program or practice is successfully implemented following an intervention is a critical component in understanding how evidence-based treatments become part of regular practice. This paper is intended to expand our understanding of factors that influence the successful adoption of new or modified HIV services in correctional settings. The nine-site project developed and directed an organization-level intervention designed to implement improvements in preventing, detecting, and treating HIV for persons under correctional supervision. Using semi-structured interviews to elicit perceptions from Senior Researchers and Executive Sponsors at each of the nine sites, this paper presents their views and observations regarding the success of the experimental intervention in their criminal justice setting. Within the areas of focus for implementation (either HIV prevention, testing, or linkage to community treatment) the complexity of programmatic needs was very influential with regards to perceptions of success. An organization's pre-existing characteristics, staffing, funding, and interorganizational relationships contributed to either the ease or difficulty of programmatic implementation. Results are discussed pertaining to furthering our understanding of why new or modified healthcare interventions achieve success, including whether the intervention is a modification of existing practice or is a new intervention, and the choice of implementation strategy.

  5. Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial.

    Science.gov (United States)

    Young, Sean D; Cumberland, William G; Lee, Sung-Jae; Jaganath, Devan; Szekeres, Greg; Coates, Thomas

    2013-09-03

    Social networking technologies are an emerging tool for HIV prevention. To determine whether social networking communities can increase HIV testing among African American and Latino men who have sex with men (MSM). Randomized, controlled trial with concealed allocation. (ClinicalTrials.gov: NCT01701206). Online. 112 MSM based in Los Angeles, more than 85% of whom were African American or Latino. Sixteen peer leaders were randomly assigned to deliver information about HIV or general health to participants via Facebook groups over 12 weeks. After participants accepted a request to join the group, participation was voluntary. Group participation and engagement were monitored. Participants could request a free, home-based HIV testing kit and completed questionnaires at baseline and 12-week follow-up. Participant acceptance of and engagement in the intervention and social network participation, rates of home-based HIV testing, and sexual risk behaviors. Almost 95% of intervention participants and 73% of control participants voluntarily communicated using the social platform. Twenty-five of 57 intervention participants (44%) requested home-based HIV testing kits compared with 11 of 55 control participants (20%) (difference, 24 percentage points [95% CI, 8 to 41 percentage points]). Nine of the 25 intervention participants (36%) who requested the test took it and mailed it back compared with 2 of the 11 control participants (18%) who requested the test. Retention at study follow-up was more than 93%. Only 2 Facebook communities were included for each group. Social networking communities are acceptable and effective tools to increase home-based HIV testing among at-risk populations. National Institute of Mental Health.

  6. Interim data monitoring to enroll higher-risk participants in HIV prevention trials

    Directory of Open Access Journals (Sweden)

    Umo-Otong John

    2009-06-01

    Full Text Available Abstract Background Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. Methods We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. Results A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. Conclusion Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. Trial Registration The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770

  7. Key Programme Science lessons from an HIV prevention 'Learning Site' for sex workers in Mombasa, Kenya.

    Science.gov (United States)

    McClarty, Leigh M; Bhattacharjee, Parinita; Isac, Shajy; Emmanuel, Faran; Kioko, Japheth; Njiraini, Margaret; Gichangi, Peter; Okoth, Clifford Duncan; Musimbi-Mbole, Janet; Blanchard, James F; Moses, Stephen; Muysyoki, Helgar; Becker, Marissa L

    2017-12-14

    In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring. Routine monitoring data collected from September 2013 through July 2015 are presented. Individual-level service utilisation data were collected monthly and indicators of interest were analysed over time to illustrate trends in enrolment, programme coverage and service utilisation among sex workers in Mombasa County. Over the monitoring period, outreach programme enrolment occurred rapidly; condom distribution targets were met consistently; rates of STI screening remained high and diagnoses declined; and reporting of and response to violent incidents increased. At the same time, enrolment in LS clinics was relatively low among female sex workers, and HIV testing at LS was low among both female and male sex workers. Lessons learnt from operationalising the Programme Science framework through the Mombasa LS can inform the development and implementation of similar LS in different geographical and epidemiological contexts. Importantly, meaningful involvement of sex workers in the design, implementation and monitoring processes ensures that overall programme performance is optimised in the context of local, 'on-the-ground' realities. Additionally, learnings from LS highlight the importance of introducing enhanced monitoring and evaluations systems into complex programmes to better understand and explain programme dynamics over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  8. HIV Prevention in Resource Limited Settings: A Case Study of Challenges and Opportunities for Implementation.

    Science.gov (United States)

    Jones, Deborah; Weiss, Stephen; Chitalu, Ndashi

    2015-06-01

    Sub-Saharan Africa has the highest global prevalence of HIV, and the prevention of transmission between HIV-seropositive and -serodiscordant sexual partners is a critical component of HIV prevention efforts. Behavioral interventions that have demonstrated efficacy in reducing risk behaviors associated with HIV transmission and infection and have been translated, or adapted, to a variety of settings. This manuscript examined implementation of behavioral interventions within resource limited health care delivery settings, and their adoption and integration within service programs to achieve sustainability. The CDC/Partner Program, an evidence-based risk reduction intervention, was implemented in Community Health Centers (CHCs) in Zambia using a staged technology transfer process, the Training the Trainers Model. Provincial workshops and training workshops on the provision of the intervention were used to establish a cadre of trainers to provide on-site intervention facilitators capable of ultimately providing coverage to over 300 CHCs. CHC staff provided the intervention to clinic attendees in four provinces over 4 years while also training new facilitators. The implementation process addressed multi-level issues within the context of training, consultants, decision making, administration, and evaluation as well as practical considerations surrounding travel, training, staff compensation and ongoing quality assurance. The majority of challenges to implementation and maintenance were addressed and resolved, with the exception of structural limitations related to restricted resources for personnel and funding. Strengths of the program included its collaborative structure, active program leadership, commitment and support at the provincial level, the use of task shifting by existing clinic staff, the train the trainer model and ongoing quality control. Enhanced infrastructure is needed in for future implementation, such as training centers within each province

  9. Peer education, gender and the development of critical consciousness: participatory HIV prevention by South African youth.

    Science.gov (United States)

    Campbell, Catherine; MacPhail, Catherine

    2002-07-01

    Despite the growing popularity of participatory peer education as an HIV-prevention strategy worldwide, our understandings of the processes underlying its impact on sexual norms are still in their infancy. Starting from the assumption that gender inequalities play a key role in driving the epidemic amongst young people, we outline a framework for conceptualizing the processes underlying successful peer education. We draw on the inter-locking concepts of social identity, empowerment (with particular emphasis on Freire's account of critical consciousness) and social capital. Thereafter we provide a critical case study of a school-based peer education programme in a South African township school, drawing on a longitudinal case study of the programme, and interviews and focus groups with young people in the township. Our research highlights a number of features of the programme itself, as well as the broader context within which it was implemented, which are likely to undermine'the development of the critical thinking and empowerment which we argue are key preconditions for programme success. In relation to the programme itself, these include peer educators' preference for didactic methods and biomedical frameworks, unequal gender dynamics amongst the peer educators, the highly regulated and teacher-driven nature of the school environment and negative learner attitudes to the programme. In relation to the broader context of the programme, we point to factors such as limited opportunities for communication about sex outside of the peer educational setting, poor adult role models of sexual relationships, poverty and unemployment, low levels of social capital and poor community facilities. We discuss the implications of our findings for the design of peer educational activities, and point to a number of broader social and community development initiatives that would maximize the likelihood of programme success.

  10. Process evaluation of school-based peer education for HIV prevention among Yemeni adolescents.

    Science.gov (United States)

    Al-Iryani, Buthaina; Basaleem, Huda; Al-Sakkaf, Khaled; Kok, Gerjo; van den Borne, Bart

    2013-03-01

    In 2005, a survey was conducted among all the 27 high schools of Aden, which revealed low levels of knowledge on major prevention measures, and a high level of stigma and discrimination towards people living with HIV (PLWH). The results served as a baseline for implementing a school-based peer education intervention for HIV prevention in the 27 schools of Aden. In 2008, and after 3 years of implementation, a quasi-experimental evaluation was conducted, which revealed that the peer education intervention has succeeded in improving HIV knowledge and skills; and in decreasing stigmatization of PLWH. This process evaluation aims to give a deeper understanding of the quasi-experimental evaluation which was conducted in the 27 high schools of Aden, and to highlight the factors that facilitated or inhibited school peer education in such a conservative Muslim setting. Qualitative methodologies were pursued, where 12 focus group discussions and 12 in-depth interviews were conducted with peer educators, targeted students, school principals, social workers, and parents of peer educators. Results revealed that school-peer education was well received. There was an apparent positive effect on the life skills of peer educators, but the intervention had a lesser effect on targeted students. Key enabling factors have been the high quality of training for peer educators, supportive school principals, and acceptance of the intervention by parents. These findings are important for improving the life skills and peer education intervention at the school level, and in better planning and implementation of life skills and peer programmes at a national scale.

  11. Family-Based HIV Preventive Intervention: Child Level Results from the CHAMP Family Program

    Science.gov (United States)

    McBride, Cami K.; Baptiste, Donna; Traube, Dorian; Paikoff, Roberta L.; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl C.; Coleman, Ida; McKay, Mary M.

    2010-01-01

    SUMMARY Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth’s exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth’s best hope to grow up and survive multiple-dangers in urban neighborhoods (Pequegnat & Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided. PMID:20852742

  12. Pilot RCT Results of an mHealth HIV Prevention Program for Sexual Minority Male Adolescents.

    Science.gov (United States)

    Ybarra, Michele L; Prescott, Tonya L; Phillips, Gregory L; Bull, Sheana S; Parsons, Jeffrey T; Mustanski, Brian

    2017-07-01

    Guy2Guy (G2G) is the first comprehensive HIV prevention program developed for sexual minority males as young as 14 years old and is delivered nationally via text messaging. Here, we report the results of the pilot randomized control trial. G2G was tested against an attention-matched "healthy lifestyle" control (eg, self-esteem). Both programs lasted 5 weeks and delivered 5 to 10 text messages daily. A 1-week booster was delivered 6 weeks subsequently. Participants were cisgender males ages 14 to 18 years old who were gay, bisexual, and/or queer and had an unlimited text messaging plan. Youth were recruited across the United States via Facebook and enrolled by telephone from October 2014 to April 2015. Ninety-day postintervention outcomes were condomless sex acts (CSA) and abstinence and, secondarily, HIV testing. We also examined these outcomes at intervention end and stratified them by sexual experience. At 90 days postintervention, there were no significant differences in CSAs or abstinence noted. Among participants who were sexually active at baseline, intervention participants were significantly more likely to report getting an HIV test (adjusted odds ratio = 3.42, P = .001). They were also less likely than control youth to be abstinent (adjusted odds ratio = 0.48, P = .05). CSAs were significantly lower for those in the intervention versus control at intervention end (incident rate ratio = 0.39, P = .04), although significance was lost once age was added to the analysis (incident rate ratio = 0.58, P = .26). G2G appears promising in increasing adolescent HIV testing rates. Sex-positive intervention messages appear to have increased the participants' comfort with having sex (ie, less abstinence) while not increasing their potential for HIV transmission (ie, more CSAs). Additional content or features may be needed to invigorate condom use. Copyright © 2017 by the American Academy of Pediatrics.

  13. HIV prevention through extended education encompassing students, parents, and teachers in Japan.

    Science.gov (United States)

    Nagamatsu, Miyuki; Sato, Takeshi; Nakagawa, Aki; Saito, Hisako

    2011-11-01

    We developed an extended HIV prevention program for students, parents, and school teachers, and then evaluated its effectiveness. The participants were 490 students, aged 13-14 years, attending four public junior high schools in Saga Prefecture, Japan. They were divided into two groups: control and intervention. All the students received group education by health professionals. In the control group, students received only two group education sessions given by health professionals. In the intervention group, there were three intervention components: parent education, teacher education, and student individual counseling by health professionals. Before and 3 months after the intervention, participants underwent evaluation of their frequency of communication about AIDS with parents or teachers, their knowledge of HIV/AIDS, and attitudes to sexual intercourse, self-esteem, and high-risk behavior. A total of 135 students (80 boys and 55 girls) from the intervention group and 236 students (115 boys and 121 girls) from the control group participated in the evaluation 3 months after intervention. Adolescents in the intervention group showed more positive changes than those in the control group from baseline to follow-up. Intervention had a significant impact on the frequency of communication about AIDS with teachers (p = 0.027) and HIV/AIDS knowledge among females (p = 0.023), and intervention also had a significant impact on refusal of sexual activity by males (p = 0.045). These findings suggest that effective prevention of HIV might be achieved by an expanded education program for students and teachers such as that described, and individual counseling that takes into consideration the sexual differences of Japanese adolescents.

  14. Women and ARV-based HIV prevention – challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Cynthia W Geary

    2014-09-01

    Full Text Available ARV-based HIV prevention methods available in pill, gel or ring formulations (broadly referred to as microbicides offer the possibility of protection against HIV for women who find it difficult because they cannot ask their partners to use condoms or even refuse sex. Partial efficacy of ARV-based medications has been demonstrated in a number of clinical trials around the world among various populations, building the evidence that ARV-based technologies will contribute to reducing the AIDS epidemic worldwide. Disappointing results, however, from two trials in sub-Saharan Africa, where poor adherence contributed to study closure due to futility, have raised questions about whether women at the centre of the epidemic are able to effectively use products that require routine use. Also, there are fears by some of risk compensation by decreased condom use because of the availability of microbicides when only partial efficacy has been demonstrated in microbicide trials to date. Of note, sub-analyses of biologic measures of adherence in trials where this was possible have shown a strong correlation between good adherence and efficacy, reinforcing the necessity of good adherence. Research conducted in conjunction with clinical trials and post-trials in advance of possible rollout of ARV-based products have examined social and cultural factors, gender-related and otherwise, influencing adherence and other aspects of women's use of products. These include HIV stigma, women's perception of risk, partner and community influences and the differing needs of women in various stages of life and in different circumstances. It is the purpose of this supplement to give voice to the needs of women who can benefit from woman-initiated methods by presenting research results and commentary to contribute to the global conversation about optimizing women's experience with ARV-based prevention.

  15. Contraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trial.

    Science.gov (United States)

    Akello, Carolyne A; Bunge, Katherine E; Nakabiito, Clemensia; Mirembe, Brenda G; Fowler, Mary Glenn; Mishra, Anupam; Marrazzo, Jeanne; Chirenje, Zvavahera M; Celum, Connie; Balkus, Jennifer E

    2017-06-01

    Recent HIV prevention trials required use of effective contraceptive methods to fulfill eligibility for enrollment. We compared pregnancy rates in a subset of participants enrolled in the Microbicide Trials Network protocol (MTN-003), a randomized trial of chemoprophylaxis to prevent HIV acquisition among women aged 18-45 years who initiated depot medroxyprogesterone acetate (DMPA) or combined oral contraceptives (COCs) at enrollment, relative to those already using DMPA or COCs. Data were analyzed from MTN-003 participants from Uganda. Before enrollment, information on contraceptive type and initiation date was obtained. Urine pregnancy tests were performed at monthly follow-up visits. Cox proportional hazards models were used to compare pregnancy incidence among new users (initiated ≤60 days before enrollment) and established users (initiated >60 days before enrollment). Of 322 women enrolled, 296 were COC or DMPA users, 82 (28%) were new users, and 214 (72%) were established users. Pregnancy incidence was higher among new contraceptive users compared to established users (20.70% vs. 10.55%; adjusted hazard ratio [HR] = 1.66; 95% confidence interval [95% CI] 0.93-2.96). Among DMPA users, pregnancy incidence was 10.20% in new users versus 3.48% in established users (HR = 2.56; 95% CI 0.86-7.65). Among new COC users, pregnancy incidence was 42.67% in new users versus 23.67% in established COC users (adjusted HR = 1.74; 95% CI 0.87-3.48). New contraceptive users, regardless of method, at the Uganda MTN-003 site had an increased pregnancy risk compared to established users, which may be due to contraceptive initiation primarily for trial eligibility. New users may benefit from intensive contraceptive counseling and additional contraceptive options, including longer acting reversible contraceptives.

  16. The impact of teachers’ modifications of an evidenced-based HIV prevention intervention on program outcomes

    Science.gov (United States)

    Wang, Bo; Stanton, Bonita; Lunn, Sonja; Rolle, Glenda; Poitier, Maxwell; Adderley, Richard; Li, Xiaoming; Koci, Veronica; Deveaux, Lynette

    2015-01-01

    The degree to which evidence-based program outcomes are affected by modifications is a significant concern in the implementation of interventions. The ongoing national implementation of an evidence-based HIV prevention program targeting grade six students in The Bahamas [Focus on Youth in The Caribbean (FOYC)] offers an opportunity to explore factors associated with teachers’ modification of FOYC lessons and to examine the impact of types and degrees of modifications on student outcomes. Data were collected in 2012 from 155 teachers and 3646 students in 77 government elementary schools. Results indicate that teachers taught 16 of 30 core activities, 24.5 of 46 total activities and 4.7 of 8 sessions. Over one-half of the teachers made modifications to FOYC core activities; one-fourth of the teachers modified 25% or more core activities that they taught (heavily modified FOYC). Omitting core activities was the most common content modification, followed by lengthening FOYC lessons with reading, writing assignments or role-play games, shortening core activities or adding educational videos. Mixed-effects modeling revealed that omitting core activities had negative impacts on all four student outcomes. Shortening core activities and adding videos into lessons had negative impacts on HIV/AIDS knowledge and/or intention to use condom protection. Heavy modifications (>1/4 core activities) were associated with diminished program effectiveness. Heavy modifications and omitting or shortening core activities were negatively related to teachers’ level of implementation. We conclude that poorer student outcomes were associated with heavy modifications. PMID:26297497

  17. Cost-threshold analyses of the National AIDS Demonstration Research HIV prevention interventions.

    Science.gov (United States)

    Pinkerton, S D; Holtgrave, D R; DiFranceisco, W; Semaan, S; Coyle, S L; Johnson-Masotti, A P

    2000-06-16

    The goal of the multisite National AIDS Demonstration Research (NADR) program was to reduce the sexual and drug injection-related HIV risks of out-of-treatment injection drug users and their sex partners. Previous analyses have established that the NADR interventions were effective at changing participants' risky behaviors. This study was to determine whether the NADR program also was cost-effective. Data from eight NADR study sites were included in the analysis. A mathematical model was used to translate reported sexual and injection-related behavior changes into an estimate of the number of infections prevented by the NADR interventions and then to calculate the corresponding savings in averted HIV/AIDS medical care costs and quality-adjusted years of life, assuming United States values for these parameters. Because cost data were not collected in the original NADR evaluation, the savings in averted medical care costs were compared with the cost of implementing a similar intervention program for injection drug users. The eight NADR interventions prevented approximately 129 infections among 6629 participants and their partners. Overall, the NADR program would be cost saving (i.e. provide net economic savings) if it cost less than US$2107 per person and would be cost-effective if it cost less than US$10,264 per person. Both of these estimates are considerably larger than the US$273 per person cost of the comparison intervention. There was substantial cross-site variability. The results of this analysis strongly suggest that the NADR interventions were cost-saving overall and were, at the very least, cost-effective at all eight sites. In the United States and other developed counties, investments in HIV-prevention interventions such as these have the potential to save substantial economic resources by averting HIV-related medical care expenses among injection drug users.

  18. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

    Directory of Open Access Journals (Sweden)

    Webster Mavhu

    Full Text Available BACKGROUND: Early infant male circumcision (EIMC is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44 indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised. Willingness was associated with knowledge of HIV and male circumcision. This qualitative study was conducted to better understand this issue. METHODS: In 2010, 24 group discussions were held across Zimbabwe with participants from seven ethnic groups. Additionally, key informant interviews were held with private paediatricians who offer EIMC (n = 2 plus one traditional leader. Discussions were audio-recorded, transcribed, translated into English (where necessary, coded using NVivo 8 and analysed using grounded theory principles. RESULTS: Knowledge of the procedure was poor. Despite this, acceptability of EIMC was high among parents from most ethnic groups. Discussions suggested that fathers would make the ultimate decision regarding EIMC although mothers and extended family can have (often covert influence. Participants' concerns centred on: safety, motive behind free service provision plus handling and disposal of the discarded foreskin. Older men from the dominant traditionally circumcising population strongly opposed EIMC, arguing that it separates circumcision from adolescent initiation, as well as allowing women (mothers to nurse the wound, considered taboo. CONCLUSIONS: EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

  19. A STD/HIV prevention trial among adolescents in managed care.

    Science.gov (United States)

    Boekeloo, B O; Schamus, L A; Simmens, S J; Cheng, T L; O'Connor, K; D'Angelo, L J

    1999-01-01

    To determine if sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection, risk assessment, and education tools provided as part of office-based primary care reduce adolescent risky sexual behaviors. A randomized intervention trial with 3- and 9-month follow-up. Five staff-model managed care sites in Washington, DC (n = 19 pediatricians). Consecutive 12- to 15-year-olds receiving a general health examination; 81% minority. Participation rate = 215/432 (50%). Nine-month follow-up rate = 197/215 (92%). Audiotaped STD risk assessment and education about staying safe (safer = condoms, safest = abstinence). Adolescent-reported sexual intercourse and condom use. More intervention adolescents reported pediatrician discussion on 11/13 sexual topics. Although more vaginal intercourse (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.04-5.84) was reported in the intervention group at 3 months, this was not true of overall sexual intercourse (OR = 1.55, 95% CI =.73-3.32). More sexually active adolescents reported condom use in the intervention group at 3 months (OR = 18.05, 95% CI = 1.27-256.03). At 9 months, there were no group differences in sexual behaviors; however, more signs of STD were reported by the control (7/103) than the intervention group (0/94). STD risk assessment and education tools administered in a single office visit facilitated STD/HIV prevention education. Any impact on sexual activity and condom use was short-lived. Further research is needed to develop brief, office-based sexual risk reduction for young adolescents.

  20. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

    Science.gov (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

    2013-01-01

    multitude of factors. Further analyses using a quasi-experimental design would be useful to programme implementers and policy makers as they face decisions regarding which HIV prevention activities to prioritize.

  1. HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

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    McMahon Tadgh

    2012-11-01

    Full Text Available Abstract Background Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention. Methods We undertook a realist review to answer the research question: ‘How are HIV prevention interventions in high-income countries adapted to suit immigrants’ needs?’ A key goal was to uncover underlying theories or mechanisms operating in behavioural HIV prevention interventions with immigrants, to uncover explanations as how and why they work (or not for particular groups in particular contexts, and thus to refine the underlying theories. The realist review mapped seven initial mechanisms underlying culturally appropriate HIV prevention with immigrants. Evidence from intervention studies and qualitative studies found in systematic searches was then used to test and refine these seven mechanisms. Results Thirty-four intervention studies and 40 qualitative studies contributed to the analysis and synthesis of evidence. The strongest evidence supported the role of ‘consonance’ mechanisms, indicating the pivotal need to incorporate cultural values into the intervention content. Moderate evidence was found to support the role of three other mechanisms – ‘understanding’, ‘specificity’ and ‘embeddedness’ – which indicated that using the language of immigrants, usually the ‘mother tongue’, targeting (in terms

  2. HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

    Science.gov (United States)

    2012-01-01

    Background Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention. Methods We undertook a realist review to answer the research question: ‘How are HIV prevention interventions in high-income countries adapted to suit immigrants’ needs?’ A key goal was to uncover underlying theories or mechanisms operating in behavioural HIV prevention interventions with immigrants, to uncover explanations as how and why they work (or not) for particular groups in particular contexts, and thus to refine the underlying theories. The realist review mapped seven initial mechanisms underlying culturally appropriate HIV prevention with immigrants. Evidence from intervention studies and qualitative studies found in systematic searches was then used to test and refine these seven mechanisms. Results Thirty-four intervention studies and 40 qualitative studies contributed to the analysis and synthesis of evidence. The strongest evidence supported the role of ‘consonance’ mechanisms, indicating the pivotal need to incorporate cultural values into the intervention content. Moderate evidence was found to support the role of three other mechanisms – ‘understanding’, ‘specificity’ and ‘embeddedness’ – which indicated that using the language of immigrants, usually the ‘mother tongue’, targeting (in terms of ethnicity) and the use of

  3. Sharing Information among Various Organizations in Relief Efforts

    National Research Council Canada - National Science Library

    Costur, Gurkan

    2005-01-01

    .... An analysis is presented of the December 2004 Indian Ocean tsunami relief effort; specifically, how different organizations such as the military, United Nations, and non-governmental organizations...

  4. Evidence and the Politics of Deimplementation: The Rise and Decline of the "Counseling and Testing" Paradigm for HIV Prevention at the US Centers for Disease Control and Prevention.

    Science.gov (United States)

    Johns, David Merritt; Bayer, Ronald; Fairchild, Amy L

    2016-03-01

    In situations of scientific uncertainty, public health interventions, such as counseling for HIV infection, sometimes must be implemented before obtaining evidence of efficacy. The history of HIV counseling and testing, which served as the cornerstone of HIV prevention efforts at the US Centers for Disease Control and Prevention (CDC) for a quarter of a century, illustrates the influence of institutional resistance on public health decision making and the challenge of de-implementing well-established programs. In 1985, amid uncertainty about the accuracy of the new test for HIV, public health officials at the Centers for Disease Control and Prevention (CDC) and AIDS activists agreed that counseling should always be provided both before and after testing to ensure that patients were tested voluntarily and understood the meaning of their results. As the "exceptionalist" perspective that framed HIV in the early years began to recede, the purpose of HIV test counseling shifted over the next 30 years from emphasizing consent, to providing information, to encouraging behavioral change. With this increasing emphasis on prevention, HIV test counseling faced mounting doubts about whether it "worked." The CDC finally discontinued its preferred test counseling approach in October 2014. Drawing on key informant interviews with current and former CDC officials, behavioral scientists, AIDS activists, and others, along with archival material, news reports, and scientific and governmental publications, we examined the origins, development, and decline of the CDC's "counseling and testing" paradigm for HIV prevention. Disagreements within the CDC emerged by the 1990s over whether test counseling could be justified on the basis of efficacy and cost. Resistance to the prospect of policy change by supporters of test counseling in the CDC, gay activists for whom counseling carried important ethical and symbolic meanings, and community organizations dependent on federal funding made it

  5. Five Intergovernmental Organizations: A Reference Primer.

    Science.gov (United States)

    Morehead, Joe

    1997-01-01

    Defines international intergovernmental organizations (IGOs) and nongovernmental organizations (NGOs); discusses the General Accounting Office report on selected IGOs; describes the World Health Organization, Pan American Health Organization, International Labor Organization, United Nations Conference on Trade and Development, and the United…

  6. Lack of Sexual Minorities' Rights as a Barrier to HIV Prevention Among Men Who Have Sex with Men and Transgender Women in Asia: A Systematic Review.

    Science.gov (United States)

    Anderson, James E; Kanters, Steve

    2015-03-01

    This study set out to assess the relationship between variation in human rights for sexual minorities in Asian countries and indicators of HIV prevention among men who have sex with men (MSM) and transgender women. To quantitatively measure the relationship between variation in HIV prevention and variation in human rights for sexual minorities, this study developed the Sexual Orientation and Gender Identity (SOGI) Human Rights Index (an original index with scores ranging from 0.0 to 1.0). Subsequently, this study collected 237 epidemiological and behavioral studies from 22 Asian countries and performed a series of meta-analyses in order to calculate national averages for five indicators of HIV prevention: HIV prevalence, inconsistent condom use, recent HIV testing, adequate HIV knowledge, and exposure to HIV prevention services. A change of human rights for sexual minorities from a score of 0.0 to 1.0 as measured by the SOGI Human Rights Index was correlated with a decrease in unprotected anal intercourse by 25.5% (p=0.075), and increases in recent HIV testing by 42.9% (p=0.011), HIV knowledge by 29.5% (p=0.032), and exposure to HIV prevention services by 37.9% (p=0.119). The relationship between HIV prevalence and variation in human rights for sexual minorities was not statistically significant. Our study found correlations between human rights and indicators of HIV prevention, further supporting the need for increased rights among marginalized populations. The paucity of studies from many Asian countries as well as the disparity in how indicators of HIV prevention are measured reveals a need for increased coverage and standardization of MSM serological and behavioral data in order to better inform evidence-based policymaking.

  7. Participation of HIV prevention programs among men who have sex with men in two cities of China—a mixed method study

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    Ma Wei

    2012-10-01

    Full Text Available Abstract Background Although various HIV prevention programs targeting men who have sex with men (MSM are operating in China, whether and how these programs are being utilized is unclear. This study explores participation of HIV prevention programs and influencing factors among MSM in two cities in China. Methods This is a mixed-method study conducted in Beijing and Chongqing. A qualitative study consisting of in-depth interviews with 54 MSM, 11 key informants, and 8 focus group discussions, a cross-sectional survey using respondent-driven sampling among 998 MSM were conducted in 2009 and 2010 respectively to elicit information on MSM’s perception and utilization of HIV prevention programs. Qualitative findings were integrated with quantitative multivariate factors to explain the quantitative findings. Results Fifty-six percent of MSM in Chongqing and 75.1% in Beijing ever participated in at least one type of HIV prevention program (P=0.001. Factors related to participation in HIV prevention programs included age, ethnicity, income, HIV risk perception, living with boyfriend, living in urban area, size of MSM social network, having talked about HIV status with partners, and knowing someone who is HIV positive. Reasons why MSM did not participate in HIV prevention programs included logistical concerns like limited time for participation and distance to services; program content and delivery issues such as perceived low quality services and distrust of providers; and, cultural issues like HIV-related stigma and low risk perception. Conclusions The study shows that there is much room for improvement in reaching MSM in China. HIV prevention programs targeting MSM in China may need to be more comprehensive and incorporate the cultural, logistic and HIV-related needs of the population in order to effectively reach and affect this population’s risk for HIV.

  8. Navigating HIV prevention policy and Islam in Malaysia: contention, compatibility or reconciliation? Findings from in-depth interviews among key stakeholders

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    Sima Barmania

    2016-07-01

    Full Text Available Abstract Background Malaysia is a multicultural society, predominantly composed of a Muslim majority population, where Islam is influential. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as, Intravenous Drug Users (IVDU, sex workers, transgender women and Men who have sex with Men (MSM. The objective of this study is to understand how Islam shapes HIV prevention strategies in Malaysia by interviewing the three key stakeholder groups identified as being influential, namely the Ministry of Health, Religious leaders and People living with HIV. Methods Thirty-Five in depth semi structured interviews were undertaken with religious leaders, Ministry of Health and People living with HIV in the last half of 2013 using purposive sampling. Interviews adhered to a topic guide, were audiotaped, and transcribed verbatim and analyzed using a framework analysis. Results Themes including the importance of Islam to health, stakeholder relationships and opinions on HIV prevention emerged. Islam was seen to play a pivotal role in shaping strategies relating to HIV prevention in Malaysia both directly and indirectly. Stakeholders often held different approaches to HIV prevention, which had to be sensitively considered, with some favouring promotion of Islamic principles, whilst others steering towards a more public health centred approach. Conclusions The study suggests that Islam indeed plays an important role in shaping health policies and strategies related to HIV prevention in Malaysia. Certainly, stakeholders do hold differing viewpoints, such as stances of what constitutes the right approach to HIV prevention. However there are also areas of broad consensus, such as the importance in Islamic tradition to prevent harm and disease, which can be crafted into existing and future HIV prevention strategies in Malaysia, as well as the wider Muslim world.

  9. Experiences in conducting multiple community-based HIV prevention trials among women in KwaZulu-Natal, South Africa

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    Moodley Jothi

    2010-04-01

    Full Text Available Abstract Background South Africa, with its scientific capacity, good infrastructure and high HIV incidence rates, is ideally positioned to conduct large-scale HIV prevention trials. The HIV Prevention Research Unit of the South African Medical Research Council conducted four phase III and one phase IIb trials of women-initiated HIV prevention options in KwaZulu-Natal between 2003 and 2009. A total of 7046 women participated, with HIV prevalence between 25% and 45% and HIV incidence ranging from 4.5-9.1% per year. Unfortunately none of the interventions tested had any impact on reducing the risk of HIV acquisition; however, extremely valuable experience was gained, lessons learned and capacity built, while the communities gained associated benefits. Experience Our experience in conducting these trials ranged from setting up community partnerships to developing clinical research sites and dissemination of trial results. Community engagement included setting up community-based research sites with approval from both political and traditional leaders, and developing community advisory groups to assist with the research process. Community-wide education on HIV/sexually transmitted infection prevention, treatment and care was provided to over 90 000 individuals. Myths and misconceptions were addressed through methods such as anonymous suggestion boxes in clinic waiting areas and intensive education and counselling. Attempts were made to involve male partners to foster support and facilitate recruitment of women. Peer educator programmes were initiated to provide ongoing education and also to facilitate recruitment of women to the trials. Recruitment strategies such as door-to-door recruitment and community group meetings were initiated. Over 90% of women enrolled were retained. Community benefits from the trial included education on HIV prevention, treatment and care and provision of ancillary care (such as Pap smears, reproductive health care and

  10. 'It looks like you just want them when things get rough': civil society perspectives on negative trial results and stakeholder engagement in HIV prevention trials.

    Science.gov (United States)

    Koen, Jennifer; Essack, Zaynab; Slack, Catherine; Lindegger, Graham; Newman, Peter A

    2013-12-01

    Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the global HIV epidemic, CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders in HIV research. This study explored the perspectives of CSO representatives involved in HIV prevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents from South African and international CSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement in HPTs. Interviews were conducted from February-May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively. CSO representatives largely described positive outcomes of recent microbicide and HIV vaccine trial terminations, particularly in South Africa, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time-points, as well as the need for legitimate alternatives to CABs as mechanisms for engagement. Key issues for CSOs in relation to research were also raised. © 2012 John Wiley & Sons Ltd.

  11. HIV prevention while the bulldozers roll: exploring the effect of the demolition of Goa's red-light area.

    Science.gov (United States)

    Shahmanesh, Maryam; Wayal, Sonali; Andrew, Gracy; Patel, Vikram; Cowan, Frances M; Hart, Graham

    2009-08-01

    Interventions targeting sex-workers are pivotal to HIV prevention in India. Community mobilisation is considered by the National AIDS Control Programme to be an integral component of this strategy. Nevertheless societal factors, and specifically policy and legislation around sex-work, are potential barriers to widespread collectivisation and empowerment of sex-workers. Between November 2003 and December 2005 we conducted participatory observation and rapid ethnographic mapping with several hundred brief informant interviews, in addition to 34 semi-structured interviews with key-informants, 16 in-depth interviews with female sex-workers, and 3 focus-group-discussions with clients and mediators. This provides a detailed examination of the demolition of Baina, one of India's large red-light areas, in 2004, and one of the first accounts of the effect of dismantling the red-light area on the organisation of sex-work and sex-workers' sexual risk. The results suggest that the concentrated and homogeneous brothel-based sex-work environment rapidly evolved into heterogeneous, clandestine and dispersed modes of operation. The social context of sex-work that emerged from the dust of the demolition was higher risk and less conducive to HIV prevention. The demolition acted as a negative structural intervention; a catastrophic event that fragmented sex-workers' collective identity and agency and rendered them voiceless and marginalised. The findings suggest that an abolitionist approach to sex-work and legislation or policy that either criminalises this large group of women, or renders them as invisible victims, will increase the stigma and exclusion they experience. For the targeted HIV prevention approaches advocated by the National AIDS Control Programme to be effective, there is a need for legislation and policy that supports sex-workers' agency and self-organisation and enables them to create a safer working environment for themselves.

  12. Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.

    Science.gov (United States)

    Fortune, Thierry; Wright, Erin; Juzang, Ivan; Bull, Sheana

    2010-03-01

    There is abundant evidence of the HIV crisis in the black community, yet African Americans-and African American men in particular-are consistently under-represented in research on HIV prevention. The purpose of this paper is to describe the methods used to recruit and retain young black men in Philadelphia for an HIV prevention intervention. We formed a partnership between community members, Media Education Entertainment (MEE) Productions, Inc., and academic researchers of the Colorado School of Public Health (CSPH). Recognizing the core principles of community-based participatory research (CBPR), face-to-face recruitment was first conducted by MEE with the assistance of their community partners; subsequent enrollment and data collection were conducted over the telephone by staff in Colorado. We enrolled 58% of the young black men recruited, retained 77% of the young men for a follow-up survey at three months, and 65% of the initial enrollees were retained for the six-month follow-up survey. Enrollment staff in Colorado reported initial challenges because of time elapse between recruitment and enrollment as well as participants' unfamiliarity with the enrollment staff. Subsequently, MEE recruitment staff emphasized the telephone area code and specific names of Colorado enrollment staff who would call. Our results demonstrate the importance of the community-academic partnership formed and adherence to the principles of CBPR in carrying out this work. Despite challenges in recruitment of racially and ethnically diverse participants for research, we successfully recruited, enrolled, and retained young black men in an HIV prevention program. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Comprehensive STD/HIV prevention education targeting US adolescents: review of an ethical dilemma and proposed ethical framework.

    Science.gov (United States)

    Brown, E J; Simpson, E M

    2000-07-01

    Adolescents are increasingly at risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. The prolonged latency period, sometimes in excess of five years, and the incubation period of up to 10 years before the manifestation of symptoms, may foster adolescents' false sense of invincibility and denial as they often do not see the devastating effects of the disease in their peers until they are older. In turn, their practice of safer sex may be hindered and thereby contribute to the escalation of this public health crisis among sexually active adolescents. Prevention-focused recommendations were made in the USA as a result of this crisis. Recommendations were made to: (1) include STD/HIV education in the curricula of grades kindergarten to 12; (2) increase to at least 75% the proportion of primary care and mental health professionals who provide age-appropriate STD/HIV prevention counselling to adolescents; and (3) expand HIV prevention services to include age-appropriate HIV education curricula for students in grades 4-12 in 95% of schools. Yet, in the USA, the provision of school-based comprehensive STD/HIV education has been difficult to achieve owing to certain limitations and, in some instances, legal action. These limitations include: limited student access; restricted content; and the implementation of sporadic and/or brief educational programmes. Given these recommendations and the fact that adolescents are acquiring STDs and HIV infections at increasing rates, and despite the limitations and legal actions, do health care professionals not have an ethical obligation to provide adolescents with comprehensive STD/HIV prevention education? This ethical dilemma will be discussed using the ethical decision-making principles of 'autonomy' and 'beneficence', and a decision-making model proposed by Thompson and Thompson, and by Chally and Loric.

  14. An appraisal of female sex work in Nigeria--implications for designing and scaling up HIV prevention programmes.

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    Akudo Ikpeazu

    Full Text Available BACKGROUND: The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs--a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. METHODOLOGY: It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients ("hotspots". In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. RESULTS: Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%, hotels/lodges (29.6%, streets (16.6%, and brothels (14.6%. Furthermore, the population density of FSWs (per thousand adult men across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. CONCLUSION: FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning

  15. Perceptions of vaginal microbicides as an HIV prevention method among health care providers in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Mantell Joanne E

    2007-03-01

    Full Text Available Abstract Background The promise of microbicides as an HIV prevention method will not be realized if not supported by health care providers. They are the primary source of sexual health information for potential users, in both the public and private health sectors. Therefore, the aim of this study was to determine perceptions of vaginal microbicides as a potential HIV prevention method among health care providers in Durban and Hlabisa, South Africa, using a combination of quantitative and qualitative methods. Results During 2004, semi structured interviews with 149 health care providers were conducted. Fifty seven percent of hospital managers, 40% of pharmacists and 35% of nurses possessed some basic knowledge of microbicides, such as the product being used intra-vaginally before sex to prevent HIV infection. The majority of them were positive about microbicides and were willing to counsel users regarding potential use. Providers from both public and private sectors felt that an effective microbicide should be available to all people, regardless of HIV status. Providers felt that the product should be accessed over-the-counter in pharmacies and in retail stores. They also felt a need for potential microbicides to be available free of charge, and packaged with clear instructions. The media was seen by health care providers as being an effective strategy for promoting microbicides. Conclusion Overall, health care providers were very positive about the possible introduction of an effective microbicide for HIV prevention. The findings generated by this study illustrated the need for training health care providers prior to making the product accessible, as well as the importance of addressing the potential barriers to use of the product by women. These are important concerns in the health care community, and this study also served to educate them for the day when research becomes reality.

  16. Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi.

    Science.gov (United States)

    Crittenden, Kathleen S; Kaponda, Chrissie P N; Jere, Diana L; McCreary, Linda L; Norr, Kathleen F

    2015-05-01

    This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more

  17. Voluntary Medical Male Circumcision for HIV Prevention in Swaziland: Modeling the Impact of Age Targeting.

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    Katharine Kripke

    Full Text Available Voluntary medical male circumcision (VMMC for HIV prevention has been a priority for Swaziland since 2009. Initially focusing on men ages 15-49, the Ministry of Health reduced the minimum age for VMMC from 15 to 10 years in 2012, given the existing demand among 10- to 15-year-olds. To understand the implications of focusing VMMC service delivery on specific age groups, the MOH undertook a modeling exercise to inform policy and implementation in 2013-2014.The impact and cost of circumcising specific age groups were assessed using the Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0, a simple compartmental model. We used age-specific HIV incidence from the Swaziland HIV Incidence Measurement Survey (SHIMS. Population, mortality, births, and HIV prevalence were imported from a national Spectrum/Goals model recently updated in consultation with country stakeholders. Baseline male circumcision prevalence was derived from the most recent Swaziland Demographic and Health Survey. The lowest numbers of VMMCs per HIV infection averted are achieved when males ages 15-19, 20-24, 25-29, and 30-34 are circumcised, although the uncertainty bounds for the estimates overlap. Circumcising males ages 25-29 and 20-24 provides the most immediate reduction in HIV incidence. Circumcising males ages 15-19, 20-24, and 25-29 provides the greatest magnitude incidence reduction within 15 years. The lowest cost per HIV infection averted is achieved by circumcising males ages 15-34: $870 U.S. dollars (USD.The potential impact, cost, and cost-effectiveness of VMMC scale-up in Swaziland are not uniform. They vary by the age group of males circumcised. Based on the results of this modeling exercise, the Ministry of Health's Swaziland Male Circumcision Strategic and Operational Plan 2014-2018 adopted an implementation strategy that calls for circumcision to be scaled up to 50% coverage for neonates, 80% among males ages 10-29, and 55% among males ages 30-34.

  18. What constitutes the best sex life for gay and bisexual men? Implications for HIV prevention.

    Science.gov (United States)

    Bourne, Adam; Hammond, Gary; Hickson, Ford; Reid, David; Schmidt, Axel J; Weatherburn, Peter

    2013-11-20

    While a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men (MSM), less attention has been paid to the wider sexual health and well-being of this population. While some community-based organisations aim to support a more holistic sense of sexual well-being there is little evidence to draw on to inform their interventions. The current study sought to explore gay and bisexual men's conceptions of what constitutes the 'best sex'. The EMIS survey of 2010 recruited more than 180,000 respondents from 38 European countries to complete an online questionnaire about sexual health and behaviour. The 12,942 English language, UK-based responses to the open ended question, "What's your idea of the best sex life?" were subjected to a detailed content analysis. A framework was devised to reflect and describe the key themes emerging from the data, which was then used to code all responses to one (or more) of these themes. Further statistical analysis sought to establish if and how responses differed according to key demographic variables. Eight themes emerged that capture the diversity of gay and bisexual men's sexual desires. Most common among responses was a desire for sex within committed relationships, followed by a desire for sex which is emotionally or psychologically connected. Men also expressed a desire for volume and variety in their sexual lives, and for sex that is free from physical, social or psychological harm. Comparative analysis identified that older men were less likely to idealise a relationship or emotional connection, but were more likely to specify the sexual acts or behaviours they wished to engage in. Attending to what men value or aspire to can help ensure interventions are engaging and meaningful to the target population. HIV prevention interventions need to attend to the broad range of sexual desires held by gay and bisexual men in delivery of holistic sexual

  19. Cost-effectiveness of male circumcision for HIV prevention in a South African setting.

    Directory of Open Access Journals (Sweden)

    James G Kahn

    2006-12-01

    -Saharan Africa with high or moderate HIV prevalence among the general population, adult MC is likely to be a cost-effective HIV prevention strategy, even when it has a low coverage. MC generates large net savings after adjustment for averted HIV medical costs.

  20. STD/HIV prevention in Turkey: planning a sequence of interventions.

    Science.gov (United States)

    Aral, S O; Fransen, L

    1995-12-01

    This study was initiated to assess which mix of early STD/HIV prevention interventions would potentially be effective, cost-effective and sustainable in Turkey; and to program an intervention sequence to maximize synergy among the interventions. During rapid assessment we: 1) reviewed past issues of 3 leading newspapers; 2) collected information on TV coverage; 3) interviewed key informants including taxicab drivers, hotel employees, grocery store owners, academicians in public health and law, investigators of STD/HIV and reproductive tract infections, and officials in the ministry of health; 4) reviewed available evidence on STD/HIV morbidity, sexual behavior patterns, migration patterns and same/opposite gender sex trade. We found: 1) discrepancies between decision makers' perceptions and social realities with respect to the epidemiology of sexual behavior and STDs, and the state of public health programs; 2) discrepancies between sexual practices and public expression regarding sexual practices; 3) economic, demographic, and political pressures in Turkey and in surrounding countries for the expansion of prostitution; 4) a sexual double standard and gender specific migration patterns which sustain a high demand for commercial sex; 5) patterns of health care seeking behaviors and provision of STD clinical services which indicate other STDs may play a very important role in spread of HIV infection; 6) an important mass media role in opinion formation; 7) consensual denial of risk for the majority based on beliefs embedded in machismo, nationalism and religion, and a resulting marginalization and externalization of STD/HIV risk; 8) high prevalence of syphilis among both Turkish and immigrant female prostitutes in Istanbul (early latent 8 and 13%; late latent 0 and 4%; previous history 9 and 22%) 9) and high rates of syphilis among male prostitutes (early latent 11%, late latent 21% and previous history 58%). We concluded that interventions should initially include