WorldWideScience

Sample records for hiv-uninfected rwandan women

  1. CCR5 Expression Levels in HIV-Uninfected Women Receiving Hormonal Contraception.

    Science.gov (United States)

    Sciaranghella, Gaia; Wang, Cuiwei; Hu, Haihong; Anastos, Kathryn; Merhi, Zaher; Nowicki, Marek; Stanczyk, Frank Z; Greenblatt, Ruth M; Cohen, Mardge; Golub, Elizabeth T; Watts, D Heather; Alter, Galit; Young, Mary A; Tsibris, Athe M N

    2015-11-01

    Human immunodeficiency virus (HIV) infectivity increases as receptor/coreceptor expression levels increase. We determined peripheral CD4, CCR5, and CXCR4 expression levels in HIV-uninfected women who used depot medroxyprogesterone acetate (DMPA; n = 32), the levonorgestrel-releasing intrauterine device (LNG-IUD; n = 27), oral contraceptive pills (n = 32), or no hormonal contraception (n = 33). The use of LNG-IUD increased the proportion of CD4(+) and CD8(+) T cells that expressed CCR5; increases in the magnitude of T-cell subset CCR5 expression were observed with DMPA and LNG-IUD use (P < .01 for all comparisons). LNG-IUD and, to a lesser extent, DMPA use were associated with increased peripheral T-cell CCR5 expression. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Perinatal Depressive Symptoms in HIV-Infected Versus HIV-Uninfected Women: A Prospective Study from Preconception to Postpartum

    Science.gov (United States)

    Cook, Judith A.; Grey, Dennis D.; Weber, Kathleen; Wells, Christina; Golub, Elizabeth T.; Wright, Rodney L.; Schwartz, Rebecca M.; Goparaju, Lakshmi; Cohan, Deborah; Wilson, Melissa L.; Maki, Pauline M.

    2011-01-01

    Abstract Objective Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women. Methods We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62% African American) from the Women's Interagency HIV Study (WIHS). Results The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44%, HIV-uninfected 50%, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95% confidence interval [CI] 2.67-12.19, ppreconception was marginally significant (OR 3.10, 95% CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95% CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95% CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95% CI 1.06-3.46, p=0.03). Conclusions Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children. PMID:21732738

  3. Antiretroviral Drug Use in a Cohort of HIV-Uninfected Women in the United States: HIV Prevention Trials Network 064.

    Directory of Open Access Journals (Sweden)

    Iris Chen

    Full Text Available Antiretroviral (ARV drug use was analyzed in HIV-uninfected women in an observational cohort study conducted in 10 urban and periurban communities in the United States with high rates of poverty and HIV infection. Plasma samples collected in 2009-2010 were tested for the presence of 16 ARV drugs. ARV drugs were detected in samples from 39 (2% of 1,806 participants: 27/181 (15% in Baltimore, MD and 12/179 (7% in Bronx, NY. The ARV drugs detected included different combinations of non-nucleoside reverse transcriptase inhibitors and protease inhibitors (1-4 drugs/sample. These data were analyzed in the context of self-reported data on ARV drug use. None of the 39 women who had ARV drugs detected reported ARV drug use at any study visit. Further research is needed to evaluate ARV drug use by HIV-uninfected individuals.

  4. The Cervicovaginal Microbiota and Its Associations With Human Papillomavirus Detection in HIV-Infected and HIV-Uninfected Women.

    Science.gov (United States)

    Reimers, Laura L; Mehta, Supriya D; Massad, L Stewart; Burk, Robert D; Xie, Xianhong; Ravel, Jacques; Cohen, Mardge H; Palefsky, Joel M; Weber, Kathleen M; Xue, Xiaonan; Anastos, Kathryn; Minkoff, Howard; Atrio, Jessica; D'Souza, Gypsyamber; Ye, Qian; Colie, Christine; Zolnik, Christine P; Spear, Gregory T; Strickler, Howard D

    2016-11-01

     Bacterial vaginosis (BV) is characterized by low abundance of Lactobacillus species, high pH, and immune cell infiltration and has been associated with an increased risk of human papillomavirus (HPV) infection. We molecularly assessed the cervicovaginal microbiota over time in human immunodeficiency virus (HIV)-infected and HIV-uninfected women to more comprehensively study the HPV-microbiota relationship, controlling for immune status.  16S ribosomal RNA gene amplicon pyrosequencing and HPV DNA testing were conducted annually in serial cervicovaginal lavage specimens obtained over 8-10 years from African American women from Chicago, of whom 22 were HIV uninfected, 22 were HIV infected with a stable CD4+ T-cell count of > 500 cells/mm3, and 20 were HIV infected with progressive immunosuppression. Vaginal pH was serially measured.  The relative abundances of Lactobacillus crispatus and other Lactobacillus species were inversely associated with vaginal pH (all P High (vs low) L. crispatus relative abundance was associated with decreased HPV detection (odds ratio, 0.48; 95% confidence interval, .24-.96; Ptrend = .03) after adjustment for repeated observation and multiple covariates, including pH and study group. However, there were no associations between HPV and the relative abundance of Lactobacillus species as a group, nor with Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii individually.  L. crispatus may have a beneficial effect on the burden of HPV in both HIV-infected and HIV-uninfected women (independent of pH). © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  5. Unintended pregnancy, contraceptive use, and childbearing desires among HIV-infected and HIV-uninfected women in Botswana: across-sectional study.

    Science.gov (United States)

    Mayondi, Gloria K; Wirth, Kathleen; Morroni, Chelsea; Moyo, Sikhulile; Ajibola, Gbolahan; Diseko, Modiegi; Sakoi, Maureen; Magetse, Jane Dipuo; Moabi, Kebaiphe; Leidner, Jean; Makhema, Joseph; Kammerer, Betsy; Lockman, Shahin

    2016-01-16

    Little is known about the impact of knowledge of HIV serostatus on pregnancy intention and contraceptive use in high-HIV-burden southern African settings in the era of widespread antiretroviral treatment availability. We analyzed interview data collected among 473 HIV-uninfected and 468 HIV-infected pregnant and recently postpartum women at two sites in southern Botswana. Participants were interviewed about their knowledge of their HIV status prior to pregnancy, intendedness of the pregnancy, contraceptive use, and future childbearing desires. The median age of the 941 women was 27 years, median lifetime pregnancies was 2, and 416 (44%) of pregnancies were unintended. Among women reporting unintended pregnancy, 36% were not using a contraceptive method prior to conception. Among contraception users, 81% used condoms, 13% oral contraceptives and 5% an injectable contraceptive. In univariable analysis, women with unintended pregnancy had a higher number of previous pregnancies (P = HIV-infected, 48% reported knowing they were HIV-uninfected, and 22% reported not knowing their HIV status prior to conception. In multivariable analysis, women who did not know their HIV status pre-conception were more likely to report their pregnancy as unintended compared to women who knew that they were HIV-uninfected (aOR = 1.7; 95%CI: 1.2-2.5). After controlling for other factors, unintended pregnancy was not associated with knowing one's HIV positive status prior to conception (compared with knowing one's negative HIV status prior to conception). Among women with unintended pregnancy, there was no association between knowing their HIV status and contraceptive use prior to pregnancy in adjusted analyses. Sixty-one percent of women reported not wanting any more children after this pregnancy, with HIV-infected women significantly more likely to report not wanting any more children compared to HIV-uninfected women (aOR = 3.9; 95%CI: 2.6-5.8). The high rates of reported unintended

  6. Placental pathology in HIV infection at term: a comparison with HIV-uninfected women.

    Science.gov (United States)

    Kalk, Emma; Schubert, Pawel; Bettinger, Julie A; Cotton, Mark F; Esser, Monika; Slogrove, Amy; Wright, Colleen A

    2017-05-01

    To describe and correlate placental characteristics from pregnancies in HIV-infected and HIV-negative women with maternal and infant clinical and immunological data. Prospective descriptive study of placentas from term, uncomplicated vaginal births in a cohort of HIV-infected (n = 120) and HIV-negative (n = 103) women in Cape Town, South Africa. Microscopic and macroscopic features were used to determine pathological cluster diagnoses. The majority of HIV-infected women received some form of drug treatment for the prevention of vertical transmission of HIV. Data were analysed using logistic regression. HIV-infected women were older (median [IQR] 27.4 years [24-31] vs. 25.8 [23-30]), more likely to be multiparous (81.7% vs. 71.8%) and had lower CD4 counts (median [IQR] 323.5 cells/ml [235-442] vs. 467 [370-656]). There were no differences in gestational age at first antenatal visit or at delivery. The proportion of specimens with placental lesions was similar in both groups (39.2% vs. 44.7%). Half of all samples were below the tenth percentile expected-weight-for-gestation regardless of HIV status. This was unaffected by adjustment for confounding variables. Maternal vascular malperfusion (MVM) was more frequent in HIV infection (24.2% vs. 12.6%; P = 0.028), an association which strengthened after adjustment (aOR 2.90 [95% confidence interval 1.11-7.57]). Otherwise the frequency of individual diagnoses did not differ between the groups on multivariate analysis. In this cohort of term, uncomplicated pregnant women, few differences were observed between the HIV-infected and uninfected groups apart from MVM. This lesion may underlie the development of hypertensive disorders of pregnancy, which have been observed at higher rates in some HIV-infected women on ART. © 2017 John Wiley & Sons Ltd.

  7. Anthropometric profile of HIV-uninfected and HIV-infected women ...

    African Journals Online (AJOL)

    The women were divided into two age groups, namely 25–34 years (n = 273) and 35–44 years (n = 215). Anthropometric ... Socio-demographic status, health status, dietary intake, level of physical activity, body perception and attitude toward weight control, as well as prevalence and risk of lifestyle diseases were ...

  8. "I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

    Science.gov (United States)

    Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

    2017-11-01

    The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

  9. Seroincidence of 2009 H1N1 infection in HIV-infected and HIV-uninfected women prior to vaccine availability

    Science.gov (United States)

    Althoff, Keri N.; Eichelberger, Maryna; Gange, Stephen J.; Sharp, Gerald B.; Gao, Jin; Glesby, Marshall J.; Young, Mary; Greenblatt, Ruth M.; French, Audrey L.; Villacres, Maria C.; Minkoff, Howard

    2012-01-01

    The 2009 H1N1 pandemic was a unique opportunity to investigate differences in influenza infection using serology by HIV status. Using serial serum specimens collected from 1 April to 30 September 2009 and the prior 2 years from Women’s Interagency HIV study participants, there was no difference in serologic evidence of 2009 H1N1 infection among HIV-infected women with a CD4 cell count at least 350 cells/µl compared with HIV-uninfected women. Owing to evidence showing a greater risk of influenza-related complications, HIV-infected individuals should continue to be a priority group for vaccination. PMID:21505313

  10. Associations between neighborhood characteristics and sexual risk behaviors among HIV-infected and HIV-uninfected women in the southern United States.

    Science.gov (United States)

    Haley, Danielle F; Haardörfer, Regine; Kramer, Michael R; Adimora, Adaora A; Wingood, Gina M; Goswami, Neela D; Rubtsova, Anna; Ludema, Christina; Hickson, DeMarc A; Ramirez, Catalina; Ross, Zev; Bolivar, Hector; Cooper, Hannah L F

    2017-04-01

    Neighborhood characteristics shape sexual risk in HIV-uninfected adults in the United States (US). We assess relationships between census tract characteristics and sexual risk behaviors in a predominantly HIV-infected cohort of women living in the Southern US. This cross-sectional multilevel analysis included data from 737 HIV-infected and HIV-uninfected women enrolled in the Women's Interagency HIV Study. Administrative data captured characteristics of census tracts where women lived; participant-level data were gathered via survey. We used principal components analysis to condense tract-level variables into components: social disorder (e.g., violent crime rate), and social disadvantage (e.g., alcohol outlet density). We used hierarchical generalized linear models to assess relationships between tract-level characteristics and condomless vaginal intercourse, anal intercourse, and condomless anal intercourse. Greater social disorder was associated with less anal intercourse (OR = 0.63, 95% CI = 0.43-0.94) and condomless anal intercourse (OR = 0.49, 95% CI = 0.30-0.80), regardless of HIV status. There were no statistically significant additive or multiplicative interactions between tract characteristics and HIV status. Neighborhood characteristics are associated with sexual risk behaviors among women living in the Southern US, these relationships do not vary by HIV status. Future studies should establish temporality and explore the causal pathways through which neighborhoods influence sexual risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.

    Science.gov (United States)

    McCoy, Sandra I; Buzdugan, Raluca; Ralph, Lauren J; Mushavi, Angela; Mahomva, Agnes; Hakobyan, Anna; Watadzaushe, Constancia; Dirawo, Jeffrey; Cowan, Frances M; Padian, Nancy S

    2014-01-01

    Prevention of unintended pregnancies among women living with HIV infection is a strategy recommended by the World Health Organization for prevention of mother-to-child transmission of HIV (PMTCT). We assessed pregnancy intentions and contraceptive use among HIV-positive and HIV-negative women with a recent pregnancy in Zimbabwe. We analyzed baseline data from the evaluation of Zimbabwe's Accelerated National PMTCT Program. Eligible women were randomly sampled from the catchment areas of 157 health facilities offering PMTCT services in five provinces. Eligible women were ≥16 years old and mothers of infants (alive or deceased) born 9 to 18 months prior to the interview. Participants were interviewed about their HIV status, intendedness of the birth, and contraceptive use. Of 8,797 women, the mean age was 26.7 years, 92.8% were married or had a regular sexual partner, and they had an average of 2.7 lifetime births. Overall, 3,090 (35.1%) reported that their births were unintended; of these women, 1,477 (47.8%) and 1,613 (52.2%) were and were not using a contraceptive method prior to learning that they were pregnant, respectively. Twelve percent of women reported that they were HIV-positive at the time of the survey; women who reported that they were HIV-infected were significantly more likely to report that their pregnancy was unintended compared to women who reported that they were HIV-uninfected (44.9% vs. 33.8%, pHIV status and lack of contraception use prior to pregnancy. Unmet need for family planning and contraceptive failure contribute to unintended pregnancies among women in Zimbabwe. Both HIV-infected and HIV-uninfected women reported unintended pregnancies despite intending to avoid or delay pregnancy, highlighting the need for effective contraceptive methods that align with pregnancy intentions.

  12. High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination.

    Science.gov (United States)

    Mbatha, Joyce N; Taylor, Myra; Kleppa, Elisabeth; Lillebo, Kristine; Galapaththi-Arachchige, Hashini N; Singh, Deepak; Kjetland, Eyrun F; Baay, Marc F D; Mkhize-Kwitshana, Zilungile L

    2017-08-01

    High-risk human papillomavirus (hr-HPV) infections and low-grade squamous intraepithelial lesions occur frequently in young women. The available vaccines cover up to seven hr-HPV genotypes (HPV16, HPV18, HPV31, HPV33, HPV45, HPV52 and HPV58) and two low-risk HPV types (HPV6 and HPV11). The objective of this study was to describe the hr-HPV genotypes present among HIV-uninfected and HIV-infected young women in rural high schools. Cervicovaginal lavages were obtained from sexually active young women recruited from high schools in KwaZulu-Natal (n = 1223). HPV testing was done by the polymerase chain reaction using GP5+/GP6 + primers and enzyme immunoassay. HIV testing was done using rapid test kits. Of the 1223 cervicovaginal lavages, 301 (25%) were positive for hr-HPV. The HPV prevalence was higher in HIV infected (32.20%, 95% CI: 0.27-0.38) than in HIV-uninfected women (22.50%, 95% CI: 0.21-0.26), (p = .001). Similarly, multiple infections were slightly more common in HIV infected (59.32%) than in HIV-uninfected women (53.51%), (p = .37). The nine predominant genotypes in descending order were HPV types 16 (n = 99, 22.10%), 51 (n = 58, 12.91%), 18 (n = 56, 12.50%), 35 (n = 50, 11.10%), 33 (n = 47, 10.82%), 56 (n = 42, 9.31%), 45 (n = 34, 7.60%), 52 (n = 32, 7.14%) and 59 (n = 31, 6.91%). HPV 35, 51, 56 and 59 (40.62%), which are not covered by any vaccine, were among the most prevalent in the schools of KwaZulu-Natal. Four of the most predominant high-risk HPV types in this region are not covered by the new nine-valent HPV vaccine.

  13. Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women.

    Science.gov (United States)

    Rubin, Leah H; Pyra, Maria; Cook, Judith A; Weber, Kathleen M; Cohen, Mardge H; Martin, Eileen; Valcour, Victor; Milam, Joel; Anastos, Kathryn; Young, Mary A; Alden, Christine; Gustafson, Deborah R; Maki, Pauline M

    2016-04-01

    The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17% HIV+, 16% HIV-; p = 0.49) but was associated with lower verbal learning (p learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.

  14. Relationships between neighbourhood characteristics and current STI status among HIV-infected and HIV-uninfected women living in the Southern USA: a cross-sectional multilevel analysis.

    Science.gov (United States)

    Haley, Danielle F; Kramer, Michael R; Adimora, Adaora A; Haardörfer, Regine; Wingood, Gina M; Ludema, Christina; Rubtsova, Anna; Hickson, DeMarc A; Ross, Zev; Golub, Elizabeth; Bolivar, Hector; Cooper, Hannah Lf

    2017-03-07

    Neighbourhood characteristics (eg, high poverty rates) are associated with STIs among HIV-uninfected women in the USA. However, no multilevel analyses investigating the associations between neighbourhood exposures and STIs have explored these relationships among women living with HIV infection. The objectives of this study were to: (1) examine relationships between neighbourhood characteristics and current STI status and (2) investigate whether the magnitudes and directions of these relationships varied by HIV status in a predominantly HIV-infected cohort of women living in the Southern USA. This cross-sectional multilevel analysis tests relationships between census tract characteristics and current STI status using data from 737 women enrolled at the Women's Interagency HIV Study's southern sites (530 HIV-infected and 207 HIV-uninfected women). Administrative data (eg, US Census) described the census tract-level social disorder (eg, violent crime rate) and social disadvantage (eg, alcohol outlet density) where women lived. Participant-level data were gathered via survey. Testing positive for a current STI was defined as a laboratory-confirmed diagnosis of chlamydia, gonorrhoea, trichomoniasis or syphilis. Hierarchical generalised linear models were used to determine relationships between tract-level characteristics and current STI status, and to test whether these relationships varied by HIV status. Eleven per cent of participants tested positive for at least one current STI. Greater tract-level social disorder (OR=1.34, 95% CI 0.99 to 1.87) and social disadvantage (OR=1.34, 95% CI 0.96 to 1.86) were associated with having a current STI. There was no evidence of additive or multiplicative interaction between tract-level characteristics and HIV status. Findings suggest that neighbourhood characteristics may be associated with current STIs among women living in the South, and that relationships do not vary by HIV status. Future research should establish the

  15. Impact of eating probiotic yogurt on colonization by Candida species of the oral and vaginal mucosa in HIV-infected and HIV-uninfected women.

    Science.gov (United States)

    Hu, Haihong; Merenstein, Daniel J; Wang, Cuiwei; Hamilton, Pilar R; Blackmon, Mandy L; Chen, Hui; Calderone, Richard A; Li, Dongmei

    2013-10-01

    Candidiasis in HIV/AIDS patients continues to be a public health problem. Antifungal therapies are not always effective and may result in complications, such as the development of drug-resistant strains of Candida species. This study evaluated the impact of probiotic consumption on Candida colonization of the oral and vaginal mucosa. A pilot study was conducted in 24 women (17 HIV-infected, 7 HIV-uninfected) from the Women's Interagency HIV Study. The women underwent a 60-day initiation period with no probiotic consumption, followed by two 15-day consumption periods, with a different probiotic yogurt (DanActive™ or YoPlus™ yogurt) during each interval. There was a 30-day washout period between the two yogurt consumption periods. Oral and vaginal culture swabs were collected on days 0, 60, 74, and 120. Candida was detected by inoculating each swab in both Sabouraud's dextrose agar with or without chloramphenicol and CHROMagar. Less fungal colonization among women was observed when the women consumed probiotic yogurts (54 % of the women had vaginal fungal colonization during the non-probiotic yogurt consumption period, 29 % during the DanActive™ period, and 38 % during YoPlus™ yogurt consumption period), and HIV-infected women had significantly lower vaginal fungal colonization after they consumed DanActive™ yogurt compared to the non-intervention periods (54 vs 29 %, p = 0.03). These data are promising, but as expected in a small pilot study, there were some significant changes but also some areas where colonization was not changed. This type of conflicting data is supportive of the need for a larger trial to further elucidate the role of probiotic yogurts in fungal growth in HIV-infected women.

  16. Testing domains of the healing experiences in all life stressors questionnaire in a cohort of HIV-infected and HIV-uninfected Chicago women.

    Science.gov (United States)

    Mistretta, Erin G; Sloan, Danetta; BrintzenhofeSzoc, Karlynn; Weber, Kathleen M; Berger, Ann

    2017-01-01

    Patients may deal with issues of spiritual and religious meaning when coping with life-threatening or chronic illness. Researchers at the National Institutes of Health have developed the healing experiences in all life stressors (HEALS) questionnaire, an assessment to determine psychosocial spiritual adjustment to healing. Many measures assess religious and spiritual behavior, but there exists a need to capture the meaning of these factors in the process of healing. The instrument consists of spirituality, religion, interpersonal, and intrapersonal domains. This study explores the preliminary partial validation of the spirituality and religion domains of the HEALS against the Ironson-Woods Spirituality and Religiousness Index (IWSR). The abbreviated HEALS, IWSR, and a measure of depression were completed by 205 human immunodeficiency virus (HIV)-infected and HIV-uninfected women from Chicago as part of the Women's Interagency HIV Study. Total scores on the HEALS and IWSR were correlated using Pearson correlations to examine convergent validity. Total depression scores were analyzed with Pearson correlations to investigate criterion validity. Responses between the abbreviated HEALS and IWSR were highly correlated (r=0.74). Similar to other measures of its kind, scores on the HEALS were associated with depressive symptoms. Women with clinically significant depressive symptoms scored significantly lower on the HEALS than women without. No significant differences were found for race, age, education, or HIV status. This study is an important step in the future validation of the HEALS. Results suggest that the spirituality and religion domains of the HEALS have good construct validity with the IWSR. After further validation, this measure may provide clinicians and researchers with a unique way to assess psychosocial spiritual healing.

  17. Screening for psychological morbidity in HIV-infected and HIV-uninfected pregnant women using community counselors in Zimbabwe.

    Science.gov (United States)

    Stranix-Chibanda, Lynda; Chibanda, Dixon; Chingono, Albert; Montgomery, Elizabeth; Wells, Jennifer; Maldonado, Yvonne; Chipato, Tsungai; Shetty, Avinash K

    2005-12-01

    To examine the prevalence of psychological morbidity in HIV-infected and uninfected pregnant women seeking antenatal care in Zimbabwe. Pregnant women were screened for psychological morbidity at the initial antenatal care visit using the 14-item Shona Symptom Questionnaire (SSQ) before voluntary HIV counseling and testing (VCT). The primary outcome measure was "cases," as determined by a SSQ score of >or= 8. Demographic characteristics and HIV status were compared between cases and noncases to determine the risk factors for psychological morbidity. Of the 437 participants, psychological morbidity was detected in 73 (17%) women before undergoing VCT. Risk factors for psychological morbidity included having a spouse older than 35 years of age. HIV infection by itself was not a risk factor for psychological morbidity for women. There is a high burden of psychological morbidity among pregnant women in Zimbabwe. Mental health services should be integrated into antenatal care to improve psychological health for all women in Zimbabwe.

  18. Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women.

    Science.gov (United States)

    Kuhns, Lisa M; Reisner, Sari L; Mimiaga, Matthew J; Gayles, Travis; Shelendich, Michael; Garofalo, Robert

    2016-07-01

    Transgender women are at high risk of HIV infection, with younger transgender women (YTW) particularly vulnerable. Pre-Exposure Prophylaxis (PrEP) has shown efficacy in reducing HIV acquisition, but little is known about PrEP indication or initiation among YTW. Baseline data from 180 YTW age 18-29 years enrolled in Project LifeSkills, an on-going HIV prevention intervention for YTW, were analyzed to examine factors associated with PrEP indication. The sample (mean age = 23.4, SD = 3.2) was comprised largely of women of color (69 %) and of low socioeconomic status (71 % unemployed). Overall, 62 % met criteria for PrEP indication, but only 5 % reported ever taking PrEP. Factors associated with increased odds of PrEP indication were: PrEP interest (aOR 3.24; 95 % CI 1.44, 7.33), number of recent anal sex partners (aOR 1.23; 95 % CI 1.04, 1.46), and lower collective self-esteem scores (aOR 0.67; 95 % CI 0.47, 0.94). Despite high levels of PrEP indication, there remain low levels of PrEP awareness and uptake among YTW.

  19. Testing domains of the healing experiences in all life stressors questionnaire in a cohort of HIV-infected and HIV-uninfected Chicago women

    Directory of Open Access Journals (Sweden)

    Mistretta EG

    2017-07-01

    Full Text Available Erin G Mistretta,1,2 Danetta Sloan,1 Karlynn BrintzenhofeSzoc,3 Kathleen M Weber,4 Ann Berger1 1Pain and Palliative Care Service, National Institutes of Health, Bethesda, MD, 2Department of Psychology, Catholic University of America, Washington, DC, 3School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, 4HIV Research, Hektoen Institute of Medicine/Cook County Health and Hospitals System, Chicago, IL, USA Purpose: Patients may deal with issues of spiritual and religious meaning when coping with life-threatening or chronic illness. Researchers at the National Institutes of Health have developed the healing experiences in all life stressors (HEALS questionnaire, an assessment to determine psychosocial spiritual adjustment to healing. Many measures assess religious and spiritual behavior, but there exists a need to capture the meaning of these factors in the process of healing. The instrument consists of spirituality, religion, interpersonal, and intrapersonal domains. This study explores the preliminary partial validation of the spirituality and religion domains of the HEALS against the Ironson–Woods Spirituality and Religiousness Index (IWSR.Methods: The abbreviated HEALS, IWSR, and a measure of depression were completed by 205 human immunodeficiency virus (HIV-infected and HIV-uninfected women from Chicago as part of the Women’s Interagency HIV Study. Total scores on the HEALS and IWSR were correlated using Pearson correlations to examine convergent validity. Total depression scores were analyzed with Pearson correlations to investigate criterion validity.Results: Responses between the abbreviated HEALS and IWSR were highly correlated (r=0.74. Similar to other measures of its kind, scores on the HEALS were associated with depressive symptoms. Women with clinically significant depressive symptoms scored significantly lower on the HEALS than women without. No significant differences were found for

  20. Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women: A Prospective Short-Term Study of Antiretroviral Excretion in Breast Milk and Infant Absorption.

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    Kenneth K Mugwanya

    2016-09-01

    Full Text Available As pre-exposure prophylaxis (PrEP becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women.We conducted a prospective short-term, open-label study of daily oral emtricitabine-tenofovir disoproxil fumarate PrEP among 50 HIV-uninfected breastfeeding African mother-infant pairs between 1-24 wk postpartum (ClinicalTrials.gov Identifier: NCT02776748. The primary goal was to quantify the steady-state concentrations of tenofovir and emtricitabine in infant plasma ingested via breastfeeding. PrEP was administered to women through daily directly observed therapy (DOT for ten consecutive days and then discontinued thereafter. Non-fasting peak and trough samples of maternal plasma and breast milk were obtained at drug concentration steady states on days 7 and 10, and a single infant plasma sample was obtained on day 7. Peak blood and breast milk samples were obtained 1-2 h after the maternal DOT PrEP dose, while maternal trough samples were obtained at the end of the PrEP dosing interval (i.e., 23 to 24 h after maternal DOT PrEP dose. Tenofovir and emtricitabine concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS assays. Of the 50 mother-infant pairs enrolled, 48% were ≤12 wk and 52% were 13-24 wk postpartum, and median maternal age was 25 y (interquartile range [IQR] 22-28. During study follow-up, the median (IQR daily reported frequency of infant breastfeeding was 15 times (12 to 18 overall, 16 (14 to 19 for the ≤12 weeks, and 14 (12 to 17 for the 13-24 wk infant age groups. Overall, median (IQR time-averaged peak concentrations in breast milk were 3.2 ng/mL (2.3 to 4.7 for tenofovir and 212.5 ng/mL (140.0 to 405.0 for

  1. Insulin resistance change and antiretroviral therapy exposure in HIV-infected and uninfected Rwandan women: a longitudinal analysis.

    Science.gov (United States)

    Mutimura, Eugene; Hoover, Donald R; Shi, Qiuhu; Dusingize, Jean Claude; Sinayobye, Jean D'Amour; Cohen, Mardge; Anastos, Kathryn

    2015-01-01

    We longitudinally assessed predictors of insulin resistance (IR) change among HIV-uninfected and HIV-infected (ART-initiators and ART-non-initiators) Rwandan women. HIV-infected (HIV+) and uninfected (HIV-) women provided demographic and clinical measures: age, body mass index (BMI) in Kg/(height in meters)2, Fat-Mass (FMI) and Fat-Free-Mass (FFMI) index, fasting serum glucose and insulin. Homeostasis Model Assessment (HOMA) was calculated to estimate IR change over time in log10 transformed HOMA measured at study enrollment or prior to ART initiation in 3 groups: HIV- (n = 194), HIV+ ART-non-initiators (n=95) and HIV+ ART-initiators (n=371). ANCOVA linear regression models of change in log10-HOMA were fit with all models included the first log10 HOMA as a predictor. Mean±SD log10-HOMA was -0.18±0.39 at the 1st and -0.21±0.41 at the 2nd measure, with mean change of 0.03±0.44. In the final model (all women) BMI at 1st HOMA measure (0.014; 95% CI=0.006-0.021 per kg/m2; pchange in BMI from 1st to 2nd measure (0.024; 95% CI=0.013-0.035 per kg/m2; pchange. When restricted to subjects with FMI measures, FMI at 1st HOMA measure (0.020; 95% CI=0.010-0.030 per kg/m2; pchange in FMI from 1st to 2nd measure (0.032; 95% CI=0.020-0.043 per kg/m2; pchange in HOMA. While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time. Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women. Baseline BMI and change in BMI, and in particular fat mass and change in fat mass predicted insulin resistance change over ~3 years in HIV-infected and uninfected Rwandan women. Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

  2. Insulin resistance change and antiretroviral therapy exposure in HIV-infected and uninfected Rwandan women: a longitudinal analysis.

    Directory of Open Access Journals (Sweden)

    Eugene Mutimura

    Full Text Available We longitudinally assessed predictors of insulin resistance (IR change among HIV-uninfected and HIV-infected (ART-initiators and ART-non-initiators Rwandan women.HIV-infected (HIV+ and uninfected (HIV- women provided demographic and clinical measures: age, body mass index (BMI in Kg/(height in meters2, Fat-Mass (FMI and Fat-Free-Mass (FFMI index, fasting serum glucose and insulin. Homeostasis Model Assessment (HOMA was calculated to estimate IR change over time in log10 transformed HOMA measured at study enrollment or prior to ART initiation in 3 groups: HIV- (n = 194, HIV+ ART-non-initiators (n=95 and HIV+ ART-initiators (n=371. ANCOVA linear regression models of change in log10-HOMA were fit with all models included the first log10 HOMA as a predictor.Mean±SD log10-HOMA was -0.18±0.39 at the 1st and -0.21±0.41 at the 2nd measure, with mean change of 0.03±0.44. In the final model (all women BMI at 1st HOMA measure (0.014; 95% CI=0.006-0.021 per kg/m2; p<0.001 and change in BMI from 1st to 2nd measure (0.024; 95% CI=0.013-0.035 per kg/m2; p<0.001 predicted HOMA change. When restricted to subjects with FMI measures, FMI at 1st HOMA measure (0.020; 95% CI=0.010-0.030 per kg/m2; p<0.001 and change in FMI from 1st to 2nd measure (0.032; 95% CI=0.020-0.043 per kg/m2; p<0.0001 predicted change in HOMA. While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time. Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women.Baseline BMI and change in BMI, and in particular fat mass and change in fat mass predicted insulin resistance change over ~3 years in HIV-infected and uninfected Rwandan women. Exposure to specific ART (d4T, AZT, EFV did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

  3. Correlating Pap Smear Results and Colposcopy-Directed Large Loop Excision of the Transformation Zone Histopathology in HIV-Infected and HIV-Uninfected Women: A Case-Control Study in South Africa

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    Louis-J. van Bogaert

    2013-01-01

    Full Text Available Background. In low-resource settings (LRS with high HIV/AIDS and cervical cancer rates, new screening strategies face many logistic hurdles. Since cytology is there to stay, at least in the median-term future, it is important to assess to what extent HIV-HPV coinfection impacts the accuracy of screening methods and strategies. Methods. We audited the correlation between cytological diagnosis of minimal abnormality (CIN1, CIN2+, or cancer and the histological diagnosis of colposcopy-directed large loop excision of the transformation zone of 399 HIV-uninfected controls and 389 HIV-infected cases. Results. The average age at diagnosis of CIN2+ of the cases was 4.2 years younger than controls (. The endpoint used to assess the accuracy of cytology was minimal cytological abnormality (≤CIN1/LGSIL. The sensitivity, specificity, and negative and positive predictive values were 92.7, 18.5, 45.1, and 77.9%, respectively. The overall ratio of discordance/concordance between cytology and histology was similar in both groups. Conclusion. In LRS, where rapid-HPV testing is not yet part of screening algorithms, a cytological diagnosis of minimal abnormality requires visual inspection and treatment of visualized lesions especially in HIV-infected women aged 30 years. The cytological endpoint of accuracy should be set low to avoid false negative smears.

  4. Improvement in posttraumatic stress disorder in postconflict Rwandan women.

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    Cohen, Mardge H; Shi, Qiuhu; Fabri, Mary; Mukanyonga, Henriette; Cai, Xiaotao; Hoover, Donald R; Binagwaho, Agnes; Anastos, Kathryn

    2011-09-01

    Depression and posttraumatic stress disorder (PTSD) are common in developing and postconflict countries. The purpose of this study is to examine longitudinal changes in PTSD in HIV-infected and uninfected Rwandan women who experienced the 1994 genocide. Five hundred thirty-five HIV-positive and 163 HIV-negative Rwandan women in an observational cohort study were followed for 18 months. Data on PTSD symptoms were collected longitudinally by the Harvard Trauma Questionnaire (HTQ) and analyzed in relationship to demographics, HIV status, antiretroviral treatment (ART), and depression. PTSD was defined as a score on the HTQ of ≥2. There was a continuing reduction in HTQ scores at each follow-up visit. The prevalence of PTSD symptoms changed significantly, with 61% of the cohort having PTSD at baseline vs. 24% after 18 months. Women with higher HTQ score were most likely to have improvement in PTSD symptoms (p<0.0001). Higher rate of baseline depressive symptoms (p<0.0001) was associated with less improvement in PTSD symptoms. HIV infection and ART were not found to be consistently related to PTSD improvement. HIV care settings can become an important venue for the identification and treatment of psychiatric problems affecting women with HIV in postconflict and developing countries. Providing opportunities for women with PTSD symptoms to share their history of trauma to trained counselors and addressing depression, poverty, and ongoing violence may contribute to reducing symptoms.

  5. Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women.

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    Cohen, Mardge H; Fabri, Mary; Cai, Xiaotao; Shi, Qiuhu; Hoover, Donald R; Binagwaho, Agnes; Culhane, Melissa A; Mukanyonga, Henriette; Karegeya, Davis Ksahaka; Anastos, Kathryn

    2009-11-01

    During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean > 2) and depressive symptoms (CES-D > or = 16) for 850 women (658 HIV-positive and 192 HIV-negative). PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p = 0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making genocidal rape, and having more PTSD symptoms. The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts < 200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

  6. Effect of HIV infection on body composition and fat distribution in Rwandan women.

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    Mutimura, Eugene; Anastos, Kathryn; Zheng Lin; Cohen, Mardge; Binagwaho, Agnes; Kotler, Donald P

    2010-01-01

    To assess the association of HIV infection with body weight and composition in Rwandan women. Body weight and composition, the latter determined by bioelectrical impedance analysis (BIA) and by anthropometry, were compared in 620 HIV-positive and 211 HIV-negative participants. Associations of HIV with body composition were assessed, and t tests compared the groups. HIV-positive women were younger (-7.0 years, P < .001) and shorter (-2.1 cm, P < .001). Mean body weight, body mass index (BMI), total body fat, and waist-to-hip ratio (WHR) were similar. Mean fat-free mass was 2.5% greater in HIV-negative participants, and 19% of HIV-positive group had BMI <18.5 kg/m(2) versus 26% of the HIV-negative group (P < .05). CD4 counts and body composition were not associated. Malnutrition was common in this cohort of Rwandan women. However, HIV infection was not associated with nutritional status. Factors other than malnutrition may influence quality-of-life outcomes in HIV-infected Rwandan women. Initiatives to improve nutritional status should be population-wide and not restricted to the HIV-infected population.

  7. Incident anal human papillomavirus and human papillomavirus-related sequelae in HIV-infected versus HIV-uninfected adolescents in the United States.

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    Mullins, Tanya L Kowalczyk; Wilson, Craig M; Rudy, Bret J; Sucharew, Heidi; Kahn, Jessica A

    2013-09-01

    Little is known about the incidence of anal human papillomavirus (HPV) infection and related sequelae, as well as factors associated with these outcomes, among adolescents who are HIV infected versus HIV uninfected but at risk. We analyzed the data from a multisite US study, the Reaching for Excellence in Adolescent Care and Health Project. Adolescents aged 12 to 18 years who were behaviorally HIV infected (n = 319) or HIV uninfected but at risk (n = 177) were recruited. Incidence rates for anal HPV, high-risk anal HPV, anogenital warts, and anal dysplasia were calculated using Poisson modeling. Factors associated with these outcomes were examined using Cox proportional hazards modeling. Mean age at entry was 16.8 years; mean (SD) follow-up time for detection of anal HPV was 22.4 (10.8) months. Most participants (76%) were female; 70% were black non-Hispanic. HIV-infected (vs. HIV-uninfected) women had a significantly higher incidence of anal HPV (30 vs. 14 per 100 person-years; P = 0.002), high-risk anal HPV (12 vs. 5.3 per 100 person-years; P = 0.04), and anogenital warts (6.7 vs. 1.6 per 100 person-years; P = 0.002) but not anal dysplasia. Although incidence rates were higher for these outcomes among HIV-infected versus HIV-uninfected men, the differences were not statistically significant. Among women, factors associated with anal HPV and related sequelae differed by HIV status and included biological, behavioral, and HIV-related factors. No factors were associated with outcomes in men. HIV-infected versus HIV-uninfected adolescent women had higher rates of anal HPV and anogenital warts. Because HIV-infected youth are at increased risk of these outcomes, enhanced HPV prevention efforts such as vaccination are warranted for this group.

  8. Comparison of lower genital tract microbiota in HIV-infected and uninfected women from Rwanda and the US.

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    Lorie Benning

    Full Text Available Previous studies have shown that alterations of the bacterial microbiota in the lower female genital tract influence susceptibility to HIV infection and shedding. We assessed geographic differences in types of genital microbiota between HIV-infected and uninfected women from Rwanda and the United States.Genera of lower genital tract bacterial microbiota were identified by high-throughput pyrosequencing of the 16S rRNA gene from 46 US women (36 HIV-infected, 10 HIV-uninfected and 40 Rwandan women (18 HIV-infected, 22 HIV-uninfected with similar proportions of low (0-3 Nugent scores. Species of Lactobacillus were identified by assembling sequences along with reference sequences into phylogenetic trees. Prevalence of genera and Lactobacillus species were compared using Fisher's exact tests.Overall the seven most prevalent genera were Lactobacillus (74%, Prevotella (56%, Gardnerella (55%, Atopobium (42%, Sneathia (37%, Megasphaera (30%, and Parvimonas (26%, observed at similar prevalences comparing Rwandan to US women, except for Megasphaera (20% vs. 39%, p = 0.06. Additionally, Rwandan women had higher frequencies of Mycoplasma (23% vs. 7%, p = 0.06 and Eggerthella (13% vs. 0%, p = 0.02, and lower frequencies of Lachnobacterium (8% vs. 35%, p<0.01 and Allisonella (5% vs. 30%, p<0.01, compared with US women. The prevalence of Mycoplasma was highest (p<0.05 in HIV-infected Rwandan women (39%, compared to HIV-infected US women (6%, HIV-uninfected Rwandan (9% and US (10% women. The most prevalent lactobacillus species in both Rwandan and US women was L. iners (58% vs. 76%, p = 0.11, followed by L. crispatus (28% vs. 30%, p = 0.82, L. jensenii (20% vs. 24%, p = 0.80, L. gasseri (20% vs. 11%, p = 0.37 and L. vaginalis (20% vs. 7%, p = 0.10.We found similar prevalence of most major bacterial genera and Lactobacillus species in Rwandan and US women. Further work will be needed to establish whether observed differences

  9. Childbearing intentions among sexually active HIV-infected and HIV-uninfected female adolescents in South Africa.

    Science.gov (United States)

    Adler, David H; Abar, Beau; Bennie, Thola; Sadeghi, Rokhsanna; Bekker, Linda-Gail

    2017-07-01

    Women of reproductive age account for nearly half of all HIV-infected people worldwide. Childbearing intention among HIV-infected women is complicated by social and reproductive concerns related to their HIV status. We conducted a cross-sectional study of HIV-infected and HIV-uninfected sexually active South African women aged 17 to 21 in order to compare their childbearing intentions and to identify predictors of the desire to have children among women with HIV. We found the rate of childbearing intention to be similarly high among both HIV-infected and HIV-uninfected study participants (80 and 79% respectively, p=0.81). History of previous parity was found to be associated with decreased intention to have children. No difference in childbearing intention was found between HIV-infected women on anti-retroviral therapy (ART) and women not on ART. High rates of childbearing intention among HIV-infected women require integration of reproductive health services with comprehensive HIV/AIDS care in order to mitigate the risks of sexual and vertical transmission of HIV.

  10. HIV-1 specific IgA detected in vaginal secretions of HIV uninfected women participating in a microbicide trial in Southern Africa are primarily directed toward gp120 and gp140 specificities.

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    Kelly E Seaton

    Full Text Available Many participants in microbicide trials remain uninfected despite ongoing exposure to HIV-1. Determining the emergence and nature of mucosal HIV-specific immune responses in such women is important, since these responses may contribute to protection and could provide insight for the rational design of HIV-1 vaccines.We first conducted a pilot study to compare three sampling devices (Dacron swabs, flocked nylon swabs and Merocel sponges for detection of HIV-1-specific IgG and IgA antibodies in vaginal secretions. IgG antibodies from HIV-1-positive women reacted broadly across the full panel of eight HIV-1 envelope (Env antigens tested, whereas IgA antibodies only reacted to the gp41 subunit. No Env-reactive antibodies were detected in the HIV-negative women. The three sampling devices yielded equal HIV-1-specific antibody titers, as well as total IgG and IgA concentrations. We then tested vaginal Dacron swabs archived from 57 HIV seronegative women who participated in a microbicide efficacy trial in Southern Africa (HPTN 035. We detected vaginal IgA antibodies directed at HIV-1 Env gp120/gp140 in six of these women, and at gp41 in another three women, but did not detect Env-specific IgG antibodies in any women.Vaginal secretions of HIV-1 infected women contained IgG reactivity to a broad range of Env antigens and IgA reactivity to gp41. In contrast, Env-binding antibodies in the vaginal secretions of HIV-1 uninfected women participating in the microbicide trial were restricted to the IgA subtype and were mostly directed at HIV-1 gp120/gp140.

  11. Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women.

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    Musiime, Stephenson; Muhairwe, Fred; Rutagengwa, Alfred; Mutimura, Eugene; Anastos, Kathryn; Hoover, Donald R; Qiuhu, Shi; Munyazesa, Elizaphane; Emile, Ivan; Uwineza, Annette; Cowan, Ethan

    2011-01-01

    Scale-up of highly active antiretroviral treatment therapy (HAART) programs in Rwanda has been highly successful but data on adherence is limited. We examined HAART adherence in a large cohort of HIV+ Rwandan women. The Rwanda Women's Interassociation Study Assessment (RWISA) was a prospective cohort study that assessed effectiveness and toxicity of ART. We analyzed patient data 12±3 months after HAART initiation to determine adherence rates in HIV+ women who had initiated HAART. Of the 710 HIV+ women at baseline, 490 (87.2%) initiated HAART. Of these, 6 (1.2%) died within 12 months, 15 others (3.0%) discontinued the study and 80 others (19.0%) remained in RWISA but did not have a post-HAART initiation visit that fell within the 12±3 month time points leaving 389 subjects for analysis. Of these 389, 15 women stopped their medications without being advised to do so by their doctors. Of the remaining 374 persons who reported current HAART use 354 completed the adherence assessment. All women, 354/354, reported 100% adherence to HAART at the post-HAART visit. The high self-reported level of adherence is supported by changes in laboratory measures that are influenced by HAART. The median (interquartile range) CD4 cell count measured within 6 months prior to HAART initiation was 185 (128, 253) compared to 264 (182, 380) cells/mm(3) at the post-HAART visit. Similarly, the median (interquartile range) MCV within 6 months prior to HAART initiation was 88 (83, 93) fL compared to 104 (98, 110) fL at the 12±3 month visit. Self-reported adherence to antiretroviral treatment 12±3 months after initiating therapy was 100% in this cohort of HIV-infected Rwandan women. Future studies should explore country-specific factors that may be contributing to high levels of adherence to HAART in this population.

  12. Sexual behavior and risk practices of HIV positive and HIV negative Rwandan women

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    ADEDIMEJI, Adebola A.; HOOVER, Donald R.; SHI, Qiuhu; GARD, Tracy; MUTIMURA, Eugene; SINAYOBYE, Jean d’Amour; COHEN, Mardge H.; ANASTOS, Kathryn

    2014-01-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75% of participants were HIV positive and ~50% reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents’ age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors. PMID:25488169

  13. Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women.

    Science.gov (United States)

    Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu; Gard, Tracy; Mutimura, Eugene; Sinayobye, Jean d'Amour; Cohen, Mardge H; Anastos, Kathryn

    2015-07-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors.

  14. Association of serum albumin with markers of nutritional status among HIV-infected and uninfected Rwandan women.

    Science.gov (United States)

    Dusingize, Jean-Claude; Hoover, Donald R; Shi, Qiuhu; Mutimura, Eugene; Kiefer, Elizabeth; Cohen, Mardge; Anastos, Kathryn

    2012-01-01

    The objectives of this study are to address if and how albumin can be used as an indication of malnutrition in HIV infected and uninfected Africans. In 2005, 710 HIV-infected and 226 HIV-uninfected women enrolled in a cohort study. Clinical/demographic parameters, CD4 count, albumin, liver transaminases; anthropometric measurements and Bioelectrical Impedance Analysis (BIA) were performed. Malnutrition outcomes were defined as body mass index (BMI), Fat-free mass index (FFMI) and Fat mass index (FMI). Separate linear predictive models including albumin were fit to these outcomes in HIV negative and HIV positive women by CD4 strata (CD4>350,200-350 and HIV-negative and HIV positive women with CD4>350 cells/µl, serum albumin was not significantly associated with BMI, FFMI or FMI. Albumin was significantly associated with all three outcomes (pHIV+ women with CD4 200-350 cells/µl, and highly significant in HIV+ women with CD4HIV+ women with CD4>200. While serum albumin is widely used to indicate nutritional status it did not consistently predict malnutrition outcomes in HIV- women or HIV+ women with higher CD4. This result suggests that albumin may measure end stage disease as well as malnutrition and should not be used as a proxy for nutritional status without further study of its association with validated measures.

  15. Deficit of IgG2 in HIV-positive pregnant women is responsible of inadequate IgG2 levels in their HIV-uninfected children in Malawi.

    Science.gov (United States)

    Baroncelli, Silvia; Galluzzo, Clementina Maria; Liotta, Giuseppe; Andreotti, Mauro; Mancinelli, Sandro; Mphwere, Robert; Bokola, Enok; Amici, Roberta; Marazzi, Maria Cristina; Palombi, Leonardo; Lucaroni, Francesca; Giuliano, Marina

    2018-02-27

    Transplacental passage of IgGs is impaired in HIV + pregnant women, possibly determining an inadequate immunological protection in their children. We aimed to determine the impact of maternal immunological IgG profile and immunoactivation status on the efficiency of transplacental passage of IgG subclasses in HIV + mothers. 16 mother/infants pairs were studied in Malawi. Mothers received antiretroviral therapy (ART) from the third trimester of pregnancy. Determinations of pre-ART levels of maternal sCD14, of IgG subclasses in mothers at delivery and in their 1-month-old infants, were performed using commercial ELISA kits. At delivery, after a median of 10 weeks of ART, 12/16 mothers were hypergammaglobulinemic, with IgG levels (20.5 mg/ml, 95% CI:18.8-26.8) directly correlated to the plasmatic levels of sCD14 (r = 0.640, p = 0.014). IgG1 levels (17.9 mg/ml) accounted for 82% of IgG, IgG3 and IgG4 levels were in the normal range. A profound deficit of IgG2 was observed both in mothers (0.60 mg/ml) and in infants (0.14 mg/ml). Placental transfer ratio (range 0.16-0.42) did not show a selective impairment between the different IgG subclasses. The transplacental passage of all IgG subclasses was decreased in the presence of maternal IgG over 16 mg/ml (significantly for IgG1, p = 0.031) and of high levels of sCD14 (p = 0.063). Transplacental passage was reduced for all IgG subclasses and inversely correlated to high levels of maternal IgGs and to the degree of immunoactivation. The profound depression of IgG2 in mothers suggests that IgG2 neonatal levels mostly reflect the maternal deficit rather than a selective impairment of IgG2 transfer.

  16. HIV-infected Rwandan women have a high frequency of long-term survival.

    Science.gov (United States)

    Peters, Philip J; Karita, Etienne; Kayitenkore, Kayitesi; Meinzen-Derr, Jareen; Kim, Dhong-Jin; Tichacek, Amanda; Allen, Susan A

    2007-11-01

    To evaluate rates of long-term survival in a prospective, longitudinal, closed HIV cohort in Africa between 1986 and 2006. A total of 548 HIV-infected Rwandan women were recruited from prenatal clinics in Kigali and followed at 3-6 month intervals to February 2006. Overall, 401 women (73%) were HIV positive at initial cross-sectional testing in 1986 (seroprevalent cohort) and 147 women (27%) were initially HIV negative but seroconverted during follow-up from 1986 to 1993 (seroincident cohort). Kaplan-Meier survival methods were used to calculate survival times censored in mid-2003. In February 2006, 109 women (20%) remained alive in the cohort. Time to 50% non-genocide mortality was 11.9 years among seroincident women and 8.9 years among seroprevalent women. Smoothed mortality rates increased with duration of follow-up to a peak of 0.12 deaths per person-year at 9.5 years of follow-up but subsequently declined. After 15 years of follow-up (pre-HAART introduction), the survival probability was 36% for seroincident women and 26% for seroprevalent women. Most survivors had virological and immunological evidence of disease progression. The median CD4 cell count of survivors declined from 447 cells/mul in 1998 to 268 cells/mul in 2003. Among survivors, 57 women (52%) met treatment criteria and initiated antiretroviral treatment by 2006. Although median survival times in this cohort were similar to those observed in high-income countries, the rates of long-term survival after 15 years of follow-up were higher than expected. A levelling off of mortality rates during the late stages of follow-up may explain this high rate of long-term survival.

  17. Rwanda's Women and Children: The Long Road to Reconciliation. A Field Report Assessing the Protection and Assistance Needs of Rwandan Women and Children.

    Science.gov (United States)

    Women's Commission for Refugee Women and Children, New York, NY.

    Rwanda faces tremendous challenges as it tries to fight off insurgents, rebuild its infrastructure, reintegrate refugees, and assist genocide survivors. This report details an investigation which assessed the protection and assistance needs of Rwandan women and children. Part 1 of the report contains the executive summary, key findings, and the…

  18. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    Five HIV-infected children (11%) died and four of the deaths were known to be due to nosocomial infection; only one HIV-uninfected child died from severe miliary TB. Conclusion Nosocomial infections occurring in HIV-infected children are a serious cause of morbidity and mortality in children hospitalised for the treatment ...

  19. Mortality and health outcomes in HIV-infected and HIV-uninfected mothers at 18-20 months postpartum in Zomba District, Malawi.

    Directory of Open Access Journals (Sweden)

    Megan Landes

    Full Text Available BACKGROUND: Maternal morbidity and mortality among HIV-infected women is a global concern. This study compared mortality and health outcomes of HIV-infected and HIV-uninfected mothers at 18-20 months postpartum within routine prevention of mother-to-child transmission of HIV (PMTCT services in a rural district in Malawi. METHODS: A retrospective cohort study of mother-child dyads at 18-20 months postpartum in Zomba District. Data on socio-demographic characteristics, service uptake, maternal health outcomes and biometric parameters were collected. RESULTS: 173 HIV-infected and 214 HIV-uninfected mothers were included. HIV-specific cohort mortality at 18-20 months postpartum was 42.4 deaths/1000 person-years; no deaths occurred among HIV-uninfected women. Median time to death was 11 months post-partum (range 3-19. Women ranked their health on a comparative qualitative scale; HIV-infected women perceived their health to be poorer than did HIV-uninfected women (RR 2.4; 95% CI 1.6-3.7. Perceived maternal health status was well correlated with an objective measure of functional status (Karnofsky scale; p<0.001. HIV-infected women were more likely to report minor (RR 3.8; 95% CI 2.3-6.4 and major (RR 6.2; 95% CI 2.2-17.7 signs or symptoms of disease. In multivariable analysis, HIV-infected women remained twice as likely to report poorer health [adjusted OR (aOR 2.3; 95% CI 1.4-3.6], as did women with low BMI (aOR 2.1; 95% CI 1.1-4.0 and scoring lowest on the welfare scale (aOR 2.0; 95% CI 1.1-3.8. CONCLUSIONS: HIV-infected women show increased mortality and morbidity at 18-20 months postpartum. In our rural Malawian operational setting, where there is documented under-application of ART and poor adherence to PMTCT services, these results support attention to optimizing maternal participation in PMTCT programs.

  20. Vitamin D levels and influenza vaccine immunogenicity among HIV-infected and HIV-uninfected adults.

    Science.gov (United States)

    Crum-Cianflone, Nancy F; Won, Seunghyun; Lee, Rachel; Lalani, Tahaniyat; Ganesan, Anuradha; Burgess, Timothy; Agan, Brian K

    2016-09-22

    Vaccination is the most important preventive strategy against influenza, however post-vaccination antibody responses are often inadequate especially among HIV-infected persons. Vitamin D deficiency has been suggested to adversely influence immune responses and is highly prevalent among HIV-infected adults. Therefore, we evaluated the association between 25-hydroxyvitamin D [25(OH)D] levels and post-influenza vaccination responses. We conducted a prospective cohort study evaluating the immunogenicity of monovalent influenza A (H1N1) vaccination among both HIV-infected and HIV-uninfected adults (18-50years of age) during the 2009-2010 influenza season. Antibody titers were evaluated at baseline, day 28, and 6months post-vaccination using hemagluttination inhibition assays. Serum 25(OH)D levels were measured at day 28. Univariate and multivariate regression analyses examined the association between 25(OH)D levels [categorized as <20ng/ml (deficiency) vs. ⩾20ng/ml] with the primary outcome of seroconversion. Secondary outcomes included seroprotection; a ⩾4-fold increase in titers; and geometric mean titers post-vaccination. Analyses were repeated using 25(OH)D levels as a continuous variable. A total of 128 adults [64 HIV-infected (median CD4 count 580cells/mm(3)) and 64 HIV-uninfected] were included. Seroconversion at day 28 post-vaccination was achieved in fewer HIV-infected participants compared with HIV-uninfected participants (56% vs. 74%, p=0.03). Vitamin D deficiency was more prevalent among HIV-infected persons vs. HIV-uninfected persons (25% vs. 17%), although not significantly different (p=0.39). There were no associations found between lower 25(OH)D levels and poorer antibody responses at day 28 or 6months for any of the study outcomes among either HIV-infected or HIV-uninfected adults. Vitamin D deficiency was common among both HIV-infected and HIV-uninfected adults, but lower levels did not predict antibody responses after H1N1 (2009) influenza

  1. Prevalence and determinants of unemployment among ageing HIV-1-infected and HIV-uninfected individuals

    Directory of Open Access Journals (Sweden)

    P Reiss

    2012-11-01

    Full Text Available Purpose of the study: People living with HIV (PLWH appear to be at increased risk for earlier onset of age-associated non-communicable co-morbidity (AANCC and declines in physical and mental capacities, compared to the general population [1]. This earlier onset of AANCC in the setting of HIV infection is likely to negatively affect work participation and quality of life. Present study investigates prevalence and determinants of unemployment among older HIV-1-infected and HIV-uninfected participants of the AGEhIV Cohort Study. Methods: Data were collected (Oct. 2010–Jan. 2012 within the ongoing prospective AGEhIV Cohort Study, recruiting HIV-1-infected patients >45 years from a tertiary care HIV outpatient clinic, and HIV-uninfected Public Health Service attendants, comparable regarding age, gender and ethnicity. Data on socio-demographics, lifestyle, quality of life, AANCC and unemployment were collected, using a self-administered questionnaire and through medical examination. Current analysis was restricted to participants in the working age (45–65 years. Logistic regression analysis was used to study determinants of unemployment. Summary of results: The majority from the first enrolled 277 HIV-1-infected and 251 HIV-uninfected subjects was male (88%, Dutch (76% and homosexual (74%. About 50% was highly educated and the median age was 52 [IQR: 48–57]. Almost all (94% HIV-1-infected individuals were on cART, median time since first ART was 11 years [IQR: 4–15], median time since HIV-diagnosis was 12 years [IQR: 7–18] and they had been diagnosed with more AANCC than HIV-uninfected individuals (p<0.01. Unemployment was higher among HIV-1-infected (36.5% compared to HIV-uninfected participants (21.9% (p<0.01. In multivariate analysis, being HIV-infected (ORadj 2.0 [95% CI: 1.3–3.3], experiencing >2 AANCC (ORadj 3.1 [95% CI: 1.4–6.8], lower physical health status (ORadj 2.0 [95% CI: 1.6–2.6], being unmarried (ORadj 2.1 [95% CI: 1.3

  2. INCIDENCE OF LYMPHOMAS AND OTHER CANCERS IN HIV-INFECTED AND HIV-UNINFECTED PATIENTS WITH HEMOPHILIA

    NARCIS (Netherlands)

    RABKIN, CS; HILGARTNER, MW; HEDBERG, KW; ALEDORT, LM; HATZAKIS, A; EICHINGER, S; EYSTER, ME; WHITE, GC; KESSLER, CM; LEDERMAN, MM; DEMOERLOOSE, P; BRAY, GL; COHEN, AR; ANDES, WA; MANCOJOHNSON, M; SCHRAMM, W; KRONER, BL; BLATTNER, WA; GOEDERT, JJ

    1992-01-01

    Objective. - To determine the types and rates of cancers occurring in excess in the presence of infection with the human immunodeficiency virus type 1 (HIV-1). Design. - Cohort analytic study of HIV-infected and HIV-uninfected subjects followed for up to 12 years. Setting. - Fifteen hemophilia

  3. Lack of definitive severe mitochondrial signs and symptoms among deceased HIV-uninfected and HIV-indeterminate children

    NARCIS (Netherlands)

    Dominguez, K; Bertolli, J; Fowler, M; Peters, [No Value; Ortiz, [No Value; Melville, S; Rakusan, T; Frederick, T; Hsu, H; D'Almada, P; Maldonado, Y; Wilfert, C; Ammann, AJ; Rubinstein, A

    2000-01-01

    Background: In response to recent reports of mitochondrial dysfunction in HIV-uninfected infants exposed to antiretroviral (ARV) prophylaxis., the Perinatal Safety Review Working Group reviewed deaths in five large HIV-exposed perinatal cohorts in the United States to determine if similar cases of

  4. The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors.

    Science.gov (United States)

    Gard, Tracy L; Hoover, Donald R; Shi, Qiuhu; Cohen, Mardge H; Mutimura, Eugene; Adedimeji, Adebola A; Anastos, Kathryn

    2013-10-01

    We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics. Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.

  5. Update on PML: lessons from the HIV uninfected and new insights in pathogenesis and treatment.

    Science.gov (United States)

    Hartman, Elizabeth A; Huang, DeRen

    2008-08-01

    Significant advances in our understanding of progressive multifocal leukoencephalopathy (PML) and its causative agent, JC virus, have been made since PML was first described 50 years ago. However, immune reconstitution remains the only proven, effective therapy in this devastating central nervous system disorder. Early diagnosis and adjustments of immune suppressants and modulator agents are critical in managing PML in HIV-negative patients. This review summarizes recent advances in our understanding of PML in HIV-uninfected patients in oncology, rheumatology, organ transplantation, and idiopathic immune deficiency and in association with novel therapeutics. Brain MRI data from our case series of brain biopsy-proven HIV-negative PML patients indicate the presence of an inflammatory/immune reaction in brain tissues, which was confirmed by immunocytologic analysis. Future studies to better understand PML pathogenesis in HIV-negative individuals may help uncover new potential therapeutic targets and improve PML outcomes.

  6. Clinical outcomes of HIV-exposed, HIV-uninfected children in sub-Saharan Africa.

    Science.gov (United States)

    le Roux, Stanzi M; Abrams, Elaine J; Nguyen, Kelly; Myer, Landon

    2016-07-01

    HIV-exposed but HIV-uninfected (HEU) children are widely considered at increased risk of mortality and morbidity. Recent advances in prevention of mother-to-child HIV transmission (PMTCT) strategies, incorporating life-long universal maternal antiretroviral therapy (ART, "Option B+") with extended breastfeeding, may improve HEU child health substantially. We critically reviewed reports of mortality/morbidity among HEU and HIV-unexposed (HU) children in sub-Saharan Africa. We searched Medline, EMBASE, CINAHL, PsycINFO, Academic Search Premier, Global Health & Psychosocial Instruments databases, conference abstracts, and reference lists for longitudinal studies from sub-Saharan Africa reporting mortality and clinical morbidity among HIV-uninfected children aged ≤10 years, by maternal HIV status. Studies were appraised by Newcastle-Ottawa Scale and ACROBAT-NRSI. Due to substantial heterogeneity of study designs, populations and results (I(2) = 75%), data were not synthesised. We included 37 reports (28 studies, 11 164 HEU children); methodological and reporting quality were variable. Most reports came from settings without universal access to maternal ART (n = 35). Results were conflicting, with some studies indicating increased risk of mortality, hospitalisation and/or under-nutrition among HEU children, while others found no evidence of increased risk. In subanalyses, improved maternal health, ART use and breastfeeding were strongly protective for all outcomes. Only 39% (11/28) of studies adjusted for major confounders. Reports from settings using universal maternal ART with breastfeeding (n = 2) found no differences in growth or development but did not report mortality or infectious morbidity. The existing literature provides little insight into HEU child health under recently adopted PMTCT strategies. There is a need for robust comparative data on HEU and HIV-unexposed child health outcomes under Option B+; optimising breastfeeding practices and increasing

  7. “I think my future will be better than my past”: Examining support group influence on the mental health of HIV-infected Rwandan women

    Science.gov (United States)

    Walstrom, Paige; Operario, Don; Zlotnick, Caron; Mutimura, Eugene; Benekigeri, Chantal; Cohen, Mardge H.

    2017-01-01

    Urgent need exists for improved psychological services among HIV-infected women in post-genocide Rwanda. Psychological problems associated with trauma and sexual violence (i.e. depression, PTSD) place women at increased risk for sexual risk behaviour, low health-seeking behaviour, delay of antiretroviral therapy (ART) and reduced ART-adherence. We explored experiences of HIV-infected Rwandan women attending psychosocial support groups and their narratives about how participation affected their mental health and HIV treatment. Focus group discussions examined why participants attended support groups, whether participants perceived support groups as beneficial to their psychological well-being, influenced ART-adherence, and other influences on health behaviours and attitudes. Rwandan women (aged 18-65) were randomly selected from 10 health clinic-facilitated support groups for HIV-infected trauma survivors in Kigali. Results identified positive psychological and physical changes as well as behaviour changes in relationships with men, which participants attributed to support group attendance. Data showed significant improvement in mental health, ART-adherence and HIV-serostatus disclosure resulting from group attendance. Participants acknowledged limitations of support groups with respect to addressing poverty and hunger. Implementing psychosocial support groups may leverage clinical outcomes and rejuvenate the well-being of HIV-infected women with interpersonal trauma and/or PTSD and depressive symptoms, particularly those from post-conflict countries. PMID:22812728

  8. 'I think my future will be better than my past': examining support group influence on the mental health of HIV-infected Rwandan women.

    Science.gov (United States)

    Walstrom, Paige; Operario, Don; Zlotnick, Caron; Mutimura, Eugene; Benekigeri, Chantal; Cohen, Mardge H

    2013-01-01

    Urgent need exists for improved psychological services among HIV-infected women in post-genocide Rwanda. Psychological problems associated with trauma and sexual violence (i.e., depression, posttraumatic stress disorder [PTSD]) place women at increased risk for sexual risk behaviour, low health-seeking behaviour, delay of antiretroviral therapy (ART) and reduced ART adherence. We explored experiences of HIV-infected Rwandan women attending psychosocial support groups and their narratives about how participation affected their mental health and HIV treatment. Focus group discussions examined participants' reasons for support group attendance, perceived psychological benefit of support groups, influence on ART adherence, and other influences on health behaviors and attitudes. Rwandan women (aged 18-65) were randomly selected from 10 health clinic-facilitated support groups for HIV-infected trauma survivors in Kigali. Results identified positive psychological and physical changes as well as behaviour changes in relationships with men, which participants attributed to support group attendance. Data showed significant improvement in mental health, ART adherence and HIV serostatus disclosure resulting from group attendance. Participants acknowledged limitations of support groups with respect to addressing poverty and hunger. Implementing psychosocial support groups may leverage clinical outcomes and rejuvenate the well-being of HIV-infected women with interpersonal trauma and/or PTSD and depressive symptoms, particularly those from post-conflict countries.

  9. Longitudinal Changes Over 10 Years in Free Testosterone Among HIV-Infected and HIV-Uninfected Men.

    Science.gov (United States)

    Slama, Laurence; Jacobson, Lisa P; Li, Xiuhong; Palella, Frank J; Margolick, Joseph B; Kingsley, Lawrence A; Wiley, Dorothy J; Pialoux, Gilles; Dobs, Adrian S; Brown, Todd T

    2016-01-01

    Aging in males is associated with lower testosterone levels and a decrease in diurnal variation of testosterone secretion. Cross-sectional studies have shown lower than expected testosterone levels among HIV-infected men, but whether age-related changes in serum testosterone differ by HIV serostatus are not known. HIV-infected men from the Multicenter AIDS Cohort Study (MACS), age ≥ 45 years at highly active antiretroviral therapy initiation, who had ≥ 2 samples from the subsequent 10 years, were matched to HIV-uninfected men by age, race, MACS site, and calendar time of samples. Linear mixed-effects regression models were used to determine whether free testosterone (FT) and its rate of change differed by HIV serostatus. One hundred eighty-two HIV-infected and 267 HIV-uninfected men were included, median age: 48.8 years (interquartile range: 45.8-53.4), median numbers of FT measurements per participant 4 (interquartile range: 3-5), 65% were drawn in the adjusted morning (AM). Mean-adjusted FT levels were lower among HIV-infected than HIV-uninfected men in AM samples {-6.1 ng/dL [95% confidence interval (CI): -9.8 to -2.4], P = 0.001}, but not in afternoon samples [-1.7 ng/dL (-6.0 to 2.6), P = 0.441]. The rate of FT decline with age did not differ by HIV serostatus: 9.2 ng/dL (95% CI: -13.4 to -5.0) per 10 years for HIV-infected vs. 7.9 ng/dL (95% CI: -10.2 to -5.5) for HIV-uninfected men, P = 0.578. FT decreased similarly with increasing age regardless of HIV serostatus. The lower AM, but not adjusted afternoon, FT levels among HIV-infected men compared with HIV-uninfected men suggest a loss of diurnal variation in FT levels among HIV-infected men.

  10. Breaking the Silence: Women's Experiences With Sexual Violence During the 1994 Rwandan Genocide

    OpenAIRE

    Hubbard, Jessica Alison

    2007-01-01

    In times of war, women are subjected to sexual abuse that is largely ignored by military organizations, media outlets, and international courts. Existing literature has illustrated how wartime rape was accepted or dismissed in the past, and how today, while this practice continues, international courts are beginning to identify the harm being done to women, making explicit how rape is used as a tool of genocide. In this thesis I argue that wartime rape serves as a means of genocide, a way to ...

  11. Bone mineral density changes among HIV-uninfected young adults in a randomised trial of pre-exposure prophylaxis with tenofovir-emtricitabine or placebo in Botswana.

    Directory of Open Access Journals (Sweden)

    Michael Kasonde

    Full Text Available Tenofovir-emtricitabine (TDF-FTC pre-exposure prophylaxis (PrEP has been found to be effective for prevention of HIV infection in several clinical trials. Two studies of TDF PrEP among men who have sex with men showed slight bone mineral density (BMD loss. We investigated the effect of TDF and the interaction of TDF and hormonal contraception on BMD among HIV-uninfected African men and women.We evaluated the effects on BMD of using daily oral TDF-FTC compared to placebo among heterosexual men and women aged 18-29 years enrolled in the Botswana TDF2 PrEP study. Participants had BMD measurements at baseline and thereafter at 6-month intervals with dual-energy X-ray absorptiometry (DXA scans at the hip, spine, and forearm.A total of 220 participants (108 TDF-FTC, 112 placebo had baseline DXA BMD measurements at three anatomic sites. Fifteen (6.8% participants had low baseline BMD (z-score of 3.0% at any anatomic site at any time after baseline were significantly greater for the TDF-FTC treatment group [34/68 (50.0% TDF-FTC vs. 26/79 (32.9% placebo; p = 0.04]. There was a small but significant difference in the mean percent change in BMD from baseline for TDF-FTC versus placebo at all three sites at month 30 [forearm -0.84% (p = 0.01, spine -1.62% (p = 0.0002, hip -1.51% (p = 0.003].Use of TDF-FTC was associated with a small but statistically significant decrease in BMD at the forearm, hip and lumbar spine. A high percentage (6.8% of healthy Batswana young adults had abnormal baseline BMD Further evaluation is needed of the longer-term use of TDF in HIV-uninfected persons.ClinicalTrials.gov NCT00448669.

  12. Anthropometric profile of HIV-uninfected and HIV-infected women ...

    African Journals Online (AJOL)

    Anthropometric measurements, including height, weight [to calculate the body mass index (BMI)] and waist circumference (WC) were taken. Fat percentage was measured with bioelectrical impedance. HIV status was determined using a microparticle enzyme immunoassay method. Socio-demographic status, health status, ...

  13. Differences in the Nonuse of any Contraception and Use of Specific Contraceptive Methods in HIV Positive and HIV Negative Rwandan Women

    Directory of Open Access Journals (Sweden)

    Adebola A. Adedimeji

    2012-01-01

    Full Text Available Contraception can reduce the dual burden of high fertility and high HIV prevalence in sub-Sahara Africa, but significant barriers remain regarding access and use. We describe factors associated with nonuse of contraception and with use of specific contraceptive methods in HIV positive and HIV negative Rwandan women. Data from 395 HIV-positive and 76 HIV-negative women who desired no pregnancy in the previous 6 months were analyzed using univariate and multivariate logistic regression models to identify clinical and demographic characteristics that predict contraceptive use. Differences in contraceptive methods used were dependent on marital/partner status, partner’s knowledge of a woman’s HIV status, and age. Overall, condoms, abstinence, and hormonal methods were the most used, though differences existed by HIV status. Less than 10% of women both HIV+ and HIV− used no contraception. Important differences exist between HIV-positive and HIV-negative women with regard to contraceptive method use that should be addressed by interventions seeking to improve contraceptive prevalence.

  14. Envisioning human dignity to enhance practice while journeying with Rwandan women: student nurses teaching-learning Parse's theory of humanbecoming.

    Science.gov (United States)

    Oaks, Geneva; Drummond, Susan

    2009-07-01

    California Baptist University School of Nursing opened in September 2006 as the first baccalaureate nursing education program in Riverside, California. Under the direction of Dr. Constance Milton, the curriculum was cocreated using Parse's humanbecoming school of thought as a framework. In August 2008, nursing students traveled to Rwanda where they bore witness to the transformation after the 1994 genocide. Dimensions and processes of Parse's practice methodology-illuminating meaning by explicating what is with languaging, synchronizing rhythms while dwelling with ups and downs in the struggle of connecting-separating, and mobilizing transcendence as moving beyond with the not-yet while transforming- emerged in the students' journaling as lived all-at-once amid reverence that honored the dignity and worth of the Rwandan people.

  15. Epidemiology of respiratory syncytial virus-associated acute lower respiratory tract infection hospitalizations among HIV-infected and HIV-uninfected South African children, 2010-2011.

    Science.gov (United States)

    Moyes, Jocelyn; Cohen, Cheryl; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Walaza, Sibongile; Haffejee, Sumayya; Chhagan, Meera; Naby, Fathima; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Madhi, Shabir A

    2013-12-15

    There are limited data on respiratory syncytial virus (RSV) infection among children in settings with a high prevalence of human immunodeficiency virus (HIV). We studied the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) hospitalizations among HIV-infected and HIV-uninfected children in South Africa. Children aged infection among HIV-infected and uninfected children were examined. The relative risk of hospitalization in HIV-infected and HIV-uninfected children was calculated in 1 site with population denominators. Of 4489 participants, 4293 (96%) were tested for RSV, of whom 1157 (27%) tested positive. With adjustment for age, HIV-infected children had a 3-5-fold increased risk of hospitalization with RSV-associated ALRTI (2010 relative risk, 5.6; [95% confidence interval (CI), 4.5-6.4]; 2011 relative risk, 3.1 [95% CI, 2.6-3.6]). On multivariable analysis, HIV-infected children with RSV-associated ALRTI had higher odds of death (adjusted odds ratio. 31.1; 95% CI, 5.4-179.8) and hospitalization for >5 days (adjusted odds ratio, 4.0; 95% CI, 1.5-10.6) than HIV-uninfected children. HIV-infected children have a higher risk of hospitalization with RSV-associated ALRTI and a poorer outcome than HIV-uninfected children. These children should be targeted for interventions aimed at preventing severe RSV disease.

  16. Evaluating Safer Conception Options for HIV-Serodiscordant Couples (HIV-Infected Female/HIV-Uninfected Male: A Closer Look at Vaginal Insemination

    Directory of Open Access Journals (Sweden)

    Okeoma Mmeje

    2012-01-01

    Full Text Available HIV serodiscordant couples represent at least half of all HIV-affected couples worldwide. Many of these couples have childbearing desires. Safer methods of conception may allow for pregnancy while minimizing the risk of sexual transmission of HIV. In serodiscordant partnerships with an HIV-infected female and HIV-uninfected male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.

  17. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children.

    Science.gov (United States)

    Mazur, Natalie I; Bont, Louis; Cohen, Adam L; Cohen, Cheryl; von Gottberg, Anne; Groome, Michelle J; Hellferscee, Orienka; Klipstein-Grobusch, Kerstin; Mekgoe, Omphile; Naby, Fathima; Moyes, Jocelyn; Tempia, Stefano; Treurnicht, Florette K; Venter, Marietje; Walaza, Sibongile; Wolter, Nicole; Madhi, Shabir A

    2017-02-15

    Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged respiratory illness (SARI) hospitalization conducted in South Africa during February 2009-December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death. Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)-associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39-1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6-7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0-4.5; P = .05) compared with RSV monoinfection. RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.

  18. Sexual violence and girls' performance in Rwandan schools: A case ...

    African Journals Online (AJOL)

    user17

    among girls in Rwandan schools. Literature review. The study began by a desk review about GBV and sexual violence worldwide, in Rwanda and in schools. In total, 58 published and .... roles, societal representation of women, conflicts and humanitarian crises (Cooper, Paluck & Fletcher, 2012). Concerning the relationship ...

  19. Diagnostic accuracy of GeneXpert MTB/RIF in musculoskeletal tuberculosis: High sensitivity in tissue samples of HIV-infected and HIV-uninfected patients

    Directory of Open Access Journals (Sweden)

    M Held

    2017-10-01

    Full Text Available Background. GeneXpert MTB/RIF is useful for the diagnosis of pulmonary TB in adults, but there is limited evidence on its usefulness in extrapulmonary TB. Objectives. To investigate the diagnostic accuracy of GeneXpert MTB/RIF in HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. Methods. A prospective study of patients with suspected musculoskeletal (bone and joint TB was undertaken. The diagnostic accuracy of GeneXpert MTB/RIF was compared with the reference standards of culture and histopathology. Results. A total of 206 biopsies from 201 patients (23% HIV-infected were evaluated. The sensitivity and specificity of GeneXpert MTB/RIF was 92.3% (84/91 and 99.1% (114/115, respectively. GeneXpert MTB/RIF detected 8.8% more cases than culture (84/91 (92.3% v. 76/91 (83.5%, respectively; p=0.069. GeneXpert MTB/RIF also detected all 4 multidrug-resistant TB cases and an additional 2 rifampicin-resistant cases in culture-negative samples. The sensitivity of GeneXpert MTB/RIF in HIV-infected patients was 96.9% (31/32 v. 89.6% (43/48 in HIV-uninfected patients (p=0.225. Conclusion. GeneXpert MTB/RIF is an accurate test for the detection of TB in tissue samples of HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. A positive GeneXpert MTB/RIF result should be regarded as microbiological confirmation of TB.

  20. Diagnostic accuracy of GeneXpert MTB/RIF in musculoskeletal tuberculosis: High sensitivity in tissue samples of HIV-infected and HIV-uninfected patients.

    Science.gov (United States)

    Held, M; Laubscher, M; Workman, L; Zar, H J; Dunn, R

    2017-09-22

    GeneXpert MTB/RIF is useful for the diagnosis of pulmonary TB in adults, but there is limited evidence on its usefulness in extrapulmonary TB. To investigate the diagnostic accuracy of GeneXpert MTB/RIF in HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. A prospective study of patients with suspected musculoskeletal (bone and joint) TB was undertaken. The diagnostic accuracy of GeneXpert MTB/RIF was compared with the reference standards of culture and histopathology. A total of 206 biopsies from 201 patients (23% HIV-infected) were evaluated. The sensitivity and specificity of GeneXpert MTB/RIF was 92.3% (84/91) and 99.1% (114/115), respectively. GeneXpert MTB/RIF detected 8.8% more cases than culture (84/91 (92.3%) v. 76/91 (83.5%), respectively; p=0.069). GeneXpert MTB/RIF also detected all 4 multidrug-resistant TB cases and an additional 2 rifampicin-resistant cases in culture-negative samples. The sensitivity of GeneXpert MTB/RIF in HIV-infected patients was 96.9% (31/32) v. 89.6% (43/48) in HIV-uninfected patients (p=0.225). GeneXpert MTB/RIF is an accurate test for the detection of TB in tissue samples of HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. A positive GeneXpert MTB/RIF result should be regarded as microbiological confirmation of TB.

  1. Prevalence of anal human papillomavirus infection and cytologic abnormalities among HIV-infected and HIV-uninfected men who have sex with men

    Directory of Open Access Journals (Sweden)

    Alessandra Latini

    2014-11-01

    Full Text Available Introduction: Human papillomavirus (HPV is responsible for 85% of anal cancers. Recently, anal cancer incidence has been increasing, particularly in men who have sex with men (MSM. Cytology may be a useful tool for the detection of anal precancerous lesions. We assessed the prevalence and determinants of anal HPV infection and cytologic abnormalities among HIV-infected and -uninfected MSM. Materials and Methods: MSM ≥18-year-old attending an STI clinic in Rome (Italy were enrolled. Anal cytologic samples were collected in PreservCyt (Hologic using a Dacron swab. The Linear Array HPV Genotyping Test (Roche Diagnostics was used for the detection and genotyping of 37 mucosal HPV types. Liquid-based cytological slides were obtained using a ThinPrep2000 processor (Hologic. The morphology of the anal pap-test was classified following the Bethesda 2001 guidelines. Results: We enrolled 180 HIV-infected (median age 41 years, IQR 33–47 and 438 HIV-uninfected MSM (median age 32 years, IQR: 27–39. Most of the individuals were Caucasian (92.2% and 97.0%, respectively. HPV prevalence, both overall (93.3% vs 72.4%, p<.001 and by high-risk (HR HPV types (80.5% vs 56.0%, p<.001, was significantly higher among HIV-infected than HIV-uninfected individuals. HPV-multiple infections were evidenced in 48.2% of the HIV-uninfected and 76.1% of the HIV-infected MSM (p<.001. HPV16 was the most prevalent genotype in both groups (23.3% in HIV-positive and 17.6% in HIV-negative MSM. HPV6 and 84 were the most frequent low-risk types in both cohorts. Anal cytologic abnormalities were found in a significantly higher proportion of HIV-infected MSM (46.1% vs 27.9%, p<.001. H-SILs (high-grade squamous intraepithelial lesions were exclusively observed among the HIV-infected individuals, although at a low prevalence (1.2%. Conclusions: A high prevalence of anal HPV infection and cytologic abnormalities was evidenced in both populations. Nonetheless, HIV-infected MSM showed a

  2. DURABILITY OF ANTIBODY RESPONSES AFTER RECEIPT OF THE MONOVALENT 2009 INFLUENZA A (H1N1) VACCINE AMONG HIV-INFECTED AND HIV-UNINFECTED ADULTS

    Science.gov (United States)

    Crum-Cianflone, Nancy F.; Iverson, Erik; Defang, Gabriel; Blair, Patrick J.; Eberly, Lynn; Maguire, Jason; Ganesan, Anuradha; Faix, Dennis; Duplessis, Christopher; Lalani, Tahaniyat; Whitman, Timothy; Brandt, Carolyn; Macalino, Grace; Millar, Eugene V.; Burgess, Timothy

    2011-01-01

    Background Human immunodeficiency virus (HIV)-infected persons are at risk for severe influenza infections. Although vaccination against the H1N1 pandemic influenza strain is recommended, currently, there are no data on the durability of post-vaccination antibody responses in this population. Methods HIV-infected and HIV-uninfected adults (18–50 years old) received a single dose of monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009H1N1). Antibody levels to the 2009 H1N1 pandemic strain were determined at day 0, day 28, and 6 months by hemagglutination-inhibition assay. A seroprotective response was a post-vaccination titer of ≥1:40 among those with a pre-vaccination level of ≤1:10. Geometric mean titers (GMT) and factors associated with higher levels were also evaluated. Results We studied 127 participants with a median age of 35 (interquartile range (IQR) 28, 42) years. Among the HIV-infected arm (n=63), the median CD4 count was 595 (IQR 476, 819) cells/mm3 and 83% were receiving HAART. Thirty-five percent of all participants had a pre-vaccination level of >1:10. HIV-infected compared to HIV-uninfected adults were less likely to generate a seroprotective response at day 28 (54% vs. 75%, adjusted OR 0.23, p=0.021) or have a durable response at 6 months post-vaccination (28% vs. 56%, adjusted OR 0.19, p=0.005). Additionally, although pre-vaccination GMT were similar in both arms (median 7 vs. 8, p=0.11), the GMT at 6 months was significantly lower among HIV-infected versus HIV-uninfected adults (median 20 vs. 113, p=0.003). Among HIV-infected persons, younger age (p=0.035) and receipt of HAART (p=0.028) were associated with higher GMTs at 6 months. Conclusions Despite vaccination, most HIV-infected adults do not have durable seroprotective antibody responses to the 2009 influenza A (H1N1) virus, and hence may remain vulnerable to infection. In addition to HAART use, more immunogenic vaccines are likely needed for improving protection

  3. Chlamydia trachomatis Infection in HIV-Infected Women: Need for Screening by a Sensitive and Specific Test

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    Sonali Bhattar

    2013-01-01

    Full Text Available Reproductive tract infection (RTIs/sexually transmitted infections (STIs are recognized as a major public health problem, particularly due to their relationship with HIV infection. Early detection and treatment of Chlamydia trachomatis infection (CTI among HIV-infected and HIV-uninfected women may impact heterosexual HIV transmission. A total of 120 participants were enrolled: 30 HIV seropositive women with symptoms of RTIs, 30 HIV seropositive women without symptoms of RTIs, 30 HIV seronegative women with symptoms of RTIs, and 30 HIV seronegative women without symptoms of RTIs. One endocervical swab was collected from all participants and CTI was detected by real-time PCR (COBAS TaqMan CT Test, v2.0. CTI was detected in 4 (6.67% HIV-infected women and in 1 (1.67% HIV-uninfected woman (OR 4.214; 95% CI 0.457–38.865. Vaginal discharge was present in almost half of HIV-infected and HIV-uninfected women; lower abdominal pain was present in 11 (18.3% of HIV-infected and in 9 (15% of HIV-uninfected women. This study showed that CTI is more prevalent among HIV-infected females as compared to HIV-uninfected females. As the use of real-time PCR is not feasible in most hospitals, efforts should be made to develop a simple, sensitive, and specific test to identify women with CTI for prevention of sequelae and HIV transmission.

  4. Decline in bone mass with tenofovir disoproxil fumarate/emtricitabine is associated with hormonal changes in the absence of renal impairment when used by HIV uninfected adolescent boys and young men for HIV pre-exposure

    Science.gov (United States)

    Background. We aimed to define the relative importance of renal and endocrine changes in tenofovir disoproxil fumarate (TDF)-related bone toxicity. Methods. In a study of daily TDF/emtricitabine (FTC) pre-exposure prophylaxis (PrEP) in HIV uninfected young men who have sex with men, we measured ch...

  5. Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study

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    Tegbaru Belete

    2009-10-01

    Full Text Available Abstract Background Toxoplasmosis in immuno-compromised hosts manifests primarily as a life threatening condition, toxoplasmic encephalitis. However, there is scarce information about the magnitude of Toxoplasma gondii infection among HIV-infected people in Ethiopia. This study was, therefore, conducted to determine the sero-prevalence of T. gondii infection among HIV-infected and HIV-uninfected subjects. Findings Sera were collected from people with and without HIV infection for the purpose of studying hepatitis B virus (HBV at St. Paul Hospital, Addis Ababa, Ethiopia from 24 January 2007 to 15 February 2007. Among these sera, the first 330 consecutive sera, 165 from each HIV sero-group, were selected and tested for anti-T. gondii IgG antibodies using Enzyme Linked Immunosorbent Assay. The seroprevalence of Toxoplasma infection was assessed against socio-demographic characteristics, HIV and HBV serostatus and HBV-related risk factors. The overall sero-prevalence of latent T. gondii infection among the study subjects was 90.0%. Toxoplasma infection was observed with respective prevalence of 93.3% and 86.7% among HIV-infected and HIV-uninfected people. Though Toxoplasma infection seems to be influenced by age, gender and HIV serostatus, only HBV serostatus was significantly associated (OR 2.71, CI 1.12 to 6.57 in multivariate logistic regression analysis. Conclusion The seroprevalence of latent T. gondii infection is high and similar by HIV status. Educating people to prevent acquisition of new Toxoplasma infection and minimizing the risk of disease manifestations among HIV-Toxoplasma co-infected individuals is important.

  6. Within and between race differences in lymphocyte, CD4+, CD8+ and neutrophil levels in HIV-uninfected children with or without HIV exposure in Europe and Uganda.

    Science.gov (United States)

    Bunders, Madeleine; Lugada, Eric; Mermin, Jonathan; Downing, Robert; Were, Willy; Thorne, Claire; Newell, Marie-Louise

    2006-09-01

    Racial immuno-haematological differences have been reported in children but to date have not been well quantified. To investigate differences in haemato-immunological markers over age between children born and living in Europe and Uganda. HIV-uninfected children living in Uganda (n = 1633) with cross-sectional data. Black (n = 604) and white children (n = 1355) living in Europe, both with prospective data. The children born in Europe were HIV-uninfected but born to HIV-infected mothers and were included in the European Collaborative Study (ECS). Patterns and levels of total lymphocyte (TLC), CD4+, CD8+ counts and CD4% were visualised by smoothers (a line representing the weighted average of all measurements over age by study group). Differences between groups were quantified using age-standardised Z-scores for individual TLC, CD4+ and CD8+ counts in uni- and multivariate regression models. In infancy, TLC, CD4+ and CD8+ counts were lower in Ugandan than black European children; neutrophil counts were similar. Thereafter, only neutrophil counts were lower in Ugandan children. To assess within-race differences, we compared Z-scores of ECS children born to Ugandan mothers with those of Ugandan children. Levels of all four markers were lower in Ugandan children at all ages. In Ugandan children, CD4+ counts were 0.5985 Z-score (p < 0.001) and neutrophil counts 0.3872 Z-score (p < 0.001) lower than in European children born to Ugandan mothers. There are differences in levels of haemato-immunological markers in children with comparable genetic backgrounds, suggesting that environmental factors such as nutrition and exposure to micro-organisms might have important effects on the developing immune system.

  7. A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam - high prevalence of Cryptococcus neoformans var grubii in the absence of underlying disease

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    Baker Stephen

    2010-07-01

    Full Text Available Abstract Background Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood. We describe a cohort of HIV uninfected Vietnamese patients with cryptococcal meningitis in whom underlying disease is uncommon, and relate presenting features of patients and the characteristics of the infecting species to outcome. Methods A prospective descriptive study of HIV negative patients with cryptococcal meningitis based at the Hospital for Tropical Diseases, Ho Chi Minh City. All patients had comprehensive clinical assessment at baseline, were cared for by a dedicated study team, and were followed up for 2 years. Clinical presentation was compared by infecting isolate and outcome. Results 57 patients were studied. Cryptococcus neoformans var grubii molecular type VN1 caused 70% of infections; C. gattii accounted for the rest. Most patients did not have underlying disease (81%, and the rate of underlying disease did not differ by infecting species. 11 patients died while in-patients (19.3%. Independent predictors of death were age ≥ 60 years and a history of convulsions (odds ratios and 95% confidence intervals 8.7 (1 - 76, and 16.1 (1.6 - 161 respectively. Residual visual impairment was common, affecting 25 of 46 survivors (54.3%. Infecting species did not influence clinical phenotype or outcome. The minimum inhibitory concentrations of flucytosine and amphotericin B were significantly higher for C. neoformans var grubii compared with C. gattii (p Conclusion In HIV uninfected individuals in Vietnam, cryptococcal meningitis occurs predominantly in people with no clear predisposing factor and is most commonly due to C. neoformans var grubii. The rates of mortality and visual loss are high and independent of infecting species. There are detectable differences in susceptibility to commonly used antifungal drugs between species, but the clinical

  8. Rethinking Rwandan Higher Education Assessment System and ...

    African Journals Online (AJOL)

    In recent years, there have been increasing critiques leveled against Rwandan higher education for the quality of its graduates and various attempts have been made to address the problem. It is argued here that the role played by assessment in Rwandan higher education system has not been given sufficient attention in ...

  9. Parasite Clearance and Artemether Pharmacokinetics Parameters Over the Course of Artemether-Lumefantrine Treatment for Malaria in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Ugandan Children.

    Science.gov (United States)

    Kajubi, Richard; Huang, Liusheng; Were, Moses; Kiconco, Sylvia; Li, Fangyong; Marzan, Florence; Gingrich, David; Nyunt, Myaing M; Ssebuliba, Joshua; Mwebaza, Norah; Aweeka, Francesca T; Parikh, Sunil

    2016-10-01

    Artemisinins are primarily responsible for initial parasite clearance. Antimalarial pharmacokinetics (PK), human immunodeficiency virus (HIV) infection, and antiretroviral therapy have been shown to impact treatment outcomes, although their impact on early parasite clearance in children has not been well characterized. Parasite clearance parameters were generated from twice-daily blood smears in HIV-infected and HIV-uninfected Ugandan children treated with artemether-lumefantrine (AL). Artemether and dihydroartemisinin (DHA) area-under-the-curve from 0-8 hours (AUC0-8hr) after the 1st AL dose was compared with AUC0-8hr after the last (6th) dose in a concurrently enrolled cohort. The association between post-1st dose artemisinin AUC0-8hr and parasite clearance was assessed. Parasite clearance was longer in HIV-infected versus HIV-uninfected children (median, 3.5 vs 2.8 hours; P = .003). Artemether AUC0-8hr was 3- to 4-fold lower after the 6th dose versus the 1st dose of AL in HIV-infected children on nevirapine- or lopinavir/ritionavir-based regimens and in HIV-uninfected children (P ≤ .002, 1st vs 6th-dose comparisons). Children on efavirenz exhibited combined post-1st dose artemether/DHA exposure that was significantly lower than those on lopinavir/ritonavir and HIV-uninfected children. Multiple regression analysis supported that the effect of artemether/DHA exposure on parasite clearance was significantly moderated by HIV status. Parasite clearance rates remain rapid in Uganda and were not found to associate with PK exposure. However, significant decreases in artemisinin PK with repeated dosing in nearly all children, coupled with small, but significant increase in parasite clearance half-life in those with HIV, may have important implications for AL efficacy, particularly because reports of artemisinin resistance are increasing.

  10. Cervical Dysplasia and High-Risk Human Papillomavirus Infections among HIV-Infected and HIV-Uninfected Adolescent Females in South Africa

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    David H. Adler

    2014-01-01

    In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytological abnormalities. Comparisons were made using Pearson χ2 and independent-samples t-tests analyses, and associations between demographic and behavioral characteristics and HPV infections were examined. Results. HIV-infected participants were more likely to be infected with any HPV (88.6% versus 48.0%; P<0.001 and with at least one HR-HPV (60.0% versus 24.0%; P=0.001, and to have multiple concurrent HPV infections (68.6% versus 22.0%; P<0.001. HPV 16 and 18 were relatively underrepresented among HR-HPV infections. Abnormal Pap test results were more common among HIV-infected participants (28.8% versus 12.0%; P=0.054. A history of smoking was associated with HR-HPV infection. Conclusions. HIV-infected adolescents have an increased risk of infection with HR-HPV and of Pap test abnormalities. The majority of HR-HPV infections among our participants would not be prevented by the currently available vaccinations against HPV.

  11. Flicien Kabuga, multimillionaire Rwandan businessman, Bosco ...

    African Journals Online (AJOL)

    gerhard

    1002 ... multimillionaire Rwandan businessman, Bosco Ntaganda, military chief of staff of the National Congress for the Defence of the People ... Department of Languages and Culture, Faculty of Military. Science, University of Stellenbosch.

  12. Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women.

    Science.gov (United States)

    Mandala, Wilson L; Gondwe, Esther N; Molyneux, Malcolm E; MacLennan, Jenny M; MacLennan, Calman A

    2017-09-01

    We investigated leukocyte and lymphocyte subsets in HIV-infected or HIV-uninfected, pregnant or non-pregnant Malawian women to explore whether HIV infection and pregnancy may act synergistically to impair cellular immunity. We recruited 54 pregnant and 48 non-pregnant HIV-uninfected women and 24 pregnant and 20 non-pregnant HIV-infected Malawian women. We compared peripheral blood leukocyte and lymphocyte subsets between women in the four groups. Parturient HIV-infected and HIV-uninfected women had more neutrophils (each P<.0001), but fewer lymphocytes (P<.0001; P=.0014) than non-pregnant women. Both groups had fewer total T cells (P<.0001; P=.002) and CD8+ T cells (P<.0001; P=.014) than non-pregnant women. HIV-uninfected parturient women had fewer CD4+ and γδ T cells, B and NK cells (each P<.0001) than non-pregnant women. Lymphocyte subset percentages were not affected by pregnancy. Malawian women at parturition have an increased total white cell count due to neutrophilia and an HIV-unrelated pan-lymphopenia. © 2017 The Author. American Journal of Reproductive Immunology Published by John Wiley & Sons Ltd.

  13. Effect of breastfeeding on immunogenicity of oral live-attenuated human rotavirus vaccine: a randomized trial in HIV-uninfected infants in Soweto, South Africa

    Science.gov (United States)

    Moon, Sung-Sil; Velasquez, Daniel; Jones, Stephanie; Koen, Anthonet; van Niekerk, Nadia; Jiang, Baoming; Parashar, Umesh D; Madhi, Shabir A

    2014-01-01

    Abstract Objective To investigate the effect of abstention from breastfeeding, for an hour before and after each vaccination, on the immune responses of infants to two doses of rotavirus vaccine. Methods In Soweto, South Africa, mother–infant pairs who were uninfected with human immunodeficiency virus (HIV) were enrolled as they presented for the “6-week” immunizations of the infants. Each infant was randomly assigned to Group 1 – in which breastfeeding was deferred for at least 1 h before and after each dose of rotavirus vaccine – or Group 2 – in which unrestricted breastfeeding was encouraged. Enzyme-linked immunosorbent assays were used to evaluate the titres of rotavirus-specific IgA in samples of serum collected from each infant immediately before each vaccine dose and 1 month after the second dose. Among the infants, a fourfold or greater increase in titres of rotavirus-specific IgA following vaccination was considered indicative of seroconversion. Findings The evaluable infants in Group 1 (n = 98) were similar to those in Group 2 (n = 106) in their baseline demographic characteristics and their pre-vaccination titres of anti-rotavirus IgA. After the second vaccine doses, geometric mean titres of anti-rotavirus IgA in the sera of Group-1 infants were similar to those in the sera of Group-2 infants (P = 0.685) and the frequency of seroconversion in the Group-1 infants was similar to that in the Group-2 infants (P = 0.485). Conclusion Among HIV-uninfected South African infants, abstention from breastfeeding for at least 1 h before and after each vaccination dose had no significant effect on the infants’ immune response to a rotavirus vaccine. PMID:24700991

  14. Micronutrient intake of HIV-infected women in Mangaung, Free State ...

    African Journals Online (AJOL)

    Older HIV-infected women had significantly lower intakes of haem iron (p = 0.03), non-haem iron (p = 0.04) and selenium (p = 0.04) than their HIV-uninfected counterparts. Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient ...

  15. Disentangling Contributions of Reproductive Tract Infections to HIV Acquisition in African Women

    NARCIS (Netherlands)

    van de Wijgert, Janneke H. H. M.; Morrison, Charles S.; Brown, Joelle; Kwok, Cynthia; van der Pol, Barbara; Chipato, Tsungai; Byamugisha, Josaphat K.; Padian, Nancy; Salata, Robert A.

    2009-01-01

    Objective: To estimate the effects of reproductive tract infections (RTIs) on HIV acquisition among Zimbabwean and Ugandan women. Methods: A multicenter prospective observational cohort study enrolled 4439 HIV-uninfected women aged 18 to 35 attending family planning clinics in Zimbabwe and Uganda.

  16. Sequential Immunization with gp140 Boosts Immune Responses Primed by Modified Vaccinia Ankara or DNA in HIV-Uninfected South African Participants.

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    Gavin Churchyard

    Full Text Available The safety and immunogenicity of SAAVI DNA-C2 (4 mg IM, SAAVI MVA-C (2.9 x 109 pfu IM and Novartis V2-deleted subtype C gp140 (100 mcg with MF59 adjuvant in various vaccination regimens was evaluated in HIV-uninfected adults in South Africa.Participants at three South African sites were randomized (1:1:1:1 to one of four vaccine regimens: MVA prime, sequential gp140 protein boost (M/M/P/P; concurrent MVA/gp140 (MP/MP; DNA prime, sequential MVA boost (D/D/M/M; DNA prime, concurrent MVA/gp140 boost (D/D/MP/MP or placebo. Peak HIV specific humoral and cellular responses were measured.184 participants were enrolled: 52% were female, all were Black/African, median age was 23 years (range, 18-42 years and 79% completed all vaccinations. 159 participants reported at least one adverse event, 92.5% were mild or moderate. Five, unrelated, serious adverse events were reported. The M/M/P/P and D/D/MP/MP regimens induced the strongest peak neutralizing and binding antibody responses and the greatest CD4+ T-cell responses to Env. All peak neutralizing and binding antibody responses decayed with time. The MVA, but not DNA, prime contributed to the humoral and cellular immune responses. The D/D/M/M regimen was poorly immunogenic overall but did induce modest CD4+ T-cell responses to Gag and Pol. CD8+ T-cell responses to any antigen were low for all regimens.The SAAVI DNA-C2, SAAVI MVA-C and Novartis gp140 with MF59 adjuvant in various combinations were safe and induced neutralizing and binding antibodies and cellular immune responses. Sequential immunization with gp140 boosted immune responses primed by MVA or DNA. The best overall immune responses were seen with the M/M/P/P regimen.ClinicalTrials.gov NCT01418235.

  17. Identification of episomal human papillomavirus and other DNA viruses in cytological anal samples of HIV-uninfected men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Donà

    Full Text Available To date, there have been only few studies that investigated integration of anal Human Papillomavirus (HPV. Most of them were conducted on HIV-infected individuals and mainly analyzed samples from high-grade lesions and invasive cancer. We aimed to investigate HPV physical status in HIV-negative men who have sex with men (MSM with a detectable anal HPV infection, irrespective of the presence of lesions. We also sought to explore the presence of other circular DNA viruses in the anal region. Study participants were attendees of an STI screening program, which were also screened for anal HPV infection and cytological abnormalities. HPV physical status was assessed using multiply-primed RCA. HPV16-positive samples were also analyzed using E2/E6 multiplex PCR, qRT-PCR and APOT assay. RCA and virus-specific PCR were employed to investigate the presence of other DNA viruses. Anal HPV infection was detected in 76.9% of the 230 MSM enrolled. The anal cytological reports were: 129 NILM, 37 ASC-US and 28 L-SIL (36 samples were inadequate for interpretation. HPV physical status was evaluated in the 109 anal specimens that harbored one or two different HPV genotypes. Integration was observed only in one HPV16-positive sample (0.9%, in which integrate-derived viral transcripts of type B were detected. Integration occurred in chromosome 14 q. In 22 of the 53 (41.5% mucosal HPV-negative samples, RCA restriction results would seem to indicate the presence of circular DNA viruses. Indeed, cutaneous HPV (4 samples, MCPyV (5 samples and TTV (4 samples were detected. In conclusion, anal HPV integration was rarely evidenced in HIV-uninfected MSM with no or mild anal cytological abnormalities, although the integration rate may have been underestimated because of the limitations of the employed assays. Other DNA viruses were detected in the anal samples of these individuals, although the significance of this occurrence needs to be assessed.

  18. Placental malaria among HIV-infected and uninfected women receiving anti-folates in a high transmission area of Uganda

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    Dorsey Grant

    2009-11-01

    Full Text Available Abstract Background HIV infection increases the risk of placental malaria, which is associated with poor maternal and infant outcomes. Recommendations in Uganda are for HIV-infected pregnant women to receive daily trimethoprim-sulphamethoxazole (TS and HIV-uninfected women to receive intermittent sulphadoxine-pyrimethamine (SP. TS decreases the risk of malaria in HIV-infected adults and children but has not been evaluated among pregnant women. Methods This was a cross sectional study comparing the prevalence of placental malaria between HIV-infected women prescribed TS and HIV-uninfected women prescribed intermittent preventive therapy with sulphadoxine-pyrimethamine (IPT-SP in a high malaria transmission area in Uganda. Placental blood was evaluated for malaria using smear and PCR. Results Placentas were obtained from 150 HIV-infected women on TS and 336 HIV-uninfected women on IPT-SP. The proportion of HIV-infected and HIV-uninfected women with placental malaria was 19% vs. 26% for those positive by PCR and 6% vs. 9% for those positive by smear, respectively. Among all infants, smear+ placental malaria was most predictive of low birth weight (LBW. Primigravidae were at higher risk than multigravidae of having placental malaria among HIV-uninfected, but not HIV-infected, women. Adjusting for gravidity, age, and season at the time of delivery, HIV-infected women on TS were not at increased risk for placental malaria compared to HIV-uninfected women on IPT-SP, regardless of the definition used. Conclusion Prevalence of placental malaria was similar in HIV-infected women on TS and HIV-uninfected women on IPT-SP. Nonetheless, while nearly all of the women in this study were prescribed anti-folates, the overall risk of placental malaria and LBW was unacceptably high. The population attributable risk of placental malaria on LBW was substantial, suggesting that future interventions that further diminish the risk of placental malaria may have a

  19. Religion and the Rwandan genocide

    Directory of Open Access Journals (Sweden)

    Gerard van’t Spijker

    2006-01-01

    Full Text Available This article discusses the problems concerning the relation of religion and the genocide in Rwanda in 1990. One of the most urgent questions – formulated as an accusation by the present political regime in Rwanda – is whether religion and the influence of the churches and church leaders have, in fact, fuelled the genocide, or even was Christian missionary activity the ultimate cause of the genocide? In the broader circles of the present regime that articulate public opinion, it is argued that the presence of Christianity, more precisely the activities of the Roman Catholic Church, has not only contrib­uted to the possibility of the genocide, but has been at the root of the political constellation that led to the genocide, and that during the genocide, Church leaders were actively involved in it. In many documents, it is argued that the Rwandan genocide would never have taken place, if Christian mis­sions, particularly those of the Roman Catholic Church, had not been estab­lished in Rwanda. Related to this is the question of how the religious change after the genocide is to be interpreted, since in fact, after 1994, many new Christian communities have been founded, and a striking growth of Islam may be noticed.

  20. Rwandan grade 6 mathematics teachers' knowledge

    African Journals Online (AJOL)

    owner

    measure two types of teachers' knowledge, i.e. Content Knowledge (CK) and Pedagogical Content Knowledge (PCK) of Rwandan grade six mathematics teachers. 7 Kinyarwanda is a language spoken in Rwanda, one of the countries situated in East Africa. We would like to notify that it is the mother tongue of the first author ...

  1. Rethinking Rwandan higher education assessment system and ...

    African Journals Online (AJOL)

    Annestar

    Research suggests that assessment plays a major role in what and how students learn. Assessments explicitly designed to promote learning lead to complex learning achievements that are widely deemed critical in the 21st century. However, there are indications that Rwandan higher education assessment system has ...

  2. Incident Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Men Who Have Sex With Men From Pre-HAART to HAART Periods: A Cohort Study.

    Science.gov (United States)

    Falade-Nwulia, Oluwaseun; Seaberg, Eric C; Snider, Anna E; Rinaldo, Charles R; Phair, John; Witt, Mallory D; Thio, Chloe L

    2015-11-03

    Men who have sex with men (MSM) are at high risk for hepatitis B virus (HBV) infection. Data on the effect of highly active antiretroviral therapy (HAART) on incident HBV infection in HIV-infected and HIV-uninfected MSM are limited. To determine predictors of incident HBV infection in MSM during pre-HAART and HAART periods. Observational cohort study. Cohort of MSM who have, or are at risk for, HIV infection. 2375 HBV-uninfected MSM in the Multicenter AIDS Cohort Study. Poisson regression was used to compare incidence rates of HBV infection in the pre-HAART and HAART eras and to identify factors associated with incidence of HBV infection. In 25,322 person-years of follow-up, 244 incident HBV infections occurred. The unadjusted incidence rate was higher in HIV-infected MSM than in HIV-uninfected MSM (incidence rate ratio [IRR], 1.9 [95% CI, 1.5 to 2.4]) and was significantly lower in the HAART era than in the pre-HAART era among HIV-infected (IRR, 0.2 [CI, 0.1 to 0.4]) and HIV-uninfected (IRR, 0.3 [CI, 0.2 to 0.4]) MSM. Age younger than 40 years (IRR, 2.3 [CI, 1.7 to 3.0]), more than 1 recent sexual partner (IRR, 3.1 [CI, 2.3 to 4.2]), and HIV infection (IRR, 2.4 [CI, 1.8 to 3.1]) were independently associated with higher incidence of HBV infection, whereas HBV vaccination was protective (IRR, 0.3 [CI, 0.2 to 0.4]). Highly active antiretroviral therapy with HIV RNA levels less than 400 copies/mL was associated with protection (IRR, 0.2 [CI, 0.1 to 0.5]), but HAART in those with HIV RNA levels of 400 copies/mL or greater was not. The observational nature limits inferences about causality. Effective HAART is associated with lower incidence of HBV infection; however, even in the HAART era, incidence of HBV infection remains high among MSM. National Institute of Allergy and Infectious Diseases.

  3. The Amagugu Intervention: A Conceptual Framework for Increasing HIV Disclosure and Parent-Led Communication about Health among HIV-Infected Parents with HIV-Uninfected Primary School-Aged Children.

    Science.gov (United States)

    Rochat, Tamsen J; Mitchell, Joanie; Stein, Alan; Mkwanazi, Ntombizodumo Brilliant; Bland, Ruth M

    2016-01-01

    Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalization, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counselors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement, and custody planning. An uncontrolled pre-post-evaluation study with 281 families showed that the intervention was feasible, acceptable, and effective in increasing maternal disclosure. The aim of this paper is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms, and activities; and to present a summary of results from the large-scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The

  4. The Amagugu Intervention: A conceptual framework for increasing HIV disclosure and parent-led communication about health and HIV prevention among HIV-infected parents with HIV-uninfected primary school-aged children

    Directory of Open Access Journals (Sweden)

    Tamsen Jean Rochat

    2016-08-01

    Full Text Available Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalisation, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counsellors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement and custody planning. An uncontrolled pre-post evaluation study with 281 families showed the intervention was feasible, acceptable and effective in increasing maternal disclosure. The aim of this manuscript is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms and activities; and to present a summary of results from the large scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for

  5. Testing domains of the healing experiences in all life stressors questionnaire in a cohort of HIV-infected and HIV-uninfected Chicago women

    OpenAIRE

    Mistretta, Erin G; Sloan, Danetta; BrintzenhofeSzoc, Karlynn; Weber, Kathleen M; Berger, Ann

    2017-01-01

    Erin G Mistretta,1,2 Danetta Sloan,1 Karlynn BrintzenhofeSzoc,3 Kathleen M Weber,4 Ann Berger1 1Pain and Palliative Care Service, National Institutes of Health, Bethesda, MD, 2Department of Psychology, Catholic University of America, Washington, DC, 3School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, 4HIV Research, Hektoen Institute of Medicine/Cook County Health and Hospitals System, Chicago, IL, USA Purpose: Patients may deal with issues of s...

  6. Surviving Genocide, Thriving in Politics: Rwandan Women’s Power

    Directory of Open Access Journals (Sweden)

    Gerise Herndon

    2013-03-01

    Full Text Available Rwandan women have given their nation new status as a world leader in gender equality, having achieved a 56 percent majority in Parliament. Women have reached this level of political power for many reasons, including the current government’s political will and women parliamentarians’ conscious decision to emphasize pre-colonial traditions of leadership as an alternative to prevailing patriarchal notions of women’s capacity. Highlighting women’s historical roles as behind-the-scenes advisors effectively promoted gender equality in the public sphere. Not only have women in Parliament taken leadership in promoting laws that protect women against gender-based violence, but also civil society organizations have participated in rebuilding and unifying the country following the trauma of horrific sexual violence and killing during the 1994 genocide. Interviews conducted in Kigali and Butare in 2009 and 2010 inform this study of perceptions of women’s power at the parliamentary and the grassroots levels. Women’s visibility in national government has not immediately translated into empowerment in the home, in agriculture, in the office or in social life. Formal education is key to providing girls and women the tools to analyze and dismantle remaining obstacles to gender equality in the professional, social and private spheres, building on their political achievement.

  7. Rwandan young people's perceptions on sexuality and relationships ...

    African Journals Online (AJOL)

    This study aimed to gain more insight into young Rwandans' perceptions on sex and relationships, which is essential for formulating effective sexual and reproductive health (SRH) promotion interventions. Using a 'mailbox technique', this paper studies the spontaneous thoughts of Rwandan young people on sexuality.

  8. Exclusive breastfeeding, diarrhoeal morbidity and all-cause mortality in infants of HIV-infected and HIV uninfected mothers: an intervention cohort study in KwaZulu Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Nigel C Rollins

    Full Text Available INTRODUCTION: Antiretroviral drug interventions significantly reduce the risk of HIV transmission to infants through breastfeeding. We report diarrhoea prevalence and all-cause mortality at 12 months of age according to infant feeding practices, among infants born to HIV-infected and uninfected mothers in South Africa. METHODS: A non-randomised intervention cohort study that followed both HIV-infected and HIV-uninfected mothers and their infants until 18 months of age. Mothers were supported in their infant feeding choice. Detailed morbidity and vital status data were collected over the first year. At the time, only single dose nevirapine was available to prevent mother-to-child transmission of HIV. RESULTS: Among 2,589 infants, detailed feeding data and vital status were available for 1,082 HIV-exposed infants and 1,155 HIV non-exposed infants. Among exclusively breastfed (EBF infants there were 9.4 diarrhoeal days per 1,000 child days (95%CI. 9.12-9.82 while among infants who were never breastfed there were 15.6 diarrhoeal days per 1,000 child days (95%CI. 14.62-16.59. Exclusive breastfeeding was associated with fewer acute, persistent and total diarrhoeal events than mixed or no breastfeeding in both HIV-exposed infants and also infants of HIV uninfected mothers. In an adjusted cox regression analysis, the risk of death among all infants by 12 months of age was significantly greater in those who were never breastfed (aHR 3.5, p<0.001 or mixed fed (aHR 2.65, p<0.001 compared with those who were EBF. In separate multivariable analyses, infants who were EBF for shorter durations had an increased risk of death compared to those EBF for 5-6 months [aHR 2.18 (95% CI, 1.56-3.01; p<0.001]. DISCUSSION: In the context of antiretroviral drugs being scaled-up to eliminate new HIV infections among children, there is strong justification for financial and human resource investment to promote and support exclusive breastfeeding to improve HIV-free survival

  9. The Climate Change and Rwandan Coffee Sector

    Directory of Open Access Journals (Sweden)

    Fidele Hakorimana

    2017-10-01

    Full Text Available This paper provides a detailed overview of the current situation of the coffee sector in the Rwandan economy and identifies the possible challenges that the sector is currently facing. The study has identified the economic and the livelihood indicators for farmers who are engaged in coffee production and also gives the Rwandan coffee sector’ situation and its position in the global coffee market. Also, the research has found out that in Rwanda, nearly 500,000 farmers produce coffee along with other crops, notably beans, savory banana and corn and found out that in 2012, coffee accounted for almost 30 percent of Rwanda’s total export revenue. On the other hand, the study revealed that the sector throughout all the coffee production process, has undergone different challenges especially climate change as it is reported by the Ministry of Agriculture and Animal resources. A low yield was reported in 2007 and climate variability was quoted among the causes. Insufficient rainfall in the last three months of 2006 (the period of coffee flowering proceeding the short dry season in the first two months of 2007 was recorded. The reduced rainfall was also poorly distributed across coffee growing regions in Rwanda. In addition, the research revealed that even though the area under coffee production is increasing, the coffee production is decreasing due to unexpected climate change and variability in current years and also the improper use of chemical fertilizers by coffee farmers is very critical. The study concluded that adding value to the coffee supply chain of Rwanda is adding direct economic benefits and important indirect social benefits to the lives of individuals and to the health of communities in Rwanda. Moreover, more effort should continue to raise the profile of the Rwandan coffee sector suggesting that proper use of chemical fertilizers, solid marketing channels and climate change adaptations measures would be the fair ways of making the

  10. Vaccination of HIV-infected pregnant women: implications for protection of their young infants.

    Science.gov (United States)

    Dangor, Ziyaad; Nunes, Marta C; Kwatra, Gaurav; Lala, Sanjay G; Madhi, Shabir A

    2017-01-01

    The prevention of mother to child transmission of HIV has resulted in reduced burden of pediatric HIV-infection, but the prevalence of maternal HIV infection remains high in sub-Saharan African countries. HIV-exposed-uninfected infants have an increased risk of morbidity and mortality due to infectious diseases than HIV-unexposed infants, particularly during the first six months of life, which in part might be due to lower levels of pathogen-specific protective antibodies acquired transplacentally from their mothers. This could be mitigated by vaccinating pregnant women to boost antibody levels; although vaccine responses among HIV-infected pregnant women might differ compared to HIV-uninfected women. We reviewed studies that compared natural and vaccine-induced antibody levels to different epitopes between HIV-infected and HIV-uninfected pregnant women. Most studies reported lower baseline/pre-vaccination antibody levels in HIV-infected pregnant women, which may not be reversed by antiretroviral therapy during pregnancy. There were only few studies on vaccination of HIV-infected pregnant women, mainly on influenza virus and group B Streptococcus (GBS) vaccines. Immunogenicity studies on influenza vaccines indicated that HIV-infected pregnant women had lower vaccine induced hemagglutination inhibition antibody titers and a decreased likelihood of seroconversion compared to HIV-uninfected women; and while higher CD4+ T-lymphocyte levels were associated with better immune responses to vaccination, HIV viral load was not associated with responses. Furthermore, infants born to influenza vaccinated HIV-infected pregnant women also had lower antibody levels and a lower proportion of HIV-exposed infants had titers above the putative correlate of protection compared to HIV-unexposed infants. The immunogenicity of a CRM197-conjugated trivalent GBS vaccine was also lower in HIV-infected pregnant women compared to HIV-uninfected women, irrespective of CD4+ T-lymphocyte counts

  11. Longitudinal development of cognitive, visuomotor and adaptive behavior skills in HIV uninfected children, aged 3-5 years of age, exposed pre- and perinatally to anti-retroviral medications.

    Science.gov (United States)

    Smith, Mary Lou; Puka, Klajdi; Sehra, Ramandeep; Read, Stanley E; Bitnun, Ari

    2017-10-01

    Little is known about the neurodevelopmental outcomes of children older than 3 years of age born to HIV infected mother but who are HIV-uninfected (HEU), and who have been exposed in utero and early in life to HIV and to antiretroviral medications (ARVs). We conducted a longitudinal study of cognitive, visuomotor and adaptive function of HEU children, who were assessed at two ages, 3.5 and 5.5 years. Sixty-four children (33 female) were assessed. In comparison with population norms for their age, at 3.5 years of age they had scores significantly below age expectations on aspects of adaptive behavior, but at age 5.5 years, their scores did not significantly diverge from the population norms on any of the measures. Verbal intelligence was lower at age 5.5 than at age 3.5 years, although there were also improvements in some features of adaptive behavior. Exposure to PI-based ARVs (compared to NNRTIs) was associated with higher Performance IQ, visuomotor and communication scores at age 5.5 years. Birth, early growth, and sociodemographic variables were predictive of outcomes. This study is important in tracking the trajectory of neurocognitive development across the pre-school and early school age years. The findings suggest that the full impact of early ARV exposure may not be evident until a considerable period of development has occurred. The results raise the possibility of negative effects of early ARV exposure on neurodevelopment that emerge over time, and reiterate the importance of sociodemographic and early health variables for optimal development.

  12. High risk human papillomavirus persistence among HIV-infected young women in South Africa.

    Science.gov (United States)

    Adler, David; Wallace, Melissa; Bennie, Thola; Abar, Beau; Sadeghi, Rokhsanna; Meiring, Tracy; Williamson, Anna-Lise; Bekker, Linda-Gail

    2015-04-01

    Persistence of infection with high-risk Human papillomaviruses (HR-HPV) increases the risk of incident and progressive precancerous lesions of the cervix. Rates of HR-HPV persistence have been shown to be increased among HIV-infected adult women, however there is a paucity of literature addressing HPV persistence in the young HIV-infected population. We compared rates of HR-HPV persistence between HIV-infected and HIV-uninfected young women. We obtained self-collected vaginal swabs at six-month intervals from 50 HIV-uninfected and 33 HIV-infected young women recruited through a community youth center (age 17-21 years) and compared rates of HR-HPV persistence. HR-HPV testing was conducted using the Roche's Linear Array® HPV Test. Eighty-three prevalent (upon baseline testing) and incident (upon subsequent testing) individual HR-HPV infections were identified among 43 members of the cohort (23 HIV-uninfected and 20 HIV-infected). At twelve months, 19% of baseline HR-HPV infections continued to be present with a statistically significant difference between HIV-uninfected and HIV-infected participants (4% versus 31%; p=0.01). HIV-infected young women in our cohort had a seven-fold increased rate of persistence of HR-HPV overall at 12 months, indicating an increased risk for incident and progressive precancerous lesions. Identification of persistent infection with HR-HPV may complement cytological findings in determining the need for colposcopy. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Implications of Post-LLETZ “Treatment Failure” for Further Management of HIV-Infected Women

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    Louis-Jacques van Bogaert

    2014-01-01

    Full Text Available Background. Since the preconisation presence of high-risk human papillomavirus (HR-HPV is the main determinant of the risk of progression of preinvasive lesions; the state of the excision margins could be of less importance. Relatively little is known about the effect of human immunodeficiency virus (HIV infection on the relation between the states of the excision margins. Methods. We compared 120 HIV-infected and 139 HIV-uninfected women who underwent a hysterectomy after large loop excision of the transformation zone (LLETZ for abnormal Pap smear. Results. The excision margins had been reported negative in 21.7% of infected and 7.8% of uninfected cases (P=0.03. Three (11.5% of 26 negative margins in HIV-infected and 2 (18.2 out of HIV-uninfected cases were falsely negative as evidenced on hysterectomy specimens (P=0.73. The persistence rate of the initial lesion was similar in both groups (P=0.20. The persistence rate with highly active antiretroviral treatment (HAART was similar to untreated patients (P=0.20. The progression rate from low-grade to high-grade preinvasive lesions was higher in HIV-infected than HIV-uninfected women (P=0.027. Conclusion. HIV-infected women with incomplete excision margins after LLETZ are at higher risk of progression of residual preneoplastic lesions.

  14. Spatial Thinking Ability Assessment in Rwandan Secondary Schools: Baseline Results

    Science.gov (United States)

    Tomaszewski, Brian; Vodacek, Anthony; Parody, Robert; Holt, Nicholas

    2015-01-01

    This article discusses use and modification of Lee and Bednarz's (2012) Spatial Thinking Ability Test (STAT) as a spatial thinking assessment device in Rwandan secondary schools. After piloting and modifying the STAT, 222 students total from our rural and urban test schools and one control school were tested. Statistical analysis revealed that…

  15. Analysis of Rwandan Economic Performance Before and After the ...

    African Journals Online (AJOL)

    They included Domestic Investment (DI), Foreign Direct Investment (FDI), Domestic Savings (DS) and Trade (TR).Chow test based on data ... The apparent existence of structural change for the two regimes suggests that the disequilibrium impact of genocide on the Rwandan economy was transitory. This could be explained ...

  16. The correlates of safe sex practices among Rwandan youth: a ...

    African Journals Online (AJOL)

    This paper presents the results of a 2001 sample survey and uses an ideation model to identify the factors affecting primary sexual abstinence and condom use among Rwandan youth. The findings showed that urban residence and age negatively influence primary sexual abstinence and positively affect condom use.

  17. Staging the Rwandan Diaspora: The Politics of Performance

    DEFF Research Database (Denmark)

    Turner, Simon

    2013-01-01

    This article explores how the Rwandan state ‘stages’ its diaspora as agents of change. I argue that ‘staging’ – in the sense of creating a specific, positive image – is an important aspect of the present government’s effort to create a new Rwanda of national unity and reconciliation. Although...

  18. Editorial message Dear readers, The Rwandan Journal of Education ...

    African Journals Online (AJOL)

    owner

    The Rwandan Journal of Education strives to maintain its standard as a scholarly, peer-reviewed journal dedicated to education, and its goal to publish and advance knowledge and research in the field of education. The Journal was initiated by the former Kigali Institute of Education, which is currently the. College of ...

  19. Rwandans Studying Chinese A Case Study at the University of ...

    African Journals Online (AJOL)

    The study adds to current research on modern foreign language instruction in two ways. First, whereas a body of research suggests a decline in learners' interests in foreign language learning, this study suggests that Rwandan students are highly motivated to learn a foreign language. Second, where many studies propose ...

  20. Aggressive desmoid fibromatosis: First case in a Rwandan child ...

    African Journals Online (AJOL)

    Desmoid tumours are a rare group of locally aggressive, non-malignant tumours of broblastic origin that can result in signicant morbidity due to local invasion. Facial involvement in children with aggressive bromatosis is uncommon. We present the case of a 14-month-old Rwandan child with an aggressive desmoid tumour ...

  1. Motivation of Students for Learning English in Rwandan Schools

    Science.gov (United States)

    Takahashi, Tomoharu

    2018-01-01

    Since Rwanda decided that from 2009 English will be the sole medium of instruction from upper level primary school onwards, motivation for learning English has become an especially important issue. Therefore this study investigated motivation for Rwandan primary and secondary school students to learn English. The study was carried out in Nyagatare…

  2. Rwandan young people's perceptions on sexuality and relationships ...

    African Journals Online (AJOL)

    Kristien Michielsen

    2014-06-20

    Jun 20, 2014 ... (2014) Rwandan young people's perceptions on sexuality and relationships: Results from a qualitative study using the. 'mailbox ... Keywords: mailbox technique, vulnerability, young people, sexuality and reproductive health, Rwanda. Résumé ..... Also, advice on how to avoid temptations is needed. Stu-.

  3. Rwandan young people's perceptions on sexuality and relationships ...

    African Journals Online (AJOL)

    Kristien Michielsen

    2014-06-20

    Jun 20, 2014 ... and relationships: Results from a qualitative study using the 'mailbox ... MSc in Public Health, is coordinator of the health programme of the Rwandan Red Cross ... younger girls/boys in exchange for money or goods. Both types ..... the short term (after one gift) or over a longer period of time (after a series of ...

  4. The Role of Radio in the Rwandan Genocide.

    Science.gov (United States)

    Kellow, Christine L.; Steeves, H. Leslie

    1998-01-01

    Examines and interprets the role of the government-controlled radio-television station in the 1994 Rwandan genocide. Considers historical and political contexts of the genocide and analyzes excerpts from radio broadcasts and observational accounts. Interprets, via several strands of communication, scholarship related to collective reaction effects…

  5. Counting the countless – rape victimisation during the Rwandan Genocide

    NARCIS (Netherlands)

    Bijleveld, C.C.J.H.; Morssinkhof, A.; Smeulers, A.L.

    2009-01-01

    Rape is regularly committed during a period of collective violence such as war. The article discusses the Rwandan genocide during which rape was used with the deliberate intent to destroy in whole or in part the Tutsi community. Rape is not often studied in such particular contexts, so little is

  6. Gonadotropin and Sex Steroid Levels in HIV-Infected Premenopausal Women and Their Association With Subclinical Atherosclerosis in HIV-Infected and -Uninfected Women in the Women's Interagency HIV Study (WIHS)

    Science.gov (United States)

    Mack, Wendy J.; Kono, Naoko; Tien, Phyllis C.; Anastos, Kathryn; Lazar, Jason; Young, Mary; Cohen, Mardge; Golub, Elizabeth; Greenblatt, Ruth M.; Kaplan, Robert C.; Hodis, Howard N.

    2013-01-01

    Background: HIV-infected women may experience prolonged amenorrhea, suggesting altered gonadotropin and sex hormone levels. However, the impact of these endocrine disruptions on atherosclerosis has not been evaluated in women living with, or at risk for, HIV infection. We investigated the association of sex hormone and gonadotropin concentrations with subclinical atherosclerosis in HIV-infected and -uninfected premenopausal women in the Women's Interagency HIV Study. Methods: Using B-mode ultrasound, the common carotid artery intima-media thickness and distensibility were measured once. Cycle-specific FSH, total estradiol (E2), and inhibin-B concentrations were measured in 584 (414 HIV infected, 170 HIV uninfected) women. Random concentrations of total T, dehydroepiandrosterone sulphate, and SHBG were measured in 1094 (771 HIV infected, 323 HIV uninfected) women. The endocrine analytes were measured at or before the ultrasound visit. Sex hormones, FSH, and SHBG concentrations were compared between HIV-infected and -uninfected women using nonparametric testing. Linear regression models were used to evaluate the association of sex hormones, FSH, and SHBG with carotid artery intima-media thickness and distensibility adjusted for confounders. Separate analyses were conducted by HIV status. Results: Compared with HIV-uninfected women, E2, T, and dehydroepiandrosterone sulphate concentrations were significantly lower and SHBG was higher in HIV-infected women. Adjusted for the confounders, T was significantly positively associated with distensibility (β-estimate = .04, P = .0005) among HIV-infected women, and the magnitude of association did not differ by CD4 cell count. E2 was significantly positively associated with distensibility among HIV-infected women with CD4 count less than 350 cells/μL. Conclusions: HIV-infected women had reduced estrogen and androgen compared with HIV-uninfected premenopausal women. T deficiency is linked with carotid artery stiffness

  7. Amnesty, Reconciliation and Reintegration: The International Community and the Rwandan Process

    Science.gov (United States)

    2008-05-22

    The idea of Rwandan national unity is a cornerstone to a successful reintegration of all members of society, both the victims of the genocide and...Amnesty, Reconciliation and Reintegration : The International Community and the Rwandan Process A Monograph by Major Jeffrey H. Powell, II...GRANT NUMBER 4. TITLE AND SUBTITLE Amnesty, Reconciliation and Reintegration : The International Community and the Rwandan Process 5c. PROGRAM

  8. Evaluation of Olfactory and Gustatory Function of HIV Infected Women

    Directory of Open Access Journals (Sweden)

    Ayotunde James Fasunla

    2016-01-01

    Full Text Available Background. Compliance with medication requires good sense of smell and taste. Objective. To evaluate the olfactory and gustatory function of HIV infected women in Ibadan, Nigeria. Methods. A case control study of women comprising 83 HIV infected women and 79 HIV uninfected women. Subjective self-rating of taste and smell function was by visual analogue scale. Olfactory function was measured via olfactory threshold (OT, olfactory discrimination (OD, olfactory identification (OI, and TDI using “Sniffin’ sticks” kits and taste function (Total Taste Strips (TTS score measurement was by taste strips. Results. The mean age of the HIV infected women was 43.67 years ± 10.72 and control was 41.48 years ± 10.99. There was no significant difference in the self-reported assessment of smell (p=0.67 and taste (p=0.84 of HIV infected and uninfected women. Although the mean OT, OD, OI, TDI, and TTS scores of HIV infected and uninfected women were within the normosmic and normogeusic values, the values were significantly higher in the controls (p<0.05. Hyposmia was in 39.7% of subjects and 12.6% of controls while hypogeusia was in 15.7% of subjects and 1.3% of controls. Conclusions. Hyposmia and hypogeusia are commoner among the HIV infected women than the HIV uninfected women and the risk increases with an increased duration of highly active antiretroviral therapy.

  9. Glycated Hemoglobin in Diabetic Women with and Without HIV Infection: Data from the Women's Interagency HIV Study

    Science.gov (United States)

    Glesby, Marshall J.; Hoover, Donald R.; Shi, Qiuhu; Danoff, Ann; Howard, Andrea; Tien, Phyllis; Merenstein, Dan; Cohen, Mardge; Golub, Elizabeth; DeHovitz, Jack; Nowicki, Marek; Anastos, Kathryn

    2010-01-01

    Background Limited data suggest that glycated hemoglobin (hemoglobin A1c; A1C) values may not reflect glycemic control accurately in HIV-infected individuals with diabetes. Methods We evaluated repeated measures of paired fasting glucose and A1C values in 315 HIV-infected and 109 HIV-uninfected diabetic participants in the Women's Interagency HIV Study. Generalized estimating equations used log A1C as the outcome variable, with adjustment for log fasting glucose concentration in all models. Results An HIV-infected woman on average had 0.9868 times as much A1C (that is, 1.32% lower; 95% confidence interval 0.9734-0.9904) as an HIV-uninfected woman with the same log fasting glucose concentration. In multivariate analysis, HIV serostatus was not associated, but white, other non-black race, and higher red blood cell mean corpuscular volume (MCV) were statistically associated with lower A1C values. Use of diabetic medication was associated with higher A1C values. In multivariate analysis restricted to HIV-infected women, white and other race, higher MCV, and HCV viremia were associated with lower A1C values whereas older age, use of diabetic medications and higher CD4 cell count were associated with higher A1C values. Use of combination antiretroviral therapy, protease inhibitors, zidovudine, stavudine, or abacavir was not associated with A1C values. Conclusions We conclude that A1C values were modestly lower in HIV-infected diabetic women relative to HIV-uninfected diabetic women after adjustment for fasting glucose concentration. The difference was abrogated by adjustment for MCV, race, and diabetic medication use. Our data suggest that in clinical practice A1C gives a reasonably accurate refection of glycemic control in HIV-infected diabetic women. PMID:20587850

  10. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.

    Science.gov (United States)

    Slyker, Jennifer A; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-06-15

    Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)-associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA-negative infants. Monthly clinical examinations were performed by pediatricians. The probability of EBV infection by 1 year of age was .78 (95% CI, .67-.88) in HIV-infected and .49 (95% CI, .35-.65) in HIV-uninfected infants (P EBV infection was .96 (95% CI, .89-.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection.

  11. What psychological and sociological processes lead to the Rwandan Genocide

    OpenAIRE

    Mortensen, Kasper Houmøller; Jonsson, Anna Ida Halsgaard; Nielsen, Astrid Kure; Hansen, Carsten Rodin; Postelnicu, Irina; Lind, Martine Søs

    2012-01-01

    This project investigates the 1994 Rwandan genocide from a primarily social psychological angle, analyzing the Hutu/Tutsi group dynamics. From the period of the Belgian colonization until and during the genocide, this project investigates the sociological motives for the genocide. Special attention is given to a range of theories that work with mass violence, inclusion and exclusion group processes, propaganda and furthermore incorporates the 8 stages to genocide. The project concludes that t...

  12. A comparative study of psychotic and affective symptoms in Rwandan and Kenyan students.

    Science.gov (United States)

    Owoso, A; Jansen, S; Ndetei, D M; Musau, A; Mutiso, V N; Mudenge, C; Ngirababyeyi, A; Gasovya, A; Mamah, D

    2017-01-26

    War and conflict are known to adversely affect mental health, although their effects on risk symptoms for psychosis development in youth in various parts of the world are unclear. The Rwandan genocide of 1994 and Civil War had widespread effects on the population. Despite this, there has been no significant research on psychosis risk in Rwanda. Our goal in the present study was to investigate the potential effects of genocide and war in two ways: by comparing Rwandan youth born before and after the genocide; and by comparing Rwandan and Kenyan adolescents of similar age. A total of 2255 Rwandan students and 2800 Kenyan students were administered the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen. Prevalence, frequency and functional impairment related to affective and psychosis-risk symptoms were compared across groups using univariate and multivariate statistics. Rwandan students born before the end of the genocide and war in 1994 experienced higher psychotic and affective symptom load (p's Rwandans. 5.35% of older Rwandan students met threshold for clinical high-risk of psychosis by the WERCAP Screen compared with 3.19% of younger Rwandans (χ 2 = 5.36; p = 0.02). Symptom severity comparisons showed significant (p Rwandan and Kenyan secondary school students on affective and psychotic symptom domains with Rwandans having higher symptom burden compared with Kenyans. Rwandan female students also had higher rates of psychotic symptoms compared with their male counterparts - a unique finding not observed in the Kenyan sample. These results suggest extreme conflict and disruption to country from genocide and war can influence the presence and severity of psychopathology in youth decades after initial traumatic events.

  13. Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Paula Matos Oliveira

    Full Text Available BACKGROUND: Vulvovaginal candidiasis (VVC is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil. RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7% than in HIV-uninfected controls (14.5% (p = 0.02. The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 - 6.32 p = 0.03. Candida albicans was the most commonly isolated species in both HIV-infected (52.3% and uninfected women (85.7%, followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

  14. Twenty Years On: Finding a Place for the Rwandan Genocide in Education

    Science.gov (United States)

    Gray, Michael

    2014-01-01

    The Rwandan genocide was perhaps the most paradigmatic human rights catastrophe in the post-Holocaust era, which challenged the mantra of "never again." Yet as we approach the twentieth anniversary, it remains a relatively marginalised entity within mainstream English education. This paper argues that a study of the Rwandan genocide…

  15. Physical activity profile of urbanized Rwandan women | Kagwiza ...

    African Journals Online (AJOL)

    It is estimated that by 2020 chronic diseases of lifestyle will be almost 50% of the burden of disease in Sub-Saharan Africa. Rapid urbanization with changes in lifestyle, such as physical activity patterns could explain at least partially the ongoing epidemiological transition. The purpose of this study was to assess levels of ...

  16. Physical activity profile of urbanized Rwandan women | Kagwiza ...

    African Journals Online (AJOL)

    72% of the participants were classified as sedentary and only 28% of the participants were classified as physically active. Participation in physical activity decreased with age, and there were more participants classified as sedentary in the married group (77%) than in non-married group (63%). There was an association ...

  17. "God must have been sleeping": faith as an obstacle and a resource for Rwandan genocide survivors in the United States.

    Science.gov (United States)

    Fox, Nicole

    2012-01-01

    In 1994, 1 million Rwandans were violently killed in only 100 days. Devastating for some Rwandan survivors was the significant role that some Catholic parishes and leaders took in ignoring, facilitating, and even perpetuating the genocide. This article seeks to understand how Rwandan genocide survivors draw on religion as they negotiate their postgenocide identities in the United States and comprehend their current faiths, beliefs, and practices. Based on qualitative interviews with Rwandan survivors now located within the United States, I argue that the experiences of religiosity postgenocide serve as both an obstacle and a resource in postgenocide life, creating significant individual and local ramifications for community engagement, reconciliation, and trauma recovery.

  18. Trauma exposure and psychological reactions to genocide among Rwandan children.

    Science.gov (United States)

    Dyregrov, A; Gupta, L; Gjestad, R; Mukanoheli, E

    2000-01-01

    A total of 3030 children age 8-19 years from Rwanda was interviewed about their war experiences and reactions approximately 13 months after the genocide that started in April 1994. Rwandan children had been exposed to extreme levels of violence in the form of witnessing the death of close family members and others in massacres, as well as other violent acts. A majority of these children (90%) believed that they would die; most had to hide to survive, and 15% had to hide under dead bodies to survive. A shortened form of the Impact of Event Scale used in a group of 1830 of these children documented high levels of intrusion and avoidance. While children living in shelters were exposed to more trauma, they evidenced less posttraumatic reactions. Analyses showed that reactions were associated with loss, violence exposure, and, most importantly, feeling their life was in danger.

  19. Association of subclinical atherosclerosis with lipid levels amongst antiretroviral-treated and untreated HIV-infected women in the Women’s Interagency HIV Study

    Science.gov (United States)

    Parrinello, Christina M; Landay, Alan L; Hodis, Howard N; Gange, Stephen J.; Norris, Philip J; Young, Mary; Anastos, Kathryn; Tien, Phyllis C; Xue, Xiaonan; Lazar, Jason; Benning, Lorie; Tracy, Russell P; Kaplan, Robert C

    2013-01-01

    Objective We examined serum lipids in association with carotid artery intima-media thickness (CIMT) in HIV-infected and HIV-uninfected women. Methods In 2003–4, among 1827 Women’s Interagency HIV Study participants, we measured CIMT and lipids (high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], total cholesterol [TC], non-HDL-c). A subset of 520 treated HIV-infected women had pre-1997 lipid measures. We used multivariable linear regression to examine associations between lipids and CIMT. Results In HIV-uninfected women, higher TC, LDL-c and non-HDL-c were associated with increased CIMT. Among HIV-infected women, associations of lipids with CIMT were observed in treated but not untreated women. Among the HIV-infected women treated in 2003–4, CIMT was associated both with lipids measured a decade earlier in infection, and with late lipid measurements. Conclusion Among HIV-infected women, hyperlipidemia is most strongly associated with subclinical atherosclerosis in treated women. Among treated women, the association appeared strongest early in the disease course. PMID:23089369

  20. Cesarean section indications and anthropometric parameters in Rwandan nulliparae: preliminary results from a longitudinal survey.

    Science.gov (United States)

    Kakoma, Jean-Baptiste

    2016-01-01

    Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

  1. Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia.

    Science.gov (United States)

    Salazar, Laura F; Crosby, Richard A; Jones, Jamal; Kota, Krishna; Hill, Brandon; Masyn, Katherine E

    2017-10-01

    This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.

  2. Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide.

    Science.gov (United States)

    Hagengimana, Athanase; Hinton, Devon; Bird, Bruce; Pollack, Mark; Pitman, Roger K

    2003-01-25

    The present study is the first to attempt to determine rates of panic attacks, especially 'somatically focused' panic attacks, panic disorder, symptoms of post-traumatic stress disorder (PTSD), and depression levels in a population of Rwandans traumatized by the 1994 genocide. The following measures were utilized: the Rwandan Panic-Disorder Survey (RPDS); the Beck Depression Inventory (BDI); the Harvard Trauma Questionnaire (HTQ); and the PTSD Checklist (PCL). Forty of 100 Rwandan widows suffered somatically focused panic attacks during the previous 4 weeks. Thirty-five (87%) of those having panic attacks suffered panic disorder, making the rate of panic disorder for the entire sample 35%. Rwandan widows with panic attacks had greater psychopathology on all measures. Somatically focused panic-attack subtypes seem to constitute a key response to trauma in the Rwandan population. Future studies of traumatized non-Western populations should carefully assess not only somatoform disorder but also somatically focused panic attacks.

  3. HIV-1 Is Associated With Lower Group B Streptococcus Capsular and Surface-Protein IgG Antibody Levels and Reduced Transplacental Antibody Transfer in Pregnant Women.

    Science.gov (United States)

    Dangor, Ziyaad; Kwatra, Gaurav; Izu, Alane; Adrian, Peter; van Niekerk, Nadia; Cutland, Clare L; Adam, Yasmin; Velaphi, Sithembiso; Lala, Sanjay G; Madhi, Shabir A

    2015-08-01

    Human immunodeficiency virus (HIV)-exposed infants are at increased risk of invasive Group B Streptococcus (GBS) disease; however, the reason for this increased susceptibility has not been characterized. We compared GBS capsular and surface-protein maternal immunoglobin G antibody concentrations and cord-maternal ratios between HIV-infected and HIV-uninfected mother-newborn dyads. Median capsular antibody concentrations (µg/mL) were lower in HIV-infected than HIV-uninfected women for serotypes Ib (P = .033) and V (P = .040); and for pilus island (PI)-1 (P = .016), PI-2a (P = .015), PI-2b (P = .015), and fibrinogen-binding protein A (P < .001). For serotypes Ia and III, cord-maternal ratios were 37.4% (P < .001) and 32.5% (P = .027) lower in HIV-infected compared to HIV-uninfected mother-newborn dyads. The adjusted odds of having capsular antibody concentration ≥2 µg/mL when comparing HIV-infected to -uninfected women were 0.33 (95% confidence interval [CI], .15-.75) and 0.34 (95% CI, .12-1.00) for serotypes Ia and III, respectively. Antibody levels and cord-maternal ratios were independent of CD4(+) lymphocyte counts or HIV-1 viral load. The lower GBS antibody concentrations and reduced transplacental antibody transfer in HIV-infected women, which likely contribute to their infants being at heightened susceptibility for invasive GBS disease, could possibly be mitigated by vaccination with a GBS conjugate vaccine currently under clinical development. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Infection with Hepatitis C Virus among HIV-Infected Pregnant Women in Thailand

    Directory of Open Access Journals (Sweden)

    Denise J. Jamieson

    2008-01-01

    Full Text Available Objective. The purpose of this study was to describe the epidemiology of coinfection with hepatitis C virus (HCV and HIV among a cohort of pregnant Thai women. Methods. Samples from 1771 pregnant women enrolled in three vertical transmission of HIV studies in Bangkok, Thailand, were tested for HCV. Results. Among HIV-infected pregnant women, HCV seroprevelance was 3.8% and the active HCV infection rate was 3.0%. Among HIV-uninfected pregnant women, 0.3% were HCV-infected. Intravenous drug use by the woman was the factor most strongly associated with HCV seropositivity. Among 48 infants tested for HCV who were born to HIV/HCV coinfected women, two infants were HCV infected for an HCV transmission rate of 4.2% (95% 0.51–14.25%. Conclusions. HCV seroprevalence and perinatal transmission rates were low among this Thai cohort of HIV-infected pregnant women.

  5. Beyond Conflict and Spoilt Identities: How Rwandan Leaders Justify a Single Recategorization Model for Post-Conflict Reconciliation

    Directory of Open Access Journals (Sweden)

    Sigrun Marie Moss

    2014-08-01

    Full Text Available Since 1994, the Rwandan government has attempted to remove the division of the population into the ‘ethnic’ identities Hutu, Tutsi and Twa and instead make the shared Rwandan identity salient. This paper explores how leaders justify the single recategorization model, based on nine in-depth semi-structured interviews with Rwandan national leaders (politicians and bureaucrats tasked with leading unity implementation conducted in Rwanda over three months in 2011/2012. Thematic analysis revealed this was done through a meta-narrative focusing on the shared Rwandan identity. Three frames were found in use to “sell” this narrative where ethnic identities are presented as a an alien construction; b which was used to the disadvantage of the people; and c non-essential social constructs. The material demonstrates the identity entrepreneurship behind the single recategorization approach: the definition of the category boundaries, the category content, and the strategies for controlling and overcoming alternative narratives. Rwandan identity is presented as essential and legitimate, and as offering a potential way for people to escape spoilt subordinate identities. The interviewed leaders insist Rwandans are all one, and that the single recategorization is the right path for Rwanda, but this approach has been criticised for increasing rather than decreasing intergroup conflict due to social identity threat. The Rwandan case offers a rare opportunity to explore leaders’ own narratives and framing of these ‘ethnic’ identities to justify the single recategorization approach.

  6. Aspects of tuberculosis and HIV diagnosis, care and treatment in Rwandan health facilities: operational studies

    NARCIS (Netherlands)

    Kayigamba, R.F.

    2014-01-01

    This thesis outlines studies that were conducted between 2006 and 2010 in Rwandan clinical and public health settings to respond to some unresolved research priority questions. It describes and analyses sputum completion and conversion rates at two months of treatment and their determinants. It

  7. Technology Use in Rwandan Secondary Schools: An Assessment of Teachers' Attitudes towards Geographic Information Systems (GIS)

    Science.gov (United States)

    Akinyemi, Felicia O.

    2016-01-01

    Technology use is evident in all spheres of human endeavour. Focusing on technology use in education, this paper examines teachers' attitudes towards geographic information system (GIS). An assessment was made of GIS teachers in Rwandan secondary schools. Key areas covered include how GIS is implemented in schools, teachers' attitudes and…

  8. Coping with Change in ICT-Based Learning Environments: Newly Qualified Rwandan Teachers' Reflections

    Science.gov (United States)

    Mukama, E.; Andersson, S. B.

    2008-01-01

    The overarching aim of this study is to investigate how newly qualified Rwandan teachers can contribute to the creation of theoretical and practical knowledge for professional development with information and communication technology (ICT). Questionnaires, focus groups and interviews were used for data collection. The findings show that novice…

  9. Drama as a Cross-Curricula teaching method | Amooti R | Rwandan ...

    African Journals Online (AJOL)

    Rwandan Journal of Education. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 1 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

  10. Violence and the Politics of Gender Identity in the Rwandan Genocide

    African Journals Online (AJOL)

    Violence and the Politics of Gender Identity in the Rwandan Genocide. Richard Ssewakiryanga. Abstract. (The Journal of Cultural Studies, 2000 2(1): 96-118). Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/jcs.v2i1.6235 · AJOL African Journals ...

  11. The Anonymous Member of the Interhamwe: Bill Clinton's Complicity in the Rwandan Genocide

    Science.gov (United States)

    Model, David

    2009-01-01

    Ranked as one of the great human rights tragedies since World War II, the Rwandan genocide, which left 800,000 dead in its wake, is commonly understood in the context of a tribal internecine conflict between the Hutus and Tutsis. The event that triggered the genocide is imputed to the shooting down of a plane carrying the President of Rwanda and…

  12. Psychometric properties and longitudinal validation of the self-reporting questionnaire (SRQ-20 in a Rwandan community setting: a validation study

    Directory of Open Access Journals (Sweden)

    van Lammeren Anouk

    2011-08-01

    Full Text Available Abstract Background This study took place to enable the measurement of the effects on mental health of a psychosocial intervention in Rwanda. It aimed to establish the capacities of the Self-Reporting Questionnaire (SRQ-20 to screen for mental disorder and to assess symptom change over time in a Rwandan community setting. Methods The SRQ-20 was translated into Kinyarwanda in a process of forward and back-translation. SRQ-20 data were collected in a Rwandan setting on 418 respondents; a random subsample of 230 respondents was assessed a second time with a three month time interval. Internal reliability was tested using Cronbach's alpha. The optimal cut-off point was determined by calculating Receiver Operating Curves, using semi-structured clinical interviews as standard in a random subsample of 99 respondents. Subsequently, predictive value, likelihood ratio, and interrater agreement were calculated. The factor structure of the SRQ-20 was determined through exploratory factor analysis. Factorial invariance over time was tested in a multigroup confirmatory factor analysis. Results The reliability of the SRQ-20 in women (α = 0.85 and men (α = 0.81 could be considered good. The instrument performed moderately well in detecting common mental disorders, with an area under the curve (AUC of 0.76 for women and 0.74 for men. Cut-off scores were different for women (10 and men (8. Factor analysis yielded five factors, explaining 38% of the total variance. The factor structure proved to be time invariant. Conclusions The SRQ-20 can be used as a screener to detect mental disorder in a Rwandan community setting, but cut-off scores need to be adjusted for women and men separately. The instrument also shows longitudinal factorial invariance, which is an important prerequisite for assessing changes in symptom severity. This is a significant finding as in non-western post-conflict settings the relevance of diagnostic categories is questionable. The use of the

  13. Association of Kidney Function and Early Kidney Injury With Incident Hypertension in HIV-Infected Women.

    Science.gov (United States)

    Ascher, Simon B; Scherzer, Rebecca; Peralta, Carmen A; Tien, Phyllis C; Grunfeld, Carl; Estrella, Michelle M; Abraham, Alison; Gustafson, Deborah R; Nowicki, Marek; Sharma, Anjali; Cohen, Mardge H; Butch, Anthony W; Young, Mary A; Bennett, Michael R; Shlipak, Michael G

    2017-02-01

    Subclinical kidney disease is associated with developing hypertension in the general population, but data are lacking among HIV-infected people. We examined associations of kidney function and injury with incident hypertension in 823 HIV-infected and 267 HIV-uninfected women in the Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-infected and uninfected women in the United States. Baseline kidney biomarkers included estimated glomerular filtration rate using cystatin C, urine albumin-to-creatinine ratio, and 7 urine biomarkers of tubular injury: α-1-microglobulin, interleukin-18, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, N-acetyl-β-d-glucosaminidase, and α1-acid-glycoprotein. We used multivariable Poisson regression to evaluate associations of kidney biomarkers with incident hypertension, defined as 2 consecutive visits of antihypertensive medication use. During a median follow-up of 9.6 years, 288 HIV-infected women (35%) developed hypertension. Among the HIV-infected women, higher urine albumin-to-creatinine ratio was independently associated with incident hypertension (relative risk =1.13 per urine albumin-to-creatinine ratio doubling, 95% confidence interval, 1.07-1.20), as was lower estimated glomerular filtration rate (relative risk =1.10 per 10 mL/min/1.73 m2 lower estimated glomerular filtration rate; 95% confidence interval, 1.04-1.17). No tubular injury and dysfunction biomarkers were independently associated with incident hypertension in HIV-infected women. In contrast, among the HIV-uninfected women, urine albumin-to-creatinine ratio was not associated with incident hypertension, whereas higher urine interleukin-18, α1-acid-glycoprotein, and N-acetyl-β-d-glucosaminidase levels were significantly associated with incident hypertension. These findings suggest that early glomerular injury and kidney dysfunction may be involved in the pathogenesis of hypertension in HIV

  14. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania

    DEFF Research Database (Denmark)

    Chiduo, M; Theilgaard, Z P; Bakari, V

    2012-01-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were...... collected from HIV-infected (n = 105) and HIV-uninfected pregnant women (n = 100) attending ANCs between April 2009 and August 2010. Syphilis prevalence showed a declining trend (3.1%, 1.4% and 1.3%), while HIV prevalence was stable (6.1%, 6.4% and 5.4%) during 2008-2010. HIV-infected women had...... significantly higher prevalence of trichomoniasis (18.8% versus 5.0%; P women. There were no statistically significant...

  15. Ten years after the genocide: trauma confrontation and posttraumatic stress in Rwandan adolescents.

    Science.gov (United States)

    Schaal, Susanne; Elbert, Thomas

    2006-02-01

    A decade after the 1994 Rwandan genocide, we interviewed a total of 68 Rwandan orphans about their war experiences and posttraumatic stress disorder (PTSD) symptoms. The two samples comprised youth living either in a child-headed household (CHH) or in an orphanage. All had been exposed to extreme levels of violence and 41% had witnessed the murder of their own mother or father. Of the sample, 44% had PTSD. PTSD vulnerability was greater for youth who at the time of the study lived in CHH than those in an orphanage; it was also higher in those aged 8 to 13 during the outbreak of the genocide than those aged 3 to 7 at the time. Furthermore, a significant relationship was found between the number of traumatic experiences and subsequent stress responses.

  16. Levamisole-Contaminated Cocaine Use in HIV-Infected and Uninfected Unstably Housed Women.

    Science.gov (United States)

    Riley, Elise D; Kral, Alex H; Cohen, Jennifer; Dilworth, Samantha E; Shumway, Martha; Lynch, Kara L

    2016-09-01

    A growing number of case reports cite serious health complications linked to the cocaine adulterant, levamisole and women are disproportionately affected; however, the clinical effects are not well established. Between April and October of 2010, we conducted a cross-sectional study among 222 homeless and unstably housed women (116 human immunodeficiency virus [HIV]-infected and 106 HIV-uninfected). Immune markers and behavioral factors were compared in separate models by cocaine and levamisole exposure. Overall, 63% of participants were toxicology positive for cocaine/benzoylecgonine, 85% of whom also tested positive for levamisole. Differences in immune markers did not reach levels of significance among HIV-uninfected persons. Compared to HIV-infected persons who were negative for both cocaine and levamisole, the adjusted odds of low white blood cell count were significantly higher among HIV-infected persons positive for both (p = 0.03), but not for those positive for cocaine only. Neutrophil count and HIV viral load did not differ by cocaine and levamisole status among HIV-infected persons. In a separate model, the adjusted odds of testing positive for levamisole were higher among African American women compared to Caucasian and Asian women (p = 0.02). In the context of high levamisole prevalence, results suggest that decreased immune function as a result of levamisole exposure occurs mainly in individuals who are already immune compromised (e.g., HIV-positive), and race/ethnicity appears to be an important factor in understanding levamisole exposure among cocaine-using women. While larger and geographically diverse studies are needed to elucidate these initial findings, results suggest that levamisole may be one mechanism of immune dysfunction in HIV-infected cocaine-using women.

  17. Job Reintegration For Depressed Women At 'Second Chance ...

    African Journals Online (AJOL)

    The present paper reproduces a part of spring 2013 master's thesis findings carried out in Sweden, at the University of Gothenburg and has never been published before. It focuses on human rights of depressed women in the process of their job reintegration at 'Second Chance' with critical eye on the Rwandan situation in ...

  18. Injuries among female Rwandan soccer players: Return-to-play ...

    African Journals Online (AJOL)

    Soccer or football is regarded as an increasingly popular sport for women. Several studies highlighted the increased injury rate proportionally to its increased participation. Researchers are of the opinion that some injuries might not be regarded as serious by either the player or the coach thus leading to premature return to ...

  19. The factor structure of the CES-D in a sample of Rwandan genocide survivors.

    Science.gov (United States)

    Lacasse, Justin J; Forgeard, Marie J C; Jayawickreme, Nuwan; Jayawickreme, Eranda

    2014-03-01

    Past research suggests that culture shapes the way psychopathology is experienced and expressed. Standard psychiatric assessment instruments may therefore not capture the same underlying constructs in different contexts. The present study investigated the factor structure of a standard depression scale in a sample of Rwandan genocide survivors. One hundred ninety six Rwandan adults provided socio-demographic information and completed the Center for Epidemiological Studies-Depression scale (CES-D), one of the most widely used self-report instruments assessing depressive symptoms, as part of a larger study on well-being and mental health in Rwanda. A two-factor solution provided the best fit for these CES-D data. The first factor corresponded to general depressive symptoms (including depressed affect, somatic symptoms, and interpersonal concerns) and explained 37.20% of the variance. The second factor included items assessing positive affect and explained 8.68% of the variance. The two-factor solution found in the present study deviates from the commonly reported four-factor structure, but is consistent with studies showing that depressed affect and somatic symptoms may not be experienced as distinct in certain non-Western and minority cultural groups.

  20. QUALITY ASSURANCE IN RWANDAN HIGHER LEARNING EDUCATION: IS THE SYSTEM ADAPTIVE OR COMPLEX?

    Directory of Open Access Journals (Sweden)

    Nathan Kanuma Taremwa

    2014-01-01

    Full Text Available Developing knowledge infrastructure by massive investments in education and training are taken as a benchmark in facilitating the acceleration and possible increases in skills, capacities and competences of Rwandan people has become apriority issue in the recent years. This notion is relevant to vision 2020 where human resource development and building of a knowledge based economy are fundamental pillars. In the past years, several policy reforms have taken place in education sector. However, the overarching question is if such reforms are becoming adaptive or complex and if such reforms will not compromise the quality of education in higher learning education in Rwanda? The main objective of the study was to investigate the impact of changes in Higher Learning Institutions on the quality of education in Rwanda. This research had three hypotheses, namely; there is an impact of changes in Higher Learning Institutions on quality of education in Rwanda; the current complexity in Rwandan education system is affecting the quality of education in HLIs; Tailoring education system to the regional reforms and implementation strategies is affecting the quality of education in Rwanda. This study was carried out in 10 higher learning institutions (5 public, 5 private and 2 Ministry of Education directorates (HEC and REB. Key informants were the senior management/head of institutions, experienced academic staff, and students. The parameters considered included; the learning methods, assessment styles, workloads, language of instruction, merging of public HLIs, curriculum, and the transformation of some private higher learning institutions into company forms. Main research instruments were questionnaires and interview guides. Both qualitative and quantitative research was collected. Analyses were done using SPSS and excel packages. Major findings indicate that the system is still in transition with indicative gaps. Ample time would therefore be necessary for

  1. Mortality and morbidity among Rwandan refugees repatriated from Zaire, November, 1996.

    Science.gov (United States)

    Banatvala, N; Roger, A J; Denny, A; Howarth, J P

    1998-01-01

    Following renewed ethnic violence at the end of September 1996, conflict between Tutsi rebels and the Zairian army spread to North Kivu, Zaire where approximately 700,000 Rwandan Hutu refugees resided following the 1994 genocide. After a major rebel offensive against the camps' militia groups on 15 November, a massive movement of refugees towards Rwanda through Goma town, the capital of North Kivu, began. Massive population movements such as this are likely to be associated with substantial mortality and morbidity. To study patterns of mortality, morbidity, and health care associated with the Rwandan refugee population repatriation during November 1996. This study observed the functioning of the health-care facilities in the Gisenyi District in Rwanda and the Goma District in Zaire, and surveyed mortality and morbidity among Rwandan refugees returning from Zaire to Rwanda. Patterns of mortality, morbidity, and health care were measured mainly by mortality and health centre consultation rates. Between 15 and 21 November 1996, 553,000 refugees returned to Rwanda and 4,530 (8.2/1,000 refugees) consultations took place at the border dispensary (watery diarrhea, 63%; bloody diarrhea, 1%). There were 129 (0.2/1,000) surgical admissions (72% soft tissue trauma) to the Gisenyi hospital in the subsequent two weeks. The average number of consultations from the 13 health centres during the same period was 500/day. Overall, the recorded death rate was 0.5/10,000 (all associated with diarrhea). A total of 3,586 bodies were identified in the refugee camps and surrounding areas of Goma, almost all the result of trauma. Many had died in the weeks before the exodus. Health centres were overwhelmed and many of the deficiencies in provision of health care identified in 1994 again were evident. Non-violent death rates were low, a reflection of the population's health status prior to migration and immunity acquired from the 1994 cholera outbreak. Health facilities were over stretched

  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. Risk and protective factors for suicidal ideation and behaviour in Rwandan children.

    Science.gov (United States)

    Ng, Lauren C; Kirk, Catherine M; Kanyanganzi, Frederick; Fawzi, Mary C Smith; Sezibera, Vincent; Shema, Evelyne; Bizimana, Justin I; Cyamatare, Felix R; Betancourt, Theresa S

    2015-09-01

    Suicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk. To identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10-17. Matched case-control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers. Over 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems. Policies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV. © The Royal College of Psychiatrists 2015.

  4. Pattern of congenital heart diseases in Rwandan children with genetic defects.

    Science.gov (United States)

    Teteli, Raissa; Uwineza, Annette; Butera, Yvan; Hitayezu, Janvier; Murorunkwere, Seraphine; Umurerwa, Lamberte; Ndinkabandi, Janvier; Hellin, Anne-Cécile; Jamar, Mauricette; Caberg, Jean-Hubert; Muganga, Narcisse; Mucumbitsi, Joseph; Rusingiza, Emmanuel Kamanzi; Mutesa, Leon

    2014-01-01

    Congenital heart diseases (CHD) are commonly associated with genetic defects. Our study aimed at determining the occurrence and pattern of CHD association with genetic defects among pediatric patients in Rwanda. A total of 125 patients with clinical features suggestive of genetic defects were recruited. Echocardiography and standard karyotype studies were performed in all patients. CHDs were detected in the majority of patients with genetic defects. The commonest isolated CHD was ventricular septal defect found in many cases of Down syndrome. In total, chromosomal abnormalities represented the majority of cases in our cohort and were associated with various types of CHDs. Our findings showed that CHDs are common in Rwandan pediatric patients with genetic defects. These results suggest that a routine echocardiography assessment combined with systematic genetic investigations including standard karyotype should be mandatory in patients presenting characteristic clinical features in whom CHD is suspected to be associated with genetic defect.

  5. Prolonged grief disorder and depression in widows due to the Rwandan genocide.

    Science.gov (United States)

    Schaal, Susanne; Elbert, Thomas; Neuner, Frank

    2009-01-01

    Should pathological grief be viewed as a nosological category, separate from other forms of mental diseases? Diagnostic criteria for "Prolonged Grief Disorder" (PGD) have recently been specified by Prigerson and her coworkers. We interviewed a total of 40 widows who had lost their husbands during the Rwandan genocide in 1994. We assessed Major Depression using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and prolonged grief reactions with the PG-13. In order to examine the distinctiveness of the two syndromes we performed a multitrait correlational matrix analysis using modified versions of Generalized Proximity Functions (GPFs). 12.5% (n = 5) of the sample fulfilled the criteria for a diagnosis of PGD; 40% (n = 16) met criteria for Major Depressive Episode. The two syndromes were strongly associated. No discriminant validity was found between the two constructs suggesting that PGD may rather be an appearance of depression than a separate nosological entity.

  6. Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide.

    Science.gov (United States)

    Neugebauer, Richard; Fisher, Prudence W; Turner, J Blake; Yamabe, Saori; Sarsfield, Julia A; Stehling-Ariza, Tasha

    2009-08-01

    Epidemiological investigations of post-traumatic stress reactions in Sub-Saharan Africa, where atrocious violence against civilians is endemic, are rare. This article is the first complete report of the key community-based findings of a 1995 psychiatric epidemiological survey of young survivors of the 1994 Rwandan Genocide. The National Trauma Survey (NTS) of Rwandans aged 8-19 measured traumatic exposures using an inventory of possible war time experiences and post-traumatic stress reactions with a checklist of symptoms of Post-traumatic stress disorder (PTSD). Individuals meeting assessed PTSD diagnostic criteria are classified as cases of 'probable PTSD'. The NTS interviewed youth residing in the community and others institutionalized in unaccompanied children's centres; the former (n = 1547) are the subject of the present report. Instrument change midway into the study divides respondents into two samples. Among respondents, over 90% witnessed killings and had their lives threatened; 35% lost immediate family members; 30% witnessed rape or sexual mutilation; 15% hid under corpses. In Sample 1, 95% of respondents reported one or more re-experiencing symptom, 95% reported three or more avoidance/blunting symptoms and 63% reported two or more arousal symptoms; in Sample 2, these figures were 96%, 95% and 56%, respectively. The overall rate of 'probable PTSD' was 62% and 54% in Samples 1 and 2, respectively, and exhibited a dose-response relationship with exposure. Among the most heavily exposed individuals the rate was 100%. Rates of 'probable PTSD' were higher among females than among males. Results for age were inconsistent. In industrialized societies, most survivors of traumatizing violence experience symptoms only transiently. In the Rwanda survey, symptom levels and rates of 'probable PTSD' were exceptionally elevated, suggesting that at the limits of catastrophic man-made violence, psychological resilience among youth is all but extinguished.

  7. The Gift and the Theft: an Economic-Political Interpretation of Rwandan Missionary Diaries of White Fathers (1900-1910

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    Silvia Cristofori

    2012-11-01

    Full Text Available This article proposes an economic/political interpretation of two missionary Diaries drafted in Rwanda in the first decade of the last century. The events recorded in these documents aid the reader in understanding how the missions were, in that period, centers of power that interacted with the local environment in a manner which was relatively independent of a colonial administration that was still weak. As a result, while the missionaries learned and incorporated certain Rwandan socio-political logics, they also introduced embryonic forms of capitalism. From this paper the reader can understand how, thogether with these elements of capitalism in the daily life of mission, a policy of ethnicization and feudalization of rwandan society started to take shape. A policy, with was to be fully realized twenty years later under Belgian colonial rule.

  8. 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.

  9. The correlates of safe sex practices among Rwandan youth: a positive deviance approach.

    Science.gov (United States)

    Babalola, Stella; Awasum, David; Quenum-Renaud, Brigitte

    2002-01-01

    This paper presents the results of a 2001 sample survey and uses an ideation model to identify the factors affecting primary sexual abstinence and condom use among Rwandan youth. The findings showed that urban residence and age negatively influence primary sexual abstinence and positively affect condom use. Living within the same household as the father tends to protect girls from early sexual experimentation but has no noticeable effect on boys. Moslems are considerably less likely than Christians to report primary sexual abstinence. The use of alcohol tends to be negatively associated with sexual abstinence. The ideational factors that are significant for primary sexual abstinence are perceptions about the sexual behaviours of peers, perceived self-efficacy to refuse sex with someone truly loved, perceived self-efficacy to refuse sex with someone known for more than three months, self-esteem and attitudes toward premarital sex. As for condom use, the ideational variables with significant independent effects on the behavior are: discussion of HIV/AIDS with sexual partner, and to a lesser extent, the perceived self-efficacy to use condoms, and discussion of condom use with the sex partner. The programmatic and policy implications of the results are discussed.

  10. Treatment of PTSD in Rwandan child genocide survivors using thought field therapy.

    Science.gov (United States)

    Sakai, Caroline E; Connolly, Suzanne M; Oas, Paul

    2010-01-01

    Thought Field Therapy (TFT), which utilizes the self-tapping of specific acupuncture points while recalling a traumatic event or cue, was applied with 50 orphaned adolescents who had been suffering with symptoms of PTSD since the Rwandan genocide 12 years earlier. Following a single TFT session, scores on a PTSD checklist completed by caretakers and on a self-rated PTSD checklist had significantly decreased (p < .0001 on both measures). The number of participants exceeding the PTSD cutoffs decreased from 100% to 6% on the caregiver ratings and from 72% to 18% on the self-ratings. The findings were corroborated by informal interviews with the adolescents and the caregivers, which indicated dramatic reductions of PTSD symptoms such as flashbacks, nightmares, bedwetting, depression, isolation, difficulty concentrating, jumpiness, and aggression. Following the study, the use of TFT on a self-applied and peer-utilized basis became part of the culture at the orphanage, and on one-year follow-up the initial improvements had been maintained as shown on both checklists.

  11. Morbidity and mortality surveillance in Rwandan refugees--Burundi and Zaire, 1994.

    Science.gov (United States)

    1996-02-09

    In April 1994, resumption of a longstanding conflict between the Hutus and Tutsis--the two major ethnic groups in the central African countries of Burundi and Zaire--resulted in civil war and mass genocide in Rwanda. An estimated 63,000 (primarily Tutsi) refugees subsequently moved from Rwanda into northern Burundi, and 500,000 refugees fled to Tanzania (Figure 1). In early July 1994, as armed strife subsided, many Tutsis returned home to Rwanda, and an estimated 1 million Rwandan Hutus fled to Zaire, and 170,000 fled to Burundi. To monitor the health status of the refugees, the Office of the United Nations High Commissioner for Refugees (UNHCR) and nongovernmental organizations (NGOs) working in refugee camps in both countries established systems for rapid surveillance of morbidity and mortality. This report presents the findings of these systems during May-September 1994 (the period of the most intensive population migration) and indicates that mortality was high among refugees in camps in both countries.

  12. The Impact of Couple HIV Testing and Counseling on Consistent Condom Use Among Pregnant Women and Their Male Partners: An Observational Study.

    Science.gov (United States)

    Rosenberg, Nora E; Graybill, Lauren A; Wesevich, Austin; McGrath, Nuala; Golin, Carol E; Maman, Suzanne; Bhushan, Nivedita; Tsidya, Mercy; Chimndozi, Limbikani; Hoffman, Irving F; Hosseinipour, Mina C; Miller, William C

    2017-08-01

    In sub-Saharan Africa couple HIV testing and counseling (CHTC) has been associated with substantial increases in safe sex, especially when at least one partner is HIV infected. However, this relationship has not been characterized in an Option B+ context. The study was conducted at the antenatal clinic at Bwaila District Hospital in Lilongwe, Malawi in 2016 under an Option B+ program. Ninety heterosexual couples with an HIV-infected pregnant woman (female-positive couples) and 47 couples with an HIV-uninfected pregnant woman (female-negative couples) were enrolled in an observational study. Each couple member was assessed immediately before and 1 month after CHTC for safe sex (abstinence or consistent condom use in the last month). Generalized estimating equations were used to model change in safe sex before and after CHTC and to compare safe sex between female-positive and female-negative couples. Mean age was 26 years among women and 32 years among men. Before CHTC, safe sex was comparable among female-positive couples (8%) and female-negative couples (2%) [risk ratio (RR): 3.7, 95% confidence interval (CI): 0.5 to 29.8]. One month after CHTC, safe sex was higher among female-positive couples (75%) than among female-negative couples (3%) (RR: 30.0, 95% CI: 4.3 to 207.7). Safe sex increased substantially after CTHC for female-positive couples (RR 9.6, 95% CI: 4.6 to 20.0), but not for female-negative couples (RR: 1.2, 95% CI: 0.1 to 18.7). Engaging pregnant couples in CHTC can have prevention benefits for couples with an HIV-infected pregnant woman, but additional prevention approaches may be needed for couples with an HIV-uninfected pregnant woman.

  13. Legacy of Colonialism in the Empowerment of Women in Rwanda

    Directory of Open Access Journals (Sweden)

    Ilaria Buscaglia

    2012-03-01

    Full Text Available The empowerment of women in Rwanda is rooted in colonial times. In the second half of the 1940s, the Belgian administration, together with religious missionaries, started some educational and social welfare programs for women, known as the foyers sociaux (social homes. This paper explores how this program of female promotion and its progeny affected the domestication of Rwandan women, what caused the situation to change following the genocide against the Tutsi in 1994, and what more might be done to stimulate full gender equality in education and employment for women in Rwanda.

  14. Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection

    Science.gov (United States)

    Burgos-Soto, Juan; Orne-Gliemann, Joanna; Encrenaz, Gaëlle; Patassi, Akouda; Woronowski, Aurore; Kariyiare, Benjamin; Lawson-Evi, Annette K.; Leroy, Valériane; Dabis, François; Ekouevi, Didier K.

    2014-01-01

    Background A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence. Methods A cross-sectional survey was conducted between May and July 2011 within Sylvanus Olympio University Hospital in Lomé. HIV-infected women attending HIV care and uninfected women attending postnatal care and/or children immunization visits were interviewed. Intimate partner physical and sexual violence and controlling behaviors were assessed using an adapted version of the WHO Multi-country study on Women’s Health and Life Events questionnaire. Results Overall, 150 HIV-uninfected and 304 HIV-infected women accepted to be interviewed. The prevalence rates of lifetime physical and sexual violence among HIV-infected women were significantly higher than among uninfected women (63.1 vs. 39.3%, pviolence. Among injured women, only one-third had ever disclosed real causes of injuries to medical staff and none of them had been referred to local organizations to receive appropriate psychological support. Regardless of HIV status and after adjustment on potential confounders, the risk of intimate partner physical and sexual violence was strongly and significantly associated with male partner multi-partnership and early start of sexual life. Among uninfected women, physical violence was significantly associated with gender submissive attitudes. Discussion and conclusions The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women

  15. Violence against women in war: rape, AIDS, sex slavery. International.

    Science.gov (United States)

    At an international conference attended by 2000 delegates, violence against women in Rwanda, former Yugoslavia, and Kurdistan was discussed. Kalliope Migirou, of the United Nations Human Rights Field Operation in Rwanda, described the slaughter of between 500,000 and 1.5 million Tutsis and moderate Hutus in 1994; estimates of the number of rapes ranged from 15,700 (Rwandan government) to 250,000-500,000 (UN special representative). Women were gang-raped and sexually mutilated; fathers were forced to rape their daughters, and sons, their mothers. The transmission of HIV was used as a weapon to murder women and their communities. Women were taken to refugee camps as sex slaves and have written their families about their "new marriages" to Hutu militia men. No rape charge is found among the more than 4000 cases prepared for the Rwandan war crimes trial. 80,000 Rwandans are in prison on suspicion of participating in the genocide; 8% are women. Violete Krasnic, of the Autonomous Women's Center Against Sexual Violence in Belgrade, spoke about the war in former Yugoslavia, which increased all forms of violence against women: 1) domestic violence, particularly in inter-ethnic marriages; 2) death threats against women (up 30-50%); 3) rape (up 30%); and 4) threats with weapons (40%). Men, upon exposure to nationalistic propaganda, used violence against their wives. Nazaneen Rasheed, a London-based representative of the Women's Union of Kurdistan, stated that women in northern Iraq had no power or land. While some turned to prostitution to survive, hundreds were killed by male relatives because of shame to the family.

  16. Assessment of soil degradation and chemical compositions in Rwandan tea-growing areas

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    Jean de la Paix Mupenzi

    2011-10-01

    Full Text Available This study has focused on the processes of soil degradation and chemical element concentration in tea-growing regions of Rwanda, Africa. Soil degradation accelerated by erosion is caused not only by topography but also by human activities. This soil degradation involves both the physical loss and reduction in the amount of topsoil associated with nutrient decline. Soil samples were collected from eleven tropical zones in Rwanda and from variable depth within each collecting site. Of these, Samples from three locations in each zone were analyzed in the laboratory, with the result that the pH of all soil samples is shown to be less than 5 (pH<5 with a general average of 4.4. The elements such as iron (Fe, copper (Cu, manganese (Mn, and zinc (Zn are present in high concentration levels. In contrast calcium (Ca and sodium (Na are present at low-level concentrations and carbon (C was found in minimal concentrations. In addition, elements derived from fertilizers, such as nitrogen (N, phosphorous (P, and potassium (K which is also from minerals such as feldspar, are also present in low-level concentrations. The results indicate that the soil in certain Rwandan tea plantations is acidic and that this level of pH may help explain, in addition to natural factors, the deficiency of some elements such as Ca, Mg, P and N. The use of chemical fertilizers, land use system and the location of fields relative to household plots are also considered to help explain why tea plantation soils are typically degraded.

  17. Local perceptions of the mental health effects of the Rwandan genocide.

    Science.gov (United States)

    Bolton, P

    2001-04-01

    The objectives of this study were to investigate how Rwandans perceive the mental health effects of the 1994 genocide, to investigate the local validity of western mental illness concepts, and (if these concepts were found to be valid) to provide data to adapt existing mental health assessment instruments for local use. We used three ethnographic methods to interview people in two rural areas in Rwanda: first, free listing provided a list of local terms for mental symptoms and disorders; second, key informant interviews then provided more detailed information about these disorders; and finally, pile sorts confirmed the relationships among symptoms and disorders that emerged from the other methods. We found that interviewees described the diagnostic symptoms of depression and posttraumatic stress disorder as results of the genocide and also described associated "local" symptoms not included in the established diagnostic criteria. They divided symptoms into a "mental trauma" syndrome that included the posttraumatic stress disorder symptoms and some depression and local symptoms, and a grief syndrome that included other depression and local symptoms. In the pile sorts, we focused on investigating mood disorders and confirmed that four of the locally described symptoms formed part of a local depression-like illness. The results suggest that depression occurs among this population and support the local content validity of depression assessment instruments, such as the Depression section of the Hopkins Symptom Checklist. Similar independent evidence of validity is missing from most cross-cultural surveys. Our work supports the need and feasibility for collecting this supporting evidence prior to conducting cross-cultural surveys using existing instruments.

  18. Narrative exposure therapy versus interpersonal psychotherapy. A pilot randomized controlled trial with Rwandan genocide orphans.

    Science.gov (United States)

    Schaal, Susanne; Elbert, Thomas; Neuner, Frank

    2009-01-01

    The aim of the present study was to evaluate the efficacy of treatment modules for trauma spectrum disorders in a sample of Rwandan genocide orphans. Twenty-six orphans (originally 27) who presented with posttraumatic stress disorder (PTSD) at first assessment continued to meet a PTSD DSM-IV diagnosis 6 months after their initial assessment. They were offered participation in a controlled treatment trial. A group adaptation of interpersonal psychotherapy (IPT, n = 14) was compared to individual narrative exposure therapy (NET, n = 12). The last NET session involved guided mourning. Each treatment program consisted of 4 weekly sessions. Main outcome measures were diagnostic status and symptoms of PTSD and depression assessed before treatment, at 3 months post-test and at 6 months follow-up using the Clinician-Administered PTSD Scale, Mini-International Neuropsychiatric Interview, and Hamilton Rating Scale. At post-test, there were no significant group differences between NET and IPT on any of the examined outcome measures. At 6-month follow-up, only 25% of NET, but 71% of IPT participants still fulfilled PTSD criteria. There was a significant time x treatment interaction in the severity of PTSD [Wilks' Lambda = 0.75, F(2,23) = 3.93; p < 0.05] and depression symptoms [Wilks' Lambda = 0.23, F(2,23) = 3.40; p = 0.05]. At follow-up, NET participants were significantly more improved than IPT participants with respect to both the severity of symptoms of PTSD and depression. Individual NET in combination with group-based mourning comprises an effective treatment for traumatized survivors who have to bear the loss of loved ones and have been suffering from symptoms of PTSD and depression. Copyright 2009 S. Karger AG, Basel.

  19. Factors associated with previously undiagnosed human immunodeficiency virus infection in a population of men who have sex with men and male-to-female transgender women in Lima, Peru.

    Science.gov (United States)

    Billings, Joshua D; Joseph Davey, Dvora L; Konda, Kelika A; Bristow, Claire C; Chow, Jeremy; Klausner, Jeffrey D; Cáceres, Carlos F

    2016-10-01

    The aim of the study was to identify factors associated with undiagnosed human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) and male-to-female transgender women in Lima, Peru.We analyzed characteristics of 378 MSM and transgender women recruited from 2 sexually transmitted infection (STI) clinics in Lima, Peru. Descriptive analyses compared: (A) HIV-uninfected, (B) previously undiagnosed HIV-infected, and (C) previously diagnosed HIV-infected participants. Multivariable logistic regression models identified: (1) correlates of previously undiagnosed HIV-infection among participants thought to be HIV-uninfected (B vs A); and (2) correlates of previously undiagnosed HIV-infection among HIV-infected participants (B vs C). Subanalysis identified correlates of frequent HIV testing among participants thought to be HIV-uninfected.Among participants, 31.0% were HIV-infected; of those, 35.0% were previously undiagnosed. Among participants thought to be HIV-uninfected (model 1), recent condomless receptive anal intercourse and last HIV test being over 1-year ago (compared to within the last 6-months) were associated with increased odds of being previously undiagnosed HIV-infected (adjusted odds ratio [aOR] = 2.43, 95% confidence interval [95%CI] = 1.10-5.36; aOR = 2.87, 95%CI = 1.10-7.53, respectively). Among HIV-infected participants (model 2), recent condomless receptive anal intercourse was again associated with previously undiagnosed HIV-infection (aOR = 2.54, 95%CI = 1.04-6.23). Achieving post-secondary education and prior syphilis infection were associated with lower odds of having previously undiagnosed HIV-infection (aOR = 0.35, 95%CI = 0.15-0.81; aOR = 0.32, 95%CI = 0.14-0.75, respectively).Reporting semiannual testing was associated with higher educational attainment, identifying as a transgender woman, or reporting a history of syphilis (aOR = 1.94, 95%CI = 1.11-3.37; aOR = 2.40, 95

  20. Does provider-initiated HIV testing and counselling lead to higher HIV testing rate and HIV case finding in Rwandan clinics?

    NARCIS (Netherlands)

    Kayigamba, Felix R.; van Santen, Daniëla; Bakker, Mirjam I.; Lammers, Judith; Mugisha, Veronicah; Bagiruwigize, Emmanuel; de Naeyer, Ludwig; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2016-01-01

    Provider-initiated HIV testing and counselling (PITC) is promoted as a means to increase HIV case finding. We assessed the effectiveness of PITC to increase HIV testing rate and HIV case finding among outpatients in Rwandan health facilities (HF). PITC was introduced in six HFs in 2009-2010. HIV

  1. [Rehabilitation of the population in areas devastated by the Rwandan war].

    Science.gov (United States)

    Rwamucyo, E; Niyibizi, S

    1993-04-01

    Data from communal and prefectural authorities and from the general census of 1991 were used to assess the demographic effects of the war in Rwanda between October 1990 and February 1993. Rehabilitation after the devastation of war on the scale experienced in the Rwandan prefectures of Byumba and Ruhengeri since October 1990 requires urgent and careful preparation. Accurate data on the whereabouts of the population is one necessary element. The often incomplete available data indicate that the populations of Byumba and Ruhengeri declined from 783,350 and 766,112 respectively in August 1991 to 257,160 and 255,413 in February 1993. The communes of Giti, Muhura, Murambi, and Rutare in Byumba and Cyabingo, Gatonde, Mukingo, Ndusu, Nkuli, Nyakinama, and Nyamutera in Ruhengeri were only slightly affected by the combat except for the arrival of refugees. Reports of a few communes such as Muvumba and Ngarama which indicate that more people fled then actually were enumerated in 1991 suggest that individuals were counted as fleeing who actually resided in other communes or that a large number of persons were omitted from the census. Some communes, such as Cyeru, Nyamugali, and Ruhondo in Ruhengeri and Buyoga, Bwisige, Cyungo, Kibali, Kinyami, Ngarama, and Tumba in Byumba were swollen by refugees before intensification of hostilities led a large part of their own populations to emigrate. The population more than doubled in 11 communes, while 5 of the 16 communes in Ruhengeri and 5 of the 17 in Byumba lost almost all of their normal populations. Increased mortality has resulted from the precarious health and nutritional conditions in the refugee camps and on the roads. The war itself was responsible for a large number of deaths. Around 50,000 persons each in Ruhengeri and Byumba are estimated to have been taken prisoner and exploited as an unpaid source of labor. Refugee camps have swelled the populations of at least 12 rural communes in the prefecture of Kigali. One camp

  2. The 1994 Rwandan Genocide: The Religion/Genocide Nexus, Sexual Violence, and the Future of Genocide Studies

    Directory of Open Access Journals (Sweden)

    Kate E. Temoney

    2016-12-01

    Full Text Available In recent genocides and other conflicts—for example, the Sudan, Burma, and now Iraq—sexual violence and religion have received increasing but modest systematic treatment in genocide studies. This essay contributes to the nascent scholarship on the religious and sexual dimensions of genocide by providing a model for investigating the intersections among religion, genocide, and sexual violence. I treat the Rwandan genocide as a case study using secondary and primary sources and proffer the reinforcing typologies of “othering,” justification, and authorization as an investigatory tool. I further nuance the influences of religion on forms of sexual violation by arguing that religion indirectly (distally and directly (proximately furthers the aims of genocide by coding genocidal ideology and violence as “religious.” Ultimately, I contend that studying the religious and sexual aspects of genocide deepens our understanding of the complex dynamics of genocide and opens new lines of inquiry into genocide studies.

  3. Treating psychological trauma among Rwandan orphans is associated with a reduction in HIV risk-taking behaviors: A pilot study.

    Science.gov (United States)

    Talbot, Annie; Uwihoreye, Chaste; Kamen, Charles; Grant, Philip; McGlynn, Lawrence; Mugabe, Isaac; Nshimyumukiza, Martin; Dongier, Pierre; Slamowitz, Debbie; Padilla, Cindy; Uvamahoro, Jaqueline; Musayidire, Irene; Mukarubuga, Ancilla; Zolopa, Andrew

    2013-12-01

    The nongovernmental organization, Uyisenga N'Manzi (UNM), provides Rwandan orphans of genocide and HIV/AIDS with education, social, and mental health services. Many orphans in UNM report symptoms of psychological trauma. The primary study objective was to evaluate a multidisciplinary program integrating HIV prevention with an existing package of mental health services. We randomly selected 120 orphans between ages 15-25 years served by UNM and evaluated sexually-transmitted infections, HIV risk-taking behaviors and knowledge, and mental health at baseline, 5, 9, and 12 months. Increased trauma symptoms at baseline were associated with poorer coping skills and social functioning, and increased psychological distress and HIV risk-taking behavior. Following the 12-month intervention, trauma symptoms declined significantly, with those accessing counseling services showing greatest improvement. Orphans with the highest trauma scores benefited most from the intervention. In this at-risk population, addressing mental health issues in the context of HIV prevention is critical.

  4. Preexposure prophylaxis for HIV infection among African women.

    Science.gov (United States)

    Van Damme, Lut; Corneli, Amy; Ahmed, Khatija; Agot, Kawango; Lombaard, Johan; Kapiga, Saidi; Malahleha, Mookho; Owino, Fredrick; Manongi, Rachel; Onyango, Jacob; Temu, Lucky; Monedi, Modie Constance; Mak'Oketch, Paul; Makanda, Mankalimeng; Reblin, Ilse; Makatu, Shumani Elsie; Saylor, Lisa; Kiernan, Haddie; Kirkendale, Stella; Wong, Christina; Grant, Robert; Kashuba, Angela; Nanda, Kavita; Mandala, Justin; Fransen, Katrien; Deese, Jennifer; Crucitti, Tania; Mastro, Timothy D; Taylor, Douglas

    2012-08-02

    Preexposure prophylaxis with antiretroviral drugs has been effective in the prevention of human immunodeficiency virus (HIV) infection in some trials but not in others. In this randomized, double-blind, placebo-controlled trial, we assigned 2120 HIV-negative women in Kenya, South Africa, and Tanzania to receive either a combination of tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) or placebo once daily. The primary objective was to assess the effectiveness of TDF-FTC in preventing HIV acquisition and to evaluate safety. HIV infections occurred in 33 women in the TDF-FTC group (incidence rate, 4.7 per 100 person-years) and in 35 in the placebo group (incidence rate, 5.0 per 100 person-years), for an estimated hazard ratio in the TDF-FTC group of 0.94 (95% confidence interval, 0.59 to 1.52; P=0.81). The proportions of women with nausea, vomiting, or elevated alanine aminotransferase levels were significantly higher in the TDF-FTC group (P=0.04, P<0.001, and P=0.03, respectively). Rates of drug discontinuation because of hepatic or renal abnormalities were higher in the TDF-FTC group (4.7%) than in the placebo group (3.0%, P=0.051). Less than 40% of the HIV-uninfected women in the TDF-FTC group had evidence of recent pill use at visits that were matched to the HIV-infection window for women with seroconversion. The study was stopped early, on April 18, 2011, because of lack of efficacy. Prophylaxis with TDF-FTC did not significantly reduce the rate of HIV infection and was associated with increased rates of side effects, as compared with placebo. Despite substantial counseling efforts, drug adherence appeared to be low. (Supported by the U.S. Agency for International Development and others; FEM-PrEP ClinicalTrials.gov number, NCT00625404.).

  5. Associations between plasma tenofovir concentration and renal function markers in HIV-infected women

    Directory of Open Access Journals (Sweden)

    Mwila Mulubwa

    2016-07-01

    Objective: To investigate the correlation between plasma tenofovir (TFV concentration and certain renal function markers in HIV-infected women on TDF antiretroviral therapy (ART.These markers were also compared to a HIV-uninfected control group. Methods: HIV-infected women (n = 30 on TDF-based ART were matched with 30 controls forage and body mass index. Renal markers analysed were estimated glomerular filtration rate (eGFR, creatinine clearance (CrCl, serum creatinine, albuminuria, glucosuria, serum urea, serum uric acid, urine sodium and maximum tubular reabsorption of phosphate. Baseline eGFR and CrCl data were obtained retrospectively for the HIV-infected women. Plasma TFV was assayed using a validated HPLC-MS/MS method. Step wise regression, Mann–Whitney test, unpaired and paired t-tests were applied in the statistical analyses. Results: TFV concentration was independently associated with albuminuria (adjusted r2 = 0.339; p = 0.001 in HIV-infected women. In the adjusted (weight analysis, eGFR (p = 0.038,CrCl (p = 0.032 and albuminuria (p = 0.048 were significantly higher in HIV-infected compared to the uninfected women, but eGFR was abnormally high in HIV-infected women. Both eGFR (p < 0.001 and CrCl (p = 0.008 increased from baseline to follow-up in HIV-infected women. Conclusion: Plasma TFV concentration was associated with increased albuminuria in HIV infected women in this sub-study. Both eGFR and CrCl were increased in HIV-infected women from baseline. These findings should be confirmed in larger studies, and hyperfiltration in HIV-infected women warrants further investigation.

  6. Barriers to and Facilitators of Adherence to Exclusive Breastfeeding Practices Among HIV Infected and Non-Infected Women in Jos, Nigeria.

    Science.gov (United States)

    Coetzee, Bronwynè; Tomlinson, Mark; Osawe, Sophia; Abimiku, Alash'le; Kagee, Ashraf

    2017-04-01

    Objectives In Nigeria adherence to exclusive breastfeeding (EBF) practices is currently suboptimal and a better understanding of the factors affecting adherence to EBF is needed. We sought to identify and delineate the barriers to and facilitators of adherence to EBF amongst HIV-infected and uninfected women in Nigeria. Methods We explored the barriers and facilitators to EBF amongst 37 (25 HIV-infected and 12 HIV-uninfected) pregnant women attending an antenatal clinic in Jos, Nigeria. In-depth interviews were conducted with each of the pregnant women in their third trimester of pregnancy and again 1 month after giving birth. Results The themes that emerged were mothers' feeding intentions, significant role players in the decision to breastfeed, perceived barriers (e.g. physiological issues, stigma, employment) and perceived facilitators (e.g. pleasure and enjoyment derived from breastfeeding, natural milk from God, disclosure and family support) associated with EBF. Conclusions Most women preferred EBF and offered it to their infants. However, more efforts are needed to improve support structures at home and at work to accommodate women who choose to do EBF.

  7. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    14 a. Introduction. The interaction between tuberculosis and human immunodeficiency virus. (HIV) infection is well known and is responsible for the inordinate increase in the incidence of tuberculosis (TB) in sub-Saharan Africa over the last de- cade.1 This epidemic affects both adult and childhood tuberculosis and places.

  8. PrEP Use During Periods of HIV Risk Among East African Women in Serodiscordant Relationships.

    Science.gov (United States)

    Pyra, Maria; Haberer, Jessica E; Heffron, Renee; Kidoguchi, Lara; Brown, Elizabeth R; Bukusi, Elizabeth A; Asiimwe, Stephen; Celum, Connie; Katabira, Elly; Mugo, Nelly R; Baeten, Jared M

    2017-09-29

    PrEP is efficacious for African women at risk for HIV, but data on adherence outside of clinical trials are sparse. We describe the persistence and execution of PrEP use among women participating in a large open-label PrEP demonstration project, particularly during periods of HIV risk. & Methods: 310 HIV-uninfected women in HIV serodiscordant couples in Kenya and Uganda were offered and accepted PrEP. Electronic monitoring caps were used to measure daily PrEP adherence. Time on PrEP while at risk for HIV (when the HIV-infected partner was on ART PrEP were calculated and compared among older and younger (PrEP during their entire risk period and 24% stopped but re-started PrEP during their risk period. While on PrEP, women took ≥6 doses/week for 78% of weeks (67% of weeks for women PrEP successfully over sustained periods of risk. While young women had lower adherence than older women, they achieved strong protection, suggesting women can align PrEP use to periods of risk and imperfect adherence can still provide substantial benefit.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

  9. In vitro and in vivo antiplasmodial activity of three Rwandan medicinal plants and identification of their active compounds.

    Science.gov (United States)

    Muganga, Raymond; Angenot, Luc; Tits, Monique; Frédérich, Michel

    2014-04-01

    In our previous study, we reported the interesting in vitro antiplasmodial activity of some Rwandan plant extracts. This gave rise to the need for these extracts to also be evaluated in vivo and to identify the compounds responsible for their antiplasmodial activity. The aim of our study was, on the one hand, to evaluate the antiplasmodial activity in vivo and the safety of the selected Rwandan medicinal plants used in the treatment of malaria, with the objective of promoting the development of improved traditional medicines and, on the other hand, to identify the active ingredients in the plants. Plant extracts were selected according to their selectivity index. The in vivo antiplasmodial activity of aqueous, methanolic, and dichloromethane extracts was then evaluated using the classical 4-day suppressive test on Plasmodium berghei infected mice. The activity of the plant extracts was estimated by measuring the percentage of parasitemia reduction, and the survival of the experimental animals was recorded. A bioguided fractionation was performed for the most promising plants, in terms of antiplasmodial activity, in order to isolate active compounds identified by means of spectroscopic and spectrometric methods. The highest level of antiplasmodial activity was observed with the methanolic extract of Fuerstia africana (> 70 %) on days 4 and 7 post-treatment after intraperitoneal injection and on day 7 using oral administration. After oral administration, the level of parasitemia reduction observed on day 4 post-infection was 44 % and 37 % with the aqueous extract of Terminalia mollis and Zanthoxylum chalybeum, respectively. However, the Z. chalybeum extract presented a high level of toxicity after intraperitoneal injection, with no animals surviving on day 1 post-treatment. F. africana, on the other hand, was safer with 40 % mouse survival on day 20 post-treatment. Ferruginol is already known as the active ingredient in F. Africana, and ellagic acid (IC50

  10. Prevalence and psychosocial correlates of suicidal ideation among pregnant women living with HIV in Mpumalanga Province, South Africa.

    Science.gov (United States)

    Rodriguez, Violeta J; Cook, Ryan R; Peltzer, Karl; Jones, Deborah L

    2017-05-01

    Pregnant women living with HIV (WLHIV) in South Africa (SA) report higher rates of suicidal ideation than those who are HIV uninfected, and antenatal suicidal ideation has been previously associated with adverse maternal and neonatal outcomes. Few studies have attempted to identify correlates and psychosocial predictors of suicidal ideation in this population. In this study, we sought to estimate the prevalence of and identify risk factors for suicidal ideation among pregnant WLHIV in rural SA (N = 673). Thirty-nine percent of women endorsed suicidal ideation (95% CI: 35.2% to 42.3%) and in multivariable logistic regression analysis, suicidal ideation was associated with intimate partner violence and stigma, which interacted to multiplicatively increase the odds of suicidal thoughts. Given the high rates of reported suicidal ideation identified in this sample, and the potential harm to mothers and neonates, suicide risk assessment and management protocols for pregnant WLHIV should be considered for inclusion in the standard of care in rural SA.

  11. Immune activation markers in peripartum women in Botswana: association with feeding strategy and maternal morbidity.

    Directory of Open Access Journals (Sweden)

    Elizabeth S Russell

    Full Text Available Hormone levels shift the immune state in HIV-uninfected pregnant and breastfeeding women away from Th1 responses and toward regulation to permit fetal tolerance. Limited data exist on inflammation during pregnancy or postpartum in HIV-infected women, though certain inflammatory markers are associated with adverse health outcomes among HIV-infected persons. We measured hsCRP, D-dimer, IFN-γ, IL-6, IL-10 and TNF-α at 34 weeks gestation and six months postpartum in HIV-infected women from the Botswana Mashi PMTCT trial who were randomized to breastfeeding or formula-feeding. Differences in inflammatory markers between gestation and postpartum periods, and by randomized feeding method, were estimated using generalized estimating equations, adjusting for baseline plasma HIV-1 viral load, CD4 count, calendar time, and antiretroviral treatment status. Additionally, we studied the association between marker concentrations at six months postpartum and major adverse clinical events over the following 4.5 years, using case-cohort sampling and adjusted Cox proportional hazards models. In 86 breastfeeding and 75 formula-feeding women, hsCRP and D-dimer decreased significantly between 34 weeks gestation and six months postpartum, while IFN-γ increased. There was no significant association between inflammatory marker change and randomized feeding method after adjusting for multiple comparisons and removing outliers. In univariate analysis, TNF-α, D-dimer, and IFN-γ concentrations at six months postpartum were significant predictors of subsequent clinical events, and TNF-α remained significant in multivariate analysis (HR = 4.16, p = 0.001. In young HIV-infected women in Botswana inflammatory marker concentrations did not differ significantly between women who breast- vs. formula-fed. However, postpartum TNF-α level was predictive of subsequent adverse clinical event.

  12. ANALYSIS OF CORRELATION BETWEEN CONSUMPTION AND REVENUE IN RWANDAN ECONOMY (ECONOMETRIC APPROACH, PERIOD OF STUDY: 1980-2012

    Directory of Open Access Journals (Sweden)

    Habyarimana Cyprien

    2014-01-01

    Full Text Available This study was designed to make analysis of correlation between consumption and revenue in Rwandan Economy; but for having a deep analysis; other macroeconomic variables have been included such as: consumer price index and interest rate. Without a deep and safe analysis of the macroeconomic variables, our economy will not have a trend to follow.The econometric approach has been used for dissecting those macroeconomic variables, and various tools have been applied for avoiding the problem of spurious, nonsense regression. After running the model, the different results have been shown. Considering the model as whole, the correlation is high, R2 is 98%. The regression has provided the long-run relation between those macroeconomic variables, but the error correction model has not provided any information.In a given country if the consumption is not managed and linked with its explanatory variables, the economy is not sustained, reason why the present research has been conducted for showing the correlation between those variables and consumption and then after, there are the proposed measures for a sustainable economy after interpreting the results found. 

  13. High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines.

    Science.gov (United States)

    Gaisa, Michael; Ita-Nagy, Fanny; Sigel, Keith; Arens, Yotam; Hennessy, Mary Ann; Rodriguez-Caprio, Gabriela; Mullen, Michael; Aberg, Judith A; Cespedes, Michelle

    2017-02-01

    Human immunodeficiency virus (HIV)-infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  14. The legacy of gender-based violence and HIV/AIDS in the postgenocide era: Stories from women in Rwanda.

    Science.gov (United States)

    Russell, Susan Garnett; Lim, Sanaya; Kim, Paul; Morse, Sophie

    2016-07-01

    Drawing on qualitative interviews with 22 Rwandan women, we describe the lived experiences of women survivors of gender-based violence (GBV) more than a decade and a half after the 1994 Genocide. We argue that the intersection between GBV and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) has long-term implications: the majority of women interviewed continue to endure trauma, stigma, social isolation, and economic hardship in the postgenocide era and are in need of expanded economic and mental health support. Our findings have implications for the importance of providing integrated psychosocial support to survivors of GBV postconflict contexts.

  15. Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru.

    Science.gov (United States)

    Satcher, Milan F; Segura, Eddy R; Silva-Santisteban, Alfonso; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

    2017-08-01

    Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.

  16. Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi.

    Science.gov (United States)

    Price, Joan T; Rosenberg, Nora E; Vansia, Dhrutika; Phanga, Twambilile; Bhushan, Nivedita L; Maseko, Bertha; Brar, Savvy K; Hosseinipour, Mina C; Tang, Jennifer H; Bekker, Linda-Gail; Pettifor, Audrey

    2018-01-01

    Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception. This study is ongoing at 4 public health centers in Lilongwe, Malawi (2016-2017). AGYW of 15-24 years old were recruited to participate in a study assessing 4 models of service delivery. At each health center, participants completed a baseline survey assessing socioeconomic, behavioral, biomedical, and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry. Among 1000 AGYW, median age was 19 years (IQR: 17-21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (≤4 factors, 0.5%; 5-8 factors, 6%; >8 factors, 21%). Having more risk factors was also associated with higher risk perception (P risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry. Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.

  17. Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians.

    Science.gov (United States)

    Henwood, Patricia C; Mackenzie, David C; Rempell, Joshua S; Douglass, Emily; Dukundane, Damas; Liteplo, Andrew S; Leo, Megan M; Murray, Alice F; Vaillancourt, Samuel; Dean, Anthony J; Lewiss, Resa E; Rulisa, Stephen; Krebs, Elizabeth; Raja Rao, A K; Rudakemwa, Emmanuel; Rusanganwa, Vincent; Kyanmanywa, Patrick; Noble, Vicki E

    2016-12-01

    We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months. Trainee knowledge acquisition and skill retention were assessed via observed structured clinical examinations (OSCEs) administered at six points during the study, and an image-based assessment completed at three points. Trainees reported minimal structured ultrasound education and little confidence using point-of-care ultrasound before the training. Mean scores on the image-based assessment increased from 36.9% (95% CI 32-41.8%) before the initial 10-day training to 74.3% afterwards (95% CI 69.4-79.2; P < 0.001). The mean score on the initial OSCE after the introductory course was 81.7% (95% CI 78-85.4%). The mean OSCE performance at each subsequent evaluation was at least 75%, and the mean OSCE score at the 58-week follow up was 84.9% (95% CI 80.9-88.9%). Physicians providing acute care in a resource-limited setting demonstrated sustained improvement in their ultrasound knowledge and skill 1 year after completing a clinical ultrasound training programme. They also reported improvements in their ability to provide patient care and in job satisfaction. © 2016 John Wiley & Sons Ltd.

  18. Perceived and post-traumatic stress are associated with decreased learning, memory, and fluency in HIV-infected women.

    Science.gov (United States)

    Rubin, Leah H; Cook, Judith A; Springer, Gayle; Weber, Kathleen M; Cohen, Mardge H; Martin, Eileen M; Valcour, Victor G; Benning, Lorie; Alden, Christine; Milam, Joel; Anastos, Kathryn; Young, Mary A; Gustafson, Deborah R; Sundermann, Erin E; Maki, Pauline M

    2017-08-28

    Psychological risk factors (PRFs) are associated with impaired learning and memory in HIV-infected (HIV+) women. We determined the dynamic nature of the effects of PRFs and HIV serostatus on learning and memory over time. Multi-center, prospective cohort study METHODS:: Every two years between 2009 and 2013 (3 times), 646 HIV+ and 300 demographically-similar HIV-uninfected (HIV-) women from the Women's Interagency HIV Study completed neuropsychological (NP) testing and questionnaires measuring PRFs (perceived stress, post-traumatic stress disorder (PTSD) symptoms, depressive symptoms). Using mixed-effects regressions, we examined separate and interactive associations between HIV-serostatus and PRFs on performance over time. HIV+ and HIV- women had similar rates of PRFs. Fluency was the only domain where performance over time depended on the combined influence of HIV-serostatus and stress or PTSD (p's stress and PTSD were associated with a greater cognitive decline in performance (p's stress and PTSD. Irrespective of time, performance on learning and memory depended on the combined influence of HIV-serostatus and stress or PTSD (p's ≤ 0.05). In the context of HIV, stress and PTSD were negatively associated with performance. Effects were pronounced on learning among HIV+ women without effective treatment or viral suppression. Regardless of time or HIV-serostatus, all PRFs were associated with lower speed, global NP, and executive function. More than depression, perceived stress and PTSD symptoms are treatment targets to potentially improve fluency, learning, and memory in women living with HIV particularly when HIV treatment is not optimal.

  19. Food fortification improves the intake of all fortified nutrients, but fails to meet the estimated dietary requirements for vitamins A and B6, riboflavin and zinc, in lactating South African women.

    Science.gov (United States)

    Papathakis, Peggy C; Pearson, Kerry E

    2012-10-01

    To investigate the impact of fortification by comparing food records and selected biochemical indicators of nutritional status pre- and post-fortification. Mean intake from 24 h recalls (n 142) was compared with the Estimated Average Requirement (EAR) to determine the proportion with inadequate intake. In a subsample (n 34), diet and serum retinol, folate, ferritin and Zn were compared pre- and post-fortification for fortified nutrients vitamin A, thiamin, riboflavin, niacin, folic acid, Fe and Zn. South Africa. Breast-feeding women (ninety-four HIV-infected, forty eight HIV-uninfected) measured at ~6, 14, 24 weeks, and 9 and 12 months postpartum. Pre-fortification, >80 % of women did not meet the EAR for vitamins A, C, D, thiamin, riboflavin, niacin, B6, B12 and folate and minerals Zn, iodine and Ca. Dietary intake post-fortification increased for all fortified nutrients. In post-fortification food records, >70 % did not meet the EAR for Zn and vitamins A, riboflavin and B6. Serum folate and Zn increased significantly post-fortification (P 93 % were retinol replete. There was no change in Fe deficiency (16.7 % pre v. 19.4 % post; P = 0.728). Micronutrient intake improved with fortification, but >70 % of lactating women did not meet the EAR for Zn, vitamins A, riboflavin and B6. Although 100 % exceeded the EAR for Fe after fortification, Fe status did not improve.

  20. A time for renewal: a lessons-learned review on the role of CISM in caring for missionaries after the Rwandan genocide.

    Science.gov (United States)

    Feldbush, Martin W; Mitchell, Jeffrey T

    2010-01-01

    In 1994 more than 800,000 people were killed in the Rwandan genocide. Seventh Day Adventist missionaries were forced to evacuate the country under conditions of extraordinary stress and personal threat. Their Church was faced with the necessity of rapidly developing a spectrum of support services to assist the distressed missionaries and their family members in the immediate aftermath of the catastrophe. Individual missionaries, and sometimes their entire family units, had witnessed horrific atrocities perpetrated against members of their congregations and the general public. In some situations of their own church members actively participated in the murders. Church leaders combined their efforts with the resources of the International Critical Incident Stress Foundation to provide immediate, multifaceted support services to the missionaries and their families. This article briefly describes the breadth and depth of the specific Critical Incident Stress Management (CISM) program that was developed and provided to Rwandan Seventh Day Adventist missionaries in April of 1994. The results of a brief post-support evaluation survey are presented.

  1. The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C.

    Science.gov (United States)

    Fodor, Kinga E; Pozen, Joanna; Ntaganira, Joseph; Sezibera, Vincent; Neugebauer, Richard

    2015-05-01

    The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct. Copyright © 2015. Published by Elsevier Ltd.

  2. 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

  3. [Population: evolution of Rwandan attitudes or the adaptation of the Rwanda population to population growth].

    Science.gov (United States)

    Ngendakumana, M

    1988-04-01

    A consequence of the increasing pressure on Rwanda's ecosystem resulting from population growth has been that demographic factors have played a significant role in modifying attitudes and beliefs of the population. The history of Rwanda demonstrates a constant struggle for survival in the face of increasing population pressure. Migration, colonization of new agricultural lands, adoption of new crops and new forms of animal husbandry have been responses to population pressures. Recent unprecedented population growth has exceeded the capacity of older systems of cultivation and combinations of agricultural and animal husbandry to support the population. Smaller animals have largely replaced the cattle that once roamed freely in extensive pastures, and new techniques of stabling animals, use of organic or chemical fertilizers, and new tools adapted to the shrinking size of farm plots have represented responses to the new demographic realities. The concept of the family is likewise undergoing modification in the face of population growth and modernization. Children, who once were valued as a source of labor and constrained to conform to the wishes of the parents in return for the eventual inheritance of the goods and livelihood, now increasingly look beyond the household for education and employment. Family land holdings have become too small to support all the members with a claim on them. The greater distances between family members inevitably mean that relations between them lose closeness. The choice of a marriage partner is increasingly assumed by the young people themselves and not by their families. Old traditions of food sharing and hospitality have been curtailed because of the increasing scarcity of food. Despite the changes engendered by increasing population pressure, pronatalist sentiments are still widespread. But the desire to assure the future of each child rather than to await his services, a new conception of women less dependent on their reproductive

  4. Assessing the twinning model in the Rwandan Human Resources for Health Program: goal setting, satisfaction and perceived skill transfer.

    Science.gov (United States)

    Ndenga, Esperance; Uwizeye, Glorieuse; Thomson, Dana R; Uwitonze, Eric; Mubiligi, Joel; Hedt-Gauthier, Bethany L; Wilkes, Michael; Binagwaho, Agnes

    2016-01-28

    Because of the shortage of health professionals, particularly in specialty areas, Rwanda initiated the Human Resources for Health (HRH) Program. In this program, faculty from United States teaching institutions (USF) "twin" with Rwandan Faculty (RF) to transfer skills. This paper assesses the twinning model, exploring USF and RF goal setting, satisfaction and perceptions of the effectiveness of skill transfer within the twinning model. All USF and RF in the HRH Program from August 2012-May 2014 were invited to participate. An 85-item questionnaire for USF and 71-item questionnaire for RF were administered via Survey Monkey in April and May 2014. Associations among primary outcomes were assessed and factors related with outcomes were modeled using logistic regression. Most RF and USF reported setting goals with their twin (89% and 71%, respectively). Half of RF (52%) reported effective skill transfer compared to 10% of USF. Only 38% of RF and 28% of USF reported being very satisfied with the twinning model. There was significant overlap in the three operational outcomes. For RF, the following factors were associated with outcomes: for effective skill transfer, being able to communicate in a common language and working at a nursing site outside of Kigali; and for satisfaction, 7+ years of professional experience and being part of a male RF-female USF twin pair. For USF, the following factors were associated with outcomes: for setting goals, prior teaching experience; and for satisfaction, experience in low resource settings for one month or less and feeling that HRH promotes a culture of respect. Twinning is the cornerstone of the HRH Program in Rwanda. These findings helped the HRH team identify key areas to improve the twinning experience including better recruitment and orientation of USF and RF, consideration of additional factors during the twinning process, provide language training support, facilitate joint twin activities and cross-cultural training and

  5. Hepatitis B virus strains from Rwandan blood donors are genetically similar and form one clade within subgenotype A1.

    Science.gov (United States)

    Twagirumugabe, Theogene; Swaibu, Gatare; Walker, Timothy David; Lindh, Magnus; Gahutu, Jean Bosco; Bergström, Tomas; Norder, Heléne

    2017-01-06

    Rwanda is a central African country with about 12 million inhabitants. The 1994 genocide against the Tutsi destroyed much of the infrastructure, including the health system. Although this has improved significantly, many challenges remain to be addressed. In this study, the prevalence of serological markers of past and ongoing hepatitis B virus (HBV) infection and HBV vaccine related immunity was investigated in samples from blood donors from all regions of Rwanda. The results from hepatitis B surface antigen (HBsAg) analyses of all (45,061) blood donations collected countrywide in 2014 from 13,637 first time and 31,424 repeat blood donors were compiled. Samples from 581 HBsAg negative blood donors were selected for further analysis for antibodies against HBV, anti-HBs and anti-HBc. Additional 139 samples from HBsAg positive donors were analyzed for HBeAg/anti-HBe (132 samples) and for HBV DNA. The S-gene was amplified by PCR, products sequenced, and phylogenetic analysis was performed. HBsAg was found in 4.1% of first time donors with somewhat higher prevalence among those from the Central and Eastern regions than from other parts of the country. Indications of past infection was found in 21% of the HBsAg negative donors, 4.3% had only anti-HBs suggesting HBV vaccination. HBeAg was detected in 28 (21%), anti-HBe in 97 (73%), and both HBeAg and anti-HBe in 4 of 132 HBsAg positive donors. HBV DNA was found in 85 samples, and the complete S-gene was sequenced in 58 of those. Phylogenetic analysis of the sequences revealed that all HBV strains belonged to subgenotype A1, and formed one clade in the phylogenetic tree. In addition, 12 strains from first time donors had a unique 18 amino acid deletion in the N-terminal part of the pre-S2 region. This study indicated that the prevalence of hepatitis B is intermediate in Rwanda and that the vaccination coverage is relatively low in young adults. All surveyed Rwandan blood donors were infected with similar subgenotype A1

  6. HIV-positive pregnant and postpartum women's perspectives about Option B+ in Malawi: a qualitative study.

    Science.gov (United States)

    Katirayi, Leila; Namadingo, Hazel; Phiri, Mafayo; Bobrow, Emily A; Ahimbisibwe, Allan; Berhan, Aida Yemane; Buono, Nicole; Moland, Karen Marie; Tylleskär, Thorkild

    2016-01-01

    The implementation of lifelong antiretroviral treatment (ART) for all pregnant women (Option B+) in Malawi has resulted in a significant increase in the number of HIV-positive pregnant women initiating treatment. However, research has highlighted the challenge of retaining newly initiated women in care. This study explores barriers and facilitators that affect a woman's decision to initiate and to adhere to Option B+. A total of 39 in-depth interviews and 16 focus group discussions were conducted. Eligible women were ≥18 years old, living with HIV and either pregnant and receiving antenatal care from a study site or had delivered a child within the last 18 months, breastfed their child and received services at one of the study sites. Eligible women were identified by healthcare workers (HCWs) in the antenatal clinic and ART unit. Focus groups were also conducted with HCWs employed in these departments. Qualitative data were analyzed using Maxqda version 10 (VERBI Software, Berlin, Germany). The general perception towards the drug regimen used in Option B+ was positive; women reported fewer side effects and acknowledged the positive benefits of ART. Women felt hopeful about prolonging their life and having an HIV-uninfected baby, yet grappled with the fact that ART is a lifelong commitment. Women and HCWs discussed challenges with the counselling services for prevention of mother-to-child HIV transmission under the new Option B+ guidelines, and many women struggled with initiating ART on the same day as learning their HIV status. Women wanted to discuss their circumstances with their husbands first, receive a CD4 count and obtain an HIV test at another facility to confirm their HIV status. HCWs expressed concern that women might just agree to take the drugs to please them. HCWs also discussed concerns around loss to follow-up and drug resistance. Although Option B+ has significantly increased the number of women initiating ART, there are still challenges that need

  7. Maternal Near Miss and quality of care in a rural Rwandan hospital.

    Science.gov (United States)

    Kalisa, Richard; Rulisa, Stephen; van den Akker, Thomas; van Roosmalen, Jos

    2016-10-21

    The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death. In 3979 deliveries, 3827 singletons and 152 twins pairs were born. Among the 4131 neonates, there were 3994 live births and 137 stillbirths. Ninety-nine women suffered severe maternal outcome (SMO): 86 maternal near misses and 13 deaths. This adds up to a maternal near miss ratio of 21.5 per 1000 live births (95 % CI 17.3-26.5), a maternal mortality ratio of 325 per 100 000 live births (95 % CI 181-543) and a mortality index of 13.1 % (95 % CI 7.3-21.9). Hemorrhage (n = 49, 57 %) and hypertensive disorders (n = 27, 31.4 %) were the commonest MNM conditions. Eclampsia (n = 4/13; 30.7 %) was the leading cause of maternal mortality, while sepsis/peritonitis following cesarean section (n = 2/6; 33.3 %) had the highest mortality index. Seventy-seven out of 99 SMO cases (77.9 %) were referred from other facilities with critical conditions and 28 out of 99 SMO cases (28.3 %) were admitted into the Intensive Care Unit. Several indicators such as administration of oxytocin, magnesium sulfate and antibiotics were found to be suboptimal. MNM is common at district level in Rwanda. The MNM approach enabled us to identify shortfalls in clinical practice and the referral system.

  8. Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience.

    Science.gov (United States)

    Chotun, Nafiisah; Preiser, Wolfgang; van Rensburg, Christoffel Johannes; Fernandez, Pedro; Theron, Gerhard Barnard; Glebe, Dieter; Andersson, Monique Ingrid

    2017-01-01

    Elimination of HIV and syphilis mother-to-child transmission (MTCT) has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC) test and implementing interventions to prevent HBV MTCT. In this observational prospective cohort study, HIV-uninfected pregnant women who consented to testing were screened for HBV using a rapid POC test for HBsAg. Positive results were laboratory-confirmed and tested for HBV DNA and serological markers. Women with viral loads ≥ 20 000 IU/ml received tenofovir (TDF) treatment and all infants received birth-dose HBV vaccine. Two blood samples collected six months apart from HBV-exposed infants within their first year of life were tested for HBV DNA. Of 144 women who were approached, 134 consented to participating (93% acceptance rate of HBV POC test). Six women tested positive for HBsAg (4.5%; 95% CI 0.99%-8.01%), all confirmed by laboratory testing. Two mothers, M1 and M4, were treated with TDF during their third trimester of pregnancy. Six HBV-exposed infants received the HBV vaccine within 24 hours of birth, of whom two were lost to follow-up and four (including the two born to M1 and M4) had undetectable levels of HBV DNA when tested at the two time points. We found that HBV screening using POC testing fulfilled the criteria considered necessary for implementation. It has acceptable performance, is inexpensive, reliable, and was well accepted by the study participants. Screening pregnant women as part of the HBV MTCT prevention strategy is therefore feasible in a South African clinical setting.

  9. Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience.

    Directory of Open Access Journals (Sweden)

    Nafiisah Chotun

    Full Text Available Elimination of HIV and syphilis mother-to-child transmission (MTCT has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC test and implementing interventions to prevent HBV MTCT.In this observational prospective cohort study, HIV-uninfected pregnant women who consented to testing were screened for HBV using a rapid POC test for HBsAg. Positive results were laboratory-confirmed and tested for HBV DNA and serological markers. Women with viral loads ≥ 20 000 IU/ml received tenofovir (TDF treatment and all infants received birth-dose HBV vaccine. Two blood samples collected six months apart from HBV-exposed infants within their first year of life were tested for HBV DNA.Of 144 women who were approached, 134 consented to participating (93% acceptance rate of HBV POC test. Six women tested positive for HBsAg (4.5%; 95% CI 0.99%-8.01%, all confirmed by laboratory testing. Two mothers, M1 and M4, were treated with TDF during their third trimester of pregnancy. Six HBV-exposed infants received the HBV vaccine within 24 hours of birth, of whom two were lost to follow-up and four (including the two born to M1 and M4 had undetectable levels of HBV DNA when tested at the two time points.We found that HBV screening using POC testing fulfilled the criteria considered necessary for implementation. It has acceptable performance, is inexpensive, reliable, and was well accepted by the study participants. Screening pregnant women as part of the HBV MTCT prevention strategy is therefore feasible in a South African clinical setting.

  10. Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa.

    Science.gov (United States)

    Mlisana, Koleka; Naicker, Nivashnee; Werner, Lise; Roberts, Lindi; van Loggerenberg, Francois; Baxter, Cheryl; Passmore, Jo-Ann S; Grobler, Anneke C; Sturm, A Willem; Williamson, Carolyn; Ronacher, Katharina; Walzl, Gerhard; Abdool Karim, Salim S

    2012-07-01

    Diagnosis and treatment of sexually transmitted infections (STIs) is a public health priority, particularly in regions where the incidence of human immunodeficiency virus (HIV) infection is high. In most developing countries, STIs are managed syndromically. We assessed the adequacy of syndromic diagnosis of STIs, compared with laboratory diagnosis of STIs, and evaluated the association between STI diagnosis and the risk of HIV acquisition in a cohort of high-risk women. HIV-uninfected high-risk women (n = 242) were followed for 24 months. Symptoms of STIs were recorded, and laboratory diagnosis of common STI pathogens was conducted every 6 months. Forty-two cytokines were measured by Luminex in cervicovaginal lavage specimens at enrollment. Human immunodeficiency virus type 1 (HIV-1) infection was evaluated monthly. Only 12.3% of women (25 of 204) who had a laboratory-diagnosed, discharge-causing STI had clinically evident discharge. Vaginal discharge was thus a poor predictor of laboratory-diagnosed STIs (sensitivity, 12.3%; specificity, 93.8%). Cervicovaginal cytokine concentrations did not differ between women with asymptomatic STIs and those with symptomatic STIs and were elevated in women with asymptomatic STIs, compared with women with no STIs or bacterial vaginosis. Although laboratory-diagnosed STIs were associated with increased risk of HIV infection (hazard ratio, 3.3 [95% confidence interval, 1.5-7.2)], clinical symptoms were not. Syndromic STI diagnosis dependent on vaginal discharge was poorly predictive of laboratory-diagnosed STI. Laboratory-diagnosed STIs were associated with increased susceptibility to HIV acquisition, while vaginal discharge was not.

  11. Pregnancy Incidence and Outcomes among Women Receiving Pre-Exposure Prophylaxis for HIV Prevention: A Randomized Clinical Trial

    Science.gov (United States)

    Mugo, Nelly R.; Hong, Ting; Celum, Connie; Donnell, Deborah; Bukusi, Elizabeth A.; John-Stewart, Grace; Wangisi, Jonathan; Were, Edwin; Heffron, Renee; Matthews, Lynn T.; Morrison, Susan; Ngure, Kenneth; Baeten, Jared M.

    2015-01-01

    Importance Antiretroviral pre-exposure prophylaxis (PrEP), using tenofovir disoproxil fumarate and combination tenofovir disoproxil fumarate / emtricitabine, is efficacious for prevention of HIV acquisition. PrEP could reduce periconception HIV risk, but the effect on pregnancy outcomes is not well defined. Objective To assess pregnancy incidence and outcomes among women using PrEP during the periconception period. Design Randomized trial among 1785 HIV serodiscordant heterosexual couples (the Partners PrEP Study) in which the female partner was HIV uninfected that demonstrated that PrEP was efficacious for HIV prevention, conducted between July 2008 and June 2013 at 9 sites in Kenya and Uganda. Intervention Daily oral tenofovir disoproxil fumarate (TDF) (n=598), combination tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) (n=566), or placebo (n=621) through July 2011, when PrEP demonstrated efficacy for HIV prevention; thereafter, participants continued receiving active PrEP, without placebo. Pregnancy testing occurred monthly and study medication was discontinued upon pregnancy detection. Main Outcomes Pregnancy incidence, birth outcomes (pregnancy loss, preterm birth, congenital anomalies), infant growth. Results A total of 431 pregnancies occurred. Pregnancy incidence was 10.0 per 100 person-years among women assigned placebo, 11.9 among those assigned TDF (incidence difference 1.9, 95% confidence interval [CI] −1.1–4.9, p=0.22 versus placebo), and 8.8 among those assigned TDF-FTC (incidence difference −1.3, 95% CI −4.1–1.5, p=0.39 versus placebo). Prior to discontinuation of the placebo treatment group in July 2011, the occurrence of pregnancy loss (96 of 288 pregnancies), was 42.5% for women receiving TDF-FTC compared with 32.3% for those receiving placebo (difference for TDF-FTC versus placebo 10.2%, 95% CI −5.3–25.7, p=0.16) and was 27.7% for those receiving TDF alone (difference versus placebo −4.6%, 95% CI −18.1–8.9, p=0

  12. Punishing Genocide: A Comparative Empirical Analysis of Sentencing Laws and Practices at the International Criminal Tribunal for Rwanda (ICTR, Rwandan Domestic Courts, and Gacaca Courts

    Directory of Open Access Journals (Sweden)

    Barbora Hola

    2016-12-01

    Full Text Available This article compares sentencing of those convicted of participation in the 1994 genocide in Rwanda. With over one million people facing trial, Rwanda constitutes the world’s most comprehensive case of criminal accountability after genocide and presents an important case study of punishing genocide. Criminal courts at three different levels— international, domestic, and local—sought justice in the aftermath of the violence. In order to compare punishment at each level, we analyze an unprecedented database of sentences given by the ICTR, the Rwandan domestic courts, and Rwanda’s Gacaca courts. The analysis demonstrates that sentencing varied across the three levels—ranging from limited time in prison to death sentences. We likewise find that sentencing at the domestic courts appears to have been comparatively more serious than sentencing at the ICTR and at the Gacaca courts, which calls into question consistency of sentences across levels of justice and should be explored in future research.

  13. Associations between plasma tenofovir concentration and renal function markers in HIV-infected women

    Directory of Open Access Journals (Sweden)

    Mwila Mulubwa

    2016-02-01

    Full Text Available Background: Tenofovir disoproxil fumarate (TDF has been associated with kidney tubulardys function and reduced renal function. Limited studies were performed in Europe and Asia that related plasma tenofovir (TFV concentration with renal function; no such studies to date have been performed on Africans.Objective: To investigate the correlation between plasma tenofovir (TFV concentration and certain renal function markers in HIV-infected women on TDF antiretroviral therapy (ART.These markers were also compared to a HIV-uninfected control group.Methods: HIV-infected women (n = 30 on TDF-based ART were matched with 30 controls forage and body mass index. Renal markers analysed were estimated glomerular filtration rate (eGFR, creatinine clearance (CrCl, serum creatinine, albuminuria, glucosuria, serum urea, serum uric acid, urine sodium and maximum tubular reabsorption of phosphate. Baseline eGFR and CrCl data were obtained retrospectively for the HIV-infected women. Plasma TFV was assayed using a validated HPLC-MS/MS method. Step wise regression, Mann–Whitney test, unpaired and paired t-tests were applied in the statistical analyses.Results: TFV concentration was independently associated with albuminuria (adjusted r2 = 0.339; p = 0.001 in HIV-infected women. In the adjusted (weight analysis, eGFR (p = 0.038,CrCl (p = 0.032 and albuminuria (p = 0.048 were significantly higher in HIV-infected compared to the uninfected women, but eGFR was abnormally high in HIV-infected women. Both eGFR (p < 0.001 and CrCl (p = 0.008 increased from baseline to follow-up in HIV-infected women.Conclusion: Plasma TFV concentration was associated with increased albuminuria in HIV infected women in this sub-study. Both eGFR and CrCl were increased in HIV-infected women from baseline. These findings should be confirmed in larger studies, and hyperfiltration in HIV-infected women warrants further investigation.

  14. Association of the Fractal Dimension of Retinal Arteries and Veins with Quantitative Brain MRI Measures in HIV-Infected and Uninfected Women.

    Science.gov (United States)

    Crystal, Howard A; Holman, Susan; Lui, Yvonne W; Baird, Alison E; Yu, Hua; Klein, Ronald; Rojas-Soto, Diana Marcella; Gustafson, Deborah R; Stebbins, Glenn T

    2016-01-01

    The fractal dimension of retinal arteries and veins is a measure of the complexity of the vascular tree. We hypothesized that retinal fractal dimension would be associated with brain volume and white matter integrity in HIV-infected women. Nested case-control within longitudinal cohort study. Women were recruited from the Brooklyn site of the Women's Interagency HIV study (WIHS); 34 HIV-infected and 21 HIV-uninfected women with analyzable MRIs and retinal photographs were included. Fractal dimension was determined using the SIVA software program on skeletonized retinal images. The relationship between predictors (retinal vascular measures) and outcomes (quantitative MRI measures) were analyzed with linear regression models. All models included age, intracranial volume, and both arterial and venous fractal dimension. Some models were adjusted for blood pressure, race/ethnicity, and HIV-infection. The women were 45.6 ± 7.3 years of age. Higher arterial dimension was associated with larger cortical volumes, but higher venous dimension was associated with smaller cortical volumes. In fully adjusted models, venous dimension was significantly associated with fractional anisotropy (standardized β = -0.41, p = 0.009) and total gray matter volume (β = -0.24, p = 0.03), and arterial dimension with mean diffusivity (β = -0.33,.p = 0.04) and fractional anisotropy (β = 0.34, p = 0.03). HIV-infection was not associated with any retinal or MRI measure. Higher venous fractal dimension was associated with smaller cortical volumes and lower fractional anisotropy, whereas higher arterial fractal dimension was associated with the opposite patterns. Longitudinal studies are needed to validate this finding.

  15. Relative time to pregnancy among HIV-infected and uninfected women in the Women’s Interagency HIV Study, 2002–2009

    Science.gov (United States)

    LINAS, Beth S.; MINKOFF, Howard; COHEN, Mardge H.; KARIM, Roksana; COHAN, Deborah; WRIGHT, Rodney L.; YOUNG, Mary; WATTS, D. Heather; GOLUB, Elizabeth T.

    2012-01-01

    Objectives To determine the incidence rate of, and the relative time to pregnancy by HIV status in US women between 2002 and 2009. Design The Women’s Interagency HIV Study (WIHS) is an ongoing, multicenter prospective cohort study of the natural and treated history of HIV infection and related outcomes among women with and without HIV. Methods Eligible participants were ≤45 years of age; sexually active with male partner(s) or reported a pregnancy outcome within the past year; and never reported hysterectomy, tubal ligation, or oopherectomy. Poisson regression was conducted to compare pregnancy incidence rates over time by HIV status. Relative time to pregnancy was ascertained via Kaplan-Meier plots and generalized gamma survival analysis. Results Adjusting for age, number of male sex partners, contraception, parity, exchanging sex, and alcohol use, HIV infection was associated with a 40% reduction in the incidence rate of pregnancy (incidence rate ratio=0.60, 95% confidence interval: [C.I.] 0.46–0.78). The time for HIV-infected women to become pregnant was 73% longer relative to HIV-uninfected women (relative time=1.73, 95% C.I.: 1.35–2.36). In addition to HIV infection, decreased parity and older age were independent predictors of lower pregnancy incidence. Conclusions Despite the beneficial effects of modern antiretroviral therapy on survival and prevention of maternal-to-child transmission, our findings suggest that pregnancy incidence remains lower among HIV-infected women. Whether this lower incidence is due to behavioral differences or reduced biologic fertility remains an area worthy of further study. PMID:21297418

  16. Studies of Cream Seeded Carioca Beans (Phaseolus vulgaris L.) from a Rwandan Efficacy Trial: In Vitro and In Vivo Screening Tools Reflect Human Studies and Predict Beneficial Results from Iron Biofortified Beans.

    Science.gov (United States)

    Tako, Elad; Reed, Spenser; Anandaraman, Amrutha; Beebe, Steve E; Hart, Jonathan J; Glahn, Raymond P

    2015-01-01

    targeting of such compounds during the breeding process may yield improved dietary Fe-bioavailability. Our findings are in agreement with the human efficacy trial that demonstrated that the biofortified carioca beans improved the Fe-status of Rwandan women. We suggest the utilization of these in vitro and in vivo screening tools to guide studies aimed to develop and evaluate biofortified staple food crops. This approach has the potential to more effectively utilize research funds and provides a means to monitor the nutritional quality of the Fe-biofortified crops once released to farmers.

  17. Studies of Cream Seeded Carioca Beans (Phaseolus vulgaris L. from a Rwandan Efficacy Trial: In Vitro and In Vivo Screening Tools Reflect Human Studies and Predict Beneficial Results from Iron Biofortified Beans.

    Directory of Open Access Journals (Sweden)

    Elad Tako

    , specific targeting of such compounds during the breeding process may yield improved dietary Fe-bioavailability. Our findings are in agreement with the human efficacy trial that demonstrated that the biofortified carioca beans improved the Fe-status of Rwandan women. We suggest the utilization of these in vitro and in vivo screening tools to guide studies aimed to develop and evaluate biofortified staple food crops. This approach has the potential to more effectively utilize research funds and provides a means to monitor the nutritional quality of the Fe-biofortified crops once released to farmers.

  18. Rwandan Journal of Education

    African Journals Online (AJOL)

    reviewed, and annual journal dedicated to education. Its primary goal is to publish and advance knowledge and research in the field of education. The journal is based at the University of Rwanda – College of Education (former Kigali Institute of ...

  19. GB Virus C (GBV-C) Infection in Hepatitis C Virus (HCV) Seropositive Women with or at Risk for HIV Infection.

    Science.gov (United States)

    Blackard, Jason T; Ma, Gang; Welge, Jeffrey A; King, Caroline C; Taylor, Lynn E; Mayer, Kenneth H; Klein, Robert S; Celentano, David D; Sobel, Jack D; Jamieson, Denise J; Gardner, Lytt

    2014-01-01

    GB virus C (GBV-C) may have a beneficial impact on HIV disease progression; however, the epidemiologic characteristics of this virus are not well characterized. Behavioral factors and gender may lead to differential rates of GBV-C infection; yet, studies have rarely addressed GBV-C infections in women or racial/ethnic minorities. Therefore, we evaluated GBV-C RNA prevalence and genotype distribution in a large prospective study of high-risk women in the US. 438 hepatitis C virus (HCV) seropositive women, including 306 HIV-infected and 132 HIV-uninfected women, from the HIV Epidemiologic Research Study were evaluated for GBV-C RNA. 347 (79.2%) women were GBV-C RNA negative, while 91 (20.8%) were GBV-C RNA positive. GBV-C positive women were younger than GBV-C negative women. Among 306 HIV-infected women, 70 (22.9%) women were HIV/GBV-C co-infected. Among HIV-infected women, the only significant difference between GBV-negative and GBV-positive women was age (mean 38.4 vs. 35.1 years; pGBV-C genotypes were 1 (n = 31; 44.3%), 2 (n = 36; 51.4%), and 3 (n = 3; 4.3%). The distribution of GBV-C genotypes in co-infected women differed significantly by race/ethnicity. However, median CD4 cell counts and log10 HIV RNA levels did not differ by GBV-C genotype. GBV-C incidence was 2.7% over a median follow-up of 2.9 (IQR: 1.5, 4.9) years, while GBV-C clearance was 35.7% over a median follow-up of 2.44 (1.4, 3.5) years. 4 women switched genotypes. Age, injection drug use, a history of sex for money or drugs, and number of recent male sex partners were associated with GBV-C infection among all women in this analysis. However, CD4 cell count and HIV viral load of HIV/HCV/GBV-C co-infected women were not different although race was associated with GBV-C genotype.

  20. GB Virus C (GBV-C Infection in Hepatitis C Virus (HCV Seropositive Women with or at Risk for HIV Infection.

    Directory of Open Access Journals (Sweden)

    Jason T Blackard

    Full Text Available GB virus C (GBV-C may have a beneficial impact on HIV disease progression; however, the epidemiologic characteristics of this virus are not well characterized. Behavioral factors and gender may lead to differential rates of GBV-C infection; yet, studies have rarely addressed GBV-C infections in women or racial/ethnic minorities. Therefore, we evaluated GBV-C RNA prevalence and genotype distribution in a large prospective study of high-risk women in the US.438 hepatitis C virus (HCV seropositive women, including 306 HIV-infected and 132 HIV-uninfected women, from the HIV Epidemiologic Research Study were evaluated for GBV-C RNA. 347 (79.2% women were GBV-C RNA negative, while 91 (20.8% were GBV-C RNA positive. GBV-C positive women were younger than GBV-C negative women. Among 306 HIV-infected women, 70 (22.9% women were HIV/GBV-C co-infected. Among HIV-infected women, the only significant difference between GBV-negative and GBV-positive women was age (mean 38.4 vs. 35.1 years; p<0.001. Median baseline CD4 cell counts and plasma HIV RNA levels were similar. The GBV-C genotypes were 1 (n = 31; 44.3%, 2 (n = 36; 51.4%, and 3 (n = 3; 4.3%. The distribution of GBV-C genotypes in co-infected women differed significantly by race/ethnicity. However, median CD4 cell counts and log10 HIV RNA levels did not differ by GBV-C genotype. GBV-C incidence was 2.7% over a median follow-up of 2.9 (IQR: 1.5, 4.9 years, while GBV-C clearance was 35.7% over a median follow-up of 2.44 (1.4, 3.5 years. 4 women switched genotypes.Age, injection drug use, a history of sex for money or drugs, and number of recent male sex partners were associated with GBV-C infection among all women in this analysis. However, CD4 cell count and HIV viral load of HIV/HCV/GBV-C co-infected women were not different although race was associated with GBV-C genotype.

  1. Combination Antiretroviral Therapy for HIV in Rwandan Adults: Clinical Outcomes and Impact on Reproductive Health up to 24 Months

    NARCIS (Netherlands)

    Asiimwe-Kateera, Brenda; Veldhuijzen, Nienke; Balinda, Jean Paul; Rusine, John; Eagle, Sally; Vyankandondera, Joseph; Mugabekazi, Julie; Ondoa, Pascale; Boer, Kimberly; Asiimwe, Anita; Lange, Joep; Reiss, Peter; van de Wijgert, Janneke

    2015-01-01

    Adult women (n = 113) and men (n = 100) initiating combination antiretroviral therapy (cART) and women not yet eligible for cART (n = 199) in Kigali, Rwanda, were followed for 6-24 months between 2007 and 2010. In the cART groups, 21% of patients required a drug change due to side effects and 11% of

  2. Condom migration after introduction of pre-exposure prophylaxis among HIV-uninfected adolescents in South Africa: A cohort analysis

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    Lennart P. Maljaars

    2017-09-01

    Full Text Available Background: Approximately 3 million adolescents and young adults (AYA, between the ages of 15 years and 24 years, are living with HIV in sub-Saharan Africa. The use of pre-exposure prophylaxis (PrEP may be a promising HIV prevention tool to bridge the high-risk years of AYA between sexual debut and adulthood. Objectives: Concerns have been raised that the use of PrEP could lead to an increase in sexual risk behaviour and sexually transmitted infections in general and less condom use in particular among adolescents. Methods: This study assesses condom use among South African adolescents enrolled on a demonstration PrEP study, called Pluspills, being conducted in Cape Town and Soweto. A questionnaire on sexual risk behaviour was administered at baseline and after 4, 8 and 12 weeks. Three different questions on condom use were asked at each visit. Unless all answers indicated condom use at all times, a participant was scored ‘at risk’. McNemar’s tests and a Cochran’s Q test were used to investigate changes in condom use over time. Results: We interviewed 148 adolescents (66% female at baseline. Eighty-nine participants completed all visits. In this group, an increase in condom use was observed over the period of 12 weeks. Most participants who reported behavioural changes mentioned an increase in condom use. Conclusion: There was no sign of sexual risk compensation in the 12 weeks of the study. Observed increase in condom use can be explained by an increased awareness of personal HIV risk or by social desirability or recall biases. In future research, additional data including other biomarkers of unprotected sex and longer follow-up time would be useful to help understand the relationship between PrEP use, sexual risk perception and consequent behaviours, especially in adolescents.

  3. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

    NARCIS (Netherlands)

    Mazur, Natalie I; Bont, Louis; Cohen, Adam L; Cohen, Cheryl; von Gottberg, Anne; Groome, Michelle J; Hellferscee, Orienka; Klipstein-Grobusch, Kerstin; Mekgoe, Omphile; Naby, Fathima; Moyes, Jocelyn; Tempia, Stefano; Treurnicht, Florette K; Venter, Marietje; Walaza, Sibongile; Wolter, Nicole; Madhi, Shabir A

    2017-01-01

    Background.: Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort.

  4. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control...... hospitalization for ischemic heart disease and comorbidity were obtained from the Danish National Hospital Registry for all study participants. We used Cox's regression to compute the hospitalization rate ratio as an estimate of relative risk, adjusting for comorbidity. RESULTS: Although the difference...

  5. Estimating the risk of HIV transmission from homosexual men receiving treatment to their HIV-uninfected partners

    NARCIS (Netherlands)

    Hallett, Timothy B.; Smit, Colette; Garnett, Geoff P.; de Wolf, Frank

    2011-01-01

    To determine how the risk of HIV transmission from homosexual men receiving antiretroviral treatment is related to patterns of patient monitoring and condom use. A stochastic mathematical simulation model was developed of cohorts of men in the Netherlands who have sex with men (MSM), defining the

  6. Estimating the risk of HIV transmission from homosexual men receiving treatment to their HIV-uninfected partners

    NARCIS (Netherlands)

    Hallett, T.B.; Smit, C.; Garnett, G.P.; de Wolf, F.

    2011-01-01

    Objective To determine how the risk of HIV transmission from homosexual men receiving antiretroviral treatment is related to patterns of patient monitoring and condom use. Methods A stochastic mathematical simulation model was developed of cohorts of men in the Netherlands who have sex with men

  7. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control...... group. METHODS: We determined the rate of first hospitalization for ischemic heart disease in all Danish patients with HIV infection (3953 patients) from 1 January 1995 through 31 December 2004 and compared this rate with that for 373,856 subjects in a population-based control group. Data on first...... was not statistically significant, patients with HIV infection who had not initiated HAART were slightly more likely to be hospitalized for the first time with ischemic heart disease than were control subjects (adjusted relative risk, 1.39; 95% confidence interval, 0.81-2.33). After HAART initiation, the risk increase...

  8. Condom migration after introduction of pre-exposure prophylaxis among HIV-uninfected adolescents in South Africa: A cohort analysis

    Directory of Open Access Journals (Sweden)

    Lennart P. Maljaars

    2017-01-01

    Full Text Available Background: Approximately 3 million adolescents and young adults (AYA, between the ages of 15 years and 24 years, are living with HIV in sub-Saharan Africa. The use of pre-exposure prophylaxis (PrEP may be a promising HIV prevention tool to bridge the high-risk years of AYA between sexual debut and adulthood.Objectives: Concerns have been raised that the use of PrEP could lead to an increase in sexual risk behaviour and sexually transmitted infections in general and less condom use in particular among adolescents.Methods: This study assesses condom use among South African adolescents enrolled on a demonstration PrEP study, called Pluspills, being conducted in Cape Town and Soweto. A questionnaire on sexual risk behaviour was administered at baseline and after 4, 8 and 12 weeks. Three different questions on condom use were asked at each visit. Unless all answers indicated condom use at all times, a participant was scored ‘at risk’. McNemar’s tests and a Cochran’s Q test were used to investigate changes in condom use over time.Results: We interviewed 148 adolescents (66% female at baseline. Eighty-nine participants completed all visits. In this group, an increase in condom use was observed over the period of 12 weeks. Most participants who reported behavioural changes mentioned an increase in condom use.Conclusion: There was no sign of sexual risk compensation in the 12 weeks of the study. Observed increase in condom use can be explained by an increased awareness of personal HIV risk or by social desirability or recall biases. In future research, additional data including other biomarkers of unprotected sex and longer follow-up time would be useful to help understand the relationship between PrEP use, sexual risk perception and consequent behaviours, especially in adolescents.

  9. Association study of trauma load and SLC6A4 promoter polymorphism in posttraumatic stress disorder: evidence from survivors of the Rwandan genocide.

    Science.gov (United States)

    Kolassa, Iris-Tatjana; Ertl, Verena; Eckart, Cindy; Glöckner, Franka; Kolassa, Stephan; Papassotiropoulos, Andreas; de Quervain, Dominique J-F; Elbert, Thomas

    2010-05-01

    As exposure to different types of traumatic stressors increases, the occurrence of posttraumatic stress disorder (PTSD) increases. However, because some people exhibit either surprising resilience or high vulnerability, further influencing factors have been conjectured, such as gene-environment interactions. The SLC6A4 gene, which encodes serotonin transporter, has been identified as predisposing toward differential emotional processing between genotypes of its promoter polymorphism. We investigated 408 refugees from the Rwandan genocide and assessed lifetime exposure to traumatic events, PTSD (according to DSM-IV) status, and genotype of the SLC6A4 promoter polymorphism. The study was conducted from March 2006 to February 2007. The prevalence of PTSD approached 100% when traumatic exposure reached extreme levels. However, persons homozygous for the short allele of the SLC6A4 promoter polymorphism showed no dose-response relationship but were at high risk for developing PTSD after very few traumatic events. This genotype influence vanished with increasing exposure to traumatic stressors. We find evidence for a gene-environment interplay for PTSD and show that genetic influences lose importance when environmental factors cause an extremely high trauma burden to an individual. In the future, it may be important to determine whether the effectiveness of therapeutic interventions in PTSD is also modulated by the SLC6A4 genotype. ©Copyright 2010 Physicians Postgraduate Press, Inc.

  10. Trust, Individual Guilt, Collective Guilt and Dispositions Toward Reconciliation Among Rwandan Survivors and Prisoners Before and After Their Participation in Postgenocide Gacaca Courts in Rwanda

    Directory of Open Access Journals (Sweden)

    Patrick Kanyangara

    2014-08-01

    Full Text Available A field experiment compared the level of personal and collective guilt in survivors (N = 200 and accused perpetrators (N = 184 of the Rwandan genocide before and after participation in Gacaca community courts and in control groups of survivors (N = 195 and prisoners (N = 179 who did not participate in Gacaca. Participation in Gacaca led to a marked reduction in survivors’ personal and collective guilt and to an increase in prisoners' personal guilt. Prisoners’ collective guilt was unaffected by participation but collective guilt was higher for prisoners participating in Gacaca suggesting an effect of the mere anticipation of participation. Survivors who participated in Gacaca had greater doubts about Gacaca, trusted the prisoners' apologies less, were less inclined to forgive, were more revengeful, and opted more for intragroup contact and less for intergroup contact. In sum, participation in Gacaca failed to have direct effects upon dispositions to reconciliation but it produced important indirect effects in this direction by drastically reducing survivors' guilt feelings, which may have enhanced their empowerment.

  11. Male partner circumcision associated with lower Trichomonas vaginalis incidence among pregnant and postpartum Kenyan women: a prospective cohort study.

    Science.gov (United States)

    Pintye, Jillian; Drake, Alison L; Unger, Jennifer A; Matemo, Daniel; Kinuthia, John; McClelland, R Scott; John-Stewart, Grace

    2017-03-01

    Trichomonas vaginalis is the world's most common curable STI and has implications for reproductive health in women. We determined incidence and correlates of T. vaginalis in an HIV-uninfected peripartum cohort. Women participating in a prospective study of peripartum HIV acquisition in Western Kenya were enrolled during pregnancy and followed until 9 months post partum. T. vaginalis was assessed every 1-3 months using wet mount microscopy. Correlates of incident T. vaginalis were determined using Cox proportional hazards models. Among 1271 women enrolled, median age was 22 years (IQR 19-27) and gestational age was 22 weeks (IQR 18-26); most (78%) were married and had uncircumcised male partners (69%). Prevalent T. vaginalis was detected in 81 women (6%) at enrolment. Among women without T. vaginalis at enrolment, 112 had T. vaginalis detected during 1079 person-years of follow-up (10.4 per 100 person-years). After adjustment for socio-economic factors, male partner circumcision status, pregnancy status and other STIs, T. vaginalis incidence was higher during pregnancy than post partum (22.3 vs 7.7 per 100 person-years, adjusted HR (aHR) 3.68, 95% CI 1.90 to 7.15, pvaginalis compared with women with uncircumcised partners (aHR 0.42, 95% CI 0.23 to 0.76, p=0.004). Employed women had lower risk of incident T. vaginalis than unemployed women (aHR 0.49, 95% CI 0.31 to 0.79, p=0.003); recent STI was associated with increased T. vaginalis risk (aHR 2.97, 95% CI 1.49 to 5.94, p=0.002). T. vaginalis was relatively common in this peripartum cohort. Male circumcision may confer benefits in preventing T. vaginalis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. The effect of HIV infection and HCV viremia on inflammatory mediators and hepatic injury-The Women's Interagency HIV Study.

    Science.gov (United States)

    Keating, Sheila M; Dodge, Jennifer L; Norris, Philip J; Heitman, John; Gange, Stephen J; French, Audrey L; Glesby, Marshall J; Edlin, Brian R; Latham, Patricia S; Villacres, Maria C; Greenblatt, Ruth M; Peters, Marion G

    2017-01-01

    Hepatitis C virus infection induces inflammation and while it is believed that HIV co-infection enhances this response, HIV control may reduce inflammation and liver fibrosis in resolved or viremic HCV infection. Measurement of systemic biomarkers in co-infection could help define the mechanism of inflammation on fibrosis and determine if HIV control reduces liver pathology. A nested case-control study was performed to explore the relationship of systemic biomarkers of inflammation with liver fibrosis in HCV viremic and/or seropositive women with and without HIV infection. Serum cytokines, chemokines, growth factors and cell adhesion molecules were measured in HIV uninfected (HIV-, n = 18), ART-treated HIV-controlled (ARTc, n = 20), uncontrolled on anti-retroviral therapy (ARTuc, n = 21) and elite HIV controllers (Elite, n = 20). All were HCV seroreactive and had either resolved (HCV RNA-; infection (HCV RNA+). In HCV and HIV groups, aspartate aminotransferase to platelet ratio (APRI) was measured and compared to serum cytokines, chemokines, growth factors and cell adhesion molecules. APRI correlated with sVCAM, sICAM, IL-10, and IP-10 levels and inversely correlated with EGF, IL-17, TGF-α and MMP-9 levels. Collectively, all HCV RNA+ subjects had higher sVCAM, sICAM and IP-10 compared to HCV RNA-. In the ART-treated HCV RNA+ groups, TNF-α, GRO, IP-10, MCP-1 and MDC were higher than HIV-, Elite or both. In ARTuc, FGF-2, MPO, soluble E-selectin, MMP-9, IL-17, GM-CSF and TGF-α are lower than HIV-, Elite or both. Differential expression of soluble markers may reveal mechanisms of pathogenesis or possibly reduction of fibrosis in HCV/HIV co-infection.

  13. The effect of HIV infection and HCV viremia on inflammatory mediators and hepatic injury-The Women's Interagency HIV Study.

    Directory of Open Access Journals (Sweden)

    Sheila M Keating

    Full Text Available Hepatitis C virus infection induces inflammation and while it is believed that HIV co-infection enhances this response, HIV control may reduce inflammation and liver fibrosis in resolved or viremic HCV infection. Measurement of systemic biomarkers in co-infection could help define the mechanism of inflammation on fibrosis and determine if HIV control reduces liver pathology. A nested case-control study was performed to explore the relationship of systemic biomarkers of inflammation with liver fibrosis in HCV viremic and/or seropositive women with and without HIV infection. Serum cytokines, chemokines, growth factors and cell adhesion molecules were measured in HIV uninfected (HIV-, n = 18, ART-treated HIV-controlled (ARTc, n = 20, uncontrolled on anti-retroviral therapy (ARTuc, n = 21 and elite HIV controllers (Elite, n = 20. All were HCV seroreactive and had either resolved (HCV RNA-; <50IU/mL or had chronic HCV infection (HCV RNA+. In HCV and HIV groups, aspartate aminotransferase to platelet ratio (APRI was measured and compared to serum cytokines, chemokines, growth factors and cell adhesion molecules. APRI correlated with sVCAM, sICAM, IL-10, and IP-10 levels and inversely correlated with EGF, IL-17, TGF-α and MMP-9 levels. Collectively, all HCV RNA+ subjects had higher sVCAM, sICAM and IP-10 compared to HCV RNA-. In the ART-treated HCV RNA+ groups, TNF-α, GRO, IP-10, MCP-1 and MDC were higher than HIV-, Elite or both. In ARTuc, FGF-2, MPO, soluble E-selectin, MMP-9, IL-17, GM-CSF and TGF-α are lower than HIV-, Elite or both. Differential expression of soluble markers may reveal mechanisms of pathogenesis or possibly reduction of fibrosis in HCV/HIV co-infection.

  14. Postnatal anemia and iron deficiency in HIV-infected women and the health and survival of their children

    Science.gov (United States)

    Isanaka, Sheila; Spiegelman, Donna; Aboud, Said; Manji, Karim P.; Msamanga, Gernard I.; Willet, Walter C.; Duggan, Christopher; Fawzi, Wafaie W.

    2011-01-01

    Prenatal iron supplementation may improve pregnancy outcomes and decrease the risk of child mortality. However, little is known about the importance of postnatal maternal iron status for child health and survival, particularly in the context of HIV infection. We examined the association of maternal anemia and hypochromic microcytosis, an erythrocyte morphology consistent with iron deficiency, with child health and survival in the first two to five years of life. Repeated measures of maternal anemia and hypochromic microcytosis from 840 HIV-positive women enrolled in a clinical trial of vitamin supplementation were prospectively related to child mortality, HIV infection, and CD4 T-cell count. Median duration of follow-up for the endpoints of child mortality, HIV infection and CD4 cell count was 58, 17 and 23 months, respectively. Maternal anemia and hypochromic microcytosis were associated with greater risk of child mortality (HR for severe anemia=2.58, 95% CI: 1.66-4.01, P trendanemia was not significantly associated with greater risk of child HIV infection (HR for severe anemia=1.46, 95% CI: 0.91, 2.33, P trend=0.08) but predicted lower CD4 T-cell counts among HIV-uninfected children (difference in CD4 T-cell count/μL for severe anemia:-93, 95% CI: -204-17, P trend=0.02). The potential child health risks associated with maternal anemia and iron deficiency may not be limited to the prenatal period. Efforts to reduce maternal anemia and iron deficiency during pregnancy may need to be expanded to include the postpartum period. PMID:22236211

  15. High viral load and elevated angiogenic markers associated with increased risk of preeclampsia among women initiating highly active antiretroviral therapy in pregnancy in the Mma Bana study, Botswana.

    Science.gov (United States)

    Powis, Kathleen M; McElrath, Thomas F; Hughes, Michael D; Ogwu, Anthony; Souda, Sajini; Datwyler, Saul A; von Widenfelt, Erik; Moyo, Sikhulile; Nádas, Marisa; Makhema, Joseph; Machakaire, Esther; Lockman, Shahin; Essex, Max; Shapiro, Roger L

    2013-04-15

    Risk factors associated with preeclampsia in HIV-infected women remain largely unknown. Systemic angiogenic imbalance contributes to preeclampsia in HIV-uninfected women, but changes in angiogenic markers after highly active antiretroviral therapy (HAART) initiation have not been studied. The Mma Bana study randomized 560 HIV-infected, HAART-naive pregnant women with CD4 counts ≥ 200 cells per cubic millimeter between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine or abacavir/zidovudine/lamivudine. Another 170 participants with CD4 counts less than 200 cells per cubic millimeter initiated nevirapine/zidovudine/lamivudine between 18 and 34 weeks gestation. Characteristics of 11 women who developed preeclampsia were compared with the remaining 722 Mma Bana participants who delivered using logistic regression. Plasma samples drawn at HAART initiation and 1 month later from 60 women without preeclampsia and at HAART initiation for all 11 preeclamptic women were assayed for placental growth factor (PlGF) and soluble FMS toll-like tyrosine kinase-1 (sFlt-1). Pre-HAART viral load greater than 100,000 copies per milliliter was associated with preeclampsia (odds ratio: 5.8, 95% confidence interval: 1.8 to 19.4, P = 0.004). Median pre-HAART PlGF level was lower and sFlt-1 was higher in women who developed preeclampsia vs those who did not (130 vs 992 pg/mL, P = 0.001; 17.5 vs 9.4 pg/mL, P = 0.03, respectively). In multivariate analysis, PlGF and viral load remained significantly associated with preeclampsia. No significant changes in angiogenic factors were noted after 1 month of HAART treatment among non-preeclamptic women. Pre-HAART viral load greater than 100,000 copies per milliliter and PlGF predicted preeclampsia among women starting HAART in pregnancy. Among non-preeclamptic women, HAART treatment did not significantly alter levels of PlGF or sFlt-1 after 1 month of treatment.

  16. Implementing the Emergency Triage, Assessment and Treatment plus admission care (ETAT+) clinical practice guidelines to improve quality of hospital care in Rwandan district hospitals: healthcare workers' perspectives on relevance and challenges.

    Science.gov (United States)

    Hategeka, Celestin; Mwai, Leah; Tuyisenge, Lisine

    2017-04-07

    An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation. HCWs enrolled in the ETAT+ training were asked, immediately after the training, their perspective regarding (i) relevance of the ETAT+ training to Rwandan district hospitals; (ii) if attending the training would bring about change in their work; and (iii) challenges that they encountered during the training, as well as those they anticipated to hamper their ability to translate the knowledge and skills learned in the ETAT+ training into practice in order to improve care for severely ill infants and children in their hospitals. They wrote their perspectives in French, Kinyarwanda, or English and sometimes a mixture of all these languages that are official in the post-genocide Rwanda. Their notes were translated to (if not already in) English and transcribed, and transcripts were analyzed using thematic content analysis. One hundred seventy-one HCWs were included in our analysis. Nearly all these HCWs stated that the training was highly relevant to the district hospitals and that it aligned with their work expectation. However, some midwives believed that the "neonatal resuscitation and feeding" components of the training were more relevant to them than other components. Many HCWs anticipated to change practice by initiating a triage system in their hospital and by using job aids including guidelines for prescription and feeding. Most of the challenges stemmed

  17. Transgenerational consequences of PTSD: risk factors for the mental health of children whose mothers have been exposed to the Rwandan genocide.

    Science.gov (United States)

    Roth, Maria; Neuner, Frank; Elbert, Thomas

    2014-04-01

    Understanding how parental Posttraumatic Stress Disorder (PTSD) may or may not affect the development and mental health in the offspring is particularly important in conflict regions, where trauma-related illness is endemic. In Rwanda, organised atrocities and the genocide against the Tutsi of 1994 have left a significant fraction of the population with chronic PTSD. The aim of the present investigation was to establish whether PTSD in mothers is associated with symptoms of depression, anxiety, and aggressive and antisocial behaviour in their children. A community sample of 125 Rwandan mothers who experienced the genocide of 1994 and their 12-year-old children were interviewed. Using a structured interview, symptoms of maternal PTSD and children's depression, anxiety, and aggressive and antisocial behaviour were assessed by trained and on-site supervised local B.A. psychologists. The interview also included a detailed checklist of event types related to family violence. In showing that a maternal PTSD was not associated with child's psychopathology, the results contradict the assumption of straight "trans-generational trauma transmission". Instead, a child's exposure to maternal family violence posed a significant risk factor for a negative mental health outcome. Furthermore, it was not maternal PTSD-symptoms but mother's exposure to family violence during her own childhood that was associated with the magnitude of adversities that a child experiences at home. Contrary to a simple model of a trans-generational transmission of trauma, neither maternal PTSD nor maternal traumatic experiences were directly associated with symptoms of anxiety, depression, or antisocial and aggressive behaviour in the children. Instead, the present results suggest a relationship between parental child rearing practices and children's mental health. Furthermore, the study details the "cycle of violence", showing a significant link between maternal violence against a child and its mother

  18. Nothing can defeat combined hands (Abashize hamwe ntakibananira): protective processes and resilience in Rwandan children and families affected by HIV/AIDS.

    Science.gov (United States)

    Betancourt, Theresa Stichick; Meyers-Ohki, Sarah; Stulac, Sara N; Barrera, Amy Elizabeth; Mushashi, Christina; Beardslee, William R

    2011-09-01

    In Rwanda, the dual vectors of HIV and legacy of the 1994 genocide have had devastating consequences for children and families. In this and other low-resource settings, extreme poverty, poor access to services, family conflict, and other adversities put children and families affected by HIV/AIDS at increased risk of mental health problems. However, even in the face of tremendous hardship, many children and families demonstrate better than expected outcomes. To design interventions that harness these natural sources of resilience, greater knowledge of local protective processes is needed. This study used free listing exercises (N = 68) and key informant interviews (N = 58) with adults and children (ages 10-17) to investigate strengths and sources of resilience in Rwandan children and families at risk for psychosocial difficulties due to HIV/AIDS. Clinician key informants (N = 10) were also interviewed. Five forms of protective resources emerged through this research: perseverance (kwihangana); self-esteem/self-confidence (kwigirira ikizere); family unity/trust (kwizerana); good parenting (kurera neza) and collective/communal support (ubufasha abaturage batanga). Operating within individual, family, and collective/community systems, these resources support children at multiple ecological levels. Study evidence suggests that these protective processes provide "leverage points" for strengths-based interventions designed to increase resilient outcomes and prevent mental health problems. This information on culturally-appropriate practices for building resilience, along with input from local community advisory boards and the government, has informed the development of a Family Strengthening Intervention, which has broad applications to many forms of adversity and trauma. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. "A man's gonna do what a man wants to do": African American and Hispanic women's perceptions about heterosexual relationships: a qualitative study.

    Science.gov (United States)

    McLellan-Lemal, Eleanor; Toledo, Lauren; O'Daniels, Christine; Villar-Loubet, Olga; Simpson, Cathy; Adimora, Ada A; Marks, Gary

    2013-05-24

    HIV prevention efforts have given limited attention to the relational schemas and scripts of adult heterosexual women. These broader schemas and scripts of romantic and other sexual liaisons, partner selection, relationship dynamics, and power negotiations may help to better understand facilitators and barriers to HIV risk-reduction practices. We conducted exploratory qualitative interviews with 60 HIV-uninfected heterosexual African-American women from rural counties in North Carolina and Alabama, and Hispanic women from an urban county in southern Florida. Data were collected for relationship expectations; relationship experiences, and relationship power and decision-making. Interview transcripts underwent computer-assisted thematic analysis. Participants had a median age of 34 years (range 18-59), 34% were married or living as married, 39% earned an annual income of $12,000 or less, 12% held less than a high school education, and 54% were employed. Among the Hispanic women, 95% were foreign born. We identified two overarching relationship themes: contradictions between relationship expectations and desires and life circumstances that negated such ideals, and relationship challenges. Within the contradictions theme, we discovered six subthemes: a good man is hard to find; sex can be currency used to secure desired outcomes; compromises and allowances for cheating, irresponsible, and disrespectful behavior; redefining dating; sex just happens; needing relationship validation. The challenges theme centered on two subthemes: uncertainties and miscommunication, and relationship power negotiation. Gender differences in relationship intentions and desires as well as communication styles, the importance of emotional and financial support, and the potential for relationships to provide disappointment were present in all subthemes. In examining HIV risk perceptions, participants largely held that risk for HIV-infection and the need to take precautions were problems of

  20. Detection and treatment of Fiebig stage I HIV-1 infection in young at-risk women in South Africa: a prospective cohort study.

    Science.gov (United States)

    Dong, Krista L; Moodley, Amber; Kwon, Douglas S; Ghebremichael, Musie S; Dong, Mary; Ismail, Nasreen; Ndhlovu, Zaza M; Mabuka, Jenniffer M; Muema, Daniel M; Pretorius, Karyn; Lin, Nina; Walker, Bruce D; Ndung'u, Thumbi

    2018-01-01

    HIV incidence among young women in sub-Saharan Africa remains high and their inclusion in vaccine and cure efforts is crucial. We aimed to establish a cohort of young women detected during Fiebig stage I acute HIV infection in whom treatment was initiated immediately after diagnosis to advance research in this high-risk group. 945 women aged 18-23 years in KwaZulu-Natal, South Africa, who were HIV uninfected and sexually active consented to HIV-1 RNA testing twice a week and biological sampling and risk assessment every 3 months during participation in a 48-96 week life-skills and job-readiness programme. We analysed the effect of immediate combination antiretroviral therapy (ART) on viraemia and immune responses, sexual risk behaviour, and the effect of the socioeconomic intervention. 42 women were diagnosed with acute HIV infection between Dec 1, 2012, and June 30, 2016, (incidence 8·2 per 100 person-years, 95% CI 5·9-11·1), of whom 36 (86%) were diagnosed in Fiebig stage I infection with a median initial viral load of 2·97 log10 copies per mL (IQR 2·42-3·85). 23 of these 36 women started ART at a median of 1 day (1-1) after detection, which limited the median peak viral load to 4·22 log10 copies per mL (3·27-4·83) and the CD4 nadir to 685 cells per μL (561-802). ART also suppressed viral load (to women, prevented seroconversion, as shown with western blotting. 385 women completed the 48 week socioeconomic intervention, of whom 231 were followed up for 1 year. 202 (87%) of these 231 women were placed in jobs, returned to school, or started a business. Frequent HIV screening combined with a socioeconomic intervention facilitated sampling and risk assessment before and after infection. In addition to detection of acute infection and immediate treatment, we established a cohort optimised for prevention and cure research. Bill & Melinda Gates Foundation, National Institute of Allergy and Infectious Diseases, International AIDS Vaccine Initiative, Wellcome

  1. Pathway to social justice: research on human rights and gender-based violence in a Rwandan refugee cAMP.

    Science.gov (United States)

    Pavlish, Carol; Ho, Anita

    2009-01-01

    Gender-based violence persists in postconflict settings. Implementing an ethnographic study with Congolese refugees in Rwanda, we investigated community perspectives on justice and human rights. As core concepts, participants described the right to equal value as human beings and the corresponding responsibility to respect human rights as the basis for justice. Three factors that impede human rights include cultural ideology, social distance, and lack of a rights-enabling environment. Men described gender similarities while women emphasized gender differences in human rights. Ecological perspectives and rights-based approaches to achieving social justice seem warranted.

  2. Use of Lipid-Based Nutrient Supplements by HIV-Infected Malawian Women during Lactation Has No Effect on Infant Growth from 0 to 24 Weeks1234

    Science.gov (United States)

    Flax, Valerie L.; Bentley, Margaret E.; Chasela, Charles S.; Kayira, Dumbani; Hudgens, Michael G.; Knight, Rodney J.; Soko, Alice; Jamieson, Denise J.; van der Horst, Charles M.; Adair, Linda S.

    2012-01-01

    The Breastfeeding, Antiretrovirals, and Nutrition Study evaluated the effect of daily consumption of lipid-based nutrient supplements (LNS) by 2121 lactating, HIV-infected mothers on the growth of their exclusively breast-fed, HIV-uninfected infants from 0 to 24 wk. The study had a 2 × 3 factorial design. Malawian mothers with CD4+ ≥250 cells/mm3, hemoglobin ≥70 g/L, and BMI ≥17 kg/m2 were randomized within 36 h of delivery to receive either no LNS or 140 g/d of LNS to meet lactation energy and protein needs, and mother-infant pairs were assigned to maternal antiretroviral drugs (ARV), infant ARV, or no ARV. Sex-stratified, longitudinal, random effects models were used to estimate the effect of the 6 study arms on infant weight, length, and BMI. Logistic regression models were used to calculate the odds of growth faltering [decline in weight-for-age Z-score (WAZ) or length-for-age Z-score (LAZ) >0.67] using the control arm as the reference. Although some differences between study arms emerged with increasing infant age in boys, there were no consistent effects of the maternal supplement across the 3 growth outcomes in longitudinal models. At the ages where differences were observed, the effects on weight and BMI were quite small (≤200 g and ≤0.4 kg/m2) and unlikely to be of clinical importance. Overall, 21 and 34% of infants faltered in WAZ and LAZ, respectively. Maternal supplementation did not reduce the odds of infant weight or length faltering from 0 to 24 wk in any arm. These results indicate that blanket supplementation of HIV-infected lactating women may have little impact on infant growth. PMID:22649265

  3. Liver and renal safety of tenofovir disoproxil fumarate in combination with emtricitabine among African women in a pre-exposure prophylaxis trial.

    Science.gov (United States)

    Mandala, Justin; Nanda, Kavita; Wang, Meng; De Baetselier, Irith; Deese, Jennifer; Lombaard, Johan; Owino, Fredrick; Malahleha, Mookho; Manongi, Rachel; Taylor, Douglas; Van Damme, Lut

    2014-12-24

    Safety of tenofovir disoproxil fumarate/emtricitabine (TDF-FTC) has been studied more extensively among HIV-infected patients than among HIV-uninfected people. Using data from a pre-exposure trial - FEM-PrEP -, we determined the cumulative probabilities of grade 1+ ALT, AST and creatinine and grade 2+ phosphorus toxicities; ALT/AST toxicities by baseline hepatitis B status; and change in mean creatinine, phosphorus, ALT and AST levels controlling for TDF-FTC adherence. FEM-PrEP was a randomized, blinded, placebo-controlled trial of daily TDF-FTC among women in Africa. Enrolled women were in general good health, HIV antibody negative, 18 to 35 years old, hepatitis B surface antigen negative, and had normal hepatic and renal function at baseline. AST, ALT, phosphorus and serum creatinine were measured regularly throughout the trial. TDF-FTC concentrations were measured to assess adherence to TDF-FTC. The cumulative probabilities of grade 1+ creatininemia and grade 2+ phosphatemia toxicities were not statistically different between TDF-FTC and placebo arms. The cumulative probabilities of grade 1+ ALT and AST toxicities were higher among participants in the TDF-FTC arm than in the placebo arm (p = 0.03 for both). The proportions of grade 1+ and grade 2+ ALT or AST toxicities were significantly higher in participants who were hepatitis B virus surface antibody (HBsAb) positive than in those who were HBsAb-negative. Women with good adherence had higher mean change from baseline to week 4 in their AST levels (2.90 (0.37, 5.42); p = 0.025) than women with less than good adherence. We did not observe a significant relationship between randomization to TDF-FTC and creatinine or phosphorus toxicities. Women randomized to TDF-FTC had higher rates of mild to moderate ALT/AST toxicities, especially women with prior hepatitis B virus exposure. We also observed a significant increase in AST from baseline to week 4 among women who had higher adherence to TDF-FTC during that

  4. Carcinogenicity of Human Papillomavirus (HPV) Types in HIV-Positive Women: A Meta-Analysis From HPV Infection to Cervical Cancer.

    Science.gov (United States)

    Clifford, Gary M; Tully, Stephen; Franceschi, Silvia

    2017-05-01

    Data on the relative carcinogenic potential of human papillomavirus (HPV) types among women infected with human immunodeficiency virus (HIV) (WHIV) are needed to inform prevention programs for this population. A systematic literature review and meta-analysis of high-risk HPV-type distribution in 19883 HIV-positive women was performed. The women, from 86 studies worldwide, included 11739 with normal cytological findings; 1784 with atypical squamous cells of undetermined significance (ASCUS); 2173 with low-grade and 1282 with high-grade squamous intraepithelial lesions (HSILs) diagnosed cytologically; 1198 with cervical intraepithelial neoplasia grade 1 (CIN1), 456 with CIN2, and 455 with CIN3 diagnosed histologically; and 796 with invasive cervical cancers (ICCs). A large proportion of WHIV, and almost all with ICCs, were from Africa. In Africa, HPV 16 accounted for 13% of HPV-positive WHIV with normal cytological findings, but this proportion increased through ASCUS, low-grade squamous intraepithelial lesions, CIN1, and CIN2 (18%-25%), up to 41%-47% for CIN3 and ICCs. Only HPV 16, HPV 18, and HPV 45 accounted for a greater proportion of HPV infections in ICCs compared with normal cytological findings (ICC:normal ratios, 3.68, 2.47, and 2.55, respectively). Other high-risk types accounted for important proportions of low- and/or high-grade lesions, but their contribution dropped in ICCs, with ICC:normal ratios in Africa ranging from 0.79 for HPV 33 down to 0.38 for HPV 56. Findings for HPV 16 and HPV 18 in Europe/North America, Asia, and Latin America were compatible with those from Africa. HPV 16 and HPV 18 in particular, but also HPV 45, at least in Africa, warrant special attention in WHIV. Broad consistency of findings with those in HIV-uninfected population would suggest that the risk stratification offered by partial HPV genotyping tests also have relevance for HIV-positive women.

  5. Maternal HIV status and infant feeding practices among Ugandan ...

    African Journals Online (AJOL)

    ... 30% of the HIV-infected women and 55% of the HIV-uninfected mothers were using mixed feeding, with no significant differences. Programmes for the prevention of motherto- child transmission of HIV should re-enforce counselling activities to address the issue of early weaning by HIV-infected women, and to support safe ...

  6. Rwandan Journal of Education: Submissions

    African Journals Online (AJOL)

    Style: For referencing style, authors must follow guidelines in the latest edition of the American Psychological Association (APA) guidelines (http://www.apa.org), and paginate all text at the centre bottom of each page. Examples of APA Bibliography: Abd-Kadir, J., & Hardman F. (2007). The discourse of whole class teaching: ...

  7. a Rwandan-Canadian partnership

    African Journals Online (AJOL)

    abp

    2014-04-25

    Apr 25, 2014 ... Abstract. Simulation replicates clinical experiences without patient risk; it remains uncommon in lower-income countries. We outline the creation of Rwanda's first centre for simulation and skills training. We secured funding for renovations, equipment and staff; curricula were developed, tested, and refined ...

  8. Prevalence of shingles and its association with PTSD among HIV-infected women in Rwanda.

    Science.gov (United States)

    Sinayobye, Jean d'Amour; Hoover, Donald R; Shi, Qiuhu; Mutimura, Eugene; Cohen, Hillel W; Anastos, Kathryn

    2015-03-06

    To examine the prevalence of reported shingles in the last 6 months and its association with post-traumatic stress disorder (PTSD), depression and severity of HIV disease in Rwandan women with HIV. This cross-sectional study was conducted as part of the Rwanda Women's Interassociation Study and Assessment (RWISA), an observational cohort study designed to assess the impact of HIV and residual factors from experiencing rape in the 1994 genocide in Rwandan women. Participants were recruited through grassroots women's associations of people living with HIV infection and clinical care sites for HIV infection. Most participants (58.5%, n=405/692) had PTSD. This cross-sectional analysis was conducted in 710 HIV-infected women enrolled in RWISA. Inclusion criteria were: age >15 years, informed consent, HIV test, ability to complete the interview in the local language, travel to and from the research site and participate in a baseline outpatient visit, and being naive to antiretroviral therapy at enrolment. The outcome of interest was self-reported shingles in the past 6 months. The exposure was PTSD defined using the cross-culturally validated Harvard Trauma Questionnaire. Overall prevalence of reported shingles in the past 6 months was 12.5% (n=89/710). There was an inverse relationship between shingles prevalence and immunological status: 7.6%, 12.3% and 16.7% of women with CD4 >350, 200-350 and <200 cells/µL, respectively, reported singles (p=0.01). In multivariate analysis, PTSD (aOR 1.7; 95% CI 1.02 to 2.89) and low CD4 (aOR 2.4; 95% CI 1.23 to 4.81) were independently associated with reported shingles in the past 6 months. Our study found a significant independent relationship between PTSD and reported shingles, suggesting that PTSD may be associated with immune compromise that can result in herpes zoster reactivation. Further study is needed. It also confirmed previous findings of a strong relationship between shingles and greater immunosuppression in

  9. Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomised trial in Rakai, Uganda.

    Science.gov (United States)

    Wawer, Maria J; Tobian, Aaron A R; Kigozi, Godfrey; Kong, Xiangrong; Gravitt, Patti E; Serwadda, David; Nalugoda, Fred; Makumbi, Frederick; Ssempiija, Victor; Sewankambo, Nelson; Watya, Stephen; Eaton, Kevin P; Oliver, Amy E; Chen, Michael Z; Reynolds, Steven J; Quinn, Thomas C; Gray, Ronald H

    2011-01-15

    Randomised trials show that male circumcision reduces the prevalence and incidence of high-risk human papillomavirus (HPV) infection in men. We assessed the efficacy of male circumcision to reduce prevalence and incidence of high-risk HPV in female partners of circumcised men. In two parallel but independent randomised controlled trials of male circumcision, we enrolled HIV-negative men and their female partners between 2003 and 2006, in Rakai, Uganda. With a computer-generated random number sequence in blocks of 20, men were assigned to undergo circumcision immediately (intervention) or after 24 months (control). HIV-uninfected female partners (648 of men from the intervention group, and 597 of men in the control group) were simultaneously enrolled and provided interview information and self-collected vaginal swabs at baseline, 12 months, and 24 months. Vaginal swabs were tested for high-risk HPV by Roche HPV Linear Array. Female HPV infection was a secondary endpoint of the trials, assessed as the prevalence of high-risk HPV infection 24 months after intervention and the incidence of new infections during the trial. Analysis was by intention-to-treat. An as-treated analysis was also done to account for study-group crossovers. The trials were registered, numbers NCT00425984 and NCT00124878. During the trial, 18 men in the control group underwent circumcision elsewhere, and 31 in the intervention group did not undergo circumcision. At 24-month follow-up, data were available for 544 women in the intervention group and 488 in the control group; 151 (27·8%) women in the intervention group and 189 (38·7%) in the control group had high-risk HPV infection (prevalence risk ratio=0·72, 95% CI 0·60-0·85, p=0·001). During the trial, incidence of high-risk HPV infection in women was lower in the intervention group than in the control group (20·7 infections vs 26·9 infections per 100 person-years; incidence rate ratio=0·77, 0·63-0·93, p=0·008). Our findings

  10. Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine.

    Science.gov (United States)

    Madhi, Shabir A; Izu, Alane; Nunes, Marta C; Violari, Avye; Cotton, Mark F; Jean-Philippe, Patrick; Klugman, Keith P; von Gottberg, Anne; van Niekerk, Nadia; Adrian, Peter V

    2015-05-28

    Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age. HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method. Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7. Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania

    DEFF Research Database (Denmark)

    PrayGod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel

    2011-01-01

    Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patients with smear-positive (PTB+) or -negative (PTB-) pul......-) pulmonary TB were randomly allocated to receive a daily biscuit with or without multi-micronutrients for 60 d during the intensive phase of TB treatment. Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi...... as a biscuit is beneficial among HIV- PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients....

  12. Analysis of the Phenotype of Mycobacterium tuberculosis-Specific CD4+ T Cells to Discriminate Latent from Active Tuberculosis in HIV-Uninfected and HIV-Infected Individuals

    Directory of Open Access Journals (Sweden)

    Catherine Riou

    2017-08-01

    Full Text Available Several immune-based assays have been suggested to differentiate latent from active tuberculosis (TB. However, their relative performance as well as their efficacy in HIV-infected persons, a highly at-risk population, remains unclear. In a study of 81 individuals, divided into four groups based on their HIV-1 status and TB disease activity, we compared the differentiation (CD27 and KLRG1, activation (HLA-DR, homing potential (CCR4, CCR6, CXCR3, and CD161 and functional profiles (IFNγ, IL-2, and TNFα of Mycobacterium tuberculosis (Mtb-specific CD4+ T cells using flow cytometry. Active TB disease induced major changes within the Mtb-responding CD4+ T cell population, promoting memory maturation, elevated activation and increased inflammatory potential when compared to individuals with latent TB infection. Moreover, the functional profile of Mtb-specific CD4+ T cells appeared to be inherently related to their degree of differentiation. While these specific cell features were all capable of discriminating latent from active TB, irrespective of HIV status, HLA-DR expression showed the best performance for TB diagnosis [area-under-the-curve (AUC = 0.92, 95% CI: 0.82–1.01, specificity: 82%, sensitivity: 84% for HIV− and AUC = 0.99, 95% CI: 0.98–1.01, specificity: 94%, sensitivity: 93% for HIV+]. In conclusion, these data support the idea that analysis of T cell phenotype can be diagnostically useful in TB.

  13. Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults.

    Directory of Open Access Journals (Sweden)

    Brian W Pence

    Full Text Available In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations.We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228, individuals newly testing positive for HIV (n = 267, individuals testing negative for HIV at the same sites (n = 182, and a random sample of community-dwelling adults (n = 249. We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively than the community cohort (1.8 and 2.3. Those with established HIV infection reported greater post-traumatic stress disorder (PTSD symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning.This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.

  14. Prevalence of Psychological Trauma and Association with Current Health and Functioning in a Sample of HIV-infected and HIV-uninfected Tanzanian Adults

    Science.gov (United States)

    Pence, Brian W.; Shirey, Kristen; Whetten, Kathryn; Agala, Bernard; Itemba, Dafrosa; Adams, Julie; Whetten, Rachel; Yao, Jia; Shao, John

    2012-01-01

    Background In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA) than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations. Methodology/Principal Findings We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228), individuals newly testing positive for HIV (n = 267), individuals testing negative for HIV at the same sites (n = 182), and a random sample of community-dwelling adults (n = 249). We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively) than the community cohort (1.8 and 2.3). Those with established HIV infection reported greater post-traumatic stress disorder (PTSD) symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning. Conclusions/Significance This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries. PMID:22606252

  15. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children

    NARCIS (Netherlands)

    Nunes, Marta C.; Kuschner, Zachary; Rabede, Zelda; Madimabe, Richard; Van Niekerk, Nadia; Moloi, Jackie; Kuwanda, Locadiah; Rossen, John W.; Klugman, Keith P.; Adrian, Peter V.; Madhi, Shabir A.

    2014-01-01

    Background: Advances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV), human rhinovirus (hRV), polyomavirus-WU (WUPyV) and -KI (KIPyV) and human

  16. Evaluation of T and B memory cell responses elicited by the pandemic H1N1 vaccine in HIV-infected and HIV-uninfected individuals.

    Science.gov (United States)

    Sun, Peifang; Crum-Cianflone, Nancy F; Defang, Gabriel; Williams, Maya; Ganesan, Anuradha; Agan, Brian K; Lalani, Tahaniyat; Whitman, Timothy; Brandt, Carolyn; Burgess, Timothy H

    2017-10-27

    This study was to compare B and T memory cells elicited by a single dose monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009 H1N1) in HIV+ and HIV- groups, and to analyze the impact of the prior seasonal vaccines to the immunogenicity of this vaccine. Blood samples were collected before vaccination (day 0) and at days 28 and 180. Participants were categorized into HIV-/LAIV, HIV-/TIV and HIV+/TIV subgroups according to the trivalent live-attenuated or inactivated (LAIV or TIV) seasonal influenza vaccines they received previously. The IgG+ memory B cells (BMem) and IFNγ+ T cells were measured against antigens including the H1N1 vaccine, the hemagglutinin (HA) and neuraminidase (NA) proteins or peptide pools of the pandemic and the seasonal H1N1 strains, respectively. Overall BMem responses increased significantly at day 28 but returned to baseline by day 180 in all three subgroups. The average frequency of the H1N1-specific BMem at day 28 for the HIV-/LAIV, HIV-/TIV and HIV+/TIV groups was 2.14%, 1.26% and 1.67%, respectively, and the average fold change was 14.39, 3.81 and 3.93, respectively. The differences of BMem between HIV-/LAIV and the two TIV subgroups were significant. For the IFNγ response, the overall spot counts ranged widely between 0 and 958/106 PBMCs. The group average spot counts to H1N1 vaccine was 89, 102, and 30 at day 28 for HIV-/LAIV, HIV-/TIV and HIV+/TIV subgroups, respectively. The average increase of IFNγ response at day 28 vs day 0 in all three subgroups did not reach 2-fold. Participants with a prior LAIV seasonal vaccine, as compared to a TIV seasonal vaccine, responded significantly better to the monovalent H1N1 vaccine. Excluding LAIV participants, no difference was seen between the HIV+ and HIV- subject groups in terms of BMem. The BMem response declined at 6months. Copyright © 2017. Published by Elsevier Ltd.

  17. Women's Health

    Science.gov (United States)

    Women have unique health issues. And some of the health issues that affect both men and women can affect women differently. Unique issues ... and men also have many of the same health problems. But these problems can affect women differently. ...

  18. Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers

    NARCIS (Netherlands)

    Braunstein, S.L.; Nash, D.; Kim, A.A.; Ford, K.; Mwambarangwe, L.; Ingabire, C.M.; Vyankandondera, J.; van de Wijgert, J.H.H.M.

    2011-01-01

    To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda. Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to

  19. Randomized Phase I: Safety, Immunogenicity and Mucosal Antiviral Activity in Young Healthy Women Vaccinated with HIV-1 Gp41 P1 Peptide on Virosomes.

    Science.gov (United States)

    Leroux-Roels, Geert; Maes, Cathy; Clement, Frédéric; van Engelenburg, Frank; van den Dobbelsteen, Marieke; Adler, Michael; Amacker, Mario; Lopalco, Lucia; Bomsel, Morgane; Chalifour, Anick; Fleury, Sylvain

    2013-01-01

    Mucosal antibodies harboring various antiviral activities may best protect mucosal surfaces against early HIV-1 entry at mucosal sites and they should be ideally induced by prophylactic HIV-1 vaccines for optimal prevention of sexually transmitted HIV-1. A phase I, double-blind, randomized, placebo-controlled trial was conducted in twenty-four healthy HIV-uninfected young women. The study objectives were to assess the safety, tolerability and immunogenicity of virosomes harboring surface HIV-1 gp41-derived P1 lipidated peptides (MYM-V101). Participants received placebo or MYM-V101 vaccine at 10 μg/dose or 50 μg/dose intramuscularly at week 0 and 8, and intranasally at week 16 and 24. MYM-V101 was safe and well-tolerated at both doses administered by the intramuscular and intranasal routes, with the majority of subjects remaining free of local and general symptoms. P1-specific serum IgGs and IgAs were induced in all high dose recipients after the first injection. After the last vaccination, vaginal and rectal P1-specific IgGs could be detected in all high dose recipients. Approximately 63% and 43% of the low and high dose recipients were respectively tested positive for vaginal P1-IgAs, while 29% of the subjects from the high dose group tested positive for rectal IgAs. Serum samples had total specific IgG and IgA antibody concentrations ≥ 0.4 μg/mL, while mucosal samples were usually below 0.01 μg/mL. Vaginal secretions from MYM-V101 vaccinated subjects were inhibiting HIV-1 transcytosis but had no detectable neutralizing activity. P1-specific Th1 responses could not be detected on PBMC. This study demonstrates the excellent safety and tolerability of MYM-V101, eliciting systemic and mucosal antibodies in the majority of subjects. Vaccine-induced mucosal anti-gp41 antibodies toward conserved gp41 motifs were harboring HIV-1 transcytosis inhibition activity and may contribute to reduce sexually-transmitted HIV-1. ClinicalTrials.gov NCT01084343.

  20. Randomized Phase I: Safety, Immunogenicity and Mucosal Antiviral Activity in Young Healthy Women Vaccinated with HIV-1 Gp41 P1 Peptide on Virosomes.

    Directory of Open Access Journals (Sweden)

    Geert Leroux-Roels

    Full Text Available Mucosal antibodies harboring various antiviral activities may best protect mucosal surfaces against early HIV-1 entry at mucosal sites and they should be ideally induced by prophylactic HIV-1 vaccines for optimal prevention of sexually transmitted HIV-1. A phase I, double-blind, randomized, placebo-controlled trial was conducted in twenty-four healthy HIV-uninfected young women. The study objectives were to assess the safety, tolerability and immunogenicity of virosomes harboring surface HIV-1 gp41-derived P1 lipidated peptides (MYM-V101. Participants received placebo or MYM-V101 vaccine at 10 μg/dose or 50 μg/dose intramuscularly at week 0 and 8, and intranasally at week 16 and 24. MYM-V101 was safe and well-tolerated at both doses administered by the intramuscular and intranasal routes, with the majority of subjects remaining free of local and general symptoms. P1-specific serum IgGs and IgAs were induced in all high dose recipients after the first injection. After the last vaccination, vaginal and rectal P1-specific IgGs could be detected in all high dose recipients. Approximately 63% and 43% of the low and high dose recipients were respectively tested positive for vaginal P1-IgAs, while 29% of the subjects from the high dose group tested positive for rectal IgAs. Serum samples had total specific IgG and IgA antibody concentrations ≥ 0.4 μg/mL, while mucosal samples were usually below 0.01 μg/mL. Vaginal secretions from MYM-V101 vaccinated subjects were inhibiting HIV-1 transcytosis but had no detectable neutralizing activity. P1-specific Th1 responses could not be detected on PBMC. This study demonstrates the excellent safety and tolerability of MYM-V101, eliciting systemic and mucosal antibodies in the majority of subjects. Vaccine-induced mucosal anti-gp41 antibodies toward conserved gp41 motifs were harboring HIV-1 transcytosis inhibition activity and may contribute to reduce sexually-transmitted HIV-1.ClinicalTrials.gov NCT01084343.

  1. Intimate partner violence among pregnant women in Rwanda

    Directory of Open Access Journals (Sweden)

    Siziya Seter

    2008-10-01

    Full Text Available Abstract Background Intimate partner violence (IPV, defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%, slapping (32.0% vs. 15.3%, kicking with fists (36.3% vs. 19.7%, throwing to the ground and kicking with feet (23.3% vs. 12.7%, and burning with hot liquid (4.1% vs. 3.5%. HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]. Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29], having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers, and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be

  2. High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project.

    Science.gov (United States)

    Hoagland, Brenda; Moreira, Ronaldo I; De Boni, Raquel B; Kallas, Esper G; Madruga, José Valdez; Vasconcelos, Ricardo; Goulart, Silvia; Torres, Thiago S; Marins, Luana M S; Anderson, Peter L; Luz, Paula M; Costa Leite, Iuri da; Liu, Albert Y; Veloso, Valdilea G; Grinsztejn, Beatriz

    2017-04-06

    The efficacy of pre-exposure prophylaxis (PrEP) in preventing sexual acquisition of human immunodeficiency virus (HIV) is well established. Little is known about the feasibility of PrEP implementation in middle-income settings with concentrated epidemics among men who have sex with men (MSM) and transgender women (TGW). PrEP Brasil is a prospective, multicentre, open-label demonstration project assessing PrEP delivery in the context of the Brazilian Public Health System. HIV-uninfected MSM and TGW in 3 referral centres in Rio de Janeiro and São Paulo were evaluated for eligibility and offered 48 weeks of daily emtricitabine/tenofovir for PrEP. Concentrations of tenofovir diphosphate in dried blood spot samples (DBS) at week 4 after enrolment (early adherence) were measured. Predictors of drug levels were assessed using ordinal logistic regression models considering the DBS drug level as a 3 level variable (<350 fmol/punch, ≥350-699 fmol/punch and ≥700 fmol/punch). 1,270 individuals were assessed for participation; n = 738 were potentially eligible and n = 450 were offered PrEP (PrEP uptake was 60.9%). Eligible but not enrolled individuals were younger, had lower HIV risk perception and had lower PrEP awareness. At week 4, 424 participants (of the 450 enrolled) had DBS TFV-DP concentrations, 94.1% in the protective range (≥350 fmol/punch, consistent with ≥2 pills per week), and 78% were in the highly protective range (≥700 fmol/punch, ≥4 pills per week). Participants with ≥12 years of schooling had 1.9 times the odds (95%CI 1.10-3.29) of a higher versus lower drug level than participants with <12 years of schooling. Condomless receptive anal intercourse in the prior 3 months was also associated with higher drug levels (adjusted OR = 1.78; 95% CI 1.08-2.94). The high uptake and early adherence indicate that PrEP for high-risk MSM and TGW can be successfully delivered in the context of the Brazilian Public Health System. Interventions to

  3. Dual testing algorithm of BED-CEIA and AxSYM Avidity Index assays performs best in identifying recent HIV infection in a sample of Rwandan sex workers.

    Directory of Open Access Journals (Sweden)

    Sarah L Braunstein

    Full Text Available BACKGROUND: To assess the performance of BED-CEIA (BED and AxSYM Avidity Index (Ax-AI assays in estimating HIV incidence among female sex workers (FSW in Kigali, Rwanda. METHODOLOGY AND FINDINGS: Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR. STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI tested; 23 were classified as recent infection (RI. Assay FRR with 95% confidence intervals were: 3.6% (1.2-8.1 (BED; 10.6% (6.1-17.0 (Ax-AI; and 2.1% (0.4-6.1 (BED/Ax-AI combined. After FRR-adjustment, incidence estimates by BED, Ax-AI, and BED/Ax-AI were: 5.5/100 person-years (95% CI 2.2-8.7; 7.7 (3.2-12.3; and 4.4 (1.4-7.3. After CD4-adjustment, BED, Ax-AI, and BED/Ax-AI incidence estimates were: 5.6 (2.6-8.6; 9.7 (5.0-14.4; and 4.7 (2.0-7.5. HIV incidence rates in the first and second 6 months of the cohort were 4.6 (1.6-7.7 and 2.2 (0.1-4.4. CONCLUSIONS: Adjusted incidence estimates by BED/Ax-AI combined were similar to incidence in the first 6 months of the cohort. Furthermore, false-recent rate on the combined BED/Ax-AI algorithm was low and substantially lower than for either assay alone. Improved assay specificity with time since seroconversion suggests that specificity would be higher in population-based testing where more individuals have long-term infection.

  4. Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda.

    Directory of Open Access Journals (Sweden)

    Aline Umubyeyi

    Full Text Available Despite its burden on a person's life, Intimate Partner Violence (IPV is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals' experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda.Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis.The theme "Gendered norms and values defeat the violence legislation in women's health care seeking when women are abused" expressed the health care professionals' experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter.Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.

  5. Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda.

    Science.gov (United States)

    Umubyeyi, Aline; Persson, Margareta; Mogren, Ingrid; Krantz, Gunilla

    2016-01-01

    Despite its burden on a person's life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals' experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. The theme "Gendered norms and values defeat the violence legislation in women's health care seeking when women are abused" expressed the health care professionals' experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.

  6. Women boxers

    DEFF Research Database (Denmark)

    Gems, Gerald; Pfister, Gertrud Ursula

    2014-01-01

    This article fills a gap in the very limited literature on women's boxing by examining the gendered space in which women engaged in the sport as participants in saloons, vaudeville theatres and the prize ring. In doing so, they challenged the contemporary gender order and disputed the notion...... of women as the weak sex. Vaudeville provided women with an opportunity to present physical performances that surpassed the restrictions placed on women within the mainstream middle-class society. This article includes biographical sketches of some of the outstanding female boxers of the era by drawing...

  7. The Rwandan teachers' and learners' perceived speaking ...

    African Journals Online (AJOL)

    owner

    The paper argues that ... speaking, reading and writing; as well as on language components such as grammar, vocabulary, phonology and .... cognitive skills. M stands for learner's affective factors such as personality, attitudes, motivation, and anxiety while O stands for opportunity for learning the language, including the ...

  8. Rwandan grade 6 mathematics teachers' knowledge | Maniraho ...

    African Journals Online (AJOL)

    A test and a questionnaire were used as data collection tools including questions on Content Knowledge (CK) and Pedagogical Content Knowledge (PCK).The results reveal that the teachers' CK is best in numbers and measurements whereas their PCK is much better in unpacking mathematics compared to the other three ...

  9. The Rwandan teachers' and learners' perceived speaking ...

    African Journals Online (AJOL)

    owner

    and integrate 'theories of basic communication skills' and 'sociolinguistic perspectives on communicative competence' (Canale & Swain, 1980), which inform communication skills that participants needed to have for their proficiency in speaking English and Kinyarwanda. The literature below describes the speaking ...

  10. Rwandan Journal of Education: Editorial Policies

    African Journals Online (AJOL)

    All the reviewers and authors are anonymous to each other through appropriate coding of each manuscript to blind each transmission. It is after coding that each manuscript is forwarded to at least two reviewers with different backgrounds but with relevant scholarly experiences. The review is conducted for a period of one ...

  11. Rwandan Journal of Education: Journal Sponsorship

    African Journals Online (AJOL)

    Publisher. Publisher contact person: Prof. George K. NJOROGE (PhD) (Principal UR-CE). Email: principal.ce@ur.ac.rw. Phone: 0788300895. Fax: (250) (0) 252586890 / (0) 252586885. Mailing address: P.O. Box 5039 Kigali - Rwanda. UNIVERSITY OF RWANDA - COLLEGE OF EDUCATION (UR – CE) ...

  12. Rwandan Journal of Education: Advanced Search

    African Journals Online (AJOL)

    Search tips: Search terms are case-insensitive; Common words are ignored; By default only articles containing all terms in the query are returned (i.e., AND is implied); Combine multiple words with OR to find articles containing either term; e.g., education OR research; Use parentheses to create more complex queries; e.g., ...

  13. Studying the Microdynamics of the Rwandan Genocide

    NARCIS (Netherlands)

    Smeulers, A.L.; Hoex, L.

    2010-01-01

    The genocide in Rwanda in 1994 stands out for the enormous number of people killed in a relatively short period of time; the mass involvement of the civilian population and the extreme and violent nature of the killings: victims were hunted down, beaten, raped and mutilated before being killed by

  14. The Case of the Rwandan Genocide Archives

    African Journals Online (AJOL)

    Ten years on from the horrors of the civil war in Rwanda in 1994, the International Criminal Tribunal for Rwanda [ICTR] has come a long way in terms of its recordkeeping practices. In four years since 2000 many innovative and sustainable practices have been adopted. The main focus of the work of the Judicial Records and ...

  15. Flicien Kabuga, multimillionaire Rwandan businessman, Bosco ...

    African Journals Online (AJOL)

    gerhard

    virtual nature. One clicks on their names on the Internet and are hyperlinked to anything from chat groups infested with either hate speech or love speech for the same person listed above, to peer-reviewed articles on the topic of war crimes, to unsavoury YouTube videos, and from there as far as one wants to travel mentally.

  16. Women's health

    Science.gov (United States)

    ... may affect women can include: Bladder emptying disorders Urinary incontinence and overactive bladder Interstitial cystitis Prolapse of the ... the cervix (LEEP, Cone biopsy) Procedures to treat urinary incontinence Tubal ligation and reversal of tubal sterilization Uterine ...

  17. pregnant women

    Directory of Open Access Journals (Sweden)

    Ewelina Buraczewska

    2016-09-01

    Full Text Available Background . Diabetes in pregnancy is a condition which includes pre-pregnancy diabetes in women already suffering from diabetes who become pregnant, and hyperglycaemia first diagnosed during pregnancy, defined as a disorder of carbohydrate tolerance resulting in increased blood glucose concentrations, which were first diagnosed in pregnant healthy women. Women’s knowledge about the disease and the practical use of this knowledge play an important role in the healing process. Objectives. The assessment of the state of knowledge about diabetes in pregnant women diagnosed with hyperglycaemia during pregnancy. Material and methods. The study involved 127 pregnant women with hyperglycemia which was first diagnosed during pregnancy. The median age of the subjects was 32.1 (19–45. A diagnostic survey was a research method. A self-prepared survey questionnaire was the research tool. The results were statistically analyzed. Results. The surveyed women assessed their knowledge about gestational diabetes as good and very good. The study showed, however, very poor knowledge about the clinical signs of diabetes among the subjects. The most frequently cited risk factors for gestational diabetes include: the presence of diabetes in one’s family, overweight states or obesity, and diabetes in previous pregnancy. The Internet was the main source of knowledge about diabetes among the subjects. Conclusions . 1. The level of knowledge in women about gestational diabetes is insufficient. 2. There is a need to extend educational activities related to the symptoms of diabetes and the principles of its prevention among pregnant women. 3. The participation of general practitioners in the education of women about diabetes in pregnancy is insufficient.

  18. Women and Diabetes

    Medline Plus

    Full Text Available ... Mammography Women and Diabetes HPV, HIV, Birth Control Heart Health for Women Pregnancy Menopause More Women's Health Topics Resources for You YourDiabetesInfo.org American Diabetes Association Get Other FDA Publications for Women For Women ...

  19. On Campus with Women.

    Science.gov (United States)

    Liberal Education, 1988

    1988-01-01

    A newsletter on women and higher education contains a variety of articles on women and sports, women's studies, working in academe, minority women, campus life and environment, child care, international education, women and science, sexual harassment, and campus violence. (MSE)

  20. Women and Diabetes

    Medline Plus

    Full Text Available ... Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More ... women during pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help ...

  1. Women and Diabetes

    Medline Plus

    Full Text Available ... Office of Research on Women's Health to raise awareness about diverse women of different ages, races, ethnic ... Women's Health Topics Mammography Women and Diabetes HPV, HIV, Birth Control Heart Health for Women Pregnancy Menopause ...

  2. Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide

    Science.gov (United States)

    Rugema, Lawrence; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

    2015-01-01

    Objectives To investigate mental health effects associated with exposure to trauma in Rwanda during the 1994 genocide period, and over the lifetime, in Rwandan men and women aged 20–35 years. Setting This was a cross-sectional population-based study conducted in the southern province of Rwanda. Data was collected during December 2011 to January 2012. Participants A total population of 917 individuals were included, 440 (48%) men and 477 (52%) women aged 20–35 years. Number of households for inclusion in each village was selected proportional to the total number of households in each selected village. The response rate was 99.8%. Face-to-face interviewing was done by experienced and trained clinical psychologists, following a structured questionnaire. Results Women were slightly less exposed during the genocide period (women 35.4% and men 37.5%; p=0.537), but more women than men were exposed to traumatic episodes over their lifetime (women 83.6%, n=399; men 73.4%, n=323; pgenocide period severely affected men's current mental health status with relative risk (RR) 3.02 (95% CI 1.59 to 5.37) for MDE past and with RR 2.15 (95% CI 1.21 to 3.64) for suicidality. Women's mental health was also affected by trauma experienced in the genocide period but to an even higher extent, by similar trauma experienced in the lifetime with RR 1.91 (95% CI 1.03 to 3.22) for suicidality and RR 1.90 (95% CI 1.34 to 2.42) for generalised anxiety disorder, taking spousal physical/sexual violence into consideration. Conclusions Depression, post-traumatic stress disorder, anxiety and suicidal attempts are prevalent in Rwanda, with rates twice as high in women compared with men. For women, exposure to physical and sexual abuse was independently associated with all these disorders. Early detection of gender-based violence through homes and community interventions is important. PMID:26109109

  3. Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide.

    Science.gov (United States)

    Rugema, Lawrence; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

    2015-06-24

    To investigate mental health effects associated with exposure to trauma in Rwanda during the 1994 genocide period, and over the lifetime, in Rwandan men and women aged 20-35 years. This was a cross-sectional population-based study conducted in the southern province of Rwanda. Data was collected during December 2011 to January 2012. A total population of 917 individuals were included, 440 (48%) men and 477 (52%) women aged 20-35 years. Number of households for inclusion in each village was selected proportional to the total number of households in each selected village. The response rate was 99.8%. Face-to-face interviewing was done by experienced and trained clinical psychologists, following a structured questionnaire. Women were slightly less exposed during the genocide period (women 35.4% and men 37.5%; p=0.537), but more women than men were exposed to traumatic episodes over their lifetime (women 83.6%, n=399; men 73.4%, n=323; pgenocide period severely affected men's current mental health status with relative risk (RR) 3.02 (95% CI 1.59 to 5.37) for MDE past and with RR 2.15 (95% CI 1.21 to 3.64) for suicidality. Women's mental health was also affected by trauma experienced in the genocide period but to an even higher extent, by similar trauma experienced in the lifetime with RR 1.91 (95% CI 1.03 to 3.22) for suicidality and RR 1.90 (95% CI 1.34 to 2.42) for generalised anxiety disorder, taking spousal physical/sexual violence into consideration. Depression, post-traumatic stress disorder, anxiety and suicidal attempts are prevalent in Rwanda, with rates twice as high in women compared with men. For women, exposure to physical and sexual abuse was independently associated with all these disorders. Early detection of gender-based violence through homes and community interventions is important. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study.

    Science.gov (United States)

    Umubyeyi, Aline; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

    2014-11-18

    In low income countries, mental disorders are a neglected health problem. Mental disorders are influenced by a number of factors in people's everyday life of which intimate partner violence (IPV) commonly form an important part. The aim of this study was to investigate the prevalence of mental disorders in young men and women in Rwanda and their risk factors with main emphasis on IPV and its contribution to mental disorders, taking into account the genocide context. This population-based study included a representative sample of 917 men and women aged 20-35 years. The prevalence of mental disorders was investigated using of a diagnostic tool, the "MINI: Mini International Neuropsychiatric Interview". Risk factor patterns were analysed with bi- and multivariate logistic regression. To find the proportion of mental disorders attributed to IPV, the population attributable fraction was computed. The prevalence rates of current depression, suicide risk and PTSD were more than two times higher in women than in men while for generalized anxiety disorder, the prevalence was about the same. Physical, sexual and psychological intimate partner violence exposure was highly associated with all forms of mental disorders for women. For physical violence, after adjusting for socio-demographic factors and exposure to traumatic episodes during the Rwandan genocide, the risk of current depression for women was elevated four times. Even though few men reported partner violence exposure, physical violence in the past year was found to be a statistically significant risk factor for current depression and for generalized anxiety disorder. However, having an experience of traumatic episodes during the genocide contributed to the risk of most of mental disorders investigated for men. In Rwanda, IPV contributed considerably to mental disorders investigated. Thus, prevention of IPV should be considered as a public health priority, as its prevention would considerably reduce the prevalence of

  5. Association of sex work with reduced activation of the mucosal immune system.

    Science.gov (United States)

    Lajoie, Julie; Kimani, Makubo; Plummer, Francis A; Nyamiobo, Francis; Kaul, Rupert; Kimani, Joshua; Fowke, Keith R

    2014-07-15

    Unprotected intercourse and seminal discharge are powerful activators of the mucosal immune system and are important risk factors for transmission of human immunodeficiency virus (HIV). This study was designed to determine if female sex work is associated with changes in the mucosal immunity. Cervicovaginal lavage and plasma from 122 HIV-uninfected female sex workers (FSW) and 44 HIV-uninfected low-risk non-FSW from the same socioeconomic district of Nairobi were analyzed for evidence of immune activation (IA). The cervico-mononuclear cells (CMC) were analyzed for cellular activation by flow cytometry. Lower IA was observed in FSW compared to the low-risk women as demonstrated by the lower level of MIP-3α (P sex work and increased with duration of sex work. This study showed that sex work is associated with important changes in the mucosal immune system. By analyzing chemokine/cytokine levels and CMC activation, we observed a lower mucosal IA in HIV-uninfected FSW compared to low-risk women. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. Smokefree Women

    Science.gov (United States)

    ... and advice about quitting smoking through real-time messaging. › HealthyYou TXT A text message program that provides ... share home about smokefree women for health professionals privacy accessibility viewing files disclaimer FOIA smokefree.gov teen. ...

  7. Women's Workshop.

    Science.gov (United States)

    Karelius, Karen

    The Women's Workshop Notebook is the tool used in the nine-week course designed for the mature woman returning to school at Antelope Valley College. The notebook exercises along with the group interaction and instruction stress the importance of personal assessment of strengths, weaknesses, dreams, deliberations and life history in…

  8. Obstetric fistula management and predictors of successful closure among women attending a public tertiary hospital in Rwanda: a retrospective review of records.

    Science.gov (United States)

    Egziabher, Tekle G; Eugene, Ngoga; Ben, Karenzi; Fredrick, Kateera

    2015-12-12

    Globally, 50,000-100,000 women develop obstetric fistula annually. At least 33,000 of these women live in Sub-Saharan Africa where limitations in quality obstetric care and fistula corrective repairs are prevalent. Among women with fistula seeking care at public health facilities in resource-limited settings, there is paucity of data on quality of care received. The aim of this study was to characterize obstetric fistula among Rwandan women managed at a public tertiary hospital and evaluate for predictors of successful fistula closures. A retrospective review of records for all obstetric fistula women managed at a public referral health facility between 2007 and 2013 was performed. Patient socio-demographics, obstetric characteristics and fistula repair outcomes data were reviewed. A multivariate logistic regression model was used to analyse for predictors of successful fistula repair outcomes. A total of 272 women aged between 16 to 78 years and with a mean age of 34.6 years were included. Of these, 93 (34.2 %), 48 (17.6 %), 65 (24 %) and 64 (23 %) women had vesico-vaginal fistula, recto-vaginal fistula, urethro-vaginal fistula and vesico-uteral fistula types, respectively. Successful fistula closure was achieved among 86.3 %. Women with fistula who reported being in labour for ≥3 days, having ≥1 previous fistula repair attempt, and having lived with the fistula for >1 year, had significantly lower odds of successful repair outcomes. Among 272 women with obstetric fistula managed in this study, 69.5 and 26.5 % of their fistula were causally associated with obstructed labour complications and iatrogenic factors, respectively. Successful fistula closure rates of about 89 % among women of index repair attempt were achieved. Conversely, reported histories of ≥3 days in labour, ≥1 previous failed attempts at repair and a fistula duration of >1 year, were significant determinants of failed fistula closures. To effectively mitigate obstetric fistula burden in

  9. Women and Mental Health

    Science.gov (United States)

    ... Chats with Experts Clinical Trials Share Women and Mental Health Overview Mental disorders can affect women and men ... biological and psychosocial factors that may impact the mental health of both women and men. Warning Signs Women ...

  10. Women's Club

    CERN Multimedia

    Women's Club

    2014-01-01

        CERN WOMEN’S CLUB Coffee Morning Tuesday 8th Avril 2014, 9:30 – 14:00 Bldg 504 (Restaurant No 2 – DSR) Ground Floor Spring Jumble Sale   Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://cern.ch/Club-WomensClub/

  11. Grassroots Women

    Directory of Open Access Journals (Sweden)

    Rebecca Kay

    2004-01-01

    Full Text Available The economic, social and political changes that have occurred in Russia over the last 10 years have had a profound effect on Russian women’s lives. Economic reform has brought poverty, insecurity and high levels of anxiety and stress to much of the population, both male and female. The impact of these changes on women was amplified in the early 1990s by their structural positioning both within the workforce and within the population, brought about by the legacies of the Soviet planned economy, Soviet attitudes to gender and long established demographic trends. Alongside these historical influences, ‘new’ essentialist attitudes towards gender and the appropriate roles and responsibilities of women in post-Soviet Russian society have been strongly promoted through the media, political and social discourses, imposing new pressures and dilemmas on many post-Soviet Russian women. Numerous women’s organisations have been established in Russia since the early 1990s, many of them with a specific remit of helping Russian women to overcome the upheavals and hardships which they face. Struggling to survive themselves with very few resources and minimal external support, Russia’s grassroots women’s organisations have nonetheless offered practical help and advice and emotional support and solidarity to their members. This paper is based on the findings of a period of intensive fieldwork carried out in 1995-6 with grassroots women’s organisations in Moscow and three Russian provincial centres. It will present the aims, activities and impact of the groups studied. It will also investigate the ways in which these groups and their membership positioned themselves in relation to the development of essentialist attitudes and opinions on gender within Russia on the one hand, and a dialogue with ‘western’ feminist theory and practice on the other.

  12. Women's club

    CERN Document Server

    Club des cernoises

    2012-01-01

    Coffee MorningTuesday 9th October 2012, 9:00 – 11:00 Bldg 504 (Restaurant No 2 – DSR) 1st Floor, Club Room 3 Presentation of the charity to benefit from the Christmas Sale “Nous aussi”. Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://cern.ch/Club-WomensClub/

  13. Women's Club

    CERN Multimedia

    CERN Women's Club

    2012-01-01

     Coffee Morning Tuesday 7th February 2012, 9:00 – 11:00 Bldg 504 (Restaurant n°2 – DSR) 1st Floor, Club Room 3 Presentation of cheque to Terre des Hommes Those interested in helping should come along. New arrivals and all members are cordially invited.You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/

  14. Women's Club

    CERN Multimedia

    Club des Cernoises

    2012-01-01

    Coffee Morning   Tuesday 24th  April 2012, 9:00 – 14:00 Bldg 504, Ground Floor Spring Jumble Sale   Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/

  15. Rebellious Women

    DEFF Research Database (Denmark)

    Madsen, Peter

    2010-01-01

    At the background of a short presentation of concepts of discourse (in particular in Jürgen Habermas and Michel Foucault) and of the concept of shari'a a Spanish court case against an imam in reference to his publication on Women in Islam, where sura 4 verse 34 of the Quran is a central reference......, is analyzed; the article finally bring a discussion of - primarily female - endeavours to develope critical interpretations of the Quran, in particular 4:34....

  16. Women's Club

    CERN Multimedia

    Club des Cernoises

    2012-01-01

    Coffee Morning Tuesday 13th  March 2012, 9:00 – 11:00 - Bldg 504 (Restaurant No 2 – DSR) - 1st Floor, Club Room 3. German Theme Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/     CWC – Chinese Women's Community at CERN With an increasing number of Chinese people working at CERN, there are also surely an increasing number of Chinese women in the area, who are not always familiar with the environment, languages, or the people. In the context of the CERN Women’s Club, let's meet together and chat about integrating into the local community, available activities, commerce’s, restaurants, etc. It is also obviously a good opportunity to meet new friends. Everyone is welcome to join us to meet fo...

  17. Women's club

    CERN Multimedia

    Club des Cernoises

    2012-01-01

        CWC – Chinese Women's Community at CERN With an increasing number of Chinese people working at CERN, there are also surely an increasing number of Chinese women in the area, who are not always familiar with the environment, languages, or the people. In the context of the CERN Women’s Club, let's meet together and chat about integrating into the local community, available activities, commerce’s, restaurants, etc. It is also obviously a good opportunity to meet new friends. Everyone is welcome to join us to meet for tea, coffee, and a chat. We will meet every 3rd Tuesday of the month, starting on 20th March 2012, in building 504 (Restaurant 2) in room E-005. 20th March at 9-11am 17th April at 9-11am 22nd May at 9-11am 19th June at 9-11am For more details contact Mme Jean RODERICK, +41 (0) 76 426 61 08, jean.chow.roderick@gmail.com http://club-womensclub.web.cern.ch/Club-WomensClub/     CWC-華人茶敍 越來�...

  18. A multi-platform metabolomics approach identifies highly specific biomarkers of bacterial diversity in the vagina of pregnant and non-pregnant women.

    Science.gov (United States)

    McMillan, Amy; Rulisa, Stephen; Sumarah, Mark; Macklaim, Jean M; Renaud, Justin; Bisanz, Jordan E; Gloor, Gregory B; Reid, Gregor

    2015-09-21

    Bacterial vaginosis (BV) increases transmission of HIV, enhances the risk of preterm labour, and is associated with malodour. Clinical diagnosis often relies on microscopy, which may not reflect the microbiota composition accurately. We use an untargeted metabolomics approach, whereby we normalize the weight of samples prior to analysis, to obtained precise measurements of metabolites in vaginal fluid. We identify biomarkers for BV with high sensitivity and specificity (AUC = 0.99) in a cohort of 131 pregnant and non-pregnant Rwandan women, and demonstrate that the vaginal metabolome is strongly associated with bacterial diversity. Metabolites associated with high diversity and clinical BV include 2-hydroxyisovalerate and γ-hydroxybutyrate (GHB), but not succinate, which is produced by both Lactobacillus crispatus and BV-associated anaerobes in vitro. Biomarkers associated with high diversity and clinical BV are independent of pregnancy status, and were validated in a blinded replication cohort from Tanzania (n = 45), where we predicted clinical BV with 91% accuracy. Correlations between the metabolome and microbiota identified Gardnerella vaginalis as a putative producer of GHB, and we demonstrate production by this species in vitro. This work illustrates how changes in community structure alter the chemical composition of the vagina, and identifies highly specific biomarkers for a common condition.

  19. Proportions of CD4+, CD8+ and B cell subsets are not affected by exposure to HIV or to Cotrimoxazole prophylaxis in Malawian HIV-uninfected but exposed children.

    Science.gov (United States)

    Longwe, Herbert; Phiri, Kamija S; Mbeye, Nyanyiwe M; Gondwe, Thandile; Jambo, Kondwani C; Mandala, Wilson L

    2015-08-28

    As a result of successful PMTCT programs, children born from HIV-infected mothers are now effectively protected from contracting the infection. However, it is not well known whether in utero exposure to the virus and the subsequent exposure to Cotrimoxazole (CTX) prophylaxis affect the cell mediated immune system of the children. This observational prospective study was aimed at determining how CD4(+) T, CD8(+) T and B cell subsets varied in HIV-exposed but uninfected (HEU) children at different ages. We recruited HEU and HIV-unexposed and uninfected (HUU) children from 6 months of age and followed them up until they were 18 months old. HEU children received daily CTX prophylaxis beginning at 6 weeks of age until when 12 months of age. Venous blood samples were collected 6 monthly and analysed for different subsets of CD8(+) T, B cells and totalCD4(+) T cells. At 6 months of age, HEU children had a lower percentage of total CD4(+) T cells compared to HUU children and a lower proportion of naïve CD8(+) T cells but higher percentage of effector memory CD8(+) T cells compared to HUU children. HEU and HUU children had similar proportions of all B cell subsets at all ages. The study showed that the subtle variations in CD4(+) and CD8(+) T cell subsets observed at 6 months do not last beyond 12 months of age, suggesting that HEU children have a robust cell-mediated immune system during first year of life. This article report is not based on results of a controlled health-care intervention.

  20. Women for women's health: Uganda.

    Science.gov (United States)

    Andrews, C M

    1996-01-01

    The primary health care model targets social, political, and economic environments as key determinants of health for populations, as well as for individuals. If nursing in Uganda is to make a difference in health care outcomes and in the health of all Ugandans, nurses must look broadly at situations and be educated to practice primary health care nursing. After 14 years of civil war, Uganda is finally experiencing a period of reconstruction and rehabilitation: the whole infrastructure is undergoing a face-lift. Ugandan nurses recognize that their educational preparation has stagnated for many years and that it was not only the political unrest in their country that put them behind professionally. They realize that, given the new directions set by the government, they must become prepared to implement primary health care. They are demanding a university education so they may take their place alongside other health care providers prepared at the university level. Some of the most convincing arguments for a university program for nurses came from doctors at the university who spoke about the need to raise the standards of nursing practice, the quality of teachers, and the morale of practitioners. One nurse said: "If we lose hope for a BScN program, I think all the nurses will quit and we won't have any new students going into the profession." This program is designed to improve the health and well-being of all Ugandans, especially the most vulnerable groups of women and children in rural areas, through strengthening and expanding health services by targeting the educational preparation of nurses. Health planners in Uganda envision the professional nurse as key to the implementation of the national health policy of primary health care. University-educated nurses should be able to assess problems, make clinically sound decisions, and act appropriately within the scope of nursing practice. They should be able to interact and consult collegially with other health care

  1. Women and Industrial Education

    Science.gov (United States)

    Bjorkquist, David C.

    1973-01-01

    Deals with these three questions: (1) What is the employment status of women, (2) What do advocates of the women's rights movement want, (3) How should industrial educators respond to the women's rights movement? (SB)

  2. Women and Diabetes

    Medline Plus

    Full Text Available ... main page content Skip to search Skip to topics menu Skip to common links HHS U.S. Department ... Consumer Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it ...

  3. Women and Diabetes

    Medline Plus

    Full Text Available ... booklet for women Other FDA Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments ... women Insulin - easy-to-read booklet for women How to Store your Insulin during Storms and Blackouts ...

  4. Women and Diabetes

    Medline Plus

    Full Text Available ... Women's Health Publications Women's Health Information on Twitter Information from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in Older Women ...

  5. Women and Diabetes

    Medline Plus

    Full Text Available ... booklet for women Other FDA Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some ... women Insulin - easy-to-read booklet for women How to Store your Insulin during Storms and Blackouts Safety ...

  6. Women and Diabetes

    Medline Plus

    Full Text Available ... Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet ...

  7. Women and Diabetes

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  8. Women and Diabetes

    Medline Plus

    Full Text Available ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  9. Women and Diabetes

    Medline Plus

    Full Text Available ... women with diabetes can make a difference. Other Resources from the FDA FDA Information on Diabetes Treatment ... for Women Pregnancy Menopause More Women's Health Topics Resources for You YourDiabetesInfo.org American Diabetes Association Get ...

  10. Women of ATLAS - International Women's Day 2016

    CERN Multimedia

    Biondi, Silvia

    2016-01-01

    Women play key roles in the ATLAS Experiment: from young physicists at the start of their careers to analysis group leaders and spokespersons of the collaboration. Celebrate International Women's Day by meeting a few of these inspiring ATLAS researchers.

  11. The Case for Women Mentoring Women

    Science.gov (United States)

    Block, Betty Ann; Tietjen-Smith, Tara

    2016-01-01

    The authors argue that there will be a critical mass of women in leadership positions in kinesiology and across higher education for substantial gender-based mentoring to take place in the 21st century. First, the current state of women in higher education leadership, trends in mentoring, and the reasons it is important for women who have…

  12. Resources for Women's Studies.

    Science.gov (United States)

    Ridinger, Robert B.

    Over 120 bibliographies and other reference sources relevant to women's studies are identified in this annotated listing. Subjects include feminist scholarship, women in management, popular culture, autobiographies, other cultures and countries, history, lesbian women, women's education, the arts, politics, and rape. In addition to author, title,…

  13. Women and Diabetes

    Medline Plus

    Full Text Available ... Diabetes Information on WebMD Order Free Women's Health Publications Women's Health Information on Twitter Information from Other ... YourDiabetesInfo.org American Diabetes Association Get Other FDA Publications for Women For Women Homepage FDA Diabetes Information ...

  14. Good performance of an immunoassay based method for nevirapine measurements in human breast milk

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Theilgaard, Zahra Persson; Chiduo, Mercy

    2011-01-01

    , requires complicated extraction techniques. The ARK method employs an immunoassay technology and requires a small sample volume (40 μL) and no pre-treatment of the samples. Methods: Commercial enzyme and antibody were used and calibration standards and quality controls were prepared from pooled breast milk...... from HIV-uninfected women. Clinical samples from HIV-infected women receiving a single-dose of nevirapine were analyzed. Results: Precision and accuracy were evaluated with two concentrations of quality control materials analyzed in three replicates on four different days and was...

  15. Women and sustainable development.

    Science.gov (United States)

    Meena, R

    1992-07-01

    Gender issues in sustainable development focuses on constraints, the policy environment, land rights, the division of labor, reproductive rights, human resource development, productive energy, care of children, education, politics, security, social norms, and women's initiatives. African women's participation in the development process has been limited by the policy environment, sociocultural setting, and women's initiatives. African policy has not recognized the different roles that men and women play. There is unequal division of labor, legal discrimination against women, and abuse of women's basic human rights. Women's subordinate position in society and their concrete needs are ignored. Land tenure and credit systems are based on discriminatory policies. Women share a major portion and in some cases all of the agricultural labor with few tools or equipment. The operating assumption is that women's labor supply is inelastic. In order to fully participate in the development process, women need to be able to determine the number of children needed, the spacing between children, and the timing and the method of contraception. Human resource development in Africa has focused on training men. Women must contribute a major portion of time and labor to processing and cooking food in addition to caring for children. Access to higher education is limited. Political accords have been reached without women when women have contributed significantly to political struggles. Social security is compromised during violence and civil strife. There is sexual harassment in the work place. Culture can subordinate women. Women have been unable to change policy making, planning, and patriarchal ideology. Women are marginal contributors to the labor force. Income-generating projects are primarily confined to the informal sector. The governments impose the women's programs. Political influence is highly desired if change in women's stature is to be accomplished.

  16. [Women's organizations in India].

    Science.gov (United States)

    Patel, V

    1985-01-01

    Community development projects in India during the 1950s and 60s viewed women as beneficiaries, but in fact few women benefitted measurably. The realization among field motivators of the necessity of improving the status of women prompted formation of women's organizations based on the participation of women in development. Non-government organizations and militant organizations have had greater success than government sponsored organizations in creation of employment for women. Some employment-generating organizations directed by high caste women or by men merely continue the oppression of poor women, providing abysmal pay for long hours, but a women's cooperative serving textile workers in Bombay has been successful because of the large number of unaccompanied males migrating to the city who desire reasonably priced home-cooked food. Other organizations have attempted to mobilize women to allow them to benefit from development. Struggles of women in the electronics, pharmaceutical, textile, mining, clothing, and other small scale industries have been supported by women's organizatinns. Rural women's organizations have forced village authorities to provide drinkig water and have demanded creation of employment for unemployed rural workers. The "Self-Employed Women's Association" supports negotiations of such women in their respective professions, and others struggling for women's rights have also undertaken development projects in health, education, and employment with a view to increasing women's independence. Some organizations provide child care services and others assist women in obtaining credit. Numerous cooperatives for food and housework have been formed but their ultimate effect on the distribution of power between castes and classes remains uncertain. Government sponsored cooperatives and women's organizations have benefitted mainly the intermediaries and have tended to use women as a source of cheap labor. A strategic plan for the emancipation of women

  17. Women in public life.

    Science.gov (United States)

    1992-01-01

    The UN Division for the Advancement of Women publication has devoted an issue to the role of women in public lie based on an analysis of women's status in industrialized countries presented in Vienna, Austria, in May 1991. Women already contribute to political life and make a difference in politics, but societal institutions and government processes have not yet adapted to this fact. Women's nongovernmental organizations promote women's interests at the governmental level, but often do not have the economic or political power as do other interests groups such as trade unions. Women often participation public life via their membership in women's organizations, community action groups, voluntary organizations, and other close to home groups. They prefer to participate in activities which are problem solving rather than institution building. These activities and groups operate outside established political institutions and are not considered as part of public and political life. Society's exclusion of women from leadership positions in public life keeps it from benefiting from the special contributions that women bring to decision making. Women show a tendency to have different leadership styles than men (e.g., ability to relate to people affected by their decisions), which are most needed for the modern world. They often do not campaign just for women's issues, but, once in office, they do tend to become more involved in women's issues. Women have affected positive changes in career and child care, often on a non-Socialist agenda, in various countries (e.g. Norway). This effect is referred to as the politics of motherhood. More access to politics and public life calls for removal of structural and situational barriers including the glass ceiling, discrimination, insufficient funds, and bearing most of the responsibility for child care. The UN women's groups has drafted a platform for interregional consultation on women's role in public life and scheduled the 4th

  18. Women's rights to health.

    Science.gov (United States)

    1997-08-01

    Women's rights and health are threatened by cultural, religious, and social biases against women that create barriers in women's ability to access health information, education, and services. The fact that women's basic human rights include a right to health has been incorporated in international rights covenants, but violations occur in the form of 1) direct state actions, such as coercive abortion; 2) failure of states to meet health needs; 3) discrimination that denies health care to specific groups; and 4) failure of states to protect women from violence, child marriage, female infanticide, and other forms of health- and life-threatening discrimination. In order to improve this situation, a basic set of indicators must be developed to monitor implementation of agreements to protect women. Health professionals must continue to incorporate women's rights into the ethics or charters of health practices, to improve service to women, and to increase governmental advocacy on behalf of women. Governments must acknowledge the benefits of applying a rights approach to women's health status and must develop plans to implement recommendations arising from international conferences on women's rights. Women-centered nongovernmental organizations must create a clear framework on women's rights to health and develop advocacy and networking strategies.

  19. Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda

    Science.gov (United States)

    Tolley, Elizabeth E; McKenna, Kevin; Mackenzie, Caroline; Ngabo, Fidele; Munyambanza, Emmanuel; Arcara, Jennet; Rademacher, Kate H; Lendvay, Anja

    2014-01-01

    system to facilitate injections by providers and to reduce the risk of pain or discomfort for women. While providers and policy makers ranked cost as one of the most important issues, it was among the least important issues for most potential users. Many Kenyan, but few Rwandan, participants appeared willing to pay for an LAI, with some presuming cost savings from reduced menstruation and fewer clinic visits. Conclusions: Some TPP preferences for an LAI have implications for product development decisions about formulation, delivery mechanism, or presentation, while others point to the need for tailored communication and counseling approaches to ensure acceptability and adherence within clinical trials and beyond. PMID:25276576

  20. Women and Diabetes

    Medline Plus

    Full Text Available ... Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments for ... ethnic backgrounds, and health conditions participating in clinical trials. Visit the Women in Clinical Trials webpage to ...

  1. Women and Diabetes

    Medline Plus

    Full Text Available ... pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments ... races, ethnic backgrounds, and health conditions participating in clinical trials. Visit the Women in Clinical Trials webpage ...

  2. Heart Attack and Women

    Science.gov (United States)

    ... Awareness Day National Women's Health Week Supporting Nursing Moms at Work Popular Topics Autoimmune diseases Breastfeeding Carpal tunnel syndrome ... Awareness Day National Women's Health Week Supporting Nursing Moms at Work Popular Topics Autoimmune diseases Breastfeeding Carpal tunnel syndrome ...

  3. Women in American Literature

    Science.gov (United States)

    Wells, Nancy

    1973-01-01

    Discusses the objectives and presents instructional materials for a course entitled Women in American Literature'' which attempts to introduce students to the concept of alternative life styles for American women. (RB)

  4. Women Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report summarizes the history of women Veterans in the military and as Veterans. It profiles the characteristics of women Veterans in 2015, and illustrates how...

  5. Women and Diabetes

    Medline Plus

    Full Text Available ... Women's Health Topics Resources for You YourDiabetesInfo.org American Diabetes Association Get Other FDA Publications for Women ... Compliance Federal, State & Local Officials Consumers Health Professionals Science & Research Industry Scroll back to top Popular Content ...

  6. Women and Alcohol

    Science.gov (United States)

    ... turn JavaScript on. Feature: Rethinking Drinking Women and Alcohol Past Issues / Spring 2014 Table of Contents Women react differently than men to alcohol and face higher risks from it. Pound for ...

  7. Infertility and Women

    Science.gov (United States)

    Fact Sheet & Infertility Women What is infertility? Infertility is the inability of a sexually active couple, not using any birth control, to ... available in Spanish at www. hormone. org/ Spanish . Infertility and Women Fact Sheet www. hormone. org

  8. Women and Diabetes

    Medline Plus

    Full Text Available ... on WebMD Order Free Women's Health Publications Women's Health Information on Twitter Information from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ...

  9. Women and Diabetes

    Medline Plus

    Full Text Available ... to help doctors learn more about how diabetes medicines affect women during pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn ...

  10. Osteoporosis and Hispanic Women

    Science.gov (United States)

    ... you Breadcrumb Home Osteoporosis Osteoporosis and Hispanic Women Osteoporosis and Hispanic Women It is a common misconception ... Are Available? Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  11. Women and Parasitic Diseases

    Science.gov (United States)

    ... ectoparasites such as lice ( Pediculus spp.), and pinworms ( Enterobius vermicularis ) that cause anal itching. Chagas disease is ... Women who have severe anemia more often deliver infants with low birth weight. Pregnant women often need ...

  12. Women and Diabetes

    Medline Plus

    Full Text Available ... Medicines and Devices Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the ... Clinical trials can help doctors learn more about treatments for diabetes. The FDA Office of Women's Health is partnering ...

  13. Women and Diabetes

    Medline Plus

    Full Text Available ... Women For Women Homepage FDA Diabetes Information for Patients Page Last Updated: 02/16/2018 Note: If ... FDA Archive Combination Products Advisory Committees Regulatory Information Safety Emergency Preparedness International Programs News & Events Training & Continuing ...

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... on testing your blood sugar. Follow Us on Twitter There is good news. Diabetes can be controlled ... Free Women's Health Publications Women's Health Information on Twitter Information from Other Government Agencies and Offices National ...

  15. Women and HIV

    Science.gov (United States)

    ... Consumer Information by Audience For Women Women and HIV: Get the Facts on HIV Testing, Prevention, and Treatment Share Tweet Linkedin Pin ... How can you lower your chance of HIV? HIV Quick Facts What is HIV? HIV is the ...

  16. Substance Use in Women

    Science.gov (United States)

    ... Viral) HIV/AIDS Mental Health Military Opioid Overdose Reversal with Naloxone (Narcan, Evzio) Pain Prevention Recovery Substance ... in Women Email Facebook Twitter Revised April 2017 Sex and Gender Differences in Substance Use Women may ...

  17. Sexual Dysfunction in Women

    Science.gov (United States)

    ... for you.You may have heard that taking sildenafil (Viagra) or the male hormone testosterone can help women ... not been many studies on the effects of Viagra or testosterone on women, so doctors do not ...

  18. Women in Portugal.

    Science.gov (United States)

    Barbosa, M

    1981-01-01

    Prior to 1974, women in Portugal were restricted by the Penal Code and had little organizational power. Women's groups were formed within the Catholic Church to teach women about cooking, child care, and home economics. There was no contact with international women's groups. The press only reported events such as bra burning. 80% of all illiterates in Portugal are women. The conditions of Portuguese women are described after the revolution of April 25, 1974. Present roles are discussed for work, health, education, religion, trade unions and political parties, and women's organizations. The Women's Liberation Movement (WLM) appeared in May 1974 among a heterogenous group of women in Lisbon who were concerned about the oppression of women. WLM made feminist issues public amid ridicule and promoted the declaration of equal rights for women in the 1976 Republic Constitution and in the Family Code. Wage discrimination became illegal in 1979. Women represent 32.8% of the labor force. Unemployment is particularly high among women and is increasing. Women's wages and levels of skill are the lowest. The Christian Democratic government is actively engaged in a campaign to keep women at home and has formed the special Ministry of Family Affairs, which encourages large families and women's home activity in order to save jobs for men. There is a crisis in education: large class sizes and limited number of schools. Child care for the working mother is expensive when available and rarely available. An obstacle to women's rights has been the role of the Catholic Church, which fought equal rights legislation, condemned the Family Code and divorce laws, forbade the practice of contraception, and supported the movement against abortion. Only 1 member of government is a women, and she is considered a token. Trade unions have a women's section, but little attention is given to the problems of women. Women's groups within larger organizations have little autonomy. Those with autonomy

  19. Women and Diabetes

    Medline Plus

    Full Text Available ... common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration A to ... Women's Health Topics Mammography Women and Diabetes HPV, HIV, Birth Control Heart Health for Women Pregnancy Menopause ...

  20. Women of California.

    Science.gov (United States)

    Gray, Harry

    This publication points out the achievements of women who contributed to the development and history of California from the 16th century, when the Spanish Conquistadores moved westward into the San Francisco Bay area, to the gold rush of 1848, and during the following period when women helped stabilize society on the rugged frontier. Women not…

  1. Women in Engineering

    Science.gov (United States)

    Maurice, H. M.

    1977-01-01

    This discussion of the history of women in engineering in Great Britain covers (1) the founding and activities of the Women's Engineering Society, (2) women engineers in the 1930's, in wartime, in the postwar period, in the present, and in the future, and (3) attitudes about sex roles in the face of changing social values. (SH)

  2. Workplace Safety and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-11

    This women's health podcast focuses on four important issues for women at work: job stress, work schedules, reproductive health, and workplace violence.  Created: 5/11/2009 by Office of Women's Health (OWH) and National Institute for Occupational Safety and Health (NIOSH).   Date Released: 5/11/2009.

  3. Women and Leadership.

    Science.gov (United States)

    Turock, Betty J.

    2001-01-01

    Discussion of women and leadership focuses on women in librarianship. Highlights include the evolution of thought about women and leadership; feminist research and theory; Margaret McIntosh's model for leadership, including womanless leadership, problems in leadership, and leadership redefined; equity in leadership; and implications for…

  4. On Campus with Women.

    Science.gov (United States)

    Liberal Education, 1987

    1987-01-01

    Current trends, events, and resources concerning issues of interest to women in higher education are reported. They include notes on educational and employment trends, legislation, court litigation and dispute resolutions, sexual harrassment, campus violence, women's studies, women's athletics, and relevant resources. (MSE)

  5. Automation and Women Workers.

    Science.gov (United States)

    Wells, Jean A.

    To determine the repercussions of scientific and technological progress on the employment of women and their conditions of work, the Women's Bureau used available statistical data from 1958-68 to study: (1) Employment and Unemployment, (2) Vocational Guidance and Training, (3) Training and Retraining of Older Women, (4) Remuneration, (5) Hours of…

  6. Psychotherapy and Women's Liberation

    Science.gov (United States)

    Holroyd, Jean

    1976-01-01

    Personality theories and scientific data on women frequently contribute negatively to the psychotherapy of female clients. This paper examines some of the background factors which have shaped our information about women, and then reviews some contemporaneous approaches to the therapy of women. (Author)

  7. Women and Diabetes

    Medline Plus

    Full Text Available ... Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration ... Consumers Consumer Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin ...

  8. Women and Diabetes

    Medline Plus

    Full Text Available ... Women's Health Topics Resources for You YourDiabetesInfo.org American Diabetes Association Get Other FDA Publications for Women For Women ... by Product Area Product Areas back Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products

  9. Improving women's lives

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

    and discovered that in these things women are men's followers. Whatever music they play, women have to follow and dance to the music. Everything is manipulated, hijacked, and handled by men.” An IDRC-supported fund in Lebanon has helped 123 Palestinian women obtain a university degree and escape from poverty.

  10. Women and Diabetes

    Medline Plus

    Full Text Available ... and Devices Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the first time ... about how diabetes medicines affect women during pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical ...

  11. Strategy to improve the burden of gestational diabetes in African ...

    African Journals Online (AJOL)

    Strategy to improve the burden of gestational diabetes in African women: Rwandan perspective. Herbert T. Mapira, David K. Tumusiime, Kevin Yarasheski, Nadine Rujeni, Todd W. Cade, Eugene Mutimura ...

  12. Women scientists joining Rokkasho women to sciences

    Energy Technology Data Exchange (ETDEWEB)

    Aratani, Michi [Office of Regional Collaboration, Institute for Environmental Sciences, Rokkasho, Aomori (Japan); Sasagawa, Sumiko

    1999-09-01

    Women scientists generally play a great role in the public acceptance (PA) for the national policy of atomic energy developing in Japan. The reason may be that, when a woman scientist stands in the presence of women audience, she will be ready to be accepted by them as a person with the same gender, emotion and thought to themselves. A case of interchange between the Rokkasho women and the women scientists either resident at the nuclear site of Rokkasho or staying for a short time at Rokkasho by invitation has been described from the viewpoint of PA for the national policy of atomic energy developing, and more fundamentally, for promotion of science education. (author)

  13. Women in physics in France

    Energy Technology Data Exchange (ETDEWEB)

    Pierron-Bohnes, Véronique [CNRS-University of Strasbourg, Strasbourg (France)

    2015-12-31

    We present six associations and entities working in France on issues of women in physics: the Women and Physics Commission, French Physical Society; Women in Nuclear (WiN) France; Women and Science Association; Mission for the Place of Women at CNRS; Parity, Diversity, and Women Network, CEA; and the Network of University Equality-Diversity Representatives.

  14. Women in Latin American History.

    Science.gov (United States)

    Lavrin, Asuncion

    1981-01-01

    Presents a bibliography and suggests a number of topics around which a college level history course on Latin American women could be organized. Course topics include migration of women, definition of sex roles, legal status of women, women's work and society, feminism, politics, religion, women and the family, and women's education and…

  15. First Mayan Women's Congress.

    Science.gov (United States)

    Teissedre, S

    1997-01-01

    In October 1997, over 200 participants attended the First Mayan Women's Congress in Mexico and called for financial assistance, capacity building, and training to help Mayan women escape poverty. The Congress was initiated by the UN Development Fund for Women in collaboration with the Small Grants Program of the UN Development Program. Traditionally, Mayan women and men have played distinct roles in society, and efforts are underway to increase gender sensitivity and achieve a new balance of power. Mayan women attending the Congress reported that they face daily challenges in gaining their husbands' approval for participation in income-generating activities outside of the home. Eventually, however, some husbands also start working in these enterprises and are learning to assume their share of domestic responsibilities. Mayan women have been forced to reevaluation their role in society by a prevailing agricultural and environmental crisis as well as a high unemployment rate. Crafts that were once produced only for household consumption are now considered for export. Because the women need funds to initiate income-generating activities, the Conference linked women's groups with development practitioners, policy-makers, and donors. The women requested financial aid for more than 30 specific projects, and Congress participants agreed to pursue innovate strategies to support the enterprises with funds, training, and technical assistance. The Congress also encouraged environmental nongovernmental organizations to include Mayan women in mainstream development activities. This successful Congress will be duplicated in other Mexican states.

  16. Women and political representation.

    Science.gov (United States)

    Rathod, P B

    1999-01-01

    A remarkable progress in women's participation in politics throughout the world was witnessed in the final decade of the 20th century. According to the Inter-Parliamentary Union report, there were only eight countries with no women in their legislatures in 1998. The number of women ministers at the cabinet level worldwide doubled in a decade, and the number of countries without any women ministers dropped from 93 to 48 during 1987-96. However, this progress is far from satisfactory. Political representation of women, minorities, and other social groups is still inadequate. This may be due to a complex combination of socioeconomic, cultural, and institutional factors. The view that women's political participation increases with social and economic development is supported by data from the Nordic countries, where there are higher proportions of women legislators than in less developed countries. While better levels of socioeconomic development, having a women-friendly political culture, and higher literacy are considered favorable factors for women's increased political representation, adopting one of the proportional representation systems (such as a party-list system, a single transferable vote system, or a mixed proportional system with multi-member constituencies) is the single factor most responsible for the higher representation of women.

  17. The Impact of HIV on Maternal Morbidity in the Pre-HAART Era in Uganda

    Directory of Open Access Journals (Sweden)

    Harriet Nuwagaba-Biribonwoha

    2012-01-01

    Results. Major morbidity was observed in 46/129 (36% and 104/390 (27% of the HIV-infected and HIV-uninfected women, respectively, who remained in followup. In the multivariable analysis, major morbidity was independently associated with HIV infection, adjusted odds ratio (AOR 1.7 (1.1 to 2.7, nulliparity (AOR 2.0 (1.3 to 3.0, and lack of, or minimal, formal education (AOR 2.1 (1.1 to 3.8. Conclusions. HIV was associated with a 70% increase in the odds of major maternal morbidity in these Ugandan mothers.

  18. Maternal deaths following nevirapine-based antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    E Bera

    2012-11-01

    Full Text Available We report 2 cases illustrating that it is too simplistic to link nevirapine (NVP toxicity exclusively to individuals with immune preservation. Not enough is known about the mechanism of hepatotoxicity or cutaneous eruption to predict these events. This type of hypersensitivity reaction occurs rarely among HIV-exposed infants taking NVP prophylaxis or antiretroviral therapy (ART-experienced adults with complete plasma viral load suppression. Conversely, HIV-uninfected adults and ART-naive pregnant women appear to be disproportionately affected by the adverse effects of NVP.

  19. Women in Otolaryngology.

    Science.gov (United States)

    O'Connell Ferster, Ashley P; Hu, Amanda

    2017-08-01

    Advances in gender equality have been sought in the field of medicine for centuries, including the specialty of otolaryngology. Currently, about 14.5% of practicing otolaryngologists are women. Strides have been made to support equality by the American Academy of Otolaryngology-Head and Neck Surgery through the development of the Women in Otolaryngology Section in 2010, among other efforts. This article reviews the literature of women in otolaryngology, as well as current trends toward equality among otolaryngologists of all genders.

  20. Obesity and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-11

    This women's health podcast focuses on obesity in women and girls. It discusses obesity-related health risks and includes tips to help achieve and maintain a healthy weight.  Created: 5/11/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/11/2009.

  1. Gestational Diabetes and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-12

    This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

  2. Chlamydia and Women

    Centers for Disease Control (CDC) Podcasts

    2009-04-02

    This women's health podcast focuses on chlamydia, its severe health consequences for women if left untreated, and the importance of annual chlamydia screening.  Created: 4/2/2009 by Office of Women’s Health (OWH) and National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 4/2/2009.

  3. Spring of women?

    Directory of Open Access Journals (Sweden)

    Mónica Castillo

    2012-12-01

    Full Text Available Terms such as “Islamic feminism” and “women’s movement” refer to those social movements of women that seek to assert their rights in Islamic societies. This brief study focuses on theses social movements of women and will presentan overview of the role and participation of women in the Arab Spring by examining news, events, press articles and opinions in order to contextualize the participation of women and feminists in the Arab Spring from a perspective of the social networking phenomenon as apparent drivers of the revolution.

  4. Womens Business Center

    Data.gov (United States)

    Small Business Administration — Women's Business Centers (WBCs) represent a national network of nearly 100 educational centers throughout the United States and its territories, which are designed...

  5. Women and finance.

    Science.gov (United States)

    Seaforth, W

    1995-12-01

    This article discusses women's rights to inherit land, the impact of flexible loan schemes for women, and the paucity of available loan schemes for women. The poor without land ownership have many problems obtaining credit for shelter from conventional finance markets. The poor must limit loans to small amounts that banks do not want to bother with. Eligibility criteria for loans usually require collateral, such as a high and regular income, savings, or land. The poor, and particularly poor women, cannot acquire credit or can do so only through a husband or male relative. Female heads of households are discriminated against when the man is assumed to be the major income source. Most housing purchases in developing countries are made through cash payments from family savings or informal loans. Even small loans may place a heavy burden on women. The author gives several examples of credit groups and their success in generating income and housing security. There remains a need to provide training and education for women and to improve women's access to credit and land. Information should be available to women on how to obtain credit. Governments and nongovernmental organizations have a responsibility to provide support for women's efforts to provide housing and support for their families.

  6. Women in Meteorology.

    Science.gov (United States)

    Lemone, Margaret A.; Waukau, Patricia L.

    1982-11-01

    The names of 927 women who are or have been active in meteorology or closely related fields have been obtained from various sources. Of these women, at least 500 are presently active. An estimated 4-5% of the total number of Ph.D.s in meteorology are awarded to women. About 10% of those receiving B.S. and M.S. degrees are women.The work patterns, accomplishments, and salaries of employed women meteorologists have been summarized from 330 responses to questionnaires, as functions of age, family status, part- or full-time working status, and employing institutions. It was found that women meteorologists holding Ph.D.s are more likely than their male counterparts to be employed by universities. As increasing number of women were employed in operational meteorology, although few of them were married and fewer still responsible for children. Several women were employed by private industry and some had advanced into managerial positions, although at the present time, such positions remain out of the reach of most women.The subjective and objective effects of several gender-related factors have been summarized from the comments and responses to the questionnaires. The primary obstacles to advancement were found to be part-time work and the responsibility for children. Part-time work was found to have a clearly negative effect on salary increase as a function of age. prejudicated discrimination and rules negatively affecting women remain important, especially to the older women, and affirmative action programs are generally seen as beneficial.Surprisingly, in contrast to the experience of women in other fields of science, women Ph.D.s in meteorology earn salaries comparable of their employment in government or large corporations and universities where there are strong affirmative action programs and above-average salaries. Based on the responses to the questionnaire, the small size of the meteorological community is also a factor, enabling women to become recognized

  7. HIDDEN WAR AGAINST WOMEN

    OpenAIRE

    Şahin Kaya, Şehriban

    2011-01-01

    For the last couple of decades, there has been a dramatic regress in the women’s economic, social and political positions in Turkey. The number of women participating in job market decreased from 34.1 percent in 1990 to 23.5 percent in 2009. Almost 85 percent of the working women are still stuck in traditional female jobs. A diminishing representation of women in politics and increasing violence against women have been other features of this regression. At the same time period, a transformati...

  8. Violence against Women and Women Shelters

    Directory of Open Access Journals (Sweden)

    Burcu Rahsan Erim

    2016-12-01

    Full Text Available Violence against women is a violation of basic human rights and freedoms and at the same time, it is an important public health problem. Recently, "World Health Organization", especially many organizations against women domestic violence emphasized that it is the most common form of violence. Despite being one of the first points of contact after violence, unfortunately it is conspicuous that there are very few publications about violence and women shelters in the psychiatric field. For this reason, in this review we did not limit our evaluation just with psychiatry but also explored large scale studies in in psychology and sociology field. [Archives Medical Review Journal 2016; 25(4.000: 536-549

  9. [Cardiac rehabilitation in women].

    Science.gov (United States)

    Ghannem, M; Ghannem, L; Lamouchi, S; Justin, K D; Meimoun, P; Ghannem, L

    2016-12-01

    Coronary artery disease (CAD) occurs later in life in women when compared to men (10 years later). The FAST-MI study has shown that the profile of women with CAD has changed in the past 15 years, they are younger, more obese, and usually smokers. Whatever the age at which CAD occurs in women, the prognosis tends to be worse than in men, despite a higher frequency of acute coronary syndrome (ACS) with angiographically normal coronary arteries in women. In women without significant lesion at coronary angiography, the WISE study has shown abnormalities of the coronary vasomotricy. Despite its beneficial effect on morbidity and mortality, cardiac rehabilitation is underused particularly in women. Indeed, several factors do not encourage a woman to follow a cardiac rehabilitation program, even after an ACS. These factors may be cultural, domestic, familial, orthopedic, or even the fear of exercising. Therefore, physicians have to be particularly convincing in women, in order to have them participating in rehabilitation programs. Physical capacity is lower in women when compared to men. However, the weaker the physical capacity, the better the benefit of cardiac rehabilitation. Physical endurance training continuously or in interval, associated to muscle strengthening can improve the physical capacity in women. Vascular risk factors correction is also an important step for the management of women with CAD. Therapeutic education and several available workshops help women to better understand their disease and to improve their self-management when they return home. Anxiety, depression, and sexual dysfunction frequently deteriorate the quality of life of our patients. Therefore, psychological management is also essential in our departments. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. The political vision of the Rwandan kingdom | Mulinda | Rwanda ...

    African Journals Online (AJOL)

    If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link ...

  11. 3 Editorial message Dear readers, The Rwandan Journal of ...

    African Journals Online (AJOL)

    Amy Stambach

    The support the journal has so far received from the University of Rwanda – College of Education, the editorial team, and the article contributors has continued to strengthen the determination to maintain the high standards of publications. The editorial team thus expresses its gratitude to all well-wishers and contributors ...

  12. The use of computer based instructions to enhance Rwandan ...

    African Journals Online (AJOL)

    La formation fût conduit dans le laboratoire informatique de ladite école. Comme approche méthodologique, la formation a combiné l'apprentissage individualisé, l'apprentissage de groupe, l'apprentissage par pair et l'assistance de la part des chercheurs. Les données ont été recueillies en utilisant des formulaires ...

  13. The alignment between the Rwandan Ordinary level national ...

    African Journals Online (AJOL)

    ahavugimana

    from http://www.bioscience.heacademy ac.uk/ journal/vol6/. Beej-6-5.pdf. 11. Jideani, VA & Jideani, IA 2012, Alignment of Assessment. Objectives with Instructional Objectives Using Revised. Bloom's Taxonomy—The Case for Food Science and. Technology Education, Journal of Food Science Education, vol. 11, pp. 34-42.

  14. Establishing Baseline Data for Pressure Ulcers in a Rwandan ...

    African Journals Online (AJOL)

    The objective of this study was to establish baseline data and compare prevalence, incidence, and severity of pressure ulcers in this ICU before and after educational classes. Methods. Educational classes on pressure ulcer assessment and classification were held for all ICU nurses. After train- ing, data collection was ...

  15. Rwandan Journal of Education - Vol 3, No 1 (2015)

    African Journals Online (AJOL)

    Power dynamics among PWDs during adult learning processes: Motivator or demotivator? EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Ephraim Lemmy Nuwagaba, Peter Neville Rule, 52-65 ...

  16. Plights of learners with Visual Impairments in Rwandan science ...

    African Journals Online (AJOL)

    The article is thus an outcome of a study conducted in HVP Gatagara – Rwamagana, the only 9YBE school for the VIS in Rwanda, and the finding underlines the fact that the planning of alternative solutions ought not to focus on the VIS as the source of the problem, rather on their school and whole education system's ...

  17. The use of computer based instructions to enhance Rwandan ...

    African Journals Online (AJOL)

    Annestar

    extent to which teachers integrate ICT in their teaching activities (Makinde, Makinde & Shorunke, 2013). Here below are the main ... Indeed, these teachers were more confident, excited and less anxious. .... in the course included hyperlinks for further readings, stories, pictures and games that could make the learner relaxing.

  18. A Rwandan spirometry and resting ventilation study | Gahutu ...

    African Journals Online (AJOL)

    To illustrate spirometric population variation and ventilatory adaptation to moderate altitude, we report the spirometric and resting ventilation values observed in a student population in Butare, Rwanda (altitude: 1 768 m; barometric pressure: 629 mm Hg). Spirometry was carried out with a Mijnhardt Volutest VT-3 ...

  19. The Role of Remittance in Development: The Case of Rwandan ...

    African Journals Online (AJOL)

    Remittances and development are progressively becoming inseparable areas. In other words, remittances are increasingly associated with development factors. This is because money transferred by the Diaspora to their native country is contributing to improving the living conditions of beneficiaries as well as the economic ...

  20. The alignment between the Rwandan Ordinary level national ...

    African Journals Online (AJOL)

    However, while the curriculum recommends the development of learners' communicative competence, the examinations do not evaluate learners' listening and speaking abilities which are crucial for this type of competence. In addition, the development of critical thinking skills and abilities which are recommended by the ...

  1. Career change among Rwandan nurses | Nkosi | African Journal for ...

    African Journals Online (AJOL)

    Quantitative analysis revealed that job dissatisfaction related to poor salaries, lack of professional growth and nursing management are major driving forces to career change among Rwanda nurses. Some respondents reported that nursing has never been their career choice and hence have no desire to continue being ...

  2. Rwandan Journal of Education - Vol 3, No 2 (2016)

    African Journals Online (AJOL)

    -lenges of unemployment and underemployment of higher education graduates in Rwanda, Kenya and Ghana · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Irénée Ndayambaje ...

  3. Aggressive desmoid fibromatosis: First case in a Rwandan child

    African Journals Online (AJOL)

    palate region with complete obstruction of the left nostril (Fig. 1). On admission, the patient's general status was marked by facial deformity with mild respiratory distress. The rest of the clinical examination was unremarkable, and there was no lymph node involvement. The patient received immediate supportive care in the ...

  4. Tailoring agroforestry technologies to the diversity of Rwandan smallholder agriculture

    NARCIS (Netherlands)

    Bucagu, C.

    2013-01-01

    Keywords: food security, biophysical and socioeconomic conditions, farmer resource groups, productivity, economic evaluation, scenario analysis  Smallholder livelihoods in sub-Saharan Africa(SSA) are constrained by a number of factors that

  5. Rwandan Journal of Education - Vol 2, No 1 (2014)

    African Journals Online (AJOL)

    Six years of inclusive education at the University of Rwanda-College of Education: Evaluation and perspectives · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. E Nsanzabiga, 30-45 ...

  6. The political vision of the Rwandan kingdom | Mulinda | Rwanda ...

    African Journals Online (AJOL)

    This article discusses the political vision of pre-colonial Rwanda. The authors used oral traditions as privileged sources of the history of pre-colonial Rwanda. Such vision is spotted by means of the analysis of declarations and decisions of the kings of Rwanda where it is possible to identify a net formulation of the political ...

  7. The correlates of safe sex practices among Rwandan youth: a ...

    African Journals Online (AJOL)

    The ideational factors that are significant for primary sexual abstinence are perceptions about the sexual behaviors of peers, perceived self-efficacy to refuse sex with someone truly loved, perceived self-efficacy to refuse sex with someone known for more than three months, self-esteem and attitudes toward premarital sex.

  8. Rwandan teachers as educational researchers: why it matters ...

    African Journals Online (AJOL)

    Teachers have generally been conceptualized as passive adopters of policies articulated in high educational and political offices, which has limited their reflection, creativeness and independent ... One way to achieve this is to engage in educational research, allowing a critical view on educational policies and practices.

  9. Sexual violence and girls' performance in Rwandan schools: a case ...

    African Journals Online (AJOL)

    As for the nature of sexual violence faced, the study indicates that a half of adolescent schoolgirls experience either sexual abuse or sexual exploitation. The major causes of sexual violence include perpetrators who pretend to be inoffensive while committing sexual abuse; curiosity of adolescents to perform sexual acts and ...

  10. Immunity ratione materiae of foreign state officials before Rwandan ...

    African Journals Online (AJOL)

    The article seeks to determine when, as a matter of international law, foreign state officials should be granted immunity ratione materiae when they are sued in civil and criminal proceedings in Rwanda. It also investigates the questions as to whether this immunity can be waived by the state on behalf of which the official ...

  11. Rwandan Journal of Education - Vol 1, No 2 (2013)

    African Journals Online (AJOL)

    Instructional constraints faced by learners with duchenne muscular dystrophy: A case study of Joy Town Special Primary School, Thika, Kenya. EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. WA Wanjiku, F Wamocho, P Kioy, 77-85 ...

  12. Rwandan teachers as educational researchers: why it matters

    African Journals Online (AJOL)

    user17

    gether eight articles written by English language teachers in Africa (Farell & Makalela, 2009). It should be noted that while teachers can and should engage in general research, I argue that they would be better placed to do action research which Ferrance (2000, p. 1) defines as “a process in which participants exam-.

  13. Factors associated with injuries among first-division Rwandan ...

    African Journals Online (AJOL)

    EB

    . Studies have suggested that female soccer players are more susceptible to injuries than their male counterparts, and their vulnerability is due mainly to intrinsic factors such as their anatomical and physiological structure. Objectives: To ...

  14. Factors associated with injuries among first-division Rwandan ...

    African Journals Online (AJOL)

    Background: Female soccer has grown tremendously in the last decade. Studies have suggested that female soccer players are more susceptible to injuries than their male counterparts, and their vulnerability is due mainly to intrinsic factors such as their anatomical and physiological structure. Objectives: To establish ...

  15. Rwandan Journal of Education - Vol 4, No 1 (2017)

    African Journals Online (AJOL)

    Barriers and challenges of educational development in China: an analysis on rural-urban migrant residents · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Emile Uwamahoro, Bekoe A. McJerry, 13-21 ...

  16. The Role of Remittance in Development: The Case of Rwandan ...

    African Journals Online (AJOL)

    economy. Second, remittances exhibit countercyclical features that are non. – negligible; despite economic cycles, remittances follow an incremental growth informed by .... According to respondents' views, those two systems are exploited: the ... Thus, the charges which the Diasporas mean to notify include payment fees.

  17. U.S. Policy Choices During the Rwandan Genocide

    National Research Council Canada - National Science Library

    Hooker, Jr, Richard D

    2003-01-01

    ... since the Cambodian killing fields of the 1970s. Alone among the great powers, the United States possessed the political and military power to organize and lead a rapid military intervention to stop the slaughter yet America took no action...

  18. Armed conflict and schooling : evidence from the 1994 Rwandan genocide

    OpenAIRE

    Akresh, Richard; de Walque, Damien

    2008-01-01

    Civil war, and genocide in particular, are among the most destructive of social phenomena, especially for children of school-going age. In Rwanda school enrollment trends suggest that the school system recovered quickly after 1994, but these numbers do not tell the full story. Two cross-sectional household surveys collected before and after the genocide are used to compare children in the ...

  19. Life in the Aftermath of the 1994 Rwandan Genocide

    Science.gov (United States)

    Totten, Samuel

    2009-01-01

    For six months in 2008, as a Fulbright Scholar, this author served as a senior researcher at the Centre for Conflict Management at the National University of Rwanda where he conducted research into the lives of survivors of the 1994 genocide. The research comprised lengthy interviews (between seven and fifteen hours) with each survivor. The…

  20. Women in Engineering Revisited.

    Science.gov (United States)

    McAfee, Naomi J.

    Engineering as a profession for women is examined. Although 1.0% of the engineering population is presently female, undergraduate enrollment has been increasing steadily since 1970. Some universities today have women representing 10-15% of their engineering enrollment. Beginning salaries are higher for female engineers than for male engineers, but…

  1. WOMEN and STEM

    OpenAIRE

    Shapiro, Jenessa

    2011-01-01

    This article describes a Faculty Speaker Series organized by Jenessa Shapiro, Assistant Professor in the Psychology Department at UCLA, in Conjunction with UCLA's Center for the Study of Women. The Speaker Series has invited scholars to discuss the issues surrounding women and STEM.

  2. Violence against women.

    Science.gov (United States)

    Shiva, M

    1999-01-01

    In India, violence against women is increasing and takes many forms while laws to protect women are ignored. Despite this fact, the new reproductive and child health program ignores sexual violence. Health personnel can respond by: 1) accepting the magnitude of the problem; 2) investigating the deaths of young women; 3) documenting findings; 4) ensuring that sexual abuse is recognized as a public health problem; 5) disseminating findings; 6) ensuring the protection of female field workers; 7) recognizing violence as an occupational health hazard; 8) facilitating the empowerment of women; 9) training women in self-defense; 10) ensuring that colleges and training institutes address violence as a women's health concern; 11) studying the psychological effects of violence; 12) collaborating with the National Commission for Women and the National Human Rights Commission; and 13) advocating for incorporation of sexual violence as a reproductive health issue in the national reproductive health program. In particular, domestic violence is a pervasive violation of women's human rights and has been resistant to social advances because of its "hidden" nature. Domestic violence exists because husbands believe they have an absolute right over the sexuality of their wives. Abusive husbands also abuse their daughters while sons learn violent behavior from their fathers. Crimes must be considered irrespective of whether they are committed outside or inside the home.

  3. Women in rural development.

    Science.gov (United States)

    Palmer, I

    1980-01-01

    The integration of women in rural development means something more than mere labor involvement, but there has never been a clear definition of what it means. 4 principal concerns of policy-makers are briefly described as they affect women: unemployment and inadequate employment; 2) the satisfaction of basic needs and women's participation in decision-making; 3) population issues; and 4) rural-to-urban migration. The actual inter-household and inter-personal distribution of more work and higher productivity work could result in some hard-working people working even longer hours because of additional tasks with others losing their intermittent employment opportunities due to mechanization. These contradictions can be particularly acute for women. The non-material basic need of decision-making powers is more important in the case of women than of men, yet the personal status of women is being threatened by the institution-building that accompanies peasant-based agricultural intensification plans and anti-poverty programs. The education of females has been seen as a possible factor favoring family planning. In addition, education for women can mean access to public information and new expectations from life for themselves. At this time more women than men seem to be migrating to towns and cities in a number of countries with varied economic structures. 3 cases studies of agricultural development in Kenya, Bangladesh and Java, Indonesia are presented.

  4. Cancer and Women

    Science.gov (United States)

    ... in Young Women Cancer and Men Cancer and Women Cancer Prevention in the Workplace Cancer Prevention Starts in Childhood Cancer, the Flu, and You Cervical Cancer Awareness Colorectal Cancer Awareness Gynecologic Cancer Awareness Health Disparities in Cancer Improving Health and Quality of ...

  5. Women and Diabetes

    Medline Plus

    Full Text Available ... pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments for ... races, ethnic backgrounds, and health conditions participating in clinical trials. Visit the Women in Clinical Trials webpage to ...

  6. Women's safety and transport

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

    harassment/assault among women not only restricts their mobility, but it also places constraints on their ability to make .... and provide mobility around the city and between localities. The city has many settlements on hills, .... spread, the sun sets early in this part of the country. In the absence of street lights, women preferred ...

  7. Women and Business Management.

    Science.gov (United States)

    Brown, Linda Keller

    1979-01-01

    Analyzes the current research on women as managers in business, commerce, and industry. Examines the areas of career choice and availability of women for managerial positions, stereotypes of managerial characteristics, the behavioral consequences of stereotypes, intrapsychic and structural barriers to advancement, and characteristics of the…

  8. Women's Health Insurance Coverage

    Science.gov (United States)

    ... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

  9. Women and Land

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

    Despite land reforms passed in 1999, women in Tanzania still face constraints around inheriting ancestral land. C u rt C a rn e m a rk. /W o rld. B a n k. Although local courts provide hope for rural women who lack the means to appear at magistrates' court, they need the tools to be more effective. Researchers in Kenya found ...

  10. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing ... the blood vessels that supply blood to the heart itself. This is called coronary artery disease, and ...

  11. Iowa Women of Achievement.

    Science.gov (United States)

    Ohrn, Deborah Gore, Ed.

    1993-01-01

    This issue of the Goldfinch highlights some of Iowa's 20th century women of achievement. These women have devoted their lives to working for human rights, education, equality, and individual rights. They come from the worlds of politics, art, music, education, sports, business, entertainment, and social work. They represent Native Americans,…

  12. Women, Families, and Prison.

    Science.gov (United States)

    Durham, Marian B.; And Others

    Services to imprisoned women under the age of 21 and the effects of incarceration on inmate mothers and their children are the two major subjects discussed in this report of a study conducted at the two state prison facilities for women in North Carolina. Information on these topics was obtained through site visits, interviews with staff and…

  13. Mentoring Freshmen Women.

    Science.gov (United States)

    Taylor, Irmgard C.; McLaughlin, Marilou B.

    1982-01-01

    Describes the mentoring component of a federally funded project, Women's Academic and Career Choices. The objective of the project was to open and broaden young college women's thinking about academic and career choices through a two-credit strategy course, intensive mentoring/advising activity, and role-modeling. (Author)

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... called gestational (jes-Tay-shun-ul) diabetes. Other women have diabetes before they get pregnant. Use these resources to help you talk to your health care provider about how to manage diabetes during pregnancy. Medicine and Pregnancy Fact ... and Pregnancy (CDC) Diverse Women ...

  15. Oral Health and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-12

    This women's health podcast focuses on the importance of maintaining good oral health during pregnancy.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

  16. Women Deans: Leadership Becoming

    Science.gov (United States)

    Isaac, Carol A.; Behar-Horenstein, Linda S.; Koro-Ljungberg, Mirka

    2009-01-01

    The term "leadership" metaphorically embodies a gendered hierarchy of labour. In this study women deans' values were found to be incongruent with the masculine discourse creating inner conflicts and alternative discourses. Data collected from 10 women deans from both male-dominated and female-dominated colleges were used to deconstruct leadership…

  17. Farm Women and Work.

    Science.gov (United States)

    Sander, William

    1986-01-01

    The participation by farm women in on-farm and off-farm work is estimated and the effects of female earnings on farm family income are measured. It is shown that farm women make significant contributions to income and help manage income instability. (Author/CH)

  18. Women as Farm Labor.

    Science.gov (United States)

    Reimer, Bill

    1986-01-01

    Women's participation in family farm labor has been underestimated. A study of small farms in rural Quebec during 1978 measured laborer characteristics, time spent on activities, distribution of responsibility, and extent of household production. Results indicate that women's direct and indirect contributions must be integrated into agricultural…

  19. Professional Women and Marriage.

    Science.gov (United States)

    Allen, Suzanne M.; Kalish, Richard A.

    1984-01-01

    Explored the phenomenon of late marriage in 41 highly educated professional women. Compared with normative marriers, the late-marrying women had higher career goals, a more egalitarian role structure in marriage, and were more accepting of premarital sex and cohabitation. Factors associated with family backgrounds were identified. (JAC)

  20. Women NGO's and Women Empowerment in

    African Journals Online (AJOL)

    FIRST LADY

    world Conferences on women were held; Mexico City 1975, Copenhagen. 1980, Nairobi 1985 and 1995 Beijing Conference. These conferences directed the ... development plans due to corruption by government officials, bureaucratic bottleneck, lack of commitment by government officials etc. The failure of government ...

  1. International Women's Day speech.

    Science.gov (United States)

    Kazibwe, S W

    1993-01-01

    The objectives of the International Women's Day are: 1) to celebrate the struggle for women's rights in the economic, social, political, and cultural domain; 2) to reaffirm women's solidarity in the struggle for peace; 3) and to show what women have achieved. In 1988, Uganda's government of the National Resistance Movement created the Ministry of Women in Development. The period 1988-1990 was one of consultations, needs assessment, planning, and recruiting staff for the Ministry. From 1990 to 1993, measurable results have been achieved. The Ministry's gender concerns pertained to the sector policies of the Ministries of Agriculture, Animal Industry and Fisheries, Education, Health, Water, Energy, Minerals, and Environment Protection. Under the Umbrella Project for Women in Development, gender sensitization has been achieved with policy makers in ministries, at district level, and in the media. Gender issues have also been incorporated in the National Political School Curriculum. The Ministry has also trained a corps of 73 women trainers from 38 districts. The Ministry, with funding from DANIDA, collected women's views on the constitution through meetings and seminars in all the districts in the country. Recommendations were submitted in a consolidated report to the Constitution Commission. A pilot para-legal scheme is successfully being implemented in Kamuli district. A community-based pool of legal advisors has been developed. Legal matters that affect both women and men are undertaken at the community level. The economic emancipation of women is a crucial part of the Ministry's mandate. In conjunction with NGOs, pilot credit programs are being run in Mukono, Jinja, Mbale, and Kapchorwa districts. Cross-sectoral programs are in close collaboration with the rural water and sanitation program, the Northern Uganda rehabilitation program, and the integrated Basic Education Pilot Project to be implemented in 8 districts.

  2. Ways women lead.

    Science.gov (United States)

    Rosener, J B

    1990-01-01

    Women managers are succeeding not by adopting the traditional command-and-control leadership style but by drawing on what is unique to their experience as women. According to a study the author conducted for the International Women's Forum, men and women in similar managerial jobs make the same amount of money and experience roughly the same degree of work-family conflict. But when they describe their leadership styles, vast differences arise. Men are much more likely than women to view leadership as a series of transactions with subordinates, and to use their position and control of resources to motivate their followers. Women, on the other hand, are far more likely than men to describe themselves as transforming subordinates' self-interest into concern for the whole organization and as using personal traits like charisma, work record, and interpersonal skills to motivate others. Women leaders practice what the author calls "interactive leadership"--trying to make every interaction with coworkers positive for all involved by encouraging participation, sharing power and information, making people feel important, and energizing them. In general, women have been expected to be supportive and cooperative, and they have not held long series of positions with formal authority. This may explain why women leaders today tend to be more interactive than men. But interactive leadership should not be linked directly to being female, since some men use that style and some women prefer the command-and-control style. Organizations that are open to leadership styles that play to individuals' strengths will increase their chances of surviving in a fast-changing environment.

  3. HIV in women

    Directory of Open Access Journals (Sweden)

    Mulcahy F

    2012-11-01

    Full Text Available Globally over 50% of HIV-infected individuals are women. With the widespread use of HAART, we can expect women to have mortality rates approaching normal. Indeed, studies have shown that women may expect a slower disease progression than men following seroconversion; furthermore, it appears that female who injects drugs can live longer than their male counterparts. However, other studies from cohort analysis have reported worse outcomes in women. In essence, many studies are consistently underpowered to adequately address these questions. The proportion of women in clinical trials remains at 20 to 30%, with pregnancy potential being a major exclusion factor. Hence, many questions remain unanswered. Recent data suggest women are more likely to present late with a new AIDS diagnosis. Why this should be the case is not well understood. In addition, HIV-positive women should have the same access to reproduction health as their negative counterparts, but unfortunately many inequalities remain. Advise on contraception and fertility services are very variable across both the developed and developing world. Data are limited on the most appropriate use of contraceptives in the presence of HAART, the possible drug interactions and possible increased risk of HIV transmission. There remain significant differences in guidelines regarding prevention of mother-to-child transmission (MTCT across Europe, and implications of stopping and starting HAART for MTCT have not been adequately addressed. The mode of timing of delivery, and the effect of length of time of ruptured membranes on this decision is also contentious. Further issues relate to the desire for HIV-positive women to breastfeed in the setting of HIV viral suppression, where some guidelines now support women in this situation and others categorically would inform child protection authorities. Finally as women age it is more difficult to separate the effect of the menopause and its symptoms from the

  4. Vietnamese women at solidarity meeting of world women in Cuba.

    Science.gov (United States)

    1998-01-01

    This article summarizes experiences of a Vietnamese delegation at a solidarity meeting of world women during April 13-16, 1998, in Cuba. The President of the Viet Nam Women's Union headed the delegation. The advisor was the vice-chairperson of the Vietnamese National Assembly. The delegation participated in 6 forums: women and sustainable economic development; women, health, education, and social security; women, communication and the mass media; women in politics and decision-making; women, violence and discrimination; and national independence, sovereignty, peace, and women. The delegation also participated in sessions on women's issues; implementation issues; women parliamentarians; and migrant and displaced women. The delegation met with delegates from other countries and participated in a world meeting and an Asian-Pacific meeting to support Cuban women. The entire delegation presented a stage show of songs, which was well received by the 3000 participants. The delegation met with Cuban delegates to discuss the formation of women's groups and to build better relations between the women of both countries. The delegation visited a training center of women cadres and the center for gender education. Participants adopted the Havana Declaration, which states the intention of world women to eradicate poverty and war and to promote peace, progress, and happiness in all countries. The Havana Declaration condemned the US embargo against Cuba. Fidel Castro spoke and expressed gratitude for the strong support from world women, especially Vietnamese women.

  5. Osteoporosis and Asian American Women

    Science.gov (United States)

    ... Breadcrumb Home Osteoporosis Osteoporosis and Asian American Women Osteoporosis and Asian American Women Asian American women are ... Are Available? Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  6. Women and HIV/AIDS

    Science.gov (United States)

    ... AIDS from other websites National Women and Girls HIV/AIDS Awareness Day Blog topics HIV and AIDS Breaking Down ... t Miss a Beat National Women and Girls HIV/AIDS Awareness Day National Women's Health Week Supporting Nursing Moms ...

  7. Women and Diabetes -- Diabetes Medicines

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  8. Financial Literacy Education for Women

    Science.gov (United States)

    Jarecke, Jodi; Taylor, Edward W.; Hira, Tahira K.

    2014-01-01

    Exploring the pedagogical approaches of four women's financial literacy education programs, this chapter provides an overview of trends and needs in financial education for women and offers pedagogical strategies for teaching women about finance.

  9. Infant feeding, HIV transmission and mortality at 18 months: the need for appropriate choices by mothers and prioritization within programmes.

    Science.gov (United States)

    Rollins, Nigel C; Becquet, Renaud; Bland, Ruth M; Coutsoudis, Anna; Coovadia, Hoosen M; Newell, Marie-Louise

    2008-11-12

    To determine the late HIV transmission and survival risks associated with early infant feeding practices. A nonrandomized intervention cohort. HIV-infected pregnant women were supported in their infant feeding choices. Infant feeding data were obtained weekly; blood samples from infants were taken monthly to diagnose HIV infection. Eighteen-month mortality and HIV transmission risk were assessed according to infant feeding practices at 6 months. One thousand one hundred and ninety-three live-born infants were included. Overall 18-month probabilities of death (95% confidence interval) were 0.04 (0.03-0.06) and 0.53 (0.46-0.60) for HIV-uninfected and HIV-infected children, respectively. The eighteen-month probability of survival was not statistically significantly different for HIV-uninfected infants breastfed or replacement fed from birth. In univariate analysis of infant feeding practices, the probability of HIV-free survival beyond the first 6 months of life in children alive at 6 months was 0.98 (0.89-1.00) amongst infants replacement fed from birth, 0.96 (0.90-0.98; P = 0.25) and 0.91 (0.87-0.94; P = 0.03) in those breastfed for less or more than 6 months, respectively. In multivariable analyses, maternal unemployment and low antenatal CD4 cell count were independently associated with more than three-fold increased risk of infant HIV infection or death. Breastfeeding and replacement feeding of HIV-uninfected infants were associated with similar mortality rates at 18 months. However, these findings were amongst mothers and infants who received excellent support to first make, and then practice, appropriate infant feeding choices. For programmes to achieve similar results, the quality of counselling and identification of mothers with low CD4 cell count need to be the targets of improvement strategies.

  10. HIV is associated with airway obstruction: a matched controlled study.

    Science.gov (United States)

    Makinson, Alain; Hayot, Maurice; Eymard-Duvernay, Sabrina; Ribet, Céline; Raffi, François; Pialoux, Gilles; Zucman, David; Poizot-Martin, Isabelle; Bonnet, Fabrice; Abgrall, Sophie; Tattevin, Pierre; Cheret, Antoine; Ferry, Tristan; Mauboussin, Jean-Marc; Marchand, Lucie; Rouzaud, Claire; Reynes, Jacques; Zins, Marie; Le Moing, Vincent

    2018-01-14

    To explore whether airway obstruction is associated with HIV in a cohort of HIV-infected and uninfected smokers. People living with HIV (PLWHIV) participated in the ANRS EP48 HIV CHEST study, an early lung cancer diagnosis study with low-dose chest tomography. HIV-uninfected study participants were from the CONSTANCES cohort. Inclusion criteria were an age greater than 40 years, a smoking history of at least 20 pack-years, and for PLWHIV, a CD4 T-lymphocyte nadir less than 350/μl and last CD4 cell count more than 100 cells/μl. Two randomly selected HIV-uninfected study participants were matched by age and sex with one PLWHIV. Prebronchodilatator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio was the primary outcome, and association of FEV1/FVC ratio less than 0.70 and FEV1 less than 80% of the theoretical value, as a proxy of chronic obstructive pulmonary disease, the secondary outcome. In total, 351 PLWHIV and 702 HIV-uninfected study participants were included. Median age was 50 years, and 17% of study participants were women. Plasma HIV RNA was less than 50 copies/ml in 89% of PLWHIV, with a median CD4 cell count of 573 cells/μl. HIV (β -2.19), age (per 10 years increase; β -2.81), tobacco use (per 5 pack-years increase; β -0.34), and hepatitis C virus serology (β-2.50) were negatively associated with FEV1/FVC. HIV [odds ratio (OR: 1.72)], age (per 10 years increase; OR 1.77), and tobacco use (per 5 pack-years increase; OR 1.11) were significantly associated with the secondary outcome. Our study found a significant association of airway obstruction with HIV status in smokers aged more than 40 years with previous immunodeficiency.

  11. Educated women in Syria

    DEFF Research Database (Denmark)

    Sparre, Sara Cathrine Lei

    2008-01-01

    in the work force and thus indirectly questioning the gender ideals of secular Arab nationalism. In Syria too, Islamization has occurred, as is evident from the increased numbers of young muhajabat women, the construction of new mosques and the significant growth in Islamic charity organizations. However...... it comes to gender roles and womanhood: almost everywhere Islamic actors are gaining influence at the expense of secular nationalists. When it comes to the question of women's role and position in society, however, Islamic actors tend to emphasize "female domesticity," questioning women's participation...

  12. Hereditary angioedema in women

    Directory of Open Access Journals (Sweden)

    Bouillet Laurence

    2010-07-01

    Full Text Available Abstract Women with hereditary angioedema (HAE are more likely to be symptomatic that men. Hormonal factors (puberty, contraception, pregnancy,.... play a significant role in the precipitation or worsening of the condition in women. So, combined contraceptive pills are not indicated and progestogen pill must be preferred. During pregnancy, attack rate can increase (38-48% of women. C1Inhibitor concentrate and tranexamic acid can be used during pregnancy. Attenuated androgens for long term prophylaxis are effective but side effects appear more often in female patients. These side effects are dose dependant and can be attenuated by titrating the dose down the lowest effective level.

  13. Women and Addiction.

    Science.gov (United States)

    Ait-Daoud, Nassima; Blevins, Derek; Khanna, Surbhi; Sharma, Sana; Holstege, Christopher P

    2017-06-01

    Gender-related alcohol and drug abuse problems are related not only to biological differences, but also to social and environmental factors, which can influence the clinical presentation, consequences of use, and treatment approaches. Women are becoming the fastest-growing population of substance abusers in the United States. Given that women experience a more rapid progression of their addiction than men, it is important that we understand and address the differences to help develop prevention and treatment programs that are tailored for women, incorporating trauma assessment and management, identification and intervention for medical and psychiatric comorbidities, financial independence, pregnancy, and child care. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... million people in the United States. Watch and learn helpful tips about managing your diabetes medicines. Veal ... Sign-up for a study to help doctors learn more about how diabetes medicines affect women during ...

  15. Women and Diabetes

    Medline Plus

    Full Text Available ... diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy-to-read booklet for women Other ... Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need ...

  16. Democracy and Women's Health.

    Science.gov (United States)

    Safaei, Jalil

    2009-01-01

    New research on broader determinants of health has culminated into the new paradigm of social determinants of health. The fundamental view that underlies this new paradigm is that socioeconomic and political contexts in which people live have significant bearing upon their health and well-being. Unlike a wealth of research on socioeconomic determinants, few studies have focused on the role of political factors. Some of these studies examine the role of political determinants on health through their mediation with the labour environments and systems of welfare state. A few others study the relationship between polity regimes and population health more directly. However, none of them has a focus on women's health. This study explores the interactions, both direct and indirect, between democracy and women's health. In doing so, it identifies some of the main health vulnerabilities for women and explains, through a conceptual model, how democracy and respect for human rights interacts with women's health.

  17. Women and Diabetes

    Medline Plus

    Full Text Available ... Us on Twitter There is good news. Diabetes can be controlled by maintaining a healthy diet, exercising, ... Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments for diabetes. ...

  18. Women and Diabetes

    Medline Plus

    Full Text Available ... you need depends on your health and the type of diabetes you have. Use these resources to ... Health is partnering with the NIH Office of Research on Women's Health to raise awareness about diverse ...

  19. Women and sexual problems

    Science.gov (United States)

    ... gov/ency/patientinstructions/000663.htm Women and sexual problems To use the sharing features on this page, ... feel better about your sex life. Common Sexual Problems You may have sexual dysfunction if you are ...

  20. Women and Mice

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is an advertisement for Dr. Pierce's "Favorite Prescription," which he developed in the 1880's to relieve women of nervous symptoms caused by disease of the...

  1. Women and Diabetes

    Medline Plus

    Full Text Available ... your health and the type of diabetes you have. Use these resources to help you talk with ... gestational (jes-Tay-shun-ul) diabetes. Other women have diabetes before they get pregnant. Use these resources ...

  2. Women and Diabetes

    Medline Plus

    Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  3. Women and Diabetes

    Medline Plus

    Full Text Available ... women Other FDA Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people ... back to top Popular Content Home Latest Recalls Report an Adverse Event MedWatch Safety Alerts News Releases ...

  4. Women in pharmacy.

    Science.gov (United States)

    Chappell, N L; Barnes, G E

    1981-01-01

    The incomes, current positions, and work status of pharmacists were examined to assess whether the situation differs for males and females. Data on sex, region, age, marital status, education, and income were collected from a random sample of practicing pharmacists in six major urban centers in Canada. Women were more likely to earn less than +20,000 per year and to be employees rather than owners. Both men and women were just as likely to be managers. There is no sex difference in administrative positions for those under 30 years of age. It is at this age, when one starts moving up the professional ladder, that the sex differences emerge. It was also found that women are more likely than men to be part-time pharmacists. It is suggested that women's socialization and/or attitudinal or structural barriers at the work level account for the sex differences.

  5. Healthy Lifestyle: Women's Health

    Science.gov (United States)

    ... reduce menopausal symptoms, such as hot flashes and sleep disturbances. However, regular exercise can help you maintain a healthy weight, relieve stress and improve your quality of life. For most healthy women, the Department ...

  6. Infertility and Women

    Science.gov (United States)

    ... medical history about your menstrual cycle, past illnesses, sexually transmitted diseases, surgeries, and any drugs you are taking. Surgery may help women with fibroids, uterine polyps, scarring, or endometriosis. Surgery ...

  7. HIV among Women

    Science.gov (United States)

    ... reported having anal sex without a condom. Some sexually transmitted diseases, such as gonorrhea and syphilis, greatly increase the likelihood of getting or transmitting HIV. Women who have been sexually abused may be more ...

  8. Women and Diabetes

    Medline Plus

    Full Text Available ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  9. Women and Diabetes

    Medline Plus

    Full Text Available ... to raise awareness about diverse women of different ages, races, ethnic backgrounds, and health conditions participating in ... Follow FDA on Facebook View FDA videos on YouTube View FDA photos on Flickr FDA Archive Combination ...

  10. Women and Diabetes

    Medline Plus

    Full Text Available ... Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the first time ... care provider about how to manage diabetes during pregnancy. Medicine and Pregnancy Fact Sheet Pregnancy Registries - Sign- ...

  11. Women and War

    Directory of Open Access Journals (Sweden)

    Redazione Camerablu

    2012-05-01

    Full Text Available In the traditional representation of war the protagonist is always the man, the soldier, portrayed in his full virility, strength and justified aggressiveness. In every public discourse on war women are presented as the personification of something to be protected and even the country itself, the homeland, that is in danger of being invaded by the enemy. However this stereotype is far from portraying the full range of women’s activity in war. In many cases throughout history, from the mythical Antigone to the forgotten heroism of resistance of women against Nazi-German occupation in the Second World War, women have taken action both to save human lives and to preserve the values of their communities that war threatens to destroy. Avoiding an essentialist and reductive interpretation that identifies tout court women with peace, this issue explores women’s wartime experiences.

  12. Women and Diabetes

    Medline Plus

    Full Text Available ... awareness about diverse women of different ages, races, ethnic backgrounds, and health conditions participating in clinical trials. ... FEAR Act Site Map Nondiscrimination Website Policies U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver ...

  13. Democracy and Women's Health

    Science.gov (United States)

    Safaei, Jalil

    2009-01-01

    New research on broader determinants of health has culminated into the new paradigm of social determinants of health. The fundamental view that underlies this new paradigm is that socioeconomic and political contexts in which people live have significant bearing upon their health and well-being. Unlike a wealth of research on socioeconomic determinants, few studies have focused on the role of political factors. Some of these studies examine the role of political determinants on health through their mediation with the labour environments and systems of welfare state. A few others study the relationship between polity regimes and population health more directly. However, none of them has a focus on women's health. This study explores the interactions, both direct and indirect, between democracy and women's health. In doing so, it identifies some of the main health vulnerabilities for women and explains, through a conceptual model, how democracy and respect for human rights interacts with women's health. PMID:21836777

  14. Violence against Women

    Science.gov (United States)

    ... setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or ... gender equality by: ending discrimination against women in marriage, divorce and custody laws ending discrimination in inheritance ...

  15. Effects of Women's Studies Courses on Women's Attitudes and Goals.

    Science.gov (United States)

    Canty, Eileen M.

    Significant changes in attitudes towards women, their vocational and educational roles, and marital relationships were found in two groups of women's college students after exposure to women's studies courses in adolescent psychology and the psychology of women. Both experimental groups indicated more liberal plans for combining marriage and…

  16. Other Women in Science Groups | Women in Science | Initiatives ...

    Indian Academy of Sciences (India)

    Other Women in Science Groups. Here is the information on various national and international groups/organizations working towards empowering women participation in science. 1. DST Task Force on Women in Science. The Department of Science & Technology has set up a National Task Force on Women in Science to ...

  17. Covering Women: Women's Publications and the Mass Media.

    Science.gov (United States)

    Silver, Sheila J.

    Before reporting on a study of the relationship between the mass media and advocates of women's rights who edit periodicals for women, the first half of this paper discusses the following: the problematic area of the coverage of women in newspapers, feminist criticism of the restricted content of women's pages, the press's controversial coverage…

  18. [Specific phobias in women].

    Science.gov (United States)

    Reggers, J; Ansseau, M

    1999-04-01

    Specific phobias are common, leading to a high level of suffering and disability when subjects have to face the phobic stimulus. According to the epidemiologic survey of Liège, one fifth of the population exhibits some phobic disorder during lifetime. Women are more affected than men (2:1). This article reviews definitions, etiopathogeny and treatments of specific phobias, and tries to explain the reasons why the trouble is more frequent in women.

  19. Married women's retirement behavior.

    Science.gov (United States)

    Pozzebon, S; Mitchell, O S

    1989-01-01

    The Longitudinal Retirement Survey, a panel study conducted by the US Social Security Administration in 1969-79 of married women who were private sector workers in 1969 and had employed husbands, allows for the empirical analysis of the economic and family determinants of women's retirement behavior. This study tested a life cycle model of women's retirement behavior. This study tested a life cycle model of women's retirement decisions. In the sample of 139 women who were followed for 10 years, the average age at retirement was 62 years (compared with 64 years for males). 67% of the respondents retired prior to or at the same time as their husbands. The model incorporated 3 types of explanatory factors: measures of income opportunities, measures of retirement or years away from the labor force, and family responsibility measures. Evidence from the regression model suggests that a working wife's retirement decision is most strongly influenced by the husband's income, his health status, and the difference in age between the spouses. The increase in the wife's discounted income stream if she defers retirement to age 65 years has a stronger substitution than income effect, but the coefficient is not significant. Logit models, which can explicitly incorporate income and leisure information relevant to each retirement date, further confirm the greater impact of family responsibilities that economic opportunities on married women's retirement decisions. Married women seem to value nonwork years highly, especially if their spouse is older than they, but will defer retirement if their husband is in poor health. On the other hand, women's retirement choices are not affected by whether the husband is retired or the presence of dependent children. These findings contrast sharply with research indicating that economic opportunities are the predominant determinants of men's retirement decisions.

  20. Violence against women.

    Science.gov (United States)

    Nelson, T

    1996-01-01

    This essay opens its discussion of violence against women by referring to the 1994 television broadcast of a 10-year-old Egyptian girl undergoing female genital mutilation (FGM) without benefit of infection control measures or anesthesia at the hands of a local barber. After presenting a brief description of FGM, its various justifications, and its impacts on its victims, the official Egyptian policy is described as ambiguous, and the broadcast is shown to have caused influential religious leaders and medical personnel to defend FGM and, thus, led to postponement of a bill to outlaw FGM. The next section of the essay shows that Egypt's response to FGM reflects the international debate on all forms of violence against women emerging from and reinforcing the social relationships that give men power over women. These forms of violence include domestic violence in almost all societies; the dowry-related, bride-burning homicides that claim 5000-12,000 lives each year in India; son preference that leads to abortion of female fetuses and female infanticide; and crimes such as rape, sexual abuse, and forced prostitution. The essay continues with a look at the costs of violence hidden in the damage to women that increases health care costs substantially and reduces economic productivity. Violence towards women, which occurs throughout the world and can prevent women from participating in public life or from controlling their fertility, is a male tool to inhibit women from gaining autonomy outside the home. The essay concludes that victims of violence are beginning to break the silence that surrounded these deeds and are seeking legislative protection. Laws may not result in real-life changes, but the movement to eliminate FGM may prove to be the first success in women's efforts to achieve human rights. An example is the important precedent being set in the US by a woman seeking asylum to avoid facing an arranged marriage and FGM in her native Togo.

  1. [The God of women].

    Science.gov (United States)

    Perez Aguirre, L

    1991-01-01

    The discourse of Christian theologians is by men and for men. The story of Salvation is about men; women have been excluded or colonized in ways carefully delimited by the Patriarchy. But a new struggle for liberation of women is underway worldwide in the dawn of the 21st century. The totality of relations between men and women is in change. The recent conquest of fertility control by women, which transferred ancestral male powers to them, and the decline of the Patriarchy are substantially modifying control of territory previously under male authority. The 2 revolutions are slowly but inexorably changing the social landscape. The feminization of poverty is of interest in this context. Women, 52% of the population, sow over half of food corps, account for 35% of the paid labor force and 60% of the hours worked, but receive only 10% of the income and possess only 1% of the world's property. Changes are occurring in the compulsively masculine culture, as well. A new consciousness and new intuitive knowledge of reality and its multiple cycles of change is emerging in which the individual is more satisfactorily related to the totality of the cosmos. Women in increasing numbers are freeing themselves of the known ways of the past which exalted the rational and mental to a new way which acknowledges the physical. In theology, the gods are beginning to appear as they were: true projections of the societies and structures of their times. Male theologians who reflect on these gods are always patriarchal because the church separates them from the world of women. They have been incapable as yet of comprehending the struggle of women who are opposing the world's oldest colonialism. For the same reasons they have been incapable of recognizing or accepting a fuller reality of existence and the divine. The prophetic female voice is still scarcely audible in an ecclesiastical world that remains enclosed in patriarch.

  2. Women and Budget Deficits

    OpenAIRE

    Signe Krogstrup; Sébastien Wälti

    2007-01-01

    If women have different economic preferences than men, then female economic and political empowerment is likely to change policy and household decisions, and in turn macroeconomic outcomes. We test the hypothesis that female enfranchisement leads to lower government budget deficits due gender differences in preferences over fiscal outcomes. Estimating the impact of women's vote on budget deficits in a differences-in-differences regression for Swiss cantonal panel data, we find that including ...

  3. [Elderly women and alcohol].

    Science.gov (United States)

    Moscato, Alba

    It is important to understand the reasons for alcohol abuse in elderly people and in particular women. Psychological suffering must be envisaged. This behaviour can be considered as a necessary narcissistic retreat when ageing. The mental health of these women should be taken into account when providing them with help when they want it. This involves understanding them and supporting them as they adjust to the passage of time. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Substance abuse in women.

    Science.gov (United States)

    Greenfield, Shelly F; Back, Sudie E; Lawson, Katie; Brady, Kathleen T

    2010-06-01

    Gender differences in substance use disorders (SUDs) and treatment outcomes for women with SUDs have been a focus of research in the last 15 years. This article reviews gender differences in the epidemiology of SUDs, highlighting the convergence of male/female prevalence ratios of SUDs in the last 20 years. The telescoping course of SUDs, recent research on the role of neuroactive gonadal steroid hormones in craving and relapse, and sex differences in stress reactivity and relapse to substance abuse are described. The role of co-occurring mood and anxiety, eating, and posttraumatic stress disorders is considered in the epidemiology, natural history, and treatment of women with SUDs. Women's use of alcohol, stimulants, opioids, cannabis, and nicotine are examined in terms of recent epidemiology, biologic and psychosocial effects, and treatment. Although women may be less likely to enter substance abuse treatment than men over the course of the lifetime, once they enter treatment, gender itself is not a predictor of treatment retention, completion, or outcome. Research on gender-specific treatments for women with SUDs and behavioral couples treatment has yielded promising results for substance abuse treatment outcomes in women. Copyright 2010 Elsevier Inc. All rights reserved.

  5. Popliteal Artery Aneurysm in Women

    DEFF Research Database (Denmark)

    Ravn, Hans; Pansell-Fawcett, Karin; Björck, Martin

    2017-01-01

    OBJECTIVES: Ninety-five per cent of those operated on for popliteal artery aneurysm (PA) are men. Thus, PAs in women are difficult to investigate. The aim was to study the disease in women. METHODS: Women treated for PA in 1987-2012, prospectively registered in the Swedish vascular registry......, Swedvasc, supplemented by case records, were compared with the larger male cohort. Survival was determined through cross linkage with the National Population Registry. RESULTS: 1509 patients (men and women), 1872 legs, were identified; of these 74 patients (4.9%) were women, 81 legs (4.3%). The median age...... was 70 years in women versus 69 in men. Twenty-nine centres operated on women (range 1-7 women/centre). There were no time trends in the proportion of women operated on (p=.5). Bilateral PA occurred in 9.5% of women and 27.0% of men (p=.002). For symptomatic aneurysms, there was a larger proportion...

  6. Namibian women and land.

    Science.gov (United States)

    Andima, J J

    1994-03-01

    More than 50% of Namibia's 1.5 million inhabitants live in reserved communal areas; most of these are women who make up a third of the country's total population. Women are the main food producers, but access to land, livestock, water, and fuelwood is determined for women by marriage arrangements and settlements. In some parts of the country, women can obtain land in their own right, but they suffer from such subtle discouragements as receiving inferior land or having their stock mysteriously disappear. In some villages, a fee must be paid to a village head upon the allocation of land. This fee guarantees land tenure until the death or eviction of the person who paid the fee. In some areas, only men or widows (and sometimes divorced women) are eligible, and widows must reapply for permission to stay on their husband's land. Women also have a heavy labor burden. Since most of the men migrate to the urban areas for wage employment, the women must tend livestock and harvest and store the grain as well as run their households. Woman also may be evicted from commercial farms if their husbands die. In some areas, all property reverts to a husband's family upon his death, and the wife must return to her own relative. In some tribes, widows must leave their houses empty-handed; their sisters-in-law inherit any stored grain or clothing available. Other tribes are more liberal, and property remains with the widow. In this case, a male relative will be assigned to help the widow manage the property. Reform efforts which attempt to end such abuses by bringing common and customary law in compliance with the Namibian constitution are having an effect. The Women and Law Committee of the Law Reform and the Development Commission is working with the Customary Law Commission to involve traditional leaders in the adaptation of customary law to modern requirements which make discrimination against women unlawful. Until woman have security of land tenure, they are unwilling to invest

  7. Women under penal sanctions

    Directory of Open Access Journals (Sweden)

    Isaura Tadioto

    2009-07-01

    Full Text Available The objective of this article is to characterize imprisoned and non- imprisoned women  in the State of São Paulo, as  well as the realities faced by them while under penal sanctions, searching,  to the possible extent, for a comparison with the male population  under the same sanctions.  In the case of imprisoned women, such exposition is based on data from the Justice Department and SAP (Penitentiary Administration Office, and , in the case of non-imprisoned women, documental research on the Presidente Prudente Center for  Penalties and Alternative Measures Monthly Follow-up Reports . Results showed that, when compared with the male population, women have to face extra difficulties when under penal sanctions. They also showed that gender inequalities are also present in the universe of these women, which are materialized in the compliance with the penal conditions and in the maintenance of the female responsibility for care taking, mainly of children.

  8. Working Women: Indian Perspective

    Directory of Open Access Journals (Sweden)

    Dharmendra MEHTA

    2014-06-01

    Full Text Available In India, due to unprecedented rise in the cost of living, ris-ing prices of commodities, growing expenses on children ed-ucation, huge rate of unemployment, and increasing cost of housing properties compel every Indian family to explore all the possible ways and means to increase the household income. It is also witnessed that after globalization Indian women are able to get more jobs but the work they get is more casual in nature or is the one that men do not prefer to do or is left by them to move to higher or better jobs. Working women refers to those in paid employment. They work as lawyers, nurses, doctors, teachers and secretaries etc. There is no profession today where women are not employed. University of Oxford’s Professor Linda Scott recently coined the term the Double X Economy to describe the global economy of women. The present paper makes an attempt to discuss issues and challenges that are being faced by Indian working women at their respective workstations.

  9. Celebrating women in physics

    CERN Multimedia

    Rolf Heuer

    2010-01-01

    Next Monday the 8th of March is International Women’s Day. In an ideal world, there would be no need for such an event – equality would be taken as read. But since the world is not there yet, let’s take the opportunity to celebrate women in physics, and indeed the full cultural diversity of our field. Perceived as a discipline dominated by men, reality has been diverging from that perception for a long time. Today at CERN, women play key roles in every aspect of the Organization’s activities.   On Women’s Day, we will be sending a clear message to all young women interested in science and engineering that this is also a field for them. In the CERN Control Centre, half of the Engineers-in-Charge who take responsibility for operating the world’s most powerful particle accelerator are women. In the experiments, in all CERN departments and in the management, women are increasingly represented. That’s because at CERN, and in particl...

  10. Women's sexual pain disorders.

    Science.gov (United States)

    van Lankveld, Jacques J D M; Granot, Michal; Weijmar Schultz, Willibrord C M; Binik, Yitzchak M; Wesselmann, Ursula; Pukall, Caroline F; Bohm-Starke, Nina; Achtrari, Chahin

    2010-01-01

    Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and treatment of women's sexual pain disorders. An expert committee, invited from six countries by the 3rd International Consultation, was comprised of eight researchers and clinicians from biological and social science disciplines, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of women's sexual pain disorders. Expert opinion was based on grading of evidence-based medical literature, extensive internal committee discussion, public presentation, and debate. Results. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence-based recommendations for assessment of women's sexual pain disorders are reviewed. An evidence-based approach to management of these disorders is provided. Continued efforts are warranted to conduct research and scientific reporting on the optimal assessment and management of women's sexual pain disorders, including multidisciplinary approaches.

  11. Advancing Women's Health and Women's Leadership With Endowed Chairs in Women's Health.

    Science.gov (United States)

    Carnes, Molly; Johnson, Paula; Klein, Wendy; Jenkins, Marjorie; Bairey Merz, C Noel

    2017-02-01

    Gender-based bias and conflation of gender and status are root causes of disparities in women's health care and the slow advancement of women to leadership in academic medicine. More than a quarter of women physicians train in internal medicine and its subspecialties, and women physicians almost exclusively constitute the women's health focus within internal medicine. Thus, internal medicine has considerable opportunity to develop women leaders in academic medicine and promote women's health equity.To probe whether holding an endowed chair-which confers status-in women's health may be an effective way to advance women leaders in academic medicine and women's health, the authors explored the current status of endowed chairs in women's health in internal medicine. They found that the number of these endowed chairs in North America increased from 7 in 2013 to 19 in 2015, and all were held by women. The perceptions of incumbents and other women's health leaders supported the premise that an endowed chair in women's health would increase women's leadership, the institutional stature of women's health, and activities in women's health research, education, and clinical care.Going forward, it will be important to explore why not all recipients perceived that the endowed chair enhanced their own academic leadership, whether providing women's health leaders with fundraising expertise fosters future success in increasing the number of women's health endowed chairs, and how the conflation of gender and status play out (e.g., salary differences between endowed chairs) as the number of endowed chairs in women's health increases.

  12. Discrimination against women and the human rights of women

    Directory of Open Access Journals (Sweden)

    Žunić Natalija

    2014-01-01

    Full Text Available This paper investigates the concept of the human rights of women and its connection with the phenomenon and the instances of discrimination against women. Discrimination against women, its social visibility and the fight against it, within the idea of the rights and the equality of women, are a source of many theoretical debates. Academic discussions and a powerful influence of the women's movement have brought about the establishment and the exercise of the human rights of women at different levels of the public and the private spheres of society, as a substantial part of the universal regime of human rights.

  13. What impact have women physicians had on women's health?

    Science.gov (United States)

    Lorber, J

    2000-01-01

    The proportion of women in medicine in the United States is approaching that of men, but women physicians are still the minority in positions of power. Research has shown that women physicians order more preventive tests for women patients, are more attuned to patients' psychosocial needs, and have developed more patient-oriented communication styles than men physicians. Recent organized efforts of women physicians have brought attention to many gender gaps in medical research and practice. If more women move into policy-making positions, especially in education and research, their gender-sensitive perspective could permanently influence the profession as a whole.

  14. Banking on women's spirit.

    Science.gov (United States)

    Yunus, M

    1993-11-01

    An interview with Professor Mummadad Yunus, Managing Director of the Grameen Bank, revealed that he has provided loans to poor women in Bangladesh since 1976 and that the Grameen Bank has continued his work since 1983. The idea behind the banking system is that poor people without traditionally accepted collateral are good credit risks. In 1993, the Grameen Bank had operations in 33,000 out of a possible 68,000 villages in Bangladesh. The operations include 1030 branches and a staff of 12,000 people. 1.6 million people are recipients of loans, of whom 94% are women. The population served is the poorest and has no experience in income generation. Conclusions drawn from this experience are that women are better managers of resources and are more serious entrepreneurs than men and that the benefits of loan programs for the poor go directly to children and households. Women's self-image suffers from negative social conceptions, and one task is to convince women of their value, skills, and possibility of advancement. The bank philosophy rests with the belief that all human beings are a "treasure of potential possibilities." Women are advised to protect their money and marriage and not to sacrifice one for the other. Husbands initially are against money going to wives, but eventually they understand that the family benefits. Over 200,000 loans have been made for the provision of housing. The loan requirement is that the woman must own the land on which the house is built. Husband's have the opportunity to transfer title of the land to the wife. Ownership of land provides security for the wife.

  15. Research posts for women

    Science.gov (United States)

    The National Science Foundation (NSF) is accepting proposals for its Visiting Professorships for Women (VPW) program. Under this program, female scientists and engineers who are experienced in independent research can undertake advanced research as visiting professors at universities or research institutions that have the necessary facilities. In addition to research, each visiting professor takes on lecturing, counseling, and “other interactive activities” intended to increase the visibility of female scientists at the host institution and to encourage other women to pursue careers in science and engineering, according to NSF.

  16. PHYSICAL (INACTIVITY AND WOMEN

    Directory of Open Access Journals (Sweden)

    Nina Đukanović

    2008-08-01

    Full Text Available Physical activity simply means movement of the body that uses energy. Physical inactivity is more common among women than men. In women physical activity reduces the risk of dying from coronary heart disease and stroke and of developing high blood pressure, diabetes mellitus, reduces blood cholesterol level, helps control weight and reduce body fat, helps control and prevention osteoporosis and artritis, reduces symptoms of anxiety and depression, reduces the risk for breast cancer. From health benefits, physical activity should be moderate or vigorous and add up to at the least 30 minutes a day.

  17. Rural women's health

    National Research Council Canada - National Science Library

    Thurston, Wilfreda E; Leach, Belinda; Leipert, Beverly

    2012-01-01

    ... about reduction of government funding and access to health care, and about the shortage of new volunteers to replace them when they burn out. These are a few of the stories told in the chapters of this book. This ground-breaking collection of essays identifies priority issues that must be addressed to ensure rural women's well-being, and offers innovative ideas for improvement and further research. Rural women play a critical role within their families and communities, and the health of these wome...

  18. [Three women, cancer, love.

    Science.gov (United States)

    Attardi, Gaia

    2017-12-01

    Amy, Chloé and Sophie are three women. All of them have cancer. All of them have love. All of them elect to dedicate their last days to love. Amy Krouse Rosenthal is an American writer, Chloé and Sophie live in the pages of B. Vian and D.F. Wallace, respectively. The link between the three women is a theatrical improvisational laboratory that the author attended in her medical school. Through the three stories the author thinks about the possible meaning of theatrical performance in teaching medical students.

  19. Social representations of women

    Directory of Open Access Journals (Sweden)

    Álvaro Estramiana, José Luis

    2006-05-01

    Full Text Available Social Representations is one of the most important theories in contemporary social psychology. Since the social psychologist Serge Moscovici developed his theory of social representations to explain how a scientific theory such as the psychoanalysis turns into a common sense knowledge many studies have been done by different social psychologists. The analysis of the social representations of women as represented in myths and popular beliefs is an excellent opportunity to study how this theory can be applied to this representational field. At the same time it makes possible to understand the formation of attitudes towards women

  20. Women as Agents

    DEFF Research Database (Denmark)

    Košťál, Jaroslav; Pristed Nielsen, Helene

    2011-01-01

    This part of the project report contain an overview of some quantitative characteristics of the Eurosphere interview data, with a specific view to addressing the two broad research areas ‘where are the women?’ and ‘gendering as a process'. We consider two aspects of whether gender matters...... for the overall research questions of the project: I) women´s position/presence within the organizations, and II) gender differences in attitudes towards key questions in the interview guide....

  1. Can women detect cues to ovulation in other women's faces?

    Science.gov (United States)

    Lobmaier, Janek S; Bobst, Cora; Probst, Fabian

    2016-01-01

    Recent research suggests that men find portraits of ovulatory women more attractive than photographs of the same women taken during the luteal phase. Only few studies have investigated whether the same is true for women. The ovulatory phase matters to men because women around ovulation are most likely to conceive, and might matter to women because fertile women might pose a reproductive threat. In an online study 160 women were shown face pairs, one of which was assimilated to the shape of a late follicular prototype and the other to a luteal prototype, and were asked to indicate which face they found more attractive. A further 60 women were tested in the laboratory using a similar procedure. In addition to choosing the more attractive face, these participants were asked which woman would be more likely to steal their own date. Because gonadal hormones influence competitive behaviour, we also examined whether oestradiol, testosterone and progesterone levels predict women's choices. The women found neither the late follicular nor the luteal version more attractive. However, naturally cycling women with higher oestradiol levels were more likely to choose the ovulatory woman as the one who would entice their date than women with lower oestradiol levels. These results imply a role of oestradiol when evaluating other women who are competing for reproduction. © 2016 The Author(s).

  2. Female Studies: No. 4. Teaching About Women.

    Science.gov (United States)

    Showalter, Elaine, Ed.; Ohmann, Carol, Ed.

    This document on women's studies presents essays on the subject, a review of the special collections on women, and an annotated bibliography of materials dealing with women's studies and women's liberation. The essays presented include such topics as teaching about women, women in education, all male students and women's liberation, the feminist…

  3. Women in Technology: A Scheme for Women Engineer Returners.

    Science.gov (United States)

    Swarbrick, Ailsa

    1986-01-01

    Explains the Women in Technology (WIT) program, which aims to help women engineers not currently in paid employment to prepare for a return to technological work. Provides evidence that the project is fulfilling its objectives at a modest cost. (ML)

  4. Human immunodeficiency virus infection and female lower genital tract malignancy.

    Science.gov (United States)

    Kuhn, L; Sun, X W; Wright, T C

    1999-02-01

    The risk of lower genital tract neoplasia is increased in women infected with HIV. This has been best demonstrated in cervical squamous intraepithelial lesions, but has also been observed in vulvar and perianal intraepithelial lesions in some studies. Alterations in the prevalence and natural history of human papillomavirus infections of the lower genital tract appear to account for much of the increase. HIV-infected women are approximately four times more likely to be infected with human papillomavirus (including infection with high oncogenic risk human papillomavirus types) than are HIV-uninfected women, and these infections are more likely to be persistent. Human papilomavirus-associated lesions may be more difficult to treat in HIV-infected women. These data highlight the need to develop effective cervical cancer prevention programs for HIV-infected women.

  5. Gender Bias in Women

    Science.gov (United States)

    Bynum, Gregory Lewis

    2014-01-01

    The philosophical anthropologist Dorothy Dinnerstein, in her 1976 work "The Mermaid and the Minotaur: Sexual Arrangements and Human Malaise," argued that in order for us to address the excesses of male-dominated rule in society (militarism, rapacious consumerism), we must attack the root cause of patriarchy--women's domination of early…

  6. Women Scientists in India

    Indian Academy of Sciences (India)

    women's participation in governance structures is fairly limited. With such low numbers, changes are difficult to bring about. The Indian Academies of Sciences and the. World Academy of Sciences. There are three Academies of Science in India: The. Indian National Science Academy (INSA), Indian. Academy of Sciences ...

  7. We the American Women.

    Science.gov (United States)

    Bureau of the Census (DOC), Suitland, MD.

    The 1970 United States census counted a female population of 104,299,734. Of all the nations in the world, only three have larger female populations: China, India, and the Soviet Union. Females made up 51.3 percent of the United States population. Over 70 million American women are of voting age--that's nearly seven million more than the number of…

  8. Women of Niger Delta

    African Journals Online (AJOL)

    Religion Dept

    One of such attribute they say is affection. They asserted that scholars have proven that girls think more in terms of relationships than boys do, that they care more for other human beings show more empathy, and think more about human and social consequences of acts. This cultural belief that women are the peacemakers ...

  9. Center for Women Veterans

    Science.gov (United States)

    ... various organizations and individuals are doing to challenge perceptions about women Veterans. Learn more » #VeteranOfTheDay - Nominate a Veteran Today! Veteran of the Day has been a tradition on VA’s social media pages for more than two years now. This ...

  10. Women in the Army

    Science.gov (United States)

    1980-06-06

    active during the war, and in 1920 , they succeeded in pressuring the Army to appoint a Director of Women’s Relations under the office of the G-1 General...Personnel management officials have found that after the glamour of being different wears off, their attitudes toward their work changes and they try to

  11. Women in Science

    Indian Academy of Sciences (India)

    CICINCES. C.V. Raman Avenue, P.B. No. 8005. Sadashivanagar P.O., Bangalore-560 080, INDIA. Tel : 91-80-23612546, 23614592, 23611034 Pºº P Haº. is j Women in Science. E-mail: womenscióDias.ernet.in d - An Indian Academy of Sciences Initiative. SANATANADHARMA college. - Alappuzha. § §: - - 2. : & . - - X- …

  12. Women and Land

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

    Women in many African countries have a legal right to own land, but this often means little in areas ... set of customary laws that formalize current interpretations of how society traditionally dealt with these .... policymakers, other researchers, and communities around the world. The result is innovative, lasting local — and ...

  13. Women at Work.

    Science.gov (United States)

    Valiant, Sharon

    During the prehistoric era, most advances in society were developed by women. These advances included agriculture, building, weaving, basketry, pottery, woodworking, trading, and domesticating animals. Pottery and basketry allowed for the long-term storage of food and water and permitted humanity to stop living the nomadic life and begin the first…

  14. Women at CERN

    CERN Multimedia

    2004-01-01

    To mark International Women's Day on 8 March, the Weekly Bulletin has looked at the careers of six female physicists, engineers and administrators working at CERN. A frequent question on the lips of newcomers to CERN as they take a quick look around them is 'But where are the women?' However, while it's true that the Laboratory has never had a huge number of female personnel, a closer look reveals that there are in fact quite a few around. To mark International Women's Day, the Bulletin has interviewed six women working at CERN to find out how they see the Organization, what they do and what they think about their daily working lives. Creating a link 'Maybe because I grew up during World War II, my parents always taught me to respect people of other nationalities, religions, colour, etc., so one thing I have always appreciated about CERN is that it promotes this tolerance and understanding by giving us the great privilege of working side by side with colleagues from many cultures and walks of life.' Pegg...

  15. Women and Land

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

    Thus decentralization can provide new opportunities for women and men to participate in, and be represented in, matters that closely affect their lives. .... The studies involved regional literature reviews, consultations with numerous organizations engaged in gender and tenure issues in selected countries, and, in some ...

  16. Women in physics

    CERN Document Server

    Indovino, Shaina

    2013-01-01

    What does it take to be a physicist? Lise Meitner, Katharine Blodgett, Maria Goeppert-Mayer, Chien-Shiung Wu, Ursula Franklin, Argelia Velez-Rodriguez, Sau Lan Wu, Shirley Ann Jackson, Lisa Randall and opportunities for women in physics today.

  17. Young women and suntanning

    DEFF Research Database (Denmark)

    Castle, Catherine M.; Skinner, T. Chas; Hampson, Sarah E.

    1999-01-01

    Adolescents' sun exposure is particularly important because of the increased risk of melanoma associated with sunburn in youth. Further education students (N=97, all women) aged 16-19 years were randomised by classroom to either receive an informational leaflet about skin cancer or not. All parti...

  18. Equal Time for Women.

    Science.gov (United States)

    Kolata, Gina

    1984-01-01

    Examines social influences which discourage women from pursuing studies in computer science, including monopoly of computer time by boys at the high school level, sexual harassment in college, movies, and computer games. Describes some initial efforts to encourage females of all ages to study computer science. (JM)

  19. Hardiness among Elderly Women.

    Science.gov (United States)

    Wagnild, Gail; Young, Heather

    Hardiness has been defined as a mediator in life stress and, within the health/illness context, has been conceptualized as a personality characteristic. This study used a descriptive exploratory design to examine the concept of hardiness among elderly women. The Stress, Appraisal, and Coping model developed by Lazarus and Folkman (1986) was the…

  20. Women and Land

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

    ... by law,” says Fatou Diop Sall, coordinator of the. Groupe d'Études et de Recherches Genre et Société (GESTES) at the Université Gaston Berger in Saint Louis, Senegal. Equality a collective effort in Senegal. Researchers found that Senegalese women who are politically active also tend to have access to land. Je re m.

  1. Women, Power, and Libraries.

    Science.gov (United States)

    Schuman, Patricia Glass

    1984-01-01

    Discusses the concept of power in the context of women and the library profession, citing views of power by Max Weber, John Kenneth Galbraith, Letty Cottin Pogrebin, and Rosabeth Moss Kantor. Male power and female submission, defining power, organizing for power, and sharing power are highlighted. A 12-item bibliography is included. (EJS)

  2. Women in Medical School.

    Science.gov (United States)

    Bean, Glynis; Kidder, Louise H.

    Research on the characteristics of women in non-traditional fields, e.g., medicine, has yielded complex information in terms of adherence to sex-role stereotypes. To determine whether students' attitudes toward helping and achieving followed sex-role typing and were different at various stages in medical school, 384 male and female oncology…

  3. Women and kidney transplantation.

    Science.gov (United States)

    Adey, Deborah B

    2013-09-01

    Kidney transplant is the best kidney replacement treatment for end-stage kidney disease. The first step in moving toward kidney transplantation is referral to a transplant center for transplant evaluation. Education of dialysis staff and health-care providers may help increase referrals for evaluation. Patient education has been shown to enhance patient completion of the evaluation process. Patients have difficulty asking others to donate a kidney, but this process can be improved with home and community education. Living donors are more likely to be women than men, especially spousal donors. Deceased donors are more likely to be males younger than 35 years of age. There is a slight decrease in the rate of transplantation of women as compared with men, although not statistically significant. Pretransplant development of anti-human leukocyte antigen antibodies is more common amongst women and can be a barrier to successful transplantation and may prolong the waiting time for transplant. The long-term management of cardiovascular risk factors, osteoporosis, and age-appropriate cancer screening need to be addressed with posttransplant recipients. Women have an overall increased patient and graft survival as compared with men after transplant. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  4. Integrative Women's Health.

    Science.gov (United States)

    Chiaramonte, Delia; Ring, Melinda; Locke, Amy B

    2017-09-01

    This article addresses the common women's health concerns of menopause-related symptoms, premenstrual syndrome, and chronic pelvic pain. Each can be effectively addressed with an integrative approach that incorporates interventions such as pharmaceuticals, nutraceuticals, mind-body approaches, acupuncture, and lifestyle modification. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Women and social security

    NARCIS (Netherlands)

    Westerveld, M.; Pennings, F.; Vonk, G.

    2015-01-01

    Does ‘the’ social security take sufficient account of women? Are its protection schemes sufficiently aimed at safeguarding women’s interests? These are the questions I was invited to answer for this handbook on social security law. At the same time I was asked to adopt an unorthodox approach, one

  6. Women and Diabetes

    Medline Plus

    Full Text Available ... Español Search FDA Submit search Popular Content Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, ... Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Information by Audience For Women ...

  7. Giant prolactinomas in women

    DEFF Research Database (Denmark)

    Delgrange, Etienne; Raverot, Gerald; Bex, Marie

    2014-01-01

    OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg/l and id......OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg....../l and identified 19 similar cases from the literature; a gender-based comparison of the frequency and age distribution was obtained from a literature review. RESULTS: The initial PubMed search using the term 'giant prolactinomas' identified 125 patients (13 women) responding to the inclusion criteria. The female......:male ratio was 1:9. Another six female patients were found by extending the literature search, while our own series added 15 patients. The median age at diagnosis was 44 years in women compared with 35 years in men (P

  8. Women and Alcohol

    Science.gov (United States)

    ... the risk of many chronic diseases, moderate alcohol consumption is up to one drink per day for women and up to two ... regularly misuse alcohol are more likely to develop alcoholic hepatitis, a serious acute illness, than men who drink the same amount of alcohol. This pattern of ...

  9. Images of Women

    DEFF Research Database (Denmark)

    Anderberg, Birgitte

    2016-01-01

    Images of Women, which took place in Copenhagen in March 1970, at the same time as the first political interventions of the feminist movement, the "Redstockings", was the first feminist art exhibition in Scandinavia. The essay analyses the content of this collaborative project and demonstrates how...

  10. Genital ulcers in women

    NARCIS (Netherlands)

    Bruisten, Sylvia M.

    2003-01-01

    Women who are in a low socioeconomic status are most vulnerable to genital ulcer disease (GUD). GUD is recognized as an important co-factor for acquisition of HIV. GUD etiology has been elucidated in the past decade, with the availability of multiplex polymerase chain reaction. Worldwide, herpes

  11. Women's Literacy and Empowerment.

    Science.gov (United States)

    Nguyen, Thi Van; Vu, Van Duc

    This paper discusses initiatives of the Vietnamese government to address the educational and training needs of the working population, particularly women. Since 1986, the Vietnamese government has initiated efforts to develop a multisectoral, market-oriented economy. Education and training are considered to be essential for promoting long-term…

  12. Women and mental health

    National Research Council Canada - National Science Library

    Kohen, Dora

    2000-01-01

    ... for the individual. Covering issues including perinatal psychiatric disorders, depression, eating disorders, schizophrenia, and alcohol and drug abuse - from a female perspective - Women and Mental Health will prove a valuable tool for all those working in the fields of mental health. Dora Kohen is a Consultant Psychiatrist and an Honorary Senior...

  13. Women and mental health

    Directory of Open Access Journals (Sweden)

    Unaiza Niaz

    2016-07-01

    Full Text Available Issues related to the mental health of women are a priority these days. Many international organisations working in the field of psychiatry are having sections on it now. This approach can go a long way in the improvement of the available mental health services for this population.

  14. Inguinal herniorrhaphy in women

    DEFF Research Database (Denmark)

    Bay-Nielsen, Morten; Kehlet, Henrik

    2006-01-01

    Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5...

  15. Women's Sexual Pain Disorders

    NARCIS (Netherlands)

    van Lankveld, Jacques J. D. M.; Granot, Michal; Schultz, Willibrord C. M. Weijmar; Binik, Yitzchak M.; Wesselmann, Ursula; Pukall, Caroline F.; Bohm-Starke, Nina; Achtrari, Chahin

    Introduction. Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area. Aim. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and

  16. Women migrants in Nigeria.

    Science.gov (United States)

    Makinwa-adebusoye, P K

    1994-06-01

    The prevailing notion in Nigeria is that female migration is associational migration. This survey of the towns of Ibadan, Enugu, Lagos, and Kaduna examines the need for female paid employment and the reasons for migration based on marital status among 2316 migrant women with comparisons to 1363 nonmigrant women. A primary motivation for migration is dissatisfaction with living conditions. Families are support groups providing transportation and initial reinforcement for moves to urban areas. Remittances to families in the place of origin reinforce the investment. The expectation is that women will use migration as an option for advanced education, paid employment, and increased income. The survey found that only 8.2% of migrants made the decision to migrate alone. 82.7% make migration decisions jointly with family members: husbands, parents, and other relatives. Single women were more likely to make sole decisions or decisions with parents. 94% indicated family support for the decision to migrate. About 18% of single women paid the cost of transportation and the move themselves. 70% made the move in the company of parents and other relatives. Married women's costs were underwritten by husbands, except for 9.5% who paid for it themselves. 82.6% did not have a prearranged job before migrating. The average stay ranged from three months to several years. About 33% stayed less than a year. Most migrants with wage employment in the formal sector secured their positions with the help of relatives. 55.4% of migrants in the survey stayed with relatives on arrival, 8.6% were in rented units, and 2.5% stayed in employer housing. Slightly more than 50% of migrants staying with relatives and received free board. Female migration between 1971 and 1981 was influenced by modernization and greater advancement in education. Transportation and communication improvements made it easier to migrate. The economic recession and structural adjustment measures during the 1980s stimulated

  17. Rural African women and development.

    Science.gov (United States)

    Kabadaki, K

    1994-01-01

    70-90% of Africans still live in rural areas, and 25-30% of rural households are headed by women. Standards of living in rural areas are lower than in urban areas. Rural African women's involvement in development is in its initial stages, and social development for women is likely to be slow. Increasing women's opportunities for education is a means of promoting social justice and fairness. Schools should offer courses of practical value for those not planning on higher education and special programs and career counseling for gifted girls. Women's organizations, African leaders, and other influential parties should aggressively create awareness about the oppressive aspects of traditional attitudes, beliefs, and views about women. Laws on ownership of property, inheritance, access to credit, and employment must be equitable and enforced. Consciousness-raising among rural women is an effective means of encouraging rural women to seek and assume new roles and for questioning unreasonable expectations and norms. Women's professional associations serve important functions and fulfill the need for role models. The quality of rural women's life is effectively improved through formulation of policies relevant to women's needs and problems and improve rural conditions. Women should have fair representation at local and national levels of government. Women's role in agriculture is likely to be enhanced through improved transportation systems, electricity supply, and introduction of intermediate technology. This assessment of rural African women's contributions to economic growth emphasizes women's involvement in farming and the informal sector and their lack of equal remuneration or low wages. Illiteracy places women in a disadvantaged position when competing for employment in the formal sector. Lack of access to credit and limits on credit are other obstacles in the informal sector. The reduced participation of rural women in the formal and informal sector is due to lack of

  18. Women NGO's and Women Empowerment in Nigeria | Arum ...

    African Journals Online (AJOL)

    An investigation was carried out into the activities of various women non – governmental organizations (NGO) in Nigeria, as a veritable tool for women empowerment. The results of the research revealed that women NGO's have ventured into areas that were previously ignored by government such areas include female ...

  19. Assessment of Rural Women\\'s Knowledge, Constraints and ...

    African Journals Online (AJOL)

    Assessment of Rural Women\\'s Knowledge, Constraints and Perceptions on Cervical Cancer Screening: The Case of Two Districts in Zimbabwe. ... 95.78% of the interviewed women had never gone for screening and had little knowledge about the various aspects of the disease in terms of causes, prevention and treatment.

  20. Women Fellows of IASc | Women in Science | Initiatives | Indian ...

    Indian Academy of Sciences (India)

    She is well known for her outstanding contribution to cytogenetics and plant geography. The Academy governing council had in the past two women Fellows over the years and in the present council there are two women office bearers. At present, the number of women in the Academy committees like sectional committee, ...