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Title: Male circumcision: a cancer prevention strategy?
Source: Lancet Oncology. 2009 May;10(5):431.
Abstract: Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer? In developing countries, male circumcision could have a vital role in specific segments of the population depending on the answers to specific scientific and infrasturcture related questions. Discussions around male circumcision strategies should be encouraged within the context of cancer prevention, and these should include local communities alongside assessments of current capacities, measurable targets, cost analyses and modelling, and the development of practicable guidelines, so as to place male circumcision within the possible options available for disease prevention.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PREVALENCE | MEN | MALE CIRCUMCISION | CANCER | PREVENTION AND CONTROL | HIV PREVENTION | STANDARDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neoplasms | Diseases | HIV Infections | Viral Diseases
Document Number: 341199

Title: Constructive men's engagement in reproductive health: a training-of-trainers' manual. Couple communication and shared decisionmaking related to reproductive health.
Author: Futures Group International. Health Policy Initiative; Care International. Keneya Ciwara; Mali. Ministere de la Sante. Division de la Sante Reproductive
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 May. 26 p. (USAID Contract No. GPO-I-01-05-00040-00)
Abstract: This curriculum was developed as part of a USAID | Health Policy Initiative, Task Order 1 project focused on building an enabling policy and institutional environment for constructive men's engagement (CME) in reproductive health in Mali. The project worked with the Ministry of Health and other partners in facilitating the process of creating national guidelines to integrate CME in family planning and reproductive health (FP / RH) and to improve women's and men's uptake of FP / RH services. The project brought together the assembly of a large, multisectoral group of stakeholders to develop, refine, and validate Mali's national guidelines in support of the national Reproductive Health Strategic Plan. The Minister of Health quickly approved the guidelines and signed them into effect on May 20, 2008. This document contains the manual used in the pilot workshops with relais communautaires. It is designed to enable community health educators to incorporate activities related to constructive men's engagement in reproductive health (CME-RH) in their daily work. This includes promoting dialogue among men and women to increase couple communication and shared decisionmaking related to FP / RH. As such, it can be adapted in other settings, based on local needs.
Language: English
Keywords:
KENYA | MANUAL | TRAINING ACTIVITIES | COUPLES | DECISION MAKING | TRAINING OF TRAINERS | REPRODUCTIVE HEALTH | MEN'S INVOLVEMENT | INTERPERSONAL COMMUNICATION | WORKSHOPS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Training Programs | Education | Family Characteristics | Family and Household | Sociocultural Factors | Behavior | Health | Programs | Organization and Administration | Communication
Document Number: 331535

Title: Overcoming barriers to treatment for children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: Only 11 percent of HIV-positive children eligible for treatment in Kenya receive life-saving therapy. Through surveys, group discussions, and interviews with families and health workers, Council researchers identified barriers that prevent parents and caregivers from seeking treatment for HIV-infected children. Applying its research findings, the Council and the government of Kenya are supporting community-awareness activities to educate and assist caregivers, inform them of available services, and reduce stigma. The Council is also working with health facilities to improve counseling, support, and outreach services, and to provide Kenya's government with recommendations for improving pediatric HIV services so HIV-positive children across the country receive life-saving treatment. (Excerpts)
Language: English
Keywords:
KENYA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | OBSTACLES | TREATMENT | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Organization and Administration | Medical Procedures | Medicine | Delivery of Health Care | Health
Document Number: 331492

Title: The conceptions of care among family caregivers of persons living with HIV/AIDS in Addis Ababa, Ethiopia.
Author: Aga F; Kylma J; Nikkonen M
Source: Journal of Transcultural Nursing. 2009 Jan;20(1):37-50.
Abstract: This focused ethnographic study explores and describes the conceptions of care among family caregivers of people living with HIV/AIDS (PLWAs) in Addis Ababa, Ethiopia. Leininger's theory of culture care diversity and universality is the conceptual anchor of this ethnographic study. Using semistructured interviews and participant observation, 6 key informants and 12 general informants were interviewed in their home in Amharic language. Data were analyzed in Amharic using Leininger's phases of ethnonursing analysis for qualitative data and then translated to English. Four major themes representing family caregivers' conceptions of care were identified: nourishing the PLWA while struggling with poverty, maintenance of cleanliness and hygiene of the person and surroundings, comforting the PLWA, and sacrificing self to sustain the PLWA. Valuable data were gathered about the family caregivers' conceptions of care. Nurses can use this knowledge to design and provide culturally congruent care to family caregivers and PLWAs in the community.
Language: English
Keywords:
ETHIOPIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | PERCEPTION | CARE AND SUPPORT | TREATMENT | HYGIENE | POVERTY | SANITATION | FAMILY AND HOUSEHOLD | HOME CARE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Psychological Factors | Behavior | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Public Health | Socioeconomic Factors | Economic Factors | Sociocultural Factors
Document Number: 330218

Title: The quality of family planning services and client satisfaction in the public and private sectors in Kenya.
Author: Agha S; Do M
Source: International Journal For Quality In Health Care. 2009 Apr;21(2):87-96.
Abstract: OBJECTIVE: To compare the quality of family planning services delivered at public and private facilities in Kenya. METHODS: Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. RESULTS: Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. CONCLUSIONS: Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.
Language: English
Keywords:
KENYA | RESEARCH REPORT | DATA ANALYSIS | CLIENTS | FAMILY PLANNING | SATISFACTION | PUBLIC SECTOR | PRIVATE SECTOR | QUALITY OF HEALTH CARE | HEALTH SERVICES | REPRODUCTIVE HEALTH | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Psychological Factors | Behavior | Macroeconomic Factors | Economic Factors | Health Services Evaluation | Delivery of Health Care | Health
Document Number: 342098

10.

Title: Assessment of family planning services in Kenya: Evidence from the 2004 Kenya Service Provision Assessment Survey.
Author: Agwanda A; Khasakhala A; Kimani M
Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [51] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 4) Based on further analysis of the 2004 Kenya Service Provision Assessment Survey.
Abstract: This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2004 Kenya Service Provision Assessment. The composite indicators scores for facility readiness were generally low and many facilities lacked simple items like visual aids, guidelines, towels, speculum, etc. There were marked differences in facility readiness by region, facility type, and managing authority. Provider service provision scores were generally high but the only important difference was by region. Client satisfaction was dependent on the facility type, managing authority, sex of the provider, and the waiting time to receive services. Clients were more likely to be satisfied with female rather than male providers. Clients were less satisfied in Nyanza, although the facilities were more ready with high-performing providers. In contrast, North Eastern Province had less ready facilities, but high client satisfaction and high provider performance. Health centre, clinics, and dispensaries need to be revamped to appropriate standards so as to include all basic elements of family planning service provision. North Eastern Province, with motivated workers, highly satisfied clients but poor facilities, deserves proper attention. Facilities in Nairobi need improvements in staff supervision and retraining. There is need to educate the clientele on the availability of appropriate services within the government facilities.
Language: English
Keywords:
KENYA | RESEARCH REPORT | RECOMMENDATIONS | HEALTH SURVEYS | KAP SURVEYS | EVALUATION INDEXES | FAMILY PLANNING PERSONNEL CHARACTERISTICS | FAMILY PLANNING PERSONNEL EVALUATION | FAMILY PLANNING PROGRAM EVALUATION | PERCEPTION | HUMAN GEOGRAPHY | SATISFACTION | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Family Planning Personnel | Family Planning Programs | Family Planning | Psychological Factors | Behavior | Geography | Social Sciences | Science | Sociocultural Factors | Population Characteristics | Demographic Factors | Population
Document Number: 329890

11.

Peer Reviewed

Title: Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda.
Author: Ahoua L; Guenther G; Pinoges L; Anguzu P; Chaix ML; Le Tiec C; Balkan S; Olson D; Olaro C; Pujades-Rodriguez M
Source: BMC Infectious Diseases. 2009;9:81.
Abstract: BACKGROUND: Little is known about immunovirological treatment outcomes and adherence in HIV/AIDS patients on antiretroviral therapy (ART) treated using a simplified management approach in rural areas of developing countries, or about the main factors influencing those outcomes in clinical practice. METHODS: Cross-sectional immunovirological, pharmacological, and adherence outcomes were evaluated in all patients alive and on fixed-dose ART combinations for 24 months, and in a random sample of those treated for 12 months. Risk factors for virological failure (>1,000 copies/ml) and subtherapeutic antiretroviral (ARV) concentrations were investigated with multiple logistic regression. RESULTS: At 12 and 24 months of ART, 72% (n = 701) and 70% (n = 369) of patients, respectively, were alive and in care. About 8% and 38% of patients, respectively, were diagnosed with immunological failure; and 75% and 72% of patients, respectively, had undetectable HIV RNA (<400 copies/ml). Risk factors for virological failure (>1,000 copies/ml) were poor adherence, tuberculosis diagnosed after ART initiation, subtherapeutic NNRTI concentrations, general clinical symptoms, and lower weight than at baseline. About 14% of patients had low ARV plasma concentrations. Digestive symptoms and poor adherence to ART were risk factors for low ARV plasma concentrations. CONCLUSION: Efforts to improve both access to care and patient management to achieve better immunological and virological outcomes on ART are necessary to maximize the duration of first-line therapy.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | RURAL AREAS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TREATMENT | ADMINISTRATION AND DOSAGE | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Program Evaluation
Document Number: 342064

12.

Peer Reviewed

Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya.
Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D
Source: Plos One. 2009 Jul;4(7):e6470.
Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13�34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity.
Language: English
Keywords:
KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 339909

13.

Peer Reviewed

Title: Mortality and loss-to-follow-up during the pre-treatment period in an antiretroviral therapy programme under normal health service conditions in Uganda.
Author: Amuron B; Namara G; Birungi J; Nabiryo C; Levin J; Grosskurth H; Coutinho A; Jaffar S
Source: BMC Public Health. 2009 Aug 11;9(1):290.
Abstract: ABSTRACT: BACKGROUND: In many HIV programmes in Africa, patients are assessed clinically and prepared for antiretroviral treatment over a period of 4-12 weeks. Mortality rates following initiation of ART are very high largely because patients present late with advanced disease. The rates of mortality and retention during the pre-treatment period are not well understood. We conducted an observational study to determine these rates. METHODS: HIV-infected subjects presenting at The AIDS Support Clinic in Jinja, SE Uganda, were assessed for antiretroviral therapy (ART). Eligible subjects were given information and counselling in 3 visits done over 4-6 weeks in preparation for treatment. Those who did not complete screening were followed-up at home. Survival analysis was done using poisson regression. RESULTS: 4321 HIV-infected subjects were screened of whom 2483 were eligible for ART on clinical or immunological grounds. Of these, 637 (26%) did not complete screening and did not start ART. Male sex and low CD4 count were associated independently with not completing screening. At follow-up at a median 351 days, 181 (28%) had died, 189 (30%) reported that they were on ART with a different provider, 158 (25%) were alive but said they were not on ART and 109 (17%) were lost to follow-up. Death rates (95% CI) per 100 person-years were 34 (22, 55) (n.18) within one month and 37 (29, 48) (n.33) within 3 months. 70/158 (44%) subjects seen at follow-up said they had not started ART because they could not afford transport. CONCLUSIONS: About a quarter of subjects eligible for ART did not complete screening and pre-treatment mortality was very high even though patients in this setting were well informed. For many families, the high cost of transport is a major barrier preventing access to ART.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | SCREENING | AIDS PREVENTION | DEATH RATE | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | AIDS | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation
Document Number: 342534

14.

Peer Reviewed

Title: Knowledge of HIV status, sexual risk behaviors and contraceptive need among people living with HIV in Kenya and Malawi.
Author: Anand A; Shiraishi RW; Bunnell RE; Jacobs K; Solehdin N; Abdul-Quader AS; Marum LH; Muttunga JN; Kamoto K; Aberle-Grasse JM; Diaz T
Source: AIDS. 2009 Jun 17;
Abstract: BACKGROUND:: Several studies support the need for effective interventions to reduce HIV transmission risk behaviors among people living with HIV/AIDS (PLWHAs). DESIGN:: Cross-sectional nationally representative demographic health survey of Kenya (2003) and Malawi (2004-2005) that included HIV testing for consenting adults. METHODS:: We analyzed demographic health survey data for awareness of HIV status and sexual behaviors of PLWHAs (Kenya: 412; Malawi: 664). The analysis was adjusted (weighted) for the design of the survey and the results are nationally representative. FINDINGS:: Eighty-four percent of PLWHAs in Kenya and 86% in Malawi had sex in the past 12 months and in each country, 10% reported using condoms at last intercourse. Among sexually active PLWHAs, 86% in Kenya and 96% in Malawi reported their spouse or cohabiting partner as their most recent partner. In multivariate logistic regression models, married or cohabiting PLWHAs were significantly more likely to be sexually active and less likely to use condoms. Over 80% of PLWHAs were unaware of their HIV status. Of HIV-infected women, nearly three-quarters did not want more children either within the next 2 years or ever, but 32% in Kenya and 20% in Malawi were using contraception. INTERPRETATION:: In 2003-2005, majority of PLWHAs in Kenya and Malawi were unaware of their HIV status and were sexually active, especially married or cohabiting PLWHAs. Of HIV-infected women not wanting more children, few used contraception. HIV testing should be expanded, prevention programs should target married or cohabiting couples and family planning services should be integrated with HIV services.
Language: English
Keywords:
KENYA | MALAWI | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | PERSONS LIVING WITH HIV/AIDS | AWARENESS | SEX BEHAVIOR | CONDOM USE | CONTRACEPTION | NEEDS | FERTILITY PREFERENCES | HIV/FP INTEGRATION | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Southern | Demographic Surveys | Population Dynamics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Knowledge | Sociocultural Factors | Behavior | Risk Reduction Behavior | Family Planning | Economic Factors | Fertility | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341748

15.

Peer Reviewed

Title: Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda.
Author: Andia I; Kaida A; Maier M; Guzman D; Emenyonu N; Pepper L; Bangsberg DR; Hogg RS
Source: American Journal of Public Health. 2009 Feb;99(2):340-7.
Abstract: OBJECTIVES: We investigated whether the prevalence of contraceptive use among women who are HIV positive varied according to use of highly active antiretroviral therapy (HAART) in Mbarara, Uganda. METHODS: We used data from a cross-sectional survey of 484 women who were HIV positive (18-50 years) and were attending Mbarara University's HIV clinic, 45% of whom were receiving HAART. Multivariate logistic regression was used to investigate the association between HAART use and contraceptive use. Data were collected between November 2005 and June 2006. RESULTS: Overall, 45% of the women were sexually active in the previous 3 months. Of these, 85% reported using contraceptive methods, with 84% reporting use of barrier contraceptive methods. Women receiving HAART were more than twice as likely to use contraceptive methods (adjusted odds ratio [AOR] = 2.64; 95% confidence interval [CI] = 1.07, 6.49) and more than 3 times as likely to use barrier contraceptive methods (AOR = 3.62; 95% CI = 1.54, 8.55) than were women not receiving HAART. CONCLUSIONS: Our findings support the need for increased attention to better integration of reproductive health and HIV and AIDS services for women who are HIV positive.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN | CONTRACEPTIVE USAGE | ANTIRETROVIRAL THERAPY | REPRODUCTIVE HEALTH | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Contraception | Family Planning | HIV | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 329768

16.

Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance.
Author: Aqil A; Lippeveld T
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS.
Language: English
Keywords:
PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs
Document Number: 339994

17.

18.

Peer Reviewed

Title: Rapid scale-up of antiretroviral treatment in Ethiopia: successes and system-wide effects.
Author: Assefa Y; Jerene D; Lulseged S; Ooms G; Van Damme W
Source: PLoS Medicine. 2009 Apr 28;6(4):e1000056.
Abstract: There has been substantial expansion of access to ART and HIV counseling and testing in Ethiopia, whilst maintaining the performance of other health programs such as tuberculosis and maternal and child health services. Task shifting to the health officers, nurses, and health extension workers is thought to be responsible for these successes. However, HIV prevention interventions and management of chronic care patients are lagging behind. This may be due to lack of attention to these health care areas and to physicians leaving the public sector for NGOs, including AIDS-related NGOs. Prevention of HIV infection, retention of patients in chronic care, and retention of physicians in the public sector need urgent attention for effective and sustainable HIV/AIDS and health systems responses in the long term.
Language: English
Keywords:
ETHIOPIA | EVALUATION REPORT | ANTIRETROVIRAL THERAPY | PUBLIC HEALTH | PROGRAM ACCESSIBILITY | DECENTRALIZATION | HIV TESTING | HIV PREVENTION | AIDS PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | HIV | HIV Infections | Viral Diseases | Diseases | Health | Program Evaluation | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | AIDS
Document Number: 341678

19.

Title: Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda.
Author: Atuyambe L; Mirembe F; Annika J; Kirumira EK; Faxelid E
Source: Journal of Adolescence. 2009;32:781-796.
Abstract: Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Results: Two main themes emerged; ?feeling exposed and powerless?, and ?seeking safety and empathy?. The categories identified in the first theme were ?the dilemma of becoming an adolescent mother? and ?lack of decision power?. In the second theme the following categories were identified: ?cultural practices and beliefs about birth?, ?expectations and experiences?, ?transport, a key determinant to health seeking?, and ?dealing with constraints?. Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health care services but their experiences of the services were rather negative. Transport was a key determinant for health seeking and adolescents to some extent had learnt how to cope with constraints they face. Conclusion and implications: Pregnant adolescents seek health care in both modern and traditional health sectors in order to get safety and empathy. However, our findings indicate that they mostly utilize the traditional sector because it is most accessible in terms of distance, cost and cultural context. Adolescent mothers are disempowered in decision making because of their pregnancy state which often puts them in dilemma. We therefore suggest that policy makers need to improve health systems (including the traditional sector) especially maternal health services for adolescent girls. Improved infrastructure and attitudes of health worker as well as training in delivery of adolescent health services is critical.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS | YOUTH | PREGNANCY | SAFETY | SAFE MOTHERHOOD | MATERNAL HEALTH | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Public Health | Health | Delivery of Health Care | Programs | Organization and Administration
Document Number: 340225

20.

Title: Adherence and treatment response among HIV-1 infected adults receiving antiretroviral therapy in a rural government hospital in southwestern Uganda.
Author: Bajunirwe F; Arts EJ; Tisch DJ; King CH; Debanne SM
Source: Journal of the International Association of Physicians in AIDS Care. 2009 Mar-Apr;8(2):139-147.
Abstract: Background. Large-scale, government-based antiretroviral therapy (ART) programs in rural areas of resource-poor countries remain largely unevaluated. Methods. We conducted a retrospective review of all patients receiving (n = 399) to assess survival and retention in care and a prospective evaluation of patients on ART for at least 6 months (n = 175). We used 3-day self-report to measure adherence. Results. The probability (95% confidence interval [CI]) of surviving and remaining in care was 0.76 (0.72, 0.81) at 1 year. Men and patients with advanced disease were more likely to die or be lost to follow-up. At baseline, 149 (85%) reported 100% adherence. Nonadherence was associated with lack of suppression of viral replication (odds ratio [OR] = 4.5; 95% CI: 1.8, 11.5). Missing a scheduled clinic visit and lack of disclosure of HIV status were associated with nonadherence. Conclusion. Viral suppression was high, but counseling to include HIV disclosure to family and keeping scheduled clinic appointments may improve long-term adherence and treatment outcomes.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | RURAL POPULATION | HIV INFECTIONS | USER COMPLIANCE | ANTIRETROVIRAL THERAPY | GOVERNMENT PROGRAMS | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | HIV | Programs | Organization and Administration
Document Number: 331336

21.

Peer Reviewed

Title: Quality of life and social support among patients receiving antiretroviral therapy in Western Uganda.
Author: Bajunirwe F; Tisch DJ; King CH; Arts EJ; Debanne SM; Sethi AK
Source: AIDS Care. 2009 Mar;21(3):271-9.
Abstract: Quality of life (QOL) among patients with HIV/AIDS has been shown to improve once treatment with antiretroviral therapy (ART) has been initiated. We conducted a cross-sectional study in Western Uganda to examine the factors associated with QOL among patients who had received ART for the duration of at least six months. We interviewed 330 patients attending the HIV/AIDS clinic at two government-supported hospitals in Western Uganda. We measured QOL using a culturally adapted version of the Medical Outcomes Study (MOS-HIV) tool and calculated the physical health summary (PHS) and mental health summary (MHS) scores. In addition, data were collected on sociodemographic factors, three-day self-reported adherence, social support, sexual behavior, CD4 count and viral load. Informational social support was significantly positively correlated with PHS (p=0.001) and MHS (p=0.002). Affectionate support was also significantly positively correlated to PHS (p=0.05) and MHS (p=0.03) but tangible support was not (PHS p value=0.85 and MHS p value=0.31). In the univariate analysis, older age, rural dwelling, alcohol use, CD4 count less than 200, and ART duration of less than one year were significantly associated with lower PHS scores. Lower PHS scores were also associated with sexual inactivity. In multivariate analysis, higher scores on informational social support and CD4> or =200 were associated with higher PHS score and past or recent alcohol consumption was associated with lower scores on MHS. Optimizing ART to restore CD4 count and provision of informational and affectionate social support but not tangible support, to HIV/AIDS patients may improve their QOL.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HIV INFECTIONS | QUALITY OF LIFE | CARE AND SUPPORT | SEX BEHAVIOR | HEALTH | MENTAL HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | HIV | Viral Diseases | Diseases | Behavior | Social Welfare | Economic Factors | Health Services | Delivery of Health Care
Document Number: 341987

22.

Title: Demographic data for development in sub-Saharan Africa.
Author: Baldwin W; Diers J
Source: New York, New York, Population Council, 2009. 15 p. (Poverty, Gender, and Youth Working Paper No. 13)
Abstract: More demographic data are being collected throughout the developing world than ever before, but the effective use of that data to further development goals is often lacking. This paper summarizes case studies on the demand for data in four sub-Saharan African countries, namely Ethiopia, Ghana, Senegal, and Uganda. The project's objective was to create a detailed portrait of access and demand at the country level, and to determine whether policymakers are getting the data they need to develop sound policies. Common findings across the four countries include an increased external demand from international initiatives that has not necessarily translated into internal demand for data; a missing link between producers and users of data; and a need for data to be presented in user-friendly formats. One driver of internal demand for data is the decentralization and democratization process that is underway in all four countries; this demand highlighted the paucity of available data that can be disaggregated at the level to which policies were being devolved. Next steps are to support initiatives to establish data access as a right, encourage a culture of data-sharing among funders and producers of data, strengthen intermediaries between policymakers and data collectors, display data in accessible formats such as maps, and disaggregate available data to the most useful levels. (Author's abstract)
Language: English
Keywords:
ETHIOPIA | GHANA | SENEGAL | UGANDA | SUMMARY REPORT | DEMOGRAPHIC ANALYSIS | DATA COLLECTION | CASE STUDIES | DATA QUALITY | NEEDS | DECENTRALIZATION | DEMOCRACY | INFORMATION DISTRIBUTION | POVERTY | GENDER ISSUES | YOUTH | POLICY | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Western | Research Methodology | Studies | Data Analysis | Economic Factors | Political Factors | Sociocultural Factors | Political Systems | Communication | Socioeconomic Factors | Age Factors | Population Characteristics | Demographic Factors | Population | Program Evaluation | Programs | Organization and Administration
Document Number: 331433

23.

Title: Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania.
Author: Bastien S; Leshabari MT; Klepp KI
Source: African Journal of AIDS Research. 2009;8(2):213-222.
Abstract: A structured face-to-face interview was completed by 993 young people out of school, between the ages of 13 and 18, in Kilimanjaro, Tanzania; additionally, the questionnaire was self-administered by 1,007 students attending either their last year of primary or first year of secondary school. Significant factors associated with the frequency of exposure to HIV/AIDS information and frequency of communication about HIV/AIDS included urban/rural location, sex, socio-economic status, and educational attainment. Both groups ranked the radio as the most frequent source of HIV/AIDS information. The in-school group reported significantly more frequent exposure to all sources of HIV/AIDS information, and they communicated more frequently about the topic than did the out-of-school group. The in-school group gave high credibility ratings to medical doctors, the radio, and parents as sources of information, whereas the out-of-school group attributed the most credibility to the mass media. Irrespective of school attendance, the young people ranked friends, parents, and doctors as preferred communicators of sexual and reproductive health information.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | COMPARATIVE STUDIES | OUT-OF-SCHOOL YOUTHS | STUDENTS | HIV INFECTIONS | INFORMATION SOURCES | INTERPERSONAL COMMUNICATION | INTERVIEWS | KNOWLEDGE | MASS MEDIA | SOCIOECONOMIC STATUS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Educational Status | Socioeconomic Factors | Economic Factors | Education | Viral Diseases | Diseases | Information | Communication | Data Collection | Sociocultural Factors
Document Number: 339889

24.

Peer Reviewed

Title: Reflecting and shaping the discourse: the role of music in AIDS communication in Tanzania.
Author: Bastien S
Source: Social Science and Medicine. 2009 Apr;68(7):1357-60.
Abstract: Failure to recognize the importance of oral traditions in Africa and the potential of music and song for stimulating social and behavior change would represent a missed opportunity in HIV prevention strategies. Local narratives concerning AIDS are often utilized in popular songs and constitute rich sources of contextual information about the epidemic that have thus far been un- or underutilized in HIV prevention strategies. Endogenously conceived messages delivered via a channel such as music increase the likelihood of messages being contextually appropriate and culturally engaging. This form of media also presents the greatest opportunity for wide dissemination. Drawing on field work conducted in the Kilimanjaro region, this paper presents examples of how music and musicians in Tanzania reflect and potentially shape AIDS discourse. Three broad recurrent themes addressed in songs are discussed: AIDS metaphors, stigma and broader HIV prevention messages. By tapping into the wealth of information about AIDS discourse contained within popular songs, and by recognizing musicians as potential opinion leaders and agents of social change, the effectiveness of prevention strategies may be increased.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | BEHAVIOR CHANGE | MUSIC | HIV PREVENTION | HIV INFECTIONS | AIDS | COMMUNICATION STRATEGY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Behavior | Culture | Sociocultural Factors | Viral Diseases | Diseases | Communication
Document Number: 341617

25.

Peer Reviewed

Title: Women's use of private and government health facilities for childbirth in Nairobi's informal settlements.
Author: Bazant ES; Koening MA; Fotso JC; Mills S
Source: Studies in Family Planning. 2009 Mar;40(1):39-50.
Abstract: The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.
Language: English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | REFUGEES | TRADITIONAL BIRTH ATTENDANTS | HOUSEHOLDS | CHILDBIRTH | REFUGEE CAMPS | UTILIZATION OF HEALTH CARE | PRIVATE SECTOR | GOVERNMENT PROGRAMS | HEALTH FACILITIES | DEMOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Population | Migrants | Migration | Population Dynamics | Health Personnel | Delivery of Health Care | Health | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Health Services | Macroeconomic Factors | Programs | Organization and Administration
Document Number: 341077

26.

Peer Reviewed

Title: HIV infection, malnutrition, and invasive bacterial infection among children with severe malaria.
Author: Berkley JA; Bejon P; Mwangi T; Gwer S; Maitland K; Williams TN; Mohammed S; Osier F; Kinyanjui S; Fegan G; Lowe BS; English M; Peshu N; Marsh K; Newton CR
Source: Clinical Infectious Diseases. 2009 Aug 1;49(3):336-43.
Abstract: BACKGROUND: Human immunodeficiency virus (HIV) infection, malnutrition, and invasive bacterial infection (IBI) are reported among children with severe malaria. However, it is unclear whether their cooccurrence with falciparum parasitization and severe disease happens by chance or by association among children in areas where malaria is endemic. METHODS: We examined 3068 consecutive children admitted to a Kenyan district hospital with clinical features of severe malaria and 592 control subjects from the community. We performed multivariable regression analysis, with each case weighted for its probability of being due to falciparum malaria, using estimates of the fraction of severe disease attributable to malaria at different parasite densities derived from cross-sectional parasitological surveys of healthy children from the same community. RESULTS: HIV infection was present in 133 (12%) of 1071 consecutive parasitemic admitted children (95% confidence interval [CI], 11%-15%). Parasite densities were higher in HIV-infected children. The odds ratio for admission associated with HIV infection for admission with true severe falciparum malaria was 9.6 (95% CI, 4.9-19); however, this effect was restricted to children aged 1 year. Malnutrition was present in 507 (25%) of 2048 consecutive parasitemic admitted children (95% CI, 23%-27%). The odd ratio associated with malnutrition for admission with true severe falciparum malaria was 4.0 (95% CI, 2.9-5.5). IBI was detected in 127 (6%) of 2048 consecutive parasitemic admitted children (95% CI, 5.2%-7.3%). All 3 comorbidities were associated with increased case fatality. CONCLUSIONS: HIV, malnutrition and IBI are biologically associated with severe disease due to falciparum malaria rather than being simply alternative diagnoses in co-incidentally parasitized children in an endemic area.
Language: English
Keywords:
KENYA | RESEARCH REPORT | CONTROL GROUPS | MULTIVARIATE ANALYSIS | CHILDREN | MALARIA | SIGNS AND SYMPTOMS | HIV INFECTIONS | MALNUTRITION | BACTERIAL AND FUNGAL DISEASES | CASE FATALITY RATE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Viral Diseases | Nutrition Disorders | Infections | Death Rate | Mortality | Population Dynamics
Document Number: 342633

27.

Peer Reviewed

Title: Independent association between rate of clearance of infection and clinical outcome of HIV-associated cryptococcal meningitis: analysis of a combined cohort of 262 patients.
Author: Bicanic T; Muzoora C; Brouwer AE; Meintjes G; Longley N; Taseera K; Rebe K; Loyse A; Jarvis J; Bekker LG; Wood R; Limmathurotsakul D; Chierakul W; Stepniewska K; White NJ; Jaffar S; Harrison TS
Source: Clinical Infectious Diseases. 2009 Sep 1;49(5):702-9.
Abstract: BACKGROUND: Progress in therapy for cryptococcal meningitis has been slow because of the lack of a suitable marker of treatment response. Previously, we demonstrated the statistical power of a novel endpoint, the rate of clearance of infection, based on serial quantitative cultures of cerebrospinal fluid, to differentiate the fungicidal activity of alternative antifungal drug regimens. We hypothesized that the rate of clearance of infection should also be a clinically meaningful endpoint. METHODS: We combined data from cohorts of patients with human immunodeficiency virus-associated cryptococcal meningitis from Thailand, South Africa, and Uganda, for whom the rate of clearance of infection was determined, and clinical and laboratory data prospectively collected, and explored the association between the rate of clearance of infection and mortality by Cox survival analyses. RESULTS: The combined cohort comprised 262 subjects. Altered mental status at presentation, a high baseline organism load, and a slow rate of clearance of infection were independently associated with increased mortality at 2 and 10 weeks. Rate of clearance of infection was associated with antifungal drug regimen and baseline cerebrospinal fluid interferon-gamma levels. CONCLUSIONS: The results support the use of the rate of clearance of infection or early fungicidal activity as a means to explore antifungal drug dosages and combinations in phase II studies. An increased understanding of how the factors determining outcome interrelate may help clarify opportunities for intervention.
Language: English
Keywords:
SOUTH AFRICA | THAILAND | UGANDA | RESEARCH REPORT | CLIENTS | MENINGITIS | HIV INFECTIONS | DRUGS | INTERVENTIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Asia, Southeastern | Asia | Africa, Eastern | Program Activities | Programs | Organization and Administration | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342967

28.

Title: Role of parents in adolescent sexual activity and contraceptive use in four african countries.
Author: Biddlecom A; Awusabo-Asare K; Bankole A
Source: International Perspectives On Sexual and Reproductive Health. 2009 Jun;35(2):72-81.
Abstract: Data were collected in 2004 in nationally representative surveys of 12- to 19-year-olds in Burkina Faso, Ghana, Malawi, and Uganda. Bivariate analysis was used to compare gender differences for two outcomes among unmarried 15- to 19-year-olds having had sexual intercourse in the last 12 months and, among those who had had sex in this period, having used contraception at last sex. Unmarried adolescents reported moderate to high levels of parental monitoring and low levels of parent-child communication about sexual matters. In all countries, adolescent males who reported low monitoring were at elevated risk of having had sex in the last year, as were their female counterparts in three of the countries. Communication with parents was positively associated with sexual activity among Malawian males and Ugandan females. Parental monitoring was not associated with contraceptive use at last sex, whereas parent-child communication was associated with such use among Ghanaian females and among Ugandan adolescents of both genders. The authors conclude that programs to improve adolescent sexual and reproductive health should include dimensions of parental involvement.
Language: English
Keywords:
BURKINA FASO | GHANA | MALAWI | UGANDA | RESEARCH REPORT | SURVEYS | ADOLESCENTS | SEX BEHAVIOR | PARENTAL INVOLVEMENT | REPRODUCTIVE HEALTH | INTERPERSONAL COMMUNICATION | CONTRACEPTIVE USAGE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Africa, Southern | Africa, Eastern | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Child Rearing | Health | Communication | Contraception | Family Planning
Document Number: 342142

29.

Peer Reviewed

Title: Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993 2006.
Author: Biraro S; Shafer LA; Kleinschmidt I; Wolff B; Karabalinda A; Nalwoga A; Musinguzi J; Kirungi W; Opio A; Whitworth J; Grosskurth H
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i3-i11.
Abstract: Objective: To describe sexual behaviour trends in a rural Ugandan cohort in the context of an evolving HIV epidemic, 1993-2006. Methods: Sexual behaviour data were collected annually from a population cohort in which HIV serological surveys were also conducted. Behaviour trends were determined using survival analysis and logistic regression. Trends are reported based on the years in which the respective indicators were collected. Results: Between 1993 and 2006, median age at first sex increased from 16.7 years to 18.2 years among 17-20-year-old girls and from 18.5 years to 19.9 years among boys. Both sexes reported a dip in age at sexual debut between 1998 and 2001. One or more casual partners in the past 12 months among men rose from 11.6% in 1997 to 12.7% in 2004 and then declined to 10.2% in 2006. Among women it increased from 1.4% in 1997 to 3.7% in 2004 and then reduced to 1.4% in 2006. The rise in casual partners between 1997 and 2004 was driven mainly by older age groups. Trends in condom use with casual partners varied by age, increasing among those aged 35+ years, declining in the middle age groups and presenting a dip and then a rise in the youngest aged group (13-19 years). Conclusion: Among youth, risky behaviour declined but increased in the late 1990s/early 2000s. Among those aged 35+ years, condom use rose but casual partners also rose. Several indicators portrayed a temporary increase in risk taking behaviour from 1998 to 2002.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | RURAL POPULATION | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | SEX FACTORS | FIRST INTERCOURSE | AGE FACTORS | CONDOM USE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Viral Diseases | Diseases | Risk Reduction Behavior
Document Number: 340101

30.

Peer Reviewed

Title: Preventive service needs of young people perinatally infected with HIV in Uganda.
Author: Birungi H; Obare F; Mugisha JF; Evelia H; Nyombi J
Source: AIDS Care. 2009 Jun;21(6):725-731.
Abstract: This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15-19 years who were born with HIV. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda. The analysis involves both quantitative and qualitative approaches. The quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions. The qualitative approach involves an analysis of individual case stories, in-depth probes, and focus group discussions for content. The findings show disconnect between: (1) the information service providers give to young people and young people's actual needs and desires; (2) adolescents' fears and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs need to recognize that young people perinatally infected with HIV are sexually active or anticipatebeing so in future.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | PERSONS LIVING WITH HIV/AIDS | ADOLESCENT PREGNANCY | HIV INFECTIONS | AIDS | HIV PREVENTION | SEX BEHAVIOR | FEAR | CONDOM USE | PREGNANCY, UNWANTED | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Emotions | Psychological Factors | Risk Reduction Behavior | Health | Delivery of Health Care | Economic Factors
Document Number: 339860


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