Oral and injectable contraception use and risk of HIV acquisition among women in sub-Saharan Africa

AIDS ◽  
2013 ◽  
Vol 27 (6) ◽  
pp. 1001-1009 ◽  
Author(s):  
Sandra I. McCoy ◽  
Wenjing Zheng ◽  
Elizabeth T. Montgomery ◽  
Kelly Blanchard ◽  
Ariane van der Straten ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Contraception Use ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

scholarly journals Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa

2021 ◽  
Author(s):  
Eva van Empel ◽  
Rebecca A. de Vlieg ◽  
Livia Montana ◽  
F. Xavier Gómez-Olivé ◽  
Kathleen Kahn ◽  
...  
Keyword(s):  
South Africa ◽  
Perceived Risk ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Baseline Survey ◽  
Home Based ◽  
Estimated Risk ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

AbstractPerceptions of HIV acquisition risk and prevalence shape sexual behavior in sub-Saharan Africa (SSA). We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa baseline survey. Data were collected through home-based interviews of 5059 people ≥ 40 years old. We elicited information on perceived risk of HIV acquisition and HIV prevalence among adults  ≥ 15 and ≥ 50 years old. We first describe these perceptions in key subgroups and then compared them to actual estimates for this cohort. We then evaluated the relationship between sociodemographic characteristics and accurate perceptions of prevalence in regression models. Finally, we explored differences in behavioral characteristics among those who overestimated risk compared to those who underestimated or accurately estimated risk. Compared to the actual HIV acquisition risk of < 1%, respondents vastly overestimated this risk: 35% (95% CI: 32–37) and 34% (95% CI: 32–36) for men and women, respectively. Respondents overestimated HIV prevalence at 53% (95% CI: 52–53) for those ≥ 15 years old and 48% (95% CI: 48–49) for those ≥ 50 years old. True values were less than half of these estimates. There were few significant associations between demographic characteristics and accuracy. Finally, high overestimators of HIV prevalence tested themselves less for HIV compared to mild overestimators and accurate reporters. More than 30 years into the HIV epidemic, older people in a community with hyperendemic HIV in SSA vastly overestimate both HIV acquisition risk and prevalence. These misperceptions may lead to fatalism and reduced motivation for prevention efforts, possibly explaining the continued high HIV incidence in this community.

scholarly journals Maternal PrEP use in HIV-uninfected pregnant women in South Africa: Role of Stigma in PrEP initiation, retention and adherence

2020 ◽  
Author(s):  
Alexander Moran ◽  
Nyiko Mashele ◽  
Rufaro Mvududu ◽  
Pamina Gorbach ◽  
Linda-Gail Bekker ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Antenatal Visit ◽  
Sub Saharan ◽  
Anticipated Stigma ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
The Relationship

AbstractPregnant women in sub-Saharan Africa are at high risk of HIV acquisition and require effective methods to prevent HIV. In a cohort of pregnant women offered pre-exposure prophylaxis (PrEP), we evaluate the relationship between internalized and anticipated stigma and PrEP initiation at first antenatal visit, 3-month continuation and adherence using multivariable logistic regression. High internalized and anticipated PrEP stigma are associated with lower PrEP initiation at first antenatal visit (aOR internalized stigma=0.06; 95%CI=0.03-0.12 & aOR anticipated stigma=0.53; 95%CI=0.29-0.97) compared to women with low reported stigma, after controlling for covariates. Women whose partners have not been tested for HIV or whose serostatus remains unknown have 1.6-times odds of PrEP retention at 3-months compared to women whose partners have been tested (aOR=1.60; 95%CI=1.02-2.52) after adjusting for covariates. PrEP counseling and maternal PrEP interventions must consider individual- and relational-level interventions to overcome anticipated PrEP stigma and other barriers to PrEP initiation and adherence.

Point-of-care testing for HIV and sexually transmitted infections reveals risky behavior among men at gambling centers in Uganda”

2021 ◽  
pp. 095646242110009
Author(s):  
Agnes N Kiragga ◽  
John M Bwanika ◽  
Joshua Kyenkya ◽  
Grace Banturaki ◽  
Joanita Kigozi ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Risky Sexual Behavior ◽  
Illicit Drugs ◽  
Point Of Care ◽  
Sub Saharan Africa ◽  
Multiple Sexual Partners ◽  
Sexually Transmitted ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

In sub-Saharan Africa (SSA), men are generally difficult to engage in healthcare programs. However, sports gambling centers in SSA can be used as avenues for male engagement in health programs. We offered point-of-care HIV and syphilis testing for men located at five gambling centers in Uganda and assessed HIV risky sexual behavior. Among 507 men, 0.8% were HIV-positive and 3.8% had syphilis. Risky sexual behavior included condomless sex with partner(s) of unknown HIV status (64.9%), having multiple sexual partners (47.8%), engaging in transactional sex (15.5%), and using illicit drugs (9.3%). The majority at 64.5% were nonalcohol consumers, 22.9% were moderate users, and 12.6% had hazardous consumption patterns. In 12 months of follow-up, the incidence rate of syphilis was 0.95 (95% CI: 0.82-1.06) among 178 men. Thus, men in SSA have a high prevalence of syphilis and risky sexual behavior which should be more effectively addressed to reduce the risk of HIV acquisition.

scholarly journals PrEP as a Lifestyle and Investment for Adolescent Girls and Young Women in Sub-Saharan Africa

2019 ◽  
Vol 18 ◽  
pp. 232595821983101 ◽  
Author(s):  
Jessica E. Haberer ◽  
Nelly Mugo ◽  
Jared M. Baeten ◽  
Maria Pyra ◽  
Elizabeth Bukusi ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Sub Saharan Africa ◽  
Lifestyle Choice ◽  
Hiv Epidemic ◽  
Sub Saharan ◽  
The Many ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

Adolescent girls and young women (AGYW) are highly affected by the HIV epidemic, yet standard approaches to pre-exposure prophylaxis (PrEP) delivery will not meet their needs. This commentary highlights key characteristics of AGYW related to PrEP use and delivery, including typical neurocognitive development, lack of experience with sustained medication use, and the social and connected nature of AGYW’s lives. We then suggest ways for programs to embrace these characteristics, such as presenting PrEP as a lifestyle choice and not a biomedical tool, making access to PrEP simple and easy, and recognizing the many influences AGYW face in taking PrEP. We also suggest ways for programs to identify AGYW at the highest risk of HIV acquisition. Adolescent girls and young women have an important role to play in ending the HIV epidemic and they deserve considerable, tailored investment.

scholarly journals Hormonal contraception and HIV acquisition among women: an updated systematic review

2020 ◽  
Vol 46 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Kathryn M Curtis ◽  
Philip C Hannaford ◽  
Maria Isabel Rodriguez ◽  
Tsungai Chipato ◽  
Petrus S Steyn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Study ◽  
Oral Contraceptives ◽  
Hiv Risk ◽  
Contraceptive Method ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraception Use ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

ObjectiveTo update a 2016 systematic review on hormonal contraception use and HIV acquisition.MethodsWe searched Pubmed and Embase between 15 January 2016 and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using a hormonal contraceptive method and either non-users or users of another specific hormonal contraceptive method. We extracted information from newly identified studies, assessed study quality, and updated forest plots and meta-analyses.ResultsIn addition to 31 previously included studies, five more were identified; three provided higher quality evidence. A randomised clinical trial (RCT) found no statistically significant differences in HIV risk among users of intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG implant) or the copper intrauterine device (Cu-IUD). An observational study found no statistically significant differences in HIV risk among women using DMPA, norethisterone enanthate (NET-EN), implants (type not specified) or Cu-IUD. Updated results from a previously included observational study continued to find a statistically significant increased HIV risk with oral contraceptives and DMPA compared with no contraceptive use, and found no association between LNG implant and HIV risk.ConclusionsHigh-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.

scholarly journals Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 126 ◽  
Author(s):  
Ying-Ru Lo ◽  
Masaya Kato ◽  
Nittaya Phanuphak ◽  
Masami Fujita ◽  
Duong Bui Duc ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Treatment As Prevention ◽  
The Pacific ◽  
Prep Implementation ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Operational Issues ◽  
Exposure Prophylaxis ◽  
Firm Evidence

Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of ‘real world’ effectiveness is still lacking.

Intimate partner violence and contraception use among women in Sub-Saharan Africa

2009 ◽  
Vol 107 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Amina P. Alio ◽  
Ellen M. Daley ◽  
Philip N. Nana ◽  
Jingyi Duan ◽  
Hamisu M. Salihu
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Contraception Use ◽  
Sub Saharan

scholarly journals “I wish to remain HIV negative”: Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244226
Author(s):  
Makobu Kimani ◽  
Elise M. van der Elst ◽  
Oscar Chirro ◽  
Elizabeth Wahome ◽  
Fauz Ibrahim ◽  
...  
Keyword(s):  
Risk Behaviour ◽  
Healthcare Services ◽  
Transgender Women ◽  
Situational Factors ◽  
Sub Saharan Africa ◽  
Sexual Risk Behaviour ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Background Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700–1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.

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