scholarly journals The Intersection between Sex Work and Reproductive Health in Northern Karnataka, India: Identifying Gaps and Opportunities in the Context of HIV Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Marissa Becker ◽  
Satyanarayana Ramanaik ◽  
Shiva Halli ◽  
James F. Blanchard ◽  
T. Raghavendra ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Reproductive Health ◽  
Hiv Testing ◽  
Sex Work ◽  
Sex Workers ◽  
Prevention Program ◽  
Hiv Transmission ◽  
Health Indicators ◽  
Hiv Interventions ◽  
To Receive

Objective. To examine the reproductive health practices of female sex workers (FSWs) in the context of an HIV prevention program in Karnataka, India.Methods. Data obtained from a survey of 1,011 FSWs registered with an HIV prevention program. We examined reproductive health indicators, and performed multivariate logistic regression among primiparous FSWs to assess sex work during pregnancy and antenatal HIV testing.Results. Among primiparous FSWs (N=251), 92.0% continued sex work during pregnancy, and 55.4% received antenatal HIV testing. A longer duration in sex work (AOR 2.7, 95% CI: 1.0–7.5), rural residence (AOR 3.3, 95% CI: 1.2–8.9), and antenatal HIV testing (AOR 6.3, 95% CI: 2.0–20.1) were associated with continued sex work during pregnancy. Older FSWs (age >25 years, AOR 0.12, 95% CI: 0.05–0.33), who delivered at home (AOR 0.14, 95% CI: 0.09–0.34), were least likely to receive antenatal HIV testing. Antenatal HIV testing was associated with awareness of methods to prevent vertical HIV transmission (AOR 3.9, 95% CI: 1.9–14.1).Conclusions. Antenatal HIV testing remains low in the context of ongoing sex work during pregnancy. Existing HIV prevention programs are well positioned to immediately integrate reproductive health care with HIV interventions targeted to FSWs.

scholarly journals A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohan D. Jeremiah ◽  
Dhruvi R. Patel ◽  
Ellen Chirwa ◽  
Esnath Kapito ◽  
Xiaohan Mei ◽  
...  
Keyword(s):  
Health Promotion ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Antenatal Care ◽  
Hiv Testing ◽  
Late Pregnancy ◽  
Sub Saharan Africa ◽  
Partner Communication ◽  
Logistic Regression Models ◽  
Hiv Test

Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.

scholarly journals Understanding the Impact of a Community-led HIV Prevention Program in South Africa: Context, Conceptual Framework and Methodology

1999 ◽  
Vol 5 (4) ◽  
pp. 9 ◽  
Author(s):  
Catherine Campbell ◽  
Brian Williams
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Hiv Transmission ◽  
Evaluation Research ◽  
Evaluation Study ◽  
Social Contexts ◽  
Outcome Evaluation ◽  
Evaluation Methodology ◽  
Sexually Transmitted ◽  
The Impact

In this paper we provide an account of our multi-dimensional evaluation of a community led HIV-prevention program in the southern African mining community of Carletonville. The Mothusimpilo Project has three pillars: peer education and condom distribution, syndromic management of sexually transmitted diseases (STDs), and stakeholder mobilisation. Substantial efforts are being made to evaluate the impact of the intervention and in this paper we outline the theoretical rationale, research design and some preliminary results of the evaluation. The first section provides the setting for the evaluation work, viz an intervention which seeks to contextualise traditional biomedical and behavioural approaches to HIV-transmission within their broader community and social contexts. In the second section we outline the theoretical assumptions underlying the evaluation (which has both 'outcome evaluation' and 'process evaluation' components). In particular, we discuss the way in which the concepts of identity, empowerment and social capital are used to understand the processes involved in health-enhancing behaviour change. In the third section we describe our multi-disciplinary evaluation methodology and present some preliminary findings from our on-going evaluation study. One important goal of our evaluation research is to demonstrate the extent to which community level factors serve to assist or hinder the project in achieving its goals. In this way we hope to contribute to understandings of the role of community participation in influencing the outcomes of community-based health promotional projects.

scholarly journals HIV testing behaviour and HIV prevalence among female sex workers in Ukraine: findings from an Integrated Bio-Behavioural Survey, 2013–2014

2019 ◽  
Vol 95 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Anna Tokar ◽  
Iana Sazonova ◽  
Sharmistha Mishra ◽  
Pavlo Smyrnov ◽  
Tetiana Saliuk ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Work ◽  
Sex Workers ◽  
Sexual Partner ◽  
Female Sex Workers ◽  
Hiv Prevalence ◽  
Factors Associated ◽  
Female Sex ◽  
Living With Hiv ◽  
Test Result

ObjectivesUkraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine.MethodsWe used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013–2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue.ResultsRecent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9).ConclusionHIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one’s status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.

The Balm of Gilead: Is the Provision of Treatment to Those Who Seroconvert in HIV Prevention Trials a Matter of Moral Obligation or Moral Negotiation?

2006 ◽  
Vol 34 (4) ◽  
pp. 793-808 ◽  
Author(s):  
Charles Weijer ◽  
Guy J. LeBlanc
Keyword(s):  
Hiv Prevention ◽  
Sex Workers ◽  
Hiv Transmission ◽  
National Institutes Of Health ◽  
International Studies ◽  
Phnom Penh ◽  
Antiretroviral Drug ◽  
Control And Prevention ◽  
Prevention Trials ◽  
Gates Foundation

Is there no balm in Gilead; is there no physician there? Why then is not the health of the daughter of my people recovered?(Jeremiah 8:22)In July of 2004, Cambodian sex workers staged a protest of an HIV prevention trial set to enroll 900 sex workers in Phnom Penh, charging the study planners with exploitation. The Cambodian study was one of a series of international clinical trials sponsored by the U.S. National Institutes of Health (NIH), U.S. Centers for Disease Control and Prevention (CDC), and the Bill and Melinda Gates Foundation (Gates Foundation) testing the safety and efficacy of tenofovir (Viread), an antiretroviral drug produced by Gilead Sciences, Inc., to prevent HIV transmission. To date, two of these international studies have been closed and one is suspended, prompting calls for re-examination of the ethics of HIV prevention trials.

Correlates of Receiving Reproductive Health Care Services Among U.S. Men Aged 15 to 44 Years

2011 ◽  
Vol 5 (4) ◽  
pp. 358-366 ◽  
Author(s):  
Marina J. Chabot ◽  
Carrie Lewis ◽  
Heike Thiel de Bocanegra ◽  
Philip Darney
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Reproductive Health ◽  
Health Services ◽  
Hiv Testing ◽  
Birth Control ◽  
Physical Exam ◽  
Reproductive Health Services ◽  
Reproductive Health Care ◽  
To Receive

Men have a significant role in reproductive health decision making and behavior, including family planning and prevention of sexually transmitted diseases (STDs).Yet studies on reproductive health care of men are scarce. The National Survey of Family Growth 2006-2008 provided data that allowed assessment of the predisposing, enabling, and need factors associated with men’s receipt of reproductive health services in the United States. Although more than half (54%) of U.S. men received at least one health care service in the 12 months prior to the survey, far fewer had received birth control counseling/methods, including condoms (12%) and STD/HIV testing/STD treatment (12%). Men with publicly funded health insurance and men who received physical exam were more likely to receive reproductive health services when compared with men with private health insurance and men who did not receive a physical exam. Men who reported religion was somewhat important were significantly more likely to receive birth control counseling/ methods than men who stated religion was very important. The pseudo- R2 (54%), a measure of model fit improvement, suggested that enabling factors accounted for the strongest association with receiving either birth control counseling/ methods or STD/HIV testing/STD treatment.

scholarly journals Assessment of the scale, coverage and outcomes of the Avahan HIV prevention program for female sex workers in Tamil Nadu, India: is there evidence of an effect?

2011 ◽  
Vol 11 (Suppl 6) ◽  
pp. S3 ◽  
Author(s):  
S Thilakavathi ◽  
K Boopathi ◽  
CP Girish Kumar ◽  
A Santhakumar ◽  
R Senthilkumar ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Sex Workers ◽  
Prevention Program ◽  
Tamil Nadu ◽  
Female Sex Workers ◽  
Female Sex

scholarly journals Emerging trends in contraceptive use, transitions and preferences among female sex workers screened for an HIV prevention clinical trial in Kisumu, Kenya: a cross-sectional study

2019 ◽  
Vol 3 ◽  
pp. 1505 ◽  
Author(s):  
Dismas Oketch ◽  
Eunice C. Kaguiri ◽  
Joseph O. Orinda ◽  
Grace Mboya ◽  
Phoebe Ogutu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Contraceptive Use ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prevention Clinical Trial

Background: Globally about 210 million women conceive annually and 38% of these pregnancies are unintended. Female sex workers (FSWs) are at increased risk of both unintended pregnancy and acquiring HIV, which could lead to adverse sexual and reproductive health (SRH) outcomes. We sought to assess contraceptive use or non-use, preferences and determinants among a cohort of FSWs screened for an HIV prevention clinical trial in Kisumu, Kenya. Methods: A cross sectional study of healthy FSWs referred for possible recruitment into the Antibody Mediated HIV Prevention (AMP) Study was conducted between December 2016 and September 2018. Potentially eligible participants were screened for HIV and data on social-demographic, contraceptive use and other SRH characteristics were collected. Those not on a method recorded their contraceptive preferences.   Results: Data on 210 FSWs with a median age of 24.5 years (interquartile range, IQR 22-26) are presented. Of these, 187 (89.1%) had two children or fewer; only 56 (26.7%) had completed secondary or higher education. At the time of the interview, 18 (8.6%) were HIV-infected and 181 (86.2%) were using a modern contraceptive. Implants (48.6%) and depot injections (37.6%) were the most commonly used methods. Most (41.4%) of those not on family planning preferred oral pills. Respondents who had two or more children were three times more likely than their primiparous and nulliparous counterparts to report use of a contraceptive. Use of modern contraception methods did not differ by respondent’s ownership of a medical insurance cover or other occupation. Conclusion: There is high use of modern contraception among FSWs in Kisumu with the majority using subdermal implants. Reproductive health programs should implement targeted SRH interventions for specific populations and risk groups. Effective contraceptive counselling and interventions among FSWs should consider the client’s parity and level of education.

Missed Opportunities for Perinatal HIV Prevention Among HIV-Exposed Infants Born 1996–2000, Pediatric Spectrum of HIV Disease Cohort

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1186-1191 ◽  
Author(s):  
Vicki Peters ◽  
Kai-Lih Liu ◽  
Kenneth Dominguez ◽  
Toni Frederick ◽  
Sharon Melville ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Prevention ◽  
Prenatal Care ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Illicit Drug ◽  
Missed Opportunities ◽  
Perinatal Hiv ◽  
Hiv Exposed ◽  
Perinatal Hiv Prevention

Objective. Despite dramatic reductions in perinatal human immunodeficiency virus (HIV) transmission in the United States, obstacles to perinatal HIV prevention that include lack of prenatal care; failure to test pregnant women for HIV before delivery; and lack of prenatal, intrapartum, or neonatal antiretroviral (ARV) use remain. The objective of this study was to describe trends in perinatal HIV prevention methods, perinatal transmission rates, and the contribution of missed opportunities for perinatal HIV prevention to perinatal HIV infection. Methods. We analyzed data obtained from infant medical records on 4755 HIV-exposed singleton deliveries in 1996–2000, from 6 US sites that participate in the Centers for Disease Control and Prevention’s Pediatric Spectrum of HIV Disease Project. HIV-exposed deliveries refer to deliveries in which the mother was known to have HIV infection during the pregnancy. Results. Of the 4287 women with data on prenatal care, 92% had prenatal care. From 1996 to 2000, among the 3925 women with prenatal care, 92% had an HIV test before delivery; the use of prenatal zidovudine (ZDV) alone decreased from 71% to 9%, and the use of prenatal ZDV with other ARVs increased from 6% to 70%. Complete data on maternal and neonatal ARVs were available for 3284 deliveries. Perinatal HIV transmission was 3% in 1651 deliveries with prenatal ZDV in combination with other ARVs, intrapartum ZDV, and neonatal ZDV; 6% in 1111 deliveries with prenatal, intrapartum, and neonatal ZDV alone; 8% in 152 deliveries with intrapartum and neonatal ZDV alone; 14% of 73 deliveries with neonatal ZDV only started within 24 hours of birth; and 20% in 297 deliveries with no prenatal, intrapartum, and neonatal ARVs. Complete data on prenatal events were available in 328 HIV-infected and 3258 HIV-uninfected infants. A total of 56% of mothers of HIV-infected infants had missed opportunities for perinatal HIV prevention versus 16% of mothers of HIV-uninfected infants. Forty-four percent of the infected infants were born to mothers who had prenatal care, a prenatal HIV diagnosis, and documented prenatal ARV therapy. Seventeen percent of women with reported illicit drug use had no prenatal care versus 3% of women with no reported drug use. In a multivariate analysis, maternal illicit drug use was significantly associated with lack of prenatal care. In a multivariate analysis, year of infant birth and the combination of lack of maternal HIV testing before delivery and lack of prenatal antiretroviral therapies were significantly associated with perinatal HIV transmission. Conclusions. Missed opportunities for perinatal HIV prevention contributed to more than half of the cases of HIV-infected infants. Prenatal care and HIV testing before delivery are major opportunities for perinatal HIV prevention. Illicit drug use was highly associated with lack of prenatal care, and lack of HIV testing before delivery was highly associated with perinatal HIV transmission.

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