Poster session on HIV/AIDS and STDs (1)

Adherence to ARV (antiretroviral) is a significant factor that prolong the life expectancy of people living with HIV AIDS (PLHIVs). This research aimed to identify the sociocultural factors that facilitate or inhibit adherence to ARV.
This research is a qualitative research conducted in West Java province (Bandung and Cimahi districts) and Bali province (Denpasar and Badung districts) from September to November 2011. Data collected by doing in depth interview with the staffs of district health office, Local AIDS Commission, district hospitals, NGOs and 17 PLHIVs who ever or still consuming ARV. Data were analyzed descriptively by triangulation and content analysis methods.
It is concluded that the internal supporting factors of adherence to ARV are the motivation to live longer, the eagerness to get cured and to be healthy, considering ARV as vitamin, and the faith in their own religion. Other supporting factors are the social support family, responsibility and affection for their children, willingness to get married, support from peer groups, NGO staffs, and good relationship with health provider staffs. Adherence to ARV should be improved by motivating PLHIVs and including family, peer groups, NGO staff and health provider to be ARV taking watchers, and providing better accessibility and affordability to ARV

Southern African countries are facing among the highest levels of HIV infection in the world. Multiple and concurrent sexual partnerships (MCP) and inconsistent condom use are the key drivers of the epidemic. Although nationally representative data on concurrency in Namibia have not been available until recently, several local studies have recorded high levels of concurrent partnerships. This study analyzes data from a 2011-2012 household survey of Namibia to identify the extent which various attitudinal factors and perceived norms are associated with multiple sexual partnerships, and to assess how these factors vary by gender. We use probit regression models to the relationship between attitudes and norms and these indicators of multiple and concurrent partnerships. Specifically, we examine the role of perceived norms regarding multiple partnerships, attitudes toward multiple partnerships, social support for refraining from multiple partnerships, self-efficacy to resist having multiple partners, and personal HIV/AIDS. Our analyses show that the factors that affect multiple partnerships vary by gender. Consequently, there is a need for HIV prevention programs to design messages that address male attitudes and perceived norms toward multiple partnerships.

Considering the criticallity of perceptively gauging combined effect of risky sexual behavior and substance abuse, this study employs ‘concept of critical events’. Critical event is formulated based on combination of alcohol use, partner type and un/protected sex focusing at context and sequence of events. Data used is collected through randomized cluster sample of 1239 young men from slums of Mumbai. Over three-fourths respondents engaged in critical events, four-fifths of which were unprotected. Girlfriend(s) are more risky partner as perceived partner faithfulness translates into unprotected sex (66%), which further falls six times after alcohol intoxication. Men reporting sex with commercial partner were 8 and 3 times more likely to mix alcohol-sex and unprotected sex. Peer pressure is influential in sexual experimentation and condom use even with girlfriend. Findings highlight alcohol-sex interface with girlfriend being receiver of elevated risk. Study underlines inevitability of innovative methodology to expose convoluted sexuality issues.

Year 2011 witnessed two milestones acknowledging issues of “International-Migrant-PLHIVs” globally, Political Declaration HIV/AIDS which targeta at ‘eliminating HIV-related restriction on entry, stay and residence by 2015’ and US president ‘ending the ban prohibiting PLHIV from entering America.’ India-Nepal and India-Bangladesh are two prominent cross-border migration corridors, prior being open-boarder and later an illegal gateway. This study explores ART related issues of Nepali and Bangladeshi PLHIVs residing in Mumbai. Data is collected through in-depth-interactions and FGDs with PLHIVs during July-August, 2012. Unavailability of entitlements including bank account results in disposable cash migrants usually spend on various risk-behavior. Despite free ART services at India, factors like self-stigma, fear of discrimination at and losing employment, language incompatibility, lack of local identity documents/proof hurdles treatment initiation. Secrecy regarding nationality to avoid being deported restricts the Bangladeshis. Non-Indian status often demands extra effort, time, and additional formalities, sometimes-even money. Unfavorable provider’s attitude, side effects leads to default and non-disclosure to spouse and family and unavailability of ART when visiting native country result even in discontinuation.

Using propensity score matching methodology, this paper examine the impact of community group membership on experience of physical violence, any positive sexual transmitted infections, and HIV tested and collected result among female sex workers (FSWs) in India. A cross sectional survey was administered in 2009-2010 and covered 7,806 FSWs through probability sampling. About 38 percent of FSWs reported being member of community group and majority of FSWs were aged above 24 years, currently married, street based FSWs by typology, had experience of physical violence, had HIV test done and collected result. The average effect of treatment (being a member of community group) on treated (experience of physical violence and consistent condom use with regular partner) was 21% and 10%, respectively. The average effect of membership was marginally high among those who tested for HIV and collected results. On sexually transmitted infections, average impact was 5% higher compared to those who did not have any STIs. These finding suggest that community group membership are an effective intervention strategy to reduce risk of STIs and HIV among the FSWs.

Over the last decade, the Zimbabwe Government has implemented a range of services to prevent new infections and to support people living with HIV, e.g. HIV testing and counselling (HTC), anti-retroviral treatment (ART), prevention of mother-to-child transmission (PMTCT), and male circumcision (MC).

We describe trends and patterns in knowledge and uptake of these services, investigate individual-level factors associated with greater levels of coverage, and analyse shortfalls in order to inform future policies on the scale-up of HIV services.

Data from the latest round of a large (n≈12,000) population-based cohort study in eastern Zimbabwe will be used in logistic regression models to analyse associations between demographic, socio-economic, behavioural and other factors, and knowledge and uptake of services. Temporal trends in uptake of services will be measured using data from earlier rounds of the study.

Preliminary univariate results suggest that knowledge of HIV services was high for HTC (82.3%; 95% CI: 91.6%-82.9%) and PMTCT (90.1%; 88.9%-91.2%) but lower for ART (40.1%; 39.3%-40.9%) and MC (8.4%; 7.7%-9.2%). Overall uptake was moderate for HTC (49.6%; 48.7%-50.4%) but quite high for PMTCT (86.4%; 79.3%-91.7%) and ART (79.8%; 76.9%-82.5%). Uptake varied by sex and age and may also differ by many other factors.

Background: The epidemiology of HIV in children in sub-Saharan Africa remains poorly understood. We describe patterns of HIV infection in children aged 2-14 years in eastern Zimbabwe in 2009-2011.
Methods: Data on possible socio-demographic correlates of HIV prevalence, sources of childhood infection, and the effects of HIV were collected in a general population survey and analysed using multi-variable logistic regression. The possibility of horizontal transmission was assessed by comparing the age-pattern of HIV prevalence with a mathematical model of the pattern expected from survival of infants infected through mother-to-child transmission (MTCT).
Results: HIV prevalence in children was 2.2% (73/3,399). Prevalence did not differ by sex, age, socio-economic status, location or religion. The age-specific HIV pattern was consistent with the model prediction of that expected from survival of infants infected through MTCT, but 9/73 infected children had living HIV-negative mothers. Infected children were more likely than uninfected ones to be malnourished (21.6% vs 9.9%, p=0.006) and stunted (42.0% vs 30.6%, p=0.03). HIV status was not correlated with physical or psychological ill-health, or school drop-out.
Conclusion: Childhood HIV infection in Zimbabwe is due primarily to MTCT and is linked with poor physical development.

As part of HVP-Cameroon AIDS Initiative, a behaviour change communication programme sought to increase consistent condom use (CCU) among male clients of female sex workers (FSWs) in four Cameroonian regions through the use of outdoor static promotional materials, interpersonal communication and mid-media activities. This paper presents key findings related to programme coverage levels, trends over time in self reported condom use, and correlations between levels of exposure to programme activities and self-reported condom use.
Methods
Five stratified two-stage cluster sample surveys were conducted between April 2008 and November 2010 (sample sizes ranged from 1741 to 2041). The independent samples were composed of clients of FSWs in selected clusters. Multivariate logistic regression was used to model whether behavioural outcomes varied between baseline and endline, and whether they varied with levels of exposure to the intervention.
Results
Over two-thirds of men in each survey round recalled one or two of the main intervention channels. An increase in CCU with FSWs was found between baseline and endline (63.6% vs 86.5; p<0.01). Men exposed to two intervention channels reported higher CCU than men exposed to none or only static outdoor media (89.4% vs 82.0%, p<0.05).

Introduction: In Cambodia, the HIV prevalence was 2.4% in 1999 and 1.1% in 2006. Overall access to and uptake of HIV testing and antiretrovirals (ARVs) for prevention of mother-to-child transmission (PMTCT) of HIV was low and limited for most pregnant women (PW) at that time. The Linked Response (LR) was launched to integrate PMTCT into maternal and child health services.
Methods: A descriptive analysis of routine data collected at LR sites, then of PMTCT program data including all antenatal care (ANC)/ PMTCT sites at national level from 2008 to 2011 was conducted.
Results: The number of operational districts (ODs) where LR was implemented increased from 5 to 71 between 2008-2011. The coverage of HIV testing among PW from 62% to 69% from 2009 to 2011.
Countrywide, the proportion of PW who attended ANC increased from 74% to 97% and the coverage of expected PW tested for HIV at ANC augmented from 25% in 2007 to 86% in 2011. In 2011, 62% of eligible PW received ARV prophylaxis. The proportion of exposed infants (EI) who received ARVs augmented from 27% in 2008 to 62% in 2011.
Discussion: The LR increased HIV testing, ARV uptake and follow up among PW and EI.
Conclusion: The LR contributed to the results of PMTCT. The effectiveness of the LR has been used to expand the provision of comprehensive PMTCT services nationwide.

When it comes to the topic of sex, analysts are often skeptical. And with good reason: respondents may lie or forget the juicy details of their intimate lives, and interviewers may exercise authority in how they capture it. In between the two lies a more fundamental problem endemic to social life: how people appear to others is never unmediated nor unfiltered. In this paper we use data from a cross-sectional HIV prevalence and sexual behavior survey conducted in 2010-2011 in a rural Southern African setting to explore the broader question of who says what to whom about their sexual lives. Preliminary results show a consistent age effect across outcomes-- that respondents report more “moral”, responsible sexual behavior to older fieldworkers; and a strong sex effect-- that men report more sexual partners to female fieldworkers. Understanding fieldworker effects on the production of sexual behavior survey data serves both methodological and theoretical goals.