The scale-up of HIV services in sub-Saharan Africa has catalyzed the development of highly effective chronic care systems. The strategies, systems, and tools developed to support life-long HIV care and treatment are locally owned contextually appropriate resources, many of which could be adapted to support continuity care for noncommunicable chronic diseases (NCD), such as diabetes mellitus (DM). We conducted two proof-of-concept studies to further the understanding of the status of NCD programs and the feasibility and effectiveness of adapting HIV program-related tools and systems for patients with DM. In Swaziland, a rapid assessment illustrated gaps in the approaches used to support DM services at 15 health facilities, despite the existence of chronic care systems at HIV clinics in the same hospitals, health centers, and clinics. In Ethiopia, a pilot study found similar gaps in DM services at baseline and illustrated the potential to rapidly improve the quality of care and treatment for DM by adapting HIV-specific policies, systems, and tools.

No abstract

No abstract

Appropriate and consistent use of condom remains an effective approach to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) intervention. We analyzed the baseline data gathered for a situationally based HIV/AIDS intervention to assess the potential predictors of condom use among the Uniformed Services Personnel in Nigeria. Using condom purchase as a proxy for intention to use condom, we examined the distribution of the demographic and lifestyle characteristics, knowledge of HIV transmission mode, and knowledge of how to correctly use a condom. A univariable logistic regression was used to identify the potential predictors, followed by multivariable logistic regression modeling. The knowledge of how to correctly wear a condom was the most significant positive predictor of the intention to use a condom (adjusted prevalence odds ratio (APOR), 5.99 (95% confidence interval (CI), 1.26, 19.79). The other main positive predictors of intent to use a condom were the knowledge of the mode of HIV transmission via blood, APOR 2.43 (95% CI, 1.01, 5.82), saliva (5. 87, 95% CI, 3.15, 10.94), and pre-ejaculatory fluid (APOR, 3.58, 95% CI, 1.67, 7.48). Male gender was also a significant positive predictor of the intent to use a condom (APOR, 2.55, (95% CI, 1.10, 5.97)). The results further indicated alcohol use (APOR, 0.32, 95%CI, 0.16, 0.61), marijuana use (APOR, 0.24, 95% CI, 0.11, 0.56), and the frequency of oral sexual behavior (APOR, 0.006, 95%CI, 0.002, 0.019) as negative predictors of the intent to use a condom. Therefore, these findings suggest that for an HIV/AIDS intervention to be effective in this population, it must incorporate these predictor variables into its design and conduct.