Objective. To examine the impact of out‐migration on Kenya's nursing workforce. Study Setting. This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design. We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out‐migrate, measured by requests for verification of credentials from destination countries. Principle Findings. From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out‐migrate. Eighty‐five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first‐time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out‐migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions. Nurse out‐migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country.

This paper reports on the development and psychometric properties of the Antiretroviral General Adherence Scale (AGAS) in 2 NIH-funded projects: the Get Busy Living Project, a behavioral clinical trial to promote consistent use of antiretroviral therapy (ART); and the KHARMA Project, which addressed issues of adherence and risk reduction behavior in women. AGAS assesses the ease and ability of participants to take ART according to a health care provider's recommendations. Data were analyzed from completed baseline assessments of the 2 studies. The AGAS was internally consistent in both samples. Content, construct, and criterion validity were established using factor analysis and correlations of total AGAS scores with 2 measures of adherence: electronic drug monitoring (EDM) and an Adult AIDS Clinical Trials Group (AACTG) adherence scale. Viral load, CD4 cell counts, and depression scores were also examined. Reliability and validity of the AGAS were supported in both samples. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access An Examination of the Psychometric Properties of the Antiretroviral General Adherence Scale (AGAS) in Two Samples of HIV-Infected IndividualsNon-adherence to antiretroviral therapy (ART) can undermine the therapeutic effect of the medications and contribute to the occurrence of viral mutation and drug resistance. Strict adherence to the drug regimen is extremely important for patients to prolong life, prevent opportunistic infections, prevent hospitalizations (Paterson et al., 2000), and protect themselves and their partners from drug resistant strains of HIV.There is no universally accepted definition of medication adherence because it is a multifaceted concept. Essentially, adherence is "the extent to which patients follow the instructions they were given for prescribed treatments" (Haynes, Ackloo, Sahota, McDonald, Yao, 2008, p. 2). For ART, adherence might involve obtaining the medications; taking the correct number of pills and the correct number of doses at the correct times; and following any dietary, storage, or other medication-related instructions. The patient is expected to do what is needed to meet the regimen requirements. Patients who follow the instructions exactly are considered to be 100% adherent.Often medication adherence is measured by the number of doses taken and/or the number of doses taken as scheduled. Depending on the durability of the antiretroviral (ARV) medications in a regimen, patients may need to adhere to as many as 95% of the recommended doses (Paterson et al., 2000). Because higher levels of a...

No abstract

Internet-recruited gay, bisexual, and other men who have sex with men (MSM) were offered HIV self-tests (HIVSTs) after completing baseline, 3-, 6-, and 9-month follow-up surveys. The surveys asked about the use and distribution of these HIVSTs. Among 995 who reported on their distribution of HIVSTs, 667 (67.0%) distributed HIVSTs to their social network associates (SNAs), which resulted in 34 newly identified HIV infections among 2301 SNAs (1.5%). The main reasons participants reported not distributing HIVSTs included: wanting to use the HIVSTs themselves (74.9%); thinking that their SNAs would get angry or upset if offered HIVSTs (12.5%); or not knowing that they could give the HIVSTs away (11.3%). Self-testing programs can provide multiple HIVSTs and encourage the distribution of HIVST by MSM to their SNAs to increase awareness of HIV status among persons disproportionately affected by HIV. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-022-03903-2.