Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient–provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient’s trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient–provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.

Understanding the client, provider, and system barriers to cervical cancer screening could guide development of effective interventions.

Prostate cancer is a major sexual and reproductive health problem for men the world over. It remains an important public health concern in Western countries and an emerging malignancy in developing nations (Rawla, 2019). Ferlay et al. (2013) and Ervik and Asplund (2012) stated that prostate cancer is the second most common malignancy and the fifth leading cause of cancer mortality in men. By the year 2013, prostate cancer incidence and mortality in men had risen to 240,000 new cases and to more than 29,000 deaths, respectively, per year in the United States (American Cancer Society, 2013), and to 19,000 new cases and 3,300 deaths per year in Australia (Australian Institute of Health & Welfare, 2012). These figures made prostate cancer the most commonly diagnosed cancer in Australia, accounting for 31% of male cancers and 17% of all cancers in 2007 (Australian Institute of Health & Welfare, 2012). However, with early intervention, many of these deaths can be prevented. In Africa, prostate cancer contributes significantly to the public health burden. However, there are not enough data about prostate cancer; therefore, the exact burden remains unknown (Adeloye et al., 2016). In sub-Saharan Africa, 53.9 per 100,000 men are

BackgroundMaternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications.MethodsA retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients’ records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed.ResultA total of 619 patients’ records were reviewed with a mean (SD) age of 27.12 (5.97) years. The majority of abortions (95.5%) were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%). Offensive vaginal discharge (17.9%), tender uterus (11.3%), septic shock (3.9%) and pelvic peritonitis (2.4%) were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2%) of the cases followed by hypovolemic and septic shock 65 (10.5%). There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively).ConclusionAbortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for clinical audit on post-abortion care to insure implementation of standard protocol and reduce complications.

Participants reported the following problems, which were hindering the success of the programmes: problems in the ABC message; permissive campus environment; lack of entertainment; and students' perceptions about HIV/AIDS and their own vulnerability. Participants came up with suggestions for improving the initiatives. The authors discuss implications of the study findings for the university's initiatives.