Exploring the Potential of Savings-Led Economic Strengthening HIV Interventions Among High-Risk Economically Vulnerable Fishing Communities in Uganda: Associations Between Use of Commitment Savings, Sexual Risk Behavior, and Problematic Alcohol Use

Kiene, Susan M.; Ediau, Michael; Schmarje, Katherine A.; Kintu, Michael; Tumwesigye, Nazarius Mbona

doi:10.1007/s10461-019-02475-y

Cited by 12 publications

(17 citation statements)

References 46 publications

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“…Kiene et al (2019a) found that problematic alcohol use increased the rate of risky unprotected sex with all partners [adjusted Incident Rate Ratio (IRR) = 6.08; 95% CI = 4.30–8.60]. The increased risk was also seen among sex with casual partners and CSW/clients (IRR = 4.90; 95% CI = 3.09–7.78), and problematic alcohol use increased the odds of meeting a sex partner at an alcohol venue (OR = 2.84; 95%CI = 1.46–5.51) compared to those without problematic alcohol use [ 39 ]. In the same study, the use of commitment savings, restricted access savings account, moderated the association between problematic alcohol use and unprotected sex [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…The increased risk was also seen among sex with casual partners and CSW/clients (IRR = 4.90; 95% CI = 3.09–7.78), and problematic alcohol use increased the odds of meeting a sex partner at an alcohol venue (OR = 2.84; 95%CI = 1.46–5.51) compared to those without problematic alcohol use [ 39 ]. In the same study, the use of commitment savings, restricted access savings account, moderated the association between problematic alcohol use and unprotected sex [ 39 ]. The use of alcohol was linked to intimate partner violence, transactional sex, and risky sexual behavior including unprotected sex and multiple sexual partnerships [ 30 , 68 ].…”

Section: Resultsmentioning

confidence: 99%

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HIV epidemic in fishing communities in Uganda: A scoping review

et al. 2021

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Background Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. In Uganda, literature on HIV in fishing communities has grown extensively since the first country’s documented case of HIV in a fishing community in 1985. The current study describes the status of the HIV burden, prevention, and treatment in Ugandan fishing communities. Method This scoping review was conducted based on the York Framework outlined by Arksey and O’Malley. We searched the PubMed, Embase, and Web of Science databases to identify relevant quantitative and qualitative studies on HIV incidence, HIV prevalence, HIV-related risk factors, HIV testing, antiretroviral therapy coverage and adherence, and interventions to improve treatment outcomes and reduce HIV risk factors. Results & conclusion We identified 52 papers and 2 reports. Thirty-four were quantitative, 17 qualitative, and 3 had a mixed-methods design. Eleven studies reported on the prevalence of HIV and 8 on HIV incidence; 9 studies documented factors associated with HIV incidence or HIV positive status; 10 studies reported on HIV testing coverage and/or associated factors; 7 reported on antiretroviral therapy coverage/adherence/outcomes; and 1 study reported on the impact of combination HIV interventions in fishing communities. This scoping review revealed a significant lack of evidence in terms of what works in HIV prevention and for improving adherence to ART, in contrast to the relatively large amount of evidence from observational quantitative and qualitative studies on HIV prevalence, incidence and related risk factors in Ugandan fishing communities. Intervention studies are urgently needed to fill the current evidence gaps in HIV prevention and ART adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

HIV epidemic in fishing communities in Uganda: A scoping review

et al. 2021

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“…The predominantly rural nature and high poverty levels of participants in the surveyed districts may explain the low levels of HIV knowledge. Several studies have linked HIV knowledge and also infection with poverty and low levels of development [8,[15][16][17][18]. The lower knowledge levels in OR Tambo was possibly due to the predominantly rural setting of many clusters surveyed in OR Tambo compared to Nkangala whose greater population is more exposed to urban life in the Capital City, Tshwane.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two high HIV burden districts, South Africa

et al. 2020

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Background: With an HIV incidence of 1.00 skewed against women (1.51), adolescents in South Africa are at high HIV risk. This paper assesses young adults' (18-24 years) knowledge, attitudes and practices regarding HIV prevention in Nkangala and OR Tambo districts. Methods: A cross-sectional household survey was conducted in two districts in 2017/8. Participants completed computer-assisted self-interviews on HIV knowledge, attitudes, behaviour practices, use of social media and condom use at last sex (proxy for high-risk sex). HIV knowledge was assessed using the South African-adapted UNAIDS scale. Descriptive analyses were conducted and logistic regression models were built to assess factors associated with being knowledgeable of HIV and condom use at last sex. Results: One thousand nine hundred fifty-five participants were interviewed (90% response rate). Less than half (44.7%) had correct knowledge of HIV prevention and 73% used a condom at last sex. Social media use predicted high HIV knowledge as higher odds were observed among participants using the print media (aOR1.87; 1.34-2.60), WhatsApp (aOR1.55; 1.26-1.90), radio/television (aOR2.75; 1.15-6.55) although social networking sites' use protected against knowledge acquisition (aOR0.53; 0.34-0.82). Females (aOR0.75; 0.58-0.97) and participants reporting sexual risk were less likely to have HIV knowledge as negative associations were found for having multiple sexual partners in the last 3 months (aOR0.63;0.48-0.82) and ever having sex (aOR0.37;0.23-0.61). Participants who abused drugs (aOR1.40; 1.05-1.88) and had attitudes accepting people living with HIV (aOR2.05; 1.14-3.69) had higher odds of having HIV knowledge. Females (aOR0.70; 0.54-0.91), students (aOR0.52; 0.40-0.66) and participants who abused

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“…15 papers were excluded for other reasons, including one that failed critical appraisal and two that researchers could not access in full (Mugisha et al 2010;Sileo et al 2019b). Data was extracted from the remaining 23 papers (listed in Table 1), along with two additional papers identified by 'snowballing' (Kiene et al 2019;Sileo et al 2019c). Seven studies involved HIV prevention, six testing and counseling, three treatment, and nine interventions included combinations of more than one intervention type (e.g., HIV testing and starting ART) (see visual abstract).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies, one quantitative and four qualitative, assessed financial interventions to combat HIV in African fishing communities (Hüsken and Heck 2012;MacPherson et al 2015;Nevin et al 2015;Nathenson et al 2017;Kiene et al 2019) Establishing community savings groups to improve saving skills was successful in two studies: the 'No sex for fish' (Nathenson et al 2017) and 'Fish Trader +' (Hüsken and Heck 2012) projects. The latter was coupled with a health promotion campaign, and by the end, members were promoting healthy behaviors and sharing information about HIV.…”

Section: Social and Behavioral Interventionsmentioning

confidence: 99%

Efficacy of HIV interventions in African fishing communities: A systematic review and qualitative synthesis

Toms

Potter

Balaba

et al. 2020

International Journal of Infectious Diseases

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This systematic review aims to qualitatively synthesize existing evidence on the efficacy of HIV interventions in African fishing communities. Methods: Five databases (NCBI PubMed, EMBASE, Web of Science Core Collection, The Cochrane Library, and CABI Global Health Database) were searched in March 2019 for eligible studies. All peer-reviewed papers with a defined HIV intervention explicitly mentioning African fishing communities were included. Outcomes included any measure of the efficacy of HIV interventions. Results: Of 22,289 search results, data was extracted from 25 eligible studies that passed critical appraisal; seven involved HIV prevention, six HIV testing and counseling, three treatment, and nine combinations of more than one intervention. Findings include a high coverage of safe male circumcision (SMC) but low condom use among fisher folk, and a preference for PrEP over other HIV prevention services. Uptake of HIV testing and ART coverage are below levels required to reach UNAIDS 90-90-90 targets, and there is a high demand for ART and HIV self-testing kits. Conclusions: Greater provision of services to combat HIV, specifically amongst fishing communities, is required; there is limited information on retaining fisher folk in care and achieving an undetectable viral load. Interventions tailored to individual fishing populations, offered in parallel to education or counseling services are likely to be most effective. Use of innovations, including mobile health and medical drones, could assist these hard-to-reach populations. Our findings will inform future HIV service provision in fishing communities.

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Exploring the Potential of Savings-Led Economic Strengthening HIV Interventions Among High-Risk Economically Vulnerable Fishing Communities in Uganda: Associations Between Use of Commitment Savings, Sexual Risk Behavior, and Problematic Alcohol Use

Cited by 12 publications

References 46 publications

HIV epidemic in fishing communities in Uganda: A scoping review

HIV epidemic in fishing communities in Uganda: A scoping review

Knowledge, attitudes and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two high HIV burden districts, South Africa

Efficacy of HIV interventions in African fishing communities: A systematic review and qualitative synthesis

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