HIV combination prevention and declining orphanhood among adolescents, Rakai, Uganda, 2001–18: an observational community cohort study

Santelli, John; Chen, Ivy S.; Nabukalu, Dorean; Lutalo, Tom; Spindler, Esther; Chang, Larry W.; Grabowski, M Kate; Grilo, Stephanie A.; Kreniske, Philip; Wei, Ying; Nalugoda, Fred; Hoffman, Susie; Maru, Mahlet; Chu, Sofia; Ssewamala, Fred M.; Byansi, William; Kagaayi, Joseph; Wawer, Maria J.; Gray, Ronald H.; Serwadda, David; Makumbi, Fred

doi:10.1016/s2352-3018(21)00275-7

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Furthermore, HIV status was observed to be associated with 17.2% of the effect of ADI. Many studies have demonstrated that HIV diagnosis rates are higher for individuals from low-SES communities compared with those from high-SES communities (29,30). Also, once infected with HIV, persons with acquired immune deficiency syndrome (AIDS) had a markedly increased risk of malignancies including PCNSLs (31).…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic deprivation and survival outcomes in primary central nervous system lymphomas

et al. 2022

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ObjectiveTo our knowledge, the impact of area-level socioeconomic status (SES) has not yet been described in primary central nervous system lymphomas (PCNSLs). Current study sought to explore the association of socioeconomic deprivation, measured using the Area Deprivation Index (ADI), with PCNSL outcomes.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was used to identify PCNSL patients diagnosed between 2006 and 2015 for our analyses. The impact of ADI on overall survival (OS) and cancer-specific survival (CSS) were investigated. Survival analyses were conducted using Kaplan-Meier method with log-rank tests. The Inverse Probability Weighting (IPW) analysis and multivariate cox proportional hazards regression analysis were employed to make covariate adjustments. Multiple mediation analysis (MMA) was performed to estimate the mediating effects.ResultsA total of 3159 PCNSL patients classified into low and high ADI subgroups according to the median ADI score were studied. The Kaplan-Meier analyses showed that low ADI was significantly associated with higher OS rates (HR 1.15, 95%CI 1.06-1.26, P<0.01) and CSS rates (HR 1.15, 95%CI 1.05-1.27, P<0.01). Similar results were observed in analyses adjusted via IPW and multivariate cox methods. Subgroup analyses revealed that ADI could remain a prognostic indictor among different subsets. MMA revealed that several factors including chemotherapy and HIV status making up about 40% of the overall effect, mediated PCNSL survival disparities related to the ADI. Finally, multivariable logistic regression analysis showed that ADI as well as several other factors were independently related to receipt of chemotherapy.ConclusionsOur study highlights the role of area-level SES in prognosis of PCNSLs. And several factors including chemotherapy and HIV status of PCNSL patents contributed to the CSS disparities between ADI subgroups were uncovered by MMA. Such relationships would highlight the importance of policies development to enhance healthcare delivery and promote awareness of HIV prevention and treatment in low-resource neighborhoods.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic deprivation and survival outcomes in primary central nervous system lymphomas

et al. 2022

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“…It is estimated to reduce the risk of female-to-male transition of HIV by 60%. 2 , 10–14 There is some evidence that VMMC may also reduce the risk of other sexually transmitted infections (STIs), such as syphilis, herpes simplex virus type 2 and human papillomavirus (HPV). 15 With VMMC being a one-time, efficient, safe and cost-effective HIV prevention method, both WHO and UNAIDS identified 15 African countries with high HIV prevalence and low male circumcision (MC) prevalence as priority countries to scale up VMMC.…”

Section: Introductionmentioning

confidence: 99%

Voluntary medical male circumcision and educational gradient in relation to HIV infection among sexually active adult men in Eswatini: evidence from the national surveys in 2006–2007 and 2016

Masango,

Ferrandiz-Mont,

Chiao

2023

International Health

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Background To address knowledge gaps, this study examined social determinants, such as education attainment and HIV prevention, among sexually active men (SAM), with a focus on voluntary medical male circumcision (VMMC). Methods Two nationally representative surveys, the Eswatini Demographic and Health Survey 2006 and the Eswatini HIV Incidence Measurement Survey 2016, were used to estimate whether or not VMMC at the individual and community levels contributes to HIV disparities to any meaningful extent. Multilevel logistic regression models further explored the educational gradient in HIV infection for 2006–2007 and 2016 with regard to VMMC among SAM, while adjusting for household poverty, sexual practices and individual characteristics. Results Among SAM with tertiary education, HIV prevalence declined from 25.0% in 2006–2007 to 10.5% in 2016. A 51% decrease in HIV prevalence was found to be associated with an increase in VMMC (adjusted odds ratio 0.49; 95% CI 0.40 to 0.60). Compared with SAM with tertiary education, those who had a lower level of education were more likely to have HIV infection and this education gradient effect had become particularly profound in 2016. Conclusions VMMC began to be promoted in 2008 in Eswatini and results suggest its effect, along with the education attainment effect, significantly resulted in a meaningful reduction in HIV prevalence among SAM by 2016.

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The Impact of Parent–Adolescent Communication on Reduction of Sexual Risk Possibility Among Adolescents: Findings from the Suubi-Maka Study

et al. 2023

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HIV combination prevention and declining orphanhood among adolescents, Rakai, Uganda, 2001–18: an observational community cohort study

Cited by 5 publications

References 25 publications

Socioeconomic deprivation and survival outcomes in primary central nervous system lymphomas

Socioeconomic deprivation and survival outcomes in primary central nervous system lymphomas

Voluntary medical male circumcision and educational gradient in relation to HIV infection among sexually active adult men in Eswatini: evidence from the national surveys in 2006–2007 and 2016

The Impact of Parent–Adolescent Communication on Reduction of Sexual Risk Possibility Among Adolescents: Findings from the Suubi-Maka Study

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