Progress toward HIV elimination goals: trends in and projections of annual HIV testing and condom use in Africa

Nguyen, Phuong; Gilmour, Stuart; Le, Phuong Mai; Onishi, Kazunari; Kato, Kosuke; Nguyen, Huy Van

doi:10.1097/qad.0000000000002870

Cited by 22 publications

(17 citation statements)

References 29 publications

(30 reference statements)

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“…The largest challenge to feasibility was recruitment. We screened very few men over the period because of the absence of men in the clinic setting where our intervention was based; only 78% of men with HIV in South Africa know their status, fewer are in care, and low testing is a trend across the continent [ 84 ]. The challenges of clinic recruitment highlight the importance of community engagement to reach men who are often not available during clinic hours and who experience or anticipate health care worker stigma at clinics [ 66 , 85 ].…”

Section: Discussionmentioning

confidence: 99%

Demonstration and Acceptability of a Safer Conception Intervention for Men With HIV in South Africa: Pilot Cohort Study

Matthews¹,

Psaros²,

Mathenjwa³

et al. 2022

JMIR Form Res

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Background Many men with HIV (MWH) want to have children. HIV viral suppression minimizes sexual HIV transmission risks while allowing for conception and optimization of the health of men, their partners, and their infants. Objective This study developed and evaluated the feasibility and acceptability of an intervention to promote serostatus disclosure, antiretroviral therapy (ART) uptake and adherence, and viral suppression among MWH who want to have children in South Africa. Methods We developed a safer conception intervention (Sinikithemba Kwabesilisa or We give hope to men) to promote viral suppression via ART uptake and adherence, HIV serostatus disclosure, and other safer conception strategies for MWH in South Africa. Through 3 counseling and 2 booster sessions over 12 weeks, we offered education on safer conception strategies and aided participants in developing a safer conception plan. We recruited MWH (HIV diagnosis known for >1 month), not yet accessing ART or accessing ART for <3 months, in a stable partnership with an HIV-negative or unknown-serostatus woman, and wanting to have a child in the following year. We conducted an open pilot study to evaluate acceptability based on patient participation and exit interviews and feasibility based on recruitment and retention. In-depth exit interviews were conducted with men to explore intervention acceptability. Questionnaires collected at baseline and exit assessed disclosure outcomes; CD4 and HIV-RNA data were used to evaluate preliminary impacts on clinical outcomes of interest. Results Among 31 eligible men, 16 (52%) enrolled in the study with a median age of 29 (range 27-44) years and a median time-since-diagnosis of 7 months (range 1 month to 9 years). All identified as Black South African, with 56% (9/16) reporting secondary school completion and 44% (7/16) reporting full-time employment. Approximately 44% (7/16) of participants reported an HIV-negative (vs unknown-serostatus) partner. Approximately 88% (14/16) of men completed the 3 primary counseling sessions. In 11 exit interviews, men reported personal satisfaction with session content and structure while also suggesting that they would refer their peers to the program. They also described the perceived effectiveness of the intervention and self-efficacy to benefit. Although significance testing was not conducted, 81% (13/16) of men were taking ART at the exit, and 100% (13/13) of those on ART were virally suppressed at 12 weeks. Of the 16 men, 12 (75%) reported disclosure to pregnancy partners. Conclusions These preliminary data suggest that safer conception care is acceptable to men and has the potential to reduce HIV incidence among women and their children while supporting men’s health. Approximately half of the men who met the screening eligibility criteria were enrolled. Accordingly, refinement to optimize uptake is needed. Providing safer conception care and peer support at the community level may help reach men. Trial Registration ClinicalTrials.gov NCT03818984; https://clinicaltrials.gov/ct2/show/NCT03818984 International Registered Report Identifier (IRRID) RR2-https://doi.org/10.1007/s10461-017-1719-4

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Section: Discussionmentioning

confidence: 99%

Demonstration and Acceptability of a Safer Conception Intervention for Men With HIV in South Africa: Pilot Cohort Study

Matthews¹,

Psaros²,

Mathenjwa³

et al. 2022

JMIR Form Res

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“…In models that were disaggregated by wealth quintile or living areas, we also tested the inclusion of interaction terms between wealth index (or living areas) and survey year using the leave-one-out cross-validation method (Supplementary Table S3, S4). We applied Bayesian mixed-effect models to evaluate the variations between sub-national levels (regions) over time, as described elsewhere, 21 with random slope tested (Supplementary Table S5). We fitted 182 Bayesian models using the Markov Chain Monte Carlo (MCMC) algorithm with 50 0 0 samples, two chains, 10 0 0 iterations burn-in, and 2x thinning for each.…”

Section: Discussionmentioning

confidence: 99%

Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels

Nguyen

Rahman

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 20 0 0 −2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators. Methods:We used national population-based datasets of 44,624 households in Vietnam from 20 0 0 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality.Findings: We projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators.Interpretation: Vietnam has made substantial progress toward UHC. By improving the government's health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs.

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“… 39 Particularly, for models of regional level, we applied the Bayesian mixed-effect models and tested the significance of random slope to assess the variations between regions over time. 40 Details of covariate selections are in Supplementary Tables S3-S8. We fitted a series of 240 models using a Markov Chain Monte Carlo (MCMC) algorithm with 5000 samples, 1000 for burn-in, two chains, and thinning two times.…”

Section: Methodsmentioning

confidence: 99%

Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010–2030 and progress toward universal health coverage: A Bayesian analysis at national and sub-national levels

Nguyen

Gilmour

et al. 2022

eClinicalMedicine

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Progress toward HIV elimination goals: trends in and projections of annual HIV testing and condom use in Africa

Abstract: Objectives: To estimate trends in and projections of annual HIV testing and condom use at last higher-risk sex and to calculate the probability of reaching key United Nations Programme on AIDS (UNAIDS)'s target.

Cited by 22 publications

References 29 publications

Demonstration and Acceptability of a Safer Conception Intervention for Men With HIV in South Africa: Pilot Cohort Study

Demonstration and Acceptability of a Safer Conception Intervention for Men With HIV in South Africa: Pilot Cohort Study

Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels

Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010–2030 and progress toward universal health coverage: A Bayesian analysis at national and sub-national levels

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