Health education alone has a limited impact on HIV prevention programs, possibly because it does not systematically target social and cognitive factors that affect condom use. To systematically eva...

Interventions targeting social cognitive determinants of condom use in the general Sub-Saharan population: A Systematic Review

Objective: An effective method for preventing the Human Immunodeficiency Virus (HIV) is condom use. Yet, research shows limited effects of education on increasing condom use. This research examined...

https://tandfonline.com/doi/pdf/10.1080/21642850.2019.1614928

Effects of a computerized psychological inoculation intervention on condom use tendencies in sub Saharan and Caucasian students: two feasibility trials

Pre-exposure prophylaxis (PrEP) is an experimental approach to HIV prevention and consists of antiretroviral drugs to be taken before potential HIV exposure in order to reduce the risk of HIV infection and continued during periods of risk. An effective PrEP could provide an additional safety net to sexually active persons at risk, when combined with other prevention strategies. Women represent nearly 60% of adults infected with HIV and PrEP can be a female-controlled prevention method for women who are unable to negotiate condom use. Two antiretroviral nucleoside analog HIV-1 reverse transcriptase inhibitor drugs are currently under trial as PrEP drugs, namely tenofovirdisoproxilfumarate (TDF) alone and TDF in combination with emricitabine (FTC), to be taken as daily single dose oral drugs. There are 11 ongoing trials of ARV-based prevention in different at risk populations across the world. The iPrex trial showed that daily use of oral TDF/FTC by MSM resulted in 44% reduction in the incidence of HIV. This led to publication of interim guidance by CDC to use of PrEP by health providers for MSM. Few other trials are Bangkok Tenofovir Study, Partners PrEP Study, FEM-PrEP study, and VOICE (MTN-003) study. Future trials are being formulated for intermittent PrEP (iPrEP) where drugs are taken before and after sex, \"stand-in dose\" iPrEP, vaginal or rectal PrEP, etc. There are various issues/concerns with PrEP such as ADRs and resistance to TDF/FTC, adherence to drugs, acceptability, sexual disinhibition, use of PrEP as first line of defense for HIV without other prevention strategies, and cost. The PrEP has a potential to address unmet need in public health if delivered as a part of comprehensive toolkit of prevention services, including risk-reduction, correct and consistent use of condoms, and diagnosis and treatment of sexually transmitted infections.

Pre-exposure prophylaxis in HIV

This paper describes the process of engaging young people in a user centred, co-design strategy to define their perfect condom. Our aims were 1) to find a way to destigmatise discussions about sexu...

Can you design the perfect condom? Engaging young people to inform safe sexual health practice and innovation

The proliferation of voluntary and grassroots relief initiatives during the recent ‘refugee crisis’ in Europe brought renewed attention to the feelings, desires, and motivations that prompt aid wor...

Hope on the move: Israeli humanitarians between resilience and utopianism

One of the challenges facing researchers in the domain of human immunodeficiency virus prevention is the assessment of condom use in an unbiased self-reported manner. The current study presents the development and preliminary validation of an indirect condom use test (I-CUTE), designed to assess condom use tendencies and to overcome self-report biases. Two samples were included using correlational designs. In sample 1, 88 students from European university completed the I-CUTE with questionnaires of condom use barriers, social desirability, and condom use negotiation self-efficacy. In sample 2, 212 students from sub-Saharan universities completed the I-CUTE with questionnaires of condom use barriers and knowledge. The I-CUTE included 17 pictures of human figures in relation to condom use, where participants had to choose one of the four a-priori given sentences reflecting the figures' thoughts. This represented a semi-projective, yet standardized test. In sample 1, I-CUTE scores were inversely related to barriers, positively correlated with condom use negotiation self-efficacy and unrelated to social desirability. In sample 2, I-CUTE scores were inversely related to barriers and unrelated to knowledge scores. In a multiple regression, condom use barriers had a unique contribution to explaining variance in I-CUTE scores, beyond the contribution of background variables and knowledge. These results support the preliminary reliability and validity of the I-CUTE tool in a variety of cultures, and reveal its lack of bias by social desirability and the importance of condom use barriers in condom use tendencies.

/pdf/a-new-measurement-of-an-indirect-measure-of-condom-use-and-4npjpaikg9.pdf

A new measurement of an indirect measure of condom use and its relationships with barriers.

Thousands of migrants passed through the Balkans whilst migrating from the Middle East to Europe between 2015 and 2016. Humanitarian actions were conducted throughout this route as agencies and governments provided support. The Camp of Presevo, on the Southern border of Serbia, was established by the local authorities as a registration camp to monitor the migration and deliver aid. Part of this aid was psychosocial. Past studies show a relatively high prevalence of stress symptoms among forced migrants, presumably due to exposure to war-related atrocities and experience of forced migration. NATAN, an Israeli non-governmental organisation, is a volunteer-based organisation that delivered psychosocial support to the migrants using the ‘SIX Cs model’. This model focuses on cognitive and behavioural components and is based on the neuropsychology of resilience. It has advantages that were relevant to the context of the camp, namely culturally adaptive, easy to administer, short and adjustable to varied contexts. Moreover, the model gives tools, which could be used later by the migrants in the absence of a therapist. This report describes the SIX Cs model and the implementation of its intervention in the Presevo camp.

Psychological first aid through the ‘SIX Cs model’ − an intervention with migrants on the move

Objective Condom use prevents the contraction of the HIV. Research shows limited effects of education on increasing condom use. Psychological inoculation (PI) has been found to be more effective in this domain, however, its mechanism is unknown. This study examined effects of PI versus education on condom use barriers and tendencies, and its relations with cognitive dissonance, using a fully automatized online system. Design The study was a randomized controlled trial (RCT) and included 149 students from a German University randomly assigned to PI or a control condition. Main outcome measures An indirect condom use test (I-CUTE), a condom use barriers questionnaire, self-reported condom use, and cognitive dissonance estimations were all assessed at baseline and one-month post-intervention. Results PI significantly increased I-CUTE scores when participants had sexual relations. Control participants increased in self-reported condom use and on I-CUTE scores in people without sexual relations. No changes in barriers were seen in either group. The cognitive dissonance tended to be higher in PI participants as compared to control participants. Conclusions PI increases I-CUTE scores compared to controls (based on effect sizes), and significantly in those with sexual relations. The role of relationship status and the mechanisms of PI should be further examined.

The effects of psychological inoculation on condom use tendencies and barriers; a randomized controlled trial.

Thousands of migrants arrived in Europe via the Balkan route, many with various health conditions. The camp of Presevo, Serbia, close to the Macedonian border, was established by the Serbian government and run by the United Nations High Commissioner. The camp was wstablished for Refugees (UNHCR) late in 2015 as a registration and a transfer camp for refugees traveling through the Balkans on their way from the Near East to Western Europe. Refugees stayed at the camp for several hours or a day. NATAN, an Israeli non-governmental volunteer organization, in collaboration with HUMEDICA, a German organization, established a clinic at the camp, staffed by Israeli and German personnel. The Israeli team consisted of a doctor, nurse, and social worker, at least one of whom spoke Arabic. The language barrier was bridged through the fact that Arabic is commonly spoken in Israel, and more than half of the volunteers were Palestinian-Israelis. As for the Farsi language, we were helped by interpreters from the Department of Languages in the University of Belgrade. This report contains data on 2136 consecutive clients visiting the clinic between December 2015 and February 2016. The report focuses on the three most frequent major countries of origin, Syria (51%), Iraq (18%), and Afghanistan (31%). Analysis of the age distribution revealed that 36% were under 18 years of age, while only 5% were above the age of 60. Male gender was predominant. Infections were the most common diagnosis (61%) followed by pain in various body parts (13%). Antibiotics were prescribed in 47.6% of the infections. Most of the visits were for minor illnesses, with very few cases of chronic diseases such as diabetes (28 visits) or hypertension (17 visits). We provide the demographic correlates of migrants’ health conditions and discuss the findings in light of past studies and the context of the present sample of migrants.

/pdf/medical-conditions-and-treatment-in-a-transit-camp-in-serbia-vccxk4kzru.pdf

Einav Levy

Papers

A new measurement of an indirect measure of condom use and its relationships with barriers.

Effects of a computerized psychological inoculation intervention on condom use tendencies in sub Saharan and Caucasian students: two feasibility trials

Psychological first aid through the ‘SIX Cs model’ − an intervention with migrants on the move

The effects of psychological inoculation on condom use tendencies and barriers; a randomized controlled trial.

Medical conditions and treatment in a transit camp in Serbia for Syrian, Afghani, and Iraqi migrants