Showing papers by "Starley B. Shade published in 2014"

The Mpumalanga Men's Study (MPMS): results of a baseline biological and behavioral HIV surveillance survey in two MSM communities in South Africa.

Abstract: The Mpumalanga Men's Study (MPMS) is the assessment of the Project Boithato HIV prevention intervention for South African MSM. Boithato aims to increase consistent condom use, regular testing for HIV-negative MSM, and linkage to care for HIV-positive MSM. The MPMS baseline examined HIV prevalence and associated risk behaviors, and testing, care, and treatment behaviors among MSM in Gert Sibande and Ehlanzeni districts in Mpumalanga province, South Africa in order to effectively target intervention activities. We recruited 307 MSM in Gert Sibande and 298 in Ehlanzeni through respondent-driven sampling (RDS) between September 2012-March 2013. RDS-adjusted HIV prevalence estimates are 28.3% (95% CI 21.1%-35.3%) in Gert Sibande, and 13.7% (95% CI 9.1%-19.6%) in Ehlanzeni. Prevalence is significantly higher among MSM over age 25 [57.8% (95% CI 43.1%-72.9%) vs. 17.9% (95% CI 10.6%-23.9%), P<0.001 in Gert Sibande; 34.5% (95%CI 20.5%-56.0%) vs. 9.1% (95% CI 4.6%-13.9%), P<0.001 in Ehlanzeni]. In Gert Sibande, prevalence is higher among self-identified gay and transgender MSM vs. other MSM [39.3% (95%CI, 28.3%-47.9%), P<0.01], inconsistent condom users [38.1% (18.1%-64.2%), P<0.05], those with a current regular male partner [35.0% (27.1%-46.4%), P<0.05], and those with lifetime experience of intimate partner violence with men [40.4%, (95%CI 28.9%-50.9%), P<0.05]. Prevalence of previous HIV testing was 65.8% (95%CI 58.8%-74.0%) in Gert Sibande, and 69.3% (95%CI 61.9%-76.8%) in Ehlanzeni. Regular HIV testing was uncommon [(34.6%, (95%CI 27.9%-41.4%) in Gert Sibande; 31.0% (95%CI 24.9%-37.8%) in Ehlanzeni]. Among HIV-positive participants, few knew their status (28.1% in Gert Sibande and 14.5% in Ehlanzeni), or were appropriately linked to care (18.2% and 11.3%, respectively), or taking antiretroviral therapy (13.6% and 9.6% respectively). MPMS results demonstrate the importance of implementing interventions for MSM to increase consistent condom use, regular HIV testing, and linkage and engagement in care for HIV-infected MSM.

Fertility desires and intentions among HIV-positive women during the post-natal period in Uganda.

Abstract: This study describes the fertility intentions and discusses the potential reproductive health needs of post-natal HIV-infected Ugandan women. HIV-infected mothers attending post-natal services in Kampala, Uganda participated in this cross-sectional study using structured interviewer administered questionnaires. Descriptive statistics and logistic regression models were used to identify predictors of desire for more children. Among 403 participants, 35% desired more children. Of these, 25% wanted another child within 2 years and 75% within 3 years or more. In multivariable analyses, believing that one’s partners wanted more children (OR=2.44; 95% CI = 1.30, 4.59) was associated with the desire for future children while having more living children was negatively associated with the desire for future children (OR=0.08; 95% CI = 0.02, 0.39). A minority of women desired future pregnancies, and most wanted to delay pregnancy for 3 years. These women are in need of family planning (FP) methods to meet stated desires to delay or end future pregnancies. Perceived partner desire for children also impacts on women’s fertility intentions, highlighting the importance of engaging men during the post-natal period. (Afr J Reprod Health 2014; 18[3]: 67-77) Keywords: fertility intentions; desire for children; Post-natal women; HIV; reproductive health; contraception. Resume Cette etude decrit les intentions de la fecondite et examine les besoins potentiels de la reproduction chez les femmes ougandaises post-natales infectees par le VIH. Des meres seropositives qui frequentent les services de post-natal a Kampala, en Ouganda, ont participe a cette etude transversale en utilisant des questionnaires structures et administres par les intervieweurs. Les statistiques descriptives et des modeles de la regression logistique ont ete utilises pour identifier les indices de l’envie d’avoir plus d’enfants. Parmi 403 participants, 35% desire avoir plus d'enfants. Parmi celles-ci, 25% voulaient avoir un autre enfant dans 2 ans et 75% dans 3 ans ou plus. Dans les analyses multivariees, estimant que ses partenaires voulaient plus d'enfants (OR = 2,44; IC a 95% = 1,30, 4,59) a ete associee a la volonte de leurs futurs enfants tout en ayant plus d'enfants alors que d’avoir plus d’enfants vivant a ete negativement associes au desir d'avoir des enfants dans l’avenir (OR = 0,08 IC a 95% = 0,02, 0,39). Une minorite de femmes ont desire des grossesses futures, et la plupart voulaient reporter la grossesse pendant 3 ans. Ces femmes ont besoin des methodes de la planification familiale (PF) pour satisfaire aux desirs exprimes pour retarder ou pour mettre fin a des grossesses futures. Le desir percu du partenaire des enfants a egalement un impact sur les intentions de la fecondite chez les femmes, soulignant ainsi l'importance de la participation des hommes au cours de la periode post-natale. (Afr J Reprod Health 2014; 18[3]: 67-77) Mots-cles: intentions de fecondite; Desir d'enfants; femmes post-natales; VIH; sante de la reproduction; contraception.