This study assessed factors influencing adherence to pre-exposure prophylaxis (PrEP) among key populations in Matayos Sub-County, Kenya. The study found that 37% of key populations showed adherence to PrEP based on the Morisky Medical Adherence Scale-4. Adherence varied among different key populations, with 36% for commercial sex workers, 37% for men who have sex with men, and 52% for people who inject drugs. Statistical analysis revealed that education level, marital status, key population category, occupation, stigma, perceptions of side effects, facility accessibility, actual side effects experienced, and condom use were associated with adherence to PrEP. The study concluded that socio-demographic factors, individual characteristics
Socio-Economic Effect of HIV/AIDS on Orphans and Vulnerable Children in Nyami...paperpublications3
Since the first case of HIV/AIDS was reported in Kenya in 1984 the numbers of those infected have risen and many people have since died or are living with the HIV/AIDS since the epidemic started in 1980s in the drug injecting people and the homosexuals. These deaths have resulted in Orphans and Vulnerable Children (OVC). This was a descriptive cross-sectional study, with one of the objective of finding out the socio-economic effect of HIV/AIDS on Orphans and Vulnerable Children in Nyamira district. A sample of 384 people participated in the study. The people were through simple random selected from Bonyegwe sublocation of Nyamusi division. Semi-structured interview schedules were used in data collection from the households. To remove ambiguity, the research tools were pre-tested to both HIV/AIDS organizations and householders not in the sample population but with similar characteristics. The research tools were refined and used on the actual sample population. Text, graphs, figures and tables were used in data presentation. The study indicates that those people who had not attained any level of formal education were (17%). The study revealed that householders (40%) had higher proportion of secondary education as compared with members of HIV/AIDS organizations (37%). Most of the members of HIV/AIDS organizations (89%) indicated that farming is their main source of income and a cushion for food security as compared with householders (63%). The ministry of health should strengthen provision of PMTCT services at the ANC clinic so that we prevent more cases of orphans and vulnerable children. The study suggests that in future all mothers who test positive for HIV virus should be put on treatment in order to reduce defaulters at the same time reach sustainable coverage in the provision of HIV/AIDS services to the orphans and vulnerable children in the society.
Levels of Utilization and Socio - Economic Factors Influencing Adherence to U...inventionjournals
The paper intends to assess the level of utilization and socio-economic factors influencing adherence to utilization of Anti Retroviral Therapy (ART) for People Living with HIV/AIDS in Dodoma Municipality and Kongwa District in Tanzania. Documentary review, interview and Focus Group Discussion were used in collecting data. A total of 140 respondents (99 PLWHIV/AIDS and 41 key informants) from four hospitals, two health centers and one dispensary were selected and interviewed as representatives for the purpose of this study. Quantitative data were collected and analyzed by using SPSS version 16 software. The study revealed 100% of PLWHIV/AIDS used ART drugs in Dodoma General Hospital, Kongwa Hospital, Mkoka Health Center and Makole Health Center while 40% in St. Gemma Hospital. Also the study indicated there were high dropout from utilization of ART drugs among PLWHIV/AIDS, 60% in Mirembe hospital, (50%) in Mkoka health center and (44%) in St. Gemma hospital as compared to the rest health centers and hospitals. The drop out caused by ART drugs side effects such as vomiting (25.1%), frequently sickness (19.9%) and decrease in CD 4 (11.2%). Lastly the study revealed four main socio-economic factors influencing adherence to utilization of ART services among PLHIV/AIDS including lack of employment support (66.7 %,) lack of confidentiality (50 %,) patient’s preference to traditional medicines (30%) and cultural belief (29.3%). The study recommends all PLWHIV/AIDS with side effects should report their cases to health centers and hospitals because not all side effects require a change of drugs or discontinuation, PLWHIV/AIDS should be assisted by Government and Non-Government Organizations and family members to secure soft loans that will enable them to establish income generation activities, education on patients confidentiality should be provided to services providers in hospitals and health centers
Quality of life and its sociodemographic and clinicalpredictorsamong people o...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
Health Beliefs and Health Seeking Behaviours of Mbororos Communities in Mezam...ijtsrd
The purpose of this study was to investigate how indigenous health beliefs affect health seeking behaviours of the Mbororos in their communities in Mezam Division. The study employed a cross sectional survey research design using explanatory sequential mixed methods. Quantitative data were collected using questionnaire while focus group discussions and interview guides were used to collect qualitative data. Questionnaires were completed by 500 Mbororos selected by simple random sampling while 36 Mbororo leaders and elders and 3 healthcare providers were purposefully selected, making a total of 539 respondents. The data were analysed with the aid of the Statistical Package for Social Sciences SPSS version 23.0 for windows where descriptive statistics such as percentages, mean scores and standard deviation were gotten. Equally SPSS was also used for regression analysis and tested the effects between the independent and dependent variables. The qualitative data were analysed using thematic analysis method. The findings showed that Indigenous health belief had a statistically significant effect on health seeking behaviour towards traditional therapy at 1 level p = 0.000 . . On another perspective the qualitative data which complemented the findings showed that indigenous health beliefs had effects on health seeking behaviours towards traditional therapy among the Mbororos. The study supports the notion that the Mbororo communities in Mezam Division and beyond should develop more tolerance for conventional medicine and rush for appropriate diagnosis and treatment before complementing with traditional treatment. Integration of modern and traditional medicine is recommended. In addition the healthcare providers should be accommodating, culturally competent and apply a culturally congruent approach in treatment. Foncham Paul Babila | Einstein Moses Egebe Anyi | Fomba Emmanuel Mbebeb "Health Beliefs and Health Seeking Behaviours of Mbororos Communities in Mezam Division of the North West Region of Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-3 , June 2023, URL: https://www.ijtsrd.com.com/papers/ijtsrd56359.pdf Paper URL: https://www.ijtsrd.com.com/humanities-and-the-arts/education/56359/health-beliefs-and-health-seeking-behaviours-of-mbororos-communities-in-mezam-division-of-the-north-west-region-of-cameroon/foncham-paul-babila
Abstract—Hepatitis B virus (HBV) infection is one of the major global public health problems with nearly 2 billion people infected worldwide. So this present study was planned to have information about socio-demographic characteristics of study subjects, level of knowledge about Hepatitis B and vaccination among adults. A cross-sectional, community-based study about hepatitis B knowledge and vaccination status among ethnic 1300 Kashmiri population aged 18 years and above was conducted. The study area was block Hazratbal of district Srinagar. There were 970 (74.6%) females and 330 (25.4%) males. Majority of our participants (54.7%) were in the age group of 21-40 years. Most of the participants were from urban areas(68%), currently married(66.8%), illiterate(64.8), members of joint family(59%) and belonging to socio-economic class II(67.2%). Regarding knowledge, only 10.2% subjects had heard of Hepatitis B before this study. Among them, 50 (37.6%) participants were aware of the modes of transmission of this disease. About the Hepatitis B vaccination, only 26 (2%) participants out of 1300 had ever received the vaccine. Keeping in view, the low level of knowledge about Hepatitis B in the general population, there is a need to organize health education campaigns targeting both health care workers as well as public, so that they adopt all possible measures to prevent the spread of this fatal infection.
Socio-Economic Effect of HIV/AIDS on Orphans and Vulnerable Children in Nyami...paperpublications3
Since the first case of HIV/AIDS was reported in Kenya in 1984 the numbers of those infected have risen and many people have since died or are living with the HIV/AIDS since the epidemic started in 1980s in the drug injecting people and the homosexuals. These deaths have resulted in Orphans and Vulnerable Children (OVC). This was a descriptive cross-sectional study, with one of the objective of finding out the socio-economic effect of HIV/AIDS on Orphans and Vulnerable Children in Nyamira district. A sample of 384 people participated in the study. The people were through simple random selected from Bonyegwe sublocation of Nyamusi division. Semi-structured interview schedules were used in data collection from the households. To remove ambiguity, the research tools were pre-tested to both HIV/AIDS organizations and householders not in the sample population but with similar characteristics. The research tools were refined and used on the actual sample population. Text, graphs, figures and tables were used in data presentation. The study indicates that those people who had not attained any level of formal education were (17%). The study revealed that householders (40%) had higher proportion of secondary education as compared with members of HIV/AIDS organizations (37%). Most of the members of HIV/AIDS organizations (89%) indicated that farming is their main source of income and a cushion for food security as compared with householders (63%). The ministry of health should strengthen provision of PMTCT services at the ANC clinic so that we prevent more cases of orphans and vulnerable children. The study suggests that in future all mothers who test positive for HIV virus should be put on treatment in order to reduce defaulters at the same time reach sustainable coverage in the provision of HIV/AIDS services to the orphans and vulnerable children in the society.
Levels of Utilization and Socio - Economic Factors Influencing Adherence to U...inventionjournals
The paper intends to assess the level of utilization and socio-economic factors influencing adherence to utilization of Anti Retroviral Therapy (ART) for People Living with HIV/AIDS in Dodoma Municipality and Kongwa District in Tanzania. Documentary review, interview and Focus Group Discussion were used in collecting data. A total of 140 respondents (99 PLWHIV/AIDS and 41 key informants) from four hospitals, two health centers and one dispensary were selected and interviewed as representatives for the purpose of this study. Quantitative data were collected and analyzed by using SPSS version 16 software. The study revealed 100% of PLWHIV/AIDS used ART drugs in Dodoma General Hospital, Kongwa Hospital, Mkoka Health Center and Makole Health Center while 40% in St. Gemma Hospital. Also the study indicated there were high dropout from utilization of ART drugs among PLWHIV/AIDS, 60% in Mirembe hospital, (50%) in Mkoka health center and (44%) in St. Gemma hospital as compared to the rest health centers and hospitals. The drop out caused by ART drugs side effects such as vomiting (25.1%), frequently sickness (19.9%) and decrease in CD 4 (11.2%). Lastly the study revealed four main socio-economic factors influencing adherence to utilization of ART services among PLHIV/AIDS including lack of employment support (66.7 %,) lack of confidentiality (50 %,) patient’s preference to traditional medicines (30%) and cultural belief (29.3%). The study recommends all PLWHIV/AIDS with side effects should report their cases to health centers and hospitals because not all side effects require a change of drugs or discontinuation, PLWHIV/AIDS should be assisted by Government and Non-Government Organizations and family members to secure soft loans that will enable them to establish income generation activities, education on patients confidentiality should be provided to services providers in hospitals and health centers
Quality of life and its sociodemographic and clinicalpredictorsamong people o...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
Health Beliefs and Health Seeking Behaviours of Mbororos Communities in Mezam...ijtsrd
The purpose of this study was to investigate how indigenous health beliefs affect health seeking behaviours of the Mbororos in their communities in Mezam Division. The study employed a cross sectional survey research design using explanatory sequential mixed methods. Quantitative data were collected using questionnaire while focus group discussions and interview guides were used to collect qualitative data. Questionnaires were completed by 500 Mbororos selected by simple random sampling while 36 Mbororo leaders and elders and 3 healthcare providers were purposefully selected, making a total of 539 respondents. The data were analysed with the aid of the Statistical Package for Social Sciences SPSS version 23.0 for windows where descriptive statistics such as percentages, mean scores and standard deviation were gotten. Equally SPSS was also used for regression analysis and tested the effects between the independent and dependent variables. The qualitative data were analysed using thematic analysis method. The findings showed that Indigenous health belief had a statistically significant effect on health seeking behaviour towards traditional therapy at 1 level p = 0.000 . . On another perspective the qualitative data which complemented the findings showed that indigenous health beliefs had effects on health seeking behaviours towards traditional therapy among the Mbororos. The study supports the notion that the Mbororo communities in Mezam Division and beyond should develop more tolerance for conventional medicine and rush for appropriate diagnosis and treatment before complementing with traditional treatment. Integration of modern and traditional medicine is recommended. In addition the healthcare providers should be accommodating, culturally competent and apply a culturally congruent approach in treatment. Foncham Paul Babila | Einstein Moses Egebe Anyi | Fomba Emmanuel Mbebeb "Health Beliefs and Health Seeking Behaviours of Mbororos Communities in Mezam Division of the North West Region of Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-3 , June 2023, URL: https://www.ijtsrd.com.com/papers/ijtsrd56359.pdf Paper URL: https://www.ijtsrd.com.com/humanities-and-the-arts/education/56359/health-beliefs-and-health-seeking-behaviours-of-mbororos-communities-in-mezam-division-of-the-north-west-region-of-cameroon/foncham-paul-babila
Abstract—Hepatitis B virus (HBV) infection is one of the major global public health problems with nearly 2 billion people infected worldwide. So this present study was planned to have information about socio-demographic characteristics of study subjects, level of knowledge about Hepatitis B and vaccination among adults. A cross-sectional, community-based study about hepatitis B knowledge and vaccination status among ethnic 1300 Kashmiri population aged 18 years and above was conducted. The study area was block Hazratbal of district Srinagar. There were 970 (74.6%) females and 330 (25.4%) males. Majority of our participants (54.7%) were in the age group of 21-40 years. Most of the participants were from urban areas(68%), currently married(66.8%), illiterate(64.8), members of joint family(59%) and belonging to socio-economic class II(67.2%). Regarding knowledge, only 10.2% subjects had heard of Hepatitis B before this study. Among them, 50 (37.6%) participants were aware of the modes of transmission of this disease. About the Hepatitis B vaccination, only 26 (2%) participants out of 1300 had ever received the vaccine. Keeping in view, the low level of knowledge about Hepatitis B in the general population, there is a need to organize health education campaigns targeting both health care workers as well as public, so that they adopt all possible measures to prevent the spread of this fatal infection.
[[INOSR ES 11(2)108-121, 2023.Evaluation of Male partner participation in pre...PUBLISHERJOURNAL
Evaluation of Male partner participation in prevention of mother to child transmission of HIV/AIDs at Hoima Referral hospital
Sebwami Richard
School of Allied Health Sciences, Kampala International University Uganda.
________________________________________
ABSTRACT
The purpose of the study was to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in the prevention of mother-to-child transmission of HIV in Hoima municipality. This study was a descriptive cross section in which quantitative method of data collection was employed in collection of data from respondents. Questionnaires were distributed to participants to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in prevention of mother-to-child transmission of HIV (PMTCT) in Hoima municipality. Sample size of 200 participants were used, this included the Male partners who hard escorted their pregnant partners to the antenatal clinic aged between 20-50years.The predominant religion were Catholics 59% and seventh day Adventists. Regarding educational levels, majority of respondents had completed secondary level and above (61%) and the predominant ages were between 20-29 years. The study revealed that very few males partner were involved in the PMTCT program especially during HIV counseling and testing (HCT) because of being at old age group above 30years couples, couples not living together, high number of wife’s pregnancies four and above, having no knowledge on methods of MTCT, and husbands failure to discuss HCT with their wives. From the findings, majority of the respondents have ever had about the male involvement in the PMTCT but there was still low male involvement in PMTCT programs at antenatal clinics. There is a need to do an in-depth assessment of women’s experiences when tested HIV-positive in the presence of their partners at the ANC, as well as to develop strategies to improve male involvement. The study again recommends formative research on the use of incentives to promote male involvement in the PMTCT program and the government should train more of the health promoters and the Village Health Teams in order to reach even those that are deep in the village that are not having easy access to the health facility.
Keywords: HIV, Hoima municipality, Male partner, counseling
Lady health workers' perceptions towards tuberculosis and its determinants at...Zubia Qureshi
Background: Lady Health Workers (LHWs), performing in Tuberculosis control programs have direct access in the communities. This study was designed to improve the TB status in Sindh province by improving the knowledge and practices of LHWs. Objective: To assess the TB related knowledge, attitude and practices among LHWs at tehsil Latifabad, district Hyderabad, Sindh. Method: A mixed method Cross-sectional study was done on universally selected 384 LHWs from Latifabad. Three focus group discussions were conducted with eight participants for each group. A pre-tested structured questionnaire and eld guidelines were used for data collection. Analysis was done on SPSS software by calculating frequencies, percentages, mean and median. While for inferential analysis chi square, t-test and Mann Whitney U tests were used. For FGDs, content analysis method was used. Results: Sufcient knowledge was found in about half 193(50.3%) of the participants. The overall attitude and practices of most of the LHWs 214(55.7%) and 205 (53.4%) respectively was not good. A signicant difference was found between LHWs knowledge score of those who had insufcient (28.08 ± 3.0) and sufcient knowledge (28.08 ± 3.1) with p-value <0.001. Also good attitude (47.74±2.8) and practices (51.45±3.8) of LHWs differed signicantly from those who did not have good attitude (36.09±4.8), and practices (40.44±3.3) with p-value <0.001. The insufcient knowledge was associated with unsafe practices. Tuberculosis related stigma was found in the community, people do not want to disclose their disease. Conclusion: Overall knowledge, attitude and practices about TB were not satisfactory among LHWs of Latifabad. An educational intervention is recommended for LHWs. Key words: Community health workers, infectious disease, knowledge, attitude, practices, developing country
Household Demographic Predictors of Drug and Substance Abuse among High Schoo...Premier Publishers
Purpose: The accessibility, affordability, and consumption of abused drugs by the youths have attracted great concern among public health personnel. This descriptive cross-sectional study investigated household demographic predictors of drugs and substance abuse among high school students in Kisumu East Sub-County, Kisumu County.
Methods: Sample size of 434 was calculated using Yamane formula and the participants selected through Snow ball, random, cluster and stratified sampling. Descriptive data was summarized using tables while inferential statistic done using Chi square and logistic regression. Data collection done through observation and semi- structured questionnaires. P value <0.05 was considered statistically significant.
Results: Overall, 219 (61.17%) students reported to have engaged in drug and illicit substance abuse with higher proportion reported among the Christians as compared to Islamic and Hinduism. Religion, Parental / guardian’s level of education and the person living with the student were found to significantly predict the abuse of drug and illicit substance among high school students (p<0.05).
Conclusion: Drug and illicit substance abuse remains a major public health problem among all age groups worldwide with several negative impacts. Due to its magnitude, it calls for concerted multi-sectorial effort by all stakeholders for the dream of drug free world to be achieved.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Participation of the population in decisions about their health and in the pr...Pydesalud
Póster presentado por Lilisbeth Perestelo en el congreso Summer Institute for Informed Patient Choice (SIIPC14) celebrado del 25 al 27 de junio de 2014 en Dartmouth, Hanover (EEUU). Web: http://siipc.org
Contacto: lperperr@gobiernodecanarias.org
Achievements and Implications of HIV Prevention Programme among Men who have ...inventionjournals
Background: Targeted interventions among men who have sex with men (MSM) could have a considerable effect in slowing the spread of HIV epidemic. This paper therefore presents the achievements and implications of HIV prevention programme among MSM in Bayelsa State, Nigeria Methods: The project was an intervention study carried out among MSM in Bayelsa State, Nigeria. The calculated sample size for this project was 155 MSM and snowball sampling technique was used for their selection. The project adopted the minimum prevention package intervention (MPPI) and data collected with output indicators were entered into the District Health Information Software (DHIS) 2, exported into Microsoft Excel and analysed using same. Results: The overall target population reached during this intervention was 381 MSM given a target reached of 245.8%. A total of 35 community dialogues were held within the duration of the intervention and 49 influencers participated. The number of peers registered during the intervention were 203 and out of the total number of condom (20582) required for this intervention, only 15235 (74.0%) were distributed. A total of 185 (91.1%) of the registered peers were reached with all the three stages of MPPI and 381 (245.8%) were reached with HCT. Among these, 17 (4.5%) were tested positive to HIV. Conclusion: This study showed an HIV prevalence of 4.5% among men who have sex with men in Bayelsa state at the time of the intervention. Given this high HIV prevalence, it is vital to enact more targeted and evidencebased prevention programs for these men.
[[INOSR ES 11(2)108-121, 2023.Evaluation of Male partner participation in pre...PUBLISHERJOURNAL
Evaluation of Male partner participation in prevention of mother to child transmission of HIV/AIDs at Hoima Referral hospital
Sebwami Richard
School of Allied Health Sciences, Kampala International University Uganda.
________________________________________
ABSTRACT
The purpose of the study was to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in the prevention of mother-to-child transmission of HIV in Hoima municipality. This study was a descriptive cross section in which quantitative method of data collection was employed in collection of data from respondents. Questionnaires were distributed to participants to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in prevention of mother-to-child transmission of HIV (PMTCT) in Hoima municipality. Sample size of 200 participants were used, this included the Male partners who hard escorted their pregnant partners to the antenatal clinic aged between 20-50years.The predominant religion were Catholics 59% and seventh day Adventists. Regarding educational levels, majority of respondents had completed secondary level and above (61%) and the predominant ages were between 20-29 years. The study revealed that very few males partner were involved in the PMTCT program especially during HIV counseling and testing (HCT) because of being at old age group above 30years couples, couples not living together, high number of wife’s pregnancies four and above, having no knowledge on methods of MTCT, and husbands failure to discuss HCT with their wives. From the findings, majority of the respondents have ever had about the male involvement in the PMTCT but there was still low male involvement in PMTCT programs at antenatal clinics. There is a need to do an in-depth assessment of women’s experiences when tested HIV-positive in the presence of their partners at the ANC, as well as to develop strategies to improve male involvement. The study again recommends formative research on the use of incentives to promote male involvement in the PMTCT program and the government should train more of the health promoters and the Village Health Teams in order to reach even those that are deep in the village that are not having easy access to the health facility.
Keywords: HIV, Hoima municipality, Male partner, counseling
Lady health workers' perceptions towards tuberculosis and its determinants at...Zubia Qureshi
Background: Lady Health Workers (LHWs), performing in Tuberculosis control programs have direct access in the communities. This study was designed to improve the TB status in Sindh province by improving the knowledge and practices of LHWs. Objective: To assess the TB related knowledge, attitude and practices among LHWs at tehsil Latifabad, district Hyderabad, Sindh. Method: A mixed method Cross-sectional study was done on universally selected 384 LHWs from Latifabad. Three focus group discussions were conducted with eight participants for each group. A pre-tested structured questionnaire and eld guidelines were used for data collection. Analysis was done on SPSS software by calculating frequencies, percentages, mean and median. While for inferential analysis chi square, t-test and Mann Whitney U tests were used. For FGDs, content analysis method was used. Results: Sufcient knowledge was found in about half 193(50.3%) of the participants. The overall attitude and practices of most of the LHWs 214(55.7%) and 205 (53.4%) respectively was not good. A signicant difference was found between LHWs knowledge score of those who had insufcient (28.08 ± 3.0) and sufcient knowledge (28.08 ± 3.1) with p-value <0.001. Also good attitude (47.74±2.8) and practices (51.45±3.8) of LHWs differed signicantly from those who did not have good attitude (36.09±4.8), and practices (40.44±3.3) with p-value <0.001. The insufcient knowledge was associated with unsafe practices. Tuberculosis related stigma was found in the community, people do not want to disclose their disease. Conclusion: Overall knowledge, attitude and practices about TB were not satisfactory among LHWs of Latifabad. An educational intervention is recommended for LHWs. Key words: Community health workers, infectious disease, knowledge, attitude, practices, developing country
Household Demographic Predictors of Drug and Substance Abuse among High Schoo...Premier Publishers
Purpose: The accessibility, affordability, and consumption of abused drugs by the youths have attracted great concern among public health personnel. This descriptive cross-sectional study investigated household demographic predictors of drugs and substance abuse among high school students in Kisumu East Sub-County, Kisumu County.
Methods: Sample size of 434 was calculated using Yamane formula and the participants selected through Snow ball, random, cluster and stratified sampling. Descriptive data was summarized using tables while inferential statistic done using Chi square and logistic regression. Data collection done through observation and semi- structured questionnaires. P value <0.05 was considered statistically significant.
Results: Overall, 219 (61.17%) students reported to have engaged in drug and illicit substance abuse with higher proportion reported among the Christians as compared to Islamic and Hinduism. Religion, Parental / guardian’s level of education and the person living with the student were found to significantly predict the abuse of drug and illicit substance among high school students (p<0.05).
Conclusion: Drug and illicit substance abuse remains a major public health problem among all age groups worldwide with several negative impacts. Due to its magnitude, it calls for concerted multi-sectorial effort by all stakeholders for the dream of drug free world to be achieved.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Participation of the population in decisions about their health and in the pr...Pydesalud
Póster presentado por Lilisbeth Perestelo en el congreso Summer Institute for Informed Patient Choice (SIIPC14) celebrado del 25 al 27 de junio de 2014 en Dartmouth, Hanover (EEUU). Web: http://siipc.org
Contacto: lperperr@gobiernodecanarias.org
Achievements and Implications of HIV Prevention Programme among Men who have ...inventionjournals
Background: Targeted interventions among men who have sex with men (MSM) could have a considerable effect in slowing the spread of HIV epidemic. This paper therefore presents the achievements and implications of HIV prevention programme among MSM in Bayelsa State, Nigeria Methods: The project was an intervention study carried out among MSM in Bayelsa State, Nigeria. The calculated sample size for this project was 155 MSM and snowball sampling technique was used for their selection. The project adopted the minimum prevention package intervention (MPPI) and data collected with output indicators were entered into the District Health Information Software (DHIS) 2, exported into Microsoft Excel and analysed using same. Results: The overall target population reached during this intervention was 381 MSM given a target reached of 245.8%. A total of 35 community dialogues were held within the duration of the intervention and 49 influencers participated. The number of peers registered during the intervention were 203 and out of the total number of condom (20582) required for this intervention, only 15235 (74.0%) were distributed. A total of 185 (91.1%) of the registered peers were reached with all the three stages of MPPI and 381 (245.8%) were reached with HCT. Among these, 17 (4.5%) were tested positive to HIV. Conclusion: This study showed an HIV prevalence of 4.5% among men who have sex with men in Bayelsa state at the time of the intervention. Given this high HIV prevalence, it is vital to enact more targeted and evidencebased prevention programs for these men.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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4.9%. In Kenya, 7 Counties had the highest burden of
HIV which include Homa Bay County 19.6%, Kisumu
County 17.5%, Siaya County 15.3%, Migori County
13.0%, Busia County 9.9%, Turkana County 6,8% and
Kisii County 6.1%.3
Within these seven counties, the HIV
burden varies and is more in specific segments of the
population, especially the key populations (KPs).4
Kenya has a spread HIV epidemic among the adult
population, but Key Populations (KPs) carry the huge
burden of the virus. They have a higher risk of exposure
to HIV infection and transmission.5
In Kenya, the Key
Populations consists of Female Sex Workers (FSW),
Male Sex Workers (MSW), Men Who have Sex with
Men (MSM), and the People Who Inject Drugs (PWID).
HIV prevalence is persistently high among KPs ranging
from an estimated 18.2% among MSMs, 29% among
FSW, and 18.7% among PWID. Busia county HIV
prevalence is 9.9 percent making it 5% higher compared
to the national HIV prevalence.3
Pre-exposure prophylaxis (PrEP) is an HIV prevention
approach used to reduce the rates of new HIV infections
among HIV negative people.6
The method consists of
antiretroviral drugs administered before a person exposes
himself/herself to the risk of HIV infection to reduce the
risk of disease and continues to use the medication for the
period they are exposed to the risk of infection.6
PrEP
involves the use of two co-formulated antiretroviral drugs
that is Tenofovir Disoproxil Fumarate (TDF) and
Emtricitabine (FTC), with the brand name Truvada.1
METHODS
Study setting
Matayos Sub County in Busia County was the setting for
the study. Of the 3839 total estimated number of KPs in
Busia County, 1554 CSWs, 72 PWIDs, and 160 MSMs
reside in Matayos Sub-County and were enrolled on
PrEP. Survivors Organization a Community-Based
Organization (CBO), ADT DIC, Apokoor Dispensary,
Madende Health Centre, Igara Dispensary, Busia County
Referral Hospital, Osieko DIC, Rukala DIC, Busangwa
DIC and Khajula DIC that works with KPs, and PrEP
were used to reach KPs seeking PrEP services in Matayos
Sub County.
Study design and participants
The study used an analytical cross-sectional design that
utilized mixed method which employed both qualitative
and quantitative data collection methods. To be included
in the study one had to be 18 years and above and willing
to participate in the study. You also had to be identified
as a Key Population, enrolled on PrEP, and must have
lived in Busia County for at least 6 months. The study
took a period of 9 months (Nov 2021 to July 2022).
Sampling
Busia County was purposively sampled among the 47
counties in Kenya. The reason for choosing Busia County
includes the county had a PrEP program being
implemented among KPs and had a prevalence rate of 9.9
% of HIV infection, which is higher compared to the
national prevalence of 4.9% according to NASCOP.
Matayos Sub County was equally selected using a
purposively as it hosts the most significant number of
PLWH in Busia County. KPs segment of the population
was sampled to participate in the study as the PrEP
program is majorly focused on the KPs due to their role in
the spread of HIV.7
Systematic random sampling was
applied to select KPs enrolled on PrEP in each health
facility or DIC.
Measurement
The Morisky scale-4 was used to determine the level of
adherence to PrEP by the respondents. The scale had four
questions with dichotomous response categories of yes or
no. The rationale behind the four items is that drug errors
of omissions may occur in any or all the four ways that is
forgetting, carelessness, stopping the drug when feeling
better or starting to use the drug when feeling worse or at
risk. A score of below 2 in the four items indicates
adherence and a score of 3 and 4 indicates nonadherence.
Data analysis
Quantitative data was cleaned and coded using MS Excel
software. The data analysis incorporated both descriptive
and inferential statistics. The analysis used descriptive
statistics to describe the data. Inferential statistics were
used to draw conclusions for the study. The study further
utilized univariate analysis to describe and summarize the
essential characteristics of the respondents. Bivariate
analysis (chi-square test) was used to examine the
relationship between dependent and independent
variables. Thematic analysis following the five stages of
thematic analysis: - familiarization, identification of the
themes, indexing, charting, mapping, and interpretation
was used to analyse qualitative data.
RESULTS
Socio-demographics
Majority (73%) of the participants were between the 18 to
27 years old, twenty percent 28 to 32 years and 7% were
above 33 years as shown in Table 1 below. 82% were
female and 18% were male. Majority of the KPs who
participated in the study were CSWs (85%), 8% were
MSMs while 7% were PWIDs. Among the participants
60% were single, 29% separated, 5% divorced and 9%
were married. 33% of the participants indicated that they
were either unemployed or self-employed, 20% were in
paid employment while 14% were students as illustrated
in Table 1. Majority of respondents had college/university
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education and secondary education 40% and 39%
respectively, 19% had primary education while 2% had
no formal education. A half of the participants had been
enrolled on PrEP for 5 months and below, 24% between 6
to 8 months, 11% 9 to 11 months, 5% 12 to 14 months
and 3% more than 15 months.
Table 1: Socio-demographic characteristics of respondents.
Variable Response Frequency Percentage (%)
Age (years)
18-22 123 36
23-27 129 37
28-32 68 20
33 and above 23 7
Gender
Male 63 18
Female 280 82
Key Population Type
CSWs 291 85
MSMs 27 8
PWIDs 25 7
Marital Status
Married 31 9
Single 206 60
Separated 90 26
Divorced 16 5
Occupation
Unemployed 112 33
Self Employed 113 33
Paid Employment 69 20
Students 48 14
Level of Education
No formal education 6 2
Primary 65 19
Secondary 134 39
College / University 138 40
Duration on PrEP
(Months)
3 -5 Months 196 57
6– 8 months 82 24
9 – 11 months 36 11
12 – 14 months 17 5
15- 18 months 12 3
Level of adherence
The Morisky scale-4 was used to determine the level of
adherence to PrEP by the respondents. 37% of the
participants were adherent to PrEP while 63% (216) were
non-adherent. Among the CSWs 35% were adherent and
65% were not adherent to PrEP. More than half of the
PWID were adherent to PrEP (52%) while 37% of the
MSMs were adherent. The study indicated that the longer
a KP is on PrEP the higher the adherence rate. 100% of
KPs who had been on PrEP for more than 13 months
were adherent while 44% of those who had been enrolled
on PrEP for between 10 to 12 months where adherent.
Among KPs who had been enrolled on PrEP for between
7 to 9 months 61% adherent. The group with the highest
percentage of non-adherent KPs was that enrolled for a
period of between 3 to 6 months with 70% non-adherent.
Socio-demographic factors and the adherence to PrEP
by KPs
Half of the participants aged 33 and above were adherent
to PrEP. However, the study established that the age of
the KP wasn’t a determinant for adherence to PrEP
(p=0.84) as shown in Table 2 below. KPs with no formal
education had the higher percentage of non-adherence to
PrEP. KPs with mid-level college education 46% were
adherent, primary education had 43% adherence level,
secondary education 28% and university education
recorded the highest levels of adherence at 69%.
Education had an association with PrEP adherence
(p=0.05). Widowed KPs had a higher adherence rate at
56% followed by married KPs at 48% and separated and
single KPs 32% and 36% adherence levels respectively.
Marital status had a significant statistical relationship
with PrEP adherence (P=0.011) as illustrated in Table 2
below. All the participants who reported to receive
support from family members were adherent while those
who received support from friends, partners and those
who did not receive any support had 31%, 38% and 40%
adherence levels. There was significant relationship
between the fear of stigma, place of residence, disclosure
of PrEP use with adherence to PrEP (p=0.000), while also
the occupation of the KPs was a big determinant for
adherence to PrEP (p=0.014). In addition, KP’s type was
established in the study to have influence on the
adherence to PrEP (P=0.034) as shown in Table 2.
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Table 2: Socio-demographic characteristics and PrEP adherence by KPs (n=343).
Independent
variable
Response Proportion
Dependent variable –
adherence to PREP
Statistical
significance
Social-
demographic
factors
Adherent
(n= 37%)
Non
adherent
(n=63%)
Adherent
(n= 127)
Non
adherent
(n=216)
Age (years)
18-22 15 85 18 105
Χ2
=44.26
DF=3
P=0.84
23-27 45 55 58 71
28-32 57 43 39 29
33-37 52 48 12 11
KPS category
CSWS 36 64 104 187 Χ2
=2.61
DF=2
P=0.034
MSMS 37 63 10 17
PWIDS 52 48 13 12
Marital status
Married 48 52 15 16
Χ2
=5.25
DF=3
P=0.011
Separated 32 68 29 61
Single 36 64 74 132
Widowed 56 44 9 7
Level of
education
Middle lev
college
41 59 50 72
Χ2
=16.59
DF=4
P= 0.05
No formal
education
0 100 0 6
Primary 43 57 28 37
Secondary 28 72 38 96
University 69 31 11 5
Occupation
Paid
employment
43 57 30 39
Χ2
=13.69
DF=4
P=0.014
Self employed 42 58 47 66
Student 16 84 7 37
Unemployed 38 62 43 69
Fear of stigma
No 37 63 29 50 Χ2
=0.004
DF=1
P=0.00
Yes 63 37 98 166
Health systems factors and the adherence to PrEP by
KPs
The study established statistically the PrEP service health
facility did not have any association with adherence to
PrEP by KPs (p=0.38). Among those who visited CBOs
for PrEP services 36% were adherent, FBOs 80%
adherent, GoK facility 81% adherent while those getting
the services from private facilities 58% were adherent as
detailed in Table 3. Majority (60%) of the KPs who
received PrEP services at night were adherent, in the
evening 43% adherent, afternoon 17% adherent, anytime
42% adherent, mid-day 73% adherent while morning
hours 23% adherent. Moreover, participants who spent
less than 30 minutes when seeking PrEP services majority
were adherent (68%), compared to those who spent 30
minutes to 1 hour 33% adherent and 1 to 2 hours 26%
adherent. Statistically, the time scheduled for PrEP clinic,
attitude of the health care provider offering PrEP services
and time spent in the health facility while seeking PrEP
services do not have any association to the adherence to
PrEP by KPs (P=0.38, p=0.98, p=0.87 respectively).
Accessibility to the facility where the KPs get PrEP
services 76% of those who indicated not accessible were
adherent while 39% of KPs who stated that their PrEP
service point was accessible were adherent. Statistically
therefore, the accessibility of the PrEP services facility
that is distance, cost and time had significant influence on
adherence to PrEP by KPs (P=0.00). The study
established that the side effects associated with PrEP had
equally a statistical significance to PrEP adherence by
KPs (P=0.001) as shown in Table 3.
Level of knowledge on PrEP by KPs
Most of the participants (50%) indicated that the
effectiveness of PrEP in preventing HIV is 70-90%. 74%
of the participants indicated they have received health
education on PrEP with 27% reporting to never have
received health education on PrEP. Among those who
reported to have received health education 66% received
health education on every visit while 30% and 4%
received health education every 3 months and 6 months
respectively. Additionally, 43% of the respondents
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indicate that their source of information on PrEP is
media, 39% friends, 34% health providers and 26% peer
educators. More than half of those who indicated that
PrEP protection from HIV was 70%-90% were adherent.
KPs who indicated that PrEP protects a person by 100%,
33% were adherent while 67% were non-adherent.
However, the study established that the level of protection
from HIV by PrEP had no statistical significance to
adherence to PrEP by KPs (p=0.20). Statistically,
receiving health education during PrEP service delivery
was established to have a significance on the level of
adherence by the Key Populations (p=0.00) as shown in
Table 4. The study also established the number of times
the KPs received health education on PrEP (p=0.29),
levels of satisfaction with the information they receive
during health education (p=0.56) and the source of
information on health education (p=0.95) did not have
any statistical significance to adherence to PrEP by KPs.
On the other hand, 36% of those who had knowledge of
PrEP side effects were adherent to PrEP compared to
38% who were adherent and reported not to have
knowledge of side effects of PrEP. Knowledge of side
effects was also measured for significance and the study
established that knowledge on side effects had a
significance influence of the adherence to PrEP by KPs
(p=0.00) as shown in Table.4.
Table 3: Health facility environment and PrEP adherence by KPs (n=343).
Independent
variable
Respondent
response
Proportions Dependent variable
Statistical
significance
Adherent
(n= 37%)
Non adherent
(n=63%)
Adherent
(N= 127)
Non adherent
(n=216)
PrEP service
health facility
CBO 36 64 36 60 χ2
= 48.06
FBO facility 80 20 16 4 df =4
GoK Facility 81 19 26 112 P=0.38
NGO Facility 53 47 27 24
Private health
facilities
58 42 22 16
Accessibility
No 76 24 9 29
χ2
=3.26
df=1
Yes 39 71 118 187 p= 0.00
PrEP services
scheduled time
At night 60 40 3 2 χ2
= 46.24
Evening 43 67 15 20 df=5
Afternoon 17 83 7 35 p= 0.37
Anytime 42 58 39 54
Mid-day 73 27 35 13
Morning Hours 23 77 28 92
Time spent
during PrEP
services visit
Less than 30 minutes 68 32 44 21 χ2
=33.99
1 hour to 2 hours 26 74 31 90 df=2
30 minutes to 1 hour 33 77 52 105 p=0.98
Side effect KPs
are most
worried about
Infertility 44 56 12 15 χ2
=21.29
Abdominal pain 69 31 11 5 df=7
Bone Weakness 25 75 1 3 p=0.001
Headache 30 70 16 37
Kidney Failure 23 77 7 24
Liver Failure 81 19 7 29
Weight Loss 64 36 9 5
None 40 60 64 98
Table 4: Level of Knowledge on PrEP and adherence to PrEP by KPs.
Independent
variable
Respondent
response
Proportions
Dependent variable –
adherence to PrEP
Statistical
significance
Knowledge
Adherent
(n= 37%)
Non
adherent
(n=63%)
Adherent
(n=127)
Non
adherent
(n=216 )
Level of protection
from HIV by PrEP
100% 33 67 18 37 χ2
=39.30
50% to 65% 23 77 21 72 df=3
70% to 90% 52 48 88 82 p=0.20
Continued.
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Independent
variable
Respondent
response
Proportions
Dependent variable –
adherence to PrEP
Statistical
significance
Below 50% 0 100 0 25
Do you receive
health education?
No 51 49 46 45
χ2
=9.71
df=1
Yes 32 68 81 171 p=0.00
How often they
received health
education?
Once in 3 months 12 88 9 66 χ2
=28.69
During every visit 40 60 67 100 df=3
Once in 6 months 50 50 5 5 p=0.29
Non 51 49 46 45
Satisfaction with
the health
education received?
Adequate 29 71 22 54 χ2
=30.02
Not Adequate 0 100 0 11 df=3
Somehow 15 85 11 60 p=0.56
Very Adequate 51 49 48 46
Source of
information on
PrEP
Peer educators 40 60 25 38 χ2
=6.71
Friends 44 56 42 53 df=3
Health providers 39 61 32 50 p=0.95
Media 27 73 28 75
Knowledge on the
side effects of PrEP
No 38 62 65 107
χ2
=0.09
df=1
Yes 36 64 62 109 p=0.00
DISCUSSION
Using the Morisky Medication Adherence Scale- 4
(MMSA-4) the study established that KPS adherent to
PrEP level is 37%. PrEP adherence level among the
different KP categories was 36%, 52% and 37% of
CSWs, PWIDs and respectively. The results of the study
were comparable with adherence rates of 40% in West
China among MSMs and 36% in a meta-analysis study
conducted among women in Canada.8,9
However, the
study was found to be inconsistent with the findings in
Latin America, South Africa, and Thailand (51%) and in
East Africa among sero-discordant couples (82%).10
This study assessed whether social demographic
characteristics influence adherence to PrEP. The findings
of this study were similar to a study conducted in Nairobi,
Kenya among seronegative participants which established
that level of education (p=0.01) has a significant
influence adherence to PrEP. In addition, the study
indicated that maturity and age of the KPs had influence
on adherence to PrEP which was similar to the findings of
this study where those between 18 to 22 years had the
highest percentage (85%) of non-adherence to PrEP.11
Furthermore, the study indicated place of residence of the
person (p=0.04) on PrEP influences adherence same to
the findings of this study. In addition, indicates in his
findings that partners support (p=0.04), disclosure
(p=0.04) and relationship status (p=0.04) impact
adherence to PrEP positively similar to this study.11
Another study conducted in Kenya is consistent with this
study indicating that occupation of the KPs have an
influence of the adherence.12
This study evaluated weather health facility factors affect
adherence to PrEP among the KPs. Accessibility in this
study had a significant influence on adherence to PrEP by
KPs. The results of this study were similar to the
conclusions of a study conducted in rural Uganda that
indicated that participants who lived more than 2 KMs
from the PrEP facility service point were less likely to
adhere to PrEP (p=0.024).13
Another study conducted in
Kenya; Nyanza is consistent with the findings of this
study that distance to the health facility offering PrEP
services was a barrier to adherence to PrEP among
fishermen enrolled on.14
Health education and knowledge of side effects of PrEP
in the study had statistical significance to adherence of
PrEP among KPs. A study conducted Europe among
women at high risk of contracting HIV, 59% of the
participants indicated that lack of information about PrEP
was the most had a high influence on adherence to PrEP
among participants.15
In a study conducted in Kenya the
results were consistent with the result of this study. The
study concluded that adherence to PrEP is facilitated by
proper and well-structured health education sessions to
the PrEP users. In this study in the first 3 months of
initiation on PrEP uptake and adherence to PrEP was high
at 81% and this was directly attributed to the increased
awareness enabled by individual and group health
education sessions at the points of service.16
In this study
the KII discussions illustrated the key role training to
health care workers and lack of adequate information on
PrEP. This was consistent with a qualitative study
conducted in Kenya which concluded that nurses need
more training on PrEP, adherence counselling and how to
manage Key Populations.14
In this study additionally the nature of the PrEP pill was
found to have a high significance to the adherence to
PrEP by KPs (p=0.001). This was consistent with the
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qualitative indicated that having to take the pill every day
affected adherence to PrEP among discordant couple,
widows, and female sex workers.14
In this study majority
of the participants (79%) who reported that the colour and
size of the PrEP pill were non-adherent while only 21%
were adherent. This was also well articulated in the KII
by the participants. This finding was different from a
study conducted in South Africa where the size of the pill
and the colour were significantly associated with good
adherence.17
Furthermore, the study found that side
effects of PrEP had a high significance to adherence of
KPs to PrEP (p=0.00). This is consistent with a study
conducted in South Africa among the MSMs that
indicated 74% of the participants stopped using or had
issues with adherence because of side effects as their
main reason.18
The study evaluated individual characteristics (drug and
alcohol use, use of condoms and other HIV prevention
strategies, number of sexual partners and the perceived
risk to HIV by KPs). The study established that 78%
missed their daily PrEP pill due to intoxication by alcohol
or other drugs. In addition, 64% indicated that condom
use affects their adherence to PrEP. When bivariate
analysis was conducted alcohol and drug use was found
to have significant influence on the adherence to PrEP by
KPs (p=0.00). A qualitative study conducted in USA is
consistent with this study indicating that alcohol and
other substance use is associated with adherence to
PrEP.19
In another study conducted among LGBTQ
community indicated that using drugs increased the
chances of missing the daily PrEP pill by 55% on the
same day and by 60% in the next day.20
This study also established that the use of condom has a
statistical significance to adherence to PrEP by KPs
(p=0.00). On the other hand, increase in the number of
sexual partners was on the rise 82% of participants
indicated to have one sexual partner before enrolling on
PrEP and 63% indicating to have 3 or more sexual
partners after enrolling on PrEP. This is consistent with a
study conducted in Mississippi that indicated that
individual risk behaviors also influence adherence to
PrEP.21
In a study carried out in South Africa indicates
that with the use of PrEP and the reduced risk of HIV due
to high adherence lowered condom use.22
This study has few limitations. The study area being a
boarder county with a higher incidence rate of Covid 19
compared to the national incidence made it difficult to
collect data because of adherence to MoH Covid 19
protocols. This occasioned data collection to take more
days compared to the planned time. The study coincided a
lot with other work-related assignments which prolonged
the study by two weeks as I was away engaged in end
year evaluations of program work. The study may have
been limited by the recruitment strategy used where the
KPs who had dropped out of the PrEP program were not
included. In addition, the participant’s recruitment
processes also missed KPs who had travelled or were not
available during the data collection period.
CONCLUSION
The study concluded that the adherence levels of KPs to
PrEP is 37%. In addition, the duration a person has been
enrolled on PrEP has an influence on adherence to PrEP
by KPs. Statically socio-demographic factors that were
found to have an influence on adherence to PrEP include
marital status, level of education, occupation, place of
residence, disclosure, and fear of stigma. Moreover,
accessibility to the PrEP service point and the side effects
of PrEP had a significant influence on adherence to PrEP
by KPs. In addition, receiving health education during the
visits for PrEP services was also influential to the
adherence to PrEP. Behavioural factors such as alcohol
use, use of condoms and number of sexual partners for
the MSMs were influencing adherence to PrEP.
Recommendations
Adherence to PrEP or any other treatment requires
teamwork of the KPs, community organizations, health
facilities and health care providers and policy makes
among other active participants. The specific
recommendations from this study include:
KPs need more information on how to use PrEP, how it
works, the side effects, what to do in case they experience
the side effects and why adherence to PrEP is important.
Health care providers should receive additional training
on PrEP, adherence counselling and friendly services
delivery.
The Busia County Department of health should create
PrEP service points away from the Comprehensive Care
Clinic (CCC) and the general out-patient clinic.
More sensitization and awareness creation programs
should be done in the community to reduce stigma around
PrEP and increase uptake of PrEP among those at risk of
HIV.
ACKNOWLEDGEMENTS
We would like to thank Dean and staff School of Public
Health of Mount Kenya University guidance and support.
We are also grateful to all Survivors CBO and KPs who
took part in this study, without them this publication
would not have been possible. Special thanks are
expressed to the health staff of the PrEP clinics of Busia
County, Matayos Sub- County for their kind cooperation.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the Mount
Kenya University Ethics Review Board
8. Barasa JW et al. Int J Community Med Public Health. 2023 May;10(5):1697-1704
International Journal of Community Medicine and Public Health | May 2023 | Vol 10 | Issue 5 Page 1704
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Cite this article as: Barasa JW, Kerochi A, Mogere D.
Adherence to HIV pre-exposure prophylaxis (PrEP)
among key populations: an analytical cross-sectional
study in Matayos Sub County, Busia County, Kenya.
Int J Community Med Public Health 2023;10:1697-
704.