The document summarizes key findings from a survey of 500 male sexual partners of adolescent girls and young women in Port-au-Prince, Haiti and 300 male sexual partners in St. Marc, Haiti. The survey assessed HIV risk behaviors, testing, and relationships. Key results include: 1) Over 60% of men reported concurrent sexual partnerships. Concurrency was higher among those in age-discordant relationships (over 5 years older). 2) Condom use at last sex was around 75-80% but lower among those who purchased sex and those at higher risk. 3) Confidence in obtaining and using condoms correctly correlated with increased condom use.
Seven Steps to EnGendering Evaluations of Public Health ProgramsMEASURE Evaluation
Because international development increasingly focuses on gender, evaluators need a better understanding of how to measure and incorporate gender—including its economic, social, and health dimensions—in their evaluations. This interactive training, consisting of this presentation and a tool, will help participants learn to better evaluate programs with gender components. Access the tool at https://www.measureevaluation.org/resources/publications/tl-19-40
Seven Steps to EnGendering Evaluations of Public Health ProgramsMEASURE Evaluation
Because international development increasingly focuses on gender, evaluators need a better understanding of how to measure and incorporate gender—including its economic, social, and health dimensions—in their evaluations. This interactive training, consisting of this presentation and a tool, will help participants learn to better evaluate programs with gender components. Access the tool at https://www.measureevaluation.org/resources/publications/tl-19-40
Lessons learned in using process tracing for evaluationMEASURE Evaluation
Access the recording for this Data for Impact (D4I) webinar at https://www.data4impactproject.org/lessons-learned-in-using-process-tracing-for-evaluation/
Collecting the PEPFAR OVC MER Essential Survey Indicators: Frequently Asked Q...MEASURE Evaluation
Gretchen Bachman and Christine Fu (USAID); Lisa Parker, Jenifer Chapman, Lisa Marie Albert, Walter Obiero, and Susan Settergren from MEASURE Evaluation. January 2017 Webinar.
Data for Impact hosted a one-hour webinar sharing guidance for using routine data in evaluations. More: https://www.data4impactproject.org/resources/webinars/routine-data-use-in-evaluation-practical-guidance/
Evaluating Impact of OVC Programs: Standardizing our methodsMEASURE Evaluation
Jen Chapman presents on the Orphans and Vulnerable Children Program Evaluation Tool Kit, which supports PEPFAR-funded programs and helps fulfill the aims presented in the USAID Evaluation Policy.
Webinar presentation by Susan Pietryzk. Access the webinar recording at http://www.measureevaluation.org/resources/webinars/measuring-impact-qualitatively
Ben Bavinton, (The Kirby Institute) discusses how the Opposites Attract' stdy will address the unanswered questions about wther treatment as prevention will work for gay men. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
Lessons learned in using process tracing for evaluationMEASURE Evaluation
Access the recording for this Data for Impact (D4I) webinar at https://www.data4impactproject.org/lessons-learned-in-using-process-tracing-for-evaluation/
Collecting the PEPFAR OVC MER Essential Survey Indicators: Frequently Asked Q...MEASURE Evaluation
Gretchen Bachman and Christine Fu (USAID); Lisa Parker, Jenifer Chapman, Lisa Marie Albert, Walter Obiero, and Susan Settergren from MEASURE Evaluation. January 2017 Webinar.
Data for Impact hosted a one-hour webinar sharing guidance for using routine data in evaluations. More: https://www.data4impactproject.org/resources/webinars/routine-data-use-in-evaluation-practical-guidance/
Evaluating Impact of OVC Programs: Standardizing our methodsMEASURE Evaluation
Jen Chapman presents on the Orphans and Vulnerable Children Program Evaluation Tool Kit, which supports PEPFAR-funded programs and helps fulfill the aims presented in the USAID Evaluation Policy.
Webinar presentation by Susan Pietryzk. Access the webinar recording at http://www.measureevaluation.org/resources/webinars/measuring-impact-qualitatively
Ben Bavinton, (The Kirby Institute) discusses how the Opposites Attract' stdy will address the unanswered questions about wther treatment as prevention will work for gay men. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
Jill Blumenthal, MD
Assistant Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
Georgia State School of Public Health Ph.D. student Rachel Culbreth discussed her research into HIV and other diseases among young people living in slum communities in Kampala, Uganda, during the APHA 2016 annual meeting in Denver. This is her presentation.
Oluwayemisi Ishola: Contraceptive Use Autonomy, Decision and Dependence Level...GetItTogetherNG
This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
This workshop is designed to talk about the impact of STDs on youth under the age of 25. This workshop will discuss the importance of sexual health screenings, partner management, and current data around STD morbidity rates. We will also talk about current STD clinical recommendations for the treatment of gonorrhea, chlamydia, and syphilis. Participants will engage in an interactive activity where they will sharpen their skills on effective partner management strategies.
This is the abstract presentation by Nicole Banister (Leveraging sport to improve perceptions of violence and sexual and reproductive health and rights for adolescents: Insights gained from Grassroot Soccer’s play-based approach in Papua New Guinea) which took place as part of the fourth session of #APCRSHR10 #Virtual on the theme of "Young people and sexual and reproductive health and rights in Asia and the Pacific" | more details are online at www.bit.ly/apcrshr10virtual4 Thanks
Utilizing HIV at-home testing and Telehealth TechonologyYTH
Through the use of telehealth technology, at-home HIV testing is brought to research participants in the comfort of their own home. This presentation explains the significance and impact of two active research studies of using telehealth for remote counseling sessions and at-home HIV testing from the University of Michigan.
Managing missing values in routinely reported data: One approach from the Dem...MEASURE Evaluation
This Data for Impact webinar was held in December 2020. Access the recording and learn more at https://www.data4impactproject.org/resources/webinars/managing-missing-values-in-routinely-reported-data-one-approach-from-the-democratic-republic-of-the-congo/
This Data for Impact webinar took place October 29, 2020. Learn more at https://www.data4impactproject.org/resources/webinars/use-of-routine-data-for-economic-evaluations/
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
HIV Risk and Service Use: Results of a Survey of Men in Port-au-Prince and St. Marc, Haiti, 2019
1. HIV Risk and Service Use:
Results of a Survey of Men
in Port-au-Prince and
St. Marc, Haiti, 2019
The DREAMS Study Team
Port-au-Prince, Haiti
June 26, 2019
2. Five-year global cooperative agreement and USD $232M
6 partners, led by the University of North Carolina at Chapel Hill (UNC)
Strategic objective:
To build capacity of developing countries to collect, interpret, and use
data to improve health
3. Local partners and capacity building
Prime: UNC and partners:
ICF
John Snow, Inc.
Management Sciences for Health
Palladium
Tulane University
MEASURE Evaluation works with more than 72
smaller contractors in more than 27 countries
More than 26% of project funding goes to
smaller subcontractors
5. DREAMS
• A global partnership to help girls develop into
Determined, Resilient, Empowered, AIDS-free,
Mentored and Safe women
• Implemented in select countries, including Haiti, where
there is a high prevalence of HIV and adolescent girls
and young women (AGYW) are at increased risk for
HIV
A global initiative
7. Male characterization studies
• HIV interventions that focus on male partners in
addition to AGYW may have greater impact.
• Limited information exists from the perspective of
male partners of AGYW globally and in Haiti.
• In Haiti, women are twice as likely to acquire HIV
as men, but they report less risk. Addressing the
risk posed by their male partners is important.
Schaefer, R., Gregson, S., Eaton, J. W., et al. (2017). Age-disparate relationships and HIV incidence in
adolescent girls and young women: Evidence from Zimbabwe. AIDS, 31(10):1461−1470.
Fawzi, M. C., Lambert, W., Boehm, F,, et al. (2010). Economic risk factors for HIV infection among women in
rural Haiti: Implications for HIV prevention policies and programs in resource-poor settings. Journal of Women’s
Health,19(5):885−892.
8. Study goal
To increase understanding of HIV
sexual risk behavior, HIV testing
and treatment, and sexual
partnerships from the perspective of
male sexual partners of AGYW in
Haiti
9. Methods
• Cross-sectional survey
• 500 male sexual partners of AGYW, Port-au-Prince
• 300 male sexual partners of AGTW, St. Marc
• Questionnaire (approximately 45 minutes long) was
administered by interviewer,
• Eligibility criteria:
• 18 years of age or older
• AGYW sexual partner, past 12 months
• In study area past 3 months1
• Provided informed consent
• Study sites:
• Delmas area of Port-au-Prince
• St. Marc
1 Lived, worked, or studied in area during past 3 months
10. Sample selection
• Respondent-driven sampling
(RDS) is a type of sampling that
can be used when there is no
sampling frame (e.g., list to
select from)
• Each participant is given a
limited number of coupons to
recruit others (3 in this study)
• Analysis is done to check that
respondents vary from the initial
seed
Respondent-driven sampling
INCENTIVES
Primary Haitian
gourdes (HTG) 500
in phone cards.
HTG 250 transport.
Secondary: HTG
150
11. Fieldwork
• Field office located in Delmas
neighborhood of Port-au-Prince and
St. Marc
• Each team consisted of 1
supervisor, 1 coupon manager,
1 receptionist, and 3 interviewers.
• Data collection period: February
6−March 22, 2019
• Sociopolitical unrest from February
8−17 affected fieldwork
Mackenson Michel, coupon manager for the
Port-au-Prince field site.
Photo: Ralph Stevens Jeudi. Both Mr. Jeudi
and Mr. Michel are with the Pentagone
Consulting Group.
12. Recruitment
• Port-au-Prince • Saint-Marc
The coupon return rate was 93%
(352/377). During the screening, 52
were deemed ineligible based on
study criteria (14,7% or 52/352).
The coupon return rate was 91%
(551/605). During the screening, 51
were deemed ineligible based on study
criteria (9.3% or 51/605).
605
551
500
51
Coupons
distributed
Coupons
returned
Eligible Ineligible
Coupon distribution and return
Port-au-Prince
377 352
300
52
Coupons
distributed
Coupons
returned
Eligible Ineligible
Coupon distribution and return St.
Marc
13. Survey instrument
Sections:
1. Eligibility
2. Sociodemographics
3. Condom use
4. Sexual risk behavior
5. Alcohol and drug use
6. Partner-specific sexual risk
behavior and relationship
dynamics (up to 3 partners, past
12 months)
7. HIV knowledge
8. HIV testing
9. HIV treatment (for those HIV+)
10. Gender norms
Approximately 45-60
minutes to complete
14. Data analysis
• Data analyzed separately for each site*
• RDS diagnostics and calculation of sampling
weights** conducted in RDS Analyst
• Frequencies and bivariate and multivariate
analysis conducted in Stata using exported
population weights
* RDS data are a sample of a social network; prohibits pooling across cities
** Giles RDS-SS estimator used to calculate population weights using
participant’s social network size and population estimates
17. Study sample characteristics
Port-au-Prince
• Average age: 25 years
• 81% report secondary school as highest level of education;
42% currently in school
• 27% report having children─3 on average
• Average monthly income Haitian gourdes (HTG) $4,734; 60%
report not having enough food in past month
St. Marc
• Average age: 24 years
• 77% report secondary school as highest level of education;
68% currently in school
• 14% report having children─5 on average
• Average monthly income HTG$4,873; 36% report not having
enough food in past month
Sociodemographics
18. Percentage ever participated in an HIV
education activity
44%
39%
0% 100%
Ever participated in an educational
activity like a workshop or
presentation about HIV/sexually
transmitted infection (STI)
Port-au-Prince St. Marc
19. HIV-related survey results
Part 1: Sexual risk behavior, focus on
condom use
Part 2: HIV testing and HIV treatment
Part 3: Sexual relationships, focus on
intimate partner violence (IPV)
20. Sexual risk behavior
Port-au-Prince
• Age of sexual debut: 15 years (average)
• Lifetime number of sexual partners: 14 (average)
• Paid for sex in the past 12 months: 12%
St. Marc
• Sexual debut: 15 years (average)
• Lifetime number of sexual partners: 12 (average)
• Paid for sex in the past 12 months: 6%
21. Concurrent sexual partnerships
61%
39%
Port-au-Prince
No Yes
61%
39%
St. Marc
No Yes
A concurrent sexual partnership is defined as one that
overlaps in time with another sexual partnership.
• Participants were asked to report the start and end dates of sexual
partnerships for up to 3 partners in the past 12 months. Those
reporting overlapping partnerships were recorded as “yes” for
concurrency.
22. Age-discordant partnership
64%
36%
Port-au-Prince
No Yes
81%
19%
St. Marc
No Yes
In this study, an age-discordant sexual partnership is defined
as one in which the male participant is >5 years older than his
female partner.
• Participants were asked to report the age of their sexual partner for up
to 3 partners in the past 12 months. Those whose age was >5 years
older than any of these partners is recorded as “yes” for age
discordance.
23. Age discordance and concurrency
Port-au-Prince
55%
29%
45%
71%
0%
100%
> 5 years older Same/similar age
Percentage concurrent, by age discordance
Yes No
24. Age discordance and concurrency
St. Marc
69%
31%
31%
69%
0%
100%
> 5 years older Same/similar age
Percentage concurrent, by age discordance
Yes No
25. “High-risk” male sexual partners
20%
80%
0% 50% 100%
Age-
discordant
and…
Lower sexual
risk
Port-au-Prince
Age-discordant and concurrent
Lower sexual risk
13%
87%
0% 50% 100%
Age-
discordant
and…
Lower sexual
risk
St. Marc
Age-discordant and concurrent
Lower sexual risk
Age-discordant and concurrent
27. Percentage reporting condom use at last
sex, by education
90%
82%
64%
0% 50% 100%
University
Secondary
None-primary
Port-au-Prince
University Secondary
None-primary
*
*
77%
75%
75%
0% 50% 100%
University
Secondary
None-primary
St. Marc
University Secondary
None-primary
• Age and income not associated with condom use at last sex
• Increased education also significantly associated with condom use at last sex
with partner 1, and having condom at time of interview in Port-au-Prince
28. Percentage reporting condom use at last
sex, by purchase of sex
67%
83%
0% 50% 100%
Purchased sex
Did not
purchase sex
Port-au-Prince
Purchased sex
Did not purchase sex
*
*
*
58%
76%
0% 50% 100%
Purchased sex
Did not
purchase sex
St. Marc
Purchased sex
Did not purchase sex
• Question worded: In the last 12 months have you given someone money,
drugs, clothing, food, or a place to sleep in exchange for sex?
29. Percentage reporting condom use at
last sex, by sexual risk
79%
81%
0% 50% 100%
Age-
discordant
and…
Lower sexual
risk
Port-au-Prince
Age-discordant and concurrent
Lower sexual risk
69%
78%
0% 50% 100%
Age-
discordant
and…
Lower sexual
risk
St. Marc
Age-discordant and concurrent
Lower sexual risk
30. Where participants get condoms
5%
3%
9%
35%
4%
17%
69%
8%
14%
19%
28%
32%
37%
80%
0% 20% 40% 60% 80% 100%
Clinic
Outreach worker
Mobile clinic
Friend
Pharmacy
Store
Drop-in center
Port-au-Prince St. Marc
Port-au-Prince
31. Confidence in ability to obtain and
use condoms
71%
94%
95%
78%
96%
92%
Have a condom if you needed one
Use a condom correctly
Tell your partner you want to use
condoms
How confident are you that you could…
Port-au-Prince St. Marc
Men with higher levels of confidence in these three
areas were more likely to use a condom at last sex.
32. Perception of condom use among
closest friends
52%48%
Port-au-Prince
None/few/half Most/All
61%
39%
St. Marc
None/few/half Most/All
Question worded: How many of your closest friends do you think
use condoms when they have sex?
33. Percentage reporting condom use at last sex,
by perception of friend condom use
89%
74%
0% 50% 100%
Most, all friends
use condoms
None, few,
some friends
use condoms
Port-au-Prince
Most, all friends use condoms
None, few, some friends use condoms
*
*
89%
70%
0% 50% 100%
Most, all
friends use
condoms
None, few,
some friends
use condoms
St. Marc
Most, all friends use condoms
None, few, some friends use condoms
*
*
34. Sexual communication skills
91%
82%
90%
71%
It is easy to talk to my partner
about condoms
It is easy to talk to my partner
about sex
Port-au-Prince St. Marc
Percentage reporting “agree” and “strongly agree” in response to the statement
35. Percentage reporting condom use at last
sex, by sexual communication
83%
53%
0% 50% 100%
Agree/ strongly
agree
Disagree/
strongly…
Port-au-Prince
*
*
80%
46%
0% 50% 100%
Agree/ strongly
agree
Disagree/
strongly…
St. Marc
*
**
It is easy to talk about condoms with this partner…
36. HIV-related survey results
Part 1: Sexual risk behavior, focus on
condom use
Part 2: HIV testing and HIV treatment
Part 3: Sexual relationships, focus
on IPV
38. Where men accessed HIV testing
19%
2%
2%
9%
32%
37%
1%
1%
8%
11%
34%
45%
Health post
Healthcare worker/peer…
Private hospital
Mobile clinic
Health center
Public hospital
Port-au-Prince St. Marc
39. Percentage who tested for HIV, by
sexual risk behavior
65%
81%
84%
60%
60%
57%
Condom use at last sex
Bought sex past 12…
Age-discordant and…
Port-au-Prince
No Yes
55%
82%
73%
59%
53%
52%
Condom use at last sex
Bought sex past 12…
Age-discordant and…
St. Marc
No Yes
*
*
*
*
40. Top three reasons for not having
tested for HIV
48%
13%
45%
35%
35%
21%
0% 50% 100%
I am not interested in HIV
testing
I am afraid of HIV testing
I don't think I'm at risk for
HIV
Port-au-Prince St. Marc
41. Motivations for HIV testing
5%
9%
13%
9%
41%
10%
10%
9%
10%
32%
0% 50%
Because I was about to marry
Because I had a doubt
On a doctor's request
Conversation with or support from
spouse/partner
Part of routine healthcare
Port-au-Prince St. Marc
42. People who influence men’s
HIV testing
0%
0%
6%
4%
4%
33%
0%
6%
9%
6%
4%
37%
0% 50%
Peer educator/mentor
Doctor/healthcare worker
Friends
Parents
Relatives
Sexual partner
Port-au-Prince St. Marc
Question worded: Can your _____ influence you to test for HIV?
43. Sexual partner communication about
HIV testing
Port-au-Prince
50%
0% 50% 100%
Talked about HIV
testing with most
recent AGYW
sexual partner
Yes
30%
44%
54%
My HIV status
Her HIV status
Testing together
HIV testing topic
discussed with AGYW
sexual partner (n=251)
44. Sexual partner communication about
HIV testing
St. Marc
47%
0% 50% 100%
Talked about HIV
testing with most
recent AGYW
sexual partner
Yes
20%
59%
38%
My HIV status
Her HIV status
Testing together
HIV testing topic
discussed with AGYW
sexual partner (n=134)
45. Percentage who tested for HIV, by testing
communication with sexual partner
83%
55%
0% 50% 100%
Discussed HIV
testing with a…
Did not discuss
HIV testing…
Port-au-Prince
*
*
73%
46%
0% 50% 100%
Discussed HIV
testing with a…
Did not discuss
HIV testing…
St. Marc
*
**
Men were asked if they discussed HIV testing with their 3 most
recent sexual partners in the past 12 months. Those who
discussed HIV testing with any partner are compared to those
who did not.
46. Perception of HIV testing among
closest friends
66%
34%
Port-au-Prince
None/few Half/almost all
75%
25%
St. Marc
None/few Half/almost all
Question worded: How many of your closest friends do you think
have tested for HIV?
47. Percentage who tested for HIV, by
perception of friend HIV testing
85%
53%
0% 50% 100%
Half to almost
all friends have
tested for HIV
None, few
friends have
testd for HIV
Port-au-Prince
*
*
75%
51%
0% 50% 100%
Half to almost
all friends have
tested for HIV
None, few
friends have
tested for HIV
St. Marc
*
*
48. Self-reported HIV status
6%
94%
HIV status
Port-au-Prince
Negative, don't know HIV+
1%
99%
HIV status
St. Marc
Negative, don't know HIV+
• 30 men self-reported as HIV+
o 29 HIV+ men in Port-au-Prince
o 1 HIV+ man in St. Marc
49. Antiretroviral therapy (ART)
HIV+ participants, n=30
• All HIV+ participants report taking ART for HIV at
some point.
• 4/30 HIV+ participants stopped ART at some
point.
• 27/30 HIV+ participants are currently taking ART.
• Almost all HIV+ men (29/30) access ART from a
health center; some (7/30) access ART through a
hospital.
50. ART adherence
HIV+ participants on ART, n=27
1
1
4
7
14
0 9 18 27
Number of HIV+
participants currently on
ART reporting missed
doses of ART in the past 4
days
No days missed
One day missed
Two days missed
Three days missed
Four days missed
51. Sexual risk behavior among HIV+
men in the past 12 months
28
Age discordance, n=30
No Yes
11
19
Sexually concurrent partnership, n=30
No Yes
HIV+ participants report:
• 5 sexual partners on average (range 1−20);
• 2 new sexual partners on average (range 0−15)
52. Condom use at last sex among
HIV+ men
12
18
0
10
20
Number reporting condom use at last sex with
AGYW sexual partner (n=30)
No Yes
53. Posttest counseling for HIV+ men
HIV+ participants, n=30
What were you recommended to do after receiving
your HIV test result?
16
19
19
24
29
30
Talk to sexual partners about HIV testing
Join a support group
Remain faithful to one sex partner
Get my CD4 checked
Use condoms every time
Start drug treatment
54. Disclosure of HIV status
HIV+ participants, n=30
11
0 30
Does anyone in
your personal life
know you are
HIV+?
Yes
1
1
1
3
3
3
3
4
9
Mother/aunt
Child
Borther/sister
Peer navigator
Male friend
Who knows you are HIV+?
(n=11)
55. HIV-related survey results
Part 1: Sexual risk behavior, focus on
condom use
Part 2: HIV testing and HIV treatment
Part 3: Sexual relationships, focus on
intimate partner violence (IPV)
56. Perpetration of IPV against AGYW
sexual partner
4%
3%
1%
73%
Ridiculed or criticized…
Put down her physical…
Put her down in front…
Tried to control what…
Emotional violence
Yes
17%
8%
Forced her to have sex
Hit, pushed, slapped,
punched, or kicked her
Physical violence
Yes
Port-au-Prince
Violence perpetration reported for most recent AGYW sexual partner
57. Perpetration of IPV against AGYW
sexual partner
10%
7%
6%
65%
Ridiculed or criticized…
Put down her physical…
Put her down in front…
Tried to control what…
Emotional violence
Yes
20%
7%
Forced her to have
sex
Hit, pushed, slapped,
punched or kicked…
Physical violence
Yes
St. Marc
Violence perpetration reported for most recent AGYW sexual partner
58. Sexual risk behavior by physical IPV
22%
26%
16%
23%
20%
25%
Condom use at last…
Concurrent
Age-discordant
Port-au-Prince
No Yes
19%
36%
28%
40%
17%
23%
Condom use at last…
Concurrent
Age-discordant
St. Marc
No Yes
*
*
*
*
Violence perpetration and sexual risk behavior reported for most recent AGYW sexual
partner
59. Equity in relationship power with most
recent AGYW sexual partner
66%
36%
45%
49%
34%
36%
40%
42%
26%
50%
48%
44%
50%
49%
40%
42%
8%
14%
7%
7%
16%
15%
20%
16%
0% 50%
In general, who has more power?
The type of sexual acts you do
Whether you use condoms
When you talk about serious things
How often you see one another
What you do together
Whether you have sex
Who you go out with
AGYW partner Both of us Me
Reported for most recent AGYW sexual partner
Who usually has more say about…
Port-au-Prince
60. Equity in relationship power with most
recent AGYW sexual partner
72%
43%
62%
42%
34%
40%
42%
48%
18%
29%
29%
42%
41%
40%
32%
31%
10%
28%
9%
15%
26%
20%
26%
21%
0% 50%
In general, who has more power?
The type of sexual acts you do
Whether you use condoms
When you talk about serious things
How often you see one another
What you do together
Whether you have sex
Who you go out with
AGYW partner Both of us Me
Reported for most recent AGYW sexual partner
Who usually has more say about…
St. Marc
61. Sexual risk behavior by relationship
equity
43%
30%
36%
51%
52%
48%
Condom use at last sex
Concurrent
Age-discordant
Port-au-Prince
No Yes
37%
37%
21%
32%
35%
38%
Condom use at last sex
Concurrent
Age-discordant
St. Marc
No Yes
*
*
Reported for most recent AGYW sexual partner
62. Conclusions
• Results confirm need for increased HIV services for
male partners (education, access to condoms, testing,
and treatment support)
• There is a higher-risk subset of AGYW male partners not
sufficiently reached with effective HIV interventions
• HIV+ partners report low ART adherence and continued
sexual risk behavior
• An increase in condom use and HIV testing may be
achieved through:
• Increased access
• Promotion of communication in sexual partnerships
• Using social norms in messaging
• Using peer groups to promote behaviors
63. Points for discussion
• Survey results from men show an increase in condom
use and HIV testing when men talk about these issues
with AGYW sexual partners.
• Meetings with DREAMS girls suggest that girls don’t
think they can influence their male partners to get
tested.
I think they have to decide for themselves, they are not
children. The only thing I say to him is that I am HIV-
negative and wish he is also negative.
If I influence him, it may be unconsciously when I told
him about my HIV status.
64. Points for discussion
• Survey results from men show that perpetration of
emotional and physical violence is a common
problem. Relationship power is also low for many of
the AGYW.
• Meetings with DREAMS girls suggest girls also think
men have more power in the relationship. Some feel
they are still able to influence such things as condom
use.
We both have power to decide on that. I would never let
him force me to do sex without condoms.
65. Points for discussion
• Survey results from men show a need for more
HIV services for this group.
• Meetings with DREAMS girls indicate that girls
agree that men need these services and suggest
replicating the DREAMS intervention with boys
and men.
I think they can either offer the [HIV] testing at
school or within a program like DREAMS for the
boys.
If it were not for DREAMS and FOSREF, I would
never accepted to get tested for HIV…So it can work
for the boys also.”
66. Acknowledgments
Field staff:
• Suzette Etienne
• Valery Michel
• Ralph Stevens Jeudi
• Mackenson Michel
• Marie Yvelene Eliacin
• Regine Noel
• Linetcheli Michel
• Cecile Luxamar
• Rony Brignolle
68. This presentation was produced with the support of the United States Agency
for International Development (USAID) under the terms of MEASURE
Evaluation cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation
is implemented by the Carolina Population Center, University of North
Carolina at Chapel Hill in partnership with ICF International; John Snow, Inc.;
Management Sciences for Health; Palladium; and Tulane University. Views
expressed are not necessarily those of USAID or the United States
government.
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