Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
This study examined the relationship between knowledge of HIV transmission and prevention and HIV counselling and testing uptake among young people in Nigeria. The study is a quantitative research guided by one research question and one hypothesis. The target population comprised young people in Nigeria ages 15 to 24 years because the focus of this study was to identify the factors affecting HCT uptake among young people in this age cohort. The representative sample was obtained from the updated master sample frame of rural and urban zones developed by the National Population Commission in Nigeria. This master sample frame was a national survey that comprises all 36 states in Nigeria [2]. Probability sampling technique was used to obtain a sample of 10091 respondents (ages 15 to 24 years) for the study. The multistage cluster sampling was used to select suitable young people with known probability. Data were collected throughout Nigeria between September and December 2012 from 32,543 households (rural = 22,192; urban = 10,351) using structured and semi-structured questionnaires. The individual questionnaires asked about household characteristics, background characteristics of the respondents. Data were analyzed by inputing them into SPSS v21.0 for analysis [4] and then coded them for each participant. The data were summed using descriptive statistics. Frequencies and percentages; measures of central tendencies were used to answer the research question while nonparametric test such as chi-square was used to analyze non-normally distributed data at 0.5 level of significance. Results of data analysis indicated that the cognitive factors of knowledge of HIV prevention and knowledge of HIV transmission were statistically significant predictors of the likelihood of having HCT uptake. It was among others recommended that stakeholders, authorities, and providers of health services in Nigeria should strive to increase the rate of HCT uptake among young people ages 15 to 24 years.
Achievements and Implications of HIV Prevention Programme among Female Sex wo...QUESTJOURNAL
Background: Plateau State, Nigeria with HIV prevalence rate of 7.7% as at 2010 had among the highest HIV and syphilis levels in Nigeria, earning itself a reputation of being one of the 12 + 1 states contributing the highest HIV prevalence in Nigeria and described as “hot zone” of HIV infections. Factors responsible for this were not unrelated to the high-risk activities of Female Sex Workers (FSWs). This paper therefore presents achievements and implications HIV prevention among FSWs in Plateau State, Nigeria Methods: This project was an intervention effort focused on delivering evidence-based HIV prevention activities among FSWs in 3 local government areas within the State. The estimated target population for the study was 460 and this project used the minimum prevention package intervention (MPPI). Peer educators were selected and trained among the FSWs to reach out to their peers using cohort session. Data were documented using various monitoring and evaluation tools, entered on the District Health Information Software version 2 and analyzed using Microsoft Excel. Results: A total of 68 community dialogues were held with 1,466 influencers participating in the process. In addition, 601 peers were registered, while 18 persons benefitted from 27 income generation activities aimed at capacity building for FSWs. A total of 642 persons were counseled, tested and shown their results, with 15 persons tested positive resulting in HIV prevalence of 2.3%. Although 10,560 condoms were distributed however, these numbers was below the number of condoms required during the intervention. Conclusion: This intervention was a success. However, more needs to be done with regards to condom distribution and supply among FSWs since there is a crucial role for FSWs to play in the plot of taking the HIV prevalence of Plateau State even further down
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ...Razak Mohammed Gyasi
Since 2003, the HIV Voluntary Counselling and Testing (VCT) has been identified as one of the key strategies in the HIV/AIDS prevention, control and care programmes in Ghana. However, utilization of this service is low among Ghanaian youth. This study examined predictors associated with VCT utilization among youth in Ghana. This study utilized quantitative and qualitative data in a cross-sectional survey in three sub-metropolitan areas in Kumasi. Using a multi-variate regression, evidence from 120 respondents showed potential factors associated with VCT utilization. The qualitative data were subjected to a content analysis through direct quotes. The results suggest that less than 30% of the youth had ever tested for HIV through VC. Women were more likely to avail themselves for counselling testing than men. Psychological and emotional trauma experienced by the seropositive, lack of confidentiality, proximity to VCT sites, HIV-related stigma inter alia, were found to be strongly associated with HIV VCT in the study prefecture. VCT utilization among the youth in Ghana was low and affected by HIV/AIDS-related stigma and residence. In order to increase VCT acceptability, HIV/AIDS prevention and control programs in the country should focus on reducing HIV/AIDS-related stigma.
This study examined the relationship between knowledge of HIV transmission and prevention and HIV counselling and testing uptake among young people in Nigeria. The study is a quantitative research guided by one research question and one hypothesis. The target population comprised young people in Nigeria ages 15 to 24 years because the focus of this study was to identify the factors affecting HCT uptake among young people in this age cohort. The representative sample was obtained from the updated master sample frame of rural and urban zones developed by the National Population Commission in Nigeria. This master sample frame was a national survey that comprises all 36 states in Nigeria [2]. Probability sampling technique was used to obtain a sample of 10091 respondents (ages 15 to 24 years) for the study. The multistage cluster sampling was used to select suitable young people with known probability. Data were collected throughout Nigeria between September and December 2012 from 32,543 households (rural = 22,192; urban = 10,351) using structured and semi-structured questionnaires. The individual questionnaires asked about household characteristics, background characteristics of the respondents. Data were analyzed by inputing them into SPSS v21.0 for analysis [4] and then coded them for each participant. The data were summed using descriptive statistics. Frequencies and percentages; measures of central tendencies were used to answer the research question while nonparametric test such as chi-square was used to analyze non-normally distributed data at 0.5 level of significance. Results of data analysis indicated that the cognitive factors of knowledge of HIV prevention and knowledge of HIV transmission were statistically significant predictors of the likelihood of having HCT uptake. It was among others recommended that stakeholders, authorities, and providers of health services in Nigeria should strive to increase the rate of HCT uptake among young people ages 15 to 24 years.
Achievements and Implications of HIV Prevention Programme among Female Sex wo...QUESTJOURNAL
Background: Plateau State, Nigeria with HIV prevalence rate of 7.7% as at 2010 had among the highest HIV and syphilis levels in Nigeria, earning itself a reputation of being one of the 12 + 1 states contributing the highest HIV prevalence in Nigeria and described as “hot zone” of HIV infections. Factors responsible for this were not unrelated to the high-risk activities of Female Sex Workers (FSWs). This paper therefore presents achievements and implications HIV prevention among FSWs in Plateau State, Nigeria Methods: This project was an intervention effort focused on delivering evidence-based HIV prevention activities among FSWs in 3 local government areas within the State. The estimated target population for the study was 460 and this project used the minimum prevention package intervention (MPPI). Peer educators were selected and trained among the FSWs to reach out to their peers using cohort session. Data were documented using various monitoring and evaluation tools, entered on the District Health Information Software version 2 and analyzed using Microsoft Excel. Results: A total of 68 community dialogues were held with 1,466 influencers participating in the process. In addition, 601 peers were registered, while 18 persons benefitted from 27 income generation activities aimed at capacity building for FSWs. A total of 642 persons were counseled, tested and shown their results, with 15 persons tested positive resulting in HIV prevalence of 2.3%. Although 10,560 condoms were distributed however, these numbers was below the number of condoms required during the intervention. Conclusion: This intervention was a success. However, more needs to be done with regards to condom distribution and supply among FSWs since there is a crucial role for FSWs to play in the plot of taking the HIV prevalence of Plateau State even further down
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.
Factors Influencing the Uptake of National Health Insurance Schemes among the...Premier Publishers
Purpose: Penetration of health insurance in the informal sector is very poor, this calls for upward scaling of successful interventions to remedy this situation given that health insurance increases access to healthcare services and improves financial risk protection. This study assessed the factors influencing uptake of national health insurance schemes among informal sector in Vihiga sub-county, Kenya.
Methods: Descriptive cross-sectional study design was used. The target population was the informal sector workers. A sample of 384 participants was selected by cluster and simple random sampling techniques. Data was collected using a semi-structured questionnaire. Descriptive statistics was summarized using tables, chi-square and bivariate logistic regression were used to test for associations (p<0.05).
Results: The study revealed that there was a significant influence of trust and knowledge of the health insurance scheme on the uptake of national health insurance (p < 0.05). The study further revealed that the attractiveness of the scheme had a big influence on the uptake of national health insurance
Conclusion: Trust and knowledge of the health insurance scheme had significant influence on uptake of national health insurance. Health Insurance Schemes should be designed in such a way that they attract informal sector workers and information regarding these schemes is disseminated to these people.
Achievements and Implications of HIV Prevention Programme Among Out of School...inventionjournals
Background: The increasing number of sexually transmitted infections including HIV/AIDS among the youths in sub-Saharan Africa indicates that successive efforts towards preventing the scourge remain inadequate in the continent. Preventing the spread of HIV infection among youths aged 15 – 24 years is critical to reducing the incidence of new HIV infection. This paper therefore presents HIV prevention programme among Out of School Youths (OSYs) in Kogi State, Nigeria. Methods: This intervention was carried out among out-of-school youths in 7 randomly selected Local Government Areas (LGAs) in the state with a total target population of 19, 600 OSY. One hundred and twenty (120) OSY comprising (68 males and 52 females) were recruited and trained as Peer Educators. Activities carried out included structural, behavioural and biomedical interventions using the Minimum Prevention Package for Intervention (MPPI) strategy. Data were documented using various monitoring and evaluation tools and entered in the DHIS2 platform. The data were later exported into Microsoft Excel and analysed using same. Results: Three hundred and three community dialogues were held within the 2-years period with 672 participants and 25787 peers recruited by the peer educators resulting in 131.6% of the estimated target population. A total of 8812 of out of school youths were counselled, tested and received results for HIV. Among these, a total of 175 (2.0%) were tested positive. Conclusion: Effective implementation of minimum prevention package for intervention in HIV/AIDS prevention programme carried out in these communities could be attributed to the dialogues held at the commencement of the project. However, there are still shortfalls in attainment of the expected results. It is therefore recommended that there be increased integration of services and decentralization of MPPI activities to primary health care centers and rural communities, stepwise supervision and monitoring of HIV prevention activities be strengthened and engagement of all tiers of governance to engender political commitment and ownership of the HIV response with a view of ensuring sustainability of these programmes.
Delivering community-led integrated HIV and sexual and reproductive health services for sex workers: A mixed methods evaluation of the DIFFER study in Mysore, South India
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Educational and Occupational Maternal Attitude towards Prevention of Malaria ...iosrjce
IOSR Journal of Humanities and Social Science is a double blind peer reviewed International Journal edited by International Organization of Scientific Research (IOSR).The Journal provides a common forum where all aspects of humanities and social sciences are presented. IOSR-JHSS publishes original papers, review papers, conceptual framework, analytical and simulation models, case studies, empirical research, technical notes etc.
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
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.
Factors Influencing the Uptake of National Health Insurance Schemes among the...Premier Publishers
Purpose: Penetration of health insurance in the informal sector is very poor, this calls for upward scaling of successful interventions to remedy this situation given that health insurance increases access to healthcare services and improves financial risk protection. This study assessed the factors influencing uptake of national health insurance schemes among informal sector in Vihiga sub-county, Kenya.
Methods: Descriptive cross-sectional study design was used. The target population was the informal sector workers. A sample of 384 participants was selected by cluster and simple random sampling techniques. Data was collected using a semi-structured questionnaire. Descriptive statistics was summarized using tables, chi-square and bivariate logistic regression were used to test for associations (p<0.05).
Results: The study revealed that there was a significant influence of trust and knowledge of the health insurance scheme on the uptake of national health insurance (p < 0.05). The study further revealed that the attractiveness of the scheme had a big influence on the uptake of national health insurance
Conclusion: Trust and knowledge of the health insurance scheme had significant influence on uptake of national health insurance. Health Insurance Schemes should be designed in such a way that they attract informal sector workers and information regarding these schemes is disseminated to these people.
Achievements and Implications of HIV Prevention Programme Among Out of School...inventionjournals
Background: The increasing number of sexually transmitted infections including HIV/AIDS among the youths in sub-Saharan Africa indicates that successive efforts towards preventing the scourge remain inadequate in the continent. Preventing the spread of HIV infection among youths aged 15 – 24 years is critical to reducing the incidence of new HIV infection. This paper therefore presents HIV prevention programme among Out of School Youths (OSYs) in Kogi State, Nigeria. Methods: This intervention was carried out among out-of-school youths in 7 randomly selected Local Government Areas (LGAs) in the state with a total target population of 19, 600 OSY. One hundred and twenty (120) OSY comprising (68 males and 52 females) were recruited and trained as Peer Educators. Activities carried out included structural, behavioural and biomedical interventions using the Minimum Prevention Package for Intervention (MPPI) strategy. Data were documented using various monitoring and evaluation tools and entered in the DHIS2 platform. The data were later exported into Microsoft Excel and analysed using same. Results: Three hundred and three community dialogues were held within the 2-years period with 672 participants and 25787 peers recruited by the peer educators resulting in 131.6% of the estimated target population. A total of 8812 of out of school youths were counselled, tested and received results for HIV. Among these, a total of 175 (2.0%) were tested positive. Conclusion: Effective implementation of minimum prevention package for intervention in HIV/AIDS prevention programme carried out in these communities could be attributed to the dialogues held at the commencement of the project. However, there are still shortfalls in attainment of the expected results. It is therefore recommended that there be increased integration of services and decentralization of MPPI activities to primary health care centers and rural communities, stepwise supervision and monitoring of HIV prevention activities be strengthened and engagement of all tiers of governance to engender political commitment and ownership of the HIV response with a view of ensuring sustainability of these programmes.
Delivering community-led integrated HIV and sexual and reproductive health services for sex workers: A mixed methods evaluation of the DIFFER study in Mysore, South India
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Educational and Occupational Maternal Attitude towards Prevention of Malaria ...iosrjce
IOSR Journal of Humanities and Social Science is a double blind peer reviewed International Journal edited by International Organization of Scientific Research (IOSR).The Journal provides a common forum where all aspects of humanities and social sciences are presented. IOSR-JHSS publishes original papers, review papers, conceptual framework, analytical and simulation models, case studies, empirical research, technical notes etc.
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
PAGE 24The perceptions of health workers on the effecti.docxalfred4lewis58146
PAGE
24
The perceptions of health workers on the effectiveness of HIV Prevention Programmes for MSM in Jamaica
May 2013
Abstract
The Jamaican Ministry of Health (MOH) has framed a policy and strategy that allows for sexual health promotion and HIV prevention programmes to be conducted for men who have sex with men (MSM), despite an enforced legal framework which makes it illegal to participate in anal sex. The population of Jamaica’s MSM accounts for the highest HIV prevalence rate on the island. While the National HIV/ STI Programme conducts a government-run programme, a significant portion of the work is conducted by local and internationally funded non-government organizations (NGO). This study seeks to explore the efficiency of these HIV/AIDS prevention programmes from the experiences and perspectives of the health care workers involved in their implementation. It will utilize qualitative research methodology of a descriptive cross-sectional design. The procedure will involve the use of interviews. These will be conducted with health workers in MSM programmes from NGOs and the Jamaica National HIV/STI Programme. It is expected that the results may indicate a view of success with many programmes, with limitations being attributed to the societal and legal framework within which they work. It may also show disparities between government and locally ran programmes conducted by NGOs. The results of this study will be shared and made available to public libraries, the government of Jamaica and other stakeholders working to alleviate the impact of HIV and AIDS in Jamaica and the world. *
Keywords: HIV/AIDS, health promotion and HIV prevention, men who have sex with men (MSM), Jamaica, sexual health, gay men, other MSM and transgender individuals (GMT).Table of Contents
Page #
Abstract
Introduction
Methodology
Discussion
Conclusion
Reflection
References
Appendix Consent
Appendix Draft Interview
Glossary
Privacy Statement
1. Introduction
This study explores the effectiveness of the HIV and AIDS response within the target population of MSM in Jamaica. It investigates, the views and perspectives of the health workers who carry out or implement these programmes.
Thanks to science, the ability to treat and care for persons living with HIV (PLHIV) and AIDS has grown exponentially. Individuals are defying their prognoses and are living with HIV and AIDS for record number of years than they did when the virus was first discovered. Gay, bisexual, transgendered and other men who have sex with men but may not identify as gay, are disproportionately affected by sexually transmitted infections like HIV (MOH, 2011a). For the purpose of this research the term MSM will be defined and utilized as the public health terminology to capture the target audience of all males who have sex with males.
For the purpose of this research.
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv...CrimsonpublishersCJMI
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv-1 DNA Quantification by Tuofu Zhu in Cohesive Journal of Microbiology & Infectious Disease
Achievements and Implications of HIV Prevention of Mother-toChild Transmissio...QUESTJOURNAL
Background: Mother-to-child transmission is the predominant route through which children contract HIV and can be controlled through Prevention of Mother-to-Child Transmission (PMTCT) programme. This paper presents programme activities on PMTCT conducted among women of reproductive age in Plateau State, Nigeria. Methods: This intervention was carried out among women of reproductive age in eight local government areas of Plateau state. Seven civil society organizations were engaged and provided with funding by Plateau State Agency for the Control of AIDS under the HIV/AIDS fund (HAF) II. A total of 7460 women of reproductive age are the estimated sample size for this intervention and the minimum prevention package intervention was used for this project activities. Data were documented using various monitoring and evaluation tools and DHIS2 while analysis was carried out using Microsoft Excel. Results: The total number of community dialogues/advocacy held was 85 and a total of 1,437 people participated. Seventeen income generation activities were carried out in this intervention and 131 people benefitted from it. A total of 87,028 pieces of condom were distributed with majority (88.5%) being distributed in 2014. Only a total of 5606 women were counseled tested and received result and 44 (0.8%) were tested positive. A total of 3275 women were referred for antenatal care during this programme and more than half (52.0%) were referred in 2014. Conclusion: This intervention has been helpful in reducing the burden of HIV and AIDS among women of reproductive age in Plateau State. However, the coverage of minimum prevention package intervention was low. More needs to be done in terms of coverage in future programmes and the intervention should also be extended to other local government areas.
GENDER DISPARITYOF TUBERCULOSISBURDENIN LOW-AND MIDDLE-INCOME COUNTRIES: A SY...hiij
The tuberculosis burden is higher in the population from low- and middle-income countries (LMICs) and
differently affects gender. This review explored risk factors that determine gender disparity in tuberculosis
in LMICs. The research design was a systematic review. Three databases; Google Scholar, PubMed, and
HINARI provided 69 eligible papers.The synthesized data were coded, grouped and written in a descriptive
narrative style. HIV-TB co-infected women had a higher risk of mortality than TB-HIV-infected men. The
risk of Vitamin-D deficiency-induced tuberculosis was higher in women than in men. Lymph node TB,
breast TB, and cutaneous and abdominal TB occurred commonly in women whereas pleuritis, miliary TB,
meningeal TB, pleural TB and bone and joint TB were common in men. Employed men had higher contact
with tuberculosis patients and an increased chance of getting the disease. Migrant women were more likely
to develop tuberculosis than migrant men. The TB programmers and policymakers should balance the
different gaps of gender in TB-related activities and consider more appropriate approaches to be genderbased and have equal access to every TB-associated healthcare.
GENDER DISPARITYOF TUBERCULOSISBURDENIN LOW-AND MIDDLE-INCOME COUNTRIES: A SY...hiij
The tuberculosis burden is higher in the population from low- and middle-income countries (LMICs) and
differently affects gender. This review explored risk factors that determine gender disparity in tuberculosis
in LMICs. The research design was a systematic review. Three databases; Google Scholar, PubMed, and
HINARI provided 69 eligible papers.The synthesized data were coded, grouped and written in a descriptive
narrative style. HIV-TB co-infected women had a higher risk of mortality than TB-HIV-infected men. The
risk of Vitamin-D deficiency-induced tuberculosis was higher in women than in men. Lymph node TB,
breast TB, and cutaneous and abdominal TB occurred commonly in women whereas pleuritis, miliary TB,
meningeal TB, pleural TB and bone and joint TB were common in men. Employed men had higher contact
with tuberculosis patients and an increased chance of getting the disease. Migrant women were more likely
to develop tuberculosis than migrant men. The TB programmers and policymakers should balance the
different gaps of gender in TB-related activities and consider more appropriate approaches to be genderbased and have equal access to every TB-associated healthcare.
HIV and AIDS still remains the greatest public health challenge globally (Strauss and Thomas, 2008).
It is undoubtedly a major cause of premature deaths in many parts of the world with the poorest regions being the most affected.
The lack of an imminent cure or vaccine means that more deaths and large disease burden are inevitable (WHO, 2001).
By the end of 2010, approximately 34 million people globally were living with HIV infection.
In the same year, nearly 2.7 million new infections including slightly over 300,000 among children and 1.8 million AIDS related deaths occurred (UNAIDS, 2010).
Ijsrp p8825 Caregiver factors influencing seeking of Early Infant Diagnosis (...Elizabeth kiilu
Caregiver factors influencing seeking of Early Infant Diagnosis (EID) of HIV services in selected hospitals in Nairobi County, Kenya:A qualitative Study
Similar to FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ACCEPTANCE AND UPTAKE AMONG YOUTH IN KUMASI METROPOLIS, GHANA (20)
FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS COUNSELLING AND TESTING ACCEPTANCE AND UPTAKE AMONG YOUTH IN KUMASI METROPOLIS, GHANA
1. FACTORS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS
COUNSELLING AND TESTING ACCEPTANCE AND UPTAKE AMONG
YOUTH IN KUMASI METROPOLIS, GHANA
EVA DEDEI TAGOE-DARKO
CHARLOTTE MONICA MENSAH
RAZAK MOHAMMED GYASI
DEPARTMENT OF GEOGRAPHY AND RURAL DEVELOPMENT, COLLEGE OF ART AND
SOCIAL SCIENCES, FACULTY OF SOCIAL SCIENCES, KWAME NKRUMAH UNIVERSITY
OF SCIENCE AND TECHNOLOGY, KUMASI, GHANA
E-mail: binghi_econ@yahoo.com
Mob: 0322 (0) 208 545 052
1
2. 1. Introduction
Sub-Saharan Africa continues to bear a disproportionate share of the global HIV burden. In
mid-2010, about 68% of all people living with HIV resided in sub-Saharan Africa, a region
with only 12% of the global population (WHO/UNAIDS, 2012). HIV/AIDS pandemic
significantly and unabatedly continues to spread in many parts of Africa. Ghana is identified
as one of the countries with the lowest official HIV prevalence rate of 1.9%, where an
estimated 260,000 Ghanaians were living with HIV/AIDS by the end of 2009, whilst 23,236
new infections occurred in the same year (WHO/UNAIDS, 2012). Notwithstanding, the
prevalence rate among Ghanaian youth (15 – 24 year olds) increased from 1.9% in 2008 to
2.1% in 2009 (GHS and MoH, 2009). Moreover, AIDS has been identified as one of the
highest causes of mortality in Ghana, claiming about 21,000 lives in 2007 (UNAIDS, 2008).
The Ghana AIDS Commission (2010) estimated that about 1.2 million of the projected 25
million Ghanaians will be living with HIV/AIDS by the end of 2014.
This HIV/AIDS prevalence and mortality rates pose a great threat to Ghana‘s development
agenda. The pressure on Government of Ghana (GoG) to develop the country is exacerbated,
considering the amount of resources being channelled to HIV/AIDS prevention and
treatment. In 2008, for instance, the GoG spent $38,850,940 on HIV/AIDS and the annual
cost of treating HIV/AIDS opportunistic infections is also expected to triple by the year 2014
(MoH, 2001; Ghana AIDS Commission, 2010; 2008). Barnett and Whiteside (2006) have
also indicated that Ghana and other countries, south of Sahara are not likely to meet the
health-related Millennium Development Goals (MDGs)1 by 2015 because HIV/AIDS-
induced infant, mother-to-child-transmission and child mortality will continue to increase in
the years ahead. Consequently, the Ghana AIDS Commission (2010) has identified the need
1
The three health-related MDGs include goals 4, 5 and 6 of reducing infant mortality, improving maternal
health and combating HIV/AIDS, malaria and other diseases respectively.
2
3. for a combination of evidence informed and targeted interventions in HIV programme as key
for effective HIV prevention and treatment. In this regard, the GoG adopted Counselling and
Testing (CT) in 2003 as a conduit to complement ongoing ABC HIV prevention campaigns
(UNAIDS, 2000). HIV CT is the process by which an individual undergoes confidential
counselling, enabling him or her to cope with stress and make an informed choice about
being tested for HIV and to take appropriate action thereof (UNAIDS, 2000; UNFPA and
IPPF, 2004).
In recent years, testing for HIV, in combination with pre- and post-test counselling, has
become increasingly important in national and international prevention and care efforts. CT
has been recognized as the crux of HIV surveillance, prevention and treatment programs
(WHO/UNAIDS, 2009). The benefits of HIV CT are manifold and well documented in the
literature. Denison et al., (2008), in their study on the voluntary counselling and testing and
behavioural risk reduction in developing countries, point out that CT serves as an effective
prevention strategy for HIV-1 since the combined effect of one‘s knowledge of their HIV
status and counselling under CT helps individuals change their behaviour to skirmish further
transmission of the virus. Additionally, when an individual tests seronegative high quality
counselling helps them to maintain a lifestyle that will keep them seronegative (Denison et
al., 2008; Wolitski et al., 1997; Baggaley, 2001; de Paula et al., 2008; 2010). Baggaley
(2001) has explicated the need for HIV prevention to address injecting drug use and
homosexual transmission. Individuals who test HIV positive after an HIV CT have the
chance to access medical treatment that can prevent mortality. This is a way of ensuring that
HIV seropositive people stay longer to contribute their quota to the development agenda of
their countries and the world at large (Baggaley, 2001). Moreover, knowledge of serostatus
through CT can be a motivating force for HIV-positive and-negative people alike to adopt
3
4. safer sexual behaviour, which enables seropositive people to prevent their sexual partners
from getting infected and those who test seronegative to remain negative (Ghana Statistical
Service [GSS], 2008; UNAIDS, 2001; WHO/UNAIDS, 2007; UNFPA and IPPF, 2004).
Lack of knowledge of serostatus by people living with HIV is a major obstacle to actualizing
the goal of universal access to treatment and prevention. A significant proportion of people
living with HIV continues to present late for treatment because they are unaware that they are
seropositive (Cohen, 2008; UNFPA, 2002), thus reducing the effectiveness of antiretroviral
therapy on morbidity, survival and preventing HIV infection.
Since 2003, GoG has launched a number of HIV prevention and treatment programs
including CT services (Koku, 2010). In the face of these efforts vis-avis the benefits of CT,
desire for and uptake of HIV testing remains disproportionately low. The Ghana
Demographic and Health Survey found that 14% of men and 21% of women aged, 15-49
have ever undergone HIV CT. Moreover, only 7% and 4% of women and men respectively of
those recently tested have received results (GSS, 2008). The relatable factors that influence
the decision to accept CT are mixed and still far from comprehension. Studies have correlated
poor intention of testing in general to such psycho-social and physical factors as
psychological and emotional trauma experienced by the seropositive individual or the fear of
testing outcomes, lack of confidentiality, proximity and access to CT site and HIV-related
stigmatization and discrimination experienced by seropositive people leading to loss of
family and employment (Koku, 2010; Mansergh et al., 1998; Dannenbueg et al., 1996;
Maman et al., 2000 and Yeager et al., 2000; Nuwaha et al., 2002; Kalichman and Simbayi,
2003). Others include socio-demographic and economic determinants such as age (Shisana et
al, 2005; Hutchinson and Mahlalela, 2006; Ma et al, 2007; Wringe et al, 2008; Bwambale et
4
5. al, 2008) marital status, educational level, occupation, household wealth, and area of
residence (Hutchinson and Mahlalela, 2006; Wringe et al, 2008; Gage and Ali, 2005; Haile et
al, 2008).
Research has shown that the introduction of routine testing has particularly increased testing
experience among women through prevention of mother-to-child transmission programs
(Byamugisha et al, 2010a; Chandisarewa et al, 2007). Conversely, men are reluctant and thus
do not show up to the antenatal clinics with their wives for CT (Falnes et al, 2011;
Byamugisha et al, 2010b; Theuring et al, 2009). Improving CT utilization by men has the
potency to influence directly or indirectly women’s CT utilization (Demissie et al, 2009; Lata
et al, 2012). There is thus urgent need to understand the predictors of acceptability and
uptake of HIV CT by men since it connotes with nitty-gritty for designing policy measures
and options to stem future spread of HIV infections and foster its treatment, care and support.
The 2009 national Official HIV Sentinel Survey conducted by Ghana AIDS Commission
revealed that the Ashanti Region recorded 3.0% prevalence rate of HIV with 4.0% in the
capital city, Kumasi (Ghana AIDS Commission, 2010). What makes the situation more
looming is the fact that most of the young people in the area are express little willingness to
accept and uptake HIV CT to ascertain their HIV serostatus. Campaigns that entreat them to
know their status have been coldly and grimly embraced, and CT services that are taken to
the various communities have recorded minimal turn out rates. The possible consequence of
this is that most of these young folks ignorantly spread the disease. Nevertheless, studies on
HIV CT in Ghana have focused on the other side of the subject; see Wyss et al. (2007),
Holmes et al. (2008), Appiah et al. (2009) and Koku (2010). This informed the thesis and the
locus of this research and the selection of Kumasi Metropolis as the study prefecture.
5
6. 2. Methods
2.1 Study setting
The study will be conducted between December, 2012 and March, 2013 in the Kumasi
Metropolitan District of Ashanti Region, Ghana. This is one of the 27 political and
administrative districts in the Ashanti Region with Kumasi as capital. The Metropolis is
located in the transitional moist semi-deciduous forest zone and spans an area of 254km2
forming approximately 1.04% of the total landmass of the region. It is located in the south-
central portion of Ashanti Region. The Metropolis shares boundaries with Afigya Kwabre
and Kwabre East Districts to the North, Ejisu-Juaben to the East, Atwima Kwanwoma to the
south and Atwima Nwabiagya District to the West. Specifically, the Metropolis stretches
between latitude 6.35o – 6.40o and longitude 1.30o – 1.35o, an elevation which ranges
between 250 – 300 metres above sea level (see figure 1) (KMA/Ghana District, 2012). The
predominant economic activities in the Metropolis are trading, commerce and other services.
The unique centrality of Kumasi as a traversing point from all parts of the country makes it a
special place for many to migrate to. Kumasi is the most populous district in the region and
accounts for almost a third of the region’s population. According to the 2010 Population and
Housing Census Report, Kumasi accommodates a total of 2,035,064 people, reflecting an
inter-censal growth rate of 5.4% (GSS, 2012).
The Metropolis is made up of 10 Sub-Metros with 189 health facilities. It is worth noting that
the private sector operates a significant number by taking over 90% share of the facilities.
Komfo Anokye Teaching Hospital (KATH), 1 of the national autonomous hospitals, is
situated in Kumasi Metropolis. There are other 4 quasi-government health institutions, 172
private health institutions and 3 CHAG in the Metropolis (Kumasi Metropolitan Health
Directorate, 2012). These health institutions are evenly distributed across the district to
6
7. enhance easy access and use of health care services. The common diseases in the Metropolis
include malaria, diarrhoea, HIV/AIDS, tuberculosis, hypertension and diabetes mellitus.
Septic abortion and road traffic accidents also constitute another major challenge to the health
sector (Kumasi Metropolitan Health Directorate, 2012).
Among other services, CT provided at 10 health facilities videlicet, Kumasi South, Suntreso,
Tafo, Manhyia, Bomso Clinic, Aninwaa Medical Centre, KNUST hospital, Kwadaso,
Seventh Day Adventist Hospital and KATH whilst Anti retroviral treatment is provided at the
KATH, the Kumasi South Hospital and the Bomso Clinic only (Kumasi Metropolitan Health
Directorate, 2012).
2.2 Study design and sampling
This retrospective cross-sectional survey will employ triangulation of both quantitative and
qualitative approaches of research. Individuals, both male and female between the age
brackets of 15-29 found in the selected communities in the study prefecture will constitute the
study sample. The target population from which the sample will be drawn is 601,336. A
sample size of 360, representing .061% of the population will be used. A multi-stage
stratified cluster and simple random sampling technique will be utilised to select 6 Sub-
Metros and 12 study settlements from the Metropolis for the study. The selected Sub-Metros
will be Asokwa, Subin, Manhyia, Nhyiaeso, Kwadaso and Oforikrom.
Two communities will be selected randomly from each Sub-Metro for the study. The research
communities will include: Atonsu, Kaase, Asafo, Amakom, Krofrom, Ashanti New Town,
Ayigya, Kotei, Ahodwo, Fankyinebra, Kwadaso and Asuoyeboa (see figure 1). The sub-
sample for each community will be proportionately determined based on population size.
7
8. Unit of analysis will be households and one (1) respondent will be selected from each
household through systematic random sampling method. The sample interval of the
communities will base on the density of houses and households and that the intervals will be
pegged at 5 for communities with high density of houses and 3 for research settlements with
low house densities. The underpinning factor in the selection of these communities is to
ensure fair and adequate coverage of the Metropolis to boost accuracy and representativeness
of research findings.
2.3 Data collection
Primary data will be sourced and collected from households in the various selected study
communities for this research. In-depth interviews and questionnaire instruments will
respectively be considered in obtaining qualitative and quantitative data in the primary data
collection. The illiterate and semi-literate respondents who find it relatively difficult to read
and interpret the questionnaire guide will be interviewed. However, some literates will have
the option to be interviewed so as to play down possible challenges of call-backs. The
questionnaire and interviews will be translated into Twi, the major language spoken in the
study prefecture and verified by a second translator. Where inconsistencies are found, these
will be corrected. Pre-testing of the questionnaire will be completed with 5 qualified persons
but not be included in the study. However, English will be used to administer the interviews
where necessary. Besides, secondary information will be utilised to place the study in the
context of scholarly world.
Ethical approval will be obtained from the Committee on Human Research and Publication
Ethics, School of Medical Sciences, Kwame Nkrumah University of Science and
Technology, Kumasi prior to the data collection exercise. Israel and Hay (2006) have
8
9. reverberated that Social Scientists do not have an inalienable right to conduct research
involving other people. The opinion leaders, household heads and respondents in each
selected community will be notified and briefed on the objectives of the research and be
made to sign consent form before the commencement of the data collection. Questionnaire
will be anonymised, with no personal identifying information recorded on them. Also,
contributions made by participants will be treated anonymous and confidential. Besides, a
respondent will reserve the right to withdraw at any point in time or deny certain information
in the course of the interview. Each interview will approximately last for 45 minutes.
Detailed notes will be taken and those in local dialect then translated and back translated into
English for analysis.
2.4 Outcome measures
Respondents will be interviewed with an anonymously structured questionnaire that requests
information on demographic variables, socioeconomic status, knowledge of HIV, HIV risk
history, impact of HIV, HIV CT history and knowledge and determinants of intension to
accept and utilise CT (Peltzer et al, 2009).
The survey will include questions concerning history of HIV antibody testing. These
measures will be used to classify participants into groups based on whether they had been
tested for HIV and know their results. Participants who will report having been tested for
HIV will be made to indicate their HIV awareness status of their most recent test, or that they
did not know the results.
To assess HIV risk history, participants will indicate the number of sex partners they had in
the previous 12 months, had symptoms of a sexually transmitted infection, and whether they
9
10. have ever used a condom, a condom with their last sexual partner and their last sexual non-
regular partner. All responses will be dichotomous indicating the occurrence or non-
occurrence of each risk factor. A 4-item HIV knowledge test will be used; e.g. is it possible to
transmit HIV through unprotected sex? Response options will be “Yes”, “No”, and “Does not
know”. “Does not know” responses will be scored as “No”; CT knowledge will be assessed
with one item: “Have you ever heard about test for people with HIV called HIV CT?”
Response options will be “Yes” or “No”. A 3-item will be used to measure HIV impact
items; thus, Has anyone in the household ever been diagnosed with HIV/AIDS, is there a
person in the household who is bed-ridden with an AIDS related illness and past year
occurrence of AIDS-related death of household member. Response options will be “Yes” or
“No”. For AIDS stigma attitudes, 4-AIDS-stigma items will be used; “Would you be willing
to care for a family member with AIDS”. Response options were, “Yes”, “No”, or “Do not
know”.
Demographic and social variables linked to HIV CT will be included in the survey. These
will include sex, age, marital status, ethnic background, religious affiliation, and place of
residence whist socioeconomic status included will be household income standing, formal
education completed and employment status.
2.5 Data Analysis
Data analysis will be performed using Predictive Analytic Software (PASW) for Windows
software application program version 17.0. Data will be ordered, edited, coded, and entered
into the software and analysed quantitatively using multiple regression. Stepwise method will
be employed to determine the relative strengths of the independent variables on HIV CT. The
multiple regression analysis will be preceded by a bivariate correlation matrix to examine the
10
11. strength of associations between the dependent variable HIV CT utilization and relevant
potential predictor variables. The probability (p) value less or equal to 0.05 will be used to
indicate statistical significance in the regression model. Frequencies, means, and standard
deviations will be computed to describe the sample. The qualitative data will be subjected to
a content analysis. The analysis will be done using the grounded-theory approach. This
method is based on techniques to systematically discover categories, themes or patterns that
emerge from the data, through coding and categorisation of information into manageable
units (Strauss and Corbin, 1998). In this respect, the categories for analysis will be drawn
from the interview guides and then, themes and patterns emerge after reviewing the data
within and across groups of respondents (Carey, 1994; Charmaz, 1990). Results will be
presented through direct quotes.
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